Nursing Department, Université du Québec en Outaouais, Saint-Jérôme, Quebec, Canada.
Nursing Department, Université du Québec en Outaouais, Gatineau, Quebec, Canada.
Matern Child Nutr. 2018 Jul;14(3):e12607. doi: 10.1111/mcn.12607. Epub 2018 Apr 14.
The aim of this systematic review and meta-analysis was to assess the efficacy on an intervention on breastfeeding self-efficacy and perceived insufficient milk supply outcomes. The literature search was conducted among 6 databases (CINAHL, Medline, PsyncInfo, Scopus, Cochrane, and ProQuest) in between January 2000 to June 2016. Two reviewers independently assessed the articles for the following inclusion criteria: experimental or quasi-experimental studies; healthy pregnant women participants intending to breastfeed or healthy breastfeeding women who gave birth to a term singleton and healthy baby; intervention administered could have been educational, support, psycho-social, or breastfeeding self-efficacy based, offered in prenatal or postnatal or both, in person, over the phone, or with the support of e-technologies; breastfeeding self-efficacy or perceived insufficient milk supply as outcomes. Seventeen studies were included in this review; 12 were randomized controlled trials. Most interventions were self-efficacy based provided on 1-to-1 format. Meta-analysis of RCTs revealed that interventions significantly improved breastfeeding self-efficacy during the first 4 to 6 weeks (SMD = 0.40, 95% CI 0.11-0.69, p = 0.006). This further impact exclusive breastfeeding duration. Only 1 study reported data on perceived insufficient milk supply. Women who have made the choice to breastfeed should be offered breastfeeding self-efficacy-based interventions during the perinatal period. Although significant effect of the interventions in improving maternal breastfeeding self-efficacy was revealed by this review, there is still a paucity of evidence on the mode, format, and intensity of interventions. Research on the modalities of breastfeeding self-efficacy should be pursued.
本系统评价和荟萃分析的目的是评估干预对母乳喂养自我效能和感知不足的奶量供应结果的疗效。文献检索在 6 个数据库（CINAHL、Medline、PsycINFO、Scopus、Cochrane 和 ProQuest）中进行，时间范围为 2000 年 1 月至 2016 年 6 月。两位审查员独立评估了以下纳入标准的文章：实验或准实验研究；打算母乳喂养的健康孕妇参与者或分娩足月单胎和健康婴儿的健康母乳喂养妇女；干预措施可以是教育、支持、心理社会或基于母乳喂养自我效能的，在产前或产后或两者都提供，面对面、通过电话或在电子技术的支持下提供；母乳喂养自我效能或感知不足的奶量供应为结果。本综述共纳入 17 项研究，其中 12 项为随机对照试验。大多数干预措施都是基于自我效能的，采用一对一的模式提供。RCT 的荟萃分析显示，干预措施在头 4 到 6 周内显著提高了母乳喂养自我效能（SMD=0.40，95%CI 0.11-0.69，p=0.006）。这进一步影响了纯母乳喂养的持续时间。只有 1 项研究报告了关于感知不足的奶量供应的数据。已经选择母乳喂养的妇女应在围产期提供基于母乳喂养自我效能的干预措施。虽然本综述显示干预措施在提高产妇母乳喂养自我效能方面有显著效果，但关于干预模式、形式和强度的证据仍然很少。应该对母乳喂养自我效能的模式进行研究。
