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Kronborg H, Skaaning D, Brødsgaard A. Breastfeeding Self-Efficacy, a Predictor of Early Cessation of Exclusive Breastfeeding Among Mothers Giving Birth Preterm. J Perinat Neonatal Nurs 2023:00005237-990000000-00008. [PMID: 37115956 DOI: 10.1097/jpn.0000000000000699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
The aim was to describe the prevalence of exclusive breastfeeding among mothers of premature infants and investigate the extent to which breastfeeding self-efficacy is associated with early cessation of exclusive breastfeeding. The study population consisted of 136 mother-infant dyads with information on the outcome of exclusive breastfeeding and exposure of self-efficacy, recruited between September 2016 and February 2018. Data were collected via questionnaires with follow-up at 6 months. The statistical analysis included descriptive analysis with survival curves and logistic regression analysis. At 2 months, 101 (74%) premature infants were exclusively breastfed; at 4 and 6 months, 82 (60%) and 41 (30%), respectively. Higher levels of self-efficacy were significantly associated with breastfeeding exclusively for 2 months (P = .03). In multivariate analysis, mothers who had a low level of early self-efficacy toward breastfeeding had 2½ times higher odds of breastfeeding cessation before 2 months (odds ratio = 2.63, 95% confidence interval: 1.16-5.96). The risk did not change when adjusted for potential confounders. Breastfeeding self-efficacy is an early predictor of exclusive breastfeeding for 2 months of the premature infant. Health professionals should use self-efficacy as a prognostic factor to identify mothers at risk of early cessation of breastfeeding and support those with low self-efficacy to increase duration of exclusive breastfeeding.
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Affiliation(s)
- Hanne Kronborg
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark (Drs Kronborg and Brødsgaard); and Departments of Paediatrics and Adolescent Medicine (Drs Skaaning and Brødsgaard) and Obstetrics and Gynaecology (Dr Brødsgaard), Copenhagen University Hospital Amager Hvidovre, Capital Region of Denmark, Hvidovre, Denmark
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2
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Tahmasebifard N, Briley PM, Ellis C, Perry JL. Early Nutrition among Infants Admitted to the NICU with Cleft Lip and Palate. Cleft Palate Craniofac J 2023; 60:299-305. [PMID: 34812064 DOI: 10.1177/10556656211059371] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE The objective of this study was to examine differences in human milk feeding outcomes among infants admitted to a neonatal intensive care unit (NICU) with and without cleft lip and palate (CLP). METHOD Data were used from a sample of infants admitted to the NICU with and without CLP from the 2018 National Vital Statistics System. For baseline comparisons, Chi-square tests of independence were used to compare categorical variables, and independent samples t tests were used for continuous variables. Logistic regression models were performed to determine the odds of human milk feeding at discharge in infants admitted to the NICU with CLP. RESULTS The total sample included 345,429 infants admitted to the NICU, of which 660 had CLP. Significant differences were found among the following variables when baseline comparisons were made between infants admitted to the NICU with and without CLP: mother's race, mother's education, maternal smoking record, childbirth delivery method, presence of maternal pre-pregnancy diabetes, five-minute APGAR score, multiparity record (having more than one baby at birth), gestational age, and gestational weight. After controlling for baseline differences, results indicated reduced odds of human milk feeding at discharge in infants admitted to the NICU with CLP compared to those without CLP (OR = .543; 95% CI.455,.648). CONCLUSION Results suggest reduced odds of human milk feeding at discharge among infants admitted to the NICU with CLP compared to those without CLP. These findings emphasize the necessity of awareness and facilitation of human milk feeding in this population.
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Affiliation(s)
- Neda Tahmasebifard
- Department of Communication Sciences & Disorders, 3627East Carolina University, Greenville, USA
| | - Patrick M Briley
- Department of Communication Sciences & Disorders, 3627East Carolina University, Greenville, USA
| | - Charles Ellis
- Department of Speech, Language, and Hearing Sciences, University of Florida, USA
| | - Jamie L Perry
- Department of Communication Sciences & Disorders, 3627East Carolina University, Greenville, USA
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Talisman S, Guedalia J, Farkash R, Avitan T, Srebnik N, Kasirer Y, Schimmel MS, Ghanem D, Unger R, Grisaru Granovsky S. NICU Admission for Term Neonates in a Large Single-Center Population: A Comprehensive Assessment of Risk Factors Using a Tandem Analysis Approach. J Clin Med 2022; 11:jcm11154258. [PMID: 35893346 PMCID: PMC9332268 DOI: 10.3390/jcm11154258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: Neonatal intensive care unit (NICU) admission among term neonates is associated with significant morbidity and mortality, as well as high healthcare costs. A comprehensive NICU admission risk assessment using an integrated statistical approach for this rare admission event may be used to build a risk calculation algorithm for this group of neonates prior to delivery. Methods: A single-center case−control retrospective study was conducted between August 2005 and December 2019, including in-hospital singleton live born neonates, born at ≥37 weeks’ gestation. Analyses included univariate and multivariable models combined with the machine learning gradient-boosting model (GBM). The primary aim of the study was to identify and quantify risk factors and causes of NICU admission of term neonates. Results: During the study period, 206,509 births were registered at the Shaare Zedek Medical Center. After applying the study exclusion criteria, 192,527 term neonates were included in the study; 5292 (2.75%) were admitted to the NICU. The NICU admission risk was significantly higher (ORs [95%CIs]) for offspring of nulliparous women (1.19 [1.07, 1.33]), those with diabetes mellitus or hypertensive complications of pregnancy (2.52 [2.09, 3.03] and 1.28 [1.02, 1.60] respectively), and for those born during the 37th week of gestation (2.99 [2.63, 3.41]; p < 0.001 for all), adjusted for congenital malformations and genetic syndromes. A GBM to predict NICU admission applied to data prior to delivery showed an area under the receiver operating characteristic curve of 0.750 (95%CI 0.743−0.757) and classified 27% as high risk and 73% as low risk. This risk stratification was significantly associated with adverse maternal and neonatal outcomes. Conclusion: The present study identified NICU admission risk factors for term neonates; along with the machine learning ranking of the risk factors, the highly predictive model may serve as a basis for individual risk calculation algorithm prior to delivery. We suggest that in the future, this type of planning of the delivery will serve different health systems, in both high- and low-resource environments, along with the NICU admission or transfer policy.
