Nurse and midwife interventions to protect, promote and support breastfeeding: an umbrella review

Background Low breastfeeding rates continue to be a global concern among nurses and midwives, raising critical questions about knowledge and effectiveness in promoting breastfeeding. Summarising evidence on nursing and midwifery interventions to protect, promote, and support breastfeeding enables a deeper understanding of how these professionals can enhance breastfeeding practices, inform decision-makers, and improve care quality. Aim To synthesise nursing and midwifery interventions that protect, promote, and support breastfeeding. Methods The JBI methodology for umbrella reviews guided this study. Searches were conducted in databases aggregated by EBSCOhost, SCOPUS, and Web of Science, as well as relevant grey literature. Systematic reviews published in English, Portuguese, and Spanish from January 2018 to December 2023 were included. Two independent reviewers used a JBI critical appraisal tool and a specific data extraction instrument to synthesise findings. Findings A total of 29 studies met the inclusion criteria. Synthesised findings include: (1) the absence of nursing/midwifery interventions focused on breastfeeding protection; (2) five nursing/midwifery interventions aimed at breastfeeding promotion, with the primary intervention being prenatal education; and (3) twenty-four interventions of nurses/midwives on breastfeeding support, the most frequent being home visits, telephone technology and follow-up. Conclusion This umbrella review reveals limited involvement of nurses/midwives in breastfeeding protection, despite their expertise and potential influence on policy development to support breastfeeding. They are involved in breastfeeding promotion, but most of their intervention is focused on breastfeeding support. The diverse roles and settings of nursing and midwifery practice present challenges in evaluating intervention effectiveness. Further research specific to nursing and midwifery is needed to inform evidence-based practice and policymaking in breastfeeding care.