Partner-inclusive postpartum counselling versus breastfeeding friendly hospital initiative (BFHI) standard care to improve six-month exclusive breastfeeding among primiparous women
Improving exclusive breastfeeding at six months among primiparous postpartum women.
This is a two-arm, parallel-group randomized controlled trial. Eligible primiparous postpartum women and their partners will be randomly allocated in a 1:1 ratio to either the intervention or control group after providing written informed consent. Regarding the randomisation method, participants will be randomly allocated using a computer-generated randomization sequence. The allocation sequence will be generated before recruitment, and assignments will be placed in sequentially numbered, opaque, sealed envelopes. After informed consent and completing the baseline assessment, the next envelope in sequence will be opened to determine group allocation. Intervention group: Participants will receive routine Baby-Friendly Hospital Initiative (BFHI) postpartum care plus a single structured partner-inclusive breastfeeding counselling session before hospital discharge. The session will include a standardized educational video followed by face-to-face discussion with the research team to reinforce key messages, answer questions, and address breastfeeding concerns. Topics include breastfeeding techniques and positioning, common breastfeeding challenges, breast milk expression and storage, and practical and emotional partner support. The session will be delivered once during the postnatal admission. Control group: Participants will receive routine postpartum care according to BFHI standards at University of Malaya Medical Centre without the additional partner-inclusive counselling session. Participants in both groups will complete baseline questionnaires before discharge. Follow-up assessments will be conducted at 3 and 6 months postpartum to assess exclusive breastfeeding status and complete the study questionnaires.
1. Primiparous women aged 18 years or older 2. Delivered a healthy singleton term infant (≥37 completed weeks' gestation) 3. Intend to exclusively breastfeed their infant 4. Recruited within 24–48 hours postpartum prior to hospital discharge 5. Able to understand the study information and provide written informed consent 6. Have a partner who is available, willing to participate in the counselling session and follow-up assessments, and able to provide written informed consent
1. Mothers with medical contraindications to breastfeeding 2. Infants requiring prolonged neonatal intensive care unit (NICU) admission or with significant medical conditions that preclude breastfeeding 3. Mothers or partners unable to understand the study information or communicate in the study languages 4. Mothers or partners with major psychiatric illness, cognitive impairment, or any condition that would limit participation or informed consent 5. Women who screen positive for intimate partner violence (IPV) using the HARK screening tool 6. Partners who are unavailable or unwilling to participate in the counselling session and follow-up assessments