Find Established Evidence

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Educational Material
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material
Intervention Description: To examine the associations of duration of exclusive breastfeeding with infections in the upper respiratory (URTI), lower respiratory (LRTI), and gastrointestinal tracts (GI) in infancy. This study was embedded in the Generation R Study, a population-based prospective cohort study from fetal life onward in the Netherlands. Rates of breastfeeding during the first 6 months (never; partial for <4 months, not thereafter; partial for 4-6 months; exclusive for 4 months, not thereafter; exclusive for 4 months, partial thereafter; and exclusive for 6 months) and doctor-attended infections in the URTI, LRTI, and GI until the age of 12 months were assessed by questionnaires and available for 4164 subjects.
Primary Outcomes: N/A
Conclusion: Exclusive breastfeeding until the age of 4 months and partially thereafter was associated with a significant reduction of respiratory and gastrointestinal morbidity in infants. Our findings support health-policy strategies to promote exclusive breastfeeding for at least 4 months, but preferably 6 months, in industrialized countries.
Study Design: population-based prospective cohort study
Significant Findings: Yes
Setting: Netherlands
Data Source: embedded in the Generation R Study, a population-based prospective cohort study from fetal life onward in the Netherlands
Sample Size: 4164 subjects
Age Range: Newborns 6-12 months

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Expert Support (Provider), Educational Material
Intervention Description: Sites were randomly assigned to receive an experimental intervention (n = 16) modeled on the Baby-Friendly Hospital Initiative of the World Health Organization and United Nations Children's Fund, which emphasizes health care worker assistance with initiating and maintaining breastfeeding and lactation and postnatal breastfeeding support, or a control intervention (n = 15) of continuing usual infant feeding practices and policies.
Primary Outcomes: N/A
Conclusion: Our experimental intervention increased the duration and degree (exclusivity) of breastfeeding and decreased the risk of gastrointestinal tract infection and atopic eczema in the first year of life. These results provide a solid scientific underpinning for future interventions to promote breastfeeding.
Study Design: The Promotion of Breastfeeding Intervention Trial (PROBIT), a cluster-randomized trial conducted June 1996-December 1997 with a 1-year follow-up.
Significant Findings: Yes
Setting: Thirty-one maternity hospitals and polyclinics in the Republic of Belarus.
Data Source: N/A
Sample Size: 17 046 mother-infant pairs 16491 (96.7%) of which completed the entire 12 months of follow-up
Age Range: mother-infant pairs consisting of full-term singleton infants weighing at least 2500 g and their healthy mothers who intended to breastfeed

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Assessment (patient/consumer)
Intervention Description: We examined the effects on infant growth and health of 3 compared with 6 mo of exclusive breastfeeding.
Primary Outcomes: N/A
Conclusion: Exclusive breastfeeding for 6 mo is associated with a lower risk of gastrointestinal infection and no demonstrable adverse health effects in the first year of life.
Study Design: observational cohort study nested within a large randomized trial
Significant Findings: Yes
Setting: Belarus
Data Source: N/A
Sample Size: 3483 infants
Age Range: Infants under 1 year

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material
Intervention Description: The aim of the present study was to perform a literature review on breastfeeding and dummy use and how they influenced one another and to renew the advice to the Swedish public and to personnel working in hospitals and health services.
Primary Outcomes: N/A
Conclusion: We found ample evidence that both breastfeeding and dummy use reduce the risk of SIDS. There has been a general reluctance to endorse dummy use in case it has a detrimental effect of breastfeeding. However, recent evidence suggests that dummy use might not be as harmful to breastfeeding as previously believed.
Study Design: literature review
Significant Findings: Yes
Setting: Sweden; but studies from multiple places
Data Source: N/A
Sample Size: 121 relevent abstracts; 54 studies considered relevant
Age Range: N/A

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material
Intervention Description: Pertinent studies were identified by a search of PubMed between January 1, 2008 and July 31, 2014. The random-effect model was used. Sensitivity analysis, subgroups analysis, and publication bias were conducted.
Primary Outcomes: N/A
Conclusion: Findings from this meta-analysis suggest that breastfeeding, particularly a longer duration of breastfeeding, was inversely associated with risk of breast cancer.
Study Design: Meta-analysis
Significant Findings: Yes
Setting: N/A
Data Source: PubMed
Sample Size: 13907
Age Range: N/A

