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Parker LA, Varma D, Bendixen MM, Sullivan S, Cacho N, Martina M. Biomarker-based text messages to promote lactation success in mothers of critically Ill infants: a randomized controlled pilot study. J Perinatol 2024; 44:1312-1319. [PMID: 38705950 DOI: 10.1038/s41372-024-01975-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 03/27/2024] [Accepted: 04/15/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE Infrequent breast pumping limits mother's own milk production in mothers of infants admitted to the neonatal intensive care unit. We aimed to determine the feasibility and benefit of biomarker-based personalized text messages on pumping frequency and milk sodium levels. A secondary aim examined lactation outcomes. STUDY DESIGN In this randomized controlled pilot study, 51 mothers were randomized to receive personalized text messages regarding pumping frequency or standard care. RESULTS There were no differences in pumped milk volume or sodium level, however, there was a trend towards the intervention group pumping more frequently, which was significant on day 5 (p = 0.035), and they lactated nearly 9 days longer. Post-hoc analysis found the intervention group tended to be more likely to pump ≥ 500 mL by day14 (p = 0.08), a marker of long-term lactation success. CONCLUSION Personalized biomarker-based text messages are feasible and may support lactation in mothers of critically ill infants.
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Liu LY, Roig J, Rekawek P, Naert MN, Cadet J, Monro J, Stone JL. Comparison of Breastfeeding Success by Mode of Delivery. Am J Perinatol 2024; 41:1329-1336. [PMID: 35863374 DOI: 10.1055/a-1906-8642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE This article identifies how mode of delivery and the presence of labor affect the initiation and effectiveness of breastfeeding. STUDY DESIGN This is a retrospective cohort study of breastfeeding success after vaginal delivery, cesarean section after labor, and scheduled cesarean section in term, singleton deliveries in nulliparous patients at a large academic institution from 2017 to 2018. Exclusion criteria included major postpartum complications requiring admission to the surgical intensive care unit or neonatal intensive care unit, general anesthesia, and major fetal anomalies. Breastfeeding success in the immediate postpartum period, defined as the first 2 to 3 days postpartum prior to hospital discharge, was measured by the presence of breastfeeding, the need for formula supplementation, the average number of breastfeeding sessions per day, the average amount of time spent at each breastfeeding session, the average number of newborn stools and wet diapers produced daily, and the neonatal percentage in weight loss over the first 2 to 3 days of life. Multivariable linear and logistic regression were used to assess the association between mode of delivery and markers of breastfeeding success after adjusting for potential confounders. A Tukey's post hoc analysis with pairwise comparisons was performed to assess differences in breastfeeding outcomes between vaginal delivery, scheduled cesarean section, and cesarean section after labor. RESULTS A total of 2,966 women met inclusion criteria during the study period, 1,936 (65.3%) of whom underwent spontaneous vaginal delivery, 415 (14.0%) of whom delivered by scheduled cesarean section, and 615 (20.7%) of whom underwent cesarean section after labor. There were significant differences in maternal age, obesity, race/ethnicity, insurance status, gestational age at delivery, birth weight, and 1-minute Apgar's score less than 7 between vaginal delivery, scheduled cesarean section, and cesarean section after labor. There were also significant differences between indication for oxytocin, type of anesthesia, and postpartum hemorrhage between the three groups. After controlling for these factors, women who underwent vaginal delivery were more likely to have infants with decreased need for formula supplementation (adjusted odds ratio [aOR] = 1.71, 95% confidence interval [CI]: 1.52-1.93) and were less likely to switch from breast to formula feeding (aOR = 1.71, 95% CI: 1.04-1.31) in comparison to women who delivered via cesarean section in labor or scheduled cesarean section. The infants of these women also had an increased number of breastfeeding sessions on average (β = 0.06, p = 0.002), required fewer number of daily formula feedings (β = 0.14, p < 0.001), and experienced a smaller percentage in neonatal weight loss over the first 2 to 3 days of life (β = 0.18, p < 0.001) compared to those born after cesarean section and cesarean section after labor. These women comparatively required less time at each breastfeeding session (β = 0.06, p = 0.005), and produced fewer wet diapers and stools on average (β = 0.12, p < 0.001 and β = 0.12, p < 0.001, respectively). On post hoc analysis with pairwise comparisons, and on separate sensitivity analysis of only women who underwent cesarean delivery, there was no difference in breastfeeding outcome measures between scheduled cesarean section and cesarean section in labor. CONCLUSION Women who deliver by cesarean section, despite the presence or absence of labor, are less likely to maintain exclusive breastfeeding postpartum and are more likely to require formula supplementation. These women may need more support with breastfeeding after surgery in order to experience similar benefits for neonatal growth and weight gain. KEY POINTS · Women who deliver by cesarean section are less likely to maintain exclusive breastfeeding.. · Women who deliver by cesarean section are more likely to require formula supplementation.. · Women may need more support with breastfeeding after cesarean delivery..
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Affiliation(s)
- Lilly Y Liu
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jacqueline Roig
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Patricia Rekawek
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, NYU Winthrop Hospital, Mineola, New York
| | - Mackenzie N Naert
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Julie Cadet
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Johanna Monro
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joanne L Stone
- Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, New York
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Massa K, Ramireddy S, Ficenec S, Mank C, Josephsen J, Babbar S. A Randomized Control Trial of Meditation for Mothers Pumping Breastmilk for Preterm Infants. Am J Perinatol 2024; 41:842-852. [PMID: 35240703 DOI: 10.1055/a-1787-7576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Mothers of preterm infants face unique challenges in establishing milk supply. We hypothesized that daily meditation practice while pumping would increase milk volume. STUDY DESIGN This was a randomized control trial examining the effect of meditation on the breastmilk supply of women delivering preterm infants. The meditation group engaged in daily use of a mindfulness-focused meditation app in addition to routine lactation support. The primary outcome was mean breastmilk volume on the infant's nineth day of life. Secondary outcomes included use of lactation-promoting behaviors, continuation of breastfeeding, and measures of mental health and breastfeeding self-efficacy by validated questionnaires. In addition to the intention to treat analysis, a per protocol analysis examined the association of frequent meditation with these breastfeeding and mental health outcomes. RESULTS A total of 60 women were analyzed. Mean milk volume was 647.1 ± 467.8 mL in the meditation group and 514.9 ± 393.5 mL in the routine care group (p = 0.27). Median number of pumping sessions was 7 (interquartile range [IQR] 5-8) in the meditation group, compared to 6 (IQR 4-7) in the routine care group (p = 0.11). Other lactation-promoting behaviors, breastfeeding continuation, and questionnaire scores were similar.Adjusting for confounders, we found an increase in breastmilk production of 223.2 mL (95% CI 98.8-347.5, p = 0.001) and in pumping episodes by 0.93 (95% CI 0.16-1.70, p = 0.020) associated with frequent meditation. Skin-to-skin contact was increased to 100% (p = 0.006) among women who meditated seven or more times. Adjusted odds of a clinically significant Edinburgh Postnatal Depression Scale score of >9 was 0.057 (95% CI 0.0014-0.711, p = 0.023) with frequent meditation. CONCLUSION Breastmilk production was similar in mothers practicing meditation compared to those receiving routine lactation support. For women engaging in frequent mediation, there may be an effect in establishing breastmilk supply and reduction of depression symptoms. KEY POINTS · Breastmilk is not increased for neonatal intensive care unit (NICU) moms asked to engage in meditation.. · Maternal mental health is not improved among NICU moms asked to meditate.. · However, higher-frequency meditation is associated with increased milk volume and lower odds of high scores on depression screening..
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Affiliation(s)
- Katherine Massa
- Department of Obstetrics and Gynecology, Washington University, Saint Louis, Missouri
| | - Soumya Ramireddy
- Saint Louis University School of Medicine, Saint Louis, Missouri
| | - Sara Ficenec
- Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington
| | - Carolyn Mank
- Department of Obstetrics and Gynecology, Saint Louis University School of Medicine, Saint Louis, Missouri
| | - Justin Josephsen
- Department of Pediatrics, Saint Louis University School of Medicine, Saint Louis, Missouri
| | - Shilpa Babbar
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Missouri-Kansas City, Children's Mercy Kansas City, Kansas City, Missouri
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Öztürk Özen D, Koç G, Nacir B. The effect of progressive relaxation exercises and transcutaneous electrical neural stimulation administered to women delivering via cesarean delivery on pain, breastfeeding success, and comfort levels: A randomized controlled study. J Obstet Gynaecol Res 2024; 50:438-447. [PMID: 38148300 DOI: 10.1111/jog.15869] [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: 09/18/2023] [Accepted: 12/12/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVE This study aimed to determine the effect of progressive relaxation exercises (PRE) and transcutaneous electrical nerve stimulation administered to women delivering via cesarean delivery on acute pain, breastfeeding success, and comfort levels. METHODS This is a single-blind, randomized controlled study. This study was carried out in the obstetrics and gynecology clinic of a university hospital affiliated with the Ministry of Health in Turkey between August 20, 2018 and April 15, 2019. A total of 120 participants were randomly assigned to one of four groups, which included a transcutaneous electrical neural stimulation (TENS) group, a PRE group, a combined intervention group, and a control group. Data were collected with a Data Collection Form, The Visual Analogue Scale, The LATCH Breastfeeding Diagnostic Tool, and The Postpartum Comfort Scale. RESULTS According to the findings of the study, it was determined that pain significantly decreased and comfort increased after having a cesarean delivery in all three intervention groups compared to the control group (p < 0.05). Regarding the breastfeeding success, while there was no statistically significant change in this behavior in the TENS group, it was significantly better in the PRE group and the combined intervention group, where TENS and PRE were administered together (p < 0.05). CONCLUSIONS According to our study results, we recommend that TENS and PRE should be employed together after a cesarean delivery as safe non-pharmacological methods in pain management, eliminating breastfeeding problems, and increasing comfort.
