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Feria-Ramirez C, Gonzalez-Sanz JD, Molina-Luque R, Molina-Recio G. Influence of gestational weight gain on the nutritional status of offspring at birth and at 5 years of age. Midwifery 2024; 129:103908. [PMID: 38142650 DOI: 10.1016/j.midw.2023.103908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 11/24/2023] [Accepted: 12/07/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVE To determine the influence of pre-pregnancy maternal BMI and increases in maternal weight during pregnancy on perinatal and child outcomes at birth and at 5 years. RESEARCH DESIGN/SETTING A prospective cohort study was conducted between November 2016 and December 2021. The participants were a total of 115 women-child dyads, selected from among pregnant women receiving routine prenatal care in different health centres belonging to 2 health districts. Follow-ups were conducted with the women during pregnancy and with their children during the 10 days after birth and at 5 years. FINDINGS The total weight gain during pregnancy is influenced by an inadequate pre-pregnancy BMI (0.03; 95 % CI, 0.004 - 0.25; P=.001) and a greater increase in maternal BMI during the first and second term of pregnancy. A greater increase in BMI during pregnancy was associated with higher breastfeeding rates both in the short term (1.21; 95 % CI, 1.01-1.44; P = 0.04) and the long term (12 months: 1.30; 95 % CI, 1.02 - 1.67; P = 0.04; 24 months: 1.30; 95 % CI, 1.02 - 1.69; P = 0.04). No links were found between gains in maternal weight and the weight of the newborn, nor between maternal weight and/or pre-pregnancy BMI with the nutritional status of the child. KEY CONCLUSIONS After studying these results, it was concluded that promoting and implementing health and education policies focused on enhancing maternal nutritional status is essential to improve the nutritional status of children. IMPLICATIONS FOR PRACTICE Healthy gestational weight gain (GWG) is an important issue to be addressed by the midwife in primary care, both in the preconception period and throughout pregnancy. As a result, it is important that the midwife is trained and has the appropriate resources and tools to work with pregnant women individually and collectively. In addition to paying attention to overweight and obese pregnant women, the midwife should also pay attention to women with a normal BMI, as they seem to have greater difficulty in maintaining a healthy weight gain. Another line of intervention to be addressed is breastfeeding (BF), where the midwife should be the main point of reference from the beginning of this process, taking into account the relationship between BMI and BF.
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Affiliation(s)
- Carmen Feria-Ramirez
- Department of Nursing, Faculty of Nursing, University of Huelva, Avda. Tres de Marzo, s/n, Huelva 21071, Spain
| | - Juan D Gonzalez-Sanz
- Department of Nursing, Faculty of Nursing, University of Huelva, Avda. Tres de Marzo, s/n, Huelva 21071, Spain; COIDESO Research Center, University of Huelva, Avda. Tres de Marzo, s/n, Huelva 21071, Spain.
| | - Rafael Molina-Luque
- Lifestyles, Innovation and Health Research Associate Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Avda. Menéndez Pidal, s/n, Córdoba 14004, Spain; Department of Nursing, Pharmacology and Physiotherapy, Faculty of Nursing, University of Cordoba, Avda. Menéndez Pidal, s/n, Córdoba 14004, Spain
| | - Guillermo Molina-Recio
- Lifestyles, Innovation and Health Research Associate Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Avda. Menéndez Pidal, s/n, Córdoba 14004, Spain; Department of Nursing, Pharmacology and Physiotherapy, Faculty of Nursing, University of Cordoba, Avda. Menéndez Pidal, s/n, Córdoba 14004, Spain
