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Revista Matronas

Revista Matronas

SEPTIEMBRE 2019 N° 2 Volumen 7

A clinical trial for improving adherence to exclusive breastfeeding through a brief motivational intervention

Section: Artículo Especial

How to quote

Franco-Antonio C, Santano-Mogena E, Calderón-García JF, Rico-Martín S, Poblador-Borrella S, Soto-Terrón L, et al. Ensayo clínico para mejorar la adherencia a la lactancia materna exclusiva con una intervención motivacional breve (IMB). Matronas hoy 2019; 7(2):28-35

Authors

1,2 Cristina Franco-Antonio, 3 Esperanza Santano-Mogena, 3 Julián Fernando Calderón-García, 3 Sergio Rico-Martín, 2 Soledad Poblador-Borrella, 2 Laura Soto-Terrón, 3 Sergio Cordovilla-Guardia

Position

1 Matronas del Departamento de Enfermería. Universidad de Extremadura2 Matronas Servicio Extremeño de Salud3 Enfermeros del Departamento de Enfermería, Universidad de Extremadura

Contact email: cristinafrancounex@gmail.com

Abstract

Objective: this study is included in the development of the MOTIVA Breastfeeding Project, which consists in the use of “Brief Motivational Interventions” in health promotion, specifically for addressing the support for breastfeeding in order to achieve the overall health objective by the World Health Organization (WHO), which is to prolong exclusive breastfeeding (EBF) for the first six months of life.
Objectives: to increase the number of women giving EBF during the first six months. To assess the efficacy of the BMI for improving adherence to EBF.
Method: a multicenter randomized clinical trial, conducted in two hospitals from Badajoz, in women who underwent vaginal delivery with a healthy newborn and BF initiated during the first hour of life.
Results: while no final outcomes were available, no significant differences were detected in the preliminary analyses on the efficacy of the BMI in terms of BF duration between both arms; however, there seemed to be a trend towards the longer duration of EBF and BF in the arm which received the BMI, and this was supported by the analysis of EBF survival, where significant differences started to appear in favour of the arm receiving the BMI (Long Rank p= 0.045). It is encouraging to find that BMI seems to present a trend towards a protective effect on EBF discontinuation, preventing almost 70% of discontinuations (HR 0.288 (0.075-1.104) p= 0.064).

Keywords:

breastfeeding; support; promotionbrief motivational intervention

Versión en Español

Título:

Ensayo clínico para mejorar la adherencia a la lactancia materna exclusiva con una intervención motivacional breve (IMB)

Artículo completo no disponible en este idioma / Full article is not available in this language

