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Suppiger D, Natalucci G, Reinelt T. Reliability and validity of the German version of the Iowa infant feeding attitude scale (IIFAS-G) and relations to breastfeeding duration and feeding method. Int Breastfeed J 2024; 19:58. [PMID: 39169418 PMCID: PMC11337571 DOI: 10.1186/s13006-024-00665-6] [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: 09/14/2023] [Accepted: 08/12/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Public health initiatives (e.g., the Baby Friendly Hospital Initiative) have led to an increase in breastfeeding rates worldwide. However, as (exclusive) breastfeeding duration is still below WHO recommendations, it is crucial to understand the factors that influence decisions on breastfeeding practice. Modifiable psychological factors such as intention to breastfeed have therefore become targets of recent interventions. As the intention to breastfeed is among the strongest predictors of breastfeeding duration, reliable tools for measuring the intention to breastfeed are needed. The Iowa Infant Feeding Attitude Scale (IIFAS) measures attitudes towards infant feeding and is used in various languages and across different cultural contexts. However, there has been no German version of the IIFAS (IIFAS-G) so far. The aim of this study was to investigate reliability, validity, and associations of the IIFAS-G with feeding method and breastfeeding duration. METHODS Between August and November 2022, a total of 353 mothers (Mage = 35 years, SDage = 4.2 years) of singleton infants (47.3% female (1 undetermined), Mage = 10.8 months, SDage = 4.7 months, age range: 3-547 days; 90.4% living in Switzerland) participated in an online survey. The IIFAS-G was administered as a part of a larger study on early child development and infant feeding method. RESULTS The translated IIFAS-G showed unsatisfactory model fit for the two factor 17-item solution. Four items showed low factor loadings. After item reduction, a 13-item two factor solution showed satisfactory model fit (CFI = 0.92, TLI = 0.90, RMSEA = 0.07) and high internal consistency (Cronbach's α = 0.85). The IIFAS-G score was higher for mothers who exclusively breastfed their infants compared to mothers who additionally or exclusively fed infant formula. Moreover, mothers with higher IIFAS-G scores were less likely to stop breastfeeding their child over the course of 1.5years (HR = 0.87). CONCLUSION A shorter two-factor IIFAS-G is proposed to investigate attitudes towards breastfeeding and formula feeding in German-speaking mothers.
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Affiliation(s)
- Debora Suppiger
- Family Larsson-Rosenquist Foundation Center for Neurodevelopment, Growth, and Nutrition of the Newborn, Department of Neonatology, University Hospital Zurich and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland.
| | - Giancarlo Natalucci
- Family Larsson-Rosenquist Foundation Center for Neurodevelopment, Growth, and Nutrition of the Newborn, Department of Neonatology, University Hospital Zurich and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland
| | - Tilman Reinelt
- Family Larsson-Rosenquist Foundation Center for Neurodevelopment, Growth, and Nutrition of the Newborn, Department of Neonatology, University Hospital Zurich and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland
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Takahashi Y, Brimdyr K, Cadwell K. Does an early hands-on breastfeeding intervention by midwives affect nipple pain incidence? An observational pilot study. Jpn J Nurs Sci 2024:e12613. [PMID: 39138899 DOI: 10.1111/jjns.12613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 06/20/2024] [Accepted: 07/14/2024] [Indexed: 08/15/2024]
Abstract
AIM To describe the timing and characteristics of midwives' hands-on interruptions of newborns' behavior while in skin-to-skin contact during the first hour after birth and to elucidate the relationship between these hands-on interruptions and the incidence of nipple pain during the first 4 days postpartum. METHODS An observational pilot study was conducted at a Baby-Friendly® hospital in Japan from 2016 to 2018. Iterative analysis of video recordings from a larger study of the behavior of newborns while skin-to-skin with their mothers in the first hour after birth found 16 full-term newborns who were born vaginally and that met the inclusion criteria of a midwife's hands-on intervention (HOI) interrupting the infant's progress toward breast self-attachment. The timing of the HOI and the stage of the newborn's progress through Widström's 9 Stages was noted by two research assistants who had been blinded to the medical records. The degree of nipple pain after breastfeeding was self-evaluated by mothers each day during their hospitalization. All data were statistically analyzed. RESULTS Interrupting the infant's progressive behaviors in the first hour after birth by midwives' hands-on "help" to breastfeed, may increase nipple pain during the 4 days after birth. One hundred percent of the mothers reported nipple pain in the postpartum with the highest pain reports occurring on day 4. CONCLUSION Interrupting skin-to-skin contact with HOI does not decrease the incidence of nipple pain during the first days postpartum. HOI for newborn infants was not shown to support breastfeeding in the early postnatal period.
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Affiliation(s)
- Yuki Takahashi
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kajsa Brimdyr
- Healthy Children Project's Center for Breastfeeding, Maternal Child Health, Nagoya, Japan
| | - Karin Cadwell
- Healthy Children Project's Center for Breastfeeding, Maternal Child Health, Nagoya, Japan
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Valero-Chillerón MJ, Soriano-Vidal FJ, Mena-Tudela D, Cervera-Gasch Á, Vila-Candel R, Llagostera-Reverter I, Andreu-Pejó L, Ortíz-Mallasén V, González-Chordá VM. Monitoring of the Main Reasons for Early Abandonment of Breastfeeding during the First Six Months of Life: A Secondary Analysis. NURSING REPORTS 2024; 14:1937-1947. [PMID: 39189274 PMCID: PMC11348122 DOI: 10.3390/nursrep14030144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 08/01/2024] [Accepted: 08/04/2024] [Indexed: 08/28/2024] Open
Abstract
The rate of six-month-old infants exclusively breastfed in Spain remains below the recommended rate. This study aimed to explore in detail the evolution of feeding during the first six months of life of a group of newborns, as well as to identify the reasons reported by the mothers for feeding change. A secondary analysis of two prospective longitudinal observational studies was conducted. In both studies, women participants, during the clinical puerperium, opted for exclusive breastfeeding for their newborns. The participants were followed up during the infants' first six months. A sample size of 314 participants was obtained, of which 77.1% (n = 232) were of Spanish origin, and 51% (n = 160) were primiparous. The prevalence of exclusive breastfeeding at six months was 55.4% (n = 174). During the first four months of life, the main reason for early abandonment of breastfeeding was the perception of insufficient milk production. After the fourth month, the predominant reason was starting work. Statistically significant differences were observed between the reasons for giving up and the total weeks of exclusive breastfeeding (p < 0.001) and total weeks of breastfeeding (p = 0.002). Early weaning from breastfeeding is a multifactorial phenomenon. However, depending on the moment cessation occurs, some reasons predominate over others and, in many cases, can be prevented. These results indicate the need to continue investing efforts to promote and protect breastfeeding in Spain.
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Affiliation(s)
- María Jesús Valero-Chillerón
- Nursing Research Group (GIENF Code 241), Nursing Department, Universitat Jaume I, 12071 Castellόn, Spain
- Joint Research Unit PECAWOL (Perinatal Care and Women’s Health) FISABIO-UJI, 46020 Valencia, Spain
| | - Francisco Javier Soriano-Vidal
- Joint Research Unit PECAWOL (Perinatal Care and Women’s Health) FISABIO-UJI, 46020 Valencia, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO-SP), 46020 Valencia, Spain
- Department of Nursing, Universitat de València, 46010 Valencia, Spain
- Department of Obstetrics and Gynaecology, Hospital Lluis Alcanyis, 46800 Xàtiva, Spain
| | - Desirée Mena-Tudela
- Nursing Research Group (GIENF Code 241), Nursing Department, Universitat Jaume I, 12071 Castellόn, Spain
- Joint Research Unit PECAWOL (Perinatal Care and Women’s Health) FISABIO-UJI, 46020 Valencia, Spain
- Feminist Institute, Universitat Jaume I, 12071 Castellón, Spain
| | - Águeda Cervera-Gasch
- Nursing Research Group (GIENF Code 241), Nursing Department, Universitat Jaume I, 12071 Castellόn, Spain
- Joint Research Unit PECAWOL (Perinatal Care and Women’s Health) FISABIO-UJI, 46020 Valencia, Spain
| | - Rafael Vila-Candel
- Joint Research Unit PECAWOL (Perinatal Care and Women’s Health) FISABIO-UJI, 46020 Valencia, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO-SP), 46020 Valencia, Spain
- La Ribera Primary Health Department, 46600 Alzira, Spain
- Faculty of Health Sciences, Universidad Internacional de Valencia (VIU), 46002 Valencia, Spain
| | - Irene Llagostera-Reverter
- Nursing Research Group (GIENF Code 241), Nursing Department, Universitat Jaume I, 12071 Castellόn, Spain
| | - Laura Andreu-Pejó
- Nursing Research Group (GIENF Code 241), Nursing Department, Universitat Jaume I, 12071 Castellόn, Spain
- Joint Research Unit PECAWOL (Perinatal Care and Women’s Health) FISABIO-UJI, 46020 Valencia, Spain
| | - Víctor Ortíz-Mallasén
- Nursing Research Group (GIENF Code 241), Nursing Department, Universitat Jaume I, 12071 Castellόn, Spain
| | - Víctor Manuel González-Chordá
- Nursing Research Group (GIENF Code 241), Nursing Department, Universitat Jaume I, 12071 Castellόn, Spain
- Joint Research Unit PECAWOL (Perinatal Care and Women’s Health) FISABIO-UJI, 46020 Valencia, Spain
- Nursing and Healthcare Research Unit (INVESTÉN-ISCIII), Institute of Health Carlos III, 28029 Madrid, Spain
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Teng YF, Ho YJ. The Influence of Prenatal Breastfeeding Self-Efficacy on Breastfeeding Behavior of Taiwanese Pregnant Women. J Hum Lact 2024; 40:445-453. [PMID: 38847354 DOI: 10.1177/08903344241254785] [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: 08/22/2024]
Abstract
BACKGROUND The benefits of breastfeeding for mothers and infants are well known. However, in Taiwan, the average breastfeeding rate remains below the World Health Organization recommendations. Breastfeeding self-efficacy is a known predictor of breastfeeding. RESEARCH AIMS To determine: (1) the relationship of sociodemographic factors to prenatal breastfeeding self-efficacy, and (2) the relationship of sociodemographic factors and prenatal breastfeeding self-efficacy to breastfeeding behavior at 8 weeks postpartum among women living in Taiwan. METHODS This was a prospective cohort study of 206 pregnant women collected in an outpatient clinic located in Taiwan. The validated Chinese version of the Prenatal Breastfeeding Self-Efficacy Scale (PBSES) was used to measure self-efficacy for breastfeeding during pregnancy. At 8 weeks postpartum, participants were contacted by telephone to obtain information regarding infant feeding method and duration. RESULTS The mean age of the pregnant women was 32 years, and the mean prenatal breastfeeding self-efficacy score was 78.6 (SD = 10.6). Scores differed across levels of maternal education, previous breastfeeding experience, and support systems. Prenatal breastfeeding self-efficacy scores were highest among participants reporting spouse support versus other types of support. Maternal age and prenatal breastfeeding self-efficacy were predictive of breastfeeding duration. A 1-year increase in maternal age was associated with a 6% lower likelihood of breastfeeding for at least 2 months postpartum, and a 1-point increase in the prenatal breastfeeding self-efficacy score was associated with a 14% increase in the likelihood of breastfeeding for at least 2 months postpartum. CONCLUSIONS Prenatal breastfeeding self-efficacy may help predict breastfeeding continuation among Taiwanese women in the first 2 months postpartum.
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Affiliation(s)
- Ya-Fang Teng
- Department of Nursing, Jen-Ai Hospital, Taichung, Taiwan
| | - Yen-Ju Ho
- Central Taiwan University of Science and Technology, Department of Nursing, Taichung, Taiwan
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Henshaw E, Cooper M, Wood T, Krishna S, Lockhart M, Doan S. A randomized controlled trial of the Happy, Healthy, Loved personalized text-message program for new parent couples: impact on breastfeeding self-efficacy and mood. BMC Pregnancy Childbirth 2024; 24:506. [PMID: 39060974 PMCID: PMC11282811 DOI: 10.1186/s12884-024-06684-9] [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: 04/04/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Breastfeeding self-efficacy has been identified as an important influence on breastfeeding outcomes. Among new parent couples, partners are uniquely positioned to be sources of support for developing breastfeeding self-efficacy, yet few breastfeeding programs have attempted to involve partners directly. The purpose of this study was to test the impact of a novel program, Happy, Healthy, Loved, on breastfeeding self-efficacy and maternal mood through emphasizing partner support and actively addressing postpartum-specific stress management in a tailored text message delivery program. METHODS A randomized trial was conducted in which primiparous mother-partner dyads intending to exclusively breastfeed were recruited at midwestern hospitals 2-3 days after delivery. The clinical trial was pre-registered at clinicaltrials.gov (#NCT04578925, registration date 7/24/2020). Couples were randomized to receive intervention or an attentional control. Couples randomized to the intervention group then completed a brief interactive educational tablet program together (Happy, Healthy, Loved), followed by 6 weeks of tailored text messages providing reminders, coping strategies, and motivational milestones to improve breastfeeding self-efficacy. Participants in the control group received usual care followed by 6 weeks of attentional control text messages about infant development. Surveys were delivered at baseline, 6 weeks, and 6 months postpartum to both mother and partner to assess breastfeeding self-efficacy, mood, and social support (n = 62 couples). RESULTS Outcomes of ANCOVA with baseline self-efficacy as a covariate showed a significant effect of intervention on 6 months breastfeeding self-efficacy when compared to control group. No other significant differences were found at 6 weeks or 6 months postpartum in breastfeeding self-efficacy, depressive or anxious symptoms. CONCLUSIONS Results of the present investigation suggest that a text-based dyad intervention improved breastfeeding self-efficacy at 6 months, but not 6 weeks, postpartum, indicating that text-based mother-partner interventions are a promising direction to continue exploring in postpartum health research. TRIAL REGISTRATION Clinicaltrials.gov #NCT04578925.
