151
|
Costa JA, Mambié M, Verd S. The hidden treasure of gestational diabetes-mediated myocardial function. Diabetes Res Clin Pract 2024; 207:111049. [PMID: 38070542 DOI: 10.1016/j.diabres.2023.111049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 02/10/2024]
Affiliation(s)
- Juan-Antonio Costa
- Cardiology Unit, Department of Paediatrics, Ca'n Misses District Hospital, Corona Street, 07800 Eivissa, Spain.
| | - Marianna Mambié
- La Vileta Surgery, Paediatric Unit, Department of Primary Care, Matamusinos Street, 07013 Palma de Mallorca, Spain.
| | - Sergio Verd
- La Vileta Surgery, Paediatric Unit, Department of Primary Care, Matamusinos Street, 07013 Palma de Mallorca, Spain; Balearic Institute of Medical Research (IdISBa), Valldemossa Road, 07120 Palma de Mallorca, Spain.
| |
Collapse
|
152
|
Onur H, Rahmanalı Onur A, Aslan Ö. The relationship between nutrition and micronutrients in healthy Turkish infants and young children. Arch Pediatr 2024; 31:15-19. [PMID: 37940505 DOI: 10.1016/j.arcped.2023.08.013] [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: 11/19/2022] [Revised: 05/05/2023] [Accepted: 08/22/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND A healthy diet is important at every stage of life. We aimed to determine the serum vitamin D and iron, folic acid, and vitamin B12 levels in healthy children younger than 48 months and to investigate the relationship between nutrition and micronutrients in children of this age. METHODS In this observational study children who presented to the Pediatrics Clinic of our hospital during the period 2015-2022 were included. Vitamin D and other nutritional parameters (serum folate, vitamin B12, iron, ferritin) were evaluated from the study participants' serum samples during the outpatient clinic visit (jaundice check-up, pre-circumcision surgery, etc.). RESULTS Overall, 766 cases were included in the study. Vitamin D was higher in the group that was fed only breast milk (p = 0.019), and vitamin D insufficiency was statistically higher in the formula group (p = 0.015). Hemoglobin levels were significantly higher in the formula group (p = 0.007). The folic acid level was found to be normal in all infants, and was higher in formula-fed infants (p = 0.012). Vitamin B12 was found to be significantly higher in infants fed with formula (p = 0.001). Vitamin D deficiency was most common in infants aged 25-48 months (p < 0.001). Similarly, vitamin D insufficiency (12-20 ng/mL) was detected in infants aged between 25 and 48 months (p < 0.001). CONCLUSION Micronutrients such as calcium, folic acid, iron, vitamin D, and iodine are critical in early fetal development from pregnancy onward. It is vital to raise awareness of this issue for mothers, starting from pregnancy, and for mothers to feed their babies more carefully in the first years of life.
Collapse
Affiliation(s)
- Hakan Onur
- Department of Pediatrics, Private Memorial Hospital, Diyarbakir, Turkey.
| | - Arzu Rahmanalı Onur
- Department of Microbiology, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey
| | - Özgür Aslan
- Department of Biochemistry, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey
| |
Collapse
|
153
|
Martín-Ramos S, Domínguez-Aurrecoechea B, García Vera C, Lorente García Mauriño AM, Sánchez Almeida E, Solís-Sánchez G. [ Breastfeeding in Spain and the factors related to its establishment and maintenance: LAyDI Study (PAPenRed)]. Aten Primaria 2024; 56:102772. [PMID: 37741187 PMCID: PMC10520303 DOI: 10.1016/j.aprim.2023.102772] [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: 05/02/2023] [Revised: 08/21/2023] [Accepted: 08/26/2023] [Indexed: 09/25/2023] Open
Abstract
OBJECTIVE To find out actual statistics on breastfeeding in Spain, as well as sociocultural and perinatal factors that affect its initiation and maintenance. DESIGN Prospective, multicentre, longitudinal, nationwide study (XXX study). SITE: Primary care paediatricians' office. PARTICIPANTS Cohort of newborns born between April 2017 and March 2018 in Spain who were followed up to two years of age in 8 visits. MAIN MEASURES Rates of different types of breastfeeding were analysed at each visit and variables related to gestation, delivery, neonatal period, social, economic and biological variables were also analysed. RESULTS Initial sample of 1946 (50.1% male). 90.7% decided to initiate breastfeeding at birth. Exclusive breastfeeding (EBF) was 66.4% at 15days and 35.2% at 6months. Any type of breastfeeding (total breastfeeding [TBF]) at 6months was 61.7%. Median survival from TBF was 6.0months (95%CI: 6.0-6.1). Variables related to EBF at 15days: previous children, mother's level of education, absence of illness during pregnancy, no separation of mother and child at birth, no dummy use, no nipple problems, and time of decision to breastfeed. Variables related to longer duration of TBF: relationship of parents older than 5years, no dummy use, co-sleeping at one month of life, deciding to breastfeed before pregnancy, receiving information on breastfeeding during pregnancy and using support from associations. CONCLUSIONS Early abandonment of breastfeeding is a major problem in Western societies. There are factors that can be worked on to improve outcomes.
Collapse
Affiliation(s)
- Silvia Martín-Ramos
- Servicio de Pediatría, Unidad de Neonatología, Hospital Río Hortega, Valladolid, España.
| | - Begoña Domínguez-Aurrecoechea
- Pediatría de Atención Primaria, Miembro del equipo coordinador PAPenRed, Instituto de investigación sanitaria del Principado de Asturias (ISPA), Oviedo, España
| | - César García Vera
- Pediatría, Centro de Salud «José Ramón Muñoz Fernandez», Coordinador de la red de investigación PAPenRED, Profesor Asociado de la Facultad de Medicina de la Universidad de Zaragoza, Zaragoza, España
| | - Ana María Lorente García Mauriño
- Pediatría de Atención Primaria, Centro de Salud Juan de la Cierva, Miembro del Equipo Coordinador nacional de PAPenRED y Coordinadora autonómica de PAPenRED por la Comunidad de Madrid, Getafe, Madrid, España
| | - Elena Sánchez Almeida
- Pediatría de Atención Primaria, Centro de Salud La Guancha-San Juan de la Rambla, Miembro del Equipo Coordinador nacional de PAPenRED y Coordinadora autonómica por la Comunidad de Canarias, Formadora en lactancia materna por la IHAN, Miembro de la Comisión de lactancia materna de atención primaria de Tenerife, Presidenta de la Asociación de Pediatría de atención primaria de Canarias, La Guancha, Santa Cruz de Tenerife, España
| | - Gonzalo Solís-Sánchez
- Servicio de Pediatría, Unidad Neonatología, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Universidad de Oviedo, Oviedo, España
| |
Collapse
|
154
|
Rojo Gutiérrez MI, Moncayo-Coello CV. [Prevention in food allergies]. Rev Alerg Mex 2023; 70:293-296. [PMID: 38506874 DOI: 10.29262/ram.v70i4.1314] [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: 08/01/2023] [Accepted: 10/29/2023] [Indexed: 03/21/2024] Open
Abstract
Preventing food allergies is key to reducing the incidence of the disease. Exclusive breastfeeding is recommended during the first months of life, in addition to supplementation with vitamin D and, due to the importance of the microbiota, addition of probiotics, prebiotics and symbiotic. Currently, late exposure to foods is controversial, and it is suggested to introduce allergenic foods early, trying not to expose the cutaneous route. The application of biologics in food allergy is an evolving area of research and treatment. Biologics are indicated in diseases evaluated in various studies, such as atopic dermatitis, and are approved by the FDA for prescription; However, its potential administration in the treatment of severe allergic reactions caused by food is still debated. These therapies may change the way food allergy is addressed in the future, but they are still in experimental stages and not widely available. Food anaphylaxis is a life-threatening allergic reaction that requires quick action. Prevention involves avoiding the triggering food, awareness of symptoms, and availability of epinephrine for immediate administration in case of a reaction.
