Scoping Review of Women's Experiences of Breastfeeding Associated With Maternity Care in Hospitals That Implement Baby-Friendly Policies

Abstract

Objective: To explore what is currently known about women's breastfeeding experiences associated with maternity care in facilities that implement policies supported by the Baby-Friendly Hospital Initiative (BFHI).

Data sources: We used the scoping review methodology of JBI. We searched the Scopus, CINAHL, Embase, MEDLINE (Ovid), and PsycINFO databases and gray literature.

Study selection: We considered articles published during or after 1991 in English. Inclusion criteria were based on the participant, concept, and context framework and included women who gave birth and initiated breastfeeding during or after maternity care in facilities that were certified through the BFHI, were working toward certification, or were implementing BFHI-aligned policies.

Data extraction: We extracted the following data from each report: author(s), year/country of publication, study design, research aim, patient population/sample size, clinical setting, BFHI status, and outcomes. We further extracted relevant outcomes by using concepts from the interactive theory of breastfeeding.

Data synthesis: We included 44 reports of studies conducted in 19 countries in the review: 27 quantitative, 9 qualitative, and 8 mixed-methods studies. We mapped the extracted data to 10 concepts from the interactive theory of breastfeeding to classify patient experiences, including dynamic interaction between mother and child; stress; time; woman's and child's biological conditions; woman's and child's perception; woman's decision-making; family and social authority; woman's body image; space; and organizational systems for the protection, promotion, and support of breastfeeding.

Conclusion: We found that various interrelated factors in addition to BFHI-specific policies influenced women's experiences. Based on these results, we suggest that awareness of women's personal breastfeeding experiences is crucial to delivering optimal care and developing evidence-based policies. Breastfeeding practice guidelines and policies should be developed to encompass women's experiences to enhance future inpatient breastfeeding support.

Keywords: breastfeeding; decision-making; hospitals; mother–child relations; patient outcome assessment; policy.