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Affiliation(s)
- Erin Henshaw
- Department of Psychology, Denison University, 100 W. College St, Granville, OH, 43023, USA.
| | - Marie Cooper
- Riverside Methodist Hospital, OhioHealth, 3535 Olentangy River Rd., Columbus, OH, USA
| | - Teresa Wood
- OhioHealth, 3535 Olentangy River Rd, Columbus, OH, 43214, USA
| | - Sanchita Krishna
- OhioHealth Research Institute, 3535 Olentangy River Rd, Columbus, OH, 43214, USA
| | - Marie Lockhart
- OhioHealth Research Institute, 3535 Olentangy River Rd, Columbus, OH, 43214, USA
| | - Stacey Doan
- Berger Institute, Claremont McKenna College, 888 N. Columbia Ave, Claremont, CA, 91711, USA
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Esquerra-Zwiers AL, Heter M, Perecki A, Jackson O, Jongekryg DA, Yurk B. Comparison of human milk bottle with infant/toddler test weights in the community setting. BMC Nutr 2024; 10:105. [PMID: 39054548 PMCID: PMC11270915 DOI: 10.1186/s40795-024-00911-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 07/15/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND The accuracy of infant intake using test weights (TWs), the change in weight before and after an infant feeds, has only been validated in hospitalized premature infants. This study's primary aim was to identify how accurate parent infants/toddler (< 2 years old) TWs are at measuring infant intake. METHODS Data were collected from 101 paired bottle and infant/toddler TWs with 31 participants. Parents participated in the feeding sessions by completing infant/toddler TWs blinded to the researcher. Research assistants completed human milk bottle TWs. Infants were fed previously expressed human milk, initially 30 g, but volumes were increased to not exceed the scale's capacity. RESULTS The mean difference between the bottle TWs measured using the Tanita and OHAUS scales was not significantly different from zero (95% CI (Tanita - OHAUS): (-0.251, 0.108) g). The mean difference between infant/toddler and bottle TWs was significantly different from 0 (95% CI (infant-bottle): (-3.45, -0.915 g or -3.57, -0.95 mL). Infant/toddler and bottle TWs were in agreement with a difference of 2.18 g (SD = 6.63) or 2.25 mL within the scale stated accuracy. CONCLUSIONS The Tanita infant digital scale accurately measures bottle TWs. The differences in parent infant/toddler TWs are within a clinically acceptable range.
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Affiliation(s)
| | - Madeline Heter
- Hope College Nursing Department, Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA
| | - Anastasia Perecki
- Hope College Nursing Department, Children's Hospital of Michigan, Detroit, MI, USA
| | - Olivia Jackson
- Hope College Nursing Department, DeVos Children's Hospital, Grand Rapids, MI, USA
| | - D Addam Jongekryg
- Hope College Nursing Department, Medical University of South Carolina, Charleston, SC, USA
| | - Brian Yurk
- Hope College Mathematics and Statistics Department, Holland, MI, USA
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Brani P, Mrvoljak-Theodoropoulou I, Pechlivani F, Iliadou M, Antoniou E, Daskalakis G, Drakakis P, Dagla M. Breastfeeding Intention and Breastfeeding Postpartum Outcomes between High-Risk and Low-Risk Pregnant Women: A Greek Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:755. [PMID: 38929000 PMCID: PMC11204224 DOI: 10.3390/ijerph21060755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 05/26/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND This prospective cohort study, conducted from pregnancy to six months postpartum and grounded in STROBE methodology, quantitatively explores the relationship between antenatal breastfeeding intentions and subsequent breastfeeding outcomes among high-risk pregnant women, compared to a low-risk pregnancy group. METHODS The study was conducted in one of the largest public hospitals in Attica that provides care to pregnant women, enrolling 380 participants divided into high-risk (n = 200) and low-risk (n = 180) cohorts. Data were collected over 20 months (starting from the end of May 2020 until January 2022), spanning from pregnancy to six months postpartum, via comprehensive questionnaires. RESULTS Statistical analysis revealed a pronounced correlation between prenatal breastfeeding intentions and actual breastfeeding behaviors across both groups. Specifically, 81.1% of women in the high-risk group and 82.5% in the low-risk group expressed intentions of exclusively breastfeeding during pregnancy. By six months postpartum, 54.9% of the high-risk and 64.3% of the low-risk pregnancy group managed to sustain breastfeeding. Extended antenatal hospitalization emerged as a statistically significant factor (p = 0.045) negatively impacting exclusive breastfeeding intentions among high-risk pregnancies. CONCLUSION The findings illuminate the critical influence of antenatal intentions on breastfeeding outcomes, particularly among high-risk pregnancies. Moreover, the study identifies the detrimental effect of prolonged hospital stays on breastfeeding aspirations. These insights underscore the necessity for nuanced, supportive interventions aimed at bolstering breastfeeding rates, thereby advancing maternal and neonatal health objectives aligned with World Health Organization recommendations.
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Affiliation(s)
- Panagiota Brani
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (M.I.); (E.A.)
| | | | - Fani Pechlivani
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (M.I.); (E.A.)
| | - Maria Iliadou
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (M.I.); (E.A.)
| | - Evangelia Antoniou
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (M.I.); (E.A.)
| | - Georgios Daskalakis
- First Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Peter Drakakis
- Third Department of Obstetrics and Gynecology, University General Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Maria Dagla
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (M.I.); (E.A.)
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Grattan RE, London SM, Bueno GE. Perceived pressure to breastfeed negatively impacts postpartum mental health outcomes over time. Front Public Health 2024; 12:1357965. [PMID: 38638486 PMCID: PMC11024305 DOI: 10.3389/fpubh.2024.1357965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/15/2024] [Indexed: 04/20/2024] Open
Abstract
Introduction Positive maternal mental health is associated with improved outcomes for infants, and yet the consideration of maternal mental health is often neglected in breastfeeding interventions. Breastfeeding interventions typically focus on breastfeeding promotion, and do not always include supports for the mother. This may result in isolated perceived pressure to breastfeed, the mental health impacts of which are not well understood. Methods This mixed-methods, longitudinal study examined whether perceived pressure to breastfeed was associated with depression, suicide ideation, anxiety, birth trauma and stress concurrently and 4 weeks later for postpartum mothers. It also examined qualitative experiences of feeding. Results Perceived pressure to breastfeed was associated with increased anxiety, stress and birth trauma symptoms four weeks later. Thematic analysis suggested this may be due to difficulties living up to the "breast is best" ideal, believing breastfeeding was part of success as a mother, lack of choices and autonomy in feeding choices for infants and general lack of support. Discussion As such it appears we may be doing more harm than good by focusing our interventions for breastfeeding primarily on increasing pressure to breastfeed, and interventions should consider strategies for promoting positive maternal mental health alongside breastfeeding.
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Affiliation(s)
- Rebecca E. Grattan
- School of Psychology, Te Herenga Waka, Victoria University of Wellington, Wellington, New Zealand
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Rodríguez-Gallego I, Corrales-Gutierrez I, Gomez-Baya D, Leon-Larios F. Effectiveness of a Postpartum Breastfeeding Support Group Intervention in Promoting Exclusive Breastfeeding and Perceived Self-Efficacy: A Multicentre Randomized Clinical Trial. Nutrients 2024; 16:988. [PMID: 38613021 PMCID: PMC11013075 DOI: 10.3390/nu16070988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
There are numerous recognized benefits of breastfeeding; however, sociocultural, individual, and environmental factors influence its initiation and continuation, sometimes leading to breastfeeding rates that are lower than recommended by international guidelines. The aim of this study was to evaluate the effectiveness of a group intervention led by midwives supporting breastfeeding during the postpartum period in promoting exclusive breastfeeding, as well as to assess the impact of this intervention on perceived self-efficacy. This was a non-blind, multicentric, cluster-randomized controlled trial. Recruitment started October 2021, concluding May 2023. A total of 382 women from Andalusia (Spain) participated in the study. The results showed that at 4 months postpartum there was a higher prevalence of breastfeeding in the intervention group compared to formula feeding (p = 0.01), as well as a higher prevalence of exclusive breastfeeding (p = 0.03), and also at 6 months (p = 0.01). Perceived self-efficacy was similar in both groups for the first two months after delivery, which then remained stable until 4 months and decreased slightly at 6 months in both groups (p = 0.99). The intervention improved the average scores of perceived self-efficacy and indirectly caused higher rates of exclusive breastfeeding (p = 0.005). In conclusion, the midwife-led group intervention supporting breastfeeding proved to be effective at maintaining exclusive breastfeeding at 6 months postpartum and also at increasing perceived self-efficacy.
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Affiliation(s)
- Isabel Rodríguez-Gallego
- Foetal Medicine, Genetics and Reproduction Unit, Virgen del Rocío University Hospital, 41013 Seville, Spain;
- Red Cross Nursing University Centre, University of Seville, 41009 Seville, Spain
| | - Isabel Corrales-Gutierrez
- Surgery Department, Faculty of Medicine, University of Seville, 41009 Seville, Spain
- Foetal Medicine Unit, Virgen Macarena University Hospital, 41009 Seville, Spain
| | - Diego Gomez-Baya
- Department of Social, Developmental and Educational Psychology, Universidad de Huelva, 21007 Huelva, Spain
| | - Fatima Leon-Larios
- Nursing Department, School of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
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McGuigan M, Larkin P. Laid-back breastfeeding: knowledge, attitudes and practices of midwives and student midwives in Ireland. Int Breastfeed J 2024; 19:13. [PMID: 38373983 PMCID: PMC10877745 DOI: 10.1186/s13006-024-00619-y] [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: 07/10/2023] [Accepted: 02/03/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Despite concerted efforts by policy developers, health professionals and lay groups, breastfeeding rates in Ireland remain one of the lowest in world, with 63.6% of mothers initiating breastfeeding at birth, dropping to 37.6% of mothers breastfeeding exclusively on hospital discharge. Nipple trauma and difficulties with baby latching are major contributors to the introduction of formula and discontinuation of breastfeeding. Research shows laid-back breastfeeding (LBBF) significantly reduces breast problems such as sore and cracked nipples, engorgement, and mastitis as well as facilitating a better latch. Although the benefits of LBBF are well documented, this position does not seem to be routinely suggested to mothers as an option when establishing breastfeeding. This study aims to determine midwives' and student midwives' knowledge, attitudes, and practices of using laid-back breastfeeding in Ireland. METHOD A cross-sectional descriptive survey distributed to midwives and student midwives in three maternity hospitals in Ireland and two online midwifery groups based in the Republic of Ireland, during June, July, and August 2021. RESULTS Two hundred and fifty-three valid responses were received from nine maternity units. Most participants (81.4%) were aware of laid-back breastfeeding. However, only 6.8% of respondents cited it as the position they most frequently use. Over one-third (38.34%) had never used this position with mothers. Those more likely to suggest LBBF had personal experience of it, were lactation consultants or working towards qualification, or had participated in specific education about LBBF. Barriers included lack of education, confidence, time, and experience. Further issues related to work culture, a tendency to continue using more familiar positions and concerns about mothers' anatomy and mothers' unfamiliarity with LBBF. CONCLUSION Although there was a high level of awareness of laid-back breastfeeding among midwives and student midwives, there are challenges preventing its use in practice. Education specifically related to using LBBF in practice is required to overcome the barriers identified. A greater understanding of mothers' and babies' intrinsic feeding capacities may give midwives more confidence to recommend this method as a first choice, potentially leading to more successful breastfeeding establishment and maintenance.
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Affiliation(s)
- Margaret McGuigan
- Staff Midwife, Our Lady of Lourdes Hospital, Co. Louth, Drogheda, Ireland.
| | - Patricia Larkin
- The School of Health and Science, Dundalk Institute of Technology, Co. Louth, Ireland
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Kam RL, Bennetts SK, Cullinane M, Amir LH. "I didn't want to let go of the dream": Exploring women's personal stories of how their low milk supply was discovered. SEXUAL & REPRODUCTIVE HEALTHCARE 2024; 40:100953. [PMID: 38437771 DOI: 10.1016/j.srhc.2024.100953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 03/06/2024]
Abstract
PROBLEM Low milk supply is the most common reason women give for stopping breastfeeding early and yet there is a lack of understanding about these women's experiences. BACKGROUND Most women plan to breastfeed but many experience challenges such as low milk production, leading them to seek help and support. AIM To explore women's personal stories of how their low supply was discovered. METHODS Inductive template analysis was used to analyse free-text online survey responses of women from the United States of America, Australia and the United Kingdom. FINDINGS 384 women responded to the open-ended survey item between October 2021 and January 2022. We identified three themes: (i) Events and observations: From 'risk factors' to 'failure of breast changes' to 'my baby was so unhappy', (ii) Seeking support and taking action: 'I tried everything' and (iii) A rollercoaster of emotion: 'I didn't want to let go of the dream'. DISCUSSION Our findings emphasise women's need to feel heard and understood and their quest to find answers. The rollercoaster of emotions they experienced largely stemmed from a gap between the expectations and reality of breastfeeding. Some participants described accepting a different feeding journey. CONCLUSION Findings underscore the need for quality and accessible psychosocial support for women experiencing low milk supply, in addition to the provision of evidence-based advice.
