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Verea-Nuñez C, Novoa-Maciñeiras N, Suarez-Casal A, Vazquez-Lago JM. Factors Associated with Exclusive Breastfeeding during Admission to a Baby-Friendly Hospital Initiative Hospital: A Cross-Sectional Study in Spain. Nutrients 2024; 16:1679. [PMID: 38892611 PMCID: PMC11174580 DOI: 10.3390/nu16111679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/21/2024] [Accepted: 05/25/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Breastfeeding is the optimal nourishment for infants and it is recommended that children commence breastfeeding within the first hour of birth and be exclusively breastfed for the initial 6 months of life. Our objective was to determine which factors related to mothers could influence the degree of exclusive breastfeeding during hospitalization, as well as to assess breastfeeding mothers' attitudes towards breastfeeding. METHODS A multicenter cross-sectional study was undertaken in the healthcare area of Santiago de Compostela, Spain. The necessary variables were collected using a specially designed ad hoc questionnaire. The researcher responsible for recruitment conducted the interviews with the participants. The reduced Iowa Infant Feeding Attitude Scale (IIFAS-s) was employed to gauge maternal attitudes toward feeding their baby. RESULTS In total, 64 women were studied. The overall score of IIFAS-s (mean ± standard deviation) was 36.95 ± 5.17. A positive attitude towards breastfeeding was therefore observed in our sample. No use of a pacifier by the newborn was associated with a positive attitude for breastfeeding. Having previous children (Ora = 6.40; IC95% 1.26-32.51) and previous experience with breastfeeding (Ora = 6.70; IC95% 1.31-34.27) increased the likelihood of exclusive breastfeeding during admission. CONCLUSIONS In our study, exclusive breastfeeding during hospitalization is associated with having previous children and prior breastfeeding experience.
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Affiliation(s)
- Cristina Verea-Nuñez
- Resident Nurse in Pediatrics, Pediatric Service, University Hospital of Santiago de Compostela, Rua da Choupana s/n, 15705 Santiago de Compostela, Spain;
| | - Nuria Novoa-Maciñeiras
- Nurse Specialist in Pediatrics, Hospitalary Unit of Neonatology, University Hospital of Santiago de Compostela, Rua da Choupana s/n, 15705 Santiago de Compostela, Spain; (N.N.-M.); (A.S.-C.)
| | - Ana Suarez-Casal
- Nurse Specialist in Pediatrics, Hospitalary Unit of Neonatology, University Hospital of Santiago de Compostela, Rua da Choupana s/n, 15705 Santiago de Compostela, Spain; (N.N.-M.); (A.S.-C.)
| | - Juan Manuel Vazquez-Lago
- Preventive Medicine and Public Health Service, University Hospital of Santiago de Compostela, Rua da Choupana s/n, 15705 Santiago de Compostela, Spain
- UTAMI, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
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Vila-Candel R, Mena-Tudela D, Franco-Antonio C, Quesada JA, Soriano-Vidal FJ. Effects of a mobile application on breastfeeding maintenance in the first 6 months after birth: Randomised controlled trial (COMLACT study). Midwifery 2024; 128:103874. [PMID: 37979550 DOI: 10.1016/j.midw.2023.103874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/31/2023] [Accepted: 11/06/2023] [Indexed: 11/20/2023]
Abstract
PROBLEM It is necessary to continue promoting breastfeeding rates. BACKGROUND Information and communication technologies have significantly impacted healthcare services and are transforming the sector. There is little evidence of the usefulness of mobile applications to support breastfeeding and increase its duration. AIM To assess whether mobile application-LactApp® (Barcelona, Spain)-usage compared with standard care increases the 6-month postpartum breastfeeding rate. METHODS A multicentre, randomised, controlled clinical trial of parallel groups was conducted. The study was conducted in four public hospitals in Spain from January 2022 to January 2023. 270 Women were randomly assigned to each parallel group. The women in the intervention group received free access to the mobile application LactApp®, which provides personalised and convenient support to women about BF. Women in the control group received standard care, which included individual counselling about the benefits of maintaining BF for the first 6 months of the baby's life. FINDINGS The rate of breastfeeding abandonment at 15 days was 6.4 % in the control group vs 0.0 % in the intervention group (p = 0.105). LactApp® usage did not increase the 6-month postpartum breastfeeding rate compared with standard care (CG = 41.6% vs. IG = 43.6 %; p = 0.826). DISCUSSION Further studies must explore how technologies can help improve long-term breastfeeding maintenance. The mobile app seems to reduce early weaning in the first 15 days slightly. CONCLUSION Mobile application usage did not increase the breastfeeding rate compared with standard practice but may reduce breastfeeding abandonment in the first 2 weeks postpartum.
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Affiliation(s)
- Rafael Vila-Candel
- Health Science Faculty, Universidad Internacional de Valencia - VIU, 46002 Valencia, Spain; Department of Primary Health, La Ribera Health Department, 46600 Alzira, Spain; Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
| | - Desirée Mena-Tudela
- Department of Nursing, Feminist Institute, Universitat Jaume I, 12071 - Castellón de la Plana, Spain
| | - Cristina Franco-Antonio
- Department of Nursing, Universidad de Extremadura, 10003 Cáceres, Spain; Health and Care Research Group (GISyC), University of Extremadura, 10003 Cáceres, Spain.
| | - José Antonio Quesada
- Department of Clinical Medicine, Universidad Miguel Hernández, 03202 Elche, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 03550, Alicante, Spain
| | - Francisco Javier Soriano-Vidal
- Department of Obstetrics and Gynaecology, Xàtiva-Oninyent Health Department, 46800 Xàtiva, Spain; Department of Nursing, Universitat de Valencia, 46010, Valencia, Spain; Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
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Marín Gabriel MÁ, Martín Lozoya S, de Las Heras Ibarra S, Domingo Comeche L, González Carrasco E, Lalaguna Mallada P, Villó Sirerol N, García Fernández L, Jiménez Martínez J, Royuela Vicente A. Association of the presence of a COVID-19 infection at the time of birth and the rates of exclusive breastfeeding upon discharge in BFHI hospitals: a multicenter, prospective cohort study. Int Breastfeed J 2023; 18:54. [PMID: 37794406 PMCID: PMC10552201 DOI: 10.1186/s13006-023-00590-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/22/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Very few studies have assessed the association between COVID-19 infection and the rates of exclusive breastfeeding (EBF) upon discharge following the first waves of the pandemic and after initiation of vaccination. The primary objective of this study is to compare the rates of EBF since birth upon discharge in mothers diagnosed with COVID-19 infection at the time of the delivery versus a group of non-infected mothers in maternity hospitals with Baby Friendly Hospital Initiative (BFHI) accreditation. The secondary objectives include determining the rates of any breastfeeding at three and six months of life in both groups, as well as determining the possible factors associated with EBF rates observed upon discharge. METHODS An observational, Spanish multi-center hospital, prospective cohort study conducted from 1 to 2021 to 31 March 2022 and with follow-up during the first six months of life. Follow-up was performed via telephone contact with calls performed at three and six months. A multivariate logistic regression analysis model was used to identify the factors related to a lower probability of EBF upon discharge. RESULTS 308 mother-infant pairs participated in the study, 111 in the cohort of women with COVID infection and 197 in the comparison group. EBF upon discharge was 62.7% in the COVID group vs. 81.2% in the comparison group (p = 0.002); at three months; 52.4% vs. 57.0% (p = 0.33) were performing EBF, with the rates of EBF at six months being 43.0% vs. 39.3% (p = 0.45), respectively. Exposure to COVID-19 at delivery (AOR 5.28; 95% CI 2.01, 13.86), not practicing BF previously (AOR 36.3; 95% CI 7.02, 187.74), birth via Cesarean section (AOR 5.06; 95% CI 1.62, 15.79) and low birth weight of the newborn (AOR 1.01; 95% CI 1.01, 1.01) were associated with a greater risk of not performing EBF upon discharge. CONCLUSIONS Mothers with a mild or asymptomatic COVID-19 infection at the time of the delivery were less likely to have exclusively breastfed during their hospital stay than other mothers in these BFHI-accredited hospitals. However, there were no differences in breastfeeding rates between the groups at three and six months postpartum.
