Systematic Review: Factors That Impact the Continuation of Breastfeeding Practice Among Working Mothers in Asia

Abstract

Mothers are recommended to continue exclusive breastfeeding (EBF) up until six months of infant’s age. The duration of exclusive breastfeeding is affected by numerous significant factors such as mothers’ work. The average length of maternity leaves in Asian countries varies from 60 to 90 days. Many studies reported that the low rate of exclusive breastfeeding among employe mothers are associated with the inappropriate breastfeeding facilities at the workplace. Therefore, this systematic review aims to identify the factors affect Asian working mothers’ ability to continue/ discontinue breastfeeding their infants after they return to work following postpartum. PubMed, CINAHL, international breastfeeding journals and references list were searched on July 2019. All observational studies including cross-sectional that identified factors that impact the continuation of breastfeeding practice among employed mothers in Asia, were eligible for inclusion in the review. All studies included in this review were formally assessed for their methodological quality, independently by two reviewers, using A Standard Quality Assessment Tool for Quantitative Studies by Kmet et al. (2004). Data were extracted independently by the first reviewer (Student M), using he Joanna Briggs Institute (JBI) form. Two-hundred and seventy-five studies were identified, eight full-text articles were fully assessed for inclusion in this review. Four articles subsequently were excluded, resulting in four included articles. A narrative synthesis of studies outcomes was performed independently by the first reviewer (Student M). This review finds that lack of private breastfeeding rooms, separate refrigerators and inflexible breastfeeding break times were the most significant factors that impact the continuation of breastfeeding practice among working mothers in Asia. Also, few studies have identified factors affect the mothers’ choice to continue breastfeeding up until six months of infants’ age around all 49 Asian Countries. Employers, governments and policymakers should implement or enhance policies that support breastfeeding for employed mothers to build up a supportive environment at the workplace. Further research should be performed to cover all Asian countries and also to assess the effect of breastfeeding-friendly policies at the workplace.