Nutritional counseling strategies in breastfeeding: a scoping review

Breastfeeding provides unparalleled health benefits for infants and mothers, yet exclusive breastfeeding (EBF) rates remain suboptimal worldwide. Nutritional counseling (NC) has been identified as a key strategy to support and sustain breastfeeding, but the scope and effectiveness of such interventions have not been systematically mapped. We conducted a scoping review to identify and synthesize evidence on NC strategies for breastfeeding mothers. Following Arksey & O'Malley's framework and PRISMA-ScR guidelines, we searched PubMed (2015-2025) for studies of prenatal or postnatal counseling interventions aimed at improving breastfeeding outcomes. Twenty-nine studies (RCTs, quasi-experimental, qualitative) from diverse countries were included. Counseling interventions (delivered individually, remotely or face-to-face) were generally associated with higher EBF rates and longer breastfeeding duration. Twelve studies also reported improvements in maternal breastfeeding self-efficacy and reductions in common breastfeeding problems. Mobile-based and peer support interventions showed promising results, especially in low-resource settings. These findings align with current global recommendations on breastfeeding counseling. We discuss implementation challenges (e.g., training needs, definitional clarity) and underline that targeted NC is an effective tool to increase breastfeeding rates. Future work should standardize counseling approaches, expand training for providers, and evaluate long-term impacts and cost-effectiveness.