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Ng C, Szücs A, Goh LH. Common maternal health problems and their correlates in early post-partum mothers. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241227879. [PMID: 38282548 PMCID: PMC10826383 DOI: 10.1177/17455057241227879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 12/16/2023] [Accepted: 01/04/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Mothers experience a wide range of maternal health problems after childbirth, which in turn, affect their well-being and ability to care for their newborn. These problems may be influenced by factors such as mode of delivery or socio-economic status. OBJECTIVE This study aims to investigate the prevalence of common maternal health problems and their correlates in a public primary healthcare institution in Singapore. DESIGN This was a cross-sectional study, based on a self-administered questionnaire. METHODS A total of 373 mothers (mean age 31.9 years) who accompanied their infants for their 4- to 8-week development assessments at a public primary care clinic in Singapore completed a self-administered questionnaire from June 2021 to December 2021. The questionnaire assessed demographic factors, mode of delivery, number of children, number of individuals providing significant help, and the frequency of common physical and mental maternal health problems using a 5-point Likert-type scale. RESULTS The five most common maternal health problems were fatigue (77.7%), lower back pain (59.3%), Caesarean wound pain (54.3%), upper back pain (53.0%) and vaginal pain (41.2%). The prevalence of depression and anxiety was 22.0% and 11.3%, respectively. With respect to the symptoms' correlates, pain on passing urine was more frequent after assisted vaginal deliveries than all other forms of deliveries (all pairwise p < 0.01), and pain on passing motion was more frequent in vaginal deliveries than in Caesarean deliveries (all pairwise p < 0.05). Mothers having a larger number of children more frequently experienced headaches (β = 0.17, SE = 0.05, p = 0.002) and less frequently experienced breastfeeding difficulties (β = -0.28, SE = 0.08, p < 0.001). CONCLUSION Mothers experienced a high prevalence of maternal health problems in multiple domains during the first 8 weeks after childbirth. Mode of delivery and number of children were associated with increased prevalence of certain problems. Mothers' physical and mental well-being should be investigated early after delivery and addressed with adequate treatments and resources.
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Affiliation(s)
- Christine Ng
- National University Polyclinics (NUP), Singapore
| | - Anna Szücs
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lay Hoon Goh
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Massare BA, Hackman NM, Sznajder KK, Kjerulff KH. Helping first-time mothers establish and maintain breastfeeding: Access to someone who can provide breastfeeding advice is an important factor. PLoS One 2023; 18:e0287023. [PMID: 37379273 DOI: 10.1371/journal.pone.0287023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 05/28/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND AND AIMS First-time mothers often need help with breastfeeding and may feel isolated and uncertain about whom they can turn to for help with breastfeeding challenges. Exploration of whether access to breastfeeding advice helps new mothers initiate and continue breastfeeding is necessary. This study investigated the associations between ease of access to breastfeeding advice for first-time mothers and breastfeeding initiation and duration. METHODS This was a prospective, longitudinal cohort study of 3,006 women who delivered their first child in Pennsylvania, USA; with prenatal and postpartum interviews. At 1-month postpartum participants reported the extent to which they had access to "Someone to give you advice about breastfeeding if you needed it", via a 5-point scale ranging from "none of the time" to "all of the time". RESULTS There were 132 women (4.4%) who reported that they had access to someone to give them advice about breastfeeding "none of the time"; 697 (23.3%) reported access "a little of the time" or "some of the time"; and 2,167 (72.3%) reported access "most of the time" or "all of the time". While the majority of the new mothers were breastfeeding at 1-month postpartum (72.5%), less than half were still breastfeeding at 6-months postpartum (44.5%). The higher the level of access to advice about breastfeeding the more likely women were to establish breastfeeding by 1-month postpartum and to still be breastfeeding at 6-months. CONCLUSIONS For first-time mothers, ease of access to someone who can give them advice about breastfeeding facilitates breastfeeding establishment and continuation.
