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Alvarado G, Howell K, Waymouth M, Demirci J, Rogers R, Ray K, Uscher-Pines L. Telelactation Within the Landscape of Breastfeeding Support: Experiences of Latina Parents. J Hum Lact 2024:8903344241274760. [PMID: 39286909 DOI: 10.1177/08903344241274760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
BACKGROUND Despite increasing breastfeeding initiation rates in the United States, disparities in breastfeeding continuation and exclusivity by race and ethnicity persist. RESEARCH AIM We aimed to understand the perceptions and experiences of Latina parents who received access to telelactation, and assessed the implications of integrating telelactation into pediatric settings. METHODS This cross-sectional qualitative study drew from participants enrolled in a randomized controlled trial about breastfeeding support. We recruited 20 participants from among those participating in a randomized controlled trial assessing the effect of telelactation on breastfeeding outcomes. The study design was informed by an Equity-Centered Model and authentic entry. We conducted a thematic content analysis through an iterative approach, where we systematically generated themes to describe code application patterns. RESULTS We identified three themes: (1) telelactation within the broader landscape of breastfeeding support; (2) perceptions of telelactation support; and (3) recommendations on the use of telelactation in the context of pediatric care. We found that participants had an escalation approach for seeking breastfeeding support and propose a new model: Breastfeeding Support Escalation Protocol, which can be applied to lactation support in pediatric care. Parents' perceptions and recommendations highlighted their desire for care coordination, expanded options for telelactation engagement, and care continuity, which are important reflections for pediatric offices considering integrating telelactation services into their practice. CONCLUSIONS Latina parents found telehealth to be helpful and an acceptable alternative to in-person services. Pediatric offices can take steps toward becoming Breastfeeding-Friendly by partnering with telelactation services. More research is needed on the logistical implications and cost-effectiveness of telelactation services as part of the pediatric practice.
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Affiliation(s)
| | | | | | - Jill Demirci
- University of Pittsburgh School of Nursing, Department of Health Promotion and Development, Pittsburgh, PA, USA
| | | | - Kristin Ray
- University of Pittsburgh School of Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
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O'Reilly SL, McNestry C, McGuinness D, Killeen SL, Mehegan J, Coughlan B, O'Brien EC, O'Brien D, Szafranska M, Brosnan M, Sheehy L, Murtagh R, O'Hagan L, Corbett M, Walsh M, Keogh R, Power P, Woodcock M, Phelan M, Carroll A, Murray S, Scallan C, Dunn E, McAuliffe FM. Multicomponent perinatal breastfeeding support in women with BMI >25: The Latch On multi-centre randomised trial. BJOG 2024; 131:1197-1206. [PMID: 38344894 DOI: 10.1111/1471-0528.17782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 01/17/2024] [Accepted: 01/24/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVE To investigate the effectiveness of a multicomponent breastfeeding support intervention on breastfeeding prevalence at 3 months among women with a body mass index (BMI) >25 kg/m2. DESIGN Multicentre multicomponent randomised controlled trial. SETTING Four maternity centres in Ireland. POPULATION A total of 225 primiparous women and their nominated support partners. Participants were aged 18 years and over, with BMI ≥25 kg/m2, carrying a singleton pregnancy and without contraindication for breastfeeding. METHODS The intervention included an antenatal group breastfeeding education session for participants and their support partners, followed by a planned postnatal breastfeeding assessment and telephone support for up to 6 weeks by a lactation consultant. MAIN OUTCOME MEASURES Any breastfeeding at 3 months postpartum. RESULTS Any breastfeeding prevalence was 68.7% (n = 68) in the intervention group and 62.1% (n = 59) in the control group at 3 months postpartum (odds ratio 1.33, 95% confidence interval 0.72-2.46, p = 0.36). Any and exclusive breastfeeding rates did not significantly differ at any other time point. More women in the control group accessed support from private lactation consultants (intervention 23.5% [n = 12], control 45.3% [n = 24], p = 0.02). CONCLUSIONS The control group had higher than expected breastfeeding rates, and the study found no evidence of effect on the primary outcome. Providing comprehensive education and support for women intending to breastfeed remains of paramount importance.
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Affiliation(s)
- Sharleen L O'Reilly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Catherine McNestry
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Denise McGuinness
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - John Mehegan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Barbara Coughlan
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Eileen C O'Brien
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Denise O'Brien
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Marcelina Szafranska
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | | | | | | | | | | | | | | | - Paula Power
- St Luke's General Hospital, Mullingar, Ireland
| | | | - Mary Phelan
- St Luke's General Hospital, Mullingar, Ireland
| | - Amy Carroll
- St Luke's General Hospital, Mullingar, Ireland
| | | | | | | | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
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Uhr SD, Johnson TS, Taani MH. Prelicensure Nursing Students' Attitudes Regarding Breastfeeding Education. Nurs Educ Perspect 2024; 45:177-179. [PMID: 37725496 DOI: 10.1097/01.nep.0000000000001191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
ABSTRACT Breast milk feeding is vital to the health outcomes of the breastfeeding dyad. Nurses have a significant role to promote, educate, and support breastfeeding practices for breastfeeding dyads in diverse settings. Nurses should also promote breastfeeding awareness to normalize breastfeeding as the optimal food for infants. This pilot study investigated the effects of a basic breastfeeding educational module on the breastfeeding attitudes of prelicensure nursing students. There was a statistically significant change in attitudes from pretest and posttest. Developing a comprehensive breastfeeding module is a significant step to standardize education and promote breastfeeding best practices.
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Affiliation(s)
- Stephanie D Uhr
- About the Authors Stephanie D. Uhr, PhD, RN, IBCLC, an assistant professor at Northern Illinois University School of Nursing, DeKalb, Illinois, was a doctoral student when this project was developed and implemented. Teresa S. Johnson, PhD, RN, is a professor, University of Wisconsin-Milwaukee School of Nursing, Milwaukee, Wisconsin. Murad H. Taani, PhD, MPH, RN, is an assistant professor, University of Wisconsin-Milwaukee. For more information, contact Dr. Uhr at or
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Martin SL, Zongrone AA, Craig HC, Litvin K, Fort P, Cooper S, Haller M, Dickin KL. Measuring the intangible resources caregivers need to provide nurturing care during the complementary feeding period: a scoping review in low- and lower-middle-income countries. Public Health Nutr 2024; 27:e78. [PMID: 38223942 DOI: 10.1017/s1368980024000065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
OBJECTIVE Caregivers require tangible (e.g. food and financial) and intangible resources to provide care to ensure child health, nutrition and development. Intangible resources include beliefs and knowledge, education, self-efficacy, perceived physical health, mental health, healthy stress levels, social support, empowerment, equitable gender attitudes, safety and security and time sufficiency. These intangible caregiver resources are included as intermediate outcomes in nutrition conceptual frameworks yet are rarely measured as part of maternal and child nutrition research or evaluations. To facilitate their measurement, this scoping review focused on understudied caregiver resources that have been measured during the complementary feeding period in low- and lower-middle-income countries. DESIGN We screened 9,232 abstracts, reviewed 277 full-text articles and included 163 articles that measured caregiver resources related to complementary feeding or the nutritional status of children 6 months to 2 years of age. RESULTS We identified measures of each caregiver resource, though the number of measures and quality of descriptions varied widely. Most articles (77 %) measured only one caregiver resource, mental health (n 83) and social support (n 54) most frequently. Psychometric properties were often reported for mental health measures, but less commonly for other constructs. Few studies reported adapting measures for specific contexts. Existing measures for mental health, equitable gender attitudes, safety and security and time sufficiency were commonly used; other constructs lacked standardised measures. CONCLUSIONS Measurement of caregiver resources during the complementary feeding period is limited. Measuring caregiver resources is essential for prioritising caregivers and understanding how resources influence child care, feeding and nutrition.
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Affiliation(s)
- Stephanie L Martin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, CB 7461, Chapel Hill, NC, 27599-7461, USA
| | | | - Hope C Craig
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Kate Litvin
- USAID Advancing Nutrition, Arlington, Virginia, USA
| | - Peyton Fort
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Stephanie Cooper
- Global Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mia Haller
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katherine L Dickin
- USAID Advancing Nutrition, Arlington, Virginia, USA
- Department of Public and Ecosystem Health, Cornell University, Ithaca, New York, USA
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Lazenby GB, Sundstrom B, Momplaisir FM, Badell ML, Rahangdale L, Nissim OR, Tarleton JL, Dempsey AR. Attitudes on breast feeding among persons with HIV who have given birth and their perceptions of coercion during counseling on safe infant feeding practices. AIDS Care 2023; 35:1852-1862. [PMID: 36435965 PMCID: PMC10213150 DOI: 10.1080/09540121.2022.2147481] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 11/08/2022] [Indexed: 11/28/2022]
Abstract
Persons with HIV can receive mixed messages about the safety of breastfeeding. We sought to assess if they felt coerced to formula feed when counseled about practices to reduce HIV transmission. Persons with HIV who had given birth were eligible to complete a survey to describe their experiences with infant feeding counseling and if they felt coerced to formula feed. An Iowa Infant Feeding Attitude Scale (IIFAS) assessed attitudes towards breastfeeding. Qualitative analyses were performed on narrative responses. One hundred surveys were collected from sites in Georgia, North Carolina, Pennsylvania, and South Carolina. The mean IIFAS score (n, 85) was 47 (SD 9.2), suggesting relatively favorable attitudes toward breastfeeding. Thirteen persons reported feeling coerced to formula feed. When controlling for choosing to give any breast milk, persons with any college education were more likely to report feeling coerced (aOR 9.8 [95% CI 1.8-52.5]). Qualitative analyses revealed three themes: perceiving breastfeeding as unsafe, engaging in shared decision-making, and resisting advice to formula feed. Persons with HIV desire to be counseled about safe infant feeding practices and have their questions answered without judgement. We highlight experiences of persons with HIV that reflect a need for a nuanced approach to infant feeding counseling.
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Affiliation(s)
- Gweneth B Lazenby
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
| | - Beth Sundstrom
- Department of Communication, College of Charleston, Charleston, SC, USA
| | - Florence M Momplaisir
- Department of Medicine, Division of Infectious Diseases, University of Pennsylvania, Philadelphia, PA, USA
| | - Martina L Badell
- Department of Obstetrics of Gynecology, Emory University, Atlanta, GA, USA
| | - Lisa Rahangdale
- Department of Obstetrics of Gynecology, University of North Carolina, Chapel Hill, NC, USA
| | - Oriel R Nissim
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
| | - Jessica L Tarleton
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
| | - Angela R Dempsey
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
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Cimino S, Cerniglia L. Breastfeeding Apps: A Descriptive Report. Behav Sci (Basel) 2023; 13:801. [PMID: 37887451 PMCID: PMC10604718 DOI: 10.3390/bs13100801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 09/20/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Women are increasingly using breastfeeding apps to facilitate and organize breastfeeding; however, no study has so far focused on maternal psychopathological risk and on the quality of dyadic exchanges in this field. AIM AND METHODS This preliminary, descriptive study aimed at evaluating levels of psychopathological symptoms (through the SCL-90/R) and for the quality of the interactions they have with their children during feeding (through the SVIA) in mothers who use breastfeeding apps with different grades of engagement. RESULTS Data analyses showed that mothers with a mild use of the apps present a higher quality of dyadic interactions during feeding and lower psychopathological risk. CONCLUSIONS The cross-sectional and descriptive nature of this study does not allow any causal conclusions. However, results suggest that the higher the engagement and use of breastfeeding apps, the lower the quality of feeding interactions and the higher the maternal psychopathological risk.
