Background: Breastfeeding is a critical public health issue, with maternal employment being a leading factor for not breastfeeding or early weaning worldwide. While some countries, including Ireland, have introduced legislation to support workplace breastfeeding, significant gaps remain between policy and practice. Globally, only 20% of countries legislate mandatory provision of both paid breaks and nursing facilities, falling short of the WHO and UNICEF target of 50% by 2030. Employers play a crucial role in policy implementation, yet no review has synthesised the qualitative evidence on barriers and facilitators they experience.
Aim: This rapid qualitative evidence synthesis (QES) aims to summarise and evaluate the international evidence on employer-perceived barriers and facilitators to implementing workplace breastfeeding policies, guiding strategies to optimise their implementation and improve breastfeeding rates.
Methods: This rapid QES will adhere to best-practice methodological guidance. Comprehensive literature searches will be conducted in MEDLINE and CINAHL. Primary research studies published in English that use qualitative methods to explore employer perspectives on implementing breastfeeding policies will be included, with no restrictions on publication year or country. A ‘best fit’ framework approach will synthesise data, deductively coding to the Consolidated Framework for Implementation Research (CFIR) and inductively coding factors not represented by CFIR constructs. The GRADE-CERQual approach will assess confidence in the findings.
Expected impact: By synthesising evidence on implementation determinants, this review will guide the development of strategies to optimise the implementation of workplace breastfeeding policies globally. The findings will inform policymakers, employers, and public health professionals, promoting evidence-informed decision-making and ultimately contributing to improved breastfeeding rates and population health outcomes. The review will also identify gaps in the current evidence base and guide future research priorities in this area.
Dissemination: The findings will be disseminated through a peer-reviewed publication and a policy brief to support evidence-informed implementation of workplace breastfeeding policies.