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To explore the effects of different family breastfeeding interventions on improving exclusive breastfeeding rates from 0 to 6&#x2009;months postpartum and to identify the key characteristics of effective interventions. This systematic review and meta-analysis follows the Cochrane Handbook for Systematic Reviews of Interventions. The risk of bias in the included studies was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Nineteen studies were included in this systematic review. Family-based interventions significantly improved exclusive breastfeeding rates at 6&#x2009;months postpartum compared with routine care (OR&#x2009;=&#x2009;2.93, 95% CI [1.90, 4.50], p&#x2009;<&#x2009;0.001). Interventions underpinned by theoretical frameworks enhanced exclusive breastfeeding within 2&#x2009;months postpartum compared with non-theoretical ones (OR&#x2009;=&#x2009;5.50, 95% CI [2.30, 13.19], p&#x2009;<&#x2009;0.001). Multi-component interventions were more effective than single-method approaches (OR&#x2009;=&#x2009;2.70, 95% CI [2.04, 3.57], p&#x2009;<&#x2009;0.001). Programmes spanning both prenatal and postnatal periods achieved higher exclusive breastfeeding rates at 4-6&#x2009;months than those implemented in a single phase (OR&#x2009;=&#x2009;4.84, 95% CI [2.50, 9.40], p&#x2009;<&#x2009;0.001). Family-based breastfeeding interventions could improve exclusive breastfeeding rates within the first 6&#x2009;months postpartum. Future breastfeeding interventions should include key family members, consider the guidance of theoretical frameworks on the intervention design, cover both the prenatal and postnatal periods, and use multiple methods to meet the needs of breastfeeding families. Nurses, midwives, lactation nurses, and public health nurses should actively involve fathers, grandparents, and other key family members in breastfeeding education and support. Family-centred breastfeeding interventions may help improve exclusive breastfeeding outcomes and strengthen family support for breastfeeding. Not registered.

Breastfeeding myths negatively affect breastfeeding initiation, duration, and maternal confidence. While literature extensively covers maternal attitudes, few studies simultaneously examine the prevalence of these myths among pregnant women and their spouses, despite the spouses' critical role in breastfeeding outcomes. This study aimed to examine and compare the levels of belief in breastfeeding myths among pregnant women and their spouses, and to determine the factors associated with these myths. This descriptive, cross-sectional, comparative study included 616 participants (308 pregnant women and their spouses) via convenience sampling. Data were collected using a descriptive characteristics form and the Breastfeeding Myths Scale, and analyzed via descriptive statistics, t-tests, and multiple linear regression. Spouses had significantly higher breastfeeding myth scores than pregnant women. Myths were more common among participants with low education and income levels. Among pregnant women, higher myth scores were associated with unemployment, lack of children, no breastfeeding education, and daily social media use exceeding 5&#x2009;hours. Younger age and longer prior breastfeeding duration were also linked to greater myth prevalence. The results of this study indicate that efforts to dispel breastfeeding myths must focus more heavily on spouses and socioeconomically disadvantaged groups. Actively involving not only expectant mothers but also their partners-who are more prone to believing breastfeeding myths-in childbirth preparation and breastfeeding education may help reduce these misconceptions. Furthermore, it is crucial for healthcare professionals to be aware of culturally prevalent breastfeeding myths and to guide individuals toward reliable sources of information.

