Abstract

Objective:To compare the effect of traditional and baby-led breastfeeding advice on early infant weight gain and exclusive breastfeeding rates.

Design:Longitudinal cohort study: part prospective, part retrospective.

Setting:One UK General Practice.

Participants:63 exclusively breastfed infants in 2 cohorts: 32 babies born before and 31 babies born after a change in breastfeeding advice.

Intervention:A change from “baby-led” to traditional breastfeeding advice.

Main outcome measures:Primary analysis: The effectiveness of the intervention: weight gain expressed as Standard Deviation Score Gain [SDSG] between birth and 6 to 8 weeks, and of exclusive breastfeeding rates between babies whose mothers received traditional advice and those whose mothers received “baby-led” advice.<br> Secondary analysis: The relevance of feed length: weight gain expressed as SDSG between birth and 6 to 8 weeks in babies feeding for 10 minutes or less from the first breast and those feeding for longer than 10 minutes.

Results: The two groups were equivalent with respect to important demographic variables, including birthweight, gestational age, and parity.

Primary outcome: Babies whose mothers received the traditional advice were more likely to be exclusively breastfed up to 12 weeks (log-rank ÷2 =9.68 p=0.002) and gained more weight up to 6 to 8 weeks than those given “baby-led” advice (mean SDSG 0.41 [0.13 to 0.69] versus -0.23 [-0.72 to 0.27]).

Secondary outcome: Irrespective of feeding advice given, babies feeding for 10 minutes or less from the first breast gained more weight by 6-8 weeks than babies feeding for longer than 10 minutes (mean SDSG 0.42 [CI 0.11 to 0.73] versus -0.19 [-0.64 to 0.26])

Conclusions: In this study, traditional breastfeeding advice resulted in increased weight gain and increased exclusive breastfeeding rates compared to “baby-led” advice. Exclusively breastfed babies having shorter feeds (10 minutes or less from the first breast) gained more weight.