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Basic, High-Risk, and Critical Care Intrapartum Nursing: Clinical Competencies and Education Guide, 7th Edition. Nurs Womens Health 2024; 28:e17-e44. [PMID: 38551535 DOI: 10.1016/j.nwh.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
This guide has been prepared by the AWHONN Task Force to revise the AWHONN Education Guide, Basic, High-Risk, and Critical Care Intrapartum Nursing: Clinical Competencies and Education Guide. Education guides are reviewed periodically. This guide is not intended to be exhaustive; other sources of information and guidance are available and should be consulted. This guide is intended to encourage systematic education and ongoing skill development in basic, high-risk, and critical care obstetrics during the intrapartum period, immediate postpartum period, and newborn transition. It is not designed to define standards of practice for employment, licensure, discipline, legal, or other purposes. Variations and innovations that demonstrably improve the quality of patient care are encouraged.
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Yuan ZW, Ma L, Chen YL, Ge WL, Zhao H, Du Y, Li XX. Knowledge and attitude of spouses of puerperas towards breastfeeding. BMC Womens Health 2024; 24:289. [PMID: 38750465 PMCID: PMC11097401 DOI: 10.1186/s12905-024-03116-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] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 04/25/2024] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVE To investigate the extent of knowledge about breastfeeding and attitudes towards infant feeding among spouses of puerperas at the time of discharge from hospital, and explore the factors influencing spousal attitudes toward breastfeeding. METHODS We conducted a questionnaire survey among 204 spouses of puerperas who were admitted in the maternity wards at a tertiary hospital in Shaanxi Province between October 2021 and December 2021. Respondents who fulfilled the inclusion criteria were identified using convenient sampling. RESULTS (1) The score of breastfeeding knowledge among spouses prior to discharge from the hospital was (10.56 ± 3.78), with an accuracy rate of 59.6%, and the lowest accuracy rate was for Item 1 "Newborns should be fed on time, not on demand" (42.6%) and Item 5 "Breastfeeding can prevent infant rickets" (49.5%). (2) The average score of spouses' infant feeding attitudes was (58.15 ± 5.55), and the lowest scoring was for Item 17 "Daily urine volume of infants is a reliable indicator to judge whether they get enough breast milk" (1.99 ± 1.14). (3) Generalized linear model analysis showed a more positive attitude (higher score) among spousal attitudes towards infant feeding in those who had received breastfeeding education [OR = 4.588, 95% CI (0.160 ∼ 3.598)] and those with a master's degree or above [OR = 18.278, 95% CI (3.471 ∼ 9.346)]. CONCLUSION (1) Spouses that received breastfeeding education and those that had a Masters Degree and above had more positive attitude towards infant feeding. (2) Medical staff should focus on puerperas'spouses with degrees below master's level who had not received breastfeeding education. We recommend using a variety of education methods to enable them to acquire more knowledge on breastfeeding and develop a more positive attitude towards breastfeeding, which will further enhance spousal support for breastfeeding, thus positivizing postpartum co-parenting attitudes and improving the rate of exclusive breastfeeding.
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Affiliation(s)
- Zhan-Wang Yuan
- Department of Nursing Care (Nursing Department), Northwest Women's and Children's Hospital, Xi'an, Shaanxi, 710061, China
| | - Li Ma
- Department of Nursing Care (Nursing Department), Northwest Women's and Children's Hospital, Xi'an, Shaanxi, 710061, China
| | - Yu-Ling Chen
- Department of Nursing Care (Deputy Director of Nursing Department), Xi'an DaXing Hospital, No. 353 of Laodong North Road, Lianhu District, Xi'an, Shaanxi, 710018, China.
