The ABA intervention for improving breastfeeding initiation and continuation: Feasibility study results

Abstract

The UK has low breastfeeding rates, with socioeconomic disparities. The Assetsbased feeding help Before and After birth (ABA) intervention was designed to be inclusive and improve infant feeding behaviours. ABA is underpinned by the behaviour change wheel and offers an assets-based approach focusing on positive capabilities of individuals and communities, including use of a Genogram. This study aimed to investigate feasibility of intervention delivery within a randomised controlled trial (RCT). Nulliparous women ≥16 years, (n = 103) from two English sites were recruited and randomised to either intervention or usual care. The interventiondelivered through face-to-face, telephone and text message by trained Infant Feeding Helpers (IFHs)ran from 30-weeks' gestation until 5-months postnatal. Outcomes included recruitment rates and follow-up at 3-days, 8-weeks and 6-months postnatal, with collection of future full trial outcomes via questionnaires. A mixed-methods process evaluation included qualitative interviews with 30 women, 13 IFHs and 17 maternity providers; IFH contact logs; and fidelity checking of antenatal contact recordings. This study successfully recruited women, including teenagers, from socioeconomically disadvantaged areas; postnatal follow-up rates were 68.0%, 85.4% and 80.6% at 3-days, 8-weeks and 6-months respectively. Breastfeeding at 8-weeks was obtained for 95.1% using routine data for non-responders. It was possible to recruit and train peer supporters to deliver the intervention with adequate fidelity. The ABA intervention was acceptable to women, IFHs and maternity services. There was minimal contamination and no evidence of intervention-related harm. In conclusion, the intervention is feasible to deliver within an RCT, and a definitive trial required. KEYWORDS assets-based approach, behaviour change theory, breastfeeding, infant feeding, peer support, randomised controlled trial ---

Proactive telephone-based peer support for breastfeeding: a cross-sectional survey of women’s experiences of receiving support in the RUBY randomised controlled trial

“…It is imperative for organisations implementing a proactive peer support intervention for breastfeeding to understand the consumer experience to ensure programmes are acceptable, accessible, responsive and provide improved outcomes. 11 The current literature describing mothers' experiences of proactive breastfeeding support programmes is mainly limited to a few relatively small studies in Sweden 12 (proactive, telephone-based professional support), the UK [13][14][15][16] (predominantly face to face peer support models) and Australia 17 18 (mixture of peer/professional support face to face). Dennis' 19 20 Canadian study of the effect of proactive telephone-based peer support on breastfeeding, on which the RUBY study was based, reports maternal experiences including high rates of overall satisfaction and satisfaction with 'enough peer contact to help them with breast feeding'.…”

Exploring the use and experience of an infant feeding genogram to facilitate an assets-based approach to support infant feeding

“…While full details of intervention delivery and recruitment into the feasibility trial are reported elsewhere [21,22] a summary is provided as follows. The ABA intervention was an Infant Feeding Helper (IFH) peer support service delivered from~32 weeks gestation to5 months postnatal.…”

“…In the "Assets-based infant feeding help Before and After birth (ABA)" feasibility trial [21][22][23] a modified version of Darwent's infant feeding genogram [20] was used to increase women's assets for infant feeding. This paper explores infant feeding helpers and women's use and experience of the genogram as an intervention component in the ABA feasibility trial.…”

Exploring the use and experience of an infant feeding genogram to facilitate an assets-based approach to support infant feeding

“…While full details of intervention delivery and recruitment into the feasibility trial are reported elsewhere (21,22) -a summary is provided as follows. The ABA intervention was an Infant Feeding Helper (IFH) peer support service delivered from ~32 weeks gestation to ~5 months postnatal.…”

“…In the Assets-based infant feeding help Before and After birth (ABA) feasibility trial (21,22) a modified version of Darwent's infant feeding genogram (20) was used to increase women's assets for infant feeding. This paper explores infant feeding helpers and women's use and experience of the genogram as an intervention component in the ABA feasibility trial.…”