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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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Augustyn M, Haskins D, Gross S, Resnik AK, Ducharme-Smith K, Orta-Aleman D, Silbert-Flagg J, Rosenblum N, Caulfield LE. Maternity care experiences and breastfeeding at discharge among Maryland WIC participants: A qualitative analysis. Birth 2023; 50:1009-1017. [PMID: 37533361 DOI: 10.1111/birt.12758] [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: 09/16/2021] [Revised: 04/18/2023] [Accepted: 07/20/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Breastfeeding imparts numerous health and social benefits for families. Barriers deter some individuals from breastfeeding. Rates are lower among certain populations, including participants of the federally funded Women, Infants, and Children's Program (WIC). Women, Infants, and Children's Program provides low-income pregnant and postpartum women and children under 5 with nutrition education, supplemental foods, breastfeeding education and support, and resource linkages. Investigation of WIC participants' hospital experiences and breastfeeding decisions is limited. We explore qualitative themes associated with breastfeeding-related hospital maternity care practices experienced by WIC participants. METHODS Thirty pregnant individuals intending to breastfeed were recruited at WIC clinics to complete in-depth interviews at 2 weeks, 3 months, and 6 months of postpartum. Using the Thematic Framework methodology, we analyzed data from the two-week interviews of 29 participants with respect to hospital breastfeeding experiences. RESULTS Fourteen participants were exclusively breastfeeding at discharge (EBFD). Fifteen were partially breastfeeding at discharge (PBFD). Differences between groups were found in hospital breastfeeding experiences, particularly in staff support. All participants EBFD reported positive breastfeeding-related staff experiences. Most participants PBFD reported limited and ineffective staff interaction, leading to formula introduction. CONCLUSIONS Individuals EBFD and those PBFD reported about the same rate of hospital breastfeeding difficulties, yet half introduced formula within the first few days postpartum. Results reiterate the importance of hospital staff support to breastfeeding exclusivity at 2-3 days postpartum. The challenges that these individuals faced may have been resolved through available, responsive, and effective intervention. Data-driven breastfeeding education programs for hospital health professionals are critical to affect patient breastfeeding outcomes.
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Affiliation(s)
- Marycatherine Augustyn
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - Danielle Haskins
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - Susan Gross
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - Amy Kovar Resnik
- Maryland WIC Program, Maryland Department of Health, Baltimore, Maryland, USA
| | - Kirstie Ducharme-Smith
- Center for Human Nutrition, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - Dania Orta-Aleman
- Center for Human Nutrition, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - JoAnne Silbert-Flagg
- Pediatric Nurse Practitioner Track, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Nadine Rosenblum
- Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, Maryland, USA
- Adjunct Faculty, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Laura E Caulfield
- Center for Human Nutrition, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
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Chen Y, Zhao Y, Wang W, Wang F, Jiang H, Wang L. Factors associated with exclusive breastfeeding during postpartum in Lanzhou city, China: a cross-sectional study. Front Public Health 2023; 11:1089764. [PMID: 37711249 PMCID: PMC10498539 DOI: 10.3389/fpubh.2023.1089764] [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: 11/04/2022] [Accepted: 08/15/2023] [Indexed: 09/16/2023] Open
Abstract
Aim Breastfeeding generates short-term and long-term benefits for both mother and child. Exclusive breastfeeding (EBF) is promoted in China for years, but its practice still lags far behind the international average, even among low- and middle- income countries. This study aimed to investigate factors associated with EBF during postpartum. Methods This study was conducted in a tertiary referral hospital in Gansu Province, Northwest China from October 2019 to April 2020. 3,738 postnatal women were finally included and each of them completed an elaborately designed questionnaire. Infant feeding patterns (EBF or not) and reasons for NEBF (non-exclusive breastfeeding) were collected. The feeding knowledge score was based on 17 questions in relation to breastfeeding. The total score ranges from 0 to 17. Higher score means better understanding about breastfeeding knowledge. Multivariate logistic regression models were used to determine associated factors of EBF during postpartum. A subgroup analysis was conducted to investigate the association between feeding knowledge score and exclusive breastfeeding. Results Six weeks after childbirth, 1891 mothers (50.6%) maintained EBF. Among the NEBF mothers, 57.01% (n = 1,053) of them stopped exclusive breastfeeding due to self-perceived lack of breast milk production. Factors associated with NEBF were higher maternal age, ethnic minorities and cesarean section. Protective factors of EBF included multipara, positive feeding attitude and high breastfeeding knowledge score. In subgroup analysis, we found the breastfeeding knowledge score had a significant impact on the mothers of Han nationality, underwent cesarean or natural delivery, both primiparous and multiparous, and those with positive attitude towards breastfeeding (p < 0.05). Conclusion We need a comprehensive and individualized framework of strategies to support children, mothers and their families. During puerperium, improving maternal knowledge of breastfeeding is beneficial to EBF practice. However, for ethnic minorities and those with less active breastfeeding attitudes, breastfeeding knowledge is of limited use, more researches are needed to explore the uncovered reasons, so that more personalized interventions could be developed for them.
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Affiliation(s)
- Yuelu Chen
- Department of Reproductive Health and Infertility, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
| | - Yong Zhao
- College of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Wenling Wang
- Perinatology Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, China
| | - Fengdi Wang
- Department of Reproductive Health and Infertility, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
| | - Huimin Jiang
- Department of Reproductive Health and Infertility, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
| | - Lianlian Wang
- Department of Reproductive Health and Infertility, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
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Zimmerman DR, Kaplan M, Shoob H, Freisthler M, Toledano M, Stein-Zamir C. Breastfeeding challenges and support in a high initiation population. Isr J Health Policy Res 2022; 11:31. [PMID: 36071536 PMCID: PMC9449948 DOI: 10.1186/s13584-022-00538-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The breastfeeding initiation rate in Israel is approximately 90%, yet exclusive breastfeeding drops sharply in the early postnatal period. The study objective was to assess early postpartum professional breastfeeding support, its association with breastfeeding success and identification of risk factors for early breastfeeding discontinuation. METHODS As part of a post-discharge newborn follow-up study, a convenience sample of 868 mothers attending Maternal and Child Health Centers (MCHCs) up to three months post-partum were interviewed using a 26-item questionnaire. Breastfeeding-related questions covered demographic variables, pregnancy and birth details; breastfeeding duration, lactation support in hospital and post-discharge; and problems experienced. RESULTS Most mothers, 797 (91.8%), initiated breastfeeding in hospital. All women who initiated breastfeeding in the hospital reported exclusive breastfeeding; by two weeks postpartum, 70 women (13.2%) were supplementing with formula (partial breastfeeding). Kaplan-Meier Survival Analysis revealed an estimated mean duration of exclusive breastfeeding in the sample population of 66.8 ± 1.5 days. This duration was shorter for women with preterm births, low birthweight infants (LBW), cesarean births, and hospitalizations in neonatal intensive care units (NICU). A total of 472 (59.3%) breastfeeding mothers reported receiving in-hospital guidance. Of these, 290 (61.3%) were observed breastfeeding. Of all women who initiated breastfeeding, 280 (35.1%) attended MCHC follow-up within 72 h of hospital discharge. A higher proportion of women experiencing breastfeeding difficulties attended an MCHC within 72 h (131/297, 44.1%) compared to women not experiencing difficulties (148/499, 29.7%). The most frequently reported problems were mechanical (55.2%) or milk supply concerns (18.5%). First-time mothers were more likely to report problems, as were Jewish (vs Arab) mothers. CONCLUSIONS Even in a population with high initiation rates of breastfeeding, breastfeeding duration, both exclusive and partial, is less than recommended. As much of this drop-off occurs during maternity leave, it is likely related to breastfeeding challenges other than employment. Breastfeeding support needs of women are currently not adequately met; staffing and time for both in-hospital and community-based counseling needs to be funded as well as mandated. Counseling hours should be tailored to assure adequate coverage of high-risk groups such as women after cesarean delivery and newborns requiring intensive care.
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Affiliation(s)
- Deena R Zimmerman
- Department of Maternal and Child Health, Public Health Services, Ministry of Health, 39 Yirmyahu St, P.O.B. 1176, 9446724, Jerusalem, Israel.
| | - Michael Kaplan
- Jerusalem District Health Office, Ministry of Health, 86 Jaffa Road, Jerusalem, Israel
| | - Hanna Shoob
- Jerusalem District Health Office, Ministry of Health, 86 Jaffa Road, Jerusalem, Israel
| | - Marlaina Freisthler
- Jerusalem District Health Office, Ministry of Health, 86 Jaffa Road, Jerusalem, Israel
| | - Monique Toledano
- Jerusalem District Health Office, Ministry of Health, 86 Jaffa Road, Jerusalem, Israel
| | - Chen Stein-Zamir
- Jerusalem District Health Office, Ministry of Health, 86 Jaffa Road, Jerusalem, Israel.,Faculty of Medicine, The Hebrew University and Hadassah Braun School of Public and Community Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
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Pezley L, Cares K, Duffecy J, Koenig MD, Maki P, Odoms-Young A, Clark Withington MH, Lima Oliveira M, Loiacono B, Prough J, Tussing-Humphreys L, Buscemi J. Efficacy of behavioral interventions to improve maternal mental health and breastfeeding outcomes: a systematic review. Int Breastfeed J 2022; 17:67. [PMID: 36064573 PMCID: PMC9446548 DOI: 10.1186/s13006-022-00501-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 08/08/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Despite extensive benefits and high intentions, few mothers breastfeed exclusively for the recommended duration. Maternal mental health is an important underlying factor associated with barriers and reduced rates of breastfeeding intent, initiation, and continuation. Given evidence of a bidirectional association between maternal mental health and breastfeeding, it is important to consider both factors when examining the efficacy of interventions to improve these outcomes. The purpose of this manuscript is to review the literature on the efficacy of behavioral interventions focused on both maternal mental health and breastfeeding outcomes, examining the intersection of the two. METHODS This systematic review was completed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Studies were selected if they were available in English, used primary experimental design, and used a behavioral intervention type to examine maternal mental health and breastfeeding outcomes. Articles were identified from PubMed, CINAHL, Embase, and PsycINFO from database inception to 3 March 2022. Study quality was assessed using the Cochrane Risk of Bias tool. Results were synthesized by intervention success for 1. Mental health and breastfeeding, 2. Breastfeeding only, 3. Mental health only, and 4. No intervention effect. PROSPERO CRD42021224228. RESULTS Thirty interventions reported in 33 articles were identified, representing 15 countries. Twelve studies reported statistically significant positive effect of the intervention on both maternal mental health and breastfeeding; most showing a decrease in self-report depressive and/or anxiety symptoms in parallel to an increase in breastfeeding duration and/or exclusivity. Common characteristics of successful interventions were a) occurring across pregnancy and postpartum, b) delivered by hospital staff or multidisciplinary teams, c) offered individually, and d) designed to focus on breastfeeding and maternal mental health or on breastfeeding only. Our results are not representative of all countries, persons, experiences, circumstances, or physiological characteristics. CONCLUSIONS Interventions that extend the perinatal period and offer individualized support from both professionals and peers who collaborate through a continuum of settings (e.g., health system, home, and community) are most successful in improving both mental health and breastfeeding outcomes. The benefits of improving these outcomes warrant continued development and implementation of such interventions. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021224228.
