Breastfeeding peer counselling for mothers of preterm neonates: protocol of a stepped-wedge cluster randomised controlled trial

Introduction Among preterm infants, mother’s own milk feeding reduces neonatal morbidity and decreases the length of hospital stay. However, breastfeeding rates and duration are lower than among term infants. It is reported that peer counselling is effective in increasing breast feeding in term infa...

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Main Authors: Mathilde Morisod Harari, Antje Horsch, Sandrine Touzet, Pauline Occelli, Angelique Denis, Céline Julie Fischer Fumeaux, Sophie Laborie, Jennifer Margier, Olivier Claris
Format: Article
Language:English
Published: BMJ Publishing Group 2020-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/1/e032910.full
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author Mathilde Morisod Harari
Antje Horsch
Sandrine Touzet
Pauline Occelli
Angelique Denis
Céline Julie Fischer Fumeaux
Sophie Laborie
Jennifer Margier
Olivier Claris
author_facet Mathilde Morisod Harari
Antje Horsch
Sandrine Touzet
Pauline Occelli
Angelique Denis
Céline Julie Fischer Fumeaux
Sophie Laborie
Jennifer Margier
Olivier Claris
author_sort Mathilde Morisod Harari
collection DOAJ
description Introduction Among preterm infants, mother’s own milk feeding reduces neonatal morbidity and decreases the length of hospital stay. However, breastfeeding rates and duration are lower than among term infants. It is reported that peer counselling is effective in increasing breast feeding in term infants in low-income and middle-income countries, but results are mixed in high-income countries. We aim to investigate herein whether peer counselling may be a feasible and effective breastfeeding support among preterm infants in French-speaking high-income countries.Methods and analysis Eight European centres will participate in this stepped-wedge cluster randomised controlled trial. We plan to include 2400 hospitalised neonates born before 35 gestational weeks. Each centre will begin with an observational period. Every 3 months, a randomised cluster (centre) will begin the interventional period with peer counsellors until the end of the study. The counsellors will be trained and supervised by the trained nurses. They will have a weekly contact with participating mothers, with a face-to-face meeting at least once every fortnight. During these meetings, peer counsellors will listen to mothers’ concerns, share experiences and help the mother with their own knowledge of breast feeding. The main outcome is breastfeeding rate at 2 months corrected age. Secondary outcomes are breastfeeding rates at hospital discharge and at 6 months, breastfeeding duration and severe neonatal morbidity and mortality. The mental health of the mother, mother–infant bonding and infant behaviour will be assessed using self-report questionnaires. A neurodevelopmental follow-up, a cost-effectiveness analysis and a cost–consequence at 2 years corrected age will be performed among infants in a French subgroup.Ethics and dissemination French, Belgian and Swiss ethics committees gave their agreement. Publications in peer-reviewed journals are planned on breast feeding, mental health and economic outcomes.Trial registration number NCT03156946
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spelling doaj-art-6ccdfc0ce2e54e908287248401ad1dbd2024-12-07T00:00:07ZengBMJ Publishing GroupBMJ Open2044-60552020-01-0110110.1136/bmjopen-2019-032910Breastfeeding peer counselling for mothers of preterm neonates: protocol of a stepped-wedge cluster randomised controlled trialMathilde Morisod Harari0Antje Horsch1Sandrine Touzet2Pauline Occelli3Angelique Denis4Céline Julie Fischer Fumeaux5Sophie Laborie6Jennifer Margier7Olivier Claris89 Child and Adolescent Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne, Vaud, SwitzerlandInstitute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland13 Laboratoire Health Services and Performance Research (HESPER) EA 7425, Université de Lyon 1, Villeurbanne, France7 Laboratoire Health Services and Performance Research, EA 7425 HESPER, Université Lyon 1, Villeurbanne, France2 Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France5 Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland1 Hopital Femme Mère Enfant, Neonatology, Hospices Civils de Lyon, Bron, France8 Public Health, University Hospital Centre Lyon, Lyon, France3 Service de néonatologie et de réanimation néonatale, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Bron, FranceIntroduction Among preterm infants, mother’s own milk feeding reduces neonatal morbidity and decreases the length of hospital stay. However, breastfeeding rates and duration are lower than among term infants. It is reported that peer counselling is effective in increasing breast feeding in term infants in low-income and middle-income countries, but results are mixed in high-income countries. We aim to investigate herein whether peer counselling may be a feasible and effective breastfeeding support among preterm infants in French-speaking high-income countries.Methods and analysis Eight European centres will participate in this stepped-wedge cluster randomised controlled trial. We plan to include 2400 hospitalised neonates born before 35 gestational weeks. Each centre will begin with an observational period. Every 3 months, a randomised cluster (centre) will begin the interventional period with peer counsellors until the end of the study. The counsellors will be trained and supervised by the trained nurses. They will have a weekly contact with participating mothers, with a face-to-face meeting at least once every fortnight. During these meetings, peer counsellors will listen to mothers’ concerns, share experiences and help the mother with their own knowledge of breast feeding. The main outcome is breastfeeding rate at 2 months corrected age. Secondary outcomes are breastfeeding rates at hospital discharge and at 6 months, breastfeeding duration and severe neonatal morbidity and mortality. The mental health of the mother, mother–infant bonding and infant behaviour will be assessed using self-report questionnaires. A neurodevelopmental follow-up, a cost-effectiveness analysis and a cost–consequence at 2 years corrected age will be performed among infants in a French subgroup.Ethics and dissemination French, Belgian and Swiss ethics committees gave their agreement. Publications in peer-reviewed journals are planned on breast feeding, mental health and economic outcomes.Trial registration number NCT03156946https://bmjopen.bmj.com/content/10/1/e032910.full
spellingShingle Mathilde Morisod Harari
Antje Horsch
Sandrine Touzet
Pauline Occelli
Angelique Denis
Céline Julie Fischer Fumeaux
Sophie Laborie
Jennifer Margier
Olivier Claris
Breastfeeding peer counselling for mothers of preterm neonates: protocol of a stepped-wedge cluster randomised controlled trial
BMJ Open
title Breastfeeding peer counselling for mothers of preterm neonates: protocol of a stepped-wedge cluster randomised controlled trial
title_full Breastfeeding peer counselling for mothers of preterm neonates: protocol of a stepped-wedge cluster randomised controlled trial
title_fullStr Breastfeeding peer counselling for mothers of preterm neonates: protocol of a stepped-wedge cluster randomised controlled trial
title_full_unstemmed Breastfeeding peer counselling for mothers of preterm neonates: protocol of a stepped-wedge cluster randomised controlled trial
title_short Breastfeeding peer counselling for mothers of preterm neonates: protocol of a stepped-wedge cluster randomised controlled trial
title_sort breastfeeding peer counselling for mothers of preterm neonates protocol of a stepped wedge cluster randomised controlled trial
url https://bmjopen.bmj.com/content/10/1/e032910.full
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