Breastfeeding Medicine最新文献

{"title":"Procurement and Use of Pasteurized Donor Human Milk in the Outpatient Setting: A Case Study.","authors":"Paula Hayden-Vázquez, Maryanne T Perrin, Geraldine M Maurer, Jennifer L Kloesz, Lauren Narbey, Jill R Demirci","doi":"10.1177/15568253261480858","DOIUrl":"https://doi.org/10.1177/15568253261480858","url":null,"abstract":"<p><strong>Background: </strong>While pasteurized donor human milk (PDHM) is increasingly available to hospitalized infants, PDHM use in the outpatient setting has limited precedent. This research describes one mother's experience with acquiring and using PDHM in the outpatient setting for an infant with complex care needs.Case Selection and Methods:We reviewed a list of infants receiving PDHM in the outpatient setting from a regional milk bank and sub-selected potential infant cases to profile based on recency of PDHM receipt and diversity of circumstances surrounding PDHM use and need. The mother of one infant responded to our request for an interview. A telephone interview was conducted with the mother, and the infant's medical records were reviewed.</p><p><strong>Case presentation: </strong>Following birth, the selected infant was diagnosed with genetic anomalies associated with a high palate, small jaw, feeding intolerance, and respiratory dysfunction. Although the mother produced enough milk to meet her infant's needs during hospitalization, her supply declined rapidly following the infant's transfer to a pediatric step-down facility and her return to work. Trials of commercial infant formula were not tolerated by the infant, mainly due to the aforementioned diagnosis. After learning about PDHM from her own research, the mother engaged in 4 months of letter writing and telephone calls with staff at the milk bank, her employment-based health insurer, and Medicaid. PDHM was eventually covered by Medicaid for 10 months, which included 3 coverage renewals. The infant progressed well medically and developmentally on an all-human milk diet, including PDHM and direct breastfeeding, until she was 20 months old, at which point they began to self-wean.</p><p><strong>Conclusion: </strong>This case illustrates that PDHM may still be medically necessary in the outpatient setting and that pediatric care coordination/case management and discharge planning should include assistance with outpatient PDHM cost coverage.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"15568253261480858"},"PeriodicalIF":2.1,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Inpatient Lactation Nurse Visit Frequency and Duration on Feeding Outcomes: A Retrospective Review.","authors":"Miranda L Byrd, Mary G Carey","doi":"10.1177/15568253261476456","DOIUrl":"https://doi.org/10.1177/15568253261476456","url":null,"abstract":"<p><strong>Background: </strong>Inpatient lactation support is essential for establishing breastfeeding, yet disparities in support and feeding outcomes persist across racial and ethnic groups. The objective of this project was to evaluate the frequency and duration of inpatient lactation nurse visits and determine whether support intensity aligned with parental feeding goals through the lens of racial and ethnic demographics.</p><p><strong>Methods: </strong>This retrospective analysis reviewed electronic health record data from 633 mother-infant dyads (≥37 weeks, rooming-in level care) discharged from a postpartum unit at a U.S. Magnet-designated academic medical center between September and December 2024. Nurse-documented data were extracted from the medical record for the number of visits with a lactation nurse and the estimated duration of bedside support, recorded as categorical time ranges. Total bedside time was calculated using the midpoints of documented time ranges.</p><p><strong>Results: </strong>The sample was 69.7% White, 11.7% Black, and 8.4% Hispanic. The mean number of lactation nurse visits was 3.46 (standard deviation [SD] = 1.52), with a mean total bedside time of 64 minutes. Support intensity was similar across racial and ethnic groups. However, significant differences emerged when results were sorted by feeding goals. Dyads who initially intended to exclusively breastfeed but utilized formula supplementation received the highest support intensity, averaging 3.97 visits (SD = 1.63) and 79 minutes of bedside time. Comparatively, those who met their exclusive breastfeeding goal received 3.33 visits and an average of 64 minutes with lactation.