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Affiliation(s)
- Renee L Kam
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia.
| | - Shannon K Bennetts
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia; Intergenerational Health Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Meabh Cullinane
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia
| | - Lisa H Amir
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia; Intergenerational Health Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Breastfeeding Service, The Royal Women's Hospital, Parkville, Victoria, Australia
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12
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Chou HF, Wang YF, Chen TL, Gau ML. Development and Validation of a Breastfeeding Health Literacy Scale (BFHLS) for Taiwanese Pregnant Women. J Hum Lact 2024; 40:25-32. [PMID: 38006249 DOI: 10.1177/08903344231211494] [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: 11/26/2023]
Abstract
BACKGROUND Breastfeeding is the best source of nutrition for infants. Health literacy is a critical factor affecting breastfeeding rates. RESEARCH AIMS The aim of this research was to develop and test the Breastfeeding Health Literacy Scale to determine its validity and reliability. METHODS This study featured a cross-sectional telephone survey design. Researchers reviewed the literature and used expert opinions to develop the content-validated 30-item Breastfeeding Health Literacy Scale covering five dimensions. We examined internal consistency, exploratory factor analysis, and confirmatory factor analysis to assess reliability and construct validity. A Taiwanese government organization provided potential participants' contact information. After mailing an invitation letter, researchers phoned all participants to invite participation, obtain oral consent and complete a Breastfeeding Health Literacy Scale and collect demographic data. RESULTS Participants (N = 300) had a mean age of 31.8 (SD = 4.66) years. The item-level content validity index was 0.67 to 1.00 and scale-content validity index was 0.94. After performing exploratory factor analysis, three factors were extracted. Examining content factor analysis for the three factors resulted in χ2/df = 2.05; p < .001; goodness of fit index = 0.90; Comparative Fit Index (CFI) = 0.96; and Root Mean Square Error of Approximation (RMSEA) = 0.06. Cronbach's alphas on the total scale and the subscales ranged from 0.87 to 0.94. Women with multigravida, breastfeeding information from physicians and nurses, and previous breastfeeding experience had better breastfeeding health literacy. CONCLUSIONS Psychometric analysis demonstrated that the newly developed 20-item Breastfeeding Health Literacy Scale is a valid self-assessment instrument. Improving breastfeeding health literacy during pregnancy could help enable breastfeeding success.
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Affiliation(s)
- Hsueh-Fen Chou
- Department of Nurse-Midwifery and Women Health, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei
| | - Ya-Fen Wang
- Department of Nursing, College of Nursing, Kent State University, Kent, OH, USA
| | - Tzu-Ling Chen
- Department of Nurse-Midwifery and Women Health, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei
| | - Meei-Ling Gau
- Department of Nurse-Midwifery and Women Health, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei
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13
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Agarwal R, Eddis-Finbow M, Tam J, Broatch J, Bussey KJ. New Validated Tool to Diagnose Breastfeeding Dysfunction. J Hum Lact 2024; 40:120-131. [PMID: 38037896 DOI: 10.1177/08903344231209306] [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: 12/02/2023]
Abstract
BACKGROUND Breastfeeding behaviors and experiences exist on a continuum. What differentiates normal from dysfunctional is defined by frequency and severity. No current validated tool addresses the subjective experience of dyads with a predictive score that can be followed over time. RESEARCH AIM To create and validate a self-report tool to assess breastfeeding and evaluate its ability to predict risk of breastfeeding dysfunction. METHODS This study used a cross-sectional design to determine the validity of a novel instrument to assess breastfeeding dysfunction. We gave the initial questionnaire to 2085 breastfeeding dyads. We assessed content validity by comparison with other tools. We used exploratory factor analysis with varimax rotation for concept identification and Cronbach's alpha for internal consistency. We employed logistic regression to assess the tool's ability to differentiate between normal breastfeeding and breastfeeding dysfunction. RESULTS Factor analysis mapped 17 questions to four concepts to create a score (FLIP; flow, latch, injury [to the nipple], and post-feed behavior). Internal consistency and reliability of the scores in these concepts were acceptable (Cronbach's alpha ≥ 0.087 for all measures). A logistic regression model that controlled for infant age, with a breastfeeding dysfunction risk classification threshold of 60%, yielded a correct classification of 88.7%, with 93.1% sensitivity, 64.6% specificity, and a 6.5% false positive rate. CONCLUSIONS The FLIP score was determined to be a valid and reliable instrument for quantifying the severity of breastfeeding dysfunction in children under 1 year old. Further studies will assess its usefulness in the management of breastfeeding dysfunction.
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Affiliation(s)
| | | | - Jodie Tam
- University of Arizona, Tucson, AZ, USA
| | | | - Kimberly J Bussey
- University of Arizona, Tucson, AZ, USA
- Midwestern University, Glendale, AZ, USA
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14
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Ramírez-Durán MDV, Gutiérrez-Alonso C, Moreno-Casillas L, Del Río-Gutiérrez A, González-Cervantes S, Coronado-Vázquez V. An Educational Intervention to Explore and Overcome Nursing Students' Breastfeeding Barriers: A Mixed-Methods Quasi-experimental Study. J Perinat Neonatal Nurs 2024; 38:E3-E13. [PMID: 37319350 PMCID: PMC10807748 DOI: 10.1097/jpn.0000000000000742] [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: 06/17/2023]
Abstract
BACKGROUND Nursing and midwifery students do not feel adequately prepared during their clinical training to support women who breastfeed, demanding more effective communication skills and knowledge. AIM The aim was to evaluate changes in students' breastfeeding knowledge. METHODS This was a mixed-methods quasi-experimental design. Forty students voluntarily participated. Using a 1:1 ratio, 2 groups were randomly created and completed the validated questionnaire ECoLaE (pre-post). The educational program consisted of focus groups, a clinical simulation, and a visit to the local breastfeeding association. FINDINGS The control group's posttest scores ranged from 6 to 20 (mean = 13.1, standard deviation [SD] = 3.0). The intervention group ranged from 12 to 20 (mean = 17.3, SD = 2.3). A Student's t test for independence samples was calculated ( P < .005, t = 4.5, median = 4.2). The intervention group had a mean difference of 10 points in improvement (mean =10.53, SD = 2.20, min = 7, max = 14), whereas the control group had a mean of 6 points (mean = 6.80, SD = 3.03, min = 3, max = 13). The multiple linear regression explained the intervention's effect. The regression model had statistical significance ( F = 4.87, P = 0.004), with an adjusted R2 = 0.31. The linear regression between the posttest scores and group variables after adjusting by age showed an increment of 4.1 points in the intervention posttest scores ( P < .005, 95% confidence interval [CI] = 2.1-6.1). CONCLUSIONS The educational program "Engage in breaking the barriers to breastfeeding" improved nursing students' knowledge.
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Affiliation(s)
| | | | - Luis Moreno-Casillas
- Department of Nursing, Catholic University “Santa Teresa de Jesús” Ávila, Avila, Spain
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15
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Madden SK, Ahuja KDK, Blewitt C, Hill B, Hills AP, Skouteris H. Understanding the pathway between work and health outcomes for women during the preconception, pregnancy, and postpartum periods through the framing of maternal obesity. Obes Rev 2023; 24:e13637. [PMID: 37655832 PMCID: PMC10909566 DOI: 10.1111/obr.13637] [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: 12/05/2022] [Revised: 07/25/2023] [Accepted: 08/09/2023] [Indexed: 09/02/2023]
Abstract
The link between work and health outcomes for preconception, pregnant, and postpartum (PPP) working women is complex. Further, innovation and enhanced understanding are required to address the work-related determinants of maternal obesity. However, workplace health promotion is not typically systems-based nor attuned to the specific needs and context of individual PPP women. We propose that to improve health outcomes for PPP women, we must understand the pathways between paid work and health for the individual woman by taking a systems-thinking approach. In this paper, we (a) outline the rationale for why the oversimplification or "dilution" of individual context may occur; (b) present a systems-informed pathway model (the "Context-Exposure-Response" Model) and overview of potential work-related impacts on health and wellbeing outcomes for PPP women using maternal obesity to provide context examples; (c) further investigate the role of motivational factors from a systems perspective; and (d) briefly examine the implications for policy, practice, and intervention design. It is anticipated that this research may act as a starting point to assist program developers, researchers, and policymakers to adopt a systems-focused perspective while contributing to the health improvement and obesity prevention of PPP women.
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Affiliation(s)
- Seonad K. Madden
- School of Health Sciences, College of Health and MedicineUniversity of TasmaniaLauncestonTasmaniaAustralia
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Kiran D. K. Ahuja
- School of Health Sciences, College of Health and MedicineUniversity of TasmaniaLauncestonTasmaniaAustralia
| | - Claire Blewitt
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Briony Hill
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Andrew P. Hills
- School of Health Sciences, College of Health and MedicineUniversity of TasmaniaLauncestonTasmaniaAustralia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Warwick Business SchoolUniversity of WarwickCoventryUK
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16
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Sevda KÖ, Sevil İ. Continuous Lactation Support Provided Through the WhatsApp Messaging Application: A Randomized Controlled Trial. J Hum Lact 2023; 39:666-678. [PMID: 37646262 DOI: 10.1177/08903344231192948] [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: 09/01/2023]
Abstract
BACKGROUND Although WhatsApp can be used to provide continuous lactation support, there are few studies on this subject. RESEARCH AIMS To determine the influence of lactation support provided through WhatsApp on the duration and exclusivity of breastfeeding, initiation of complementary feeding, breastfeeding problems, breastfeeding difficulties score, and the use of bottles and pacifiers. METHODS We conducted a randomized controlled trial assessing the efficacy of education and support provided through the cell phone based WhatsApp application. There were 129 primiparous participants recruited while attending a Baby-Friendly Hospital in Istanbul, Turkey. Participants were randomized to intervention (n = 64) and control (n = 65) groups. All participants received the same routine postpartum breastfeeding education in the hospital, and the intervention group received additional continuous breastfeeding education for 6 months. For both groups, data was collected by telephone interview on Days 7 and 15, and Months 1, 2, 4, and 6 months. T-tests were used to assess inter-group differences in duration of exclusivity of breastfeeding. Mixed-model ANOVA was used to compare breastfeeding difficulties scores. Chi-square tests were used to compare breastfeeding problems, feeding practices, and the proportion of the use of bottles and pacifiers. RESULTS The mean duration of exclusive breastfeeding for groups receiving breastfeeding support was higher (4.75, SD = 1.72) than that of the control group (2.21, SD = 1.98; p = 0.001). The change in the mean breastfeeding difficulties severity score between the initial and final measurements (17.03, SD = 8.66) was more in the intervention group than the control group (11.42, SD = 10.34, F = 4.081, p = 0.001). The proportion of exclusive breastfeeding in the 6th month was higher in the intervention group (62.5%) than in the control group (10.8%; p = 0.001). CONCLUSIONS The use of cellphone applications are accessible to both patients and health workers and offer a low-cost alternative for providing uninterrupted breastfeeding support.
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Affiliation(s)
- Korkut Öksüz Sevda
- Department of Midwifery, Kırsehir Ahi Evran University, Kırsehir, Turkey
| | - İnal Sevil
- Department of Midwifery, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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17
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Hookway L, Brown A. Barriers to optimal breastfeeding of medically complex children in the UK paediatric setting: a mixed methods survey of healthcare professionals. J Hum Nutr Diet 2023; 36:1857-1873. [PMID: 37501256 DOI: 10.1111/jhn.13202] [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: 03/08/2023] [Accepted: 06/15/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Breastfeeding is indisputably significant for infants and children, as well as their mothers. However, when breastfed children are admitted to the paediatric ward, they may experience breastfeeding modification due to clinical challenges, lack of staff training and institutional barriers. Although previous research has identified multiple barriers to optimal feeding within the maternity, neonatal and community settings, we know less about the barriers that exist in paediatrics. Paediatric healthcare staff attitudes, training and awareness as well as ward culture are likely to have an impact on the experiences of families but are relatively unresearched in the paediatric setting, especially with regard to the multidisciplinary nature of clinical paediatric care. The aim of this study was to explore the attitudes, awareness and perceived barriers to effective breastfeeding support provision, as well as healthcare professional perception of barriers for families. METHODS This was a mixed methods study utilising a questionnaire which was completed by 409 healthcare professionals who identified as working within the paediatric setting. It included responses from paediatricians of all training grades, nurses, healthcare assistants and allied health professionals. Qualitative data from professionals were analysed to develop themes around professional and perceived parent barriers to optimal breastfeeding. RESULTS This study explored the barriers experienced by staff, as well as professionals' perception of parent barriers. These included lack of knowledge of how to help, a default formula culture, the pressure of maintaining strict fluid balance and breastfeeding being a low priority in the face of critical illness. Of the paediatric departments represented by this sample of healthcare professionals, most had a relatively poor culture of supporting breastfeeding, with multiple institutional barriers identified. Most professionals felt that there was not enough support for breastfeeding families on an average shift, and a large proportion identified as being one of just a few breastfeeding advocates on their ward. CONCLUSION In this relatively motivated and experienced sample of healthcare professionals, there were many identified barriers to optimal breastfeeding which could potentially be addressed by training that is carefully nuanced for the paediatric population. Ensuring that paediatric multidisciplinary healthcare professionals have sufficient skills and knowledge would address the identified challenge of poor awareness of breastfeeding and of how to overcome clinical lactation obstacles. Further improvements at policy level need to address the systemic lack of resourcing in paediatrics, as well as the lack of embedded breastfeeding-friendly organisational structures.
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Affiliation(s)
- Lyndsey Hookway
- School of Health and Social Care, Swansea University, Swansea, Wales
- Centre for Lactation, Infant Feeding and Translation, Swansea, Wales
| | - Amy Brown
- School of Health and Social Care, Swansea University, Swansea, Wales
- Centre for Lactation, Infant Feeding and Translation, Swansea, Wales
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18
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Friedman C, Dabelea D, Keil AP, Adgate JL, Glueck DH, Calafat AM, Starling AP. Maternal serum per- and polyfluoroalkyl substances during pregnancy and breastfeeding duration. Environ Epidemiol 2023; 7:e260. [PMID: 37545807 PMCID: PMC10402953 DOI: 10.1097/ee9.0000000000000260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/01/2023] [Indexed: 08/08/2023] Open
Abstract
Per- and polyfluoroalkyl substances (PFAS) are endocrine-disrupting chemicals that may affect breastfeeding duration. We examined associations between maternal PFAS concentrations during pregnancy and breastfeeding cessation. We investigated potential effect modification by parity status. Methods Among 555 women enrolled in the Healthy Start study (2009-2014), we quantified maternal serum concentrations of 5 PFAS during mid- to late-pregnancy (mean 27 weeks of gestation). Participants self-reported their breastfeeding practices through 18-24 months postnatally. Among all participants and stratified by parity, we estimated associations between maternal PFAS concentrations and breastfeeding discontinuation by 3 and 6 months, using Poisson regression, and breastfeeding duration, using Cox regression. Results Median PFAS concentrations were similar to those in the general US population. Associations between PFAS and breastfeeding duration differed by parity status. After adjusting for covariates, among primiparous women, associations between PFAS and breastfeeding cessation by 3 and 6 months were generally null, with some inverse associations. Among multiparous women, there were positive associations between perfluorohexane sulfonate, perfluorooctane sulfonate, perfluorooctanoate (PFOA), and perfluorononanoate and breastfeeding cessation by 3 and 6 months. For example, per ln-ng/mL increase in PFOA, the risk ratio for breastfeeding discontinuation by 6 months was 1.45 (95% confidence interval, 1.18, 1.78). Hazard ratios reflected similar patterns between PFAS and breastfeeding duration. Conclusions Among primiparous women, we did not find evidence for associations between PFAS concentrations and breastfeeding duration. In contrast, among multiparous women, PFAS serum concentrations were generally inversely associated with breastfeeding duration, though estimates may be biased due to confounding by unmeasured previous breastfeeding.
