Perinatal EDucation: Pedagogical Strategy and Facilitators for the PROMotion of BreastFeeding
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 128
- 试验地点
- 2
- 主要终点
- To find out the contribution of educational engineering to the choice and continuation of breastfeeding from the point of view of women until 4 months after the birth of the child.
研究概览
简要总结
Breastfeeding up to 6 months of a child's life, for its benefits to mother and child, has become a global public health goal. However, there is a disparity in the prevalence of breastfeeding (BF) in different regions of the world. According to French perinatal surveys, the rate of BF at birth decreased significantly between 2010 and 2016. Even if that figure remains stable according to the last perinatal survey in 2021, it decreases sharply, to 34.4%, at 2 months.While many plans at the national level advocate for BF, it is rare to see an action plan or an education intervention for women and couples aimed at promoting BF. However, women's needs to educate about BF and the need for professionals to reflect on their practices are highlighted by numerous perinatal surveys. It should be noted that despite the importance given to the promotion of BF found in all National Nutrition and Health Programs, none of them provide pedagogical means or an education program to achieve the objectives set. At present, in France, there is no breastfeeding education program and professionals accompany women by implementing experimental actions without considering the complexity of the promotional dimension (producing a behavioral change) and the educational dimension (understanding the pedagogy of the proposed actions)
详细描述
The benefits of exclusive breastfeeding for infants and mothers are widely recognized by the scientific community.
As a result, its promotion has become a global public health goal: 75% of newborns should be breastfed by 2030. According to the World Health Organization (WHO), the global average for exclusive breastfeeding has increased from 14% in 1985 to 37% in 2015. The WHO report also notes a disparity in the prevalence of exclusive breastfeeding at birth and at six months of age.
According to the National Health Nutrition Programs and the recommendations of Public Health France and the French Society of Pediatrics, the promotion of exclusive breastfeeding remains the main preventive measure to combat health inequalities from childhood to ensure healthy and equitable development. They emphasize the education of mothers and/or couples, providing women with "know-how to act" by acquiring knowledge, developing management skills, and building self-confidence and motivation. However, these plans set quantified objectives, but do not propose educational actions or interventions to promote BF, and even less indicate the means for professionals to achieve these objectives.
In France, couples and/or women can, if they wish, benefit from birth and parenting preparation sessions offered by midwives in the prenatal period. One of these sessions is dedicated to encouraging and educating pregnant women to breastfeed. In the postnatal period, despite an increase in the number of staff trained to support breastfeeding mothers, more than 84% of couples are referred to breastfeeding support networks outside the maternity unit (PMI, private midwives, associations). Even the practice of early discharge (stay < 2 days) for low-risk women has inevitably reduced the time spent by hospital staff in educating women. At present, this activity is outsourced and carried out by private midwives, who carry out between 2 and 3 early postnatal follow-up consultations to assess the mother's and newborn's needs on a medical, psycho-educational level. These consultations are not mandatory but are strongly recommended.
Further scientific research:
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Sequential
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •for women for all pregnant women in Control Group & Intervention Group:
- •Aged ≥ 18, French-speaking, with access to and use of the internet
- •Pregnant woman followed in one of the maternity wards, presenting with a simple pregnancy, physiological course
- •Consenting to participate in the research For Liberal Midwives
- •Participation on a voluntary basis
- •Experience teaching parenting and breastfeeding classes
排除标准
- •for women for all pregnant women in Control Group & Intervention Group
- •Medical-gynecological history requiring medication management incompatible with lactation
- •History of breast surgery that contraindicates breastfeeding
- •Women without access to the Internet and who do not speak French.
- •Women refusing to participate in research.
- •For Liberal Midwives
- •- Liberal midwives refusing to participate in research
研究组 & 干预措施
CONTROL GROUP
Pregnant women have taken a routine parenthood preparation courses and follow-up by independent midwives in antenatally
INTERVENTION GROUP
Pregnant women have taken a new parenthood preparation courses and follow-up by independent midwives in antenatality, postnatality short term, and postnatality long term)
干预措施: educational intervention (Other)
结局指标
主要结局
To find out the contribution of educational engineering to the choice and continuation of breastfeeding from the point of view of women until 4 months after the birth of the child.
时间窗: T1: Prenatal: during the 9th month of pregnancy T2: Postnatal: during the 1st week after returning home T3: Postnatal: during the 3rd week of returning home T4: Postnatal: during the 8th week of return home, i.e. 2nd month after the birth of the child
The percentage of women who are exclusively breastfeeding. They will be asked about their breastfeeding status at 15 days, 1 month, 2 months, and 4 months.
次要结局
- To determine contexts and generative mechanisms of pedagogical design that influence women's knowledge of breastfeeding up to 4 months afther birth.(T2: Postnatal: during the 1st week after returning home T3: Postnatal: during the 3rd week of returning home T4: Postnatal: during the 8th week of return home, i.e. 2nd month after the birth of the child)
- To explain interactions between existing contexts, generative mechanisms and effects on women's breastfeeding management skills.(T2: Postnatal: during the 1st week after returning home T3: Postnatal: during the 3rd week of returning home T4: Postnatal: during the 8th week of return home, i.e. 2nd month after the birth of the child)
- To explain contexts and generative mechanisms of pedagogical design that influence breastfeeding management up to 4 months afther birth.(T2: Postnatal: during the 1st week after returning home T3: Postnatal: during the 3rd week of returning home T4: Postnatal: during the 8th week of return home, i.e. 2nd month after the birth of the child)
研究者
Lépine Alexandra
responsable-bred@univ-paris.fr
Université Sorbonne Paris Nord