Promoting breastfeeding through health education at the time of immunizations: a randomized trial from Guinea Bissau

As an intervention against diarrhoea, promotion of breastfeeding has been suggested by the World Health Organization (WHO). In the present study from Guinea Bissau we tested the possibilities of promoting breastfeeding at a local health centre. A total of 1250 children were allocated randomly into two groups. Mothers in the intervention group were given health education according to WHO's recommendations; about exclusive breastfeeding for at least the first 4 mo, prolonged breastfeeding and family planning methods. At 4 mo of age introduction of weaning food was delayed in the intervention group (risk rate 1.18 (95% CI 1.03-1.38) and more mothers had an IUD inserted (risk rate 2.45 (1.27-4.70). The median length of breastfeeding was 23 mo in both groups. There was no difference in the number of children weaned early. Although exclusive breastfeeding was promoted by the intervention, early weaning of children in special risk groups was not avoided. An evaluation of the impact of the WHO recommendations in different settings is warranted.