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Affiliation(s)
- Shahar Talisman
- Shaare Zedek Medical Center, Department of Obstetrics & Gynecology, School of Medicine, Hebrew University, Jerusalem 9103102, Israel; (S.T.); (R.F.); (N.S.); (D.G.); (S.G.G.)
| | - Joshua Guedalia
- The Mina and Everard Goodman Faculty of Life Sciences, Bar Ilan University, Ramat-Gan 5290002, Israel; (J.G.); (R.U.)
| | - Rivka Farkash
- Shaare Zedek Medical Center, Department of Obstetrics & Gynecology, School of Medicine, Hebrew University, Jerusalem 9103102, Israel; (S.T.); (R.F.); (N.S.); (D.G.); (S.G.G.)
| | - Tehila Avitan
- Shaare Zedek Medical Center, Department of Obstetrics & Gynecology, School of Medicine, Hebrew University, Jerusalem 9103102, Israel; (S.T.); (R.F.); (N.S.); (D.G.); (S.G.G.)
- Correspondence: ; Tel.: +972-548000541
| | - Naama Srebnik
- Shaare Zedek Medical Center, Department of Obstetrics & Gynecology, School of Medicine, Hebrew University, Jerusalem 9103102, Israel; (S.T.); (R.F.); (N.S.); (D.G.); (S.G.G.)
| | - Yair Kasirer
- Shaare Zedek Medical Center, Department of Pediatrics, School of Medicine, Hebrew University, Jerusalem 9103102, Israel; (Y.K.); (M.S.S.)
| | - Michael S. Schimmel
- Shaare Zedek Medical Center, Department of Pediatrics, School of Medicine, Hebrew University, Jerusalem 9103102, Israel; (Y.K.); (M.S.S.)
| | - Dunia Ghanem
- Shaare Zedek Medical Center, Department of Obstetrics & Gynecology, School of Medicine, Hebrew University, Jerusalem 9103102, Israel; (S.T.); (R.F.); (N.S.); (D.G.); (S.G.G.)
| | - Ron Unger
- The Mina and Everard Goodman Faculty of Life Sciences, Bar Ilan University, Ramat-Gan 5290002, Israel; (J.G.); (R.U.)
| | - Sorina Grisaru Granovsky
- Shaare Zedek Medical Center, Department of Obstetrics & Gynecology, School of Medicine, Hebrew University, Jerusalem 9103102, Israel; (S.T.); (R.F.); (N.S.); (D.G.); (S.G.G.)
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Abstract
INTRODUCTION Mother's own milk improves health outcomes in infants of all gestational ages. Although pump-dependent mothers of extremely premature infants are at risk of insufficient milk production, whether mother's milk production is impacted by gestational age and pump dependency in mothers of more mature critically ill infants is unknown. PURPOSE To determine whether there is a relationship between gestational age, milk production, and time to secretory activation in mothers delivering a critically ill infant. METHODS A convenience sample of 136 pump-dependent mothers whose infants were admitted to the neonatal intensive care unit was enrolled between 2013 and 2016 as part of a quality improvement project. Group 1 (early preterm) delivered infants at 30 to 33 weeks of gestation (n = 41), group 2 (late preterm) 34 to 36 weeks (n = 48), and group 3 (term) 37 weeks and more (n = 47). Milk volume on days 1 to 7 was measured by weighing each vial of expressed milk and compared using general linear mixed-model analysis. Time to the onset of secretory activation was compared using censored regression analysis. RESULTS Main effect for gestational age controlling for day was statistically significant (P = .0234). The early preterm group produced more milk over the 7-day study than the term (P = .01) and late preterm (P = .02) groups. The early preterm group achieved secretory activation earlier than the late preterm group (adjusted P = .039). IMPLICATIONS FOR PRACTICE Pump-dependent mothers of all infants admitted to the neonatal intensive care unit may be at risk of inadequate milk production and delayed secretory activation and may therefore benefit from early milk production monitoring and lactation support. IMPLICATIONS FOR RESEARCH Further studies should examine targeted interventions to increase milk production in pump-dependent mothers.
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Lechosa-Muñiz C, Paz-Zulueta M, Cayón-De las Cuevas J, Llorca J, Cabero-Pérez MJ. Declared Reasons for Cessation of Breastfeeding during the First Year of Life: An Analysis Based on a Cohort Study in Northern Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168414. [PMID: 34444163 PMCID: PMC8394949 DOI: 10.3390/ijerph18168414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/07/2021] [Accepted: 08/08/2021] [Indexed: 12/22/2022]
Abstract
Background: Breastfeeding is the gold standard of infant feeding due to the many advantages it offers to both the child and the mother. Objective: To identity the main reasons for cessation of breastfeeding reported by mothers during the first year of life. Design: A prospective cohort study was conducted, recruiting 970 infants from a university hospital in Spain. The main maternal variables studied were maternal age, parity, educational level, work occupation, smoking habit, weeks of gestation at birth, birth weight, feeding type, and duration of breastfeeding. All participants were followed for one year to determinate the duration of breastfeeding and to gather reasons for abandoning breastfeeding. Results: At six months, the percentage of breastfeeding experienced a decline of 50%, and only 24.5% of these mothers maintained breastfeeding. Up to 15.8% of the mothers decided to give up exclusive breastfeeding by their own choice, whereas 15.4% did so because they suspected low milk production. Work-related causes represent the third reason of abandonment. Conclusions: Our results highlight the need to improve the health policies for the promotion, protection, and support for the initiation and maintenance of breastfeeding. In particular, our results highlight the importance of researching women’s low milk production and work-related factors, with particular emphasis on improving conciliation measures.