</p><p><strong>Conclusions: </strong>Inpatient lactation support was distributed equally by racial and ethnic groups but varied significantly based on clinical acuity and adjustments in feeding plans. The increased support provided to families struggling to meet exclusivity goals reflects a responsive, acuity-based model of care. Specialized lactation support remains a vital clinical intervention for bridging the gap between parental intentions and inpatient feeding outcomes.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"15568253261476456"},"PeriodicalIF":2.1,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Describing the Infrastructure of Breastfeeding and Lactation Medicine Divisions and Centers Established Within U.S. Health Systems.","authors":"Deanna Nardella, Casey Rosen-Carole, Mariana Castaño Colmenares, María-Teresa Hernández-Aguilar, Meredith Young, Emily Swisher Rosa, Veronika Shabanova, Josefa L Martinez-Brockman, Katherine R Standish","doi":"10.1177/15568253261476454","DOIUrl":"https://doi.org/10.1177/15568253261476454","url":null,"abstract":"<p><strong>Background: </strong>There is a well-described need for a more coordinated, systems-based approach to breastfeeding care delivery in the United States. Although several Breastfeeding and Lactation Medicine (BFLM) Divisions, Centers, and Institutes (D/C/Is) exist within U.S. health systems, they remain poorly described. We aimed to describe the U.S. national landscape of BFLM D/C/Is and the clinical and nonclinical activities they conduct.</p><p><strong>Methods: </strong>We present a secondary analysis of cross-sectional survey data collected from U.S. BFLM prescribing clinicians from November 2024 to February 2025. Participants were recruited from conferences, professional listservs, and social media groups relevant to BFLM clinicians. If they reported working under a BFLM D/C/I, additional questions assessed clinical infrastructure and non-clinical activities of their D/C/I. Descriptive summaries were completed.</p><p><strong>Results: </strong>Of 138 participants in our final sample, 20 (15%) from 10 states worked under a BFLM D/C/I and thus were included in this secondary analysis. Participants were physicians (<i>n</i> = 14, 70.0%), midwives (2, 10.0%), and nurse practitioners (4, 20.0%) with an average of 10.5 (standard deviation 8.6) years of BFLM experience. Most (70.0%) held positions as directors. D/C/Is had existed for an average of 7.2 years and delivered outpatient (95.0%), electronic (45.0%, i.e., \"e-consult\"), and inpatient (35.0%) clinical consultation services for an average of 7.9, 2.1, and 5.6 years, respectively. Most provided evidence-based staff education (95.0%), oversaw system lactation services and policies (75.0%), and conducted quality improvement and research (65.0%).</p><p><strong>Conclusion: </strong>Our national description of BFLM D/C/Is can inform future research and expansion of BFLM infrastructure in U.S. health systems.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"15568253261476454"},"PeriodicalIF":2.1,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Maternal Ambivalence and Readiness to Discontinue Breastfeeding: A Descriptive and Correlational Study Among Mothers in Türkiye.","authors":"Süheyla Yaralı, Sultan Esra Sayar","doi":"10.1177/15568253261476492","DOIUrl":"https://doi.org/10.1177/15568253261476492","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding is widely recognized as the optimal method of infant feeding and provides substantial biological, psychological, and relational benefits for the mother-infant dyad. However, the transition from breastfeeding to weaning remains insufficiently explored, particularly regarding mothers' psychological readiness to discontinue breastfeeding and the internal conflicts associated with the maternal role. Maternal ambivalence, defined as the coexistence of affection and burden in the maternal experience, may complicate the weaning process, especially in sociocultural contexts where breastfeeding is strongly associated with ideals of good motherhood. This study aimed to examine the relationship between maternal ambivalence and mothers' readiness to discontinue breastfeeding in Türkiye.