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Clinical Interventions to Promote Breastfeeding by Latinas: A Meta-analysis.

<h3>Abstract</h3><div><h4>CONTEXT: </h4><p><abstracttext nlmcategory=”BACKGROUND” label=”CONTEXT”>Breastfeeding duration and exclusivity among Latinas fall below recommended levels, indicating a need for targeted interventions. The effectiveness of clinical breastfeeding interventions for Latinas remains unclear.</abstracttext></p><h4>OBJECTIVE: </h4><p><abstracttext nlmcategory=”OBJECTIVE” label=”OBJECTIVE”>To systematically review the documented effectiveness of clinical breastfeeding interventions on any and exclusive breastfeeding among Latinas.</abstracttext></p><h4>DATA SOURCES: </h4><p><abstracttext nlmcategory=”METHODS” label=”DATA SOURCES”>English-language publications in Medline, CINAHL, and Embase were searched through May 28, 2015.</abstracttext></p><h4>STUDY SELECTION: </h4><p><abstracttext nlmcategory=”METHODS” label=”STUDY SELECTION”>Fourteen prospective, controlled studies describing 17 interventions met inclusion criteria.</abstracttext></p><h4>DATA EXTRACTION: </h4><p><abstracttext nlmcategory=”METHODS” label=”DATA EXTRACTION”>Extracted study characteristics include study design, population characteristics, intervention components, timing and intensity of delivery, provider type, control procedures, and outcome measures.</abstracttext></p><h4>RESULTS: </h4><p><abstracttext nlmcategory=”RESULTS” label=”RESULTS”>Random-effects meta-analyses estimated risk differences (RDs) between breastfeeding mothers in intervention and control arms of each study and 95% prediction intervals (PIs) within which 95% of intervals cover the true value estimated by a future study. Interventions increased any breastfeeding at 1 to 3 and 4 to 6 months (RD 0.04 [95% PI -0.15 to 0.23] and 0.08 [-0.08 to 0.25], respectively) and exclusive breastfeeding at 1 to 3 and 4 to 6 months (0.04 [-0.09 to 0.18] and 0.01 [-0.01 to 0.02]). Funnel plot asymmetry suggested publication bias for initiation and 1- to 3-month any breastfeeding. Estimates were slightly larger among interventions with prenatal and postpartum components, 3 to 6 patient contacts, and delivery by an International Board Certified Lactation Consultant or lay provider.</abstracttext></p><h4>LIMITATIONS: </h4><p><abstracttext nlmcategory=”CONCLUSIONS” label=”LIMITATIONS”>The published evidence for Latinas is limited, and studies have varying methodologic rigor.</abstracttext></p><h4>CONCLUSIONS: </h4><p><abstracttext nlmcategory=”CONCLUSIONS” label=”CONCLUSIONS”>Breastfeeding interventions targeting Latinas increased any and exclusive breastfeeding compared with usual care.</abstracttext></p><p>Copyright © 2016 by the American Academy of Pediatrics.</p></div>

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