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Affiliation(s)
- Carolina Lechosa-Muñiz
- Faculty of Nursing, University of Cantabria, Avda Valdecilla s/n. C.P., 39008 Santander, Spain;
- Pediatrics Section, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain
| | - María Paz-Zulueta
- Faculty of Nursing, University of Cantabria, Avda Valdecilla s/n. C.P., 39008 Santander, Spain;
- IDIVAL, Grupo de Investigación en Derecho Sanitario y Bioética, GRIDES, C/Cardenal Herrera Oria s/n. C.P., 39011 Santander, Spain
- Correspondence: ; Tel.: +34-677984506
| | - Joaquín Cayón-De las Cuevas
- IDIVAL, Grupo de Investigación en Derecho Sanitario y Bioética, GRIDES, C/Cardenal Herrera Oria s/n. C.P., 39011 Santander, Spain
- Faculty of Law, University of Cantabria, Avda. de los Castros s/n. C.P., 39005 Santander, Spain;
| | - Javier Llorca
- Faculty of Medicine, University of Cantabria, Avenida del Cardenal Herrera Oria 2, C.P., 39010 Santander, Spain; (J.L.); (M.J.C.-P.)
- CIBER Epidemiology and Public Health (CIBERESP), C.P., 28029 Madrid, Spain
| | - María Jesús Cabero-Pérez
- Pediatrics Section, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain
- Faculty of Medicine, University of Cantabria, Avenida del Cardenal Herrera Oria 2, C.P., 39010 Santander, Spain; (J.L.); (M.J.C.-P.)
- IDIVAL, C/Cardenal Herrera Oria s/n. C.P., 39011 Santander, Spain
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Piwoszkin LM, Corley M, Meganathan K, Narendran V, Nommsen-Rivers L, Ward LP. Predictors of the Provision of Mother's Milk Feedings in Newborns Admitted to the Neonatal Intensive Care Unit. Breastfeed Med 2021; 16:640-647. [PMID: 33835834 DOI: 10.1089/bfm.2020.0284] [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: 11/13/2022]
Abstract
Background: Breast milk reduces morbidity and mortality in infants admitted to neonatal intensive care unit (NICU). Objectives: We determined predictors of procuring mother's own milk (MOM) among NICU-admitted newborn-mother dyads: (1) initiation of any milk expression; (2) initiation of milk expression within 6 hours of birth; (3) MOM as the first enteral feeding; (4) colostrum for oral care within 36 hours of birth if not yet orally fed; and (5) provision of MOM at 21 days of life or discharge, whichever occurred first. Methods: We performed a retrospective chart review of NICU-admitted newborn-mother dyads at an urban medical center from June 1, 2018-May 31, 2019. We excluded infants not directly admitted to the NICU, those never enterally fed, multiple gestations if not the first to be discharged, and infants discharged to a nonbiological caregiver. We used chi-square analysis to examine unadjusted associations between independent variables and MOM outcomes and then used logistic regression to determine the adjusted odds ratio and 95% confidence interval (AOR [95% CI]) for predictors of MOM outcomes. Results: There were 341 mother-infant dyads who met inclusion criteria and 71% of these mothers initiated milk expression. Smoking, multiparity, gestational diabetes, and Hepatitis C lowered the odds for at least one MOM outcome; whereas mothers who delivered at 28-32 weeks versus ≥33 weeks, and infants with birthweight <1,500 g versus 1,500-2,500 g had higher odds for at least one MOM outcome. Conclusion: Maternal/infant dyad characteristics may predict some, but not all NICU breastfeeding outcomes. This suggests that hospital practices may influence these outcomes and can inform future interventions.
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Affiliation(s)
- Lisa Marie Piwoszkin
- Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Megan Corley
- Department of Rehabilitation, Exercise, and Nutrition, University of Cincinnati College of Allied Health Sciences, Cincinnati, Ohio, USA
| | - Karthikeyan Meganathan
- Department of Analytical and Diagnostic Sciences, University of Cincinnati, Cincinnati, Ohio, USA
| | - Vivek Narendran
- Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Laurie Nommsen-Rivers
- Department of Rehabilitation, Exercise, and Nutrition, University of Cincinnati College of Allied Health Sciences, Cincinnati, Ohio, USA
| | - Laura P Ward
- Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
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Lechosa-Muñiz C, Paz-Zulueta M, Sota SM, de Adana Herrero MS, Del Rio EC, Llorca J, Cabero-Perez MJ. Factors associated with duration of breastfeeding in Spain: a cohort study. Int Breastfeed J 2020; 15:79. [PMID: 32907592 PMCID: PMC7488233 DOI: 10.1186/s13006-020-00324-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/02/2020] [Indexed: 11/12/2022] Open
Abstract
Background Factors associated with duration of breastfeeding have been usually studied at specific times after birth. Little is known about how much time is added to breastfeeding by each associated factor. Methods A cohort of 969 mother-child dyads was followed-up for twelve months at the Marqués de Valdecilla University Hospital, Spain, in 2018. Data on mother characteristics, pregnancy, delivery and children characteristics were obtained from medical records. Length of breastfeeding was reported by the mothers and recorded in paediatric medical record at hospital discharge and 2, 4, 6, 9 and 12 months of life. Factors associated with duration of breastfeeding were analysed via multivariate Weibull regression parameterized as accelerated time of failure. Results are presented as time ratios. Results About four out of five children were breastfed at hospital discharge, although this proportion dropped to 65% in children born from smoker women, 70% in preterm children and 68% in neonates weighting less than 2500 g. Mother’s age was associated with longer breastfeeding, adding 2% more breastfeeding time per year (adjusted time ratio 1.02; 95% confidence interval 1.00, 1.04). Children born from mothers with university studies were breastfed 53% more time than those born from mothers with primary studies (adjusted time ratio 1.53; 95% confidence interval 1.21, 1.95); smoking in pregnancy decreased length of breastfeeding by 41% (adjusted time ratio 0.59; 95% confidence interval 0.46, 0.76). Other factors associated with longer breastfeeding were single pregnancy and newborn weight over 2500 g. Conclusions Analysing factors associated with duration of breastfeeding as time parameters allows us to quantify the amount of time gained or lost by each factor, which could make it easier to evaluate the relevance of programmes directed to promote facilitating breastfeeding factors.