Prenatal education is key to promoting breastfeeding. To address equity and access challenges, health care facilities are increasingly offering online prenatal education in addition to in-person sessions. This study aimed to estimate the influence of online and group prenatal education services, used separately or together, on breastfeeding determinants (intentions, self-efficacy) and outcomes (initiation, exclusivity) among nulliparous pregnant persons, compared with standard prenatal care. A prospective cohort study was conducted from June 2018 to September 2020 in Qu&#xe9;bec, Canada with 863 nulliparous pregnant persons from 2 adjacent regions. Prior to the COVID-19 pandemic, 358 participants completed questionnaires at 3 time points about their use of prenatal education services in which breastfeeding-related content was optional. Based on their self-reported use, participants were divided into 5 categories: (1) face-to-face group prenatal education, (2) asynchronous online prenatal education, (3) both (with breastfeeding), (4) either group/online/both (opted out of breastfeeding content), and (5) standard prenatal care only. Repeated-measures analysis of variance, generalized linear mixed models, mixed-effects logistic regression, &#x3c7;2, and Fisher's exact test were conducted. A total of 53.3% of participants chose the prenatal education services with breastfeeding information. When compared with standard prenatal care only, exposure to breastfeeding information from the online option alone or from both services was associated with breastfeeding intentions and initiation. No prenatal education services were associated with self-efficacy or exclusivity; however, higher prenatal breastfeeding self-efficacy predicted exclusivity 4 weeks after childbirth. Study findings highlight the complementary contribution of asynchronous online and in-person group prenatal education services to breastfeeding, adding to the scant literature comparing these educational options. This can help health care providers, decision-makers, and policy makers identify avenues to strengthen equity in the administration of breastfeeding education, thereby providing expectant persons with better strategies for choosing and maintaining breastfeeding.

To examine the association between breastfeeding duration and incidence of type 2 diabetes (T2D) across five racial and ethnic groups. Breastfeeding is a potent protective factor for many adverse perinatal outcomes and subsequent chronic disease conditions. Compared to non-breastfeeding parous women, multinational meta-analysis revealed that women who breastfed, especially for a duration extending beyond 12&#x2009;months, experienced a significant T2D risk reduction later in life. This study will examine the relationship between breastfeeding and T2D in women from five racial and ethnic groups with a range of risks. All multiethnic cohort (MEC) women who completed the 2003-2008 follow-up questionnaire when breastfeeding was assessed. Incident T2D was assessed using self-reported data and administrative data sources. Cox proportional hazards regression of incident T2D with age as the time metric stratified by race and ethnicity estimated its association with breastfeeding adjusted for relevant covariates. After exclusion of prevalent T2D cases, 5122 incident cases were detected. Of these, 53% of women without incident T2D ever breastfed in comparison to 51.8% of those with incident T2D. In women with any number of children, cumulative breastfeeding duration of &#x2265;24&#x2009;months resulted in an adjusted hazard ratio (HR) of 0.87 [0.78, 0.96], P-value <.01. In models examining any breastfeeding stratified by race and ethnic group, a lower risk was observed only in White women (adjusted HR of 0.87 [0.77,0.98], P-value < .02) while for cumulative duration of &#x2265;24&#x2009;months a lower risk was observed only in Native Hawaiian women (adjusted HR of 0.65 [0.45,0.93], P-value < .02). Risk of T2D was reduced with cumulative duration of breastfeeding &#x2265;24&#x2009;months, especially in Native Hawaiian women. Extended breastfeeding should be encouraged as a preventative strategy for T2D prevention, especially in Native Hawaiian women who have a high risk for T2D.

This is a descriptive cross-sectional study that aimed to determine the factors that affect suboptimal breastfeeding practices among mothers, assess the nutritional status of infants 1-6 months of age, and determine the association between suboptimal breastfeeding practices and the nutritional status of infants. The study was done at various pediatric wards and outpatient departments of the All India Institute of Medical Sciences, Bhubaneswar, Odisha, India. A total of 258 mother-child dyads participated in this study. Suboptimal breastfeeding practices (which means delayed initiation of breastfeeding, discarding colostrum, giving prelacteal feeding, or nonexclusive breastfeeding) and their associated factors (maternal, socioeconomic, environmental, and infant characteristics) were assessed, as well as the nutritional status of infants and its association with suboptimal breastfeeding. The prevalence of suboptimal breastfeeding was 45.7%. Significant factors included outborn delivery (prevalence ratio [PR] = 1.50, p = 0.003), cesarean delivery (PR = 1.38, p = 0.03), preterm birth (PR = 1.47, p = 0.01), and lack of postnatal breastfeeding assistance (PR = 1.56, p = 0.02). Finally, suboptimal breastfeeding practices were associated with being underweight (p = 0.04) and with stunting (p = 0.01).

