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Fiedor AR, Lauzon S, Dhaurali S, Voegtline KM. Maternal Work and Infant Feeding Practices in the First 6 Months. Matern Child Health J 2024:10.1007/s10995-024-03977-5. [PMID: 39180604 DOI: 10.1007/s10995-024-03977-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2024] [Indexed: 08/26/2024]
Abstract
OBJECTIVES The purpose of this study was to examine the relationship between maternal work and infant feeding practices and explore the moderating impact of parental stress. METHODS Prospective data on categorical hours worked and infant feeding practices were collected at 3 and 6 months postpartum in a prospective prenatal cohort of 95 women. Chi-square tests were used to compare change in proportion of exclusive breastfeeding from birth to 6 months and maternal work status. RESULTS Rates of exclusive breastfeeding significantly decreased from birth to 6 months, while the percent of mothers working outside of the home significantly increased from 3 to 6 months. At 6 months, mothers who worked full time pumped significantly more than their non-working counterparts. Multivariate logistic regression models were used to test the prediction of exclusive breastfeeding by maternal work, including sociodemographic covariates, and the moderating impact of parental stress. Results indicated that maternal education, paternal education, and maternal work significantly predicted exclusive breastfeeding at 6 months. Full time work (OR = 0.09, 95% CI = 0.01, 0.62) was associated with a decreased odds of exclusive breastfeeding. Additionally, higher maternal (OR = 1.44, 95% CI = 1.05, 1.97) and paternal (OR = 1.28, 95% CI = 1.00, 1.66) education was associated with an increased odds of exclusive breastfeeding. Maternal stress did not predict exclusive breastfeeding, nor did it have a moderating effect on the relationship between maternal work and breastfeeding. CONCLUSIONS FOR PRACTICE Future studies should investigate maternal work in more diverse birthing populations to better understand how families can incorporate breastfeeding as a primary infant feeding practice.
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Affiliation(s)
- Anna R Fiedor
- Department of Population, Family, and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
| | - Sylvie Lauzon
- Department of Population, Family, and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
| | - Supriya Dhaurali
- Department of Pediatrics, Johns Hopkins University School of Medicine, 200 North Wolfe Street Room, Baltimore, MD, 2076, 21287, USA
| | - Kristin M Voegtline
- Department of Population, Family, and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA.
- Department of Pediatrics, Johns Hopkins University School of Medicine, 200 North Wolfe Street Room, Baltimore, MD, 2076, 21287, USA.
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2
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The effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum: A systematic review. Midwifery 2023; 118:103579. [PMID: 36580847 DOI: 10.1016/j.midw.2022.103579] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 09/29/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The decision to breastfeed is influenced by physiological, psychological, and emotional factors. However, the importance of equipping mothers with the necessary knowledge for successful breastfeeding practice cannot be ruled out. Studies suggest that the decline in global breastfeeding rate can be linked to lack of adequate breastfeeding education during prenatal stage. Therefore, this review aims to determine the effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum. METHOD A systematic review of the studies identified by electronic database search (Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Psych INFO, and Sociological Abstracts and Applied Social Sciences Index and Abstracts (ASSIA) published between 2014 - 2021. RESULTS A total of 14 studies met the inclusion criteria. Results showed an increase in breastfeeding uptake, breastfeeding knowledge, increase in positive attitude to breastfeeding and an increase in maternal breastfeeding self-efficacy among mothers who participated in breastfeeding educational programs during prenatal care. CONCLUSION Prenatal breastfeeding education increases women's knowledge of breastfeeding. Mothers who are knowledgeable about breastfeeding and hold a positive approach towards breastfeeding have the tendency to initiate breastfeeding and continue for a lengthened period. Findings demonstrates a general correlation between prenatal breastfeeding education and increased breastfeeding uptake postpartum. The high level of positive breastfeeding outcome inherent in all the studies can be attributed to prenatal breastfeeding education.
