P0327 - Experience of Home-Based Breastfeeding Support Programs in two centers in Colombia

Introduction: Colombia and Latin America in general show low rates of Exclusive Breast Feeding (EBF), which are far from the goal of 50% EBF by 2025 proposed by the World Health Organization (WHO) (1). Home-Based Breastfeeding Support Programs (HBSP) are a strategy created to strengthen adoption and adherence to EBF during the first 6 months, with the ultimate goal of providing the benefits of this practice and of preventing complications related to its absence (2). In 2012, the Keralty Group implemented an HBSP as one of its tools for postnatal care during the first 2 weeks of life. The program followed recommendations for successful EBF issued by the WHO and the United Nations Children’s Fund (UNICEF) (3).

Objective: To describe the characteristics and experience with an HBSP program by reporting the number of home visits carried out, the percentage of mothers in BE on first visit, and maternal and neonatal findings.

Methods: Retrospective, descriptive, study analyzing the records of all mother visited between the 3rd and 10th day postpartum by the HBSP in two healthcare clinics (CRS and CUC) in Colombia during 2012 and 2018.

Results: Records of 30,926 visits were retrieved, EBF average on the day of visit was 73% during 2012-2018 (Figure 1). In this sample, the frequencies of primary maternal outcomes were of 28.06% for nipple fissures and 20.9% for breast engorgement. Analysis of neonatal findings showed jaundice in 50.3%, but only in 1.7% of them was it considered severe enough to warrant referrals to emergency services (Table 1).

Conclusions: Records from visits carried out in a period of 6 years showed that the percentage of BE in the first 10 days postpartum was less than 80%. This study shows that this low rate was accompanied by conditions associated with breastfeeding, like nipple fissures and breast engorgement, both of which are fully preventable. This highlights the importance that HBSPs have as a tool to detect and correct these issues promptly. Previous studies have demonstrated the impact of HBSPs on EBF rates. A study in Sri Lanka showed that 2 home visits during the first 10 days postpartum achieved increments in EBF rates of between 17% and 20% in 12 years (4). McGinnis reported an increment of 1.5% in breastfeeding adoption per percent point in the number of home visits during the first week, as well as an increase of 11% in the probability of EBF for 6 months if the visit was carried out within 3 months (5). Hence, we plan on implementing and evaluating an HBSP with a greater number of visits to measure its impact on EBF rates.
References
1.WHO.Global Nutrition Monitoring Framework.Geneva:WHO/UNICEF;2017
2.Cheng LY. IntJPublicHealth.2019;64(7):999-1014
3.WHO.protecting,promoting and supporting breastfeeding.Geneva:WHO/UNICEF;2018
4.WHO.GlobalNutritionTargets 2025.Geneva:WHO/UNICEF;2014
5.McGinnis S.AmJHealthPromot.2018;32(4):989-996