Effect of an extended midwifery postnatal support programme on the duration of breast feeding: a randomised controlled trial.

OBJECTIVE

to evaluate the effects of an extended midwifery support (EMS) programme on the proportion of women who breast feed fully to six months.

DESIGN

randomised controlled trial.

SETTING

large public teaching hospital in Australia.

PARTICIPANTS

849 women who had given birth to a healthy, term, singleton baby and who wished to breast feed.

INTERVENTION

participants were allocated at random to EMS, in which they were offered a one-to-one postnatal educational session and weekly home visits with additional telephone contact by a midwife until their baby was six weeks old; or standard postnatal midwifery support (SMS). Participants were stratified for parity and tertiary education.

MEASUREMENTS

the main outcome measures were prevalence of full and any breast feeding at six months postpartum.

FINDINGS

there was no difference between the groups at six months postpartum for either full breast feeding [EMS 43.3% versus SMS 42.5%, relative risk (RR) 1.02, 95% confidence interval (CI) 0.87-1.19] or any breast feeding (EMS 63.9% versus SMS 67.9%, RR 0.94, 95%CI 0.85-1.04).

CONCLUSIONS

the EMS programme did not succeed in improving breast-feeding rates in a setting where there was high initiation of breast feeding. Breast-feeding rates were high but still fell short of national goals.

IMPLICATIONS FOR PRACTICE

continuing research of programmes designed to promote breast feeding is required in view of the advantages of breast feeding for all mothers and babies.