1
|
Pereira TLB, Rajendran PDO, Nantsupawat A, Shorey S. Fathers' breastfeeding knowledge, attitudes, and involvement in the Asian context: A mixed-studies review. Midwifery 2024; 131:103956. [PMID: 38401252 DOI: 10.1016/j.midw.2024.103956] [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: 09/09/2022] [Revised: 01/17/2024] [Accepted: 02/13/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Despite numerous initiatives attempting to enhance BF across Asia, recent studies show that exclusive BF rates remain alarmingly low. With globalization, society has shifted from traditional family roles towards more egalitarian marriages, where Asian fathers are now more involved in parenting. As fathers' involvement in breastfeeding is highly complex and context-sensitive, evaluation of a wide range of concepts and evidence within the Asian context is necessary. OBJECTIVE This review aims to consolidate and appraise empirical studies exploring fathers' breastfeeding knowledge, attitude, and involvement within the Asian context. DESIGN A systematic mixed-studies review was conducted. Six electronic databases (PubMed, CINAHL, PsycINFO, Embase, Scopus, and ProQuest Dissertations and Theses Global) were searched from each database's inception date until June 2022. Studies were appraised using the Mixed Method Appraisal Tool and data was synthesised using the results-based convergent integration method. FINDINGS Twenty-two studies were included in this review. The synthesis of findings identified two main themes and six sub-themes. KEY CONCLUSIONS Asian fathers have a varied understanding of breastfeeding and their involvement in breastfeeding is influenced by personal, cultural, religious, social, and environmental factors. IMPLICATIONS FOR PRACTICE Perinatal care professionals play a crucial role in engaging and enhancing fathers' involvement in breastfeeding education programmes. The findings also urge policymakers to introduce more 'father-friendly' breastfeeding guidelines and educate perinatal care professionals to be more aware and sensitive to the needs of fathers. There is also a need to introduce more flexible and economically sensitive paternal leave policies to improve fathers' breastfeeding involvement.
Collapse
Affiliation(s)
- Travis Lanz-Brian Pereira
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Priyadharshni DO Rajendran
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Shefaly Shorey
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| |
Collapse
|
2
|
Yas A, Abdollahi M, Khadivzadeh T, Karimi FZ. Investigating the Effect of Supportive Interventions on Initiation of Breastfeeding, Exclusive Breastfeeding, and Continuation of Breastfeeding in Adolescent Mothers: A Systematic Review and Meta-Analysis. Breastfeed Med 2023; 18:198-211. [PMID: 36927075 DOI: 10.1089/bfm.2022.0219] [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: 03/18/2023]
Abstract
Introduction: The initiation of breastfeeding, exclusive breastfeeding, and its duration for 2 years in adolescent mothers is less than adult mothers. The purpose of this study is to determine the effect of supportive interventions on the initiation of breastfeeding, exclusive breastfeeding, and continuation of breastfeeding in adolescent mothers. Methods: Web of Science, PubMed, Scopus, Cochrane Library, EMBASE, ProQuest, SID, Iranmedex, and Google Scholar were searched to find English and Persian clinical trial studies without time limit. The Cochrane checklist was used to check the bias of the articles. Data analysis was done using STATA version 11. I-squared index was used to check the heterogeneity, and funnel plot and Begg test were used to examine the publication bias. The combined odds ratio (OR) and random effects model were used to combine the studies and perform meta-analysis. Results: Of 492 articles, 11 articles were entered to the systematic review. Of 11 articles, three articles were entered to the meta-analysis. The supportive interventions included educational and counseling interventions, home visit, and peer support. The results of the present random effects meta-analysis model showed that the combined OR was 3.38 with 95% confidence interval (1.66-6.88, p = 0.001), thus that, breastfeeding initiation in the intervention group was higher than the control group. Conclusion: Supportive interventions such as educational and counseling interventions, home visits, and peer support are suitable strategies to promote breastfeeding in adolescent mothers. Therefore, it is suggested to integrate these strategies in prenatal and postpartum care of adolescent mothers.
Collapse
Affiliation(s)
- Atefeh Yas
- Department of Reproductive Health, Student Research Committee, Faculty of Nursing and Midwifery, Mashhad University of Medical Science, Mashhad, Iran
| | - Mahbubeh Abdollahi
- Department of Public Health, Torbat Heydarieh University of Medical Sciences, Torbat Heydarieh, Iran
| | - Talat Khadivzadeh
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Midwifery, Mashhad University of Medical Sciences, School of Nursing and Midwifery, Mashhad, Iran
| | - Fatemeh Zahra Karimi
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Midwifery, Mashhad University of Medical Sciences, School of Nursing and Midwifery, Mashhad, Iran
| |
Collapse
|
3
|
Dagla C, Antoniou E, Sarantaki A, Iliadou M, Mrvoljak-Theodoropoulou I, Andersson E, Dagla M. The Effect of Antenatal Education on Expectant Fathers' Attitudes toward Breastfeeding and Attachment to the Fetus. NURSING REPORTS 2023; 13:243-254. [PMID: 36810274 PMCID: PMC9944450 DOI: 10.3390/nursrep13010023] [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: 01/25/2023] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND This study explores the effect of antenatal education on fathers' attitudes toward: (i) breastfeeding and (ii) attachment to the fetus. A secondary aim is to explore the relationship of fathers' demographic and the psycho-emotional characteristics that come with breastfeeding and attachment. METHODS This is a longitudinal study involving a group of 216 Greek expectant fathers who participated with their partners in an antenatal educational program performed by midwives in Athens, Greece (September 2020-November 2021). The Iowa Infant Feeding Attitudes Scale (IIFAS) and Paternal Antenatal Attachment Scale (PAAS) were administered at two time points: (a) 24th-28th gestation week and (b) 34th-38th gestation week. The T-test and Univariate Analyses of Variance (ANOVA) were performed. RESULTS The expectant fathers' scores show that breastfeeding intention/exclusivity and prenatal attachment to the fetus were higher after their participation in the antenatal education program, but the difference was not statistically insignificant. Expectant fathers with a cohabitation agreement (p = 0.026), who felt very much supported by their partners (p = 0.001) and had no relationship difficulties with their partners (p < 0.001), as well as those who reported being very happy during pregnancy (p < 0.001), showed greater paternal antenatal attachment to the fetus. CONCLUSIONS Although the difference was statistically insignificant, antenatal education appears to have an impact on paternal breastfeeding attitudes and antenatal attachment to the fetus. Additionally, several paternal characteristics were associated with greater antenatal attachment. Future research should be directed toward the investigation of additional factors that impact antenatal-paternal attachment and breastfeeding attitudes so that effective education programs can be designed.
Collapse
Affiliation(s)
- Calliope Dagla
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
- Correspondence: ; Tel.: +30-6984493365
| | - Evangelia Antoniou
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
| | - Antigoni Sarantaki
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
| | - Maria Iliadou
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
| | | | - Ewa Andersson
- Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Maria Dagla
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
| |
Collapse
|
4
|
Mitchell F, Walker T, Hill K, Browne J. Factors influencing infant feeding for Aboriginal and Torres Strait Islander women and their families: a systematic review of qualitative evidence. BMC Public Health 2023; 23:297. [PMID: 36759814 PMCID: PMC9912532 DOI: 10.1186/s12889-022-14709-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/23/2022] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Breastfeeding provides all the necessary energy and nutrients for an infant and provides many benefits for mothers and babies. The effects of colonisation have contributed to reduced prevalence and duration of breastfeeding among Australian Aboriginal women and widespread use of infant formula as a substitute for breastmilk. This review aimed to synthesise qualitative evidence about the factors that influence breastfeeding and infant feeding practices of Aboriginal and Torres Strait Islander women and their families. METHODS MEDLINE, CINAHL, Informit and Google Scholar were systematically searched for qualitative studies that included the perspective of Aboriginal and Torres Strait Islander women and their families about the factors influencing infant feeding decisions. Included studies were appraised using an Indigenous quality assessment tool and were synthesised via inductive thematic analysis informed by an ecological framework. RESULTS The search identified 968 studies with 7 meeting the inclusion criteria. Key factors influencing breastfeeding and infant feeding practices of Aboriginal women included cultural practices, normalisation of bottle feeding, shame associated with breastfeeding in public, access to culturally safe nutrition education, support services and health professionals, family/partner support, knowledge of the benefits of breastfeeding, experiences with previous babies and concern that the baby was not getting enough milk. CONCLUSION The perspectives of Aboriginal and Torres Strait Islander women must be considered when providing breastfeeding and infant feeding advice. This can be achieved through Aboriginal and Torres Strait Islander people designing, implementing, and leading the delivery of education and information regarding breastfeeding and health infant feeding practices that have been influenced by the priorities of Aboriginal and Torres Strait Islander communities.
Collapse
Affiliation(s)
- Fiona Mitchell
- Deakin Rural Health, School of Medicine, Deakin University, PO Box 423, 3280 Warrnambool, VIC Australia
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, 3125 Burwood, VIC Australia
| | - Troy Walker
- Institute for Health Transformation, School of Health and Social Development, Deakin University, Locked Bag 20000, 3220 Geelong, VIC Australia
| | - Karen Hill
- Institute for Health Transformation, School of Health and Social Development, Deakin University, Locked Bag 20000, 3220 Geelong, VIC Australia
| | - Jennifer Browne
- Institute for Health Transformation, School of Health and Social Development, Deakin University, Locked Bag 20000, 3220 Geelong, VIC Australia
| |
Collapse
|
5
|
Hackman NM, Sznajder KK, Kjerulff KH. Paternal Education and Its Impact on Breastfeeding Initiation and Duration: An Understudied and Often Overlooked Factor in U.S. Breastfeeding Practices. Breastfeed Med 2022; 17:429-436. [PMID: 35180349 PMCID: PMC9127829 DOI: 10.1089/bfm.2021.0338] [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: 11/12/2022]
Abstract
Objective: The primary objective was to determine the role that paternal education level plays in the initiation and duration of breastfeeding for their infants. Materials and Methods: As part of a prospective cohort study, primiparous women, aged 18-35 years, living in Pennsylvania, were enrolled and interviewed during pregnancy (N = 3,006) and at 1 and 6 months postpartum. Logistic regression models were used to evaluate the associations between paternal education level and breastfeeding initiation and duration, controlling for maternal education level and other covariates-including marital/relationship status, household poverty level, maternal age, race/ethnicity, smoking, attending breastfeeding class during pregnancy, mode of delivery, gestational age, and plans to return to work ≤2 months after delivery. Results: Information on both paternal and maternal education levels and breastfeeding outcomes was available for 2,839 couples. Most of the women reported that they planned to breastfeed (92.5%); 92.0% initiated breastfeeding; and 49.5% of those who initiated breastfeeding were still breastfeeding by 6 months postpartum. Paternal education level was independently associated with breastfeeding initiation and duration in both regression models-the higher the level of education of the father, the more likely breastfeeding was initiated and the mother was still breastfeeding at 6 months postpartum, even after controlling for maternal education level and other relevant covariates. Conclusions: In this large prospective cohort study of first-time mothers and their newborns, paternal education level was independently associated with breastfeeding initiation and duration. These findings highlight the importance of including the father in prenatal breastfeeding education initiatives.
Collapse
Affiliation(s)
- Nicole M Hackman
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Kristin K Sznajder
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Kristen H Kjerulff
- Department of Public Health Sciences and Obstetrics and Gynecology, Penn State College of Medicine, Hershey, Pennsylvania, USA
| |
Collapse
|
6
|
Lundquist A, McBride BA, Donovan SM, Wszalek M. Father support for breastfeeding mothers who plan to utilize childcare: A qualitative look at Mothers' perspectives. Appetite 2022; 169:105854. [PMID: 34890723 DOI: 10.1016/j.appet.2021.105854] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/23/2021] [Accepted: 12/06/2021] [Indexed: 02/02/2023]
Abstract
Breastfeeding exerts many health benefits for the infant and the benefit is affected by exclusivity and duration, however, most mothers in the U.S. breastfeed for a shorter duration than recommended. First-time mothers who return to work outside the home, utilize childcare, and pump to continue to provide human milk, all of which have been found to reduce breastfeeding duration individually, represent a subset of breastfeeding mothers facing several known barriers to breastfeeding continuation and at risk for early breastfeeding cessation. The aim of this study is to understand and describe the perceptions of first-time mothers with prenatal intentions to breastfeed and utilize childcare, of paternal support for the breastfeeding experience. A semi-structured interview guided data collection with 24 first-time breastfeeding mothers and responses were analyzed using thematic analysis. Two main themes from mothers' experiences highlight the perceptions of first-time mothers, who had prenatal intentions to breastfeed and utilize childcare, were shaped by the actions, behaviors, and beliefs of their partners throughout the breastfeeding process, as well as illustrate both mothers and fathers lack knowledge of how to optimally involve fathers in breastfeeding. Our findings extend evidence for two existing models of father support to promote breastfeeding as relevant to mothers who return to work outside the home and utilize childcare, and additionally identify an area of support not included in either model. Early and improved education that situates breastfeeding within the co-parenting relationship and includes paternal support for pumping has the potential to improve mothers' breastfeeding experience and breastfeeding duration through mothers' return to work and infants' transition to childcare.
