Analysis of Knowledge About Breastfeeding Among Health Science Students in Southern Europe

Background: Healthcare professionals play a key role in supporting breastfeeding, yet undergraduate breastfeeding education may be insufficient. This study assessed breastfeeding knowledge among final-year health sciences students in Southern Europe. Methods: We conducted a multicenter cross-sectional survey among final-year medical, nursing, and physiotherapy students from universities in Spain and Italy between January and June 2025. An ad hoc questionnaire, developed by an expert panel and content-validated using a modified Delphi process, assessed knowledge of breastfeeding benefits, lactation physiology, breastfeeding management, and international promotion policies. Descriptive statistics summarized responses. Results: A total of 342 students participated. Only 40.6% reported specific breastfeeding-related teaching during their studies, whereas 90.1% reported having participated in a course dedicated entirely to breastfeeding outside their regular coursework. Only 57.9% correctly identified WHO recommendations on breastfeeding duration, 67.6% recognized the importance of initiating breastfeeding immediately after birth, and fewer than half correctly identified on-demand feeding. Knowledge of lactation biology was variable, particularly regarding bioactive milk components. Awareness of promotion frameworks was limited: only 15.4% were familiar with the WHO/UNICEF Ten Steps to Successful Breastfeeding, and 48.8% recognized the International Code of Marketing of Breast-milk Substitutes. Self-perceived competence in counseling families was generally low. Conclusions: Final-year health sciences students in Spain and Italy demonstrate good awareness of the benefits of breastfeeding but show notable deficiencies in practical recommendations, lactation biology, and international promotion strategies. Standardized competency-based breastfeeding education should be strengthened within undergraduate health sciences curricula.