Effectiveness of Video-Based Health Education on Breastfeeding Practices Among Infants Aged 0–6 Months in Dirashe District, South Ethiopia: A Cluster Randomized Controlled Trial

Abstract

Background: Exclusive breastfeeding (EBF) of infants during the first 6 months of their life is strongly recommended. Video-based communication is an innovative method that could promote EBF. The present study is aimed at assessing the effectiveness of video-based intervention in promoting breastfeeding practices from birth to 6 months postpartum. This was evaluated through maternal reports, as well as EBF of infants at 3 and 5 months of age, using the deuterium oxide dose-to-mother (DTM) technique.

Methods: In a cluster randomized community trial, 16 communities were assigned to receive a video-based behavior change communication (Video-Health) or standard health care messages (Control). Pregnant women in their first trimester (12 ± 2 weeks) were enrolled and followed up, together with their infants, until 6 months postpartum. Data on breastfeeding practices were collected by questionnaire, monthly, in all the participants (n = 508). Human milk intake (HMI) and nonmilk oral intake (NMOI) were measured in a subsample of 60 mother–infant pairs at 3 and 5 months postpartum using DTM. Mixed models and logistic regression were used to examine the difference in continuous and discrete breastmilk practices between the intervention and the control arms, respectively.

Results: The majority of mothers initiated breastfeeding early (92.1%), 82.4% reported colostrum feeding, and 17.5% provided prelacteal feeding. No significant differences were found between Video-Health and Control arms (p > 0.05). The intervention significantly improved reported EBF rates at 4 and 5 months postpartum (p < 0.05). DTM results showed that the proportion of women practicing EBF was 50%–67% less than reported at 3 months for both arms and at 5 months in the intervention arm. The intervention did not significantly affect measured EBF at 3 and 5 months postpartum but did improve HMI at 3 months. Non significant differences in NMOI were observed at 3 months, but at 5 months, there was a significant difference between the study arms.

Conclusions: Video-based behavior change communication did not result in significant improvements in reported breastfeeding practices, except for a higher reported adherence to EBF beyond 3 months. Additionally, the intervention had no effect on EBF as measured by the DTM. Early introduction of non-breastmilk foods and liquids persisted, despite self-reported EBF extending up to 6 months postpartum.

Trial Registration: ClinicalTrials.gov identifier: NCT04414527