Identifying the Core Indicators of a Breastfeeding-Friendly City: A Delphi Study

Area of Science:

• Public Health
• Maternal and Child Health
• Community Health

Background:

• A breastfeeding-friendly city fosters a supportive environment for breastfeeding mothers.
• Previous research identified potential indicators through scoping reviews and interviews.

Purpose of the Study:

• To establish a consensus-based set of indicators for a breastfeeding-friendly city.

Main Methods:

• A modified two-round online Delphi survey involving experts, policymakers, and families.
• Participants rated 52 potential indicators, with consensus defined as >70% agreement.
• A final consensus meeting addressed items without agreement.

Main Results:

• 107 participants from 14 countries completed the survey.
• 52 indicators reached consensus and were grouped into five sectors: city administration, community, health care, workplace, and collaboration.
• The final list provides a practical framework for cities.

Conclusions:

• A systematic Delphi approach successfully identified comprehensive indicators for breastfeeding-friendly cities.
• These indicators can guide cities in evaluating and enhancing breastfeeding support.
• The framework has the potential to improve global breastfeeding outcomes.