nursing-care-breast-congress-2017-posters-abstracts

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Page 54
Volume 1, Issue 1 J Nurs Res Pract Nursing Care & Breast Congress 2017
December 11-13, 2017
December 11-13, 2017 | Rome, Italy
Joint Event
&
45th WORLD CONGRESS ON NURSING CARE
8TH EUROPEAN BREAST CONGRESS
Effectiveness of an educational intervention in primary care to maintain exclusive breast-feeding:
Cluster randomised clinical trial; Prolact study
Maria Jesus Santamaria Martin1, S Martín Iglesias2 and Prolact group3
1Lucero Primary Care Center, Spain
2 South Primary Care Direction, Spain
3Professionals Madrid Health Service, Spain
Background: The World Health Organization recommends exclusive breast-feeding (EBF) until six months of life. The WHO
leads a global strategy to promote the initiation and maintenance of breastfeeding. In Spain the rates of EBF at six months are
28.5%. More evidence is needed on the effectiveness of group interventions to maintenance EBF
Methods: This study involves a community-based cluster randomized trial conducted at 10 Primary Healthcare Centres in the
Community of Madrid (Spain). The project aims to evaluate the effectiveness of an educational group intervention performed
by primary healthcare professionals in increasing the proportion of mother-infant pairs using exclusive breastfeeding at six
months compared to routine practice. The number of patients required is 432 (216 in each arm). All mother-infant pairs using
exclusive breastfeeding in the last 24 hours that seek care or information at Healthcare Centres are included to consecutive
sampling, if the infant is not older than four weeks, and the mother gives consent to participate. The main response variable
is mother-infant pairs using EBF at six months. Main effectiveness is analysed by comparing the proportion of mother-
infant pairs (dyads) using exclusive breast-feeding at six months between the intervention group and the control group. All
statistical tests are performed with intention-to-treat. The estimation is adjusted using an explanatory logistic regression
model. A survival analysis is used to compare the two groups using the log-rank test to assess the effect of the intervention on
the duration of breastfeeding. The control of potential confounding variables is performed through the construction of Cox
regression models.
Results: 434 dyads were included, the mean age of the mother was 32.8 (5), 80% were Spanish nationality, 72.6% were active
workers, Vaginal delivery 79.7%. Average weight at birth 3.303 (0.391), median gestational age 39.5 (RIQ 39-40). 226 dyads
were assigned to the intervention and 208 control groups. The 6-month LME was higher in the experimental group RR=2.37
(1.45-3.89) than the control group, RAR 0.13 (0.06-0.19), NNT 8.0.
Discussion: We must implement strategies with scientific to improve the percentage of exclusive breast-feeding at six months
in our environment as established by the WHO. Group education is an instrument used by professionals in Primary Care
that favors the acquisition of skills and modification of already-acquired behavior, all making it a potential method of choice
to improve rates of exclusive breast-feeding in this period. The Prolact intervention has been effective in primary care to
maintain LME at 6 months.
Recent Publications
1. EU Project on Promotion of Breastfeeding in Europe. Protection, promotion and support of breastfeeding in Europe:
a blueprint for action. European Commission, Directorate Public Health and Risk Assessment, Luxembourg, 2004.
Available in:
2. WHO. Global Strategy for Infant and Young Child Feeding. Geneva; WHO; 2003
3. Díaz-Gómez NM, Ruzafa-Martínez M, Ares S, Espiga I, De Alba C. (2016) Motivations and perceived barriers to
initiate or sustain breastfeeding among Spanish women. Rev. Esp. Public Health. 90:16.
Maria Jesus Santamaria Martin et al., J Nurs Res Pract 2017, 1:1(Suppl)