Maternal intention to exclusively breast feed among mainland Chinese mothers: A cross-sectional study

Workplace breastfeeding support for working women: A scale development study

Objective

In this study, authors aimed to develop a scale to evaluate workplace breastfeeding support.

Methods

The study was carried out with 490 working women who applied to the women's and children's outpatient clinics of a hospital in Turkey. The study data were collected by using a 'Personal Information Form' and the 'Workplace Breastfeeding Support for Working Women Draft Scale'. The data were analyzed on SPSS 25 and AMOS 21 software packages. In the development process of the scale; Content validity, exploratory factor analysis, item-total score correlation methods and Cronbach's Alpha coefficient were used.

Results

The content validity index of the scale was 0.90, and the Cronbach's alpha value was 0.93. Kaiser-Meyer-Olkin value of the scale was 0.91, Bartlett test values were χ2 = 11,573.924 and p < 0.000. According to the results of the exploratory factor analysis for the construct validity of the scale, the scale consisted of 31 items and 6 factors.

Conclusions

The developed scale can be used to evaluate workplace breastfeeding support for working women as a valid and reliable measurement tool.

Protective factors for early initiation of breastfeeding among Brazilian nursing mothers

Objectives

Evaluate the protective factors associated with early initiation of breastfeeding.

Methods

Cross-sectional study conducted with Brazilian nursing mothers. Breastfeeding in the first hour of life and difficulty initiating breastfeeding in the birth room were adopted as outcome variables and associated with other maternal and child information. Poisson regression was conducted to synthesize the data.

Results

Among 104 nursing mothers evaluated, 56.7% reported breastfeeding in the first hour of life and 43% had difficulty initiating breastfeeding in the birth room. There was a higher prevalence of breastfeeding in the first hour of life among mothers with previous breastfeeding experience (PR = 1.47, 95% CI 1.04-2.07). Difficulty initiating breastfeeding in the birth room was more prevalent among mothers who did not receive breastfeeding guidance during antenatal care (PR = 2.83, 95% CI 1.43-4.32) and those without previous breastfeeding experience (PR = 2.49, 95% CI 1.24-6.45).

Conclusion

These findings highlight the importance of adequate professional guidance, especially for primiparous mothers.

Characterization and comparison site-specific N-glycosylation profiling of milk fat globule membrane proteome in donkey and human colostrum and mature milk

Milk fat globule membrane (MFGM) proteins are highly glycosylated and involved in various biological processes within the body. However, information on site-specific N-glycosylation of MFGM glycoproteins in donkey and human milk remains limited. This study aimed to map the most comprehensive site-specific N-glycosylation fingerprinting of donkey and human MFGM glycoproteins using a site-specific glycoproteomics strategy. We identified 1,360, 457, 2,617, and 986 site-specific N-glycans from 296, 77, 214, and 196 N-glycoproteins in donkey colostrum (DC), donkey mature milk (DM), human colostrum (HC), and human mature milk (HM), respectively. Bioinformatics was used to describe the structure-activity relationships of DC, DM, HC, and HM MFGM N-glycoproteins. The results revealed differences in the molecular composition of donkey and human MFGM N-glycoproteins and the dynamic changes to site-specific N-glycosylation of donkey and human MFGM glycoproteins during lactation, deepening our understanding of the composition of donkey and human MFGM N-glycoproteins and their potential physiological roles.

Exclusive breastfeeding rate and related factors among mothers within maternal health WeChat groups in Jiaxing, Zhejiang province, China: a cross-sectional survey

BACKGROUND

The health workers in Jiaxing of China have established maternal health WeChat groups for maternal health education and management since 2019. Pregnant women in Jiaxing are invited to join the WeChat groups and a health worker as the group manager provides health education and individual counselling for women within the group. This study aimed to investigate the exclusive breastfeeding (EBF) status up to six months and its associated factors among the mothers of infants aged 7-12 months within the WeChat groups.

