title: Breastfeeding expectations versus reality: a cluster randomised controlled trial.
abstract: OBJECTIVE
  To evaluate the affect of an antenatal educational breastfeeding intervention on women's breastfeeding duration.
  
  
  METHODS
  Cluster randomised controlled trial. Unit of randomisation: electoral ward. The primary outcome was the proportion that fulfilled their antenatal breastfeeding expectation. Secondary outcomes were the number of women breastfeeding on discharge and at four months. Data were collected using a series of questionnaires and diaries.
  
  
  METHODS
  Teaching hospital in North West of England.
  
  
  METHODS
  Women who expressed a desire to breast-feed at the start of their pregnancy.
  
  
  METHODS
  Women were allocated to either routine antenatal education or an additional single educational group session supervised by a lactation specialist and attended by midwives from their locality.
  
  
  METHODS
  The proportion of women who fulfilled their expectation of breastfeeding.
  
  
  RESULTS
  One thousand three hundred and twelve women were randomised, with 1249 (95%) women available for analysis. There was no difference between the groups in the proportion of women who attained their expected duration of breastfeeding (OR 1.2; 95% CI 0.89-1.6; chi(2)= 1.4, df= 1, P= 0.2; mean cluster size 156, design effect 1.6). There were no differences between the groups in the uptake of breastfeeding on discharge (OR = 1.2; 95% CI 0.8-1.7; chi(2)= 1.1, df= 1, P= 0.3; mean cluster size 163, design effect = 2.0) or exclusively at four months (OR = 1.1; 95% CI 0.6-1.8; chi(2)= 0.07, df= 1, P= 0.8; mean cluster size 156, design effect 1.6).
  
  
  CONCLUSIONS
  The provision of a single educational group session supervised by a lactation specialist, and attended by midwives and women, failed to promote the uptake of breastfeeding. Public health interventions, which encourage positive attitudes to breastfeeding within the family and wider community, should be developed and evaluated.
authors.affiliation: Department Midwifery Studies, University of Central Lancashire, Preston, UK.
authors.forename: Tina
authors.initials: T
authors.lastname: Lavender
authors.forename: Lisa
authors.initials: L
authors.lastname: Baker
authors.forename: Rebecca
authors.initials: R
authors.lastname: Smyth
authors.forename: Stuart
authors.initials: S
authors.lastname: Collins
authors.forename: Anne
authors.initials: A
authors.lastname: Spofforth
authors.forename: Paola
authors.initials: P
authors.lastname: Dey
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D016000:Cluster Analysis; D004739:England; D005260:Female; D006801:Humans; D009721:Nurse Midwives / Q000193:education*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D011295:Prenatal Care / Q000379:methods; D011795:Surveys and Questionnaires; D013997:Time Factors