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Affiliation(s)
- Chloe Friedman
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Alexander P. Keil
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - John L. Adgate
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Deborah H. Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Antonia M. Calafat
- Centers for Disease Control and Prevention, National Center for Environmental Health, Atlanta, Georgia
| | - Anne P. Starling
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Scott AL, Lambert AW, Wang CH, Johnson KV, Weiss J, Stankus T. University campus breastfeeding, knowledge, and perceptions of support: An exploratory study. PLoS One 2023; 18:e0285008. [PMID: 37235590 DOI: 10.1371/journal.pone.0285008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/14/2023] [Indexed: 05/28/2023] Open
Abstract
Breastfeeding is often considered principally a biological issue but success is impacted by the socio-ecological environment of the lactating parent. Identifying current attitudes towards breastfeeding is essential in the effort toward normalizing breastfeeding in communities, including university campuses. The study explored campus community knowledge, awareness, and attitudes about breastfeeding, including available resources and applicable laws on two university campuses in the southern United States. This cross-sectional, self-reporting study utilized the Iowa Infant Feeding Attitude Scale and an adaptation of the Breastfeeding Behavior Questionnaire to survey a convenience sample. Results revealed decreased awareness of protective laws, availability of private lactation space, and insufficient public appreciation of breastfeeding's unique advantages to both lactating parent and infant as barriers to breastfeeding. These findings will help develop additional breastfeeding strategies to improve university campus community breastfeeding initiatives.
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Affiliation(s)
- Allison L Scott
- Eleanor Mann School of Nursing, University of Arkansas, Fayetteville, Arkansas, United States of America
| | - Ann W Lambert
- Auburn University College of Nursing, Auburn University, Auburn, Alabama, United States of America
| | - Chih-Hsuan Wang
- Auburn University College of Education, Auburn University, Auburn, Alabama, United States of America
| | - Kelly V Johnson
- Eleanor Mann School of Nursing, University of Arkansas, Fayetteville, Arkansas, United States of America
| | - Jessica Weiss
- St. Luke's Health System, Kansas City, Missouri, United States of America
| | - Tony Stankus
- University of Arkansas Libraries, University of Arkansas, Fayetteville, Arkansas, United States of America
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20
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Mahoney SE, Taylor SN, Forman HP. No such thing as a free lunch: The direct marginal costs of breastfeeding. J Perinatol 2023; 43:678-682. [PMID: 36949157 DOI: 10.1038/s41372-023-01646-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/19/2023] [Accepted: 03/08/2023] [Indexed: 03/24/2023]
Abstract
Understanding costs associated with breastfeeding is critical to developing maximally effective policy to support breastfeeding by addressing financial barriers. Breastfeeding is not without cost; direct costs include those of equipment, modified nutritional intake, and time (opportunity cost). Breastfeeding need not require more equipment than formula feeding, though maternal equipment use varies by maternal preference. Meeting increased nutritional demands requires increased spending on food and potentially dietary supplementation, the marginal cost of which depends on a mother's baseline diet. The opportunity cost of the three to four hours per day breastfeeding demands may be prohibitively high, particularly to low-income workers. These costs are relatively highest for low-income individuals, a group disproportionately comprising racial and ethnic minorities, and who demonstrate lower rates of breastfeeding than their white and higher-income peers. Acknowledging and addressing these costs and their regressive nature represents a critical component of effective breastfeeding policy and promotion.
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Affiliation(s)
- Sarah E Mahoney
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Sarah N Taylor
- Department of Pediatrics, Yale School of Medicine, Yale University, New Haven, CT, USA.
| | - Howard P Forman
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, Yale University, New Haven, CT, USA
- Yale School of Management, Yale University, New Haven, CT, USA
- Yale School of Public Health, Yale University, New Haven, CT, USA
- Department of Economics, Yale University, New Haven, CT, USA
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21
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Winkel T, Wilson J, Spence M, Colby S, Springer C, Hedrick M, Kavanagh K. Tethered Oral Tissue Release Among Breastfed Infants: Maternal Sources of Information and Treatment. J Hum Lact 2023:8903344231159378. [PMID: 36945736 DOI: 10.1177/08903344231159378] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND Despite limited clinical consensus regarding surgery for tethered oral tissues ("tongue-tie") for resolving breastfeeding-related issues, the procedure has been increasing in the United States. Greater understanding of maternal experiences with obtaining surgical release may help to improve breastfeeding outcomes. RESEARCH AIM To explore experiences of breastfeeding mothers with infants having undergone "tongue-tie" surgery. METHOD This online, cross-sectional, observational survey occurred between August and September 2020. Eligibility included being ≥ 18 years of age and previously or currently breastfeeding an infant with ≥ 1 tissue surgically released. Of 463 screens, 318 mothers were eligible and 115 consented. The final sample was 90. RESULTS The sample was predominantly white (n = 86; 95%), non-Hispanic (n = 84; 93%), married/cohabitating (n = 85; 94%), and currently providing their own milk (n = 81; 89%).Difficult latch was the primary reason for seeking help. Participants reported lingual (n = 84; 93%), labial (n = 79; 88%), and buccal (n = 16; 17%) tissue-release, with 80% (n = 73) reporting > 1 released. For each tissue released, > 80% (n = 72) of participants felt "very confident" in their ability to correctly identify it and 97% (n = 87) felt "very involved" and "strongly agreed" with surgical release. International Board Certified Lactation Consultants® were the most frequently identified source of information (n = 45; 50%) and referrals (n = 38; 42%), while pediatric dentists most frequently performed interventions (n = 60; 67%). CONCLUSIONS Participants reported being confident, involved, and in agreement with surgical release and lactation support professionals were frequent information and referral sources.
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Affiliation(s)
- Taylor Winkel
- Department of Nutrition, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Jennifer Wilson
- Department of Audiology and Speech Pathology, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Marsha Spence
- Department of Nutrition, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Sarah Colby
- Department of Nutrition, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Cary Springer
- Office of Information Technology, Research Computing Support, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Mark Hedrick
- Department of Audiology and Speech Pathology, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Katherine Kavanagh
- Department of Nutrition, University of Tennessee Knoxville, Knoxville, TN, USA
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22
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Rossau HK, Nilsson IMS, Busck-Rasmussen M, Ekstrøm CT, Gadeberg AK, Hirani JC, Strandberg-Larsen K, Villadsen SF. Effectiveness of a community-based support programme to reduce social inequality in exclusive breastfeeding: study protocol for a cluster-randomised trial. BMC Public Health 2023; 23:450. [PMID: 36890478 PMCID: PMC9993656 DOI: 10.1186/s12889-023-15256-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/09/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Breastmilk is the ideal nutrition for infants, and breastfeeding protects infants and mothers from a range of adverse health outcomes. In Denmark, most mothers initiate breastfeeding but many cease within the first months resulting in just 14% reaching the World Health Organization recommendation of six months of exclusive breastfeeding. Furthermore, the low breastfeeding proportion at six months is characterised by a marked social inequality. A previous intervention tested in a hospital setting succeeded in increasing the proportion of mothers breastfeeding exclusively at six months. However, most breastfeeding support is provided within the Danish municipality-based health visiting programme. Therefore, the intervention was adapted to fit the health visiting programme and implemented in 21 Danish municipalities. This article reports the study protocol, which will be used to evaluate the adapted intervention. METHODS The intervention is tested in a cluster-randomised trial at the municipal level. A comprehensive evaluation approach is taken. The effectiveness of the intervention will be evaluated using survey and register data. Primary outcomes are the proportion of women who breastfeed exclusively at four months postpartum and duration of exclusive breastfeeding measured as a continuous outcome. A process evaluation will be completed to evaluate the implementation of the intervention; a realist evaluation will provide an understanding of the mechanisms of change characterising the intervention. Finally, a health economic evaluation will assess the cost-effectiveness and cost-utility of this complex intervention. DISCUSSION This study protocol reports on the design and evaluation of the Breastfeeding Trial - a cluster-randomised trial implemented within the Danish Municipal Health Visiting Programme from April 2022 to October 2023. The purpose of the programme is to streamline breastfeeding support provided across healthcare sectors. The evaluation approach is comprehensive using a multitude of data to analyse the effect of the intervention and inform future efforts to improve breastfeeding for all. TRIAL REGISTRATION Prospectively registered with Clinical Trials NCT05311631 https://clinicaltrials.gov/ct2/show/NCT05311631.
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Affiliation(s)
- Henriette Knold Rossau
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark.
| | | | - Marianne Busck-Rasmussen
- The Danish Committee for Health Education, Classensgade 71, 5th floor, 2100, Copenhagen, Denmark
| | - Claus Thorn Ekstrøm
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark
| | - Anne Kristine Gadeberg
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark
| | - Jonas Cuzulan Hirani
- The Danish Center for Social Science Research, Herluf Trolles Gade 11, 1052, Copenhagen, Denmark
| | - Katrine Strandberg-Larsen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark
| | - Sarah Fredsted Villadsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark
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Comparing Experiences of Women Who Were Direct Breastfeeding and Women Who Used Expressed Breast Milk to Feed Their Infants. MCN Am J Matern Child Nurs 2023; 48:96-102. [PMID: 36823725 DOI: 10.1097/nmc.0000000000000892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
PURPOSE To provide understanding about feeding experiences of women who provide breast milk through direct breastfeeding and exclusive expression and to compare these experiences. STUDY DESIGN AND METHODS A qualitative study was conducted to gather experiences from the perspectives of women who had given birth to a healthy, term infant within the past 12 months and exclusively fed breast milk for at least 2 weeks. The sample was recruited from motherhood and breastfeeding support groups on Facebook. Groups had state- or national-based memberships. Interviews were examined for themes that were compared between feeding groups using thematic analysis. RESULTS Fifteen new mothers participated. Under the primary themes of Similarities and Differences, seven subthemes were identified: Fatigue, Importance of Support, Finding Joy in a Common Goal, Mixed Feelings, Trusting versus Tracking, Latching versus Body Failure, and Pumping in Isolation. CLINICAL IMPLICATIONS Mothers who provide breast milk share common experiences and feelings of satisfaction. Expressed breast milk feeding offers some mothers a way to provide the benefits of breast milk while preserving a balance between maternal and infant physical and mental health needs. Understanding the different ways in which women manage breast milk feeding while balancing maternal and infant needs can prepare nurses to discuss various methods of breast milk feeding and provide individualized support.
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McBride GM, Stevenson R, Zizzo G, Rumbold AR, Amir LH, Keir A, Grzeskowiak LE. Women's experiences with using domperidone as a galactagogue to increase breast milk supply: an australian cross-sectional survey. Int Breastfeed J 2023; 18:11. [PMID: 36750944 PMCID: PMC9903405 DOI: 10.1186/s13006-023-00541-9] [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] [Received: 09/01/2022] [Accepted: 01/07/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Domperidone is one of the most commonly utilised pharmacological galactagogues, with evidence of increasing use in clinical practice. However, the use of domperidone as a galactagogue remains controversial, with mixed evidence on safety and efficacy, leading to variable clinical practice recommendations. We sought to evaluate contemporary patterns of domperidone use and examine maternal experiences related to perceived safety and effectiveness. METHODS In 2019, we conducted an online, cross-sectional survey of Australian breastfeeding women to examine individual experiences related to domperidone use, in addition to perceptions of safety and effectiveness. RESULTS Among 1876 survey responses, 19% (n = 355) reported using domperidone. Domperidone use was significantly higher in women who were primiparous, gave birth preterm, delivered by caesarean section, had self-perceived low milk supply, and saw a lactation consultant. Nearly 20% of women commenced domperidone use in the first week postpartum (19%, n = 67). The median duration of use was six weeks (interquartile range 3-16 weeks). Maximum reported doses of domperidone used ranged from 20 mg/day to 160 mg/day. Half (n = 178, 50%) of women reported using a dose of 30 mg/day or less, 44% (n = 155) reported using a dose between 31 and 60 mg/day, and 6% (n = 22) reported using a dose greater than 61 mg/day. Nearly half of the respondents reported domperidone as 'very' or 'extremely effective' (45%, n = 161), with only 8% (n = 27) reporting it was 'not at all effective'. Almost half (n = 172, 48%) of all women using domperidone reported side effects, including weight gain (25%), headaches (17%) and dry mouth (13%). Higher doses were associated with an increased likelihood of any side effects (≤ 30 mg/day, 38%; >31-≤60 mg/day, 48%, > 61 mg/day 73%; P < 0.004), with 31 (9%) stopping domperidone because of side effects. CONCLUSION We identified widespread variation in domperidone utilisation patterns, with domperidone broadly perceived to be effective in increasing breast milk supply. Side effects associated with domperidone treatment were common, appeared to be dose-related, and were frequently associated with treatment cessation. These findings highlight the importance of improved clinical practice recommendations and generation of evidence from additional high-quality clinical trials evaluating the efficacy and safety of domperidone. More conclusive clinical trials are needed to determine the efficacy, as well as optimal dose and duration, of domperidone use.