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Affiliation(s)
- Silvia Cimino
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Luca Cerniglia
- Faculty of Psychology, International Telematic University Uninettuno, Corso Vittorio Emanuele II, 39, 00186 Rome, Italy
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Mashayekh-Amiri S, Hosseinzadeh M, Jafarabadi MA, Soltani S, Mirghafourvand M. Examining psychometric properties of the Iranian version of exclusive breastfeeding social support scale (EBFSS). BMC Psychol 2023; 11:234. [PMID: 37587499 PMCID: PMC10433609 DOI: 10.1186/s40359-023-01262-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 07/26/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND The exclusive breastfeeding (EBF) is undeniably proven significant in mothers' health and infants' growth and survival. Its persistence has many familial, social, and economical benefits. Social support is known to be an effective factor in EBF's success and sustainability. However, Exclusive breastfeeding social support (EBFSS) scale validity and reliability is not evaluated in Iran. This study aimed to determine the psychometric properties of EBFSS during postpartum period in Tabriz city, Iran. METHODS It is a cross-sectional study with descriptive survey method performed between March 2021 and August 2022. Psychometric properties were determined for the Persian version of EBFSS in six stages: translation process, evaluating content validity, face validity, construct validity, discriminant validity, and reliability. A group of experts (n = 10), followed by a group of women with EBF (n = 10), evaluated the instrument's items based on content and face validities, respectively. A cross-sectional study using the multi-stage cluster random sampling method on 348 women with EBF in the first four months after delivery was conducted to determine the construct validity. The internal consistency and repeatability (test-retest on 30 women, 2 weeks apart) were used to find out the reliability. RESULTS Content validity ratio (CVR), content validity index (CVI), and impact score were 0.98, 0.98, and 3.54 for EBFSS, respectively. This indicates a good content and face validity. Exploratory factor analysis (EFA) was performed on 16 items to examine the construct validity identified emotional, instrumental, and informational factors. These factors explained 59.26% of the cumulative variance. The fit indices (CFI = 0.98، TLI = 0.95، χ2/df = 4.20، RMSEA = 0.07 and SRMSEA = 0.05) confirmed the validity of the model in a confirmatory factor analysis (CFA). The internal consistency was examined through Cronbach's alpha and McDonald's omega coefficients that were 0.90 and 0.92, respectively. Finally, Repeatability and reproducibility were found 0.97 (95% CI: 0.92 to 0.99) using Intra-class correlation. This shows an appropriate reliability of the instrument. CONCLUSIONS The research findings indicate that the Persian version of the EBFSS has appropriate psychometric properties for evaluating the social support in Iranian women with EBF. This means healthcare providers can use it for screening social support in EBF. Researchers also can use it as a valid instrument.
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Affiliation(s)
- Sepideh Mashayekh-Amiri
- Students Research Committee, Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical sciences, Tabriz, Iran
| | - Mina Hosseinzadeh
- Department of Community Health Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Cabrini Research, Cabrini Health, Melbourne, VIC, 3144, Australia
- School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, 3004, Australia
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sepideh Soltani
- Students Research Committee, Department of Community Health Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
- Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Volpato LK, Gugel LS, Rengel GK, Nunes RD, Traebert J. Transcultural adaptation of a scale for exclusive breastfeeding to be used in Brazil. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20221476. [PMID: 37812811 PMCID: PMC10351992 DOI: 10.1590/1806-9282.20221476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 04/25/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVE The aim of this study was to perform a cross-cultural adaptation of the Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding for use in a Brazilian-Portuguese context. METHODS The cross-cultural adaptation process involved the translation from original English into Brazilian Portuguese by two qualified and independent translators. Both translations were synthesized into a single version that was back-translated into English. An expert committee was created to assess linguistic equivalences, formulating a pre-final version that was tested on ten nursing women attending a maternity hospital. To assess its psychometric properties, a cross-sectional study was carried out. The population consisted of 99 nursing women from a reference maternity hospital in southern Brazil. The scale's stability and internal consistency were measured through Cronbach's alpha. The Pearson's correlation coefficient and the intraclass correlation coefficient between two applications were assessed to ascertain the Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding-Br scale's reliability. The construct validity was evaluated through exploratory factorial analysis. RESULTS The Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding-Br showed a general Cronbach's alpha of 0.849. The test-retest analysis showed a Pearson's correlation coefficient of 0.483 and intraclass correlation coefficient of 0.645. The exploratory factorial analysis showed two domains among the nine items of the Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding-Br: the functional domain, including six items, and the cognitive domain, including three items, explaining 59.77% of the variance. CONCLUSION The Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding-Br was considered adequate for the cultural context and reliable and valid for Brazilian nursing women.
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Affiliation(s)
- Lia Karina Volpato
- Hospital Regional Dr. Homero de Miranda Gomes, Gynecology and Obstetrics Service – São José (SC), Brazil
- Universidade do Sul de Santa Catarina, Graduate Program in Health Sciences – Palhoça (SC), Brazil
| | - Laura Schuck Gugel
- Universidade do Sul de Santa Catarina, School of Medicine – Palhoça (SC), Brazil
| | | | - Rodrigo Dias Nunes
- Hospital Regional Dr. Homero de Miranda Gomes, Gynecology and Obstetrics Service – São José (SC), Brazil
- Universidade do Sul de Santa Catarina, Graduate Program in Health Sciences – Palhoça (SC), Brazil
| | - Jefferson Traebert
- Universidade do Sul de Santa Catarina, Graduate Program in Health Sciences – Palhoça (SC), Brazil
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Scott AL, Lambert AW, Wang CH, Johnson KV, Weiss J, Stankus T. University campus breastfeeding, knowledge, and perceptions of support: An exploratory study. PLoS One 2023; 18:e0285008. [PMID: 37235590 DOI: 10.1371/journal.pone.0285008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/14/2023] [Indexed: 05/28/2023] Open
Abstract
Breastfeeding is often considered principally a biological issue but success is impacted by the socio-ecological environment of the lactating parent. Identifying current attitudes towards breastfeeding is essential in the effort toward normalizing breastfeeding in communities, including university campuses. The study explored campus community knowledge, awareness, and attitudes about breastfeeding, including available resources and applicable laws on two university campuses in the southern United States. This cross-sectional, self-reporting study utilized the Iowa Infant Feeding Attitude Scale and an adaptation of the Breastfeeding Behavior Questionnaire to survey a convenience sample. Results revealed decreased awareness of protective laws, availability of private lactation space, and insufficient public appreciation of breastfeeding's unique advantages to both lactating parent and infant as barriers to breastfeeding. These findings will help develop additional breastfeeding strategies to improve university campus community breastfeeding initiatives.
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Affiliation(s)
- Allison L Scott
- Eleanor Mann School of Nursing, University of Arkansas, Fayetteville, Arkansas, United States of America
| | - Ann W Lambert
- Auburn University College of Nursing, Auburn University, Auburn, Alabama, United States of America
| | - Chih-Hsuan Wang
- Auburn University College of Education, Auburn University, Auburn, Alabama, United States of America
| | - Kelly V Johnson
- Eleanor Mann School of Nursing, University of Arkansas, Fayetteville, Arkansas, United States of America
| | - Jessica Weiss
- St. Luke's Health System, Kansas City, Missouri, United States of America
| | - Tony Stankus
- University of Arkansas Libraries, University of Arkansas, Fayetteville, Arkansas, United States of America
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Laws RA, Cheng H, Rossiter C, Kuswara K, Markides BR, Size D, Corcoran P, Ong K, Denney‐Wilson E. Perinatal support for breastfeeding using mHealth: A mixed methods feasibility study of the My Baby Now app. MATERNAL & CHILD NUTRITION 2023; 19:e13482. [PMID: 36725007 PMCID: PMC10019053 DOI: 10.1111/mcn.13482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/20/2022] [Accepted: 01/13/2023] [Indexed: 02/03/2023]
Abstract
Despite the well-known benefits of breastfeeding, breastfeeding rates remain suboptimal, particularly for women with lower socioeconomic position. Although popular, breastfeeding apps are often poor quality; their impact on breastfeeding knowledge, attitudes, confidence and intentions is unknown. A mixed method pre-post feasibility study was conducted to: 1) explore the feasibility of the My Baby Now app in providing perinatal breastfeeding support; 2) examine the impact on breastfeeding knowledge, attitudes, confidence and intentions; 3) to examine any differences in acceptability and impact of the app according to maternal education. The My Baby Now app was offered to pregnant women 20-30 weeks gestation. Breastfeeding knowledge and intentions were collected at baseline (T1) and 36-38 weeks gestation (T2); attitudes and confidence were collected at baseline, T2 and T3 (8-12 weeks post-partum). App engagement was measured via app analytics. Qualitative interviews were conducted with a purposeful sample following T3. Of 266 participants recruited, 169 (64%) completed T2 and 157 (59%) completed T3. Mothers without university education rated the app to be higher quality, more useful and impactful than mothers with university education. From T1-T2, breastfeeding knowledge (59.6% vs. 66.5%, p < 0.001) and exclusive breastfeeding intentions (76.6% vs. 80.9%, p < 0.001) increased. Breastfeeding attitudes and confidence scores also increased significantly across T1-T2 and T1-T3. App engagement during pregnancy predicted changes in breastfeeding attitudes from T1-T2 among participants without university education. App engagement did not predict changes in breastfeeding knowledge, confidence or intentions. Future randomised controlled studies should examine the effectiveness of mHealth interventions on breastfeeding outcomes.
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Affiliation(s)
- Rachel A. Laws
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition ScienceDeakin UniversityGeelongAustralia
| | - Heilok Cheng
- Susan Wakil School of Nursing and MidwiferyThe University of SydneyCamperdownAustralia
| | - Chris Rossiter
- Susan Wakil School of Nursing and MidwiferyThe University of SydneyCamperdownAustralia
| | - Konsita Kuswara
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition ScienceDeakin UniversityGeelongAustralia
| | - Brittany R. Markides
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition ScienceDeakin UniversityGeelongAustralia
| | - Donna Size
- Sydney Institute for Women, Children and their Families, Sydney Local Health DistrictSydneyAustralia
| | - Patricia Corcoran
- Sydney Institute for Women, Children and their Families, Sydney Local Health DistrictSydneyAustralia
- Canterbury Hospital Maternity Unit, Sydney Local Health DistrictSydneyAustralia
| | - Kok‐Leong Ong
- Department of Information Systems and Business Analytics, AISSCRMIT UniversityMelbourneAustralia
| | - Elizabeth Denney‐Wilson
- Susan Wakil School of Nursing and MidwiferyThe University of SydneyCamperdownAustralia
- Sydney Institute for Women, Children and their Families, Sydney Local Health DistrictSydneyAustralia
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Mäkelä H, Axelin A, Kolari T, Niela-Vilén H. Exclusive breastfeeding, breastfeeding problems, and maternal breastfeeding attitudes before and after the baby-friendly hospital initiative: A quasi-experimental study. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 35:100806. [PMID: 36521260 DOI: 10.1016/j.srhc.2022.100806] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/02/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Breastfeeding practices remain globally suboptimal despite many known maternal and neonatal health benefits and the Baby-Friendly Hospital Initiative as a global effort to support breastfeeding. OBJECTIVE We aimed to evaluate the effects of the implementation of the Baby-Friendly Hospital Initiative for a proportion of mothers who exclusively breastfed during a 6-month period, including breastfeeding problems, and maternal breastfeeding attitudes. METHODS Using a quasi-experimental non-equivalent two-group design, we recruited two independent samples of postpartum mothers in a maternity hospital to compare the situation before (N = 162) and after (N = 163) the implementation. We measured breastfeeding status and possible breastfeeding problems via text-message questions at 2 weeks, 1, 4 and 6 months after birth. We measured Mothers' attitudes toward breastfeeding at the maternity hospital and 4 months after birth using the Iowa Infant Feeding Attitude Scale. RESULTS The implementation of the Baby-Friendly Hospital Initiative had no effect on the proportion of mothers who exclusively breastfed, and we found no significant differences in exclusive breastfeeding at 6 months (41.3 % vs 52.9 %, p =.435). The intervention did not influence the reported number of breastfeeding problems (p =.260) or maternal breastfeeding attitudes (p =.354). More favourable breastfeeding attitudes (p <.001) and less problematic breastfeeding (p <.001) were associated positively with exclusive breastfeeding. CONCLUSION Exclusive breastfeeding rates did not increase after the intervention; however, the rates at baseline were already high. Ensuring the Baby-Friendly Hospital Initiative practices through pre- and postnatal periods and preparing mothers to manage common breastfeeding problems might improve breastfeeding rates. This trial was registered (0307-0041) with ClinicalTrials.gov on 03/03/2017.