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Affiliation(s)
- Brittany A Massare
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, United States of America
| | - Nicole M Hackman
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, United States of America
| | - Kristin K Sznajder
- Departments of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, United States of America
| | - Kristen H Kjerulff
- Departments of Public Health Sciences and Obstetrics and Gynecology, Penn State College of Medicine, Hershey, Pennsylvania, United States of America
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Coca KP, Chien LY, Lee EY, Souza ACDP, Hong SA, Chang YS. Factors associated with postpartum depression symptoms among postpartum women in five countries during the COVID-19 pandemic: an online cross-sectional study. BMC Psychiatry 2023; 23:171. [PMID: 36922822 PMCID: PMC10016169 DOI: 10.1186/s12888-023-04607-0] [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: 10/23/2022] [Accepted: 02/13/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND This study aimed to examine factors associated with postpartum depression (PPD) symptoms during the COVID-19 pandemic among postpartum women in five countries, a subject that has not been investigated thus far. METHODS A multi-country, cross-sectional, online survey was conducted with a convenience sample of 3,523 postpartum women in Brazil, South Korea, Taiwan, Thailand, and the United Kingdom, from July to November 2021. Sociodemographic and obstetric data, food insecurity, COVID-19 positive status, COVID-19 vaccination, infant feeding, breastfeeding belief score, and social support were investigated. PPD and social support were measured using the Edinburgh Postnatal Depression Scale and Maternal Social Support Scale, respectively. Descriptive statistics, chi-squared tests, and t-tests were used to identify associations with PPD symptoms. A binary logistic regression model was used to identify explanatory factors associated with PPD and adjusted odds ratios (OR) and 95% confidence intervals (CIs) were calculated. RESULTS Women in Taiwan (AOR = 0.5; 95%CI 0.34, 0.73) and Thailand (AOR = 0.68; 95%CI 0.46, 0.99) had a lower risk of PPD symptoms than those in Brazil. In addition, women with planned pregnancies had a lower risk of PPD (AOR = 0.74; 95%CI 0.60, 0.91). Younger women (AOR = 1.62; 95%CI 1.05, 2.51), health problems during pregnancy, delivery, or postpartum (AOR = 1.71; 95%CI 1.42, 2.06), and no change or worse food insecurity during COVID-19 (AOR = 1.66; 95%CI 1.21, 1.27 for no change and AOR = 1.68; 95%CI 1.27, 1.23, respectively) presented a higher likelihood of having PPD. Feeding babies with expressed human milk (AOR = 1.25; 95%CI 1.03, 1.50) and/or complementary food (AOR = 1.51; 95%CI 1.17, 1.94) were associated with PPD symptoms. Women who received low (AOR = 7.74; 95%CI 5.43, 11.03) or medium support (AOR = 3.25; 95%CI 2.71, 3.88) had higher likelihoods of PPD. CONCLUSION PPD symptoms during the pandemic were high in young women, particularly Brazilian women, with health problems in the puerperal pregnancy cycle who fed their babies expressed breast milk and/or complementary food. Low social support also impacted PPD symptoms. This study highlights the need for the professional screening for PPD and provision of virtual or personal support.
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Affiliation(s)
- Kelly Pereira Coca
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Li-Yin Chien
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Yang-Ming Campus, Taipei, Taiwan
| | - Eun Young Lee
- Department of Nursing, Catholic Kkottongnae University, Cheongju, Republic of Korea
| | | | - Seo Ah Hong
- ASEAN Institute for Health Development, Institute for Health and Society, Mahidol University, Hanyang University, Seoul, Republic of Korea.
- ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand.
| | - Yan-Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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5
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Siwik E, Larose S, Peres D, Jackson KT, Burke SM, Mantler T. Experiences of At-Risk Women in Accessing Breastfeeding Social Support During the Covid-19 Pandemic. J Hum Lact 2022; 38:422-432. [PMID: 35466789 PMCID: PMC9329748 DOI: 10.1177/08903344221091808] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND With strict public health measures implemented in March 2020 due to the COVID-19 pandemic, many breastfeeding parents, who are within an at-risk population, have experienced limited formal and/or informal breastfeeding social support. In the Canadian context, the experiences of these women is unknown. RESEARCH AIM To explore the experiences of at-risk postpartum breastfeeding women in accessing formal and informal breastfeeding social support during the COVID-19 pandemic. METHODS This was a prospective, longitudinal interpretive description study using mixed methods. Data were gathered using an online survey and one 52-112-min semi-structured interview at 12-weeks postpartum. At-risk breastfeeding participants were those who lack social support and had at least one of the following: age < 25 years; experiencing or had experienced intimate partner violence; or of low income. We sought participants' experiences of accessing breastfeeding social support during the first few months of the COVID-19 pandemic/lockdown. Seven participants completed the survey and the interview. RESULTS Participants identified that the COVID-19 pandemic created barriers to accessing formal and informal breastfeeding social support, which stemmed from public health restrictions and difficulties communicating online with families and healthcare providers. Additionally, participants identified that the COVID-19 pandemic/lockdowns facilitated feelings of connectedness, protection, and resiliency. CONCLUSION We provide preliminary insight into the experiences of trying to access breastfeeding social support during the COVID-19 pandemic. Future researchers should seek to prioritize improved communication and resources in supporting breastfeeding during COVID-19 and future pandemics/lockdowns.
