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Bektas G, Boelsma F, Gündüz M, Klaassen EN, Seidell JC, Wesdorp CL, Dijkstra SC. A qualitative study on the perspectives of Turkish mothers and grandmothers in the Netherlands regarding the influence of grandmothers on health related practices in the first 1000 days of a child's life. BMC Public Health 2022; 22:1364. [PMID: 35842646 PMCID: PMC9287533 DOI: 10.1186/s12889-022-13768-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Given the importance of the first 1000 days of a child's life in terms of laying the foundations for healthy growth and development, parents are a logical target group for supporting health-related practices with regard to young children. However, little attention is paid to the influence of the wider social community on the health and development of young children during this crucial period. This includes grandmothers, who often have a significant influence on health-related practices of their grandchildren. The aim of this study was therefore to explore the influence of grandmothers on health related practices of their grandchildren during the first 1000 days, from the perspectives of both grandmothers and mothers with a Turkish background. METHOD This qualitative study in the Netherlands collected data during focus group discussions with grandmothers (N = 3), interviews with grandmothers (N = 18) and interviews with mothers (N = 16), all with a Turkish background. Data was collected in the period between June 2019 and April 2021 and analysed using a thematic content analysis. RESULTS The influence of grandmothers and the wider social community on health related practices during the first 1000 days of a child's life is substantial and self-evident. The support of grandmothers is often rooted in various socio-cultural norms and practices. The mothers of young children can experience the guidance and pressure they receive from grandmothers and the wider social community as quite stressful. Conflicting views and practices tend to arise between grandmothers and mothers when a grandmother babysits. Both mothers and grandmothers often find it difficult to discuss these differences openly, for fear this might lead to a family conflict. CONCLUSION This study shows that grandmothers and the wider social community play an influential role in supporting a healthy first 1000 days of a child's life. The strong involvement of grandmothers may lead to tension between the mothers and grandmothers when their ideas about healthy practices are not in agreement and may lead to unhealthy practices. In targeting this wider social community, it is important to consider the various socio-cultural factors that underlie the advice, support, practices and beliefs of the individuals involved.
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Affiliation(s)
- Gülcan Bektas
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorstraat 7, BT, 1081, Amsterdam, the Netherlands.
| | - Femke Boelsma
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorstraat 7, BT, 1081, Amsterdam, the Netherlands
| | - Meryem Gündüz
- Faculty of Sports and Nutrition, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Dokter Meurerlaan 8, 1067, SM, Amsterdam, the Netherlands
| | - Eva N Klaassen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorstraat 7, 1081, BT, Amsterdam, the Netherlands
| | - Jacob C Seidell
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorstraat 7, BT, 1081, Amsterdam, the Netherlands
| | - Carline L Wesdorp
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorstraat 7, BT, 1081, Amsterdam, the Netherlands
| | - S Coosje Dijkstra
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorstraat 7, BT, 1081, Amsterdam, the Netherlands.
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Russell PS, Smith DM, Birtel MD, Hart KH, Golding SE. The role of emotions and injunctive norms in breastfeeding: a systematic review and meta-analysis. Health Psychol Rev 2021; 16:257-279. [PMID: 33618626 DOI: 10.1080/17437199.2021.1893783] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Breastfeeding has many known benefits, but rates vary globally. We propose two main reasons why psychological theory and interventions have not been successful to date in explaining breastfeeding behaviours. Specifically, prior research underestimates the importance of (1) specific emotions and (2) wider injunctive influences (i.e., societal and moral norms about what women feel they ought to be doing) in the breastfeeding experience. Therefore, we conducted a systematic review of quantitative, qualitative, and mixed-methods studies that explored whether injunctive norms and/ or specific emotions are associated with breastfeeding behaviours (i.e., intentions, initiation and duration). Seventy-two papers were included in this review; data were extracted and quality appraisals conducted for all included studies. A meta-analysis of effect sizes was performed with the quantitative data. A convergent qualitative synthesis of the data was conducted, resulting in the following line of argument: Breastfeeding is a social behaviour and not a personal/individual behaviour. From this line of argument, three themes with associated sub-themes were developed, highlighting the importance of both specific emotions and injunctive norms on breastfeeding behaviours. These influences are discussed in relation to both theoretical and practical implications, as well as future research.
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Affiliation(s)
- Pascale Sophie Russell
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Debbie M Smith
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | | | - Kathryn H Hart
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Sarah E Golding
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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Chen H, Li C, Zhou Q, Cassidy TM, Younger KM, Shen S, Kearney JM. How to promote exclusive breastfeeding in Ireland: a qualitative study on views of Chinese immigrant mothers. Int Breastfeed J 2021; 16:10. [PMID: 33446223 PMCID: PMC7809803 DOI: 10.1186/s13006-021-00358-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 01/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The exclusive breastfeeding rate in Ireland is very low with extremely slow annual growth. The population of immigrants in Ireland is increasing. Improving exclusive breastfeeding practice among immigrants may contribute to the overall improvement of exclusive breastfeeding rates in Ireland. This study was conducted to elicit suggestions on improving exclusive breastfeeding rate for the first 6 months among Chinese immigrants in Ireland. METHODS Fourteen semi-structured in-depth interviews were conducted with Chinese immigrant mothers residing in Ireland, who breastfed exclusively for 4 to 6 months. Interviews were recorded and transcribed in Chinese. Data were analyzed using a qualitative thematic analysis. Themes were developed through categorization of codes and via in-depth discussion between two researchers. RESULTS Themes generated from the thematic content analysis were: 1) suggestions for new mothers: being strong mentally and getting support from family and friends; 2) suggestions for employers: creating a supportive workplace by setting up private rooms and breastmilk storage facilities; 3) suggestions for healthcare professionals: advocating breastfeeding in the hospital and addressing cultural differences by recruiting multilingual staff; 4) suggestions for the government: promoting breastfeeding by initiating societal and policy changes. CONCLUSIONS The key findings emerging from this study may be considered in the development of breastfeeding promotion strategies in Ireland. Our findings could also have implications for other English-speaking countries with low rates of exclusive breastfeeding.
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Affiliation(s)
- Haoyue Chen
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Cheng Li
- Beijing Nutrition Resources Institute, Beijing Academy of Sciences, Beijing, China
| | - Qianling Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China.
| | - Tanya M Cassidy
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin 9, Ireland
| | - Katherine M Younger
- School of Biological Sciences, Technological University Dublin, Kevin Street, Dublin 8, Ireland
| | - Siao Shen
- The Stony Brook School, Stony Brook, NY, USA
| | - John M Kearney
- School of Biological Sciences, Technological University Dublin, Kevin Street, Dublin 8, Ireland
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Wen J, Yu G, Kong Y, Liu F, Wei H. An exploration of the breastfeeding behaviors of women after cesarean section: A qualitative study. Int J Nurs Sci 2020; 7:419-426. [PMID: 33195754 PMCID: PMC7644566 DOI: 10.1016/j.ijnss.2020.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/21/2020] [Accepted: 07/17/2020] [Indexed: 02/06/2023] Open
Abstract
Objectives To explore the factors affecting breastfeeding behaviors in women after cesarean section. Methods This is a qualitative study that used a phenomenological approach. This study used individual face-to-face interviews with 19 women who underwent a cesarean section in a Women and Children’s Hospital in China between July to September 2019. Information saturation was used to determine sample size. Data were analyzed using a thematic content analysis method. Themes were developed based on the theory of planned behavior. Results Thirteen (68.42%) had a planned cesarean section, and six (31.58%) cesarean sections were unplanned or emergent. Three major themes emerged: ambivalent attitude about breastfeeding, motivation to comply with the traditional cultural norms, and barriers and challenges. The motivating factors for breastfeeding after cesarean sections included perceived benefits of human milk, support from healthcare professionals, and responsibility for breastfeeding. The challenges for breastfeeding after cesarean sections included physical discomfort, knowledge and skills deficit of breastfeeding, lactation deficiency, and lack of knowledge and coping skills in managing their depressive mood after cesarean sections. There were a couple of neutral factors, such as the influences of family and peers. These factors could influence women either positively as facilitators or negatively as barriers. Conclusions The findings can offer valuable information for healthcare professionals to help women breastfeed after cesarean sections. To promote women’s breastfeeding behaviors after cesarean sections, it is necessary to change women’s attitudes, belief systems, and the external environments and help them become more confident.
