Support for healthy breastfeeding mothers with healthy term babies

Mother and Infant Research Unit, Department of Health Sciences, University of York, York, UK.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 05/2012; 5(5):CD001141. DOI: 10.1002/14651858.CD001141.pub4
Source: PubMed


There is extensive evidence of important health risks for infants and mothers related to not breastfeeding. In 2003, the World Health Organization recommended infants be exclusively breastfed until six months of age, with breastfeeding continuing as an important part of the infant's diet till at least two years of age. However, breastfeeding rates in many countries currently do not reflect this recommendation.
To assess the effectiveness of support for breastfeeding mothers.
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (3 October 2011).
Randomised or quasi-randomised controlled trials comparing extra support for healthy breastfeeding mothers of healthy term babies with usual maternity care.
Two review authors independently assessed trial quality and extracted data.
Of the 67 studies that we assessed as eligible for inclusion, 52 contributed outcome data to the review (56,451 mother-infant pairs) from 21 countries. All forms of extra support analysed together showed an increase in duration of 'any breastfeeding' (includes partial and exclusive breastfeeding) (risk ratio (RR) for stopping any breastfeeding before six months 0.91, 95% confidence interval (CI) 0.88 to 0.96). All forms of extra support together also had a positive effect on duration of exclusive breastfeeding (RR at six months 0.86, 95% CI 0.82 to 0.91; RR at four to six weeks 0.74, 95% CI 0.61 to 0.89). Extra support by both lay and professionals had a positive impact on breastfeeding outcomes. Maternal satisfaction was poorly reported.
All women should be offered support to breastfeed their babies to increase the duration and exclusivity of breastfeeding. Support is likely to be more effective in settings with high initiation rates, so efforts to increase the uptake of breastfeeding should be in place. Support may be offered either by professional or lay/peer supporters, or a combination of both. Strategies that rely mainly on face-to-face support are more likely to succeed. Support that is only offered reactively, in which women are expected to initiate the contact, is unlikely to be effective; women should be offered ongoing visits on a scheduled basis so they can predict that support will be available. Support should be tailored to the needs of the setting and the population group.

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Available from: Mary Josephine Renfrew, Oct 16, 2014
    • "foods are introduced to alleviate sole responsibility of feeding , to modify behaviour or to attempt to counteract frequent demands for feeding e . g . for non - nutritious reasons . Introduction is often at an earlier stage than the current DoH guid - ance even though typically knowledge of guidelines is high among mothers ( Moore et al . 2012b ; Renfrew et al . 2012 ) . Although much debate surrounds whether ' around twenty - six weeks ' is the most appro - priate time to introduce solid foods , most agree than introducing solid foods before 4 months is detrimen - tal to infant health ( Agostoni et al . 2008 ; Schwartz et al . 2011 ) . Moving away from age , introduction of solid foods should be re"
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    Maternal and Child Nutrition 02/2015; DOI:10.1111/mcn.12166 · 3.06 Impact Factor
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