Systematic review of peer support for breastfeeding continuation: metaregression analysis of the effect of setting, intensity, and timing

Objective To examine the effect of setting, intensity, and timing of peer support on breast feeding. Design Systematic review and metaregression analysis of randomised controlled trials. Data sources Cochrane Library, Medline, CINAHL, the National Research Register, and British Nursing Index were searched from inception or from 1980 to 2011. Review methods Study selection, data abstraction, and quality assessment were carried out independently and in duplicate. Risk ratios and 95% confidence intervals were calculated for individual studies and pooled. Effects were estimated for studies grouped according to setting (high income countries, low or middle income countries, and the United Kingdom), intensity (= 5 planned contacts), and timing of peer support (postnatal period with or without antenatal care), and analysed using metaregression for any and exclusive breast feeding at last study follow-up. Results Peer support interventions had a significantly greater effect on any breast feeding in low or middle income countries (P