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Record W4411947471 · doi:10.1186/s13006-025-00744-2

Predictors of exclusive breastfeeding: a systematic review and meta-analysis

2025· review· en· W4411947471 on OpenAlexaff
Mehri Kalhor, Mansoureh Yazdkhasti, Masoumeh Simbar, Sepideh Hajian, Zahra Kiani, Behjat Khorsandi, Zainab Ezadi, Haniyeh Nazem, Massoma Jafari

Bibliographic record

VenueInternational Breastfeeding Journal · 2025
Typereview
Languageen
FieldMedicine
TopicBreastfeeding Practices and Influences
Canadian institutionsUniversity of Toronto
Fundersnot available
KeywordsMedicineBreastfeedingMeta-analysisSystematic reviewMEDLINEPediatricsInternal medicine

Abstract

fetched live from OpenAlex

Breast milk is the ideal and complete food for infants. Demographic, social, economic and clinical factors affect exclusive breastfeeding (EBF). Identifying and understanding these factors can improve breastfeeding success. This study systematically reviews and analyzes the predictors of EBF. This study is a systematic review and meta-analysis. we searched electronic databases including PubMed/MEDLINE, Web of Science, PsycINFO, Cochrane, Scopus, EMBASE, Google Scholar, SID, and Magiran. we examined articles published between 2000 to 2023 using keywords like "risk factors", "related factors", "predictive factors", "exclusive breastfeeding ", and "women". The review included observational studies. Two reviewers independently selected the studies extracted data. Quality assessment was based on the Newcastle–Ottawa Scale. The association between predictive factors and breastfeeding was combined in a meta-analysis using a restricted maximum likelihood method (REML). Heterogeneity was quantified using I 2 and investigated through meta-regression, subgroup, and sensitivity analyses, while publication bias was assessed via a funnel plot. Thirty eight articles were included in this review. Predictive factors in EBF were categorized into seven groups: mother’s awareness of breastfeeding benefits, support received in breastfeeding and child-rearing, early breastfeeding after birth, mother’s education level, annual income, mother’s age, and prenatal care. Nineteen articles with a sample size of 70,183 were included in the meta-analysis. Results showed that a mother's awareness of breastfeeding benefits increases the odds of EBF by 2.70 times, support in child-rearing by 2.57 times, early breastfeeding (< 24 h) by 1.853 times, higher education level by 1.44 times, self-efficacy by 1.067, multiparity ≥ 2 by 1.50 times, having upper-middle annual income was associated with 28.3% higher than odds of EBF (95% CI 1.68, 1.54), female sex of infant by 1.07 times, and one to three antenatal visits by 0.108 times, (95% CI 1.27, 4.18). In normal vaginal delivery (NVD), the odds increased 2.22 fold, all statistically significant (95% CI 0.91, 5.43). The maternal awareness of the benefits of breastfeeding, maternal support, early breastfeeding, high education level, and improved family economic conditions are associated with EBF. Therefore, improving the educational, social, and economic levels of mothers improves EBF. PROSPERO CRD42023483049.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.014
metaresearch head score (Gemma)0.037
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Meta-analysis · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.021
Threshold uncertainty score0.073

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0140.037
Meta-epidemiology (narrow)0.0030.002
Meta-epidemiology (broad)0.0210.040
Bibliometrics0.0090.010
Science and technology studies0.0010.001
Scholarly communication0.0040.002
Open science0.0020.002
Research integrity0.0020.002
Insufficient payload (model declined to judge)0.0040.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.060
GPT teacher head0.377
Teacher spread0.318 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designMeta-analysis
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations24
Published2025
Admission routes1
Has abstractyes

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