Fiona McLardie Hore
Fiona has been a midwife since 1990 and has spent more than 25 years clinically working with women across the continuum of maternity care. She is currently working as the Research Coordinator in the Midwifery and Maternity Services Research Unit at the Royal Women's Hospital in Melbourne, and the Judith Lumley Centre, La Trobe University. Her three key areas of research are - Models of care, Breastfeeding and Indigenous health.
Fiona is completing her PhD entitled 'Exploring the outcomes, experiences and satisfaction of women receiving early telephone peer support for breastfeeding' based upon the RUBY - Ringing up about breastfeeding randomised controlled trial, at the Judith Lumley Centre, La Trobe University.
Ringing Up about Breastfeeding (RUBY): outcomes from a randomised controlled trial of telephone peer support for breastfeeding
Most Australian women initiate breastfeeding; however, many discontinue sooner than they intended, and less than two thirds of women are continuing to breastfeed at six months. Few strategies increase breastfeeding maintenance in countries with relatively high breastfeeding initiation.
We will determine whether proactive telephone peer support during the postnatal period increases the proportion of infants who are breastfed at six months.
A multi-site two-arm RCT was conducted. We recruited primiparous, English-speaking women who intended to breastfeed from the postnatal wards of three hospitals in Melbourne, Australia. Women were randomised to peer (mother-to-mother) support or to ‘usual’ care. Women randomised to peer support were allocated a peer volunteer, who contacted them by telephone guided by a suggested call schedule – two telephone calls within the first ten days postpartum, then weekly telephone calls until week twelve, with continued contact until six months postpartum. Our sample size is adequate to detect a 10% difference in the proportion of women breastfeeding between the two trial arms. Outcome data has been collected by telephone interview at six months postpartum, and analysed by ‘intention to treat’, with relative risks described for all key outcomes. Ethical approval was received from La Trobe University and the three participating hospitals.
In total, 573 women were allocated to peer support and 579 to standard care, and 233 peer volunteers provided support to women. The response rate at six months was 88%. Primary trial outcomes will be presented.
Conclusion and implications
The costs and health burdens of not breastfeeding fall disproportionately and increasingly on disadvantaged groups. We have therefore deliberately chosen trial sites which have a high proportion of women from disadvantaged backgrounds. This will be the first Australian RCT to test the effectiveness and cost effectiveness of proactive peer telephone support for breastfeeding.