Educational and supportive interventions to prolong breastfeeding in Australia: a scoping review

Abstract

Background: The World Health Organization (WHO) recommends exclusive breastfeeding (EBF) i.e. feeding infants breastmilk and no other foods or liquids for the first 6 months of life. In Australia, the initiation rate of breastfeeding is high (90.4%). Yet, breastfeeding duration and exclusivity is well below the WHO recommendation. This scoping review examines the efficacy and characteristics of interventions aimed to improve the duration of breastfeeding whether exclusive or in combination up to 6 months of age in Australia. Methods: Online databases Medline and Embase were searched for relevant studies. Studies were included if they were undertaken in Australia during the last 10 years, and included educational, support-based or in-hospital breastfeeding interventions and documented duration of breastfeeding. Results: 11 studies met the imposed criteria. Most interventions improved breastfeeding rates, for example from 6.5% to 19% for EBF when assessed at 6 months, from 75% to 82% for breastfeeding at 6 weeks. The interventions included: accreditation for breastfeeding friendly hospitals, breastfeeding classes, nurse home visits and drop-in clinics, breastfeeding support in primary care, telephone support, breastfeeding smartphone applications, relevant websites and text-messaging services. Interventions that were successful, provided support for mothers beyond their postnatal period. Most common enablers reported were program facilitators that were volunteers who were peers with similar experiences, rather than breastfeeding professionals, in addition to interventions that focussed on psychological factors that influenced breastfeeding outcomes. Conclusions: While the interventions to date were promising, further prospective randomised controlled trials are needed to determine which interventions would be best in prolonging breastfeeding. The findings would help support the commendable intentions to breastfeed expressed by most Australian mothers shortly after the birth of their infant.