Effect of breastfeeding education and support provided to the male partner on optimal breastfeeding practice in southern Ethiopia: Study protocol of a cluster- randomized controlled trial

Background: Optimal breastfeeding is essential for the survival, growth, and development of children, as well as the health of mothers. Globally, optimal breastfeeding practices are still low: only 42% of newborns start breastfeeding within the first hour of birth, 41% of infants less than 6 months of age are exclusively breastfed, and only 45% of mother’s breastfeed for at least two years. Every year, it is estimated that optimal breastfeeding practices might avoid 823,000 child deaths. However, breastfeeding practices are not optimal in Ethiopia. Male partners play a vital but frequently neglected role in the promotion of breastfeeding practices, and they are not included in the breastfeeding education. The effect of interventions to promote breastfeeding that specifically target male partners on optimal breastfeeding practices has not been investigated in the Ethiopian context. Methods: A parallel cluster-randomized controlled trial will be conducted to evaluate the effect of breastfeeding education and support provided to male partners on optimal breastfeeding practice compared to routine care at the community level. Trained healthcare professionals chosen from the closest health center to the intervention cluster will provide the intervention to the mothers and male partners. The mothers and male partners in the Intervention Group (IG) will receive both antenatal and postnatal breastfeeding education and support starting from their 3 ^rd trimester of pregnancy till 6 month post-delivery, but those in the Control Group (CG) will receive routine care. The breastfeeding education and support intervention is comprised of four components: 1) Antenatal BF education on their 3 ^rd trimester of pregnancy, 2) providing specific take-home print materials, 3) Individual home visit . A total of 408 couples with pregnancies in the third trimester from 16 clusters (Kebeles) will be randomly assigned to the intervention group (204) or the control group (204). Epi-data version 3.1 will be used to enter data, and STATA version 14.0 will be used to analyze it. The analysis will be done by intention to treat approach. Generalized Estimating Equation (GEE) model will be used to determine the effect of the intervention on optimal breastfeeding practice. P values < 0.05 will be used to declare statistical significance. Discussion: The results of the trial will provide evidence of the effectiveness of male partner-focused breastfeeding education and support interventions on optimal breastfeeding practices in community settings in Ethiopia. The study's findings will help policymakers and practitioners understand how to best involve male partners and establish their contributions to breastfeeding best practices. Trial registration: ClinicalTrials.gov identifier (NCT number): NCT05173454, May 20, 2022.