Randomized Controlled Trial of Motivational Interviewing to Support Breastfeeding Among Appalachian Women.
Sarah H Addicks, Daniel W McNeil
PMID 31181186WHAT IT FOUND
A brief prenatal motivational interviewing did not improve planned feeding, initiation, or exclusive breastfeeding, but mothers were more likely to report any breastfeeding at one month.
Attitudes improved only among first-time mothers.
Key findings
01At one month postpartum, women assigned to motivational interviewing were more likely to report any current breastfeeding than women assigned to psychoeducation.
02Motivational interviewing did not improve breastfeeding initiation, exclusive breastfeeding, or the proportion of daily feedings that were breast milk.
03Breastfeeding attitudes improved among first-time mothers assigned to motivational interviewing only.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Participants were mostly White, married or cohabiting, well-educated, and higher income than the Appalachian average, so results may not apply to lower-income women. 269 women indicated interest, 165 were eligible, and 81 were enrolled; this self-selection may mean participants already had positive breastfeeding attitudes. Most women already planned exclusive breastfeeding, so there was little room for improvement. Outcomes were self-reported and could be affected by social desirability. Follow-up stopped at one month, so the study did not capture breastfeeding after return to work. The intervention was delivered by clinical psychologists, not nurses or lactation consultants, so nurse-delivered motivational interviewing is not established. The positive attitude finding was limited to first-time mothers, so it may not apply to women with previous children.
Declared interests
The publication types list NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that motivational interviewing improves exclusive breastfeeding or long-term breastfeeding duration. The trial found no group differences for exclusive breastfeeding, proportion of breast milk feedings, or planned duration, and the positive finding was any current breastfeeding at one month.