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Affiliation(s)
- Juan Wen
- School of Nursing of Qingdao University, Qingdao, Shandong, China
| | - Guiling Yu
- Qingdao Women and Children's Hospital, Qingdao, Shandong, China
| | - Yan Kong
- Qingdao Women and Children's Hospital, Qingdao, Shandong, China
| | - Furong Liu
- Qingdao Women and Children's Hospital, Qingdao, Shandong, China
| | - Holly Wei
- College of Nursing at East Carolina University, Greenville, NC, USA
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Zhou Q, Chen H, Younger KM, Cassidy TM, Kearney JM. "I was determined to breastfeed, and I always found a solution": successful experiences of exclusive breastfeeding among Chinese mothers in Ireland. Int Breastfeed J 2020; 15:47. [PMID: 32434576 PMCID: PMC7240908 DOI: 10.1186/s13006-020-00292-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 05/13/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The prevalence of exclusive breastfeeding for at least 4 months was previously found to be very low among Chinese immigrants in Ireland, at 5.8% (Zhou et al., Front Public Health 6:351, 2018). This study investigates the successful experiences of Chinese mothers living in Ireland who exclusively breastfeed for between four and 6 months. METHODS Participants were recruited from the sample of the Ireland Chinese Mother Survey. Qualitative in-depth interviews were conducted with fourteen participants in their homes or public places. RESULTS A content analysis revealed that various factors contributed to a successful experience of exclusive breastfeeding among the group of Chinese immigrant mothers, including strong self-determination; appropriate physical conditions; awareness of the benefits of exclusive breastfeeding; a lack of time constraints; and family, professional and policy support. The barriers that the mothers faced included the difficulty of balancing breastfeeding and employment, infant health issues, language barriers, an inability to consume the traditional Chinese postpartum diet and a lack of public breastfeeding facilities. Measures taken to overcome these barriers included seeking family support, resting during the lactation period, and pumping breast milk to feed from a bottle when outside the home. CONCLUSIONS This study highlights unique factors affecting exclusive breastfeeding among Chinese mothers in Ireland, which may be useful to health care professionals working with Chinese immigrant women internationally.
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Affiliation(s)
- Qianling Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China.
| | - Haoyue Chen
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Katherine M Younger
- School of Biological and Health Sciences, Technological University Dublin, Kevin Street, Dublin 8, Ireland
| | - Tanya M Cassidy
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin 9, Ireland
| | - John M Kearney
- School of Biological and Health Sciences, Technological University Dublin, Kevin Street, Dublin 8, Ireland
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6
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Zhou Q, Younger KM, Cassidy TM, Wang W, Kearney JM. Breastfeeding practices 2008-2009 among Chinese mothers living in Ireland: a mixed methods study. BMC Pregnancy Childbirth 2020; 20:51. [PMID: 31973693 PMCID: PMC6979383 DOI: 10.1186/s12884-019-2713-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 12/30/2019] [Indexed: 11/10/2022] Open
Abstract
Background Migration to another country has a potential influence on breastfeeding practices. A significant difference in breastfeeding rates between Irish nationals and non-nationals has been reported. This study was conducted to explore breastfeeding practices of the Chinese in Ireland, one of the largest Irish ethnic groups, and to explore the influence of living in Ireland on breastfeeding practices. This is the first and the only migration study so far on breastfeeding practices among the Chinese in Ireland. Methods A sequential explanatory mixed methods approach was adopted. The first phase was a cross-sectional self-administered retrospective mailed survey, to explore breastfeeding practices and determinants of breastfeeding among a convenience sample of Chinese mothers living in Ireland (n = 322). Recruitment was conducted in the Dublin metropolitan area, with the application of the snowball technique to increase sample size. The second phase consisted of seven semi-structured focus groups (n = 33) conducted in Dublin, to explore the influence of living in Ireland on breastfeeding among Chinese mothers who had given birth in Ireland. Quantitative data were analyzed by univariate and multivariate logistic regression analyses, and informed the qualitative data collection. Qualitative data were analyzed by thematic content analyses, to explain and enrich the qualitative results. Results The breastfeeding initiation rate among Chinese immigrants to Ireland who gave birth in Ireland (CMI) (75.6%) was high and close to that of Chinese immigrant mothers who gave birth in China (CMC) (87.2%). However, giving birth in Ireland was independently associated with a shorter duration of breastfeeding (< 4 months) among Chinese immigrants. Qualitative results explained that a shorter breastfeeding duration among CMI than that of CMC was mainly due to cultural conflicts, a lack of family support, language barriers, immigrants’ low socioeconomic status, and mothers’ preference for infant formula on the Irish market. Both quantitative and qualitative data revealed a strong cultural belief in the efficacy of the traditional Chinese postpartum diet for breast milk production for both CMC and CMI. Antenatal feeding intention was a strong determinant for breastfeeding initiation and duration among CMI. Conclusion Migration to Ireland was found to be associated with a shorter duration of breastfeeding of the Chinese. Culturally sensitive and language-specific education and support of breastfeeding is needed for the Chinese mothers living in Ireland. The mixed methods design presented here might serve as a template for future migration research on breastfeeding.
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Affiliation(s)
- Qianling Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China.
| | - Katherine M Younger
- School of Biological Sciences, Dublin Institute of Technology, Kevin Street, Dublin 8, Republic of Ireland
| | - Tanya M Cassidy
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Republic of Ireland
| | - Wenyi Wang
- Johns Hopkins University, Baltimore, USA
| | - John M Kearney
- School of Biological Sciences, Dublin Institute of Technology, Kevin Street, Dublin 8, Republic of Ireland
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Lau CYK, Lok KYW, Tarrant M. Breastfeeding Duration and the Theory of Planned Behavior and Breastfeeding Self-Efficacy Framework: A Systematic Review of Observational Studies. Matern Child Health J 2019; 22:327-342. [PMID: 29427014 DOI: 10.1007/s10995-018-2453-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Introduction Numerous studies have shown that the constructs of the Theory of Reasoned Action (TRA), Theory of Planned Behavior (TPB) and Breastfeeding Self-Efficacy (BSE) Framework can effectively identify relationships between maternal psychosocial factors and breastfeeding initiation. However, the ability of these theories to predict breastfeeding duration has not been adequately analyzed. The aim of the review was to examine the utility of the constructs of TRA/TPB and BSE to predict breastfeeding duration. Methods We conducted a literature search using Pubmed (1980-May 2015), Medline (1966-May 2015), CINAHL (1980-May 2015), EMBASE (1980-May 2015) and PsycINFO (1980-May 2015). We selected studies that were observational studies without randomization or blinding, using TRA, TPB or BSE as the framework for analysis. Only studies reporting on breastfeeding duration were included. Results Thirty studies were selected, which include four using TRA, 10 using TPB, 15 using BSE and one using a combination of TPB and BSE. Maternal intention and breastfeeding self-efficacy were found to be important predictors of breastfeeding duration. Inconsistent findings were found in assessing the relationship between maternal attitudes, subjective norms, perceived behavior control and breastfeeding duration. Discussion The inadequacy of these constructs in explaining breastfeeding duration indicates a need to further explore the role of maternal self-determination in breastfeeding behavior.
