Antenatal training to improve breast feeding: a randomised trial.
OBJECTIVE
to assess the effect of an antenatal training programme on knowledge, self-efficacy and problems related to breast feeding and on breast-feeding duration.


METHODS
a randomised controlled trial.


METHODS
the Aarhus Midwifery Clinic, a large clinic connected to a Danish university hospital in an urban area of Denmark.


METHODS
a total of 1193 nulliparous women were recruited before week 21+6 days of gestation, 603 were randomised to the intervention group, and 590 to the reference group.


METHODS
we compared a structured antenatal training programme attended in mid-pregnancy with usual practice.


METHODS
data were collected through self-reported questionnaires sent to the women's e-mail addresses and analysed according to the intention to treat principle. The primary outcomes were duration of full and any breast feeding collected 6 weeks post partum (any) and 1 year post partum (full and any).


RESULTS
no differences were found between groups according to duration of breast feeding, self-efficacy score, or breast-feeding problems, but after participation in the course in week 36 of gestation women in the intervention group reported a higher level of confidence (p=0.05), and 6 weeks after birth they reported to have obtained sufficient knowledge about breast feeding (p=0.02). Supplemental analysis in the intervention group revealed that women with sufficient knowledge breast fed significantly longer than women without sufficient knowledge (HR=0.74 CI: 0.58-0.97). This association was not found in the reference group (HR=1.12 CI: 0.89-1.41).


CONCLUSIONS
antenatal training can increase confidence of breast feeding in pregnancy and provide women with sufficient knowledge about breast feeding after birth. Antenatal training may therefore be an important low-technology health promotion tool that can be provided at low costs in most settings. The antenatal training programme needs to be followed by postnatal breast-feeding support as it is not sufficient in itself to increase the duration of breast feeding or reduce breast-feeding problems.
Department of Nursing Science, School of Public Health, Aarhus University, Denmark. hk@nursingscience.au.dk
Hanne
H
Kronborg
Rikke Damkjær
RD
Maimburg
Michael
M
Væth
D000328:Adult; D001942:Breast Feeding / Q000379:methods* / Q000523:psychology; D003718:Denmark; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008880:Midwifery / Q000379:methods*; D009035:Mothers / Q000193:education* / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D055815:Young Adult