The RIING Project "Infant Feeding Practices"

RANDOMIZED CONTROLLED TRIAL FOR EXCLUSIVE BREASTFEEDING (GHANA)-Preliminary results
B. Chinebuah-Aidam (Univ. of Connecticut), R. Pérez Escamilla Ph. D. (Univ. of Connecticut), & A. Lartey PhD (Univ. of Ghana)

Infant feeding practices of mothers is an important determinant of children’s nutritional status. In Ghana, breastfeeding is near universal although exclusive breastfeeding to 6 months is still low.

The objectives of this study were to assess the effect of lactation peer counseling on rates of exclusive breastfeeding (EBF) at different time points and to determine stages at which counseling and support for EBF are most critical (i.e., is pre-natal needed?)

The study design was a randomized control trial in 2 health institutions in Tema (Tema General, and Narh-Bita hospital). Subjects were 136 mother-infant pairs randomly allocated to 1 of 3 groups within institutions. The pregnant women in the last trimester of gestation must have been planning to deliver at selected health institutions and planning to live close by for at least 6 months after delivery. Also, all newborns were full term and had a normal birth weight (>2.5 kg). Children were free of any medical conditions or treatments making any breastfeeding or EBF difficult or inadvisable.

Study groups

Intervention Group 1: Provided with EBF promotion consistent with WHO recommendations pre- and post-natally
Intervention group 2: Provided with support for EBF post-natally
Control group: Received non-EBF health-related education

Three definitions of Exclusive breastfeeding (EBF) were employed:

Excusive breastfeeding over the previous month
Exclusive breastfeeding over the past 24 hours
Exclusive breastfeeding over the cumulative 6 months

Results
The “over the previous month EBF” rate was consistently higher for groups 1 and 2 than the control group. A similar trend was observed for “over the previous 24 hours EBF”. Spearman correlations of both EBF measures were highly significant. Cumulative EBF over the 6 months for both groups 1 and 2 were about twice that for group 3. Lactation peer-counseling had an impact on EBF rate in this trail.

Implications are that providing BF support and education within the peri-natal period and through the 6 months postpartum is crucial to increasing EBF rates.

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