title: Clinical Interventions to Promote Breastfeeding by Latinas: A Meta-analysis.
abstract: BACKGROUND
  Breastfeeding duration and exclusivity among Latinas fall below recommended levels, indicating a need for targeted interventions. The effectiveness of clinical breastfeeding interventions for Latinas remains unclear.
  
  
  OBJECTIVE
  To systematically review the documented effectiveness of clinical breastfeeding interventions on any and exclusive breastfeeding among Latinas.
  
  
  METHODS
  English-language publications in Medline, CINAHL, and Embase were searched through May 28, 2015.
  
  
  METHODS
  Fourteen prospective, controlled studies describing 17 interventions met inclusion criteria.
  
  
  METHODS
  Extracted study characteristics include study design, population characteristics, intervention components, timing and intensity of delivery, provider type, control procedures, and outcome measures.
  
  
  RESULTS
  Random-effects meta-analyses estimated risk differences (RDs) between breastfeeding mothers in intervention and control arms of each study and 95% prediction intervals (PIs) within which 95% of intervals cover the true value estimated by a future study. Interventions increased any breastfeeding at 1 to 3 and 4 to 6 months (RD 0.04 [95% PI -0.15 to 0.23] and 0.08 [-0.08 to 0.25], respectively) and exclusive breastfeeding at 1 to 3 and 4 to 6 months (0.04 [-0.09 to 0.18] and 0.01 [-0.01 to 0.02]). Funnel plot asymmetry suggested publication bias for initiation and 1- to 3-month any breastfeeding. Estimates were slightly larger among interventions with prenatal and postpartum components, 3 to 6 patient contacts, and delivery by an International Board Certified Lactation Consultant or lay provider.
  
  
  CONCLUSIONS
  The published evidence for Latinas is limited, and studies have varying methodologic rigor.
  
  
  CONCLUSIONS
  Breastfeeding interventions targeting Latinas increased any and exclusive breastfeeding compared with usual care.
authors.affiliation: Carolina Global Breastfeeding Institute, Department of Maternal and Child Health, and khouk@live.unc.edu.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Wouk
authors.affiliation: Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champaign, Champaign, Illinois;
authors.forename: Sandraluz
authors.initials: S
authors.lastname: Lara-Cinisomo
authors.affiliation: Carolina Global Breastfeeding Institute, Department of Maternal and Child Health, and Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;
authors.forename: Alison M
authors.initials: AM
authors.lastname: Stuebe
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;
authors.forename: Charles
authors.initials: C
authors.lastname: Poole
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Petrick
authors.affiliation: School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: McKenney
mesh_terms: D001942:Breast Feeding / Q000208:ethnology / Q000706:statistics & numerical data; D006293:Health Promotion; D006630:Hispanic or Latino; D006801:Humans