Breastfeeding is one of those issues around which there's almost no controversy with regard to health benefits for both mother and baby, so, as Rick and I discuss on PodMed this week and published in JAMA, it's a bit disconcerting that only about 22% of infants born in the United States are exclusively breastfed until they're six months of age, per current recommendations, although it is initiated among 80%. This fact emerged as part of the USPSTF review of the literature regarding the benefits and harms of breastfeeding interventions conducted to enable updating of the guidelines, last done in 2008.
Fifty-two studies with over 66,000 participants were included in this analysis, which took a look at both individual and system interventions to promote breastfeeding. Data indicate that the individual-level interventions, whether by peers or professionals, were much more likely to result in initiation of breastfeeding and longer duration than system wide programs such as the Baby Friendly Hospital Initiative. Very modest harms were reported in the review: a couple of subjects reporting anxiety, decreased confidence and concerns about confidentiality after a peer visit.
In short, it appears to Rick and me that more individual level interventions should be designed and employed to promote breastfeeding, although the USPSTF stops short of this assertion. Other topics this week include http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2571615 on state level smoking and cancer, and two from NEJM:Long-Term Oxygen for COPD with Moderate Desaturation and Child–Parent Familial Hypercholesterolemia Screening. Until next week, y'all live well.