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Affiliation(s)
- Lacey Pezley
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA.
| | - Kate Cares
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA
| | - Jennifer Duffecy
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Mary Dawn Koenig
- Department of Human Development Nursing Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Pauline Maki
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | | | | | - Manoela Lima Oliveira
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA
| | | | - Jilian Prough
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA
| | - Lisa Tussing-Humphreys
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA
| | - Joanna Buscemi
- Department of Psychology, DePaul University, Chicago, IL, USA
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6
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Huang Y, Liu Y, Yu XY, Zeng TY. The rates and factors of perceived insufficient milk supply: A systematic review. MATERNAL AND CHILD NUTRITION 2021; 18:e13255. [PMID: 34382733 PMCID: PMC8710095 DOI: 10.1111/mcn.13255] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/27/2022]
Abstract
Perceived insufficient milk supply (PIMS) is one of the major reasons for discontinued breastfeeding. We aimed to estimate the rates and evaluate related factors of PIMS. We searched four databases for relevant articles published from January 2000 to March 2021. We then performed a meta‐analysis of the pooled data to estimate the rates and related factors of PIMS using Stata 15.0. Descriptive analyses of textual data were performed to summarise the related factors of PIMS if data could not be synthesised quantitatively. The quality of included studies was assessed using Newcastle–Ottawa scale (NOS), AHRQ checklist or Consolidated Criteria for Reporting Qualitative Research (COREQ). Overall, 27 studies were included in this review. At different periods after delivery, approximately 50% of mothers reported PIMS as the reason for stopping breastfeeding, while for breastfeeding mothers, the incidence of PIMS ranged from 10% to 25%. Breastfeeding initiation (OR 4.22, 95%CI 1.57–11.34) and breastfeeding knowledge (OR 7.10, 95%CI 2.00–25.26) were two factors influencing PIMS. Besides, PIMS had a strong negative relationship with breastfeeding self‐efficacy (r = −0.57); moderate negative association with infant suck ability (r = −0.46) and planned breastfeeding duration (r = −0.45); and a moderate positive correlation with formula supplementation (r = 0.42). Descriptive analyses revealed that infant crying was reported to be a sign of PIMS, and inadequate intake of energy/liquids was a reported cause of it. This review identified a high proportion of women reporting PIMS, particularly among those who stopped breastfeeding. Deliberate interventions were needed to improve breastfeeding for mothers at risk.
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Affiliation(s)
- Yi Huang
- Nursing Department, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, China
| | - Yu Liu
- Nursing Department, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, China
| | - Xiao-Yan Yu
- Nursing Department, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, China
| | - Tie-Ying Zeng
- Nursing Department, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, China
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7
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Zerfu TA, Griffiths P, Macharia T, Kamande EW, Anono E, Kiige L, Gatheru PM, Jobando S, Moloney G, Kimani-Murage EW. Communities and employers show a high level of preparedness in supporting working mothers to combine breastfeeding with work in rural Kenya. MATERNAL AND CHILD NUTRITION 2021; 17:e13180. [PMID: 33856124 PMCID: PMC8476406 DOI: 10.1111/mcn.13180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/19/2021] [Accepted: 02/24/2021] [Indexed: 11/29/2022]
Abstract
Community Readiness Model (CRM) through pragmatic mixed methods design, combining quantitative CRM survey with qualitative data, was used to assess the level of preparedness and readiness among local leaders, employers and community members in supporting working mothers to combine breastfeeding with work. The study was conducted in one of the tea state farms in Kericho County of Kenya. A total of 17 purposively selected men (fathers), lactating mothers, peer educators, health professionals (doctors, nurses and nutritionists), tea plantation managers and grandmothers were interviewed. The CRM that has six different dimensions was applied to determine the stage of readiness to support working mothers to combine breastfeeding with work. Community Readiness Score (CRS) was calculated descriptively as mean ± standard deviation (SD). Thematic analysis using NVIVO software was used to analyse qualitative data. We found that the mean (±SD) CRS was 7.3 (1.9), which corresponded to the third highest level of the nine stages or the ‘stabilization’ stage of community readiness. Dimensionally, the mean CRS was the highest (8.3 ± 1.9) for leadership followed by community efforts (7.5 ± 2.1), whereas the lowest CRS was observed for knowledge of efforts (6.6 ± 2.3) and availability of resources (6.6 ± 1.9). In conclusion, high level of readiness to support working women to combine work with breastfeeding with suboptimal knowledge of efforts and availability of resources was observed in the area. Future interventions should focus on enabling the community to feel more comfortable and creating detailed and refined knowledge on combining breastfeeding with work.
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Affiliation(s)
- Taddese Alemu Zerfu
- Global Academy of Agriculture and Food Security, University of Edinburgh (UoE), UK.,African Population and Health Research Center, Nairobi, Kenya.,International Livestock Research Institute (ILRI) Kenya, Nairobi, Kenya
| | | | | | - Eva W Kamande
- African Population and Health Research Center, Nairobi, Kenya
| | - Esther Anono
- African Population and Health Research Center, Nairobi, Kenya
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Khorana M, Wongsin P, Torbunsupachai R, Kanjanapattanakul W. Effect of Domperidone on Breast Milk Production in Mothers of Sick Neonates: A Randomized, Double-Blinded, Placebo-Controlled Trial. Breastfeed Med 2021; 16:245-250. [PMID: 33202169 DOI: 10.1089/bfm.2020.0234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: Mothers of many preterm babies are unable to produce sufficient milk for their babies during the prolonged hospitalization. Domperidone stimulates the release of prolactin, thereby increasing breast milk production. The primary outcome was to study the efficacy of domperidone in augmenting breast milk production in mothers with lactation failure (LF). The secondary outcomes included the effect of domperidone on prolactin levels, adverse effects of domperidone, and outcome on breastfeeding rates at discharge. Materials and Methods: This was a randomized, double-blinded, placebo-controlled trial where mothers with LF were either allocated domperidone (10 mg) or placebo, 2 tablets three times a day for 14 days. Milk volumes were recorded daily for 14 days. Serum prolactin levels were measured at the start and at day 7 of study. Results: Out of 166 women eligible for the study, 119 (71.7%) mothers were able to increase their breast milk production without pharmacological treatment after being counseled on the advantages of human milk and proper breastfeeding management. Forty-seven mothers were finally enrolled in the study; 24 in the domperidone group (DG) and 23 in the placebo group (PG). Breast milk production increased from a baseline of 156 + 141.1 to 400.9 + 239.2 mL in the DG and increased from a baseline of 175.8 + 150.7 to 260.5 + 237.5 mL in the PG, after 14 days (p < 0.01). The prolactin levels in the DG and PG increased from 72.85 (22.2-167.15) and 42.33 (14.02-93.54) ng/mL, respectively, to 223.4 (49.79-280.2) ng/mL (p = 0.005) in the DG and 60.08 (14.31-132.14) ng/mL (p = 0.232) in the PG on the 7th day of treatment. No adverse effects were recorded. Ninety-five percent of babies in the DG were exclusively breastfeeding at hospital discharge, compared with 52.4% in the PG (p = 0.008). Conclusion: Domperidone treatment can result in an increase in breast milk production with no adverse effects. The study was registered with the Thai Clinical Trials Registry ID TCTR2020091008.
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Affiliation(s)
- Meera Khorana
- Neonatal Unit, Department of Pediatrics, Queen Sirikit National Institute of Child Health, College of Medicine, Rangsit University, Bangkok, Thailand
| | - Panrada Wongsin
- Neonatal Unit, Department of Pediatrics, Queen Sirikit National Institute of Child Health, College of Medicine, Rangsit University, Bangkok, Thailand
| | - Roongrawee Torbunsupachai
- Neonatal Unit, Department of Pediatrics, Queen Sirikit National Institute of Child Health, College of Medicine, Rangsit University, Bangkok, Thailand
| | - Wiboon Kanjanapattanakul
- Neonatal Unit, Department of Pediatrics, Queen Sirikit National Institute of Child Health, College of Medicine, Rangsit University, Bangkok, Thailand
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9
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Chrzan-Dętkoś M, Walczak-Kozłowska T, Pietkiewicz A, Żołnowska J. Improvement of the breastfeeding self-efficacy and postpartum mental health after lactation consultations - Observational study. Midwifery 2020; 94:102905. [PMID: 33360178 DOI: 10.1016/j.midw.2020.102905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/24/2020] [Accepted: 12/10/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Maternal self-efficacy in breastfeeding may be undermined by common mental health difficulties in the postpartum, leading to an early breastfeeding cessation. The relationship may also be the opposite: problems with effective breastfeeding and breastfeeding cessation may increase the postpartum mental health difficulties. The purpose of this study was the assessment of the effectiveness of lactation consultations in strengthening the breastfeeding self-efficacy and maternal postpartum mental health. DESIGN AND PARTICIPANTS 160 Polish women (90 consultation participants and 70 controls) completed a structured interview, the General Health Questionnaire, and the Breastfeeding Self-Efficacy Scale twice: before lactation consultation and one month later. SETTING Research was conducted in the city of Gdańsk, Poland. FINDINGS Study revealed that women seeking lactation support exhibited greater mental health difficulties while their breastfeeding self-efficacy was similar to the control group. Initial breastfeeding self-efficacy was negatively correlated with the severity of the postpartum mental health problems. One month after lactation consultations, a significant increase in the breastfeeding self-efficacy and significantly reduced symptoms of mental health difficulties (somatic symptoms, functional disorders, and anxiety and insomnia) were observed among mothers. KEY CONCLUSIONS Women willing to benefit from the lactation consultations may exhibit symptoms of mental health difficulties that may be associated with difficulties in breastfeeding. Strengthening the breastfeeding confidence during lactation consultations, may reflect in the improvement of the woman's mental health. IMPLICATIONS FOR PRACTICE Midwives and lactation consultants can make a difference in the mental health promotion by offering breastfeeding interventions which address the emotional needs of a mother.
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Affiliation(s)
| | - Tamara Walczak-Kozłowska
- Institute of Psychology, University of Gdansk, Jana Bażyńskiego 4, 80-309 Gdańsk, Poland; Department of Psychology, Gdansk University of Physical Education and Sport, Kazimierza Górskiego 1, 80-336, Gdańsk, Poland.
| | | | - Joanna Żołnowska
- St. Wojciech Hospital in Gdańsk, aleja Jana Pawła II 50, 80-462 Gdańsk, Poland.
