Exclusive breastfeeding policy research has grown 18.57% annually since 2016, shifting from narrow child health focus to system-wide approaches addressing maternal support, workplace policies, and health system resilience. The research base remains geographically imbalanced, with limited contributions from the low- and middle-income countries where the greatest challenges exist.
Researchers conducted a bibliometric analysis of 449 publications on exclusive breastfeeding (EBF) policy spanning 2016 to 2025, tracking publication trends, influential authors, collaboration networks, and how research themes have evolved. The findings reveal a field in rapid expansion, but one with persistent blind spots in global representation.
Publication output accelerated consistently over the decade, with notable peaks in 2020 and 2023. The 2020 spike coincides with the COVID-19 pandemic, when health systems worldwide faced unprecedented disruptions to maternal and child health services. Rather than momentum waning post-2020, another surge in 2023 suggests EBF policy has gained traction as a sustained priority in global health agendas. The International Breastfeeding Journal and Maternal and Child Nutrition emerged as the dominant publication venues, indicating that policy-focused research is concentrating in journals with explicit commitments to lactation and maternal-infant health.
The analysis identified key research leaders: Rafael Pérez-Escamilla, Kingsley Agho, and Andrew Ogbo appear as the most influential authors by publication count and citation impact. These researchers have anchored the field intellectually, but the analysis also found that international collaboration networks have expanded. This is methodologically important because policy research benefits from diverse contexts and perspectives. However, this collaboration remains skewed geographically. Despite nearly half the global burden of malnutrition and suboptimal breastfeeding rates occurring in low- and middle-income countries (LMICs), these regions contributed disproportionately few publications. The research infrastructure and funding necessary to participate in global research networks remain unequally distributed.
The thematic analysis reveals a meaningful shift in research priorities. From 2016 to 2019, the dominant focus was biomedical and child-centered: immunological benefits, infant growth outcomes, and disease prevention mechanisms. After 2020, research increasingly examined maternal health, workplace lactation support, nutrition policy integration, and health system capacity. This broadening reflects a growing recognition that exclusive breastfeeding cannot be promoted in isolation. Success depends on structural support for mothers, workplace policies that protect nursing time, food systems that supply complementary nutrition, and health systems resilient enough to maintain services during crises. COVID-19 accelerated this reorientation by exposing fragility in supply chains, antenatal care access, and lactation support infrastructure.
This study does not directly establish clinical guidance but maps the knowledge landscape relevant to maternal and child health policy. Here are the practical implications:
If you work in maternal or child health policy: The field's evolution toward systems-level analysis suggests that sustainable improvements in breastfeeding rates require concurrent attention to workplace policy, health system resilience, and maternal nutrition. Single-intervention approaches have demonstrable limits.
If you are pregnant or postpartum: The research trends underscore that breastfeeding support is a systems problem, not an individual one. Success depends on access to lactation support, workplace accommodation, healthcare continuity, and partner/family involvement. If you face barriers, this reflects policy gaps, not personal failure.
If you conduct research in this space: The geographic imbalance in the publication record is a signal. Evidence from high-income country contexts may not transfer directly to settings with different health infrastructure, food security, or labor market structures. Research conducted in and led by LMICs is essential for generating context-appropriate policy solutions.
| Aspect | Details |
|---|---|
| Study Type | Bibliometric analysis (systematic mapping of research publications) |
| Sample Size | 449 publications (2016-2025) |
| Data Source | Scopus database |
| Key Findings | 18.57% annual growth rate; publication peaks in 2020 and 2023; International Breastfeeding Journal and Maternal and Child Nutrition as leading venues; thematic shift from biomedical to systems-oriented; geographic concentration in high-income countries |
| Limitations | Bibliometric analysis describes research trends but does not evaluate quality of individual studies; cannot assess publication bias; does not directly measure policy impact |
| Journal | F1000Research |
| PubMed ID | 42732100 |
Pérez-Escamilla R, et al. Trends and Research Frontiers on Exclusive Breastfeeding Policy: A Bibliometric Analysis. F1000Research. PubMed.
https://pubmed.ncbi.nlm.nih.gov/42732100/
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