{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T09:58:19Z","timestamp":1784282299448,"version":"3.55.0"},"reference-count":53,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Breastfeeding Medicine"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Breastfeeding is considered the ideal source of infant nutrition and has been shown to enhance maternal-infant health, but most women do not achieve their breastfeeding goals. Significant racial, ethnic, and socioeconomic disparities exist in breastfeeding outcomes. While current literature indicates a positive association between doula support and breastfeeding, the specific breastfeeding outcomes impacted by doulas remain unclear. Our objective was to synthesize existing literature on breastfeeding outcomes when doulas are utilized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Electronic searches were conducted in February 2022 and updated in April 2024 to include primary studies that examined doula support and breastfeeding outcomes (intention, initiation, duration, exclusivity, support, knowledge, education). Studies were excluded if they were secondary research or outside the perinatal period (pregnancy, childbirth, and\/or up to 1 year postpartum). Data were extracted and synthesized narratively, and risk of bias was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 1,917 deduplicated studies were screened, and 32 were included. Twenty-two studies were quantitative, and 10 studies were qualitative or mixed methods. Most studies (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 24) consisted of birthing populations that experience marginalization, such as adolescents, low-income status, and racially\/ethnically minoritized groups. Although doula support was associated with improved breastfeeding outcomes overall, there were mixed findings regarding breastfeeding duration and exclusivity. Lactating clients found doulas to be an important source of breastfeeding support, education, and knowledge. However, doulas reported a need for increased breastfeeding education during their training. Health care providers had limited knowledge of doulas\u2019 role in promoting breastfeeding.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Doulas are associated with improved breastfeeding outcomes. Increased breastfeeding education in doula training and greater inclusion and awareness of doulas among the health care team could maximize this benefit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15568253251367430","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T21:11:56Z","timestamp":1758921116000},"page":"685-706","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Doula Support and Breastfeeding Outcomes: A Systematic Review"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4498-2602","authenticated-orcid":false,"given":"Anika","family":"Heuberger","sequence":"first","affiliation":[{"name":"University of Florida College of Medicine, Gainesville, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle","family":"Ramos","sequence":"additional","affiliation":[{"name":"Drexel University College of Medicine, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wasana","family":"Weerasuriya","sequence":"additional","affiliation":[{"name":"South University, Tampa, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noralbis","family":"Barrientos","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine, Gainesville, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janelle","family":"Applequist","sequence":"additional","affiliation":[{"name":"University of South Florida Zimmerman School of Advertising and Mass Communications, Tampa, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adetola F.","family":"Louis-Jacques","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine, Gainesville, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.4081\/pmc.2017.155"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1159\/000442724"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-057988"},{"key":"e_1_3_5_5_2","unstructured":"World Health Organization. Infant and young child feeding. World Health Organization; 2024. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/infant-and-young-child-feeding [Last accessed: June10 2025]."},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-3633"},{"key":"e_1_3_5_7_2","unstructured":"Centers for Disease Control and Prevention. Breastfeeding among U.S. children born 2014\u20132021 CDC NIS-Child. May 18 2025 2025. Available from: https:\/\/www.cdc.gov\/breastfeeding-data\/survey\/results.html"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2014.0152"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.5888\/pcd20.230199"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2017.04.007"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000736"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000647"},{"issue":"5","key":"e_1_3_5_13_2","first-page":"e39451","article-title":"The effect of doulas on maternal and birth outcomes: A scoping review","volume":"15","author":"Alexandria S","year":"2023","unstructured":"Alexandria S, , Taylor L, , Solomon S, et al. The effect of doulas on maternal and birth outcomes: A scoping review. Cureus, 2023; 15(5):e39451.","journal-title":"Cureus"},{"key":"e_1_3_5_14_2","unstructured":"Chen A Rohde K. Doula Medicaid training and certification requirements: Summary of current state approaches and recommendations for improvement. 2025. Available from: https:\/\/healthlaw.org\/doula-medicaid-training-and-certification-requirements-summary-of-current-state-approaches-and-recommendations-for-improvement\/ [Last accessed: April20 2025]."},{"key":"e_1_3_5_15_2","unstructured":"Gebel C Hodin S. Expanding access to doula care: State of the union. Maternal Health Taskforce at The Harvard Chan School at the Center of Excellence in Maternal and Child Health; 2020. Available from: https:\/\/www.mhtf.org\/2020\/01\/08\/expanding-access-to-doula-care\/ [Last accessed: June10 2025]."},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000005337"},{"key":"e_1_3_5_17_2","unstructured":"DONA International. Become a Doula. Available from: https:\/\/www.dona.org\/become-a-doula\/ [Last accessed: April20 2025]."},{"key":"e_1_3_5_18_2","unstructured":"Ramey-Collier K Jackson M Malloy A et al. Doula Care: A review of outcomes and impact on birth experience. (1533-9866 (Electronic))."},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1891\/J-PE-D-20-00037"},{"key":"e_1_3_5_20_2","unstructured":"Antigonish NS. Glossary of essential health equity terms. National Collaborating Centre for Determinants of Health St Francis Xavier University. 2022."},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.20467\/HumanCaring-D-20-00019"},{"issue":"4","key":"e_1_3_5_22_2","first-page":"16","article-title":"Doulas touch the lives of others, and their handprints become indelible","volume":"29","author":"Wechsler N","year":"2009","unstructured":"Wechsler N. Doulas touch the lives of others, and their handprints become indelible. 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