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10
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Fadiloglu E, Karatas E, Tez R, Cagan M, Unal C, Nar M, Tanacan A, Beksac MS. Assessment of Factors Affecting Breastfeeding Performance and Latch Score: A Prospective Cohort Study. Z Geburtshilfe Neonatol 2020; 225:353-360. [PMID: 33022737 DOI: 10.1055/a-1255-3525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To determine the risk factors that may affect LATCH scores. MATERIALS AND METHODS We prospectively evaluated the LATCH scores and any relevant risk factors of patients who delivered at our institution during April and May 2020. All examinations were performed by the same physicians during the study period. LATCH scores were determined at initial breastfeeding session, and postnatal days 1 and 2. RESULTS We analyzed 338 patients in this prospective study. Patients with high-risk pregnancies were found to have lower LATCH scores at each measurement (p: 0.002, 0.001, and 0.09, respectively). Skin-to-skin contact immediately after delivery and breastfeeding longer than 20 min in the first session did not improve LATCH scores (p>0.05). Breastfeeding within 30 min after delivery significantly improved LATCH scores at each session (p<0.01 for all). Odds ratios of having a LATCH score lower than 8 was 10.9 (95% CI: 4.22-28.37) for the patients breastfed after more than 30 min, while this ratio was 2.17 (95% CI: 1.34-3.50) and 6.5 (95% CI: 3.46-12.58) for the patients having a high-risk pregnancy and cesarean section, respectively. Furthermore, we also determined a positive statistically significant association between parity and all LATCH scores according to regression analyses (p: 0.005, 0.028, and 0.035 for LATCH scores at initial breastfeeding, postnatal day 1 and 2, respectively) CONCLUSION: High-risk pregnancies, patients who delivered by cesarean section, and patients not attempting to breastfeed within 30 min tend to have lower LATCH scores.
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Affiliation(s)
- Erdem Fadiloglu
- Division of Perinatal Medicine, Department of Obstetrics and Gynecology, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Esra Karatas
- Division of Perinatal Medicine, Department of Obstetrics and Gynecology, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Ruya Tez
- Division of Perinatal Medicine, Department of Obstetrics and Gynecology, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Murat Cagan
- Division of Perinatal Medicine, Department of Obstetrics and Gynecology, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Canan Unal
- Division of Perinatal Medicine, Department of Obstetrics and Gynecology, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Makbule Nar
- Division of Perinatal Medicine, Department of Obstetrics and Gynecology, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Atakan Tanacan
- Division of Perinatal Medicine, Department of Obstetrics and Gynecology, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Mehmet Sinan Beksac
- Division of Perinatal Medicine, Department of Obstetrics and Gynecology, Hacettepe University Medical Faculty, Ankara, Turkey
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Patterson JA, Keuler NS, Eglash AR, Olson BH. Outpatient Breastfeeding Champion Program: Breastfeeding Support in Primary Care. Breastfeed Med 2020; 15:44-48. [PMID: 31397581 DOI: 10.1089/bfm.2019.0108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Breastfeeding support offered by trained professionals can increase breastfeeding success. The Outpatient Breastfeeding Champion (OBC) program creates a network of Breastfeeding Champions (typically nurses) who are trained to identify and resolve common breastfeeding issues and refer to lactation professionals as needed. The objective of this study was to evaluate the impact the OBC program on nurses' attitudes toward breastfeeding and self-confidence in providing breastfeeding care. Materials and Methods: The OBC program was implemented in 11 medical offices within a health care system. Nurses were surveyed before (n = 9) and immediately after (n = 9) participating in OBC training sessions, and 6 months following the implementation of the OBC training (n = 15). Data were collected on their breastfeeding attitude and self-confidence in providing breastfeeding care, and the responses at the different time points were compared using Wilcoxon Rank-Sum tests. Results: Nurses' attitudes toward breastfeeding (p = 0.049) and self-confidence in managing breastfeeding position and attachment (p = 0.09) were higher immediately after completion of the OBC training than they were before training. There was no significant difference in either response between immediately after completion and 6 months following training. Conclusion: This study presents a model of breastfeeding care that extends the reach of an International Board Certified Lactation Consultant to improve breastfeeding support in the primary care setting. Nurses' more positive breastfeeding attitudes and self-confidence in providing breastfeeding care following training suggest that the use of a breastfeeding training program may improve the breastfeeding support provided by nurses, which could be sustained over time.
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Affiliation(s)
- Julie A Patterson
- Department of Nutrition, Dietetics and Wellness, College of Health and Human Sciences, Northern Illinois University, DeKalb, Illinois.,Department of Nutritional Sciences, College of Agricultural and Life Sciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Nicholas S Keuler
- Department of Statistics, College of Letters and Science, University of Wisconsin-Madison, Madison, Wisconsin
| | - Anne R Eglash
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Beth H Olson
- Department of Nutritional Sciences, College of Agricultural and Life Sciences, University of Wisconsin-Madison, Madison, Wisconsin
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12
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Bochner RE, Kuroki R, Lui K, Russell CJ, Rackovsky E, Piper L, Ban K, Yang K, Mandal P, Mackintosh L, Mirzaian CB, Gross E. Variations in Care for Breastfed Infants Admitted to US Children's Hospitals: A Multicenter Survey of Inpatient Providers. Hosp Pediatr 2019; 10:70-75. [PMID: 31826917 DOI: 10.1542/hpeds.2019-0199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Studies have revealed an association between hospitalization of breastfed infants and weaning posthospitalization. It is unknown what steps inpatient providers at children's hospitals are currently taking to support breastfeeding mothers of hospitalized infants, their comfort providing breastfeeding counseling, and what training they receive. METHODS We conducted a multicenter survey study of pediatric providers who care for infants hospitalized at 3 urban, tertiary-care children's hospitals over a 12-month period. A convenience sample of nurses, residents, and attending physicians agreed to participate. Participants completed a 24-question questionnaire addressing provider practices, comfort with breastfeeding counseling, and previous breastfeeding education. Data were summarized as medians (interquartile ranges) and frequencies (percentages). Kruskal-Wallis and χ2 tests were used to compare between provider types. RESULTS A total of 361 out of 1097 (33%) eligible providers completed the survey: 133 (21%) nurses, 166 (45%) residents, and 62 (63%) attending physicians. Provider practices varied by provider type. We observed a general trend that providers do not routinely review breastfeeding techniques, directly observe feeds, or use standardized breastfeeding assessment tools. Residents and attending physicians were more likely than nurses to feel comfortable with breastfeeding counseling (P = .02). Residents were more likely than nurses and attending physicians to have received breastfeeding education in the last 3 years (P < .001). CONCLUSIONS Practices, comfort, and previous education varied by provider type. There was a general pattern that providers do not routinely perform certain practices. Further studies are needed to determine if inpatient provider practices affect weaning posthospitalization and if inpatient quality improvement initiatives will help mothers continue breastfeeding posthospitalization.
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Affiliation(s)
- Risa E Bochner
- Department of Pediatrics, University Hospital of Brooklyn, State University of New York Downstate Medical Center and Kings County Hospital Center, Brooklyn, New York;
| | - Robyn Kuroki
- Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Karen Lui
- Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Christopher J Russell
- Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Elia Rackovsky
- Department of Pediatrics, Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, New York
| | - Laura Piper
- Department of Pediatrics, Cincinnati Children's Hospital and College of Medicine, University of Cincinnati, Cincinnati, Ohio; and
| | - Kathryn Ban
- Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Katharine Yang
- Department of Internal Medicine, Los Angeles County + University of Southern California Medical Center and Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Purnima Mandal
- Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Liza Mackintosh
- Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Christine B Mirzaian
- Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Elissa Gross
- Department of Pediatrics, Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, New York
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Piccinin E, Morgano A, Peres C, Contursi A, Bertrand-Michel J, Arconzo M, Guillou H, Villani G, Moschetta A. PGC-1α induced browning promotes involution and inhibits lactation in mammary glands. Cell Mol Life Sci 2019; 76:5011-5025. [PMID: 31154462 PMCID: PMC11105553 DOI: 10.1007/s00018-019-03160-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/19/2019] [Accepted: 05/22/2019] [Indexed: 12/17/2022]
Abstract
The PPARγ coactivator 1α (PGC-1α) is a transcriptional regulator of mitochondrial biogenesis and oxidative metabolism. Recent studies have highlighted a fundamental role of PGC-1α in promoting breast cancer progression and metastasis, but the physiological role of this coactivator in the development of mammary glands is still unknown. First, we show that PGC-1α is highly expressed during puberty and involution, but nearly disappeared in pregnancy and lactation. Then, taking advantage of a newly generated transgenic mouse model with a stable and specific overexpression of PGC-1α in mammary glands, we demonstrate that the re-expression of this coactivator during the lactation stage leads to a precocious regression of the mammary glands. Thus, we propose that PGC-1α action is non-essential during pregnancy and lactation, whereas it is indispensable during involution. The rapid preadipocyte-adipocyte transition, together with an increased rate of apoptosis promotes a premature mammary glands involution that cause lactation defects and pup growth retardation. Overall, we provide new insights in the comprehension of female reproductive cycles and lactation deficiency, thus opening new roads for mothers that cannot breastfeed.
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Affiliation(s)
- Elena Piccinin
- Department of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy
| | - Annalisa Morgano
- Department of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy
| | - Claudia Peres
- Department of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy
- INBB, National Institute for Biostuctures and Biosystems, Rome, Italy
| | - Annalisa Contursi
- Department of Neuroscience, Imaging and Clinical Sciences and Center for Research on Aging and Translational Medicine (CeSI-MeT), "G. d'Annunzio" University of Chieti, Chieti, Italy
| | - Justine Bertrand-Michel
- MetaToul-Lipidomic Facility-MetaboHUB, INSERM UMR1048, Institute of Cardiovascular and Metabolic Diseases, Université Paul Sabatier, Toulouse, France
| | - Maria Arconzo
- INBB, National Institute for Biostuctures and Biosystems, Rome, Italy
| | - Hervé Guillou
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, UMR1331 INRA, ENVT, INP-Purpan, Université Paul Sabatier, Toulouse, France
| | - Gaetano Villani
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, "Aldo Moro" University of Bari, Bari, Italy
| | - Antonio Moschetta
- Department of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy.
- National Cancer Center, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.
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14
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Huang P, Yao J, Liu X, Luo B. Individualized intervention to improve rates of exclusive breastfeeding: A randomised controlled trial. Medicine (Baltimore) 2019; 98:e17822. [PMID: 31764775 PMCID: PMC6882561 DOI: 10.1097/md.0000000000017822] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Despite breastfeeding is significant benefits for maternal and infant, the discontinuation of breastfeeding is high. Some of studies showed that the effect of intervention in improving the rate of exclusively breastfeeding is unclear. The aim of this study is to investigate the effectiveness of individualized intervention compared with routine care in improving rates of exclusive breast feeding. METHODS Women were divided into two groups. We provided individual antenatal breastfeeding education and postnatal lactation support to intervention group. Control group received routine care. Significance was set at P < .05. RESULTS We recruited 352 women of whom 176 were randomized to intervention group, 176 to control group. In total, 293 (83.2%) completed 4 months of follow-up. At discharge from hospital, 43.2% of women randomized to intervention group were exclusively breastfeeding compared with 30.0% of women in control group (relative risk 1.78; 95% confidence interval [CI] 1.12-2.82). At 4 months, 70.9% of women in the intervention group were exclusively breastfeeding compared with 46.2% of the women in the control group (2.84; 1.76-4.60). At discharge from hospital, 95.1% of women in the intervention group were breastfeeding on demand compared with 68.1% of women receiving routine care (9.00; 4.09-19.74). At 4 months, 94.6% of women in intervention group were breastfeeding on demand compared with 75.9% of women in the control group (5.57; 2.48-12.49). CONCLUSION The regular ongoing individualized antenatal education and postnatal support can effective increase the rates of exclusive breastfeeding from delivery to postpartum 4 months and change the breastfeeding behavior.
