• Ghareeba A. Hasan Hawler Medical University – College of Nursing – Nursing department- Erbil city- Kurdistan region/ Iraq
  • Shukir S. Hasan Hawler Medical University – College of Nursing – Nursing department- Erbil city- Kurdistan region/ Iraq / Tishik International University- Faculty of Nursing- Nursing Department- Erbil city- Kurdistan region/ Iraq



Background and Purpose: Breast milk (mother's milk) is the most natural and valuable nutrient that can be provided easily and comfortably for the infant. Although beginning the breast-feeding is often done without any problems, the continuation of that, especially the exclusive form of mother's milk, is underestimated in many cases by some factors. Studies aimed at identifying effective factors can be useful in planning for breastfeeding promotion. Therefore, considering this important issue made the researcher carry out this study with the purpose of identifying the factors affecting the lack of continuity of breastfeeding in mothers with a review of researchers and experts standpoints in this regard.

Method: All domestic studies conducted between 2001 and 2018 by using the keywords of exclusive breastfeeding with mother's milk, a continuation of breastfeeding, length of breastfeeding continuity,  factors affecting breastfeeding and meta-analysis of the country's databases, including Mag Iran, SID, Med lib, were examined and data were analyzed by using the meta-analysis method (random effect model).

Findings: 30 articles aimed at identifying effective factors in the lack of the continuation of successful breastfeeding in infants aged between 0 and 6 months were examined. Finally, a variety of factors influencing the lack of continuous breastfeeding have been classified and discussed in order of maternal, neonatal and environmental factors(in order of effect).

Conclusion: In order to facilitate the effective factors in the lack of breastfeeding continuity by mothers, we all nurses can take a long step for promoting the breast-feeding and benefit our children from this great blessing by avoiding recommending unnecessary cesarean deliveries, advertisements about the benefits of normal vaginal delivery (NVD) for mother and infant, as well as training the breast-feeding and encouraging it during pregnancy and postpartum, especially in mothers with cesarean deliveries.


Affective factors in breastfeeding, Exclusive breastfeeding with mother's milk, continuous nutrition (breastfeeding)


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Abasikakruodi, M., Rahbar, A., Yaghoobi, A. & Eskandari, S. (2008). Breastfeeding: A Vital Emergency in Crisis. Journal of Holistic Nursing and Midwifery, 18(2), pp 51-53.

Akaberian, S., Jamand, T., Zahmatkeshan, N., Bagherzadeh, R., Mirzaei, K., Gharibi, T., Yazdankhah, M., Kamali, F., Khoramroodi, R. & Pouladi, S. (2015). Comparing the Effectiveness of Multimedia and Routine Educations on Exclusive Breast Feeding in Children Less than 6 Months In Health Centers of Bushehr City. Iranian South Medical Journal, 17(6), pp 1252-1260.

Allahkarampour, F., Pishva, N. & Keshavarzi, S. (2015). A Survey Of The Impact of Proper Breastfeeding Education On Blood Sugar Levels of Healthy Term Infants In The Public Hospital of Shahid Rajai In Gachsaran In 2013. Journal Of Clinical Nursing And Midwifery, 4(3), pp 12-22.

Almasi, H., Saberi, H. & Moravveji, S.A. (2010). The Pattern of Exclusive Breast Feeding In Neonates under Healthcares in Health Centers of Kashan City During 2006. Feyz, 14(2), pp 163-168.

Amini, R., Mohammadi, N., Omid, A., Khodavisi, M., Borzo, R. & Moradi, F. (2012). Causes of Lactation in Children under 1 year of age in Women Referring to Health Centers 20 Hamedan. Journal of Nursing and Midwifery (Nasim Danesh), 20(2), pp 58-64.

Amirshahi, M., Shiri, S., Salehin, S. & Mohamad Rezaei, Z. (2013), A Study on the Relationship Between Duration of Breastfeeding and Some Maternal and Neonatal Factors. Journal of Urmia Nursing and Midwifery Faculty, 11(5), pp 1-5.

Ansari Jaberi, A., Negahban Bonabi, T., Alahtavakoli, M. & Kazemi, M. (2015). Maternal Affectivity and their Infants Feeding Pattern among Referrers to Health Care Centers in Rafsanjan in 2011. Journal of Rafsanjan University of Medical Sciences, 14(1), pp 47-56.

Arshad, S.M., Khani-Jeihooni, A., Moradi, Z., Kouhpayeh, S.A., Kashfi, S.M. & Dehghan, A. (2017). Effect of Theory of Planned Behavior-Based Educational Intervention On Breastfeeding Behavior in Pregnant Women In Fasa City, Iran. Journal of Education and Community Health, 4(2), pp 55-63.

