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Monge-Montero C, van der Merwe LF, Tagliamonte S, Agostoni C, Vitaglione P. Why do mothers mix milk feed their infants? Results from a systematic review. Nutr Rev 2024; 82:1355-1371. [PMID: 38041551 PMCID: PMC11384123 DOI: 10.1093/nutrit/nuad134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023] Open
Abstract
CONTEXT Combining or supplementing breastfeeding with formula feeding, also called mixed milk feeding (MMF), is a common infant feeding practice. However, there is no well-established MMF evidence-base for informing and guiding parents. A better understanding of the reasons why mothers practice MMF may facilitate identification of efficient strategies for supporting exclusive breastfeeding, and/or opportunities to prolong breastfeeding, at least partially. OBJECTIVE An updated systematic literature review was undertaken with the primary aim of gaining a deeper understanding of the reasons why mothers choose MMF. DATA SOURCES Six databases were searched for relevant articles published in English from January 2012 to January 2022. DATA EXTRACTION Two reviewers independently performed the screenings and data extraction, and any differences were resolved by a third reviewer. Data from 138 articles were included, 90 of which contained data on MMF reasons/drivers, and 60 contained data on infant age and/or maternal demographic factors associated with MMF. DATA ANALYSIS A total of 13 different unique MMF drivers/reasons were identified and categorized according to whether the drivers/reasons related to perceived choice, necessity, or pressure. Risk of bias was evaluated using the Quality Assessment Tool of Diverse Studies and the JBI Systematic Reviews tool. Several different terms were used to describe and classify MMF across the studies. The most commonly reported reasons for MMF were related to a perception of necessity (39% of drivers, eg, concerns about infant's hunger/perceived breast milk insufficiency or breastfeeding difficulties), followed by drivers associated with perceived choice (34%; eg, having more flexibility) and perceived pressure (25%; eg, returning to work or healthcare professionals' advice). This was particularly true for infants aged 3 months or younger. CONCLUSION The key global drivers for MMF and their distribution across infant age and regions were identified and described, providing opportunities for the provision of optimal breastfeeding support. A unified definition of MMF is needed in order to enable more comparable and standardized research. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022304253.
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Affiliation(s)
- Carmen Monge-Montero
- Department of Research, Monge Consultancy Food and Nutrition Research, Leiden, The Netherlands
| | | | - Silvia Tagliamonte
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
| | - Carlo Agostoni
- Fondazione IRCCS Ospedale Maggiore Policlinico, Pediatric Clinic, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paola Vitaglione
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
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Trześniowska A, Wagner E, Ściseł A, Szymańska K, Szyprowski K, Kimber-Trojnar Ż. Did the COVID-19 Pandemic Affect the Stress Levels among the Mothers of Premature Infants? A Narrative Review of the Present State of Knowledge, Prevention Strategies, and Future Directions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1095. [PMID: 39200705 PMCID: PMC11353938 DOI: 10.3390/ijerph21081095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 08/16/2024] [Accepted: 08/18/2024] [Indexed: 09/02/2024]
Abstract
Understanding COVID-19's effects on susceptible populations remains essential for clinical implementations. Our review aimed to examine whether the pandemic significantly impacted the stress levels in the mothers of premature infants in NICUs. The review of the literature from Google Scholar and PubMed resulted in identifying specific stressors such as the disruption of healthcare systems, limited access to neonatal care, uncertainty due to frequent changes in restrictions, the risk of COVID-19 infection, social isolation, and financial stress. While some quantitative studies concerning this topic did not show a significant increase in the perception of stress in this population compared to the pre-pandemic group, various research has indicated that the COVID-19 pandemic may result in enduring impacts on the emotional and neurological development of children. This article demonstrates a correlation between the repercussions of the COVID-19 pandemic and an elevated incidence of depressive symptoms among the mothers of premature infants. Further studies are needed to assess the long-term impact of pandemic-induced stress.
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Affiliation(s)
| | - Emilia Wagner
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland; (A.T.); (A.Ś.); (K.S.); (K.S.)
| | | | | | | | - Żaneta Kimber-Trojnar
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland; (A.T.); (A.Ś.); (K.S.); (K.S.)
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da Silva TPR, Soares LOD, dos Santos LC, Ferreira FM, Schreck RSC, Gonçalves RM, dos Santos GMV, Matozinhos FP. Factors associated with the length of breastfeeding during the COVID-19 pandemic: a survival study. Rev Esc Enferm USP 2024; 58:e20240078. [PMID: 39178020 PMCID: PMC11343085 DOI: 10.1590/1980-220x-reeusp-2024-0078en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/21/2024] [Indexed: 08/24/2024] Open
Abstract
OBJECTIVE To investigate the repercussions of COVID-19 on the length of breastfeeding and analyze the associated factors in Belo Horizonte, Minas Gerais, Brazil. METHOD This is an epidemiological, prospective cohort study. Data were collected from medical records and through telephone interviews. Women who weaned were estimated using Kaplan-Meier survival analysis. The log-rank test was used to verify differences between groups, analyzing weaning time, according to sociodemographic and clinical characteristics. The values of hazard ratio and 95% confidence intervals were estimated using Cox regression analysis. RESULTS A total of 1,729 women participated in the study. During the COVID-19 pandemic, brown women and women undergoing cesarean section were more likely to stop breastfeeding. CONCLUSION The birth route and mothers' ethnic characteristics were associated with early weaning during the COVID-19 pandemic. Such findings are important to guide the assistance of the multidisciplinary team, especially nursing, during the post-pandemic period and in future epidemiological scenarios.
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Affiliation(s)
- Thales Philipe Rodrigues da Silva
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem na Saúde da Mulher, São Paulo, SP, Brazil
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem, Belo Horizonte, MG, Brazil
| | - Lorrayne Oliveira Dias Soares
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | - Luana Carolina dos Santos
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Nutrição, Belo Horizonte, MG, Brazil
| | - Fernanda Marçal Ferreira
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Psiquiátrica, São Paulo, SP, Brazil
| | - Rafaela Siqueira Costa Schreck
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | - Renata Melgaço Gonçalves
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | | | - Fernanda Penido Matozinhos
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
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Devi PU, Beake S, Chang YS. Women's views and experiences of breastfeeding during the coronavirus disease 2019 pandemic: A systematic review of qualitative evidence. MATERNAL & CHILD NUTRITION 2024:e13708. [PMID: 39120558 DOI: 10.1111/mcn.13708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 07/17/2024] [Accepted: 07/22/2024] [Indexed: 08/10/2024]
Abstract
The coronavirus disease 2019 pandemic affected breastfeeding women in various ways. Understanding their experiences during the pandemic is crucial for informing actionable recommendations, evidence-based strategies and future policies to support breastfeeding during global pandemics. This review aimed to synthesise qualitative evidence on women's breastfeeding perceptions, experiences and support needs during the pandemic. The Joanna Briggs Institute's (JBI) guidelines on systematic reviews of qualitative evidence were followed. MEDLINE, Embase, CINAHL and Web of Science Core Collection databases were searched. Methodological quality of included papers was assessed using JBI's checklist for qualitative research. The synthesised findings were generated using JBI's meta-aggregation approach. The JBI ConQual process was used to rank each synthesised finding. Fifty-two papers were included. The synthesised findings included: (1) women's awareness and commitment to breastfeeding during the pandemic, (2) the multifaceted breastfeeding experiences of women during the pandemic, (3) breastfeeding practices and challenges for working women, (4) professional support during the pandemic: navigating breastfeeding in an evolving health care context and (5) family and peer support groups during the challenging times of the pandemic. Breastfeeding women require clear information, accessible in-person lactation support, family emotional support, food security and protection of psychological well-being. The review reported diverse breastfeeding experiences, from social support challenges to positive aspects like remote work. Breastfeeding support and lactation consultants should be considered as essential services in future pandemics. Food security is crucial for breastfeeding households. Lactation services could prioritise face-to-face consultations for physical challenges and providing online informational support. Future research could explore innovative breastfeeding education strategies.
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Affiliation(s)
- Padma Uma Devi
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Sarah Beake
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Yan-Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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Abdul-Fatah A, Bezanson M, Lopez Steven S, Tippins E, Jones S, MacDonald H, Ysseldyk R. COVID-19 Public Health Restrictions and New Mothers' Mental Health: A Qualitative Scoping Review. QUALITATIVE HEALTH RESEARCH 2024:10497323241251984. [PMID: 39030700 DOI: 10.1177/10497323241251984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/21/2024]
Abstract
Public health restrictions to protect physical health during the COVID-19 pandemic had unintended effects on mental health, which may have disproportionately affected some potentially vulnerable groups. This scoping review of qualitative research provides a narrative synthesis of new mothers' perspectives on their mental health during COVID-19 pandemic restrictions through pregnancy to the postpartum period. Database searches in PubMed, CINAHL, and PsycINFO sought primary research studies published until February 2023, which focused on new mothers' self-perceived mental health during the pandemic (N = 55). Our synthesis found that new mothers' mental health was impacted by general public health restrictions resulting in isolation from family and friends, a lack of community support, and impacts on the immediate family. However, public health restrictions specific to maternal and infant healthcare were most often found to negatively impact maternal mental health, namely, hospital policies prohibiting the presence of birthing partners and in-person care for their infants. This review of qualitative research adds depth to previous reviews that have solely examined the quantitative associations between COVID-19 public health restrictions and new mothers' mental health. Here, our review demonstrates the array of adverse impacts of COVID-19 public health restrictions on new mothers' mental health throughout pregnancy into the postpartum period, as reported by new mothers. These findings may be beneficial for policy makers in future public health emergency planning when evaluating the impacts and unintended consequences of public health restrictions on new mothers.
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Affiliation(s)
| | - Michelle Bezanson
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | | | - Emily Tippins
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | - Sarah Jones
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | | | - Renate Ysseldyk
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
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Gavine A, Farre A, Lynn F, Shinwell S, Buchanan P, Marshall J, Cumming S, Wallace L, Wade A, Ahern E, Hay L, Cranwell M, McFadden A. Lessons for the UK on implementation and evaluation of breastfeeding support: evidence syntheses and stakeholder engagement. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-206. [PMID: 39054917 DOI: 10.3310/dgtp5702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Background Breastfeeding impacts positively on multiple health outcomes, but < 50% of UK women breastfeed at 8 weeks. Women with long-term conditions face additional challenges in breastfeeding. Objectives To synthesise global and UK evidence to co-create an implementation and evaluation toolkit for cost-effective breastfeeding support in the NHS. Design Evidence syntheses with stakeholder engagement. Review methods Systematic reviews examined effectiveness of breastfeeding support for (1) healthy women and (2) women with long-term conditions using Cochrane Pregnancy and Childbirth Group methods. Mixed-methods systematic reviews synthesised process evaluations of effective breastfeeding support interventions for healthy women and experiences of receiving/providing support for breastfeeding women with long-term conditions. Cross-study synthesis integrated qualitative and quantitative findings. Systematic reviews synthesised evidence on the incremental costs and cost-effectiveness of breastfeeding support following National Institute for Health and Care Excellence guidance. All searches were conducted from May 2021 to October 2022. Stakeholder engagement and toolkit development comprised online discussions, a modified Delphi study, focus groups and four workshops. Participants were 23 stakeholders, 16 parents in the parents' panels, 15 women in the focus groups and 87 stakeholders who attended the workshops. Results We found considerably more interventions designed for healthy women (review 1) than aimed at women with long-term conditions (reviews 1 and 4); approximately half of the studies were targeted at groups at higher risk of poor breastfeeding outcomes, and the impact of support may be different in these populations. Despite this, studies from review 2 found that women perceived the provision of support as positive, important and needed. Studies from review 5 echoed a range of suggestions from participants regarding potential strategies to improve breastfeeding support, with the most widely reported being the need to acknowledge the role and influence of other sources of support (e.g. partners, family, friends, peers, external professionals, web-based resources) and involving these sources in the provision of breastfeeding support for women with long-term conditions. In reviews 3 and 6, there was uncertainty about the cost-effectiveness of breastfeeding support interventions due to the limited number of studies and lack of good-quality evidence. Limitations There was a lack of evidence for the effectiveness and cost-effectiveness of breastfeeding interventions in the UK. There was often insufficient information reported about intervention characteristics. Conclusions 'Breastfeeding only' support probably reduces the number of women stopping any or exclusive breastfeeding. The evidence for 'breastfeeding plus' interventions is less consistent, but these may reduce the number of women stopping exclusive breastfeeding at 4-6 weeks and at 6 months. We found no evidence of differential intervention effects regarding mode of provision or provider. Cost-effectiveness is uncertain due to the lack of good-quality evidence. Key enablers of successful implementation were responsiveness and tailoring of interventions to both women's and supporters' needs. Breastfeeding support as delivered in the included studies probably has little to no effect on breastfeeding outcomes for women with long-term conditions. The mixed-methods synthesis and stakeholder work identified that existing interventions may not address the complex needs of these women. The main study output is a co-produced toolkit to guide implementation and evaluation of breastfeeding support services in the UK. Future work Evaluation of breastfeeding support for all women, particularly those at risk of poor breastfeeding outcomes (e.g. long-term conditions, deprivation). This could involve tailoring the toolkit to local contexts via implementation and effectiveness studies or using quality improvement studies. Study registration This study is registered as PROSPERO CRD42022337239, CRD42021229769 and CRD42022374509. The reviews of economic evidence were not registered; however, the review protocol can be accessed via the repository held by Queen's University Belfast Research Portal (https://pure.qub.ac.uk/). Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR130995) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 20. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Anna Gavine
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Albert Farre
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Fiona Lynn
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Shona Shinwell
- School of Health Sciences, University of Dundee, Dundee, UK
| | | | - Joyce Marshall
- Department of Nursing and Midwifery, University of Huddersfield, Huddersfield, UK
| | - Sara Cumming
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Louise Wallace
- School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, UK
| | - Angie Wade
- Population, Policy and Practice, Great Ormond Street Institute of Child Health, London, UK
| | - Elayne Ahern
- Department of Psychology, University of Limerick, Castletroy, Ireland
| | - Laura Hay
- School of Health Sciences, University of Dundee, Dundee, UK
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Hutchins-Wiese HL, Powell S, Ford O, Spitzer T. Lactation Initiation During COVID-19 at a Single Military Hospital. Mil Med 2024:usae321. [PMID: 38916937 DOI: 10.1093/milmed/usae321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/10/2024] [Accepted: 06/12/2024] [Indexed: 06/26/2024] Open
Abstract
INTRODUCTION Human milk is associated with positive short- and long-term health outcomes. Women's choice to breastfeed is influenced by personal, social, health, and economic factors. The COVID-19 pandemic impacted health care delivery, non-emergent health care services, and family lifestyles, primarily in the early months of 2020. The aim of this study was to determine if breastfeeding initiation rates differed during a global pandemic among women in the military health care system. MATERIALS AND METHODS This was a cross-sectional chart review study. We compiled all birthing event health records from March to August in 2019 and 2020 from a single military medical center. Of the 2,737 maternal-infant dyads available, 1,463 met complete inclusion criteria and were analyzed to determine associations between delivery year, maternal and infant characteristics, and initial feeding methods. Institutional research approvals were obtained from the university and medical center institutional review boards. RESULTS There was no significant association between breastfeeding initiation rates and delivery year (X2(1) = 2.898, P = .089). Some maternal and infant characteristics significantly associated with the feeding method in the logistic regression model and differed by delivery year. Black women were 1.9 times less likely to initiate breastfeeding compared to White women; this disparity became more pronounced in 2020. Multiparous mothers, those who gave birth via cesarean section, and those at earlier gestational ages (32-37 weeks) were less likely to initiate breastfeeding. Models differed by delivery year, with only Black race and cesarean birth significantly impacting the overall model in 2020. Maternal age, military status, military rank, marital status, birth complications, and infant gender were not associated with the feeding method. CONCLUSIONS Overall breastfeeding initiation rates did not differ during the COVID-19 pandemic when rates in 2020 were compared to those in the year prior. Race, birth method, parity, and gestational age were associated with breastfeeding initiation rates in women cared for at military centers.