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Affiliation(s)
- Christine Y K Lau
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, 4/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Kris Y W Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, 4/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Marie Tarrant
- School of Nursing, University of British Columbia, Okanagan Campus, Kelowna, BC, Canada
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Whipps MD, Yoshikawa H, Demirci JR. Latent trajectories of infant breast milk consumption in the United States. MATERNAL & CHILD NUTRITION 2019; 15:e12655. [PMID: 30216665 PMCID: PMC7198923 DOI: 10.1111/mcn.12655] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 06/23/2018] [Accepted: 07/04/2018] [Indexed: 01/03/2023]
Abstract
Patterns of breastfeeding over time are not currently well understood. Limited qualitative and quantitative evidence suggests that there may be latent subgroups of mothers in the United States following very different trajectories of breast milk provision for their infants. This study used a quantitative modelling method (group-based trajectory modelling) to identify and describe these subgroups. Using data from the Infant Feeding Practices Study II (n = 3,023), the authors identified four distinct trajectories of breastfeeding intensity, each of which included a substantial subset of the total sample. A model with four groups fit the data well by objective and conceptual standards. Bivariate associations were analysed, and significant difference between trajectory group membership was found on an array of maternal and family determinants, including maternal demographics, hospital experience, and psychosocial resources, as well as on postweaning perceptions. These associations were used to create group profiles for each subgroup. Controlling for sociodemographic covariates, we also found that trajectory membership was significantly associated with several health outcomes for the target child 6 years later, including certain infections, picky eating, and health care utilization; trajectory group membership was also associated with maternal breastfeeding of subsequent children and maternal body mass index (BMI) at Year 6. Child BMI z-score and maternal breast cancer diagnosis were not significantly different across trajectory groups after accounting for confounding covariates, nor was time missed from school for the target child. Though exploratory, the initial identification and description of these four subgroups suggest future directions using breastfeeding trajectory methods, with potential implications for measurement, intervention development, and targeting.
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Affiliation(s)
- Mackenzie D.M. Whipps
- Department of Applied PsychologyNew York University Steinhardt School of Culture, Education, and Human DevelopmentNew YorkNew YorkUSA
| | - Hirokazu Yoshikawa
- Department of Applied PsychologyNew York University Steinhardt School of Culture, Education, and Human DevelopmentNew YorkNew YorkUSA
| | - Jill R. Demirci
- Department of Health Promotion and DevelopmentUniversity of Pittsburgh School of NursingPittsburghPennsylvaniaUSA
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Lidgate ED, Li B, Lindenmeyer A. A qualitative insight into informal childcare and childhood obesity in children aged 0-5 years in the UK. BMC Public Health 2018; 18:1229. [PMID: 30400788 PMCID: PMC6219155 DOI: 10.1186/s12889-018-6131-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 10/19/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Previous studies in various countries have found that informal childcare (provided by relatives, friends etc.) was associated with an increased risk of obesity in children aged 0-5 years. However, no qualitative research has been done to explore possible reasons for such a relationship and potential interventions to tackle it. We conducted a qualitative study with both parents and informal carers to explore their 1) experiences in receiving or giving informal childcare for British children aged 0-5 years; 2) perceived explanations of the relationship between informal childcare and childhood obesity and 3) preferred intervention ideas and delivery strategies for preventing obesity among those children under informal care. METHODS Four in-depth focus groups with a total of 14 participants (7 parents, 7 informal caregivers) were conducted in Birmingham and Edinburgh (1 parent group and 1 informal caregiver group in each city). Data were audio recorded, transcribed verbatim and analysed using a thematic approach. RESULTS The significance of informal care to parents, carers, and society was recognised (theme one). Informal carers were identified to have practical and emotional support roles for the parents (theme two). Informal care was perceived to contribute to childhood obesity in four ways (theme three): cross-generation conflict preventing adoption of healthy practices; the trade-off for parents between receiving childcare and maintaining control; reduced energy capacity of carers; and increased snacking. Potential intervention ideas and delivery strategies (theme four) were identified. Examples of identified ideas included providing carers with up-to-date weaning advice, and suggestions of healthy snacks and ways to increase physical activity level in informal care. The suggestion of utilising existing primary care platforms (e.g. health visitor check-ups) to reach and deliver low-cost information based interventions, to all children aged 0-5 years who receive informal care, was highlighted. CONCLUSIONS This exploratory qualitative study provided novel insights into potential explanations for the evidenced link between informal care and childhood obesity in children aged 0-5 years, despite a small size and limited participants in each focus group. Our findings support the idea of and inform the development towards an information based and low-cost intervention delivered through existing primary care platforms.
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Affiliation(s)
- Eleanor Diana Lidgate
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, West Midlands UK
| | - Bai Li
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, West Midlands B15 2TT UK
| | - Antje Lindenmeyer
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, West Midlands B15 2TT UK
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Zheng X, Watts K, Morrell J. Chinese primiparous women's experience of the traditional postnatal practice of "Doing the month": A descriptive method study. Jpn J Nurs Sci 2018; 16:253-262. [PMID: 30259684 PMCID: PMC6767130 DOI: 10.1111/jjns.12232] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 07/01/2018] [Accepted: 07/13/2018] [Indexed: 12/01/2022]
Abstract
Aim “Doing the month” has been a traditionally postnatal practice that women follow for one full month after giving birth. The aim of this study was to explore Chinese primiparous women's experience of “Doing the month” and why Chinese women felt satisfied or dissatisfied with the experience. Methods This was a descriptive survey using open and closed questions. In total, 420 Chinese primiparous women were recruited in obstetric wards at three hospitals in Xiamen City, China. Baseline questionnaires were distributed to the participants face‐to‐face by the researcher on the postnatal ward at 3 days’ postnatally. Follow‐up questionnaires of “Doing the month” were sent via email by the researcher to the participants at 6 weeks’ postnatally and were returned by the participants via email. The quantitative data were analyzed with SPSS and the qualitative data were analyzed by using a thematic text analysis. Results Most of the women thought that “Doing the month” after childbirth was necessary. Some women felt satisfied with “Doing the month” because their family helped them to have a good rest, they felt a sense of achievement when taking care of their baby, and that having an appreciative attitude helped them to get along with the older generations. In contrast, some women felt dissatisfied with “Doing the month” because of being tired of following taboos, having conflicts with their mother‐in‐law, the lack of family help and care, and undue expectations of “Doing the month.” Conclusions In order to improve postnatal care for Chinese primiparous women, health professionals could be more aware of how health care needs to be customized to fit the special tradition of “Doing the month.”