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Affiliation(s)
- Derya Öztürk Özen
- Akdağmadeni School of Health, Yozgat Bozok University, Yozgat, Turkey
| | - Gülten Koç
- Faculty of Nursing, Hacettepe University, Ankara, Turkey
| | - Barış Nacir
- Physical Medicine and Rehabilitation Clinic, University of Health Sciences, Ankara Education and Research Hospital, Ankara, Turkey
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Niyigena A, Gato S, Alayande B, Miranda E, Hedt-Gauthier B, Goodman AS, Nkurunziza T, Mazimpaka C, Hakizimana S, Ngamije P, Kateera F, Riviello R, Boatin AA. Functional recovery after cesarean delivery: a prospective cohort study in rural Rwanda. BMC Pregnancy Childbirth 2023; 23:858. [PMID: 38087238 PMCID: PMC10717631 DOI: 10.1186/s12884-023-06159-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 11/26/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Women who deliver via cesarean section (c-section) experience short- and long-term disability that may affect their physical health and their ability to function normally. While clinical complications are assessed, postpartum functional outcomes are not well understood from a patient's perspective or well-characterized by previous studies. In Rwanda, 11% of rural women deliver via c-section. This study explores the functional recovery of rural Rwandan women after c-section and assesses factors that predict poor functionality at postoperative day (POD) 30. METHODS Data were collected prospectively on POD 3, 11, and 30 from women delivering at Kirehe District Hospital between October 2019 and March 2020. Functionality was measured by self-reported overall health, energy level, mobility, self-care ability, and ability to perform usual activities; and each domain was rated on a 4-point likert scale, lower scores reflecting higher level of difficulties. Using the four functionality domains, we computed composite mean scores with a maximum score of 4.0 and we defined poor functionality as composite score of ≤ 2.0. We assessed functionality with descriptive statistics and logistic regression. RESULTS Of 617 patients, 54.0%, 25.9%, and 26.8% reported poor functional status at POD3, POD11, and POD30, respectively. At POD30, the most self-reported poor functionality dimensions were poor or very poor overall health (48.1%), and inability to perform usual activities (15.6%). In the adjusted model, women whose surgery lasted 30-45 min had higher odds of poor functionality (aOR = 1.85, p = 0.01), as did women who experienced intraoperative complications (aOR = 4.12, 95% CI (1.09, 25.57), p = 0.037). High income patients had incrementally lower significant odds of poor physical functionality (aOR = 0.62 for every US$1 increase in monthly income, 95% CI (0.40, 0.96) p = 0.04). CONCLUSION We found a high proportion of poor physical functionality 30 days post-c-section in this Rwandan cohort. Surgery lasting > 30 min and intra-operative complications were associated with poor functionality, whereas a reported higher income status was associated with lower odds of poor functionality. Functional status assessments, monitoring and support should be included in post-partum care for women who delivered via c-section. Effective risk mitigating intervention should be implemented to recover functionality after c-section, particularly among low-income women and those undergoing longer surgical procedures or those with intraoperative complications.
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Affiliation(s)
- Anne Niyigena
- Partners In Health/Inshuti Mu Buzima, KG 9 Avenue 46, PO Box 3432, Remera, Kigali, Rwanda.
| | - Saidath Gato
- Partners In Health/Inshuti Mu Buzima, KG 9 Avenue 46, PO Box 3432, Remera, Kigali, Rwanda
| | | | | | | | | | | | - Christian Mazimpaka
- Partners In Health/Inshuti Mu Buzima, KG 9 Avenue 46, PO Box 3432, Remera, Kigali, Rwanda
| | - Sadoscar Hakizimana
- Partners In Health/Inshuti Mu Buzima, KG 9 Avenue 46, PO Box 3432, Remera, Kigali, Rwanda
| | - Patient Ngamije
- Kirehe District Hospital, Ministry of Health, Kirehe, Rwanda
| | - Fredrick Kateera
- Partners In Health/Inshuti Mu Buzima, KG 9 Avenue 46, PO Box 3432, Remera, Kigali, Rwanda
| | - Robert Riviello
- Harvard Medical School, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
| | - Adeline A Boatin
- Harvard Medical School, Boston, MA, USA
- Massachusetts General Hospital, Boston, MA, USA
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Eksioglu A, Unal İ, Akyar A. Factors Affecting Breastfeeding in Births Given During the Day and at Night; A Cross-Sectional Comparative Study. Breastfeed Med 2023; 18:913-920. [PMID: 38100439 DOI: 10.1089/bfm.2023.0228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Objective: How giving birth at night and during the day affects the breastfeeding process should be evaluated when health services are planned. In this study, we investigated the effect of giving birth at night and during the day on the breastfeeding process. Materials and Methods: In this cross-sectional comparative study, we included 228 women who gave birth at night and 192 women who gave birth during the day. We compared the effect of giving birth at night or during the day on breastfeeding with the univariate analysis in terms of intrapartum and postpartum factors. Results: While the mothers who gave birth during the daytime started the first breastfeeding earlier (p < 0.001), the duration of the first breastfeeding and skin-to-skin contact practice was longer in mothers who gave birth at night (p < 0.05). While the rate of formula supplementing in babies born at night was 44.8%, it was 55.2% in babies born during the day (p < 0.001). The rate of receiving support from health workers (p = 0.040) and intending to breastfeed babies exclusively after discharge (p < 0.05) was higher in mothers who gave birth during the day than it was in mothers who gave birth at night. Conclusion: Day and night labor have different advantages and disadvantages on breastfeeding. It is important to address these differences in terms of intrapartum and postpartum care process to prevent negative breastfeeding experiences in the early period.
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Affiliation(s)
- Aysun Eksioglu
- Midwifery Department, Ege University Faculty of Health Sciences, Izmir, Turkey
| | - İlkay Unal
- Midwifery Department, Ege University Faculty of Health Sciences, Izmir, Turkey
| | - Ayşe Akyar
- Izmir Democracy University Buca Seyfi Demirsoy Training and Research Hospital, Izmir, Turkey
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Felipe-Dimog EB, Dumalhin YJB, Liang FW. Factors of early breastfeeding initiation among Filipino women: A population-based cross-sectional study. Appl Nurs Res 2023; 74:151732. [PMID: 38007244 DOI: 10.1016/j.apnr.2023.151732] [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: 10/07/2022] [Revised: 08/03/2023] [Accepted: 08/14/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Early breastfeeding initiation (EBI) within the first hour after birth has the potential to reduce neonatal mortality. However, the prevalence of EBI still falls short of the 70 % target set by the WHO for 2030. Limited research has been conducted on this issue. Therefore, the study aimed to assess the prevalence and factors of EBI in the Philippines. METHODS This study is a secondary analysis of the data from the Philippine National Demographic and Health Survey (PNDHS) in 2017. Women survey participants aged 15 to 49 (n = 3750) who had given birth within the two years prior to the survey were included in this study. A p-value < 0.05 was used to define statistical significance when identifying the factors associated with EBI using hierarchical logistic regression analysis. RESULTS Women who were more likely to practice EBI were those from the Cordillera Administrative Region, who read newspaper/magazines, and delivered infants at 2 or later birth order. On the contrary, women from Central Luzon, CALABARZON (Cavite, Laguna, Batangas, Rizal, and Quezon provinces), Central Visayas, Eastern Visayas, and the Autonomous Region of Muslim Mindanao; who listen to the radio at least once a week; and give birth through cesarean section were less likely to practice EBI. CONCLUSION Channeling breastfeeding messages through printed mass media and provision of specialized breastfeeding support to mothers with cesarean section delivery may help in reducing the barriers to early breastfeeding initiation. Targeted interventions and strategies that promote breastfeeding practices, particularly among primigravida women and in regions with lower rates of EBI contribute to increased rate of optimal breastfeeding.
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Affiliation(s)
- Eva Belingon Felipe-Dimog
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Sanmin District, Kaohsiung 807, Taiwan; Nursing Department, Mountain Province State Polytechnic College, Bontoc 2616, Mountain Province, Philippines.
| | - Yvette Joy B Dumalhin
- Nursing Department, Mountain Province State Polytechnic College, Bontoc 2616, Mountain Province, Philippines
| | - Fu-Wen Liang
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Sanmin District, Kaohsiung 807, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road, Sanmin District, Kaohsiung 807, Taiwan; Center for Big Data Research, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Sanmin District, Kaohsiung 807, Taiwan.
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Ulfa Y, Maruyama N, Igarashi Y, Horiuchi S. Early initiation of breastfeeding up to six months among mothers after cesarean section or vaginal birth: A scoping review. Heliyon 2023; 9:e16235. [PMID: 37292274 PMCID: PMC10245156 DOI: 10.1016/j.heliyon.2023.e16235] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 05/01/2023] [Accepted: 05/10/2023] [Indexed: 06/10/2023] Open
Abstract
Background Early initiation of breastfeeding is important for establishing continued breastfeeding. However, previous research report that cesarean section (C-section) may hinder early initiation of breastfeeding. Despite this, there is currently a lack of literature that examines the rates of breastfeeding after both cesarean section and vaginal birth globally. Research aims The objective of this scoping review was to systematically assess the available literature on the rate of early initiation of breastfeeding within the first hour and exclusive breastfeeding up to 6 months after C-section and vaginal birth, as well as any other factors associated with initiation and exclusive breastfeeding. Methods We adhered to the PRISMA extension guidelines for scoping reviews in conducting our review. In August 2022, we carried out an electronic database search on CINALH, PubMed, EMBASE, and Cochrane Library, and also manually searched the reference list. Results A total of 55 articles were included in the scoping review. The majority of these studies found that mothers who delivered vaginally had higher rates of breastfeeding compared to those who underwent a C-section, at various time points such as breastfeeding initiation, hospital discharge, one month, three months, and six months postpartum. Notably, there was a significant difference in the rate of early initiation of breastfeeding between the two groups. However, at 3 and 6 months after delivery the gap of exclusive breastfeeding rate between C-section and vaginal delivery is narrow. Breastfeeding education, health care providers support, and mother and baby bonding are other factors associate with initiation and exclusive breastfeeding. Conclusions The rate of breastfeeding initiation after C-section has remained low to date. This is due in part to insufficient knowledge about and support for breastfeeding from healthcare providers.
