A breastfeeding support program changed breastfeeding patterns but did not affect the mothers' self-efficacy in breastfeeding at two months

Breastfeeding patterns in one-year-old children was not affected by a breastfeeding support intervention

BACKGROUND

Breastfeeding patterns in 12-month-old children play a central role in the mother-infant dyad, but studies describing the patterns are scarce.

AIM

To investigate breastfeeding patterns in 12-month-old infants before and after a breastfeeding support programme.

STUDY DESIGN

A baseline/intervention design as part of a larger implementation project aiming to revive the Ten Steps to Successful Breastfeeding programme.

SUBJECTS

During a 24-h period, 28 mothers from a baseline group and 24 mothers from an intervention group recorded all breastfeeding sessions on a pen and paper form.

RESULTS

The median (range) frequency of breastfeeding sessions was 6 (1-22) in the baseline group and 7 (1-20) times per 24 h in the intervention group. No significant difference was observed in frequencies between the two groups. The majority of children (57 % in the baseline group and 62 % in the intervention group) exhibited a pattern classified as partial breastfeeding, engaging in breastfeeding 6 or more times per 24 h throughout a substantial part of the day. A second pattern was classified as token breastfeeding, with few breastfeeding sessions, suggesting that breastfeeding occurred primarily for comfort.

CONCLUSION

This study illuminates the breastfeeding behaviours of 12-month-old children and can serve to normalise frequent breastfeeding patterns, potentially aiding mothers who wish to continue breastfeeding beyond infancy. The findings indicate no difference between the groups, suggesting that the implemented intervention did not influence maternal breastfeeding practices at one year of age. This underscores the potential necessity for prolonged support for parents throughout the breastfeeding period. ISRCTN registry: doi.org/10.1186/ISRCTN91972905.

Instrument development and an intervention to increase parents' self-efficacy regarding their infant's sleep

OBJECTIVE

Many Swedish parents experience that their infant has sleeping problems. Parents' self-efficacy regarding their infants' sleep may play an important role in how they perceive these problems. This pilot study aimed to develop an instrument measuring parents' self-efficacy regarding their infant's sleep and to examine if parents' self-efficacy was affected by an intervention focusing on parental education.

METHOD

Mothers and fathers, at a maternity unit in Sweden, were drawn into either an intervention (n = 46) or a control (n = 42) group. The intervention group received a home visit from a nurse who provided information about infant sleep; the importance of attachment; and advice regarding sleep, breastfeeding and bed sharing, including guidelines for safe bed sharing. Three months later, the participants answered questions on background data, breastfeeding, sleep and self-efficacy.

RESULTS

The 11-item two-factor Uppsala Parental Self-Efficacy about Infant Sleep Instrument (UPPSEISI) was constructed to measure parents' perceived self-efficacy. In adjusted analyses, being in the intervention group was associated with a higher self-efficacy (P = 0.035), as were being a mother (P = 0.003) and being satisfied with one's own sleep (P = 0.007), while parents' own sleeping problems were associated with a lower self-efficacy (P = 0.015).

CONCLUSION

Importantly, parental education may increase parents' self-efficacy regarding their infant's sleep.

The effects of video-assisted breastfeeding education given to primiparous pregnant women on breastfeeding self-efficacy: randomized control study

BACKGROUND

Breastfeeding is vitally important for the health of the mother, baby, family and society. Especially the perception of breastfeeding self-efficacy of primiparous pregnant women is an important factor in breastfeeding. This study was conducted to determine the effects of online video-supported breastfeeding education on breastfeeding self-efficacy in primiparous pregnant women.

METHODS

This randomized controlled study was conducted with primiparous pregnant women admitted to a university hospital in northern Turkey. The study involved 80 pregnant women, with 40 assigned to the experimental group and 40 to the control group. Participants in the intervention group received online video-assisted education, which covered the first meeting of the mother and baby as well as the initial breastfeeding session. The data for the breastfeeding self-efficacy scale were gathered at the onset of the study and three weeks later. In data analysis, categorical variables were assessed using the chi-square test, continuous variables and intergroup comparisons were conducted through the independent sample t-test, and intragroup comparisons were performed using the paired sample t-test.

RESULTS

While the baseline breastfeeding self-efficacy levels of the primiparous pregnant women were similar between the groups, statistically significant differences were observed both within (p = 0.000) and between (p = 0.000) groups in the breastfeeding self-efficacy scores of pregnant women in the intervention group after the education intervention.

CONCLUSION

Breastfeeding self-efficacy levels in the education group showed a statistically significant increase compared to both the pre-education and control groups. This highlights the importance of nurses providing support to primiparous pregnant women through video-assisted education during pregnancy to enhance breastfeeding self-efficacy.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT06121973 date of first registration (27/10/2023), retrospectively registered (08/11/2023).

