In pregnancy mother-infant from 21 funded for evidence Support for Group, interactive, countries. All forms of extra national • supporting the healthy education sessions support analysed together implementation use of these breastfeeding Group education sessions on showed an increase in duration (Baby Friendly • interventions mothers with positioning and attachment of breastfeeding’ (includes Initiative), but ’any but it is not healthy term Antenatal education partial and exclusive implementation • conclusive babies individually tailored to the needs breastfeeding) (risk ratio (RR) is dependent on of low-income women for stopping any breastfeeding components before six months 0.91, 95% CI which are 0.88 to 0.96). All forms of extra variable Immediate postnatal care Basing prevention and support together also had a • treatment of sore nipples on positive effect on duration of principles of positioning and exclusive breastfeeding (RR at 6 attachment months 0.86, 95% CI 0.82 to Cabbage leaves/extract for 0.91; RR at four to six weeks • treatment of engorgement 0.74, 95% CI 0.61 to 0.89). Systemic antibiotics for Extra support by both lay and • infected nipples professionals had a positive impact on breastfeeding Postnatal care in the community outcomes. Maternal satisfaction Self-monitoring daily log for was poorly reported. • women from higher economic groups Support is likely to be more Combination of supportive care, effective in settings with high teaching breastfeeding initiation so efforts to technique, rest and reassurance increase the uptake of for women with milk’ breastfeeding should be in ‘insufficient Division of the frenulum in place. Support may be offered • infants with signs of either by professional or congenital ankyloglossia [tongue lay/peer supporters, or a tie] and breastfeeding difficulties combination of both. Strategies
Support for healthy breastfeeding mothers with healthy term babies In pregnancy • Group, interactive, education sessions • Group education sessions on positioning and attachment • Antenatal education individually tailored to the needs of low-income women Immediate postnatal care • Basing prevention and treatment of sore nipples on principles of positioning and attachment • Cabbage leaves/extract for treatment of engorgement • Systemic antibiotics for infected nipples Postnatal care in the community • Self-monitoring daily log for women from higher economic groups Combination of supportive care, teaching breastfeeding technique, rest and reassurance for women with ‘insufficient milk’ • Division of the frenulum in infants with signs of congenital ankyloglossia [tongue tie] and breastfeeding difficulties mother-infant from 21 countries. All forms of extra support analysed together showed an increase in duration of ’any breastfeeding’ (includes partial and exclusive breastfeeding) (risk ratio (RR) for stopping any breastfeeding before six months 0.91, 95% CI 0.88 to 0.96). All forms of extra support together also had a positive effect on duration of exclusive breastfeeding (RR at 6 months 0.86, 95% CI 0.82 to 0.91; RR at four to six weeks 0.74, 95% CI 0.61 to 0.89). Extra support by both lay and professionals had a positive impact on breastfeeding outcomes. Maternal satisfaction was poorly reported. Support is likely to be more effective in settings with high initiation so efforts to increase the uptake of breastfeeding should be in place. Support may be offered either by professional or lay/peer supporters, or a combination of both. Strategies funded for national implementation (Baby Friendly Initiative), but implementation is dependent on components which are variable evidence supporting the use of these interventions but it is not conclusive
Nutrition%20Evidence%20Review%20Final.docx