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1145 Improving postnatal breastfeeding support for mothers of low-birth-weight infants in rural Kenyan hospitals- a feasibility study

Dickinson, Fiona ORCID:, Achieng, Florence, K’Oloo, Alloys, Tindi, Linda, Boga, Mwanamvua, Kimani, Mary, Kiige, Laura, Mellor, Kathy, Barsosio, Hellen, Kariuki, Simon and Nabwera, Helen (2022) '1145 Improving postnatal breastfeeding support for mothers of low-birth-weight infants in rural Kenyan hospitals- a feasibility study'. Archives of Disease in Childhood, Vol 107, Issue Suppl 2, A333.1-A333.

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To assess the feasibility and acceptability of using trained peer mothers to deliver breastfeeding support to mothers of low-birth-weight (LBW, <2500g) infants in healthcare facilities in rural, western Kenya.

The study was conducted in Homa Bay County. Seventeen peer mothers attended a 4-day training programme that focussed on communication skills, breastfeeding support, Kangaroo Mother Care, hygiene and identification of danger signs. Competency-based scenarios were used to select the 10 (59%) peer mothers, who delivered the interventions to the mother-LBW infant pairs (<28 post-delivery) across 8 healthcare facilities in Homa Bay County. A mixed methods approach was employed using structured observations and post-intervention semi-structured interviews with mothers, healthcare providers and peer mothers. Descriptive statistics were used to analyse the quantitative data. A thematic framework was used to analyse the qualitative data.

From September-November 2021, 23 mother-LBW infant pairs (3 sets of twins so 26 infants) were recruited and received the intervention. The median maternal age was 25 years (Interquartile range, IQR 22, 29) and all infants were born in hospital. The median age of the infants was 1 day (IQR 1,3), median birth weight 2100g (IQR 1900, 2260) and median gestation was 34 weeks (IQR 34,36). Although all the mothers who received the intervention looked well, worryingly 4 (17%) showed no signs for bonding with the infant. Peer mothers consistently explored mothers’ wellbeing (25, 100%), positioning on the breast (21, 87%) and supported mothers with expressing breast milk but were less consistent with supporting and observing infant breast attachment (15, 63%) and suckling (13, 54%) during feeds. Only one infant was noted to be too weak to suckle and was referred to the health care providers. Key themes from the interviews were the promotion of resilience in infant feeding decision making among mothers, against community misconceptions of practices such as expressing breast milk; and the enhancement of positive interactions between mothers, peer mothers and health care providers in the context of healthcare facility restrictions on visitors due to COVID-19 and staff shortages. Insufficient breastmilk was a recurrent theme sometimes attributed to poor maternal diet.

Facility-based breastfeeding peer support for mothers of LBW infants has the potential to improve uptake of appropriate infant feeding practices and their post-discharge survival and growth outcomes in rural communities in Kenya. These preliminary data, including the observed implementation challenges will be used to inform the design of a future trial to rigorously evaluate this potentially sustainable approach to addressing adverse post discharge outcomes of these vulnerable infants.

Item Type: Article
Additional Information: Abstract only
Subjects: WQ Obstetrics > WQ 20 Research (General)
WS Pediatrics > Child Care. Nutrition. Physical Examination > WS 115 Nutritional requirements. Nutrition disorders
WS Pediatrics > Child Care. Nutrition. Physical Examination > WS 125 Breast feeding
WS Pediatrics > By Age Groups > WS 420 Newborn infants. Neonatology
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):
Depositing User: Lynn Roberts-Maloney
Date Deposited: 26 Jan 2023 15:04
Last Modified: 26 Jan 2023 15:15


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