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3
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Oggero MK, Wardell DW. Changes in Breastfeeding Exclusivity and Satisfaction During the COVID-19 Pandemic. J Hum Lact 2022; 38:433-442. [PMID: 35382624 DOI: 10.1177/08903344221086974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Because of its many benefits, exclusive breastfeeding for 6 months is a common public health goal. However, only 44% of infants aged 0-6 months are exclusively breastfed worldwide and, in the United States, only 26% of infants are exclusively breastfed for 6 months. The restrictions imposed during the COVID-19 pandemic may have reduced these rates even further. RESEARCH AIM To examine the differences in breastfeeding exclusivity and satisfaction before and during the COVID-19 pandemic. METHODS A cross-sectional, two-group survey design was used. Parents (N = 110) of infants born April 1 to December 31, 2019 (pre-pandemic; n = 69), or April 1 to December 31, 2020 (during the pandemic; n = 41), who received lactation support services from an urban academic breastfeeding clinic were surveyed. RESULTS Respondents who gave birth in 2020 (pandemic year) were no less likely to exclusively breastfeed for the first 6 months of their infant's life compared to respondents who gave birth in 2019 (pre-pandemic year). After multivariable logistic regression, the odds of high breastfeeding satisfaction were 73% lower in respondents with infants born in 2020 than in respondents with infants born in 2019 (OR = 0.27, 95% CI [0.08, 0.89]). The strongest contributor to high breastfeeding satisfaction was a prenatal breastfeeding visit with an International Board Certified Lactation Consultant. CONCLUSIONS Future research is needed to identify the specific pandemic-related factors that led to the difference in breastfeeding satisfaction between the two groups and to confirm the impact of prenatal International Board Certified Lactation Consultant visits on breastfeeding satisfaction.
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Affiliation(s)
- Megan K Oggero
- Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Diane W Wardell
- Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
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4
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Chang YS, Harger L, Beake S, Bick D. Women's and Employers' Experiences and Views of Combining Breastfeeding with a Return to Paid Employment: A Systematic Review of Qualitative Studies. J Midwifery Womens Health 2021; 66:641-655. [PMID: 34423557 DOI: 10.1111/jmwh.13243] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/07/2021] [Accepted: 04/11/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Returning to paid employment is one of the reasons women stop breastfeeding earlier than they planned to. This systematic review aimed to provide insight into the experiences and views of women and employers on breastfeeding and returning to paid employment, with findings used to inform practice and policy. METHODS The review was guided by the Joanna Briggs Institute (JBI) methodology for systematic reviews of qualitative evidence. Medline, CINAHL, PsycINFO, and Web of Science databases were searched for studies published in English. JBI's meta-aggregative approach informed data analysis. The studies in this analysis included women who stopped breastfeeding before, and those who continued breastfeeding after, returning to paid employment and the employers, work managers, or supervisors of women who continued breastfeeding after returning to paid employment. RESULTS Twenty-six articles presenting findings from 25 studies were included and critically appraised. Synthesized findings showed that women experienced physical and emotional difficulties and described gender and employment inequalities in accessing and receiving the support they needed. Women reported that the importance of their own motivation and having workplace legislation in place facilitated breastfeeding during employment. Support from employers, colleagues, and family members, as well as access to convenient child care, helped women continue breastfeeding on return to paid employment. Employers' personal experiences influenced their views on breastfeeding and working, and the need for more education and communication between employers and employers on breastfeeding in the workplace was recognized. DISCUSSION Support from family, work colleagues, and employers was important to reduce the physical and emotional challenges women experienced when combing breastfeeding with return to paid employment. Gender inequalities, especially in low- and middle-income countries, in accessing support exacerbated the difficulties women experienced. Limited data were identified regarding employers' experiences and views, suggesting an urgent need for further research to explore employers' and work colleagues' experiences and views.
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Affiliation(s)
- Yan-Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom
| | - Laura Harger
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom.,Lewisham and Greenwich NHS Trust, London, United Kingdom
| | - Sarah Beake
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom
| | - Debra Bick
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Warwick, United Kingdom
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5
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Dutheil F, Méchin G, Vorilhon P, Benson AC, Bottet A, Clinchamps M, Barasinski C, Navel V. Breastfeeding after Returning to Work: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168631. [PMID: 34444380 PMCID: PMC8393856 DOI: 10.3390/ijerph18168631] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/08/2021] [Accepted: 08/09/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The benefits of breastfeeding are widely known; however, continuation after returning to work (RTW) is not. We aimed to conduct a systematic review and meta-analysis to assess the prevalence of breastfeeding after RTW. The secondary objectives were to compare the economic statuses between continents. METHOD PubMed, Cochrane Library, Base, and Embase were searched until 1 September 2020, and two independent reviewers selected the studies and collated the data. To be included, articles needed to describe our primary outcome, i.e., prevalence of breastfeeding after RTW. RESULTS We included 14 studies, analyzing 42,820 women. The overall prevalence of breastfeeding after RTW was 25% (95% CI, 21% to 29%), with an important heterogeneity (I2 = 98.6%)-prevalence ranging from 2% to 61%. Stratification by continents and by GDP per capita also showed huge heterogeneity. The Middle East had the weakest total prevalence with 10% (6% to 14%), and Oceania the strongest with 35% (21% to 50%). Despite the prevalence of breastfeeding in general increasing with GDP per capita (<US$5000: 19%, US$5000-30,000: 22%; US$30,000 to 50,000: 25%, >US$50,000 42%), the prevalence of non-exclusive breastfeeding follows more of a U-curve with the lowest and highest GDP per capita having the highest percentages of breastfeeding (<US$5000: 47% and >US$50,000: 50%, versus <28% for all other categories). CONCLUSION Breastfeeding after RTW is widely heterogeneous across the world. Despite economic status playing a role in breastfeeding after RTW, cultural aspects seem influential. The lack of data regarding breastfeeding after RTW in most countries demonstrates the strong need of data to inform effective preventive strategies.
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Affiliation(s)
- Frédéric Dutheil
- CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Occupational and Environmental Medicine, Université Clermont Auvergne, WittyFit, F-63000 Clermont-Ferrand, France;
- Correspondence: ; Tel.: +33-6-88-22-48-48; Fax: +33-4-73-27-46-49
| | - Grégory Méchin
- Department of General Practice, UFR Medicine, 28 Place Henri-Dunant, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France;
| | - Philippe Vorilhon
- Department of General Practice, UFR Medicine, Research Unit ACCePPT Self-Medication, Multi-Professional Support for Patients, Université Clermont Auvergne, 28 Place Henri-Dunant, F-63000 Clermont-Ferrand, France; (P.V.); (A.B.)
| | - Amanda C. Benson
- Swinburne University of Technology, Health and Biostatistics, Hawthorn, Victoria, VIC 3122, Australia;
| | - Anne Bottet
- Department of General Practice, UFR Medicine, Research Unit ACCePPT Self-Medication, Multi-Professional Support for Patients, Université Clermont Auvergne, 28 Place Henri-Dunant, F-63000 Clermont-Ferrand, France; (P.V.); (A.B.)
| | - Maëlys Clinchamps
- CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Occupational and Environmental Medicine, Université Clermont Auvergne, WittyFit, F-63000 Clermont-Ferrand, France;
| | - Chloé Barasinski
- CNRS, SIGMA Clermont, Institut Pascal, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Université Clermont Auvergne Perinatality, F-63000 Clermont-Ferrand, France;
| | - Valentin Navel
- CNRS, INSERM, GReD, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Ophthalmology, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France;
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6
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Syam A, Musni M, Amin AN, Iskandar I. Potential Loss among Infant Feeding Options. JURNAL NERS 2021. [DOI: 10.20473/jn.v16i1.23285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: The conceptual relationship between economics and breastfeeding is still mathematically invaluable, while the family's economic burden increases along with babies born. Indicating potential loss when a family chooses other than breastmilk is a progressive way to manage campaign messages about exclusive breastmilk and prolonged breastfeeding. Descriptive studies are needed to magnify all of these indicators and transform them into measuring instruments generalized to assess family expenditures related to infant feeding.Methods: This study uses a quantitative descriptive design, questionnaire draft upon qualitative open questions containing all micro indicators impacted financially during the baby’s first year. Data collection was carried out in Makassar based on telephone surveys with 330 preliminary samples. After structural analysis and data reduction, the expenditure indicators were divided into medical and non-medical expenses.Results: The study show there is a difference in the average amount of family expenses of those who provide formula milk compared to breastmilk. This outcome is 21.1 times higher in non-medical components and 2.5 times higher in the medical component. One of the highest contributions in medical expenses is the cost of a recurrent visit to a pediatrician due to a history of illness such as allergies, respiratory infections, and diarrhea.Conclusion: This empirical fact stated the strong affirmation of how families should consider wisely to choose the best feeding pattern for babies aged 0-12 months.
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Zerfu TA, Griffiths P, Macharia T, Kamande EW, Anono E, Kiige L, Gatheru PM, Jobando S, Moloney G, Kimani-Murage EW. Communities and employers show a high level of preparedness in supporting working mothers to combine breastfeeding with work in rural Kenya. MATERNAL AND CHILD NUTRITION 2021; 17:e13180. [PMID: 33856124 PMCID: PMC8476406 DOI: 10.1111/mcn.13180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/19/2021] [Accepted: 02/24/2021] [Indexed: 11/29/2022]
Abstract
Community Readiness Model (CRM) through pragmatic mixed methods design, combining quantitative CRM survey with qualitative data, was used to assess the level of preparedness and readiness among local leaders, employers and community members in supporting working mothers to combine breastfeeding with work. The study was conducted in one of the tea state farms in Kericho County of Kenya. A total of 17 purposively selected men (fathers), lactating mothers, peer educators, health professionals (doctors, nurses and nutritionists), tea plantation managers and grandmothers were interviewed. The CRM that has six different dimensions was applied to determine the stage of readiness to support working mothers to combine breastfeeding with work. Community Readiness Score (CRS) was calculated descriptively as mean ± standard deviation (SD). Thematic analysis using NVIVO software was used to analyse qualitative data. We found that the mean (±SD) CRS was 7.3 (1.9), which corresponded to the third highest level of the nine stages or the ‘stabilization’ stage of community readiness. Dimensionally, the mean CRS was the highest (8.3 ± 1.9) for leadership followed by community efforts (7.5 ± 2.1), whereas the lowest CRS was observed for knowledge of efforts (6.6 ± 2.3) and availability of resources (6.6 ± 1.9). In conclusion, high level of readiness to support working women to combine work with breastfeeding with suboptimal knowledge of efforts and availability of resources was observed in the area. Future interventions should focus on enabling the community to feel more comfortable and creating detailed and refined knowledge on combining breastfeeding with work.
