Donnelly A, Snowden H M, Renfrew M J, Woolridge M W
Mother and Infant Research Unit, 22 Hyde Terrace, Leeds, UK, LS2 9LN.
Cochrane Database Syst Rev. 2000(2):CD002075. doi: 10.1002/14651858.CD002075.
Exclusive breastfeeding until around six months of age, followed by the introduction of solids with continued breastfeeding, is considered to be the optimal nutritional start for newborn infants.
To determine whether the exclusivity and duration of breastfeeding is affected by giving mothers commercial discharge packs in hospital which contain artificial formula or promotional material for artificial formula. These packs are those which are commonly given to mothers on leaving hospital after giving birth (thus discharge packs).
Comprehensive electronic search of the register of clinical trials maintained and updated by the Cochrane Pregnancy and Childbirth Group and CINAHL and MEDLINE.
All randomised controlled trials with or without blinding to examine the effects of commercial discharge packs on breastfeeding.
Consenting postpartum women who initiate breastfeeding while in hospital or immediately upon discharge.
Commercial discharge packs which contain free samples of infant formula or promotional material versus non commercial discharge packs (specifically those from which free samples of infant formula have been removed or have been replaced with e.g. breast pads) or no pack.
The proportion of women breastfeeding at six weeks and 3 months (13 weeks) postpartum. Other outcomes: Rates of breastfeeding at other fixed time points between 0 and 6 months postpartum.
Data were extracted by one reviewer and checked by a second reviewer.
Nine randomised controlled trials involving a total of 3730 women were analysed. The studies only included women from North America. The meta-analysis showed that when comparing commercial discharge packs with any of the controls (no intervention, non-commercial pack and combinations of these), exclusive breastfeeding was reduced at all time points in the presence of commercial hospital discharge packs. There was no evidence to support the conjecture that use of hospital discharge packs causes the early termination of non-exclusive breastfeeding. Where the introduction of solid food was measured, giving a commercial pack (with or without formula) reduced the time before solid food was introduced.
REVIEWER'S CONCLUSIONS: The giving of commercial hospital discharge packs (with or without formula) appears to reduce the number of women exclusively breastfeeding at all times but has no significant effect upon the earlier termination of non-exclusive breastfeeding.
纯母乳喂养至六个月左右，随后在持续母乳喂养的同时引入固体食物，被认为是新生儿最佳的营养开端。
确定在医院向母亲发放包含人工配方奶粉或人工配方奶粉促销材料的商业出院包，是否会影响母乳喂养的排他性和持续时间。这些包是母亲产后出院时通常会收到的（即出院包）。
对由Cochrane妊娠与分娩小组维护和更新的临床试验注册库以及CINAHL和MEDLINE进行全面电子检索。
所有考察商业出院包对母乳喂养影响的随机对照试验，无论是否设盲。
同意在住院期间或出院后立即开始母乳喂养的产后妇女。
包含婴儿配方奶粉免费样品或促销材料的商业出院包与非商业出院包（特别是那些已去除婴儿配方奶粉免费样品或已被例如防溢乳垫替代的出院包）或无出院包。
产后六周和三个月（十三周）时进行母乳喂养的妇女比例。其他结局：产后0至6个月其他固定时间点的母乳喂养率。
由一名审阅者提取数据，另一名审阅者进行核对。
分析了九项随机对照试验，共涉及3730名妇女。这些研究仅纳入了来自北美的妇女。荟萃分析表明，将商业出院包与任何对照组（无干预、非商业包以及这些的组合）进行比较时，在有商业医院出院包的情况下，所有时间点的纯母乳喂养率均降低。没有证据支持关于使用医院出院包会导致非纯母乳喂养提前终止的推测。在测量引入固体食物的情况时，发放商业包（有无配方奶粉）会缩短引入固体食物前的时间。
发放商业医院出院包（有无配方奶粉）似乎会在各个时间段减少纯母乳喂养的妇女数量，但对非纯母乳喂养的提前终止没有显著影响。