Collapse
Affiliation(s)
- María Isabel Rojo Gutiérrez
- Pediatra, Alergóloga e Inmunóloga; profesora de Alergia pediátrica, Facultad de Medicina; Presidenta electa de la Sociedad Latinoamericana de Alergia, Asma e Inmunología (SLAAI) Montevideo,
| | | |
Collapse
|
155
|
Acevedo-Bedoya SY, Londoño-Sierra DC, Sterling-Villada MDLA, Osorio-Posada A, Garnica-Cardona C, Restrepo-Mesa SL. Breastfeeding experiences from the perspective of the breastfeeding woman: qualitative study. Rev Colomb Obstet Ginecol 2023; 74:287-296. [PMID: 38421224 PMCID: PMC10911416 DOI: 10.18597/rcog.4105] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/21/2023] [Indexed: 03/02/2024]
Abstract
Objectives To understand the breastfeeding experience from the perspective of a group of women who breastfeed for the first time. Materials and Methods Qualitative study from an ethnographic perspective, focusing on a group of women from the eastern region of the Department of Antioquia (Colombia). Intentional sampling until data saturation was used. The group included 16 first-time breastfeeding mothers aged 18 or older, with children under 24 months of age and who were breastfeeding or had breastfed exclusively for at least three months. Semi-structured interviews and participant observations were carried out. Data were analyzed by triangulation and open and axial coding. The results are presented in the form of category descriptions. Results Four categories were identified in relation to the breastfeeding experience: exhaustion and pain dispelled by love, breastfeeding and the new order of things, emotions of a woman embodied in a mother, and breastfeeding as a social act. Conclusions Protection of breastfeeding requires special attention to the woman as a subject beyond the act of breastfeeding, giving priority to her physical and emotional health as essential elements that must be kept in mind by healthcare professionals. Studies to assess the effects of creating support groups that foster the exchange of insights to help the breastfeeding woman are required.
Collapse
|
156
|
Evenson KR, Brown WJ, Brinson AK, Budzynski-Seymour E, Hayman M. A review of public health guidelines for postpartum physical activity and sedentary behavior from around the world. J Sport Health Sci 2023:S2095-2546(23)00130-8. [PMID: 38158180 DOI: 10.1016/j.jshs.2023.12.004] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The period following pregnancy is a critical time window when future habits with respect to physical activity (PA) and sedentary behavior (SB) are established; therefore, it warrants guidance. The purpose of this scoping review was to summarize public health-oriented country-specific postpartum PA and SB guidelines worldwide. METHODS To identify guidelines published since 2010, we performed a (a) systematic search of 4 databases (CINAHL, Global Health, PubMed, and SPORTDiscus), (b) structured repeatable web-based search separately for 194 countries, and (c) separate web-based search. Only the most recent guideline was included for each country. RESULTS We identified 22 countries with public health-oriented postpartum guidelines for PA and 11 countries with SB guidelines. The continents with guidelines included Europe (n = 12), Asia (n = 5), Oceania (n = 2), Africa (n = 1), North America (n = 1), and South America (n = 1). The most common benefits recorded for PA included weight control/management (n = 10), reducing the risk of postpartum depression or depressive symptoms (n = 9), and improving mood/well-being (n = 8). Postpartum guidelines specified exercises to engage in, including pelvic floor exercises (n = 17); muscle strengthening, weight training, or resistance exercises (n = 13); aerobics/general aerobic activity (n = 13); walking (n = 11); cycling (n = 9); and swimming (n = 9). Eleven guidelines remarked on the interaction between PA and breastfeeding; several guidelines stated that PA did not impact breast milk quantity (n = 7), breast milk quality (n = 6), or infant growth (n = 3). For SB, suggestions included limiting long-term sitting and interrupting sitting with PA. CONCLUSION Country-specific postpartum guidelines for PA and SB can help promote healthy behaviors using a culturally appropriate context while providing specific guidance to public health practitioners.
Collapse
Affiliation(s)
- Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8050, USA.
| | - Wendy J Brown
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Alison K Brinson
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3115, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8120, USA
| | | | - Melanie Hayman
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia
| |
Collapse
|
157
|
Corsi Decenti E, Salvatore MA, Mandolini D, Sampaolo L, D'Aloja P, Donati S. Perinatal care in SARS-CoV-2 infected women: the lesson learnt from a national prospective cohort study during the pandemic in Italy. BMC Public Health 2023; 23:2562. [PMID: 38129838 PMCID: PMC10740257 DOI: 10.1186/s12889-023-17390-0] [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] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Despite the growing importance given to ensuring high-quality childbirth, perinatal good practices have been rapidly disrupted by SARS-CoV-2 pandemic. This study aimed at describing the childbirth care provided to infected women during two years of COVID-19 emergency in Italy. METHODS A prospective cohort study enrolling all women who gave birth with a confirmed SARS-CoV-2 infection within 7 days from hospital admission in the 218 maternity units active in Italy during the periods February 25, 2020-June 30, 2021, and January 1-May 31, 2022. Perinatal care was assessed by evaluating the prevalence of the following indicators during the pandemic: presence of a labour companion; skin-to-skin; no mother-child separation at birth; rooming-in; breastfeeding. Logistic regression models including women' socio-demographic, obstetric and medical characteristics, were used to assess the association between the adherence to perinatal practices and different pandemic phases. RESULTS During the study period, 5,360 SARS-CoV-2 positive women were enrolled. Overall, among those who had a vaginal delivery (n = 3,574; 66.8%), 37.5% had a labour companion, 70.5% of newborns were not separated from their mothers at birth, 88.1% were roomed-in, and 88.0% breastfed. These four indicators showed similar variations in the study period with a negative peak between September 2020 and January 2021 and a gradual increase during the Alpha and Omicron waves. Skin-to-skin (mean value 66.2%) had its lowest level at the beginning of the pandemic and gradually increased throughout the study period. Among women who had a caesarean section (n = 1,777; 33.2%), all the indicators showed notably worse outcomes with similar variations in the study period. Multiple logistic regression analyses confirm the observed variations during the pandemic and show a lower adherence to good practices in southern regions and in maternity units with a higher annual number of births. CONCLUSIONS Despite the rising trend in the studied indicators, we observed concerning substandard childbirth care during the SARS-CoV-2 pandemic. Continued efforts are necessary to underscore the significance of the experience of care as a vital component in enhancing the quality of family-centred care policies.
