Breastfeeding throughout pregnancy in Turkish women

Mothers' Experiences of Tandem Breastfeeding: A Phenomenological Study

OBJECTIVE

Despite many benefits of tandem breastfeeding, mothers stop breastfeeding their older babies early during pregnancy due to inadequate knowledge and support. This study was conducted to determine the tandem breastfeeding experiences of mothers.

STUDY DESIGN

A phenomenological design was used in this study. The data of the study were collected between January and August 2018. In-depth, individual, open-ended interviews were carried out for data collection. A personal information form and a semi-structured in-depth interview form were used to collect data. It was conducted with 13 women who were tandem breastfeeding, 9 of whom had given birth and 4 of whom were pregnant.

RESULTS

The data obtained from the interviews with mothers who were tandem breastfeeding were classified into nine themes, namely: metaphors, feelings, benefits, myths, facilitators, pathways to tandem breastfeeding, fears and worries, difficulties, and obstacles. Mothers experienced many benefits of tandem breastfeeding for maternal and infant health. In addition, although there was no evidence in the literature regarding the harms of tandem breastfeeding, they encountered many myths about it. These myths increased their concerns about this type of breastfeeding. Mothers could not get enough information and support from health care professionals, and this was reported as a challenging experience of tandem breastfeeding.

CONCLUSION

Despite many positive experiences, mothers who tandem breastfeed may also face various difficulties. They need a breastfeeding-friendly environment and support from family and health professionals to cope with these challenges.

KEY POINTS

· Mothers experienced many benefits of tandem breastfeeding for maternal and infant health.. · Pain and tenderness in the breasts, insomnia, and fatigue show the issues that should be supported in tandem breastfeeding mothers.. · Some women felt uterine contractions during pregnancy, but none of them experienced abortion or premature birth.. · In the absence of a risky condition, tandem breastfeeding should be supported and the concerns caused by myths should be replaced by proven scientific results..

Determining Breastfeeding Behaviors During Pregnancy and Opinions on Tandem Breastfeeding among Postpartum Women in a High Fertility Region of Turkey

BACKGROUND

Particularly, in regions with high fertility rates, promoting breastfeeding during pregnancy and tandem breastfeeding can be important in increasing breastfeeding rates.

OBJECTIVES

This study aimed to understand how postpartum women in a high-fertility region in Turkey approach breastfeeding behaviors during pregnancy and opinions on tandem breastfeeding.

MATERIALS AND METHODS

We conducted a descriptive study involving 267 postpartum women hospitalized in a public hospital's postpartum clinic in Sanliurfa, Turkey. Data were collected through face-to-face interviews using a Data Collection Form.

RESULTS

15.7% of the women had prior experience with breastfeeding during pregnancy. 58.8% of women became pregnant again while breastfeeding their older baby, and 84.7% of these women continued breastfeeding for 1 to 20 weeks after learning that they were pregnant. The study revealed that women with highly educated partners and those who learned about their pregnancy early tended to breastfeed for a longer duration during pregnancy (P < 0.05). Overall, 9% of women were aware of tandem breastfeeding, but 84.3% of them held negative opinions about it, with the most common concern being a potential lack of breast milk (31.1%). 4.9% of women expressed their intention to engage in tandem breastfeeding if their older child wanted to suck again. This intention was more common among those who most commonly spoke Turkish at home (P < 0.05).

CONCLUSIONS

The study's findings emphasize the importance of providing informed support and education to women who choose to breastfeed during pregnancy, addressing common misconceptions about tandem breastfeeding, and recognizing the impact of cultural and educational factors on breastfeeding practices.

Feto-Maternal Outcomes of Breastfeeding during Pregnancy: A Systematic Review and Meta-Analysis

BACKGROUND

Breastfeeding is beneficial to both mother and infant. However, overlap of lactation with pregnancy and short recuperative intervals may impact mothers nutritionally. We aimed to investigate the possible effects of pregnancy during breastfeeding.

METHODS

In October 2018, we searched systematically in nine electronic databases to investigate any association of breastfeeding during pregnancy with fetal and/or maternal outcomes. The study protocol was registered in PROSPERO (CRD41017056490). A meta-analysis was done to detect maternal and fetal outcomes and complications during pregnancy. Quality assessment was performed using the Australian Cancer Council bias tool for included studies.

RESULTS

With 1992 studies initially identified, eight were eligible for qualitative analysis and 12 for quantitative analysis. Our results showed no significant difference in different abortion subtypes between lactating and non-lactating ones. In delivery, no difference between two groups regarding the time of delivery in full-term healthy, preterm delivery and preterm labor. No significant difference was detected in rates of antepartum, postpartum hemorrhage and prolonged labor between two groups. The women with short reproductive intervals may have higher supplemental intake and greater reduction fat store. The present studies showed that breastfeeding during pregnancy does not lead to adverse outcomes in the mother and her fetus in normal low-risk pregnancy, although it may lead to the nutritional burden on the mother.

