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Open research questions in Breastfeeding Practices and Influences

94 unresolved questions extracted from the limitations and future-work sections of 1,724 Breastfeeding Practices and Influences papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Enuresis in obese children may also be the necessity of underrecognized, emphasizing careful unnecessary to assessment psychological distress in this vulnerable group [19].

    Association of Infancy Breastfeeding with the Childhood Mono-Symptomatic Enuresis in Iraqi Children · 2026 · DOI

  • Results: In all, 86% of participants were unaware of human milk banks, 75% had limited knowledge of them, and 67% were willing to donate milk.

    Knowledge and Acceptability Towards Human Milk Bank Use Among Women Attending Haydom Lutheran Hospital, Tanzania · 2026 · DOI

  • Some limitations of this study include the lack of maternal inflammatory biomarker data at 3 months, which limited our ability to interpret the role of inflammation in this cohort. Another limitation of this study is the lack of maternal dietary data collection, since maternal dietary intake can impact milk fatty acid profile, particularly the milk PUFA (34,35).

    Milk mid-chain fatty acids and vitamin D supplementation are associated with prevalence of exclusive breastfeeding in Bangladeshi mothers · 2026 · DOI

  • This study was limited by its retrospective na- ture and small sample size (n = 34), which precludes broad generalization. The cohort was drawn from a private online practice, suggesting potential selec- tion bias for highly motivated patients. Additionally, the lack of controlled comparison groups limits de- finitive conclusions about causality, although the findings align with previous research. Future research should examine long-term out- comes, such as sustained breastfeeding rates and maternal adherence [30], prescriber and maternal confidence and satisfaction to understand the full im- pact and scalability of the intervention. The service was provided through a private telepharmacy mod- el (self-pay). For real-world scalability, establishing reimbursement pathways for pharmacist consulta- tions is essential to ensure long-term sustainability and equitable access. CONCLUSIONS The multifaceted nature of pharmacist opti- mization interventions documented in this study— encompassing patient education, interprofessional communication, and systemic monitoring—directly addresses the fragmented care and fear-based bar- riers that compromise maternal health and breast- feeding continuation. The evidence supports the integration of specialized pharmacist services as a valuable component of comprehensive maternal health care delivery.

    Pharmacotherapy Optimization in Breastfeeding Mothers: A Retrospective Analysis of Interprofessional Pharmacist Interventions Using the MILC-APIC Tool · 2026 · DOI

  • Although the precise biological mechanisms through which the bioactive constituents of human milk exert their effects on the infant organism have not yet been fully elucidated, the current body of evidence supports the conclusion that breastfeeding is superior to formula feeding in terms of health benefits. Nonetheless, further large-scale, well-designed studies are warranted to precisely delineate the optimal duration of breastfeeding, the most appropriate maternal dietary patterns during lactation, and the type, frequency, and intensity of maternal physical activity that would most effectively contribute to minimizing the risk of overweight, obesity, and other non-communicable diseases in offspring in the long term.

    BREASTFEEDING AND PHYSICAL ACTIVITY, ITS IMPACT ON THE INCIDENCE OF OBESITY IN OFFSPRING IN THE FUTURE · 2026 · DOI

  • Exclusive breastfeeding (EBF) for the first six months is a critical protective practice, yet determinants beyond knowledge among young mothers in peri-urban sub-Saharan Africa remain insufficiently understood.

    Beyond knowledge: Psychosocial, traditional, and structural determinants of exclusive breastfeeding among young mothers aged 15-29 years in Peri-urban Lusaka, Zambia. A Facility-based cross-sectional study · 2026 · DOI

  • However, there are limited data from the context of universal antiretroviral therapy (ART) and promotion of extended breastfeeding (BF) for infants HEU.

    Association between infant feeding practices and infant growth by maternal HIV and antiretroviral therapy status: a prospective study in Cape Town, South Africa · 2026 · DOI

  • This study had some limitations. Although this was a national study, most participants resided in western US states. Therefore, findings may be more representative of the experiences of PWH from the Western states. Future research should seek to have a broad and even geographic distribution to better compare the experiences of PWH across the US. Furthermore, while this study utilized an intersectional lens, questions exploring the role of race and ethnicity on infant feeding decisions were not asked. Therefore, the research team was unable to confirm racial identities as an influence on infant feeding decision-making. the study’s modest sample size, we Additionally, despite identified recurring themes in the data. However, we may not have reached data saturation due to the pilot nature of this study. While we know that all women who took part in the study were on ART, we do not know if they were virologically suppressed. Therefore, we cannot speak the information given by providers about infant feeding options or HIV risk was correct or incorrect. Regardless of whether the participant was viremic or not and whether the information given by the provider was medically accurate, some participants described their providers. Finally, participation bias may also be present, as this was a sample of people willing to share their infant feeding decisions, who had time reliable internet access.

