A large overseas study has found that postnatal home visits by community health workers reduced the incidence of breastfeeding problems in newborn babies. The health workers made antenatal and postnatal home visits to promote good practices in infant care, including breast-feeding. In all, data was recorded for 3,495 neonates to assess the effects on feeding of the health workers' visits. As well as visiting the mothers before the baby was born, the workers visited postpartum to assess the adequacy of breast-feeding and provide hands-on support to establish breast-feeding. Analysis of the histories and observational data found that inappropriate positioning of the baby at the breast and failure to attach properly to the breast were the main problems, occurring in 12-15% of the mothers studied. Of the newborns who received a home visit by a community health worker within three days of birth, only 6% developed feeding problems, compared with 34% of those who did not receive a visit. Babies in the unvisited group were 11.4 times more likely to have feeding difficulties as late as 6-7 days after birth than the visited group. The authors conclude that advice and practical help with breast-feeding techniques by trained health workers within the first three days of birth should be part of postpartum interventions in the community.

Mannan I, Rahman SM, Sania A

Can early postpartum home visits by trained community health workers improve breastfeeding of newborns?
Journal of Perinatology 2008 Jul 3. Epub ahead of print