Effectiveness of interventions on breastfeeding self‐efficacy and perceived insufficient milk supply: A systematic review and meta‐analysis

The aim of this systematic review and meta‐analysis was to assess the efficacy on an intervention on breastfeeding self‐efficacy and perceived insufficient milk supply outcomes. The literature search was conducted among 6 databases (CINAHL, Medline, PsyncInfo, Scopus, Cochrane, and ProQuest) in between January 2000 to June 2016. Two reviewers independently assessed the articles for the following inclusion criteria: experimental or quasi‐experimental studies; healthy pregnant women participants intending to breastfeed or healthy breastfeeding women who gave birth to a term singleton and healthy baby; intervention administered could have been educational, support, psycho‐social, or breastfeeding self‐efficacy based, offered in prenatal or postnatal or both, in person, over the phone, or with the support of e‐technologies; breastfeeding self‐efficacy or perceived insufficient milk supply as outcomes. Seventeen studies were included in this review; 12 were randomized controlled trials. Most interventions were self‐efficacy based provided on 1‐to‐1 format. Meta‐analysis of RCTs revealed that interventions significantly improved breastfeeding self‐efficacy during the first 4 to 6 weeks (SMD = 0.40, 95% CI 0.11–0.69, p = 0.006). This further impact exclusive breastfeeding duration. Only 1 study reported data on perceived insufficient milk supply. Women who have made the choice to breastfeed should be offered breastfeeding self‐efficacy‐based interventions during the perinatal period. Although significant effect of the interventions in improving maternal breastfeeding self‐efficacy was revealed by this review, there is still a paucity of evidence on the mode, format, and intensity of interventions. Research on the modalities of breastfeeding self‐efficacy should be pursued.