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Affiliation(s)
- Pan Huang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education
- West China School of Nursing/West China Second Hospital Obstetrics Department Sichuan University
| | - Jianrong Yao
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education
- Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Xinghui Liu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education
- Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Biru Luo
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education
- Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
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15
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Abstract
Guidelines recommend breastfeeding in cystic fibrosis (CF) but breastfeeding rates decline rapidly in CF. We initiated a quality improvement project to improve breastfeeding in CF by incorporating International Board-Certified Lactation Consultants (IBCLC) into the initial CF-diagnosis visit to support mothers who were breastfeeding at diagnosis. In the preintervention group, only 8/14 (57%) continued to provide breast milk after the first visit, whereas postintervention, 16/17 (94%) mothers continued to do so (P = 0.03). The duration of any (or partial) breastfeeding increased to an average of 7.7 months from an average of 6.4 months preintervention (P = 0.45). The weight z score and weight-for-length z score at diagnosis showed no change at 6 or 12 months (all comparisons P value >0.05). We conclude that mothers who met with the IBCLC were less likely to quit breastfeeding and hypothesize that lactation support to mothers can prolong the duration of breastfeeding in infants with CF.
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16
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Foss KA, Blake K. "It's natural and healthy, but I don't want to see it": Using Entertainment-Education to Improve Attitudes Toward Breastfeeding in Public. HEALTH COMMUNICATION 2019; 34:919-930. [PMID: 29474130 DOI: 10.1080/10410236.2018.1440506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
While it has been well established that breastfeeding provides the best nourishment for children, few women achieve the recommended breastfeeding duration. Negative media messages have been identified as one explanation for the lack of individual and public support for breastfeeding. This study explored the influence of media on the knowledge and attitudes of a nearly childless population to ascertain if and how entertainment media can positively impact perceptions of breastfeeding. Using cultivation and parasocial interaction, this research measured entertainment television's effect on breastfeeding attitudes using randomized-group experiments involving 375 students. Overall, participants generally held positive attitudes but were uncomfortable seeing breastfeeding. Moreover, results indicate that viewing a prime-time television clip that depicted public breastfeeding not only significantly lessened the extent to which participants believed that breastfeeding was a private activity but also improved attitudes and support for breastfeeding in public. This study concludes that more pro-breastfeeding media messages in entertainment media could help create a climate conducive to breastfeeding success.
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Affiliation(s)
| | - Ken Blake
- a School of Journalism , Middle Tennessee State University
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17
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McCue KF, Stulberger ML. Maternal Satisfaction With Parallel Pumping Technique. CLINICAL LACTATION 2019. [DOI: 10.1891/2158-0782.10.2.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Pumping is a necessary practice for many families and due to the time-intensive nature, optimal techniques are in high demand. The objective of this study was to assess the experiences and feelings of women who utilized the parallel pumping technique. Three phone interviews were conducted with all participants who met the inclusion criteria. Participants in this study favored the parallel pumping technique over the triple-feeding technique and felt it streamlined their feeding routine. Future studies should focus on identifying if the parallel pumping technique quantifiably increases production of mothers' milk.
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18
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Chang PC, Li SF, Yang HY, Wang LC, Weng CY, Chen KF, Chen W, Fan SY. Factors associated with cessation of exclusive breastfeeding at 1 and 2 months postpartum in Taiwan. Int Breastfeed J 2019; 14:18. [PMID: 31080493 PMCID: PMC6505256 DOI: 10.1186/s13006-019-0213-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 04/26/2019] [Indexed: 11/12/2022] Open
Abstract
Background Breastfeeding benefits both mothers and infants. Even though Taiwan national policy promotes exclusive breastfeeding (EBF), the rates in Taiwan are below those in other developed countries. This study aimed to investigate factors associated with EBF cessation at 1 and 2 months postpartum. Methods This study was conducted in a community hospital in southern Taiwan between December 2016 and June 2017. Birth mothers (n = 1077) were interviewed by telephone at 1 and 2 months postpartum to collect information on infant feeding patterns (EBF since birth or not) and reasons for EBF cessation. Multivariate logistic regression models were used to determine risk factors associated with EBF cessation at 1 and 2 months. Results At 1 month, 432 participants (40.1%) maintained EBF. Factors associated with cessation were lack of tertiary education, primiparity, perceived low milk quantity, mother/infant separation, medical condition in mother, inconvenience/fatigue due to breastfeeding, and baby-centered factors. At 2 months, 316 participants (29.3%) maintained EBF. Factors associated with cessation were lack of tertiary education, primiparity, perceived low milk quantity, and return to work. Conclusions Education level, primiparity, perceived low milk quantity, and return to work are associated with premature cessation of EBF in Taiwan. Strategies about health education, family support, and baby-mother friendly environment can be used to achieve higher EBF rate.
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Affiliation(s)
- Pei-Chi Chang
- 1Division of Community Nursing, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Sin-Fong Li
- 1Division of Community Nursing, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Hsin-Yi Yang
- 2Clinical Research Center, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Li-Chu Wang
- 1Division of Community Nursing, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Cing-Ya Weng
- 1Division of Community Nursing, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Kuan-Fen Chen
- 1Division of Community Nursing, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Wei Chen
- 3Department of Community Health, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Sheng-Yu Fan
- 4Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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19
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The private journey: An interpretative phenomenological analysis of exclusive breastfeeding. Women Birth 2019; 32:e34-e42. [DOI: 10.1016/j.wombi.2018.03.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 01/16/2018] [Accepted: 03/15/2018] [Indexed: 11/23/2022]
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20
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Hornsby PP, Gurka KK, Conaway MR, Kellams AL. Reasons for Early Cessation of Breastfeeding Among Women with Low Income. Breastfeed Med 2019; 14:375-381. [PMID: 30994371 DOI: 10.1089/bfm.2018.0206] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background: Most women in the United States do not meet their breastfeeding goals, and low-income women breastfeed at lower rates than the general population. While risk factors for early cessation have been documented, specific reasons for discontinuing among this population are less understood. We examined reasons for cessation among low-income mothers to inform the development of targeted strategies to address breastfeeding disparities. Materials and Methods: We performed a secondary data analysis using prospective data collected during a randomized intervention trial of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)-eligible women interviewed in the third trimester and at 1, 3, and 6 months postpartum. We included the 221 women who initiated breastfeeding and stopped by 6 months. Women's reasons for discontinuing breastfeeding were grouped by thematic category and compared by time of breastfeeding cessation. Results: The most common reasons reported overall for breastfeeding cessation were concerns about breast milk supply and latch difficulty. Some reasons differed significantly by time of cessation. Latch difficulty was reported most often by women who breastfed for 1 month or less; supply concerns increased with increasing breastfeeding duration. Returning to work/school was uncommonly reported for those who stopped by 1 month, but more frequently reported in those with later cessation. Conclusions: We found that low-income women reported similar reasons for early breastfeeding cessation as have been reported for other populations of women. These results underscore the need for appropriately timed, culturally sensitive interventions to reduce disparities in duration of breastfeeding, specifically to address latch difficulty in the first few weeks and supply concerns as infants grow.
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Affiliation(s)
- Paige P Hornsby
- 1 Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia
| | - Kelly K Gurka
- 2 Department of Epidemiology, University of Florida, Gainesville, Florida
| | - Mark R Conaway
- 1 Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia
| | - Ann L Kellams
- 3 Department of Pediatrics, University of Virginia, Charlottesville, Virginia
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Gürarslan Baş N, Karatay G, Arikan D. Weaning practices of mothers in eastern Turkey. J Pediatr (Rio J) 2018; 94:498-503. [PMID: 28893515 DOI: 10.1016/j.jped.2017.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 05/30/2017] [Accepted: 06/14/2017] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The study aimed to determine the practices used by breastfeeding mothers to wean their children from the breast. METHOD This qualitative-quantitative research was conducted with mothers whose children were registered the pediatric clinics of a state hospital between June and September 2016. In accordance with a purposeful sampling method, 232 mothers of children between the ages of 2 and 5 years were included in the study. Data were collected through face-to-face interviews using a questionnaire with demographic characteristics of mothers as well as their weaning practices. The data obtained were analyzed with a computer-assisted program using number and percentage distributions. RESULTS The mean breastfeeding duration was 19.00±7.11 months. It was determined that the majority of mothers (56.5%) used traditional methods for weaning their children. These included applying substances with a bad taste (58.1%) to their breasts, covering their breasts with various materials (26.2%) to make the child not want to nurse anymore, and using a pacifier or feeding bottle (9.2%) to substitute for the mother's breast. CONCLUSIONS It was observed that more than half of the mothers were used some traditional practices that could cause trauma in their children, instead of natural weaning.
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Affiliation(s)
| | - Gülnaz Karatay
- Munzur University, School of Health Science, Tunceli, Turkey
| | - Duygu Arikan
- Atatürk University, Nursing Faculty, Erzurum, Turkey
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22
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Weaning practices of mothers in eastern Turkey. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2018. [DOI: 10.1016/j.jpedp.2017.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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23
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Doğum Tipi Değişkeninin Anne-Bebek Etkileşimi ve Annenin Bebeğini Algılaması Üzerindeki Etkilerinin İncelenmesi. JOURNAL OF CONTEMPORARY MEDICINE 2018. [DOI: 10.16899/gopctd.418653] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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24
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Walker RD, Messing S, Rosen-Carole C, McKenna Benoit M. Defining Tip-Frenulum Length for Ankyloglossia and Its Impact on Breastfeeding: A Prospective Cohort Study. Breastfeed Med 2018; 13:204-210. [PMID: 29620937 DOI: 10.1089/bfm.2017.0116] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the normal lingual frenulum anatomy in newborns and to evaluate tip-frenulum distance as an objective diagnostic tool for identifying newborns at risk for anterior and posterior tongue tie and breastfeeding difficulty. MATERIALS AND METHODS The distance from the tongue tip to the insertion of the lingual frenulum was measured in a group of 100 healthy newborns to establish normative data. The presence of a visible or palpable cord was noted. Inter-rater reliability was assessed. Breastfeeding surveys including a maternal pain scale and Infant Breastfeeding Assessment Tool (IBFAT) were administered on days of life 2 and 14 to determine whether these findings predict breastfeeding difficulty. RESULTS Mean tip-frenulum length was 9.07 mm. Intraclass correlation coefficient between observers for tip-frenulum length was 0.82. A visible cord was identified in 21 subjects (21%). A palpable cord was identified in 59 subjects (59%). Unweighted κ coefficients for inter-rater reliability of visible and palpable cords were 0.91 and 0.47, respectively. Visible cord and shorter tip-frenulum distance were independently predictive of higher maternal pain scores. A positive correlation was identified between tip-frenulum length and IBFAT scores for mothers with two or more previous breastfed children. CONCLUSIONS Tongue tip-frenulum length correlated with maternal nipple pain, and was useful as an objective tool for identifying newborns at risk for ankyloglossia. Maternal breastfeeding experience appears to be an important factor in the link between tongue anatomy and breastfeeding difficulty. The presence of a palpable cord was variable across examiners, and should be interpreted with caution when evaluating newborns for posterior tongue tie.
