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Islam M, Assani D, Ramlawi S, Murphy MS, Alibhai KM, White RR, Dingwall-Harvey AL, Dunn SI, El-Chaâr D. Investigating factors influencing decision-making around use of breastmilk substitutes by health care professionals: a qualitative study. Int Breastfeed J 2024; 19:48. [PMID: 38982529 PMCID: PMC11234533 DOI: 10.1186/s13006-024-00656-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 06/29/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Breastfeeding is recognized as the gold standard of infant feeding and nutrition. The World Health Organization recommends exclusive breastfeeding (EBF) of infants for the first 6 months of life. A variety of factors may impact breastfeeding practices in-hospital which may continue after hospital discharge, such as the use of breastmilk substitutes (BMS). The Baby-Friendly Initiative (BFI), which aims to promote and support breastfeeding practices, established a target rate of 75% for EBF from birth to hospital discharge. Currently, this target is not being met at The Ottawa Hospital (TOH), indicating there is room for improvement in EBF rates. The purpose of this study is to explore health care professionals (HCP) decision-making around use of BMS and identify factors that drive the use of BMS with and without medical indications. METHODS In this qualitative study, semi-structured interviews were conducted with HCPs within TOH from January to June 2022. All participants had experience in maternity or postpartum care and were probed on factors influencing use of BMS at this institution. Interview transcripts were coded using an inductive approach. RESULTS A total of 18 HCPs were interviewed including physicians, midwives, lactation consultants, and registered nurses. Multilevel barriers influencing the use of BMS were categorized into patient, HCP, and institution-level factors. Subthemes that emerged ranged from parental preferences, training differences amongst HCPs, to budget and staffing issues. Over half of HCPs were prepared to answer questions on EBF and were familiar with the BFI. Although most were supportive of this institution receiving BFI designation, a few providers raised concerns of its impact on parents who would like to supplement. CONCLUSIONS Several modifiable factors influencing decision-making for use of BMS were identified. These findings will be used to inform unit leads, help identify effective strategies to address modifiable barriers, and develop tailored breastfeeding supports to improve EBF rates.
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Affiliation(s)
- Maisha Islam
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Dourra Assani
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Serine Ramlawi
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Malia Sq Murphy
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | | | - Ruth Rennicks White
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, Ottawa, Canada
| | | | - Sandra I Dunn
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Better Outcomes Registry and Network Ontario, Children's Hospital of Eastern Ontario, Ottawa, Canada
- School of Nursing, University of Ottawa, Ottawa, Canada
| | - Darine El-Chaâr
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
- Faculty of Medicine, University of Ottawa, Ottawa, Canada.
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
- Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, Ottawa, Canada.
- Department of Obstetrics & Gynecology, University of Ottawa, Ottawa, Canada.
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Monge-Montero C, van der Merwe LF, Tagliamonte S, Agostoni C, Vitaglione P. Why do mothers mix milk feed their infants? Results from a systematic review. Nutr Rev 2023:nuad134. [PMID: 38041551 DOI: 10.1093/nutrit/nuad134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023] Open
Abstract
CONTEXT Combining or supplementing breastfeeding with formula feeding, also called mixed milk feeding (MMF), is a common infant feeding practice. However, there is no well-established MMF evidence-base for informing and guiding parents. A better understanding of the reasons why mothers practice MMF may facilitate identification of efficient strategies for supporting exclusive breastfeeding, and/or opportunities to prolong breastfeeding, at least partially. OBJECTIVE An updated systematic literature review was undertaken with the primary aim of gaining a deeper understanding of the reasons why mothers choose MMF. DATA SOURCES Six databases were searched for relevant articles published in English from January 2012 to January 2022. DATA EXTRACTION Two reviewers independently performed the screenings and data extraction, and any differences were resolved by a third reviewer. Data from 138 articles were included, 90 of which contained data on MMF reasons/drivers, and 60 contained data on infant age and/or maternal demographic factors associated with MMF. DATA ANALYSIS A total of 13 different unique MMF drivers/reasons were identified and categorized according to whether the drivers/reasons related to perceived choice, necessity, or pressure. Risk of bias was evaluated using the Quality Assessment Tool of Diverse Studies and the JBI Systematic Reviews tool. Several different terms were used to describe and classify MMF across the studies. The most commonly reported reasons for MMF were related to a perception of necessity (39% of drivers, eg, concerns about infant's hunger/perceived breast milk insufficiency or breastfeeding difficulties), followed by drivers associated with perceived choice (34%; eg, having more flexibility) and perceived pressure (25%; eg, returning to work or healthcare professionals' advice). This was particularly true for infants aged 3 months or younger. CONCLUSION The key global drivers for MMF and their distribution across infant age and regions were identified and described, providing opportunities for the provision of optimal breastfeeding support. A unified definition of MMF is needed in order to enable more comparable and standardized research. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022304253.
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Affiliation(s)
- Carmen Monge-Montero
- Department of Research, Monge Consultancy Food and Nutrition Research, Leiden, The Netherlands
| | | | - Silvia Tagliamonte
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
| | - Carlo Agostoni
- Fondazione IRCCS Ospedale Maggiore Policlinico, Pediatric Clinic, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paola Vitaglione
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
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Vidović Roguljić A, Zakarija-Grković I. 'She was hungry'-Croatian mothers' reasons for supplementing their healthy, term babies with formula during the birth hospitalisation. Acta Paediatr 2023; 112:2113-2120. [PMID: 37431058 DOI: 10.1111/apa.16907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/27/2023] [Accepted: 07/07/2023] [Indexed: 07/12/2023]
Abstract
AIM To explore why Croatian mothers request formula for their healthy, term newborn infants during the postnatal hospital stay. METHODS Four focus groups discussions were conducted with a total of 25 women who gave birth to healthy newborn infants, between May and June 2021 in Split, Croatia. A homogenous, non-random purposive sampling technique was used. The semi-structured interview schedule contained 15 open-ended questions. Reflexive thematic analysis was applied. RESULTS Three themes were generated. The first theme fear of hunger referred to the mothers' fears arising from difficulties in interpreting newborn infant behaviour and finding solace in giving formula. The second theme too little support-too late reflected participants' unrealised expectations of hospital staff. The third theme non-supportive communication addressed mother's need for empathy during the postpartum hospital stay. CONCLUSION Croatian mothers want to breastfeed, but often feel unsupported in doing so in the maternity hospital setting. Antenatal education of expectant mothers and training of maternity staff in breastfeeding counselling, with a strong emphasis on communication skills, as well as employment of International Board Certified Lactation Consultants and/or volunteer breastfeeding counsellors, were perceived by participants as a way to decrease mothers' requests for formula for their healthy, newborn infants.
