GOLD Learning Speakers

Despite irrefutable research evidence for the benefits of breastfeeding, less than 37% of infants worldwide meet WHO targets for optimal breastfeeding. Persistently low breastfeeding rates are due in part due to poor uptake of breastfeeding best-practice guidelines, such as the Baby-Friendly Hospital Initiative. The growing field of knowledge translation in healthcare reveals that it takes from 8-30 years for research findings to be adopted into clinical practice, and that up to 45% of patients don’t receive evidence-based healthcare. This presentation aims to help those providing lactation support to better understand the complexity of factors influencing the use of evidence in practice, as well as what can be done to facilitate the uptake of best practice guidelines to protect, promote and support breastfeeding. Whether or not care providers follow evidence-based practices is influenced by the nature of the evidence (e.g., perceived relevance of the evidence), characteristics of the care providers (e.g., motivations to change practice) as well as characteristics of the care environment (e.g., leadership support for change). Successful strategies for supporting practice change are tailored to local barriers and facilitators to evidence use, and can be informed by the growing number of theoretical models and frameworks for KT in healthcare.

There is mounting research evidence that lactation is associated with both short- and long-term benefits for maternal cardiovascular health. Observational studies have found that lactation can lower maternal blood pressure, risk of metabolic syndrome, and other markers of cardiovascular risk (Rameez et al, 2019; Qu et al, 2018), and a recent meta-analysis involving more than 1 million individuals concluded that breast/chest-feeding is associated with a 10% lower risk of fatal and non-fatal cardiovascular disease or stroke in later life (Tschiderer et al, 2022). Potential explanations for the cardioprotective impacts of lactation include the role of lactation in postpartum lipid metabolism (Countouris et al, 2020), beneficial effects of oxytocin on the cardiovascular system (Jankowski, 2020), and the role of oxytocin in the stress response (Brunton et al, 2008). However, the relationship between lactation and cardiovascular outcomes is complex and may be mediated by such factors as obesity and metabolic syndrome (Stuebe, 2015). This presentation will review the latest research evidence related to the association between lactation and cardiovascular outcomes, and provide guidance on how to promote breast/chest-feeding for maternal cardiometabolic health.