1
|
Billings H, Horsman J, Soltani H, Spencer RL. Breastfeeding experiences of women with perinatal mental health problems: a systematic review and thematic synthesis. BMC Pregnancy Childbirth 2024; 24:582. [PMID: 39242552 PMCID: PMC11380431 DOI: 10.1186/s12884-024-06735-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 08/02/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND Despite its known benefits, breastfeeding rates among mothers with perinatal mental health conditions are staggeringly low. Systematic evidence on experiences of breastfeeding among women with perinatal mental health conditions is limited. This systematic review was designed to synthesise existing literature on breastfeeding experiences of women with a wide range of perinatal mental health conditions. METHODS A systematic search of five databases was carried out considering published qualitative research between 2003 and November 2021. Two reviewers conducted study selection, data extraction and critical appraisal of included studies independently and data were synthesised thematically. RESULTS Seventeen articles were included in this review. These included a variety of perinatal mental health conditions (e.g., postnatal depression, post-traumatic stress disorders, previous severe mental illnesses, eating disorders and obsessive-compulsive disorders). The emerging themes and subthemes included: (1) Vulnerabilities: Expectations versus reality; Self-perception as a mother; Isolation. (2) Positive outcomes: Bonding and closeness; Sense of achievement. (3) Challenges: Striving for control; Inconsistent advice and lack of support; Concerns over medication safety; and Perceived impact on milk quality and supply. CONCLUSIONS Positive breastfeeding experiences of mothers with perinatal mental health conditions can mediate positive outcomes such as enhanced mother/infant bonding, increased self-esteem, and a perceived potential for healing. Alternatively, a lack of consistent support and advice from healthcare professionals, particularly around health concerns and medication safety, can lead to feelings of confusion, negatively impact breastfeeding choices, and potentially aggravate perinatal mental health symptoms. Appropriate support, adequate breastfeeding education, and clear advice, particularly around medication safety, are required to improve breastfeeding experiences for women with varied perinatal mental health conditions.
Collapse
Affiliation(s)
- Hayley Billings
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Collegiate Campus, Sheffield, S10 2DN, UK.
| | - Janet Horsman
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Collegiate Campus, Sheffield, S10 2DN, UK
| | - Hora Soltani
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Collegiate Campus, Sheffield, S10 2DN, UK
| | - Rachael Louise Spencer
- Nursing and Midwifery College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Collegiate Campus, Sheffield, S10 2DN, UK
| |
Collapse
|
2
|
McGovern LM, O'Toole L, Laws RA, Skinner TC, McAuliffe FM, O'Reilly SL. An exploration of prenatal breastfeeding self-efficacy: a scoping review. Int J Behav Nutr Phys Act 2024; 21:95. [PMID: 39223645 PMCID: PMC11367871 DOI: 10.1186/s12966-024-01641-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Breastfeeding self-efficacy is a woman's self-belief and confidence in her perceived ability to breastfeed. This modifiable determinant is strongly associated with breastfeeding initiation, exclusivity, and duration. It is unclear how important the timing of breastfeeding self-efficacy measurement and interventions are. The prenatal period appears underexplored in the literature and yet a prenatal focus provides increased opportunity for breastfeeding self-efficacy enhancement and further potential improvement in breastfeeding outcomes. This scoping review aims to synthesise the evidence on prenatal breastfeeding self-efficacy, describing for the first time the theoretical frameworks, measurement tools, and interventions used in the prenatal period. METHODS 8 databases were searched using the PCC framework (Problem: breastfeeding, Concept: self-efficacy, Context: prenatal period). From 4,667 citations and 156 additional sources identified through grey literature and snowballing, data were extracted from 184 studies and 2 guidance documents. All were summarised descriptively and narratively. RESULTS Just over half (57%) of included studies stated their theoretical underpinning, with Bandura's Self-Efficacy Theory / Dennis' Breastfeeding Self-Efficacy Framework predominant. Only half of intervention studies incorporated theory in their design. More intervention studies were undertaken in the past decade than previously, but the level of theoretical underpinning has not improved. Prenatal interventions incorporating theory-led design and using components addressing the breadth of theory, more frequently reported improving breastfeeding self-efficacy and breastfeeding outcomes than those not theory-led. Intervention components used less frequently were vicarious or kinaesthetic learning (52.5%) and involvement of social circle support (26%). The Breastfeeding Self-Efficacy Scales were the most common measurement tool, despite being designed for postpartum use. Overall, issues were identified with the late prenatal timing of breastfeeding self-efficacy investigation and the design, content and phraseology of measurements and interventions used in the prenatal period. CONCLUSION This review provides novel insights for consideration in the design and conduct of breastfeeding self-efficacy studies in the prenatal period. Future research should aim to be theory-led, commence earlier in pregnancy, and embed the breadth of self-efficacy theory into the design of interventions and measurement tools. This would provide more robust data on prenatal breastfeeding self-efficacy's role in impacting breastfeeding outcomes.
Collapse
Affiliation(s)
- Liz M McGovern
- UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, D04 V1W8, Ireland
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, D02 YH21, Ireland
| | - Laura O'Toole
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, D02 YH21, Ireland
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, D04 V1W8, Ireland
| | - Rachel A Laws
- School of Exercise & Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, 3220, Australia
| | - Timothy C Skinner
- Institute of Psychology, University of Copenhagen, Copenhagen K, 1353, Denmark
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, D02 YH21, Ireland
| | - Sharleen L O'Reilly
- UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, D04 V1W8, Ireland.
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, D02 YH21, Ireland.
| |
Collapse
|
3
|
Wood NK, Barbosa-Leiker C, Odom-Maryon T. Determinants of exclusive direct breastfeeding using constructs from the breastfeeding relationship scale. J Reprod Infant Psychol 2024; 42:949-963. [PMID: 36939003 DOI: 10.1080/02646838.2023.2191113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 03/07/2023] [Indexed: 03/21/2023]
Abstract
OBJECTIVES This study examined the relationship among constructs of the Breastfeeding Relationship Scale and exclusive direct breastfeeding (EDBF) while controlling for covariates in US breastfeeding dyads in the first 3 months. BACKGROUND The Breastfeeding Relationship Scale was developed to measure mother-infant mutual responsiveness during breastfeeding in response to perceived insufficient milk, but there is no clear understanding about the relationships between the Breastfeeding Relationship Scale's constructs and EDBF. METHODS A cross-sectional design was used. The convenience sample of 589 directly breastfeeding mothers in the US whose infants were between 1 and 12 weeks of age were included for analysis using a structural equation model. Covariates for EDBF included mother's age, education, marital status, parity, prior breastfeeding experience, infant's age, weight, and sex. RESULTS Mother-Infant Breastfeeding Interaction and Breastfeeding Synchronicity were related (β = 0.33, p < .001), as were Breastfeeding Synchronicity and Perceived Adequate Milk Supply (β = 0.35, p < .001) and Mother-Infant Breastfeeding Interaction and Perceived Adequate Milk Supply (β = 0.08, p = .05). The relationship between Mother-Infant Breastfeeding Interaction and Breastfeeding Synchronicity with EDBF was fully mediated by Perceived Adequate Milk Supply, where the odds of EDBF was higher for mothers with higher scores on Perceived Adequate Milk Supply (OR = 1.61, p < .001) and prior breastfeeding experience (OR = 2.31, p = .006). CONCLUSIONS Perceived Adequate Milk Supply and prior breastfeeding experience are major determinants of EDBF in the first 3 months. Breastfeeding Synchronicity can bolster Mother-Infant Breastfeeding Interaction and promote Perceived Adequate Milk. More attention should be paid to breastfeeding relationship to be the result of EDBF.
Collapse
Affiliation(s)
- Natsuko K Wood
- Assistant Professor, Washington State University College of Nursing, Spokane, WA, USA
| | - Celestina Barbosa-Leiker
- Executive Vice Chancellor For Research And Administration, Washington State University Health Sciences Spokane, Spokane, WA, USA
| | - Tamara Odom-Maryon
- Assistant Professor, Washington State University College of Nursing, Spokane, WA, USA
- Biostatistician at Washington State University College of Nursing, Spokane, WA, USA
| |
Collapse
|
4
|
Jack A, Mullin C, Brown E, Burtner M, Standish KR, Fields A, Rosen-Carole C, Hartman S. Academy of Breastfeeding Medicine Clinical Protocol #19: Breastfeeding Promotion in the Prenatal Period (Revised 2024). Breastfeed Med 2024; 19:575-587. [PMID: 39186728 DOI: 10.1089/bfm.2024.0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
Background: The Academy of Breastfeeding Medicine revised the 2015 version of this clinical protocol to review the evidence and provide recommendations related to breastfeeding promotion in the prenatal period. Key Information: Promoting and normalizing breastfeeding in the prenatal period can improve breastfeeding outcomes including initiation and duration of breastfeeding. Ideally, prenatal interventions should be a part of a comprehensive longitudinal breastfeeding support program. Recommendations: Clinicians or other health workers should discuss breastfeeding at each prenatal visit. Counseling topics should include the health benefits of breastfeeding versus not breastfeeding, the basics of breastfeeding (e.g., physiology, positioning), what to expect of hospital-based and immediate postpartum breastfeeding support (i.e., Baby-Friendly Ten Steps), and the risks of unnecessary supplementation. Medical, anatomical, and other risk factors for breastfeeding challenges should be identified, and targeted anticipatory guidance should be given. Prenatal counseling should include distribution of structured breastfeeding education at low literacy levels and in the parent's preferred language. Counseling should be culturally sensitive and patient-centered, including family members when appropriate. Prenatal support may integrate various health workers (e.g., medical doctors, midwives, community health workers, lactation consultants, among others) and include various modalities including telecommunication. Enhancing breastfeeding education for prenatal care providers is also imperative. Additional themes related to implementation of recommendations for specific populations are also reviewed.
Collapse
Affiliation(s)
- Anna Jack
- Department of Family Medicine, East Ridge Family Medicine, Department of Pediatrics, Division of Breastfeeding and Lactation Medicine, University of Rochester, Rochester, New York, USA
| | - Caroline Mullin
- Department of Family Medicine, Chobanian & Avedisian School of Medicine, Boston Medical Center and East Boston Neighborhood Health Center, Boston University, Boston, Massachusetts, USA
| | - Elizabeth Brown
- Department of Family Medicine, Highland Family Medicine, University of Rochester, Rochester, New York, USA
| | - Michele Burtner
- Department of Pediatrics, Division of Breastfeeding and Lactation Medicine, Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York, USA
| | - Katherine R Standish
- Department of Family Medicine, Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston University, Boston, Massachusetts, USA
| | - Alecia Fields
- Women's Care of Lake Cumberland, Cumberland Family Medical Center, Somerset, Kentucky, USA
| | - Casey Rosen-Carole
- Department of Pediatrics, Division of Breastfeeding and Lactation Medicine, Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York, USA
| | - Scott Hartman
- Department of Family Medicine, North Ponds Family Medicine and Maternity Care, Department of Pediatrics, Division of Breastfeeding and Lactation Medicine, University of Rochester, Rochester, New York, USA
| |
Collapse
|
5
|
Maurer L, Schultz A, Dennis CL, Alexandrowicz RW, McQueen K. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF): German Translation and Psychometric Assessment. J Hum Lact 2024; 40:374-385. [PMID: 38831687 DOI: 10.1177/08903344241254108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
BACKGROUND German-speaking mothers have breastfeeding rates below the international breastfeeding recommendations. Previous research has found that breastfeeding self-efficacy is an important and modifiable predictor of breastfeeding outcomes, thus improving breastfeeding rates. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) is used in many countries to assess maternal breastfeeding self-efficacy. This instrument has not been available in German. RESEARCH AIMS To translate the BSES-SF into German and assess its psychometric properties among breastfeeding mothers up to 12 weeks postpartum. METHODS This cross-sectional study was conducted online with 355 breastfeeding mothers recruited from breastfeeding groups through Facebook. The BSES-SF was translated into German using forward and back-translation. To test reliability, item-total characteristics, including Cronbach's alpha, were examined. We used principal component analysis, as well as known-groups comparisons for evaluating construct validity, and examined the relationship between breastfeeding self-efficacy and demographic variables. RESULTS The mean age of participants was 32.4 years (SD = 4.32). The Cronbach's alpha coefficient was .88 and corrected item-total correlations ranged between .37 and .73. Principal components analysis yielded one component with factor loadings >.40 and an eigenvalue of 5.62, which explained 40% of the total variance. In addition, known group comparisons provided further evidence for construct validity. There was no significant difference in BSES-SF scores in terms of demographic and obstetrics characteristics. CONCLUSION Our results provide evidence that the German version of the BSES-SF is a reliable and valid tool for measuring breastfeeding self-efficacy among mothers in German-speaking countries.
