Comment: The quality of evidence is downgraded by inconsistency (unexplained heterogeneity).
A Cochrane review «Support for healthy breastfeeding mothers with healthy term babies»1 «Gavine A, Shinwell SC, Buchanan P et al. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev 2022;10(10):CD001141. »1 included 116 studies with a total of 98 816 mother-infant pairs. All forms of extra support analysed together showed an increase in duration of 'any breastfeeding' (includes partial and exclusive breastfeeding) (table «Breastfeeding support only compared to usual care»1). All forms of extra support together also had a positive effect on duration of exclusive breastfeeding. Extra support by both lay and professionals had a positive impact on breastfeeding outcomes. Support can also be offered face-to-face, via telephone or digital technologies, or a combination.
| Outcome | Relative effect (95% CI) | Risk with usual care | Risk with support (95% CI) | № of participants (studies) Certainty of the evidence |
|---|---|---|---|---|
| Stopping breastfeeding (any) at 6 months | RR 0.93 (0.89 to 0.97) | 600 per 1000 | 558 per 1000 (534 to 582) | 14610 (30) Moderate |
| Stopping exclusive breastfeeding at 6 months | RR 0.90 (0.88 to 0.93) | 847 per 1000 | 763 per 1000 (746 to 788) | 16332 (40) Moderate |
| Stopping exclusive breastfeeding at 4-6 weeks | RR 0.83 (0.76 to 0.90) | 518 per 1000 | 430 per 1000 (394 to 466) | 14544 (42) Moderate |
| Stopping breastfeeding (any) at 3-4 months | RR 0.87 (0.81 to 0.93) | 462 per 1000 | 402 per 1000 (374 to 430) | 12054 (32) Moderate |
| Stopping exclusive breastfeeding at 3-4 months | RR 0.81 (0.77 to 0.85) | 731 per 1000 | 592 per 1000 (563 to 621) | 11575 (43) Moderate |
However, another Cocrane review «»2 «Lumbiganon P, Martis R, Laopaiboon M et al. Antenatal breastfeeding education for increasing breastfeeding duration. Cochrane Database Syst Rev 2016;(12):CD006425. »2included 24 studies (10 056 women) assessing the effectiveness of antenatal breastfeeding education. There was no conclusive evidence supporting any antenatal breastfeeding education for improving initiation of breastfeeding, proportion of women giving any breastfeeding or exclusively breastfeeding at 3 or 6 months or the duration of breastfeeding.