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D'Hollander CJ, McCredie VA, Uleryk EM, Keown-Stoneman CDG, Birken CS, O'Connor DL, Maguire JL. Breastfeeding support provided by lactation consultants in high-income countries for improved breastfeeding rates, self-efficacy, and infant growth: a systematic review and meta-analysis protocol. Syst Rev 2023; 12:75. [PMID: 37131212 PMCID: PMC10152596 DOI: 10.1186/s13643-023-02239-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 04/19/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND It is well established that breast milk offers numerous health benefits for mother and child. Mothers are recommended to exclusively breastfeed their child until 6 months of age, with continued breastfeeding up to 1-2 years of age or beyond. Yet, these recommendations are met less than half of the time in high-income countries. Lactation consultants specialize in supporting mothers with breastfeeding and are a promising approach to improving breastfeeding rates. For lactation consultant interventions to be implemented widely as part of public health policy, a better understanding of their effect on breastfeeding rates and important health outcomes is needed. METHODS The overall aim of this systematic review is to evaluate the effect of lactation consultant interventions provided to women, compared to usual care, on breastfeeding rates (primary outcome), maternal breastfeeding self-efficacy, and infant growth. A search strategy has been developed to identify randomized controlled trials published in any language between 1985 and April 2023 in CENTRAL, MEDLINE, EMBASE, CINAHL, Scopus, and Web of Science. We will also perform a search of the grey literature and reference lists of relevant studies and reviews. Two reviewers will independently extract data on study design, baseline characteristics, details of the interventions employed, and primary and secondary outcomes using a pre-piloted standardized data extraction form. Risk of bias and quality of evidence assessment will be done independently and in duplicate using the Cochrane Risk of Bias tool and GRADE approach, respectively. Where possible, meta-analysis using random-effects models will be performed, otherwise a qualitative summary will be provided. We will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. DISCUSSION This review will fill an important gap in the lactation support literature. The findings will be of importance to policymakers who seek to implement interventions to improve breastfeeding rates. TRIAL REGISTRATION This review has been registered in the PROSPERO database (ID: CRD42022326597).
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Affiliation(s)
- Curtis J D'Hollander
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
- Department of Paediatrics, St. Michael's Hospital, Toronto, ON, Canada
| | - Victoria A McCredie
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
- Department of Medicine (Respirology), Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | - Charles D G Keown-Stoneman
- Applied Health Research Centre, Unity Health Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Catherine S Birken
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Division of Pediatric Medicine, Hospital for Sick Children, Toronto, ON, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Joannah & Brian Lawson Centre for Child Nutrition, Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Deborah L O'Connor
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
- Translational Medicine Program, Hospital for Sick Children, Toronto, ON, Canada
| | - Jonathon L Maguire
- Department of Paediatrics, St. Michael's Hospital, Toronto, ON, Canada.
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada.
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Joannah & Brian Lawson Centre for Child Nutrition, Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.
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Consales A, Colombo L, Zanotta L, Morniroli D, Sannino P, Rampini S, Piccoli G, Donghi M, Marchisio P, Mosca F, Plevani L, Giannì ML. Pilot Feasibility Study of a Hospital-Based Post-Natal Educational Intervention on New Mothers in a BFHI-Compliant Tertiary Referral Center for Neonatal Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042020. [PMID: 35206209 PMCID: PMC8871806 DOI: 10.3390/ijerph19042020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 11/16/2022]
Abstract
The immediate post-partum period offers a valuable opportunity for parental education on various health topics. The aim of this study was to pilot test the feasibility in a tertiary referral center for neonatal care of a post-natal educational intervention (the Diary) designed to provide mothers with basic information concerning newborn care and breastfeeding. Furthermore, we aimed to evaluate its effect on exclusive breastfeeding rates at discharge and at 48 h post-discharge, and on maternal perceived support during hospital stay, compared to standard care. A single-center two-phase interventional study was carried out from 1 December 2018 to 2 June 2019. The Diary was given to mothers enrolled in Phase 2, together with the Nurse-Parent Support Tool (NPST). The Diary-NPST couples analyzed were 269. The Diaries filled out and returned were 62.2%. Overall, mothers rated the information received through the Diary as "clear and comprehensive". Exclusive breastfeeding rates at discharge resulted in being higher in Phase 1 than in Phase 2 (80.6% vs. 72.5%, p = 0.04), whereas no difference emerged in terms of exclusive breastfeeding rates at 48 h. In both phases, the median NPST total score (4.05) was high. In conclusion, we propose a new instrument of in-hospital post-natal maternal education and, in line with the current literature, we support well-designed written educational materials to promote mothers' knowledge and satisfaction with post-partum hospital assistance. Further studies that are multicentric and with a longer follow-up period are needed to evaluate the potential impact of the Diary on exclusive breastfeeding duration.
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Affiliation(s)
- Alessandra Consales
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
| | - Lorenzo Colombo
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
| | - Lidia Zanotta
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
| | - Daniela Morniroli
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
- Correspondence: ; Tel.: +39-0255032907
| | - Patrizio Sannino
- Direzione Professioni Sanitarie, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 28, 20122 Milan, Italy; (P.S.); (S.R.)
| | - Serena Rampini
- Direzione Professioni Sanitarie, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 28, 20122 Milan, Italy; (P.S.); (S.R.)
| | - Giulia Piccoli
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
| | - Michaela Donghi
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
| | - Paola Marchisio
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Pediatric Unit, 20122 Milan, Italy;
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Fabio Mosca
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
| | - Laura Plevani
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
| | - Maria Lorella Giannì
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; (A.C.); (G.P.); (M.D.); (F.M.); (M.L.G.)
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Via della Commenda 12, 20122 Milan, Italy; (L.C.); (L.Z.); (L.P.)
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