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Ozkan A, Aktas E, Dissiz M, Acar Z, Karakoç B. Breastfeeding health literacy scale for pregnant women: A scale development study. J Eval Clin Pract 2024. [PMID: 39319524 DOI: 10.1111/jep.14147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2024] [Revised: 09/04/2024] [Accepted: 09/09/2024] [Indexed: 09/26/2024]
Abstract
RATIONALE, AIMS, AND OBJECTIVE Breastfeeding provides optimal nutrition for infants, and health literacy significantly influences breastfeeding rates. This study aimed to develop a tool to assess the breastfeeding health literacy levels of pregnant women. METHODS This methodologically structured study was conducted with 590 pregnant women who visited the pregnancy follow-up clinic between January and April 2024 and met the sampling criteria. Data were collected using a participant form and the Health Literacy Scale for Breastfeeding for Pregnant Women (BFHLS). To assess the BFHLS validity, the content validity index (CVI) and factor analysis were used, while the reliability was evaluated using the test-retest method, item-total score correlation, and Cronbach's alpha reliability coefficient. RESULTS The BFHLS for pregnant women is structured into four dimensions, comprising 25 items. To assess the scale's stability, test-retest measurements were conducted with a minimum interval of 2 weeks, revealing no significant difference in mean scores (p > 0.05). The CVI for each item was 99%. The corrected item-total correlations ranged from 0.48 to 0.92, and Cronbach's alpha value was determined to be 0.96. CONCLUSION The BFHLS developed for pregnant women is a valid and reliable tool. Higher scores on the scale indicate a greater level of breastfeeding health literacy in pregnant women. This scale can effectively be used to assess the breastfeeding health literacy levels of pregnant women.
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Affiliation(s)
- Asibe Ozkan
- Department of Obstetrics and Gynecology Nursing, University of Health Sciences Hamidiye Faculty of Nursing, Istanbul, Turkey
| | - Eda Aktas
- Department of Pediatric Nursing, University of Health Sciences Hamidiye Faculty of Nursing, Istanbul, Turkey
| | - Melike Dissiz
- Hamidiye Faculty of Nursing, Department of Obstetrics and Gynecology Nursing Istanbul, Health Science University, Turkey
| | - Zehra Acar
- Department of Obstetrics and Gynecology Nursing, University of Health Sciences Hamidiye Faculty of Nursing, Istanbul, Turkey
| | - Bahar Karakoç
- Başakşehir Çam ve Sakura City Hospital, Istanbul, Turkey
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Ho HMY, Fan HSL, Hu GH, Nagesh N, Ip HL, Leung ETY, Choi EPH, Lok KYW. Effectiveness of layperson-based interventions in promoting exclusive breastfeeding: A systematic review and meta-analysis. Int J Nurs Stud 2024; 160:104894. [PMID: 39299049 DOI: 10.1016/j.ijnurstu.2024.104894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 08/31/2024] [Accepted: 09/01/2024] [Indexed: 09/22/2024]
Abstract
OBJECTIVE The objective of this study is to determine the effectiveness of layperson-based interventions in sustaining exclusive breastfeeding and to identify the optimal characteristics of such layperson-led strategies for promoting exclusive breastfeeding. METHODS A systematic review and meta-analysis were conducted using a comprehensive search in seven electronic databases from their inception to January 2024. Two independent reviewers assessed the risk of bias using version 2 of the Cochrane Risk of Bias tool for randomized trials. RESULTS Out of the 29,703 articles identified, 27 studies met the inclusion criteria and were included in the analysis. A total of 38,412 participants were included in these studies. The majority of the included studies utilized home visits as the intervention method. However, there is limited data available for other interventions, such as group discussions, phone support, short message service, and combined approaches, making it difficult to determine their effectiveness. Laypersons, with or without breastfeeding experience, were found to be effective intervention providers. DISCUSSION Home visit interventions conducted by laypersons have proven effective in promoting exclusive breastfeeding. To maximize effectiveness, the content of home visits should be tailored based on the stages of pregnancy, and ideally, the duration of the visits should extend up to six months postpartum to sustain breastfeeding. REGISTRATION The protocol for this review is registered on PROSPERO (registration number: CRD42021235078). A major deviation from the protocol was the exclusion of network meta-analysis due to the small number of articles identified and the primary outcome being the exclusive breastfeeding rate.
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Affiliation(s)
| | | | | | - Nitya Nagesh
- School of Nursing, University of Hong Kong, Hong Kong
| | - Hoi Lam Ip
- School of Nursing, University of Hong Kong, Hong Kong
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Almoayad F, Alhashem A, Alotaibi R, Alashwl R, Albahouth A, Benajiba N, Kelly PJ, Aboul-Enein BH. YouTube Video Clips on Breastfeeding Education and Promotion for Arabic-Speaking Populations: A Social Media Content Analysis. Breastfeed Med 2024; 19:734-741. [PMID: 39049793 DOI: 10.1089/bfm.2024.0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Background/Objective: Although the benefits of breastfeeding are well-documented and widely recognized, reports indicate that optimal breastfeeding rates are low in Arabic-speaking countries. This is a significant concern given the health benefits associated with breastfeeding for both infants and mothers. Previous research has shown that education interventions can increase breastfeeding knowledge, attitudes, and practices in Arabic-speaking populations. The social media platform YouTube holds significant potential for distributing customized health education for diverse audiences; specifically, this platform has the potential to empower mothers and normalize long-term breastfeeding. The aim of this study was to evaluate the quality of YouTube videos on breastfeeding available in the Arabic language. Methods: We used standard procedures to search YouTube for Arabic breastfeeding videos posted on YouTube in December 2023. Videos were evaluated using the three scales of the DISCERN quality evaluation instrument (reliability, information quality, video quality) and total score. Comparative statistics were generated. Results: In total, 165 videos met the inclusion criteria, with 29.7% in the Education category; 43.6% were in Egyptian Arabic dialect. Almost all (91.75%) of the educational videos had a "medium" quality assessment. Educational videos and those using health professionals had higher quality assessments than those in other categories or done with other speakers. Conclusion: The results of this review suggest that most content on the topic of breastfeeding was of only medium reliability and informational quality. New mothers seeking breastfeeding information or support may be in need of specific problem-solving information at a time when they are living with the often-difficulty reality of caring for a newborn or very young infant. There is a clear need for accurate, culturally congruent information to effectively support breastfeeding in Arabic-speaking countries. Future efforts should focus on improving the quality of online health education content, with implications for public health strategies and policy development.
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Affiliation(s)
- Fatmah Almoayad
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Anwar Alhashem
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Reem Alotaibi
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Renad Alashwl
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Alanoud Albahouth
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Nada Benajiba
- Joint Research Unit in Nutrition and Food, RDC-Nutrition AFRA/IAEA, Ibn Tofail University-CNESTEN, Kenitra, Morocco
| | - Patricia J Kelly
- College of Nursing, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Basil H Aboul-Enein
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Gavine A, Farre A, Lynn F, Shinwell S, Buchanan P, Marshall J, Cumming S, Wallace L, Wade A, Ahern E, Hay L, Cranwell M, McFadden A. Lessons for the UK on implementation and evaluation of breastfeeding support: evidence syntheses and stakeholder engagement. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-206. [PMID: 39054917 DOI: 10.3310/dgtp5702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Background Breastfeeding impacts positively on multiple health outcomes, but < 50% of UK women breastfeed at 8 weeks. Women with long-term conditions face additional challenges in breastfeeding. Objectives To synthesise global and UK evidence to co-create an implementation and evaluation toolkit for cost-effective breastfeeding support in the NHS. Design Evidence syntheses with stakeholder engagement. Review methods Systematic reviews examined effectiveness of breastfeeding support for (1) healthy women and (2) women with long-term conditions using Cochrane Pregnancy and Childbirth Group methods. Mixed-methods systematic reviews synthesised process evaluations of effective breastfeeding support interventions for healthy women and experiences of receiving/providing support for breastfeeding women with long-term conditions. Cross-study synthesis integrated qualitative and quantitative findings. Systematic reviews synthesised evidence on the incremental costs and cost-effectiveness of breastfeeding support following National Institute for Health and Care Excellence guidance. All searches were conducted from May 2021 to October 2022. Stakeholder engagement and toolkit development comprised online discussions, a modified Delphi study, focus groups and four workshops. Participants were 23 stakeholders, 16 parents in the parents' panels, 15 women in the focus groups and 87 stakeholders who attended the workshops. Results We found considerably more interventions designed for healthy women (review 1) than aimed at women with long-term conditions (reviews 1 and 4); approximately half of the studies were targeted at groups at higher risk of poor breastfeeding outcomes, and the impact of support may be different in these populations. Despite this, studies from review 2 found that women perceived the provision of support as positive, important and needed. Studies from review 5 echoed a range of suggestions from participants regarding potential strategies to improve breastfeeding support, with the most widely reported being the need to acknowledge the role and influence of other sources of support (e.g. partners, family, friends, peers, external professionals, web-based resources) and involving these sources in the provision of breastfeeding support for women with long-term conditions. In reviews 3 and 6, there was uncertainty about the cost-effectiveness of breastfeeding support interventions due to the limited number of studies and lack of good-quality evidence. Limitations There was a lack of evidence for the effectiveness and cost-effectiveness of breastfeeding interventions in the UK. There was often insufficient information reported about intervention characteristics. Conclusions 'Breastfeeding only' support probably reduces the number of women stopping any or exclusive breastfeeding. The evidence for 'breastfeeding plus' interventions is less consistent, but these may reduce the number of women stopping exclusive breastfeeding at 4-6 weeks and at 6 months. We found no evidence of differential intervention effects regarding mode of provision or provider. Cost-effectiveness is uncertain due to the lack of good-quality evidence. Key enablers of successful implementation were responsiveness and tailoring of interventions to both women's and supporters' needs. Breastfeeding support as delivered in the included studies probably has little to no effect on breastfeeding outcomes for women with long-term conditions. The mixed-methods synthesis and stakeholder work identified that existing interventions may not address the complex needs of these women. The main study output is a co-produced toolkit to guide implementation and evaluation of breastfeeding support services in the UK. Future work Evaluation of breastfeeding support for all women, particularly those at risk of poor breastfeeding outcomes (e.g. long-term conditions, deprivation). This could involve tailoring the toolkit to local contexts via implementation and effectiveness studies or using quality improvement studies. Study registration This study is registered as PROSPERO CRD42022337239, CRD42021229769 and CRD42022374509. The reviews of economic evidence were not registered; however, the review protocol can be accessed via the repository held by Queen's University Belfast Research Portal (https://pure.qub.ac.uk/). Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR130995) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 20. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Anna Gavine
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Albert Farre
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Fiona Lynn
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Shona Shinwell
- School of Health Sciences, University of Dundee, Dundee, UK
| | | | - Joyce Marshall
- Department of Nursing and Midwifery, University of Huddersfield, Huddersfield, UK
| | - Sara Cumming
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Louise Wallace
- School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, UK
| | - Angie Wade
- Population, Policy and Practice, Great Ormond Street Institute of Child Health, London, UK
| | - Elayne Ahern
- Department of Psychology, University of Limerick, Castletroy, Ireland
| | - Laura Hay
- School of Health Sciences, University of Dundee, Dundee, UK
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Thomsen K, Gonzalez-Nahm S, Benjamin-Neelon SE. Reported Adherence to the 10 Steps to Successful Breastfeeding Is Higher Among Baby-Friendly Hospitals. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:392-398. [PMID: 38483429 DOI: 10.1016/j.jneb.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 02/17/2024] [Accepted: 02/21/2024] [Indexed: 06/09/2024]
Abstract
OBJECTIVE Quantify and compare reported breastfeeding support practices in the Baby-Friendly Hospital Initiative (BFHI) and non-BFHI facilities. DESIGN Cross-sectional survey. SETTING Regions across the US. PARTICIPANTS Two hundred and eighty-six facilities (110 BFHI and 176 non-BFHI) selected by a stratified (by hospital size) random sample of 50% BFHI and 50% non-BFHI facilities. INTERVENTION Emailed survey Fall 2019 through Spring 2020. MAIN OUTCOME MEASURE Reported adherence to the 10 Steps to Successful Breastfeeding. ANALYSIS Wilcoxon rank sum test with continuity correction, Pearson chi-square test of independence, and Fisher's exact test. RESULTS Baby-Friendly Hospital Initiative facilities were more likely to report adherence to the 10 Steps to Successful Breastfeeding. Only 2 of the reported steps were not significantly different: immediate postnatal care and responsive feeding. CONCLUSIONS AND IMPLICATIONS This research supports breastfeeding support interventions within hospitals as both BFHI and non-BFHI facilities have room for improvement. Interventions targeting non-BFHI facilities are an opportunity to close the disparity in breastfeeding care.
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Affiliation(s)
| | - Sarah Gonzalez-Nahm
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA
| | - Sara E Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of International Health, Division of Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Martins CD, Bicalho CV, Furlan RMM, Friche AADL, Motta AR. Breastfeeding outpatient in primary care as an important action to promote breastfeeding: experience report. Codas 2024; 36:e20220234. [PMID: 38808855 PMCID: PMC11166039 DOI: 10.1590/2317-1782/20232022234pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 09/05/2023] [Indexed: 05/30/2024] Open
Abstract
This paper describe a successful experience of promotion, prevention and support for breastfeeding developed by professionals from a basic health unit. This is a Breastfeeding Outpatient Clinic, implemented in a health center in Belo Horizonte, in August 2019. The Outpatient Clinic was established based on the perception of the unit's team that many mothers had difficulty breastfeeding, however, due to the work overload of this team, this assistance did not occur in a timely manner, resulting in early weaning. Initially, a meeting was held to sensitize the team on the breastfeeding indicators of the unit. Based on this knowledge, the implementation of a breastfeeding Outpatient clinic was proposed, aimed not only at dyad with difficulties in managing breastfeeding, but at all postpartum women in the area covered by that health center. A flow was created, through which it was established that all postpartum women who brought their children to carry out the heel prick test at the unit would be referred to the Breastfeeding Outpatient Clinic to perform this service. With the improvement of care, the users of the health center started to breastfeed for longer, which reflected in the improvement of the unit's indicators.
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Affiliation(s)
- Camila Dantas Martins
- Programa de Pós-graduação em Ciências Fonoaudiológicas, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
| | - Carine Vieira Bicalho
- Programa de Pós-graduação em Ciências Fonoaudiológicas, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
| | - Renata Maria Moreira Furlan
- Departamento de Fonoaudiologia, Faculdade de Medicina, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
| | - Amélia Augusta de Lima Friche
- Departamento de Fonoaudiologia, Faculdade de Medicina, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
| | - Andréa Rodrigues Motta
- Departamento de Fonoaudiologia, Faculdade de Medicina, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
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Knop MR, Nagashima-Hayashi M, Lin R, Saing CH, Ung M, Oy S, Yam ELY, Zahari M, Yi S. Impact of mHealth interventions on maternal, newborn, and child health from conception to 24 months postpartum in low- and middle-income countries: a systematic review. BMC Med 2024; 22:196. [PMID: 38750486 PMCID: PMC11095039 DOI: 10.1186/s12916-024-03417-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 05/01/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Mobile health (mHealth) technologies have been harnessed in low- and middle-income countries (LMICs) to address the intricate challenges confronting maternal, newborn, and child health (MNCH). This review aspires to scrutinize the effectiveness of mHealth interventions on MNCH outcomes during the pivotal first 1000 days of life, encompassing the period from conception through pregnancy, childbirth, and post-delivery, up to the age of 2 years. METHODS A comprehensive search was systematically conducted in May 2022 across databases, including PubMed, Cochrane Library, Embase, Cumulative Index to Nursing & Allied Health (CINAHL), Web of Science, Scopus, PsycINFO, and Trip Pro, to unearth peer-reviewed articles published between 2000 and 2022. The inclusion criteria consisted of (i) mHealth interventions directed at MNCH; (ii) study designs, including randomized controlled trials (RCTs), RCT variations, quasi-experimental designs, controlled before-and-after studies, or interrupted time series studies); (iii) reports of outcomes pertinent to the first 1000 days concept; and (iv) inclusion of participants from LMICs. Each study was screened for quality in alignment with the Cochrane Handbook for Systematic Reviews of Interventions and the Joanne Briggs Institute Critical Appraisal tools. The included articles were then analyzed and categorized into 12 mHealth functions and outcome domain categories (antenatal, delivery, and postnatal care), followed by forest plot comparisons of effect measures. RESULTS From the initial pool of 7119 articles, we included 131 in this review, comprising 56 RCTs, 38 cluster-RCTs, and 37 quasi-experimental studies. Notably, 62% of these articles exhibited a moderate or high risk of bias. Promisingly, mHealth strategies, such as dispatching text message reminders to women and equipping healthcare providers with digital planning and scheduling tools, exhibited the capacity to augment antenatal clinic attendance and enhance the punctuality of child immunization. However, findings regarding facility-based delivery, child immunization attendance, and infant feeding practices were inconclusive. CONCLUSIONS This review suggests that mHealth interventions can improve antenatal care attendance and child immunization timeliness in LMICs. However, their impact on facility-based delivery and infant feeding practices varies. Nevertheless, the potential of mHealth to enhance MNCH services in resource-limited settings is promising. More context-specific implementation studies with rigorous evaluations are essential.