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Affiliation(s)
- Emila Siwik
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
| | - Samantha Larose
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
| | - Dalia Peres
- Health Sciences with Biology Program, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
| | - Kimberley T Jackson
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
| | - Shauna M Burke
- School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
| | - Tara Mantler
- School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
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Gray KD, Hannon EA, Erickson E, Stewart AB, Wood CT, Fisher K, Shaikh SK, Tanaka D. Influence of Early Lactation Assistance on Inpatient Exclusive Breastfeeding Rates. J Hum Lact 2021; 37:556-565. [PMID: 32926658 DOI: 10.1177/0890334420957967] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Human milk feeding reduces the incidence and costs of several maternal and childhood illnesses. Initiation and success of human milk feeding are influenced by race, socioeconomic status, and family support. The influence of early in-hospital lactation assistance in breastfeeding success has been not well described. RESEARCH AIMS We aimed to determine how suspected known factors influencing breastfeeding success influence in-hospital human milk feeding rates. Second, we aimed to examine how timing of lactation assistance is related to success of human milk feeding during the newborn hospitalization for healthy infants. METHODS We conducted a retrospective cohort study of term infants born between January 1, 2014 and December 31, 2016 at a large tertiary academic hospital. We considered "success" to be 100% human milk feeding during the birth hospitalization, and compared differences in success by demographics, payor, race, and initial feeding preference. Influences of lactation assistance on success were analyzed using multivariable logistic regression. RESULTS Mean success with exclusive human milk feeding among 7,370 infants was 48.9%, (n = 3,601). Successful participants were more likely to be 39-40 weeks' gestation (64.9%, n = 2,340), non-Hispanic/non-Latino (80.0%, n = 2,882), and using private insurance (69.2%, n = 2,491). Participants who had early feeding assisted by an International Board Certified Lactation Consultant (IBCLC) before being fed any formula were more likely to be successful than participants who had a feeding assisted by a non-IBCLC nurse (80% vs. 40% respectively). CONCLUSIONS Success for exclusive human milk feeding during newborn hospitalization is strongly associated with several factors. Early intervention with IBCLCs can greatly improve breastfeeding success.
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Affiliation(s)
- Keyaria D Gray
- 12277 Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Emily A Hannon
- 12277 Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Elizabeth Erickson
- 12277 Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Ariana B Stewart
- 12277 Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Charles T Wood
- 12277 Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Kimberley Fisher
- 12277 Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Sophie K Shaikh
- 12277 Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - David Tanaka
- 12277 Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
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Yin XH, Zhao C, Yang YM, Shi HF, Wu TC, Xie JL, Niu JQ, Wang XL, Fang J. What is the impact of rural-to-urban migration on exclusive breastfeeding: a population-based cross-sectional study. Int Breastfeed J 2020; 15:86. [PMID: 33054799 PMCID: PMC7560081 DOI: 10.1186/s13006-020-00330-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 10/09/2020] [Indexed: 12/03/2022] Open
Abstract
Background In China, less than one third of infants under 6 months of age are being exclusively breastfed. Maternal rural-to-urban migration contributes to these low rates of breastfeeding practices. Therefore, the aim of this study was to assess the prevalence of breastfeeding practices and associated factors among rural-to-urban migrant children and local children with infants aged 0–12 months in China, 2018. Methods Data were collected from a population-based cross-sectional survey in 2018 that included 6995 infants from eight urban areas (four metropolis and four medium sized/small cities) in China. The prevalence of breastfeeding practices was calculated using a 24-h recall questionnaire for all infants aged under 12 months. Logistic regression was conducted to examine the association between the prevalence of breastfeeding practices and maternal migrant status, after adjusting for sociodemographic characteristics, mother-infant health information and supportive information. For exclusive breastfeeding, we further analyzed its association with maternal rural-to-urban migration, stratified by maternal education level, maternal resident place and maternal ethnicity, respectively. Results The overall prevalence of ever breastfeeding, exclusive breastfeeding, predominant breastfeeding and age-appropriate breastfeeding (exclusive breastfeeding of infants under 6 months of age and complementary feeding from six to 12 months of age) was 97.51, 29.84, 59.89 and 45.07%, respectively. Rural-to-urban migrant children were less likely to be exclusively breastfed compared to local children (AOR 0.81, 95% CI 0.68, 0.95). Stratified by different sociodemographic variables, a negative association between exclusive breastfeeding and rural-to-urban migration was only found in the group with high education level, in the group living in metropolis and in the group of minorities, respectively. Conclusions The overall prevalence of breastfeeding practices was low in both rural-to-urban migrant children and local children. Besides common strategies, special approaches should be provided for urban highly educated migrants.
