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Clayton PK, Putnick DL, Trees IR, Ghassabian A, Tyris JN, Lin TC, Yeung EH. Early Infant Feeding Practices and Associations with Growth in Childhood. Nutrients 2024; 16:714. [PMID: 38474842 DOI: 10.3390/nu16050714] [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: 01/24/2024] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
Early infant growth trajectories have been linked to obesity risk. The aim of this study was to examine early infant feeding practices in association with anthropometric measures and risk of overweight/obesity in childhood. A total of 2492 children from Upstate KIDS, a population-based longitudinal cohort, were included for the analysis. Parents reported breastfeeding and complementary food introduction from 4 to 12 months on questionnaires. Weight and height were reported at 2-3 years of age and during later follow-up at 7-9 years of age. Age and sex z-scores were calculated. Linear mixed models were conducted, adjusting for maternal and child sociodemographic factors. Approximately 54% of infants were formula-fed at <5 months of age. Compared to those formula-fed, BMI- (adjusted B, -0.23; 95% CI: -0.42, -0.05) and weight-for-age z-scores (adjusted B, -0.16; -0.28, -0.03) were lower for those exclusively breastfed. Infants breastfed for ≥12 months had a lower risk of being overweight (aRR, 0.33; 0.18, 0.59) at 2-3 years, relative to formula-fed infants. Compared to introduction at <5 months, the introduction of fruits and vegetables between 5 and 8 months was associated with lower risk of obesity at 7-9 years (aRR, 0.45; 0.22, 0.93). The type and duration of breastfeeding and delayed introduction of certain complementary foods was associated with lower childhood BMI.
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Affiliation(s)
- Priscilla K Clayton
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Dr, Bethesda, MD 20817, USA
| | - Diane L Putnick
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Dr, Bethesda, MD 20817, USA
| | - Ian R Trees
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Dr, Bethesda, MD 20817, USA
| | - Akhgar Ghassabian
- Department of Pediatrics and Population Health, NYU Grossman School of Medicine, 550 First Avenue, New York, NY 10016, USA
| | - Jordan N Tyris
- Division of Hospital Medicine, Children's National Hospital, 111 Michigan Avenue NW, Washington, DC 20010, USA
| | - Tzu-Chun Lin
- Glotech Inc., 1801 Research Blvd Ste 605, Rockville, MD 20850, USA
| | - Edwina H Yeung
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Dr, Bethesda, MD 20817, USA
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Hoyos-Loya E, Pérez Navarro C, Burrola-Méndez S, Hernández-Cordero S, Omaña-Guzmán I, Sachse Aguilera M, Ancira-Moreno M. Barriers to promoting breastfeeding in primary health care in Mexico: a qualitative perspective. Front Nutr 2024; 10:1278280. [PMID: 38264191 PMCID: PMC10803647 DOI: 10.3389/fnut.2023.1278280] [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: 08/16/2023] [Accepted: 12/18/2023] [Indexed: 01/25/2024] Open
Abstract
Objective This article aimed to identify the main barriers related to promoting and counseling breastfeeding (BF) at the Primary Health Care (PHC) in Mexico. Methodology A qualitative study with a phenomenological approach was carried out in 88 health centers of the Ministry of Health in the states of Chihuahua, Oaxaca, Chiapas, Veracruz, Mexico, and Yucatan. From September to November 2021, we interviewed 88 key health professionals (HPs) (physicians, nurses, nutritionists, and others) from the PHC of the Ministry of Health in Mexico and 80 parents of children under 5 years old. In addition, nine focus groups were conducted with parents and caregivers. The data obtained were triangulated with information from focus groups and semi-structured interviews. Results Of the total interviews, 43.2% (n = 38) were nurses, 29.5% (n = 26) were physicians, 19.3% (n = 17) were nutritionists, and the rest were other health professionals. In the group of users, 97.6% (n = 121) were women. We identified contextual barriers, such as the lack of well-trained health professionals and the scarcest nutrition professionals, as material resources in the health units, without mentioning the low user attendance at their control consultations. Furthermore, we identified barriers related to the orientation and promotion of breastfeeding in health units, including a lack of specific strategies, ineffective communication, and the recommendations of commercial milk formulas. Conclusion The results presented reflect the reality of Mexico in relation to BF, making it urgent to take immediate action to improve the quality of nutritional care related to the promotion and orientation of BF at the PHC.
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Affiliation(s)
- Elizabeth Hoyos-Loya
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Mexico City, Mexico
| | - Cecilia Pérez Navarro
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Mexico City, Mexico
- Health Department, Universidad Iberoamericana, Mexico City, Mexico
| | - Soraya Burrola-Méndez
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Mexico City, Mexico
- Health Department, Universidad Iberoamericana, Mexico City, Mexico
| | - Sonia Hernández-Cordero
- Health Department, Universidad Iberoamericana, Mexico City, Mexico
- Research Center for Equitable Development EQUIDE, Universidad Iberoamericana, Mexico City, Mexico
| | - Isabel Omaña-Guzmán
- Health Department, Universidad Iberoamericana, Mexico City, Mexico
- Pediatric Obesity Clinic and Wellness Unit, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico
| | | | - Mónica Ancira-Moreno
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Mexico City, Mexico
- Health Department, Universidad Iberoamericana, Mexico City, Mexico
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Kaya Ö, Tecik S, Suzan ÖK, Kabul F, Koyuncu O, Çınar N. The effect of interventions on flat and inverted nipple on breastfeeding: A systematic review. J Pediatr Nurs 2024; 74:e1-e13. [PMID: 37558567 DOI: 10.1016/j.pedn.2023.07.024] [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: 01/27/2023] [Revised: 07/31/2023] [Accepted: 07/31/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Some methods have been developed to solve flat and/or inverted nipple problems. This study aimed to examine the effects of flat and/or inverted nipple interventions on nipples and breastfeeding. METHODS Before initiating the review, the protocol was registered in the 'PROSPERO' database. This study was based on the PRISMA-P guideline. Seven databases (Web of Science, PubMed, ScienceDirect, Scopus, The Cochrane Library, TÜBİTAK Ulakbim and Google Scholar) were searched, and nine studies were included in this review. RESULTS Hoffman's exercise, the inverted syringe method, and the nipple exercise was quite effective in increasing breastfeeding success. The rate of exclusive breastfeeding in the first, third, and sixth months of mothers followed up with postpartum multidimensional visits was found to be significantly higher in the intervention group than in the control group (p < 0.05). A study in which a rubber band was applied with the help of an injector on flat and inverted nipples showed that 63% of mothers on the third day and all of them in the first month were able to breastfeed without a rubber band. Hoffman's exercise, the inverted syringe technique, and rubber bands corrected the flat and/or inverted nipple. There were studies reporting complications as a result of nipple interventions. CONCLUSIONS AND IMPLICATIONS It is necessary to disseminate the information that breastfeeding of mothers with flat and/or inverted nipples can be sustained with various interventions. Furthermore, it is believed that providing mothers with a chance to choose the interventions, and thus, the compliance of mothers to the intervention with the method of their choice may increase the success of the intervention.
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Affiliation(s)
- Özge Kaya
- Sakarya University, Institute of Health Sciences, Esentepe Campus, Sakarya 54050, Türkiye.
| | - Seda Tecik
- Sakarya University, Institute of Health Sciences, Esentepe Campus, Sakarya 54050, Türkiye
| | - Özge Karakaya Suzan
- Sakarya University, Faculty of Health Sciences, Esentepe Campus, Sakarya 54050, Türkiye
| | - Faruk Kabul
- Sakarya University, Institute of Health Sciences, Esentepe Campus, Sakarya 54050, Türkiye
| | - Oğuz Koyuncu
- Sakarya University, Institute of Health Sciences, Esentepe Campus, Sakarya 54050, Türkiye
| | - Nursan Çınar
- Sakarya University, Faculty of Health Sciences, Esentepe Campus, Sakarya 54050, Türkiye
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Augustyn M, Haskins D, Gross S, Resnik AK, Ducharme-Smith K, Orta-Aleman D, Silbert-Flagg J, Rosenblum N, Caulfield LE. Maternity care experiences and breastfeeding at discharge among Maryland WIC participants: A qualitative analysis. Birth 2023; 50:1009-1017. [PMID: 37533361 DOI: 10.1111/birt.12758] [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: 09/16/2021] [Revised: 04/18/2023] [Accepted: 07/20/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Breastfeeding imparts numerous health and social benefits for families. Barriers deter some individuals from breastfeeding. Rates are lower among certain populations, including participants of the federally funded Women, Infants, and Children's Program (WIC). Women, Infants, and Children's Program provides low-income pregnant and postpartum women and children under 5 with nutrition education, supplemental foods, breastfeeding education and support, and resource linkages. Investigation of WIC participants' hospital experiences and breastfeeding decisions is limited. We explore qualitative themes associated with breastfeeding-related hospital maternity care practices experienced by WIC participants. METHODS Thirty pregnant individuals intending to breastfeed were recruited at WIC clinics to complete in-depth interviews at 2 weeks, 3 months, and 6 months of postpartum. Using the Thematic Framework methodology, we analyzed data from the two-week interviews of 29 participants with respect to hospital breastfeeding experiences. RESULTS Fourteen participants were exclusively breastfeeding at discharge (EBFD). Fifteen were partially breastfeeding at discharge (PBFD). Differences between groups were found in hospital breastfeeding experiences, particularly in staff support. All participants EBFD reported positive breastfeeding-related staff experiences. Most participants PBFD reported limited and ineffective staff interaction, leading to formula introduction. CONCLUSIONS Individuals EBFD and those PBFD reported about the same rate of hospital breastfeeding difficulties, yet half introduced formula within the first few days postpartum. Results reiterate the importance of hospital staff support to breastfeeding exclusivity at 2-3 days postpartum. The challenges that these individuals faced may have been resolved through available, responsive, and effective intervention. Data-driven breastfeeding education programs for hospital health professionals are critical to affect patient breastfeeding outcomes.
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Affiliation(s)
- Marycatherine Augustyn
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - Danielle Haskins
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - Susan Gross
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - Amy Kovar Resnik
- Maryland WIC Program, Maryland Department of Health, Baltimore, Maryland, USA
| | - Kirstie Ducharme-Smith
- Center for Human Nutrition, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - Dania Orta-Aleman
- Center for Human Nutrition, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - JoAnne Silbert-Flagg
- Pediatric Nurse Practitioner Track, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Nadine Rosenblum
- Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, Maryland, USA
- Adjunct Faculty, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Laura E Caulfield
- Center for Human Nutrition, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
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Ajuzie S. Evaluating the Challenges and Potential Complications of Breastfeeding in Naval Aviation. Mil Med 2023; 188:e2543-e2549. [PMID: 36545809 DOI: 10.1093/milmed/usac396] [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: 06/04/2022] [Revised: 09/13/2022] [Accepted: 11/28/2022] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION Active duty flight crew plays a critical role in military operations. The occupational demands of the flying environment require a certain level of medical suitability. Additionally, such an environment could be more hazardous for certain populations. While the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and the World Health Organization strongly support exclusive breastfeeding for the health benefit of both the mother and the child in the first 6 months of life, the aeromedical implications of lactating are not widely discussed. Breastfeeding is inherently challenging for many women, in part because of the frequent emptying required to maintain breastmilk supply and avoid complications such as engorgement, clogged ducts, and mastitis. This pilot study evaluated the experiences of individuals concurrently breastfeeding while on active duty Naval flying status to (1) assess whether these individuals experience frequent challenges or complications associated with lactating and (2) establish the need for future expanded studies. MATERIALS AND METHODS This survey-based, retrospective, descriptive study evaluated the experiences of 17 lactating individuals on active duty Naval flying status. Women were recruited using word of mouth and social media platforms. Responses were tabulated and summarized from the survey, which included yes/no questions and free-response sections regarding flying position, breastfeeding history, and breastfeeding challenges. This trial was approved by the Naval Air Warfare Center Aircraft Division (NAWCAD) Institutional Review Board (Protocol Number NAWCAD.2021.0004-IR-EP7). RESULTS Of the 27 women who received study materials after expression of interest, 17 individuals completed the informed consent and survey protocols. Although limited by sample size and the demographics of respondents, the results highlight that the active duty flying environment did impact the breastfeeding experiences of the participants, with 88% of respondents reporting some difficulty or complication associated with breastfeeding and the operational flying environment. Difficulty in maintaining breastmilk supply, engorgement, and the need for supplementation were some of the concerns discussed. CONCLUSIONS This study hypothesizes that occupational demands associated with aviation result in a decreased ability to maintain exclusive breastfeeding, an increased risk for engorgement and clogged ducts, and a higher likelihood of early weaning among Naval aviators. It included only the perspectives of Naval officers, thereby lacking the input of enlisted aircrew on flight status, who comprise a large population of active duty flyers. The responses, although limited by a lack of controls and survey limitations, indicate that a future study to expand understanding of the aeromedical implications on lactating individuals would be valuable for improving workplace support and the ultimate success of lactating women in meeting their breastfeeding goals.