Collapse
Affiliation(s)
- Linda Maurer
- Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Anna Schultz
- Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Steiermark
| | - Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | | | - Karen McQueen
- School of Nursing, Lakehead University, Thunder Bay, ON, Canada
| |
Collapse
|
6
|
Henshaw E, Cooper M, Wood T, Krishna S, Lockhart M, Doan S. A randomized controlled trial of the Happy, Healthy, Loved personalized text-message program for new parent couples: impact on breastfeeding self-efficacy and mood. BMC Pregnancy Childbirth 2024; 24:506. [PMID: 39060974 PMCID: PMC11282811 DOI: 10.1186/s12884-024-06684-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Breastfeeding self-efficacy has been identified as an important influence on breastfeeding outcomes. Among new parent couples, partners are uniquely positioned to be sources of support for developing breastfeeding self-efficacy, yet few breastfeeding programs have attempted to involve partners directly. The purpose of this study was to test the impact of a novel program, Happy, Healthy, Loved, on breastfeeding self-efficacy and maternal mood through emphasizing partner support and actively addressing postpartum-specific stress management in a tailored text message delivery program. METHODS A randomized trial was conducted in which primiparous mother-partner dyads intending to exclusively breastfeed were recruited at midwestern hospitals 2-3 days after delivery. The clinical trial was pre-registered at clinicaltrials.gov (#NCT04578925, registration date 7/24/2020). Couples were randomized to receive intervention or an attentional control. Couples randomized to the intervention group then completed a brief interactive educational tablet program together (Happy, Healthy, Loved), followed by 6 weeks of tailored text messages providing reminders, coping strategies, and motivational milestones to improve breastfeeding self-efficacy. Participants in the control group received usual care followed by 6 weeks of attentional control text messages about infant development. Surveys were delivered at baseline, 6 weeks, and 6 months postpartum to both mother and partner to assess breastfeeding self-efficacy, mood, and social support (n = 62 couples). RESULTS Outcomes of ANCOVA with baseline self-efficacy as a covariate showed a significant effect of intervention on 6 months breastfeeding self-efficacy when compared to control group. No other significant differences were found at 6 weeks or 6 months postpartum in breastfeeding self-efficacy, depressive or anxious symptoms. CONCLUSIONS Results of the present investigation suggest that a text-based dyad intervention improved breastfeeding self-efficacy at 6 months, but not 6 weeks, postpartum, indicating that text-based mother-partner interventions are a promising direction to continue exploring in postpartum health research. TRIAL REGISTRATION Clinicaltrials.gov #NCT04578925.
Collapse
Affiliation(s)
- Erin Henshaw
- Department of Psychology, Denison University, 100 W. College St, Granville, OH, 43023, USA.
| | - Marie Cooper
- Riverside Methodist Hospital, OhioHealth, 3535 Olentangy River Rd., Columbus, OH, USA
| | - Teresa Wood
- OhioHealth, 3535 Olentangy River Rd, Columbus, OH, 43214, USA
| | - Sanchita Krishna
- OhioHealth Research Institute, 3535 Olentangy River Rd, Columbus, OH, 43214, USA
| | - Marie Lockhart
- OhioHealth Research Institute, 3535 Olentangy River Rd, Columbus, OH, 43214, USA
| | - Stacey Doan
- Berger Institute, Claremont McKenna College, 888 N. Columbia Ave, Claremont, CA, 91711, USA
| |
Collapse
|
7
|
Brani P, Mrvoljak-Theodoropoulou I, Pechlivani F, Gourounti K, Iliadou M, Palaska E, Antsaklis P, Drakakis P, Dagla M. Mothers' Breastfeeding Self-Efficacy after a High-Risk or Normal Pregnancy: A Greek Longitudinal Cohort Study. Eur J Investig Health Psychol Educ 2024; 14:1803-1820. [PMID: 38921085 PMCID: PMC11202792 DOI: 10.3390/ejihpe14060119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 06/16/2024] [Accepted: 06/17/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND the objective of this longitudinal study (from pregnancy to the end of the sixth month postpartum) is to elucidate the association between maternal self-efficacy, defined as a mother's confidence in her ability to breastfeed, and breastfeeding outcomes. METHODS This prospective cohort study was conducted among high-risk pregnant women (including those with conditions such as gestational diabetes, hypertension, pre-eclampsia, and other pathological medical conditions) and normal-risk pregnant women in Greece. The high-risk group included 164 women, while the normal-risk group comprised 154 women. Data were collected using validated psychometric scales, including the Breastfeeding Self-Efficacy Scale-Short Form, State-Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale, Maternal Antenatal Attachment Scale, and Iowa Infant Feeding Attitude Scale. RESULTS Higher maternal self-efficacy was significantly associated with a longer duration and greater exclusivity of breastfeeding. A statistically significant relationship between the type of breastfeeding and the degree of breastfeeding self-efficacy was observed at multiple postpartum milestones: in the first and third 24 h postpartum, and at the end of the sixth week, third month, and sixth month postpartum. CONCLUSION The findings underscore the critical role of maternal self-efficacy in breastfeeding success, influenced by individual psychological factors and broader socio-cultural contexts. Strengthening maternal self-efficacy is essential for improving breastfeeding outcomes.
Collapse
Affiliation(s)
- Panagiota Brani
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (K.G.); (M.I.); (E.P.)
| | | | - Fani Pechlivani
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (K.G.); (M.I.); (E.P.)
| | - Kleanthi Gourounti
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (K.G.); (M.I.); (E.P.)
| | - Maria Iliadou
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (K.G.); (M.I.); (E.P.)
| | - Ermioni Palaska
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (K.G.); (M.I.); (E.P.)
| | - Panagiotis Antsaklis
- First Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, General Hospital “ALEXANDRA”,11528 Athens, Greece;
| | - Peter Drakakis
- Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, University Hospital “ATTIKON”,12461 Athens, Greece;
| | - Maria Dagla
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (K.G.); (M.I.); (E.P.)
| |
Collapse
|
8
|
Inderstrodt J, Stryczek KC, Vargas SE, Crawford JN, Hooker T, Kroll-Desrosiers AR, Marteeny V, Wallace KF, Mattocks K. Facilitators and Barriers to Breastfeeding Among Veterans Using Veterans Affairs Maternity Care Benefits. Womens Health Issues 2024; 34:309-316. [PMID: 38326149 DOI: 10.1016/j.whi.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 12/21/2023] [Accepted: 12/21/2023] [Indexed: 02/09/2024]
Abstract
INTRODUCTION U.S. veterans of childbearing age represent one of the fastest growing populations using Veterans Affairs (VA) health care. The VA does not provide obstetric care directly but pays for VA-enrolled veterans to obtain outside obstetric care. The VA also provides maternity care coordination (MCC) services, including lactation support. Breastfeeding benefits mothers and babies; however, previous research shows that veteran mothers quit exclusive breastfeeding earlier than the American Academy of Pediatrics and World Health Organization recommendation of 6 months. This study aimed to understand facilitators and barriers to breastfeeding among a cohort of veterans who used VA maternity care benefits. METHODS Qualitative data from an open-ended question from a national sample of postpartum veterans using VA pregnancy benefits were coded using deductive and inductive content analysis within a matrix framework. Quantitative data were used to contextualize the responses. RESULTS Four themes emerged from the data: (1) impacts on health of baby/mother; (2) the ability to breastfeed; (3) early postnatal experiences breastfeeding; and (4) cost/convenience. Among those who responded to the open-ended breastfeeding question (329/669), most participants (n = 316; 96%) attempted breastfeeding their current baby. Respondents who did not initiate breastfeeding or who discontinued breastfeeding earlier than planned cited diverse reasons. These included low milk supply, poor latch, nipple pain, mental health factors, and low confidence in their ability to continue breastfeeding. Participants cited the MCC program as a facilitator to breastfeeding, and non-VA hospital experiences were mentioned as barriers. CONCLUSION Veterans in this cohort of 329 veterans who responded to an open-ended breastfeeding question wanted and attempted to breastfeed; however, barriers such as lactation challenges and unsupportive health care providers made it difficult to continue the practice. As the MCC program grows to include more lactation professionals, MCCs may address barriers such as lactation challenges and unsupportive non-VA health care providers. Further program development should focus on addressing these challenges prenatally.
Collapse
Affiliation(s)
- Jill Inderstrodt
- Indiana University Fairbanks School of Public Health, Indianapolis, Indiana.
| | | | - Sara E Vargas
- Miriam Hospital & Brown University Medical School, Providence, Rhode Island
| | - Jennifer N Crawford
- Albuquerque VA Medical Center, Albuquerque, New Mexico; University of New Mexico, Albuquerque, New Mexico
| | - Taylor Hooker
- Office of Health Equity, Veterans Health Administration, Washington, District of Columbia
| | - Aimee R Kroll-Desrosiers
- VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts; University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Valerie Marteeny
- VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts
| | - Kate F Wallace
- VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts
| | - Kristin Mattocks
- VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts; University of Massachusetts Chan Medical School, Worcester, Massachusetts
| |
Collapse
|
9
|
Ryan RA, Hepworth AD, Bihuniak JD, Lyndon A. A Qualitative Study of Breastfeeding Experiences Among Mothers Who Used Galactagogues to Increase Their Milk Supply. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:122-132. [PMID: 38159094 DOI: 10.1016/j.jneb.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To qualitatively describe breastfeeding experiences among mothers who used galactagogues to increase their milk supply. DESIGN One-time, semistructured phone interviews. SETTING US. PARTICIPANTS Breastfeeding mothers (n = 19) who reported ever consuming foods, beverages, or herbal supplements to increase their milk supply in a cross-sectional online survey were purposefully sampled to participate in this qualitative study. Participants were diverse in terms of race and ethnicity, education, income, infant age (0-18 months), and prior breastfeeding experience (32% first-time breastfeeding). PHENOMENON OF INTEREST Reasons for trying to increase milk supply, sources of information about increasing milk supply, and strategies tried to increase milk supply. ANALYSIS Interviews were transcribed verbatim and analyzed using reflexive thematic analysis. RESULTS Participants expressed determination and commitment to breastfeeding but unexpectedly struggled to breastfeed and increase their milk supply. They sought information from multiple sources and used individualized approaches to address milk supply concerns on the basis of recommendations from others, as well as the perceived convenience, cost, palatability, and safety of potential strategies. CONCLUSIONS AND IMPLICATIONS Results suggest a need to expand breastfeeding education and support so that lactating parents anticipate common breastfeeding challenges and are aware of evidence-based strategies for increasing their milk supply.
Collapse
Affiliation(s)
- Rachel A Ryan
- Department of Nutrition and Food Studies, New York University, New York, NY; Public Health Nutrition, School of Global Public Health, New York University, New York, NY.
| | | | | | - Audrey Lyndon
- Rory Meyers College of Nursing, New York University, New York, NY
| |
Collapse
|
10
|
Dennis CL, McQueen K, Dol J, Brown H, Beck C, Shorey S. Psychometrics of the breastfeeding self-efficacy scale and short form: a systematic review. BMC Public Health 2024; 24:637. [PMID: 38419045 PMCID: PMC10903029 DOI: 10.1186/s12889-024-17805-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/18/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The Breastfeeding Self-Efficacy Scale and its short-form were developed in Canada and have been used internationally among numerous maternal populations. However, the psychometric properties of the scales have not been reviewed to confirm their appropriateness in measuring breastfeeding self-efficacy in culturally diverse populations. The purpose of this research was to critically appraise and synthesize the psychometric properties of the scales via systematic review. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Three databases (EMBASE, MEDLINE, and PsycINFO) were searched from 1999 (original publication of the Scale) until April 27, 2022. The search was updated on April 1, 2023. Studies that assessed the psychometric properties of the BSES or BSES-SF were included. Two researchers independently extracted data and completed the quality appraisals. RESULTS Forty-one studies evaluated the psychometrics of the BSES (n = 5 studies) or BSES-SF (n = 36 studies) among demographically or culturally diverse populations. All versions of the instrument demonstrated good reliability, with Cronbach's alphas ranging from .72 to .97. Construct validity was supported by statistically significant differences in mean scores among women with and without previous breastfeeding experience and by correlations between the scales and theoretically related constructs. Predictive validity was demonstrated by statistically significant lower scores among women who ultimately discontinued breastfeeding compared to those who did not. CONCLUSION The BSES and BSES-SF appear to be valid and reliable measures of breastfeeding self-efficacy that may be used globally to (1) assess women who may be at risk of negative breastfeeding outcomes (e.g., initiation, duration and exclusivity), (2) individualize breastfeeding support, and (3) evaluate the effectiveness of breastfeeding interventions.
Collapse
Affiliation(s)
- Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada.
| | | | | | | | | | | |
Collapse
|
11
|
Tang F, Wu L, Yang L, Zhou BF, Qiu K, Wang LC, Shi L, Long XF. Qualitative research on the cognition of breastfeeding knowledge in primiparas during pregnancy. Technol Health Care 2024; 32:303-312. [PMID: 38534047 DOI: 10.3233/thc-230129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND In view of the lack of attention and predictability in postpartum breastfeeding in primiparas, health education on breastfeeding during pregnancy should be carried out to publicize the benefits of breastfeeding. OBJECTIVE To investigate how well the primiparas during pregnancy are known of breastfeeding knowledge, and to provide a basis for developing health education measures for them. METHODS With the adoption of the objective sampling method and the principle of saturation, 10 primiparas in the obstetrics outpatient department of the Hunan Provincial People's Hospital were selected as the study participants. Semi-structured in-depth interviews combined with the observation method were used for data collection. The interview data were analyzed and the theme was refined by Colaizzi's seven-step method. RESULTS The results of the four themes of the cognition of breastfeeding knowledge among primiparas were as follows: Lack of knowledge and curiosity about breastfeeding in some women, lack of access to correct breastfeeding knowledge, insufficient support from family members for postpartum breastfeeding, and lack of approach to solve problems during breastfeeding among primiparas. CONCLUSION Due to the current problems of the cognition of breastfeeding knowledge in primiparas, it was imperative to build a health education model suitable for primiparas to improve this knowledge.