Collapse
Affiliation(s)
- Edoardo Corsi Decenti
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore Di Sanità - Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Michele Antonio Salvatore
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore Di Sanità - Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| | - Donatella Mandolini
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore Di Sanità - Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| | - Letizia Sampaolo
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore Di Sanità - Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| | - Paola D'Aloja
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore Di Sanità - Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| | - Serena Donati
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore Di Sanità - Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
| |
Collapse
|
158
|
Brown HK, Pablo L, Scime NV, Aker AM, Dennis CL. Maternal disability and initiation and duration of breastfeeding: analysis of a Canadian cross-sectional survey. Int Breastfeed J 2023; 18:70. [PMID: 38129879 PMCID: PMC10734132 DOI: 10.1186/s13006-023-00608-7] [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: 08/28/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND The World Health Organization recommends breastfeeding as the best method for infant feeding. Known risk factors for breastfeeding non-initiation and early cessation of breastfeeding are diverse and include low breastfeeding self-efficacy, poverty, smoking, obesity, and chronic illness. Although women with disabilities experience elevated rates of these risk factors, few studies have examined their breastfeeding outcomes. Our objective was to examine breastfeeding non-initiation and early cessation of breastfeeding in women with and without disabilities. METHODS We used data from the 2017-2018 Canadian Community Health Survey. Included were n = 4,817 women aged 15-55 years who had a birth in the last five years, of whom 26.6% had a disability, ascertained using the Washington Group Short Set on Functioning. Prevalence ratios (aPR) of breastfeeding non-initiation, and of early cessation of any and exclusive breastfeeding before 6 months, were calculated for women with versus without disabilities. We also examined disability by severity (moderate/severe and mild, separately) and number of action domains impacted (≥ 2 and 1, separately). The main multivariable models were adjusted for maternal age, marital status, level of education, annual household income level, and immigrant status. RESULTS There were no differences between women with and without disabilities in breastfeeding non-initiation (9.6% vs. 8.9%; aPR 0.88, 95% CI 0.63, 1.23). Women with disabilities were more likely to have early cessation of any (44.4% vs. 35.7%) and exclusive breastfeeding before 6 months (66.9% vs. 61.3%), with some attenuation in risk after adjustment for sociodemographic factors (aRR 1.15, 95% CI 0.99, 1.33 and aRR 1.07, 95% 0.98, 1.16, respectively). Disparities were larger for women with moderate/severe disabilities and disabilities in ≥ 2 domains, with differences attenuated by adjustment for socio-demographics. CONCLUSIONS Women with disabilities, and particularly those with moderate/severe and multiple disabilities, could benefit from tailored, accessible breastfeeding supports that attend to the social determinants of health.
Collapse
Affiliation(s)
- Hilary K Brown
- Department of Health & Society, University of Toronto Scarborough, Toronto, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
| | - Lesley Pablo
- Department of Health & Society, University of Toronto Scarborough, Toronto, ON, Canada
| | - Natalie V Scime
- Department of Health & Society, University of Toronto Scarborough, Toronto, ON, Canada
| | - Amira M Aker
- Department of Health & Society, University of Toronto Scarborough, Toronto, ON, Canada
| | - Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, Toronto, ON, Canada
- Lunenfeld-Tannenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
159
|
Monteith H, Mamakeesick M, Rae J, Galloway T, Harris SB, Birken C, Hamilton J, Maguire JL, Parkin P, Zinman B, Hanley AJG. Determinants of Anishinabeck infant and early childhood growth trajectories in Northwestern Ontario, Canada: a cohort study. BMC Pediatr 2023; 23:641. [PMID: 38115010 PMCID: PMC10729431 DOI: 10.1186/s12887-023-04449-5] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND The Developmental Origins of Health and Disease (DOHaD) paradigm emphasizes the significance of early life factors for the prevention of chronic health conditions, like type 2 diabetes (T2DM) and obesity, which disproportionately affect First Nations communities in Canada. Despite increasing DOHaD research related to maternal health during pregnancy, early childhood growth patterns, and infant feeding practices with many populations, data from First Nations communities in Canada are limited. In partnership with Sandy Lake First Nation, the aims of this project were to characterize birthweights and growth patterns of First Nations infants/children over the first 6 years of life and to study the impact of maternal and infant social and behavioral factors on birthweight and growth trajectories. METHODS We recruited 194 families through community announcements and clinic visits. Infant/child length/height and weight were measured at 1 and 2 weeks; 1, 2, 6, 12, and 18 months; and 2, 3, 4, 5 and 6 years. Maternal and infant/child questionnaires captured data about health, nutrition, and social support. Weight-for-Age z-score (WAZ), Height-for-Age z-score (HAZ), and BMI-for-Age z-score (BAZ) were calculated using WHO reference standards and trajectories were analyzed using generalized additive models. Generalized estimating equations and logistic regression were used to determine associations between exposures and outcomes. RESULTS WAZ and BAZ were above the WHO mean and increased with age until age 6 years. Generalized estimating equations indicated that WAZ was positively associated with age (0.152; 95% CI 0.014, 0.29), HAZ was positively associated with birthweight (0.155; 95% CI 0.035, 0.275), and BAZ was positively associated with caregiver's BMI (0.049; 95% CI 0.004, 0.090). There was an increased odds of rapid weight gain (RWG) with exposure to gestational diabetes (OR: 7.47, 95% CI 1.68, 46.22). Almost 70% of parents initiated breastfeeding, and breastfeeding initiation was modestly associated with lower WAZ (-0.18; 95% CI -0.64, 0.28) and BAZ (-0.23; 95% CI -0.79, 0.34). CONCLUSIONS This work highlights early life factors that may contribute to T2DM etiology and can be used to support community and Indigenous-led prevention strategies.