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Tsunoda K, Matsumura K, Inano H, Hatakeyama T, Tsuchida A, Inadera H. Association of infants' feeding pattern up to 2 years postpartum with mothers' mental and physical health: the Japan Environment and Children's Study. J Affect Disord 2023; 327:262-269. [PMID: 36739006 DOI: 10.1016/j.jad.2023.01.106] [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: 09/27/2022] [Revised: 01/09/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Exclusive breastfeeding, a longer breastfeeding duration, and interaction with the baby during lactation improve mothers' mental health. However, few studies have targeted women around 2.5 years after childbirth, when women are still considered to have been in a period of mental and physical health vulnerability. This study examined this aspect in a large cohort of mother-child pairs. METHODS Data were obtained from 85,735 mothers in an ongoing nationwide birth cohort study in Japan. Exposures were exclusive breastfeeding (yes/no), continued breastfeeding up to 2 years (yes/no), and interaction with the baby during feeding (yes/no). Outcomes were mothers' mental and physical health 2.5 years after childbirth measured using Mental and Physical Component Summary scores (MCS and PCS scores, respectively) from the 8-item Short-Form Health Survey. Generalized additive mixed model analysis was used to derive each estimate for the three exposures and their interactions, with each "no" answer as reference. RESULTS Exclusive breastfeeding and interaction with the baby during feeding were associated with MCS score increases of 0.28 (95%CI: 0.10-0.47) and 0.41 (95%CI: 0.29-0.54), respectively. However, no associations were found for continued breastfeeding up to 2 years and no interactions were identified. No significant differences were observed for PCS scores. LIMITATIONS All variables were measured using a self-administered questionnaire. CONCLUSIONS Continued exclusive breastfeeding until 6 months and interaction with the baby during feeding may help to promote mother's mental health 2.5 years after childbirth. These findings further strengthen the rationale for the World Health Organization's recommended lactation practices.
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Affiliation(s)
- Kasumi Tsunoda
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan; Department of Food and Nutrition, Toyama College, Toyama, Japan
| | - Kenta Matsumura
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Hitomi Inano
- Department of Maternal Nursing, Graduate School of Medicine and Pharmaceutical Science for Education, University of Toyama, Toyama, Japan
| | | | - Akiko Tsuchida
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan; Toyama Regional Center for JECS, University of Toyama, Toyama, Japan.
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Polic A, Eutsler KM, Patel SS. Breastfeeding and the patient's perspective. ABDOMINAL RADIOLOGY (NEW YORK) 2023; 48:1629-1636. [PMID: 36625897 DOI: 10.1007/s00261-022-03791-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE The purpose of this article is to summarize available data on breastfeeding in patients with a cancer diagnosis. MATERIALS AND METHODS A review of available literature in the MEDLINE database was performed and the data summarized. In addition, two patient interviews were conducted to gain insight into the patient perspective. RESULTS Breastmilk is the nutritional standard for human infants and understanding the implications of a cancer diagnosis on lactation is important in optimizing maternal and infant outcomes. Though limited, available data suggest that breastfeeding may be a safe and appropriate option for some patients undergoing treatment of a malignancy. CONCLUSIONS Patient experiences with breastfeeding in the setting of a cancer diagnosis vary widely, and depend on the type of malignancy, the timing of the diagnosis, and the indicated treatment. Breastfeeding may be an appropriate option for certain patients after multidisciplinary counseling. Alternatives to breastfeeding exist for patients who are unable to or do not desire to breastfeed.
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Affiliation(s)
- Aleksandra Polic
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA.
| | - Kaitlin M Eutsler
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA
| | - Soha S Patel
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA
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Bunik M, Jimenez-Zambrano A, Solano M, Beaty BL, Juarez-Colunga E, Zhang X, Moore SL, Bull S, Leiferman JA. Mother's Milk Messaging™: trial evaluation of app and texting for breastfeeding support. BMC Pregnancy Childbirth 2022; 22:660. [PMID: 36002798 PMCID: PMC9400217 DOI: 10.1186/s12884-022-04976-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND New mothers experience BF challenges but have limited evidence-based technology-enabled support. OBJECTIVES 1) Determine if using the Mother's Milk Messaging™ app improved aspects of breastfeeding and breastfeeding rates and 2) Describe engagement as well as themes from the qualitative feedback on the app. METHOD Randomized Controlled Trial National sample of primiparous, singleton mothers recruited online and then randomized using stratification by language into three arms: 1) BF text messages plus app; 2) BF text messages, app and physician-moderated private Facebook (FB) group; 3) Attention control group who received injury prevention texts. Exclusive breastfeeding rates as primary outcome and knowledge/attitude, confidence, and social support as secondary outcomes. We determined engagement through analysis of app usage metrics. We conducted and content-coded interviews with participants to learn more about app usage and BF experience. Due to the nature of the intervention participants could not be blinded. RESULTS There were a total of 346 participants in the trial, with 227 in the Intervention (n = 154 group 1 and n = 156 group 2) and 119 in the control group. Because of minimal Facebook activity, the two intervention groups 1 and 2 were combined. There were no differences in breastfeeding exclusivity and duration. (NS). Women in the intervention arm reported significantly higher confidence with breastfeeding and perceived social support to the control group (p < .05). Greater than 80% registered the app and those that engaged with the app had higher scores with time. Mothers appreciated receiving text messages and videos with reliable information. No harm was reported in this study. CONCLUSION MMM increased confidence with breastfeeding and with gathering social supports. Exclusively BF was high in all participants. Mothers perceived it as useful and dependable especially the texting.
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Affiliation(s)
- Maya Bunik
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. .,Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. .,Children's Hospital Colorado, 13123 E. 16th Ave B032, Aurora, CO, 80045, USA.
| | - Andrea Jimenez-Zambrano
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Michael Solano
- Children's Hospital Colorado, 13123 E. 16th Ave B032, Aurora, CO, 80045, USA
| | - Brenda L Beaty
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Elizabeth Juarez-Colunga
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Xuhong Zhang
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Susan L Moore
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sheana Bull
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jenn A Leiferman
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Peregoy JA, Pinheiro GM, Geraghty SR, Dickin KL, Rasmussen KM. Human milk-sharing practices and infant-feeding behaviours: A comparison of donors and recipients. MATERNAL & CHILD NUTRITION 2022; 18:e13389. [PMID: 35757994 PMCID: PMC9480963 DOI: 10.1111/mcn.13389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 03/04/2022] [Accepted: 03/14/2022] [Indexed: 11/28/2022]
Abstract
Human milk sharing (HMS) is growing in popularity as an infant-feeding strategy in the United States. HMS families are a hidden population because HMS is a nonnormative and stigmatized behaviour. Thus, gaining access to HMS participants is challenging, and research on this topic remains limited. In particular, little is known about the broader infant-feeding behaviours of HMS parents. This study aimed to describe and compare the infant-feeding behaviours and HMS practices among a network of HMS donors and recipients. A detailed online survey was distributed to HMS parents in the Washington, DC region. Bivariate analyses were used to summarize the data by donor/recipient status when possible. Group differences were tested using analysis of variance for continuous variables and χ2 tests for categorical variables. Donors and recipients did not differ in their sociodemographic characteristics. Recipients were significantly more likely than donors to have experienced complications of labour and delivery, traumatic birth, postpartum depression or a negative breastfeeding experience. Donors and recipients did not differ significantly in their duration of lactation or HM-feeding. Interestingly, 30% of recipients ever produced excess milk and 21% of donors ever had difficulty producing enough milk for their child. Compared with donors, recipients faced numerous maternal health challenges, but were still able to achieve a long duration of HM-feeding. HMS recipients represent a vulnerable group who may benefit from additional psychosocial and lactation support to improve their health and breastfeeding outcomes. Additional research is needed to investigate the associations between HMS participation, infant-feeding behaviours and lactation outcomes.
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Affiliation(s)
| | | | | | - Katherine L. Dickin
- Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA,Department of Public and Ecosystem HealthCornell UniversityIthacaNYUSA
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Apanga PA, Christiansen EJ, Weber AM, Darrow LA, Riddle MS, Tung WC, Liu Y, Kohnen T, Garn JV. The role of state breastfeeding laws and programs on exclusive breastfeeding practice among mothers in the special supplemental nutrition program for Women, Infants, and Children (WIC). Int Breastfeed J 2022; 17:46. [PMID: 35752853 PMCID: PMC9233787 DOI: 10.1186/s13006-022-00490-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 06/18/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND It is unclear if state laws supporting breastfeeding are associated with exclusive breastfeeding (EBF) practice among low-income mothers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The main objectives of our study were to assess the relationship between such laws and EBF among WIC-participating mothers and to assess whether this association varied by employment status. We also assessed how mother's exposure to WIC breastfeeding consultation was associated with EBF. METHODS A cross-sectional study was conducted across seven WIC program locations (i.e., Georgia, Massachusetts, Nevada, Pennsylvania, Wisconsin, Wyoming, Chickasaw Nation) between July-August 2020. Data were collected using convenient sampling from each program location and surveys were administered electronically or on paper to WIC-participating mothers. We restricted our analysis to data from 1161 WIC-participating mothers with infants aged zero to five months old. Multivariable mixed models were used to estimate the relationship between our exposures of interest (i.e., number of laws supporting breastfeeding, employment-related breastfeeding laws, WIC breastfeeding consultation) and EBF, while controlling for potential confounders and accounting for clustering by program location. Effect modification by employment status was assessed on the additive and multiplicative scales. RESULTS Among WIC-participating mothers living in program locations with no employment-related breastfeeding laws, EBF was 26% less prevalent for employed mothers compared to unemployed mothers (adjusted prevalence ratios [aPR]: 0.74, 95% CI: 0.67,0.83). Among all mothers, a one-unit increase in laws supporting breastfeeding was not associated with EBF (aPR: 0.88, 95% CI: 0.71,1.10). However, among employed mothers, living in areas with more employment-related laws was associated with a higher prevalence of EBF (aPR: 1.43, 95% CI: 0.83, 2.44). Infants whose mothers received a WIC breastfeeding consultation had 33% higher prevalence of being exclusively breastfed compared to infants whose mothers did not receive a WIC breastfeeding consultation (aPR: 1.33, 95% CI: 1.05,1.70). CONCLUSIONS Infants whose WIC-participating mothers were employed, were less likely to be exclusively breastfed, but our effect modification analyses showed that laws supporting breastfeeding at the workplace may promote EBF among employed women. EBF was more prevalent among mothers who received a WIC breastfeeding consultation compared to those who did not receive such a consultation.
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Affiliation(s)
- Paschal A Apanga
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Elizabeth J Christiansen
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Ann M Weber
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Lyndsey A Darrow
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Mark S Riddle
- School of Medicine, University of Nevada, Reno, 1664 N Virginia St, NV, 89557, Reno, USA
| | - Wei-Chen Tung
- The Valley Foundation of School of Nursing, San Jose State University, 1 Washington Sq, San Jose, CA, 95192, USA
| | - Yan Liu
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Taya Kohnen
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Joshua V Garn
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA.
