Rapid increases in hospital and cesarean deliveries threaten an already falling exclusive breastfeeding rate (EBR) in Bangladesh. There is neither a sustained Baby-Friendly Hospital Initiative (BFHI) nor any community support for breastfeeding mothers. Our aim was to find out whether breastfeeding support after hospital delivery and subsequently by mobile phone at home is effective in improving EBR in infants under six-months of age. A quasi-experimental study was carried out in 2010 at the Centre for Woman and Child Health (CWCH), Savar, Bangladesh. A total of 129 mothers delivered at CWCH were recruited in pre-intervention phase and their infants followed up between 0 and 5 months of age in the community for exclusive breastfeeding (EBF), anthropometry and illness. An intervention package was then implemented with postpartum support for first hour breastfeeding initiation, correction of position and attachment and face-to-face counseling in hospital followed by mobile phone support by two trained Research Assistants once every 15 days after discharge up to six months of age. During the intervention phase, 164 pregnant women delivered at CWCH were recruited and followed up as in the pre-intervention phase. In the pre-intervention phase among 114 infants, 66 (58%) were found to be exclusively breastfed. In the intervention phase among 151 infants, 118 (78%) were exclusively breastfed (p = 0.000). In the pre-intervention phase EBR at less than one month and five months were 85 and 42% as in the intervention phase these EBR were 89 and 71% respectively. Wasting (weight-for-height Z-score < − 2.00), stunting (height-for-age Z-score < − 2.00), and underweight (weight-for-age Z-score < − 2.00) was 17 (15%), 7 (6%), and 14 (13%) respectively in the pre-intervention phase. In the intervention phase wasting, stunting, and underweight was 16 (11%), 16 (11%), and 15 (10%) respectively. Therefore, there was no statistically significant differences in nutritional status of the infants in the two phases. There was also no significant differences in child morbidity (pneumonia and diarrhea) between the two phases. A combination of hospital support and mobile phone counseling in the community sustained higher rates of EBF in the community after hospital delivery.

中文翻译：

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在医院分娩和咨询后维持社区纯母乳喂养的手机支持：一项半实验研究。

医院和剖宫产的迅速增加威胁到孟加拉国已经下降的纯母乳喂养率。既没有持续的爱婴医院倡议（BFHI），也没有任何社区支持母乳喂养的母亲。我们的目的是找出在分娩后以及随后在家中通过手机进行母乳喂养的支持是否能有效改善6个月以下婴儿的EBR。2010年在孟加拉国萨瓦尔的妇女和儿童健康中心（CWCH）进行了一项准实验研究。在干预前阶段，总共招募了129名在CWCH分娩的母亲，他们的婴儿在社区中接受了0至5个月的随访，以进行纯母乳喂养（EBF），人体测量学和疾病。然后实施干预措施，并在产后支持后开始头一个小时的母乳喂养，纠正位置和依恋关系以及在医院进行面对面咨询，然后由两名训练有素的研究助理在出院后六个月每15天提供一次手机支持。年龄。在干预阶段，招募了164名在CWCH分娩的孕妇，并进行了干预前的随访。在干预前阶段，在114名婴儿中，有66名（58％）被发现是纯母乳喂养的。在干预阶段的151名婴儿中，有118名（78％）仅靠母乳喂养（p = 0.000）。在干预前阶段，不到一个月和五个月的EBR分别为85％和42％，而在干预阶段，这些EBR分别为89％和71％。浪费（身高体重Z得分<− 2.00），发育迟缓（年龄Z评分<-2.00）和体重不足（年龄Z-评分<-2.00）分别为17（15％），7（6％）和14（13％）在干预前阶段。在干预阶段，消瘦，发育迟缓和体重不足分别为16（11％），16（11％）和15（10％）。因此，在两个阶段中，婴儿的营养状况没有统计学上的显着差异。在这两个阶段之间，儿童发病率（肺炎和腹泻）也没有显着差异。社区医院支持和手机咨询相结合，使分娩后社区的EBF发生率更高。在干预阶段，消瘦，发育迟缓和体重不足分别为16（11％），16（11％）和15（10％）。因此，在两个阶段中，婴儿的营养状况没有统计学上的显着差异。在两个阶段之间，儿童发病率（肺炎和腹泻）也没有显着差异。社区住院支持和移动电话咨询相结合，使分娩后社区的EBF发生率更高。在干预阶段，消瘦，发育迟缓和体重不足分别为16（11％），16（11％）和15（10％）。因此，在两个阶段中，婴儿的营养状况没有统计学上的显着差异。在这两个阶段之间，儿童发病率（肺炎和腹泻）也没有显着差异。社区住院支持和移动电话咨询相结合，使分娩后社区的EBF发生率更高。