Supporting breast feeding

1. Evidence-based interventions to
support breastfeeding
Journal club

2. • Author: Lori Feldman-Winter,MD,MPH
• Journal:Pediatric clinics of North America:
Breast feeding Updates for the
Pediatrician.
Morrow and Chantry
February 2013,Volume 60,Number 1

3. Introduction
• Decision to breast feed is one of the most
important decision a mother can make.
• 75% of US mothers started breastfeeding in early
postpartum period according to CDC and NIS.
• Merely 14.8% women exclusively breast fed upto
6 months(NIS) in 2008.
• Therefore along with focusing on the decision to
breastfeed there should be focus on protection
and support of breastfeeding

4. • Describes evidence based practices that have
been established to support breastfeeding.
• Discusses barriers and challenges to
breastfeeding support .

5. Support for pregnant women:
 Ample time with prenatal health
care practioner providing ample
opputunity for brestfeeding
support.
 Peer counselling , formal
lactational consultation and breast
feeding education.
 Mothers who are at more risk of
not breast feeding are more to gain
from prenatal support.

6. Content of effective sessions-benefits,priciples
of lactation,myths,common
problems,solutions and skill training.
Prenatal classes in workshop format increases
self efficacy.
Weight control strategies should be offered.
More effective when combined with
elimination of infant formula marketing
Step 3 of BFHI

7. Support in preipartum setting:
• Importance of skin to skin
conatct : improves physiologic
transition,increases success of
first breast feed and more
effective breast feeding.
• The first breast feed: early first
breastfeed leads to increased
milk supply in first days, early
passage of meconium and
continuing of breast feeding.
• Newborn
procedures:weighing,injectons,b
lood sampling.

8. BFHI:
• Has been shown to increase initiation,
continuation and exclusivity.
• 10 steps have dose dependent effect.

10. Support for postpartum women in
community
• Support by physician and advanced practice
nurses.

11. Professional support by other health care
professional:

12. Peer(lay) Support

13. Employment

14. • Schools and preconception education:

15. • Government and legistation:

16. Conclusion
• Considerable progress has been made in past
decade in developing support systems to enable
more women to reach breastfeeding goals.
• Each of this system is to rigorously tested and
replicated if effective.
• Additional research is needed to determine best
support during preconception period
• Along with outcome ,cost benefit analysis of
breast feeding support program.
• evaluation of government activities and program.