Effect of Lactation Support and Human Milk banks in Uganda
Compromised nutrition and postnatal growth faltering (PGF) drive high morbidity and mortality. This project will address PGF by implementing an enhanced lactational support program (ELSP) with certified breastfeeding support and a low-cost human milk bank (HMB), while evaluating the safety and properties of term versus preterm breast milk.
About the research project
Complications of prematurity are the leading cause of childhood deaths. Sub-Saharan Africa and Asia are responsible for >60% of preterm births and >80% of the 1.1million neonatal deaths annually.
The LASUHUMU project will address two of the research questions identified by the WHO guideline development group for care of preterm or low birth weight infants to improve nutrition for this vulnerable group.
- How can exclusive breastfeeding be promoted, supported and scaled up for very preterm or VLBW infants? and
- What is the effectiveness, safety, and feasibility of setting up human milk banks (HMB) in low- and middle-income countries?
The project will use a model using an enhanced lactational support program (ELSP) with a certified breastfeeding consultant and a low-cost human milk bank (HMB) that has been established in Mbale, Uganda.
The LASUHUMU project will include end-users and non-research organizations, and together we will contribute with novel knowledge with potential to promote growth, prevent ill health and death in the most vulnerable child population.
Project title
Effect of LActation SUpport and HUman Milk banks in Uganda on health, breastfeeding and growth in very low birthweight infants: a step-wedged trial project exploring infant outcomes, health economy, nutritional and implementation factors.
Acronym: LASUHUMU
Partners
In partnership with the Ministry of Health (MoH) in Uganda, the non-profit organization Born on the Edge, the TTA Breastmilk Community, Elgon Centre for Health Research and Innovation (ELCHRI) and end-users in Uganda, the LASUHUMU project will test the implementation of the Bridge to Breastfeeding program.
Work packages (WPs)
The project will use a model using an enhanced lactational support program (ELSP) with a certified breastfeeding consultant and a low-cost human milk bank (HMB) that has been established in Mbale, Uganda, this model is called “Bridge to Breastfeeding”. This project will scale up this model and apply three methodologies to answer the 2 WHO questions mentioned above.
WP1: A step-wedged-trial implementing the ELSP and HMB model in 3 new sites will answer: What is the effectiveness and cost-effectiveness of the ELSP and HMB among infants weighing <1500g on: in-patient growth, health and survival; exclusive breastfeeding up to 6 months of age; and growth, health and neurodevelopment up to 12 months corrected age?
WP 2: Laboratory studies will answer: What is the macro- and micronutrient composition of human milk in Ugandan mothers at various gestational and chronological ages; and what are the implications on the nutritional needs of preterm infants; and are there heavy metals and pesticides in the breastmilk?
WP 3: Lastly, through qualitative methods and implementation research we will answer if scale-up ELSP and HMB is feasible and sustainable in Uganda.
There is insufficient evidence on the effectiveness, safety, and feasibility of setting up lactation support and human milk banks (HMBs) in SSA and their effect on inpatient and longer-term nutritional intake, growth, health, and survival in infants weighing <1500g. The LASUHUMU project will mitigate this gap.
People
Project manager
Ingunn M. S. Engebretsen Project manager (PI)
Kathy Burgoine Project co-PI, UiB, Uganda
Project members
Nicholas Embleton Neonatologist, co-researcher, University of Newcastle, UK
Anna Coutsoudis Nutritionist, co-researcher, University of KwaZulu-Natal (UKZN), South Africa
Deogratius Migadde Co-researcher, Ministry of Health, Uganda
Laura Ahumuza Senior Nutritionist and co-researcher at the Ministry of Health (MoH) in Uganda
John Ssenkusu Statistician, Makerere University, Uganda
Lumbwe Chola Health Economics, University of Oslo (UiO)
Tracy Ahumuza Team Leader ATTA Breastmilk community, Uganda/UK
Jovia Nakitende ATTA Breastmilk community, Uganda
Goretti Ayebale Certified breastfeeding specialist, Born on the Edge, Uganda
Marte Emilie Sandvik Haaland Assoc. Professor, University of Bergen
Ambrose Okibure Statistician, ELCHRI
Annet Imamut Study coordinator
Miriam Burega Qualitative researcher, ELCHRI
Herbert Kiwalya Data Manager, ELCHRI
