Effect of Telephone Counseling During Puerperium on Exclusive Breastfeeding and Postpartum Depression: A Randomized Controlled Trial.

Abstract

Abstract: Introduction: Infants should be breastfed exclusively in the first 6 months to achieve the most desirable growth, development and health. However, in Iran only 23% of infants are exclusively breastfed for the first 6 months. Postpartum depression is a common disorder. Systematic reviews emphasized the need to conduct more trials about interventions to prevent postpartum depression. The aim of this study was to determine the effect of postpartum telephone counseling on exclusive breastfeeding and maternal depression during postpartum period. Methods: 366 postpartum women were randomly assigned into control (244) and intervention (122) groups. The control group received only routine postpartum care. In the intervention group telephone counseling was provided twice in the first week and once a week during the second to sixth week of postpartum by a trained midwife in addition to the routine care. In order to meet their unpredicted needs, the mothers could contact the consultant 24 hours a day. We used the WHO exclusive breast –feeding indicator “What other things did you give and how many times to your baby during the past 24 hours in addition to mothers’ milk? “. And postpartum depression was assessed using the self –administered Edinburg depression scale. Mothers with scores of 13 and above were considered to have depression. Data were analyzed by SPSS –13 using Chi –square test, logistic regression and student t -test. Results: At the age of 65 -60 days, exclusive breast –feeding was significantly more frequent in the intervention than control group (87% vs, 65%, p<0.001). But there was no significant difference regarding frequency of depression between the intervention and control groups (29.9% vs 31.6%; odd ratio 0.91, 95% CI 0.56 to 1.49). Mean of Edinburg scale score was not significantly different between the groups {9.2(6.1) vs. 10.4(5.8); mean difference -1.19, 95%, CI -2.5 to 0.13}. Conclusion: It seems offering the telephone counseling by midwives could increase frequency of exclusive breastfeeding, but this study did not provide evidence to show that telephone support have a preventive effect on postpartum depression.