Breastfeeding duration, costs, and benefits of a support program for low-income breastfeeding women

Four-month breastfeeding duration in postcesarean women of different cultures in the Israeli Negev

The objective of the study was to increase breastfeeding initiation and duration rates among postcesarean women by implementing a culturally appropriate breastfeeding intervention. This study was a prospective population-based, controlled evaluation of a breastfeeding intervention consisting of 570 Jewish and Muslim postcesarean women who had delivered healthy, term infants at an Israeli hospital. Women in the control group (n = 264) received standard hospital care and women in the intervention group (n = 306) received early, culturally sensitive, postcesarean breastfeeding guidance. Surveys regarding breastfeeding duration practices were conducted at 10 and 16 weeks postpartum. Overall and exclusive 4-month breastfeeding duration rates were significantly higher for the intervention group as compared to the control group for the Jewish women at 10 and 16 weeks postpartum. Since few Muslim women ceased breastfeeding, only exclusive breastfeeding rates were evaluated. At 10 and 16 weeks, significantly more Muslim women in the intervention group were exclusively breastfeeding as compared to the control group, although rates dramatically declined by 16 weeks. Despite the challenges to breastfeeding posed by cesarean delivery, early and appropriate breastfeeding guidance facilitated successful outcomes for both Jewish and Muslim women.

The loving support breastfeeding campaign: awareness and practices of health care providers in Mississippi

OBJECTIVES

To evaluate the impact of the national breastfeeding promotion campaign, Loving Support Makes Breastfeeding Work, on health care providers in Mississippi.

DESIGN

Cross-sectional study.

SETTING

The Mississippi WIC (Women, Infants, and Children) program implemented the national Loving Support project for the state. Questionnaires were mailed to all hospitals with obstetric services and WIC clinics and to a random sample of one half of the practicing pediatricians and one third of the practicing family physicians in the state.

PARTICIPANTS

Two hundred and two health care providers, including 104 nurses and 98 physicians, responded to the questionnaire.

MAIN OUTCOME MEASURES

Health care providers' (a) awareness of the breastfeeding promotion activities in the state; (b) changes in practice in providing breastfeeding advice and referrals to lactation specialists and for breast pumps; and (c) changes in the management of breastfeeding-related problems.

RESULTS

A significantly higher proportion of nurses than physicians mentioned breastfeeding benefits to mothers, provided breastfeeding management advice, and referred mothers for breast pumps and to lactation specialists after the campaign.

CONCLUSIONS

This study showed the positive impact of the campaign on nurses' breastfeeding awareness and practices. More efforts are needed to continue breastfeeding outreach activities for health care providers.

Evaluation of a lactation support service in a children's hospital neonatal intensive care unit

Breastfeeding hospitalized infants can be difficult. The authors assessed the effectiveness of an International Board Certified Lactation Consultants (IBCLC) service to increase the proportion of infants given their own mother's milk (OMM) in a children's hospital neonatal intensive care unit (NICU). The charts of 350 randomly selected patients admitted the year before and after implementation of the service in July 1997 were abstracted. Factors significantly associated with infants being given OMM included infant sex, ethnicity, length of NICU stay, and 5-minute Apgar score. After comparison of the periods before and after program implementation, the proportion of NICU infants ever given their OMM was found to have increased from 31% to 47% (P = .002). This increase differed significantly in relation to infants' clinical status and/or management (5-minute Apgar score, length of NICU stay, and age at NICU admission) but not in relation to maternal factors. Mothers with infants in the NICU should have access to lactation counseling.

Health beliefs and parenting attitudes influence breastfeeding patterns among low-income African-American women

OBJECTIVE

To describe breastfeeding initiation among 210 urban African-American mothers with inadequate prenatal care.

METHODS

This study is a case-control study of postpartum mothers recruited from four large urban hospitals.

RESULTS

Mothers who chose to breastfeed were more educated, employed before birth, married, and using contraception postnatally. Regression model analysis controlling for demographic differences revealed that breastfeeding was significantly associated with a higher perception of severity of illness and higher confidence in the ability of health care to prevent illness. Breastfeeding mothers were less likely to reverse parent-child roles and had a lower perception of hassle from their infant's behavior. When comparing mothers who breastfed longer than 8 weeks to those who did not breastfeed, breastfeeding mothers had high scores related to empathy toward infants on the Adult-Adolescent Parenting Inventory as well as a low perception of hassle on the Parenting Daily Hassle. The perception of existing formal or informal social support did not influence breastfeeding behavior.

CONCLUSION

Personal attributes of low-income urban mothers such as health beliefs and parental attitudes may play a role in the initiation and duration of breastfeeding. Low-income African-American mothers may be influenced in their choice to breastfeed by supportive messages from physicians and nurses delivering care to mothers and their newborns. Emphasis should be placed on the role breastfeeding can play in preventing childhood illnesses.

First time mothers' views of breastfeeding support from nurses

PURPOSE

To gain insights into the perceptions of first-time mothers regarding nurses' support of breastfeeding.

STUDY DESIGN

Phenomenology.

METHOD

Audiotaped interviews were conducted with 20 primiparous breastfeeding mothers within the first month after giving birth vaginally to healthy term infants. Data analysis was concurrent with data collection, and trustworthiness of the data was established.

RESULTS

Nurses provided emotional, informational, and tangible support. Nonsupportive behaviors were also identified, including a sense that the nurse was in a hurry, failed to offer breastfeeding assistance, and was inflexible while working with the mother and infant.

CLINICAL IMPLICATIONS

Nurses can contribute significantly to the successful initiation of and continuation of breastfeeding, and provide new mothers with the confidence and reassurance critical for breastfeeding success.