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Affiliation(s)
| | - María Paz-Zulueta
- Faculty of Nursing, Universidad de Cantabria. IDIVAL, GI Derecho Sanitario y Bioética. GRIDES, 39008, Santander, Spain.
| | - Sonia Mateo Sota
- Hospital Universitario Marqués de Valdecilla, 39008, Santander, Spain
| | | | | | - Javier Llorca
- Universidad de Cantabria - IDIVAL, Santander, Spain.,CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - María J Cabero-Perez
- Hospital Universitario Marqués de Valdecilla, 39008, Santander, Spain.,Universidad de Cantabria - IDIVAL, Santander, Spain
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Buckman C, Diaz AL, Tumin D, Bear K. Parity and the Association Between Maternal Sociodemographic Characteristics and Breastfeeding. Breastfeed Med 2020; 15:443-452. [PMID: 32456452 DOI: 10.1089/bfm.2019.0284] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Objective: Although clinicians recognize the importance of breastfeeding for child health, breastfeeding initiation can be limited by maternal characteristics such as race/ethnicity, age at first birth, and educational attainment. We hypothesized that the strong influence of prior infant feeding experiences on multiparous women's decision to initiate and continue breastfeeding may mean that these maternal characteristics influence breastfeeding more strongly for primiparas than multiparas. Materials and Methods: Using Pregnancy Risk Assessment and Monitoring System (PRAMS) (Phase 8) survey data from 2016 to 2017, we analyzed mothers' responses to the supplemental question about parity, "Before you got pregnant with your new baby, did you ever have any other babies who were born alive?" Study variables were summarized by using weighted means and proportions and compared according to parity by using Wald tests. In the overall cohort, we evaluated the interaction between parity and each covariate by using logistic regression. Results: In our sample (N = 20,694), 40% of respondents were first-time mothers, and 88% had initiated breastfeeding. Primiparas were more likely to breastfeed than multiparas (92% versus 86%; p < 0.001), but they had shorter mean breastfeeding duration. On unadjusted analysis, four covariates were more strongly associated with breastfeeding initiation among primiparas than multiparas (maternal age, educational attainment, receiving breastfeeding information from a nurse or other medical professional, and receiving breastfeeding information from family or friends). Conclusions: Breastfeeding initiation is impacted more strongly by maternal characteristics for primiparas than multiparas.
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Affiliation(s)
- Cierra Buckman
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA
| | - Amy L Diaz
- Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA
| | - Dmitry Tumin
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA
| | - Kelly Bear
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA
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Colbourne G, Crane J, Murphy P, O'Brien D. The Rates of Any Breastfeeding at the Time of Postpartum Hospital Discharge for Early Term (37 0-38 6 Weeks) Versus Full Term (39 0-41 6 Weeks) Infants. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019; 42:453-461. [PMID: 31882282 DOI: 10.1016/j.jogc.2019.09.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE This study sought to compare the rates of any breastfeeding between early term (370-386 weeks) and full term (390-416 weeks) infants at the time of postpartum hospital discharge. METHODS A retrospective cohort study of women with live, singleton pregnancies who were delivered in St. John's, Newfoundland and Labrador, between April 2001 and March 2018 was completed. The primary outcome was any breastfeeding at the time of postpartum hospital discharge. Secondary analyses included a comparison of breastfeeding by week of gestational age at term and by maternal and neonatal demographics and outcomes of pregnancy. Univariate and multiple logistic regression analyses were performed. RESULTS A total of 34 511 women were included. Early term infants were less likely to be breastfed than were full-term infants (67.9 vs. 70.4%) (adjusted odds ratio [aOR] 0.91; 95% confidence interval [CI] 0.86-0.97). Multiple logistic regression analysis also showed a significant effect of maternal age (aOR 1.07; 95% CI 1.05-1.09), partner status (aOR 1.56; 95% CI 1.20-2.03), smoking (aOR 0.32; 95% CI 0.26-0.41), prenatal education (aOR 2.43; 95% CI 1.99-2.97), pre-pregnancy body mass index (kg/m2) (aOR 0.97; 95% CI 0.96-0.98), and cesarean section (aOR 0.72; 95% CI 0.60-0.88). When compared by week of gestational age at term, the likelihood of breastfeeding significantly increased with each successive week (aOR 1.08; 95% CI 1.007-1.16). CONCLUSION Early term delivery is an independent risk factor for not breastfeeding at the time of postpartum hospital discharge. It is important to target and support these women to increase breastfeeding rates. Additionally, these findings further validate recommendations to avoid non-medically indicated early term deliveries because of the increased risks of adverse outcomes.
