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Menon M, Huber R, Russell RB, Feldman-Winter L, Goodstein MH, Scott S, Berns SD. Maternity Care Clinicians' Experiences Promoting Infant Safe Sleep and Breastfeeding During the COVID-19 Pandemic. Nurs Womens Health 2023; 27:90-102. [PMID: 36803607 PMCID: PMC9937429 DOI: 10.1016/j.nwh.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/25/2022] [Accepted: 01/15/2023] [Indexed: 02/19/2023]
Abstract
OBJECTIVE To explore the phenomenon of clinicians' perceptions and experiences of promoting infant safe sleep (ISS) and breastfeeding during the COVID-19 pandemic. DESIGN Descriptive qualitative hermeneutical phenomenology of key informant interviews conducted as part of a quality improvement initiative. SETTING Maternity care services of 10 U.S. hospitals from April through September 2020. PARTICIPANTS Ten hospital teams, including 29 clinicians. INTERVENTION Participants were part of a national quality improvement intervention focused on promoting ISS and breastfeeding. Participants were asked about challenges and opportunities promoting ISS and breastfeeding during the pandemic. RESULTS We identified four themes summarizing the experiences and perceptions of clinicians promoting ISS and breastfeeding in the COVID-19 pandemic: Strain on Clinicians Related to Hospital Policies, Coordination, and Capacity; Effects of Isolation for Parentsin Labor and Delivery; ReevaluatingOutpatient Follow-Up Care andSupport; and AdoptingShared Decision-Makingaround ISS andBreastfeeding. CONCLUSIONS Our results support the need for physical and psychosocial care to reduce crisis-related burnout for clinicians to encourage the continued provision of ISS and breastfeeding education, particularly while navigating capacity constraints. Our findings also suggest that clinicians perceived that parents may require additional support to enhance potentially limited ISS and breastfeeding education. These findings may be used to inform approaches to parental and clinician maternity care support in future public health crises.
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Sussman H. Alone (together): becoming a parent in the pandemic. JOURNAL OF CHILD PSYCHOTHERAPY 2023. [DOI: 10.1080/0075417x.2022.2161002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Helen Sussman
- Tavistock and Portman NHS Trust, 120 Belsize Lane, London NW3 5BA, UK
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Ukoli F, Leavell J, Mayo A, Moore J, Nchami N, Britt A. Encouraging and Reinforcing Safe Breastfeeding Practices during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1756. [PMID: 36767117 PMCID: PMC9914864 DOI: 10.3390/ijerph20031756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 06/18/2023]
Abstract
AIM Promote safe breastfeeding during the pandemic. METHODS All participants were encouraged to request safe breastfeeding education from their prenatal provider. Pregnant mothers received appropriate breastfeeding and COVID-19 safe breastfeeding education in line with the CDC's COVID-19 breastfeeding guidelines. Data were obtained from 39 mothers attending Nashville General Hospital pediatric well-baby clinics (Group I: from December 2019 to June 2020) and 97 pregnant women attending prenatal clinics (Group II: from July 2020 to August 2021). RESULTS The participants' ages ranged from 15 to 45 years, with a mean of 27.5 ± 6.2. The women in both groups were similar in age, education, employment, and breastfeeding experience. They were equally unlikely to use face masks at home even while receiving guests or holding their babies. Although 121 (89.0%) women claimed face mask use while shopping, the rate for never doing so was 7 (18.0%) vs. 8 (8.3%) (p < 0.006) for Groups I and II, respectively. Safe practices included limited outing (66 (48.5%)), sanitized hands (62 (45.6%)), restricted visitors (44 (32.4%)), and limited baby outing (27 (19.9%)), and 8 (8.3%) in Group II received COVID-19 vaccinations. About half described fair and accurate COVID-19 safe breastfeeding knowledge, but 22 (30.1%) of them claimed they received no information. Breastfeeding contraindication awareness for Groups I and II were as follows: cocaine = 53.8% vs. 37.1%, p < 0.06; HIV = 35.9% vs. 12.4%, p < 0.002; breast cancer = 17.9% vs. 16.5%; and COVID-19 with symptoms = 28.2% vs. 5.2%, p < 0.001. The information source was similar, with family, friends, and media accounting for 77 (56.6%) of women while doctors, nurses, and the CLC was the source for 21 (15.4%) women. Exclusive breastfeeding one month postpartum for Groups I and II was 41.9% and 12.8% (p < 0.006), respectively. CONCLUSION The mothers were not more knowledgeable regarding breastfeeding safely one year into the COVID-19 pandemic. Conflicting lay information can create healthy behavior ambivalence, which can be prevented by health professionals confidently advising mothers to wear face masks when breastfeeding, restricting visitors and outings, and accepting COVID-19 vaccination. This pandemic remains an open opportunity to promote and encourage breastfeeding to every mother as the default newborn feeding method.
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Affiliation(s)
- Flora Ukoli
- Department of Surgery, Meharry Medical College, Nashville, TN 37208, USA
| | - Jacinta Leavell
- Department of Dental Public Health, School of Dentistry, Meharry Medical College, Nashville, TN 37208, USA
| | - Amasyah Mayo
- Meharry Medical College, Nashville, TN 37208, USA
| | - Jayla Moore
- Meharry Medical College, Nashville, TN 37208, USA
| | - Nia Nchami
- Meharry Medical College, Nashville, TN 37208, USA
| | - Allysceaeioun Britt
- Division of Public Health Practice, School of Graduate Studies and Research, Meharry Medical College, Nashville, TN 37208, USA
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Harrison S, Alderdice F, Quigley MA. Impact of sampling and data collection methods on maternity survey response: a randomised controlled trial of paper and push-to-web surveys and a concurrent social media survey. BMC Med Res Methodol 2023; 23:10. [PMID: 36635637 PMCID: PMC9835028 DOI: 10.1186/s12874-023-01833-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 01/03/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Novel survey methods are needed to tackle declining response rates. The 2020 National Maternity Survey included a randomised controlled trial (RCT) and social media survey to compare different combinations of sampling and data collection methods with respect to: response rate, respondent representativeness, prevalence estimates of maternity indicators and cost. METHODS A two-armed parallel RCT and concurrent social media survey were conducted. Women in the RCT were sampled from ONS birth registrations and randomised to either a paper or push-to-web survey. Women in the social media survey self-selected through online adverts. The primary outcome was response rate in the paper and push-to-web surveys. In all surveys, respondent representativeness was assessed by comparing distributions of sociodemographic characteristics in respondents with those of the target population. External validity of prevalence estimates of maternity indicators was assessed by comparing weighted survey estimates with estimates from national routine data. Cost was also compared across surveys. RESULTS The response rate was higher in the paper survey (n = 2,446) compared to the push-to-web survey (n = 2,165)(30.6% versus 27.1%, difference = 3.5%, 95%CI = 2.1-4.9, p < 0.0001). Compared to the target population, respondents in all surveys were less likely to be aged < 25 years, of Black or Minority ethnicity, born outside the UK, living in disadvantaged areas, living without a partner and primiparous. Women in the social media survey (n = 1,316) were less representative of the target population compared to women in the paper and push-to-web surveys. For some maternity indicators, weighted survey estimates were close to estimates from routine data, for other indicators there were discrepancies; no survey demonstrated consistently higher external validity than the other two surveys. Compared to the paper survey, the cost saving per respondent was £5.45 for the push-to-web survey and £22.42 for the social media survey. CONCLUSIONS Push-to-web surveys may cost less than paper surveys but do not necessarily result in higher response rates. Social media surveys cost significantly less than paper and push-to-web surveys, but sample size may be limited by eligibility criteria and recruitment window and respondents may be less representative of the target population. However, reduced representativeness does not necessarily introduce more bias in weighted survey estimates.
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Affiliation(s)
- Siân Harrison
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus Headington, Oxford, OX3 7LF UK
| | - Fiona Alderdice
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus Headington, Oxford, OX3 7LF UK
| | - Maria A. Quigley
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus Headington, Oxford, OX3 7LF UK
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Cimino S, Cerniglia L. Impact of Maternal-Newborn Separation in Italian Women with Suspected COVID-19 Infection on Psychopathological Symptoms and Quality of Interactions during Breastfeeding. Psychopathology 2023; 56:335-341. [PMID: 36599310 PMCID: PMC9893000 DOI: 10.1159/000528410] [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: 05/30/2022] [Accepted: 11/28/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Before the COVID-19 pandemic, proximity between mothers and their newborn infants was at the core of sanitary guidelines. With the aim of stopping the virus transmission from mothers to infants and possible physical dangers due to the infection, some hospitals discouraged or even prohibited skin-to-skin contact and breastfeeding. METHOD This study recruited 180 dyads in private and public hospitals in Italy with the aim of verifying whether mother-infant separation after delivery is associated with higher maternal psychopathological distress (assessed through the SCL-90-R) and poorer quality of dyadic interactions during breastfeeding (evaluated through the SVIA). RESULTS Our results showed that mothers separated from their infants displayed more anxiety, depression, and obsessive-compulsive symptoms and a lower quality of feeding interactions on all the subscales of the SVIA (mother's affective state; interactive conflict; food refusal behavior; dyad's affective state). CONCLUSION In light of these results, our study suggests that separating mothers from their newborns is associated with increased psychopathological symptoms in mothers and poorer feeding interactions. These issues have been posited as key predictors of maladaptive outcomes in infants' later lives; therefore, health services must fully consider the short- and long-term consequences of separating mothers and infants in their policies in the event of future pandemics.
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Affiliation(s)
- Silvia Cimino
- Department of Dynamic Clinical and Health Psychology, Sapienza, University of Rome, Rome, Italy
| | - Luca Cerniglia
- Faculty of Psychology, International Telematic University Uninettuno, Rome, Italy
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Hanum S, Rustina Y, Waluyanti FT. Breastfeeding a Premature Baby During the Covid-19 Pandemic in Perinatology: An Exploration of Mothers' Experiences. Glob Qual Nurs Res 2023; 10:23333936231220738. [PMID: 38152670 PMCID: PMC10752073 DOI: 10.1177/23333936231220738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 12/29/2023] Open
Abstract
This study was conducted to explore the meaning of mothers' experiences of breastfeeding premature babies while being treated in the perinatology room during the COVID-19 pandemic. A descriptive phenomenological design was used in this study to describe the meaning of mothers' experiences. In-depth interviews were conducted with 11 mothers. The analysis of transcribed data resulted in three themes: (1) The pandemic has made it difficult for me to meet my baby, (2) Breastfeeding is not easy, and (3) I am a breast milk pumper. The breastfeeding experience of having a premature baby and being cared for by perinatology during a pandemic is full of challenges and limited support. The results of this study suggest that a review of the current regulations be carried out, and the staff be given continuing lactation education to strengthen breastfeeding support to mothers with premature babies.
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Affiliation(s)
| | - Yeni Rustina
- Universitas Indonesia, Depok, West Java, Indonesia
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Mufdlilah M, Kusuma NI, Suryaningsih EK. Mother's Experience with COVID-19 in Breastfeeding: A Phenomenological Study. SAGE Open Nurs 2023; 9:23779608231172360. [PMID: 37187547 PMCID: PMC10176538 DOI: 10.1177/23779608231172360] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/31/2023] [Accepted: 04/10/2023] [Indexed: 05/17/2023] Open
Abstract
Background The COVID-19 pandemic has disrupted mothers' and children's access to essential health services. Concerns about the transmission of COVID-19 to infants resulted in strict procedures, which then caused delays in initial contact and breastfeeding. This delay then impacted the well-being of mothers and babies. Purpose This study aimed to explore the experience of mothers with COVID-19 in breastfeeding. This study was qualitative research with a phenomenological approach. Methods Participants were mothers with a confirmed history of COVID-19 during the breastfeeding period either in 2020, 2021, or 2022. Semi-structured in-depth interviews were conducted with 21 mothers. Data were analyzed using thematic analysis. Results Three themes were obtained: breastfeeding during the mother was confirmed COVID-19, changes in the mother's condition, and social support received by the mother. Based on this theme, it can be seen that mothers are temporarily separated from their newborns, which causes breastfeeding difficulties. Mothers confirmed to have COVID-19 in 2020 and 2021 appear to have more significant concerns about transmitting COVID-19, as indicated by the mother's decision not to breastfeed and to undergo separate isolation with the baby. Conclusion Mothers need support to continue to breastfeed. The benefits obtained from breastfeeding are far more significant than efforts to prevent transmission by separating mother and baby, so mothers should be encouraged to continue breastfeeding.
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Affiliation(s)
- Mufdlilah Mufdlilah
- Faculty of Health Sciences, Universitas ‘Aisyiyah
Yogyakarta, Yogyakarta, Indonesia
| | - Nur Intan Kusuma
- Faculty of Health Sciences, Universitas ‘Aisyiyah
Yogyakarta, Yogyakarta, Indonesia
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Martínez-Líbano J, Torres-Vallejos J, Oyanedel JC, González-Campusano N, Calderón-Herrera G, Yeomans-Cabrera MM. Prevalence and variables associated with depression, anxiety, and stress among Chilean higher education students, post-pandemic. Front Psychiatry 2023; 14:1139946. [PMID: 37065901 PMCID: PMC10097937 DOI: 10.3389/fpsyt.2023.1139946] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 03/09/2023] [Indexed: 04/18/2023] Open
Abstract
Background Mental health among university students is a public health problem in Chile, understanding that this population is susceptible to mental disorders. Objective The present study aimed to determine the prevalence and variables influencing depression, anxiety, and stress in Chilean university students. Method A representative sample (n = 1,062) of Chilean university students and a cross-sectional study design were used. Bivariate analysis and multiple logistic regression were performed to identify risk factors associated with symptomatology. They were analyzed using descriptive statistics. A questionnaire with sociodemographic variables was applied in November 2022, in addition to the depression anxiety stress scale (DASS-21), instruments with excellent reliability in this population (α = 0.955; ω = 0.956). On the other hand, the Questionnaire of Problematic Alcohol and Drug Consumption (DEP-ADO) was applied. A descriptive analysis was performed, followed by bivariate analysis and multiple logistic regression using SPSS version 25. The variables showed a value of p <0.05; they were declared statistically significant in the final model. Odds ratios (OR) were adjusted to a 95% confidence interval (95% CI), which was used to determine the independent predictors. Results The prevalence of mental health problems in this population was high, with depressive symptoms in 63.1% of the sample; 69.2% with anxiety; 57% with stress; 27.4% with problematic alcohol consumption; and 14.9% with inappropriate marijuana consumption. Some 10.1% of the sample reported daily medication with antidepressants and/or anxiolytics. Concerning significant variables for depression, these were: being female, belonging to sexual, not having children, having problematic marijuana use, and using prescription drugs. Concerning anxiety, the significant variables were being a woman, belonging to sexual minorities, being an adolescent, and consuming prescription medication. Finally, concerning stress, the significant variables were being a woman, belonging to sexual minorities, being a student dedicated exclusively to academic activities, and taking prescription medication. Conclusion Chilean university students presented a high prevalence of anxiety, depression, and stress, where being female and belonging to sexual minorities seem to be the variables that have the greatest impact on susceptibility to mental health problems. These results should call the attention of political and university authorities in Chile to improve this population's mental health and quality of life since they are the following professional generation of our country.
