Impact of a Lactation Consultant Support Program on Breastfeeding Rates, Infant Growth, and Morbidity: A Randomized Clinical Trial
AI Summary
IBCLC-led programme achieved markedly higher exclusive breastfeeding versus control: discharge 98.8% vs 21.2%, three months 98.8% vs 10%, six months 91.4% vs 3.8%.
First year morbidity significantly lower in intervention group with reduced bronchitis and bronchiolitis and fewer hospital readmissions.
Supports implementation of structured IBCLC-led breastfeeding support programme within public health policy and expansion to additional neonatal units.
PURPOSE: This study evaluates the effectiveness of a Breastfeeding Support and Promotion Program (PAP-LM), led by an International Board Certified Lactation Consultant (IBCLC), on exclusive breastfeeding (EBF) rates, morbidity, and hospital readmissions in preterm infants.
BACKGROUND: Breastfeeding is a key preventive strategy for preterm infants. However, the integration of IBCLCs into neonatal units is variable, and the evidence regarding their impact on morbidity in this high-risk population remains inconsistent.
METHODS: In this parallel-group randomized clinical trial, 162 preterm infants (32 + 0 to 36 + 6 gestation weeks) were randomly assigned (1:1) to receive either the PAP-LM intervention or standard care. The study followed CONSORT guidelines. Primary outcomes included breastfeeding rates; secondary outcomes encompassed growth, neonatal morbidity, and hospital readmissions.
RESULTS: Significant differences in EBF rates were observed between the intervention group (IG) and the control group (CG) at discharge (98.8% vs 21.2%; P < 0.001), at 3 months (98.8% vs 10%; P < 0.001), and at 6 months (91.4% vs 3.8%; P < 0.001). First-year morbidity was significantly lower in the IG compared with the CG (32.1% vs 66.2%; P < 0.001), particularly for bronchitis and bronchiolitis.
CONCLUSIONS: A structured IBCLC-led support program, initiated in the neonatal unit and continued through 6 months of home-based follow-up, promotes sustained EBF and reduces neonatal morbidity and hospital readmissions.
IMPLICATIONS FOR RESEARCH AND PRACTICE: The results support the implementation of structured breastfeeding support programs within public health policies targeting high-risk newborns and encourage the expansion of IBCLC-led services to additional neonatal units. Trial registration: gov, NCT06653595.
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