</p><p><strong>Methods: </strong>This descriptive and correlational study was conducted between July and October 2025 using an online survey distributed to mothers residing in Erzurum and across Türkiye who had a child aged 18 months or older. Data were collected using a Sociodemographic and Obstetric Information Form, the Maternal Readiness to Discontinue Breastfeeding Scale, and the Maternal Ambivalence Scale. Readiness was evaluated across four dimensions: maternal readiness, infant readiness, process management, and environmental readiness. Data were analyzed using IBM SPSS 22.0 with descriptive statistics, Kolmogorov-Smirnov tests, independent samples <i>t</i> tests, analysis of variance with Tukey post hoc comparisons, and correlation analyses.</p><p><strong>Results: </strong>Mothers' readiness to discontinue breastfeeding was most strongly associated with maternal intention and perceived infant readiness, which showed a strong positive correlation (<i>r</i> = 0.644, <i>p</i> < 0.001). Process management demonstrated a moderate association with total readiness (<i>r</i> = 0.479), while maternal emotional readiness showed a weak but significant relationship (<i>r</i> = 0.215). Maternal ambivalence was not significantly correlated with any readiness dimension (<i>p</i> > 0.05). Sociodemographic and obstetric variables had minimal influence on readiness scores.</p><p><strong>Conclusions: </strong>Readiness to discontinue breastfeeding is a multidimensional process primarily shaped by maternal intention and perceived infant readiness, while maternal ambivalence operates as an independent psychological construct. These findings highlight the need for psychologically informed and culturally sensitive weaning support.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"15568253261476492"},"PeriodicalIF":2.1,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Early Kangaroo Mother Care Coverage and Associated Factors Among Low-Birth-Weight Neonates in Selected Hospitals in Northwest Ethiopia: A Multicenter Convergent Parallel Mixed-Method Study.","authors":"Tigabu Eskeziya Zerihun, Woretaw Sisay Zewdu, Abel Temeche Kassaw, Samuel Agegnew Wondm, Samuel Berihun Dagnew, Getachew Yitayew Tarekegn, Tilaye Arega Moges, Fasil Bayafers Tamene, Desalegn Addis Mussie","doi":"10.1177/15568253261474782","DOIUrl":"https://doi.org/10.1177/15568253261474782","url":null,"abstract":"<p><strong>Background: </strong>In 2020, ∼13.4 million newborns were born preterm worldwide, with 65% occurring in sub-Saharan Africa and Southern Asia. In Ethiopia, fewer than 10% of eligible newborns received Kangaroo Mother Care (KMC) in 2021, despite WHO endorsement. This study evaluated effective early KMC (EeKMC) coverage and associated factors in northwest Ethiopia.</p><p><strong>Methods: </strong>A facility-based cross-sectional study with a convergent parallel mixed-methods design was conducted from October 2024 to November 2025. Quantitative data were extracted from existing hospital records (secondary data) for 713 low-birth-weight neonates (<2,000 g). EeKMC was defined as ≥8 hours of skin-to-skin contact combined with exclusive breastfeeding within 24 hours of birth. Qualitative data were collected through in-depth interviews (<i>n</i> = 14) and observations to identify barriers and facilitators. Bivariate and multivariate logistic regression were used for quantitative analysis; thematic analysis was used for qualitative data.</p><p><strong>Results: </strong>Of the 713 newborns, only 4.6% (33/713; 95% confidence interval [CI]: 3.2-6.4%) received EeKMC, whereas 55.5% (396/713) were exclusively breastfed within 24 hours. Newborns in incubators were less likely to receive EeKMC (adjusted odds ratio = 0.07; 95% CI: 0.015-0.34). Barriers included inadequate infrastructure, skill gaps, and cultural norms, while facilitators involved quality improvement initiatives and maternal willingness.</p><p><strong>Conclusion: </strong>EeKMC coverage is critically low at 4.6%, with incubator use identified as a significant barrier. Qualitative findings revealed barriers, including inadequate infrastructure, skill gaps among health care workers, cultural norms, and maternal fears. The cross-sectional design limits causal interpretation of the identified associations. Comprehensive interventions addressing health care infrastructure, provider training, family engagement, and cultural acceptance are urgently needed.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"15568253261474782"},"PeriodicalIF":2.1,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Progressive Relaxation Exercises on Mothers', Self-Efficacy, and Maternal Attachment Levels: A Randomized Controlled Experimental Study.","authors":"Çiğdem Gök, Nazan Tuna Oran","doi":"10.1177/15568253261473742","DOIUrl":"https://doi.org/10.1177/15568253261473742","url":null,"abstract":"<p><strong>Objective: </strong>The postpartum period is critical for maintaining breastfeeding and developing maternal attachment. Stress and emotional difficulties may adversely affect breastfeeding self-efficacy and maternal bonding. This study examined the effects of progressive relaxation exercises (PRE) on breastfeeding self-efficacy, breastfeeding attitudes, and maternal attachment.