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Affiliation(s)
- Gina Colbourne
- Department of Obstetrics and Gynecology, Eastern Health, Memorial University, St. John's, NL.
| | - Joan Crane
- Department of Obstetrics and Gynecology, Eastern Health, Memorial University, St. John's, NL
| | - Phil Murphy
- Newfoundland and Labrador Provincial Perinatal Program, Eastern Health, St John's, NL
| | - Donnette O'Brien
- Department of Obstetrics and Gynecology, Eastern Health, Memorial University, St. John's, NL
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Herrera-Gómez A, Ramos-Torrecillas J, Ruiz C, Ocaña Peinado F, de Luna Bertos E, García-Martínez O. [Prevalence of the early onset of maternal breastfeeding]. NUTR HOSP 2019; 36:786-791. [PMID: 31282172 DOI: 10.20960/nh.02510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION Introduction: the situation with maternal breastfeeding is difficult to describe with any certainty, given the absence of any data gathered in maternity hospitals, and the timing of its onset has not been explicitly evaluated. Further research is needed to evaluate breastfeeding support measures. The objective of the present study was to determine the prevalence of early onset of maternal breastfeeding (EOMB) and to analyze the relationship with different maternal and newborn factors. Methods: a descriptive study was performed of births in a public hospital over a three-year period. The database used for the study derived from an electronic clinical record system designed by professionals. Descriptive and univariate analyses were performed. The association of early onset of maternal breastfeeding with other parameters from mother and newborn was analyzed by the Fisher's test. Results: the prevalence of EOMB was 88.4%. A total of 2,683 births were included in the study. Significant associations were found between this EOMB and different maternal factors, such as parity (p = 0.05) and weeks of gestation (p = 0.047), but not with age (p = 0.522). A strong association was also found with all the factors of the child (p = 0.000), such as weight, color of the amniotic fluid, the Apgar test at one and five minutes, the type of resuscitation required or the need for admission in the neonatal unit. Conclusions: There has been a high rate of (EOMB) in our setting.
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Affiliation(s)
- Antonio Herrera-Gómez
- Hospital Universitario "San Cecilio" (Granada). Sistema Sanitario Público Andaluz. Junta de Andalucía
| | | | - Concepción Ruiz
- Departamento de Enfermería. Facultad de Ciencias de la Salud. Universidad de Granada
| | - Francisco Ocaña Peinado
- Departamento de Estadística e Investigación Operativa. Facultad de Farmacia. Universidad de Granada
| | | | - Olga García-Martínez
- Departamento de Enfermería. Facultad de Ciencias de la Salud. Universidad de Granada
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Goodman DC, Ganduglia-Cazaban C, Franzini L, Stukel TA, Wasserman JR, Murphy MA, Kim Y, Mowitz ME, Tyson JE, Doherty JR, Little GA. Neonatal Intensive Care Variation in Medicaid-Insured Newborns: A Population-Based Study. J Pediatr 2019; 209:44-51.e2. [PMID: 30955790 DOI: 10.1016/j.jpeds.2019.02.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 12/19/2018] [Accepted: 02/12/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To assess the contribution of maternal and newborn characteristics to variation in neonatal intensive care use across regions and hospitals. STUDY DESIGN This was a retrospective population-based live birth cohort of newborn infants insured by Texas Medicaid in 2010-2014 with 2 subcohorts: very low birth weight (VLBW) singletons and late preterm singletons. Crude and risk-adjusted neonatal intensive care unit (NICU) admission rates, intensive and intermediate special care days, and imaging procedures were calculated across Neonatal Intensive Care Regions (n = 21) and hospitals (n = 100). Total Medicaid payments were calculated. RESULTS Overall, 11.5% of live born, 91.7% of VLBW, and 37.6% of infants born late preterm were admitted to a NICU, receiving an average of 2 days, 58 days, and 5 days of special care with payments per newborn inpatient episode of $5231, $128 075, and $10 837, respectively. There was little variation across regions and hospitals in VLBW NICU admissions but marked variation for NICU admissions in late preterm newborn infants and for special care days and imaging rates in all cohorts. The variation decreased slightly after health risk adjustment. There was moderate substitution of intermediate for intensive care days across hospitals (Pearson r VLBW -0.63 P < .001; late preterm newborn -0.53 P < .001). CONCLUSIONS Across all risk groups, the variation in NICU use was poorly explained by differences in newborn illness levels and is likely to indicate varying practice styles. Although the "right" rates are uncertain, it is unlikely that all of these use patterns represent effective and efficient care.
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Affiliation(s)
- David C Goodman
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH; Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, NH.
| | - Cecilia Ganduglia-Cazaban
- Department of Management, Policy & Community Health, University of Texas School of Public Health, Houston, TX
| | - Luisa Franzini
- Department of Health Services Administration, University of Maryland School of Public Health, College Park, MD
| | - Therese A Stukel
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Jared R Wasserman
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - Megan A Murphy
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - Youngran Kim
- Department of Management, Policy & Community Health, University of Texas School of Public Health, Houston, TX
| | | | - Jon E Tyson
- Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, TX
| | - Julie R Doherty
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | - George A Little
- Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
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12
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Fan HSL, Wong JYH, Fong DYT, Lok KYW, Tarrant M. Association between early-term birth and breastfeeding initiation, duration, and exclusivity: A systematic review. Birth 2019; 46:24-34. [PMID: 30051544 DOI: 10.1111/birt.12380] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 06/16/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Infants born early-term, between 37 weeks, 0 days and 38 weeks, 6 days of gestation, are more likely to have adverse health outcomes and to undergo interventions that could pose barriers to breastfeeding. The objectives of this review are to examine the effect of early-term birth on breastfeeding initiation and the duration of any and exclusive breastfeeding. METHODS We systematically searched PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, and Scopus, from January 2007 to June 2017, for studies examining the associations between early-term birth and rates of breastfeeding initiation and the duration of any and exclusive breastfeeding. RESULTS Nine studies were included in the review, of which four assessed breastfeeding initiation rates, eight assessed any breastfeeding duration and two assessed exclusive breastfeeding duration. Two studies found that early-term birth was associated with a lower rate of breastfeeding initiation and five studies reported an association between early-term birth and breastfeeding cessation. One study found that early-term birth was associated with a shorter duration of exclusive breastfeeding. CONCLUSION Although the majority of the reviewed studies reported that early-term infants were less likely to be breastfed and were more likely to be breastfed for a shorter duration, study quality varied and the duration of follow-up was short. Further research with longer follow-up would be beneficial to better understand the effect of early-term birth on breastfeeding.
