Department of Education and Early Childhood Development Supporting breastfeeding In Local Communities (SILC): a cluster randomised trial Assoc Prof Helen.

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Department of Education and Early Childhood Development Supporting breastfeeding In Local Communities (SILC): a cluster randomised trial Assoc Prof Helen McLachlan Mother & Child Health Research, La Trobe University Maternal and Child Health Conference 14 Feb 2012

A/Prof Helen McLachlan Prof Della Forster A/Prof Lisa Amir Prof Rhonda Small Dr Meabh Cullinane (Project co-ordinator) Dr Touran Shafiei (Research officer) Statisticians: Dr Lyn Watson and Mr Paul Agius Toni Ormston, Project Manager Breastfeeding, DEECD Funding: Department of Education and Early Childhood Development (DEECD) Research team

Background to SILC – MCH data  Breastfeeding rates vary across Victoria  Data from Maternal & Child Health Services (Annual Report )  Initiation (hospital discharge): range from 67% to 97%  ‘Any’ breast milk at 6 months : range from 18% to 71% of infants  Lower in outer LGAs and rural/regional LGAs Department of Education and Early Childhood Development, Maternal & Child Health Services Annual Report

Background to SILC  The Victorian Government is committed to increasing breastfeeding rates  The Victorian Breastfeeding Research Project  Phase one DEECD engaged Mother & Child Health Research to:  Provide an updated literature review  ‘Breastfeeding in Victoria: A Report’ 1  Design a community trial to improve the maintenance of breastfeeding  Phase two: SILC DEECD contracted Mother & Child Health Research to undertake a trial evaluating interventions to increase breastfeeding in Victorian communities 1 Amir, Forster, McLachlan et al. (2010) Breastfeeding in Victoria: A Report. Mother & Child Health Research, La Trobe University.

 SILC has been offered to LGAs with low breastfeeding rates low rate of ‘any’ breastfeeding at hospital discharge and with more than 450 total record cards in drawer 2 (based on 2009/2010 MCH Annual Report)  Ethics approval: La Trobe University and DEECD  Trial registered with the Australian and New Zealand Clinical Trials Registry (ANZCTR) ACTR number ACTRN  SILC is a three-arm cluster randomised trial Participating LGAs will be randomly allocated to one of the three trial arms SILC trial information

Questions SILC will investigate 1.Does additional early home-based breastfeeding support for women with identified breastfeeding issues, compared with ‘comparison’ communities, increase ‘any’ breastfeeding rates at 4 and 6 months (Intervention 1)? 2.Does the early home-based support plus access to a community-based breastfeeding drop-in centre, compared with ‘comparison’ communities, increase ‘any’ breastfeeding rates at 4 and 6 months (Intervention 2)?

Trial arms and study process Trial arm 1: Standard care by MCHNs (the comparison arm) Trial arm 3: Standard care by MCHNs plus early home-based breastfeeding support by a SILC-MCHN plus access to a local breastfeeding drop-in centre Trial arm 2: Standard care by MCHNs plus early home-based breastfeeding support by additional funded MCHNs (SILC-MCHN)

Thank you for your attention LGAs involved in SILC: City of Ballarat Cardinia Shire City of Greater Bendigo City of Hume Macedon Ranges Shire Mitchell Shire Wellington Shire City of Whittlesea City of Wodonga City of Wyndham Acknowledgements Funding for SILC: Department of Education and Early Childhood Development