Breastfeeding

The Centre is interested in all aspects of breastfeeding. Our staff and students have conducted randomised trials, cohort studies, cross-sectional studies, audits and qualitative studies in this area. Our projects include clinically focused studies on nipple and breast pain and infection and the use of medicines for breastfeeding women, as well as interventions aiming to increase the maintenance of breastfeeding in communities with low rates. We have partnerships with the major Victorian maternity services, Maternal and Child Health services, and the Australian Breastfeeding Association, the main advocacy group in Australia.

The role of micro-organisms (S. aureus & C. albicans) in the pathogenesis of breast pain and infection in lactating women (CASTLE Study)

This project is a descriptive study of 360 breastfeeding women, recruited from the Royal Women’s Hospital and Frances Perry House. The aim was to investigate the role of microorganisms in nipple and breast pain in breastfeeding women. Secondary outcomes were maternal physical and mental health in the first eight weeks postpartum.

researchers Lisa Amir, Méabh Cullinane; in collaboration with Suzanne Garland and Sepehr Tabrizi, Bio21 Molecular Science & Biotechnology, University of Melbourne; Susan Donath, Murdoch Children’s Research Institute; Catherine Bennett, Deakin University
websiteCASTLE website
publications

Cooklin AR, Amir LH, Nguyen CD, Buck ML, Cullinane M, Fisher JRW, Donath SM, the CASTLE Study Team. Physical health, breastfeeding problems and maternal mood in the early postpartum: a prospective cohort study. Arch Womens Ment Health 2018; 21(3):365–74.

Buck ML, Amir LH, Cullinane M, Donath SM, for the CASTLE Study Team. Nipple pain, damage and vasospasm in the first 8 weeks postpartum. Breastfeed Med 2014; 9(2):56-62

Amir LH, Donath SM, Garland SM, Tabrizi SN, Bennett CM, Cullinane M, Payne MS. Does Candida and/or Staphylococcus play a role in nipple and breast pain in lactation? A cohort study in Melbourne, Australia. BMJ Open 2013; 3(3): e002351

Amir LH, Cullinane M, Garland SM, Tabrizi SN, Donath SM, Bennett CM, Cooklin AR, Fisher JR, Payne MS. The role of micro-organisms (Staphylococcus aureus and Candida albicans) in the pathogenesis of breast pain and infection in lactating women: study protocol. BMC Pregnancy Childbirth 2011; 11: 54

funding NHMRC Health Professional Research Fellowship (LA); NHMRC Project Grant; NHMRC Equipment Grant; Helen Macpherson Smith

RUBY (Ringing up about breastfeeding early): Proactive peer (mother-to-mother) breastfeeding support by telephone

The RUBY (Ringing Up about Breastfeeding earlY) study aimed to determine whether proactive telephone-based peer support during the postnatal period increases the proportion of infants being breastfed at six months of age. RUBY was a multicentre, randomised controlled trial conducted in three hospitals in Victoria, between February 2013 and December 2015. Over 1150 first-time mothers intending to breastfeed were recruited at one of the three hospitals (Royal Women’s, Monash Health, Western Health Sunshine) after birth and prior to hospital discharge. They were randomly assigned to usual care or usual care plus proactive telephone-based breastfeeding support from a trained peer volunteer for up to six months postpartum.

The study found that infants of women allocated to telephone-based peer support were more likely than those allocated to usual care to be receiving breast milk at six months of age (intervention 75%, usual care 69%).

researchers Della Forster, Lisa Amir, Helen McLachlan, Touran Shafiei, Rhonda Small, Fiona McLardie-Hore, Heather Grimes; in collaboration with Anita Moorhead, Royal Women’s Hospital; Mary-Ann Davey, Christine East, Monash University; Cindy-Lee Dennis, University of Toronto; Lisa Gold, Deakin University; Kate Mortensen and Susan Tawia, Australian Breastfeeding Association
websiteRuby website
publications

