Peer support and exclusive breastfeeding duration in low and middle-income countries: a systematic review and meta-analysis.

To examine the effect of peer support on duration of exclusive breastfeeding (EBF) in low and middle-income countries (LMICs).Medline, EMBASE, and Cochrane Central Register for Controlled Trials were searched from inception to April 2012.Two authors independently searched, reviewed, and assessed the...

Full description

Bibliographic Details
Main Authors: Christopher R Sudfeld, Wafaie W Fawzi, Chandrakant Lahariya
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3445598?pdf=render
_version_ 1811231797941370880
author Christopher R Sudfeld
Wafaie W Fawzi
Chandrakant Lahariya
author_facet Christopher R Sudfeld
Wafaie W Fawzi
Chandrakant Lahariya
author_sort Christopher R Sudfeld
collection DOAJ
description To examine the effect of peer support on duration of exclusive breastfeeding (EBF) in low and middle-income countries (LMICs).Medline, EMBASE, and Cochrane Central Register for Controlled Trials were searched from inception to April 2012.Two authors independently searched, reviewed, and assessed the quality of randomized controlled trials utilizing peer support in LMICs. Meta-analysis and metaregression techniques were used to produce pooled relative risks and investigate sources of heterogeneity in the estimates.Eleven randomized controlled trials conducted at 13 study sites met the inclusion criteria for systematic review. We noted significant differences in study populations, peer counselor training methods, peer visit schedule, and outcome ascertainment methods. Peer support significantly decreased the risk of discontinuing EBF as compared to control (RR: 0.71; 95% CI: 0.61-0.82; I(2) =92%). The effect of peer support was significantly reduced in settings with >10% community prevalence of formula feeding as compared to settings with <10% prevalence (p=0.048). There was no evidence of effect modification by inclusion of low birth weight infants (p=0.367) and no difference in the effect of peer support on EBF at 4 versus 6 months postpartum (p=0.398).Peer support increases the duration of EBF in LMICs; however, the effect appears to be reduced in formula feeding cultures. Future studies are needed to determine the optimal timing of peer visits, how to best integrate peer support into packaged intervention strategies, and the effectiveness of supplemental interventions to peer support in formula feeding cultures.
first_indexed 2024-04-12T10:52:09Z
format Article
id doaj.art-92d2421a818f4e66b1317b576c3ddf38
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-04-12T10:52:09Z
publishDate 2012-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-92d2421a818f4e66b1317b576c3ddf382022-12-22T03:36:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0179e4514310.1371/journal.pone.0045143Peer support and exclusive breastfeeding duration in low and middle-income countries: a systematic review and meta-analysis.Christopher R SudfeldWafaie W FawziChandrakant LahariyaTo examine the effect of peer support on duration of exclusive breastfeeding (EBF) in low and middle-income countries (LMICs).Medline, EMBASE, and Cochrane Central Register for Controlled Trials were searched from inception to April 2012.Two authors independently searched, reviewed, and assessed the quality of randomized controlled trials utilizing peer support in LMICs. Meta-analysis and metaregression techniques were used to produce pooled relative risks and investigate sources of heterogeneity in the estimates.Eleven randomized controlled trials conducted at 13 study sites met the inclusion criteria for systematic review. We noted significant differences in study populations, peer counselor training methods, peer visit schedule, and outcome ascertainment methods. Peer support significantly decreased the risk of discontinuing EBF as compared to control (RR: 0.71; 95% CI: 0.61-0.82; I(2) =92%). The effect of peer support was significantly reduced in settings with >10% community prevalence of formula feeding as compared to settings with <10% prevalence (p=0.048). There was no evidence of effect modification by inclusion of low birth weight infants (p=0.367) and no difference in the effect of peer support on EBF at 4 versus 6 months postpartum (p=0.398).Peer support increases the duration of EBF in LMICs; however, the effect appears to be reduced in formula feeding cultures. Future studies are needed to determine the optimal timing of peer visits, how to best integrate peer support into packaged intervention strategies, and the effectiveness of supplemental interventions to peer support in formula feeding cultures.http://europepmc.org/articles/PMC3445598?pdf=render
spellingShingle Christopher R Sudfeld
Wafaie W Fawzi
Chandrakant Lahariya
Peer support and exclusive breastfeeding duration in low and middle-income countries: a systematic review and meta-analysis.
PLoS ONE
title Peer support and exclusive breastfeeding duration in low and middle-income countries: a systematic review and meta-analysis.
title_full Peer support and exclusive breastfeeding duration in low and middle-income countries: a systematic review and meta-analysis.
title_fullStr Peer support and exclusive breastfeeding duration in low and middle-income countries: a systematic review and meta-analysis.
title_full_unstemmed Peer support and exclusive breastfeeding duration in low and middle-income countries: a systematic review and meta-analysis.
title_short Peer support and exclusive breastfeeding duration in low and middle-income countries: a systematic review and meta-analysis.
title_sort peer support and exclusive breastfeeding duration in low and middle income countries a systematic review and meta analysis
url http://europepmc.org/articles/PMC3445598?pdf=render
work_keys_str_mv AT christopherrsudfeld peersupportandexclusivebreastfeedingdurationinlowandmiddleincomecountriesasystematicreviewandmetaanalysis
AT wafaiewfawzi peersupportandexclusivebreastfeedingdurationinlowandmiddleincomecountriesasystematicreviewandmetaanalysis
AT chandrakantlahariya peersupportandexclusivebreastfeedingdurationinlowandmiddleincomecountriesasystematicreviewandmetaanalysis