An assessment of the impact of breastfeeding clinic attendance on women's breastfeeding experiences

Promoting breastfeeding in Chinese women undergoing cesarean section based on the health belief model: A randomized controlled trial

BACKGROUND

The high rate of cesarean section is an important factor affecting breastfeeding in China. To improve the nation's current situation of breastfeeding, promoting breastfeeding in women undergoing cesarean section is essential.

OBJECTIVE

To explore the effects of health belief model-based interventions on breastfeeding knowledge, breastfeeding behaviors, and breastfeeding satisfaction of Chinese cesarean women.

METHODS

A total of 346 cesarean section women were enrolled in the randomized controlled trial conducted at a center in Chengdu, China, between July 1, 2018 and August 31, 2018. While the control group (n = 173) received conventional breastfeeding guidance only, the intervention group (n = 173) received additional interventions based on the health belief model. Questionnaires were distributed to assess breastfeeding knowledge, breastfeeding behavior, and breastfeeding satisfaction at discharge, 42 days postpartum, and 4 months postpartum, respectively.

RESULTS

At discharge from hospital, the breastfeeding knowledge score of the intervention group was higher than that of the control group (Z = -11.753, P < .001). The exclusive breastfeeding rates in the intervention group at the time of discharge, 42 days postpartum, and 4 months postpartum were 67.3%, 60.7%, and 52.9%, respectively, while those of the control group were 41.2%, 41.6%, and 40.4%, respectively. The differences were statistically significant (χ = 23.353, P < .001; χ = 11.853, P < .001; χ = 4.805, P = .03). The breastfeeding satisfaction of the intervention group was also higher than the control group at the time of discharge, 42 days postpartum and 4 months postpartum (t = 4.955, P < .001; t = 3.051, P = .002; Z = -3.801, P < .001).

CONCLUSION

The health belief model-based interventions can effectively increase breastfeeding knowledge for Chinese cesarean women and improve their breastfeeding behaviors and breastfeeding satisfaction within 4 months after delivery.

CLINICAL TRIAL REGISTRATION

ChiCTR1900026006 <http://www.chictr.org.cn/usercenter.aspx>.

Efficacy of an Osteopathic Treatment Coupled With Lactation Consultations for Infants' Biomechanical Sucking Difficulties

BACKGROUND

Despite well-known recommendations from national and international bodies including the World Health Organization, few mothers achieve the goal of breastfeeding exclusively for 6 months. Half of mothers stop breastfeeding due to biomechanical issues in the first month, despite increasing support from lactation consultants. Osteopaths worldwide work with these babies, but there is little empirical evidence for this type of treatment. Research aim: This study aimed to determine the efficacy of an osteopathic treatment coupled with usual lactation consultations on infants' ability to latch. Secondary objectives included assessment of nipple pain and mothers' perceptions of the effect of treatment.

METHODS

We conducted a single blind, randomized controlled trial at a mother-to-mother support group between January and December 2015. Data were collected at four different times over a 10-day period (T0-T10) from 97 mother-infant dyads using the LATCH assessment tool, a visual analog scale (VAS) to document mothers' nipple pain, and a de novo questionnaire for breastfeeding management and potential treatment side effects.

RESULTS

There were consistent statistical and clinical differences in the mean LATCH scores between the treatment and the control groups ( p < .001). However, no significant differences in the VAS scores were reported over time ( p = .713). Mothers reported no serious or unexpected side effects during the follow-up period.

CONCLUSION

This study is one of the first to bring together lactation consultants and osteopaths to address infants with biomechanical sucking difficulties. Findings support the hypothesis that the addition of osteopathy to regular lactation consultations is beneficial and safe.

Interventions to improve breastfeeding outcomes: a systematic review and meta-analysis

AIM

To provide comprehensive evidence of the effect of interventions on early initiation, exclusive, continued and any breastfeeding rates when delivered in five settings: (i) Health systems and services (ii) Home and family environment (iii) Community environment (iv) Work environment (v) Policy environment or a combination of any of above.

METHODS

Of 23977 titles identified through a systematic literature search in PUBMED, Cochrane and CABI, 195 articles relevant to our objective, were included. We reported the pooled relative risk and corresponding 95% confidence intervals as our outcome estimate. In cases of high heterogeneity, we explored its causes by subgroup analysis and meta-regression and applied random effects model.