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Affiliation(s)
- Yunefit Ulfa
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
- National Research and Innovation Agency, Jakarta, Indonesia
| | - Naoko Maruyama
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - Yumiko Igarashi
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - Shigeko Horiuchi
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
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Igarashi Y, Horiuchi S, Mwilike B. Effectiveness of an Early Skin-to-Skin Contact Program for Pregnant Women with Cesarean Section: A Quasi-Experimental Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105772. [PMID: 37239500 DOI: 10.3390/ijerph20105772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/22/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVE This study aimed to clarify the effectiveness of early skin-to-skin contact (SSC) after a cesarean section (CS) program. METHODS An "early SSC after CS" program was implemented at a tertiary care hospital in Tanzania. A non-equivalent group design was used. A questionnaire was used to collect data on exclusive breastfeeding, breastfeeding intention, Birth Satisfaction Scale-Revised Indicator (BSS-RI) score, perioperative pain with a visual analogue scale, and infant hospitalization for infectious diseases and diarrhea at 2-3 days postpartum. Follow-up surveys were conducted until 4 months postpartum regarding exclusive breastfeeding, breastfeeding intention, and hospitalization of the infants. RESULTS This study involved 172 parturient women who underwent CS, with 86 in the intervention group and 86 in the control group. The exclusive breastfeeding rates at 4 months postpartum were 57 (76.0%) in the intervention group and 58 (76.3%) in the control group, with no significant difference. The BSS-RI score was higher in the intervention group (7.91, range 4-12, SD 2.42) than in the control group (7.18, range 3-12, SD 2.02) (p = 0.007) for women who underwent emergency CS. The survival probability for infants hospitalized owing to infectious diseases, and diarrhea was significantly higher in the intervention group (98.5%) than in the control group (88.3%) (χ2 = 5.231, p = 0.022) for multiparas. CONCLUSION The early SSC after CS program showed a positive effect on the birth satisfaction of women undergoing emergency CS. It also reduced the incidence of infants hospitalized owing to infectious diseases and diarrhea for multiparas.
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Affiliation(s)
- Yumiko Igarashi
- Graduate School of Nursing, St. Luke's International University, 10-1 Akashi-cho, Tokyo 104-0044, Japan
| | - Shigeko Horiuchi
- Graduate School of Nursing, St. Luke's International University, 10-1 Akashi-cho, Tokyo 104-0044, Japan
| | - Beatrice Mwilike
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65004, Tanzania
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Oliver Olid A, Moreno-Galarraga L, Moreno-Villares JM, Bibiloni MDM, Martínez-González MÁ, de la O V, Fernandez-Montero A, Martín-Calvo N. Breastfeeding Is Associated with Higher Adherence to the Mediterranean Diet in a Spanish Population of Preschoolers: The SENDO Project. Nutrients 2023; 15:nu15051278. [PMID: 36904277 PMCID: PMC10005753 DOI: 10.3390/nu15051278] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 02/26/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVE To assess whether breastfeeding during the first months of life is associated with adherence to the Mediterranean dietary (MedDiet) pattern in preschool children. DESIGN The Seguimiento del Niño para un Desarrollo Óptimo (SENDO) project is an ongoing pediatric cohort with open recruitment, started in 2015 in Spain. Participants, recruited when they are 4 to 5 years old at their primary local health center or school, are followed annually through online questionnaires. For this study, 941 SENDO participants with full data on study variables were included. Breastfeeding history was collected retrospectively at baseline. Adherence to the Mediterranean diet was assessed with the KIDMED index (range -3 to 12). RESULTS After accounting for multiple sociodemographic and lifestyle confounders, including parental attitudes and knowledge about dietary recommendations for children, breastfeeding was independently associated with a higher adherence to the MedDiet. Compared with children who were never breastfed, children breastfed for ≥6 months had a one-point increase on their mean KIDMED score (Mean difference +0.93, 95%confidence interval [CI]. 0.52-1.34, p for trend <0.001). The odds ratio of high adherence to the MedDiet (KIDMED index ≥8) was 2.94 (95%CI 1.50-5.36) in children who were breastfed for at least 6 months, as compared to their peers who were never breastfeed. Children who were breastfed for less than 6 months exhibited intermediate levels of adherence (p for trend <0.01). CONCLUSION Breastfeeding for 6 months or longer is associated with a higher adherence to the Mediterranean diet during the preschool years.
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Affiliation(s)
- Asier Oliver Olid
- Department of Pediatrics, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Laura Moreno-Galarraga
- Department of Pediatrics, Hospital Universitario de Navarra, 31008 Pamplona, Spain
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain
- Correspondence: (L.M.-G.); (A.F.-M.); Tel.: +34-848429888 (L.M.-G.)
| | | | - Maria del Mar Bibiloni
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, 07122 Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Miguel Ángel Martínez-González
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain
- Department of Preventive Medicine and Public Health, Facultad de Medicina, Universidad de Navarra, 31008 Pamplona, Spain
- Pathophysiology of Obesity and Nutrition, Centro de Investigación Biomédica en Red, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Víctor de la O
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain
- Department of Preventive Medicine and Public Health, Facultad de Medicina, Universidad de Navarra, 31008 Pamplona, Spain
| | - Alejandro Fernandez-Montero
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain
- Department of Occupational Medicine, Clínica Universidad de Navarra, 31008 Pamplona, Spain
- Correspondence: (L.M.-G.); (A.F.-M.); Tel.: +34-848429888 (L.M.-G.)
| | - Nerea Martín-Calvo
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, 31008 Pamplona, Spain
- Department of Preventive Medicine and Public Health, Facultad de Medicina, Universidad de Navarra, 31008 Pamplona, Spain
- Pathophysiology of Obesity and Nutrition, Centro de Investigación Biomédica en Red, Instituto de Salud Carlos III, 28029 Madrid, Spain
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11
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Stipelman CH, Stoddard GJ, Bennion J, Young PC, Brown LL. Real-Time Breastfeeding Documentation: Timing of Breastfeeding Initiation and Outpatient Duration. Acad Pediatr 2023; 23:351-358. [PMID: 35863738 PMCID: PMC10516406 DOI: 10.1016/j.acap.2022.07.010] [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: 01/17/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Current breastfeeding guidelines promote initiating breastfeeding ≤1 h after birth to establish long-term breastfeeding. Previous studies dichotomized initiation to ≤1 h versus subsequent hours combined. There are limited data evaluating the effect of initiation in each subsequent hour on breastfeeding duration. Our objective was to evaluate the association between breastfeeding initiated at ≤1 h versus the subsequent 23 hours after birth and outpatient breastfeeding duration. METHODS In this retrospective cohort study, we analyzed real-time, discretely documented electronic health record (EHR) breastfeeding data for 3315 infants born at a university center and followed to age ≥12 mo at 27 university primary care clinics. The primary outcome was breastfeeding duration. The exposure variable was hour of breastfeeding initiation within 24 h postnatally. Data were analyzed by univariable and multivariable linear regression separately for infants born by vaginal versus cesarean delivery. RESULTS In adjusted models, initiating breastfeeding during each hour from age >1 to ≤6 h and during ages >6 to ≤24 h was not associated with decreased breastfeeding duration versus initiating breastfeeding at ≤1 h after birth for infants born via vaginal or cesarean delivery. CONCLUSIONS Delaying breastfeeding initiation to >1 to ≤24 h after birth is not associated with decreased breastfeeding duration compared with initiating breastfeeding at ≤1 h after birth. Integration of breastfeeding measures into inpatient and outpatient EHR discrete data fields may clarify best practices that support long-term breastfeeding as a public health imperative.
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Affiliation(s)
- Carole H Stipelman
- University Pediatric Clinic, Department of Pediatrics (CH Stipelman, PC Young, and LL Brown), University of Utah School of Medicine, Salt Lake City; Sugar House Health Center, Department of Pediatrics (CH Stipelman), University of Utah School of Medicine, Salt Lake City; University Information Technology (CH Stipelman and J Bennion), University of Utah, Salt Lake City.
| | - Gregory J Stoddard
- Department of Internal Medicine (GJ Stoddard), University of Utah School of Medicine, Salt Lake City
| | - Jeff Bennion
- University Information Technology (CH Stipelman and J Bennion), University of Utah, Salt Lake City
| | - Paul C Young
- University Pediatric Clinic, Department of Pediatrics (CH Stipelman, PC Young, and LL Brown), University of Utah School of Medicine, Salt Lake City
| | - Laura L Brown
- University Pediatric Clinic, Department of Pediatrics (CH Stipelman, PC Young, and LL Brown), University of Utah School of Medicine, Salt Lake City
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12
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Mena-Tudela D, Soriano-Vidal FJ, Vila-Candel R, Quesada JA, Martínez-Porcar C, Martin-Moreno JM. Is Early Initiation of Maternal Lactation a Significant Determinant for Continuing Exclusive Breastfeeding up to 6 Months? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3184. [PMID: 36833878 PMCID: PMC9966801 DOI: 10.3390/ijerph20043184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND The World Health Organization (WHO) recommends early initiation of breastfeeding (EIBF) within the first hour after birth. However, certain perinatal factors, namely caesarean section, may prevent this goal from being achieved. The aim of our study was to examine the relationship between EIBF (maternal lactation in the first hours and degree of latching before hospital discharge) and the maintenance of exclusive breastfeeding (MBF) up to the recommended 6 months of age (as advocated by the WHO). METHODS This observational, retrospective cohort study included a random sample of all births between 2018 and 2019, characterising the moment of breastfeeding initiation after birth and the infant's level of breast latch (measured by LATCH assessment tool) prior to hospital discharge. Data were collected from electronic medical records and from follow-up health checks of infants up to 6 months postpartum. RESULTS We included 342 women and their newborns. EIBF occurred most often after vaginal (p < 0.001) and spontaneous births with spontaneous amniorrhexis (p = 0.002). LATCH score <9 points was associated with a 1.4-fold relative risk of abandoning MBF (95%CI: 1.2-1.7) compared with a score of 9-10 points. CONCLUSIONS Although we were unable to find a significant association between EIBF in the first 2 h after birth and MBF at 6 months postpartum, low LATCH scores prior to discharge were associated with low MBF, indicating the importance of reinforcing the education and preparation efforts of mothers in the first days after delivery, prior to the establishment of an infant feeding routine upon returning home.
