An interventional study of implementation of the Baby-Friendly Hospital Initiative and BFHI steps 1-9 +well-child clinic in Breastfeeding, sponsored by University of North Carolina, Chapel Hill. Completed at 1 site in Congo. Open to participants aged Up to 3 Days, including healthy volunteers. Per ClinicalTrials.gov, last updated 2017-04-25.
Sponsored by University of North Carolina, Chapel Hill · Not applicable, Interventional, and Other
A cluster-randomized controlled trial will be conducted in the Democratic Republic of Congo to compare rates of early initiation and exclusive breastfeeding between mothers who give birth in hospitals with the current standard of care, mothers who give birth in hospitals that have implemented the first nine steps of the Baby-Friendly Hospital Initiative, and mothers who give birth in hospitals that have implemented all ten steps of the Baby-Friendly Hospital Initiative, with the 10th step being the provision of breastfeeding support during well-child clinic visits.
If at least 90% of children were exclusively breastfed for the first 6-months of life, the potential reduction in mortality that can be achieved will be higher than for any other interventions with sufficient evidence of effect. In the DRC >500,000 under-five deaths occurred in 2008. While >95% of children were breastfed at some point, 18% received something other than breast milk before initiation of breastfeeding, and half received something other than human milk by 1.4 months. Pre- and post-partum breastfeeding support has been shown to best improve the rate of exclusive breastfeeding (EBF). The global initiatives to improve breastfeeding practices have focused on maternity-level policies and procedures known as the Ten Steps to Successful Breastfeeding, which served as the basis for the Baby-Friendly Hospital Initiative. These quality of care steps impact hospital breastfeeding rates as well as breastfeeding rates throughout the 6 months postpartum period. However, EBF rates fall off rapidly in the DRC. In the proposed cluster randomized controlled trial, we plan to evaluate the effect of breastfeeding support provided by well-child clinic staff including the use of culturally appropriate messages in addition to the implementation of BFHI steps 1-9 Steps in maternities on the rate of breastfeeding initiation within 1 hour of birth and EBF throughout 6 months postpartum. If effective, this approach has great potential for scale up where most needed.
Exclusion Criteria:
Hospital retrained in BFHI steps 1-9 Mothers can call hospital to obtain BF support/Mothers given phone # of maternity nurse whom she can call or go see if she has BF problems
Other: implementation of the Baby-Friendly Hospital Initiative
Hospital retrained in BFHI steps 1-9 Mothers can call hospital to obtain BF support/Mothers given phone # of maternity nurse whom she can call or go see if she has BF problems Provision of BF support during 1) clinic visit to obtain birth certificate or home visit if mother does not come into clinic and 2) well-child clinics Flyers to mother with culturally appropriate messages designed to address some of the most important local barrier to EBF
Other: BFHI steps 1-9 +well-child clinic
Implementation of BFHI steps 1-9 in maternities
Implementation of BFHI steps 1-9 in maternities and provision of breastfeeding support including culturally appropriate educational messages and metaphors as the ongoing aspect of step 10 in well-child clinic
Early initiation of breastfeeding
initiation of breastfeeding within one hour of birth
Time frame: Within 1 hour of birth
Exclusive breastfeeding rate
Infants will be classified as exclusively breastfed if they received only breast milk (no water, other liquids, or solids)
Time frame: up to 6 months after birth
Episodes of diarrhea
Time frame: in the first 6 months of life
Episodes of Lower Respiratory Track Infection
Time frame: in the first 6 months of life
Partial Breastfeeding rate
Time frame: up to 6 months after birth
Number of hospitalization
Time frame: in the first 6 months of life
Number of mothers seeking breastfeeding help
Time frame: in the first 6 months of life
Amount and type of breastfeeding support given by Health care provider to mothers
Time frame: in the first 6 months after birth
This study is completed, as verified in Jan 2017. You cannot join it, but the record below documents what was studied.
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University of North Carolina, Chapel Hill