Collapse
Affiliation(s)
- Hiliary Monteith
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, University of Toronto Medical Sciences Building, 5Th Floor, Room 5253A, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | | | - Joan Rae
- Sandy Lake First Nation, Sandy Lake, ON, P0V 1V0, Canada
| | - Tracey Galloway
- Department of Anthropology, University of Toronto Mississauga Campus, Terrence Donnelly Health Sciences Complex, Room 354, 3359 Mississauga Rd, Mississauga, ON, L5L 1C6, Canada
| | - Stewart B Harris
- Schulich School of Medicine and Dentistry, Western Centre for Public Health & Family Medicine, Western University, 1465 Richmond St, London, N6G 2M1, ON, Canada
| | - Catherine Birken
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, University of Toronto Medical Sciences Building, 5Th Floor, Room 5271, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Jill Hamilton
- Division of Endocrinology, Hospital for Sick Children, Department of Nutritional Sciences, University of Toronto, 555 University Ave, Toronto, ON, M5S 1X8, Canada
| | - Jonathon L Maguire
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, University of Toronto Medical Sciences Building, 5Th Floor, Room 5271, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Patricia Parkin
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, University of Toronto Medical Sciences Building, 5Th Floor, Room 5271, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Bernard Zinman
- Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, 600 University Ave, Toronto, ON, M5G 1X5, Canada
| | - Anthony J G Hanley
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, University of Toronto Medical Sciences Building, 5Th Floor, Room 5253A, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
| |
Collapse
|
160
|
Ferreira LB, Tirapeli KG, Silva CC, Goldberg TBL. Lumbar spine bone mineral density in women breastfeeding for a period of 4 to 6 months: systematic review and meta-analysis. Int Breastfeed J 2023; 18:68. [PMID: 38111005 PMCID: PMC10729562 DOI: 10.1186/s13006-023-00607-8] [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: 07/19/2022] [Accepted: 12/08/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND During the breastfeeding period, important transient changes in calcium homeostasis are verified in the maternal skeleton, to meet the demand for calcium for breastmilk production. The literature is inconclusive regarding the causes and percentages of involvement of bone densitometry resulting from exclusive breastfeeding (4 to 6 months). METHODS This article aims to systematically review the literature, to determine the occurrence, intensity, and factors involved in alterations in maternal bone mineral density (BMD), during a period of 4 to 6 months of exclusive breastfeeding. The search descriptors "woman", "breastfeeding", "human milk", and "bone mineral density" were used in the electronic databases of the Virtual Health Library, Scielo (Scientific Electronic Library Online), CAPES Periodicals Portal, LILACS, Embase, PubMed/Medline, Cochrane, Scopus, and Web of Science in June 2023. Inclusion criteria for breastfeedingmothers were; aged to 40 years, primigravida, exclusively breastfeeding, with BMD assessments using dual-energy X-ray absorptiometry (DXA), with values expressed at baseline and from 4 to 6 months postpartum. The Jadad scale, Newcastle-Ottawa Scale, and Oxford Centre for Evidence-based Medicine - levels of evidence were adopted to assess the quality of the studies. For the meta-analytical study, statistical calculations were performed. RESULTS Initially, 381 articles were found using the search strategy and 26 were read in full. After risk of bias analysis, 16 articles remained in the systematic review and four were included in the meta-analysis. The studies showed a reduction in bone mass in the lumbar spine in the first months postpartum (4 - 6 months), when compared with a longer period of breastfeeding (12-18 months). The breastfeeding group presented a greater impact in the meta-analysis than the control group (non-breastfeeding, pregnant, or immediate postpartum), with a reduction in BMD in the lumbar spine of -0.18 g/cm2 (-0.36, -0.01 g/cm2); 95% Confidence Interval, on a scale from 0 to 10. CONCLUSIONS Our results demonstrated a transitory reduction in bone densitometry of the lumbar spine during exclusive breastfeeding for 4 to 6 months, which was gradually restored later in the postpartum period. More prospective studies are needed to better understand the topic. TRIAL REGISTRATION PROSPERO platform (nº CRD42021279199), November 12th, 2021.
Collapse
Affiliation(s)
- Larissa Brazolotto Ferreira
- Postgraduate Program in Tocogynecology, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Keny Gonçalves Tirapeli
- Postgraduate Program in Tocogynecology, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Carla Cristiane Silva
- Department of Human Movement Studies, Londrina State University (UEL), Londrina, Brazil
| | - Tamara Beres Lederer Goldberg
- Postgraduate Program in Tocogynecology, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
| |
Collapse
|
161
|
Hu X, Xiong D, Luo M, Ling C, Liu X, Yang K, Wen X. Retrospective analysis on the efficacy of epidural labor analgesia on early breast feeding after vaginal delivery. BMC Anesthesiol 2023; 23:413. [PMID: 38097947 PMCID: PMC10720227 DOI: 10.1186/s12871-023-02373-w] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/06/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Breastfeeding is essential for infants and mothers. Epidural labor analgesia is used frequently to alleviate pain during vaginal delivery. Studies have found that epidural labor analgesia potentially have negative effects on postpartum breastfeeding. However, the efficacy of epidural labor analgesia on early breastfeeding after vaginal delivery is unclear. Therefore, a retrospective analysis was performed to illuminate the efficacy of epidural labor analgesia on postpartum breast feeding. METHODS A total of 392 women who received vaginal delivery in the Second People's Hospital of Foshan from July 2022 to June 2023 were selected for this study, and all women received epidural labor analgesia and were divided into three groups according to the efficacy of labor analgesia. There were three groups: parturients with VAS scores < 3 were divided into Group E (n = 192), parturients with VAS scores 4-6 were divided into Group M (n = 127), and parturients with VAS scores > 7 were divided into Group P (n = 73). The labor process, lactation initiation time, and incidence of delayed onset of lactation were analyzed. The lactation volume and time and LATCH score at 24, 48 and 72 h after vaginal delivery were also analyzed. RESULTS There was no significant difference in labor process times among the three groups (P > 0.05). The cases of prolactin use in Group M were less than those in Group E and Group P, with a significant difference (all P < 0.05). There was no significant difference in cases of prolactin use between Group E and Group P (P > 0.05). The lactation initiation time in Group M was significantly shorter than those in Group E and Group P (all P>0.05). There was no significant difference in lactation initiation time after vaginal delivery between Group E and Group P (P>0.05). The incidence of delayed onset of lactation in Group M was significantly lower those that in Group E and Group P (all P < 0.05). There was no statistically significant difference in the incidence of delayed onset of lactation between Group E and Group P (P > 0.05). The lactation volumes at 24, 48 and 72 h after vaginal delivery in Group M were significantly higher than those in Group E and Group P (all P < 0.05). There was no significant difference in lactation volume at 24, 48 and 72 h after vaginal delivery between Group E and Group P (P > 0.05). The lactation times at 24, 48 and 72 h after vaginal delivery in Group M were significantly higher than those in Group E and Group P (all P < 0.05). There was no significant difference in lactation times at 24, 48 and 72 h after vaginal delivery between Group E and Group P (P > 0.05). There was no significant difference in LATCH scores at 24, 48 and 72 h after vaginal delivery among the three groups (all P > 0.05). CONCLUSIONS Compared with labor analgesia with excellent and poor analgesia efficacy, labor analgesia with moderate analgesia efficacy has fewer cases of prolactin use, more lactation volume and time, a shorter lactation initiation time, a lower incidence of delayed onset of lactation and no effect on the LATCH score of breastfeeding.