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Affiliation(s)
- Desirée Mena-Tudela
- Department of Nursing, Universitat Jaume I, 12071 Castellón de la Plana, Spain
| | - Francisco Javier Soriano-Vidal
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
- Department of Obstetrics and Gynaecology, Xàtiva-Oninyent Health Department, 46800 Xàtiva, Spain
| | - Rafael Vila-Candel
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, 46600 Alzira, Spain
| | - José Antonio Quesada
- Department of Clinical Medicine, Universidad Miguel Hernández, 03202 Elche, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 03550 Alicante, Spain
| | - Cristina Martínez-Porcar
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, 46600 Alzira, Spain
| | - Jose M. Martin-Moreno
- Department of Preventive Medicine and Public Health, Universitat de València, 46010 Valencia, Spain
- Biomedical Research Institute INCLIVA, Clinic University Hospital, 46010 Valencia, Spain
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13
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Lee HK, Joo E, Kim S, Cho I, Lee KN, Kim HJ, Kim B, Park JY. A Comparison of Ultrasound Imaging Texture Analyses During the Early Postpartum With the Mode of Delivery. J Hum Lact 2023; 39:59-68. [PMID: 35272509 DOI: 10.1177/08903344221081866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Breastfeeding is beneficial to infants. However, cesarean section is reported to be a risk factor for unsuccessful breastfeeding. RESEARCH AIMS (1) To extract discriminating data from texture analysis of breast ultrasound images in the immediate postpartum period; and (2) to compare the analysis results according to delivery mode. METHODS A cross-sectional, prospective non-experimental design with a questionnaire and observational components was used. Participants (N = 30) were women who delivered neonates at a center from September 2020 to December 2020. The participants underwent ultrasound examination of bilateral breasts 7-14 days after delivery. Ultrasound images were collected for texture analysis. A questionnaire about breastfeeding patterns was given to the participants on the day of the ultrasound examination. RESULTS No significant differences were found in texture analysis between the breasts of participants who had undergone Cesarean section and vaginal deliveries. The mean volume of total human milk produced in 1 day was significantly greater in the vaginal delivery group than in the cesarean section group (M = 350.87 ml, SD = 183.83 vs. M = 186.20 ml, SD = 184.02; p = .017). The pain score due to breast engorgement measured subjectively by participants was significantly lower in the vaginal delivery group than in the cesarean section group (M = 2.8, SD = 0.86 vs. M = 3.4, SD = 0.63; p = .047). CONCLUSION Texture analysis of breast ultrasound images did not demonstrate difference between the cesarean section and vaginal delivery groups in the immediate postpartum period; nevertheless, cesarean section was independently associated with less successful breastfeeding.
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Affiliation(s)
- Hyun Kyoung Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Eunwook Joo
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seongbeen Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Iseop Cho
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Kyong-No Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyeon Ji Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Bohyoung Kim
- Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Gyeonggi-do, Republic of Korea
| | - Jee Yoon Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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14
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Suárez-Cortés M, Castaño-Molina MDLÁ, Ramos-Morcillo AJ, Molina-Rodriguez A, Jiménez-Ruiz I, Hernández-López MJ, Harillo-Acevedo FD, Carrillo-García C. Impact of COVID-19 Restrictions in Childbirth and Puerperium: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:249. [PMID: 36673617 PMCID: PMC9859232 DOI: 10.3390/healthcare11020249] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023] Open
Abstract
Introduction (1): The COVID-19 pandemic led to changes in healthcare during pregnancy, childbirth and puerperium. The objective of this study was to know the impact of visit restrictions, PCR performance and use of masks on delivery and puerperium care. Methods (2): A descriptive cross-sectional study was carried out. A survey was used to assess the impact of COVID-19-related measures on women who had given birth in hospitals in the Region of Murcia, Spain, between March 2020 and February 2022. Results (3): The final sample size was 434 women. The average scores were 4.27 for dimension 1 (Visit restrictions), 4.15 for dimension 2 (PCR testing) and 3.98 for dimension 3 (Mask use). More specifically, we found that the restriction of visits was considered a positive measure for the establishment of the mother-newborn bond (mean score 4.37) and that the use of masks at the time of delivery should have been made more flexible (mean score 4.7). Conclusions (4): The policy of restricting hospital visits during the pandemic caused by COVID-19 has been considered beneficial by mothers, who expressed that they did not feel lonely during their hospital stay.
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Affiliation(s)
- María Suárez-Cortés
- Servicio Murciano de Salud, 30120 Murcia, Spain
- Faculty of Nursing, University of Murcia, 30120 Murcia, Spain
| | | | | | - Alonso Molina-Rodriguez
- Servicio Murciano de Salud, 30120 Murcia, Spain
- Faculty of Nursing, University of Murcia, 30120 Murcia, Spain
| | | | - María Jesús Hernández-López
- Servicio Murciano de Salud, 30120 Murcia, Spain
- Faculty of Nursing, University of Murcia, 30120 Murcia, Spain
| | | | - César Carrillo-García
- Servicio Murciano de Salud, 30120 Murcia, Spain
- Faculty of Nursing, University of Murcia, 30120 Murcia, Spain
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15
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Sindi AS, Cheema AS, Trevenen ML, Geddes DT, Payne MS, Stinson LF. Characterisation of human milk bacterial DNA profiles in a small cohort of Australian women in relation to infant and maternal factors. PLoS One 2023; 18:e0280960. [PMID: 36696407 PMCID: PMC9876237 DOI: 10.1371/journal.pone.0280960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 01/11/2023] [Indexed: 01/26/2023] Open
Abstract
Human milk is composed of complex microbial and non-microbial components that shape the infant gut microbiome. Although several maternal and infant factors have been associated with human milk microbiota, no study has investigated this in an Australian population. Therefore, we aimed to investigate associations between human milk bacterial composition of Australian women and maternal factors (body mass index (BMI), mode of delivery, breast pump use, allergy, parity) and infant factors (sex, mode of feeding, pacifier use, and introduction of solids). Full-length 16S rRNA gene sequencing was used to characterise milk bacterial DNA profiles. Milk from mothers with a normal BMI had a higher relative abundance of Streptococcus australis than that of underweight mothers, while milk from overweight mothers had a higher relative abundance of Streptococcus salivarius compared with underweight and obese mothers. Mothers who delivered vaginally had a higher relative abundance of Streptococcus mitis in their milk compared to those who delivered via emergency caesarean section. Milk of mothers who used a breast pump had a higher relative abundance of Staphylococcus epidermidis and Streptococcus parasanguinis. Milk of mothers whose infants used a pacifier had a higher relative abundance of S. australis and Streptococcus gwangjuense. Maternal BMI, mode of delivery, breast pump use, and infant pacifier use are associated with the bacterial composition of human milk in an Australian cohort. The data from this pilot study suggests that both mother and infant can contribute to the human milk microbiome.
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Affiliation(s)
- Azhar S Sindi
- Division of Obstetrics and Gynaecology, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.,College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ali S Cheema
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Michelle L Trevenen
- Centre for Applied Statistics, The University of Western Australia, Perth, Western Australia, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Matthew S Payne
- Division of Obstetrics and Gynaecology, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.,Women and Infants Research Foundation, Perth, Western Australia, Australia
| | - Lisa F Stinson
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
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16
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Zhao L, Wei H. The research frontier of cesarean section recovery: A bibliometric analysis. Front Med (Lausanne) 2022; 9:1071707. [PMID: 36582295 PMCID: PMC9792604 DOI: 10.3389/fmed.2022.1071707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 11/25/2022] [Indexed: 12/15/2022] Open
Abstract
Background Cesarean section (CS) has become an effective means to solve dystocia and some obstetric complications, and to save the lives of women and perinatal women. Disparities in quality obstetric care and rehabilitation in CS result from differences in health care systems across regions, and more scientific and reasonable rehabilitation programmes and management measures will benefit more parturient and newborns worldwide who must take CS. In this study, we performed a bibliometric analysis to collect a graphical representation of the CS recovery. Methods A total of 995 documents of CS recovery were retrieved from the Web of Science Core Collection (WOSCC) on December 31, 2021, and then VOS viewer 1.6.18 was used for visual analysis. Results Over the last 20 years, the researches of CS recovery have gradually increased and it will continue to grow in the next period. Anesthesia and Analgesia is the most popular journal in CS recovery. Most of the representative achievements are concentrated in the relevant institutions of European and American countries, Brendan Carvalho and Ian J. Wrench are among the outstanding scholars in this field, but the overall outcome is limited by limited regional work and lack of broad cooperation and representation. "CS," "surgery," "management," "recovery," "enhanced recovery," and "risk factors" are high frequency keywords, and there is a close relationship between "management" and "enhanced recovery" around the CS and they also become one of the key factors to regulate the condition of patients. Conclusion This work firstly analyzed the research condition of CS recovery by a bibliometric analysis. According to the practice guideline, it produces some outstanding representative productions, which involves enhanced recovery after surgery (ERAS) and will continue to be the focus of researchers. More substantive research articles and large-scale clinical studies may greatly enhance the scientific value, and it is necessary to strengthen the ERAS guideline and cooperation between researchers, generate broader consensus and results, and ultimately provide help for CS recovery.
