Factors and interventions that positively influence breastfeeding rates at six months postpartum : An integrative literature review

Journal article

Whittaker, Xanthe, Meedya, Shahla and Capper, Tanya. (2025). Factors and interventions that positively influence breastfeeding rates at six months postpartum : An integrative literature review. Women and Birth. 38(3), p. Article 101904. https://doi.org/10.1016/j.wombi.2025.101904
AuthorsWhittaker, Xanthe, Meedya, Shahla and Capper, Tanya
Abstract

Background
Despite the health benefits of breastmilk, many women discontinue breastfeeding prior to six months postpartum. Previous work from 2010 has identified women’s breastfeeding intention, self-efficacy, and support as the main modifiable factors that influence breastfeeding at six months postpartum. However, due to societal changes during the past decade, factors influencing women’s decision to continue breastfeeding requires further exploration.

Aim
To determine “what modifiable contemporary factors and interventions can positively influence women’s decision to continue breastfeeding until six months postpartum?”

Method
An integrative literature review was conducted based on Whittemore and Knafl’s framework. Databases were searched using combinations of the following main key words: breastfeeding, duration, factors, and interventions. Studies addressing the research question and published in English language since 2010 were included. Interventional studies were limited to only randomised controlled trials.

Results
Women's positive breastfeeding intention, self-efficacy, and support remained the key modifiable factors that could increase breastfeeding rates up to six months postpartum. The main effective interventions included education support or counselling when they targeted women’s needs, intention, self-efficacy and support; and were held over multiple sessions commencing antenatally or immediately after birth. Contemporary effective strategies included digital communications such as phone calls, virtual meetings and messaging via social media including FacebookTM, WhatsAppTM and TelegramTM. Main conceptual frameworks were motivational interviewing, planned behaviour theory and cognitive behavioural therapy.

Conclusion
Interventions that support breastfeeding up to six months should include contemporary strategies that target the main modifiable factors and are tailored based to women’s needs and their sociocultural influences.

Keywordsbreastfeeding; breastfeeding duration; factors; interventions; social media
Year2025
JournalWomen and Birth
Journal citation38 (3), p. Article 101904
PublisherElsevier Ltd
ISSN1871-5192
Digital Object Identifier (DOI)https://doi.org/10.1016/j.wombi.2025.101904
PubMed ID40199118
Scopus EID2-s2.0-105001952231
Open accessPublished as ‘gold’ (paid) open access
Page range1-13
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online08 Apr 2025
Publication process dates
Accepted08 Apr 2025
Deposited10 Jun 2025
Additional information