Bibliography

  1. Franco-Antonio C, Calderón-García JF, Vilar-López R, Portillo-Santamaría M, Navas-Pérez JF, Cordovilla-Guardia S. A randomized controlled trial to evaluate the effectiveness of a brief motivational intervention to improve exclusive breastfeeding rates: study protocol. J Advan Nurs. 2018. Doi: https://doi.org/10.1111/jan.13917
  2. Lozano de la Torre MJ. Lactancia materna. En: Junta Directiva de la SEGHNP (ed.). Protocolos diagnóstico-terapéuticos de Gastroenterología, Hepatología y Nutrición Pediátrica SEGHNP-AE. 2ª ed. Barcelona: Egon; 2010. p. 279-86.
  3. Horta B, Victora C. Short-term effects of breastfeeding: a systematic review on the benefits of breastfeeding on diarrhoea and pneumonia mortality. Geneva: World Health Organization (WHO); 2013.
  4. Organización Mundial de la Salud (OMS). Alimentación del lactante y del niño pequeño [internet]. Ginebra: OMS; 2016. [citado 8 ago 2019]. Disponible en: http://www.who.int/mediacentre/factsheets/fs342/es/
  5. Breastfeeding and the Use of Human Milk. Pediatrics 2012; 129(3):e827-e841. Doi: https://doi.org/10.1542/peds.2011-3552
  6. Comité de Lactancia Materna AEP. Recomendaciones sobre lactancia materna. 2012.
  7. Hernández Aguilar M, Muñoz Guillén A, Lasarte Velillas J, García Vera C, Díaz Marijuan C, Martín Calama J. La lactandia materna en la Comunidad Valenciana. Análisis multivariante de una encuesta a 6.400 lactantes. Rev Pediatr Aten Primaria 2004; 6(21):19-37.
  8. Instituto Nacional de Estadística (INE). Determinantes de salud (Lactancia Materna). Madrid: INE; 2017. [internet] [citado 8 ago 2019]. Disponible en: http://www.ine.es/ss/Satellite?L=es_ES&c=INESeccion_C&cid=1259926457058&p=1254735110672&pagename=ProductosYServicios/PYSLayout
  9. Oribe M, Lertxundi A, Basterrechea M, Begiristain H, Santa Marina L, Villar M, et al. Prevalencia y factores asociados con la duración de la lactancia materna exclusiva durante los 6 primeros meses en la cohorte INMA de Guipúzcoa. Gaceta Sanitaria 2015; 29(1):4-9. Doi: https://doi.org/10.1016/J.GACETA.2014.08.002
  10. Ramiro González MD, Ortiz Marrón H, Arana Cañedo-Argüelles C, Esparza Olcina MJ, Cortés Rico O, Terol Claramonte M, et al. Prevalencia de la lactancia materna y factores asociados con el inicio y la duración de la lactancia materna exclusiva en la Comunidad de Madrid entre los participantes en el estudio ELOIN. Anales de Pediatría. 2017. Doi: https://doi.org/10.1016/J.ANPEDI.2017.09.002
  11. WHO, & UNICEF. Global Nutrion Target 2025. Breastfeeding policy brief. WHO/MNH/NHD 14.7. WHO Library Cataloguing-in-Publication Data. 2014.
  12. Bailey C, Pain RH, Aarvold JE. A “give it a go” breast-feeding culture and early cessation among low-income mothers. Midwifery, 2004; 20(3):240-50. Doi: https://doi.org/10.1016/j.midw.2003.12.003
  13. Meedya S, Fahy K, Kable A. Factors that positively influence breastfeeding duration to 6 months: a literature review. Women and birth: journal of the Australian College of Midwives 2010; 23(4):135-45. Doi: https://doi.org/10.1016/j.wombi.2010.02.002
  14. American Academy of Paediatrics (AAP). Breastfeeding and the use of human milk. Journal of Population Therapeutics and Clinical Pharmacology 2012; 19(3):e827-e841. Doi: https://doi.org/10.1542/peds.2011-3552
  15. Koskinen KS, Aho AL, Hannula L, Kaunonen M. Maternity hospital practices and breast feeding self-efficacy in Finnish primiparous and multiparous women during the immediate postpartum period. Midwifery, 2014; 30(4):464-70. Doi: https://doi.org/10.1016/j.midw.2013.05.003
