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Christou E, Liakou E, Pouliakis A, Sokou R, Volaki P, Paliatsou S, Boutsikou T, Iacovidou N, Iliodromiti Z. Increase in Breastfeeding Rates in Baby-Friendly Hospitals in Greece: Comparison with the National Study of 2017. CHILDREN (BASEL, SWITZERLAND) 2024; 11:932. [PMID: 39201867 PMCID: PMC11352986 DOI: 10.3390/children11080932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/25/2024] [Accepted: 07/28/2024] [Indexed: 09/03/2024]
Abstract
BACKGROUND/OBJECTIVES The primary purpose of this study was to correlate the factors influencing the onset and duration of exclusive breastfeeding (EBF) and breastfeeding (BF) rates at different time points in baby-friendly hospitals (BFHs) in Greece. METHODS This study was conducted from October 2020 to January 2022. The sample consisted of 1201 mothers with corresponding newborn births out of the total 7201 that took place during the same period. We used a questionnaire that the mothers answered during the first hour after birth, before being discharged from the maternity hospital, and at the 2nd, 4th, and 6th month of the infant's life. The results were compared with the data of the national study from 2017 (concerning births from general maternity hospitals and not only from BFHs). RESULTS The EBF rate within 1 h after birth was 71.3%, which gradually declined to 21.2% in the 6th month. Between the two studies, differences were recorded in BF and EBF rates at the 6th and 4th month of the infants' life, respectively, especially in mothers who are less likely to breastfeed (e.g., those without breastfeeding experience, those over 40 years old, etc.). CONCLUSION This study showed that EBF and BF rates are higher in infants born in BFHs compared to non-BFHs both during their hospitalization in the first days of life and during the first 6 months of life. BFHs also play a decisive role in mothers who, due to their socio-economic profile, have lower chances of starting to breastfeed.
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Affiliation(s)
- Evangelos Christou
- Neonatal Department, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (E.L.); (R.S.); (P.V.); (T.B.); (N.I.); (Z.I.)
| | - Eftychia Liakou
- Neonatal Department, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (E.L.); (R.S.); (P.V.); (T.B.); (N.I.); (Z.I.)
| | - Abraham Pouliakis
- 2nd Department of Pathology, “ATTIKON” University Hospital, National and Kapodistrian University of Athens, 124 61 Athens, Greece;
| | - Rozeta Sokou
- Neonatal Department, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (E.L.); (R.S.); (P.V.); (T.B.); (N.I.); (Z.I.)
| | - Paraskevi Volaki
- Neonatal Department, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (E.L.); (R.S.); (P.V.); (T.B.); (N.I.); (Z.I.)
| | - Styliani Paliatsou
- Neonatal Department, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (E.L.); (R.S.); (P.V.); (T.B.); (N.I.); (Z.I.)
| | - Theodora Boutsikou
- Neonatal Department, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (E.L.); (R.S.); (P.V.); (T.B.); (N.I.); (Z.I.)
| | - Nicoletta Iacovidou
- Neonatal Department, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (E.L.); (R.S.); (P.V.); (T.B.); (N.I.); (Z.I.)
| | - Zoi Iliodromiti
- Neonatal Department, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece; (E.L.); (R.S.); (P.V.); (T.B.); (N.I.); (Z.I.)
