This document summarizes evidence-based interventions to support breastfeeding. It describes interventions during pregnancy, such as peer counseling and breastfeeding education, which increase breastfeeding self-efficacy and initiation rates. The document also outlines postpartum supports like the Baby-Friendly Hospital Initiative's 10 steps, support from healthcare providers, and peer support groups, which have been shown to increase breastfeeding continuation and exclusivity. While progress has been made in developing breastfeeding support systems, additional research is still needed to determine the most effective supports.

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.