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Breastfeeding Support Intervention in Jaundiced Infants
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Purpose
Breastfeeding decreases the risk of many infantile infectious diseases and certain types of cancers in women. It strengthens the bond between mothers and babies and decreases the health care cost to society by making children healthier. Although it is controversial, breastfeeding has been reported to increase the risk of jaundice in the neonatal period. There is some evidence that mothers of hospitalized jaundiced infants discontinue breastfeeding early, as they feel responsible for the baby's condition.
The main objective of this study is to determine the effect of a breastfeeding intervention on breastfeeding duration in jaundiced infants. All eligible infants will be randomized to one of two groups (an intervention or a control group). Mothers of infants in the intervention group will meet with a lactation consultant during their hospital stay, and three times post hospital discharge. Lactation consultants are individuals who have received certification in breastfeeding support from an international board, ensuring safe and effective practice. Mothers of infants in the control group will receive the current standard of care, which is typically support from the nursing staff, who are often not trained in lactation support. Information will be collected on length of time that infants are fed only breast milk, future visits to health care providers, mothers' need for breastfeeding support post hospital discharge, mothers' perception of their physicians' attitudes towards breastfeeding, and mothers' experiences at the hospital, as well as feedback on the intervention. Phone follow-up will occur one week post hospital discharge, and when the child is 2, 3, 4 and 6 months old.
The results of this study will clarify the importance of offering sound breastfeeding advice to mothers of young infants hospitalized with jaundice and help determine whether there is a need for trained lactation specialists in children's hospitals. It will allow us to examine whether such an intervention can have a quantifiable impact on children's health in their first 6 months of life, as measured by physician encounters and hospitalizations. It will also allow collection of information on advice and support given to breastfeeding women by primary care physicians, potentially identifying needs for more rigorous breastfeeding training during medical training.
| Condition | Intervention |
|---|---|
| Jaundice Breastfeeding | Other: Lactation Consultant support |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Single (Investigator) |
| Official Title: | The Impact of a Breastfeeding Support Intervention on Breastfeeding Duration in Jaundiced Infants Admitted to a Tertiary Care Centre: a Randomized Controlled Trial. |
- Exclusive breastfeeding at 3 months, or 3 months corrected if the infant was born prematurely. [ Time Frame: 3 months ]
- Exclusive breastfeeding at six months [ Time Frame: 6 months ]
- Partial breastfeeding at three months [ Time Frame: 3 months ]
- Partial breastfeeding at six months [ Time Frame: 6 months ]
- Number of re-hospitalization for jaundice in the first six months of life [ Time Frame: 6 months ]
- Number of re-hospitalization for non-jaundice related causes in the first six months of life [ Time Frame: 6 months ]
- Number of physician encounters in first 6 months of life [ Time Frame: 6 months ]
- Number of mothers seeking breastfeeding help [ Time Frame: 6 months ]
- Amount and type of breastfeeding support given by child's primary physician in first six months of life [ Time Frame: 6 months ]
| Enrollment: | 99 |
| Study Start Date: | October 2009 |
| Study Completion Date: | April 2013 |
| Primary Completion Date: | January 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Lactation Consultant
In hospital meeting with lactation consultant 1 to 3 follow up visits at weekly intervals with lactation consultant |
Other: Lactation Consultant support
Meeting with lactation consultant once while in hospital and up to 3 times after discharge, in addition to current standard of care for jaundice.
Other Name: Breastfeeding support
|
|
No Intervention: current treatment for jaundice
Babies will receive current standard of care for jaundice (IV fluids and phototherapy)
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | up to 1 Month (Child) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Mothers of infants admitted during the study period with hyperbilirubinemia, breastfeeding at the time of admission (any amount of breastfeeding)
- Mothers of infants < 1 month of age at the time of admission
Exclusion Criteria:
- Mothers of infants admitted with hyperbilirubinemia who are exclusively formula-fed
- Mothers of infants with hyperbilirubinemia of the predominantly conjugated type as this is a different disease, not associated with breastfeeding difficulties
- Mothers of infants with anatomical abnormalities, such as cleft lip or palate, as this would interfere with breastfeeding and require more intensive intervention.
- Mothers of neurologically impaired infants as breastfeeding may be more difficult in this population
- Mother of infants who were admitted to the Neonatal Intensive Care Unit (NICU) after birth and never went home as they are likely to have other comorbidities affecting feeding.
- Mothers of infants feeding via naso-gastric, naso-jejunal, or gastric tube
- Mothers of infants > 1 month of age
- Mothers who have had breast surgery in the past
- Foster mothers or adoptive mothers
- Mothers who do not understand English or French
- Mothers of infants that are the result of multiple birth (eg twins)
Contacts and LocationsPlease refer to this study by its ClinicalTrials.gov identifier: NCT00966719
| Canada, Ontario | |
| Children's Hospital of Eastern Ontario | |
| Ottawa, Ontario, Canada, K1H8L1 | |
| Principal Investigator: | Catherine M Pound, MD | Children's Hospital of Eastern Ontario and Research Institute |
More Information
Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Children's Hospital of Eastern Ontario |
| ClinicalTrials.gov Identifier: | NCT00966719 History of Changes |
| Other Study ID Numbers: |
09/23E |
| Study First Received: | August 26, 2009 |
| Last Updated: | January 28, 2016 |
Keywords provided by Children's Hospital of Eastern Ontario:
|
Jaundice Breastfeeding Infants |
Additional relevant MeSH terms:
|
Jaundice Hyperbilirubinemia Pathologic Processes Skin Manifestations Signs and Symptoms |
ClinicalTrials.gov processed this record on August 18, 2017