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Glick L, Heifetz EM, Finkelstein A. Nourishing two hearts: The journey of nursing student mothers during academic studies and clinical rotations: A qualitative study. Nurse Educ Pract 2024; 79:104068. [PMID: 39059153 DOI: 10.1016/j.nepr.2024.104068] [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: 03/20/2024] [Revised: 06/26/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024]
Abstract
AIM To explore and understand breastfeeding experiences and challenges among student mothers who breastfeed during their academic studies and clinical rotations in nursing school. BACKGROUND Breastfeeding is recommended for the nourishment of infants. An increasing number of students combine parenthood and higher education, including student mothers who give birth while pursuing their degrees. Nursing students confront a dual challenge. In addition to the rigorous demands of theoretical academic coursework they must also contend with clinical rotations. There is limited literature regarding the experiences of nursing students who breastfeed during their studies and even more limited literature regarding their experiences during clinical rotations. DESIGN A qualitative design using a constructionist framework for thematic analysis. METHODS Fifteen semi-structured interviews were conducted between June 2023 and September 2023 and were analyzed using a thematic analysis. RESULTS Four themes were identified, which describe the experiences of nursing student mothers during their academic studies and clinical rotations: The importance of breastfeeding for baby's health and emotional connection; Breastfeeding and pumping during academic studies and clinical rotations requires the students to juggle between the various tasks; Dealing with privacy and modesty during breastfeeding in public on campus and in clinical settings; and Attitudes from academic educators, clinical instructors and classmates that foster, support, or impede the integration of breastfeeding during nursing studies. CONCLUSIONS Creating a supportive atmosphere for breastfeeding students necessitates a comprehensive strategy from academic institutions and hospital nursing administration.
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Affiliation(s)
- Laurie Glick
- Jerusalem College of Technology, Department of Nursing, Faculty of Life and Health Sciences, 11 Bet Hadfus St., Jerusalem 95483, Israel.
| | - Eliyahu M Heifetz
- Jerusalem College of Technology, Department of Nursing, Faculty of Life and Health Sciences, 11 Bet Hadfus St., Jerusalem 95483, Israel.
| | - Adi Finkelstein
- Jerusalem College of Technology, Department of Nursing, Faculty of Life and Health Sciences, 11 Bet Hadfus St., Jerusalem 95483, Israel.
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Bowe AK, Lightbody G, O'Boyle DS, Staines A, Murray DM. Predicting low cognitive ability at age 5 years using perinatal data and machine learning. Pediatr Res 2024; 95:1634-1643. [PMID: 38177251 PMCID: PMC11126385 DOI: 10.1038/s41390-023-02914-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 10/06/2023] [Accepted: 11/03/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND There are no early, accurate, scalable methods for identifying infants at high risk of poor cognitive outcomes in childhood. We aim to develop an explainable predictive model, using machine learning and population-based cohort data, for this purpose. METHODS Data were from 8858 participants in the Growing Up in Ireland cohort, a nationally representative study of infants and their primary caregivers (PCGs). Maternal, infant, and socioeconomic characteristics were collected at 9-months and cognitive ability measured at age 5 years. Data preprocessing, synthetic minority oversampling, and feature selection were performed prior to training a variety of machine learning models using ten-fold cross validated grid search to tune hyperparameters. Final models were tested on an unseen test set. RESULTS A random forest (RF) model containing 15 participant-reported features in the first year of infant life, achieved an area under the receiver operating characteristic curve (AUROC) of 0.77 for predicting low cognitive ability at age 5. This model could detect 72% of infants with low cognitive ability, with a specificity of 66%. CONCLUSIONS Model performance would need to be improved before consideration as a population-level screening tool. However, this is a first step towards early, individual, risk stratification to allow targeted childhood screening. IMPACT This study is among the first to investigate whether machine learning methods can be used at a population-level to predict which infants are at high risk of low cognitive ability in childhood. A random forest model using 15 features which could be easily collected in the perinatal period achieved an AUROC of 0.77 for predicting low cognitive ability. Improved predictive performance would be required to implement this model at a population level but this may be a first step towards early, individual, risk stratification.
