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Ashrafinia F, Chen H, Heydari O, Mirzaei M, Abdi F. The Importance of Personal and Familial Factors on Breastfeeding Intention and Practices, and Postpartum Distress during the Pandemic: A Longitudinal Observational Study. Matern Child Health J 2024; 28:513-523. [PMID: 37924418 DOI: 10.1007/s10995-023-03813-2] [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] [Accepted: 10/23/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND The COVID-19 pandemic has significantly impacted pregnant and breastfeeding women. Both low- and high-risk groups adopted preventive approaches such as mask-wearing and handwashing to slow down and prevent viral transmission during critical periods that may affect mother-child interactions. METHODS A longitudinal observational study was conducted with primiparous women recruited using convenience sampling from the postpartum care ward of Afzalipour Teaching Hospital in Kerman from August 1, 2020 to March 30, 2021. The research questionnaires included demographic information, preventive behaviors, breastfeeding intention and practices, postpartum distress, and Edinburgh Postpartum Depression Scale. All the questionnaires were self-reported online in three stages: before discharge from the postpartum ward, the first month after delivery, and the third month after delivery. RESULTS A Total of 160 primiparous women were included. The results showed significant changes in preventive behaviors and postpartum distress levels during the study. Breastfeeding intention and practices were negatively affected by postpartum distress (P = 0.034), unwanted pregnancies (P = 0.009), and cesarean delivery (P < 0.001). Postpartum distress was directly affected by the presence of depression (P < 0.001). Preventive behaviors at discharge were significantly associated with postpartum distress three months after delivery (P = 0.013). The study also found an association between women's and partner's education, unwanted pregnancy, and cesarean delivery that determined postpartum distress. CONCLUSIONS Pandemic restrictions did not affect breastfeeding intentions or practices, possibly due to sufficient social and family support during the pandemic. However, robust guidelines are required to increase enable women's access to specializede care to cope with future pandemics, particularly during the first few weeks after childbirth.
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Affiliation(s)
- Farzaneh Ashrafinia
- Department of Reproductive Health and Midwifery, Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran.
| | - Hui Chen
- Foetal Programming, School of Life Sciences, University of Technology Sydney, Sydney, Australia
| | - Omolbanin Heydari
- Midwifery, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Mirzaei
- Obstetrics and Gynecology, Infertility, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Fatemeh Abdi
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
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Wang YW, Chang YJ. Effects of the experience of breastfeeding-friendly practices and breastfeeding intention and self-efficacy on breastfeeding behavior: a cohort study in Taiwan. Int Breastfeed J 2023; 18:5. [PMID: 36653866 PMCID: PMC9847041 DOI: 10.1186/s13006-022-00539-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 12/20/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Approximately 80% of births in Taiwan occurred in Baby-Friendly accredited facilities, although the trend of exclusively breastfeeding infants until 6 months of age has stagnated in the last ten years. To guide breastfeeding promotion interventions during postnatal stays and encourage mothers to continue breastfeeding for the first 6 months, factors associated with breastfeeding behaviors to 6 months post-delivery must be investigated. This study explored the relationships among breastfeeding intention, experience of breastfeeding-friendly practices, breastfeeding self-efficacy, and breastfeeding behavior at four and 6 months after childbirth. METHODS In this longitudinal cohort study, women who gave birth to healthy newborns at two Baby-Friendly hospitals in Taiwan and who had initiated breastfeeding were recruited two to 4 days after giving birth. Data were collected three to 5 days after childbirth during hospitalization and at one, two, four, and 6 months after childbirth using a self-developed questionnaire to measure breastfeeding intention and the experience of breastfeeding-friendly practices, and the traditional Chinese version of the Breastfeeding Self-Efficacy Scale-Short Form to measure self-efficacy. RESULTS A total of 155 women completed the questionnaires five times within 6 months. The determinants of exclusive breastfeeding at 4 months and any breastfeeding at 6 months were the intention to breastfeed for over 6 months; a higher score for the experience of breastfeeding-friendly practices; and a higher level of breastfeeding self-efficacy during that period. The experience of breastfeeding-friendly practices during hospitalization did not predict breastfeeding behavior at 4 and 6 months. Intending to breastfeed for less than 4 months and lower breastfeeding self-efficacy during the hospital stay were both associated with shorter breastfeeding durations of less than 6 months after childbirth. CONCLUSIONS Longer intended duration of breastfeeding, sustaining breastfeeding-friendly practices after discharge, and maintenance of a higher level of breastfeeding self-efficacy were the determinants of breastfeeding at 4 and 6 months. Healthcare professionals in Taiwan must support breastfeeding-friendly practices and consider interactive interventions to promote continued breastfeeding at different stages during the first 6 months after childbirth on the basis of the mother's breastfeeding plan and breastfeeding self-efficacy during their postnatal hospitalization.