Collapse
Affiliation(s)
- Fang Tang
- Department of Medical Administration, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China
| | - Ling Wu
- Department of Obstetrics, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China
| | - Li Yang
- Office of Outpatient Department, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China
| | - Bei-Fang Zhou
- Department of Obstetrics, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China
| | - Kun Qiu
- Department of Obstetrics, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China
| | - Li-Chun Wang
- Department of Obstetrics, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China
| | - Lu Shi
- Department of Obstetrics, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China
| | - Xiao-Feng Long
- Hospital Office, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China
| |
Collapse
|
12
|
Lucchini-Raies C, Marquez-Doren F, Perez JC, Campos S, Beca P, Lopez-Dicastillo O. A complex intervention to support breastfeeding: A feasibility and acceptability study. Int J Nurs Pract 2023; 29:e13184. [PMID: 37461904 DOI: 10.1111/ijn.13184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 05/30/2023] [Accepted: 06/24/2023] [Indexed: 12/18/2023]
Abstract
AIMS The aims of this study are to assess the acceptability and feasibility of a multicomponent intervention to support breastfeeding women and their families and explore its effectiveness. METHODS A pilot study with control and intervention groups was conducted using the complex intervention framework in two primary healthcare centres. Overall, 44 childbearing women, their partners/relatives and 20 healthcare professionals participated in the study. The intervention's feasibility and acceptability were measured. The percentage of exclusive breastfeeding rates and women's self-efficacy were measured at pre-intervention, at 10 days postpartum, and again at 2, 4 and 6 months postpartum. Postpartum depression risk was measured at 2 and 6 months postpartum. Professional self-efficacy was measured at pre-intervention and 3 months later. RESULTS The intervention was feasible and acceptable. No difference in self-efficacy existed between the intervention and control groups. Preliminary effects of the intervention were found in exclusive breastfeeding percentage and postpartum depression risk in the intervention group. CONCLUSION The intervention is feasible and acceptable. The results are promising not only for breastfeeding maintenance but also for preventing postpartum depression and recovering exclusive breastfeeding during pandemics. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT03944642.
Collapse
Affiliation(s)
- Camila Lucchini-Raies
- School of Nursing, PAHO/WHO Collaborating Center, Pontificia Universidad Católica de Chile, Santiago, Chile
- Alpha Beta Omicron Chapter, Sigma Theta Tau International, Santiago, Chile
| | - Francisca Marquez-Doren
- School of Nursing, PAHO/WHO Collaborating Center, Pontificia Universidad Católica de Chile, Santiago, Chile
- Alpha Beta Omicron Chapter, Sigma Theta Tau International, Santiago, Chile
| | - J Carola Perez
- Faculty of Psychology, Universidad del Desarrollo, Santiago, Chile
| | - Solange Campos
- School of Nursing, PAHO/WHO Collaborating Center, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paulina Beca
- School of Medicine, Family Health Center San Alberto Hurtado ANCORA, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | |
Collapse
|
13
|
Linares AM, Cartagena D, Christoffel MM. Hospital Adhering to the Ten Steps to Successful Breastfeeding Predicts Exclusive Breastfeeding in Latinx Mothers. HISPANIC HEALTH CARE INTERNATIONAL 2023; 21:203-212. [PMID: 37376801 DOI: 10.1177/15404153231181699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Introduction: Assessing how well a hospital adheres to the Ten Steps to Successful Breastfeeding is the key to outlining necessary modifications in mother breastfeeding support. This study aimed to assess Latinx mothers' perception of how well a hospital adheres to the Ten Steps to Successful Breastfeeding and its influence on exclusive breastfeeding (EBF) rates at hospital discharge. Methods: Secondary analysis of two longitudinal studies. The combined sample (N = 74) of Latinx pregnant women residing in the US. We modified, translated, and evaluated reliability of the Questionnaire for the Breastfeeding Mother (QBFM), which was applied to evaluate mothers' perception of how well a hospital adheres to the Ten Steps to Successful Breastfeeding. Results: The QBFM obtained a standardized KR-20 of 0.77. Mothers who EBF had higher scores of the QBFM than mothers who used formula during hospitalization. For each point that the QBFM score increased, the likelihood that the mother was EBF at discharge increased by 1.30 times. Conclusion: Mothers' perceptions of how well a hospital adheres to the Ten Steps to Successful Breastfeeding were the only significant variable associated with EBF at discharge. The QBFM Spanish version is a valuable instrument that can be used to obtain measurable outcomes and outlines necessary changes after implementing the Ten Steps to Successful Breastfeeding.
Collapse
Affiliation(s)
| | - Diana Cartagena
- College of Health Sciences, School of Nursing, Old Dominion University, Virginia Beach, VA, USA
| | | |
Collapse
|
14
|
Güneş AO, Karadağ N, Karatekin G. The Effect of Breastfeeding Self-Efficacy on Infants' Weights and Breastfeeding Outcomes. Turk Arch Pediatr 2023; 58:588-593. [PMID: 37737229 PMCID: PMC10724744 DOI: 10.5152/turkarchpediatr.2023.23113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/25/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the effects of breastfeeding self-efficacy (BSE) and breastfeeding success (BFS) on infants' weight gain rates and breastfeeding outcomes. MATERIALS AND METHODS Mothers were evaluated within the postpartum 72 hours with "Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF)" and "LATCH Scale." After 6 months, the mothers were called to learn the exclusive breastfeeding (EB) duration and the weight of the infants. RESULTS Two hundred mother-infant couples were enrolled, 176 (88%) of them could be reached in the sixth month. The BSES-SF scores were positively correlated with LATCH scores (P = .0001). The EB rate in the sixth month was positively correlated with BFS but not correlated with BSE (r, P = .218, .004; .79, .297, respectively). The percentage of weight gain and the rate of weight percentile change of babies according to birth weight at the sixth month of age were negatively correlated with BSE (r = -0.226, -0.148, P = .003, .049, respectively) but not correlated with BFS. CONCLUSION Higher BFS was associated with increased duration of EB in the first 6 months of life, and higher BSE was related to lower increase in the percentage of weight gain and a lower rate of weight percentile change of babies at 6 months of age.
Collapse
Affiliation(s)
- Aslı Okbay Güneş
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Zeynep Kamil Maternity and Children’s Training and Research Hospital, İstanbul, Turkey
| | - Nilgün Karadağ
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Zeynep Kamil Maternity and Children’s Training and Research Hospital, İstanbul, Turkey
| | - Güner Karatekin
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Zeynep Kamil Maternity and Children’s Training and Research Hospital, İstanbul, Turkey
| |
Collapse
|
15
|
Paramashanti BA, Dibley MJ, Huda TM, Prabandari YS, Alam NA. Factors influencing breastfeeding continuation and formula feeding beyond six months in rural and urban households in Indonesia: a qualitative investigation. Int Breastfeed J 2023; 18:48. [PMID: 37653430 PMCID: PMC10472632 DOI: 10.1186/s13006-023-00586-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 08/25/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Global and Indonesian guidelines suggest that breastfeeding should continue for at least the first two years of life. While many studies have focused on six-month exclusive breastfeeding practices, little is known about why mothers do not sustain breastfeeding beyond this period. This qualitative study aimed to explore factors influencing breastfeeding continuation and formula feeding beyond six months, regardless of any additional food consumed, focusing on Indonesia's rural and urban areas. METHODS We collected the data through 46 in-depth interviews in Pati District and Surakarta City, Central Java, Indonesia. Participants were mothers, grandmothers, health care practitioners, and village kader (frontline female health workers). We used thematic analysis combining deductive and inductive techniques for analysing the data. RESULTS Rural mothers practised breastfeeding and intended to breastfeed for a longer duration than urban mothers. Maternal attitude towards breastfeeding, breastfeeding knowledge, previous experiences, and other breastfeeding strategies (e.g., enhancing maternal dietary quality) positively influenced breastfeeding sustainability. In the urban setting, mothers encountered several breastfeeding barriers, such as perceived breast milk insufficiency and child hunger and satiety, child biting, and breastfeeding refusal, causing them to provide formula milk as a breast milk substitute or supplement. In addition, families, communities, health practitioners, and employment influenced maternal decisions in breastfeeding continuation and formula-feeding practices. CONCLUSIONS Optimal breastfeeding practices up to two years of age are determined by the individual and setting (i.e., community, healthcare, employment) factors. Providing breastfeeding education covering practical breastfeeding guidance will encourage mothers to breastfeed for longer. Such interventions should involve families, communities, health workers, and the work environment as a breastfeeding support system. Policymakers should develop, enforce, and monitor the implementation of breastfeeding policies to protect, promote, and support breastfeeding in households, communities, health systems, and work settings.
Collapse
Affiliation(s)
- Bunga Astria Paramashanti
- Department of Nutrition, Faculty of Health Sciences, Universitas Alma Ata, Yogyakarta, Indonesia.
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
| | - Michael J Dibley
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Tanvir M Huda
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Yayi Suryo Prabandari
- Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Neeloy Ashraful Alam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
16
|
D'Hollander CJ, McCredie VA, Uleryk EM, Keown-Stoneman CDG, Birken CS, O'Connor DL, Maguire JL. Breastfeeding support provided by lactation consultants in high-income countries for improved breastfeeding rates, self-efficacy, and infant growth: a systematic review and meta-analysis protocol. Syst Rev 2023; 12:75. [PMID: 37131212 PMCID: PMC10152596 DOI: 10.1186/s13643-023-02239-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 04/19/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND It is well established that breast milk offers numerous health benefits for mother and child. Mothers are recommended to exclusively breastfeed their child until 6 months of age, with continued breastfeeding up to 1-2 years of age or beyond. Yet, these recommendations are met less than half of the time in high-income countries. Lactation consultants specialize in supporting mothers with breastfeeding and are a promising approach to improving breastfeeding rates. For lactation consultant interventions to be implemented widely as part of public health policy, a better understanding of their effect on breastfeeding rates and important health outcomes is needed. METHODS The overall aim of this systematic review is to evaluate the effect of lactation consultant interventions provided to women, compared to usual care, on breastfeeding rates (primary outcome), maternal breastfeeding self-efficacy, and infant growth. A search strategy has been developed to identify randomized controlled trials published in any language between 1985 and April 2023 in CENTRAL, MEDLINE, EMBASE, CINAHL, Scopus, and Web of Science. We will also perform a search of the grey literature and reference lists of relevant studies and reviews. Two reviewers will independently extract data on study design, baseline characteristics, details of the interventions employed, and primary and secondary outcomes using a pre-piloted standardized data extraction form. Risk of bias and quality of evidence assessment will be done independently and in duplicate using the Cochrane Risk of Bias tool and GRADE approach, respectively. Where possible, meta-analysis using random-effects models will be performed, otherwise a qualitative summary will be provided. We will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. DISCUSSION This review will fill an important gap in the lactation support literature. The findings will be of importance to policymakers who seek to implement interventions to improve breastfeeding rates. TRIAL REGISTRATION This review has been registered in the PROSPERO database (ID: CRD42022326597).
Collapse
Affiliation(s)
- Curtis J D'Hollander
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
- Department of Paediatrics, St. Michael's Hospital, Toronto, ON, Canada
| | - Victoria A McCredie
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
- Department of Medicine (Respirology), Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | - Charles D G Keown-Stoneman
- Applied Health Research Centre, Unity Health Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Catherine S Birken
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Division of Pediatric Medicine, Hospital for Sick Children, Toronto, ON, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Joannah & Brian Lawson Centre for Child Nutrition, Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Deborah L O'Connor
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
- Translational Medicine Program, Hospital for Sick Children, Toronto, ON, Canada
| | - Jonathon L Maguire
- Department of Paediatrics, St. Michael's Hospital, Toronto, ON, Canada.
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada.
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Joannah & Brian Lawson Centre for Child Nutrition, Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.
| |
Collapse
|
17
|
Al-Thubaity DD, Alshahrani MA, Elgzar WT, Ibrahim HA. Determinants of High Breastfeeding Self-Efficacy among Nursing Mothers in Najran, Saudi Arabia. Nutrients 2023; 15:nu15081919. [PMID: 37111138 PMCID: PMC10145845 DOI: 10.3390/nu15081919] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Many factors have been found to correlate with satisfactory Exclusive Breastfeeding (EBF) practices. The relationships between EBF practices and associated factors are complex and multidimensional; Breastfeeding Self-Efficacy (BSE) is the most important psychological factor that may help the mother to overcome any expected barriers. This study investigates the determinants of high breastfeeding self-efficacy among Saudi nursing mothers. METHODS This is a descriptive cross-sectional study investigating the determinant of BSE among 1577 nursing mothers in primary health centers in Najran City, Saudi Arabia. The study uses a cluster random sampling technique. Data collection was performed from June 2022 to January 2023 using a self-reported questionnaire that encompasses the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), Gender Friendly Breastfeeding Knowledge Scale (GFBKS), Iowa Infant Feeding Attitude Scale (IIFAS), and a basic data questionnaire to assess women's demographic factors and obstetric history. RESULTS The mean score for all BSES-SF items was between 3.23-3.41, the highest mean score was in mothers who felt comfortable breastfeeding with family members present (3.41 ± 1.06), and the lowest mean was in mothers who could breastfeed their baby without using formula as a supplement (3.23 ± 0.94). The overall BSE score was high among 67% of the study participants. Binary logistic regression showed that being a housewife, being highly educated, having breastfeeding experience, and being multiparous are positive predictors for high BSE (p ≤ 0.001). In addition, having adequate breastfeeding knowledge and positive breastfeeding attitudes were positively associated with higher BSE (p = 0.000). CONCLUSION BSE can be predicted by modifiable predictors such as mothers' education, working status, parity, breastfeeding experience, adequate breastfeeding knowledge, and positive attitudes toward breastfeeding. If such predictors are considered during breastfeeding-related educational interventions, it could lead to more effective and sustainable effects in community awareness regarding breastfeeding.