To estimate the prevalence of breastfeeding-overall, exclusive, partial and depending on infants' age-in infants with Down syndrome, and to investigate associated factors. A systematic literature search was conducted in Medline, Cochrane Library, Web of Science, Embase, CINAHL and SciELO up to 1 August 2024. Original articles that estimated the prevalence of breastfeeding in infants with Down syndrome, written in French, English or Spanish, were included. Study quality was assessed using the Joanna Briggs Institute (JBI) scale. Meta-analyses were performed for breastfeeding outcomes and meta-regression explored heterogeneity. The review was registered in PROSPERO (CRD42021278019). Twenty-six studies (3463 infants) were included. The estimated prevalence of overall breastfeeding regardless of duration was 71.6% (95% CI [60.3; 80.7]; 25 studies, 3351 infants) with high heterogeneity, I2&#x2009;=&#x2009;94%. The estimated prevalence of exclusive breastfeeding was 38.4% (95% CI [22.4; 57.3]; 10 studies, 1099 infants). No factor assessed in meta-regression was significantly associated with overall breastfeeding. The estimated breastfeeding prevalence in infants with Down syndrome is similar to that reported in the general population, despite high heterogeneity. Further studies using standardised methodology to assess breastfeeding barriers and facilitators in the context of Down syndrome would allow us to improve support for breastfeeding.

Perinatal depression is a common mood disorder that can negatively affect maternal health and early mother-infant interactions, including breastfeeding practices. Although depression has been linked to lower breastfeeding initiation and duration, the mechanisms underlying this relationship remain poorly understood. Childbirth experience-a subjective psychological response to labor and delivery-may play a key mediating role, yet limited research has examined this pathway in the early postpartum period. This study aimed to understand the mediating effect of childbirth experience on the correlation between perinatal depression and early breastfeeding behavior. One hundred and one puerpera with natural childbirth were enrolled at the Lianyungang Maternity and Child Health Hospital during September and October 2022 through convenient sampling. Questionnaires were completed within three days postpartum. We investigated the demographic characteristics and early breastfeeding behaviors and measured the childbirth experience and perinatal depression levels using the Childbirth Experience Questionnaire (CEQ 2.0) and the Edinburgh Postnatal Depression Scale (EPDS), respectively. Pearson correlation analysis and T-tests were used to explore their early-stage correlation, and the mediating effect of the childbirth experience was analyzed using Bootstrap. Childbirth experience had a negative correlation with perinatal depression (r = -0.217, P&#x2009;<&#x2009;0.05). T-test results indicated a significant relationship between early breastfeeding behavior, perinatal depression level, and childbirth experience (P&#x2009;<&#x2009;0.05). Mediation analysis revealed that childbirth experience accounted for 39.9% of the total effect of perinatal depression on early breastfeeding behavior, indicating partial mediation. However, perinatal depression remained directly and significantly associated with early breastfeeding behavior after accounting for the mediator (P&#x2009;<&#x2009;0.05). Childbirth experience partially mediates the relationship between perinatal depression and early breastfeeding behavior. These findings suggest an association rather than a causal relationship, and highlight the importance of addressing both psychological well-being and childbirth experiences in clinical settings to promote breastfeeding.

To examine the impact of one-to-one peer support on mothers' personal breastfeeding goals. Scoping review guided by Arksey and O'Malley's five-stage framework and reported in accordance with PRISMA-ScR guidelines. Qualitative data were analysed using descriptive content analysis. Quantitative data were analysed by identifying numerical trends and recurring patterns, and a concise overview of key descriptive findings was provided using frequency counts and proportions. Studies conducted across 10 countries globally, identified through systematic searches of seven electronic databases and screening of reference lists. Thirty-eight studies were included: 20 quantitative, 7 qualitative, 6 mixed-methods, and three secondary analyses (drawing on two relevant primary sources). Participants were mothers who received one-to-one breastfeeding peer support, predominantly in community or home-based settings. One primary outcome was assessed: The impact of one-to-one peer support on mothers' personal breastfeeding goals. Two secondary outcomes were identified. The first examined the effect of one-to-one peer support on breastfeeding outcomes based on traditional measures of breastfeeding success. Of the included studies, 50% reported positive effects of one-to-one peer support on traditional measures of breastfeeding success, while 21% found no statistically significant differences. An additional secondary outcome reported in 34% of the included studies examined the impact of mother-centred breastfeeding peer support on maternal emotional well-being. One-to-one peer support enhances the mothers' ability to achieve their personal breastfeeding goals and positively influences emotional well-being. These findings underscore the need to integrate structured one-to-one peer support into maternal health services in Ireland and globally.