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Affiliation(s)
| | | | - Juan C. Oyanedel
- Facultad de Educación y Ciencias Sociales, Universidad Andrés Bello, Santiago, Chile
| | | | | | - María-Mercedes Yeomans-Cabrera
- Facultad de Salud y Ciencias Sociales, Universidad de las Américas, Santiago, Chile
- *Correspondence: María-Mercedes Yeomans-Cabrera,
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Nismath S, Rao SS, Addala S, Ravikiran SR, Kamath N. Breastfeeding Self-efficacy in COVID-19 Positive Postpartum Mothers in a Community Maternal Facility in South India: A Case Control Study. Ethiop J Health Sci 2023; 33:13-20. [PMID: 36890928 PMCID: PMC9987277 DOI: 10.4314/ejhs.v33i1.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/21/2022] [Indexed: 03/10/2023] Open
Abstract
Background Breastfeeding experiences have altered during the COVID-19 pandemic. Breastfeeding self-efficacy is a strong determinant of the breastfeeding behaviour of women. We aimed to study breastfeeding self-efficacy and assess the perceived factors for breastfeeding hindrance in COVID-19 positive mothers in the postpartum period. Method A facility based case-control study was conducted with 63 COVID-19 positive (cases) and 63 COVID-19 negative postnatal mothers (controls). A breastfeeding self-efficacy short form (BFSE SF) instrument measured Breastfeeding self-efficacy 24 to 48 hours post-delivery. Mothers who tested positive for COVID-19 were interviewed about perceived factors for breastfeeding hindrance. Data was analyzed by SPSS version 25. Descriptive statistics were used for maternal parameters. BFSE SF scores were compared by a t test. Results The mean BFSE SF score of COVID-19 positive mothers was 53.14 which was significantly lower than the mean BFSE SF score of 56.52 of COVID-19 negative mothers (p=0.013). Mothers who had received postpartum breastfeeding advice had significantly higher BFSE SF mean scores (p= 0.031). Sixty-seven percentage of COVID-19 positive mothers reported fear of transmission of illness to the neonate as a hindering factor. Conclusions Breastfeeding self-efficacy scores were significantly lower in COVID- 19 positive mothers. Higher breastfeeding self-efficacy scores were observed in mothers who had received postpartum breastfeeding advice. The fear of transmission of the COVID-19 illness to the neonate was perceived as a breastfeeding hindering factor in most of the mothers. These observations imply the need for professional lactation support programs.
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Affiliation(s)
- Shifa Nismath
- Department of Pediatrics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Suchetha S Rao
- Department of Pediatrics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Soundarya Addala
- Department of Pediatrics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - S R Ravikiran
- Department of Pediatrics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Nutan Kamath
- Department of Pediatrics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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Harthi AM, Harthi AM, Hendy A. Effect of Training Program on Knowledge and Practice of Breast feeding Women During COVID-19. SAGE Open Nurs 2023; 9:23779608231167826. [PMID: 37020659 PMCID: PMC10068981 DOI: 10.1177/23779608231167826] [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: 08/30/2022] [Revised: 03/06/2023] [Accepted: 03/19/2023] [Indexed: 04/03/2023] Open
Abstract
Aim Evaluate the effect of the training program on knowledge and practice of breastfeeding women during coronavirus disease 2019 (COVID-19). Methods One-group pretest/post-test quasiexperimental research design was utilized to accomplish the aim of this study. The study was carried out at the primary health care units Ad Dar Al Baida 1, Ad Dar Al Baida 2, Al Aziziyah at Riyadh Province of Saudi Arabia. The study included a convenience sample of 100 breastfeeding women. Tool A structured interviewing questionnaire sheet was used for data collection that included three parts knowledge, reported practice, and demographic characteristics. Results More than one-quarter (30%) and (28%) of studied women had satisfactory knowledge-related causes, risk factor and signs, symptoms of COVID-19 at preintervention, while the majority 85% and 86% of them had satisfactory knowledge postintervention at p-value <.01**. In addition, less than one-fifth (17%) and (16%) of studied women had satisfactory knowledge about Breastfeeding guidelines during COVID-19 and care of breastfeeding women during COVID-19, compared with most of them (89%) and (92%) postintervention at p-value <.01**. Conclusion Based on our current study, it was concluded that the educational program effectively improves breastfeeding women's knowledge and practices. There was a highly statistically significant positive linear correlation between the breastfeeding women's knowledge and reported practices regarding COVID-19 infection before and after the implementation of the educational program at p < .0.
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Affiliation(s)
| | - Abeer M. Harthi
- King Fahad Medical City Hospital, Riyadh, Kingdom of Saudi Arabia
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Socio-economic inequalities in the effect of public policies and the COVID-19 pandemic on exclusive breastfeeding in Chile. Public Health 2023; 214:61-68. [PMID: 36521273 PMCID: PMC9640405 DOI: 10.1016/j.puhe.2022.11.001] [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: 08/07/2022] [Revised: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To assess the impact of the addition of 12 maternity leave (ML) weeks (2011), a pay for performance (P4P) exclusive breastfeeding (EBF) promotion strategy (2015), and the COVID-19 pandemic in EBF inequalities in Chile. STUDY DESIGN Interrupted time-series analyses (ITSAs). METHODS Aggregated national EBF data by municipality and month were collected from 2009 to 2020. We assess the impact of the three events in EBF inequalities using two procedures: 1. ITSA stratified by municipal SES quintiles (Q1-Q5); 2. Calculating the EBF slope index of inequality (SII). RESULTS The EBF prevalence was higher in lower SES municipalities before and after the three time-events. No impact in EBF inequalities was observed after the extended ML. The P4P strategy increased EBF at six months in all SES quintiles (effect size between 4% and 5%), but in a higher level in poorer municipalities (SII: -0.36% and -1.05%). During COVID-19, wealthier municipalities showed a slightly higher EBF at six months prevalence (SII: 1.44%). CONCLUSION The null impact of the extended ML in EBF inequalities could be explained by a low access to ML among affiliated to the public health system (20%). The P4P strategy includes multiple interventions that seemed effective in increasing EBF across all SES quintiles, but further in lower quintiles. The restrictions in healthcare access in poorer municipalities could explain EBF inequalities during COVID-19.
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Nuampa S, Patil CL, Prasong S, Kuesakul K, Sudphet M. Exploring the Association between Socioeconomic and Psychological Factors and Breastfeeding in the First Year of Life during the COVID-19 Pandemic in Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:130. [PMID: 36612453 PMCID: PMC9819422 DOI: 10.3390/ijerph20010130] [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: 11/11/2022] [Revised: 12/15/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Breastfeeding is essential for the survival, nutrition, and development of infants and young children. As a result of COVID-19’s effects of economic crises and psychological difficulties, breastfeeding outcomes have declined. The purpose of this study was to examine the association between socioeconomic and psychological factors with breastfeeding duration in the first year of life during the COVID-19 pandemic. Cross-sectional online surveys (n = 390) were conducted between August and November 2021. The participants were women aged 15 years and above who had given birth within 6−12 months before data collection and delivered in public hospitals in the top three provinces with the worst COVID-19 outbreaks during the second wave in Thailand. The average breastfeeding duration in this study was 6.20 months (±2.5) with a range of 1−12 months. Of mothers, 44.9% continued to breastfeed until between 6 and 12 months of age. In a multiple regression analysis, family income (Beta = 0.112, t = 1.988, p < 0.05), breastfeeding intention (beta = 0.097, t = 2.142, p < 0.05), intended breastfeeding duration (beta = 0.391, t = 8.355, p < 0.05), intention to receive vaccination (beta =0.129, t = 2.720, p < 0.05), and anxiety (beta = 0.118, t = 2.237, p < 0.05) were associated with breastfeeding duration in the first year of life (F (7, 382) = 20.977, p < 0.05, R2 = 0.278, R2 Adjusted = 0.264). During COVID-19, psychological factors were more strongly associated with breastfeeding duration in the first year of life than socioeconomic factors. Healthcare providers should promote breastfeeding intention, motivate COVID-19 vaccination intention, and support mental health among lactating mothers, particularly in the event of a pandemic.
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Affiliation(s)
- Sasitara Nuampa
- Department of Obstetrics and Gynecological Nursing, Faculty of Nursing, Mahidol University, Bangkok 10700, Thailand
| | - Crystal L. Patil
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Sudhathai Prasong
- Department of Obstetrics and Gynecological Nursing, Faculty of Nursing, Mahidol University, Bangkok 10700, Thailand
| | - Kornkanok Kuesakul
- Department of Obstetrics and Gynecological Nursing, Faculty of Nursing, Mahidol University, Bangkok 10700, Thailand
| | - Metpapha Sudphet
- Department of Obstetrics and Gynaecology, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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Fan HSL, Ho MY, Ko RWT, Kwok JYY, Chau PH, Wong JYH, Wang MP, Lok KYW. Feasibility and effectiveness of WhatsApp online group on breastfeeding by peer counsellors: a single-blinded, open-label pilot randomized controlled study. Int Breastfeed J 2022; 17:91. [PMID: 36544208 PMCID: PMC9771777 DOI: 10.1186/s13006-022-00535-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION With mobile technologies becoming more advanced and accessible, mobile health (mHealth) has been incorporated in delivering timely and convenient breastfeeding support. However, its feasibility and potential efficacy remain to be examined. Therefore, the primary objective of this study is to assess the feasibility and acceptability of an online instant messaging peer support group for breastfeeding. The secondary objective is to evaluate the effect of the intervention on breastfeeding outcomes. METHODS A pilot randomized controlled trial was conducted. A total of 33 primiparous women were recruited in the antenatal clinic at a public hospital in Hong Kong between March and April 2021. They were randomized to receive either standard care (n = 18) or standard care and receive peer-group support in an online instant messaging app (n = 15). Participants received telephone follow-up for up to six months postpartum or until they stopped breastfeeding. After completing the study, six participants in the intervention group were interviewed to understand their perceptions of the intervention. RESULTS This pilot study shows that online messaging peer support group is feasible and acceptable to women. In total, 54.4% of the eligible women agreed to participate, and 97.0% completed the follow-up. Participants perceived that providing peer support through instant messaging app is appropriate. It serves as a channel for the participants to ask questions and obtain information. Furthermore, meetings of the peer supporters and group members can be held to enhance the effectiveness of the intervention. In addition, no significant differences were found in any and exclusive breastfeeding rates, breastfeeding attitude, and breastfeeding self-efficacy between the two groups. CONCLUSIONS This study shows that online messaging peer support group is feasible and acceptable. A full-scale study should be conducted to understand the effect of the online instant messaging peer support group on breastfeeding outcomes. TRIAL REGISTRATION The study protocol is registered on Clinicaltrial.gov (NCT04826796) on 1 April 2021.
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Affiliation(s)
- Heidi S. L. Fan
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - M. Y. Ho
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - Rachel W. T. Ko
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - Jojo Y. Y. Kwok
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - P. H. Chau
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - Janet Y. H. Wong
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - M. P. Wang
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - Kris Y. W. Lok
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
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Jiravisitkul P, Thonginnetra S, Kasemlawan N, Suntharayuth T. Supporting factors and structural barriers in the continuity of breastfeeding in the hospital workplace. Int Breastfeed J 2022; 17:87. [PMID: 36536399 PMCID: PMC9761035 DOI: 10.1186/s13006-022-00533-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The World Health Organization recommends that babies should receive exclusive breastfeeding (EBF) for six months, and mothers should be encouraged to breastfeed until their infant is aged two years or older. The breastfeeding rate in Thailand is currently much lower than the target. One critical factor is lactating mothers returning to work, especially in a hospital workplace with high job stress. In this study, we aimed to identify supporting factors and obstacles to sustaining breastfeeding in hospital-type workplaces. METHODS We conducted a mixed methods study between February 2021 and August 2021 at Chulabhorn Hospital, Thailand. Quantitative data were collected using questionnaires, and qualitative data were gathered in a focus group discussion among purposefully chosen participants, including mothers with both successful and unsuccessful continuation of breastfeeding after returning to work. We conducted multivariate analysis and thematic analysis in quantitative and qualitative data analysis, respectively. RESULTS Questionnaires were completed by 65 permanent employees of the hospital, and seven of these participated in focus group discussion. The rate of exclusive breastfeeding from birth to six months was sixty six percent, and was measured by the responses from questionnaires, which defined as a practice whereby the infants receive only breastmilk without mixing it with other food. Seventy-seven percent of participants were continuing to breastfeed when they returned to work, with 24% (12/50) having to stop after three months. Factors associated with exclusive breastfeeding was caesarean delivery (OR 7.9; 95% CI 2.00, 31.08). Additionally, childcare at the workplace and the attitude of colleagues were found to be supporting factors for sustaining breastfeeding. Barriers included inadequate private facilities (location and equipment), lack of a breastfeeding break, workload, and inconvenient uniform. CONCLUSIONS Effort is needed to sustain breastfeeding after maternal return to work. Our findings are crucial in determining how best to support nursing mothers in breastfeeding after returning to work, particularly during the ongoing COVID-19 pandemic. A breastfeeding-friendly policy with clear operating guidelines in the workplace is critical to sustaining breastfeeding. Learning from others who have had a positive experience will ensure that all breastfeeding women are better supported in the workplace in future.
