Elsevier

Journal of Adolescent Health

Volume 49, Issue 3, September 2011, Pages 258-264
Journal of Adolescent Health

Original article
Reduction of Unnecessary Intake of Water and Herbal Teas on Breast-fed Infants: A Randomized Clinical Trial With Adolescent Mothers and Grandmothers

https://doi.org/10.1016/j.jadohealth.2010.12.009Get rights and content

Abstract

Purpose

To evaluate the efficacy of counseling sessions on breast-feeding for adolescent mothers and maternal grandmothers on the reduction of unnecessary water and herbal teas intake on breast-fed infants.

Methods

A randomized clinical trial was conducted involving adolescent mothers, newborn infants, and maternal grandmothers allocated into four groups: mother and grandmother not cohabitating, without intervention; mother and grandmother not cohabitating, with intervention directed only toward mother; mother and grandmother cohabitating, without intervention; and mother and grandmother cohabitating, with intervention directed toward both. The intervention consisted of six counseling sessions on breastfeeding: in the maternity ward, and after birth on days 7, 15, 30, 60, and 120 at home. The data about feeding practices were collected by telephone every month until the end of the sixth month of the baby's life. The effect of the intervention was measured by comparing the medians and the survival curves for initiation of water and/or tea intake in the first 6 months of life, and Cox regression was used to estimate its magnitude.

Results

The intervention had a positive effect for the group in which the adolescent mothers cohabitated with the baby's grandmother (hazard ratio = .53; 95% confidence interval = .35–.80), and also for the group in which they did not cohabitate with the baby's grandmother (hazard ratio = .48; 95% confidence interval = .31–.76). By comparing the medians of the time of initiation of water and/or tea intake between control and intervention groups, it was observed that the intervention postponed the use of these liquids in 67 days in the group in which mothers and grandmothers cohabitated and in 44 days in the group in which they did not live together.

Conclusion

Multiple counseling sessions on infant feeding in the first 4 months postpartum for adolescent mothers and maternal grandmothers, when they cohabitate, proved to be an effective strategy to postpone the unnecessary water and/or tea intake of breast-fed infants.

Section snippets

Methods

A randomized clinical trial involving adolescent mothers, their babies/infants, and respective maternal grandmothers was conducted in the city of Porto Alegre, in the south of Brazil, where the climate is usually mild; however, it can get very hot during summer season. The adolescents were recruited for the study in the rooming-in of the maternity ward of the Hospital de Clinicas de Porto Alegre, which is a university general hospital, accredited as Baby-Friendly Hospital, where 3,000–4,000

Results

The clinical trial profile is shown in Figure 1, from the recruitment of the adolescent mothers until the outcome evaluation in the sixth month. From the 342 mothers eligible for the study, 19 (5.5%) were not included because of their refusal to participate. The losses during the 6 months of the follow-up totaled to 63 mothers (intervention = 28/163, 17.2%; control: 35/160, 21.8%).

The characteristics of the adolescent mothers, infants, and maternal grandmothers included in the study are shown

Discussion

The recommendation of exclusive breastfeeding in the first 6 months of life has been incorporated to the public health policies in Brazil for over a decade. However, this recommendation has not been followed, as shown in the last national survey about feeding in the first year of life. According to this survey, the prevalence of exclusive breastfeeding at 4 months of age is 23.3% and at 6 months only 9.3% [11]. Frequently, interruption of exclusive breastfeeding is caused by early initiation of

Acknowledgments

The authors thank Cléa Carvalho, Lilia Refosco and Olga Bica who participated in the intervention, as well as the families that agreed to take part in the study. They also thank the Brazilian National Agency for Science and Technology (CNPq) that supported this research. Leandro Nunes, Elsa Giugliani, Lilian Espírito Santo, and Luciana Oliveira were responsible for sample collecting, statistical analyses, and writing the article.

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