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Affiliation(s)
- Andrea K Bowe
- INFANT Research Centre, University College Cork, Cork, Ireland.
| | - Gordon Lightbody
- INFANT Research Centre, University College Cork, Cork, Ireland
- Department of Electrical and Electronic Engineering, University College Cork, Cork, Ireland
| | | | - Anthony Staines
- School of Nursing, Psychotherapy, and Community Health, Dublin City University, Dublin, Ireland
| | - Deirdre M Murray
- INFANT Research Centre, University College Cork, Cork, Ireland
- Department of Paediatrics, Cork University Hospital, Cork, Ireland
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Brown KJ, Beck KL, von Hurst P, Heath AL, Taylor R, Haszard J, Daniels L, Te Morenga L, McArthur J, Paul R, Jones E, Katiforis I, Rowan M, Casale M, McLean N, Cox A, Fleming E, Bruckner B, Jupiterwala R, Wei A, Conlon C. Adherence to Infant Feeding Guidelines in the First Foods New Zealand Study. Nutrients 2023; 15:4650. [PMID: 37960303 PMCID: PMC10647304 DOI: 10.3390/nu15214650] [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: 10/07/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
Infant feeding guidelines provide evidence-based recommendations to support optimal infant health, growth, and development, and exploring adherence to guidelines is a useful way of assessing diet quality. The aim of this study was to determine adherence to the recently updated Ministry of Health "Healthy Eating Guidelines for New Zealand Babies and Toddlers (0-2 years old)". Data were obtained from First Foods New Zealand, a multicentre observational study of 625 infants aged 7.0-10.0 months. Caregivers completed two 24-h diet recalls and a demographic and feeding questionnaire. Nearly all caregivers (97.9%) initiated breastfeeding, 37.8% exclusively breastfed to around six months of age, and 66.2% were currently breastfeeding (mean age 8.4 months). Most caregivers met recommendations for solid food introduction, including appropriate age (75.4%), iron-rich foods (88.3%), puréed textures (80.3%), and spoon-feeding (74.1%). Infants consumed vegetables (63.2%) and fruit (53.9%) more frequently than grain foods (49.5%), milk and milk products (38.6%), and meat and protein-rich foods (31.8%). Most caregivers avoided inappropriate beverages (93.9%) and adding salt (76.5%) and sugar (90.6%). Our findings indicated that while most infants met the recommendations for the introduction of appropriate solid foods, the prevalence of exclusive breastfeeding could be improved, indicating that New Zealand families may need more support.
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Affiliation(s)
- Kimberley J. Brown
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Kathryn L. Beck
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Pamela von Hurst
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Anne-Louise Heath
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Rachael Taylor
- Department of Medicine, University of Otago, Dunedin 9016, New Zealand; (R.T.); (L.D.); (A.C.)
| | - Jillian Haszard
- Biostatistics Centre, University of Otago, Dunedin 9016, New Zealand;
| | - Lisa Daniels
- Department of Medicine, University of Otago, Dunedin 9016, New Zealand; (R.T.); (L.D.); (A.C.)
| | - Lisa Te Morenga
- Research Centre for Hauora and Health, Massey University, Wellington 6140, New Zealand;
| | - Jenny McArthur
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Rebecca Paul
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Emily Jones
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Ioanna Katiforis
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Madeleine Rowan
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Maria Casale
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Neve McLean
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Alice Cox
- Department of Medicine, University of Otago, Dunedin 9016, New Zealand; (R.T.); (L.D.); (A.C.)
| | - Elizabeth Fleming
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Bailey Bruckner
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; (A.-L.H.); (J.M.); (I.K.); (M.R.); (N.M.); (E.F.); (B.B.)
| | - Rosario Jupiterwala
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Andrea Wei
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
| | - Cathryn Conlon
- School of Sport, Exercise and Nutrition, Massey University, Auckland 0632, New Zealand; (K.J.B.); (K.L.B.); (P.v.H.); (R.P.); (E.J.); (M.C.); (R.J.); (A.W.)
