Interpersonal counseling sessions during routine immunization visits improve infant feeding practices - A randomized controlled trial.

BACKGROUND: Existing studies on counseling interventions for infant and young child feeding practices, delivered at critical points in a child's development, have often been broad in scope, addressing multiple aspects and requiring additional resources with sessions ranging from 5 to 15. In this study, we estimate the effect of providing two focused feeding counseling sessions during routine immunization visits on exclusive breastfeeding for 6 months, complementary feeding practices, and child weight. MATERIALS AND METHODS: A randomized controlled trial was conducted in a health center at a socially disadvantaged urban community in Delhi, India, from September 2022 to February 2024. The randomization sequence was generated using an online random number sequence generator. Block randomization with variable block sizes and allocation concealment was done. Ninety-two mother-child dyads were recruited, 46 each in the intervention and control groups. Interpersonal counseling on breastfeeding and complementary feeding was provided to the intervention group, when mother-child dyads came for the first or second and the third dose of pentavalent vaccine, respectively. Final assessment was conducted at 9 months of child's age. Descriptive analysis demonstrates baseline sociodemographic, childbirth-related, and breastfeeding characteristics. Primary inferential analysis was conducted using Chi-square tests of independence for comparing the proportion of mothers practicing exclusive breastfeeding and appropriate complementary feeding practices based on the Intention-To-Treat approach. Linear mixed model analysis was used to compare weights of the infants. RESULTS: The intervention group showed a higher rate of exclusive breastfeeding for 6 months (RR: 1.67 [1.10-2.53]) as well as timely initiation of complementary feed (2.60 [1.42,4.76]) compared to the control group. Weights of children were found to be significantly higher in the intervention group at final visit compared to the control. CONCLUSION: We conclude that two one-to-one interpersonal counseling sessions are effective in improving infant feeding practices and weight gain among infants. The study forms an evidence base on utilizing the operational platform of the National Immunization Program in scaling up the IYCF (Infant and Young Child Feeding) counseling as envisioned under the MAA (Mothers Absolute Affection) program.