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. 2011 Nov 9:(11):CD006425.
doi: 10.1002/14651858.CD006425.pub2.

Antenatal breastfeeding education for increasing breastfeeding duration

Pisake Lumbiganon  1 , Ruth Martis, Malinee Laopaiboon, Mario R Festin, Jacqueline J Ho, Mohammad Hakimi
Affiliations

Antenatal breastfeeding education for increasing breastfeeding duration

Pisake Lumbiganon et al. Cochrane Database Syst Rev. .

Update in

Abstract

Background: Breastfeeding (BF) is well recognised as the best food for infants. The impact of antenatal BF education on the duration of BF has not been evaluated.

Objectives: To evaluate the effectiveness of antenatal BF education for increasing BF initiation and duration.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (21 April 2010), CENTRAL (The Cochrane Library 2010, Issue 2), MEDLINE (1966 to April 2010) and SCOPUS (January 1985 to April 2010). We contacted experts and searched reference lists of retrieved articles. We updated the search of the Pregnancy and Childbirth Group's Trials Register on 28 September 2011 and added the results to the awaiting classification section of the review.

Selection criteria: All identified published, unpublished and ongoing randomised controlled trials (RCTs) assessing the effect of formal antenatal BF education or comparing two different methods of formal antenatal BF education, on duration of BF. We excluded RCTs that also included intrapartum or postpartum BF education.

Data collection and analysis: We assessed all potential studies identified as a result of the search strategy. Two review authors extracted data from each included study using the agreed form and assessed risk of bias. We resolved discrepancies through discussion.

Main results: We included 17 studies with 7131 women in the review and 14 studies involving 6932 women contributed data to the analyses. We did not do any meta-analysis because there was only one study for each comparison.Five studies compared a single method of BF education with routine care. Peer counselling significantly increased BF initiation.Three studies compared one form of BF education versus another. No intervention was significantly more effective than another intervention in increasing initiation or duration of BF.Seven studies compared multiple methods versus a single method of BF education. Combined BF educational interventions were not significantly better than a single intervention in initiating or increasing BF duration. However, in one trial a combined BF education significantly reduced nipple pain and trauma.One study compared different combinations of interventions. There was a marginally significant increase in exclusive BF at six months in women receiving a booklet plus video plus lactation consultation (LC) compared with the booklet plus video only.Two studies compared multiple methods of BF education versus routine care. The combination of BF booklet plus video plus LC was significantly better than routine care for exclusive BF at three months.

Authors' conclusions: Because there were significant methodological limitations and the observed effect sizes were small, it is not appropriate to recommend any antenatal BF education.There is an urgent need to conduct RCTs study with adequate power to evaluate the effectiveness of antenatal BF education.

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Figures

Figure 1
Figure 1
Methodological quality summary: review authors’ judgements about each methodological quality item for each included study.
Figure 2
Figure 2
Methodological quality graph: review authors’ judgements about each methodological quality item presented as percentages across all included studies.
See this image and copyright information in PMC

References

References to studies included in this review

    1. Duffy EP, Percival P, Kershaw E. Positive effects of an antenatal group teaching session on postnatal nipple pain, nipple trauma and breast feeding rates. Midwifery. 1997;13(4):189–96. - PubMed
    1. Finch C, Daniel EL. Breastfeeding education program with incentives increases exclusive breastfeeding among urban WIC participants. Journal of the American Dietetic Association. 2002;102(7):981–4. - PubMed

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    1. Forster D, McLachlan H, Lumley J, Beanland C, Waldenstrom U, Harris H, et al. ABFAB. Attachment to the breast and family attitudes to breastfeeding. The effect of breastfeeding education in the middle of pregnancy on the initiation and duration of breastfeeding: a randomised controlled trial. BMC Pregnancy Childbirth. 2003;3(1):5. - PMC - PubMed
    1. Forster DA, McLachlan HL, Lumley J. Factors associated with breastfeeding at six months postpartum in a group of Australian women. International Breastfeeding Journal. 2006;1:18. - PMC - PubMed

References to studies excluded from this review

    1. Aidam BA, Perez-Escamilla R, Lartey A. Lactation counseling increases exclusive breast-feeding rates in Ghana. Journal of Nutrition. 2005;135(7):1691–5. - PubMed
    1. Anderson AK, Damio G, Chapman DJ, Perez-Escamilla R. Differential response to an exclusive breastfeeding peer counseling intervention: the role of ethnicity. Journal of Human Lactation. 2007;23(1):16–23. - PubMed

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    2. Anderson AK, Damio G, Young S, Chapman DJ, Perez-Escamilla R. A randomized trial assessing the efficacy of peer counseling on exclusive breastfeeding in a predominantly Latina low-income community. Archives of Pediatrics and Adolescent Medicine. 2005;159(9):836–41. - PubMed
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    1. Bonuck KA. [accessed 9 April 2008];Boosting breastfeeding in low-income, multi-ethnic women: a primary care based RCT (BINGO) 2008 ClinicalTrials.gov. http://clinicaltrials.gov/

References to studies awaiting assessment

    1. Kupratakul J, Taneepanichskul S, Voramongkol N, Phupong V. A randomized controlled trial of knowledge sharing practice with empowerment strategies in pregnant women to improve exclusive breastfeeding during the first six months postpartum. Journal of the Medical Association of Thailand. 2010;93(9):1009–18. - PubMed
    1. Olenick P, Berens P. The effect of structured group prenatal education on breastfeeding confidence, duration, and exclusivity to 12 weeks postpartum. Breastfeeding Medicine. 2010;5(6):334.

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    2. Olenick PL. The effect of structured group prenatal education on breastfeeding confidence, duration, and exclusivity to 12 weeks postpartum. Journal of Human Lactation. 2011;27(1):71–2.
    1. Patel A. [accessed 2 August 2011];Effectiveness of cell phone counseling to improve breast feeding indicators. Clinical Trials Registry - India. http://ctri.nic.in.

Additional references

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