Collapse
Affiliation(s)
- DaifAllah D Al-Thubaity
- Department of Maternity and Childhood Nursing, Nursing College, Najran University, Najran 66441, Saudi Arabia
| | - Mohammed A Alshahrani
- Department of Clinical Laboratory Sciences, Applied Medical Sciences College, Najran University, Najran 66441, Saudi Arabia
| | - Wafaa T Elgzar
- Department of Maternity and Childhood Nursing, Nursing College, Najran University, Najran 66441, Saudi Arabia
- Department of Obstetrics and Gynecologic Nursing, Nursing College, Damanhour University, Damanhour 22514, Egypt
| | - Heba A Ibrahim
- Department of Maternity and Childhood Nursing, Nursing College, Najran University, Najran 66441, Saudi Arabia
- Department of Obstetrics and Woman Health Nursing, Benha University, Benha 13511, Egypt
| |
Collapse
|
18
|
Sağlik M, Karaçam Z. Effectiveness of structured education and follow-up in the management of perceived breastmilk insufficiency: A randomized control trial. Health Care Women Int 2023; 44:276-294. [PMID: 34919025 DOI: 10.1080/07399332.2021.2007249] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In this study, we examine the effectiveness of structured education and follow-up in the management of perceived milk insufficiency and in increasing the baby's amount of milk intake in breastfeeding mothers. We conducted a randomized controlled trial over the period December 2018-June 2019 at Family Health Centers in Turkey with 64 mothers (intervention group: 33 and control group: 31). We provided the intervention group with education using structured educational material. A Descriptive Information Form, a Breastfeeding Follow-up Form, and the Scoring System for Measuring a Baby's Intake of Breast Milk were the instruments we used in the data collection. Mothers in the intervention group started breastfeeding their babies in the first one hour after birth. We observed at each monitoring that a significantly greater percentage of the mothers in the intervention group believed their milk to be sufficient and that they fed their babies exclusively with breast milk in the three follow-ups. We found from the data we obtained that all three tracking times indicated that the baby's amount of milk intake in the intervention group was better than in the control group; the differences were statistically significant. We concluded that structured education and follow-ups increased the exclusive breastfeeding of 0-2-month-old babies, improved perceptions of sufficient milk intake, diminishing the perception of breast milk deficiency.Supplemental data for this article is available online at https://doi.org/10.1080/07399332.2021.2007249.
Collapse
Affiliation(s)
| | - Zekiye Karaçam
- Faculty of Health Sciences, Division of Midwifery, Aydın Adnan Menderes University, Aydın, Turkey
| |
Collapse
|
19
|
Saether KM, Berg RC, Fagerlund BH, Glavin K, Jøranson N. First-time parents' experiences related to parental self-efficacy: A scoping review. Res Nurs Health 2023; 46:101-112. [PMID: 36564911 PMCID: PMC10107989 DOI: 10.1002/nur.22285] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 11/04/2022] [Accepted: 11/25/2022] [Indexed: 12/25/2022]
Abstract
Becoming a parent for the first time is a major transition, and parental self-efficacy (PSE) is considered an important predictor of parenting functioning. We aimed to describe and synthesize qualitative studies that explore first-time parents' experiences related to PSE in the transition to parenthood in the first-year postpartum. We conducted a scoping review in accordance with international guidelines. The main search strategy consisted of searches in six electronic databases. We selected studies based on predetermined inclusion and exclusion criteria, extracted data, and conducted a descriptive qualitative thematic analysis. We included 58 studies (presented in 61 reports) with 1341 participants from 17 countries. Most of the participants (89%) were mothers, and a third of the studies were task-specific regarding breastfeeding. The thematic analysis of the findings concerning PSE revealed five main, interconnected themes: culture-factors in society and the healthcare services; parents-processes within the parents; tasks-different parental tasks; support-parents' perceived support from professionals, peers, friends, family, and partner; and child-the child's well-being and feedback. This scoping review describes qualitative studies on first-time parents' experiences related to PSE. The findings inform future studies of PSE and clinical practice by confirming the importance of PSE in the transition to parenthood, the complexity of different factors that may have an impact, and the centrality of breastfeeding in PSE. Based on these findings, we suggest that a full systematic review with quality assessment would be appropriate.
Collapse
Affiliation(s)
- Kristin M Saether
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway.,Faculty of Health Studies, VID Specialized University, Oslo, Norway
| | - Rigmor C Berg
- Norwegian Institute of Public Health, Oslo, Norway.,Department of Community Medicine, University of Tromsø, Tromsø, Norway
| | | | - Kari Glavin
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| | - Nina Jøranson
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| |
Collapse
|
20
|
Singh J, Scime NV, Chaput KH. Association of Caesarean delivery and breastfeeding difficulties during the delivery hospitalization: a community-based cohort of women and full-term infants in Alberta, Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:104-112. [PMID: 35902540 PMCID: PMC9849537 DOI: 10.17269/s41997-022-00666-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/20/2022] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Breastfeeding difficulties are the most common reason for breastfeeding cessation, particularly in the early postpartum. Caesarean delivery is associated with earlier breastfeeding cessation than is the case with vaginal delivery, but differences in breastfeeding difficulties by mode of delivery have not been thoroughly examined. Our objective was to explore the association between Caesarean delivery and types of breastfeeding difficulties. METHODS We conducted a secondary analysis of data from a prospective cohort study of mothers who delivered full-term, singleton infants in Calgary, Alberta, Canada (N = 418). Women completed self-report questionnaires during the delivery hospitalization. Mode of delivery was defined as vaginal or Caesarean, and further classified as planned or unplanned Caesarean. Breastfeeding difficulties were measured using the Breastfeeding Experiences Scale and operationalized with binary variables for presence of various types of maternal (i.e. physical, supply, social) and infant (i.e. latch, behaviour/health) difficulties that were reported as moderate to unbearable. Multivariable logistic regression was used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). RESULTS Overall, 37.1% of women had a Caesarean delivery and 80.9% experienced a breastfeeding difficulty during the delivery hospitalization. Of the difficulties studied, Caesarean delivery was significantly associated with low milk supply (AOR = 1.62, 95% CI = 1.16-2.28) and infant behaviour/health difficulties (AOR = 1.33, 95% CI = 1.01-1.75). The association with low milk supply persisted when examining both planned (AOR = 2.42, 95% CI = 1.19-4.92) and unplanned (AOR = 2.21, 95% CI = 1.16-4.22) Caesarean deliveries. CONCLUSION Mothers who deliver by Caesarean have higher odds of reporting low milk supply and infant behaviour/health difficulties than women who deliver vaginally.
Collapse
Affiliation(s)
- Joyce Singh
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Natalie V Scime
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Kathleen H Chaput
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Obstetrics & Gynecology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
21
|
Wong MS, Chien WT. A Pilot Randomized Controlled Trial of an Online Educational Program for Primiparous Women to Improve Breastfeeding. J Hum Lact 2023; 39:107-118. [PMID: 36189735 DOI: 10.1177/08903344221125129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There are different approaches to breastfeeding interventions, but the global 6-month exclusive breastfeeding rates remain suboptimal. The COVID-19 pandemic has brought extra difficulties in promoting breastfeeding. RESEARCH AIM To test the feasibility and effectiveness of a theory-based, real-time online educational and support program for breastfeeding related outcomes. METHODS An assessor-blinded, prospective pilot randomized controlled trial with parallel-group, repeated-measures design was used. The sample was low-risk primiparous mothers (N = 40) who delivered in the local public hospitals. Study outcomes consisted of exclusive breastfeeding rate, breastfeeding self-efficacy, and other breastfeeding outcomes measured by a self-reported questionnaire, including the Breastfeeding Self-Efficacy Scale and the Edinburgh Postnatal Depression Scale. Comparisons between the differences in the intervention and control groups were carried out. RESULTS Thirteen participants in the intervention group successfully completed the program. They had a higher exclusive breastfeeding rate, breastfeeding self-efficacy, breastfeeding initiation rate, and longer exclusive breastfeeding duration than the control group. Additionally, the intervention group had a lower partial breastfeeding rate, and a higher maternal postnatal depression score and infant's morbidity at postnatal 2 months. However, all the results were not statistically significant (p > .050). Overall, the intervention was highly valued by all participants who appreciated the regular postnatal follow-ups. CONCLUSIONS Despite showing the satisfactory feasibility of the program, no significant improvements were found in all study outcomes. Considering the participants' comments, we suggest refining and further testing the intervention with a larger sample size over a longer-term follow-up to confirm its effectiveness.This study has been registered at ClinicalTrials.gov (NCT04741425).
Collapse
Affiliation(s)
- Mei Sze Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| |
Collapse
|
22
|
Study protocol for the sheMATTERS study (iMproving cArdiovascular healTh in new moThERS): a randomized behavioral trial assessing the effect of a self-efficacy enhancing breastfeeding intervention on postpartum blood pressure and breastfeeding continuation in women with hypertensive disorders of pregnancy. BMC Pregnancy Childbirth 2023; 23:68. [PMID: 36703104 PMCID: PMC9878496 DOI: 10.1186/s12884-022-05325-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/14/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Individuals with hypertensive disorders of pregnancy (HDP) have an elevated lifetime risk of chronic hypertension, metabolic syndrome, and premature cardiovascular disease. Because breastfeeding duration and exclusivity have been associated in observational studies with improved cardiovascular health, optimizing breastfeeding in those with HDP might be an unrealized cardio-prevention approach, in particular because individuals with HDP have more breastfeeding challenges. Breastfeeding supportive interventions targeting one's breastfeeding self-efficacy have been shown to improve breastfeeding rates. METHODS We designed an open-label, multi-center 1:1 randomized behavioral trial to test whether a previously validated self-efficacy enhancing breastfeeding intervention can improve breastfeeding duration and/or exclusivity, and lower postpartum blood pressure at 12 months. Randomization is computer-generated and stratified by site (four hospitals in Montreal, Quebec and one hospital in Kingston, Ontario; all in Canada). Included are breastfeeding participants with HDP (chronic/gestational hypertension or preeclampsia) who delivered a live singleton infant at > 34 weeks, speak English or French, and have no contraindications to breastfeeding. Informed and written consent is obtained at hospitalization for delivery or a re-admission with hypertension within 1 week of discharge. Participants assigned to the intervention group receive a breastfeeding self-efficacy-based intervention delivered by a trained lactation consultant in hospital, with continued reactive/proactive support by phone or text message for up to 6 months postpartum. Regardless of group assignment, participants are followed for self-reported outcomes, automated office blood pressure, and home blood pressure at several time points with end of follow-up at 12 months. DISCUSSION This study will assess whether an intensive nurse-led behavioral intervention can improve breastfeeding rates and, in turn, postpartum blood pressure - an early marker for atherosclerotic cardiovascular disease. If effective, this form of enhanced breastfeeding support, along with closer BP and metabolic surveillance, can be implemented broadly in individuals lactating after HDP. TRIAL REGISTRATION ClinicalTrials.gov, # NCT04580927 , registered on Oct 9, 2020.
Collapse
|
23
|
Akyıldız D, Bay B. The effect of breastfeeding support provided by video call on postpartum anxiety, breastfeeding self-efficacy, and newborn outcomes: A randomized controlled study. Jpn J Nurs Sci 2023; 20:e12509. [PMID: 36071624 DOI: 10.1111/jjns.12509] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/23/2022] [Accepted: 08/12/2022] [Indexed: 01/05/2023]
Abstract
AIM To examine the effects of breastfeeding support given by video call on anxiety, breastfeeding self-efficacy, and newborn outcomes. METHODS We conducted a randomized controlled experimental trial with 72 women and their babies. Participants were randomly assigned to the intervention (video call) group (VCG: standard care + video call) and control group (CG: standard care). The primary outcomes of this study were the mean postpartum maternal anxiety level and the mean breastfeeding self-efficacy level. The secondary outcome was neonatal outcomes. This study followed the CONSORT (Consolidated Standards of Reporting Trials) checklist. RESULTS Women in VCG had lower anxiety levels than the CG at postpartum 2 weeks (mean difference [MD] 25.42, p = .000) and 1 month (MD 47.72, p = .000). The breastfeeding self-efficacy level of women in the VCG was higher than the CG at postpartum 2 weeks (MD 13.18, p = .007) and 1 month (MD 10.1, p = .001). The newborns in VCG had higher weight gain and daily breastfeeding frequency than the CG at the postpartum second week (MD 9.64, p = .001, MD 2.88, p = .000; respectively) and 1 month (MD 47.16, p = .000, MD 2.98, p = .000; respectively). There were lower rates of challenges of breastfeeding, hyperbilirubinemia, and feeding with formula in VCG than CG at the postpartum second week (p = .043, p = .043, p = .039; respectively). CONCLUSIONS Breastfeeding support via video calling has positive effects on maternal anxiety, breastfeeding self-efficacy, and newborn health. Postpartum caregivers may benefit from video calling for breastfeeding support.
Collapse
Affiliation(s)
- Deniz Akyıldız
- Division of Midwifery, Kahramanmaras Sutcu Imam University, Faculty of Health Sciences, Onikişubat, Turkey
| | - Betül Bay
- School of Nursing and Midwifery/College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| |
Collapse
|
24
|
Venancio SI, Melo DS, Relvas GRB, de Bortoli MC, de Araújo BC, Oliveira CDF, da Silva LALB, de Melo RC, Moreira HDOM, Rodrigues JM. Effective interventions for the promotion of breastfeeding and healthy complementary feeding in the context of Primary Health Care. REVISTA PAULISTA DE PEDIATRIA 2023; 41:e2021362. [DOI: 10.1590/1984-0462/2023/41/2021362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 05/06/2022] [Indexed: 12/23/2022]
Abstract
Abstract Objective: To develop a rapid review on effective actions for the promotion of breastfeeding and healthy complementary feeding in primary health care and to summarize a list of actions and their elements for implementation. Data source: The review included systematic reviews on the effectiveness of interventions to promote breastfeeding and/or healthy complementary feeding for mothers and other caregivers, and/or professionals who work with this population, in comparison with any usual approach or none. Data synthesis: A total of 32 systematic reviews were included in the evidence synthesis. Ten types of interventions were evaluated in systematic reviews on promotion of breastfeeding and four types of interventions on promotion of healthy complementary feeding. The synthesis allowed six aspects to be discussed, and these must be considered to increase the chances of interventions’ impact: type of intervention, target audience, timing of intervention, actors that can implement it, strategies and methods of intervention, and intensity of intervention. Conclusions: It was possible to assemble a list of actions whose effectiveness has already been demonstrated, providing elements for local adaptations. Evidence is expected to support and strengthen the implementation of programs aimed at promoting breastfeeding and complementary feeding in primary health care.
