Can early postpartum home visits by trained community health workers improve breastfeeding of newborns?

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Abstract
Objective: Whether postpartum visits by trained community health workers (CHWs), reduce newborn breastfeeding problems. Method: Community health workers made antenatal and postpartum home visits promoting newborn care practices including breastfeeding. CHWs assessed neonates for adequacy of breastfeeding and provided hands-on support to mothers to establish breastfeeding. History and observation data of 3495 neonates were analyzed to assess effects of CHW visitation on feeding problems. Result: Inappropriate breastfeeding position and attachment were the predominant problems (12 to 15%). Only 6% of newborns who received home visit by CHWs within 3 days had feeding difficulties, compared to 34% of those who did not (odds ratio: 7.66, 95% confidence interval (CI): 6.03 to 9.71, P=0.00). Latter group was 11.4 times (95% CI: 6.7 to 19.3, P=0.00) more likely to have feeding problems as late as days 6 to 7, than the former. Conclusion: Counseling and hands-on support on breastfeeding techniques by trained workers within first 3 days of birth, should be part of community-based postpartum interventions.