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Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
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Figure 1

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
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Figure 2

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.

Comparison 1 Formal BF education verus routine care, Outcome 1 Initiation rate of breastfeeding.
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Analysis 1.1

Comparison 1 Formal BF education verus routine care, Outcome 1 Initiation rate of breastfeeding.

Comparison 1 Formal BF education verus routine care, Outcome 2 Breastfeeding at three months.
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Analysis 1.2

Comparison 1 Formal BF education verus routine care, Outcome 2 Breastfeeding at three months.

Comparison 1 Formal BF education verus routine care, Outcome 3 Breastfeeding at six months.
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Analysis 1.3

Comparison 1 Formal BF education verus routine care, Outcome 3 Breastfeeding at six months.

Comparison 1 Formal BF education verus routine care, Outcome 4 Exclusive breastfeeding at three months.
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Analysis 1.4

Comparison 1 Formal BF education verus routine care, Outcome 4 Exclusive breastfeeding at three months.

Comparison 1 Formal BF education verus routine care, Outcome 5 Exclusive breastfeeding at six months.
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Analysis 1.5

Comparison 1 Formal BF education verus routine care, Outcome 5 Exclusive breastfeeding at six months.

Comparison 1 Formal BF education verus routine care, Outcome 6 Duration of any breastfeeding (weeks).
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Analysis 1.6

Comparison 1 Formal BF education verus routine care, Outcome 6 Duration of any breastfeeding (weeks).

Comparison 2 One BF education versus another BF education, Outcome 1 Initiation of BF.
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Analysis 2.1

Comparison 2 One BF education versus another BF education, Outcome 1 Initiation of BF.

Comparison 2 One BF education versus another BF education, Outcome 2 Breastfeeding at three months.
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Analysis 2.2

Comparison 2 One BF education versus another BF education, Outcome 2 Breastfeeding at three months.

Comparison 2 One BF education versus another BF education, Outcome 3 Breastfeeding at six months.
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Analysis 2.3

Comparison 2 One BF education versus another BF education, Outcome 3 Breastfeeding at six months.

Comparison 2 One BF education versus another BF education, Outcome 4 Exclusive breastfeeding at six months.
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Analysis 2.4

Comparison 2 One BF education versus another BF education, Outcome 4 Exclusive breastfeeding at six months.

Comparison 2 One BF education versus another BF education, Outcome 5 Duration of any breastfeeding.
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Analysis 2.5

Comparison 2 One BF education versus another BF education, Outcome 5 Duration of any breastfeeding.

Comparison 3 Multiple BF educational interventions versus a single BF educational interventions, Outcome 1 Initiation rate of breastfeeding.
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Analysis 3.1

Comparison 3 Multiple BF educational interventions versus a single BF educational interventions, Outcome 1 Initiation rate of breastfeeding.

Comparison 3 Multiple BF educational interventions versus a single BF educational interventions, Outcome 2 Breastfeeding at three months.
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Analysis 3.2

Comparison 3 Multiple BF educational interventions versus a single BF educational interventions, Outcome 2 Breastfeeding at three months.

Comparison 3 Multiple BF educational interventions versus a single BF educational interventions, Outcome 3 Breastfeeding at six months.
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Analysis 3.3

Comparison 3 Multiple BF educational interventions versus a single BF educational interventions, Outcome 3 Breastfeeding at six months.

Comparison 3 Multiple BF educational interventions versus a single BF educational interventions, Outcome 4 Exclusive breastfeeding at three months.
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Analysis 3.4

Comparison 3 Multiple BF educational interventions versus a single BF educational interventions, Outcome 4 Exclusive breastfeeding at three months.

Comparison 3 Multiple BF educational interventions versus a single BF educational interventions, Outcome 5 Duration of any breastfeeding.
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Analysis 3.5

Comparison 3 Multiple BF educational interventions versus a single BF educational interventions, Outcome 5 Duration of any breastfeeding.

Comparison 3 Multiple BF educational interventions versus a single BF educational interventions, Outcome 6 Mastitis.
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Analysis 3.6

Comparison 3 Multiple BF educational interventions versus a single BF educational interventions, Outcome 6 Mastitis.