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Walsh A, McCluskey R, Cassidy D, McGoldrick G, Howlin C, Muldoon K, Butler É, Byrne G. The Support Needs and Current Practices of Public Health Nurses in the Republic of Ireland Who Provide Support to Breastfeeding Mothers: A Cross-Sectional Survey. J Hum Lact 2023; 39:733-742. [PMID: 37232139 PMCID: PMC10580677 DOI: 10.1177/08903344231172991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 04/13/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Breastfeeding continuation rates are low in Ireland. The Breastfeeding Observation and Assessment Tool (BOAT) was developed to assist public health nurses in assessing breastfeeding challenges; however, little is known of its actual usage, the level of training experienced or desired by public health nurses, or their level of confidence in the support they provide to breastfeeding mothers. RESEARCH AIM To identify the current practices and support needs of public health nurses who provide breastfeeding support in Ireland. METHOD An online questionnaire was devised to collect respondents' confidence with breastfeeding issues, caseload, and practices. It was distributed to public health nurses with a current child health caseload in one Community Healthcare Organization. Mann Whitney U tests were used to ascertain the relationship between public health nurses' confidence level and those with qualifications in midwifery or as an International Board Certified Lactation Consultant (IBCLC). RESULTS The survey was completed by 66 public health nurses. Only 14 respondents (21.2%) indicated that they always used the BOAT. The most common reason for not doing so was a lack of education on its use (n = 17, 25.8%). Postholders also certified as IBCLCs were considered by participants to be the most appropriate professionals to resolve certain breastfeeding issues. Confidence levels to manage breastfeeding issues were highest among public health nurses with IBCLC credentialing (U = 12.5, p = .001) while no difference was seen when comparing those with a midwifery degree to those without (U = 184.0, p = .92). Face-to-face workshops and blended-learning approaches were ranked as the preferred formats for breastfeeding education (Median rank = 2). CONCLUSIONS Breastfeeding education incorporating a face-to-face component is needed to support public health nurses who work with breastfeeding mothers, as is prioritization of recruitment in the community of public health nurses with IBCLC credentials.
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Affiliation(s)
- Annemarie Walsh
- Dublin South, Kildare and West Wicklow Community Healthcare Organisation 7 (CHO 7), Health Service Executive, Dublin, Ireland
| | - Rachel McCluskey
- Dublin South, Kildare and West Wicklow Community Healthcare Organisation 7 (CHO 7), Health Service Executive, Dublin, Ireland
| | - Deirdre Cassidy
- Dublin South, Kildare and West Wicklow Community Healthcare Organisation 7 (CHO 7), Health Service Executive, Dublin, Ireland
| | - Gerardine McGoldrick
- Dublin South, Kildare and West Wicklow Community Healthcare Organisation 7 (CHO 7), Health Service Executive, Dublin, Ireland
| | - Claire Howlin
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Kathryn Muldoon
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Éadaoin Butler
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Gobnait Byrne
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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Houlihan AE, Zaikman Y, Alford AM. The influence of bystander presence on evaluations of public breastfeeding among adults in the United States. BMC Public Health 2023; 23:1753. [PMID: 37684595 PMCID: PMC10492271 DOI: 10.1186/s12889-023-16635-2] [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: 04/20/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND In general, people tend to support private breastfeeding more than public breastfeeding, and discomfort surrounding public breastfeeding may contribute to sub-optimal rates of breastfeeding in the United States. Few studies have systematically examined situational factors that contribute to (negative) reactions to public breastfeeding. It is unclear whether the physical location or the presence of others is more influential in shaping people's evaluations of public breastfeeding. This study aimed to experimentally investigate the influence of location, bystander presence, bystander gender, and the breastfeeding woman's use of a cover on people's evaluations of breastfeeding images. METHOD A sample of adults residing in the United States was randomly assigned to view an image of a breastfeeding woman in an experimental study that examined four independent variables: breastfeeding location (public vs. private), bystander presence (present vs. not present), gender of bystander (male vs. female), and use of a cover (cover vs. no cover). Participants then reported their emotional reactions to, perceptions of, and behavioral intentions toward the breastfeeding woman. In addition, participants completed measures of sexism, traditional gender role endorsement, sexual comfort, body gaze, and breastfeeding knowledge and experience. RESULTS Hierarchical regressions revealed no differences between private and public breastfeeding images. Perceptions of the breastfeeding woman were more favorable when she was alone than with others, and when she was covered than when she was not covered. Evaluations tended to be more favorable among participants who scored lower on hostile sexism, higher on benevolent sexism, higher on sexual comfort, and higher on breastfeeding knowledge. CONCLUSION The presence of bystanders may be more consequential than the physical location in shaping reactions to public breastfeeding. These findings can be applied to improve support for public breastfeeding, which may contribute to higher breastfeeding rates and the associated public health benefits.