CONCLUSION

The present studies showed that breastfeeding during pregnancy did not lead to the adverse outcomes in the mother and her fetus.

Breastfeeding While Pregnant: A Country-Wide Population Study

Background: There are no national data on the prevalence of breastfeeding during pregnancy (BDP) in the world. Also, there is no consensus for the BDP. Aim: The purpose was to determine the prevalence of breastfeeding status in pregnant mothers having children younger than 24 months of age and to evaluate the associated sociodemographic factors and characteristics of the last-born child and current pregnancy through two consecutive national health survey. Methods: Data from the 2012 and 2017 Jordan Family Health and Population Survey were merged. Individual, household, and community-level factors associated with BDP were analyzed by using complex sample multivariate logistic regression. Results: Two surveys enrolled 6,858 women having at least one child younger than 24 months and 8.8% (weighted count: 603) of them got pregnant also. Of the pregnant women, 8.9% continued breastfeeding their last-born children. Being younger than 12 months positively affected breastfeeding compared to last-born child aged 12-23 months. Multivariate analysis revealed that BDP was associated positively with wealth index (richest vs. poorest) and postnatal care for the last-born child within 2 months (presence vs. absence), whereas negatively with bottle use (presence vs. absence), traditional contraceptive methods (abstinence/withdrawn vs. modern, lactational amenorrhea vs. modern), short interpregnancy interval (months), and current pregnancy duration (months) in Jordan. Conclusions: The prevalence for BDP differs according to some maternal, last-born infant, and current pregnancy characteristics. Prospective cohort studies are necessary to evaluate the impact of BDP on "mother, last-child, and future-child," and to detect the duration and prevalence of BDP in different countries.

Antenatal breastmilk expression for women with diabetes in pregnancy - a feasibility study

Background

Mothers with diabetes are less likely to achieve successful breastfeeding. Antenatal breastmilk expression (ABE) may facilitate earlier breastfeeding, but feasibility of introducing ABE and its acceptance among Scandinavian women have previously not been investigated.

Methods

This observational trial was conducted between the 1 January 2019 and the 12 March 2020 in Tromsø, Norway. We aimed to determine the feasibility of ABE in terms of practicality and acceptability among women with medically (metformin or insulin) treated diabetes. Women were invited to participate during antenatal visits from 32 weeks gestation. Participants received instruction and started ABE from gestation week 37 + 0. Participants, and their infants, were followed until 6–8 weeks after birth. We collected data on breastfeeding rates, infant hypoglycemia, transfer to the neonatal unit, and the women’s overall experience and satisfaction with antenatal breastmilk expression.

Results

Twenty-eight of 34 (82%) invited women consented to participate. All started ABE from week 37 + 0, and continued until hospital admission. No women reported any discomfort or side effects. Labor was induced at 38 weeks gestation. Twenty-four women brought harvested colostrum to the maternity ward, which was given to their infants during the first 24 h of life. Breastfeeding rates at discharge were 24/28 (86%) and 21/27 (78%) at 6–8 weeks after delivery. Seven (25%) infants were transferred to the neonatal unit; four because of hypoglycemia. Maternal satisfaction assessed 6–8 weeks after delivery revealed that all participants felt positive about the ABE, but one woman would not recommend it to other pregnant women.

Conclusions

Implementing a structured ABE guideline for women with medically treated diabetes was feasible. The intervention was associated with high level of satisfaction among study participants. No obvious side effects were observed, and breastfeeding rates at discharge and 6–8 weeks after delivery were higher than in comparable studies.

Trial registration

The study was registered at the research study registry at the University Hospital of North Norway (Nr 2018/7181).

Breast-feeding During Pregnancy and the Risk of Miscarriage

CONTEXT

Breast-feeding rates and durations have been increasing among U.S. women in recent decades. As a result, women may be more likely to practice breast-feeding during pregnancy (BDP), which has been hypothesized to increase the risk of miscarriage, yet there has been little research into the issue.

METHODS

Data on 10,661 pregnancies from several waves of the National Survey of Family Growth, covering the years 2002-2015, were used to calculate unadjusted miscarriage rates according to BDP status. Multivariate Cox proportional hazards models were employed to investigate the association between BDP and the risk of miscarriage.