RESULTS

Intervention delivery in combination of settings seemed to have higher improvements in breastfeeding rates. Greatest improvements in early initiation of breastfeeding, exclusive breastfeeding and continued breastfeeding rates, were seen when counselling or education were provided concurrently in home and community, health systems and community, health systems and home settings, respectively. Baby friendly hospital support at health system was the most effective intervention to improve rates of any breastfeeding.

CONCLUSION

To promote breastfeeding, interventions should be delivered in a combination of settings by involving health systems, home and family and the community environment concurrently.

Multiparous mothers: Breastfeeding support provided by nurses

The study aimed to identify the informational, practical and emotional support that multiparous mothers had received from nurses in the early postpartum period.This is a descriptive and cross-sectional study on 278 multiparous mothers who took part in the research prior to their discharge from a maternity hospital in Ankara, Turkey. The instrument used was a 38-item questionnaire. Experiencing breastfeeding problems was the only statistically significant predictor of in-hospital supplementation (P < 0.01, OR 0.028, 95% CI 0.005-0.159). There were no statistically significant association between some predictor variables with regard to breastfeeding support and breastfeeding outcomes including in-hospital formula supplementation and breastfeeding problems. No significant associations are indicative for the need of more effective implementation of informational, practical and emotional breastfeeding support for multiparous mothers in easing their adjustment to breastfeeding. Nurses can encourage multiparous mothers to maintain breastfeeding through individual teaching, giving mothers a sense of security, providing understanding care and telling about what to do with regard to breastfeeding problems. Antenatal education and support could be more likely to make a difference.

Questioning current definitions for breastfeeding research

Background

The aim of this paper is to examine how breastfeeding is defined for research purposes.

Discussion

Current breastfeeding definitions focus on the amount of breast milk an infant receives and do not encompass how a baby is fed. Our concerns are that key variables are not measured when mothers are pumping or expressing their milk and bottle feeding. It seems the breastfeeding relationship is not considered in the definition.

Conclusion

While we appreciate the implications of full versus partial breastfeeding in research studies, we also believe the method of infant feeding to be significant. Researchers should develop new definitions.

To explore the experiences of women on reasons in initiating and maintaining breastfeeding in urban area of karachi, pakistan: an exploratory study

This is an exploratory study that explores the experiences of lactating women in initiating, continuing, or discontinuing breastfeeding in an urban area of Karachi, Pakistan. Objectives. To explore the experiences of lactating women and to understand their support and hindering mechanisms in initiating and maintaining breastfeeding. Methods. This is an exploratory design assisting in exploring the participant's experiences of initiating and maintaining breastfeeding to better understand their world. Purposive sampling was used, and data was analyzed through manual thematic analysis. Results. The data revealed that mother's knowledge, sociocultural environment, breastfeeding decision, and self- and professional support acted as driving forces for the participants. However, sociocultural environment, physiological changes, time management, and being a housewife to breastfeed their children were all challenges and barriers that the participants thought hindered their breastfeeding initiation and maintenance. Conclusion. Breastfeeding is a natural but taxing phenomenon, and breastfeeding mothers experience supporting and hindering factors in initiating and maintaining breastfeeding.

The breastfeeding experience of women with major difficulties who use the services of a breastfeeding clinic: a descriptive study

Background

Many women experience breastfeeding difficulties. Sometimes these difficulties lead to breastfeeding cessation. Breastfeeding clinics provide support for women facing such problems. This study aims to describe the breastfeeding experience of women, particularly those who use the services of the breastfeeding clinic located in the Greater Quebec City area.

Methods

This is a descriptive study based on information gathered through telephone questionnaires that were administered in 2006 to a sample of 86 women and semi-structured interviews conducted with 12 of these women.

Results

Painful nipples/breasts, low milk supply and latching difficulties were the three most frequent major breastfeeding problems identified by women. Their personal characteristics as well as the moral and physical support provided by family and friends and by health professional and clinicians at the breastfeeding clinic were the factors identified most often as having a positive influence on the breastfeeding experience.

Conclusion

The results suggest that breastfeeding clinics have a critical role to play in improving the breastfeeding experience of women with major difficulties.