Are 2 weeks of daily breastfeeding support insufficient to overcome the influences of formula?

Acad Pediatr. Jan-Feb 2010;10(1):21-8. doi: 10.1016/j.acap.2009.09.014.

Abstract

Objective: To evaluate the effectiveness of proactive telephone breastfeeding support in low-income, primiparous, primarily Latina women on 1) duration and exclusivity of breastfeeding, 2) satisfaction with feeding, 3) rationale for discontinuing breastfeeding and 4) health care utilization.

Methods: Randomized controlled trial comparing usual care to 2 weeks of daily telephone calls by nurses by using culturally informed scripted protocols; and qualitative study of focused interviews on a sample of women in the intervention group (n = 40).

Results: Breastfeeding duration and exclusivity rates, feeding method satisfaction, and reasons for stopping breastfeeding did not differ significantly between intervention (n = 161) and control (n = 180) groups, with 74% of both breastfeeding at 1 month and 28% and 37%, respectively, at 6 months. Insufficient milk supply was the main reason for stopping in both groups. Intervention infants were less likely to have a sick visit by 1 month (25%) than controls (35%, P = .05). Qualitative interviews revealed that the intervention was informative and helpful, with breastfeeding reported as healthier but harder; formula was a good alternative. Intervention mothers reporting < or =2 supplemental formula feedings on day 4 were more likely than mothers reporting > or =3 supplemental feedings to breastfeed at 1 month (odds ratio 7.7; 95% confidence interval 2.4-24.3).

Conclusions: Two weeks of daily telephone support did not increase breastfeeding duration but was associated with a decrease in sick visits in the first month. Early supplementation and the perception of formula as a good alternative to dealing with the breastfeeding difficulties appeared to be factors in failure of the intervention.

Trial registration: ClinicalTrials.gov NCT00717496.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Breast Feeding / psychology*
  • Breast Feeding / statistics & numerical data*
  • Colorado
  • Female
  • Health Promotion / methods*
  • Hispanic Americans / psychology
  • Hispanic Americans / statistics & numerical data*
  • Humans
  • Infant
  • Infant Formula
  • Infant, Newborn
  • Interviews as Topic
  • Logistic Models
  • Mothers / psychology
  • Poverty
  • Primary Health Care / statistics & numerical data
  • Social Support*
  • Telephone
  • Time Factors
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT00717496