Literature review for - Flourish Paediatrics

Population/study
information
breastfeeding duration.
10 studies investigated a
dose-response relationship
with BF duration
Systematic literature search
of Cochrane Library (Issue
2, 2001), Medline,
CINAHL, Current
Contents, PsychInfo,
Lactation Resource Centre
(grey literature). J Hum
Lact and Birth hand
searched volumes 1985 to
end 2000.
Systematic literature search
of Medline (1966- July 1997)
Scientific Citations Index
(1985 – July 1997)
Pediatrics, J of Pediatrics,
NEMJ and Lancet (1966 –
July 1997)
Primiparous mothers
South Australia, Australia
Recruited from antenatal
clinic at large, teaching
hospital (sample not
necessarily random)
First contact prior to baby’s
birth, follow-up in hospital
post delivery, 1 week, 6
weeks, 3 months & 6 months
postpartum
Key words smoking AND
breastfeeding or lactation.
Languages included English,
Key words were “smoking”
AND “breastfeeding”
French, Spanish and
Portuguese
Quality P P P P
Results
Intention to breastfeed
5/6 studies reported a
significant negative
association between
maternal smoking and
intention to breastfeed. One
UK prospective cohort
study (ALSPAC) reported a
dose-response relationship
with # of cigarettes,
although no significant
difference between light
smokers and non-smokers
Pooled OR 1.93 (95% CI
1.55-2.40)
For studies with less than
15% loss to follow-up and
adequate adjustment for
confounders
Adjusted OR of 1.50 (95% CI
1.34-1.68)
Adj HR for weaning (95%CI)
1.35 (0.85-2.16)
Estimated HR for
parsimonious model
predicting duration of BF
Adj HR (95%CI)
1.49 (0.97-2.28)
Glasgow, Scotland
Recruitment from 4
maternity units
Adj OR intention to
breastfeed at maternity
booking:
0.55 (95%CI 0.41-0.75)
302