A Scoping Review of Breastfeeding in Active Duty US Military Women

Purpose: Active duty (AD) women in the U.S. military experience challenges during childbearing owing to unique occupational demands. The purpose of this article is to report the findings from a scoping review on pregnancy, childbirth, and the postpartum period that are specific to breastfeeding among servicewomen. A secondary aim is to identify leverage points that would promote breastfeeding in this population. Methods: We developed a PRISMA-ScR protocol to identify publications from 2000 to 2018 regarding pregnancy, childbirth, and the postpartum period in AD women. Among articles pertaining to the postpartum period, we recognized those specific to breastfeeding for separate analysis. Using the social ecological model for military women's health (SEM-MWH) to synthesize our results, we identified actionable leverage points in the military setting for positive change. Results: Research articles specific to breastfeeding (n = 8) included descriptive, cross-sectional, and qualitative studies. Non-research articles (n = 7) were either an integrative review, nonsystematic review, or commentary. Thirty-four leverage points were identified throughout the social ecological system of military women, including support for lactation in the workplace, employment of lactation consultants, occupational hazards assessment, personnel policies that delay the separation of women and their infants, and research to fill gaps in knowledge about breastfeeding while on AD. The greatest number of leverage points are in the SEM-MWH mesosystem and exosystem. Conclusions: There are multiple potential leverage points throughout the SEM-MWH to generate positive changes in the social ecological system of military women. These changes could serve to enhance the breastfeeding experiences of AD women. (C) 2021 Jacobs Institute of Women's Health. Published by Elsevier Inc.