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Yuan M, Lu M, Guo Y, Lam KBH, Lu J, He J, Shen S, Wei D, Thomas GN, Cheng KK, Qiu X. Timing of infant formula introduction in relation to BMI and overweight at ages 1 and 3 years: the Born in Guangzhou Cohort Study (BIGCS). Br J Nutr 2023; 129:166-174. [PMID: 35264258 DOI: 10.1017/s000711452200071x] [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: 11/07/2022]
Abstract
Mounting evidence suggests that the first few months of life are critical for the development of obesity. The relationships between the timing of solid food introduction and the risk of childhood obesity have been examined previously; however, evidence for the association of timing of infant formula introduction remains scarce. This study aimed to examine whether the timing of infant formula introduction is associated with growth z-scores and overweight at ages 1 and 3 years. This study included 5733 full-term (≥ 37 gestational weeks) and normal birth weight (≥ 2500 and < 4000 g) children in the Born in Guangzhou Cohort Study, a prospective cohort study with data collected at 6 weeks, 6, 12 and 36 months. Compared with infant formula introduction at 0-3 months, introduction at 4-6 months was associated with the lower BMI, weight-for-age and weight-for-length z-scores at 1 and 3 years old. Also, introduction at 4-6 months was associated with the lower odds of at-risk of overweight at age 1 (adjusted OR 0·72, 95 % CI 0·55, 0·94) and 3 years (adjusted OR 0·50, 95 % CI 0·30, 0·85). Introduction at 4-6 months also decreased the odds of overweight at age 1 year (adjusted OR 0·42, 95 % CI 0·21, 0·84) but not at age 3 years. Based on our findings, compared with introduction within the first 3 months, introduction at 4-6 months has a reduction on later high BMI risk and at-risk of overweight. However, these results need to be replicated in other well-designed studies before more firm recommendations can be made.
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Affiliation(s)
- Mingyang Yuan
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Minshan Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Yixin Guo
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | | | - Jinhua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Jianrong He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Songying Shen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Dongmei Wei
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
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Abukari AS, Acheampong AK. Breastfeeding practices and coping strategies adopted by lactating nurses and midwives: A qualitative study. J Pediatr Nurs 2022; 66:e61-e66. [PMID: 35637105 DOI: 10.1016/j.pedn.2022.05.017] [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] [Received: 02/06/2022] [Revised: 05/22/2022] [Accepted: 05/22/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to explore the breastfeeding practices and coping mechanisms of nurses and midwives to navigate the breastfeeding experience as health professionals. DESIGN AND METHODS A descriptive qualitative design was employed. Twenty-five registered nurses' and midwives' breastfeeding habits and coping methods were explored through five focus group discussions, each with five members. A purposive sampling approach was used to recruit participants. Only women who were currently breastfeeding an infant between the ages of 3 and 18 months were considered. For thematic content analysis, MAXQDA qualitative software was used. RESULTS Breastfeeding practices and breastfeeding coping mechanisms emerged as the two main themes. Theme 1: Breastfeeding practices had four sub-themes: breastfeeding positions, breastfeeding duration, lactation nutrition, and expressed breast milk. Theme 2: breastfeeding coping strategies had four subthemes, support from family and co-workers, crying, praying, and communicating with infants. CONCLUSIONS Due to work and other related pressures, our study indicates a disparity in exclusive breastfeeding practice among registered nurses and midwives. Working lactating health professionals can use some of the study's coping strategies and beneficial breastfeeding practices to enhance effective breastfeeding. PRACTICE IMPLICATIONS Breastfeeding in the ideal sitting posture, eating the right diet to increase milk flow, and freezing breast milk to feed the infant while at work are all strategies proposed to help practicing nurses, midwives, and other working women navigate breastfeeding.
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Affiliation(s)
- Alhassan Sibdow Abukari
- School of Nursing, Wisconsin International University College-Ghana, P.O Box LG, Accra, Ghana
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The Attitudes of Polish Women towards Breastfeeding Based on the Iowa Infant Feeding Attitude Scale (IIFAS). Nutrients 2021; 13:nu13124338. [PMID: 34959890 PMCID: PMC8703357 DOI: 10.3390/nu13124338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/25/2021] [Accepted: 11/27/2021] [Indexed: 12/02/2022] Open
Abstract
Background: The Iowa Infant Feeding Attitude Scale (IIFAS), which is used for the assessment of attitudes towards breastfeeding, has been found to be reliable and valid in a number of countries, but has not yet been psychometrically tested in Polish women. The purpose of the study was to report on the cultural adaptation of the IIFAS to Polish settings and on its validation, to evaluate the breastfeeding attitudes in Polish women who recently gave birth, and to identify the determinants of these attitudes. Methods: The study was performed in a group of 401 women in their first postpartum days. Results: Cronbach’s α for the scale was 0.725. Discriminative power coefficients of all questionnaire items were higher than 0.2. Subscales were strongly correlated with the total score, with a correlation coefficient of 0.803 for the “favorable toward breastfeeding” subscale (p < 0.001), and 0.803 for the “favorable toward formula feeding” subscale (p < 0.05). For the item “A mother who occasionally drinks alcohol should not breastfeed her baby”, the factor loading did not reach the criterion value, and so the item was not included in further analyses. The mean IIFAS score was 63.12 (±7.34). Conclusions: The Polish version of the IIFAS is a reliable and appropriate measure of women’s attitudes towards infant feeding in Polish settings, with acceptable psychometric properties and construct validity.
