Wouk Kathryn, Tully Kristin P, Labbok Miriam H
1 Carolina Global Breastfeeding Institute, Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
2 Center for Developmental Science, University of North Carolina, Chapel Hill, NC, USA.
J Hum Lact. 2017 Feb;33(1):50-82. doi: 10.1177/0890334416679618. Epub 2016 Dec 20.
The Ten Steps to Successful Breastfeeding outline maternity practices that protect, promote, and support breastfeeding and serve as the foundation for the Baby-Friendly Hospital Initiative. Research aim: This systematic review describes interventions related to Step 3 of the Ten Steps, which involves informing pregnant women about the benefits and management of breastfeeding. Our main objective was to determine whether prenatal clinic- or hospital-based breastfeeding education increases breastfeeding initiation, duration, or exclusivity.
The electronic databases MEDLINE and CINAHL were searched for peer-reviewed manuscripts published in English between January 1, 2000, and May 5, 2016. Bibliographies of relevant systematic reviews were also screened to identify potential studies.
Thirty-eight studies were included. The research studies were either randomized controlled trials or quasi-experimental studies conducted in developed or developing countries. Findings suggest that prenatal interventions, delivered alone or in combination with intrapartum and/or postpartum components, are effective at increasing breastfeeding initiation, duration, or exclusivity where they combine both education and interpersonal support and where women's partners or family are involved. However, varying study quality and lack of standardized assessment of participants' breastfeeding intentions limited the ability to recommend any single intervention as most effective.
Future studies should test the strength of maternal breastfeeding intentions, assess the role of family members in influencing breastfeeding outcomes, compare the effectiveness of different health care providers, and include more explicit detail about the time and full cost of different interventions.
“成功母乳喂养十步骤”概述了保护、促进和支持母乳喂养的产科实践，是“爱婴医院倡议”的基础。研究目的：本系统评价描述了与“十步骤”第三步相关的干预措施，该步骤涉及向孕妇告知母乳喂养的益处及管理方法。我们的主要目标是确定基于产前诊所或医院的母乳喂养教育是否能提高母乳喂养的开始率、持续时间或纯母乳喂养率。
检索电子数据库MEDLINE和CINAHL，查找2000年1月1日至2016年5月5日期间以英文发表的同行评审手稿。还筛选了相关系统评价的参考文献以确定潜在研究。
纳入38项研究。这些研究为在发达国家或发展中国家进行的随机对照试验或准实验研究。研究结果表明，产前干预单独实施或与产时和/或产后部分相结合，在结合了教育和人际支持且女性伴侣或家人参与的情况下，能有效提高母乳喂养的开始率、持续时间或纯母乳喂养率。然而，研究质量参差不齐以及对参与者母乳喂养意愿缺乏标准化评估，限制了推荐任何单一干预措施为最有效措施的能力。
未来的研究应测试母亲母乳喂养意愿的强度，评估家庭成员在影响母乳喂养结果中的作用，比较不同医疗服务提供者的有效性，并更明确详细地说明不同干预措施的时间和全部成本。