Collapse
Affiliation(s)
- Alexandra Lundquist
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Child Development Lab, 1105 West Nevada Street, Urbana, IL, 61801, USA.
| | - Brent A McBride
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Child Development Lab, 1105 West Nevada Street, Urbana, IL, 61801, USA; Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, 2013 Christopher Hall, 904 West Nevada Street, Urbana, IL, 61801, USA.
| | - Sharon M Donovan
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, 339 Bevier Hall, 905 S. Goodwin Ave, Urbana, IL, 61801, USA.
| | - Maris Wszalek
- Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
| |
Collapse
|
7
|
Gilchrist CA, Chelimo C, Tatnell R, Atatoa Carr P, Camargo CA, Morton S, Grant CC. Vaccination information fathers receive during pregnancy and determinants of infant vaccination timeliness. Hum Vaccin Immunother 2021; 17:5214-5225. [PMID: 34797748 DOI: 10.1080/21645515.2021.1932212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
The information fathers receive about infant vaccination may influence their decision to vaccinate. We describe fathers' sources of vaccination information and paternal determinants of timely infant vaccinations. Participants were from a child cohort study in New Zealand. The child cohort was established by enrolling pregnant women and their partners. During pregnancy, fathers (n = 4017) of the cohort children born 2009-2010 described information sources that encouraged or discouraged infant vaccination. The National Immunization Register provided infant vaccination data. Independent associations of the vaccination information received by fathers with the timeliness of their infant's vaccination were determined using multivariable logistic regression. Associations were described using adjusted odds ratios and 95% confidence intervals. One-third of fathers (1430/4017 [36%]) recalled receiving vaccination information, 64% of which encouraged vaccination. Most infants (2900/4017 [72%]) received all their vaccinations on time, however only 58% of Māori infants were vaccinated on time. Paternal determinants of vaccination timeliness were the father receiving discouraging or conflicting information about vaccination, father's ethnicity, father's vaccination hesitancy, and whether the mother received vaccination information. To improve vaccination uptake and timeliness, a vaccination conversation with mothers, fathers and whānau could be included in routine antenatal care, informing and supporting decision-making, and addressing concerns. Vaccination education should address present and historic distrust of the health system. Framing vaccination within a Māori model of health and including fathers and whānau in decision-making will address vaccination inequities in New Zealand.
Collapse
Affiliation(s)
- Catherine A Gilchrist
- Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
| | - Carol Chelimo
- Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
| | - Ryan Tatnell
- General Paediatrics, Starship Children's Health, Auckland, New Zealand
| | - Polly Atatoa Carr
- Growing up in New Zealand, The University of Auckland, Auckland, New Zealand.,National Institute of Demographic and Economic Analysis, University of Waikato, Hamilton, New Zealand
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Harvard University, Boston, MA, USA
| | - Susan Morton
- Growing up in New Zealand, The University of Auckland, Auckland, New Zealand.,Centre for Longitudinal Research - He Ara Ki Mua, The University of Auckland, Auckland, New Zealand
| | - Cameron C Grant
- Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand.,General Paediatrics, Starship Children's Health, Auckland, New Zealand.,Centre for Longitudinal Research - He Ara Ki Mua, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
8
|
Matriano MG, Ivers R, Meedya S. Factors that influence women's decision on infant feeding: An integrative review. Women Birth 2021; 35:430-439. [PMID: 34674954 DOI: 10.1016/j.wombi.2021.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/07/2021] [Accepted: 10/07/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Many women stop breastfeeding earlier than what they intended prior to birth. Although there are many studies that focus on the factors that influence women's antenatal breastfeeding decisions, the factors that influence women's decisions during the continuum of antenatal and postnatal period are less known. AIM To understand and synthesise the contemporary factors that influence women's decisions on infant feeding from the antenatal period and across the breastfeeding continuum. METHOD Five online databases (CINAHL, Medline, PubMed, Scopus and Web of Science) were searched. We included original search articles that were published since 2015 to August 2021 and were available in English. The framework of Whittemore and Knafl was used to guide this integrative literature review. Out of the 872 articles identified, 14 studies met the inclusion criteria of our study. We used theory of birth territory and midwifery guardianship to synthesise the interactions between the themes. FINDINGS Five main themes were identified: (a) Women's own views, (b) Family and friend's preferences and advice, (c) Health professional's preference, advice and practice, (d) Sociocultural norms, and (e) Media representation. The interaction between the themes was explained based on women's intrinsic and extrinsic power outlined in the birth territory and midwifery guardianship theory. CONCLUSION The factors that influence women's decisions towards infant feeding methods are complex and multi-dimensional. Promoting and supporting women towards breastfeeding need to focus on the factors that are tailored for a woman within her social network where she can feel safe about her breastfeeding decisions.
Collapse
Affiliation(s)
| | | | - Shahla Meedya
- School of Nursing, University of Wollongong, Australia.
| |
Collapse
|
9
|
Cunningham K, Nagle D, Gupta P, Adhikari RP, Singh S. Associations between parents' exposure to a multisectoral programme and infant and young child feeding practices in Nepal. MATERNAL & CHILD NUTRITION 2021; 17 Suppl 1:e13143. [PMID: 34241957 PMCID: PMC8269143 DOI: 10.1111/mcn.13143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 12/07/2020] [Accepted: 01/04/2021] [Indexed: 12/28/2022]
Abstract
In Nepal, an at-scale, multisectoral programme-Suaahara (2011-2023)-aims to improve nutrition behaviours. Suaahara II (2016-2023) transitioned from a mother/child dyad focus to explicitly targeting all family members. Evidence is scant, however, regarding how exposure by men to social and behaviour change interventions relates to nutrition outcomes. This study uses a 2019 cross-sectional monitoring dataset to test associations between maternal and male household head exposure to Suaahara II interventions (interacting with a frontline worker, participating in a community event or listening to the Bhanchhin Aama radio programme) and adoption of three infant and young child feeding practices: minimum dietary diversity, minimum acceptable diet and sick child feeding, in households with a child under 2 years (n = 1827). Maternal exposure to Suaahara II had a positive association with minimum dietary diversity (OR: 1.71, 95% CI [1.27, 2.28], P < 0.001), minimum acceptable diet (OR: 1.60, 95% CI [1.19, 2.14], P = 0.002) and increased feeding to a sick child (OR: 2.11, 95% CI [1.41, 3.17], P < 0.001). Male household head exposure was only associated with increased feeding to a sick child (OR: 2.21, 95% CI [1.27, 3.84], P = 0.005). Among households with an exposed mother, having an exposed male household head nearly tripled the odds of appropriate sick child feeding (OR: 2.90, 95% CI [1.57, 5.34], P = 0.001) but was not significantly associated with the other two outcomes. These findings suggest that the relationships between exposure to nutrition programmes and outcomes are complex and further research is needed to understand variation by family member, behavioural outcome and context.
Collapse
Affiliation(s)
- Kenda Cunningham
- Helen Keller InternationalNew YorkNew YorkUSA
- Department of Population Health, Faculty of Epidemiology, London School of Hygiene and Tropical MedicineLondonEngland
| | - Devin Nagle
- Heilbrunn Department of Population and Family Health, Mailman School of Public HealthColumbia UniversityNew YorkNew YorkUSA
| | - Poonam Gupta
- Department of International Health, Johns Hopkins Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | | | | |
Collapse
|
10
|
Atkinson L, Silverio SA, Bick D, Fallon V. Relationships between paternal attitudes, paternal involvement, and infant-feeding outcomes: Mixed-methods findings from a global on-line survey of English-speaking fathers. MATERNAL & CHILD NUTRITION 2021; 17 Suppl 1:e13147. [PMID: 34241959 PMCID: PMC8269144 DOI: 10.1111/mcn.13147] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 01/09/2021] [Accepted: 01/12/2021] [Indexed: 01/16/2023]
Abstract
The breastfeeding intention-behaviour gap remains wide in developed countries. Current studies have focused on maternal attitudes and behaviours concerning infant feeding in order to explore barriers to breastfeeding continuation. There has been limited consideration of the impact of paternal attitudes and behaviours, despite contemporary parenthood evolving and evidence indicating that there are greater levels of paternal involvement in routine childcare tasks. This mixed-methods study used a triangulation design to examine the associations between paternal attitudes towards parenthood and infant-feeding methods, levels of paternal involvement, infant-feeding outcomes, and father-infant relationships. Fathers of infants <52 weeks completed an online survey providing quantitative data (N = 212) and qualitative data (N = 208). For the quantitative data, fathers completed validated measures about their attitude towards parenthood and infant feeding, levels of paternal involvement, and infant-feeding history. For the qualitative data, questions explored influences on paternal attitudes towards infant feeding and the father-infant relationship. After controlling for covariates, regression analyses found egalitarian attitudes towards parenthood were positively associated with both attitudes towards breastfeeding and levels of paternal involvement. Positive paternal attitudes towards breastfeeding were significantly associated with increased likelihood of breastfeeding. A thematic framework analysis indicated fathers' attitudes towards infant feeding were largely influenced by their families and partners or healthcare professionals. Polarised views were expressed about the impact infant-feeding methods had on the father-infant relationship, although fathers were united in their desire to bond with their infant. Addressing paternal attitudes and the importance of father-infant involvement in domains other than feeding maybe beneficial in supporting breastfeeding and the father-infant relationship.
Collapse
Affiliation(s)
- Lydia Atkinson
- Department of PsychologyUniversity of LiverpoolLiverpoolUK
| | - Sergio A. Silverio
- Department of Women & Children's HealthKing's College LondonLondonUK
- Elizabeth Garrett Anderson Institute for Women's HealthUniversity College LondonLondonUK
| | - Debra Bick
- Warwick Clinical Trials Unit, Warwick Medical SchoolUniversity of WarwickCoventryUK
| | | |
Collapse
|
11
|
Dychtwald DK, Kaimal G, Kilby LM, Klobodu C, Milliron BJ. "When a Father feels Excluded": A Qualitative Study Exploring the Role of Fathers in the Women, Infants, and Children (WIC) Supplemental Nutrition Program. Int J Qual Stud Health Well-being 2021; 16:1932026. [PMID: 34155962 PMCID: PMC8221125 DOI: 10.1080/17482631.2021.1932026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
Background: Evidence suggests that men can play a key role in influencing maternal health behaviours, potentially affecting birthing outcomes. However, that role may not be fostered in safety net programmes like the Special Supplemental Nutrition programme for Women, Infants, and Children (WIC), a programme for which men do not qualify.Purpose: The primary objective of this research was to explore the experiences, expectations, and attitudes of men towards WIC.Methods: This qualitative study employed semi-structured interviews of couples recruited at Philadelphia WIC. Data were analysed using thematic analysis.Results: Eight couples completed the interviews (16 independent interviews). Among participating fathers, only two fully participated in WIC. Barriers to participation was the primary theme identified as participants shared challenges from multiple sources. Subthemes, including fears of coercion, masculinity, and the unacknowledged role of fathers illustrated that these barriers were both internal and external to WIC and in alignment with the framework of the social ecological model (SEM).Conclusion: These findings indicate that paternal involvement is limited due to numerous barriers, including those attributable to WIC. Future research should investigate these barriers and their intersectionality, as well as the appropriateness of WIC as an organization to foster paternal involvement.