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Affiliation(s)
| | - Shawndra Powell
- School of Health Sciences, Eastern Michigan University, Ypsilanti, MI 48130, USA
| | - Olivia Ford
- School of Health Sciences, Eastern Michigan University, Ypsilanti, MI 48130, USA
| | - Trimble Spitzer
- Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Obstetrics and Gynecology, Naval Medical Center Portsmouth, Portsmouth, VA 23708, USA
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Gill S, Wong K, Cook C. Impact of COVID-19 Public Health Restrictions on the Pregnancy Experience: A Mixed-Methods Study. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2024; 46:102460. [PMID: 38615914 DOI: 10.1016/j.jogc.2024.102460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/23/2024] [Accepted: 02/27/2024] [Indexed: 04/16/2024]
Abstract
The COVID-19 pandemic impacted the provision of obstetrical care. This mixed-methods study explores pregnant women's experiences during the COVID-19 pandemic using an explanatory sequential design. The experiences and opinions of obstetrical patients were elicited using an online questionnaire and semi-structured interview as a follow-up. There were 162 completed questionnaires, and 17 interviews. Qualitative analysis themes included worries about the intrapartum experience, its impact on partners, and lack of postpartum support for breastfeeding and mental health. This study provides an understanding of how the pandemic impacted pregnancy experiences, and the potential future repercussions of isolation and restrictions on wellbeing during public health crises.
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Affiliation(s)
- Stephanie Gill
- Department of Obstetrics and Gynecology, Memorial University of Newfoundland, St. John's, NL.
| | - Karen Wong
- Department of Maternal-Fetal Medicine, University of Ottawa, Ottawa, ON
| | - Colleen Cook
- Department of Obstetrics and Gynecology, Memorial University of Newfoundland, St. John's, NL
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Premer C, Caruso K. Safety profile of the most ordered medications for breastfeeding patients in the emergency department. Am J Emerg Med 2024; 80:1-7. [PMID: 38461649 DOI: 10.1016/j.ajem.2024.02.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Emergency Medicine (EM) physicians routinely treat breastfeeding patients. Physicians frequently recommend pumping and dumping milk for perceived safety risks. We hypothesized that the majority of the most commonly ordered medications in the emergency department (ED) are safe for breastfeeding patients. Accordingly, we performed a comprehensive safety analysis of the commonly ordered medications and provided an algorithm for EM physicians to utilize when treating breastfeeding patient in the ED. METHODS We investigated the 90 most administered medications to female patients between the ages of 15 to 50 for common ED chief complaints at a tertiary care academic medical center from January 2018 to December 2022. A total of 145,960 doses were analyzed. We subsequently searched LactMed®, InfantRisk Application, and Pubmed® for all safety information on these medications and divided them by categories. Ultimately, we proposed a treatment algorithm for breastfeeding patients in the ED. RESULTS Analgesics were the most commonly ordered medications in the ED, and importantly analgesics ranging from ibuprofen to morphine are safe in limited doses in the ED setting. Antibiotics and antifungals pose limited restrictions. All systems-based medications have a variety of safe options available. Lastly, supplements and electrolytes are safe. CONCLUSION The majority of medications utilized in the acute setting are compatible with breastfeeding. There should be limited circumstances to advise pumping and dumping in the ED.
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Affiliation(s)
- Courtney Premer
- McGaw Medical Center of Northwestern University, Department of Emergency Medicine, USA.
| | - Kelsea Caruso
- McGaw Medical Center of Northwestern University, Department of Emergency Medicine, USA
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Thomson G, Balaam MC, Tishkovskaya S. Comparing factors associated with overall satisfaction for different forms of remote breastfeeding support in the UK. Int Breastfeed J 2024; 19:36. [PMID: 38778298 PMCID: PMC11112964 DOI: 10.1186/s13006-024-00641-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Remote forms of breastfeeding support, such as helplines and social media, offer a flexible and convenient form of support to offer help at critical points, e.g., when the risk of breastfeeding cessation is high. Currently, there is little known about who accesses different forms of remote breastfeeding support and what factors impact overall satisfaction. As part of an evaluation of the UK National Breastfeeding Helpline (NBH) (which offers breastfeeding support via a helpline and online media), we aimed to (a) understand who accesses different forms of NBH support, and (b) identify key factors associated with overall satisfaction for helpline and online media support. METHODS All service users who contacted the NBH between November 2021 and March 2022 were invited to participate in the evaluation via an online survey. Survey questions explored the type and timing of support, reasons for the contact, attitudes towards the help and support received, impact of the support on breastfeeding experiences and demographic factors. Chi-squared and Mann-Whitney tests explored variations in who accessed the helpline or online media. Multiple linear regression models were fitted to explore the factors related to the service users' 'overall satisfaction'. The quantitive data were combined with qualitative comments into descriptive themes. RESULTS Overall, online media users were significantly more likely to be younger, White, multiparous, less educated and have English as a first language compared to those who contact the helpline. Similar factors that significantly influenced overall satisfaction for both support models were the service being easy to access, receiving helpful information that met expectations, resolving breastfeeding issues, and feeling reassured and more confident. Significant factors for the helpline were callers feeling understood and more knowledgeable about breastfeeding following the call, being able to put into practice the information provided, feeling encouraged to continue breastfeeding, feeling that the volunteer gave the support that was needed, and seeking out additional support. CONCLUSIONS Online and helpline forms of breastfeeding support suit different demographics and call purposes. While optimal breastfeeding support needs to be accessible, flexible and instrumental, helpline users need real-time relational support to deal with more complex challenges.
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Affiliation(s)
- Gill Thomson
- School of Nursing and Midwifery, University of Central Lancashire, Preston, UK.
| | - Marie-Clare Balaam
- School of Nursing and Midwifery, University of Central Lancashire, Preston, UK
| | - Svetlana Tishkovskaya
- Health Statistics Lancashire Clinical Trials Unit, University of Central Lancashire, Preston, UK
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Karimi M, Maleki A, Rastegari L. The impact of continuous and intermittent supportive counseling on self-efficacy and continuation of breastfeeding in lactating women affected by COVID-19: a quasi-experimental trial. BMC Pregnancy Childbirth 2024; 24:376. [PMID: 38760730 PMCID: PMC11100109 DOI: 10.1186/s12884-024-06572-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Promoting exclusive breastfeeding can have a great effect in reducing the complications and mortality rate of mother and child. OBJECTIVE The study aimed to compare the effects of continuous and intermittent supportive counselling on the self-efficacy and continuity of breastfeeding among Lactating mothers with COVID-19. METHODS The study was a semi-experimental research method and was conducted on 73 mothers with COVID-19 who were hospitalized in Ayatollah Mousavi Hospital in Zanjan, Iran from May 2021 to April 2022. In the continuous counselling group, counselling was provided daily for 14 days, while in the intermittent counselling group, counselling was provided once a week for four weeks. Breastfeeding continuity was assessed based on the World Health Organization's classification, and breastfeeding self-efficacy was measured using Dennis' standard breastfeeding self-efficacy questionnaire (BSE) up to four months after delivery. The data were analyzed using chi-square tests, independent t-tests, paired t-tests, analysis of variance with repeated measures, and survival analysis (Kaplan-Meier) with a 95% confidence level. RESULTS The survival analysis revealed that the cessation of exclusive breastfeeding occurred in 17 cases within the continuous counselling group and in 22 cases within the intermittent counselling group. The rates of continuation for exclusive breastfeeding were 52.8% and 40.5% in the continuous and intermittent counselling group respectively. However, no statistically significant differences were observed in the continuation of breastfeeding and the trend of changes in the mean scores of breastfeeding self-efficacies between the continuous and intermittent counselling groups. Furthermore, comparing the change in breastfeeding self-efficacy scores between the one-month and four-month follow-ups within the continuous counselling group, a statistically significant increase was observed. CONCLUSION The results indicated no difference in the effectiveness of continuous and intermittent counseling methods in improving breastfeeding continuity in women with COVID-19. Further research is needed to explore the long-term effects of different counseling approaches on breastfeeding outcomes during crises. TRIAL REGISTRATION The study was registered on the Iranian Registry of Clinical Trials website on 29/06/2021 with the registration code IRCT20150731023423N19. It can be accessed via this link: https://irct.behdasht.gov.ir/user/trial/55391/view .
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Affiliation(s)
- Maryam Karimi
- Department of Midwifery, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Azam Maleki
- Social Determinants of Health Research Center, Health and Metabolic Diseases Research Institute, Zanjan University of Medical Sciences, Zanjan, Iran.
- Social Determinants of Health Research Center, Health and Metabolic Diseases Research Institute, Zanjan University of Medical Sciences, Azadi Square, Jomhori Eslami St, Zanjan, 4515613191, Iran.
| | - Leila Rastegari
- Department of Midwifery, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
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Silva AGRD, Oliveira FSE, Melo ATD, Guimarães RA, Guimarães JV, Vieira FVM. In-hospital breastfeeding and predictive factors during the SARS-CoV-2 pandemic: A retrospective cohort study - Aleitamento materno hospitalar e fatores preditores durante a pandemia pelo SARS-CoV-2: Coorte retrospectiva. J Pediatr Nurs 2024; 76:30-37. [PMID: 38340676 DOI: 10.1016/j.pedn.2024.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE To analyze breastfeeding and the factors that positively influence the first hour of life, during hospitalization, and at discharge during the SARS-CoV-2 pandemic. DESIGN AND METHOD This is a retrospective cohort study, with data collected from medical records. Consisting of 225 mother-newborn dyads with deliveries between 2020 and 2021. Breastfeeding in the first hour of life, during hospitalization, and at discharge was considered as the outcome variable. The independent variables were sociodemographic, obstetric, and neonatal data. The analysis was performed with bivariate and multivariate regression through a generalized linear model (Poisson family), with a 5% significance level. It was approved by the Institutional Review Board (IRB), under approval number 4,911,317. RESULT Newborns of women without COVID-19 suspicion or diagnosis and who had skin-to-skin contact with their mother at birth are twice as likely to be breastfed in the first hour of life. Absence of complications in the newborn during hospitalization and no COVID-19 suspicion or diagnosis double the exclusive breastfeeding rate during hospitalization. Newborns exclusively breastfed during hospitalization present 1.6 times more chances of being exclusively breastfeeding at hospital discharge. CONCLUSION It was evidence that women who gave birth without COVID-19 suspicion, and newborns who had skin-to-skin contact with their mother at birth represented a predictive factor for favoring exclusive breastfeeding. PRACTICE IMPLICATIONS This research contributes to the innovation of evaluating breastfeeding in the newborn's first hour of life, during hospitalization, and at discharge in a pandemic context.
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Lee AP, Libadia AGI, de Ocampo FS. Feeding Practices of Stable Term and Late Preterm Neonates Born at a Tertiary Hospital in the Philippines during the COVID-19 Pandemic. ACTA MEDICA PHILIPPINA 2024; 58:142-151. [PMID: 38882918 PMCID: PMC11168948 DOI: 10.47895/amp.v58i7.6430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Objective We aimed to evaluate the impact of maternal COVID-19 infection and separation of the mother-baby dyad on feeding practices by determining modes of feeding upon discharge and following up at 2-3 days, 14 days, and 1 month post-discharge. Methods This was a prospective observational cohort study conducted at the Philippine General Hospital, a tertiary government COVID-19 referral center in Manila. Mothers who delivered between the months of July and August 2021, and whose COVID-19 status was known were followed up on their baby's mode of feeding at 2-3 days, 14 days, and 1 month post-discharge via phone call. For babies of COVID-19 positive mothers, presence of any symptoms (up to the 14-day time point only) as well as adherence to infection prevention and control practices were also identified. Results For all time points post-discharge, breastfeeding rates were higher in babies born to COVID-19-negative mothers and in those who were roomed in. However, the differences were not statistically significant. Of the 108 infants, 72.90% remained exclusively breastfed by 1 month of age, with 4.67% formula-fed and 22.43% on mixed feeding. Perception of insufficient milk supply was the most common reason for shifting to formula or mixed feeding. We found a significantly higher direct breastfeeding rate upon discharge in the roomed-in population compared to those admitted to the NICU. Risk factors affecting breastfeeding at 1 month of age was the presence of COVID-19 infection in the mother and mother-baby separation due to NICU admissionCOVID-19-positive mothers were 66.02% less likely (p=0.016, 95% CI 0.1411 to 0.8183) to still be breastfeeding at 1 month, and separation was not found to be a significant risk factor. Conclusions Feeding practices can be affected not only by COVID-19 infection in the mother and its attendant difficulties such as prolonged hospital stay and physical and social isolation, but also by limitations in the hospital environment that can have an impact on breastfeeding education, support, and opportunities for mother-child bonding.
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Affiliation(s)
- Alexandra P Lee
- Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila
| | - Aurora Gloria I Libadia
- Division of Newborn Medicine, Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila
| | - Fay S de Ocampo
- Division of Newborn Medicine, Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila
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Tan A, Blair A, Homer CS, Digby R, Vogel JP, Bucknall T. Pregnant and postpartum women's experiences of the indirect impacts of the COVID-19 pandemic in high-income countries: a qualitative evidence synthesis. BMC Pregnancy Childbirth 2024; 24:262. [PMID: 38605319 PMCID: PMC11007880 DOI: 10.1186/s12884-024-06439-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 03/24/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Pregnant and postpartum women's experiences of the COVID-19 pandemic, as well as the emotional and psychosocial impact of COVID-19 on perinatal health, has been well-documented across high-income countries. Increased anxiety and fear, isolation, as well as a disrupted pregnancy and postnatal period are widely described in many studies. The aim of this study was to explore, describe and synthesise studies that addressed the experiences of pregnant and postpartum women in high-income countries during the first two years of the pandemic. METHODS A qualitative evidence synthesis of studies relating to women's experiences in high-income countries during the pandemic were included. Two reviewers extracted the data using a thematic synthesis approach and NVivo 20 software. The GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) was used to assess confidence in review findings. RESULTS Sixty-eight studies were eligible and subjected to a sampling framework to ensure data richness. In total, 36 sampled studies contributed to the development of themes, sub-themes and review findings. There were six over-arching themes: (1) dealing with public health restrictions; (2) navigating changing health policies; (3) adapting to alternative ways of receiving social support; (4) dealing with impacts on their own mental health; (5) managing the new and changing information; and (6) being resilient and optimistic. Seventeen review findings were developed under these themes with high to moderate confidence according to the GRADE-CERQual assessment. CONCLUSIONS The findings from this synthesis offer different strategies for practice and policy makers to better support women, babies and their families in future emergency responses. These strategies include optimising care delivery, enhancing communication, and supporting social and mental wellbeing.
