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Article History

Received: 19 September 2025

Accepted: 11 June 2026

First Online: 19 June 2026

Declarations

Ethics approval and consent to participate: This study was conducted in accordance with the Declaration of Helsinki. Ethical approval was obtained from the Ethics Commission of Northwestern and Central Switzerland (EKNZ; reference number 2024-00015, April 9, 2024) and the Brazilian National Commission for Ethics in Research (CONEP; approval number 7.643.369, March 15, 2024). All participants provided written informed consent prior to participation. Participants were informed of their right to withdraw at any time without consequences, and all data were anonymized to ensure confidentiality. Full ethics approval can be provided upon request.

Consent for publication: Informed consent was obtained from all subjects involved in the study.

Competing interests: The authors declare no competing interests. KC is an Editorial Board member of the International Breastfeeding Journal but did not participate in the review of this manuscript. KC affirms that her views are her own and do not represent those of the International Board of Lactation Consultant Examiners, and that she does not have access to any International Board Certified Lactation Consultant examination materials or other non-public information related to that organization's credentials.