Primary Care Interventions to Support Breastfeeding: Updated Evidence Report and Systematic Review for the US...

Area of Science:

• Public Health
• Evidence-Based Medicine
• Maternal and Child Health

Background:

• High rates of infant breastfeeding initiation in the U.S. contrast with low rates of exclusive breastfeeding at 6 months.
• Professional organizations recommend exclusive breastfeeding for approximately 6 months.

Purpose of the Study:

• To systematically review evidence on breastfeeding intervention benefits and harms.
• To support the U.S. Preventive Services Task Force in updating recommendations.

Main Methods:

• Systematic review of randomized clinical trials and before-and-after studies.
• Searched multiple databases (MEDLINE, PubMed, etc.) for English-language studies from 2008-2016.
• Included 52 studies (66,757 participants) evaluating primary care-relevant breastfeeding interventions.

Main Results:

• Individual-level breastfeeding interventions were associated with increased rates of any and exclusive breastfeeding at various durations.
• Absolute increases in breastfeeding rates ranged from 14.1% to 18.4%.
• No significant association was found with breastfeeding initiation; limited evidence exists for system-level interventions and harms.

Conclusions:

• Updated evidence confirms breastfeeding support interventions enhance breastfeeding rates.
• Further research is needed on system-level interventions' impact on breastfeeding and child health.
• Limited evidence exists regarding maternal health outcomes and intervention harms.