Breastfeeding in the first six months of life for babies seen by Lactation Consulting

Effective breastfeeding techniques and associated factors among lactating women in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Effective breastfeeding is crucial for maternal and child health, particularly in low-resource settings like Ethiopia. It encompasses a range of skills and strategies, including proper latch, positioning, and frequency of feeding. These techniques not only ensure sufficient milk transfer but also foster bonding between mother and child, enhancing the breastfeeding experience. To effectively prioritize maternal and child health, it is crucial to comprehensively understand the prevalence and factors influencing effective breastfeeding nationwide. Therefore, this study aimed to provide a pooled prevalence of effective breastfeeding techniques and associated factors among lactating mothers in Ethiopia.

METHODS

The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist, focusing on studies conducted in Ethiopia. We identified eight relevant studies through Google Scholar, Medline, PubMed, Scopus, and the Cochrane Library. Analysis was conducted using STATA version 11, and systematic data extraction employed a checklist to extract relevant data. I2 tests and the Cochrane Q test statistic were used to evaluate heterogeneity. To explore potential publication bias, Egger's weighted regression, Begg's test, and a funnel plot were utilized.

RESULTS

We identified a total of 955 research articles. Eight studies meeting the eligibility criteria were incorporated into this meta-analysis and systematic review. The pooled prevalence of effective breastfeeding techniques was 41.99% [95% CI 32.16-51.81]. According to the results of the current meta-analysis, effective breastfeeding techniques were significantly associated with antenatal care follow-up [OR = 1.75, 95% CI 1.10-2.78], maternal educational status [OR = 2.70, 95% CI 1.55-4.71], breastfeeding technique counseling [OR = 2.02, 95% CI 1.41-2.90], the absence of breast problems [OR = 2.26, 95% CI 1.49-3.43], breastfeeding experience [OR = 1.98, 95% CI 1.14-3.46], and immediate skin-to-skin contact [OR = 2.32, 95% CI 1.56-3.44].

CONCLUSION

Our findings highlight the vital role of various factors in shaping effective breastfeeding.

IMPLICATIONS

To improve practices and health outcomes, we recommend targeted interventions, such as strengthening antenatal care, implementing maternal education, and providing comprehensive breastfeeding counseling. Proactively addressing breast problems and prioritizing immediate skin-to-skin contact is crucial for successful breastfeeding.

Ineffective breastfeeding techniques and associated factors among breastfeeding mothers who gave birth in the last 6 months in Sinan Woreda, Northwest Ethiopia

Background

Optimal infant feeding is critical for children's growth and development during their first years of life. Plenty of evidence on ineffective breastfeeding techniques, yet the problem is still deep-rooted and requires further research in Ethiopia.

Objective

To determine the proportion of ineffective breastfeeding techniques and associated factors among breastfeeding mothers who gave birth in the last 6 months in Sinan Woreda.

Design and methods

A community-based cross-sectional study was conducted from March 10 to April 8, 2021 with a total of 389 samples. A computer-generated simple random sampling was used to select mothers. An observational checklist and interviewer-administered questionnaires were used. EpiData 4.2 for data entry and SPSS 25 for cleaning and analysis were used. Variables with a p-value < 0.05 and 95% confidence interval (CI) corresponding adjusted odds ratio (AOR) were used to identify factors of ineffective breastfeeding techniques.

Results

The proportion of ineffective breastfeeding techniques was 66.8%. The mean (SD) age of mothers was 29.4 ± 5.95 years. No formal education [AOR: 5.88 (95% CI: (2.97, 11.65)], primipara [AOR: 4.34 (95% CI: 2.25, 8.36)], home delivery [AOR: 3.02 (95% CI: 1.12, 8.14)], not received breastfeeding counseling during antenatal care [AOR: 4.94 (95% CI: 1.83, 13.36)], breast problem [AOR: 2.62 (95% CI: 1.25, 5.48)], and breastfeeding experience [AOR: 1.82 (95% CI: 1.01, 3.28)] were statistically significant factors.

Conclusions

The proportion of ineffective breastfeeding techniques 66.8% was unacceptable. Socio-demographic and maternal health care services were identified factors. Strengthening maternal care, improving health education and promotions, and designing appropriate strategies were required.

