Abstract / Summary
Breastfeeding is a cost-effective public health intervention that reduces infant morbidity and mortality while providing long-term benefits for mothers and children. In Southeast Asia, rising female labor force participation and complex regulatory environments highlight the need to understand how breastfeeding policies and workplace support are implemented. Breastfeeding protection sits at the intersection of maternal and child health, gender equity, decent work and social protection, yet evidence mapping on its implementation in the region remains limited. This scoping review mapped the national regulatory frameworks and workplace support provisions for breastfeeding reported in the peer-reviewed literature from Southeast Asia, along with their reported implementation, compliance, monitoring and enforcement; the barriers and facilitators encountered; and the evidence gaps identified (RQ1–RQ4). This scoping review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews and was reported in line with the PRISMA-ScR guideline. The protocol was registered a priori with the Open Science Framework. Five information sources of three distinct types were searched on 16 March 2026: two bibliographic databases (PubMed/MEDLINE, Scopus), two publisher platforms (ScienceDirect, Taylor & Francis Online) and one academic search engine (Google Scholar). Two reviewers independently screened records using the Population–Concept–Context (PCC) framework. Findings were then organized along a six-link implementation chain—policy existence, implementation, accessibility, utilization, compliance, and effectiveness to distinguish what is enacted from what reaches workers. This review included 22 studies. The evidence was geographically concentrated: all included studies reported on only five of the eleven ASEAN member states: Indonesia (n = 13), the Philippines (n = 4), Thailand (n = 3), Malaysia (n = 1), and one multi-country study covering Indonesia, the Philippines, and Viet Nam. Along the implementation chain, the duty-bearer links were well reported: policy existence in 22 of 22 sources, implementation in 21, and compliance in 20. In contrast, worker-facing links were less well reported: accessibility in 12, utilization in 7, and effectiveness in 4. Policy coverage remained concentrated in the formal sector, with limited protection for informal workers, and implementation often depended on institutional commitment rather than national enforcement. Organizational-level barriers were the most frequently reported (18 of 22 studies), followed by structural or policy-level barriers (11 of 22). Within the five ASEAN member states for which evidence was located, a consistent gap was reported between enacted provisions and their implementation in workplaces. The literature documents that employers are required to provide far more fully than employed women can actually access and use, and the absence of evidence from six member states is itself a priority gap. Because no critical appraisal was undertaken and the included designs cannot support effect estimates, this review makes no claim about policy effectiveness.