Impact of family level counselling on breast feeding practices and weight gain: a community based cluster randomized controlled trial
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20160438Keywords:
Child growth, Exclusive breastfeeding, Breastfeeding initiation, Pre-lacteal feeds, Continuation of breastfeeding, Frequency of breastfeedingAbstract
Background: Objective of the study was to assess the effectiveness of the family level counseling to mothers on breastfeeding practices and weight gain in children.
Methods:A community based cluster randomized controlled trial was conducted in Udupi District in Karnataka State, South India. All the children born to pregnant mothers registered in the third trimester were followed until 2 years of age in selected Anganwadi (AW) centres.
Results: Baseline characteristics of the subjects were found to be similar in both intervention and control groups. The baseline knowledge assessed on a 15-point scale showed similar mean score in both groups. Mean measured weight increased significantly in the intervention group (0.794 kg, p < 0.002) at 24 months of age. At 24 months more babies in intervention group were receiving breastfeeding than control group (68.6 % vs. 14.7 %, 95 % CI 2.01 – 10.80, and p < 0.001). Frequency of breast feeding at 4 months was 77.1 % in intervention and 57.8 % in control group (p < 0.0001) while at 6 months it was 77.1 % in intervention and 33.3 % in control group (p < 0.0001). The breastfeeding position assessed on a ten-point scale showed mothers in intervention group followed more than 7 correct positions than control group at birth, 4 months and 6 months of age (p < 0.001).
Conclusions:The study shows promotion of child nutrition and breastfeeding practices in developing countries through family level counselling (IYCF strategy) will improve the nutritional status of children less than 2 years of age.
References
Shariff A, Farsana C. Breast-feeding practices, beliefs and taboos in Karnataka. The Indian Journal of Social Work. 1990;1:141-8.
World Health Organization. Breast feeding, Nutrition update - 2003- 2004. Available from: www.who.in. Accessed on 2005 July 22.
Singh R, Kumar OA, Rana RS. Breast feeding and weaning practices among Urban Muslims of District Luknow. Indian Pediatrics. 1991;23:217-8.
World Health Organization /UNICEF-Breastfeeding and Complementary feeding. www.who.in Nutrition Availed on 23/08/2005.
Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS. How many child deaths can we prevent this year? Lancet. 2003;362:65-71.
National Guidelines on Infant and Young Child Feeding. Ministry of Women and Child Development (Food and Nutrition Board) Government of India, 2006.
World Health Organization-Global strategy for infant and Young child feeding IYCF. 2003.
Jakobsen MS, Sodemann M, Biai S, Nielson J, Aaby P. Promotion of exclusive breastfeeding is not likely to be cost effective in West Africa. A randomized intervention study from Guinea-Bissau. Acta Paediatrica. 2008;97:68-75.
Michael S. Kramer, Ritsuko Kakuma The optimal duration of exclusive breastfeeding: a systematic review. Adv Exp Med Biol. 2004;554:63-77
Bhandari N, Bahl R, Mazumdar S, Martines J, Black RE, Bhan MK. Effect of community-based promotion of exclusive breast feeding on diarrhoeal illness and growth: a cluster randomized controlled trial. The Lancet. 2003;361(5):1418-23.
Nayak DS, Nagaraj K, Bhat Vonod. Risk factors of child malnutrition in Udupi district, a community based cross sectional study.
Formative Research: Skills and Practice for Infant and Young Child Feeding and Maternal Nutrition. Manual by AFD/LINKAGES India 17.Poorvi Marg, Vasant Vihar. New Delhi-110057, India.
Behavior Change Communication for Improved Infant Feeding – Training of Trainers for Negotiating Sustainable Behavior Change – Linkage Project –Updated March 2004. Accessed on 14/03/2006.
Campbell MK, Mollison J, Steen N. Analysis of cluster randomized trials in primary care: a practical approach, Family Practice. 2000;17:192-6.
Cluster randomized trials: Methodological and ethical considerations MRC clinical trials series, Medical Research Council; November 2002.
Onyango AW, Esrey SA, Kramer MS. Continued breastfeeding and child growth in the second year of life: A prospective cohort study in Western Kenya. The Lancet. 1999;354:2041-5.
Mehta MJ, Betkerur. A study of growth pattern in the first year of life in Surat (South Gujarat). Indian Journal of Pediatrics. 1973;40:235-339.
