Effectiveness of Couple‐Based Optimal Breastfeeding Promotion and Support Interventions on Child Morbidity in Central Ethiopia: A Cluster‐Randomized Controlled Trial

ABSTRACT Background and Aims The most effective intervention to reduce child morbidity and mortality both in developed and developing countries is the promotion of optimal breastfeeding practices. Breastfeeding practices are usually affected by influential people in the family, such as the husband. Therefore, this study aimed to evaluate the effect of a couple‐based optimal breastfeeding promotion and support intervention on the frequency of child morbidity in central Ethiopia. Methods A two‐arm, parallel, cluster randomized controlled trial was carried out among couples in a community setting in the Hadiya Zone, Central Ethiopia. A total of 408 couples from 16 clusters were randomly assigned to either the intervention group ( n = 204) or the control group ( n = 204). Fathers and mothers in the intervention arm received breastfeeding education and support interventions, while those in the control arm received existing routine care. The outcome variable was measured by assessing three specific morbidities in children: diarrhoea, fever, and acute respiratory illnesses during the post‐delivery period as count data. A zero‐inflated multivariable negative binomial regression (ZINB) model was used for the analysis of data. The incidence rate ratio (IRR) with a 95% CI was used to report the result. Results In the 6‐month follow‐up, 34.5% of infants remained healthy with no episodes of illness. In this trial, the incidence of morbidity was decreased by 92.7% (IRR = 0.073, 95% CI: 0.039–0.138, p < 0.001) for neonatal and infants whose parents received optimal breastfeeding promotion and support interventions compared to infants whose mothers received routine care during the intervention period. Conclusion Couple‐based optimal breastfeeding promotion intervention has shown a protective effect against the frequency of neonatal and infants morbidity, highlighting the effectiveness in community settings of this optimal breastfeeding counselling model that includes the father. Trial Registration This trial was registered on ClinicalTrials. gov with identifier (NCT number): NCT05173454 , First registered on 30/12/2021.