Effect of community-based peer counsellors on exclusive breastfeeding practices in Dhaka, Bangladesh: a randomised controlled trial
Effect of community-based peer counsellors on exclusive breastfeeding practices in Dhaka, Bangladesh: a randomised controlled trial
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DOI：
10.1016/s0140-6736(00)03159-7
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发表时间：
2000-11-11
期刊：
影响因子：
168.9
通讯作者：
Huttly, SRA
中科院分区：
文献类型：
--
作者：
Haider, R;Ashworth, A;Huttly, SRA
在孟加拉国，大多数母亲母乳喂养，但很少实行纯母乳喂养。以医院为基础的母乳喂养推广战略无法触及她们，因为约95%的妇女在家分娩。我们假设，经过培训的同伴辅导员的干预，母亲可以使母乳喂养完全为推荐的持续时间为5 months.Methods在达卡的40个相邻区域随机干预或对照组。妇女在1996年2月至12月的妊娠最后三个月期间入组。在干预组中，安排了15次家庭咨询访问，其中两次在最后三个月，三次在产后早期（48小时内，第5天，第10天和第14天之间），此后每两周一次，直到婴儿5个月大。同伴辅导员是当地的母亲谁接受了10天的training.Findings 363名妇女参加了每一组。同伴咨询大大改善了母乳喂养的做法。对于主要结局，干预组5个月时纯母乳喂养的患病率为202/228（70%），对照组为17/285（6%）（差异=64%; 95%CI 57%-71%，p>0.0001）。对于次要结果，干预组的母亲比对照组的母亲更早开始母乳喂养，并且不太可能提供乳前和乳后食物。在第4天，显着更多的母亲在干预组纯母乳喂养比controls.Interpretation同行辅导员可以有效地增加纯母乳喂养的开始和持续时间。我们建议在发展中国家的母亲和儿童保健方案中纳入同侪顾问。
Background Most mothers breastfeed in Bangladesh, but they rarely practise exclusive breastfeeding. Hospital-based strategies for breastfeeding promotion cannot reach them because about 95% have home deliveries. We postulated that with the intervention of trained peer counsellors, mothers could be enabled to breastfeed exclusively for the recommended duration of 5 months.Methods 40 adjacent zones in Dhaka were randomised to intervention or control groups. Women were enrolled during the last trimester of pregnancy between February and December, 1996. In the intervention group, 15 home-based counselling visits were scheduled, with two visits in the last trimester, three early postpartum (within 48 h, on day 5, between days 10 and 14), and fortnightly thereafter until the infant was 5 months old. Peer counsellors were local mothers who received 10 days' training.Findings 363 women were enrolled in each group. Peer counselling significantly improved breastfeeding practices. For the primary outcome, the prevalence of exclusive breastfeeding at 5 months was 202/228 (70%) for the intervention group and 17/285 (6%) for the control group (difference=64%; 95% CI 57%-71%, p>0.0001). For the secondary outcomes, mothers in the intervention group initiated breastfeeding earlier than control mothers and were less likely to give prelacteal and postlacteal foods. At day 4, significantly more mothers in the intervention group breastfed exclusively than controls.Interpretation Peer counsellors can effectively increase the initiation and duration of exclusive breastfeeding. We recommend incorporation of peer counsellors in mother and child health programmes in developing countries.