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Affiliation(s)
- Marianne Ravn Knop
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Michiko Nagashima-Hayashi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Ruixi Lin
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Chan Hang Saing
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Mengieng Ung
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Sreymom Oy
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Esabelle Lo Yan Yam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Marina Zahari
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Siyan Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
- KHANA Center for Population Health Research, Phnom Penh, Cambodia.
- Public Health Program, College of Education and Health Sciences, Touro University California, Vallejo, CA, USA.
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8
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Gao Y, Wilkes L, Tafe A, Quanchi A, Ruthenberg L, Warriner M, Kildea S. Clinical outcomes and financial estimates for women attending the largest private midwifery service in Australia compared to national data: a retrospective cohort study. Women Birth 2024; 37:101591. [PMID: 38402093 DOI: 10.1016/j.wombi.2024.101591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/11/2024] [Accepted: 02/14/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND AND PROBLEM Multiple barriers to national scale-out of private midwifery practice in Australia exist. AIM To describe and compare maternal infant health outcomes of the largest private midwifery service in Australia with the national core maternity indicators and estimate the financial impact on collaborating public hospitals. METHODS A retrospective cohort of 2747 maternal health records from 2014 to 2022 were compared to national indicators. Financial calculations estimated the impact on hospitals. FINDINGS Compared to national data, women cared by private midwives were significantly: more likely to be 25-34 years and primiparous; less likely to be Indigenous, have diabetes, hypertension or multiple births. At birth, 5% required discussion with specialists, 25% required consultation and 39% were referred; 86% women had their primary midwife at birth; 12.5% birthed at home and 14.5% at a birth centre. Compared to national data, primiparous women had fewer inductions (22.9% vs 45.8%), caesarean sections (22.6% vs 32.1%), instrumental vaginal births (17.0% vs 25.7%), episiotomies (9.5% vs 23.9%) and more birthed vaginally after caesarean section (75.9% vs 11.9%). Significantly less babies were born with a birthweight <2750 g (0.5% vs 1.2%) and 83.7% babies were exclusively breastfed at six weeks. Collaborating hospitals would receive less DRG funding compared to public patients, require less intrapartum midwifery staff and receive a net benefit, even when bed fees were waived. CONCLUSION Women attending My Midwives had significantly lower intervention rates when compared to national indicators although maternal characteristics could be contributing. Multidisciplinary care was evident. Financial modelling shows positive impacts for hospitals.
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Affiliation(s)
- Yu Gao
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane, Queensland 4000, Australia
| | - Liz Wilkes
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane, Queensland 4000, Australia; My Midwives, 29 Hill Street, Toowoomba, Queensland 4350, Australia
| | - Annabel Tafe
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane, Queensland 4000, Australia
| | - Andrea Quanchi
- My Midwives, 29 Hill Street, Toowoomba, Queensland 4350, Australia
| | | | | | - Sue Kildea
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane, Queensland 4000, Australia.
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9
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Awosemusi Y, Keenan-Devlin L, Martinez NG, Yee LM, Borders AEB. The role of clinic-based breastfeeding peer counseling on breastfeeding rates among low-income patients. BMC Pregnancy Childbirth 2024; 24:312. [PMID: 38664768 PMCID: PMC11044488 DOI: 10.1186/s12884-024-06395-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/05/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Despite the benefits of breastfeeding (BF), rates remain lower than public health targets, particularly among low-income Black populations. Community-based breastfeeding peer counselor (BPC) programs have been shown to increase BF. We sought to examine whether implementation of a BPC program in an obstetric clinical setting serving low-income patients was associated with improved BF initiation and exclusivity. METHODS This is a quasi-experimental time series study of pregnant and postpartum patients receiving care before and after implementation of a BPC program in a teaching hospital affiliated prenatal clinic. The role of the BPC staff included BF classes, prenatal counseling and postnatal support, including in-hospital assistance and phone triage after discharge. Records were reviewed at each of 3 time points: immediately before the hire of the BPC staff (2008), 1-year post-implementation (2009), and 5 years post-implementation (2014). The primary outcomes were rates of breastfeeding initiation and exclusivity prior to hospital discharge, secondary outcomes included whether infants received all or mostly breastmilk during inpatient admission and by 6 weeks post-delivery. Bivariable and multivariable analyses were utilized as appropriate. RESULTS Of 302 patients included, 52.3% identified as non-Hispanic Black and 99% had Medicaid-funded prenatal care. While there was no improvement in rates of BF initiation, exclusive BF during the postpartum hospitalization improved during the 3 distinct time points examined, increasing from 13.7% in 2008 to 32% in 2014 (2009 aOR 2.48, 95%CI 1.13-5.43; 2014 aOR 1.82, 95%CI 1.24-2.65). This finding was driven by improved exclusive BF for patients who identified as Black (9.4% in 2008, 22.9% in 2009, and 37.9% in 2014, p = 0.01). CONCLUSION Inpatient BF exclusivity significantly increased with the tenure of a BPC program in a low-income clinical setting. These findings demonstrate that a BPC program can be a particularly effective method to address BF disparities among low-income Black populations.
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Affiliation(s)
- Yetunde Awosemusi
- Women's Health of Las Colinas, Medical City Healthcare, 6750 N MacArthur Blvd, Suite 100, Irving, TX, 75039, USA.
| | - Lauren Keenan-Devlin
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, 2650 Ridge Ave, Walgreen Building Suite 1507, Evanston, IL, 60201, USA
- Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, Chicago, IL, USA
| | - Noelle Griffin Martinez
- Department of Family and Community Medicine, University of California San Francisco, 995 Potrero Avenue Ward 83, San Francisco, CA, 94110, USA
| | - Lynn M Yee
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, 250 E. Superior St, Suite 5-2145, Chicago, IL, 60611, USA
| | - Ann E B Borders
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, 2650 Ridge Ave, Walgreen Building Suite 1507, Evanston, IL, 60201, USA
- Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, Chicago, IL, USA
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10
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Rodríguez-Gallego I, Corrales-Gutierrez I, Gomez-Baya D, Leon-Larios F. Effectiveness of a Postpartum Breastfeeding Support Group Intervention in Promoting Exclusive Breastfeeding and Perceived Self-Efficacy: A Multicentre Randomized Clinical Trial. Nutrients 2024; 16:988. [PMID: 38613021 PMCID: PMC11013075 DOI: 10.3390/nu16070988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
There are numerous recognized benefits of breastfeeding; however, sociocultural, individual, and environmental factors influence its initiation and continuation, sometimes leading to breastfeeding rates that are lower than recommended by international guidelines. The aim of this study was to evaluate the effectiveness of a group intervention led by midwives supporting breastfeeding during the postpartum period in promoting exclusive breastfeeding, as well as to assess the impact of this intervention on perceived self-efficacy. This was a non-blind, multicentric, cluster-randomized controlled trial. Recruitment started October 2021, concluding May 2023. A total of 382 women from Andalusia (Spain) participated in the study. The results showed that at 4 months postpartum there was a higher prevalence of breastfeeding in the intervention group compared to formula feeding (p = 0.01), as well as a higher prevalence of exclusive breastfeeding (p = 0.03), and also at 6 months (p = 0.01). Perceived self-efficacy was similar in both groups for the first two months after delivery, which then remained stable until 4 months and decreased slightly at 6 months in both groups (p = 0.99). The intervention improved the average scores of perceived self-efficacy and indirectly caused higher rates of exclusive breastfeeding (p = 0.005). In conclusion, the midwife-led group intervention supporting breastfeeding proved to be effective at maintaining exclusive breastfeeding at 6 months postpartum and also at increasing perceived self-efficacy.
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Affiliation(s)
- Isabel Rodríguez-Gallego
- Foetal Medicine, Genetics and Reproduction Unit, Virgen del Rocío University Hospital, 41013 Seville, Spain;
- Red Cross Nursing University Centre, University of Seville, 41009 Seville, Spain
| | - Isabel Corrales-Gutierrez
- Surgery Department, Faculty of Medicine, University of Seville, 41009 Seville, Spain
- Foetal Medicine Unit, Virgen Macarena University Hospital, 41009 Seville, Spain
| | - Diego Gomez-Baya
- Department of Social, Developmental and Educational Psychology, Universidad de Huelva, 21007 Huelva, Spain
| | - Fatima Leon-Larios
- Nursing Department, School of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
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11
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Subramani S, Vinay R, März JW, Hefti M, Biller-Andorno N. Ethical Issues in Breastfeeding and Lactation Interventions: A Scoping Review. J Hum Lact 2024; 40:150-163. [PMID: 38087449 PMCID: PMC10799543 DOI: 10.1177/08903344231215073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 10/31/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND Infant feeding interventions that promote and support breastfeeding are considered important contributions to global public health. As these interventions often target private settings (e.g., individuals' homes) and involve vulnerable populations (e.g., pregnant women, infants, and underprivileged families), a keen awareness of ethical issues is crucial. RESEARCH AIM The purpose of this scoping review was to capture the key elements of the current ethical discourse regarding breastfeeding and lactation interventions. METHOD A scoping review was conducted using Arksey and O'Malley's (2005) methodology to identify the ethical issues of breastfeeding and lactation interventions as they are reflected in the scholarly literature published between January 1990 and October 2022. Abstracts (N = 3715) from PubMed, ScienceDirect, JSTOR and the Cochrane Database of Systematic Reviews were screened. The final sample consisted of 26 publications. RESULTS The recurring ethical issues identified in these studies were: the normative assumptions of motherhood; maternal autonomy and informed choice; information disclosure, balancing risks and benefits, and counseling practices; stigma and social context; ethics of health communication in breastfeeding campaigns; and the ethical acceptability of financial incentives in breastfeeding interventions. CONCLUSION This review illustrated that, while a wide range of ethical arguments were examined, the emphasis has been primarily on accounting for mothers' experiences and lactating persons' choices, as well as achieving public health objectives relating to infant nutrition in breastfeeding interventions. To effectively and ethically implement breastfeeding and lactation interventions, we must consider the social, economic, and cultural contexts in which they occur. One key learning identified was that women's experiences were missing in these interventions and, in response, we suggest moving beyond the dichotomous approach of individual health versus population health.
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Affiliation(s)
- Supriya Subramani
- Sydney Health Ethics, School of Public Health, Faculty of Medicine and Health, University of Medicine, Camperdown, NSW, Australia
| | - Rasita Vinay
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
| | - Julian W. März
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
| | - Michaela Hefti
- Family Larsson-Rosenquist Foundation, Frauenfeld, Switzerland
| | - Nikola Biller-Andorno
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
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12
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Fan Y, Li J, Wong JYH, Fong DYT, Wang KMP, Lok KYW. Text messaging interventions for breastfeeding outcomes: A systematic review and meta-analysis. Int J Nurs Stud 2024; 150:104647. [PMID: 38056353 DOI: 10.1016/j.ijnurstu.2023.104647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/31/2023] [Accepted: 11/15/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Given the health benefits of breastfeeding for infants and mothers, breastfeeding has become a significant public health issue. The global growth of mobile phone usage has created new options for breastfeeding promotion, including text messaging. OBJECTIVE We aimed to evaluate the efficacy of text messaging interventions on breastfeeding outcomes and to identify the efficacy moderators of such interventions. METHODS Ten electronic databases were searched from the inception of the databases to 5 July 2023. Studies were included if they used randomized controlled trials or quasi-experimental designs to evaluate the effect of text messaging interventions on breastfeeding outcomes. Two reviewers screened the included studies, assessed the risk of bias, and extracted the data. Pooled results were obtained by the random-effects model, and subgroup analyses were conducted on intervention characteristics to identify potential moderators. The protocol of this study was registered on PROSPERO (ID: CRD42022371311). RESULTS Sixteen studies were included. Text messaging interventions could improve the exclusive breastfeeding rate (at <3 months: OR = 2.04; 95 % CI: 1.60-2.60, P < 0.001; at 3-6 months: OR = 1.66; 95 % CI: 1.18-2.33, P = 0.004; at ≥6 months: OR = 2.13; 95 % CI: 1.47-3.08, P < 0.001), and the breastfeeding self-efficacy (SMD = 0.30, 95 % CI: 0.14-0.45, P < 0.001). Text messaging interventions that covered antenatal and postnatal periods, delivered weekly were most effective in improving the exclusive breastfeeding rate. CONCLUSIONS Text messaging interventions may improve breastfeeding practice compared with no or general health information. We suggest text messaging conducted from the pre- to postnatal periods in a weekly manner can effectively increase exclusive breastfeeding rates and breastfeeding self-efficacy. Further studies should investigate the relation between new theories (such as the health action process approach and the theory of message-framing) and efficacy of breastfeeding interventions, using text components.
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Affiliation(s)
- Yingwei Fan
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Junyan Li
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Janet Yuen Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan, Hong Kong, China
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13
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Mei H, Zhang Y, Chang R, Xu K, Zhang J, Wang F. Mediating role of birth at a baby-friendly hospital in the association between parental socioeconomic status and infant exclusive breastfeeding at six months old. BMC Public Health 2024; 24:78. [PMID: 38172763 PMCID: PMC10762853 DOI: 10.1186/s12889-023-17586-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 12/26/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Current evidence suggests that the exclusive breastfeeding (EBF) rate at six months postpartum in China falls considerably below the targets recommended by the World Health Organization (WHO). Socioeconomic disparities in EBF have been observed in developing countries, with significant heterogeneity across studies. Despite the implementation of the Baby-Friendly Hospital Initiative (BFHI) in China since the 1990s to promote breastfeeding, there has been a lack of assessment concerning infants from different socioeconomic backgrounds. This study sought to investigate the association between socioeconomic status (SES) and EBF and explore the potential impact of giving birth at a Baby-Friendly Hospital (BFH) on this association. METHODS We analyzed data from 98,469 mother-child dyads selected from the Maternal and Child Health Management Information System. We used log-binomial models to examine the relationships between SES and EBF, SES and giving birth at a BFH, as well as BFH births and EBF. Additionally, we explored a counterfactual mediation approach to assess the mediating role of BFH births in the SES-EBF association. FINDINGS We identified a significant association between SES and EBF (RRMedium vs. Low = 1.47, 95% CI 1.39-1.55; RRHigh vs. Low = 1.40, 95% CI 1.32-1.49). Mothers with higher SES were more likely to give birth at BFHs (RRMedium vs. Low = 1.85, 95% CI 1.81-1.88; RRHigh vs. Low=2.29, 95% CI 2.25-2.33). The significance of the SES-EBF association was attenuated when the type of hospital for childbirth was considered, revealing the significant mediating effect of BFH births in the SES-EBF association. CONCLUSION Socioeconomic disparities are linked to infant EBF rates, with giving birth at a BFH mediating this association, especially for cases with low SES in rural areas.
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Affiliation(s)
- Hong Mei
- Institute of Maternal and Child Health, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital, Huazhong University of Science and Technology, 100 Hongkong Road, Wuhan, Hubei, China
| | - Yuanyuan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13, Hangkong Road, Wuhan, Hubei, China
| | - Ruixia Chang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13, Hangkong Road, Wuhan, Hubei, China
| | - Ke Xu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13, Hangkong Road, Wuhan, Hubei, China
| | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13, Hangkong Road, Wuhan, Hubei, China.
| | - Fang Wang
- Department of Obstetrics, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital, Huazhong University of Science and Technology, 100 Hongkong Road, Wuhan, Hubei, China.
