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Subject:
From:
"Susan E. Burger" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 2 Jul 2002 12:56:28 -0400
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I've been trying to study for the IBCLE exams with variable results so I
haven't been really following all the LACTNET discussions although someone
(I think it was Rachel Myr) said LACTNET was a great way to study).  So
forgive me if I don't happen to have picked up on the finer points of the
discussions surrounding a study on the effectiveness of support provided
for breastfeeding.

If someone hasn't already mentioned it, there is a very nice compliation of
intervention research that was done by Cythina Green on
"Improving Breastfeeding Behaviors:  Evidence from Two Decades of
Intervention Research".  It is published by the LINKAGES Project of the
Academy for Educational Development (www.linkagesproject.org).  It both
covers various interventions:

* National Policy Changes
* Prenatal Education
* Changes in Hospital Practices including Health Worker Training (which
does have some references to training, but, if I remember correctly, not as
substantial as IBCLCs)
* Mass Media and Print Materials
* Peer Counseling and Education
* Women's Groups
* Postpartum Counseling and Guidance by Health Workers

and also different benefits from these interventions

* early initiation of breastfeeding
* feeding of colostrum
* exclusive breastfeeding for the first six months
* continued breastfeeding through the 2nd year and beyond

Its a great review for thinking through the major issues of improving
support for breastfeeding in a variety of settings, though it doesn't get
down to the nitty gritty specifics of any one particular intervention.

The review also goes over some of the issues in terms of study design that
I would think should be interesting background for anyone planning a study.
The review doesn't include cost-effectiveness because I think none of the
studies really were designed in a way to address this particular outcome.
There is a difference between the cost-effectiveness of breastfeeding
compared to the cost-effectiveness of any one intervention designed to
increase breastfeeding (intiation, frequency, duration, etc).

Hope this is of some interest.

Susan Burger, PhD, MHS
(obviously in procrastination mode)

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