Breastfeeding Support Provided by Lactation Consultants: A Systematic Review and Meta-Analysis.

Area of Science:

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

Background:

• Breast milk provides essential health benefits, yet breastfeeding rates in high-income countries fall short of recommendations.
• Low breastfeeding rates highlight a need for effective interventions to support mothers.

Purpose of the Study:

• To evaluate the impact of lactation consultant (LC) interventions on breastfeeding duration, maternal self-efficacy, and infant growth compared to usual care.
• To synthesize evidence from randomized clinical trials on LC interventions in high-income settings.

Main Methods:

• A systematic review and meta-analysis of randomized clinical trials published between 1985 and 2024.
• Searched multiple databases including Cochrane, MEDLINE, Embase, CINAHL, Scopus, and Web of Science.
• Utilized 3-level correlated and hierarchical effects models for data synthesis and meta-regression for characteristic analysis.

Main Results:

• Forty studies involving 8582 participants were included. LC interventions reduced the risk of stopping exclusive breastfeeding (RR, 0.96) and any breastfeeding (RR, 0.92).
• LC interventions increased any breastfeeding duration by 3.63 weeks. Evidence for increased exclusive breastfeeding duration and maternal self-efficacy was weak.
• Intervention effectiveness was greater with earlier postpartum measurement and higher intensity (more LC visits).

Conclusions:

• Lactation consultant interventions show promise for improving exclusive and any breastfeeding rates in high-income countries.
• The timing and intensity of LC interventions are key factors influencing their success.
• These findings support the integration of LC support to enhance breastfeeding outcomes.