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Affiliation(s)
- Taddese Alemu Zerfu
- Global Academy of Agriculture and Food Security, University of Edinburgh (UoE), UK.,African Population and Health Research Center, Nairobi, Kenya.,International Livestock Research Institute (ILRI) Kenya, Nairobi, Kenya
| | | | | | - Eva W Kamande
- African Population and Health Research Center, Nairobi, Kenya
| | - Esther Anono
- African Population and Health Research Center, Nairobi, Kenya
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Taylor YJ, Scott VC, Danielle Connor C. Perceptions, Experiences, and Outcomes of Lactation Support in the Workplace: A Systematic Literature Review. J Hum Lact 2020; 36:657-672. [PMID: 32530352 DOI: 10.1177/0890334420930696] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Despite legislation requiring break time and a private space to express milk, variations exist in accommodations for breastfeeding employees in the United States. RESEARCH AIMS We aimed to describe employee and employer perceptions of and experiences with workplace lactation support in the United States and to identify research needed to inform workplace lactation support programs. METHODS We searched Academic Search Complete, Business Search Complete, CINAHL, MEDLINE, PubMed, and PsycInfo for peer-reviewed articles published from 2009 to 2019 (n = 1638). We included 27 articles. Studies were categorized into four non-exclusive themes: (a) employee perceptions of and experiences with workplace lactation support; (b) employer reports of workplace lactation support; (c) association between workplace lactation support and business outcomes; and (d) association between workplace lactation support and breastfeeding outcomes. RESULTS Analyses of associations between lactation support at work and employee breastfeeding outcomes (n = 14, 52%), and employee perceptions of and experiences with lactation support at work (n = 14, 52%) were most common, followed by employer reports of lactation support (n = 3, 11%) and associations between lactation support at work and job satisfaction (n = 3, 11%). Results indicated that workplace lactation support varied by employer, and that employee perceptions of and experiences with workplace lactation support varied by demographic and employment characteristics. The use of cross-sectional designs, unvalidated instruments, and limited representation from women with low incomes and minorities were common study limitations. CONCLUSIONS More research is needed to learn about experiences of employers and low-income and minority women with workplace lactation support and associations with business-relevant outcomes.
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Affiliation(s)
- Yhenneko J Taylor
- 2351 Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, USA
| | - Victoria C Scott
- 124546 Department of Psychological Sciences, University of North Carolina at Charlotte, Charlotte, USA
| | - C Danielle Connor
- 2351 Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, USA
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Washio Y, Collins BN, Hunt-Johnson A, Zhang Z, Herrine G, Hoffman M, Kilby L, Chapman D, Furman LM. Individual breastfeeding support with contingent incentives for low-income mothers in the USA: the 'BOOST (Breastfeeding Onset & Onward with Support Tools)' randomised controlled trial protocol. BMJ Open 2020; 10:e034510. [PMID: 32554737 PMCID: PMC7304794 DOI: 10.1136/bmjopen-2019-034510] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION National breastfeeding rates have improved in recent years, however, disparities exist by socioeconomic and psychosocial factors. Suboptimal breastfeeding overburdens the society by increasing healthcare costs. Existing breastfeeding supports including education and peer support have not been sufficient in sustaining breastfeeding rates especially among low-income women. The preliminary outcomes of contingent incentives for breastfeeding in addition to existing support show promising effects in sustaining breastfeeding among mothers in the Special Supplemental Nutrition Programme for women, infants and children (WIC). METHODS AND ANALYSIS This trial uses a parallel randomised controlled trial. This trial is conducted at two sites in separate states in the USA. Mothers who were enrolled in WIC and initiated breastfeeding are eligible. Participants (n=168) are randomised into one of the two study groups: (1) standard care control (SC) group consisting of WIC breastfeeding services plus home-based individual support or (2) SC plus breastfeeding incentives (SC +BFI) contingent on demonstrating successful breastfeeding. All participants receive standard breastfeeding services from WIC, home-based individual support and assessments. Participants in SC receive financial compensation based on the number of completed monthly home visits, paid in a lump sum at the end of the 6-month intervention period. Participants in SC +BFI receive an escalating magnitude of financial incentives contingent on observed breastfeeding, paid monthly during the intervention period, as well as bonus incentives for selecting full breastfeeding food packages at WIC. The primary hypothesis is that monthly incentives contingent on breastfeeding in SC +BFI will significantly increase rates of any breastfeeding compared with SC. The primary outcome is the rate of any breastfeeding over 12 months. Randomisation is completed in an automated electronic system. Staff conducting home visits for support and assessments are blinded to study groups. ETHICS AND DISSEMINATION The Advarra Institutional Review Board has approved the study protocol (Pro00033168). Findings will be disseminated to our participants, scientific communities, public health officials and any other interested community members. TRIAL REGISTRATION NUMBER NCT03964454.
