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Ouyang YQ, Guo J, Zhou J, Zhouchen Y, Huang C, Huang Y, Wang R, Redding SR. Theoretical approaches in the development of interventions to promote breastfeeding: A scoping review. Midwifery 2024; 132:103988. [PMID: 38583270 DOI: 10.1016/j.midw.2024.103988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 03/19/2024] [Accepted: 04/02/2024] [Indexed: 04/09/2024]
Abstract
PROBLEM AND BACKGROUND There is a low world rate of exclusive breastfeeding and a short duration of breastfeeding. More studies have constructed interventions to improve breastfeeding behavior, but the actual effect is not significant. AIM The purpose of this review is identifying the ways that various theories have an influence on theory-based breastfeeding intervention studies. METHODS A scoping review using Arksey and O'Malley's framework explored breastfeeding promotion practices. PubMed, The Cochrane Library, Web of Science, Embase, and CINAHL databases were searched from database creation to March 9, 2024. Building on previous research, key terms were used to search the literature. Data analysis involved descriptive and interpretive summaries of theories used and the proposed interventions. FINDINGS An online search yielded 906 articles, with 28 meeting the inclusion criteria for the scoping review, including 5 reviews and 23 articles. Reviews demonstrated that interventions based on theories were more effective. Articles promoting breastfeeding used theories of self-efficacy (n = 9), theory of planned behavior (n = 8), social cognitive theory (n = 5) and individual and family self-management theory (n = 1). These theories were used in developing specific content of the intervention program (n = 20, 86.9%), constructing the framework of the program (n = 10, 43.5%), and evaluating outcomes (n = 19, 82.6%). Most interventions focused on education, professional support, and/or peer support for breastfeeding. CONCLUSION AND DISCUSSION Theory can guide decisions and play a role in selecting a methodology or lens. Researchers should make deliberate choices in the use of a theory that relates to aspects of breastfeeding behavior. Future interventions based on theories should be more varied and effective and need to consider families' and social factors.
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Affiliation(s)
| | - Jinyi Guo
- School of Nursing, Wuhan University, Wuhan, China.
| | - Jie Zhou
- School of Nursing, Wuhan University, Wuhan, China.
| | | | - Canran Huang
- School of Nursing, Wuhan University, Wuhan, China
| | - Yiyan Huang
- School of Nursing, Wuhan University, Wuhan, China
| | - Rong Wang
- Renmin Hospital of Wuhan University, Wuhan, China
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Huber R, Menon M, Russell RB, Smith S, Scott S, Berns SD. Community infant safe sleep and breastfeeding promotion and population level-outcomes: A mixed methods study. Midwifery 2024; 132:103953. [PMID: 38430791 DOI: 10.1016/j.midw.2024.103953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 11/14/2023] [Accepted: 02/10/2024] [Indexed: 03/05/2024]
Abstract
PROBLEM In the U.S., sudden unexpected infant deaths due to accidental suffocation and strangulation in bed are increasing. Though breastfeeding is a protective factor against sudden unexpected infant death, motivations to breastfeed often couple with unsafe infant sleep practices. Racial/ethnic disparities are present in sudden unexpected infant death, accidental suffocation and strangulation in bed, and breastfeeding. BACKGROUND Promoting infant safe sleep and breastfeeding through community-level initiatives could address disparities in related outcomes. AIM Investigate the relationship between community-level strategies and associated state-level outcomes for infant safe sleep and breastfeeding. METHODS We employed an intervention mixed methods framework and exploratory sequential design. The qualitative component entailed a hermeneutical phenomenological framework to analyze key informant interview data from seven U.S. community-level providers participating in a practice improvement initiative. The quantitative component entailed descriptively analyzing infant safe sleep and breastfeeding indicators from the 2019 Pregnancy Risk Assessment Monitoring System and Ohio Pregnancy Assessment Survey. Qualitative and quantitative data were linked through embedded integration. FINDINGS We identified two mixed insights: gaps in promotion and outcomes, and persistent disparities between infant safe sleep and breastfeeding promotion and outcomes. DISCUSSION Our findings indicate conversational approaches could improve infant safe sleep and breastfeeding promotion, outcomes, and relative disparities. We find that community collaboration is needed to address organizational capacity limitations in promoting infant safe sleep and breastfeeding. CONCLUSION Community-level organizations and providers should consider tailoring program offerings and care delivery to include conversational approaches and community collaboration to promote infant safe sleep and breastfeeding and decrease relative disparities in outcomes.
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Affiliation(s)
- Rebecca Huber
- The National Institute for Children's Health Quality (NICHQ), 308 Congress Street, 5th Floor, Boston, MA 02210, USA.
| | - Meera Menon
- The National Institute for Children's Health Quality (NICHQ), 308 Congress Street, 5th Floor, Boston, MA 02210, USA
| | - Rebecca B Russell
- The National Institute for Children's Health Quality (NICHQ), 308 Congress Street, 5th Floor, Boston, MA 02210, USA
| | - Sharla Smith
- Preventive Medicine and Public Health Department, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA; Kansas Birth Equity Network, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
| | - Stacy Scott
- The National Institute for Children's Health Quality (NICHQ), 308 Congress Street, 5th Floor, Boston, MA 02210, USA
| | - Scott D Berns
- The National Institute for Children's Health Quality (NICHQ), 308 Congress Street, 5th Floor, Boston, MA 02210, USA; Department of Pediatrics, Warren Alpert Medical School of Brown University, 222 Richmond St, Providence, RI 02903, USA; Department of Health Services, Policy and Practice, Brown University School of Public Health, 121 S Main St, Providence, RI 02903, USA
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Gomez JA, Abela K, LoBiondo-Wood G. A Systemic Review of the Difference Between Diets for Preterm Infants Containing Raw Mother's Own Milk and Frozen or Pasteurized Mother's Own Milk. J Hum Lact 2024; 40:259-269. [PMID: 38328919 DOI: 10.1177/08903344241227941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
BACKGROUND Raw, never stored or pasteurized mother's own milk (MOM) is not always available to feed preterm infants; however, storage and pasteurization of MOM diminishes some bioactive components. It can be difficult to feed raw MOM to preterm infants due to transportation and storage of small volumes that might be pumped away from the infant, and a concern that they might harbor bacteria. However, the higher availability of bioactive components in raw MOM may provide benefits to preterm infants compared to frozen or pasteurized MOM. RESEARCH AIM To systematically review and summarize the results of studies on feeding raw MOM versus frozen or pasteurized MOM to preterm infants born at less than 37 weeks of gestation. METHODS Four databases were searched (Cochrane, Embase, Ovid MEDLINE, and Web of Science) for this systematic review. Of 542 studies identified, nine met inclusion criteria and were critically evaluated using the quality assessment tool for quantitative studies by the Effective Public Health Practice Project. Studies were organized using the Breastfeeding Challenges Facing Preterm Mother-Infant Dyads theoretical framework. RESULTS Included studies evaluated the outcomes of preterm infants fed raw versus pasteurized MOM (n = 7, 77.8%) or raw versus frozen MOM (n = 2, 22.2%). Researchers found that raw MOM did not increase infant infections and may have improved health and growth outcomes for study participants. CONCLUSION There is laboratory evidence supporting the safety and efficacy of the use of raw MOM for preterm infants. A raw MOM diet is recommended for preterm infants by professional organizations. Despite this, it may not be universally prioritized and could require purposeful implementation by each institution. Further research is needed to pursue the potential benefits of a raw MOM diet for preterm infants.
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Affiliation(s)
- Jessica Ann Gomez
- Department of Pediatrics/Neonatal-Perinatal Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Karla Abela
- Department of Research, The University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, TX, USA
| | - Geri LoBiondo-Wood
- Bette P. Thomas Distinguished Professor for Innovative Healthcare Delivery, Director, Ph.D. Program, The University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, TX, USA
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Qin M, Chang G, Zhou X, Wang L, Liang Y, Xu Y, Liu S, Cai S, Dai M. Fathers' needs of breastfeeding support: Perspective of health nurses. Midwifery 2024; 132:103959. [PMID: 38471334 DOI: 10.1016/j.midw.2024.103959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 01/09/2024] [Accepted: 02/25/2024] [Indexed: 03/14/2024]
Abstract
PURPOSE To explore the improvement of health education on father's participation in breastfeeding from the perspective of maternal and child health nurses. METHODS Qualitative phenomenological research was used, and 15 maternal and child health nurses who provided breastfeeding support were invited. With semi-structured deep interviews and on-site recordings, data were analyzed through content analysis. RESULTS Four main themes were extracted, including 'cultivating fathers' awareness of participation in breastfeeding', 'collaboration of multiple disciplines to improve health education on breastfeeding for fathers in hospital', 'Simulated scenarios to develop fathers' skills in solving breastfeeding problems', and 'establishing a hospital-community interface network to improve breastfeeding continuation care after hospital discharge'. CONCLUSIONS Medical and health care departments should attach importance to guidance on health education for fathers' breastfeeding participation, cultivate fathers' awareness of participation in breastfeeding, provide multi-disciplinary collaboration-based health education on breastfeeding for fathers from the prenatal period and improve post-discharge health education on breastfeeding. The additional education being suggested would contribute to fathers being able to play an important role in breastfeeding.
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Affiliation(s)
- Meijiao Qin
- The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, China; School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Guangting Chang
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Xiaoyu Zhou
- The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, China
| | - Lixia Wang
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yuzhen Liang
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yiyi Xu
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Siqi Liu
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Shu Cai
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China.
| | - Meifen Dai
- The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, China.
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Spatz DL. Human Milk and Medications: Nurses' Responsibility. MCN Am J Matern Child Nurs 2024; 49:174. [PMID: 38679829 DOI: 10.1097/nmc.0000000000001008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Affiliation(s)
- Diane L Spatz
- Diane L. Spatz is Professor of Perinatal Nursing & the Helen M. Shearer Professor of Nutrition, Family and Community Department, University of Pennsylvania School of Nursing, Nurse Scientist-Lactation, The Center for Pediatric Nursing Research and Evidence Based Practice, Children's Hospital of Philadelphia and an MCN Editorial Board Member. Dr. Spatz can be reached at
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Arcusio A, Villa MC, Felloni F, Migliori C. The myofascial release as neuromotor support to improve the ineffective sucking ability in term infants: a preliminary study. Ital J Pediatr 2024; 50:61. [PMID: 38580981 PMCID: PMC10998315 DOI: 10.1186/s13052-024-01611-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 02/24/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Breastfeeding plays a primary role in the events that characterize the development of the relationship between a mother and her newborn. However, this essential process sometimes does not fully cover the nutritional requirements of the newborn due to altered biomechanical sucking skills. In this context, adequate osteopathic treatment associated with neuromotor facilitation techniques could play a promoting role. METHODS This study evaluated the effect of the osteopathic approach using myofascial release on 26 infants with ineffective sucking ability, identified by the POFRAS scale and LATCH score, compared with 26 untreated similar infants. After the procedure was initially performed in the hospital, the strategy based on basic neuromotor patterns was taught to the parents to be continued at home. The effects were measured at hospital discharge, during the first outpatient visit, which occurred after about seven days, and at one month of life. RESULTS The number of valid and continuous suctions, initially less than five per feed in both groups, at the first outpatient check-up was significantly higher (p < 0.00001) in the treated group. Exclusive breastfeeding, initially present in all enrolled children, was maintained mainly in treated children, both at discharge (p < 0.003), at outpatient follow-up (p < 0.00001), and at one month of life (p < 0.00001). Differences in growth and health conditions were not found between the groups. CONCLUSION We believe that osteopathic treatment associated with neuromotor facilitation techniques can optimize newborns' sucking skills, improving the acquisition and duration of breastfeeding.
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Affiliation(s)
- Andrea Arcusio
- Department of Rehabilitation Medicine, Ospedale San Giuseppe MultiMedica, Milan, Italy.
| | | | - Federica Felloni
- Department of Neonatology, Ospedale San Giuseppe MultiMedica, Milan, Italy
| | - Claudio Migliori
- Department of Neonatology, Ospedale San Giuseppe MultiMedica, Milan, Italy
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Srichalerm T, Jacelon CS, Sibeko L, Granger J, Briere CE. Thai novice nurses' lived experiences and perspectives of breastfeeding and human milk in the Neonatal Intensive Care Unit (NICU). Int Breastfeed J 2024; 19:20. [PMID: 38509594 PMCID: PMC10956329 DOI: 10.1186/s13006-024-00620-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 02/03/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Breastfeeding and human milk have well-documented health benefits for newborn infants, particularly those who are sick. However, breastfeeding rates and human milk feeding among infants in neonatal intensive units (NICU) in Thailand are still low; thus, breastfeeding promotion and support are required for Thai mothers of premature infants. Newly graduated nurses can play a critical role within the healthcare support system and can have a significant impact on improving breastfeeding practices in the NICU. The objective of this study was to investigate the lived experiences and perspectives of Thai novice nurses on supporting breastfeeding and human milk feeding in the NICU. METHODS The study was conducted between March 2021 and May 2022 at three medical centers in the central region of Thailand. This study employed a descriptive phenomenological approach to explore Thai novice nurses' experiences and perspectives on breastfeeding. Purposive sampling was used to invite Thai novice nurses who have work experience in providing breastfeeding support to NICU mothers and their infants to participate in online interviews using a video conference platform (Zoom). Semi-structured questions were used to interview study participants in their native language. Data were analyzed using Colaizzi's method of data analysis to identify emergent themes. Member checks, peer debriefing, and self-reflection were applied to ensure the validity and trustworthiness of the study results. Back-translation was also used as a quality and accuracy assurance. RESULTS A total of thirteen novice nurses agreed to participate in the study. All were female, and their ages ranged from 21 to 24 years old at the time of the interview. The researchers identified five major themes related to the overall study objectives and research questions. They are: positive attitude toward breastfeeding and human milk, facing breastfeeding challenges at work, self-confidence rooted in experience, professional skill needs, and requiring further support. CONCLUSIONS Our results suggest that breastfeeding education plays a vital role in encouraging new nurses to provide breastfeeding support to mothers of preterm infants. Establishing breastfeeding support training and innovative learning strategies can be crucial in developing appropriate breastfeeding practice guidelines and policies to support Thai breastfeeding mothers in the NICU.