| | - Wen-Li Ge
- Department of President's Office, Northwest Women's and Children's Hospital, Xi'an, Shaanxi, 710061, China
| | - Hong Zhao
- Department of Maternity (Maternity Department), Northwest Women's and Children's Hospital, Xi'an, Shaanxi, 710061, China
| | - Yun Du
- Department of Maternity (Maternity Department), Northwest Women's and Children's Hospital, Xi'an, Shaanxi, 710061, China
| | - Xiu-Xiu Li
- Department of Maternity (Maternity Department), Xi'An QinHuang Hospital, Middle section of Qinhan Avenue, Lintong District, Xi'an, Shaanxi, 710061, China
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Basic, High-Risk, and Critical Care Intrapartum Nursing: Clinical Competencies and Education Guide, 7th Edition. J Obstet Gynecol Neonatal Nurs 2024; 53:e49-e76. [PMID: 38551543 DOI: 10.1016/j.jogn.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024] Open
Abstract
This guide has been prepared by the AWHONN Task Force to revise the AWHONN Education Guide, Basic, High-Risk, and Critical Care Intrapartum Nursing: Clinical Competencies and Education Guide. Education guides are reviewed periodically. This guide is not intended to be exhaustive; other sources of information and guidance are available and should be consulted. This guide is intended to encourage systematic education and ongoing skill development in basic, high-risk, and critical care obstetrics during the intrapartum period, immediate postpartum period, and newborn transition. It is not designed to define standards of practice for employment, licensure, discipline, legal, or other purposes. Variations and innovations that demonstrably improve the quality of patient care are encouraged.
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Asiodu IV, Gay CL, Gates-Burgess B, Negrete G. Access to and interest in human milk research opportunities among Black pregnant and postpartum people. Front Nutr 2024; 11:1274833. [PMID: 38680532 PMCID: PMC11048474 DOI: 10.3389/fnut.2024.1274833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 03/12/2024] [Indexed: 05/01/2024] Open
Abstract
Background Concerns exist regarding biomedical research participation in marginalized and historically disadvantaged communities. Objectives The purpose of this study was to understand critical barriers to participation in human milk research from the perspective of Black pregnant and postpartum people. Methods A national sample of Black pregnant and postpartum people (n = 104) was recruited to complete a cross-sectional online survey informed by the Life Course Perspective. Survey questions assessed research experiences and preferences, particularly related to human milk research, knowledge of historical events/policies targeting Black communities, and demographic characteristics. A socio-economic composite score was calculated as an indicator of socio-economic advantage. Survey data were summarized descriptively and potential correlates of research engagement were evaluated. Results Most (69%, n = 71) respondents reported previous participation in a research study, yet only 8 (8%) reported ever being asked to participate in a breastfeeding/chestfeeding or human milk study, and one respondent was unsure. Despite so few having been asked, 59% (n = 61) of respondents indicated they would donate breast/human milk to research if asked. Respondent characteristics associated with prior research participation included having greater socio-economic advantage (p = 0.027) and greater knowledge of discriminatory historical events/policies (p < 0.001). In contrast, the only respondent characteristic associated with willingness to donate human milk to research was younger age (p = 0.002). Conclusion Our findings suggest that Black pregnant and postpartum people are interested in biomedical research, specifically human milk and lactation research. However, greater intentionality and targeted recruitment of this underrepresented population is needed to increase diversity among human milk and lactation study samples. Structural and community-based interventions, informed by community members, are needed to address concerns and improve participant engagement.