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14
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Vila-Candel R, Mena-Tudela D, Franco-Antonio C, Quesada JA, Soriano-Vidal FJ. Effects of a mobile application on breastfeeding maintenance in the first 6 months after birth: Randomised controlled trial (COMLACT study). Midwifery 2024; 128:103874. [PMID: 37979550 DOI: 10.1016/j.midw.2023.103874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/31/2023] [Accepted: 11/06/2023] [Indexed: 11/20/2023]
Abstract
PROBLEM It is necessary to continue promoting breastfeeding rates. BACKGROUND Information and communication technologies have significantly impacted healthcare services and are transforming the sector. There is little evidence of the usefulness of mobile applications to support breastfeeding and increase its duration. AIM To assess whether mobile application-LactApp® (Barcelona, Spain)-usage compared with standard care increases the 6-month postpartum breastfeeding rate. METHODS A multicentre, randomised, controlled clinical trial of parallel groups was conducted. The study was conducted in four public hospitals in Spain from January 2022 to January 2023. 270 Women were randomly assigned to each parallel group. The women in the intervention group received free access to the mobile application LactApp®, which provides personalised and convenient support to women about BF. Women in the control group received standard care, which included individual counselling about the benefits of maintaining BF for the first 6 months of the baby's life. FINDINGS The rate of breastfeeding abandonment at 15 days was 6.4 % in the control group vs 0.0 % in the intervention group (p = 0.105). LactApp® usage did not increase the 6-month postpartum breastfeeding rate compared with standard care (CG = 41.6% vs. IG = 43.6 %; p = 0.826). DISCUSSION Further studies must explore how technologies can help improve long-term breastfeeding maintenance. The mobile app seems to reduce early weaning in the first 15 days slightly. CONCLUSION Mobile application usage did not increase the breastfeeding rate compared with standard practice but may reduce breastfeeding abandonment in the first 2 weeks postpartum.
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Affiliation(s)
- Rafael Vila-Candel
- Health Science Faculty, Universidad Internacional de Valencia - VIU, 46002 Valencia, Spain; Department of Primary Health, La Ribera Health Department, 46600 Alzira, Spain; Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
| | - Desirée Mena-Tudela
- Department of Nursing, Feminist Institute, Universitat Jaume I, 12071 - Castellón de la Plana, Spain
| | - Cristina Franco-Antonio
- Department of Nursing, Universidad de Extremadura, 10003 Cáceres, Spain; Health and Care Research Group (GISyC), University of Extremadura, 10003 Cáceres, Spain.
| | - José Antonio Quesada
- Department of Clinical Medicine, Universidad Miguel Hernández, 03202 Elche, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 03550, Alicante, Spain
| | - Francisco Javier Soriano-Vidal
- Department of Obstetrics and Gynaecology, Xàtiva-Oninyent Health Department, 46800 Xàtiva, Spain; Department of Nursing, Universitat de Valencia, 46010, Valencia, Spain; Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
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15
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Ouyang YQ, Zhou J, Guo JY, Wang SY, Wang X, Zhou-Chen YB, Redding SR, Chen HJ. Effectiveness of a breastfeeding promotion intervention model based on Society ecosystems Theory for maternal women: a study protocol of randomized controlled trial. Reprod Health 2023; 20:182. [PMID: 38062456 PMCID: PMC10704786 DOI: 10.1186/s12978-023-01719-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Breastfeeding is recognized internationally as the most scientific and effective way to feed infants and young children. According to the World Health Organization in 2022, the exclusive breastfeeding rate within 6 months is 34.1% in China, which is still far from the goal of "more than 60% exclusive breastfeeding rate of infants within 6 months" by 2030 required by China's State Council. It is necessary to promote breastfeeding and provide maternal breastfeeding guidance to increase exclusive breastfeeding. Factors influencing breastfeeding can be explained by the society ecosystems theory, distributed in macro, mezzo and micro systems. The interventions focused on breastfeeding promotion are mainly carried out in the health systems and services, home and family environment, community environment, work environment, policy environment or a combination of these facilities. But there is sparse research on integrating resources in the macro, mezzo and micro systems of maternal breastfeeding processes to promote breastfeeding behavior. A randomized controlled trial will test the effect of a breastfeeding promotion intervention model based on the society ecosystems theory versus usual prenatal and postnatal care on maternal and infant health and the exclusive breastfeeding rate at 6 months. METHODS/DESIGN The study is a single-blind, parallel design, randomized controlled trial with an intervention group (n = 109) and a control group (n = 109) that compares the effect of a breastfeeding promotion intervention model based on the society ecosystems theory with usual prenatal and postnatal care. The intervention covers macro- (policy, culture), mezzo- (family-hospital-community) and micro- (biological, psychological and social) systems of the maternal breastfeeding process. Infant feeding patterns, neonatal morbidity and physical and mental health of antenatal and postpartum women will be collected at baseline (28 to 35 weeks of gestation), 1-, 4-, and 6-month postpartum. DISCUSSION This is a multifaceted, multifactorial, and multi-environmental breastfeeding promotion strategy to help mothers and their families learn breastfeeding knowledge and skills. The study provides a new modality for adding breastfeeding interventions to prenatal and postnatal care for healthcare providers in the hospital and the community. TRIAL REGISTRATION Chinese Clinical Trial Registry at www.chictr.org.cn , ChiCTR2300075795.
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Affiliation(s)
- Yan-Qiong Ouyang
- School of Nursing, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Jie Zhou
- School of Nursing, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, China.
| | - Jin-Yi Guo
- School of Nursing, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Shi-Yun Wang
- School of Nursing, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Xin Wang
- School of Nursing, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Yi-Bei Zhou-Chen
- School of Nursing, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, China
| | | | - Hui-Jun Chen
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, 430071, China.
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16
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Bednarek A, Bodys-Cupak I, Serwin A, Cipora E. Mothers' Attitudes Towards Breastfeeding in Terms of Health Safety and Professional Lactation Education: A National Survey of Women. J Multidiscip Healthc 2023; 16:3273-3286. [PMID: 37942283 PMCID: PMC10629448 DOI: 10.2147/jmdh.s431576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/28/2023] [Indexed: 11/10/2023] Open
Abstract
Introduction and Objective An important role in building opinions and attitudes regarding breastfeeding by mothers is played by the medical staff taking care of the mother woman expecting a baby. Breastfeeding is a standard in infant nutrition. The knowledge and support of the medical staff can help a woman make the decision to breastfeed. At the same time, it creates conditions for an optimal working environment for medical staff, affecting the quality of care. The aim of the study was identify mothers' attitudes towards breastfeeding in the context of health safety and professional lactation education. Materials and Methods Data for the study were obtained on the basis of a proprietary questionnaire and a standardized research tool, which was the questionnaire for assessing knowledge and attitudes towards breastfeeding The Iowa Infant Feeding Attitude Scale designed by Arlene De la Mora (IIFAS). The study involved 439 women who gave birth to a child in the last 5 years. Results Extensive knowledge about the benefits of breastfeeding for the child's body is declared by 67.9% of women. The vast majority of respondents (94.1%) pointed to supporting the development of the immune system. Most women (85%) obtained information on breastfeeding from the Internet, and 58.5% from medical personnel. Most respondents (88.8%) assessed their partner's attitude towards breastfeeding as positive. The result, The Iowa Infant Feeding Attitude Scale was equal to 50.97, which proves the positive attitude of women to breastfeeding. Conclusion Promoting the best way to feed children, which is breastfeeding, plays an important role in building mothers' opinions and attitudes about breastfeeding.
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Affiliation(s)
- Anna Bednarek
- Department of Health Promotion, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Iwona Bodys-Cupak
- Department of Nursing Fundamentals, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Adrianna Serwin
- Department of Health Promotion, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Elżbieta Cipora
- Medical Institute, Jan Grodek State University in Sanok, Sanok, Poland
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Marín Gabriel MÁ, Martín Lozoya S, de Las Heras Ibarra S, Domingo Comeche L, González Carrasco E, Lalaguna Mallada P, Villó Sirerol N, García Fernández L, Jiménez Martínez J, Royuela Vicente A. Association of the presence of a COVID-19 infection at the time of birth and the rates of exclusive breastfeeding upon discharge in BFHI hospitals: a multicenter, prospective cohort study. Int Breastfeed J 2023; 18:54. [PMID: 37794406 PMCID: PMC10552201 DOI: 10.1186/s13006-023-00590-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/22/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Very few studies have assessed the association between COVID-19 infection and the rates of exclusive breastfeeding (EBF) upon discharge following the first waves of the pandemic and after initiation of vaccination. The primary objective of this study is to compare the rates of EBF since birth upon discharge in mothers diagnosed with COVID-19 infection at the time of the delivery versus a group of non-infected mothers in maternity hospitals with Baby Friendly Hospital Initiative (BFHI) accreditation. The secondary objectives include determining the rates of any breastfeeding at three and six months of life in both groups, as well as determining the possible factors associated with EBF rates observed upon discharge. METHODS An observational, Spanish multi-center hospital, prospective cohort study conducted from 1 to 2021 to 31 March 2022 and with follow-up during the first six months of life. Follow-up was performed via telephone contact with calls performed at three and six months. A multivariate logistic regression analysis model was used to identify the factors related to a lower probability of EBF upon discharge. RESULTS 308 mother-infant pairs participated in the study, 111 in the cohort of women with COVID infection and 197 in the comparison group. EBF upon discharge was 62.7% in the COVID group vs. 81.2% in the comparison group (p = 0.002); at three months; 52.4% vs. 57.0% (p = 0.33) were performing EBF, with the rates of EBF at six months being 43.0% vs. 39.3% (p = 0.45), respectively. Exposure to COVID-19 at delivery (AOR 5.28; 95% CI 2.01, 13.86), not practicing BF previously (AOR 36.3; 95% CI 7.02, 187.74), birth via Cesarean section (AOR 5.06; 95% CI 1.62, 15.79) and low birth weight of the newborn (AOR 1.01; 95% CI 1.01, 1.01) were associated with a greater risk of not performing EBF upon discharge. CONCLUSIONS Mothers with a mild or asymptomatic COVID-19 infection at the time of the delivery were less likely to have exclusively breastfed during their hospital stay than other mothers in these BFHI-accredited hospitals. However, there were no differences in breastfeeding rates between the groups at three and six months postpartum.
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Affiliation(s)
- Miguel Ángel Marín Gabriel
- Department of Pediatrics, Puerta de Hierro-Majadahonda University Hospital, BFHI Hospital-Coordinator, Majadahonda, Madrid, Spain.
| | - Sergio Martín Lozoya
- Department of Pediatrics, Puerta de Hierro-Majadahonda University Hospital, BFHI Hospital-Coordinator, Majadahonda, Madrid, Spain
| | | | - Laura Domingo Comeche
- Department of Neonatology, Fuenlabrada University Hospital, Fuenlabrada, Madrid, Spain
| | | | | | | | | | | | - Ana Royuela Vicente
- Biostatistics Unit, Hospital Universitario Puerta de Hierro Majadahonda, IDIPHISA. CIBERESP, ISCIII., Madrid, España
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18
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Chen S, Washio Y, Liu A, Acker C, Herrine G. Teaching antenatal hand expression: a feasibility study in an inner urban U.S. hospital. Int Breastfeed J 2023; 18:39. [PMID: 37563682 PMCID: PMC10416364 DOI: 10.1186/s13006-023-00578-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 07/26/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Many women have low confidence in breastfeeding and have concerns regarding low milk volume or discomfort with breastfeeding. Antenatal hand expression may be an opportunity to help women feel more comfortable with breastfeeding and help promote exclusive breastfeeding. A study at a hospital in Philadelphia, Pennsylvania, U.S. assessed the feasibility of teaching antenatal hand expression at 39 weeks among socioeconomically disadvantaged populations, overall participant satisfaction and adoption of hand expression and breastfeeding. METHODS From March 2020 to June 2021, women recruited at 34-39 weeks were taught to hand express, collect, and store colostrum. Starting from 39 weeks, participants were asked to practice hand expression 1-3 times / day until delivery, log their experiences, and store colostrum expressed. Women were contacted to encourage continued hand expression and answer any questions. Postpartum, a survey assessed satisfaction with hand expression and issues encountered. The survey also inquired about breastfeeding plans and barriers, and whether women were exclusively breastfeeding (defined as infants who received only breastmilk from the time of birth). Chart review of postpartum or well-baby visit notes determined whether women continued breastfeeding. RESULTS Of the 29 participants, 72% (21/29) reported hand expressing at home, and no women reported contractions when hand expressing. Participants rated mean satisfaction of 8.1/10 (SD = 1.62) with antenatal hand expression, mean satisfaction of 9.4/10 (SD = 0.90) toward hand expression education, mean likelihood of 9.4/10 (SD = 1.24) recommending hand expression to others, and a mean score of 8.1/10 (SD = 1.69) on how helpful hand expression was in breastfeeding initiation. 90% (26/29) of women initiated breastfeeding after birth and 72% (21/29) exclusively breastfed on discharge, but only 11/29 (38%) continued exclusively breastfeeding when re-assessed 4-6 weeks postpartum. Barriers included maternal discomfort, low milk supply, and maternal or infant illness. CONCLUSIONS This study suggests that women in an urban setting would be willing to practice antenatal hand expression. A larger and adequately powered study could be feasible to determine associations between antenatal hand expression and breastfeeding rates and confidence.
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Affiliation(s)
- Sally Chen
- Obstetrics, Gynecology, and Reproductive Sciences, Temple University Hospital, Philadelphia, PA USA
| | - Yukiko Washio
- Obstetrics, Gynecology, and Reproductive Sciences, Temple University Hospital, Philadelphia, PA USA
- RTI International, Research Triangle Park, NC USA
| | - Angela Liu
- Obstetrics, Gynecology, and Reproductive Sciences, Temple University Hospital, Philadelphia, PA USA
| | | | - Gail Herrine
- Obstetrics, Gynecology, and Reproductive Sciences, Temple University Hospital, Philadelphia, PA USA
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Zullo F, Di Mascio D, Berghella V. Evidence-based labor management: postpartum care after vaginal delivery (part 6). Am J Obstet Gynecol MFM 2023; 5:100977. [PMID: 37094636 DOI: 10.1016/j.ajogmf.2023.100977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/31/2023] [Accepted: 04/18/2023] [Indexed: 04/26/2023]
Abstract
In the setting of postpartum care after vaginal delivery, rooming-in is associated with a higher rate of exclusive breastfeeding rate at hospital discharge, but there is insufficient evidence to support or refute rooming-in to increase breastfeeding at 6 months. Education and support for breastfeeding are valuable interventions to promote initiation of breastfeeding whether it is offered by a healthcare professional, nonhealthcare professional, or peer. A combined intervention, a professional provider-led intervention, having a protocol available for the provider training program, and implementation during both the prenatal and postnatal periods increased the rate of exclusive breastfeeding for 6 months. There is no single effective treatment for breast engorgement. Breast massage, continuing breastfeeding, and pain relief are recommended by national guidelines. Nonsteroidal anti-inflammatory drugs and acetaminophen are better than placebo for relief of pain caused by uterine cramping and perineal trauma; acetaminophen is effective in breastfeeding individuals who underwent episiotomy; and local cooling pain relievers have been shown to reduce perineal pain for 24 to 72 hours, compared with no treatment. There is insufficient evidence to assess the safety and efficacy of postpartum routine universal thromboprophylaxis after vaginal delivery. Anti-D immune globulin administration is recommended in Rhesus-negative individuals who have given birth to a Rhesus-positive infant. There is very low-quality evidence that a universal complete blood count is useful in reducing the risk of receiving blood products. In the absence of any postpartum complication, there is insufficient evidence to recommend a routine postpartum ultrasound. Measles, mumps, and rubella combination; varicella; human papillomavirus; and tetanus, diphtheria, and pertussis vaccines should be administered in nonimmune individuals in the postpartum period. Smallpox and yellow fever vaccines should be avoided. Individuals undergoing postplacental placement are more likely to use an intrauterine device at 6 months than those advised to follow-up for placement during outpatient postpartum care. An implant is safe and effective for immediate postpartum contraception. There is insufficient evidence to support or refute the routine administration of micronutrient supplements in breastfeeding women. Placentophagia does not provide any benefits and exposes mothers and offspring to infectious risks. Therefore, it should be discouraged. Because of the low level of evidence, there is insufficient data to assess the efficacy of home visits in the postpartum period. There is insufficient evidence to recommend when to resume daily activities, and individuals should be counseled to return to prepregnancy level of activity or exercise when comfortable. Sexual activity, housework exercise, driving, climbing stairs, and lifting weights should be resumed as soon as postpartum individuals want. A behavioral educational intervention reduces depression symptoms and increases breastfeeding duration. Physical activity after delivery is protective against postpartum mood disorders. There is no strong evidence that supports early discharge after vaginal delivery compared with standard discharge (ie, ≥48 hours).