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Affiliation(s)
- Annie Tan
- School of Nursing and Midwifery, Deakin University, Geelong, Australia.
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia.
- Centre for Quality and Patient Safety Research, Institute of Health Transformation, Geelong, Australia.
| | - Amanda Blair
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Caroline Se Homer
- School of Nursing and Midwifery, Deakin University, Geelong, Australia
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Robin Digby
- School of Nursing and Midwifery, Deakin University, Geelong, Australia
- Centre for Quality and Patient Safety Research, Institute of Health Transformation, Geelong, Australia
- Alfred Health, Melbourne, Australia
| | - Joshua P Vogel
- School of Nursing and Midwifery, Deakin University, Geelong, Australia
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Tracey Bucknall
- School of Nursing and Midwifery, Deakin University, Geelong, Australia
- Centre for Quality and Patient Safety Research, Institute of Health Transformation, Geelong, Australia
- Alfred Health, Melbourne, Australia
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Hirani SAA. Barriers Affecting Breastfeeding Practices of Refugee Mothers: A Critical Ethnography in Saskatchewan, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:398. [PMID: 38673311 PMCID: PMC11050554 DOI: 10.3390/ijerph21040398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/16/2024] [Accepted: 03/22/2024] [Indexed: 04/28/2024]
Abstract
Refugee mothers are vulnerable to cultural stereotyping and socioeconomic hardships when they migrate to a new country. This vulnerability often has a negative impact on refugee mothers' breastfeeding practices. Saskatchewan is one of the growing provinces in Canada that has a noticeable increase in refugee population with young children and limited availability of healthcare settings with baby-friendly status. Considering existing gaps in knowledge, this critical ethnographic study aimed to explore barriers that impede the breastfeeding practices of refugee mothers in Saskatchewan. After seeking ethics approval, data were collected using multiple methods, including in-depth interviews undertaken with 27 refugee mothers with young children of age range 1 day to 24 months, a review of media communications and field observations of community-based services/facilities available to refugee mothers. Findings suggest that psychosocial barriers, healthcare barriers, environmental barriers, and maternal and child health-related barriers impede the breastfeeding practices of refugee mothers in Saskatchewan. Breastfeeding practices of refugee mothers can be promoted through healthcare support, culturally appropriate services, interpretation services in healthcare settings, implementation of baby-friendly initiatives, hospital and community-based breastfeeding campaigns, and follow-up services. Collaborative efforts by healthcare settings, healthcare providers, policymakers, public health agencies, service providers, and governments are essential to support the breastfeeding practices of refugee mothers.
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Affiliation(s)
- Shela Akbar Ali Hirani
- Faculty of Nursing, University of Regina, 516 RIC, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
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16
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LoCasale-Crouch J, Wallace MK, Heeren T, Kerr S, Yue Y, Deeken G, Turnbull K, Jaworski B, Mateus MC, Moon R, Hauck FR, Kellams A, Colson E, Corwin MJ. The importance of community resources for breastfeeding. Int Breastfeed J 2024; 19:16. [PMID: 38448983 PMCID: PMC10916149 DOI: 10.1186/s13006-024-00623-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/18/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Breastfeeding has long-lasting effects on children's cognition, behavioral, mental and physical health. Previous research shows parental characteristics (e.g., education, race/ethnicity, income level) are associated with breastfeeding initiation and duration. Further, research shows significant variation in access to community resources by race/ethnicity. It is unclear how community resources may impact breastfeeding practices and how this might intersect with maternal race/ethnicity. METHODS This study combined nationally-representative data from the Study of Attitudes and Factors Effecting Infant Care (SAFE), which surveyed US mothers immediately after the infant's birth and at two to six months of infant age, with the Child Opportunity Index (COI) 2.0, a census tract measure of community resources associated with child development, to explore the association between community resources and breastfeeding initiation and whether this varies based on maternal race/ethnicity and country of birth. The SAFE Study used a stratified, two-stage, clustered design to obtain a nationally representative sample of mothers of infants, while oversampling Hispanic and non-Hispanic (NH) Black mothers. The SAFE study enrolled mothers who spoke English or Spanish across 32 US birth hospitals between January 2011 and March 2014. RESULTS After accounting for individual characteristics, mothers residing in the highest-resourced communities (compared to the lowest) had significantly greater likelihood of breastfeeding. Representation in higher-resourced communities differed by race/ethnicity. Race/ethnicity did not significantly moderate the association between community resources and breastfeeding. In examining within race/ethnic groups, however, community resources were not associated with non-US born Black and Hispanic mothers' rates of breastfeeding, while they were with US born Black and Hispanic mothers. CONCLUSIONS Findings suggest that even health behaviors like breastfeeding, which we often associate with individual choice, are connected to the community resources within which they are made. Study implications point to the importance of considering the impact of the contextual factors that shape health and as a potential contributor to understanding the observed race/ethnicity gap.
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Affiliation(s)
| | | | - Timothy Heeren
- School of Public Health, Boston University, Boston, MA, USA
| | - Stephen Kerr
- Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA
| | - Yitong Yue
- School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
| | - Genevieve Deeken
- Department of Global Public Health- Global Studies, University of Virginia, Charlottesville, VA, USA
| | - Khara Turnbull
- School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
| | - Brianna Jaworski
- School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
| | - Mayaris Cubides Mateus
- School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
| | - Rachel Moon
- School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Fern Robin Hauck
- School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Ann Kellams
- School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Eve Colson
- School of Medicine, Washington University in St. Louis, Saint Louis, MO, USA
| | - Michael Jay Corwin
- Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA
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Ryan RA, Hepworth AD, Bihuniak JD, Lyndon A. A Qualitative Study of Breastfeeding Experiences Among Mothers Who Used Galactagogues to Increase Their Milk Supply. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:122-132. [PMID: 38159094 DOI: 10.1016/j.jneb.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To qualitatively describe breastfeeding experiences among mothers who used galactagogues to increase their milk supply. DESIGN One-time, semistructured phone interviews. SETTING US. PARTICIPANTS Breastfeeding mothers (n = 19) who reported ever consuming foods, beverages, or herbal supplements to increase their milk supply in a cross-sectional online survey were purposefully sampled to participate in this qualitative study. Participants were diverse in terms of race and ethnicity, education, income, infant age (0-18 months), and prior breastfeeding experience (32% first-time breastfeeding). PHENOMENON OF INTEREST Reasons for trying to increase milk supply, sources of information about increasing milk supply, and strategies tried to increase milk supply. ANALYSIS Interviews were transcribed verbatim and analyzed using reflexive thematic analysis. RESULTS Participants expressed determination and commitment to breastfeeding but unexpectedly struggled to breastfeed and increase their milk supply. They sought information from multiple sources and used individualized approaches to address milk supply concerns on the basis of recommendations from others, as well as the perceived convenience, cost, palatability, and safety of potential strategies. CONCLUSIONS AND IMPLICATIONS Results suggest a need to expand breastfeeding education and support so that lactating parents anticipate common breastfeeding challenges and are aware of evidence-based strategies for increasing their milk supply.
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Affiliation(s)
- Rachel A Ryan
- Department of Nutrition and Food Studies, New York University, New York, NY; Public Health Nutrition, School of Global Public Health, New York University, New York, NY.
| | | | | | - Audrey Lyndon
- Rory Meyers College of Nursing, New York University, New York, NY
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18
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Kelley K, Campbell E, Steiber A, Yakes Jimenez E. Repeated Cross-Sectional Surveys of Registered Dietitian Nutritionists Demonstrate Rapid Practice Changes to Address Food Insecurity During the Coronavirus Disease 2019 Pandemic. J Acad Nutr Diet 2024; 124:268-278.e13. [PMID: 35963532 PMCID: PMC9364914 DOI: 10.1016/j.jand.2022.08.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 07/08/2022] [Accepted: 08/05/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND The coronavirus disease 2019 pandemic had worldwide economic impact, exacerbating food insecurity risk for vulnerable populations. OBJECTIVE To describe changes in practice and challenges and areas of need related to addressing food insecurity during the coronavirus disease 2019 pandemic for registered dietitian nutritionist survey respondents. DESIGN A cross-sectional, anonymous, online survey distributed via the Academy of Nutrition and Dietetics e-mail communication platform and social media accounts from April through May 2020 (Wave 1 [W1]) and December 2020-February 2021 (Wave 2 [W2]). PARTICIPANTS AND SETTING Participants were US-based registered dietitian nutritionists practicing in community-based settings to address food insecurity (W1: n = 454; W2: n = 331). STATISTICAL ANALYSES Responses were descriptively summarized using means ± SD, medians and interquartile ranges, or number of observations and percentages. Open-ended responses were manually reviewed and organized into major themes. RESULTS Respondents had about 10 years of experience in addressing food insecurity and were most commonly involved with the Special Supplemental Nutrition Program for Women, Infants and Children, federal school nutrition programs, or food banks. Participants described increased demand for food security assistance (W1: 68%; W2: 60%). Among respondents involved in food preparation and handling (W1: n = 183; W2: n = 110), supply chain (W1: 61%; W2: 56%) and staffing (W1: 37%; W2: 50%) challenges were commonly reported. Child nutrition program professionals (W1: n = 143; W2: n = 84) reported widespread implementation of optional program waivers, with the most commonly implemented waivers allowing noncongregate meal service (W1: 83%; W2: 81%), caregivers to pick up meals (W1: 69%; W2: 85%), and flexibility in mealservice times (W1: 75%; W2: 87%). CONCLUSIONS Respondents quickly adapted programs to ensure staff and client safety while continuing to provide essential food security services. They identified the need for ongoing nutrition program policy advocacy and timely access to best practice resources during public health emergencies.
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Affiliation(s)
- Kathryn Kelley
- Nutrition Research Network, Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, Illinois.
| | - Elizabeth Campbell
- Legislative and Government Affairs, Academy of Nutrition and Dietetics, Chicago, Illinois
| | - Alison Steiber
- Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, Illinois
| | - Elizabeth Yakes Jimenez
- Nutrition Research Network, Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, Illinois; Department of Pediatrics and Internal Medicine and College of Population Health, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
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19
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Roess AA, Robert RC, Kuehn D, Andrews CF, Vinjamuri S. The Impact of COVID-19 on Breastfeeding Initiation and Duration in a Low-Income Population, Washington, DC. Breastfeed Med 2024; 19:120-128. [PMID: 38386992 DOI: 10.1089/bfm.2023.0223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Objective: To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on breastfeeding initiation (BFI) and duration among women enrolled in the Special Supplemental Nutrition Program for women, infants, and children (WIC) in Washington District of Columbia (DC). Materials and Methods: We used WIC program data from Washington DC to assess the pandemic's impact on BFI and duration among WIC recipients. t-Tests and unadjusted odds ratios compared breastfeeding outcomes before and during the pandemic. Multivariable logistic and linear regression models estimated the pandemic's impact on initiation and duration, respectively, while controlling for social determinants of health and other factors. Results: BFI was similar among women who gave birth before (61.4%) or during the pandemic (60.4%) (p = 0.359). However, the proportion of women who breastfed at 1 month decreased significantly from 56.1% (before pandemic) to 47.6% (during pandemic) (p < 0.0001). This pattern for duration continued at 3 and 6 months: 46.9% to 37.1% (p < 0.0001) at 3 months and 34.8% to 25.7% (p < 0.0001) at 6 months. On average, women who delivered during the pandemic breastfed 33.9 fewer days than those who delivered before (p < 0.0001). Conclusions: BFI among DC WIC recipients was similar for infants born before or during the pandemic, and determinants of initiation remained similar to previous reports (e.g., race/ethnicity, education). However, for women who initiated breastfeeding, average duration was significantly lower for infants born during the pandemic than before. Our findings suggest the importance of leveraging WIC and other breastfeeding supports to promote breastfeeding during pandemics and other emergencies.
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Affiliation(s)
- Amira A Roess
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Rebecca C Robert
- Conway School of Nursing, The Catholic University of America, Washington, District of Columbia, USA
| | - Doris Kuehn
- The District of Columbia (DC) Department of Health, DC Women Infant Child (WIC) State Agency, Washington, District of Columbia, USA
| | - Caroline F Andrews
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Swathi Vinjamuri
- The District of Columbia (DC) Department of Health, DC Women Infant Child (WIC) State Agency, Washington, District of Columbia, USA
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Li S, Zhang W, Liu Y, Yu M, Yang S, Luo M, Yang Q. Lactating nurses' experiences of return to work after lifting COVID-19 lockdown: A qualitative study. Heliyon 2024; 10:e23761. [PMID: 38332884 PMCID: PMC10851297 DOI: 10.1016/j.heliyon.2023.e23761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 02/10/2024] Open
Abstract
Aim To explore the lactating nurses' experiences of return to work after lifting COVID-19 lockdown. Background Return to work is a key reason for the low rates of breastfeeding. Especially after lifting COVID-19 lockdown, case counts reached recorded highs. So lactating nurses face more challenges when they return to work. Method The empirical phenomenology method was used to conduct a qualitative study. Lactating nurses were recruited in a tertiary hospital through purposive and snowball sampling, and participated in semi-structured video interviews. Colaizzi's method was used to analyze the data. Results Three themes and 10 sub-themes emerged from the interview data of 15 participants. The first theme was "preparation for return to work", which helped lactating nurses adapt to return to work quickly. The second was "experiences of return to work". The inconvenience of pumping was mentioned repeatedly. In addition, the flexible work schedule was highlighted. The third was "experiences of infection". The attitudes toward breastfeeding differed due to different perceptions of COVID-19. Conclusions Lactation nurses easily interrupted or stopped breastfeeding when they returned to work after lifting COVID-19 lockdown. Recommendations include the further provision of longer periods of leave, flexible working arrangements, separate facilities for breast pumping, and breastfeeding strategies for epidemics.