Collapse
|
25
|
Atchan M, Graham K, Hartney N, Martis R, Kearney L, Davey K, Daellenbach R, Hall H, Sweet L. Either 'a blessing in disguise', or 'I couldn't get help,': Australian and Aotearoa NZ women's experiences of early infant feeding during COVID-19. Women Birth 2022; 36:e305-e313. [PMID: 36443218 PMCID: PMC9699799 DOI: 10.1016/j.wombi.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND To manage the COVID-19 pandemic, public health restrictions and a rapid pivot to telehealth occurred. Peripartum services were significantly affected by a strained infrastructure. Decreased face to face access to health services and support affected maternal experiences and confidence internationally, yet little was reported with the Australian and Aotearoa New Zealand context. AIM To explore the early parenting and infant feeding experiences of new mothers from Australia and Aotearoa New Zealand in the context of a pandemic. METHODS An interpretive qualitative approach and thematic analysis obtained an in-depth understanding of the experiences of 27 mothers who gave birth during the first wave of the COVID-19 pandemic in 2020. FINDINGS Australian and Aotearoa New Zealand women reported similar experiences, which varied contextually. Restrictions and requirements impacted favourably and unfavourably. Many women found the peace and space of social distancing an unexpected benefit and were proud of their achievements, whilst others shared feelings of isolation and distress. Some women felt they instinctively did what they needed to do. Experiences correlated with differing levels of self-efficacy. DISCUSSION While many women relished the freedom from social obligations when faced with feeding challenges, there was general dissatisfaction with the level of support available. Care was fragmented, and health care needs were unmet, impacting feeding and parenting decisions and mental health. CONCLUSION Access to timely and appropriate professional support is an important factor in establishing breastfeeding and developing parenting confidence, particularly in the context of a pandemic and should be a health policy priority.
Collapse
Affiliation(s)
- Marjorie Atchan
- School of Nursing, Midwifery and Public Health, University of Canberra, Locked Bag 1, Canberra, ACT 2617 Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia,Corresponding author at: School of Nursing, Midwifery and Public Health, University of Canberra, Locked Bag 1, Canberra, ACT 2617, Australia
| | - Kristen Graham
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Nicki Hartney
- Deakin University, School of Nursing and Midwifery, 1 Gheringhap St., Geelong, Vic. 3227 Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Ruth Martis
- Liggins Institute, The University of Auckland, Aotearoa, New Zealand,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Lauren Kearney
- The University of Queensland, School of Nursing, Midwifery & Social Work, Brisbane, QLD 4072 Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Kym Davey
- School of Nursing and Midwifery, Monash University, Peninsula campus, McMahons Rd, Frankston, VIC 3199 Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Rea Daellenbach
- Department of Health Practice, Ara Institute of Canterbury, New Zealand,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Helen Hall
- Institute of Health and Wellbeing, Federation University, Mt Helen Campus, Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| | - Linda Sweet
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia,Institute of Health and Wellbeing, Federation University, Mt Helen Campus, Australia,Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
| |
Collapse
|
26
|
Chipojola R, Dennis CL, Kuo SY. Psychometric Assessment of the Breastfeeding Self-Efficacy Scale-Short Form: A Confirmatory Factor Analysis in Malawian Mothers. J Hum Lact 2022:8903344221127002. [PMID: 36214473 DOI: 10.1177/08903344221127002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Exclusive breastfeeding to 6 months postpartum has been related to breastfeeding self-efficacy in diverse populations. Globally, this is measured using the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). RESEARCH AIM To evaluate the psychometric properties of the BSES-SF among women in Malawi; and to examine the relationship between breastfeeding self-efficacy and demographic and health factors. METHODS The study design was a prospective, cross-sectional survey with a 2 week follow-up reliability check. Postpartum women (N = 180) were recruited at a maternity hospital in Lilongwe, Malawi. In addition to the BSES-SF, the World Health Organization's Quality of Life Scale (QoL) was also administered. Furthermore, confirmatory factor analysis, Cronbach's alpha, and Pearson's correlations were used to examine the construct validity, reliability, test-retest reliability, and convergent validity. RESULTS The confirmatory factor analysis supported a unidimensional structure of the Malawian version of the 12-item BSES-SF. Cronbach's alpha and the intra-class correlation coefficient were 0.79 and 0.75, respectively. BSES-SF scores had significant correlation with QoL domains (physical QoL: r = 0.31, p < .001; and environmental QoL: r = 0.22, p < .01). Participants' age, parity, and mode of delivery were positively correlated with breastfeeding self-efficacy scores. CONCLUSION The findings of our study confirmed that the 12-item BSES-SF is a reliable and valid scale for assessing women's breastfeeding self-efficacy in Malawi.
Collapse
Affiliation(s)
- Roselyn Chipojola
- School of Nursing, College of Nursing, Taipei Medical University, Taipei.,Public Health Department, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | | | - Shu-Yu Kuo
- School of Nursing, College of Nursing, Taipei Medical University, Taipei
| |
Collapse
|
27
|
Costa S, Priolo F, Fattore S, Tedesco M, Rubortone SA, Giordano L, Chioma R, Neri Md C, Lanzone A, Buonsenso D, Valentini P, Vento G. Rooming-In Practice During the Pandemic: Results From a Retrospective Cohort Study. J Hum Lact 2022; 38:443-451. [PMID: 35272513 DOI: 10.1177/08903344221081840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Coronavirus disease 2019 (COVID-19) pandemic emerged in December 2019 and spread rapidly worldwide. So far, evidence regarding the breastfeeding and rooming-in management of mothers with COVID-19 and their newborn infants is scarce. RESEARCH AIMS 1) To assess the rate of exclusive breastfeeding at discharge among mothers with COVID-19 and their newborn infants managed either using a rooming-in or a separation regimen; and 2) to evaluate different neonatal outcomes, including the need for re-hospitalization related to COVID-19 among newborn infants in the two groups. METHOD We conducted a retrospective two-group comparative observational study. The sample was participants with COVID-19 and their newborn infants (N = 155 dyads) between March 1, 2020, and April 30, 2021. Two time periods were outlined resulting from the two different clinical practices of mother-infant separation and rooming-in. RESULTS Within the sample, 145 (93.5%) were asymptomatic. All neonates had documented Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) test results, and six tested positive by reverse transcriptase polymerase chain reaction within 48 hr of life. The rate of exclusive breastfeeding was significantly higher (p < .0001) within the rooming-in group. Length of hospital stay was significantly lower (p = .001) within the rooming-in group. CONCLUSIONS Protected rooming-in practice has proven to be safe and effective in supporting breastfeeding: None of the infants enrolled were hospitalized due to COVID-19 infection and the rate of exclusive breastfeeding at discharge was increased compared to those infants separated from their mothers.
Collapse
Affiliation(s)
- Simonetta Costa
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesca Priolo
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | | | - Serena Antonia Rubortone
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Lucia Giordano
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Caterina Neri Md
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Lanzone
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Danilo Buonsenso
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Piero Valentini
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy.,Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Vento
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
28
|
Thomson G, Ingram J, Clarke J, Johnson D, Jolly K. Who Gets to Breastfeed? A Narrative Ecological Analysis of Women's Infant Feeding Experiences in the UK. FRONTIERS IN SOCIOLOGY 2022; 7:904773. [PMID: 35938089 PMCID: PMC9352850 DOI: 10.3389/fsoc.2022.904773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/21/2022] [Indexed: 06/15/2023]
Abstract
The early post-natal period is a critical period in women's infant feeding journeys, often marked by high levels of unintended breastfeeding cessation. Previous research has argued that infant feeding should be perceived within a complex system whereby factors operating at different ecological levels (i.e., individual, social/community networks, cultural/institutional) interact to affect individual behaviors. However, currently, more work needs to be done to implement an ecological approach in breastfeeding programs. We adopted a complex-systems lens approach to explore how multi-level factors-individual, mother-infant dyad, health service, family and social networks, and wider community infrastructure-interacted with women's motivations and experiences of breastfeeding. We undertook a secondary analysis of 24 women's interviews; all the women had a strong antenatal intention to breastfeed and were expecting their first baby. The interviews were collected during the UK-based Assets-based feeding help Before and After birth (ABA) feasibility trial when their infant was aged between 4 and 21 weeks. Categorical content analysis was used to explore the interrelationships between key factors and to identify different infant feeding typologies. Two different typologies emerged: "disappointed" (n = 7) and "by hook or by crook" (n = 17). "Disappointed" women had stopped breastfeeding early; women classified as "by hook or by crook" continued breastfeeding despite facing challenges. Sociodemographic, social, and service level differences between the typologies were noted. "Disappointed" women were more likely to be younger, White-British, to have considered mixed-feeding antenatally and experienced negative breastfeeding support from healthcare professionals and personal networks. Infants of "disappointed" women were more likely to have received unexpected "top-ups" and to be perceived as having infant feeding difficulties. Women classified as "by hook or by crook" were just as likely as "disappointed" women to experience birth-related complications, but demonstrated more proactive help-seeking behaviors, had positive experiences of personal/professional support and accessed wider support. While further research is needed to consolidate and/or refute the typologies, the ecological approach shifts the focus away from mothers' decisions to consider the multi-level factors that need to be in place to enable women to breastfeed successfully. Further work to encourage help-seeking behaviors and toward improving facilities, support, and services is needed.
Collapse
Affiliation(s)
- Gill Thomson
- School of Community Health & Midwifery, University of Central Lancashire, Preston, United Kingdom
| | - Jenny Ingram
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Joanne Clarke
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Debbie Johnson
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
29
|
Howard TF, Ye Y, Hinten B, Szychowski J, Tita ATN. Factors That Influence Posthospital Infant Feeding Practices Among Women Who Deliver at a Baby Friendly Hospital in Southern United States. Breastfeed Med 2022; 17:584-592. [PMID: 35404088 DOI: 10.1089/bfm.2021.0324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Introduction: The Baby Friendly Hospital Initiative has had a positive impact on breastfeeding initiation; however, little is known about posthospital infant feeding practices among women who deliver at baby friendly hospitals. Therefore we sought to evaluate posthospital breastfeeding outcomes among women who deliver at a baby friendly hospital (BFH) by (1) estimating exclusive breastfeeding rates at the postpartum visit (PPV), (2) quantifying the exclusive breastfeeding discontinuation rate, and (3) identifying which factors are associated with breastfeeding discontinuation. Methods: This was a prospective cohort study of women aged 14 and over, who delivered at the University of Alabama at Birmingham. The primary outcome was mode of infant feeding categorized as exclusive breastfeeding (EBF), combination breastfeeding and formula feeding (CF), and exclusive formula feeding (EFF) at the PPV. Secondary outcome was EBF discontinuation rate. Patients who initiated formula and/or who stopped breastfeeding were asked what influenced their decision. Results: At hospital discharge, 71.1% of the participants were EBF, 21.7% were CF, and 7.2% were EFF. At the PPV, the frequency of the primary outcome of EBF was 31.6% (95% confidence interval: 25.2-38.8); 34.6% (28.0-41.9) were CF, and 33.8% (27.3-41.1) were EFF. Therefore, the EBF absolute and relative discontinuation rates were 39.5% and 55.6%, respectively. No demographic factors, delivery characteristics, or maternal medical morbidities were associated with EBF in the multivariable logistic regression. However, women in the EBF group were more likely to report a workplace environment conducive to breastfeeding and partner and friend support. Conclusion: Significant breastfeeding discontinuation rates occur even among women who deliver at a BFH. Our findings suggest that multifactorial interventions, including a focus on the prevention of formula introduction, are needed in the early postpartum period to achieve higher EBF rates at the PPV.
Collapse
Affiliation(s)
- Tera F Howard
- Department of Women's Health, University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - Yuanfan Ye
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Brittany Hinten
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Jeff Szychowski
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Alan T N Tita
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| |
Collapse
|
30
|
Kwan J, Jia J, Yip KM, So HK, Leung SSF, Ip P, Wong WHS. A mixed-methods study on the association of six-month predominant breastfeeding with socioecological factors and COVID-19 among experienced breastfeeding women in Hong Kong. Int Breastfeed J 2022; 17:40. [PMID: 35597945 PMCID: PMC9123774 DOI: 10.1186/s13006-022-00484-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 05/10/2022] [Indexed: 02/01/2023] Open
Abstract
Background In the past decade, various breastfeeding policies were implemented in Hong Kong, including changes in perinatal guidelines in public hospitals, adoption of the Baby-Friendly Hospital Initiative (BFHI), provision of guidelines for the marketing of formula milk, penalisation of discrimination towards breastfeeding, and extension of the statutory maternity leave. Meanwhile, the COVID-19 pandemic brought new challenges and opportunities to breastfeeding practices. Infection control measures in public hospitals included the cancellation of antenatal classes, hospital tours, and postnatal classes; suspension of perinatal visiting periods; and compulsory separation of COVID-19 positive mothers from newborns. In addition, work-from-home policies were widely implemented. This study aimed to identify the associated factors of six-month predominant breastfeeding (PBF), and to evaluate the impact of COVID-19 on breastfeeding practice. Methods This study was conducted from 1 March 2021 to 7 April 2021 using a mixed-methods approach. An electronic questionnaire was distributed to members of breastfeeding or parenting groups who have had breastfeeding experience in the past 10 yrs. Logistic and linear regression analyses were conducted to identify factors associated with six-month PBF both in general and during the pandemic period. A qualitative content analysis was conducted using an inductive approach. Results The study included 793 participants. Giving birth in a public hospital (OR 2.21; 95% CI 1.46, 3.34) and breastfeeding support from family and friends (OR 1.28; 95% CI 1.05, 1.57) were significantly associated with six-month PBF, even during COVID-19. Factors associated with the self-rated impact of COVID-19 on breastfeeding include working from home, the perceived immunological benefits of breastfeeding, and the wish to avoid breastfeeding or expressing breast milk in public premises. Furthermore, breastfeeding practice in public hospitals was more likely to be affected by the busyness of staff, while private hospitals had worse rooming-in practices and staff who had inadequate breastfeeding knowledge. Conclusions Giving birth in a public hospital and having breastfeeding support from family and friends were associated with six-month PBF. Furthermore, COVID-19 in Hong Kong had an overall positive impact on six-month PBF. Further studies should investigate the impact of hospital practices and the COVID-19 pandemic on breastfeeding behaviours. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-022-00484-7.
