Impact of lactation counseling on exclusive breastfeeding in Ghana

Date of Completion

January 2004


Health Sciences, Nutrition|Health Sciences, Public Health




We first conducted a cross-sectional study to assess factors associated with exclusive breast-feeding (EBF) in Ghana. Data on current and past infant feeding patterns, socio-demographic, biomedical and bio-cultural factors were collected from 376 women with children 0–6 months, attending child well-fare clinics. The outcome variable (EBF) was defined in two ways: (a) based on a 24-hour recall, and (b) based on a recall of liquids or foods given since birth. Almost all women (99.7%) were currently BF, 97.9% had heard about EBF, and 85.6% planned to EBF their child on delivery. Variables that came out as significantly associated with EBF since birth were: house ownership, delivery place, planned EBF when child was born and opinion towards EBF. Using the 24-hour recall EBF, three out of these 4 variables were significantly associated with the EBF since birth definition. The only exception was house ownership. ^ Following this first study, we conducted a randomized trial on the impact of lactation counseling on EBF. Pregnant women attending prenatal clinics were randomly assigned to three groups: (i) received EBF support pre-, peri- and postnatally (IG1, n = 43); (ii) received only peri- and postnatal EBF support (IG2, n = 44); or (iii) a non-BF health educational support (C, n = 49) that had equal amount of contact with lactation counselors, to account for the Hawthorne effect. ^ Results indicate that all 3 groups were similar with regards to socio-demographic characteristics. At 3 mo pp, 92.1% in IG1 and 88.1% in IG2 were exclusively breast-fed during the previous 24 h. By contrast only 65.9% in C were doing so (p = 0.004). At 6 mo 90.0%, 79.5% and 54.5% were EBF, respectively (p < 0.001). Likewise, the percent EBF throughout 6 mo was significantly higher (p = 0.02) for IG1 and IG2 (39.5%) than C (19.6%). Consistent with this, women in IG1 (69.8%) and IG2 (61.4%) were more likely (p = 0.02) than those in C (42.9%) to remain amenorrheic at 6 mo. Findings indicate that peri- and postnatal support are needed to improve EBF in this Ghanaian urban context. ^