  16. Oliver Roig A. El abandono prematuro de la lactancia materna: incidencia, factores de riesgo y estrategias de protección, promoción y apoyo a la lactancia. Universidad de Alicante; 2012.
  17. Wambach K, Campbell SH, Gill SL, Dodgson JE, Abiona TC, Heinig MJ. Clinical lactation practice: 20 years of evidence. Journal of human lactation: official journal of International Lactation Consultant Association 2005; 21(3):245-58. Doi: https://doi.org/10.1177/0890334405279001
  18. Díaz-Gómez M, Ruzafa-Martínez M, Ares S, Espiga I, De Alba C. Motivaciones y barreras percibidas por las mujeres españolas en relación a la lactancia materna. Rev Esp Salud Pública 2016; 90(15):1-18.
  19. Dewey KG, Nommsen-rivers LA, Heinig MJ, Cohen RJ. Risk Factors for Suboptimal Infant Breastfeeding Behavior, Delayed Onset of Lactation, and Excess Neonatal Weight Loss. Pediatrics, 2003; 113(3 Pt 1):607-19. Doi: https://doi.org/10.1542/peds.112.3.607
  20. Odom EC, Li R, Scanlon KS, Perrine CG, Grummer-Strawn L. Reasons for Earlier Than Desired Cessation of Breastfeeding. Pediatrics 2013; 131(3):e726-e732. Doi: https://doi.org/10.1542/peds.2012-1295
  21. Neifert MR. Prevention of breastfeeding tragedies. Pediatric clinics of North America, 2001; 48(2):273-97. Doi: https://doi.org/10.1016/S0031-3955(08)70026-9
  22. Blyth R, Creedy D, Dennis C, Moyle W, Pratt J, De Vries S, Healy G. Breastfeeding duration in an Australian population: the influence of modifiable antenatal factors. Journal of human lactation: official journal of International Lactation Consultant Association 2004; 20(1):30-8. Doi: https://doi.org/10.1177/0890334403261109
  23. Demirtas B. Strategies to support breastfeeding: A review. International Nursing Review 2012; 59(4):474-81. Doi: https://doi.org/10.1111/j.1466-7657.2012.01017.x
  24. Dennis C. Theoretical Underpinnings of Breastfeeding Confidence: A Self-Efficacy Framework. Journal of Human Lactation 1999; 15(3):195-201. Doi: https://doi.org/10.1177/089033449901500303
  25. Blyth R, Creedy D, Dennis C, Moyle W, Pratt J, De Vries S. Effect of maternal confidence on breastfeeding duration: an application of breastfeeding self-efficacy theory. Birth (Berkeley, Calif.) 2002; 29(4):278-84. Doi: https://doi.org/10.1046/j.1523-536X.2002.00202.x
  26. Noel-Weiss J, Rupp A, Cragg B, Bassett V, Woodend AK. Randomized Controlled Trial to Determine Effects of Prenatal Breastfeeding Workshop on Maternal Breastfeeding Self-Efficacy and Breastfeeding Duration. Journal of Obstetric, Gynecologic & Neonatal Nursing 2006; 35(5):616-24. Doi: https://doi.org/10.1111/j.1552-6909.2006.00077.x
  27. Otsuka K, Taguri M, Dennis CL, Wakutani K, Awano M, Yamaguchi T, et al. Effectiveness of a breastfeeding self-efficacy intervention: do hospital practices make a difference? Maternal and child health journal 2014; 18(1):296-306. Doi: https://doi.org/10.1007/s10995-013-1265-2
  28. Wu DS, Hu J, Mccoy TP, Efird JT. The effects of a breastfeeding self-efficacy intervention on short-term breastfeeding outcomes among primiparous mothers in Wuhan, China. Journal of Advanced Nursing 2014; 70(8):1867-79. Doi: https://doi.org/10.1111/jan.12349
  29. Ansari S, Abedi P, Hasanpoor S, Bani S. The Effect of Interventional Program on Breastfeeding Self-Efficacy and Duration of Exclusive Breastfeeding in Pregnant Women in Ahvaz, Iran. International Scholarly Research Notices 2014; 1-6. Doi: https://doi.org/10.1155/2014/510793
  30. Chan MY, Ip WY, Choi KC. The effect of a self-efficacy-based educational programme on maternal breast feeding self-efficacy, breast feeding duration and exclusive breast feeding rates: A longitudinal study. Midwifery 2016; 36:92-8. Doi: https://doi.org/10.1016/j.midw.2016.03.003