Collapse
Affiliation(s)
- Xudong Hu
- Department of Anesthesiology, The Second People's Hospital of Foshan, Weiguo Road NO78, Destrict of Chancheng, Foshan City, Guangdong Province, China, 528000
| | - Dongqin Xiong
- Department of Obstetrics, The Second People's Hospital of Foshan, Weiguo Road NO78, Destrict of Chancheng, Foshan City, Guangdong Province, China, 528000
| | - Meifang Luo
- Department of Obstetrics, The Second People's Hospital of Foshan, Weiguo Road NO78, Destrict of Chancheng, Foshan City, Guangdong Province, China, 528000
| | - Chen Ling
- Department of Anesthesiology, The Second People's Hospital of Foshan, Weiguo Road NO78, Destrict of Chancheng, Foshan City, Guangdong Province, China, 528000
| | - Xingqing Liu
- Department of Anesthesiology, The Second People's Hospital of Foshan, Weiguo Road NO78, Destrict of Chancheng, Foshan City, Guangdong Province, China, 528000
| | - Kai Yang
- Department of Anesthesiology, The Second People's Hospital of Foshan, Weiguo Road NO78, Destrict of Chancheng, Foshan City, Guangdong Province, China, 528000
| | - Xianjie Wen
- Department of Anesthesiology, The Second People's Hospital of Foshan, Weiguo Road NO78, Destrict of Chancheng, Foshan City, Guangdong Province, China, 528000.
| |
Collapse
|
162
|
Douglass E, Johnson C, Lucas G, Dowling S. "Work with us… to make it more accessible". What women with intellectual disabilities want from infant-feeding health resources: an exploratory study. Int Breastfeed J 2023; 18:67. [PMID: 38066508 PMCID: PMC10704706 DOI: 10.1186/s13006-023-00606-9] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/03/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND More women with intellectual disabilities are becoming mothers but fewer are known to breastfeed compared with other women. Women with intellectual disabilities are entitled to accessible antenatal and infant feeding information, yet are rarely asked for their views on available resources. This article reports on the final stage of a UK project exploring how women with intellectual disabilities are supported to make infant feeding decisions. The wider project includes a scoping review and interviews with healthcare professionals, here we focus on the voices of the women themselves. METHODS Four women with an intellectual disability participated in a focus group where they were asked to give their views on the accessibility of currently available infant feeding resources and on alternative representations of infant feeding. All were interested in women's health issues, including infant feeding. Photo-elicitation was used to gather views on videos, bespoke 'Easy Read' material and several alternative representations of infant feeding. A transcription of the discussion was thematically analysed whilst a critical visual analysis was undertaken of the women's preferred images/resources. The study took place in Bristol, UK, during 2022. RESULTS Two themes were identified from the group discussion: 'The desire for choice' and 'How easy is 'Easy Read'?' The desire for choice was expressed in terms through agreements and disagreements about preferred imagery, differing tastes, and reasons for these preferences. We identified a challenge to 'Easy Read' as a default standard and concerns that some forms of 'Easy Read' can confuse rather than inform. Critical visual analysis identified the importance of the story and social setting of the preferred infant feeding image. CONCLUSIONS Findings suggest a need for a suite of resources, avoiding the one-size-fits-all approach, including people with an intellectual disability at every stage of the design and production process. Resources should recognise and embrace differences in terms of understanding, visual literacy and cultural taste, as well as being freely available to support women with intellectual disabilities to make informed infant feeding decisions. An accessible film was co-produced, to disseminate the findings from all three stages of the completed project.
Collapse
Affiliation(s)
- Emma Douglass
- School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Glenside Campus, Blackberry Hill, Fishponds, Bristol, BS16 1DD, UK
| | - Clare Johnson
- School of Arts, College of Arts, Technology and Environment, University of the West of England Bristol, City Campus, Arnolfini, 6 Narrow Quay, Bristol, BS1 4QA, UK
| | - Geraldine Lucas
- School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Glenside Campus, Blackberry Hill, Fishponds, Bristol, BS16 1DD, UK
| | - Sally Dowling
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, 69 St Michael's Hill, Bristol, BS2 8DZ, UK.
| |
Collapse
|
163
|
Janz C, Hadelsberg UP, Broekman M, Cavallo C, Engel D, Majernik GH, Hoellig A, Ilic T, Jeltema HR, Mielke D, Rodríguez-Hernández A, Ryang YM, Fozia S, Syrmos N, Vanchaze K, Vayssiere P, Hernandez-Duran S. Parenthood and neurosurgery in Europe, a white paper from the European association of neurosurgical societies' diversity in neurosurgery committee, part II - practice with children. Brain Spine 2023; 4:102717. [PMID: 38510633 PMCID: PMC10951702 DOI: 10.1016/j.bas.2023.102717] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 11/17/2023] [Accepted: 11/25/2023] [Indexed: 03/22/2024]
Abstract
Introduction In the first part of this White Paper, the European Association of Neurosurgical Societies (EANS) Diversity in Neurosurgery Committee (DC) addressed the obstacles faced by neurosurgeons when planning to have a family and practice during pregnancy, attempting to enumerate potential, easily implementable solutions for departments to be more family-friendly and retain as well as foster talent of parent-neurosurgeons, regardless of their gender identity and/or sexual orientation. Attrition avoidance amongst parent-neurosurgeons is at the heart of these papers. Research question In this second part, we address the obstacles posed by practice with children and measures to mitigate attrition rates among parent-neurosurgeons. For the methodology employed to compose this White Paper, please refer to Supplementary Electronic Materials (SEM) 1. Materials and methods For composing these white papers, the European Association of Neurosurgical Societies (EANS)'s Diversity Committee (DC) recruited neurosurgeon volunteers from all member countries, including parents, aspiring parents, and individuals without any desire to have a family to create a diverse and representative working group (WG). Results In spite of the prevailing heterogeneity in policies across the continent, common difficulties can be identified for both mothers and fathers considering the utilization of parental leave. Discussion and conclusion Reconciliation of family and a neurosurgical career is challenging, especially for single parents. However, institutional support in form of childcare facilities and/or providers, guaranteed lactation breaks and rooms, flexible schedule models including telemedicine, and clear communication of policies can improve working conditions for parent-neurosurgeons, avoid their attrition, and foster family-friendly work environments.
Collapse
Affiliation(s)
- Claudia Janz
- Städtisches Klinikum Solingen, Neurochirurgische Klinik, Gotenstrasse 1, 42563, Solingen, Germany
| | | | - Marike Broekman
- Dept of Neurosurgery, Haaglanden Medical Center, The Hague and Dept of Neurosurgery, Leiden University Medical Centre, Leiden, the Netherlands
| | - Claudio Cavallo
- Department of Neurosurgery, Neurocenter of Southern Switzerland, Switzerland
- Regional Hospital of Lugano, Lugano, Switzerland
| | - Doortje Engel
- Department of Neurosurgery, Canton Hospital, St. Gall, Switzerland
| | - Gökce Hatipoglu Majernik
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Anke Hoellig
- Department of Neurosurgery, University Hospital RWTH Aachen, Germany
| | - Tijana Ilic
- National Department of Neurosurgery, Centre Hospitalier de Luxembourg, the Netherlands
| | - Hanne-Rinck Jeltema
- Department of Neurosurgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Dorothee Mielke
- Department of Neurosurgery, University Hospital Göttingen, Göttingen, Germany
| | - Ana Rodríguez-Hernández
- Dept. of Neurological Surgery, Germans Trias i Pujol University Hospital, Universidad Autónoma, Barcelona, Spain
| | - Yu-Mi Ryang
- Dept. of Neurosurgery &Center for Spinetherapy, Helios Klinikum Berlin-Buch, Germany
| | - Saeed Fozia
- Department of Neurosurgery at Leeds General Infirmary, Leeds, United Kingdom
| | | | | | - Pia Vayssiere
- Department of Neurosurgery, Hôpitaux Universitaires de Genève (HUG), Geneva, Switzerland
- Faculty of Medicine, Université de Genève (UNIGE), Geneva, Switzerland
| | - Silvia Hernandez-Duran
- Klinik für Neurochirurgie, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| |
Collapse
|
164
|
Rossi G, Cesca J, Fong C, Wallace A, DComm PS, Osuagwu UL, Bailey J, Dutton T, De Alwis AC. Rural parents' adherence to infant feeding guidelines to prevent allergy: a cross sectional study in New South Wales. BMC Public Health 2023; 23:2458. [PMID: 38066470 PMCID: PMC10704778 DOI: 10.1186/s12889-023-17396-8] [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: 05/15/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Responding to international research showing that early introduction of common food allergens can reduce the chance of developing allergies, in 2016 the Australasian Society of Clinical Immunology and Allergy (ASCIA) revised allergen introduction guidelines, recommending earlier introduction of allergens to infants in their first year. Australia has high food allergy rates, and limited understanding of adherence to allergen introduction guidelines, especially in rural areas. This project explored rural parent adherence to ASCIA guidelines. METHODS This was a mixed method cross sectional study using an online survey including multiple-choice and qualitative short answer responses. The sample were 336 women from two rural health districts in New South Wales. All were aged 18 or over, and either pregnant or had delivered a baby since July 2018. Descriptive statistics were used to measure behavioural alignment with the recommended guidelines, thematic analysis was used to analyse attitudes and explanations. RESULTS In 84.3% of children, feeding adhered to all four guidelines studied, including no elimination of allergens during pregnancy (98%), age of introduction of solids (97.7%), continuation of breast milk/cow's milk formula during introduction of solids (95%), and age of introduction of allergens (92.9%). Adherence was not significantly correlated with the education (X2 = 17.9, P = .056), prior history of allergy [neither mother (X2 = 0.945,P = .623) nor previous children (X2 = 0.401,P = .818)], or primary care received during pregnancy. More than 90% of participants agreed or strongly agreed that the guidelines are realistic, trustworthy, and important for the health of their child. However, thematic analysis revealed that parents' perceptions of a child's individual progress, and medical conditions or other circumstances, such as challenges with breastfeeding, will often take precedence over adherence to specific guideline recommendations. CONCLUSIONS High rates of adherence with ASCIA guidelines found here are comparable with findings from metropolitan studies and encouraging for future population health. Participant comments on the guidelines imply to rural policymakers that there are multiple influences on parent decisions about infant feeding, often including parents' own intuition and experiences. Further studies to improve understanding of the role of information, carers, and other influences on parent decision-making concerning feeding attitudes and behaviours will be necessary to optimise adherence in rural areas.
Collapse
Affiliation(s)
- Gianni Rossi
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Sydney, Australia
| | - Jessica Cesca
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Sydney, Australia
| | - Charmie Fong
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Sydney, Australia
| | - Andrew Wallace
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Sydney, Australia
| | - Peter Simmons DComm
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Sydney, Australia
- School of Rural Medicine, Charles Sturt University, Bathurst, Australia
- Gulbali Research Institute, Charles Sturt University, Bathurst, Australia
| | - Uchechukwu Levi Osuagwu
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Sydney, Australia.
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, Australia.
| | - Jannine Bailey
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Tegan Dutton
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Sydney, Australia
| | - Adambarage Chandima De Alwis
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Sydney, Australia
- Department of Paediatrics, Bathurst Base Hospital, Bathurst, NSW, 2795, Australia
| |
Collapse
|
165
|
Ouyang YQ, Zhou J, Guo JY, Wang SY, Wang X, Zhou-Chen YB, Redding SR, Chen HJ. Effectiveness of a breastfeeding promotion intervention model based on Society ecosystems Theory for maternal women: a study protocol of randomized controlled trial. Reprod Health 2023; 20:182. [PMID: 38062456 PMCID: PMC10704786 DOI: 10.1186/s12978-023-01719-4] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Breastfeeding is recognized internationally as the most scientific and effective way to feed infants and young children. According to the World Health Organization in 2022, the exclusive breastfeeding rate within 6 months is 34.1% in China, which is still far from the goal of "more than 60% exclusive breastfeeding rate of infants within 6 months" by 2030 required by China's State Council. It is necessary to promote breastfeeding and provide maternal breastfeeding guidance to increase exclusive breastfeeding. Factors influencing breastfeeding can be explained by the society ecosystems theory, distributed in macro, mezzo and micro systems. The interventions focused on breastfeeding promotion are mainly carried out in the health systems and services, home and family environment, community environment, work environment, policy environment or a combination of these facilities. But there is sparse research on integrating resources in the macro, mezzo and micro systems of maternal breastfeeding processes to promote breastfeeding behavior. A randomized controlled trial will test the effect of a breastfeeding promotion intervention model based on the society ecosystems theory versus usual prenatal and postnatal care on maternal and infant health and the exclusive breastfeeding rate at 6 months. METHODS/DESIGN The study is a single-blind, parallel design, randomized controlled trial with an intervention group (n = 109) and a control group (n = 109) that compares the effect of a breastfeeding promotion intervention model based on the society ecosystems theory with usual prenatal and postnatal care. The intervention covers macro- (policy, culture), mezzo- (family-hospital-community) and micro- (biological, psychological and social) systems of the maternal breastfeeding process. Infant feeding patterns, neonatal morbidity and physical and mental health of antenatal and postpartum women will be collected at baseline (28 to 35 weeks of gestation), 1-, 4-, and 6-month postpartum. DISCUSSION This is a multifaceted, multifactorial, and multi-environmental breastfeeding promotion strategy to help mothers and their families learn breastfeeding knowledge and skills. The study provides a new modality for adding breastfeeding interventions to prenatal and postnatal care for healthcare providers in the hospital and the community. TRIAL REGISTRATION Chinese Clinical Trial Registry at www.chictr.org.cn , ChiCTR2300075795.
