TABLE 32.

Breastfeeding Promotion and Education

SourceLocation and Type of TrialInterventionMaternal OutcomePerinatal/Neonatal Outcome
Jakobsen et al62West Africa; suburban setting; RCT1226 pregnant women who gave birth to 1250 children were randomized to 1 of 2 groups. Mothers in the intervention group (n = 659) were given individual health education sessions at the local health center on their routine visits (ie, first antenatal visit, vaccination sessions in weeks 6, 10 and 14, and when the child reached the age of 9 mo). Mothers in the control group (n = 591) were not exposed to these messages. Intervention messages encouraged breastfeeding for 2 y, avoidance of introducing weaning foods and water for 4–5 mo, and continued breastfeeding for ill children. Family-planning information was also included.Significantly more mothers in the intervention group had had an intrauterine device inserted (rate ratio = 2.45 (CI: 1.27–4.70) compared with the control group. However, mothers who had an intrauterine device inserted did not breastfeed longer compared with mothers who reported not to have had an intrauterine device inserted.Introduction of weaning foods was significantly delayed in the intervention group compared with the control group (incidence rate 1.22; CI: 1.05–1.42). More children in the intervention group (31.1%) compared to controls (24.8%) were almost exclusively breastfed at 4 mo of age (OR: 1.18; CI: 1.03–1.38).
Morrow et al61Mexico; periurban setting; RCT130 pregnant women were randomized to 1 of 3 groups. Group 1 (n = 44) received 6 visits by a peer counselor. Group 2 (n = 52) received 3 visits by a peer counselor. Group 3 (n = 34) was the control group; women in this group were referred to a physician for lactation problems.There were significantly more females who were exclusively breastfeeding their infants in the intervention groups than the control group. Duration of any breastfeeding (>3 mo or >6 mo) was significantly greater in the intervention group than the control groups (P = .024).Control infants had a significantly higher risk of diarrhea than those in the intervention groups (OR: 2.1; 90% CI: 1.11–4.04; P = .029).
Lutter et al59Brazil; urban hospital setting; PCS442 women were enrolled in the study; 236 women delivered at the program hospital and 206 delivered at the control hospital. The intervention hospital had an active breastfeeding promotion program, characterized by rooming-in, early initiation of breastfeeding and breastfeeding assistance and talks during hospitalization. The control hospital had no such programs.The median duration of exclusive breastfeeding was 75 d among women in the program hospital compared with 22 d in the control hospital. At 1 mo, the probability of exclusive breastfeeding was 0.64 in the program group compared with 0.39 in the control group.
Haider et al531*Bangladesh; urban setting; cross-sectional knowledge, attitudes, and practices surveyStudy area covered 30 000 households; a random sample of households with infants ages 0–6 mo (n = 1100) were selected. Mothers were interviewed at home. The WHO classification was used to describe infant feeding practices.93% of mothers fed their infants colostrum during the first 3 d of life. However, only 8% fed colostrum as the first food. 97% claimed they had heard the term “exclusive breastfeeding” and understood it but 70% wrongly perceived it to mean giving the baby breast milk and water. 33% and 5% of infants in their first and fifth mo of life, respectively, were breastfed exclusively.
Haider et al532*Bangladesh; urban setting; community- based RCT40 adjacent zones were randomized to control or intervention groups. Women were enrolled during the last trimester of pregnancy. 15 house-based counseling visits were scheduled, with 2 visits in the last trimester, 3 during the early postnatal period (1 within 48 h, 1 on day 5, and 1 between days 10 and 14), and every 2 wk until the infant was 5 mo old. Peer counselors were local mothers who received 10 d of training.363 women were enrolled in each group. Peer counseling significantly improved breastfeeding practices. For the primary outcome, the prevalence of exclusive breastfeeding at 5 mo was 202/228 (70%) for the intervention group and 17/285 (6%) for the control group (mean difference: 64%; CI: 57–71%; P < .0001). For the secondary outcomes, mothers in the intervention group initiated breastfeeding earlier than control mothers and were less likely to give prelacteal and postlacteal foods.
  • * Data are from the same trial.