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Giang HTN, Duy DTT, Vuong NL, Ngoc NTT, Pham TT, Tuan LQ, Oai L, Do Thuc Anh P, Khanh TT, Thi NTA, Luu MN, Nga TTT, Hieu LTM, Huy NT. Prevalence of early skin-to-skin contact and its impact on exclusive breastfeeding during the maternity hospitalization. BMC Pediatr 2022; 22:395. [PMID: 35799125 PMCID: PMC9261219 DOI: 10.1186/s12887-022-03455-3] [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: 03/25/2022] [Accepted: 06/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early essential newborn care has been implemented in countries regardless high or low neonatal mortality. This study aims to investigate the current practice of skin-to-skin contact (SSC) and its effect on exclusive breastfeeding during the hospital stay. METHODS This is a cross-sectional study of 1812 Vietnamese mothers in multicenter. A questionnaire answered by the mothers was used to assess the duration of both SSC and breastfeeding practices. Multivariable logistic regression was used to identify a dose-response relationship between early SSC and prevalence of exclusive breastfeeding in hospital. RESULTS There were 88.7% of mothers experiencing SSC with their infants right after birth and the highest prevalence of SSC was found in district hospitals. Among those experiencing SSC, 18.8% of the infants received more than 90 min of SSC and completed the first breastfeeding during SSC time. Prevalence of exclusive breastfeeding during maternity hospital stay was 46.7%. We found a significant dose-response relation between the duration of SSC and exclusive breastfeeding in hospital. Compared with infants without SSC, the prevalence of exclusive breastfeeding was higher in infants who experienced SSC for 15-90 min (adjusted odds ratio [aOR], 95% confidence interval [95%-CI]: 2.62 [1.61-4.27]) and more than 90 min (aOR [95%-CI]: 5.98 [3.48-10.28]). Completed first breastfeeding during SSC time (aOR [95%-CI]: 4.24 [3.28-5.47]) and being born in district hospitals (aOR [95%-CI]: 2.35 [1.79-3.09]) were associated with increased prevalence of exclusive breastfeeding during hospital stay. On the other hand, mother education level as high school/intermediate (aOR [95%-CI]: 0.58 [0.42-0.82]) and place of residence classified as rural decreased odds of exclusive breastfeeding in hospital (aOR [95%-CI]: 0.78 [0.61-0.99]). CONCLUSION Our results demonstrate a strong dose-response relationship between duration of SSC and exclusive breastfeeding in hospital. Interventions that support exclusive breastfeeding during hospital stay, especially achieving prolonged uninterrupted SSC, could improve the duration of breastfeeding.
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Affiliation(s)
- Hoang Thi Nam Giang
- School of Medicine and Pharmacy, The University of Danang, Danang City, Vietnam.
| | - Do Thi Thuy Duy
- School of Medicine and Pharmacy, The University of Danang, Danang City, Vietnam
| | - Nguyen Lam Vuong
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nguyen Thi Tu Ngoc
- Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen City, Vietnam
| | - Thu Thi Pham
- School of Medicine and Pharmacy, The University of Danang, Danang City, Vietnam
| | - Le Quang Tuan
- School of Medicine and Pharmacy, The University of Danang, Danang City, Vietnam
| | - Le Oai
- School of Medicine and Pharmacy, The University of Danang, Danang City, Vietnam
| | - Pham Do Thuc Anh
- School of Medicine and Pharmacy, The University of Danang, Danang City, Vietnam
| | - Ton That Khanh
- School of Medicine and Pharmacy, The University of Danang, Danang City, Vietnam
| | - Nguyen Thi Anh Thi
- School of Medicine and Pharmacy, The University of Danang, Danang City, Vietnam
| | - Mai Ngoc Luu
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Tran Thi Tuyet Nga
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Le Tho Minh Hieu
- School of Medicine and Pharmacy, The University of Danang, Danang City, Vietnam
| | - Nguyen Tien Huy
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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Park S, Yu SY, Kwak E, Min D. A comparative study of cumulative stress patterns within 14 days postpartum in healthy mothers and those with gestational diabetes: A prospective study. Medicine (Baltimore) 2021; 100:e27472. [PMID: 34731125 PMCID: PMC8519200 DOI: 10.1097/md.0000000000027472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/21/2021] [Indexed: 01/05/2023] Open
Abstract
Although the number of mothers with gestational diabetes mellitus (GDM) is on the rise, only few studies have examined the cumulative stress associated with breastfeeding after childbirth. GDM mothers are susceptible to stress due to insulin resistance, and their level of stress is associated with breastfeeding. This study aimed to identify patterns of stress change over time in GDM mothers and healthy mothers and to identify the factors influencing those patterns.The participants of this study were mothers within 14 days after childbirth. The GDM group consisted of 32 mothers, and the healthy group comprised 30 mothers. Cumulative stress was measured in terms of heart rate variability, and linear mixed models were used to analyze changes over time.The cumulative stress of healthy mothers was about 8 points higher than that of mothers with GDM (t = -2.95, P = .005). The cumulative stress level was inversely associated with the mother's age (β=-1.20, P = .018), the mother's weight (β=-0.64, P = .008), and the baby's body mass index (β=-3.09, P = .038). Furthermore, an insufficient amount of breast milk was associated with higher stress (β=16.09, P = .007).GDM mothers and healthy mothers experienced different patterns of cumulative stress. Breastfeeding should be started quickly to promote health and stress reduction among mothers who are physically and psychologically vulnerable after childbirth.It is necessary to incorporate programs to promote breastfeeding considering stress levels at an appropriate time according to the mother's health condition.
