Breastfeeding and Environmental Sustainability Through a Green Midwifery Lens: A Scoping Review of Evidence Relevant to Support and Counselling

Breastfeeding is increasingly recognised as relevant to both public and planetary health, yet evidence on how environmental sustainability can be translated into breastfeeding support and counselling remains limited. This scoping review mapped evidence on the environmental sustainability of breastfeeding and its relevance to support and counselling through a green midwifery lens. Following JBI guidance and PRISMA-ScR, MEDLINE/PubMed, CINAHL Complete, GreenFILE, Scopus, and Web of Science were searched from inception to 3 July 2026. Two reviewers independently screened records and full texts. Thirteen studies were included and synthesised descriptively and thematically. One study directly evaluated a sustainability-focused professional education approach, four provided evidence relevant to breastfeeding support, practice, or policy, and eight provided contextual environmental or system-level evidence. Five themes were identified: environmental evidence informing counselling; environmental awareness and professional capacity; resource-conscious practices, maternal diet, and feeding accessories; climate-resilient support in disasters and emergencies; and health-system, food-system, and policy support. Breastfeeding generally showed lower environmental impacts than commercial milk formula, although estimates varied by system boundaries, maternal diet, household practices, and equipment use. No included study evaluated a parent-facing sustainability-oriented breastfeeding counselling intervention. Environmental considerations may therefore inform future breastfeeding counselling, but current practice implications should be regarded as evidence-informed directions rather than demonstrated intervention effects.