Azimi, N., Akhavan Karbasi, M. & Jafari, A. (2010). Quantitative Comparison of Oral Fungal Colonies in the Breast-Feeding and Bottle-Feeding Infants. Journal of Dental Medicine, 23(3), pp 175-182.

Barak, M., Amani, F., Mirza Rahimi, M., Abbasgholizadeh, N. & Hamid Kholgh, A.R. (2005). Evaluating Mothers’ Knowledge About Infant Proper Nutrition in Hir Health Center, 2001. Journal of Ardabil University of Medical Sciences, 5(1), pp 26-29.

Ekhtiari, A. & Emami, P. (2008). Comparison of Success Rates in Breastfeeding after Vaginal Delivery and Cesarean Section. Medical Sciences, 18(1), pp 51-54.

Emami, P. & Aref, S. (2007). Maternal Knowledge, Attitude and Perception About. Medical Sciences, 17(3), pp 165-169.

Esfarjani, F., Salarkia, N., Roustaee, R. & Abadi, A. (2008). Anthropometric Assessment of the Nutritional Status of Under-5-Year-Old Children in Mother-Headed Households Under Coverage of the Imam Khomeini Relief Foundation of Tehran and Factors Related to it, 2005. Iranian Journal of Nutrition Sciences & Food Technology, 2(4), pp 41-48.

Gafari Asl, M., Fadakar Sogheh, R., Ghavi, A. & Ahmad Shear Bafi, M. (2014). Related Factors to Continued Breastfeeding in Infants. Journal of Holistic Nursing and Midwifery, 24(2), pp 1-8.

Hajikazemi, E., Allahgholi, L., Jamshidimanesh, M. & Hosseini, F. (2009). The Relationship between Body Mass Index Before Pregnancy and Duration of Breast Feeding. Iran Journal of Nursing, 22(57), pp 9-18.

Hamidi, M., Khoshdel, A., Khadivi, R., Deris, F., Salehi-Fard, A., Parvin, N. & Malekahmadi, M. (2011). The Causes of Formula Milk Consumption in the Infants Under 1 Year Old In Charmahalva Bakhtiari Provins Iran, 2007. Journal of Shahrekord University of Medical Sciences, 13(3), pp 77-83.

Hasan, S.S. (2016). Factors influence on Primigravida’s knowledge regarding exclusive breastfeeding benefits in Maternity Teaching Hospital: Erbil city - Kurdistan region – Iraq. Zanco Journal of Medical Sciences, 20(3), pp 1505-12.

Hauck, F.R., Thompson, J.M., Tanabe, K.O. & Moon, R.Y. & Vennemann, M.M. (2011). Breastfeeding and Reduced Risk of Sudden Infant Death Syndrome: A Meta-Analysis. Pediatrics, 28(1), pp 103-110.

Heidari, B., Etemadifar, S. & Raeisi, M. (2016). The Effectiveness of a Supportive Educative Program on Mothers’ Knowledge and Behavior About Breast Feeding in Health Care Centers of Shahrekord City 2012. Journal of Clinical Nursing and Midwifery, 5(1), pp 67-75.

Khoshnevisasl, P., Sadeghzadeh, M., Mazloomzadeh, S., Koosha, A. & Dariabari, S. (2010). Maternal Knowledge about Nutritional Status of 6 to 12-Month-Old Infants in the Community Oriented Medical Education of Zanjan University of Medical Sciences. Journal of Advances in Medical and Biomedical Research, 18(71), pp 61-69.

Khoshtarash, M., Ghanbari, A., Yeganeh, M., Kazemnezhad, E. & Rezasoltani, P. (2010). Survey the Effect of Foot Reflexology on Pain and Physiological Parameters after Cesarean Section in Patients Referring to Alzahra Educational Center in Rasht. Journal of Holistic Nursing and Midwifery, 20(2), pp 27-33.

Kramer, M.S. & Kakuma, R. (2012) Optimal Duration Of Exclusive Breastfeeding. Cochrane Database of Systematic Reviews, 8, CD003517.

Lewallen, L.P. & Street, D.J. (2010). Initiating and Sustaining Breastfeeding in African American Women. Journal of Obstetric, Gynecologic & Neonatal Nursing, 39(6), pp 667-674.

Mirmohammadali, M., Golian Tehrani, S., Kazemnejad, A., Hosseini Baharanchi, F.S., Minaee, B., Bekhradi, R. & Dehkordi, Z.R. (2011). A Comparative Study of the Effect of Massage with Sunflower oil or Sesame Oil on Infants' Crying and Sleep Times: A Randomized Clinical Trial. Hayat, 17(3), pp 80-90.

Mohammadpour, A., Khajavi, A., Moshki, M., Zarei, M., Hashemizadeh, H., Farzamfar, S. & Namnik F. (2015). Level of Malnutrition and Failure to Thrive in 1-18 Month Old Infants. The Horizon of Medical Sciences, 21(4), pp 1-6.

