Original Article

Journal of Perinatology (2008) 28, 632–640; doi:10.1038/jp.2008.64; published online 3 July 2008

Can early postpartum home visits by trained community health workers improve breastfeeding of newborns?

Contributors: IM conceptualized the current analysis, SMR developed manuals and trained CHWs, AS performed the literature review. IM did the data analysis, IM and AS wrote the draft manuscript and further modifications. AHB, GLD, SEA and HRS designed the protocol for the parent study, reviewed the study instruments and the results of the study. AHB, PW and GLD provided feedback on the analysis and made critical suggestions on the manuscript. All authors reviewed the manuscript.

I Mannan1,2, S M Rahman2, A Sania2, H R Seraji1,2, S E Arifeen2, P J Winch1, G L Darmstadt1 and A Baqui1 for the Bangladesh Projahnmo Study Group

  1. 1Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
  2. 2Public Health Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh

Correspondence: Dr I Mannan, Child Health Unit, Public Health Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, PO Box no. 128, Dhaka 1000, Bangladesh. E-mail: ishtiaqm@icddrb.org

Received 20 November 2007; Revised 30 April 2008; Accepted 20 May 2008; Published online 3 July 2008.

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Abstract

Objective:

 

Whether postpartum visits by trained community health workers (CHWs), reduce newborn breastfeeding problems.

Method:

 

Community health workers made antenatal and postpartum home visits promoting newborn care practices including breastfeeding. CHWs assessed neonates for adequacy of breastfeeding and provided hands-on support to mothers to establish breastfeeding. History and observation data of 3495 neonates were analyzed to assess effects of CHW visitation on feeding problems.

Result:

 

Inappropriate breastfeeding position and attachment were the predominant problems (12 to 15%). Only 6% of newborns who received home visit by CHWs within 3 days had feeding difficulties, compared to 34% of those who did not (odds ratio: 7.66, 95% confidence interval (CI): 6.03 to 9.71, P=0.00). Latter group was 11.4 times (95% CI: 6.7 to 19.3, P=0.00) more likely to have feeding problems as late as days 6 to 7, than the former.

Conclusion:

 

Counseling and hands-on support on breastfeeding techniques by trained workers within first 3 days of birth, should be part of community-based postpartum interventions.

Keywords:

breastfeeding, community health workers, newborn care, postpartum visit, Bangladesh

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