There is strong evidence that using breastmilk substitutes disadvantages the infant, mother and community as a whole. There is also increasing evidence regarding the lactation process, breastfeeding inhibitors and enablers, and breastfeeding management options. However, there appears to be a gap between this evidence base and practice with breastfeeding rates being unacceptably low, especially following hospital discharge. This paper discusses barriers to the implementation of breastfeeding best practice using a framework of the research-to-practice pipeline: acceptance, applicable, available and able, acted upon, agreed to and adhered to. As blocks or restrictions to the flow of information or evidence may occur at any point along the pathway, researchers designing interventions to increase breastfeeding rates need to consider using multi-strategy interventions and target collaborative care across professions.
Conclusion: Barriers to implementing evidence-based breastfeeding practices are common and wide ranging. These barriers should be considered when developing new breastfeeding services and research programmes.