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11
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Hodgson EC, Livingston MH, Robinson T, Farrokhyar F, Walton JM. Use of breast milk in infants with uncomplicated gastroschisis: A retrospective cohort study. J Pediatr Surg 2022; 57:840-845. [PMID: 35058060 DOI: 10.1016/j.jpedsurg.2021.12.045] [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: 12/28/2021] [Accepted: 12/30/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Infants with gastroschisis often experience slow return of bowel function following closure. The purpose of this study was to determine whether exclusive breast milk is associated with decreased time to enteral autonomy. METHODS We conducted a retrospective cohort study of infants with uncomplicated gastroschisis from a tertiary pediatric hospital. The primary outcome was enteral autonomy, defined as days from initiating enteral feeds to stopping parenteral nutrition. Secondary outcomes included days of parenteral nutrition, length of stay, positive culture, necrotizing enterocolitis, cholestasis, additional surgery, readmission, and mortality. RESULTS We identified 100 infants with gastroschisis treated from 2005 to 2019. Twenty-five were excluded due to gestational age <32 weeks, birth weight <1500 g, or gastroschisis-associated complications (e.g., intestinal atresia). Seventy-five were included in the analysis. Mean gestational age was 36 weeks, 48% were female, and all were diagnosed antenatally. Sixty-five infants (87%) received exclusive maternal (n = 64) or donor (n = 1) breast milk, while 10 others (13%) were fed formula for 1-16 days (mean 7 days). Two infants received formula only. Demographics and gastroschisis prognostic scores were similar between groups. Infants who were given breast milk exclusively demonstrated decreased time to enteral autonomy (median 18 versus 25 days, p = 0.023) and shorter duration of parenteral nutrition (median 20 versus 26 days, p = 0.037). CONCLUSION Exclusive breast milk may be associated with improved outcomes among infants with gastroschisis. Further research is needed to evaluate the economic impact of this association and explore possible confounders. These efforts may expand the role of donor breast milk for these patients.
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Affiliation(s)
- Emily C Hodgson
- Division of General Surgery, McMaster University, Hamilton, Canada; Biomedical Graduate Studies, University of Pennsylvania, Philadelphia, USA; Division of Pediatric General, Thoracic and Fetal Surgery, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Michael H Livingston
- Division of Pediatric Surgery, McMaster University, Hamilton, Canada; McMaster Pediatric Surgery Research Collaborative, McMaster University, Hamilton, Canada
| | - Tessa Robinson
- Division of Pediatric Surgery, McMaster University, Hamilton, Canada; Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, Hamilton, Canada
| | - Forough Farrokhyar
- Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, Hamilton, Canada; Department of Surgery, McMaster University, Hamilton, Canada
| | - J Mark Walton
- Division of Pediatric Surgery, McMaster University, Hamilton, Canada; McMaster Pediatric Surgery Research Collaborative, McMaster University, Hamilton, Canada.
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12
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Topothai C, Topothai T, Suphanchaimat R, Waleewong O, Putthasri W, Patcharanarumol W, Tangcharoensathien V. Exclusive Breastfeeding Experiences of Thai Mothers in Metropolitan Bangkok. Int J Womens Health 2022; 14:155-166. [PMID: 35173490 PMCID: PMC8842719 DOI: 10.2147/ijwh.s344389] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/12/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction In 2019, only 14% of mothers in Thailand performed six-month exclusive breastfeeding. This study sought to understand the pathways that mothers in Bangkok Metropolitan took to achieve successful six-month exclusive breastfeeding. Methods A total of 50 mothers living in Bangkok with children aged 6–12 months, who achieved and not achieved 6-month exclusive breastfeeding, were recruited for in-depth interviews during February to July 2020. Inductive thematic analysis of participants’ viewpoints was applied for data analysis and interpretation. Results Four themes that contributed to six-month exclusive breastfeeding were i) maternal breastfeeding self-efficacy; ii) support provided by family members; iii) engagement with and support from healthcare professionals; and iv) employers’ support and workplace environments. Mothers with strong breastfeeding intentions and “perceived capability” to succeed at breastfeeding tended to prioritize breastfeeding and overcome and cope well with unforeseen breastfeeding challenges. Supportive family members, who were convinced of the benefits of breastfeeding, engaged in maternal decision-making, and provided optimal support, contributed to successful exclusive breastfeeding. Health professionals were key in supporting mothers throughout pregnancy until the postpartum period. Lactating-mother-friendly working conditions, flexible working hours and enabling workplace environments, including the provision of breastfeeding breaks and a dedicate space for breast milk expression, were enabling factors for successful exclusive breastfeeding among working mothers. Conclusion We recommend that all mothers and their family members are fully informed and convinced of the benefit from breastfeeding and trained with practical skill during their visit to antenatal care clinics. These interventions aim to develop mothers’ self-efficacy for breastfeeding and to prepare them to manage common breastfeeding challenges. Health professionals should provide regular follow-up and counseling sessions on breastfeeding practices to mothers and families throughout the lactating period, especially working mothers for breastfeeding continuation after resume to work. Enhanced societal collective actions such as breastfeeding-friendly policy in workplace, including breastfeeding break-time and corner, can create enabling environments for successful exclusive breastfeeding.
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Affiliation(s)
- Chompoonut Topothai
- International Health Policy Program, Ministry of Public Health, Nonthaburi, 11000, Thailand.,Department of Health, Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Thitikorn Topothai
- International Health Policy Program, Ministry of Public Health, Nonthaburi, 11000, Thailand.,Department of Health, Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Rapeepong Suphanchaimat
- International Health Policy Program, Ministry of Public Health, Nonthaburi, 11000, Thailand.,Department of Disease Control, Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Orratai Waleewong
- International Health Policy Program, Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Weerasak Putthasri
- National Health Commission Office, Ministry of Public Health, Nonthaburi, 11000, Thailand
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13
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Wahyuni S, Budi NGMAA, Mulyo GPE, Mulyati S, Fauzia F. Predictors of Exclusive Breast Milk Failure Before Six Months: A Study on Exclusive Breastfeeding in the City of Bogor, West Java, Indonesia. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Exclusive breastfeeding is the cornerstone of a child’s survival and health because it provides essential and irreplaceable nutrients for their growth and development. The coverage rate for exclusive breastfeeding for infants 0–6 months in West Java in 2017 was 55.4%, below the national figure of 61.33%.
AIM: The purpose of this article is to identify the failure factors for exclusive breastfeeding.
METHODS: The study began with a quasi-experimental period with a pre- and post-test group design approach through a health education process about exclusive breastfeeding in the third trimester of pregnancy, followed by a prospective study on breastfeeding practice in infants in the first 6 months of life. The analysis used was Chi-square analysis (χ2) and Paired t-test. Then, followed by a qualitative study to explore the supports and barriers to exclusive breastfeeding through in-depth interviews and carried out an analysis with modified Aronso’s qualitative analysis steps. The quantitative study sample is 50 people. The sample for the qualitative study was 15 people consisting of mothers with babies over 6-months-old, midwives, health staff. The study started from March 2017 to September 2018.
RESULTS: The knowledge score of the intervention group increased significantly from 26.08 before the intervention to 31.78 after the intervention (p-value 0.000), with 3.52 more excellent than the control group. The attitude score of the intervention group rose significantly from 8.2 before the intervention to 13.16 after the intervention (p-value 0.000), with 3.12 more excellent than the control group. The intervention significantly affected exclusive breastfeeding behavior with a p-value of 0.047, but the behavior of exclusive breastfeeding was still 36%. The qualitative study findings contained support and obstacles in implementing exclusive breastfeeding in the city of Bogor. Supporting factors range from a support system in regional regulations and class programs for pregnant women to support for infrastructure. At the same time, obstacles include parenting patterns, individual factors, other internal and external influences.
CONCLUSION: Health education can improve knowledge, attitudes and behavior of exclusive breastfeeding. There are still other predictors of the failure of exclusive breastfeeding before 6 months outside of health education.
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Ribeiro MRC, Santos AMD, Gama MEA, Santos ALGDA, Lago DCF, Yokokura AVCP, Costa LC, Silva KM, Sá LP, Silva AAMD. Ocupação materna e duração do aleitamento materno exclusivo: resultados de uma coorte de nascimento em São Luís, Maranhão, Brasil. CAD SAUDE PUBLICA 2022; 38:e00180221. [DOI: 10.1590/0102-311xpt180221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 05/13/2022] [Indexed: 11/22/2022] Open
Abstract
Nas investigações dos determinantes da duração do aleitamento materno exclusivo (AME), a variável trabalho materno remunerado é quase sempre dicotomizada em não e sim. Este estudo analisa possíveis associações entre características da ocupação materna e menor duração do AME. Foi realizado um estudo de coorte em uma amostra sistemática de nascimentos do Município de São Luís (Maranhão, Brasil) em 2010. As exposições tipo de ocupação materna, números de dias trabalhados/semana e de horas trabalhadas/dia, trabalha em pé a maior parte do tempo e levanta objetos pesados nesse trabalho foram coletadas com 5.166 mães de nascidos vivos. A amostra final desse estudo teve 3.268 observações. Foi utilizada análise de sobrevida para testar associações entre as exposições e os desfechos AME até 4 meses (AME4) e AME até 6 meses (AME6). Não ter trabalho remunerado foi a categoria de referência. Regressões ajustadas de Cox mostraram que mães com ocupações manuais semiespecializadas (intervalo de 95% de confiança, IC95%: 1,02-1,58 para AME4 e IC95%: 1,11-1,56 para AME6) e mães que trabalhavam 8 ou mais horas diárias (IC95%: 1,01-1,36 para AME4 e IC95%: 1,11-1,41 para AME6) mais frequentemente interromperam AME. Mães com ocupações em funções de escritório (IC95%: 1,07-1,46), que trabalhavam 4-5 dias (IC95%: 1,01-1,36) ou 6-7 dias/semana (IC95%: 1,09-1,40) e por 5-7 horas (IC95%: 1,03-1,43) também praticaram menos AME6. Trabalhar (IC95%: 1,08-1,40) ou não (IC95%: 1,03-1,34) em pé a maior parte do tempo e levantar (IC95%: 1,07-1,56) ou não (IC95%: 1,06-1,33) objetos pesados no trabalho diminuíram a duração de AME6. Tipos de ocupação e de jornada de trabalho interferiram mais frequentemente na duração de AME6.
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15
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Stelson EA, Kulkacek L, Frasso R, Hall M, Guevara JP. Perspectives on Breastfeeding from Mothers with Postpartum Depression Symptoms: A Qualitative Assessment of Antecedents, Barriers, Facilitators, and Intervention Suggestions. Breastfeed Med 2021; 16:790-798. [PMID: 34010030 PMCID: PMC8817733 DOI: 10.1089/bfm.2020.0251] [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: 11/13/2022]
Abstract
Background: Postpartum depression (PPD) is one of the most common birthing complications, and studies negatively associate PPD with breastfeeding initiation and continuation. However, little is known about either the breastfeeding experience of mothers with PPD or what resources mothers need for sustained breastfeeding from their perspectives. This study aimed to identify the antecedents, barriers, and facilitators to breastfeeding for mothers with PPD, understand the relationship between self-efficacy and emergent themes, and generate suggestions to inform supportive interventions. Materials and Methods: Birth mothers who screened positive for PPD and reported breastfeeding were recruited to participate in semistructured interviews. Interviews were transcribed verbatim, and inter-coder discrepancies from double coding were resolved through consensus. Thematic analysis was facilitated using immersion-crystallization methods. Results: Participants identified five antecedent themes that encourage initiation (professional support, infant health, mother's health, cost-effectiveness, and faith), four facilitator themes for sustained breastfeeding (infant connection, decreased stress, personal attributes, and logistical strategies), and seven barrier themes (physical pain, infant nutrition, negative feelings, latching difficulties, medical conditions, public breastfeeding, and sleep). Participants' suggestions fell into three primary themes: supportive services, managing expectations, and respecting self-determination. Conclusion: Antecedent and facilitator themes did not overlap, indicating that factors encouraging breastfeeding initiation differ from sustaining factors. Participant suggestions, barriers, and facilitators did not largely differ from mothers without PPD in other qualitative studies. Therefore, interventions should tailor support to specific breastfeeding phase and may not need to be markedly different for mothers with PPD, in addition to depression management.
