EFBRI – An Evolving Ethical Framework Informing Breastfeeding Research and Interventions

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EFBRI is an open access compilation of ethical principles to guide biomedical research in breastfeeding and lactation. Built on established international standards by the University of Zurich (UZH), it was created to streamline research processes for people working with breastfeeding mothers and children. With EFBRI, researchers and other stakeholders can align their work to universal research ethics standards – confidently and efficiently.

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EFBRI is a modular framework

Module 1 focuses on research. Access the framework and helpful checklist in PDF: EFBRI – An Evolving Ethical Framework Informing Breastfeeding Research and Interventions.

Module 2 will focus on interventions (in development by UZH and expected in 2022).

Future modules will be shaped by your needs and globally evolving ethics. Please, help us develop EFBRI by sharing your feedback and suggestions: ethics@lactahub.org.


Discussing the principles laid out in the framework in the light of real-life cases will contribute to a continuously refined understanding of the multifaceted ethical issues of breastfeeding and lactation research and how they can best be solved.

--- Prof. Dr. med. Dr. phil. NIKOLA BILLER-ANDORNO, Director, Institute of Biomedical Ethics and History of Medicine, UZH

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Who is EFBRI for? Researchers, reviewers, healthcare practitioners, decisionmakers, policymakers, planners, implementation specialists, educators, funders and other stakeholders. The framework is easy to use and globally applicable.

Why was EFBRI created? To bring established international ethics standards for biomedical research together in one package, relevant for breastfeeding and lactation. By consolidating accepted standards and removing duplication, research processes that involve breastfeeding mothers and children can become more efficient. EFBRI can be particularly helpful in cross-border or collaborative work. EFBRI is also intended to lay the groundwork for best practice ethics in healthcare policy, implementation and funding activities.

The aim? Safeguard the rights and dignity of all people while advancing health around the globe.

Why is EFBRI ‘evolving’? Ethical considerations play leading roles in breastfeeding and lactation research. As ethics evolve globally and EFBRI is applied to new and different situations, the framework will require reviews and updates to evolve in parallel. In the tradition of community science, explicit user feedback and suggestions (email to ethics@lactahub.org) from real-life cases will help EFBRI’s creators build a comprehensive, evergreen resource.

Access EFBRI in PDF.

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EFBRI was created by Institute of Biomedical Ethics and History of Medicine (University of Zurich).

Authors: Mirriam Tyebally Fang, M.B.B.S (NUS), M.R.C.S (Edin.), and Nikola Biller-Andorno, MD, PhD, MHBA

Published exclusively on LactaHub – A Resource for Evidence-Based Breastfeeding Intelligence

LactaHub is a partnership project of The Global Health Network (University of Oxford) and the Family Larsson-Rosenquist Foundation.

DISCLAIMER. EFBRI – An Evolving Ethical Framework Informing Breastfeeding Research and Interventions is provided in good faith. It is not a legal document and does not supersede any national or international legal regulations. The resulting framework, intended for researchers, reviewers and funders, is a synthesis of relevant Swiss and international norms related to breastfeeding and lactation research. It is a guide for globally accepted best practices and in accordance with Swiss and international research ethics standards yet does not intend to replace any national norms, cultural values or country-specific review processes. The framework lays out rules and principles but does not claim to specify Good Clinical Practice or safety standards. The framework focuses on human participants only but does not cover animal ethics or environmental ethics. The framework will be refined as necessary based on periodic reviews. Therefore, we cannot guarantee its status as definitive guide and do not assume any liability. Liability claims against the authors and/or the publisher regarding damages whether material or immaterial caused by the use or non-use of the provided framework are excluded as a matter of principle.

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