Impact of Lactation Consultants on the Breastfeeding Prevalence at 6 Months: Systematic Review and Meta-Analysis

Background: International Board-Certified Lactation Consultants play a crucial role in protecting and promoting breastfeeding. Their specialized training and advanced practice skills enhance care quality and contribute to improved breastfeeding outcomes. However, evidence regarding their long-term impact on breastfeeding maintenance remains limited. Aim: This systematic review and meta-analysis aim to evaluate the effectiveness of lactation consultants' interventions on exclusive breastfeeding (EBF) at 6 months and to identify the most effective strategies in sustaining EBF through that period. Methods: A systematic review was conducted using electronic databases to identify studies published until March 2024. Eligible studies assessed prenatal, intranatal, and postnatal programs involving pregnant women intending to breastfeed or postpartum women in the lactation period. Findings: Nineteen studies involving 1,475 women were included. Interventions combining intranatal and postnatal support from lactation consultants showed a positive effect on EBF maintenance at 6 months (risk ratio [RR] for EBF vs. not EBF at 6 months = 2.04; 95% confidence interval [CI], 1.27-3.27). Individual face-to-face intranatal care had a positive effect (RR for EBF vs. not EBF at 6 months = 1.42; 95% [CI], 1.19-1.70). Discussion and Conclusions: Lactation consultant support initiated during hospitalization and continued through the postnatal period has the potential to improve breastfeeding outcomes. A dose-response relationship was observed, with interventions offering extended follow-up up to 6 months showing more favorable results. Face-to-face interventions that ensure direct contact and build trust with the mother appear to foster better breastfeeding outcomes. Standardization and rigorous monitoring of such programs are critical priorities.