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Affiliation(s)
- Paveewan Jiravisitkul
- Department of Pediatrics, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Saraiorn Thonginnetra
- Department of Pediatrics, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Naruporn Kasemlawan
- Department of Pediatrics, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Thitiphong Suntharayuth
- grid.512982.50000 0004 7598 2416Data Management Unit, Centre of Learning and Research in Celebration of HRH Princess Chulabhorn’s 60th Birthday Anniversary, Chulabhorn Royal Academy, Bangkok, Thailand
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Adesanya AM, Barrett S, Moffat M, Aquino MRJ, Nicholson W, Turner G, Cook E, Tyndall S, Rankin J. Impact of the COVID-19 pandemic on expectant and new parents' experience of pregnancy, childbirth, breast feeding, parental responsiveness and sensitivity, and bonding and attunement in high-income countries: a systematic review of the evidence. BMJ Open 2022; 12:e066963. [PMID: 36523240 PMCID: PMC9748518 DOI: 10.1136/bmjopen-2022-066963] [Citation(s) in RCA: 2] [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] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To review the evidence on how pregnancy, birth experience, breast feeding, parental responsiveness and sensitivity, and bonding and attunement were impacted by COVID-19. METHODS We searched eight literature databases and websites of relevant UK-based organisations. The review focused on evidence during pregnancy and the early years (0-5 years). Studies of any study design published in English from 1 March 2020 to 15 March 2021 and conducted in high-income countries were included. Screening and data extraction were undertaken in duplicate. Evidence was synthesised using a narrative approach. Study quality of included studies was assessed using the Mixed Methods Appraisal Tool. RESULTS The search yielded 9776 publications, of which 26 met our inclusion criteria. Significant knowledge gaps on how COVID-19 affected pregnancy and breast feeding limited healthcare providers' ability to provide consistent evidence-based information and care at the start of the pandemic. There was an enduring sense of loss about loved ones being restricted from taking part in key moments. Parents were concerned about the limitations of virtual healthcare provision. Some parents reported more opportunities for responsive breast feeding and improved parent-infant bonding due to reduced social and work pressures. Women from minoritised ethnic groups were less likely to continue breast feeding and attributed this to a lack of face-to-face support. CONCLUSIONS The evidence suggests that new and expectant families have been both negatively and positively impacted by the COVID-19 pandemic and the resulting restrictions. The impacts on parents' opportunities to bond with their young children and to be attuned to their needs were felt unequally. It is important that emergency response policies consider the mother and the partner as a family unit when making changes to the delivery of maternal and child health and care services, so as to mitigate the impact on the family and existing health inequalities. PROSPERO REGISTRATION NUMBER CRD42021236769.
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Affiliation(s)
- Adenike Motunrayo Adesanya
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Simon Barrett
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Malcolm Moffat
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Maria Raisa Jessica Aquino
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Applied Research Collaboration North East and North Cumbria, Newcastle upon Tyne, UK
| | - Wendy Nicholson
- Office of Health Improvement and Disparities, UK Department of Health and Social Care, London, UK
| | - Gillian Turner
- Office of Health Improvement and Disparities, UK Department of Health and Social Care, London, UK
| | - Emma Cook
- Office of Health Improvement and Disparities, UK Department of Health and Social Care, London, UK
| | - Sarah Tyndall
- Office of Health Improvement and Disparities, UK Department of Health and Social Care, London, UK
| | - Judith Rankin
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Applied Research Collaboration North East and North Cumbria, Newcastle upon Tyne, UK
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Maria A, Mukherjee R, Upadhyay S, Pratima K, Bandyopadhyay T, Gupta R, Dubey B, Sharma A, Mall PK, Sahoo M, Pathak KK, Pawar P, Mohapatra A. Barriers and enablers of breastfeeding in mother-newborn dyads in institutional settings during the COVID-19 pandemic: A qualitative study across seven government hospitals of Delhi, India. Front Nutr 2022; 9:1052340. [PMID: 36570141 PMCID: PMC9773092 DOI: 10.3389/fnut.2022.1052340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/10/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction The COVID-19 pandemic disrupted newborn care and breastfeeding practices across most healthcare facilities. We undertook this study to explore the barriers and enablers for newborn care and breastfeeding practices in hospitals in Delhi, India for recently delivered mother (RDM)-newborn dyads during the first wave of the COVID-19 pandemic (2020) and inductively design a "pathway of impaction" for informing mitigatory initiatives during the current and future pandemics, at least in the initial months. Materials and methods We used an exploratory descriptive design (qualitative research method) and collected information from seven leading public health facilities in Delhi, India. We conducted separate interviews with the head and senior faculty from the Departments of Pediatrics/Neonatology (n = 12) and Obstetrics (n = 7), resident doctors (n = 14), nurses (labor room/maternity ward; n = 13), and RDMs (n = 45) across three profiles: (a) COVID-19-negative RDM with healthy newborn (n = 18), (b) COVID-19-positive RDM with healthy newborn (n = 19), and (c) COVID-19 positive RDM with sick newborn needing intensive care (n = 8) along with their care-giving family members (n = 39). We analyzed the data using grounded theory as the method and phenomenology as the philosophy of our research. Results Anxiety among clients and providers, evolving evidence and advisories, separation of the COVID-positive RDM from her newborn at birth, providers' tendency to minimize contact duration and frequency with COVID-positive mothers, compromised counseling on breastfeeding, logistic difficulties in expression and transportation of COVID-positive mother's milk to her baby in the nursery, COVID restrictions, staff shortage and unavailable family support in wards and nursery, and inadequate infrastructure were identified as major barriers. Keeping the RDM-newborn together, harmonization of standard operating procedures between professional associations and within and between departments, strategic mobilization of resources, optimization of human resources, strengthening client-provider interaction, risk triaging, leveraging technology, and leadership-in-crisis-situations were notable enablers. Conclusion The separation of the RDM and newborn led to a cascade of disruptions to newborn care and breastfeeding practices in the study institutions. Separating the newborn from the mother should be avoided during public health emergencies unless there is robust evidence favoring the same; routine institutional practices should be family centered.
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Affiliation(s)
- Arti Maria
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India,*Correspondence: Arti Maria
| | - Ritika Mukherjee
- Generating Research Insights for Development (GRID) Council, Executive Office, Noida, Uttar Pradesh, India
| | - Swati Upadhyay
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Kumari Pratima
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Tapas Bandyopadhyay
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Rachita Gupta
- WHO Country Office for India, Nutrition, R.K. Khanna Stadium, Safdarjung Enclave, New Delhi, India
| | - Bhawna Dubey
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Abhinav Sharma
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Pranaya Kumar Mall
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Manaswinee Sahoo
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Keshav Kumar Pathak
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Priyanka Pawar
- Generating Research Insights for Development (GRID) Council, Executive Office, Noida, Uttar Pradesh, India
| | - Archisman Mohapatra
- Generating Research Insights for Development (GRID) Council, Executive Office, Noida, Uttar Pradesh, India,Archisman Mohapatra
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Maria A, Singh BK, Agrawal P, Bandyopadhyay T. A short-term follow-up study on breastfeeding practices, growth parameters and immunization practices among babies born to COVID-19 positive mothers in a tertiary care hospital. J Trop Pediatr 2022; 69:7008359. [PMID: 36708041 DOI: 10.1093/tropej/fmad006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We aimed to study the impact of the COVID-19 pandemic on exclusive breastfeeding (EBF) rate and routine follow-up practices including immunization. A total of 62 neonates born to COVID-19 positive mothers and an equal number of neonates born to COVID-19 negative mothers were prospectively evaluated for EBF rate and routine neonatal follow-up practices including delay (>7 days) in routine immunization at 3 months follow-up. We further tried to compare the results across two epochs (epoch 1, March-June 2020 and epoch 2, July-November 2020). There was significantly lesser number of babies born to COVID-19 positive mothers on EBF at 3 months of age when compared with the control group (45.1% vs. 96.7%, p = 0.00) as well it was significantly lesser in epoch 1 when compared with epoch 2 (16% vs. 74%, p = 0.00). Further, a significantly higher number of babies born to COVID-19 positive mothers had their routine immunization delayed with no significant difference across the epochs. There was no significant difference in growth parameters between babies born to COVID-19 positive mother when compared with the control group as well as across the epochs. The COVID-19 pandemic has significantly disrupted the EBF rates as well as hampered the routine immunization practices among babies born to COVID-19 positive mothers. Although such practices got improved after the implementation of evidence-based national guidelines, but it is still much below when compared with those born to COVID-19 negative mother.
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Affiliation(s)
- Arti Maria
- Department of Neonatology, ABVIMS and Dr RML Hospital, New Delhi 110001, India
| | - Bhawana Komal Singh
- Department of Neonatology, ABVIMS and Dr RML Hospital, New Delhi 110001, India
| | - Payal Agrawal
- Department of Neonatology, ABVIMS and Dr RML Hospital, New Delhi 110001, India
| | - Tapas Bandyopadhyay
- Department of Neonatology, ABVIMS and Dr RML Hospital, New Delhi 110001, India
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Chertok IA, Artzi-Medvedik R, Arendt M, Sacks E, Otelea MR, Rodrigues C, Costa R, Linden K, Zaigham M, Elden H, Drandic D, Grylka-Baeschlin S, Miani C, Valente EP, Covi B, Lazzerini M, Mariani I. Factors associated with exclusive breastfeeding at discharge during the COVID-19 pandemic in 17 WHO European Region countries. Int Breastfeed J 2022; 17:83. [PMID: 36461061 PMCID: PMC9716162 DOI: 10.1186/s13006-022-00517-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 11/05/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Exclusive breastfeeding is the optimal infant nutrition, providing infants immunoprotection against many diseases including SARS-CoV-2 infection. Restrictions during the COVID-19 pandemic may have negatively affected breastfeeding practices in maternity care facilities. The aims of the study were to examine exclusive breastfeeding rates at discharge over time and to identify factors associated with exclusive breastfeeding during the pandemic. METHODS A cross-sectional survey was conducted among mothers who gave birth in a maternity care facility in the World Health Organization (WHO) European Region countries during the COVID-19 pandemic. The socio-ecological model was employed to examine intrapersonal, interpersonal, organizational, and community/society factors associated with maternal report of exclusive breastfeeding at the time of discharge. RESULTS There were 26,709 participating mothers from 17 European Region countries who were included in the analysis. Among the mothers, 72.4% (n = 19,350) exclusively breastfed and 27.6% (n = 7,359) did not exclusively breastfeed at discharge. There was an overall decline in exclusive breastfeeding rates over time (p = 0.015) with a significantly lower rate following the publication of the WHO breastfeeding guidelines on 23 June 2020 (AOR 0.88; 95% CI 0.82, 0.94). Factors significantly associated with exclusive breastfeeding outcomes in the logistic regression analysis included maternal age, parity, education, health insurance, mode of birth, inadequate breastfeeding support, lack of early breastfeeding initiation, lack of full rooming-in, birth attendant, perceived healthcare professionalism and attention, facility room cleanliness, timing of birth, and location of birth. CONCLUSIONS Results from the study indicate the decline in exclusive breastfeeding rates in the WHO European Region during the COVID-19 pandemic. Using the socio-ecological model to identify factors associated with breastfeeding outcomes facilitates an integrated and holistic approach to address breastfeeding needs among women across the region. These findings demonstrate the need to augment breastfeeding support and to protect exclusive breastfeeding among mother-infant dyads, in an effort to reverse the declining exclusive breastfeeding rates. The study highlights the need to educate mothers and their families about the importance of exclusive breastfeeding, reduce maternal-infant separation, increase professional breastfeeding support, and follow evidence-based practice guidelines to promote breastfeeding in a comprehensive and multi-level manner. TRIAL REGISTRATION NUMBER Clinical Trials NCT04847336.
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Affiliation(s)
- Ilana Azulay Chertok
- grid.20627.310000 0001 0668 7841Ohio University, Athens, OH USA ,grid.443022.30000 0004 0636 0840Ruppin College, Emek Hefer, Israel
| | - Rada Artzi-Medvedik
- grid.20627.310000 0001 0668 7841Ohio University, Athens, OH USA ,grid.7489.20000 0004 1937 0511Ben-Gurion University of the Negev, Beersheva, Israel
| | - Maryse Arendt
- BLL Beruffsverband vun den Laktatiounsberoderinnen zu Lëtzebuerg, Luxembourg, Luxembourg
| | - Emma Sacks
- grid.21107.350000 0001 2171 9311Johns Hopkins University, Baltimore, MD USA
| | - Marina Ruxandra Otelea
- grid.8194.40000 0000 9828 7548Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Carina Rodrigues
- grid.5808.50000 0001 1503 7226Instituto de Saude Publica, Universidade Do Porto, Porto, Portugal
| | - Raquel Costa
- grid.5808.50000 0001 1503 7226Instituto de Saude Publica, Universidade Do Porto, Porto, Portugal
| | - Karolina Linden
- grid.8761.80000 0000 9919 9582Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mehreen Zaigham
- grid.411843.b0000 0004 0623 9987Skane University Hospital, Lund University, Lund, Sweden
| | - Helen Elden
- grid.8761.80000 0000 9919 9582Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Daniela Drandic
- Reproductive Rights Advocacy Program (RODA)- Parents in Action, Zagreb, Croatia
| | | | - Céline Miani
- grid.7491.b0000 0001 0944 9128School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Emanuelle Pessa Valente
- grid.418712.90000 0004 1760 7415Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Benedetta Covi
- grid.418712.90000 0004 1760 7415Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Marzia Lazzerini
- grid.418712.90000 0004 1760 7415Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Ilaria Mariani
- grid.418712.90000 0004 1760 7415Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste, Italy
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Liu Y, Chee JH, Wang Y. Parental burnout and resilience intervention among Chinese parents during the COVID-19 pandemic. Front Psychol 2022; 13:1034520. [DOI: 10.3389/fpsyg.2022.1034520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/11/2022] [Indexed: 12/03/2022] Open
Abstract
IntroductionParental burnout is a mental state that combines long-term stress and depression with an overwhelming feeling of parental pressure.MethodsIn Study 1, we conducted a web-based survey of 390 Chinese parents (75.1% mothers) with children aged 1–18 years old (Mean age = 9.05 years, SD = 5.098) to examine the parental burnout during the COVID-19 global pandemic and to identify associated factors during the national lockdown. In Study 2, eight weeks of resilience intervention was administered to 20 parents to compare parental resilience and parental burnout before and after the intervention.ResultsThe correlational study showed that greater parental burnout occurred in parents with the lower educational levels and in parents of school-age children. The risk factors of parental burnout included household burden and children’s interference with work; while protective factors included living materials, family atmosphere, and parent–child meeting frequency. The intervention study showed the effectiveness of meditation intervention in resilience and parental burnout, suggesting that meditation training can effectively increase parental resilience and reduce parental burnout.DiscussionThese findings demonstrate the risk and protective factors associated with parental burnout during the COVID-19 lockdown and highlight the positive role of meditation in mitigating parental burnout.