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Affiliation(s)
- Seungmi Park
- Department of Nursing Science, Chungbuk National University, Cheongju, Republic of Korea
| | - Soo-Young Yu
- Department of Nursing Science, Jeonju University, Jeonju, Republic of Korea
| | - Eunju Kwak
- Department of Nursing Science, Chungbuk National University, Cheongju, Republic of Korea
| | - Deulle Min
- Department of Nursing, College of Medicine, Wonkwang University, Iksan, Republic of Korea
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Impact of early-onset sepsis guidelines on breastfeeding. J Perinatol 2021; 41:2499-2504. [PMID: 34362994 DOI: 10.1038/s41372-021-01154-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/22/2021] [Accepted: 07/08/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the impact of changes to neonatal early-onset sepsis (EOS) guidelines on in-hospital breastfeeding. STUDY DESIGN Asymptomatic neonates admitted to the Neonatal Intensive Care Unit (NICU) for sepsis evaluations over a 2-year period were identified. A retrospective chart review was conducted as part of a larger quality initiative on antibiotic stewardship. RESULT In Epoch 1, Epoch 2, and Epoch 3, there were 268 babies, 138 babies and 138 babies admitted to the NICU based on sepsis protocol, respectively. When comparing Epoch 1 to Epoch 3, there was a 14% increase in total breast milk consumption rates (p < 0.0001) and a 15% increase in exclusive breastfeeding at discharge (p < 0.002). CONCLUSION By implementing new EOS protocols, we have decreased NICU length of stay. We suggest that the decrease in mother-infant separation time leads to an improvement in breastfeeding.
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Llupià A, Torà I, Lladó A, Cobo T, Sotoca JM, Puig J. Factors related to inhibition of lactation by pharmacological means at birth in a Spanish referral hospital (2011-2017). GACETA SANITARIA 2021; 36:6-11. [PMID: 34246499 DOI: 10.1016/j.gaceta.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/29/2021] [Accepted: 05/17/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the maternal, neonatal and pregnancy characteristics related to inhibition of lactation (IL) with cabergoline. METHOD We assessed 20,965 occasions of breastfeeding initiation, according to data collected from obstetric records at the Hospital Clinic of Barcelona (Spain) between January 2011 and December 2017. RESULTS IL decreased over the study period from 8.78% to 6.18% (odds ratio [OR]: 0.93 per year; 95% confidence interval [95%CI]: 0.90-0.95). Women with a lower educational level (OR: 2.5; 95%CI: 2.0-3.0), mothers living in more depressed areas (OR: 1.08 per 10 extra points over 100; 95%CI: 1.04-1.12), smokers (OR: 2.2; 95%CI: 1.9-2.6), and those with more children (OR: 1.2 for each sibling; 95%CI: 1.1-1.3), preterm birth (OR: 1.8; 95%CI: 1.4-2.3), multiple births (OR: 1.6; 95%CI: 1.2-2.1) and a higher risk pregnancy (OR: 1.3 per risk point; 95%CI: 1.2-1.4) showed a higher prevalence of IL. Compared to women born in Spain, IL was less likely in all other women with the exception of Chinese women (OR: 7.0; 95%CI: 5.7-8.6). These disparities remained during the study period. CONCLUSIONS Factors related to lower socioeconomic status and poor health were more likely to be associated with IL. The overall use of cabergoline decreased during the study period while inequalities persisted. Taking these inequalities into account is the first step to addressing them.
