title: Telephone-based support prolongs breastfeeding duration in obese women: a randomized trial.
abstract: BACKGROUND
  Obese women often have difficulties breastfeeding.
  
  
  OBJECTIVE
  We evaluated whether telephone-based support could increase the duration of breastfeeding in obese women and, thereby, reduce offspring growth.
  
  
  METHODS
  We recruited 226 dyads of obese mothers and their singleton, healthy, term infants. The women were randomly assigned to 6 mo of breastfeeding support or standard care controls. At 6 mo, there were 207 dyads in the study; 105 dyads received support, and 102 dyads were control subjects. One International Board Certified Lactation Consultant carried out the intervention, which was based on structured interviews and consisted of encouraging telephone calls.
  
  
  RESULTS
  The support group breastfed exclusively for a median of 120 d (25th-75th percentiles: 14-142 d) compared with 41 d (3-133 d) for control subjects (P = 0.003). Any breastfeeding was maintained for a median of 184 d (92-185 d) for the support group compared with 108 d (16-185 d) for control subjects (P = 0.002). Support increased the adjusted ORs for exclusive breastfeeding at 3 mo and the ratios for partial breastfeeding at 6 mo to 2.45 (95% CI: 1.36, 4.41; P = 0.003) and 2.25 (95% CI: 1.24, 4.08; P = 0.008, respectively). Although the duration of exclusive breastfeeding was inversely associated with infant weight (β = -4.39 g/d; 95% CI: -0.66, -8.11 g/d; P = 0.021) and infant length at 6 mo (β = -0. 012 cm/d; 95% CI: -0.004, -0.02 cm/d; P = 0.004), the breastfeeding support did not achieve a significant effect on infant growth at 6 mo (n = 192).
  
  
  CONCLUSIONS
  Telephone-based advisory support was very effective in prolonging breastfeeding in obese mothers who often terminate the breastfeeding of their infants prematurely. A longer duration of breastfeeding may decrease risk of noncommunicable diseases in these infants. This trial was registered at clinicaltrials.gov as NCT01235663.
authors.affiliation: Departments of Pediatrics (EMC, AK, DC, and OP) and Obstetrics and Gynecology (KMR), Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark; and the Department of Nutrition, Exercise and Sports, Faculty of Life Science, University of Copenhagen, Copenhagen, Denmark (KFM).
authors.forename: Emma Malchau
authors.initials: EM
authors.lastname: Carlsen
authors.forename: Anne
authors.initials: A
authors.lastname: Kyhnaeb
authors.forename: Kristina M
authors.initials: KM
authors.lastname: Renault
authors.forename: Dina
authors.initials: D
authors.lastname: Cortes
authors.forename: Kim F
authors.initials: KF
authors.lastname: Michaelsen
authors.forename: Ole
authors.initials: O
authors.lastname: Pryds
mesh_terms: D000328:Adult; D000886:Anthropometry; D001942:Breast Feeding; D002657:Child Development; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D009035:Mothers; D009765:Obesity / Q000378:metabolism*; D011181:Postnatal Care; D012307:Risk Factors; D013689:Telephone; D013997:Time Factors