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

ObjectiveTo evaluate the effect of two postnatal professional support interventions on the duration of any and exclusive breastfeeding. DesignMulticentre, three-arm, cluster randomised controlled trial. PopulationA cohort of 722 primiparous breastfeeding mothers with uncomplicated, full-term pregnancies. MethodsThe three study interventions were: (1) standard postnatal maternity care; (2) standard care plus three in-hospital professional breastfeeding support sessions, of 30-45minutes in duration; or (2) standard care plus weekly post-discharge breastfeeding telephone support, of 20-30minutes in duration, for 4weeks. The interventions were delivered by four trained research nurses, who were either highly experienced registered midwives or certified lactation consultants. Main outcome measuresPrevalence of any and exclusive breastfeeding at 1, 2, and 3months postpartum. ResultsRates 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 telephone support were significantly more likely to continue any breastfeeding at 1month (76.2 versus 67.3%; odds ratio, OR1.63, 95% confidence interval, 95%CI 1.10-2.41) and at 2months (58.6 versus 48.9%; OR1.48, 95%CI 1.04-2.10), and to be exclusively breastfeeding at 1month (28.4 versus 16.9%; OR1.89, 95%CI 1.24-2.90). 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. ConclusionsProfessional breastfeeding telephone support provided early in the postnatal period, and continued for the first month postpartum, improves breastfeeding duration among first-time mothers. It is also possible that it was the continuing nature of the support that increased the effectiveness of the intervention, rather than the delivery of the support by telephone specifically.