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Barnes C, Hauck Y, Mabbott K, Officer K, Ashton L, Bradfield Z. Influencers of women's choice and experience of exclusive formula feeding in hospital. Midwifery 2021; 103:103093. [PMID: 34311337 DOI: 10.1016/j.midw.2021.103093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 06/18/2021] [Accepted: 07/03/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Explore what influenced women's decision to exclusively formula feed, and their experiences with formula feeding within a maternity hospital environment. DESIGN This mixed methods study used a cross-sectional exploratory survey design. Short surveys were administered by telephone in the postpartum period. Content analysis revealed common themes for responses to open-ended questions on what influenced women's choice and experience with formula feeding. Descriptive statistics were used for demographic characteristics, and frequencies conducted on some themes. PARTICIPANTS AND SETTING English-speaking women who chose to exclusively formula feed, and attended a tertiary maternity hospital in Australia were invited to participate; 102 women were interviewed. FINDINGS Themes that influenced women to choose exclusive formula feeding were: 'Previous breastfeeding challenges', 'social and societal issues' including convenience, comfort, and trust in formula, and 'maternal health' including medical issues and medications, breast physiology and mental health. Themes from the formula feeding experience in hospital were: 'Supportive' elements such as midwifery care, convenience, and resources, and 'hindering' elements such as a perceived breastfeeding agenda and systemic barriers. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Previous breastfeeding difficulties were a common influence on exclusive formula feeding in subsequent pregnancies, highlighting the importance of adequate support during the primary lactation/infant feeding experience. Greater comfort and confidence levels with formula feeding and a sense of trust in formula were also influential. Some maternal medications, conditions, or physiological circumstances were perceived by women as impacting breastfeeding or breastmilk, signposting the importance of antenatal screening and assessment to support women's options and decisions regarding infant feeding. A perception of professional and organisational preferences for breastfeeding over formula feeding contributed to some women feeling judged for their choice. This reminds midwives to consider the complex intersection of factors that influence infant feeding decisions and ensure all mothers are respected and fully supported.
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Affiliation(s)
- Courtney Barnes
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, Western Australia 6008, Australia.
| | - Yvonne Hauck
- School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Perth, Western Australia 6102, Australia
| | - Kelly Mabbott
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, Western Australia 6008, Australia
| | - Kirsty Officer
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, Western Australia 6008, Australia
| | - Liz Ashton
- Breastfeeding Centre, King Edward Memorial Hospital, Subiaco, Perth, Western Australia 6008, Australia
| | - Zoe Bradfield
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, Western Australia 6008, Australia; School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Perth, Western Australia 6102, Australia
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St Croix KA. Supporting breastfeeding in rural Newfoundland and Labrador communities during COVID-19. Canadian Journal of Public Health 2021; 112:595-598. [PMID: 33929698 PMCID: PMC8086964 DOI: 10.17269/s41997-021-00513-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/25/2021] [Indexed: 11/22/2022]
Abstract
Exclusive breastfeeding for the first 6 months of life has become the global standard of infant feeding for its extensive benefits to maternal and infant health. Public health programs, such as the Baby-Friendly Initiative, have helped increase the national breastfeeding initiation rate to 90%. However, initiation rates in Newfoundland and Labrador (NL) continue to rank the lowest in the country at 70%, with a 6-month exclusivity rate of 16%. This commentary will discuss the influence of geographical location, societal norms, and accessibility to health care services on breastfeeding in rural and remote NL communities. While the SARS-CoV-2 virus itself does not impact the mother’s ability to breastfeed, the indirect impacts of COVID-19 on health care services, social isolation, and economic burden challenge breastfeeding initiation and continuation. Priority solutions will draw on capacity building by emphasizing relationships within the community to deliver innovative and appropriate support programs. Continued education with health practitioners and further research into breastfeeding barriers in rural communities is critical moving forward.
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Affiliation(s)
- Kayla A St Croix
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, Prince Philip Drive, St. John's, NL, A1B 3V6, Canada.