    Infant feeding decisions among people living with human immunodeficiency virus in the United States: a pilot study · 2026 · DOI

  • Based on the findings of this study, it is recommended to strengthen breastfeeding education for adolescent mothers by developing age-appropriate, simplified breastfeeding modules that include visual aids and instructional guides to ensure that young mothers learn and understand proper breastfeeding techniques before discharge. The institution should enhance lactation support services by establishing a dedicated breastfeeding and lactation management committee composed of nurses, midwives, and lactation counselors to assist mothers and provide bedside coaching during the immediate postpartum period, thereby enhancing their skills and building maternal confidence. It is also recommended to include family members or a support person during counseling sessions to reinforce the mother’s support system at home. A discharge monitoring system should be implemented through a 48- to 72-hour follow-up service after discharge at the Outpatient Department or the local Rural Health Unit to support sustained breastfeeding. Future research should employ larger sample sizes and longitudinal designs to better understand other factors or variables that may influence breastfeeding practices. ACKNOWLEDGMENT I humbly express my heartfelt gratitude to all those who made the completion of this study possible. To my adviser, mentors, family, and friends for unwavering assistance and support. Most especially to the participants of this study, whose participation served as the foundation of this study. To all who contributed, directly or indirectly, to the success of this study, I offer my sincere appreciation and gratitude. AI DECLARATION STATEMENT: AI-supported tools helped with grammar and structure in creating this article. No AI tools were used to collect, analyze, or interpret data; all authors are credited for their academic contributions. https://epublications.myeduheart.com/index.php/ijnhha/index E-ISSN: 3116-5974 P-ISSN: 3116-5966 101 REFERENCES Burgard, J., Palmquist, A. E. L., & Smith, J. (2023). Missed care and equitable breastfeeding support: An integrative review of exposure to hospital care by patient characteristics and breastfeeding outcomes. Journal of Human Lactation, 39(4), 686-700. Maramag, C.C., Samaniego, J.A.R., Castro, M.C. et al. Maternity protection policies and the enabling environment for breastfeeding in the Philippines: a qualitative study. Int Breastfeed J 18, 60 (2023). https://doi.org/10.1186/s13006-023-00594-w Martínez-García, E., López-Alarcón, M., & Rivera-Dommarco, J. (2025). Impact of Baby- Friendly Hospital Initiative implementation on breastfeeding outcomes: A systematic review and meta-analysis. Maternal & Child Nutrition, 21(1), e13598. World Health Organization. topics/breastfeeding (2023). Breastfeeding.

    Evaluating the Breastfeeding Policy Implementation and Its Influence on Breastfeeding Practices Among Primiparous Adolescent Mothers in a Primary Government Hospital · 2026 · DOI

  • 1. Implementing family-inclusive antenatal/postnatal education, explicitly inviting husbands and mothers-in-law. 2. Mandating breastfeeding-friendly policies in tertiary institutions: lactation rooms and breastfeeding breaks. 3. Implementing family-inclusive antenatal/postnatal education, explicitly inviting husbands and mothers-in-law. 4. Developing postnatal follow-up mechanisms (lactation consultants, hotlines, scheduled check-ins). 5. Designing of male engagement campaigns to normalize paternal support in infant feeding. 6. Community campaigns targeted at older women to dispel myths and align cultural practices with WHO guidelines.

    SIGNIFICANT OTHERS AND PRACTICE OF EXCLUSIVE BREASTFEEDING AMONG MOTHERS IN TERTIARY INSTITUTIONS OF OSUN STATE · 2026 · DOI

  • the absence of several include potentially relevant factors, such as detailed measures of early breastfeeding difficulties, professional lactation support, maternal mental health beyond perceived social support, as well as infant- related clinical variables (e.g., neonatal complications or Neonatal Intensive Care Unit admissions). These unmeasured factors may have influenced breastfeeding self-efficacy and could partially account for observed associations. Furthermore, the Frontiers in Global Women’s Health 08 frontiersin.org Czerwińska-Osipiak et al. 10.3389/fgwh.2026.1813521 exclusion of pre-term deliveries from the study sample limits generalizability of the findings to mothers of pre-term infants— a group in which both birth satisfaction and breastfeeding self- efficacy may be shaped by additional medical and psychological factors not captured in the present analysis. Similarly, the exclusion of mothers who exclusively formula-fed during the first six months limits the applicability of the findings to women with at least some breastfeeding experience after birth. This group may differ from breastfeeding mothers in terms of to social or medical, psychological, breastfeeding, and these determinants would require a separate analytical approach. structural barriers Finally, although a significant moderation effect was identified, the proportion of explained variance was modest, suggesting that breastfeeding self-efficacy is shaped by a broader constellation of biological, psychological and contextual influences not fully captured in the current model. Therefore, the findings should be interpreted with caution. Longitudinal designs should be employed in further research to clarify causal pathways and examine potential mediators, such as early lactation challenges and postpartum mental health. More comprehensive assessment of clinical and environmental factors may further refine the understanding of how birth satisfaction, alongside other dimensions of the childbirth experience, and social support jointly shape breastfeeding self- efficacy.

