Remarks

• In making this recommendation, the Guideline Development Group acknowledged that the evidence was insufficient to conclude on the added value of probiotics, anti-secretory factor-inducing foods, acupoint massage, and specialist breastfeeding education over usual breastfeeding advice and support for the prevention of mastitis during breastfeeding, interventions that were often incorporated into the control arms of the trials evaluated.
• In this context, responsive breastfeeding (63, 64) refers to the mother responding to her baby’s cues, as well as her own desire to breastfeed. Responsive feeding is distinct from demand feeding, as it recognizes the reciprocal mother–baby relationship and benefits of breastfeeding beyond alleviation of hunger.
• All women should be advised of common breast conditions associated with lactation, such as sore or cracked nipples, engorgement and mastitis, and encouraged to report any signs and symptoms to their care providers.
• Providers should support women to continue breastfeeding with breast engorgement if they wish to, as per the 2017 WHO guideline Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services (75).
• All women should receive breastfeeding counselling in accordance with the 2018 WHO guideline Counselling of women to improve breastfeeding practices (76).