Effectiveness of Video‐Based Health Education on Breastfeeding Practices Among Infants Aged 0–6 Months in Dirashe District, South Ethiopia: A Cluster Randomized Controlled Trial

Abstract

Background: Exclusive breastfeeding (EBF) of infants during the first 6 months of their life is strongly recommended. Video‐based communication is an innovative method that could promote EBF. The present study is aimed at assessing the effectiveness of video‐based intervention in promoting breastfeeding practices from birth to 6 months postpartum. This was evaluated through maternal reports, as well as EBF of infants at 3 and 5 months of age, using the deuterium oxide dose‐to‐mother (DTM) technique.Methods: In a cluster randomized community trial, 16 communities were assigned to receive a video‐based behavior change communication (Video‐Health) or standard health care messages (Control). Pregnant women in their first trimester (12 ± 2 weeks) were enrolled and followed up, together with their infants, until 6 months postpartum. Data on breastfeeding practices were collected by questionnaire, monthly, in all the participants (n = 508). Human milk intake (HMI) and nonmilk oral intake (NMOI) were measured in a subsample of 60 mother–infant pairs at 3 and 5 months postpartum using DTM. Mixed models and logistic regression were used to examine the difference in continuous and discrete breastmilk practices between the intervention and the control arms, respectively.Results: The majority of mothers initiated breastfeeding early (92.1%), 82.4% reported colostrum feeding, and 17.5% provided prelacteal feeding. No significant differences were found between Video‐Health and Control arms (p > 0.05). The intervention significantly improved reported EBF rates at 4 and 5 months postpartum (p < 0.05). DTM results showed that the proportion of women practicing EBF was 50%–67% less than reported at 3 months for both arms and at 5 months in the intervention arm. The intervention did not significantly affect measured EBF at 3 and 5 months postpartum but did improve HMI at 3 months. Non significant differences in NMOI were observed at 3 months, but at 5 months, there was a significant difference between the study arms.Conclusions: Video‐based behavior change communication did not result in significant improvements in reported breastfeeding practices, except for a higher reported adherence to EBF beyond 3 months. Additionally, the intervention had no effect on EBF as measured by the DTM. Early introduction of non‐breastmilk foods and liquids persisted, despite self‐reported EBF extending up to 6 months postpartum.Trial Registration: ClinicalTrials.gov identifier: NCT04414527