My recollection of the PROBIT study circumstance is that BFing rates were generally high in Belarus anyway, and that country had a "western" style or level of health care. I seem to recall that they had much better rates and durations of BFing than the US did (does). In other words, they were already breastfeeding friendly in attitude, but were not BFHI.
At any rate, the hospitals' population and practices were very similar, so they were chosen at random to get, or not get, the 18 hour BFHI staff training. That training was the only intervention. The hospitals in the control group continued as usual. The hospitals with trained staff made good use of their training as they cared for their patients. The objective was to observe and measure the patient outcomes, if any, that followed the 18-hour BFing course. Before this study, there was argument on both sides of the issue: staff training makes NO difference in patient outcomes, or, staff training makes ALL the difference in patient outcomes.
So perhaps th 18-hour cource gave the staff the tools and knowledge they needed to be more effective in helping their patients.
Women in Belarus often stay home with their babies for about 3 years before returning to work. That's one assumed reason that he PROBIT study didn't show any differences in respiratory issues for the children of either group: no infant day care! But there was a definite better outcome for other measured BF-related health issues.
My question now would be: after the PROBIT study was completed and published, did any of the control hospitals decide to invest in the 18-hour training for their staff so they could have the same kind of improved outcomes?
Phyllis
Anyone able to correct my memory of the study? It's been a long time since I read it.
---- Jan Cornfoot <[log in to unmask]> wrote:
=============
Whilst it's always good publicity to see outcomes like this, I was
immediately anxious about the PROBIT study and the need to deprive thousands
of Belarus mothers and their babies in the control group of the
'intervention' (breastfeeding support along BFHI principles), and thus the
benefits of breastfeeding or prolonged breastfeeding to both.
There was research showing cognitive benefits, but for the purposes of
proving that breastfeeding babies are smarter, thousands of mothers weren't
encouraged to breastfeed ?? The difference in numbers breastfeeding at 3
months is significant (see below).
I hope other researchers don't feel the need to replicate the study as often
happens. Personally, I find it very difficult ethically when we know that
not-to-breastfeed has important health deficits, the intervention
(breastfeeding support) was denied to thousands of mothers. I acknowledge
that Belarus now has more evidence to support BFHI, but just because the
babies might be smarter was the impetus for this ?
A retrospective study, with its imperfections, seems preferable to me. Maybe
I'm missing something !
>>>>>>>>
The experimental intervention led to a large increase in exclusive
breastfeeding at age 3 months (43.3% for the experimental group vs 6.4% for
the control group... CONCLUSION: These results, based on the largest
randomized trial ever conducted in the area of human lactation, provide
strong evidence that prolonged and exclusive breastfeeding improves
children's cognitive development.
>>>>>>>>>
Jan Cornfoot
Breastfeeding Advocate
Publisher of Birth Issues, a peer reviewed journal 1992-2006
www.capersbookstore.com.au
***********************************************
--
Phyllis Adamson, IBCLC, RLC
Glendale, AZ.
[log in to unmask]
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