Effectiveness of an educational and support intervention to increase breastfeeding, improve nutrition and reduce environmental impact: The GREEN MOTHER-II Project, an intervention study protocol

Abstract Background: The effectiveness of the educational intervention on breastfeeding was shown in previous studies. The main objective of this study is to evaluate the effectiveness of a multimodal educational and support intervention on exclusive breastfeeding rates from a holistic point of view. We will study the environmental impacts of three feeding types (exclusive breastfeeding, mixed and formula feeding), including accessories used, as well as the mother's diet and other relevant factors to reduce the carbon footprint. Methods: This is a prospective multicenter intervention study (Phase II of the GREEN MOTHER project) that will last from 24 weeks of pregnancy until 4-6 weeks after birth, with additional observations of feeding types at 1, 3, 4 and 6 months. The results on rates of different lactation types and duration together with environmental impacts associated to diet and feeding will be compared between 2 groups: 1) an experimental group, which will receive a multimodal educational and support intervention on healthy and sustainable nutrition and breastfeeding, and environmental impacts associated with both; and 2) a control group, which will receive standard educational courses and care. This project was approved by the Research Ethics Committee of the Jordi Gol i Gurina University Institute Foundation for Primary Health Care Research (IDIAP) under code 22/101-P dated 22/02/2023. Discussion: To increase awareness of the environmental impacts of different types of lactation and mother’s diet will be disseminated among relevant professionals and stakeholders: community health worker associations and the general public.