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Atchan M, Graham K, Hartney N, Martis R, Kearney L, Davey K, Daellenbach R, Hall H, Sweet L. Either 'a blessing in disguise', or 'I couldn't get help,': Australian and Aotearoa NZ women's experiences of early infant feeding during COVID-19. Women Birth 2022; 36:e305-e313. [PMID: 36443218 PMCID: PMC9699799 DOI: 10.1016/j.wombi.2022.11.003] [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] [Received: 06/03/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND To manage the COVID-19 pandemic, public health restrictions and a rapid pivot to telehealth occurred. Peripartum services were significantly affected by a strained infrastructure. Decreased face to face access to health services and support affected maternal experiences and confidence internationally, yet little was reported with the Australian and Aotearoa New Zealand context. AIM To explore the early parenting and infant feeding experiences of new mothers from Australia and Aotearoa New Zealand in the context of a pandemic. METHODS An interpretive qualitative approach and thematic analysis obtained an in-depth understanding of the experiences of 27 mothers who gave birth during the first wave of the COVID-19 pandemic in 2020. FINDINGS Australian and Aotearoa New Zealand women reported similar experiences, which varied contextually. Restrictions and requirements impacted favourably and unfavourably. Many women found the peace and space of social distancing an unexpected benefit and were proud of their achievements, whilst others shared feelings of isolation and distress. Some women felt they instinctively did what they needed to do. Experiences correlated with differing levels of self-efficacy. DISCUSSION While many women relished the freedom from social obligations when faced with feeding challenges, there was general dissatisfaction with the level of support available. Care was fragmented, and health care needs were unmet, impacting feeding and parenting decisions and mental health. CONCLUSION Access to timely and appropriate professional support is an important factor in establishing breastfeeding and developing parenting confidence, particularly in the context of a pandemic and should be a health policy priority.
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Affiliation(s)
- Marjorie Atchan
- School of Nursing, Midwifery and Public Health, University of Canberra, Locked Bag 1, Canberra, ACT 2617 Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia,Corresponding author at: School of Nursing, Midwifery and Public Health, University of Canberra, Locked Bag 1, Canberra, ACT 2617, Australia
| | - Kristen Graham
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Nicki Hartney
- Deakin University, School of Nursing and Midwifery, 1 Gheringhap St., Geelong, Vic. 3227 Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Ruth Martis
- Liggins Institute, The University of Auckland, Aotearoa, New Zealand,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Lauren Kearney
- The University of Queensland, School of Nursing, Midwifery & Social Work, Brisbane, QLD 4072 Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Kym Davey
- School of Nursing and Midwifery, Monash University, Peninsula campus, McMahons Rd, Frankston, VIC 3199 Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Rea Daellenbach
- Department of Health Practice, Ara Institute of Canterbury, New Zealand,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Helen Hall
- Institute of Health and Wellbeing, Federation University, Mt Helen Campus, Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Linda Sweet
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia,Institute of Health and Wellbeing, Federation University, Mt Helen Campus, Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
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Mena-Tudela D, Iglesias-Casas S, Cervera-Gasch A, Andreu-Pejó L, González-Chordá VM, Valero-Chillerón MJ. Breastfeeding and Obstetric Violence during the SARS-CoV-2 Pandemic in Spain: Maternal Perceptions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15737. [PMID: 36497811 PMCID: PMC9740849 DOI: 10.3390/ijerph192315737] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/18/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Catalan legislation, a pioneer in Europe, has defined obstetric violence (OV) as "preventing or hindering access to truthful information, necessary for autonomous and informed decision-making". The definition also states that OV can affect physical and mental health, as well as sexual and reproductive health. Some authors have expressed concern about an increase in OV during the SARS-CoV-2 pandemic. During the pandemic, recommendations were also openly offered on the non-establishment and/or early abandonment of breastfeeding without scientific evidence to support them. Experiencing a traumatic childbirth can influence breastfeeding outcomes. Here, we conducted a cross-sectional study using a self-administered online questionnaire. The sample consisted of women who gave birth in Spain between March 2020 and April 2021. The mean age was 34.41 (±4.23) years. Of the women, 73% were employed, 78.2% had a university education, and almost all were Caucasian. Among the subjects, 3.3% were diagnosed with SARS-CoV-2 during pregnancy and 1% were diagnosed during delivery. Some of the women (1.6%) were advised to stop breastfeeding in order to be vaccinated. Women diagnosed with SARS-CoV-2 during delivery (p = 0.048), belonging to a low social class (p = 0.031), with secondary education (p = 0.029), or who suffered obstetric violence (p < 0.001) perceived less support and that the health care providers were less inclined to resolve doubts and difficulties about breastfeeding. Breastfeeding has been significantly challenged during the pandemic. In addition to all the variables to be considered that make breastfeeding support difficult, we now probably need to add SARS-CoV-2 diagnosis and OV.
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Affiliation(s)
- Desirée Mena-Tudela
- Department of Nursing, Faculty of Health Sciences, Universitat Jaume I, Avda. Sos I Baynat s/n, 12071 Castellón, Spain
| | - Susana Iglesias-Casas
- Department of Obstetrics, Hospital do Salnés, Villgarcía de Aurousa, 36619 Pontevendra, Spain
| | - Agueda Cervera-Gasch
- Department of Nursing, Faculty of Health Sciences, Universitat Jaume I, Avda. Sos I Baynat s/n, 12071 Castellón, Spain
| | - Laura Andreu-Pejó
- Department of Nursing, Faculty of Health Sciences, Universitat Jaume I, Avda. Sos I Baynat s/n, 12071 Castellón, Spain
| | - Victor Manuel González-Chordá
- Department of Nursing, Faculty of Health Sciences, Universitat Jaume I, Avda. Sos I Baynat s/n, 12071 Castellón, Spain
| | - María Jesús Valero-Chillerón
- Department of Nursing, Faculty of Health Sciences, Universitat Jaume I, Avda. Sos I Baynat s/n, 12071 Castellón, Spain
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72
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Chang Y, Li KMC, Chien L, Lee EY, Hong SA, Coca KP. Associations between breastfeeding intention, breastfeeding practices and post-natal depression during the COVID-19 pandemic: A multi-country cross-sectional study. MATERNAL & CHILD NUTRITION 2022; 19:e13450. [PMID: 36349949 PMCID: PMC9749603 DOI: 10.1111/mcn.13450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 09/14/2022] [Accepted: 10/11/2022] [Indexed: 11/11/2022]
Abstract
Associations between breastfeeding intention, duration and post-natal depression (PND) have been shown in pre-COVID-19 studies. However, studies during COVID-19 have not examined the associations between breastfeeding intention, breastfeeding practices, and PND in an international sample of post-natal women, taking into consideration COVID-19 related factors. This is the first study to address this gap as both PND and breastfeeding may be affected by COVID-19, and have important long-term effects on women's and infant's health. A cross-sectional internet-based survey was conducted with 3253 post-natal women from five countries: Brazil, South Korea, Taiwan, Thailand, and the United Kingdom from July to November 2021. The results showed that women who intended to breastfeed during pregnancy had lower odds of having PND than women who did not intend to. Women who had no breastfeeding intention but actually breastfed had greater odds (AOR 1.75) of having PND than women who intended to breastfeed and actually breastfed. While there was no statistical significance in expressed breast milk feeding in multivariable logistic regression models, women who had shorter duration of breastfeeding directly on breast than they planned had greater odds (AOR 1.58) of having PND than those who breastfed longer than they planned even after adjusting for covariates including COVID-19-related variables. These findings suggested the importance of working with women on their breastfeeding intention. Tailored support is required to ensure women's breastfeeding needs are met and at the same time care for maternal mental health during and beyond the pandemic.
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Affiliation(s)
- Yan‐Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative CareKing's College LondonLondonUK
| | - Kan M. C. Li
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative CareKing's College LondonLondonUK,Guy's and St. Thomas' NHS Foundation TrustEvelina London Children's HospitalLondonUK
| | - Li‐Yin Chien
- Institute of Community Health Care, National Yang Ming Chiao Tung UniversityYang‐Ming CampusTaipeiTaiwan
| | - Eun Y. Lee
- Department of NursingCatholic Kkottongnae UniversityCheongjuRepublic of Korea
| | - Seo A. Hong
- ASEAN Institute for Health DevelopmentMahidol UniversityNakhon PathomThailand,Institute for Health and SocietyHanyang UniversitySeoulRepublic of Korea
| | - Kelly P. Coca
- Department of Women's Health Nursing, Escola Paulista de EnfermagemUniversidade Federal de São PauloSão PauloBrazil
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73
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Davis KM, Lu L, Williams B, Roas-Gomez MV, Leziak K, Jackson J, Feinglass J, Yee LM. The Stress of Parenting in the Postpartum Period During the COVID-19 Pandemic. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2022; 3:895-903. [PMID: 36479375 PMCID: PMC9712040 DOI: 10.1089/whr.2022.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/07/2022] [Indexed: 11/11/2022]
Abstract
Background The COVID-19 pandemic produced a major shift in parental roles, which disproportionally exacerbated existing challenges for low-income new parents. Our objective was to identify pandemic-related parenting challenges experienced by low-income postpartum individuals in the context of the early months of the COVID-19 pandemic. Methods Semistructured interviews with 40 low-income postpartum individuals were conducted within 10 weeks after giving birth in April 2020-June 2020. Interviews addressed maternal health and well-being, parental stress, including COVID-related barriers to providing for children, and access to essential services. Interview themes were developed using the constant comparative method. Results Half (n = 20) the participants identified as non-Hispanic Black and 38% (n = 15) as Hispanic; 75% (n = 30) were parents of multiple children. Parenting-related themes included challenges of parenting multiple children, barriers to maintaining self-care, and novel barriers to providing for children. Participants discussed handling new roles as educators, struggles with entertaining, allocating time among children, and effects of the pandemic on older children. Participants frequently described their lack of alone time, changes in self-care and coping strategies due to continuous parenting, and effects on maternal mental health like increased anxiety. Many participants reported lack of communal support, financial stress, and difficulty accessing services. Conclusions New burdens introduced by the pandemic challenged low-income individuals' health and well-being. Understanding these psychosocial stressors and developing interventions to ameliorate these burdens may be key to promoting family health during difficult times; one potential solution for preventing postpartum depression is offering continual social services. Clinical Trial No.: NCT03922334.
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Affiliation(s)
- Ka'Derricka M. Davis
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Layna Lu
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Brittney Williams
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Maria V. Roas-Gomez
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Karolina Leziak
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jenise Jackson
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Joe Feinglass
- Division of General Internal Medicine, Department of Medicine, and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Lynn M. Yee
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Address correspondence to: Lynn M. Yee, MD, MPH, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, 250 E. Superior Street, Suite 5-2145, Chicago, IL 60611, USA,
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74
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Morse H, Brown A. Mothers' experiences of using Facebook groups for local breastfeeding support: Results of an online survey exploring midwife moderation. PLOS DIGITAL HEALTH 2022; 1:e0000144. [PMID: 36812558 PMCID: PMC9931280 DOI: 10.1371/journal.pdig.0000144] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/11/2022] [Indexed: 06/18/2023]
Abstract
It is established that access to ongoing informational, emotional and social support from trained health professionals including midwives assists mothers in meeting their breastfeeding goals. Social media is increasingly being used to offer this support. Research has demonstrated that support via platforms such as Facebook can improve maternal knowledge and self-efficacy and ultimately breastfeeding duration. One specific form of support that is under researched is the use of Breastfeeding Support Facebook (BSF) groups that are aimed at supporting women in specific local areas, often with links to face to face support. Initial research highlights that mothers' value these groups but the role that midwives play in offering support to local mothers through these groups has not been examined. The aim of this study was therefore to examine mothers' perceptions of midwifery support for breastfeeding delivered through these groups, specifically when midwives played an active role in being a group 'moderator' or leader. An online survey was completed by 2028 mothers who were part of local BSF groups comparing the experiences of those participating in groups moderated by midwives versus other moderators such as peer supporters. Moderation was an important factor in mothers' experiences, with trained support associated with greater engagement and more frequent visits, impacting on perceptions of group ethos, reliability and inclusivity. Midwife moderation was uncommon (5% of groups) but valued: midwife moderators offered a high level of support to mothers in their groups, with 87.5% having received midwife support often or sometimes and 97.8% rating this useful or very useful. Access to a midwife moderated group was also associated with viewing local face to face midwifery support for breastfeeding more positively. This is a significant finding, highlighting that online support complements face-to-face support in local settings (67% of groups were linked to a physical group), and improves continuity of care (14% of mothers who had midwife moderators received care from them). As such midwife moderated or supported groups have the potential to add value to local face to face services and improve breastfeeding experiences in communities. The findings have important implications to support the development of integrated online interventions to improve public health.
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Affiliation(s)
- Holly Morse
- Department of Public Health, Policy and Social Sciences, Swansea University, United Kingdom
- Centre for Lactation, Infant Feeding and Translation research (LIFT), Swansea University, United Kingdom
| | - Amy Brown
- Department of Public Health, Policy and Social Sciences, Swansea University, United Kingdom
- Centre for Lactation, Infant Feeding and Translation research (LIFT), Swansea University, United Kingdom
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75
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Bernstein K, Gonrong P, Shallat S, Seidel B, Leider J. Creating a Culture of Breastfeeding Support and Continuity of Care in Central Illinois. Health Promot Pract 2022; 23:108S-117S. [DOI: 10.1177/15248399221111180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Central Illinois breastfeeding rates fall short of the recommendation to breastfeed exclusively through 6 months, and Black, low-income, and rural families disproportionately experience low rates. A continuity of care framework, which emphasizes interdisciplinary coordination from the prenatal period through weaning, can support breastfeeding. This case study describes an innovative practice model informed by the Collective Impact Model (CIM) designed to promote breastfeeding continuity of care and community support in Central Illinois. Development and maintenance of the Central Illinois Breastfeeding Professional Network (CIBPN), a network of diverse public health practitioners, leveraged CIM principles. The CIBPN began with influential Breastfeeding Champions, identified through the Illinois State Physical Activity and Nutrition program. Champions convened Central Illinois breastfeeding allies and led the CIBPN to coalesce around a common agenda and engage in mutually reinforcing activities. Linked breastfeeding data for families giving birth at a Central Illinois hospital and receiving postnatal care at a health center were analyzed as a snapshot of CIBPN initiatives. The CIBPN engaged at least 135 practitioners and more than 27 organizations. At least 33 people received advanced breastfeeding training, and many professional development opportunities were offered. Numerous breastfeeding support improvements were made at and between CIBPN sites. Breastfeeding rates at the birthing hospital and health center were stable, including during the COVID-19 pandemic. This article contributes to the practice-based evidence for breastfeeding support by strengthening continuity of care through a successful application of the CIM by public health practitioners.
