Randomised controlled trial of support from volunteer counsellors for mothers considering breast feeding

doi:10.1136/bmj.328.7430.26

BMJ 2004;328:26 (3 January), doi:10.1136/bmj.328.7430.26

Primary care

Randomised controlled trial of support from volunteer counsellors for mothers considering breast feeding

Jonathan Graffy, senior lecturer¹, Jane Taylor, researcher², Anthony Williams, senior lecturer in neonatal paediatrics³, Sandra Eldridge, lecturer in medical statistics¹

¹ Department of General Practice and Primary Care, Barts and the London, Queen Mary, University of London, London E1 4NS, ² Statham Grove Surgery, London N16 9DP, ³ St George's Hospital Medical School, London SW17 0QT

Correspondence to: Dr J Graffy, General Practice and Primary Care Research Unit, Institute of Public Health, University of Cambridge, Cambridge CB2 2SR jonathan.graffy{at}phpc.cam.ac.uk

Objective To investigate whether offering volunteer supportfrom counsellors in breast feeding would result in more womenbreast feeding.

Design Randomised controlled trial.

Setting 32 general practices in London and south Essex.

Participants 720 women considering breast feeding.

Main outcome measures Primary outcome was prevalence of anybreast feeding at six weeks. Secondary outcomes were the proportionof women giving any breast feeds, or bottle feeds at four months,duration of any breast feeding, time to introduction of bottlefeeds, and satisfaction with breast feeding.

Results Offering support in breast feeding did not significantlyincrease the prevalence of any breast feeding to six weeks (65%(218/336) in the intervention group and 63% (213/336) in thecontrol group; relative risk 1.02, 95% confidence interval 0.84to 1.24). Survival analysis up to four months confirmed thatneither duration of breast feeding nor time to introductionof formula feeds differed significantly between control andintervention groups. Not all women in the intervention groupcontacted counsellors postnatally, but 73% (123/179) of thosewho did rated them as very helpful. More women in the interventiongroup than in the control group said that their most helpfuladvice came from counsellors rather than from other sources.

Conclusions Women valued the support of a counsellor in breastfeeding, but the intervention did not significantly increasebreastfeeding rates, perhaps because some women did not askfor help.

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Rapid Responses:

Read all Rapid Responses

Breast feeding should not be a choice: I�IGO Romon-Alonso
bmj.com, 2 Jan 2004 [Full text]
Expectations: Tracy Hayden
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Re: Breast feeding should not be a choice: MC Feliciello
bmj.com, 2 Jan 2004 [Full text]
Breast is Best But . . .: Annette E Hay
bmj.com, 3 Jan 2004 [Full text]
The importance of how support is provided: Cindy-Lee Dennis
bmj.com, 6 Jan 2004 [Full text]
Graffy et al�s paper reporting an RCT on the use of volunteer counsellors for mothers considering breast feeding: Moyez Jiwa, et al.
bmj.com, 13 Jan 2004 [Full text]
Rapid response to Graffy J et al�s article on �Randomised controlled trial of support from volunteer counsellors for mothers considering breastfeeding�.: Rukhsana Haider
bmj.com, 15 Jan 2004 [Full text]
Peer support is worth further investigation: Carol MA Campbell
bmj.com, 18 Jan 2004 [Full text]
Lack of effectiveness of volunteer counselors: Adriano Cattaneo
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Issues for consideration: Jill Parnham
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Implications of our findings: Jonathan P Graffy, et al.
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Effective breastfeeding patterns increase breastfeeding rates: Carol A Walshaw, et al.
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