  31. Brockway M, Benzies K, Hayden KA. Interventions to Improve Breastfeeding Self-Efficacy and Resultant Breastfeeding Rates: A Systematic Review and Meta-Analysis. Journal of Human Lactation 2017; 33(3):486-99. Doi: https://doi.org/10.1177/0890334417707957
  32. Rollnick S, Heather N, Bell A. Negotiating behaviour change in medical settings: The development of brief motivational interviewing. Journal of Mental Health 1992; 1:25.
  33. Miller WR, Rollnick S. Motivational Interviewing: helping people change. 3rd ed. New York: Guilford press; 2013.
  34. Christie D, Channon S. The potential for motivational interviewing to improve outcomes in the management of diabetes and obesity in paediatric and adult populations: a clinical review. Diabetes, Obesity and Metabolism 2014; 16(5):381-7. Doi: https://doi.org/10.1111/dom.12195
  35. Duncan S, Goodyear-Smith F, McPhee J, Zinn C, Grøntved A, Schofield G. Family-centered brief intervention for reducing obesity and cardiovascular disease risk: A randomized controlled trial. Obesity 2016; 24(11):2311-8. Doi: https://doi.org/10.1002/oby.21602
  36. Dunn C, Ostafin B. Brief interventions for hospitalized trauma patients. The Journal of Trauma 2005; 59(3 Suppl):S88-93; discussion S94-100. Doi: https://doi.org/10.1097/01.ta.0000174682.13138.a3
  37. Lakerveld J, Bot SD, Chinapaw MJ, Tulder M, Kostense PJ, Dekker JM, et al. Motivational interviewing and problem solving treatment to reduce type 2 diabetes and cardiovascular disease risk in real life: a randomized controlled trial. The international journal of behavioral nutrition and physical activity, 2013; 10:47. Doi: https://doi.org/10.1186/1479-5868-10-47
  38. Wong EM, Cheng MM. Effects of motivational interviewing to promote weight loss in obese children. J Clin Nurs 2013; 22(17-18):2519-30. Doi: https://doi.org/10.1111/jocn.12098
  39. Field C, Hungerford DW, Dunn C. Brief motivational interventions: an introduction. The Journal of Trauma 2005; 59(3 Suppl):S21-6. Doi: https://doi.org/10.1097/01.ta.0000179899.37332.8a
  40. Madson MB, Loignon AC, Lane C. Training in motivational interviewing: a systematic review. Journal of substance abuse treatment 2009; 36(1):101-9. Doi: https://doi.org/10.1016/j.jsat.2008.05.005
  41. Cordovilla-Guardia S, Vilar-López R, Lardelli-Claret P, Navas JFJ, Guerrero-López F, Fernández-Mondéjar E. Ingreso en cuidados intensivos por un traumatismo relacionado con el consumo de alcohol o drogas, un “momento propicio de enseñanza” para el inicio del cambio. Enferm Intensiva 2017; 28(1):4-12. Doi: https://doi.org/10.1016/j.enfi.2016.12.002
  42. Cordovilla-Guardia S, Fernández-Mondéjar E, Vilar-López R, Navas J, Portillo-Santamaría M, Rico-Martín S, et al. Effect of a brief intervention for alcohol and illicit drug use on trauma recidivism in a cohort of trauma patients. PLOS ONE, 2017; 12(8):e0182441. Doi: https://doi.org/10.1371/journal.pone.0182441
  43. Donovan DM, Hatch-Maillette MA, Phares MM, McGarry E, Michelle Peavy K, Taborsky J. Lessons learned for follow-up phone booster counseling calls with substance abusing emergency department patients. Journal of Substance Abuse Treatment 2015; 50:67-75. Doi: https://doi.org/10.1016/j.jsat.2014.10.013
  44. Field C, Walters S, Marti CN, Jun J, Foreman M, Brown C. A Multisite Randomized Controlled Trial of Brief Intervention to Reduce Drinking in the Trauma Care Setting. Annals of Surgery 2014; 259(5):873-80. Doi: https://doi.org/10.1097/SLA.0000000000000339
