Learning about Techniques to Create Healthy Infants through Nutrition and Proper Growth: The LATCHING Pilot Project

Abstract

Abstract Background: Despite numerous benefits for both mom and baby, early cessation of breastfeeding and introduction of solids is common. Interventions to improve breastfeeding rates and prevent the early introduction of solids often occur in the postpartum period with variable success. Little is known about women’s attitudes, perceptions, and knowledge surrounding infant feeding decisions and postpartum weight loss. The purpose of this project was to understand timing of and factors that influence infant feeding decisions (breastfeeding and introduction of solids) and barriers that women face when breastfeeding, introducing solids, and losing weight postpartum to inform future interventions. We then conducted a randomized controlled pilot and feasibility trial to evaluate the effectiveness of a prenatal behavioral lifestyle intervention (PBLI) delivered via group based phone counseling (GBPC) on rates of breastfeeding, introducing solids, infant feeding progressions, and maternal acceptance of the intervention. Methods: Eleven women who had recently delivered (infant age 3-10 months) were recruited from a Kansas City Metro pediatric office. All women were currently breastfeeding or had previous breastfeeding experience. Women completed a feeding survey and participated in a group interview to obtain information regarding breastfeeding, introducing solids, and postpartum weight loss. A content and text analysis were performed to summarize the data. Forty-one pregnant women were recruited from a Kansas City Metropolitan Obstetrics and Gynecology office and randomly assigned to a control group or a PBLI. Women in the PBLI attended six GBPC sessions where they learned about breastfeeding and introducing solids. Feeding questionnaires to assess breastfeeding and introduction of solids were sent at two weeks, two months, four months, and six months postpartum. Structured interviews were also conducted after the intervention and at six months postpartum to assess maternal acceptance and intervention feasibility. Results: Group interviews revealed the following themes: (1) Inadequate knowledge for caring for self and infant (2) Desired knowledge from a Healthcare Provider (3) Feeding decisions before pregnancy and preparation in the second/third trimester (4) Unmet breastfeeding goals (5) Clear guidelines on introducing solids (6) Achievement of pre-pregnancy weight with a different body (7) and Lack of time and energy make postpartum weight loss hard. For the PBLI, rates of exclusive breastfeeding and any breastfeeding did not differ between groups at any time point. No between group differences were found for early introduction of solids or infant feeding progression. Participants overwhelming found the intervention acceptable and beneficial. Conclusions: Overall, women do not feel they have adequate information to successfully breastfeed, introduce solids, or lose weight postpartum. Mothers also discontinue breastfeeding earlier than recommended despite high rates of initiation. Women want basic and practical information on caring for and feeding themselves and their infant. Information should be provided during pregnancy in addition to routine well child visits. In addition, A PBLI may have positive impacts such as maternal empowerment for both breastfeeding and introducing solids. Future studies should incorporate both prenatal and postpartum components.