Proactive Peer (Mother-to-Mother) Breastfeeding Support by Telephone (Ringing up About Breastfeeding Early [RUBY]): A Multicentre, Unblinded, Randomised Controlled Trial

Abstract

Background Breastfeeding rates are suboptimal internationally, and many infants are not receiving any breast milk at all by six months of age. Few interventions increase breastfeeding duration, particularly where there is relatively high initiation. The effect of proactive peer (mother-to-mother) support has been found to increase breastfeeding in some contexts but not others, but if it is shown to be effective would be a potentially sustainable model in many settings. We aimed to determine whether proactive telephone-based peer support during the postnatal period increases the proportion of infants being breastfed at six months of age. Methods RUBY (Ringing Up about Breastfeeding earlY) was a multicentre, two-arm un-blinded randomised controlled trial conducted in three hospitals in Victoria, Australia. First-time mothers intending to breastfeed were recruited after birth and prior to hospital discharge, and randomly assigned (1:1) to usual care or usual care plus proactive telephone-based breastfeeding support from a trained peer volunteer for up to six months postpartum. A computerised random number program generated block sizes of four or six distributed randomly, with stratification by site. Research midwives were masked to block size, but masking of allocation was not possible. The primary outcome was the proportion of infants receiving any breast milk at six months of age. Analyses were by intention to treat; data were collected and analysed masked to group. The trial is registered with ACTRN, number 12612001024831. Findings Women were recruited between Feb 14, 2013 and Dec 15, 2015 and randomly assigned to peer support ( n = 574) or usual care ( n = 578). Five were not in the primary analysis [5 post-randomisation exclusions]. Infants of women allocated to telephone-based peer support were more likely than those allocated to usual care to be receiving breast milk at six months of age (intervention 75%, usual care 69%; Adj. RR 1·10; 95% CI 1·02, 1·18). There were no adverse events. Interpretation Providing first time mothers with telephone-based support from a peer with at least six months personal breastfeeding experience is an effective intervention for increasing breastfeeding maintenance in settings with high breastfeeding initiation. Funding The , Australia, philanthropic donation and grant.

Mobile phone support to sustain exclusive breastfeeding in the community after hospital delivery and counseling: a quasi-experimental study

“…EBF prevalence was much better in our study than in any previous study on proactive telephone breastfeeding support [39][40][41][42][43][44][45][46][47]. These previous studies were all done in high-income countries with much lower background breastfeeding prevalence than in Bangladesh, where continued breastfeeding rates are 95% at 9-11 and 89% at 20-23 months of age [24].…”

Social Value of Baby-Friendly Hospital Initiative Implementation in Australia: Case Study

“…Moreover, mothers' time and effort to breastfeed were not included in the calculation, with only limited data on this important investment available in the current literature (77)(78)(79). The impact of breastfeeding support programs on mothers is well documented (80)(81)(82); however, elucidation of the SROI from mothers' perspectives would be of great value in further clarifying the social impact of implementing the BFHI. Our examination of the SROI of implementation of the BFHI in one public hospital in Canberra, Australia provides the foundation for future research in other hospitals and community settings.…”

Breastfeeding support at an Australian Breastfeeding Association drop-in service: a descriptive survey

“…ABA peer counselling is based on a Rogerian model, which is a relationship-based model of care, and includes communicating empathy, building rapport and having a non-judgemental positive regard for the woman [14]. ABA predominantly provides support through their 24hour telephone helpline, and online or in community group meetings [15,16]. Face to face peer support with a trained ABA counsellor is provided on an ad hoc basis.…”