title: Early suckling and postpartum haemorrhage: controlled trial in deliveries by traditional birth attendants.
abstract: A randomised, controlled trial was carried out to determine whether suckling immediately after birth reduces the frequency of post-partum haemorrhage (PPH), the mean blood loss, and the frequency of retained placenta. The trial subjects were attended by traditional birth attendants (TBAs), and randomisation was by TBA and not by mother. 68 TBAs attended a course on third stage management and data collection; 19 had to be excluded from the trial. 23 TBAs in the early suckling group and 26 in the control group recorded blood loss in 2104 and 2123 deliveries of liveborn singletons, respectively. The frequency of PPH (loss greater than 500 ml) was 7.9% in the suckling group and 8.4% in the control group and the mean blood loss 258 ml and 256 ml, respectively. Neither of these results differed significantly between the groups. Analysis of the results by individual TBA showed no significant difference between the groups. The frequency of PPH in women of higher parity and in those with multiple pregnancies and stillbirths was high, as expected, which seems to validate the results. The frequency of retained placenta was too low to be analysed.
authors.affiliation: South Shields General Hospital, Tyne.
authors.forename: C H
authors.initials: CH
authors.lastname: Bullough
authors.forename: R S
authors.initials: RS
authors.lastname: Msuku
authors.forename: L
authors.initials: L
authors.lastname: Karonde
mesh_terms: D001942:Breast Feeding; D002986:Clinical Trials as Topic; D003466:Cultural Characteristics; D036861:Delivery, Obstetric; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007749:Labor Stage, Third / Q000502:physiology*; D007743:Labor, Obstetric / Q000502:physiology*; D008295:Malawi; D008499:Medical Records / Q000592:standards; D008880:Midwifery / Q000193:education*; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000517:prevention & control*; D011247:Pregnancy; D011897:Random Allocation; D012424:Rural Population; D013391:Sucking Behavior / Q000502:physiology*; D013997:Time Factors; D014590:Uterine Contraction