© 2025 The Authors. Published by Elsevier Ltd on behalf of Australian College of Midwives. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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Perceptions of primiparous women about the effect of childbirth preparation classes on their childbirth experience : A qualitative study
Hassanzadeh, Robab, Abbas-Alizadeh, Fatemeh, Meedya, Shahla, Mohammad-Alizadeh-charandabi, Sakineh and Mirghafourvand, Mojgan. (2021). Perceptions of primiparous women about the effect of childbirth preparation classes on their childbirth experience : A qualitative study. Midwifery. 103, pp. 1-7. https://doi.org/10.1016/j.midw.2021.103154
Prevalence and predictors of perceived disrespectful maternity care in postpartum Iranian women : A cross-sectional study
Hajizadeh, Khadije, Vaezi, Maryam, Meedya, Shahla, Mohammad Alizadeh Charandabi, Sakineh and Mirghafourvand, Mojgan. (2020). Prevalence and predictors of perceived disrespectful maternity care in postpartum Iranian women : A cross-sectional study. BMC Pregnancy and Childbirth. 20(1), p. Article 463. https://doi.org/10.1186/s12884-020-03124-2
Effectiveness of internet-based electronic technology interventions on breastfeeding outcomes : Systematic review
Almohanna, Alaa Ali, Win, Khin Than and Meedya, Shahla. (2020). Effectiveness of internet-based electronic technology interventions on breastfeeding outcomes : Systematic review. Journal of Medical Internet Research. 22(5), p. Article e17361. https://doi.org/10.2196/17361
Respectful maternity care and its relationship with childbirth experience in Iranian women : A prospective cohort study
Hajizadeh, Khadije, Vaezi, Maryam, Meedya, Shahla, Mohammad Alizadeh Charandabi, Sakineh and Mirghafourvand, Mojgan. (2020). Respectful maternity care and its relationship with childbirth experience in Iranian women : A prospective cohort study. BMC Pregnancy and Childbirth. 20(1), p. Article 468. https://doi.org/10.1186/s12884-020-03118-0
Skin-to-skin contact, early initiation of breastfeeding and childbirth experience in first time mothers : A cross sectional study
Ghanbari-Homayi, Solmaz, Fardiazar, Zahra, Mohammad-Alizadeh-Charandabi, Sakineh, Meedya, Shahla, Asghari Jafarabadi, Mohammad, Mohammadi, Eesa and Mirghafourvand, Mojgan. (2020). Skin-to-skin contact, early initiation of breastfeeding and childbirth experience in first time mothers : A cross sectional study. Journal of Neonatal Nursing. 26(2), pp. 115-119. https://doi.org/10.1016/j.jnn.2019.08.003
Impressions of using the Cohen-Mansfield Agitation Inventory as an outcome measure : Lessons learnt for future clinical researchers (innovative practice)
Brett, Lindsey, Traynor, Victoria, Meedya, Shahla and Stapley, Paul. (2020). Impressions of using the Cohen-Mansfield Agitation Inventory as an outcome measure : Lessons learnt for future clinical researchers (innovative practice). Dementia: the international journal of social research and practice. 19(2), pp. 464-471. https://doi.org/10.1177/1471301217695910
Fear of childbirth, anxiety and depression in three groups of primiparous pregnant women not attending, irregularly attending and regularly attending childbirth preparation classes
Hassanzadeh, Robab, Abbas-Alizadeh, Fateme, Meedya, Shahla, Mohammad-Alizadeh-Charandabi, Sakineh and Mirghafourvand, Mojgan. (2020). Fear of childbirth, anxiety and depression in three groups of primiparous pregnant women not attending, irregularly attending and regularly attending childbirth preparation classes. BMC Women's Health. 20(1), p. Article 180. https://doi.org/10.1186/s12905-020-01048-9
Pregnant in prison : An integrative literature review
Baldwin, Adele, Sobolewska, Agnieszka and Capper, Tanya. (2020). Pregnant in prison : An integrative literature review. Women and Birth. 33(1), pp. 41-50. https://doi.org/10.1016/j.wombi.2018.12.004
Midwifery student's perceptions of completing a portfolio of evidence for initial registration : A qualitative exploratory study
