The Relationship of Previous Breastfeeding Experiences and Factors Affecting Breastfeeding Rates: A Follow-Up Study

Effects of Exclusive Breastfeeding Duration on Pneumonia Occurrence and Course in Infants Up to 6 Months of Age: A Case-Control Study

We aimed to analyze the effects of exclusive breastfeeding duration on the occurrence and course of pneumonia in infants aged up to 6 months. Prospective case-control study. This study was conducted from August 2020 to August 2022 at a maternity and child health hospital in China. A total of 218 infants up to 6 months of age with pneumonia were included in the analyses. Health data were obtained using a hospitalization information system or an interview-based questionnaire. Univariate and multivariate logistic regression analyses were performed to analyze the data. The incidence of pneumonia, hospitalization duration, and costs to participants were significantly affected by the duration of exclusive breastfeeding (p < 0.01). The incidence of pneumonia among participants with different exclusive breastfeeding durations also differed significantly (p < 0.01). The shorter the duration of exclusive breastfeeding, the higher the incidence of pneumonia among infants. We found that the longer the exclusive breastfeeding duration in infants up to 6 months of age, the lower the recurrence of pneumonia, the shorter the hospital stay, and the lower the hospital costs. The rate of exclusive breastfeeding for infants up to 6 months of age should be increased as much as possible to reduce the occurrence of pneumonia and hospital costs.

Breastfeeding challenges and the impact of social support in Iranian Muslim mothers: A cross-sectional study

Breast milk is the perfect food during infancy. Adequate support from family and health systems can be helpful to continue breastfeeding. This study aimed to determine the status of breastfeeding challenges and its relationship with social support and socio-demographic factors. In this correlational-descriptive study, 348 breastfeeding mothers were recruited using cluster random sampling from health care centers in Tabriz, Iran in 2022. Socio-demographic, breastfeeding challenges and social support questionnaires were used for data collection. Data were analyzed for descriptive and inferential statistics (Pearson correlation tests, independent t-test, one-way ANOVA and general linear model) using SPSS version 16. Difficulty in completing household tasks and breastfeeding at the same time (32.5 percent) was the most common challenge reported by mothers. There was an inverse and significant correlation between perceived social support and experiencing challenges (r = -0.199؛ p = .001). Based on the adjusted general linear model, with increasing social support, the score of breastfeeding challenges decreased (B = -0.165; 95 percent CI: -0.07-0.25, p < .001). Considering the relationship between perceived social support and the challenges experienced during breastfeeding, it can be concluded that adequate support from family along with training and guidance from health care providers can lead women to have better breastfeeding experiences and overcome breastfeeding problems.

Lactating nurses' experiences of return to work after lifting COVID-19 lockdown: A qualitative study

Aim

To explore the lactating nurses' experiences of return to work after lifting COVID-19 lockdown.

Background

Return to work is a key reason for the low rates of breastfeeding. Especially after lifting COVID-19 lockdown, case counts reached recorded highs. So lactating nurses face more challenges when they return to work.

Method

The empirical phenomenology method was used to conduct a qualitative study. Lactating nurses were recruited in a tertiary hospital through purposive and snowball sampling, and participated in semi-structured video interviews. Colaizzi's method was used to analyze the data.

Results

Three themes and 10 sub-themes emerged from the interview data of 15 participants. The first theme was "preparation for return to work", which helped lactating nurses adapt to return to work quickly. The second was "experiences of return to work". The inconvenience of pumping was mentioned repeatedly. In addition, the flexible work schedule was highlighted. The third was "experiences of infection". The attitudes toward breastfeeding differed due to different perceptions of COVID-19.

Conclusions

Lactation nurses easily interrupted or stopped breastfeeding when they returned to work after lifting COVID-19 lockdown. Recommendations include the further provision of longer periods of leave, flexible working arrangements, separate facilities for breast pumping, and breastfeeding strategies for epidemics.

Effectiveness of an optional breastfeeding course for multidisciplinary undergraduate healthcare students: A quasi-experimental study

AIMS

This study aimed to examine and quantify the effectiveness of an optional breastfeeding course for multidisciplinary undergraduate healthcare students and to provide advice for education improvement based on students' characteristics and learning feedback.

BACKGROUND

Breastfeeding has received global awareness and educating undergraduate healthcare students is a prospective way to promote breastfeeding. This is the first report from mainland China to verify the education effects and formulate a proposal for improvement.

DESIGN

A quasi-experimental study with a one-group pretest-posttest design.

METHODS

An optional breastfeeding course covering eight topics based on the Health Belief Model was conducted for multidisciplinary students in a medical college. The Breastfeeding Knowledge Questionnaire, Iowa Infant Feeding Attitude Scale and Breastfeeding Promotion Intention Scale were completed for pre- and post-education comparison. The Wilcoxon signed-rank test, MannWhitney U test, KruskalWallis test and chi-square test were used for statistical analysis. The class average normalized gain and individual students' normalized gain were calculated to quantify the effectiveness from the perspective of learning gain.