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Affiliation(s)
| | - Janet Y H Wong
- School of Nursing, University of Hong Kong, Hong Kong, Hong Kong
| | | | | | - Marie Tarrant
- School of Nursing, University of British Columbia, Kelowna, BC, Canada
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13
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Breastfeeding outcomes among early-term and full-term infants. Midwifery 2019; 71:71-76. [PMID: 30690202 DOI: 10.1016/j.midw.2019.01.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/10/2019] [Accepted: 01/13/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND When compared with full-term birth (39 to <42 weeks), early-term birth (37 to <39 weeks) is associated with adverse neonatal outcomes that may impede breastfeeding. Breastfeeding provides numerous benefits to infants and could potentially offset the effects of early-term birth. However, the effect of early-term birth on any and exclusive breastfeeding duration among healthy normal weight infants is unclear. OBJECTIVES The objective of this study was to examine the association between early-term birth and breastfeeding duration and exclusivity among healthy term infants. METHODS Two prospective cohorts of 2704 healthy mother-infant pairs were recruited in Hong Kong in 2006-07 and 2011-12. Participants were followed prospectively for 12 months or until they stopped breastfeeding. RESULTS Approximately one-third (32.8%) of the infants were born early-term. More than one-half of all participants had stopped breastfeeding by three months postpartum and approximately one-half of the infants were not being exclusively breastfed by two weeks postpartum. There was no significant difference in the odds of any (adjusted odds ratio [aOR] = 1.05; 95% 0.85, 1.31) or exclusive (aOR = 0.89; 95% 0.73, 1.08) breastfeeding at one-month postpartum between infants born early-term and at full-term. There was also no significant difference in the duration of any (adjusted hazard ratio [aHR] = 1.0; 95% 0.91, 1.10) or exclusive (aHR = 1.0; 95% 0.91, 1.09) breastfeeding between early-term and full-term infants. CONCLUSION In this cohort, early-term birth was not associated with breastfeeding duration and exclusivity. This suggests that, in the absence of neonatal complications, early-term birth itself may not lead to a shorter duration of any or exclusive breastfeeding.
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14
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Sanghera RS, Boyle EM. Outcomes of infants born near term: not quite ready for the "big wide world"? Minerva Pediatr 2018; 71:47-58. [PMID: 30299031 DOI: 10.23736/s0026-4946.18.05406-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Until recently, there has been a strongly held belief on the part of neonatal and pediatric clinicians that outcomes for infants born close to term are not different from those of babies born at full term. In the last decade, however, this assumption has been challenged by reports suggesting that this is not correct, and highlighting differences in morbidity and mortality both in the short and long term. This has led to development of new terminology to more accurately reflect the impact of immaturity associated with birth at 32-33 weeks (moderately preterm) and 34-36 weeks (late preterm) of gestation. These babies account for around 5-7% of all births and more than 75% of the preterm births in developed countries, so this new recognition of the associated increase in adverse outcomes may have a substantial impact on health care services. This review article will discuss the changing perceptions and concepts of gestational age in the preterm population, and explore the recent and emerging evidence around neonatal, early childhood, school-age, adolescent and adult outcomes for babies who are born moderately preterm and late preterm. It highlights important neonatal and childhood morbidities and will summarize associated health care, developmental and educational problems of affected children. The implications for the provision of ongoing primary and secondary health care, educational and social support to this large and heterogeneous group of individuals will be discussed.
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Affiliation(s)
- Ranveer S Sanghera
- Neonatal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Elaine M Boyle
- Neonatal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK - .,Department of Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK
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15
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Steurer MA, Baer RJ, Burke E, Peyvandi S, Oltman S, Chambers CD, Norton ME, Rand L, Rajagopal S, Ryckman KK, Feuer SK, Liang L, Paynter RA, McCarthy M, Moon‐Grady AJ, Keller RL, Jelliffe‐Pawlowski LL. Effect of Fetal Growth on 1-Year Mortality in Neonates With Critical Congenital Heart Disease. J Am Heart Assoc 2018; 7:e009693. [PMID: 30371167 PMCID: PMC6201429 DOI: 10.1161/jaha.118.009693] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 06/29/2018] [Indexed: 12/21/2022]
Abstract
Background Infants with critical congenital heart disease ( CCHD ) are more likely to be small for gestational age (GA). It is unclear how this affects mortality. The authors investigated the effect of birth weight Z score on 1-year mortality separately in preterm (GA <37 weeks), early-term (GA 37-38 weeks), and full-term (GA 39-42 weeks) infants with CCHD . Methods and Results Live-born infants with CCHD and GA 22 to 42 weeks born in California 2007-2012 were included in the analysis. The primary predictor was Z score for birth weight and the primary outcome was 1-year mortality. Multivariable logistic regression was used. Results are presented as adjusted odds ratios and 95% confidence intervals ( CIs ). The authors identified 6903 infants with CCHD . For preterm and full-term infants, only a Z score for birth weight <-2 was associated with increased mortality compared with the reference group ( Z score 0-0.5, adjusted odds ratio, 2.15 [95% CI , 1.1-4.21] and adjusted odds ratio, 3.93 [95% CI , 2.32-6.68], respectively). In contrast, in early-term infants, the adjusted odds ratios for Z scores <-2, -2 to -1, and -1 to -0.5 were 3.42 (95% CI , 1.93-6.04), 1.78 (95% CI , 1.12-2.83), and 2.03 (95% CI , 1.27-3.23), respectively, versus the reference group. Conclusions GA seems to modify the effect of birth weight Z score on mortality in infants with CCHD . In preterm and full-term infants, only the most severe small-for-GA infants ( Z score <-2) were at increased risk for mortality, while, in early-term infants, the risk extended to mild to moderate small-for-GA infants ( Z score <-0.5). This information helps to identify high-risk infants and is useful for surgical planning.
