Counselling increased exclusive breastfeeding duration by 60 days

In Matlab, Bangladesh, over three thousand pregnant women received either focused breastfeeding counselling sessions or more general health promotion messages. Results revealed that focused counselling increased exclusive breastfeeding by 60 days compared to standard healthcare messages. This indicates that these focused counseling programmes can effectively work to prolong exclusive breastfeeding duration and promote healthy child development in resource-deprived settings.

According to the WHO, exclusive breastfeeding is recommended up to 6 months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond. In fact the Lancet states scaling up of breastfeeding to a near universal level could prevent 823,000 annual deaths in children younger than 5 years and 20,000 annual deaths  from breast cancer.

Despite breastfeeding promotional activities over the last two decades in Bangladesh, the prevalence of exclusive breastfeeding at four to five months of age has remained relatively small, at 32% as per the NIPORT.

Counseling increased exclusive breastfeeding duration by 60 days. Photo: icddr,b / Shehzad Noorani


Dr Ashraful Islam Khan, Associate Scientist and Principal Investigator from the Enteric and Respiratory Infections division at icddr,b, alongside local colleagues and international collaborators at Uppsala university, embarked on a study at Matlab where 3188 women were randomised to receive either (i) a standard health promotion message or (ii) a counselling programme with trained counsellors designed to encourage breastfeeding.

Counselling skills were taught using demonstrations and role play and included listening to mothers, learning about their difficulties, assessing the position and attachment of babies during breastfeeding, building mothers’ confidence, giving support and providing relevant information and practical help when required. The training also included practical sessions with pregnant women and mothers with infants.

As for the trial, the women allocated to breastfeeding counselling received eight sessions.Counseling was given individually at home, but key family members were also included. The duration of each counseling visit was typically 20–40 minutes, depending upon the mother’s lactation stage and her individual needs.

The results published in Acta Paediatrica revealed that the relatively small number of eight counselling sessions (with trained counsellors from pregnancy to the first part of infancy) increased the duration of exclusive breastfeeding by two months compared to mothers that received standard healthcare messages. This indicates that these kinds of focused counselling programmes can effectively work to encourage breastfeeding.

Breastfeeding brings massive benefits to the well-being of children. Photo: icddr,b / Shehzad Noorani

Dr Ashraf says, "This is a 'dose' of the intervention that could be part of regular antenatal and child health services in order to achieve better adherence to the recommended duration of exclusive breastfeeding. It is vital for development - by recognizing breastfeeding is a key to sustainable development, we will value our wellbeing from the start of life."

"Breastfeeding brings massive benefits to the well-being of children in terms of immunity against diarrheal disease, pneumonia, and improved nutritional gains," he adds.

Such interventions are crucial for promoting healthy growth and preventing childhood stunting, especially in low-income settings.

The  research study was funded by, the Swedish International Development Cooperation Agency, the UK Medical Research Council, the Swedish Research Council, the Department for International Development and United States Agency for International Development