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Affiliation(s)
- Suya Li
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenyan Zhang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Liu
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mingfeng Yu
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Siyu Yang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengdan Luo
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qing Yang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Acar Z, Şahin N. Development of a mobile application -based breastfeeding program and evaluation of its effectiveness. J Pediatr Nurs 2024; 74:51-60. [PMID: 37995477 DOI: 10.1016/j.pedn.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Breastfeeding has many benefits for maternal and infant health. Mobile health interventions are increasingly used to increase breastfeeding initiation and support breastfeeding continuation. PURPOSE This study aimed to develop a mobile application-based breastfeeding program (MABBP) and to evaluate effectiveness. DESIGN AND METHODS This randomized controlled trial study was conducted with 73 mothers on the first postpartum day hospitalized in the postpartum service of a university hospital in Turkey. Mothers in the MABBP group (experimental group) were included in the mobile application-based breastfeeding training program on the first postpartum day. The Participant Information Form, the Infant Breastfeeding Assessment Tool (IBFAT), and the Breastfeeding Experience Scale (BES), Breastfeeding Follow-up Form, and Baby Physical Development Follow-up Form were administered. In the second follow-up, the Mobile Application Evaluation Form was used additionally to collect data from the MABBP group. RESULTS There was no significant difference between the postpartum first-day MABBP and control groups in the mean IBFAT scores. In the first and second follow-up, the rate of breastfeeding exclusively was higher and the rate of experiencing breastfeeding problems was lower in the MABBP group compared to the control group. While the mean BES score on the first postpartum day was significantly higher in the MABBP group compared to the control group, it was found to be significantly lower in the second follow-up. CONCLUSION It was determined that the MABBP contributed to the mothers' experiencing fewer breastfeeding problems and feeding the babies exclusively with breast milk at a higher rate. PRACTICE IMPLICATIONS This study suggests that pediatric nurses can support mothers during breastfeeding with the breastfeeding mobile application.
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Affiliation(s)
- Zehra Acar
- University of Health Sciences Hamidiye Faculty of Nursing, Istanbul, Turkey.
| | - Nevin Şahin
- Istanbul University- Cerrahpaşa Florence Nightingale Nursing Faculty, Istanbul, Turkey
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22
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Chen A, Acharya G, Hu M, Gao X, Cheng G, Jiang L, Ni Q. Association of maternal SARS-CoV-2 infection at the time of admission for delivery with labor process and outcomes of vaginal birth: A cohort study. Acta Obstet Gynecol Scand 2024; 103:103-110. [PMID: 37926941 PMCID: PMC10755127 DOI: 10.1111/aogs.14704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/08/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION This study aimed to investigate the impact of maternal SARS-CoV-2 infection at the time of admission for delivery on labor process and outcomes of vaginal birth. MATERIAL AND METHODS A cohort study was carried out at the Obstetrics Department of Anhui Provincial Hospital, China, where universal reverse transcriptase polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 infection was introduced for all women admitted for labor and delivery from December 1-31, 2022. Women were divided into positive and negative groups based on the test result. All women having a singleton vaginal birth were included in final analysis. The effect of SARS-CoV-2 positivity on labor process and outcomes of vaginal birth was estimated by regression analyses. RESULTS Among a total of 360 women included, 87 had a positive SARS-CoV-2 test and 273 a negative test. Women in the positive group had an increased likelihood of having longer labor (median 9.3 vs 8.3 hours; sB [log-transformed] 0.19; 95% confidence interval [CI] 0.09-0.28), episiotomy (39.1% vs 23.8%; adjusted odds ratio [aOR] 2.31; 95% CI 1.27-4.21), grade III meconium-stained amniotic fluid (19.5% vs 7.0%; aOR 2.52; 95% CI 1.15-5.54) and postpartum hospital stay exceeding 37 hours (58.6% vs 46.5%; aOR 1.71; 95% CI 1.00-2.91). They had reduced rates exclusive breastfeeding (26.7% vs 39%; aOR 0.21; 95% CI 0.09-0.46) as well as mixed feeding (46.5% vs 52.2%; aOR 0.28; 95% CI 0.13-0.60) at 1 week postpartum. No significant differences were observed in other aspects of labor process and birth outcomes, including the uptake of labor analgesia, postpartum hemorrhage (>500 mL) or neonatal outcomes. CONCLUSIONS A positive maternal SARS-CoV-2 test in labor among women having vaginal birth was associated with a slightly longer duration of labor, increased likelihood of episiotomy, increased incidence of grade III meconium-stained amniotic fluid, a longer postpartum hospital stay and a lower rate of breastfeeding 1 week postpartum. However, it did not have an adverse impact on other birth outcomes.
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Affiliation(s)
- An Chen
- School of Public HealthZhejiang Chinese Medical UniversityHangzhouChina
- Department of Public Health, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | - Ganesh Acharya
- Division of Obstetrics & Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC)Karolinska InstitutetStockholmSweden
- Department of Clinical MedicineUiT The Arctic University of TromsøTromsøNorway
| | - Min Hu
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of University of Science and Technology of China (USTC)HefeiChina
| | - Xin Gao
- Medical Teaching and Research SectionAnhui Open UniversityHefeiChina
| | - Guizhi Cheng
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of University of Science and Technology of China (USTC)HefeiChina
| | - Lai Jiang
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of University of Science and Technology of China (USTC)HefeiChina
| | - Qianqian Ni
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of University of Science and Technology of China (USTC)HefeiChina
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O’Sullivan EJ, Kennedy A. Parents' experiences of infant and young child feeding during the COVID-19 pandemic in Ireland. Public Health Nutr 2023; 26:2652-2662. [PMID: 37905581 PMCID: PMC10755413 DOI: 10.1017/s1368980023002343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 08/25/2023] [Accepted: 10/24/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVE The WHO has urged member states to develop preparedness plans for infant and young child feeding (IYCF) during emergencies. Ireland has no such plan. We aimed to identify the needs of caregivers in Ireland with regards IYCF during the COVID-19 pandemic. DESIGN Online survey conducted in May-June 2020. SETTING Ireland, during the first period of severely restricted movement due to COVID-19 (lockdown). PARTICIPANTS Respondents (n 745) were primary caregivers of a child under 2 years; they were primarily well educated and likely of higher socio-economic status. RESULTS Among those who breastfed, being unable to access breast-feeding support groups and being unable to access in-person, one-to-one breast-feeding assistance were the biggest challenges reported. Nearly three quarters of those who had their babies during lockdown reported these challenges: 72·8 % and 68·8 %, respectively. For those using formula, the main challenges were structural in nature; approximately two-thirds of those who had their baby prior to lockdown feared there would be formula shortages and a third were unable to purchase formula due to shortages. CONCLUSIONS Regardless of how their babies were fed, parents in Ireland experienced multiple challenges with infant feeding during the COVID-19 crisis. Breast-feeding should be protected, supported and promoted, particularly during an infectious disease pandemic. Additionally, assurances around supply of infant formula could reduce parental stress during a pandemic or emergency. An IYCF in emergencies plan would clearly set out how we could best support and protect the nutrition of the most vulnerable members of our population.
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Affiliation(s)
- Elizabeth J O’Sullivan
- School of Biological, Health and Sports Sciences, City Campus, Technological University Dublin, CQ312 Central Quad, Grangegorman, Dublin, Ireland
| | - Aileen Kennedy
- School of Biological, Health and Sports Sciences, City Campus, Technological University Dublin, CQ312 Central Quad, Grangegorman, Dublin, Ireland
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Jagarapu J, Diaz MI, Lehmann CU, Medford RJ. Twitter discussions on breastfeeding during the COVID-19 pandemic. Int Breastfeed J 2023; 18:56. [PMID: 37925408 PMCID: PMC10625257 DOI: 10.1186/s13006-023-00593-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/22/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Breastfeeding is a critical health intervention in infants. Recent literature reported that the COVID-19 pandemic resulted in significant mental health issues in pregnant and breastfeeding women due to social isolation and lack of direct professional support. These maternal mental health issues affected infant nutrition and decreased breastfeeding rates during COVID-19. Twitter, a popular social media platform, can provide insight into public perceptions and sentiment about various health-related topics. With evidence of significant mental health issues among women during the COVID-19 pandemic, the perception of infant nutrition, specifically breastfeeding, remains unknown. METHODS We aimed to understand public perceptions and sentiment regarding breastfeeding during the COVID-19 pandemic through Twitter analysis using natural language processing techniques. We collected and analyzed tweets related to breastfeeding and COVID-19 during the pandemic from January 2020 to May 2022. We used Python software (v3.9.0) for all data processing and analyses. We performed sentiment and emotion analysis of the tweets using natural language processing libraries and topic modeling using an unsupervised machine-learning algorithm. RESULTS We analyzed 40,628 tweets related to breastfeeding and COVID-19 generated by 28,216 users. Emotion analysis revealed predominantly "Positive emotions" regarding breastfeeding, comprising 72% of tweets. The overall tweet sentiment was positive, with a mean weekly sentiment of 0.25 throughout, and was affected by external events. Topic modeling revealed six significant themes related to breastfeeding and COVID-19. Passive immunity through breastfeeding after maternal vaccination had the highest mean positive sentiment score of 0.32. CONCLUSIONS Our study provides insight into public perceptions and sentiment regarding breastfeeding during the COVID-19 pandemic. Contrary to other topics we explored in the context of COVID (e.g., ivermectin, disinformation), we found that breastfeeding had an overall positive sentiment during the pandemic despite the documented rise in mental health challenges in pregnant and breastfeeding mothers. The wide range of topics on Twitter related to breastfeeding provides an opportunity for active engagement by the medical community and timely dissemination of advice, support, and guidance. Future studies should leverage social media analysis to gain real-time insight into public health topics of importance in child health and apply targeted interventions.
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Affiliation(s)
- Jawahar Jagarapu
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- School of Biomedical Informatics, University of Texas, Houston, TX, USA.
- Division of Neonatal-Perinatal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Suite F3.118, Dallas, TX, 75390, USA.
| | - Marlon I Diaz
- Center for Clinical Informatics, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Christoph U Lehmann
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Center for Clinical Informatics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Richard J Medford
- Center for Clinical Informatics, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
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25
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McCloskey K, Henao D, Gregory C, Corsig L, Plummer D. Breastfeeding Disparities During the COVID-19 Pandemic: Race/Ethnicity, Age, Education, and Insurance Payor. J Hum Lact 2023; 39:615-624. [PMID: 37515445 DOI: 10.1177/08903344231187907] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
BACKGROUND There are well-documented disparities in rates of continued breastfeeding. Existing research regarding breastfeeding during COVID-19 has raised concerns that the pandemic may have exacerbated these disparities. RESEARCH AIMS The aim of this research was first to quantify disparities in any breastfeeding associated with the maternal factors of race/ethnicity, age, insurance payor, and zip code rates of education in North Carolina. Second, we aimed to investigate any changes in these disparities before and during the COVID-19 pandemic. METHOD This was an observational study, with a retrospective, longitudinal design. Participants included infants who were born in one of eight medical centers across North Carolina from either September 1, 2019 to October 31, 2019 (pre-COVID: n = 1,104) or from April 1, 2020 to May 31, 2020, (during COVID: n = 1,157), and whose caregivers reported whether they were breastfeeding at either a 3-month or 6-month postnatal follow-up (N = 2,261). Mixed effects logistic models, including random effects of zip code, assessed predictors associated with probability of breastfeeding cessation at 3- and 6-month child well-check. RESULTS Overall, younger maternal age, being non-Hispanic Black, not having commercial insurance, and residing in a zip code with lower rates of higher education, were all independently associated with earlier breastfeeding cessation across both cohorts. Disparities did not significantly change during the COVID-19 pandemic. CONCLUSION We did not find support for the hypothesis that the COVID-19 pandemic might have exacerbated breastfeeding disparities. Nevertheless, there is a continued need to eliminate existing disparities.
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Affiliation(s)
- Kiran McCloskey
- Office of Health Equity, Novant Health, Winston-Salem, NC, USA
| | - David Henao
- Office of Health Equity, Novant Health, Winston-Salem, NC, USA
| | - Chere Gregory
- Office of Health Equity, Novant Health, Winston-Salem, NC, USA
| | - Laura Corsig
- Department for Lactation Services, Novant Health, Charlotte, NC, USA
| | - Dianne Plummer
- Women and Children's Institute, Novant Health, Winston-Salem, NC, USA
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26
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Penny F, Brownell EA, Judge M, Marshall-Crim M, Cartagena D, McGrath JM. Use of a Supplemental Feeding Tube Device and Breastfeeding at 4 Weeks. MCN Am J Matern Child Nurs 2023; 48:334-340. [PMID: 37840203 DOI: 10.1097/nmc.0000000000000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
BACKGROUND Mothers having difficulty breastfeeding their infants may use alternative supportive feeding methods. Although a supplemental feeding tube device is commonly used, efficacy for supporting sustained breastfeeding remains unknown. PURPOSE To describe supplemental feeding tube device use by breastfeeding mothers as an alternative feeding method through exploration of associations between supplemental feeding tube device use and continued breastfeeding at 4 weeks of infant's age. METHOD Forty mothers participated. They were interviewed during the birth hospitalization and at 4 weeks postpartum. Questions addressed use of supplemental feeding tube devices, breastfeeding issues, and continued breastfeeding relationships. We examined the relationship between LATCH scores at 2 to 3 days of life. RESULTS Breastfeeding mothers who chose to supplement with bottle-feeding instead of use of a supplemental feeding tube device were 30% less likely to continue breastfeeding at a medium/high/exclusive level. CONCLUSION Use of the supplemental feeding tube device may help avoid the potentially detrimental effect of bottle-feeding on continued breastfeeding.
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27
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Marín Gabriel MÁ, Martín Lozoya S, de Las Heras Ibarra S, Domingo Comeche L, González Carrasco E, Lalaguna Mallada P, Villó Sirerol N, García Fernández L, Jiménez Martínez J, Royuela Vicente A. Association of the presence of a COVID-19 infection at the time of birth and the rates of exclusive breastfeeding upon discharge in BFHI hospitals: a multicenter, prospective cohort study. Int Breastfeed J 2023; 18:54. [PMID: 37794406 PMCID: PMC10552201 DOI: 10.1186/s13006-023-00590-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/22/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Very few studies have assessed the association between COVID-19 infection and the rates of exclusive breastfeeding (EBF) upon discharge following the first waves of the pandemic and after initiation of vaccination. The primary objective of this study is to compare the rates of EBF since birth upon discharge in mothers diagnosed with COVID-19 infection at the time of the delivery versus a group of non-infected mothers in maternity hospitals with Baby Friendly Hospital Initiative (BFHI) accreditation. The secondary objectives include determining the rates of any breastfeeding at three and six months of life in both groups, as well as determining the possible factors associated with EBF rates observed upon discharge. METHODS An observational, Spanish multi-center hospital, prospective cohort study conducted from 1 to 2021 to 31 March 2022 and with follow-up during the first six months of life. Follow-up was performed via telephone contact with calls performed at three and six months. A multivariate logistic regression analysis model was used to identify the factors related to a lower probability of EBF upon discharge. RESULTS 308 mother-infant pairs participated in the study, 111 in the cohort of women with COVID infection and 197 in the comparison group. EBF upon discharge was 62.7% in the COVID group vs. 81.2% in the comparison group (p = 0.002); at three months; 52.4% vs. 57.0% (p = 0.33) were performing EBF, with the rates of EBF at six months being 43.0% vs. 39.3% (p = 0.45), respectively. Exposure to COVID-19 at delivery (AOR 5.28; 95% CI 2.01, 13.86), not practicing BF previously (AOR 36.3; 95% CI 7.02, 187.74), birth via Cesarean section (AOR 5.06; 95% CI 1.62, 15.79) and low birth weight of the newborn (AOR 1.01; 95% CI 1.01, 1.01) were associated with a greater risk of not performing EBF upon discharge. CONCLUSIONS Mothers with a mild or asymptomatic COVID-19 infection at the time of the delivery were less likely to have exclusively breastfed during their hospital stay than other mothers in these BFHI-accredited hospitals. However, there were no differences in breastfeeding rates between the groups at three and six months postpartum.
