The dropoff in breastfeeding rates postpartum is a global health issue, not limited to the USA and other high resource countries. According to the World Health Organization, only 38% of infants aged 0 to 6 months are exclusively breastfed. One of the 6 WHO global nutrition targets for 2025 is to increase exclusive breastfeeding in the first 6 months up to at least 50%.

The authors of this week’s CQW sought to explore the effect of home visitation by professionals in increasing breastfeeding rates postpartum. Even if mothers receive optimal support of breastfeeding in the hospital or birthing center, they leave just as breastfeeding dynamics rapidly change and the infant’s nutritional needs are rapidly increasing. We just learned from the Flaherman study discussed in CQW 150 that any formula use at 2 weeks was associated with a 31.4% rate of any breastfeeding at 6 months, and a 5.7% at 12 months.

This article is a systematic review of 26 studies that researched the effect of home visitation by professionals on breastfeeding rates and that used a randomized controlled trial or quasi-experimental trial design. Professionals included physicians, nurses, midwives, IBCLCs, or trained workers who completed the 18-h or 40-h WHO/UNICEF counseling/lactation management courses. The studies were from a variety of countries, with only 5 from the USA. Other countries included Brazil, Australia, Canada, Bangladesh, Switzerland, Denmark, Syria, Italy, Turkey, Holland, and countries in Africa. The studies varied in their criteria of participant selection based on intention to breastfeed. They also varied on the breastfeeding rates measured, i.e. exclusive vs any.