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Affiliation(s)
- Lizheng Zhao
- Department of Rehabilitation, Xiamen Humanity Rehabilitation Hospital, Xiamen, Fujian, China
| | - Hong Wei
- Department of Rehabilitation Teaching and Research, Xi’an Siyuan University, Xi’an, China,*Correspondence: Hong Wei,
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17
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Postnatal growth of small for gestational age late preterm infants: determinants of catch-up growth. Pediatr Res 2022:10.1038/s41390-022-02402-3. [PMID: 36460739 DOI: 10.1038/s41390-022-02402-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/10/2022] [Accepted: 10/18/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Failure to recover growth is a risk reported in late preterm population. This study aimed to evaluate the auxological outcome of late preterm infants and identify factors associated with failure to recover growth. METHODS We enrolled late preterm infants with birth weight ≤10th percentile, followed up at High-Risk Infant Follow-up Service. We collected data at birth and at follow-up visits. A logistic regression analysis was performed to assess variables independently associated with growth failure. RESULTS The population consisted of 175 preterms. The percentage of children showing no weight recovery was 34% at 36 months. At logistic regression analysis, infants who had not regained weight at 12 months had a higher risk of not regaining weight even at 36 months. The same risk factor was highlighted for length catch-up growth. Moreover, infants fed any human milk at discharge were protected from not achieving both weight and length catch-up growth at 36 months. CONCLUSION These results indicate that children born late preterm and small for gestational age could fail to recover weight and stature growth in the first 36 months. The protective effect of human milk on failure to thrive highlights the importance of promoting breastfeeding in this population. IMPACT A significant number of SGA late preterms show a failure to recover weight and statural growth. Having experienced intrauterine growth restriction is associated with a greater chance of achieving statural catch-up growth. Being born singleton represents a risk factor for slower weight and height growth velocity. Breastmilk has a protective effect on failure to recover adequate weight and length in preterm SGA infants. This finding highlights the importance of promoting breastfeeding in this population.
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18
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Spyrakou E, Magriplis E, Benetou V, Zampelas A. Factors Associated with Breastfeeding Initiation and Duration in Greece: Data from the Hellenic National Nutrition and Health Survey. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111773. [PMID: 36421222 PMCID: PMC9688813 DOI: 10.3390/children9111773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/08/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022]
Abstract
Despite its well-documented benefits, breastfeeding rates and duration worldwide do not meet the recommended goals set by the World Health Organization. Data on infant feeding, socio-demographic, lifestyle and perinatal factors were used from 490 mothers (and 958 children), participants at the Hellenic National Nutrition and Health Survey between 2013−2015. Clustered multiple logistic regression and multilevel mixed-model regression analyses were performed to identify factors associated with breastfeeding initiation and duration, respectively. Maternal lower education [Odds Ratio (OR): 2.29, 95% Confidence intervals (95% CI): 1.30−4.04; p = 0.004], smoking during pregnancy (OR: 3.08, 95% CI: 1.64−5.77; p < 0.001), caesarean section (OR = 3.26, 95% CI: 1.83−5.83; p < 0.001), prematurity (OR = 2.74, 95% CI: 1.40−5.37; p = 0.003) and higher birth order (OR = 1.30, 95% CI: 1.04−1.62; p = 0.020) were associated with increased odds of not initiating breastfeeding. Living in rural areas [beta coefficient b = −27.93, p = 0.043], smoking during pregnancy (b = −64.47, p < 0.001), caesarean section (b = −28.76, p = 0.046) and prematurity (b = −46.67, p = 0.048) were significantly associated with shorter breastfeeding duration. Children born chronologically closer to the survey were more likely to breastfeed and for longer periods. Educational promotion and enhancement of breastfeeding awareness that account for maternal exposures are required. Prevention of prematurity and avoidance of unnecessary caesarean section is crucial, while additional breastfeeding support is needed when preterm birth occurs, or caesarean section cannot be avoided.
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Affiliation(s)
- Efthimia Spyrakou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 115 27 Athens, Greece
| | - Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
| | - Vassiliki Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 115 27 Athens, Greece
- Correspondence:
| | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
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19
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Qin X, Li P, Wu Y, Wang X, Yan S, Xu Y, Zhu P, Hao J, Tao F, Huang K. Impact of caesarean delivery on children's autism-like behaviours: the mediation of exclusive breastfeeding. Int Breastfeed J 2022; 17:53. [PMID: 35841102 PMCID: PMC9284736 DOI: 10.1186/s13006-022-00493-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 06/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background The rate of autism spectrum disorder (ASD) has been rising worldwide, and therefore it is important to identify potential causes of ASD to facilitate early prevention. This study examined the role of breastfeeding and the association between caesarean delivery (CD) and children’s autism spectrum disorder. Methods The data were from the Ma’anshan birth cohort (MABC) in China, that was set up between May 2013 and September 2014. Women within 14 gestational weeks were recruited. The delivery mode was extracted from medical notes and infant feeding was obtained from questionnaire surveys. Autism-like behaviour was assessed using the Checklist for Autism in Toddlers (CHAT-23) when children were 18 months old, and 3 years of age. At 5 years of age, autism-like behaviour was assessed using the Clancy Autism Behavior Scale behavior. Structural equation models tested the mediation effects of breastfeeding between CD and children’s autism spectrum disorder. Results In all, 1520 (48.89%) women gave birth via CD, and 406 (13.86%) children were identified with autism-like behaviours at 18 months. Compared with women giving birth via vaginal delivery, those giving birth via CD were more likely to experience a higher proportion of delayed initiation of breastfeeding (p < 0.01), and delayed onset of lactogenesis (p < 0.01). CD was associated with a lower proportion of exclusive breastfeeding at 4 months after delivery (p = 0.02). Autism-like behaviour was less likely amongst infants with exclusively breastfeeding at 4 months than amongst those not exclusively breastfeeding at 4 months (p < 0.01). SEM indicated that women who gave birth by CD were more likely to stop exclusive breastfeeding in the first 4 months (standard estimations = − 0.04, p = 0.02), and those children who were not exclusively breastfed at 4 months were more likely to have autism-like behaviours (standard estimations = − 0.05, p < 0.01). The associations persisted at 3 years, but not at 5 years. Conclusions Exclusive breastfeeding at 4 months of age mediated the association between caesarean delivery and children’s autism-like behaviours. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-022-00493-6.
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Affiliation(s)
- Xiaoyun Qin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, China.,Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, 230032, China.,NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China
| | - Peixuan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, China.,Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, 230032, China.,NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China
| | - Ya Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, China.,Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, 230032, China.,NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China
| | - Xiaoxu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, China.,Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, 230032, China.,NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China
| | - Shuangqin Yan
- Ma'anshan Maternal and Child Health Care Hospital, Ma'anshan, 243000, China
| | - Yeqing Xu
- Ma'anshan Maternal and Child Health Care Hospital, Ma'anshan, 243000, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, China.,Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, 230032, China.,NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China
| | - Jiahu Hao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, China.,Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, 230032, China.,NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, China.,Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, 230032, China.,NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei, 230032, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, China. .,Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei, 230032, China. .,NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei, 230032, China. .,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, 230032, China. .,Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, 230032, China.
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20
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The Anesthetic Effect and Safety of Dexmedetomidine in Cesarean Section: A Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1681803. [PMID: 35607304 PMCID: PMC9124121 DOI: 10.1155/2022/1681803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 11/17/2022]
Abstract
Objective. To evaluate the anesthetic effect and safety of dexmedetomidine in cesarean section. Methods. The Cochrane Library, EMBASE, and PubMed databases (established until September 2020) were searched by computer. Two authors independently screened and extracted literature related to the application of dexmedetomidine in the cesarean section according to inclusion and exclusion criteria. The control group received either subarachnoid block (lumbar anesthesia) or combined lumbar anesthesia and epidural anesthesia (combined lumbar epidural anesthesia) with bupivacaine or combined bupivacaine and fentanyl. The observation group was additionally given dexmedetomidine based on the control group, to analyze the anesthetic effect and safety of dexmedetomidine in cesarean section. Results. A total of 580 cesarean delivery women were included in 8 studies, and the results showed that the peak time of sensory block in the observation group was shorter than that in the control group (standard mean
; 95% confidence interval: -0.48, -0.08;
), sensory block lasted longer than that in the control group (standard mean
; 95% confidence interval: 1.21, 1.78;
), the sedation rate was higher than that in the control group, the onset of the first postoperative pain was significantly delayed compared with that in the control group, and the incidence of postoperative pain, nausea and vomiting, postoperative chills, and fever was lower than that in the control group (
). Conclusion. Dexmedetomidine combined with lumbar anesthesia or combined lumbar epidural anesthesia for women in cesarean section has more clinical benefits and better safety.
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Weerasinghe K, Rishard M, Brabaharan S, Mohamed A. Effectiveness of face-to-face physiotherapy training and education for women who are undergoing elective caesarean section: a randomized controlled trial. Arch Physiother 2022; 12:4. [PMID: 35109917 PMCID: PMC8812015 DOI: 10.1186/s40945-021-00128-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 12/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Caesarean Section (CS) is associated with numerous post-operative problems. The current literature reveals that physiotherapy interventions such as pelvic floor rehabilitation and post-surgical rehabilitation enable enhanced recovery in the post-operative period. The purpose of this study was to investigate the effectiveness of face-to-face physiotherapy training and education prior to elective CS in improving post-operative outcomes. METHODS A single blind parallel randomized controlled study was carried out at De Soysa Hospital for Women (DSHW), Colombo. Fifty-four women who were to undergo elective CS were recruited to the study. The women in the intervention group (n = 27) received face-to-face physiotherapy training and education; the control group (n = 27) received only the standard nursing care. Outcome measures such as perception of post-operative pain, dosage of additional analgesics required, pain upon returning to functional activities and lengths of hospital stay were collected. Results were analyzed using IBM SPSS 20 using descriptive statistics and independent samples t-test. RESULTS Mean post-operative pain score (control group; 4.2±0.46 vs. intervention group; 1.7±0.7) and doses of additional analgesics required were significantly higher in the control group than that of the intervention group. Pain upon returning to functional activities decreased significantly within 2 days in both groups, and values were lower in the intervention group. The intervention group showed a shorter hospital stay than the control group (control group;3.9 ± 0.3 vs. intervention group;3.00 ± 0.0) (p < 0.05). CONCLUSIONS Face-to-face physiotherapy training and education prior to elective CS appears to be a promising intervention to improve the post-operative outcomes by reducing post-operative pain, doses of additional analgesics required, pain upon returning to functional activities and lengths of hospital stay. TRIAL REGISTRATION SLCTR/2019/029-APPL/2019/028 ; Registered on 6th of September 2019.
