Emotional distress in mothers inhibits the let-down reflex, thus affecting breastfeeding self-efficacy. A breastfeeding mother may have to cope with both physical discomfort and psychological distress. However, literature on initiatives to improve breastfeeding rates has focused mainly on providing community-based peer support, or social policies. The aim of this review is to assess evidence on the effectiveness of a broad range of psychological interventions to facilitate breastfeeding for mothers facing difficulties around the time of delivery. The review of the literature is derived from a search on Cochrane Library, PubMed, EBSCOhost, and PsycINFO for papers published since 1980. The approach was to explore quantitative and qualitative parameters. Quantitative parameters included breastfeeding initiation, duration, and composition. Qualitative parameters recorded the evaluation of maternal perceptions on breastfeeding success. The high heterogeneity of the studies led to a narrative review; 20 selected papers that report on breastfeeding outcomes and psychological programs met the inclusion criteria. The evidence on breastfeeding support through psychotherapy is heterogeneous and scant. Out of the included studies, 11 were randomized controlled trials, two were non-randomised trials, and two used a quasi-experimental design. None of the studies reported an increase in adverse breastfeeding outcomes. Three studies failed to report an association between psychological procedures and improved breastfeeding outcomes. A literature review showed that 17 (85%) analyses support stress-releasing techniques to facilitate breastfeeding. This review suggests that relaxation interventions carefully tailored to address perinatal emotional distress may lead to important health benefits, including improvement in breastfeeding outcomes. There is also some indication that psychotherapy support while breastfeeding may have more impact than routine counselling. Conversely, this review did not find an association between self-hypnosis and breastfeeding outcomes. Data from this study can be used in designing prevention programs and future research with appropriate theoretical underpinning.

中文翻译：

---

促进母乳喂养的围产期心理干预：叙述性评论

母亲的情绪困扰会抑制泌乳反射，从而影响母乳喂养的自我效能。母乳喂养的母亲可能不得不应对身体不适和心理困扰。然而，关于提高母乳喂养率举措的文献主要集中在提供基于社区的同伴支持或社会政策。本综述的目的是评估广泛的心理干预措施的有效性证据，以促进在分娩前后面临困难的母亲进行母乳喂养。文献综述来源于在 Cochrane 图书馆、PubMed、EBSCOhost 和 PsycINFO 上搜索自 1980 年以来发表的论文。该方法是探索定量和定性参数。定量参数包括母乳喂养的开始、持续时间和组成。定性参数记录了母亲对母乳喂养成功的看法的评估。研究的高度异质性导致了叙述性审查；20 篇报告母乳喂养结果和心理计划的选定论文符合纳入标准。通过心理治疗支持母乳喂养的证据是异质的和稀少的。在纳入的研究中，11项为随机对照试验，2项为非随机试验，2项采用准实验设计。没有一项研究报告不良母乳喂养结果的增加。三项研究未能报告心理程序与改善母乳喂养结果之间的关联。一项文献综述表明，17 项 (85%) 分析支持缓解压力的技术以促进母乳喂养。本综述表明，为解决围产期情绪困扰而精心定制的放松干预措施可能会带来重要的健康益处，包括改善母乳喂养结果。还有一些迹象表明，母乳喂养期间的心理治疗支持可能比常规咨询产生更大的影响。相反，本综述并未发现自我催眠与母乳喂养结果之间存在关联。这项研究的数据可用于设计预防计划和具有适当理论基础的未来研究。本综述未发现自我催眠与母乳喂养结果之间存在关联。这项研究的数据可用于设计预防计划和具有适当理论基础的未来研究。本综述未发现自我催眠与母乳喂养结果之间存在关联。这项研究的数据可用于设计预防计划和具有适当理论基础的未来研究。