Exclusive breastfeeding rates in many high-income countries are considerably lower than the World Health Organization recommendations. Younger mothers are less likely than older mothers to exclusively breastfeed or to exclusively breastfeed for a long duration. This systematic review explores interventions to increase the rate of exclusive breastfeeding among young mothers in high-income countries. A systematic search of the following databases was completed in August 2020: CINAHL, PubMed, MEDLINE, ProQuest, PsychInfo, Web of Science, Cochrane, Scopus and Embase. A manual search of the reference lists of all the included studies and published systematic reviews was also performed. The Cochrane Collaboration Risk of Bias Tool was used to assess the quality of the included studies. A random effects model meta-analyses was applied. Heterogeneity of outcomes between the studies was assessed using both the χ2 test and the I2 statistic. Of 955 records identified in the search, 392 duplicates were removed, and nine studies met the inclusion criteria. Seven studies were randomised controlled trial (RCTs) and two were quasi-experimental in design. Eight were conducted in the United States. The interventions included peer counselling, telephone support, massage, gift packs, financial incentive and antenatal education. Most studies included a combination of strategies, peer counselling being the most common. A meta-analysis of four of nine included studies did not detect a difference in rate of exclusive breastfeeding to 3 months postpartum (RR 1.44; 95% CI 0.82, 2.55; p = 0.204). This review is limited by the relatively few studies which met the inclusion criteria and the small sample sizes of most included studies. High rates of attrition and formula supplementation among the participants made it difficult to detect a statistically significant effect. Consistency in follow up times would enable more studies to be included in a meta-analysis. Peer counselling was the most promising strategy associated with higher rates of exclusive breastfeeding. However, further studies are needed to understand the breastfeeding experiences of young mothers. Young mothers should be targeted specifically in intervention studies.

中文翻译：

---

促进年轻母亲纯母乳喂养的干预措施：系统评价和荟萃分析

许多高收入国家的纯母乳喂养率远低于世界卫生组织的建议。与年长的母亲相比，年轻的母亲不太可能完全母乳喂养或长期完全母乳喂养。本系统评价探讨了提高高收入国家年轻母亲纯母乳喂养率的干预措施。2020 年 8 月完成了对以下数据库的系统搜索：CINAHL、PubMed、MEDLINE、ProQuest、PsychInfo、Web of Science、Cochrane、Scopus 和 Embase。还对所有纳入研究和已发表的系统评价的参考文献列表进行了手动搜索。Cochrane 偏倚风险协作工具用于评估纳入研究的质量。应用了随机效应模型荟萃分析。使用 χ2 检验和 I2 统计量评估研究之间结果的异质性。在搜索中确定的 955 条记录中，删除了 392 条重复记录，9 项研究符合纳入标准。七项研究为随机对照试验 (RCT)，两项为准实验设计。八次是在美国进行的。干预措施包括同伴咨询、电话支持、按摩、礼包、经济奖励和产前教育。大多数研究包括策略的组合，同伴咨询是最常见的。对九项纳入研究中的四项进行的荟萃分析未发现产后 3 个月纯母乳喂养率存在差异（RR 1.44；95% CI 0.82, 2.55；p = 0.204）。本综述受到符合纳入标准的研究相对较少以及大多数纳入研究样本量较小的限制。参与者的高损耗率和配方补充率使得很难检测到具有统计学意义的影响。随访时间的一致性将使更多的研究能够被纳入荟萃分析。同伴咨询是与较高的纯母乳喂养率相关的最有希望的策略。然而，需要进一步的研究来了解年轻母亲的母乳喂养经历。干预研究应专门针对年轻母亲。随访时间的一致性将使更多的研究能够被纳入荟萃分析。同伴咨询是与较高的纯母乳喂养率相关的最有希望的策略。然而，需要进一步的研究来了解年轻母亲的母乳喂养经历。干预研究应专门针对年轻母亲。随访时间的一致性将使更多的研究能够被纳入荟萃分析。同伴咨询是与较高的纯母乳喂养率相关的最有希望的策略。然而，需要进一步的研究来了解年轻母亲的母乳喂养经历。干预研究应专门针对年轻母亲。