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Affiliation(s)
- Tippawan Srichalerm
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Cynthia S Jacelon
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, MA, USA
| | - Lindiwe Sibeko
- School of Public Health & Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Jumpee Granger
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Carrie-Ellen Briere
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, MA, USA.
- Institute for Nursing Research and Evidence-Based Practice, Connecticut Children's, Hartford, CT, USA.
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Mendoza-Gordillo MJ. A qualitative analysis of the breastfeeding experiences of mothers who are nurses and nutritionists. J Commun Healthc 2024; 17:84-91. [PMID: 36927478 DOI: 10.1080/17538068.2023.2189366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
BACKGROUND From a medical standpoint, breastmilk is the optimal option for feeding a baby, relegating the cultural, social, and material determinants to breastfeeding. Worldwide, breastfeeding rates are low, especially among working mothers. Healthcare providers have low breastfeeding rates due to several barriers to lactation, i.e. work schedule andlack of private places for pumping. METHOD A descriptive qualitative methodology was applied to examine the breastfeeding experiences of Ecuadorian mothers who are healthcare professionals. Twenty healthcare professionals who breastfed their babies took part in the research. Data gathering employed synchronous semi-structured interviews in Spanish. The data analysis followed the Phronetic Iterative Approach. RESULTS Women shifted the preconceived idea of the ideal breastfeeding scenario concerning duration, promotion, and support, ideals which are constructed in their training as healthcare professionals. Although these women believe that breast milk and breastfeeding is the best way to feed a baby, the internalized ideal of breastfeeding shifted with the experience of motherhood. Although they had that clash between the ideal and the external reality, they continued breastfeeding their babies, and those experiences resulted in them improving their professional practice. CONCLUSIONS This study demonstrated that breastfeeding for this group of women appears to be a unique relational and identity negotiation process. The findings emphasize that experiencing breastfeeding for this group of healthcare providers positively shifted how they communicate breastfeeding with their patients in the clinical encounter. Ensuring that healthcare professionals acquire a different approach for educating and communicating about lactation is an essential determinant in efforts to improve breastfeeding rates in Ecuador.
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Affiliation(s)
- Maria J Mendoza-Gordillo
- Center for Research on Health in Latin America, School of Nursing, Pontifical Catholic University of Ecuador, Quito, Ecuador
- Graduate College, Ohio University, Athens, OH, USA
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Ak B, Akkoyun S, Tas Arslan F. Effect of Nurse Support in the Immediate Postpartum Period on Mothers' Breastfeeding Self-Efficacy Levels in Turkey: A Quasi-Experimental Study. Matern Child Health J 2024; 28:481-488. [PMID: 37847450 DOI: 10.1007/s10995-023-03790-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES This study aimed to determine the effect of nurse-based breastfeeding support during the immediate postpartum period on mothers' breastfeeding self-efficacy levels. METHODS A quasi-experimental study was conducted with 256 mothers in the immediate postpartum period (128 in the intervention group who received nurse-based breastfeeding support and routine care and 128 in the control group who received routine care) during February-June 2018. Data were collected using the Mother-Infant Data Sheet, the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), and the Nurse-Parent Support Tool (NPST). RESULTS BSES-SF and NPST mean scores of mothers in the intervention group were higher than those of mothers in the control group (p < 0.01). While the association between breastfeeding self-efficacy and nurse support was low in the control group (0.271), it was rather high in the intervention group (0.693) (p < 0.05). It was found that nurse support explained 48% of the variance in breastfeeding self-efficacy in the intervention group, but only 7.3% of the variance in breastfeeding self-efficacy in the control group. CONCLUSIONS FOR PRACTICE The results of the study indicate that nurse support for mothers in the immediate postpartum period based on breastfeeding training has a positive impact on breastfeeding self-efficacy.
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Affiliation(s)
- Bedriye Ak
- Nursing Department, Faculty of Health Science, Izzet Baysal University, Bolu, Turkey
| | - Sevinc Akkoyun
- Vocational School of Health Services, Selcuk University, Konya, Turkey
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Larobina C, Muller A, Templeton I, Sweet L. Community Practices, Published Guidelines, and Evidence Base Surrounding Breast Milk Handling and Storage: A Qualitative Study. Breastfeed Med 2024; 19:187-196. [PMID: 38386986 DOI: 10.1089/bfm.2023.0273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Background: Expressed breast milk (EBM) is the best alternative to direct breastfeeding. However, expressing breast milk requires good milk handling and storage practices to preserve EBM safety and integrity. Mothers require handling and storage guidance, and many seek this from the internet and online support groups. Aim: This study aimed at exploring EBM handling and storage practices within an online exclusively expressing community and comparing these with both internet resources and evidence-based research. Methods: A naturalistic observational design was used. Content analysis was undertaken on 10,000 posts from an Australian Facebook peer-support community for women who exclusively express breast milk. Women's questions, reported practices, and advice for EBM handling and storage were analyzed thematically and compared with both guidelines and evidence-based research. Findings: There were 460 posts on EBM handling and storage. Three key themes emerged: "How should I store my EBM?," "How long can I store my EBM?," and "How do I use my EBM?" The greatest consistency and agreement between recommendations and community practices were found for storage methods, whereas the least was found for storage times. EBM handling and storage practices were influenced by factors such as EBM value, convenience, and cost, leading to occasional deviations from consistent practice recommendations. Conclusion: To facilitate safe EBM handling and continuation of expression, guidelines should be updated so they are consistent, align with current evidence, and cater to mothers' cost, convenience, and milk wastage concerns. Health care providers can partner with women to evaluate online information to empower mothers in their decision making.
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Affiliation(s)
- Cassandra Larobina
- Flinders University College of Medicine and Public Health, Adelaide, Australia
| | - Amanda Muller
- Flinders University College of Nursing and Health Sciences, Bedford Park, Australia
| | - Isobel Templeton
- Flinders University College of Medicine and Public Health, Adelaide, Australia
| | - Linda Sweet
- School of Nursing and Midwifery, Deakin University, Burwood, Australia
- Centre for Quality and Patient Safety Research, Western Health Partnership, Victoria, Australia
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Adetunji O, Pemmireddy P, Beleche T, Parasrampuria S. Premarket Notifications and Patents for Breast Pumps Before and After the ACA. JAMA 2024; 331:615-616. [PMID: 38252450 PMCID: PMC10804279 DOI: 10.1001/jama.2023.26528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/05/2023] [Indexed: 01/23/2024]
Abstract
This study investigates whether ACA policies to increase access to breast pumps and lactation care were associated with innovation in the market for breast pumps.
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Affiliation(s)
- Oluwarantimi Adetunji
- Office of the Assistant Secretary of Planning and Evaluation, Department of Health and Human Services, Washington, DC
| | | | - Trinidad Beleche
- Office of the Assistant Secretary of Planning and Evaluation, Department of Health and Human Services, Washington, DC
| | - Sonal Parasrampuria
- Office of the Assistant Secretary of Planning and Evaluation, Department of Health and Human Services, Washington, DC
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McGuigan M, Larkin P. Laid-back breastfeeding: knowledge, attitudes and practices of midwives and student midwives in Ireland. Int Breastfeed J 2024; 19:13. [PMID: 38373983 PMCID: PMC10877745 DOI: 10.1186/s13006-024-00619-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 02/03/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Despite concerted efforts by policy developers, health professionals and lay groups, breastfeeding rates in Ireland remain one of the lowest in world, with 63.6% of mothers initiating breastfeeding at birth, dropping to 37.6% of mothers breastfeeding exclusively on hospital discharge. Nipple trauma and difficulties with baby latching are major contributors to the introduction of formula and discontinuation of breastfeeding. Research shows laid-back breastfeeding (LBBF) significantly reduces breast problems such as sore and cracked nipples, engorgement, and mastitis as well as facilitating a better latch. Although the benefits of LBBF are well documented, this position does not seem to be routinely suggested to mothers as an option when establishing breastfeeding. This study aims to determine midwives' and student midwives' knowledge, attitudes, and practices of using laid-back breastfeeding in Ireland. METHOD A cross-sectional descriptive survey distributed to midwives and student midwives in three maternity hospitals in Ireland and two online midwifery groups based in the Republic of Ireland, during June, July, and August 2021. RESULTS Two hundred and fifty-three valid responses were received from nine maternity units. Most participants (81.4%) were aware of laid-back breastfeeding. However, only 6.8% of respondents cited it as the position they most frequently use. Over one-third (38.34%) had never used this position with mothers. Those more likely to suggest LBBF had personal experience of it, were lactation consultants or working towards qualification, or had participated in specific education about LBBF. Barriers included lack of education, confidence, time, and experience. Further issues related to work culture, a tendency to continue using more familiar positions and concerns about mothers' anatomy and mothers' unfamiliarity with LBBF. CONCLUSION Although there was a high level of awareness of laid-back breastfeeding among midwives and student midwives, there are challenges preventing its use in practice. Education specifically related to using LBBF in practice is required to overcome the barriers identified. A greater understanding of mothers' and babies' intrinsic feeding capacities may give midwives more confidence to recommend this method as a first choice, potentially leading to more successful breastfeeding establishment and maintenance.
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Affiliation(s)
- Margaret McGuigan
- Staff Midwife, Our Lady of Lourdes Hospital, Co. Louth, Drogheda, Ireland.
| | - Patricia Larkin
- The School of Health and Science, Dundalk Institute of Technology, Co. Louth, Ireland
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Mohammadzadeh Z, Sharifi L, Fatholahpour A, Bazshahi E. The investigation of serum phenylalanine levels based on infant feeding method: a cross-sectional study of children less than two years old with phenylketonuria (PKU). Int Breastfeed J 2024; 19:12. [PMID: 38351011 PMCID: PMC10865657 DOI: 10.1186/s13006-024-00617-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/28/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Clinical advice may suggest discontinuing breastfeeding after the diagnosis of phenylketonuria in infants as the only effective way to monitor the newborn's intake and accurate measurement of phenylalanine (Phe). This study aims to investigate the prevalence and duration of breastfeeding, as well as its effect on serum Phe levels in infants with phenylketonuria at Education and Therapy Medical Center, Be'sat Hospital, Iran. METHODS We conducted a cross-sectional study of 34 children under two years old diagnosed with phenylketonuria between September 2018 and December 2022. Infants were categorized as breastfed and non-breastfed (bottle-fed) based on their feeding method after diagnosis. Data on age at diagnosis, medical records, demographic information, and anthropometric indices were collected, and infants with incomplete data or mixed feeding (formula + breast milk) were excluded from the study. RESULTS Of 94 infants managed in our hospital, 34 had complete medical records. Among the all patients 13 (38%) continued to be breastfed combined with phenylalanine-free amino acid-based protein substitute, while 21 (62%) were did not receive breast milk. The mean duration of breastfeeding was 2.57 ± 0.59 (1-3) months. The mean age at diagnosis was 22.6 ± 18.4 days. Phenylalanine concentrations at diagnosis were mean 10, SD 5.44; range 4-24 mg/dL [0.22-1.33 μmol/L] in the breastfed group and mean 14.3, SD 10.2; range 5-37 mg/dL [0.27-2.05 μmol/L] in the non-breastfed group.Non-breastfed infants had lower serum Phe levels than breastfed infants: mean 3.76, SD 2.10; range 1-7 mg/dL [0.05-0.38 μmol/L] and mean 4.89, SD 3.68; range 2-19 mg/dL [0.11-1.05 μmol/L], respectively, although not statistically significant [(t (34) = 118.0, P = 0.51]. Also we found no significant associations in body measurements for weight, height, and head circumference at birth and final assessment. CONCLUSIONS In conclusion, during treatment, there were no statistically significant associations between breastfeeding and serum Phe levels with growth in children with phenylketonuria.
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Affiliation(s)
- Zaniar Mohammadzadeh
- Department of Community Nutrition, Besat Hospital, Kurdistan University of Medical Sciences, Pasdaran St., Head On Hotel Shadi, Sanandaj, 66177-13446, Iran
| | - Loghman Sharifi
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Asadolah Fatholahpour
- Department of Pediatrics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Elham Bazshahi
- Department of Community Nutrition, Besat Hospital, Kurdistan University of Medical Sciences, Pasdaran St., Head On Hotel Shadi, Sanandaj, 66177-13446, Iran.
