The effect of postnatal breastfeeding education/support offered at home 3 days after delivery on breastfeeding duration and knowledge: a randomized trial

Mendelsohn

The Journal of Pediatrics

et al. 2016

Objective To determine the effects of a child obesity prevention intervention beginning in pregnancy on infant feeding practices in low-income Hispanic families. Study design The Starting Early randomized controlled trial enrolled pregnant women at a third trimester visit. Women (n=533) were randomly allocated to a standard care control group or an intervention group participating in prenatal and postpartum individual nutrition/breastfeeding counseling and subsequent nutrition and parenting support groups coordinated with well-child visits. Outcome measures included infant feeding practices and maternal infant feeding knowledge at infant age 3 months, using questions adapted from the Infant Feeding Practices Study II and an infant 24-hour diet recall. Results 456 families completed 3-month assessments. The intervention group had higher prevalence of exclusive breastfeeding on the 24-hour diet recall (42.7% vs. 33.0%, p=.04) compared with controls. The intervention group reported a higher percentage of breastfeeding vs. formula feeding per day (mean (SD) 67.7 (39.3) vs. 59.7 (39.7), p=.03) and was less likely to introduce complementary foods and liquids compared with controls (6.3% vs. 16.7%, p=.001). The intervention group had higher maternal infant feeding knowledge scores (Cohen’s d, 0.29, 95% CI .10 to .48). The effect of Starting Early on breastfeeding was mediated by maternal infant feeding knowledge (Sobel test 2.86, p=.004). Conclusions Starting Early led to increased exclusive breastfeeding and reduced complementary foods and liquids in 3 month old infants. Findings document a feasible and effective infrastructure for promoting breastfeeding in families at high risk for obesity in the context of a comprehensive obesity prevention intervention. Trial registration ClinicalTrials.gov NCT01541761

Section: Discussionsupporting

confidence: 54%

Randomized Controlled Trial of a Primary Care-Based Child Obesity Prevention Intervention on Infant Feeding Practices

Mendelsohn

The Journal of Pediatrics

et al. 2016

“…We included 10 studies in this analysis [6, 7, 20, 22, 23, 25, 27, 39–41] which comprised of 24,490 mothers. The pooled relative risk of continuing EBF until 6 months was 3.53 (95% CI: 2.49–5.00) for the intervention group versus the control (Fig 2).…”

Section: Resultsmentioning

confidence: 99%

“…We included four studies in this analysis to measure the effect of community-based peer support for mothers on breastfeeding initiation within the first hour of life [7, 27, 32, 41]. All of the studies were conducted in LMICs.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of community-based peer support for mothers to improve their breastfeeding practices: A systematic review and meta-analysis

et al. 2017

Breastfeeding is associated with reduced mortality in children aged less than 5 years. We conducted a systematic review and meta-analysis (registered as PROSPERO 2015: CRD42015019105) to examine the effectiveness of community-based peer support for mothers on their breastfeeding practices as compared to mothers who have not received such a support.MethodsWe searched for evidence regarding community-based peer support for mothers in databases, such as PubMed/MEDLINE, the Cochrane Library, CINAHL, Web of Science, SocINDEX, and PsycINFO. We selected three outcome variables for breastfeeding practices, namely, exclusive breastfeeding duration, breastfeeding within the first hour of life, and prelacteal feeding. We conducted meta-analyses of the included randomized controlled trials and quasi-experimental studies.ResultsFor our review, we selected 47 articles for synthesis out of 1,855 retrieved articles. In low- and middle-income countries, compared to usual care, community-based peer support increased exclusive breastfeeding at 3 months (RR: 1.90, 95% CI: 1.62–2.22), at 5 months (RR: 9.55, 95% CI: 6.65–13.70) and at 6 months (RR: 3.53, 95% CI: 2.49–5.00). In high-income countries, compared to usual care, peer support increased exclusive breastfeeding at 3 months (RR: 2.61, 95% CI: 1.15–5.95). In low- and middle-income countries, compared to usual care, peer support increased the initiation of breastfeeding within the first hour of life (RR: 1.51, 95% CI: 1.04–2.21) and decreased the risk of prelacteal feeding (RR: 0.38, 95% CI: 0.33–0.45).ConclusionsCommunity-based peer support for mothers is effective in increasing the duration of exclusive breastfeeding, particularly for infants aged 3–6 months in low- and middle-income countries. Such support also encourages mothers to initiate breastfeeding early and prevents newborn prelacteal feeding.

“…Several sociodemographic characteristics were used to describe the sample, including mother's age (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), and >34 years old), mother's education (high school or less, some college, 4-year college or more) and marital status (married, widowed/divorced/ separated, never married). Prenatal smoking (non-smoker, smoker) and prepregnancy BMI (<19.8 underweight, 19.8 to ≤26 normal, >26 to ≤29 overweight, and >29 obese).…”

Section: Methodsmentioning

confidence: 99%

Mode of Delivery and Breastfeeding Practices

Palla¹,

Kitsantas²

2017

IPCB

Background: We compared early breastfeeding practices, including initiation, exclusivity, and intensity among women who had an unplanned caesarean section (c-section), a planned c-section, vaginal induced delivery, and a vaginally but not induced delivery. Methods:This was a retrospective study involving secondary data analysis using the Infant Feeding Practices Study II, a longitudinal national survey, which followed women from pregnancy to 1 year postpartum. Data were obtained from the prenatal, neonatal and 2-month surveys for 2541 mothers and their infants. Descriptive statistics and chisquare analysis were conducted to identify any associations between mode of delivery and maternal characteristics, breastfeeding patterns in the first two months of infancy, prenatal breastfeeding attitudes, sources of breastfeeding information and reasons for not initiating breastfeeding. Results:Women with a planned c-section had a significantly lower breastfeeding initiation rate (80%). Further, they were least likely to report a clinician's support for breastfeeding (40.2%) and more likely to disagree with benefits of breastfeeding (26.3%). Those with vaginally non-induced deliveries were least likely to receive breastfeeding information during the postpartum period from lactation consultants (56.5%), while women who had a planned c-section were less likely to receive breastfeeding information from relatives/ friends (48.9%). Conclusion:Findings suggest that breastfeeding practices vary considerably by mode of delivery and this should be taken into consideration when offering lactation services and information to women. Women may need encouragement from family members and clinicians in initiating breastfeeding as well as adequate breastfeeding support through month 2 postpartum.