Pendidikan penyusuan susu ibu antenatal (semasa tempoh kehamilan) untuk memanjangkan tempoh masa penyusuan
Abstract
Background
Breastfeeding (BF) is well recognised as the best food for infants. The impact of antenatal BF education on the duration of BF has not been evaluated.
Objectives
To evaluate the effectiveness of antenatal BF education for increasing BF initiation and duration.
Search methods
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (2 December 2011), CENTRAL (The Cochrane Library 2011, Issue 11), MEDLINE (1966 to 30 November 2011) and Scopus (January 1985 to 30 November 2011). We contacted experts and searched reference lists of retrieved articles.
Selection criteria
All identified published, unpublished and ongoing randomised controlled trials (RCTs) assessing the effect of formal antenatal BF education or comparing two different methods of formal antenatal BF education, on duration of BF. We excluded RCTs that also included intrapartum or postpartum BF education.
Data collection and analysis
We assessed all potential studies identified as a result of the search strategy. Two review authors extracted data from each included study using the agreed form and assessed risk of bias. We resolved discrepancies through discussion.
Main results
We included 19 studies with 8506 women in the review and 16 studies involving 8262 women contributed data to the analyses. We did not carry out any meta‐analysis because there was only one study for each comparison.
Five studies compared a single method of BF education with routine care. Peer counselling significantly increased BF initiation.
Three studies compared one form of BF education versus another. No intervention was significantly more effective than another intervention in increasing initiation or duration of BF.
Seven studies compared multiple methods versus a single method of BF education. Combined BF educational interventions were not significantly better than a single intervention in initiating or increasing BF duration. However, in one trial a combined BF education significantly reduced nipple pain and trauma.
One study compared different combinations of interventions. There was a marginally significant increase in exclusive BF at six months in women receiving a booklet plus video plus lactation consultation (LC) compared with the booklet plus video only.
Two studies compared multiple methods of BF education versus routine care. The combination of BF booklet plus video plus LC was significantly better than routine care for exclusive BF at three months.
Authors' conclusions
Because there were significant methodological limitations and the observed effect sizes were small, it is not appropriate to recommend any specific antenatal BF education.There is an urgent need to conduct RCTs with adequate power to evaluate the effectiveness of antenatal BF education.
PICO
Plain language summary
Pendidikan penyusuan susu ibu antenatal untuk memanjangkan tempoh masa penyusuan
Penyusuan susu ibu diiktiraf sebagai makanan terbaik untuk bayi dan Pertubuhan Kesihatan Sedunia (WHO) mengesyorkan bahawa semua bayi harus diberikan susu ibu secara eksklusif selama sekurang‐kurangnya enam bulan selepas lahir. Makanan tambahan yang diberikan sebelum umur enam bulan biasanya mengetepikan susu ibu dan tidak memberi apa‐apa faedah kesihatan. Penyusuan susu ibu boleh memperbaiki kesihatan anak, kesihatan ibu dan juga hubungan ibu‐bayi. Bayi yang diberi susu ibu mempunyai kadar penyakit gastrousus, penyakit respiratori, otitis media (jangkitan kuman telinga) dan alahan yang lebih rendah serta ketajaman penglihatan, perkembangan pertuturan dan kognitif yang lebih baik. Kesan kepada tempoh penyusuan susu ibu daripada intervensi pendidikan semasa kehamilan belum lagi dinilai.
Ulasan ini termasuk data daripada 16 kajian rawak terkawal yang melibatkan 8262 wanita, kebanyakannya daripada negara‐negara maju termasuk USA, Kanada, UK dan Australia. Kaunseling rakan sebaya, perundingan penyusuan dan pendidikan penyusuan susu ibu secara formal semasa kehamilan kelihatan memanjangkan tempoh masa penyusuan. Kaunseling rakan sebaya juga kelihatan lebih baik berbanding penjagaan rutin untuk memulakan penyusuan susu ibu. Namun demikian, disebabkan kebanyakan kajian yang termasuk adalah berkualiti rendah dan kesan pendidikan penyusuan adalah agak kecil, tiada intervensi pendidikan penyusuan susu ibu secara spesifik sesuai disyorkan. Hasil ulasan ini adalah berdasarkan kajian tunggal justeru kajian‐kajian klinikal yang direka dengan baik dengan saiz sampel yang mencukupi diperlukan.