Collapse
Affiliation(s)
- Yan-Qiong Ouyang
- School of Nursing, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Jie Zhou
- School of Nursing, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, China.
| | - Jin-Yi Guo
- School of Nursing, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Shi-Yun Wang
- School of Nursing, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Xin Wang
- School of Nursing, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Yi-Bei Zhou-Chen
- School of Nursing, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, China
| | | | - Hui-Jun Chen
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, 430071, China.
| |
Collapse
|
166
|
Dharod JM, Frazier CM, Labban J, Black MM. Breastfeeding duration and associations with prevention of accelerated growth among infants from low-income, racially and ethnically diverse backgrounds. Public Health Nutr 2023; 27:e6. [PMID: 38047374 PMCID: PMC10830380 DOI: 10.1017/s1368980023002689] [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: 05/02/2023] [Revised: 08/30/2023] [Accepted: 11/27/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE To describe breastfeeding rates from early to late infancy and to examine associations between breastfeeding duration and infant growth, including rapid weight gain (RWG, > 0·67 SD increase in weight-for-age Z-score), among infants from low-income, racially and ethnically diverse backgrounds. DESIGN A short, prospective cohort study was conducted assessing breastfeeding status at infant ages 2, 4, 6, 9 and 12 months. Infant length and weight measurements were retrieved from electronic health records to calculate weight-for-length Z-scores and the rate of weight gain. SETTING Pediatric clinic in the Southeastern USA. PARTICIPANTS Mother-infant dyads (n = 256). RESULTS Most participants were African American (48 %) or Latina (34 %). Eighty-one per cent were participating in the Special Supplemental Nutrition Program for Women, Infants and Children. Infants were breastfed for a median duration of 4·75 months, with partial more common than exclusive breastfeeding. At 12 months, 28 % of the participants were breastfeeding. Infants breastfed beyond 6 months had significantly lower growth trajectories than infants breastfed for 0-2 months (β = 0·045, se = 0·013, P = 0·001) or 3-6 months (β = 0·054, se = 0·016, P = 0·001). Thirty-six per cent of the infants experienced RWG. RWG was more common among infants who were breastfed for 2 months or less than 6+ month breastfed group (relative risk = 1·68, CI95 (1·03, 2·74), P = 0·03). CONCLUSIONS Breastfeeding beyond 6 months is associated with the prevention of accelerated growth among infants from low-income, racially and ethnically diverse backgrounds, suggesting progress toward health equity.
Collapse
Affiliation(s)
- Jigna M Dharod
- Department of Nutrition, School of Health and Human Sciences, 319 College Avenue, University of North Carolina at Greensboro, Greensboro, NC27412, USA
| | - Christina M Frazier
- Office of Research, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, USA
| | | | - Maureen M Black
- Department of Pediatrics, University of Maryland, School of Medicine, Baltimore, MD, USA
| |
Collapse
|
167
|
Moini A, Heidari F, Eftekhariyazdi M, Pirjani R, Ghaemi M, Eshraghi N, Rabiei M. Breastfeeding success and perceived social support in lactating women with a history of COVID 19 infection: a prospective cohort study. Int Breastfeed J 2023; 18:65. [PMID: 38049908 PMCID: PMC10696741 DOI: 10.1186/s13006-023-00601-0] [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: 07/26/2023] [Accepted: 11/15/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Given the limited availability of research on the association between COVID-19 infection and breastfeeding success, the primary objective of this study is to conduct a comprehensive evaluation of this relationship. METHODS This prospective cohort study included 260 women who were on the postnatal ward of an academic hospital affiliated with Tehran University of Medical Sciences during the COVID-19 pandemic (between March and August 2021). Among these women, 130 had tested positive for COVID-19 in pregnancy, while the remaining 130 were considered healthy. The study aimed to assess various factors, including sociodemographic characteristics and the results of four validated questionnaires: The Bristol Breastfeeding Questionnaire, The Multidimensional of Perceived Social Support (MPSS), The Breastfeeding Self-Efficacy Scale (BSES), and The Postpartum Partner Support Scale (PPSS). These questionnaires were administered to each participant to gather relevant data. After eight weeks, a telephone follow-up was carried out to assess the success of breastfeeding. The evaluation focused on determining if exclusive breastfeeding was maintained or not. Data was collected by questioning mothers about their infants' feeding habits in the past 24 h. Exclusive breastfeeding refers to the exclusive use of breast milk without the introduction of other liquids or solid foods. RESULTS Women with a previous COVID-19 infection (case group) had a lower mean infant gestational age (P < 0.001) and a higher prevalence of cesarean section (P = 0.001) compared to the control group. The proportion of women who exclusively breastfed was higher in the control group (98.5%) than in women with a history of COVID-19 infection (89.2%) (P = 0.011). Furthermore, the case group reported lower scores in perceived social support and the Breastfeeding Self-Efficacy Scale, in contrast to the control group. Notably, there was a significant correlation between breastfeeding success and women's breastfeeding self-efficacy score. CONCLUSIONS The findings of this study offer valuable insights for healthcare professionals, enabling them to promote early initiation of breastfeeding in mothers with a history of COVID-19 infection, while ensuring necessary precautions are taken.
