This series of fact sheets is based on the work of the U.S. Preventive Services Task Force (USPSTF). The USPSTF systematically reviews the evidence of effectiveness of a wide range of clinical preventive services—including screening, counseling, and chemoprevention (the use of medication to prevent disease)—to develop recommendations for preventive care in the primary care setting.
This fact sheet presents highlights of USPSTF recommendations on this topic and should not be used to make treatment or policy decisions.
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The USPSTF recommends structured breastfeeding education and behavioral counseling programs to promote breastfeeding. The USPSTF found insufficient evidence to recommend for or against:
Effective breastfeeding education and behavioral counseling programs use individual or group sessions led by specially trained nurses or lactation specialists, usually lasting 30 to 90 minutes. Sessions generally begin during the prenatal period and cover the benefits of breastfeeding for infant and mother, basic physiology, equipment, technical training in positioning and latch-on techniques, and behavioral training in skills required to overcome common situational barriers to breastfeeding and to garner needed social support.
The most effective interventions use brief, directive health education combined with behaviorally-oriented skills training and problem-solving counseling. They all use face-to-face sessions conducted outside the routine clinical visit.
There is evidence that providing ongoing support for patients, through in-person visits or telephone contacts with providers or counselors, increases the number of women who continue to breastfeed for up to 6 months.
Structured programs combining breastfeeding education with behavioral counseling promote the initiation and continuation of breastfeeding. |
The USPSTF found no evidence that counseling alone by primary care providers during routine office visits, or peer counseling initiated in the clinical setting with no additional intervention, are effective in promoting breastfeeding. Whether the combination of provider or peer counseling with structured programs is effective in promoting breastfeeding requires further study.
Counseling alone is not as effective as structured programs in promoting breastfeeding. |
No studies have evaluated whether advice by a woman's primary obstetric provider or by the infant's primary pediatric provider are effective on their own in increasing breastfeeding rates. An effective role of the primary care obstetric, pediatric, or family medicine provider is to refer women to structured programs, such as those described above.
For more information on breastfeeding education, contact:
Centers for Disease Control and Prevention
http://www.cdc.gov
healthfinder®
http://www.healthfinder.gov
Health Resources and Services Administration
http://www.hrsa.gov
National Institute of Child Health & Human Development
http://www.nichd.nih.gov
More detailed information is available in:
Members of the USPSTF represent the fields of family medicine, gerontology, obstetrics-gynecology, pediatrics, nursing, prevention research, and psychology.
Alfred O. Berg, M.D., M.P.H., Chair
Janet D. Allan, Ph.D., R.N., C.S., Vice-chair
Paul S. Frame, M.D.
Charles J. Homer, M.D., M.P.H.*
Mark S. Johnson, M.D., M.P.H.
Jonathan D. Klein, M.D., M.P.H.
Tracy A. Lieu, M.D., M.P.H.*
Cynthia D. Mulrow, M.D., M.Sc.
C. Tracy Orleans, Ph.D.
Jeffrey F. Peipert, M.D., M.P.H.*
Nola J. Pender, Ph.D., R.N.*
Albert L. Siu, M.D., M.S.P.H.
Steven M. Teutsch, M.D., M.P.H.
Carolyn Westhoff, M.D., M.Sc.*
Steven H. Woolf, M.D., M.P.H.
*Members of the USPSTF at the time this recommendation was finalized.
AHRQ Publication No. APPIP03-0016
Current as of July 2003
Internet Citation:
Behavioral Interventions to Promote Breastfeeding. What's New from the USPSTF. AHRQ Publication No. APPIP03-0016, July 2003. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/3rduspstf/brstfeed/brfeedwh.htm
U.S. Preventive Services Task Force (USPSTF)
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