Title: Effectiveness of a brief motivational intervention to increase the breastfeeding duration in the first 6 months postpartum: Randomized controlled trial.
In: Journal of Advanced Nursing 2020 Mar;76(3):888-902. doi: 10.1111/jan.14274.
Authors: Cristina Franco-Antonio, Julián F Calderón-García, Esperanza Santano-Mogena, Sergio Rico-Martín, Sergio Cordovilla-Guardia.
Abstract: "Aims: To evaluate the effectiveness of a brief motivational intervention to increase the breastfeeding duration in the first 6 months postpartum in mothers who began breastfeeding in the first hour after birth and to explore the role of general and breastfeeding self-efficacy in this relationship. Design: A multi-centre randomized controlled clinical trial. Methods: Data were collected from February 2018 - March 2019. Women were randomly assigned to an intervention group that received a brief motivational intervention (N = 44) or a control group that was offered standard education on breastfeeding (N = 44). Survival analysis techniques were carried out with a follow-up of 6 months. In addition, the roles of breastfeeding and general self-efficacy in the association between BMI and breastfeeding duration were explored through mediation/moderation analysis. Results: Among 88 randomized patients (mean age, 32.82 years), 81 (92.04%) completed the trial. The survival analyses of exclusive breastfeeding and breastfeeding (exclusive and non-exclusive) showed reductions in the risk of abandonment in the intervention group of 63% (aHR: 0.37 [0.22-0.60] p < .001) and 61% (aHR: 0.39 [0.20-0.78] p = .008), respectively. We found that self-efficacy acted as a moderator of the effect of brief motivational intervention on breastfeeding self-efficacy. A discrete indirect effect of brief motivational intervention through increased breastfeeding self-efficacy was found on breastfeeding duration, with an index of moderated mediation of 0.08 (95% CI: 0.02-0.19). Greater positive variations in the breastfeeding self-efficacy scores during follow-up predicted exclusive and non-exclusive breastfeeding duration. Conclusion: A brief motivational intervention conducted in the immediate postpartum period increases breastfeeding and exclusive breastfeeding duration in the first 6 months. Although breastfeeding self-efficacy seems to moderate the effect of brief motivational intervention on the increase in breastfeeding duration, other factors may influence its effectiveness. Further studies could focus on exploring how brief motivational intervention works and whether it also works for pregnant mothers who have not yet decided whether to breastfeed. Impact: Brief motivational intervention could be introduced as part of routine care of women who begin breastfeeding to improve the low rates of exclusive breastfeeding at 6 months postpartum."
Full text: https://onlinelibrary.wiley.com/doi/full/10.1111/jan.14274
Title: Duration of breastfeeding and maternal-related factors in Iran, systematic review and meta-analysis.
In: Journal of Pediatric Nursing 2020 Jun 15;S0882-5963(19)30667-0. doi: 10.1016/j.pedn.2020.04.011.
Authors: Hosein Dalili, Mamak Shariat, Fatemeh Nayeri, Zahra Emami, Roya Sahebi, Leyla Sahebi.
Abstract: "Background: Although the benefits of breastfeeding are commonly approved, there remains a significant discrepancy between maternal practices and World Health Organization (WHO) guidelines in some countries. Objectives: We had two aims in this study; average duration of breastfeeding, and its maternal determinants. Data sources: A web-based citation index was used for citing documents. Study eligibility criteria and participants: We included observational studies evaluating breastfeeding duration among children who were at least two years old and not older than five were included in Iran. Synthesis methods: The pooled mean and mean differences were considered. Heterogeneity was evaluated with the I2 statistic. Results: The pooled mean of breastfeeding duration was calculated at 17.31 months. Children with younger mothers and lower birth orders had shorter durations of breastfeeding. Women with a high school and higher education level had early cessation of breastfeeding in comparison with less educated women. Limitations: The main limitation of the current study was lack of librarian assistance. Conclusions: The pooled mean of breastfeeding duration in Iranian children aged 2-5 was less than WHO recommendations. Accurate identification of the effect a mother's level of education has on duration of lactation requires standardized categorization. Implications of key findings: Raising awareness among women can be an effective strategy in increasing the duration of lactation."
Abstract only: https://pubmed.ncbi.nlm.nih.gov/32553476/
Title: Breastfeeding Duration Is Associated With WIC Site-Level Breastfeeding Support Practices.
In: Journal of Nutrition Education and Behavior 2020 Jul;52(7):680-687. doi: 10.1016/j.jneb.2020.01.014. Epub 2020 Mar 11.
Authors: Stacy Gleason, Margaret K Wilkin, Linnea Sallack, Shannon E Whaley, Catherine Martinez, Courtney Paolicelli.
Abstract: "Objective: To describe Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) site-level breastfeeding support practices and associations with breastfeeding outcomes. Design: Secondary analysis of WIC Infant and Toddler Feeding Practices Study-2, including data from interviews with caregivers of infants and interviews and surveys with staff from 27 WIC state agencies and 80 study sites. Participants: A total of 1,235 mothers of breastfed infants participating in the WIC Infant and Toddler Feeding Practices Study-2. Main outcome measure: Any and fully breastfeeding 2, 6, and 12 months postpartum. Analysis: Descriptive statistics described WIC site-level breastfeeding supports. Multilevel mixed modeling of breastfeeding at 2, 6, and 12 months, controlling for site- and participant-level characteristics. Results: Five WIC site-level supports were significantly and independently associated with any and fully breastfeeding: access to breastfeeding peer counselors, access to International Board Certified Lactation Consultants, postnatal home visits, allowing any WIC staff member to provide breast pump education, and having a policy not to provide formula during the first 30 days postpartum. Likelihood of any and fully breastfeeding increased with each additional site-level support present (odds ratio = 1.09, 95% confidence interval, 1.06-1.12; and odds ratio = 1.26, 95% confidence interval, 1.21-1.31, respectively). Conclusions and implications: Positive associations between site-level supports and breastfeeding at 2, 6, and 12 months were observed. Additional research is needed to understand how site-level supports interrelate and whether specific combinations are more effective, and to identify variations in implementation of breastfeeding supports."
Abstract only: https://pubmed.ncbi.nlm.nih.gov/32171671/