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Formula feeding practice and associated factors among mothers with infants 0-6 months of age in Addis Ababa, Ethiopia: a community-based cross-sectional study. Ital J Pediatr 2021; 47:55. [PMID: 33750442 PMCID: PMC7941680 DOI: 10.1186/s13052-021-01010-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 02/26/2021] [Indexed: 12/04/2022] Open
Abstract
Background Lack of exclusive breastfeeding during the first half-year of life is an important risk factor for childhood morbidity and mortality. Despite this, less than 40% of infants below 6 months are exclusively breastfed worldwide. This is because breastfeeding is declining and being replaced by formula feeding. Nowaday, formula feeding has become a more common practice in urban communities of developing countries. However, relatively little information is available regarding formula feeding practice and its associated factors in Ethiopia, particularly in Addis Ababa. Hence, this study was aimed at assessing the prevalence of formula feeding practice and its associated factors among mothers of an infant aged 0–6 months in Addis Ababa, Ethiopia. Methods A community-based cross-sectional study was conducted from April-1 to May 30/2020 among 494 mothers with infants 0–6 months of age. Data were collected using a pre-tested structured questionnaire. Data were entered and cleaned by using Epi data version 3.1 and analysed by SPSS software version 25. Then data were processed by using descriptive analysis, including frequency distribution, and summary measures. The degree of association was assessed using binary logistic regression analysis. P-value < 0.05 was considered statistically significant. Result The prevalence of formula feeding and pre-lacteal feeding practice was 46.2 and 34.4%, respectively. Educational status with a diploma and above (AOR = 3.09, 95%CI: 1.56–6.14), delivery by cesarean section (AOR = 6.13, 95%CI: 4.01–9.37), pre-lacteal feeding practice (AOR = 7.61, 95%CI: 4.11–11.06), and delayed initiation of breastfeeding (after 1 h to 1 day (AOR = 3.43, 95% CI: 1.59–7.40), after 1 day to 3 days (AOR = 3.71, 95% CI: 1.51–9.41), and after 3 days (AOR = 5.41, 95% CI: 2.15–13.60)) were significantly associated with formula feeding practice. Conclusions Nearly half of the participants were practiced formula-feeding for their infant. Educational status of mothers, the timing of initiation of breastfeeding, delivery by cesarean section, and pre-lacteal feeding practice were significantly associated with formula feeding practice. Therefore, early initiation of breastfeeding, educating mothers about the risks associated with pre-lacteal feeding, and supporting mothers who gave birth by cesarean section for exclusive breastfeeding should be encouraged at the community and institutional levels. Supplementary Information The online version contains supplementary material available at 10.1186/s13052-021-01010-x.
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Cato K, Sylvén SM, Henriksson HW, Rubertsson C. Breastfeeding as a balancing act - pregnant Swedish women's voices on breastfeeding. Int Breastfeed J 2020; 15:16. [PMID: 32138725 PMCID: PMC7059277 DOI: 10.1186/s13006-020-00257-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 02/14/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Breastfeeding provides health benefits to both women and children. The rationale behind an individual woman's decision to breastfeed or not can depend on several factors, either independently or in combination. The aim of the current study was to explore attitudes towards breastfeeding among pregnant women in Sweden who intend to breastfeed. METHODS Eleven mothers-to-be, one of whom had previous breastfeeding experience, participated in the study. The women were interviewed either by telephone or face-to-face during late pregnancy, with the aim of exploring their attitudes towards breastfeeding. A semi-structured interview-guide was used, and the transcripts of the interviews were analyzed using thematic analysis. The social ecological model of health is the theory-based framework underpinning this study. The model provides a comprehensive approach to understanding the factors that influence breastfeeding intention. RESULTS When interviewed during pregnancy, women described breastfeeding as a balancing act between societal norms and personal desires. The women perceived a societal pressure to breastfeed, however it was accompanied by boundaries and mixed messages. This perceived pressure was balanced by their own knowledge of breastfeeding, in particular their knowledge of other women's experience of breastfeeding. When envisioning their future breastfeeding, the women made uncertain and preliminary plans, and negotiated the benefits and drawbacks of breastfeeding. There was a wish for individual breastfeeding support and information. CONCLUSIONS Pregnant Swedish women perceive their future breastfeeding as a balancing act between societal norms and personal desires. These findings suggest that while discussing breastfeeding during pregnancy, it could be of interest to collect information from pregnant women on their knowledge of breastfeeding and from where they have gained this knowledge, since stories from family and friends may make them question their own capacity to breastfeed. A thorough review of the woman's experiences and attitudes of breastfeeding is important in order to offer the best evidence-based breastfeeding support. TRIAL REGISTRATION Ethical approval for the study was obtained from the Regional Ethical Review Board in Uppsala (Dnr: 2017/256).
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Affiliation(s)
- Karin Cato
- Department of Women’s and Children’s Health, Uppsala University Hospital, 751 85 Uppsala, Sweden
| | - Sara M. Sylvén
- Department of Women’s and Children’s Health, Uppsala University Hospital, 751 85 Uppsala, Sweden
- Department of Neuroscience, Psychiatry, Uppsala University Hospital, 751 85 Uppsala, Sweden
| | | | - Christine Rubertsson
- Department of Women’s and Children’s Health, Uppsala University Hospital, 751 85 Uppsala, Sweden
- Department of Health Science, Faculty of Medicine, Lund University, Box 188, 22100 Lund, Sweden
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Rahman A, Akter F. Reasons for formula feeding among rural Bangladeshi mothers: A qualitative exploration. PLoS One 2019; 14:e0211761. [PMID: 30807588 PMCID: PMC6391007 DOI: 10.1371/journal.pone.0211761] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 01/22/2019] [Indexed: 11/19/2022] Open
Abstract
In Bangladesh the exclusive breastfeeding rate remains low and prelacteal, formula and bottle feeding is increasing. This study aims to explore reasons behind infant formula feeding practices from mothers, caregivers, and health care provider's perspective. This was a qualitative study carried out in four sub-districts of Sylhet and Jessore of rural Bangladesh. Data were collected through focus group discussions (12), in-depth interviews (4) and key informant interviews (12) from January to February 2014. The qualitative data collected and were analyzed using thematic content analysis. This study clearly showed the factor behind formula feeding by Bangladeshi rural women. One of the major findings was that women could not differentiate between formula and other milk. Main differences between formula and powder milk were the type of consumer where formula only was taken by infant and children less than 2 years. Other major reasons include; poor breastfeeding practices, lack of appropriate breastfeeding practices, superficial knowledge on harmful effect on infant formula; perceived insufficient breast milk production, the influence of family and society and authoritarian power of hospital staff. Rural mothers have intension to feed infant formula to their infants due to various factors including individual, social, cultural and institutional. These identified factors can contribute to policy making and develop more specific interventions targeting expected mother and their family members that can contribute to stop formula feeding and increase breastfeeding practices in rural Bangladesh.