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Affiliation(s)
- Xujuan Zheng
- Health Science Center, Shenzhen University, Shenzhen, China
| | - Kim Watts
- Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK
| | - Jane Morrell
- School of Health Sciences, The University of Nottingham, Nottingham, UK
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Whipps M, Yoshikawa H, Godfrey E. The Maternal Ecology of Breastfeeding: A Life Course Developmental Perspective. Hum Dev 2018. [DOI: 10.1159/000487977] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Buntuchai G, Pavadhgul P, Kittipichai W, Satheannoppakao W. Traditional Galactagogue Foods and Their Connection to Human Milk Volume in Thai Breastfeeding Mothers. J Hum Lact 2017; 33:552-559. [PMID: 28609178 DOI: 10.1177/0890334417709432] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Thai traditional galactagogue consumption is still observed today. However, there are few scientific studies that describe this practice. Research aim: The aim of this study was to describe the connection between traditional galactagogue consumption and human milk volume. METHODS Self-reported maternal surveys ( N = 36) were conducted of mothers and their infants who breastfeed exclusively. The mothers were interviewed about traditional galactagogue consumption and intake of protein-rich foods using a semiquantitative food-frequency questionnaire. They were also assessed for energy and nutrient intake using the 24-hr dietary recall method. Their infants were between 1 and 3 months of age and were test weighed for 24 hr to measure their mother's own milk volume. Partial correlation was used to test the relationship between galactagogue consumption and milk volume by controlling the infants' birth weight, weight-for-age, maternal energy, and carbohydrate intake. RESULTS The results revealed that consumption of some traditional galactagogues was significantly correlated to human milk volume, including banana flower, lemon basil, Thai basil, bottle gourd, and pumpkin ( p < .05). Furthermore, there were significant correlations between consumption of some kinds of protein and milk volume, including egg tofu, chicken, fish, and seafood ( p < .05). Maternal energy and carbohydrate intake were related to milk volume ( p < .05), but protein intake was not. CONCLUSION Certain kinds of traditional galactagogues and proteins are associated with human milk volume. However, studies related to the active ingredients in these galactagogues are required to secure a recommendation about use of traditional galactagogues among breastfeeding mothers.
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Affiliation(s)
- Ganokwun Buntuchai
- 1 Department of Nutrition, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Patcharanee Pavadhgul
- 1 Department of Nutrition, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Wirin Kittipichai
- 2 Department of Family Health, Faculty of Public Health, Mahidol University, Bangkok, Thailand
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Shepherd L, Walbey C, Lovell B. The Role of Social-Cognitive and Emotional Factors on Exclusive Breastfeeding Duration. J Hum Lact 2017; 33:606-613. [PMID: 28602112 DOI: 10.1177/0890334417708187] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Previous research has suggested that exclusive breastfeeding is likely to be predicted by social-cognitive variables and fear. However, there is little research assessing the role of regret and self-conscious emotions (e.g., pride and guilt) in promoting exclusive breastfeeding. Research aim: The primary aim of this research was to determine whether social-cognitive variables, fear, regret, and self-conscious emotions predict exclusive breastfeeding duration. The secondary aim of this research was to assess whether these factors predict infant-feeding choice (i.e., exclusively breastfed, combination fed, or generally formula fed). METHODS In this nonexperimental one-group self-report survey, 375 mothers rated social-cognitive variables toward breastfeeding (attitude, subjective norm, perceived control, and self-efficacy), their fear toward inadequate nutrition from breastfeeding and breastfeeding damaging their physical appearance, and the extent to which mothers may feel pride toward breastfeeding and negative self-conscious emotions (guilt and shame) and regret for not breastfeeding their infant. RESULTS Exclusive breastfeeding duration was positively predicted by self-efficacy, pride, and regret but negatively predicted by the fear toward inadequate nutrition. We also found that in contrast with exclusive breastfeeding, generally formula feeding an infant was associated with lower self-efficacy, pride, and regret but higher subjective norm and fear toward inadequate nutrition through breastfeeding. CONCLUSION The authors argue that it is important to consider the role of self-conscious emotions and regret on exclusive breastfeeding.
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Affiliation(s)
- Lee Shepherd
- 1 Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Cherokee Walbey
- 1 Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Brian Lovell
- 1 Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
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Lok KYW, Bai DL, Tarrant M. Family members' infant feeding preferences, maternal breastfeeding exposures and exclusive breastfeeding intentions. Midwifery 2017; 53:49-54. [PMID: 28755584 DOI: 10.1016/j.midw.2017.07.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 06/28/2017] [Accepted: 07/03/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Maternal breastfeeding intentions are strongly associated with breastfeeding exclusivity and duration. Factors that affect new mothers' exclusive breastfeeding intentions have not been adequately examined. OBJECTIVE The purpose of this study was to examine the association between family member's infant feeding preferences, breastfeeding exposures, and womens' exclusive breastfeeding intentions. METHODS 1277 breastfeeding mother-infant pairs were recruited from four public hospitals in Hong Kong. We used multiple logistic and linear regression models to explore the impact of the family members' infant feeding preferences and breastfeeding exposures on exclusive breastfeeding intentions. RESULTS 78.1% mothers reported an intention to exclusively breastfeed, and the median intended duration of exclusive breastfeeding was 26 weeks. The husband's preference for breastfeeding (aOR = 1.67; 95% CI 1.20-2.31), previous breastfeeding experience (aOR = 1.56; 95% CI 1.10-2.23) and attendance at an antenatal breastfeeding class (aOR = 2.09; 95% CI 1.45-3.02) were all strongly associated with higher maternal intention to exclusively breastfeed. For every additional family member who preferred breastfeeding, the odds of intending to exclusively breastfeed increased by 32% (aOR1.32; 95% CI, 1.13-1.55). Similarly, the proportion of participants intending to exclusively breastfeed increased progressively with more breastfeeding exposures. CONCLUSIONS Including fathers and other significant family members in antenatal breastfeeding education can help to maximize breastfeeding support for the new mother and encourage new mothers to exclusively breastfeed.
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Affiliation(s)
- Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
| | - Dorothy Li Bai
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Marie Tarrant
- School of Nursing, The University of British Columbia, Okanagan Campus, Canada
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Development and measurement properties of the Chinese breastfeeding self-regulation questionnaire. Midwifery 2017; 44:24-34. [DOI: 10.1016/j.midw.2016.10.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 09/26/2016] [Accepted: 10/26/2016] [Indexed: 11/19/2022]
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Altamimi E, Al Nsour R, Al Dalaen D, Almajali N. Knowledge, Attitude, and Practice of Breastfeeding Among Working Mothers in South Jordan. Workplace Health Saf 2016; 65:210-218. [PMID: 27794075 DOI: 10.1177/2165079916665395] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Breast milk is the ideal food for human infants, with benefits to mothers and babies. However, working mothers are more likely to choose not to breastfeed or to interrupt breastfeeding prematurely. This study assessed breastfeeding knowledge and attitudes among working mothers in South Jordan. Four hundred cross-sectional, self-administered Arabic surveys were distributed to working mothers at their workplaces. In addition to measuring mothers' knowledge of and attitudes toward breastfeeding, barriers that prevented continuing breastfeeding beyond 6 months were also explored. Three hundred forty-four (80%) completed questionnaires were returned. The breastfeeding initiation rate was 72.4%, but only 20.9% were exclusively breastfeeding by 6 months. The participants showed satisfactory knowledge about breastfeeding and had positive attitudes toward breastfeeding. Most of the women who initiated breastfeeding reported ending breastfeeding prematurely. Approximately 30% of the mothers attributed premature cessation of breastfeeding to work. The results of this study could be useful for health care providers and policy makers when planning effective breastfeeding promotion programs and creating breastfeeding-friendly workplaces.