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Affiliation(s)
- Yu-Wen Wang
- grid.469082.10000 0004 0634 2650Office of Research and Development, National Tainan Junior College of Nursing, Tainan, Taiwan
| | - Ying-Ju Chang
- Institution of Allied Health Sciences & Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan. .,Department of Nursing, National Cheng Kung University Hospital, Tainan, Taiwan.
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Wu Q, Tang N, Wacharasin C. Factors influencing exclusive breastfeeding for 6 months postpartum: A systematic review. Int J Nurs Knowl 2022; 33:290-303. [PMID: 35088945 DOI: 10.1111/2047-3095.12360] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/11/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE This systematic review aims to identify factors influencing exclusive breastfeeding (EBF) up to 6 months. METHODS The databases including PubMed, MEDLINE, CINAHL, Scopus, EMBASE, CNKI, and WANFANG were searched to retrieve studies. Quantitative research were extracted and the preferred reporting items for systematic reviews were followed. Critical appraisal checklists of Joanna Briggs Institute were used to evaluate the quality of the included studies. FINDINGS A total of 16 papers were eligible for this systematic review, comprising five cohort studies and 11 cross-sectional studies. Moderate to strong evidence supported that 6-month exclusive breastfeeding is affected by maternal working status, breastfeeding knowledge, delivery mode, parity, perception of insufficient human milk, mothers' infant feeding attitude, breastfeeding self-efficacy, and intention. CONCLUSIONS Factors influencing EBF up to 6 months postpartum play a key role in promoting mothers' health and reducing diseases in their infants. IMPLICATIONS FOR NURSING PRACTICE Interventions based on related factors should be developed and taken into practice to assist mothers in exclusive breastfeeding for up to 6 months. Additional studies from different countries in different populations with high quality are needed to provide more reliable and richer findings.
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Affiliation(s)
- Qian Wu
- Faculty of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China.,Faculty of Nursing, Burapha University, Chon Buri, Thailand
| | - Nan Tang
- Faculty of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China.,Faculty of Nursing, Burapha University, Chon Buri, Thailand
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Economou M, Kolokotroni O, Paphiti-Demetriou I, Kouta C, Lambrinou E, Hadjigeorgiou E, Hadjiona V, Middleton N. The association of breastfeeding self-efficacy with breastfeeding duration and exclusivity: longitudinal assessment of the predictive validity of the Greek version of the BSES-SF tool. BMC Pregnancy Childbirth 2021; 21:421. [PMID: 34107927 PMCID: PMC8188677 DOI: 10.1186/s12884-021-03878-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 05/13/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION While breastfeeding self-efficacy (BSES) is an important modifiable determinant of breastfeeding, a structured assessment is not standard practice in Cyprus. We assessed the Greek version of the Breastfeeding Self-Efficacy Scale (BSES-SF), including its predictive validity in terms of Breastfeeding (BF) and Exclusive Breastfeeding (EBF) up to the sixth month. METHODS A methodological study with longitudinal design among 586 mother-infant dyads, as part of the "BrEaST Start in Life" project. BSES was assessed 24-48 h after birth and at the first month. Breastfeeding status was assessed at the clinic, the 1st, 4th and 6th month. The association between BSES and breastfeeding was estimated in logistic regression models and its diagnostic ability in ROC analysis. RESULTS With Mean = 3.55 (SD = 0.85), BSES was moderate, and lower among Cypriot women, primiparas and those who delivered by Cesarean Section (C/S). There was good internal consistency across the 14 items (Cronbach's α = 0.94) while factor analysis revealed a two-factor structure. BSES scores were higher among mothers who initiated exclusive breastfeeding (M = 3.92, SD = 0.80) compared to breastfeeding not exclusively (M = 3.29, SD = 0.84) and not breastfeeding (M = 3.04, SD = 1.09; p-value < 0.001). There was a stepwise association with exclusivity (40.5% in the highest vs 7.9% lowest quartile of self-efficacy). The association between in-hospital BSES and long-term EBF persisted in multivariable models. Women in the upper quartile of BSES at 48 h were more likely to breastfeed exclusively by adjOR = 5.3 (95% CI 1.7-17.1) at the 1st and adjOR = 13.7 (95% CI 2.7-68.6) at the 4th month. Similar associations were observed between self-efficacy at the 1st month and BF at subsequent time-points. High first month BSES (> 3.96 as per ROC) had 58.9% positive and 79.6% negative predictive value for breastfeeding at 6 months which reflects higher sensitivity but lower specificity. CONCLUSIONS The Greek version of BSES-SF showed good metric properties (construct, know-group, concurrent and predictive validity). In the absence of community support structures or programmes in Cyprus, prevalence of breastfeeding remains low. This suggests a need for policy, educational and community support interventions, including the systematic use of BSES scale as a screening tool to identify those at higher risk for premature BF discontinuation.
