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Ringing up about breastfeeding: A random controlled trial exploring early telephone peer support for breastfeeding (RUBY) – Primary outcomes
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Abstracts / Women and Birth 30(S1) (2017) 1–47
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O11
From the Ground Up: Creating spaces for breastfeeding in the community
Ringing up about breastfeeding: A random controlled trial exploring early telephone peer support for breastfeeding (RUBY) – Primary outcomes
Virginia Schmied ∗ , Elaine Burns, Athena Sheehan School of Nursing and Midwifery, Western Sydney University, New South Wales, Australia Introduction: The views of family and social networks, and community attitudes particularly around breastfeeding in public, can influence infant feeding decisions. Significant efforts have been made by governments at a global and national level to promote and support breastfeeding. However, these initiatives have not resulted in a significant increase in the duration of breastfeeding to six months. This may be because many of these initiatives have not been developed from the ‘ground up’ in consultation with women and communities. Aim: In this paper, we report the findings of the ‘discovery’ phase of an appreciative Inquiry (AI) project with community members designed to develop strategies that can be adapted at the local level to increase the support for breastfeeding. Methods: Appreciative Inquiry (AI) was used to facilitate a ‘Community Conversation’ (workshop) in two local councils in Australia. Ethics approval was obtained from Western Sydney University Human Research Ethics Committee. A total of 35 participants attended the workshops and included new parents, grandparents, children’s services, local government, local business representatives, and representatives from local maternity and child health services. Qualitative content analysis was used to analyse data. Results: Participants talked broadly about the positive characteristics of the community and services that fostered health and well-being for mothers and infants including, facilities, “lots of parks, walking tracks, open spaces and playgrounds, safe community centres”. Shopping centres were described as the ‘village’. However in both workshops, participants talked about what was not working to support breastfeeding stating that breastfeeding was rarely observed in public and that bottle feeding was more evident. There are insufficient facilities for breastfeeding and parenting rooms are limited or inappropriate. Conclusion and implications: Midwives have an important role in working with communities to identify what parents’ value about their community and implement strategies to support breastfeeding. http://dx.doi.org/10.1016/j.wombi.2017.08.022
Della Forster 1,2,∗ , Fiona McLardie-Hore 1,2 , Helen McLachlan 1,3 , Mary-Ann Davey 1 , Lisa H. Amir 1,2 , Lisa Gold 4 , Kate Mortensen 5 , Anita M. Moorhead 1,2 , Heather Grimes 1,6 , Touran Shaifei 1 1
Judith Lumley Centre, La Trobe University, Melbourne, Australia 2 The Royal Women’s Hospital, Melbourne, Australia 3 School of Nursing & Midwifery, La Trobe University, Melbourne, Australia 4 Deakin Health Economics Unit, Burwood, Australia 5 Australian Breastfeeding Association, Malvern East, Australia 6 Department of Nursing & Midwifery, La Trobe Rural Health School, Bendigo, Australia Introduction: Most Australian women initiate breastfeeding, however many discontinue sooner than they intended, and less than two thirds of women are continuing to breastfeed at six months. Few strategies increase breastfeeding maintenance in countries with relatively high breastfeeding initiation. Aim: We will determine whether proactive telephone peer support during the postnatal period increases the proportion of infants who are breastfed at six months. Methods: A multi-site two-arm RCT was conducted. We recruited primiparous, English-speaking women who intended to breastfeed from the postnatal wards of three hospitals in Melbourne, Australia. Women were randomised to peer (motherto-mother) support or to ‘usual’ care. Women randomised to peer support were allocated a peer volunteer, who contacted them by telephone guided by a suggested call schedule–two telephone calls within the first ten days postpartum, then weekly telephone calls until week twelve, with continued contact until six months postpartum. Our sample size is adequate to detect a 10% difference in the proportion of women breastfeeding between the two trial arms. Outcome data was collected by telephone interview at six months postpartum, and analysed by ‘intention to treat’, with relative risks described for all key outcomes. Ethical approval was received from La Trobe University and the three participating hospitals. Results: In total, 573 women were allocated to peer support and 579 to standard care, and 233 peer volunteers provided support to women. The response rate at six months was 88%. Data analysis is underway and primary trial outcomes will be presented. Conclusion and implications: The costs and health burdens of not breastfeeding fall disproportionately and increasingly on disadvantaged groups. We have therefore deliberately chosen trial sites which have a high proportion of women from disadvantaged backgrounds. This will be the first Australian RCT to test the effectiveness and cost effectiveness of proactive peer telephone support for breastfeeding. http://dx.doi.org/10.1016/j.wombi.2017.08.023
