Interventions to promote breastfeeding: updated recommendations from the Canadian Task Force on Preventive Health Care

Palda V A, Guise J M, Wathen C N, and the Canadian Task Force on Preventive Health Care
Record ID 32004000228
English
Authors' objectives:

In 1994, the Canadian Task for Preventive Health Care (CTFPHC) found good evidence to recommend that 1) women be counselled to breastfeed to increase rates and prolong duration of breastfeeding and 2) peripartum interventions promoting breastfeeding (early, frequent mother-infant contact, rooming in, banning provision of free formula samples) should be implemented (both A-level recommendations). Level II (cohort study) evidence of improved outcomes for infants who breastfed was also cited.

In 2000, the CTFPHC undertook updating counselling recommendations as a joint review with the United States Preventive Services Task Force (USPSTF), using revised methodology and addressing new evidence, restricted to developed countries, where breastfeeding rates and effectiveness of interventions to promote breastfeeding can differ from conditions in developing countries. This document presents the current status of breastfeeding in Canada, a summary of the collaborative systematic review, and updated CTFPHC recommendations.

Authors' recommendations: The CTFPHC concludes that there is: - good evidence to recommend providing structured antepartum educational programs and postpartum support to promote breastfeeding initiation and duration (A recommendation). - fair evidence to recommend peer counseling to promote initiation and maintenance of breastfeeding. (B recommendation) - good evidence to recommend against providing written materials alone to promote breastfeeding. (D recommendation) - insufficient evidence to make a recommendation regarding advice by primary caregivers to promote breastfeeding. (I Recommendation) - good evidence to recommend against providing commercial discharge packages to new mothers. (E recommendation) - no new evidence of compelling quality to overturn the earlier published A level recommendation in favour of rooming in and early maternal contact. Clinical implications Interventions consisting of antepartum, structured breastfeeding education are effective at improving both initiation and continuation of breastfeeding during the first 2 months post-partum, compared to usual care. These interventions were shown effective when provided in the clinical setting by lactation specialists or nurses, and consisting of individual or group instruction about breastfeeding knowledge, practical skills and problem-solving techniques. Post-partum telephone or in-person support by lactation specialists, nurses or peer counsellors enhances the effectiveness of these interventions. In addition, the use of peer counsellors improves breastfeeding rates and duration, and these types of programs may offer a cost-effective alternative to professionally-delivered services, especially in places where professional services are scarce or not available. The lack of effectiveness of written materials alone even in the absence of specific harm, and the proven decreases in breastfeeding rates in those given commercial discharge packages recommends against this approaches. Advice from primary care providers has not been sufficiently evaluated, and remains a research gap.
Authors' methods: Systematic review
Details
Project Status: Completed
Year Published: 2003
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Breast Feeding
  • Health Education
  • Postnatal Care
Contact
Organisation Name: Canadian Task Force on Preventive Health Care
Contact Address: Canadian Task Force on Preventive Health Care, 100 Collip Circle, Suite 117, London, ON, N6G 4X8, Canada. Tel: 519-858-5181; Fax: 519-858-5112
Contact Name: ctf@ctfphc.org
Contact Email: ctf@ctfphc.org
Copyright: Canadian Task Force on Preventive Health Care (CTFPHC)
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