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Affiliation(s)
- Ifeyinwa V. Asiodu
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, San Francisco, CA, United States
| | - Caryl L. Gay
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, San Francisco, CA, United States
| | | | - Gabriela Negrete
- Department of Human Ecology, Human Development & Family Studies, College of Agricultural and Environmental Sciences, University of California, Davis, Davis, CA, United States
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Clark RRS, Peele ME, Mason A, Lake ET. Effects of Nurse Staffing on Missed Breastfeeding Support in Maternity Units With Different Nurse Work Environments. J Perinat Neonatal Nurs 2024; 38:158-166. [PMID: 38758272 DOI: 10.1097/jpn.0000000000000824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
PURPOSE To examine the effect of nurse staffing in varying work environments on missed breastfeeding teaching and support in inpatient maternity units in the United States. BACKGROUND Breast milk is the optimal food for newborns. Teaching and supporting women in breastfeeding are primarily a nurse's responsibility. Better maternity nurse staffing (fewer patients per nurse) is associated with less missed breastfeeding teaching and support and increased rates of breastfeeding. We examined the extent to which the nursing work environment, staffing, and nurse education were associated with missed breastfeeding care and how the work environment and staffing interacted to impact missed breastfeeding care. METHODS In this cross-sectional study using the 2015 National Database of Nursing Quality Indicator survey, maternity nurses in hospitals in 48 states and the District of Columbia responded about their workplace and breastfeeding care. Clustered logistic regression models with interactions were used to estimate the effects of the nursing work environment and staffing on missed breastfeeding care. RESULTS There were 19 486 registered nurses in 444 hospitals. Nearly 3 in 10 (28.2%) nurses reported missing breastfeeding care. In adjusted models, an additional patient per nurse was associated with a 39% increased odds of missed breastfeeding care. Furthermore, 1 standard deviation decrease in the work environment was associated with a 65% increased odds of missed breastfeeding care. In an interaction model, staffing only had a significant impact on missed breastfeeding care in poor work environments. CONCLUSIONS We found that the work environment is more fundamental than staffing for ensuring that not only breastfeeding care is not missed but also breastfeeding care is sensitive to nurse staffing. Improvements to the work environment support the provision of breastfeeding care. IMPLICATIONS FOR RESEARCH AND PRACTICE Both nurse staffing and the work environment are important for improving breastfeeding rates, but the work environment is foundational.
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Affiliation(s)
- Rebecca R S Clark
- Author Affiliations: Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia (Drs Clark and Lake and Ms Mason); Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania (Drs Clark and Lake and Ms Mason); Demography Department, University of Pennsylvania School of Arts and Sciences, Philadelphia (Dr Peele); and Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia (Dr Clark
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Ramer S, Nguyen AT, Nelson JM, Whiteman MK, Warner L, Thierry JM, Folger S, von Essen BS, Kortsmit K. Breastfeeding by Disability Status in the United States: Pregnancy Risk Assessment Monitoring System, 2018-2020. Am J Public Health 2024; 114:108-117. [PMID: 38091565 PMCID: PMC10726937 DOI: 10.2105/ajph.2023.307438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Objectives. To describe breastfeeding initiation and breastfeeding at 1, 2, and 3 months, and information sources on breastfeeding among women with a recent live birth by disability status. Methods. We analyzed October 2018 to December 2020 data from the Pregnancy Risk Assessment Monitoring System for 24 sites in the United States that included the Washington Group Short Set of Questions on Disability (seeing, hearing, walking or climbing stairs, remembering or concentrating, self-care, communicating). We defined disability as reporting "a lot of difficulty" or "cannot do this at all" on any of these questions. Results. Among 39 673 respondents, 6.0% reported disability. In adjusted analyses, breastfeeding was lower among respondents with disability at 2 (62.6% vs 66.6%; adjusted prevalence ratio [APR] = 0.94; 95% confidence interval [CI] = 0.89, 0.99) and 3 months (54.7% vs 59.6%; APR = 0.92; 95% CI = 0.86, 0.98) than those without disability. Respondents with disability were less likely to receive information from health care providers or support professionals (89.3% vs 92.3%), but as likely from breastfeeding or lactation specialists (78.1% vs 75.3%). Conclusions. Strategies to ensure women with disability, receive breastfeeding support, including breastfeeding information, could improve breastfeeding outcomes. (Am J Public Health. 2024;114(1):108-117. https://doi.org/10.2105/AJPH.2023.307438).
