From: Breastfeeding promotion interventions and breastfeeding practices: a systematic review
Quality Assessment | Summary of Findings | ||||||||
---|---|---|---|---|---|---|---|---|---|
Ìý | Directness | No of events | Ìý | Ìý | |||||
No of studies | Design | Limitations | Consistency | Generalizability to population of interest | Generalizability to intervention of interest | Intervention | Control | Relative Risk (95% CI) | Comments |
Rate of predominant breastfeeding at <1 month : Moderate outcome-specific quality | |||||||||
6 | Variable follow up periods used in studies. Recall criteria variable across studies (past 24 hr, past week or previous month). mothers in the intervention group may have over-reported feeding practices | None of the studies suggest benefit. Insignificant heterogeneity | 3 studies were conducted in developing countries | Pooled results for different types of interventions | 33 | 59 | 0.66 [0.43, 1.01] | Fixed effects meta-analysis; insignificant heterogeneity. Most studies were facility-based and all used individual counseling. | |
Rate of predominant breastfeeding at 1- 5 months : low outcome specific-quality | |||||||||
13 | 10 RCTs, 3 QE [11, 12, 18, 20, 36, 42, 46, 52, 58, 61, 72, 76, 85] | Variable follow up periods used in studies. Recall criteria variable across studies (past 24 hr, past week or previous month). mothers in the intervention group may have over-reported feeding practices | 2 studies suggest benefit. Significant heterogeneity | 8 of 13 studies were conducted in developed countries | Pooled results for different types of interventions | 1433 | 707 | 1.08 [0.55, 2.13] | Random effects meta-analysis due to significant heterogeneity. Most studies are facility-based and used individual counseling. |
Rate of partial breastfeeding at day 1 : low outcome-specific quality | |||||||||
6 | Variable follow up periods used in studies. Recall criteria variable across studies (past 24 hr, past week or previous month). Mothers in the intervention group may have over-reported feeding practices. | 1 of 6 studies suggests benefit. Significant heterogeneity | 1 of 6 studies was conducted in a developing country | Pooled results for different types of interventions | 101 | 99 | 1.21 [0.79, 1.87] | Random effects meta-analysis due to significant heterogeneity. Most studies used individual counseling and most were facility-based. | |
Rate of partial breastfeeding at <1 month : moderate outcome-specific quality | |||||||||
11 | Variable follow up periods used in studies. Recall criteria variable across studies (past 24 hr, past week or previous month). mothers in the intervention group may have over-reported feeding practices. | None of the studies suggest benefit. Insignificant heterogeneity | 5 of 11 studies were conducted in developing countries | Pooled results for different types of interventions | 112 | 151 | 0.88 [0.72, 1.08] | Fixed effects meta-analysis; insignificant heterogeneity Most studies used individual counseling and most were facility-based. | |
Rate of partial breastfeeding at 1-5 months : moderate outcome-specific quality | |||||||||
20 | 11 RCTs, 9 QE [18–20, 36, 42, 45, 47, 49, 51, 52, 59, 61, 62, 71, 72, 76, 80, 85, 86, 89] | Variable follow up periods used in studies. Recall criteria variable across studies (past 24 hr, past week or previous month). mothers in the intervention group may have over-reported feeding practices. | None of the studies suggest benefit. Significant heterogeneity | 9 of 20 studies were conducted in developing countries | Pooled results for different types of interventions | 524 | 578 | 0.87 [0.75, 1.02] | Random effects meta-analysis due to significant heterogeneity. Most studies used individual counseling and most were facility-based. |