Gray, Michelle, Downer, Terri and Capper, Tanya. (2020). Midwifery student's perceptions of completing a portfolio of evidence for initial registration : A qualitative exploratory study. Nurse Education in Practice. 43, p. Article 102696. https://doi.org/10.1016/j.nepr.2020.102696
Midwifery students’ experiences of bullying and workplace violence : A systematic review
Capper, Tanya, Muurlink, Olav and Williamson, Moira. (2020). Midwifery students’ experiences of bullying and workplace violence : A systematic review. Midwifery. 90, p. Article 102819. https://doi.org/10.1016/j.midw.2020.102819
Individual and environmental factors that influence longevity of newcomers to nursing and midwifery : A scoping review protocol
Capper, Tanya, Brown, Janie, Donovan, Helen, Hegney, Desley, Williamson, Moira, Cusack, Lynette, Solomans, Terena and Wilson, Sally. (2020). Individual and environmental factors that influence longevity of newcomers to nursing and midwifery : A scoping review protocol. JBI Evidence Synthesis. 18(6), pp. 1271-1277. https://doi.org/10.11124/JBIES-20-00003
Being bullied as a midwifery student : Does age matter?
Capper, Tanya, Muurlink, Olav and Williamson, Moira. (2020). Being bullied as a midwifery student : Does age matter? British Journal of Midwifery. 28(3), pp. 166-171. https://doi.org/10.12968/bjom.2020.28.3.166
The Australian Birth Charter
Capper, Tanya and Baldwin, Adele. (2020). The Australian Birth Charter. Australian Midwifery News. 21(1), pp. 32-34.
Midwifery students helping incarcerated fathers : M2 Midwives for Men pilot project
Ferguson, Bridget, Baldwin, Adele and Capper, Tanya. (2020). Midwifery students helping incarcerated fathers : M2 Midwives for Men pilot project. Australian Midwifery News. 22(1), pp. 50-51.
Developing of a new guideline for improving birth experiences among Iranian women : A mixed method study protocol
Ghanbari-Homayi, Solmaz, Fardiazar, Zahra, Mohammad-Alizadeh-Charandabi, Sakineh, Asghari Jafarabadi, Mohammad, Mohamadi, Eesa, Meedya, Shahla and Mirghafourvand, Mojgan. (2020). Developing of a new guideline for improving birth experiences among Iranian women : A mixed method study protocol. Reproductive Health. 17(1), p. Article 17. https://doi.org/10.1186/s12978-020-0868-5
Perinatal mental health during the COVID-19 pandemic [Editorial]
Matvienko-Sikar, Karen, Meedya, Shahla and Ravaldi, Claudia. (2020). Perinatal mental health during the COVID-19 pandemic [Editorial]. Women and Birth. 33(4), pp. 309-310. https://doi.org/10.1016/j.wombi.2020.04.006
Respectful maternity care and its related factors in maternal units of public and private hospitals in Tabriz : A sequential explanatory mixed method study protocol
Hajizadeh, Khadije, Vaezi, Maryam, Meedya, Shahla, Charandabi, Sakineh Mohammad Alizadeh and Mirghafourvand, Mojgan. (2020). Respectful maternity care and its related factors in maternal units of public and private hospitals in Tabriz : A sequential explanatory mixed method study protocol. Reproductive Health. 17(1), pp. 1-7. https://doi.org/10.1186/s12978-020-0863-x
Psychometric properties of satisfaction with the childbirth education class questionnaire for Iranian population
Hassanzadeh, Robab, Asghari Jafarabadi, Mohammad, Abbas-Alizadeh, Fatemeh, Meedya, Shahla, Mohammad-Alizadeh-charandabi, Sakineh and Mirghafourvand, Mojgan. (2020). Psychometric properties of satisfaction with the childbirth education class questionnaire for Iranian population. BMC Pregnancy and Childbirth. 20(1), pp. 1-9. https://doi.org/10.1186/s12884-020-03349-1
The psychometric properties of the respectful maternity care (RMC) for an Iranian population
Hajizadeh, Khadije, Asghari Jafarabadi, Mohammad, Vaezi, Maryam, Meedya, Shahla, Mohammad-Alizadeh-charandabi, Sakineh and Mirghafourvand, Mojgan. (2020). The psychometric properties of the respectful maternity care (RMC) for an Iranian population. BMC Health Services Research. 20(1), pp. 1-7. https://doi.org/10.1186/s12913-020-05729-x
Validation of the Iranian version of the childbirth experience questionnaire 2.0
