Plain English Summary
Background and study aims
Women with hypertensive (high blood pressure) disorders of pregnancy including preeclampsia and gestational hypertension are at increased risk for later cardiovascular (heart) disease. Breastfeeding may lower maternal blood pressure and other cardiovascular risk factors, and interventions designed to improve mothers’ breastfeeding self-efficacy (i.e., confidence about breastfeeding) have been helpful for healthy postpartum women. However, such breastfeeding support interventions have not yet been tested specifically in women who have had hypertensive disorders of pregnancy, a group who may benefit substantially from breastfeeding. This study tests a nurse-led self-efficacy based breastfeeding intervention in women with hypertensive disorders of pregnancy, to measure whether the intervention is feasible in this population and whether it improves breastfeeding rates and/or lowers maternal blood pressure.
Who can participate?
Women at least 18 years old who have been diagnosed with a hypertensive disorder of pregnancy (preeclampsia or gestational hypertension), have given birth to a live-born single infant delivered at 34 weeks gestation or later, who intend to breastfeed and have started breastfeeding before hospital discharge, speak and understand English or French, and have access to a telephone.
What does the study involve?
Participants are randomly allocated to receive either usual postpartum care, or usual postpartum care plus additional breastfeeding support. Additional breastfeeding support will include the nurse-led intervention designed to improve women’s confidence about breastfeeding.
What are the possible benefits and risks of participating?
Participants who receive additional breastfeeding support may benefit from the nurse-led breastfeeding intervention. The study involves collection of test results from blood draws that are part of routine postpartum care. Blood draws may cause temporary discomfort, minor bleeding, light-headedness, and rarely, fainting.
Where is the study run from?
McGill University Health Centre (MUHC), Montreal (Canada)
When is the study starting and how long is it expected to run for?
May 2018 to June 2021
Who is funding the study?
The study is supported by startup funds of the principal investigator, Natalie Dayan
Who is the main contact?
Dr Gabriel Shapiro
McGill University Health Centre
5252 de Maisonneuve West
+1 (0)514 934 1934 x76147
Pilot randomized trial of a nurse-led self-efficacy based breastfeeding intervention in women with hypertensive disorders of pregnancy
The trialists hypothesize that a self-efficacy based breastfeeding intervention in women with hypertensive disorders of pregnancy will be feasible in this population. They further hypothesize that there will be a trend toward protective effects on maternal health as measured by blood pressure, weight, and continued breastfeeding, at 6 months postpartum, with continued but dampened protective effects at 12 months postpartum.
Research Ethics Board of the McGill University Health Centre (MUHC), 2155 Guy Street, 2nd floor, Montreal, Quebec, H3H 2R9, Tel: +1 (0)514 934 1934 ext. 36077, Email: firstname.lastname@example.org, 20/11/2018, protocol number: 2019-4726
Single-centre pilot randomized open-label trial
Primary study design
Secondary study design
Randomised controlled trial
Patient information sheet
Hypertensive disorders of pregnancy, including preeclampsia and gestational hypertension
Nurse-led breastfeeding enhancing intervention, including a maternal assessment followed by the provision of tailored lactation management strategies to enhance breastfeeding self-efficacy and support exclusive breastfeeding. Participants are randomized 1:1 to the intervention or usual postpartum care.
Primary outcome measure
Feasibility, including recruitment, retention and participant satisfaction with the intervention:
1. Recruitment rate is defined as the number of eligible women who consented/number of eligible women who were approached, calculated at baseline
2. Retention rate is defined as the number of women who complete 12-month follow-up for the study/all women who consent to participate, calculated at 12-month follow-up
3. Participant satisfaction with the breastfeeding intervention will be measured using a self-administered questionnaire that includes quantitative and qualitative items on participants' satisfaction with the support received from the study nurse, measured at 3 months and 6 months postpartum
Secondary outcome measures
1. Exclusive breastfeeding assessed by self-report at 6 months and 12 months postpartum
2. Total breastfeeding duration assessed by self-report at 6 months and 12 months postpartum
3. Blood pressure measured by the study nurse at 12 months postpartum
4. Use of anti-hypertensive medication as ascertained from the participant's medical chart at 12 months postpartum
Overall trial start date
Overall trial end date
Reason abandoned (if study stopped)
Participant inclusion criteria
1. Age >18 years
2. Diagnosis of hypertensive disorder of pregnancy (preeclampsia or gestational hypertension)
3. Singleton live birth delivered at >34 weeks gestation
4. Mother intends to breastfeed and breastfeeding initiated before hospital discharge
5. Patient speaks and understands English or French
6. Patient has telephone access
Target number of participants
Participant exclusion criteria
1. Maternal contraindication to breastfeeding
2. Maternal condition that interferes with breastfeeding
3. Neonatal condition that interferes with breastfeeding
4. Infant born before 34 weeks gestation
5. Maternal ICU admission lasting >24 hours
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
McGill University Health Centre
1001 Boulevard Décarie
McGill University Health Centre (startup funds)
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
The study protocol will be available on request. The trialists will disseminate their findings to:
1. Members of the general public via press releases to local, national, and international media organizations, and via commercial and community organizations dedicated to women’s health such as Nourri-Source, La Leche, the Preeclampsia Foundation, and Johnson & Johnson
2. Clinicians involved in perinatal care, e.g., knowledge users from the Society of Obstetricians and Gynaecologists of Canada (SOGC), Canadian Association of Women’s Health, and Canadian Lactation Consultant Association
3. Policy makers, in particular the World Health Organization and American Academy of Pediatrics as they relate to breastfeeding recommendations, and the SOGC, Hypertension Canada, and the Canadian Cardiovascular Society as they relate to hypertension and cardiovascular risk management
IPD sharing statement
The data sharing plans for the current study are unknown and will be made available at a later date
Intention to publish date
Participant level data
To be made available at a later date
Basic results (scientific)