Van Neste Martje, Verschoren Katoo, Kempenaers Rani, Eerdekens An, Kitshoff Danine, Allegaert Karel, Bogaerts Annick
Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium.
Leuven Child and Youth Institute, KU Leuven, 3000 Leuven, Belgium.
Nutrients. 2025 Mar 8;17(6):946. doi: 10.3390/nu17060946.
Breastfeeding is associated with many health benefits, while its prevalence is determined by numerous factors, including socioeconomic status (SES). SES is the position of an individual on the socioeconomic scale, using occupation, education, income, place of residence, and wealth as key indicators. Since its interrelationship with health is complex, world region-specific insights into the relevant socioeconomic inequalities impacting breastfeeding practices are crucial to effectively address these. The purpose of this systematic review is, therefore, to explore SES indicators affecting breastfeeding initiation and duration in two different United Nations-defined regions, Western Europe and Southern Africa to assess (dis)similarities, as these can guide region-specific, targeted interventions to improve practices. A systematic literature search was conducted across seven databases, of which 47 articles were included. The risk of bias was assessed, and outcome data related to SES as well as breastfeeding initiation and duration were collected. Higher education consistently leads to better breastfeeding initiation outcomes, but economic constraints and employment in informal sectors hinder breastfeeding practices in Southern Africa. In Western Europe, supportive working conditions and a migration background have a positive impact, while employment status and income show rather mixed effects. Community, regional, and religious factors play significant, ambiguous roles. In South Africa, food insecurity, the living environment, and geographic location complicate breastfeeding. This systematic review highlights the significant influence of SES on breastfeeding initiation and duration in Western Europe and Southern Africa, while the specific factors indeed vary between both regions. This systematic review therefore illustrates the relevance of region-specific SES factors, impacting breastfeeding practices. Addressing these barriers with region-specific, targeted approaches may result in substantial progress toward achieving global breastfeeding goals. Registration: PROSPERO (CRD42023473433).
母乳喂养与诸多健康益处相关，但其普及率取决于众多因素，包括社会经济地位（SES）。SES是个体在社会经济等级中的位置，以职业、教育、收入、居住地点和财富作为关键指标。由于其与健康的相互关系复杂，针对世界不同地区影响母乳喂养行为的相关社会经济不平等现象的深入见解，对于有效解决这些问题至关重要。因此，本系统评价的目的是探讨影响西欧和南部非洲这两个联合国定义的不同地区母乳喂养开始时间和持续时间的SES指标，以评估（不）相似之处，因为这些可以指导针对特定地区的有针对性干预措施来改善母乳喂养行为。我们在七个数据库中进行了系统的文献检索，共纳入47篇文章。我们评估了偏倚风险，并收集了与SES以及母乳喂养开始时间和持续时间相关的结果数据。高等教育始终能带来更好的母乳喂养开始结果，但经济限制和非正规部门的就业阻碍了南部非洲的母乳喂养行为。在西欧，支持性的工作条件和移民背景有积极影响，而就业状况和收入的影响则较为复杂。社区、地区和宗教因素发挥着重要但不明确的作用。在南非，粮食不安全、生活环境和地理位置使母乳喂养变得复杂。本系统评价强调了SES对西欧和南部非洲母乳喂养开始时间和持续时间的重大影响，而两个地区的具体因素确实有所不同。因此，本系统评价说明了特定地区的SES因素对母乳喂养行为的相关性。采用针对特定地区的有针对性方法解决这些障碍，可能会在实现全球母乳喂养目标方面取得重大进展。注册信息：PROSPERO（CRD42023473433）
