Supporting breastfeeding In Local Communities (SILC): protocol for a cluster randomised controlled trial

BMC Pregnancy and Childbirth

Touran Shafiei²  Lyndsey F Watson²  Meabh Cullinane²  Rhonda Small²  Lisa H Amir²  Della A Forster³  Helen L McLachlan¹ 

[1]School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, 3083, Australia

[2]Judith Lumley Centre (formerly Mother & Child Health Research), La Trobe University, Melbourne, VIC, 3000, Australia

[3]Royal Women’s Hospital, Locked Bag 300, Grattan St and Flemington Rd, Parkville, VIC, 3052, Australia

关键词: Home visits;    Drop-in centre;    Community-based;    Postnatal;    Maternal and child health;    Local government;    Early professional breastfeeding support;    Randomised controlled trial;    Infant feeding;    Breastfeeding;   

Others  :  1118430
DOI  :  10.1186/1471-2393-14-346

 received in 2013-12-10, accepted in 2014-09-30,  发布年份 2014

【 摘 要 】

Background

Breastfeeding is associated with significant positive health outcomes for mothers and infants. However, despite recommendations from the World Health Organization, exclusive breastfeeding for six months is uncommon. Increased breastfeeding support early in the postpartum period may be effective in improving breastfeeding maintenance. This trial will evaluate two community-based interventions to increase breastfeeding duration in Local Government Areas (LGAs) in Victoria, Australia.

Methods/Design

A three-arm cluster randomised controlled trial design will be used. Victorian LGAs with a lower than average rate of any breastfeeding at discharge from hospital and more than 450 births per year that agree to participate will be randomly allocated to one of three trial arms: 1) standard care; 2) home-based breastfeeding support; or 3) home-based breastfeeding support plus access to a community-based breastfeeding drop-in centre. The services provided in LGAs allocated to ‘standard care’ are those routinely available to postpartum women. LGAs allocated to the home-based visiting intervention will provide home-visits to women who are identified as at risk of breastfeeding cessation in the early postnatal period. These visits will be provided by Maternal and Child Health Nurses who have received training to provide the intervention (SILC-MCHNs). In areas allocated to receive the second intervention, in addition to home-based breastfeeding support, community breastfeeding drop-in centres will be made available, staffed by a SILC-MCHN. The interventions will run in LGAs for a nine to twelve month period depending on birth numbers. The primary outcome is the proportion of infants receiving any breast milk at four months of age. Breastfeeding outcomes will be obtained from routinely collected Maternal and Child Health centre data and from a new data item collecting infant feeding ‘in the last 24 hours’. Information will also be obtained directly from women via a postal survey. A comprehensive process evaluation will be conducted.

Discussion

This study will determine if early home-based breastfeeding support by a health professional for women at risk of stopping breastfeeding, with or without access to a community-based breastfeeding drop-in centre, increases breastfeeding duration in Victorian LGAs with low breastfeeding rates.

Trial registration

Australian New Zealand Clinical Trials Registry: ACTRN12611000898954.