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Affiliation(s)
- Miguel Ángel Marín Gabriel
- Department of Pediatrics, Puerta de Hierro-Majadahonda University Hospital, BFHI Hospital-Coordinator, Majadahonda, Madrid, Spain.
| | - Sergio Martín Lozoya
- Department of Pediatrics, Puerta de Hierro-Majadahonda University Hospital, BFHI Hospital-Coordinator, Majadahonda, Madrid, Spain
| | | | - Laura Domingo Comeche
- Department of Neonatology, Fuenlabrada University Hospital, Fuenlabrada, Madrid, Spain
| | | | | | | | | | | | - Ana Royuela Vicente
- Biostatistics Unit, Hospital Universitario Puerta de Hierro Majadahonda, IDIPHISA. CIBERESP, ISCIII., Madrid, España
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28
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Shenker NS, Griffin S, Hamill‐Keays J, Thomson M, Simpson J, Weaver G. Understanding the current and future usage of donor human milk in hospitals: An online survey of UK neonatal units. MATERNAL & CHILD NUTRITION 2023; 19:e13526. [PMID: 37400943 PMCID: PMC10483937 DOI: 10.1111/mcn.13526] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 07/05/2023]
Abstract
The use of donor human milk (DHM) where there is a shortfall of maternal milk can benefit both infant and maternal outcomes but DHM supply is not always assured. This study aimed to understand current DHM usage in UK neonatal units and potential future demand to inform service planning. An online survey was disseminated to all UK neonatal units using Smart Survey or by telephone between February and April 2022 after development alongside neonatal unit teams. Surveys were completed by 55.4% of units (108/195) from all 13 Operational Delivery Networks. Only four units reported not using DHM, and another two units only if infants are transferred on DHM feeds. There was marked diversity in DHM implementation and usage and unit protocols varied greatly. Five of six units with their own milk bank had needed to source milk from an external milk bank in the last year. Ninety units (84.9%) considered DHM was sometimes (n = 35) or always (n = 55) supportive of maternal breastfeeding, and three units (2.9%) responded that DHM was rarely supportive of breastfeeding. Usage was predicted to increase by 37 units (34.9%), and this drive was principally a result of parental preference, clinical trials and improved evidence. These findings support the assumption that UK hospital DHM demand will increase after updated recommendations from the World Health Organization (WHO) and the British Association of Perinatal Medicine. These data will assist service delivery planning, underpinned by an ongoing programme of implementation science and training development, to ensure future equity of access to DHM nationally.
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Affiliation(s)
- Natalie S. Shenker
- Department of Surgery and CancerImperial College London, IRDBLondonUK
- The Human Milk Foundation, Daniel Hall BuildingRothamsted Institute, HertsHarpendenUK
| | - Samantha Griffin
- Department of Surgery and CancerImperial College London, IRDBLondonUK
| | - Jonathan Hamill‐Keays
- The Human Milk Foundation, Daniel Hall BuildingRothamsted Institute, HertsHarpendenUK
| | - Merran Thomson
- Neonatal UnitHillingdon Hospitals NHS Foundation TrustUxbridgeUK
| | - Judith Simpson
- Neonatal Intensive Care UnitRoyal Hospital for ChildrenGlasgowUK
| | - Gillian Weaver
- The Human Milk Foundation, Daniel Hall BuildingRothamsted Institute, HertsHarpendenUK
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29
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Ickes SB, Lemein H, Arensen K, Kinyua J, Denno DM, Sanders HK, Walson JL, Martin SL, Nduati R, Palmquist AEL. Perinatal care and breastfeeding education during the COVID-19 pandemic: Perspectives from Kenyan mothers and healthcare workers. MATERNAL & CHILD NUTRITION 2023; 19:e13500. [PMID: 37208841 PMCID: PMC10483952 DOI: 10.1111/mcn.13500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 02/07/2023] [Accepted: 02/15/2023] [Indexed: 05/21/2023]
Abstract
The impact of the COVID-19 pandemic on breastfeeding (BF) practices in low- and middle-income countries (LMICs) is not well understood. Modifications in BF guidelines and delivery platforms for breastfeeding education during the COVID-19 pandemic are hypothesised to have affected BF practices. We aimed to understand the experiences with perinatal care, BF education and practice among Kenyan mothers who delivered infants during the COVID-19 pandemic. We conducted in-depth key informant interviews with 45 mothers who delivered infants between March 2020 and December 2021, and 26 health care workers (HCW) from four health facilities in Naivasha, Kenya. While mothers noted that HCWs provided quality care and BF counselling, individual BF counselling was cited to be less frequent than before the pandemic due to altered conditions in health facilities and COVID-19 safety protocols. Mothers stated that some HCW messages emphasised the immunologic importance of BF. However, knowledge among mothers about the safety of BF in the context of COVID-19 was limited, with few participants reporting specific counselling or educational materials on topics such as COVID-19 transmission through human milk and the safety of nursing during a COVID-19 infection. Mothers described COVID-19-related income loss and lack of support from family and friends as the major challenge to practising exclusive breastfeeding (EBF) as they wished or planned. COVID-19 restrictions limited or prevented mothers' access to familial support at facilities and at home, causing them stress and fatigue. In some cases, mothers reported job loss, time spent seeking new means of employment and food insecurity as causes for milk insufficiency, which contributed to mixed feeding before 6 months. The COVID-19 pandemic created changes to the perinatal experience for mothers. While messages about the importance of practising EBF were provided, altered HCW education delivery methods, reduced social support and food insecurity limit EBF practices for mothers in this context.
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Affiliation(s)
- Scott B. Ickes
- Department of Biological and Health SciencesWheaton CollegeWheatonIllinoisUSA
- Department of Health Systems and Population HealthUniversity of WashingtonSeattleWashingtonUSA
- Kenya Medical Research InstituteNairobiKenya
| | | | - Kelly Arensen
- Department of Biological and Health SciencesWheaton CollegeWheatonIllinoisUSA
| | | | - Donna M. Denno
- Department of Health Systems and Population HealthUniversity of WashingtonSeattleWashingtonUSA
- Department of Global HealthUniversity of WashingtonSeattleWashingtonUSA
- Department of PediatricsUniversity of WashingtonSeattleWashingtonUSA
| | - Hannah K. Sanders
- Department of Biological and Health SciencesWheaton CollegeWheatonIllinoisUSA
| | - Judd L. Walson
- Department of Global HealthUniversity of WashingtonSeattleWashingtonUSA
- Department of PediatricsUniversity of WashingtonSeattleWashingtonUSA
- Departments of Medicine (Allergy and Infectious Disease) and EpidemiologyUniversity of WashingtonSeattleWashingtonUSA
| | - Stephanie L. Martin
- Department of Nutrition, Chapel Hill Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Ruth Nduati
- Department of Pediatrics and Child HealthUniversity of NairobiNairobiKenya
| | - Aunchalee E. L. Palmquist
- Department of Maternal and Child Health, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
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30
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Stott D, Klobodu C, Chiarello LA, Posmontier B, Egohail M, Geller PA, Andrews Horowitz J, Milliron BJ. Nutrition-Related Experiences of Women With Perinatal Depression During the COVID-19 Pandemic: A Qualitative Study. J Patient Exp 2023; 10:23743735231199818. [PMID: 37693189 PMCID: PMC10486215 DOI: 10.1177/23743735231199818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
Women with perinatal depression are at a high risk for unhealthy dietary behaviors but whether the coronavirus disease 2019 (COVID-19) pandemic has exacerbated this risk is unknown. Here we report the findings of a qualitative study exploring the impact of the COVID-19 pandemic on nutrition-related experiences of women with perinatal depression. Using a qualitative descriptive approach, in-depth interviews were conducted with 18 women with a history of perinatal depression and 10 healthcare providers. A semistructured format elicited how food and nutrition-related behaviors of women with perinatal depression were affected by the COVID-19 pandemic. Thematic analysis identified 4 themes related to the COVID-19 pandemic: (1) Adaptations in shopping and cooking behaviors; (2) increases in stress and declines in respite; (3) declines in support and increases in isolation; and (4) low levels of breastfeeding guidance. Our findings confirm the importance of resilience among women with perinatal depression and future research is needed to elucidate the mechanisms connecting resilience and dietary behaviors.
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Affiliation(s)
- Dahlia Stott
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Cynthia Klobodu
- Department of Nutrition and Food Science, College of Natural Sciences, California State University, Chico, Chico, CA, USA
| | - Lisa A Chiarello
- Department of Physical Therapy and Rehabilitation Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Bobbie Posmontier
- PhD in Nursing Program, College of Nursing, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Pamela A Geller
- Department of Psychological and Brain Sciences, College of Arts and Sciences, Drexel University, Philadelphia, PA, USA
| | - June Andrews Horowitz
- College of Nursing and Health Sciences, University of Massachusetts Dartmouth, Dartmouth, MA, USA
| | - Brandy-Joe Milliron
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
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31
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Cummins A, Sheehy A, Taylor J, DeVitry-Smith S, Nightingale H, Davis D. Association of continuity of carer and women's experiences of maternity care during the COVID-19 pandemic: A cross-sectional survey. Midwifery 2023; 124:103761. [PMID: 37327712 PMCID: PMC10257573 DOI: 10.1016/j.midw.2023.103761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 03/19/2023] [Accepted: 06/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Recent research highlights the impact of the COVID-19 pandemic on maternity services, although none to date have analysed the association between continuity of carer and how women felt about the changes to pregnancy care and birth plans. AIM To describe pregnant women's self-reported changes to their planned pregnancy care and associations between continuity of carer and how women feel about changes to their planned care. METHODS A cross-sectional online survey of pregnant women aged over 18 years in their final trimester of pregnancy in Australia. FINDINGS 1668 women completed the survey. Most women reported at least one change to pregnancy care and birthing plans. Women receiving full continuity of carer were more likely to rate the changes to care as neutral/positive (p<.001) when compared with women who received partial or no continuity. DISCUSSION Pregnant women experienced many changes to their planned pregnancy and birth care during the COVID-19 pandemic. Women who received full continuity of carer experienced fewer changes to care and were more likely to feel neutral/positive about the changes than women who did not receive full continuity of carer.
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Affiliation(s)
- Allison Cummins
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Australia.
| | - Annabel Sheehy
- Centre for Midwifery, Child and Family Health - University of Technology Sydney, 235 Jones St, Ultimo, NSW 2007, Australia
| | - Jan Taylor
- University of Canberra and ACT Government, Health Directorate, Australia
| | | | - Helen Nightingale
- La Trobe Rural Health School, La Trobe University, PO Box 199, Bendigo 3552, Australia
| | - Deborah Davis
- University of Canberra and ACT Government, Health Directorate, Australia
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32
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AlHreashy FA, AlObeid GA, Elbashir BMA, Alshathry AS. Telemedicine Breastfeeding Consultation: The Saudi Experience. Cureus 2023; 15:e45392. [PMID: 37854766 PMCID: PMC10580215 DOI: 10.7759/cureus.45392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2023] [Indexed: 10/20/2023] Open
Abstract
Background Telemedicine is widely used in health specialties. Yet, the experience of telemedicine use and its effectiveness in breastfeeding support is a research gap. The purpose of this study was to describe the pattern of telemedicine use for breastfeeding support in Saudi Arabia and to explore patients' satisfaction with the service. Methods A cross-sectional survey was conducted in outpatient settings at Ministry of Health facilities in several Saudi regions. The number of breastfeeding consultations over one year (2021) was analyzed in terms of region, month, method of consultation, and women's maternity status. Data on patient satisfaction and telemedicine techniques were gathered during 2022. Results Across the 16 regions enrolled in the project, 51,571 remote breastfeeding consultations were conducted, representing 28.2% of the total consultations. The eastern region reported the highest percentage (40.7%), and the southern region reported the lowest (2.4%). Almost two-thirds of the consultations were provided to lactating mothers (62.91%). Most data (90%) were collected from breastfeeding clinics in hospitals, and nurses were the main primary health care providers. The mean was 4,255 consultations per month. In terms of technology, telemedicine consultations were mostly conducted by phone (50%) and WhatsApp (38%). Satisfaction with telemedicine was reported by 80% of the participants, with a statistical difference found in those favoring telemedicine over in-person care (p=0.032), particularly for those using phone consultations and Telegram (p<0.001). WhatsApp respondents had the commonest neutral responses (p<0.001). Conclusion Telemedicine breastfeeding care has been widely established with high patient satisfaction. A national protocol outpatient lactation services with an intergrated hospital and primary care services and involvement of different health care professionals are recommended. Although breastfeeding counselling is proven to have a positive change on breastfeeding indicators, telemedicine tool per se needs further work on its role in breastfeeding indicators. Triage of cases to be evaluated face-to-face or referral to a specialist after telemedicine lactation care is an area for future work.