Abstracts / Women and Birth 30(S1) (2017) 1–47
O10
O11
From the Ground Up: Creating spaces for breastfeeding in the community
Ringing up about breastfeeding: A random controlled trial exploring early telephone peer support for breastfeeding (RUBY) – Primary outcomes
Virginia Schmied ∗ , Elaine Burns, Athena Sheehan School of Nursing and Midwifery, Western Sydney University, New South Wales, Australia Introduction: The views of family and social networks, and community attitudes particularly around breastfeeding in public, can influence infant feeding decisions. Significant efforts have been made by governments at a global and national level to promote and support breastfeeding. However, these initiatives have not resulted in a significant increase in the duration of breastfeeding to six months. This may be because many of these initiatives have not been developed from the ‘ground up’ in consultation with women and communities. Aim: In this paper, we report the findings of the ‘discovery’ phase of an appreciative Inquiry (AI) project with community members designed to develop strategies that can be adapted at the local level to increase the support for breastfeeding. Methods: Appreciative Inquiry (AI) was used to facilitate a ‘Community Conversation’ (workshop) in two local councils in Australia. Ethics approval was obtained from Western Sydney University Human Research Ethics Committee. A total of 35 participants attended the workshops and included new parents, grandparents, children’s services, local government, local business representatives, and representatives from local maternity and child health services. Qualitative content analysis was used to analyse data. Results: Participants talked broadly about the positive characteristics of the community and services that fostered health and well-being for mothers and infants including, facilities, “lots of parks, walking tracks, open spaces and playgrounds, safe community centres”. Shopping centres were described as the ‘village’. However in both workshops, participants talked about what was not working to support breastfeeding stating that breastfeeding was rarely observed in public and that bottle feeding was more evident. There are insufficient facilities for breastfeeding and parenting rooms are limited or inappropriate. Conclusion and implications: Midwives have an important role in working with communities to identify what parents’ value about their community and implement strategies to support breastfeeding. http://dx.doi.org/10.1016/j.wombi.2017.08.022
Della Forster 1,2,∗ , Fiona McLardie-Hore 1,2 , Helen McLachlan 1,3 , Mary-Ann Davey 1 , Lisa H. Amir 1,2 , Lisa Gold 4 , Kate Mortensen 5 , Anita M. Moorhead 1,2 , Heather Grimes 1,6 , Touran Shaifei 1 1
Judith Lumley Centre, La Trobe University, Melbourne, Australia 2 The Royal Women’s Hospital, Melbourne, Australia 3 School of Nursing & Midwifery, La Trobe University, Melbourne, Australia 4 Deakin Health Economics Unit, Burwood, Australia 5 Australian Breastfeeding Association, Malvern East, Australia 6 Department of Nursing & Midwifery, La Trobe Rural Health School, Bendigo, Australia Introduction: Most Australian women initiate breastfeeding, however many discontinue sooner than they intended, and less than two thirds of women are continuing to breastfeed at six months. Few strategies increase breastfeeding maintenance in countries with relatively high breastfeeding initiation. Aim: We will determine whether proactive telephone peer support during the postnatal period increases the proportion of infants who are breastfed at six months. Methods: A multi-site two-arm RCT was conducted. We recruited primiparous, English-speaking women who intended to breastfeed from the postnatal wards of three hospitals in Melbourne, Australia. Women were randomised to peer (motherto-mother) support or to ‘usual’ care. Women randomised to peer support were allocated a peer volunteer, who contacted them by telephone guided by a suggested call schedule–two telephone calls within the first ten days postpartum, then weekly telephone calls until week twelve, with continued contact until six months postpartum. Our sample size is adequate to detect a 10% difference in the proportion of women breastfeeding between the two trial arms. Outcome data was collected by telephone interview at six months postpartum, and analysed by ‘intention to treat’, with relative risks described for all key outcomes. Ethical approval was received from La Trobe University and the three participating hospitals. Results: In total, 573 women were allocated to peer support and 579 to standard care, and 233 peer volunteers provided support to women. The response rate at six months was 88%. Data analysis is underway and primary trial outcomes will be presented. Conclusion and implications: The costs and health burdens of not breastfeeding fall disproportionately and increasingly on disadvantaged groups. We have therefore deliberately chosen trial sites which have a high proportion of women from disadvantaged backgrounds. This will be the first Australian RCT to test the effectiveness and cost effectiveness of proactive peer telephone support for breastfeeding. http://dx.doi.org/10.1016/j.wombi.2017.08.023