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Affiliation(s)
- Amy E Houlihan
- Department of Psychology & Sociology, Texas A&M University-Corpus Christi, 6300 Ocean Dr., unit 5827, Corpus Christi, TX, 78412, USA.
| | - Yuliana Zaikman
- Department of Psychology & Sociology, Texas A&M University-Corpus Christi, 6300 Ocean Dr., unit 5827, Corpus Christi, TX, 78412, USA
| | - Allison M Alford
- Department of Psychology & Sociology, Texas A&M University-Corpus Christi, 6300 Ocean Dr., unit 5827, Corpus Christi, TX, 78412, USA
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Woolley E, Buck G, Jackson J, Bowman R, Fox L, Gallagher S, Sorrell M, Ghimire PR. Exclusive Breastfeeding at Discharge in Regional New South Wales, Australia: The Role of Antenatal Care (2011-2020). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6135. [PMID: 37372722 DOI: 10.3390/ijerph20126135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023]
Abstract
Increasing the number of infants exclusively breastfeeding on discharge from the hospital after birth is a key goal of breastfeeding policy in New South Wales (NSW), Australia. Despite consistent efforts, exclusive breastfeeding on discharge rates have declined over the past decade. Using pooled data from the New South Wales Perinatal Data Collection from 2011 to 2020, we examined the association between antenatal care (ANC) and exclusive breastfeeding at discharge from birth admission outcomes for mother-baby dyads in Southern New South Wales Local Health District (SNSWLHD). Our study confirmed that exclusive breastfeeding rates in SNSWLHD have declined over the past decade, providing local evidence to support action. Late entry to ANC and a failure to attend the recommended number of ANC visits were important predictors of a lower rate of exclusive breastfeeding on discharge. Improving accessibility to ANC visits for rural and regional mothers has potential to positively impact breastfeeding rates in SNSWLHD. We suggest that wider implementation of caseload midwifery models may have a positive impact on breastfeeding outcomes in the region for all mother-baby dyads, but particularly for Aboriginal mothers and infants, younger mothers and mothers experiencing disadvantage.
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Affiliation(s)
- Emma Woolley
- Integrated Care and Allied Health, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
| | - Gretchen Buck
- Integrated Care and Allied Health, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
| | - Jackie Jackson
- Integrated Care and Allied Health, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
| | - Rebekah Bowman
- Nursing and Midwifery, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
| | - Louise Fox
- Integrated Care and Allied Health, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
| | - Shirlena Gallagher
- People and Culture, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
| | | | - Pramesh Raj Ghimire
- Integrated Care and Allied Health, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
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Ward G, Adair P, Doherty N, McCormack D. Bereaved mothers' experience of expressing and donating breast milk: An interpretative phenomenological study. MATERNAL & CHILD NUTRITION 2023:e13473. [PMID: 36924437 DOI: 10.1111/mcn.13473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 12/01/2022] [Accepted: 12/08/2022] [Indexed: 03/18/2023]
Abstract
Perinatal loss is a devastating event for any mother. What is often overlooked is a mothers continued ability to lactate following the death of her child. Donor breast milk is a commodity highly sought after given its value for feeding sick babies resident in Neonatal Intensive Care Units. This study aimed to explore the lived experience of mothers who have expressed and donated their breast milk following the loss of their infant. Seven bereaved mothers who donated milk to the Human Milk Bank in Northern Ireland were recruited. These women took part in semistructured interviews, which explored their experiences of perinatal loss and the role that expression/donation played for them in their grief. Their accounts were analysed using a qualitative interpretative phenomenological analysis (IPA) method. After transcription and analysis, three superordinate themes emerged; (1) fulfilling the mother role; (2) the power of being able to 'Do'; (3) making good from the bad. The stories of these women reflect the independent and individual nature of grief. Each mother gained a great deal of comfort in having the ability to express milk. For some this created a physical connection to their child, for others, it created time alone to process what had happened and for all, it created a sense of autonomy and ownership in what was otherwise a very turbulent time in their lives.