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Affiliation(s)
- Mary Economou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.
| | - Ourania Kolokotroni
- St George University of London Medical School at the University of Nicosia, Nicosia, Cyprus
- Cyprus Breastfeeding Association - 'Gift for Life', Nicosia, Cyprus
| | | | - Christiana Kouta
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Ekaterini Lambrinou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Eleni Hadjigeorgiou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Vasiliki Hadjiona
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Nicos Middleton
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
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Wu SFV, Chen SC, Liu HY, Lee HL, Lin YE. Knowledge, Intention, and Self-Efficacy Associated with Breastfeeding: Impact of These Factors on Breastfeeding during Postpartum Hospital Stays in Taiwanese Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18095009. [PMID: 34065129 PMCID: PMC8125992 DOI: 10.3390/ijerph18095009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 11/29/2022]
Abstract
Breastfeeding knowledge, intention, and self-efficacy affect breastfeeding rates during the postpartum period. Insufficient knowledge, lack of intention, and poor breastfeeding self-efficacy reduce the likelihood of breastfeeding postpartum. The purposes of this study were to (1) assess women’s intention to breastfeed and knowledge and self-efficacy regarding breastfeeding following childbirth, and to (2) identify the factors associated with postpartum breastfeeding during women’s hospital stays. This longitudinal study with a pretest and posttest design study recruited pregnant women from the gynecology and obstetrics outpatient departments and inpatient wards at a medical center in northern Taiwan. Demographic and obstetric characteristics were recorded, and participants were assessed using the Numeric Rating Scale, the Breastfeeding Knowledge Questionnaire, the Breastfeeding Self-Efficacy Scale—Short Form, and breastfeeding status postpartum. Of the 120 participants, 25% reported breastfeeding during the postpartum hospital stay. Postpartum breastfeeding was associated with lower levels of education and higher prenatal levels of breastfeeding intention. Establishing a breastfeeding-friendly environment in the family and workplace may effectively increase continued breastfeeding.
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Affiliation(s)
- Shu-Fang Vivienne Wu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan;
| | - Shu-Ching Chen
- School of Nursing and Geriatric and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, Taoyuan 333, Taiwan;
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Hsiao-Yun Liu
- Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (H.-Y.L.); (H.-L.L.)
| | - Hsiu-Lan Lee
- Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (H.-Y.L.); (H.-L.L.)
| | - Yueh-E Lin
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan;
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (H.-Y.L.); (H.-L.L.)
- Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan 333, Taiwan
- Correspondence:
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Associations of rooming-in with maternal postpartum bonding: the impact of mothers' pre-delivery intentions. Midwifery 2021; 95:102942. [PMID: 33607604 DOI: 10.1016/j.midw.2021.102942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 12/22/2020] [Accepted: 02/02/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Full rooming-in, that is, mother and baby staying together for 24 hours per day after birth in the hospital, has been suggested as beneficial for positive maternal bonding. However, it has never been studied directly. We aimed to examine the association of full versus partial rooming-in and maternal bonding to her infant during the post-childbirth hospital stay. STUDY DESIGN Longitudinal questionnaire study. SETTING Maternity ward of a large tertiary health care center in Israel. PARTICIPANTS The sample consisted of postpartum women (N = 293) in a maternity ward of a tertiary health care center who were fully or partially rooming-in. MEASUREMENTS AND FINDINGS Questionnaires were administered at two time points, immediately after childbirth (T1; days 1-4) and 2 months postpartum (T2). The Childbirth Experience Questionnaire (CEQ), breastfeeding questions, and the Postpartum Bonding Questionnaire (PBQ) were administered at T1; the PBQ was repeated at T2. Regression analysis revealed that the rooming-in mode did not significantly predict bonding at 1-4 days postpartum. However, the rooming-in mode was a significant predictor of bonding at two months postpartum only for women who practiced the rooming-in mode they had initially planned (Beta = 0.12, p < .05), while controlling for other demographic as well as obstetric variables. Women who chose and practiced partial rooming-in manifested more bonding difficulties than those who chose and practiced full rooming-in. These distinctions in bonding were not manifested when including in the analysis women who partially rooming-in, but not in accordance with their intentions. CONCLUSIONS Mother-infant bonding may be optimally supported when women's pre-labor desires to participate in full rooming-in are fulfilled. IMPLICATIONS FOR PRACTICE Hospital staff should be aware of the mothers' intentions regarding full rooming-in requests and make sincere efforts to accommodate and support their wishes.
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Vila-Candel R, Soriano-Vidal FJ, Mena-Tudela D, Quesada JA, Castro-Sánchez E. Health literacy of pregnant women and duration of breastfeeding maintenance: A feasibility study. J Adv Nurs 2020; 77:703-714. [PMID: 33210369 DOI: 10.1111/jan.14625] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/23/2020] [Accepted: 10/27/2020] [Indexed: 12/20/2022]
Abstract
AIMS Research the association between health literacy (HL) and exclusive breastfeeding at 4-months postpartum. BACKGROUND Despite the benefits of breastfeeding (BF), its rates are low worldwide. Among the reasons for abandonment is the level of maternal education. Maternal education has been associated with HL, but evidence between HL and BF maintenance is limited. DESIGN A cross-sectional study. METHODS The sample compromised 229 nursing mothers recruited from January 2018 to the end of December 2018 at Spain by systematic sampling method. Women were interviewed postpartum on parameters associated with the start and continuation of BF up to 4 months postpartum. Multivariate logistic regression models to explain exposure variables and exclusive BF cessation at 4 months. RESULTS Approximately 10% of the participants had inadequate HL. Factors associated with early cessation of exclusive BF at 4 months in the multivariate model adjusted using a stepwise variable selection process based on a likelihood ratio test were civil status, risk of pregnancy, type of delivery, limited or inadequate level of HL, and LATCH score at discharge, with an 85.6% area under the ROC curve. CONCLUSIONS Our study offers preliminary evidence regarding the hitherto inconsistent relation between HL and early cessation exclusive BF at 4 months, supporting the conduct of further studies with larger sample sizes and greater statistical power. Such studies are warranted before endorsing HL-based interventions aiming to mitigate early cessation exclusive BF. IMPACT Low or inadequate HL is linked to multiple poor health and clinical outcomes. We investigated the prevalence of exclusive BF at 4 months postpartum, and the impact of HL in maintaining optimal exclusive BF practices. Limited or inadequate HL was one of the factors associated with early cessation of exclusive BF in the multivariate regression model, although further research is needed.
