Randomized trial of breastfeeding support in very low-birth-weight infants

Objective: To determine if supplementary structured breastfeeding counseling (SSBC) for both parents compared with conventional hospital breastfeeding support (CHBS) improves the duration of breastfeeding in very low-birth-weight infants up to 1 year old. Design: Randomized trial with longitudinal follow-up of infants at term, and ages 1, 3, 6, and 12 months (infant ages corrected for prematurity). Setting: A tertiary-level neonatal intensive care unit (NICU) and geographically defined region in central-west (Ontario, Canada. Participants: Parents of infants with a birth weight less than 1500 g, who planned to breastfeed. Interventions: The SSBC consisted of viewing a video on breastfeeding for preterm infants; individual counseling by the research lactation consultant; weekly personal contact in the hospital; and frequent postdischarge contact through the infants' first year or until breast-feeding was discontinued. The CHBS group had standard breastfeeding support from regular staff members confined to the period of hospitalization in the NICU. Main Outcome Measure: Duration of breastfeeding. Results: At study entry, there were no statistically significant differences in major demographic characteristics between groups. The mean duration of breastfeeding was 26.1 weeks (SD=20.8; median, 17.4) in the SSBC group and 24.0 weeks (SD=20.5; median, 17.4) in the CHBS group (not statistically significant). Conclusions: Long-term breastfeeding counseling of parents of very low-birth-weight infants in this study did not demonstrate a significant difference in duration of breastfeeding, These results may be explained by the high motivation to breastfeed in both groups, a relatively advantaged population, and the availability of community breastfeeding resources, which may have diminished any significant differences that could have resulted from a breastfeeding intervention. The results of this study, compared with previous studies of very low-birth-weight infants, indicate a new trend to longer duration of breastfeeding in preterm infants.