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Affiliation(s)
- Atiya Rahman
- Research and Evaluation Division (RED), BRAC, Mohakhali, Dhaka, Bangladesh
| | - Fahmida Akter
- Research and Evaluation Division (RED), BRAC, Mohakhali, Dhaka, Bangladesh
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Basrowi RW, Sastroasmoro S, Sulistomo AW, Bardosono S, Hendarto A, Soemarko DS, Sungkar A, Khoe LC, Vandenplas Y. Developing a workplace lactation promotion model in Indonesia using Delphi technique. Arch Public Health 2018; 76:70. [PMID: 30410756 PMCID: PMC6217783 DOI: 10.1186/s13690-018-0312-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 09/20/2018] [Indexed: 11/13/2022] Open
Abstract
Background Working mothers have a higher risk to terminate breastfeeding earlier than stay-at-home mothers. Researchers reported that support from the workplace by creating lactation facilities and develop supportive programs are necessary to increase the success of exclusive breastfeeding. The aim was to achieve expert consensus on developing a workplace-based lactation promotion model. Methods A three-round online survey using Delphi approach was conducted to reach consensus on to the development of a lactation program at a workplace. Results Twenty-two experts from Indonesian health authority, community medicine, child health and obstetrics were invited to join the Delphi study; 15 (68.2%) enrolled in the first round. The response rate in the second and third round was 80.0% (12/15) and 86.7% (13/15), respectively. The first round categorized the workplace-based promotion model into seven dimensions, i.e. policy and regulation, facility, education material, target participants, promotion approach, human resources, and time. In the final round, “maternity leave of 3-6 months” (median (Q1;Q3):2 (1, 4)) and “employees have the right to breast-pumping every 3 hours” (median (Q1;Q3):3 (2, 4)) ranked as the two most important indicators regarding policy and regulation. A dedicated lactation room (median (Q1;Q3):1 (1)) is the highest ranked indicator regarding facility dimension. Regarding education materials, benefits of breast milk for babies ranked as the highest indicator while for the education and delivering methods dimensions, social media and interactive counseling were two highest ranked indicators. The top management in the company and lactation counselor are the two highest-ranked indicators in human resources dimension. Conclusion In the view of experts, involvement of a dedicated policy maker in the company, a workplace-based lactation counselor, regular promotion with interactive education and dedicated facilities are necessary to develop an effective workplace-based lactation promotion model.
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Affiliation(s)
- Ray Wagiu Basrowi
- 1Doctoral Program Student, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Sudigdo Sastroasmoro
- 2Department of Child Health, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Astrid W Sulistomo
- 3Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Saptawati Bardosono
- 4Department of Nutrition, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Aryono Hendarto
- 2Department of Child Health, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Dewi S Soemarko
- 3Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ali Sungkar
- 5Department of Obstetric Gynecology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Levina Chandra Khoe
- 3Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Yvan Vandenplas
- 6KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
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Basrowi RW, Sastroasmoro S, Sulistomo AW, Bardosono S, Hendarto A, Soemarko DS, Sungkar A, Khoe LC, Vandenplas Y. Challenges and Supports of Breastfeeding at Workplace in Indonesia. Pediatr Gastroenterol Hepatol Nutr 2018; 21:248-256. [PMID: 30345237 PMCID: PMC6182487 DOI: 10.5223/pghn.2018.21.4.248] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 06/18/2018] [Accepted: 07/09/2018] [Indexed: 01/20/2023] Open
Abstract
Due to increased number of women workers in Indonesia in the last decade, numbers of women living as a worker and a housewife have increased. This also increases the potential risk of breastfeeding discontinuation. Three months of maternal leave policy and inadequate lactation promotion support in workplace have been identified as factors that hinder lactating practices. The World Health Organization recommendation of 6 months of exclusive breastfeeding and joined regulation of three Indonesia ministers (Ministry of Health, Ministry of Labour, and Ministry of Women Empower) have failed to improve the exclusive breastfeeding rate among female workers in Indonesia due to the lack of a standardized guideline on lactation promotion at workplace. In addition, very limited or no studies have been conducted to evaluate the impact of workplace-based lactation intervention programs on exclusive breastfeeding rate among female workers. This is because the relationship of lactation with working performance and productivity could not motivate employer to invest in workplace-based lactation promotion facility or program.
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Affiliation(s)
- Ray Wagiu Basrowi
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Depok City, Indonesia
| | - Sudigdo Sastroasmoro
- Department of Child Health, Faculty of Medicine, Universitas Indonesia, Depok City, Indonesia
| | - Astrid W Sulistomo
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Depok City, Indonesia
| | - Saptawati Bardosono
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia, Depok City, Indonesia
| | - Aryono Hendarto
- Department of Child Health, Faculty of Medicine, Universitas Indonesia, Depok City, Indonesia
| | - Dewi S Soemarko
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Depok City, Indonesia
| | - Ali Sungkar
- Department of Obstetric Gynaecology, Faculty of Medicine, Universitas Indonesia, Depok City, Indonesia
| | - Levina Chandra Khoe
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Depok City, Indonesia
| | - Yvan Vandenplas
- KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
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14
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AlKusayer NM, Midodzi WK, Newhook LA, Burrage L, Gill N, Halfyard B, Twells LK. Psychometric Assessment and Precision Remodeling of the Iowa Infant Feeding Attitude Scale to Improve Clinical Use and Efficacy Among Prenatal Women in Canada. J Hum Lact 2018; 34:20-29. [PMID: 29182888 DOI: 10.1177/0890334417741296] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The 17-item Iowa Infant Feeding Attitude Scale (IIFAS) has been widely used to assess maternal attitudes toward infant feeding and to predict breastfeeding intention. The IIFAS has been validated among prenatal women located in Newfoundland and Labrador in Canada, although its length may prove challenging to complete in a clinical setting. Research aim: The authors aimed to reduce the number of items from the original 17-item IIFAS scale while maintaining reliability and validity. METHODS A nonexperimental cross-sectional design was used among 1,283 women in their third trimester residing in Newfoundland and Labrador. Data were collected from August 2011 to June 2016. An exploratory factor analysis using principal component analysis was performed to explore the underlying structure of the IIFAS. The internal consistency of both the 17-item and reduced version was assessed using Cronbach's alpha and item-total correlation. The area under the curve and linear regression model were used to assess predictive validity of intention to breastfeed. RESULTS Our findings revealed that a 13-item IIFAS (Cronbach's α = .870) had relatively similar internal consistency to the original IIFAS (Cronbach's α = .868). Three themes were extracted from the factor analysis, resulting in the removal of four items. The reduced scale demonstrated an excellent ability to predict breastfeeding intention (area under the curve = 0.914). CONCLUSION The reduced 13-item version of the IIFAS is a psychometrically sound instrument that maintains its accuracy and validity when measuring maternal feeding attitudes during pregnancy and can be more time efficient in clinical settings compared with the 17-item IIFAS.
