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Randomized trial of breastfeeding support in very low-birth-weight infants
J Pinelli1, S A Atkinson, S Saigal
1Msc, DNS, Faculty of Health Sciences, Room 3N25D, McMaster University, 1200 Main St W, Hamilton, Ontario L8N 3Z5, Canada. pinellij@fhs.mcmaster.ca
Insights
Structured breastfeeding counseling did not significantly extend breastfeeding duration in very low-birth-weight infants. However, a trend towards longer breastfeeding in preterm infants was observed, suggesting high parental motivation and community support may influence outcomes.
Area of Science:
- Neonatal care
- Pediatric nutrition
- Public health interventions
Background:
- Breastfeeding is crucial for infant health, especially for very low-birth-weight infants.
- Optimizing breastfeeding support in neonatal intensive care units (NICUs) is essential.
- Limited data exists on the long-term impact of structured parental counseling on breastfeeding duration in this vulnerable population.
Purpose of the Study:
- To evaluate the efficacy of supplementary structured breastfeeding counseling (SSBC) for parents of very low-birth-weight infants.
- To compare SSBC with conventional hospital breastfeeding support (CHBS) in extending breastfeeding duration up to one year.
- To identify factors influencing breastfeeding success in preterm infants.
Main Methods:
- A randomized trial was conducted in a tertiary NICU in Ontario, Canada.
- Parents of infants with birth weight <1500g planning to breastfeed were enrolled.
- The SSBC group received intensive, long-term counseling, while the CHBS group received standard hospital support.
Main Results:
- No statistically significant difference in the mean duration of breastfeeding was found between the SSBC (26.1 weeks) and CHBS (24.0 weeks) groups.
- Demographic characteristics were similar between the two groups at study entry.
- Breastfeeding duration was not significantly improved by the intensive intervention.
Conclusions:
- Intensive, long-term breastfeeding counseling did not significantly increase breastfeeding duration in very low-birth-weight infants.
- High parental motivation and community resources may have influenced outcomes, potentially masking intervention effects.
- A trend towards longer breastfeeding duration in preterm infants suggests improving outcomes in this population.
Objective:
To determine if supplementary structured breastfeeding counseling (SSBC) for both parents compared with conventional hospital breastfeeding support (CHBS) improves the duration of breastfeeding in very low-birth-weight infants up to 1 year old.
Design:
Randomized trial with longitudinal follow-up of infants at term, and ages 1, 3, 6, and 12 months (infant ages corrected for prematurity).
Setting:
A tertiary-level neonatal intensive care unit (NICU) and geographically defined region in central-west Ontario, Canada.
Participants:
Parents of infants with a birth weight less than 1500 g, who planned to breastfeed.
Interventions:
The SSBC consisted of viewing a video on breastfeeding for preterm infants; individual counseling by the research lactation consultant; weekly personal contact in the hospital; and frequent postdischarge contact through the infants' first year or until breastfeeding was discontinued. The CHBS group had standard breastfeeding support from regular staff members confined to the period of hospitalization in the NICU.
Main Outcome Measure:
Duration of breastfeeding.
Results:
At study entry, there were no statistically significant differences in major demographic characteristics between groups. The mean duration of breastfeeding was 26.1 weeks (SD = 20.8; median, 17.4) in the SSBC group and 24.0 weeks (SD = 20.5; median, 17.4) in the CHBS group (not statistically significant).
Conclusions:
Long-term breastfeeding counseling of parents of very low-birth-weight infants in this study did not demonstrate a significant difference in duration of breastfeeding. These results may be explained by the high motivation to breastfeed in both groups, a relatively advantaged population, and the availability of community breastfeeding resources, which may have diminished any significant differences that could have resulted from a breastfeeding intervention. The results of this study, compared with previous studies of very low-birth-weight infants, indicate a new trend to longer duration of breastfeeding in preterm infants.