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Affiliation(s)
- Elisabeth A. Stelson
- Department of Social and Behavioral Sciences, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Laura Kulkacek
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rosemary Frasso
- College of Population Health, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Moriah Hall
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - James P. Guevara
- Department of Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Malak R, Sikorska D, Rosołek M, Baum E, Mojs E, Daroszewski P, Matecka M, Fechner B, Samborski W. Impact of umbilical cord arterial pH, gestational age, and birth weight on neurodevelopmental outcomes for preterm neonates. PeerJ 2021; 9:e12043. [PMID: 34567841 PMCID: PMC8428260 DOI: 10.7717/peerj.12043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/02/2021] [Indexed: 11/20/2022] Open
Abstract
Background The aim of this study was to determine the impact of umbilical cord arterial pH, gestational age, and birth weight on neurodevelopmental outcomes for preterm neonates. Methods We examined 112 neonates. Inclusion criteria were: Saturations greater than 88%, and heart rates between 100–205 beats per minute. Measurements We assessed several neurodevelopmental factors as part of the Brazelton Neonatal Behavioral Assessment Scale (NBAS), 4th edition, such as asymmetric tonic neck reflex (ATNR), motor maturity, response to sensory stimuli, habituation, and state regulation. Initial assessment parameters such as APGAR score and umbilical cord arterial pH were used to assess neonates. Results We found a strong correlation between the presence of the sucking reflex and umbilical cord arterial pH (r = 0.32; p = 0.018981). Umbilical cord arterial pH was also correlated with the presence of asymmetric tonic neck reflex (r = 0.27; p = 0.047124), cost of attention (r = 0.31; p = 0.025381) and general motor maturity (r = 0.34; p = 0.011741). Conclusions We found that the sucking reflex may be affected in infants with low umbilical cord arterial pH values. Practitioners and parents can use the NBAS to help determine neurodevelopmental factors and outcomes in preterm infants, possibly leading to safer and more effective feeding practices and interventions.
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Affiliation(s)
- Roksana Malak
- Department and Clinic of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Science, Poznań, Poland, Poznań, Wielkopolskie, Great Poland, Polska
| | - Dorota Sikorska
- Department and Clinic of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Science, Poznan, Polska
| | - Marta Rosołek
- Department of Physiotherapy, Poznan University of Medical Science, Poznań, Poland, Poznan University of Medical Science, Poznan, Polska
| | - Ewa Baum
- Department of Social Sciences and the Humanities Poznan University of Medical Sciences, Poznan, Polska
| | - Ewa Mojs
- Department of Clinical Psychology, Poznan University of Medical Sciences, Poznań, Poland, Poznan University of Medical Science, Poznan, Polska
| | - Przemysław Daroszewski
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, Poznan, Polska
| | - Monika Matecka
- Department of Geriatrics and Gerontology, Poznan University of Medical Sciences, Poznan, Polska
| | - Brittany Fechner
- Department and Clinic of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Science, Poznan, Polska
| | - Włodzimierz Samborski
- Department and Clinic of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Science, Poznan, Polska
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Aby JL. No Shame, No Blame: The Art of Talking With Breastfeeding Mothers. Hosp Pediatr 2021; 11:e192-e194. [PMID: 34362760 DOI: 10.1542/hpeds.2021-005967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Janelle L Aby
- Lucile Packard Children's Hospital, Palo Alto, California; and Stanford University, Stanford, California
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18
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Servante J, Abramson J, Walker KF, Ojha S. Episiotomy and Initiation of Human Milk Feeds: A Retrospective Observational Study. Breastfeed Med 2021; 16:407-413. [PMID: 33733825 DOI: 10.1089/bfm.2020.0071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To investigate the association, in the United Kingdom, between having an episiotomy during childbirth and giving human milk by any modality as an infant's first feed. We also identified maternal demographic factors and perinatal experiences associated with increased chance of the infant's first feed being human milk. Study Design: Retrospective observational cohort study at two large maternity units within district general hospitals in the United Kingdom. Population: Mothers giving birth vaginally to singleton babies at ≥34 weeks and ≥1,800 g. Methods and Main Outcome Measures: Deidentified data from hospital records were analyzed. The odds ratio (OR) of a mother giving human milk for an infant's first feed after episiotomy versus no episiotomy was calculated using a chi-squared test. Logistic regression was used to investigate and then control for confounders known to affect breastfeeding. Results: A total of 13,906 women met the inclusion criteria (2,113 had had an episiotomy and 11,793 had not). Human milk was given as a first feed to 70% of infants in the study population. Women whose infants received their first feed as human milk were on average older, had lower body mass index, lived in an area of less socioeconomic deprivation, and had fewer previous births than those women who gave formula milk as the first feed to their infant. The occurrence of an episiotomy during delivery was not associated with a change in the odds of the infant receiving human milk for the first feed (OR: 1.12 [confidence interval, CI: 0.96-1.38]). Where a woman had skin-to-skin care with her infant straight after birth, the infant was more likely to receive human milk as a first feed (OR: 4.23 [CI: 3.59-4.98]). Conclusion: There is no link between episiotomy during delivery and the odds of a woman giving human milk as the first feed to her infant.
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Affiliation(s)
- Juliette Servante
- Sherwood Forest Hospitals NHS Foundation Trust, Mansfield, United Kingdom
| | - Janine Abramson
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Kate F Walker
- Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, United Kingdom
| | - Shalini Ojha
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Neonatal Intensive Care Unit, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, United Kingdom
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Purtschert LA, Mitter VR, Zdanowicz JA, Minger MA, Spaeth A, von Wolff M, Kohl Schwartz AS. Breastfeeding following in vitro fertilisation in Switzerland-Does mode of conception affect breastfeeding behaviour? Acta Paediatr 2021; 110:1171-1180. [PMID: 32865282 PMCID: PMC7984340 DOI: 10.1111/apa.15553] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/21/2020] [Accepted: 08/21/2020] [Indexed: 12/11/2022]
Abstract
AIM Breastfeeding has numerous advantages. Our aim was to investigate whether breastfeeding initiation and duration in women with pregnancies conceived through in vitro fertilisation differ from spontaneously conceived pregnancies. METHODS This is a comparative cross-sectional study about breastfeeding behaviour performed at the Bern University Hospital including mothers of singletons conceived by in vitro fertilisation (n = 198) with or without gonadotropin stimulation between 2010 and 2016 (in vitro fertilisation group). They were compared to a population-based control group (n = 1421) of a randomly selected sample of mothers in Switzerland who delivered in 2014. RESULTS A total of 1619 women were included in this analysis. Breastfeeding initiation rates were high, similar between the in vitro fertilisation group (93.4%) and the control group (94.8%). No increased risk of stopping breastfeeding earlier after in vitro fertilisation treatment compared to the control group could be found over the observational period of 12 months (HR = 1.00, 95% CI 0.83-1.20, P = .984). There was no difference in breastfeeding initiation or duration after gonadotropin-stimulated vs unstimulated in vitro fertilisation. CONCLUSION In Switzerland, in vitro fertilisation treatments were not associated with earlier breastfeeding cessation. This result is reassuring for mothers undergoing in vitro fertilisation.
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Affiliation(s)
- Livia Amanda Purtschert
- Division of Gynaecological Endocrinology and Reproductive MedicineDepartment of Gynaecology and ObstetricsBern University HospitalUniversity of BernInselspitalBernSwitzerland
- Medical FacultyUniversity of BernBernSwitzerland
- Department of Internal Medicine NidwaldenLuzerner Kantonsspital and University of ZurichStansSwitzerland
| | - Vera Ruth Mitter
- Division of Gynaecological Endocrinology and Reproductive MedicineDepartment of Gynaecology and ObstetricsBern University HospitalUniversity of BernInselspitalBernSwitzerland
- Graduate School for Health SciencesUniversity of BernBernSwitzerland
| | - Jarmila Anna Zdanowicz
- Department of Obstetrics and GynaecologyBern University HospitalUniversity of BernInselspitalBernSwitzerland
| | - Mirja Amadea Minger
- Division of Gynaecological Endocrinology and Reproductive MedicineDepartment of Gynaecology and ObstetricsBern University HospitalUniversity of BernInselspitalBernSwitzerland
- Medical FacultyUniversity of BernBernSwitzerland
- Department of Paediatric SurgeryBern University HospitalUniversity of BernInselspitalBernSwitzerland
| | - Anna Spaeth
- Swiss Tropical and Public Health InstituteBaselSwitzerland
- University of BaselBaselSwitzerland
| | - Michael von Wolff
- Division of Gynaecological Endocrinology and Reproductive MedicineDepartment of Gynaecology and ObstetricsBern University HospitalUniversity of BernInselspitalBernSwitzerland
| | - Alexandra Sabrina Kohl Schwartz
- Division of Gynaecological Endocrinology and Reproductive MedicineDepartment of Gynaecology and ObstetricsBern University HospitalUniversity of BernInselspitalBernSwitzerland
- Division of Reproductive MedicineLuzerner KantonsspitalFrauenklinikUniversity of ZurichLucerneSwitzerland
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20
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Dagla M, Mrvoljak-Theodoropoulou I, Vogiatzoglou M, Giamalidou A, Tsolaridou E, Mavrou M, Dagla C, Antoniou E. Association between Breastfeeding Duration and Long-Term Midwifery-Led Support and Psychosocial Support: Outcomes from a Greek Non-Randomized Controlled Perinatal Health Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041988. [PMID: 33670797 PMCID: PMC7922856 DOI: 10.3390/ijerph18041988] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 02/15/2021] [Indexed: 12/17/2022]
Abstract
Background: This study investigates if a non-randomized controlled perinatal health intervention which offers (a) long-term midwife-led breastfeeding support and (b) psychosocial support of women, is associated with the initiation, exclusivity and duration of breastfeeding. Methods: A sample of 1080 women who attended a 12-month intervention before and after childbirth, during a five-year period (January 2014–January 2019) in a primary mental health care setting in Greece, was examined. Multiple analyses of variance and logistic regression analysis were conducted. Results: The vast majority of women (96.3%) initiated either exclusive breastfeeding (only breast milk) (70.7%) or any breastfeeding (with or without formula or other type of food/drink) (25.6%). At the end of the 6th month postpartum, almost half of the women (44.3%) breastfed exclusively. A greater (quantitatively) midwifery-led support to mothers seemed to correlate with increased chance of exclusive breastfeeding at the end of the 6th month postpartum (p = 0.034), and with longer any breastfeeding duration (p = 0.015). The absence of pathological mental health symptoms and of need for receiving long-term psychotherapy were associated with the longer duration of any breastfeeding (p = 0.029 and p = 0.013 respectively). Conclusions: Continuous long-term midwife-led education and support, and maternal mental well-being are associated with increased exclusive and any breastfeeding duration.
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Affiliation(s)
- Maria Dagla
- Day Center for the Care of the Mental Health of Women (Perinatal Mental Health Disorders), Non-Profit Organization “FAINARETI”, 17121 Athens, Greece; (I.M.-T.); (M.V.); (A.G.); (E.T.); (M.M.); (C.D.); (E.A.)
- Department of Midwifery, University of West Attica, 12243 Athens, Greece
- Correspondence: ; Tel.: +30-210-932-4415
| | - Irina Mrvoljak-Theodoropoulou
- Day Center for the Care of the Mental Health of Women (Perinatal Mental Health Disorders), Non-Profit Organization “FAINARETI”, 17121 Athens, Greece; (I.M.-T.); (M.V.); (A.G.); (E.T.); (M.M.); (C.D.); (E.A.)
| | - Marilena Vogiatzoglou
- Day Center for the Care of the Mental Health of Women (Perinatal Mental Health Disorders), Non-Profit Organization “FAINARETI”, 17121 Athens, Greece; (I.M.-T.); (M.V.); (A.G.); (E.T.); (M.M.); (C.D.); (E.A.)
| | - Anastasia Giamalidou
- Day Center for the Care of the Mental Health of Women (Perinatal Mental Health Disorders), Non-Profit Organization “FAINARETI”, 17121 Athens, Greece; (I.M.-T.); (M.V.); (A.G.); (E.T.); (M.M.); (C.D.); (E.A.)
| | - Eleni Tsolaridou
- Day Center for the Care of the Mental Health of Women (Perinatal Mental Health Disorders), Non-Profit Organization “FAINARETI”, 17121 Athens, Greece; (I.M.-T.); (M.V.); (A.G.); (E.T.); (M.M.); (C.D.); (E.A.)
- Department of Midwifery, University of West Attica, 12243 Athens, Greece
| | - Marianna Mavrou
- Day Center for the Care of the Mental Health of Women (Perinatal Mental Health Disorders), Non-Profit Organization “FAINARETI”, 17121 Athens, Greece; (I.M.-T.); (M.V.); (A.G.); (E.T.); (M.M.); (C.D.); (E.A.)
| | - Calliope Dagla
- Day Center for the Care of the Mental Health of Women (Perinatal Mental Health Disorders), Non-Profit Organization “FAINARETI”, 17121 Athens, Greece; (I.M.-T.); (M.V.); (A.G.); (E.T.); (M.M.); (C.D.); (E.A.)
| | - Evangelia Antoniou
- Day Center for the Care of the Mental Health of Women (Perinatal Mental Health Disorders), Non-Profit Organization “FAINARETI”, 17121 Athens, Greece; (I.M.-T.); (M.V.); (A.G.); (E.T.); (M.M.); (C.D.); (E.A.)
