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. 2020 Jan;16(1):e12907.
doi: 10.1111/mcn.12907. Epub 2019 Dec 2.

The ABA intervention for improving breastfeeding initiation and continuation: Feasibility study results

Joanne L Clarke  1 , Jenny Ingram  2 , Debbie Johnson  2 , Gill Thomson  3 , Heather Trickey  4 , Stephan U Dombrowski  5   6 , Alice Sitch  1   7 , Fiona Dykes  3 , Max Feltham  8 , Christine MacArthur  1 , Tracy Roberts  9 , Pat Hoddinott  10 , Kate Jolly  1
Affiliations

The ABA intervention for improving breastfeeding initiation and continuation: Feasibility study results

Joanne L Clarke et al. Matern Child Nutr. 2020 Jan.

Abstract

The UK has low breastfeeding rates, with socioeconomic disparities. The Assets-based feeding help Before and After birth (ABA) intervention was designed to be inclusive and improve infant feeding behaviours. ABA is underpinned by the behaviour change wheel and offers an assets-based approach focusing on positive capabilities of individuals and communities, including use of a Genogram. This study aimed to investigate feasibility of intervention delivery within a randomised controlled trial (RCT). Nulliparous women ≥16 years, (n = 103) from two English sites were recruited and randomised to either intervention or usual care. The intervention - delivered through face-to-face, telephone and text message by trained Infant Feeding Helpers (IFHs) - ran from 30-weeks' gestation until 5-months postnatal. Outcomes included recruitment rates and follow-up at 3-days, 8-weeks and 6-months postnatal, with collection of future full trial outcomes via questionnaires. A mixed-methods process evaluation included qualitative interviews with 30 women, 13 IFHs and 17 maternity providers; IFH contact logs; and fidelity checking of antenatal contact recordings. This study successfully recruited women, including teenagers, from socioeconomically disadvantaged areas; postnatal follow-up rates were 68.0%, 85.4% and 80.6% at 3-days, 8-weeks and 6-months respectively. Breastfeeding at 8-weeks was obtained for 95.1% using routine data for non-responders. It was possible to recruit and train peer supporters to deliver the intervention with adequate fidelity. The ABA intervention was acceptable to women, IFHs and maternity services. There was minimal contamination and no evidence of intervention-related harm. In conclusion, the intervention is feasible to deliver within an RCT, and a definitive trial required.

Keywords: assets-based approach; behaviour change theory; breastfeeding; infant feeding; peer support; randomised controlled trial.

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Conflict of interest statement

KJ reports grants from NIHR, local authority funding for the intervention, and part‐funding by NIHR CLAHRC West Midlands during the conduct of the study.

Alongside her Cardiff University role, HT also worked part‐time as a Senior Researcher for NCT charity during the period that the research was conducted. NCT provides breastfeeding peer support services. NCT volunteers were not included in this study.

PH is working on a funding application to take forward the FEST feasibility trial that she led and which is cited in this report. The FEST feasibility trial informed parts of the design of the ABA study.

Figures

Figure 1
Figure 1
Flow diagram to show participant flow through the ABA study
See this image and copyright information in PMC

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