Collapse
Affiliation(s)
- John Kwan
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Jimsyn Jia
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ka-Man Yip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Hung-Kwan So
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Sophie S F Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Wilfred H S Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
31
|
Segura‐Pérez S, Richter L, Rhodes EC, Hromi‐Fiedler A, Vilar‐Compte M, Adnew M, Nyhan K, Pérez‐Escamilla R. Risk factors for self-reported insufficient milk during the first 6 months of life: A systematic review. MATERNAL & CHILD NUTRITION 2022; 18 Suppl 3:e13353. [PMID: 35343065 PMCID: PMC9113468 DOI: 10.1111/mcn.13353] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 12/22/2022]
Abstract
The objective of this systematic review was to identify multifactorial risk factors for self-reported insufficient milk (SRIM) and delayed onset of lactation (DOL). The review protocol was registered a priori in PROSPERO (ID# CDR42021240413). Of the 120 studies included (98 on SRIM, 18 on DOL, and 4 both), 37 (31%) studies were conducted in North America, followed by 26 (21.6%) in Europe, 25 (21%) in East Asia, and Pacific, 15 (12.5%) in Latin America and the Caribbean, 7 (6%) in the Middle East and North Africa, 5 (4%) in South Asia, 3 (2.5%) in Sub-Saharan Africa, and 2 (1.7%) included multiple countries. A total of 79 studies were from high-income countries, 30 from upper-middle-income, 10 from low-middle-income countries, and one study was conducted in a high-income and an upper-middle-income country. Findings indicated that DOL increased the risk of SRIM. Protective factors identified for DOL and SRIM were hospital practices, such as timely breastfeeding (BF) initiation, avoiding in-hospital commercial milk formula supplementation, and BF counselling/support. By contrast, maternal overweight/obesity, caesarean section, and poor maternal physical and mental health were risk factors for DOL and SRIM. SRIM was associated with primiparity, the mother's interpretation of the baby's fussiness or crying, and low maternal BF self-efficacy. Biomedical factors including epidural anaesthesia and prolonged stage II labour were associated with DOL. Thus, to protect against SRIM and DOL it is key to prevent unnecessary caesarean sections, implement the Baby-Friendly Ten Steps at maternity facilities, and provide BF counselling that includes baby behaviours.
Collapse
Affiliation(s)
| | - Linda Richter
- DSI‐NRF Centre of Excellence in Human DevelopmentUniversity of the Witwatersrand, Office 154 School of Public HealthJohannesburgSouth Africa
| | - Elizabeth C. Rhodes
- Department of Social and Behavioral SciencesYale School of Public HealthNew HavenConnecticutUSA
| | - Amber Hromi‐Fiedler
- Department of Social and Behavioral SciencesYale School of Public HealthNew HavenConnecticutUSA
| | | | - Misikir Adnew
- Department of Health Policy and ManagementYale School of Public HealthNew HavenConnecticutUSA
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical LibraryYale UniversityNew HavenConnecticutUSA
| | - Rafael Pérez‐Escamilla
- Department of Social and Behavioral SciencesYale School of Public HealthNew HavenConnecticutUSA
| |
Collapse
|
32
|
DiTomasso D, Wambach KA, Roberts MB, Erickson-Owens DA, Quigley A, Newbury JM. Maternal Worry About Infant Weight and its Influence on Artificial Milk Supplementation and Breastfeeding Cessation. J Hum Lact 2022; 38:177-189. [PMID: 33705242 DOI: 10.1177/08903344211000284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Maternal worry about infant weight has inconsistently been reported as a breastfeeding barrier. Weight monitoring is a critical tool to assess adequacy of infant feeding. Yet, little is known about the intensity of maternal worry about infant weight or associated breastfeeding outcomes. RESEARCH AIMS To examine (1) the frequency and intensity of maternal worry about infant weight; (2) the relationship between worry about weight and use of artificial milk; and 3) the relationship between worry about weight and breastfeeding cessation. METHODS A prospective cross-sectional design was used. A questionnaire was completed by women in the United States (N = 287) from 12 web-based maternal support groups. RESULTS Sixty-three percent of women (n = 182) had some worry about infant weight. Participants breastfeeding for the first time had more worry (p = .035). Participants still breastfeeding had less worry about weight compared to those who had stopped (67%, n = 147 vs. 41%, n = 28). Exclusive breastfeeding participants had less worry (p < .001) compared to those who supplemented with artificial milk. Increased worry was associated with the use of artificial milk within 1 week of birth (p < .001) and early breastfeeding cessation (p < .001). CONCLUSIONS Worry about weight is a significant breastfeeding barrier. It is associated with first time breastfeeding, less exclusive breastfeeding, use of artificial milk, and earlier breastfeeding cessation. Lactating mothers need anticipatory guidance about expected neonatal weight changes and interventions to help relieve worry about infant weight.
Collapse
Affiliation(s)
| | | | - Mary B Roberts
- Brown University Center for Primary Care & Prevention, Care New England Medical Group/Primary Care & Specialty Services, USA
| | | | - Aimee Quigley
- 21444 Lactation Consultant, South County Hospital, Wakefield, RI, USA
| | | |
Collapse
|
33
|
Pádua AR, Melo EM, Alvarelhão JJ. An Intervention Program Based on Regular Home Visits for Improving Maternal Breastfeeding Self-efficacy: A Pilot Study in Portugal. Matern Child Health J 2022; 26:575-586. [DOI: 10.1007/s10995-021-03361-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 10/19/2022]
|
34
|
Li JY, Huang YY, Huang Y, Du MC, Xu J, Li L, Redding SR, Ouyang YQ. Development of a breastfeeding duration risk nomogram for use in postpartum Chinese women. Res Nurs Health 2021; 45:94-107. [PMID: 34907548 DOI: 10.1002/nur.22203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 11/08/2021] [Accepted: 11/27/2021] [Indexed: 11/11/2022]
Abstract
Previous studies have investigated influencing factors of early discontinuation of breastfeeding, but few studies have developed an easy-to-use tool to identify risk of breastfeeding cessation at 6 months after birth. This research team aimed to develop and validate an exclusive breastfeeding duration risk nomogram in Chinese mothers. A longitudinal cohort survey was conducted. Data were collected from 394 postpartum women in three hospitals in Hubei Province, China from December 2017 to December 2018. The LASSO regression model was used to screen for optimized factors in an exclusive breastfeeding duration model. Multivariable logistic regression was applied to construct a prediction model. Discrimination and calibration were assessed using a C-index and calibration curve, and internal validity was established using bootstrapping validation. Factors integrated in the prediction risk nomogram were monthly household income (odds ratio [OR] = 1.31, 95% confidence interval [CI]: [0.95, 1.80]), experiences of breastfeeding (OR = 1.23, 95% CI: [0.92, 1.63]), attitude (OR = 1.72, 95% CI: [0.94, 3.16]), self-efficacy (OR = 2.45, 95% CI: [1.40, 4.29]), perceived insufficient milk supply (OR = 0.12, 95% CI: [0.06, 0.25]) and postpartum depression (OR = 0.06, 95% CI: [0.02, 0.17]). The model displayed good discrimination with a C-index of 0.87 (95% CI: [0.84, 0.91]) and good calibration. The C-index interval validation was confirmed to be 0.86. This study resulted in the development of a novel nomogram with good accuracy to aid healthcare professionals in assessing the probability of a mother discontinuing exclusive breastfeeding at the breast before 6 months.
Collapse
Affiliation(s)
- Jun-Yan Li
- School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Yi-Yan Huang
- School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Yi Huang
- School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Mei-Chen Du
- School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Jing Xu
- School of Nursing, Wuhan University, Wuhan, Hubei, China
| | - Lu Li
- School of Nursing, Wuhan University, Wuhan, Hubei, China
| | | | | |
Collapse
|
35
|
Marshall J, Ross S, Buchanan P, Gavine A. Providing effective evidence based support for breastfeeding women in primary care. BMJ 2021; 375:e065927. [PMID: 34725097 DOI: 10.1136/bmj-2021-065927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Joyce Marshall
- Division of Maternal Health, University of Huddersfield, UK
| | - Sam Ross
- School of Medicine, Dentistry and Nursing, University of Glasgow and NHS Greater Glasgow and Clyde, UK
| | | | - Anna Gavine
- School of Health Sciences, University of Dundee, UK
| |
Collapse
|
36
|
Radwan H, Fakhry R, Metheny N, Baniissa W, Faris MAIE, Obaid RS, Al Marzooqi S, Al Ghazal H, ElHalik M, Dennis CL. Prevalence and multivariable predictors of breastfeeding outcomes in the United Arab Emirates: a prospective cohort study. Int Breastfeed J 2021; 16:79. [PMID: 34641934 PMCID: PMC8507212 DOI: 10.1186/s13006-021-00428-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 09/28/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Despite considerable policy actions at the national and hospital levels, rates of breastfeeding in the Middle East and North Africa (MENA) region remain below the global average. There is a need to explore the modifiable factors of breastfeeding such as maternal breastfeeding self-efficacy (BSE), support, and mental health among women in this region to guide interventions in the United Arab Emirates (UAE). The aim of this study was to examine the maternal predictors of any and exclusive breastfeeding in a cohort of Emirati and expatriate women residing in the UAE with a specific focus on modifiable factors. METHODS Using a prospective cohort design, Emirati and expatriate women were recruited in the immediate postpartum period (N = 374) and followed at three and 6 months postpartum between February 2018 and July 2019. Questionnaires with validated tools were used to collect information on sociodemographic characteristics, breastfeeding practices, BSE, postnatal depression, and anxiety. The main outcomes in the study were Any Breastfeeding and exclusivity practices, which were assessed at three and 6 months postpartum by asking the mother about her breastfeeding behaviour during the past 7 days. Multilevel, multivariate logistic regression was used to estimate the association of different variables with breastfeeding outcomes. RESULTS Almost all women reported initiating breastfeeding during their stay at the hospital (n = 357), while only 263 (70.3%) initiated breastfeeding within the first hour of delivery. At 6 months postpartum, 301 (81.5%) women continued to breastfeed of whom 100 (26.7%) were doing so exclusively. Older mothers who initiated breastfeeding within 1 h of birth and were satisfied with the breastfeeding support they received from family and friends had significantly greater odds of any breastfeeding at 6 months. Whereas a clinically significant Edinburgh Postnatal Depression Scale (EPDS) score, low BSE score as well as employment outside the home were associated with significantly lower odds of exclusive breastfeeding and any breastfeeding at 6 months postpartum. CONCLUSION This study highlights the need to develop effective education strategies and support programs targeting these modifiable variables to improve breastfeeding outcomes among women in the UAE.
Collapse
Affiliation(s)
- Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - Randa Fakhry
- Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Nick Metheny
- School of Nursing and Health Studies, University of Miami, Miami, USA
| | - Wegdan Baniissa
- Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Moez Al Islam E Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Reyad Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Suad Al Marzooqi
- Department of Psychology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Hessa Al Ghazal
- Sharjah Child-Friendly Office, Sharjah, United Arab Emirates
| | - Mahmoud ElHalik
- Department of Neonatology, Latifa Women and Children Hospital, Dubai, United Arab Emirates
| | - Cindy-Lee Dennis
- Department of Psychiatry, University of Toronto, Toronto, Canada.
| |
Collapse
|
37
|
The Effect of Educational Intervention on Improvement of Breastfeeding Self-Efficacy: A Systematic Review and Meta-Analysis. Obstet Gynecol Int 2021; 2021:5522229. [PMID: 34422058 PMCID: PMC8371651 DOI: 10.1155/2021/5522229] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/28/2021] [Accepted: 07/26/2021] [Indexed: 11/17/2022] Open
Abstract
Background Self-efficacy is an important psychological and motivational factor in breastfeeding, and it is a valuable framework that predicts breastfeeding outcomes and demonstrates maternal confidence in breastfeeding. The meta-analysis evaluated the effectiveness of educational interventions on improving breastfeeding self-efficacy (BSE). Methods The English and Persian databases including Medline, Embase, Cochrane Database of Systematic Reviews (CDSR), PubMed, Web of Science, Scopus, CINAHL, Sid, IRANDOC, and Marg-Iran were systematically searched for studies published from January 2005 to December 2020. The quality of studies was evaluated using the Cochrane risk of bias tool and the heterogeneity by I 2 statistic. The extracted data were analyzed using RevMan 5 statistical software and presented using random effects standardized mean difference (SMD). The funnel plot was used for evaluating publication bias. Results Results from 40 RCTs showed that educational intervention had a positive effect on the BSE compared with the usual/standard care (pooled SMD = 1.20; 95% CI = 0.75-1.64, p value <0.001). The subgroup analysis indicated that the educational intervention was based on theory, group class format, direct method education, during the first week of postpartum, doing during pregnancy, on primiparous women, and health center setting, and the Asian region has a more effect on BSE than the others. Conclusion Breastfeeding education is considered an influential factor in the improvement of BSE. It is recommended that breastfeeding education should be continued for several weeks after childbirth for gaining its benefit. The Asian region has a more effect on BSE than the others. Therefore, it is important to add the values in content of education in each country.
