Commentary on methodological rigor in “Predictors of exclusive breastfeeding: a systematic review and meta-analysis”

Kalhor et al. (2025) conducted a systematic review and meta-analysis on predictors of exclusive breastfeeding, offering valuable insights but facing methodological challenges. Despite a robust search strategy, PROSPERO registration, and use of the Newcastle-Ottawa Scale, heterogeneity remained high (I² >85%), with limited exploration through prediction intervals. Combining diverse designs and minimal subgroup justification reduced interpretability. Future reviews should incorporate prediction intervals, sensitivity analyses, and clearer subgroup rationale to enhance methodological transparency and reproducibility.