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Affiliation(s)
- Ryan D Walker
- 1 Department of Otolaryngology, University of Rochester , Rochester, New York
| | - Susan Messing
- 2 Department of Biostatistics and Computational Biology, University of Rochester , Rochester, New York
| | - Casey Rosen-Carole
- 3 Department of Pediatrics and Obstetrics and Gynecology, University of Rochester , Rochester, New York
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Gurley-Calvez T, Bullinger L, Kapinos KA. Effect of the Affordable Care Act on Breastfeeding Outcomes. Am J Public Health 2017; 108:277-283. [PMID: 29267066 DOI: 10.2105/ajph.2017.304108] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess how the 2012 Affordable Care Act (ACA) policy change, which required most private health insurance plans to cover lactation-support services and breastfeeding equipment (without cost-sharing), affected breastfeeding outcomes. METHODS We used a regression-adjusted difference-in-differences approach with cross-sectional observational data from the US National Immunization Survey from 2008 to 2014 to estimate the effect of the ACA policy change on breastfeeding outcomes, including initiation, duration, and age at first formula feeding. The sample included children aged 19 to 23 months covered by private health insurance or Medicaid. RESULTS The ACA policy change was associated with an increase in breastfeeding duration by 10% (0.57 months; P = .007) and duration of exclusive breastfeeding by 21% (0.74 months; P = .001) among the eligible population. Results indicate no significant effects on breastfeeding initiation and age at first formula feeding. CONCLUSIONS Reducing barriers to receiving support services and breastfeeding equipment shows promise as part of a broader effort to encourage breastfeeding, particularly the duration of breastfeeding and the amount of time before formula supplementation.
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Affiliation(s)
- Tami Gurley-Calvez
- Tami Gurley-Calvez is with the University of Kansas Medical Center, Kansas City. Lindsey Bullinger is with the School of Public and Environmental Affairs, Indiana University, Bloomington. Kandice A. Kapinos is with the RAND Corporation, Arlington, VA
| | - Lindsey Bullinger
- Tami Gurley-Calvez is with the University of Kansas Medical Center, Kansas City. Lindsey Bullinger is with the School of Public and Environmental Affairs, Indiana University, Bloomington. Kandice A. Kapinos is with the RAND Corporation, Arlington, VA
| | - Kandice A Kapinos
- Tami Gurley-Calvez is with the University of Kansas Medical Center, Kansas City. Lindsey Bullinger is with the School of Public and Environmental Affairs, Indiana University, Bloomington. Kandice A. Kapinos is with the RAND Corporation, Arlington, VA
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Park H, Cho I, Kim MK. Multiple-Case Studies of Hand-on Breast Massage Techniques used by Breastfeeding Experts. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2017; 23:155-165. [PMID: 37684895 DOI: 10.4069/kjwhn.2017.23.3.155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 09/04/2017] [Accepted: 09/06/2017] [Indexed: 09/10/2023] Open
Abstract
PURPOSE The aim of this study was to understand the hand-on breast massage techniques used by well-known experts in breastfeeding clinics. METHODS A qualitative multiple-case design was applied that involved a feasibility test. Four experts sampling qualitative data collected by observing participants and in individual interviews were analyzed by content analysis, linking data to the propositions, and cross-case pattern matching. This study explored differences within and between cases, and the possibilities of replicating findings across cases. Thirty-nine postpartum women participated voluntarily in the feasibility test, which investigated the usability of four massage techniques. RESULTS The four techniques showed considerable similarities in terms of the application of stimulation to the breast base and increased flexibility of the wired flexible body, which was the core mechanism underlying the techniques. The breast management strategies were consistent with existing practice guidelines with the exception of using cold cabbage to control engorgement pain. There was insufficient scientific evidence for supporting the massage techniques used by the experts. All of the techniques showed 100% education completeness, but application rates were higher for self-control-oriented techniques. CONCLUSION The massage techniques applied by experts in breastfeeding were based on hypotheses and self-control techniques are feasible to apply in practice.
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Affiliation(s)
- Hyunsoon Park
- Department of Nursing, Inha University Graduate School, Incheon, Korea
| | - Insook Cho
- Department of Nursing, Inha University Graduate School, Incheon, Korea
| | - Min Kyeong Kim
- Department of Nursing, Inha University Graduate School, Incheon, Korea
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Still R, Marais D, Hollis JL. Mothers' understanding of the term 'exclusive breastfeeding': a systematic review. MATERNAL & CHILD NUTRITION 2017; 13:e12336. [PMID: 27758037 PMCID: PMC6866013 DOI: 10.1111/mcn.12336] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 03/31/2016] [Accepted: 04/19/2016] [Indexed: 11/28/2022]
Abstract
There is a lack of knowledge and understanding of the term exclusive breastfeeding (EBF) among health professionals. The purpose of this review was to examine the best available literature on mothers' understanding of the term EBF. A systematic search of eight electronic databases (Medline, Embase, CINAHL, CDSR, CENTRAL, Cab Abstracts, Scopus and African Index Medicus) was conducted (Protocol registration in PROSPERO: CRD42015019402). All study designs were eligible for inclusion. Studies were included if they: (1) involved mothers aged 18 years or older; (2) assessed mothers' knowledge/understanding/awareness of the term 'EBF'; (3) used the 1991 WHO definition of EBF and (4) were published between 1988 and 2015. Two reviewers retrieved articles, assessed study quality and performed data extraction. Of the 1700 articles identified, 21 articles met the inclusion criteria. Quantitative findings were pooled to calculate a proportion rate of 70.9% of mothers who could correctly define EBF, although the range varied between 3.1 and 100%. Qualitative findings revealed three themes: (1) EBF was understood by mothers as not mixing two milks; (2) the term 'exclusive' in EBF was incorrectly understood as not giving breast milk and (3) mothers believing that water can be given while exclusively breastfeeding. Research investigating aspects of self-reported EBF may consequently be unreliable. A standardised tool to assess mothers' knowledge of EBF could provide more accurate data. Public health campaigns should emphasise EBF to target mothers, while addressing the education of health professionals to ensure that they do not provide conflicting advice.
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Affiliation(s)
- Ruth Still
- Division of Applied Health SciencesUniversity of AberdeenUnited Kingdom
| | - Debbie Marais
- Division of Applied Health SciencesUniversity of AberdeenUnited Kingdom
| | - Jenna Louise Hollis
- The Rowett Institute of Nutrition and HealthUniversity of AberdeenUnited Kingdom
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Abstract
BACKGROUND Despite widespread consensus regarding the health benefits of breastfeeding, the prevalence of six months exclusive breastfeeding is very low in developed countries including New Zealand. AIM This paper aims to evaluate the role that health professionals play in promoting exclusive breastfeeding in New Zealand. METHODS Qualitative research involving face to face postpartum interviews conducted four to six weeks after the birth with 30 new mothers who lived in New Zealand and had identified in a short antenatal questionnaire that they intended to practice exclusive breastfeeding for six months. Themes related to exclusive breastfeeding support from health professionals were extracted from the interview transcripts and interpreted using Foucault's ideas about governmentality and bio-power. RESULTS Four themes related to the quality of health care support were identified in the interview transcripts. 'Breastfeeding self-efficacy support from the community midwives', 'mothers need to know more about breastfeeding during pregnancy', 'experiencing difficulties breastfeeding' as well as 'pressure and resistance to breastfeeding'. DISCUSSION Most mothers in this research spoke about feeling pressured to breastfeed within the New Zealand health system. However, the participating mothers acknowledged the effective support that they had received from community midwives who respected their autonomy, strengthened their self-esteem and encouraged them to breastfeed. CONCLUSION Negative historical experiences related to the medicalization of infant feeding in Western countries suggests that health professionals need to provide effective skill support for breastfeeding mothers so that mothers do not consider it a form of "quiet coercion" or as an exercise of "power".
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Bream E, Li H, Furman L. The Effect of Breast Pump Use on Exclusive Breastfeeding at 2 Months Postpartum in an Inner-City Population. Breastfeed Med 2017; 12:149-155. [PMID: 28394660 DOI: 10.1089/bfm.2016.0160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Breastfeeding is the optimal form of infant nutrition, yet national rates are below recommendations with persistent disparities. Breast pumps may address the reasons that mothers discontinue breastfeeding. OBJECTIVES To determine whether breast pump use increases exclusive breastfeeding at 1.5-3.5 months postpartum. MATERIALS AND METHODS We reviewed charts for maternal-infant descriptors and feeding type for infants born between November 2013 and June 2014 who received any breast milk at a visit <14 days of age in our inner-city pediatric practice. We compared feeding at 1.5-3.5 months between those with breast pump and those without breast pump. RESULTS Of the 905 infants with feeding type recorded, 487 (54%) received any breast milk, of whom 355 (72.9%) had a visit at 1.5-3.5 months [95.4% African American (AA)]. Rates of any breastfeeding (93.8% vs. 38.9%) and exclusive breastfeeding (50.0% vs. 17.8%) were significantly higher in non-AAs than in AAs. Due to small numbers of non-AAs, further analyses were conducted for AAs only. The rate of exclusive breastfeeding at 1.5-3.5 months (19.4% vs. 16.3%) was similar between those with a breast pump and those without a breast pump, whereas rates of any breastfeeding were higher among those with no breast pump (46.9% vs. 31.4%, p = 0.004). Also, among AA mothers, rates of feeding at the breast were lower (21.5% vs. 44.4%, p < 0.0001) and rates of feeding expressed breast milk were higher (16.6% vs. 8.2%, p = 0.02) among those with a breast pump versus those without a breast pump. CONCLUSIONS Although breast pumps were free, breast pump use among predominantly AA WIC-eligible mothers was not associated with increased rates of exclusive breastfeeding at 1.5-3.5 months postpartum.
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Affiliation(s)
- Elise Bream
- 1 Department of Pediatrics, Rainbow Babies and Children's Hospital , Cleveland, Ohio
| | - Hong Li
- 2 Center for Clinical Investigation, Case Western Reserve University , Cleveland, Ohio
| | - Lydia Furman
- 1 Department of Pediatrics, Rainbow Babies and Children's Hospital , Cleveland, Ohio
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A systematic approach towards the development of quality indicators for postnatal care after discharge in Flanders, Belgium. Midwifery 2017; 48:60-68. [PMID: 28347927 DOI: 10.1016/j.midw.2017.02.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 12/27/2016] [Accepted: 02/25/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE to develop a set of quality indicators for postnatal care after discharge from the hospital, using a systematic approach. DESIGN key elements of qualitative postnatal care were defined by performing a systematic review and the literature was searched for potential indicators (step 1). The potential indicators were evaluated by five criteria (validity, reliability, sensitivity, feasibility and acceptability) and by making use of the 'Appraisal of Guidelines for Research and Evaluation', the AIRE-instrument (step 2). In a modified Delphi-survey, the quality indicators were presented to a panel of experts in the field of postnatal care using an online tool (step 3). The final results led to a Flemish model of postnatal care (step 4). SETTING Flanders, Belgium PARTICIPANTS: health care professionals, representatives of health care organisations and policy makers with expertise in the field of postnatal care. FINDINGS after analysis 57 research articles, 10 reviews, one book and eight other documents resulted in 150 potential quality indicators in seven critical care domains. Quality assessment of the indicators resulted in 58 concept quality indicators which were presented to an expert-panel of health care professionals. After two Delphi-rounds, 30 quality indicators (six structure, 17 process, and seven outcome indicators) were found appropriate to monitor and improve the quality of postnatal care after discharge from the hospital. KEY CONCLUSIONS AND IMPLICATIONS FOR CLINICAL PRACTICE: the quality indicators resulted in a Flemish model of qualitative postnatal care that was implemented by health authorities as a minimum standard in the context of shortened length of stay. Postnatal care should be adjusted to a flexible length of stay and start in pregnancy with an individualised care plan that follows mother and new-born throughout pregnancy, childbirth and postnatal period. Criteria for discharge and local protocols about the organisation and content of care are essential to facilitate continuity of care.
