The effect of home-based intervention with professional support on promoting breastfeeding: a systematic review

Breastfeeding outpatient in primary care as an important action to promote breastfeeding: experience report

This paper describe a successful experience of promotion, prevention and support for breastfeeding developed by professionals from a basic health unit. This is a Breastfeeding Outpatient Clinic, implemented in a health center in Belo Horizonte, in August 2019. The Outpatient Clinic was established based on the perception of the unit's team that many mothers had difficulty breastfeeding, however, due to the work overload of this team, this assistance did not occur in a timely manner, resulting in early weaning. Initially, a meeting was held to sensitize the team on the breastfeeding indicators of the unit. Based on this knowledge, the implementation of a breastfeeding Outpatient clinic was proposed, aimed not only at dyad with difficulties in managing breastfeeding, but at all postpartum women in the area covered by that health center. A flow was created, through which it was established that all postpartum women who brought their children to carry out the heel prick test at the unit would be referred to the Breastfeeding Outpatient Clinic to perform this service. With the improvement of care, the users of the health center started to breastfeed for longer, which reflected in the improvement of the unit's indicators.

Effective interventions for the promotion of breastfeeding and healthy complementary feeding in the context of Primary Health Care

Abstract Objective: To develop a rapid review on effective actions for the promotion of breastfeeding and healthy complementary feeding in primary health care and to summarize a list of actions and their elements for implementation. Data source: The review included systematic reviews on the effectiveness of interventions to promote breastfeeding and/or healthy complementary feeding for mothers and other caregivers, and/or professionals who work with this population, in comparison with any usual approach or none. Data synthesis: A total of 32 systematic reviews were included in the evidence synthesis. Ten types of interventions were evaluated in systematic reviews on promotion of breastfeeding and four types of interventions on promotion of healthy complementary feeding. The synthesis allowed six aspects to be discussed, and these must be considered to increase the chances of interventions’ impact: type of intervention, target audience, timing of intervention, actors that can implement it, strategies and methods of intervention, and intensity of intervention. Conclusions: It was possible to assemble a list of actions whose effectiveness has already been demonstrated, providing elements for local adaptations. Evidence is expected to support and strengthen the implementation of programs aimed at promoting breastfeeding and complementary feeding in primary health care.

Academy of Breastfeeding Medicine Clinical Protocol #2: Guidelines for Birth Hospitalization Discharge of Breastfeeding Dyads, Revised 2022

A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. The Academy of Breastfeeding Medicine recognizes that not all lactating individuals identify as women. Using gender-inclusive language, however, is not possible in all languages and all countries and for all readers. The position of the Academy of Breastfeeding Medicine (https://doi.org/10.1089/bfm.2021.29188.abm) is to interpret clinical protocols within the framework of inclusivity of all breastfeeding, chestfeeding, and human milk-feeding individuals.

Feeding practices and early weaning in the neonatal period: a cohort study

OBJECTIVE

To describe feeding practices and the risk factors for the mixed breastfeeding and early weaning in the neonatal period.

METHODS

Cohort study, which we collected socioeconomic, demographic, health care and feeding data from 415 mother/child binomials born in four public maternity hospitals in Natal/Brazil. They were followed-up at 48 hours, 7 and 28 days after birth. The association was established using Pearson's Chi-square test and Poisson's regression, after adjusting it to other variables.

RESULTS

The prevalence of mixed breastfeeding in the first 2 days was 47,2% and early weaning in 7 and 28 days was 8,4% and 16,2% in that order. The main reasons for mixed breastfeeding and early weaning were: colostrum deficiency (33.8%), difficulty in latching/sucking (23.5%) and "little milk" (70.0%). The use of formula/milk/porridge remained associated with maternal age ≤ 20 years (RR = 0.64; 95%CI: 0.47-0.86), age 20-29 years (RR = 0,70; 95%CI: 0,57-0,87), primiparity (RR = 1.37; 95%CI: 1.11-1.60) and cesarean delivery (RR = 1.20; 95%CI: 1.00-1.45) at 2 days; absence of paternal support (RR = 4.98; 95%CI: 2.54-9.79) and pacifier use (RR = 3.21; 95%CI: 1.63-6.32) at 7 days; and only pacifier use (RR = 2.48; 95%CI: 1.53-4.02) at 28 days.

CONCLUSIONS

Early weaning was associated with maternal and health care factors, thus suggesting the need to readjust good practices and educational actions to achieve the exclusive offer to the maternal breast in the neonatal period.

Current Resources for Evidence-Based Practice, May 2020

An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of a new National Academy of Medicine report on planned place of birth and implications during the SARS-CoV-2 pandemic and commentaries on reviews focused on anorectal sexually transmitted infections and feeding methods following cleft lip repair in infants.