BACKGROUND: Promoting breastfeeding is a central aim of child health care. It is critical to develop approaches that are inexpensive, effective, and suitable across cultural and socioeconomic groups. OBJECTIVE: To study the effect of training perinatal-neonatal nursing and medical staff in breastfeeding guidance on the duration of breastfeeding in a middle-income urban population. METHODS: This was an interventional study with data collection before and after. The intervention was an intensive course on breastfeeding guidance provided to all of the neonatal nurses and midwives in a local general hospital (2001-2002). Data were collected on two cohorts of mothers and infants (before -1999 [n = 471], after -2003 [n = 364]) regarding the duration of breastfeeding and factors influencing its discontinuation. RESULTS: The rate of breastfeeding initiation rose from 84% to 93% (p = 0.0001) and the mean duration of breastfeeding rose from 3.7 +/- 3.7 to 5.6 +/- 4.3 months (p = 0.0001). The rate of breastfeeding in the delivery room rose from 3% to 37% (p = 0.0001). Satisfaction with breastfeeding guidance in the hospital rose from 43% to 79% (p = 0.0001). However, there was no change in the proportion of mothers who planned to breastfeed this infant (88% in both cohorts) and no significant differences in the reasons given by the mothers for stopping breastfeeding. CONCLUSION: Training hospital nursery staff in breastfeeding guidance is a potential, cost-effective intervention even in settings with relatively high rates of breastfeeding.
Bibliographical noteFunding Information:
1Integrative Research Center, Section of Earth Sciences, Field Museum of Natural History, Chicago, United States; 2Department of Geosciences, Princeton University, Princeton, United States; 3Department of Geosciences, Princeton University, Princeton, United States; 4Institute of Deep-Sea Science and Engineering, Chinese Academy of Sciences, Sanya, China; 5Royal Tyrrell Museum of Palaeontology, Drumheller, Canada; 6Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom; 7Milner Centre for Evolution, University of Bath, Bath, United Kingdom; 8Foundation for Scientific Advancement, Sierra Vista, United States; 9Revive and Restore, San Francisco, United States; 10Department of Biomedical Engineering, Center for Computational Biology, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University, Baltimore, United States; 11Department of Computer Science, Center for Computational Biology, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University, Baltimore, United States; 12Department of Biostatistics, Center for Computational Biology, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University, Baltimore, United States; 13Division of Paleontology, American Museum of Natural History, New York, United States; 14School of Natural and Environmental Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom; 15Department of Chemistry, University of York, York, United Kingdom; 16School of Earth Sciences, University of Bristol, Bristol, United Kingdom; 17School of Biological Sciences, University of Bristol, Bristol, United Kingdom; 18School of Chemistry, University of Bristol, Bristol, United Kingdom; 19School of Physics, University of Bristol, Bristol, United Kingdom; 20School of Arts, University of Bristol, Bristol, United Kingdom
Part of this work was financially supported by the Scott Vertebrate Paleontology Fund from the Department of Geosciences, Princeton University. Many thanks to Wei Wang and Jessica Wiggins (Princeton University, Genomics Core Facility) for 16S rRNA gene amplicon sequencing, Paul Mona-ghan (University of Bristol) for assistance in preparing samples for radiocarbon AMS, Sheila Taylor (University of York) for assistance in preparing the samples for HPLC, Kirsty High (University of York) for provision of the comparator sheep bone sample, Kentaro Chiba (University of Toronto) for assistance in the quarry of BB180 and for taking photographs, the Royal Tyrrell Museum of Palaeontology for accessioning the fossils collected in Dinosaur Provincial Park and assisting in the paperwork allowing for export and study, and Adam Maloof (Princeton University), Jasmina Wiemann (Yale University), and Michael Buckley (University of Manchester) for helpful discussion. The Natural Environment Research Councial, UK, provided partial funding of the mass spectrometry facilities at Bristol (Contract No. R8/H10/63). Amino acid analyses were undertaken thanks to support to KP from the Leverhulme Trust (PLP-2012–116). Gallus gallus domesticus (Public Domain Dedication 1.0, https:// creativecommons.org/publicdomain/zero/1.0/legalcode), Odontapsidae (Dmitry Bogdanov, vectorised by T Michael Keesey, Creative Commons Attribution 3.0 Unported, https://creativecommons. org/licenses/by/3.0/legalcode, CC BY 3.0), and Centrosaurus apertus (credit: Andrew A Farke, Creative Commons Attribution 3.0 Unported, https://creativecommons.org/licenses/by/3.0/legalcode, CC BY 3.0, modified in Figure 5) silhouettes were obtained from phylopic.org.
Princeton University Scott Vertebrate Paleontology Fund Renxing Liang Maggie CY Lau Tullis Onstott Leverhulme Trust PLP-2012-116 Marc R Dickinson Kirsty E H Penkman.