Health determinants associated with exclusive breastfeeding: a scoping review

Silva, Ananda Larisse Bezerra da; Ferreira, Cecilia Rafaela Salles; Santos, Priscilla Guerra dos; Oliveira, Elizabete Regina Araújo; Miotto, Maria Helena Monteiro de Barros

doi:10.1590/1982-0216/20232556822

Ananda Larisse Bezerra da Silva

Study conceptualization and project

Article development

Data acquisition

Analysis, and interpretation

Approval of the final version

Universidade Federal do Espírito Santo - UFES, Vitória, Espírito Santo, Brasil.

https://orcid.org/0000-0003-0061-1103

Cecilia Rafaela Salles Ferreira

Critical review

Data acquisition

Analysis, and interpretation

Universidade Federal do Amapá - UFAP, Macapá, Amapá, Brasil.

https://orcid.org/0000-0001-6366-3440

Priscilla Guerra dos Santos

Data acquisition

Analysis, and interpretation

Universidade Federal do Espírito Santo - UFES, Vitória, Espírito Santo, Brasil.

https://orcid.org/0000-0001-9309-6459

Elizabete Regina Araújo Oliveira

Critical review

Approval of the final version

Universidade Federal do Espírito Santo - UFES, Vitória, Espírito Santo, Brasil.

https://orcid.org/0000-0002-6616-4273

Maria Helena Monteiro de Barros Miotto

Study conceptualization and project

Approval of the final version

Universidade Federal do Espírito Santo - UFES, Vitória, Espírito Santo, Brasil.

https://orcid.org/0000-0002-3227-7608

Corresponding author: Ananda Larisse Bezerra da Silva, Avenida França, 267, São José, CEP: 68906-172 - Macapá, Amapá, Brasil, E-mail: anandalarisse@hotmail.com

Conflict of interests: Nonexistent.

Medline	(((Breast[ti] AND (Feed[ti] OR milk[ti])) OR Breastfeed[ti] OR Breastfed[ti]) AND (exclusive*[tiab] OR only[tiab] OR full[tiab])) AND («associated factors»[tiab] OR aspect[tiab] OR cause[tiab] OR circumstance[tiab] OR determinant[tiab] OR «Associated Factor»[tiab]).
Lilacs	((ti:Breast AND ti:(Feed* OR milk)) OR ti:Breastfed* OR ti:Breastfeed* OR ti:amamanta* OR ti:amamenta* OR ti:aleitamento) AND tw:(exclusiv* OR only OR full OR apenas OR unicamente OR somente) AND tw:(«associated factors» OR aspect OR cause OR circumstance OR determinant OR «Associated Factor» OR «fatores associados» OR causa OR Circunstancia OR determinante OR «fator associado» OR «factores asociados» OR «factor asociado»).
CINAHL	TI ((Breast AND (feed* OR milk)) OR breastfeed* OR breastfed) AND (AB ((exclusive OR only OR full) AND («associated factors» OR aspect OR cause OR circumstance OR determinant OR «Associated Factor»)) OR TI ((exclusive OR only OR full) AND («associated factors» OR aspect OR cause OR circumstance OR determinant OR «Associated Factor»)))
Scopus	(((TITLE(Breast) AND (TITLE(Feed) OR TITLE(milk))) OR TITLE(Breastfeed) OR TITLE(Breastfed)) AND (TITLE-ABS(exclusive*) OR TITLE-ABS(only) OR TITLE-ABS(full))) AND (TITLE-ABS(«associated factors») OR TITLE-ABS(aspect) OR TITLE-ABS(cause) OR TITLE-ABS(circumstance) OR TITLE-ABS(determinant) OR TITLE-ABS(«Associated Factor»))
EMBASE	(((Breast:ti AND (Feed:ti OR milk:ti)) OR Breastfeed:ti OR Breastfed:ti) AND (exclusive*:ti,ab OR only:ti,ab OR full:ti,ab)) AND (‘associated factors’:ti,ab OR aspect:ti,ab OR cause:ti,ab OR circumstance:ti,ab OR determinant:ti,ab OR ‘Associated Factor’:ti,ab)
BDTD	«(Todos os campos:»Aleitamento materno» OR amamentação OR Breastfeed OR Breastfed OR Breastfeeding E Todos os campos:apenas OR unicamente OR somente OR exclusivo OR «associated factors» OR aspect OR cause OR circumstance OR determinant OR «Associated Factor» E Todos os campos:»fatores associados» OR causa OR Circunstancia OR determinante OR «fator associado» OR «factores asociados» OR «factor asociado»)»