Collapse
Affiliation(s)
- Dan K Dychtwald
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Girija Kaimal
- Department of Creative Arts Therapies, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | | | - Cynthia Klobodu
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Brandy-Joe Milliron
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| |
Collapse
|
12
|
Chiu YW, Cheng SW, Yang CY, Weng YH. Breastfeeding in Relation to Neonatal Jaundice in the First Week After Birth: Parents' Perceptions and Clinical Measurements. Breastfeed Med 2021; 16:292-299. [PMID: 33666511 DOI: 10.1089/bfm.2020.0293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Parents may consider interrupting breastfeeding to manage neonatal jaundice (NJ). Our aims were to determine correlations of breastfeeding with NJ by examining infants' manifestations in the first week after birth and to understand parents' perceptions toward NJ in relation to breastfeeding. Materials and Methods: This prospective cross-sectional study was conducted in a tertiary medical center by examining infants and administering a questionnaire survey to their parents. All healthy infants admitted to the well-baby nursery were eligible for enrollment. A 16-item questionnaire was distributed to parents of enrolled infants from October 2017 to February 2019. Items of the questionnaire included perceptions and knowledge of NJ. In addition, clinical information of enrolled infants was obtained from medical records. Hyperbilirubinemia was defined as a peak transcutaneous bilirubinometer value ≥15 mg/dL. Results: In total, 449 parents completed the consent form and participated in the study. Results showed that exclusive breastfeeding was more common in infants with a vaginal delivery (p < 0.001), who were nonprimiparous (p = 0.004) and who had weight loss of >7% (p < 0.001). There was no significant correlation of exclusive breastfeeding with hyperbilirubinemia (p = 0.414). Approximately two-thirds of parents were worried about NJ occurring in their child. Most parents were aware of phototherapy as management of NJ. However, their knowledge of risk factors, complications, and assessments of NJ was relatively deficient. Overall, 29.6% of parents rated breastfeeding as a risk factor for NJ, and 24% of parents indicated that cessation of breastfeeding was a management option for NJ. Conclusions: The results indicated that NJ in the first few days after birth poses a significant barrier to breastfeeding. Our findings provide critical information for plotting strategies to enhance parents' willingness to continue breastfeeding.
Collapse
Affiliation(s)
- Ya-Wen Chiu
- PhD Program in Global Health and Health Security, Master Program in Global Health and Development, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Shao-Wen Cheng
- Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan
| | - Chun-Yuh Yang
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Hao Weng
- Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan
| |
Collapse
|
13
|
Crippa BL, Consales A, Morniroli D, Lunetto F, Bettinelli ME, Sannino P, Rampini S, Zanotta L, Marchisio P, Plevani L, Giannì ML, Mosca F, Colombo L. From dyad to triad: a survey on fathers' knowledge and attitudes toward breastfeeding. Eur J Pediatr 2021; 180:2861-2869. [PMID: 33779804 PMCID: PMC8346446 DOI: 10.1007/s00431-021-04034-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/07/2021] [Accepted: 03/16/2021] [Indexed: 11/26/2022]
Abstract
Fathers are known to impact breastfeeding outcomes. We aimed to explore paternal knowledge and attitude toward breastfeeding, and possible association with breastfeeding rates at discharge. In this cross-sectional study, we enrolled 200 fathers of healthy term neonates. At discharge, fathers were asked to rate their degree of agreement to 12 items on a 5-point Likert scale. A total score was obtained from their answers. Univariate binary logistic regression analysis was used to verify if the total score was predictive of exclusive breastfeeding at discharge. A multivariable logistic regression model was then used to adjust for possible confounders. ROC analysis was performed, and a Youden's total score cut-off value was determined to define total score's performance in predicting exclusive breastfeeding at discharge. Fathers showed a solid knowledge of maternal (87%) and neonatal (98%) benefits of breastfeeding, skin-to-skin (99.5%), rooming-in (79%), and responsive feeding (67.5%); conversely, only 51% knew about the recommended use of pacifiers. Fathers felt personally involved in babies' feeding in 79% of cases. An association was found between total score and exclusive breastfeeding at discharge at univariate (OR: 1.07, p = 0.04) but not at multivariable analysis (OR: 1.07, p = 0.067). ROC analysis was not statistically significant (AUC 0.58, p = 0.083).Conclusion: By using a novel instrument aimed at quantifying fathers' knowledge and overall attitude toward breastfeeding, this study underlines the importance of including fathers in the promotion of breastfeeding. Expanding the classic mother-baby dyad to a more modern mother-father-baby triad may impact breastfeeding outcomes at discharge. What is known: • Social support plays a major role in improving breastfeeding outcomes. • Fathers may greatly influence initiation and duration of breastfeeding; the more they know, the more helpful they can be. What is new: • A multidisciplinary team created a structured questionnaire aimed at quantifying fathers' knowledge and attitude toward breastfeeding. • The association between a higher questionnaire total score and exclusive breastfeeding rates at discharge highlights the importance of including fathers in the promotion of breastfeeding, as part of the breastfeeding team.
Collapse
Affiliation(s)
- Beatrice Letizia Crippa
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Alessandra Consales
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Daniela Morniroli
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Flavia Lunetto
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Maria Enrica Bettinelli
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Patrizio Sannino
- Direzione Professioni Sanitarie, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Serena Rampini
- Direzione Professioni Sanitarie, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lidia Zanotta
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Paola Marchisio
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Università degli Studi di Milano, 20122 Milan, Italy
| | - Laura Plevani
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Maria Lorella Giannì
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Fabio Mosca
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Lorenzo Colombo
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| |
Collapse
|
14
|
Lucchini-Raies C, Marquez-Doren F, Beca P, Perez JC, Campos S, Lopez-Dicastillo O. The CRIAA Program complex intervention in primary care to support women and their families in breastfeeding: Study protocol for a pilot trial. J Adv Nurs 2020; 76:3641-3653. [PMID: 33058232 DOI: 10.1111/jan.14534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/26/2020] [Accepted: 07/23/2020] [Indexed: 11/26/2022]
Abstract
AIM To report a pilot study protocol to assess the feasibility of a complex intervention, in the primary healthcare context, to support women and their families in breastfeeding. DESIGN A pilot/feasibility trial with control and intervention groups. METHODS The study will be conducted in two primary healthcare centres with 40 childbearing women (20 control group; 20 intervention group), with their partner/meaningful person and their respective healthcare professionals. Intervention group participants will receive the intervention: (a) in a breastfeeding workshop during their third trimester of pregnancy; and (b) via virtual breastfeeding support for six months postpartum. Health professionals will be trained to deliver the intervention. The control group will receive standard care in the outpatient clinic. The pilot will help determine the intervention's feasibility. Data collected pre-intervention, 10-days postpartum and two-, four-, and six-months postpartum will provide estimates of the intervention's preliminary effects on self-efficacy and main outcomes. Research Ethics Committee approval was obtained in April 2019. DISCUSSION Breastfeeding support is a complex reality influenced by multiple factors. Therefore, approaches to breastfeeding are also, requiring interventions that address its multidimensional nature, including all actors involved. The proposed intervention will be applied by an interdisciplinary professional health team, allowing for its incorporation into standard practice and its perpetual maintenance. IMPACT The study will produce an original, comprehensive, complex intervention addressing contextual, and organizational factors to promote breastfeeding support using an interdisciplinary and family-based approach; breastfeeding self-efficacy is the core concept. The program evaluation and feasibility study will permit exploration of the integration of the intervention's novel aspects into the daily work of professionals and reveal how to better use existing resources in a full-scale clinical trial. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT03944642.
Collapse
Affiliation(s)
- Camila Lucchini-Raies
- School of Nursing, Pontificia Universidad Católica de Chile, Santiago, Chile
- Universidad de Navarra, Pamplona, Spain
| | | | - Paulina Beca
- School of Medicine, Family Health Center San Alberto Hurtado ANCORA, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - J Carola Perez
- Faculty of Psychology, Universidad del Desarrollo, Santiago, Chile
| | - Solange Campos
- School of Nursing, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | |
Collapse
|
15
|
Martin SL, McCann JK, Gascoigne E, Allotey D, Fundira D, Dickin KL. Mixed-Methods Systematic Review of Behavioral Interventions in Low- and Middle-Income Countries to Increase Family Support for Maternal, Infant, and Young Child Nutrition during the First 1000 Days. Curr Dev Nutr 2020; 4:nzaa085. [PMID: 32607463 PMCID: PMC7311193 DOI: 10.1093/cdn/nzaa085] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 05/08/2020] [Accepted: 05/13/2020] [Indexed: 02/06/2023] Open
Abstract
Fathers, grandmothers, and other family members' influence on maternal, infant, and young child nutrition (MIYCN) is widely recognized, yet synthesis of the effectiveness of engaging them to improve nutrition practices during the first 1000 d is lacking. We examined the impact of behavioral interventions to engage family members in MIYCN in low- and middle-income countries through a mixed-methods systematic review. We screened 5733 abstracts and included 35 peer-reviewed articles on 25 studies (16 with quantitative and 13 with qualitative data). Most quantitative studies focused on early breastfeeding, primarily engaging fathers or, less often, grandmothers. Most found positive impacts on exclusive breastfeeding rates and family members' knowledge and support. The few quantitative studies on complementary feeding, maternal nutrition, and multiple outcomes also suggested benefits. Qualitative themes included improved nutrition behaviors, enhanced relationships, and challenges due to social norms. Interventions engaging family members can increase awareness and build support for MIYCN, but more rigorous study designs are needed. This systematic review is registered at PROSPERO as CRD42018090273, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=90273.
Collapse
Affiliation(s)
- Stephanie L Martin
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Juliet K McCann
- Program in International Nutrition, Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Emily Gascoigne
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Diana Allotey
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dadirai Fundira
- Program in International Nutrition, Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Katherine L Dickin
- Program in International Nutrition, Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| |
Collapse
|
16
|
Fewtrell MS, Mohd Shukri NH, Wells JCK. 'Optimising' breastfeeding: what can we learn from evolutionary, comparative and anthropological aspects of lactation? BMC Med 2020; 18:4. [PMID: 31915002 PMCID: PMC6950880 DOI: 10.1186/s12916-019-1473-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 11/26/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Promoting breastfeeding is an important public health intervention, with benefits for infants and mothers. Even modest increases in prevalence and duration may yield considerable economic savings. However, despite many initiatives, compliance with recommendations is poor in most settings - particularly for exclusive breastfeeding. Mothers commonly consult health professionals for infant feeding and behavioural problems. MAIN BODY We argue that broader consideration of lactation, incorporating evolutionary, comparative and anthropological aspects, could provide new insights into breastfeeding practices and problems, enhance research and ultimately help to develop novel approaches to improve initiation and maintenance. Our current focus on breastfeeding as a strategy to improve health outcomes must engage with the evolution of lactation as a flexible trait under selective pressure to maximise reproductive fitness. Poor understanding of the dynamic nature of breastfeeding may partly explain why some women are unwilling or unable to follow recommendations. CONCLUSIONS We identify three key implications for health professionals, researchers and policymakers. Firstly, breastfeeding is an adaptive process during which, as in other mammals, variability allows adaptation to ecological circumstances and reflects mothers' phenotypic variability. Since these factors vary within and between humans, the likelihood that a 'one size fits all' approach will be appropriate for all mother-infant dyads is counterintuitive; flexibility is expected. From an anthropological perspective, lactation is a period of tension between mother and offspring due to genetic 'conflicts of interest'. This may underlie common breastfeeding 'problems' including perceived milk insufficiency and problematic infant crying. Understanding this - and adopting a more flexible, individualised approach - may allow a more creative approach to solving these problems. Incorporating evolutionary concepts may enhance research investigating mother-infant signalling during breastfeeding; where possible, studies should be experimental to allow identification of causal effects and mechanisms. Finally, the importance of learned behaviour, social and cultural aspects of primate (especially human) lactation may partly explain why, in cultures where breastfeeding has lost cultural primacy, promotion starting in pregnancy may be ineffective. In such settings, educating children and young adults may be important to raise awareness and provide learning opportunities that may be essential in our species, as in other primates.