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Affiliation(s)
- Heli Mäkelä
- University of Turku, Department of Nursing Science, Turku, Finland; Satakunta Hospital District, Satasairaala, Pori, Finland.
| | - Anna Axelin
- University of Turku, Department of Nursing Science, Turku, Finland
| | - Terhi Kolari
- University on Turku, Department of Biostatistics, University of Turku, Turku, Finland
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Levels and Determinants of Antenatal Breastfeeding Attitudes among Pregnant Women: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020275. [PMID: 36832403 PMCID: PMC9954942 DOI: 10.3390/children10020275] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/21/2023] [Accepted: 01/25/2023] [Indexed: 02/04/2023]
Abstract
Breastfeeding attitudes are strong predictors of breastfeeding behavior. Gaining a deeper understanding on the levels and determinants of antenatal breastfeeding attitudes is crucial. This cross-sectional study involved 124 pregnant women at a tertiary hospital in Hunan, China. A self-administered questionnaire, the Iowa Infant Feeding Attitude Scale, the Edinburgh Postnatal Depression Scale, the Pregnancy Stress Rating Scale, the Childbirth Attitude Questionnaire, the Perceived Social Support Scale, and the Breastfeeding Knowledge Questionnaire were assessed during their first-trimester, second-trimester, and third-trimester hospital visit. Multiple linear regression was conducted to identify the determinants of breastfeeding attitudes. The participants reported neutral (56.39 ± 5.69) levels of breastfeeding attitudes. The determinants of antenatal breastfeeding attitudes were other family members' support for exclusive breastfeeding: moderate (β = 0.278, p < 0.05), depressive symptoms (β = -0.191, p < 0.05), and breastfeeding knowledge (β = 0.434, p < 0.001). The variables explained 33.9% (adjusted R2) of the total variation in breastfeeding attitudes scores (F = 4.507, p < 0.001). Namely, other family members' support for EBF was a negative influence on positive breastfeeding attitudes. The women whose other family members were moderate of EBF had more positive attitudes toward breastfeeding compared to those whose other family members were very supportive of EBF. The depressive symptoms were negatively associated with positive breastfeeding attitudes, and lower levels of depressive symptoms were associated with higher levels of positive breastfeeding attitudes among pregnant women. Additionally, breastfeeding knowledge was positively associated with positive breastfeeding attitudes. The more knowledgeable about breastfeeding, the more positive the attitude towards breastfeeding. Health professionals should identify these modifiable factors that may contribute to poorer breastfeeding attitudes, which is useful in targeting promotions of breastfeeding.
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Caniçali Primo C, Brandão MAG, Dias JMS, Godoi LGD, Monroy NJ, Resende FZ, Lima EDFA. Escala Interativa de Amamentação: avaliação da confiabilidade. ESCOLA ANNA NERY 2023. [DOI: 10.1590/2177-9465-ean-2022-0124pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Resumo Objetivo avaliar a confiabilidade da Escala Interativa de Amamentação. Método estudo metodológico, que seguiu a terceira etapa do método de Pasquali para elaboração de escalas, desenvolvido com 216 puérperas, em hospital universitário da região Sudeste do Brasil. Para avaliação da confiabilidade, foram utilizados o percentual de concordância (pa) acima de 80%, o Kappa ponderado (Kp), a second-order agreement coefficient (AC2) de Gwet e o alfa de Cronbach. Resultados o percentual de concordância dos itens foi de 83,33%; o valor global do alfa de Cronbach foi de 0,67; o coeficiente AC2 com ponderações quadrática e linear obteve a confiabilidade quase perfeita. Conclusão e implicação para a prática a avaliação da confiabilidade da Escala Interativa de Amamentação foi alta, e foi confirmada pelos resultados que asseguram a qualidade do instrumento na população estudada, mostrando-se um instrumento confiável e válido para avaliar os fatores que interferem na interação mãe-filho durante a amamentação.
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Caniçali Primo C, Brandão MAG, Dias JMS, Godoi LGD, Monroy NJ, Resende FZ, Lima EDFA. Interactive Breastfeeding Scale: reliability assessment. ESCOLA ANNA NERY 2023. [DOI: 10.1590/2177-9465-ean-2022-0124en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract Objective to assess the Interactive Breastfeeding Scale reliability. Method a methodological study that followed the third stage of Pasquali’s method for the elaboration of scales, carried out with 216 postpartum women at a university hospital in southeastern Brazil. To assess reliability, percentage of agreement (pa) above 80%, the weighted Kappa (Kp), Gwet’s second-order agreement coefficient (AC2) and Cronbach’s alpha were used. Results the percentage of agreement was 83.33%; the overall Cronbach’s alpha value was 0.67; the AC2 coefficient with quadratic and linear weights obtained near-perfect reliability. Conclusion and implication for practice the Interactive Breastfeeding Scale reliability assessment was high, and it was confirmed by the results that ensure instrument quality in the population studied, proving to be a reliable and valid instrument to assess factors that interfere in the mother-child interaction while breastfeeding.
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Nuampa S, Ratinthorn A, Patil CL, Kuesakul K, Prasong S, Sudphet M. Impact of personal and environmental factors affecting exclusive breastfeeding practices in the first six months during the COVID-19 pandemic in Thailand: a mixed-methods approach. Int Breastfeed J 2022; 17:73. [PMID: 36253791 PMCID: PMC9576315 DOI: 10.1186/s13006-022-00515-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 09/28/2022] [Indexed: 11/19/2022] Open
Abstract
Background Exclusive breastfeeding (EBF) for six months is recommended as one of the most important ways to support child health and survival, particularly during the COVID-19 pandemic. However, breastfeeding women encountered several obstacles during the pandemic. The purpose of this study was to conduct a survey to document breastfeeding practices, EBF rates and associated factors with six month exclusive breastfeeding during the second wave of the coronavirus outbreak in Thailand. Methods A mixed-methods design that included a cross-sectional survey (n = 390) and semi-structured in-depth interviews (n = 15) was carried out between August and November 2021. Participants were women aged ≥ 15 years who had given birth within 6–12 months before data collection and delivered in three public hospitals in the top three provinces with the most severe COVID-19 outbreaks. Results The median duration of EBF was four months (interquartile range, IQR: 1–6 months) and 37.4% of women exclusively breastfed for six months. From binary logistic regression models, several personal factors were associated with exclusive breastfeeding for six months including being a housewife (AOR 2.848; 95% CI 1.512, 5.367), perceived sufficiency of family income (AOR 2.502; 95% CI 1.362, 4.594), working from home/business (AOR 2.071; 95% CI 1.074, 3.995), breastfeeding intention (AOR 1.162; 95% CI 1.116, 1.210), and maternal age (AOR 0.932; 95% CI 0.882, 0.986). From qualitative interviews, women who were able to exclusively breastfed during the outbreak explained five themes that were a protective shield; I have to save money, I could spend all my time with my baby and breastfeed, spousal support is valuable, and opportunity to avoid the obstructed beliefs about exclusive breastfeeding. Conclusions Mothers with higher socioeconomic status and who were unemployed/worked from home and had support structures in place were able to successfully EBF during the COVID-19 outbreak. Healthcare providers can better support breastfeeding if they provide informational support and allow family members to participate in breastfeeding programs, especially spouses who provided key emotional and tangible support during pandemic.
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Affiliation(s)
- Sasitara Nuampa
- Department of Obstetrics and Gynecological Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand.
| | - Ameporn Ratinthorn
- Department of Obstetrics and Gynecological Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Crystal L Patil
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Kornkanok Kuesakul
- Department of Obstetrics and Gynecological Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Sudhathai Prasong
- Department of Obstetrics and Gynecological Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Metpapha Sudphet
- Department of Obstetrics and Gynaecology, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Chaabna N, Mahfoud ZR, Letourneau N, Forgrave D, White D. Muslim women's attitudes toward infant feeding in Qatar: An exploration using the Iowa infant feeding attitude scale. Midwifery 2022; 114:103470. [PMID: 36096068 DOI: 10.1016/j.midw.2022.103470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/18/2022] [Accepted: 08/24/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Maternal attitude toward infant feeding is an important determinant of breastfeeding. The Islamic faith encourages breastfeeding, yet many Muslim women do not breastfeed as per the World Health Organization recommendations. In the Middle East, research has not addressed attitudes toward infant feeding among Muslim women. Assessing women's attitudes toward infant feeding choices is crucial to improve breastfeeding rates among Muslim women. AIM The aims of this study are to (a) examine postpartum Muslim women's attitudes toward infant feeding, (b) identify the determinants of these attitudes, and (c) determine whether attitudes can predict breastfeeding intention among Muslim women. A secondary aim is to examine the psychometric attributes of the Iowa Infant Feeding Attitude Scale among Muslim women. METHOD A convenience sample of postpartum Muslim women (N = 414) were recruited between November 2019 and January 2020 in a large maternity facility in Qatar. A pre-developed questionnaire and the IIFAS were used to collect data. Both Arabic (n = 228) and English (n = 186) versions of the IIFAS were distributed postnatally to measure Muslim women's attitudes towards breastfeeding. A total attitude score was computed with higher scores indicating a more positive attitude toward breastfeeding. FINDINGS The mean age of participants was 30.3 ± 5.2 years; 65.2% had a university degree and only 20.5% were employed. The mean attitude score was 61.8 ± 7.8. A significant association was found between the IIFAS attitude score and ethnicity, favouring Non-Qatari Arab women who had significantly higher attitude scores (p < .001). Women with full-time or part-time work had significantly higher scores than those not working (p = .008, p = .023). Older women had significantly lower attitude scores (adjusted slope = -0.230, p = .008). Cronbach's alpha reliability coefficient of the Arabic and English versions of the IIFAS ranged from 0.69 to 0.80. CONCLUSION Ethnicity, employment status, and age are determinants of infant feeding attitudes among Muslim women. In Qatar, Muslim women's attitudes related to breastfeeding trend toward positive; however, attitude is not a predictor of antenatal breastfeeding intention. Further research employing a larger sample with a focus on a culturally sensitive approach is recommended. The IIFAS has a moderate reliability level and needs to be culturally adapted to be used among a Muslim population.