To explore community pharmacists' breastfeeding knowledge, including medicine-breastfeeding compatibility and breastfeeding complications, training, and confidence levels. A cross-sectional survey study was conducted using a paper-based questionnaire over 2&#xa0;months. Eighty-two pharmacists out of 114 participated, yielding a 72% response rate. Although most rated their knowledge positively, objective knowledge was variable; only 11% identified correct breastfeeding duration. Confidence was highest for advising on medicine-breastfeeding compatibility but modest for identifying and managing breastfeeding complications. Nearly all participants (99%) desired further training. Pharmacists demonstrated inconsistent breastfeeding knowledge and confidence, highlighting the need for structured breastfeeding education within undergraduate and continuing professional development programmes.

We comprehensively identified the challenges associated with psychotropic-medication use during breastfeeding in Japan and explored strategies to enhance breastfeeding support. We analyzed breastfeeding-consultation records of cases involving postpartum mothers received by the Japan Drug Information Institute in Pregnancy (JDIIP) between February 2012 and March 2022, and corresponding questionnaire responses regarding the use of psychotropic medications. The "Perinatal Mental Health Consensus Guide" was used as a benchmark to examine temporal trends. To assess changes in consultation patterns over time, the study period was divided into a pre-publication (2012-2016) and post-publication phase (2017-2022). 7,863 breastfeeding consultations were analyzed. Before and after the guide's publication, no significant difference was observed in the proportion related to mental disorders. Among consultations involving mental disorders, psychiatrists were the most common healthcare providers from whom advice had been sought before consultation, before and after the guide's publication, followed by obstetricians. Although approximately half of the healthcare providers had previously indicated that medication use during breastfeeding was possible, the proportion advising mothers to discontinue breastfeeding while taking psychotropic medications decreased after the guide's publication. Most mothers were prescribed multiple medications, with benzodiazepines being the most frequently discussed. However, the proportion of such consultations decreased significantly after the guide's publication. Consultations with specialized counseling agencies regarding psychotropic medication use during breastfeeding occurred at a consistent frequency regardless of guideline dissemination. While the guidelines' publication appears to have influenced healthcare providers' awareness, further examination is necessary to determine how best to provide information supporting breastfeeding.

This study aimed to learn managers' points of view on maternity leave and breastfeeding and find promotion, protection, and support strategies for breastfeeding in the work environment. This qualitative study, using Laurence Bardin's content analysis, was conducted with eight managers in 2023 in Uberl&#xe2;ndia, Minas Gerais State, Brazil. We used a semi-structured script with questions about how managers organized women workers' activities before they took their maternity leaves and after their return to work and questions about managers' points of view about breastfeeding and maternity leave. Answers were analyzed using NVivo. We established three big topics from the content of the interviews, namely: (1) managers' point of view regarding the duration of maternity leave and breastfeeding; (2) rights, incentives, and work conditions; and (3) the organization of the work environment during maternity leave. We verified compliance with the 4-month maternity leave provided for in the Brazilian Consolidation of Labor Laws, highlighting the disagreement of leave duration and the health recommendation for exclusive breastfeeding of up to six months. We also found that managers' lack of awareness about government programs encourage companies to support breastfeeding by tax reduction benefits and extended maternity leaves. Managers' point of view and personal experiences permeate knowledge about laws protecting female workers. The pro-breastfeeding strategy only involved complying with the maternity leave duration provided by law, which indicates the need for greater investments in awareness-raising actions for managers regarding the review of the concept of maternal protection.

