Overcoming Barriers to Exclusive Breastfeeding in Lao PDR: Social Transfer Intervention Randomised Controlled Trial

Karimian-Marnani, Najmeh; Tilley, Elizabeth; Wallenborn, Jordyn T.

doi:10.3390/nu17152396

This is an early access version, the complete PDF, HTML, and XML versions will be available soon.

Open AccessArticle

Overcoming Barriers to Exclusive Breastfeeding in Lao PDR: Social Transfer Intervention Randomised Controlled Trial

by

Najmeh Karimian-Marnani

^1,*

,

Elizabeth Tilley

²

and

Jordyn T. Wallenborn

^1,3,*

¹

Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland

²

Department of Mechanical and Process Engineering, Swiss Federal Institute of Technology (ETH) Zurich, Rämistrasse 101, 8092 Zürich, Switzerland

³

University of Basel, Petersplatz 1, 4001 Basel, Switzerland

^*

Authors to whom correspondence should be addressed.

Nutrients 2025, 17(15), 2396; https://doi.org/10.3390/nu17152396

Submission received: 8 June 2025 / Revised: 17 July 2025 / Accepted: 18 July 2025 / Published: 22 July 2025

(This article belongs to the Section Nutrition and Public Health)

Download Versions Notes

Abstract

Background/Objectives: Despite the numerous health benefits of exclusive breastfeeding (EBF) for the infant and the mother, EBF rates in Lao People’s Democratic Republic, Lao PDR, remain at 40%. We investigate how barriers to EBF were overcome by a social transfer intervention. Methods: Data from the Social Transfers for Exclusive Breastfeeding ongoing randomised controlled trial (RCT) (n = 298) in Vientiane, Lao PDR, was used. Mothers in the RCT were randomised equally into a control group, an unconditional transfer group and a conditional transfer group and followed up to six months (n = 280). We used logistic and Cox proportional hazards regression models to investigate the association of predictor variables with EBF at six months and the risk of EBF cessation in each of the three groups. Results: Greater breastfeeding self-efficacy increased the odds of EBF at six months in both intervention groups (unconditional transfer OR 1.39 [95% CI 1.09, 1.87, p = 0.02] and conditional transfer OR 1.26 [1.01, 1.61, p = 0.05]) and reduced the risk of EBF cessation (unconditional transfer HR 0.87 [0.77, 0.98, p = 0.02]). Maternal secondary and tertiary education in the intervention groups showed higher odds of EBF at six months and lower EBF cessation risk. Participants in the intervention group that intended to exclusively breastfeed in pregnancy showed a reduced EBF cessation risk in both intervention groups. Conclusions: Social transfers helped overcome the exclusive breastfeeding barrier of a higher education level and working status and improved EBF outcomes for mothers who intended to exclusively breastfeed and wanted the pregnancy. Breastfeeding self-efficacy positively influences EBF outcome, regardless of whether the mother received a social transfer or not.

Keywords: breastfeeding; exclusive breastfeeding; maternal health; financial incentives; infant nutrition; factors

Share and Cite

MDPI and ACS Style

Karimian-Marnani, N.; Tilley, E.; Wallenborn, J.T. Overcoming Barriers to Exclusive Breastfeeding in Lao PDR: Social Transfer Intervention Randomised Controlled Trial. Nutrients 2025, 17, 2396. https://doi.org/10.3390/nu17152396

AMA Style

Karimian-Marnani N, Tilley E, Wallenborn JT. Overcoming Barriers to Exclusive Breastfeeding in Lao PDR: Social Transfer Intervention Randomised Controlled Trial. Nutrients. 2025; 17(15):2396. https://doi.org/10.3390/nu17152396

Chicago/Turabian Style

Karimian-Marnani, Najmeh, Elizabeth Tilley, and Jordyn T. Wallenborn. 2025. "Overcoming Barriers to Exclusive Breastfeeding in Lao PDR: Social Transfer Intervention Randomised Controlled Trial" Nutrients 17, no. 15: 2396. https://doi.org/10.3390/nu17152396

APA Style

Karimian-Marnani, N., Tilley, E., & Wallenborn, J. T. (2025). Overcoming Barriers to Exclusive Breastfeeding in Lao PDR: Social Transfer Intervention Randomised Controlled Trial. Nutrients, 17(15), 2396. https://doi.org/10.3390/nu17152396

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Menu

Overcoming Barriers to Exclusive Breastfeeding in Lao PDR: Social Transfer Intervention Randomised Controlled Trial

Abstract

Share and Cite

Article Metrics

Article Access Statistics

Further Information

Guidelines

MDPI Initiatives

Follow MDPI