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Affiliation(s)
- Nouf M AlKusayer
- 1 Faculty of Medicine, Memorial University of Newfoundland, Health Sciences Centre, St. John's, Newfoundland and Labrador, Canada.,2 Healthcare Digitization Smart Services, Evoteq, Sharjah, United Arab Emirates
| | - William K Midodzi
- 1 Faculty of Medicine, Memorial University of Newfoundland, Health Sciences Centre, St. John's, Newfoundland and Labrador, Canada
| | - Leigh Anne Newhook
- 3 Janeway Pediatric Research Unit, Discipline of Pediatrics, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada
| | - Lorraine Burrage
- 4 Perinatal Program Newfoundland Labrador, Janeway Children's Health & Rehabilitation Centre, St John's, Newfoundland and Labrador, Canada
| | - Nicole Gill
- 5 Health Analytics and Evaluation Services, Newfoundland and Labrador Centre for Health Information, St John's, Newfoundland and Labrador, Canada
| | - Beth Halfyard
- 5 Health Analytics and Evaluation Services, Newfoundland and Labrador Centre for Health Information, St John's, Newfoundland and Labrador, Canada
| | - Laurie K Twells
- 1 Faculty of Medicine, Memorial University of Newfoundland, Health Sciences Centre, St. John's, Newfoundland and Labrador, Canada.,6 School of Pharmacy, Memorial University of Newfoundland, Health Sciences Centre, St. John's, Newfoundland and Labrador, Canada
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15
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Austen EL, Beadle J, Lukeman S, Lukeman E, Aquino N. Using a Music Video Parody to Promote Breastfeeding and Increase Comfort Levels Among Young Adults. J Hum Lact 2017; 33:560-569. [PMID: 28602110 DOI: 10.1177/0890334417706360] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND North Americans are not meeting the World Health Organization's breastfeeding recommendations. Young adults understand that breastfeeding is healthy but are uncomfortable seeing breastfeeding. Research aim: The aim of the current project was to determine if a music video parody promoting breastfeeding is perceived by young adults to be an effective means of promotion and if exposure to such a video could increase comfort levels. METHODS Young adults rated how comfortable they felt looking at breastfeeding and bottle-feeding images (pretest). Two months later, a subset of participants watched the music video parody "Breastfeeding My Baby." In Phase 1, participants completed the picture-rating task again (posttest) after a 2-month delay, plus a survey to assess memory and perception of the video. In Phase 2, participants were reminded of the video before completing the comfort ratings, and in the final phase, posttest measures were administered only 1 week after exposure to the video. RESULTS Across all phases, the video was perceived to be effective and was memorable. Breastfeeding comfort ratings were comparable at pretest across participant groups; comfort ratings improved at posttest for participants who saw the video but only if they were reminded of seeing it before providing their ratings. At shorter intervals between seeing the video and completing the posttests, comfort ratings for breastfeeding images increased for all participants, highlighting the general importance of exposure to breastfeeding. CONCLUSION Young adults are receptive to using a music video parody to promote breastfeeding, which can help to increase comfort levels with breastfeeding.
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Affiliation(s)
- Erin L Austen
- 1 Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada
| | - Julie Beadle
- 1 Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada
| | - Sionnach Lukeman
- 2 School of Nursing, St. Francis Xavier University, Antigonish, NS, Canada
| | - Ellen Lukeman
- 3 Public Health, Nova Scotia Health Authority, Nova Scotia, Antigonish, NS, Canada
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16
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Thomas C, O'Riordan MA, Furman L. Effect of the Knowledge and Attitudes of a Support Person on Maternal Feeding Choice. J Hum Lact 2017; 33:195-204. [PMID: 28135475 DOI: 10.1177/0890334416678821] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Breastfeeding rates among urban, low-income populations are lower than the national average, and social support can affect breastfeeding initiation and duration both positively and negatively. Research aim: This study aimed to determine the effect of the presence of a support person and breastfeeding knowledge and attitudes of that person on a mother's feeding choice and perceived level of support for her choice. METHODS Questionnaires were administered to 192 mothers receiving care for their infants in the Pediatric Practice at University Hospitals Rainbow Babies and Children's Hospital in Cleveland, Ohio, along with 74 adults accompanying these mothers. Data on demographics, feeding characteristics, and breastfeeding knowledge and attitudes were collected. RESULTS Analysis of the entire group of mothers found that breastfeeding-supportive knowledge and attitudes were an independent predictor of exclusive breastfeeding (odds ratio [ OR] = 1.89, 95% confidence interval [CI] [1.38, 2.60]) and any breastfeeding ( OR = 2.28, 95% CI [1.62, 3.21]). The presence of an accompanying adult was not related to feeding choice. Analysis of the subgroup of mothers with surveyed accompanying adults found independent predictors of any breastfeeding include maternal intention to breastfeed ( OR = 23.68, 95% CI [1.48, 377.6]) and breastfeeding-supportive knowledge and attitudes of the mother ( OR = 2.71, 95% CI [1.36, 5.40]) and the accompanying adult ( OR = 2.78, 95% CI [1.17, 6.60]). The only independent predictor of exclusive breastfeeding was maternal intention to breastfeed ( OR = 7.64, 95% CI [2.22, 26.3]). The majority of mothers (91%) felt supported, regardless of presence or absence of an accompanying adult. CONCLUSION These findings emphasize the importance of breastfeeding education for mothers and their support persons.
