Breastfeeding in the European Union: A Systematic Literature Review

Abstract Introduction: Many countries in Europe have low breastfeeding rates, according to current European Community health indicators. This study explores the determinants, main barriers and gaps associated with breastfeeding in the UK and European countries, including the influence of culture and tradition on choosing natural breastfeeding, gaps in the promotion of this practice at social or healthcare levels and perceived legal or work-related barriers. Methods: Literature search through multi-method approach, on electronic database, in the UK databases, EU/EEA and international accredited databases. Electronic databases (WHO, OECD, GMC, NHS, Pub Med /Medline, Cochrane, NICE), were accessed for published studies, and general search on Internet. Data analysis and review with critical appraisal tools, the NICE and STROBE guidelines for quantitative and qualitative studies, and the CASP check list for quantitative and qualitative studies and systematic reviews. Results: Findings suggested lack of knowledge, lack of promotion and of appropriate support from health services or health professionals, lack of educational and support regarding breastfeeding. Conclusion: Although social and cultural determinants proved to be relevant for breastfeeding decision, a barrier also founded was lack of information, education and support, suggesting the need for further improvement and development at health policies and healthcare level.