The effect of a breastfeeding support programme on breastfeeding duration and exclusivity: a quasi-experiment

S A van Dellen, B Wisse, M P Mobach, A Dijkstra, S A van Dellen, B Wisse, M P Mobach, A Dijkstra

Abstract

Background: Breastfeeding has important positive long-term health consequences for infants and mothers. The World Health Organization recommends that all infants should be exclusively breastfed for six months or longer, and advises continuation of breastfeeding for two years or beyond. However, these recommendations are not met in many countries. This study examined whether a comprehensive, evidence-based breastfeeding intervention, the Breastfeeding Support Programme (BSP), promotes prolonged duration and exclusivity of breastfeeding among its participants.

Methods: A quasi-experimental design was used to compare breastfeeding duration and exclusivity in the BSP group (N = 66) to breastfeeding duration and exclusivity in a control group (N = 72). Participants who followed the BSP were provided with 6 consults delivered by a lactation consultant. The consults started during pregnancy and continued up until 10 weeks after delivery. Participants in the control group did not follow the BSP. Pretest and posttest questionnaires were administered through the internet. A Cox proportional hazards regression analysis was used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for cessation of any and exclusive breastfeeding, while controlling for differences at baseline.

Results: The effect of the BSP on survival rates for any and exclusive breastfeeding were significant while controlling for differences between the two groups at baseline (respectively HR = 0.34, p < .001 [95% CI = 0.18-0.61] and HR = 0.46, p < .001 [95% CI = 0.29-0.72]). Among mothers in the BSP group there was on average 66% less risk of cessation of any breastfeeding and on average 54% less risk of cessation of exclusive breastfeeding at any point in time compared to those in the control group.

Conclusions: The BSP appears to be an effective means to delay cessation of any and exclusive breastfeeding cessation and therefore to increase breastfeeding duration and exclusivity. This is an important finding, because earlier cessation of breastfeeding than desired is a common problem in many countries. Future research into the effectiveness of the BSP could consider random assignment to conditions and test the effectiveness of the intervention in other populations to investigate further whether wide-scale implementation of this intervention could be useful to promote breastfeeding.

Keywords: Breastfeeding; Breastfeeding duration; Evidence-based practice; Lactation consultant; Quasi-experimental.

Conflict of interest statement

The authors declare that they have no competing interests. The author SvD received a gift for the birth of her child (<EUR 30) from MAKIBO, the company which developed and commercially exploits the BSP. Except for the above, the authors declare they were not paid or rewarded by MAKIBO.

Figures

Fig. 1
Fig. 1
The attrition rates in the BSP group and the control group
Fig. 2
Fig. 2
Kaplan-Meier survival estimates for duration of any breastfeeding
Fig. 3
Fig. 3
Kaplan-Meier survival estimates for duration of exclusive breastfeeding

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