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Affiliation(s)
- Yukiko Washio
- Substance Use, Gender and Applied Research, RTI International, Research Triangle Park, North Carolina, USA
| | - Bradley N Collins
- College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
| | - Alison Hunt-Johnson
- College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
| | - Zugui Zhang
- Value Institute, Christiana Care Health System, Newark, Delaware, USA
| | - Gail Herrine
- Obstetrics and Gynecology Department, Temple University Hospital, Philadelphia, Pennsylvania, USA
| | - Matthew Hoffman
- Obstetrics and Gynecology Department, Christiana Care Health System, Newark, Delaware, USA
| | - Linda Kilby
- N.O.R.T.H., Inc-Philadelphia WIC program, Philadelphia, Pennsylvania, USA
| | - Donna Chapman
- Department of Exercise Science and Athletic Training, Springfield College, Springfield, Massachusetts, USA
| | - Lydia M Furman
- Department of Pediatrics, University Hospitals Rainbow Babies and Children's Hospital and Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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10
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Lok KYW, Chow CLY, Fan HSL, Chan VHS, Tarrant M. Exposure to baby-friendly hospital practices and mothers' achievement of their planned duration of breastfeeding. BMC Pregnancy Childbirth 2020; 20:261. [PMID: 32357927 PMCID: PMC7193339 DOI: 10.1186/s12884-020-02904-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 03/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Both breastfeeding intentions and exposure to baby-friendly hospital practices were found to be associated with a longer duration of breastfeeding. This study aims to examine the effect of exposure to baby-friendly hospital practices on mothers' achievement of their planned duration of breastfeeding. METHODS A total of 1011 mother-newborn pairs from the postnatal units of four public hospitals in Hong Kong were recruited. Sociodemographic data and breastfeeding intention data were collected via self-report questionnaires during the postnatal hospitalization and exposure to Baby-Friendly hospital practices were assessed through hospital records and maternal self-report. Breastfeeding status after hospital discharge was assessed through telephone follow-up for up to 12 months postnatal, or until participants were no longer breastfeeding. RESULTS Only 55% (n = 552) of study participants achieved their intended duration of breastfeeding. Participants with higher socioeconomic status, previous breastfeeding experience, and those who had lived in Hong Kong for less than 5 years, were more likely to achieve their planned duration of breastfeeding. Among baby-friendly hospital practices, feeding only breast milk during the hospitalization and providing information about breastfeeding support on discharge were associated with participants' achieving their individual breastfeeding intentions. After adjustment, when compared with women who experienced onebaby-friendly practice, participants who experienced six baby-friendly hospital practices were significantly more likely to achieve their planned duration of breastfeeding (adjusted odds ratio = 8.45, 95% confidence interval 3.03-23.6). CONCLUSIONS Nearly half of participants did not achieve their planned breastfeeding duration. Exposure to baby-friendly hospital practices, especially in-hospital exclusive breastfeeding and providing breastfeeding support information upon hospital discharge may help more mothers to achieve their individual breastfeeding goals.