Mojalli, M., Basiri Moghadam, M. & Shamshiri, M. (2010). Effectiveness of Instructional Environment and Related Factors on Breastfeeding Function of Mothers. The Horizon of Medical Sciences, 16(1), pp 59-64.

Mokhtary, L., Khorami Marekani, A. & Habibpoor, Z. (2014). The Effect of Face to Face Education and Pamphlet Giving on Knowledge of Mothers about Breast Feeding. Journal of Urmia Nursing and Midwifery Faculty, 12(9), pp 825-832.

Montgomery, A., Hale, T.W. & Academy of Breastfeeding Medicine (2012). ABM clinical protocol #15: analgesia and anesthesia for the breastfeeding mother, revised 2012. Breastfeeding Medicine, 7(6), pp 547-53.

Noohi, E., Soltani Nejad, A. & Safi Zadeh, H. (2008). Feeding Patterns and Colicky Infants. Journal of Qualitative Research in Health Sciences, 11(1 and 2), pp 51-58.

Pakpour, A., Alijanzadeh, M., Pouresmaeil, M., Taherkhani, F., Mohammadgholiha, R. & Jozi, N. (2016). Predictive Factors Associated with Breastfeeding Initiation and Duration Behaviors of 6-Months Postpartum Mothers Referred to Health Centers in the City of Qazvin Based on Theory of Planned Behavior. Iranian Journal of Health Education and Health Promotion, 4(1).

Raisi, Z.D., Raei, M., Ghassab, M.S., Raisi Dehkordi, S.A.R. & Mirmohammadali, M. (2012). Effect of Telephone Counseling on Continuity and Duration of Breastfeeding among Primiparus Women. Hayat, 18(2), pp 57-65.

Rollins, N.C., Bhandari, N., Hajeebhoy, N., Horton, S., Lutter, C.K., Martines, J.C., Piwoz, E.G., Richter, L.M., Victora, C.G. & The Lancet Breastfeeding Series Group (2016). Why Invest, and What it Will Take to Improve Breastfeeding Practices? The Lancet, 387(10017), pp 491-504.

Safari, K., Aziz, A.S., Hasan, S.S. & Moghaddam-Banaem, L. (2018). The effect of mother and newborn early skin-to-skin contact on initiation of breastfeeding, newborn temperature and duration of third stage of labor. International Breastfeeding Journal, 13(1), pp 1-8.

Sakkaki, M. & Khairkhah, M. (2013). Promotion of Exclusive Breastfeeding: Teaching Good Positioning and Support from Fathers and Families. Journal of Urmia Nursing and Midwifery Faculty, 10(6).

Shahri, P., Balooti, T., Sa'atati, N. & Haghighizadeh, M.H. (2012). Relationship between maternal and breastfeeding patterns and their continuity. Footnote, 11(6), pp 893-899.

Sharifirad, G., Shahnazi, H., Sedighi, E. & Mahaki, B. (2018). The Effect of Supporter Presence in Education Sessions of Breastfeeding on Knowledge, Attitude and Behavior of Nulliparous Women. Journal of Health, 9, pp 45–61.

Shiva, F., Sallemi, F. & Fakhteh Yavari, S.H. (2008). The Effect of Pacifier Use on Breast-Feeding Duration. Research in Medicine, 32(4), pp 261-265.

Stuart-Macadam, P. (2017). Breastfeeding in Prehistory. Inbreastfeeding, pp 75-100. UK: Routledge.

Talebi, M., Sarraf Shirazi, A. & Ismaili, H. (2005). The Relationship Between Diet and Oral Hygiene Status and Gingival Health In Preschool Children in Private Kindergartens in Mashhad. Journal of Mashhad Dental School, 29(3,4), pp 223-134.

Tarvij, S.E., Nassirian, H. & Danesh, H.A. (2014). Comparing Growth Indices between Exclusive Breastfed Infants 6 Months and Growth Standards of National Center Health Statistics in Iran. Medical Sciences, 23(4), pp 262-268.

Victora, C.G., Bahl, R., Barros, A.J., França, G.V., Horton, S., Krasevec, J., Murch, S., Sankar, M.J., Walker, N., Rollins, N.C. & Lancet Breastfeeding Series Group. (2016). Breastfeeding In The 21st Century: Epidemiology, Mechanisms, and Lifelong Effect. The Lancet, 387(10017), pp 475-90.



How to Cite

Ghareeba A. Hasan, & Shukir S. Hasan. (2020). MATERNAL AND NEONATAL BARRIERS OF BREAST-FEEDING: A SYSTEMATIC REVIEW. The Malaysian Journal of Nursing (MJN), 12(1), 49-56.