Merewood 2006.

Methods	RCT.
Participants	LHW: women with breastfeeding experience drawn from local community. Used 2 US born African‐American women, 1 non US‐born Mexican woman, 1 white US‐born woman and 1 native white American woman. Two of the women were also employed at the hospital as lay childbirth assistants and two were former teenage mothers. TRAINING: 5 day breastfeeding course operated by Centre for Breastfeeding [www.healthychildren.cc/index4.htm]. Were trained in hospital about NICU procedures, breastfeeding techniques and at regular, mandatory breastfeeding days for maternity staff throughout the course of their employment. PARTICIPANTS: Eligible women had a healthy premature infant (26‐37 weeks gestation); spoke English or Spanish; were eligible to breastfeed according to current guidelines and chose to do so. 72.9% and 66% in intervention and control groups respectively were African American. About 505 in each group were on Medicaid. TOTAL=108; INTERVENTION=53; CONTROL=55.
Interventions	OBJECTIVE: Infant feeding counselling with emphasis on encouraging breastfeeding to mothers with preterm babies. INTERVENTION: Emphasis was placed on face to face contact. One face to face meeting (at least 30 minutes) at hospital within 72 hours of birth. Thereafter weekly until 6 weeks. Met with mother whenever possible before discharge. Thereafter telephone contact unless mother chose to come to hospital. Peer counselors followed written guidelines for each contact to establish consistency of care. Counsellors had immediate daily access to a lactation consultant working on the unit and to project managers.The lactation consultants and the project managers presence helped to ensure peer counsellor consistency, accuracy of knowledge and reliability. CONTROL: Control group women received standard of care treatment, which in the baby friendly hospital included referral to the lactation consultant when needed, use of a pump in hospital, access to 3 breastfeeding classes per week and staff highly trained in lactation. MODE OF DELIVERY: Face to face contact initially and telephone contact thereafter. RECIPIENT INVOLVEMENT IN SELECTION/TRAINING/MANAGEMENT: not described. GEOGRAPHICAL SETTING: USA, urban formal. HEALTHCARE SETTING: home.
Outcomes	HEALTHCARE BEHAVIOURS: Any breastmilk at 12 weeks; mostly breastmilk at 12 weeks (more than 50% of feeds); only breastmilk at 12 weeks. LENGTH OF FOLLOW UP: 12 weeks.
Notes	Although this intervention was initiated in the hospital setting, it was decided to include it in the review as much of the intervention was delivered once the mothers and babies had been discharged home.
Risk of bias
Bias	Authors' judgement	Support for judgement
Adequate sequence generation?	Low risk	'Randomization was performed using SAS' (p682).
Allocation concealment?	Unclear risk	'Numbered envelopes were prepared by the primary investigator...opened the sealed envelope' (p682).
Blinding? All outcomes	Low risk	'Infant feeding status was assessed by a research assistant unaware of the mother's group assignment' (p682).
Incomplete outcome data addressed? All outcomes	Low risk	Missing outcome data balanced in numbers across intervention groups, with similar reasons for missing data across groups.
Free of selective reporting?	Unclear risk	Insufficient information to make an assessment.
Free of other bias?	Low risk