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Affiliation(s)
- Rafa Vila-Candel
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, Valencia, Spain.,Department of Nursing, Universitat de València, Valencia, Spain
| | - Francisco Javier Soriano-Vidal
- Department of Nursing, Universitat de València, Valencia, Spain.,Department of Nursing, University of Alicante, Alicante, Spain.,Department of Obstetrics and Gynaecology, Hospital Luis Alcanyis, Xàtiva, Spain.,Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
| | - Desirée Mena-Tudela
- Department of Nursing, Universitat Jaume I. Av de Vicent Sos Baynat, Castelló, Spain
| | - José Antonio Quesada
- Department of Clinical Medicine, Universidad Miguel Hernández, Elche, Alicante, Spain
| | - Enrique Castro-Sánchez
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU), Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, London, UK.,School of Health Sciences, City, University of London, London, UK
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Tseng JF, Chen SR, Au HK, Chipojola R, Lee GT, Lee PH, Shyu ML, Kuo SY. Effectiveness of an integrated breastfeeding education program to improve self-efficacy and exclusive breastfeeding rate: A single-blind, randomised controlled study. Int J Nurs Stud 2020; 111:103770. [PMID: 32961461 DOI: 10.1016/j.ijnurstu.2020.103770] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 08/29/2020] [Accepted: 08/30/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Low self-efficacy affects new mothers' ability to sustain breastfeeding. Interventions that increase self-efficacy could improve sustained breastfeeding. OBJECTIVES To develop an integrated breastfeeding education program based on self-efficacy theory, and evaluate the effect of the intervention on first-time mothers' breastfeeding self-efficacy and attitudes. DESIGN A single-blind, randomised controlled trial. SETTING A prenatal clinic of a teaching hospital. PARTICIPANTS First-time mothers with a singleton pregnancy (12-32 weeks' gestation) and their support partners were selected by convenience sampling (N = 104) and allocated by block-randomization to an intervention or control group. METHODS A 3-week breastfeeding intervention program was developed based on self-efficacy theory. The intervention group received the breastfeeding program; the control group received standard care. Data between groups were compared for scores on breastfeeding self-efficacy, infant feeding attitude, and breastfeeding practice, which were assessed using the Breastfeeding Self-Efficacy Scale-Short Form, the Iowa Infant Feeding Attitude Scale, and a structured questionnaire, respectively. Repeated data measurements were collected at baseline, 36-weeks' gestation, and postpartum at 1-week, and 1-, 3-, and 6-months. RESULTS Ninety-three mothers completed the study. Data were compared for the self-efficacy intervention group (n = 50) with the control group (n = 43). Baseline measures did not differ between groups. The intervention group had significantly higher breastfeeding self-efficacy at 36 weeks' gestation (mean difference (MD): 7.3, p < .001), and postpartum at 1-week (p < .001), 1-month (p < .001) and 3-months (p < .01) with MD: 6.7, 7.9, and 8.1, respectively; differences in scores from baseline were also significantly greater from 36 weeks' gestation to 3-months (MD from 9.1~9.9, p < .001) and 6-months postpartum (MD: 7.0, p < .05). Infant feeding attitude scores significantly improved from 36 weeks' gestation to 6-months postpartum for the intervention group (MD from 3.5~7.4, p < .05). Rates for exclusive and predominant breastfeeding postpartum were significantly higher for the intervention group vs control (p < .02) at 1-week (98% vs. 86%), 1-month (100% vs. 90.7%), and 3-months (94% vs. 76.7%). Odds ratio (OR) postpartum for exclusive and predominant breastfeeding was greater for the intervention group at 3-months (OR = 4.7, 95% Confidence interval (CI), 1.2 -18.6; p = .05) and for exclusive breastfeeding at 6-months (OR: 2.82, 95% CI 1.0-8.1; p = .05). CONCLUSIONS The breastfeeding education intervention improved breastfeeding self-efficacy, infant feeding attitudes, and exclusive breastfeeding rates. The breastfeeding education program could be effective for sustaining breastfeeding in new mothers. TRIAL REGISTRATION Registered with www.clinicaltrials.gov (NCT03807726).
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Affiliation(s)
- Juei-Fen Tseng
- Department of Nursing, Tri-service General Hospital, Taipei, Taiwan; School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, 11031 Taipei, Taiwan
| | - Su-Ru Chen
- School of Nursing and Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
| | - Heng-Kien Au
- Department of Obstetrics, Taipei Medical University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; TMU Research Center for Cell Therapy and Regeneration Medicine, Taipei Medical University, Taipei, Taiwan
| | - Roselyn Chipojola
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, 11031 Taipei, Taiwan; Kamuzu College of Nursing, Lilongwe, Malawi
| | - Gabrielle T Lee
- Applied Psychology, Faculty of Education, Western University, London, ON, Canada.
| | - Pi-Hsia Lee
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, 11031 Taipei, Taiwan.
| | - Meei-Ling Shyu
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, 11031 Taipei, Taiwan.
| | - Shu-Yu Kuo
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, 11031 Taipei, Taiwan.
