Evaluation of Postpartum Lactation Counselling on Exclusive Breastfeeding Rate at Six Months

Abstract

Objective: to evaluate the effects of postpartum lactation counseling on the rate of exclusive breastfeeding (EBF) at 6 months. Method: We conducted a cross-sectional analytical study with retrospective data collection over a period of 7 months in mother-child couples aged 6-15 months who received postpartum lactation counseling. Data collection was done according to a pre-established and pre-tested questionnaire; examining the mothers' socio-demographic characteristics, post-intervention practices during the first six months. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 23.0 software and the Odds Ratio (OR) with its 95% confidence interval was used to assess the association between the different counselling variables. in lactation and the exclusive practice of breastfeeding. Any difference was considered statistically significant when the p-value was less than 0.05. Results: We recruited 499 mother-child pairs, the median age was 31 years, with an interquartile range [28-34]; most employed, living in couple. Post-intervention practices were generally appropriate and above average (74% for skin-to-skin contact less than 30 minutes, 61.6% for early breastfeeding less than an hour after delivery, 84.4% for breastfeeding on demand, expression and conservation of milk for 44.1% and 83.8%, while 50.7% practice removal of teats); on the other hand, motherchild cohabitation was only possible for 4.2% of them. Postpartum lactation counseling was associated with a high rate of EBF at 6 months through practices such as: milk expression [72.2%; OR: 3,996; (CI: 1.77-8.97; p=0.001)], avoidance of teats [51.4%; Odd Ratio(OR): 2.73; (CI: 1.20-4.11; p=0.01)], breastfeeding on demand [57.5%; OR: 4.645; CI: 1.93-23.06; p=0.003)] and mother-child co-rooming [81%; OR: 4.91; CI: 1.41-19.98;p=0.012)]. Skin-to-skin contact less than 30 minutes after delivery (p= 0.807) and milk storage (p= 0.635) had no effect on the EBF rate at 6 months. The general prevalence of EBF at 6 months post-intervention was 44.3 %, higher than the national average according to the Cameroonian Demographic Health Survey (DHS 2018) and fast approaching the 50% target of 2025. Conclusion: Education and postnatal follow-up of breastfeeding mothers through lactation counselling programs have resulted in improving appropriate skills and practices; thus, are essential for the promotion of sustainable exclusive breastfeeding.