Early initiation of breastfeeding (EIBF)—placing the newborn to the breast within the first hour after birth—is one of the most effective and low-cost strategies to improve neonatal survival and maternal outcomes. Despite strong global advocacy, EIBF rates remain below the World Health Organization (WHO) target of 70%. This narrative review synthesizes recent empirical evidence (2018–2025) on midwives’ roles in promoting and supporting EIBF, highlighting institutional, educational, and sociocultural factors influencing early breastfeeding practices.

A structured review guided by the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR framework was conducted using PubMed, CINAHL, Scopus, and Google Scholar. Eleven peer-reviewed studies met inclusion criteria. Findings revealed that midwives’ knowledge, communication skills, and hands-on assistance significantly improved EIBF rates. Institutional enablers—such as Baby-Friendly Hospital Initiative (BFHI) accreditation, immediate skin-to-skin contact, and 24-hour rooming-in—were crucial in promoting successful initiation. Major barriers included Cesarean birth, staff shortages, and limited access to lactation training.

The review concludes that empowering midwives through continuous education, supportive policies, and culturally sensitive interventions is essential to achieving national and global breastfeeding targets under WHO and Saudi Vision 2030 frameworks.

Dr. Wdad Alanazy is an Assistant Professor in the Maternity and Pediatric Nursing Department at Majmaah University, Saudi Arabia. Her academic and professional work focuses on advancing midwifery practice and improving women’s health across pregnancy, birth, and the postnatal period. She has a strong interest in strengthening the role of midwives through education, evidence-based practice, and supportive care models. Dr. Alanazy is also passionate about breastfeeding research and initiatives that enhance maternal and newborn outcomes, including breastfeeding education, support strategies, and community awareness. Through teaching, research, and academic leadership, she is committed to contributing to high-quality maternity care and empowering women and families during the perinatal journey.