Collapse
Affiliation(s)
- Mary S Fewtrell
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.
| | - Nurul H Mohd Shukri
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.,Department of Nutrition & Dietetics, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| |
Collapse
|
17
|
Cameron AJ, Charlton E, Walsh A, Hesketh K, Campbell K. The influence of the maternal peer group (partner, friends, mothers' group, family) on mothers' attitudes to obesity-related behaviours of their children. BMC Pediatr 2019; 19:357. [PMID: 31619191 PMCID: PMC6794892 DOI: 10.1186/s12887-019-1726-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 09/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Relationships with others can have an impact on the attitudes of new mums to the obesity-related behaviours of their children. The aim of this study was to understand the degree to which other new mums (from their mothers' group), friends, partners, and other family members have an influence on maternal attitudes to child feeding, physical activity and television viewing behaviours in order to more accurately target obesity prevention interventions. METHODS In a retrospective cohort study design using data from the InFANT randomized controlled trial, first-time mothers (n = 307) from Melbourne, Australia were asked in 2012-13 how much of an influence their partner, friends, mothers' group and family were on their attitudes to their pre-school aged child's feeding, physical activity and television viewing behaviours. The level of influence was examined using chi-square tests, t-tests, and analysis of variance, stratified by maternal education, age and body weight. We also examined associations between the influence of others on maternal attitudes and actual behaviours including breastfeeding duration, age at introduction of solid food and time their child spent outside. RESULTS Mothers rated partners as having the strongest influence on their attitudes toward all obesity-related behaviours. The percentage reporting partners as a major influence were 28.7% (95% CI 23.8,34.0), 33.1% (28.0, 38.6) and 24.2% (19.6, 29.3) for child feeding, physical activity and television viewing, respectively. More highly educated mothers rated social connections as more influential than less educated mothers. The influence of partners on attitudes toward child feeding was associated with longer breastfeeding duration. CONCLUSIONS Mothers rated partners as a powerful influence on their attitudes toward the obesity-related behaviours of their pre-school children, suggesting that partners could be an important target of obesity-prevention initiatives. Since less educated mothers reported peers and family as a much weaker influence on their attitudes to obesity-related behaviours than more educated mothers, equity should be taken into consideration when contemplating obesity-prevention interventions that target mothers' groups.
Collapse
Affiliation(s)
- Adrian J Cameron
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia.
| | - Emma Charlton
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Adam Walsh
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Kylie Hesketh
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Karen Campbell
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| |
Collapse
|
18
|
Bich TH, Long TK, Hoa DP. Community-based father education intervention on breastfeeding practice-Results of a quasi-experimental study. MATERNAL AND CHILD NUTRITION 2019; 15 Suppl 1:e12705. [PMID: 30748110 DOI: 10.1111/mcn.12705] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 09/12/2018] [Accepted: 09/19/2018] [Indexed: 12/17/2022]
Abstract
Although the benefits of breastfeeding are well-documented, little is known about how best to encourage fathers to support breastfeeding. A quasi-experimental study of a community-based intervention was designed to examine whether health education to promote fathers' involvement in supporting women is associated with early initiation and exclusive breastfeeding practices. At baseline, 802 couples of fathers with pregnant wives from 12 to 27 weeks of gestational age were recruited to either the intervention group (n = 390) or a control group (n = 412) consisting of couples seeking care through routine maternal and child health services. Fathers in the intervention area received breastfeeding education and counselling services in health facilities and at home visits during the antenatal, delivery, and post-partum periods. Peer education and social exchange concerning breastfeeding were organized in fathers' clubs. After 1 year of the intervention, mothers in the intervention group were more likely to initiate early breastfeeding 49.2 and 35.8% in the intervention and control group respectively, P < 0.001. At 1, 4, and 6 months after birth, 34.8, 18.7, and 1.9% of the mothers in the intervention group were exclusively breastfeeding their children because of birth, respectively, compared with 5.7, 4.0, and 0.0% of those in the control group (P < 0.001). Those practices were associated with the intervention in bivariate and multivariate logistic and Cox regression analyses. Intervention targeting fathers at antenatal and postnatal periods may positively influence the breastfeeding practices of mothers, and it should be an important component of breastfeeding programs.
Collapse
|
19
|
Fiorella KJ, Gavenus ER, Milner EM, Moore M, Wilson‐Anumudu F, Adhiambo F, Mattah B, Bukusi E, Fernald LCH. Evaluation of a social network intervention on child feeding practices and caregiver knowledge. MATERNAL & CHILD NUTRITION 2019; 15:e12782. [PMID: 30676696 PMCID: PMC7199033 DOI: 10.1111/mcn.12782] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/30/2018] [Accepted: 01/09/2019] [Indexed: 01/04/2023]
Abstract
Food insecurity and poor infant and young child feeding (IYCF) practices contribute to undernutrition. The Kanyakla Nutrition Program was developed in rural Kenya to provide knowledge alongside social support for recommended IYCF practices. Utilizing a social network approach, the Kanyakla Nutrition Program trained community health workers (CHWs) to engage mothers, fathers, and grandparents in nutrition education and discussions about strategies to provide instrumental, emotional, and information support within their community. The 12-week programme included six sessions and was implemented on Mfangano Island, Kenya, in 2014-2015. We analysed intervention effects on (a) nutrition knowledge among community members or CHWs and (2) IYCF practices among children 1-3 years. Nutrition knowledge was assessed using a postintervention comparison among intervention (community, n = 43; CHW, n = 22) and comparison groups (community, n = 149; CHW, n = 64). We used a quasi-experimental design and difference-in-difference to assess IYCF indicators using dietary recall data from an ongoing cohort study among intervention participants (n = 48) with individuals living on Mfangano Island where the intervention was not implemented (n = 178) before the intervention, within 1 month postintervention, and 6 months postintervention. Findings showed no effect of the intervention on IYCF indicators (e.g., dietary diversity and meal frequency), and less than 15% of children met minimum acceptable diet criteria at any time point. However, knowledge and confidence among community members and CHWs were significantly higher 2 years postintervention. Thus, a social network approach had an enduring effect on nutrition knowledge, but no effects on improved IYCF practices.
Collapse
Affiliation(s)
- Kathryn J. Fiorella
- Department of Population Medicine and Diagnostic SciencesCornell UniversityIthacaNew YorkUSA
- Master of Public Health ProgramCornell UniversityIthacaNew YorkUSA
| | - Erika R. Gavenus
- Institute for Resources, Environment and SustainabilityUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | | | - Megan Moore
- Global Health SciencesUCSFSan FranciscoCaliforniaUSA
| | | | | | - Brian Mattah
- Research DepartmentOrganic Health ResponseMbitaKenya
| | | | | |
Collapse
|
20
|
Davidson EL, Ollerton RL. Partner behaviours improving breastfeeding outcomes: An integrative review. Women Birth 2019; 33:e15-e23. [PMID: 31196832 DOI: 10.1016/j.wombi.2019.05.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/23/2019] [Accepted: 05/23/2019] [Indexed: 01/30/2023]
Abstract
PROBLEM The impact of specific supportive behaviours of a woman's partner on breastfeeding outcomes is unclear. BACKGROUND Breastfeeding is beneficial for the infant, mother, and society. Partner support plays a significant role in promoting breastfeeding. Strategies to improve breastfeeding rates have had limited success with rates worldwide remaining well below World Health Organization recommendations, contributing to significant morbidity, mortality, and economic burden globally. AIM To determine what specific supportive behaviours of a breastfeeding woman's partner increase breastfeeding initiation, exclusivity, and duration rates in Western-culture settings. METHODS A Population-Interest-Context framework-based search strategy was applied to the Cumulative Index to Nursing Allied Health Literature Plus with full-text, Web of Science, Scopus, and PubMed databases, limited to primary research published January 2008-December 2018 in English conducted in Western-culture settings. FINDINGS From 652 articles, after critical appraisal seven articles (eight studies) satisfied the requirements of this integrative review. Supportive behaviours were categorised as knowledge, help, encouragement, and responsiveness. Help and encouragement behaviours were associated with increased initiation. Results were mixed regarding behaviours affecting exclusivity and duration; however, responsiveness was found to ameliorate otherwise generally negative effects of knowledge, help, and encouragement on these outcomes. DISCUSSION Consistent with wider social support research, awareness of receiving support is associated with negative health consequences. However, where partner support is provided in a responsive manner as part of a 'breastfeeding team', thereby promoting the woman's sense of autonomy and self-efficacy, breastfeeding outcomes improve. CONCLUSION Responsive partner behaviours improved breastfeeding outcomes in Western-culture settings. Further primary research is needed.
Collapse
Affiliation(s)
- Eirwyn L Davidson
- Port Macquarie Base Hospital, Mid North Coast Local Health District, NSW Health, Australia.
| | - Richard L Ollerton
- Charles Sturt University, School of Computing & Mathematics, NSW, Australia
| |
Collapse
|
21
|
Abbass-Dick J, Brown HK, Jackson KT, Rempel L, Dennis CL. Perinatal breastfeeding interventions including fathers/partners: A systematic review of the literature. Midwifery 2019; 75:41-51. [PMID: 30999255 DOI: 10.1016/j.midw.2019.04.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 02/23/2019] [Accepted: 04/02/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Support from fathers is consistently associated with improved breastfeeding duration and exclusivity rates. Additionally, there is growing evidence that fathers want to be included in breastfeeding interventions provided by health care professionals. The objective of this review was to determine the effect of partner-inclusive educational and psychosocial interventions on breastfeeding initiation, duration, and exclusivity. DESIGN A systematic review was conducted using a search strategy developed with an expert health sciences librarian. Electronic databases MEDLINE, EMBASE, CINAHL, and PsycINFO were systematically searched for randomized controlled trials and quasi-experimental studies from inception to August 4, 2018. Independent data extraction and quality assessments were conducted by authors using Cochrane Collaboration tools. Due to significant heterogeneity in intervention content, outcome measures, and follow-up time points, data were synthesized qualitatively. FINDINGS 3982 articles were identified, of which 12 studies in 15 publications met the inclusion criteria and were included. All of the studies improved at least one breastfeeding outcome, including duration (n = 5/9) and exclusivity (n = 8/10) up to 24 weeks postpartum. Six studies examined increasing paternal breastfeeding support and all found beneficial effects. Biases were identified in the studies with the most common bias relating to the randomization process and the blinding of outcome assessors. IMPLICATIONS FOR PRACTICE The inclusion of fathers/partners in breastfeeding interventions improves breastfeeding initiation, duration, and exclusivity rates. Interventions that include face-to-face information delivery, are designed in a culturally appropriate manner, and provide information on how partners can support breastfeeding are more likely to have a beneficial effect. Research is warranted to examine the underlying intervention mechanisms.
Collapse
|
22
|
Kothari A, Thayalan K, Dulhunty J, Callaway L. The forgotten father in obstetric medicine. Obstet Med 2019; 12:57-65. [PMID: 31217809 DOI: 10.1177/1753495x18823479] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 01/20/2023] Open
Abstract
The role of fathers prior to conception, during pregnancy, and in the post-partum period has generally not been a key consideration for Obstetric Physicians. However, this view may need challenging. This paper outlines the key importance of fathers in all phases of obstetric medical care. We review the contribution of paternal factors such as genetics, health, and lifestyle to fetal development, pregnancy complications, and maternal and neonatal wellbeing. The role of fathers in complex care decisions during pregnancy is also reviewed. Postpartum, fathers have a substantial role in shaping the future of the family unit through encouraging breastfeeding and creating a supportive environment for motherhood. This review proposes areas for future research and recommends an evidence-based change in practice in obstetric medicine that focuses on recognizing the role of fathers in the pregnancy journey.