Chandrashekar S, Chakladar BK, Rao RSP, Infant feeding-knowledge and attitude in a rural area of Karnataka. Indian Journal of Pediatrics. 1995;62.
Haider R, Ashworth A, Kabir I, Huttly SRA. Effect of community- based peer councelling on exclusive breastfeeding practices in Dhaka, Bangladesh: a randomized controlled trial. The Lancet. 2000;356:1643-7.
Agarwal RK. Importance of Optimal Infant and Young Child Feeding (IYCF) in Achieving Millennium Goals. Indian Pediatrics. 2008;45:719-21.
Cynthia P Green Interventions to Improve Breastfeeding Behaviors: Detailed Summaries of 51 Studies 199 http://www.linkagesproject.org.
Lassi ZS, Haider B, Bhutta Z. Community-Based Intervention Packages for Reducing Maternal and Neonatal Morbidity and Mortality and Improving Neonatal Outcomes. Cochrane Database of Systematic Reviews. 2010;10(11):CD007754.
Chandrashekhar TS, Joshi HS, Binu VS, Shankar PR, Rana MS, Ramachandran U. Breastfeeding initiation and determinants of exclusive breast- feeding – a questionnaire survey in an population of Western Nepal. Public Health Nutr. 2007;10(2):192-7.
Kumar D, Goel NK, Kalia M, Swami HM, Singh R. Gap Between Awareness and Practices Regarding Maternal and Child Health among Women in an Urban Slum Community. Indian Journal of Pediatrics. 2008;75:455-8.
Haroon S, Das JK, Salam RA, Imad A, Butta ZA. Breastfeeding promotion interventions and breastfeeding practices: a systematic review. BMC Public Health. 2013;13(Suppl 3):S20.
Michael SK, Beverley C, Ellen DH, Zinaida S, Irina D, Stanley S, et al. Promotion of Breastfeeding Intervention Trial (PROBIT) A Randomized Trial in the Republic of Belarus, JAMA. 2001;285(4):413-20.
Valdes V, Perez A, Labbok M, Pugin E, Zambrano I, Catalan S. The impact of a hospital and clinic-based breastfeeding promotion programme in a middle class urban environment. J Trop Pediatr. 1993;39(3):142-51.
Sinha A, Kumar AR. Infant Growth in Relation to Feeding Practices in Low income Families. Indian Pediatrics. 1991;28:57-64.
Banapurmath CR, Nagaraj MC, Banapurmath S, Kesaree N. Breast feeding practices in villages of central, Karnataka. Indian Pediatrics. 1996;33:477-9.
Onayade AA, Abiona TC, Abayomi IO, Makanjuola.RO. The first six month growth and illness of exclusively and non-exclusively breast fed infants in Nigeria. East Afr. Med J. 2004;81(3):146-53.
Hassan J, Khan Z, Sinha SN. Socio-Cultural factors influencing nutritional status of infants-a longitudinal study. Indian J. Maternal and child Health. 1991;2(3):84-6.
Lala VR, Desai AB. Feeding of newborns and infants (cultural aspect). Pediatric Clinics of India. 1970;191-7.
Deshpande SG, Zodpey SP, Vasudev ND. Infant feeding practices in a tribal community of Melgaht region in Maharastra State. Indian Journal of Medical Sciences. 1996;50(1):4-8.
Singh MB, Haldiya KR, Lakshminarayana J. Infant feeding and weaning practices in some semi-arid rural areas of Rajasthan. J Indian Med Assoc. 1997;95(11):576-8.
Kulsoom U, Saeed A. Breastfeeding Practices and beliefs about weaning among mothers of infants aged 0 to 12 months. J Pak Med. Assoc. 1997;47(2):54-60.
Katiyar GP, A-19. Katiyar G.P, Agarwal. D.K, Tripathi. A.M, Agarwal KN. Feeding practices in Varanasi District. Indian Pediatrics. 1981;18(1):65-70.
WHO UNICEF, Innocenti Declaration on the Protection, Promotion, and Support of Breastfeeding 1990.http://www.unicef.org/programme/breastfeeding/innocenti.htm
Anne M, Alicia D, Anne E, Michelle Q, Rebecca BS, Timothy JT Prepared by the AAFP Breastfeeding Advisory Committee, 2014 Breastfeeding, Family Physicians Supporting. Accessed on 06-01-2015.
Delgado C, Matijasevich A. Breastfeeding up to two years of age or beyond and its influence on child growth and development: a systematic review. Cad Saude Publica. 2013;29(2):243-56.