To evaluate the effect of training conducted using simulation- and booklet-based training techniques on breastfeeding self-efficacy, breastfeeding, and breast-related problems. This randomized controlled trial was conducted between July and December 2023 in obstetric outpatient clinics with women receiving antenatal care (control group: 22, booklet-based training group: 22, and simulation-based training group: 22). A total of five interviews with all participants were conducted. The data were collected with a Personal Information Form, the Breastfeeding Self-Efficacy Scale (BSES), and the Breastfeeding Experience Scale (BES). Data analysis was conducted using the SPSS software using descriptive statistics, chi-square, Kruskal Wallis test, and Bonferroni correction test. In the study, the groups were homogeneous in terms of obstetric and birth-related characteristics (P > 0.05). The total BSES scale scores of the women in the booklet-based and simulation-based groups were higher than those in the control group in the 2nd, 3rd, 4th, and 5th interviews after the training (&#x3b7;&#xb2; = 0.292; 0.543; 0.640; and 0.682 according to the times). The mean BES scale scores of the women in the booklet-based and simulation-based groups were lower than those of the women in the control group in the 4th and 5th interviews postpartum after the training given (&#x3b7;&#xb2; = 0.368; 0.508 according to the times). Booklet- and simulation-based breastfeeding training given starting from the antenatal period was effective in increasing breastfeeding self-efficacy, as well as in identifying and solving postpartum problems at an early stage.

Timely initiation of breastfeeding is among the major public health problems that contribute to childhood undernutrition, morbidity, mortality, impaired intellectual development, suboptimal adult work capacity, and increased risk of non-communicable chronic diseases worldwide, including in Ethiopia Nevertheless, the country-specific determinants of early initiation of breastfeeding in Ethiopia show inconsistent results, and therefore we aimed at synthesizing the existing literature on early initiation of breastfeeding in Ethiopia. While previous national systematic reviews have aggregated broad institutional data, local findings remain highly divergent, and an updated synthesis filtering for rigorous adjustment of confounding factors is lacking. This study aims to bridge this evidence gap by pooling contemporary data to provide clearer policy relevance for maternal and child health interventions. Biomedical electronic databases, including PubMed/Medline, HINARI, Science Direct, African Journal Online (AJOL), and Google Scholar, based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), were used, and the protocol was registered in PROSPERO (CRD420261307602). The available literature was critically reviewed, and STATA software version 13 was used to analyses the extracted data. Heterogeneity among studies was assessed using I2 and meta-bias statistics for publication bias. A random-effects model with a 95% confidence interval was used for pooled estimations. Of the 146 articles screened, 19 of them revealed that mothers residing in urban areas OR&#x2009;=&#x2009;OR&#x2009;=&#x2009;2.02 (95% CI: 1.31-3.10), counselled during antenatal care OR&#x2009;=&#x2009;OR&#x2009;=&#x2009;2.97 (95% CI: 2.00-4.41), advised during postnatal care OR&#x2009;=&#x2009;6.27 (95% CI: 2.09-18.74), had normal delivery (spontaneous vertex delivery) OR&#x2009;=&#x2009;2.99 (95% CI: 1.27-7.06), delivered at health institutions OR&#x2009;=&#x2009;5.24 (95% CI: 2.16-12.74), and did not practice pre-lacteal feeding to their newborns OR&#x2009;=&#x2009;7.95 (95% CI: 3.62-17.47) were the significant factors associated with early initiation of breastfeeding in Ethiopia. This review provides consolidated evidence regarding the key structural, institutional, and behavioral predictors of EIBF in Ethiopia. Because the primary data are derived from observational designs, these associations reflect strong prognostic indicators rather than definitive causal links. To increase the practice of early breastfeeding initiation, a combination of actions like behavioral change communication and the need for expanded maternal healthcare access, addressing home birth barriers, as well as implementing health service protocols are recommended.

To explore the experiences and factors associated with exclusive breastfeeding among women with postpartum depression (PPD). Following Arksey and O'Malley's methodological framework for scoping studies, searches were conducted in the CINAHL (Cumulative Index to Nursing and Allied Health Literature), PubMed, ScienceDirect, Scopus, EBSCO, Virtual Health Library, and Taylor & Francis databases. Full-text articles published in English, Spanish, and Portuguese between 2015 and 2024 on breastfeeding experiences among women up to 6 months postpartum with PPD. In total, 14 articles met the inclusion criteria. Data were charted using a spreadsheet matrix, which included the following information: authors, year of publication, country, study population, objectives, methods, and main findings. Extracted data were collated and analyzed using thematic synthesis to group recurring patterns into conceptual themes. Consequently, a variety of experiences with exclusive breastfeeding were identified among women with PPD and classified into three main categories: (a) rewarding, characterized by emotional bonding and a sense of accomplishment; (b) frustrating, often involving latching difficulties, low supply, or feelings of inadequacy; or (c) supportive, highlighting the critical role of health care provider encouragement and perseverance. These experiences were influenced by sociocultural, physical, psycho-emotional, and health care-related factors. The experiences of women with PPD who exclusively breastfeed are shaped by multiple interrelated factors that affect the breastfeeding process. Health care systems and public policies must integrate emotional and physical support strategies to strengthen breastfeeding, especially among women experiencing PPD.

