title: Professional breastfeeding support for first-time mothers: a multicentre cluster randomised controlled trial.
abstract: OBJECTIVE
  To evaluate the effect of two postnatal professional support interventions on the duration of any and exclusive breastfeeding.
  
  
  METHODS
  Multicentre, three-arm, cluster randomised controlled trial.
  
  
  METHODS
  A cohort of 722 primiparous breastfeeding mothers with uncomplicated, full-term pregnancies.
  
  
  METHODS
  The three study interventions were: (1) standard postnatal maternity care; (2) standard care plus three in-hospital professional breastfeeding support sessions, of 30-45 minutes in duration; or (2) standard care plus weekly post-discharge breastfeeding telephone support, of 20-30 minutes in duration, for 4 weeks. The interventions were delivered by four trained research nurses, who were either highly experienced registered midwives or certified lactation consultants.
  
  
  METHODS
  Prevalence of any and exclusive breastfeeding at 1, 2, and 3 months postpartum.
  
  
  RESULTS
  Rates of any and exclusive breastfeeding were higher among participants in the two intervention groups at all follow-up points, when compared with those who received standard care. Participants receiving telephone support were significantly more likely to continue any breastfeeding at 1 month (76.2 versus 67.3%; odds ratio, OR 1.63, 95% confidence interval, 95% CI 1.10-2.41) and at 2 months (58.6 versus 48.9%; OR 1.48, 95% CI 1.04-2.10), and to be exclusively breastfeeding at 1 month (28.4 versus 16.9%; OR 1.89, 95% CI 1.24-2.90). Participants in the in-hospital support group were also more likely to be breastfeeding at all time points, but the effect was not statistically significant.
  
  
  CONCLUSIONS
  Professional breastfeeding telephone support provided early in the postnatal period, and continued for the first month postpartum, improves breastfeeding duration among first-time mothers. It is also possible that it was the continuing nature of the support that increased the effectiveness of the intervention, rather than the delivery of the support by telephone specifically.
authors.affiliation: School of Nursing, The University of Hong Kong, Hong Kong, China.
authors.forename: I C Y
authors.initials: IC
authors.lastname: Fu
authors.forename: D Y T
authors.initials: DY
authors.lastname: Fong
authors.forename: M
authors.initials: M
authors.lastname: Heys
authors.forename: I L Y
authors.initials: IL
authors.lastname: Lee
authors.forename: A
authors.initials: A
authors.lastname: Sham
authors.forename: M
authors.initials: M
authors.lastname: Tarrant
mesh_terms: D000328:Adult; D001942:Breast Feeding; D005260:Female; D006801:Humans; D010298:Parity; D010353:Patient Education as Topic / Q000379:methods; D011181:Postnatal Care / Q000379:methods*; D011247:Pregnancy; D011295:Prenatal Care; D012657:Self-Help Groups; D013689:Telephone
keywords: Breastfeeding; intervention; professional support; randomised controlled trial