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Papadima EI, Vassilakou T, Grigoriadis T, Boutsiadis A, Ivanidou S, Kalampalikis A, Michala L. Nutrition knowledge, attitudes, and perceptions of Greek menopausal women. Menopause 2024; 31:415-429. [PMID: 38564702 DOI: 10.1097/gme.0000000000002342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Nutritional guidelines for postmenopausal women differ. This study aimed to assess postmenopausal women's knowledge, beliefs, and practices regarding nutrition during menopause and their dietary habits. METHODS This cross-sectional study was conducted in a menopause clinic, and data from 105 women were analyzed. A nutrition knowledge, attitudes, and perceptions (KAP) questionnaire was designed, structured, and piloted before implementation, based on the Hellenic dietary guidelines. International Physical Activity Questionnaire-Greek version, MedDietScore, and Menopause-specific Quality of Life questionnaires were administered. RESULTS The mean ± SD age of the women was 56.9 ± 4.6 years. The mean ± SD KAP score was 12.2 ± 3.5. Those who lived in rural areas had lower KAP scores than those who lived in urban areas ( P = 0.004). Of all the women, 74.5% knew the Mediterranean diet pyramid, whereas 9.8% knew the Hellenic dietary guidelines. Women who had read the guidelines showed better knowledge of Mediterranean diet food groups (Pearson, 0.309; P = 0.039). Knowledge of dairy services was correlated with consumption of dairy products ( P = 0.002). Furthermore, 76.4% were willing to participate in nutrition education programs. The International Physical Activity Questionnaire score was positively correlated with years of smoking ( P = 0.002). Physical activity correlated with adherence to the Mediterranean diet ( P = 0.044). CONCLUSIONS The majority of postmenopausal Greek women in this study were unaware of the Hellenic dietary guidelines. In general, women's knowledge of nutrition during menopause was moderate. Greek postmenopausal women are willing to participate in nutrition education programs, which should raise awareness of healthy lifestyles through nutrition, exercise, and smoking cessation.
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Affiliation(s)
- Evgenia-Ioanna Papadima
- From the 1st Department of Obstetrics and Gynaecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Tonia Vassilakou
- Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | - Themos Grigoriadis
- From the 1st Department of Obstetrics and Gynaecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Sofia Ivanidou
- From the 1st Department of Obstetrics and Gynaecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas Kalampalikis
- From the 1st Department of Obstetrics and Gynaecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Lina Michala
- From the 1st Department of Obstetrics and Gynaecology, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Tigka M, Metallinou D, Tzeli M, Lykeridou K. Maternal tobacco, alcohol and caffeine consumption during the perinatal period: A prospective cohort study in Greece during the COVID-19 pandemic. Tob Induc Dis 2023; 21:80. [PMID: 37333502 PMCID: PMC10273827 DOI: 10.18332/tid/166109] [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: 12/16/2022] [Revised: 04/06/2023] [Accepted: 05/12/2023] [Indexed: 06/20/2023] Open
Abstract
INTRODUCTION Low-level knowledge of problematic substance use during the perinatal period may lead to numerous adverse outcomes. We sought to determine maternal tobacco, alcohol and caffeine consumption during the perinatal period during the COVID-19 pandemic. METHODS This prospective cohort study recruited women from five Greek maternity hospitals between January and May 2020. Data were collected with a structured questionnaire initially completed by postpartum women during their hospitalization and re-administered via telephone interview in the first, third and sixth month postpartum. RESULTS The study sample consisted of 283 women. Smoking rates decreased during pregnancy (12.4%) compared to the pre-pregnancy period (32.9%, p<0.001) and during lactation (5.6%) compared to the antenatal period (p<0.001). The smoking rate increased again after breastfeeding cessation (16.9%) compared to the rate during lactation (p<0.001), but remained lower than the pre-pregnancy rate (p=0.008). Only 1.4% of the women reported breastfeeding cessation due to smoking, whereas those who smoked more during pregnancy were more likely to cease breastfeeding (OR=1.24; 95% CI: 1.05-1.48, p=0.012). Regarding alcohol consumption, it was significantly lower during pregnancy (5.7%), lactation (5.5%) and after breastfeeding cessation (5.2%) compared to the pre-pregnancy period (21.9%, p<0.001 for all correlations). Women who consumed alcohol during lactation were less likely to wean (OR=0.21; 95% CI: 0.05-0.83, p=0.027). Caffeine intake decreased during pregnancy compared to preconception period (p<0.001), while in lactating women it remained at low rates until the 3rd month of follow-up. Caffeine consumption at one month postpartum (β=0.09; SE=0.04, p=0.045) was positively associated with longer duration of breastfeeding. CONCLUSIONS Tobacco, alcohol and caffeine consumption decreased in the perinatal period compared to the preconception period. The pandemic may have contributed to the downtrend in smoking and alcohol consumption due to COVID-related restrictions and fear of potential illness. Nevertheless, smoking was associated with reduced duration of breastfeeding and breastfeeding cessation.