RESULTS

From March to November 2021, 102 students specialized mainly in nursing, clinical medicine, medical imaging technology and midwifery took the course. Knowledge, attitudes and intention scores improved significantly (Z = 8.70, 8.72, 7.64, respectively, p < .001) and the class average normalized gains were 81.0%, 52.3% and 70.6%, respectively. Insignificant differences were found for students of different genders and categories of specialties (p > .05). Students of first year had significantly higher individual normalized gains (p < .05). In learning feedback, the top-ranked advice for course improvement was to increase practice and experience (75.5%).

CONCLUSIONS

This optional breastfeeding course produced medium to high learning gains for multidisciplinary healthcare undergraduates. Independent breastfeeding education based on behavioral theory for multidisciplinary students is recommended to be conducted in medical colleges. The addition of practice and experience may add value to such education.

Maternal Characteristics, Intention, Self-Efficacy, Perceived Social Support, and Exclusive Breastfeeding Practice: Structural Equation Modeling Approaches

Breast milk is a perfect food for infants; however, the rate of exclusive breastfeeding is low. The relationship between exclusive breastfeeding practices and influencing factors is complex and remains unclear. This cross-sectional study was conducted in Changsha County, China, and 414 mothers were enrolled. An online questionnaire was used to collect data on general information, obstetrics and gynecology characteristics, the initial breastfeeding intention, breastfeeding practice, frequency of attending conventional breastfeeding programs before delivery, the status of breastfeeding self-efficacy, and the status of perceived social support. Structural equation modeling (SEM) was used to estimate the association between exclusive breastfeeding and potential risk factors of failing to practice exclusive breastfeeding for 6 months. The rate of exclusive breastfeeding for 6 months was 46.1%. The median and interquartile range of the scores for breastfeeding self-efficacy and perceived social support were 51.0 (18.0) and 68.0 (20.0), respectively. Factors that were statistically significant in the univariate analysis were included in the SEM and model fitness was acceptable based on the results. Exclusive breastfeeding for 6 months was directly associated with intention and self-efficacy, while it was indirectly associated with perceived social support and frequency of attending a breastfeeding program. The findings support the recommendation that comprehensive breastfeeding promotion strategies should be implemented to call on the intention and self-efficacy of breastfeeding mothers through various measures, such as education or providing medical and health services.

Effects of spousal support in the early postpartum period on breastfeeding motivation in patriarchal societies

Background and Purpose: Breastfeeding is important with regard to public health. Our aim was to examine effects of spousal support in the early postpartum period on breastfeeding motivation in patriarchal societies. Methods: Study was descriptive, cross-sectional, correlational design. Study was conducted in a University Hospital in Inland Anatolia Region in Turkey. It included primiparous and multiparous women. Results: Analysis showed a significant positive, moderate relation between spousal support and breastfeeding motivation in the primiparous women; spousal support accounted for 23.8% of breastfeeding motivation of the women. There was a significant, positive weak relation between spousal support and breastfeeding motivation in the multiparous women; spousal support explained 8.2% of breastfeeding motivation in these women. Conclusion: Spousal support in the early postpartum period was found to have a positive influence on improvement of breastfeeding motivation. However, it could explain a small percentage of breastfeeding motivation. New strategies should be created to encourage spouses to get involved in breastfeeding.

The Effect of a Structured Individualized Educational Intervention on Breastfeeding Rates in Greek Women

Breastfeeding rates remain extremely low in Greece and women with gestational diabetes mellitus and hypothyroidism may experience additional difficulties. The aim of the study was to investigate the effect of a structured individualized lactation educational intervention by a midwife on increasing breastfeeding rates in women with endocrine disorders and low-risk women compared to women receiving standard care, 24 months after delivery. Two-hundred women made up the study population. Half of them were experiencing endocrine pregnancy disorders and 100 women constituted the low-risk pregnancy standard care control group. Women who were breastfeeding exclusively were significantly higher in the midwifery intervention group with endocrine disorders, namely breastfeeding continued at four months (breastfeeding: 20% vs. 12%, exclusive breastfeeding: 50% vs. 26%, p = 0.0228), and at six months after childbirth (breastfeeding: 54% vs. 28%, exclusive breastfeeding: 32% vs. 12%, p = 0.0011), compared to the standard care control group with endocrine disorder. The low-risk midwifery intervention group breastfed at four months (22% vs. 14%, p = 0.0428) and at six months (52% vs. 26%, p = 0.0018) at higher rates compared to the standard care control group. In addition, exclusive breastfeeding was significantly higher in the low-risk midwifery intervention group at four months (46% vs. 20%, p = 0.0102) and six months (38% vs. 4%, p < 0.0001) compared to the standard care control group. This study was the first attempt of a structured midwifery breastfeeding education in Greece and its major contribution reflects a significant positive impact on breastfeeding rates in terms of duration and exclusivity in women with gestational endocrine disorders as well as in low-risk women, and could possibly be applied and instituted in everyday clinical practice to increase the low breastfeeding rates in Greece.