Davies, Philippa, Chilcot, Joseph, Chang, Yan-Shing, Norton, Sam, Hughes, Lyndsay D. and Bick, Debra (2019) Effectiveness of social-psychological interventions at promoting breastfeeding initiation, duration and exclusivity : a systematic review and meta-analysis. Health Psychology Review . pp. 1-37. doi:10.1080/17437199.2019.1630293 (In Press)

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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:	16 June 2019
Dates:	Date Event 16 June 2019 Available 7 June 2019 Accepted
Date of first compliant deposit:	20 February 2020
Page Range:	pp. 1-37
DOI:	10.1080/17437199.2019.1630293
Status:	Peer Reviewed
Publication Status:	In Press
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

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