title: Postnatal peer counselling on exclusive breastfeeding of low-birthweight infants: a randomized, controlled trial.
abstract: OBJECTIVE
  Exclusive breastfeeding increases survival and optimizes growth of low-birthweight (LBW) infants. If supported, mothers can overcome the unique difficulties associated with breastfeeding from birth to 6 mo. We tested the efficacy of postnatal peer counselling among first-time mothers that aimed to increase exclusive breastfeeding of term LBW infants.
  
  
  METHODS
  In a Manila hospital, 204 mothers were randomized into three groups. Two intervention groups receiving home-based counselling visits, one by counsellors trained in breastfeeding counselling (n=68), the other by counsellors trained in general childcare (n=67), were compared with a control group of mothers (n=69) who did not receive counselling.
  
  
  RESULTS
  Eighty-eight per cent of the participating pairs completed the trial. At 6 mo, 44% of the breastfeeding counselled mothers, 7% childcare-counselled mothers and none of the mothers in the control group were exclusively breastfeeding. More mothers in the breastfeeding counselled group than in the other groups were still breastfeeding at 6 mo. Twenty-four infants who were exclusively breastfed for 6 mo did not have any diarrhoea. All groups had improved mean weight-for-age Z-scores at 6 mo.
  
  
  CONCLUSIONS
  This study has provided fundamental evidence of successful intervention to achieve 6 mo of exclusive breastfeeding among term LBW infants. By improving health outcomes, enhanced breastfeeding offers a distinct possibility of disrupting the intergenerational cycle of undernourished women giving birth to LBW infants.
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. grace.agrasada@kbh.uu.se
authors.forename: Grace V
authors.initials: GV
authors.lastname: Agrasada
authors.forename: Jan
authors.initials: J
authors.lastname: Gustafsson
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kylberg
authors.forename: Uwe
authors.initials: U
authors.lastname: Ewald
mesh_terms: D001835:Body Weight; D001942:Breast Feeding / Q000523:psychology*; D002657:Child Development / Q000502:physiology; D003376:Counseling / Q000379:methods*; D003968:Diarrhea, Infantile / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D010379:Peer Group; D010679:Philippines; D011181:Postnatal Care / Q000379:methods; D011247:Pregnancy; D012016:Reference Values; D012307:Risk Factors; D012680:Sensitivity and Specificity