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Bazzano AN, Cenac L, Brandt AJ, Barnett J, Thibeau S, Theall KP. Maternal experiences with and sources of information on galactagogues to support lactation: a cross-sectional study. Int J Womens Health 2017; 9:105-113. [PMID: 28280392 PMCID: PMC5338995 DOI: 10.2147/ijwh.s128517] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
An increase in the marketing and use of herbal galactagogues among breastfeeding mothers in the US has raised the issue of how best to provide support and information on the use of these products, particularly in light of limited availability of certified lactation counselors and continued suboptimal rates of breastfeeding globally. Currently, no cross-sectional data are available on the experiences and attitudes of mothers regarding the use of herbal and pharmaceutical galactagogues for lactation in the US. The findings of an online survey of 188 breastfeeding mothers on experiences with and sources of information on galactagogues are presented. Most mothers (76%) reported that while breastfeeding, they felt as though they were not making enough milk to meet the needs of their child, and yet 54% also indicated that they had not supplemented with formula. A large proportion of respondents reported utilizing galactagogues to increase lactation and finding them useful. The results indicated that most women learned about galactagogues from the Internet or by word of mouth through friends. Lactation consultants were the third-most reported sources of information on these products. While many respondents reported perceiving galactagogues as innocuous, more evidence on safety and efficacy is needed to support women properly who seek out and use them. Large-scale studies of the prevalence of galactagogue use in the US and rigorous evaluation of use globally are needed to ensure that mothers who choose to breastfeed may safely avail themselves of all options when counseling support is insufficient.
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Affiliation(s)
- Alessandra N Bazzano
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Lauren Cenac
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Amelia J Brandt
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | | | | | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
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Charlick SJ, Fielder A, Pincombe J, McKellar L. 'Determined to breastfeed': A case study of exclusive breastfeeding using interpretative phenomenological analysis. Women Birth 2017; 30:325-331. [PMID: 28215560 DOI: 10.1016/j.wombi.2017.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 12/27/2016] [Accepted: 01/02/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Given the significant benefits of breastfeeding, the World Health Organization (WHO) recommend exclusive breastfeeding for six months. Despite numerous strategies aimed at increasing the percentage of babies who are exclusively breastfed, Australia currently has one of the lowest six-month exclusive breastfeeding rates in the developed world. Notably, most research focuses on the early postnatal period (birth-two months) yet the largest decline in exclusive breastfeeding rates is observed between two and six months. AIM This study aimed to understand what enabled a first-time mother to continue exclusively breastfeeding between two and six months in Australia. METHODS The qualitative approach known as interpretative phenomenological analysis (IPA) was used to explore how the new mother understood her exclusive breastfeeding journey. Data was collected retrospectively through a face-to-face, semi-structured interview, then transcribed in full and analyzed using IPA's approach to data analysis. FINDINGS Three main themes were identified as self-determination to achieve exclusive breastfeeding, the influence of social norms in Australian culture, and the impact social supports have on maintaining exclusive breastfeeding. CONCLUSION For this mother, her self-determination to exclusively breastfeed, along with positive social support, outweighed the impact of perceived social norms and negative pressure from significant others to stop exclusive breastfeeding. This qualitative reflection contributes to an understanding of the individual in the breastfeeding journey, uncovering nuances around exclusive breastfeeding that may be helpful in providing support for mothers and direction for further research.
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Affiliation(s)
- Samantha J Charlick
- School of Nursing and Midwifery, University of South Australia, GPO Box 2471, Adelaide, South Australia 5001, Australia.
| | - Andrea Fielder
- School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, South Australia 5001, Australia
| | - Jan Pincombe
- School of Nursing and Midwifery, University of South Australia, GPO Box 2471, Adelaide, South Australia 5001, Australia
| | - Lois McKellar
- School of Nursing and Midwifery, University of South Australia, GPO Box 2471, Adelaide, South Australia 5001, Australia
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Integrative Review of Breastfeeding Duration and Influencing Factors Among Women Serving Active Duty in the U.S. Military. J Obstet Gynecol Neonatal Nurs 2017; 46:171-181. [PMID: 28137541 DOI: 10.1016/j.jogn.2016.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To determine what is known about breastfeeding duration among active-duty servicewomen and to identify factors related to military employment that facilitate or inhibit breastfeeding. DATA SOURCES Literature searches using CINAHL and MEDLINE were conducted with the keywords military and breastfeeding for articles published from January 2000 through May 2016. STUDY SELECTION Abstracts and full-text research articles were retrieved and analyzed that met the inclusion criteria: English language, U.S. active-duty military personnel, peer-reviewed, and identified facilitators and/or barriers to breastfeeding. DATA EXTRACTION Eight studies were analyzed for quality and content; analysis was guided by Cooper's five stages of review synthesis processes. DATA SYNTHESIS Findings indicated that although breastfeeding initiation rates are similar to those for civilians, military women may discontinue sooner. Perception of military work as a barrier is associated with shorter duration, and enlisted personnel were less likely to breastfeed to 12 months than commissioned officers. Military women experienced work-related barriers: lack of proper facilities for pumping, pressures and obligations related to rank, conflicts between mother/soldier demands, physical fitness/weight standards, concerns related to exposure to hazardous material, and prolonged separations from their infants. CONCLUSION Most women in the military serve during their childbearing years when they may want to breastfeed. Strategies to promote breastfeeding include advocacy for policy changes, education of servicewomen and supervisors/commanders, and implementation of a breastfeeding class that addresses military-specific factors.
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Breastfeeding Supports and Services in Rural Hawaii: Perspectives of Community Healthcare Workers. Nurs Res Pract 2017; 2017:6041462. [PMID: 28168053 PMCID: PMC5266833 DOI: 10.1155/2017/6041462] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 11/03/2016] [Accepted: 11/13/2016] [Indexed: 11/18/2022] Open
Abstract
Background. In the state of Hawaii, breastfeeding initiation rates are higher than the national average but fall below target rates for duration. Accessing breastfeeding support services is challenging for mothers living in rural areas of the state. Healthcare workers (HCWs) working with mothers and infants are in a key position to encourage and support breastfeeding efforts. The purpose of this study is to gain a better understanding of a Hawaiian community's (specifically Hilo, Hawai‘i) breastfeeding service and support issues. Method. The qualitative study design utilized was a focused ethnography. This approach was used to gather data from participant HCWs (N = 23) about their individual or shared experience(s) about the breastfeeding supports and services available in their community. An iterative process of coding and categorizing the data followed by conceptual abstraction into patterns was completed. Results. Three patterns emerged from the qualitative interviews: Operating within Constraints of the Particular Environment, Coexisting Messages, and Process Interrupted. Participants identified a number of gaps in breastfeeding services available to their clients including the lack of available lactation consultants and the inconsistent communication between hospital and community providers. A number of implications for practice and further research were suggested within the results and are discussed.
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Bazzano AN, Littrell L, Brandt A, Thibeau S, Thriemer K, Theall KP. Health provider experiences with galactagogues to support breastfeeding: a cross-sectional survey. J Multidiscip Healthc 2016; 9:623-630. [PMID: 27895489 PMCID: PMC5118028 DOI: 10.2147/jmdh.s121788] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Exclusive breastfeeding for infants up to 6 months is widely recommended, yet breastfeeding rates are relatively low in the US. The most common reason women stop breastfeeding early is a perceived insufficiency of milk. Galactagogues are herbal and pharmaceutical products that can help increase milk supply; however, data on their efficacy and safety is limited. Lactation consultants, obstetricians, and other health providers are an important point of contact for breastfeeding women experiencing challenges with lactation. This study explored providers' perceptions, experiences, and practices in relation to galactagogue recommendation. METHOD A cross-sectional survey was conducted among a convenience sample of English-speaking health providers in the US who counsel breastfeeding women and their infants. RESULTS More than 70% of respondents reported to recommend galactagogues. The most frequently recommended galactagogue was fenugreek with respondents indicating that they recommend it either 'always' (8.5%) or 'most of the time' (14.9%) and 'sometimes' (46.8%). More than 80% of the respondents indicated that galactagogues were useful for their clients and only one-third reported side effects. Reasons for refraining from recommending galactagogues were insufficient evidence of its efficacy and safety. Respondents reported a wide variety of sources of information used for their own education about galactagogues. DISCUSSION Despite little evidence regarding safety and efficacy, some galactagogues are widely recommended and often perceived to be useful. However, concerns about their efficacy and safety remain. In order to assure both providers and users about safety and efficacy, more robust studies as well as better pharmacovigilance systems are needed.
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Affiliation(s)
- Alessandra N Bazzano
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine
| | - Lisa Littrell
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine
| | - Amelia Brandt
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine
| | | | | | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine
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Minas AG, Ganga-Limando M. Social-Cognitive Predictors of Exclusive Breastfeeding among Primiparous Mothers in Addis Ababa, Ethiopia. PLoS One 2016; 11:e0164128. [PMID: 27723797 PMCID: PMC5056706 DOI: 10.1371/journal.pone.0164128] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 08/25/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Despite the presence of high impact interventions to improve infant and young child feeding, only about 52% of mothers in Ethiopia exclusively breastfeed their child for the first six months after delivery. Although the decision to breastfeed a child is ultimately that of the mother, this decision could be influenced by a variety of factors including social-cognitive ones. OBJECTIVES The objectives of the study were to describe the breastfeeding behaviour of primiparous mothers during their prenatal period in terms of intentions/goals, outcome expectancies, self-efficacy, and socio-structural factors and assess their exclusive breastfeeding (EBF) practices as well as identify the social-cognitive predictors of EBF practices among these mothers in Addis Ababa, Ethiopia. METHODS A prospective follow up health facility-based study with quantitative methods was used with a sample of 233 primiparous women. Both structured and semi-structured questions were used for collection of data. The Statistical Package for Social Sciences (SPSS) version 21 was used for data analysis. Findings at the 95% confidence interval and P-value of 5% were reported as statistically significant. RESULTS 39.1% (n = 59) of the respondents were found to have high breastfeeding self-efficacy, 51.4% (n = 71) have good breastfeeding outcome expectancies, and 6.5% (n = 9) respondents had supportive breastfeeding socio-structural factors. Bivariate correlation analysis showed positive and statistically significant correlation between each of breastfeeding self-efficacy, outcome expectancy, and socio-structural factors, with EBF practice. However, only breastfeeding self-efficacy and outcome expectancies were statistically significant predictors of EBF among the primiparous women when controlling for confounding variables. CONCLUSIONS AND RECOMMENDATIONS Health programmes aimed at improving EBF among primiparous mothers should look beyond providing health information alone. Rather improving primiparous women's breastfeeding self-efficacy and outcome expectancy is strongly recommended. Further community based large scale research is also recommended among similar groups of women.