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Affiliation(s)
- Stephanie Ramer
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
| | - Antoinette T Nguyen
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
| | - Jennifer M Nelson
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
| | - Maura K Whiteman
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
| | - Lee Warner
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
| | - JoAnn M Thierry
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
| | - Suzanne Folger
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
| | - Beatriz Salvesen von Essen
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
| | - Katherine Kortsmit
- Stephanie Ramer, Antoinette T. Nguyen, Maura K. Whiteman, Lee Warner, Suzanne Folger, Beatriz Salvesen von Essen, and Katherine Kortsmit are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers of Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Jennifer M. Nelson was is with the Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta. JoAnn M. Thierry is with the Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta
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Wang C, Peng Y, Zhang Y, Xu J, Jiang S, Wang L, Yin Y. The biological functions and metabolic pathways of valine in swine. J Anim Sci Biotechnol 2023; 14:135. [PMID: 37805513 PMCID: PMC10559503 DOI: 10.1186/s40104-023-00927-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/03/2023] [Indexed: 10/09/2023] Open
Abstract
Valine is an essential amino acid and a type of branched-chain amino acid. Due to the involvement of branched-chain amino acids in various metabolic pathways, there has been a surge of interests in valine nutrition and its role in animal physiology. In pigs, the interactions between valine and other branched-chain amino acids or aromatic amino acids are complex. In this review, we delve into the interaction mechanism, metabolic pathways, and biological functions of valine. Appropriate valine supplementation not only enhances growth and reproductive performances, but also modulates gut microbiota and immune functions. Based on past observations and interpretations, we provide recommended feed levels of valine for weaned piglets, growing pigs, gilts, lactating sows, barrows and entire males. The summarized valine nutrient requirements for pigs at different stages offer valuable insights for future research and practical applications in animal husbandry.
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Affiliation(s)
- Chuni Wang
- Institute of Subtropical Agriculture, Chinese Academy of Sciences, Changsha, China
- Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha, China
| | - Yao Peng
- Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha, China
| | - Yiru Zhang
- Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha, China
| | - Juan Xu
- Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha, China
| | - Sheng Jiang
- Institute of Subtropical Agriculture, Chinese Academy of Sciences, Changsha, China
| | - Leli Wang
- Institute of Subtropical Agriculture, Chinese Academy of Sciences, Changsha, China.
- Tianjin Institute of Industrial Biotechnology, Chinese Academy of Sciences, Tianjin, China.
| | - Yulong Yin
- Institute of Subtropical Agriculture, Chinese Academy of Sciences, Changsha, China.
- Hunan Provincial Key Laboratory of Animal Intestinal Function and Regulation, College of Life Sciences, Hunan Normal University, Changsha, China.
- Tianjin Institute of Industrial Biotechnology, Chinese Academy of Sciences, Tianjin, China.
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Meeting Families Where They Are: Supporting Mixed or Combination Feeding Parent-Infant Dyads. J Perinat Neonatal Nurs 2023; 37:274-276. [PMID: 37878510 DOI: 10.1097/jpn.0000000000000775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
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Hawkins SS. Affordable Care Act and Breastfeeding. J Obstet Gynecol Neonatal Nurs 2023; 52:339-349. [PMID: 37604351 DOI: 10.1016/j.jogn.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023] Open
Abstract
In 2010, the Patient Protection and Affordable Care Act was the first federal legislation to protect breastfeeding on a broad scale. Since its implementation, several provisions have been made, including the recent Providing Urgent Maternal Protections for Nursing Mothers (PUMP) Act, which went into effect in April 2023. In this column, I review current breastfeeding recommendations, the policy landscape related to state and federal laws that protect breastfeeding, research findings on breastfeeding policies, and recommendations from professional organizations that support women's breastfeeding decisions.