Collapse
Affiliation(s)
- A Kothari
- University of Queensland, Brisbane, Australia.,Department of Obstetrics and Gynaecology, Redcliffe Hospital, Brisbane, Australia
| | - K Thayalan
- University of Queensland, Brisbane, Australia.,Department of Obstetrics and Gynaecology, The Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - J Dulhunty
- University of Queensland, Brisbane, Australia.,Medical Administration, Redcliffe Hospital, Brisbane, Australia
| | - L Callaway
- University of Queensland, Brisbane, Australia.,Department of Obstetric Medicine, The Royal Brisbane and Women's Hospital, Brisbane, Australia
| |
Collapse
|
23
|
Robinson A, Lauckner C, Davis M, Hall J, Anderson AK. Facebook support for breastfeeding mothers: A comparison to offline support and associations with breastfeeding outcomes. Digit Health 2019; 5:2055207619853397. [PMID: 31218076 PMCID: PMC6560800 DOI: 10.1177/2055207619853397] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 05/06/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES For breastfeeding mothers, online support groups through Facebook may be a more convenient and preferred source for accessing breastfeeding information and support, but few studies exist that examine the use of Facebook groups specifically for breastfeeding support. This study explores the sources of support among users of Facebook breastfeeding support groups and a possible mechanism by which support received on Facebook may translate to behavioral outcomes among breastfeeding mothers. METHODS From July-September 2017 a survey was distributed online to African American mothers (N = 277) who participate in breastfeeding support groups on Facebook. The survey assessed network support from Facebook and other sources of breastfeeding support, perceived breastfeeding norms, breastfeeding self-efficacy and breastfeeding attitudes. Correlations and linear regression analysis were used to examine the relationship between covariates and outcome variables. RESULTS The average intended breastfeeding duration among participants in this study was 19 months. Participants reported the highest amount of breastfeeding support received from their Facebook support group, in comparison to other sources of support, and Facebook support was significantly correlated with intended breastfeeding duration (p < 0.05). Self-efficacy and breastfeeding attitudes remained significant predictors of intended breastfeeding duration within the final regression model. CONCLUSIONS Breastfeeding support received within Facebook groups may compensate for inadequate support received within mothers' networks. More research is needed to understand the mechanism through which Facebook support may contribute to prolonged breastfeeding durations.
Collapse
|
24
|
Wierstra K, Sutton R, Bal J, Ismond K, Dieleman L, Halloran B, Kroeker K, Fedorak R, Berga KA, Huang V. Innovative Online Educational Portal Improves Disease-Specific Reproductive Knowledge Among Patients With Inflammatory Bowel Disease. Inflamm Bowel Dis 2018; 24:2483-2493. [PMID: 29850827 DOI: 10.1093/ibd/izy161] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is often diagnosed in early adulthood, affecting patients through their reproductive years. Many patients, lacking knowledge about IBD and reproduction, make uninformed decisions. Although patients have turned to the Internet for information, it remains unclear if online resources are effective for improving and retaining IBD-specific reproductive knowledge. We aimed to elucidate if a multimedia vs text-only online educational intervention could improve IBD-specific reproductive knowledge for more than 6 months. METHODS We developed a website covering genetics, fertility, surgery, pregnancy, medications, delivery, and postpartum in the context of IBD. Adult IBD patients were randomized into study groups (multimedia or text-only) and provided 60-day access. Participants completed pre-, post-, and 6+ month-postintervention pregnancy knowledge (CCPKnow) questionnaires. Results were compared using nonparametric tests. RESULTS Of 111 registered participants, 78 (70.3%) completed pre- and postintervention questionnaires, and 37 (47.4%) subsequently completed the 6+ month questionnaire. Demographics were as follows: median age (interquartile range [IQR]) 29.3 (25.6-32.9) years, Crohn's disease n = 54 (69.2%), females n = 63 (80.3%), of which n = 5 (7.9%) were pregnant and n = 19 (30.2%) had previously been pregnant. The median CCPKnow scores (/17) (IQR) were 8.0 (3.0-10.0) pre-intervention, 16.0 (13.00-17.00) postintervention, and 14.0 (12.0-15.0) 6+ months postintervention. The median within-subject increase in score was 6.5 pre- to postintervention, and 4.0 pre- to 6+ months postintervention (both P < 0.001). The median increase in score (pre- to post-) was 8.0 for the multimedia group and 6.0 for the text-only group (P = 0.216). CONCLUSIONS An evidence-based, online educational portal can significantly improve and maintain IBD-specific reproductive patient knowledge for more than 6 months.
Collapse
Affiliation(s)
- Kelsey Wierstra
- Division of Gastroenterology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Reed Sutton
- Division of Gastroenterology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Jasmin Bal
- Division of Gastroenterology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Kathleen Ismond
- Division of Gastroenterology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Levinus Dieleman
- Division of Gastroenterology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Brendan Halloran
- Division of Gastroenterology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Karen Kroeker
- Division of Gastroenterology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Richard Fedorak
- Division of Gastroenterology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Keri-Ann Berga
- Faculty of Nursing, MacEwan University, Edmonton, AB, Canada
| | - Vivian Huang
- Division of Gastroenterology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
25
|
Mahesh PKB, Gunathunga MW, Arnold SM, Jayasinghe C, Pathirana S, Makarim MF, Manawadu PM, Senanayake SJ. Effectiveness of targeting fathers for breastfeeding promotion: systematic review and meta-analysis. BMC Public Health 2018; 18:1140. [PMID: 30249216 PMCID: PMC6154400 DOI: 10.1186/s12889-018-6037-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 09/13/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Further research gaps exist in relation to the promotion of breastfeeding. Robust scientific evidence obtained by a meta-analysis would provide objectively summarized data while enabling the assessment of consistency of findings. This review includes the first documented meta-analysis done on the effectiveness of targeting fathers for promoting breastfeeding (BF). Assessments have been done for a primary outcome and for six more secondary outcomes. METHODS PubMed, EMBASE, Google Scholar, CENTRAL databases and unpublished researches were searched. Selections of randomized-controlled trials and quasi-experimental studies were done in three rounds. Heterogeneity and potential publication bias were assessed. Eight studies were included in meta-analysis and others in narrative synthesis of the outcomes. Pooling was done with the Mental- Haenszel method using risk ratio (RR). Summary-of-Findings table was composed by Review-Manager (version 5.3) and GRADEproGDT applications. Subsequent sensitivity analysis was done. RESULTS Selected eight interventional studies included 1852 families. Exclusive BF at six months was significantly higher (RR = 2.04, CI = 1.58-2.65) in the intervention groups. The RR at 4 months was 1.52 (CI = 1.14 to 2.03). Risk of full-formula-feeding (RR = 0.69, CI = 0.52-0.93) and the occurrence of lactation-related problems were lower in the intervention groups (RR = 0.24, CI = 0.10-0.57). More likelihood of rendering support in BF-related issues was seen in intervention groups (RR = 1.43, CI = 1.22-1.68). Increase of maternal knowledge and favorable attitudes on BF were higher in the intervention groups (P ≤; 0.001). The quality of evidence according to GRADE was "low" (for one outcome), "moderate" (for four outcomes), and "high" (for two outcomes). CONCLUSIONS Targeting fathers in promotion of BF has provided favorable results for all seven outcomes with satisfactory quality of evidence. This review was registered in the PROSPERO-registry (ID: 2017-CRD42017076163) prior to its commencement.
Collapse
|
26
|
Carreiro JDA, Francisco AA, Abrão ACFDV, Marcacine KO, Abuchaim EDSV, Coca KP. Dificuldades relacionadas ao aleitamento materno: análise de um serviço especializado em amamentação. ACTA PAUL ENFERM 2018. [DOI: 10.1590/1982-0194201800060] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Analisar a associação entre o tipo de aleitamento e as dificuldades relacionadas à essa prática entre mulheres e crianças assistidas em um ambulatório especializado em amamentação. Métodos Estudo transversal retrospectivo realizado por meio da análise de prontuários de crianças e mulheres atendidas entre 2004 e 2016 em um ambulatório especializado em aleitamento materno. Foram excluídos os registros referentes às mulheres com gestação múltipla e àqueles não realizados em formulário padrão, totalizando 1.608 prontuários. Utilizaram-se os testes Qui-Quadrado e Kruskal-Wallis para comparar o tipo de aleitamento materno com variáveis categóricas; e com os dias de vida e idade materna, respectivamente. O teste Mann-Whitney utilizou-se para comparar a frequência do aleitamento materno exclusivo. Resultados O aleitamento materno exclusivo foi praticado por 72,6% das mulheres atendidas, nos primeiros 30 dias após o parto. Houve associação significativa entre esta prática e as dificuldades: percepção materna quanto à quantidade de leite produzida, de mamas cheias antes das mamadas, de vazamento de leite e extração manual do leite com facilidade; posicionamento materno e da criança, preensão, sucção e deglutição da criança adequados; além das variáveis: maior escolaridade, situação conjugal estável; ter tido experiência prévia com aleitamento materno, ter mamilos protrusos, ter realizado contato precoce pele a pele, ter filhos com menor média de dias de idade e que faziam uso de chupeta. Conclusão O aleitamento materno exclusivo foi o mais prevalente nos primeiros 30 dias pós-parto e diversas variáveis maternas e neonatais estiveram associadas à essa prática no primeiro atendimento em ambulatório especializado.
Collapse
|
27
|
Tadesse K, Zelenko O, Mulugeta A, Gallegos D. Effectiveness of breastfeeding interventions delivered to fathers in low- and middle-income countries: A systematic review. MATERNAL AND CHILD NUTRITION 2018; 14:e12612. [PMID: 29740958 DOI: 10.1111/mcn.12612] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 03/09/2018] [Accepted: 03/15/2018] [Indexed: 11/29/2022]
Abstract
Adequate support for lactating mothers is crucial to improve the rates of early initiation, exclusive, and continued breastfeeding. Maternal breastfeeding intention and ongoing breastfeeding duration are strongly predicted by their partners' breastfeeding beliefs. Partner support has a significant effect on improving rates of any and exclusive breastfeeding, when compared with professional support, particularly in low-income populations. This systematic review investigates the effectiveness of breastfeeding interventions targeting fathers in low- and middle-income countries (LMIC). A systematic literature search was undertaken on Medline (EBSCOhost), PsycInfo, CINAHL, and Scopus databases and via manual searching. Inclusion criteria were experimental or quasiexperimental designs targeting fathers from LMIC, which measured either breastfeeding initiation, breastfeeding exclusivity, or duration of breastfeeding as the main outcomes. No time restriction was put in place, and all articles were published in English. The quality of selected papers was assessed using the Joanna Briggs Institute tool. A total of 8 articles were included from 6 interventions: 2 quasiexperimental and 4 randomized control trials. All interventions involved breastfeeding education targeting fathers; 2 were given only to fathers, and 4 delivered to both fathers and mothers. Among these interventions, 2 measured both early initiation and exclusive breastfeeding; one exclusive breastfeeding only; one exclusive breastfeeding, knowledge, and attitudes; one exclusive breastfeeding and knowledge; and one breastfeeding, continued breastfeeding, and awareness. Across all interventions, breastfeeding education showed significant improvement in breastfeeding outcomes in the intervention compared with the control groups. In summary, breastfeeding education interventions targeting fathers in LMIC are effective in improving early initiation of breastfeeding, exclusive breastfeeding, and continued breastfeeding. Thus, breastfeeding promotion should consider the education and involvement of fathers in the intervention.
Collapse
Affiliation(s)
- Kidane Tadesse
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queesnland, Australia.,School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Oksana Zelenko
- School of Design, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Afework Mulugeta
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Danielle Gallegos
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queesnland, Australia
| |
Collapse
|
28
|
Mesters I, Gijsbers B, Bartholomew LK. Promoting Sustained Breastfeeding of Infants at Risk for Asthma: Explaining the "Active Ingredients" of an Effective Program Using Intervention Mapping. Front Public Health 2018; 6:87. [PMID: 29616209 PMCID: PMC5869925 DOI: 10.3389/fpubh.2018.00087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 03/05/2018] [Indexed: 12/01/2022] Open
Abstract
Infants whose parents and/or siblings have a history of asthma or allergy may profit from receiving exclusive breastfeeding during the first 6 months of life. This is expected to diminish the chance of developing childhood asthma and/or atopic disease. Ongoing breastfeeding for 6 months seems challenging for many women. An educational program was developed using Intervention Mapping as a logic model to guide development and was found successful in improving breastfeeding rates at 6 months postpartum, improving knowledge and beliefs about breastfeeding for 6 months, after exposure to the program compared to controls. Intervention elements included an evidence- and theory-based booklet addressed during pre- and postnatal home visits by trained assistants. This paper elucidates the inner workings of the program by systematically describing and illustrating the steps for intervention development.
Collapse
Affiliation(s)
- Ilse Mesters
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Barbara Gijsbers
- Department of General Practice, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - L Kay Bartholomew
- Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX, United States
| |
Collapse
|
29
|
Abstract
BACKGROUND Although breastfeeding is associated with proven benefits to both mother and child, there are many factors that influence a mother's decision to breastfeed. Pregnancy intentionality at the time of conception is associated with postpartum maternal behavior including breastfeeding. Research aim: We sought to understand how maternal and paternal pregnancy intentions were associated with breastfeeding initiation and duration in a nationally representative sample. METHODS We used a cross-sectional, retrospective study of the CDC National Survey of Family Growth data to examine the link between pregnancy intentionality and breastfeeding initiation and duration among women ages 15 to 44 years. RESULTS We found that whereas the mother's intention to have a child was a factor in how long she breastfed, the paternal intention to have a child predicted whether the mother breastfed at all. Additionally, Hispanic mothers were most likely to breastfeed and breastfed the longest of any other group. Age and education were also positive predictors of ever breastfeeding. CONCLUSION Understanding the father's and mother's attitudes toward the pregnancy and influence on breastfeeding intention is important for intervention planning.