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Bai DL, Fong DYT, Lok KYW, Tarrant M. Relationship between the Infant Feeding Preferences of Chinese Mothers' Immediate Social Network and Early Breastfeeding Cessation. J Hum Lact 2016; 32:301-8. [PMID: 26887843 DOI: 10.1177/0890334416630537] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 01/06/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND The relationship between support from members of a mother's social network and breastfeeding continuation is receiving increased attention. OBJECTIVES The objectives of this study were to describe the infant feeding preferences of Chinese mothers' immediate social network and to examine the association between these preferences and early breastfeeding cessation. METHODS In total, 1172 mother-infant pairs were recruited from 4 public hospitals in Hong Kong and followed prospectively for 12 months or until breastfeeding stopped. RESULTS Over 40% of participants' partners preferred breastfeeding and half had no infant feeding preference. Only about 20% of participants' mothers or mothers-in-law preferred breastfeeding, and less than 10% reported that all of the 3 significant family members (partner, mother, and mother-in-law) preferred breastfeeding. The partner's preference for infant formula or mixed feeding (odds ratio [OR], 2.60; 95% confidence interval [CI], 1.43-4.71) or having no preference (OR, 1.64; 95% CI, 1.16-2.30) was strongly associated with higher odds of stopping breastfeeding before 1 month. For every additional family member who preferred breastfeeding, the odds of stopping breastfeeding was reduced by almost 20% (OR, 0.81; 95% CI, 0.68-0.97). However, living with a parent-in-law (OR, 1.45; 95% CI, 1.02-2.07) was also a predictor of early breastfeeding cessation. Knowing someone who had breastfed for ≥ 1 month (OR, 0.64; 95% CI, 0.42-0.97) or having been breastfed as a child (OR, 0.67; 95% CI, 0.45-0.98) significantly lowered the odds of early breastfeeding cessation. CONCLUSIONS The infant feeding preferences of mothers' immediate social network are significantly associated with breastfeeding continuation. Prenatal breastfeeding education programs should involve significant family members to promote breastfeeding.
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Affiliation(s)
- Dorothy Li Bai
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Marie Tarrant
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
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Lok KYW, Bai DL, Tarrant M. Predictors of breastfeeding initiation in Hong Kong and Mainland China born mothers. BMC Pregnancy Childbirth 2015; 15:286. [PMID: 26531299 PMCID: PMC4632339 DOI: 10.1186/s12884-015-0719-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 10/23/2015] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND In recent years there has been a steady influx of immigrants into Hong Kong from Mainland China, where breastfeeding patterns differ. Studies in other regions have found substantial differences in breastfeeding rates between native-born and immigrant mothers. The purpose of this study was to examine factors associated with breastfeeding initiation in Hong Kong born and Mainland China born mothers living in Hong Kong. METHODS We used a multi-center cross-sectional study design and recruited 2761 new mothers from the postnatal wards of all eight public hospitals in Hong Kong that offer obstetric services. We assessed breastfeeding status as well as various socio-demographic, maternal and birth characteristics. Chi-square tests and multivariable logistic regression were used to identify the predictors of breastfeeding initiation in Hong Kong born and Mainland China born participants. RESULTS 80.3 % of Hong Kong and 81.1 % of Mainland Chinese born women initiated breastfeeding. In the fully adjusted models, multiparity (Odds Ratio [OR] 0.53, 95 % CI 0.43-0.66) and maternal smoking (OR 0.29, 95 % CI 0.18-0.45) were strongly associated with failure to initiate breastfeeding in both Hong Kong and Mainland China born participants. In Hong Kong born mothers, participants with lower maternal education and those who had a cesarean section were significantly less likely to breastfeed. For Mainland China born mothers, paternal smoking (OR 0.70, 95 % CI 0.49-0.99) and having a pregnancy-related health problem (OR 0.60, 95 % CI 0.38-0.94) were both additional risk factors for not breastfeeding. CONCLUSION This study has identified predictors of breastfeeding initiation in Hong Kong and Mainland China born mothers. Given the current high breastfeeding initiation rates among both groups, antenatal breastfeeding education and promotion programmes need to specifically intervene with sub-groups of pregnant women at risk for not breastfeeding so that their efforts are more strategic and cost-effective.
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Affiliation(s)
- Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR.
| | - Dorothy Li Bai
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR.
| | - Marie Tarrant
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR.
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Angelo BHDB, Pontes CM, Leal LP, Gomes MDS, Silva TDAD, Vasconcelos MGLD. Práticas de apoio das avós à amamentação: revisão integrativa. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2015. [DOI: 10.1590/s1519-38292015000200002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Resumo Objetivos: investigar as práticas das avós de apoio à amamentação. Métodos: esta revisão integrativa buscou responder a seguinte questão norteadora: “Quais as práticas das avós de apoio à amamentação?”. Com o cruzamento dos descritores “rede social”, “aleitamento materno” e “relações familiares”, em agosto de 2012, nas bases de dados: National Library of Medicine (Medline), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Base de Datos de Enfermería em Español (CUIDEN), Repositório Científico de Acesso Aberto de Portugal (RCAAP), Base de Dados de Enfermagem (BDENF), Revisões Sistemáticas da Colaboração Cochrane (Cochrane) e na biblioteca virtual Scientific Electronic Library Online (SciELO), 4092 artigos foram encontrados. Após a aplicação dos critérios de inclusão e exclusão, 20 artigos compuseram a amostra do estudo. Os resultados dos estudos foram agrupados por similaridade temática. Resultados: as avós reconhecem a importância do aleitamento materno; representam um modelo a ser seguido; auxiliam nos afazeres domésticos e na prestação de cuidados; fornecem informações e, por vezes, desestimulam o aleitamento materno. Conclusões: as práticas de apoio das avós são influenciadas por suas próprias experiências e pelo contexto sociocultural que estão inseridas.