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Affiliation(s)
- Nabila Chaabna
- Patient and Family Education Unit, Nursing Department, Hamad Medical Corporation, Doha, Qatar; Faculty of Nursing, University of Calgary in Qatar, Doha, Qatar.
| | - Ziyad R Mahfoud
- Medical Education, Weill Cornell Medicine-Qatar, Doha, Qatar; Division of Epidemiology, Department of Population Health Sciences, Weill Cornell Medicine, NY, USA
| | - Nicole Letourneau
- Faculty of Nursing and Cumming School of Medicine, Departments of Paediatrics, Psychiatry and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Daniel Forgrave
- Faculty of Nursing, University of Calgary in Qatar, Doha, Qatar
| | - Deborah White
- Faculty of Nursing, University of Calgary in Qatar, Doha, Qatar
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Bunik M, Jimenez-Zambrano A, Solano M, Beaty BL, Juarez-Colunga E, Zhang X, Moore SL, Bull S, Leiferman JA. Mother's Milk Messaging™: trial evaluation of app and texting for breastfeeding support. BMC Pregnancy Childbirth 2022; 22:660. [PMID: 36002798 PMCID: PMC9400217 DOI: 10.1186/s12884-022-04976-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND New mothers experience BF challenges but have limited evidence-based technology-enabled support. OBJECTIVES 1) Determine if using the Mother's Milk Messaging™ app improved aspects of breastfeeding and breastfeeding rates and 2) Describe engagement as well as themes from the qualitative feedback on the app. METHOD Randomized Controlled Trial National sample of primiparous, singleton mothers recruited online and then randomized using stratification by language into three arms: 1) BF text messages plus app; 2) BF text messages, app and physician-moderated private Facebook (FB) group; 3) Attention control group who received injury prevention texts. Exclusive breastfeeding rates as primary outcome and knowledge/attitude, confidence, and social support as secondary outcomes. We determined engagement through analysis of app usage metrics. We conducted and content-coded interviews with participants to learn more about app usage and BF experience. Due to the nature of the intervention participants could not be blinded. RESULTS There were a total of 346 participants in the trial, with 227 in the Intervention (n = 154 group 1 and n = 156 group 2) and 119 in the control group. Because of minimal Facebook activity, the two intervention groups 1 and 2 were combined. There were no differences in breastfeeding exclusivity and duration. (NS). Women in the intervention arm reported significantly higher confidence with breastfeeding and perceived social support to the control group (p < .05). Greater than 80% registered the app and those that engaged with the app had higher scores with time. Mothers appreciated receiving text messages and videos with reliable information. No harm was reported in this study. CONCLUSION MMM increased confidence with breastfeeding and with gathering social supports. Exclusively BF was high in all participants. Mothers perceived it as useful and dependable especially the texting.
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Affiliation(s)
- Maya Bunik
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. .,Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. .,Children's Hospital Colorado, 13123 E. 16th Ave B032, Aurora, CO, 80045, USA.
| | - Andrea Jimenez-Zambrano
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Michael Solano
- Children's Hospital Colorado, 13123 E. 16th Ave B032, Aurora, CO, 80045, USA
| | - Brenda L Beaty
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Elizabeth Juarez-Colunga
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Xuhong Zhang
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Susan L Moore
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sheana Bull
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jenn A Leiferman
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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18
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Mäkelä H, Axelin A, Kolari T, Kuivalainen T, Niela-Vilén H. Healthcare Professionals' Breastfeeding Attitudes and Hospital Practices During Delivery and in Neonatal Intensive Care Units: Pre and Post Implementing the Baby-Friendly Hospital Initiative. J Hum Lact 2022; 38:537-547. [PMID: 34841935 PMCID: PMC9329761 DOI: 10.1177/08903344211058373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Baby-Friendly Hospital Initiative represents a global effort to support breastfeeding. Commitment to this program has been associated with the longer duration and exclusivity of breastfeeding and improvements in hospital practices. Further, healthcare professionals' breastfeeding attitudes have been associated with the ability to provide professional support for breastfeeding. RESEARCH AIMS To determine healthcare professionals' breastfeeding attitudes and hospital practices before and after the implementation of the Baby-Friendly Hospital Initiative. METHODS Using a quasi-experimental pretest-posttest study design, healthcare professionals (N = 131) from the single hospital labor and delivery, maternity care, and neonatal intensive care were recruited before and after the Baby-Friendly Hospital Initiative intervention during 2017 and 2019. Breastfeeding attitudes with the validated Breastfeeding Attitude Questionnaire, breastfeeding-related hospital practices, and background characteristics were collected. RESULTS The healthcare professionals' breastfeeding attitude scores increased significantly after the implementation of the Baby-Friendly Hospital Initiative, difference = 0.16, (95% CI [0.13, 0.19]) and became breastfeeding favorable among all professional groups in each study unit. Positive changes in breastfeeding-supportive hospital practices were achieved. The infants had significantly more frequent immediate and uninterrupted skin-to-skin contact with their mothers. The rate of early breastfeeding, as well as the number of exclusively breastfed infants, increased. CONCLUSIONS After the Baby-Friendly Hospital Initiative and Baby-Friendly Hospital Initiative for neonatal wards (Neo-BFHI) interventions were concluded, we found significant improvements in the breastfeeding attitudes of healthcare professionals and in breastfeeding-related care practices.This RCT was registered (0307-0041) with ClinicalTrials.gov on 03/03/2017.
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Affiliation(s)
- Heli Mäkelä
- Department of Nursing Science, University of Turku, Turku, Finland.,Satakunta Hospital District, Satasairaala, Pori, Finland
| | - Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Terhi Kolari
- University on Turku, Department of Biostatistics, University of Turku, Turku, Finland
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Jiang M, Ren G, Dai H, Tian L, Huang J, He W, Tan S. Comparation of knowledge, attitude and social support of exclusive breastfeeding between primiparae and multiparae after delivery within 6 months in Changsha, China: a cross-sectional study. Transl Pediatr 2022; 11:1323-1335. [PMID: 36072543 PMCID: PMC9442209 DOI: 10.21037/tp-22-327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/02/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The knowledge, attitude, and social support of exclusive breastfeeding among mothers are the important predictors of the starting time of lactation and the duration time of breastfeeding. Evaluating the knowledge, attitude, social support of exclusive breastfeeding of mothers is critical to recognize those at risk for suboptimal breastfeeding practices. There were a small amount of studies related to knowledge, attitude and social support of mothers, a blank for comparative study of the knowledge, attitude, social support of breastfeeding between primiparae and multiparae existed. Our aim was to compare the feeding situation between firstborns and second-born infants, and to compare the knowledge, attitude, and social support between primiparae and multiparae. METHODS This was a cross-sectional study, a total of 354 mothers of infants aged 0-6 months who underwent physical examination between February 2019 and July 2019 were randomly recruited to the study and finished an on-site questionnaire. Chi-square test or Fisher's exact test were used to make a comparison among groups. RESULTS The average rate of exclusive breastfeeding among infants aged 0-6 months was 61.30%. There is no statistical difference between the firstborns and the second-born infants regarding whether cod liver oil was supplemented, whether it was breastfeeding after birth, the signal of breastfeeding for infants, and the duration of each lactation (P>0.05); The rate of exclusive breastfeeding of second-born infants was lower than that of firstborns (P=0.001); The starting time of breastfeeding of second-born infants was earlier than that of firstborns (P=0.041). Compared to primiparae, multiparae had a higher degree of understanding of feeding knowledge (P<0.001), a higher proficiency level of self-evaluation of feeding techniques (P<0.001); and a better self-evaluation of feeding habit (P<0.001); more multiparae had prenatal feeding counselling (P<0.001); primiparae and multiparae had no statistical difference in attitude and social support of breastfeeding (all P>0.05). CONCLUSIONS Breastfeeding knowledge, skills, and habits of mothers all need to be improved. It's urgent to make up for the deficiency of news media such as television and radio in the dissemination of breastfeeding knowledge. Primiparas with a high level of education are the key object of our publicity and education.
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Affiliation(s)
- Mei Jiang
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Guofeng Ren
- Department of Nutrition and Food Hygiene, Xiangya Public Health School of Central South University, Changsha, China
| | - Hongmei Dai
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Lang Tian
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jinhui Huang
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Wei He
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Shan Tan
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
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Chan K, Whitfield KC. Article: "Too Old" and "Too Cold": Discomfort Towards Photographs of Breastfeeding Beyond Infancy and Public Breastfeeding in Nova Scotia, Canada. J Hum Lact 2022; 38:353-363. [PMID: 34549657 PMCID: PMC9016677 DOI: 10.1177/08903344211046191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/24/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Social norms and public perception of breastfeeding are well-established predictors of breastfeeding outcomes; however, little is known about perceptions of breastfeeding beyond infancy or public breastfeeding among the public in Nova Scotia, Canada. RESEARCH AIM To explore public opinion about breastfeeding beyond infancy and public breastfeeding. METHODS In this cross-sectional study participants were recruited from public spaces in Nova Scotia, Canada. Using photo elicitation methods, participants (N = 229) viewed six photographs of breastfeeding children aged 2 weeks, 13 months, and 2.5 years, one photograph captured at home, and the other in a public space (a café, a store, or outdoors). Participants were asked to score their self-rated comfort with each photograph on a 10.0 cm visual analog scale and asked to share their feelings about each photograph (open-ended responses). RESULTS Mean (SD) visual analog scale comfort scores for photographs differed by location (private, 7.9 [2.2]; public, 7.3 [2.6]; p < .05) and child age (2 weeks, 8.5 [2.0]; 13 months, 7.5 [2.6]; 2.5 years, 6.9 [3.0]; p < .05). Participants who identified as women and parents self-reported significantly higher comfort with all photographs, while younger participants and urban dwellers were generally less comfortable. Open-ended responses varied considerably, but a higher proportion of negative comments were reported for older children feeding in public spaces (e.g., 2.5-year-old in public: "Inappropriate. Indecent. Abnormal."). CONCLUSION Given the importance of social norms in supporting breastfeeding, future public health campaigns should strive to normalize breastfeeding beyond infancy, and in public spaces.
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Affiliation(s)
- Kathleen Chan
- Department of Applied Human Nutrition,
Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Kyly C. Whitfield
- Department of Applied Human Nutrition,
Mount Saint Vincent University, Halifax, Nova Scotia, Canada
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Ayari F, Sdiri Y, Cherifi E, Khemiri S, Chourou H, Cheour M, Belhajammar W, Karoui A, Channoufi MB, Kacem S, Achour R. [Knowledge of breastfeeding among mothers before maternity discharge]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2022; 50:164-172. [PMID: 34626850 DOI: 10.1016/j.gofs.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES The aim of our study was to assess the knowledge of parturients about breastfeeding and to analyze the factors influencing this level of knowledge. METHODS It was a prospective, descriptive and analytical, cross-sectional study carried out over a period of six months including 500 parturients who gave birth at the maternity unit of the National Center for Maternity and Neonatalogy of Tunis during the period from July to December 2020. Sociodemographic, obstetrical and breastfeeding related data were collected through individual interviews carried out before leaving the postpartum service using a questionnaire written in Tunisian dialectal Arabic. RESULTS The average age of the mothers was 31.5 years. Housewives accounted for 73.3 % of cases. Forty-four percent of the women surveyed were first-time mothers. The main source of information was relatives (74.8 %). The prevalence of breastfeeding was 93.8 %. Knowledge about breasfeeding was insufficient in 76.4 % of cases. The level of knowledge was insufficient in particular regarding signs of effective breastfeeding, signs of awakening of the newborn, lactogenesis, and diet of breastfeeding women. Unemployment of the parturient age over 30 and primiparity negatively influenced the knowledge of parturients. CONCLUSION The level of knowledge of parturients was heterogeneous but generally insufficient. Health education programs on MA targeting subjects most at risk of insufficient knowledge should be put in place in order to improve the knowledge base and hopefully improve the breastfeeding rates.