Distal
Characteristics of the families and homes	Characteristics that involve the support network for mothers, such as paternal age and educational attainment, family income, and housing conditions.
Characteristics of the mother	Characteristics of skin color or race, age, educational attainment, parity, previous breastfeeding experience, marital status.
Intermediate
Characteristics of the pregnancy	Maternal nutritional status, desired pregnancy, smoking, alcoholism, prenatal attention, attendance to and frequency of prenatal care, information on breastfeeding, participation in prenatal groups, and prenatal funding.
Characteristics of delivery care	Being born at a Baby Friendly Hospital or one with a human milk bank, maternity funding, and breastfeeding guidance and practices.
Characteristics of the mother during the hospital stay	Intention to breastfeed, type of delivery, time until first breastfeeding, exclusive breastfeeding at hospital discharge.
Characteristics of the infant	Birth weight, gestational age, complications immediately after birth, and infant’s sex.
Proximal
Characteristics of the breastfeeding mother/family	Employment/maternity leave, fatigue and emotional indicators, knowledge of exclusive breastfeeding, breastfeeding difficulties, family support and relationship, and child’s caregiver.
Characteristics of the infant	Age, health, pacifier use.
Characteristics of the health services	Type of primary healthcare funding, type of community health center, mother’s satisfaction with support given at the service, breastfeeding instructions, follow-up at a breastfeeding-friendly health unit.

Variables	Number of Studies	%
Continent
Africa	38	26
Central America	5	3
North America	3	2
South America	61	42
Asia	24	17
Europe	7	5
Middle East	7	5
Study type
Cross-sectional	81	56
Cohort	43	30
Case-control	4	3
Integrative and systematic reviews, with or without meta-analyses)	8	5
Multilevel analysis	3	2
Qualitative	3	2
Mixed method	3	2
Prevalence of exclusive breastfeeding
0 to 30%	45	31
31 to 50%	54	37
51 to 90%	26	18
Not assessed	5	4
Not described	15	10

DISTAL MODEL		INTERMEDIATE MODEL		PROXIMAL MODEL
Characteristics of the families or homes	n	Characteristics of the pregnancy	n	Characteristics of the breastfeeding mother/family	n
Family income	36	Attendance to and frequency of prenatal care	16	Maternal employment and maternity leave	46
Housing conditions	10	Information on breastfeeding	10	Knowledge of EBF	19
Support network	8	Prenatal attention	5	Breastfeeding difficulties	13
Paternal educational attainment	2	Desired pregnancy	4	Family support and relationship	11
Paternal age	0	Maternal nutritional status	3	Fatigue and emotional indicators	8
Characteristics of the mother		Participation in prenatal groups	1	Child’s caregiver	0
Educational attainment	48	Smoking	1	Characteristics of the infants
Maternal age	37	Alcoholism	0	Pacifier use	27
Parity	25	Prenatal funding	0	Age	21
Marital status	10	Characteristics of delivery care		Infant’s health	6
Previous breastfeeding experience	7	Breastfeeding guidance	3	Characteristics of the health services
Skin color or race	1	Breastfeeding practices	3	Breastfeeding instructions	9
		Maternity funding	1	Type of primary healthcare funding	6
		Birth at a Baby Friendly Hospital or one with a human milk bank	0	Type of community health unit	4
		Characteristics of the mother during the hospital stay		Mother’s satisfaction with support given by the service	2
		Time until first breastfeeding	17	Follow-up at a breastfeeding-friendly health unit	0
		Type of delivery	15
		Intention to breastfeed	9
		EBF at hospital discharge	1
		Characteristics of the infant
		Sex of the newborn	10
		Birth weight	5
		Gestational age	1
		Complications immediately after birth	0

[1] Corresponding author: Ananda Larisse Bezerra da Silva, Avenida França, 267, São José, CEP: 68906-172 - Macapá, Amapá, Brasil, E-mail: anandalarisse@hotmail.com

Brasil

Brasil

Health determinants associated with exclusive breastfeeding: a scoping review

ABSTRACT

Purpose:

Methods:

Literature Review

Conclusion: