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Tan ML, Mohd Shukri IA, Ho JJ, O'Sullivan EJ, Omer‐Salim A, McAuliffe F. What makes a city 'breastfeeding-friendly'? A scoping review of indicators of a breastfeeding-friendly city. MATERNAL & CHILD NUTRITION 2024; 20:e13608. [PMID: 38100143 PMCID: PMC10981478 DOI: 10.1111/mcn.13608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/20/2023] [Accepted: 11/28/2023] [Indexed: 01/19/2024]
Abstract
A breastfeeding-friendly city is one where there is an enabling environment to support breastfeeding throughout the first 2 years or more of a child's life. Indicators of a breastfeeding-friendly city have yet to be identified. What are the indicators or criteria used to define breastfeeding friendliness in a geographic area such as a city and the settings within, which we have classified as community, healthcare and workplace? Three major databases and grey literature were searched. Records were screened to identify publications describing criteria such as indicators or descriptions of a breastfeeding-friendly setting, defined as 'criteria-sets'. These criteria-sets were then categorized and summarized by settings. The search up to 2 September 2021 found 119 criteria-sets from a range of settings: geographic locations (n = 33), community entities (n = 24), healthcare facilities (n = 28), workplaces (n = 28) and others (n = 6). Overall, 15 community, 22 healthcare and 9 workplace related criteria were extracted from the criteria-sets. Criteria that were consistently present in all settings were policy, training & education, skilled breastfeeding support and physical infrastructure. Some criteria-sets of geographic locations contained criteria only from a single setting (e.g., the presence of breastfeeding-friendly cafes). Criteria-sets were present for all settings as defined in this review, but few were actual indicators. Specifically, there were no existing indicators of a breastfeeding-friendly city. Several common components of the criteria-sets were identified, and these could be used in developing indicators of a breastfeeding-friendly city. Future studies should determine which of these are important and how each can be measured.
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Affiliation(s)
- May Loong Tan
- Department of PaediatricsRCSI & UCD Malaysia CampusPenangMalaysia
- UCD Perinatal Research Centre, School of Medicine, University College DublinNational Maternity HospitalDublinIreland
| | | | - Jacqueline J. Ho
- Department of PaediatricsRCSI & UCD Malaysia CampusPenangMalaysia
| | | | | | - Fionnuala M. McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College DublinNational Maternity HospitalDublinIreland
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Tran HT, Nguyen TT, Nguyen OTX, Barnett D, Weaver G, Mathisen R. Characteristics and factors influencing the volume of breastmilk donated by women to the first human milk bank in Vietnam. Front Glob Womens Health 2023; 4:1185097. [PMID: 37849562 PMCID: PMC10577291 DOI: 10.3389/fgwh.2023.1185097] [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: 03/13/2023] [Accepted: 09/18/2023] [Indexed: 10/19/2023] Open
Abstract
Background Donor human milk (DHM) is essential to the operation of human milk banks (HMB). This study examined characteristics and factors associated with higher volumes of DHM donation at the first HMB in Vietnam. Method Data from an online HMB monitoring system collected between February 2017 and July 2022 included demographic characteristics, child information, the timing of donation, and the volume of DHM. Higher volume is defined as equal to or greater than the median DHM volume per donor of 14.4 liters (L). Potential contributors to higher DHM volume were examined using the chi-square test in univariate and multivariable logistic regression analysis. Results During the 5.5-year operation, this HMB recruited 517 donors with an average age of 28.6 years. Approximately 60.9% of donors had a college or higher degree and 97.3% gave birth in Da Nang city. Of these donors, the prevalence of cesarean birth was 48.2%, preterm births was 40.2%, and 27.9% had babies with a birth weight of less than 1,500 g. There was a similar proportion of donors between the hospital (48.2%) and community (51.8%). On average, hospital donors started their donations 15 days after birth when their newborns were 33.9 weeks corrected age compared to 63 days and 47.7 weeks among community-based donors. The overall median volume of DHM per donor was 14.4 L over a period of 46 days. The amount and duration were higher in community-based donors (17.5 L in 72 days, 300 ml/day) than those in the hospital (8.4 L in 30 days, 258 ml/day). More than 37% of donors contacted the HMB themselves; the remainder were introduced by health professionals. Factors associated with higher volumes of DHM included higher education (OR: 1.77; 95% CI: 1.09, 2.87), having a full-term newborn (OR: 2.46; 95% CI: 1.46, 4.13), and community-based donors (OR: 2.15; 95% CI: 1.22, 3.78). Conclusions Mothers with higher education and from the community donate more breastmilk over a longer duration than those with lower education and from the hospital. Breastfeeding protection, promotion, and support should be offered to all mothers with specialized breastfeeding support for mothers of preterm and sick infants. This will ensure mothers have sufficient breastmilk for their newborns and potentially surplus breastmilk for donation.
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Affiliation(s)
- Hoang Thi Tran
- Neonatal Unit and Human Milk Bank, Da Nang Hospital for Women and Children, Da Nang, Vietnam
- Department of Pediatrics, School of Medicine and Pharmacy, Da Nang University, Da Nang, Vietnam
| | | | - Oanh Thi Xuan Nguyen
- Neonatal Unit and Human Milk Bank, Da Nang Hospital for Women and Children, Da Nang, Vietnam
| | - Debbie Barnett
- Milk Bank Scotland, Queen Elizabeth University Hospital, Glasgow, United Kingdom
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Wang S, Li M, Xiang X, Guo X, Peng C, Wang D, Chen Y. Analysis on the current situation of twin breastfeeding and its influencing factors. Medicine (Baltimore) 2023; 102:e35161. [PMID: 37746974 PMCID: PMC10519451 DOI: 10.1097/md.0000000000035161] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Studies have found that exclusive breastfeeding can not only promote the growth and development of infants, but also increase the emotional communication between mothers and infants, and reduce the incidence of maternal breast diseases. To analysis the current situation and influencing factors of breastfeeding twins. A total of 420 twin mothers delivered in our hospital from January 2019 to December 2022 were selected to investigate the situation of breastfeeding within 6 months after delivery. An electronic questionnaire was conducted, and clinical information were collected. Univariate analysis and multivariate logistic regression analysis were applied to analyze the factors influencing exclusive breastfeeding. The rate of exclusive breastfeeding was 21.90%; in the exclusive breastfeeding group, the age <35 years old, bachelor degree or above, rural areas, no nipple depression or flat, no breast distension, no postpartum depression, adequate breast milk, participation in health education during pregnancy, husband support for breastfeeding, no infant feeding difficulties, infant diarrhea, lactose intolerance and return to milk were 96.74%, 53.26%, 65.22%, 80.43%, 76.09%, 80.43%, 73.91%, 63.04%, 69.57%, 71.74%, 65.22%, 70.65%, and 66.30%, respectively. It was significantly higher than that in the non-exclusive breastfeeding group (P < .05). The score of Edinburgh Postpartum Depression Scale (EPDS) was (8.08 ± 1.03) in the exclusive breastfeeding group, which was significantly lower than that in the non-exclusive breastfeeding group (P < .001), while the score of Perceived Social Support Scale (PSSS) was (67.32 ± 9.92), which was significantly higher than that in the non-exclusive breastfeeding one(P < .001). Logistic regression analysis showed that age, education level, nipple depression or flat, breast tenderness, postpartum depression, breast milk volume, health education training during pregnancy, husband support for breastfeeding, PSSS score, infant diarrhea, lactose intolerance, and delectation were the influencing factors of exclusive breastfeeding (P < .001). Our findings suggest that various factors were associated with a low rate of exclusive breastfeeding in twin births, such as age, educational level, and social support. Corresponding measures should be formulated for intervention to promote exclusive breastfeeding.
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Affiliation(s)
- Shoucui Wang
- Chongqing Health Center for Women and Children/Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Mei Li
- Chongqing Health Center for Women and Children/Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Xue Xiang
- Chongqing Health Center for Women and Children/Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Xujin Guo
- Chongqing Health Center for Women and Children/Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Chaoli Peng
- Chongqing Health Center for Women and Children/Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Daping Wang
- Chongqing Health Center for Women and Children/Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Ya Chen
- Chongqing Health Center for Women and Children/Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
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Vu DH, Ta BTT, Aasen IL, Le DQT, Mathisen R, Becker GE, Phan HT, Bui CM, Nguyen TTK, Hoang STT, Cashin J. Promoting Respectful Maternity Care by Reducing Unnecessary Episiotomies: Experiences from Centers of Excellence for Breastfeeding in Vietnam. Healthcare (Basel) 2023; 11:2520. [PMID: 37761718 PMCID: PMC10530948 DOI: 10.3390/healthcare11182520] [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] [Received: 05/19/2023] [Revised: 08/31/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: Routine episiotomy is not recommended by international guidelines; however, it occurs at a high rate in Vietnam. (2) Methods: A process to reduce unnecessary episiotomies was developed and implemented as part of the Centers of Excellence for Breastfeeding initiative, which aims to deliver high-quality breastfeeding and early essential newborn care services within a supportive policy environment. The aim of this project report is to outline the steps undertaken to reduce episiotomies, the experience in pilot hospitals, and the process towards changing policy. (3) Results: During the 14 months following the change in episiotomy policy, pilot hospital records showed no infant death or injury. Monthly monitoring data from four pilot hospitals showed that the prevalence of episiotomy was substantially lower than the average in national hospitals in Vietnam. Facilitators to reducing the episiotomy rate include the incentive of Centers of Excellence for Breastfeeding designation and supportive hospital leadership. Challenges include the ambiguity of Vietnam's national guideline on episiotomy and lack of routine monitoring on the episiotomy rate and indications. (4) Discussion: Our experience suggests that through training and routine monitoring hospitals can apply a policy of selective episiotomy and reduce the practice, particularly among multiparous women, and improve breastfeeding rates.(5) Conclusions: Sharing our experience of implementing this process and offering four areas for action will hopefully contribute to expanded use of mother-friendly, evidence-based care as policy and routine practice in Vietnam and similar settings.
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Affiliation(s)
- Duong Hoang Vu
- Alive & Thrive East Asia Pacific, FHI Solutions, Hanoi 11022, Vietnam (R.M.)
| | - Binh T. T. Ta
- Alive & Thrive East Asia Pacific, FHI Solutions, Hanoi 11022, Vietnam (R.M.)
| | - Ina Landau Aasen
- Norwegian Institute of Public Health (NIPH), N-0473 Oslo, Norway
| | - Dai Q. T. Le
- Alive & Thrive East Asia Pacific, FHI Solutions, Hanoi 11022, Vietnam (R.M.)
| | - Roger Mathisen
- Alive & Thrive East Asia Pacific, FHI Solutions, Hanoi 11022, Vietnam (R.M.)
| | | | - Hang Thi Phan
- Hung Vuong Hospital, Ho Chi Minh City 72700, Vietnam
| | - Cuong Minh Bui
- Quang Ninh Obstetrics and Pediatrics Hospital, Ha Long City 01100, Vietnam
| | | | | | - Jennifer Cashin
- Alive & Thrive East Asia Pacific, FHI Solutions, Washington, DC 20037, USA
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Nguyen TT, Cashin J, Tran HT, Hoang TA, Mathisen R, Weissman A, Murray JCS. Birth and newborn care policies and practices limit breastfeeding at maternity facilities in Vietnam. Front Nutr 2022; 9:1041065. [PMID: 36407547 PMCID: PMC9668009 DOI: 10.3389/fnut.2022.1041065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 10/10/2022] [Indexed: 09/29/2023] Open
Abstract
The prevalence of early and exclusive breastfeeding in Vietnam remains sub-optimal. The objective of this study was to determine factors associated with early initiation of breastfeeding (EIBF) and exclusive breastfeeding for the first 3 days after birth (EBF3D). We conducted a population-based, cross-sectional survey of 726 mothers with children aged 0-11 months in two provinces and one municipality from May to July 2020. Multinomial logistic regression was used to examine factors associated with EIBF and EBF3D. The prevalence of EIBF was 39.7% and EBF3D 18.0%. The EIBF prevalence is positively associated with immediate and uninterrupted skin-to-skin contact (SSC) for 10-29 min (aOR: 2.55; 95% CI: 1.49, 4.37), 30-59 min (aOR: 4.15; 95% CI: 2.08, 8.27), 60-80 min (aOR: 4.35; 95% CI: 1.50, 12.6), or ≥90 min (aOR: 5.87; 95% CI: 3.14, 10.98). EIBF was negatively associated with cesarean birth (aOR: 0.24; 95% CI: 0.11, 0.51), bringing infant formula to the birth facility (aOR: 0.49; 95% CI: 0.30, 0.78), purchased it after arrival (aOR: 0.37; 95% CI: 0.24, 0.60), or did both (aOR: 0.43; 95% CI: 0.21, 0.89). EBF3D was negatively associated with cesarean section birth (aOR: 0.15; 95% CI: 0.06, 0.39), vaginal birth with episiotomy (aOR: 0.40; 95% CI: 0.18, 0.88), bringing formula to the maternity facility (aOR: 0.03; 95% CI: 0.01, 0.07), purchased it after arrival (aOR: 0.02; 95% CI: 0.01, 0.06) or did both (aOR: 0.04; 95% CI: 0.02, 0.10). Receiving counseling from any source was not significantly associated with early breastfeeding practices. Policy and health service delivery interventions should be directed at eliminating infant formula from birthing environments, reducing unnecessary cesarean sections and episiotomies, providing immediate and uninterrupted SSC for all births, and improving breastfeeding counseling and support.
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Affiliation(s)
- Tuan T. Nguyen
- Alive & Thrive East Asia Pacific, FHI 360, Hanoi, Vietnam
| | - Jennifer Cashin
- Alive & Thrive East Asia Pacific, FHI 360, Washington, DC, United States
| | - Hoang T. Tran
- Neonatal Unit and Human Milk Bank, Department of Pediatrics, School of Medicine and Pharmacy, Da Nang Hospital for Women and Children, The University of Da Nang, Da Nang, Vietnam
| | - Tuan A. Hoang
- Department of Maternal and Child Health, Vietnam Ministry of Health, Hanoi, Vietnam
| | - Roger Mathisen
- Alive & Thrive East Asia Pacific, FHI 360, Hanoi, Vietnam
| | - Amy Weissman
- Alive & Thrive East Asia Pacific, FHI 360, Hanoi, Vietnam
- Asia Pacific Regional Office, FHI 360, Bangkok, Thailand
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Duong DTT, Binns C, Lee A, Zhao Y, Pham NM, Hoa DTP, Ha BTT. Intention to Exclusively Breastfeed Is Associated with Lower Rates of Cesarean Section for Nonmedical Reasons in a Cohort of Mothers in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020884. [PMID: 35055705 PMCID: PMC8776101 DOI: 10.3390/ijerph19020884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/05/2022] [Accepted: 01/10/2022] [Indexed: 12/01/2022]
Abstract
Background: Breastfeeding brings benefits to both mothers and children in the short term and long term. Unnecessary cesarean sections can bring risks to both parties. This study was undertaken to examine the relationship between exclusive breastfeeding intention and cesarean delivery. Methods: We analyzed data collected from 554 single mothers who delivered in Dong Anh General District Hospital or Hanoi Obstetrics and Gynecology Hospital, Vietnam, in 2020–2021. The relationship between exclusive breastfeeding intention and cesarean delivery for nonmedical reasons was adjusted for maternal education, maternal age, parity, history of fetal loss, having at least eight antenatal contacts, hospital of delivery, child sex, and birth weight. Results: Antenatally, 34.8% (184/529) of mothers intended to breastfeed exclusively until 6 months and 30.8% (84/274) underwent cesarean section for a nonmedical reason. After adjusting for other factors, mothers who intended to breastfeed exclusively until 6 months were less likely to undergo cesarean delivery for nonmedical reasons (OR = 0.55, 95% CI: 0.31–0.96, p = 0.034). Conclusions: This study adds to the growing evidence related to unnecessary cesarean sections and routine over-medicalization of normal birth in the urban areas of Vietnam. The association between breastfeeding intentions and a lower rate of cesarean section suggests that education on breastfeeding could be a useful intervention for reducing the rate of cesarean sections and improving maternal and child health.
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Affiliation(s)
- Doan Thi Thuy Duong
- Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, 1A Duc Thang Street, Bac Tu Liem District, Hanoi 10000, Vietnam; (D.T.T.D.); (B.T.T.H.)
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (A.L.); (Y.Z.); (N.M.P.)
| | - Colin Binns
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (A.L.); (Y.Z.); (N.M.P.)
- Correspondence: (C.B.); (D.T.P.H.)
| | - Andy Lee
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (A.L.); (Y.Z.); (N.M.P.)
| | - Yun Zhao
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (A.L.); (Y.Z.); (N.M.P.)
| | - Ngoc Minh Pham
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (A.L.); (Y.Z.); (N.M.P.)
- Department of Epidemiology, Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 250000, Vietnam
| | - Dinh Thi Phuong Hoa
- Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, 1A Duc Thang Street, Bac Tu Liem District, Hanoi 10000, Vietnam; (D.T.T.D.); (B.T.T.H.)
- Correspondence: (C.B.); (D.T.P.H.)
| | - Bui Thi Thu Ha
- Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, 1A Duc Thang Street, Bac Tu Liem District, Hanoi 10000, Vietnam; (D.T.T.D.); (B.T.T.H.)
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