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Affiliation(s)
- Maria Tigka
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
- Department of Obstetric Emergency, General and Maternity Hospital 'Helena Venizelou', Athens, Greece
| | - Dimitra Metallinou
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Maria Tzeli
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Katerina Lykeridou
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
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Tigka M, Metallinou D, Nanou C, Iliodromiti Z, Gryparis A, Lykeridou K. Medication Intake as a Factor for Non-Initiation and Cessation of Breastfeeding: A Prospective Cohort Study in Greece during the COVID-19 Pandemic. CHILDREN 2023; 10:children10030586. [PMID: 36980144 PMCID: PMC10047701 DOI: 10.3390/children10030586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/13/2023] [Accepted: 03/17/2023] [Indexed: 03/22/2023]
Abstract
Pharmacological treatment may become a barrier for a mother’s breastfeeding goals. We aimed to investigate maternal medication intake as a factor for non-initiation and cessation of breastfeeding and the effect of professional counseling on maternal decision-making. Throughout 2020,847 women were recruited from five healthcare institutions. Information was gathered prospectively with an organized questionnaire through interview during hospitalization and through telephone at 1, 3 and 6 months postpartum. Results revealed that from the 57 cases of breastfeeding cessation due to medication intake, only 10.5%received evidence-based counseling from a physician. Unfortunately, 68.4% (n = 39/57) of the participants ceased breastfeeding due to erroneous professional advice. The compatibility of medicines with breastfeeding was examined according to the Lactmed and Hale classification systems, which showed discrepancy in 8 out of 114 medicines used, while 17.5% and 13.2% of the medicines, respectively, were not classified. Educational level, employment at six months postpartum, mode of delivery, previous breastfeeding experience, medication intake for chronic diseases, physician’s recommendation and smoking before pregnancy were factors significantly correlated with breastfeeding discontinuation due to medication intake. The COVID-19 restrictions protected women from ceasing breastfeeding due to medication intake. Maternal and lactation consultancy should be strictly related to evidence-based approaches.
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Affiliation(s)
- Maria Tigka
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.T.)
- Department of Obstetric Emergency, General and Maternity Hospital “Helena Venizelou”, 11521 Athens, Greece
| | - Dimitra Metallinou
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.T.)
| | - Christina Nanou
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.T.)
| | - Zoi Iliodromiti
- Department of Neonatology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Alexandros Gryparis
- Department of Speech and Language Therapy, University of Ioannina, 45500 Ioannina, Greece
| | - Katerina Lykeridou
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.T.)
- Correspondence:
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Tanaka R, Tsuji M, Shimono M, Morokuma S, Morisaki N, Kusuhara K, Kawamoto T. Association between maternal socioeconomic status and breastfeeding: Results from the Japan environment and children's study. J Child Health Care 2023:13674935231158842. [PMID: 36922156 DOI: 10.1177/13674935231158842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Although breastfeeding has various benefits for mothers and children, there are several barriers to continuing breastfeeding practices. However, little is known about the relationship between breastfeeding in Japan and maternal socioeconomic circumstances. Based on data from the Japan Environment and Children's Study (n = 75,742), we evaluated maternal socioeconomic factors associated with breastfeeding 1 year after giving birth. Socioeconomic status (education, employment status, and household income), working hours, and breastfeeding were assessed using a self-administered questionnaire. After descriptive analysis, a logistic regression analysis was conducted with adjustments for age, educational level, employment status, and household income. Mothers with higher education and full-time homemakers were more likely to breastfeed one-year-old children. Mothers working long hours (both part-time and full-time) were less likely to breastfeed their one-year-old children. To improve breastfeeding among working mothers, it may be helpful to promote awareness of breastfeeding for every mother as well as to make the workplace environment conducive for working mothers to breastfeed.
