Promoting Children's Rights Through Breastfeeding Support: A Randomized Controlled Trial of a Speech-Language Pathologist–Led Intervention Among Migrant Mothers in Primary Health Care

Vollständiger Abstract

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Purpose: This randomized controlled trial evaluated a culturally adapted breastfeeding intervention led by speech-language pathologists (SLPs) for migrant mothers, grounded in the Convention on the Rights of the Child (CRC). The intervention addressed the rights to nondiscrimination (CRC Article 2), best interests of the child (CRC Article 3), survival and development (CRC Article 6), highest attainable standard of health (CRC Article 24), full potential (CRC Article 29), and cultural identity (CRC Article 30). The study examined whether the intervention improved exclusive breastfeeding (EBF) duration, maternal self-efficacy, infant oral-motor function, and maternal postpartum quality of life (MAPP-QOL). Method: Seventy-four migrant women in Portugal were randomly assigned to an intervention group (IG; n = 37) receiving culturally adapted, SLP-led breastfeeding support or a control group ( n = 37) receiving standard care. The intervention included a prenatal workshop, early feeding assessment, and individualized SLP counseling. Assessments at 1, 3, and 6 months postpartum included the Neonatal Oral-Motor Assessment Scale (NOMAS), Breastfeeding Self-Efficacy Scale, and MAPP-QOL questionnaire. Results: Groups were comparable at baseline in demographics, perinatal characteristics, and pre-intervention outcomes (all p > .05). EBF was higher and significant in the IG: at 1 month (91.9% vs. 51.4%; OR = 10.75), at 3 months (91.9% vs. 27.0%; OR = 30.30), and at 6 months (91.9% vs. 18.9%; OR = 47.62). In the IG, knowledge, attitudes, and practices improved from pre- to post-intervention ( p < .001). Self-efficacy showed a significant Group × Time interaction ( p < .001) and correlated with EBF, ranging from .391 to .644. MAPP-QOL also showed a significant Group × Time interaction ( p < .001) and correlated with both self-efficacy and EBF, ranging from .239 to .629. NOMAS favored the IG, with 13.5% undergoing frenotomy and 40.5% receiving targeted SLP therapy. Conclusions: A culturally adapted, SLP-led intervention can significantly improve breastfeeding outcomes, maternal confidence, quality of life, and infant feeding while advancing children's rights to health and cultural identity. Findings highlight the vital role of SLPs in multidisciplinary primary care. Supplemental Material: https://doi.org/10.23641/asha.33249894