Comparing structured versus non-structured breastfeeding programmes to support the initiation and duration of exclusive breastfeeding in acute and primary healthcare settings.

Abstract

Review Objectives: The primary objective of this review is to assess if a structured programme, such as the WHO/UNICEF Baby Friendly Hospital Initiative (BFHI, which may also be referred to in Australia as the Baby Friendly Initiative or the Baby Friendly Health Initiative), implemented in maternity acute care settings is more likely to be associated with higher rates of initiation and duration of exclusive breastfeeding than no structured programme. Secondary objectives include eliciting whether the introduction of a structured programme (compared with no programme): • is more likely to be effective at increasing breastfeeding initiation and duration in particular groups of women and/or particular health care settings • enhances maternal and infant health outcomes • makes more effective use of healthcare resources • influences policy with respect to infant nutrition at local, national and international level Criteria for considering studies for this review: Types of participants: Participants will include pregnant women, mothers of newborn infants and women who may decide in the future to breastfeed in hospital or community settings. Population subgroups of women, such as women from low-income or minority ethnic groups, are also part of this review. Participants will incorporate all women exposed to interventions as part of a structured programme to support increased breastfeeding initiation and duration. When considering data from RCTs, intervention and control group data will be presented. Types of interventions / phenomenon of interest: Any intervention developed as part of a structured programme to promote the initiation and duration of exclusive breastfeeding. For example, programmes may include: the BFHI 10 step initiative; initiatives to support national or local adaptation of protocols or guidelines; training of relevant health care professionals; and implementation of a national or local policy initiative aimed at increasing the initiation and duration of breastfeeding and/or support for breastfeeding. Evaluations of interventions delivered as part of a structured programme taking place after the first breastfeed or whose primary purpose is to affect the duration or exclusivity of breastfeeding (which may have commenced antenatally) will be included in this review. This may include studies which have examined the effectiveness of a package of TRUNCATED AT 350 WORDS