title: Effect of a randomised exclusive breastfeeding counselling intervention nested into the MINIMat prenatal nutrition trial in Bangladesh.
abstract: OBJECTIVE
  It is unknown whether maternal malnutrition reduces the effect of counselling on exclusive breastfeeding. This study evaluated the effect of breastfeeding counselling on the duration of exclusive breastfeeding, and whether the timing of prenatal food and different micronutrient supplements further prolonged this duration.
  
  
  METHODS
  Pregnant women in Matlab, Bangladesh, were randomised to receive daily food supplements of 600 kcal at nine weeks of gestation or at the standard 20 weeks. They also were allocated to either 30 mg of iron and 400 μg folic acid, or the standard programme 60 mg of iron and folic acid or multiple micronutrients. At 30 weeks of gestation, 3188 women were randomised to receive either eight breastfeeding counselling sessions or the usual health messages.
  
  
  RESULTS
  The median duration of exclusive breastfeeding was 135 days in the counselling group and 75 days in the usual health message group (p < 0.001). Prenatal supplements did not modify the effects of counselling. Women in the usual health message group who were randomised to multiple micronutrients exclusively breastfed for 12 days longer than mothers receiving the standard iron-folate combination (p = 0.003).
  
  
  CONCLUSIONS
  Breastfeeding counselling increased the duration of exclusive breastfeeding by 60 days. This duration was not influenced by the supplements.
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Ashraful Islam
authors.initials: AI
authors.lastname: Khan
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Iqbal
authors.initials: I
authors.lastname: Kabir
authors.affiliation: International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Hanna
authors.initials: H
authors.lastname: Eneroth
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Shams
authors.initials: S
authors.lastname: El Arifeen
authors.affiliation: International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Eva-Charlotte
authors.initials: EC
authors.lastname: Ekström
authors.affiliation: Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Frongillo
authors.affiliation: International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Lars Åke
authors.initials: LÅ
authors.lastname: Persson
mesh_terms: D000328:Adult; D001459:Bangladesh; D001942:Breast Feeding / Q000706:statistics & numerical data*; D003131:Combined Modality Therapy; D003376:Counseling; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007501:Iron / Q000627:therapeutic use; D008297:Male; D044342:Malnutrition / Q000178:diet therapy*; D018977:Micronutrients / Q000627:therapeutic use*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000178:diet therapy*; D011295:Prenatal Care / Q000379:methods*; D039401:Prenatal Nutritional Physiological Phenomena; D016896:Treatment Outcome
chemical_list: D018977:Micronutrients; D005492:Folic Acid; D007501:Iron
keywords: Counselling; Exclusive breastfeeding; Food and micronutrient supplementation; Pregnancy