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Affiliation(s)
- Gráinne Ward
- Department of Clinical Psychology, Queen's University, Belfast, Northern Ireland, UK
| | - Pauline Adair
- Department of Clinical Psychology, Queen's University, Belfast, Northern Ireland, UK
| | - Nicola Doherty
- Department of Clinical Psychology, Queen's University, Belfast, Northern Ireland, UK
| | - David McCormack
- Department of Clinical Psychology, Queen's University, Belfast, Northern Ireland, UK
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Wu JL, Pang SQ, Jiang XM, Lin Y, Zheng QX. The mothers' breastfeeding behaviour within six weeks postpartum: new scale development and psychometric validation study. BMC Pregnancy Childbirth 2023; 23:138. [PMID: 36864400 PMCID: PMC9979542 DOI: 10.1186/s12884-023-05439-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 02/09/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND The evaluation of mothers' breastfeeding behaviour within 6 weeks postpartum could help health workers comprehensively identify maternal breastfeeding shortcomings, clarify nursing problems, and provide targeted interventions. However, no prior study was found, therefore this study aimed to develop and validate the reliability and validity of the mothers' breastfeeding behaviour scale within 6 weeks postpartum. METHODS A main two-step approach was used: (1) a qualitative pilot study using the purposive sampling method was adopted to test the fitness, simplicity, and clarity of items with 30 mothers; (2) a cross-sectional survey using the convenient sampling method was conducted for item analysis and psychometric validation with 600 mothers. RESULTS The final version of the scale consisted of 36 items with seven dimensions, explaining 68.852% of the total variance. The Cronbach's α, split-half, and retest coefficients were 0.958, 0.843, and 0.753, respectively. The validity of the scale: (1) Content validity: content validity index (CVI) range of items was between 0.882 and 1.000. The scale-level-CVI was 0.990. (2) Structure validity: The fitting indices were as follows: χ2/ⅆf =2.239, RMR = 0.049, RMSEA = 0.069, TLI = 0.893, CFI = 0.903, IFI = 0.904, PGFI = 0.674, and PNFI = 0.763. (3) Convergent validity: The composite reliability and average variance extracted (AVE) of the seven dimensions were between 0.876 and 0.920 and between 0.594 and 0.696. (4) Distinguish validity: The correlation coefficients were less than the square root of the AVE, except for self-decision behaviour, self-coping behaviour, and self-control behaviour. However, the fit index of the original three-factor model was better than that of the other new models, with significant differences (P < 0.001). (5) Calibration validity: The area under the curve was 0.860 or 0.898 when the scale was used to predict exclusive or any breastfeeding at 42 days. The correlation coefficients of the maternal breasting feeding evaluation scale, breastfeeding self-efficacy short-form scale, and the scale were 0.569 and 0.674, respectively. CONCLUSION The newly developed mothers' breastfeeding behaviour scale within 6 weeks postpartum consists of 36 items belonging to seven dimensions with good reliability and validity and is a reliable and valid instrument to be used in future maternal breastfeeding behaviour assessments and interventions.
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Affiliation(s)
- Jing-Ling Wu
- grid.411504.50000 0004 1790 1622School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian China ,grid.256112.30000 0004 1797 9307Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian China
| | - Shu-Qin Pang
- grid.411504.50000 0004 1790 1622School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian China
| | - Xiu-Min Jiang
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China.