METHODS

This was a cross-sectional survey on healthy mothers with infants aged 7-12 months from seven maternal health WeChat groups in October 2021 in Jiaxing, China. EBF was defined as breastfeeding infants exclusively up to six months. Data including breastfeeding practice from birth to six months, maternal sociodemographic and obstetric characteristics, hospitalization information, work related factors and reasons for non-EBF up to six months were collected using an online self-administered questionnaire. A multivariable logistic regression analysis was performed to identify the factors independently associated with EBF up to 6 months.

RESULTS

A total of 822 mothers were included in this study. Among them, 586 mothers (71.3%) exclusively breastfed infants up to six months. Multivariable logistic regression analysis showed that older maternal age (adjusted odds ratio [AOR] 0.956; 95% confidence interval [CI] 0.917, 0.997) and perceived insufficient breast milk (AOR 0.104; 95% CI 0.072, 0.149) were associated with lower odds of EBF up to six months. The five of common reasons for non-EBF up to six months were no or insufficient breast milk (59.8%), return to work (23.9%), no flexible nursing breaks at work (18.2 %), infant crying or feeling tired or troubled with breastfeeding (9.7%), and nipple and breast problems (9.3%).

CONCLUSION

About 71.3% of infants were exclusively breastfed until six months of age in our WeChat groups. Perceived insufficient breast milk and work related factors are the main barriers to EBF up to six months in this setting. However, further comparative study is needed to confirm the effect of WeChat groups on breastfeeding.

Why do first-time mothers not intend to breastfeed? --A qualitative exploratory study on the decision-making of non-initiation in Jingzhou, China

Background

Although breastfeeding is one of the top priorities for public health in China, the rate of breastfeeding is still low and a large number of women do not initiate breastfeeding due to various reasons. Hence, this study aimed to understand the decision-making of non-initiation and reveal the underlying reasons in order to protect, support, and promote breastfeeding.

Methods

In-depth, exploratory interviews were carried out with 13 new mothers who did not initiate breastfeeding. The collected data were analyzed by inductive content analysis.

Results

Although mothers generally understood the protective effects of breastfeeding, they believed that formula milk is a good alternative to human milk and even better in some aspects. Five core themes related to non-initiation decision-making emerged: (1) expected breastfeeding stress; (2) maladjustment to the maternal role; (3) concerns about physiological issues; (4) the lack of knowledge about the risks of artificial feeding; (5) belief that it is better not to initiate than to interrupt.

Conclusions

The environment for mothers to breastfeed in China is not supportive enough, and the medical staff and families should be held responsible for the non-initiation of breastfeeding. More professionals are needed to support mothers to solve their problems and breastfeeding education should be further expanded.

Expectations and Experiences of Spanish Primiparous Women Who Decide to Breastfeed Their Infants and Strategies for Change in 2020—A Qualitative Study

To describe the experiences and expectations of Spanish women regarding breastfeeding and the support they receive from healthcare professionals, family, and friends during the breastfeeding journey, A qualitative study using an empirical-phenomenological approach was conducted. Primiparous women that had already given birth were interviewed using a purposive and snowball sampling. In-depth interviews were conducted between 1 January and 30 April 2020. The interviews were transcribed verbatim and analysed using Haase’s adaptation of Colaizzi’s phenomenological method. We recruited 14 women who had recently become mothers. Three major themes describing experiences of infant feeding by maternal lactation were identified—institutional influences, establishing breastfeeding, and cessation of breastfeeding—as well as the following 10 categories: hospital routines, lactation concerns (amount and infant nutrition), antenatal breastfeeding decision, embarrassment to breastfeed, and normalisation of breastfeeding. Prior education and support were identified as key elements in possible breastfeeding support strategies.

Factors that influence mothers' prenatal decision to breastfeed in Spain

Background

Parents’ decisions about how to feed their newborns are influenced by multiple factors. Our objective was to identify the factors that can influence the decision to breastfeed.

