Breastfeeding interventions and programs conducted in the Islamic Republic of Iran: a scoping review

The purpose of this review was to identify interventions promoting breastfeeding (BF), BF practices and their outcomes in Iran. Using the PRISMA-ScR Guidelines, we searched across 14 databases for publications published between 2010 and February 2024 to identify studies published in English or Farsi language in peer-reviewed journals, using search terms 'breastfeeding', 'lactation', 'education', 'promotion', 'intervention' and 'program'. Inclusion criteria included intervention-based studies with quantitative outcomes of pregnant women/mothers receiving education, training or other intervention that promoted BF or exclusive BF. Excluded studies were protocols, those examining Iranian communities outside of Iran publications in other languages, brief communications, gray literature and qualitative studies. After screening for relevance, identified articles that met the inclusion criteria were summarized and tabulated using Rayyan QCRI software. Of the 45 identified studies, 37 used randomized-control trial designs, 20 applied theoretical frameworks or specific counseling techniques. Samples included women pregnant for the first time, mothers of babies born prematurely or with low-birth weight, adolescents, mothers who had very young children at home. Only three studies included family members. BF self-efficacy was the most popular variable to assess, which was examined in 32 studies. Almost all studies showed positive results as a result of intervention. Majority of studies were focused at the individual level. No studies were identified that assessed strategies to change routine care or policies that might facilitate BF. Identifying barriers to moving intervention content into standard of care is an important next step in the development of BF research in Iran.