Breastfeeding in Postpartum Mothers with a History of Hypertension During Pregnancy: A Scoping Review

Title Breastfeeding Practices Among Postpartum Women With a History of Hypertensive Disorders of Pregnancy: A Scoping Review Background Hypertensive disorders of pregnancy (HDP), including chronic hypertension, gestational hypertension, and preeclampsia, remain major contributors to maternal and neonatal morbidity worldwide. Beyond pregnancy and childbirth, these conditions often persist into the postpartum period, influencing maternal recovery and long-term cardiovascular health. Breastfeeding is widely recognized as a critical public health intervention that benefits both infants and mothers, including potential cardiometabolic protection for women. However, evidence suggests that women with a history of HDP face greater challenges in initiating and sustaining breastfeeding. These challenges arise from a complex interaction of clinical, obstetric, psychological, and health system–related factors. To date, existing evidence remains fragmented, with variations in study design, outcomes, and contexts, highlighting the need for a comprehensive mapping of the literature. Objective This scoping review aims to explore and map the existing scientific evidence on breastfeeding practices among postpartum women with a history of hypertensive disorders during pregnancy. Specifically, it seeks to identify patterns related to breastfeeding initiation, duration, and exclusivity; examine clinical, psychosocial, and healthcare-related determinants influencing breastfeeding outcomes; and highlight research gaps to inform future studies and the development of targeted midwifery and lactation interventions. Methods This study employs a scoping review methodology based on the Arksey and O’Malley framework, following five stages: identifying the research question, identifying relevant studies, study selection, data charting, and collating and summarizing results. The Population–Concept–Context (PCC) framework guides the review. The population includes postpartum women with a history of hypertensive disorders during pregnancy. The concept focuses on breastfeeding practices, including initiation, duration, and exclusive breastfeeding. No contextual limitations are applied to allow broad applicability across healthcare settings. A systematic literature search was conducted in international databases (PubMed, ScienceDirect, Wiley Online Library, Springer Nature) and one search engine (SciSpace Literature). Inclusion criteria comprise primary research articles (quantitative, qualitative, or mixed methods), published in English or Indonesian between 2020 and 2025, available in full text and open access. Excluded sources include narrative reviews, editorials, opinion pieces, and studies without empirical data. Study selection and data extraction were conducted using Rayyan. Methodological quality was assessed using Joanna Briggs Institute (JBI) critical appraisal tools, without excluding studies based on quality scores. Data were analyzed descriptively and synthesized thematically. Expected Contribution This scoping review is expected to provide a comprehensive overview of how hypertensive disorders of pregnancy influence breastfeeding practices in the postpartum period. By synthesizing evidence across study designs and contexts, the review will clarify key barriers and facilitators to successful breastfeeding among high-risk mothers. The findings are intended to inform clinical practice, guide the integration of lactation support into postpartum care for women with HDP, and support the development of tailored midwifery interventions and future research agendas.