Objective To evaluate the effect of two postnatal professional support interventions on the duration of any and exclusive breastfeeding.Design Multicentre, three-arm, cluster randomised controlled trial.Population A cohort of 722 primiparous breastfeeding mothers with uncomplicated, full-term pregnancies.Methods The three study interventions were: (1) standard postnatal maternity care; (2) standard care plus three in-hospital professional breastfeeding support sessions, of 30-45 minutes in duration; or (2) standard care plus weekly post-discharge breastfeeding telephone support, of 20-30 minutes in duration, for 4 weeks. The interventions were delivered by four trained research nurses, who were either highly experienced registered midwives or certified lactation consultants.Main outcome measures Prevalence of any and exclusive breastfeeding at 1, 2, and 3 months postpartum.Results Rates of any and exclusive breastfeeding were higher among participants in the two intervention groups at all follow-up points, when compared with those who received standard care.Participants receiving telephone support were significantly more likely to continue any breastfeeding at 1 month (76.2 versus 67.3%; odds ratio, OR 1.63, 95% confidence interval, 95% CI 1.10-2.41) and at 2 months (58.6 versus 48.9%; OR 1.48, 95% CI 1.04-2.10), and to be exclusively breastfeeding at 1 month (28.4 versus 16.9%; OR 1.89, 95% CI 1.24-2.90). Participants in the in-hospital support group were also more likely to be breastfeeding at all time points, but the effect was not statistically significant.Conclusions Professional breastfeeding telephone support provided early in the postnatal period, and continued for the first month postpartum, improves breastfeeding duration among first-time mothers. It is also possible that it was the continuing nature of the support that increased the effectiveness of the intervention, rather than the delivery of the support by telephone specifically.

More could be done in symptom and psychosocial management to improve patients' QoL, in particular for those who are younger, male or single, or who have lower physical functioning.

Volunteers and staff of women's organisations who are highly active in engaging and providing community service can be recruited to motivate female smokers to quit. We described the knowledge and attitudes regarding tobacco control and smoking cessation among these affiliates in Hong Kong and identified factors associated with the practices of cessation interventions. Eight of 14 women's organisations joining the Women Against Tobacco Taskforce agreed to participate. All staff, volunteers, and members of the eight organisations were invited to complete a self-administered anonymous questionnaire during July and August 2006. A total of 623 out of 771 (80.8%) affiliates responded. Their knowledge on smoking and health (mean = 3.91, SD = 1.44 on a range of 0-7), smoking related diseases (mean = 2.91, SD = 0.97 on a range of 0-4), and women-specific diseases (mean = 2.93, SD = 1.87 on a range of 0-6), was considered to be inadequate. They had positive attitudes towards tobacco control (mean = 3.31, SD = 0.55) and their own role in smoking cessation counselling (mean = 3.19, SD = 0.56) on a 4-point Likert scale and 39.3% reported had attempted to offer quitting advice. Logistic regression analysis found that participants having direct contact with smokers who had a positive attitude towards their own role in smoking cessation counselling (OR = 2.57; 95% CI = 1.67-3.95) and better knowledge of smoking and smoking-related diseases (OR = 1.35; 95% CI = 1.06-1.71) were more likely to provide cessation counselling after controlling for gender; knowledge on smoking and health, and women-specific diseases; attitude towards tobacco control, negative and positive attitudes towards female smokers, and perceived self-efficacy in smoking cessation counselling. Women's organisations showed limited support towards tobacco control and their affiliates had a limited knowledge on smoking and health but had positive attitudes. Appropriate training, capacity building and establishing rapport with women's organisations are needed to promote smoking cessation and to support tobacco control in the community.