| | - Yan Lin
- grid.256112.30000 0004 1797 9307Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian China
| | - Qing-Xiang Zheng
- grid.256112.30000 0004 1797 9307Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian China
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McGovern L, Geraghty A, McAuliffe F, O'Reilly S. An exploration of prenatal breastfeeding self-efficacy: a scoping review protocol. OPEN RESEARCH EUROPE 2023; 2:91. [PMID: 37645344 PMCID: PMC10445816 DOI: 10.12688/openreseurope.14938.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 08/31/2023]
Abstract
Objective: To synthesise the evidence on prenatal breastfeeding self-efficacy, including identifying concepts and theoretical frameworks that underpin its development, the evidence on its measurement, interventions used to improve it, and association with breastfeeding outcomes. Background: Breastfeeding self-efficacy is described as a woman's self-belief and confidence in her perceived ability to breastfeed. It is a modifiable measure that is strongly associated with breastfeeding outcomes such as initiation, exclusivity, and duration. Interventions aimed at increasing self-efficacy are often in the postnatal period and have been shown to be effective at improving breastfeeding outcomes. The prenatal period appears to be underexplored in the literature and yet focusing on enhancing it may have the potential for further improvements in self-efficacy and on subsequent breastfeeding outcomes. A comprehensive knowledge synthesis on prenatal breastfeeding self-efficacy is lacking. Methods: The search will include databases across health, psychology, sociology, and the grey literature on breastfeeding guidance. Once the PCC framework (Problem: breastfeeding, Concept: self-efficacy, Context: prenatal period) is met, sources of evidence from any contextual setting will be eligible for inclusion. Limits will not be applied on geographic location or year of publication. The PRISMA-ScR flow diagram of search and study selection will be used to report final figures. Two independent reviewers will perform title and abstract screening and full text review. Data will be charted to provide a logical and descriptive summary of the results that align with the objectives. Conclusion: The results will provide an understanding of what has been done in the space and what gaps exist, informing recommendations for the timing of measurement and the design of prenatal interventions.
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Affiliation(s)
- Liz McGovern
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, D04 V1W8, Ireland
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, D02 YH21, Ireland
| | - Aisling Geraghty
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, D04 V1W8, Ireland
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, D02 YH21, Ireland
| | - Fionnuala McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, D02 YH21, Ireland
| | - Sharleen O'Reilly
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, D04 V1W8, Ireland
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, D02 YH21, Ireland
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Philip RK, Worobetz A, Byrt H, Beirne I, Zutshi R, Cassidy T, Dunne CP. A repeated cross-sectional analysis of breastfeeding initiation rates in Ireland for two decades and 10 recommended priorities for improvement. MATERNAL & CHILD NUTRITION 2022; 19:e13424. [PMID: 36147028 PMCID: PMC9749595 DOI: 10.1111/mcn.13424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/21/2022] [Accepted: 07/29/2022] [Indexed: 12/15/2022]
Abstract
Despite a number of public health and policy-based initiatives, Ireland's national breastfeeding rates are among the lowest globally. Regionally, the Mid-West of Ireland has historically had low breastfeeding initiation rates, and parts of its major urban area such as Limerick City suffer the highest levels of economic deprivation in the country. In that context, this repeated cross-sectional study analysed breastfeeding initiation trends in the Mid-West of Ireland for two decades, from 2001 to 2020 inclusively. Statistical analysis revealed persistently low percentages of women initiating breastfeeding in the region. Time series analyses of the data demonstrated that overall breastfeeding rates are increasing, but continue to be lower than Irish national averages. From these findings and a narrative review of published research, we determined 10 plausible reasons for these consistently low breastfeeding rates. Arising from these, we propose '10 Priorities' to increase the breastfeeding initiation rates in Ireland.
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Affiliation(s)
- Roy K. Philip
- Division of Neonatology, Department of PaediatricsUniversity Maternity Hospital LimerickLimerickIreland,School of MedicineUniversity of LimerickLimerickIreland
| | | | - Helen Byrt
- Lactation Division, Department of Nursing MidwiferyUniversity Maternity Hospital LimerickLimerickIreland
| | - Irene Beirne
- Neonatal Nursing, Department of MidwiferyUniversity Maternity Hospital LimerickLimerickIreland
| | | | - Tanya Cassidy
- Sociology and Anthropology, School of Nursing, Psychotherapy and Community HealthDublin City UniversityDublinIreland
| | - Colum P. Dunne
- School of MedicineUniversity of LimerickLimerickIreland,Centre for Interventions in Infection, Inflammation and Immunity (4i)University of Limerick School of MedicineLimerickIreland
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11