Collapse
|
38
|
Ahmed AH, Rojjanasrirat W. Breastfeeding Outcomes, Self-Efficacy, and Satisfaction Among Low-Income Women With Late-Preterm, Early-Term, and Full-Term Infants. J Obstet Gynecol Neonatal Nurs 2021; 50:583-596. [PMID: 34390676 DOI: 10.1016/j.jogn.2021.06.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To assess breastfeeding exclusivity and rate of breastfeeding, breastfeeding self-efficacy, and satisfaction with breastfeeding after hospital discharge among low-income women with late-preterm and early-term infants compared with women with full-term infants. DESIGN Prospective, comparative, with repeated measures. SETTING Four Midwestern U.S. Special Supplemental Nutrition Program for Women, Infants, and Children offices. PARTICIPANTS Participants included 270 mother-infant dyads. METHODS We assessed breastfeeding exclusivity, rate of breastfeeding, and breastfeeding self-efficacy at 2 weeks, 2 months, and 5 months and satisfaction with breastfeeding at 5 months after birth or when participants stopped breastfeeding. RESULTS More than 50% of women in each subgroup were non-Hispanic White. Late-preterm and early-term infants had lower breastfeeding exclusivity rates than full-term infants across the three time points (40%, 51%, and 65% at 2 weeks, p = .029; 22.5%, 34%, and 58% at 2 months, p < .001; and 7%, 15%, and 28.46% at 5 months, p < .001, respectively). The overall exclusive breastfeeding rate for all groups was 55.93% at 2 weeks, 44.07% at 2 months, and 20.37% at 5 months; 55.56% continued any breastfeeding at 5 months. Breastfeeding self-efficacy during the first 5 months after birth, satisfaction with breastfeeding, level of education, and attending breastfeeding classes were positively correlated with breastfeeding exclusivity. We found significantly less exclusive breastfeeding, lower breastfeeding self-efficacy, and lower satisfaction with breastfeeding among participants with late-preterm and early-term infants compared to those with full-term infants. CONCLUSION Ongoing professional breastfeeding support for women is needed to improve and promote breastfeeding exclusivity and continuation among their late-preterm and early-term infants.
Collapse
|
39
|
Wu W, Zhang J, Silva Zolezzi I, Fries LR, Zhao A. Factors influencing breastfeeding practices in China: A meta-aggregation of qualitative studies. MATERNAL AND CHILD NUTRITION 2021; 17:e13251. [PMID: 34355869 PMCID: PMC8476444 DOI: 10.1111/mcn.13251] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 06/19/2021] [Accepted: 07/07/2021] [Indexed: 12/03/2022]
Abstract
The World Health Organization recommends that women exclusively breastfeed until their babies are 6 months old and continue to breastfeed while introducing complementary foods. A meta‐aggregation methodology was used to systematically review and synthesise the qualitative studies on factors influencing breastfeeding practices of healthy Chinese women in Greater China. English and Chinese databases were searched to identify peer‐reviewed qualitative studies (published 2008–2019). Relevant data were extracted, and key themes related to factors influencing breastfeeding practices were identified. Of 7587 articles identified, 22 qualitative studies met inclusion criteria for the review, 10 of which were published in Chinese. A total of 87 themes were extracted from all included studies and classified into 9 subcategories: government enactment of policies, implementation of policies in workplaces, social expectations, social support, medical and health services, services with Chinese characteristics, breastfeeding and pumping facilities, maternal perceptions of breastfeeding and self‐efficacy to breastfeed. The nine subcategories were then grouped into four categories. Potential effect associations among these influence factors of breastfeeding practices emerged from categories and subcategories. Family members' influence on breastfeeding motivation and self‐efficacy suggest a potential benefit of breastfeeding promotion interventions targeting the whole family. The role of primary care should be fully exploited in breastfeeding promotion, including both prenatal education and post‐partum visits. Standardising the training and qualifications of maternity matrons (yuesao) and folk breastfeeding specialists (cuirushi) can promote evidence‐based approaches to facilitating breastfeeding during the confinement period. Increased availability of breastfeeding and pumping facilities in the workplace would facilitate continuing breastfeeding after returning to work.
Collapse
Affiliation(s)
- Wei Wu
- Vanke School of Public Health, Tsinghua University, Beijing, China.,Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Jian Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | | | | | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing, China
| |
Collapse
|
40
|
Chesnel MJ, Healy M, McNeill J. The experiences of trained breastfeeding support providers that influence how breastfeeding support is practised: A protocol for a qualitative evidence synthesis. PLoS One 2021; 16:e0254445. [PMID: 34324535 PMCID: PMC8321120 DOI: 10.1371/journal.pone.0254445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/19/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Many women stop breastfeeding before they intend to as they cannot overcome breastfeeding difficulties. Breastfeeding support, as an evidence-based intervention by trained lay or professional breastfeeding support providers, can prevent early unintended cessation. Yet some women report dissatisfaction with support and reluctantly stop breastfeeding despite receiving this intervention. Understanding the experiences which shape how support is provided can inform effective implementation of breastfeeding support interventions. This review aims to synthesise experiences of trained breastfeeding support providers in high income settings and how these may influence their breastfeeding support practices. METHODS A qualitative systematic review of trained breastfeeding supporters' experiences of supporting women to breastfeed, as part of a generic healthcare role or focused breastfeeding support role, will be conducted. A systematic search will be performed of the databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL +), MEDLINE ALL, Maternity and Infant Care, EMBASE, APA PsycINFO, Web of Science and Scopus. Title and abstract screening using eligibility criteria will be conducted using Covidence software. Eligible papers will be agreed by the review team following full text screening and reported using PRISMA guidelines. CASP and COREQ tools will assess study methodological quality and quality of reporting. Data will be extracted using a bespoke form and coded, using Excel software for data management. Analysis will involve the three stages of thematic synthesis: initial free coding, development of descriptive and subsequent analytical themes. Confidence in findings will be assessed using the CERQual framework. DISCUSSION This review is the first to date to synthesise qualitative evidence on experiences which influence how trained lay and professional providers support women with breastfeeding. Findings will enable deeper understanding of the underpinning mechanisms of breastfeeding support provision and inform the development of tailored interventions to improve breastfeeding rates. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number: CRD42020207380.
Collapse
Affiliation(s)
- Mary Jo Chesnel
- School of Nursing and Midwifery, Medical Biology Centre, Queen’s University Belfast, Belfast, Northern Ireland
| | - Maria Healy
- School of Nursing and Midwifery, Medical Biology Centre, Queen’s University Belfast, Belfast, Northern Ireland
| | - Jenny McNeill
- School of Nursing and Midwifery, Medical Biology Centre, Queen’s University Belfast, Belfast, Northern Ireland
| |
Collapse
|
41
|
Wood NK, Odom-Maryon T, Smart DA. Factors Associated with Perceived Insufficient Milk in the First Three Months of Breastfeeding. MCN Am J Matern Child Nurs 2021; 46:223-229. [PMID: 34166240 DOI: 10.1097/nmc.0000000000000723] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Perceived insufficient milk is the predominant risk factor for early breastfeeding discontinuation globally. The purpose of this study was to explore the association between perceived insufficient milk in the first 3 months and infant factors, maternal factors, professional support, parenting decisions, and breastfeeding concerns. Sixty-nine mothers who had perceived insufficient milk and 301 mothers who did not were included. STUDY DESIGN AND METHODS A cross-sectional online survey design was used in a convenience sample of 370 U.S. mothers with a healthy singleton infant between 1 and 12 weeks who were breastfeeding directly on the breast as part of their feeding methods. RESULTS Using stratified multivariable logistic regression, we found that among 102 mothers of infants < 4 weeks of age, planned breastfeeding duration < 6 months (OR = 13.17; 95% CI [1.42, 122.48], p = .024), and concerns about infant crying or fussing (OR = 4.72; 95% CI [1.10, 20.00], p = .03) were associated with perceived insufficient milk. Among 256 mothers of infants 4 to 12 weeks of age, concerns about frequent feedings (OR = 4.05; 95% CI [1.95, 8.40], p = .000) and latching difficulty (OR = 2.95; 95% CI [1.33, 6.54], p = .008) were associated with perceived insufficient milk. CLINICAL IMPLICATIONS Association between factors and perceived insufficient milk differed based on infant age. Maternal perceptions of crying or fussing, frequent feedings, and latching difficulty need to be assessed because of its attribution to perceived insufficient milk.
Collapse
|
42
|
Green M, Pries AM, Hadihardjono DN, Izwardy D, Zehner E, Moran VH. Breastfeeding and breastmilk substitute use and feeding motivations among mothers in Bandung City, Indonesia. MATERNAL & CHILD NUTRITION 2021; 17:e13189. [PMID: 33861515 PMCID: PMC8189241 DOI: 10.1111/mcn.13189] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/04/2021] [Accepted: 03/12/2021] [Indexed: 11/27/2022]
Abstract
Suboptimal breastfeeding is common in Indonesia, with only half of infants 0-5 months of age exclusively breastfed and feeding of breastmilk substitutes (BMS) highly prevalent among infants and toddlers. Various factors influence these feeding practices, including social norms, limited health system support and BMS manufacturer marketing practices. This cross-sectional survey aimed to identify the prevalence of breastfeeding and BMS feeding among children aged 0-35 months, explore socio-demographic characteristics and motivating factors associated with these feeding behaviours and identify the prevalence of mothers' exposure to BMS promotions. Indonesian mothers of children <3 years of age (n = 595) were interviewed in Bandung City health facilities using structured questionnaires. Although all children were ever breastfed, half of children across all age groups received BMS in the previous day. Maternal employment outside the home and insufficient breastmilk production were associated with BMS use. The most important motivational factors for feeding BMS were perceived benefits for growth, intelligence and immunity. Despite Indonesian legislation restricting some BMS marketing, 93% of mothers reported observing a BMS promotion outside the health system, with television, social media and newspapers as the most common sources. Half of mothers (43%) reported observing a BMS promotion within the health system, and half (46%) reported receiving recommendations from health workers to use BMS. Such high prevalence of BMS marketing may be influencing caregivers' feeding choices; stronger national legislation and implementation of laws are needed to ensure mothers' ability to make feeding choices free from manufacturer influence.
Collapse
Affiliation(s)
- Mackenzie Green
- Helen Keller InternationalAsia‐Pacific Regional OfficePhnom PenhCambodia
| | | | | | - Doddy Izwardy
- Kepala Pusat Penelitian, dan Pengembangan Upaya Kesehatan MasyarakatBadan Penelitian dan Pengembangan Kesehatan, Kementerian Kesehatan RIJakartaIndonesia
| | | | - Victoria Hall Moran
- School of Community Health and MidwiferyUniversity of Central LancashirePrestonUK
| |
Collapse
|
43
|
Menekse D, Tiryaki Ö, Karakaya Suzan Ö, Cinar N. An investigation of the relationship between mother's personality traits, breastfeeding self-efficacy, and perception of insufficient milk supply. Health Care Women Int 2021; 42:925-941. [PMID: 33797343 DOI: 10.1080/07399332.2021.1892114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The researchers planned this study as a descriptive-correlational study to determine the relationship between mothers' personality traits, breastfeeding self-efficacy, and perception of insufficient milk supply. This descriptive, cross-sectional, and analytical study involved 429 mothers in Turkey's Sakarya province who applied to a training and research hospital between February-June 2020. It was found that self-control and openness to development affected breastfeeding self-efficacy positively, while neuroticism affected breastfeeding self-efficacy negatively (p < 0.05). Breastfeeding self-efficacy had a significant negative effect on the perception of insufficient milk supply (p < 0.001). Breastfeeding self-efficacy is an important determinant of the amount of milk perceived by mothers.
Collapse
Affiliation(s)
- Dilek Menekse
- Department of Peadiatric Nursing, Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
| | - Öznur Tiryaki
- Institute of Health Sciences, Sakarya University, Sakarya, Turkey
| | - Özge Karakaya Suzan
- Department of Peadiatric Nursing, Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
| | - Nursan Cinar
- Department of Peadiatric Nursing, Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
| |
Collapse
|
44
|
Padró-Arocas A, Mena-Tudela D, Baladía E, Cervera-Gasch A, González-Chordá VM, Aguilar-Camprubí L. Telelactation with a Mobile App: User Profile and Most Common Queries. Breastfeed Med 2021; 16:338-345. [PMID: 33513043 DOI: 10.1089/bfm.2020.0269] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: Mobile applications related to health issues are currently expanding. Different uses of new technologies have produced positive results regarding breastfeeding support. Breastfeeding applications are increasing. Objective: We conducted a descriptive analysis of a mobile application for breastfeeding (LactApp) to study the user profile and the most frequent queries. Materials and Methods: This was a retrospective, comparative, and descriptive ecological time-series study of LactApp from 2016 to 2019. Google Analytics and the app itself were used for data collection. The data were analyzed in Excel, and for the time series, Prais-Winsten autoregressions were applied based on the Durbin-Watson method in Stata. Results: A total of 115,830 users and 71,780 infants were registered in the application. A total of 1.91% of these users obtained the medical version. The application was used for both queries and surveys and for users to interact through chat. A total of 30.17% of the responses were related with "baby's sleep" (8.94%), 8.91% were related to "preservation of milk," 6.16% were related to "breastfeeding crisis," and 6.15% were related to "physiological evolution of breastfeeding," all with an increasing trend. Conclusion: LactApp is a resource for breastfeeding that is widely downloaded and used by a substantial number of individuals. The most recurring topics were baby's sleep, milk extraction and preservation, breastfeeding crisis and physiological evolution of breastfeeding.