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Affiliation(s)
| | - Makombo Ganga-Limando
- University of South Africa, Collage of Human Science, Department of Health Studies, Pretoria, South Africa
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Why do women stop breast-feeding? Results from a contemporary prospective study in a cohort of Australian women. Eur J Clin Nutr 2016; 70:1428-1432. [DOI: 10.1038/ejcn.2016.157] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 06/07/2016] [Accepted: 06/10/2016] [Indexed: 11/08/2022]
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Flaherman VJ, Beiler JS, Cabana MD, Paul IM. Relationship of newborn weight loss to milk supply concern and anxiety: the impact on breastfeeding duration. MATERNAL & CHILD NUTRITION 2016; 12:463-72. [PMID: 25786348 PMCID: PMC6860094 DOI: 10.1111/mcn.12171] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Milk supply concern is the most common reason for breastfeeding discontinuation and maternal anxiety is also associated with reduced breastfeeding duration. Newborn excess weight loss (EWL) could trigger milk supply concern and anxiety and might be amenable to modification. Our objective was to determine the relationship between EWL and the development of milk supply concern and anxiety and the effect of such development on breastfeeding duration. We conducted a cohort analysis using data previously obtained from a randomised controlled trial comparing two post-hospital discharge follow-up strategies. For 1107 well, singleton infants born at ≥34 weeks, we extracted data on all inpatient infant weights. EWL was defined as the loss of ≥10% of birthweight. We surveyed mothers to obtain data on state anxiety and milk supply concern at birth and at 2 weeks. Our final outcome was breastfeeding at 6 months. Seventy (6.3%) infants developed EWL during the birth hospitalisation. At 2 weeks, milk supply concern and positive anxiety screen were more common (42% and 18%, respectively) among mothers whose infants had had EWL than among mothers whose infants had not had EWL (20% and 6%, respectively) (P < 0.001 for each comparison). Mothers with milk supply concern at 2 weeks were much less likely to be breastfeeding at 6 months, with odds ratio of 0.47 (0.30, 0.74) in multivariate analysis. EWL may increase milk supply concern and anxiety and these may reduce breastfeeding duration. Ameliorating EWL might alleviate milk supply concern and anxiety and improve breastfeeding duration.
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Affiliation(s)
- Valerie J Flaherman
- Department of Pediatrics, School of Medicine, University of California, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, California, USA
| | - Jessica S Beiler
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Michael D Cabana
- Department of Pediatrics, School of Medicine, University of California, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, California, USA
| | - Ian M Paul
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
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Bai DL, Fong DYT, Lok KYW, Tarrant M. Relationship between the Infant Feeding Preferences of Chinese Mothers' Immediate Social Network and Early Breastfeeding Cessation. J Hum Lact 2016; 32:301-8. [PMID: 26887843 DOI: 10.1177/0890334416630537] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 01/06/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND The relationship between support from members of a mother's social network and breastfeeding continuation is receiving increased attention. OBJECTIVES The objectives of this study were to describe the infant feeding preferences of Chinese mothers' immediate social network and to examine the association between these preferences and early breastfeeding cessation. METHODS In total, 1172 mother-infant pairs were recruited from 4 public hospitals in Hong Kong and followed prospectively for 12 months or until breastfeeding stopped. RESULTS Over 40% of participants' partners preferred breastfeeding and half had no infant feeding preference. Only about 20% of participants' mothers or mothers-in-law preferred breastfeeding, and less than 10% reported that all of the 3 significant family members (partner, mother, and mother-in-law) preferred breastfeeding. The partner's preference for infant formula or mixed feeding (odds ratio [OR], 2.60; 95% confidence interval [CI], 1.43-4.71) or having no preference (OR, 1.64; 95% CI, 1.16-2.30) was strongly associated with higher odds of stopping breastfeeding before 1 month. For every additional family member who preferred breastfeeding, the odds of stopping breastfeeding was reduced by almost 20% (OR, 0.81; 95% CI, 0.68-0.97). However, living with a parent-in-law (OR, 1.45; 95% CI, 1.02-2.07) was also a predictor of early breastfeeding cessation. Knowing someone who had breastfed for ≥ 1 month (OR, 0.64; 95% CI, 0.42-0.97) or having been breastfed as a child (OR, 0.67; 95% CI, 0.45-0.98) significantly lowered the odds of early breastfeeding cessation. CONCLUSIONS The infant feeding preferences of mothers' immediate social network are significantly associated with breastfeeding continuation. Prenatal breastfeeding education programs should involve significant family members to promote breastfeeding.
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Affiliation(s)
- Dorothy Li Bai
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Marie Tarrant
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
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Flaherman VJ, Hicks KG, Huynh J, Cabana MD, Lee KA. Positive and negative experiences of breast pumping during the first 6 months. MATERNAL & CHILD NUTRITION 2016; 12:291-8. [PMID: 25134622 PMCID: PMC6860131 DOI: 10.1111/mcn.12137] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
For mothers with breastfeeding difficulties, pumping can be recommended to help establish milk production. However, pumping may present some barriers to successful breastfeeding. Mothers with milk supply concern may be at higher risk of barriers to successful breastfeeding. No previous studies have described experiences of pumping among mothers with milk supply concern. We conducted 10 focus groups of 56 mothers who had milk supply concern in the first month after birth. A paid, trained facilitator led groups in a semi-structured approach. Sessions were audiorecorded and transcribed verbatim. The transcripts were coded independently by two investigators and analysed using grounded theory. We identified five themes related to the experience of pumping among mothers with milk supply concern: (1) additional control over breastfeeding from pumping: 'I would feed and then give him … whatever I could manage to pump to him'. (2) Painful experience: 'The first time I pumped my boobs hurt so bad'. (3) Pumped volume affected milk supply concern: 'Pump and there was hardly anything coming out that's when I started to worry'. (4) Pumping interfered with other nurturing activities: 'While you're pumping, you can't touch the baby'. (5) Frustration from inconsistent provider advice: 'They told me to pump … and then said, "That's going to cause your milk to increase too much" '. Mothers had positive and negative experiences with pumping. Clinicians should assess a mother's experience shortly after she initiates pumping, as further management and counselling may be necessary to avoid barriers to successful breastfeeding.
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Affiliation(s)
| | | | | | - Michael D. Cabana
- Department of PediatricsUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Philip R. Lee Institute for Health Policy StudiesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Kathryn A. Lee
- Department of Family Health Care NursingUniversity of CaliforniaSan FranciscoCaliforniaUSA
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de Sá Del Fiol F, Barberato-Filho S, de Cássia Bergamaschi C, Lopes LC, Gauthier TP. Antibiotics and Breastfeeding. Chemotherapy 2016; 61:134-43. [PMID: 26780532 DOI: 10.1159/000442408] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 11/12/2015] [Indexed: 11/19/2022]
Abstract
During the breastfeeding period, bacterial infections can occur in the nursing mother, requiring the use of antibiotics. A lack of accurate information may lead health care professionals and mothers to suspend breastfeeding, which may be unnecessary. This article provides information on the main antibiotics that are appropriate for clinical use and the interference of these antibiotics with the infant to support medical decisions regarding the discontinuation of breastfeeding. We aim to provide information on the pharmacokinetic factors that interfere with the passage of antibiotics into breast milk and the toxicological implications of absorption by the infant. Publications related to the 20 most frequently employed antibiotics and their transfer into breast milk were evaluated. The results demonstrate that most antibiotics in clinical use are considered suitable during breastfeeding; however, the pharmacokinetic profile of each drug must be observed to ensure the resolution of the maternal infection and the safety of the infant.
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Saidi L, Godbout P. Étude de deux indicateurs de difficulté de mise en place de l’allaitement maternel : la fatigue maternelle et le comportement non optimal du bébé au sein. Rech Soins Infirm 2016. [DOI: 10.3917/rsi.125.0032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Burns E, Fenwick J, Sheehan A, Schmied V. 'This little piranha': a qualitative analysis of the language used by health professionals and mothers to describe infant behaviour during breastfeeding. MATERNAL AND CHILD NUTRITION 2015; 12:111-24. [PMID: 26059182 DOI: 10.1111/mcn.12179] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Exclusive breastfeeding for the first 6 months of life offers the recommended best start in the life for a newborn baby. Yet, in Australia only a small number of babies receive breast milk exclusively for the first 6 months. Reasons for the introduction of formula milk are multi-factorial including access to appropriate support and the woman's experience of breastfeeding. The language and practices of health professionals can impact upon how a woman feels about breastfeeding and her breastfeeding body. One aspect of breastfeeding support that has had scarce attention in the literature is the language used by health professionals to describe the behaviour of the breastfeeding infant during the early establishment phase of breastfeeding. This paper reveals some of the ways in which midwives, lactation consultants and breastfeeding women describe the newborn baby during the first week after birth. The study was conducted at two maternity units in New South Wales. Interactions between midwives and breastfeeding women were observed and audio recorded on the post-natal ward and in women's homes, in the first week after birth. The transcribed data were analysed using discourse analysis searching for recurring words, themes and metaphors used in descriptions of the breastfeeding baby. Repeated negative references to infant personality and unfavourable interpretations of infant behaviour influenced how women perceived their infant. The findings revealed that positive language and interpretations of infant breastfeeding behaviour emerged from more relationship-based communication.
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Affiliation(s)
- Elaine Burns
- School of Nursing and Midwifery, University of Western Sydney, Penrith, New South Wales, Australia
| | - Jenny Fenwick
- School of Nursing and Midwifery, Maternity and Family, Research Centre for Clinical and Community Practice Innovation, Griffith Health, Griffith University, Meadowbrook, Queensland, Australia
| | - Athena Sheehan
- School of Nursing and Midwifery, University of Western Sydney, Penrith, New South Wales, Australia
| | - Virginia Schmied
- School of Nursing and Midwifery, University of Western Sydney, Penrith, New South Wales, Australia
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Dietrich Leurer M, Misskey E. "Be positive as well as realistic": a qualitative description analysis of information gaps experienced by breastfeeding mothers. Int Breastfeed J 2015; 10:10. [PMID: 25788970 PMCID: PMC4363194 DOI: 10.1186/s13006-015-0036-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 02/19/2015] [Indexed: 11/25/2022] Open
Abstract
Background Early breastfeeding cessation is common in many regions of the world despite high breastfeeding initiation rates and strong evidence of the health benefits to both mother and infant. This research investigated mothers’ perceived breastfeeding information needs in order to increase our understanding of this phenomenon. Methods Surveys were distributed by public health nurses in a health region in Western Canada to mothers who had initiated breastfeeding and whose infants were six to eleven months old to learn more about their infant feeding experiences during the birth to six month period. Two open-ended survey questions asked: (1) What support or advice did you receive that helped you with feeding your baby?” and (2) “What support or information on feeding your baby would you have found helpful but did not receive?” A total of 191 eligible mothers submitted a survey (response rate 35%) between January and October 2012. Qualitative description was used in analyzing the responses of the women who provided comments for the open-ended questions. Results While many mothers felt their information needs were met, others outlined important content areas where more information and guidance was desired. These areas included milk supply management, frequency/duration of feeds, proper latch and feeding positions, nipple care, expression/pumping, other nutrition sources, and realistic information regarding common breastfeeding concerns. Conclusions The results suggest that several of the information gaps highlighted by respondents in this study closely align with commonly cited reasons for breastfeeding cessation including perceived insufficient milk supply, latching difficulties and nipple discomfort. The findings emphasize the need for lactation support with systematic measures to ensure breastfeeding mothers are universally provided with information on these key content areas. Lactation supports should reinforce critical information and seek feedback to ascertain that mothers have clearly understood the information provided. Ensuring mothers receive and understand key breastfeeding information is a modifiable factor in efforts to increase breastfeeding duration rates.
