Three types of intervention have been shown to be useful in the promotion of breastfeeding when delivered as a stand-alone intervention in developed countries. Informal, small group health education, delivered during the antenatal period, appears to be effective at increasing initiation rates among women from different income groups and from some minority ethnic groups. There is also some evidence to show that one-to-one health education can be effective at increasing initiation rates among women on low incomes. Peer support programmes, delivered in the ante- and postnatal periods, have also been shown to be effective at increasing both initiation and duration rates of breastfeeding among women on low incomes, and particularly among women who have expressed a wish to breastfeed.
Packages of interventions have also been shown to be effective at increasing the initiation and, in most cases, the duration of breastfeeding in developed countries. Effective packages appear to include a peer support programme and/or a media campaign combined with structural changes to the health sector and/or health education activities.
Structural changes in hospital practices to promote breastfeeding (HSI) have been shown to be effective at increasing both initiation and duration of breastfeeding in developing countries. Rooming-in, as either a stand-alone intervention or as one component of a package of interventions, is a key example of an effective HSI.