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Women's experiences with breastfeeding in public: An integrative review. Women Birth 2020; 34:e217-e227. [PMID: 32402811 DOI: 10.1016/j.wombi.2020.04.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Much evidence around public breastfeeding does not reflect experiences of the key stakeholder, the breastfeeding woman, and focuses upon the audience. Selective evidence has explored breastfeeding experiences revealing challenges with public breastfeeding as a serendipitous finding. Although women's experiences have been explored in specific contexts, insight into commonalities reflective of an international perspective is unknown. OBJECTIVE to explore, review and synthesise published literature on women's experience with public breastfeeding. METHODS An integrative review allows inclusion of findings beyond empirical evidence. Whittemore and Knafl's approach was used to capture and analyse evidence from varied sources to provide understanding of a phenomenon from diverse methodologies. PubMed, Medline, Ovid emBase, Scopus, Science Direct, the Cumulative Index of Nursing and Allied Health Literature and PsychINFO were searched. Inclusion criteria included publications in English after 2005 offering descriptions of women's experiences. Data evaluation included assessment of literature quality. A constant comparison approach involved comparing, analysing and drawing similar concepts into themes. FINDINGS Integration of women's experience with public breastfeeding from 27 publications covering 12 countries revealed two key themes, what women shared as 'enhancing' and 'challenging'. Challenges included four subthemes: 'drawing attention', 'sexualisation of breasts', 'awareness of others' discomfort', and 'efforts not to be seen'. Enhancing incorporated subthemes: 'supportive audience' and 'confidence'. CONCLUSION Challenges confirm an international commonality that women encounter during public breastfeeding suggesting a multilayered approach addressing community and societal behaviours is required. Insight to enhance public breastfeeding experiences offers direction to improve support.
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Health literacy of parents of very preterm infants at NICU admission and discharge: a prospective cohort study. J Perinatol 2019; 39:866-875. [PMID: 30770882 DOI: 10.1038/s41372-019-0340-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/23/2019] [Accepted: 01/30/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the prevalence of limited health literacy in parents of infants born ≤32 and 0/7 weeks and if health literacy changes during hospitalization. STUDY DESIGN Multi-site, prospective cohort study measuring health literacy using the Parent Health Literacy Activities Test, which estimates caregivers' ability to complete tasks such as reading prescription labels and preparing bottles. Data were analyzed using parametric and nonparametric comparison tests and multivariable regression to control for confounders. RESULT Of the 137 participants, 31% missed ≥3 questions of 8. Scores were not associated with admission characteristics or NICU complications. Lower scores were associated with lower nurses' (rho 0.20, p = 0.04) but not parents' (rho -0.12, p = 0.22) ratings of discharge readiness. Scores improved slightly from admission to discharge (p = 0.049). CONCLUSION Many parents have difficulty answering questions related to basic infant care tasks. NICUs should ensure that communication and discharge planning are mindful of health literacy.
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Bahorski JS, Childs GD, Loan LA, Azuero A, Morrison SA, Chandler-Laney PC, Hodges EA, Rice MH. Self-efficacy, infant feeding practices, and infant weight gain: An integrative review. J Child Health Care 2019; 23:286-310. [PMID: 30071746 PMCID: PMC8513131 DOI: 10.1177/1367493518788466] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
It has been suggested that self-efficacy specific to parenting or feeding may influence the decisions parents make regarding infant feeding; however, a review of this topic has not been conducted. The purpose of this integrative review is to synthesize the literature regarding the potential role of self-efficacy in infant feeding practices or infant weight gain. A total of 40 articles were used to guide this review, which were classified into three categories examining an association with self-efficacy (1) breastfeeding; (2) infant feeding practices such as parental feeding style and dietary quality; and (3) infant weight gain. Evidence regarding breastfeeding self-efficacy (BFSE) and breastfeeding is extensive; mothers with a higher sense of BFSE more often initiate breastfeeding and breastfeed for longer durations. The evidence regarding self-efficacy and the association with infant feeding practices other than breastfeeding is sparse. However, several studies report that mothers who have a higher sense of self-efficacy are more likely to follow infant feeding practices which align with recommendations. The authors have speculated an association between self-efficacy and infant weight gain; yet, to date, no study has found a significant association. More research is needed on the topic, particularly in diverse populations and with fathers and mothers.
