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Meta-Analysis
. 2017 May 16;12(5):e0177434.
doi: 10.1371/journal.pone.0177434. eCollection 2017.

Effectiveness of community-based peer support for mothers to improve their breastfeeding practices: A systematic review and meta-analysis

Prakash Shakya  1 , Mika Kondo Kunieda  1 , Momoko Koyama  1 , Sarju Sing Rai  1 , Moe Miyaguchi  1 , Sumi Dhakal  1 , Su Sandy  1 , Bruno Fokas Sunguya  2 , Masamine Jimba  1
Affiliations
Meta-Analysis

Effectiveness of community-based peer support for mothers to improve their breastfeeding practices: A systematic review and meta-analysis

Prakash Shakya et al. PLoS One. .

Abstract

Methods: We searched for evidence regarding community-based peer support for mothers in databases, such as PubMed/MEDLINE, the Cochrane Library, CINAHL, Web of Science, SocINDEX, and PsycINFO. We selected three outcome variables for breastfeeding practices, namely, exclusive breastfeeding duration, breastfeeding within the first hour of life, and prelacteal feeding. We conducted meta-analyses of the included randomized controlled trials and quasi-experimental studies.

Results: For our review, we selected 47 articles for synthesis out of 1,855 retrieved articles. In low- and middle-income countries, compared to usual care, community-based peer support increased exclusive breastfeeding at 3 months (RR: 1.90, 95% CI: 1.62-2.22), at 5 months (RR: 9.55, 95% CI: 6.65-13.70) and at 6 months (RR: 3.53, 95% CI: 2.49-5.00). In high-income countries, compared to usual care, peer support increased exclusive breastfeeding at 3 months (RR: 2.61, 95% CI: 1.15-5.95). In low- and middle-income countries, compared to usual care, peer support increased the initiation of breastfeeding within the first hour of life (RR: 1.51, 95% CI: 1.04-2.21) and decreased the risk of prelacteal feeding (RR: 0.38, 95% CI: 0.33-0.45).

Conclusions: Community-based peer support for mothers is effective in increasing the duration of exclusive breastfeeding, particularly for infants aged 3-6 months in low- and middle-income countries. Such support also encourages mothers to initiate breastfeeding early and prevents newborn prelacteal feeding.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram of included and excluded studies.
Fig 2
Fig 2. Pooled relative risk and 95% confidence intervals for the effect of community-based peer support for mothers on duration of exclusive breastfeeding in low- and middle income countries.
Fig 3
Fig 3. Pooled relative risk and 95% confidence intervals for the effect of community-based peer support for mothers on duration of exclusive breastfeeding in high income countries.
Fig 4
Fig 4. Pooled relative risk and 95% confidence intervals for the effect of community-based peer support for mothers on initiation of breastfeeding within the first hour of life in low- and middle income countries.
Fig 5
Fig 5. Pooled relative risk and 95% confidence intervals for the effect of community-based peer support for mothers on prelacteal feeding in low and middle income countries.
Fig 6
Fig 6. Pooled relative risk and confidence intervals for the effect of community-based peer support for mothers on exclusive breastfeeding at six months (subgroup analysis by type of the interventions).
See this image and copyright information in PMC

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