Methods

Cross-sectional observational online study was conducted in Spain on women who gave birth between 2013 and 2018. The total number of participants was 5671. Data collection was after approval by the ethics committee in 2019. The data were collected retrospectively because the information was obtained from women who were mothers during the years 2013–2018. An online survey was distributed to breastfeeding associations and postpartum groups. Multivariate analysis with binary logistic regression was done to calculate the Adjusted Odds Ratios (aOR). The main result variable was “intention to breastfeed”.

Results

Ninety-seven percent (n = 5531) of women made the decision to breastfeed prior to giving birth. The internet played a role in deciding to breastfeed in 33.7% (n = 2047) of women, while 20.1% (n = 1110) said the same thing about their midwife. We identified five significant factors associated with the mother’s prenatal decision to breastfeed: attending maternal education (aOR 2.10; 95% CI 1.32, 3.34), having two (aOR 0.52; 95% CI 0.28, 0.99) and three children (aOR 0.24; 95% CI 0.10, 0.59), previous breastfeeding experience (aOR 6.99; 95% CI 3.46, 14.10), support from partner (aOR 1.58; 95% CI 1.09,2.28) and having a condition during pregnancy (aOR 0.62; 95% CI 0.43, 0.91).

Conclusions

Factors related with previous breastfeeding experience and education for mothers are decisive when it comes to making the decision to breastfeed. Given the proven influence that partners have in decision-making, it is important for them to be fully involved in the process.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13006-020-00341-5.

The Patterns and Social Determinants of Breastfeeding in 12 Selected Regions in China: A Population-Based Cross-Sectional Study

BACKGROUND

With rapid industrialization and urbanization, there is a growing need for women to enter the workforce, and affluent people are drawn to the infant formula market. The breastfeeding rates in China are below the optimal level. Large scale quantitative research studying breastfeeding practices after 2015 in China are lacking.

RESEARCH AIM

We aimed to (1) explore the latest patterns and (2) identify the determinants of breastfeeding in China.

METHODS

The study was a population-based, cross-sectional survey. A multi-stage sampling technique was adopted for the selection of participants. We recruited 10,408 mothers with children under 12 months old, in 12 regions of China, and conducted a questionnaire survey about breastfeeding patterns. The associations between social and biophysical determinants and breastfeeding outcomes were analyzed using a logistic regression model.

RESULTS

The exclusive breastfeeding rate was 29.32% (n = 3,052) decreasing from 32.71% (n = 3,404) to 15.83% (n = 1,648) among children aged 0-5 months. Cesarean section had a negative association with early breastfeeding initiation (OR = .33, 95% CI [.30, .36]), exclusive breastfeeding (OR = .78, 95% CI [.69, .89]), and predominant breastfeeding (OR = .73, 95% CI [.65, .83]). Compared to participants with an annual household income lower than 40,000 Yuan ($5,817 USD), those with over 100,000 Yuan ($14,542 USD) had an OR of .78 (95% CI [.67, .90]) in exclusive breastfeeding. Compared with illiterate and unemployed groups, middle/high school education and a current work status, respectively, were associated with a lower likelihood of exclusive breastfeeding (OR = .73, 95% CI [.63, .84]; OR = .58, 95% CI [.37, .89]).

CONCLUSIONS

The prevalence of breastfeeding in 12 selected regions in China was low and interventions focusing on the targeted population should be strengthened.

"The sweet and the bitter": mothers' experiences of breastfeeding in the early postpartum period: a qualitative exploratory study in China

Background

In China, the prevalence of exclusive breastfeeding at 6 months was only 20.8%. In promoting breastfeeding for newborns, a number of strategies have been initiated by Chinese government. These actions facilitated a high breastfeeding initiation of 77 to 99.9% in different regions. However, the exclusive breastfeeding rates remained low at 6 months resulting from a high rate of perceived insufficient breast milk and complementary feeding during the early days after childbirth. The aim of this study was to understand the experiences of women in Shenzhen with regard to breastfeeding in the first 6 weeks after giving birth, to identify the facilitators and barriers impacting their breastfeeding decisions and to identify their perceived support needs that might facilitate breastfeeding in the future.

