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Interventions to improve breastfeeding outcomes: a systematic review and meta‐analysis
Author(s) -
Sinha Bireshwar,
Chowdhury Ranadip,
Sankar M Jeeva,
Martines Jose,
Taneja Sunita,
Mazumder Sarmila,
Rollins Nigel,
Bahl Rajiv,
Bhandari Nita
Publication year - 2015
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.13127
Subject(s) - breastfeeding , medicine , psychological intervention , meta analysis , intervention (counseling) , confidence interval , breast feeding , community health , nursing , family medicine , environmental health , public health , pediatrics
Aim To provide comprehensive evidence of the effect of interventions on early initiation, exclusive, continued and any breastfeeding rates when delivered in five settings: (i) Health systems and services (ii) Home and family environment (iii) Community environment (iv) Work environment (v) Policy environment or a combination of any of above. Methods Of 23977 titles identified through a systematic literature search in PUBMED , Cochrane and CABI , 195 articles relevant to our objective, were included. We reported the pooled relative risk and corresponding 95% confidence intervals as our outcome estimate. In cases of high heterogeneity, we explored its causes by subgroup analysis and meta‐regression and applied random effects model. Results Intervention delivery in combination of settings seemed to have higher improvements in breastfeeding rates. Greatest improvements in early initiation of breastfeeding, exclusive breastfeeding and continued breastfeeding rates, were seen when counselling or education were provided concurrently in home and community, health systems and community, health systems and home settings, respectively. Baby friendly hospital support at health system was the most effective intervention to improve rates of any breastfeeding. Conclusion To promote breastfeeding, interventions should be delivered in a combination of settings by involving health systems, home and family and the community environment concurrently.