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Factors contributing to early breast-feeding cessation among Chinese mothers: An exploratory study. Midwifery 2014; 30:1088-95. [DOI: 10.1016/j.midw.2014.03.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 12/23/2013] [Accepted: 03/02/2014] [Indexed: 11/16/2022]
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Fu ICY, Fong DYT, Heys M, Lee ILY, Sham A, Tarrant M. Professional breastfeeding support for first-time mothers: a multicentre cluster randomised controlled trial. BJOG 2014; 121:1673-83. [PMID: 24861802 DOI: 10.1111/1471-0528.12884] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2014] [Indexed: 12/21/2022]
Affiliation(s)
- ICY Fu
- School of Nursing; The University of Hong Kong; Hong Kong China
| | - DYT Fong
- School of Nursing; The University of Hong Kong; Hong Kong China
| | - M Heys
- Institute of Child Health; University College London; London UK
| | - ILY Lee
- Queen Mary Hospital; Hong Kong China
| | - A Sham
- Kwong Wah Hospital; Hong Kong China
| | - M Tarrant
- School of Nursing; The University of Hong Kong; Hong Kong China
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Parry JE, Ip DKM, Chau PYK, Wu KM, Tarrant M. Predictors and consequences of in-hospital formula supplementation for healthy breastfeeding newborns. J Hum Lact 2013; 29:527-36. [PMID: 23439865 DOI: 10.1177/0890334412474719] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although exclusive breastfeeding is recommended for the first 6 months, the use of breast milk substitutes is widespread around the world. OBJECTIVES To describe the patterns of infant formula supplementation among healthy breastfeeding newborns, to identify factors contributing to in-hospital formula supplementation, and to assess the dose-response relationship between the amount of in-hospital formula supplementation and the duration of any breastfeeding. METHODS A sample of 1246 breastfeeding mother-infant pairs was recruited from 4 public hospitals in Hong Kong and followed prospectively for 12 months or until weaned. Multiple logistic regression analysis was used to examine factors associated with in-hospital supplementation. Cox regression analysis was used to explore the impact of in-hospital supplementation on breastfeeding duration. RESULTS Of the total, 82.5% of newborns were supplemented in the hospital; one-half received formula within 5 hours of birth. Assisted vaginal delivery (odds ratio [OR] = 2.06, 95% confidence interval [CI] 1.03, 4.15), cesarean section (OR = 3.45, 95% CI 1.75, 6.80), and higher birth weight (OR = 1.56, 95% CI 1.12, 2.18) were positively associated with in-hospital formula supplementation, whereas initiating breastfeeding in the delivery room (OR = 0.55, 95% CI 0.33, 0.89) was associated with decreased likelihood of in-hospital supplementation. Any infant formula in the first 48 hours was associated with a shorter duration of breastfeeding (hazard ratio [HR] = 1.51, 95% CI 1.27, 1.80), but there was no dose-response effect. CONCLUSION In-hospital formula supplementation is common in Hong Kong hospitals and appears to be detrimental to breastfeeding duration. Continued efforts should be made to avoid the provision of infant formula to breastfeeding babies while in the hospital unless medically indicated.
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Loke AY, Chan LS. Maternal Breastfeeding Self‐Efficacy and the Breastfeeding Behaviors of Newborns in the Practice of Exclusive Breastfeeding. J Obstet Gynecol Neonatal Nurs 2013; 42:672-84. [DOI: 10.1111/1552-6909.12250] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Chang SM, Rowe J, Goopy S. Non-family support for breastfeeding maintenance among career women in Taiwan: A qualitative study. Int J Nurs Pract 2013; 20:293-301. [DOI: 10.1111/ijn.12148] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Shu-min Chang
- Department of Nursing; Tzu Chi College of Technology; Hualien Taiwan
| | - Jennifer Rowe
- Teaching & Learning; Faculty of Science Health Education & Engineering; University of the Sunshine Coast; Sunshine Coast Queensland Australia
- School of Nursing and Midwifery; University of the Sunshine Coast; Sunshine Coast Queensland Australia
| | - Suzanne Goopy
- School of Nursing and Midwifery; Griffith University; Brisbane Queensland Australia
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Bai DL, Wu KM, Tarrant M. Association between intrapartum interventions and breastfeeding duration. J Midwifery Womens Health 2013; 58:25-32. [PMID: 23317341 DOI: 10.1111/j.1542-2011.2012.00254.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Few women who reside in Hong Kong exclusively breastfeed, and one-half stop breastfeeding within the first few months. There is little research in this population on the association between intrapartum interventions and breastfeeding duration. METHODS A sample of 1280 mother-infant pairs were recruited from the obstetric units of 4 public hospitals in Hong Kong and followed prospectively for 12 months or until the infant was weaned. The outcome variables for this analysis were the duration of any and exclusive breastfeeding. Predictor variables were 4 intrapartum interventions: receipt of opioid pain medication, induction versus spontaneous labor, epidural administration, and mode of birth. We used Cox proportional hazards modeling to assess the impact of intrapartum interventions on the duration of any and exclusive breastfeeding, and we constructed Kaplan-Meier survival curves to evaluate the cumulative impact of multiple intrapartum interventions on breastfeeding outcomes. RESULTS Bivariate analysis showed that induction of labor (hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.09-1.41), opioid pain medication (HR, 1.21; 95% CI, 1.06-1.37), and having an emergency cesarean birth (HR, 1.22; 95% CI, 1.01-1.48) were associated with a shorter duration of any breastfeeding. Induction of labor (HR, 1.23; 95% CI, 1.08-1.39) and having an emergency cesarean birth (HR, 1.25; 95% CI, 1.05-1.51) were associated with a shorter duration of exclusive breastfeeding. After controlling for known confounding variables, there was no longer any association between individual intrapartum interventions and the duration of any or exclusive breastfeeding. The median duration of breastfeeding for participants who experienced a natural birth with no intrapartum interventions was 9 weeks compared with 5 weeks for participants who experienced at least 3 intrapartum interventions. DISCUSSION Clinicians working with new breastfeeding mothers should focus on providing additional support to mothers who experience a difficult labor and birth with multiple interventions to improve their breastfeeding experiences.
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Ip WY, Yeung LS, Choi KC, Chair SY, Dennis CL. Translation and validation of the Hong Kong Chinese version of the breastfeeding self-efficacy scale-short form. Res Nurs Health 2012; 35:450-9. [DOI: 10.1002/nur.21493] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2012] [Indexed: 11/10/2022]
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Tarrant M, Wu KM, Fong DYT, Lee ILY, Wong EMY, Sham A, Lam C, Dodgson JE. Impact of baby-friendly hospital practices on breastfeeding in Hong Kong. Birth 2011; 38:238-45. [PMID: 21884232 DOI: 10.1111/j.1523-536x.2011.00483.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The World Health Organization (WHO) developed the Baby-Friendly Hospital Initiative to improve hospital maternity care practices that support breastfeeding. In Hong Kong, although no hospitals have yet received the Baby-Friendly status, efforts have been made to improve breastfeeding support. The aim of this study was to examine the impact of Baby-Friendly hospital practices on breastfeeding duration. METHODS A sample of 1,242 breastfeeding mother-infant pairs was recruited from four public hospitals in Hong Kong and followed up prospectively for up to 12 months. The primary outcome variable was defined as breastfeeding for 8 weeks or less. Predictor variables included six Baby-Friendly practices: breastfeeding initiation within 1 hour of birth, exclusive breastfeeding while in hospital, rooming-in, breastfeeding on demand, no pacifiers or artificial nipples, and information on breastfeeding support groups provided on discharge. RESULTS Only 46.6 percent of women breastfed for more than 8 weeks, and only 4.8 percent of mothers experienced all six Baby-Friendly practices. After controlling for all other Baby-Friendly practices and possible confounding variables, exclusive breastfeeding while in hospital was protective against early breastfeeding cessation (OR: 0.61; 95% CI: 0.42-0.88). Compared with mothers who experienced all six Baby-Friendly practices, those who experienced one or fewer Baby-Friendly practices were almost three times more likely to discontinue breastfeeding (OR: 3.13; 95% CI: 1.41-6.95). CONCLUSIONS Greater exposure to Baby-Friendly practices would substantially increase new mothers' chances of breastfeeding beyond 8 weeks postpartum. To further improve maternity care practices in hospitals, institutional and administrative support are required to ensure all mothers receive adequate breastfeeding support in accordance with WHO guidelines.