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Affiliation(s)
- Anna Llupià
- Preventive Medicine and Epidemiology Unit, Hospital Clínic, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain.
| | - Isabel Torà
- Preventive Medicine and Epidemiology Unit, Hospital Clínic, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Alba Lladó
- BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Barcelona, Spain
| | - Teresa Cobo
- BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Barcelona, Spain; Fetal I+D Fetal Medicine Research Center, IDIBAPS, University of Barcelona, Barcelona, Spain; Center for Biomedical Research on Rare Diseases (CIBER-ER), Spain
| | | | - Joaquim Puig
- Department of Mathematics, Universitat Politècnica de Catalunya, Barcelona, Spain
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Evaluation of Mother's Stress during Hospitalization Can Influence the Breastfeeding Rate. Experience in Intensive and Non Intensive Departments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041298. [PMID: 32085465 PMCID: PMC7068435 DOI: 10.3390/ijerph17041298] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 12/25/2019] [Accepted: 01/23/2020] [Indexed: 11/16/2022]
Abstract
A mother’s milk offers several benefits to infant’s health, but, some factors may lead to a reduction in the duration of breastfeeding, such as maternal stress. The objective of our study is to determine if the rate of breastfeeding can be influenced by stress induced by infants’ hospitalization. A preliminary observational non-randomized study was carried out in Bambino Gesù Children’s Hospital between October 2016 and January 2017, in order to elucidate a possible relationship between breastfeeding and maternal stress, linked to hospitalization. We modeled the modified version of the PSS NICU (Parental Stressor Scale—neonatal intensive care unit) questionnaire, which investigated parental stress during hospitalization. This included 33 items with a score from 0 to 5. The overall score, high stress, was established at 85 points or higher. The principal statistically significant correlation was between ‘high PSS score’ and reduced breastfeeding during hospitalization (p-value: 0.048; OR: 2.865, 95%; CI: 1.008–8.146). This relation was not influenced by other descriptive characteristics of the mother. The PSS questionnaire can be an instrument to evaluate the influence of stress in breastfeeding and to monitor the rate and success of lactation. Our study highlights that the stress from hospitalization could influence the success of breastfeeding, mostly in intensive settings and during long hospitalizations.
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Vehling L, Chan D, McGavock J, Becker AB, Subbarao P, Moraes TJ, Mandhane PJ, Turvey SE, Lefebvre DL, Sears MR, Azad MB. Exclusive breastfeeding in hospital predicts longer breastfeeding duration in Canada: Implications for health equity. Birth 2018; 45:440-449. [PMID: 29498088 DOI: 10.1111/birt.12345] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/26/2018] [Accepted: 01/29/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Breastfeeding has many established health benefits for women and children. We examined the association between maternal education, newborn feeding in hospital, and long-term breastfeeding duration. METHODS We studied 3195 Canadian mother-infant dyads in the CHILD pregnancy cohort. Newborn feeding was documented from hospital records. Caregivers reported sociodemographic factors and infant feeding at 3, 6, 12, 18, and 24 months. RESULTS Overall, 97% of newborns initiated breastfeeding and 74% were exclusively breastfed in hospital. Exclusively breastfed newborns were ultimately breastfed longer compared with those who received formula supplementation during their hospital stay (median 11.0 vs 7.0 months, P < .001). After controlling for maternal age, ethnicity, birth mode, and gestational age, exclusively breastfed newborns had a 21% reduced risk of breastfeeding cessation (HR = 0.79, 0.71-0.87). This effect was strongest among women without a postsecondary education (HR = 0.65, 0.53-0.79). DISCUSSION Exclusive breastfeeding in hospital is associated with longer breastfeeding duration, particularly among women of lower socioeconomic status. Initiatives that support exclusive breastfeeding of newborns in hospital could improve long-term breastfeeding rates and help reduce health inequities arising in early life.
