Evaluation of an Australian intervention to encourage breast feeding in primiparous women

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Abstract
Breast feeding has nutritional, immunologic and antiallergic advantages for the infant. Although it has been widely recommended that infants be exclusively breast fed until 4–6 months of age, only about half of all Australian babies currently receive extended breast feeding. The present study evaluated an intensive programme designed to increase the proportion ofprimi-parous mothers who breast fed for 4 months or longer. Women who registered with the hospital at least 20 weeks before delivery and who intended to breastfeed were eligible for the study. Two hundred and thirty-five women were allocated to receive either usual care or an intensive breast feeding programme when they registered with the hospital. The intensive programme consisted of written materials, and group and individual sessions with a lactation counsellor. It also included a visit from a breastfeeding consultant while in hospital after the birth and contact on return home. Women were followed up 6 weeks and 4 months after delivery. There were no significant differences in breastfeeding rates between the control and intervention groups at either follow-up point. Breast feeding until 4 months was more likely among women whose baby did not receive a bottle feed while still in hospital and who did not smoke, use the combined oral contraceptive pill or introduce solid food before 4 months. Those mothers who enjoyed and felt satisfied with breastfeeding were more likely to continue to 4 months. It seems likely that programmes designed to increase breastfeeding will need to address underlying factors such as hospital policy rather than simply providing more health education.

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