Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
Biostatistics Unit, Clinical Research Institute, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
PLoS One. 2019 Jun 14;14(6):e0218467. doi: 10.1371/journal.pone.0218467. eCollection 2019.
Effective evidence-based breastfeeding support interventions can bolster breastfeeding practices. This study investigated the effect of a multi-component breastfeeding support intervention delivered in hospital and home settings on six-month exclusive breastfeeding (EBF) relative to standard care.
This is a parallel group, randomized clinical trial, in which 362 healthy pregnant women with singleton pregnancy were randomly allocated to a multi-component intervention that included antenatal breastfeeding education, professional, and peer support, delivered in hospital and home settings for six months (experimental, n = 174), or to standard care (control, n = 188). The primary outcome was six-month EBF rate. Secondary outcomes were exclusive and any breastfeeding rates at one and three months, maternal breastfeeding knowledge, attitude, and behavior at six months, and satisfaction with the intervention.
The crude six-month EBF rate was similar in both groups (35.2% vs. 28.1% in the experimental and control groups, respectively, p = 0·16). In adjusted analysis, six-month exclusivity was twice as likely in the experimental group relative to standard care (OR = 2.02; 95%CI: 1.20 to 3.39); whereas the odds for any breastfeeding were similar. Participants compliant with all three components were six times more likely to practice EBF for six months relative to standard care (OR = 6.63; 95% CI: 3.03 to 14.51). Breastfeeding knowledge of the experimental group, at six months, was significantly improved compared to the control. No changes were observed in breastfeeding attitude or behavior.
Combining education with peer and professional breastfeeding support improved six-month breastfeeding exclusivity and knowledge.
有效的循证母乳喂养支持干预措施可以促进母乳喂养实践。本研究调查了在医院和家庭环境中提供的多组分母乳喂养支持干预措施对六个月纯母乳喂养（EBF）相对于标准护理的效果。
这是一项平行组随机临床试验，其中 362 名健康单胎妊娠孕妇被随机分配到多组分干预组，该干预组包括产前母乳喂养教育、专业和同伴支持，在医院和家庭环境中持续六个月（实验组，n=174），或接受标准护理（对照组，n=188）。主要结局是六个月 EBF 率。次要结局是一个月和三个月时的纯母乳喂养率和任何母乳喂养率、六个月时的母亲母乳喂养知识、态度和行为，以及对干预的满意度。
两组的粗母乳喂养率在六个月时相似（实验组为 35.2%，对照组为 28.1%，p=0.16）。在调整分析中，实验组六个月时的纯母乳喂养率是标准护理组的两倍（OR=2.02；95%CI：1.20 至 3.39）；而任何母乳喂养的几率相似。遵守所有三个组成部分的参与者更有可能在六个月时进行 EBF，是标准护理的六倍（OR=6.63；95%CI：3.03 至 14.51）。与对照组相比，实验组在六个月时的母乳喂养知识显著提高。母乳喂养态度或行为没有变化。
将教育与同伴和专业母乳喂养支持相结合，提高了六个月的母乳喂养专一性和知识。