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Sandoval-Pinto E, García-Gutiérrez M, Acosta-Real S, Sierra-Díaz E, Cremades R. Characterization of Three Cases of Primary Hypogalactia in Jalisco, Mexico. J Hum Lact 2024; 40:143-149. [PMID: 37837397 DOI: 10.1177/08903344231201613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
INTRODUCTION Human lactation should be taken into account as an important issue for the international agenda. Despite advances in lactation information and knowledge, insufficient milk production is still a concern for mothers and health practitioners, including International Board Certified Lactation Consultants and others. Primary hypogalactia, or insufficient milk production is uncommon, but should be considered when there is poor weight gain and decreased urine output in infants despite good latch-on and suckling, or anatomic differences in the physical exam of the lactating breast. MAIN ISSUE This case series presents three cases illustrating insufficient milk production resulting in infants who experienced significant dehydration and poor weight gain. MANAGEMENT Primary hypoplasia was diagnosed by means of a thorough interview and physical examination that entailed a consultation with a physician who was also an International Board Certified Lactation Consultant. CONCLUSION Awareness of an infant's feeding needs and proper evaluation of a child's health status is paramount if health care providers are to identify the important factors contributing to breastfeeding problems. In some instances, breastfeeding goals cannot be achieved, and then the provider's role becomes support in coming to terms with persistent insufficient milk production, and coordinating appropriate supplementation to meet each baby's nutritional needs.
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Affiliation(s)
- Elena Sandoval-Pinto
- Departamento de Biología Celular y Molecular, CUCBA, Universidad de Guadalajara, Guadalajara, JAL, México
| | - Mariana García-Gutiérrez
- Pediatric Endocrinologist, Universidad de Guadalajara, Guadalajara, JAL, México
- Hospital Angeles del Carmen, Health Services, Guadalajara, JAL, México
| | - Sara Acosta-Real
- Universidad de Guadalajara, Guadalajara, JAL, México
- Private practice, Guadalajara, JAL, México
| | - Erick Sierra-Díaz
- Departamento de Urología, Instituto Mexicano del Seguro Social (IMSS), Centro Médico Nacional de Occidente
- Departamento de Salud Pública, CUCS, Universidad de Guadalajara, Guadalajara, JAL, México
| | - Rosa Cremades
- Departamento de Microbiología y Parasitología, CUCS, Universidad de Guadalajara, Guadalajara, JAL, México
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15
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Tahmasebifard N, Perry JL, O'Brien K, Briley PM. Attributes That Increase Vulnerabilities to Reduced Human Milk Feeding Outcomes Among Babies With Cleft Lip and Palate in the Neonatal Intensive Care Unit. J Speech Lang Hear Res 2024; 67:49-58. [PMID: 37983129 DOI: 10.1044/2023_jslhr-23-00367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
OBJECTIVE The purpose of this study was to identify infant and maternal factors associated with reduced human milk feeding among infants in a neonatal intensive care unit (NICU) with cleft lip with or without cleft palate (CL ± P). METHOD Data collected on mothers and infants admitted to the NICU with CL ± P from the 2018 National Vital Statistics System were used for this study. Chi-square tests of independence and independent-samples t tests were used to compare categorical variables and continuous variables, respectively, among two groups of infants admitted to the NICU with CL ± P-those who did and did not receive human milk feeding at discharge. RESULTS The sample included 660 infants admitted to the NICU with CL ± P, of which 353 received human milk at discharge. Significant differences were found between the two groups for marital status, mother's education, maternal smoking record, total number of prenatal visits, multiparity record, gestational age, birth weight, and use of assisted ventilation. CONCLUSIONS Results indicated that, as a function of human milk feeding at discharge, mothers and their infants admitted to the NICU with CL ± P exhibited differences across infant and maternal factors. These findings further our understanding of this sample of mothers and infants with CL ± P while potentially identifying determinants to human milk feeding. This study provides insight into infant and maternal characteristics that may be associated with barriers to human milk feeding.
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Affiliation(s)
- Neda Tahmasebifard
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
| | - Jamie L Perry
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
| | - Kevin O'Brien
- Department of Public Health, East Carolina University, Greenville, NC
| | - Patrick M Briley
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
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16
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Parker LA, Hoban R, Bendixen MM, Medina-Poeliniz C, Johnson TJ, Meier PP. Milk Biomarkers of Secretory Activation in Breast Pump-Dependent Mothers of Preterm Infants: An Integrative Review. Breastfeed Med 2024; 19:3-16. [PMID: 38241129 PMCID: PMC10818056 DOI: 10.1089/bfm.2023.0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
Background: Lack of mother's own milk (MOM) at discharge from the neonatal intensive care unit (NICU) is a global problem and is often attributable to inadequate MOM volume. Evidence suggests that the origins of this problem are during the first 14 days postpartum, a time period that includes secretory activation (SA; lactogenesis II, milk coming in). Objectives: To describe and summarize evidence regarding use of MOM biomarkers (MBMs) as a measure of SA in pump-dependent mothers of preterm infants in the NICU and to identify knowledge gaps requiring further investigation. Methods: An integrative review was conducted using Whittemore and Knafl methodology incorporating the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. A search using electronic databases MEDLINE (through PubMed) and CINAHL (Cumulative Index to Nursing and Allied Health Literature) and reference lists of included articles was conducted. Results: Of the 40 articles retrieved, 6 met the criteria for inclusion. Results revealed the following five findings: (1) Achievement of SA defined by MBMs is delayed and/or impaired in mothers of preterm infants. (2) MBMs are associated with pumped MOM volume. (3) Achievement of SA defined by MBMs is associated with pumping frequency. (4) Delayed and/or impaired achievement of SA defined by MBMs may be exacerbated by maternal comorbidities. (5) There is a lack of consensus as to which MBM(s) and analysis techniques should be used in research and practice. Conclusions: MBMs hold tremendous potential to document and monitor achievement of SA in mothers of preterm infants, with multiple implications for research and clinical practice.
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Affiliation(s)
- Leslie A. Parker
- College of Nursing, University of Florida, Gainesville, Florida, USA
| | - Rebecca Hoban
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | | | | | - Tricia J. Johnson
- Department of Health Systems Management, Rush University Medical Center, Chicago, Illinois, USA
| | - Paula P. Meier
- Department of Pediatrics and Nursing, Rush University Medical Center, Chicago, Illinois, USA
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17
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Kim ES, Min HG, Lee JY, Lee JY, Yi YH. Development of a Protocol for the Direct Breastfeeding of Premature Infants in Neonatal Intensive Care Units. J Perinat Neonatal Nurs 2024; 38:73-87. [PMID: 38197807 DOI: 10.1097/jpn.0000000000000791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
PURPOSE This study aimed to develop a direct breastfeeding protocol for premature infants admitted to neonatal intensive care units (NICUs) and investigate its efficacy. BACKGROUND Direct breastfeeding increases the amount and duration of breastfeeding. However, NICUs have low direct feeding rates owing to medical staff anxiety, lack of knowledge and experience, and fear of overwork. Accordingly, this study developed a protocol for direct breastfeeding in the NICU and evaluated its effect. METHODS The protocol was developed through a literature review, expert validation, and preliminary investigation. Its application effects were identified using a nonexperimental, evidence-based research design targeting premature infants, their mothers, and NICU nurses. RESULTS The protocol comprised 5 areas and 23 items. Application of the protocol resulted in continuous weight gain of the infants and increased self-efficacy in the mothers' direct breastfeeding ( t = 3.219, P = .004). Significant increases were noted in NICU nurses' direct breastfeeding activities ( t = 3.93, P < .001), breastfeeding rates in the NICU ( P = .037), and direct breastfeeding rates ( P = .007). CONCLUSIONS Results underscore the value of an evidence-based protocol for improving breastfeeding rates in premature infants. This study highlights the need for continuous nursing education on protocol applications and human resource support.
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Affiliation(s)
- Eun Sook Kim
- Cicely Saunders Institute, King's College London, London, United Kingdom (Dr Kim); Neonatal Intensive Care Unit, Samsung Medical Center, Gangnam-Gu, Seoul, South Korea (Dr Kim and Ms Min, Ji Yeon Lee, and Ji Yoon Lee); and Graduate School of Clinical Nursing Science, Sungkyunkwan University, Gangnam-gu, Seoul, South Korea (Dr Yi)
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18
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Hendricks-Muñoz KD, Darwish N, Chahin N, Newman-Lindsay S, Shaver L, Dollings M, Xu J, Coleman V. Successes of a Focused Mothers' Own Milk (MOM) Program in Counteracting Unintended Effects of a Donor Milk Program on MOM Rates at Discharge. Breastfeed Med 2023; 18:928-933. [PMID: 38016149 DOI: 10.1089/bfm.2023.0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Background: Avoidance of early formula feeding (EFF) and advancement of mother's own milk (MOM) in very low birth weight (VLBW) infants are important health influencers to decrease serious morbidities. Objective: To present the challenges and feeding strategy successes implemented to counteract a decline in MOM at discharge after initiation of donor milk (DM) to avoid EFF in racially and ethnically diverse VLBW infants. Patients and Methods: Retrospective review of prospectively tracked inborn surviving VLBW infants and their mothers admitted to neonatal intensive care unit from 2010 to 2020 during three feeding strategy implementations baby friendly (BF), DM program, and MOM bundle. Analysis included type of feeding (MOM, DM, or formula) and maternal with descriptive and comparative statistical analysis as indicated. Results: Analysis included 616 VLBW infants. Initiation of BF program resulted in 58.5% of infants discharged on MOM with 41.5% exposed to EFF. Initiation of the DM program resulted in a decline in EFF to 5% and decline in MOM at discharge to 26%. MOM bundle strategy resulted in an increase in MOM at discharge to 41% with sustained EFF exposure 0%. MOM at discharge varied among maternal racial and ethnic backgrounds in all epochs. Early DM use was not different among mothers by race or ethnicity with DM by African American (AA) mothers 89% > White mothers 83% > Other/Hispanic mothers 75%. MOM at discharge was lowest for AA mothers 33% < Hispanic mothers 40% < White mothers 55% < Asian/Other mothers at 60%. Conclusion: Changes in VLBW feeding strategies to avoid EFF utilizing DM can be successful among diverse maternal racial and ethnic populations. Nursing and maternal education coupled with early lactation support and attention to maternal individual long-term feeding plans were critical to improve MOM at discharge among mothers of all racial-ethnic backgrounds for successful attainment of MOM utilization in term corrected VLBW infants at discharge.
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Affiliation(s)
- Karen D Hendricks-Muñoz
- Division of Neonatal Medicine, Department of Pediatrics, Children's Hospital of Richmond at VCU, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Nada Darwish
- Department of Pediatrics, Children's Hospital of Richmond at VCU, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Nayef Chahin
- Division of Neonatal Medicine, Department of Pediatrics, Children's Hospital of Richmond at VCU, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Shoshana Newman-Lindsay
- Division Neonatology, Department Pediatrics, UC Davis Medical Center, Sacramento, California, USA
| | - Lisa Shaver
- Neonatal Intensive Care, Children's Hospital of Richmond at VCU, Virginia Commonwealth University Health System, Richmond, Virginia, USA
| | - Melissa Dollings
- Neonatal Intensive Care, Children's Hospital of Richmond at VCU, Virginia Commonwealth University Health System, Richmond, Virginia, USA
| | - Jie Xu
- Neonatology Research Lab, Division of Neonatal Medicine, Department of Pediatrics, Children's Hospital of Richmond at VCU, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Valerie Coleman
- Lactation Services Children's Hospital of Richmond at VCU, Virginia Commonwealth University Health System, Richmond, Virginia, USA
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19
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Dario H, Spatz DL. An Integrative Review of Breastfeeding and Homelessness. Nurs Womens Health 2023; 27:416-426. [PMID: 37806318 DOI: 10.1016/j.nwh.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 06/14/2023] [Accepted: 09/12/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE To synthesize the current literature surrounding breastfeeding and homelessness, and to determine the impact of disparities in this population. DATA SOURCES An integrative search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and using the search terms "breastfeeding" and "homelessness" throughout electronic databases PubMed, CINAHL, and Scopus. STUDY SELECTION Inclusion criteria were articles published in English from January 2007 to September 2022. Exclusion criteria were studies published more than 15 years ago, studies published in a language other than English, opinion articles, and irrelevance to breastfeeding and homelessness. The initial search yielded 100 results. After removing duplicates and articles because of irrelevance, the final number of articles for this synthesis was seven. DATA EXTRACTION Data were extracted from each article, critically appraised using Joanna Briggs Institute criteria, and summarized in a table of evidence. DATA SYNTHESIS Three common themes were identified: Decreased Breastfeeding Initiation Rates and Duration in the Homeless Population, Impact of Community and Clinical Support, and Breastfeeding Practices Influenced by Individual Factors. CONCLUSION Providers and nurses should refer patients to the Special Supplemental Nutrition Program for Women, Infants, and Children; use techniques to instill a parent's intent to breastfeed; provide early breastfeeding education; promote breastfeeding initiation within 1 hour of birth; and encourage peer support groups. Although current researchers provide insight into potential barriers and interventions, more research is needed to gain additional data on how to overcome identified barriers to breastfeeding.
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20
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Isiguzo C, Documet P, Demirci JR, Youk A, Mendez G, Davis EM, Mendez DD. Comparative Assessment of Exclusive Breastfeeding Rates From 24-Hour Recall and Since Birth Methods in Southwestern Pennsylvania Using Ecological Momentary Assessment. J Hum Lact 2023; 39:584-594. [PMID: 37675868 DOI: 10.1177/08903344231193734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
BACKGROUND Accurate measurement of exclusive breastfeeding is important in maternal and child health research. Exclusive breastfeeding is often measured using the 24-hour recall or the since birth method for the first 6 months. These methods can produce different estimates, introducing problems in interpreting breastfeeding behavior and making accurate comparisons across settings or countries. RESEARCH AIM Our aim was to compare the exclusive breastfeeding rates between the 24-hour recall and since birth methods among a diverse cohort of birthing people using the ecological momentary assessments method. In addition, we compared the exclusive breastfeeding rates between the two methods across race and other maternal characteristics. METHODS This study is a secondary analysis using data from the Postpartum Mothers Mobile Study (PMOMS), a prospective longitudinal study which recruited participants during pregnancy and followed them for 12 months after delivery. Participants completed surveys in real-time via ecological momentary assessment. Individual exclusive breastfeeding rates from months 1-6 were computed using 24-hour recall and since birth methods for 284 participants. We calculated the percentage point difference between the two methods across child age and maternal characteristics. We used a two-sample test of proportions to determine if the differences observed in the proportions were significant. RESULTS Exclusive breastfeeding rates from the 24-hour recall were higher than the since birth rates across all ages and maternal characteristics. The difference between the two methods at 3 months was 25.7 percentage points and at 6 months was a 17.2 percentage points. Irrespective of the method used to measure exclusive breastfeeding, White participants had higher exclusive breastfeeding rates than Black participants. CONCLUSION The 24-hour recall and the since birth methods of assessing exclusive breastfeeding provided substantially different estimates. These findings highlight the importance of specificity in measuring and reporting exclusive breastfeeding.
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Affiliation(s)
- Chinwoke Isiguzo
- Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
- Palladium, Washington, DC, USA
| | - Patricia Documet
- Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Jill R Demirci
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ada Youk
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Gabriella Mendez
- Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
- Orthopedic Foot and Ankle Center, Worthington, Ohio, USA
| | - Esa M Davis
- Department of Medicine, School of Medicine, University of Pittsburgh Department of Medicine, Pittsburgh, PA, USA
| | - Dara D Mendez
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
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21
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Harris M, Schiff DM, Saia K, Muftu S, Standish KR, Wachman EM. Academy of Breastfeeding Medicine Clinical Protocol #21: Breastfeeding in the Setting of Substance Use and Substance Use Disorder (Revised 2023). Breastfeed Med 2023; 18:715-733. [PMID: 37856658 PMCID: PMC10775244 DOI: 10.1089/bfm.2023.29256.abm] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
Background: The Academy of Breastfeeding Medicine (ABM) revised the 2015 version of the substance use disorder (SUD) clinical protocol to review the evidence and provide updated literature-based recommendations related to breastfeeding in the setting of substance use and SUD treatments. Key Information: Decisions around breastfeeding are an important aspect of care during the peripartum period, and there are specific benefits and risks for substance-exposed mother-infant dyads. Recommendations: This protocol provides breastfeeding recommendations in the setting of nonprescribed opioid, stimulant, sedative-hypnotic, alcohol, nicotine, and cannabis use, and SUD treatments. Additionally, we offer guidance on the utility of toxicology testing in breastfeeding recommendations. Individual programs and institutions should establish consistent breastfeeding approaches that mitigate bias, facilitate consistency, and empower mothers with SUD. For specific breastfeeding recommendations, given the complexity of breastfeeding in mothers with SUD, individualized care plans should be created in partnership with the patient and multidisciplinary team with appropriate clinical support and follow-up. In general, breastfeeding is recommended among mothers who stop nonprescribed substance use by the time of delivery, and they should continue to receive ongoing postpartum care, such as lactation support and SUD treatment. Overall, enhancing breastfeeding education regarding substance use in pregnancy and lactation is essential to allow for patient-centered guidance.
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Affiliation(s)
- Miriam Harris
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
- Grayken Center for Addiction, Boston Medical Center, Boston, Massachusetts, USA
| | - Davida M. Schiff
- Divisions of Newborn Medicine and Mass General Hospital for Children, Boston, Massachusetts, USA
- Divisions of General Academic Pediatrics, Mass General Hospital for Children, Boston, Massachusetts, USA
| | - Kelley Saia
- Grayken Center for Addiction, Boston Medical Center, Boston, Massachusetts, USA
- Department of Obstetrics and Gynecology, Chobanian & Avedisian Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Serra Muftu
- Divisions of Newborn Medicine and Mass General Hospital for Children, Boston, Massachusetts, USA
- Divisions of General Academic Pediatrics, Mass General Hospital for Children, Boston, Massachusetts, USA
| | - Katherine R. Standish
- Department of Family Medicine, and Chobanian & Avedisian Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Elisha M. Wachman
- Grayken Center for Addiction, Boston Medical Center, Boston, Massachusetts, USA
- Department of Pediatrics, Chobanian & Avedisian Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
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22
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Dalal R, Fancy MK, Chaudhary S, Abraham M, Vir SC, Gaurav S. Establishment of cross-cradle hold technique combined with intensive breastfeeding counselling positively impacts the weight gain rate in early infancy. Matern Child Nutr 2023; 19:e13529. [PMID: 37189283 PMCID: PMC10483946 DOI: 10.1111/mcn.13529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/16/2023] [Accepted: 04/24/2023] [Indexed: 05/17/2023]
Abstract
A quasiexperimental field study was undertaken in 576 exclusively breastfed (EBF) infants from 0 to 14 weeks in Gujarat, India to assess the effect of the use of appropriate breastfeeding techniques on daily weight gain rate and on reducing the underweight rate in early infancy. The interventions were delivered through the existing health system and focused primarily on counselling pregnant women during antenatal and post-natal sessions for ensuring 'effective breastfeeding' by adoption of the technique of 'cross cradle hold', appropriate breast attachment, emptying of one breast before shifting to the other along with conducting regular monitoring of infant's weight. The intervention care group (ICG) of 300 EBF infants were compared with 276 EBF infants in the control standard care group (SCG). The findings revealed that median weight gain per day between 0 and 14 weeks was significantly higher (p = 0.000) in ICG (32.7 g) as compared with SCG (28.05 g). The median weight-for-age Z at 14 weeks of age was also significantly higher in ICG compared with SCG (p = 0.000). Underweight prevalence was three times lower in ICG (5.3%) compared with SCG (16.7%) at 14 weeks of age. Infants in the ICG were noted to be 2.65-fold more likely to achieve a weight gain of 30 g or more per day compared with infants in SCG. Nutrition interventions, therefore, must aim not only on mere promotion of EBF for up to 6 months but stress on ensuring EBF is 'effective' for optimum transfer of breastmilk through adoption of appropriate techniques, including cross-cradle hold, by mothers.
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Affiliation(s)
- Rupal Dalal
- Centre for Technology Alternatives for Rural AreasIndian Institute of Technology‐Bombay & Shrimati Malati Dahanukar TrustMumbaiMaharashtraIndia
| | | | - Shalu Chaudhary
- UNICEF & State Health System Resource CentreGandhinagarGujaratIndia
| | - Marian Abraham
- Centre for Technology Alternatives for Rural AreasIndian Institute of Technology‐BombayMumbaiIndia
| | - Sheila C. Vir
- Public Health Nutrition and Development CentreNew DelhiIndia
| | - Sarthak Gaurav
- Shailesh J. Mehta School of Management, Indian Institute of Technology‐BombayMumbaiIndia
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23
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Fleiss N, Morrison C, Nascimento A, Stone D, Myers E. Improving Early Colostrum Administration to Very Low Birth Weight Infants in a Level 3 Neonatal Intensive Care Unit: A Quality Improvement Initiative. J Pediatr 2023; 260:113421. [PMID: 37076038 DOI: 10.1016/j.jpeds.2023.113421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/13/2023] [Accepted: 02/28/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE To improve our human milk practices by increasing early and sustained use of colostrum as oral immune therapy (OIT) in very low birthweight (VLBW) infants admitted at a level 3 neonatal intensive care unit. STUDY DESIGN Using the Institute for Healthcare Improvement's Model for Improvement, several interventions aimed at increasing early OIT administration were implemented. Four key drivers included: optimizing evidence-based OIT guidelines, personnel alignment and engagement, optimal electronic health record use for ordering practices, and timely lactation consultant involvement. The primary outcome measure was early OIT administration, whereas secondary outcome measures examined all OIT administration and human milk at discharge. Process measures included the percentage of staff members who were compliant with OIT protocol. RESULTS Early OIT administration increased from a baseline mean of 6% to 55% in the 12-month study period. Percentage of total (early and late) OIT administration to VLBW infants increased from a baseline of 21% to 85%. Average human milk at discharge for VLBW infants remained at 44%, without significant improvement. CONCLUSIONS A multidisciplinary quality improvement initiative led to significant improvement in OIT administration to infants at a level 3 neonatal intensive care unit.
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Affiliation(s)
- Noa Fleiss
- Department of Pediatrics, Division of Neonatology, Yale School of Medicine, New Haven, CT; Bridgeport Campus Neonatal Intensive Care Unit, Yale New Haven Children's Hospital, Bridgeport, CT.
| | - Corinne Morrison
- Bridgeport Campus Neonatal Intensive Care Unit, Yale New Haven Children's Hospital, Bridgeport, CT
| | - Allison Nascimento
- Bridgeport Campus Neonatal Intensive Care Unit, Yale New Haven Children's Hospital, Bridgeport, CT
| | - Debra Stone
- Department of Pediatrics, Bridgeport Hospital, Bridgeport, CT
| | - Eliza Myers
- Department of Pediatrics, Division of Neonatology, Yale School of Medicine, New Haven, CT; Bridgeport Campus Neonatal Intensive Care Unit, Yale New Haven Children's Hospital, Bridgeport, CT
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Tadele H, Kassa DH, Gebriel FW, Bilal SM, Gedefaw A, Teshome M, Kawza A, Wangoro S, Muleta M, Abebo TA, Asefa A, Astatkie A, Haji Y, Alemayehu A, Aziz K, Brune T, Singhal N, Worku B, Tadesse BT. Development and evaluation of a kangaroo mother care implementation model in South Ethiopia. Acta Paediatr 2023; 112 Suppl 473:65-76. [PMID: 37519118 DOI: 10.1111/apa.16812] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 04/25/2023] [Accepted: 05/02/2023] [Indexed: 08/01/2023]
Abstract
AIM To develop a model for increasing the coverage of kangaroo mother care (KMC), which involved ≥8 h of skin-to-skin contact per day and exclusive breastfeeding, for small babies with birth weight < 2000 g in South Ethiopia. METHODS A mixed methods study was conducted between June 2017 and January 2019 at four hospitals and their catchment areas. Iterative cycles of implementation, program learning and evaluation were used to optimise KMC implementation models. The study explored the community-facility continuum of care and assessed the proportion of neonates with a birth weight less than 2000 g receiving effective KMC. RESULTS Three KMC implementation models were tested with Model 2 being the final version. This model included enhanced identification of home births, improved referral linkages, immediate skin-to-skin care initiation in facilities and early contact after discharge. These improvements resulted in 86% coverage of effective facility-based KMC initiation for eligible babies. The coverage was 81.5% at discharge and 57.5% 7 days after discharge. The mean age of babies at KMC initiation was 8.2 days (SD = 5.7). CONCLUSION The study found that the KMC implementation model was feasible and can lead to substantial population-level KMC coverage for small babies.
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Affiliation(s)
- Henok Tadele
- Department of Paediatrics and Child Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Paediatrics and Child Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Dejene Hailu Kassa
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Fitsum W Gebriel
- Department of Paediatrics and Child Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Selamawit Mengesha Bilal
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Abel Gedefaw
- Department of Obstetrics and Gynaecology, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Million Teshome
- Department of Obstetrics and Gynaecology, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Aknaw Kawza
- Southern Nations, Nationalities, and Peoples' Regional State Health Bureau, Hawassa, Ethiopia
| | - Shemels Wangoro
- Southern Nations, Nationalities, and Peoples' Regional State Health Bureau, Hawassa, Ethiopia
| | | | - Teshome Abuka Abebo
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Anteneh Asefa
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Ayalew Astatkie
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Yusuf Haji
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Akalewold Alemayehu
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Khalid Aziz
- Department of Paediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Thomas Brune
- Sachs' Children and Youth Hospital, Stockholm, Sweden
| | - Nalini Singhal
- Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Bogale Worku
- Ethiopian Paediatrics Society, Addis Ababa, Ethiopia
| | - Birkneh Tilahun Tadesse
- Department of Paediatrics and Child Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Homo RL, Martin A, Fleagle K, Carty B, Anderson A, Pavey A, Smith A. Breastfeeding Rates in the Military Are Unchanged Before and After the Onset of the COVID-19 Pandemic. Breastfeed Med 2023; 18:579-585. [PMID: 37505068 DOI: 10.1089/bfm.2023.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Introduction: The COVID-19 pandemic brought changes in clinical operations and raised concerns about breastfeeding safety. We investigated the change in breastfeeding rates within a military population, a model of universal health care coverage, and elucidated factors that enhance or deter breastfeeding. Methods: A retrospective analysis was performed on mothers delivering infants ≥35 weeks' gestation at a military treatment facility (MTF) before (PRE) and during (PERI) the pandemic. Demographic data and feeding methods (exclusive, any, and no breastfeeding) from birth to 6 months of life were obtained. The primary outcome compared the breastfeeding rates between PRE and PERI. Logistic regressions identified factors associated with breastfeeding. Results: Of the 372 dyads, 189 (51%) were in PRE and 183 (49%) were in PERI. Exclusive breastfeeding rates in the nursery (77% versus 78%, p = 0.7), at 1 month (70% versus 65%, p = 0.3), at 2 months (65% versus 62%, p = 0.6), 4 months (49% versus 56%, p = 0.2), and 6 months of life (42% versus 47%, p = 0.5) were similar between PRE and PERI. Trends for any breastfeeding were also unchanged. Interactions with a lactation consultant were most strongly associated with exclusive breastfeeding in the nursery (odds ratio 21.88, confidence interval 5.84-82.00, p < 0.001). Discussion: Breastfeeding rates from birth to 6 months of life in infants receiving care at a single MTF were unchanged before and during the pandemic. Access to lactation consultants appears to be a significant contributing factor, and universal health care coverage may have improved access to this resource. Accessibility to breastfeeding resources and education is essential to support and strengthen breastfeeding within the military community.