Collapse
Affiliation(s)
- Shimrit Keddem
- 1 Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA.,2 VISN 4 Center for the Evaluation of Patient Aligned Care Teams, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Rosemary Frasso
- 3 Master of Public Health Program, College of Population Health, Jefferson University, Philadelphia, PA, USA
| | - Melissa Dichter
- 4 Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA.,5 Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Alexandra Hanlon
- 6 School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
30
|
Garfield CF. Toward Better Understanding of How Fathers Contribute to Their Offspring's Health. Pediatrics 2018; 141:peds.2017-3461. [PMID: 29229681 DOI: 10.1542/peds.2017-3461] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2017] [Indexed: 11/24/2022] Open
Affiliation(s)
- Craig F Garfield
- Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; and Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| |
Collapse
|
31
|
Abbass-Dick J, Dennis CL. Maternal and paternal experiences and satisfaction with a co-parenting breastfeeding support intervention in Canada. Midwifery 2018; 56:135-141. [DOI: 10.1016/j.midw.2017.10.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 09/29/2017] [Accepted: 10/11/2017] [Indexed: 11/25/2022]
|
32
|
Yourkavitch JM, Alvey JL, Prosnitz DM, Thomas JC. Engaging men to promote and support exclusive breastfeeding: a descriptive review of 28 projects in 20 low- and middle-income countries from 2003 to 2013. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2017; 36:43. [PMID: 29246194 PMCID: PMC5732415 DOI: 10.1186/s41043-017-0127-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 11/27/2017] [Indexed: 05/31/2023]
Abstract
BACKGROUND Lay support has been associated with improved breastfeeding practices, but studies of programs that engage men in breastfeeding support have shown mixed results and most are from high-income countries. The purpose of our research is to review strategies to engage men in exclusive breastfeeding (EBF) promotion or support in 28 project areas across 20 low- and middle-income countries. This information may be used to inform program implementers and policymakers seeking to increase EBF. METHODS We tested the difference between baseline and final EBF proportions using Pearson's chi-square (a = 0.05) and identified project areas with a significant increase. We categorized male engagement strategies as low- and high-intensity, using information from project reports. We looked for patterns by intensity and geography and described strategies used to engage men in different places. RESULTS Twenty-eight projects were reviewed; 21 (75%) were in areas where a statistically significant increase in EBF was observed between the beginning and end of the project. A variety of high- and low-intensity male engagement strategies was used in areas with an increase in EBF prevalence and in all geographic regions. High-intensity strategies engaged men directly during home or health visits by forming men's groups and by working with male community leaders or members to promote EBF. Low-intensity strategies included large community meetings that included men, and radio messages, and other behavior change materials directed towards men. CONCLUSION Male engagement strategies took many forms in these project areas. We did not find consistent associations between the intensities or types of male engagement strategies and increases in EBF proportions. There is a gap in understanding how gender norms might impact male involvement in women's health behaviors. This review does not support the broad application of male engagement to improve EBF practices, and we recommend considering local gender norms when designing programs to support women to EBF.
Collapse
Affiliation(s)
- Jennifer M. Yourkavitch
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599-7435 USA
| | - Jeniece L. Alvey
- Public Health Institute/Global Health Fellows Program II, Washington, DC, USA
| | - Debra M. Prosnitz
- Division of International Health and Development ICF, Rockville, MD USA
| | - James C. Thomas
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599-7435 USA
| |
Collapse
|
33
|
deMontigny F, Gervais C, Larivière-Bastien D, St-Arneault K. The role of fathers during breastfeeding. Midwifery 2017; 58:6-12. [PMID: 29272696 DOI: 10.1016/j.midw.2017.12.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 12/01/2017] [Accepted: 12/02/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE identify fathers' perceptions of their role in a breastfeeding context. SETTING three different geographic areas (urban, semi-urban, and rural) of Quebec, a francophone province in Canada. PARTICIPANTS 43 fathers whose children had been exclusively breastfed for a minimum of six months. METHODS a qualitative study using semi-structured interviews was undertaken. Thematic analysis of the interviews was carried out with NVivo 11. FINDINGS variations were identified in the role of father during breastfeeding, namely, 1) acting as partners in decision-making; 2) being responsible for the family functioning, and 3) providing emotional support to the mother. These different variants each entail challenges and tasks. KEY CONCLUSIONS participating fathers perceived their role as much more complex than the limited role of breastfeeding facilitator that is usually attributed to them. Fathers saw themselves as stakeholders in decision-making relating to how their child was fed and they reacted to the imbalance created by breastfeeding. Their involvement occurred at several levels: that of their child, their spouse, and their family. IMPLICATIONS FOR PRACTICE these results suggest that more attention should be given to fathers' roles in a breastfeeding context and more investigation is required into the extent to which health professionals, such as midwives and nurses, support fathers in managing these various roles and the challenges they entail.
Collapse
Affiliation(s)
- Francine deMontigny
- Canadian Research Chair in Psychosocial Family Health, Center of Research and Studies in Family Intervention, Université du Québec en Outaouais, Gatineau, Québec, Canada.
| | - Christine Gervais
- Center of Research and Studies in Family Intervention, Université du Québec en Outaouais, Gatineau, Québec, Canada
| | - Danaë Larivière-Bastien
- Center of Research and Studies in Family Intervention, Université du Québec en Outaouais, Gatineau, Québec, Canada
| | - Kate St-Arneault
- Center of Research and Studies in Family Intervention, Université du Québec en Outaouais, Gatineau, Québec, Canada
| |
Collapse
|
34
|
Nourishing networks: A social-ecological analysis of a network intervention for improving household nutrition in Western Kenya. Soc Sci Med 2017; 197:95-103. [PMID: 29223686 DOI: 10.1016/j.socscimed.2017.11.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/03/2017] [Accepted: 11/15/2017] [Indexed: 11/20/2022]
Abstract
RATIONALE A growing body of research emphasizes the need to engage social networks in maternal and child nutrition interventions. However, an understanding of how interventions functionally engage not only mothers but fathers, grandparents, friends, and other social network members remains limited. OBJECTIVE This study uses an adaptation of a social-ecological model to analyze the multiple levels at which the Kanyakla Nutrition Program operates to change behavior. METHODS This study analyzes focus group data (four groups; n = 35, 7 men and 28 women) following the implementation of the Kanyakla Nutrition Program, a novel nutrition intervention engaging social networks to increase nutrition knowledge, shift perceptions, and promote positive practices for infant and young child feeding and community nutrition in general. RESULTS Participant perspectives indicate that the Kanyakla Nutrition Program contributed to nutrition knowledge and confidence, changed perceptions, and supported infant and child feeding practices at the individual, interpersonal, and institutional levels. However, many respondents report challenges in transcending barriers at the broader community and systems levels of influence, where environmental and economic constraints continue to affect food access. CONCLUSION Analysis of the Kanyakla Nutrition Program suggests that for interventions addressing household level determinants of nutrition, simultaneously engaging the household's network of interpersonal and community relationships can play a role in building momentum and consensus to address persistent structural barriers to improved nutrition.
Collapse
|
35
|
Boccolini CS, Boccolini PDMM, Monteiro FR, Venâncio SI, Giugliani ERJ. Breastfeeding indicators trends in Brazil for three decades. Rev Saude Publica 2017; 51:108. [PMID: 29166437 PMCID: PMC5697916 DOI: 10.11606/s1518-8787.2017051000029] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 09/26/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Update breastfeeding indicators trend in Brazil for the last three decades, incorporating more up-to-date information from the National Health Survey. METHODS We used secondary data from national surveys with information on breastfeeding (1986, 1996, 2006, and 2013) to construct the time series of prevalence for the following indicators: exclusive breastfeeding in children under six months of age (EBF6m), breastfeeding in toddlers under 2 years of age (BF), continued breastfeeding at one year of age (BF1year), and continued breastfeeding at two years of age (BF2years). RESULTS The prevalence of EBF6m, BF, and BF1year increased until 2006 (rising from 4.7%, 37.4%, and 25.5% in 1986 to 37.1%, 56.3%, and 47.2% in 2006, respectively). For these three indicators, there was relative stabilization between 2006 and 2013 (36.6%, 52.1%, and 45.4%, respectively). The BF2years indicator had a distinct behavior - relatively stable prevalence, around 25% between 1986 and 2006, and a subsequent increase, reaching 31.8% in 2013. CONCLUSIONS The time series of breastfeeding indicators in Brazil shows an upward trend until 2006, stabilizing from that date onwards on three of the four indicators evaluated. This result, which can be considered as a warning sign, requires evaluation and revision of policies and programs to promote, protect and support breastfeeding, strengthening existing ones and proposing new strategies so that the prevalence of breastfeeding indicators returns to an upwards trend.
Collapse
Affiliation(s)
- Cristiano Siqueira Boccolini
- Laboratório de Informações em Saúde. Instituto de Comunicação e Informação Científica e Tecnologia em Saúde. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | | | - Fernanda Ramos Monteiro
- Coordenadora Nacional das Políticas de Aleitamento Materno. Departamento de Ações Programáticas Estratégicas. Ministério da Saúde. Brasília, DF, Brasil
| | | | - Elsa Regina Justo Giugliani
- Departamento de Pediatria. Faculdade de Medicina. Universidade Federal do Rio Grande do Sul. Porto Alegre, RS, Brasil
| |
Collapse
|
36
|
The breastfeeding problematic: Negotiating maternal sexuality in heterosexual partnerships. WOMENS STUDIES INTERNATIONAL FORUM 2017. [DOI: 10.1016/j.wsif.2017.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
37
|
Affiliation(s)
- David L Bell
- 1 Department of Population and Family Health, Columbia University Medical Center , New York, New York.,2 Promundo, Washington, DC
| |
Collapse
|
38
|
Nilsson IMS, Strandberg‐Larsen K, Knight CH, Hansen AV, Kronborg H. Focused breastfeeding counselling improves short- and long-term success in an early-discharge setting: A cluster-randomized study. MATERNAL & CHILD NUTRITION 2017; 13:e12432. [PMID: 28194877 PMCID: PMC7082818 DOI: 10.1111/mcn.12432] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 11/26/2016] [Accepted: 01/09/2017] [Indexed: 11/27/2022]
Abstract
Length of postnatal hospitalization has decreased and has been shown to be associated with infant nutritional problems and increase in readmissions. We aimed to evaluate if guidelines for breastfeeding counselling in an early discharge hospital setting had an effect on maternal breastfeeding self-efficacy, infant readmission and breastfeeding duration. A cluster randomized trial was conducted and assigned nine maternity settings in Denmark to intervention or usual care. Women were eligible if they expected a single infant, intended to breastfeed, were able to read Danish, and expected to be discharged within 50 hr postnatally. Between April 2013 and August 2014, 2,065 mothers were recruited at intervention and 1,476 at reference settings. Results show that the intervention did not affect maternal breastfeeding self-efficacy (primary outcome). However, less infants were readmitted 1 week postnatally in the intervention compared to the reference group (adjusted OR 0.55, 95% CI 0.37, -0.81), and 6 months following birth, more infants were exclusively breastfed in the intervention group (adjusted OR 1.36, 95% CI 1.02, -1.81). Moreover, mothers in the intervention compared to the reference group were breastfeeding more frequently (p < .001), and spend more hours skin to skin with their infants (p < .001). The infants were less often treated for jaundice (p = 0.003) and there was more paternal involvement (p = .037). In an early discharge hospital setting, a focused breastfeeding programme concentrating on increased skin to skin contact, frequent breastfeeding, good positioning of the mother infant dyad, and enhanced involvement of the father improved short-term and long-term breastfeeding success.
