Office of Regional Director of Health Services, Colombo, Sri Lanka.
Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
BMC Public Health. 2018 Sep 24;18(1):1140. doi: 10.1186/s12889-018-6037-x.
Further research gaps exist in relation to the promotion of breastfeeding. Robust scientific evidence obtained by a meta-analysis would provide objectively summarized data while enabling the assessment of consistency of findings. This review includes the first documented meta-analysis done on the effectiveness of targeting fathers for promoting breastfeeding (BF). Assessments have been done for a primary outcome and for six more secondary outcomes.
PubMed, EMBASE, Google Scholar, CENTRAL databases and unpublished researches were searched. Selections of randomized-controlled trials and quasi-experimental studies were done in three rounds. Heterogeneity and potential publication bias were assessed. Eight studies were included in meta-analysis and others in narrative synthesis of the outcomes. Pooling was done with the Mental- Haenszel method using risk ratio (RR). Summary-of-Findings table was composed by Review-Manager (version 5.3) and GRADEproGDT applications. Subsequent sensitivity analysis was done.
Selected eight interventional studies included 1852 families. Exclusive BF at six months was significantly higher (RR = 2.04, CI = 1.58-2.65) in the intervention groups. The RR at 4 months was 1.52 (CI = 1.14 to 2.03). Risk of full-formula-feeding (RR = 0.69, CI = 0.52-0.93) and the occurrence of lactation-related problems were lower in the intervention groups (RR = 0.24, CI = 0.10-0.57). More likelihood of rendering support in BF-related issues was seen in intervention groups (RR = 1.43, CI = 1.22-1.68). Increase of maternal knowledge and favorable attitudes on BF were higher in the intervention groups (P ≤; 0.001). The quality of evidence according to GRADE was "low" (for one outcome), "moderate" (for four outcomes), and "high" (for two outcomes).
Targeting fathers in promotion of BF has provided favorable results for all seven outcomes with satisfactory quality of evidence. This review was registered in the PROSPERO-registry (ID: 2017-CRD42017076163) prior to its commencement.
在促进母乳喂养方面，仍存在进一步的研究空白。通过荟萃分析获得的有力科学证据将提供客观总结的数据，并能够评估研究结果的一致性。本综述包括首次对针对父亲促进母乳喂养（BF）的有效性进行的有记录的荟萃分析。评估了一个主要结局和六个次要结局。
检索了 PubMed、EMBASE、Google Scholar、CENTRAL 数据库和未发表的研究。对随机对照试验和准实验研究进行了三轮筛选。评估了异质性和潜在的发表偏倚。八项研究纳入荟萃分析，其他研究纳入结局的叙述性综合。使用风险比（RR）采用 Mental- Haenszel 方法进行合并。使用 Review-Manager（版本 5.3）和 GRADEproGDT 应用程序编制总结发现表。随后进行了敏感性分析。
选择的八项干预研究纳入了 1852 个家庭。干预组 6 个月时纯母乳喂养的比例显著更高（RR=2.04，95%CI=1.58-2.65）。4 个月时的 RR 为 1.52（95%CI=1.14-2.03）。干预组完全配方奶喂养的风险（RR=0.69，95%CI=0.52-0.93）和与哺乳相关问题的发生率较低（RR=0.24，95%CI=0.10-0.57）。干预组更有可能在 BF 相关问题上提供支持（RR=1.43，95%CI=1.22-1.68）。干预组母亲对 BF 的知识和态度更有利（P≤0.001）。根据 GRADE 评估，证据质量为“低”（一项结局）、“中”（四项结局）和“高”（两项结局）。
针对父亲促进 BF 已为所有七个结局提供了有利结果，证据质量令人满意。本综述在开始前已在 PROSPERO 注册（ID：2017-CRD42017076163）。
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