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Research ArticleOriginal Research

The Effectiveness of Primary Care-Based Interventions to Promote Breastfeeding: Systematic Evidence Review and Meta-Analysis for the US Preventive Services Task Force

Jeanne-Marie Guise, Valerie Palda, Carolyn Westhoff, Benjamin K. S. Chan, Mark Helfand and Tracy A. Lieu
The Annals of Family Medicine July 2003, 1 (2) 70-78; DOI: https://doi.org/10.1370/afm.56
Jeanne-Marie Guise
MD, MPH
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Valerie Palda
MD, MPH
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Carolyn Westhoff
MD, MSc
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Benjamin K. S. Chan
MS
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Mark Helfand
MD, MS
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Tracy A. Lieu
MD, MPH
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    Figure 1.

    Study Eligibility Flow Chart

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    Table 1.

    Breastfeeding Interventions

    Study, YearQualityTimeEducationSupportWritten MaterialsIntervention Breastfeeding N/Total (%)Control Breastfeeding N/Total (%)Difference %
    * P < .05.
    Initiation
    McEnery & Rao, 198633PoorYesNoNo7/16 (44)16/51 (31)13
    Hill, 198722FairYesNoYes19/31 (61)*15/33 (46)*15
    Kistin et al, 199020FairYesNoNo17/38 (45)*13/56 (23)*22
    Oakley & Rajan, 199024FairNoYesNo105/230 (46)89/226 (39)7
    Rossiter, 199435PoorYesNoYes73/104 (70)*28/74 (38)*32
    Brent et al, 199523FairYesYesNo33/58 (57)*18/57 (32)*25
    Sciacca et al, 199526PoorYesYesNo26/26 (100)*24/29 (83)*17
    Loh et al, 199731PoorNoNoYes43/98 (44)30/98 (32)12
    Reifsnider & Eckhart, 199745PoorYesNoNo13/14 (93)13/17 (77)17
    Short term
    Kaplowitz & Olson, 198332Poor2 moNoNoYes5/18 (28)5/22 (23)5
    Wiles, 198434Poor1 moYesNoNo18/20 (90)6/20 (30)60
    Jones & West, 198537Poor4 wkNoYesNo191/228 (84)*255/355 (72)*12
    Hill, 198722Fair6 wkYesNoYes12/31 (39)*10/33 (30)*9
    Kistin et al, 199020Fair< 6 wkYesNoNo8/38 (21)8/56 (14)7
    Serafino-Cross & Donovan, 199225Fair2 moNoYesNo16/26 (62)9/26 (35)27
    Rossiter, 199435Poor4 wkYesNoYes52/104 (50)*19/74 (26)*24
    Brent et al, 199523Fair2 moYesYesNo19/51 (37)*5/57 (9)*28
    Redman et al, 199529Fair6 wkYesYesYes64/81 (79)68/83 (82)(−) 3
    Sciacca et al, 199526Poor2 moYesYesNo21/26 (81)*9/29 (31)*50
    Duffy et al, 199719Fair< 6 wkYesNoNo32/35 (92)*10/35 (29)*63
    Loh et al, 199731Poor4 wkNoNoYes29/38 (76)17/27 (63)10
    Long term
    Jones & West, 198537Poor6 moNoYesNo86/228 (38)98/355 (28)10
    Frank et al, 198727Poor4 moNoYesYes103/163 (63)90/160 (56)7
    Rossiter, 199435Poor6 moYesNoYes26/101 (26)12/74 (16)10
    Brent et al, 199523Fair6 moYesYesNo7/51 (14)4/57 (7)7
    Redman et al, 199529Fair4 moYesYesYes42/75 (56)45/77 (58)(−) 2
    Curro et al, 199730Good6 moYesNoYes61/103 (59)50/97 (52)7
    Pugh & Milligan, 199821Fair6 moYesYesNo15/30 (50)8/30 (27)23
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    Table 2.

    Results of Meta-analyses of Studies of Education and Support

    Main Effects (Meta-Regression)Combined Effects
    BreastfeedingStudies (Subjects) No.Education Mean Difference % (95% CI)Support Mean Difference % (95% CI)Studies (Subjects) No.Education plus Support Mean Difference % (95% CI)
    CI = confidence interval.
    Initiation8 (1,060)23 (12–34)6 (−2–15)2 (170)21 (7–35)
    Short-term10 (1,408)39 (27–50)11 (3–19)2 (163)36 (22–49)
    Long-term7 (1,601)4 (−6–16)8 (2–16)2 (168)13 (1–25)

Additional Files

  • Figures
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  • Supplemental Table. Populations and Interventions in Studies of Clinically-based Interventions to Promote Breastfeeding

    Files in this Data Supplement:

    • Supplemental Table - PDF file, 4 pages, 1.18 MB.

  • Behavioral Interventions to Promote Breastfeeding: Recommendations and Rationale From the U.S. Preventive Services Task Force

    A full-text version of the USPSTF recommendations and rationale for behavioral interventions to promote breastfeeding.

    Files in this Data Supplement:

    • Full-text USPSTF Recommendations and Rationale - PDF file, 5 pages, 1.19 MB.
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The Annals of Family Medicine: 1 (2)
The Annals of Family Medicine: 1 (2)
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1 Jul 2003
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The Effectiveness of Primary Care-Based Interventions to Promote Breastfeeding: Systematic Evidence Review and Meta-Analysis for the US Preventive Services Task Force
Jeanne-Marie Guise, Valerie Palda, Carolyn Westhoff, Benjamin K. S. Chan, Mark Helfand, Tracy A. Lieu
The Annals of Family Medicine Jul 2003, 1 (2) 70-78; DOI: 10.1370/afm.56

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The Effectiveness of Primary Care-Based Interventions to Promote Breastfeeding: Systematic Evidence Review and Meta-Analysis for the US Preventive Services Task Force
Jeanne-Marie Guise, Valerie Palda, Carolyn Westhoff, Benjamin K. S. Chan, Mark Helfand, Tracy A. Lieu
The Annals of Family Medicine Jul 2003, 1 (2) 70-78; DOI: 10.1370/afm.56
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