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Affiliation(s)
- Richelle L Homo
- Department of Pediatrics, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, Washington, USA
| | - Alexandria Martin
- Department of Pediatrics, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, Washington, USA
| | - Kerri Fleagle
- Department of Pediatrics, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, Washington, USA
| | - Brendan Carty
- Department of Pediatrics, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, Washington, USA
| | - Alice Anderson
- Department of Pediatrics, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, Washington, USA
| | - Ashleigh Pavey
- Division of Neonatal and Perinatal Medicine, Department of Pediatrics, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, Washington, USA
| | - Ashley Smith
- Department of Pediatrics, Madigan Army Medical Center, Joint Base Lewis-McChord, Tacoma, Washington, USA
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Quitadamo PA, Zambianco F, Palumbo G, Copetti M, Gentile MA, Mondelli A. Trend and Predictors of Breastmilk Feeding among Very-Low-Birth-Weight Infants in NICU and at Discharge. Nutrients 2023; 15:3314. [PMID: 37571252 PMCID: PMC10421341 DOI: 10.3390/nu15153314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/10/2023] [Accepted: 07/20/2023] [Indexed: 08/13/2023] Open
Abstract
Mothers' own milk (MOM) for premature babies is considered a life-saving drug for its proven protective action against the complications of prematurity and for effects on outcome in the short and long term, especially neurological ones. We studied the use of MOM for infants weighing <1500 g for a period of 5 years, evaluating the trend over time and the impact of some variables on human milk feeding performance. Statistical comparisons concerned the rate of feeding with breast milk during a stay in an NICU and at discharge with respect to two types of variables: (1) maternal and neonatal characteristics (gestational age, birth weight, type of pregnancy (whether single or twin), maternal age) and (2) feeding characteristics (time of the start of minimal enteral feeding and availability of MOM, days until the achievement of full enteral feeding). Group comparisons were performed using ANOVA or t-test for continuous variables and Pearson chi-squared test or Fisher exact test for categorical variables. We observed an increase, between 2017 and 2021, in MOM use (p = 0.003). The availability of the own mothers' milk occurred, on average, on the fourth day of life and improved over the years. The start of minimal enteral feeding (MEF) with human milk averaged 1.78 days, and 54.3% of VLBWs received MEF with donor milk on the first day of life. The average percentage of feeding with the mothers' milk at discharge was 47.6%, with 36.1% of exclusive MOM and an increase from 45.8% in 2017 (33.3% exclusive) to 58.82% (41.18% exclusive) in 2021. The mean average daily growth of the weight improved (p < 0.001) during this period, and there was no statistical difference between infants fed with maternal milk and those fed with bank milk. Older maternal age, early-start feeding with maternal milk and low gestational age had a statistically significant impact on feeding with MOM at discharge.
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Affiliation(s)
- Pasqua Anna Quitadamo
- Neonatal Intensive Care Unit, Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy; (G.P.); (M.A.G.); (A.M.)
- HMB, Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
| | - Federica Zambianco
- San Raffaele Faculty of Medicine, University of San Raffaele Vita-Salute, 20132 Milano, Italy;
| | - Giuseppina Palumbo
- Neonatal Intensive Care Unit, Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy; (G.P.); (M.A.G.); (A.M.)
- HMB, Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
| | - Massimiliano Copetti
- Statistical Department, Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy;
| | - Maria Assunta Gentile
- Neonatal Intensive Care Unit, Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy; (G.P.); (M.A.G.); (A.M.)
- HMB, Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
| | - Antonio Mondelli
- Neonatal Intensive Care Unit, Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy; (G.P.); (M.A.G.); (A.M.)
- HMB, Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
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Sari Ozturk C, Demir K. The Effect of Mandala Activity and Technology-Based Breastfeeding Program on Breastfeeding Self-Efficacy and Mother-Infant Attachment of Primiparous Women: A Randomized Controlled Study. J Med Syst 2023; 47:44. [PMID: 37004692 PMCID: PMC10066944 DOI: 10.1007/s10916-023-01942-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/25/2023] [Indexed: 04/04/2023]
Abstract
The use of art therapy methods such as mandala is becoming increasingly popular in mother-infant health education and counseling. The aim of the study was to evaluate the effect of a mandala and technology-based breastfeeding program on women's breastfeeding self-efficacy and attachment between mother and infant. This randomized controlled, single-blind, and parallel-group trial design was conducted in foundation university hospital. The study was completed by 66 women and their infants (intervention group: n = 33; control group: n = 33). The women who are at the 32-37th gestational week in the intervention group participated in the mandala and technology-based breastfeeding (including Zoom and WhatsApp platforms) program. They received three education module via WhatsApp. Women in control group received routine care. The Maternal Attachment scale and Breastfeeding Self-efficacy Scale were applied in the first week and second month postpartum. Growth follow-ups of the infants were evaluated in the first week, first month and second month postpartum. The registration number of this study on ClinicalTrials.gov is NCT05199298. In the second month postpartum, it was determined that the women in the intervention group had higher Breastfeeding Self-efficacy and Maternal Attachment scale scores compared to the control group (p < 0.05). Also, the rates of breastfeeding in the intervention group were higher than in the control group. Mandala and technology-based breastfeeding program increased women's breastfeeding self-efficacy and maternal attachment. Health care professionals should make use of technology-based educations to give holistic care in maternal and infant health.
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Affiliation(s)
- Cigdem Sari Ozturk
- Pediatric Nursing Department, Gazi University Faculty of Nursing, Ankara, Turkey
| | - Kadriye Demir
- Nursing Department, Health Sciences Faculty, Lokman Hekim University, Ankara, Turkey
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28
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Alemdar DK, İnal S, Bulut M. Clinical validation of the infant-driven feeding scales© in Turkey. J Pediatr Nurs 2022; 67:148-154. [PMID: 36122545 DOI: 10.1016/j.pedn.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 07/20/2022] [Accepted: 09/07/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Supporting the development of feeding skills among preterm infants is an important component of neonatal care. The selection of appropriate and supportive feeding interventions begins with a comprehensive assessment of the infant's skills. PURPOSE This study aimed to adapt the Infant-Driven Feeding Scales© (IDFS) to the Turkish language. METHODS This was a methodological, observational, single-center cross-sectional study. The study included 80 infants born at a gestational age ≥ 32 weeks, consecutively admitted to a tertiary Neonatal Intensive Care Unit (NICU). Research data were collected using a premature infant descriptive information form (IDIF), IDFS, and LATCH Score for Breastfeeding Assessment. For the Turkish validity-reliability of the IDF, the translate-back translate method was used with the content validity index (CVI) assessed. RESULTS The scale had CVI values between 0.90 and 1.00 with a mean CVI = 0.96. For measures 1 and 2, there were significant positive and high-level correlations between IFDS-R and IFDS-Q correlation values (r = 0.553-0.958; p = 0.001) and significant negative, low-level correlations between IFDS-R and IFDS-Q with the LATCH scale (r = 0.439-0.532; p = 0.001). According to inter-observer compatibility analyses, the kappa value was 0.94-1.00 for the first measure and 0.96-1.00 for the second measure (p = 0.001). There were negative significant correlations between IDFS-R points with gestational age and postmenstrual age (PMA) (p = 0.001), and gestational age and PMA were explanatory factors for 13.8% of IDFS-R points (F = 7.30, p = 0.001). CONCLUSIONS The IDFS is recommended for use as a valid and reliable tool to ease the safe and successful development of oral feeding skills in preterm infants and to plan evidence-based interventions. IMPLICATIONS FOR PRACTICE The IDFS appears to be a beneficial measurement device for use in assessing the state of readiness of preterm infants for oral feeding and for early determination of risks that may occur due to delayed feeding independence of infants.
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Affiliation(s)
- Dilek Küçük Alemdar
- Associate Professor, Ordu University Faculty of Health Sciences, Department of Pediatric Nursing, Ordu, Turkey.
| | - Sevil İnal
- Professor, İstanbul-Cerrah Paşa University Faculty of Health Sciences, Department of Midwifery, İstanbul, Turkey
| | - Muhammet Bulut
- MD, Associate Professor, Giresun University Faculty of Medicine, Department of Pediatrics, Giresun, Turkey
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29
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Wood NK, Odom-Maryon T, Smart DA. Factors Associated With Exclusive Direct Breastfeeding in the First 3 Months. Nurs Womens Health 2022; 26:299-307. [PMID: 35714762 DOI: 10.1016/j.nwh.2022.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/01/2022] [Accepted: 05/19/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To identify factors associated with exclusive direct breastfeeding in the first 3 months among mother and infant dyads living in the United States. DESIGN A secondary analysis of data collected using a cross-sectional online survey completed over a 4-month period in late 2019. PARTICIPANTS We recruited a convenience sample of 370 mothers with healthy full-term singleton infants between 1 and 12 weeks of age whose feeding methods consisted of direct breastfeeding at least once a day. Mothers had not returned to work/school at the time of the survey completion. MEASUREMENTS The questionnaire consisted of 34 questions about maternal and infant factors that influence decisions about infant feeding, professional support, and parental preferences. RESULTS Mothers who practiced feeding on demand (adjusted OR [aOR] = 35.76, 95% confidence interval [CI] [2.04, 500.00]) and mothers of infants 1 to 4 weeks of age (aOR = 2.74, 95% CI [1.54, 4.85]) were more likely to use exclusive direct breastfeeding. The odds of exclusive direct breastfeeding decreased with mothers who breastfed with a nipple shield while in the hospital/birth center/home (aOR = 0.13, 95% CI [0.05, 0.35]), used pacifiers (aOR = 0.31, 95% CI [0.21, 0.65]), or had perceptions of insufficient milk (aOR = 0.11, 95% CI [0.04, 0.26]). CONCLUSION Demand feeding and an infant's age of 1 to 4 weeks contributed to exclusive direct breastfeeding. Lower rates of exclusive direct breastfeeding were associated with the use of nipple shields immediately after birth, pacifier use, and perceptions of insufficient milk. Further investigation is warranted to fully differentiate exclusive direct breastfeeding from exclusive breastfeeding.
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Guo J, Tan M, Zhu J, Tian Y, Liu H, Luo F, Wang J, Huang Y, Zhang Y, Yang Y, Wang G. Proteomic Analysis of Human Milk Reveals Nutritional and Immune Benefits in the Colostrum from Mothers with COVID-19. Nutrients 2022; 14:nu14122513. [PMID: 35745243 PMCID: PMC9227629 DOI: 10.3390/nu14122513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 02/05/2023] Open
Abstract
Despite the well-known benefits of breastfeeding and the World Health Organization’s breastfeeding recommendations for COVID-19 infected mothers, whether these mothers should be encouraged to breastfeed is under debate due to concern about the risk of virus transmission and lack of evidence of breastmilk’s protective effects against the virus. Here, we provide a molecular basis for the breastfeeding recommendation through mass spectrometry (MS)-based proteomics and glycosylation analysis of immune-related proteins in both colostrum and mature breastmilk collected from COVID-19 patients and healthy donors. The total protein amounts in the COVID-19 colostrum group were significantly higher than in the control group. While casein proteins in COVID-19 colostrum exhibited significantly lower abundances, immune-related proteins, especially whey proteins with antiviral properties against SARS-CoV-2, were upregulated. These proteins were detected with unique site-specific glycan structures and improved glycosylation diversity that are beneficial for recognizing epitopes and blocking viral entry. Such adaptive differences in milk from COVID-19 mothers tended to fade in mature milk from the same mothers one month postpartum. These results suggest that feeding infants colostrum from COVID-19 mothers confers both nutritional and immune benefits, and provide molecular-level insights that aid breastmilk feeding decisions in cases of active infection.
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Affiliation(s)
- Juanjuan Guo
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan 430071, China; (J.G.); (H.L.); (Y.Z.)
| | - Minjie Tan
- Institute for Cell Analysis, Shenzhen Bay Laboratory, Shenzhen 518132, China; (M.T.); (Y.T.); (Y.H.)
| | - Jing Zhu
- Institute of Biotechnology and Health, Beijing Academy of Science and Technology, Beijing 100089, China
- Correspondence: (J.Z.); (G.W.)
| | - Ye Tian
- Institute for Cell Analysis, Shenzhen Bay Laboratory, Shenzhen 518132, China; (M.T.); (Y.T.); (Y.H.)
| | - Huanyu Liu
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan 430071, China; (J.G.); (H.L.); (Y.Z.)
| | - Fan Luo
- State Key Laboratory of Virology, Institute of Medical Virology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China;
| | - Jianbin Wang
- School of Life Sciences, Tsinghua-Peking Center for Life Sciences, Tsinghua University, Beijing 100084, China;
| | - Yanyi Huang
- Institute for Cell Analysis, Shenzhen Bay Laboratory, Shenzhen 518132, China; (M.T.); (Y.T.); (Y.H.)
