Infant Feeding Peer Support Trial

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Final Report

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Trial objective
To assess the effectiveness of a peer support intervention on infant feeding practices.

Design
A randomised controlled trial compared nutritional and other outcomes for women offered volunteer support with those for control women who only received standard professional care. Data was collected at baseline, when the infants were 10 weeks old, post intervention when the children were 12 months old, and 6 months follow up when the sample were 18 months old. In addition to the comprehensive outcome assessment, a detailed process evaluation was also conducted.

Setting
The sample was recruited at baby clinics located across Camden and Islington, London over a 15-month period from December 2002 to February 2004.

Subjects
312 women were allocated at random to intervention (157) or control group (155).

Intervention
A group of local volunteers were recruited and trained to provide non-judgemental support and practical assistance on infant feeding, and in particular weaning practices. Home-based support was offered over a 9-month period until the infants were 12 months old. In total, 758 home visits were made and the mean length of each visit was 60 minutes. On average each mother in the intervention group received 5 volunteer visits. Mothers in the control group received standard professional care only.

Main outcome measures
The primary outcome was vitamin C in fruit. Other macro and micro nutrient intakes were also assessed. Secondary outcomes were fruit and vegetable consumption, feeding practices, child growth and health, and use of health services. In addition, information was also gathered on the mother's health, well-being, fruit and vegetable consumption and nutritional knowledge and confidence.

Results
At post intervention when the babies were 12 months old, no significant differences were found for vitamin C or any other macro and micro-nutrient intakes between the intervention and control groups. However babies in the intervention group did consume significantly more carrots, boiled potatoes, apples and pears. At follow up, again no differences were detected in terms of the intakes of vitamin C and other nutrients. However, children in the intervention group did consume more boiled potatoes, chips and pears than those in the control group. In terms of feeding practices some encouraging results were found. At the post intervention stage, mothers’ in the intervention group were less likely to give their child goats’ or soya milk. Children in the intervention group were also more likely to be eating family foods and to be having 3 solid meals per day. At follow up, children in the intervention group were less likely to be still using a bottle than those in the control group. No significant differences were detected for the child's health and growth or for the mother's health and well-being at either the post intervention or follow up. However, mothers in the intervention group were more knowledgeable about when bottle feeding should be discouraged and were more confident in following health professionals’ recommendations on how best to feed their child. The process evaluation indicated that women in the intervention group were very positive about the volunteers, and greatly appreciated the support provided during the home visits. Evaluation of the volunteer training programme also indicated that the volunteers highly rated their experience of being involved in the study.

Conclusions
The intervention did not achieve a significant change in vitamin C and other macro and micro-nutrient intakes. However, significant benefits were achieved with a range of infant feeding practices and mother's nutritional knowledge and confidence also improved. The process evaluation demonstrated that both the mother's in the intervention group and the volunteer's valued participating in the study. The study results have been extensively disseminated both locally, and at a national level. Across Camden and, more recently Islington, infant feeding peer support programmes have been established.

Acknowledgements
The research team would like to thank all the women who participated in the study and the volunteers who provided the home support. In addition, thanks are due to all the local agencies and professionals who assisted the team in conducting this study. The study was funded by the Food Standards Agency.

This page last modified 14 January, 2009 by [Web Administrator]