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Affiliation(s)
- Lorena Vehling
- Department of Pediatrics and Child Health, Health Sciences Centre, CE-208 Children's Hospital, University of Manitoba, Winnipeg, MB, Canada.,Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.,Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Deborah Chan
- Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.,College of Nursing, University of Manitoba, Winnipeg, MB, Canada
| | - Jon McGavock
- Department of Pediatrics and Child Health, Health Sciences Centre, CE-208 Children's Hospital, University of Manitoba, Winnipeg, MB, Canada.,Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Allan B Becker
- Department of Pediatrics and Child Health, Health Sciences Centre, CE-208 Children's Hospital, University of Manitoba, Winnipeg, MB, Canada.,Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Padmaja Subbarao
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Theo J Moraes
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | | | - Stuart E Turvey
- Department of Pediatrics, Child & Family Research Institute and BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Diana L Lefebvre
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Malcolm R Sears
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Meghan B Azad
- Department of Pediatrics and Child Health, Health Sciences Centre, CE-208 Children's Hospital, University of Manitoba, Winnipeg, MB, Canada.,Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
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Lee E, Jackson J. Breast is BEST: Increasing Health-Care Provider Knowledge and Confidence. J Dr Nurs Pract 2018; 11:132-138. [PMID: 32745020 DOI: 10.1891/2380-9418.11.2.132] [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: 11/25/2022]
Abstract
BACKGROUND Breastfeeding is recognized as the ideal source of nutrition for infants. However, several barriers to successful breastfeeding have been identified. Possibly one of the most significant barriers is the lack of health-care provider-related support and promotion of breastfeeding. OBJECTIVE The purpose of this study was to recognize the barriers to breastfeeding, ways health-care providers can assist patients in overcoming those barriers, and increase breastfeeding knowledge and confidence of health-care providers to better promote and manage breastfeeding clients. METHODS Study participants included: physicians, advanced practice nurses, and nurses. The American Academy of Pediatrics (AAP) Breastfeeding Residency Curriculum was utilized in the study, and participants were also educated on and encouraged to apply ACOG's Perinatal Practice Guidelines. RESULTS There was an overall increase of 19.2% in health-care provider knowledge scores and a 23% increase in confidence scores. There was also a 15.6% increase in documentation of early prenatal breastfeeding counseling. CONCLUSIONS The results and significance of the study provide evidence that once health-care providers are knowledgeable and confident in promoting breastfeeding, clients will be better equipped to successfully breastfeed. IMPLICATIONS FOR NURSING Breastfeeding success rates among mothers can be greatly improved through active support from health-care providers.
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Affiliation(s)
- Emily Lee
- Tennessee Technological University, Cookeville, Tennessee
| | - Joanie Jackson
- Tennessee Technological University, Cookeville, Tennessee
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Effective Communication Strategies for Nurses to Discuss Infant Feeding with New Mothers During Postpartum Hospitalization. MCN Am J Matern Child Nurs 2018; 43:218-224. [PMID: 29553946 DOI: 10.1097/nmc.0000000000000436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
During prenatal care and postpartum hospitalization, nurses have an important role in assisting new mothers to make informed decisions about feeding their newborn infants. There is overwhelming evidence that breastfeeding is beneficial for most new mothers and babies; therefore, perinatal nurses encourage breastfeeding. Newborn infant feeding conversations with women who have chosen to formula feed may be complicated and may cause tension in the nurse-patient relationship. Despite this potential difficulty, these conversations are essential to establish a feeding plan for the newborn infant and to promote healthy outcomes for mothers and babies. Tools are offered for nurses to guide conversations about infant feeding choices and to help to ensure that all mothers receive support and encouragement on their feeding choice.
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Abstract
Lower blood glucose values are common in the healthy neonate immediately after birth as compared to older infants, children, and adults. These transiently lower glucose values improve and reach normal ranges within hours after birth. Such transitional hypoglycemia is common in the healthy newborn. A minority of neonates experience a more prolonged and severe hypoglycemia, usually associated with specific risk factors and possibly a congenital hypoglycemia syndrome. Despite the lack of a specific blood glucose value that defines hypoglycemia, concern for substantial neurologic morbidity in the neonatal population has led to the generation of guidelines by both the American Academy of Pediatrics (AAP) and the Pediatric Endocrine Society (PES). Similarities between the 2 guidelines include recognition that the transitional form of neonatal hypoglycemia likely resolves within 48 hours after birth and that hypoglycemia that persists beyond that duration may be pathologic. One major difference between the 2 sets of guidelines is the goal blood glucose value in the neonate. This article reviews transitional and pathologic hypoglycemia in the neonate and presents a framework for understanding the nuances of the AAP and PES guidelines for neonatal hypoglycemia.
