Abstract
This study aimed to evaluate the impact of peer counselling on early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) rates for mother–infant pairs living in urban slums, Dhaka, Bangladesh. This randomized controlled trial enrolled 350 mother–infant pairs from selected slums between September 2014 and July 2016. The women assigned to intervention group received peer counselling from locally recruited, trained community female volunteers starting in third trimester of pregnancy until 6 months after delivery; control group received no intervention. EIBF, any liquids given after birth, and EBF were compared between groups. Follow‐up was scheduled at enrolment, following childbirth, and every 2 months up to 6 months after delivery. Multiple logistic regressions were used to assess the effect peer counselling and other associated factors on EIBF and EBF practices. EIBF rate was higher in the intervention group than in the control group (89.1% vs. 77.4%, p = .005). More mothers in intervention group were exclusively breastfeeding at 5 months than mothers in the control group (73% vs. 27%, p < .005). Control mothers were twice as likely to not practice EIBF compared with intervention mothers (adjusted odds risk [aOR]: 2.53, CI [1.29, 4.97], p = .007). Overall, caesarean section was associated with an 8.9‐fold higher risk of not achieving EIBF (aOR: 8.90, CI [4.05, 19.55], p < .001). Intervention mothers were 5.10‐fold more likely to practice EBF compared with control mothers (aOR: 5.10, CI [2.89, 9.01], p < .001) at 5 months. This study demonstrates peer counselling can positively influence both EIBF and EBF among mothers living in urban area.
Highlights
A significantly higher proportion of mothers in the intervention group reported early initiation of breastfeeding (EIBF) compared with the control group (89.1% vs. 77.4%, p = .005)
This study provides evidence that peer counselling positively influences EIBF and exclusive breastfeeding (EBF) practices among mothers living in an urban slum
We found that the rate of EIBF in the intervention group was 89.1%, which is higher than the values reported for studies in Pakistan and India, but lower than that in Nepal (Khanal, Scott, Lee, Karkee, & Binns, 2015; Patel et al, 2015; Zafar, Fatmi, & Shafi, 2014)
Summary
Are among infants in the developing world, mainly from preventable causes, and approximately half occur in the home. An increased risk of inappropriate child feeding practices has been reported among the rapidly growing slum populations in urban areas (Kumar, Nath, & Reddaiah, 1989), as many of these families lack the traditional support of the joint. We undertook a randomized controlled trial (RCT) to examine whether peer counselling can improve EIBF and EBF practices in an urban slum in Dhaka, Bangladesh. This prospective, RCT to examine the impact of peer counselling— starting in the third trimester of pregnancy and continuing until 6 months after delivery—on infant feeding practices was approved by the local ethics committee and registered at clinicaltrials.gov as NCT03040375 (last updated: January 31, 2017). Local pharmacies are the most widely known health care facilities in Mirpur (Abul Barkat, Mahiyuddin, Poddar, Hossain, & Ahmed, 2015)
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