title: Can early postpartum home visits by trained community health workers improve breastfeeding of newborns?
abstract: OBJECTIVE
  Whether postpartum visits by trained community health workers (CHWs), reduce newborn breastfeeding problems.
  
  
  METHODS
  Community health workers made antenatal and postpartum home visits promoting newborn care practices including breastfeeding. CHWs assessed neonates for adequacy of breastfeeding and provided hands-on support to mothers to establish breastfeeding. History and observation data of 3495 neonates were analyzed to assess effects of CHW visitation on feeding problems.
  
  
  RESULTS
  Inappropriate breastfeeding position and attachment were the predominant problems (12 to 15%). Only 6% of newborns who received home visit by CHWs within 3 days had feeding difficulties, compared to 34% of those who did not (odds ratio: 7.66, 95% confidence interval (CI): 6.03 to 9.71, P=0.00). Latter group was 11.4 times (95% CI: 6.7 to 19.3, P=0.00) more likely to have feeding problems as late as days 6 to 7, than the former.
  
  
  CONCLUSIONS
  Counseling and hands-on support on breastfeeding techniques by trained workers within first 3 days of birth, should be part of community-based postpartum interventions.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. ishtiaqm@icddrb.org
authors.forename: I
authors.initials: I
authors.lastname: Mannan
authors.forename: S M
authors.initials: SM
authors.lastname: Rahman
authors.forename: A
authors.initials: A
authors.lastname: Sania
authors.forename: H R
authors.initials: HR
authors.lastname: Seraji
authors.forename: S E
authors.initials: SE
authors.lastname: Arifeen
authors.forename: P J
authors.initials: PJ
authors.lastname: Winch
authors.forename: G L
authors.initials: GL
authors.lastname: Darmstadt
authors.forename: A
authors.initials: A
authors.lastname: Baqui
mesh_terms: D001942:Breast Feeding; D003150:Community Health Workers; D003376:Counseling; D005260:Female; D006792:House Calls; D006801:Humans; D007231:Infant, Newborn; D009035:Mothers / Q000523:psychology; D011181:Postnatal Care; D049590:Postpartum Period