Breastfeeding challenges experienced by postpartum nurses after maternity leave: a qualitative systematic review

With the continuous progress of global breastfeeding promotion, breastfeeding for postpartum returning nurses has become an important topic of medical human resource management. Nurses have always assumed a caregiver role, but postpartum nurses are seen as a particularly vulnerable and care-recipient role. Paying attention to the breastfeeding experience of postpartum returning nurses is helpful in improving the work environment of nurses and enhance the overall level of nursing service.

To systematically explore and integrate the multi-dimensional challenges of breastfeeding faced by postpartum nurses during their return to work, and to comprehensively analyze the adaptation and support needs.

We conducted a systematic search of six electronic databases including PubMed, Web of Science, Cochrane Library, Embase, Chinese National Knowledge Infrastructure and Wanfang to identify relevant qualitative studies. The search time limit was from the establishment of database to February 2025. Literature screening and data extraction were completed by two researchers independently, and the Joanna Briggs Institute criteria for qualitative research was used for evaluation. Results were reported in accordance with the Enhanced Transparency in Integrated Reporting of Qualitative Research statement. Finally, thematic analysis was used for data synthesis.

A total of 19 studies were included and synthesized into three analytical themes: (i) breastfeeding attitude, (ii) breastfeeding support, and (iii) breastfeeding control. Analysis of outcomes revealed breastfeeding resilience and support are identified as facilitators, while work pressure and role conflict are identified as hindrances. In addition, breastfeeding attitude was identified as an influencer of breastfeeding.

In this review, the breastfeeding practice of postpartum returning nurses is complex, which affects the breastfeeding experience together with their professional identity. Breastfeeding attitude, breastfeeding support, and breastfeeding control are identified as key factors. It is suggested that health institutions should intervene in view of obstacles and improve the breastfeeding support system of postpartum returning nurses.