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Affiliation(s)
- Xiao Han Yin
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Chen Zhao
- China Development Research Foundation, Beijing, China
| | - Yu Mei Yang
- School of Economics and Management, Beijing Forestry University; China Center for the Economics of Human Development, Beijing, China
| | - Hui Feng Shi
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Tian Chen Wu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Jia Lei Xie
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Jie Qiong Niu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Xiao Li Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China. .,National Health Commission Key Laboratory of Reproductive Health, Beijing, China.
| | - Jin Fang
- China Development Research Foundation, Beijing, China.
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Baraldi NG, Lettiere-Viana A, Carlos DM, Salim NR, Pimentel DTR, Stefanello J. The meaning of the social support network for women in situations of violence and breastfeeding. Rev Lat Am Enfermagem 2020; 28:e3316. [PMID: 32696921 PMCID: PMC7365605 DOI: 10.1590/1518-8345.3313.3316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 04/06/2020] [Indexed: 11/22/2022] Open
Abstract
Objective: to understand the meanings attributed to the social support network of women
breastfeeding and in situations of violence by an intimate partner. Method: a qualitative study, carried out with 21 women, through semi-structured
interviews and data analyzed by the Method of Interpretation of the Senses
in the light of the conceptual framework of Social Support Network. Results: all women suffered violence by the partner in the puerperium and only one of
them maintained exclusive breastfeeding until 180 days postpartum. In the
analysis, the category entitled “The action of the social support network in
the face of breastfeeding in the context of intimate partner violence”
emerged, with two subcategories: “Interpersonal support network” and
“Institutional support network”. In the interpersonal network, the partner
was little mentioned, on the other hand, there was a greater participation
of other women. In the institutional network, non-resolution and actions
centered on biological character were evident. Conclusions: the search for help in the interpersonal network stood out in comparison to
the institutional network, both with regard to the issue of violence and
breastfeeding and the actions related to it, mostly ineffective,
characterized by counseling and referrals.
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Affiliation(s)
- Nayara Girardi Baraldi
- Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Angelina Lettiere-Viana
- PAHO/WHO Collaborating Centre at the Nursing Research Development, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Diene Monique Carlos
- Departamento de Enfermagem, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Natália Rejane Salim
- Departamento de Enfermagem, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Daniela Taysa Rodrigues Pimentel
- PAHO/WHO Collaborating Centre at the Nursing Research Development, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Juliana Stefanello
- PAHO/WHO Collaborating Centre at the Nursing Research Development, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Bochner RE, Kuroki R, Lui K, Russell CJ, Rackovsky E, Piper L, Ban K, Yang K, Mandal P, Mackintosh L, Mirzaian CB, Gross E. Variations in Care for Breastfed Infants Admitted to US Children's Hospitals: A Multicenter Survey of Inpatient Providers. Hosp Pediatr 2019; 10:70-75. [PMID: 31826917 DOI: 10.1542/hpeds.2019-0199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Studies have revealed an association between hospitalization of breastfed infants and weaning posthospitalization. It is unknown what steps inpatient providers at children's hospitals are currently taking to support breastfeeding mothers of hospitalized infants, their comfort providing breastfeeding counseling, and what training they receive. METHODS We conducted a multicenter survey study of pediatric providers who care for infants hospitalized at 3 urban, tertiary-care children's hospitals over a 12-month period. A convenience sample of nurses, residents, and attending physicians agreed to participate. Participants completed a 24-question questionnaire addressing provider practices, comfort with breastfeeding counseling, and previous breastfeeding education. Data were summarized as medians (interquartile ranges) and frequencies (percentages). Kruskal-Wallis and χ2 tests were used to compare between provider types. RESULTS A total of 361 out of 1097 (33%) eligible providers completed the survey: 133 (21%) nurses, 166 (45%) residents, and 62 (63%) attending physicians. Provider practices varied by provider type. We observed a general trend that providers do not routinely review breastfeeding techniques, directly observe feeds, or use standardized breastfeeding assessment tools. Residents and attending physicians were more likely than nurses to feel comfortable with breastfeeding counseling (P = .02). Residents were more likely than nurses and attending physicians to have received breastfeeding education in the last 3 years (P < .001). CONCLUSIONS Practices, comfort, and previous education varied by provider type. There was a general pattern that providers do not routinely perform certain practices. Further studies are needed to determine if inpatient provider practices affect weaning posthospitalization and if inpatient quality improvement initiatives will help mothers continue breastfeeding posthospitalization.