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Affiliation(s)
- Fabrizio Zullo
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy (Drs Zullo and Mascio)
| | - Daniele Di Mascio
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy (Drs Zullo and Mascio).
| | - Vincenzo Berghella
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA (Dr Berghella)
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20
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Mohammed S, Yakubu I, Fuseini AG, Abdulai AM, Yakubu YH. Systematic review and meta-analysis of the prevalence and determinants of exclusive breastfeeding in the first six months of life in Ghana. BMC Public Health 2023; 23:920. [PMID: 37208682 PMCID: PMC10199593 DOI: 10.1186/s12889-023-15758-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 04/26/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Exclusive breastfeeding is a public health priority in sub-Saharan Africa. However, systematic reviews on its determinants in Ghana remain scarce. Therefore, we systematically reviewed the prevalence and determinants of exclusive breastfeeding in children 0-6 months in Ghana. METHODS We conducted systematic searches in Embase, Medline, and Africa-Wide Information from the databases' inception until February 2021 for studies that assessed the prevalence and determinants of exclusive breastfeeding in children 0-6 months in Ghana. Random-effects meta-analysis was used to estimate the pooled prevalence of exclusive breastfeeding and narrative synthesis to summarise the determinants. We calculated the proportion of total variability that was due to between study heterogeneity using I² statistics, and Egger's test assessed publication bias. The review is registered with PROSPERO, CRD42021278019. RESULTS Out of the 258 articles identified, 24 met the inclusion criteria. Most of the included studies were cross-sectional and were published between 2005 and 2021. The pooled prevalence of exclusive breastfeeding (EBF) among children 0-6 months in Ghana was 50% (95%CI 41.0-60.0%). The prevalence was higher in rural areas (54%) than in urban areas (44%). Several factors were identified as facilitators of EBF, including older maternal age, self-employment, unemployment, living in a large house, being a house owner, giving birth in a health facility, non-caesarean delivery, adequate antenatal attendance, counselling services, participation in support groups, adequate knowledge about EBF, positive attitude towards EBF, and higher maternal education among rural dwellers. Additionally, having an average birthweight facilitated EBF. Barriers to EBF were also identified, including higher maternal education among urban dwellers, less than three months of maternity leave, maternal HIV-positive status, the experience of partner violence, lack of access to radio, inadequate breastmilk production, lack of family support, having a partner who wants more children, counselling on complementary feeding, healthcare worker recommendation of complementary feed, single marital status, and infant admission to neonatal intensive care units. CONCLUSION In Ghana, EBF rates are low, with only about half of all children aged 0-6 months breastfed exclusively. A multi-dimensional approach is required to tackle the diverse sociodemographic, obstetric, and infant-related issues that hinder EBF practice in Ghana.
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Affiliation(s)
- Shamsudeen Mohammed
- MedicineDepartment of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Ibrahim Yakubu
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand.
- Department of Nursing, Nursing and Midwifery Training College, Gushegu, Ghana.
| | | | - Abdul-Malik Abdulai
- Department of Nursing, Nurses' and Midwives' Training College, Tamale, Ghana
| | - Yakubu H Yakubu
- School of Clinical Sciences, Department of Nursing, Auckland University of Technology, Auckland, New Zealand
- Department of Intensive Care Unit, Tamale Teaching Hospital, Tamale, Ghana
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21
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Wang T, Shang M, Chow KM. Effects of breastfeeding training programmes for midwives on breastfeeding outcomes: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2023; 23:262. [PMID: 37072728 PMCID: PMC10111770 DOI: 10.1186/s12884-023-05540-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/23/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Appropriate breastfeeding training for midwives is necessary to enhance their knowledge, attitude, and practice (KAP). However, evidence surrounding the effects of midwife breastfeeding training programmes is insufficient to draw a conclusion of its effectiveness on breastfeeding initiation, duration, and rates. OBJECTIVE The aim of this systematic review was to identify, summarise, and critically analyse the available literature to evaluate the effects of midwife breastfeeding training programmes on the midwives' KAP towards breastfeeding and breastfeeding initiation, duration and rates among postnatal mothers. METHODS Nine English and six Chinese databases were searched with relevant key words. The methodological quality of the included studies were assessed by two reviewers independently using the Joanna Briggs Institute critical appraisal checklists. RESULTS Nine English and one Chinese articles were included in this review. Five articles investigating midwives' KAP towards breastfeeding reported positive results (p < 0.05). The meta-analysis revealed that breastfeeding training programmes significantly improved midwives' breastfeeding-related knowledge and skills (standardised mean difference = 1.33; 95% confidence interval, 0.98 to 1.68; p < 0.01; I2 = 36%), as well as their attitude towards breastfeeding (p < 0.05). An additional five articles measured the effects of breastfeeding training programmes on the initiation, duration, and rates of breastfeeding among postnatal mothers. Following the implementation of a breastfeeding training programme for midwives, mothers had significantly longer durations of exclusive breastfeeding (p < 0.05), fewer breastfeeding challenges (p < 0.05) (e.g. breast milk insufficiency), and higher satisfaction with breastfeeding counselling (p < 0.01), and fewer infants received breast milk substitutes in their first week of life without medical reasons (p < 0.05) in the intervention group compared with the control group. However, no significant effects were seen on the initiation and rates of breastfeeding after implementation of the programmes. CONCLUSIONS This systematic review has demonstrated that midwife breastfeeding training programmes could improve midwives' KAP towards breastfeeding. However, the breastfeeding training programmes had limited effects on breastfeeding initiation and rates. We suggest that future breastfeeding training programme should incorporate counselling skills alongside breastfeeding knowledge and skills training. REVIEW REGISTRATION This systematic review has been registered in the International prospective register of systematic reviews (PROSPERO) (ID: CRD42022260216).
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Affiliation(s)
- Tianci Wang
- The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Meimei Shang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
- Shandong Cancer Hospital and Institute, Shandong First Medical University, Jinan, China
| | - Ka Ming Chow
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR.
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22
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Sağlik M, Karaçam Z. Effectiveness of structured education and follow-up in the management of perceived breastmilk insufficiency: A randomized control trial. Health Care Women Int 2023; 44:276-294. [PMID: 34919025 DOI: 10.1080/07399332.2021.2007249] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In this study, we examine the effectiveness of structured education and follow-up in the management of perceived milk insufficiency and in increasing the baby's amount of milk intake in breastfeeding mothers. We conducted a randomized controlled trial over the period December 2018-June 2019 at Family Health Centers in Turkey with 64 mothers (intervention group: 33 and control group: 31). We provided the intervention group with education using structured educational material. A Descriptive Information Form, a Breastfeeding Follow-up Form, and the Scoring System for Measuring a Baby's Intake of Breast Milk were the instruments we used in the data collection. Mothers in the intervention group started breastfeeding their babies in the first one hour after birth. We observed at each monitoring that a significantly greater percentage of the mothers in the intervention group believed their milk to be sufficient and that they fed their babies exclusively with breast milk in the three follow-ups. We found from the data we obtained that all three tracking times indicated that the baby's amount of milk intake in the intervention group was better than in the control group; the differences were statistically significant. We concluded that structured education and follow-ups increased the exclusive breastfeeding of 0-2-month-old babies, improved perceptions of sufficient milk intake, diminishing the perception of breast milk deficiency.Supplemental data for this article is available online at https://doi.org/10.1080/07399332.2021.2007249.
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Affiliation(s)
| | - Zekiye Karaçam
- Faculty of Health Sciences, Division of Midwifery, Aydın Adnan Menderes University, Aydın, Turkey
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Allen J, Gao Y, Germain J, O'Connor M, Hurst C, Kildea S. Impact of the Thompson method on breastfeeding exclusivity and duration: Multi-method design. Int J Nurs Stud 2023; 141:104474. [PMID: 36913911 DOI: 10.1016/j.ijnurstu.2023.104474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/13/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND How hospital clinicians facilitate breastfeeding in the first 48-72 h is critical to breastfeeding exclusivity and duration. Mothers who discharge hospital directly breastfeeding are more likely to continue exclusively breastfeeding at 3-months. OBJECTIVE To assess the impact of facility-wide implementation of a physiological breastfeeding method (the Thompson method) on direct breastfeeding at hospital discharge and exclusive breastfeeding at 3-months of age. DESIGN Multi-method design using interrupted time series analysis and surveys. SETTING(S) An Australian tertiary maternity hospital. PARTICIPANTS 13,667 mother-baby pairs (interrupted time series analysis) and 495 postnatal mothers (surveys). METHODS The Thompson method includes cradle position and hold, alignment of mouth-to-nipple, baby-led connection and seal, maternal fine-tuning for symmetry, and leisurely duration. We used a large pre-post implementation dataset and conducted interrupted time series analysis using a 24-month baseline period (January 2016 - December 2017); and a 15-month post-implementation period (April 2018 - June 2019). We recruited a sub-sample of women to complete surveys at hospital discharge and 3-months postpartum. Surveys were primarily used to measure impact of Thompson method on exclusive breastfeeding at 3-months, compared with a baseline survey conducted in same setting. RESULTS Following implementation of the Thompson method, the declining trend in direct breastfeeding at hospital discharge was significantly averted by 0.39% each month relative to baseline (95% CI: 0.03% to 0.76%; p = 0.037). While the 3-month exclusive breastfeeding rate in the Thompson group was 3 percentage points higher than the baseline group; this result did not reach statistical significance. However, a subgroup analysis of women who discharged hospital exclusively breastfeeding revealed the relative odds of exclusive breastfeeding at 3-months in the Thompson group was 0.25 (95% CI: 0.17 to 0.38; p < 0.001), significantly better than the baseline group (Z = 3.23, p < 0.01) where the relative odds was only 0.07 (95% CI: 0.03 to 0.19; p < 0.001). CONCLUSIONS Implementation of the Thompson method for well mother-baby pairs improved direct breastfeeding trends at hospital discharge. For women who discharged hospital exclusively breastfeeding, exposure to the Thompson method reduced the risk of exclusive breastfeeding discontinuation by 3-months. The positive impact of the method was potentially confounded by partial implementation and a parallel rise in birth interventions which undermine breastfeeding. We recommend strategies to strengthen clinician buy-in to the method, and future research using a cluster randomised trial design. TWEETABLE ABSTRACT Facility-wide implementation of the Thompson method improves direct breastfeeding at hospital discharge and predicts breastfeeding exclusivity at 3-months.
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Affiliation(s)
- Jyai Allen
- Mater Research Institute, Mater Mothers' Hospital, South Brisbane, Australia; College of Nursing and Midwifery, Charles Darwin University, Brisbane, Australia.
| | - Yu Gao
- Mater Research Institute, Mater Mothers' Hospital, South Brisbane, Australia; College of Nursing and Midwifery, Charles Darwin University, Brisbane, Australia.
| | - Julie Germain
- Parent Support Centre, Mater Mothers' Hospital, South Brisbane, Australia
| | - Michelle O'Connor
- Parent Support Centre, Mater Mothers' Hospital, South Brisbane, Australia
| | - Cameron Hurst
- College of Nursing and Midwifery, Charles Darwin University, Brisbane, Australia.
| | - Sue Kildea
- Mater Research Institute, Mater Mothers' Hospital, South Brisbane, Australia; College of Nursing and Midwifery, Charles Darwin University, Brisbane, Australia.
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Azzam OA, Sindiani AM, Eyalsalman MM, Odeh MK, AbedAlkareem KY, Albanna SA, Abdulrahman EM, Abukhadrah WQ, Hazaimeh HO, Zaghloul AA, Mahgoub SS. Obstetric Violence among Pregnant Jordanian Women: An Observational Study between the Private and Public Hospitals in Jordan. Healthcare (Basel) 2023; 11:healthcare11050654. [PMID: 36900659 PMCID: PMC10000996 DOI: 10.3390/healthcare11050654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/06/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Obstetric Violence (OV) is a public health matter that affects women and their children with an incidence rate between 18.3-75.1% globally. The delivery institution of public and private sectors represents a potential factor contributing to OV. This study aimed to assess OV existence among sample of pregnant Jordanian women and its risk factors domains between public and private hospitals. METHODOLOGY This is a case-control study including 259 recently delivered mothers from Al-Karak Public and Educational Hospital and The Islamic Private Hospital. A designated questionnaire including demographic variables and OV domains was used for data collection. RESULTS A significant difference was seen between patients delivering in the public sector compared to patients delivering the private sector in education level, occupation, monthly income, delivery supervision and overall satisfaction. Patients delivering in the private sector showed a significantly less physical abuse by the medical staff compared to patients delivering in the public sector, and patients delivering in a private room also showed a significantly less OV and risk of physical abuse compared to patients delivering in shared room. In public settings, medications information was lesser versus the private ones, additionally, there is significant association between performing episiotomy, physical abuse by staff and the delivery in shared rooms in private settings. CONCLUSION This study showed that OV was less susceptible during childbirth in private settings compared to public settings. Educational status, low monthly income, occupation are risk factors for OV; also, features of disrespect and abuse like obtaining consent for episiotomy performance, delivery provision updates, care perception based on payment ability and medication information were reported.
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Affiliation(s)
- Omar A. Azzam
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mutah University, Al-Karak 61710, Jordan
- Correspondence:
| | - Amer Mahmoud Sindiani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | | | - Mira K. Odeh
- Faculty of Medicine, Al-Balqaa Applied University, Al-Salt 19117, Jordan
| | - Kenda Y. AbedAlkareem
- Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Sara A. Albanna
- Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Elaf M. Abdulrahman
- Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Weaam Q. Abukhadrah
- Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Haitham O. Hazaimeh
- Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Ashraf Ahmed Zaghloul
- Department of Public Health, Faculty of Medicine, Mutah University, Al-Karak 61710, Jordan
- Department of Health Administration, High Institute of Public Health, Alexandria University, Alexandria 5424041, Egypt
| | - Samir S. Mahgoub
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Mutah University, Al-Karak 61710, Jordan
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Al-Minia University, Al-Minia 2431436, Egypt
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25
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Mena-Tudela D, Soriano-Vidal FJ, Vila-Candel R, Quesada JA, Martínez-Porcar C, Martin-Moreno JM. Is Early Initiation of Maternal Lactation a Significant Determinant for Continuing Exclusive Breastfeeding up to 6 Months? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3184. [PMID: 36833878 PMCID: PMC9966801 DOI: 10.3390/ijerph20043184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND The World Health Organization (WHO) recommends early initiation of breastfeeding (EIBF) within the first hour after birth. However, certain perinatal factors, namely caesarean section, may prevent this goal from being achieved. The aim of our study was to examine the relationship between EIBF (maternal lactation in the first hours and degree of latching before hospital discharge) and the maintenance of exclusive breastfeeding (MBF) up to the recommended 6 months of age (as advocated by the WHO). METHODS This observational, retrospective cohort study included a random sample of all births between 2018 and 2019, characterising the moment of breastfeeding initiation after birth and the infant's level of breast latch (measured by LATCH assessment tool) prior to hospital discharge. Data were collected from electronic medical records and from follow-up health checks of infants up to 6 months postpartum. RESULTS We included 342 women and their newborns. EIBF occurred most often after vaginal (p < 0.001) and spontaneous births with spontaneous amniorrhexis (p = 0.002). LATCH score <9 points was associated with a 1.4-fold relative risk of abandoning MBF (95%CI: 1.2-1.7) compared with a score of 9-10 points. CONCLUSIONS Although we were unable to find a significant association between EIBF in the first 2 h after birth and MBF at 6 months postpartum, low LATCH scores prior to discharge were associated with low MBF, indicating the importance of reinforcing the education and preparation efforts of mothers in the first days after delivery, prior to the establishment of an infant feeding routine upon returning home.
