Effectiveness of a new breastfeeding counselling intervention on breastfeeding prevalence, infant growth velocity and postpartum weight loss in overweight women: a randomized controlled trial.

BACKGROUND: Maternal overweight is a risk factor for child obesity. Breastfeeding may decrease this risk, but breastfeeding prevalence is low in overweight or obese mothers. METHODS: We conducted a randomized trial in 90 overweight/obese pregnant women in Bogotá-Colombia during 2019, to evaluate the effects of a new exclusive breastfeeding (EBF) counselling intervention for overweight/obese mothers, based on Carl Rogers' client-centered theory. The Intervention included individualized breastfeeding counseling, empowerment sessions, and a set of problem-solving strategies based on Carl Rogers' client-centered theory, conducted during late pregnancy, first week postpartum, 1 and 3 months postpartum. Primary outcomes were EBF during the last 24 h prevalence at 4 months postpartum, infant growth, and maternal weight loss at 4 months postpartum; secondary outcomes were serum and breast milk prolactin concentration, breast milk energy and macronutrient content, estimated breast milk volume at 1 and 4 months and EBF prevalence at interim time-points. Mothers were randomised in late pregnancy to intervention (new breastfeeding counselling; IG) or control group (standard breastfeeding support; CG). RESULTS: The IG had significantly higher EBF prevalence at 4 months (82.8%) compared to the CG (30.6%) (Prevalence ratio or PR = 2.7; 95% CI = 1.6, 4.5). There were no intervention effects on infant growth velocity, maternal weight loss or secondary outcomes. DISCUSSION: The intervention, which could be implemented in primary care settings, was highly effective for increasing the prevalence of EBF in overweight/obese mothers at 4 months postpartum. The results should, however, be interpreted in the context of the small sample size, short follow-up period and loss to follow-up. Further evaluation of the intervention is required in a larger sample including longer-term infant follow-up. TRIAL REGISTRATION: (UTN) U1111-1228-9913 20 February 2019; ISRCTN15922904, retrospectively registered.