Tuesday, September 09, 2008

Extended breastfeeding support does not improve breastfeeding rate or duration

Lactivists refuse to acknowledge that many women do not breastfeed because they do not want to do so, or because it is incompatible with other responsibilities like paid work. It's not because they don't understand the benefits of breastfeeding; it's not because they lack breastfeeding support; they just don't want to do it. A recent study in the journal Midwifery demonstrates that a program of extended breastfeeding support has no impact on rates or duration of breastfeeding.

Effect of an extended midwifery postnatal support programme on the duration of breast feeding: A randomised controlled trial reports the results of a randomized controlled trial involving 849 women who had given birth to a healthy, term, singleton baby and who wished to breast feed. This is a critical point. The authors were not trying to influence the behavior of women who did not intend to breastfeed; they were trying to support the efforts of women who wanted to breastfeed.

According to the authors:
...[P]articipants were allocated at random to EMS, in which they were offered a one-to-one postnatal educational session and weekly home visits with additional telephone contact by a midwife until their baby was six weeks old; or standard postnatal midwifery support (SMS). Participants were stratified for parity and tertiary education.
The study revealed:
there was no difference between the groups at six months postpartum for either full breast feeding [EMS 43.3% versus SMS 42.5%, relative risk (RR) 1.02, 95% confidence interval (CI) 0.87–1.19] or any breast feeding (EMS 63.9% versus SMS 67.9%, RR 0.94, 95%CI 0.85–1.04).
The authors concluded:
the EMS programme did not succeed in improving breast-feeding rates in a setting where there was high initiation of breast feeding. Breast-feeding rates were high but still fell short of national goals.

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