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Affiliation(s)
| | | | - Shelly Shallat
- OSF Healthcare Children’s Hospital of Illinois, Peoria, IL, USA
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Beth Seidel
- UnityPoint Health—Methodist, Peoria, IL, USA
| | - Julien Leider
- Institute for Health Research and Policy, University of Chicago, Chicago, IL, USA
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76
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Ergün S, Kaynak S, Aydın B. Fear of COVID-19 and related factors affecting mothers' breastfeeding self-efficacy during the pandemic. Rev Esc Enferm USP 2022; 56:e20220130. [PMID: 36279566 PMCID: PMC10101722 DOI: 10.1590/1980-220x-reeusp-2022-0130en] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 09/13/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE This study aimed to determine the breastfeeding self-efficacy levels of mothers during the pandemic period, to compare them according to various characteristics, and to examine the relationship between the fear of COVID-19 and breastfeeding self-efficacy. METHOD The data of this descriptive and cross-sectional were collected through a web-based survey of 392 mothers between June and August 2021. The data collection tools were the Introductory Data Form, the Breast-feeding Self-Efficacy Scale-Short Form, and the Fear of COVID-19 Scale. RESULTS The mean score for breastfeeding self-efficacy was found to be 56.18 ± 8.24, while the mean score for the Fear of COVID-19 scale was 21.77 ± 6.14. Having a high fear of COVID-19, breastfeeding more frequently in this period, and suspecting that they had COVID-19 affected the breastfeeding self-efficacy scores positively, whereas graduating from primary school had a negative effect on self-efficacy. CONCLUSION The breastfeeding self-efficacy of mothers who were fearful of COVID-19, who breastfed more frequently during the pandemic, and who had a higher education level were positively affected.
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Affiliation(s)
- Sibel Ergün
- Balıkesir University, Department of Pediatric Nursing, Faculty of
Health Sciences, Balıkesir, Turkey
| | - Serap Kaynak
- Balıkesir University, Department of Pediatric Nursing, Faculty of
Health Sciences, Balıkesir, Turkey
| | - Beray Aydın
- Institute of Health Sciences, Balıkesir, Turkey
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77
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Lubbe W, Niela-Vilén H, Thomson G, Botha E. Impact of the COVID-19 Pandemic on Breastfeeding Support Services and Women's Experiences of Breastfeeding: A Review. Int J Womens Health 2022; 14:1447-1457. [PMID: 36225180 PMCID: PMC9549794 DOI: 10.2147/ijwh.s342754] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 09/08/2022] [Indexed: 11/06/2022] Open
Abstract
Objective The aim of this systematic review was to explore the impact of the COVID-19 pandemic on breastfeeding support services and continuation rates. Methods Electronic searches were undertaken in seven databases: Academic Search Complete, Springer Nature Journals, CINAHL Medline, Health Source: Nursing/Academic Edition, Masterfile premier, and SocINDEX. Publications following the COVID-19 pandemic between January 2020 and March 2022 were searched for using the following keywords: impact or effect or influence and breastfeeding support and breastfeeding continuation and COVID-19 or coronavirus. Fifteen studies were included for investigation and extracted to identify seven themes related to breastfeeding support during COVID-19. Results Factors which impacted breastfeeding support during the COVID-19 pandemic included separation, lack of skin-to-skin contact, insufficient support, online breastfeeding support, the impact of the pandemic on breastfeeding rates and experiences, fears of the pandemic, and the need for additional support. The pandemic mostly influenced breastfeeding support negatively, with a small exception occurring where some mothers experienced lockdown as positive since it protected the mother-infant dyad from unwanted visitors. Virtual breastfeeding support was introduced in many contexts; however, practitioners and mothers reported that this could not replace the need for face-to-face support. Conclusion Breastfeeding is a lifesaving intervention, especially in the face of a disruption such as a pandemic. This work highlights the need for clear, consistent, and evidence-based information about risks, and for key practices to be maintained including not separating mothers and infants, promoting skin-to-skin contact, and ensuring availability of high-quality breastfeeding support.
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Affiliation(s)
- Welma Lubbe
- School of Nursing Science/NuMIQ Research Focus Area, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa,Correspondence: Welma Lubbe, Email
| | | | - Gill Thomson
- School of Community Health and Midwifery, University of Central Lancashire, Preston, UK
| | - Elina Botha
- School of Social Services and Health Care, Tampere University of Applied Sciences, Tampere, Finland
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78
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Morse H, Brown A. The benefits, challenges and impacts of accessing social media group support for breastfeeding: A systematic review. MATERNAL & CHILD NUTRITION 2022; 18:e13399. [PMID: 35821651 PMCID: PMC9480914 DOI: 10.1111/mcn.13399] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/09/2022] [Accepted: 06/15/2022] [Indexed: 12/12/2022]
Abstract
Breastfeeding support is a key component in meeting the public health responsibility of increasing breastfeeding rates, with access to individualised, convenient and linked support across services central to improved outcomes. With the rise of new technology and the COVID‐19 pandemic, social media (SM) support for breastfeeding has become increasingly popular and it is important to understand how and why mothers access such support, and from whom, to optimise services and to meet mothers’ needs. Increasing research is building on women's use and experience of SM for breastfeeding, although there is a paucity of UK data. This systematic review aimed to understand the impacts of SM support for breastfeeding, including benefits and challenges, to establish the evidence for wider provision within maternity services. The search was limited to studies published in English and focused on the self‐directed use of social media groups for breastfeeding (defined as platforms that facilitate group support via interactivity, allowing for user‐generated content and subsequent responses). Of 327 papers retrieved, 13 studies were included for review. The six themes identified were: breastfeeding context, including factors impacting women's decision making; the relational impact of belonging to an online community; increased self‐efficacy; critiques of SM; the nature and types of support commonly sought and received; and breastfeeding duration as an outcome. The findings confirm that mothers value SM groups for community support, which normalises breastfeeding and provides the support they attribute to improved outcomes, and highlight that UK research focused on provision linked to wider services is needed. Joining a social media (SM) group to seek support is common among those mothers intending to breastfeed. For these mothers SM groups have the potential to provide valued support where it is lacking, or in addition to their existing networks. SM groups offer reciprocity of knowledge sharing and esteem support. Belonging to a supportive online community promotes emotional wellbeing and self‐efficacy, improving breastfeeding outcomes. Online peer support is valued and trusted as a complementary source of information and shared experience. Mothers are aware of issues of reliability, lack of regulation and the need to be discerning of online advice.
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Affiliation(s)
- Holly Morse
- Department of Public Health, Policy and Social Sciences Swansea University Swansea UK
- Centre for Lactation, Infant Feeding and Translation Research (LIFT) Swansea University Swansea UK
| | - Amy Brown
- Department of Public Health, Policy and Social Sciences Swansea University Swansea UK
- Centre for Lactation, Infant Feeding and Translation Research (LIFT) Swansea University Swansea UK
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79
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Muacevic A, Adler JR. Breastfeeding Practices During COVID-19: A Narrative Article. Cureus 2022; 14:e30588. [PMID: 36420243 PMCID: PMC9678492 DOI: 10.7759/cureus.30588] [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: 07/27/2022] [Accepted: 10/22/2022] [Indexed: 01/25/2023] Open
Abstract
COVID-19 was declared a pandemic because of the rapid rise in cases worldwide. Since then, it has altered the ordinary lives of people around the globe. The surge in the pandemic also questioned breastfeeding practices. As breastfeeding is one of the most critical steps toward the wellness of the newborn and maternal health, whether to follow this practice with a child born COVID-19 positive or in the case of suspected infection in the mother was also questioned. There was little information and awareness on the influence of COVID-19 on breastfeeding and postnatal care of newborns; as a result, this situation created havoc and confusion about which processes were to be carried out and how. Thus, this article examines the supporting data and correct procedures to carry out while breastfeeding newborns born during the pandemic. For the collection of evidence, searches were conducted using PubMed and Web of Science along with multiple data published on the websites of the World Health Organization (WHO) and Ministry of Health and Family Welfare, Government of India (MoHFW) between the period March 2020 to March 2022. Articles suggested significant changes in the hospital policies, such as disallowing visits to the mother or baby and changes in the mentality of mothers where a few mothers breastfed their newborn with all the septic care, like masks and frequent handwashing practices and others discontinued breastfeeding and used artificial feeds for the newborn. Even the WHO guidelines state that the mother should breastfeed the infant with good septic care. However, due to the havoc of the pandemic and miscommunication of the various policies, there was a gap in implementing the correct measures. This article provides insight into the breastfeeding scenario in COVID-19-positive or suspected mothers with COVID-19.
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80
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Grant A, Pell B, Copeland L, Brown A, Ellis R, Morris D, Williams D, Phillips R. Views and experience of breastfeeding in public: A qualitative systematic review. MATERNAL & CHILD NUTRITION 2022; 18:e13407. [PMID: 35914544 PMCID: PMC9480936 DOI: 10.1111/mcn.13407] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 12/02/2022]
Abstract
Breastfeeding rates in many Global North countries are low. Qualitative research highlights that breastfeeding in public is a particular challenge, despite mothers often having the legal right to do so. To identify barriers and facilitators, we systematically searched the qualitative research from Organisation for Economic Co-operation and Development countries relating to breastfeeding in public spaces from 2007 to 2021. Data were analysed using the Thematic Synthesis technique. The review was registered with PROSPERO (registration number: CRD42017081504). Database searching identified 3570 unique records. In total, 74 papers, theses, or book chapters, relating to 71 studies, were included, accounting for over 17,000 mothers. Overall, data quality was high. Our analysis identified that five core factors influenced mothers' thought processes and their breastfeeding in public behaviour: legal system; structural (in)equality; knowledge; beliefs and the social environment. Macro-level factors relating to legislation and inequality urgently require redress if breastfeeding rates are to be increased. Widespread culture change is also required to enhance knowledge, change hostile beliefs and thus the social environment in which mother/infant dyads exist. In particular, the sexualisation of breasts, disgust narratives and lack of exposure among observers to baby-led infant feeding patterns resulted in beliefs which created a stigmatising environment. In this context, many mothers felt unable to breastfeed in public; those who breastfed outside the home were usually highly self-aware, attempting to reduce their exposure to conflict. Evidence-based theoretically informed interventions to remove barriers to breastfeeding in public are urgently required.
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Affiliation(s)
- Aimee Grant
- Centre for Trials ResearchCardiff UniversityCardiffUK
- Centre for Lactation, Infant Feeding and Translational ResearchSwansea UniversitySwanseaUK
| | - Bethan Pell
- Centre for Trials ResearchCardiff UniversityCardiffUK
- DECIPHerCardiff UniversityCardiffUK
| | - Lauren Copeland
- DECIPHerCardiff UniversityCardiffUK
- Division of Population MedicineCardiff UniversityCardiffUK
| | - Amy Brown
- Centre for Lactation, Infant Feeding and Translational ResearchSwansea UniversitySwanseaUK
| | - Rebecca Ellis
- Centre for Lactation, Infant Feeding and Translational ResearchSwansea UniversitySwanseaUK
| | - Delyth Morris
- Subject Librarian, Dental and MedicineCardiff UniversityCardiffUK
| | | | - Rhiannon Phillips
- Division of Population MedicineCardiff UniversityCardiffUK
- Cardiff School of Sport and Health SciencesCardiff Metropolitan UniversityCardiffUK
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81
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Sabancı Baransel E, Uçar T, Güney E. Effects of prenatal breast-feeding education on postnatal breast-feeding fear in pregnant women in the COVID-19 pandemic: A randomized clinical trial. Int J Nurs Pract 2022; 29:e13105. [PMID: 36059199 PMCID: PMC9537865 DOI: 10.1111/ijn.13105] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/05/2022] [Accepted: 08/22/2022] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to investigate the effectiveness of prenatal breast-feeding education provided to pregnant women who experience fear of breast-feeding in the COVID-19 pandemic period. METHODS A prospective randomized controlled trial study was conducted with 128 pregnant women (64 in the experimental group and 64 in the control group) between November 2021 and February 2022. The data were collected via the Numeric Pain Rating Scale, the Breastfeeding Motivation Scale and the Iowa Infant Feeding Attitude Scale to assess fear, motivation and attitudes regarding breast-feeding. The pregnant women in the experimental group were provided with and education programme on 'safe breastfeeding in the COVID-19 pandemic'. The breast-feeding education included in standard care was given to the control group after pre-test data collection was completed. RESULTS The significant differences in the mean Numeric Pain Rating Scale, Breastfeeding Motivation Scale and Iowa Infant Feeding Attitude Scale scores of the groups were in favour of the experimental group (P < 0.05). It was determined that in the first postnatal month, in the experimental group, the numbers of women who believed that their breast-feeding was not affected by COVID-19 and the numbers of infants solely breastmilk-fed were higher compared to the control group (P < 0.05). CONCLUSION Prenatal breast-feeding education about safe breast-feeding in the COVID-19 pandemic period can reduce fears of breast-feeding and increase motivation and approving attitudes regarding breast-feeding.
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Affiliation(s)
- Esra Sabancı Baransel
- Department of Midwifery, Faculty of Health Sciences, İnönü University, Malatya, Turkey
| | - Tuba Uçar
- Department of Midwifery, Faculty of Health Sciences, İnönü University, Malatya, Turkey
| | - Esra Güney
- Department of Midwifery, Faculty of Health Sciences, İnönü University, Malatya, Turkey
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82
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Zorro C, MacRae E, Teresa-Palacio M, Williams EE, Aldecoa-Bilbao V, Bhat R, Hickey A, Dassios T, Greenough A. Assessing the impact of the COVID-19 pandemic on parental satisfaction in two European neonatal intensive care units. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2021-001396. [PMID: 36645774 PMCID: PMC9490299 DOI: 10.1136/bmjpo-2021-001396] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/12/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Neonatal units across the world have altered their policies to prevent the spread of infection during the COVID-19 pandemic. Our aim was to report parental experience in two European neonatal units during the pandemic. METHODS Parents of infants admitted to each neonatal unit were asked to complete a questionnaire regarding their experience during the COVID-19 pandemic. At King's College Hospital, UK (KCH), data were collected prospectively between June 2020 and August 2020 (first wave). At the Hospital Clínic Barcelona (HCM), data were collected retrospectively from parents whose infants were admitted between September 2020 and February 2021 (second and third wave). RESULTS A total of 74 questionnaires were completed (38 from KCH and 36 from HCM). The parents reported that they were fully involved or involved in the care of their infants in 34 (89.4%) responses in KCH and 33 (91.6%) responses in HCM. Quality time spent with infants during the pandemic was more negatively affected at KCH compared with HCM (n=24 (63.2%) vs n=12 (33.3%)). Parents felt either satisfied or very satisfied with the updates from the clinical care team in 30 (79.0%) responses at KCH and 30 (83.4%) responses in HCM. The parents felt that the restrictions negatively affected breast feeding in six (15.8%) responses at KCH and two (5.6%) responses in HCM. Travelling to the hospital was reported overall to be sometimes difficult (39.2%); this did not differ between the two units (14 (36.8%) respondents at KCH and 15 (41.6%) from HCM). Furthermore, the self-reported amount of time spent giving kangaroo care also did not differ between the two countries. CONCLUSION Restrictive policies implemented due to the COVID-19 pandemic had a negative impact on the perception of quality of time spent by parents with their newborns admitted to neonatal units.