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Affiliation(s)
- Miguel Ángel Marín Gabriel
- Department of Pediatrics, Puerta de Hierro-Majadahonda University Hospital, BFHI Hospital-Coordinator, Majadahonda, Madrid, Spain.
| | - Sergio Martín Lozoya
- Department of Pediatrics, Puerta de Hierro-Majadahonda University Hospital, BFHI Hospital-Coordinator, Majadahonda, Madrid, Spain
| | | | - Laura Domingo Comeche
- Department of Neonatology, Fuenlabrada University Hospital, Fuenlabrada, Madrid, Spain
| | | | | | | | | | | | - Ana Royuela Vicente
- Biostatistics Unit, Hospital Universitario Puerta de Hierro Majadahonda, IDIPHISA. CIBERESP, ISCIII., Madrid, España
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Gálvez-Adalia E, Bartolomé-Gutiérrez R, Berlanga-Macías C, Rodríguez-Martín B, Marcilla-Toribio I, Martínez-Andrés M. Perceptions of Mothers about Support and Self-Efficacy in Breastfeeding: A Qualitative Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1920. [PMID: 36553363 PMCID: PMC9776413 DOI: 10.3390/children9121920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022]
Abstract
Breastfeeding is a complex process influenced by different personal and social factors which will determine both the initiation and the resilience for its maintenance. The aim is to identify the beliefs and expectations of mothers concerning breastfeeding to determine the perception of their self-efficacy and the influence on the management of their babies' feeding. A qualitative study through semi-structured interviews was carried out. The sample size was defined by the saturation criteria. Twenty-two women participated, eleven were from an urban environment and eleven were from a rural environment. Mothers' knowledge of breastfeeding, their expectations of that process, their experience, and their strategies for overcoming problems associated with initiating, establishing, and continuing breastfeeding were influenced by the role of nurses and midwives in supporting their perception of self-efficacy. Likewise, maternity policies are important for the continuance of exclusive breastfeeding. This study shows the complexity of the initiation and establishment of breastfeeding and the existence of several social factors surrounding these moments. Furthermore, it demonstrates the importance and reference of nurses and midwives and the role of State maternity policies.
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Affiliation(s)
| | | | - Carlos Berlanga-Macías
- Faculty of Nursing, Universidad de Castilla-La Mancha, 02071 Albacete, Spain
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
| | - Beatriz Rodríguez-Martín
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, 45600 Talavera de la Reina, Spain
| | - Irene Marcilla-Toribio
- Health, Gender and Social Determinants Research Group, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
| | - María Martínez-Andrés
- Faculty of Nursing, Universidad de Castilla-La Mancha, 02071 Albacete, Spain
- Health, Gender and Social Determinants Research Group, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
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Castillo-Cruz RA, Iracheta-Gerez MDLL, Macias-Parra M, Esparza-Aguilar M. Factors Associated with the Duration of Breastfeeding: The Practices of Mexican Mothers in a Megacity and in the Agricultural Town. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15176. [PMID: 36429894 PMCID: PMC9691165 DOI: 10.3390/ijerph192215176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 10/26/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Breast milk is irreplaceable for healthy development. In Mexico, by 2019, the prevalence of exclusive breastfeeding (EBF) was low and the use of breastmilk substitutes (BMSs) was high. OBJECTIVE The aim of this work was to evaluate the maternal and child characteristics related to breastfeeding (BF) duration and to the introduction of BMSs for residents of Mexico City (CdMX) and an agricultural town in Morelos. METHODS A cross-sectional study was conducted with 160 mother-child binomials (0-15 months of age) from the megacity CdMX and the agricultural town. OUTCOMES EBF and total breastfeeding (TBF) duration, age of transition to BMSs, and the introduction of complementary feeding (CF) were assessed. Associations with maternal and infant factors were assessed using Cox models. RESULTS The prevalence of EBF in the joint samples at 5.9 months was 32.6% and 5.8% at 6 months. EBF was favored under the following conditions: living in CdMX, receiving prenatal care, no newborn hospitalization, and breastmilk provided as first food at birth. TBF was prolonged under the following conditions: older mother, female children, rooming-in care during puerperium, receiving BF upon discharge after birth, cohabiting with extended family, and having no siblings. The introduction of BMSs predominated under the following conditions: living in an agricultural town, BMSs given after birth before discharge, younger mother, worker mother, and lack of prenatal care. The early introduction of CF (before the fourth month) was 2% for CdMX and 14% for the agricultural town. CONCLUSIONS The agricultural population had a higher risk of the premature interruption of EBF/TBF and the early introduction of BMSs and CF. Protective factors were family-friendly environments and being born in a baby-friendly hospital.
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Affiliation(s)
- Rocio Aidee Castillo-Cruz
- Unit of Research in Epidemiology, Instituto Nacional de Pediatría, Av. Insurgentes Sur 3700-C Insurgentes Cuicuilco, Mexico City 04530, Mexico
| | - Maria de la Luz Iracheta-Gerez
- Subdirectorate of Outpatient Care, Instituto Nacional de Pediatría, Av. Insurgentes Sur 3700-C Insurgentes Cuicuilco, Mexico City 04530, Mexico
| | - Mercedes Macias-Parra
- Board of Directors, Instituto Nacional de Pediatría, Av. Insurgentes Sur 3700-C Insurgentes Cuicuilco, Mexico City 04530, Mexico
| | - Marcelino Esparza-Aguilar
- Unit of Research in Epidemiology, Instituto Nacional de Pediatría, Av. Insurgentes Sur 3700-C Insurgentes Cuicuilco, Mexico City 04530, Mexico
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Madero Zambrano KP, Fernandez Aragón S, Del Toro Rubio M, Barrios Puerta Z. Representación de la lactancia, perspectiva de madres adolescentes con fondos socioeconómicos bajos. INVESTIGACIÓN EN ENFERMERÍA: IMAGEN Y DESARROLLO 2022. [DOI: 10.11144/javeriana.ie24.rlpm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Introducción: lactar hace parte de un proceso innato de la vida de una mujer, no obstante, su ejercicio requiere de un apoyo activo para iniciar y mantener prácticas adecuadas. Objetivo: develar el significado de lactar desde la experiencia de un grupo de madres adolescentes. Métodos: estudio cualitativo, descriptivo con enfoque hermenéutico; con una muestra por saturación de 15 participantes; se realizaron grupos focales, y se emplearon entrevistas semiestructuradas. Resultados: la población comprendía una edad entre 14 y 17 años. Al quedar embarazadas la mayoría no finalizaron su bachillerato, se evidenció un significado congruente con la bibliografía sobre la lactancia materna y sus beneficios, cuya orientación se ha dado desde las IPS y experiencias propias, evidenciando “un significado positivo”. De igual forma, se aproximó la lactancia materna como una práctica importante que involucra el rol paterno, haciendo de esto un proceso de plenitud y amor para la madre. Conclusión: la lactancia va más allá de las condiciones de edad, socioeconómicas y sociales. El significado proviene del afecto generado, resultan fundamentales las redes de apoyo durante la práctica de lactar.
