Modest postnatal support interventions such as providing early support with breastfeeding and conducting brief weekly telephone support can improve both the duration and exclusivity of breastfeeding.published_or_final_versio

Fong, DYT

Heys, M

Hui Choi, WH

Lee, ILY

Sham, A

Tarrant, AM

Hong Kong Medical Journal

HKU Scholars Hub

Title Professional breastfeeding support to increase the exclusivityand duration of breastfeeding: a randomised controlled trialAuthor(s) Tarrant, AM; Fong, DYT; Heys, M; Lee, ILY; Sham, A; Hui Choi,WHCitation Hong Kong Medical Journal, 2014, v. 20 n. 6, Suppl. 7, p. 34-35Issued Date 2014URL http://hdl.handle.net/10722/208749Rights Hong Kong Medical Journal. Copyright © Hong Kong Academyof Medicine Press.34 Hong Kong Med J  ⎥  Volume 20 Number 6 (Supplement 7)  ⎥  December 2014  ⎥  www.hkmj.org Hong Kong Med J  ⎥  Volume 20 Number 6 (Supplement 7)  ⎥  December 2014  ⎥  www.hkmj.orgK e y  M e s s a g e Modest postnatal support interventions such as providing early support with breastfeeding and conducting brief weekly telephone support can improve both the duration and exclusivity of breastfeeding. Professional breastfeeding support to increase the exclusivity and duration of breastfeeding: a randomised controlled trialThe benefits of breastfeeding are dose-dependent; infants attain better health outcomes with a longer duration of exclusive breastfeeding.1,2 The World Health Organization recommends that infants be exclusively breastfed for 6 months with continued breastfeeding for up to 2 years of age and beyond.3 Although breastfeeding initiation rates are high in most developed countries, the proportion of infants exclusively breastfed decreases substantially in the first 3 months.4 In Hong Kong, >80% of women initiate breastfeeding,5 but only 30% continue to breastfeed exclusively for 3 months.6 Inadequate in-hospital and community support are contributing factors to early breastfeeding cessation. Thus, early breastfeeding support and guidance are important to prevent early cessation. This study aimed to assess the effect of early postpartum professional breastfeeding support on the duration of any and exclusive breastfeeding among primiparous women.  In Hong Kong, 724 postnatal women admitted to postnatal obstetric units of three public hospitals between November 2010 and September 2011 were randomised to usual care (n=264), in-hospital support (n=191), or telephone support (n=269). Participants were followed up for 6 months or until their babies completely weaned from breastfeeding, whichever came first. Compared with the usual care group, the in-hospital support group and telephone support group were more likely to breastfeed (any and exclusive) at all four time points.7 Compared with the usual care group, the in-hospital support group was more likely to breastfeed (any) at all four time points, but the overall effect of the intervention was not significant. Participants who received the telephone support Hong Kong Med J 2014;20(Suppl 7):S34-5HHSRF project number: 07080881M Tarrant *, DYT Fong, M Heys, ILY Lee, A Sham, EWH Hui Choi1 M Tarrant *, 1 DYT Fong, 2 M Heys, 3 ILY Lee, 4 A Sham, 1 EWH Hui Choi1  School of Nursing, The University of Hong Kong2 Global Health and Development Department, Institute of Child Health, University College London, UK3 Queen Mary Hospital, Hong Kong4 Kwong Wah Hospital, Hong Kong* Principal applicant and corresponding author: tarrantm@hku.hkwere significantly more likely to breastfeed (any) at 1 month and 2 months postpartum and to exclusively breastfeed at 1 month postpartum. Compared with in-hospital support, telephone support was more effective overall, but not significantly so.  These findings suggest that postnatal telephone support can significantly improve the duration of any and exclusive breastfeeding among Hong Kong postpartum mothers. Many breastfeeding problems do not present until after hospital discharge and thus support after discharge may be more beneficial in helping mothers to resolve problems. The benefits of breastfeeding are dose-dependent, with longer duration of exclusive breastfeeding conferring greater benefits. The challenge is to encourage public hospitals to provide both in-hospital and after-discharge breastfeeding support to enhance and sustain breastfeeding. AcknowledgementThis study was supported by the Health and Health Services Research Fund, Food and Health Bureau, Hong Kong SAR Government (#07080881). We thank Ms Eudora Yuen, Ms Mo Yan Yee, Ms Loretta Sui, and Ms Iris Ip for their breastfeeding expertise and help in delivering the professional breastfeeding support. In addition, we thank Ms Cheung Ka Lun, Ms Diana Tin, Ms Vincci Chan, and all staff in the postnatal units of the study hospitals for their assistance in conducting the study. Results of this study have been published in: Fu IC, Fong DY, Heys M, Lee IL, Sham A, Tarrant M. Professional breastfeeding support for first-time mothers: a multicenter cluster randomised controlled trial. BJOG 2014;121:1673-83. HEALTH AND HEALTH SERVICES RESEARCH FUNDHong Kong Med J  ⎥  Volume 20 Number 6 (Supplement 7)  ⎥  December 2014  ⎥  www.hkmj.org#  Professional breastfeeding support  # 35Hong Kong Med J  ⎥  Volume 20 Number 6 (Supplement 7)  ⎥  December 2014  ⎥  www.hkmj.orgReferences1. Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 2012;129:e827-41.2. Kramer MS, Kakuma R. The optimal duration of exclusive breastfeeding: a systematic review. Adv Exp Med Biol 2004;554:63-77.3. World Health Organization. Global strategy for infant and young child feeding. Geneva: World Health Organization; 2003.4. La Leche League International. Breastfeeding statistics La Leche League International 2003. Available at http://www.llli.org//cbi/bfstats03.html. Accessed 16 November 2013.5. Baby Friendly Hospital Initiative Hong Kong Association. World breastfeeding week 2013: annual summary. Hong Kong; 2013.6. Tarrant M, Lok KY, Fong DY, et al. Effect of a hospital policy of not accepting free infant formula on in-hospital formula supplementation rates and breastfeeding duration. Public Health Nutr 2015 [in press].7.  Fu IC, Fong DY, Heys M, Lee IL, Sham A, Tarrant M. Professional breastfeeding support for first-time mothers: a multicentre cluster randomised controlled trial. BJOG 2014;121:1673-83.

Professional breastfeeding support to increase the exclusivity and duration of breastfeeding: a randomised controlled trial

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Professional breastfeeding support to increase the exclusivity and duration of breastfeeding: a randomised controlled trial

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