Promoting the Practice of Exclusive Breastfeeding: A Philosophic Scoping Review

Abstract Background The World Health Organization recommends exclusive breastfeeding for the first 6 months of an infant’s life and continued breastfeeding for 2 years. The global rate of exclusive breastfeeding is low at 33%. Thus, it is important to identify philosophical and theory-based strategies that can promote exclusive breastfeeding. The aim of the study is to identify philosophical schools of thought and theories used in research on promoting the practice of exclusive breastfeeding. Methods A scoping review using Arksey and O'Malley's framework explored the phenomenon of exclusive breastfeeding practice promotion. Searches were conducted using CINAHL Plus full-text, PubMed, APA PsycInfo and Academic Search Premier. Search terms included theory, philosophy, framework, model, exclusive breastfeeding, promotion, support, English, and publication between 2000 - 2020. Results The online search yielded 877 articles, however, only 40 met the inclusion criteria for the scoping review. The articles promoting exclusive breastfeeding used pragmatism (n=1) or phenomenology (n = 2) philosophies and theories of self-efficacy (n = 10), theory of planned behaviour (n = 10) and social cognitive theories (n = 17). Theories of self-efficacy and planned behaviour were the most effective theories that increased exclusive breastfeeding rates. Conclusions Theory-based exclusive breastfeeding promotion strategies are effective to increase the rates of exclusive breastfeeding. Theory of planned behaviour is better compared with theories of self-efficacy for program content development and implementation in Randomized Controlled Trial studies. Future breastfeeding interventions should be based on relevant philosophies and guided by theories of self-efficacy and planned behaviours.