Infant Feeding in Leicester City - East Midlands Public Health ...

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35review by the Cochrane Collaboration(49) assessing interventions to promote breastfeeding initiation. Thereview included data from eleven studies which all focused on low income women in the USA and reportsthat health education and peer support interventions were successful in increasing breastfeeding initiationin these groups. The authors also conclude that needs-based, informal interventions appeared to be moresuccessful than generic formal antenatal sessions. There were no specific references to cost effectivenessin this review; it did however report that there were statistically significant differences between control andintervention groups.A systematic review of studies examining the effect of antenatal peer support on breastfeeding initiationwas conducted by Ingram et.al in Canada(50). Their findings showed no significant effect of universalantenatal peer support but that support may be advantageous when it is targeted to individuals. Theseresults complement those of the previous study and suggest that targeted peer support may be asuccessful method of increasing breastfeeding prevalence.Further evidence of the effectiveness of targeted breastfeeding peer support comes from an Americanrandomised controlled trial of low-income women by Pugh et.al(51). The intervention group received extrasupport from a community health nurse and peer counselling team. They found that women in theintervention group breastfed for longer and their babies had fewer sick visits than the control group whoreceived usual care.Morrell et al(52) conducted a randomised controlled trial to investigate the effectiveness of providingcommunity postnatal support workers to assist women in the first month after birth, in addition to routinemidwife visits in the UK. Support workers were available to women for up to ten home visits during the trialperiod with each visit lasting up to three hours. The results of the study showed that there was nosignificant difference in health status or breastfeeding rates between women who had access to communitypostnatal support workers and those who only received routine care from community midwives.In another randomised controlled trial Hoddinott et al(53) looked at the effectiveness of providingbreastfeeding support groups for pregnant and breastfeeding women in Scotland. Additional breastfeedingsupport groups were set up in intervention localities and compared with similar localities receiving usualcare. The results showed that there was no significant difference in breastfeeding rates at 6-8 weeksbetween localities and that the cost was similar to providing breastfeeding support in the home.Stevens et al (54) examined the economics of home vs. hospital breastfeeding support for new mothers inCanada. They found that there was no significant difference in direct costs or outcome between groups
36given the same support in different locations, suggesting that home support may be a more beneficialoption in order to reduce other hospital related costs.It is fair to say that the evaluation of the cost-effectiveness of breastfeeding interventions does not providedefinitive conclusions, largely due to a lack of research evidence. However, it is clear that increasingbreastfeeding prevalence will reduce costs for the NHS and achieve better health outcomes. The strongestavailable evidence appears to advocate targeted peer support interventions as a successful way toincrease breastfeeding initiation and prevalence with relatively low costs. It is also important to consider thepotential emotional costs of ill health especially to the families of young infants, a factor which is to someextent addressed by the use of QALYs in calculating cost-effectiveness. However, more research isneeded in to the direct cost-effectiveness of breastfeeding interventions in order that more efficientstrategies for increasing prevalence can be developed and therefore the health and well being of mothersand their babies may be improved.
Page 6 and 7: 5Notes.The data used cover the time
Page 8 and 9: 7More support is needed for mothers
Page 11 and 12: 10Local Variation.Fig.3Breastfeedin
Page 15 and 16: 14Table 1Initiation6-8 week prevale
Page 17 and 18: 16Demographics; Age of Mother.Fig.7
Page 19 and 20: 18over 35. It can be seen that the
Page 21 and 22: Breast Feednig RatesBreast Feednig
Page 23 and 24: 22When calculating deprivation quin
Page 25 and 26: 24Health Outcomes; Gastroenteritis.
Page 27 and 28: 26was associated with a reduced ris
Page 29 and 30: 28A number of studies have shown th
Page 31 and 32: 30Health Outcomes; Obesity in Recep
Page 33 and 34: 32Mangrio et al(37) found no signif
Page 35: 34model has been applied specifical
Page 39 and 40: 38References1. Bolling, K., Grant,
Page 41 and 42: 4032. Contribution of Early Weight

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