Davies, Philippa, Chilcot, Joseph, Chang, Yan-Shing, Norton, Sam, Hughes, Lyndsay D. and Bick, Debra (2020) Effectiveness of social-psychological interventions at promoting breastfeeding initiation, duration and exclusivity : a systematic review and meta-analysis. Health Psychology Review, 14 (4). pp. 449-485. doi:10.1080/17437199.2019.1630293

Preview

PDF WRAP-effectiveness-social-psychological-interventions-promoting-breastfeeding-initiation-duration-exclusivity-Bick-2019.pdf - Accepted Version - Requires a PDF viewer. Download (10Mb) | Preview

Request Changes to record.

Abstract

Evidence for the health benefits of breastfeeding is well substantiated but breastfeeding uptake and duration remains low worldwide. Individual level breastfeeding promotion programmes are behavioural interventions, targeting malleable social-psychological processes to change behaviour. This systematic review aimed to investigate whether such interventions are effective at improving breastfeeding initiation, duration and exclusivity, and breastfeeding support. A three-stage search strategy identified eligible articles from six databases. Nine controlled-clinical trials and 11 quasi-experimental trials were included. Random-effects meta-analyses identified significant improvements in rates of breastfeeding initiation (N = 2,213; OR = 2.32, 95% CI [1.33, 4.03], p = .003; I2 = 0%, p = .966) and suggested improved exclusive breastfeeding rates up to six months postpartum (N = 3,671; OR = 1.84, 95% CI [1.38, 2.45], p < .001; I2 = 68.7%, p < .001). After considering small-sample effects, estimates for exclusive breastfeeding across the postpartum period were non-significant. There were no improvements in women maintaining any (i.e., non-exclusive) breastfeeding to one, two, three, four or six months postpartum (N = 4,153; OR = 0.88, 95% CI [0.72, 1.09], p = .253). Evidence for improvements in perceived and actual breastfeeding support was limited. Sub-group analyses suggest standalone postnatal interventions targeting first-time mothers may support breastfeeding uptake. Findings should be interpreted cautiously as the quality of evidence for each outcome was low with a high risk of bias. Future efforts to support women to breastfeed should assimilate behaviour change research, with process evaluation to identify effective processes to inform a high-quality evidence-base for implementation in practice.

Item Type:	Journal Article
Subjects:	R Medicine > RJ Pediatrics
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Breastfeeding, Infants -- Nutrition, Breastfeeding -- Psychological aspects , Breastfeeding promotion
Journal or Publication Title:	Health Psychology Review
Publisher:	Taylor & Francis
ISSN:	1743-7199
Official Date:	2020
Dates:	Date Event 2020 Published 16 June 2019 Available 7 June 2019 Accepted
Volume:	14
Number:	4
Page Range:	pp. 449-485
DOI:	10.1080/17437199.2019.1630293
Status:	Peer Reviewed
Publication Status:	Published
Publisher Statement:	This is an Accepted Manuscript of an article published by Taylor & Francis in Health Psychology Review on 16 Jun 2019, available online: http://www.tandfonline.com/10.1080/17437199.2019.1630293
Access rights to Published version:	Restricted or Subscription Access
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID PhD Research Studentship Kings College London http://dx.doi.org/10.13039/501100000764
Related URLs:	Other Repository

Request changes or add full text files to a record

Repository staff actions (login required)

View Item

Downloads