Twenty-seven studies were included in the review. Seventeen studies were judged as good quality. Eighteen studies (n=1,538) with the most accumulated evidence for outcomes were summarised.
Skin-to-skin contact (two RCTs, two quasi-experimental studies and one uncontrolled randomised trial): Two studies showed that skin-to-skin contact was associated with a statistically significant increase (p<0.05) in breastfeeding at discharge from the neonatal unit. One further study reported a borderline-significant increase in successful breastfeeding (OR 2.8, 95% CI: 1.0 to 8.3, p=0.06). One study reported a significant increase in breast milk volume over two weeks (p=0.01).
Cup-feeding (three RCTs): One study reported a significantly higher breastfeeding rate in cup-fed infants at discharge (OR 1.73, 95% CI:1.04 to 2.88, p=0.03).
Expressing breast milk (two RCTs and one uncontrolled randomised trial): One study showed that simultaneous pumping was associated with a significant increase in breast milk volume compared with sequential pumping (p<0.01).
Galactogogues (four RCTs): Two studies reported that domperidone or growth hormone was associated with a significant increase in breast milk volume from baseline (p<0.05). Two studies showed no effect of metoclopramide or oxytocin on breast milk volume.
Post-natal support (two RCTs and one case-control study): Two studies showed that additional postnatal support programmes were associated with statistically significant increased provision of breast milk feeding (p<0.03).