Factors Influencing Breastfeeding Outcomes Following Neonatal Hypoxic Ischaemic Encephalopathy: A Mixed Methods...

Area of Science:

• Neonatal care
• Perinatal research
• Lactation science

Background:

• Hypoxic-ischaemic encephalopathy (HIE) is a common neonatal brain injury in term infants.
• Families with HIE often experience significant breastfeeding and lactation difficulties.

Purpose of the Study:

• To systematically review factors influencing breastfeeding and lactation outcomes in infants with neonatal HIE.
• To identify potential solutions and support strategies for these families.

Main Methods:

• A convergent integrated analysis mixed methods systematic review was conducted.
• Seventeen studies were included after screening 3393 titles and abstracts across multiple databases.
• Searches were performed in November 2022, July 2023, and April 2025.

Main Results:

• Five categories of influencing factors were identified: infant medical factors, neuroprotective interventions, feeding during therapeutic hypothermia, milk expression support, and parent-infant closeness.
• Significant evidence gaps exist regarding environmental/social factors, lactation support interventions, and breastfeeding skills.
• A lack of qualitative and mixed methods studies specifically addressing breastfeeding post-HIE was noted.

Conclusions:

• Current research is inadequate to fully understand factors affecting breastfeeding and lactation after HIE.
• High-quality, breastfeeding-specific research is urgently required.
• This research is crucial for improving information sharing and intervention development for HIE-affected families.