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Affiliation(s)
- Marie Dietrich Leurer
- College of Nursing, University of Saskatchewan Regina Campus, #100 - 4400 4th Avenue, Regina, Saskatchewan S4T 0H8 Canada
| | - Eunice Misskey
- Freelance Public Health Nutritionist (formerly with Regina Qu'Appelle Health Region and Saskatchewan Ministry of Health), 118 Patterson Drive, Regina, Saskatchewan S4S 3W9 Canada
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Body image concerns during pregnancy are associated with a shorter breast feeding duration. Midwifery 2015; 31:80-9. [DOI: 10.1016/j.midw.2014.06.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 06/10/2014] [Accepted: 06/16/2014] [Indexed: 12/14/2022]
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Breast-feeding support in Ireland: a qualitative study of health-care professionals' and women's views. Public Health Nutr 2014; 18:2274-82. [PMID: 25435017 DOI: 10.1017/s1368980014002626] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine women's experience of professional support for breast-feeding and health-care professionals' experience of providing support. DESIGN We conducted semi-structured qualitative interviews among women with experience of breast-feeding and health-care professionals with infant feeding roles. Interviews with women were designed to explore their experience of support for breast-feeding antenatally, in hospital and postnatally. Interviews with health-care professionals were designed to explore their views on their role and experience in providing breast-feeding support. Interview transcripts were analysed using content analysis and aspects of Grounded Theory. Overarching themes and categories within the two sets were identified. SETTING Urban and suburban areas of North Dublin, Ireland. SUBJECTS Twenty-two women all of whom had experience of breast-feeding and fifty-eight health-care professionals. RESULTS Two overarching themes emerged and in each of these a number of categories were developed: theme 1, facilitators to breast-feeding support, within which being facilitated to breast-feed, having the right person at the right time, being discerning and breast-feeding support groups were discussed; and theme 2, barriers to breast-feeding support, within which time, conflicting information, medicalisation of breast-feeding and the role of health-care professionals in providing support for breast-feeding were discussed. CONCLUSIONS Breast-feeding is being placed within a medical model of care in Ireland which is dependent on health-care professionals. There is a need for training around breast-feeding for all health-care professionals; however, they are limited in their support due to external barriers such as lack of time. Alternative support such as peer support workers should be provided.
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Janjanam J, Singh S, Jena MK, Varshney N, Kola S, Kumar S, Kaushik JK, Grover S, Dang AK, Mukesh M, Prakash BS, Mohanty AK. Comparative 2D-DIGE proteomic analysis of bovine mammary epithelial cells during lactation reveals protein signatures for lactation persistency and milk yield. PLoS One 2014; 9:e102515. [PMID: 25111801 PMCID: PMC4128602 DOI: 10.1371/journal.pone.0102515] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Accepted: 06/20/2014] [Indexed: 12/21/2022] Open
Abstract
Mammary gland is made up of a branching network of ducts that end with alveoli which surrounds the lumen. These alveolar mammary epithelial cells (MEC) reflect the milk producing ability of farm animals. In this study, we have used 2D-DIGE and mass spectrometry to identify the protein changes in MEC during immediate early, peak and late stages of lactation and also compared differentially expressed proteins in MEC isolated from milk of high and low milk producing cows. We have identified 41 differentially expressed proteins during lactation stages and 22 proteins in high and low milk yielding cows. Bioinformatics analysis showed that a majority of the differentially expressed proteins are associated in metabolic process, catalytic and binding activity. The differentially expressed proteins were mapped to the available biological pathways and networks involved in lactation. The proteins up-regulated during late stage of lactation are associated with NF-κB stress induced signaling pathways and whereas Akt, PI3K and p38/MAPK signaling pathways are associated with high milk production mediated through insulin hormone signaling.
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Affiliation(s)
- Jagadeesh Janjanam
- Animal Biotechnology Center, National Dairy Research Institute, Karnal, India
- * E-mail: (JJ); (AKM)
| | - Surender Singh
- Animal Biotechnology Center, National Dairy Research Institute, Karnal, India
| | - Manoj K. Jena
- Animal Biotechnology Center, National Dairy Research Institute, Karnal, India
| | - Nishant Varshney
- Animal Biotechnology Center, National Dairy Research Institute, Karnal, India
| | - Srujana Kola
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India
| | - Sudarshan Kumar
- Animal Biotechnology Center, National Dairy Research Institute, Karnal, India
| | - Jai K. Kaushik
- Animal Biotechnology Center, National Dairy Research Institute, Karnal, India
| | - Sunita Grover
- Animal Biotechnology Center, National Dairy Research Institute, Karnal, India
| | - Ajay K. Dang
- Dairy Cattle Physiology Division, National Dairy Research Institute, Karnal, India
| | - Manishi Mukesh
- National Bureau of Animal Genetic Resources, Karnal, India
| | - B. S. Prakash
- Dairy Cattle Physiology Division, National Dairy Research Institute, Karnal, India
| | - Ashok K. Mohanty
- Animal Biotechnology Center, National Dairy Research Institute, Karnal, India
- * E-mail: (JJ); (AKM)
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Work-place predictors of duration of breastfeeding among female physicians. J Pediatr 2013; 163:1612-7. [PMID: 24011764 PMCID: PMC5551491 DOI: 10.1016/j.jpeds.2013.07.026] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 06/12/2013] [Accepted: 07/17/2013] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To identify work-related predictors of breastfeeding duration among female physicians. STUDY DESIGN Data on 238 children were obtained from 50 female physicians, whose main affiliation was with Johns Hopkins University (Baltimore, MD), and 80 female physicians, whose main affiliation was with the University of Florida (Gainesville, FL). We used a mixed linear model to determine which variables were significant predictors of breastfeeding duration when controlling for maternal demographics and taking into account the clustering of observations on study location and mothers. RESULTS Although female physicians intended to breastfeed 56% of the infants for at least 12 months and 97% of infants were breastfed at birth, only 34% of infants continued to receive breast milk at 12 months. Duration of lactation among female physicians correlated with the following work-related factors: (1) not having to make up missed call/work that occurred as result of pregnancy or maternity leave; (2) longer length of maternity leave; (3) sufficiency of time at work for milk expression; and (4) perceived level of support for breastfeeding efforts at work from colleagues, program director, or division/section chiefs. CONCLUSION Our findings support the importance of work-related factors in breastfeeding maintenance among female physicians and suggest that a tailored intervention, providing time and institutional encouragement, might result in significant improvement in their breastfeeding duration.
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Flaherman VJ, Kuzniewicz MW, Li S, Walsh E, McCulloch CE, Newman TB. First-day weight loss predicts eventual weight nadir for breastfeeding newborns. Arch Dis Child Fetal Neonatal Ed 2013; 98:F488-92. [PMID: 23864443 DOI: 10.1136/archdischild-2012-303076] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To examine the relationship between high (≥5%) weight loss during the first 24 h after birth and eventual excess weight loss (EWL) of ≥10% of birth weight. DESIGN Retrospective cohort study. SETTING Kaiser Permanente Northern California hospitals. PATIENTS 63 096 infants born at ≥36 weeks in 2009-2010, of whom 59 761 (94.5%) had a weight subsequent to birth weight measured at <24 h. MAIN PREDICTOR MEASURE Per cent of birth weight lost by 24 h of age. MAIN OUTCOME MEASURE Weight nadir, defined as the lowest recorded inpatient or outpatient weight in the first 30 days after birth, expressed as a percentage of birth weight. RESULTS Among infants who breastfed at least once, mean (±SD) weight nadir was 6.3±3.5% below birth weight, and 9.6% of the newborns lost ≥10% of birth weight. Among 2670 infants who lost ≥5% of their birth weight in the first 24 h, 782 (29%) eventually developed EWL, compared with 4840 (8%) of 57 109 infants who lost <5% (p<0.0005). In multivariate analysis, ≥5% first-day weight loss predicted eventual EWL (≥10%) with an OR of 4.06 (95% CI 3.69 to 4.46) after adjusting for gestational age, method of delivery, maternal race/ethnicity and hospital of birth. CONCLUSIONS High first-day weight loss predicts eventual weight nadir and can be used to identify infants who might benefit from targeted interventions to support breastfeeding and prevent EWL.
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Affiliation(s)
- Valerie J Flaherman
- Department of Pediatrics, School of Medicine, University of California, , San Francisco, California, USA
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Abstract
Women who receive benefits from Women, Infants, and Children (WIC) are not meeting the recommendations for breastfeeding duration. The purpose of this descriptive correlational study was to examine maternal sociodemographic and time factors related to the reason for discontinuing breastfeeding for 238 WIC participants who initiated breastfeeding. This study is a secondary data analysis of existing longitudinal survey and administrative data from a Chicago-area community health center and WIC clinic. The average length of breastfeeding within this sample was 16 weeks. Women in this sample reported a perception of insufficient milk (PIM; 46%), returning to work/school (13%), and other maternal problems (13%) as the main reasons for discontinuing breastfeeding. Within the first 16 weeks, 65% of the women who discontinued breastfeeding cited PIM as the main reason, with 2 distinct time points at 5 weeks and 13 weeks. Women of Hispanic descent were more likely than non-Hispanic women to report this perception (odds ratio 2.66, P = .01, 95% confidence interval = 1.21-5.83). Although these women initiated breastfeeding, the national recommendation for breastfeeding duration was not met in this population. Additionally, many women stopped breastfeeding early due to PIM. There are distinct time points where culturally tailored interventions may be most effective.
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Affiliation(s)
- Sandi Tenfelde
- Niehoff School of Nursing, Loyola University Chicago, Maywood, Illinois (ST)
- Bronson School of Nursing, Western Michigan University, Kalamazoo, Michigan (RZ, RLH)
| | - Ruth Zielinski
- Niehoff School of Nursing, Loyola University Chicago, Maywood, Illinois (ST)
- Bronson School of Nursing, Western Michigan University, Kalamazoo, Michigan (RZ, RLH)
| | - Rebecca L. Heidarisafa
- Niehoff School of Nursing, Loyola University Chicago, Maywood, Illinois (ST)
- Bronson School of Nursing, Western Michigan University, Kalamazoo, Michigan (RZ, RLH)
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