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Affiliation(s)
- Martina A. Steurer
- Department of PediatricsUniversity of California San FranciscoSan FranciscoCA
- Department of Epidemiology and BiostatisticsUniversity of California San FranciscoSan FranciscoCA
- California Preterm Birth InitiativeUniversity of California San FranciscoSan FranciscoCA
| | - Rebecca J. Baer
- California Preterm Birth InitiativeUniversity of California San FranciscoSan FranciscoCA
- Department of PediatricsUniversity of California San DiegoLa JollaCA
| | - Edmund Burke
- Department of PediatricsUniversity of California San FranciscoSan FranciscoCA
| | - Shabnam Peyvandi
- Department of PediatricsUniversity of California San FranciscoSan FranciscoCA
| | - Scott Oltman
- Department of Epidemiology and BiostatisticsUniversity of California San FranciscoSan FranciscoCA
- California Preterm Birth InitiativeUniversity of California San FranciscoSan FranciscoCA
| | | | - Mary E. Norton
- Department of Obstetrics, Gynecology, and Reproductive SciencesUniversity of California San FranciscoSan FranciscoCA
| | - Larry Rand
- Department of Obstetrics, Gynecology, and Reproductive SciencesUniversity of California San FranciscoSan FranciscoCA
| | - Satish Rajagopal
- Department of PediatricsUniversity of California San FranciscoSan FranciscoCA
| | - Kelli K. Ryckman
- Department of EpidemiologyCollege of Public HealthUniversity of IowaIowa CityIA
| | - Sky K. Feuer
- California Preterm Birth InitiativeUniversity of California San FranciscoSan FranciscoCA
| | - Liang Liang
- Department of GeneticsStanford UniversityStanfordCA
| | - Randi A. Paynter
- Department of Epidemiology and BiostatisticsUniversity of California San FranciscoSan FranciscoCA
- California Preterm Birth InitiativeUniversity of California San FranciscoSan FranciscoCA
| | - Molly McCarthy
- California Preterm Birth InitiativeUniversity of California San FranciscoSan FranciscoCA
| | - Anita J. Moon‐Grady
- Department of PediatricsUniversity of California San FranciscoSan FranciscoCA
| | - Roberta L. Keller
- Department of PediatricsUniversity of California San FranciscoSan FranciscoCA
| | - Laura L. Jelliffe‐Pawlowski
- Department of Epidemiology and BiostatisticsUniversity of California San FranciscoSan FranciscoCA
- California Preterm Birth InitiativeUniversity of California San FranciscoSan FranciscoCA
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16
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Shim M, Yang S, Messina CR, Mintzer JP. Discharge breastmilk feeding rates in asymptomatic term newborns admitted to the neonatal intensive care unit for maternal chorioamnionitis. J Matern Fetal Neonatal Med 2018. [PMID: 29526120 DOI: 10.1080/14767058.2018.1446078] [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: 10/17/2022]
Abstract
PURPOSE To compare discharge breastmilk feeding rates among asymptomatic term newborns receiving 48-hour versus >48-hour antibiotics in the neonatal intensive care unit (NICU) and a cohort of well-baby nursery (WBN) newborns. MATERIALS AND METHODS This retrospective review included asymptomatic term neonates admitted to the NICU due to maternal chorioamnionitis and a comparison group of WBN neonates between January 2012 and December 2015. Demographic, birth, feeding, and lactation consultant visit data were analyzed in univariate and multivariate models. RESULTS Among 272 NICU neonates, 237 (87%) received 48-hour antibiotics versus 35 (13%) who received >48-hour (h) antibiotics; a cohort of 428 WBN neonates was studied for comparison. Exclusive breastmilk feeding was seen in 14% of NICU versus 35% of WBN neonates (p < .01). Among NICU newborns, 48 h versus >48 h antibiotics was not associated with altered discharge breastmilk feeding (14 versus 14%; p = .89). On multivariate logistic regression analysis among NICU subjects, older maternal age (p < .01), lower parity (p = .02), first-feed breastmilk (p < .01), and more lactation consultant visits (p = .012) were associated with increased discharge breastmilk feeding. CONCLUSIONS NICU admission for presumed early-onset sepsis due to maternal chorioamnionitis was associated with reduced discharge breastmilk feeding in asymptomatic term neonates, but prolonged antibiotic exposure was not. We speculate that demographic factors, such as maternal age and parity, may aid in focusing lactation consultant efforts to potentially improve NICU exclusive discharge breastmilk feeding rates.
