The Assets-based infant feeding help Before and After birth (ABA) intervention for improving breastfeeding initiation and continuation: feasibility study results

Joanne Clarke, Jackie Ingram, D Johnson , H Tricky, Stephen U Dombrowski, Alice Sitch, F Dykes , Max Feltham, Christine MacArthur, Tracy Roberts, Pat Hoddinott, Kate Jolly

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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
Breastfeeding, assets-based approach, behaviour change theory, peer support, randomised controlled trial, infant feeding
Original languageEnglish
JournalMaternal and Child Nutrition
DOIs
Publication statusPublished - 30 Sept 2019

Keywords

  • Breastfeeding
  • assets-based approach
  • behaviour change theory
  • peer support
  • randomised controlled trial
  • infant feeding

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