Outcome Label | Outcome Definition | Method of Measurement |
---|---|---|
A. Primary outcome | ||
 1. Short-term exclusive breastfeeding (24-h recall) | Infant, age 1 month, was exclusively breastfed in the past 24 h | These outcomes will be measured by tablet-based surveys, adapted from the South Africa Demographic and Health Survey 2016 [7] and following the most recent WHO indicators for infant feeding practices [64]. A point-in-time or current status measurement (based on 24-h recall) is presently the most common method for measuring exclusive breastfeeding [65]. Responses to initial tablet-based surveys administered at 1 and 5 months will be verified by follow-up phone surveys, conducted by an independent, vetted phone survey research company, within one week of the initial data collection timepoint. Life-long (since birth recall) data on exclusive breastfeeding, will also be collected and verified by phone survey. Reporting indicators based on both point-in-time and life-long data has been recommended as a stronger approach than either of these in isolation [65]. |
 2. Long-term exclusive breastfeeding (24-h recall) | Infant, age 5 months, was exclusively breastfed in the past 24 h | |
B. Secondary outcomes | ||
 1. Short-term exclusive breastfeeding (since birth recall) | Infant, age 1 month, has been exclusively breastfed since birth | |
 2. Long-term exclusive breastfeeding (since birth recall) | Infant, age 5 months, has been exclusively breastfed since birth | |
 3. Early initiation of breastfeeding | Infant was breastfed within the first hour of life (based on recall at 1 month) | This outcome will be measured in the 1 month tablet-based survey and verified by phone survey within one week of the initial data collection timepoint. |
 4. Any breastfeeding at 1 month | Infant, age 1 month, received any breastmilk in the past 24 h, even if not exclusively breastfed | These outcomes will be measured by tablet-based surveys at 1 month and 5 months, adapted from the South Africa Demographic and Health Survey 2016 [7] and following the most recent WHO indicators for infant feeding practices [64]. Responses to tablet-based surveys will be verified by follow-up phone surveys, conducted by an independent, vetted phone survey research company, within one week of the initial data collection timepoint. |
 5. Any breastfeeding at 5 months | Infant, age 5 months, received any breastmilk in the past 24 h, even if not exclusively breastfed | |
 6. Bottle-feeding | Infant, under 6 months of age, was fed using a bottle with a nipple in the past 24 h. | |
 7. Early introduction of complementary foods at 1 month (24-h recall) | Infant, age 1 month, has received complementary foods in the past 24 h. | These out comes will be measured by phone surveys at 1 and 5 months. Participants will respond to an infant feeding questionnaire, incorporating both point-in-time and life-long data, adapted from previously published infant feeding measurement tools [82,83,84,85] and informed by the WHO indicators for infant feeding practices [64]. |
 8. Early introduction of complementary foods at 5 months (24-h recall) | Infant, age 5 months, has received complementary foods in the past 24 h. | |
 9. Early introduction of complementary foods at 1 month (since birth recall) | Infant, age 1 month, has received complementary foods at some point since birth. | |
 10. Early introduction of complementary foods at 5 months (since birth recall) | Infant, age 5 months, has received complementary foods at some point since birth. | |
 11. Maternal knowledge at 1 month post-delivery | Maternal knowledge of breastfeeding current recommendations and basic health principles relevant to infant feeding measured at 1 month post-delivery. | These outcomes will be measured by phone survey questionnaires on maternal knowledge about breastfeeding (developed by study team, adapted from previously published breastfeeding knowledge assessment tools [59, 86, 87]). |
 12. Maternal knowledge at 5 months post-delivery | Maternal knowledge of breastfeeding current recommendations and basic health principles relevant to infant feeding measured at 5 months post-delivery. |