Breastfeeding Clinical Trial
Official title:
Effectiveness of a Laid-back Breastfeeding Approach on Breastfeeding Initiation in Hospital Setting. A Randomized Controlled Trial
The so-called biological nurturing (BN) - or laid-back breastfeeding (LB BF), a new
neurobehavioral approach to breastfeeding (BF), has the potential to enhance BF initiation
and to reduce breast problems (pain, fissures, etc.), while easing the newborn attachment to
the breast. BN focuses on facilitating the mother to breastfeed in a relaxed, laid-back
position, with her baby laying prone on her, so that the baby's body is in the largest
possible contact with mother's curves. This position opens up the mother's body and promotes
baby's movements through the activation of 20 primary neonatal reflexes stimulating BF.
Neurophysiological studies show that, through this approach, infants instinctively know how
to feed, thanks to the presence of neonatal reflexes, at the same time mothers being able to
instinctively activate the same reflexes.
The main objective of this study is to assess the effectiveness of LB BF compared to standard
hospital practices on the frequency of breast problems (i.e., pain, fissures, etc.) at
discharge.
Despite the fact that breastfeeding (BF) benefits are largely known and that this practice is
highly recommended, available data at national and international level show that exclusive
breastfeeding rates are still low. Among the main determinants that can be addressed to
improve BF prevalence, the quality of care and the support provided by health staff to women
during labour and delivery seem to have a particular relevance. In hospital settings, an
adequate support to women initiating BF is not always granted, especially where time
availability of staff is limited and their specific skills inadequate.
In most recent years, a growing scientific evidence on neonatal primary reflexes opened new
windows of intervention. In particular, the so-called biological nurturing (BN) - or
laid-back breastfeeding (LB BF) - has the potential to enhance BF initiation and to reduce
breast problems (pain, fissures, etc.), while easing the newborn attachment to the breast. BN
is a new neurobehavioral approach to BF initiation, which focuses on facilitating the mother
to breastfeed in a relaxed, laid-back position, with her baby laying prone on her, so that
the baby's body is in the largest possible contact with mother's curves. This position opens
up the mother's body and promotes baby's movements through the activation of 20 primary
neonatal reflexes stimulating BF. Neurophysiological studies show that, through this
approach, infants instinctively know how to feed, thanks to the presence of neonatal
reflexes, at the same time mothers being able to instinctively activate the same reflexes.
The method is simple, given that there are no "correct" positions nor the need to follow
particular procedures to BF, whilst with the traditional approach precise indications on the
right BF position and attachment are to be provided to and followed by the woman. The
effectiveness of BN has however not been adequately studied through randomized controlled
trials, particularly in hospital settings.
The main objective of this study is to assess the effectiveness of LB BF compared to standard
hospital practices on the frequency of breast problems (i.e., pain, fissures, etc.) at
discharge. Secondary study objectives are to assess the effectiveness of the intervention on:
exclusive breastfeeding at discharge and during the maternity ward stay; exclusive
breastfeeding at 7 days and 1 and 4 months of life; frequency of breast problems at 7 days
and 1 and 4 months of life; frequency of use of nipple shield at discharge, at 7 days, and at
1 and 4 months. Furthermore, the study will assess the feasibility of the LB BF approach in
hospital setting and the degree of mother satisfaction.
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