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Blanco E, Otero García L. Perceived facilitating and hindering factors to exclusive breastfeeding among Latin American immigrant women living in Colmenar Viejo (Community of Madrid, Spain). HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e994-e1006. [PMID: 34245198 DOI: 10.1111/hsc.13503] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/26/2021] [Accepted: 06/16/2021] [Indexed: 06/13/2023]
Abstract
The way in which an infant is breastfed by a migrant woman reflects her bio-psycho-social circumstances and her process of cultural transformation and adaptation to the host country. Exploring facilitating and hindering factors to exclusive breastfeeding (EBF) of immigrant mothers in Spain is essential for the development of guidelines that protect EBF. The aim of this qualitative study is to explore the factors perceived as facilitating or hindering EBF during the first six months of the baby's life by Latin American women living in Colmenar Viejo, a city in the Community of Madrid (Spain). We carried out in-depth semi-structured face-to-face interviews between December 2018 and February 2019 with 11 Latin American mothers who were recruited through key informants and snowball sampling. We audio-recorded the interviews, transcribed them, and performed content analysis to examine the data. EBF was facilitated by the mother and her family having information about its benefits, lower economic expenses, family and healthcare system support, certain popular and spiritual beliefs, and the mother's acculturation process in Spanish society. The hindering factors identified were the perception of EBF as a sacrifice, incompatible with working life, with unsightly and painful consequences for the mother, insufficient to nourish the baby and ineffective after some months, poorly supported by the broader social environment and the healthcare system. EBF was restricted by certain popular beliefs, associated with a stigma if abandoned, and linked to less economically favored social classes. Some of these hindering or facilitating factors are similar to those present in the original Latin American society or the receiving Spanish society. EBF is a complex process, with satisfactory and suffering stages, regulated by beliefs and experiences. EBF must be promoted intersectorally by governmental, health and societal actors considering the biological, psychological, social, and cultural characteristics of the mother and her community.
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Affiliation(s)
- Elena Blanco
- Nursing Department, Universidad Autónoma de Madrid, Madrid, Spain
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Laura Otero García
- Nursing Department, Universidad Autónoma de Madrid, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP-ISCIII), Institute of Health Carlos III, Madrid, Spain
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Serrano-Sánchez S, González-González J, Rodríguez-Martín B, Muñoz-Rodríguez V, de las Heras-Corrochano S, Criado-Alvarez JJ. Relationship between Oral Health Knowledge and Maternal Oral Health with Obstetric Risk and Breastfeeding. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7797. [PMID: 35805455 PMCID: PMC9265655 DOI: 10.3390/ijerph19137797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/16/2022] [Accepted: 06/22/2022] [Indexed: 02/04/2023]
Abstract
The relationship between maternal gingival health status and low birth weight or preterm delivery is controversial. The aim of this study was to analyze the association between maternal oral knowledge and the level of oral health during pregnancy with the risk of obstetric complications and breastfeeding. A descriptive cross-sectional study was conducted after an oral health educational intervention in a consecutive sample of 97 pregnant women. Data collection consisted of a validated questionnaire, oral examination, the Caries Index (CAOD) and the Simplified Oral Hygiene Index (IHOS). The participants had a mean age of 32.5 ± 5.19 years and a predominantly university education (57.1%). The level of knowledge regarding oral health was fair (12.5 ± 3.56 correct answers). Older pregnant women (33.0 ± 4.80 years) practiced breastfeeding and had a higher number of correct answers to the questionnaire. Adequate IHOS was associated with higher birth-weight newborns (3333 ± 0.3), whereas poor oral hygiene control was associated with lower birth-weight newborns (2960 ± 0.1) (p < 0.05). A lower level of academic education was associated with worse oral hygiene (p < 0.05). In addition, the greater the number of children, the higher the CAOD. Finally, among non-smoking women, the weight of infants was 437 mg higher. Maternal oral hygiene and the week of delivery were associated with newborn weight (p < 0.05) in a multiple linear regression model. Smoking was also related to low birth weight (p < 0.05). Educational interventions in pregnancy are necessary to decrease the incidence of obstetric adverse effects and improve the oral health of mothers and their children.
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Affiliation(s)
- Silvia Serrano-Sánchez
- Castilla-La Mancha Health Service, 45600 Talavera de la Reina, Spain; (S.S.-S.); (V.M.-R.); (S.d.l.H.-C.)
| | - Jaime González-González
- Department of Medical Sciences, Faculty of Health Sciences, University of Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.G.-G.); (J.J.C.-A.)
| | - Beatriz Rodríguez-Martín
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Avd/Real Fábrica de Sedas s/n, 45660 Talavera de la Reina, Spain
| | - Vanesa Muñoz-Rodríguez
- Castilla-La Mancha Health Service, 45600 Talavera de la Reina, Spain; (S.S.-S.); (V.M.-R.); (S.d.l.H.-C.)
| | | | - Juan José Criado-Alvarez
- Department of Medical Sciences, Faculty of Health Sciences, University of Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.G.-G.); (J.J.C.-A.)
- Department of Health, Institute of Health Sciences, 45600 Talavera de la Reina, Spain
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Valero-Chillerón MJ, Mena-Tudela D, Cervera-Gasch Á, González-Chordá VM, Soriano-Vidal FJ, Quesada JA, Castro-Sánchez E, Vila-Candel R. Influence of Health Literacy on Maintenance of Exclusive Breastfeeding at 6 Months Postpartum: A Multicentre Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095411. [PMID: 35564807 PMCID: PMC9104596 DOI: 10.3390/ijerph19095411] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/23/2022] [Accepted: 04/27/2022] [Indexed: 01/27/2023]
Abstract
Background: International organizations recommend initiating breastfeeding within the first hour of life and maintaining exclusive breastfeeding for the first 6 months. However, worldwide rates of exclusive breastfeeding for 6-month-old infants is far from meeting the goal proposed by the World Health Organization, which is to reach a minimum of 50% of infants. Education is one of the factors affecting the initiation and continuation of breastfeeding, and incidentally, it is also related to lower health literacy. This study explored the influence of health literacy on maintenance of exclusive breastfeeding at 6 months postpartum. Methods: A longitudinal multicenter study with 343 women were recruited between January 2019 and January 2020. The first questionnaire was held during the puerperium (24−48 h) with mothers practicing exclusive breastfeeding, with whom 6-month postpartum breastfeeding follow-up was performed. Socio-demographic, clinical and obstetric variables were collected. Breastfeeding efficiency was assessed using the LATCH breastfeeding assessment tool. The health literacy level was evaluated by the Newest Vital Sign screening tool. A multivariate logistic regression model was used to detect protective factors for early exclusive breastfeeding cessation. Results: One third of the women continued exclusive breastfeeding at 6 months postpartum. Approximately half the participants had a low or inadequate health literacy level. An adequate health literacy level, a high LATCH breastfeeding assessment tool score (>9 points) and being married were the protective factors against exclusive breastfeeding cessation at 6 months postpartum. Conclusion: Health literacy levels are closely related to maintaining exclusive breastfeeding and act as a protective factor against early cessation. A specific instrument is needed to measure the lack of “literacy in breastfeeding”, in order to verify the relationship between health literacy and maintenance of exclusive breastfeeding.
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Affiliation(s)
- María Jesús Valero-Chillerón
- Department of Nursing, Universitat Jaume I, Av. de Vicent Sos Baynat, 12071 Castelló, Spain; (M.J.V.-C.); (Á.C.-G.); (V.M.G.-C.)
| | - Desirée Mena-Tudela
- Department of Nursing, Universitat Jaume I, Av. de Vicent Sos Baynat, 12071 Castelló, Spain; (M.J.V.-C.); (Á.C.-G.); (V.M.G.-C.)
- Correspondence:
| | - Águeda Cervera-Gasch
- Department of Nursing, Universitat Jaume I, Av. de Vicent Sos Baynat, 12071 Castelló, Spain; (M.J.V.-C.); (Á.C.-G.); (V.M.G.-C.)
| | - Víctor Manuel González-Chordá
- Department of Nursing, Universitat Jaume I, Av. de Vicent Sos Baynat, 12071 Castelló, Spain; (M.J.V.-C.); (Á.C.-G.); (V.M.G.-C.)
| | - Francisco Javier Soriano-Vidal
- Department of Nursing, Universitat de València, 46010 Valencia, Spain; (F.J.S.-V.); (R.V.-C.)