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Affiliation(s)
- Kalani Weerasinghe
- Department of Allied Health Sciences, Faculty of Medicine, University of Colombo, Kynsey Road, Colombo, 08, Sri Lanka.
| | - Mohamed Rishard
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Colombo, No 25, Kynsey Road, Colombo, 08, Sri Lanka
| | | | - Aysha Mohamed
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Colombo, No 25, Kynsey Road, Colombo, 08, Sri Lanka
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22
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Martin M, Keith M, Olmedo S, Edwards D, Barrientes A, Pan A, Valeggia C. Cesarean section and breastfeeding outcomes in an Indigenous Qom community with high breastfeeding support. Evol Med Public Health 2022; 10:36-46. [PMID: 35154778 PMCID: PMC8830290 DOI: 10.1093/emph/eoab045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 12/27/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Cesarean section may lead to suboptimal breastfeeding outcomes, though evidence has been mixed. Factors, such as premature birth, birth weight and maternal age may independently increase risk of cesarean and hinder breastfeeding initiation, while maternal preferences, support and sociostructural barriers may influence breastfeeding practices beyond the immediate postpartum period. METHODOLOGY We assessed impacts of cesarean section and gestational factors on breastfeeding duration among Indigenous Qom mothers in Argentina who have strong traditional breastfeeding support. We modeled transitions from exclusive breastfeeding to complementary feeding and from complementary feeding to full weaning in a Bayesian time-to-event framework with birth mode and gestational covariates (n = 89 infants). RESULTS Estimated median time to full weaning was 30 months. Cesarean-delivered babies were weaned an average of 5 months later adjusting for gestational age, maternal parity and infant sex. No factors were associated with time-to-complementary feeding, and time-to-complementary feeding was not associated with time-to-full weaning. CONCLUSIONS AND IMPLICATIONS Among Indigenous Qom mothers in Argentina, cesarean section was not associated with suboptimal breastfeeding outcomes. Although some Qom mothers do experience early breastfeeding problems, particularly following first birth, problems are not more frequent following cesarean delivery. Traditional postpartum kin and community support during prolonged postpartum periods may be instrumental in helping mothers to overcome early breastfeeding problems due to cesarean or other risk factors.
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Affiliation(s)
- Melanie Martin
- Department of Anthropology, University of Washington, 314 Denny Hall, Box 353100, Seattle, WA 98195-3100, USA,Corresponding author. Department of Anthropology, University of Washington, 314 Denny Hall, Box 353100, Seattle, WA 98195-3100, USA. Tel: +1 206-616-7701; E-mail:
| | - Monica Keith
- Department of Anthropology, University of Washington, 314 Denny Hall, Box 353100, Seattle, WA 98195-3100, USA
| | - Sofía Olmedo
- Centro de Investigaciones y Estudios sobre Cultura y Sociedad (CIECS-CONICET), Universidad Nacional de Cordoba, AV. Valparaiso S/N. Ciudad Universitaria, Cordoba, Argentina
| | - Deja Edwards
- Department of Anthropology, University of Washington, 314 Denny Hall, Box 353100, Seattle, WA 98195-3100, USA
| | - Alicia Barrientes
- Department of Anthropology, University of Washington, 314 Denny Hall, Box 353100, Seattle, WA 98195-3100, USA
| | - Anwesha Pan
- Department of Anthropology, University of Washington, 314 Denny Hall, Box 353100, Seattle, WA 98195-3100, USA
| | - Claudia Valeggia
- Department of Anthropology, Yale University, P.O. Box 208277, New Haven, CT 06520-8277, USA
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23
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Vázquez-Osorio IM, Vega-Sánchez R, Maas-Mendoza E, Heller Rouassant S, Flores-Quijano ME. Exclusive Breastfeeding and Factors Influencing Its Abandonment During the 1st Month Postpartum Among Women From Semi-rural Communities in Southeast Mexico. Front Pediatr 2022; 10:826295. [PMID: 35252066 PMCID: PMC8894443 DOI: 10.3389/fped.2022.826295] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/24/2022] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION In this study we describe breastfeeding practices among women from semi-rural communities in southeast Mexico, and explore which factors, modifiable or not, are associated with such practices. MATERIALS AND METHODS This was a formative cross-sectional study that included 143 mothers with infants 4-6 months old, from semi-rural communities in Tabasco, Mexico. We collected data on two categories of factors: (1) women's sociodemographic characteristics, and (2) maternal / infant factors. We first analyzed the frequency of various breastfeeding practices. Then, we classified participants into the up to 1 month of exclusive breastfeeding group ( ≤ 1 m-EBF) and the beyond 1 month EBF group (>1 m-EBF), if they practiced EBF for less or more than 1 month, respectively. We compared the two categories of factors between groups and then, using logistic regression models, explored which factors were associated with practicing >1 m-EBF. RESULTS By the end of the 1st month postpartum, 51.7% of participants had abandoned EBF, introduced milk formula (35%), other food (9.1%), non-nutritive liquids (7.7%), or had stopped breastfeeding completely. In the next months, EBF practice fell sharply and mixed feeding grew importantly.Logistic regression models showed that women were more likely to be in the >1 m-EBF group if they lived with the baby's father, had complications during pregnancy, delivered vaginally and attended a health center at least three times postpartum. To the contrary, women were less likely to be practice >1 m-EBF if they gave infants other liquids during their hospital stay; experienced pain or discomfort in breasts/nipples, or used a pacifier after hospitalization; had larger bodies (i.e., higher BMI); and believed that you should give the infant powdered milk or some other food when the baby is not full. CONCLUSION Many factors associated with abandoning EBF, particularly in the early postpartum period, are modifiable and can be altered through timely interventions that include giving correct information and ensuring its comprehension; assertive personal counseling and accompaniment must be provided to mothers; and reinforcement during the early postpartum at health facilities and other settings.
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Affiliation(s)
- Inocente Manuel Vázquez-Osorio
- Licenciatura de Nutrición, División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Mexico.,Jurisdicción Sanitaria 4 del Municipio de Centro, Secretaría de Salud, Villahermosa, Mexico
| | - Rodrigo Vega-Sánchez
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Eric Maas-Mendoza
- Licenciatura de Nutrición, División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Mexico
| | - Solange Heller Rouassant
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Mexico City, Mexico.,Private Practitioner, Naucalpan, Estado de México, Mexico, Mexico
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Sámano R, Chico-Barba G, Flores-Quijano ME, Godínez-Martínez E, Martínez-Rojano H, Ortiz-Hernandez L, Nájera-Medina O, Hernández-Trejo M, Hurtado-Solache C. Association of Pregestational BMI and Gestational Weight Gain with Maternal and Neonatal Outcomes in Adolescents and Adults from Mexico City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:280. [PMID: 35010540 PMCID: PMC8750657 DOI: 10.3390/ijerph19010280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/13/2021] [Accepted: 12/24/2021] [Indexed: 06/14/2023]
Abstract
During pregnancy, adolescents experience physiological changes different from adults because they have not concluded their physical growth. Therefore, maternal and neonatal outcomes may not be the same. This paper aimed to analyze the association between pregestational BMI (pBMI) and gestational weight gain (GWG) with maternal and neonatal outcomes in adolescent and adult pregnant women. The authors performed an observational study that included 1112 women, where 52.6% (n = 585) were adolescents. Sociodemographic information, pBMI, GWG, neonatal anthropometric measures, and maternal and neonatal outcomes were obtained. Adolescent women had a mean lower (21.4 vs. 26.2, p ≤ 0.001) pBMI than adults and a higher gestational weight gain (12.3 vs. 10.7 kg, p ≤ 0.001). According to Poisson regression models, gestational diabetes is positively associated with insufficient GWG and with pregestational obesity. Furthermore, the probability of developing pregnancy-induced hypertension increased with pBMI of obesity compared to normal weight. Preeclampsia, anemia, and preterm birth were not associated with GWG. Insufficient GWG was a risk factor, and being overweight was a protective factor for low birth weight and small for gestational age. We conclude that pBMI, GWG, and age group were associated only with gestational diabetes and low birth weight.
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Affiliation(s)
- Reyna Sámano
- Coordinación de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico; (M.E.F.-Q.); (E.G.-M.)
- Programa de Posgrado Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico; (L.O.-H.); (O.N.-M.)
| | - Gabriela Chico-Barba
- Coordinación de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico; (M.E.F.-Q.); (E.G.-M.)
- Escuela de Enfermería, Facultad de Ciencias de la Salud, Universidad Panamericana, Mexico City 03920, Mexico
- Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de la Salud, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - María Eugenia Flores-Quijano
- Coordinación de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico; (M.E.F.-Q.); (E.G.-M.)
| | - Estela Godínez-Martínez
- Coordinación de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico; (M.E.F.-Q.); (E.G.-M.)
| | - Hugo Martínez-Rojano
- Sección de Posgrado e Investigación de la Escuela Superior de Medicina del Instituto Politécnico Nacional, Mexico City 11340, Mexico;
| | - Luis Ortiz-Hernandez
- Programa de Posgrado Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico; (L.O.-H.); (O.N.-M.)
- Departamento de Atención a la Salud, Universidad Autónoma Metropolitana Xochimilco, Mexico City 04960, Mexico
| | - Oralia Nájera-Medina
- Programa de Posgrado Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico; (L.O.-H.); (O.N.-M.)
