A midwife-led antenatal breastfeeding education intervention for primiparous women to increase predominant breastfeeding rates at one, three, and six months after birth in Thailand: a pilot randomised controlled trial
|Institution:||University of Newcastle|
|Keywords:||antenatal; education; predominant breastfeeding; primiparous women; midwife-led; randomised controlled trial|
|Full text PDF:||http://hdl.handle.net/1959.13/1060175|
Research Doctorate - Doctor of Philosophy (PhD) Aim: To design and test the effectiveness of a midwife-led antenatal breastfeeding education program in increasing the rate of predominant breastfeeding at one, three, and six months after the birth of the baby. Design: A pilot randomised controlled trial. Setting: A tertiary hospital and a secondary hospital in Northern Thailand. Participants Sixty three low-risk primiparous women between 24 and 29 weeks gestation randomized to intervention and control groups. Of these, 10 were lost to follow up and 53 remained in the study, and intention to treat analysis was used to evaluate the effectiveness of the intervention. Main outcome measures: Primary outcome was predominant breastfeeding at one, three, and six months after birth. Secondary outcomes were: 1) Breastfeeding initiation, 2) Perceived breastfeeding self-efficacy, 3) Perceived breastfeeding support, 4) Breastfeeding intention and 5) Evaluation of the breastfeeding program (the intervention). Results: All women who attended the breastfeeding educational program were satisfied with it, and considered that it was beneficial. Women in the intervention group had a very high breastfeeding initiation rate (95%), and sustained a higher rate at three months than the initial breastfeeding rate in the control group (77%); however, this diminished rapidly between three (81%) and six months (41%). In contrast, women in the control group had a lower breastfeeding initiation rate that diminished rapidly in the first three months, and then more slowly between three (54%) and six months (46%). The difference between the intervention and control groups was significant at three months (p = 0.0204), and the odds of predominant breastfeeding was significantly higher in the intervention group (3.7 times) than in the control group. Conclusions: A Midwife-led antenatal breastfeeding educational intervention based in hospital for primiparous women significantly improved the rate of predominant breastfeeding at three months after birth. The study is useful in this context, and there is potential to use these results to inform the design of a major trial.