A new review published in the Cochrane Database of Systematic Reviews aimed to determine the impact of 'breastfeeding only' and 'breastfeeding plus' support on the duration and exclusivity of mothers breastfeeding healthy term babies.

Study: Support for healthy breastfeeding mothers with healthy term babies. Image Credit: Tomsickova Tatyana / Shutterstock.com

The importance of breastfeeding

During the first six months of a child's life, the World Health Organization (WHO) recommends that all children be exclusively breastfed, meaning no other food or liquid should be offered. Breastfeeding should be done on demand, as often as the child desires, day and night.

Children should start eating complementary foods by six months while breastfeeding until they are at least two years old.

Both infants and mothers benefit from breastfeeding in the long term and short term. For example, breastfed infants are less likely to develop gut or lung infections, diabetes, and obesity later in life. Additionally, breastfeeding can reduce mothers' risk of diabetes and ovarian or breast cancer.

There are, however, many countries where breastfeeding rates are much lower than WHO recommendations.

About the study

This study searched the Cochrane Pregnancy and Childbirth Trials Register to obtain randomized or quasi-randomized controlled trials aligned with the current research. Two review authors independently selected the trials, extracted data, assessed bias, and analyzed the worthiness of the study.

A meta-regression analysis was used to determine the heterogeneity of primary outcomes using categories such as mode of delivery, income status of the country, the intensity of support, and the person providing care.

Breastfeeding support could be provided via phone, face‐to‐face, or digital technologies. The researchers also collected information on the intensity of the support, which could be defined as the number of postnatal contacts, the individual who provided the support, and how breastfeeding support differed in high-, middle-, and low-income nations.

Four primary outcomes were assessed in this study, including stopping any form of breastfeeding before four to six weeks and six months postpartum, as well as stopping exclusive breastfeeding before four to six weeks and six months postpartum.

Study findings

A total of 103 trials were included in the study, which comprised more than 98,816 mother‐infant pairs. 'Breastfeeding only' support likely reduced the number of women who stopped breastfeeding before six months and four to six weeks postpartum. Furthermore, this type of support also increased the likelihood that mothers stopped exclusively breastfeeding before four to six weeks and six months postpartum.

Breastfeeding plus support likely reduced the number of women who stopped both any and exclusive breastfeeding at six months. However, there is less certainty whether this type of support reduced the number of women who stopped breastfeeding before four to six weeks postpartum.

Moderate levels of breastfeeding-only support, defined as four to eight visits, had a more favorable effect on women continuing to breastfeed at four to six weeks exclusively and six months postpartum. In addition, this form of support may be more effective in reducing the cessation of exclusive breastfeeding among women in low- and middle-income countries (LMICs) before six months than women in high-income countries (HICs).

Conclusions

Breastfeeding-only support effectively increases the duration and exclusivity of breastfeeding and reduces the number of women who stop breastfeeding at three to four months postpartum. However, despite the apparent benefits at some time points, the impact of breastfeeding plus support on reducing the discontinuance of breastfeeding must be further studied.

Any form of breastfeeding support can be provided by lay/peer supporters, professionals, or a combination of both. However, further research is needed to identify which aspects of breastfeeding are the most effective support interventions and how these interventions can be delivered on a larger scale.

Written by

Suchandrima Bhowmik

Suchandrima has a Bachelor of Science (B.Sc.) degree in Microbiology and a Master of Science (M.Sc.) degree in Microbiology from the University of Calcutta, India. The study of health and diseases was always very important to her. In addition to Microbiology, she also gained extensive knowledge in Biochemistry, Immunology, Medical Microbiology, Metabolism, and Biotechnology as part of her master's degree.