- Department of Midwifery, University of West Attica, 12243 Athens, Greece
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21
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Women's Mental Health as a Factor Associated with Exclusive Breastfeeding and Breastfeeding Duration: Data from a Longitudinal Study in Greece. CHILDREN-BASEL 2021; 8:children8020150. [PMID: 33671169 PMCID: PMC7922988 DOI: 10.3390/children8020150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 12/29/2022]
Abstract
Background: This study investigated the relationship between exclusive breastfeeding and breastfeeding duration, and maternal psychological well-being in the perinatal period. Methods: A longitudinal study involving a retrospective follow-up of a group of 1080 women from pregnancy to the 1st year postpartum, who gave birth during the 5-year period between January 2014 and January 2019 in Athens, Greece, was designed. Women’s history and two psychometric tools—the Edinburg Postpartum Depression Scale (EPDS) and the Patient Health Questionnaire-9 (PHQ-9) administered at 5-time points—were used for data collection. Logistic regression analysis and a series of multiple analysis of variance (MANOVA) tests were performed. Results: The chance for exclusive breastfeeding (giving only breast milk) appeared to decrease (a) with an increase of the scores for psychometric tools antenatally (PHQ-9, p = 0.030) or at the 6th week postpartum (EPDS, p < 0.001 and PHQ-9, p < 0.001), (b) with an increase in the number of psychotherapeutic sessions needed antenatally (p = 0.030), and (c) when the initiation of psychotherapy was necessary postpartum (p = 0.002). Additionally, a shorter duration of any breastfeeding (with or without formula or other types of food/drink) seems to be associated with (a) the occurrence of pathological mental health symptoms (p = 0.029), (b) increased PHQ-9 scores antenatally (p = 0.018), (c) increased EPDS scores at the 6th week (p = 0.004) and the 12th month postpartum (p = 0.031), (d) the initiation of psychotherapy postpartum (p = 0.040), and e) the need for more than 13 psychotherapeutic sessions (p = 0.020). Conclusions: This study demonstrates a negative relationship between exclusive breastfeeding and breastfeeding duration, and poor maternal mental health in the perinatal period.
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22
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Murciano M, Biancone DM, De Luca F, Piras Marafon D, Guido CA, Spalice A. Breastfeeding in Pediatric Acute-Onset Neuropsychiatric Syndrome: An Italian Observational Study. Front Pediatr 2021; 9:682108. [PMID: 34307255 PMCID: PMC8295522 DOI: 10.3389/fped.2021.682108] [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: 03/17/2021] [Accepted: 05/12/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Pediatric acute-onset neuropsychiatric syndrome (PANS) is a condition defined by sudden onset of obsessive-compulsive symptoms and/or severe eating restrictions, along with at least two other cognitive, behavioral, or neurological symptoms. Its pathogenesis is unknown but it seems triggered by infections, metabolic disturbances, and other inflammatory reactions. PANS represents a neurodevelopmental problem and infant feeding can play a role. Breast milk is the ideal food for infants and influences children's brain, cognitive, and socio-emotional development. Methods: We enrolled 52 children diagnosed with PANS. We interviewed their parents in order to investigate perinatal history, infant feeding, neurologic development, and confounding factors like socio-economic status and region of origin. We subgrouped PANS patients into three subsets: those who only received human milk (HMO), those who only received infant formula, and those who received mixed feeding. Results: The cohort is composed of 78.9% males, with a median age of 11 years (range 7-17). We found some neurodevelopmental problems (13.5%): walking disorders, ASD, ADHD, oppositional attitude, and delayed psychomotor development. We found scholar performance deficits (25%), including language problems like dysgraphia, dyslexia, and dyscalculia. The achievement of some milestones in the development of the infant is affected in 73.1% of cases. Breastfeeding is not homogeneously practiced in Italy because of social, economic, and cultural phenomena. The richest and the poorest families (100%) in the sample choose breastfeeding, probably with a different approach and for different reasons (awareness or need). In the group of PANS patients fed with HMO, compared to the rest of the patients, we registered fewer cases of growth problems (0 vs. 12.9%; p = 0.14), school performance problems or the need for school support (19.1% vs. 29%; p = 0.42), and a delay in the age of babbling/speaking (range 4-20 vs. 7-36 months; p = 0.066). Conclusion: This is the first study that investigates the role of breastfeeding in the development of PANS. Promoting breastfeeding is important in the general population and also in PANS patients because it has an important social and global health impact, also during adult life. Further studies with a bigger population are needed to investigate the mechanisms underlying PANS and the role that breastfeeding may play in their short- and long-term neurodevelopment.
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Affiliation(s)
- Manuel Murciano
- Emergency Paediatric Department, Bambino Gesù Children's Hospital, Rome, Italy
| | - Davide Maria Biancone
- Child Neurology Division, Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy
| | - Francesca De Luca
- Child Neurology Division, Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy
| | | | - Cristiana Alessia Guido
- Child Neurology Division, Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy.,Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Alberto Spalice
- Child Neurology Division, Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy
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23
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Hu J, Aris IM, Lin PID, Rifas-Shiman SL, Perng W, Woo Baidal JA, Wen D, Oken E. Longitudinal associations of modifiable risk factors in the first 1000 days with weight status and metabolic risk in early adolescence. Am J Clin Nutr 2020; 113:113-122. [PMID: 33184628 PMCID: PMC7779210 DOI: 10.1093/ajcn/nqaa297] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/28/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Many studies have identified early-life risk factors for childhood overweight/obesity (OwOb), but few have evaluated how they combine to influence later cardiometabolic health. OBJECTIVES We aimed to examine the association of risk factors in the first 1000 d with adiposity and cardiometabolic risk in early adolescence. METHODS We studied 1038 mother-child pairs in Project Viva. We chose 6 modifiable early-life risk factors previously associated with child adiposity or metabolic health in the cohort: smoking during pregnancy (yes compared with no); gestational weight gain (excessive compared with nonexcessive); sugar-sweetened beverage consumption during pregnancy (≥0.5 compared with <0.5 servings/d); breastfeeding duration (<12 compared with ≥12 mo); timing of complementary food introduction (<4 compared with ≥4 mo); and infant sleep duration (<12 compared with ≥12 h/d). We computed risk factor scores by calculating the cumulative number of risk factors for each child. In early adolescence (median: 13.1 y) we measured indicators of adiposity [BMI, fat mass index (FMI), trunk fat mass index (TFMI)]. We also calculated OwOb prevalence and metabolic syndrome (MetS) risk z score of adolescents. RESULTS Among 1038 adolescents, 71% had >1 early-life risk factor. In covariate-adjusted models, we observed positive monotonic increases in BMI, FMI, TFMI, and MetS z scores with increasing risk factor score. Children with 5‒6 risk factors (compared with 0-1 risk factors) had the highest risk of OwOb [risk ratio (RR): 2.53; 95% CI: 1.63, 3.91] and being in the highest MetS quartile (RR: 2.46; 95% CI: 1.43, 4.21). The predicted probability of OwOb in adolescence varied from 9.4% (favorable levels for all factors) to 63.6% (adverse levels for all factors), and for being in the highest MetS quartile from 9.6% to 56.6%. CONCLUSIONS Early-life risk factors in the first 1000 d cumulatively predicted higher adiposity and cardiometabolic risk in early adolescence. Intervention strategies to prevent later obesity and cardiometabolic risk may be more effective if they concurrently target multiple modifiable factors.
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Affiliation(s)
- Jiajin Hu
- Institute of Health Sciences, China Medical University, Shenyang, Liaoning, China,Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, Liaoning, China,Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | | | - Pi-I D Lin
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Wei Perng
- Department of Epidemiology, Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jennifer A Woo Baidal
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University and New York-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA
| | - Deliang Wen
- Institute of Health Sciences, China Medical University, Shenyang, Liaoning, China
| | - Emily Oken
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
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24
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Hashim S, Ishak A, Muhammad J. Unsuccessful Exclusive Breastfeeding and Associated Factors among the Healthcare Providers in East Coast, Malaysia. Korean J Fam Med 2020; 41:416-421. [PMID: 33242382 PMCID: PMC7700827 DOI: 10.4082/kjfm.19.0060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Breastfeeding is widely recognized as the optimal and natural method of feeding infants. However, there are obstacles that can limit exclusive breastfeeding practices during the first 6 months of an infant's life. This study aimed to determine the prevalence of unsuccessful exclusive breastfeeding and its associated factors among mothers who work as healthcare providers at Universiti Sains Malaysia Hospital. METHODS A cross-sectional study was conducted among 295 medical doctors and staff nurses from June to December 2015. Simple random sampling was applied. The data were collected using a self-administered questionnaire and analyzed using IBM SPSS ver. 22.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics and logistic regression analysis were performed. RESULTS The prevalence of unsuccessful exclusive breastfeeding among the study participants was 58.3%. Mothers who preferred formula milk (odds ratio [OR], 4.40; 95% confidence interval [CI], 1.45-13.31) delivered via lower segment cesarean section (OR, 2.31; 95% CI, 1.07-4.98) and produced inadequate breast milk (OR, 4.06; 95% CI, 2.40- 6.89) were significantly associated with unsuccessful exclusive breastfeeding. CONCLUSION The prevalence of unsuccessful exclusive breastfeeding among the study participants was high. Maternal characteristics such as preference towards formula milk, mode of delivery and adequacy of breast milk must be assessed to prevent unsuccessful exclusive breastfeeding among healthcare providers.
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Affiliation(s)
- Saodah Hashim
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian, Malaysia
| | - Azlina Ishak
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian, Malaysia
| | - Juliawati Muhammad
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian, Malaysia
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25
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Quality Improvement Analyses Revealed a Hidden Shift Following a Retrospective Study on Breastfeeding Rates. Pediatr Qual Saf 2020; 5:e347. [PMID: 34616963 PMCID: PMC8487780 DOI: 10.1097/pq9.0000000000000347] [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: 09/30/2019] [Accepted: 07/16/2020] [Indexed: 11/26/2022] Open
Abstract
Supplemental Digital Content is available in the text. Factors affecting exclusive breastfeeding rates are complex. Evaluations for early-onset sepsis can negatively impact breastfeeding success. We sought to determine whether implementing an algorithm utilizing the sepsis risk score (SRS) in chorioamnionitis-exposed newborns would increase exclusive breastfeeding rates. We collaborated with healthcare systems experts to analyze and understand our outcomes.
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26
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Social representations of breastfeeding and infant formula: An exploratory study with mothers and health professionals to inform policy making. Appetite 2020; 151:104683. [DOI: 10.1016/j.appet.2020.104683] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 11/21/2022]
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Bonilla Ramírez MX, Díez Recinos AL. Actitudes y beneficios acerca de la lactancia materna en Guatemala. REVISTA DE LA FACULTAD DE MEDICINA 2020. [DOI: 10.37345/23045329.v1i28.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
Introducción: La leche materna es el alimento de elección para el recién nacido debido a sus múltiples ventajas y beneficios tanto para el lactante como para la madre sin embargo, la decisión de brindar Lactancia Materna Exclusiva (LME) debe de ser debidamente informada ya que el éxito de dicha práctica está condicionado por múltiples factores, siendo uno de ellos el nivel de conocimiento sobre LME. Objetivo: Evaluar el conocimiento de las madres sobre la importancia de la lactancia materna exclusiva y relacionarlo con la duración de la misma. Metodología: Estudio descriptivo y prospectivo de 100 encuestas realizadas a madres que acuden a consulta externa del Grupo Pediátrico Multimédica y a consulta externa de Pediatría en el Hospital Roosevelt durante los meses de junio y julio del 2019. Se utilizó la prueba estadística coeficiente de correlación y t de Student. Resultados: Se encontró un resultado positivo con la prueba estadística de correlación r = 0.9993 y t de Student se obtuvo un valor P de 0.0007 con un nivel de confianza de 0.05, por lo que es posible decir que el conocimiento de las madres sobre LME se relaciona con la duración de la misma.
