1
|
Abdelrahmman K, Borg B, Mihrshahi S, Gribble K. Facilitators and Barriers of Wet Nursing from Antiquity to the Present: A Narrative Review with Implications for Emergencies. Breastfeed Med 2024; 19:155-165. [PMID: 38489525 DOI: 10.1089/bfm.2023.0318] [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: 03/17/2024]
Abstract
Background: If maternal breastfeeding is not possible, wet nursing allows infants to receive the nutrition and protection against disease that breastfeeding provides. Such protection may be particularly valuable in emergencies. However, while wet nursing is recommended in the Operational Guidance on Infant and Young Child Feeding in Emergencies it is underutilized. This narrative review aimed to develop an understanding of wet nursing practice across time and location, and why wet nursing is currently so little supported to inform interventions to support wet nursing in emergencies. Method: Medline and Embase were searched for "wet nursing," "cross-nursing," "shared breastfeeding," and "non-maternal nursing". Included articles were inductively analyzed to identify positive and negative factors associated with previous wet nursing practice. Results: This review included 74 records. Our analysis of the wet nursing literature includes historical and contemporary themes with milk kinship and wet nursing as risky being shared themes across time periods. Our analysis revealed that it is how wet nursing is undertaken that influences whether it benefits women, children, and societies or not. Facilitators and barriers to wet nursing in emergencies related to infant mortality rates, cultural and individual support for wet nursing, availability of wet nurses, and resources to support wet nursing. Conclusion: Understanding the conditions under which wet nursing has positive outcomes and what can be done to facilitate beneficial wet nursing practices will assist in enabling wet nursing to be more commonly implemented in emergencies.
Collapse
Affiliation(s)
- Khadija Abdelrahmman
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Bindi Borg
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Seema Mihrshahi
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Karleen Gribble
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
| |
Collapse
|
2
|
Bilgin DD, Karabayır N. Infant and Young Child Feeding in Emergencies: A Narrative Review. Turk Arch Pediatr 2024; 59:135-143. [PMID: 38454221 PMCID: PMC11059941 DOI: 10.5152/turkarchpediatr.2024.23184] [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: 08/30/2023] [Accepted: 12/01/2023] [Indexed: 03/09/2024]
Abstract
In emergencies, infants and young children are at risk of morbidity and mortality, which is increased by malnutrition. Environmental factors, food insecurity, household needs, misconceptions regarding breastfeeding, uncontrolled distribution of breast-milk substitutes, and psychological trauma make it difficult to implement proper feeding practices during disasters. Breastfeeding reduces the risk of infectious diseases and mortality in emergencies and is the safest way of feeding. Therefore, breastfeeding should be supported and promoted under all circumstances. When breastfeeding is not possible, relactation, wet nursing, or donor human milk should be considered as alternatives. If these options are not feasible, infant formula should be used. Formula should be provided only for infants in need, based on individual assessment. Donations of breast-milk substitutes should not be accepted; when needed, the procurement and distribution should be conducted by a single center under strict control, adhering to the requirements of the Code and Codex Alimentarius. Education and support should be provided to the family for the safe use of formulas. For infants older than 6 months, appropriate complementary feeding should be started. Complementary foods should contain nutrients that support the growth and development of infants, and they should be stored, prepared, and served safely. In conclusion, nutrition of infants and young children should be given priority in disasters as part of all emergency interventions. Determining the infants needs and ensuring proper nutrition, overcoming environmental challenges, and supporting parents will reduce nutrition-related risks and protect the health and well-being of infants and young children in emergencies.
Collapse
Affiliation(s)
- Demet Deniz Bilgin
- Health Science Institute, Social Pediatrics PhD Program, İstanbul Medipol University, International School of Medicine, İstanbul, Turkey
| | - Nalan Karabayır
- Division of Pediatrics, Department of Social Pediatrics, İstanbul Medipol University, International School of Medicine, İstanbul, Turkey
| |
Collapse
|
3
|
Cerceo E, Saxer K, Grossman L, Shapley-Quinn K, Feldman-Winter L. The Climate Crisis and Breastfeeding: Opportunities for Resilience. J Hum Lact 2024; 40:33-50. [PMID: 38158719 DOI: 10.1177/08903344231216726] [Citation(s) in RCA: 1] [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: 01/03/2024]
Abstract
The climate crisis is an emerging global challenge that poses potential risks to breastfeeding practices and outcomes. There are multifaceted effects of climate change affecting the breastfeeding dyad across environmental, societal, and human health dimensions. Breastfeeding support in the face of climate change will require solutions at the structural level-healthcare, community, and workplace settings-and at the mother-infant dyad level. Breastfeeding can additionally be an adaptive response to crisis situations and can mitigate some of the environmental challenges associated with climate change. Despite the undeniable significance of climate change on breastfeeding (and vice versa), our perspective as experts in the field is that this topic has not been systematically addressed. Although we highlight some of the challenges, potential solutions, and co-benefits of breastfeeding in the context of climate change, there are numerous issues that could be further explored and necessitate additional preparedness planning.