Breastfeeding pattern and its relationship with weight gain in children older than 6 months

Introduction

According to the World Health Organization (WHO), breastfeeding is the best way to feed infants. Adoption of some inappropriate nutritional patterns along with breast milk, especially in infants older than 6 months, may lead to a delay in the child's growth. Therefore, the present study was conducted to investigate the relationship between breastfeeding and weight gain in children aged 6-24 months.

Materials and Methods

This case-control study was conducted on 120 infants aged 6-24 months and their mothers recruited from health centers of Ahvaz, southwest of Iran. The data collection tool in the present study included a questionnaire to record demographic information and information in the child's medical records in health centers. Statistical analysis of the data was done by SPSS 23 using the Chi-square test and t-test.

Results

No significant difference was observed between the control and case groups in terms of the infant's age (P = 0.741) and gender (P = 0.564) and the mothers' age (P = 0.614), her educational attainment (P = 0.389), and socioeconomic status of the infant's family (P = 0.563). The type of delivery (P = 0.650), mothers' opinion (P = 0.133), and the interval between breastfeeding and complementary feeding (P = 0.144) had no significant relationship with the infant's growth disorder. On the other hand, duration of breastfeeding per meal (P = 0.007) and frequent breastfeeding (dependency on the mother's breast) (P = 0.049) had a significant relationship with children's developmental disorders.

Conclusion

According to the results of the present study, growth disorders in infants in the case group could be attributed to their mothers' inappropriate breastfeeding patterns.

Non-medical formula use in newborn infants still common at two Swedish hospitals after a breastfeeding support program

AIM

To evaluate the effectiveness of a breastfeeding support programme on reducing infant formula use and to investigate indications for formula in newborn infants in Sweden.

METHODS

A quasi-experimental study design was carried out. It included 255 mother-infant pairs in a control group, who received standard care and 254 pairs in an intervention group, who took part in a breastfeeding support programme. Data were collected by reviewing patient records from two regional hospitals in Uppsala and Gotland and recruitment took place between 2017 and 2019.

RESULTS

Median age of mothers were 31 years (range 20-49) and median gestational age of infants were 39 + 6 weeks/days (range 37 + 0 to 42 + 4). The intervention did not reduce infant formula use. In total, 87/507 (17%) of the infants received formula. Among children receiving formula 30/87 (34%) had a medical indication, whereas 57/87 (66%) had no medical indication. Main reasons for medically indicated formula use were hypoglycaemia, 13/30 (43%), and weight loss, 13/30 (43%). Main reasons for non-medical use were mothers'/parents' wishes, 25/57 (44%) and infants' dissatisfaction, 11/57 (19%).

CONCLUSION

Continued efforts are needed to develop effective breastfeeding interventions with increased focus on infant formula reduction.

Effect of IMB Model Combined with Spousal Support Breastfeeding Intervention on PBSES Score and Breastfeeding Rate of Primipara with Chronic Hepatitis B Virus Infection

Objective

To analyze the effects of the info-motivation-behavior skills (IMB) model combined with spousal support breastfeeding intervention on breastfeeding Self-Efficacy Scale (PBSES) scores and breastfeeding rate of primiparas with chronic hepatitis B virus (HBV) infection.

Methods

Seventy-four first-term pregnant women and 74 of their spouses were selected as the traditional control group by the convenience sampling method from July to September 2021 in obstetrics department of Shenzhen Third People's Hospital. 74 pregnant women with their first child and 74 spouses who had their first child checked during October to December 2021 were classified as the IMB model group. The traditional control group was applied with conventional intervention management mode, and the IMB model group was applied with intervention management mode based on IMB theory on the basis of the traditional control group. The self-efficacy scores of breastfeeding before and after intervention during pregnancy and during hospitalization were compared between the two groups, and the self-efficacy scores of paternal support for breastfeeding were compared. The exclusive breastfeeding rate of infants within 6 months and the maternal breastfeeding knowledge level of the two groups were compared, and the correlation between maternal breastfeeding self-efficacy score and feeding knowledge level was analyzed.

Results

After pregnancy intervention, PBSES and FBSES-SF scores were significantly increased in both groups, and scores of scales in the IMB model group increased significantly than the traditional control group (all P < 0.05). The BSES-SF and FBSES-SF scores of the IMB model group increased significantly than the traditional control group at 3 days after delivery and at discharge (P < 0.05), and the scores of each scale at discharge in both groups increased significantly than those at 3 days after delivery (P < 0.05). The rate of exclusive breastfeeding in the IMB model group was 94.59% (70/74), and that in the traditional control group was 78.38% (58/74). There was a significant difference (χ2 = 8.325, P = 0.004). At discharge, the score of maternal breastfeeding knowledge increased significantly in both groups, and the score of the IMB model group increased significantly than that of the traditional control group (all P < 0.05). Pearson correlation coefficient was used to analyze the correlation between PBSES score, FBSES-SF score, and maternal feeding knowledge level, which showed positive correlation (all P < 0.05).

