Keywords
breastfeeding curriculum; health students; interprofessional education
To review and summarise interprofessional breastfeeding curricula—educational initiatives involving multiple health professions—that have been proposed for undergraduate or pre-registration health students. This review will help guide the development of future Interprofessional Education (IPE) curricula for undergraduate health students, specifically in the area of breastfeeding care.
Breastfeeding care and support from healthcare professionals are vital for breastfeeding success. To ensure mothers receive high-quality, consistent care, healthcare professionals must receive comprehensive, evidence-based breastfeeding education. However, there is limited understanding of how breastfeeding curricula are delivered across different disciplines in undergraduate health programs, particularly in the context of IPE.
Primary research designs, including quantitative, qualitative and mixed-method studies and evidence syntheses of primary research including systematic and scoping reviews that meet the inclusion criteria will be considered. Position papers and policy documents will also be considered for inclusion in this scoping review.
Medline (Ovid), CINAHL (EBSCO), ERIC (EBSCO), Social Sciences, and Cochrane Databases of Systematic Reviews will be searched with English language and date restrictions (2005-current). Titles and abstracts and full-text articles will be independently screened by two reviewers. The reference lists of the included studies will be searched. A grey literature search will be undertaken on Google scholar, BASE and National Institute for Health and Care Excellence (NICE) website in October 2024. Studies will be screened in Covidence by two independent reviewers. All reviewers will agree on the included studies. Data will be extracted and presented graphically using figures and tables. Narrative summary text will accompany the tables and figures.
breastfeeding curriculum; health students; interprofessional education
The World Health Organisation (WHO) recommend exclusive breastfeeding for the first six months of infants’ lives to attain optimal development, growth and health (WHO, 2023). After six months, it is recommended to continue breastfeeding whilst introducing nutritional, complementary foods for up to two years or beyond (WHO, 2023). Global breastfeeding rates remain lower than required (Mulcahy et al., 2022), with approximately 44% of infants between zero to six months breastfed exclusively between 2015–2020 (WHO, 2023).
Mothers need support to breastfeed, and healthcare professionals play a key role in providing that support (McFadden et al., 2017; WHO, 2023). However, their breastfeeding knowledge can vary, with gaps reported in the literature (Leviniene et al., 2009; Mulcahy et al., 2022; Whelan et al., 2011). Comprehensive, evidence-based breastfeeding education during undergraduate training is essential to ensure consistent, high-quality care (Campbell et al., 2022; UNICEF, WHO, 2003). Yet, curricula often lack sufficient breastfeeding education, leading to varying levels of support for parents (Campbell et al., 2022; Campbell et al., 2024; Gary et al., 2017).
IPE is crucial for effective healthcare practice implementation (Homeyer et al., 2018). Learning alongside other disciplines helps students understand both their own roles and the roles of other healthcare professionals (Saragih et al., 2023). Mulcahy et al. (2022) emphasised that interdisciplinary education can improve breastfeeding support. Incorporating an IPE model into healthcare education may foster collaboration and improve students’ knowledge (Saragih et al., 2023). Applying this IPE approach to breastfeeding curricula could strengthen teamwork among healthcare professionals and improve breastfeeding knowledge. However, there is limited research on how breastfeeding education is integrated across different disciplines in undergraduate health programs. Therefore, this review aims to identify and summarise interprofessional breastfeeding curricula—educational initiatives involving multiple health professions—that have been proposed for undergraduate or pre-registration health students. For this reason, a scoping review will be undertaken.
A preliminary scoping search was undertaken to identify any existing systematic reviews or scoping reviews as per the JBI guidance for scoping reviews (Peters et al., 2020). Campbell et al. (2022) undertook a scoping review of the literature to explore educational resources, methods and curriculum provided to undergraduate health students on lactation. The authors’ recommended the need for a comprehensive breastfeeding-related curriculum for undergraduate health students as approaches to breastfeeding education lack consistency (Campbell et al., 2022). The current review aims to investigate interprofessional breastfeeding curricula only to inform future IPE curricula for undergraduate health students.