Collapse
Affiliation(s)
- Alba Padró-Arocas
- Blanquerna, Universidad Ramon Llull, Faculty of Health of Sciences, Barcelona, Spain
| | - Desirée Mena-Tudela
- Department of Nursing, Faculty of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
| | - Eduard Baladía
- Science in Human Nutrition and Dietetics, Evidence-Based Nutrition Network (RED-NuBE), Spanish Academy of Nutrition and Dietetics (AEND), Navarra, Spain
| | - Agueda Cervera-Gasch
- Department of Nursing, Faculty of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
| | | | - Laia Aguilar-Camprubí
- Atenció a la Salut Sexual i Reproductiva (ASSIR) Esquerra, Institut Català de la Salut, Sabadell, Barcelona, Spain
| |
Collapse
|
45
|
Franco-Antonio C, Santano-Mogena E, Sánchez-García P, Chimento-Díaz S, Cordovilla-Guardia S. Effect of a brief motivational intervention in the immediate postpartum period on breastfeeding self-efficacy: Randomized controlled trial. Res Nurs Health 2021; 44:295-307. [PMID: 33598937 DOI: 10.1002/nur.22115] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/11/2020] [Accepted: 02/02/2021] [Indexed: 11/10/2022]
Abstract
Brief motivational intervention (bMI) is a therapeutic approach that encourages self-efficacy and may have a positive effect on breastfeeding self-efficacy (BSE). The purpose of this study was to analyze the effectiveness of a bMI in increasing BSE in women who started breastfeeding in the immediate postpartum period and to explore the roles of general self-efficacy and other baseline variables in this relationship. A randomized, parallel-group clinical trial was carried out. A bMI was compared with an educational session on breastfeeding. Changes in BSE and its dimensions and the interaction and mediation/moderation of general self-efficacy and other variables were analyzed. BSE increased in the bMI group from a mean baseline score of 59.14 (±9.35) to 64.62 (±7.91) at 1st month (p < 0.001). An interaction was found in that only women with higher education had an improvement in BSE during the follow-up period that was attributable to the bMI (mean difference between the bMI and the attention control group: 18.25 (95% confidence interval: 5.86-30.19; p = 0.006). This interaction was not found for the changes produced in the intrapersonal thoughts dimension of BSE, whose scores were higher in the bMI group at 3 and 6 months. General self-efficacy exerted a moderating effect on the association of bMI with BSE change. The effect of bMI was no longer significant when the general self-efficacy score was above 84. Thus, bMI is effective in increasing BSE. This effectiveness was limited by the mother's educational level and moderated by baseline general self-efficacy.
Collapse
Affiliation(s)
- Cristina Franco-Antonio
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain.,Health and Care Research Group (GISyC), University of Extremadura, Cáceres, Spain
| | - Esperanza Santano-Mogena
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain.,Health and Care Research Group (GISyC), University of Extremadura, Cáceres, Spain
| | - Pablo Sánchez-García
- Health and Care Research Group (GISyC), University of Extremadura, Cáceres, Spain.,Department of Medical and Surgical Therapy, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain
| | - Sara Chimento-Díaz
- Health and Care Research Group (GISyC), University of Extremadura, Cáceres, Spain
| | - Sergio Cordovilla-Guardia
- Department of Nursing, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain.,Health and Care Research Group (GISyC), University of Extremadura, Cáceres, Spain
| |
Collapse
|
46
|
Wong MS, Mou H, Chien WT. Effectiveness of educational and supportive intervention for primiparous women on breastfeeding related outcomes and breastfeeding self-efficacy: A systematic review and meta-analysis. Int J Nurs Stud 2021; 117:103874. [PMID: 33548592 DOI: 10.1016/j.ijnurstu.2021.103874] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 12/22/2020] [Accepted: 12/24/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Breastmilk is the most nutritious food for infants to support their growth and protect them from infection. Breastfeeding promotion is an important topic for infant health; and different educational and supportive approaches to interventions have been prompted and targeted at antenatal, postnatal or both periods to promote and sustain exclusive breastfeeding. This systematic review aimed to identify the effective approaches to educational and supportive interventions to improve breastfeeding. OBJECTIVE To examine the effects of different approaches to educational and supportive interventions that can help sustain breastfeeding and improve breastfeeding self-efficacy for primiparous postnatal women; and to identify key characteristics of the effective interventions in terms of delivery time, format and mode, main components, use of theoretical framework, and number of sessions. METHODS Eleven electronic databases and reference lists of the eligible articles were searched. Randomised controlled trials of educational and supportive interventions published in English and Chinese language over recent 20 years were identified and screened against the review criteria. Risk of bias of the included studies was assessed. Primary outcome measures were exclusive breastfeeding and partial breastfeeding rate. Secondary outcomes included breastfeeding self-efficacy, breastfeeding knowledge and other breastfeeding related outcomes. Meta-analysis was performed in terms of ≤2 months, 3-5 months and ≥6 months postpartum. RESULTS Thirteen articles that met the inclusion criteria were included and showed an acceptable risk of bias. Educational and supportive interventions were found effective in increasing exclusive breastfeeding rate at ≤2 months and 6 months, partial breastfeeding rate as well as enhancing breastfeeding self-efficacy at ≤2 months. The optimal delivery time, format and structure of the interventions included: (a) delivering from antenatal to postnatal period; (b) multicomponent involving antenatal group education, postnatal individual breastfeeding coaching and telephone follow-ups; (c) both individual and group basis; (d) being guided by self-efficacy theory; and (e) having ≥3 sessions. CONCLUSIONS The findings suggest multicomponent, theory-based intervention with ≥3 sessions delivered via both face-to-face teaching and telephone follow-ups across antenatal and postnatal period can be effective to enhance exclusive breastfeeding over 6-month, partial breastfeeding and breastfeeding self-efficacy over 2-month postpartum. REGISTRATION NUMBER CRD42020175473 at the International Prospective Register of Systematic Reviews (PROSPERO).
Collapse
Affiliation(s)
- Mei Sze Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
| | - Huanyu Mou
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
| |
Collapse
|
47
|
Mohebati LM, Hilpert P, Bath S, Rayman MP, Raats MM, Martinez H, Caulfield LE. Perceived insufficient milk among primiparous, fully breastfeeding women: Is infant crying important? MATERNAL AND CHILD NUTRITION 2021; 17:e13133. [PMID: 33399268 PMCID: PMC8189230 DOI: 10.1111/mcn.13133] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/03/2020] [Accepted: 12/08/2020] [Indexed: 12/17/2022]
Abstract
Breastfeeding mothers often report perceived insufficient milk (PIM) believing their infant is crying too much, which leads to introducing formula and the early abandonment of breastfeeding. We sought to determine if infant crying was associated with reported PIM (yes/no) and number of problems associated with lactation (lactation problem score [LPS] 6-point Likert scale) before formula introduction. Primiparous breastfeeding mothers were recruited at birth and visited at 1, 2 and 4 weeks. Among those fully breastfeeding at 1 week (N = 230), infant crying variables based on maternal reports were not associated with PIM at 1 week, but LPS was. However, a mother's expectation that her infant would cry more than other infants was associated with increased odds of reporting PIM at 2 and 4 weeks, as were delayed onset of lactation and previous LPS. At 1 week, crying variables (frequency, difficulty in soothing) were associated with LPS along with percent weight change. Delayed onset of lactation, infant care style, number of breastfeeds and previous LPS were longitudinally associated with change in LPS from 1 to 2 weeks and 2 to 4 weeks. Our data suggest that reported infant crying is associated with PIM and LPS in the first 4 weeks of life. Guidance on what to expect in crying behaviour and the impact of infant care style may be beneficial in reducing PIM and LPS in the first month.
Collapse
Affiliation(s)
- Lisa M Mohebati
- Center for Human Nutrition, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,Nutrition, Food and Exercise Sciences Department, School of Biosciences and Medicine, University of Surrey, Guildford, Surrey, UK.,Food, Consumer Behaviour and Health Research Centre, University of Surrey, Guildford, Surrey, UK
| | - Peter Hilpert
- School of Psychology, University of Surrey, Guildford, Surrey, UK
| | - Sarah Bath
- Nutrition, Food and Exercise Sciences Department, School of Biosciences and Medicine, University of Surrey, Guildford, Surrey, UK
| | - Margaret P Rayman
- Nutrition, Food and Exercise Sciences Department, School of Biosciences and Medicine, University of Surrey, Guildford, Surrey, UK
| | - Monique M Raats
- Food, Consumer Behaviour and Health Research Centre, University of Surrey, Guildford, Surrey, UK
| | - Homero Martinez
- NTEAM, Nutrition International, Ottawa, Ontario, Canada.,Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Laura E Caulfield
- Center for Human Nutrition, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
48
|
Jiao X, Yu X, Wang S, Wang Z, Gong Z. Are effect sizes in self-efficacy field changing over time? A meta-meta analysis. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2020; 56:801-811. [PMID: 33337546 DOI: 10.1002/ijop.12736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 12/02/2020] [Indexed: 11/06/2022]
Abstract
Theories relating to self-efficacy have developed rapidly since Bandura first proposed the concept in 1977. In the past two decades, psychologists have carried out numerous studies to research the cultural and psychological changes in social development. The research topic of this study is whether self-efficacy changes over time. This study uses a meta-meta analysis and includes 13 meta-analyses, including 536 effect sizes, with a total sample size of 421,880. We find that individual self-efficacy increases over time, which may be related to social development trends. However, the effects of interventions on self-efficacy remain similar (Qmodel = 1.807, df = 1, p > .05), and a possible explanation is that time effects of self-efficacy confuse the effects of intervention, because both in the intervention group and control group, the average of self-efficacy increases over time. And we find that a general decline in the predictive effects of self-efficacy (Qmodel = 5.117, df = 1, p = .024), especially the ability to predict relatively objective variables (e.g. job performance, teaching effectiveness, and transfer of training). A possible explanation is that as social development people tend to overestimate their self-efficacy. Another possible explanation is that the effect sizes in the original studies being overrated, may due to intentional selective reporting or unintentional statistical errors.
Collapse
Affiliation(s)
- Xinian Jiao
- Department of Psychology, Normal College, Qingdao University, Qingdao, China
| | - Xiyan Yu
- Department of Psychology, Normal College, Qingdao University, Qingdao, China
| | - Shuyuan Wang
- Department of Psychology, Normal College, Qingdao University, Qingdao, China
| | - Zishan Wang
- Department of Psychology, Normal College, Qingdao University, Qingdao, China
| | - Zhun Gong
- Department of Psychology, Normal College, Qingdao University, Qingdao, China
| |
Collapse
|
49
|
Padró-Arocas A, Quifer-Rada P, Aguilar-Camprubí L, Mena-Tudela D. Description of an mHealth tool for breastfeeding support: LactApp. Analysis of how lactating mothers seek support at critical breastfeeding points and according to their infant's age. Res Nurs Health 2020; 44:173-186. [PMID: 33319403 DOI: 10.1002/nur.22095] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 10/13/2020] [Accepted: 11/29/2020] [Indexed: 11/11/2022]
Abstract
Interventions in mHealth have had positive effects on establishing and maintaining breastfeeding, but we still do not know what content women consult when downloading a breastfeeding mobile application. We conducted an observational, descriptive, and retrospective study using the data recorded by LactApp in 2019. The most frequently consulted topics were those related to breastfeeding technique, infant sleep, human milk management and storage, breastfeeding myths, breastfeeding stages, complementary feeding, infant care, and returning to work. Our study results suggest that LactApp's support seems to develop with mothers' needs according to their infant's development stage. The first breastfeeding days include more physiological answers. Between 15 days and 3 months, mothers look for support in topics like breastfeeding crisis/complications and returning to work. At 3 months to 1 year, answers are related to complementary feeding and weaning. When the user's infant is 1 year of age, mothers seek support for weaning, weaning management, and tandem breastfeeding.
Collapse
Affiliation(s)
- Alba Padró-Arocas
- Research and Development Department, LactApp Women Health, Barcelona, Spain
| | - Paola Quifer-Rada
- Research and Development Department, LactApp Women Health, Barcelona, Spain.,Department of Endocrinology and Nutrition, CIBER of Diabetes and Associated Metabolic Diseases, Biomedical Research Institute Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | |
Collapse
|
50
|
Abstract
PURPOSE The purpose of this study was to determine the effects of an interactive web-based breastfeeding monitoring system on breastfeeding self-efficacy and satisfaction among mothers of full-term infants at 1, 2, and 3 months after hospital discharge. STUDY DESIGN We conducted a secondary data analysis of our two-arm, repeated-measures randomized controlled trial that took place in three Midwestern hospitals. Participants were assigned to either control or intervention groups using random numbers. Of the 141 mother-baby dyads enrolled and randomized, 35 dropped out of the study, leaving 57 mothers in the control group and 49 in the intervention group. Mothers in both groups received care based on the hospital protocol, but mothers in the intervention group were also given access to an interactive web-based breastfeeding monitoring system prior to discharge. Participants were asked to enter breastfeeding data, receive educational messages for 30 days, and complete the Breastfeeding Self-Efficacy Scale (BFSE) at 1, 2, and 3 months and the Maternal Breastfeeding Evaluation Scale (MBFES) at 3 months. Mothers received feedback in case of breastfeeding problems. RESULTS A significant difference between groups in BFSE at the 2 and 3 months (p = 0.04; p = 0.04) with medium effect size (0.52, 0.53) was found. There was a significant difference between groups in the total score of MBFES (p = 0.02, effect size 0.53). Mean scores were 122.2, SD = 17.68 for intervention and 112.8, SD = 18.03 for control group. The MBFES scores were positively correlated to BFSE scores among intervention group at all time points (r = .714, n = 45, p < .00; r = .611, n = 41, p < .00; r = .637, n = 39, p < .00). CLINICAL IMPLICATIONS Interactive web-based breastfeeding monitoring improved maternal breastfeeding self-efficacy and satisfaction and may be a promising innovation to promote maternal breastfeeding self-efficacy and satisfaction.
Collapse
|