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Affiliation(s)
- F Ayari
- Service de médecine et de réanimation néonatale du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie.
| | - Y Sdiri
- Service de médecine et de réanimation néonatale du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - E Cherifi
- Service de médecine et de réanimation néonatale du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - S Khemiri
- Service de médecine et de réanimation néonatale du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - H Chourou
- Service de médecine et de réanimation néonatale du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - M Cheour
- Service de médecine et de réanimation néonatale du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - W Belhajammar
- Service de médecine et de réanimation néonatale du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - A Karoui
- Service de gynécologie et d'obstétrique 'C' du centre de maternité et de néonatologie de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - M B Channoufi
- Service de gynécologie et d'obstétrique 'C' du centre de maternité et de néonatologie de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - S Kacem
- Service de médecine et de réanimation néonatale du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - R Achour
- Service des urgences de gynécologie et d'obstétrique du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
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22
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GUPTA ARTI, ARAVINDAKSHAN RAJEEV, SATHIYANARAYANAN SATHIYAMOORTHI, NAIDU NAVYAKRISHNA, SANTHOSHI KOMAKULAN, KAKKAR RAKESH. Validation of Gender Friendly Breastfeeding Knowledge scale among young adults. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 62:E892-E903. [PMID: 35603239 PMCID: PMC9104672 DOI: 10.15167/2421-4248/jpmh2021.62.4.2032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022]
Abstract
Introduction Breastfeeding is the most effective intervention to improve child health. Young adults, both genders play an important role in society supporting breastfeeding as they will be stepping towards parenthood in the near future. Bringing awareness and busting the myths among them is essential. This study aimed to develop a Gender Friendly Breastfeeding Knowledge scale based on a conceptual framework that reflected the knowledge of young adults and evaluates its validity and reliability. Methodology Development of the questionnaire for Conceptual framework and item generation was done using PubMed, Google Scholar, other sources and expert opinion. The type of measurement was structured as a 5-point Likert scale. The Lawshe technique to assess the content validity ratio. A cross-sectional survey in graduation colleges situated in Mangalagiri or within the radius of 30 km of Mangalagiri, Andhra Pradesh, India was conducted in 2020. 1400 Adult males and females aged 20-25 years and perusing full-time graduation course were recruited. For each item in the Gender Friendly Breastfeeding Awareness scale, we assessed individual item characteristics and item-test correlation. To check to construct validity, we performed exploratory factor analysis and confirmatory factor analysis. Results Expert panel retained 23 items from initially 30 items. The content validity index score for the each of 23-items in the scale was more than 0.80. A four-factor structure perfectly fitted the data and illustrated 54% of the variation in knowledge of breastfeeding. 4 stages of CFA were completed. The chi-square = 860.534 was significantly above the 0.01 level. Cronbach's alpha = 0.787 based on standardized items reflected the overall internal consistency of the Gender Friendly Breastfeeding Awareness scale. Conclusion Gender Friendly Breastfeeding Knowledge scale is a valid and reliable tool, it is recommended that this scale be used in communities, educational institutions, and in relevant research to assess Breastfeeding knowledge among young adults of both genders, thereby promoting breastfeeding practices in the future.
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Affiliation(s)
- ARTI GUPTA
- Assistant Professor, Department of Community and Family Medicine, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India
- Correspondence: Arti Gupta, Department of Community and Family Medicine, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India - Te.: +91 9013902976 - E-mail:
| | - RAJEEV ARAVINDAKSHAN
- Additional Professor, Department of Community and Family Medicine, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India
| | - SATHIYAMOORTHI SATHIYANARAYANAN
- Assistant Professor, Department of Community and Family Medicine, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India
| | - NAVYA KRISHNA NAIDU
- Tutor, Department of Community and Family Medicine, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India
| | - KOMAKULA N.K.S. SANTHOSHI
- Nursing Officer, Department of Community and Family Medicine, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India
| | - RAKESH KAKKAR
- Professor and Head, Department of Community and Family Medicine, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India
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Yahya NFS, Teng NIMF, Shafiee N, Juliana N. Association between Breastfeeding Attitudes and Postpartum Depression among Mothers with Premature Infants during COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10915. [PMID: 34682652 PMCID: PMC8535779 DOI: 10.3390/ijerph182010915] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/06/2021] [Accepted: 10/13/2021] [Indexed: 12/21/2022]
Abstract
Breastfeeding is the best form of feeding for premature infants. However, mothers with premature delivery are frequently reported to be depressed, and this has been especially the case during the Coronavirus Disease-2019 (COVID-19) pandemic. We aimed to measure the level of breastfeeding attitude and its association with postpartum depression among mothers with premature infants in the Neonatal Intensive Care Unit (NICU) during the COVID-19 pandemic. A total of 248 mothers with a premature infant were observed in this cross-sectional study from the chosen NICUs of government hospitals in Selangor, Malaysia. The Iowa Infant Feeding Attitude Score (IIFAS) and the Edinburgh Postnatal Depression Scale, along with sociodemographic questionnaires, were used to obtain information on the mothers' attitudes towards breastfeeding and the risk of postpartum depression. A higher percentage of mothers had a positive attitude towards breastfeeding (64.9%), with a mean IIFAS score of 66.30 ± 6.92. Meanwhile, about 27% of mothers with premature infants were reported to have high risk of depressive symptoms. Mothers with a high risk of depression were less likely to have a positive attitude towards breastfeeding (OR 0.37, 95% CI 0.199, 0.675) as compared to mothers with a low risk of depression (p < 0.01). We found that there is an association between the risk of depression and the attitude towards breastfeeding. Early identification of maternal mental health problems should be addressed to ensure the willingness of mothers to continue breastfeeding.
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Affiliation(s)
- Noor Fairuzi Suhana Yahya
- Faculty of Health Sciences, Universiti Teknologi MARA, Bandar Puncak Alam 42300, Selangor, Malaysia; (N.F.S.Y.); (N.S.)
| | - Nur Islami Mohd Fahmi Teng
- Faculty of Health Sciences, Universiti Teknologi MARA, Bandar Puncak Alam 42300, Selangor, Malaysia; (N.F.S.Y.); (N.S.)
| | - Najwa Shafiee
- Faculty of Health Sciences, Universiti Teknologi MARA, Bandar Puncak Alam 42300, Selangor, Malaysia; (N.F.S.Y.); (N.S.)
| | - Norsham Juliana
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai 71800, Negeri Sembilan, Malaysia;
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Ninamou NR, Dupuis JB, Zagré NM, Daffé M, Blaney S. A tool to assess underlying factors to water provision among Guinean children. MATERNAL AND CHILD NUTRITION 2021; 18:e13249. [PMID: 34309178 PMCID: PMC8710118 DOI: 10.1111/mcn.13249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/19/2021] [Accepted: 07/03/2021] [Indexed: 11/30/2022]
Abstract
In many countries, water is provided to children under 6 months of age (CU6M) in addition to breast milk (BM), hence increasing the risk of child mortality and morbidity. Factors related to this practice have not been thoroughly investigated either a tool to assess them. Based on the extended theory of planned behaviour (eTPB), we aim to develop and validate a questionnaire to assess psychosocial and environmental factors that may contribute/limit the water provision in addition to BM by mothers of CU6M in the Republic of Guinea. A three‐step process was used. Ten focus group discussions (FGDs) were held to identify salient beliefs related to each of the four constructs of the eTPB. Data from FGDs were used to develop a questionnaire composed of 88 items administered to 428 mothers. Exploratory factor analyses were conducted to identify latent factors for each construct. A shorter version of the questionnaire was administered to another sample of 300 mothers. Confirmatory factor analyses (CFAs) were performed. Hancock and Mueller's H reliability indices were computed on final models to assess the tool's validity and reliability. The final questionnaire included 57 items. For all four final models, most criteria for fit indices of CFA were generally met. Reliability coefficients were all equal to or above 0.90 for each construct. This research offers a tool that could be used to investigate determinants of water provision besides BM among mothers of CU6M. Further validation in other contexts is warranted.
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Affiliation(s)
- Nèmanan Richard Ninamou
- École des sciences des aliments, de nutrition et d'études familiales, Université de Moncton, Moncton, New Brunswick, Canada
| | - Jérémie B Dupuis
- Faculté des sciences de l'éducation, Université de Moncton, Moncton, New Brunswick, Canada
| | | | - Mamady Daffé
- Division Alimentation et Nutrition, Ministry of Health, Conakry, Guinea
| | - Sonia Blaney
- École des sciences des aliments, de nutrition et d'études familiales, Université de Moncton, Moncton, New Brunswick, Canada
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Ungváry R, Ittzés A, Bóné V, Török S. Psychometric properties of the original and short Hungarian version of the Iowa infant feeding attitude scale. Int Breastfeed J 2021; 16:54. [PMID: 34271964 PMCID: PMC8284002 DOI: 10.1186/s13006-021-00403-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 07/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Iowa Infant Feeding Attitude Scale (IIFAS) is a widely used tool to assess attitudes towards infant feeding. Attitudes towards breastfeeding are one of the main influencing factors of feeding choice and breastfeeding duration. Adaptation of the IIFAS to the Hungarian context provides an opportunity for cross-cultural comparisons and helps to target breastfeeding support interventions. The growing number of shortened scales in various fields of research, demonstrates the necessity to adapt to a changing context of data collection to avoid fatigue and dropout among respondents. However, international comparisons are difficult due to the lack of a consensual shortened form of the scale. The aim of our study was to examine the psychometric properties of the Hungarian version of the IIFAS (IIFAS-H) and propose an 8-item short version that has appropriate construct validity. METHODS The original IIFAS was translated into Hungarian and then translated back to English. A cross-sectional study based on an internet survey in 2019 was conducted among 553 mothers whose most recent child's age was between 6 and 36 months. Psychometric properties of the Hungarian IIFAS were determined and compared with international results. In order to obtain a shorter version of the Hungarian scale, we preferably kept those items that are common with other international abbreviated IIFAS versions and deleted items with a corrected item-total correlation or factor loading of less than 0.3, where factor loadings came from a principal component analysis forcing the extraction of one principal component (factor). RESULTS The 17-item IIFAS-H showed good psychometric properties with a Cronbach's alpha of0.73. Further analyses proved that the examined three shortened versions of the IIFAS consisting of 11, 9, and 8 items also showed good properties (Cronbach's alpha = 0.79, 0.79, 0.76, respectively). CONCLUSIONS The Hungarian version of the original 17-item long IIFAS proved to be a good measurement tool with good psychometric properties. Based on our analyses, we suggest the use of the 8-item short version (IIFAS-H8) of the scale.
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Affiliation(s)
- Renáta Ungváry
- Faculty of Health and Public Administration, Institute of Mental Health, Semmelweis University, Budapest, Hungary.
| | - András Ittzés
- Department of Applied Statistics, Institute of Mathematics and Basic Science, Hungarian University of Agriculture and Life Sciences, Budapest, Hungary.,Department of Methodology for Business Analysis, Faculty of Commerce, Hospitality and Tourism, Budapest Business School, Budapest, Hungary
| | - Veronika Bóné
- Faculty of Health and Public Administration, Institute of Mental Health, Semmelweis University, Budapest, Hungary
| | - Szabolcs Török
- Faculty of Health and Public Administration, Institute of Mental Health, Semmelweis University, Budapest, Hungary
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Grover-Baltazar GA, Macedo-Ojeda G, Sandoval-Rodríguez A, Martínez-Vizmanos M, Carrera-Quintanar L, Vizmanos B. Validation of the Spanish-Mexican Version of the Australian Breastfeeding Attitude Questionnaire in Higher Education Health Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094609. [PMID: 33925475 PMCID: PMC8123818 DOI: 10.3390/ijerph18094609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 11/16/2022]
Abstract
Positive attitudes towards breastfeeding in health professionals/students have been associated with increasing their confidence to provide support and accompaniment to mothers. In Mexico, there is no valid/reliable tool to assess attitudes towards breastfeeding in this population. The Australian Breastfeeding Attitudes (and Knowledge) Questionnaire (ABAQ) measures attitudes in the Australian population. We aimed to adapt and validate the ABAQ in Mexican health students. We included 264 health students (nursing, nutrition, and medicine) from the University of Guadalajara. Bilingual translators carried out the Spanish adaptation with a reverse translation into English. Experts evaluated the content validity. Reliability was evaluated through an internal consistency analysis (Cronbach’s alpha) and construct validity through convergent–divergent validation, item–total correlation, exploratory factor analysis (by principal components), and confirmatory factor analysis. According to the exploratory factor analysis, only one component was identified. Seven items were removed (low correlation between items ≤0.2 and low factor load ≤0.3). The Cronbach’s alpha was 0.78. According to the confirmatory factor analysis, the one-factor solution of the ABAQ-13Mx showed a good model fit (X2 = 98.41, G = 62, p = 0.02, CFI = 0.940, and RMSEA = 0.048). The ABAQ-13Mx is a reliable and valid instrument for evaluating attitudes towards breastfeeding in Mexican health degree students.