Forster DA, McLardie-Hore FE, McLachlan HL, Davey M-A, Grimes HA, Dennis C-L, Mortensen K, Moorhead AM, Tawia S, Gold L, Shafiei T, Small R, East CE, Amir LH. Proactive peer (mother-to-mother) breastfeeding support by telephone (Ringing Up about Breastfeeding EarlY [RUBY]): A multicentre, unblinded, randomised controlled trial. EClinicalMedicine (in press). Epub 2019 Mar 05

Forster DA, McLachlan HL, Davey MA, Amir LH, Gold L, Small R, Mortensen K, Moorhead AM, Grimes H, McHardie-Lore F. Ringing Up about Breastfeeding: A randomised controlled trial exploring early telephone peer support for breastfeeding (RUBY) - trial protocol. BMC Pregnancy Childbirth 2014; 14:177

funding The Felton Bequest, Australia and La Trobe University

Supporting breastfeeding In Local Communities (SILC)

Breastfeeding provides infants with the optimal start to life.  However, exclusive breastfeeding for six months is uncommon in Australia. Increased breastfeeding support early in the postpartum period may improve breastfeeding maintenance.
With funding from the Victorian Department of Education and Early Childhood Development, we conducted a three-arm cluster trial evaluating two community-based interventions aimed at increasing breastfeeding rates in 10 Victorian Local Government Areas.

The trial arms were: 1) standard care; 2) early postnatal home-based breastfeeding support visits to women at risk of breastfeeding cessation, or 3) home-based breastfeeding support visits plus access to community-based breastfeeding drop-in centres.

We found no difference in breastfeeding maintenance at three, four or six months in either the home visit or home visit plus drop-in compared with the comparison arm. Early home-based and community-based support proved difficult to implement. Interventions to increase breastfeeding in complex community settings require sufficient time and partnership building for successful implementation.

researchers Helen McLachlan, Della Forster, Lisa Amir, Rhonda Small, Méabh Cullinane, Touran Shafiei, Lyn Watson, Rhian Cramer, Lael Ridgeway
websiteSILC website
publications

McLachlan HL, Forster DA, Amir LH, Cullinane M, Shafiei T, Watson LF, Ridgway L, Cramer RL, Small R. Supporting breastfeeding In Local Communities (SILC) in Victoria, Australia: a cluster randomised controlled trial. BMJ Open 2016; 6:e008292

Ridgway L, Cramer R, McLachlan HL, Forster DA, Cullinane M, Shafiei T, Amir LH. Breastfeeding support in the early postpartum: Content of home visits in the SILC trial. Birth 2016; 43(4):303-12

McLachlan HL, Forster DA, Amir LH, Small R, Cullinane M, Watson LF, Shafiei T. Supporting breastfeeding In Local Communities (SILC): protocol for a cluster randomised controlled trial. BMC Pregnancy Childbirth 2014; 14:346

McLachlan H, Forster D, Amir LH, Small R, Cullinane M, Shafiei T, Cramer R, Ridgeway L. The Victorian Breastfeeding Project Phase Two: SILC final report. Melbourne, Australia: Judith Lumley Centre, La Trobe University; July 2014

funding Victorian Department of Education and Early Childhood Development

Understanding community attitudes and identifying design solutions to increase women’s comfort with breastfeeding in public

This project explores design features and community attitudes that invite or deter breastfeeding in public.  We conducted interviews and focus groups with breastfeeding mothers in three local government areas in 2016 (Rural City of Swan Hill, City of Greater Bendigo and City of Melbourne) and at The Royal Women’s Hospital in 2018.

We received input from over 80 mothers speaking five languages, as well as health professionals and council planning staff. Using these data, we have developed design guidelines that outlined how a range of everyday shared spaces could become breastfeeding-friendly as well as the optimal design characteristics for dedicated breastfeeding spaces.

researchers Lisa Amir, Stephanie Amir, Helene Johns; in collaboration with Julie Rudner, La Trobe University; Jenny Donovan, Inclusive Design; Miranda Buck, Australian Breastfeeding Association; Sinead Currie and Pat Hoddinott, University of Stirling
funding Building Healthy Communities RFA Grant