title: Home versus hospital breastfeeding support for newborns: a randomized controlled trial.
abstract: BACKGROUND
  The advantages of breastfeeding have been well established for both mothers and their infants. Existing research reports equivocal effects of early discharge and postpartum home care on breastfeeding success. The purpose of this study was to compare the effects of breastfeeding support offered in hospital and home settings on breastfeeding outcomes and maternal satisfaction for mothers of term and near-term newborns who experienced standard or early discharge.
  
  
  METHODS
  In a randomized controlled trial with prognostic stratification for gestational age, 101 term and 37 near-term (35-37 weeks' gestational age) mother-newborn pairs were randomized to either a standard care group (standard care and standard length of hospitalization) or an experimental group (standard hospital care with early discharge and home support from nurses who were certified lactation consultants). Data collection occurred before randomization, at discharge from hospital, and from 5 to 12 days postpartum. Primary outcomes included breastfeeding rates and maternal satisfaction.
  
  
  RESULTS
  More mothers of term newborns in the experimental group were breastfeeding exclusively at follow-up (p = 0.02) compared with the control group. No significant breastfeeding differences occurred among mothers with near-term newborns in the experimental and standard care groups.
  
  
  CONCLUSIONS
  In-home lactation support appears to facilitate positive breastfeeding outcomes for mothers of term newborns. This may also be a beneficial model of postpartum care for mothers of near-term newborns; however, further research is required. The findings suggest implications for health caregivers and policy makers with respect to postpartum lactation and health care services.
authors.affiliation: Faculty of Nursing, University of Toronto, Ontario, Canada.
authors.forename: Patricia
authors.initials: P
authors.lastname: McKeever
authors.forename: Bonnie
authors.initials: B
authors.lastname: Stevens
authors.forename: Karen-Lee
authors.initials: KL
authors.lastname: Miller
authors.forename: Jo Watson
authors.initials: JW
authors.lastname: MacDonell
authors.forename: Sharyn
authors.initials: S
authors.lastname: Gibbins
authors.forename: Denise
authors.initials: D
authors.lastname: Guerriere
authors.forename: Michael S
authors.initials: MS
authors.lastname: Dunn
authors.forename: Peter C
authors.initials: PC
authors.lastname: Coyte
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology*; D003625:Data Collection / Q000379:methods; D005260:Female; D006699:Home Care Services; D006760:Hospitalization; D006801:Humans; D009035:Mothers / Q000193:education / Q000523:psychology*; D017283:Neonatal Nursing / Q000379:methods*; D024802:Nurse's Role; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods; D017060:Patient Satisfaction; D011181:Postnatal Care / Q000379:methods* / Q000523:psychology; D018401:Sample Size; D012944:Social Support