Forster Della, McLachlan Helen, Lumley Judith, Beanland Christine, Waldenström Ulla, Harris Heather, Earl Diane, Dyson Kaye
Centre for the Study of Mothers' and Children's Health, La Trobe University, 251 Faraday St, Carlton, 3053, Australia.
BMC Pregnancy Childbirth. 2003 Aug 29;3(1):5. doi: 10.1186/1471-2393-3-5.
It has proven difficult to reach World Health Organization (WHO) recommendations that infants be exclusively breastfed from birth to six months of age 12, yet there is limited knowledge about interventions that are effective in increasing breastfeeding initiation and duration. Particularly lacking is evidence about how to maintain breastfeeding rates in countries which already have a high initiation of breastfeeding. This study aims to determine whether mid-pregnancy breastfeeding education, with a focus on either attitudes to breastfeeding or on technical aspects of breastfeeding, has an effect on rates of breastfeeding initiation and duration. Secondary aims of the study are to: explore what factors might affect the duration of breastfeeding and evaluate the interventions from the participant and childbirth facilitator perspectives. METHODS/DESIGN: A randomised controlled trial (RCT) design will be used. Women having their first baby, and planning to give birth as public patients at the Royal Women's Hospital (RWH), Melbourne, will be approached at 18-20 weeks of pregnancy and invited to participate in the study. Participants will be randomly allocated to a control group or one of two group interventions: a previously designed and trialled tool to teach practical aspects of breastfeeding or an exploration of family attitudes to breastfeeding. The latter was developed and piloted by the investigators in conjunction with the group facilitators, prior to trial commencement. The interventions are planned to take place at 20-25 weeks. Data will be collected by questionnaire at recruitment, at interview in hospital after the birth and by telephone interview six months later. Medical/obstetric outcomes will be obtained from the medical record. The sample size (972) was calculated to identify an increase in breastfeeding initiation from 75 to 85% and an increase from 40 to 50% in breastfeeding at six months.
事实证明，要达到世界卫生组织（WHO）关于婴儿从出生到六个月完全母乳喂养的建议很困难，然而，对于有效提高母乳喂养开始率和持续时间的干预措施，人们了解有限。尤其缺乏关于如何在母乳喂养开始率已经很高的国家维持母乳喂养率的证据。本研究旨在确定孕中期母乳喂养教育，无论是侧重于母乳喂养态度还是母乳喂养技术方面，是否会对母乳喂养开始率和持续时间产生影响。该研究的次要目标是：探索可能影响母乳喂养持续时间的因素，并从参与者和分娩辅助人员的角度评估干预措施。
方法/设计：将采用随机对照试验（RCT）设计。首次怀孕且计划在墨尔本皇家妇女医院（RWH）作为公立医院患者分娩的妇女，将在怀孕18 - 20周时被邀请参与研究。参与者将被随机分配到对照组或两种干预组之一：一种先前设计并试验过的用于教授母乳喂养实践方面的工具，或一项关于家庭对母乳喂养态度的探索。后者是研究人员在试验开始前与小组协调员共同开发并进行试点的。干预计划在20 - 25周进行。数据将在招募时通过问卷调查收集，在产后住院访谈时收集，并在六个月后通过电话访谈收集。医疗/产科结果将从病历中获取。样本量（972）的计算是为了确定母乳喂养开始率从75%提高到85%，以及六个月时母乳喂养率从40%提高到50%。
