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More support needed for strategies that work to support breastfeeding in work

A new Cochrane review sought knowledge from randomised trials on the effects of workplace interventions to support breastfeeding. They found none.

Women are an increasingly large proportion of people in employment. Many return to work after the birth of their babies, at a time when they could continue breastfeeding. However, in the absence of support to do so, they may decide to stop breastfeeding or stop sooner then they would otherwise have done.

The authors of the Cochrane review knew about a couple of un-controlled studies of interventions to promote the uptake or continuation of breastfeeding and describe these in the Background to their review. That research showed that the interventions could be successful, and could also reduce the amount of work time missed by the mothers. However, the studies were not randomised and all of the women chose to take part in the intervention group. The results, therefore, might not be a reliable guide to the effects of the interventions.

The authors of the new review set out to find reliable evidence. They were interested in any post-delivery intervention at the workplace, provided in the context of employment. Randomised trials that compared the intervention with another strategy or with no intervention, were eligible. The search was wide. It went into the traditional databases of healthcare, CENTRAL and MEDLINE, but also several databases that cover the social sciences literature. The search covered many decades and all languages. Despite this effort, they found no trials that were suitable for the review.

The authors conclude their Cochrane review by stressing the need for randomised trials. These trials should look at the rate and duration of breastfeeding, and whether breastfeeding is exclusive or partial. Other outcomes worth exploring might be work related and the mother-child relationship. And, the authors give examples of some of the interventions that could be assessed: lactation breaks, creches and facilities to express breast milk.

This Cochrane review is available in full at www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD006177/frame.html

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September 24 2007

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