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Affiliation(s)
- Rie Tanaka
- Department of Environmental Health, School of Medicine, 13137University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Mayumi Tsuji
- Department of Environmental Health, School of Medicine, 13137University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masayuki Shimono
- Japan Environment and Children's Study, UOEH Subunit Center, 13137University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Seiichi Morokuma
- Department of Health Sciences, Graduate School of Medical Sciences, 12923Kyushu University, Fukuoka, Japan
| | - Naho Morisaki
- Department of Social Medicine, 13611National Center for Child Health and Development, Tokyo, Japan
| | - Koichi Kusuhara
- Japan Environment and Children's Study, UOEH Subunit Center, 13137University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.,Department of Pediatrics, School of Medicine, 13137University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Toshihiro Kawamoto
- Department of Environmental Health, School of Medicine, 13137University of Occupational and Environmental Health, Kitakyushu, Japan
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Perikleous EP, Fouzas S, Michailidou M, Patsourou A, Tsalkidis D, Steiropoulos P, Nena E, Chatzimichael A, Paraskakis E. Association between History of Prolonged Exclusive Breast-Feeding and the Lung Function Indices in Childhood. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1708. [PMID: 36360436 PMCID: PMC9688515 DOI: 10.3390/children9111708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 09/29/2023]
Abstract
Although the propitious effects of breastfeeding on children's health are indisputable, the impact of exclusive breastfeeding on the lung function later in life remains controversial. Our objective was to explore the possible associations between breastfeeding and the lung function of children who were exclusively breastfed for an extensive period of time. This was a cross-sectional study of children who were exclusively breastfed for more than 12 months. Demographics and anthropometric data were collected; the body mass index (BMI), % body fat, and % central obesity were calculated; and all the participants underwent standard spirometry with reversibility testing. The relationship between breastfeeding duration and spirometric parameters was assessed by Spearman's correlation and multivariable regression, after adjustment for other confounders. Forty-six children (21 boys), aged 9.2 ± 2.4 years, with a reported breastfeeding duration of 27.5 ± 12.5 months (range 12-60 months) were included; 13% were overweight (none were obese) and 21.7% had central obesity. The average FEV1 was 104.7 ± 10.4% and the average FEF25-75 was 107.9 ± 13.3%. The duration of exclusive breastfeeding was positively correlated with FEF25-75% (r = 0.422, p = 0.003). Multivariable linear regression analysis confirmed the above finding (beta coefficient 0.478, p = 0.002), independently of age, overweight, and central obesity. No correlation was noted between the duration of breastfeeding and other spirometric parameters. In addition to its favorable impact on the metabolic profile, prolonged exclusive breastfeeding seems to exert a propitious effect on the function of smaller airways throughout childhood.
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Affiliation(s)
| | - Sotirios Fouzas
- Pediatric Respiratory Unit, University Hospital of Patras, 26504 Patras, Greece
| | | | - Anna Patsourou
- Medical School, Democritus University of Thrace, 691 00 Alexandroupolis, Greece
| | - Dimos Tsalkidis
- Medical School, Democritus University of Thrace, 691 00 Alexandroupolis, Greece
| | - Paschalis Steiropoulos
- Department of Pneumonology, Medical School, Democritus University of Thrace, 691 00 Alexandroupolis, Greece
| | - Evangelia Nena
- Laboratory of Social Medicine, Medical School, Democritus University of Thrace, 691 00 Alexandroupolis, Greece
| | - Athanasios Chatzimichael
- Department of Pediatrics, Medical School, Democritus University of Thrace, 691 00 Alexandroupolis, Greece
| | - Emmanouil Paraskakis
- Pediatric Respiratory Unit, Pediatric Department, University of Crete, 700 13 Heraklion, Greece
