Table 2.
Studies’ description. Characteristics of women and infants for whom a psychological intervention to support breastfeeding has been tested. Results reported according to study design
| Study design, sample size, range or infant age | Author, country, Year, Reference | Participants at enrolment | Intervention | Breastfeeding outcomes. | Professional or self-report assessment | OR or test values or mean (S:D.); P value |
|---|---|---|---|---|---|---|
| RCT, N = 71, 1–42 DOL | Feher, USA, 1989 [54] | Mothers of preterm infants | Relaxation therapy | Breast milk yield and composition. | Professional | 90.1 mL(60.0) vs 55.4 mL (48.2); p < 0.05 |
| RCT, N = 100, 1–180 DOL | Vidas, Croatia, 2011 [40] | Nursing mothers who were ≤ 2 months post-partum | Relaxation therapy | EBF > 6 months. | Self-report | Risk ratio 11; 95% CI (3.60, 33.54); P = 0.0001 |
| RCT, N = 162, 1–14 DOL | Keith, USA, 2012 [50] | Mothers of preterm infants | Music therapy coupled with visual reminder of the mother’s baby | Breast milk yield (DOL 14) and fat content. (DOL 6) | Professional | 1028 mL (48.8) vs 591.4 mL (47.6); P < 0.001 60.7% (3.5) vs 50.7% (3.4); P = 0.001 |
| RCT, N = 145 | Spinelli, USA, 2013 [36] | 12–33 weeks gestation pregnant women | Interpersonal therapy | Rates of breastfeeding initiation | Professional | NS P = 0.74 |
| RCT, N = 1222, 1–180 DOL | Werner, Denmark, 2013 [37] | 27–20 weeks gestation pregnant women | Hypnosis sessions | Breastfeeding duration: 0–4 weeks 1–4 months | Self-report | NS P = 0.43 P = 0.95 |
| RCT, N = 456, 1–180 DOL | Sikander, Pakistan, 2014 [42] | Third trimester pregnant women | Cognitive-behavioural | EBF 6 months | Professional. | Adjusted hazard ratio 0.40; 95% CI (0.27, 0.60); P < 0.001 |
| RCT, N = 99, 1–90 DOL | Kao, USA, 2015 [38] | 20–35 weeks gestation pregnant women | Group interpersonal psychotherapy | Any breastfeeding until three months postpartum | Professional. | 54 days (32.5) vs 21 days (31.6); P = 0.013 |
| RCT, N = 60 | Procelli, USA, 2005 [53] | Just delivered mothers | Music therapy | Positive emotional response on BF efficacy | Professional | P = 0.045 |
| RCT, N = 50, 1 DOL | Sreekumar, India, 2018 [41] | Third trimester pregnant women | Cognitive-behavioural | Satisfactory LATCH score. | Professional | Odds ratio 10.29; 95% CI (1.16, 91.43); P = 0.015 |
| RCT, N = 64, 1–98 DOL | Mohd Shukri, Malaysia, 2019 [52] | Third trimester pregnant women | Relaxation therapy | Breast milk intake DOL 84 Hindmilk cortisol DOL 14 | Professional | mean difference 227 g/d; 95% CI (430, 24); P = 0.033 mean difference − 44.5%; 95% CI (−76.1, −12.9); P = 0.007 |
| Cluster-RCT, N = 71 | Shariat, Iran, 2017 [39] | Second or third trimester pregnant women | Group interpersonal psychotherapy | Any breastfeeding until 12 months after birth | Professional | P = 0.028 |
| Not randomised, N = 38, 1–42 DOL | O’Connor, USA, 1998 [48] | Mothers who were ≤ 2 days post-partum | Relaxation therapy | Breast milk secretory IgA. | Professional | NS P = 0.78 |
| Quasi-experimental, N = 220, 1–480 DOL | Patel, India, 2013 [45] | Primipara mothers within 2 h of delivery | Manual relaxation | Post-feed weight gain | Professional | P = 0.05 |
| Quasi-experimental, N = 29, 1–4 DOL | Ak, India, 2015 [51] | Mothers of preterm infants | Music therapy | Breast milk volume. | Professional | 7.12 mL (1.57) vs 6.68 mL (1.37); mean difference 0.44; 95% CI (0.05, 0.82); P = 0.033 |
| Pre-post assessment, N = 50 | Mohammadpour, Iran, 2018 [44] | Mothers of preterm infants | Manual relaxation | Breast milk yield | Self-report | P < 0.05 |
| Pre-post assessment, N = 262, 1–730 DOL | Mitchell, Australia, 2018 [55] | Mothers who were ≤ 24 months post-partum | Compassion focused relaxation therapy | Maternal Breastfeeding Satisfaction Scale. | Self-report | 6.14 (1.43) vs 6.46 (0.97); P < 0.001 |
| Within-subject study, N = 20, 01730 DOL | Yu, China, 2019 [47] | Mothers who were ≤ 24 months post-partum | Relaxation therapy | Breast milk ejection | Self-report | n/a |
| Case series, N = 3 | Tipping, UK, 2000 [46] | Mothers having a complicated delivery | Manual relaxation | Breastfeeding initiation | Professional | n/a |
| Case series, N = 3, 1–365 DOL | Cowley, Canada, 2005 [47] | Postpartum tetraplegic women | Relaxation therapy | Breast milk ejection. | Self-report | n/a |
| Case series, N = 11, 1–8 DOL | Hauck, Australia, 2008 [43] | Breastfeeding women | Relaxation therapy | Perception of breastfeeding success. | Self-report | n/a |
CI confidence interval, DOL days of life, EBF exclusive breastfeeding, NS not significant, n/a does not apply, OR odds ratio, RCT randomized controlled trial, S.D. standard deviation