Ethical Issues in Breastfeeding and Lactation Interventions: A Scoping Review

Area of Science:

• Public Health
• Bioethics
• Maternal and Child Health

Background:

• Infant feeding interventions supporting breastfeeding are vital public health initiatives.
• These interventions often involve vulnerable populations and private settings, necessitating careful ethical consideration.
• Ethical awareness is crucial for the successful implementation of breastfeeding support programs.

Purpose of the Study:

• To conduct a scoping review of the ethical discourse surrounding breastfeeding and lactation interventions.
• To identify and synthesize key ethical issues discussed in the scholarly literature.
• To capture the current state of ethical considerations in infant feeding support.

Main Methods:

• A scoping review methodology (Arksey and O'Malley, 2005) was employed.
• Literature search conducted across PubMed, ScienceDirect, JSTOR, and Cochrane Database of Systematic Reviews (1990-2022).
• Screening of 3715 abstracts, resulting in a final sample of 26 publications.

Main Results:

• Key ethical issues identified include normative motherhood assumptions, maternal autonomy, and informed choice.
• Information disclosure, risk-benefit balancing, counseling practices, stigma, social context, and health communication ethics were recurring themes.
• The ethical acceptability of financial incentives in breastfeeding interventions was also examined.

Conclusions:

• Breastfeeding interventions have focused on maternal experiences, choices, and public health objectives for infant nutrition.
• Effective and ethical implementation requires consideration of social, economic, and cultural contexts.
• There is a need to move beyond individual versus population health dichotomies and incorporate women's experiences more fully.