Methods

This was a qualitative exploratory study. Data were collected in November 2018 through semi-structured, face-to-face, in-depth interviews. A purposive sample of early postpartum women was recruited from a postpartum clinic of a tertiary maternal hospital in Shenzhen, China. The dataset was analysed using inductive content analysis.

Results

A total of 22women were interviewed within the first 6 weeks after delivery. Three themes related to breastfeeding were identified from the transcribed interviews: “breastfeeding facilitators,” “breastfeeding barriers,” and “recommendations for breastfeeding promotion.”

Conclusions

Women experienced both joy and suffering in their journey of breastfeeding. Insufficient knowledge of breastfeeding, discomfort, intergenerational disagreements regarding nutritional supplements, and a lack of professional support contributed to difficulties and the threat of discontinuation. A supportive environment for breastfeeding is crucial for women’s decision on exclusive breastfeeding and the psychological wellbeing of breastfeeding women. Interventions that target to promote exclusive breastfeeding should include both new mothers and significant family members. Future studies could test the effectiveness of breastfeeding training for home visit nurses to promote exclusive breastfeeding in the early postpartum.

Knowledge and attitudes towards breastfeeding practices: A cross-sectional survey of postnatal mothers in China

OBJECTIVE

To examine the mothers' knowledge and attitudes toward breastfeeding and highlight barriers to exclusive breastfeeding in Chinese postpartum mothers.

DESIGN

Cross sectional survey SETTING: Maternity wards of two large, multi-service teaching hospitals, Wuhan, China.

PARTICIPANTS

324 postnatal mothers completed a structured questionnaire during their stay at hospital from October 2016 to January 2017.

MEASUREMENTS AND FINDINGS

Descriptive and inferential statistics revealed that most mothers showed neutral attitude on breastfeeding and neutral knowledge level as well. The average score for the total Iowa Infant Feeding Attitude Scale (IIFAS) was 56.55±4.77 M±SD, and 10.83±2.77, M±SD for the knowledge section. The mothers who had poor knowledge were less likely to initiate breastfeeding within an hour after birth.

CONCLUSIONS

The results of this study are applicable to nurses and nurse midwives to assist in identification of women who may be at-risk to not initiate breastfeeding. Maternal positive attitude and good knowledge play key roles in the process of breastfeeding. Thus, it is important to provide antenatal and early postpartum education and periodical breastfeeding counselling, especially for new mothers, to improve maternal attitudes and knowledge toward breastfeeding practices.

An Exploration of Breastfeeding Practices by Bhutanese Women

BACKGROUND:

Researchers have shown beneficial influences of exclusive breastfeeding for women and infants. Therefore, the World Health Organization recommends exclusively breastfeeding infants for the first 6 months following birth. In Bhutan, researchers have found, through survey research, variable exclusive breastfeeding rates at 6 months. They have not, however, explored the experiences and views of participants in relation to breastfeeding.

RESEARCH AIM:

The aim was to explore first-time mothers' views, intentions, and experiences related to exclusive breastfeeding.

METHODS:

A qualitative, prospective, longitudinal, descriptive study was undertaken using semistructured, audio-recorded interviews at two points of time with first-time mothers prenatally during late third trimester ( n = 24) and at 6 weeks after birth ( n = 22). The framework approach to analysis was used to identify themes.

RESULTS:

Two themes (breastfeeding, but uncertainty about achieving exclusive breastfeeding and acceptance that breastfeeding is painful) were identified from interviews at term. Five themes were identified from interviews at 6 weeks after birth (lack of timely breastfeeding information and support from health professionals, misconceptions about exclusive breastfeeding, being unprepared for the reality of breastfeeding, limited control or choice over feeding, and adoption of cultural and traditional practices).

CONCLUSION:

The participants breastfed but did not practice exclusive breastfeeding due to a lack of timely breastfeeding information and inadequate breastfeeding support. While family elders supported breastfeeding, they also promoted the adoption of certain traditional and cultural practices, which affected exclusive breastfeeding.