Ghanbari-Homayi, Solmaz, Dencker, Anna, Fardiazar, Zahra, Asghari Jafarabadi, Mohammad, Mohammad-Alizadeh-Charandabi, Sakineh, Meedya, Shahla, Mohammadi, Eesa and Mirghafourvand, Mojgan. (2019). Validation of the Iranian version of the childbirth experience questionnaire 2.0. BMC Pregnancy and Childbirth. 19(1), p. Article 465. https://doi.org/10.1186/s12884-019-2606-y
Digital explanations and nursing students’ perception of learning science
Meedya, Shahla, Moroney, Tracey, Nielsen, Wendy and Najafi Bokat, Ida. (2019). Digital explanations and nursing students’ perception of learning science. Nurse Education in Practice. 41, p. Article 102636. https://doi.org/10.1016/j.nepr.2019.102636
The drivers of antibiotic use and misuse : The development and investigation of a theory driven community measure
Byrne, Mitchell K., Miellet, Sebastien, McGlinn, Anica, Fish, Janaye, Meedya, Shahla, Reynolds, Nina and van Oijen, Antoine M.. (2019). The drivers of antibiotic use and misuse : The development and investigation of a theory driven community measure. BMC Public Health. 19(1), p. Article 1425. https://doi.org/10.1186/s12889-019-7796-8
Assessment of childbirth preparation classes : A parallel convergent mixed study
Hassanzadeh, Robab, Abbas-Alizadeh, Fatemeh, Meedya, Shahla, Mohammad-Alizadeh-Charandabi, Sakineh and Mirghafourvand, Mojgan. (2019). Assessment of childbirth preparation classes : A parallel convergent mixed study. Reproductive Health. 16(1), p. Article 160. https://doi.org/10.1186/s12978-019-0826-2
Transitioning across professional boundaries in midwifery models of care : A literature review
Baldwin, Adele, Harvey, Clare, Willis, Eileen, Ferguson, Bridget and Capper, Tanya. (2019). Transitioning across professional boundaries in midwifery models of care : A literature review. Women and Birth. 32(3), pp. 195-203. https://doi.org/10.1016/j.wombi.2018.08.003
Australian midwifery student's perceptions of the benefits and challenges associated with completing a portfolio of evidence for initial registration : Paper based and ePortfolios
Gray, Michelle, Downer, Terri and Capper, Tanya. (2019). Australian midwifery student's perceptions of the benefits and challenges associated with completing a portfolio of evidence for initial registration : Paper based and ePortfolios. Nurse Education in Practice. 39, pp. 37-44. https://doi.org/10.1016/j.nepr.2019.07.003
The implementation of a feedback tool for mothers that have participated in the continuity of Care journey with midwifery students at Central Queensland University
Capper, Tanya. (2019). The implementation of a feedback tool for mothers that have participated in the continuity of Care journey with midwifery students at Central Queensland University. Australian Midwifery News. 19(2), pp. 26-26.
Midwifery care of HIV positive mothers in Australia
Capper, Tanya. (2019). Midwifery care of HIV positive mothers in Australia. Australian Midwifery News. 19(3), pp. 35-36.
Adolescent pregnant women's health practices and their impact on maternal, fetal and neonatal outcomes : A mixed method study protocol
Hadian, Tahereh, Mousavi, Sanaz, Meedya, Shahla, Mohammad-Alizadeh-Charandabi, Sakineh, Mohammadi, Eesa and Mirghafourvand, Mojgan. (2019). Adolescent pregnant women's health practices and their impact on maternal, fetal and neonatal outcomes : A mixed method study protocol. Reproductive Health. 16(1), p. Article 45. https://doi.org/10.1186/s12978-019-0719-4
The role of editors and reviewers [Editorial]
Stulz, Virginia, Meedya, Shahla and Sweet, Linda. (2019). The role of editors and reviewers [Editorial] Elsevier Ltd. https://doi.org/10.1016/j.wombi.2019.04.009
Predictors of traumatic birth experience among a group of Iranian primipara women : a cross sectional study
Ghanbari-Homayi, Solmaz, Fardiazar, Zahra, Meedya, Shahla, Mohammad-Alizadeh-charandabi, Sakineh, Asghari Jafarabadi, Mohammad, Mohammadi, Eesa and Mirghafourvand, Mojgan. (2019). Predictors of traumatic birth experience among a group of Iranian primipara women : a cross sectional study. BMC Pregnancy and Childbirth. 19(1), pp. 1-9. https://doi.org/10.1186/s12884-019-2333-4
