Initial breast-feeding practices of urban mothers can be influenced by peer counselling

Abstract

Objective: Assess the effect of peer counselling on early postpartum breast-feeding practices of urban mothers. Methodology: Forty localities of similar size in Dhaka were randomized as intervention or control areas. From each of the 20 intervention areas, local women who had breastfed their babies and were motivated to help other mothers, were trained as peer counsellors. Three counselling sessions were provided (two visits before delivery in presence of influential family members, and one within 48 hours of delivery) to initiate early breast- feeding and to breastfeed exclusively for five months. Socioeconomic data and information on previous infant-feeding practices were collected in the last trimester of pregnancy by trained interviewers. On day 4, they collected post-delivery feeding practices. Results: Mothers selected for the study (363 in each group) were of similar age and socioeconomic status. Significantly more mothers in the intervention group initiated breast-feeding within one hour (64% vs. 15%) and gave their babies colostrum as the first food (69% vs. 11 %). Of the intervention mothers whose babies had received prelacteals, most reported that either the baby's grandmothers had administered the prelacteals contrary to their own wishes; or they had to accept the advice of local health facility staff and family members. In spite of these obstacles, on day 4, significantly more mothers were breastfeeding exclusively in the intervention group (84% vs. 30%). Conclusion: Peer counsellors can improve early postpartum breast-feeding practices, but could be even more effective if health staff and family members do not give conflicting advice.