Interventions to improve breastfeeding outcomes: a systematic review and meta‐analysis

Abstract

Aim: To provide comprehensive evidence of the effect of interventions on early initiation, exclusive, continued and any breastfeeding rates when delivered in five settings: (i) Health systems and services (ii) Home and family environment (iii) Community environment (iv) Work environment (v) Policy environment or a combination of any of above.Methods: Of 23977 titles identified through a systematic literature search in PUBMED, Cochrane and CABI, 195 articles relevant to our objective, were included. We reported the pooled relative risk and corresponding 95% confidence intervals as our outcome estimate. In cases of high heterogeneity, we explored its causes by subgroup analysis and metaregression and applied random effects model. Results:Intervention delivery in combination of settings seemed to have higher improvements in breastfeeding rates. Greatest improvements in early initiation of breastfeeding, exclusive breastfeeding and continued breastfeeding rates, were seen when counselling or education were provided concurrently in home and community, health systems and community, health systems and home settings, respectively. Baby friendly hospital support at health system was the most effective intervention to improve rates of any breastfeeding. Conclusion:To promote breastfeeding, interventions should be delivered in a combination of settings by involving health systems, home and family and the community environment concurrently.

Breastfeeding and Sustainable Development

“…Annelerin emzirmeyi erken bırakmalarındaki en önemli bariyerlerden biri çalış-madır. Analık izni, iş yeri desteği, annelerin istihdam durumu girişimleri emzirmeyi %30 oranında arttır-maktadır (14) .…”

“…Bu ürünlerin pazarlanmasında bedava tanıtıcı ürünlerin anne ve sağlık çalışanlarına ulaştırılması, medya ve internet reklamları ile olmaktadır. Çeşitli ülkelerde yapılan araştırma sonuçlarına göre reklamlar azalmış emzirme oranları ile ilişkili bulunmuştur (14) . ASMÜ reklamlarında emzirmeme davranışı bir yaşam seçeneği olarak yansıtılmakta, bu ürünlerin olumsuz sağlık sonuçları ve ekonomik yükünden doğal olarak hiç söz edilmemektedir.…”

Intervenciones para prevenir la aparición de sobrepeso y obesidad en niños menores de cinco años

“…Nivel de evidencia* Intervenciones prenatales Intervenciones para prevenir la ganancia de peso excesivo durante el embarazo (6,7) A1, A2 Intervenciones prevención de obesidad en infantes Promoción de lactancia materna exclusiva y continuada (8,9) A1, A2 Vigilancia del crecimiento saludable en la infancia (10,11) A2 Promoción de adecuada alimentación complementaria (12,13) A3 Consejería nutricional sobre prácticas de alimentación infantil (14,15) …”

“…Las mayores tasas de inicio temprano de lactancia materna, lactancia materna exclusiva y lactancia materna continuada, se observan cuando se brinda consejería o educación, tanto en casa como en la comunidad y a nivel del sistema de salud. La iniciativa de Hospitales Amigos de la Madre y el Niño es la intervención más efectiva para mejorar cualquier tipo de lactancia (9) . El objetivo de esta iniciativa es implementar los diez pasos para una lactancia exitosa que debe cumplir todos los servicios de maternidad y atención a los recién nacidos (Tabla 2).…”

Chronic Malnutrition

“…Their target diet is exclusive breastfeeding. Even where the mother is around, establishing or reestablishing effective exclusive breastfeeding (the mainstay of treatment) is not always straightforward [27][28][29]. It can require lots of time spent with well-trained, highly skilled support workers.…”