Peer counselling improves breastfeeding practices: A cluster randomized controlled trial in urban Bangladesh

Abstract

This study aimed to evaluate the impact of peer counselling on early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) rates for mother–infant pairs living in urban slums, Dhaka, Bangladesh. This randomized controlled trial enrolled 350 mother–infant pairs from selected slums between September 2014 and July 2016. The women assigned to intervention group received peer counselling from locally recruited, trained community female volunteers starting in third trimester of pregnancy until 6 months after delivery; control group received no intervention. EIBF, any liquids given after birth, and EBF were compared between groups. Follow‐up was scheduled at enrolment, following childbirth, and every 2 months up to 6 months after delivery. Multiple logistic regressions were used to assess the effect peer counselling and other associated factors on EIBF and EBF practices. EIBF rate was higher in the intervention group than in the control group (89.1% vs. 77.4%, p = .005). More mothers in intervention group were exclusively breastfeeding at 5 months than mothers in the control group (73% vs. 27%, p < .005). Control mothers were twice as likely to not practice EIBF compared with intervention mothers (adjusted odds risk [aOR]: 2.53, CI [1.29, 4.97], p = .007). Overall, caesarean section was associated with an 8.9‐fold higher risk of not achieving EIBF (aOR: 8.90, CI [4.05, 19.55], p < .001). Intervention mothers were 5.10‐fold more likely to practice EBF compared with control mothers (aOR: 5.10, CI [2.89, 9.01], p < .001) at 5 months. This study demonstrates peer counselling can positively influence both EIBF and EBF among mothers living in urban area.

Prevalence and determinants of pre-lacteal feeding in South Sudan: a community-based survey

“…Similar findings were reported from Ethiopia [36], Burkina Faso and Uganda [37]. In addition, evidence from Bangladesh and Tanzania revealed that breastfeeding counselling increases maternal knowledge on optimal infant feeding [38,39]. Mothers who are knowledgeable on IYCF are more likely to follow the WHO recommendations on practices such as early initiation of breastfeeding, EBF and avoidance of pre-lacteal feeds [40].…”

Factors Affecting Breastfeeding Practices in Sindh Province, Pakistan: A Secondary Analysis of Cross-Sectional Survey Data

“…This may be due to the nature of their advice. In the Muslim community, relatives or friends are the main people providing breastfeeding advice [30,38]. An intervention study conducted in urban Bangladesh has highlighted the need for community-based peer counseling using trained community female volunteers to promote good breastfeeding practices.…”

“…An intervention study conducted in urban Bangladesh has highlighted the need for community-based peer counseling using trained community female volunteers to promote good breastfeeding practices. When peer counseling at home included other family members, mothers were five times more likely to practice exclusive breastfeeding for up to five months compared to mothers who received no intervention [38]. Peer counseling also had a positive effect on early initiation of breastfeeding within the first hour of birth [38].…”

Time for change is now: Experiences of participants in a community-based approach for iron and folic acid supplementation in a rural county in Kenya, a qualitative study

“…Community-based IFAS education, including peer counselling which was positively implicated in a study in Bangladesh [47], yielded positive results in this study and needs further strengthening. Likewise, the importance of family support, especially husbands, in IFAS use is critical, just as indicated in a study in Zimbabwe [48].…”