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28
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Zitkute V, Snieckuviene V, Zakareviciene J, Pestenyte A, Jakaite V, Ramasauskaite D. Reasons for Breastfeeding Cessation in the First Year after Childbirth in Lithuania: A Prospective Cohort Study. MEDICINA-LITHUANIA 2020; 56:medicina56050226. [PMID: 32397497 PMCID: PMC7279242 DOI: 10.3390/medicina56050226] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 11/19/2022]
Abstract
Background and objectives: to identify the main reasons of breastfeeding cessation in Lithuania and if there is a link between the length of maternity leave and breastfeeding cessation. Materials and methods: a prospective questionnaire study was conducted in a tertiary hospital from 2016 to 2017. The sample size included 449 women. Results: a total of 41% (n = 123) of respondents weaned off by 6 months after birth, and 57.8% (n = 173) between 6 months and 1 year. During the first few days after delivery, mothers did not breastfeed their infants mainly due to shortage of milk (n = 10; 40%) or separation from their baby due to infant health problems (n = 12; 48%) (p < 0.0001). Mothers who did not breastfeed during the first days after birth more often did not start breastfeeding later at home (p = 0.001). Going back to work was not a significant factor in weaning off. Conclusions: breastfeeding initiation and practice during the first few days after birth has a significant impact on the further commitment for full breastfeeding. Additionally, a perceived lack of support and help from both doctors and midwives influences a woman’s decision to choose not to breastfeed.
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29
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Feldman-Winter L, Kellams A, Peter-Wohl S, Taylor JS, Lee KG, Terrell MJ, Noble L, Maynor AR, Meek JY, Stuebe AM. Evidence-Based Updates on the First Week of Exclusive Breastfeeding Among Infants ≥35 Weeks. Pediatrics 2020; 145:peds.2018-3696. [PMID: 32161111 DOI: 10.1542/peds.2018-3696] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/06/2019] [Indexed: 11/24/2022] Open
Abstract
The nutritional and immunologic properties of human milk, along with clear evidence of dose-dependent optimal health outcomes for both mothers and infants, provide a compelling rationale to support exclusive breastfeeding. US women increasingly intend to breastfeed exclusively for 6 months. Because establishing lactation can be challenging, exclusivity is often compromised in hopes of preventing feeding-related neonatal complications, potentially affecting the continuation and duration of breastfeeding. Risk factors for impaired lactogenesis are identifiable and common. Clinicians must be able to recognize normative patterns of exclusive breastfeeding in the first week while proactively identifying potential challenges. In this review, we provide new evidence from the past 10 years on the following topics relevant to exclusive breastfeeding: milk production and transfer, neonatal weight and output assessment, management of glucose and bilirubin, immune development and the microbiome, supplementation, and health system factors. We focus on the early days of exclusive breastfeeding in healthy newborns ≥35 weeks' gestation managed in the routine postpartum unit. With this evidence-based clinical review, we provide detailed guidance in identifying medical indications for early supplementation and can inform best practices for both birthing facilities and providers.
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Affiliation(s)
- Lori Feldman-Winter
- Department of Pediatrics, Cooper Medical School, Rowan University and Children's Regional Hospital at Cooper, Cooper University Health Care, Camden, New Jersey;
| | - Ann Kellams
- Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, Virginia
| | | | - Julie Scott Taylor
- American University of the Caribbean School of Medicine, Sint Maarten, Netherlands Antilles.,Department of Family Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Kimberly G Lee
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - Mary J Terrell
- Division of Neonatology, Department of Pediatrics, University of North Carolina Hospitals, Chapel Hill, North Carolina
| | - Lawrence Noble
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Angela R Maynor
- Department of Food and Nutrition, University of North Carolina Health Care, Chapel Hill, North Carolina; and
| | - Joan Younger Meek
- Department of Clinical Sciences, College of Medicine, Florida State University, Tallahassee, Florida
| | - Alison M Stuebe
- Obstetrics and Gynecology, School of Medicine and.,Department of Maternal and Child Health and Carolina Global Breastfeeding Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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30
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Kenaley KM, Greenspan J, Aghai ZH. Exclusive breast feeding and dehydration fever in newborns during the first days of life. J Matern Fetal Neonatal Med 2020; 33:593-597. [PMID: 30196730 DOI: 10.1080/14767058.2018.1497605] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 06/08/2018] [Accepted: 07/03/2018] [Indexed: 10/28/2022]
Abstract
Objectives: To determine the prevalence of dehydration fever in infants admitted to the Neonatal Intensive Care Unit (NICU) from the well newborn nursery with fever in the first days of life.Study design: Retrospective data analysis of term infants admitted to the NICU from the well newborn nursery with fever (n = 75). Infants were divided into two groups based on hydration status using clinical and laboratory signs of dehydration. Clinical and laboratory variables were compared between the two groups.Results: Fifty-three of the 75 infants admitted to the NICU with fever had clinical and laboratory signs of dehydration (71%). Infants with dehydration were more likely to be exclusively breast fed and present with fever at >24 h of age. There were no positive blood or cerebrospinal fluid cultures in infants with dehydration. The incidence of dehydration fever increased after implementation of an "Exclusive Breast Feeding" policy from 1.4/1000 to 3.5/1000 live births (p ≤ .01).Conclusions: Dehydration is associated with fever in exclusively breast fed infants during the first several days of life. There were no cases of serious bacterial or viral infections in the cohort of febrile infants with clinical and laboratory signs of dehydration.
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Affiliation(s)
- Kaitlin M Kenaley
- Division of Pediatrics, Thomas Jefferson University/Nemours, Philadelphia, PA, USA
- Division of Pediatrics/Neonatology, Christiana Care Health System, Newark, DE, USA
| | - Jay Greenspan
- Division of Pediatrics, Thomas Jefferson University/Nemours, Philadelphia, PA, USA
| | - Zubair H Aghai
- Division of Pediatrics, Thomas Jefferson University/Nemours, Philadelphia, PA, USA
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31
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Brzezinski L, Mimm N, Porter S. Pediatric Nurse Practitioner Barriers to Supporting Breastfeeding by Mothers and Infants. J Perinat Educ 2018; 27:207-219. [PMID: 31073267 DOI: 10.1891/1058-1243.27.4.207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Infant health and development outcomes are positively affected by breastfeeding. Despite the multitude of breastfeeding benefits to mothers and infants along with strong recommendations for exclusive breastfeeding from government agencies and professional associations, the rate of exclusive breastfeeding during the first six months of life remains low. Strongly positive attitudes make pediatric nurse practitioners, especially those in primary care settings, ideally positioned to encourage, support, and provide breastfeeding management to mothers and infants. However, pediatric nurse practitioners may report breastfeeding education and breastfeeding skills deficits along with other barriers to optimal breastfeeding care.
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32
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Karaçam Z, Sağlık M. Breastfeeding problems and interventions performed on problems: systematic review based on studies made in Turkey. TURK PEDIATRI ARSIVI 2018; 53:134-148. [PMID: 30459512 PMCID: PMC6239069 DOI: 10.5152/turkpediatriars.2018.6350] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 03/19/2018] [Indexed: 01/17/2023]
Abstract
To determine the breastfeeding problems encountered in the postpartum period and effect of interventions done in relation to the problems based on breastfeeding studies in Turkey. This study is a systematic review and was conducted by performing a scan of the Turkish and English literature over the period October 2016-February 2017. The study included 27 articles and seven theses, which were published in 2000-2015 in Turkey and published in 2008-2017. Data are presented tabulating and the aggregate percentages were calculated for some data showing common characteristics. A total of 6736 parents and 592 babies were included in these studies. As a result of the combined percentage calculation based on the data of cross-sectional and case-control studies, the most frequently reported problems were having breastfeeding problem (24.5%), mother's milk deficiency/worry about milk deficiency/thinking her baby is not satisfied/baby's inadequate weight gain (15.7%), lack of knowledge and experience about breastfeeding/need for education and support (17.8%). Again, these studies showed that women stated the problems about have flat/depressed/small nipple (7.7%), pain/sensitivity (3.9%), swelling/fullness/engorgement (10.8%), redness (28.8%), crack/wound/bleeding (26.1%) and mastitis (5.6%). Methods of prenatal education/counselling/motivation/follow-up, strong motivation, proactive lactation management and social support, moist warm application, using of breast milk and olive oil and using of breast shield and feeding with container and pacifier using have been reported to be effective in the experimental/quasi-experimental and case report studies included in this systematic review. This study showed that women experienced a lot problem with breastfeeding and that more prenatal education/counselling/monitoring was used in reducing problems.
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Affiliation(s)
- Zekiye Karaçam
- Division of Midwifery, Adnan Menderes University School of Health Sciences, Aydın, Turkey
| | - Müge Sağlık
- Department of Midwifery, Adnan Menderes University, Health Sciences Institute, Aydın, Turkey
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Abstract
Breastfeeding initiation is on the rise in New Mexico; however, breastfeeding duration here, and around the world, does not meet international recommendations. Misunderstanding a baby’s behavior is often an overlooked variable that decreases breastfeeding duration. Hoping to help parents better understand how child development impacts breastfeeding, 138 New Mexico Women, Infants, and Children (WIC) professionals recently completed HUG Your Baby's Roadmap to Breastfeeding Success—a 2-hour online program, with accompanying resources, that covers key information from birth to 1 year. After completing the course, participants demonstrated increased knowledge of how child development impacts breastfeeding, expressed a stronger intention to teach parents about normal child behavior, and reported greater confidence to do so. The course was viewed as evidence-based, its online format was well-received, and participants would recommend it to colleagues.
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Ke J, Ouyang YQ, Redding SR. Family-Centered Breastfeeding Education to Promote Primiparas' Exclusive Breastfeeding in China. J Hum Lact 2018; 34:365-378. [PMID: 29161530 DOI: 10.1177/0890334417737293] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Few breastfeeding education programs focus on primiparas and the importance of family members on exclusive breastfeeding in China. Research aim: This study aimed to explore the influence of a family-centered breastfeeding education program in promoting exclusive breastfeeding up to 6 months postpartum and to improve women's attitude and knowledge, family members' knowledge, and family support. METHODS This was a two-group quasi-experimental design with multiple comparisons. Participants ( N = 59) were randomized to either the intervention ( n = 29) or the control ( n = 30) group. The intervention group received two prenatal breastfeeding education lectures that included important family members, three home visits, eight telephone calls, text or video/audio support, and quality online resources during lactation. The control group received in-hospital care and follow-up by community nurses after discharge. RESULTS Compared with the control group, the intervention group was more likely to exclusively breastfeed in the first 6 months, odds ratio = 0.44, 95% confidence interval [0.20, 0.98]. The mean knowledge level of the intervention group improved more across time ( p < .05) and was higher than the control group ( p < .05). Perceived family support within the intervention group was significantly higher than the control group from 1 to 6 months ( p < .05). CONCLUSION The breastfeeding education program is an effective strategy to promote exclusive breastfeeding in China.
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Affiliation(s)
- Jian Ke
- 1 School of Health Sciences, Wuhan University, Wuhan, China
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Abstract
OBJECTIVE Disparities persist in breastfeeding exclusivity and duration despite increases in breastfeeding initiation. The objective of this study was to examine factors that influence maternal decision making surrounding infant feeding practices over time in a diverse inner-city population. METHODS We conducted a prospective qualitative study with 20 mothers recruited from 2 urban primary care clinics. Participants completed open-ended interviews and demographic questionnaires in English or Spanish administered at approximately 2 weeks and 6 months postpartum. Transcripts were analyzed using a combined technique of inductive (data-driven) and deductive (theory-driven, based on the Theory of Planned Behavior) thematic analysis using 3 independent coders and iterative discussion to reach consensus. RESULTS All women initiated breastfeeding, and 65% reported perceived insufficient milk (PIM). An association between PIM and behavioral control emerged as the overarching theme impacting early breastfeeding cessation and evolved over time. Early postpartum, PIM evoked maternal distress-strong emotional responses to infant crying and need to control infant behaviors. Later, mothers accepted a perceived lack of control over milk supply with minimal distress or as a natural process. Decisions to stop breastfeeding occurred through an iterative process, informed by trials of various strategies and observations of subsequent changes in infant behavior, strongly influenced by competing psychosocial demands. CONCLUSION Infant feeding decisions evolve over time and are influenced by perceptions of control over infant behavior and milk supply. Tailored anticipatory guidance is needed to provide time-sensitive strategies to cope with challenging infant behaviors and promote maternal agency over breastfeeding in low-income populations.
