Effectiveness of layperson-based interventions in promoting exclusive breastfeeding: A systematic review and meta-analysis

IF 7.5 1区 医学 Q1 NURSING International Journal of Nursing Studies Pub Date : 2024-09-10 DOI:10.1016/j.ijnurstu.2024.104894
Harmony Mang Yan Ho, Heidi Sze Lok Fan, Gunther Huagang Hu, Nitya Nagesh, Hoi Lam Ip, Emily Tsz Yan Leung, Edmond Pui Hang Choi, Kris Yuet Wan Lok
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Abstract

Objective

The objective of this study is to determine the effectiveness of layperson-based interventions in sustaining exclusive breastfeeding and to identify the optimal characteristics of such layperson-led strategies for promoting exclusive breastfeeding.

Methods

A systematic review and meta-analysis were conducted using a comprehensive search in seven electronic databases from their inception to January 2024. Two independent reviewers assessed the risk of bias using version 2 of the Cochrane Risk of Bias tool for randomized trials.

Results

Out of the 29,703 articles identified, 27 studies met the inclusion criteria and were included in the analysis. A total of 38,412 participants were included in these studies. The majority of the included studies utilized home visits as the intervention method. However, there is limited data available for other interventions, such as group discussions, phone support, short message service, and combined approaches, making it difficult to determine their effectiveness. Laypersons, with or without breastfeeding experience, were found to be effective intervention providers.

Discussion

Home visit interventions conducted by laypersons have proven effective in promoting exclusive breastfeeding. To maximize effectiveness, the content of home visits should be tailored based on the stages of pregnancy, and ideally, the duration of the visits should extend up to six months postpartum to sustain breastfeeding.

Registration

The protocol for this review is registered on PROSPERO (registration number: CRD42021235078). A major deviation from the protocol was the exclusion of network meta-analysis due to the small number of articles identified and the primary outcome being the exclusive breastfeeding rate.

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非专业人员干预对促进纯母乳喂养的效果:系统回顾和荟萃分析
目标本研究旨在确定非专业人士干预措施在维持纯母乳喂养方面的有效性,并确定此类非专业人士主导的促进纯母乳喂养策略的最佳特征。方法通过对七个电子数据库从开始到 2024 年 1 月的全面检索,进行了系统综述和荟萃分析。两位独立审稿人使用科克伦随机试验偏倚风险工具第 2 版评估了偏倚风险。结果在已确定的 29,703 篇文章中,有 27 项研究符合纳入标准并被纳入分析。这些研究共纳入了 38,412 名参与者。大部分纳入的研究都采用了家访作为干预方法。然而,关于其他干预方法(如小组讨论、电话支持、短信服务和综合方法)的数据有限,因此很难确定其有效性。讨论由非专业人士进行的家访干预已被证明能有效促进纯母乳喂养。为了最大限度地提高效果,家访的内容应根据妊娠阶段进行调整,理想情况下,家访时间应延长至产后六个月,以维持母乳喂养。由于确定的文章数量较少,且主要结果是纯母乳喂养率,因此排除了网络荟萃分析,这是与方案的一个主要偏差。
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来源期刊
CiteScore
15.00
自引率
2.50%
发文量
181
审稿时长
21 days
期刊介绍: The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).
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