</p><p><strong>Methods: </strong>This randomized controlled experimental study was conducted at Uşak Dikilitaş Family Health Center between May and November 2022. Using non-probability sampling, 114 postpartum breastfeeding mothers were recruited and randomly assigned to PRE, relaxation background music (RBM), and control groups. The PRE group performed relaxation exercises three times weekly for 4 weeks, while the RBM group listened to relaxation music with the same frequency and duration. The control group received routine postpartum care. Data were collected using the Personal Information Form, Breastfeeding Self-Efficacy Scale-Short Form, Maternal Attachment Inventory, Breastfeeding Classification Form, and Intervention Satisfaction Assessment Form. Analyses included one-way analysis of variance (ANOVA) and repeated measures ANOVA.</p><p><strong>Results: </strong>Baseline characteristics were similar across groups. Breastfeeding self-efficacy scores increased significantly in the PRE and RBM groups. At the second follow-up, scores were 63.57 ± 0.82 (PRE), 48.81 ± 1.43 (RBM), and 47.36 ± 1.69 (control) (F = 42.782; <i>p</i> < 0.001). At the third follow-up, scores were 67.63 ± 0.60, 51.05 ± 1.51, and 47.81 ± 1.92, respectively (F = 53.289; <i>p</i> < 0.001). Maternal attachment scores were highest in the PRE group (101.57 ± 0.82, 97.89 ± 1.40, and 94.28 ± 1.72; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>PRE improved breastfeeding self-efficacy and maternal attachment, suggesting that this practical intervention may enhance postpartum care.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"15568253261473742"},"PeriodicalIF":2.1,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Renewed Call to Action for Breastfeeding Support: Let's Collaborate.","authors":"Julie Ware","doi":"10.1177/15568253261464472","DOIUrl":"10.1177/15568253261464472","url":null,"abstract":"","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"455-456"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Breast Massage on Enhancing Breast Milk Production in Postpartum Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Chinnaphat Chaloemram, Wiraphol Phimarn, Ronnachai Poowanna, Sirikran Winyupan, Nichaphat Ngenkummoon","doi":"10.1177/15568253261454249","DOIUrl":"10.1177/15568253261454249","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the efficacy of breast massage (BM) in enhancing breast milk production in postpartum women, as compared to control interventions.</p><p><strong>Methods: </strong>A systematic review was conducted using PubMed, Scopus, ScienceDirect, TCI, and ThaiLis. Relevant articles were identified from inception to July 2025. Only randomized controlled trials (RCTs) reporting the effect of BM on breast milk production and breastfeeding discomfort were included. The risk of bias in the included studies was assessed using the Cochrane Collaboration's tool. Data analysis was performed using RevMan 5.4.1.</p><p><strong>Results: </strong>A total of 18 RCTs with 1,099 participants were included. Compared with the control group, BM demonstrated a significantly greater effect on increasing breast milk volume (standardized mean difference = 0.76; 95% CI = 0.47, 1.05; <i>p</i> < 0.00001, <i>I² =</i> 87%). Additionally, BM significantly reduced scores for breast engorgement, pain, and temperature, while increasing the number of infant urinations compared to the control group. However, the number of infant defecations did not significantly differ. Participants receiving BM also experienced greater resolution of breast engorgement, although there was no significant difference in complete breastfeeding rates. BM was also associated with a significantly lower anxiety level and a significant increase in serum prolactin levels compared to the control group.</p><p><strong>Conclusion: </strong>BM appears to be an effective intervention for enhancing breast milk production and decreasing breast engorgement, breast pain, and anxiety levels in postpartum women.