RESULTS

BDP was practiced for 6% of the total time at risk of miscarriage. The miscarriage rate was higher when mothers exclusively breast-fed during pregnancy (35%) than when they practiced either complementary BDP (i.e., the child also consumed other food) or did not breast-feed (14% and 15%, respectively). After adjustment for maternal and pregnancy characteristics, the risk of miscarriage was greater when mothers exclusively breast-fed than when mothers did not breast-feed (hazard ratio, 3.9), but no increased risk was found with complementary BDP. The miscarriage risk during exclusive BDP was similar to that for women who conceived when they were 40 or older (3.2).

CONCLUSIONS

Exclusive BDP is associated with an elevated risk of miscarriage, but it remains unclear whether and how the practice is associated with health outcomes for the mother and breast-fed child. Research is needed to further explore these outcomes to inform recommendations regarding BDP.

An analysis of the effects of intrapartum factors, neonatal characteristics, and skin-to-skin contact on early breastfeeding initiation

This study aims to determine relationships between intrapartum factors, neonatal characteristics, skin-to-skin contact (SSC), and early breastfeeding initiation after spontaneous vaginal and Caesarean section or operative vaginal birth. A total of 915 mother-newborn dyads were considered in a hypothetical model based on integrated concepts of breastfeeding initiation model, infant learning framework, and attachment theory. Multiple-group path analysis was used to determine whether differences exist between effects of immediate SSC (≤30 min) on early breastfeeding initiation in different modes of birth. SSC, mode of birth, labour duration, and neonatal intensive care unit admission were significantly associated with early breastfeeding initiation, as indicated by the path analysis model, which included all samples. Women with immediate SSC were more likely to initiate early breastfeeding in different modes of birth. In the spontaneous vaginal birth group, women showed a lower likelihood of initiating early breastfeeding when their neonates were admitted to the neonatal intensive care unit and presented an Apgar score of <7 at 1 min. Multiple-group analysis showed no significant difference between effects of immediate SSC on early breastfeeding initiation in different modes of birth (critical ratio = -0.309). Results showed that models satisfactorily fitted the data (minimum discrepancy divided by degrees of freedom = 1.466-1.943, goodness of fit index = 0.981-0.986, comparative fit index = 0.947-0.955, and root mean square error of approximation = 0.023-0.032). Our findings emphasize the crucial importance of prioritizing promotion of immediate SSC under different modes of birth.

Breastfeeding during pregnancy: A systematic review

BACKGROUND

The consequences of breastfeeding during pregnancy (BDP) have not been clearly established. Available studies have addressed isolated aspects of this issue using different methodologies, often resulting in contradictory results. To our knowledge, no systematic review has assessed and compared these studies, making it difficult to obtain a clear picture of the consequences of BDP.

AIM

To review and summarise all the scientific evidence relating to BDP, and determine whether this evidence is sufficient to establish clear implications for the mother, breastmilk, breastfed child, current pregnancy, and ultimately, the newborn.

METHODS

We conducted a systematic review of the English and Spanish literature published between 1990 and 2015 using Cinahl, PubMed, IME, CUIDEN, Cochrane Library, Web of Science and PyscINFO.

FINDINGS

3278 publications were identified from databases, their titles and abstracts were checked to ensure the studies were related to the subject and met the selection criteria. Only 19 studies met all requirements and were included in the review.

CONCLUSIONS AND IMPLICATIONS

Data suggest that BDP does not affect the way pregnancies end or even birth weights. However, several questions remain unanswered. Specifically, it is unclear how BDP affects maternal nutritional status in developed countries, the growth and health of breastfed siblings, the composition of breastmilk, or the growth of the newborn after delivery. Further studies of BDP are needed with larger samples, adequate methodology and proper control of the main confounders.

Antenatal breast milk expression by women with diabetes for improving infant outcomes

BACKGROUND

Some women with diabetes in pregnancy are encouraged to express and store colostrum prior to birthing. Following birth, the breastfed infant may be given the stored colostrum to minimise the use of artificial formula or intravenous dextrose administration if correction of hypoglycaemia is required. However, findings from observational studies suggest that antenatal breast milk expression may stimulate labour earlier than expected and increase admissions to special care nurseries for correction of neonatal hypoglycaemia.

OBJECTIVES

To evaluate the benefits and harms of the expression and storage of breast milk during late pregnancy by women with diabetes.

SEARCH METHODS

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2014).

SELECTION CRITERIA

All published and unpublished randomised controlled trials comparing antenatal breast milk expressing with not expressing, by pregnant women with diabetes (pre-existing or gestational) and a singleton pregnancy.

DATA COLLECTION AND ANALYSIS

Two review authors independently evaluated reports identified by the search strategy.

MAIN RESULTS

There were no published or unpublished randomised controlled trials comparing antenatal expressing with not expressing. One randomised trial is currently underway.

AUTHORS' CONCLUSIONS

There is no high level systematic evidence to inform the safety and efficacy of the practice of expressing and storing breast milk during pregnancy.