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Affiliation(s)
- Jessica S Bahorski
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gwendolyn D Childs
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lori A Loan
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Andres Azuero
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Shannon A Morrison
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Paula C Chandler-Laney
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eric A Hodges
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Marti H Rice
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
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Catala P, Peñacoba C, Carmona J, Marin D. Maternal Personality and Psychosocial Variables Associated with Initiation Compared to Maintenance of Breastfeeding: A Study in Low Obstetric Risk Women. Breastfeed Med 2018; 13:680-686. [PMID: 30403497 DOI: 10.1089/bfm.2018.0034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
INTRODUCTION The benefits of breastfeeding are well known for mother and child. Research about the predictive factors related to the initiation and maintenance of breastfeeding is of great interest to public health. AIM To analyze the factors associated with the timely initiation of breastfeeding at immediate postpartum and the variables that facilitate their maintenance 4 months after birth. MATERIALS AND METHODS A longitudinal prospective design was used, including four stages: first trimester of pregnancy (personality), third trimester (childbirth expectations, breastfeeding intention, pregnancy worries, and coping strategies), immediately after childbirth (initiation of breastfeeding and childbirth satisfaction), and 4 months after birth (continuation of breastfeeding). RESULTS A sample of 116 women took part in the study from the first trimester to 4 months after birth. Timely initiation of breastfeeding is associated with vaginal birth (p < 0.000) and with variables related to the absence of stress factors: fewer worries regarding childbirth (p = 0.009), higher satisfaction during birth in relation to holding the baby (p > 0.000), and the meeting of expectations (p = 0.017). These associations disappear when the type of birth is introduced. Maintenance of breastfeeding is associated with maternal personality and psychosocial variables: openness to experience (p = 0.007), increased worries about coping with the baby (p = 0.046), relationship with partner (p = 0.047), and overt emotional expression (p = 0.040). CONCLUSION Different factors are associated with initiation and maintenance of breastfeeding. Specific prevention strategies are needed, aimed toward health care staff for improving breastfeeding initiation and to empower women during the entire pregnancy for breastfeeding maintenance.
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Affiliation(s)
- Patricia Catala
- 1 Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Cecilia Peñacoba
- 1 Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Javier Carmona
- 2 Critical Care Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - Dolores Marin
- 1 Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.,3 Obstetrics Department, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
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What promotes and hinders success in breastfeeding in hospital care? – the role of social support and anxiety. HEALTH PSYCHOLOGY REPORT 2018. [DOI: 10.5114/hpr.2018.73051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Affiliation(s)
- Maya Bunik
- Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO
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O’Sullivan A, Farver M, Smilowitz JT. The Influence of Early Infant-Feeding Practices on the Intestinal Microbiome and Body Composition in Infants. Nutr Metab Insights 2015; 8:1-9. [PMID: 26715853 PMCID: PMC4686345 DOI: 10.4137/nmi.s29530] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/10/2015] [Accepted: 11/13/2015] [Indexed: 01/10/2023] Open
Abstract
Despite many years of widespread international recommendations to support exclusive breastfeeding for the first six months of life, common hospital feeding and birthing practices do not coincide with the necessary steps to support exclusive breastfeeding. These common hospital practices can lead to the infant receiving formula in the first weeks of life despite mothers' dedication to exclusively breastfeed. Consequently, these practices play a role in the alarmingly high rate of formula-feeding worldwide. Formula-feeding has been shown to alter the infant gut microbiome in favor of proinflammatory taxa and increase gut permeability and bacterial load. Furthermore, several studies have found that formula-feeding increases the risk of obesity in later childhood. While research has demonstrated differences in the intestinal microbiome and body growth between exclusively breast versus formula-fed infants, very little is known about the effects of introducing formula to breastfed infants either briefly or long term on these outcomes. Understanding the relationships between mixed-feeding practices and infant health outcomes is complicated by the lack of clarity in the definition of mixed-feeding as well as the terminology used to describe this type of feeding in the literature. In this commentary, we highlight the need for hospitals to embrace the 10 steps of the Baby Friendly Hospital Initiative developed by UNICEF and the WHO for successful breastfeeding. We present a paucity of studies that have focused on the effects of introducing formula to breastfed infants on the gut microbiome, gut health, growth, and body composition. We make the case for the need to conduct well-designed studies on mixed-feeding before we can truly answer the question: how does brief or long-term use of formula influence the health benefits of exclusive breastfeeding?
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Affiliation(s)
- Aifric O’Sullivan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Marie Farver
- Sutter Davis Hospital Birthing Center, Davis, CA, USA
| | - Jennifer T. Smilowitz
- Department of Food Science and Technology, University of California Davis, Davis, CA, USA
- Foods for Health Institute, University of California Davis, Davis, CA, USA
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