Literature review for - Flourish Paediatrics

Time to first feed and breastfeeding
Early breastfeeding (colostrum feeding) is important for the establishment of breastfeeding
and infant health. Two Australian cohort studies found no association between breastfeeding
duration and initiating breastfeeding within the first 30 minutes of birth, as recommended by
the BFHI. However, two other Australian cohort studies which investigated the association
with a longer time to first breastfeed (i.e. > 1 hr and >12 hours postpartum) reported a
negative association with breastfeeding duration.
What is the relationship between breastfeeding in first hour after delivery and
breastfeeding outcomes?
Draft Evidence statement
Breastfeeding in the first hour after delivery is associated
with improved breastfeeding outcomes
Draft Grade
C
Component Rating Notes
Evidence Base Good 4 cohort studies (3P, 1 O), 2 cross-sectional study (O), 1
RCT (O),
Consistency Satisfactory All of the studies using time to first breastfeed of > 1 hr
found an effect on breastfeeding outcomes.
Clinical impact Poor There was an inconsistent association
Generalisability Excellent All studies involved either Australian women or women
from relevant population sub-groups
Applicability Satisfactory
The studies included in the body of evidence statement are shown in the Table below
Additional international reviews that provide evidence include; WHO Evidence for the Ten
Steps (WHO/CHD 1998), ABM Protocol (Academy of Breastfeeding Medicine 2008; Philipp
2010).
This is a Millennium Development Goal indicator because of its importance to infant
nutrition (UNICEF 2010).
10