The effect of a breastfeeding support programme on breastfeeding duration and exclusivity: a quasi-experiment

Abstract

Background Breastfeeding has important positive long-term health consequences for infants and mothers. The World Health Organization recommends that all infants should be exclusively breastfed for six months or longer, and advises continuation of breastfeeding for two years or beyond. However, these recommendations are not met in many countries. This study examined whether a comprehensive, evidence-based breastfeeding intervention, the Breastfeeding Support Programme (BSP), promotes prolonged duration and exclusivity of breastfeeding among its participants. Methods A quasi-experimental design was used to compare breastfeeding duration and exclusivity in the BSP group ( N = 66) to breastfeeding duration and exclusivity in a control group ( N = 72). Participants who followed the BSP were provided with 6 consults delivered by a lactation consultant. The consults started during pregnancy and continued up until 10 weeks after delivery. Participants in the control group did not follow the BSP. Pretest and posttest questionnaires were administered through the internet. A Cox proportional hazards regression analysis was used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for cessation of any and exclusive breastfeeding, while controlling for differences at baseline. Results The effect of the BSP on survival rates for any and exclusive breastfeeding were significant while controlling for differences between the two groups at baseline (respectively HR = 0.34, p < .001 [95% CI = 0.18–0.61] and HR = 0.46, p < .001 [95% CI = 0.29–0.72]). Among mothers in the BSP group there was on average 66% less risk of cessation of any breastfeeding and on average 54% less risk of cessation of exclusive breastfeeding at any point in time compared to those in the control group. Conclusions The BSP appears to be an effective means to delay cessation of any and exclusive breastfeeding cessation and therefore to increase breastfeeding duration and exclusivity. This is an important finding, because earlier cessation of breastfeeding than desired is a common problem in many countries. Future research into the effectiveness of the BSP could consider random assignment to conditions and test the effectiveness of the intervention in other populations to investigate further whether wide-scale implementation of this intervention could be useful to promote breastfeeding. Electronic supplementary material The online version of this article (10.1186/s12889-019-7331-y) contains supplementary material, which is available to authorized users.

Factors associated with the maintenance of exclusive breastfeeding in the late postpartum

“…It can be inferred from this that, although the subjects studied present some previous difficulty related to BF, the support offered by breastfeeding consultancy acted in solving this demand, increasing the proportion of mothers and children in EBF. A quasi-experiment conducted in the Netherlands corroborates the assertion that the intervention by individuals trained by the IBCLC is effective in increasing the duration and exclusivity of breastfeeding, as well as in delaying weaning (5) .…”

“…Studies in Italy and the Netherlands, as well as a systematic review and meta-analysis, have already shown the superiority of a consultant's role in improving breastfeeding outcomes (4)(5)(6).…”

Knowledge, attitude, motivation and planning of breastfeeding: a cross-sectional study among Jordanian women

“…In their systematic review of professional support interventions for breastfeeding, Hannula et al reinforced the importance of providing obstetric professionals with educational tools to support breastfeeding which would in turn improve the women's self-efficacy and power to ensure better breastfeeding behavior [30]. In their recently published study, Van Dellen et al examined the association between breastfeeding practice and a comprehensive evidence based intervention named "Breastfeeding Support Program (BSP)" that combines antenatal and postpartum support and education, and concluded that BSP promotes longer duration and higher exclusivity of breastfeeding among their participants [31]. Besides obstetric care providers, neonatal care providers including neonatologists and nurse practitioners should frequently receive enough education and reminders to support breastfeeding to ensure compliance with Step 2 of the BFHI [8].…”

Knowledge, Attitude, Motivation and Planning of Breastfeeding; A cross Sectional Study among Jordanian Women.

“…examined the association between BF practice and a comprehensive evidence based intervention named "Breastfeeding Support Program, BSP" that combines antenatal and postpartum support and education, and concluded that BSP promotes longer duration and higher exclusivity of BF among their participants [29]. Additionally, the strong association between husband's support and intention to breastfeed among the women in our culture makes us believe that husbands should attend the antenatal and postnatal educational sessions about BF as their influences might have a great impact on their wives' intentions.…”