title: Systematic review and meta-analysis of randomized controlled trials evaluating primary care-based interventions to promote breastfeeding in low-income women.
abstract: BACKGROUND
  Given the benefits of breastfeeding (BF), health care institutions recommend that a child should be breastfed for the first 6 months of its life. However, differences between social groups as regards BF behaviour are very prevalent.
  
  
  OBJECTIVE
  To identify effective programmes that can be implemented by GPs to promote BF in low-income women.
  
  
  METHODS
  A review of the literature was based on the Medline, Cochrane and Public Health databases (1985-2009), using index terms relating to BF, general medicine and social inequalities in health. Randomized controlled trials were included in our analysis. Two people independently selected which studies would be used by rating the quality of the articles. The results of these studies were presented in raw form and in terms of a pooled relative risk.
  
  
  RESULTS
  We analysed 10 studies (of the 343 articles originally selected) involving a population of 1445 'mother and child' pairs. The studies that assessed ways of encouraging the initiation of any form of BF showed that educational programmes are effective [relative risk (RR) for starting BF, 1.46, 95% confidence interval (CI): 1.03-2.08]. As regards the studies that involved ways to encourage mothers to continue BF, the programmes used showed significant success rates after 3-month postpartum (RR: 1.15, 95% CI: 1.01-1.30). The successful programmes usually involved multiple 'short' follow-up appointments (<20 to 30 minutes).
  
  
  CONCLUSIONS
  Educational programmes delivered in the context of ongoing personal contact with a health professional are effective in promoting BF in low-income women.
authors: Department of General Practice, School of Medicine, UPMC Université Paris 06, Paris, France. gladys.ibanez@upmc.fr
authors: Gladys
authors: G
authors: Ibanez
authors: Cyrille
authors: C
authors: de Reynal de Saint Michel
authors: Mady
authors: M
authors: Denantes
authors: Marie-Josèphe
authors: MJ
authors: Saurel-Cubizolles
authors: Virginie
authors: V
authors: Ringa
authors: Anne-Marie
authors: AM
authors: Magnier
mesh_terms: D001942:Breast Feeding; D005260:Female; D006293:Health Promotion; D006801:Humans; D011203:Poverty; D011320:Primary Health Care; D011369:Professional-Patient Relations; D016032:Randomized Controlled Trials as Topic