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Affiliation(s)
- Carolina Zorro
- Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, UK
| | - Eva MacRae
- Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, UK
| | - Marta Teresa-Palacio
- Neonatology Department, Barcelona Clinic University Hospital Biomedical Diagnosis Center, Barcelona, Spain
| | - Emma E Williams
- Department of Women and Children's Health, King's College London, London, UK
| | - Victoria Aldecoa-Bilbao
- Neonatology Department, Barcelona Clinic University Hospital Biomedical Diagnosis Center, Barcelona, Spain
| | - Ravindra Bhat
- Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, UK
| | - Ann Hickey
- Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, UK
| | - Theodore Dassios
- Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, UK.,Department of Women and Children's Health, King's College London, London, UK
| | - Anne Greenough
- Department of Women and Children's Health, King's College London, London, UK
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83
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Holand BL, de Oliveira Agostini C, Pacheco MCM, de Leon DMZ, Drehmer M, Bosa VL. Association between breastfeeding and complementary feeding in pre-pandemic and pandemic COVID-19 times: Maternar cohort study. J Pediatr (Rio J) 2022; 98:496-503. [PMID: 35139343 PMCID: PMC8801333 DOI: 10.1016/j.jped.2021.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/25/2021] [Accepted: 12/14/2021] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE Evaluate the association between breastfeeding, exclusive breastfeeding at six months and the introduction of complementary feeding during the pre-pandemic and the COVID-19 pandemic periods. METHODS Cohort study conducted with puerperal women and their newborns in the immediate postpartum period at a reference maternity hospital in Southern Brazil between 2018-2020. The COVID-19 pandemic period and the need to work outside the home during restricted circulation were the factors of exposure. The outcome evaluated was the weaning in the first six months (breastfeeding and exclusive breastfeeding) and the introduction of complementary feeding before the sixth month of life. RESULTS 547 puerperal women and their newborns were included. During the COVID-19 pandemic, there was a higher risk to weaning of exclusive breastfeeding up until six months (RR 1.16; 95%CI 1.03-1.31) and introducing complementary feeding early (RR 1.40; 95%CI 1.01-1.96). The need to work outside the home during the COVID-19 pandemic increased the risk of not breastfeeding exclusively at the sixth month (RR 1.27; 95%CI 1.08-1.49). CONCLUSIONS The difficulties of the pandemic did reflect negatively on breastfeeding and complementary feeding practices. The pandemic was a risk factor for the early weaning of exclusive breastfeeding and the introduction of complementary feeding. However, not having to work outside the home during the pandemic period was a protective factor for exclusive breastfeeding at six months.
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Affiliation(s)
- Bruna Luiza Holand
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Social, Programa de Pós-Graduação em Epidemiologia, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Nutrição, Programa de Pós-Graduação em Alimentação Nutrição e Saúde, Porto Alegre, RS, Brazil.
| | - Clarissa de Oliveira Agostini
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Nutrição, Programa de Pós-Graduação em Alimentação Nutrição e Saúde, Porto Alegre, RS, Brazil
| | - Marcela Caridad Medina Pacheco
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Nutrição, Programa de Pós-Graduação em Alimentação Nutrição e Saúde, Porto Alegre, RS, Brazil
| | - Dulce Montserrat Zuchini de Leon
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Nutrição, Graduação em Nutrição, Porto Alegre, RS, Brazil
| | - Michele Drehmer
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Social, Programa de Pós-Graduação em Epidemiologia, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Nutrição, Programa de Pós-Graduação em Alimentação Nutrição e Saúde, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Nutrição, Graduação em Nutrição, Porto Alegre, RS, Brazil
| | - Vera Lúcia Bosa
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Nutrição, Programa de Pós-Graduação em Alimentação Nutrição e Saúde, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Nutrição, Graduação em Nutrição, Porto Alegre, RS, Brazil
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84
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Magnazi MB, Sartena G, Goldberg M, Zimmerman D, Ophir E, Baruch R, Goldsmith R, Endevelt R. Impact of the COVID-19 pandemic on breastfeeding in Israel: a cross- sectional, observational survey. Int Breastfeed J 2022; 17:61. [PMID: 36028836 PMCID: PMC9412797 DOI: 10.1186/s13006-022-00505-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 08/08/2022] [Indexed: 11/25/2022] Open
Abstract
Background Since March 2020, the world has been coping with the COVID-19 pandemic. One group particularly affected were mothers of newborns. The Israeli government imposed three lockdowns, with the first from 14 March to 11 May 2020. It had the strictest rules, with effects among mothers including panic and stress. These mothers coped with new challenges as they were often without help from the extended family, could not meet lactation counsellors in person, and stayed longer on maternity leave. Methods A cross-sectional, observational study collected data via an online anonymous survey in Israel. From 27 April 2020 to 11 May 2020, the survey was distributed through Facebook groups for breastfeeding mothers. It contained 32 multiple choice and 10 open questions. Multivariate logistic regression analysis, with adjustment for potential factors, was performed to determine the pandemic-related factors influencing breastfeeding, including the decision to breastfeed longer than planned. Results Five hundred eighty women participated in the survey. Most mothers were over 30, (mean age 32.55), married with an academic degree (81.5%). 127 (22%) women reported changes in their lactation plans. 85 (15%) responded that due to the COVID -19 pandemic they extended their breastfeeding period and 42 (7%) reported shortening it. A significant relationship was found between this extension and returning to work later than expected adjusted OR = 2.38 95% CI 1.46,3.87). When asked to rank steps national health authorities should take to encourage breastfeeding, the highest agreement (96%) was with maternity leave extension. More than 90% believed that receiving breastfeeding counselling at home and/or in hospital will encourage breastfeeding. Conclusions This study demonstrated that most women did not change their breastfeeding patterns because of the lockdown though some did experience difficulties. Some lengthened their breastfeeding period, as, due to the pandemic, they stayed home longer than expected. This finding should be considered for future emergency situations. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-022-00505-5.
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Affiliation(s)
- Moran Blaychfeld Magnazi
- Nutrition Division, Ministry of Health, Jerusalem, Israel. .,School of Public Health, University of Haifa, Haifa, Israel.
| | - Gaya Sartena
- Nutrition Division, Ministry of Health, Jerusalem, Israel
| | - Michal Goldberg
- Administration for Strategic and Economic Planning, Ministry of Health, Jerusalem, Israel.,Public Health Department, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Deena Zimmerman
- Maternal Child and Adolescent, Ministry of Health, Jerusalem, Israel
| | - Einat Ophir
- Ministry of Health, Public Health Services, Tel Aviv, Israel
| | - Ravit Baruch
- Maternal Child and Adolescent, Ministry of Health, Jerusalem, Israel
| | | | - Ronit Endevelt
- Nutrition Division, Ministry of Health, Jerusalem, Israel.,School of Public Health, University of Haifa, Haifa, Israel
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85
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Coca KP, Lee EY, Chien LY, Souza ACP, Kittikul P, Hong SA, Chang YS. Postnatal women's breastfeeding beliefs, practices, and support during the COVID-19 pandemic: a cross-sectional comparative study across five countries. Int Breastfeed J 2022; 17:58. [PMID: 35978362 PMCID: PMC9385077 DOI: 10.1186/s13006-022-00497-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background Women with COVID-19 experienced numerous concerns and doubts about the safety of breastfeeding their babies, and lack of support may have impacted breastfeeding practices. This study aims to compare breastfeeding beliefs, practices, and contact with healthcare professionals regarding the level of postnatal feeding support provided during the COVID-19 pandemic in Brazil, South Korea, Taiwan, Thailand, and the United Kingdom. Methods A multi-country cross-sectional study was conducted with postnatal women in five countries. Women up to six months postpartum were invited to complete an online survey concerning the transmission of preventative measures, beliefs toward breastfeeding, infant feeding practices in the last 24 hours and experiences of postnatal infant feeding support between July to November 2021. Bivariate and multivariate analyses were performed to identify the association. Results Of the 3,253 eligible responses received, 39.5% of children were aged between one and two months, but in Taiwan (36%) and South Korea (42.8%) they were between three and four months. The mean of the belief score was significantly different among countries (p < 0.0001). Women in Brazil and the UK had a higher rate of breastfeeding at the breast (90.7% and 85.4%, respectively) compared to the three Asian countries (p < 0.0001) while feeding with expressed breastmilk in Thailand (59.9%), Taiwan (52.6%), and South Korea (50.4%) was higher than the others (p < 0.0001). Brazil and UK mothers (mean = 16.0 and 14.5 respectively) had a higher mean score for belief toward breastfeeding during the COVID-19 than the others. These results are inversely associated with breastfeeding but positively related to formula feeding practice. Postnatal feeding support during the COVID-19 pandemic was mainly provided by healthcare professionals (67.1%) and peers / family through face-to-face personal contact (51.6%) in all countries. Conclusion Some differences were found in breastfeeding beliefs during the COVID-19 pandemic in Asian countries. A positive breastfeeding belief was associated with the practice of breastfeeding at the breast. Women from all countries received postpartum infant feeding support from health professionals and peers / family through personal contacts. Governments need to emphasize and disseminate the importance of breastfeeding safety, especially in Asian countries.
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Affiliation(s)
- K P Coca
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil
| | - E Y Lee
- Department of Nursing, Catholic Kkottongnae University, Cheongju-si, Republic of Korea
| | - L Y Chien
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Yang-Ming Campus, Taipei, Taiwan
| | - A C P Souza
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil
| | - P Kittikul
- Breastfeeding Clinic Nakhon Pathom Hospital, Nakhon Pathom, Thailand
| | - S A Hong
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand. .,Institute for Health and Society, Hanyang University, Seoul, Republic of Korea.
| | - Y S Chang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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86
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Sweet L, Muller A, Kearney L, Martis R, Hartney N, Davey K, Daellenbach R, Hall H, Atchan M. Predictors and impact of women's breastfeeding self-efficacy and postnatal care in the context of a pandemic in Australia and Aotearoa New Zealand. Midwifery 2022; 114:103462. [PMID: 36001943 DOI: 10.1016/j.midw.2022.103462] [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: 02/07/2022] [Revised: 07/05/2022] [Accepted: 08/16/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate predictors of breastfeeding self-efficacy, postnatal care experiences, and there subsequent impact on breastfeeding outcomes in Australia and Aotearoa New Zealand in the context of the COVID-19 pandemic. DESIGN A cross-sectional online survey collected data between August and October 2020 with recruitment via social media. Quantitative data were analyzed using descriptive analyses, and linear and logistic regression analysis related to the Breastfeeding Self-Efficacy Scale-Short Form findings. Open text responses were analyzed using content analysis. FINDINGS There were 1001 complete responses. Visitor restrictions impacted the woman's early parenting experience in both positive and negative ways. One third of participants stated their postnatal needs were not met with 82 stating that they had no postnatal care at all. During the first six weeks postnatal, 48.1% felt not very or not at all confident caring for their baby. Despite 94.3% of participants initiating breastfeeding, only 70% were exclusively breastfeeding at six weeks. The mean self-efficacy score was 49.98 suggesting the need for additional help, with first time mothers having a statistically significant lower score. DISCUSSION/CONCLUSION Sub-optimal postnatal care and support negatively influence breastfeeding self-efficacy. Women desired additional help during the COVID-19 pandemic inclusive of support and education to meet their postnatal needs and exclusively breastfeed. IMPLICATIONS FOR PRACTICE Women require appropriate and timely postnatal care and support to promote confidence in caring for baby and achieve their breastfeeding goals. Preferably this care should be provided face-to-face.
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Affiliation(s)
- Linda Sweet
- School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood 3125, Australia; Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia.
| | - Amanda Muller
- College of Nursing and Health Sciences, Flinders University, South Australia, Australia
| | - Lauren Kearney
- School of Nursing, Midwifery and Social Work, University of Queensland, Australia
| | - Ruth Martis
- Liggins Institute, The University of Auckland, Aotearoa New Zealand
| | - Nicki Hartney
- School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood 3125, Australia
| | - Kym Davey
- School of Nursing and Midwifery, Monash University, Australia
| | - Rea Daellenbach
- Department of Health Practice, Ara Institute of Canterbury, New Zealand
| | - Helen Hall
- School of Health, Federation University, Australia
| | - Marjorie Atchan
- School of Nursing, Midwifery & Public Health, University of Canberra, Australia
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87
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Hielscher L, Ludlow A, Mengoni SE, Rogers S, Irvine K. The experiences of new mothers accessing feeding support for infants with down syndrome during the COVID-19 pandemic. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 70:469-478. [PMID: 38699493 PMCID: PMC11062264 DOI: 10.1080/20473869.2022.2109000] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/26/2022] [Indexed: 05/05/2024]
Abstract
Infants with Down syndrome are more likely to experience feeding problems and mothers are likely to require more feeding support than mothers of typically developing infants. During the COVID-19 pandemic, many feeding support services changed from face-to-face to online, which impacted some maternal feeding experiences negatively, but no studies to date have explored the impact for mothers of infants with Down syndrome. Thematic analysis was conducted on semi-structured interviews from thirteen new mothers of infants (aged 8-17 months) with Down syndrome in the UK. Three superordinate themes were generated: (1) Every baby with Down syndrome has a unique journey, (2) There's no point asking, they won't know, (3) Lack of in-person support. Many mothers expressed frustrations over health professionals' lack of Down syndrome specific knowledge resulting in unmet needs, further magnified due to the nature of the virtual support being offered. Moreover, mothers struggled with reduced social support from other mothers when encountering feeding problems. These results hold real-world implications for health professionals who could provide more specialised face-to-face feeding support to mothers of infants with Down syndrome. This should be prioritised for children's overall development and mothers' wellbeing.