- Biomedical Pioneering Innovation Center, Peking University, Beijing 100871, China
| | - Yuanzhen Zhang
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan 430071, China; (J.G.); (H.L.); (Y.Z.)
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China
| | - Yuexin Yang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China;
| | - Guanbo Wang
- Institute for Cell Analysis, Shenzhen Bay Laboratory, Shenzhen 518132, China; (M.T.); (Y.T.); (Y.H.)
- Biomedical Pioneering Innovation Center, Peking University, Beijing 100871, China
- Correspondence: (J.Z.); (G.W.)
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Shaki F, Aziznejadroshan P, Rad ZA, Chehrazi M, Arzani A. Comparison of the effect of two methods of sucking on pacifier and mother's finger on oral feeding behavior in preterm infants: a randomized clinical trial. BMC Pediatr 2022; 22:292. [PMID: 35585519 PMCID: PMC9118858 DOI: 10.1186/s12887-022-03352-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 05/12/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Oral feeding problems will cause long-term hospitalization of the infant and increase the cost of hospitalization. This study aimed to compare the effect of two methods of sucking on pacifier and mother's finger on oral feeding behavior in preterm infants. METHODS This single-blind randomized controlled clinical trial was performed in the neonatal intensive care unit of Babol Rouhani Hospital, Iran. 150 preterm infants with the gestational age of 31 to 33 weeks were selected and were divided into three groups of 50 samples using randomized block method, including non-nutritive sucking on mother's finger (A), pacifier (B) and control (C). Infants in groups A and B were stimulated with mother's finger or pacifier three times a day for five minutes before gavage, for ten days exactly. For data collection, demographic characteristics questionnaire and preterm infant breastfeeding behavior scale were used. RESULTS The mean score of breastfeeding behavior in preterm infants in the three groups of A,B,C was 12.34 ± 3.37, 11.00 ± 3.55, 10.40 ± 4.29 respectively, which had a significant difference between the three groups (p = 0.03). The mean rooting score between three groups of A, B, and C was 1.76 ± 0.47, 1.64 ± 0.48, and 1.40 ± 0.90 (p < 0.001) respectively. Also, the mean sucking score in groups of A, B and C was 2.52 ± 0.76, 2.28 ± 0.64 and 2.02 ± 0.74 respectively, which had a significant difference (p = 0.003), but other scales had no significant difference between the three groups (P > 0.05). The mean time to achieve independent oral feeding between the three groups of A, B, C was 22.12 ± 8.15, 22.54 ± 7.54 and 25.86 ± 7.93 days respectively (p = 0.03), and duration of hospitalization was 25.98 ± 6.78, 27.28 ± 6.20, and 29.36 ± 5.97 days (p = 0.02), which had a significant difference. But there was no significant difference between the two groups of A and B in terms of rooting, sucking, the total score of breastfeeding behavior and time of achieving independent oral feeding (P > 0.05). CONCLUSION Considering the positive effect of these two methods, especially non-nutritive sucking on mother's finger, on increasing oral feeding behaviors, it is recommended to implement these low-cost methods for preterm infants admitted to neonatal intensive care unit. TRIAL REGISTRATION Trial Registration: IRCT, IRCT20191116045460N1 . Registered 11 January 2020- prospective registered.
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Affiliation(s)
- Fatemeh Shaki
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Parvin Aziznejadroshan
- Non-Communicable Pediatric Disease Research Center, Health Research Institute, School of Nursing and Midwifery, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Akbarian Rad
- Non-Communicable Pediatric Disease Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, School of Public Health, Babul University of Medical Sciences, Babol, Iran
| | - Afsaneh Arzani
- Non-Communicable Pediatric Disease Research Center, Health Research Institute, School of Nursing and Midwifery, Babol University of Medical Sciences, Babol, Iran
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Mitchell KB, Johnson HM, Rodríguez JM, Eglash A, Scherzinger C, Zakarija-Grkovic I, Cash KW, Berens P, Miller B. Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022. Breastfeed Med 2022; 17:360-376. [PMID: 35576513 DOI: 10.1089/bfm.2022.29207.kbm] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. The Academy of Breastfeeding Medicine recognizes that not all lactating individuals identify as women. Using gender-inclusive language, however, is not possible in all languages and all countries and for all readers. The position of the Academy of Breastfeeding Medicine (https://doi.org/10.1089/bfm.2021.29188.abm) is to interpret clinical protocols within the framework of inclusivity of all breastfeeding, chestfeeding, and human milk-feeding individuals.
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Affiliation(s)
- Katrina B Mitchell
- Department of Breast Surgery, Ridley-Tree Cancer Center, Sansum Clinic, Santa Barbara, California, USA
| | - Helen M Johnson
- Department of Surgery, East Carolina University Brody School of Medicine, Greenville, North Carolina, USA
| | - Juan Miguel Rodríguez
- Department of Nutrition and Food Science, Complutense University of Madrid, Madrid, Spain
| | - Anne Eglash
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | | | | | - Kyle Widmer Cash
- Department of Medicine, Tulane University School of Medicine, Southeast, Louisiana Veterans Health Care System, New Orleans, Louisiana, USA
| | - Pamela Berens
- Department of Obstetrics and Gynecology, University of Texas, Houston, Texas, USA
| | - Brooke Miller
- Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
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33
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Aquino LM, Newcomb P, True B, Hoff T, Gentile D, Patton L, Raquepo F, Cash E. Cross-Sectional Study of Influences on Maternal Decisions Regarding Feeding Premature and Ill Neonates. J Perinat Neonatal Nurs 2022; 36:209-217. [PMID: 34570044 DOI: 10.1097/jpn.0000000000000553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This cross-sectional study investigated the influences on feeding decisions made by mothers of infants admitted to neonatal intensive care units. The primary aims were to describe discrete influences on maternal behavior and to test Fishbein and Azjen's Theory of Planned Behavior in the neonatal intensive care unit (NICU) setting. The study included a convenience sample of 445 mothers in North Texas and Wisconsin. An investigator-designed tool was administered to subjects by research team members in the study units. Significant differences between minority and dominant racial groups emerged, which highlight known disparities in perinatal outcomes. Results supported the Theory of Planned Behavior and demonstrated predictors of exclusive breastfeeding at discharge including intention, race/ethnicity, length of stay in the NICU, and beliefs that the following factors influenced feeding decisions: having help with chores or childcare at home, talking with mothers in the NICU, having the NICU nurse help with feeding, and space for breastfeeding in the NICU. Incidental findings included the observation that mothers in the only NICU with private rooms were significantly more likely to report fatigue and to perceive that unit busyness, space, and privacy affected their feeding decisions, although there was no difference in breastfeeding at discharge between this NICU and others.
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Affiliation(s)
- Laarnie Maria Aquino
- Women's Services, Texas Health Harris Methodist Hospital, Fort Worth (Mss Aquino and Raquepo); Nursing Research, Texas Health Resources, Arlington (Dr Newcomb); Women's Services, Texas Health Arlington Memorial Hospital (Ms True); Neonatal Intensive Care, Cook Children's Medical Center, Fort Worth, Texas (Dr Hoff); Nursing Research Manager, Advocate Aurora Health, Milwaukee, Wisconsin (Dr Gentile); and Women's Services, Baylor Scott & White All Saints Hospital, Fort Worth, Texas (Ms Patton); Professional Development Specialist, Aurora BayCare Medical Center, Green Bay, Wisconsin (Ms Cash)
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Douglas PS, Perrella SL, Geddes DT. A brief gestalt intervention changes ultrasound measures of tongue movement during breastfeeding: case series. BMC Pregnancy Childbirth 2022; 22:94. [PMID: 35105336 PMCID: PMC8808964 DOI: 10.1186/s12884-021-04363-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 12/06/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Lactation consultants frequently advise adjustments to fit and hold (or positioning and attachment) with the aim of optimising intra-oral nipple placement. However, approaches to fit and hold vary widely, with limited evidence of benefits, and effects of fit and hold on infant tongue movement have not been examined. The aim of this preliminary study was to investigate whether a gestalt breastfeeding intervention alters tongue movement, using measurements from ultrasound imaging to determine nipple placement and intra-oral nipple and breast tissue dimensions. METHODS Ultrasound measurements were conducted in five breastfeeding dyads, infants aged 4-20 weeks, while feeding in their usual or 'standard' position and again after brief application of gestalt principles of fit and hold. Four of the mother-baby pairs, who had received comprehensive lactation support, reported persisting nipple pain. Three of these infants had difficulty latching and fussed at the breast; three had been diagnosed with oral ties. A fifth pair was breastfeeding successfully. RESULTS Ultrasound demonstrated that the distance from nipple tip to junction of the hard and soft palate decreased, intra-oral nipple and breast tissue dimensions increased, and nipple slide decreased after a brief gestalt intervention. CONCLUSION These preliminary findings suggest that changes in fit and hold impact on infant tongue movement and contour. Further research investigating short- and long-term outcomes of a gestalt breastfeeding intervention in larger cohorts is required.
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Affiliation(s)
- Pamela Sylvia Douglas
- Possums & Co., PO Box 5139, West End, Brisbane, 4101, Australia.
- School of Nursing and Midwifery, Griffith University, Nathan, Australia.
- Primary Care Clinical Unit, The University of Queensland, Herston Road, Herston, Australia.
| | - Sharon Lisa Perrella
- Geddes Hartmann Human Lactation Research Group, The University of Western Australia, Perth, Australia
| | - Donna Tracy Geddes
- Geddes Hartmann Human Lactation Research Group, The University of Western Australia, Perth, Australia
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Shohaimi NM, Mazelan M, Ramanathan K, Meor Hazizi MS, Leong YN, Cheong XB, Ambigapathy S, Cheong AT. Intention and practice on breastfeeding among pregnant mothers in Malaysia and factors associated with practice of exclusive breastfeeding: A cohort study. PLoS One 2022; 17:e0262401. [PMID: 34995321 PMCID: PMC8741045 DOI: 10.1371/journal.pone.0262401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 12/22/2021] [Indexed: 11/19/2022] Open
Abstract
Background Exclusive breastfeeding rate in Malaysia is low despite its known health benefits. This study aims to determine the prevalence of intention to breastfeed among pregnant mothers, the prevalence of exclusive breastfeeding practice after delivery, and factors associated with exclusive breastfeeding practice. Methods This was a prospective cohort study. All pregnant women at 36 weeks gestation or above from 17 antenatal health clinics in an urban district were invited to participate in the study. A self-administered questionnaire was used, encompassing sociodemographic, breastfeeding knowledge, attitude, and intention towards the practice of breastfeeding. The participants were followed up one month post-natal for their practice of breastfeeding via telephone or during their post-natal follow-up appointment. Results 483 pregnant mothers participated in the study initially. 462 (95.7%) were contactable after one month. 99.4% (459/462) of participants intended to breastfeed. 65.4% (302/462) of participants practiced exclusive breastfeeding. There was no significant association between intention and practice of exclusive breastfeeding. Multiple logistic regression analysis shows, pregnant mothers with high breastfeeding knowledge (AOR = 1.138; 95% CI 1.008–1.284) and Malay ethnicity (AOR = 2.031; 95% CI 1.066–3.868) were more likely to breastfeed their infant exclusively. Conclusions Prevalence of exclusive breastfeeding practice at one month in the studied district was 65.4%. Malay mothers and mothers with high breastfeeding knowledge were more likely to breastfeed exclusively. Thus, we recommend targeted intervention towards non-Malay mothers and increasing breastfeeding knowledge to all pregnant mothers.
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Affiliation(s)
| | - Majidah Mazelan
- Jelapang Health Clinic, Ministry of Health Malaysia, Ipoh, Perak, Malaysia
| | - Kanesh Ramanathan
- Tanjung Malim Health Clinic, Ministry of Health Malaysia, Tanjung Malim, Perak, Malaysia
| | | | - Yan Ning Leong
- Simee Health Clinic, Ministry of Health Malaysia, Ipoh, Perak, Malaysia
| | - Xiang Bin Cheong
- Chemor Health Clinic, Ministry of Health Malaysia, Ipoh, Perak, Malaysia
| | | | - Ai Theng Cheong
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- * E-mail: ,
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Cozma-Petruţ A, Filip L, Banc R, Mîrza O, Gavrilaş L, Ciobârcă D, Badiu-Tişa I, Hegheş SC, Popa CO, Miere D. Breastfeeding Practices and Determinant Factors of Exclusive Breastfeeding among Mothers of Children Aged 0-23 Months in Northwestern Romania. Nutrients 2021; 13:3998. [PMID: 34836253 PMCID: PMC8623634 DOI: 10.3390/nu13113998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 11/26/2022] Open
Abstract
In terms of breastfeeding (BF) practices in Romania, there is a lack of up-to-date data. The aim of the present study was to assess current BF practices, and to investigate the factors associated with exclusive BF (EBF) under 6 months of age in northwestern Romania. A structured questionnaire was used to collect data among 1399 mothers of children aged 0-23 months, recruited between March and June 2019, from the community. BF practices were evaluated based on the World Health Organization indicators for assessing infant and young child feeding practices, whereas determinants of EBF were explored using logistic regression models. Almost all mothers (95.7%) breastfed their child at least once. The EBF rate was 46.7%, the continued BF rate at one year of age was 54.2%, and the continued BF rate at 2 years of age was 30.3%. The place of delivery and parental leave duration were strong determinants of EBF. The improving rates observed in this study for all the BF practices assessed suggest the continuation of efforts to develop effective national policies and programs for promoting, protecting, and supporting BF in Romania. Particular emphasis should be given to the creation in maternity hospitals of an environment that is supportive towards breastfeeding.
