Objective\nTo evaluate the efficacy, safety, and maternal satisfaction of a newly established integrative\npostpartum community-based clinic providing comprehensive support for mothers during\nthe first month after discharge from the hospital. Our primary interests were breastfeeding\nrates, readmission and patient satisfaction.\nMethods\nA randomized controlled trial was conducted in Ottawa, Canada, where 472 mothers were\nrandomized via a 1:2 ratio to either receive standard of care (n = 157) or to attend the postpartum\nbreastfeeding clinic (n = 315). Outcome data were captured through questionnaires\ncompleted by the participants at 2, 4, 12 and 24 weeks postpartum. Unadjusted and\nadjusted logistic regression models were conducted to determine the effect of the intervention\non exclusive breastfeeding at 12 weeks (primary outcome). Secondary outcomes\nincluded breastfeeding rate at 2, 4 and 24 weeks, breastfeeding self-efficacy scale, readmission\nrate, and satisfaction score.\nResults\nMore mothers in the intervention group (n = 195, 66.1%) were exclusively breastfeeding at\n12 weeks compared to mothers in the control group (n = 81, 60.5%), however no statistically\nsignificant difference was observed (OR = 1.28; 95% CI:0.84ââ?¬â??1.95)). The rate of emergency\nroom visits at 2 weeks for the intervention group was 11.4% compared to the standard of\ncare group (15.2%) (OR = 0.69; 95% CI: 0.39ââ?¬â??1.23). The intervention group was significantly\nmore satisfied with the overall care they received for breastfeeding compared to the\ncontrol group (OR = 1.96; 95% CI: 3.50ââ?¬â??6.88)). Conclusion\nThis new model of care did not significantly increase exclusive breastfeeding at 12 weeks.\nHowever, there were clinically meaningful improvements in the rate of postnatal problems\nand satisfaction that support this new service delivery model for postpartum care. A community-\nbased multidisciplinary postpartum clinic is feasible to implement and can provide\nappropriate and highly satisfactory care to mother-baby dyads. This model of care may be\nmore beneficial in a population that is not already predisposed to breastfeed.
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