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The investigators hypothesize that counseling of mothers will increase exclusive breast feeding rates at six weeks postnatal age. In developing countries like India,there is shortage of staff and the number of newborns cared is huge. So counseling of mothers for breast feeding becomes difficult. In such a situation using audio-visual aids may be a more practical option to increase breast feeding rates. Therefore the investigators will compare the use of video demonstration with counseling for exclusive breast feeding.
Study design - Randomized controlled trial.
Inclusion criteria- All mothers who deliver at term at Deen Dayal Upadhayay Hospital [DDUH ]whether booked or unbooked.
Exclusion criteria -
Setting of the study - The study will be conducted at postnatal wards of DDUH, New Delhi
Period of study-January 2009 to December 2009.
Sample size- We did a pilot study to see the baseline exclusive breast feeding rates at six weeks in mothers who delivered at DDUH. The baseline exclusive breast feeding rates at six weeks is 60%. Expecting a 10% absolute increase in exclusive breast feeding rates and alpha=0.05 and power beta=80% our sample size is 376 per group. Taking into account the loss to follow up of 20% we plan to enroll 470 mothers per group. So our sample size is 1410 mothers.
Ethics and consent-Ethical clearance will be obtained from ethical committee of DDUH. Written and informed consent will be taken from the mothers before enrolment.
Randomization - It will be an open-label randomized controlled trial. Random numbers will be obtained from a computer generated table. Mothers will be grouped into three groups: counseling group, video group and control group. The codes will be kept in sealed opaque envelopes. There will be allocation concealment since the mothers and the principle investigator will be unaware of the group to which they will be randomized.
Methods- The principle investigator will visit the postnatal wards daily except on holidays and look for the eligible mothers who will be asked for written and informed consent. Those who give the consent will be enrolled and randomized to counseling group, video group and control groups. The mothers in the intervention group will be counseled along with the husband and mother/mother-in-law/female caretaker. The mothers in the video group will be shown a video on breast feeding. The baseline characteristics of the three groups will be recorded. The mothers in the control group will receive standard care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| counselling | Active Comparator | counselling: Breast feeding counselling will be done to mothers |
|
| Video demonstration | Active Comparator | Video demonstration to mothers on the advantages of exclusive breast feeding |
|
| Standard Care | No Intervention | Standard care includes the routine care provided to the neonates as per hospital protocol |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| video demonstration | Behavioral | video will be shown to mothers |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Exclusive Breast Feeding Rate at Six Weeks Postnatal Age | 6 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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None excluded after enrolment. Those who did not follow up were not analysed.
January 2009 to June 2010 Tertiary care neonatal unit
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| ID | Title | Description |
|---|---|---|
| FG000 | Counselling | counselling: Breast feeding counselling will be done to mothers |
| FG001 | Video Demonstration | Video demonstration to mothers on the advantages of exclusive breast feeding |
| FG002 | Standard Care | Standard care includes the routine care provided to the neonates as per hospital protocol |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Counselling | counselling: Breast feeding counselling will be done to mothers |
| BG001 | Video Demonstration | Video demonstration to mothers on the advantages of exclusive breast feeding |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Exclusive Breast Feeding Rate at Six Weeks Postnatal Age | Posted | Number | Participants | 6 weeks |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Counselling | counselling: Breast feeding counselling will be done to mothers |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr Kanchan Sharma | Deen Dayal Upadhaya Hospital, New Delhi | 919417938224 | psaiims@yahoo.co.in |
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| ID | Term |
|---|---|
| D001942 | Breast Feeding |
| ID | Term |
|---|---|
| D005247 | Feeding Behavior |
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D003376 | Counseling |
| ID | Term |
|---|---|
| D008605 | Mental Health Services |
| D004191 | Behavioral Disciplines and Activities |
| D003153 | Community Health Services |
| D006296 | Health Services |
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| counselling |
| Behavioral |
breast feeding counselling |
|
| BG002 | Standard Care | Standard care includes the routine care provided to the neonates as per hospital protocol |
| BG003 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Units | Counts |
|---|---|
| Participants |
|
|
| 0 |
| 0 |
| 0 |
| 0 |
| EG001 | Video Demonstration | Video demonstration to mothers on the advantages of exclusive breast feeding | 0 | 0 | 0 | 0 |
| EG002 | Standard Care | Standard care includes the routine care provided to the neonates as per hospital protocol | 0 | 0 | 0 | 0 |
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| D005159 | Health Care Facilities Workforce and Services |