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Affiliation(s)
- Desirée Mena-Tudela
- Department of Nursing, Universitat Jaume I, 12071 Castellón de la Plana, Spain
| | - Francisco Javier Soriano-Vidal
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
- Department of Obstetrics and Gynaecology, Xàtiva-Oninyent Health Department, 46800 Xàtiva, Spain
| | - Rafael Vila-Candel
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, 46600 Alzira, Spain
| | - José Antonio Quesada
- Department of Clinical Medicine, Universidad Miguel Hernández, 03202 Elche, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 03550 Alicante, Spain
| | - Cristina Martínez-Porcar
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, 46600 Alzira, Spain
| | - Jose M. Martin-Moreno
- Department of Preventive Medicine and Public Health, Universitat de València, 46010 Valencia, Spain
- Biomedical Research Institute INCLIVA, Clinic University Hospital, 46010 Valencia, Spain
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Pérez-Escamilla R, Tomori C, Hernández-Cordero S, Baker P, Barros AJD, Bégin F, Chapman DJ, Grummer-Strawn LM, McCoy D, Menon P, Ribeiro Neves PA, Piwoz E, Rollins N, Victora CG, Richter L. Breastfeeding: crucially important, but increasingly challenged in a market-driven world. Lancet 2023; 401:472-485. [PMID: 36764313 DOI: 10.1016/s0140-6736(22)01932-8] [Citation(s) in RCA: 138] [Impact Index Per Article: 138.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 08/18/2022] [Accepted: 09/26/2022] [Indexed: 02/10/2023]
Abstract
In this Series paper, we examine how mother and baby attributes at the individual level interact with breastfeeding determinants at other levels, how these interactions drive breastfeeding outcomes, and what policies and interventions are necessary to achieve optimal breastfeeding. About one in three neonates in low-income and middle-income countries receive prelacteal feeds, and only one in two neonates are put to the breast within the first hour of life. Prelacteal feeds are strongly associated with delayed initiation of breastfeeding. Self-reported insufficient milk continues to be one of the most common reasons for introducing commercial milk formula (CMF) and stopping breastfeeding. Parents and health professionals frequently misinterpret typical, unsettled baby behaviours as signs of milk insufficiency or inadequacy. In our market-driven world and in violation of the WHO International Code for Marketing of Breast-milk Substitutes, the CMF industry exploits concerns of parents about these behaviours with unfounded product claims and advertising messages. A synthesis of reviews between 2016 and 2021 and country-based case studies indicate that breastfeeding practices at a population level can be improved rapidly through multilevel and multicomponent interventions across the socioecological model and settings. Breastfeeding is not the sole responsibility of women and requires collective societal approaches that take gender inequities into consideration.
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Affiliation(s)
- Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA.
| | - Cecília Tomori
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Sonia Hernández-Cordero
- Research Center for Equitable Development (EQUIDE), Universidad Iberoamericana, Mexico City, Mexico
| | - Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Aluisio J D Barros
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | | | | | | | - David McCoy
- International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | - Purnima Menon
- International Food Policy Research Institute, New Delhi, India
| | | | | | - Nigel Rollins
- Department of Maternal, Newborn, Child and Adolescent Health, WHO, Geneva, Switzerland
| | - Cesar G Victora
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Linda Richter
- Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
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Gyamfi A, Spatz DL, Jefferson UT, Lucas R, O'Neill B, Henderson WA. Breastfeeding Social Support Among African American Women in the United States: A Meta-Ethnography. Adv Neonatal Care 2023; 23:72-80. [PMID: 35939758 PMCID: PMC9891275 DOI: 10.1097/anc.0000000000001021] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND In the United States, there are racial disparities in 6 months of exclusive breastfeeding. Only, 25.8% of American infants were breastfed for the first 180 days of life, with African American infants least (19.8%) exclusively breastfed in 2018. PURPOSE The meta-ethnography explored the breastfeeding support for African American women in the United States. DATA SOURCES The online databases of American Psychological Association, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, PubMed, and Scopus were searched with key words, and the search was not limited by the year of publication. STUDY SELECTION The inclusion criteria for the study selection entailed all qualitative studies conducted on breastfeeding support among self-identified African American women in the United States, written in English language, peer reviewed, or dissertation. The initial search produced 905 articles of which 8 met the eligibility criteria. DATA EXTRACTION Data extraction and analysis were guided by Noblit and Hare's (1988) meta-ethnography approach. The analysis process was completed by a team of researchers, inclusive of breastfeeding experts. RESULTS Five overarching themes emerged including trustworthy information; early postpartum support by key influencers; maternal culture; tangible resources, and Black mothers' empowerment. IMPLICATIONS FOR PRACTICE AND RESEARCH Social support is a major determinant for the initiation and continuation of breastfeeding among African American women in the United States. Future longitudinal studies are warranted to explore the social support of breastfeeding among African American women in the United States.
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Affiliation(s)
- Adwoa Gyamfi
- Correspondence: Adwoa Gyamfi, PhD, MPH, BSc, RN, University of Connecticut, School of Nursing, 231 Glenbrook Rd Unit 4026, Storrs, CT 06269 ()
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28
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Radwan H, Fakhry R, Boateng GO, Metheny N, Bani Issa W, Faris ME, Obaid RS, Al Marzooqi S, Al Ghazal H, Dennis CL. Translation and Psychometric Evaluation of the Arabic Version of the Breastfeeding Self-Efficacy Scale-Short Form Among Women in the United Arab Emirates. J Hum Lact 2023; 39:40-50. [PMID: 35363102 DOI: 10.1177/08903344221084623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Breastfeeding self-efficacy as a construct has been theoretically and empirically linked to exclusive breastfeeding in studies globally using the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). However, its application in the Middle East and North Africa region is limited, as it has not been validated. RESEARCH AIMS To psychometrically validate the BSES-SF among a sample of mothers in the United Arab Emirates. METHODS We psychometrically evaluated the Arabic version of the BSES-SF using a sample of mothers (N = 457) residing in the United Arab Emirates. We used translation techniques, item-test and item-total correlations, confirmatory factor analysis, tests of reliability, and tests of validity. RESULTS Item-test correlations of scale items ranged from 0.67 to 0.84, while item-total correlations ranged from 0.58 to 0.81. The confirmatory factor model assessed the 14-item scale to be unidimensional with satisfactory model fit indices. Our findings suggested the Arabic-language version of the BSES-SF was a reliable measure (α = 0.95) with strong construct and discriminant validity. BSES-SF scores significantly predicted exclusive breastfeeding (aOR = 1.04; 95% CI [1.02, 1.08]) and exclusive duration (β = .06; 95% CI [0.4, 0.08]), which suggested strong predictive, validity after adjusting for parity, maternal age, maternal education, and study site. CONCLUSIONS We have provided rigorous evidence that the BSES-SF is a valid and reliable measure of breastfeeding self-efficacy among Arabic-speaking women in the UAE. Interventions designed specifically to increase breastfeeding self-efficacy among Arabic-speaking women may be a mechanism to increase the suboptimal rates of breastfeeding exclusivity occurring in much of the MENA region.
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Affiliation(s)
- Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Randa Fakhry
- Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Godfred O Boateng
- Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, TX, USA
| | - Nick Metheny
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA.,Affiliate Scientist, MAP Centre for Urban Health Solutions, St Michael's Hospital, Toronto, ON Canada
| | - Wegdan Bani Issa
- Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - MoezAlIslam E Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Reyad Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Suad Al Marzooqi
- Department of Psychology, Al Ain, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Hessa Al Ghazal
- Sharjah Child-Friendly Office, Sharjah, United Arab Emirates
| | - Cindy-Lee Dennis
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Venancio SI, Melo DS, Relvas GRB, de Bortoli MC, de Araújo BC, Oliveira CDF, da Silva LALB, de Melo RC, Moreira HDOM, Rodrigues JM. Effective interventions for the promotion of breastfeeding and healthy complementary feeding in the context of Primary Health Care. REVISTA PAULISTA DE PEDIATRIA 2023; 41:e2021362. [DOI: 10.1590/1984-0462/2023/41/2021362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 05/06/2022] [Indexed: 12/23/2022]
Abstract
Abstract Objective: To develop a rapid review on effective actions for the promotion of breastfeeding and healthy complementary feeding in primary health care and to summarize a list of actions and their elements for implementation. Data source: The review included systematic reviews on the effectiveness of interventions to promote breastfeeding and/or healthy complementary feeding for mothers and other caregivers, and/or professionals who work with this population, in comparison with any usual approach or none. Data synthesis: A total of 32 systematic reviews were included in the evidence synthesis. Ten types of interventions were evaluated in systematic reviews on promotion of breastfeeding and four types of interventions on promotion of healthy complementary feeding. The synthesis allowed six aspects to be discussed, and these must be considered to increase the chances of interventions’ impact: type of intervention, target audience, timing of intervention, actors that can implement it, strategies and methods of intervention, and intensity of intervention. Conclusions: It was possible to assemble a list of actions whose effectiveness has already been demonstrated, providing elements for local adaptations. Evidence is expected to support and strengthen the implementation of programs aimed at promoting breastfeeding and complementary feeding in primary health care.
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30
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A theory-based behavioural change communication intervention to decrease the provision of water to infants under 6 months of age in the Republic of Guinea. Public Health Nutr 2022; 25:3067-3078. [PMID: 35983677 PMCID: PMC9991650 DOI: 10.1017/s1368980022001732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE In many countries, the provision of water in the early months of a baby's life jeopardises exclusive breast-feeding (EBF). Using a behavioural theory, this study assessed the impact of a behaviour change intervention on mothers' intention to act and, in turn, on the water provision in addition to breast milk to their infants under 6 months of age (IU6M) in two regions of Guinea. DESIGN A quasi-experimental design. Data on individual and environmental factors of the theoretical framework, sociodemographic and outcomes were collected using validated questionnaires before and after the intervention. The outcomes examined were the intention to provide water to IU6M, the provision of water and EBF. Path analyses were performed to investigate pathways by which psychosocial and environmental factors influenced the water provision in addition to breast milk. SETTING Four health centres were assigned randomly to each study's arm (one control/CG and one intervention group/IG per region). PARTICIPANTS The sample included 300 mothers of IU6M: 150 per group. RESULTS In IG, the proportion of mothers providing water decreased from 61 % to 29 % before and after the intervention (P < 0·001), while no difference was observed in CG (P = 0·097). The EBF rate increased in IG (from 24·0 % to 53·8 %, P < 0·001) as opposed to CG (36·7 % to 45·9 %, P = 0·107). An association (P < 0·001) between the intention and the behaviour was observed in both groups. CONCLUSIONS An intervention developed using a sound framework reduces the provision of water among IU6M and improves EBF.
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Shing JS, Lok KY, Fong DY, Fan HS, Chow CL, Tarrant M. The Influence of the Baby-Friendly Hospital Initiative and Maternity Care Practices on Breastfeeding Outcomes. J Hum Lact 2022; 38:700-710. [PMID: 35403491 DOI: 10.1177/08903344221086975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Baby-Friendly Hospital Initiative (BFHI) was launched in 1991 to promote breastfeeding through hospital policy. Researchers have reported breastfeeding improvements after hospitals became "Baby-Friendly." In Hong Kong, the first public hospital was designated as a Baby-Friendly Hospital in 2016. RESEARCH AIM To examine the influence of the BFHI on breastfeeding by comparing breastfeeding outcomes in a study cohort recruited before the implementation of the BFHI and a cohort recruited after its implementation. METHODS This was a quasi-experimental interrupted time-series design. Two cohorts of mother-infant pairs (N = 2369) were recruited immediately postpartum from four public hospitals in Hong Kong and followed up prospectively. Comparisons were made in five of the BFHI steps experienced in both cohorts and the duration of any and exclusive breastfeeding. RESULTS A higher proportion of participants from the post-implementation cohort breastfed and breastfed exclusively at all follow-up periods. Participants in the pre-BFHI cohort, on average experienced 3.10 (SD = 1.42) of the BFHI steps, whereas the participants in the post-BFHI cohort experienced 3.59 (1.09) of the BFHI steps. Half of the participants discontinued any breastfeeding by 13 weeks in the pre-BFHI cohort; more than half in the post-BFHI cohort were still breastfeeding at 6 months postpartum (p < .001). Giving only human milk in the first 48 hr of delivery and not providing pacifiers or bottles were associated with lower risk of not exclusive breastfeeding in both cohorts. CONCLUSION Implementation of the BFHI was associated with improvements in breastfeeding practices and outcomes.
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Affiliation(s)
- Jeffery Sy Shing
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Kris Yw Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yt Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Heidi Sl Fan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Charlotte Ly Chow
- 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, Kelowna, BC, Canada
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Gavine A, Shinwell SC, Buchanan P, Farre A, Wade A, Lynn F, Marshall J, Cumming SE, Dare S, McFadden A. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev 2022; 10:CD001141. [PMID: 36282618 PMCID: PMC9595242 DOI: 10.1002/14651858.cd001141.pub6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is extensive evidence of important health risks for infants and mothers related to not breastfeeding. In 2003, the World Health Organization recommended that infants be breastfed exclusively until six months of age, with breastfeeding continuing as an important part of the infant's diet until at least two years of age. However, current breastfeeding rates in many countries do not reflect this recommendation. OBJECTIVES 1. To describe types of breastfeeding support for healthy breastfeeding mothers with healthy term babies. 2. To examine the effectiveness of different types of breastfeeding support interventions in terms of whether they offered only breastfeeding support or breastfeeding support in combination with a wider maternal and child health intervention ('breastfeeding plus' support). 3. To examine the effectiveness of the following intervention characteristics on breastfeeding support: a. type of support (e.g. face-to-face, telephone, digital technologies, group or individual support, proactive or reactive); b. intensity of support (i.e. number of postnatal contacts); c. person delivering the intervention (e.g. healthcare professional, lay person); d. to examine whether the impact of support varied between high- and low-and middle-income countries. SEARCH METHODS We searched Cochrane Pregnancy and Childbirth's Trials Register (which includes results of searches of CENTRAL, MEDLINE, Embase, CINAHL, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform (ICTRP)) (11 May 2021) and reference lists of retrieved studies. SELECTION CRITERIA Randomised or quasi-randomised controlled trials comparing extra support for healthy breastfeeding mothers of healthy term babies with usual maternity care. Support could be provided face-to-face, over the phone or via digital technologies. All studies had to meet the trustworthiness criteria. DATA COLLECTION AND ANALYSIS: We used standard Cochrane Pregnancy and Childbirth methods. Two review authors independently selected trials, extracted data, and assessed risk of bias and study trustworthiness. The certainty of the evidence was assessed using the GRADE approach. MAIN RESULTS This updated review includes 116 trials of which 103 contribute data to the analyses. In total more than 98,816 mother-infant pairs were included. Moderate-certainty evidence indicated that 'breastfeeding only' support probably reduced the number of women stopping breastfeeding for all primary outcomes: stopping any breastfeeding at six months (Risk Ratio (RR) 0.93, 95% Confidence Interval (CI) 0.89 to 0.97); stopping exclusive breastfeeding at six months (RR 0.90, 95% CI 0.88 to 0.93); stopping any breastfeeding at 4-6 weeks (RR 0.88, 95% CI 0.79 to 0.97); and stopping exclusive breastfeeding at 4-6 (RR 0.83 95% CI 0.76 to 0.90). Similar findings were reported for the secondary breastfeeding outcomes except for any breastfeeding at two months and 12 months when the evidence was uncertain if 'breastfeeding only' support helped reduce the number of women stopping breastfeeding. The evidence for 'breastfeeding plus' was less consistent. For primary outcomes there was some evidence that 'breastfeeding plus' support probably reduced the number of women stopping any breastfeeding (RR 0.94, 95% CI 0.91 to 0.97, moderate-certainty evidence) or exclusive breastfeeding at six months (RR 0.79, 95% CI 0.70 to 0.90). 'Breastfeeding plus' interventions may have a beneficial effect on reducing the number of women stopping exclusive breastfeeding at 4-6 weeks, but the evidence is very uncertain (RR 0.73, 95% CI 0.57 to 0.95). The evidence suggests that 'breastfeeding plus' support probably results in little to no difference in the number of women stopping any breastfeeding at 4-6 weeks (RR 0.94, 95% CI 0.82 to 1.08, moderate-certainty evidence). For the secondary outcomes, it was uncertain if 'breastfeeding plus' support helped reduce the number of women stopping any or exclusive breastfeeding at any time points. There were no consistent findings emerging from the narrative synthesis of the non-breastfeeding outcomes (maternal satisfaction with care, maternal satisfaction with feeding method, infant morbidity, and maternal mental health), except for a possible reduction of diarrhoea in intervention infants. We considered the overall risk of bias of trials included in the review was mixed. Blinding of participants and personnel is not feasible in such interventions and as studies utilised self-report breastfeeding data, there is also a risk of bias in outcome assessment. We conducted meta-regression to explore substantial heterogeneity for the primary outcomes using the following categories: person providing care; mode of delivery; intensity of support; and income status of country. It is possible that moderate levels (defined as 4-8 visits) of 'breastfeeding only' support may be associated with a more beneficial effect on exclusive breastfeeding at 4-6 weeks and six months. 'Breastfeeding only' support may also be more effective in reducing women in low- and middle-income countries (LMICs) stopping exclusive breastfeeding at six months compared to women in high-income countries (HICs). However, no other differential effects were found and thus heterogeneity remains largely unexplained. The meta-regression suggested that there were no differential effects regarding person providing support or mode of delivery, however, power was limited. AUTHORS' CONCLUSIONS: When 'breastfeeding only' support is offered to women, the duration and in particular, the exclusivity of breastfeeding is likely to be increased. Support may also be more effective in reducing the number of women stopping breastfeeding at three to four months compared to later time points. For 'breastfeeding plus' interventions the evidence is less certain. Support may be offered either by professional or lay/peer supporters, or a combination of both. Support can also be offered face-to-face, via telephone or digital technologies, or a combination and may be more effective when delivered on a schedule of four to eight visits. Further work is needed to identify components of the effective interventions and to deliver interventions on a larger scale.