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Strong G, Gober M, Walker M. Speaking the Same Language: A Call for Standardized Lactation Terminology in the United States. J Hum Lact 2023; 39:121-131. [PMID: 36511175 DOI: 10.1177/08903344221131041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Genae Strong
- Loewenberg College of Nursing, University of Memphis, Memphis, TN, USA
| | - Merrilee Gober
- National Lactation Consultant Alliance, Inc, Atlanta, GA, USA
| | - Marsha Walker
- National Lactation Consultant Alliance, Inc, Atlanta, GA, USA
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Palmquist AE, Asiodu IV, Tucker C, Tully KP, Asbill DT, Malloy A, Stuebe AM. Racial Disparities in Donor Human Milk Feedings: A Study Using Electronic Medical Records. Health Equity 2022; 6:798-808. [PMID: 36338802 PMCID: PMC9629910 DOI: 10.1089/heq.2022.0085] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The aim of this study was to evaluate differences in the use of pasteurized donor human milk (PDHM) by maternal race-ethnicity during postpartum hospitalization using electronic medical records (EMRs). MATERIALS AND METHODS A retrospective cohort study of all live-born infants at our academic research institution from July 1, 2014, to June 30, 2016, was conducted. EMR data were used to determine whether each infant received mother's own milk (MOM), PDHM, or formula. These data were stratified based on whether the infant received treatment in the Neonatal Critical Care Center. Generalized estimating equation models were used to calculate the odds of receiving PDHM by maternal race-ethnicity, adjusting for gestational age, birth weight, insurance, preferred language, nulliparity, and mode of delivery. RESULTS Infant feeding data were available for 7097 infants, of whom 49% were fed only MOM during their postpartum hospitalization. Among the 15.9% of infants admitted to neonatal critical care, infants of non-Hispanic Black (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.31-0.72), Hispanic (OR 0.65, 95% CI 0.36-1019), and Other (OR 0.63, 95% CI 0.32-1.26) mothers had lower rates of PDHM feedings than infants of non-Hispanic White mothers in the adjusted models. Among well infants, the use of PDHM was lower among non-Hispanic Black and Hispanic mothers (OR 0.25, 95% CI 0.18-0.36, and OR 0.38, 95% CI 0.26-0.56) compared with non-Hispanic White mothers. CONCLUSIONS Inequities in exclusive human milk feeding and use of PDHM by maternal race-ethnicity were identified. Antiracist interventions are needed to promote equitable access to skilled lactation support and counseling for PDHM use.
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Affiliation(s)
- Aunchalee E.L. Palmquist
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Address correspondence to: Aunchalee E.L. Palmquist, PhD, MA, IBCLC, Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB-7445, Chapel Hill, NC 27599-7400, USA.
| | - Ifeyinwa V. Asiodu
- Department of Family Health Care Nursing, University of California, San Francisco, California, USA
| | - Christine Tucker
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kristin P. Tully
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Angela Malloy
- Momma's Village of Fayetteville, Fayetteville, North Carolina, USA
| | - Alison M. Stuebe
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Hunagund S, Golan Y, Asiodu IV, Prahl M, Gaw SL. Effects of Vaccination Against Influenza, Pertussis, and COVID-19 on Human Milk Antibodies: Current Evidence and Implications for Health Equity. Front Immunol 2022; 13:910383. [PMID: 35903100 PMCID: PMC9314549 DOI: 10.3389/fimmu.2022.910383] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/20/2022] [Indexed: 12/15/2022] Open
Abstract
Human milk contains three antibody classes that confer mucosal immunity to the breastfed infant: secretory IgA (SIgA), secretory IgM (SIgM), and IgG. Influenza and pertussis vaccines administered during pregnancy induce pathogen specific SIgA and IgG responses in human milk that have been shown to protect the breastfed infant from these respiratory illnesses. In addition, mRNA vaccines against the SARS-CoV-2 virus administered during pregnancy and lactation induce anti-SARS-CoV-2 IgG and IgA responses in human milk. This review summarizes the immunologic benefits of influenza, pertussis, and COVID-19 vaccines conferred by human milk. Additionally, future research direction in human milk immunity and public health needs to improve lactational support are discussed.