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Affiliation(s)
- L. Hielscher
- Department of Psychology, Sport and Geography, University of Hertfordshire, Hatfield, UK
| | - A. Ludlow
- Department of Psychology, Sport and Geography, University of Hertfordshire, Hatfield, UK
| | | | - S. Rogers
- University of Hertfordshire, Hatfield, Herts, UK
| | - K. Irvine
- University of Hertfordshire, Hatfield, Herts, UK
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88
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Siwik E, Larose S, Peres D, Jackson KT, Burke SM, Mantler T. Experiences of At-Risk Women in Accessing Breastfeeding Social Support During the Covid-19 Pandemic. J Hum Lact 2022; 38:422-432. [PMID: 35466789 PMCID: PMC9329748 DOI: 10.1177/08903344221091808] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND With strict public health measures implemented in March 2020 due to the COVID-19 pandemic, many breastfeeding parents, who are within an at-risk population, have experienced limited formal and/or informal breastfeeding social support. In the Canadian context, the experiences of these women is unknown. RESEARCH AIM To explore the experiences of at-risk postpartum breastfeeding women in accessing formal and informal breastfeeding social support during the COVID-19 pandemic. METHODS This was a prospective, longitudinal interpretive description study using mixed methods. Data were gathered using an online survey and one 52-112-min semi-structured interview at 12-weeks postpartum. At-risk breastfeeding participants were those who lack social support and had at least one of the following: age < 25 years; experiencing or had experienced intimate partner violence; or of low income. We sought participants' experiences of accessing breastfeeding social support during the first few months of the COVID-19 pandemic/lockdown. Seven participants completed the survey and the interview. RESULTS Participants identified that the COVID-19 pandemic created barriers to accessing formal and informal breastfeeding social support, which stemmed from public health restrictions and difficulties communicating online with families and healthcare providers. Additionally, participants identified that the COVID-19 pandemic/lockdowns facilitated feelings of connectedness, protection, and resiliency. CONCLUSION We provide preliminary insight into the experiences of trying to access breastfeeding social support during the COVID-19 pandemic. Future researchers should seek to prioritize improved communication and resources in supporting breastfeeding during COVID-19 and future pandemics/lockdowns.
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Affiliation(s)
- Emila Siwik
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
| | - Samantha Larose
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
| | - Dalia Peres
- Health Sciences with Biology Program, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
| | - Kimberley T Jackson
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
| | - Shauna M Burke
- School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
| | - Tara Mantler
- School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
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89
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Tekiner SA, Çullas Ilarslan NE, Günay F, Ceyhun Peker GA. The Effect of Knowledge Levels of Breastfeeding Mothers About the Disease on Their Levels of Anxiety During the COVID-19 Pandemic Process. Front Public Health 2022; 10:856228. [PMID: 35899173 PMCID: PMC9309883 DOI: 10.3389/fpubh.2022.856228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/30/2022] [Indexed: 11/28/2022] Open
Abstract
Background: The health impact of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) spans across all age groups including mothers and their newly born infants; and breastfeeding women during this pandemic deserves special attention due to its short and long-term health implications. When planning the current study, our hypothesis was that the anxiety of transmitting the COVID-19 disease to the baby through breastfeeding would increase among breastfeeding women and it would predominantly be state anxiety. The current study aims to investigate the relationship between the knowledge levels of breastfeeding mothers about COVID-19 and their anxiety levels. Materials and Methods This is a cross-sectional study and we aimed to reach all mothers with babies between 0 and 24 months of age who applied to the Healthy Child Care Policlinic of Ankara University Faculty of Medicine Hospital between July 1 and August 31, 2020 Questionnaires measuring the level of knowledge about COVID-19 disease and breast milk and questionnaires measuring anxiety levels were administered to mothers. The state-trait anxiety levels and knowledge levels of breastfeeding mothers about COVID-19 disease, as well as their knowledge levels about breast milk and sociodemographic characteristics were compared. Results A total of 145 breastfeeding mothers were included in the study. The trait anxiety was found to be either absent or mild in 89 (61.4%), moderate in 28 (19.3%), and advanced in 28 (19.3%) mothers. The state anxiety level, however, was found to be either absent or mild in 51 (35.2%), moderate in 42 (29%), and advanced in 52 (35.9%) mothers. When mothers' trait and state anxiety levels and their knowledge levels about breast milk, their knowledge levels about COVID-19 disease and their sociodemographic characteristics were compared, it was determined that mothers with 0–6 months old infants had lower state anxiety levels compared to mothers with older infants. However, the anxiety levels of mothers whose children were >12 months old were mostly moderate (p < 0.05). There was no statistically significant difference in terms of other variables (p < 0.05). A positive correlation was found between the child age and state anxiety level (p = 0.027). Conclusion Moderate and advanced level of state anxiety was found to be higher than level of trait anxiety parallel to our hypothesis. Among breastfeeding mothers, those with the lowest state anxiety scores were those who had babies between 0 and 6 months. It is important to support breastfeeding mothers in promoting breastfeeding, especially after 6 months of birth. Policymakers, obstetricians and especially the family physicians should be aware that adverse life events may put a higher burden on the emotional wellbeing of breastfeeding women especially after 6 months of birth of the babies. So, breastfeeding promotion, protection and support strategies should be reconsidered specially after 6 months.
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Affiliation(s)
- Selda Ayşe Tekiner
- Department of Family Medicine, Ankara University School of Medicine, Ankara, Turkey
| | | | - Fatih Günay
- Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
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90
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Chua CMS, Mathews J, Ong MSB, Liew KK, Shorey S. Use of telelactation interventions to improve breastfeeding outcomes among mothers: A mixed-studies systematic review. Women Birth 2022; 36:247-256. [PMID: 35792035 DOI: 10.1016/j.wombi.2022.06.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 06/20/2022] [Accepted: 06/27/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Breastfeeding has multiple positive impacts on infants, mothers, and the economy. PROBLEM However, the global breastfeeding rates fall short of the World Health Organization's recommendations. Telelactation interventions have been shown to improve breastfeeding outcomes, yet this field has not been systematically reviewed. AIM This mixed-studies systematic review aims to consolidate and synthesize findings on the available evidence of telelactation interventions on breastfeeding outcomes, uptake of these interventions, and provide recommendations for future lactation interventions. METHODS A literature search was conducted in six electronic databases (PubMed, EMBASE, CINAHL, PsycINFO, Cochrane, and Scopus) and one gray literature (Mednar) from their inception date to October 2021. Thirteen articles met the selection criteria, and thematic synthesis was conducted to consolidate and synthesize findings from the included studies. FINDINGS Three themes and nine subthemes were identified: (1) Attributes and receptivity of telelactation interventions, (2) Benefits associated with telelactation interventions, and (3) Recommendations and improvement opportunities. DISCUSSION Telelactation interventions were well-received by stakeholders (mothers, fathers, and healthcare providers), and receptivity was found to be influenced by primiparity and the perceived usefulness of telelactation consultations (extrinsic motivation). These interventions showed promising improvement in the provider-user relationship and breastfeeding outcomes. Future studies should make telelactation user-friendly, secure their telelactation platforms, increase communication options and built-in functions, and improve care continuity. CONCLUSION This review highlighted the advantages, recommendations, and future considerations for telelactation interventions. More research is needed to pilot telelactation interventions in various regions and obtain longitudinal data with different time points.
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Affiliation(s)
- Crystal Min Siu Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore
| | - Jancy Mathews
- National University Polyclinics, National University Health Systems, 1 Jurong East Street 21, Tower A, Basement 2, Singapore 609606, Singapore
| | - Mabel Sor Boh Ong
- National University Polyclinics, National University Health Systems, 1 Jurong East Street 21, Tower A, Basement 2, Singapore 609606, Singapore
| | - Kelly Kaili Liew
- National University Polyclinics, National University Health Systems, Blk 451 #02-307, Clementi Ave 3, Singapore 120451, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597, Singapore.
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91
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Twanow JDE, McCabe C, Ream MA. The COVID-19 Pandemic and Pregnancy: Impact on Mothers and Newborns. Semin Pediatr Neurol 2022; 42:100977. [PMID: 35868726 PMCID: PMC9122838 DOI: 10.1016/j.spen.2022.100977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 11/30/2022]
Abstract
The severe acute respiratory syndrome coronavirus 2 pandemic has markedly, and likely permanently, changed health care. This includes changing the obstetric and perinatal care of mothers and infants, and by extension, the care of their families. Infection during pregnancy is associated with an increased risk for severe coronavirus disease 2019 illness and related complications that can significantly impact maternal health and the health of the neonate. Viral transmission from mother to fetus is possible, but rare during pregnancy, and current health care policies focusing on maternal masking, and hand washing allows infected mothers to safely care for neonates (including nursing or feeding with expressed breast milk). The newly developed vaccines have been shown to be safe and effective for pregnant and breast-feeding mothers, with measurable antibody levels in cord blood and breast milk potentially providing a level of passive immunity to neonates. While studies looking at short-term outcomes for neonates have been reassuring, it is critical that we continue to work to understand and improve the care of pregnant woman and newborns with coronavirus disease 2019 to optimize long term outcomes. Although the knowledge base continues to evolve, the available evidence influencing the care of pregnant women and their infants is summarized in this focused review.
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Affiliation(s)
- Jaime-Dawn E. Twanow
- Nationwide Children's Hospital Columbus, OH,The Ohio State University College of Medicine, Columbus, OH,Address reprint requests to Jaime-Dawn E. Twanow, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205
| | - Corinne McCabe
- Nationwide Children's Hospital Columbus, OH,The Ohio State University College of Medicine, Columbus, OH
| | - Margie A. Ream
- Nationwide Children's Hospital Columbus, OH,The Ohio State University College of Medicine, Columbus, OH
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92
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Broom M, Cochrane T, Cruickshank D, Carlisle H. Parental perceptions on the impact of visiting restrictions during COVID-19 in a tertiary neonatal intensive care unit. J Paediatr Child Health 2022; 58:1747-1752. [PMID: 35775959 PMCID: PMC9350120 DOI: 10.1111/jpc.16079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/14/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022]
Abstract
AIM During the first wave of coronavirus disease 2019 (COVID-19), visiting guidelines in neonatal units changed to maintain the health and safety of staff, neonates, and families. In the neonatal intensive care unit/special care nursery (NICU/SCN), restrictions were placed on parental contact and extended family excluded. Our team was interested in evaluating the effect of these restrictions on parental stress and discharge confidence. METHODS A prospective descriptive study utilising survey methodology was undertaken. The survey was developed and previously used by the NICU research group to evaluate parental knowledge and understanding, parental role, communication, and parental stress (admission/discharge). We have also included a section regarding COVID19 visiting restrictions (ETH.2020.LRE.00124). The survey used a five-level Likert scale. Statistical analysis was completed using SPSS version 21. RESULTS Notably, 33 surveys were returned. Results showed visiting restrictions reduced social contact between partners 26/33 (84%), with their other children 14/16 (87.5%) and extended family 28/33 (84.8%). Parents indicated that they had high levels of confidence in understanding their babies' medical needs (78-93%) and gaining hands-on experience caring for their baby (87-100%). However, 11/33 (33%) of parents reported concerns with discharge processes and gaining consistent information as challenges during their baby's admission. Notably, 17/33 (51.5) stated their NICU/SCN experience had been very to extremely stressful. Parents openly described how the restrictions had affected their mental/emotional health identifying the need to treat parents as one unit, and a gap in the psychological support available for families. CONCLUSION Support services and consistency of communication with NICU/SCN families need to be enhanced and prioritised during periods of restrictions, especially peri-discharge.
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Affiliation(s)
- Margaret Broom
- Centenary Hospital for Women and ChildrenCanberra HospitalCanberraAustralian Capital TerritoryAustralia,SYNERGY: Nursing and Midwifery Research CentreUniversity of Canberra and ACT HealthCanberraAustralian Capital TerritoryAustralia
| | - Tim Cochrane
- Centenary Hospital for Women and ChildrenCanberra HospitalCanberraAustralian Capital TerritoryAustralia,College of Health and MedicineAustralian National University Medical SchoolCanberraAustralian Capital TerritoryAustralia
| | - Debbora Cruickshank
- Centenary Hospital for Women and ChildrenCanberra HospitalCanberraAustralian Capital TerritoryAustralia
| | - Hazel Carlisle
- Centenary Hospital for Women and ChildrenCanberra HospitalCanberraAustralian Capital TerritoryAustralia,College of Health and MedicineAustralian National University Medical SchoolCanberraAustralian Capital TerritoryAustralia
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Proulx K, Lenzi-Weisbecker R, Hatch R, Hackett K, Omoeva C, Cavallera V, Daelmans B, Dua T. Nurturing care during COVID-19: a rapid review of early evidence. BMJ Open 2022; 12:e050417. [PMID: 35680273 PMCID: PMC9184993 DOI: 10.1136/bmjopen-2021-050417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic has brought significant changes to family life, society and essential health and other services. A rapid review of evidence was conducted to examine emerging evidence on the effects of the pandemic on three components of nurturing care, including responsive caregiving, early learning, and safety and security. DESIGN Two academic databases, organisational websites and reference lists were searched for original studies published between 1 January and 25 October 2020. A single reviewer completed the study selection and data extraction with verification by a second reviewer. INTERVENTIONS We included studies with a complete methodology and reporting on quantitative or qualitative evidence related to nurturing care during the pandemic. PRIMARY AND SECONDARY OUTCOME MEASURES Studies reporting on outcomes related to responsive caregiving, early learning, and safety and security were included. RESULTS The search yielded 4410 citations in total, and 112 studies from over 30 countries met our eligibility criteria. The early evidence base is weighted towards studies in high-income countries, studies related to caregiver mental health and those using quantitative survey designs. Studies reveal issues of concern related to increases in parent and caregiver stress and mental health difficulties during the pandemic, which was linked to harsher and less warm or responsive parenting in some studies. A relatively large number of studies examined child safety and security and indicate a reduction in maltreatment referrals. Lastly, studies suggest that fathers' engagement in caregiving increased during the early phase of the pandemic, children's outdoor play and physical activity decreased (while screen time increased), and emergency room visits for child injuries decreased. CONCLUSION The results highlight key evidence gaps (ie, breastfeeding support and opportunities for early learning) and suggest the need for increased support and evidence-based interventions to ensure young children and other caregivers are supported and protected during the pandemic.