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Sakaguchi K, Koyanagi A, Kamachi F, Harauma A, Chiba A, Hisata K, Moriguchi T, Shimizu T, Miyake S. Breast-feeding regulates immune system development via transforming growth factor-β in mice pups. Pediatr Int 2018; 60:224-231. [PMID: 29290091 DOI: 10.1111/ped.13507] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 06/17/2017] [Accepted: 10/31/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Breast milk contains important nutrients and immunoregulatory factors that are essential for newborn infants. Recently, epidemiological studies suggested that breast-feeding prevents a wide range of infectious diseases and lowers the incidence of infant allergic diseases. METHODS To examine the effects of breast milk on immunological development in infancy, we established an artificial rearing system for hand-feeding mice and compared mouse pups fed with either breast milk or milk substitute. All mice were killed at 14 days of age and immune cells in the thymus, spleen, and small intestine were examined on flow cytometry. RESULTS The number of thymocytes was higher whereas that of total immune cells of peripheral lymphoid tissues was lower in mice fed breast milk compared with milk substitute-fed mice. In peripheral lymphoid tissues, the proportion of B cells was higher and that of CD8+ T cells, macrophages, dendritic cells, and granulocytes was significantly lower in breast milk-fed mice. The same alteration in immune cells of the thymus and peripheral lymphoid tissues in milk substitute-fed mice was also observed in pups reared by mother mice treated with anti-transforming growth factor-β (anti-TGF-β) monoclonal antibody. CONCLUSIONS Breast milk regulates the differentiation and expansion of innate and adaptive immune cells partly due to TGF-β. Hence, TGF-β in breast milk may be a new therapeutic target for innate immune system-mediated diseases of infancy.
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Affiliation(s)
- Keita Sakaguchi
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akemi Koyanagi
- Laboratory of Cell Biology, Juntendo University Graduate School of Medicine Research Center, Tokyo, Japan
| | - Fumitaka Kamachi
- Department of Immunology, Juntendo University School of Medicine, Tokyo, Japan
| | - Akiko Harauma
- School of Life and Environmental Science, Azabu University, Sagamihara, Kanagawa, Japan
| | - Asako Chiba
- Department of Immunology, Juntendo University School of Medicine, Tokyo, Japan
| | - Ken Hisata
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Toru Moriguchi
- School of Life and Environmental Science, Azabu University, Sagamihara, Kanagawa, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Sachiko Miyake
- Department of Immunology, Juntendo University School of Medicine, Tokyo, Japan
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Alden KR. A Web-Based Module to Enhance BSN Students’ Knowledge and Confidence in Teaching Parents About Newborn Behavior. J Perinat Educ 2018; 27:104-114. [DOI: 10.1891/1058-1243.27.2.104] [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] Open
Abstract
As an adjunct to traditional instructional strategies, students enrolled in a Bachelor of Science in Nursing maternity course completed a Web-based module called “HUG Your Baby” (HYB) about newborn behavior, interpreting and responding to an infant’s cues and body language, and teaching new parents. Students who completed the HYB program were compared with students enrolled in another semester of the same maternity course in which only traditional teaching strategies were used. Both groups were compared on knowledge and confidence about newborn behaviors and teaching new parents. Knowledge and confidence scores increased significantly in both groups from beginning to end of the semester. Students who completed the HYB program demonstrated a significantly greater increase in knowledge and confidence compared with students who did not complete the HYB program. Students highly rated the HYB program and recommended it for incorporation into the maternity course.
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Abstract
The purpose of this pilot study was to determine the prevalence of sustained breastfeeding in late preterm and early term breastfeeding infants at 1 and 2 months of age and to identify the factors that were related to sustained breastfeeding. Subjects were identified through purposive sampling and completed the Breastfeeding Self-Efficacy Scale and data were collected on lactation support, hospital course details, and demographic factors. At 1 and 2 months of age, structured telephone interviews determined the current feeding status and postdischarge lactation support. Of 126 mothers, 82% sustained breastfeeding at 1 month and 71.2% at 2 months. Factors associated with sustained breastfeeding at 2 months included a college education (P = .014), higher day 1 breastfeeding scores (P = .007), higher Breastfeeding Self-Efficacy scores (P = .046), and continued maternal skin-to-skin contact (P = .007). High after day 1 breastfeeding scores were associated with sustained breastfeeding at 1 month (P = .000) and 2 months (P = .001). Unsustained breastfeeding at 1 and 2 months was associated with the occurrence of supplemental feedings (P = .001) and pumping at discharge (1 month, P = .002; 2 months, P = .015). Identifying the factors associated with the high-sustained breastfeeding rate in this population helps nurses focus on how to best support their breastfeeding experience.
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Feldman-Winter L, Szucs K, Milano A, Gottschlich E, Sisk B, Schanler RJ. National Trends in Pediatricians' Practices and Attitudes About Breastfeeding: 1995 to 2014. Pediatrics 2017; 140:peds.2017-1229. [PMID: 28924062 DOI: 10.1542/peds.2017-1229] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/27/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The American Academy of Pediatrics (AAP) has affirmed breastfeeding as the preferred method of infant feeding; however, there has been little systematic examination of how pediatricians' recommendations, affiliated hospitals' policies, counseling practices, and attitudes toward breastfeeding have shifted over the past 2 decades. These trends were examined from 1995 to 2014. METHODS Data are from the Periodic Survey (PS) of Fellows, a nationally representative survey of AAP members. PS #30 (1995; response rate = 72%; N = 832), PS #57 (2004; response rate = 55%; N = 675), and PS #89 (2014; response rate = 51%; N = 620) collected demographics, patient and practice characteristics, and detailed responses on pediatricians' recommendations, affiliated hospitals' policies, counseling practices, and attitudes toward breastfeeding. By using bivariate statistics and logistic regression models, the analysis investigated changes over time with predicted values (PVs). RESULTS From 1995 to 2014, more pediatricians reported their affiliated hospitals applied for "baby-friendly" designation (PV = 12% in 1995, PV = 56% in 2014; P < .05), and more reported that they recommend exclusive breastfeeding (65% to 76% [P < .05]). However, fewer respondents indicated that mothers can be successful breastfeeding (PV = 70% in 1995, PV = 57% in 2014; P < .05) and that the benefits outweigh the difficulties (PV = 70% in 1995, PV = 50% in 2014; P < .05). Younger pediatricians were less confident than older pediatricians in managing breastfeeding problems (P < .01). CONCLUSIONS Pediatricians' recommendations and practices became more closely aligned with AAP policy from 1995 to 2014; however, their attitudes about the likelihood of breastfeeding success have worsened. These 2 divergent trends indicate that even as breastfeeding rates continue to rise, continued efforts to enhance pediatricians' training and attitudes about breastfeeding are necessary.
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Affiliation(s)
- Lori Feldman-Winter
- Department of Pediatrics, Children's Regional Hospital, Cooper University Health Care, Cooper Medical School, Rowan University, Camden, New Jersey;
| | | | - Aubri Milano
- Department of Pediatrics, Children's Regional Hospital, Cooper University Health Care, Cooper Medical School, Rowan University, Camden, New Jersey
| | - Elizabeth Gottschlich
- Department of Research, American Academy of Pediatrics, Elk Grove Village, Illinois; and
| | - Blake Sisk
- Department of Research, American Academy of Pediatrics, Elk Grove Village, Illinois; and
| | - Richard J Schanler
- Cohen Children's Medical Center, Northwell Health and Hofstra, Hofstra Northwell School of Medicine, Hofstra University, Hempstead, New York
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Fallon V, Komninou S, Bennett KM, Halford JC, Harrold JA. The emotional and practical experiences of formula-feeding mothers. MATERNAL & CHILD NUTRITION 2017; 13:e12392. [PMID: 27862970 PMCID: PMC6866173 DOI: 10.1111/mcn.12392] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 09/12/2016] [Accepted: 09/13/2016] [Indexed: 11/27/2022]
Abstract
The majority of infant-feeding research is focused on identifying mother's reasons for the cessation of breastfeeding. The experience of mothers who choose to use formula is largely overlooked in quantitative designs. This study aimed to describe the emotional and practical experiences of mothers who formula feed in any quantity, and examine whether these experiences would vary among different cohorts of formula-feeding mothers according to prenatal feeding intention and postnatal feeding method. A total of 890 mothers of infants up to 26 weeks of age, who were currently formula feeding in any quantity, were recruited through relevant international social media sites via advertisements providing a link to an online survey. Predictors of emotional experiences included guilt, stigma, satisfaction, and defense as a result of their infant feeding choices. Practical predictor variables included support received from health professionals, respect displayed by their everyday environment, and main sources of infant feeding information. Descriptive findings from the overall sample highlighted a worryingly high percentage of mother's experienced negative emotions as a result of their decision to use formula. Multinomial logit models revealed that negative emotions such as guilt, dissatisfaction, and stigma were directly associated with feeding intention and method. The evidence suggests that the current approach to infant-feeding promotion and support may be paradoxically related to significant issues with emotional well-being. These findings support criticisms of how infant-feeding recommendations are framed by health care professionals and policy makers, and highlight a need to address formula feeding in a more balanced, woman-centered manner.
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Affiliation(s)
| | - Sophia Komninou
- Department of Psychological Sciences, Eleanor Rathbone Building, Bedford St SouthUniversity of LiverpoolLiverpoolUK
| | - Kate M. Bennett
- Department of Psychological Sciences, Eleanor Rathbone Building, Bedford St SouthUniversity of LiverpoolLiverpoolUK
| | - Jason C.G. Halford
- Department of Psychological Sciences, Eleanor Rathbone Building, Bedford St SouthUniversity of LiverpoolLiverpoolUK
| | - Joanne A. Harrold
- Department of Psychological Sciences, Eleanor Rathbone Building, Bedford St SouthUniversity of LiverpoolLiverpoolUK
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Saraf MK, Piccolo BD, Bowlin AK, Mercer KE, LeRoith T, Chintapalli SV, Shankar K, Badger TM, Yeruva L. Formula diet driven microbiota shifts tryptophan metabolism from serotonin to tryptamine in neonatal porcine colon. MICROBIOME 2017; 5:77. [PMID: 28705171 PMCID: PMC5513086 DOI: 10.1186/s40168-017-0297-z] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 07/04/2017] [Indexed: 05/06/2023]
Abstract
BACKGROUND The gut microbiota of breast-fed and formula-fed infants differ significantly, as do the risks for allergies, gut dysfunction, and upper respiratory tract infections. The connections between breast milk, various formulas, and the profiles of gut bacteria to these childhood illnesses, as well as the mechanisms underlying the effects, are not well understood. METHODS We investigated distal colon microbiota by 16S RNA amplicon sequencing, morphology by histomorphometry, immune response by cytokine expression, and tryptophan metabolism in a pig model in which piglets were sow-fed, or fed soy or dairy milk-based formula from postnatal day (PND) 2 to 21. RESULTS Formula feeding significantly (p < 0.05) altered the colon microbiota relative to the sow feeding. A significant reduction in microbial diversity was noted with formula groups in comparison to sow-fed. Streptococcus, Blautia, Citrobacter, Butrycimonas, Parabacteroides, Lactococcus genera were increased with formula feeding relative to sow feeding. In addition, relative to sow feeding, Anaerotruncus, Akkermansia, Enterococcus, Acinetobacter, Christensenella, and Holdemania were increased in milk-fed piglets, and Biliophila, Ruminococcus, Clostridium were increased in soy-fed piglets. No significant gut morphological changes were noted. However, higher cytokine mRNA expression (BMP4, CCL11, CCL21) was observed in the distal colon of formula groups. Formula feeding reduced enterochromaffin cell number and serotonin, but increased tryptamine levels relative to sow feeding. CONCLUSION Our data confirm that formula diet alters the colon microbiota and appears to shift tryptophan metabolism from serotonin to tryptamine, which may lead to greater histamine levels and risk of allergies in infants.
