Innovative Intervention Program Works in Belarus.(to promote breastfeeding )

2001 FEB 1 - (NewsRx.com) -- An experimental intervention program to promote breastfeeding among mothers in the former Soviet Republic of Belarus increased the duration and degree of breastfeeding, and decreased the risk of gastrointestinal tract infection by 40% and atopic eczema by 46% in the first year of life for breastfed babies, according to an article in the January 24/31, 2001, issue of The Journal of the American Medical Association.

Michael S. Kramer, MD, of McGill University Faculty of Medicine, Montreal, Quebec, and colleagues assessed the effects of the Promotion of Breastfeeding Intervention Trial (PROBIT), a randomized trial conducted from June 1996 to December 1997, with a one-year follow-up. The trial included 31 maternity hospitals and polyclinics in Belarus, and a total of 17,046 pairs of healthy mothers and their babies. All the mothers intended to breastfeed, and 16,491 completed the entire 12-month follow-up.

According to background information cited in the study, breastfeeding has been widely reported to reduce the risk of infection and atopic disease in the recipient infant and child. But current evidence that breastfeeding is beneficial for infant and child health is based exclusively on observational studies, and potential sources of bias in such studies have led to doubts about the magnitude of these health benefits in industrialized countries.

PROBIT sites were randomly assigned to receive either an experimental intervention (n=16) modeled on the Baby-Friendly Hospital Initiative (BFHI) of the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF), or a control intervention (n=15). The BFHI emphasizes health care worker assistance with initiating and maintaining breastfeeding and lactation and postnatal breastfeeding support. The control intervention continued the usual infant feeding practices and policies.

"Our breastfeeding promotion intervention, modeled on the BFHI, succeeded in increasing the duration and exclusivity of breastfeeding in the first year of life," the authors write. "Infants from the intervention sites were significantly more likely than control infants to be breastfed to any degree at 12 months (19.7% vs. 11.4%), were more likely to be exclusively breastfed at three months (43.3% vs. 6.4%) and at six months (7.9% vs. 0.6%)."

"In the control group, 60% of mothers (range among sites, 46%-78%) were still breastfeeding to some degree at three months, considerably higher than the 50% we had estimated based on data prior to initiating our trial. Nonetheless, the intervention group had significantly higher rates of continued breastfeeding at three months (73%; range 64%-87%) and throughout the first year," Kramer et al. report.

They suggest the higher-than-expected breastfeeding duration in the control group may be attributable to deteriorating economic conditions in Belarus during the trial and the higher costs of formula feeding.