The Effect of Lactation Consultation on the Duration of Breastfeeding in New Mothers: A Systematic Review

In the United States, 3.978 million babies were born in the year 2015 (U.S. Department of Health & Human Services, 2016). Statistics show that less than 25% of newborns in the United States are breastfed for half of the recommended time by The American Academy of Pediatrics. There are many benefits to breastfeeding, but babies are not receiving these benefits. This systematic review identifies, reviews, and critically appraises the evidence regarding the effect of lactation consultation on duration of breastfeeding in new mothers. Literature was retrieved from CINAHL and Google Scholar. Each study was vetted based on criteria to fully describe the current state of the science. The researchers from the studies reported mixed results. Most studies found that lactation consultants do increase the duration of breastfeeding, while other studies claimed the results were not significant enough to make a definite conclusion. LACTATION CONSULTATION AND BREASTFEEDING 3 The common problem found with breastfeeding mothers is that they do not breastfeed their babies long enough based on health recommendations. The American Academy of Pediatrics (AAP) recommends mothers breastfeed their children for at least 12 months, and the World Health Organization recommends breastfeeding for even longer, up to 2 years of age and beyond (U.S. Department of Health and Human Services, 2016). Per the U.S. Department of Health and Human Services (2016), 81% of newborns start out being breastfed, but at the age of 6 months, only 22% are still being breastfed. This is a problem because when babies are not breastfed long enough, they are not getting the full benefits of breast milk and may not be as healthy as the babies who are breastfed for longer durations (Alder & DiMaggio, 2016). Breastfeeding has positive consequences for both mothers and the babies. The benefits of breastfeeding for babies include increased immunity from antibodies in the breast milk, adequate nutrients to grow and develop, decreased health problems such as ear infections, allergies, eczema, stomach problems and respiratory infections, decreased incidence of Sudden Infant Death Syndrome, and decreased likelihood of obesity and diabetes as children grow and develop (Alder & DiMaggio, 2016). For mothers, breastfeeding increases mother-baby bonding, increases weight loss after pregnancy, and lowers risk of breast and ovarian cancers, diabetes, and osteoporosis (Alder & DiMaggio, 2016). Therefore, breastfeeding has the potential to improve the health of both mother and baby. Some mothers who do decide to breastfeed experience difficulties. Studies have indicated that many health professionals providing care to mothers and infants are inadequately prepared LACTATION CONSULTATION AND BREASTFEEDING 4 to provide prenatal education, perinatal support and postpartum follow-up for breastfeeding women, suggesting the need for lactation consultants (Wambach, Campbell, Gill, Dodgson, Abiona & Heinig, 2005). Lactation consultants talk with and help instruct new mothers on the proper techniques for breastfeeding before, during and after childbirth. Often, the information the lactation consultant provides during the prenatal period can influence a mother’s feeding choice. They are also trained to provide clinical management of complex problems with lactation. Lactation consultants are key providers of lactation care and management for breastfeeding mothers, with the goal to teach mothers how to properly breastfeed and provide positive reinforcement. This may in turn encourage mothers to breastfeed for the recommended amounts of time and ensure mothers and babies both receive all the benefits breast milk has to offer. Since healthcare professionals practice based on evidence from research, this leads to the question: In new mothers, how do lactation consultations, compared with no lactation consultations, affect the duration of breastfeeding? This systematic review was conducted to identify, review, and critically appraise the evidence about the effect of lactation consultation on duration of breastfeeding in new mothers. Based on the analysis, practice and research recommendations will be advanced. The variables in the systematic review included the duration of time in which mothers breastfeeds, the dependent variable, and lactation consultation, the independent variable. This review is relevant to nursing because it is a nurses’ professional obligation and scope of practice to not only provide education and support to breastfeeding mothers, but to also recognize the need for LACTATION CONSULTATION AND BREASTFEEDING 5 breastfeeding help and refer their patient to nurses who are International Board Certified Lactation Consultants (IBCLC). IBCLCs are candidates who underwent academic programs including 90 hours of didactic education on human lactation and breastfeeding and 300 hours of directly supervised clinical practice in lactation management (Webber & Watkins, 2017). In addition to the academic programs, IBCLCs must pass the certification exam administered by the International Board of Lactation Consultant Examiners (Webber & Watkins, 2017). By using IBCLCs as resource support for nurses and also using their knowledge to encourage patients to breastfeed, breastfeeding goals can be met. Healthy People 2020 set a goal that 81.9% of infants be breastfed in the early postpartum period, with continued breastfeeding to 6 months for 60.6% of infants (U.S. Department of Health & Human Services, 2014). With IBCLCs and nurses working together to achieve the goals set by Healthy People 2020, the health of mothers and their infants will increase and, in turn, help promote population health in the United States.