Breast-Feeding Interventions Better Than Usual Care
Primary care interventions to improve breast-feeding are moderately successful and unlikely to cause harm
TUESDAY, Oct. 21 (HealthDay News) -- Pre- and post-natal interventions improve breast-feeding rates more than usual care, researchers report, and the U.S. Preventive Services Task Force (USPSTF) provides evidenced-based recommendations regarding the promotion of breast-feeding, in two reports published in the Oct. 21 issue of the Annals of Internal Medicine.
Mei Chung, of Tufts Medical Center in Boston, and colleagues performed a systematic review of 38 randomized, controlled trials examining the effectiveness of primary care-initiated interventions promoting breast-feeding. Data was extracted by a single investigator and then confirmed by another investigator. Relative risks were calculated to determine the effectiveness of breast-feeding interventions and heterogeneity was assessed.
Primary care interventions promoting breast-feeding increased rates of short- and long-term exclusive breast-feeding (rate ratios 1.28 and 1.44), respectively, the researchers report. Combining pre- and post-natal breast-feeding interventions was more successful than either pre- or post-natal interventions alone, and interventions including peer support or peer counseling were more effective over one to three months than usual care. There was significant heterogeneity across the studies making the summary effects difficult to interpret, the authors note.
The accompanying recommendation states, "the USPSTF found that the benefits of breast-feeding are substantial and that the benefits of multimodal interventions to promote and support breast-feeding are moderate. Although the evidence was inadequate to determine the potential harms of these interventions, the USPSTF estimated these potential harms to be no greater than small. The USPSTF concluded with moderate certainty that the net benefits are moderate for multifaceted interventions to promote and support breast-feeding."