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| Name | Class |
|---|---|
| University of Sao Paulo | OTHER |
| University of Basel | OTHER |
| Swiss National Science Foundation | OTHER |
| Federal University of São Paulo |
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The goal of this study is to assess the effectiveness of social transfers on exclusive breastfeeding rates in São Paulo, Brazil. The main research questions are:
Participants will be randomly assigned to one of three groups: 1) control, no social transfer 2) non-conditional social transfer at 6-months postpartum, and 3) conditional social transfer at six months postpartum; conditional upon the mothers exclusive breastfeeding status.
All participants receive education about the benefits of exclusive breastfeeding and current international recommendations.
Researchers will compare the intervention groups to the control group to see if social transfers are effective at increasing exclusive breastfeeding rates at six months postpartum.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control Group | No Intervention | Only educational materials focused on the benefits of exclusive breastfeeding and the current international recommendations are provided. | |
| Intervention Group 1 - Non-Conditional Social Transfer | Experimental | Educational materials focused on the benefits of exclusive breastfeeding and the current international recommendations are provided. At the baseline visit, participants are told that at the 6-month visit, they will receive a gift of their choice - which is meant to show our appreciation and support for their efforts in breastfeeding. Intervention: Behavioral: Social Transfer |
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| Intervention Group 2 - Conditional Social Transfer | Experimental | Educational materials focused on the benefits of exclusive breastfeeding and the current international recommendations are provided. At the baseline visit, participants are told that at the 6-month visit, they will receive a gift of their choice if they are still exclusively breastfeeding. Intervention: Behavioral: Social Transfer |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Social Transfer | Behavioral | Social transfers are defined as a cash or in-kind transfer. Based on previous social transfer programs in Brazil, we will offer gift packages for mothers at 6 months. The options include: diapers, hygiene products, child developmental toys, transport vouchers, or a combination of these. |
| Measure | Description | Time Frame |
|---|---|---|
| Prevalence of Exclusive Breastfeeding | The proportion of women exclusively breastfeeding at 6-months postpartum will be assessed using a questionnaire. Exclusive breastfeeding is defined as receipt of only human milk - which is consistent with the World Health Organization guidelines. At six months postpartum, mothers are asked if they are still currently breastfeeding. If they answer yes, a follow-up question on if they provided any other liquids, solids, or supplements to their child to determine the exclusive breastfeeding status. | 6 months postpartum |
| Duration of Exclusive Breastfeeding | The duration of exclusive breastfeeding will be assessed using a questionnaire. Exclusive breastfeeding is defined as receipt of only human milk - which is consistent with the World Health Organization guidelines. At six months postpartum, mothers are asked if they are still currently breastfeeding. If they answer yes, a follow-up question on if they provided any other liquids, solids, or supplements to their child to determine the exclusive breastfeeding status. | 6 months postpartum |
| Measure | Description | Time Frame |
|---|---|---|
| Child Health Outcomes | We will assess the child's health outcomes by using a questionnaire. The questionnaire will ask a range of yes or no questions about disease/illness history, hospitalizations, and other health events. | 1 month, 6 months, 1 year, 2 years |
| Early Childhood Development |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jordyn Wallenborn | Contact | +41 76 525 01 83 | jordyn.wallenborn@swisstph.ch | |
| Stephanie Khoury | Contact | +41 78 265 20 60 | stephanie.khoury@swisstph.ch |
| Name | Affiliation | Role |
|---|---|---|
| Jordyn Wallenborn | Swiss Tropical & Public Health Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Sao Paulo | Recruiting | São Paulo | Butantã | 05508-220 | Brazil |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42321811 | Derived | Khoury S, Onofre AC, Sartorio B, Coca K, Costa ML, Karimian-Marnani N, Merten S, Brentani A, Wallenborn J. Barriers to breastfeeding and targeted breastfeeding social transfer programs in Sao Paulo, Brazil: a qualitative study. Int Breastfeed J. 2026 Jun 19. doi: 10.1186/s13006-026-00865-2. Online ahead of print. | |
| 40991943 | Derived |
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| ID | Term |
|---|---|
| D001942 | Breast Feeding |
| ID | Term |
|---|---|
| D005247 | Feeding Behavior |
| D001519 | Behavior |
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| OTHER |
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When the child is two years of age, a comprehensive end line assessment will be conducted to evaluate early childhood development indicators (e.g. The Global Scale for Early Development (GSED). This indicator will be normalized to a mean of 0 and a standard deviation of 1 to facilitate interpretation of estimated group differences. |
| 1 year, 2 years |
| Prevalence of Complementary Breastfeeding | The proportion of women complementary breastfeeding at 1-year, and 2-years postpartum will be assessed using a questionnaire. Complementary breastfeeding is defined as receipt of human milk in combination with complementary foods and liquid. At each time point postpartum, mothers are asked if they are still currently breastfeeding. If they answer yes, a follow-up question on if they provided any other liquids, solids, or supplements to their child to determine the complementary breastfeeding status. | 6 months, 1 year, 2 years |
| Duration of Complementary Breastfeeding | The duration of complementary breastfeeding at 1-year, and 2-years postpartum will be assessed using a questionnaire. Complementary breastfeeding is defined as receipt of human milk in combination with complementary foods and liquid. At each time point postpartum, mothers are asked if they are still currently breastfeeding. If they answer yes, a follow-up question on if they provided any other liquids, solids, or supplements to their child to determine the complementary breastfeeding status. | 6 months, 1 year, 2 years |
| Federal University of São Paulo | Recruiting | São Paulo | 04021-001 | Brazil |
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| Khoury S, Brentani A, Brentani H, Fiamoncini J, Francisco R, Onofre AC, Rodrigues Henrique SE, Fink G, Wallenborn J. Social Transfers for Exclusive Breastfeeding in Brazil: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. 2025 Sep 24;14:e75796. doi: 10.2196/75796. |