Primary Care Interventions to Promote Breastfeeding: Article

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Table 2. Interventions to Support or Promote Breastfeeding

Intervention	Definition
Formal or structured breastfeeding education	Structured one-to-one or group education sessions or classes (e.g., curriculum or standard agenda) directed at mothers or other family members
Breastfeeding support Professional support	System-level: Baby-Friendly Hospital Initiative;¹ training of health professionals Individual-level: one-to-one support during hospital stay or outpatient visits; social support (e.g., home visits or telephone support) from health professionals
Lay support	Peer counseling; social support (e.g., home visits or telephone support) from peers
Other interventions	Examples include skin-to-skin contact,² pacifier use, and motivational interviews³

¹ The Baby-Friendly Hospital Initiative promotes, protects, and supports breastfeeding through The Ten Steps to Successful Breastfeeding for Hospitals. The steps for the United States are: 1) maintain a written breastfeeding policy that is routinely communicated to all health care staff; 2) train all health care staff in skills necessary to implement this policy; 3) inform all pregnant women about the benefits and management of breastfeeding; 4) help mothers initiate breastfeeding within 1 hour of birth; 5) show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants; 6) give infants no food or drink other than breast milk, unless medically indicated; 7) practice "rooming in" (allowing mothers and infants to remain together 24 hours a day); 8) encourage unrestricted breastfeeding; 9) give no pacifiers or artificial nipples to breastfeeding infants; and 10) foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic (accessed at www.babyfriendlyusa.org/eng/10steps.html on 3 September 2008).
² After birth, the newborn is weighed and then immediately placed naked in a prone position between the mother’s breasts until the mother chooses to stop the contact or the newborn seems to be ready for feeding.
³ Motivational interviewing with the goal of decreasing ambivalence and resistance toward sustained breastfeeding.

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