- Department of Nursing, University of Alicante, 03080 Alicante, Spain
- Department of Obstetrics and Gynaecology, Hospital Luis Alcanyis, 46819 Xàtiva, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO-SP), 46020 Valencia, Spain
| | - José Antonio Quesada
- Department of Clinical Medicine, Universidad Miguel Hernández, 03202 Elche, Spain;
| | - Enrique Castro-Sánchez
- Health Protection Research Unit in Healthcare-Associated Infection and Antimicrobial Resistance at Imperial College London, London W12 0NN, UK;
- College of Nursing, Midwifery and Healthcare, University of West London, Brentford TW8 9GA, UK
| | - Rafael Vila-Candel
- Department of Nursing, Universitat de València, 46010 Valencia, Spain; (F.J.S.-V.); (R.V.-C.)
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO-SP), 46020 Valencia, Spain
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, 46600 Valencia, Spain
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Llorente-Pulido S, Custodio E, López-Giménez MR, Otero-García L. Barriers and Facilitators for Exclusive Breastfeeding within the Health System and Public Policies from In-Depth Interviews to Primary Care Midwives in Tenerife (Canary Islands, Spain). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:128. [PMID: 35010387 PMCID: PMC8750100 DOI: 10.3390/ijerph19010128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
The aim of this study is to describe the perspectives of Primary Care midwives regarding factors that benefit or are detrimental to exclusive breastfeeding (EBF) within the health system and public policies. The study was carried out in Tenerife (Canary Islands, Spain) and is based on qualitative methodology. Twenty in-depth interviews were carried out with midwives who work in Primary Care centres in Tenerife, using a content analysis approach. The transcript data were then encoded following an inductive approach. The factors, according to midwives, that affect EBF, with regard to the healthcare system, are related to training of healthcare professionals in breastfeeding and their support to women during pregnancy, childbirth and postnatal care. Regarding public policies, midwives believe the maternity leave periods in Spain, together with a lack of laws and social policies to protect EBF are detrimental. The findings from our study show that there is a need to boost training and the role of professionals in EBF and, at the same time, promote protective policies that foster equality, favouring, among other issues, the work-life balance.
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Affiliation(s)
- Seila Llorente-Pulido
- PhD Programme in Public Health and Epidemiology, Preventive Medicine and Public Health and Microbiology Department, Faculty of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
- Servicio Canario de Salud, Gerencia de Atención Primaria de Tenerife, Primary Health Care San Isidro, 38611 Tenerife, Spain
| | - Estefanía Custodio
- CIBER Infectious Diseases (ISCIII), 28029 Madrid, Spain
- National Centre for Tropical Medicine, Health Institute Carlos III, 28029 Madrid, Spain
| | - María Rosario López-Giménez
- Preventive Medicine and Public Health and Microbiology Department, Faculty of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
| | - Laura Otero-García
- Nursing Department, Faculty of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
- CIBER Epidemiology and Public Health (CIBERESP-ISCIII), 28029 Madrid, Spain
- National School of Public Health, Health Institute Carlos III, 28029 Madrid, Spain
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11
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Lechosa-Muñiz C, Paz-Zulueta M, Cayón-De las Cuevas J, Llorca J, Cabero-Pérez MJ. Declared Reasons for Cessation of Breastfeeding during the First Year of Life: An Analysis Based on a Cohort Study in Northern Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8414. [PMID: 34444163 PMCID: PMC8394949 DOI: 10.3390/ijerph18168414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/07/2021] [Accepted: 08/08/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Breastfeeding is the gold standard of infant feeding due to the many advantages it offers to both the child and the mother. OBJECTIVE To identity the main reasons for cessation of breastfeeding reported by mothers during the first year of life. DESIGN A prospective cohort study was conducted, recruiting 970 infants from a university hospital in Spain. The main maternal variables studied were maternal age, parity, educational level, work occupation, smoking habit, weeks of gestation at birth, birth weight, feeding type, and duration of breastfeeding. All participants were followed for one year to determinate the duration of breastfeeding and to gather reasons for abandoning breastfeeding. RESULTS At six months, the percentage of breastfeeding experienced a decline of 50%, and only 24.5% of these mothers maintained breastfeeding. Up to 15.8% of the mothers decided to give up exclusive breastfeeding by their own choice, whereas 15.4% did so because they suspected low milk production. Work-related causes represent the third reason of abandonment. CONCLUSIONS Our results highlight the need to improve the health policies for the promotion, protection, and support for the initiation and maintenance of breastfeeding. In particular, our results highlight the importance of researching women's low milk production and work-related factors, with particular emphasis on improving conciliation measures.
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Affiliation(s)
- Carolina Lechosa-Muñiz
- Faculty of Nursing, University of Cantabria, Avda Valdecilla s/n. C.P., 39008 Santander, Spain;
- Pediatrics Section, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain
| | - María Paz-Zulueta
- Faculty of Nursing, University of Cantabria, Avda Valdecilla s/n. C.P., 39008 Santander, Spain;
- IDIVAL, Grupo de Investigación en Derecho Sanitario y Bioética, GRIDES, C/Cardenal Herrera Oria s/n. C.P., 39011 Santander, Spain
| | - Joaquín Cayón-De las Cuevas
- IDIVAL, Grupo de Investigación en Derecho Sanitario y Bioética, GRIDES, C/Cardenal Herrera Oria s/n. C.P., 39011 Santander, Spain
- Faculty of Law, University of Cantabria, Avda. de los Castros s/n. C.P., 39005 Santander, Spain;
| | - Javier Llorca
- Faculty of Medicine, University of Cantabria, Avenida del Cardenal Herrera Oria 2, C.P., 39010 Santander, Spain; (J.L.); (M.J.C.-P.)
- CIBER Epidemiology and Public Health (CIBERESP), C.P., 28029 Madrid, Spain
| | - María Jesús Cabero-Pérez
- Pediatrics Section, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain
- Faculty of Medicine, University of Cantabria, Avenida del Cardenal Herrera Oria 2, C.P., 39010 Santander, Spain; (J.L.); (M.J.C.-P.)
- IDIVAL, C/Cardenal Herrera Oria s/n. C.P., 39011 Santander, Spain
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12
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Valero-Chillerón MJ, González-Chordà VM, Cervera-Gasch Á, Vila-Candel R, Soriano-Vidal FJ, Mena-Tudela D. Health literacy and its relation to continuing with breastfeeding at six months post-partum in a sample of Spanish women. Nurs Open 2021; 8:3394-3402. [PMID: 33939303 PMCID: PMC8510722 DOI: 10.1002/nop2.885] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/26/2021] [Accepted: 03/15/2021] [Indexed: 11/05/2022] Open
Abstract
AIM To explore the relation between health literacy (HL) and continuing breastfeeding (BF) at 6 months post-partum. DESIGN Observational, longitudinal and prospective study between December 2018-May 2019. The STROBE checklist was used. METHODS 114 mother/baby pairings from a Spanish Hospital were included. Mothers' health literacy was studied with the Newest Vital Sign and Short Assessment of Health Literacy for Spanish Adults 50 (SAHLSA-50). Before hospital discharge, BF efficiency was studied using the LATCH BF score and BF continuity was followed for 6 months. Survival analysis and Cox regression were done. RESULTS Health literacy levels and BF effectiveness were adequate before hospital discharge. At 6 months post-partum, less than half the sample still exclusively breastfed. The main reason for early exclusive BF cessation was lower than the recommended newborn weight gain. The HL level acted as a protective factor against abandonment of BF.