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Affiliation(s)
- Fouzia Abdulaziz AlHreashy
- Family Medicine, General Directorate of Nutrition, Deputyship of Therapeutic Services, Ministry of Health, Riyadh, SAU
| | - Gazi Ali AlObeid
- Health Education, Al-Ahsa Health Directorate, Ministry of Health, Al-Ahsa, SAU
| | - Bushra M A Elbashir
- Clinical Nutrition, General Directorate of Nutrition, Deputyship of Therapeutic Services, Ministry of Health, Riyadh, SAU
| | - Albandri Saleh Alshathry
- Clinical Nutrition, General Directorate of Nutrition, Deputyship of Therapeutic Services, Ministry of Health, Riyadh, SAU
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33
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Vacaru SV, Scatolin SW, van den Heuvel MI, Beijers R, de Weerth C. Breastfeeding and room-sharing during COVID-19 in the Netherlands: The impact of perinatal healthcare support. Early Hum Dev 2023; 183:105812. [PMID: 37379684 PMCID: PMC10290183 DOI: 10.1016/j.earlhumdev.2023.105812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/20/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023]
Abstract
AIM The recommendations of 6 months of exclusive breastfeeding (EBF) and parent-infant room-sharing (RS) are often not followed. As these early caregiving practices may have been affected by the COVID-19-related restrictions, we documented BF and RS practices in the Netherlands (2020-2021) and the effects of perceived perinatal healthcare support. METHODS Pregnant women and mothers of an infant younger than 6 months (N = 784) completed online questionnaires (e.g., demographic information, the impact of COVID-19 on their lives aspects, infant childcare practices) twice: at the beginning of the pandemic and when the infant reached 6 months of age. RESULTS The pandemic EBF practices mirrored pre-pandemic Dutch reports (17.8 %; Mduration = 3.4 months), while RS rates and duration seemingly doubled (30.6 %; Mduration = 3.98 months). Higher maternal education (r = 0.18) and multiparity (r = 0.08) were significantly associated with longer EBF, and similarly for education (r = 0.17) and multiparity (r = 0.11) with RS durations. Higher perceived perinatal healthcare support predicted shorter RS duration [β = -0.509, t(5,596) = -2.27, p = .023]. CONCLUSION While the COVID-19 pandemic did not impact EBF, it may have promoted RS. The negative association between perinatal healthcare support and RS may suggest that parents who need more support from their providers also experience more challenges adhering to RS recommendations, yet this hypothesis remains to be corroborated.
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Affiliation(s)
- Stefania V Vacaru
- Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, the Netherlands.
| | | | | | - Roseriet Beijers
- Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, the Netherlands; Radboud University, Nijmegen, the Netherlands
| | - Carolina de Weerth
- Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, the Netherlands
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Silva CF, Bezerra ICDS, Soares AR, Leal ASLG, Faustino WDM, Reichert APDS. Implications of the COVID-19 pandemic on breastfeeding and health promotion: perceptions of breastfeeding women. CIENCIA & SAUDE COLETIVA 2023; 28:2183-2192. [PMID: 37531527 DOI: 10.1590/1413-81232023288.05882023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 03/28/2023] [Indexed: 08/04/2023] Open
Abstract
This article aims to understand the implications of the COVID-19 pandemic on breastfeeding and health promotion actions within primary care from the perception of breastfeeding women. This qualitative study was developed with 24 women who breastfed during the first year of the pandemic. Data were analyzed using Content Analysis and interpreted in the light of the Interactive Breastfeeding Theory (IBT). The pandemic affected the vulnerability of the mental health of breastfeeding women, entailed difficulties for the continuity of breastfeeding and early insertion of formulas, impacted COVID-19 preventive measures in breastfeeding, and produced changes in the work of breastfeeding women. Furthermore, areas for improvement were identified in health promotion actions and the mother-child binomial support due to the interruption of childcare visits. Actions to promote child health in primary care were unsatisfactory. However, most study participants maintained exclusive breastfeeding for the first six months, which could adversely affect child morbimortality.
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Affiliation(s)
- Clariana Falcão Silva
- Universidade Federal da Paraíba (UFPB). Campus I Lot. Cidade Universitária. 58051-900 João Pessoa PB Brasil.
| | | | - Anniely Rodrigues Soares
- Universidade Federal da Paraíba (UFPB). Campus I Lot. Cidade Universitária. 58051-900 João Pessoa PB Brasil.
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Ruiz MT, de Oliveira KF, Azevedo NF, Paschoini MC, Rodrigues WF, de Oliveira CJF, de Oliveira JF, Fonseca LMM, Wernet M. Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review. Rev Bras Enferm 2023; 76Suppl 1:e20220173. [PMID: 37531480 PMCID: PMC10389650 DOI: 10.1590/0034-7167-2022-0173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 01/17/2023] [Indexed: 08/04/2023] Open
Abstract
OBJECTIVES to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19. METHODS a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation. RESULTS fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90-72.88), and artificial breastfeeding, 43.23% (CI = 30.99 - 55.88), without statistically significant differences. CONCLUSIONS despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Monika Wernet
- Universidade Federal de São Carlos. São Carlos, São Paulo, Brazil
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Lawlor N, Prihodova L, Byrne D, Etherton M, Rahill F, Wilson C, O'Sullivan EJ. A qualitative analysis of women's postnatal experiences of breastfeeding supports during the perinatal period in Ireland. PLoS One 2023; 18:e0288230. [PMID: 37494302 PMCID: PMC10370717 DOI: 10.1371/journal.pone.0288230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/22/2023] [Indexed: 07/28/2023] Open
Abstract
Ireland has among the lowest rates of breastfeeding worldwide. Despite policies to support breastfeeding, breastfeeding initiation and exclusivity remain low in Ireland. Greater knowledge about support received in the maternity unit may-in part-shed light on why this is so. Our aim was to analyse women's experiences of the breastfeeding supports available in the early postnatal period in Ireland. We conducted an analysis of an open-ended question on a cross-sectional survey about breastfeeding support conducted in the Republic of Ireland in 2022. Participants were asked to provide comments about the breastfeeding support they received in the maternity unit or during your home birth. Data were analysed using Braun and Clarke's six-step Thematic Analysis Framework. There were 5,412 unique responses to the survey and 2,264 responses to the question of interest. Two themes were generated from the data: (i) 'Breastfeeding support in theory but not in practice.' Although breastfeeding was promoted by healthcare professionals antenatally, breastfeeding challenges were rarely mentioned. Participants then felt unsupported in overcoming challenges postnatally. (ii) 'Support was either inaccessible due to lack of staff/time, inadequate; i.e., unhelpful or non-specific, and/or physically inappropriate.' Most participants described receiving supports that were less than optimal in aiding them to establish breastfeeding. While many described difficulties in accessing supports, others found support to be 'non-specific,' 'rushed' and sometimes 'rough.' A lack of knowledge, time and support from healthcare professionals was frequently described, which was often recognised as a failing of the healthcare system. Women require practical, informative, and specific breastfeeding support. Barriers such as lack of time and trained staff in the maternity unit need to be addressed.
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Affiliation(s)
- Niamh Lawlor
- School of Biological, Health and Sports Sciences, Technological University Dublin, Dublin, Ireland
| | - Lucia Prihodova
- Bainne Beatha, Parent-led Breastfeeding Advocacy Group, Dublin, Ireland
| | - Deborah Byrne
- Bainne Beatha, Parent-led Breastfeeding Advocacy Group, Dublin, Ireland
| | - Megan Etherton
- Bainne Beatha, Parent-led Breastfeeding Advocacy Group, Dublin, Ireland
| | - Felicienne Rahill
- Bainne Beatha, Parent-led Breastfeeding Advocacy Group, Dublin, Ireland
| | - Catie Wilson
- Bainne Beatha, Parent-led Breastfeeding Advocacy Group, Dublin, Ireland
| | - Elizabeth J O'Sullivan
- School of Biological, Health and Sports Sciences, Technological University Dublin, Dublin, Ireland
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Jegatheesan P, Narasimhan SR, Huang A, Nudelman M, Song D. Higher NICU admissions in infants born at ≥35 weeks gestational age during the COVID-19 pandemic. Front Pediatr 2023; 11:1206036. [PMID: 37484778 PMCID: PMC10360125 DOI: 10.3389/fped.2023.1206036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/23/2023] [Indexed: 07/25/2023] Open
Abstract
Background Increasing evidence has shown that the COVID-19 pandemic has had a profound negative impact on vulnerable populations and a significant effect on maternal and neonatal health. We observed an increase in the percentage of infants admitted to NICU from 8% to 10% in the first year of the pandemic. This study aimed to compare the delivery room outcomes, NICU admissions and interventions, and neonatal outcomes two years before and during the pandemic. Methods This was a retrospective study in a public hospital between pre-COVID-19 (April 2018-December 2019) and COVID-19 (April 2020-December 2021). Data were obtained from all live births at ≥35 weeks gestation (GA). Maternal and neonatal demographics, delivery room (DR), and NICU neonatal outcomes were compared between the study periods using simple bivariable generalized estimating equations (GEE) regression. Multivariable GEE logistic regression analysis was performed to adjust for the effects of baseline differences in demographics on the outcomes. Results A total of 9,632 infants were born ≥35 weeks gestation during the study period (pre-COVID-19 n = 4,967, COVID-19 n = 4,665). During the COVID-19 period, there was a small but significant decrease in birth weight (33 g); increases in maternal diabetes (3.3%), hypertension (4.1%), and Hispanic ethnicity (4.7%). There was a decrease in infants who received three minutes (78.1% vs. 70.3%, p < 0.001) of delayed cord clamping and increases in the exclusive breastfeeding rate (65.9% vs. 70.1%, p < 0.001), metabolic acidosis (0.7% vs. 1.2%, p = 0.02), NICU admission (5.1% vs. 6.4%, p = 0.009), antibiotic (0.7% vs. 1.7%, p < 0.001), and nasal CPAP (1.2% vs. 1.8%, p = 0.02) use. NICU admissions and nasal CPAP were not significantly increased after adjusting for GA, maternal diabetes, and hypertension; however, other differences remained significant. Maternal hypertension was an independent risk factor for all these outcomes. Conclusion During the COVID-19 pandemic period, we observed a significant increase in maternal morbidities, exclusive breastfeeding, and NICU admissions in infants born at ≥35 weeks gestation. The increase in NICU admission during the COVID-19 pandemic was explained by maternal hypertension, but other adverse neonatal outcomes were only partly explained by maternal hypertension. Socio-economic factors and other social determinants of health need to be further explored to understand the full impact on neonatal outcomes.
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Affiliation(s)
- Priya Jegatheesan
- Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, United States
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Sudha Rani Narasimhan
- Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, United States
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Angela Huang
- Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, United States
| | - Matthew Nudelman
- Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, United States
- Neonatology/Pediatrics, Mountain Health Network, Marshall University, Huntington, WV, United States
| | - Dongli Song
- Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, United States
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
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Antoniou E, Tzitiridou-Chatzopoulou M, Voyatzaki C, Iliadou M, Eskitzis P, Dagla M, Palaska E, Orovou E. What Are the Implications of COVID-19 on Breastfeeding? A Synthesis of Qualitative Evidence Studies. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1178. [PMID: 37508675 PMCID: PMC10378339 DOI: 10.3390/children10071178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 06/24/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION Exclusive breastfeeding until six months of life is the ideal way to feed infants. However, there is a significant number of infants who have never breastfed, despite the beneficial properties of breastfeeding. On the other hand, the coronavirus outbreak had significant effects on people's health, both mentally and physically, and has also impacted the breastfeeding process. AIM The aim of this study was to investigate the implication of COVID-19 on breastfeeding through qualitative data from databases. METHODS We searched online databases (PubMed, Google Scholar, PsycINFO) for studies published from 2019 to 2023. 'Out of the 2598 papers we found, only 12 were included in the review'. More specifically, from the 1558 papers remaining from the title and abstract evaluation as well as duplicates, a further 1546 papers belonging to our exclusion criteria were removed (all types of reviews, letters to editors, and quantitative articles). RESULTS Our results covered three subjects: breastfeeding support during the pandemic, effects of social containment measures on breastfeeding, and additional outcomes regarding breastfeeding. Most voices found the effects of the pandemic on breastfeeding beneficial, with reduced professional support and a high degree of support from the environment. Additional negative factors were observed, as well as consequences of the pandemic in women's lives. CONCLUSIONS COVID-19 was the occasion to understand the power of the supportive environment of the woman, especially the partner, in establishing and maintaining breastfeeding. Therefore, policy makers and health professionals, especially midwives, should implement family-centered breastfeeding strategies that are more supportive of the partner role, providing problem counseling when and where deemed necessary.
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Affiliation(s)
- Evangelia Antoniou
- Department of Midwifery, Egaleo Park Campus, University of West Attica, Ag. Spyridonos Str., 12243 Egaleo, Greece
| | | | - Chrysa Voyatzaki
- Department of Biomedical Sciences, Egaleo Park Campus, University of West Attica, Ag. Spyridonos Str., 12243 Egaleo, Greece
| | - Maria Iliadou
- Department of Midwifery, Egaleo Park Campus, University of West Attica, Ag. Spyridonos Str., 12243 Egaleo, Greece
| | - Panagiotis Eskitzis
- Department of Midwifery, University of Western Macedonia, 50200 Ptolemaida, Greece
| | - Maria Dagla
- Department of Midwifery, Egaleo Park Campus, University of West Attica, Ag. Spyridonos Str., 12243 Egaleo, Greece
| | - Ermioni Palaska
- Department of Midwifery, Egaleo Park Campus, University of West Attica, Ag. Spyridonos Str., 12243 Egaleo, Greece
| | - Eirini Orovou
- Department of Midwifery, Egaleo Park Campus, University of West Attica, Ag. Spyridonos Str., 12243 Egaleo, Greece
- Department of Midwifery, University of Western Macedonia, 50200 Ptolemaida, Greece
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Navarro-Rosenblatt D, Benmarhnia T, Bedregal P, Lopez-Arana S, Rodriguez-Osiac L, Garmendia ML. The impact of health policies and the COVID-19 pandemic on exclusive breastfeeding in Chile during 2009-2020. Sci Rep 2023; 13:10671. [PMID: 37393366 PMCID: PMC10314914 DOI: 10.1038/s41598-023-37675-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/26/2023] [Indexed: 07/03/2023] Open
Abstract
In 2011, Chile added 12 mandatory extra weeks of maternity leave (ML). In January 2015, a pay-for-performance (P4P) strategy was included in the primary healthcare system, incorporating exclusive breastfeeding (EBF) promotion actions. The COVID-19 pandemic led to healthcare access difficulties and augmented household workloads. Our aim was to evaluate the effect of a 24-week ML, the P4P strategy, and COVID-19 on EBF prevalence, at 3 and 6 months in Chile. Aggregated EBF prevalence data from public healthcare users nationwide (80% of the Chilean population) was collected by month. Interrupted time series analyses were used to quantify changes in EBF trends from 2009 to 2020. The heterogeneity of EBF changes was assessed by urban/setting and across geographic settings. We found no effect of ML on EBF; the P4P strategy increased EBF at 3 months by 3.1% and 5.7% at 6 months. COVID-19 reduced EBF at 3 months by - 4.5%. Geographical heterogeneity in the impact of the two policies and COVID-19 on EBF was identified. The null effect of ML on EBF in the public healthcare system could be explained by low access from public healthcare users to ML (20% had access to ML) and by an insufficient ML duration (five and a half months). The negative impact of COVID-19 on EBF should alert policy makers about the crisis's effect on health promotion activities.
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Affiliation(s)
- Deborah Navarro-Rosenblatt
- PhD Program, School of Public Health, University of Chile, Av. Independencia 939, Independencia, Santiago, Chile
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California at San Diego, California, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Paula Bedregal
- School of Public Health, Pontifical Catholic University of Chile, Av. Libertador Bernardo O'Higgins 340, Santiago, Chile
| | - Sandra Lopez-Arana
- Department of Nutrition, Faculty of Medicine, University of Chile, Av. Independencia 1027, Santiago, Chile
| | | | - Maria Luisa Garmendia
- Institute of Nutrition and Food Technology, University of Chile, Av. El Libano 5524, Macul, Santiago, Chile.
