Labadarios, Demetre,Nduati, Ruth W.,Ochola, Sophie A.
Human Sciences Research Council-South Africa, Kenyatta University, Stellenbosch University, University of Nairobi
"Labadarios, Demetre: Human Sciences Research Council-South Africa","Nduati, Ruth W.: University of Nairobi",
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.
"Breast-feeding counselling","BREAST-FEEDING PROMOTION","EXCLUSIVE BREAST-FEEDING",KENYA,"RANDOMIZED CONTROLLED TRIAL",AFRICA,AREA,"CHILD UNDERNUTRITION",COMMUNITY,EFFICACY,"HIGH HIV PREVALENCE"