The Influence of Breastfeeding Educational Interventions on Breast Engorgement and Exclusive Breastfeeding: A Systematic Review and Meta-Analysis

Mega Hasanul Huda, Roselyn Chipojola, Yen Miao Lin, Gabrielle T. Lee, Meei Ling Shyu, Shu Yu Kuo

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Background: Breast engorgement and breast pain are the most common reasons for the early cessation of exclusive breastfeeding by mothers. Research Aims: (1) To examine the influence of breastfeeding educational interventions on breast engorgement, breast pain, and exclusive breastfeeding; and (2) to identify effective components for implementing breastfeeding programs. Methods: Randomized controlled trials of breastfeeding educational interventions were searched using five English and five Chinese databases. Eligible studies were independently evaluated for methodological quality, and data were extracted by two investigators. In total, 22 trials were identified, and 3,681 participants were included. A random-effects model was used to pool the results, and a subgroup analysis and meta-regression analysis were conducted. Results: Breastfeeding education had a significant influence on reducing breast engorgement at postpartum 3 days (odds ratio [OR]: 0.27, 95% CI [0.15, 0.48] p <.001), 4 days (OR: 0.16, 95% CI [0.11, 0.22], p <.001), and 5–7 days (OR: 0.24, 95% CI [0.08, 0.74], p =.013) and breast pain (standardized mean difference: −1.33, 95% CI [−2.26, −0.40]) at postpartum 4–14 days. Participants who received interventions had higher odds of exclusive breastfeeding. Breastfeeding educational interventions provided through lecture combined with skills practical effectively reduced breast engorgement (OR: 0.21; 95% CI [0.15, 0.28]; p =.001) and improved exclusive breastfeeding at postpartum 1–6 weeks (OR: 2.16; 95% CI [1.65, 2.83]; p =.001). Conclusions: Breastfeeding educational interventions have been effective in reducing breast engorgement, breast pain, and improved exclusive breastfeeding. A combination of knowledge and skill-based education has been beneficial for sustaining exclusive breastfeeding by mothers.

Original languageEnglish
Pages (from-to)156-170
Number of pages15
JournalJournal of Human Lactation
Issue number1
Publication statusAccepted/In press - 2021


  • breast engorgement
  • breast pain
  • breastfeeding
  • exclusive breastfeeding
  • lactation education
  • meta-analysis
  • randomized controlled trials
  • systematic reviews

ASJC Scopus subject areas

  • Obstetrics and Gynaecology


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