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Affiliation(s)
| | | | | | - Rafael Vila-Candel
- Department of Nursing, Faculty of Nursing and Podiatry, Universitat de València, València, Spain.,Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, Alcira, Spain.,Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
| | - Francisco Javier Soriano-Vidal
- Department of Nursing, Faculty of Nursing and Podiatry, Universitat de València, València, Spain.,Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain.,Department of Obstetrics and Gynaecology, Hospital Lluis Alcanyís, Xativa, Spain
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13
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Llorente-Pulido S, Custodio E, López-Giménez MR, Sanz-Barbero B, Otero-García L. Barriers and Facilitators for Exclusive Breastfeeding in Women's Biopsychosocial Spheres According to Primary Care Midwives in Tenerife (Canary Islands, Spain). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3819. [PMID: 33917424 PMCID: PMC8038662 DOI: 10.3390/ijerph18073819] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 11/17/2022]
Abstract
(1) The objective of our study is to determine, from a primary care midwife's perspective, which biopsychosocial factors can favour or be detrimental to exclusive breast feeding. (2) The study was carried out in Tenerife (Canary Islands, Spain) and is based on qualitative methodology. Twenty in-depth interviews were carried out with midwives working in primary care centres in Tenerife, using a content analysis approach. The transcript data was then encoded following an inductive approach. (3) According to the perceptions of the primary care midwives who were interviewed, the barriers and facilitators that influence exclusive breastfeeding related to the biopsychosocial spheres of women are, at an individual level, the physical and emotional aspects during the postnatal period; at the relationship level, the presence or not of support from the close family and partner; at the community level, the environment and social networks the new mothers may have; and at the work level, characteristics of jobs and early return to work. (4) The findings of our research can help healthcare professionals to approach the promotion and encouragement of exclusive breast feeding at each of the levels studied, with the aim of increasing rates following recommendations issued by The World Health Organization.
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Affiliation(s)
- Seila Llorente-Pulido
- Servicio Canario de Salud. Gerencia de Atención Primaria de Tenerife, Primary Health Care San Isidro, 38611 Tenerife (Canary Islands), Spain
| | - Estefanía Custodio
- Joint Research Centre European Commission, 21027 Ispra, Italy;
- National Centre for Tropical Medicine, Health Institute Carlos III, 28029 Madrid, Spain
| | - Maria Rosario López-Giménez
- Preventive Medicine and Public Health and Microbiology Department, Universidad Autónoma of Madrid, 28029 Madrid, Spain;
| | - Belén Sanz-Barbero
- National School of Public Health. Health Institute Carlos III, 28029 Madrid, Spain;
- CIBER Epidemiology and Public Health (CIBERESP-ISCIII), 28029 Madrid, Spain
| | - Laura Otero-García
- CIBER Epidemiology and Public Health (CIBERESP-ISCIII), 28029 Madrid, Spain
- Nursing Department, Faculty of Medicine, Universidad Autónoma of Madrid, 28029 Madrid, Spain
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14
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Vila-Candel R, Soriano-Vidal FJ, Mena-Tudela D, Quesada JA, Castro-Sánchez E. Health literacy of pregnant women and duration of breastfeeding maintenance: A feasibility study. J Adv Nurs 2020; 77:703-714. [PMID: 33210369 DOI: 10.1111/jan.14625] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/23/2020] [Accepted: 10/27/2020] [Indexed: 12/20/2022]
Abstract
AIMS Research the association between health literacy (HL) and exclusive breastfeeding at 4-months postpartum. BACKGROUND Despite the benefits of breastfeeding (BF), its rates are low worldwide. Among the reasons for abandonment is the level of maternal education. Maternal education has been associated with HL, but evidence between HL and BF maintenance is limited. DESIGN A cross-sectional study. METHODS The sample compromised 229 nursing mothers recruited from January 2018 to the end of December 2018 at Spain by systematic sampling method. Women were interviewed postpartum on parameters associated with the start and continuation of BF up to 4 months postpartum. Multivariate logistic regression models to explain exposure variables and exclusive BF cessation at 4 months. RESULTS Approximately 10% of the participants had inadequate HL. Factors associated with early cessation of exclusive BF at 4 months in the multivariate model adjusted using a stepwise variable selection process based on a likelihood ratio test were civil status, risk of pregnancy, type of delivery, limited or inadequate level of HL, and LATCH score at discharge, with an 85.6% area under the ROC curve. CONCLUSIONS Our study offers preliminary evidence regarding the hitherto inconsistent relation between HL and early cessation exclusive BF at 4 months, supporting the conduct of further studies with larger sample sizes and greater statistical power. Such studies are warranted before endorsing HL-based interventions aiming to mitigate early cessation exclusive BF. IMPACT Low or inadequate HL is linked to multiple poor health and clinical outcomes. We investigated the prevalence of exclusive BF at 4 months postpartum, and the impact of HL in maintaining optimal exclusive BF practices. Limited or inadequate HL was one of the factors associated with early cessation of exclusive BF in the multivariate regression model, although further research is needed.
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Affiliation(s)
- Rafa Vila-Candel
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, Valencia, Spain.,Department of Nursing, Universitat de València, Valencia, Spain
| | - Francisco Javier Soriano-Vidal
- Department of Nursing, Universitat de València, Valencia, Spain.,Department of Nursing, University of Alicante, Alicante, Spain.,Department of Obstetrics and Gynaecology, Hospital Luis Alcanyis, Xàtiva, Spain.,Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
| | - Desirée Mena-Tudela
- Department of Nursing, Universitat Jaume I. Av de Vicent Sos Baynat, Castelló, Spain
| | - José Antonio Quesada
- Department of Clinical Medicine, Universidad Miguel Hernández, Elche, Alicante, Spain
| | - Enrique Castro-Sánchez
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU), Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, London, UK.,School of Health Sciences, City, University of London, London, UK
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15
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Drehmer JE, Ossip DJ, Nabi-Burza E, Hipple Walters B, Gorzkowski JA, Winickoff JP. Pediatric Office Delivery of Smoking Cessation Assistance for Breast-Feeding Mothers. Nicotine Tob Res 2020; 22:346-353. [PMID: 30521040 DOI: 10.1093/ntr/nty247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 11/13/2018] [Indexed: 11/15/2022]
Abstract
INTRODUCTION National and international organizations have done an excellent job of advocating and promoting breast feeding for all mothers. This study assessed to what extent an intervention increased delivery of cessation assistance to breast-feeding mothers who smoke. METHODS Data were collected between April and October 2015 in five US states as part of a cluster randomized controlled trial in 10 pediatric practices. Practices were randomized to the Clinical Effort Against Secondhand Smoke Exposure (CEASE) intervention or usual care control arms. Mothers were asked about their smoking status and breast-feeding history during a screening interview upon exiting the practice and eligible mothers who agreed to participate in an enrollment interview were asked if they received smoking cessation assistance during their child's visit. Mothers with a child 1 year old and younger were included in the analyses. RESULTS Current breast feeding was associated with a reduced likelihood of current smoking (adjusted odds ratio [aOR] = 0.38, 95% confidence interval [95% CI] = 0.25 to 0.57) and a greater likelihood of quitting smoking (aOR = 2.33, 95% CI = 1.29 to 4.21) after controlling for known confounders. Mothers who concurrently smoked and breast-fed were more likely to be asked about smoking (66.7% vs. 28.6%, p = .01), advised to quit (61.1% vs. 21.4%, p < .01), prescribed nicotine replacement therapy (50.0% vs. 0%, p < .001), and enrolled into the quitline (27.8% vs. 0%, p < .01) at CEASE practices compared to control practices. CONCLUSION Breast-feeding mothers were less likely to be current smokers and more likely to have recently quit smoking. Among mothers who continue to smoke and breast feed, the CEASE intervention enhances delivery of smoking cessation assistance. IMPLICATIONS Breast feeding and eliminating infants' exposure to tobacco smoke are important protective factors for serious pediatric health risks including sudden infant death. This study shows that breast feeding was positively associated with desirable tobacco control outcomes, specifically that breast feeding was associated with a lower likelihood of smoking among ever smokers and a greater likelihood of recently quitting smoking. This is also the first study to look specifically at delivery of smoking cessation assistance to breast-feeding mothers seen at pediatric offices and demonstrates the effectiveness of delivering evidence-based smoking cessation assistance to them in this context. TRIAL REGISTRATION www.ClinicalTrials.gov (identifier NCT01882348).
