OBJECTIVE: To determine the impact of facility-based semi-intensive and home-based intensive counselling in improving exclusive breast-feeding (EBF) in a low-resource urban setting in Kenya. DESIGN: A cluster randomized controlled trial in which nine villages were assigned on a 1:1:1 ratio, by computer, to two intervention groups and a control group. The home-based intensive counselling group (HBICG) received seven counselling sessions at home by trained peers, one prenatally and six postnatally. The facility-based semi-intensive counselling group (FBSICG) received only one counselling session prenatally. The control group (CG) received no counselling from the research team. Information on infant feeding practices was collected monthly for 6 months after delivery. The data-gathering team was blinded to the intervention allocation. The outcome was EBF prevalence at 6 months. SETTING: Kibera slum, Nairobi. SUBJECTS: A total of 360 HIV-negative women, 34-36 weeks pregnant, were selected from an antenatal clinic in Kibera; 120 per study group. RESULTS: Of the 360 women enrolled, 265 completed the study and were included in the analysis (CG n 89; FBSICG n 87; HBICG n 89). Analysis was by intention to treat. The prevalence of EBF at 6 months was 23.6% in HBICG, 9.2% in FBSICG and 5.6% in CG. HBICG mothers had four times increased likelihood to practise EBF compared with those in the CG (adjusted relative risk = 4.01; 95% CI 2.30, 7.01; P=0.001). There was no significant difference between EBF rates in FBSICG and CG. CONCLUSIONS:EBF can be promoted in low socio-economic conditions using home-based intensive counselling. One session of facility-based counselling is not sufficient to sustain EBF.
RCT Entities:
OBJECTIVE: To determine the impact of facility-based semi-intensive and home-based intensive counselling in improving exclusive breast-feeding (EBF) in a low-resource urban setting in Kenya. DESIGN: A cluster randomized controlled trial in which nine villages were assigned on a 1:1:1 ratio, by computer, to two intervention groups and a control group. The home-based intensive counselling group (HBICG) received seven counselling sessions at home by trained peers, one prenatally and six postnatally. The facility-based semi-intensive counselling group (FBSICG) received only one counselling session prenatally. The control group (CG) received no counselling from the research team. Information on infant feeding practices was collected monthly for 6 months after delivery. The data-gathering team was blinded to the intervention allocation. The outcome was EBF prevalence at 6 months. SETTING: Kibera slum, Nairobi. SUBJECTS: A total of 360 HIV-negative women, 34-36 weeks pregnant, were selected from an antenatal clinic in Kibera; 120 per study group. RESULTS: Of the 360 women enrolled, 265 completed the study and were included in the analysis (CG n 89; FBSICG n 87; HBICG n 89). Analysis was by intention to treat. The prevalence of EBF at 6 months was 23.6% in HBICG, 9.2% in FBSICG and 5.6% in CG. HBICG mothers had four times increased likelihood to practise EBF compared with those in the CG (adjusted relative risk = 4.01; 95% CI 2.30, 7.01; P=0.001). There was no significant difference between EBF rates in FBSICG and CG. CONCLUSIONS: EBF can be promoted in low socio-economic conditions using home-based intensive counselling. One session of facility-based counselling is not sufficient to sustain EBF.
Authors: Alison McFadden; Anna Gavine; Mary J Renfrew; Angela Wade; Phyll Buchanan; Jane L Taylor; Emma Veitch; Anne Marie Rennie; Susan A Crowther; Sara Neiman; Stephen MacGillivray Journal: Cochrane Database Syst Rev Date: 2017-02-28
Authors: Betty Mogesi Samburu; Judith Kimiywe; Sera Lewise Young; Elizabeth W Kimani-Murage; Frederick Murunga Wekesah; Milka Njeri Wanjohi; Peter Muriuki; Nyovani Janet Madise; Paula L Griffiths Journal: Int Breastfeed J Date: 2021-05-08 Impact factor: 3.461
Authors: Rose Bosire; Bourke Betz; Adam Aluisio; James P Hughes; Ruth Nduati; James Kiarie; Bhavna H Chohan; Michele Merkel; Barbara Lohman-Payne; Grace John-Stewart; Carey Farquhar Journal: Breastfeed Med Date: 2016-02-17 Impact factor: 1.817
Authors: Elizabeth W Kimani-Murage; Paula L Griffiths; Frederick Murunga Wekesah; Milka Wanjohi; Nelson Muhia; Peter Muriuki; Thaddaeus Egondi; Catherine Kyobutungi; Alex C Ezeh; Stephen T McGarvey; Rachel N Musoke; Shane A Norris; Nyovani J Madise Journal: Global Health Date: 2017-12-19 Impact factor: 4.185
Authors: Betty Mogesi Samburu; Sera Lewise Young; Frederick Murunga Wekesah; Milkah Njeri Wanjohi; Judith Kimiywe; Peter Muriuki; Paula L Griffiths; Stephen T McGarvey; Nyovani Janet Madise; Elizabeth W Kimani-Murage Journal: Int Breastfeed J Date: 2020-07-14 Impact factor: 3.461