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Affiliation(s)
- Soumya Hunagund
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Yarden Golan
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, United States
- Institute for Human Genetics, University of California, San Francisco, San Francisco, CA, United States
| | - Ifeyinwa V. Asiodu
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, CA, United States
| | - Mary Prahl
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States
- Division of Pediatric Infectious Diseases and Global Health, University of California, San Francisco, San Francisco, CA, United States
| | - Stephanie L. Gaw
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States
- Center for Reproductive Sciences, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States
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Rosenbaum KA. Exclusive breastmilk pumping: A concept analysis. Nurs Forum 2022; 57:946-953. [PMID: 35716155 PMCID: PMC9546173 DOI: 10.1111/nuf.12766] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/24/2022] [Accepted: 06/02/2022] [Indexed: 01/04/2023]
Abstract
Aim To analyze and examine the concept of exclusive breast pumping (EP). Background Breastmilk is the ideal nutrition for infants, yet when breastfeeding is unsuccessful, parents resort to informal breastmilk sharing, artificial formula feeding, or EP. A growing proportion of families exclusively pump yet they often receive guidance from social media rather than healthcare providers because healthcare providers are uninformed about this feeding method. Data Source Cumulative Index of Nursing and Allied Health Literature, PubMed, and Google Scholar databases were searched using the following keywords: human milk express*, breast express*, breast milk express, breastmilk express*, exclusive pump, exclusive breast pumping, and exclusive expression. Review Methods Concept analysis design using Walker and Avant's method. Results Three defining attributes of (1) absence of direct breastfeeding, (2) breastmilk expression, (3) and an enduring infant feeding pattern of feeding expressed breastmilk only via a bottle were identified. All three attributes are required to confirm the presence of the concept of exclusive pumping. Definitions, antecedents, consequences, and empirical referents are described. Model and contrary cases are discussed. Conclusion This exclusive pumping concept analysis allows for consistency in terminology in practice and research. EP is a feeding method which can increase the proportion of infants who are fed breastmilk and may reduce the risks that arise from artificial formula feeding.
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王 琳, 赵 小, 刘 辉, 邓 丽, 梁 红, 段 思, 杨 依, 张 华. [Evidence-based standardized nutrition protocol can shorten the time to full enteral feeding in very preterm/very low birth weight infants]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:648-653. [PMID: 35762431 PMCID: PMC9250396 DOI: 10.7499/j.issn.1008-8830.2202121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To investigate whether evidence-based standardized nutrition protocol can facilitate the establishment of full enteral nutrition and its effect on short-term clinical outcomes in very preterm/very low birth weight infants. METHODS A retrospective analysis was performed on the medical data of 312 preterm infants with a gestational age of ≤32 weeks or a birth weight of <1 500 g. The standardized nutrition protocol for preterm infants was implemented in May 2020; 160 infants who were treated from May 1, 2019 to April 30, 2020 were enrolled as the control group, and 152 infants who were treated from June 1, 2020 to May 31, 2021 were enrolled as the test group. The two groups were compared in terms of the time to full enteral feeding, the time to the start of enteral feeding, duration of parenteral nutrition, the time to recovery to birth weight, the duration of central venous catheterization, and the incidence rates of common complications in preterm infants. RESULTS Compared with the control group, the test group had significantly shorter time to full enteral feeding, time to the start of enteral feeding, duration of parenteral nutrition, and duration of central venous catheterization and a significantly lower incidence rate of catheter-related bloodstream infection (P<0.05). There were no significant differences between the two groups in the mortality rate and the incidence rate of common complications in preterm infants including grade II-III necrotizing enterocolitis (P>0.05). CONCLUSIONS Implementation of the standardized nutrition protocol can facilitate the establishment of full enteral feeding, shorten the duration of parenteral nutrition, and reduce catheter-related bloodstream infection in very preterm/very low birth weight infants, without increasing the risk of necrotizing enterocolitis.
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Affiliation(s)
| | | | | | | | | | | | | | - 华岩 张
- 费城儿童医院 及宾夕法尼亚大学佩雷尔曼医学院新生儿科,美国宾夕法尼亚州费城
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