title: Support for healthy breastfeeding mothers with healthy term babies.
abstract: BACKGROUND
  There is extensive evidence of important health risks for infants and mothers related to not breastfeeding. In 2003, the World Health Organization recommended infants be exclusively breastfed until six months of age, with breastfeeding continuing as an important part of the infant's diet till at least two years of age. However, breastfeeding rates in many countries currently do not reflect this recommendation.
  
  
  OBJECTIVE
  To assess the effectiveness of support for breastfeeding mothers.
  
  
  METHODS
  We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (3 October 2011).
  
  
  METHODS
  Randomised or quasi-randomised controlled trials comparing extra support for healthy breastfeeding mothers of healthy term babies with usual maternity care.
  
  
  METHODS
  Two review authors independently assessed trial quality and extracted data.
  
  
  RESULTS
  Of the 67 studies that we assessed as eligible for inclusion, 52 contributed outcome data to the review (56,451 mother-infant pairs) from 21 countries. All forms of extra support analysed together showed an increase in duration of 'any breastfeeding' (includes partial and exclusive breastfeeding) (risk ratio (RR) for stopping any breastfeeding before six months 0.91, 95% confidence interval (CI) 0.88 to 0.96). All forms of extra support together also had a positive effect on duration of exclusive breastfeeding (RR at six months 0.86, 95% CI 0.82 to 0.91; RR at four to six weeks 0.74, 95% CI 0.61 to 0.89). Extra support by both lay and professionals had a positive impact on breastfeeding outcomes. Maternal satisfaction was poorly reported.
  
  
  CONCLUSIONS
  All women should be offered support to breastfeed their babies to increase the duration and exclusivity of breastfeeding. Support is likely to be more effective in settings with high initiation rates, so efforts to increase the uptake of breastfeeding should be in place. Support may be offered either by professional or lay/peer supporters, or a combination of both. Strategies that rely mainly on face-to-face support are more likely to succeed. Support that is only offered reactively, in which women are expected to initiate the contact, is unlikely to be effective; women should be offered ongoing visits on a scheduled basis so they can predict that support will be available. Support should be tailored to the needs of the setting and the population group.
authors.affiliation: Mother and Infant Research Unit, Department of Health Sciences, University of York, York, UK.
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Renfrew
authors.forename: Felicia M
authors.initials: FM
authors.lastname: McCormick
authors.forename: Angela
authors.initials: A
authors.lastname: Wade
authors.forename: Beverley
authors.initials: B
authors.lastname: Quinn
authors.forename: Therese
authors.initials: T
authors.lastname: Dowswell
mesh_terms: D001942:Breast Feeding; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D007223:Infant; D016032:Randomized Controlled Trials as Topic; D012944:Social Support; D047929:Term Birth