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Affiliation(s)
| | - Thomas Havranek
- Division of Neonatology, Children's Hospital at Montefiore, Bronx, NY
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10
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Abstract
Objectives: Identify, synthesize, and critically review research on common barriers to successful breastfeeding and ways healthcare providers can assist patients in overcoming the barriers.Methods: A search of databases and citations for evidence-based research published from 2001 to 2015 was conducted. Forty-nine articles were reviewed with 22 articles being discussed.Results: Three major themes were identified: (a) characteristics of breastfeeding education in the prenatal setting, (b) primary care interventions to promote breastfeeding, and (c) healthcare provider education on breastfeeding.Conclusions: Findings of this review collectively suggest the need to increase breastfeeding rates among women in the United States. To achieve this, there is great significance placed on healthcare providers implementing interventions to promote breastfeeding, which subsequently requires improving healthcare provider knowledge and self-confidence on breastfeeding.
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11
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Tozier PK. Colostrum versus formula supplementation for glucose stabilization in newborns of diabetic mothers. J Obstet Gynecol Neonatal Nurs 2015; 42:619-28. [PMID: 25803211 DOI: 10.1111/1552-6909.12260] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The purpose of this article is to describe practice change designed to facilitate breastfeeding while maintaining glucose stabilization in infants born to diabetic mothers. Postpractice change outcomes of newborn blood glucose levels, formula supplementation, and colostrum feeds are specifically addressed. There were no significant differences between glucose values for infants given formula supplementation versus those fed colostrum. Postpractice change, admissions to the neonatal intensive care unit (NICU) for glucose stabilization decreased and exclusive breastfeeding increased.
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12
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Gregory EF, Butz AM, Ghazarian SR, Gross SM, Johnson SB. Are unmet breastfeeding expectations associated with maternal depressive symptoms? Acad Pediatr 2015; 15:319-25. [PMID: 25906701 DOI: 10.1016/j.acap.2014.12.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 12/06/2014] [Accepted: 12/08/2014] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Most US women intend and initiate breastfeeding, yet many do not breastfeed as long as desired. Not meeting one's own prenatal expectations is a plausible mechanism for the previously observed association between lack of breastfeeding and postpartum depression (PPD). This study explored whether meeting prenatal expectations for exclusive breastfeeding was associated with PPD symptoms. METHODS The 2005 Infant Feeding Practices Study II (IFPSII) followed US mothers, primarily white women with higher education and income, from midpregnancy to 1 year postpartum. Depressive symptoms were defined as Edinburgh Postnatal Depression Scale (EPDS) of 10 or higher, measured at 2 months postpartum. Logistic regression analysis evaluated the odds of maternal depressive symptoms as a function of meeting prenatal expectations for exclusive breastfeeding, accounting for breastfeeding behavior, demographics, and postnatal experiences. RESULTS Among IFPSII participants, 1501 intended exclusive breastfeeding and completed the EPDS. At 2 months, 589 (39.2%) had met prenatal expectations for exclusive breastfeeding. EPDS was 10 or higher for 346 participants (23.1%). Adjusted odds of depressive symptoms were lower among women meeting prenatal exclusive breastfeeding expectations versus those who were not (odds ratio 0.71, 95% confidence interval 0.52-0.96). In subgroup analysis, there was no association between met expectations and depressive symptoms among women with lower incomes (<200% federal poverty level) or those intending mixed breast and formula feeding. CONCLUSIONS Among middle- and higher-income women who intended exclusive breastfeeding, those meeting prenatal breastfeeding expectations reported fewer PPD symptoms at 2 months postpartum. Clinician understanding and support of maternal expectations may improve maternal mental health.
