Narrative Review of Effectiveness of Breastfeeding Education Interventions in Improving Exclusive Breastfeeding Knowledge and Practice among Adolescent Mothers

Abstract Exclusive breastfeeding (EBF) for the first six months of life retains the importance of being an initial public health priority for reducing infant mortality and maternal health problems, however rates of practice in adolescent mothers remain consistently low, despite their reach of mass communications. This narrative review focuses on empirical evidence of effects of breastfeeding education interventions on EBF knowledge and practice by adolescent mothers in diverse circumstances, with special focus on low- and middle-income countries. Evidence is available from cross-sectional, quasi-experimental and review studies indicating that adolescents often demonstrate partial awareness and limited actionable knowledge, weak intention and limited self-efficacy concerning EBF. Education interventions, such as antenatal counselling, structured educational packages, skills-based coaching, peer support and digital follow up, have been found to be effective in consistently improving knowledge, confidence and technical breastfeeding skills. However, translating of knowledge gains into prolonged six months EBF practice is variable and highly moderated by socio-cultural beliefs, the influence of family, stigma and initial challenges with breastfeeding, and structural barriers that include return to school and lack of support for childcare. Multi-component interventions, that integrate education, practical demonstration, repeated reinforcement, peer and family engagement, and mobile health support have more lasting impact than those involving single session and information-focused approaches. The review has concluded that adolescent-focused, culturally responsive, skills-based and socially supported education packages are more likely to bridge the knowledge - practice gap and to better the outcomes of EBF among adolescent mothers. Keywords: Exclusive breastfeeding, Adolescent mothers, Breastfeeding education, Health education interventions, Breastfeeding practice, maternal knowledge,