Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment, blinding, selective reporting).
A Cochrane review included 52 studies with a total of 56 451 mother-infant pairs from 21 countries. All forms of extra support analysed together showed an increase in duration of 'any breastfeeding' (includes partial and exclusive breastfeeding) (RR for stopping any breastfeeding before 6 months 0.91, 95% CI 0.88 to 0.96; 40 trials, n=14 227; I² 56%). All forms of extra support together also had a positive effect on duration of exclusive breastfeeding (RR at 6 months 0.86, 95% CI 0.82 to 0.91; RR at 4 to 6 weeks 0.74, 95% CI 0.61 to 0.89; 24 trials, n=7693). Extra support by both lay and professionals had a positive impact on breastfeeding outcomes. Strategies that rely mainly on face-to-face support are more likely to succeed. Support that is only offered reactively, in which women are expected to initiate the contact, is unlikely to be effective. Maternal satisfaction was poorly reported.
However, another Cocrane review included 24 studies (10 056 women) assessing the effectiveness of antenatal breastfeeding education. There was no conclusive evidence supporting any antenatal breastfeeding education for improving initiation of breastfeeding, proportion of women giving any breastfeeding or exclusively breastfeeding at 3 or 6 months or the duration of breastfeeding.
Date of latest search:1 March 2016