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material, Access, Lactation Consultant
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Other (Communities)
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material, Individual Supports, Social Supports, Lactation Consultant
Intervention Description: The current statement updates the evidence for this conclusion and serves as a basis for AAP publications that detail breastfeeding management and infant nutrition, including the AAP Breastfeeding Handbook for Physicians,2 AAP Sample Hospital Breastfeeding Policy for Newborns,3 AAP Breastfeeding Residency Curriculum,4 and the AAP Safe and Healthy Beginnings Toolkit.
Primary Outcomes: N/A
Conclusion: Research and practice in the 5 years since publication of the last AAP policy statement have reinforced the conclusion that breastfeeding and the use of human milk confer unique nutritional and nonnutritional benefits to the infant and the mother and, in turn, optimize infant, child, and adult health as well as child growth and development. Recently, published evidence-based studies have confirmed and quantitated the risks of not breastfeeding. Thus, infant feeding should not be considered as a lifestyle choice but rather as a basic health issue. As such, the pediatrician’s role in advocating and supporting proper breastfeeding practices is essential and vital for the achievement of this preferred public health goal.
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Peer Counselor, Educational Material, Group Education
Intervention Description: The objective of this critical review is to identify and evaluate U.S.-based randomized trials evaluating breastfeeding interventions targeting minorities and highlight promising public health approaches for minimizing breastfeeding disparities.
Primary Outcomes: N/A
Conclusion: This critical review identified several interventions that successfully improved breastfeeding outcomes among minority women in the United States, including PC, breastfeeding teams (a peer counselor working with a health professional), group prenatal classes, breastfeeding-specific clinic appointments, and hospital/WIC policy change. Breastfeeding interventions provided by nurses working alone were generally less effective than the other types of interventions. This may highlight the need for a more diverse health care workforce who develops a better rapport with minority women (8).
Study Design: Systematic Review
Significant Findings: Yes
Setting: N/A
Data Source: PubMed
Sample Size: 22 full text relevent articles
Age Range: N/A

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Access, Policy/Guideline (Hospital)
Intervention Description: This article's aim is to review the literature on racial and ethnic disparities in breastfeeding rates and practices, address barriers to breastfeeding among minority women, conduct a systematic review of breastfeeding interventions, and provide obstetrician-gynecologists with recommendations on how they can help increase rates among minority women. In order to do so, the literature of racial and ethnic disparities in breastfeeding rates and barriers among minority women was reviewed, and a systematic review of breastfeeding interventions among minority women on PubMed and MEDLINE was conducted.
Primary Outcomes: N/A
Conclusion: Obstetrician-gynecologists have a unique opportunity to promote and support breastfeeding through their clinical practices and public policy, and their efforts can have a meaningful impact on the future health of the mother and child.
Study Design: Systematic Review
Significant Findings: Yes
Setting: N/A
Data Source: PubMed and MEDLINE
Sample Size: 22 articles
Age Range: N/A

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Media Campaign (Print Materials, Public Address System, Social Media), Television Media, Social Media
Intervention Description: The objective of this review was to synthesise the best of available evidence by conducting a meta-analysis to evaluate whether e-technologies have had any effect in improving breastfeeding outcomes among perinatal women. The review was conducted using nine electronic databases to search for English-language research studies from 2007 to 2014.
Primary Outcomes: N/A
Conclusion: This review provides support for the development of web-based, texting messaging, compact disc read-only memory, electronic prompts and interactive computer agent interventions for promoting and supporting breastfeeding.
Study Design: Meta-Analysis
Significant Findings: Yes
Setting: N/A
Data Source: N/A
Sample Size: N/a
Age Range: N/A

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Telephone Support
Intervention Description: To assess the effects of telephone support during pregnancy and the first six weeks post birth, compared with routine care, on maternal and infant outcomes.
Primary Outcomes: N/A
Conclusion: Despite some encouraging findings, there is insufficient evidence to recommend routine telephone support for women accessing maternity services, as the evidence from included trials is neither strong nor consistent. Although benefits were found in terms of reduced depression scores, breastfeeding duration and increased overall satisfaction, the current trials do not provide strong enough evidence to warrant investment in resources.
Study Design: Systematic Review
Significant Findings: No
Setting: N/A
Data Source: Cochrane Pregnancy and Childbirth Group's Trials Register
Sample Size: 27 randomised trials involving 12,256 women
Age Range: N/A

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material, Peer Counselor
Intervention Description: To assess the effectiveness of antenatal breastfeeding (BF) education for increasing BF initiation and duration. We assessed all potential studies identified as a result of the search strategy. Two review authors extracted data from each included study using the agreed form and assessed risk of bias. We resolved discrepancies through discussion. We assessed the quality of the evidence using the GRADE approach.
Primary Outcomes: N/A
Conclusion: There was no conclusive evidence supporting any antenatal BF education for improving initiation of BF, proportion of women giving any BF or exclusively BF at three or six months or the duration of BF. There is an urgent need to conduct a high‐quality, randomised controlled study to evaluate the effectiveness and adverse effects of antenatal BF education, especially in low‐ and middle‐income countries. Evidence in this review is primarily relevant to high‐income settings.
Study Design: Systematic Review
Significant Findings: No
Setting: N/A
Data Source: Cochrane Pregnancy and Childbirth's Trials Register on 1 March 2016, CENTRAL (The Cochrane Library, 2016, Issue 3), MEDLINE (1966 to 1 March 2016) and Scopus (January 1985 to 1 March 2016)
Sample Size: 24 reviews using 10,056 women
Age Range: N/A