To review and summarise interprofessional breastfeeding curricula (education initiatives that include more than one profession) that have been proposed for undergraduate or pre-registration health students for breastfeeding care to inform future IPE curricula for undergraduate health students.
1. What evidence exists regarding IPE on breastfeeding, including the curricular content and intended learning outcomes?
2. How has breastfeeding education been integrated into health professional curricula?
3. What IPE competency frameworks, approaches, principles, or models have been applied in breastfeeding education?
4. Which groups of students have received interprofessional breastfeeding education?
5. What outcomes have been reported in relation to IPE in the context of breastfeeding care?
Undergraduate or pre-registration health students, from any health profession (e.g. dentists, dieticians, doctors, midwives, nurses, occupational therapists, pharmacists, physiotherapists, public health students, speech and language therapists). There will be no restriction on age or gender.
Studies that report on breastfeeding curricular content, curricular learning outcomes (skills, attitudes, knowledge, confidence), curriculum integration processes that have been offered to students from two or more professions (i.e. with an IPE component). IPE is defined as education that occurs when “students from two or more professions learn about, from, and with each other to enable effective collaboration and improve health outcomes” (World Health Organization, 2010)
Breastfeeding education programmes that include breastfeeding care in the curriculum in Higher Education Institutions (HEI). There will be no limit on countries.
This scoping review will consider quantitative, qualitative and mixed-method studies. In addition, systematic reviews and scoping reviews that meet the inclusion criteria will also be considered. Position papers and policy documents will also be considered for inclusion in this scoping review.
Non-health students will be excluded. Studies examining or exploring undergraduate or pre-registration health students’ breastfeeding knowledge, skills, confidence or attitudes without including breastfeeding education/curriculum will be excluded. Studies that include breastfeeding education/curriculum offered to students from only one profession will be excluded. Studies identifying scales that have been developed to assess knowledge acquired during training will be excluded.
The Joanna Briggs Institute (JBI) guidelines for scoping reviews will be followed (Peters et al., 2020). This scoping review will be reported in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) extension for scoping reviews, PRISMA-ScR (Tricco et al., 2018).
The search strategy will aim to locate both published and unpublished studies. A three-step search strategy as per the JBI methodology for scoping reviews will be utilised in this review (Peters et al., 2020). First an initial limited search of MEDLINE (Ovid) and CINAHL (EBSCO) was undertaken in September 2024 to identify articles on the topic. The text words contained in the titles and abstracts of relevant articles were used to develop a full search strategy for Medline (Ovid), CINAHL (EBSCO), ERIC (EBSCO), Social Sciences and Cochrane Databases of Systematic Reviews (Table 1 and Table 2). Keywords were mapped to relevant subject headings for the appropriate databases. The search strategy was reviewed by topic experts and knowledge users who are professionals in this area.
The search strategy will be adapted for each included database. Syntax and subject headings will be adapted to match each database. One full search has been included in the protocol (Table 3). The reference list of all included studies will be searched to identify additional studies. A grey literature search will be undertaken on Google scholar, BASE and NICE website. Studies published in English will be included. The date range of evidence will be set to 2005 to the current time. This parameter was set in line with international recommendations for curriculum content in breastfeeding support to be included in undergraduate programs (The Global Strategy for Infant and Young Child Feeding, 2003; The NICE Guidelines on Maternal and Infant Nutrition, 2008;2014).
Following the search, all identified citations will be transferred to Covidence, and duplicates removed. Following a pilot test by two independent reviewers, titles and abstracts will then be screened by two independent reviewers for assessment against the inclusion criteria for the review. Potentially relevant sources will be retrieved in full and screened in Covidence. The full text of selected citations will be assessed in detail against the inclusion criteria by two independent reviewers. Any disagreements that arise between the reviewers at each stage of the selection process will be resolved through discussion. Where consensus cannot be reached, a third reviewer will be consulted (Peters et al., 2020). Reasons for exclusion of studies will be provided. The results of the search and the study inclusion process will be reported in the final scoping review and presented in a PRISMA flow diagram (Tricco et al., 2018).
