Women's experiences and decision-making process of breastfeeding following or during cancer: An integrative systematic review.

BACKGROUND

Cancers diagnosed in young and reproductively aged women are increasing globally. The impact of cancer is known to affect women's pregnancy and breastfeeding outcomes and experiences. International recommendations promote exclusive breastfeeding for infants, yet there is an absence of evidence to inform and support breastfeeding following or during cancer.

OBJECTIVE

To examine women's breastfeeding experiences and decision-making following or during cancer treatment.

METHODS

This integrative systematic review followed the PRISMA 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analysis, using the Joanna Briggs Institute (JBI) methodology. All data was qualitised for the purpose of thematic analysis to critically analyse and deduce robust findings. A feminist research perspective was employed to enable an ethical approach that valued women's situated knowledge of their experiences and decision-making.

FINDINGS: 2095 records were identified; 50 full-text records were reviewed, and 15 studies were included. Many women experienced inadequate breastfeeding information and support. There were 55 individual findings within the studies generating three themes, (1) Emotional aspects, (2) Adaptive care and (3) Professional involvement. Women's care requirements were unique to their cancer characteristics.

DISCUSSION: Women affected by cancer require comprehensive breastfeeding information and support to meet their individualised needs and informed feeding decisions. Care by midwives, lactation services, nurses and medical specialists as well as health services broadly, are required to promote and support lactation.

CONCLUSIONS

Considering the increasing incidence of early onset cancers, evidence-based lactation information and support is required to improve maternal experiences and outcomes in this cohort.