Collapse
Affiliation(s)
- Ingrid M. S. Nilsson
- The Danish Committee for Health EducationCopenhagenDenmark
- Department of Public Health, Section of NursingAarhus UniversityAarhusDenmark
- Department of Public health, Section of Social MedicineCopenhagen UniversityCopenhagenDenmark
| | | | - Christopher H. Knight
- Institute of Veterinary Clinical and Animal SciencesCopenhagen UniversityCopenhagenDenmark
| | - Anne Vinkel Hansen
- Department of Public health, Section of Social MedicineCopenhagen UniversityCopenhagenDenmark
| | - Hanne Kronborg
- Department of Public Health, Section of NursingAarhus UniversityAarhusDenmark
| |
Collapse
|
39
|
Abbass-Dick J, Brolly M, Huizinga J, Newport A, Xie F, George S, Sterken E. Designing an eHealth Breastfeeding Resource With Indigenous Families Using a Participatory Design. J Transcult Nurs 2017; 29:480-488. [PMID: 29308703 DOI: 10.1177/1043659617731818] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The traditional practice of breastfeeding has been negatively affected by the historical trauma experienced by the Canadian Indigenous community. Culturally relevant information and support should be created to enable the communities to reclaim this traditionally revered infant feeding method. The objective of this participatory design study was to work in partnership with Indigenous communities to create an eHealth breastfeeding resource for Indigenous families. METHODOLOGY In partnership with Indigenous mothers and care providers in Ontario, Canada, an eHealth breastfeeding resource was designed based on their recommendations. Once the new resource was created, it was evaluated by additional Indigenous mothers. RESULTS The participants indicated the resource was culturally relevant and that they liked the content and design. DISCUSSION Using a participatory design when creating services and programs in partnership with Indigenous communities ensures the creation of resources that meet their needs, are culturally relevant, and align with cultural beliefs.
Collapse
Affiliation(s)
| | - Michele Brolly
- 2 Durham Region Health Department, Whitby, Ontario, Canada
| | | | - Amber Newport
- 2 Durham Region Health Department, Whitby, Ontario, Canada
| | - Fangli Xie
- 2 Durham Region Health Department, Whitby, Ontario, Canada
| | | | | |
Collapse
|
40
|
Abbass-Dick J, Xie F, Koroluk J, Alcock Brillinger S, Huizinga J, Newport A, Goodman WM, Dennis CL. The Development and piloting of an eHealth breastfeeding resource targeting fathers and partners as co-parents. Midwifery 2017; 50:139-147. [DOI: 10.1016/j.midw.2017.04.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/22/2017] [Accepted: 04/16/2017] [Indexed: 12/01/2022]
|
41
|
Wasser HM, Thompson AL, Suchindran CM, Hodges EA, Goldman BD, Perrin EM, Faith MS, Bulik CM, Heinig MJ, Bentley ME. Family-based obesity prevention for infants: Design of the "Mothers & Others" randomized trial. Contemp Clin Trials 2017; 60:24-33. [PMID: 28600160 DOI: 10.1016/j.cct.2017.06.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 05/29/2017] [Accepted: 06/05/2017] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Our goal is to test the efficacy of a family-based, multi-component intervention focused on infants of African-American (AA) mothers and families, a minority population at elevated risk for pediatric obesity, versus a child safety attention-control group to promote healthy weight gain patterns during the first two years of life. DESIGN, PARTICIPANTS, AND METHODS The design is a two-group randomized controlled trial among 468 AA pregnant women in central North Carolina. Mothers and study partners in the intervention group receive anticipatory guidance on breastfeeding, responsive feeding, use of non-food soothing techniques for infant crying, appropriate timing and quality of complementary feeding, age-appropriate infant sleep, and minimization of TV/media. The primary delivery channel is 6 home visits by a peer educator, 4 interim newsletters and twice-weekly text messaging. Intervention families also receive 2 home visits from an International Board Certified Lactation Consultant. Assessments occur at 28 and 37weeks gestation and when infants are 1, 3, 6, 9, 12, and 15months of age. RESULTS The primary outcome is infant/toddler growth and likelihood of overweight at 15months. Differences between groups are expected to be achieved through uptake of the targeted infant feeding and care behaviors (secondary outcomes) and change in caregivers' modifiable risk factors (mediators) underpinning the intervention. CONCLUSIONS If successful in promoting healthy infant growth and enhancing caregiver behaviors, "Mothers and Others" will have high public health relevance for future obesity-prevention efforts aimed at children younger than 2years, including interventional research and federal, state, and community health programs. TRIAL REGISTRATION ClinicalTrials.gov, NCT01938118, August 9, 2013.
Collapse
Affiliation(s)
| | | | | | - Eric A Hodges
- University of North Carolina, Chapel Hill, NC, United States.
| | | | - Eliana M Perrin
- 3643 N. Roxboro Street, Duke University, Durham, NC 27704, United States.
| | | | - Cynthia M Bulik
- University of North Carolina, Chapel Hill, NC, United States; Karolinska Institutet, Stockholm, Sweden.
| | | | | |
Collapse
|
42
|
Bresnahan M, Zhuang J, Anderson J, Zhu Y, Nelson J, Yan X. The “pumpgate” incident: Stigma against lactating mothers in the U.S. workplace. Women Health 2017; 58:451-465. [DOI: 10.1080/03630242.2017.1306608] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Mary Bresnahan
- Department of Communication, Michigan State University, East Lansing, Michigan, USA
| | - Jie Zhuang
- Department of Communication Studies, Texas Christian University, Fort Worth, Texas, USA
| | - Jennifer Anderson
- Department of Communication Studies and Theatre, South Dakota State University, Brookings, South Dakota, USA
| | - Yi Zhu
- Department of Communication, Michigan State University, East Lansing, Michigan, USA
| | - Joshua Nelson
- Department of Communication, Central Washington University, Bellingham, Washington, USA
| | - Xiaodi Yan
- Department of Communication, Michigan State University, East Lansing, Michigan, USA
| |
Collapse
|
43
|
Altshuler AL, Nguyen BT, Riley HEM, Tinsley ML, Tuncalp Ö. Male Partners' Involvement in Abortion Care: A Mixed-Methods Systematic Review. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2016; 48:209-219. [PMID: 27727503 DOI: 10.1363/psrh.12000] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 04/08/2016] [Accepted: 04/12/2016] [Indexed: 06/06/2023]
Abstract
CONTEXT Although some women may desire the involvement of their partners when obtaining abortion care, male partners are not routinely included in the abortion process. A review of the literature on how male involvement relates to women's abortion experiences may help guide facilities that are considering incorporating male partners in abortion care. METHODS PubMed, PsycINFO (Ovid), the Cumulative Index to Nursing and Allied Health Literature, the Latin American and Caribbean Health Sciences Literature database, and the Cochrane Library were systematically searched without restrictions through September 23, 2015, to identify qualitative and quantitative primary studies investigating male partner accompaniment during the abortion process in noncoercive situations. Analysis focused on identifying different types of male involvement and their associations with women's abortion experiences. RESULTS Some 1,316 unique articles were reviewed; 15 were analyzed. These studies were conducted in six countries and published between 1985 and 2012, primarily with observational designs. Four types of male partner involvement emerged: presence in the medical facility, participation in preabortion counseling, presence in the room during the surgical abortion procedure or while the woman is experiencing the effects of abortifacient medications, and participation in postabortion care. Studies explored relationships between type of involvement and women's access to abortion care and their emotional and physical well-being. Most findings suggested that male involvement was positively associated with women's well-being and their assessment of the experience; no negative associations were found. CONCLUSION In noncoercive circumstances, women who include their male partners in the abortion process may find this involvement beneficial.
Collapse
Affiliation(s)
- Anna L Altshuler
- Obstetriciangynecologist, California Pacifi c Medical Center Research Institute, San Francisco
| | - Brian T Nguyen
- Fellow in family planning, Department of Obstetrics and Gynecology, University of Chicago
| | - Halley E M Riley
- Doctoral student, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta
| | - Marilyn L Tinsley
- Research services librarian, Lane Medical Library, Stanford University School of Medicine, Stanford, California
| | - Özge Tuncalp
- Scientist, Department of Reproductive Health and Research, World Health Organization, Geneva
| |
Collapse
|
44
|
Bai DL, Fong DYT, Lok KYW, Tarrant M. Relationship between the Infant Feeding Preferences of Chinese Mothers' Immediate Social Network and Early Breastfeeding Cessation. J Hum Lact 2016; 32:301-8. [PMID: 26887843 DOI: 10.1177/0890334416630537] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 01/06/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND The relationship between support from members of a mother's social network and breastfeeding continuation is receiving increased attention. OBJECTIVES The objectives of this study were to describe the infant feeding preferences of Chinese mothers' immediate social network and to examine the association between these preferences and early breastfeeding cessation. METHODS In total, 1172 mother-infant pairs were recruited from 4 public hospitals in Hong Kong and followed prospectively for 12 months or until breastfeeding stopped. RESULTS Over 40% of participants' partners preferred breastfeeding and half had no infant feeding preference. Only about 20% of participants' mothers or mothers-in-law preferred breastfeeding, and less than 10% reported that all of the 3 significant family members (partner, mother, and mother-in-law) preferred breastfeeding. The partner's preference for infant formula or mixed feeding (odds ratio [OR], 2.60; 95% confidence interval [CI], 1.43-4.71) or having no preference (OR, 1.64; 95% CI, 1.16-2.30) was strongly associated with higher odds of stopping breastfeeding before 1 month. For every additional family member who preferred breastfeeding, the odds of stopping breastfeeding was reduced by almost 20% (OR, 0.81; 95% CI, 0.68-0.97). However, living with a parent-in-law (OR, 1.45; 95% CI, 1.02-2.07) was also a predictor of early breastfeeding cessation. Knowing someone who had breastfed for ≥ 1 month (OR, 0.64; 95% CI, 0.42-0.97) or having been breastfed as a child (OR, 0.67; 95% CI, 0.45-0.98) significantly lowered the odds of early breastfeeding cessation. CONCLUSIONS The infant feeding preferences of mothers' immediate social network are significantly associated with breastfeeding continuation. Prenatal breastfeeding education programs should involve significant family members to promote breastfeeding.
Collapse
Affiliation(s)
- Dorothy Li Bai
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Marie Tarrant
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| |
Collapse
|
45
|
Schafer EJ, Williams NA, Digney S, Hare ME, Ashida S. Social Contexts of Infant Feeding and Infant Feeding Decisions. J Hum Lact 2016; 32:132-40. [PMID: 26744497 DOI: 10.1177/0890334415592850] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 06/01/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Infant feeding takes place within a network of social relationships. However, the social context in which infant feeding advice is received remains underresearched. OBJECTIVE The objective of this study was to evaluate the social contexts of infant feeding by examining individual and relationship characteristics of mothers and network members associated with advice to exclusively breastfeed, exclusively formula feed, or use a combination of breast milk and formula. METHODS Information about 287 network members was reported by 80 low-income mothers during a one-time survey. Characteristics of relationships associated with mothers receiving advice (exclusively breastfeed/formula feed, combination feed) from each network member were identified using 2-level logistic regression analyses. RESULTS Mothers had greater odds of receiving advice to exclusively breastfeed from network members who help make feeding decisions (odds ratio [OR], 2.44; 95% confidence interval [CI], 1.35-4.42), exclusively breastfed their own child or children (OR, 6.99; 95% CI, 2.96-16.51), and were health care providers (OR, 4.82; 95% CI, 1.70-13.67). Mothers had greater odds of receiving advice to breastfeed in combination with formula from network members who provided emotional support (OR, 2.45; 95% CI, 1.31-4.55), combination fed their own child or children (OR, 4.85; 95% CI, 1.80-13.05), and had an opinion that was important to the mother (OR, 2.67; 95% CI, 1.13-6.33). Mothers had greater odds of receiving advice to exclusively formula feed from network members who exclusively formula fed their own child or children (OR, 2.23; 95% CI, 1.07-4.66) than those who did not. CONCLUSION Social relationship characteristics and network members' infant feeding experiences may have implications for the advice new mothers receive. Future research should investigate social contexts of infant feeding longitudinally to inform interventions.