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Affiliation(s)
- Kerrie Proulx
- Research and Evaluation, FHI 360, Durham, North Carolina, USA
- Alliance for Human Development, Samuel Lunenfeld Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
| | | | - Rachel Hatch
- Research and Evaluation, FHI 360, Durham, North Carolina, USA
| | - Kristy Hackett
- Research and Evaluation, FHI 360, Durham, North Carolina, USA
- Epidemiology Division, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Carina Omoeva
- Research and Evaluation, FHI 360, Durham, North Carolina, USA
| | - Vanessa Cavallera
- Department of Mental Health and Substance Abuse Use, WHO, Geneva, Switzerland
| | - Bernadette Daelmans
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, WHO, Geneva, Switzerland
| | - Tarun Dua
- Department of Mental Health and Substance Abuse Use, WHO, Geneva, Switzerland
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94
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Aydin E, Weiss SM, Glasgow KA, Barlow J, Austin T, Johnson MH, Lloyd-Fox S. COVID-19 in the context of pregnancy, infancy and parenting (CoCoPIP) study: protocol for a longitudinal study of parental mental health, social interactions, physical growth and cognitive development of infants during the pandemic. BMJ Open 2022; 12:e053800. [PMID: 35667736 PMCID: PMC9170803 DOI: 10.1136/bmjopen-2021-053800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION While the secondary impact of the COVID-19 pandemic on the psychological well-being of pregnant women and parents has become apparent over the past year, the impact of these changes on early social interactions, physical growth and cognitive development of their infants is unknown, as is the way in which a range of COVID-19-related changes have mediated this impact. This study (CoCoPIP) will investigate: (1) how parent's experiences of the social, medical and financial changes during the pandemic have impacted prenatal and postnatal parental mental health and parent-infant social interaction; and (2) the extent to which these COVID-19-related changes in parental prenatal and postnatal mental health and social interaction are associated with fetal and infant development. METHODS AND ANALYSIS The CoCoPIP study is a national online survey initiated in July 2020. This ongoing study (n=1700 families currently enrolled as of 6 May 2021) involves both quantitative and qualitative data being collected across pregnancy and infancy. It is designed to identify the longitudinal impact of the pandemic from pregnancy to 2 years of age as assessed using a range of parent- and self-report measures, with the aim of identifying if stress-associated moderators (ie, loss of income, COVID-19 illness, access to ante/postnatal support) appear to impact parental mental health, and in turn, infant development. In addition, we aim to document individual differences in social and cognitive development in toddlers who were born during restrictions intended to mitigate COVID-19 spread (eg, social distancing, national lockdowns). ETHICS AND DISSEMINATION Ethical approval was given by the University of Cambridge, Psychology Research Ethics Committee (PRE.2020.077). Findings will be made available via community engagement, public forums (eg, social media,) and to national (eg, NHS England) and local (Cambridge Universities Hospitals NHS Foundation Trust) healthcare partners. Results will be submitted for publication in peer-reviews journals.
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Affiliation(s)
- Ezra Aydin
- Department of Psychology, University of Cambridge, Cambridge, UK
- Department of Psychiatry, Columbia University, New York City, NY, USA
| | - Staci M Weiss
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Kevin A Glasgow
- Department of Education, University of Cambridge, Cambridge, UK
| | - Jane Barlow
- Department of Social Policy, University of Oxford, Oxford, Oxfordshire, UK
| | - Topun Austin
- Rosie Hospital, Cambridge, Cambridgeshire, UK
- NIHR Cambridge Biomedical Research Centre, Cambridge, Cambridgeshire, UK
| | - Mark H Johnson
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Sarah Lloyd-Fox
- Department of Psychology, University of Cambridge, Cambridge, UK
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95
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Impact of Coronavirus Disease-2019 on Hospital Care for Neonatal Opioid Withdrawal Syndrome. J Pediatr 2022; 245:47-55. [PMID: 35131283 PMCID: PMC8816795 DOI: 10.1016/j.jpeds.2022.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/24/2022] [Accepted: 02/01/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare prenatal exposures, hospital care processes, and hospitalization outcomes for opioid-exposed newborns before and during the coronavirus disease 2019 (COVID-19) pandemic. STUDY DESIGN In this multicenter retrospective analysis, data were collected from 19 Massachusetts hospitals, including 5 academic and 14 community hospitals. The pre-COVID-19 cohort was defined as births occurring during March 1, 2019-February 28, 2020, and the COVID-19 cohort was defined as births occurring during March 1, 2020-December 31, 2020. Opioid-exposed newborns born at ≥35 weeks of gestation were included. Differences in prenatal substance exposures, hospital care processes, and neonatal opioid withdrawal syndrome (NOWS) outcomes, including pharmacologic treatment for NOWS (PharmTx), length of stay (LOS), and as-needed (prn) treatment failure rates, were evaluated. RESULTS There were 663 opioid-exposed newborns in the pre-COVID-19 group and 476 in the COVID-19 group. No between-group differences were seen in prenatal substance exposures or the need for PharmTx. Compared with the pre-COVID-19 group, in the COVID-19 group there was less rooming-in after maternal discharge (53.8% vs 63.0%; P = .001) and less care in the pediatric unit setting (23.5% vs 25.3%; P = .001), longer LOS (adjusted risk ratio, 1.04; 95% CI, 1.01-1.08), and a higher rate of breast milk receipt at discharge (aOR, 2.03; 95% CI, 1.22-3.39). Within the subset of academic centers, more infants failed prn treatment in the COVID-19 group (53.8% vs 26.5%, P = .02; aOR, 3.77; 95% CI, 0.98-14.5). CONCLUSIONS Among the hospitals in our collaborative, hospital processes for NOWS, including care setting, rooming-in, and LOS were negatively impacted in the COVID-19 group, particularly in academic medical centers.
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96
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Breastfeeding, Complementary Feeding, Physical Activity, Screen Use, and Hours of Sleep in Children under 2 Years during Lockdown by the COVID-19 Pandemic in Chile. CHILDREN 2022; 9:children9060819. [PMID: 35740756 PMCID: PMC9221584 DOI: 10.3390/children9060819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 11/16/2022]
Abstract
Infants and children are a risk group in terms of developing healthy habits, an important aspect if we consider that many of them were born during the COVID-19 pandemic. Our objective was to evaluate compliance with lifestyle recommendations proposed at the national and international levels in children aged 0 to 23 months during confinement due to the COVID-19 pandemic in Chile. A cross-sectional study was conducted, and 211 online questionnaires were completed with sociodemographic and lifestyle information of children. Our results show high compliance with the recommendations on breastfeeding intake (78.3% and 69.5% in 0–5-month-old and 6–23-month-old children, respectively); age of starting complementary feeding (87.4%); non-consumption of salt and sugar (80.1%), non-caloric sweeteners (90.7%), and sweet and salty snacks (68.9%); and hours of physical activity (66.8%) and sleep (65.4%). However, we observed low compliance with the recommendations on the age of introduction of dinner (58.0%), eggs (23.0%), legumes (39.2%), and fish (35.1%); low consumption of legumes (43.4%) and fish (20.5%); and low compliance with the recommendations on screen use during meals (59.2%) and daily screen hours (41.2%). In conclusion, feeding behavior, physical activity, use of screens, and hours of sleep in children were altered by confinement during the pandemic, harming the development of healthy lifestyles.
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97
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Literature Review of Mothers Diagnosed With COVID-19 and the Impact on Breastfeeding Their Newborns. Nurs Womens Health 2022; 26:234-241. [PMID: 35551888 PMCID: PMC9611848 DOI: 10.1016/j.nwh.2022.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 03/04/2022] [Accepted: 03/29/2022] [Indexed: 01/09/2023]
Abstract
In early 2020, newborns were separated from their mothers who were diagnosed with COVID-19 infection. The purpose of this literature review is to examine the current evidence to determine if the transmission of COVID-19 infection to the neonate increases if newborns are directly breastfed by mothers who are positive for COVID-19 infection. There were 28 studies conducted in seven countries, with 10 of those studies conducted in the United States. In total, 5,123 neonates were born to mothers diagnosed with COVID-19, with 3,872 neonates determined to have been breastfed or provided mixed feeding including breast milk. Overall, 2.35% (91/3,872) of the newborns tested positive, and all recovered from COVID-19 infection. As frontline health care providers, nurses are instrumental in offering support and education on the risks and benefits of breastfeeding for individuals diagnosed with COVID-19.
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98
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Licheni SH, Devaraja L, Watson B, Simeonovic M, Cheng DR, Hoq M, Standish J, Gawler L, McNab S, Danchin M. Impact of COVID-19 public health restrictions on hospital admissions for young infants in Victoria, Australia. J Paediatr Child Health 2022; 58:1001-1006. [PMID: 35020962 DOI: 10.1111/jpc.15885] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/18/2021] [Accepted: 12/26/2021] [Indexed: 12/14/2022]
Abstract
AIM Strict public health measures during the COVID-19 pandemic led to less support for infants and their parents. We aimed to characterise the frequency and nature of infant admissions to the Royal Children's Hospital (RCH), Melbourne in 2020, compared to the previous year. METHODS A retrospective review of medical records identified infants ≤3 months admitted to the general medicine unit, RCH from March to September in 2019 and 2020. Diagnoses potentially related to the impact of public health measures and reduced family and community supports were identified and compared to all infant diagnoses across both years. Clinical characteristics and need for referral for additional supports or mental health services were also ascertained. RESULTS There were fewer admissions for infants ≤3 months in 2020 (n = 411) compared to 2019 (n = 678), with a threefold increase in admissions with a primary or secondary diagnosis of feeding difficulties, growth disturbance, infant irritability or maternal mental health concerns (191/411; 46% vs. 97/678; 14%). There were more infants of first-time parents (112/191; 59% vs. 44/97; 45%) and a reduction in the number of admissions due to infection (145/411; 35%; vs. 467/678; 69%). CONCLUSION During the COVID-19 pandemic, there was a threefold increase in admissions for infants ≤3 months due to poor growth, feeding difficulties, irritability and maternal mental health concerns in 2020 compared to 2019. These findings may inform future pandemic planning and policy development to ensure maintenance of community supports such as maternal child health nurse (MCHN) service delivery for young infants.
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Affiliation(s)
- Shane H Licheni
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Latha Devaraja
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Benjamin Watson
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Marcelle Simeonovic
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Daryl R Cheng
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Monsurul Hoq
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Jane Standish
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Louise Gawler
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Sarah McNab
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Margie Danchin
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
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99
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Komaroff AR, Forest S. Lessons Learned from the Pandemic—We Can Do Better. CLINICAL LACTATION 2022. [DOI: 10.1891/cl-2021-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Many breastfeeding issues can be addressed with postpartum lactation support. However, COVID-19 presented new challenges for the breastfeeding dyad with a disruption in normal healthcare practices. The objective of the study was to examine new mothers’ breastfeeding intentions and practices during the COVID-19 pandemic. A 40-question survey was administered to a convenience sample of 50 new mothers during April–June 2020. Findings revealed most mothers (52%) had the intention to breastfeed for one year or longer. However, at the time of hospital discharge only 34% of mothers were exclusively breastfeeding and 60% of mothers were supplementing with formula within the first four days of life. Recommendations for bridging the gap between the hospital and primary care setting include educating providers and nurses on breastfeeding management practices, increasing hospital lactation support, and using telelactation to provide remote support to mothers.
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100
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Nanishi K, Okawa S, Hongo H, Shibanuma A, Abe SK, Tabuchi T. Influence of the COVID-19 pandemic on breastfeeding support for healthy mothers and the association between compliance with WHO recommendations for breastfeeding support and exclusive breastfeeding in Japan. PeerJ 2022; 10:e13347. [PMID: 35611173 PMCID: PMC9124456 DOI: 10.7717/peerj.13347] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/06/2022] [Indexed: 01/13/2023] Open
Abstract
Background Professional breastfeeding support contributes to maternal and child health. However, the influence of the current coronavirus disease 2019 (COVID-19) pandemic on breastfeeding support has not been carefully examined. Therefore, we assessed maternal breastfeeding intention and professional breastfeeding support before and during the pandemic. We further examined the association of compliance with World Health Organization (WHO) recommendations for professional breastfeeding support with exclusive breastfeeding during the pandemic. Methods This cross-sectional, internet-based, questionnaire study analyzed data from 484 healthy women with live singleton births between 15 October 2019 and 25 October 2020 in Japan. A delivery before 5 March 2020 was classified as a before-pandemic delivery (n = 135), and a delivery after 6 March 2020 was a during-pandemic delivery (n = 349). Among the ten breastfeeding support steps recommended by the WHO, we assessed the five steps that are measurable by maternal self-report and would likely exhibit variability. Receipt of a free formula sample or invitation to a free sample campaign by the time of survey was also asked. Infant feeding status at the time of the survey was measured among women with infants younger than 5 months, which was a subgroup of mothers who delivered during the pandemic. Mothers were asked what was given to infants during the 24 h before the survey and when nothing other than breast milk was given, the status was classified as exclusive breastfeeding. Results While 82.2% of women with a delivery before the pandemic intended to breastfeed, the rate was 75.6% during the pandemic (p = 0.120). The average number of breastfeeding support steps received was 3.24 before the pandemic but it was 3.01 during the pandemic (p = 0.069). In particular, rooming-in was less frequent (39.3% before vs. 27.8% during the pandemic, p = 0.014). Among mothers with infants younger than 5 months who had a delivery during the pandemic (n = 189), only 37.0% (n = 70) reported exclusively breastfeeding during the 24 h before completing the survey. Multiple logistic regression analysis indicated that receiving support for all five steps was positively associated with exclusive breastfeeding during the 24 h before the survey (adjusted odds ratio 4.51; 95% CI [1.50-13.61]). Receipt of a free formula sample or invitation to a free sample campaign was negatively associated with exclusive breastfeeding (adjusted odds ratio 0.43; 95% CI [0.19-0.98]). Other factors related to non-exclusive breastfeeding were older maternal age, lower education level, primiparity, and no breastfeeding intention. Conclusions The pandemic weakened breastfeeding support for healthy women in Japan; however, support practice that adhered to WHO recommendations appeared to be effective during the pandemic.
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Affiliation(s)
- Keiko Nanishi
- Office of International Academic Affairs, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Sumiyo Okawa
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Hiroko Hongo
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Akira Shibanuma
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Sarah K. Abe
- Division of Prevention, National Cancer Center, Institute for Cancer Control, Chuo-ku, Tokyo, Japan
| | - Takahiro Tabuchi
- Department of Cancer Epidemiology, Cancer Control Center, Osaka International Cancer Institute, Osaka City, Osaka, Japan
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