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Affiliation(s)
- Grace M. McBride
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia ,grid.430453.50000 0004 0565 2606SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Robyn Stevenson
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia
| | - Gabbie Zizzo
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia
| | - Alice R. Rumbold
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia ,grid.430453.50000 0004 0565 2606SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Lisa H. Amir
- grid.1018.80000 0001 2342 0938Judith Lumley Centre, La Trobe University, Melbourne, Australia ,grid.416259.d0000 0004 0386 2271Breastfeeding Service, Royal Women’s Hospital, Parkville, Australia
| | - Amy Keir
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia ,grid.430453.50000 0004 0565 2606SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Luke E. Grzeskowiak
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia ,grid.430453.50000 0004 0565 2606SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia ,grid.467022.50000 0004 0540 1022SA Pharmacy, SA Health, Adelaide, Australia ,grid.1014.40000 0004 0367 2697College of Medicine and Public, Flinders Health and Medical Research Institute Flinders University, GPO Box 2100, SA 5001 Adelaide, Australia
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Roberts D, Jackson L, Davie P, Zhao C, Harrold JA, Fallon V, Silverio SA. Exploring the reasons why mothers do not breastfeed, to inform and enable better support. Front Glob Womens Health 2023; 4:1148719. [PMID: 37122597 PMCID: PMC10132506 DOI: 10.3389/fgwh.2023.1148719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/20/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction Infant and maternal breastfeeding benefits are well documented, globally. Despite efforts to increase global breastfeeding rates, the majority of high-income settings fall short of recommended targets. Breastfeeding rates in the UK are especially poor, and physiological difficulties (e.g., inverted nipples), fail to account for the observed breastfeeding intention-behaviour gap. Method The current online study sought to investigate the infant feeding experiences of 624 UK formula feeding mothers, through open text survey responses. Results A content analysis identified the following clusters of reasons for formula feeding: Feeding Attitudes, Feeding Problems, Mental Health, and Sharing the Load. Discussion Feeding Attitudes explained a large percentage of reasons given for formula feeding. Recommendations are made to improve antenatal breastfeeding education and to develop an intervention with an aim to improve maternal breastfeeding attitudes and subsequent practice. Feeding Problems also explained a large portion of combination feeding and started but stopped infant feeding accounts. The current paper calls for more comprehensive and tailored antenatal breastfeeding education to refine practical breastfeeding skills necessary for successful breastfeeding establishment and maintenance. Mental Health explained relatively small coverage. Suggestions are therefore made to train mental health practitioners on infant feeding with an aim to provide more extensive support, which may serve to disrupt the bidirectional relationship between poor mental health and poor breastfeeding outcomes. Finally, Sharing the Load explained moderate coverage across never breastfed, combination fed, and started but stopped feeding groups. Recommendations are made, in light of these findings, to tighten workplace legislation to protect breastfeeding women.
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Affiliation(s)
- Dean Roberts
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Leanne Jackson
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
- Correspondence: Leanne Jackson
| | - Philippa Davie
- Department of Women & Children’s Health, School of Life Course & Population Sciences, King’s College London, London, United Kingdom
| | - Catherine Zhao
- Department of Nutritional Sciences, School of Life Course & Population Sciences, King’s College London, London, United Kingdom
| | - Joanne A. Harrold
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Sergio A. Silverio
- Department of Women & Children’s Health, School of Life Course & Population Sciences, King’s College London, London, United Kingdom
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Barger MK. Systematic Reviews to Inform Practice, January/February 2023. J Midwifery Womens Health 2023; 68:140-145. [PMID: 36606662 DOI: 10.1111/jmwh.13466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023]
Affiliation(s)
- Mary K Barger
- Midwifery researcher and consultant, San Diego, California
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27
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Pommeret-de Villepin B, Barasinski C, Rigourd V. Initiating and Supporting Breastfeeding: Guidelines for Interventions during the Perinatal Period from the French National College of Midwives. J Midwifery Womens Health 2022; 67 Suppl 1:S56-S73. [PMID: 36480673 DOI: 10.1111/jmwh.13420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/10/2022] [Indexed: 12/13/2022]
Abstract
Exclusive breastfeeding is recommended for children for the first 4 to 6 months of life, with complementary foods added thereafter. It is the most ecological way of protecting the child's and mother's health. Training of health professionals is required to avoid transmitting inconsistent information in 3 areas: 1) implementing these 3 predictors: safe skin-to-skin, first breastfeed, and rooming-in 24/7; 2) teaching and monitoring: i) early signs of waking and feeding rhythms, ii) positioning and latching, and iii) signs of effective transfer; and 3) referring women to specialized support services if difficulties arise (eg, inadequate milk production, pain, cracked nipples, engorgement). Breastfeeding should continue during mastitis or an abscess. Ultrasound-guided needle aspiration is beneficial in treating an abscess. Précis: Information is provided to enable health professionals to better support breastfeeding and help women with the most common difficulties, thus promoting breastfeeding initiation and duration.
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Affiliation(s)
- Brune Pommeret-de Villepin
- Service gynécologie-obstétrique, Centre hospitalier de Tourcoing, 155 rue du Président-René-Coty, Tourcoing, 59200, France
| | - Chloé Barasinski
- Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, Axe TGI-DecisipH, Clermont-Ferrand, F-63000, France
| | - Virginie Rigourd
- Pédiatre en néonatalogie médecin responsable du lactarium régional d'Ile de France Hopital, Necker Enfants malades, Paris, France
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Chaabna N, Mahfoud ZR, Letourneau N, Forgrave D, White D. Muslim women's attitudes toward infant feeding in Qatar: An exploration using the Iowa infant feeding attitude scale. Midwifery 2022; 114:103470. [PMID: 36096068 DOI: 10.1016/j.midw.2022.103470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/18/2022] [Accepted: 08/24/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Maternal attitude toward infant feeding is an important determinant of breastfeeding. The Islamic faith encourages breastfeeding, yet many Muslim women do not breastfeed as per the World Health Organization recommendations. In the Middle East, research has not addressed attitudes toward infant feeding among Muslim women. Assessing women's attitudes toward infant feeding choices is crucial to improve breastfeeding rates among Muslim women. AIM The aims of this study are to (a) examine postpartum Muslim women's attitudes toward infant feeding, (b) identify the determinants of these attitudes, and (c) determine whether attitudes can predict breastfeeding intention among Muslim women. A secondary aim is to examine the psychometric attributes of the Iowa Infant Feeding Attitude Scale among Muslim women. METHOD A convenience sample of postpartum Muslim women (N = 414) were recruited between November 2019 and January 2020 in a large maternity facility in Qatar. A pre-developed questionnaire and the IIFAS were used to collect data. Both Arabic (n = 228) and English (n = 186) versions of the IIFAS were distributed postnatally to measure Muslim women's attitudes towards breastfeeding. A total attitude score was computed with higher scores indicating a more positive attitude toward breastfeeding. FINDINGS The mean age of participants was 30.3 ± 5.2 years; 65.2% had a university degree and only 20.5% were employed. The mean attitude score was 61.8 ± 7.8. A significant association was found between the IIFAS attitude score and ethnicity, favouring Non-Qatari Arab women who had significantly higher attitude scores (p < .001). Women with full-time or part-time work had significantly higher scores than those not working (p = .008, p = .023). Older women had significantly lower attitude scores (adjusted slope = -0.230, p = .008). Cronbach's alpha reliability coefficient of the Arabic and English versions of the IIFAS ranged from 0.69 to 0.80. CONCLUSION Ethnicity, employment status, and age are determinants of infant feeding attitudes among Muslim women. In Qatar, Muslim women's attitudes related to breastfeeding trend toward positive; however, attitude is not a predictor of antenatal breastfeeding intention. Further research employing a larger sample with a focus on a culturally sensitive approach is recommended. The IIFAS has a moderate reliability level and needs to be culturally adapted to be used among a Muslim population.
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Affiliation(s)
- Nabila Chaabna
- Patient and Family Education Unit, Nursing Department, Hamad Medical Corporation, Doha, Qatar; Faculty of Nursing, University of Calgary in Qatar, Doha, Qatar.
| | - Ziyad R Mahfoud
- Medical Education, Weill Cornell Medicine-Qatar, Doha, Qatar; Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, NY, USA
| | - Nicole Letourneau
- Faculty of Nursing and Cumming School of Medicine, Departments of Paediatrics, Psychiatry and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Daniel Forgrave
- Faculty of Nursing, University of Calgary in Qatar, Doha, Qatar
| | - Deborah White
- Faculty of Nursing, University of Calgary in Qatar, Doha, Qatar
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29
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Froh EB, Spatz DL. Lactation Outcomes After Participation in a Tailored Prenatal Nutrition Consultation Among Women With Infants With Congenital Anomalies. J Obstet Gynecol Neonatal Nurs 2022; 51:590-598. [PMID: 35988697 DOI: 10.1016/j.jogn.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/19/2022] [Accepted: 07/25/2022] [Indexed: 10/15/2022] Open
Abstract
OBJECTIVE To describe lactation outcomes among of a cohort of mother-infant dyads in which the women had an individualized prenatal nutrition consultation intervention. DESIGN Descriptive cohort study. SETTING A free-standing children's hospital with a center for fetal diagnosis and treatment and a specialized maternity unit. PARTICIPANTS A total of 160 women who had prenatal nutrition consultations in 2014 to 2017 and gave birth to infants with known congenital anomalies and required intensive care after birth. METHODS We surveyed women regarding their lactation outcomes after the Breastfeeding Report Card metrics of the Centers for Disease Control and Prevention and obtained permission to abstract demographic and clinical information from the setting's electronic health record. We analyzed data with standard descriptive statistics. RESULTS Among the cohort, 86.9% (n = 139) of participants intended to provide human milk or combination feeding in the prenatal period. A total of 128 (92.1%) infants were first exposed to human milk enterally. At the time of discharge, 92.1% (n = 128) of the infants received human milk. The breastfeeding outcomes of the cohort significantly surpassed national data: initiation (98.1% vs. 84.1% national), breastfeeding at 3 months (89.4%), exclusive breastfeeding at 3 months (60% vs. 46.9% national), breastfeeding at 6 months (76.9% vs. 58.3% national), exclusive breastfeeding at 6 months (45% vs. 25.6% national), breastfeeding at 12 months (50.6% vs. 35.3% national), and breastfeeding beyond 12 months (34.4%). CONCLUSIONS Lactation outcomes among women who had prenatal nutrition consultations far surpassed national data, and this intervention has implications for family-centered prenatal care, informed decision making, and improved breastfeeding outcomes in the hospital setting and postdischarge.
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Preventing nipple pain/trauma in breastfeeding women: a best practice implementation project at the Marqués de Valdecilla University Hospital (Spain). INT J EVID-BASED HEA 2022; 20:374-384. [DOI: 10.1097/xeb.0000000000000340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mogaka JN, Owuor PM, Odhiambo S, Waterman C, McGuire MK, Fuchs GJ, Attia SL. Investigating the Impact of Moringa oleifera Supplemented to Kenyan Breastfeeding Mothers on Maternal and Infant Health: A Cluster Randomized Single-Blinded Controlled Pilot Trial Protocol. JPGN REPORTS 2022; 3:e237. [PMID: 37168619 PMCID: PMC10158460 DOI: 10.1097/pg9.0000000000000237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 06/22/2022] [Indexed: 05/13/2023]
Abstract
Undernutrition contributes to up to 45% of deaths globally in children <5 years, with an optimal time for intervention before 24 months of age. Breastmilk microbiome helps establish the infant intestinal microbiome and impacts infant intestinal and nutritional health. Inadequacies in breastmilk composition such as low vitamin A contribute to infant nutrient deficiencies. Changes in milk fatty acid composition (reduced saturated and increased unsaturated fatty acids) may reduce susceptibility to enteric infection and increase protective intestinal bacteria. Moringa oleifera leaves (moringa) provide high nutrient concentrations (including protein, iron, vitamin A) and increase milk production; this may enhance breastmilk quantity and quality and improve infant health. Objective To investigate the role of moringa supplementation to improve maternal and infant nutritional and intestinal health via changes in maternal milk quantity and quality. Methods Fifty mother-infant pairs exclusively breastfeeding will be enrolled in a single-blinded randomized controlled trial in Kombewa County Hospital and Chulaimbo SubCounty Hospital, Kisumu, Kenya. Intervention Dietary Supplementation of 20 g of Moringa oleifera leaf powder divided twice daily in corn porridge consumed daily for 3 months while control comparator will receive porridge daily for 3 months. Outcomes Change in infant growth and maternal milk output (primary); maternal and infant vitamin A and iron status, changes in infant and maternal intestinal health (secondary). Participating Centers Pamoja Community Based Organization, Kombewa Sub-County Hospital, and Chulaimbo Sub-County Hospital.
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Affiliation(s)
| | - Patrick Mbullo Owuor
- Pamoja Community Based Organization, Kisumu, Kenya
- Department of Anthropology, Weinberg College of Arts and Sciences, Northwestern University, Chicago, Illinois
| | | | - Carrie Waterman
- Institute of Global Nutrition, University of California, Davis, Davis, California
| | - Michelle K. McGuire
- College of Agricultural and Life Sciences, Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho
| | - George J. Fuchs
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Kentucky College of Medicine, Lexington, Kentucky
- Department of Epidemiology and Department of Preventive Medicine and Environmental Health, University of Kentucky College of Public Health, Lexington, Kentucky
| | - Suzanna L. Attia
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Kentucky College of Medicine, Lexington, Kentucky
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Reverri EJ, Arensberg MB, Murray RD, Kerr KW, Wulf KL. Young Child Nutrition: Knowledge and Surveillance Gaps across the Spectrum of Feeding. Nutrients 2022; 14:nu14153093. [PMID: 35956275 PMCID: PMC9370290 DOI: 10.3390/nu14153093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/18/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
The first 1000 days is a critical window to optimize nutrition. Young children, particularly 12–24 month-olds, are an understudied population. Young children have unique nutrient needs and reach important developmental milestones when those needs are met. Intriguingly, there are differences in the dietary patterns and recommendations for young children in the US vs. globally, notably for breastfeeding practices, nutrient and food guidelines, and young child formulas (YCFs)/toddler drinks. This perspective paper compares these differences in young child nutrition and identifies both knowledge gaps and surveillance gaps to be filled. Parental perceptions, feeding challenges, and nutrition challenges are also discussed. Ultimately, collaboration among academia and clinicians, the private sector, and the government will help close young child nutrition gaps in both the US and globally.
