Antenatal Education to Increase Exclusive Breastfeeding: A Randomized Controlled Trial

Objective: To evaluate the effectiveness of a professional one-to-one antenatal breastfeeding support and education intervention on the exclusivity and duration of breastfeeding.

Methods:  A total of 469 primiparous women who attended the antenatal clinics of two geographically distributed public hospitals in Hong Kong were randomized to receive either standard antenatal care or a one-to-one antenatal breastfeeding support and education session. The primary outcome was the prevalence of exclusive breastfeeding at 6 weeks postpartum. Secondary outcomes were the prevalence of exclusive breastfeeding at 3 and 6 months postpartum, as well as the overall duration of any and exclusive breastfeeding across the first 6 months postpartum.

Results: The exclusive breastfeeding rate in the intervention group was 37.8% at 6 weeks postpartum compared with 36.4% in the standard care group (p=0.77; 95% confidence interval (CI) -0.08, 0.11). There were no significant differences between the two treatment groups in exclusive breastfeeding rates at 3 and 6 months or in the overall duration of any (hazard ratio (HR) =1.11; 95% CI 0.88, 1.40) or exclusive breastfeeding (HR=0.96; 95% CI 0.79, 1.17). The study had a least 80% power to detect a 50% increase in the rate of exclusive breastfeeding at 6 weeks postpartum.

Conclusion: In a setting with a high breastfeeding initiation rate, one-to-one antenatal breastfeeding support and education did not increase the exclusivity or duration of breastfeeding.

Clinical Trial Registration: www.clinicaltrials.gov,  NCT01648114.