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Feduniw S, Kajdy A, Sys D, Malinowska O, Wieczorek K, Bagińska K, Rabijewski M, Tataj-Puzyna U, Baranowska B. Did everyone change their childbirth plans due to the COVID-19 pandemic? A web-based cross-sectional survey of Polish pregnant women. J Adv Nurs 2023; 79:2664-2674. [PMID: 36895080 DOI: 10.1111/jan.15621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 11/22/2022] [Accepted: 02/19/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND AND AIM With the worldwide outbreak of coronavirus, a significant impact has been observed on the functioning of healthcare systems and the process of childbirth. Women probably did not even have a choice to adjust their plans accordingly to the current situation. The aim of the study was to examine how the outbreak of the SARS CoV-2 pandemic state affected the decisions of pregnant women about their childbirth plan. DESIGN This cross-sectional study was performed using a web-based survey published on social media in Poland. METHODS The cross-sectional study was performed using web-based questionnaires. The study group included Polish women who changed their childbirth plans, compared to a group of women not sure about delivery plan change and those whose plans had not changed. The data were collected from 4 March 2020 to 2 May 2020, when the first rising count of new infections was observed in Poland and worldwide. Statistical analysis was performed using STATISTICA Software, Inc., 13.3 (2020). RESULTS Of 969 women who completed the questionnaire and were enrolled into the study, 57.2% had not changed their childbirth plans (group I), 28.4% had changed their plans (group II), and 14.4% of respondents answered "not sure" to this question (group III). The majority of women changed their birth plans during the pandemic because of the potential absence of their partner during labour (56% of women who had changed their plans and 48% of those whose answer was "I am not sure", p < .001). Another reason was the fear of separation from the child after delivery (33% of women who had changed their plans and 30% of those whose answer was "I am not sure", p < .001). CONCLUSION Restrictions due to the COVID-19 outbreak have influenced the childbirth plans of pregnant women. The changes were independent of women's vision of birth before the pandemic. IMPACT The restriction on births with accompanying person and the risk of separation from their infant after childbirth significantly influenced the decision-making process. As a result, some women were more likely to opt for a home birth with or even without medical assistance. PATIENT OR PUBLIC CONTRIBUTION The study participants were women who were pregnant at the time of completing the questionnaire, were over 18 years old and spoke Polish.
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Affiliation(s)
- Stepan Feduniw
- Department of Gynecology, University Zürich, Zürich, Switzerland
| | - Anna Kajdy
- I-st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Dorota Sys
- Department of Medical Statistics, School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | | | | | - Michał Rabijewski
- Department of Reproductive Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Urszula Tataj-Puzyna
- Department of Midwifery, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Barbara Baranowska
- Department of Midwifery, Centre of Postgraduate Medical Education, Warsaw, Poland
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Wijenayake S, Martz J, Lapp HE, Storm JA, Champagne FA, Kentner AC. The contributions of parental lactation on offspring development: It's not udder nonsense! Horm Behav 2023; 153:105375. [PMID: 37269591 PMCID: PMC10351876 DOI: 10.1016/j.yhbeh.2023.105375] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/11/2023] [Accepted: 05/13/2023] [Indexed: 06/05/2023]
Abstract
The Developmental Origins of Health and Disease (DOHaD) hypothesis describes how maternal stress exposures experienced during critical periods of perinatal life are linked to altered developmental trajectories in offspring. Perinatal stress also induces changes in lactogenesis, milk volume, maternal care, and the nutritive and non-nutritive components of milk, affecting short and long-term developmental outcomes in offspring. For instance, selective early life stressors shape the contents of milk, including macro/micronutrients, immune components, microbiota, enzymes, hormones, milk-derived extracellular vesicles, and milk microRNAs. In this review, we highlight the contributions of parental lactation to offspring development by examining changes in the composition of breast milk in response to three well-characterized maternal stressors: nutritive stress, immune stress, and psychological stress. We discuss recent findings in human, animal, and in vitro models, their clinical relevance, study limitations, and potential therapeutic significance to improving human health and infant survival. We also discuss the benefits of enrichment methods and support tools that can be used to improve milk quality and volume as well as related developmental outcomes in offspring. Lastly, we use evidence-based primary literature to convey that even though select maternal stressors may modulate lactation biology (by influencing milk composition) depending on the severity and length of exposure, exclusive and/or prolonged milk feeding may attenuate the negative in utero effects of early life stressors and promote healthy developmental trajectories. Overall, scientific evidence supports lactation to be protective against nutritive and immune stressors, but the benefits of lactation in response to psychological stressors need further investigation.
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Affiliation(s)
- Sanoji Wijenayake
- Department of Biology, The University of Winnipeg, Winnipeg, Manitoba, Canada.
| | - Julia Martz
- School of Arts & Sciences, Health Psychology Program, Massachusetts College of Pharmacy and Health Sciences, Boston, MA, USA
| | - Hannah E Lapp
- Deparment of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Jasmyne A Storm
- Department of Biology, The University of Winnipeg, Winnipeg, Manitoba, Canada
| | | | - Amanda C Kentner
- School of Arts & Sciences, Health Psychology Program, Massachusetts College of Pharmacy and Health Sciences, Boston, MA, USA.
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Haeusslein L, Gano D, Gay CL, Kriz RM, Bisgaard R, Vega M, Cormier DM, Joe P, Walker V, Kim JH, Lin C, Sun Y, Franck LS. Relationship between social support and post-discharge mental health symptoms in mothers of preterm infants. J Reprod Infant Psychol 2023; 41:260-274. [PMID: 34587850 PMCID: PMC8960471 DOI: 10.1080/02646838.2021.1984404] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/17/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Social support is associated with decreased symptoms of postpartum mood and anxiety disorders (PMAD) in mothers of healthy infants, but less is known about social support and PMADs in mothers with preterm infants. The purpose of this study was to examine the relationship between social support and symptoms of PMADs reported by mothers in the months following hospital discharge of their preterm infant. METHODS Mothers of infants less than 33 weeks gestational age were enrolled from neonatal intensive care units (NICU) at 6 sites. Mothers completed PMAD measures of depression, anxiety and post-traumatic stress approximately 3 months following their infant's discharge. Multivariable regression was used to evaluate relationships between social support and PMAD measures. RESULTS Of 129 mothers, 1 in 5 reported clinically significant PMAD symptoms of: depression (24%), anxiety (19%), and post-traumatic stress (20%). Social support was strongly inversely associated with all 3 PMADs. Social support explained between 21% and 26% of the variance in depression, anxiety and post-traumatic stress symptoms. CONCLUSION Increased social support may buffer PMAD symptoms in mothers of preterm infants after discharge. Research is needed to determine effective screening and interventions aimed at promoting social support for all parents during and following their infant's hospitalisation.
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Affiliation(s)
- Laurel Haeusslein
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Dawn Gano
- Department of Neurology and Pediatrics, UCSF
| | - Caryl L. Gay
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Rebecca M. Kriz
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Robin Bisgaard
- Intensive Care Nursery, UCSF Benioff Children’s Hospital, San Francisco
| | - Myrna Vega
- Intensive Care Nursery, UCSF Benioff Children’s Hospital, San Francisco
| | | | - Priscilla Joe
- Division of Neonatology, UCSF Benioff Children’s Hospital, Oakland
| | - Valencia Walker
- Department of Pediatrics, Division of Neonatology, The Ohio State University College of Medicine, Columbus, Ohio
| | - Jae H. Kim
- Division of Neonatology, Perinatal Institute, Cincinnati Children’s Hospital Medical Center
| | - Carol Lin
- Division of Neonatology, Kaiser Permanente Santa Clara
| | - Yao Sun
- Division of Neonatology, UCSF Benioff Children’s Hospital, San Francisco
| | - Linda S. Franck
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, California, USA
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Ganho-Ávila A, Guiomar R, Sobral M, Pacheco F, Caparros-Gonzalez RA, Diaz-Louzao C, Motrico E, Domínguez-Salas S, Mesquita A, Costa R, Vousoura E, Hadjigeorgiou E, Bina R, Buhagiar R, Mateus V, Contreras-García Y, Wilson CA, Ajaz E, Hancheva C, Dikmen-Yildiz P, de la Torre-Luque A. The impact of COVID-19 on breastfeeding rates: An international cross-sectional study. Midwifery 2023; 120:103631. [PMID: 36822049 PMCID: PMC9922537 DOI: 10.1016/j.midw.2023.103631] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 01/17/2023] [Accepted: 02/06/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND Breastfeeding promotes children's health and is associated with positive effects to maternal physical and mental health. Uncertainties regarding SARS-CoV-2 transmission led to worries experienced by women and health professionals which impacted breastfeeding plans. We aimed to investigate the impact of self-reported and country-specific factors on breastfeeding rates during the COVID-19 pandemic. METHODS This study is part of a broader international prospective cohort study about the impact of the COVID-19 pandemic on perinatal mental health (Riseup-PPD-COVID-19). We analysed data from 5612 women, across 12 countries. Potential covariates of breastfeeding (sociodemographic, perinatal, physical/mental health, professional perinatal care, changes in healthcare due to the pandemic, COVID-19 related, breastfeeding support, governmental containment measures and countries' inequality levels) were studied by Generalized Linear Mixed-Effects Models. RESULTS A model encompassing all covariates of interest explained 24% of the variance of breastfeeding rates across countries (first six months postpartum). Overall, first child (β = -0.27), age of the child (β = -0.29), preterm birth (β = -0.52), admission to the neonatal/pediatric care (β = -0.44), lack of breastfeeding support (β = -0.18), current psychiatric treatment (β = -0.69) and inequality (β = -0.71) were negatively associated with breastfeeding (p < .001). Access to postnatal support groups was positively associated with breastfeeding (β = 0.59; p < .001). In countries with low-inequality, governmental measures to contain virus transmission had a deleterious effect on breastfeeding (β = -0.16; p < .05) while access to maternity leave protected breastfeeding (β = 0.50; p < .001). DISCUSSION This study shows that mother's COVID-19 diagnosis and changes in healthcare and birth/postnatal plans did not influence breastfeeding rates. Virtual support groups help women manage breastfeeding, particularly when their experiencing a first child and for those under psychiatric treatment. The complex associations between covariates and breastfeeding vary across countries, suggesting the need to define context-specific measures to support breastfeeding.
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Affiliation(s)
- Ana Ganho-Ávila
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal.
| | - Raquel Guiomar
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal.
| | - Mónica Sobral
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal
| | - Francisca Pacheco
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal
| | - Rafael A Caparros-Gonzalez
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; Instituto de Investigación Biosanitaria ibs. Granada, Spain; Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain
| | - Carla Diaz-Louzao
- Research Methodology Group, University Clinical Hospital of Santiago (CHUS), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, 15706, Spain
| | - Emma Motrico
- Psychology Department, Universidad Loyola Andalucia, Avenida de las Universidades s/n, Dos Hermanas (Sevilla), Spain
| | - Sara Domínguez-Salas
- Psychology Department, Universidad Loyola Andalucia, Avenida de las Universidades s/n, Dos Hermanas (Sevilla), Spain
| | - Ana Mesquita
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Raquel Costa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; HEI-Lab: Digital Human-environment Interaction. Lusófona University, Lisbon, Portugal
| | - Eleni Vousoura
- Department of Psychology, National and Kapodistrian University of Athens, Greece
| | - Eleni Hadjigeorgiou
- Nursing Department, School of Health Science, Cyprus University of Technology, Cyprus
| | - Rena Bina
- School of Social Work, Bar Ilan University, Ramat Gan, Israel
| | | | - Vera Mateus
- Graduate Program on Developmental Disorders and Mackenzie Center for Research in Childhood and Adolescence, Center for Biological and Health Sciences, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Yolanda Contreras-García
- Departamento de Obstetricia y Puericultura. Facultad de Medicina. Universidad de Concepción, Chile
| | - Claire A Wilson
- Section of Women's Mental Health, King's College London and South London and Maudsley NHS Foundation Trust, UK
| | | | | | | | - Alejandro de la Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid. Centre for Biomedical Research in Mental Health (CIBERSAM), 28040 Madrid, Spain
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Matyas M, Valeanu M, Hasmasanu M, Voina B, Tutu A, Zaharie GC. The Effect of Maternal SARS-CoV-2 Infection on Neonatal Outcome. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050771. [PMID: 37238319 DOI: 10.3390/children10050771] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 04/15/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023]
Abstract
(1) Background: Neonates born to SARS-CoV-2 positive mothers are at risk of infection, as well as adverse outcomes due to the infection. The aim of our study was to analyze the impact of maternal SARS-CoV-2 infection on neonatal outcome. (2) Methods: We conducted a prospective, longitudinal study. We collected data on maternal symptomatology upon admission and their correlation with the development of the infant. Through a questionnaire we analyzed the impact on breastfeeding of the separation of the mother from the newborn, as well as the maternal psycho-emotional effect. (3) Results: Ninety infants were enrolled in the study, from one twin pregnancy and the rest singleton pregnancies. Out of the 89 mothers, 34 showed symptoms. Neonates from mothers with anosmia and ageusia had a higher value of WBC and lymphocytes (p = 0.06 and p = 0.04). Breastfeeding was started in 57.3% of mothers after their discharge from hospital and only 41.6% of the whole study group continued at the follow-up visit. Mothers who described a negative experience during hospitalization associated a 2.42 times higher risk of not continuing breastfeeding. (4) Conclusion: None of the infants enrolled in the study had SARS-CoV-2 infection either at birth or within the first two months of life. Breastfeeding was started with more than half newborns after discharge from hospital. The negative experience generated by the separation from their babies influenced breastfeeding.
