Including families and friends enhances breastfeeding among women with no formal education (Uganda)

A study of 218 breastfeeding mothers in Uganda has shown that involving family members/friends and also hospital based peer mothers results in mothers continuing breastfeeding for longer, though this applies only to mothers with no formal education.

The researchers compared three interventions to see what happened to the duration of exclusive breastfeeding and the duration of any breastfeeding. The three interventions were:

  1. Standard care, namely group sessions, videos and print material available at antenatal and postnatal follow-up clinic visits, along with counselling and support from prevention of mother-to-child transmission (PMTCT) counsellors. This service conveyed current Ministry of Health PMTCT messages: the importance of exclusive breastfeeding, appropriate breastfeeding practice and maternal nutrition.
  2. Standard care but with the inclusion of family members or friends and of hospital-based peer mothers providing support over 6 months.
  3. Standard care with additional hands-on coaching with breastfeeding techniques and on safe preparation of locally available nutritious foods by a special infant counsellor.

Among women with no formal education, the second and third enhanced interventions reduced the risk of early breastfeeding cessation by 88% and 93%, respectively when compared to standard care.

The study found no differences between groups of women with some formal education. Perhaps for these women, the current standard care (which is not insubstantial) is enough. Also, exclusive breastfeeding rates are high in the overall sample – 85% at 6 months.

The study participants were all infected with HIV. In common with other studies, both exclusive breastfeeding and any breastfeeding were much lower if the woman’s partner knew about the infection. This is driven by partner concerns for the safety of the baby.

The researchers recommend family inclusive and hands-on support for women with little education as a way of extending breastfeeding. Engagement of families is particularly important if the woman has HIV and they know about it.


Namale-Matovu J, Owora AH, Onyango-Makumbi C, Mubiru M, Namuli PE, Motevalli-Oliner M, Musoke P, Nolan M & Fowler MG (2018), Comparative effects of three methods of promoting breastfeeding among human immunodeficiency virus-infect women in Uganda: A parallel randomized clinical trial, International Health 10.6

Photo: The White Ribbon Alliance. Creative Commons.