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USPSTF: Primary care interventions associated with increased likelihood of breastfeeding
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Breastfeeding support and education interventions targeting individuals in primary care were associated with a statistically significant higher likelihood of any and exclusive breastfeeding for up to 6 months, according to draft evidence released by the U.S. Preventive Services Task Force.
The evidence is part of a new draft recommendation promoting primary care interventions in support of breastfeeding, according to a USPSTF statement. The task force is seeking to update its 2008 B-grade recommendation, which concluded that there was adequate evidence that primary care interventions to promote breastfeeding during pregnancy and after birth increased rates of initiation, duration and exclusivity of breastfeeding. The update, also a B-grade recommendation, focuses on the effectiveness of breastfeeding support interventions on initiation, duration and exclusivity
“There is convincing evidence that breastfeeding provides substantial health benefits for children and adequate evidence that breastfeeding provides moderate health benefits for women,” the USPSTF states in the draft recommendation. “However, nearly one half of all mothers in the United States stop breastfeeding by 6 months, and there are significant disparities in breastfeeding rates among younger mothers and disadvantaged communities.”
The draft recommendation is based on an evidence review requested by the Agency for Healthcare Research and Quality and performed by the Kaiser Permanente Center for Health Research. Researchers reviewed 2,769 abstracts and 211 articles published between Jan. 1, 2008 and Sept. 25, 2015, and included 52 studies in their analysis.
The researchers found that breastfeeding support and education interventions targeting individuals were associated with a statistically significant higher likelihood of any and exclusive breastfeeding at less than 3 months, and at 3 to 6 months, compared with usual care among adults.
Primary care interventions included in the new draft recommendation include professional support from clinicians, peer support from mothers with positive breastfeeding experience, and formal education through group sessions, telephone support, videos and electronic and print materials.
“The body of fair-to-good quality evidence on the effectiveness of individual- and system-level interventions to support breastfeeding has nearly doubled since the previous USPSTF recommendation in 2009,” the report concludes. “Although there was a substantial variation between the settings, participants and interventions among the included studies, there is consistent evidence that individual-level support and education interventions that take place during the prenatal, peripartum and/or postpartum periods can increase the prevalence of breastfeeding, including exclusive breastfeeding, for up to 6 months.”
The draft recommendation and draft evidence will be available for review and public comment through May 23. – by Jason Laday
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