Labor induction using medications such as synthetic oxytocin (synOT) and prostaglandins (PG) has become increasingly common; however, its implications for mother-to-infant bonding remain unclear. These agents may plausibly influence early bonding by altering peripartum oxytocin-related physiology and by affecting early breastfeeding establishment. We examined whether labor induction and specific induction agents are associated with postpartum mother-to-infant bonding trajectories and evaluated breastfeeding mode as a potential mediator. We analyzed data from the Japan Environment and Children's Study (JECS). Among 104,059 fetal records, we included 58,384 mother-infant dyads with complete bonding data at 1, 6, and 12 months postpartum (56.1%; complete-case analysis), restricted to liveborn, term, singleton vaginal deliveries. Mother-to-infant bonding was assessed as mothers' self-reported bonding-related feelings using the Mother-to-Infant Bonding Scale (MIBS). Induction status and induction agents (synOT, PG) were obtained from transcribed medical records. Linear mixed-effects models tested associations with bonding trajectories, and mediation analyses evaluated whether 1-month feeding mode (exclusive formula vs. any breastfeeding) accounted for observed associations. Induction was associated with a time-varying pattern in mother-to-infant bonding (time&#x2009;&#xd7;&#x2009;induction: &#x3b2;&#x2009;=&#x2009;-0.057, 95% CI [-0.067, -0.046], p&#x2009;<&#x2009;0.001), although contrasts at 1, 6, and 12 months were not significant (&#x3b2;&#x2009;=&#x2009;0.013, p&#x2009;=&#x2009;0.109; &#x3b2;&#x2009;=&#x2009;0.005, p&#x2009;=&#x2009;0.482; &#x3b2;&#x2009;=&#x2009;0.000, p&#x2009;=&#x2009;0.953). SynOT was associated with poorer bonding at 1 and 6 months (&#x3b2;&#x2009;=&#x2009;0.027, p&#x2009;=&#x2009;0.004; &#x3b2;&#x2009;=&#x2009;0.016, p&#x2009;=&#x2009;0.024), but not at 12 months (&#x3b2;&#x2009;=&#x2009;0.010, p&#x2009;=&#x2009;0.205). Mediation via feeding was small for induction (indirect effect&#x2009;=&#x2009;0.001, 95% CI [0.0002, 0.001]) and not supported for synOT (indirect effect&#x2009;=&#x2009;0.0004, 95% CI [-0.00009, 0.001]). Labor induction and synOT exposure were associated with poorer early postpartum mother-to-infant bonding, with differences attenuating over the first postpartum year. Exclusive formula feeding was associated with poorer bonding and may contribute to early postpartum differences, supporting the clinical value of proactive breastfeeding support and attention to maternal wellbeing while reassuring families that early challenges often ease over time.

This longitudinal case report describes the unique experiences of a single mother-infant dyad focusing on the impact of early pacifier use, scheduled feeding, and alcohol resumption at 3 weeks postpartum on breastfeeding behavior and infant growth. Early pacifier use and scheduled feeding were associated with decreased breast stimulation and suckling frequency. Alcohol resumption at 3 weeks, initiation of pumping at 7 weeks, and increased consumption, coinciding with menses, likely accelerated a decline in milk supply and suboptimal infant weight gain that preexisted. These challenges necessitated formula supplementation and the pharmacologic galactagogue metoclopramide. Alcohol use ceased at 17 weeks during a transition to mixed feeding but resumed at 24 weeks. This case illustrates a cycle where reduced suckling and alcohol-induced inhibition of the milk ejection reflex contributed to low milk supply, early supplementation, and pharmacologic intervention. Nurses play a critical role in providing proactive education on these factors.

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