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Affiliation(s)
- Anna Gavine
- Mother and Infant Research Unit, School of Health Sciences, University of Dundee, Dundee, UK
| | - Shona C Shinwell
- Mother and Infant Research Unit, School of Health Sciences, University of Dundee, Dundee, UK
| | | | - Albert Farre
- Mother and Infant Research Unit, School of Health Sciences, University of Dundee, Dundee, UK
| | - Angela Wade
- Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, London, UK
| | - Fiona Lynn
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, Belfast, UK
| | - Joyce Marshall
- Division of Maternal Health, University of Huddersfield, Huddersfield, UK
| | - Sara E Cumming
- Mother and Infant Research Unit, School of Health Sciences, University of Dundee, Dundee, UK
- Mother and Infant Research Unit, University of Dundee, Dundee, UK
| | - Shadrach Dare
- Mother and Infant Research Unit, School of Health Sciences, University of Dundee, Dundee, UK
| | - Alison McFadden
- Mother and Infant Research Unit, School of Health Sciences, University of Dundee, Dundee, UK
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Shipton EV, Callaway L, Foxcroft K, Lee N, de Jersey SJ. Midwife-Led Continuity of Antenatal Care and Breastfeeding Duration Beyond Postpartum Hospital Discharge: A Systematic Review. J Hum Lact 2022:8903344221126644. [PMID: 36197006 DOI: 10.1177/08903344221126644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life and that breastfeeding should continue for 2 years and beyond. Most women initiate breastfeeding, but many do not continue for the recommended duration. While midwife-led continuity of antenatal care is linked to improved mother and infant outcomes, the influence on breastfeeding duration has not been previously reviewed. RESEARCH AIM To critically analyze the literature that compared midwife-led continuity of antenatal care with other models of care where researchers have measured breastfeeding duration beyond postpartum hospital discharge. METHODS A systematic literature review with critical analysis was used to answer the research aim. We systematically searched and screened five databases for quantitative studies where researchers had reported breastfeeding duration beyond postpartum hospital discharge after midwife-led continuity of antenatal care, compared with another model of antenatal care. Methodological quality was assessed using tools from the Cochrane Collaboration (RoB2 and ROBINS-I). In total, nine studies met the inclusion criteria. RESULTS Clear conclusions about the association between midwife-led continuity of antenatal care and breastfeeding duration were not found. The risk of bias within non-randomized studies ranged from serious to critical, and a judgement of "some concerns" of risk of bias in the one randomized study. CONCLUSION To date, the question of whether midwife-led continuity of antenatal care improves breastfeeding duration has not been established. There has been a lack of consistency in definitions of breastfeeding and descriptions of models of care, which has weakened the evidence-based of literature reviewed.Our review protocol was registered with PROSPERO; although due to COVID-19, this registration was not checked for eligibility by the PROSPERO team (CRD42020151276). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020151276.
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Affiliation(s)
- Emma V Shipton
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Metro North Hospital and Health Service, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Leonie Callaway
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Metro North Hospital and Health Service, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Katie Foxcroft
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Metro North Hospital and Health Service, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Nigel Lee
- School of Nursing, Midwifery and Social Work, The University of Queensland, South Brisbane, QLD, Australia
| | - Susan J de Jersey
- University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Metro North Hospital and Health Service, Royal Brisbane and Women's Hospital, Brisbane, Australia
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Anaba UC, Johansson EW, Abegunde D, Adoyi G, Umar-Farouk O, Abdu-Aguye S, Hewett PC, Hutchinson PL. The role of maternal ideations on breastfeeding practices in northwestern Nigeria: a cross-section study. Int Breastfeed J 2022; 17:63. [PMID: 36050774 PMCID: PMC9438163 DOI: 10.1186/s13006-022-00500-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/08/2022] [Indexed: 11/21/2022] Open
Abstract
Background Early initiation of breastfeeding within the first hour of birth and exclusive breastfeeding (EBF) for the first six months of life are beneficial for child survival and long-term health. Yet breastfeeding rates remain sub-optimal in Northwestern Nigeria, and such practices are often influenced by complex psychosocial factors at cognitive, social and emotional levels. To understand these influences, we developed a set of breastfeeding-related ideational factors and quantitatively examined their relationship with early initiation of breastfeeding and EBF practices. Methods A cross‐sectional population‐based survey was conducted in Kebbi, Sokoto, and Zamfara states from September–October 2019. A random sample of 3039 women with a child under-2 years was obtained. Respondents were asked about the two main outcomes, early initiation of breastfeeding and EBF, as well as breastfeeding-related ideations according to the Ideation Model of Strategic Communication and Behavior Change. Average marginal effects were estimated from mixed-effects logistic regression models adjusted for ideational and socio-demographic variables. Results Among 3039 women with a child under 2 years of age, 42.1% (95% CI 35.1%, 49.4%) practiced early initiation of breastfeeding, while 37.5% (95% CI 29.8%, 46.0%) out of 721 infants aged 0–5 months were exclusively breastfed. Women who knew early initiation of breastfeeding was protective of newborn health had 7.9 percentage points (pp) [95% CI 3.9, 11.9] higher likelihood of early initiation of breastfeeding practice than those who did not know. Women who believed colostrum was harmful had 8.4 pp lower likelihood of early initiation of breastfeeding (95% CI -12.4, -4.3) and EBF (95% CI -15.7%, -1.0%) than those without that belief. We found higher likelihood of early initiation of breastfeeding (5.1 pp, 95% CI 0.8%, 9.4%) and EBF (13.3 pp, 95% CI 5.0%, 22.0%) among women who knew at least one benefit of breastfeeding compared to those who did not know. Knowing the timing for introducing complementary foods andself-efficacy to practice EBF were also significantly associated with EBF practices. Conclusion Ideational metrics provide significant insights for SBC programs aiming to change and improve health behaviors, including breastfeeding practices, Various cognitive, emotional and social domains played a significant role in women’s breastfeeding decisions. Maternal knowledge about the benefits of breastfeeding to the mother (cognitive), knowledge of the appropriate time to introduce complementary foods (cognitive), beliefs on colostrum (cognitive), self-efficacy to breastfeed (emotional) and perceived social norms (social) are among the most important ideations for SBC programs to target to increase early initiation of breastfeeding and EBF rates in northwestern Nigeria.
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Affiliation(s)
- Udochisom C Anaba
- Breakthrough RESEARCH/Nigeria, Plot 839 Idris Ibrahim Crescent, Jabi, Abuja, Nigeria. .,Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA.
| | - Emily White Johansson
- Breakthrough RESEARCH/Nigeria, Plot 839 Idris Ibrahim Crescent, Jabi, Abuja, Nigeria.,Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
| | - Dele Abegunde
- Breakthrough RESEARCH/Nigeria, Plot 839 Idris Ibrahim Crescent, Jabi, Abuja, Nigeria.,Formerly Population Council, Washington DC, USA
| | - Gloria Adoyi
- Breakthrough ACTION/Nigeria, Abuja, Nigeria.,Save the Children, Abuja, Nigeria
| | - Olayinka Umar-Farouk
- Breakthrough ACTION/Nigeria, Abuja, Nigeria.,Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | - Shittu Abdu-Aguye
- Breakthrough ACTION/Nigeria, Abuja, Nigeria.,Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | | | - Paul L Hutchinson
- Breakthrough RESEARCH/Nigeria, Plot 839 Idris Ibrahim Crescent, Jabi, Abuja, Nigeria.,Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
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35
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Manzar S. Severity of Hyperbilirubinaemia. J Paediatr Child Health 2022; 58:1704. [PMID: 35851734 DOI: 10.1111/jpc.16123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Shabih Manzar
- Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, Louisiana, United States
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Titaley CR, Dibley MJ, Ariawan I, Mu'asyaroh A, Paramashanti BA, Alam A, Damayanti R, Do TT, Ferguson E, Htet MK, Li M, Sutrisna A, Fahmida U. The impact of a package of behaviour change interventions on breastfeeding practices in East Java Province, Indonesia. MATERNAL & CHILD NUTRITION 2022; 18:e13362. [PMID: 35488406 PMCID: PMC9218323 DOI: 10.1111/mcn.13362] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 03/15/2022] [Accepted: 03/30/2022] [Indexed: 11/30/2022]
Abstract
Suboptimal infant young child feeding practices are frequently reported globally, including in Indonesia. This analysis examined the impact of a package of behaviour change interventions on breastfeeding practices in Malang and Sidoarjo Districts, East Java Province, Indonesia. The BADUTA study (which in the Indonesian Language is an acronym for BAwah DUa TAhun, or children aged less than 2 years) was an impact evaluation using a cluster‐randomized controlled trial with two parallel treatment arms. We conducted household surveys in 12 subdistricts from Malang and Sidoarjo. We collected information from 5175 mothers of children aged 0–23 months: 2435 mothers at baseline (February 2015) and 2740 mothers at endline (January to February 2017). This analysis used two indicators for fever and diarrhoea and seven breastfeeding indicators (early initiation of breastfeeding, prelacteal feeding, exclusive breastfeeding under 6 months, predominant breastfeeding, continued breastfeeding, age‐appropriate breastfeeding and bottle‐feeding). We used multilevel logistic regression analysis to assess the effect of the intervention. After 2 years of implementation of interventions, we observed an increased odds of exclusive breastfeeding under 6 months (adjusted odds ratio [aOR] = 1.85; 95% confidence interval [CI]: 1.35–2.53) and age‐appropriate breastfeeding (aOR = 1.39; 95% CI: 1.07–1.79) in the intervention group than in the comparison group, at the endline survey. We found significantly lower odds for prelacteal feeding (aOR = 0.52; 95% CI: 0.41–0.65) in the intervention than in the comparison group. Our findings confirmed the benefits of integrated, multilayer behaviour change interventions to promote breastfeeding practices. Further research is required to develop effective interventions to reduce bottle use and improve other breastfeeding indicators that did not change with the BADUTA intervention. The integrated package of behaviour change interventions in the BADUTA study (which in the Indonesian Language is an acronym for BAwah DUa TAhun, or children aged less than 2 years) increased exclusive and age‐appropriate breastfeeding practices in children under 2 years old in Indonesia. The BADUTA study interventions did not significantly affect early breastfeeding initiation, breastfeeding in the last 24 h, ever breastfed, continued breastfeeding, predominant breastfeeding, bottle‐feeding practices, fever and diarrhoea 2 weeks before the interview. Further research is required to develop effective interventions to improve continued breastfeeding after 12 months of age and reduce predominant breastfeeding for children aged 0–5 months and bottle‐feeding practices.
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Affiliation(s)
| | - Michael J Dibley
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Iwan Ariawan
- Center for Health Research, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Anifatun Mu'asyaroh
- Alian Health Center, District Health Office of Kebumen, Central Java, Indonesia
| | - Bunga Astria Paramashanti
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.,Department of Nutrition, Faculty of Health Sciences, Universitas Alma Ata, Yogyakarta, Indonesia
| | - Ashraful Alam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Rita Damayanti
- Center for Health Research, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Tran Thanh Do
- National Institute of Nutrition, Hai Bà Trưng, Hanoi, Vietnam
| | - Elaine Ferguson
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Min Kyaw Htet
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.,South-East Asian Ministers of Education Organization, Regional Center for Food and Nutrition, Pusat Kajian Gizi Regional Universitas Indonesia, Jakarta, Indonesia
| | - Mu Li
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Aang Sutrisna
- Global Alliance for Improved Nutrition (GAIN), Jakarta, Indonesia
| | - Umi Fahmida
- South-East Asian Ministers of Education Organization, Regional Center for Food and Nutrition, Pusat Kajian Gizi Regional Universitas Indonesia, Jakarta, Indonesia
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Mokha S, Heintz C, Agrawal V, Reynolds AM, Berkelhamer SK. Increased prevalence of severe neonatal hyperbilirubinaemia during social distancing. J Paediatr Child Health 2022; 58:991-995. [PMID: 34997787 DOI: 10.1111/jpc.15881] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 12/16/2022]
Abstract
AIM Social distancing guidelines implemented with the COVID-19 pandemic impacted health-care utilisation and disrupted critical social supports. Resurgence of highly transmissible strains has resulted in revisiting restrictions with potential impacts on newborn health. With concerns for inadequate post-partum support, we sought to determine if social distancing correlated with increased rates of readmission for hyperbilirubinaemia. METHODS Retrospective chart review identified all readmissions for hyperbilirubinaemia between 1/18 and 4/20 in Western New York. Infant/maternal demographics and data on hospital course were collected on control (1/1/18-31/1/20) and social distancing (1/2/20-30/4/20) cohorts. Nineteen outpatient clinics were surveyed regarding lactation support. RESULTS Monthly readmissions for hyperbilirubinaemia nearly tripled during social distancing (0.90 ± 0.91 vs. 2.63 ± 2.29 per 1000 births during early COVID, P = 0.015). Comparable severity of disease at readmission was observed with no difference in the need for therapies (phototherapy, intravenous immunoglobulin or exchange transfusion) or length of hospital stay. Mothers were younger (25.8 ± 3.3 vs. 31.3 ± 4.7 years; P = 0.005) with higher rates of primiparity and exclusive breastfeeding than national norms, however not significantly higher than controls in our small cohort (62.5 vs. 37.0% for primiparity; 87.5 vs. 81.5% for breastfeeding). Of 19 clinics surveyed, only six confirmed a telemedicine option for lactation support. CONCLUSIONS Rates of readmission for hyperbilirubinaemia increased during social distancing. Younger maternal age with high rates of primiparity and exclusive breastfeeding raise concern for inadequate social and/or lactation support. Proactive identification of mothers at risk and expansion of remote lactation services may be indicated with recurrent waves of the pandemic.
