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Extending Breastfeeding Duration Through Primary Care: A Systematic Review of Prenatal and Postnatal Interventions

Rua Pacheco Leão 536, casa 3, Jardim Botânico, 22460-030 Rio de Janeiro, RJ, Brazil

Luiz Antonio Bastos Camacho, MD, DrPH

Brazilian National School of Public Health

Alison E. Tedstone, PhD

London School of Hygiene and Tropical Medicine

This literature review provides an overview of the effectiveness of strategies and procedures used to extend breastfeeding duration. Interventions carried out during pregnancy and/or infant care conducted in primary health care services, community settings, or hospital clinics were included. Interventions covering only the delivery period were excluded. Interventions that were most effective in extending the duration of breastfeeding generally combined information, guidance, and support and were long term and intensive. During prenatal care, group education was the only effective strategy reported. Home visits used to identify mothers' concerns with breastfeeding, assist with problem solving, and involve family members in breastfeeding support were effective during the postnatal period or both periods. Individual education sessions were also effective in these periods, as was the combination of 2 or 3 of these strategies in interventions involving both periods. Strategies that had no effect were characterized by no face-to-face interaction, practices contradicting messages, or small-scale interventions.

Key Words: breastfeeding duration • effectiveness • procedures • strategies • primary care

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