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material, Peer Counselor
Intervention Description: We assessed all potential studies identified as a result of the search strategy. Two review authors extracted data from each included study using the agreed form and assessed risk of bias. We resolved discrepancies through discussion.
Primary Outcomes: N/A
Conclusion: Because there were significant methodological limitations and the observed effect sizes were small, it is not appropriate to recommend any antenatal BF education.There is an urgent need to conduct RCTs study with adequate power to evaluate the effectiveness of antenatal BF education.
Study Design: Systematic Review
Significant Findings: No
Setting: N/A
Data Source: Cochrane Pregnancy and Childbirth Group's Trials Register (21 April 2010), CENTRAL (The Cochrane Library 2010, Issue 2), MEDLINE (1966 to April 2010) and SCOPUS (January 1985 to April 2010)
Sample Size: 31 studies including 14063 women
Age Range: N/A

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Lactation Consultant, Peer Counselor
Intervention Description: The objective of this review was to assess if lactation education or support programs using lactation consultants or lactation counselors would improve rates of initiation and duration of any breastfeeding and exclusive breastfeeding compared with usual practice. A systematic literature review of the evidence was conducted using electronic databases. The review was limited to randomized trials and yielded 16 studies with 5084 participants.
Primary Outcomes: N/A
Conclusion: Most of the evidence would suggest developing and improving postpartum support programs incorporating lactation consultants and lactation counselors.
Study Design: Systematic Review
Significant Findings: Yes
Setting: N/A
Data Source: Electronic Databases
Sample Size: 16 studies with 5084 participants
Age Range: N/A

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Peer Counselor, Educational Material
Intervention Description: A systematic literature search was conducted by: (1) searching Internet databases; (2) conducting backward searches from reference lists of articles of interest; (3) manually reviewing the archives of the Center for Eliminating Health Disparities among Latinos; (4) searching the Journal of Nutrition Education and Behavior; and (5) directly contacting researchers in the field. The authors reviewed 22 articles derived from experimental or quasi-experimental studies.
Primary Outcomes: N/A
Conclusion: There is a need for longitudinal randomized trials testing the impact of peer nutrition education interventions grounded on goal setting and culturally appropriate behavioral change theories. Inclusion of reliable scales and the construct of acculturation are needed to further advance knowledge in this promising field. Operational research is also needed to identify the optimal peer educator characteristics, the type of training that they should receive, the client loads and dosage (ie, frequency and amount of contact needed between peer educator and client), and the best educational approaches and delivery settings.
Study Design: Systematic Review
Significant Findings: Yes
Setting: N/A
Data Source: a) searching internet databases (PubMed), b) conducting backward searches using reference lists from articles of interest, c) manually reviewing the archives of the Center for Eliminating Health Disparities among Latinos (CEHDL), d) searching the Journal of Nutrition Education and Behavior, and e) directly contacting researchers in the field.
Sample Size: N/A
Age Range: N/A

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Midwife
Intervention Description: To compare midwife‐led continuity models of care with other models of care for childbearing women and their infants.
Primary Outcomes: regional analgesia (epidural/spinal), caesarean birth, instrumental vaginal birth (forceps/vacuum), spontaneous vaginal birth, intact perineum, preterm birth (less than 37 weeks) and all fetal loss before and after 24 weeks plus neonatal death
Conclusion: This review suggests that women who received midwife‐led continuity models of care were less likely to experience intervention and more likely to be satisfied with their care with at least comparable adverse outcomes for women or their infants than women who received other models of care. Further research is needed to explore findings of fewer preterm births and fewer fetal deaths less than 24 weeks, and all fetal loss/neonatal death associated with midwife‐led continuity models of care.
Study Design: Systematic Review
Significant Findings: Yes
Setting: N/A
Data Source: Cochrane Pregnancy and Childbirth Group's Trials Register
Sample Size: 15 trials involving 17,674 women
Age Range: N/A

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Access
Intervention Description: The purpose of this article is to present a review of literature regarding factors that influence breastfeeding intentions, initiation, and duration in the African American population. Research related to health disparities experienced by African Americans in the United States, as well as research regarding the protective benefits of breastfeeding for those specific health disparities, are also presented.
Primary Outcomes: N/A
Conclusion: Future research regarding African American women's breastfeeding experiences using Black feminist thought as a theoretical foundation is recommended.
Study Design: Literature Review
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 4: Breastfeeding
Intervention Components (click on component to see a list of all articles that use that intervention): Family Leave, Workplace Policies, State Laws
Intervention Description: Assessment of the literature on the length of maternity leaves and health of mothers and children; evaluation of the Swiss situation in view of the maternity leave policy implemented in 2005.
Primary Outcomes: N/A
Conclusion: Longer maternity leaves are likely to produce health benefits. The new policy in Switzerland will probably improve the situation of those women, who previously were granted only minimal leave and/or mothers with additional social risk factors.
Study Design: Systematic Review
Significant Findings: Yes
Setting: N/A
Data Source: PubMed
Sample Size: 13 studies
Age Range: N/A