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Affiliation(s)
- Kris Y W Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Charlotte L Y Chow
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Heidi S L Fan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Vincci H S Chan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Marie Tarrant
- School of Nursing, University of British Columbia, 1147 Research Road, ART 360B, Kelowna, BC, Canada
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11
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Cato K, Sylvén SM, Henriksson HW, Rubertsson C. Breastfeeding as a balancing act - pregnant Swedish women's voices on breastfeeding. Int Breastfeed J 2020; 15:16. [PMID: 32138725 PMCID: PMC7059277 DOI: 10.1186/s13006-020-00257-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 02/14/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Breastfeeding provides health benefits to both women and children. The rationale behind an individual woman's decision to breastfeed or not can depend on several factors, either independently or in combination. The aim of the current study was to explore attitudes towards breastfeeding among pregnant women in Sweden who intend to breastfeed. METHODS Eleven mothers-to-be, one of whom had previous breastfeeding experience, participated in the study. The women were interviewed either by telephone or face-to-face during late pregnancy, with the aim of exploring their attitudes towards breastfeeding. A semi-structured interview-guide was used, and the transcripts of the interviews were analyzed using thematic analysis. The social ecological model of health is the theory-based framework underpinning this study. The model provides a comprehensive approach to understanding the factors that influence breastfeeding intention. RESULTS When interviewed during pregnancy, women described breastfeeding as a balancing act between societal norms and personal desires. The women perceived a societal pressure to breastfeed, however it was accompanied by boundaries and mixed messages. This perceived pressure was balanced by their own knowledge of breastfeeding, in particular their knowledge of other women's experience of breastfeeding. When envisioning their future breastfeeding, the women made uncertain and preliminary plans, and negotiated the benefits and drawbacks of breastfeeding. There was a wish for individual breastfeeding support and information. CONCLUSIONS Pregnant Swedish women perceive their future breastfeeding as a balancing act between societal norms and personal desires. These findings suggest that while discussing breastfeeding during pregnancy, it could be of interest to collect information from pregnant women on their knowledge of breastfeeding and from where they have gained this knowledge, since stories from family and friends may make them question their own capacity to breastfeed. A thorough review of the woman's experiences and attitudes of breastfeeding is important in order to offer the best evidence-based breastfeeding support. TRIAL REGISTRATION Ethical approval for the study was obtained from the Regional Ethical Review Board in Uppsala (Dnr: 2017/256).
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Affiliation(s)
- Karin Cato
- Department of Women’s and Children’s Health, Uppsala University Hospital, 751 85 Uppsala, Sweden
| | - Sara M. Sylvén
- Department of Women’s and Children’s Health, Uppsala University Hospital, 751 85 Uppsala, Sweden
- Department of Neuroscience, Psychiatry, Uppsala University Hospital, 751 85 Uppsala, Sweden
| | | | - Christine Rubertsson
- Department of Women’s and Children’s Health, Uppsala University Hospital, 751 85 Uppsala, Sweden
- Department of Health Science, Faculty of Medicine, Lund University, Box 188, 22100 Lund, Sweden
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12
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Breastfeeding Difficulties and Risk for Early Breastfeeding Cessation. Nutrients 2019; 11:nu11102266. [PMID: 31547061 PMCID: PMC6835226 DOI: 10.3390/nu11102266] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 09/12/2019] [Accepted: 09/17/2019] [Indexed: 11/16/2022] Open
Abstract
Although breast milk is the normative feeding for infants, breastfeeding rates are lower than recommended. We investigated breastfeeding difficulties experienced by mothers in the first months after delivery and their association with early breastfeeding discontinuation. We conducted a prospective observational study. Mothers breastfeeding singleton healthy term newborns at hospital discharge were enrolled and, at three months post-delivery, were administered a questionnaire on their breastfeeding experience. Association among neonatal/maternal characteristics, breastfeeding difficulties and support after hospital discharge, and type of feeding at three months was assessed using multivariate binary logistic regression analysis. We enrolled 792 mothers, 552 completed the study. Around 70.3% of mothers experienced breastfeeding difficulties, reporting cracked nipples, perception of insufficient amount of milk, pain, and fatigue. Difficulties occurred mostly within the first month. Half of mothers with breastfeeding issues felt well-supported by health professionals. Maternal perception of not having a sufficient amount of milk, infant's failure to thrive, mastitis, and the return to work were associated with a higher risk of non-exclusive breastfeeding at three months whereas vaginal delivery and breastfeeding support after hospital discharge were associated with a decreased risk. These results underline the importance of continued, tailored professional breastfeeding support.