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Affiliation(s)
- Gabriela Alejandra Grover-Baltazar
- Cuerpo Académico UDG-CA-454 “Alimentación y Salud en el proceso Salud-Enfermedad”, Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud (CUCS) Universidad de Guadalajara (UdeG), México, Calle Hospital 320, Colonia El Retiro, Guadalajara 44280, Jalisco, Mexico; (G.A.G.-B.); (G.M.-O.); (A.S.-R.); (M.M.-V.); (L.C.-Q.)
| | - Gabriela Macedo-Ojeda
- Cuerpo Académico UDG-CA-454 “Alimentación y Salud en el proceso Salud-Enfermedad”, Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud (CUCS) Universidad de Guadalajara (UdeG), México, Calle Hospital 320, Colonia El Retiro, Guadalajara 44280, Jalisco, Mexico; (G.A.G.-B.); (G.M.-O.); (A.S.-R.); (M.M.-V.); (L.C.-Q.)
- Instituto de Investigación en Ciencias Biomédicas (IICB), CUCS, UdeG, Sierra Mojada 950, edificio Q, Colonia Independencia, Guadalajara 44340, Jalisco, Mexico
| | - Ana Sandoval-Rodríguez
- Cuerpo Académico UDG-CA-454 “Alimentación y Salud en el proceso Salud-Enfermedad”, Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud (CUCS) Universidad de Guadalajara (UdeG), México, Calle Hospital 320, Colonia El Retiro, Guadalajara 44280, Jalisco, Mexico; (G.A.G.-B.); (G.M.-O.); (A.S.-R.); (M.M.-V.); (L.C.-Q.)
- Instituto de Biología Molecular en Medicina, CUCS, UdeG, Sierra Mojada 950, edificio Q, Colonia Independencia, Z.C., Guadalajara 44340, Jalisco, Mexico
| | - Marianne Martínez-Vizmanos
- Cuerpo Académico UDG-CA-454 “Alimentación y Salud en el proceso Salud-Enfermedad”, Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud (CUCS) Universidad de Guadalajara (UdeG), México, Calle Hospital 320, Colonia El Retiro, Guadalajara 44280, Jalisco, Mexico; (G.A.G.-B.); (G.M.-O.); (A.S.-R.); (M.M.-V.); (L.C.-Q.)
| | - Lucrecia Carrera-Quintanar
- Cuerpo Académico UDG-CA-454 “Alimentación y Salud en el proceso Salud-Enfermedad”, Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud (CUCS) Universidad de Guadalajara (UdeG), México, Calle Hospital 320, Colonia El Retiro, Guadalajara 44280, Jalisco, Mexico; (G.A.G.-B.); (G.M.-O.); (A.S.-R.); (M.M.-V.); (L.C.-Q.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, CUCS, UdeG, Sierra Mojada 950, edificio Q, Colonia Independencia, Guadalajara 44340, Jalisco, Mexico
| | - Barbara Vizmanos
- Cuerpo Académico UDG-CA-454 “Alimentación y Salud en el proceso Salud-Enfermedad”, Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud (CUCS) Universidad de Guadalajara (UdeG), México, Calle Hospital 320, Colonia El Retiro, Guadalajara 44280, Jalisco, Mexico; (G.A.G.-B.); (G.M.-O.); (A.S.-R.); (M.M.-V.); (L.C.-Q.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, CUCS, UdeG, Sierra Mojada 950, edificio Q, Colonia Independencia, Guadalajara 44340, Jalisco, Mexico
- Correspondence: or ; Tel.: +52-33-1058-5200 (ext. 33872)
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Mercan Y, Tari Selcuk K. Association between postpartum depression level, social support level and breastfeeding attitude and breastfeeding self-efficacy in early postpartum women. PLoS One 2021; 16:e0249538. [PMID: 33798229 PMCID: PMC8018654 DOI: 10.1371/journal.pone.0249538] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/21/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The study was aimed at investigating the association between postpartum women's breastfeeding self-efficacy levels and their depression levels, social support levels, and breastfeeding attitudes in early postpartum period. METHODS The cross-sectional study was carried out in Kirklareli in Turkey. The population of the study consisted of 398 women aged 15-49 in the first 42 days of the postpartum period who presented to eight family health centers. The study data were collected face-to-face using the Personal Information Form, Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), Edinburgh Postnatal Depression Scale (EPDS), Multidimensional Scale of Perceived Social Support (MSPSS), and Breastfeeding Attitudes of the Evaluation Scale (BAES). RESULTS The mean age of the participants was 28.61±5.72 (Min:18, Max: 44), and the mean score they obtained from the BSES-SF was 55.13±8.39. Statistically significant differences were detected between the participants' BSES-SF scores and age groups, employment status, perceived income level, and the number of living children (p < 0.05). No statistically significant differences were detected between marital status, educational status and BSES-SF scores (p > 0.05). In the multivariate regression analysis adjusted according to the sociodemographic characteristics, BAES, EPDS and MSPSS accounted for 48.3% of the BSES-SF. A negative association was found between BSES-SF scores and EPDS scores (β = -0.178, 95% CI:-0.349, -0.006), and a positive relation between the BAES scores (β = 0.194, 95% CI: 0.163, 0.226) and the MSPSS scores (β = 0.114, 95% CI: 0.037, 0.191). CONCLUSION As the level of depression of women increases in the postpartum period, the level of breastfeeding self-efficacy decreases. The breastfeeding self-efficacy increases as the level of social support increases and as the attitudes that drive breastfeeding behavior change positively.
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Affiliation(s)
- Yeliz Mercan
- Department of Health Management, School of Health Kirklareli University, Kirklareli, Turkey
| | - Kevser Tari Selcuk
- Department of Nurition and Dietetics, Faculty of Health Sciences, Bandirma Onyedi Eylul University, Balikesir, Turkey
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Shah MH, Roshan R, Parikh T, Sathe S, Vaidya U, Pandit A. LATCH Score at Discharge: A Predictor of Weight Gain and Exclusive Breastfeeding at 6 Weeks in Term Healthy Babies. J Pediatr Gastroenterol Nutr 2021; 72:e48-e52. [PMID: 32868667 DOI: 10.1097/mpg.0000000000002927] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES World Health Organization recommends exclusive breastfeeding (EBF) for 6 months after birth. However, problems with the baby failing to latch properly are common in the postpartum period contributing to breastfeeding cessation. The aim of the study was to evaluate the utility of LATCH score to predict EBF and weight gain at 6 weeks postpartum along with an optimum LATCH score cutoff. PATIENTS AND METHODS This prospective cohort study was conducted in India. Ninety-three mother-infant dyads at term gestation were enrolled. Two LATCH score assessments were done by a lactation consultant: first within 24 hours of birth and second at discharge. Mothers with low LATCH scores were counselled before discharge. EBF rate and weight gain velocity were analyzed at 6 weeks. RESULTS LATCH score ≥6 at discharge has the highest sensitivity (92.1%) and specificity (66.7%) for predicting EBF at 6 weeks postpartum (RR, 95% CI; 5.63 [4.32-12.65], P = 0.0003). Receiver operating characteristic (ROC) of LATCH score at discharge and EBF at 6 weeks had an area under the curve of 0.785 with a cutoff ≥5.5, showing the highest sensitivity of 93.6% with a false-positive rate of 30.1%. LATCH score >6 at discharge was significantly associated with higher EBF rate (RR, 95% CI; 0.61 [0.39-0.94]) and appropriate weight gain (≥ 20 grams/day) at 6 weeks of age (RR, 95% CI; 0.44 [0.25-0.75]). After counselling, the LATCH score significantly improved at discharge in mothers (n = 62) with an initial score <6 (P < 0.001). CONCLUSION LATCH score is a simple tool to identify mothers who require breastfeeding support and counselling before discharge from the hospital to prevent early breastfeeding cessation.
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Affiliation(s)
- Mubashir Hassan Shah
- Division of Neonatology, Department of Pediatrics, King Edward Memorial Hospital and Research Centre (KEMHRC), Pune, Maharashtra, India
| | - Reashma Roshan
- Department of Hematology, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
| | - Tushar Parikh
- Division of Neonatology, Department of Pediatrics, King Edward Memorial Hospital and Research Centre (KEMHRC), Pune, Maharashtra, India
| | - Sayali Sathe
- Division of Neonatology, Department of Pediatrics, King Edward Memorial Hospital and Research Centre (KEMHRC), Pune, Maharashtra, India
| | - Umesh Vaidya
- Division of Neonatology, Department of Pediatrics, King Edward Memorial Hospital and Research Centre (KEMHRC), Pune, Maharashtra, India
| | - Anand Pandit
- Division of Neonatology, Department of Pediatrics, King Edward Memorial Hospital and Research Centre (KEMHRC), Pune, Maharashtra, India
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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.
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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
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Chan K, Whitfield KC. High confidence, yet poor knowledge of infant feeding recommendations among adults in Nova Scotia, Canada. MATERNAL & CHILD NUTRITION 2020; 16:e12903. [PMID: 31777186 PMCID: PMC7083488 DOI: 10.1111/mcn.12903] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 01/12/2023]
Abstract
In Canada, adherence to the national 'Nutrition for Healthy Term Infants' recommendations of infant and young child feeding (IYCF; 0-24 months) is suboptimal. While maternal knowledge of IYCF is commonly assessed, that of the general public has rarely been explored. Our objective was to assess the knowledge of, and confidence in answers to, Canadian IYCF recommendations among a diverse sample of adults in Nova Scotia, Canada. Between March and May 2018, a self-administered questionnaire examining IYCF knowledge, self-rated confidence, and sociodemographic information was conducted among Nova Scotians (≥19 years) in public locations. We surveyed 229 adults; 60% (n=134) were women. Mean (95% CI) age was 44 (41,46) years, 73% self-identified as white, 77% were born in Canada, and 69% were parents. Knowledge deficits were: age to terminate breastfeeding (18.3 (16.7,19.9) months; recommendation: ≥24 months), age to introduce solids (9.2 (8.2,10.2) months; recommendation: 6 months), vitamin D supplementation (10% correct), and optimal complementary foods (only 37% indicated iron-rich foods). Correct IYCF knowledge was lower among men, non-parents, young adults (19-29 years) and low-income adults (<$50,000/year). Mean self-rated confidence (out of 10) was high (7.2 (6.9,7.5)), and not different (p>0.05) between correct and incorrect responses for: best food for a newborn, age to terminate any breastfeeding, and age to start family meal foods. We found low knowledge of IYCF guidelines, yet high confidence in responses regardless of accuracy, among adults in Nova Scotia. General public knowledge deficits may contribute to an unsupportive culture around IYCF practices and low adherence to current recommendations.
