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Where all mothers receive at least 7 skilled support / counselling contacts
exclusive breastfeeding
rates are
higher.
A review of current randomized controlled trials suggest that the benefits of holding for preterm babies include shortened hospital stay, decreased illness,
higher exclusive breastfeeding
rates / longer breastfeeding duration, increased weight gain, improved temperature regulation, and improved maternal sense of competence.
Several factors may have also improved results for women practising
exclusive breastfeeding, such as interventions delivered with a face - to - face component,
high background initiation
rates of breastfeeding, lay support, and a specific schedule of four to eight contacts.
Despite the widened socioeconomic inequalities by the intervention in
rates of prolonged
exclusive and any breastfeeding, breastfeeding
rates were even
higher among mothers with the lowest education (secondary school or less) in the intervention group than they were among mothers who completed university in the control group.
Although not directly comparable, our findings are in broad agreement with those from routine data in Scotland that have indicated a positive association between Baby Friendly accreditation, but not certification, and breastfeeding at 1 week of age.17 Our findings reinforce those of Coutinho and colleagues who reported that
high exclusive breastfeeding
rates achieved in Brazilian hospitals implementing staff training with the course content of the Baby Friendly Hospital Initiative were short - lived and not sustained at home unless implemented in combination with post-natal home visits.35 Similarly in Italy, training of staff with an adapted version of the Baby Friendly course content resulted in
high breastfeeding
rates at discharge, with a rapid decrease in the days after leaving hospital.36 In contrast, a cluster randomized trial in Belarus (PROBIT) found an association between an intervention modelled on the Baby Friendly Initiative with an increased duration of breastfeeding37 an association also reported from an observational study in Germany.38 Mothers in Belarus stay in hospital post-partum for 6 — 7 days, and in Germany for 5 days, with post-natal support likely to be particularly important in countries where mothers stay in the hospital for a shorter time, with early discharge likely to limit the influence of a hospital - based intervention.
At 4 wk PP, the intervention group had a significantly
higher rate of
exclusive breastfeeding than controls (based on 24 - h recall).
One research summary found that after reviewing all available studies regarding the outcomes of using IBCLCs, mothers who had
higher breastfeeding initiation
rates, a longer duration of
exclusive breastfeeding, a longer duration of any breastfeeding,
higher breastfeeding
rates for all infant age groups, AND better maternal and infant health outcomes as compared to those who didn't seek out IBCLC support (5).
The reported
exclusive breastfeeding
rate may be
higher than the national average as the sample consisted of women with established intension to breastfeed exclusively.
A randomised trial in Brazil that compared a hospital based protocol (similar to the baby friendly hospital initiative) with another incorporating intensive home visits, however, found that while the protocol achieved
high rates of
exclusive breast feeding in hospital, the
rates fell rapidly thereafter.27 These findings were confirmed in the UK by the millennium cohort study, 5 and the authors recommended that the baby friendly hospital initiative as a strategy for promotion of breast feeding should be reassessed and that other strategies are required to support mothers in the UK to breast feed for the recommended duration.5 27 Although combined antenatal education and postnatal support is ideal, this may be limited by economic or time resources.
The
highest exclusive breastfeeding
rates are reported in eastern and southern regions in Africa (51 %)[9].
At all ages, control infants were breastfed at
higher rates than SIDS victims, and the protective effect of partial or
exclusive breastfeeding remained statistically significant after adjustment for confounders.244 A recent meta - analysis that included 18 case - control studies revealed an unadjusted summary OR for any breastfeeding of 0.40 (95 % CI: 0.35 — 0.44).
National baseline prevalence reported in paper was similar to the control group
rates; UNICEF quoted
higher rates - 53 %
exclusive breastfeeding at 0 - 3 months
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