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Affiliation(s)
- Elizabeth J. Reverri
- Abbott Nutrition, Abbott Laboratories, Columbus, OH 43219, USA; (M.B.A.); (K.W.K.); (K.L.W.)
- Correspondence:
| | - Mary Beth Arensberg
- Abbott Nutrition, Abbott Laboratories, Columbus, OH 43219, USA; (M.B.A.); (K.W.K.); (K.L.W.)
| | - Robert D. Murray
- Department of Pediatrics, The Ohio State University, Columbus, OH 43219, USA;
| | - Kirk W. Kerr
- Abbott Nutrition, Abbott Laboratories, Columbus, OH 43219, USA; (M.B.A.); (K.W.K.); (K.L.W.)
| | - Karyn L. Wulf
- Abbott Nutrition, Abbott Laboratories, Columbus, OH 43219, USA; (M.B.A.); (K.W.K.); (K.L.W.)
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Human Milk–Expression Technologies. Obstet Gynecol 2022; 139:1180-1188. [DOI: 10.1097/aog.0000000000004804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/20/2022] [Indexed: 11/26/2022]
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Cerminaro C, Sazonov E, McCrory MA, Steiner-Asiedu M, Bhaskar V, Gallo S, Laing E, Jia W, Sun M, Baranowski T, Frost G, Lo B, Anderson AK. Feasibility of the automatic ingestion monitor (AIM-2) for infant feeding assessment: a pilot study among breast-feeding mothers from Ghana. Public Health Nutr 2022; 25:1-11. [PMID: 35616087 PMCID: PMC9991851 DOI: 10.1017/s1368980022001264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 03/23/2022] [Accepted: 05/12/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Passive, wearable sensors can be used to obtain objective information in infant feeding, but their use has not been tested. Our objective was to compare assessment of infant feeding (frequency, duration and cues) by self-report and that of the Automatic Ingestion Monitor-2 (AIM-2). DESIGN A cross-sectional pilot study was conducted in Ghana. Mothers wore the AIM-2 on eyeglasses for 1 d during waking hours to assess infant feeding using images automatically captured by the device every 15 s. Feasibility was assessed using compliance with wearing the device. Infant feeding practices collected by the AIM-2 images were annotated by a trained evaluator and compared with maternal self-report via interviewer-administered questionnaire. SETTING Rural and urban communities in Ghana. PARTICIPANTS Participants were thirty eight (eighteen rural and twenty urban) breast-feeding mothers of infants (child age ≤7 months). RESULTS Twenty-five mothers reported exclusive breast-feeding, which was common among those < 30 years of age (n 15, 60 %) and those residing in urban communities (n 14, 70 %). Compliance with wearing the AIM-2 was high (83 % of wake-time), suggesting low user burden. Maternal report differed from the AIM-2 data, such that mothers reported higher mean breast-feeding frequency (eleven v. eight times, P = 0·041) and duration (18·5 v. 10 min, P = 0·007) during waking hours. CONCLUSION The AIM-2 was a feasible tool for the assessment of infant feeding among mothers in Ghana as a passive, objective method and identified overestimation of self-reported breast-feeding frequency and duration. Future studies using the AIM-2 are warranted to determine validity on a larger scale.
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Affiliation(s)
- Caroline Cerminaro
- Department of Nutritional Sciences, University of Georgia, 280 Dawson Hall, 305 Sanford Drive, Athens, GA30602, USA
| | - Edward Sazonov
- Department of Electrical and Computer Engineering, University of Alabama, Tuscaloosa, AL, USA
| | - Megan A McCrory
- Department of Health Sciences, Boston University, Boston, MA, USA
| | | | - Viprav Bhaskar
- Department of Electrical and Computer Engineering, University of Alabama, Tuscaloosa, AL, USA
| | - Sina Gallo
- Department of Nutritional Sciences, University of Georgia, 280 Dawson Hall, 305 Sanford Drive, Athens, GA30602, USA
| | - Emma Laing
- Department of Nutritional Sciences, University of Georgia, 280 Dawson Hall, 305 Sanford Drive, Athens, GA30602, USA
| | - Wenyan Jia
- Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mingui Sun
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tom Baranowski
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Gary Frost
- Department of Medicine, Imperial College London, London, UK
| | - Benny Lo
- The Hamlyn Center, Imperial College London, London, UK
| | - Alex Kojo Anderson
- Department of Nutritional Sciences, University of Georgia, 280 Dawson Hall, 305 Sanford Drive, Athens, GA30602, USA
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Hayashi Y, Fisher NM, Hantula DA, Furman L, Washio Y. A behavioral economic demand analysis of mothers' decision to exclusively breastfeed in the workplace. J Exp Anal Behav 2022; 118:132-147. [PMID: 35607847 DOI: 10.1002/jeab.772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 04/15/2022] [Accepted: 05/03/2022] [Indexed: 11/05/2022]
Abstract
The present study determined whether behavioral economic demand analysis could characterize mothers' decision to exclusively breastfeed in the workplace. Females, aged between 18 and 50 who have given birth in the past three years, completed a novel demand task with hypothetical scenarios, in which they returned to work with a 2-month-old baby. Participants rated their likelihood of breastfeeding their baby at a workplace lactation room versus formula-feeding their baby at their desk. The distance to the lactation room ranged from 10 s to 60 min. This assessment was conducted with and without hypothetical financial incentives for 6-month exclusive breastfeeding. Primary dependent measures were demand intensity and change in demand elasticity, which could conceptually represent initiation and continuation of breastfeeding, respectively. Demand for breastfeeding was more intense and less elastic (i.e., more likely to initiate and continue breastfeeding) among mothers with an experience of 6-month exclusive breastfeeding and under the condition with the financial incentives. The novel demand task can potentially provide a useful behavioral marker for quantifying mothers' decision to initiate and continue exclusive breastfeeding in the workplace, informing workplace policy regarding lactation rooms, identifying risk for early cessation, and developing and individualizing an intervention to assist mothers to exclusively breastfeed in the workplace.
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Affiliation(s)
- Yusuke Hayashi
- Division of Social Sciences and Education, Pennsylvania State University, Hazleton
| | - Nicole M Fisher
- Division of Social Sciences and Education, Pennsylvania State University, Hazleton
| | | | - Lydia Furman
- Department of Pediatrics, Rainbow Babies and Children's Hospital
| | - Yukiko Washio
- Substance Use, Gender and Applied Research, RTI International.,Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University Lewis Katz School of Medicine
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Freund-Azaria A, Bar-Shalita T, Regev R, Bart O. The Role of Motor Coordination, ADHD-Related Characteristics and Temperament among Mothers and Infants in Exclusive Breastfeeding: A Cohort Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5509. [PMID: 35564903 PMCID: PMC9099549 DOI: 10.3390/ijerph19095509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 02/05/2023]
Abstract
Although exclusive breastfeeding is recommended for the first 6 months of life, breastfeeding rates are low. Motor skills and ADHD-related characteristics have not yet been examined as breastfeeding barriers. The aim of this study was to explore whether mothers' and infants' motor skills, mothers' ADHD-related characteristics and infants' temperament are associated with exclusive breastfeeding at 6 months after birth. Participants were 164 mothers and their infants recruited 2 days after birth. Mothers completed a demographic and delivery information questionnaire, the Infant Feeding Intentions Scale and the Iowa Infant Feeding Attitude Scale. At 6 months, mothers completed the Adult DCD (developmental coordination disorder)/Dyspraxia Checklist, the Adult ADHD (attention deficit hyperactivity disorder) Self-Report Scale Symptom Checklist-v1.1, and the Infant Characteristics Questionnaire, and provided information about their breastfeeding status. They were then divided into two groups accordingly: EBF (exclusive breastfeeding) and NEBF (non-exclusive breastfeeding). Infants were observed using the Test of Sensory Functions in Infants and the Alberta Infant Motor Scale. At 6 months, NEBF mothers reported higher prevalence of DCD (10.2% vs. 1.9%, χ2 = 5.561, p = 0.018) and ADHD (20.3% vs. 8.6%, χ2 = 4.680, p = 0.030) compared to EBF mothers. EBF infants demonstrated better motor coordination (t = 2.47, p = 0.016, d = 0.511), but no temperament differences compared to NEBF infants. Maternal DCD, ADHD and poor infant motor coordination are associated with non-exclusive breastfeeding and may become exclusive breastfeeding barriers. These findings may assist in identifying women at risk of not exclusively breastfeeding and encourage tailoring interventions for achieving higher exclusive breastfeeding rates.
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Affiliation(s)
- Adi Freund-Azaria
- Occupational Therapy Department, School of Health Professions, Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel-Aviv 6997801, Israel; (A.F.-A.); (T.B.-S.)
- Department of Neonatology, Meir Medical Center, Kfar-Saba 4428164, Israel
| | - Tami Bar-Shalita
- Occupational Therapy Department, School of Health Professions, Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel-Aviv 6997801, Israel; (A.F.-A.); (T.B.-S.)
| | - Rivka Regev
- Clalit Health Organization and Neonatal Follow-Up Clinic, Kfar-Saba 4428164, Israel;
| | - Orit Bart
- Occupational Therapy Department, School of Health Professions, Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel-Aviv 6997801, Israel; (A.F.-A.); (T.B.-S.)
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Towfighi P, Johng SY, Lally MM, Harley EH. A Retrospective Cohort Study of the Impact of Upper Lip Tie Release on Breastfeeding in Infants. Breastfeed Med 2022; 17:446-452. [PMID: 35235369 DOI: 10.1089/bfm.2021.0140] [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: 11/12/2022]
Abstract
Objectives: Lingual frenotomies for the purpose of improving infant breastfeeding remain controversial, whereas maxillary frenotomies are even more so given the scant data and differing opinions on the matter. This study aimed at further elucidating the effect that maxillary frenula have on breastfeeding difficulties in infants. Methods: A retrospective chart review was performed on infants approximately aged 0-3 months who presented to a tongue tie/breastfeeding clinic from January to December of 2019. All analyzed infants had both lip and tongue ties classified by a clinician. Data on pre-frenotomy pain scores, lingual Coryllos classification, maxillary Kotlow classification, post-frenotomy complications, and breastfeeding success were captured. Results: Of the 316 infants, 224 underwent their first procedure at the tongue tie/breastfeeding clinic. Two hundred eleven out of 224 infants received a lingual frenotomy only, whereas the remaining 13 (5.8%) underwent both lingual and maxillary frenotomy procedures. Of the group of 211, 207 (98.1%) had successful feeding after 1 procedure; the remaining 4 underwent revision procedures to achieve successful feeding. All maxillary frenulum releases (n = 13) led to successful feeding without the need for revision procedures. Coryllos and Kotlow classification scores were significantly higher in the infants receiving both a maxillary and lingual frenulum release as compared with those receiving solely a lingual frenulum release. Conclusions: The majority (98.1%) of infants receiving a lingual frenulum release alone had successful feeding after only one procedure, and only 5.8% of all infants receiving any intervention required a maxillary frenulum release for successful feeding, calling into question the relative necessity of performing maxillary frenulum releases for breastfeeding difficulties.
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Affiliation(s)
- Parhom Towfighi
- Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Stephanie Y Johng
- Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Michelle M Lally
- Department of Otolaryngology-Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia, USA
| | - Earl H Harley
- Georgetown University School of Medicine, Washington, District of Columbia, USA.,Department of Otolaryngology-Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia, USA.,Department of Pediatrics, MedStar Georgetown University Hospital, Washington, District of Columbia, USA
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Nielsen C, Li Y, Lewandowski M, Fletcher T, Jakobsson K. Breastfeeding initiation and duration after high exposure to perfluoroalkyl substances through contaminated drinking water: A cohort study from Ronneby, Sweden. ENVIRONMENTAL RESEARCH 2022; 207:112206. [PMID: 34653413 DOI: 10.1016/j.envres.2021.112206] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 09/29/2021] [Accepted: 10/09/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The drinking water in parts of Ronneby was heavily contaminated with perfluoroalkyl substances (PFAS) for decades. Although PFAS has endocrine-disrupting properties and may interfere with breastfeeding, the effects in populations with a point source of high exposure are unknown. OBJECTIVES To investigate associations between high PFAS exposure and 1) initiation and 2) duration of breastfeeding. METHODS We retrieved data on infant feeding practices for 2374 children born between 1999 and 2009 from Child Health Care centers in Ronneby and a reference municipality. Residential address before delivery was used as a proxy for exposure, and confounders were obtained from charts and registers. We used modified Poisson regressions to estimate the relative risks (RR) of not initiating breastfeeding, not breastfeeding exclusively after 3 months, and not breastfeeding at all at 6 months. We also estimated hazard ratios (HR) of cessation of exclusive breastfeeding before 6 months and any breastfeeding before 12 months. RESULTS Mothers who had received contaminated water seemed to have a higher risk of not initiating breastfeeding (RR = 2.4; 95% CI: 0.8, 6.7). Primiparous mothers from the exposed area were at a 1.2 times increased risk (95% CI: 0.9, 1.6) of not exclusively breastfeeding at 3 months and a 1.6 times increased risk (95% CI: 1.2, 2.1) of not breastfeeding at 6 months. The results were confirmed by the Cox regressions, which further showed that the HR for cessation of any breastfeeding was time dependent and higher in early lactation, thereafter decreasing as lactation progressed. We observed no overall associations in multiparous mothers. DISCUSSION Exposure to high levels of PFAS seemed to be associated with increased risks of not initiating breastfeeding and shorter breastfeeding duration in primiparous mothers. The findings imply that the ability of first-time mothers to establish breastfeeding is a sensitive outcome after high exposure to PFAS.