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Affiliation(s)
- Risa E Bochner
- Department of Pediatrics, University Hospital of Brooklyn, State University of New York Downstate Medical Center and Kings County Hospital Center, Brooklyn, New York;
| | - Robyn Kuroki
- Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Karen Lui
- Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Christopher J Russell
- Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Elia Rackovsky
- Department of Pediatrics, Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, New York
| | - Laura Piper
- Department of Pediatrics, Cincinnati Children's Hospital and College of Medicine, University of Cincinnati, Cincinnati, Ohio; and
| | - Kathryn Ban
- Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Katharine Yang
- Department of Internal Medicine, Los Angeles County + University of Southern California Medical Center and Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Purnima Mandal
- Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Liza Mackintosh
- Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Christine B Mirzaian
- Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Elissa Gross
- Department of Pediatrics, Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, New York
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10
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Quinn EM, Gallagher L, de Vries J. A qualitative exploration of breastfeeding support groups in Ireland from the women's perspectives. Midwifery 2019; 78:71-77. [PMID: 31398596 DOI: 10.1016/j.midw.2019.08.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/31/2019] [Accepted: 08/01/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Volunteer breastfeeding support groups are deemed effective in promoting breastfeeding initiation and duration, but women's views are not well reported. The aim of this study was to explore women's experiences of Breastfeeding Support Groups in Ireland from their perspective. DESIGN AND PARTICIPANTS Semi-structured interviews with 15 breastfeeding mothers were conducted with participants recruited as part of a larger mixed-methods study. METHODS Interviews were conducted online. Interviews were audiorecorded, transcribed, and analysed using Thematic Analysis. Cultural Historical Activity Theory was used as the theoretical framework. FINDINGS Six key themes were identified: 'complexity of breastfeeding support', 'community and connection', 'impact of culture on breastfeeding needs', 'the journey', 'passing on', and 'what mothers want'. Mothers primarily attend in order to meet other mothers, and not necessarily with a problem, getting practical suggestions to meet their individual and changing needs. The social aspect of support groups fosters a sense of community and inclusion, long-standing friendships, a social outlet, and ongoing support. CONCLUSIONS Mothers attend breastfeeding support groups in order to meet other mothers and continue to attend for this reason to get mothering and breastfeeding support, as well as passing on their knowledge and experiences to other mothers, while meeting their social needs. IMPLICATIONS FOR PRACTICE More resources, acknowledgement and funding are needed to provide breastfeeding support groups in local communities. Breastfeeding support groups and health professionals need to emphasise the social aspects of the interactions at these group rather than attending for a breastfeeding problem.
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Affiliation(s)
| | - Louise Gallagher
- School of Nursing & Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland
| | - Jan de Vries
- School of Nursing & Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland
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Abou-Dakn M. [Health effects of breastfeeding on the mother]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2018; 61:986-989. [PMID: 29978234 DOI: 10.1007/s00103-018-2776-1] [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: 12/24/2022]
Abstract
We evaluated the effect of breastfeeding on maternal health outcomes. We distinguished between long-term effects (breast carcinoma, ovarian carcinoma, endometrial carcinoma, osteoporosis, and type 2 diabetes mellitus) and short-term effects (lactational amenorrhea, postpartum depression, and postpartum weight change).Predominant breastfeeding increases the duration of lactational amenorrhea, which has a short-term effect on the reduction of fertility. There are many studies that show that breastfeeding is protective against breast, ovarian carcinoma, and endometrial carcinoma. The effects depend on the duration of breastfeeding. There is evidence that breastfeeding reduces the risk of type 2 diabetes and metabolic syndrome and cardiac diseases. However, an association between breastfeeding and bone mineral density or maternal depression or postpartum weight change was not clearly evident.
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Affiliation(s)
- Michael Abou-Dakn
- Klinik für Gynäkologie und Geburtshilfe, St. Joseph Krankenhaus Berlin-Tempelhof, Wüsthofstr. 15, 12101, Berlin, Deutschland.
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