Collapse
Affiliation(s)
- Ellen J Schafer
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Natalie A Williams
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Siri Digney
- Department of Social and Behavioral Sciences, University of Memphis School of Public Health, Memphis, TN, USA
| | - Marion E Hare
- Department of Preventive Medicine and Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sato Ashida
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
| |
Collapse
|
46
|
Furman L, Killpack S, Matthews L, Davis V, O'Riordan MA. Engaging Inner-City Fathers in Breastfeeding Support. Breastfeed Med 2016; 11:15-20. [PMID: 26565924 DOI: 10.1089/bfm.2015.0092] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Our objective was to pilot a method of engaging fathers/partners of high-risk inner-city mothers in breastfeeding support. MATERIALS AND METHODS Breast for Success was a breastfeeding promotion initiative with a father engagement component. In collaboration with Community Endeavors, Inc., we organized father-friendly evening programs (one night per week for 3 weeks, repeating quarterly) led by a male facilitator to provide breastfeeding education, with ongoing availability of a resource specialist to link men to community resources relevant to their legal, financial, and health needs. Fathers/partners were recruited from community programs and via our community partner, The City of Cleveland Department of Public Health MomsFirst™ Project, a federally funded Healthy Start program. University Hospitals Case Medical Center Institutional Review Board approved the study. RESULTS Sixty-six fathers/partners attended eight evening programs, and 30 (45%) attended all three nights. Their median age was 27.5 years (range, 17-64 years), and 49 (74%) self-described themselves as African American. At the start of the groups, 39% (21/54 responding) had a breastfed child, and 64% (39/61 responding) said they were comfortable with breastfeeding for their own child. After Sessions 1, 2, and 3, respectively, 40 (85%), 42 (89%), and 33 (80%) were "more likely" to want their next baby to breastfeed. On average, in 62% of all responses (278/450 possible), men endorsed learning "a lot more" about the 10 breastfeeding curriculum topics presented. CONCLUSIONS Recruitment of inner-city fathers/partners for a breastfeeding education program was feasible, and among men who attended, fathers' perceptions about their breastfeeding knowledge were positively impacted.
Collapse
Affiliation(s)
- Lydia Furman
- 1 Department of Pediatrics, Rainbow Babies and Children's Hospital , Cleveland, Ohio
| | - Steve Killpack
- 2 Community Endeavors Foundation, Inc. , Cleveland, Ohio
| | - Lisa Matthews
- 3 Cleveland Department of Public Health MomsFirst™ Program , Cleveland, Ohio
| | - Valeria Davis
- 3 Cleveland Department of Public Health MomsFirst™ Program , Cleveland, Ohio
| | - Mary Ann O'Riordan
- 1 Department of Pediatrics, Rainbow Babies and Children's Hospital , Cleveland, Ohio
| |
Collapse
|
47
|
Martin SL, Muhomah T, Thuita F, Bingham A, Mukuria AG. What motivates maternal and child nutrition peer educators? Experiences of fathers and grandmothers in western Kenya. Soc Sci Med 2015; 143:45-53. [PMID: 26342912 DOI: 10.1016/j.socscimed.2015.08.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 08/12/2015] [Accepted: 08/19/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND Peer-led dialogue groups (i.e., support or self-help groups) are a widely used community-based strategy to improve maternal and child health and nutrition. However, the experiences and motivation of peer educators who facilitate these groups are not well documented. OBJECTIVE We implemented eight father and ten grandmother peer dialogue groups in western Kenya to promote and support recommended maternal dietary and infant and young child feeding practices and sought to understand factors that influenced peer educator motivation. METHODS After four months of implementation, we conducted 17 in-depth interviews with peer educators as part of a process evaluation to understand their experiences as group facilitators as well as their motivation. We analyzed the interview transcripts thematically and then organized them by level: individual, family, peer dialogue group, organization, and community. RESULTS Father and grandmother peer educators reported being motivated by multiple factors at the individual, family, dialogue group, and community levels, including increased knowledge, improved communication with their wives or daughters-in-law, increased respect and appreciation from their families, group members' positive changes in behavior, and increased recognition within their communities. This analysis also identified several organization-level factors that contributed to peer educator motivation, including clearly articulated responsibilities for peer educators; strong and consistent supportive supervision; opportunities for social support among peer educators; and working within the existing health system structure. CONCLUSION Peer educator motivation affects performance and retention, which makes understanding and responding to their motivation essential for the successful implementation, sustainability, and scalability of community-based, peer-led nutrition interventions.
Collapse
Affiliation(s)
- Stephanie L Martin
- Division of Nutritional Sciences, 118 Savage Hall, Cornell University, Ithaca, NY, 14853, USA.
| | | | - Faith Thuita
- School of Public Health, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya
| | | | - Altrena G Mukuria
- Global Health Monitoring and Evaluation Consultant, Baltimore, MD, USA
| |
Collapse
|
48
|
Maycock BR, Scott JA, Hauck YL, Burns SK, Robinson S, Giglia R, Jorgensen A, White B, Harries A, Dhaliwal S, Howat PA, Binns CW. A study to prolong breastfeeding duration: design and rationale of the Parent Infant Feeding Initiative (PIFI) randomised controlled trial. BMC Pregnancy Childbirth 2015; 15:159. [PMID: 26231519 PMCID: PMC4522088 DOI: 10.1186/s12884-015-0601-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 07/28/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Very few Australian infants are exclusively breastfed to 6 months as recommended by the World Health Organization. There is strong empirical evidence that fathers have a major impact on their partner's decision to breastfeed and continuation of breastfeeding. Fathers want to participate in the breastfeeding decision making process and to know how they can support their partner to achieve their breastfeeding goals. The aim of the Parent Infant Feeding Initiative (PIFI) is to evaluate the effect on duration of any and exclusive breastfeeding of three breastfeeding promotion interventions of differing intensity and duration, targeted at couples but channelled through the male partner. The study will also undertake a cost-effectiveness evaluation of the interventions. METHODS/DESIGN The PIFI study is a factorial randomised controlled trial. Participants will be mothers and their male partners attending antenatal classes at selected public and private hospitals with maternity departments in Perth, Western Australia. Fathers will be randomly allocated to either the usual care control group (CG), one of two medium intensity (MI1 and MI2) interventions, or a high intensity (HI) intervention. MI1 will include a specialised antenatal breastfeeding education session for fathers with supporting print materials. MI2 will involve the delivery of an antenatal and postnatal social support intervention delivered via a smartphone application and HI will include both the specialised antenatal class and the social support intervention. Outcome data will be collected from couples at baseline and at six and 26 weeks postnatally. A total of 1600 couples will be recruited. This takes into account a 25% attrition rate, and will detect at least a 10% difference in the proportion of mothers breastfeeding between any two of the groups at 26 weeks at 80% power and 5% level of significance, using a Log-rank survival test. Multivariable survival and logistic regression analyses will be used to assess the effect of the treatment groups on the outcomes after adjusting for covariates. DISCUSSION The PIFI study will be the first Australian study to provide Level II evidence of the impact on breastfeeding duration of a comprehensive, multi-level, male-partner-focused breastfeeding intervention. Unique features of the intervention include its large sample size, delivery of two of the interventions by mobile device technology, a rigorous assessment of intervention fidelity and a cost-effectiveness evaluation. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12614000605695. Registered 6 June 2014.
Collapse
Affiliation(s)
- Bruce R Maycock
- School of Public Health, Curtin University, GPO Box U1987, Perth, 6845, Australia.
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, Perth, Australia.
| | - Jane A Scott
- School of Public Health, Curtin University, GPO Box U1987, Perth, 6845, Australia.
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, Perth, Australia.
| | - Yvonne L Hauck
- School of Nursing and Midwifery, Curtin University, Perth, Australia.
| | - Sharyn K Burns
- School of Public Health, Curtin University, GPO Box U1987, Perth, 6845, Australia.
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, Perth, Australia.
| | - Suzanne Robinson
- School of Public Health, Curtin University, GPO Box U1987, Perth, 6845, Australia.
| | - Roslyn Giglia
- School of Public Health, Curtin University, GPO Box U1987, Perth, 6845, Australia.
- Telethon Kids Institute, Perth, Australia.
| | - Anita Jorgensen
- School of Public Health, Curtin University, GPO Box U1987, Perth, 6845, Australia.
| | - Becky White
- School of Public Health, Curtin University, GPO Box U1987, Perth, 6845, Australia.
| | - Annegrete Harries
- School of Public Health, Curtin University, GPO Box U1987, Perth, 6845, Australia.
| | - Satvinder Dhaliwal
- School of Public Health, Curtin University, GPO Box U1987, Perth, 6845, Australia.
- School of Nursing and Midwifery, Curtin University, Perth, Australia.
| | - Peter A Howat
- School of Public Health, Curtin University, GPO Box U1987, Perth, 6845, Australia.
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, Perth, Australia.
| | - Colin W Binns
- School of Public Health, Curtin University, GPO Box U1987, Perth, 6845, Australia.
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, Perth, Australia.
| |
Collapse
|
49
|
Competing infant feeding information in mothers' networks: advice that supports v. undermines clinical recommendations. Public Health Nutr 2015. [PMID: 26223281 DOI: 10.1017/s1368980015002220] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To identify the social contextual factors, specifically the presence of information that supports v. undermines clinical recommendations, associated with infant feeding behaviours among mothers in low-income areas. DESIGN Cross-sectional survey evaluating social support networks and social relationships involved in providing care to the infant along with feeding beliefs and practices. SETTING Out-patient paediatric and government-funded (Women, Infants, and Children) clinics in an urban, low-income area of the south-eastern USA. SUBJECTS Eighty-one low-income mothers of infants between 0 and 12 months old. RESULTS Most mothers reported receiving both supportive and undermining advice. The presence of breast-feeding advice that supports clinical recommendations was associated with two infant feeding practices that are considered beneficial to infant health: ever breast-feeding (OR=6·7; 95% CI 1·2, 38·1) and not adding cereal in the infant's bottle (OR=15·9; 95% CI 1·1, 227·4). Advice that undermines clinical recommendations to breast-feed and advice about solid foods were not associated with these behaviours. CONCLUSIONS Efforts to facilitate optimal infant feeding practices may focus on increasing information supportive of clinical recommendations while concentrating less on reducing the presence of undermining information within mothers' networks. Cultural norms around breast-feeding may be stronger than the cultural norms around the introduction of solid foods in mothers' social environments; thus, additional efforts to increase information regarding introduction of solid foods earlier in mothers' infant care career may be beneficial.
Collapse
|
50
|
Sipsma HL, Jones KL, Cole-Lewis H. Breastfeeding among adolescent mothers: a systematic review of interventions from high-income countries. J Hum Lact 2015; 31:221-9; quiz 321-2. [PMID: 25480018 DOI: 10.1177/0890334414561264] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 11/03/2014] [Indexed: 11/17/2022]
Abstract
Despite growing evidence of the benefits of breastfeeding, rates of breastfeeding remain disproportionately low among adolescent mothers compared with older mothers in the United States. Current interventions primarily target adult women, and little evidence is available for breastfeeding promotion among young women. Accordingly, we aim to review interventions designed to improve breastfeeding rates among adolescents to make recommendations for future research and practice. We searched MEDLINE and PsycINFO for articles that evaluated interventions aiming to improve rates of breastfeeding initiation, duration, or exclusivity among adolescents. Inclusion criteria included interventions targeting pregnant or postpartum adolescents (mean/median age <22 years) that were conducted in high-income settings. Six interventions met our inclusion criteria; of these, 4 interventions aimed to increase breastfeeding initiation, 5 aimed to increase breastfeeding duration, and 4 aimed to increase breastfeeding exclusivity. Interventions included school-based programs, home visits, and telephone support that were implemented by a combination of peer counselors, nurse clinicians, doulas, and lactation consultants. Only 1 intervention, a combination of education and counseling provided by a lactation consultant-peer counselor team, significantly improved both breastfeeding initiation and duration. Other results were mixed, and studies were subject to several methodological limitations. We recommend that more interventions should be developed and evaluated. In addition, interventions should be less resource intensive, be more theoretically driven, and specifically include mothers and partners of adolescents to successfully promote breastfeeding among adolescent mothers.
Collapse
Affiliation(s)
- Heather L Sipsma
- Department of Women, Children and Family Health Science, University of Illinois at Chicago College of Nursing, Chicago, IL, USA
| | - Krista L Jones
- Department of Health Systems Sciences, University of Illinois at Chicago College of Nursing, Chicago, IL, USA
| | - Heather Cole-Lewis
- Department of Biomedical Informatics, Columbia University Medical Center, New York, NY, USA ICF International, Rockville, MD, USA
| |
Collapse
|