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Affiliation(s)
- Manish Kumar Saraf
- Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR 72202 USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Brian D. Piccolo
- Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR 72202 USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Anne K. Bowlin
- Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR 72202 USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Kelly E. Mercer
- Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR 72202 USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Tanya LeRoith
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, USA
| | - Sree V. Chintapalli
- Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR 72202 USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Kartik Shankar
- Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR 72202 USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Thomas M. Badger
- Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR 72202 USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Laxmi Yeruva
- Arkansas Children’s Nutrition Center, 15 Children’s Way, Little Rock, AR 72202 USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA
- Arkansas Children’s Research Institute, Little Rock, USA
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Anderson KG. Establishment of Legal Paternity for Children of Unmarried American Women : Trade-Offs in Male Commitment to Paternal Investment. HUMAN NATURE (HAWTHORNE, N.Y.) 2017; 28:168-200. [PMID: 28205120 PMCID: PMC5466473 DOI: 10.1007/s12110-017-9284-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The establishment of a legal father for children of unmarried parents reflects both high paternity confidence and male willingness to commit to paternal investment. Whether an unmarried man voluntarily acknowledges paternity after a child is born has important consequences for both the mother and child. This paper brings to bear a life history perspective on paternity establishment, noting that men face trade-offs between mating and parental effort and that women will adjust their investment in children based on expected male investment. I predict that paternity establishment will be more likely when the mother has high socioeconomic status, when maternal health is good, and when the child is male, low parity, or a singleton (versus multiple) birth. I further predict that establishment of paternity will be associated with increased maternal investment in offspring, resulting in healthier babies with higher birthweights who are more likely to be breastfed. These predictions are tested using data on 5.4 million births in the United States from 2009 through 2013. Overall the results are consistent with the hypothesis that the trade-offs men face between reproductive and parental investment influence whether men voluntarily acknowledge paternity when a child is born.
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Affiliation(s)
- Kermyt G Anderson
- Department of Anthropology, University of Oklahoma, 521 Dale Hall Tower, 455 West Lindsey, Norman, OK, 73131, USA.
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Lubbe W, ten Ham-Baloyi W. When is the use of pacifiers justifiable in the baby-friendly hospital initiative context? A clinician's guide. BMC Pregnancy Childbirth 2017; 17:130. [PMID: 28449646 PMCID: PMC5408445 DOI: 10.1186/s12884-017-1306-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 04/11/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The use of pacifiers is an ancient practice, but often becomes a point of debate when parents and professionals aim to protect and promote breastfeeding as most appropriately for nurturing infants. We discuss the current literature available on pacifier use to enable critical decision-making regarding justifiable use of pacifiers, especially in the Baby-Friendly Hospital Initiative context, and we provide practical guidelines for clinicians. DISCUSSION Suck-swallow-breathe coordination is an important skill that every newborn must acquire for feeding success. In most cases the development and maintenance of the sucking reflex is not a problem, but sometimes the skill may be compromised due to factors such as mother-infant separation or medical conditions. In such situations the use of pacifiers can be considered therapeutic and even provide medical benefits to infants, including reducing the risk of sudden infant death syndrome. The argument opposing pacifier use, however, is based on potential risks such as nipple confusion and early cessation of breastfeeding. The Ten Steps to Successful Breastfeeding as embedded in the Baby-Friendly Hospital Initiative initially prohibited the use of pacifiers in a breastfeeding friendly environment to prevent potential associated risks. This article provides a summary of the evidence on the benefits of non-nutritive sucking, risks associated with pacifier use, an identification of the implications regarded as 'justifiable' in the clinical use of pacifiers and a comprehensive discussion to support the recommendations for safe pacifier use in healthy, full-term, and ill and preterm infants. The use of pacifiers is justifiable in certain situations and will support breastfeeding rather than interfere with it. Justifiable conditions have been identified as: low-birth weight and premature infants; infants at risk for hypoglyceamia; infants in need of oral stimulation to develop, maintain and mature the sucking reflex in preterm infants; and the achievement of neurobehavioural organisation. Medical benefits associated with the use of pacifiers include providing comfort, contributing towards neurobehavioural organisation, and reducing the risk of sudden infant death syndrome. Guidelines are presented for assessing and guiding safe pacifier use, for specific design to ensure safety, and for cessation of use to ensure normal childhood development.
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Affiliation(s)
- Welma Lubbe
- North-West University, School of Nursing Science, Private Bag X6001, Potchefstroom, 2520 South Africa
| | - Wilma ten Ham-Baloyi
- Nelson Mandela Metropolitan University, Faculty of Health Sciences, Private Bag 77000, Port Elizabeth, 6031 South Africa
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Mother’s Milk and the Environment: Might Chemical Exposures Impair Lactation? ENVIRONMENTAL HEALTH PERSPECTIVES 2017. [PMCID: PMC5226708 DOI: 10.1289/ehp.125-a17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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45
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Development and measurement properties of the Chinese breastfeeding self-regulation questionnaire. Midwifery 2017; 44:24-34. [DOI: 10.1016/j.midw.2016.10.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 09/26/2016] [Accepted: 10/26/2016] [Indexed: 11/19/2022]
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46
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Boies EG, Vaucher YE. ABM Clinical Protocol #10: Breastfeeding the Late Preterm (34-36 6/7 Weeks of Gestation) and Early Term Infants (37-38 6/7 Weeks of Gestation), Second Revision 2016. Breastfeed Med 2016; 11:494-500. [PMID: 27830934 DOI: 10.1089/bfm.2016.29031.egb] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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)
- Eyla G Boies
- Department of Pediatrics, University of California , San Diego, California
| | - Yvonne E Vaucher
- Department of Pediatrics, University of California , San Diego, California
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Dennison BA, Nguyen TQ, Gregg DJ, Fan W, Xu C. The Impact of Hospital Resources and Availability of Professional Lactation Support on Maternity Care: Results of Breastfeeding Surveys 2009-2014. Breastfeed Med 2016; 11:479-486. [PMID: 27644007 DOI: 10.1089/bfm.2016.0072] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Breastfeeding provides maternal and infant health benefits. Maternity care practices encompassed in the 10 Steps to Successful Breastfeeding are positively associated with improved breastfeeding outcomes. This study assessed changes in maternity care practices and lactation support. MATERIALS AND METHODS In 2009, 2011, and 2014, New York (NY) hospitals providing maternity care services were surveyed to assess the implementation of 9 of the 10 Steps to Successful Breastfeeding, professional lactation support, distribution of formula and discharge packs, and patient and hospital barriers to breastfeeding success. Generalized estimating equations were used to evaluate changes over time. RESULTS Surveys were completed by 138/138 (2009), 128/129 (2011), and 125/125 (2014) NY hospitals. During this time period, the percent of hospitals reporting implementation of Steps 2, 4, 6, or 9 increased, and the mean number of 9 steps implemented increased from 4.3 to 5.3. Hospitals distributing formula samples at discharge to breastfeeding mothers decreased significantly from 39 (32%) to 3 (2%). Professional lactation staffing ratios (N/1,000 births) of both International Board Certified Lactation Consultants and Certified Lactation Counselors increased between 2009 and 2011, but then decreased between 2011 and 2014. Reported barriers to breastfeeding support changed, with reductions in mixed messages from staff, but increases in lack of financial resources for breastfeeding support, inadequate prenatal education, mothers not being prepared, and family not being receptive to breastfeeding. CONCLUSIONS Between 2009 and 2014, NY hospitals reported increased barriers and a reduction in professional lactation support, which may have contributed to the limited improvements in breastfeeding support.
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Affiliation(s)
- Barbara A Dennison
- 1 New York State Department of Health, Albany, New York.,2 School of Public Health, University at Albany, State University of New York , Rensselaer, New York
| | | | | | - Wei Fan
- 1 New York State Department of Health, Albany, New York
| | - Changning Xu
- 1 New York State Department of Health, Albany, New York
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Hauck YL, Blixt I, Hildingsson I, Gallagher L, Rubertsson C, Thomson B, Lewis L. Australian, Irish and Swedish women's perceptions of what assisted them to breastfeed for six months: exploratory design using critical incident technique. BMC Public Health 2016; 16:1067. [PMID: 27724932 PMCID: PMC5057437 DOI: 10.1186/s12889-016-3740-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 10/04/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Breastfeeding initiation rates in some developed countries are high (98 % in Sweden and 96 % in Australia) whereas in others, they are not as favourable (46 % to 55 % in Ireland). Although the World Health Organization recommends exclusively breastfeeding for six months, 15 % of Australian women, 11 % of Swedish women and less than 7 % of Irish women achieve this goal. Awareness of what women in different countries perceive as essential breastfeeding support is a gap in our knowledge. METHODS Our aim was to explore Australian, Irish and Swedish women's perceptions of what assisted them to continue breastfeeding for six months. An exploratory design using critical incident techniques was used. Recruitment occurred through advertisements in local newspapers and on social networking platforms. Initial sampling was purposive, followed by snowball sampling. Telephone interviews were conducted with 64 Irish, 139 Swedish and 153 Australian women who responded to one question "what has assisted you to continue breastfeeding for at least six months?" Content analysis was conducted and common categories determined to allow comparison of frequencies and priority ranking. RESULTS Categories reflected the individual mother, her inner social network, her outer social network (informal support either face to face or online), and societal support (health professionals, work environment and breastfeeding being regarded as the cultural norm). Categories ranked in the top five across the three countries were 'informal face to face support' and 'maternal determination'. Swedish and Australian women ranked "health professional support" higher (first and third respectively) than Irish women who ranked 'informal online support' as second compared to ninth and tenth for Swedish and Australian women. CONCLUSIONS The support required to assist breastfeeding women is complex and multi-faceted. Although common international categories were revealed, the ranking of these supportive categories varied. We must recognize how the cultural context of breastfeeding support can vary for women in differing countries and acknowledge the resourcefulness of women who embrace innovations such as social media where face to face formal and informal support are not as accessible.
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Affiliation(s)
- Yvonne L. Hauck
- School of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Bagot Rd, Subiaco, WA 6008 Australia
| | - Ingrid Blixt
- Department of Women’s and Children’s Health, Uppsala University, 751 85 Uppsala, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Kungsgatan 41, 631 88 Eskilstuna, Sweden
| | - Ingegerd Hildingsson
- Department of Women’s and Children’s Health, Uppsala University, 751 85 Uppsala, Sweden
| | - Louise Gallagher
- Trinity College Dublin, School of Nursing and Midwifery, 24 D’Olier Street, Dublin, Ireland
| | - Christine Rubertsson
- Department of Women’s and Children’s Health, Uppsala University, 751 85 Uppsala, Sweden
| | - Brooke Thomson
- School of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
| | - Lucy Lewis
- School of Nursing, Midwifery and Paramedicine, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Bagot Rd, Subiaco, WA 6008 Australia
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Komninou S, Fallon V, Halford JCG, Harrold JA. Differences in the emotional and practical experiences of exclusively breastfeeding and combination feeding mothers. MATERNAL AND CHILD NUTRITION 2016; 13. [PMID: 27714927 DOI: 10.1111/mcn.12364] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 07/08/2016] [Accepted: 07/13/2016] [Indexed: 11/29/2022]
Abstract
The majority of research examining the barriers to breastfeeding focuses on the physical challenges faced by mothers rather than the risks of encountering negative emotional and practical feeding experiences. We aimed to quantify the emotional and practical experiences of the overall sample of breastfeeding mothers and identify the differences in the emotional and practical experiences of exclusively breastfeeding mothers and combination feeding mothers, by feeding type and intention. Eight hundred forty-five mothers with infants up to 26 weeks of age and who had initiated breastfeeding were recruited through relevant social media via advertisements providing a link to an online survey. Predictors of emotional experiences included guilt, stigma, satisfaction with feeding method, and the need to defend themselves due to infant feeding choices. Practical predictors included perceived support from health professionals, main sources of infant feeding information, and respect from their everyday environment, workplace, and when breastfeeding in public. Current feeding type and prenatal feeding intention. In the overall sample, 15% of the mothers reported feeling guilty, 38% stigmatized, and 55% felt the need to defend their feeding choice. Binary logit models revealed that guilt and dissatisfaction were directly associated with feeding type, being higher when supplementing with formula. No associations with feeding intention were identified. This study demonstrates a link between current breastfeeding promotion strategies and the emotional state of breastfeeding mothers who supplement with formula to any extent. To minimize the negative impact on maternal well-being, it is important that future recommendations recognize the challenges that exclusive breastfeeding brings and provide a more balanced and realistic target for mothers.
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Affiliation(s)
- Sophia Komninou
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Victoria Fallon
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
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Masho SW, Morris MR, Wallenborn JT. Role of Marital Status in the Association between Prepregnancy Body Mass Index and Breastfeeding Duration. Womens Health Issues 2016; 26:468-75. [DOI: 10.1016/j.whi.2016.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 05/11/2016] [Accepted: 05/16/2016] [Indexed: 10/21/2022]
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