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Affiliation(s)
- Jeremy E Drehmer
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA.,Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA
| | - Deborah J Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY
| | - Emara Nabi-Burza
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA.,Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA
| | - Bethany Hipple Walters
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA.,Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA
| | - Julie A Gorzkowski
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, IL
| | - Jonathan P Winickoff
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA.,Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA.,Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, IL
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16
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Abstract
Introduction Introduction and objectives: breastfeeding (BF) is a feeding method that provides multiple benefits for the health of infants and their mothers. This study aimed to determine the prevalence of BF during the first year of life of children of women who gave birth in a private clinic in Biscay, Basque Country, Spain, and to identify the facilitating determinants and reasons for abandonment. Method: an observational, descriptive, longitudinal and prospective study in a random sample of 453 newborns (NBs) recruited between 2016 and 2017. Results: in all, 366 women agreed to participate in all the study phases. The prevalence of exclusive breastfeeding (EBF) was 51.7 % at baseline, 77.1 % at discharge, and 21.6 % after sixth months; and that of BF, 87.1 % at the beginning, 48.4 % at month six, and 20.6 % at one year. The facilitating factors of EBF were: at the beginning, not using a nest or breast pump; 15 days of satisfaction with LM and not using a pacifier or breast pump; 4 months of satisfaction with LM; 6 months attending Lactation Support Groups (GAL) and not introducing complementary feeding (CA); and those of LM at 1 year, attending GAL. The main reasons for abandonment were: own initiative, incorporation to work, and little weight gain by the NB. Conclusions: one in 5 newborns received EBF up to 6 months and BF up to one year. It would be necessary to promote strategies that favor breastfeeding, such as eliminating the nest, advising against breast pumps and pacifiers at the beginning, starting CA from the sixth month, and organizing GALs during the first year.
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17
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Mothers' Expectations and Factors Influencing Exclusive Breastfeeding during the First 6 Months. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010077. [PMID: 31861896 PMCID: PMC6981479 DOI: 10.3390/ijerph17010077] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 11/25/2022]
Abstract
The aims were to determine Spanish women’s expectations about exclusive breastfeeding (EB) and the effect of expectations and other factors on EB during the first 6 months. A prospective cohort study was conducted with 236 participants. Variables were maternal age, marital status, occupation, expectations about breastfeeding, knowledge about breastfeeding, type of delivery, type of feeding, and duration of EB. Data were collected through three personal interviews, at the hospital (before delivery) and in two telephone calls in the first and sixth months postpartum. Average age was 32.3 years (SD = 5.3); average duration of EB was 2.73 months (SD = 2.49). Of 236 women who had decided to breastfeed before birth, 201 (85.2%) offered EB after delivery. Achievement of expectations was most influenced by the decision to continue breastfeeding ‘as long as I can’ (OR: 5.4; CI: 2.0–14.6) and previous experience (OR: 3.2; CI: 1.2–8.5). Knowledge of breastfeeding acquired from relatives (OR: 9.2; CI: 3.0–27.9), caesarean delivery (OR: 4.6; CI: 1.7–12.8) and maternal age (36–40 years old) (OR: 7.5; CI: 1.8–30.9) were associated with failure to achieve EB. Achievement of EB may depend on a woman’s confidence in her ability to do so and on knowledge obtained in the social environment.
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18
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Hernández Luengo M, Álvarez-Bueno C, Pozuelo-Carrascosa DP, Berlanga-Macías C, Martínez-Vizcaíno V, Notario-Pacheco B. Relationship between breast feeding and motor development in children: protocol for a systematic review and meta-analysis. BMJ Open 2019; 9:e029063. [PMID: 31530597 PMCID: PMC6756461 DOI: 10.1136/bmjopen-2019-029063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 08/05/2019] [Accepted: 08/12/2019] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The recommendations of most health organisations encourage mothers to keep exclusive breast feeding during the first 6 months and combining breast feeding with complementary feeding at least during the first and second years, due to the numerous immunologic, cognitive developmental and motor skill benefits that breast feeding confers. Although the influence of breast feeding on motor development during childhood has been studied, the findings are inconsistent, and some studies have even reported no effect. This manuscript presents a protocol for a systematic review and meta-analysis, with the aim of reviewing the relationship between breast feeding and motor skill development in children in terms of duration, exclusivity or non-exclusivity of breast feeding. METHODS AND ANALYSIS The search will be conducted using Medline (via PubMed), EMBASE, Web of Science and Cochrane Library from inception to December 2019. Observational studies (cross-sectional and follow-up studies) written in English or Spanish that investigate the association between breast feeding and motor development in children will be included. This systematic review and meta-analysis protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. The Critical Appraisal Checklist for Analytical Cross-Sectional Studies and The Newcastle-Ottawa Quality Assessment Scale for longitudinal studies will be used to assess the quality of included studies. The effect of breast feeding on motor skill development will be calculated as the primary outcome. Subgroup analyses will be carried out based on the characteristics of motor skill development and the population included. ETHICS AND DISSEMINATION Ethical approval is not required because the data used will be obtained from published studies, and there will be no concerns about privacy. The findings from this study will be relevant information regarding the association of breast feeding with motor development in children and could be used encourage to improve breastfeeding rates. The results will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42018093706.
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Affiliation(s)
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | | | | | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
| | - Blanca Notario-Pacheco
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Faculty of Nursing, Universidad de Castilla-La Mancha, Ciudad Real, Spain
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19
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Cortés-Rúa L, Díaz-Grávalos GJ. Interrupción temprana de la lactancia materna. Un estudio cualitativo. ENFERMERIA CLINICA 2019; 29:207-215. [DOI: 10.1016/j.enfcli.2018.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 11/12/2018] [Accepted: 11/13/2018] [Indexed: 11/28/2022]
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20
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Silva VA, Caminha MF, Silva SL, Serva VM, Azevedo PT, Batista Filho M. Maternal breastfeeding: indicators and factors associated with exclusive breastfeeding in a subnormal urban cluster assisted by the Family Health Strategy. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2019. [DOI: 10.1016/j.jpedp.2018.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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21
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Silva VAAL, Caminha MFC, Silva SL, Serva VMSBD, Azevedo PTACC, Filho MB. Maternal breastfeeding: indicators and factors associated with exclusive breastfeeding in a subnormal urban cluster assisted by the Family Health Strategy. J Pediatr (Rio J) 2019. [PMID: 29530663 DOI: 10.1016/j.jped.2018.01.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To describe and analyze indicators of feeding practices related to breastfeeding and factors associated with exclusive breastfeeding (EBF) in a subnormal urban cluster (slums) in Pernambuco, Brazil. METHODS Four breastfeeding indicators were used to interview mothers of children under 3 years of age. An inventory of the families' socioeconomic and environmental factors, maternal obstetric history, and basic health care access was undertaken. The sample consisted of all 310 children under the age of 3 years from Coelhos, PE, Brazil. Spearman's correlation was carried out, as well as crude and adjusted prevalence ratios for a final statistical model that showed associated factors with the main outcome at a level of 0.05. RESULTS The prevalence of breastfeeding in the first hour of life, exclusive breastfeeding up to 6 months, continued breastfeeding at 1 year, and continued breastfeeding at 2 years were 60.2%, 32.9%, 45.9, and 35.9%, respectively. A correlation was observed between start of pacifier use and duration of either exclusive (rs=0.358 [p<0.001]) or non-exclusive breastfeeding (rs=0.248 [p=0.006]). Maternal age over 35 years (p<0.001), home visit in the first week after birth (p=0.003), having had a male baby (p=0.029), and not using a pacifier (p<0.001) remained protective factors in the final model. CONCLUSION The prevalence rates of exclusive breastfeeding at 6 months were well above the results obtained by other Brazilian authors. Home visit and maternal age prevailed as protective factors, while pacifier use was shown to be a discouraging practice.
