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

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.

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Acknowledgements

We thank the study participants in Sylhet District Bangladesh who were generous with their time and patience with CHWs through the sessions of observation and interviews. We thank Dr Mahbub E Elahi Chowdhury of Reproductive Health Unit, ICDDR, Bangladesh who provided advice on statistical issues. Funding for the PROJAHNMO Project was provided by the United States Agency for International Development through the Family Health and Child Survival Cooperative Agreement, Global Research Activity Cooperative Agreement, and the USAID Mission in Dhaka, Bangladesh, and the Saving Newborn Lives initiative of Save the Children Federation—USA through a grant from the Bill and Melinda Gates Foundation.

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Correspondence to I Mannan.

Additional information

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.

Conflict of interest

The authors declare that they have no conflict of interest arising through participation in this study.

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Mannan, I., Rahman, S., Sania, A. et al. Can early postpartum home visits by trained community health workers improve breastfeeding of newborns?. J Perinatol 28, 632–640 (2008). https://doi.org/10.1038/jp.2008.64

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  • DOI: https://doi.org/10.1038/jp.2008.64

Keywords

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

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