Chinle Comprehensive Health Care Facility, Indian Health Services, Chinle, Arizona, USA.
National Clinician Scholars Program, Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, New Haven, Connecticut, USA.
Matern Child Nutr. 2018 Jan;14(1). doi: 10.1111/mcn.12488. Epub 2017 Aug 1.
Breastfeeding rates among mothers in the Supplemental Nutrition Program for Women, Infants, and Children (WIC) are lower than for other mothers in the United States. The objective of this study was to test the acceptability and feasibility of the Lactation Advice thru Texting Can Help intervention. Mothers were enrolled at 18-30 weeks gestation from two WIC breastfeeding peer counselling (PC) programmes if they intended to breastfeed and had unlimited text messaging, more than fifth-grade literacy level, and fluency in English or Spanish. Participants were randomized to the control arm (PC support without texting) or the intervention arm (PC support with texting). The two-way texting intervention provided breastfeeding education and support from peer counsellors. Primary outcomes included early post-partum (PP) contact and exclusive breastfeeding (EBF) rates at 2 weeks PP. Feasibility outcomes included text messaging engagement and mother's satisfaction with texting platform. Fifty-eight women were enrolled, 52 of whom were available for intention-to-treat analysis (n = 30 texting, n = 22 control). Contact between mothers and PCs within 48 hr of delivery was greater in the texting group (86.6% vs. 27.3%, p < .001). EBF rates at 2 weeks PP among participants in the texting intervention was 50% versus 31.8% in the control arm (p = .197). Intervention group mothers tended to be more likely to meet their breastfeeding goals (p = .06). Participants were highly satisfied with the Lactation Advice thru Texting Can Help intervention, and findings suggest that it may improve early post-delivery contact and increase EBF rates among mothers enrolled in WIC who receive PC. A large, multicentre trial is feasible and warranted.
参加妇女、婴儿和儿童补充营养计划(WIC)的母亲的母乳喂养率低于美国其他母亲。本研究的目的是测试 Lactation Advice thru Texting Can Help 干预措施的可接受性和可行性。如果母亲打算母乳喂养,且具备以下条件,则在妊娠 18-30 周时参加两个 WIC 母乳喂养同伴咨询(PC)计划:可无限量发送短信、具有五年级以上的读写能力、且英语或西班牙语流利。参与者被随机分配到对照组(接受 PC 支持但不发送短信)或干预组(接受 PC 支持并发送短信)。双向短信干预提供了来自同伴顾问的母乳喂养教育和支持。主要结局包括产后 2 周内的早期接触和纯母乳喂养(EBF)率。可行性结局包括短信参与度和母亲对短信平台的满意度。共纳入 58 名女性,其中 52 名可进行意向治疗分析(短信组 n = 30,对照组 n = 22)。短信组母亲在分娩后 48 小时内与 PC 的联系率(86.6% vs. 27.3%,p < 0.001)更高。在短信干预组中,2 周时 EBF 率为 50%,而对照组为 31.8%(p = 0.197)。干预组的母亲更有可能实现母乳喂养目标(p = 0.06)。参与者对 Lactation Advice thru Texting Can Help 干预措施非常满意,研究结果表明,该措施可能改善产后早期的联系,并提高参加 WIC 且接受 PC 的母亲的 EBF 率。一项大型的、多中心的试验是可行的,也是有必要的。