Randomised controlled trial of support from volunteer counsellors for mothers considering breast feeding.

OBJECTIVE To investigate whether offering volunteer support from counsellors in breast feeding would result in more women breast feeding. DESIGN Randomised controlled trial. SETTING 32 general practices in London and south Essex. PARTICIPANTS 720 women considering breast feeding. MAIN OUTCOME MEASURES Primary outcome was prevalence of any breast feeding at six weeks. Secondary outcomes were the proportion of women giving any breast feeds, or bottle feeds at four months, duration of any breast feeding, time to introduction of bottle feeds, and satisfaction with breast feeding. RESULTS Offering support in breast feeding did not significantly increase the prevalence of any breast feeding to six weeks (65% (218/336) in the intervention group and 63% (213/336) in the control group; relative risk 1.02, 95% confidence interval 0.84 to 1.24). Survival analysis up to four months confirmed that neither duration of breast feeding nor time to introduction of formula feeds differed significantly between control and intervention groups. Not all women in the intervention group contacted counsellors postnatally, but 73% (123/179) of those who did rated them as very helpful. More women in the intervention group than in the control group said that their most helpful advice came from counsellors rather than from other sources. CONCLUSIONS Women valued the support of a counsellor in breast feeding, but the intervention did not significantly increase breastfeeding rates, perhaps because some women did not ask for help.