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Affiliation(s)
- Miry Shim
- a Department of Pediatrics , Stony Brook Children's Hospital , Stony Brook , NY , USA
| | - Sara Yang
- b Stony Brook University School of Medicine , Stony Brook , NY , USA
| | - Catherine R Messina
- c Department of Family , Population and Preventive Medicine, Stony Brook University Hospital , Stony Brook , NY , USA
| | - Jonathan P Mintzer
- d Department of Pediatrics, Division of Neonatal-Perinatal Medicine , Stony Brook Children's Hospital , Stony Brook , NY , USA
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17
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Scime NV, Burke SM. Environmental Scan of Breastfeeding Resources in Canadian NICUs. J Obstet Gynecol Neonatal Nurs 2018; 47:202-213. [PMID: 29425679 DOI: 10.1016/j.jogn.2017.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2017] [Indexed: 01/26/2023] Open
Abstract
We conducted an environmental scan using a mixed methods approach to determine the types and frequencies of breastfeeding resources available to mothers of infants in Canadian NICUs. Through interviews with key informants from 29 Level 3 NICUs, we identified six categories of resources: breastfeeding-friendly layout, breastfeeding support personnel, breastfeeding education for mothers, breast pump-related resources, coordination of postdischarge breastfeeding support, and breastfeeding-related policies. Findings from this national study indicate that a wide range of breastfeeding resources were reportedly available in Canadian Level 3 NICUs. NICU professionals are encouraged to connect with other units across Canada to facilitate the exchange of breastfeeding resources and best practices.
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18
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Buck CO, Gjelsvik A, Vivier PM, Monteiro K, Amanullah S. Prenatal Exposure to Stressful Life Events and Infant Breastfeeding. Breastfeed Med 2018; 13:426-432. [PMID: 29985635 DOI: 10.1089/bfm.2017.0200] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Of the various barriers to breastfeeding, limited information is available on the relationship between prenatal stress and breastfeeding. This study investigates the association between prenatal stressful life event (SLE) exposure and breastfeeding initiation postpartum. MATERIALS AND METHODS Using Rhode Island Pregnancy Risk Assessment Monitoring System data from 2012 to 2014, SLE was defined as self-report of prenatal exposure to 14 predefined life events such as job loss or illness. Exposure to SLE was categorized by number and type of events. Multivariable logistic regression was performed to assess the relationship between SLE and breastfeeding initiation. Results accounted for complex survey design and were adjusted for maternal and infant characteristics (age, race, ethnicity, insurance, delivery type, parity, gestational age, birth weight for gestational age, and neonatal intensive care unit admission). RESULTS Among 3,353 respondents, 86% reported breastfeeding initiation, 74% reported exposure to ≥1 SLE, and 17% reported exposure to ≥4 SLE. Decreased odds of breastfeeding initiation were associated with prenatal exposure to ≥4 SLE (adjusted odds ratio [aOR] 0.67; 95% confidence interval [CI]: 0.48-0.95), emotional stressors (aOR 0.77; 95% CI: 0.61-0.98), and traumatic stressors (aOR 0.68; 95% CI: 0.50-0.91). CONCLUSION This study underscores the impact of exposure to prenatal SLE on breastfeeding initiation among postpartum women. Findings may assist providers in identifying at-risk women for anticipatory guidance to improve breastfeeding rates.
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Affiliation(s)
- Catherine O Buck
- 1 Division of Neonatology, Women and Infants Hospital of Rhode Island , Providence, Rhode Island.,2 Department of Pediatrics, Warren Alpert Medical School of Brown University , Providence, Rhode Island.,3 Hassenfeld Child Health Innovation Institute , Providence, Rhode Island
| | - Annie Gjelsvik
- 2 Department of Pediatrics, Warren Alpert Medical School of Brown University , Providence, Rhode Island.,3 Hassenfeld Child Health Innovation Institute , Providence, Rhode Island.,4 Department of Epidemiology, School of Public Health, Brown University , Providence, Rhode Island
| | - Patrick M Vivier
- 2 Department of Pediatrics, Warren Alpert Medical School of Brown University , Providence, Rhode Island.,3 Hassenfeld Child Health Innovation Institute , Providence, Rhode Island.,5 Department of Health Services Policy and Practice, School of Public Health, Brown University , Providence, Rhode Island
| | - Karine Monteiro
- 6 Rhode Island Department of Health, Center for Health Data and Analysis , Providence, Rhode Island
| | - Siraj Amanullah
- 2 Department of Pediatrics, Warren Alpert Medical School of Brown University , Providence, Rhode Island.,3 Hassenfeld Child Health Innovation Institute , Providence, Rhode Island.,5 Department of Health Services Policy and Practice, School of Public Health, Brown University , Providence, Rhode Island.,7 Department of Emergency Medicine, Warren Alpert Medical School of Brown University , Providence, Rhode Island
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19
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Sisson H, Jones C, Williams R, Lachanudis L. Metaethnographic Synthesis of Fathers' Experiences of the Neonatal Intensive Care Unit Environment During Hospitalization of Their Premature Infants. J Obstet Gynecol Neonatal Nurs 2015; 44:471-480. [PMID: 26017337 DOI: 10.1111/1552-6909.12662] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To synthesize existing qualitative findings about fathers' experiences of the neonatal intensive care unit (NICU) environment. DATA SOURCES Relevant key terms including preterm, father, and NICU were used to search the databases of CINAHL Plus, Academic Search Premier, MEDLINE, and PsychInfo. STUDY SELECTION Only primary qualitative studies were included. Studies were excluded that did not focus on the NICU environment. DATA EXTRACTION Twenty-four studies were included. All authors critically appraised and extracted data relating to fathers' experiences in the NICU using an agreed data extraction form. DATA SYNTHESIS Findings were synthesized by translating the initial concepts and findings from an identified key paper into the data from the remaining 23 studies. Initially this was done separately by each author followed by further group discussion and synthesis. Emergent themes included Proximity, Parental Autonomy, Vulnerability, Communication and Exclusion, and Isolation. CONCLUSIONS The needs of fathers to interact and be involved with their infants' care was a prominent factor that enhanced their experiences in the NICU. Staff in the NICU can play a key role in facilitating this interaction through encouragement and reassurance.
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