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Affiliation(s)
- Anamaria Cozma-Petruţ
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (A.C.-P.); (L.F.); (O.M.); (L.G.); (D.C.); (D.M.)
| | - Lorena Filip
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (A.C.-P.); (L.F.); (O.M.); (L.G.); (D.C.); (D.M.)
| | - Roxana Banc
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (A.C.-P.); (L.F.); (O.M.); (L.G.); (D.C.); (D.M.)
| | - Oana Mîrza
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (A.C.-P.); (L.F.); (O.M.); (L.G.); (D.C.); (D.M.)
| | - Laura Gavrilaş
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (A.C.-P.); (L.F.); (O.M.); (L.G.); (D.C.); (D.M.)
| | - Daniela Ciobârcă
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (A.C.-P.); (L.F.); (O.M.); (L.G.); (D.C.); (D.M.)
| | - Ioana Badiu-Tişa
- Department of Mother and Child Care, “Iuliu Haţieganu” University of Medicine and Pharmacy, 2–4 Câmpeni Street, 400217 Cluj-Napoca, Romania;
| | - Simona Codruţa Hegheş
- Department of Pharmaceutical Analysis, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania;
| | - Cristian Olimpiu Popa
- Department of European Studies, Babeș-Bolyai University, 1 E. de Martonne Street, 400090 Cluj-Napoca, Romania;
| | - Doina Miere
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (A.C.-P.); (L.F.); (O.M.); (L.G.); (D.C.); (D.M.)
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Park S, Yu SY, Kwak E, Min D. A comparative study of cumulative stress patterns within 14 days postpartum in healthy mothers and those with gestational diabetes: A prospective study. Medicine (Baltimore) 2021; 100:e27472. [PMID: 34731125 PMCID: PMC8519200 DOI: 10.1097/md.0000000000027472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/21/2021] [Indexed: 01/05/2023] Open
Abstract
Although the number of mothers with gestational diabetes mellitus (GDM) is on the rise, only few studies have examined the cumulative stress associated with breastfeeding after childbirth. GDM mothers are susceptible to stress due to insulin resistance, and their level of stress is associated with breastfeeding. This study aimed to identify patterns of stress change over time in GDM mothers and healthy mothers and to identify the factors influencing those patterns.The participants of this study were mothers within 14 days after childbirth. The GDM group consisted of 32 mothers, and the healthy group comprised 30 mothers. Cumulative stress was measured in terms of heart rate variability, and linear mixed models were used to analyze changes over time.The cumulative stress of healthy mothers was about 8 points higher than that of mothers with GDM (t = -2.95, P = .005). The cumulative stress level was inversely associated with the mother's age (β=-1.20, P = .018), the mother's weight (β=-0.64, P = .008), and the baby's body mass index (β=-3.09, P = .038). Furthermore, an insufficient amount of breast milk was associated with higher stress (β=16.09, P = .007).GDM mothers and healthy mothers experienced different patterns of cumulative stress. Breastfeeding should be started quickly to promote health and stress reduction among mothers who are physically and psychologically vulnerable after childbirth.It is necessary to incorporate programs to promote breastfeeding considering stress levels at an appropriate time according to the mother's health condition.
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Affiliation(s)
- Seungmi Park
- Department of Nursing Science, Chungbuk National University, Cheongju, Republic of Korea
| | - Soo-Young Yu
- Department of Nursing Science, Jeonju University, Jeonju, Republic of Korea
| | - Eunju Kwak
- Department of Nursing Science, Chungbuk National University, Cheongju, Republic of Korea
| | - Deulle Min
- Department of Nursing, College of Medicine, Wonkwang University, Iksan, Republic of Korea
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Safayi BL, Assimamaw NT, Kassie DG. Breastfeeding technique and associated factors among lactating mothers visiting Gondar town health facilities, Northwest Ethiopia: observational method. Ital J Pediatr 2021; 47:206. [PMID: 34641916 PMCID: PMC8507121 DOI: 10.1186/s13052-021-01158-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 09/21/2021] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND The breastfeeding technique is explained positioning, attachment, and suckling during breastfeeding. Ineffective breast feeding technique is one of the factors leading to premature discontinuation of breastfeeding and malnutrition. There is a limited study on the assessments of BFT and associated factors among lactating mothers in the study area. Therefore, the study aimed to assess breastfeeding technique and the associated factors among lactating mothers visiting Gondar town health facilities, Northwest Ethiopia. METHODS An institution-based cross-sectional study was conducted from February 20 to March 20, 2020. An observational checklist and structured interviewer-administered questionnaire were applied to collect the data. The data were entered into Epi-Data 4.6 version and transferred to analyzed using SPSS version 20. Bi-variable and multivariable logistic regressions were performed to identify the association. The strength of association was identified using odds ratio with a 95% confidence interval (), and a p-value of 0.05 was declare as statistically significant. RESULTS The proportion of effective BFT was 48% (95%, CI: 43.0-53.0%). The likelihood of applying proper BFT among age group of 18-20 years was 70% lower than (AOR = 0.3; 95% CI: 0.11-0.83) age group > 30 years. The odds of effective BFT in primipara mothers were 49% (AOR = 0.51; 95% CI: 0.32-0.82) lower compared to multiparous mothers. Likewise, the provability of effective BFT was 55% (AOR = 0.45; 95% CI: 0.29-0.70) times lower in women who had no counseling immediately after delivery compared to their counterparts. Moreover, effective breast feeding technique mothers who have breast problem was 78% lower than (AOR = 0.22; 95% CI: 0.07-0.68) mothers who have no breast problem. And mothers who had counselling of BFT during ANC follow up was 55% (AOR = 0.45; 95% CI: 0.29, 0.70) lower than mothers who had no counseling. CONCLUSION Just under half of the women in the study area applied proper breast feeding technique Younger and primipara mothers poorly performed to effective BFT. But women having counseling during antenatal care follow-up and immediately after delivery and not having breast problems applied BFT effectively. Hence, special emphasis have to give for younger and primipara mothers. Besides, educate the mother for preventing breast problems and working on enhancing counseling at postnatal clinic.
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Affiliation(s)
- Boko Loka Safayi
- Nursing Department, College of Health and Medical Sciences, Bule Hora University, Bule Hora, Ethiopia
| | - Nega Tezera Assimamaw
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, School of Nursing, University of Gondar, P.O .Box:196, Gondar, Ethiopia
| | - Destaye Guadie Kassie
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, School of Nursing, University of Gondar, P.O .Box:196, Gondar, Ethiopia
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Gazzolo D, Picone S, Gaiero A, Bellettato M, Montrone G, Riccobene F, Lista G, Pellegrini G. Early Pediatric Benefit of Lutein for Maturing Eyes and Brain-An Overview. Nutrients 2021; 13:3239. [PMID: 34579116 PMCID: PMC8468336 DOI: 10.3390/nu13093239] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 01/15/2023] Open
Abstract
Lutein is a dietary carotenoid preferentially accumulated in the eye and the brain in early life and throughout the life span. Lutein accumulation in areas of high metabolism and oxidative stress such as the eye and the brain suggest a unique role of this ingredient during the development and maturation of these organs of common embryological origin. Lutein is naturally provided to the developing baby via the cord blood, breast milk and then infant diet. The presence of this carotenoid depends on fruit and vegetable intakes and its bioavailability is higher in breastmilk. This paper aims to review the anatomical development of the eye and the brain, explore the presence and selective deposition of lutein in these organs during pregnancy and infancy and, based on its functional characteristics, present the latest available research on the beneficial role of lutein in the pediatric population. The potential effects of lutein in ameliorating conditions associated with increase oxidative stress such as in prematurity will be also addressed. Since consumption of lutein rich foods falls short of government guidelines and in most region of the world infant formulas lack this bioactive, dietary recommendations for pregnant and breastfeeding women and their child can help to bridge the gap.
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Affiliation(s)
- Diego Gazzolo
- Neonatal Intensive Care Unit, Department of Pediatrics, University G. d’Annunzio, 65100 Chieti, Italy
- Department of Pediatrics, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Simonetta Picone
- Neonatal Intensive Care Unit, Policlinico Casilino, 00169 Rome, Italy;
| | - Alberto Gaiero
- Pediatric and Neonatology Unit, asl2 Ospedale San Paolo Savona, 17100 Savona, Italy;
| | - Massimo Bellettato
- Department of Women and Child’s Health, San Bortolo Hospital, 36100 Vicenza, Italy;
| | - Gerardo Montrone
- S.S.V.D “NIDO E STEN” Ospedali Riuniti Foggia, 71122 Foggia, Italy;
| | | | - Gianluca Lista
- Neonatal Intensive Care Unit, Department of Pediatrics, Ospedale dei Bambini V. Buzzi, ASST-FBF-Sacco, 20154 Milan, Italy;
| | - Guido Pellegrini
- Department of Pediatrics and Neonatology, Presidio Ospedaliero “Città di Sesto San Giovanni, Sesto san Giovanni, 20099 Milan, Italy;
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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. Lancet Child Adolesc 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Geddes DT, Gridneva Z, Perrella SL, Mitoulas LR, Kent JC, Stinson LF, Lai CT, Sakalidis V, Twigger AJ, Hartmann PE. 25 Years of Research in Human Lactation: From Discovery to Translation. Nutrients 2021; 13:3071. [PMID: 34578947 PMCID: PMC8465002 DOI: 10.3390/nu13093071] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 08/26/2021] [Accepted: 08/26/2021] [Indexed: 02/06/2023] Open
Abstract
Researchers have recently called for human lactation research to be conceptualized as a biological framework where maternal and infant factors impacting human milk, in terms of composition, volume and energy content are studied along with relationships to infant growth, development and health. This approach allows for the development of evidence-based interventions that are more likely to support breastfeeding and lactation in pursuit of global breastfeeding goals. Here we summarize the seminal findings of our research programme using a biological systems approach traversing breast anatomy, milk secretion, physiology of milk removal with respect to breastfeeding and expression, milk composition and infant intake, and infant gastric emptying, culminating in the exploration of relationships with infant growth, development of body composition, and health. This approach has allowed the translation of the findings with respect to education, and clinical practice. It also sets a foundation for improved study design for future investigations in human lactation.
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Affiliation(s)
- Donna Tracy Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Sharon Lisa Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Leon Robert Mitoulas
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
- Medela, AG, Lättichstrasse 4b, 6340 Baar, Switzerland
| | - Jacqueline Coral Kent
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Lisa Faye Stinson
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Vanessa Sakalidis
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | | | - Peter Edwin Hartmann
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
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Muñoz-Esparza NC, Vásquez-Garibay EM, Guzmán-Mercado E, Larrosa-Haro A, Comas-Basté O, Latorre-Moratalla ML, Veciana-Nogués MT, Vidal-Carou MC. Influence of Breastfeeding Factors on Polyamine Content in Human Milk. Nutrients 2021; 13:nu13093016. [PMID: 34578894 PMCID: PMC8467147 DOI: 10.3390/nu13093016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 08/18/2021] [Indexed: 12/12/2022] Open
Abstract
The polyamine content of human breast milk, which is the first exogenous source of polyamines for the newborn, can be affected by several factors associated with the mother, the infant, or breastfeeding itself. The aim of this study was to evaluate the influence of different breastfeeding factors on the polyamines found in human milk. For this study, a cohort of 83 mothers was considered for up to 4 months, and a subgroup of 33 mothers were followed during the first six months of breastfeeding. Two breast milk samples were collected at each sampling point (foremilk and hindmilk) and the polyamine content was determined by UHPLC-FL. Polyamine levels varied considerably between the mothers and tended to decrease over time. Putrescine was the minor polyamine, whereas spermidine and spermine contents were very similar. The concentrations of the three polyamines were significantly higher in hindmilk than foremilk (p < 0.001). Spermidine and spermine levels decreased significantly through the lactation progress (p < 0.05). Finally, slightly higher levels of polyamines were observed in the milk of mothers providing partial, rather than full, breastfeeding, although the differences were not significant. The polyamine content in human milk was found to change during a single feed (foremilk versus hindmilk) and as lactation progressed, mainly in response to the specific circumstances of the newborn.
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Affiliation(s)
- Nelly C. Muñoz-Esparza
- Departament de Nutrició, Ciències de l’Alimentació i Gastronomia, Facultat de Farmàcia i Ciències de l’Alimentació, Campus de l’Alimentació de Torribera, Universitat de Barcelona, Av. Prat de la Riba 171, 08921 Santa Coloma de Gramenet, Spain; (N.C.M.-E.); (O.C.-B.); (M.L.L.-M.); (M.T.V.-N.)
