A pilot feasibility study of a continuity of care model of breastfeeding support in a regional Australian population.

PROBLEM: Despite numerous public health initiatives, rates of exclusive breastfeeding in Australia do not meet recommendations. BACKGROUND: Currently 35% of maternity services provide some form of continuity of care, with superior results in key outcomes. AIM: This pilot study was undertaken to determine feasibility of a lactation consultant led continuity of care model for breastfeeding support. METHODS: Randomisation occurred at 36-weeks gestation. Usual care followed NSW Health guidelines, the new model provided support by a board-certified lactation consultant, with up to 14 postnatal appointments available until six months postpartum. The primary outcome was study feasibility, measured by recruitment and retention, and protocol adherence. Secondary outcomes were breastfeeding rates at discharge, 4-months and 6-months postpartum. FINDINGS: Recruitment uptake was high, over 95% of women approached enrolled in the study, with 90.1% completing the study protocol. Attrition was < 10% and rates of monthly data collection completion varied between 45% and 88%. The intervention utilised 225 service hours. End point data at 6-months was available for 88.9% (intervention) and 84.8% (usual care) of participants. DISCUSSION: Despite higher rates of breastfeeding issues, women in the intervention group had similar rates of breastfeeding at 4- and 6-months and reduced hospital readmissions for breastfeeding related issues. Women indicated a preference for text and phone support once breastfeeding was established, however this preference may need to be balanced with more in-person support to ensure maximum benefits. CONCLUSION: Outcomes indicate a larger RCT using this protocol would be feasible, with an economic evaluation recommended.