Breastfeeding Support in the Early Postpartum: Content of Home Visits in the SILC Trial.

Lael Ridgway,Touran Shafiei,Méabh Cullinane,Helen L Mclachlan,Rhian Cramer,Lisa H Amir,Della A Forster

doi:10.1111/birt.12241

Lael Ridgway, Touran Shafiei + Show 5 more

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https://doi.org/10.1111/birt.12241

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Abstract

BackgroundThe Supporting breastfeeding In Local Communities (SILC) cluster randomized controlled trial evaluated whether a home visit focussed on infant feeding early in the postpartum period increased the percentage of infants breastfeeding at 4 months in low socioeconomic areas of Victoria, Australia. The visits were offered to women identified as at risk of early breastfeeding cessation after discharge home with a new baby. This paper describes the content of the home visits.MethodsSILC visited 1,043 women from September 2012 to March 2013, and completed a data sheet for each visit documenting topics discussed, as well as what support and resources were offered. Frequencies and percentages are presented.ResultsHome visits most commonly included the provision of reassurance to women (91%). Topics discussed included general breastfeeding information (83%), supply and demand (83%), positioning (79%), and feeding frequency (78%). Newborn feeding/behavior (57%), expression of breastmilk (54%), nipple pain (41%), low breastmilk supply (41%), and the use of nipple shields (18%) were also prominent topics. The issues and support needs of women were similar across locations (rural, regional or metropolitan) and regardless of maternal parity or age. There was some variation in the resources suggested in different localities.ConclusionsNew mothers require help and reassurance independent of whether this is their first or subsequent child, reinforcing the need for support, breastfeeding information, and education about normal neonatal behavior. Key aspects of support are reassurance, normalization of infant behavior, and education.

Highlights

The Supporting breastfeeding In Local Communities (SILC) cluster randomized controlled trial evaluated whether a home visit focussed on infant feeding early in the postpartum period increased the percentage of infants breastfeeding at 4 months in low socioeconomic areas of Victoria, Australia
Previous studies have largely focussed on women who themselves seek breastfeeding support services [14,15,16]. These women are more likely to have a strong desire to breastfeed and have the confidence and motivation to overcome any issues encountered [17,18]. Because these SILC home visits were proactive and preventative, conducted in women’s own homes and offered to all women identified as at risk of early cessation of breastfeeding, this paper addresses a gap in the literature by including a wider population of breastfeeding mothers, instead of only those who are motivated to seek out help independently
The SILC home visit data indicate that the SILC-Maternal and Child Health Nurses (MCHNs) provided breastfeeding support and reassurance in the early postpartum period to the majority of women they visited, irrespective of whether this was their first or subsequent child

Summary

Introduction

The Supporting breastfeeding In Local Communities (SILC) cluster randomized controlled trial evaluated whether a home visit focussed on infant feeding early in the postpartum period increased the percentage of infants breastfeeding at 4 months in low socioeconomic areas of Victoria, Australia. The visits were offered to women identified as at risk of early breastfeeding cessation after discharge home with a new baby. Methods: SILC visited 1,043 women from September 2012 to March 2013, and completed a data sheet for each visit documenting topics discussed, as well as what support and resources were offered. Results: Home visits most commonly included the provision of reassurance to women (91%). Topics discussed included general breastfeeding information (83%), supply and demand (83%), positioning (79%), and feeding frequency (78%). Conclusions: New mothers require help and reassurance independent of whether this is their first or subsequent child, reinforcing the need for support, breastfeeding information, and education about normal neonatal behavior. Key aspects of support are reassurance, normalization of infant behavior, and education. (BIRTH 43:4 December 2016)

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