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Delle Donne A, Hatch A, Carr NR, Aden J, Shapiro J. Extended Maternity Leave and Breastfeeding in Active Duty Mothers. Pediatrics 2019; 144:peds.2018-3795. [PMID: 31331985 DOI: 10.1542/peds.2018-3795] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/06/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES In 2016, the Department of Defense extended maternity leave from 6 to 12 weeks for active duty mothers to support breastfeeding initiation and duration. Limited data exist regarding the impact of prolonged maternity leave. Our objective was to evaluate the prolongation of maternity leave on the initiation and duration of breastfeeding in active duty mothers. METHODS In this single-center retrospective cohort study, we used data collected from Department of Defense electronic health care records of infants born to active duty mothers who were delivered during calendar years 2014 and 2016. The primary outcomes were initiation and duration of breastfeeding and breastfeeding exclusivity evaluated throughout the first year of life. Secondary outcomes were differences in breastfeeding rates between military-branch affiliation and military rank. RESULTS No changes in breastfeeding initiation occurred between the 2 cohorts (n = 423 and 434). However, an increase in breastfeeding establishment was identified at the 2- (81.5% vs 72.4%; P = .002), 4- (70.5% vs 56.7%; P < .001), 6- (60.3% vs 46.5%; P < .001), and 9-month (45.4% vs 34.9%; P = .003) visits in the 12-week leave cohort. Exclusive breastfeeding increased at 2 (56.4% vs 47.2%; P = .007), 4 (47.5% vs 36.4%; P = .001), and 6 (37.3% vs 29.3%; P = .016) months. CONCLUSIONS Increases in maternity leave correlated with increased breastfeeding duration and exclusivity through 9 months for active duty mothers. These data support the benefit of extended maternity leave in the military and the need for future studies to validate findings at other military treatment facilities.
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Affiliation(s)
- Andrew Delle Donne
- Department of Pediatrics, Naval Medical Center Portsmouth, Portsmouth, Virginia; .,Departments of Pediatrics and
| | - Alex Hatch
- Departments of Pediatrics and.,Department of Pediatrics, University of Utah and Primary Children's Hospital, Salt Lake City, Utah
| | | | - James Aden
- Statistics, Brooke Army Medical Center, Fort Sam Houston, Texas; and
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Addicks SH, McNeil DW. Randomized Controlled Trial of Motivational Interviewing to Support Breastfeeding Among Appalachian Women. J Obstet Gynecol Neonatal Nurs 2019; 48:418-432. [PMID: 31181186 DOI: 10.1016/j.jogn.2019.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2019] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To determine the effectiveness of a single session of prenatal motivational interviewing (MI) to enhance breastfeeding outcomes. DESIGN A randomized controlled trial with two groups (MI and psychoeducation) with repeated measures: preintervention, postintervention, and at 1 month postpartum. SETTING The intervention was conducted at a university-associated clinic, community locations, and participants' homes. Postpartum follow-up was conducted by telephone. PARTICIPANTS A total of 81 women with low-risk pregnancies enrolled at 28 to 39 weeks gestation who lived in Appalachia. METHODS Participants were randomly assigned to MI or psychoeducation on infant development. Pre- and postintervention outcome measures included intention to breastfeed, confidence in and importance of breastfeeding plan, and breastfeeding attitudes. At 1 month postpartum, participants completed a telephone interview to assess actual breastfeeding initiation, exclusivity, and plans to continue breastfeeding. RESULTS At 1 month postpartum, women in the MI group were more likely to report any current breastfeeding than women in the psychoeducation group, regardless of parity, χ2(1, N = 79) = 4.30, p = .040, Φ = .233. At the postintervention time point, the MI intervention had a significant effect on improving attitudes about breastfeeding among primiparous women only (p < .05). CONCLUSION One session of MI was effective to promote breastfeeding at 1 month postpartum and to enhance positive attitudes toward breastfeeding among primiparous women in Appalachia.
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Wallenborn JT, Chambers GJ, Masho SW. The Role of Paternity Acknowledgment in Breastfeeding Noninitiation. J Hum Lact 2018; 34:737-744. [PMID: 29161532 DOI: 10.1177/0890334417743209] [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: 11/16/2022]
Abstract
BACKGROUND In the United States, less than a quarter of mothers breastfeed in accordance with national recommendations. To date, researchers have demonstrated that paternal support directly influences breastfeeding outcomes; however, healthcare practitioners may not be able to quantify a lack of support in the immediate postpartum period. Research aim: The aim is to investigate the relationship between breastfeeding noninitiation and paternity acknowledgment, a factor that can be easily identified in the immediate postpartum period. METHODS Data from the 2014 Vital Statistics Natality Birth database were analyzed. Analysis included primiparous singleton births with no health complications ( N = 1,127,861). Based on the birth certificate data, paternity acknowledgment was categorized as married with paternity acknowledged, unmarried with paternity acknowledged, and unmarried without paternity acknowledged. Breastfeeding initiation was dichotomized (yes or no). Multiple logistic regression analyses were conducted to obtain crude and adjusted odds ratios and 99% confidence intervals (α = .01). RESULTS Approximately one in seven births had no paternity acknowledgment on their birth certificate. After adjusting for confounders, mothers who were not married but the paternity of the infant was acknowledged had 50% higher odds of breastfeeding noninitiation compared with mothers who were married and their infants' paternity was acknowledged (adjusted odds ratio = 1.50, 99% confidence interval [1.47, 1.53]). Furthermore, women who were unmarried and without paternity acknowledgment had 135% higher odds of breastfeeding noninitiation compared with married women with paternity acknowledgment (adjusted odds ratio = 2.35, 99% confidence interval [2.30, 2.41]). CONCLUSION Women whose births were not acknowledged by the fathers may need additional breastfeeding support from healthcare practitioners.
