Linkages Between Breast Milk Substitute Limiting Interventions and Breastfeeding Outcomes: A Scoping Review

Adwoa Gyamfi; William Ekow Spio  Donkor; Richmond Aryeetey

doi:10.4314/just.v43i1.1798

Adwoa Gyamfi Kwame Nkrumah University of Science and Technology https://orcid.org/0000-0001-7855-6672
William Ekow Spio Donkor University of Ghana School of Public Health
Richmond Aryeetey University of Ghana School of Public Health https://orcid.org/0000-0003-4667-592X

DOI: https://doi.org/10.4314/just.v43i1.1798

Keywords: Exclusive breastfeeding, breast milk substitutes, breastfeeding outcomes, breast milk substitute interventions, and the International Code of Breastmilk Substitutes

Abstract

Background: The initiation of infants to human milk within the first hour of delivery, exclusive breastfeeding for 180 days and continued breastfeeding up to 24 months or beyond are standard breastfeeding recommendations. However, globally, the majority of infants do not experience optimal breastfeeding for many reasons including the unethical and inappropriate commercial marketing strategies that expose children to breast milk substitutes (BMS). Research Aim: To identify and categorise published interventions that promote, protect and support breastfeeding while limiting exposure to and use of BMS, globally.

Methods: Arksey and O’Malley’s (2005) scoping review process guided this review. An initial search of peer-reviewed health-related literature databases was updated by searching through CINAHL, Google Scholar, Pubmed, PSYCHINFO, and SCOPUS. WHO and UNICEF’s websites. Keywords used included human milk, breastfeeding, breast milk substitute, formula feeding and interventions. Full-text, peer-reviewed research articles published in the English language between 1990-2022 were eligible for the review. Thematic data analysis was done.
Results: We identified 447 records and of these, there were seven articles that were eligible for inclusion in this review. Seven themes were discovered as key intervention strategies to facilitate breastfeeding and limit BMS use, globally. The interventions included health worker training programs and educational strategy; implementation and revitalisation of the Baby- Friendly Hospital Initiative; formula payment policy; diaper bag donation (not containing BMS); government-owned breastfeeding programs; enforcement of the International Code of Breastmilk Substitutes and implementation of other enabling factors.
Conclusion: Globally, there are few facility-and community-based strategies to mitigate the marketing and use of BMS. The adoption of the identified BMS interventions can be leveraged to protect, promote and support optimal breastfeeding.

Author Biographies

Adwoa Gyamfi, Kwame Nkrumah University of Science and Technology

Adwoa Gyamfi, PhD, MPH, BSc, RN, Postgraduate Certificates (Education; Clinical Genetics and Genomics) is a Lecturer in the Department of Public Health Nursing at the Kwame Nkrumah University of Science and Technology, School of Nursing and Midwifery. Dr. Gyamfi’s research interests include human milk and lactation, nursing, health disparities and injuries.

William Ekow Spio Donkor, University of Ghana School of Public Health

Mr. William Ekow Spio Donkor, MPH was affiliated to the University of Ghana School of Public Health during the research.

Richmond Aryeetey, University of Ghana School of Public Health

Richmond Aryeetey is a Professor of Public Health Nutrition at the University of Ghana School of Public Health; a fellow of the Ghana Academy of Arts and Sciences and Visiting Scholar at University of Sheffield Centre for Health and Related Research | SCHARR. His research generally focuses on infant and young child feeding with a special interest in breastfeeding interventions.