A Feasibility, Acceptability And Potential Efficacy Of An Innovative Postnatal Home-based Breastfeeding Peer Counselling Programme: A Pilot Randomised Controlled Trial

Abstract

Peer counselling is being introduced worldwide in supporting mothers’ needs for successful maintenance of breastfeeding. The objectives of this study are to determine the feasibility of conducting a 6 months, four-times monthly home-based breastfeeding peer counselling programme in postpartum Chinese women. This study used an open-labelled pilot randomized controlled trial. We recruited 20 mother-infant dyads who intend to breastfeed in one public hospital in Hong Kong. Participants completed self-administered questionnaires, which gathered information about sociodemograhic characteristics, infant feeding status and breastfeeding self-efficacy. Participants were followed-up for six months. The overall duration of any and exclusive breastfeeding among participants in the home-based peer support programme to the control group which received usual post-natal care were compared. At 1 month, most were mixed feeding. Less than half of the mothers in the intervention group (44.4%) were exclusive breastfeeding while 30% of the mothers in the control group were exclusive breastfeeding. At 6 months follow-up, a significant difference was observed between the two groups with one mother exclusively breastfeeding in the intervention group compared to six mothers mixed feeding in the control group (p = 0.03). There were no differences of breastfeeding self-efficacy at baseline or at two-month follow-up. The intervention group had a baseline BSES-SF score of 37.1 (SD: 10.8, n = 10) being confident in breastfeeding while the control group had a BSES-SF score of 44.5 (SD: 12.1, n = 10) being confident in breastfeeding. Both groups had increased levels of BSES-SF across timepoints but the change was not significant. This pilot study demonstrated home-based breastfeeding peer counselling was feasible to implement and accepted by mothers. Peer counselling did not have any impact on breastfeeding self-efficacy and exclusive breastfeeding when compared to usual postnatal care. Modifications to the programme, such as tailoring counselling to sustain exclusive breastfeeding should be incorporated.