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Sokou R, Parastatidou S, Ioakeimidis G, Tavoulari EF, Makrogianni A, Isaakidou E, Iacovidou N, Konstantinidi A. Breastfeeding in Neonates Admitted to an NICU: 18-Month Follow-Up. Nutrients 2022; 14:nu14183841. [PMID: 36145216 PMCID: PMC9500865 DOI: 10.3390/nu14183841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction: The admission of neonates to Neonatal Intensive Care Units (NICUs) has been identified as a primary inhibiting factor in the establishment of breastfeeding. The aims of this study were to (1) estimate the prevalence and duration of breastfeeding in infants/toddlers who had been admitted to an NICU in Greece and (2) to investigate factors, associated with the NICU stay, which affected the establishment and maintenance of breastfeeding in infants/toddlers previously admitted to the NICU. Materials and methods: Data for this cohort study were retrieved from interviews with mothers of infants/toddlers who had been admitted to our NICU as neonates during the period of 2017−2019. Interviews were conducted based on a questionnaire regarding the child’s nutrition from birth to the day of the interview, including previous maternal experience with breastfeeding. Information related to the prenatal period, gestation age, delivery mode, duration of NICU stay, and neonatal feeding strategies during their hospital stay were recorded. Results: The response rate to the telephone interviews was 57%, resulting in 279 mother−infant pairs being included in this study. The results showed that 78.1% of children received maternal milk during their first days of life. Of all infants, 58.1% were exclusively breastfed during their first month, with a gradual decrease to 36.9% and 19.4% by the end of the third and sixth months of life, respectively. The prevalence of breastfed children reached 14.7% and 7.5% at the ages of twelve and eighteen months, respectively. In the multivariate analysis, prematurity emerged as an independent prognostic factor for the duration of exclusive and any breastfeeding (aHR 1.64, 95% CI: 1.03−2.62; and 1.69, 95% CI: 1.05−2.72, respectively; p < 0.05). Additionally, the nationality of the mother, NICU breastfeeding experience, the administration of maternal milk during neonatal hospital stay, and previous breastfeeding experience of the mother were independent prognostic factors for the duration of breastfeeding. Conclusions: Although breastfeeding is a top priority in our NICU, the exclusive-breastfeeding rates at 6 months were quite low for the hospitalized neonates, not reaching World Health Organization (WHO) recommendations. Mothers/families of hospitalized neonates should receive integrated psychological and practical breastfeeding support and guidance.
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Affiliation(s)
- Rozeta Sokou
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 3 D. Mantouvalou Str., Nikea, 18454 Piraeus, Greece
- Neonatal Department, Aretaieio Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
- Correspondence: ; Tel.: +30-2132077346 or +30-2132077000
| | - Stavroula Parastatidou
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 3 D. Mantouvalou Str., Nikea, 18454 Piraeus, Greece
| | - Georgios Ioakeimidis
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 3 D. Mantouvalou Str., Nikea, 18454 Piraeus, Greece
| | - Evangelia-Filothei Tavoulari
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 3 D. Mantouvalou Str., Nikea, 18454 Piraeus, Greece
| | - Athanasia Makrogianni
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 3 D. Mantouvalou Str., Nikea, 18454 Piraeus, Greece
| | - Elina Isaakidou
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 3 D. Mantouvalou Str., Nikea, 18454 Piraeus, Greece
| | - Nicoletta Iacovidou
- Neonatal Department, Aretaieio Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Aikaterini Konstantinidi
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 3 D. Mantouvalou Str., Nikea, 18454 Piraeus, Greece
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Coca KP, Lee EY, Chien LY, Souza ACP, Kittikul P, Hong SA, Chang YS. Postnatal women's breastfeeding beliefs, practices, and support during the COVID-19 pandemic: a cross-sectional comparative study across five countries. Int Breastfeed J 2022; 17:58. [PMID: 35978362 PMCID: PMC9385077 DOI: 10.1186/s13006-022-00497-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background Women with COVID-19 experienced numerous concerns and doubts about the safety of breastfeeding their babies, and lack of support may have impacted breastfeeding practices. This study aims to compare breastfeeding beliefs, practices, and contact with healthcare professionals regarding the level of postnatal feeding support provided during the COVID-19 pandemic in Brazil, South Korea, Taiwan, Thailand, and the United Kingdom. Methods A multi-country cross-sectional study was conducted with postnatal women in five countries. Women up to six months postpartum were invited to complete an online survey concerning the transmission of preventative measures, beliefs toward breastfeeding, infant feeding practices in the last 24 hours and experiences of postnatal infant feeding support between July to November 2021. Bivariate and multivariate analyses were performed to identify the association. Results Of the 3,253 eligible responses received, 39.5% of children were aged between one and two months, but in Taiwan (36%) and South Korea (42.8%) they were between three and