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"421-434"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Pasteurized Donor Human Milk in Healthy Newborns and Lactation Outcomes After Hospital Discharge in the United States: An Integrative Review.","authors":"Nicole Conover, Diane L Spatz","doi":"10.1177/15568253261454243","DOIUrl":"10.1177/15568253261454243","url":null,"abstract":"<p><strong>Background: </strong>Pasteurized donor human milk (PDHM) is frequently used to supplement healthy, breastfeeding newborns in birth hospitals, with varied practices and limited postdischarge outcomes. This review examines the use of PDHM supplementation in healthy, noncritically ill newborns cared for in postpartum units and level 1 nurseries and aims to understand its effects on lactation after hospital discharge.</p><p><strong>Methods: </strong>We conducted an integrative review of both qualitative and quantitative studies that were conducted in the United States, in English, and reported the use of PDHM in healthy or noncritically ill infants, and where the primary setting was a mother-baby unit or level 1 nursery. Data sources included PubMed, CINAHL, Scopus, Web of Science, Embase, Emcare, and the Maternity and Infant Care Database. We included 18 articles published between 2014 and 2025 in the final review. Common characteristics were categorized, quantified, and compared across the studies.</p><p><strong>Results: </strong>Inductively derived categories are as follows: (1) indication for PDHM supplementation, (2) hospital-level characteristics, (3) breastfeeding outcomes, (4) maternal and infant demographic and socioeconomic characteristics, and (5) opinions on the use of PDHM when reported from clinical and patient perspectives. In addition, we specifically examined each article for examples of the protection of milk supply (interventions to support lactation and/or pumping recommendations).</p><p><strong>Conclusions: </strong>PDHM is preferable to formula for supplementation and has been associated with improved breastfeeding outcomes. However, evidence suggested that supplementation without interventions to protect milk supply may pose a risk to breastfeeding after discharge.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"408-420"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hand Expression Across 30 Countries: A Scoping Review of Utilization, Outcomes, and Patient and Health Care Provider Experiences.","authors":"Sarah E Ames, María Jimena Paz, Sruthi Treasa George, Katherine R Standish","doi":"10.1177/15568253261456819","DOIUrl":"10.1177/15568253261456819","url":null,"abstract":"<p><strong>Introduction: </strong>Hand expression (HE) of breast milk enables milk collection at any stage of lactation. Its use is widely recommended for breastfeeding mothers. However, evidence surrounding utilization, outcomes, and experiences using HE is limited.</p><p><strong>Objective: </strong>This scoping review aims to broadly examine the literature describing patient and health care provider experiences, utilization, and clinical outcomes of HE of breast milk.</p><p><strong>Methods: </strong>We conducted systematic searches in MEDLINE, Embase, Web of Science, Scielo, and DialNet. We included both primary research and quality improvement reports. Four reviewers screened all papers for eligibility, read the full text of included studies, and extracted data.</p><p><strong>Results: </strong>Of the 620 reports identified, 118 studies from 30 countries met eligibility criteria. Studies found high rates of familiarity with HE but variable rates of use. Most women expressed favorable views and experiences with HE. Multiple successful methods of teaching HE to lactating women and health care professionals were described. Many studies report teaching HE within wider interventions, such as antenatal milk expression programs and initiatives to increase breastfeeding among preterm infants. Most reports of breastfeeding outcomes, breast milk volume, and constituents gave mixed results, although HE in the first days postpartum was often associated with improved outcomes. No studies were found testing the use of HE for particular breast conditions such as mastitis or hyperlactation.</p><p><strong>Conclusions: </strong>While HE is generally favorably experienced by women and health care providers and may improve breastfeeding outcomes, further research is needed on HE as a primary exposure to better apply it in clinical lactation management.</p>","PeriodicalId":9142,"journal":{"name":"Breastfeeding Medicine","volume":" ","pages":"391-407"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}