Breastfeeding Support for Women with Long-Term Conditions

BackgroundMany women stop breastfeeding before they intended and report a lack of support from healthcare providers. Women with long-term conditions may have additional difficulties breastfeeding, which has resulted in lower rates of breastfeeding in this group. The aim of this work is to identify effective interventions to support all women to breastfeed.MethodsA Systematic Review and meta-analysis was conducted to identify effective interventions for women with long-term conditions. This is part of the larger Action4Breastfeeding study which included an update of the Cochrane Review on breastfeeding support for healthy women with healthy term babies.ResultsThe Systematic Review on breastfeeding support for women with long-term conditions identified 22 studies meeting the inclusion criteria. The majority of studies evaluated support interventions for women with obesity and/or gestational diabetes (n=12). Other conditions for which specific breastfeeding support interventions were identified include HIV, depression and anxiety, and substance misuse. Meta-analysis suggested that breastfeeding support compared to usual care may have some small beneficial effects for exclusive breastfeeding at 3-4 months (Relative Risk [RR] 0.77, 95% Confidence Interval [CI] 0.60, 0.99) and at 6 months (RR 0.95, 95% CI 0.90-1.00). There was no evidence of beneficial effects for any breastfeeding at any of the time points (4-8 weeks, 3-4 months or 6 months) or for exclusive breastfeeding at 4-8 weeks.ConclusionCompared to interventions for women without long-term conditions, there is a lack of studies evaluating breastfeeding support interventions. Moreover, such interventions are less likely to be effective. Given the increase in prevalence of maternal long-term conditions, we need to better understand how support can also be effective for women with long-term conditions. Further linked work is also on-going to better understand how the effective interventions identified in these work packages can be implemented in an NHS setting.Acknowledgment: This study is funded by the NIHR Health and Social Care Delivery Research programme (NIHR 130955). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.<br/