Doula Support and Breastfeeding Outcomes: A Systematic Review

Area of Science:

• Perinatal Health
• Maternal-Infant Nutrition
• Health Disparities

Background:

• Breastfeeding is optimal for infant nutrition and maternal-infant health, yet many women struggle to meet their goals.
• Significant disparities in breastfeeding outcomes exist across racial, ethnic, and socioeconomic groups.
• While doula support is linked to breastfeeding, specific outcomes affected remain unclear.

Purpose of the Study:

• To synthesize existing literature on breastfeeding outcomes associated with doula utilization.
• To clarify the impact of doula support on various breastfeeding metrics.

Main Methods:

• Conducted comprehensive electronic searches updated through April 2024.
• Included primary studies on doula support and breastfeeding outcomes (intention, initiation, duration, exclusivity, support, knowledge, education).
• Excluded secondary research and studies outside the perinatal period; performed narrative synthesis and risk of bias assessment.

Main Results:

• Included 32 studies, with most focusing on marginalized birthing populations.
• Doula support generally showed improved breastfeeding outcomes, though duration and exclusivity findings were mixed.
• Lactating clients valued doulas for support, education, and knowledge; doulas desired more breastfeeding training.

Conclusions:

• Doulas are associated with enhanced breastfeeding outcomes.
• Increased breastfeeding education within doula training is recommended.
• Greater integration and awareness of doulas within healthcare teams can optimize benefits.