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Affiliation(s)
- Christel Nielsen
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
| | - Ying Li
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Magdalena Lewandowski
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Tony Fletcher
- London School of Hygiene and Tropical Medicine, London, UK
| | - Kristina Jakobsson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
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Meira CAR, Buccini G, Azeredo CM, Conde WL, Rinaldi AEM. Evolution of breastfeeding indicators and early introduction of foods in Latin American and Caribbean countries in the decades of 1990, 2000 and 2010. Int Breastfeed J 2022; 17:32. [PMID: 35459227 PMCID: PMC9034574 DOI: 10.1186/s13006-022-00477-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 04/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background Early introduction of liquid/solid food before 6 months of age is one of the major barriers to exclusive breastfeeding. Our objective was to analyze the evolution of infant feeding practices for infants under 6 months of age in Latin American and Caribbean countries in the decades of 1990, 2000 and 2010. Method Cross-sectional time series study with data from Demographic and Health Surveys carried out between 1990 and 2017 in six Latin America and Caribbean countries: Bolivia (1994 to 2008), Colombia (1995 to 2010), Dominican Republic (1996 to 2013), Guatemala (1995 to 2015), Haiti (1994/1995 to 2016/2017), Peru (1996 to 2018). Pooled sample comprised of 22,545 infants under the age of 6 months. Surveys were grouped in three decades: 1990s for surveys from 1990 to 1999, 2000s for surveys from 2000 to 2009, and 2010s for surveys from 2010 to 2017. Exclusive breastfeeding (EBF), predominant breastfeeding (PBF), mixed breastfeeding (mixed BF), supplemented breastfeeding (supplemented BF) and non-breastfeeding (non-BF), and individual foods (water, liquids, milk, infant formula, semi-solid/solid) were analyzed. Prevalence of breastfeeding and food indicators were calculated in pooled sample, according to the infant monthly age groups, decade of survey and residence area(rural/urban). Results Between 1990s and 2010s, there was an increase in the exclusive breastfeeding prevalence (1990s = 38.1%, 2010s = 46.6%) and a reduction in the PBF prevalence (1990s = 51.7%, 2010 s = 43.1%). There was a decrease in the liquids (1990s = 40.7%, 2010s = 15.8%) and milk prevalence (1990s = 20.4%, 2010s = 8.3%) and an increase in water (1990s = 32.3%, 2010s = 37.6%), and infant formula (1990s = 16.6%, 2010s = 25.5%) prevalence. All breastfeeding indicators, except exclusive breastfeeding, progressively increased according to the monthly age group in three decades, and EBF prevalence sharply decreased from 2 to 3 months of age in all decades. Exclusive breastfeeding prevalence was higher in rural area in the three decades (1990s rural = 43.8%, 1990s urban = 32.4%, 2010s rural = 51.1%, 2010s urban = 42.4%) and infant formula prevalence was higher in urban area (1990s rural = 8.6%, 1990s urban = 24.6%, 2010s rural = 15.9%, 2010s urban = 34.1%). Conclusions In the last three decades, in all age groups, there was an increase in exclusive breastfeeding prevalence, as well as a significant reduction in liquids and milk. In the rural area, EBF prevalence remains higher than in urban. Increased water and infant formula feeding are the main barriers to achieving the Global Nutrition Target 2025 for exclusive breastfeeding. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-022-00477-6.
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40
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Darling AJ, Gatta LA, Tucker A, Adkins LD, Mitchell C, Reiff E, Dotters-Katz S. Gestational weight gain and patterns of breastfeeding among patients with class III obesity. J Matern Fetal Neonatal Med 2022; 35:9851-9856. [PMID: 35382671 DOI: 10.1080/14767058.2022.2060734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Maternal obesity is associated with delayed lactogenesis and shorter duration of breastfeeding compared to patients with a normal BMI. RESEARCH AIM/QUESTION We investigated the impact of excessive gestational weight gain, defined as greater than the Institute of Medicine guidelines (>9.1 kg), on the initiation and duration of breastfeeding in patients with class III obesity. METHODS Retrospective cohort of patients with body mass index ≥40 in first trimester, delivering a singleton term infant at a tertiary care center between July 2013 and December 2017. Primary outcome was exclusive breastfeeding at discharge and at postpartum visit. Secondary outcomes included any breastfeeding at discharge and postpartum visit, and cessation of breastfeeding by the postpartum visit. Descriptive statistics were used to compare those whose gestational weight gain exceeded (eIOM) versus met (mIOM) Institute of Medicine guidelines. Regression models were performed to adjust for baseline confounding factors. RESULTS Of 294 women included, 117(39.8%) were in the eIOM group. These women were more likely to be primigravida, have a higher delivery BMI, greater delivery blood loss, and have a neonate admitted to the intensive care unit. Exclusive breastfeeding at discharge was not different between eIOM and mIOM (66.7% vs 70.9%, p = .44), nor did eIOM impact likelihood of exclusive breastfeeding at postpartum visit (40.1% vs 34.2%, p = .31). When controlling for confounding factors, breastfeeding at discharge (aOR 1.54 95% CI [0.68-3.49]) or postpartum visit (aOR 0.67[0.31-1.47]) did not differ between eIOM compared to mIOM. CONCLUSIONS Among women with class III obesity, excessive gestational weight gain did not impact the rate of exclusive breastfeeding at discharge or postpartum visit.
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Affiliation(s)
- Alice J Darling
- Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC, USA
| | - Luke A Gatta
- Department of Obstetrics & Gynecology, Duke University, Durham, NC, USA
| | - Ann Tucker
- Department of Obstetrics & Gynecology, University of Mississippi, Jackson, MS, USA
| | - LaMani D Adkins
- Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC, USA
| | - Courtney Mitchell
- Department of Obstetrics & Gynecology, Duke University, Durham, NC, USA
| | - Emily Reiff
- Department of Obstetrics & Gynecology, Brigham and Women's Hospital, Boston, MA, USA
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Fei Y, Zhang ZY, Fu WN, Wang L, Mao J. Why do first-time mothers not intend to breastfeed? --A qualitative exploratory study on the decision-making of non-initiation in Jingzhou, China. BMC Pregnancy Childbirth 2022; 22:183. [PMID: 35255855 PMCID: PMC8903621 DOI: 10.1186/s12884-022-04494-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 02/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Although breastfeeding is one of the top priorities for public health in China, the rate of breastfeeding is still low and a large number of women do not initiate breastfeeding due to various reasons. Hence, this study aimed to understand the decision-making of non-initiation and reveal the underlying reasons in order to protect, support, and promote breastfeeding. Methods In-depth, exploratory interviews were carried out with 13 new mothers who did not initiate breastfeeding. The collected data were analyzed by inductive content analysis. Results Although mothers generally understood the protective effects of breastfeeding, they believed that formula milk is a good alternative to human milk and even better in some aspects. Five core themes related to non-initiation decision-making emerged: (1) expected breastfeeding stress; (2) maladjustment to the maternal role; (3) concerns about physiological issues; (4) the lack of knowledge about the risks of artificial feeding; (5) belief that it is better not to initiate than to interrupt. Conclusions The environment for mothers to breastfeed in China is not supportive enough, and the medical staff and families should be held responsible for the non-initiation of breastfeeding. More professionals are needed to support mothers to solve their problems and breastfeeding education should be further expanded.
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Affiliation(s)
- Yang Fei
- School of nursing, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, China.,Yangtze University Medical School, Nanhuan Road 1, Jingzhou, China
| | - Ze-Yu Zhang
- School of nursing, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, China
| | - Wen-Ning Fu
- School of nursing, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, China
| | - Li Wang
- Jingzhou First Hospital, Hangkong Road, JingZhou, China
| | - Jing Mao
- School of nursing, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan, China.
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Yasuda S, Fukuda T, Toba N, Kamo N, Imaizumi K, Yokochi M, Okawara T, Takano S, Yoshida H, Kobayashi N, Kudo S, Miyazaki K, Hosoya M, Sato K, Takano K, Kanno A, Murata T, Kyozuka H, Yamaguchi A, Ito F, Oda S, Momoi N, Hosoya M, Fujimori K. Risk factors for discontinuation of exclusive breast feeding within 1month: a retrospective cohort study in Japan. Int Breastfeed J 2022; 17:20. [PMID: 35248098 PMCID: PMC8898407 DOI: 10.1186/s13006-022-00449-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 01/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While breastfeeding provides benefits for infants and the mother, many women either do not breastfeed or terminate breastfeeding earlier than recommended. The aim of this analysis was to identify factors associated with early discontinuation of breastfeeding in Japanese women. METHODS This study used data from medical records of women delivering a singleton live birth between March 2017 and August 2019 in Iwase General Hospital, Fukushima Prefecture, Japan to assess cessation of breastfeeding by the 1-month postpartum appointment. Demographic (age at birth, and employment status), medical (parity, and physical and mental condition of the mother; and infant medical factors, such as sex, Apgar score, and jaundice, among other), and family factors (husband/partner, family members living at the same house, among others) in 734 women who had initiated breastfeeding during their delivery hospital stay were examined, and multiple logistic regression was used to determine significant predictors of early cessation of exclusive breastfeeding. RESULTS Bivariate analysis revealed that women who were primipara, unmarried, exposed to secondhand smoke, and employed; those who smoked before pregnancy; and those who had asthma were more likely to discontinue exclusive breastfeeding than other women. Infant factors associated with discontinuation were lower birthweight, earlier gestational age, neonatal intensive care unit admission, treatment for jaundice, or lower weight gain. Multivariable analysis revealed that primiparity, passive smoking before pregnancy, maternal employment, and neonatal jaundice therapy were associated with discontinuation of breastfeeding. CONCLUSIONS In particular, women whose partners smoked before pregnancy may need to be targeted for additional support for breastfeeding.
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Affiliation(s)
- Shun Yasuda
- Departments of Obstetrics and Gynecology, Iwase General Hospital, Sukugawa City, Fukushima Prefecture, Japan.
- Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima City, Fukushima Prefecture, Japan.
| | - Toma Fukuda
- Departments of Obstetrics and Gynecology, Iwase General Hospital, Sukugawa City, Fukushima Prefecture, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima City, Fukushima Prefecture, Japan
| | - Naoya Toba
- Departments of Obstetrics and Gynecology, Iwase General Hospital, Sukugawa City, Fukushima Prefecture, Japan
| | - Norihito Kamo
- Departments of Obstetrics and Gynecology, Iwase General Hospital, Sukugawa City, Fukushima Prefecture, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima City, Fukushima Prefecture, Japan
| | - Karin Imaizumi
- Departments of Obstetrics and Gynecology, Iwase General Hospital, Sukugawa City, Fukushima Prefecture, Japan
- Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima City, Fukushima Prefecture, Japan
| | - Midori Yokochi
- Departments of Obstetrics and Gynecology, Iwase General Hospital, Sukugawa City, Fukushima Prefecture, Japan
| | - Tomoko Okawara
- Departments of Obstetrics and Gynecology, Iwase General Hospital, Sukugawa City, Fukushima Prefecture, Japan
| | - Seiko Takano
- Departments of Obstetrics and Gynecology, Iwase General Hospital, Sukugawa City, Fukushima Prefecture, Japan
| | - Hideko Yoshida
- Departments of Obstetrics and Gynecology, Iwase General Hospital, Sukugawa City, Fukushima Prefecture, Japan
| | - Nobuko Kobayashi
- Departments of Obstetrics and Gynecology, Iwase General Hospital, Sukugawa City, Fukushima Prefecture, Japan
| | - Shingo Kudo
- Department of Pediatrics, Iwase General Hospital, Sukugawa City, Fukushima Prefecture, Japan
| | - Kyohei Miyazaki
- Department of Pediatrics, Iwase General Hospital, Sukugawa City, Fukushima Prefecture, Japan
| | - Mamiko Hosoya
- Department of Pediatrics, Iwase General Hospital, Sukugawa City, Fukushima Prefecture, Japan
| | - Kenichi Sato
- Department of Pediatrics, Iwase General Hospital, Sukugawa City, Fukushima Prefecture, Japan
| | - Kei Takano
- Department of Pediatrics, Iwase General Hospital, Sukugawa City, Fukushima Prefecture, Japan
| | - Aya Kanno
- Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima City, Fukushima Prefecture, Japan
| | - Tsuyoshi Murata
- Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima City, Fukushima Prefecture, Japan
| | - Hyo Kyozuka
- Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima City, Fukushima Prefecture, Japan
| | - Akiko Yamaguchi
- Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima City, Fukushima Prefecture, Japan
| | - Fumihiro Ito
- Departments of Obstetrics and Gynecology, Iwase General Hospital, Sukugawa City, Fukushima Prefecture, Japan
| | - Shinichiro Oda
- Department of Pediatrics, Iwase General Hospital, Sukugawa City, Fukushima Prefecture, Japan
| | - Nobuo Momoi
- Department of Pediatrics, Fukushima Medical University, Fukushima City, Fukushima Prefecture, Japan
| | - Mitsuaki Hosoya
- Department of Pediatrics, Fukushima Medical University, Fukushima City, Fukushima Prefecture, Japan
| | - Keiya Fujimori
- Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima City, Fukushima Prefecture, Japan
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DiTomasso D, Wambach KA, Roberts MB, Erickson-Owens DA, Quigley A, Newbury JM. Maternal Worry About Infant Weight and its Influence on Artificial Milk Supplementation and Breastfeeding Cessation. J Hum Lact 2022; 38:177-189. [PMID: 33705242 DOI: 10.1177/08903344211000284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Maternal worry about infant weight has inconsistently been reported as a breastfeeding barrier. Weight monitoring is a critical tool to assess adequacy of infant feeding. Yet, little is known about the intensity of maternal worry about infant weight or associated breastfeeding outcomes. RESEARCH AIMS To examine (1) the frequency and intensity of maternal worry about infant weight; (2) the relationship between worry about weight and use of artificial milk; and 3) the relationship between worry about weight and breastfeeding cessation. METHODS A prospective cross-sectional design was used. A questionnaire was completed by women in the United States (N = 287) from 12 web-based maternal support groups. RESULTS Sixty-three percent of women (n = 182) had some worry about infant weight. Participants breastfeeding for the first time had more worry (p = .035). Participants still breastfeeding had less worry about weight compared to those who had stopped (67%, n = 147 vs. 41%, n = 28). Exclusive breastfeeding participants had less worry (p < .001) compared to those who supplemented with artificial milk. Increased worry was associated with the use of artificial milk within 1 week of birth (p < .001) and early breastfeeding cessation (p < .001). CONCLUSIONS Worry about weight is a significant breastfeeding barrier. It is associated with first time breastfeeding, less exclusive breastfeeding, use of artificial milk, and earlier breastfeeding cessation. Lactating mothers need anticipatory guidance about expected neonatal weight changes and interventions to help relieve worry about infant weight.
