Individualized intervention to improve rates of exclusive breastfeeding: A randomised controlled trial

Pan Huang, Jianrong Yao, Xinghui Liu, Biru Luo, Pan Huang, Jianrong Yao, Xinghui Liu, Biru Luo

Abstract

Background: Despite breastfeeding is significant benefits for maternal and infant, the discontinuation of breastfeeding is high. Some of studies showed that the effect of intervention in improving the rate of exclusively breastfeeding is unclear. The aim of this study is to investigate the effectiveness of individualized intervention compared with routine care in improving rates of exclusive breast feeding.

Methods: Women were divided into two groups. We provided individual antenatal breastfeeding education and postnatal lactation support to intervention group. Control group received routine care. Significance was set at P < .05.

Results: We recruited 352 women of whom 176 were randomized to intervention group, 176 to control group. In total, 293 (83.2%) completed 4 months of follow-up. At discharge from hospital, 43.2% of women randomized to intervention group were exclusively breastfeeding compared with 30.0% of women in control group (relative risk 1.78; 95% confidence interval [CI] 1.12-2.82). At 4 months, 70.9% of women in the intervention group were exclusively breastfeeding compared with 46.2% of the women in the control group (2.84; 1.76-4.60). At discharge from hospital, 95.1% of women in the intervention group were breastfeeding on demand compared with 68.1% of women receiving routine care (9.00; 4.09-19.74). At 4 months, 94.6% of women in intervention group were breastfeeding on demand compared with 75.9% of women in the control group (5.57; 2.48-12.49).

Conclusion: The regular ongoing individualized antenatal education and postnatal support can effective increase the rates of exclusive breastfeeding from delivery to postpartum 4 months and change the breastfeeding behavior.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow of participants through each stage of randomized trial.