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Affiliation(s)
- Kathleen Chan
- Department of Applied Human NutritionMount Saint Vincent UniversityHalifaxNova ScotiaCanada
| | - Kyly C. Whitfield
- Department of Applied Human NutritionMount Saint Vincent UniversityHalifaxNova ScotiaCanada
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Intergenerational Transmissible Meanings in Breastfeeding in Spain: A Phenomenological Study. J Pediatr Nurs 2020; 51:e108-e114. [PMID: 31926645 DOI: 10.1016/j.pedn.2019.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/30/2019] [Accepted: 12/30/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND The process of breastfeeding is linked to intergenerational influences based on attitudes and messages of grandmothers about their own experience, and this can reinforce or interfere with the experiences of future mothers in breastfeeding. The aim of this study was to explore the meanings transmissible to the next generation of nursing mothers, based on the experiences of grandmothers. METHODS We report the findings of an interpretive phenomenological qualitative research based on the philosophy of Martin Heidegger. In-depth interviews were conducted in Madrid with 17 participants who breastfed before the age of 35 and more than 8 years ago (to ensure the settlement of transmissible meanings in remote memory). Data were analyzed by interpretive phenomenological analysis (IPA). FINDINGS Two thematic categories were identified: "Breastfeeding: life experiences" and "Breastfeeding: body and mind process", which show that mothers want to convey the need for a balance that allows maintaining the role of women outside of stereotypes but that is also compatible with the rhythm of life, giving new meanings to attachment, weaning, and modesty. CONCLUSIONS Meanings that future grandmothers wish to transmit to the next generation of nursing mothers are related to the search for a satisfactory experience for the mother, who must make an adjustment in her life, freeing herself of inflexible messages about attachment and the maternal role. PRACTICAL IMPLICATIONS Strategies to promote breastfeeding and care for nursing mothers can improve the impact of trying to understand the meanings that are transmitted by the grandmothers in the family environment.
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Quinn P, Tanis SL. Attitudes, Perceptions, and Knowledge of Breastfeeding Among Professional Caregivers in a Community Hospital. Nurs Womens Health 2020; 24:77-83. [PMID: 32112725 DOI: 10.1016/j.nwh.2020.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 12/17/2019] [Accepted: 01/01/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To explore the knowledge, attitudes, and perceptions of exclusive breastfeeding among professional caregivers in a suburban community hospital who typically provide, or influence, the care of parturient women. DESIGN Cross-sectional quantitative study. SETTING Acute care community hospital in suburban New Jersey with 3,500 births per year. PARTICIPANTS Obstetricians, midwives, neonatologists, pediatricians, and registered nurses. INTERVENTIONS/MEASUREMENTS We designed a survey using two instruments-the Iowa Infant Feeding Attitudes Scale and the Breastfeeding Attitudes Scale-to explore concepts of breastfeeding knowledge, attitudes, and perceptions. Data were analyzed by using descriptive and inferential statistics with SPSS (Version 19). Independent sample t tests, Pearson's correlation coefficient, and Pearson's chi-square test (×2) were used to assess differences between the groups. RESULTS When the physician scores were separated out by specialty, statistically significant differences in mean scores were found (p = .002). Pediatricians had lower scores on attitude toward breastfeeding. In contrast, mean scores for perceptions and knowledge of breastfeeding were positive for physicians and nurses, regardless of area of specialization, with no statistically significant differences found. CONCLUSION Although pediatricians' attitudes, perceptions, and knowledge of breastfeeding cannot be deemed the sole cause for our organization's low rates of sustained exclusive breastfeeding in the postpartum period, this study provided an avenue for exploration that we did not immediately consider as we dissected our performance metrics related to exclusive breastfeeding. We encourage teams at other organizations to replicate and build on this work to explore influences surrounding low rates of exclusive breastfeeding.
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Abbass-Dick J, Newport A, Pattison D, Sun W, Kenaszchuk C, Dennis CL. Development, psychometric assessment, and predictive validity of the comprehensive breastfeeding knowledge scale. Midwifery 2020; 83:102642. [PMID: 32014619 DOI: 10.1016/j.midw.2020.102642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 12/13/2019] [Accepted: 01/19/2020] [Indexed: 11/28/2022]
Abstract
AIM To develop a breastfeeding knowledge scale that aligns with the Baby Friendly Hospital Initiative and psychometrically test it among expectant parents. BACKGROUND Although breastfeeding is recommended by all leading health authorities, rates remain suboptimal with women often not achieving their breastfeeding goals. One factor found to positively influence infant feeding behaviours is increased maternal breastfeeding knowledge. However, little research has been conducted validating the dimensions of breastfeeding knowledge to guide interventions to promote positive breastfeeding outcomes. DESIGN Following an extensive literature review, the 28-item Comprehensive Breastfeeding Knowledge Scale (CBKS) was developed and psychometrically tested. METHOD A sample of 217 Canadian expectant parents (113 women and 104 coparents) was recruited and administered the CBKS with follow-up questionnaires at 4 and 12 weeks postpartum. Psychometric analyses included exploratory factor analysis, internal consistency, concurrent validity, and predictive validity. RESULTS Exploratory factor analysis resulted in three dimensions: (1) managing milk supply; (2) persisting through challenges; and (3) correcting misconceptions. Coefficient alpha for the total scale was 0.83 and support for concurrent validity was demonstrated through significant positive correlations with the Iowa Infant Feeding Attitude scale. Further, higher total and subscale scores in pregnancy were associated with exclusive breastfeeding at 4 and 12 weeks postpartum, providing good evidence for predictive validity. CONCLUSION Preliminary data suggest the CBKS is a valid and reliable measure of breastfeeding knowledge. Upon further testing, this self-report measure may be used to (1) identify women with low breastfeeding knowledge requiring targeted support, (2) individualize health professional care with breastfeeding women, and (3) evaluate the effectiveness of breastfeeding interventions and programs.
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Affiliation(s)
| | | | - Denise Pattison
- Ontario Tech University, 2000 Simcoe Street North, ON, L1G 0C5 Oshawa, Canada
| | - Winnie Sun
- Ontario Tech University, 2000 Simcoe Street North, ON, L1G 0C5 Oshawa, Canada
| | - Chris Kenaszchuk
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
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Iliadou M, Lykeridou K, Prezerakos P, Tzavara C, Tziaferi SG. Reliability and Validity of the Greek Version of the Iowa Infant Feeding Attitude Scale Among Pregnant Women. Mater Sociomed 2019; 31:160-165. [PMID: 31762695 PMCID: PMC6853719 DOI: 10.5455/msm.2019.31.160-165] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction: A modifiable factor related to breastfeeding is breastfeeding attitudes. The Iowa Infant Feeding Attitude Scale (IIFAS) is used to evaluate this factor. Although the breastfeeding rates in Greece are declined there is not available any validated instrument to evaluate infant feeding attitudes. Aim: to determine the psychometric properties of the Greek adaptation of the IIFAS in a sample of pregnant women. Materials and Methods: Pregnant women (N=203) from a University Hospital in Athens, Greece, were administered the Greek version of the IIFAS, while being in hospital, and their infant feeding mode at six months postpartum was recorded by telephone. The reliability of the scale was assessed by using corrected item-total correlations and Cronbach’s alpha. Construct validity of the scale was assessed by using confirmatory factor analysis and predictive validity by using t-tests. Multiple linear regression analyses in a stepwise method (p for removal was set at 0.1 and p for entry was set at .05) was performed in order to find variables independently associated with IIFAS total score. Results: The mean IIFAS score was 70.0 (SD=7.6). The corrected item-total correlation ranged from 0.22 to 0.51. Cronbach’s alpha was equal to 0.71. The confirmatory factor analysis indicated an adequate fit of the one-factor model. Concerning the predictive validity of IIFAS it was significant for breastfeeding at six months. The mean IIFAS score was significantly greater (p=0.001) for women that had exclusive breastfeeding at six months (mean (SD): 68.4(6.6)) as compared with those that did not (mean (SD): 64.0(7.5)). Higher IIFAS scores were found in older women, with higher educational level and in those that had breastfed children in their social environment. Conclusion: The Greek version of the IIFAS demonstrated satisfying reliability and validity for measuring women’s infant feeding attitudes in the Greek context. Also, the results of the present study provide further evidence of the international applicability of the IIFAS.
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Affiliation(s)
- Maria Iliadou
- Department of Nursing, Laboratory of Integrated Health Care, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparti, Greece.,Department of Midwifery, Faculty of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Katerina Lykeridou
- Department of Midwifery, Faculty of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Panagiotis Prezerakos
- Department of Nursing, Laboratory of Integrated Health Care, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparti, Greece
| | - Chara Tzavara
- Department of Hygiene, Epidemiology and Medical Statistics, Centre for Health Services Research, National and Kapodistrian University of Athens, Athens, Greece
| | - Styliani G Tziaferi
- Department of Nursing, Laboratory of Integrated Health Care, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparti, Greece
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Kronborg H, Væth M. Validation of the Breastfeeding Score-A Simple Screening Tool to Predict Breastfeeding Duration. Nutrients 2019; 11:nu11122852. [PMID: 31766388 PMCID: PMC6950692 DOI: 10.3390/nu11122852] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/02/2019] [Accepted: 11/18/2019] [Indexed: 01/14/2023] Open
Abstract
Easy to use screening tools to identify mothers in risk of early breastfeeding cessation are needed. The purpose was to validate a revised version of the breastfeeding score, consisting of four questions addressing completed education, earlier breastfeeding duration, self-efficacy, and sense of security not knowing the exact amount of milk the baby ingests. We used two cohorts from 2004 (n = 633) and 2017 (n = 579) to explore the predictive validity of the breastfeeding score to identify mothers at risk of breastfeeding cessation within the first 17 weeks postpartum. The analyses included sensitivity and specificity, clinically relevant cut-points, and calibrations plots. A cut-point ≥5 points identified 61% of first-time and 42% of multiparous mothers in the validation cohort 2017 to be at risk of early breastfeeding cessation with a sensitivity and specificity of 80% and 60% for first-time, and 69% and 82% for multiparous, respectively. The corresponding numbers in the 2004 cohort were almost identical. The area under the receiver operating characteristic (ROC) curves were 0.77 and 0.78 and the calibration plots showed good agreement for the two cohorts. The breastfeeding score indicated good ability to discriminate between mothers at risk of early exclusive breastfeeding cessation. The simple form of the tool makes it easy to use in daily practice.
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Bender WR, Koelper NC, Sammel MD, Durnwald C. Validation of a Breastfeeding History Questionnaire for the Risk of In-Hospital Formula Supplementation Among Multiparous Women. J Hum Lact 2019; 35:665-671. [PMID: 31513459 DOI: 10.1177/0890334419868157] [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 A woman's prior breastfeeding history may influence future decisions regarding infant feeding. Few quantitative tools utilizing this information have been demonstrated to predict breastfeeding success. RESEARCH AIM To evaluate the efficacy of a prenatal breastfeeding history (BAP) questionnaire administered in prenatal care to predict in-hospital formula supplementation among multiparous women. METHODS This is a prospective observational study of multiparous women with singleton pregnancies who presented to a Baby-Friendly urban tertiary care center for 1st prenatal visit at < 20 weeks' gestation. The BAP tool generates a numerical score, with higher score (≥ 2) indicating prior successful breastfeeding experiences. The primary outcome was occurrence of non-medically indicated formula supplementation during the postpartum hospital stay. Student's t test and Pearson's chi-square test were used to compare continuous and categorical variables. A multivariable logistic regression was performed to assess the relationship of BAP score to formula supplementation. Of 587 women screened, 433 (73.8%) mother-infant dyads were analyzed. RESULTS Rates of formula supplementation in women with BAP scores ≤ 1 were 67% (156/234) compared with 37% (73/199) in women with higher scores (p < 0.0001). After controlling for race/ethnicity, insurance, and obesity, women with BAP scores of ≤ 1 were 2.6 times more likely to supplement formula than women with higher scores (aOR 2.62, 95% CI [1.70, 4.04], p < .0001). CONCLUSION In this prospective validation study, women with negative prior breastfeeding experiences, as evidenced by a lower BAP score, were more likely to supplement formula during the postpartum hospital stay.