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Affiliation(s)
- Jordyn T Wallenborn
- 1 Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Gregory J Chambers
- 1 Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Saba W Masho
- 1 Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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Horwood C, Haskins L, Engebretsen IM, Phakathi S, Connolly C, Coutsoudis A, Spies L. Improved rates of exclusive breastfeeding at 14 weeks of age in KwaZulu Natal, South Africa: what are the challenges now? BMC Public Health 2018; 18:757. [PMID: 29914417 PMCID: PMC6006942 DOI: 10.1186/s12889-018-5657-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 06/01/2018] [Indexed: 11/10/2022] Open
Abstract
Background Increasing the rate of exclusive breastfeeding (EBF) to 50% in the first six months of life is one of six major global targets set by the United Nations Decade of Nutrition, and is essential to achieve the sustainable development goals to eradicate hunger and end malnutrition by 2030. Methods A survey using multistage random sampling design included 99 primary health care (PHC) clinics in all 11 districts in KwaZulu-Natal (KZN). All mothers and caregivers of infants 14 weeks of age attending the clinics in the study period were requested to participate in a structured interview to explore feeding practices since birth. As non-maternal caregivers may not have detailed knowledge of feeding practices, they provided limited information about current feeding practices. Respondents who consistently reported giving no other food or fluids except breastmilk since birth were classified as practising exclusive breastfeeding (EBF), and those who were currently breastfeeding but had given other food or fluids since birth were categorised as practising mixed breastfeeding (MBF). Results A total of 4172 interviews were conducted with mothers and caregivers of 14 week old infants. Among mothers 49.8% were EBF, 23.1% were MBF and 27.0% were not breastfeeding. Among non-maternal caregivers 11.8% reported EBF, 23.4% MBF and 62.3% were not giving breastmilk. Higher education (OR 0.6, 95% CI 0.4–0.8) and being in the highest socio-economic tertile (OR 0.7, 95% CI 0.6–0.9) were risk factors for not practising EBF, while returning to work (OR 0.3, 95% CI 0.2–0.3) or school (OR 0.2 95% CI, 0.1–0.3) was associated with less EBF. HIV-positive mothers were more likely to have never started breastfeeding (OR 3.6, 95% CI 2.7–4.8). However, they were similar in having stopped breastfeeding by 14 weeks (OR 1.1, 95% CI 0.9–1.4) compared to HIV-negative mothers, and, they had similar rates of EBF at 14 weeks of age (OR 1.0, 95% CI 0.9–1.3). Conclusions Estimates of breastfeeding practices at 14 weeks in KZN are higher than previously shown. However, particular challenges that should be addressed if international targets for EBF are to be achieved include improving breastfeeding practices of HIV positive mothers and supporting all mothers, particularly working or schooling mothers to continue giving breastmilk while they are away from their children.
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Affiliation(s)
- C Horwood
- Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa.
| | - L Haskins
- Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa
| | - I M Engebretsen
- Centre for International Health, Department of global public health and primary care, University of Bergen, Bergen, Norway
| | - S Phakathi
- Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa
| | - C Connolly
- Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa
| | - A Coutsoudis
- Department of Paediatrics & Child Health, School of Clinical Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal , Durban, South Africa
| | - L Spies
- KwaZulu-Natal Department of Health, Pietermaritzburg, KwaZulu-Natal, South Africa
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Abstract
A return to work and school presents mothers with barriers to breastfeeding. Concerns include negative attitudes toward breastfeeding, scheduling and break-time, and appropriate, private space. Current federal laws require worksite support and provision of adequate accommodations for lactation purposes, as do some state laws. An evaluation of faculty, staff, and students (N = 510) at a large public university, assessed breastfeeding knowledge, attitudes, and support following the implementation of new mother-friendly policies and lactation rooms. Additionally, awareness of the lactation rooms and university policies were assessed. Overall, the university climate reflected high breastfeeding knowledge and positive attitudes. Employees had higher awareness of the new lactation facilities and university policies than did students. Implementation limitations were a need for education and awareness efforts targeted to students. Future directions for worksites and schools are addressed.
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