Evidence Check: Review of effective strategies to promote breastfeeding

The Sax Institute has published an Evidence Check review focusing on interventions to support breastfeeding, which are among the key childbirth and postnatal interventions that have a beneficial impact on maternal and newborn outcomes.

Babies who are not breastfed, and women who don’t breastfeed, are at an increased chance of many health risks in both the short and long term, including in high-income countries such as Australia. Studies in countries such as the US, Britain and Australia have also shown that the economic and health treatment costs of prevailing low rates of breastfeeding are high.

However, only about one in 10 Australian children are breastfed according to national dietary guidelines, and only about one in 20 meet WHO optimal breastfeeding recommendations. Virtually all children (92%–96%) in Australia initiated breastfeeding in 2010–11, but one in three received non-human milk or formula before one month of age. Median duration of breastfeeding is less than 7–9 months, though 60% of babies still breastfeed at six months of age. About 18% of mothers continue to breastfeed their child beyond 12 months, and 7% are still breastfed at 19–24 months. However, the gap between the most disadvantaged and least disadvantaged families has widened.

This review, commissioned by the Australian Government Department of Health, examines the effectiveness of strategies designed to improve breastfeeding considering their impact on breastfeeding initiation, exclusivity and duration. The review found that breastfeeding practices can be improved through a range of proven interventions in health settings. The Baby Friendly Health Initiative Ten Steps approach is central to achieving this; however, systematic approaches that promote wide access to maternity care as well as policies to protect, support and promote breastfeeding are also necessary.

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