Integrative Review of Breastfeeding Duration and Influencing Factors Among Women Serving Active Duty in the U.S. Military.

OBJECTIVE: To determine what is known about breastfeeding duration among active-duty servicewomen and to identify factors related to military employment that facilitate or inhibit breastfeeding.

DATA SOURCES: Literature searches using CINAHL and MEDLINE were conducted with the keywords military and breastfeeding for articles published from January 2000 through May 2016.

STUDY SELECTION: Abstracts and full-text research articles were retrieved and analyzed that met the inclusion criteria: English language, U.S. active-duty military personnel, peer-reviewed, and identified facilitators and/or barriers to breastfeeding.

DATA EXTRACTION: Eight studies were analyzed for quality and content; analysis was guided by Cooper's five stages of review synthesis processes.

DATA SYNTHESIS: Findings indicated that although breastfeeding initiation rates are similar to those for civilians, military women may discontinue sooner. Perception of military work as a barrier is associated with shorter duration, and enlisted personnel were less likely to breastfeed to 12 months than commissioned officers. Military women experienced work-related barriers: lack of proper facilities for pumping, pressures and obligations related to rank, conflicts between mother/soldier demands, physical fitness/weight standards, concerns related to exposure to hazardous material, and prolonged separations from their infants.

CONCLUSION: Most women in the military serve during their childbearing years when they may want to breastfeed. Strategies to promote breastfeeding include advocacy for policy changes, education of servicewomen and supervisors/commanders, and implementation of a breastfeeding class that addresses military-specific factors.