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Affiliation(s)
| | | | - Mary B Roberts
- Brown University Center for Primary Care & Prevention, Care New England Medical Group/Primary Care & Specialty Services, USA
| | | | - Aimee Quigley
- 21444 Lactation Consultant, South County Hospital, Wakefield, RI, USA
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Huda MH, Chipojola R, Lin YM, Lee GT, Shyu ML, Kuo SY. The Influence of Breastfeeding Educational Interventions on Breast Engorgement and Exclusive Breastfeeding: A Systematic Review and Meta-Analysis. J Hum Lact 2022; 38:156-170. [PMID: 34229526 DOI: 10.1177/08903344211029279] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Breast engorgement and breast pain are the most common reasons for the early cessation of exclusive breastfeeding by mothers. RESEARCH AIMS (1) To examine the influence of breastfeeding educational interventions on breast engorgement, breast pain, and exclusive breastfeeding; and (2) to identify effective components for implementing breastfeeding programs. METHODS Randomized controlled trials of breastfeeding educational interventions were searched using five English and five Chinese databases. Eligible studies were independently evaluated for methodological quality, and data were extracted by two investigators. In total, 22 trials were identified, and 3,681 participants were included. A random-effects model was used to pool the results, and a subgroup analysis and meta-regression analysis were conducted. RESULTS Breastfeeding education had a significant influence on reducing breast engorgement at postpartum 3 days (odds ratio [OR]: 0.27, 95% CI [0.15, 0.48] p < .001), 4 days (OR: 0.16, 95% CI [0.11, 0.22], p < .001), and 5-7 days (OR: 0.24, 95% CI [0.08, 0.74], p = .013) and breast pain (standardized mean difference: -1.33, 95% CI [-2.26, -0.40]) at postpartum 4-14 days. Participants who received interventions had higher odds of exclusive breastfeeding. Breastfeeding educational interventions provided through lecture combined with skills practical effectively reduced breast engorgement (OR: 0.21; 95% CI [0.15, 0.28]; p = .001) and improved exclusive breastfeeding at postpartum 1-6 weeks (OR: 2.16; 95% CI [1.65, 2.83]; p = .001). CONCLUSIONS Breastfeeding educational interventions have been effective in reducing breast engorgement, breast pain, and improved exclusive breastfeeding. A combination of knowledge and skill-based education has been beneficial for sustaining exclusive breastfeeding by mothers.
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Affiliation(s)
- Mega Hasanul Huda
- 38032 School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Roselyn Chipojola
- 38032 School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yen Miao Lin
- 38032 School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Gabrielle T Lee
- 6221 Applied Psychology, Faculty of Education, Western University, London, ON, Canada
| | - Meei-Ling Shyu
- 38032 School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Shu-Yu Kuo
- 38032 School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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45
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Bell E, Hunter C, Benitez T, Uysal J, Walovich C, McConnell L, Vega C, Cisneros N, Hidalgo L, Reyes Walton J, Wang M. Intervention Strategies and Lessons Learned From a Student-Led Initiative to Support Lactating Women in the University Setting. Health Promot Pract 2021; 23:154-165. [PMID: 33884924 DOI: 10.1177/15248399211004283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The benefits of breastfeeding for mother and baby are strongly supported by research. However, lactating parents who return to school or work soon after delivery face many barriers to continued breastfeeding. This article presents a student-led initiative to support lactation at a large public university that emerged from advocacy efforts of student mothers of color. The socioecological model was used as a framework to understand and address the multifaceted influences on breastfeeding practices. Project activities included providing breastfeeding education to lactating parents and their partners, measuring availability and accessibility of lactation spaces, improving lactation spaces, connecting university stakeholders, and strengthening university lactation policies. The project achieved the following outcomes: formation of a stakeholder group with members across campus departments, improvement in accessibility and appropriateness of lactation spaces, provision of breastfeeding services through workshops and one-on-one appointments with lactation educators, and creation and dissemination of an online toolkit outlining parents' lactation rights and support available on campus. Comprehensive lactation support at universities is essential to enhance educational and professional equity for women and to promote postpartum and infant health. Throughout the project implementation, the team learned many lessons that can help guide similar university initiatives.
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Affiliation(s)
- Emily Bell
- University of California, Los Angeles, CA, USA
| | | | - Trista Benitez
- University of California, Los Angeles, CA, USA.,University of Michigan Medical School, Ann Arbor, MI, USA
| | - Jasmine Uysal
- University of California, San Diego, La Jolla, CA, USA
| | | | | | | | | | | | | | - May Wang
- University of California, Los Angeles, CA, USA
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Louis-Jacques AF, Schafer EJ, Livingston TA, Logan RG, Marhefka SL. Modesty and Security: Attributes Associated with Comfort and Willingness to Engage in Telelactation. CHILDREN (BASEL, SWITZERLAND) 2021; 8:271. [PMID: 33916051 PMCID: PMC8066511 DOI: 10.3390/children8040271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/21/2021] [Accepted: 03/26/2021] [Indexed: 11/26/2022]
Abstract
The objectives were to identify conditions under which mothers may be willing to use telelactation and explore associations between participant characteristics, willingness, and beliefs regarding telelactation use. Mothers 2-8 weeks postpartum were recruited from two Florida maternal care sites and surveyed to assess demographics, breastfeeding initiation, and potential telelactation use. Analyses included descriptive statistics and logistic regression models. Of the 88 participants, most were white, married, earned less than USD 50,000 per year, had access to technology, and were willing to use telelactation if it was free (80.7%) or over a secure server (63.6%). Fifty-six percent were willing to use telelactation if it involved feeding the baby without a cover, but only 45.5% were willing if their nipples may be seen. Those with higher odds of willingness to use telelactation under these modesty conditions were experienced using videochat, white, married, and of higher income. Mothers with security concerns had six times the odds of being uncomfortable with telelactation compared to mothers without concerns. While telelactation can improve access to critical services, willingness to use telelactation may depend on conditions of use and sociodemographics. During the COVID-19 pandemic and beyond, these findings offer important insights for lactation professionals implementing virtual consultations.
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Affiliation(s)
- Adetola F. Louis-Jacques
- Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL 33606, USA;
- College of Nursing, University of South Florida, Tampa, FL 33612, USA
| | - Ellen J. Schafer
- Department of Community and Environmental Health, College of Health Sciences, Boise State University, Boise, ID 83725, USA;
| | - Taylor A. Livingston
- Department of Anthropology, University of Nebraska—Lincoln, Lincoln, NE 68588, USA;
| | - Rachel G. Logan
- College of Public Health, University of South Florida, Tampa, FL 33612, USA;
| | - Stephanie L. Marhefka
- College of Public Health, University of South Florida, Tampa, FL 33612, USA;
- The Chiles Center, University of South Florida, Tampa, FL 33613, USA
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Padró-Arocas A, Quifer-Rada P, Aguilar-Camprubí L, Mena-Tudela D. Description of an mHealth tool for breastfeeding support: LactApp. Analysis of how lactating mothers seek support at critical breastfeeding points and according to their infant's age. Res Nurs Health 2020; 44:173-186. [PMID: 33319403 DOI: 10.1002/nur.22095] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 10/13/2020] [Accepted: 11/29/2020] [Indexed: 11/11/2022]
Abstract
Interventions in mHealth have had positive effects on establishing and maintaining breastfeeding, but we still do not know what content women consult when downloading a breastfeeding mobile application. We conducted an observational, descriptive, and retrospective study using the data recorded by LactApp in 2019. The most frequently consulted topics were those related to breastfeeding technique, infant sleep, human milk management and storage, breastfeeding myths, breastfeeding stages, complementary feeding, infant care, and returning to work. Our study results suggest that LactApp's support seems to develop with mothers' needs according to their infant's development stage. The first breastfeeding days include more physiological answers. Between 15 days and 3 months, mothers look for support in topics like breastfeeding crisis/complications and returning to work. At 3 months to 1 year, answers are related to complementary feeding and weaning. When the user's infant is 1 year of age, mothers seek support for weaning, weaning management, and tandem breastfeeding.
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Affiliation(s)
- Alba Padró-Arocas
- Research and Development Department, LactApp Women Health, Barcelona, Spain
| | - Paola Quifer-Rada
- Research and Development Department, LactApp Women Health, Barcelona, Spain.,Department of Endocrinology and Nutrition, CIBER of Diabetes and Associated Metabolic Diseases, Biomedical Research Institute Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Oras P, Ljungberg T, Hellström-Westas L, Funkquist EL. A breastfeeding support program changed breastfeeding patterns but did not affect the mothers' self-efficacy in breastfeeding at two months. Early Hum Dev 2020; 151:105242. [PMID: 33137580 DOI: 10.1016/j.earlhumdev.2020.105242] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/20/2020] [Accepted: 10/20/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Even though the biological norm in humans is frequent on demand breastfeeding, sparse feeding intervals have become the cultural norm in most Western countries due to a history of on schedule breastfeeding. This discrepancy between the biological basis and the culturally driven practice continues to interfere with women's ability to breastfeed. AIM Our aim was to describe breastfeeding patterns in 2-month-old infants before and after the implementation of a breastfeeding support program. A secondary aim was to investigate the relationship between breastfeeding patterns and the mother's self-efficacy in breastfeeding. METHODS The study had a baseline/intervention design and was part of a larger project aiming to revive the Ten Steps to Successful Breastfeeding program. The larger project included breastfeeding training for health care professionals and provision of breastfeeding information to parents, including information about on demand breastfeeding. Data were gathered via breastfeeding diaries (n = 79 mothers from each group) and the Breastfeeding Self-efficacy Scale-Short Form (n = 83 in the baseline group and n = 79 in the intervention group). RESULTS On demand breastfeeding patterns were more common in the intervention group (97.5%) than in the baseline group (74.7%) (p < 0.001), and breastfeeding sessions were more frequent in the intervention group (a median of 14 times per 24 h versus 11 times in the baseline group; p = 0.026). Self-efficacy in breastfeeding did not differ between the groups, but was higher in mothers with exclusive breastfeeding. CONCLUSIONS Knowledge about infants' breastfeeding behavior can strengthen on demand breastfeeding. Exclusive breastfeeding is associated with higher self-efficacy.
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Affiliation(s)
- Paola Oras
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | | | | | - Eva-Lotta Funkquist
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Hill RR, Pados BF. Symptoms of problematic feeding in infants under 1 year of age undergoing frenotomy: A review article. Acta Paediatr 2020; 109:2502-2514. [PMID: 32654280 DOI: 10.1111/apa.15473] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 12/18/2022]
Abstract
AIM The aims of this systematic review were to first identify and summarise original research that compared symptoms of problematic feeding in infants with tongue tie before and after frenotomy and then evaluate the quality of measures used to assess problematic feeding. METHODS CINAHL and PubMed were searched for ((tongue-tie) or (ankyloglossia)) and ((feeding) or (breastfeeding) or (bottle-feeding)) and ((frenotomy) or (frenectomy) or (frenulectomy) or (frenulotomy)). Original research reporting on feeding before and after frenotomy in infants under 1 year old was included. RESULTS Maternal nipple pain, breastfeeding self-efficacy and LATCH scores improved after frenotomy. Few data are available on the effect of frenotomy on infant feeding. The measures used to assess infant feeding were not comprehensive and did not possess strong psychometric properties. CONCLUSION Literature suggests that maternal nipple pain, self-efficacy and LATCH scores improve in breastfeeding mother-infant dyads after frenotomy. However, current literature does not provide adequate data regarding the effect of frenotomy on the infant's ability to feed or which infants benefit from the procedure. Future research should utilise comprehensive, psychometrically sound measures to assess infants for tongue tie and to evaluate infant feeding to provide stronger evidence for the effect of frenotomy on feeding in infants with tongue tie.
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Affiliation(s)
- Rebecca R. Hill
- MGH Institute of Health Professions School of Nursing Boston MA USA
| | - Britt F. Pados
- Boston College William F. Connell School of Nursing Chestnut Hill MA USA
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Firouzabadi M, Pourramezani N, Balvardi M. Comparing the effects of yarrow, honey, and breast milk for healing nipple fissure. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2020; 25:282-285. [PMID: 33014738 PMCID: PMC7494169 DOI: 10.4103/ijnmr.ijnmr_133_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 06/03/2019] [Accepted: 05/05/2020] [Indexed: 11/11/2022]
Abstract
Background: Nipple fissure is a common problem among breastfeeding women, which can lead to early cessation of breastfeeding. Because of the lack of effective treatment and given the approved efficacy of honey and yarrow on sore healing, this study was conducted to evaluate and compare the effects of yarrow, honey, and breast milk on the treatment of nipple fissure. Materials and Methods: This study was a three-group clinical trial, and sampling was conducted at Sina breastfeeding counseling center from September 2016 to March 2018 in Sirjan, Iran, using a target-based method. The sample size consisted of 150 individuals who were randomly assigned into three groups as topical use of yarrow, the mountain honey, and breast milk after obtaining the written informed consent. The correct method of breastfeeding and using materials were instructed to these three groups on the 1st, 3rd, and 7th days, where the Storr scale was completed by the researcher. Results: Friedman test showed that, in these three groups of yarrow (χ2 = 92.19, df = 2, p < 0.001), honey (χ2 = 93.29, df = 2, p < 0.001), and breast milk (χ2 = 90.51, df = 2, p < 0.001)); severity of fissure had a significant reduction. Nevertheless, Kruskal–Wallis test revealed no significant difference among the severity of fissure scores in these three groups (p > 0.05). Conclusions: Use of honey, yarrow, and breast milk can be recommended to women in breastfeeding counseling and pharmaceutical companies can be advised to use honey and yarrow in the preparation of anti-fissure creams.
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