1. Clinical breastfeeding interventions appear to increase any breastfeeding and exclusive breastfeeding between the ages of 1 to 3 months and 4 to 6 months compared to usual care.
2. Larger effects on breastfeeding were seen when interventions were made during both prenatal and postpartum periods.
Study Rundown: The American Academy of Pediatrics recommends breastfeeding for at least 12 months, with exclusive breastfeeding for the first 6 months of a child’s life. While the majority of Latina mothers began breastfeeding in 2011, less than a quarter exclusively breastfed for the first 6 months and even less continued breastfeeding at 12 months. To better understand how to address low breastfeeding rates among Latina women, researchers reviewed studies of interventions on breastfeeding among Latina mothers. Results indicated that prenatal and post-partum clinical interventions supported breastfeeding when compared to usual care and that those administered by lactation consultants were most effective. While strengthened by the large sample examined via this meta-analysis, conclusions may be limited by publication bias and variations in study quality. Findings of this meta-analysis suggest that providers should be aware of the needs of Latina mothers both prenatally and following the birth of their child as interventions can improve breastfeeding rates if implemented during these time periods.
Relevant Reading: Centers for Disease Control and Prevention: National Center for Chronic Disease Prevention and Health Promotion. Rates of Any and Exclusive Breastfeeding by Sociodemographics among Children Born in 2012
In-Depth [meta-analysis]: In this study, 14 different studies (published between 2004 and 2014) of 17 interventions met criteria for inclusion. Clinical interventions included education delivered in-person, phone calls, optional/required home visits, and clinic/hospital visits to provide interpersonal support with durations ranging from 1 week to 1 year. The providers delivering interventions varied by study, but included physicians, nurses, social workers, and lay people. Interventions that resulted in increases in any breastfeeding at 1 to 3 months (p = 0.03, risk difference* [RD] 0.10, 95%CI 0.04-0.15) and 4 to 6 months (p = 0.037, RD 0.08, 95% CI – 0.01-9.15) involved a prenatal and postpartum component. Interventions that resulted in increases in exclusive breastfeeding at 1 to 3 months included a prenatal (p = 0.01, RD 0.05, 95%CI 0.01-0.11) and postpartum (p = 0.03, RD 0.01, 95%CI 0.12-0.13) component and greater than 6 intended points of contact with the participant (p = 0.001, RD 0.05, 95%CI 0.04-0.14). For any breastfeeding and exclusive breastfeeding at 1 to 3 months, and exclusive breastfeeding at 4 to 6 months, interventions resulted in larger effects when they were done during the prenatal and postpartum periods as opposed to postpartum only. In addition, interventions with 3 to 6 points of contact by an international board-certified lactation consultant were slightly more effective on any breastfeeding than no breastfeeding.
*Risk difference is an absolute measure looking at the proportion of study participants who experience the investigated outcome.
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