Mixed Methods Studies on Breastfeeding: A Scoping Review

Prenatal and postnatal health guidance, along with women's individual experiences, greatly influences mothers' breastfeeding decisions and duration. To understand this better, a methodology combining quantitative and qualitative data is essential. Objective: To map the scientific production on the promotion, protection, and support of breastfeeding developed from mixed methods research. Method: A scoping review that followed the JBI and PRISMA-ScR methodology. The search was carried out in the following databases: Medline/PubMed, EMBASE, Cochrane, BVS, CINAHL, Web of Science, and BDTD. The guiding question was: Which studies on the promotion, protection, and support of breastfeeding were developed using mixed methods? The research took place from December 2023 to June 2024. Results: Of the 3569 studies found, 36 studies using mixed methods were included, with a prevalence of explanatory sequential approaches. Breastfeeding rates in the selected studies remain lower than global recommendations. The barriers to breastfeeding reported by mothers include biological; emotional; cultural; unfavorable social and hospital environment; difficulties in clinical management; lack of support from family, friends, health professionals, and employers; and skepticism about the benefits of breastfeeding. On the other hand, the main facilitators of breastfeeding reported were education and counseling during prenatal, childbirth, and postpartum periods; women's intention to breastfeed; support from family, employer, spouse, and health professionals. Conclusions: The studies highlighted various issues related to breastfeeding rates, barriers, and facilitators across different contexts and cultures worldwide. The findings demonstrate that employing mixed methods enables a comprehensive and nuanced assessment of breastfeeding practices and the evaluation of relevant interventions.