Professional breastfeeding support for first-­time mothers: a multi-centre cluster randomised controlled trial

Abstract

The purpose of this study was to evaluate the effect of two postnatal professional support interventions on the duration of any and exclusive breastfeeding. We used a multi-centre, three-arm, cluster randomised controlled trial design and recruited 722 primiparous breastfeeding mothers with uncomplicated, full-term pregnancies. The three study interventions were (1) standard postnatal maternity care, (2) standard care plus three 30 to 45-minute in-hospital professional breastfeeding support sessions, or (2) standard care plus weekly 20 to 30-minute post-discharge breastfeeding telephone support for four weeks. The main outcome measures were the prevalence of any and exclusive breastfeeding at one, two, and three months postpartum. After the interventions, the rates of any and exclusive breastfeeding were higher among participants in the two intervention groups at all follow-up points when compared with those who received standard care. Participants receiving the telephone support were significantly more likely to continue any breastfeeding at 1 month (76.2% vs. 67.3%; OR=1.63, 95% CI 1.10-2.41) and 2 months (58.6% vs. 48.9%; OR=1.48, 95% CI 1.04-2.10), and to be exclusively breastfeeding at 1 month (28.4% vs. 16.9%; OR=1.90, 95% CI 1.24-2.91). Participants in the in-hospital support group were also more likely to be breastfeeding at all time points but the effect was not statistically significant. Professional breastfeeding telephone support provided early in the postnatal period and continued for the first month postpartum improves breastfeeding outcomes among first-time mothers.