Outcome Measures in Interventions That Enhance Breastfeeding Initiation, Duration, and Exclusivity

Abstract

Objective-The purpose of this review was to examine outcome measures used in interventions focusing on enhancement of breastfeeding initiation, duration, and exclusivity. Methods-A literature search guided by search terms on outcome measures of breastfeeding interventions was conducted using PubMed, CINAHL Plus, & PsycINFO databases on publications between 2006 and 2017.Results-Nine studies were included in this review, using PRISMA guidelines. Rates of breastfeeding initiation, duration, and exclusivity were measured during specific points in time. Data collection methods involve interviews, self-report, observations, and/or feeding logs. Although breastfeeding types (exclusive breastfeeding, predominant breastfeeding, and complementary breastfeeding) were measured, methods of infant feeding (breastfeeding and bottle feeding) were rarely assessed, ignoring significant mediators or moderators of breastfeeding.Conclusions-There were methodological limitations to the reviewed studies: (1) a 24-hour recall bias, (2) misclassification of breastfeeding categories, (3) lack of consistency in breastfeeding definitions, and (4) few reports of the reason for breastfeeding discontinuation. Future studies should focus on the modifiable cause of the problem: outcome measures attributed to the targets of the intervention, followed by breastfeeding initiation, duration, and/or exclusivity.

Midwife-Led Continuity of Antenatal Care and Breastfeeding Duration Beyond Postpartum Hospital Discharge: A Systematic Review

“…Use of an internationally accepted definition of breastfeeding and utilization of valid and reliable methods to assess breastfeeding duration are fundamental to examining the effectiveness of health care interventions on breastfeeding outcomes (Wood & Woods, 2018). Although some authors of studies included in this review described breastfeeding using the terms “fully breastfeeding” and “exclusive breastfeeding,” these descriptors were not consistent with internationally accepted breastfeeding definitions.…”

“…Within the reviewed studies, breastfeeding outcomes were mostly measured through self-completed questionnaires, surveys, or diaries. This outcome measure is among the simplest method of collecting information about breastfeeding status and limits interviewer bias (Wood & Woods, 2018). However, where there is inappropriate terminology of breastfeeding status used or a failure to cite recognized definitions—which was a common finding across all included studies—misclassifications of breastfeeding outcomes may occur (Wood & Woods, 2018).…”

Robust estimation of infant feeding indicators by data quality assessment of longitudinal electronic health records from birth up to 18 months of life

“…The outcomes' indicators recommended for BFHI monitoring are the "indicators for assessing infant and young child feeding (IYCF)" defined by WHO/UNICEF [13]. In particular, breastfeeding initiation, duration and exclusivity are major outcomes for breastfeeding studies [14]. Also, to achieve BFHI accreditation, health facilities must demonstrate a rate of at least 75% exclusive breastfeeding at discharge.…”

Diseño, construcción y evaluación de repositorios estandarizados con calidad de datos asegurada para la monitorización de la atención a la alimentación infantil

“…La OMS/UNICEF también ha definido el conjunto de "Indicadores para evaluar las prácticas de alimentación del lactante y del niño pequeño" (WHO, UNICEF, 2007). Incluye la definición de indicadores para medir la iniciación, la duración y la exclusividad de la lactancia materna, que son los principales resultados de los estudios sobre lactancia materna (Wood & Woods, 2018). Este conjunto de indicadores constituye también el conjunto de indicadores de resultado recomendados para el seguimiento de la BFHI.…”

“…Los indicadores de resultado recomendados para el seguimiento de la BFHI son los "indicadores para evaluar las prácticas de alimentación del lactante y del niño pequeño (IYCF, del inglés Indicators for assessing infant and young child feeding practices)" definidos por la OMS / UNICEF (WHO, UNICEF, 2007). En particular, el inicio, la duración y la exclusividad de la lactancia materna son resultados importantes de los estudios sobre lactancia materna (Wood & Woods, 2018). Además, para lograr la acreditación BFHI, los establecimientos sanitarios deben demostrar una tasa de al menos 75% de lactancia materna exclusiva al alta.…”