Data will be extracted from papers included in the scoping review by two independent reviewers using a data extraction template (Peters et al., 2020) that will be adapted by the reviewers (Table 4). The JBI data extraction template was modified to include the PCC relevant to this review. Data relevant to address the review objectives and associated questions will be extracted (Peters et al., 2020). The following data will be extracted; author, year, country, type of evidence source, study aim and objectives, participants, context, methodology, curricular content, learning outcomes, integration processes, IPE components, delivery approach, teaching and assessment strategy and key findings as they relate to the review questions.
The data extraction form will be piloted by two reviewers independently on two studies before use (Peters et al., 2020). Revisions will be made as required. The draft data extraction tool will be modified and revised as necessary during the process of extracting data from each included evidence source. Modifications will be detailed in the scoping review. Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer. If appropriate, authors of papers will be contacted to request missing or additional data, where required.
The evidence will be mapped and summarised in line with the review aims and objectives. The data will be presented graphically using figures and tables. Narrative summaries will accompany these results. The included studies will be summarised based on the studies’ characteristics, including the year, country and type of evidence source, study aim and objectives, participants, context and methodology. Narrative summaries will outline characteristics of interprofessional breastfeeding curricula, including curricular content, learning outcomes, integration processes, delivery approach, teaching and assessment strategy, IPE approaches, competency frameworks, models or principles and key findings as they relate to the review questions. This information will be analysed to inform future IPE curricula for undergraduate health students.
A reflexive approach will be adopted throughout the review process. The reviewers will critically reflect on the selection of studies, interpretation of the literature and the potential biases inherent in the synthesis process. Reflexivity will involve the reviewers’ being transparent about their perspectives, decisions made during the review process, and how these may influence findings. A reflexive statement will be included in the review discussing these considerations to provide a richer understanding of the choices made and how these may shape the conclusions drawn.
Ethics and consent were not required
Is the rationale for, and objectives of, the study clearly described?
Yes
Is the study design appropriate for the research question?
Yes
Are sufficient details of the methods provided to allow replication by others?
Yes
Are the datasets clearly presented in a useable and accessible format?
Yes
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Expertise in the area of scoping reviews and also breastfeeding
Is the rationale for, and objectives of, the study clearly described?
Yes
Is the study design appropriate for the research question?
Yes
Are sufficient details of the methods provided to allow replication by others?
Yes
Are the datasets clearly presented in a useable and accessible format?
Not applicable
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: My area of expertise is implementation of clinical practice guidelines, breastfeeding, evidence-based practice, primary health care.
Is the rationale for, and objectives of, the study clearly described?
Yes
Is the study design appropriate for the research question?
Yes
Are sufficient details of the methods provided to allow replication by others?
Yes
Are the datasets clearly presented in a useable and accessible format?
Yes
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Maternal and Child Health, Health Disparity, Community-Engaged Research
Alongside their report, reviewers assign a status to the article:
Invited Reviewers | |||
---|---|---|---|
1 | 2 | 3 | |
Version 1 22 Jan 25 |
read | read | read |
Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list:
Sign up for content alerts and receive a weekly or monthly email with all newly published articles
Register with HRB Open Research
Already registered? Sign in
Submission to HRB Open Research is open to all HRB grantholders or people working on a HRB-funded/co-funded grant on or since 1 January 2017. Sign up for information about developments, publishing and publications from HRB Open Research.
We'll keep you updated on any major new updates to HRB Open Research
The email address should be the one you originally registered with F1000.
You registered with F1000 via Google, so we cannot reset your password.
To sign in, please click here.
If you still need help with your Google account password, please click here.
You registered with F1000 via Facebook, so we cannot reset your password.
To sign in, please click here.
If you still need help with your Facebook account password, please click here.
If your email address is registered with us, we will email you instructions to reset your password.
If you think you should have received this email but it has not arrived, please check your spam filters and/or contact for further assistance.
Comments on this article Comments (0)