Postnatal parental education for optimizing infant general health and parent‐infant relationships
Abstract
Background
Many learning needs arise in the early postpartum period, and it is important to examine interventions used to educate new parents about caring for their newborns during this time.
Objectives
The primary objective was to assess the effects of structured postnatal education delivered by an educator to an individual or group on infant general health and parent‐infant relationships.
Search methods
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (April 2009), CINAHL (1982 to July 2009), ERIC (1966 to July 2009), HealthSTAR (1966 to July 2009), PsycINFO (1806 to July 2009), Sociological Abstracts (1974 to July 2009), ClinicalTrials.gov (August 2009), Current Controlled Trials (August 2009), and Trialscentral.org (August 2009).
Selection criteria
We included randomized controlled trials of any structured postnatal education provided by an educator to individual parents or groups of parents within the first two months postbirth related to the care of an infant or parent‐infant relationships. We excluded studies of educational interventions for parents of infants in neonatal intensive care units.
Data collection and analysis
Both authors assessed trial quality and extracted data from published reports.
Main results
Of the 25 trials (3689 mothers and 793 fathers) that met the inclusion criteria, only 15 (2868 mothers and 613 fathers) reported useable data. Educational interventions included: four on infant sleep enhancement, 13 on infant behaviour, two on general postbirth health, two on infant care, three on infant safety, and one on father involvement/skills with infants. Details of the randomization procedures, allocation concealment, blinding, and participant loss were often not reported. Of the outcomes analyzed, only six were measured similarly enough by more than one study to be combined in meta‐analyses. Of these six meta‐analyses, only two were found to have a low enough level of heterogeneity to provide an overall estimate of effect. Education on sleep enhancement resulted in a mean difference of 29 more night‐time minutes of infant sleep in 24 hours (95% confidence interval (CI) 18.53 to 39.73) than usual care. Education on infant behaviour increased maternal knowledge of infant behaviour by a mean difference of 2.85 points (95% CI 1.78 to 3.91).
Authors' conclusions
The benefits of educational programs to participants and their newborns remain unclear. Education on sleep enhancement appears to increase infant sleep and education about infant behaviour potentially enhances mothers' knowledge; however more and larger, well‐designed studies are needed to confirm this.
PICOs
Plain language summary
Postnatal parental education for optimizing infant general health and parent‐infant relationships
The benefits of postbirth parental education for infant health and parent‐infant relationships remain unclear.
Parenting is important in the development of healthy children. New parents have much to learn soon after the birth of an infant and parents do not always have social support or role models to follow. This makes it essential to examine the effectiveness of interventions used by health personnel to educate new parents about caring for their newborn infants in the best possible way. This review sought to assess educational programs delivered to one or both parents individually or in a group in the first eight weeks after birth. Although the review identified 25 trials involving 3689 mothers and 793 fathers, only 15 (2868 mothers and 613 fathers) provided useable data on outcomes of interest. Infant sleep and maternal knowledge of infant behaviours were the only outcomes that could be effectively analyzed. Results showed that an educational intervention aimed at sleep enhancement increased the amount of infant sleep by an average of 29 minutes in 24 hours and education on infant behaviour increased mothers' knowledge of infant behaviour four weeks after birth by an average of 2.85 points. Further research is required.
