TY - JOUR
T1 - Focused breastfeeding counselling improves short- and long-term success in an early-discharge setting
T2 - A cluster-randomized study
AU - Nilsson, Ingrid M. S.
AU - Strandberg-Larsen, Katrine
AU - Knight, Christopher H.
AU - Hansen, Anne Vinkel
AU - Kronborg, Hanne
PY - 2017/10
Y1 - 2017/10
N2 - Length of postnatal hospitalization has decreased and has been shown to be associated with infant nutritional problems and increase in readmissions. We aimed to evaluate if guidelines for breastfeeding counselling in an early discharge hospital setting had an effect on maternal breastfeeding self-efficacy, infant readmission and breastfeeding duration. A cluster randomized trial was conducted and assigned nine maternity settings in Denmark to intervention or usual care. Women were eligible if they expected a single infant, intended to breastfeed, were able to read Danish, and expected to be discharged within 50 hr postnatally. Between April 2013 and August 2014, 2,065 mothers were recruited at intervention and 1,476 at reference settings. Results show that the intervention did not affect maternal breastfeeding self-efficacy (primary outcome). However, less infants were readmitted 1 week postnatally in the intervention compared to the reference group (adjusted OR 0.55, 95% CI 0.37, −0.81), and 6 months following birth, more infants were exclusively breastfed in the intervention group (adjusted OR 1.36, 95% CI 1.02, −1.81). Moreover, mothers in the intervention compared to the reference group were breastfeeding more frequently (p <.001), and spend more hours skin to skin with their infants (p <.001). The infants were less often treated for jaundice (p = 0.003) and there was more paternal involvement (p =.037). In an early discharge hospital setting, a focused breastfeeding programme concentrating on increased skin to skin contact, frequent breastfeeding, good positioning of the mother infant dyad, and enhanced involvement of the father improved short-term and long-term breastfeeding success.
AB - Length of postnatal hospitalization has decreased and has been shown to be associated with infant nutritional problems and increase in readmissions. We aimed to evaluate if guidelines for breastfeeding counselling in an early discharge hospital setting had an effect on maternal breastfeeding self-efficacy, infant readmission and breastfeeding duration. A cluster randomized trial was conducted and assigned nine maternity settings in Denmark to intervention or usual care. Women were eligible if they expected a single infant, intended to breastfeed, were able to read Danish, and expected to be discharged within 50 hr postnatally. Between April 2013 and August 2014, 2,065 mothers were recruited at intervention and 1,476 at reference settings. Results show that the intervention did not affect maternal breastfeeding self-efficacy (primary outcome). However, less infants were readmitted 1 week postnatally in the intervention compared to the reference group (adjusted OR 0.55, 95% CI 0.37, −0.81), and 6 months following birth, more infants were exclusively breastfed in the intervention group (adjusted OR 1.36, 95% CI 1.02, −1.81). Moreover, mothers in the intervention compared to the reference group were breastfeeding more frequently (p <.001), and spend more hours skin to skin with their infants (p <.001). The infants were less often treated for jaundice (p = 0.003) and there was more paternal involvement (p =.037). In an early discharge hospital setting, a focused breastfeeding programme concentrating on increased skin to skin contact, frequent breastfeeding, good positioning of the mother infant dyad, and enhanced involvement of the father improved short-term and long-term breastfeeding success.
KW - breastfeeding
KW - cluster-randomized controlled trial
KW - early discharge
KW - postpartum care
KW - readmission
KW - self-efficacy
U2 - 10.1111/mcn.12432
DO - 10.1111/mcn.12432
M3 - Journal article
C2 - 28194877
AN - SCOPUS:85013035487
SN - 1740-8695
VL - 13
JO - Maternal and Child Nutrition
JF - Maternal and Child Nutrition
IS - 4
M1 - e12432
ER -