An Integrative Review of Breastfeeding and Homelessness

Abstract

Objective: To synthesize the current literature surrounding breastfeeding and homelessness, and to determine the impact of disparities in this population.

Data sources: An integrative search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and using the search terms "breastfeeding" and "homelessness" throughout electronic databases PubMed, CINAHL, and Scopus.

Study selection: Inclusion criteria were articles published in English from January 2007 to September 2022. Exclusion criteria were studies published more than 15 years ago, studies published in a language other than English, opinion articles, and irrelevance to breastfeeding and homelessness. The initial search yielded 100 results. After removing duplicates and articles because of irrelevance, the final number of articles for this synthesis was seven.

Data extraction: Data were extracted from each article, critically appraised using Joanna Briggs Institute criteria, and summarized in a table of evidence.

Data synthesis: Three common themes were identified: Decreased Breastfeeding Initiation Rates and Duration in the Homeless Population, Impact of Community and Clinical Support, and Breastfeeding Practices Influenced by Individual Factors.

Conclusion: Providers and nurses should refer patients to the Special Supplemental Nutrition Program for Women, Infants, and Children; use techniques to instill a parent's intent to breastfeed; provide early breastfeeding education; promote breastfeeding initiation within 1 hour of birth; and encourage peer support groups. Although current researchers provide insight into potential barriers and interventions, more research is needed to gain additional data on how to overcome identified barriers to breastfeeding.

Keywords: breastfeeding; homeless; homeless persons; homelessness; housing instability; lactation; unhoused.