References

    1. Available at: (accessed on October 02, 2008).
    1. Victora CG, Bahl R, Barros AJ, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet 2016;387:475–90.
    1. Sankar MJ, Sinha B, Chowdhury R, et al. Optimal breastfeeding practices and infant and child mortality: a systematic review and meta-analysis. Acta Paediatr 2015;104:3–13.
    1. Duijts L, Jaddoe VW, Hofman A, et al. Prolonged and exclusive breastfeeding reduces the risk of infectious diseases in infancy. Pediatrics 2010;126:e18–25.
    1. Kramer MS, Kakuma R. Optimal duration of exclusive breastfeeding. Cochrane Database Syst Rev 2012;CD003517.
    1. Bowatte G, Tham R, Allen KJ, et al. Breastfeeding and childhood acute otitis media: a systematic review and meta-analysis. Acta Paediatr 2015;104:85–95.
    1. Pisacane A, Graziano L, Mazzarella G, et al. Breast-feeding and urinary tract infection. J Pediatr 1992;120:87–9.
    1. Ajetunmobi OM, Whyte B, Chalmers J, et al. Breastfeeding is associated with reduced childhood hospitalization: evidence from a Scottish Birth Cohort (1997–2009). J Pediatr 2015;166:620.e4–5.e4.
    1. Chua S, Arulkumaran S, Lim I, et al. Influence of breastfeeding and nipple stimulation on postpartum uterine activity. Br J Obstet Gynaecol 1994;101:804–5.
    1. Mezzacappa ES, Kelsey RM, Katkin ES. Breast feeding, bottle feeding, and maternal autonomic responses to stress. J Psychosom Res 2005;58:351–65.
    1. Lord SJ, Bernstein L, Johnson KA, et al. Breast cancer risk and hormone receptor status in older women by parity, age of first birth, and breastfeeding: a case-control study. Am Assoc Cancer Res 2008;17:1723–30.
    1. Okamura C, Tsubono Y, Ito K, et al. Lactation and risk of endometrial cancer in Japan: a case-control study. Tohoku J Exp Med 2006;208:109–15.
    1. Weimer JP. Economic benefits of breastfeeding: a review and analysis. Food Assistance and Nutrition Research Report. Washington, DC: Economic Research Service, US Dept of Agriculture, 2001.
    1. Cattaneo A, Ronfani L, Burmaz T, et al. Infant feeding and cost of health care: a cohort study. Acta Paediatr 2006;95:540–6.
    1. Ball TM, Bennett DM. The economic impact of breastfeeding. Pediatr Clin North Am 2001;48:253–62.
    1. Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 2012;129:e827.
    1. World Health Organization. Global Strategy for Infant and Young Child Feeding; 2003. Available at: (accessed on April 10, 2009).
    1. U.S. Preventive Services Task Force. Primary care interventions to promote breastfeeding: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2008;149:560–4.
    1. Committee on Health Care for Underserved Women, American College of Obstetricians, Gynecologists. ACOG Committee Opinion No. 361: breastfeeding: maternal and infant aspects. Obstet Gynecol 2007;109:479–80.
    1. Victora CG, Bahl R, Barros AJD, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet 2016;387:475–90.
    1. Guo S, Fu X, Scherpbier RW, et al. Breastfeeding rates in central and western China in 2010: implications for child and population health. Bull World Health Organ 2013;91:322–31.
    1. Centers for Disease Control and Prevention, Breastfeeding Report Card United States, 2018. .
    1. McCarter-Spaulding DE, Kearney MH. Parenting self-efficacy and perception of insufficient breast milk. J Obstet Gynecol Neonatal Nurs 2001;30:515–22.
    1. Li R, Fein SB, Chen J, et al. Why mothers stop breastfeeding: mothers’ self-reported reasons for stopping during the first year. Pediatrics 2008;122: suppl: S69–76.
    1. Taveras EM, Capra AM, Braveman PA, et al. Clinician support and psychosocial risk factors associated with breastfeeding discontinuation. Pediatrics 2003;112:108–15.
    1. Palda VA, Guise JM, Wathen CN. Canadian Task Force on Preventive Health Care. Interventions to promote breast-feeding: applying the evidence in clinical practice. CMAJ 2004;170:976–8.
    1. Bonuck KA, Freeman K, Trombley M. Randomized controlled trial of a prenatal and postnatal lactation consultant intervention on infant health care use. Arch Pediatr Adolesc Med 2006;160:953–60.
    1. Sikorski J, Renfrew MJ, Pindoria S, et al. Support for breastfeeding mothers. Cochrane Database Syst Rev 2002;CD001141.
    1. Graffy J, Taylor J, Williams A, et al. Randomised controlled trial of support from volunteer counsellors for mothers considering breastfeeding. BMJ 2004;328:26.
    1. Coutinho SB, de Lira PI, de Carvalho Lima M, et al. Comparison of the effect of two systems for the promotion of exclusive breastfeeding. Lancet 2005;366:1094–100.
    1. Su LL, Chong YS, Chan YH, et al. Antenatal education and postnatal support strategies for improving rates of exclusive breast feeding: randomised controlled trial. BMJ 2007;335:596.
    1. Renfrew MJ, McCormick FM, Wade A, et al. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev 2012;CD001141.
    1. Lumbiganon P, Martis R, Laopaiboon M, et al. Antenatal breastfeeding education for increasing breastfeeding duration. Cochrane Database Syst Rev 2012;CD006425.
    1. Gerd AT, Bergman S, Dahlgren J, et al. Factors associated with discontinuation of breastfeeding before 1 month of age. Acta Paediatr 2012;101:55–60.
    1. Pisacane A, Continisio GI, Aldinucci M, et al. A controlled trial of the father's role in breastfeeding promotion. Pediatrics 2005;116:e494–8.
    1. Anderson AK, Damio G, Young S, et al. A randomized trial assessing the efficacy of peer counseling on exclusive breastfeeding in a predominantly Latina low-income community. Arch Pediatr Adolesc Med 2005;159:836–41.
    1. Kronborg H, Vaeth M, Olsen J, et al. Effect of early postnatal breastfeeding support: a cluster-randomized community based trial. Acta Paediatr 2007;96:1064–70.
    1. Graffy J, Taylor J, Williams A, et al. Randomised controlled trial of support from volunteer counsellors for mothers considering breast feeding. BMJ 2004;328:26.
    1. McFadden A, Gavine A, Renfrew MJ, et al. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev 2017;2:CD001141.
    1. Gao F, Zhang LQ, Liu L, et al. Investigation on the factors influencing the satisfaction of breastfeeding in inpatient primipara. Chin J Mod Nurs 2015;29:3570–2.
    1. Lewallen LP, Dick MJ, Flowers J, et al. Breastfeeding support and early cessation. J Obstet Gynecol Neonatal Nurs 2010;35:166–72.

Source: PubMed

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