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Wszołek KM, Chmaj-Wierzchowska K, Pięt M, Tarka A, Chuchracki M, Męczekalski B, Wilczak M. Neonatal breast-suckling skills in the context of lactation and peripartum hormonal changes and additional factors-a pilot study. Int Breastfeed J 2022; 17:66. [PMID: 36050767 PMCID: PMC9436720 DOI: 10.1186/s13006-022-00508-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 08/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background Childbirth and lactation are intricate processes, involving several hormones, the most important of which are prolactin (a protein hormone) and cortisol (one of the glucocorticoids). The early postpartum period is crucial for both mother and newborn and has an impact on the lactation and breastfeeding process. Methods The study included 78 patients who were admitted to the Gynecology-Obstetrics Clinical Hospital in Poznań for labor induction and/or in the active phase of the first labor stage. The levels of cortisol and prolactin in serum were assessed in these women during admission in labor, during the third labor stage, and on the second day postpartum. The levels of cortisol and prolactin in the umbilical cord serum were assessed immediately after cord clamping. The “Protocol for the assessment of breast-suckling skills” was used to assess the neonatal breast-suckling skills on the second day postpartum. Some additional parameters were evaluated in mothers via a telephone interview at three and six months postpartum. The study was conducted from January to August 2020, however the study was suspended during April–July 2020 due to the SARS-CoV-2 pandemic, which led to restrictions in the hospital limiting access to the hospital wards unless necessary. Results Early breastfeeding with skin-to-skin contact was associated with low levels of hormones, cortisol levels were lower in serum (p = 0.0108) and umbilical vein (p = 0.0273) in mothers who breastfed immediately after childbirth. At three months postpartum, 88% of the mothers who did not offer a pacifier to the child during the first few days of life breastfed the child naturally (p = 0.037), and at six months, 96% of those who did not offer a pacifier continued to breastfeed (p = 0.0008). Multiple, statistically significant correlations were observed between the variables assessed according to the “Protocol for the assessment of breast-suckling skills” and breastfeeding after three months. Conclusions Breastfeeding immediately after childbirth, appropriate assessment of the breast-suckling skills of newborns, avoiding pacifiers and infant formula feeding, and offering support to new mothers in the early days after childbirth seem to be important factors for sustaining breastfeeding after three and six months of childbirth.
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Affiliation(s)
- Katarzyna Maria Wszołek
- Department of Maternal and Child Health, Poznan University of Medical Sciences, Poznań, Poland. .,Gynecology-Obstetrics Clinical Hospital, Poznan University of Medical Sciences, Poznań, Poland.
| | - Karolina Chmaj-Wierzchowska
- Department of Maternal and Child Health, Poznan University of Medical Sciences, Poznań, Poland.,Gynecology-Obstetrics Clinical Hospital, Poznan University of Medical Sciences, Poznań, Poland
| | - Małgorzata Pięt
- Gynecology-Obstetrics Clinical Hospital, Poznan University of Medical Sciences, Poznań, Poland.,Facility of Practical Midwifery Sciences, Poznan University of Medical Sciences, Poznań, Poland
| | - Agata Tarka
- Gynecology-Obstetrics Clinical Hospital, Poznan University of Medical Sciences, Poznań, Poland.,Facility of Practical Midwifery Sciences, Poznan University of Medical Sciences, Poznań, Poland
| | - Marek Chuchracki
- Faculty of Health Sciences, Chair of Cosmetology, Calisia University, Kalisz, Poland
| | - Błażej Męczekalski
- Gynecology-Obstetrics Clinical Hospital, Poznan University of Medical Sciences, Poznań, Poland.,Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznań, Poland
| | - Maciej Wilczak
- Department of Maternal and Child Health, Poznan University of Medical Sciences, Poznań, Poland.,Gynecology-Obstetrics Clinical Hospital, Poznan University of Medical Sciences, Poznań, Poland
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12
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Evaluation of the Effects of Skin-to-Skin Contact on Newborn Sucking, and Breastfeeding Abilities: A Quasi-Experimental Study Design. Nutrients 2022; 14:nu14091846. [PMID: 35565813 PMCID: PMC9101996 DOI: 10.3390/nu14091846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 12/04/2022] Open
Abstract
Mother and newborn skin-to-skin contact (SSC) after birth has numerous protective effects. Although positive associations between SSC and breastfeeding behavior have been reported, the evidence for such associations between early SSC and breastfeeding success was limited in high-income countries. This quasi-experimental intervention design study aimed to evaluate the impact of different SSC regimens on newborn breastfeeding outcomes in Taiwan. In total, 104 healthy mother–infant dyads (52 in the intervention group and 52 in the control group) with normal vaginal delivery were enrolled from 1 January to 30 July 2019. The intervention group received 60 min of immediate SSC, whereas the control group received routine care (early SSC with 20 min duration). Breastfeeding performance was evaluated by the IBFAT and BSES-Short Form. Generalized estimating equations (GEEs) were used to evaluate the effectiveness of the intervention. In the intervention group, the breastfeeding ability of newborns increased significantly after 5 min of SSC and after SSC. The intervention also improved the total score for breastfeeding self-efficacy (0.18 point; p = 0.003). GEE analysis revealed that the interaction between group and time was significant (0.65 point; p = 0.003). An initial immediate SSC regimen of 60 min can significantly improve neonatal breastfeeding ability and maternal breastfeeding self-efficacy in the short term after birth.
