Systematic Review of Human Milk Feeding Practices and Policies in Infant and Young Child Feeding Trainings for Early Care and Education Providers

Introduction

Early care and education (ECE) providers play a critical role in supporting infant and young child feeding (IYCF) practices for US children. This systematic review synthesizes literature on IYCF interventions and curricula for training ECE providers.

Method

Searches were conducted across 5 databases. Eligible studies were published in the US in English through April 2024. Studies addressed infant feeding in ECE and policies, practices, or training related to breastfeeding practices in ECE.

Results

Fourteen studies were identified. Most IYCF training was in the context of obesity prevention. Training approaches included multimodal education, online platforms, opportunities for peer learning and support, ongoing technical assistance, and external motivators to encourage and sustain practices.

Discussion

Effective training approaches embedded ongoing external supports and motivators (e.g., the availability of technical support or refresher training and direct support and coaching via phone calls, emails, and on-site visits). A barrier was ECE providers’ perception of human milk feeding training as irrelevant outside the context of infant care. Research limitations included a lack of comparison groups in testing interventions and vague dose exposure and assessment definitions.

Conclusions and Implications

A centralized repository could advance national scale-up. Findings suggest external stakeholders with authority, acting as champions, increase implementation of supportive human milk feeding practices in IYCF training.