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Affiliation(s)
- Courtney Thomas
- 1 Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Mary Ann O'Riordan
- 2 Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | - Lydia Furman
- 2 Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
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17
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Austen EL, Dignam J, Hauf P. Using breastfeeding images to promote breastfeeding among young adults. Health Psychol Open 2016; 3:2055102916671015. [PMID: 35223072 PMCID: PMC8864535 DOI: 10.1177/2055102916671015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Young adults’ reactions to breastfeeding images were assessed using
varied approaches. In Study 1, participants viewed posters from a
breastfeeding campaign; many anticipated negative reaction to the
campaign. In Study 2, participants viewed novel infant-feeding
posters; breastfeeding posters were viewed for less time than
bottle-feeding posters, regardless of the task assigned. In Study 3,
participants were asked to rate their comfort level viewing
infant-feeding images; greater discomfort was reported for
breastfeeding images. Taken together, we argue that many young adults
expect, and experience, discomfort viewing breastfeeding, but it is
important to continue using breastfeeding images in promotion
efforts.
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18
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Twells LK, Midodzi WK, Ludlow V, Murphy-Goodridge J, Burrage L, Gill N, Halfyard B, Schiff R, Newhook LA. Assessing Infant Feeding Attitudes of Expectant Women in a Provincial Population in Canada: Validation of the Iowa Infant Feeding Attitude Scale. J Hum Lact 2016; 32:NP9-NP18. [PMID: 25425631 DOI: 10.1177/0890334414559647] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 10/19/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Maternal attitudes to infant feeding are predictive of intent and initiation of breastfeeding. OBJECTIVES The Iowa Infant Feeding Attitude Scale (IIFAS) has not been validated in the Canadian population. This study was conducted in Newfoundland and Labrador, a Canadian province with low breastfeeding rates. Objectives were to assess the reliability and validity of the IIFAS in expectant mothers; to compare attitudes to infant feeding in urban and rural areas; and to examine whether attitudes are associated with intent to breastfeed. METHODS The IIFAS assessment tool was administered to 793 pregnant women. Differences in the total IIFAS scores were compared between urban and rural areas. Reliability and validity analysis was conducted on the IIFAS. The receiver operating characteristic (ROC) of the IIFAS was assessed against mother's intent to breastfeed. RESULTS The mean ± SD of the total IIFAS score of the overall sample was 64.0 ± 10.4. There were no significant differences in attitudes between urban (63.9 ± 10.5) and rural (64.4 ± 9.9) populations. There were significant differences in total IIFAS scores between women who intend to breastfeed (67.3 ± 8.3) and those who do not (51.6 ± 7.7), regardless of population region. The high value of the area under the curve (AUC) of the ROC (AUC = 0.92) demonstrates excellent ability of the IIFAS to predict intent to breastfeed. The internal consistency of the IIFAS was strong, with a Cronbach's alpha greater than .80 in the overall sample. CONCLUSION The IIFAS examined in this provincial population provides a valid and reliable assessment of maternal attitudes toward infant feeding. This tool could be used to identify mothers less likely to breastfeed and to inform health promotion programs.
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Affiliation(s)
- Laurie K Twells
- School of Pharmacy and Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada
| | - William K Midodzi
- Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada
| | - Valerie Ludlow
- Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada
| | - Janet Murphy-Goodridge
- Perinatal Program NL, Janeway Children's Health & Rehabilitation Centre, St John's, Newfoundland and Labrador, Canada
| | - Lorraine Burrage
- Perinatal Program NL, Janeway Children's Health & Rehabilitation Centre, St John's, Newfoundland and Labrador, Canada
| | - Nicole Gill
- Research and Evaluation, Newfoundland and Labrador Centre for Health Information, St John's, Newfoundland and Labrador, Canada
| | - Beth Halfyard
- Research and Evaluation, Newfoundland and Labrador Centre for Health Information, St John's, Newfoundland and Labrador, Canada
| | - Rebecca Schiff
- Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada
| | - Leigh Anne Newhook
- Janeway Pediatric Research Unit, Discipline of Pediatrics, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada
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Vieth A, Woodrow J, Murphy-Goodridge J, O'Neil C, Roebothan B. The Ability of Posters to Enhance the Comfort Level with Breastfeeding in a Public Venue in Rural Newfoundland and Labrador. J Hum Lact 2016; 32:174-81. [PMID: 26151965 DOI: 10.1177/0890334415593944] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 05/26/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND The acceptance and support of breastfeeding in public venues can influence breastfeeding practices and, ultimately, the health of the population. OBJECTIVE The primary aim of this study was to investigate whether posters targeted at the general public could improve acceptability of breastfeeding in public places. METHODS A convenience sample of 255 participants was surveyed at shopping centers in 2 rural communities of Newfoundland and Labrador. Experimentally, questions were posed to 117 participants pre- and post-exposure to 2 specific posters designed to promote public acceptance of breastfeeding in public. RESULTS Initially, we surveyed that only 51.9% of participants indicated that they were comfortable with a woman breastfeeding anywhere in public. However, context played a role, whereby a doctor's office (84.5%) or park (81.4%) were the most acceptable public places for breastfeeding, but least acceptable was a business office environment (66.7%). Of participants, 35.4% indicated previously viewing specific posters. We used a visual analog scale to test poster viewing on the acceptability of public breastfeeding in the context of a doctor's office and a restaurant. Results of pre- versus post-viewing of the promotional posters indicated significant improvements in both scenarios: in a doctor's office (P = .035) and in a restaurant (P = .021). CONCLUSION Nearly 50% of the surveyed population indicated discomfort with a mother breastfeeding in public. Both cross-sectional and interventional evidence showed that posters significantly improved the reported level of comfort toward seeing breastfeeding in public.