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Chen WL. Understanding the cultural context of Chinese mothers' perceptions of breastfeeding and infant health in Canada. J Clin Nurs 2010; 19:1021-9. [PMID: 20492046 DOI: 10.1111/j.1365-2702.2009.02956.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES The purpose of this study was to explore Chinese mothers' perceptions about breastfeeding and infant health in the Canadian context. BACKGROUND Chinese mothers' breastfeeding perceptions are challenging for health professionals in North America, but few studies have focused on this issue in depth. DESIGN An interpretive qualitative methodology was used. METHODS Data were collected through semi-structured individual interviews with 15 purposively sampled Chinese mothers two months after delivery in Vancouver, British Columbia. Interviews were audiotaped and transcribed verbatim. Constant comparative analysis was used to develop coding categories and identify themes. RESULTS Two main themes emerged: (1) the idea of harmony within change and (2) the meaning of infant health. The first represents mothers' perceptions about breastfeeding: the value of common sense, purity of breast milk and the laws of nature. The second represents notions of infant health, including its indicators and the relationship between mother's health and infant health. CONCLUSIONS Chinese mothers' concepts of breastfeeding are associated with Western biomedical thought, traditional Chinese medicine and personal experiences, especially those embedded in the traditional Chinese cultural context. Perceptions of breastfeeding and infant health regarding notions of harmony within natural dynamic patterns must be considered when promoting breastfeeding. RELEVANCE TO CLINICAL PRACTICE This study highlights the cultural context affecting Chinese mothers' breastfeeding practices. Nurses and other health professionals require sensitivity when assessing Chinese mothers' breastfeeding practice so that they are able to provide appropriate postnatal and breastfeeding support.
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Affiliation(s)
- Wil-Lie Chen
- School of Nursing, China Medical University, Taichung, Taiwan.
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Tarrant M, Fong DYT, Wu KM, Lee ILY, Wong EMY, Sham A, Lam C, Dodgson JE. Breastfeeding and weaning practices among Hong Kong mothers: a prospective study. BMC Pregnancy Childbirth 2010; 10:27. [PMID: 20509959 PMCID: PMC2887376 DOI: 10.1186/1471-2393-10-27] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Accepted: 05/29/2010] [Indexed: 11/26/2022] Open
Abstract
Background Breastfeeding provides optimal and complete nutrition for newborn babies. Although new mothers in Hong Kong are increasingly choosing to breastfeed their babies, rates of exclusive breastfeeding are low and duration remains short. The purpose of this study was to describe the breastfeeding and weaning practices of Hong Kong mothers over the infant's first year of life to determine the factors associated with early cessation. Methods A cohort of 1417 mother-infant pairs was recruited from the obstetric units of four public hospitals in Hong Kong in the immediate post-partum period and followed prospectively for 12 months or until weaned. We used descriptive statistics to describe breastfeeding and weaning practices and multiple logistic regression to investigate the relationship between maternal characteristics and breastfeeding cessation. Results At 1 month, 3 months, 6 months and 12 months only 63%, 37.3%, 26.9%, and 12.5% of the infants respectively, were still receiving any breast milk; approximately one-half of breastfeeding mothers were exclusively breastfeeding. Younger mothers, those with a longer duration of residence in Hong Kong, and those returning to work postpartum were more likely to wean before 1 month. Mothers with higher education, previous breastfeeding experience, who were breastfed themselves and those who were planning to exclusively breastfeed and whose husbands preferred breastfeeding were more likely to continue breastfeeding beyond 1 month. The introduction of infant formula before 1 month and returning to work postpartum were predictive of weaning before 3 months. Conclusions Breastfeeding promotion programs have been successful in achieving high rates of breastfeeding initiation but the focus must now shift to helping new mothers exclusively breastfeed and sustain breastfeeding for longer.
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Affiliation(s)
- Marie Tarrant
- School of Nursing, Li Ka Shing Faculty of Medicine, 21 Sassoon Road, Pokfulam, Hong Kong.
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Putthakeo P, Ali M, Ito C, Vilayhong P, Kuroiwa C. Factors influencing breastfeeding in children less than 2 years of age in Lao PDR. J Paediatr Child Health 2009; 45:487-92. [PMID: 19702610 DOI: 10.1111/j.1440-1754.2009.01547.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This study aimed to investigate the prevalence of, and factors influencing, exclusive breastfeeding (EBF) at 6 months and continued breastfeeding (CBF) at 2 years. METHODS Between January and February 2007, a cross-sectional study was conducted using a semi-structured questionnaire in 40 villages in the Vientiane capital and the Vientiane province of Lao PDR. A total of 400 mothers with children less than 2 years old were recruited by multistage random sampling. Based on the 1991 World Health Organization Breastfeeding Indicators, children were classified into three groups, 6-23-month-old children for assessing EBF at 6 months, 12-15-month-old children for CBF at 1 year and 20-23-month-old children for CBF at 2 years. RESULTS The prevalence of EBF at 6 months and CBF at 2 years were 19.4% (n= 283) and 18.6% (n= 43), respectively. Some of the factors influencing EBF at 6 months in a univariate logistic regression model included: location of residence, (OR: 19.19, 95% CI 6.96-57.01), ethnicity (OR: 3.15, 95% CI 1.63-6.08), encouragement of the child's father (OR: 9.03, 95%CI 1.21-67.57) and inter-spousal communication (OR: 5.20, 95% CI 2.34-11.56). A majority of the mothers (75.0%) had watched television advertisements for infant formula from Thailand, and 48.4% reported that they wanted to buy formula milk after having watched them. CONCLUSION This study showed a low prevalence of EBF at 6 months in the studied area in Lao PDR. Some of the factors that had a strong impact on EBF at 6 months included: location of residence, ethnicity, father's involvement, early breastfeeding plan, Mother's Card in antenatal care and television advertisement. There may be opportunities for government to review a range of policies relating to paternal involvement, antenatal care and formula advertising that could help to improve EBF rate.
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Affiliation(s)
- Pornpai Putthakeo
- Department of Health Policy and Planning, University of Tokyo, Japan
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Janssen PA, Livingstone VH, Chang B, Klein MC. Development and evaluation of a Chinese-language newborn feeding hotline: a prospective cohort study. BMC Pregnancy Childbirth 2009; 9:3. [PMID: 19178746 PMCID: PMC2637834 DOI: 10.1186/1471-2393-9-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2008] [Accepted: 01/29/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preference for formula versus breast feeding among women of Chinese descent remains a concern in North America. The goal of this study was to develop an intervention targeting Chinese immigrant mothers to increase their rates of exclusive breastfeeding. METHODS We convened a focus group of immigrant women of Chinese descent in Vancouver, British Columbia to explore preferences for method of infant feeding. We subsequently surveyed 250 women of Chinese descent to validate focus group findings. Using a participatory approach, our focus group participants reviewed survey findings and developed a priority list for attributes of a community-based intervention to support exclusive breastfeeding in the Chinese community. The authors and focus group participants worked as a team to plan, implement and evaluate a Chinese language newborn feeding information telephone service staffed by registered nurses fluent in Chinese languages. RESULTS Participants in the focus group reported a strong preference for formula feeding. Telephone survey results revealed that while pregnant Chinese women understood the benefits of breastfeeding, only 20.8% planned to breastfeed exclusively. Only 15.6% were breastfeeding exclusively at two months postpartum. After implementation of the feeding hotline, 20% of new Chinese mothers in Vancouver indicated that they had used the hotline. Among these women, the rate of exclusive breastfeeding was 44.1%; OR 3.02, (95% CI 1.78-5.09) compared to women in our survey. CONCLUSION Initiation of a language-specific newborn feeding telephone hotline reached a previously underserved population and may have contributed to improved rates of exclusive breastfeeding.