  45. Mello MJ, Baird J, Nirenberg TD, Lee C, Woolard R, Longabaugh R. DIAL: a randomised trial of a telephone brief intervention for alcohol. Injury Prevention 2013; 19(1):44-8. Doi: https://doi.org/10.1136/injuryprev-2012-040334
  46. Elliott-Rudder M, Pilotto L, McIntyre E, Ramanathan S. Motivational interviewing improves exclusive breastfeeding in an Australian randomised controlled trial. Acta Paediatrica, International Journal of Paediatrics 2014; 103(1):e11-e16. Doi: https://doi.org/10.1111/apa.12434
  47. Wilhelm SL, Aguirre TM, Koehler AE, Rodehorst TK. Evaluating motivational interviewing to promote breastfeeding by rural Mexican-American mothers: the challenge of attrition. Issues Compr Pediatr Nurs 2015; 38(1):7-21. Doi: https://doi.org/10.3109/01460862.2014.971977
  48. Wilhelm SL, Stepans MBF, Hertzog M, Rodehorst TKC, Gardner P. Motivational interviewing to promote sustained breastfeeding. JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing 2006; 35(3):340-8.
  49. Lawson PJ, Flocke SA. Teachable moments for health behavior change: A concept analysis. Patient Education and Counseling 2009; 76(1):25-30. Doi: https://doi.org/10.1016/j.pec.2008.11.002
  50. Fonarow GC. In-hospital initiation of statins: taking advantage of the “teachable moment2". Cleveland Clinic journal of medicine 2003; 70(6):502, 504-6.
  51. Pollak KI, Denman S, Gordon KC, Lyna P, Rocha P, Brouwer RN, et al. Is pregnancy a teachable moment for smoking cessation among US Latino expectant fathers? A pilot study. Ethnicity & Health 2010; 15(1):47-59. Doi: https://doi.org/10.1080/13557850903398293
  52. Joshi A, Amadi C, Meza J, Aguire T, Wilhelm S. Evaluation of a computer-based bilingual breastfeeding educational program on breastfeeding knowledge, self-efficacy and intent to breastfeed among rural Hispanic women. International Journal of Medical Informatics 2016; 91:10-9. Doi: https://doi.org/10.1016/j.ijmedinf.2016.04.001
  53. Maldonado JA. Lactancia Materna. Sevilla: Junta de Andalucia. Consejeria de Salud; 2005.
  54. Oliver-Roig A, Chulvi-Alabort V, López-Valero F, Salud Lozano-Dura M, Seva-Soler C, Pérez-Hoyos S. Momentos críticos de abandono de la lactancia materna en un seguimiento de 6 meses. Enferm Clin 2008; 18(6):317-20. Doi: https://doi.org/10.1016/S1130-8621(08)75854-6
  55. Balogun O, O’Sullivan E, McFadden A, Ota E, Gavine A, Garner C, MacGillivray S. Interventions for promoting the initiation of breastfeeding. In: Balogun (ed.). The Cochrane Database of Systematic Reviews 2016. p. 100. Chichester, UK: John Wiley & Sons, Ltd. Doi: https://doi.org/10.1002/14651858.CD001688
  56. Oliver-Roig A, D’Anglade-González ML, García-García B, Silva-Tubio JR, Richart-Martínez M, Dennis CL. The Spanish version of the Breastfeeding Self-Efficacy Scale-Short Form: Reliability and validity assessment. International Journal of Nursing Studies 2012; 49(2):169-73. Doi: https://doi.org/10.1016/j.ijnurstu.2011.08.005
  57. Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect. The Lancet. 2016. Doi: https://doi.org/10.1016/S0140-6736(15)01024-7
  58. omité de Lactancia Materna (AEP). ¡Enhorabuena por tu reciente maternidad! [internet]. Madrid: Asociación Española de Pediatría; 2015. [citado 8 ago 2019]. Disponible en: http://www.aeped.es/sites/default/files/documentos/triptico-lactancia-maternidad.pdf
  59. Sanjuán Suárez P, Pérez García AM, Bermúdez Moreno J. Escala de autoeficacia general: datos psicométricos de la adaptación para población española. Psicothema 2000; 12:509-13.
  60. Garcia-Esteve L, Ascaso C, Ojuel J, Navarro P. Validation of the Edinburgh Postnatal Depression Scale (EPDS) in Spanish mothers. Journal of affective disorders 2003; 75(1):71-6.