This paper is a critical literature review on issues and concerns of initiation and maintenance of breastfeeding amongst high-risk populations including mothers of African American descent and underage mothers. To guide the critical literature review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework was used. A PRISMA flow diagram outlining the process of the critical literature review is included. The review identified 28 articles which matched the inclusion criteria. Eight common themes emerged, specifically: healthcare or hospital services, knowledge/education, support, social norms and cultural beliefs, return to work or school, policy and legislation, programs and initiatives, and self-efficacy. A detailed discussion of the eight themes along with nursing implications and thoughts on future research is presented.