Breastfeeding Clinical Trial
Official title:
Effectiveness of a Community Based Early Nutrition Program on Promoting Breastfeeding and Optimizing Infant Growth and Diet Quality
Effective early life programs that reduce the long-term non-communicable diseases (NCDs) risk
could bring great economic benefits to the society. However, there is a lack of local data on
the effect of nutrition on child growth and most research on early life intervention focus on
disease models such as obese women to improve offspring health outcomes. There is limited
research on postpartum interventions in the community that optimize maternal and infant
nutrition through improving success of breastfeeding, infant growth diet quality and
microbiota to enhance health in the adulthood.
In this study, it is hypothesized that our early nutrition program could promote
breastfeeding successful rate (increase the number of months the mothers breastfed their
infants) and improve growth status, diet quality and microbiota of the infants which may
reduce the risk of NCDs in the adulthood. The planned project proposal would like to include
240 pairs of mothers and infants. In order to test the protocol in the planned proposal, the
investigators hope to run a pilot study to set up this community based early nutrition
program including breastfeeding workshops and supports, healthy lifestyle courses, parenting
education, introduction of solid foods for infants, child development and cooking classes of
infant foods. the investigators will evaluate the effectiveness of this early nutrition
program and determine its impacts on breastfeeding, infant growth (by comparing infants'
biomarkers and microbiota in different stages) , diet quality and microbiota, as well as the
benefits to the postpartum mothers such as reducing the postpartum weight retention so that
to generate pilot result and facilitate the up scale study that the investigators proposed in
the planned proposal.
The ultimate goal is that a long term follow up with the children in this project could also
be arranged to determine the long term health effects of this early nutrition program.
Study background:
Effective early life programs that reduce the long-term non-communicable diseases (NCDs) risk
could bring great economic benefits to the society. NCDs are responsible for roughly
two-thirds of worldwide death and cause large burden of health care cost. Most policies
nowadays that combat disease focus on treatment after disease occurs and on reducing risk
factors in adult life. Early life interventions are an unexplored and promising new avenue of
health policy . One of the oldest US early life intervention programs, the Carolina
Abecedarian Project, started from 1970s has been shown to have substantial benefits in
boosting adult health. However, most research on early life intervention focus on disease
models such as obese women to improve offspring health outcomes. There is limited research on
postpartum interventions in the community that optimize maternal and infant nutrition through
improving success of breastfeeding, infant growth, diet quality and microbiota to enhance
health in the adulthood
Aim of study:
To evaluate the effects of postpartum nutrition program on i) success of breastfeeding by
comparing the average duration of breastfeeding between intervention group and control group
(primary outcome) ii) diet quality of the infants and mothers (secondary outcome) The diet
quality will be measured by 3-day dietary records using Diet Quality Index-International
(DQI-I).
Briefly, the DQI-I assesses four categories (variety, adequacy, moderation, and overall
balance) and contains six food items and 11 nutrient items. This scoring scale is complex.
The maximum possible score for each category ranges from 10 to 40 points, and the full score
is 100 points.
Paired t-tests will be used to compare the difference between intervention group and control
group.
iii) the infant growth by comparing the Z-scores of weight-for-age, length-for-age,
BMI-for-age and head circumference-for-age at 2, 4, 6, 8, 10 and 12 month old between
intervention group and control group (secondary outcome) Z-score (or SD-score) = (observed
value - median value of the reference population) / standard deviation value of reference
population
iv) the microbiota profiles (secondary outcome)
Method of Investigation:
In this project, a randomized controlled trial will be conducted which subjects will be 40
pairs of local Chinese healthy postpartum mothers aged 18-40 years old and their infants. The
participants will be randomly assigned into 1:1 ratio to the control group or the
intervention group. A study coordinator will randomize subjects by means of a
computer-generated list of random numbers in blocks of 4. Treatment assignments will be
concealed in consecutively-numbered sealed envelopes, which will be opened sequentially upon
subject enrollment.
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