Collapse
Affiliation(s)
- Elizabeth Cerceo
- Cooper University Healthcare, Cooper Medical School of Rowan University, Camden, NJ, USA
| | | | - Lauren Grossman
- General Internal Medicine and Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Lori Feldman-Winter
- Cooper University Healthcare, Cooper Medical School of Rowan University, Camden, NJ, USA
| |
Collapse
|
4
|
Amat Camacho N, Chara A, Briskin E, Pellecchia U, Kyi HA, de Rubeis ML, Hussain F, Ahmed T, Ogundipe OF, Burzio C, Kamis U, Bukar LM, Von Schreeb J, Kolokotroni O, Della Corte F, Sunyoto T. Promoting and supporting breastfeeding in a protracted emergency setting-Caregivers' and health workers' perceptions from North-East Nigeria. Front Public Health 2023; 11:1077068. [PMID: 37333552 PMCID: PMC10272820 DOI: 10.3389/fpubh.2023.1077068] [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: 10/28/2022] [Accepted: 05/09/2023] [Indexed: 06/20/2023] Open
Abstract
Background Breastfeeding (BF) should be protected, promoted, and supported for all infants in humanitarian settings. The re-establishment of exclusive BF is also a central part of the management of acutely malnourished infants under 6 months (<6 m). Médecins Sans Frontières (MSF) runs a nutrition project in Maiduguri, a protracted emergency setting in North-East Nigeria. This study aimed to explore caregivers' (CGs) and health workers' (HWs) perceptions of BF practice, promotion, and support among CGs with infants <6 m in this setting. Methods We conducted a qualitative study using in-depth interviews and focus group discussions combined with non-participant observations. Participants included CGs of young infants enrolled in MSF nutritional programs or who attended health promotion activities in a displacement camp. MSF HWs were involved at different levels in BF promotion and support. Data were collected involving a local translator and analyzed using reflexive thematic analysis directly from audio recordings. Results Participants described how feeding practices are shaped by family, community, and traditional beliefs. The perception of breastmilk insufficiency was common and led to early supplementary feeding with inexpensive but unsuitable products. Participants often linked insufficient breastmilk production with poor maternal nutrition and stress, in a context shaped by conflict and food insecurity. BF promotion was generally well received but could be improved if tailored to address specific barriers to exclusive BF. Interviewed CGs positively valued BF support received as part of the comprehensive treatment for infant malnutrition. One of the main challenges identified was the length of stay at the facility. Some participants perceived that improvements in BF were at risk of being lost after discharge if CGs lacked an enabling environment for BF. Conclusion This study corroborates the strong influence of household and contextual factors on the practice, promotion, and support of BF. Despite identified challenges, the provision of BF support contributes to improvements in BF practice and was positively perceived by CGs in the studied setting. Greater attention should be directed toward providing support and follow-up for infants <6 m and their CGs in the community.
Collapse
Affiliation(s)
- Nieves Amat Camacho
- Center for Research in Healthcare in Disasters, Global Public Health Department, Karolinska Institutet, Stockholm, Sweden
- Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Abdullahi Chara
- Médecins Sans Frontières, Operational Center Brussels, Abuja, Nigeria
| | - Emily Briskin
- Luxembourg Operational Research Unit, Médecins Sans Frontières, Operational Center Brussels, Luxembourg, Luxembourg
| | - Umberto Pellecchia
- Luxembourg Operational Research Unit, Médecins Sans Frontières, Operational Center Brussels, Luxembourg, Luxembourg
| | - Htet Aung Kyi
- Médecins Sans Frontières, Operational Center Brussels, Abuja, Nigeria
| | - Maria Livia de Rubeis
- Luxembourg Operational Research Unit, Médecins Sans Frontières, Operational Center Brussels, Luxembourg, Luxembourg
| | - Faisal Hussain
- Médecins Sans Frontières, Operational Center Brussels, Abuja, Nigeria
| | - Tasneem Ahmed
- Médecins Sans Frontières, Operational Center Brussels, Brussels, Belgium
| | | | - Chiara Burzio
- Médecins Sans Frontières, Operational Center Brussels, Brussels, Belgium
| | - Uba Kamis
- Nutrition Unit EPID, Borno State Primary Health Care Development Agency, Maiduguri, Nigeria
| | - Lawan M. Bukar
- Faculty of Clinical Sciences, University of Maiduguri, Maiduguri, Nigeria
| | - Johan Von Schreeb
- Center for Research in Healthcare in Disasters, Global Public Health Department, Karolinska Institutet, Stockholm, Sweden
| | - Ourania Kolokotroni
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Francesco Della Corte
- Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Temmy Sunyoto
- Luxembourg Operational Research Unit, Médecins Sans Frontières, Operational Center Brussels, Luxembourg, Luxembourg
| |
Collapse
|