Conclusion

The self-efficacy of prenatal breastfeeding in pregnant women with HBV is low, and the application of the IMB model combined with the intervention mode of spy-supported breastfeeding has positive effects on the improvement of maternal breastfeeding efficiency, breastfeeding health knowledge level, and postpartum breastfeeding rate, which is worthy of clinical promotion and application.

Breastfeeding Supportive Services in Baby-Friendly Hospitals Positively Influenced Exclusive Breastfeeding Practice at Hospitalization Discharge and Six Months Postpartum

BACKGROUND

Studies have shown that implementing the Ten Steps to Successful Breastfeeding of the Baby-Friendly Hospital Initiative can protect, promote, and support breastfeeding. However, few studies have valuated the quality of breastfeeding supportive services provided by Baby-Friendly Hospitals from the perspective of service users.

METHODS

This was a hospital-based prospective study, conducted at eight Baby-Friendly Hospitals with a total of 707 pregnant women in Shanghai, China between October 2016 and September 2021. Breastfeeding supportive services during hospitalization were assessed at childbirth discharge using a 12-question questionnaire based on the Chinese "Baby-Friendly Hospital Evaluation Standards". Women were followed up on six months postpartum. The impact of breastfeeding supportive services during hospitalization on the exclusive breastfeeding at discharge and six months postpartum were assessed.

RESULTS

Of the 707 mothers who completed the survey at discharge, 526 were followed up on six months after delivery. The overall exclusive breastfeeding rate among participants was 34.4% at discharge and 52.1% at six months postpartum. Mothers who received better breastfeeding supportive services during hospitalization were more likely to practice exclusive breastfeeding at hospitalization discharge compared with mothers who received poorer services (aOR: 3.00; 95% CI: 2.08, 4.35; p < 0.001). Furthermore, they were also more likely to exclusively breastfeed at six months postpartum (aOR: 1.50; 95% CI: 1.03, 2.22; p = 0.033).

CONCLUSION

Better breastfeeding supportive services during hospitalization were significantly associated with higher rate of exclusive breastfeeding at discharge and six months postpartum. More effective measures should be adopted to improve the implementation of the breastfeeding supportive services in Baby-Friendly Hospitals to promote exclusive breastfeeding and better maternal and child health.

The effect of social media-based support on breastfeeding self-efficacy: a randomised controlled trial

OBJECTIVE

The study aimed to determine the effect of breastfeeding support through social media on women's breastfeeding self-efficacy.

METHODS

A randomised controlled trial was conducted in the maternity unit of Aksaray University Education and Research Hospital, Turkey. Education and counselling on breastfeeding were given via WhatsApp to women in the intervention group. Women in the control group received routine breastfeeding teaching before discharge from hospital. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) was administered to both groups immediately after birth and at 3 and 6 months postpartum. The study was completed by 31 women in the intervention group and 37 women in the control group.

RESULTS

At 3 and 6 months there was a statistically significant difference in BSES-SF mean scores between the intervention and control groups (p < 0.05). BSES-SF scores in the intervention group were higher at 3 and 6 months compared with baseline, while BSES-SF scores in the control group were lower at 6 months compared with baseline.

CONCLUSION

Women's breastfeeding self-efficacy was improved through a social media-based teaching and counselling intervention. Health care professionals should make use of social media tools to improve women's breastfeeding self-efficacy and encourage continuity of breastfeeding.

Exclusive Breastfeeding Is Not Associated with Maternal-Infant Bonding in Early Postpartum, Considering Depression, Anxiety, and Parity

It is important to clarify how the breastfeeding method affects women’s mental health, and how women’s mental health affects the breastfeeding method in the early postpartum period when major depression and other psychiatric problems are most likely to occur. This study aimed to examine this bidirectional relationship in the early postpartum period. Participants were 2020 postpartum women who completed the Hospital Anxiety and Depression Scale (HADS) and Mother-to-Infant Bonding Scale (MIBS). We obtained data for participants’ breastfeeding method for four weeks after childbirth. We performed a path analysis with factors including breastfeeding method (exclusive breastfeeding or non-exclusive breastfeeding), parity (primipara or multipara), the two HADS subscales (anxiety and depression), and the two MIBS subscales (lack of affection and anger and rejection). The path analysis showed that breastfeeding method did not significantly affect depression, anxiety, and maternal–infant bonding in the early postpartum period. Women with higher anxiety tended to use both formula-feeding and breastfeeding. Our study suggests that exclusive breastfeeding is not associated with maternal-fetal bonding in early postpartum, considering depression, anxiety, and parity.