Comparison 3 Multiple BF educational interventions versus a single BF educational interventions, Outcome 7 Breastfeeding complication (nipple pain).
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Analysis 3.7

Comparison 3 Multiple BF educational interventions versus a single BF educational interventions, Outcome 7 Breastfeeding complication (nipple pain).

Comparison 3 Multiple BF educational interventions versus a single BF educational interventions, Outcome 8 Breastfeeding complication (nipple trauma).
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Analysis 3.8

Comparison 3 Multiple BF educational interventions versus a single BF educational interventions, Outcome 8 Breastfeeding complication (nipple trauma).

Comparison 4 Different combinations of multiple methods of providing education, Outcome 1 Exclusive breastfeeding at three months.
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Analysis 4.1

Comparison 4 Different combinations of multiple methods of providing education, Outcome 1 Exclusive breastfeeding at three months.

Comparison 4 Different combinations of multiple methods of providing education, Outcome 2 Exclusive breastfeeding at six months.
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Analysis 4.2

Comparison 4 Different combinations of multiple methods of providing education, Outcome 2 Exclusive breastfeeding at six months.

Comparison 5 Multiple interventions versus no formal BF education, Outcome 1 Exclusive breastfeeding at three months.
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Analysis 5.1

Comparison 5 Multiple interventions versus no formal BF education, Outcome 1 Exclusive breastfeeding at three months.

Comparison 5 Multiple interventions versus no formal BF education, Outcome 2 Exclusive breastfeeding at six months.
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Analysis 5.2

Comparison 5 Multiple interventions versus no formal BF education, Outcome 2 Exclusive breastfeeding at six months.

Comparison 1. Formal BF education verus routine care

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Initiation rate of breastfeeding Show forest plot

5

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 BF education workshop versus routine care

1

80

Risk Ratio (M‐H, Fixed, 95% CI)

1.19 [0.97, 1.45]

1.2 Peer counselling versus routine care

1

59

Risk Ratio (M‐H, Fixed, 95% CI)

1.82 [1.13, 2.93]

1.3 BF practical skills versus routine care

1

616

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.98, 1.04]

1.4 BF attitude education versus routine care

1

618

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.95, 1.02]

1.5 Training programme versus routine care

1

1162

Risk Ratio (M‐H, Fixed, 95% CI)

1.04 [0.98, 1.11]

1.6 Structured group prenatal education versus routine care

1

165

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.87, 1.11]

2 Breastfeeding at three months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 BF education workshop versus routine care

1

185

Risk Ratio (M‐H, Fixed, 95% CI)

1.07 [0.92, 1.24]

3 Breastfeeding at six months Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 BF education workshop versus routine care

1

178

Risk Ratio (M‐H, Fixed, 95% CI)

1.15 [0.87, 1.51]

3.2 BF practical skills versus routine care

1

596

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.87, 1.17]

3.3 BF attitude education versus routine care

1

592

Risk Ratio (M‐H, Fixed, 95% CI)

0.92 [0.79, 1.07]

4 Exclusive breastfeeding at three months Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 BF education workshop versus routine care

1

185

Risk Ratio (M‐H, Fixed, 95% CI)

1.08 [0.84, 1.38]

4.2 Structured group prenatal education versus routine care

1

168

Risk Ratio (M‐H, Fixed, 95% CI)

1.08 [0.81, 1.43]

5 Exclusive breastfeeding at six months Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 BF education workshop versus routine care

1

178

Risk Ratio (M‐H, Fixed, 95% CI)

1.13 [0.70, 1.80]

5.2 BF practical skills versus routine care

1

596

Risk Ratio (M‐H, Fixed, 95% CI)

1.19 [0.69, 2.05]

5.3 Formal BF attitude versus routine care

1

592

Risk Ratio (M‐H, Fixed, 95% CI)

1.16 [0.67, 2.01]

6 Duration of any breastfeeding (weeks) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

6.1 Structured group prenatal education versus routine care

1

165

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐2.78, 2.78]

Figures and Tables -
Comparison 1. Formal BF education verus routine care
Comparison 2. One BF education versus another BF education

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Initiation of BF Show forest plot

2

Odds Ratio (Fixed, 95% CI)

Subtotals only

1.1 Peer counselling versus BF information and advice

1

2398

Odds Ratio (Fixed, 95% CI)