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Affiliation(s)
- Melinda Matyas
- Neonatology Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj Napoca, Romania
| | - Madalina Valeanu
- Medical Informatics and Biostatistics Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj Napoca, Romania
| | - Monica Hasmasanu
- Neonatology Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj Napoca, Romania
| | - Bianca Voina
- Neonatology Department, County Emergency Hospital, 400006 Cluj Napoca, Romania
| | - Adelina Tutu
- Neonatology Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj Napoca, Romania
| | - Gabriela C Zaharie
- Neonatology Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj Napoca, Romania
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Parlak ME, Öz E, Küçükkelepçe O. COVID-19 Vaccination and Breastfeeding Mothers in Kahta District, Turkey. Vaccines (Basel) 2023; 11:vaccines11040813. [PMID: 37112725 PMCID: PMC10143137 DOI: 10.3390/vaccines11040813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/29/2023] Open
Abstract
We aimed to determine the attitudes and behaviors of breastfeeding mothers regarding the vaccine by examining their knowledge of the COVID-19 virus vaccine and their hesitations about it. The research is a cross-sectional and descriptive study conducted in the Kahta district of Adıyaman, a southeastern province in Turkey, between January and May 2022. The study population consisted of 405 mothers who applied to the Kahta State Hospital Pediatrics outpatient clinic. A questionnaire form was used as a data collection tool, and a consent form was obtained from the participants. The vaccination rate (89%) of those who graduated from high school and above was significantly higher than that of those who graduated from secondary school or below (77.7%). As the economic situation worsened, the vaccination rate decreased. The vaccination rate (85.7%) of mothers whose breastfed child was 0-6 months old was found to be significantly higher than that of those with 7-24-month-olds (76.4%) (p:0.02). The rate of being vaccinated (73.3%) of those who had a new type of COVID-19 virus infection was significantly lower than the rate of being vaccinated (86.3%) of those who did not have a COVID-19 virus infection. The vaccination rate of those who received information from their family doctor and the internet was higher than that of those who received information from radio/TV and people around. The rate of mothers thinking babies should stop breastfeeding who graduated from secondary school or below was higher (53.2%) than the rate of mothers who graduated from high school or above (30.2%) to be vaccinated against the COVID-19 virus. To eliminate the hesitancy about vaccination in mothers, it is necessary to inform and educate the whole society correctly, starting with families with low education and economic levels.
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Affiliation(s)
- Mehmet Emin Parlak
- Adıyaman University Training and Research Hospital, Adıyaman 02100, Turkey
| | - Erdoğan Öz
- Adıyaman Province Health Directorate, Adıyaman 02100, Turkey
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Winkel T, Wilson J, Spence M, Colby S, Springer C, Hedrick M, Kavanagh K. Tethered Oral Tissue Release Among Breastfed Infants: Maternal Sources of Information and Treatment. J Hum Lact 2023:8903344231159378. [PMID: 36945736 DOI: 10.1177/08903344231159378] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND Despite limited clinical consensus regarding surgery for tethered oral tissues ("tongue-tie") for resolving breastfeeding-related issues, the procedure has been increasing in the United States. Greater understanding of maternal experiences with obtaining surgical release may help to improve breastfeeding outcomes. RESEARCH AIM To explore experiences of breastfeeding mothers with infants having undergone "tongue-tie" surgery. METHOD This online, cross-sectional, observational survey occurred between August and September 2020. Eligibility included being ≥ 18 years of age and previously or currently breastfeeding an infant with ≥ 1 tissue surgically released. Of 463 screens, 318 mothers were eligible and 115 consented. The final sample was 90. RESULTS The sample was predominantly white (n = 86; 95%), non-Hispanic (n = 84; 93%), married/cohabitating (n = 85; 94%), and currently providing their own milk (n = 81; 89%).Difficult latch was the primary reason for seeking help. Participants reported lingual (n = 84; 93%), labial (n = 79; 88%), and buccal (n = 16; 17%) tissue-release, with 80% (n = 73) reporting > 1 released. For each tissue released, > 80% (n = 72) of participants felt "very confident" in their ability to correctly identify it and 97% (n = 87) felt "very involved" and "strongly agreed" with surgical release. International Board Certified Lactation Consultants® were the most frequently identified source of information (n = 45; 50%) and referrals (n = 38; 42%), while pediatric dentists most frequently performed interventions (n = 60; 67%). CONCLUSIONS Participants reported being confident, involved, and in agreement with surgical release and lactation support professionals were frequent information and referral sources.
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Affiliation(s)
- Taylor Winkel
- Department of Nutrition, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Jennifer Wilson
- Department of Audiology and Speech Pathology, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Marsha Spence
- Department of Nutrition, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Sarah Colby
- Department of Nutrition, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Cary Springer
- Office of Information Technology, Research Computing Support, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Mark Hedrick
- Department of Audiology and Speech Pathology, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Katherine Kavanagh
- Department of Nutrition, University of Tennessee Knoxville, Knoxville, TN, USA
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Nuampa S, Kuesakul K, Prasong S, Sudphet M. Social Support for Breastfeeding Practice During the COVID-19 Second Wave in Thailand: A Cross-Sectional Study. J Hum Lact 2023; 39:206-216. [PMID: 36932858 PMCID: PMC10028445 DOI: 10.1177/08903344231156441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
BACKGROUND Since December 2020, the second wave of COVID-19 in Thailand has had a considerable impact, and mothers have struggled to receive breastfeeding support in hospitals. In this situation, there has been limited research that addresses social support for breastfeeding and the influences of support in determining breastfeeding outcomes. RESEARCH AIMS (1) To describe the influence of COVID-19 on social support for breastfeeding and breastfeeding practices in the Thai context, and (2) to examine breastfeeding duration with different levels of social support from families and healthcare providers. METHOD This descriptive, cross-sectional online survey design was part of a larger multi-methods project about breastfeeding behaviors and experiences among postpartum mothers during the COVID-19 pandemic. Online questionnaires were administered from August to November 2021 to participants (N = 390) who were from three provinces in Thailand and had given birth 6-12 months prior to the survey. RESULTS Exclusive breastfeeding for 6 months was observed in less than half of the participants (n = 146, 37.4%). Perceptions of breastfeeding support were generally high overall among both family (Mdn = 45, IQR = 7) and healthcare providers (Mdn = 43, IQR = 7). Participants who perceived more breastfeeding support from families than the median had significantly longer exclusive breastfeeding durations than those who perceived less breastfeeding support than the median (z = -2.246, p = .025). The same pattern was present for breastfeeding support from healthcare providers (z = -2.380, p = 0.017). CONCLUSIONS While the exclusive breastfeeding rate was better than the pre-pandemic rate, successful breastfeeding was more common when participants perceived that they had received breastfeeding support. Policymakers should execute breastfeeding support systems along with COVID-19 management.
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Affiliation(s)
- Sasitara Nuampa
- Department of Obstetric and
Gynecological Nursing, Faculty of Nursing, Mahidol University, Bangkok,
Thailand
- Sasitara Nuampa, RN, PhD (Nursing),
Assistant Professor, Department of Obstetric and Gynecological Nursing, Faculty
of Nursing, Mahidol University, 2 Wang Lang Road, Siriraj, Bangkok noi, Bangkok,
10700, Thailand.
| | - Kornkanok Kuesakul
- Department of Obstetric and
Gynecological Nursing, Faculty of Nursing, Mahidol University, Bangkok,
Thailand
| | - Sudhathai Prasong
- Department of Obstetric and
Gynecological Nursing, Faculty of Nursing, Mahidol University, Bangkok,
Thailand
| | - Metpapha Sudphet
- Department of Obstetrics and
Gynaecology, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Tigka M, Metallinou D, Nanou C, Iliodromiti Z, Gryparis A, Lykeridou K. Medication Intake as a Factor for Non-Initiation and Cessation of Breastfeeding: A Prospective Cohort Study in Greece during the COVID-19 Pandemic. CHILDREN 2023; 10:children10030586. [PMID: 36980144 PMCID: PMC10047701 DOI: 10.3390/children10030586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/13/2023] [Accepted: 03/17/2023] [Indexed: 03/22/2023]
Abstract
Pharmacological treatment may become a barrier for a mother’s breastfeeding goals. We aimed to investigate maternal medication intake as a factor for non-initiation and cessation of breastfeeding and the effect of professional counseling on maternal decision-making. Throughout 2020,847 women were recruited from five healthcare institutions. Information was gathered prospectively with an organized questionnaire through interview during hospitalization and through telephone at 1, 3 and 6 months postpartum. Results revealed that from the 57 cases of breastfeeding cessation due to medication intake, only 10.5%received evidence-based counseling from a physician. Unfortunately, 68.4% (n = 39/57) of the participants ceased breastfeeding due to erroneous professional advice. The compatibility of medicines with breastfeeding was examined according to the Lactmed and Hale classification systems, which showed discrepancy in 8 out of 114 medicines used, while 17.5% and 13.2% of the medicines, respectively, were not classified. Educational level, employment at six months postpartum, mode of delivery, previous breastfeeding experience, medication intake for chronic diseases, physician’s recommendation and smoking before pregnancy were factors significantly correlated with breastfeeding discontinuation due to medication intake. The COVID-19 restrictions protected women from ceasing breastfeeding due to medication intake. Maternal and lactation consultancy should be strictly related to evidence-based approaches.
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Affiliation(s)
- Maria Tigka
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.T.)
- Department of Obstetric Emergency, General and Maternity Hospital “Helena Venizelou”, 11521 Athens, Greece
| | - Dimitra Metallinou
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.T.)
| | - Christina Nanou
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.T.)
| | - Zoi Iliodromiti
- Department of Neonatology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Alexandros Gryparis
- Department of Speech and Language Therapy, University of Ioannina, 45500 Ioannina, Greece
| | - Katerina Lykeridou
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.T.)
- Correspondence:
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Pillai A, Nayak A, Tiwari D, Pillai PK, Pandita A, Sakharkar S, Balasubramanian H, Kabra N. COVID-19 Disease in Under-5 Children: Current Status and Strategies for Prevention including Vaccination. Vaccines (Basel) 2023; 11:693. [PMID: 36992278 PMCID: PMC10058749 DOI: 10.3390/vaccines11030693] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/11/2023] [Accepted: 03/14/2023] [Indexed: 03/31/2023] Open
Abstract
Since the coronavirus disease (COVID-19) pandemic hit the globe in early 2020, we have steadily gained insight into its pathogenesis; thereby improving surveillance and preventive measures. In contrast to other respiratory viruses, neonates and young children infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have a milder clinical presentation, with only a small proportion needing hospitalization and intensive care support. With the emergence of novel variants and improved testing services, there has been a higher incidence of COVID-19 disease reported among children and neonates. Despite this, the proportion of young children with severe disease has not increased. Key mechanisms that protect young children from severe COVID-19 disease include the placental barrier, differential expression of angiotensin-converting enzyme 2 (ACE-2) receptors, immature immune response, and passive transfer of antibodies via placenta and human milk. Implementing mass vaccination programs has been a major milestone in reducing the global disease burden. However, considering the lower risk of severe COVID-19 illness in young children and the limited evidence about long-term vaccine safety, the risk-benefit balance in children under five years of age is more complex. In this review, we do not support or undermine vaccination of young children but outline current evidence and guidelines, and highlight controversies, knowledge gaps, and ethical issues related to COVID-19 vaccination in young children. Regulatory bodies should consider the individual and community benefits of vaccinating younger children in their local epidemiological setting while planning regional immunization policies.
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Affiliation(s)
- Anish Pillai
- Surya Hospitals, Mangal Ashirwad Building, Swami Vivekananda Road, Santacruz West, Mumbai 400054, Maharashtra, India
- British Columbia Children’s Hospital Research Institute, 938 West 28th Avenue, Vancouver, BC V5Z 4H4, Canada
| | - Anuja Nayak
- Bai Jerabai Wadia Hospital for Children, Acharya Donde Marg, Parel East, Parel, Mumbai 400012, Maharashtra, India
| | - Deepika Tiwari
- Surya Hospitals, Mangal Ashirwad Building, Swami Vivekananda Road, Santacruz West, Mumbai 400054, Maharashtra, India
| | - Pratichi Kadam Pillai
- Surya Hospitals, Mangal Ashirwad Building, Swami Vivekananda Road, Santacruz West, Mumbai 400054, Maharashtra, India
| | - Aakash Pandita
- Medanta Super Specialty Hospital, Sector-A, Pocket-1, Amar Shaheed Path, Golf City, Lucknow 226030, Uttar Pradesh, India
| | - Sachin Sakharkar
- Surya Hospitals, Mangal Ashirwad Building, Swami Vivekananda Road, Santacruz West, Mumbai 400054, Maharashtra, India
| | | | - Nandkishor Kabra
- Surya Hospitals, Mangal Ashirwad Building, Swami Vivekananda Road, Santacruz West, Mumbai 400054, Maharashtra, India
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Vik ES, Kongslien S, Nedberg IH, Mariani I, Valente EP, Covi B, Lazzerini M. Women's experiences and views on early breastfeeding during the COVID-19 pandemic in Norway: quantitative and qualitative findings from the IMAgiNE EURO study. Int Breastfeed J 2023; 18:15. [PMID: 36895002 PMCID: PMC9998246 DOI: 10.1186/s13006-023-00553-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 02/25/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Little is known about women's experience of care and views on early breastfeeding during the COVID-19 pandemic in Norway. METHODS Women (n = 2922) who gave birth in a facility in Norway between March 2020 and June 2021 were invited to answer an online questionnaire based on World Health Organization (WHO) Standard-based quality measures, exploring their experiences of care and views on early breastfeeding during the COVID-19 pandemic. To examine associations between year of birth (2020, 2021) and early breastfeeding-related factors, we estimated odds ratios (ORs) with 95% confidence intervals (CIs) using multiple logistic regression. Qualitative data were analysed using Systematic Text Condensation. RESULTS Compared to the first year of the pandemic (2020), women who gave birth in 2021 reported higher odds of experiencing adequate breastfeeding support (adjOR 1.79; 95% CI 1.35, 2.38), immediate attention from healthcare providers when needed (adjOR 1.89; 95% CI 1.49, 2.39), clear communication from healthcare providers (adjOR 1.76; 95% CI 1.39, 2.22), being allowed companion of choice (adjOR 1.47; 95% CI 1.21, 1.79), adequate visiting hours for partner (adjOR 1.35; 95% CI 1.09, 1.68), adequate number of healthcare providers (adjOR 1.24; 95% CI 1.02, 1.52), and adequate professionalism of the healthcare providers (adjOR 1.65; 95% CI 1.32, 2.08). Compared to 2020, in 2021 we found no difference in skin-to-skin contact, early breastfeeding, exclusive breastfeeding at discharge, adequate number of women per room, or women's satisfaction. In their comments, women described understaffed postnatal wards, early discharge and highlighted the importance of breastfeeding support, and concerns about long-term consequences such as postpartum depression. CONCLUSIONS In the second year of the pandemic, WHO Standard-based quality measures related to breastfeeding improved for women giving birth in Norway compared to the first year of the pandemic. Women's general satisfaction with care during COVID-19 did however not improve significantly from 2020 to 2021. Compared to pre-pandemic data, our findings suggest an initial decrease in exclusive breastfeeding at discharge during the COVID-19 pandemic in Norway with little difference comparing 2020 versus 2021. Our findings should alert researchers, policy makers and clinicians in postnatal care services to improve future practices.
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Affiliation(s)
- Eline Skirnisdottir Vik
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
| | - Sigrun Kongslien
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Ilaria Mariani
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", WHO Collaborating Centre for Maternal and Child Health, Trieste, Italy
| | - Emanuelle Pessa Valente
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", WHO Collaborating Centre for Maternal and Child Health, Trieste, Italy
| | - Benedetta Covi
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", WHO Collaborating Centre for Maternal and Child Health, Trieste, Italy
| | - Marzia Lazzerini
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", WHO Collaborating Centre for Maternal and Child Health, Trieste, Italy
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