【 授权许可】

   
2014 McLachlan et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Ip S, Chung M, Raman G, Chew P, Magula N, DeVine D, Trikalinos T, Lau J: Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries. In Evidence Report/Technology Assessment No 153 (Prepared by Tufts-New England Medical Center Evidence-based Practice Center, under Contract No 290-02-0022) AHRQ Publication No 07-E007. Rockville, MD: Agency for Healthcare Research and Quality; 2007.
• [2]Cattaneo A, Quintero-Romero S: Protection, promotion and support of breastfeeding in low-income countries. Semin Fetal Neonatal Med 2006, 11(1):48-53.
• [3]Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS, Bellagio Child Survival Study Group: How many child deaths can we prevent this year? Lancet 2003, 362:65-71.
• [4]Labbok MH: Effects of breastfeeding on the mother. Pediatr Clin North Am 2001, 48(1):143-158.
• [5]Renfrew MJ, Pokhrel S, Quiqley M, McCormick F, Fox-Rushby J, Dodds R, Duffy S, Trueman P, Williams A: Preventing disease and saving resources: the potential contribution of increasing breastfeeding rates in the UK. London, UK: UNICEF; 2012.
• [6]Smith JP, Thompson JF, Ellwood DA: Hospital system costs of artificial infant feeding: estimates for the Australian Capital Territory. Aust N Z J Public Health 2002, 26(6):543-551.
• [7]House of Representatives Standing Committee on Health and Ageing: The Best Start: Report on the Inquiry into the Health Benefits of Breastfeeding. Canberra: The Parliament of the Commonwealth of Australia; 2007.
• [8]National Health and Medical Research Council: The Dietary Guidelines for Children and Adolescents in Australia incorporating the Infant Feeding Guidelines for Health Workers. Canberra: Commonwealth of Australia; 2003.
• [9]Expert consultation on the optimal duration of exclusive breastfeeding. Conclusions and recommendations [http://www.who.int/nutrition/publications/infantfeeding/WHO_NHD_01.09/en webcite]
• [10]Australian Institute for Health and Welfare: Key national indicators of children’s health, development and wellbeing: indicator framework for A picture of Australia’s children 2009. Cat. no. AUS 100. Canberra: AIHW; 2008.
• [11]Australian Institute of Health and Welfare: 2010 Australian National Infant Feeding Survey: indicator results. Canberra: AIHW; 2011.
• [12]Amir LH, Donath SM: Socioeconomic status and rates of breastfeeding in Australia: evidence from three recent national health surveys. Med J Aust 2008, 189(5):254-256.
• [13]National Health Survey: Users’ Guide Cat. no. 4363.0.55.001. Canberra: Australian Bureau of Statistics; 2004.
• [14]Breastfeeding in Victoria: A Report [http://www.education.vic.gov.au/Documents/childhood/professionals/health/breastfeedvic.pdf webcite]
• [15]Maternal and Child Health Services Annual Report (2011–2012) [http://www.education.vic.gov.au/Documents/childhood/providers/support/report12.pdf webcite]
• [16]Child and Adolescent Health and Wellbeing Division, Department of Education and Early Childhood Development: Request for Quote: The Victorian Breastfeeding Research Project Phase two (RFQCHWD003). Melbourne, Australia; 2011.
• [17]Gagnon AJ, Sandall J: Individual or group antenatal education for childbirth or parenthood, or both. Cochrane Database Syst Rev 2007, 3:CD002869.
• [18]Lumbiganon P, Martis R, Laopaiboon M, Festin MR, Ho JJ, Hakimi M: Antenatal breastfeeding education for increasing breastfeeding duration. Cochrane Database Syst Rev 2012, 9:CD006425.
• [19]Dyson L, McCormick F, Renfrew MJ: Interventions for promoting the initiation of breastfeeding. Cochrane Database Syst Rev 2005, 2:CD001688.
• [20]Renfrew MJ, McCormick FM, Wade A, Quinn B, Dowswell T: Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev 2012, 5:CD001141.
• [21]Moore ER, Anderson GC, Bergman N, Dowswell T: Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev 2012, 5:CD003519.
• [22]Hoddinott P, Tappin D, Wright C: Breast feeding. BMJ 2008, 336(7649):881-887.
