Is Early Initiation of Maternal Lactation a Significant Determinant for Continuing Exclusive Breastfeeding up to 6 Months?

Exclusive breastfeeding among Indonesian working mothers: does early initiation of breastfeeding matter?

BACKGROUND

Early initiation of breastfeeding (EIBF) is a starting point that lays the foundation for breastfeeding and bonding between mother and baby. Meanwhile, working mothers are one of the vulnerable groups for the success of exclusive breastfeeding (EBF). The study analyzed the role of EIBF on EBF among Indonesian working mothers.

METHODS

The cross-sectional study examined secondary data from the 2021 Indonesian National Nutritional Status Survey. The study analyzed 4,003 respondents. We examined EBF practice as an outcome variable and EIBF as an exposure variable. We included nine control variables (residence, maternal age, marital, education, prenatal classes, wealth, infant age, sex, and birth weight). All variables were assessed by questionnaire. The study employed a binary logistic regression test in the last stage.

RESULTS

The result showed that the proportion of EBF among working mothers in Indonesia in 2021 was 51.9%. Based on EIBF, Indonesian working mothers with EIBF were 2.053 times more likely than those without to perform EBF (p < 0.001; AOR 2.053; 95% CI 2.028-2.077). Moreover, the study also found control variables related to EBF in Indonesia: residence, maternal age, marital, education, prenatal classes, wealth, infant age, sex, and birth weight.

CONCLUSION

The study concluded that EIBF was related to EBF. Indonesian working mothers with EIBF were two times more likely than those without to perform EBF. The government needs to release policies that strengthen the occurrence of EIBF in working mothers to increase EBF coverage.

Effects of a mobile application on breastfeeding maintenance in the first 6 months after birth: Randomised controlled trial (COMLACT study)

PROBLEM

It is necessary to continue promoting breastfeeding rates.

BACKGROUND

Information and communication technologies have significantly impacted healthcare services and are transforming the sector. There is little evidence of the usefulness of mobile applications to support breastfeeding and increase its duration.

AIM

To assess whether mobile application-LactApp® (Barcelona, Spain)-usage compared with standard care increases the 6-month postpartum breastfeeding rate.

METHODS

A multicentre, randomised, controlled clinical trial of parallel groups was conducted. The study was conducted in four public hospitals in Spain from January 2022 to January 2023. 270 Women were randomly assigned to each parallel group. The women in the intervention group received free access to the mobile application LactApp®, which provides personalised and convenient support to women about BF. Women in the control group received standard care, which included individual counselling about the benefits of maintaining BF for the first 6 months of the baby's life.

FINDINGS

The rate of breastfeeding abandonment at 15 days was 6.4 % in the control group vs 0.0 % in the intervention group (p = 0.105). LactApp® usage did not increase the 6-month postpartum breastfeeding rate compared with standard care (CG = 41.6% vs. IG = 43.6 %; p = 0.826).

DISCUSSION

Further studies must explore how technologies can help improve long-term breastfeeding maintenance. The mobile app seems to reduce early weaning in the first 15 days slightly.

CONCLUSION

Mobile application usage did not increase the breastfeeding rate compared with standard practice but may reduce breastfeeding abandonment in the first 2 weeks postpartum.

Effect of Mobile-Based Counselling on Breastfeeding in Spain: A Randomized Controlled Trial Protocol (COMLACT Study)

PURPOSE

The primary aim of this study is to determine the influence of an intervention in women based on a free mobile application (LactApp^®, Barcelona, Spain) in maintaining breastfeeding (BF) up to 6 months postpartum. The secondary aim is to assess the effect of health literacy (HL) on breastfeeding duration.

METHODS

A multicenter, randomized controlled clinical trial of parallel groups will be carried out. Women will be randomly assigned to each of the parallel groups. In the control group, usual clinical practice will be followed from the third trimester of pregnancy to promote BF. In the intervention group, and in addition to usual clinical practice, the women will use a free mobile application (LactApp^®) from the third trimester to 6 months postpartum. The type of BF at birth, at 15 days and at 3 and 6 months postpartum and the causes of cessation of BF in both groups will be monitored. The hypothesis will be tested using inferential analysis, considering an alpha of 5%. The study protocol was approved by the Clinical Research Ethics Committee of Hospital de la Ribera (Alzira, Valencia, Spain) in February 2021. A per protocol analysis and an intention-to-treat analysis will be performed.

DISCUSSION

This study will identify the influence of a mobile application on improving BF rates. If the application proves effective, we will have a tool with free information available to any user at any time of day, which may be complemented by normal clinical practice and be integrated into our health care system.

TRIAL REGISTRATION

ClinicalTrials.gov ID: NCT05432700.