- Departamento de Atención a la Salud, Universidad Autónoma Metropolitana Xochimilco, Mexico City 04960, Mexico
| | - María Hernández-Trejo
- Departamento de Neurobiología del Desarrollo, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico;
| | - Cristopher Hurtado-Solache
- Escuela de Ciencias de la Salud, Universidad del Valle de México-Chapultepec, Mexico City 11810, Mexico;
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Effects of Breastfeeding on Endometriosis-Related Pain: A Prospective Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010602. [PMID: 34682348 PMCID: PMC8535640 DOI: 10.3390/ijerph182010602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/05/2021] [Accepted: 10/07/2021] [Indexed: 01/01/2023]
Abstract
Endometriosis is a gynecological estrogen-dependent disease whose commonest pain symptoms are dysmenorrhea, dyspareunia, and acyclic chronic pelvic pain (CPP). Hormonal changes occurring during breastfeeding seem to reduce pain and disease recurrence. The aim of this observational prospective study was to assess the effect of breastfeeding on pain and endometriotic lesions in patients with endometriosis and to evaluate a possible correlation between the duration of breastfeeding, postpartum amenorrhea, and pain. Out of 156 pregnant women with endometriosis enrolled, 123 who breastfed were included in the study and were monitored for 2 years after delivery; 96/123 exclusively breastfed for at least 1 month. Mode of delivery, type and duration of breastfeeding, intensity of pain symptoms, and lesion size before pregnancy and during the 24-month follow-up were analyzed. All patients experienced a significant reduction in dysmenorrhea proportional to the duration of breastfeeding. CPP was significantly reduced only in women who exclusively breastfed. No significant improvement in dyspareunia was observed. Ovarian endometriomas were significantly reduced. Therefore, breastfeeding, particularly if exclusive, may cause improvement in dysmenorrhea and CPP proportional to the duration of breastfeeding, as well as a reduction in the size of ovarian endometriomas.
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26
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Greene N, Kilcoyne J, Grey A, Gregory KD. Method to Calculate Nurse-Specific Cesarean Rates for the First and Second Stages of Labor. J Obstet Gynecol Neonatal Nurs 2021; 50:632-641. [PMID: 34310902 DOI: 10.1016/j.jogn.2021.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 11/28/2022] Open
Abstract
To date, efforts to safely lower the cesarean birth rate for women with low-risk pregnancies have largely ignored the influence of labor and delivery nurses on mode of birth. This is mainly because of the complexity involved in attributing outcomes to specific nurses whose care had the greatest effect on mode of birth. An additional level of complexity arises from the type of care given to the woman during different stages of labor. In this article, we describe a strategy to designate nurses to births using an electronic medical record flowsheet, and we describe a method to calculate nurse-specific cesarean birth rates for the first and second stages of labor. Similar to physician-specific rates, we found wide variation in nurse-specific cesarean birth rates in both stages of labor, which suggests an opportunity to learn from best practices.
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Lai BY, Yu BW, Chu AJ, Liang SB, Jia LY, Liu JP, Fan YY, Pei XH. Risk factors for lactation mastitis in China: A systematic review and meta-analysis. PLoS One 2021; 16:e0251182. [PMID: 33983987 PMCID: PMC8118550 DOI: 10.1371/journal.pone.0251182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/22/2021] [Indexed: 12/30/2022] Open
Abstract
Background Lactation mastitis (LM) affects approximately 3% to 33% of postpartum women and the risk factors of LM have been extensively studied. However, some results in the literature reports are still not conclusive due to the complexity of LM etiology and variation in the populations. To provide nationally representative evidence of the well-accepted risk factors for LM in China, this study was aimed to systematically summary the risk factors for LM among Chinese women and to determine the effect size of individual risk factor. Material and methods Six major Chinses and English electronic literature databases (PubMed, Web of Science, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wan fang Database and China Science Technology Journal Database) were searched from their inception to December 5st, 2020. Two authors extracted data and assessed the quality of included trials, independently. The strength of the association was summarized using the odds ratio (OR) with 95% confidence intervals (CI). The population attributable risk (PAR) percent was calculated for significant risk factors. Results Fourteen studies involving 8032 participants were included. A total of 18 potential risk factors were eventually evaluated. Significant risk factors for LM included improper milking method (OR 6.79, 95%CI 3.45–13.34; PAR 59.14%), repeated milk stasis (OR 6.23, 95%CI 4.17–9.30; PAR 49.75%), the first six months postpartum (OR 5.11, 95%CI 2.66–9.82; PAR 65.93%), postpartum rest time less than 3 months (OR 4.71, 95%CI 3.92–5.65; PAR 56.95%), abnormal nipple or crater nipple (OR 3.94, 95%CI 2.34–6.63; PAR 42.05%), breast trauma (OR 3.07, 95%CI 2.17–4.33; PAR 15.98%), improper breastfeeding posture (OR 2.47, 95%CI 2.09–2.92; PAR 26.52%), postpartum prone sleeping position (OR 2.46, 95%CI 1.58–3.84; PAR 17.42%), little or no nipple cleaning (OR 2.05, 95%CI 1.58–2.65; PAR 24.73%), primipara (OR 1.73, 95%CI 1.25–2.41; PAR 32.62%), low education level (OR 1.63, 95%CI 1.09–2.43; PAR 23.29%), cesarean section (OR 1.51, 95%CI 1.26–1.81; PAR 18.61%), breast massage experience of non-medical staff (OR 1.51, 95%CI 1.25–1.82; PAR 15.31%) and postpartum mood disorders (OR 1.47, 95%CI 1.06–2.02; PAR 21.27%). Conclusions This review specified several important risk factors for LM in China. In particular, the incidence of LM can be reduced by controlling some of the modifiable risk factors such as improper breastfeeding posture, improper milking method, repeated milk stasis, nipple cleaning, breast massage experience of non-medical staff and postpartum sleeping posture.
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Affiliation(s)
- Bao-Yong Lai
- Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Bo-Wen Yu
- Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Ai-Jing Chu
- Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Shi-Bing Liang
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Li-Yan Jia
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Jian-Ping Liu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ying-Yi Fan
- Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
- * E-mail: (XHP); (YYF)
| | - Xiao-Hua Pei
- Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
- The Xiamen Hospital of Beijing Universality of Chinese Medicine, Xiamen, China
- * E-mail: (XHP); (YYF)
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McKinley EM, Knol LL, Turner LW, Burnham JJ, Graettinger KR, Hernandez-Reif M, Leeper JD. Enhancing Patient-Provider Breastfeeding Conversations: Breastfeeding Intention and Prenatal Breastfeeding Self-Efficacy among a Sample of Pregnant Women. South Med J 2021; 114:223-230. [PMID: 33787936 DOI: 10.14423/smj.0000000000001238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate and identify which sociodemographic factors may be associated with breastfeeding intention and breastfeeding self-efficacy among pregnant women. METHODS Pregnant women at a medical center in Alabama completed a cross-sectional survey. The Prenatal Rating of Efficacy in Preparation to Breastfeed Scale (PREP to BF) was used to assess prenatal breastfeeding self-efficacy. A valid 3-item breastfeeding intention scale and the Fetal Health Locus of Control Scale also were used. Nonparametric tests were used to assess differences in breastfeeding intention, locus of control subscales, and PREP to BF scores by history with breastfeeding, planned mode of delivery, and sociodemographic factors. RESULTS The participants in the final analysis (N = 124) had a mean prenatal breastfeeding self-efficacy score of 299.5 (±92.33), with a range of 0 to 390. Significantly lower scores related to intention and PREP to BF were found among Black women (P ≤ 0.05), those with a high school education or less (P ≤ 0.019), single women (P ≤ 0.028), and those who had no breastfeeding experience (P ≤ 0.035). CONCLUSIONS Identifying pregnant women with low breastfeeding self-efficacy and intention and recognizing the effects of social and cultural influences on breastfeeding are vital. Healthcare providers can engage in meaningful dialog to address ways to increase social support, communication, goal-setting skills, and overcoming mental and emotional barriers.
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Affiliation(s)
- Erin M McKinley
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - Linda L Knol
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - Lori W Turner
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - Joy J Burnham
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - Kristine R Graettinger
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - Maria Hernandez-Reif
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - James D Leeper
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
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Effects of a theory of planned behavior-based intervention on breastfeeding behaviors after cesarean section: A randomized controlled trial. Int J Nurs Sci 2021; 8:152-160. [PMID: 33997128 PMCID: PMC8105542 DOI: 10.1016/j.ijnss.2021.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/21/2021] [Accepted: 03/18/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives To examine the efficacy of an intervention based on the theory of planned behavior (TPB) in improving breastfeeding behavior among women with cesarean sections (C-sections). Methods This research was a randomized controlled trial. Women with planned elective C-sections were recruited to participate in a randomized controlled trial between June and September 2020. One hundred thirty-two women were divided randomly into the intervention (n = 66) and control group (n = 66) by systematic random sampling. In the intervention group, an intervention project was implemented after the C-section to establish positive breastfeeding attitudes, cultivate supportive subjective norms, enhance perceived behavioral control, and strengthen breastfeeding intention to change behaviors. Those in the control group received routine pre-and post-delivery care. Exclusive breastfeeding rate and breast problem were collected at 5 days, 2 weeks, and 1 month after C-section. The modified Breastfeeding Attrition Prediction Tool (BAPT) on the first day in the hospital, two weeks, and one month after C-section and Numerical Rating Scale (NRS) 24 h postoperatively were used to compare the intervention effect between the two groups. Results After the intervention, the intervention group had significantly higher exclusive breastfeeding rates than the control group at five days (86.4% vs. 60.6%), two weeks (77.3% vs. 57.6%), and one month (74.2% vs. 50.0%) after the C-section. Besides, the intervention group was less likely to have sore nipples at five days (6.1% vs. 18.2% in the control group, P < 0.05) and two weeks (9.1% vs. 12.1% in the control group, P < 0.05). After two weeks of intervention, attitude scores (90.64 ± 8.31 vs. 87.20 ± 8.15, P < 0.05), subjective norm scores (88.07 ± 24.65 vs. 79.42 ± 19.47, P < 0.05)and behavior control scores in the intervention group were significantly higher than those in the control group. After one month of intervention, attitude scores (90.34 ± 10.35 vs. 84.22 ± 10.51, P < 0.05) and behavior control scores (43.13 ± 5.02 vs. 39.15 ± 4.69, P < 0.05)in the intervention group were significantly higher than those in the control group, which resulted in the higher breastfeeding intention in the intervention group. Conclusion This study indicated that the TPB-based interventions effectively improved women's breastfeeding behaviors after C-sections.
