Baby Carrier Intervention Tied to Increased Breastfeeding

By Lisa Rapaport

July 02, 2021

(Reuters Health) - Infants are more likely to breastfeed or consume expressed human milk at six months when parents are given free baby carriers and support to promote increased physical contact, a clinical trial suggests.

The trial recruited 100 women who received prenatal care through a home health program for pregnant parents in a predominantly Latinx, low-income neighborhood in California. Researchers randomized participants 1:1 to receive an ergonomic infant carrier and both in-person and video support to promote baby wearing or to join a waitlist control group.

At six months, parents were more likely to be breastfeeding or feeding expressed human milk in the intervention group (68%) than in the control group (40%), researchers report in Pediatrics.

There are many potential explanations for why baby carriers increase breastfeeding and expressed milk feeding, said lead study author Emily Little, a certified lactation educator and counselor and executive director of Nurturely in Eugene, Oregon.

"Having infants in a carrier may increase the likelihood that parents recognize and respond to early hunger cues rather than waiting for the onset of crying, which is an important clinical recommendation for increasing ease of latch," Little said by email.

Feeding in response to early hunger cues may also increase milk supply from feeding more frequently, Little said. Parent-infant physical contact also increases oxytocin, which is responsible for the milk ejection reflex, a critical part of the breastfeeding or pumping process, Little added.

"These results are exciting, but definitely not surprising," Little said.

There wasn't a significant difference in the proportion of women in the intervention group and the control group who were breastfeeding or feeding babies expressed human milk at six weeks (78% vs 81%) or at three months (66% vs 57%), the study found.

In addition, there wasn't a significant difference in the proportion of intervention and control group participants who exclusively fed babies human milk at six weeks (66% vs 49%) or three months (45% vs 40%).

Limitations of the study include its small size as well as the high attrition at six months, the researchers note. The study also didn't track breastfeeding beyond six months, and the American Academy of Pediatrics recommends breastfeeding for at least one year.

Many of the study participants also weren't working, and it's possible that their ability to breastfeed might differ from women who are not able to be home with babies at six months, said Dr. Lori Feldman-Winter, a professor of pediatrics at Cooper University Health Care and Cooper Medical School of Rowan University in Camden, New Jersey.

"It would be expected that increased infant contact with the breastfeeding mother would lead to more opportunities to breastfeed, more responsiveness to feeding cues, and more hormonal stimulation of milk production," Dr. Feldman-Winter, who wasn't involved in the study, said by email.

Breastfeeding mothers will have a greater likelihood of continued breastfeeding to 6 months if they are able to hold their infants and using a carrier may facilitate holding, Dr. Feldman-Winter added.

"Frequent holding also implies availability of the mother, and thus paid leave from work is an important investment that our nation must consider in order to achieve the best outcomes for our youth," Dr. Feldman-Winter said.

SOURCE: Pediatrics, online June 30, 2021.