TY - JOUR
T1 - Effectiveness of biological nurturing on early breastfeeding problems: A randomized controlled trial
AU - Luca Ronfani
AU - Milinco, Mariarosa
AU - Travan, Laura
AU - Cattaneo, Adriano
AU - Knowles, Alessandra
AU - Sola, Maria Vittoria
AU - Causin, Enrica
AU - Cortivo, Caterina
AU - Degrassi, Maura
AU - Di Tommaso, Francesca
AU - Verardi, Giuseppa
AU - Dipietro, Laura
AU - Piazza, Maria
AU - Scolz, Sabrina
AU - Rossetto, Martina
AU - Ronfani, Luca
AU - Andreassich, Graziella
AU - Antonino, Antonietta
AU - Bidoli, Silvia
AU - Bonelli, Maria
AU - Brovedani, Pierpaolo
AU - Bua, Jenny
AU - Bubnich, Donatella
AU - Chignoli, Maria
AU - Ciacci, Valentina
AU - Cirillo, Rosaria
AU - Colombera, Aurora
AU - Cont, Gabriele
AU - Crismani, Elisabetta
AU - Delli Carri, Cristiana
AU - Dovier, Enrica
AU - Favuzza, Filippa
AU - Ferro, Claudia
AU - Flaiban, Claudia
AU - Garofalo, Chiara
AU - Giugovaz, Marina
AU - Guerrera, Simona
AU - Imbrogno, Erika
AU - Kis, Izabella
AU - Liut, Valentina
AU - Marandola, Carla
AU - Marzullo, Miriana
AU - Mottola, Antonella
AU - Nider, Silvia
AU - Pavan, Matteo
AU - Pelaschiar, Annalisa
AU - Persic, Emma
AU - Petruzzelli, Maria
AU - Pirrone, Angela
AU - Sustersich, Cristina
AU - Trappan, Antonella
N1 - Funding Information:
The study was supported by the Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”, Trieste, Italy (RC 29/17). The funder did not act as sponsor of the trial and had no role in study design, data collection, data analysis, data interpretation, or writing of the report.
Publisher Copyright:
© 2020 The Author(s).
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/4/5
Y1 - 2020/4/5
N2 - Background: Biological nurturing is a neurobehavioral approach to breastfeeding support that encourages women to breastfed in a relaxed, laidback position. This approach has the potential to reduce breast problems (e.g., sore nipples), making good latch easier and thus facilitating the initiation of exclusive breastfeeding. However, its effects have not been adequately investigated in a real-life situation. The aim of this randomized controlled trial was to assess the effectiveness of biological nurturing, compared to usual hospital practices, on the frequency of breast problems and on the prevalence of exclusive breastfeeding at discharge from the maternity ward, after 1 week, and at one and 4 months. Methods: Open randomized parallel controlled trial carried out in a third level maternity ward (IRCCS Burlo Garofolo, Trieste, Italy) between March and December 2018. Two-hundred eight women who planned to give birth at the hospital and who expressed the intention to breastfeed were enrolled during pregnancy and randomized to receive breastfeeding support following either the biological nurturing approach or the usual care protocol based on the WHO/UNICEF 20-h course, in use at the hospital. The primary study outcome was the incidence of breast problems during hospital stay, defined as the presence of one or more of the following outcomes, collected separately: sore nipples, cracked nipples, engorgement and mastitis. The primary analysis was performed by intention to treat. The follow up lasted 4 months. Results: One hundred eighty eight out of 208 women (90.3%) were included in the analysis, 90 allocated to the biological nurturing group and 98 to the usual care group. At discharge from the maternity ward, biological nurturing significantly reduced the risk of breast problems (Relative risk [RR] 0.56, 95% Confidence Interval [CI] 0.40, 0.79), including cracked (RR 0.42, 95% CI 0.24, 0.74) and sore nipples (RR 0.59, 95% CI 0.40, 0.88). No statistically significant difference was observed for exclusive breastfeeding at discharge and up to 4 months. No adverse events occurred. Conclusions: The biological nurturing approach applied in the real-life situation of a third level hospital was effective in preventing breast problems. Trial registration: Clinicaltrials.gov NCT03503500. Date of First Submission: 28 March 2018.
AB - Background: Biological nurturing is a neurobehavioral approach to breastfeeding support that encourages women to breastfed in a relaxed, laidback position. This approach has the potential to reduce breast problems (e.g., sore nipples), making good latch easier and thus facilitating the initiation of exclusive breastfeeding. However, its effects have not been adequately investigated in a real-life situation. The aim of this randomized controlled trial was to assess the effectiveness of biological nurturing, compared to usual hospital practices, on the frequency of breast problems and on the prevalence of exclusive breastfeeding at discharge from the maternity ward, after 1 week, and at one and 4 months. Methods: Open randomized parallel controlled trial carried out in a third level maternity ward (IRCCS Burlo Garofolo, Trieste, Italy) between March and December 2018. Two-hundred eight women who planned to give birth at the hospital and who expressed the intention to breastfeed were enrolled during pregnancy and randomized to receive breastfeeding support following either the biological nurturing approach or the usual care protocol based on the WHO/UNICEF 20-h course, in use at the hospital. The primary study outcome was the incidence of breast problems during hospital stay, defined as the presence of one or more of the following outcomes, collected separately: sore nipples, cracked nipples, engorgement and mastitis. The primary analysis was performed by intention to treat. The follow up lasted 4 months. Results: One hundred eighty eight out of 208 women (90.3%) were included in the analysis, 90 allocated to the biological nurturing group and 98 to the usual care group. At discharge from the maternity ward, biological nurturing significantly reduced the risk of breast problems (Relative risk [RR] 0.56, 95% Confidence Interval [CI] 0.40, 0.79), including cracked (RR 0.42, 95% CI 0.24, 0.74) and sore nipples (RR 0.59, 95% CI 0.40, 0.88). No statistically significant difference was observed for exclusive breastfeeding at discharge and up to 4 months. No adverse events occurred. Conclusions: The biological nurturing approach applied in the real-life situation of a third level hospital was effective in preventing breast problems. Trial registration: Clinicaltrials.gov NCT03503500. Date of First Submission: 28 March 2018.
KW - Biological nurturing
KW - Breast problems
KW - Breastfeeding
KW - Exclusive breastfeeding
KW - Public health
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U2 - 10.1186/s13006-020-00261-4
DO - 10.1186/s13006-020-00261-4
M3 - Article
C2 - 32248838
AN - SCOPUS:85083072254
VL - 15
JO - International Breastfeeding Journal
JF - International Breastfeeding Journal
SN - 1746-4358
IS - 1
M1 - 21
ER -