Antenatal breastfeeding education for increasing breastfeeding duration
Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. . Cochrane database of systematic reviews (Online)
(Impact Factor: 6.03).
09/2012; 9(11):CD006425. DOI: 10.1002/14651858.CD006425.pub3
Breastfeeding is well recognised as the best food for infants and the World Health Organization recommends that all infants should have exclusive breastfeeding for at least six months after birth. Complementary foods offered before six months of age tend to displace breast milk and do not give any health advantage. Breastfeeding (BF) can improve the child's health, the mother's health and mother-infant bonding. Infants with BF have lower rates of gastrointestinal and respiratory diseases, otitis media and allergies, better visual acuity, and speech and cognitive development. The impact of educational interventions during pregnancy on breastfeeding duration has not yet been evaluated. This review includes data from 14 randomised controlled studies involving 6932 women, mostly from developed countries including the USA, Canada, UK and Australia. Peer counselling, lactation consultation and formal BF education during pregnancy appear to increase BF duration. Peer counselling also appears to be better than routine care for initiating BF. However, because most included studies were of poor quality and the effects of BF education were quite small, it is not appropriate to recommend any specific BF educational intervention. The findings of this review are based on single studies and there is a need for well-designed clinical trials with adequate sample sizes.
Available from: Zohra S Lassi
- "Individual and group counseling to pregnant mothers showed an increase in rates of mothers exclusively breastfeeding in the neonatal period and at six months [42,43]. Also, group counseling showed better results of mothers who breastfeed in the neonatal period and at 6 months compared to those mothers who were individually counseled on the benefits of breastfeeding . Current evidence suggests that interventions to promote complementary feeding have a positive impact on health outcomes of infants, including stunting and weight gain. "
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ABSTRACT: In an effort to accelerate progress towards achieving Millennium Development Goal (MDG) 4 and 5, provision of essential reproductive, maternal, newborn and child health (RMNCH) interventions is being considered. Not only should a state-of-the-art approach be taken for services delivered to the mother, neonate and to the child, but services must also be deployed across the household to hospital continuum of care approach and in the form of packages. The paper proposed several packages for improved maternal, newborn and child health that can be delivered across RMNCH continuum of care. These packages include: supportive care package for women to promote awareness related to healthy pre-pregnancy and pregnancy interventions; nutritional support package for mother to improve supplementation of essential nutrients and micronutrients; antenatal care package to detect, treat and manage infectious and noninfectious diseases and promote immunization; high risk care package to manage preeclampsia and eclampsia in pregnancy; childbirth package to promote support during labor and importance of skilled birth attendance during labor; essential newborn care package to support healthy newborn care practices; and child health care package to prevent and manage infections. This paper further discussed the implementation strategies for employing these interventions at scale.
Available from: Zohra S Lassi
- "When evaluating antenatal breastfeeding education, a formal breastfeeding education workshop vs. routine care increased the initiation rate of breastfeeding (RR 1.19; 95% CI: 0.97, 1.45); peer counseling versus routine care showed higher increments in the initiation rates of breastfeeding (RR 1.82; 95% CI: 1.13, 2.93). Less significant increases were observed at 3 months and 6 months after the education workshop . Another review by Imdad et al. 2011 compared breastfed versus non breastfed infants and showed a significant 70% reduction in the risk of neonatal mortality. "
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ABSTRACT: Childbirth and the postnatal period, spanning from right after birth to the following several weeks, presents a time in which the number of deaths reported still remain alarmingly high. Worldwide, about 800 women die from pregnancy- or childbirth-related complications daily while almost 75% of neonatal deaths occur within the first seven days of delivery and a vast majority of these occur in the first 24 hours. Unfortunately, this alarming trend of mortality persists, as287,000 women lost their lives to pregnancy and childbirth related causes in 2010. Almost all of these deaths were preventable and occurred in low-resource settings, pointing towards dearth of adequate facilities in these parts of the world. The main objective of this paper is to review the evidence based childbirth and post natal interventions which have a beneficial impact on maternal and newborn outcomes. It is a compilation of existing, new and updated interventions designed to help physicians and policy makers and enable them to reduce the burden of maternal and neonatal morbidities and mortalities. Interventions during the post natal period that were found to be associated with a decrease in maternal and neonatal morbidity and mortality included: advice and support of family planning, support and promotion of early initiation and continued breastfeeding; thermal care or kangaroo mother care for preterm and/or low birth weight babies; hygienic care of umbilical cord and skin following delivery, training health personnel in basic neonatal resuscitation; and postnatal visits. Adequate delivery of these interventions is likely to bring an unprecedented decrease in the number of deaths reported during childbirth.
Available from: Judy Jou
- "Multiple research studies and systematic reviews confirm that simply counseling women to breastfeed is not sufficient for encouraging women to breastfeed; rather, tailored support offered both prenatally and postpartum is most effective in supporting pregnant women to set and attain breastfeeding goals –. Clinicians should discuss breastfeeding intentions when establishing relationships with patients prenatally, including consultation on plans for the use of anti-diabetic or anti-hypertensive medications compatible with a mother's intentions, and follow up to ensure that women with complicated pregnancies have access to breastfeeding support in the hospital . It is also important to address breastfeeding intentions and provide encouragement and support at the time of delivery, given that delivery third of US women lack a prior relationship with the clinician attending their delivery . "
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Breastfeeding is beneficial for women and infants, and medical contraindications are rare. Prenatal and labor-related complications may hinder breastfeeding, but supportive hospital practices may encourage women who intend to breastfeed. We measured the relationship between having a complex pregnancy (entering pregnancy with hypertension, diabetes, or obesity) and early infant feeding, accounting for breastfeeding intentions and supportive hospital practices.
We performed a retrospective analysis of data from a nationally-representative survey of women who gave birth in 2011–2012 in a US hospital (N = 2400). We used logistic regression to examine the relationship between pregnancy complexity and breastfeeding. Self-reported prepregnancy diabetes or hypertension, gestational diabetes, or obesity indicated a complex pregnancy. The outcome was feeding status 1 week postpartum; any breastfeeding was evaluated among women intending to breastfeed (N = 1990), and exclusive breastfeeding among women who intended to exclusively breastfeed (N = 1418). We also tested whether breastfeeding intentions or supportive hospital practices mediated the relationship between pregnancy complexity and infant feeding status.
More than 33% of women had a complex pregnancy; these women had 30% lower odds of intending to breastfeed (AOR = 0.71; 95% CI, 0.52–0.98). Rates of intention to exclusively breastfeed were similar for women with and without complex pregnancies. Women who intended to breastfeed had similar rates of any breastfeeding 1 week postpartum regardless of pregnancy complexity, but complexity was associated with >30% lower odds of exclusive breastfeeding 1 week among women who intended to exclusively breastfeed (AOR = 0.68; 95% CI, 0.47–0.98). Supportive hospital practices were strongly associated with higher odds of any or exclusive breastfeeding 1 week postpartum (AOR = 4.03; 95% CI, 1.81–8.94; and AOR = 2.68; 95% CI, 1.70–4.23, respectively).
Improving clinical and hospital support for women with complex pregnancies may increase breastfeeding rates and the benefits of breastfeeding for women and infants.
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