Abstract
BackgroundAs suggested by the World Health Organization, breastfeeding peer support is being introduced worldwide to support women’s breastfeeding needs. Evidence has shown that when such support is offered to women, the duration and exclusivity of breastfeeding is increased. We developed an innovative home-based intervention to sustain exclusive breastfeeding in Hong Kong. However, potential barriers must be addressed before a full randomised controlled trial (RCT) is conducted. The aim of this study was to determine the feasibility of a breastfeeding support programme with home-based visits from peer supporters over a six month period among postpartum Chinese women in Hong Kong.MethodsWe conducted a feasibility and pilot randomised controlled trial. Twenty primiparous women intending to breastfeed their healthy term singleton infant were recruited from a hospital in Kowloon, Hong Kong between February and March 2019. Participants were randomly allocated to the intervention or control group. Participants in the intervention group received five home-based visits with a peer supporter over a six month period, as well as standard care, whereas participants in the control group received standard care only. We assessed feasibility, compliance, and acceptability of the breastfeeding peer support programme. Other outcomes assessed were breastfeeding self-efficacy, duration, and exclusivity.ResultsIt was feasible to recruit and train existing peer supporters, and peer supporters were able to deliver the intervention, which was acceptable to women, but rates of stopping the intervention and loss to follow-up were high. There was higher retention seen within the first month. Women interviewed at the end of the study reported that the intervention was positive. The cessation risk of any, and exclusive breastfeeding were not statistically different between the intervention and control groups.ConclusionsThis study provided valuable information on feasibility of the trial design and intervention. Modifications to the intervention, such as targeting women with lower breastfeeding self-efficacy, or combining home visits with technology and telephone follow-up may be more appropriate in a larger trial. Implementing the programme early during the antenatal phase and tailoring peer support to most appropriately sustain exclusive breastfeeding and other feeding modes should be incorporated in a future home-based peer support arm.Trial registrationNCT03705494 on 15 Oct 2018.
Highlights
As suggested by the World Health Organization, breastfeeding peer support is being introduced worldwide to support women’s breastfeeding needs
Feasibility of recruitment Participant recruitment began in February 2019; the final participant was randomised in March 2019, and the final follow-up outcome measurement completed in September 2019
Reasons for stopping the intervention included the husband disagreeing with home visits, weaning and stopping home visits, and participants feeling pressured to breastfeed from peer supporters
Summary
As suggested by the World Health Organization, breastfeeding peer support is being introduced worldwide to support women’s breastfeeding needs. The aim of this study was to determine the feasibility of a breastfeeding support programme with home-based visits from peer supporters over a six month period among postpartum Chinese women in Hong Kong. Despite the importance of exclusive breastfeeding for the first six months postpartum, the maintenance of exclusive breastfeeding remains a major public health issue. This is true in Hong Kong where there is a high drop off rate in exclusive breastfeeding during the first two months following birth and low proportion of infants exclusively breastfed for the first 4–6 months [4]. Home visits during the first few days after birth by healthcare professionals or trained support workers could offer opportunities to assess the woman and newborn and provide health education, infant feeding support, and emotional and practical support
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