title: The FEeding Support Team (FEST) randomised, controlled feasibility trial of proactive and reactive telephone support for breastfeeding women living in disadvantaged areas.
abstract: OBJECTIVE
  To assess the feasibility of implementing a dedicated feeding support team on a postnatal ward and pilot the potential effectiveness and cost-effectiveness of team (proactive) and woman-initiated (reactive) telephone support after discharge.
  
  
  METHODS
  Randomised controlled trial embedded within a before-and-after study. Participatory approach and mixed-method process evaluation.
  
  
  METHODS
  A postnatal ward in Scotland.
  
  
  METHODS
  Women living in disadvantaged areas initiating breast feeding.
  
  
  METHODS
  Eligible women were recruited to a before-and-after intervention study, a proportion of whom were independently randomised after hospital discharge to intervention: daily proactive and reactive telephone calls for ≤14 days or control: reactive telephone calls ≤ day 14. Intention-to-treat analysis compared the randomised groups on cases with complete outcomes at follow-up.
  
  
  METHODS
  
  
  
  METHODS
  any breast feeding at 6-8 weeks assessed by a telephone call from a researcher blind to group allocation.
  
  
  RESULTS
  exclusive breast feeding, satisfaction with care, NHS costs and cost per additional woman breast feeding.
  
  
  RESULTS
  There was no difference in feeding outcomes for women initiating breast feeding before the intervention (n=413) and after (n=388). 69 women were randomised to telephone support: 35 intervention (32 complete cases) and 34 control (26 complete cases). 22 intervention women compared with 12 control women were giving their baby some breast milk (RR 1.49, 95% CI 0.92 to 2.40) and 17 intervention women compared with eight control women were exclusively breast feeding (RR 1.73, 95% CI 0.88 to 3.37) at 6-8 weeks after birth. The incremental cost of providing proactive calls was £87 per additional woman breast feeding and £91 per additional woman exclusively breast feeding at 6-8 weeks; costs were sensitive to service organisation.
  
  
  CONCLUSIONS
  Proactive telephone care delivered by a dedicated feeding team shows promise as a cost-effective intervention for improving breastfeeding outcomes. Integrating the FEeding Support Team (FEST) intervention into routine postnatal care was feasible.
  
  
  BACKGROUND
  ISRCTN27207603. The study protocol and final report are available on request.
authors.affiliation: Health Services Research Unit, University of Aberdeen, Aberdeen, UK.
authors.forename: Pat
authors.initials: P
authors.lastname: Hoddinott
authors.forename: Leone
authors.initials: L
authors.lastname: Craig
authors.forename: Graeme
authors.initials: G
authors.lastname: Maclennan
authors.forename: Dwayne
authors.initials: D
authors.lastname: Boyers
authors.forename: Luke
authors.initials: L
authors.lastname: Vale