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Affiliation(s)
- Emily F Gregory
- Department of General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Md.
| | - Arlene M Butz
- Department of General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Md
| | - Sharon R Ghazarian
- Department of General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Md
| | - Susan M Gross
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md
| | - Sara B Johnson
- Department of General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Md
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Korhonen K, Lehtonen L. Unnecessary and necessary in-hospital formula supplementation. J Pediatr 2014; 165:877. [PMID: 25109243 DOI: 10.1016/j.jpeds.2014.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 07/07/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Kalle Korhonen
- Department of Pediatrics, Turku University Central Hospital, Turku, Finland
| | - Liisa Lehtonen
- Department of Pediatrics, Turku University Central Hospital, Turku, Finland
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Nickel NC, Martens PJ, Chateau D, Brownell MD, Sarkar J, Goh CY, Burland E, Taylor C, Katz A. Have we left some behind? Trends in socio-economic inequalities in breastfeeding initiation: a population-based epidemiological surveillance study. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2014; 105:e362-8. [PMID: 25365271 PMCID: PMC6972463 DOI: 10.17269/cjph.105.4499] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 08/01/2014] [Accepted: 07/18/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Breastfeeding is associated with improved health. Surveillance data show that breastfeeding initiation rates have increased; however, limited work has examined trends in socio-economic inequalities in initiation. The study's research question was whether socio-economic inequalities in breastfeeding initiation have changed over the past 20 years. METHODS This population-based study is a project within PATHS Equity for Children. Analyses used hospital discharge data for Manitoba mother-infant dyads with live births, 1988-2011 (n=316,027). Income quintiles were created, each with ~20% of dyads. Three-year, overall and by-quintile breastfeeding initiation rates were estimated for Manitoba and two hospitals. Age-adjusted rates were estimated for Manitoba. Rates were modelled using generalized linear models. Three measures, rate ratios (RRs), rate differences (RDs) and concentration indices, assessed inequality at each time point. We also compared concentration indices with Gini coefficients to assess breastfeeding inequality vis-à-vis income inequality. Trend analyses tested for changes over time. RESULTS Manitoba and Hospital A initiation rates increased; Hospital B rates did not change. Significant inequalities existed in nearly every period, across all three measures: RRs, RDs and concentration indices. RRs and concentration indices suggested little to no change in inequality from 1988 to 2011. RDs for Manitoba (comparing initiation in the highest to lowest income quintiles) did not change significantly over time. RDs decreased for Hospital A, suggesting decreasing socio-economic inequalities in breastfeeding; RDs increased for Hospital B. Income inequality increased significantly in Manitoba during the study period. CONCLUSIONS Overall breastfeeding initiation rates can improve while inequality persists or worsens.
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Holmes AV, McLeod AY, Bunik M. ABM Clinical Protocol #5: Peripartum breastfeeding management for the healthy mother and infant at term, revision 2013. Breastfeed Med 2013; 8:469-73. [PMID: 24320091 PMCID: PMC3868283 DOI: 10.1089/bfm.2013.9979] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.
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Affiliation(s)
- Allison V. Holmes
- Department of Pediatrics and of Community and Family Medicine, Geisel School of Medicine, Dartmouth, New Hampshire
| | | | - Maya Bunik
- Department of Pediatrics, University of Colorado, Aurora, Colorado
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Sundercombe SL, Raynes-Greenow CH, Carberry AE, Turner RM, Jeffery HE. Audit of a clinical guideline for neonatal hypoglycaemia screening. J Paediatr Child Health 2013; 49:833-8. [PMID: 23795770 DOI: 10.1111/jpc.12293] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/09/2013] [Indexed: 11/30/2022]
Abstract
AIM This study aims to evaluate adherence to a clinical guideline for screening and prevention of neonatal hypoglycaemia on the post-natal wards. METHODS Retrospective chart review of 581 healthy term neonates born at a tertiary maternity hospital. Indications for hypoglycaemia screening included small for gestational age (SGA), infants of diabetic mothers (IDM; gestational, Type 1 or 2), symptomatic hypoglycaemia, macrosomia and wasted (undernourished) appearance. Outcomes were protocol entry and adherence with hypoglycaemia prevention strategies including early and frequent feeding and timely blood glucose measurement. RESULTS Of 115 neonates screened for hypoglycaemia, 67 were IDM, 19 were SGA (including two both IDM and SGA), and two were macrosomic. One IDM and one SGA were not screened. Twenty-two neonates were screened for a reason not identifiable from the medical record, and 13 neonates were SGA by a definition different to the guideline definition, including five who were also IDM. Guideline adherence was variable. Few neonates (41 of 106, 39%) were fed in the first post-natal hour, and blood glucose measurement occurred later than recommended for 41 of 106 (39%) of neonates. CONCLUSIONS Most IDM and SGA neonates were screened. While guideline adherence overall was comparable with other studies, neonates were fed late. We recommend staff education about benefits of early (within the first hour) frequent breastfeeding for neonates at risk.
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