Multicomponent perinatal breastfeeding support in women with BMI >25: The Latch On multi-centre randomised trial

BJOG. 2024 Feb 12. doi: 10.1111/1471-0528.17782. Online ahead of print.

Abstract

Objective: To investigate the effectiveness of a multicomponent breastfeeding support intervention on breastfeeding prevalence at 3 months among women with a body mass index (BMI) >25 kg/m2 .

Design: Multicentre multicomponent randomised controlled trial.

Setting: Four maternity centres in Ireland.

Population: A total of 225 primiparous women and their nominated support partners. Participants were aged 18 years and over, with BMI ≥25 kg/m2 , carrying a singleton pregnancy and without contraindication for breastfeeding.

Methods: The intervention included an antenatal group breastfeeding education session for participants and their support partners, followed by a planned postnatal breastfeeding assessment and telephone support for up to 6 weeks by a lactation consultant.

Main outcome measures: Any breastfeeding at 3 months postpartum.

Results: Any breastfeeding prevalence was 68.7% (n = 68) in the intervention group and 62.1% (n = 59) in the control group at 3 months postpartum (odds ratio 1.33, 95% confidence interval 0.72-2.46, p = 0.36). Any and exclusive breastfeeding rates did not significantly differ at any other time point. More women in the control group accessed support from private lactation consultants (intervention 23.5% [n = 12], control 45.3% [n = 24], p = 0.02).

Conclusions: The control group had higher than expected breastfeeding rates, and the study found no evidence of effect on the primary outcome. Providing comprehensive education and support for women intending to breastfeed remains of paramount importance.

Keywords: antenatal breastfeeding support; breastfeeding education; breastfeeding intervention; lactation consultant; maternal obesity; postnatal breastfeeding support.