title: Motivational interviewing improves exclusive breastfeeding in an Australian randomised controlled trial.
abstract: OBJECTIVE
  To increase maintenance of breastfeeding through improved primary care support.
  
  
  METHODS
  A cluster randomised controlled trial recruited 15 rural family doctor's offices and 330 women who were currently breastfeeding took part. Eight practices formed the intervention group (154 women) and seven formed the control group (176 women). The practice nurses who provided the intervention used a specially designed motivational flowchart to speak to the mothers when they brought their child for immunisation at 2, 4 and 6 months. The nurses also attended preparatory workshops on breastfeeding management, counselling skills, motivational interviewing and reflective practice and were given resources and support. Breastfeeding rates were measured at 4 and 6 months.
  
  
  RESULTS
  Randomisation equally distributed all measured variables except prenatal intentions to rejoin employment within 12 months (70% intervention, 56% control, p < 0.05). After adjustment, the 4-month figures showed significantly higher rates of exclusive breastfeeding (OR 1.88; 95%CI 1.01-3.50; p = 0.047) and full breastfeeding (water/juice allowed) (OR 1.95; 95%CI 1.03-3.69; p = 0.04) in the intervention group. There were no differences at 6 months.
  
  
  CONCLUSIONS
  A motivational interviewing intervention by primary care health professionals who have undertaken a replicable training programme is feasible and effective in increasing exclusive breastfeeding and full/predominant breastfeeding at 4 months.
authors.affiliation: Rural Clinical School, Faculty of Medicine, The University of New South Wales, Wagga Wagga, NSW, Australia; Rural Clinical School, School of Medicine Sydney, University of Notre Dame Australia, Wagga Wagga, NSW, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Elliott-Rudder
authors.forename: L
authors.initials: L
authors.lastname: Pilotto
authors.forename: E
authors.initials: E
authors.lastname: McIntyre
authors.forename: S
authors.initials: S
authors.lastname: Ramanathan
mesh_terms: D000328:Adult; D001315:Australia; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D062405:Motivational Interviewing; D011247:Pregnancy; D012424:Rural Population; D055815:Young Adult
keywords: Breastfeeding; exclusive breastfeeding; health behaviours; nursing practice; primary care