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Affiliation(s)
- Patricia A Janssen
- School of Population and Public Health, University of British Columbia, Child & Family Research Institute, Vancouver, BC, Canada.
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Dodgson JE, Tarrant M, Thompson JT, Young B. An analysis of infant feeding content found within the Hong Kong print media. J Hum Lact 2008; 24:317-25. [PMID: 18689719 DOI: 10.1177/0890334408318834] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Worldwide public media greatly affect women's decisions about infant feeding and may not reflect evidence-based practices. The aims of this research were to (1) describe the characteristics of printed articles having infant-feeding content, (2) describe this thematic content, and (3) compare the thematic content found in groupings based on media type and language (English and Chinese). Four Chinese-language newspapers, the English-language newspaper, and 3 bilingual parenting magazines were analyzed. A multiphase qualitative and quantitative content analysis found 5 themes (social context, mothers' information, effects on baby, the value of breast milk, and the utility of formula). Significant differences were found based on media type and language. Although breastfeeding was usually positively framed in all the media, Chinese media had more inaccurate information. Through this analysis, areas where actions could be taken to improve the quality of information about infant feeding received by the public have been identified.
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Affiliation(s)
- Joan E Dodgson
- School of Nursing & Dental Hygiene, Honolulu, Hawaii, USA
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Tarrant M, Dodgson JE. Knowledge, Attitudes, Exposure, and Future Intentions of Hong Kong University Students Toward Infant Feeding. J Obstet Gynecol Neonatal Nurs 2007; 36:243-54. [PMID: 17489930 DOI: 10.1111/j.1552-6909.2007.00144.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To explore relationships between university students' infant feeding knowledge, attitudes, breastfeeding exposures, and future infant feeding intentions. DESIGN Descriptive cross-sectional survey. SETTING This study was conducted at a large publicly funded university in Hong Kong. Student enrollment in the university is approximately 15,000. PARTICIPANTS Four hundred three male and female Chinese university students. Participants were young (94.4% less than 25 years of age), undergraduate students (92.2%), unmarried (99.2%), and without children (100%). RESULTS Sixty-three percent of participants wanted their future child to be breastfed. Infant feeding knowledge scores ranged from 28.6% to 100%, with a mean of 71.1% (SD= 13.3), indicating overall high knowledge levels. Participants who intended to breastfeed were more likely to have positive attitudes, to have been breastfed themselves, or to know someone who had breastfed. CONCLUSIONS The results provide information to health care providers on the planning of effective breastfeeding promotion programs. Findings from this study suggest that promoting breastfeeding solely to childbearing couples is unlikely to result in significant improvements in either breastfeeding initiation or duration. Future infant feeding campaigns should be directed at the societal level to change negative attitudes and to increase acceptance of breastfeeding as a normal and natural feeding method.
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Affiliation(s)
- Marie Tarrant
- Department of Nursing Studies, University of Hong Kong, Hong Kong SAR, China.
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Kulakac O, Oncel S, Meydanlioglu A, Muslu L. The opinions of employed mothers about their own nutrition during lactation: A questionnaire survey. Int J Nurs Stud 2007; 44:589-600. [PMID: 16638614 DOI: 10.1016/j.ijnurstu.2006.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2005] [Revised: 03/03/2006] [Accepted: 03/04/2006] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The main purpose of the study was to identify the changes employed mothers of infants aged 0-24 months made in their nutrition with the aim of increasing their milk production and extending their breastfeeding period. METHODS The 135 full-time employed mothers enrolled in this study came to the Well-Child Clinic at Akdeniz University Hospital. Dietary data were collected from the mothers via a questionnaire prepared by the researchers to elicit details about what kind of foods or nutrition supplements women added, avoided or were recommended to avoid or add to their diets and why. RESULTS All the mothers made changes in their diets while breastfeeding. The number one change that mothers made in their diet in order to increase milk production was to increase their fluid intake (38.6%) while the second was to increase their consumption of sweets (25.3%). The main type of food mothers were advised to avoid were dried legumes and grains (28.9%). The most important reason for this was the belief that they increased the chance of newborn colic (89.4%). There were statistically significant differences between foods avoided by breastfeeding mothers related to their age (chi(2)=6.88, p=.009), education level and those who mentioned increasing their consumption of fluid while breastfeeding (chi(2)=13.12, p=.000). CONCLUSIONS All of the mothers espoused specific practices, and had been given recommendations by others about their nutrition while breastfeeding. Mothers need to be informed about the factors that increase and decrease milk production and affect infant colic, and should be encouraged that they can successfully breastfeed without increasing their consumption of sweets or avoiding dried legumes and some vegetables.
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Affiliation(s)
- Ozen Kulakac
- Akdeniz Universitesi Antalya Saglik Yuksekokulu, Dumlupinar Bulvari 07058 Kampus Antalya, Türkiye.
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Lau Y, Chan KS. Influence of intimate partner violence during pregnancy and early postpartum depressive symptoms on breastfeeding among chinese women in Hong Kong. J Midwifery Womens Health 2007; 52:e15-e20. [PMID: 17336812 DOI: 10.1016/j.jmwh.2006.09.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Numerous studies show that breastfeeding is beneficial to both mothers and babies. This study explores two understudied correlates that may influence breastfeeding initiation: intimate partner violence during pregnancy and early postnatal depressive symptoms. A cross-sectional comparative study design investigated the correlates of feeding modes of 1200 Chinese mother and infant pairs in a university-affiliated regional hospital in Hong Kong. The prevalence rates of breastfeeding and mixed feeding were 42.25% and 26.25%, respectively. Women who had no experience of intimate partner violence during pregnancy were significantly more likely to initiate breastfeeding (adjusted odds ratio = 1.84; 95% confidence interval, 1.16-2.91) after adjustment for demographic, socioeconomic, and obstetric variables. Early postnatal depressive symptoms were not significantly associated with feeding modes in a multinomial logistic regression model. Midwives are in a key position to identify and intervene to encourage more successful breastfeeding practice.
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Lau Y, Keung DWF. Correlates of depressive symptomatology during the second trimester of pregnancy among Hong Kong Chinese. Soc Sci Med 2007; 64:1802-11. [PMID: 17316942 DOI: 10.1016/j.socscimed.2007.01.001] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2006] [Indexed: 11/24/2022]
Abstract
The study investigated the correlates of antenatal depressive symptoms among Hong Kong Chinese women during their second trimester of pregnancy. A total of 2178 women were recruited at five regional public hospitals in Hong Kong to participate in a study with a cross-sectional design. Associations were examined between depressive symptoms (using the Edinburgh Postnatal Depression Scale) and socioeconomic, obstetric, and Chinese family relations. Logistic regression analysis revealed that younger age, a personal or family psychiatric history, an unplanned pregnancy, a history of menstruation discomfort or premenstrual mood change, high marital conflict, and high mother-in-law conflict were found to be associated with more severe depressive symptoms. Antenatal depression is important because of its association with risk of adverse consequences for mothers and their families. There is a consensus that depression is most treatable when detected early. These findings therefore provide important information for the prevention of antenatal depressive symptoms among the Hong Kong population, amongst whom depression is rarely talked about. The implications and limitations of these findings and directions for future research are discussed.
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Affiliation(s)
- Ying Lau
- School of Health Sciences, Macao Polytechnic Institute, Alameda Dr. Carlos D' Assumpcao No. 335-341, Centro Hotline 5 Andar, Macau.
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