Counselling sessions increased duration of exclusive breastfeeding: a randomized clinical trial with adolescent mothers and grandmothers

Luciana Dias de Oliveira, Elsa Regina Justo Giugliani, Lilian Córdova do Espírito Santo, Leandro Meirelles Nunes, Luciana Dias de Oliveira, Elsa Regina Justo Giugliani, Lilian Córdova do Espírito Santo, Leandro Meirelles Nunes

Abstract

Background: Considering that adolescent mothers may be more vulnerable to discontinuing exclusive breastfeeding (EBF) before 6 months and that their mothers may exert a negative influence on this practice, this study was conducted with the objective of evaluating the efficacy of breastfeeding counselling for adolescent mothers and their mothers in increasing EBF duration.

Methods: A clinical trial was performed in 323 adolescent mothers with newborns and their mothers randomized in four groups: (1) not living with mother, without intervention; (2) not living with mother, with intervention; (3) living with mother, without intervention, (4) living with mother, with intervention. The intervention consisted of five counselling sessions directed to mother and grandmother, in the maternity hospital and on follow-up. Information about feeding practices during the newborn's first six months of life was collected monthly by telephone. Intervention's efficacy was measured through Cox regression and comparison of exclusive breastfeeding medians and survival curves for the different groups.

Results: The intervention increased the duration of EBF by67 days for the group which included grandmothers (HR = 0.64; CI 95% = 0.46-0.90) and 46 days for the group which did not include grandmothers (HR = 0.52; CI 95% = 0.36-0.76).

Conclusions: Counselling sessions in the first four months of children's lives proved to be effective in increasing EBF duration among adolescent mothers.

Trial registration: ClinicalTrials.gov NCT00910377.

Figures

Figure 1
Figure 1
Flowchart of randomization of the study since the beginning of the collection until the sixth month of follow-up.
Figure 2
Figure 2
Kaplan-Meier curve of exclusive breastfeeding in the first 6 months of living in groups of adolescent mothers without the presence of maternal grandmother, intervention (A) and control (B) and in groups with the presence of the maternal grandmother, intervention (C) and control (D).
Figure 3
Figure 3
Kaplan-Meier curve of EB in the first 6 months of life in control group (Aand C) and intervention group (B and D), according to cohabitation with the maternalgrandmother.

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