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In Croatia, between 95% and 99% of mothers initiate breastfeeding, but by 3 months a third have stopped, and by six months only half are still providing any human milk for their babies. Exclusive breastfeeding rates are even lower, with only about 9% of Croatian mothers exclusively breastfeeding at 6 months, despite the WHO recommendation of 6 months of exclusive breastfeeding. Currently, in Croatia, no breastfeeding information or other pregnancy and parenting related written information is routinely provided to expectant couples. In our study we would like to find out whether providing written breastfeeding information in pregnancy and breastfeeding focused support phone calls during pregnancy and after the birth of the baby result in better outcomes than providing general pregnancy/parenting information and support phone calls. This will be tested by randomising women, attending their primary health care provider for routine antenatal visits between 20 and 32 weeks, to an intervention focused on promoting and supporting breastfeeding, to an intervention focused on general pregnancy and parenting issues, and to a non-intervention control group. Women will be followed-up for 6 months after the birth of their baby and data will be collected at 3 and 6 months on breastfeeding rates, breastfeeding self-efficacy, breastfeeding difficulties, social support and attitudes toward infant feeding.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Breastfeeding support | Experimental | A breastfeeding brochure will be distributed to expectant mothers from 20 weeks gestation during their regular antenatal visit. This will be followed 2 weeks later by a phone call offering clarification/explanation of the brochure. Three standardized phone calls, offering breastfeeding support, will be conducted at 2,6 and 10 weeks following birth of the baby. |
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| General Support | Active Comparator | The active control group of mothers will receive a brochure in pregnancy covering general pregnancy and parenting issues and follow-up phone calls but breastfeeding issues will not be specifically addressed. If a mother raises any breastfeeding issue she will be referred to appropriate support. |
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| Standard Care | No Intervention | This group will receive standard antenatal care provided by their chosen gynaecologist and obstetrician, consisting of regular antenatal visits. No written materials or telephone calls are routinely provided to pregnant women in Croatia. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Breastfeeding support | Behavioral | A breastfeeding brochure will be distributed to expectant mothers from 20 weeks gestation during their regular antenatal visit. This will be followed 2 weeks later by a phone call offering clarification/explanation of the brochure. Three phone calls, offering breastfeeding support, will be conducted at 2,6 and 10 weeks following the birth of the baby. |
| Measure | Description | Time Frame |
|---|---|---|
| Exclusive breastfeeding | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Any breastfeeding | 3 & 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Maternal attitudes toward infant feeding | Validated Iowa Infant Feeding Attitude Scale to be used. | Before (at recruitment) and after (at 3 months) |
| Breastfeeding self-efficacy scale | Validated tool measuring a mother's confidence in her ability to breastfeed |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Irena Zakarija-Grkovic, MD, PhD | University of Split | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cito Obstetrics and Gynaecology Clinic | Split | Outside AUS | 21000 | Croatia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31943761 | Derived | Puharic D, Malicki M, Borovac JA, Sparac V, Poljak B, Aracic N, Marinovic N, Luetic N, Zakarija-Grkovic I. The effect of a combined intervention on exclusive breastfeeding in primiparas: A randomised controlled trial. Matern Child Nutr. 2020 Jul;16(3):e12948. doi: 10.1111/mcn.12948. Epub 2020 Jan 13. |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Dec 6, 2024 | |
| Reset | Jan 16, 2025 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Dec 6, 2024 | Jan 16, 2025 |
| ID | Term |
|---|---|
| D001942 | Breast Feeding |
| ID | Term |
|---|---|
| D005247 | Feeding Behavior |
| D001519 | Behavior |
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|
| At 3 months post birth |
| Breastfeeding difficulties | At 3 months postbirth |