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Affiliation(s)
- Vera A A L Silva
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, PE, Brazil
| | - Maria F C Caminha
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, PE, Brazil; Faculdade Pernambucana de Saúde (FPS), Recife, PE, Brazil
| | - Suzana L Silva
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, PE, Brazil; Faculdade Pernambucana de Saúde (FPS), Recife, PE, Brazil.
| | - Vilneide M S B D Serva
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Centro de Incentivo ao Aleitamento Materno (CIAMA), Banco de Leite Humano (BLH), Recife, PE, Brazil
| | | | - Malaquias Batista Filho
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, PE, Brazil; Universidade de São Paulo (USP), São Paulo, SP, Brazil
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22
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Vila-Candel R, Soriano-Vidal FJ, Murillo-Llorente M, Pérez-Bermejo M, Castro-Sánchez E. [Maintenance of exclusive breastfeeding after three months postpartum: An experience in a health department of a Valencian Community]. Aten Primaria 2019; 51:91-98. [PMID: 29454498 PMCID: PMC6837006 DOI: 10.1016/j.aprim.2017.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 08/16/2017] [Accepted: 09/05/2017] [Indexed: 11/24/2022] Open
Abstract
AIMS To investigate the prevalence of EBF at 3-months postpartum, and the early factors for discontinuation. DESIGN Observational, retrospective study. LOCATION Health department of La Ribera, Valencia, Spain. PARTICIPANTS Newborns between December 2012 to January 2017. METHODS Pregnant women were interviewed at postpartum and at 3 months regarding variables associated with breastfeeding initiation and continuation, matched with socio-demographic and obstetric-neonatal information. MAIN MEASUREMENTS Prevalence of breastfeeding at discharge and exclusive breastfeeding at 3 months. Reasons for interrupt exclusive breastfeeding. Chi-square determination between qualitative variables. FINDINGS One thousand three hundred and thirty-eighth women were recruited. EBF at discharge was 68.2% (913) and at 3 months 46.7% (625). EBF duration was 68.7±32.7 days (95% CI: 66.9-71.2). We found statistically significant differences between the type of breastfeeding and the variables, year of study, country of origin and parity (P<0.001, P=0.005 and P=0.05 respectively). Hypogalactia (21.8%) and lower than recommended increase in newborn weight gain (14.9%) were most frequent factors for discontinuation. CONCLUSION The prevalence of EBF at 3 months is low compared to other similar studies, although we see an upward trend. Belief in hypogalactia influenced the maintenance of exclusive breastfeeding.
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Affiliation(s)
- Rafael Vila-Candel
- Departamento de Obstetricia y Ginecología, Hospital Universitario de la Ribera, Alzira, Valencia, España; Facultad de Enfermería Nuestra Señora de los Desamparados, Universidad Católica de Valencia, Valencia, España.
| | - Francisco J Soriano-Vidal
- Facultad de Enfermería Nuestra Señora de los Desamparados, Universidad Católica de Valencia, Valencia, España; Departamento de Obstetricia y Ginecología, Hospital Lluis Alcanyis, Xàtiva, Valencia, España
| | - Mayte Murillo-Llorente
- Facultad de Enfermería Nuestra Señora de los Desamparados, Universidad Católica de Valencia, Valencia, España
| | - Marcelino Pérez-Bermejo
- Facultad de Enfermería Nuestra Señora de los Desamparados, Universidad Católica de Valencia, Valencia, España
| | - Enrique Castro-Sánchez
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU), Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, Londres, Reino Unido
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Pol-Pons A, Aubanell-Serra M, Vidal M, Martí-Lluch R, Ponjoan A. [Breastfeeding: Basic competence of primary health care professionals]. Aten Primaria 2019; 51:47-49. [PMID: 30459018 PMCID: PMC6837085 DOI: 10.1016/j.aprim.2018.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 04/12/2018] [Accepted: 05/01/2018] [Indexed: 12/02/2022] Open
Affiliation(s)
- Anna Pol-Pons
- Centre d'Atenció Primària Tordera, Gerència d'Àmbit d'Atenció Primària de Girona, Institut Català de la Salut, Gerona, España
| | - Mercè Aubanell-Serra
- Centre d'Atenció Primària Tordera, Gerència d'Àmbit d'Atenció Primària de Girona, Institut Català de la Salut, Gerona, España
| | - Mireia Vidal
- Centre d'Atenció Primària Arenys de Mar, Gerència d'Àmbit d'Atenció Primària Metropolitana Nord, Institut Català de la Salut, Arenys de Mar, Barcelona, España
| | - Ruth Martí-Lluch
- Unitat de Suport a la Recerca de Girona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, España; Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), Gerona, España
| | - Anna Ponjoan
- Unitat de Suport a la Recerca de Girona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, España; Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), Gerona, España.
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Vila-Candel R, Duke K, Soriano-Vidal FJ, Castro-Sánchez E. Affect of Early Skin-to-Skin Mother-Infant Contact in the Maintenance of Exclusive Breastfeeding: Experience in a Health Department in Spain. J Hum Lact 2018; 34:304-312. [PMID: 28099044 DOI: 10.1177/0890334416676469] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Breastfeeding has been shown to result in extensive physical and psychological benefits for both the mother and the newborn. However, the rate and duration of exclusive breastfeeding (EBF) remains low worldwide. Mother-infant skin-to-skin contact (SSC) immediately after birth has demonstrated results that support the argument for breastfeeding continuation. Research aim: This study aimed to investigate the prevalence of EBF 3 months postpartum and the effect of early SSC in maintaining optimal EBF practices for mothers and their healthy newborns. METHODS We conducted an observational, retrospective study in Spain from 2013 to 2015. Pregnant women were interviewed immediately postpartum and again at 3 months postpartum regarding variables associated with breastfeeding initiation and continuation. RESULTS There were 1,071 women recruited. Early SSC was performed in 92% of vaginal births but only 57% of urgent cesarean births. Of women breastfeeding at discharge, 69.5% performed SSC with their newborn. We found that 68.6% of women were exclusively breastfeeding by discharge and 46.7% by 3 months postpartum. Type of feeding at discharge, country of origin, and parity were found to be associated with each other ( p = .003, p = .001, respectively). Early SSC was also significantly associated with type of feeding at discharge, 1 month, 2 months, and 3 months postpartum ( p < .001). Hypogalactia (19.8%) was the most frequently reported factor for breastfeeding discontinuation. CONCLUSION Breastfeeding promotion interventions are likely to improve breastfeeding rates at 3 months postpartum. Social and economic factors should be taken into account when such programs are planned to be implemented.