1.11 [0.86, 1.43]

1.2 BF practical skills versus BF attitude education

1

614

Odds Ratio (Fixed, 95% CI)

1.03 [0.99, 1.07]

2 Breastfeeding at three months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 Group education versus individual education

1

74

Risk Ratio (M‐H, Fixed, 95% CI)

2.84 [0.61, 13.18]

3 Breastfeeding at six months Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 BF practical skills versus BF attitude education

1

590

Odds Ratio (M‐H, Fixed, 95% CI)

1.21 [0.87, 1.67]

4 Exclusive breastfeeding at six months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 BF practical skills versus BF attitude education

1

590

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.61, 1.73]

5 Duration of any breastfeeding Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

5.1 BF education discussion versus handouts

1

16

Mean Difference (IV, Fixed, 95% CI)

6.20 [‐10.84, 23.24]

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Comparison 2. One BF education versus another BF education
Comparison 3. Multiple BF educational interventions versus a single BF educational interventions

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Initiation rate of breastfeeding Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 LC + routine BF education versus routine BF education

1

144

Risk Ratio (M‐H, Random, 95% CI)

1.33 [0.86, 2.07]

2 Breastfeeding at three months Show forest plot

1

Odds Ratio (Fixed, 95% CI)

Subtotals only

2.1 LC + BF booklet versus BF booklet

1

698

Odds Ratio (Fixed, 95% CI)

0.82 [0.59, 1.14]

3 Breastfeeding at six months Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Video + education session versus pamphlets

1

175

Risk Ratio (M‐H, Fixed, 95% CI)

1.59 [0.86, 2.94]

3.2 Routine BF education + formal BF education versus routine BF education

1

1249

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.79, 1.19]

4 Exclusive breastfeeding at three months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 LC + BF booklet versus BF booklet

1

698

Risk Ratio (M‐H, Fixed, 95% CI)

0.85 [0.68, 1.08]

5 Duration of any breastfeeding Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

5.1 BF education discussion + baby quarantine versus BF handout

1

16

Mean Difference (IV, Fixed, 95% CI)

14.20 [‐2.97, 31.37]

5.2 BF education discussion+ baby quarantine versus BF education discussion

1

18

Mean Difference (IV, Fixed, 95% CI)

8.0 [‐6.84, 22.84]

6 Mastitis Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

6.1 Formal BF education + LC versus routine BF education

1

70

Risk Ratio (M‐H, Fixed, 95% CI)

0.2 [0.01, 4.02]

7 Breastfeeding complication (nipple pain) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

7.1 Formal BF education + LC versus routine BF education

1

70

Mean Difference (IV, Fixed, 95% CI)

‐19.8 [‐23.23, ‐16.37]

8 Breastfeeding complication (nipple trauma) Show forest plot

1

70

Mean Difference (IV, Fixed, 95% CI)

38.65 [32.95, 44.35]

8.1 Formal BF education + LC versus routine BF education

1

70

Mean Difference (IV, Fixed, 95% CI)

38.65 [32.95, 44.35]

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Comparison 3. Multiple BF educational interventions versus a single BF educational interventions
Comparison 4. Different combinations of multiple methods of providing education

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Exclusive breastfeeding at three months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 BF booklet + video + LC versus BF booklet + video

1

150

Risk Ratio (M‐H, Fixed, 95% CI)

1.29 [0.80, 2.06]

2 Exclusive breastfeeding at six months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 BF booklet + video + LC versus BF booklet + video

1

169

Risk Ratio (M‐H, Fixed, 95% CI)

2.23 [1.01, 4.92]

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Comparison 4. Different combinations of multiple methods of providing education
Comparison 5. Multiple interventions versus no formal BF education

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Exclusive breastfeeding at three months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 BF booklet + video + LC versus no formal BF education

1

159

Risk Ratio (M‐H, Fixed, 95% CI)

2.02 [1.16, 3.49]

2 Exclusive breastfeeding at six months Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 BF booklet + video + LC versus no formal BF education

1

175

Risk Ratio (M‐H, Fixed, 95% CI)

2.11 [0.99, 4.52]

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Comparison 5. Multiple interventions versus no formal BF education