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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

From: Perinatal psychological interventions to promote breastfeeding: a narrative review

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

  1. 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