Task Force Recommends
Specific Types Programs to Promote Breastfeeding
Press Release Date: July 29, 2003
http://www.ahrq.gov/news/press/pr2003/brfeedpr.htm
The
U.S.
Preventive Services Task Force today recommended structured education and
counseling programs to promote breastfeeding because such programs increase
the proportion of women who begin and continue to breastfeed their
babies. Simply telling mothers they should breastfeed or giving them pamphlets
is not enough, they said.
According to the Task Force, structured
programs share some elements: they include from one to eight individual or
group sessions that follow specific formats and last between 30 and 90
minutes; they are led by specially trained nurses, midwives, lactation
specialists, and peer counselors; and they include lectures along with
practical skills that help women master breastfeeding techniques and deal with
problems that may arise from breastfeeding. In addition, structured programs
include information about the benefits of breastfeeding for mother and child,
how the body produces breast milk, training in positioning the baby and
latch-on techniques, and the use of mechanical breast pumps.
The Task Force recommendations, which appear in
the July/August issue of Annals of Family Medicine, are based on a
systematic review of 35 studies, including 22 randomized control trials of
breastfeeding counseling. They examined the effects of education, support, and
written materials on increasing breastfeeding rates.
Meanwhile, the Task Force found insufficient
evidence to recommend less-intensive intervention such as having primary care
providers give others advice or written materials such as pamphlets. The Task
Force also found insufficient evidence for peer counseling alone, although
some studies show that peer support can enhance structured education programs
by encouraging women after they begin to breastfeed to continue the practice
longer than they otherwise might. Peer counselors are women who have practical
training but not necessarily clinical expertise in breastfeeding techniques.
"We hope that these recommendations will help
women and their clinicians understand which kinds of programs are most
effective and will encourage their wider availability for pregnant women,"
said Task Force Chair, Alfred O. Berg, M.D., M.P.H., who is also Chair of the
Department of Family Medicine at the University of Washington in Seattle. "In
addition, there is a need for further studies about how clinicians and peer
counselors can more effectively encourage women to breastfeed."
The Task Force found that supplementing
successful programs by providing ongoing support to new mothers through
in-person visits or telephone contacts by providers or counselors may help
women to stay with breastfeeding for longer periods than 3 months. However,
more research is needed in this area. It was clear that providing ongoing
support to women is not effective as a stand-alone strategy for increasing
rates of breastfeeding.
National data from 1998 showed that 64 percent
of all mothers breastfed immediately after giving birth, but only 29 percent
of all mothers and 19 percent of black mothers were breastfeeding by 6 months.
The goal for Healthy People 2010 is 75 percent of mothers to be
breastfeeding right after having a baby, 50 percent at 6 months, and 25
percent at 1 year.
While the programs reviewed by the Task Force
did not all take place in primary care clinics, the Task Force highlighted the
important role of primary care clinicians in referring women to breastfeeding
programs to ensure they begin and continue to breastfeed.
The Task Force is the leading independent panel
of experts in prevention and primary care and is sponsored by the Agency for
Healthcare Research and Quality. The Task Force grades the strength of the
evidence from "A" (strongly recommends), "B" (recommends), "C" (no
recommendation for or against), "D" (recommends against) or "I" (insufficient
evidence to recommend for or against screening). The Task Force recommends
structured breastfeeding education and behavioral counseling programs to
promote breastfeeding, a "B" recommendation. The Task Force found insufficient
evidence to recommend for or against brief education and counseling by primary
care providers, peer counseling used alone and initiated in the clinical
setting, and written materials, used alone or in combination with other
interventions, an "I" recommendation.
The Task Force conducts rigorous, impartial
assessments of all the scientific evidence for a broad range of preventive
services. Its recommendations are considered the gold standard for clinical
preventive services. The Task Force based its conclusions on report prepared
by a team led by Jeanne-Marie Guise, M.D., M.P.H., at AHRQ's Evidence-based
Practice Center at
Oregon
Health & Sciences University in Portland.
The counseling for breastfeeding
recommendations and materials for clinicians are available on AHRQ's Web site
at
http://www.ahrq.gov/clinic/uspstf/uspsbrfd.htm. Previous Task Force
recommendations, summaries of the evidence, easy-to-read fact sheets
explaining the recommendations, and related materials are available from the
AHRQ Publications Clearinghouse by calling (800) 358-9295 or sending an E-mail
to ahrqpubs@ahrq.gov. Clinical
information also is available from the National Guideline Clearinghouse™ at
http://www.guideline.gov.
For more information, please contact
AHRQ Public Affairs: Barbara Najar, (301) 427-1399 (BNajar@ahrq.gov);
Farah Englert, (301) 427-1865 (FEnglert@ahrq.gov).
Internet Citation:
Task Force Recommends
Specific Types of Programs to Promote Breastfeeding.
Press Release, July 29, 2003. Agency for Healthcare Research and Quality,
Rockville, MD.
http://www.ahrq.gov/news/press/pr2003/brfeedpr.htm
