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Randomized Trial of Breastfeeding Support in Very Low-Birth-Weight Infants
Janet Pinelli, RNC, MScN, DNS;
Stephanie A. Atkinson, PhD, RD;
Saroj Saigal, MD
Arch Pediatr Adolesc Med. 2001;155:548-553.
Objective To determine if supplementary structured breastfeeding counseling (SSBC)
for both parents compared with conventional hospital breastfeeding support
(CHBS) improves the duration of breastfeeding in very low-birth-weight infants
up to 1 year old.
Design Randomized trial with longitudinal follow-up of infants at term, and
ages 1, 3, 6, and 12 months (infant ages corrected for prematurity).
Setting A tertiary-level neonatal intensive care unit (NICU) and geographically
defined region in central-west Ontario, Canada.
Participants Parents of infants with a birth weight less than 1500 g, who planned
to breastfeed.
Interventions The SSBC consisted of viewing a video on breastfeeding for preterm infants;
individual counseling by the research lactation consultant; weekly personal
contact in the hospital; and frequent postdischarge contact through the infants'
first year or until breastfeeding was discontinued. The CHBS group had standard
breastfeeding support from regular staff members confined to the period of
hospitalization in the NICU.
Main Outcome Measure Duration of breastfeeding.
Results At study entry, there were no statistically significant differences
in major demographic characteristics between groups. The mean duration of
breastfeeding was 26.1 weeks (SD = 20.8; median, 17.4) in the SSBC group and
24.0 weeks (SD = 20.5; median, 17.4) in the CHBS group (not statistically
significant).
Conclusions Long-term breastfeeding counseling of parents of very low-birth-weight
infants in this study did not demonstrate a significant difference in duration
of breastfeeding. These results may be explained by the high motivation to
breastfeed in both groups, a relatively advantaged population, and the availability
of community breastfeeding resources, which may have diminished any significant
differences that could have resulted from a breastfeeding intervention. The
results of this study, compared with previous studies of very low-birth-weight
infants, indicate a new trend to longer duration of breastfeeding in preterm
infants.
From the School of Nursing (Dr Pinelli) and the Department of Pediatrics
(Drs Atkinson and Saigal), McMaster University, Hamilton, Ontario; and the
Children's Hospital of the Hamilton Health Sciences Corporation, Hamilton
(Dr Pinelli).
Corresponding author: Janet Pinelli, RNC, Msc, DNS, Faculty of Health
Sciences, Room 3N25D, McMaster University, 1200 Main St W, Hamilton, Ontario
L8N 3Z5, Canada (e-mail: pinellij{at}fhs.mcmaster.ca).
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