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Affiliation(s)
- Whitney R Bender
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Nathanael C Koelper
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.,Hospital of the University of Pennsylvania, Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women's Health, Philadelphia, PA, USA
| | - Mary D Sammel
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.,Hospital of the University of Pennsylvania, Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women's Health, Philadelphia, PA, USA
| | - Celeste Durnwald
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Bamberger ET, Eden AR, Marinelli KA, Gonzalez PA, Tinsley S, Dodgson JE. Growth and Change in the Journal of Human Lactation: A Content Analysis 1985-2018. J Hum Lact 2019; 35:759-773. [PMID: 31465695 DOI: 10.1177/0890334419869621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND A professional association journal should reflect the needs of its organization, its readers, and the field it represents. Evaluating the needs that the Journal of Human Lactation has met, and those it has not, is essential if it is to remain relevant to its readers. AIMS (1) Describe the characteristics of articles published from 1985 through 2018. (2) Describe content intended to educate lactation support providers and clinicians. (3) Explore the ways the content has illustrated the growth and development of lactation knowledge, and (4) identify the reoccurring content threads consistent throughout the 34 years. METHODS A prospective mixed methods approach incorporating a quantitative content analysis and a qualitative thematic analysis was used. Frequency distributions were done on all the variables extracted from published articles (N = 1586). The second level of analysis identified themes using an iterative and consensus approach. RESULTS Mirroring the growth in the lactation field, the volume of research articles published each year has increased along with the percent of research articles per issue. Research methods have become more diverse. The international scope and relevance, while always present, has been steadily increasing. Threads identified were; striving for international scope, advancing lactation education, developing a body of knowledge that informs clinical practice in lactation, and creating a centralized place for multidisciplinary research about lactation. CONCLUSION The body of work published in the Journal of Human Lactation parallels the development of the lactation specialty. We have highlighted areas for improvement and possible further study.
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Affiliation(s)
| | - Aimee R Eden
- American Board of Family Medicine, Lexington, KY, USA
| | - Kathleen A Marinelli
- Clinical Professor of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, USA.,Connecticut Children's Medical Center, Neonatology, Hartford, CT, USA
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Paynter MJ. Clinical Opinion Letters Regarding Breastfeeding and Neonatal Abstinence Syndrome for Child Apprehension Family Court Proceedings. J Hum Lact 2019; 35:349-353. [PMID: 30543758 DOI: 10.1177/0890334418818421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The accelerating reach of opioid use disorder in North America includes increasing prevalence among pregnant people. In Canada, the rate of Neonatal Abstinence Syndrome (NAS) rose 27% between 2012-2013 and 2016-2017, and it is estimated that 0.51% of all infants now experience NAS after delivery. Pregnant people are a priority population for access to opioid replacement therapy programs. Participation in such programs demonstrates significant commitment to self-care among pregnant people and concern for fetal and infant wellbeing. Participation in opioid replacement therapy often results in family surveillance by Child Protection Services and infant apprehension. Children of Indigenous descent are held in foster care at high and disproportionate rates.The Convention on the Rights of the Child principle of Best Interests of the Child governs family law and child access decisions. The value of breastfeeding for all children and in particular for children recovering from NAS can be a consideration in the Best Interest of the Child. Clinicians with expertise in lactation may support the breastfeeding dyad to remain together by preparing Clinical Opinion Letters for the court. This Insights into Policy presents a how-to description of the content of clinical opinion letters in such cases, including context and process considerations, client background, breastfeeding science, and factors specific to neonatal abstinence syndrome.
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Yang SF, Schmied V, Burns E, Brodribb W, Salamonson Y. Validation of the Chinese Version of the Australian Breastfeeding Attitude Questionnaire. J Hum Lact 2018; 34:674-681. [PMID: 29596756 DOI: 10.1177/0890334418761567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND The Australian Breastfeeding Knowledge and Attitude Questionnaire-Short Form (ABKAQ-SF) was designed to measure breastfeeding knowledge and attitudes of health professionals. To date, a Chinese version of the attitude component of the ABKAQ-SF (ABAQ) is not yet available and has not been cross-validated with nursing students. Research aims: This study aimed to examine (a) the psychometric properties of the ABAQ and (b) group differences and responsiveness of the revised 12-item ABAQ (ABAQ12) among nursing students in Taiwan. METHODS Using a cross-sectional two-cohort study design, nursing students in Years 2 and 3 of a 4-year bachelor of nursing program ( N = 205) completed the Chinese version of the ABAQ, translated using forward and backward translations. Content validity, internal consistency reliability, construct validity, group differences, and responsiveness of the Chinese version of the ABAQ were assessed. RESULTS Using the principal axis factoring procedure of exploratory factor analysis to examine the dimensionality of the ABAQ, a one-component structure was identified. Six items were deleted, based on the average interitem correlation (< 0.2), low corrected item-total correlation (< 0.35), and low factor loading (< 0.3). Confirmatory factor analysis of the ABAQ12 supported a one-factor solution, with good overall model fit (goodness-of-fit index = 0.949, Tucker-Lewis index = 0.951, comparative fit index = 0.965, root mean square error of approximation = 0.042). Responsiveness of the ABAQ12 scores indicated a positive change in breastfeeding attitude between the pre- and postclinical placement period. CONCLUSION The Chinese version of the ABAQ12 is valid, reliable, and responsive and is suitable for assessing the breastfeeding attitudes of nursing students in the Taiwanese higher education settings.
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Affiliation(s)
- Shu-Fei Yang
- 1 School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia.,2 Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Virginia Schmied
- 1 School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Elaine Burns
- 1 School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Wendy Brodribb
- 3 School of Medicine, University of Queensland, St. Lucia, QLD, Australia
| | - Yenna Salamonson
- 1 School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia.,4 Centre for Applied Nursing Research, Ingham Institute for Applied Medical Research, Penrith, NSW, Australia
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Boateng GO, Martin SL, Collins SM, Natamba BK, Young SL. Measuring exclusive breastfeeding social support: Scale development and validation in Uganda. MATERNAL AND CHILD NUTRITION 2018; 14:e12579. [PMID: 29356347 DOI: 10.1111/mcn.12579] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 10/26/2017] [Accepted: 11/21/2017] [Indexed: 11/30/2022]
Abstract
The World Health Organization recommends exclusive breastfeeding (EBF) for 6 months and continued breastfeeding for at least 2 years. Social support has been widely recognized to influence breastfeeding practices. However, existing scales do not measure exclusive breastfeeding social support (EBFSS), rather they assess social support for any breastfeeding. Further, they are tailored towards high-income settings. Therefore, our objectives were to develop and validate a tool to measure EBFSS in low-income settings. To develop the scale, local and international breastfeeding experts were consulted on modifications to the Hughes' Breastfeeding Social Support Scale. It was then implemented in an observational cohort in Gulu, Uganda, at 1 (n = 238) and 3 (n = 237) months post-partum (NCT02925429). We performed polychoric and polyserial correlations to remove redundant items and exploratory factor analysis at 1 month post-partum to determine the latent factor structure of EBFSS. We further applied confirmatory factor analysis to assess dimensionality of the scale at 3 months post-partum. We then conducted tests of predictive, convergent, and discriminant validity against EBF, self-efficacy, general social support, and depression. The modification of the Hughes' scale resulted in 18 items, which were reduced to 16 after examining variances and factor loadings. Three dimensions of support emerged: Instrumental, Emotional, and Informational, with alpha coefficients of 0.79, 0.85, and 0.83, respectively. Predictive, convergent, and discriminant validity of the resultant EBFSS scale was supported. The EBFSS scale is valid and reliable for measuring EBFSS in northern Uganda and may be of use in other low-income settings to assess determinants of EBF.
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Affiliation(s)
- Godfred O Boateng
- Department of Anthropology and Global Health, Northwestern University, Evanston, Illinois, USA
| | - Stephanie L Martin
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Shalean M Collins
- Department of Anthropology and Global Health, Northwestern University, Evanston, Illinois, USA
| | - Barnabas K Natamba
- Division of Public Health, Michigan State University, East Lansing, Michigan, USA
| | - Sera L Young
- Department of Anthropology and Global Health, Northwestern University, Evanston, Illinois, USA.,Institute for Policy Research, Northwestern University, Evanston, Illinois, USA
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Iliadou M, Lykeridou K, Prezerakos P, Swift EM, Tziaferi SG. Measuring the Effectiveness of a Midwife-led Education Programme in Terms of Breastfeeding Knowledge and Self-efficacy, Attitudes Towards Breastfeeding, and Perceived Barriers of Breastfeeding Among Pregnant Women. Mater Sociomed 2018; 30:240-245. [PMID: 30936785 PMCID: PMC6377922 DOI: 10.5455/msm.2018.30.240-245] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Exclusive breastfeeding is the optimal mode of feeding for the first six months of a child’s life. Modifiable factors associated with increased breastfeeding, may be addressed through antenatal breastfeeding education. In Greece, the rates of exclusive breastfeeding remain rather low. Aim: The aim of the current study was to evaluate the effectiveness of a structured in-hospital midwife-led antenatal breastfeeding educational programme on breastfeeding knowledge and self-efficacy, attitudes towards breastfeeding and perceived-barriers of breastfeeding. Patients and Methods: This was a quasi-experimental study with two study groups: an intervention group (following a four-hour midwife-led antenatal breastfeeding programme) and a control group. All nulliparous women attending antenatal care at the tertiary hospital in Athens, Greece during May 2016–January 2017 were invited to participate, of which 203 nulliparous pregnant women took part. Demographic data forms, the Breastfeeding Self-efficacy Scale, the Iowa Infant Feeding Attitude Scale, the Breast Feeding Knowledge Questionnaire and the Perceived Breast Feeding Barriers Questionnaire were used for data collection. Results: Post-intervention, women in the intervention group had a more positive attitude towards breastfeeding (73.5% versus 66.1%, p<0.001), greater knowledge (14.6% versus 13.1%, p<0.001) and more breastfeeding self-efficacy (51.4% versus 45.6%, p<0.001) compared to the control group. Furthermore, they had significantly less perceived barriers regarding breastfeeding (27.4% versus 31.0%, p<0.001). Conclusion: The four-hour antenatal breastfeeding education intervention which occurred and was evaluated for the first time in the Greek female population was effective in increasing breastfeeding knowledge, self-efficacy and a positive attitude towards breastfeeding. The intervention was furthermore effective in lowering perceived breastfeeding barriers. This midwife-led antenatal breastfeeding education programme could be suitable for integration to routine antenatal care in health care services in Greece.
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Affiliation(s)
- Maria Iliadou
- Department of Nursing, Laboratory of Integrated Health Care, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparti, Greece.,Department of Midwifery, Faculty of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Katerina Lykeridou
- Department of Midwifery, Faculty of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Panagiotis Prezerakos
- Department of Nursing, Laboratory of Integrated Health Care, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparti, Greece
| | - Emma Marie Swift
- Faculty of Nursing, Department of Midwifery, University of Iceland, Reykjavik, Iceland
| | - Styliani G Tziaferi
- Department of Nursing, Laboratory of Integrated Health Care, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparti, Greece
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Affiliation(s)
- Joan E Dodgson
- 1 Patricia and James R. Hemak Endowed Professor of Maternal Child Nursing Research at the School of Nursing, Saint Louis University, Saint Louis MO USA
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Affiliation(s)
- Georgine Burke
- 1 University of Connecticut School of Medicine, Connecticut Children's Medical Center, Hartford, CT, USA
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