Antenatal education and postnatal support strategies for improving rates of exclusive breast feeding: randomised controlled trial.
OBJECTIVE
To investigate whether antenatal breast feeding education alone or postnatal lactation support alone improves rates of exclusive breast feeding compared with routine hospital care.


METHODS
Randomised controlled trial.


METHODS
A tertiary hospital in Singapore.


METHODS
450 women with uncomplicated pregnancies.


METHODS
Primary outcomes were rates of exclusive breast feeding at discharge from hospital and two weeks, six weeks, three months, and six months after delivery. Secondary outcomes were rates of any breast feeding.


RESULTS
Compared with women who received routine care, women in the postnatal support group were more likely to breastfeed exclusively at two weeks (relative risk 1.82, 95% confidence interval 1.14 to 2.90), six weeks (1.85, 1.11 to 3.09), three months (1.87, 1.03 to 3.41), and six months (2.12, 1.03 to 4.37) postnatally. Women receiving antenatal education were more likely to breast feed exclusively at six weeks (1.73, 1.04 to 2.90), three months (1.92, 1.07 to 3.48), and six months (2.16, 1.05 to 4.43) postnatally. The numbers needed to treat to achieve one woman exclusively breast feeding at six months were 11 (6 to 80) for postnatal support and 10 (6 to 60) for antenatal education. Women who received postnatal support were more likely to exclusively or predominantly breast feed two weeks after delivery compared with women who received antenatal education (1.53, 1.01 to 2.31). The rate of any breastfeeding six weeks after delivery was also higher in the postnatal support group compared with women who received routine care (1.16, 1.02 to 1.31).


CONCLUSIONS
Antenatal breast feeding education and postnatal lactation support, as single interventions based in hospital both significantly improve rates of exclusive breast feeding up to six months after delivery. Postnatal support was marginally more effective than antenatal education.


BACKGROUND
Clinical Trials NCT00270920 [ClinicalTrials.gov].
Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119074.
Lin-Lin
LL
Su
Yap-Seng
YS
Chong
Yiong-Huak
YH
Chan
Yah-Shih
YS
Chan
Doris
D
Fok
Kay-Thwe
KT
Tun
Faith S P
FS
Ng
Mary
M
Rauff
D001942:Breast Feeding / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods*; D011181:Postnatal Care / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods*; D012846:Singapore; D012944:Social Support