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Affiliation(s)
- Alissa Vieth
- Memorial University of Newfoundland, St John's, NF, Canada
| | - Janine Woodrow
- Memorial University of Newfoundland, St John's, NF, Canada
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Young F, Twells L, Joy R, Newhook LA, Goodridge JM, Burrage L. Infant Feeding in Newfoundland and Labrador, Canada: Perceptions and Experiences of Maternal Grandmothers. J Perinat Educ 2016; 25:223-231. [DOI: 10.1891/1058-1243.25.4.223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACTThe purpose of this study was to examine the primary factors that influenced grandmothers’ choices of infant feeding and to explore the role that grandmothers feel they played in their daughters’ choices about infant feeding. Twenty-two maternal grandmothers who bottle fed their children and whose daughters also bottle fed their babies were recruited to participate in 4 focus groups and/or 2 interviews. Using the constant comparative method of data analysis, 3 themes emerged that described how grandmothers felt about their infant feeding experiences: “powerlessness,” “modesty,” and “ambivalence.” These themes and their implications are discussed in this article.
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Nouer SS, Ware JL, Baldwin KM, Hare ME. Changes in Breastfeeding Attitudes in a Metropolitan Community in Tennessee. J Hum Lact 2015; 31:519-29. [PMID: 25829477 DOI: 10.1177/0890334415578648] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 02/22/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Southern United States has low breastfeeding rates, particularly among African Americans. Breastfeeding rates are influenced by community attitudes and norms. OBJECTIVE This study aimed to examine changes in breastfeeding attitudes and demographic factors related to these attitudes. METHODS Cross-sectional data from a community-based survey, repeated annually from 2004 to 2008, were analyzed. Univariable analysis examined trends over time and log binomial regression estimated the strength of the association between year of the survey, demographic factors, and outcome responses related to the survey questions. RESULTS After adjusting for sex, race, marital status, age, and education, compared to 2004, 2008 respondents were 26% more likely to rate breastfeeding as extremely important compared to formula feeding (prevalence ratio [PR] = 1.26; 95% confidence interval [CI], 1.10-1.43). Similarly, 2008 respondents were 29% more likely to rate the importance of breastfeeding for long-term health as extremely important (PR = 1.29; 95% CI, 1.14-1.46). Comfort levels with breastfeeding outside the home also increased. Respondents to the 2008 survey were more likely to report that they were comfortable with a mother breastfeeding in their workplace (PR = 1.20; 95% CI, 1.11-1.31) and in a mall or restaurant (PR = 1.15; 95% CI, 1.06-1.26). After controlling for demographic factors, there were no significant differences in responses between African Americans and other races. CONCLUSION Despite significantly lower breastfeeding rates among African Americans, this analysis revealed significant positive changes in attitudes regarding breastfeeding between 2004 and 2008, regardless of race. These changes in attitude coincided with increased breastfeeding initiation rates, suggesting that federal, state, and local breastfeeding promotion efforts had an effect.
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Affiliation(s)
- Simonne S Nouer
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Julie L Ware
- All Better Pediatrics, Memphis, TN, USA Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
| | | | - Marion E Hare
- Departments of Preventive Medicine and Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
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Braimoh J, Davies L. When 'breast' is no longer 'best': Post-partum constructions of infant-feeding in the hospital. Soc Sci Med 2014; 123:82-9. [PMID: 25462608 DOI: 10.1016/j.socscimed.2014.10.052] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 10/24/2014] [Accepted: 10/27/2014] [Indexed: 10/24/2022]
Abstract
In this paper, we focus on the initial experiences of breastfeeding among mothers to examine the ways that infant-feeding is socially constructed in the hospital. Data comes from 51 in-depth interviews with 17 first-time mothers in Ontario, Canada. Analysis reveals 52 magnified moments that we categorize as Successful, Ultimately Successful and Unsuccessful. For mothers who describe Successful and Ultimately Successful moments, breastfeeding is understood as physiologically natural, and as something they must learn to do. Unsuccessful moments reveal that when health care providers interpret breastfeeding as not working, the breastfeeding discourse frequently shifts to one that incorporates formula as the means to achieve optimal infant health. In other words, in the hospital 'breast is best' holds true when breast 'works', otherwise mothers are often directed to give their babies formula. While formula appears to be compulsory in these moments, it is not typically understood as a "good or best" infant-feeding practice. For mothers in this situation, the shift from breast to formula is experienced as failures or evidence of inadequacy in their mothering. Paradoxically, our results suggest that formula may not, in and of itself, pose a threat to mothers' overall continued practice of breastfeeding. It appears that Successful and Ultimately Successful moments coincide with the current dominant 'breast is best' understanding. Unsuccessful moments, conversely, are insightful because they reveal when and how hospital practices disrupt mothers' understanding of their bodies and their role in providing the 'best' form of infant food. The implications for policy and practice are discussed.
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Affiliation(s)
- Jessica Braimoh
- Department of Sociology, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8, Canada.
| | - Lorraine Davies
- Department of Sociology, University of Western Ontario, 1151 Richmond Street, London, Ontario N6A 5C2, Canada.
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Parahoo K. Qualitative Research. Nurs Res 2014. [DOI: 10.1007/978-1-137-28127-2_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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