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Randomized Controlled Trial
. 2014 Feb;104 Suppl 1(Suppl 1):S119-27.
doi: 10.2105/AJPH.2013.301360. Epub 2013 Dec 19.

Effect of primary care intervention on breastfeeding duration and intensity

Karen Bonuck  1 , Alison Stuebe, Josephine Barnett, Miriam H Labbok, Jason Fletcher, Peter S Bernstein
Affiliations
Randomized Controlled Trial

Effect of primary care intervention on breastfeeding duration and intensity

Karen Bonuck et al. Am J Public Health. 2014 Feb.

Abstract

Objectives: We determined the effectiveness of primary care-based, and pre- and postnatal interventions to increase breastfeeding.

Methods: We conducted 2 trials at obstetrics and gynecology practices in the Bronx, New York, from 2008 to 2011. The Provider Approaches to Improved Rates of Infant Nutrition & Growth Study (PAIRINGS) had 2 arms: usual care versus pre- and postnatal visits with a lactation consultant (LC) and electronically prompted guidance from prenatal care providers (EP). The Best Infant Nutrition for Good Outcomes (BINGO) study had 4 arms: usual care, LC alone, EP alone, or LC+EP.

Results: In BINGO at 3 months, high intensity was greater for the LC+EP (odds ratio [OR] = 2.72; 95% confidence interval [CI] = 1.08, 6.84) and LC (OR = 3.22; 95% CI = 1.14, 9.09) groups versus usual care, but not for the EP group alone. In PAIRINGS at 3 months, intervention rates exceeded usual care (OR = 2.86; 95% CI = 1.21, 6.76); the number needed to treat to prevent 1 dyad from nonexclusive breastfeeding at 3 months was 10.3 (95% CI = 5.6, 50.7).

Conclusions: LCs integrated into routine care alone and combined with EP guidance from prenatal care providers increased breastfeeding intensity at 3 months postpartum.

Trial registration: ClinicalTrials.gov NCT00619632 NCT00643253.

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