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Kenkel W. Birth signalling hormones and the developmental consequences of caesarean delivery. J Neuroendocrinol 2021; 33:e12912. [PMID: 33145818 PMCID: PMC10590550 DOI: 10.1111/jne.12912] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 12/12/2022]
Abstract
Rates of delivery by caesarean section (CS) are increasing around the globe and, although several epidemiological associations have already been observed between CS and health outcomes in later life, more are sure to be discovered as this practice continues to gain popularity. The components of vaginal delivery that protect offspring from the negative consequences of CS delivery in later life are currently unknown, although much attention to date has focused on differences in microbial colonisation. Here, we present the case that differing hormonal experiences at birth may also contribute to the neurodevelopmental consequences of CS delivery. Levels of each of the 'birth signalling hormones' (oxytocin, arginine vasopressin, epinephrine, norepinephrine and the glucocorticoids) are lower following CS compared to vaginal delivery, and there is substantial evidence for each that manipulations in early life results in long-term neurodevelopmental consequences. We draw from the research traditions of neuroendocrinology and developmental psychobiology to suggest that the perinatal period is a sensitive period, during which hormones achieve organisational effects. Furthermore, there is much to be learned from research on developmental programming by early-life stress that may inform research on CS, as a result of shared neuroendocrine mechanisms at work. We compare and contrast the effects of early-life stress with those of CS delivery and propose new avenues of research based on the links between the two bodies of literature. The research conducted to date suggests that the differences in hormone signalling seen in CS neonates may produce long-term neurodevelopmental consequences.
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Affiliation(s)
- William Kenkel
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
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Bašková M, Chabanová B, Škodová Z, Malinovská N, Urbanová E. Promotion and support of breastfeeding within the baby-friendly hospital initiative programme in Slovakia. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2020. [DOI: 10.15452/cejnm.2020.11.0031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Gribble K, Marinelli KA, Tomori C, Gross MS. Implications of the COVID-19 Pandemic Response for Breastfeeding, Maternal Caregiving Capacity and Infant Mental Health. J Hum Lact 2020; 36:591-603. [PMID: 32757878 DOI: 10.1177/0890334420949514] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Karleen Gribble
- 89381 School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW, Australia
| | - Kathleen A Marinelli
- 12227 University of Connecticut School of Medicine, Department of Pediatrics, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Cecília Tomori
- 15851 Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Marielle S Gross
- 223121 Johns Hopkins Berman Institute of Bioethics, Bloomberg School of Public Health, Baltimore, MD, USA
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Seidu AA, Ameyaw EK, Ahinkorah BO, Bonsu F. Determinants of early initiation of breastfeeding in Ghana: a population-based cross-sectional study using the 2014 Demographic and Health Survey data. BMC Pregnancy Childbirth 2020; 20:632. [PMID: 33076852 PMCID: PMC7574209 DOI: 10.1186/s12884-020-03308-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 10/02/2020] [Indexed: 11/12/2022] Open
Abstract
Background The World Health Organisation (WHO) recommends that breastfeeding should be initiated within the first hour of delivery followed by exclusive breastfeeding up to 6 months. This study examined the determinants of early initiation of breastfeeding in Ghana using data from the 2014 Ghana Demographic and Health Survey. Methods A sample size of 4219 was used for the study. Descriptive statistics was conducted to ascertain the proportion of children who had early initiation of breastfeeding after which binary logistic regression analysis was carried out. Results were presented using frequencies, percentages, unadjusted and adjusted odds ratios. Statistical significance was pegged at p<0.05. Results Children of first birth order [AOR = 0.71, CI = 0.61–0.84], those who were delivered by non-professionals [AOR = 0.51, CI = 0.30–0.88] and those whose mothers were Traditionalists [AOR = 0.65, CI = 0.46–0.92] and Mole-Dagbanis [AOR = 0.69, CI = 0.54–0.89] were less likely to go through early initiation of breastfeeding compared to those of 2–4 birth order, those who were delivered by health professionals, those whose mothers were Christians and Akan, respectively. Conversely, children born to mothers who read newspaper/magazine at least once a week were more likely to go through early initiation of breastfeeding, compared to those who never read newspaper/magazine [AOR = 1.40, CI = 1.01–1.95]. Children born to mothers who watched television less than once a week were more likely to go through early initiation of breastfeeding compared to those who watched television at least once a week [AOR = 1.40, CI = 1.01–1.95]. Finally, women from the Northern [AOR = 2.40, CI = [1.77–3.26] and Upper East regions [AOR = 2.57, CI = [1.86–3.56] practiced early initiation of breastfeeding compared to those from the Ashanti region. Conclusions Empowering healthcare providers to be consistent in early breastfeeding initiation advocacy and effective community engagement on the need to embrace and practice early initiation of breastfeeding can improve the situation.
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Affiliation(s)
- Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Edward Kwabena Ameyaw
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Freda Bonsu
- Asutifi South District Health Directorate, Hwidiem, Ghana
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Kent JC, Ashton E, Hardwick CM, Rea A, Murray K, Geddes DT. Causes of perception of insufficient milk supply in Western Australian mothers. MATERNAL AND CHILD NUTRITION 2020; 17:e13080. [PMID: 32954674 PMCID: PMC7729526 DOI: 10.1111/mcn.13080] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/28/2020] [Accepted: 09/02/2020] [Indexed: 01/11/2023]
Abstract
A perception of insufficient milk supply (PIMS) is associated with early discontinuation of breastfeeding. Ideally, an objective measure of milk supply would either dispel or confirm this perception and provide reassurance or guide professional advice. Clinical signs of sufficient milk intake (steady growth, sufficient elimination, infant alertness and breasts feeling full before breastfeeds and soft after breastfeeds) should provide confidence in milk supply. We surveyed 423 mothers in early lactation who had breastfeeding problems to determine the proportion that had PIMS and to determine if the mothers with PIMS relied on these clinical signs or other perceptions of their infants' behaviour as indications of insufficient milk supply. By 3 weeks after birth, we found that the rate of PIMS among mothers with breastfeeding problems was 44%. Supplementary infant formula was being given to 66% of the infants, so the clinical indications were that milk intake was sufficient, but 74% of the mothers with PIMS cited concerns that their infants did not appear satisfied after breastfeeds. After targeted advice from lactation consultants, mothers with PIMS showed positive changes in their perceptions of their milk supply, underlining the value of professional guidance soon after birth. We conclude that an appearance of infant dissatisfaction is the major cause of PIMS in Western Australia.
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Affiliation(s)
- Jacqueline Coral Kent
- School of Molecular Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Elizabeth Ashton
- Breastfeeding Centre of WA, King Edward Memorial Hospital for Women, Subiaco, Western Australia, Australia
| | - Catherine Meria Hardwick
- Breastfeeding Centre of WA, King Edward Memorial Hospital for Women, Subiaco, Western Australia, Australia
| | - Alethea Rea
- College of Science, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia
| | - Kevin Murray
- Population and Public Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Donna Tracy Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, Western Australia, Australia
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Wen J, Yu G, Kong Y, Liu F, Wei H. An exploration of the breastfeeding behaviors of women after cesarean section: A qualitative study. Int J Nurs Sci 2020; 7:419-426. [PMID: 33195754 PMCID: PMC7644566 DOI: 10.1016/j.ijnss.2020.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/21/2020] [Accepted: 07/17/2020] [Indexed: 02/06/2023] Open
Abstract
Objectives To explore the factors affecting breastfeeding behaviors in women after cesarean section. Methods This is a qualitative study that used a phenomenological approach. This study used individual face-to-face interviews with 19 women who underwent a cesarean section in a Women and Children’s Hospital in China between July to September 2019. Information saturation was used to determine sample size. Data were analyzed using a thematic content analysis method. Themes were developed based on the theory of planned behavior. Results Thirteen (68.42%) had a planned cesarean section, and six (31.58%) cesarean sections were unplanned or emergent. Three major themes emerged: ambivalent attitude about breastfeeding, motivation to comply with the traditional cultural norms, and barriers and challenges. The motivating factors for breastfeeding after cesarean sections included perceived benefits of human milk, support from healthcare professionals, and responsibility for breastfeeding. The challenges for breastfeeding after cesarean sections included physical discomfort, knowledge and skills deficit of breastfeeding, lactation deficiency, and lack of knowledge and coping skills in managing their depressive mood after cesarean sections. There were a couple of neutral factors, such as the influences of family and peers. These factors could influence women either positively as facilitators or negatively as barriers. Conclusions The findings can offer valuable information for healthcare professionals to help women breastfeed after cesarean sections. To promote women’s breastfeeding behaviors after cesarean sections, it is necessary to change women’s attitudes, belief systems, and the external environments and help them become more confident.
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Affiliation(s)
- Juan Wen
- School of Nursing of Qingdao University, Qingdao, Shandong, China
| | - Guiling Yu
- Qingdao Women and Children's Hospital, Qingdao, Shandong, China
| | - Yan Kong
- Qingdao Women and Children's Hospital, Qingdao, Shandong, China
| | - Furong Liu
- Qingdao Women and Children's Hospital, Qingdao, Shandong, China
| | - Holly Wei
- College of Nursing at East Carolina University, Greenville, NC, USA
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