Boss Melinda, Saxby Nicole, Pritchard Douglas, Pérez-Escamilla Rafael, Clifford Rhonda
School of Allied Health, Division of Pharmacy, The University of Western Australia, Crawley, Western Australia, Australia.
Women's and Children's Services, Royal Hobart Hospital, Hobart, Tasmania, Australia.
Matern Child Nutr. 2021 Jul;17(3):e13160. doi: 10.1111/mcn.13160. Epub 2021 Feb 16.
Most children globally are not breastfed to recommendations. Medical practitioners are frequently visited in the first 6 months post-partum, and the interaction at such visits significantly influences subsequent infant feeding decisions. Medical practitioners report that clinical practice in lactation is often disproportionately reliant on personal experience. This systematic review synthesises the literature on lactation health interventions used to support clinical decision making by medical practitioners. MEDLINE, Embase, PsycINFO, Scopus and Cochrane Library databases were searched for peer-reviewed empirical studies published after 2000. Two reviewers independently screened and then assessed full-text articles against inclusion criteria. Quality of reporting and risk of bias were independently assessed using three validated tools. No conclusions can be made regarding the success or failure of implementation strategies used or the outcomes of putting them into effect due to problems with study methodology, intervention reporting and risk of bias. Good-quality research, which follows proven implementation frameworks, is needed to guide and sustain the incorporation of evidence-based decision support into medical practitioners' care of breastfeeding mothers and infants.
全球大多数儿童未按照建议进行母乳喂养。产后头6个月，产妇频繁就医，而此类就诊时的互动会显著影响后续的婴儿喂养决策。医生报告称，哺乳期的临床实践往往过度依赖个人经验。本系统评价综合了有关用于支持医生临床决策的哺乳期健康干预措施的文献。检索了MEDLINE、Embase、PsycINFO、Scopus和Cochrane图书馆数据库，查找2000年后发表的同行评审实证研究。两名评审员独立筛选，然后根据纳入标准评估全文文章。使用三种经过验证的工具独立评估报告质量和偏倚风险。由于研究方法、干预措施报告和偏倚风险方面的问题，无法就所采用的实施策略的成败或实施结果得出结论。需要开展遵循成熟实施框架的高质量研究，以指导并持续将循证决策支持纳入医生对母乳喂养母婴的护理工作中。