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Affiliation(s)
- Sonam Mokha
- Department of Pediatrics, University of California Davis, Sacramento, California, United States
| | - Chana Heintz
- Department of Pediatrics, University at Buffalo SUNY, Buffalo, New York, United States
| | - Vikash Agrawal
- Department of Pediatrics, Loma Linda University, San Bernardino, California, United States
| | - Anne Marie Reynolds
- Department of Pediatrics, University at Buffalo SUNY, Buffalo, New York, United States
| | - Sara K Berkelhamer
- Department of Pediatrics, University of Washington, Seattle, Washington, United States
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Tomori C, Hernández-Cordero S, Busath N, Menon P, Pérez-Escamilla R. What works to protect, promote and support breastfeeding on a large scale: A review of reviews. MATERNAL & CHILD NUTRITION 2022; 18 Suppl 3:e13344. [PMID: 35315573 PMCID: PMC9113479 DOI: 10.1111/mcn.13344] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 01/08/2023]
Abstract
Globally women continue to face substantial barriers to breastfeeding. The 2016 Lancet Breastfeeding Series identified key barriers and reviewed effective interventions that address them. The present study updates the evidence base since 2016 using a review of reviews approach. Searches were implemented using the Epistomenikos database. One hundred and fifteen reviews of interventions were identified and assessed for quality and risk of bias. Over half of reviews (53%) were high- or moderate quality, with the remaining low or critically low quality due to weaknesses in assessment of bias. A large portion of studies addressed high-income and upper-middle income settings, (41%), and a majority (63%) addressed health systems, followed by community and family settings (39%). Findings from reviews continue to strengthen the evidence base for effective interventions that improve breastfeeding outcomes across all levels of the social-ecological model, including supportive workplace policies; implementation of the Baby-Friendly Hospital Initiative, skin to skin care, kangaroo mother care, and cup feeding in health settings; and the importance of continuity of care and support in community and family settings, via home visits delivered by CHWs, supported by fathers', grandmothers' and community involvement. Studies disproportionately focus on health systems in high income and upper-middle income settings. There is insufficient attention to policy and structural interventions, the workplace and there is a need for rigorous assessment of multilevel interventions. Evidence from the past 5 years demonstrates the need to build on well-established knowledge to scale up breastfeeding protection, promotion and support programmes.
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Affiliation(s)
- Cecília Tomori
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA.,Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Natalie Busath
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Purnima Menon
- International Food Policy Research Institute, Delhi, India
| | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Rhode Island, USA
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Valero-Chillerón MJ, Mena-Tudela D, Cervera-Gasch Á, González-Chordá VM, Soriano-Vidal FJ, Quesada JA, Castro-Sánchez E, Vila-Candel R. Influence of Health Literacy on Maintenance of Exclusive Breastfeeding at 6 Months Postpartum: A Multicentre Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095411. [PMID: 35564807 PMCID: PMC9104596 DOI: 10.3390/ijerph19095411] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/23/2022] [Accepted: 04/27/2022] [Indexed: 01/27/2023]
Abstract
Background: International organizations recommend initiating breastfeeding within the first hour of life and maintaining exclusive breastfeeding for the first 6 months. However, worldwide rates of exclusive breastfeeding for 6-month-old infants is far from meeting the goal proposed by the World Health Organization, which is to reach a minimum of 50% of infants. Education is one of the factors affecting the initiation and continuation of breastfeeding, and incidentally, it is also related to lower health literacy. This study explored the influence of health literacy on maintenance of exclusive breastfeeding at 6 months postpartum. Methods: A longitudinal multicenter study with 343 women were recruited between January 2019 and January 2020. The first questionnaire was held during the puerperium (24−48 h) with mothers practicing exclusive breastfeeding, with whom 6-month postpartum breastfeeding follow-up was performed. Socio-demographic, clinical and obstetric variables were collected. Breastfeeding efficiency was assessed using the LATCH breastfeeding assessment tool. The health literacy level was evaluated by the Newest Vital Sign screening tool. A multivariate logistic regression model was used to detect protective factors for early exclusive breastfeeding cessation. Results: One third of the women continued exclusive breastfeeding at 6 months postpartum. Approximately half the participants had a low or inadequate health literacy level. An adequate health literacy level, a high LATCH breastfeeding assessment tool score (>9 points) and being married were the protective factors against exclusive breastfeeding cessation at 6 months postpartum. Conclusion: Health literacy levels are closely related to maintaining exclusive breastfeeding and act as a protective factor against early cessation. A specific instrument is needed to measure the lack of “literacy in breastfeeding”, in order to verify the relationship between health literacy and maintenance of exclusive breastfeeding.
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Affiliation(s)
- María Jesús Valero-Chillerón
- Department of Nursing, Universitat Jaume I, Av. de Vicent Sos Baynat, 12071 Castelló, Spain; (M.J.V.-C.); (Á.C.-G.); (V.M.G.-C.)
| | - Desirée Mena-Tudela
- Department of Nursing, Universitat Jaume I, Av. de Vicent Sos Baynat, 12071 Castelló, Spain; (M.J.V.-C.); (Á.C.-G.); (V.M.G.-C.)
- Correspondence:
| | - Águeda Cervera-Gasch
- Department of Nursing, Universitat Jaume I, Av. de Vicent Sos Baynat, 12071 Castelló, Spain; (M.J.V.-C.); (Á.C.-G.); (V.M.G.-C.)
| | - Víctor Manuel González-Chordá
- Department of Nursing, Universitat Jaume I, Av. de Vicent Sos Baynat, 12071 Castelló, Spain; (M.J.V.-C.); (Á.C.-G.); (V.M.G.-C.)
| | - Francisco Javier Soriano-Vidal
- Department of Nursing, Universitat de València, 46010 Valencia, Spain; (F.J.S.-V.); (R.V.-C.)
- Department of Nursing, University of Alicante, 03080 Alicante, Spain
- Department of Obstetrics and Gynaecology, Hospital Luis Alcanyis, 46819 Xàtiva, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO-SP), 46020 Valencia, Spain
| | - José Antonio Quesada
- Department of Clinical Medicine, Universidad Miguel Hernández, 03202 Elche, Spain;
| | - Enrique Castro-Sánchez
- Health Protection Research Unit in Healthcare-Associated Infection and Antimicrobial Resistance at Imperial College London, London W12 0NN, UK;
- College of Nursing, Midwifery and Healthcare, University of West London, Brentford TW8 9GA, UK
| | - Rafael Vila-Candel
- Department of Nursing, Universitat de València, 46010 Valencia, Spain; (F.J.S.-V.); (R.V.-C.)
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO-SP), 46020 Valencia, Spain
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, 46600 Valencia, Spain
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Kim TH, Chung SH, Kim JH, Ahn Y, Shin SM, Lee WR, Choi EK, Lee J, Shin HJ, Jung E, Heo JS, Lee JA, Lee SM, Bae SP, Song J, Kim CY, Yi DY. Survey on the Status of Breastfeeding in Korean Medical Institution Workers. J Korean Med Sci 2022; 37:e120. [PMID: 35437968 PMCID: PMC9015900 DOI: 10.3346/jkms.2022.37.e120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/17/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Human breast milk is essential and provides irreplaceable nutrients for early humans. However, breastfeeding is not easy for various reasons in medical institution environments. Therefore, in order to improve the breastfeeding environment, we investigated the difficult reality of breastfeeding through questionnaire responses from medical institution workers. METHODS A survey was conducted among 179 medical institution workers with experience in childbirth within the last five years. The survey results of 175 people were analyzed, with incoherent answers excluded. RESULTS Of the 175 people surveyed, a total of 108 people (61.7%) worked during the day, and 33 people (18.9%) worked in three shifts. Among 133 mothers who stayed with their babies in the same nursing room, 111 (93.3%) kept breastfeeding for more than a month, but among those who stayed apart, only 10 (71.4%) continued breastfeeding for more than a month (P = 0.024). Ninety-five (88.0%) of daytime workers, 32 (94.1%) two-shift workers, and 33 (100%) three-shift workers continued breastfeeding for more than a month (P = 0.026). Workers in general hospitals tended to breastfeed for significantly longer than those that worked in tertiary hospitals (P = 0.003). A difference was also noted between occupation categories (P = 0.019), but a more significant difference was found in the comparison between nurses and doctors (P = 0.012). Longer breastfeeding periods were noted when mothers worked three shifts (P = 0.037). Depending on the period planned for breastfeeding prior to childbirth, the actual breastfeeding maintenance period after birth showed a significant difference (P = 0.002). Of 112 mothers who responded to the question regarding difficulties in breastfeeding after returning to work, 87 (77.7%) mentioned a lack of time caused by being busy at work, 82 (73.2%) mentioned the need for places and appropriate circumstances. CONCLUSION In medical institutions, it is recommended that environmental improvements in medical institutions, the implementation of supporting policies, and the provision of specialized education on breastfeeding are necessary to promote breastfeeding.
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Affiliation(s)
- Tae Hyeong Kim
- Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Sung-Hoon Chung
- Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
| | - Jun Hwan Kim
- Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Youngmin Ahn
- Department of Pediatrics, Jangs Hospital, Seoul, Korea
| | - Son Moon Shin
- Department of Pediatrics, Inje University Busan Paik Hospital, Busan, Korea
| | - Woo Ryoung Lee
- Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Eui Kyung Choi
- Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Juyoung Lee
- Department of Pediatrics, Bucheon St. Mary's Hospital, The Catholic University College of Medicine, Bucheon, Korea
| | - Hye-Jung Shin
- Department of Pediatrics, National Medical Center, Seoul, Korea
| | - Euiseok Jung
- Department of Pediatrics, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | - Ju Sun Heo
- Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jin A Lee
- Department of Pediatrics, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Seong Phil Bae
- Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jeonglyn Song
- Chung-Ang University Industry Academic Cooperation Foundation, Seoul, Korea
| | - Chae-Young Kim
- Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Dae Yong Yi
- Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
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Gavine A, Marshall J, Buchanan P, Cameron J, Leger A, Ross S, Murad A, McFadden A. Remote provision of breastfeeding support and education: Systematic review and meta-analysis. MATERNAL & CHILD NUTRITION 2022; 18:e13296. [PMID: 34964542 PMCID: PMC8932718 DOI: 10.1111/mcn.13296] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/23/2022]
Abstract
The Covid-19 pandemic has led to a substantial increase in remotely provided maternity care services, including breastfeeding support. It is, therefore, important to understand whether breastfeeding support provided remotely is an effective method of support. To determine if breastfeeding support provided remotely is an effective method of support. A systematic review and meta-analysis were conducted. Twenty-nine studies were included in the review and 26 contributed data to the meta-analysis. Remotely provided breastfeeding support significantly reduced the risk of women stopping exclusive breastfeeding at 3 months by 25% (risk ratio [RR]: 0.75, 95% confidence interval [CI]: 0.63, 0.90). There was no significant difference in the number of women stopping any breastfeeding at 4-8 weeks (RR: 1.10, 95% CI: 0.74, 1.64), 3 months (RR: 0.89, 95% CI: 0.71, 1.11), or 6 months (RR: 0.91, 95% CI: 0.81, 1.03) or the number of women stopping exclusive breastfeeding at 4-8 weeks (RR: 0.86, 95% CI: 0.70, 1.07) or 6 months (RR: 0.93, 95% CI: 0.85, 1.0). There was substantial heterogeneity of interventions in terms of mode of delivery, intensity, and providers. This demonstrates that remote interventions can be effective for improving exclusive breastfeeding at 3 months but the certainty of the evidence is low. Improvements in exclusive breastfeeding at 4-8 weeks and 6 months were only found when studies at high risk of bias were excluded. They are also less likely to be effective for improving any breastfeeding. Remote provision of breastfeeding support and education could be provided when it is not possible to provide face-to-face care.
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Affiliation(s)
- Anna Gavine
- School of Health SciencesUniversity of DundeeDundeeScotlandUK
| | - Joyce Marshall
- Department of Nursing and MidwiferyUniversity of HuddersfieldHuddersfieldUK
| | | | - Joan Cameron
- School of Health SciencesUniversity of DundeeDundeeScotlandUK
| | | | - Sam Ross
- School of Medicine, Dentistry and NursingUniversity of Glasgow and NHS Greater Glasgow and ClydeGlasgowScotlandUK
| | - Amal Murad
- Maternity and Childhood Nursing Department, College of NursingTaibah UniversityMedinaSaudi Arabia
| | - Alison McFadden
- School of Health SciencesUniversity of DundeeDundeeScotlandUK
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Magenis ML, de Faveri W, Castro K, Forte GC, Grande AJ, Perry IS. Down syndrome and breastfeeding: A systematic review. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:244-263. [PMID: 33234015 DOI: 10.1177/1744629520970078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Several conditions related to serious difficulty in initiating and maintaining breastfeeding in neonates with Down syndrome are described in the literature. This study aimed to investigate the frequency of breastfeeding in neonates with Down syndrome, as well as the reasons for not breastfeeding, through a systematic literature review by searching MEDLINE via PubMed, Cochrane Library, Scopus, Embase via Elsevier, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Sixteen studies were included with a total sample size of 2022 children with Down syndrome. The frequency of exclusive breastfeeding was 31.6-55.4%, with five studies reporting breastfeeding for longer than 6 months. Breastfeeding from birth was present for 48-92.5% of the children with Down syndrome in six studies. Two studies reported that around 50% and 23.3% of the children with Down syndrome were never breastfed, and rates of breastfeeding in infants with Down syndrome were lower than those in controls in three studies. The reasons for not breastfeeding or cessation of breastfeeding were associated with Down syndrome-specific challenges, maternal reasons, and healthcare aspects.
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Saade S, Flacking R, Ericson J. Parental experiences and breastfeeding outcomes of early support to new parents from family health care centres-a mixed method study. BMC Pregnancy Childbirth 2022; 22:150. [PMID: 35197015 PMCID: PMC8867764 DOI: 10.1186/s12884-022-04469-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/11/2022] [Indexed: 11/22/2022] Open
Abstract
Background Early parenthood is a sensitive period for parents. Parents may feel uncertain about their new roles and unsure about where to find trusted information and support. The aim of this study was to explore the association between breastfeeding and early home visits and a proactive telephone support intervention and to describe parental experiences. Method This study was conducted as a mixed method study with a convergent design using qualitative data from the written comments of parents, and the quantitative data consisted of demographics, breastfeeding, and Likert questions about parents’ satisfaction with the early home visit and telephone support. Historic control (2017–2018) and intervention (2019–2020) data were collected from one family health care centre, and control (2019–2020) data were collected from another family health care centre. Results In total, 838 infants, 42 mothers and 38 fathers contributed to the data in the study. The intervention group had a statistically significantly earlier home visit than the control groups. Early home visits and proactive telephone support to parents with newborn infants were not associated with breastfeeding outcomes up to six months after birth, but we could not exclude the possibility that this was a consequence of our observational study design. However, the early home visit was appreciated by the parents where they received both practical and emotional support. Conclusions Although the intervention was not associated with breastfeeding, the parents appreciated the service. This shows the importance of continuing to investigate how and which support parents of newborn infants need and the effects of such support, including interventions to provide optimal support to facilitate continued breastfeeding. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04469-6.
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Affiliation(s)
- Sandra Saade
- School of Health and Wellfare, Dalarna University, Högskolegatan 2, 791 31, Falun, Sweden.
| | - Renée Flacking
- School of Health and Wellfare, Dalarna University, Högskolegatan 2, 791 31, Falun, Sweden
| | - Jenny Ericson
- School of Health and Wellfare, Dalarna University, Högskolegatan 2, 791 31, Falun, Sweden.,Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden.,Department of Paediatrics, Falu Hospital, Falun, Sweden
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44
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Rodríguez-Gallego I, Strivens-Vilchez H, Agea-Cano I, Marín-Sánchez C, Sevillano-Giraldo MD, Gamundi-Fernández C, Berná-Guisado C, Leon-Larios F. Breastfeeding experiences during the COVID-19 pandemic in Spain:a qualitative study. Int Breastfeed J 2022; 17:11. [PMID: 35193625 PMCID: PMC8861604 DOI: 10.1186/s13006-022-00453-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/26/2022] [Indexed: 12/17/2022] Open
Abstract
Background The pandemic caused by COVID-19 has affected reproductive and perinatal health both through the infection itself and, indirectly, as a consequence of changes in medical care, social policy or social and economic circumstances. The objective of this study is to explore the impact of the pandemic and of the measures adopted on breastfeeding initiation and maintenance. Methods A qualitative descriptive study was conducted by means in-depth semi-structured interviews, until reaching data saturation. The study was conducted between the months of January to May 2021. Participants were recruited by midwives from the Primary Care Centres of the Andalusian provinces provinces of Seville, Cádiz, Huelva, Granada, and Jaén. The interviews were conducted via phone call and were subsequently transcribed and analysed by means of reflexive inductive thematic analysis, using Braun and Clarke’s thematic analysis. Results A total of 30 interviews were conducted. Five main themes and ten subthemes were developed, namely: Information received (access to the information, figure who provided the information), unequal support from the professionals during the pandemic (support to postpartum hospitalization, support received from Primary Health Care during the postpartum period), social and family support about breastfeeding (support groups, family support), impact of confinement and of social restriction measures (positive influence on breastfeeding, influence on bonding with the newborn), emotional effect of the pandemic (insecurity and fear related to contagion by coronavirus, feelings of loneliness). Conclusion The use of online breastfeeding support groups through applications such as WhatsApp®, Facebook® or Instagram® has provided important breastfeeding information and support sources. The main figure identified that has provided formal breastfeeding support during this period was that of the midwife. In addition, the social restrictions inherent to the pandemic have exerted a positive effect for women in bonding and breastfeeding, as a consequence of the increase in the time spent at their homes and in the family nucleus co-living. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-022-00453-0.