Exercise and dementia in nursing homes : Views of staff and family carers
Brett, Lindsey, Traynor, Victoria, Stapley, Paul and Meedya, Shahla. (2018). Exercise and dementia in nursing homes : Views of staff and family carers. Journal of Aging and Physical Activity. 26(1), pp. 89-96. https://doi.org/10.1123/japa.2016-0368
From the ground up : Improving pregnancy and birth experiences through the provision of extraordinary learning opportunities in Australia
Baldwin, Adele, Capper, Tanya, Rogers, Lucy and Wood, Elspeth. (2018). From the ground up : Improving pregnancy and birth experiences through the provision of extraordinary learning opportunities in Australia. Journal of Forensic Nursing. 14(2), pp. 80-87. https://doi.org/10.1097/JFN.0000000000000200
Sufficient exercise for Australians living with dementia in residential aged care facilities is lacking : An exploration of policy incoherence [Commentary]
Brett, Lindsey, Stapley, Paul, Meedya, Shahla and Traynor, Victoria. (2018). Sufficient exercise for Australians living with dementia in residential aged care facilities is lacking : An exploration of policy incoherence [Commentary] John Wiley & Sons, Inc.. https://doi.org/10.1111/1753-6405.12800
Association between maternal sense of competence and self-efficacy in primiparouswomen during postpartum period
Bagherinia, Marzieh, Meedya, Shahla and Mirghafourvand, Mojgan. (2018). Association between maternal sense of competence and self-efficacy in primiparouswomen during postpartum period. Shiraz E-Medical Journal. 19(3), p. Article e59286. https://doi.org/10.5812/semj.59286
Acceptability of the Cohen-Mansfield Agitation Inventory in an Australian residential aged care facility
Brett, Lindsey, Traynor, Victoria, Stapley, Paul and Meedya, Shahla. (2017). Acceptability of the Cohen-Mansfield Agitation Inventory in an Australian residential aged care facility. Collegian. 24(6), pp. 579-584. https://doi.org/10.1016/j.colegn.2016.11.005
Effect of educational and support interventions on long-term breastfeeding rates in primiparous women : A systematic review and meta-analysis
Meedya, Shahla, Fernandez, Ritin and Fahy, Kathleen. (2017). Effect of educational and support interventions on long-term breastfeeding rates in primiparous women : A systematic review and meta-analysis. JBI Evidence Synthesis. 15(9), pp. 2307-2332. https://doi.org/10.11124/JBISRIR-2016-002955
Midwifery students go to prison
Capper, Tanya. (2017). Midwifery students go to prison. Australian Midwifery News. 17(3), pp. 24-24.
Effect of educational and support interventions to increase long-term breastfeeding rates in primiparous women : A systematic review protocol
Meedya, Shahla, Fernandez, Ritin and Fahy, Kathleen. (2017). Effect of educational and support interventions to increase long-term breastfeeding rates in primiparous women : A systematic review protocol. JBI Evidence Synthesis. 15(3), pp. 594-602. https://doi.org/10.11124/JBISRIR-2016-003132
Effects and feasibility of an exercise intervention for individuals living with dementia in nursing homes : Study protocol
Brett, Lindsey, Traynor, Victoria, Stapley, Paul and Meedya, Shahla. (2017). Effects and feasibility of an exercise intervention for individuals living with dementia in nursing homes : Study protocol. International Psychogeriatrics. 29(9), pp. 1565-1577. https://doi.org/10.1017/S1041610217000138
The health and health preparation of long-term Australian travellers
Halcomb, Elizabeth, Stephens, Moira, Smyth, Elizabeth, Meedya, Shahla and Tillott, Sarah. (2017). The health and health preparation of long-term Australian travellers. Australian Journal of Primary Health. 23(4), pp. 386-390. https://doi.org/10.1071/PY16138
The Milky Way educational and support programme : Structure, content and strategies
Meedya, Shahla, Fahy, Kathleen and Parratt, Jenny A.. (2016). The Milky Way educational and support programme : Structure, content and strategies. Women and Birth. 29(4), pp. 388-393. https://doi.org/10.1016/j.wombi.2016.01.006