Women's views and experiences of breastfeeding during the coronavirus disease 2019 pandemic: A systematic review of qualitative evidence

The coronavirus disease 2019 pandemic affected breastfeeding women in various ways. Understanding their experiences during the pandemic is crucial for informing actionable recommendations, evidence-based strategies and future policies to support breastfeeding during global pandemics. This review aimed to synthesise qualitative evidence on women's breastfeeding perceptions, experiences and support needs during the pandemic. The Joanna Briggs Institute's (JBI) guidelines on systematic reviews of qualitative evidence were followed. MEDLINE, Embase, CINAHL and Web of Science Core Collection databases were searched. Methodological quality of included papers was assessed using JBI's checklist for qualitative research. The synthesised findings were generated using JBI's meta-aggregation approach. The JBI ConQual process was used to rank each synthesised finding. Fifty-two papers were included. The synthesised findings included: (1) women's awareness and commitment to breastfeeding during the pandemic, (2) the multifaceted breastfeeding experiences of women during the pandemic, (3) breastfeeding practices and challenges for working women, (4) professional support during the pandemic: navigating breastfeeding in an evolving health care context and (5) family and peer support groups during the challenging times of the pandemic. Breastfeeding women require clear information, accessible in-person lactation support, family emotional support, food security and protection of psychological well-being. The review reported diverse breastfeeding experiences, from social support challenges to positive aspects like remote work. Breastfeeding support and lactation consultants should be considered as essential services in future pandemics. Food security is crucial for breastfeeding households. Lactation services could prioritise face-to-face consultations for physical challenges and providing online informational support. Future research could explore innovative breastfeeding education strategies. Breastfeeding women require clear information, accessible in-person lactation support, family emotional support, food security and protection of psychological well-being during a pandemic. The review reported diverse breastfeeding experiences, from social support challenges to positive aspects like remote work. Food security has been found to be crucial for breastfeeding households. image Breastfeeding women, during the pandemic, faced challenges due to disrupted post-natal care, cancelled breastfeeding classes and insufficient health care professional support, leading to feelings of neglect, isolation and uncertainty. During the pandemic, breastfeeding women received limited face-to-face support from family and friends. In the absence of in-person support, online platforms emerged as valuable resources for breastfeeding guidance. In future pandemics, breastfeeding support and designate lactation consultants should be prioritised as essential services to ensure uninterrupted breastfeeding support. Innovative strategies, including online and real-time breastfeeding education and support, should be further developed and rigorously evaluated to effectively address breastfeeding challenges during pandemics.