four months. The mean of the belief score was significantly different among countries (p < 0.0001). Women in Brazil and the UK had a higher rate of breastfeeding at the breast (90.7% and 85.4%, respectively) compared to the three Asian countries (p < 0.0001) while feeding with expressed breastmilk in Thailand (59.9%), Taiwan (52.6%), and South Korea (50.4%) was higher than the others (p < 0.0001). Brazil and UK mothers (mean = 16.0 and 14.5 respectively) had a higher mean score for belief toward breastfeeding during the COVID-19 than the others. These results are inversely associated with breastfeeding but positively related to formula feeding practice. Postnatal feeding support during the COVID-19 pandemic was mainly provided by healthcare professionals (67.1%) and peers / family through face-to-face personal contact (51.6%) in all countries. Conclusion Some differences were found in breastfeeding beliefs during the COVID-19 pandemic in Asian countries. A positive breastfeeding belief was associated with the practice of breastfeeding at the breast. Women from all countries received postpartum infant feeding support from health professionals and peers / family through personal contacts. Governments need to emphasize and disseminate the importance of breastfeeding safety, especially in Asian countries.
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Affiliation(s)
- K P Coca
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil
| | - E Y Lee
- Department of Nursing, Catholic Kkottongnae University, Cheongju-si, Republic of Korea
| | - L Y Chien
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Yang-Ming Campus, Taipei, Taiwan
| | - A C P Souza
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil
| | - P Kittikul
- Breastfeeding Clinic Nakhon Pathom Hospital, Nakhon Pathom, Thailand
| | - S A Hong
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand. .,Institute for Health and Society, Hanyang University, Seoul, Republic of Korea.
| | - Y S Chang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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Tigka M, Metallinou D, Pardali L, Lykeridou K. Shared decision-making about medication intake during lactation: A prospective longitudinal study in Greece. Eur J Midwifery 2022; 6:48. [PMID: 35974713 PMCID: PMC9340817 DOI: 10.18332/ejm/149830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/16/2022] [Accepted: 05/05/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The need for medication intake during lactation may affect women’s decision on breastfeeding initiation, duration or cessation. We investigated shared decision-making about medication intake (MI) during lactation by breastfeeding women. METHODS The study was conducted in five maternity hospitals in Greece (January–August 2020). A total of 283 mothers participated in the study. Data were obtained through a self-designed questionnaire. Mothers answered the questionnaire before discharge and were followed up by phone interviewing at one, three and six months postpartum. Information about breastfeeding status, reasons for cessation and MI during lactation were gathered. RESULTS In total, 30.7% of the mothers were receiving medication due to a pre-pregnancy chronic condition but only 23.7% maintained it during lactation; 48.4% of mothers stated that they would avoid MI during lactation as a personal attitude and 45.2% were satisfied with the information provided by healthcare professionals (HPs) concerning MI during lactation. But, 66.1% of the mothers indicated the necessity of further guidance. Mothers with higher education, Greek ethnicity and vaginal delivery participated significantly in the decision-making process concerning MI during lactation (p=0.001, p=0.001 and p=0.01, respectively). Mothers who shared decision-making, primarily consulted a pediatrician (p=0.02) and were more likely to maintain full and mixed breastfeeding for one month postpartum, rather than cease breastfeeding (p=0.005). Breastfeeding duration of all indicators was for a mean of 110 days (SD: 74.58). CONCLUSIONS Advancing HPs’ evidence-based knowledge, communication skills, confidence and competence in breastfeeding management will contribute favorably to breastfeeding indicators and maternal satisfaction regarding professional counseling.
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Affiliation(s)
- Maria Tigka
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
- Obstetric Emergency Department, General and Maternity Hospital ‘Helena Venizelou’, Athens, Greece
| | - Dimitra Metallinou
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
- Neonatal Department, ‘Alexandra’ General Hospital, Athens, Greece
| | - Lemonia Pardali
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Katerina Lykeridou
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
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