    Social support as a moderator between birth satisfaction and breastfeeding self-efficacy among polish mothers · 2026 · DOI

  • To our knowledge, this review represents the first NMA to evaluate the efficacy of non-pharmacological TCM therapies on human milk feeding outcomes, providing a comprehensive comparison and ranking of multiple interventions. However, several limitations should be acknowledged. First, due to the inherent characteristics of most non- pharmacological TCM therapies, blinding of participants and providers was not feasible, potentially introducing a Hawthorne effect. Second, provider enthusiasm for the interventions may have unintentionally prolonged breast- feeding guidance beyond standardized protocols. Third, substantial variability in intervention dosage across stud- ies prevented quantitative assessment of dose–response Chu et al. International Breastfeeding Journal (2026) 21:43 Author contribution Liangliang Chu: Writing – review & editing, Writing –original draft, Visualization, Supervision, Software, Resources, Methodology, Investigation, Formal analysis, Data curation, Conceptualization. Cuiping Xu: Writing – review & editing, Writing – original draft, Resources, Investigation. Yanping Liu: Statistical analysis, Writing – review & editing, Project administration, Investigation, Writing –original draft.

    Effectiveness of non-pharmacological traditional Chinese medicine therapies in promoting human milk feeding outcomes: a systematic review and network meta-analysis · 2026 · DOI

  • The indicated reasons for not donating were no milk excess (38%), insufficient knowledge about the procedure or unawareness of its existence (33% and 25%, respectively), long distance to affiliated facility (17%).

    Knowledge, opinions and attitudes of Polish women towards banking and donation of human breast milk · 2021 · DOI

  • Excluding type 2 diabetes (because of insufficient data), we conducted a cost analysis for all pediatric diseases for which the Agency for Healthcare Research and Quality reported risk ratios that favored breastfeeding: necrotizing enterocolitis, otitis media, gastroenteritis, hospitalization for lower respiratory tract infections, atopic dermatitis, sudden infant death syndrome, childhood asthma, childhood leukemia, type 1 diabetes mellitus, and childhood obesity.

    The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis · 2010 · DOI

  • CONCLUSIONS: Recommendations include improvement of maternal education about behaviors to ensure adequate supply, assessment of milk supply, and infant cues as well as further research into the root causes of PIM.

    Maternal Perceptions of Insufficient Milk Supply in Breastfeeding · 2008 · DOI

  • Thematic analysis of women's responses to open questions identified five components of the support that women wanted: information about breastfeeding and what to expect, practical help with positioning the baby to breastfeed, effective advice and suggestions, acknowledgment of mothers' experiences and feelings, and reassurance and encouragement.

    What Information, Advice, and Support Do Women Want With Breastfeeding? · 2005 · DOI

  • UNLABELLED: OBJECTIVES, DESIGN AND SUBJECTS: Earlier results on the effect of breastfeeding on the one hand, and non-nutritive sucking habits (pacifier and/or digit sucking) on the other, on the orofacial development of infants are inconclusive.

    Association between early weaning, non‐nutritive sucking habits and occlusal anomalies in 3‐year‐old Finnish children · 1999 · DOI

  • This schema and framework: (1) acknowledge that the term "breastfeeding" alone is insufficient to describe the numerous types of breastfeeding behavior, (2) distinguish full from partial breastfeeding, (3) subdivide full breastfeeding into categories of exclusive and almost exclusive breastfeeding, (4) differentiate among levels of partial breastfeeding, and (5) recognize that there can be token breastfeeding with little to no nutritional impact.

    Toward Consistency in Breastfeeding Definitions · 1990 · DOI

  • Rationale: Prior studies have found that a history of adverse childhood experiences (ACEs) is associated with breastfeeding initiation and duration, but the evidence is inconsistent.

    Associations between adverse childhood experiences and breastfeeding initiation and duration: a longitudinal birth cohort study in Pakistan · 2026 · DOI

  • Currently, little is known about the relationship between PIMS, actual milk insufficiency, and human milk nutrient composition.

    Maternal perception vs actual breast milk supply: is there a difference? protocol for an observational study · 2026 · DOI

  • The findings contribute to the limited literature on infant feeding practices among indigenous populations in India and may inform breastfeeding promotion and nation-wide maternal-child health programmes in similar settings.

    Determinants of early initiation and exclusive breastfeeding of the Bhumij community of India: a community-based cross-sectional study · 2026 · DOI

  • Guidelines around how best to support breastfeeding women vary widely, and few lay out specific strategies to support EBF in the workplace.

    What Does It Really Mean to Support Exclusive Breastfeeding in Southern Africa? It’s Time to Shift the Paradigm · 2026 · DOI

  • However, rates of EBF in this region, particularly Sub-Saharan Africa, vary widely and fail to reach global targets.

    What Does It Really Mean to Support Exclusive Breastfeeding in Southern Africa? It’s Time to Shift the Paradigm · 2026 · DOI

  • Evidence suggests BFHI may positively influence rates for mothers of varying income levels and racial/ethnic backgrounds, though findings are mixed.

    Baby-Friendly Hospital Initiative and Breastfeeding Across Social Determinants of Health · 2026 · DOI

  • Different levels of training are available post registration; however, the impact of in-depth breastfeeding training, such as that leading to the International Board-Certified Lactation Consultant certification, has not been studied.

    In-Depth Breastfeeding Training for Healthcare Professionals: A Systematic Review · 2026 · DOI

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