Patterns of breastfeeding can vary greatly from one country or place to another. Two very different approaches are often used to determine when the baby will breastfeed and for how long. One approach is led by the baby, and is known as baby-led, unrestricted or breastfeeding on demand. The clock leads the other approach, which is known as scheduled, timed or restricted breastfeeding.
From the early 20th century mothers in many health settings were advised to breastfeed according to the clock; timing and restricting both the frequency and length of breastfeeds. This practice changed when baby-led or demand breastfeeding was advocated. With baby-led breastfeeding, the amount of milk produced is determined by the baby's demand. In this way the baby controls the supply of milk, ensuring that enough milk is produced to meet his or her needs. With this approach, close contact between the mother and her baby is encouraged with no restrictions placed on their time together. However, the mother may not always be in a position to breastfeed her baby on demand due to, for example, being separated from her baby for any reason, and there can be uncertainty for the mother if and when her baby does not demand a breastfeed.
We looked for studies that compared baby-led with scheduled (or mixed) breastfeeding for successful breastfeeding for healthy newborn babies. However, no studies were found that met the inclusion criteria for this review, therefore no conclusions could be taken at this point. It is recommended that no changes are made to current practice guidelines without undertaking further robust research, to include many patterns of breastfeeding and not limited to baby-led and scheduled breastfeeding. Further research is needed to also evaluate the effects of baby-led compared with scheduled (or mixed) breastfeeding on successful breastfeeding, for healthy newborns. However, conducting such a study, particularly a randomised controlled trial is unlikely to receive ethical approval, as the issue of obtaining informed consent from new mothers or mothers to be for randomisation between baby-led and scheduled breastfeeding is a difficult one and it is likely that the Baby Friendly Hospital Initiative practices would prohibit such a study.
Patterns of breastfeeding can vary greatly from one country or place to another. Two very different approaches are often used to determine when the baby will breastfeed and for how long. One approach is led by the baby, and is known as baby-led, unrestricted or breastfeeding on demand. The clock leads the other approach, which is known as scheduled, timed or restricted breastfeeding.
From the early 20th century mothers in many health settings were advised to breastfeed according to the clock; timing and restricting both the frequency and length of breastfeeds. This practice changed when baby-led or demand breastfeeding was advocated. With baby-led breastfeeding, the amount of milk produced is determined by the baby's demand. In this way the baby controls the supply of milk, ensuring that enough milk is produced to meet his or her needs. With this approach, close contact between the mother and her baby is encouraged with no restrictions placed on their time together. However, the mother may not always be in a position to breastfeed her baby on demand due to, for example, being separated from her baby for any reason, and there can be uncertainty for the mother if and when her baby does not demand a breastfeed.
We looked for studies that compared baby-led with scheduled (or mixed) breastfeeding for successful breastfeeding for healthy newborn babies. However, no studies were found that met the inclusion criteria for this review, therefore no conclusions could be taken at this point. It is recommended that no changes are made to current practice guidelines without undertaking further robust research, to include many patterns of breastfeeding and not limited to baby-led and scheduled breastfeeding. Further research is needed to also evaluate the effects of baby-led compared with scheduled (or mixed) breastfeeding on successful breastfeeding, for healthy newborns. However, conducting such a study, particularly a randomised controlled trial is unlikely to receive ethical approval, as the issue of obtaining informed consent from new mothers or mothers to be for randomisation between baby-led and scheduled breastfeeding is a difficult one and it is likely that the Baby Friendly Hospital Initiative practices would prohibit such a study.
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