Objectives
1. To assess the effectiveness of workplace interventions in assisting with the initiation, continuation, duration and exclusiveness of breastfeeding.
2. To evaluate the impact of workplace interventions on process outcomes pertinent to employees and employers.
Methods
Criteria for considering studies for this review
Types of studies
Randomised controlled trials (including those using cluster randomisation) and quasi-randomised controlled trials comparing workplace interventions with no intervention or two or more workplace interventions against each other.
Types of participants
Women in full-time or part-time employment in both private and public sectors returning to paid work after giving birth.
Types of interventions
Any type of workplace strategy (including lactation breaks, physical facilities, creches and nurseries) to encourage, assist and support breastfeeding (nursing or expressing) for women returning to work after giving birth. We planned to include studies if the intervention occurred on-site or outside the workplace, as long as it was delivered in the context of employment. We excluded interventions implemented during pregnancy.
Types of outcome measures
Primary outcomes
The rate, duration and prevalence of exclusive breastfeeding (breastfeeding defined as feeding a baby exclusively on breast milk, including expressed milk).
Secondary outcomes
Employer-related (return rates after maternity leave, turnover following childbirth, retention following childbirth, work absenteeism associated with infant illness, productivity).
Mother-related (health, emotional and physical well-being, job satisfaction, morale, sick leave, resignation from work).
Infant-level outcomes (for example, health, emotional well-being, etc).
Search methods for identification of studies
Electronic searches
We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register by contacting the Trials Search Co-ordinator (2 August 2012).
The Cochrane Pregnancy and Childbirth Group’s Trials Register is maintained by the Trials Search Co-ordinator and contains trials identified from:
1. monthly searches of the Cochrane Central Register of Controlled Trials (CENTRAL);
2. weekly searches of MEDLINE;
3. weekly searches of EMBASE;
4. handsearches of 30 journals and the proceedings of major conferences;
5. weekly current awareness alerts for a further 44 journals plus monthly BioMed Central email alerts.
Details of the search strategies for CENTRAL, MEDLINE and EMBASE, the list of handsearched journals and conference proceedings, and the list of journals reviewed via the current awareness service can be found in the ‘Specialized Register’ section within the editorial information about the Cochrane Pregnancy and Childbirth Group.
Trials identified through the searching activities described above are each assigned to a review topic (or topics). The Trials Search Co-ordinator searches the register for each review using the topic list rather than keywords.
For details of additional searches we carried out for the previous version of this review, see Appendix 1.
We did not apply any language restrictions.
Data collection and analysis
Selection of studies
Both authors independently assessed the identified studies from the search strategy for inclusion and any disagreements were resolved by consensus or advice from the editorial team.
Data extraction and management
We planned to use the form developed by the Cochrane Pregnancy and Childbirth Group for data extraction, independently extract the data and resolve discrepancies by discussion. For dichotomous outcomes, the plan was to abstract the number of per-group participants and the number experiencing the outcome, and for continuous variables the number of participants per group and the mean (and standard deviation) within each group. We intended to use the Review Manager software (RevMan 2003) to double enter all the data or a subsample.
If information regarding any of the above had been unclear, we planned to contact authors of the original reports to provide further details.
The following methods for conducting the review were planned. As no randomised or quasi-randomised controlled trials were found, these methods were not followed but are included here for subsequent updates of the review.