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13
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Affiliation(s)
- Zelalem T Haile
- Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, USA
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14
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Neves PAR, Vaz JS, Maia FS, Baker P, Gatica-Domínguez G, Piwoz E, Rollins N, Victora CG. Rates and time trends in the consumption of breastmilk, formula, and animal milk by children younger than 2 years from 2000 to 2019: analysis of 113 countries. THE LANCET. CHILD & ADOLESCENT HEALTH 2021; 5:619-630. [PMID: 34245677 PMCID: PMC8376656 DOI: 10.1016/s2352-4642(21)00163-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/13/2021] [Accepted: 05/17/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Previous analyses of trends in feeding indicators of children younger than 2 years have been limited to low-income and middle-income countries. We aimed to assess time trends in the consumption of different types of milk (breastmilk, formula, and animal milk) by children younger than 2 years from 2000 to 2019 at a global level. METHODS In this time-series analysis, we combined cross-sectional data from 487 nationally representative surveys from low-income and middle-income countries and information from high-income countries to estimate seven infant and young child feeding indicators in up to 113 countries. Multilevel linear models were used in pooled analyses to estimate annual changes in feeding practices from 2000 to 2019 for country income groups and world regions. FINDINGS For the absolute average annual changes, we found significant gains in any breastfeeding at age 6 months in high-income countries (1·29 percentage points [PPs] per year [95% CI 1·12 to 1·45]; p<0·0001) and at age 1 year in high-income countries (1·14 PPs per year [0·99 to 1·28]; p<0·0001) and upper-middle-income countries (0·53 PPs per year [0·23 to 0·82]; p<0·0001). We also found a small reduction in low-income countries for any breastfeeding at age 6 months (-0·07 PPs per year [-0·11 to -0·03]; p<0·0001) and age 1 year (-0·13 PPs per year [-0·18 to -0·09]; p<0·0001). Data on exclusive breastfeeding and consumption of formula and animal milk were only available for low-income and middle-income countries, where exclusive breastfeeding in the first 6 months of life increased by 0·70 PPs per year (0·51-0·88; p<0·0001) to reach 48·6% (41·9-55·2) in 2019. Exclusive breastfeeding increased in all world regions except for the Middle East and north Africa. Formula consumption in the first 6 months of life increased in upper-middle-income countries and in east Asia and the Pacific, Latin America and the Caribbean, the Middle East and north Africa, and eastern Europe and central Asia, whereas the rates remained below 8% in sub-Saharan Africa and south Asia. Animal milk consumption by children younger than 6 months decreased significantly (-0·41 PPs per year [-0·51 to -0·31]; p<0·0001) in low-income and middle-income countries. INTERPRETATION We found some increases in exclusive and any breastfeeding at age 6 months in various regions and income groups, while formula consumption increased in upper-middle-income countries. To achieve the global target of 70% exclusive breastfeeding by 2030, however, rates of improvement will need to be accelerated. FUNDING Bill & Melinda Gates Foundation, through WHO.
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Affiliation(s)
- Paulo A R Neves
- International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil.
| | - Juliana S Vaz
- International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil; Faculty of Nutrition, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Fatima S Maia
- International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil; Universidade Federal do Rio Grande (FURG), Rio Grande, Brazil
| | - Philip Baker
- Institute for Physical Education and Nutrition, Deakin University, Melbourne, VIC, Australia
| | | | - Ellen Piwoz
- Global Development Program, Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Nigel Rollins
- Department of Maternal, Newborn, Child, and Adolescent Health, WHO, Geneva, Switzerland
| | - Cesar G Victora
- International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil
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