Going home with baby: innovative and comprehensive support for new mothers

What makes a city 'breastfeeding-friendly'? A scoping review of indicators of a breastfeeding-friendly city

A breastfeeding-friendly city is one where there is an enabling environment to support breastfeeding throughout the first 2 years or more of a child's life. Indicators of a breastfeeding-friendly city have yet to be identified. What are the indicators or criteria used to define breastfeeding friendliness in a geographic area such as a city and the settings within, which we have classified as community, healthcare and workplace? Three major databases and grey literature were searched. Records were screened to identify publications describing criteria such as indicators or descriptions of a breastfeeding-friendly setting, defined as 'criteria-sets'. These criteria-sets were then categorized and summarized by settings. The search up to 2 September 2021 found 119 criteria-sets from a range of settings: geographic locations (n = 33), community entities (n = 24), healthcare facilities (n = 28), workplaces (n = 28) and others (n = 6). Overall, 15 community, 22 healthcare and 9 workplace related criteria were extracted from the criteria-sets. Criteria that were consistently present in all settings were policy, training & education, skilled breastfeeding support and physical infrastructure. Some criteria-sets of geographic locations contained criteria only from a single setting (e.g., the presence of breastfeeding-friendly cafes). Criteria-sets were present for all settings as defined in this review, but few were actual indicators. Specifically, there were no existing indicators of a breastfeeding-friendly city. Several common components of the criteria-sets were identified, and these could be used in developing indicators of a breastfeeding-friendly city. Future studies should determine which of these are important and how each can be measured.

Academy of Breastfeeding Medicine Clinical Protocol #2: Guidelines for Birth Hospitalization Discharge of Breastfeeding Dyads, Revised 2022

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. The Academy of Breastfeeding Medicine recognizes that not all lactating individuals identify as women. Using gender-inclusive language, however, is not possible in all languages and all countries and for all readers. The position of the Academy of Breastfeeding Medicine (https://doi.org/10.1089/bfm.2021.29188.abm) is to interpret clinical protocols within the framework of inclusivity of all breastfeeding, chestfeeding, and human milk-feeding individuals.

Evaluation of a midwifery network to guarantee outpatient postpartum care: a mixed methods study

BACKGROUND

The necessity of outpatient postpartum care has increased due to shorter hospital stays. In a health care system, where postpartum care after hospital discharge must be arranged by families themselves, this can be challenging for those experiencing psychosocial disadvantages. Therefore, we compared characteristics of users of a midwifery network which referred women to outpatient postpartum care providers with those of women organising care themselves. Additionally, we investigated benefits of the network for women and health professionals.

METHODS

Evaluation of the services of a midwifery network in Switzerland. We combined quantitative secondary analysis of routine data of independent midwives with qualitative telephone interviews with users and a focus group with midwives and nurses. Descriptive statistics and logistic regression modelling were done using Stata 13. Content analysis was applied for qualitative data.

RESULTS

Users of the network were more likely to be: primiparas (OR 1.52, 95% CI [1.31-1.75, p < 0.001]); of foreign nationality (OR 2.36, 95% CI [2.04-2.73], p < 0.001); without professional education (OR 1.89, 95% CI [1.56-2.29] p < 0.001); unemployed (OR 1.28, 95% CI [1.09-1.51], p = 0.002) and have given birth by caesarean section (OR 1.38, 95% CI [1.20-1.59], p < 0.001) compared to women organising care themselves. Furthermore, users had cumulative risk factors for vulnerable transition into parenthood more often (≥ three risk factors: 4.2% vs. 1.5%, p < 0.001). Women appreciate the services provided. The collaboration within the network facilitated work scheduling and the better use of resources for health professionals.

CONCLUSIONS

The network enabled midwives and nurses to reach families who might have struggled to organise postpartum care themselves. It also facilitated the work organisation of health professionals. Networks therefore provide benefits for families and health professionals.

Reasons for Breastfeeding Cessation in the First Year after Childbirth in Lithuania: A Prospective Cohort Study

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.