Opportunities to Effectively Promote Breastfeeding in German Workplaces : A Systematic Review

Abstract

Background: Even though breastfeeding has several advantages, the prevalence in Germany is low and far beneath recommendations. One field that has an impact on breastfeeding is maternal employment. The aim of this thesis was, to identify interventions, which can be introduced by employers in Germany to effectively promote breastfeeding among employed mothers. Methods: A systematic review was conducted following the guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). It focused on employed women of all ages and professions returning (or having recently returned) to work after giving birth, being or having recently been exposed to interventions or workplace characteristics promoting breastfeeding in the workplace. Self-employed women, pupils, or students in respective settings not constituting a workplace were excluded. All types of workplace- level interventions within the sphere of influence of the employer focusing on breastfeeding support are of interest, whereas any direct breastfeeding indicator focusing on the duration of breastfeeding represents a possible outcome variable. All types of published primary quantitative studies in English and German, published between 2013 and 2023 in high-income countries, for which free full text was available were included. The search was performed in the databases MEDLINE, EMBASE, CINAHL, Web of Science, and CENTRAL, accompanied by an additional search in Google Scholar. Methodological quality and risk of bias of the included studies are assessed using the critical appraisal checklists by the Joanna Briggs Institute (JBI). Synthesis of the result is conducted narratively by forming subgroups. In the discussion, the results are transferred to Germany and targeted application opportunities are outlined.