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Affiliation(s)
- Rafael Vila-Candel
- 1 Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, Valencia, Spain.,2 Department of Nursing, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | - Kiri Duke
- 2 Department of Nursing, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | - F Javier Soriano-Vidal
- 2 Department of Nursing, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain.,3 Department of Obstetrics and Gynaecology, Hospital Lluis Alcanyís de Xativa, Valencia, Spain.,4 Department of Nursing, University of Alicante, Cta. San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig, Alicante, Spain
| | - Enrique Castro-Sánchez
- 5 National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, London, UK
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25
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Análisis de los factores ligados al diagnóstico del trastorno por déficit de atención e hiperactividad en la infancia. Neurologia 2017; 32:431-439. [DOI: 10.1016/j.nrl.2016.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 01/08/2016] [Accepted: 01/26/2016] [Indexed: 11/24/2022] Open
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26
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Rivas-Juesas C, de Dios J, Benac-Prefaci M, Colomer-Revuelta J. Analysis of the factors linked to a diagnosis of attention deficit hyperactivity disorder in children. NEUROLOGÍA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.nrleng.2016.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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27
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Fernández-Cañadas Morillo A, Durán Duque M, Hernández López AB, Muriel Miguel C, Martínez Rodríguez B, Oscoz Prim A, Pérez Riveiro P, Salcedo Mariña A, Royuela Vicente A, Casillas Santana ML, Marín Gabriel MA. A Comparison of Factors Associated with Cessation of Exclusive Breastfeeding at 3 and 6 Months. Breastfeed Med 2017; 12:430-435. [PMID: 28787188 DOI: 10.1089/bfm.2017.0045] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIM To analyze the association of labor and sociodemographic factors with cessation of exclusive breastfeeding (EBF) at 3 and 6 months of life. MATERIALS AND METHODS A prospective cohort study (n = 529) was performed in a tertiary hospital with the Baby-Friendly Hospital Initiative (BFHI) award. Labor and sociodemographic factors were investigated. Single-term newborns were included. After 3 and 6 months, telephone calls were made to determine the type of lactation. Univariate analysis was performed with the chi-square test or Fisher's exact test. Multivariable logistic regression models were developed to determine risk factors associated with cessation of breastfeeding at 3 and 6 months. RESULTS At 3 months, 523 participants (98.9%) were contacted, of whom 64.4% maintained EBF. Factors associated with cessation were pacifier use (odds ratio [OR] 3.49; 95% confidence interval [95% CI] 2.24-5.43), cesarean delivery (OR 4.49; 95% CI 2.96-6.83), no college degree (OR 2.01; 95% CI 1.35-3.01), and not attending breastfeeding support groups (OR 1.96; 95% CI 1.22-3.12). At 6 months, 512 participants (96.8%) were contacted, of whom 31.4% maintained EBF. Factors associated with cessation were reintegration into the workplace (OR 4.49; 95% CI 2.96-6.83), pacifier use (OR 3.49; 95% CI 2.24-5.43), and primiparity (OR 1.61; 95% CI 1.05-2.46). CONCLUSIONS Several risk factors are associated with the premature cessation of EBF. There is a need to define strategies to correct modifiable factors and to promote protective factors with the aim of improving the success rate of EBF to reach the recommendations of the World Health Organization.
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Affiliation(s)
| | - Modesto Durán Duque
- 1 Department of Midwifery, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain
| | - Ana B Hernández López
- 1 Department of Midwifery, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain
| | - Cristina Muriel Miguel
- 1 Department of Midwifery, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain
| | - Begoña Martínez Rodríguez
- 2 Neonatology and Newborn Nursery Division, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain
| | - Ana Oscoz Prim
- 2 Neonatology and Newborn Nursery Division, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain
| | - Pilar Pérez Riveiro
- 2 Neonatology and Newborn Nursery Division, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain
| | - Angel Salcedo Mariña
- 3 Department of Obstetrics, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain
| | - Ana Royuela Vicente
- 4 Clinical Biostatistics Unit, Puerta de Hierro Majadahonda University Hospital , Instituto de Investigación Puerta de Hierro (IDIPHIM), Madrid, Spain
| | | | - Miguel A Marín Gabriel
- 6 Department of Neonatology, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain .,7 Department of Pediatrics, Autónoma University , Madrid, Spain
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Gómez Fernández-Vegue M, Menéndez Orenga M. Development and validation of a Breastfeeding Knowledge and Skills Questionnaire. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2015. [DOI: 10.1016/j.anpede.2015.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Becerra Bulla F. EL ENTORNO FAMILIAR Y SOCIAL DE LA MADRE COMO FACTOR QUE PROMUEVE O DIFICULTA LA LACTANCIA MATERNA. REVISTA DE LA FACULTAD DE MEDICINA 2015. [DOI: 10.15446/revfacmed.v63n2.44051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
<p>La lactancia materna trae consigo múltiples beneficios para toda la comunidad, en especial para la madre y su bebe. La lactancia materna es un acto que debe darse naturalmente pero se tiende a abandonar esta práctica por diferentes factores o creencias. Por ello es importante para la sociedad conocer las principales causas de dicho abandono y poder resolver este problema social. El entorno social y familiar,figuran como los factores más determinantes. <strong>Metodología:</strong> Se realizó una búsqueda sistemática de artículos de revisión y de investigación acerca del entorno familiar, escolar y laboral de la madre lactante y su relación con el inicio, la duración y el éxito de su lactancia. <strong>Resultados:</strong> Dentro de los factores que protegen la lactancia materna se encuentran; el apoyo de la familia, el acompañamiento de la pareja y el haber tenido una experiencia previa positiva con otros hijos. El rol que ejerce la abuela es discordante en distintos estudios; en varios de éstos, el papel de la abuela es un factor protector, en especial la abuela materna. La mayoría de estudios refieren que a mayor nivel de estudios hay mayor prevalencia de lactancia materna. Los estudios concuerdan que las madres trabajadoras lactan menos tiempo a sus hijos, y por el contrario, las madres que permanecen en la casa lactan más, en entornos laborales donde la madre está protegida con políticas legales, la duración es aún mayor. <strong>Conclusión:</strong> Tener presente el entorno materno es fundamental en la planeación programas, planes y proyectos que promuevan la lactancia.</p>
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[Development And Validation Of A Breastfeeding Knowledge And Skills Questionnaire]. An Pediatr (Barc) 2015; 83:387-96. [PMID: 25818018 DOI: 10.1016/j.anpedi.2015.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 01/12/2015] [Accepted: 01/14/2015] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Pediatricians play a key role in the onset and duration of breastfeeding. Although it is known that they lack formal education on this subject, there are currently no validated tools available to assess pediatrician knowledge regarding breastfeeding. OBJECTIVE To develop and validate a Breastfeeding Knowledge and Skills Questionnaire for Pediatricians. MATERIAL AND METHODS Once the knowledge areas were defined, a representative sample of pediatricians was chosen to carry out the survey. After pilot testing, non-discriminating questions were removed. Content validity was assessed by 14 breastfeeding experts, who examined the test, yielding 22 scorable items (maximum score: 26 points). To approach criterion validity, it was hypothesized that a group of pediatricians with a special interest in breastfeeding (1) would obtain better results than pediatricians from a hospital without a maternity ward (2), and the latter would obtain a higher score than the medical residents of Pediatrics training in the same hospital (3). The questionnaire was also evaluated before and after a basic course in breastfeeding. RESULTS Breastfeeding experts have an index of agreement of >.90 for each item. The 3 groups (n=82) were compared, finding significant differences between group (1) and the rest. Moreover, an improvement was observed in the participants who attended the breastfeeding course (n=31), especially among those with less initial knowledge. Regarding reliability, internal consistency (KR-20=.87), interobserver agreement, and temporal stability were examined, with satisfactory results. CONCLUSIONS A practical and self-administered tool is presented to assess pediatrician knowledge regarding breastfeeding, with a documented validity and reliability.
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Dietary and health profiles of Spanish women in preconception, pregnancy and lactation. Nutrients 2014; 6:4434-51. [PMID: 25333199 PMCID: PMC4210927 DOI: 10.3390/nu6104434] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 08/19/2014] [Accepted: 09/26/2014] [Indexed: 01/10/2023] Open
Abstract
The nutritional status and lifestyle of women in preconception, pregnancy and lactation determine maternal, fetal and child health. The aim of this cross-sectional study was to evaluate dietary patterns and lifestyles according the perinatal physiological status in a large sample of Spanish women. Community pharmacists that were previously trained to collect the data recruited 13,845 women. General information, anthropometric measurements, physical activity, unhealthy habits and dietary data were assessed using a validated questionnaire. Mean values and percentages were used as descriptive statistics. The t-test, ANOVA or chi-squared test were used to compare groups. A score that included dietary and behavioral characteristics was generated to compare lifestyles in the three physiological situations. The analysis revealed that diet quality should be improved in the three stages, but in a different manner. While women seeking a pregnancy only met dairy recommendations, those who were pregnant only fulfilled fresh fruits servings and lactating women only covered protein group requirements. In all cases, the consumption allowances of sausages, buns and pastries were exceeded. Food patterns and unhealthy behaviors of Spanish women in preconception, pregnancy and lactation should be improved, particularly in preconception. This information might be useful in order to implement educational programs for each population group.
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