The opinions of employed mothers about their own nutrition during lactation: A questionnaire survey

E-learning to Improve Healthcare Professionals' Attitudes and Practices on Breastfeeding

INTRODUCTION

Breastfeeding training has a crucial role in increasing healthcare professionals' attitudes and in improving professional support for breastfeeding. The collaboration between the Italian National Institute of Health, UNICEF, and the Local Health Authority of Milan has led to the development of an online course on lactation and infant feeding practices.

AIM

To assess if the course was effective in improving healthcare professionals' attitudes and practices (APs).

METHODS

We conducted a prestudy-poststudy, comparing users' APs before (T0) and after (T1) the course through a 20-item questionnaire. Changes in APs were analyzed using paired t-test. Lower mean differences indicated more positive attitudes and more frequent professional practices favoring breastfeeding. Statistical analysis was carried out using SPSS version 15.0.

RESULTS

The course had 26,009 registrants and was successfully completed by 91.3% of users. The dropout rate was 8.7%. The final cohort was composed of 15,004 participants. The course improved attitudes, while minor changes were observed on practices (p < 0.05). Mean total attitude scores were 2.4 at T0 and 1.9 at T1, while mean total practice scores were 2.2 and 2.1, respectively. The main effects regarded the use of medications during breastfeeding (3.02 ± 1.29 at T0 and 1.88 ± 1.08 at T1) and the self-reported compliance with the International Code of Marketing of Breast Milk Substitutes (2.29 ± 1.24 at T0, 2.03 ± 1.21 at T1).

CONCLUSION

The noninteractive, high-coverage e-learning approach seems to be a useful tool for improving awareness and positive attitudes toward breastfeeding among healthcare professionals.

Dietary practices of Saudi women during puerperium

AIM

Poor maternal health sometimes can be a consequence of practicing different myths during puerperium. This cross-sectional study describes the practice of different myths regarding diet among Saudi women.

MATERIAL AND METHODS

The study comprised women attending the postnatal clinic at the Mother and Child Hospital in Buraidah from January to December 2011.

RESULTS

Almost 65.9% of women were using a combination of herbs such as ginger (zingiber officinale), hilba (fenugreek) and black seeds (nigella sativa). The multinomial logistic regression of herbs on age, education, occupation, parity and mode of delivery was statistically significant (χ² [48] = 214.645, P < 0.001). Hilba was more commonly used by women with instrumental delivery. It was common for women to avoid different fruits and vegetables (33.89%). Eggs were avoided by 16.5% of women and 11% avoided cold drinks. The multinomial logistic regression of diet on age, education, occupation, parity and mode of delivery was statistically significant (χ² [72] = 389.861, P < 0.001). Individuals below college level education were more likely to avoid fruits, vegetables and cold drinks in their diet.

CONCLUSION

Health education programs are needed to improve knowledge about dietary malpractices during puerperium. This may help eliminate myths regarding avoidance of certain dietary components.

Systematic review of breastfeeding and herbs

OBJECTIVES

Despite popular and historical use, there has been little modern research conducted to determine the safety and efficacy of herb use during breastfeeding. The purpose of this study was to systematically review the clinical literature on herbal medicine and lactation.

METHODS

The databases PubMed, CAB Abstracts, Cochrane Central Register of Controlled Trials, HealthSTAR, Cumulative Index to Nursing and Allied Health Literature, and Reprotox were systematically searched for human trials from 1970 until 2010. Reference lists from relevant articles were hand-searched.

RESULTS

Thirty-two studies met the inclusion criteria. Clinical studies were divided into three categories: survey studies (n=11), safety studies (n=8), and efficacy studies (n=13). Six studies were randomized controlled trials. The most common herbs studied were St. John's wort (Hypericum perforatum L.) (n=3), garlic (Allium sativum L.) extract (n=2), and senna (Cassia senna L.) (n=2). Studies were very heterogeneous with regard to study design, herbal intervention, and outcome measures. Overall, poor methodological quality predominated among the studies.

CONCLUSIONS

Our review concludes that further research is needed to assess the prevalence, efficacy, and safety of commonly used herbs during breastfeeding.