Effect of Counseling Service on Breastfeeding Practice among Saudi Mothers

Objective: To assess the knowledge and practice of breastfeeding and the effects of lactation counseling, as a health promotion intervention, on breastfeeding duration and exclusive breastfeeding (EBF) among Saudi women. Methods: In this quasi-experimental design study, 664 mothers attending a women’s hospital from January 2017 to December 2018 were interviewed. Women were allocated into two groups, control and intervention groups, based on received lactation counseling. Interviews were performed using a structured questionnaire collecting data on the sociodemographic characteristics, knowledge, attitude and practice of breastfeeding mothers. A chi-squared test was used to determine the level of significance on breastfeeding practices among two groups. Propensity score matching was presented to control confounders, as women cannot be randomly assigned to lactation counseling. Results: Of 664 women, 592 were Saudi nationals, and the majority of mothers were literate (96.2%). A significantly higher number of mothers in the consultation group were employed as compared with the non-consultation group (p = 0.015). One third (33.3%) of the women practiced EBF, while 39.8% preferred mixed feeding for the first six months of the infant’s life. The consultation group demonstrated a significantly higher response rate in their knowledge on the benefits of breastfeeding in babies (increased intelligence; p < 0.05) and mothers (breast engorgement; p = 0.004), colostrum and its importance (p = 0.027) and effective breastfeeding practices (initiate breastfeeding within 30 min after birth (p = 0.01), baby needs 10–20 min between each feed (p = 0.009), breastfeeding should last for 6 months (p = 0.01)) compared with the non-consultation group. The age of weaning (5.3 ± 2.8 vs. 5.9 ± 3.2 months) was similar across both the groups. However, “the intended duration of BF” was higher in the non-consultation group, and the difference was statistically significant (p = 0.002). The mean weight and length of the baby at follow-up were similar in both groups, with no statistical significance. The duration of exclusive breastfeeding among two groups was not statistically significantly different (8.7 ± 6.9 vs. 8.1 ± 7.1 weeks). Mothers in the two groups were satisfied with their breastfeeding experience. The mean scores lie within the range of 4.2 to 5.0. Baby age (month), mother LoE, mother job and type of BF were controlled for, and the propensity-score-matched 62.5% sample from both the groups yielded the same results. Conclusions: Breastfeeding women in our study showed a fair knowledge of EBF. However, the duration of actual EBF was very short, and the counseling intervention showed no impact on EBF in our study population. We recommend interventions that are tailored to the needs of this population, while identifying factors that improve breastfeeding practice among mothers.

Chemical Effects on Breast Development, Function, and Cancer Risk: Existing Knowledge and New Opportunities

Population studies show worrisome trends towards earlier breast development, difficulty in breastfeeding, and increasing rates of breast cancer in young women. Multiple epidemiological studies have linked these outcomes with chemical exposures, and experimental studies have shown that many of these chemicals generate similar effects in rodents, often by disrupting hormonal regulation. These endocrine-disrupting chemicals (EDCs) can alter the progression of mammary gland (MG) development, impair the ability to nourish offspring via lactation, increase mammary tissue density, and increase the propensity to develop cancer. However, current toxicological approaches to measuring the effects of chemical exposures on the MG are often inadequate to detect these effects, impairing our ability to identify exposures harmful to the breast and limiting opportunities for prevention. This paper describes key adverse outcomes for the MG, including impaired lactation, altered pubertal development, altered morphology (such as increased mammographic density), and cancer. It also summarizes evidence from humans and rodent models for exposures associated with these effects. We also review current toxicological practices for evaluating MG effects, highlight limitations of current methods, summarize debates related to how effects are interpreted in risk assessment, and make recommendations to strengthen assessment approaches. Increasing the rigor of MG assessment would improve our ability to identify chemicals of concern, regulate those chemicals based on their effects, and prevent exposures and associated adverse health effects.

Breastfeeding in times of COVID-19: a scoping review

OBJECTIVE

to identify how the COVID-19 pandemic has influenced postpartum women in breastfeeding.

METHOD

a scoping review, with a search in seven databases. Studies available in full, in English, Portuguese or Spanish, published from December/2019-April/2021 were included. The analysis was carried out by categorizing common themes.

RESULTS

25 studies were included, grouped into five categories, presenting the influence of the pandemic: in the routine of breastfeeding care, evidencing preventive measures against COVID-19; in breastfeeding rates, highlighting changes in dietary practices; in the support network for breastfeeding, indicating a lack of service care; in the postpartum women's emotions, with predominance of concern and stress; in the use of technology to support breastfeeding, with teleservice facilitating care.

CONCLUSION

the COVID-19 pandemic has influenced new forms of care, in the offer and duration of breastfeeding, in emotional health and in the support network fragility. It is expected to contribute so that health professionals provide care with greater assertiveness in the face of this new situation.

Aleitamento materno em tempos de COVID-19: uma scoping review

RESUMO Objetivo: identificar como a pandemia de COVID-19 tem influenciado as puérperas no aleitamento materno. Método: scoping review, com busca em sete bases de dados. Incluíram-se estudos disponíveis na íntegra, em inglês, português ou espanhol, publicados de dezembro/2019-abril/2021. A análise deu-se por categorização de temas comuns. Resultados: incluíram-se 25 estudos, agrupados em cinco categorias, apresentando a influência da pandemia: na rotina de cuidados ao aleitamento materno, evidenciando medidas preventivas contra COVID-19; nas taxas do aleitamento materno, destacando mudanças nas práticas alimentares; na rede de apoio para o aleitamento materno, apontando falta de assistência de serviços; nas emoções das puérpera, predominando preocupação e estresse; no uso da tecnologia para apoio ao aleitamento materno, com teleatendimento facilitando a assistência. Conclusão: a pandemia de COVID-19 influenciou novas formas de assistência, na oferta e no tempo de amamentação, na saúde emocional e na fragilidade da rede de apoio. Espera-se contribuir para que profissionais da saúde proporcionem assistência com maior assertividade diante dessa nova situação.