- Institut de Recerca en Nutrició i Seguretat Alimentària (INSA·UB), Universitat de Barcelona, Av. Prat de la Riba 171, 08921 Santa Coloma de Gramenet, Spain
- Xarxa d’Innovació Alimentària (XIA), C/Baldiri Reixac 4, 08028 Barcelona, Spain
- Instituto de Nutrición Humana, Universidad de Guadalajara, Salvador Quevedo y Zubieta 750, Guadalajara 44360, Mexico; (E.M.V.-G.); (E.G.-M.); (A.L.-H.)
| | - Edgar M. Vásquez-Garibay
- Instituto de Nutrición Humana, Universidad de Guadalajara, Salvador Quevedo y Zubieta 750, Guadalajara 44360, Mexico; (E.M.V.-G.); (E.G.-M.); (A.L.-H.)
| | - Elizabeth Guzmán-Mercado
- Instituto de Nutrición Humana, Universidad de Guadalajara, Salvador Quevedo y Zubieta 750, Guadalajara 44360, Mexico; (E.M.V.-G.); (E.G.-M.); (A.L.-H.)
| | - Alfredo Larrosa-Haro
- Instituto de Nutrición Humana, Universidad de Guadalajara, Salvador Quevedo y Zubieta 750, Guadalajara 44360, Mexico; (E.M.V.-G.); (E.G.-M.); (A.L.-H.)
| | - Oriol Comas-Basté
- Departament de Nutrició, Ciències de l’Alimentació i Gastronomia, Facultat de Farmàcia i Ciències de l’Alimentació, Campus de l’Alimentació de Torribera, Universitat de Barcelona, Av. Prat de la Riba 171, 08921 Santa Coloma de Gramenet, Spain; (N.C.M.-E.); (O.C.-B.); (M.L.L.-M.); (M.T.V.-N.)
- Institut de Recerca en Nutrició i Seguretat Alimentària (INSA·UB), Universitat de Barcelona, Av. Prat de la Riba 171, 08921 Santa Coloma de Gramenet, Spain
- Xarxa d’Innovació Alimentària (XIA), C/Baldiri Reixac 4, 08028 Barcelona, Spain
| | - M. Luz Latorre-Moratalla
- Departament de Nutrició, Ciències de l’Alimentació i Gastronomia, Facultat de Farmàcia i Ciències de l’Alimentació, Campus de l’Alimentació de Torribera, Universitat de Barcelona, Av. Prat de la Riba 171, 08921 Santa Coloma de Gramenet, Spain; (N.C.M.-E.); (O.C.-B.); (M.L.L.-M.); (M.T.V.-N.)
- Institut de Recerca en Nutrició i Seguretat Alimentària (INSA·UB), Universitat de Barcelona, Av. Prat de la Riba 171, 08921 Santa Coloma de Gramenet, Spain
- Xarxa d’Innovació Alimentària (XIA), C/Baldiri Reixac 4, 08028 Barcelona, Spain
| | - M. Teresa Veciana-Nogués
- Departament de Nutrició, Ciències de l’Alimentació i Gastronomia, Facultat de Farmàcia i Ciències de l’Alimentació, Campus de l’Alimentació de Torribera, Universitat de Barcelona, Av. Prat de la Riba 171, 08921 Santa Coloma de Gramenet, Spain; (N.C.M.-E.); (O.C.-B.); (M.L.L.-M.); (M.T.V.-N.)
- Institut de Recerca en Nutrició i Seguretat Alimentària (INSA·UB), Universitat de Barcelona, Av. Prat de la Riba 171, 08921 Santa Coloma de Gramenet, Spain
- Xarxa d’Innovació Alimentària (XIA), C/Baldiri Reixac 4, 08028 Barcelona, Spain
| | - M. Carmen Vidal-Carou
- Departament de Nutrició, Ciències de l’Alimentació i Gastronomia, Facultat de Farmàcia i Ciències de l’Alimentació, Campus de l’Alimentació de Torribera, Universitat de Barcelona, Av. Prat de la Riba 171, 08921 Santa Coloma de Gramenet, Spain; (N.C.M.-E.); (O.C.-B.); (M.L.L.-M.); (M.T.V.-N.)
- Institut de Recerca en Nutrició i Seguretat Alimentària (INSA·UB), Universitat de Barcelona, Av. Prat de la Riba 171, 08921 Santa Coloma de Gramenet, Spain
- Xarxa d’Innovació Alimentària (XIA), C/Baldiri Reixac 4, 08028 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-4031984
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Juntereal NA, Spatz DL. Integrative Review of Antenatal Milk Expression and Mother-Infant Outcomes During the First 2 Weeks After Birth. J Obstet Gynecol Neonatal Nurs 2021; 50:659-668. [PMID: 34403651 DOI: 10.1016/j.jogn.2021.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To explore the practice of antenatal milk expression (AME) and related outcomes for mother-infant dyads during the first 2 weeks after birth. DATA SOURCES We searched the electronic databases MEDLINE, Embase, CINAHL, Emcare, Maternity & Infant Care Database, Scopus, and Web of Science for relevant literature. We also conducted backward reference searches on relevant publications and nondatabase searches after review of the full texts. STUDY SELECTION Articles were eligible for inclusion if they reported primary studies focused on AME, included samples of mother-infant dyads, and were published in English. We did not impose time or design limitations given the sparse availability of literature on AME. We identified 766 articles. After the removal of duplicates, we screened 588 articles, and of these, we included 15 articles in our review. DATA EXTRACTION We used the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines to guide data extraction and reporting. We evaluated the quality of evidence using the Melnyk and Fineout-Overholt rating system and the Joanna Briggs Institute critical appraisal tools. DATA SYNTHESIS We synthesized data from the included articles into four themes: Breastfeeding Self-Efficacy, Milk Supply, Infant Well-Being, and Infant Feeding Methods. CONCLUSION AME may support breastfeeding by improving breastfeeding self-efficacy and milk supply and by decreasing early formula use. Synthesized literature on AME shows the safety of the practice and that infants of women who practice AME have a greater likelihood of breastfeeding exclusivity during the short term.
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Affiliation(s)
- Diane L Spatz
- Dr. Diane L. Spatz is a Professor of Perinatal Nursing & the Helen M. Shearer Professor of Nutrition at the University of Pennsylvania. She holds a joint appointment with the Children's Hospital of Philadelphia (CHOP) where she is a nurse scientist for the lactation program & founder of CHOP's Mothers' Milk Bank. Dr. Spatz can be reached via email at
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Beal JA. Consensus Reached on Feeding Infants and Children. MCN Am J Matern Child Nurs 2021; 46:57. [PMID: 33284244 DOI: 10.1097/nmc.0000000000000679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Judy A Beal
- Dr. Judy A. Beal is a Professor and Dean Emerita, College of Natural, Behavioral, and Health Sciences, Simmons University, Boston, MA. Dr. Beal can be reached via email at
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Felício JS, de Alcântara AL, Janaú LC, de Moraes LV, de Oliveira MCNI, de Lemos MN, de Souza Neto NJK, Neto JFA, da Silva WM, de Souza ÍJA, Said NM, de Lemos GN, Vieira GM, Khayat AS, dos Santos ÂKCR, de Queiroz NNM, de Sousa ACCB, dos Santos MC, de Melo FTC, Piani PPF, Felício KM. Association of Soy and Exclusive Breastfeeding With Central Precocious Puberty: A Case-Control Study. Front Endocrinol (Lausanne) 2021; 12:667029. [PMID: 34290667 PMCID: PMC8287825 DOI: 10.3389/fendo.2021.667029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/11/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction While soy is suggested as a possible risk factor, exclusive breastfeeding (EBF) has a likely protective effect in precocious puberty. Our aim was to evaluate the association between both of these variables with central precocious puberty (CPP). Methods We performed a retrospective, case-control study. A total of 161 girls were divided into two groups: 84 patients diagnosed with CPP composed the case group and 77 patients without the diagnosis of CPP (had gone through normal onset of puberty) were the control group. Results Our control group had a higher presence of EBF >6 months, which was an important protective factor for CPP (OR: 0.5; IC 95%: 0.3-0.9, p = 0.05) and also correlated negatively with the presence of it (r = -0.2; p < 0.05). Oppositely, the use of soy was significantly higher in the CPP group, (OR: 3.8; IC 95%: 1.5-6, p < 0.05) and positively correlating (r = 0.2; p < 0.01) with the presence of CPP. Duration of soy intake (years) correlated with bone age (r = 0.415; p < 0.05). A logistic regression was performed to evaluate the effects of EBF duration and soy on CPP. The model was significant (x² (2) = 20,715, p = <0.001) and explained 12.2% (Nagelkerke R2) of the variance, correctly classifying 62.5% of cases. EBF was associated with a reduction of likelihood of having CPP [OR = 0,187 (CI = 0.055-0,635); Wald = 7,222, p = 0.007], while soy intake increased the risk [OR = 3.505 (CI) = 1,688-7,279, Wald = 11,319, p = 0.001]. Conclusion Our data found the use of soy was associated with CPP. Additionally, EBF was pointed as a protective factor. However, future prospective studies are needed to clarify this issue.
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Affiliation(s)
- João Soares Felício
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Brazil
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Machold CA, O'Rinn SE, McKellin WH, Ballantyne G, Barrett JFR. Women's experiences of skin-to-skin cesarean birth compared to standard cesarean birth: a qualitative study. CMAJ Open 2021; 9:E834-E840. [PMID: 34465580 PMCID: PMC8428890 DOI: 10.9778/cmajo.20200079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Skin-to-skin contact between mother and infant immediately after birth is recommended regardless of delivery method; however, it is less common after cesarean delivery. We aimed to describe and compare women's experiences of cesarean birth with and without skin-to-skin contact at an urban tertiary care hospital. METHODS In this hermeneutic phenomenologic study, we used semistructured telephone interviews from 2015 to 2018 to interview a convenience sample of women who delivered at term by scheduled skin-to-skin cesarean birth at an urban tertiary care hospital in Toronto, Ontario. Women were invited to participate if they had had a previous planned or unplanned cesarean birth and a scheduled skin-to-skin cesarean birth between 2013 and 2017. Participants were excluded if they had antenatally diagnosed conditions, they delivered before 37 weeks, they had general anesthesia, their condition was unstable at the time of surgery, a skin-to-skin cesarean birth was not possible or they declined skin-to-skin cesarean birth. Interviews were recorded, transcribed and analyzed by means of thematic analysis. RESULTS Ten women were interviewed 1-19 months postpartum. Four central themes emerged: support for skin-to-skin cesarean birth (women feeling supported by their families and health care providers); control (participants experiencing greater control during their skin-to-skin cesarean birth); connection with the infant, which enabled women to be active participants in their delivery, enhanced bonding and intimacy, facilitated breastfeeding and bolstered confidence during early parenthood; and logistic considerations, with participants recognizing that skin-to-skin cesarean birth required additional resources. INTERPRETATION These findings refine what is known about skin-to-skin cesarean birth and provide a critical perspective, that of mothers. They support the transformation of traditional operating room dynamics to a more patient-centred environment.
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Affiliation(s)
- Clea A Machold
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont.
| | - Susan E O'Rinn
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont
| | - William H McKellin
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont
| | - Gillian Ballantyne
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont
| | - Jon F R Barrett
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont
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Abstract
As nurses, we must continue to promote and protect the use of human milk and breastfeeding during and after the COVID-19 pandemic. We should continue access to online and virtual breastfeeding help but expand opportunities for in-person technical breastfeeding assistance in pediatric offices and in the community. Our breastfeeding expert, Dr. Spatz, offers suggestions for promoting breastfeeding during the pandemic and beyond.
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Affiliation(s)
- Diane L Spatz
- Dr. Diane L. Spatz is a Professor of Perinatal Nursing & the Helen M. Shearer Professor of Nutrition at the University of Pennsylvania. She holds a joint appointment with the Children's Hospital of Philadelphia (CHOP) where she is a nurse scientist for the lactation program & founder of CHOP's Mothers' Milk Bank. Dr. Spatz can be reached via email at
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Affiliation(s)
- Margot Robinson
- Brown University, Department of Family Medicine, Pawtucket, Rhode Island
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Kyei-Arthur F, Agyekum MW, Afrifa-Anane GF. The association between paternal characteristics and exclusive breastfeeding in Ghana. PLoS One 2021; 16:e0252517. [PMID: 34081726 PMCID: PMC8174696 DOI: 10.1371/journal.pone.0252517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/17/2021] [Indexed: 12/29/2022] Open
Abstract
Background Studies have shown that partners play an influential role in exclusive breastfeeding practice and that they can act as either deterrents or supporters to breastfeeding. However, there are limited studies on the influence of partners’ characteristics on exclusive breastfeeding in Ghana. This study examined the association between partners’ characteristics and exclusive breastfeeding in Ghana. Methods This cross-sectional study used data from the 2014 Ghana Demographic and Health Survey. Infants less than 6 months old (exclusively breastfed or not) with maternal and paternal characteristics were included in the study. A total of 180 participants were used for the study. A binary logistic regression was used to examine the influence of partners’ characteristics on exclusive breastfeeding. Results Partners’ characteristics such as education, desire for children, religion, and children ever born were associated with exclusive breastfeeding. Mothers whose partners had primary education (AOR = 0.12; CI 95%: 0.02–0.93; p = 0.04) were less likely to practice exclusive breastfeeding compared to those whose partners had no formal education. Also, mothers whose partners desired more children (AOR = 0.20; CI 95%: 0.06–0.70; p = 0.01) were less likely to practice exclusive breastfeeding compared to those whose partners desire fewer children. Conclusion Improving EBF requires the involvement of partners in exclusive breastfeeding campaigns/programmes. A more couple-oriented approach is required by health practitioners to educate and counsel both mothers and partners on the importance of exclusive breastfeeding in Ghana.
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Affiliation(s)
- Frank Kyei-Arthur
- Regional Institute for Population Studies, University of Ghana, Legon, Accra, Ghana
- * E-mail:
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