• [23]Duffy EP, Percival P, Kershaw E: Positive effects of an antenatal group teaching session on postnatal nipple pain, nipple trauma and breast feeding rates. Midwifery 1997, 13(4):189-196.
• [24]Forster D, McLachlan H, Lumley J, Beanland C, Waldenstrom U, Amir L: Two mid-pregnancy interventions to increase the initiation and duration of breastfeeding: a randomized controlled trial. Birth 2004, 31(3):176-182.
• [25]Rossiter JC: The effect of a culture-specific education program to promote breastfeeding among Vietnamese women in Sydney. Int J Nurs Stud 1994, 31(4):369-379.
• [26]Redman S, Watkins J, Evans L, Lloyd D: Evaluation of an Australian intervention to encourage breast feeding in primiparous women. Health Promot Int 1995, 10(2):101-113.
• [27]Maycock B, Binns CW, Dhaliwal S, Tohotoa J, Hauck Y, Burns S, Howat P: Education and support for fathers improves breastfeeding rates: a randomized controlled trial. J Hum Lact 2013, 29(4):484-490.
• [28]Hauck YL, Dimmock JE: Evaluation of an information booklet on breastfeeding duration: a clinical trial. J Adv Nurs 1994, 20:836-843.
• [29]Henderson A, Stamp G, Pincombe J: Postpartum positioning and attachment education for increasing breastfeeding: a randomized trial. Birth 2001, 28(4):236-242.
• [30]McDonald SJ, Henderson JJ, Faulkner S, Evans SF, Hagan R: Effect of an extended midwifery postnatal support programme on the duration of breast feeding: A randomised controlled trial. Midwifery 2010, 26(1):88-100.
• [31]Quinlivan JA, Box H, Evans SF: Postnatal home visits in teenage mothers: a randomised controlled trial. Lancet 2003, 361(9361):893-900.
• [32]Maternal and Child Health Service [http://www.education.vic.gov.au/childhood/professionals/health/Pages/maternalchildhealth.aspx webcite]
• [33]Maternal and Child Health Service: Practice Guidelines [http://www.education.vic.gov.au/Documents/childhood/professionals/health/mchpracticeguidelines.pdf webcite]
• [34]Maternal and Child Health Services Annual Report (2009–2010) [http://www.eduweb.vic.gov.au/edulibrary/public/earlychildhood/mch/report10annual.pdf webcite]
• [35]Ratnaike D: Baby Cafe culture. Community Pract 2008, 81(5):12-13.
• [36]Clifford J, McIntyre E: Who supports breastfeeding? Breastfeed Rev 2008, 16(2):9-19.
• [37]Hoddinott P, Craig LC, Britten J, McInnes RM: A serial qualitative interview study of infant feeding experiences: idealism meets realism. BMJ Open 2012, 2(2):e000504.
• [38]Forster D, McLachlan H, Lumley J: Factors associated with continuing to feed any breast milk at six months postpartum in a group of Australian women. Int Breastfeed J 2006, 1:18. BioMed Central Full Text
• [39]Haggkvist AP, Brantsaeter AL, Grjibovski AM, Helsing E, Meltzer HM, Haugen M: Prevalence of breast-feeding in the Norwegian Mother and Child Cohort Study and health service-related correlates of cessation of full breast-feeding. Public Health Nutr 2010, 13(12):2076-2086.
• [40]Johns HM, Forster DA, Amir LH, Moorhead AM, McEgan KM, McLachlan HL: Infant feeding practices in the first 24–48 h of life in healthy term infants. Acta Paediatr 2013, 102(7):e315-e320.
• [41]Schwartz K, D’Arcy HJS, Gillespie B, Bobo J, Longeway M, Foxman B: Factors associated with weaning in the first 3 months postpartum. J Fam Pract 2002, 51(5):439-444.
• [42]Chamberlain C, O’Mara-Eves A, Oliver S, Caird JR, Perlen SM, Eades SJ, Thomas J: Psychosocial interventions for supporting women to stop smoking in pregnancy. Cochrane Database Syst Rev 2013, 10:CD001055.
• [43]Maternal and Child Health Services Annual Report (2012–2013) [http://www.education.vic.gov.au/Documents/childhood/providers/support/Victoria%20Statewide%20Report.pdf webcite]
• [44]Microsoft Access Redmond, Washington: Microsoft Corporation; 2010.
• [45]Stata 13 College Station, Texas, USA: StataCorp LP; 2013.
• [46]Pope C, Ziebland S, Mays N: Qualitative research in health care. Analysing qualitative data. BMJ 2000, 320(7227):114-116.