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Affiliation(s)
- Isabel Rodríguez-Gallego
- Maternal-fetal Clinical Management Unit, Genetics and Reproduction, Virgen del Rocío University Hospital, Red Cross Nursing University Centre, University of Seville, Seville, Spain.
| | | | - Irene Agea-Cano
- Obstetrics and Gynecology, San Juan de la Cruz Hospital, Jaén, Spain
| | | | | | | | | | - Fatima Leon-Larios
- Nursing Department, School of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
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Laws R, Adam M, Esdaile E, Love P, Campbell KJ. What Works to Improve Nutrition and Food Sustainability across the First 2000 Days of Life: A Rapid Review. Nutrients 2022; 14:731. [PMID: 35215381 PMCID: PMC8878998 DOI: 10.3390/nu14040731] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 12/12/2022] Open
Abstract
Informed by the Innocenti framework, this rapid review of systematic reviews (n = 60) and sentinel grey literature (n = 27) synthesises the evidence of what works to improve nutrition and food sustainability across the first 2000 days. Most systematic reviews focused on interventions targeting the behaviour of parents and caregivers (n = 49), with fewer reviews focusing on the personal (n = 7) and external (n = 4) food environments. No reviews focused on food supply-chain activities. Most reviews were rated as critically low (n = 28, 47%) or low (n = 21, 35%) quality using AMSTAR 2. Evidence supports the effectiveness of multi-component breastfeeding interventions, interventions delivered in home and child-care settings, particularly when involving parents, interactive skill building and repeated exposure to vegetables. Food vouchers and access to local farmers markets and community gardens have potential for improving access and availability to healthier foods, while evidence supports interventions improving the external food environment, including fiscal strategies such as the SSB tax, restrictions on marketing and advertising of discretionary products and improved food labelling. Overall, this review highlights the importance of action across a range of settings and sectors at the international, national and local levels to improve young children's diets.
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Affiliation(s)
- Rachel Laws
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC 3220, Australia; (M.A.); (E.E.); (P.L.); (K.J.C.)
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Campbell SH, de Oliveira Bernardes N, Tharmaratnam T, Mendonça Vieira FV. Educational Resources and Curriculum on Lactation for Health Undergraduate Students: A Scoping Review. J Hum Lact 2022; 38:89-99. [PMID: 33351689 PMCID: PMC8814947 DOI: 10.1177/0890334420980693] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Breastfeeding is a fundamental component of health care, and health professionals need to be adequately prepared. As part of the system, health care professionals have the ability to influence the establishment and maintenance of breastfeeding. The global literature regarding the curricular approach or established best practices for health professional education in lactation is inconclusive and lacking in rigor. RESEARCH AIM To explore the literature for the educational resources, methods, and curriculum used in the education of undergraduate health students related to lactation. METHODS A scoping review examining the curricular programs of health professional students in lactation was undertaken exploring and summarizing evidence from peer reviewed and grey literature. A scoping review with a five-stage review process was followed. The database search between 1982-2018 generated 625 results, 79 full-text articles were reviewed, and 29 articles published in English met the inclusion criteria. RESULTS In general, educational resources, methods, curricular approaches, and foundational topics were based on best practice standards. Some authors incorporated a variety of learning methods and provided experiential learning, with evidence of translation of knowledge into clinical practice. In the studies examined, researchers reported that students had improved their: knowledge and attitudes (59%); breastfeeding support skills (45%); and confidence (10%). However, even in programs that focused on developing students' breastfeeding support skills, authors reported a lack of change in students' confidence. CONCLUSIONS Although only English articles met the inclusion criteria, this review was unique in its search of multidisciplinary, multilingual, and international studies. Consistency in teaching across disciplines is key and not evident in the studies reviewed.
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Affiliation(s)
| | - Nicole de Oliveira Bernardes
- 70439 University of British Columbia School of Nursing, Vancouver, BC, Canada.,Department of Physical Therapy, Pontifical Catholic University of Minas Gerais - PUC Minas, Minas Gerais, Brazil
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Rosen-Carole C, Halterman J, Baldwin CD, Martin H, Goldstein NP, Allen K, Fagnano M, Widanka H, Dozier A. Prenatal Provider Breastfeeding Toolkit: Results of a Pilot to Increase Women's Prenatal Breastfeeding Support, Intentions, and Outcomes. J Hum Lact 2022; 38:64-74. [PMID: 33823702 PMCID: PMC8492789 DOI: 10.1177/08903344211008797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Breastfeeding rates for United States women with lower incomes fall below the government's Healthy People 2020 Goals. Breastfeeding recommendations combined with support from providers and peer counselors help women decide to begin and sustain breastfeeding, but peer counselor uptake is low. RESEARCH AIM To evaluate changes in referrals to Women, Infants, and Children's Supplemental Nutrition Program peer counselors, reported prenatal provider education and support, and breastfeeding outcomes (intention, initiation, 1-month duration of any and exclusive breastfeeding) after a prenatal breastfeeding promotion intervention. METHOD In this pre-post intervention study (2015-2016; upstate New York), providers implemented a Toolkit to discuss infant feeding recommendations and initiate peer counselor referral. We surveyed women pre- and post-implementation (after delivery; 1 month postpartum) about prenatal breastfeeding intentions, provider support, and breastfeeding outcomes. Analyses controlled for secular trends. RESULTS Pre-intervention (n = 71) and post-intervention (n = 70) participants were 49% Black, 61% publicly insured, and 16% uninsured. More post-intervention participants had > 1 Toolkit use (76%), peer counselor program referrals (60.0% post vs. 36.6% pre, p < .01), reported any breastfeeding intention (89% vs. 72%, p = .013), and intended to breastfeed for > 1 year (31% vs. 14%, p = .014). Post-intervention breastfeeding initiation and exclusivity were higher, but not significantly different. Post-intervention participants reported better prenatal breastfeeding support. CONCLUSIONS Implementing a prenatal Breastfeeding Toolkit, including facilitating peer counselor referral, was associated with increases in provider counseling, participants' breastfeeding intentions, and uptake of peer counselors. Replicating this approach may reinforce efforts to support breastfeeding in similar practices serving women with lower incomes.
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Affiliation(s)
- Casey Rosen-Carole
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry
| | - Jill Halterman
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry
| | - Constance D. Baldwin
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry
| | - Hayley Martin
- Public Health Sciences, University of Rochester School of Medicine and Dentistry
- University of Rochester School of Medicine and Dentistry
| | | | - Katherine Allen
- Department of Pediatrics, University of Minnesota at Minneapolis, MN
| | - Maria Fagnano
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry
| | - Holly Widanka
- Public Health Sciences, University of Rochester School of Medicine and Dentistry
| | - Ann Dozier
- Public Health Sciences, University of Rochester School of Medicine and Dentistry
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48
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Marín Gabriel MA, Domingo Goneche L, Cuadrado Pérez I, Reyne Vergeli M, Forti Buratti A, Royuela Vicente A, Olabarrieta Arnal I, Sánchez L, Alonso Díaz C, Criado E, Carrizosa Molina T, Caserío Carbonero S, Casas Satre C, Fernández-Cañadas Morillo A. Baby Friendly Hospital Initiative Breastfeeding Outcomes in Mothers with COVID-19 Infection During the First Weeks of the Pandemic in Spain. J Hum Lact 2021; 37:639-648. [PMID: 34374323 DOI: 10.1177/08903344211039182] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Adherence to the Ten Steps of the Baby-Friendly Hospital Initiative has been shown to have a protective role for the initiation and maintenance of breastfeeding. RESEARCH AIMS (1) To determine the breastfeeding rate during the first 6 months of life in children of mothers diagnosed with COVID-19 infection at the time of birth; and (2) to assess the possible influence of being born in a center with Baby-Friendly Hospital Initiative accreditation. METHODS This was a two-group comparative longitudinal observational study of infants born to mothers with COVID-19 at the time of birth, between March 13-May 31, 2020 (the first wave of the pandemic) in Spain. Fourteen Spanish hospitals participated, five (35.7%) were Baby-Friendly Hospital Initiative accredited. Type of feeding was assessed prospectively at discharge, 1, 3, and 6 months of age. A total of 248 newborns were included in the study. RESULTS A total of 117 (47.3%) newborns were born in Baby-Friendly Hospital Initiative (BFHI) accredited centers. These centers applied skin-to-skin contact with greater probability (OR = 1.9; 95% CI [1.18, 3.29]) and separated the newborns from their mothers less frequently (OR = 0.46; 95% CI [0.26, 0.81]) than non-accredited centers. No differences were observed in relation to the presence of a companion at the time of birth. At discharge, 49.1% (n = 57) of newborns born in BFHI-accredited centers received exclusive breastfeeding versus 35.3% (n = 46) in non-accredited centers (p = .03). No differences were observed in breastfeeding rates throughout follow-up. CONCLUSIONS The exclusive breastfeeding rate at discharge in children of mothers with COVID-19 infection at birth was higher in Baby-Friendly Hospital Initiative accredited centers, which most frequently applied skin-to-skin contact at birth as well as rooming-in.
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Affiliation(s)
| | - Miguel A Marín Gabriel
- Deparment of Neonatology, Puerta de Hierro-Majadahonda University Hospital, Majadahonda, Madrid, Spain. Pediatric Deparment Associate Professor, Autónoma University, Madrid, Spain
| | - Laura Domingo Goneche
- Deparment of Neonatology, Fuenlabrada University Hospital, Fuenlabrada, Madrid, Spain
| | | | - Mar Reyne Vergeli
- Deparment of Neonatology, Sant Joan de Deu University Hospital, Barcelona, Catalunya, Spain
| | - Azul Forti Buratti
- Deparment of Psychiatry, Puerta de Hierro-Majadahonda University Hospital, Majadahonda, Madrid, Spain
| | - Ana Royuela Vicente
- Biostatistics Unit, Puerta de Hierro Biomedical Research Institute, CIBERESP, Madrid, Spain
| | | | - Laura Sánchez
- Deparment of Neonatology, La Paz University Hospital, Madrid, Spain
| | - Clara Alonso Díaz
- Deparment of Neonatology, 12 de Octubre University Hospital, Madrid, Spain
| | - Enrique Criado
- Deparment of Neonatology, Clínico San Carlos University Hospital, Madrid, Spain
| | | | - Sonia Caserío Carbonero
- Deparment of Neonatology, Río Hortega University Hospital, Valladolid, Castilla y León, Spain
| | - Cristina Casas Satre
- Deparment of Neonatology, Josep Trueta University Hospital, Girona, Catalunya, Spain
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Truva T, Valasoulis G, Pouliakis A, Gkorezi-Ntavela I, Pappa D, Bargiota A, Garas A, Grivea I, Daponte A. The Effect of a Structured Individualized Educational Intervention on Breastfeeding Rates in Greek Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11359. [PMID: 34769876 PMCID: PMC8582789 DOI: 10.3390/ijerph182111359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/06/2021] [Accepted: 10/20/2021] [Indexed: 11/17/2022]
Abstract
Breastfeeding rates remain extremely low in Greece and women with gestational diabetes mellitus and hypothyroidism may experience additional difficulties. The aim of the study was to investigate the effect of a structured individualized lactation educational intervention by a midwife on increasing breastfeeding rates in women with endocrine disorders and low-risk women compared to women receiving standard care, 24 months after delivery. Two-hundred women made up the study population. Half of them were experiencing endocrine pregnancy disorders and 100 women constituted the low-risk pregnancy standard care control group. Women who were breastfeeding exclusively were significantly higher in the midwifery intervention group with endocrine disorders, namely breastfeeding continued at four months (breastfeeding: 20% vs. 12%, exclusive breastfeeding: 50% vs. 26%, p = 0.0228), and at six months after childbirth (breastfeeding: 54% vs. 28%, exclusive breastfeeding: 32% vs. 12%, p = 0.0011), compared to the standard care control group with endocrine disorder. The low-risk midwifery intervention group breastfed at four months (22% vs. 14%, p = 0.0428) and at six months (52% vs. 26%, p = 0.0018) at higher rates compared to the standard care control group. In addition, exclusive breastfeeding was significantly higher in the low-risk midwifery intervention group at four months (46% vs. 20%, p = 0.0102) and six months (38% vs. 4%, p < 0.0001) compared to the standard care control group. This study was the first attempt of a structured midwifery breastfeeding education in Greece and its major contribution reflects a significant positive impact on breastfeeding rates in terms of duration and exclusivity in women with gestational endocrine disorders as well as in low-risk women, and could possibly be applied and instituted in everyday clinical practice to increase the low breastfeeding rates in Greece.
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Affiliation(s)
- Theoni Truva
- Department of Obstetrics & Gynaecology, University Hospital of Larisa, 41334 Larisa, Greece; (G.V.); (I.G.-N.); (A.G.)
| | - George Valasoulis
- Department of Obstetrics & Gynaecology, University Hospital of Larisa, 41334 Larisa, Greece; (G.V.); (I.G.-N.); (A.G.)
- Hellenic National Public Health Organization—ECDC, 15123 Athens, Greece
| | - Abraham Pouliakis
- Second Department of Pathology, National and Kapodistrian University of Athens, Attikon University Hospital, 12464 Athens, Greece;
| | - Irontianta Gkorezi-Ntavela
- Department of Obstetrics & Gynaecology, University Hospital of Larisa, 41334 Larisa, Greece; (G.V.); (I.G.-N.); (A.G.)
| | - Dimitra Pappa
- Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41334 Larissa, Greece; (D.P.); (A.B.)
| | - Alexandra Bargiota
- Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41334 Larissa, Greece; (D.P.); (A.B.)
| | - Antonios Garas
- Department of Obstetrics & Gynaecology, University Hospital of Larisa, 41334 Larisa, Greece; (G.V.); (I.G.-N.); (A.G.)
| | - Ioanna Grivea
- Department of Pediatrics, University of Thessaly, University Hospital of Larissa, 41334 Larissa, Greece;
| | - Alexandros Daponte
- Department of Obstetrics & Gynaecology, University Hospital of Larisa, 41334 Larisa, Greece; (G.V.); (I.G.-N.); (A.G.)
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Jang GJ, Ko S. Effects of a breastfeeding coaching program on growth and neonatal jaundice in late preterm infants in South Korea. CHILD HEALTH NURSING RESEARCH 2021; 27:377-384. [PMID: 35004525 PMCID: PMC8650952 DOI: 10.4094/chnr.2021.27.4.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/23/2021] [Accepted: 10/03/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This study examined the effects of a breastfeeding coaching program for mothers on growth and neonatal jaundice in late preterm infants (LPIs). METHODS This was a quasi-experimental study (non-randomized intervention) with a time-series design. The study was conducted among 40 LPIs who were admitted to the neonatal intensive care unit of a university hospital in Daegu, South Korea. In the order of admission, the first 21 infants were assigned to the experimental group, and 19 were assigned to the control group. The intervention program consisted of home- based and web-based practical breastfeeding support education for mothers across a total of 5 sessions. Infant growth was measured using body weight, length, and head circumference, and neonatal jaundice was assessed using transcutaneous bilirubin levels. RESULTS The likelihood of breastfeeding for infants in the experimental group at 4 weeks after discharge was the same as on the day of discharge, whereas it steadily decreased in the control group. There were significant differences in head circumference between the groups. However, weight, length, and transcutaneous bilirubin levels did not show a significant group-time interaction. CONCLUSION A formal breastfeeding coaching program should be considered in clinical settings and at home within the first few weeks postpartum.
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Affiliation(s)
- Gun Ja Jang
- Professor, Department of Nursing, Daegu University, Daegu, Korea
| | - Sangjin Ko
- Assistant Professor, Department of Nursing, University of Ulsan, Ulsan, Korea
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