Collapse
Affiliation(s)
- Ashraf Moini
- Department of Obstetrics and Gynecology, Endocrinology and Female Infertility Unit, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Fatemeh Heidari
- Department of Obstetrics and Gynecology, Endocrinology and Female Infertility Unit, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Eftekhariyazdi
- Department of Obstetrics and Gynecology, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Reihaneh Pirjani
- Department of Obstetrics and Gynecology, Endocrinology and Female Infertility Unit, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Marjan Ghaemi
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Eshraghi
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Rabiei
- Department of Obstetrics and Gynecology, Endocrinology and Female Infertility Unit, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
168
|
Mathias EG, Patil DS, Kolakemar A, Krishnan JB, Renjith V, Gudi N, Swamy RS, Brand A. Barriers and Facilitators for the Donation and Acceptance of Human Breast milk: A Scoping Review. Curr Nutr Rep 2023; 12:617-634. [PMID: 37999918 PMCID: PMC10766659 DOI: 10.1007/s13668-023-00506-8] [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] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE OF REVIEW Human milk is the best source of nutrients for all infants. When a mother's own milk is unavailable, the World Health Organization suggests using donor human milk for premature neonates with or without medical complications. Exploring the barriers and facilitators for breast milk donation and its acceptability is essential for developing this intervention. A scoping review was conducted based on a methodological framework developed by Arksey and O'Malley (Int J Soc Res Methodol 8:19-32, 2005). A search was conducted in PubMed (NCBI), CINAHL (EBSCO), and Web of Science (Elsevier). A two-stage sequential screening process was adopted. Data extraction was done using a piloted data extraction form. RECENT FINDINGS We included 20 articles for narrative synthesis. Barriers and facilitators for donating and accepting breast milk were categorized under six themes: individual, family, community, workplace, health system, and policy-related. The common individual barriers were time requirements for BMD, personal dislike of the process, lack of knowledge, insufficient milk, negative opinions, and lack of information. Family stigma, negative rumors, less educated family members, and illness of a family member were identified as family-related barriers. Community-related barriers include cultural or religious unacceptable practices, societal taboos, and distance to milk banks. The major barriers identified in relation to the health system were lack of practical and psychological support, lack of information, storing and transportation issues, lack of knowledge among HCWs, and logistical challenges of creating a milk lab. The common work-related barriers were the lack of adequate time, philosophical objections, and incomprehension at returning to work. Policy-related barriers identified include the need for hygiene requirements, donation costs, and lack of standardized guidelines. Making the donation process faster, providing pick-up services for donors, and community education and male partner engagement regarding breast milk donation could help to boost the acceptability of breast milk donation.
Collapse
Affiliation(s)
- Edlin Glane Mathias
- Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Divya Sussana Patil
- Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Ashwija Kolakemar
- Department of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Jisha B Krishnan
- Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Vishnu Renjith
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Nachiket Gudi
- Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India.
- Faculty of Health Medicine and Life Sciences (FHML), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Ravi Shankar Swamy
- Imperial College Healthcare NHS Trust, London, UK
- Manipal Hospitals Bengaluru, Bangalore, Karnataka, India
| | - Angela Brand
- Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
- United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (UNU-MERIT), Boschstraat 24, NL - 6211 AX, Maastricht, The Netherlands
- Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| |
Collapse
|
169
|
Korkalo L, Alfthan G, Fidalgo L, Freese RI. Prevalence of vitamin E inadequacy, dietary intake and sources of alpha-tocopherol, and predictors of alpha- and gamma-tocopherol status in adolescent girls in Central Mozambique. J Nutr Sci 2023; 12:e121. [PMID: 38155808 PMCID: PMC10753459 DOI: 10.1017/jns.2023.103] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 12/30/2023] Open
Abstract
An adequate alpha-tocopherol status is important for females at reproductive age. We studied the dietary intake and sources of alpha-tocopherol and alpha- and gamma-tocopherol status indicators in 14-19-year-old girls in Central Mozambique. We also explored factors associated with alpha- and gamma-tocopherol status. The participants (n 508) were from the cross-sectional ZANE Study that was conducted in 2010. We recruited two separate samples, one in January-February and the other in May-June. We collected venous blood samples and conducted 24 h dietary recall interviews. At the time of blood sampling, 11 % of participants were pregnant and 10 % were lactating. In the total sample, both seasons combined, the median intake of alpha-tocopherol was 6⋅7 mg/d, the mean plasma alpha- and gamma-tocopherol concentrations were 13⋅5 and 0⋅75 μmol/l, respectively, and the prevalence of vitamin E inadequacy (alpha-tocopherol <12 μmol/l) was 36⋅7 % (95 % CI: 31⋅9-42⋅0 %). Season and lactation status were significant predictors of alpha-tocopherol status regardless of which the three indicators (plasma concentration, alpha-tocopherol:total cholesterol ratio, gamma-tocopherol:alpha-tocopherol ratio) were used. Being a lactating mother was negatively associated and having a blood sample taken in January-February, when the main sources of alpha-tocopherol were mango and dark green leafy vegetables, was positively associated with alpha-tocopherol status. In conclusion, vitamin E inadequacy was common in Central Mozambique, and the status may fluctuate due to seasonal changes in the diet. We suggest that lactating mothers are specifically at risk of poor alpha-tocopherol status in resource-poor settings.
Collapse
Affiliation(s)
- Liisa Korkalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Georg Alfthan
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Lourdes Fidalgo
- Food Security and Nutrition Association (ANSA), Maputo, Mozambique
| | - Riitta I. Freese
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| |
Collapse
|
170
|
Tomlinson C, Haiek LN. Breastfeeding and human milk in the NICU: From birth to discharge. Paediatr Child Health 2023; 28:510-526. [PMID: 38638537 PMCID: PMC11022875 DOI: 10.1093/pch/pxad034] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 04/20/2022] [Indexed: 04/20/2024] Open
Abstract
It is well recognized that human milk is the optimal nutritive source for all infants, including those requiring intensive care. This statement reviews evidence supporting the importance of breastfeeding and human milk for infants, and why breastfeeding practices should be prioritized in the neonatal intensive care unit (NICU). It also reviews how to optimally feed infants based on their stability and maturity, and how to support mothers to establish and maintain milk production when their infants are unable to feed at the breast.
Collapse
Affiliation(s)
- Christopher Tomlinson
- Canadian Paediatric Society, Nutrition and Gastroenterology Committee, Ottawa, Ontario, Canada
| | - Laura N Haiek
- Canadian Paediatric Society, Nutrition and Gastroenterology Committee, Ottawa, Ontario, Canada
| |
Collapse
|
171
|
Nouzha DO, Louise G, Claudia SB, Héloïse FM, Laurence L, Joël P, Virginie R. Trace elements status in human breast milk of mothers from Île-de-France region. J Trace Elem Med Biol 2023; 80:127317. [PMID: 37864918 DOI: 10.1016/j.jtemb.2023.127317] [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: 12/01/2022] [Revised: 09/18/2023] [Accepted: 10/09/2023] [Indexed: 10/23/2023]
Abstract
Breastfeeding is the main source of nutrition during first months of life. Its composition varies according to parameters like mother's diet and health, living area, number of pregnancies and lactation duration… Trace-elements concentration in breastmilk is then an important parameter that can affect infant's health, growth or immune system and organ functions. Few data are available on this topic, and results are often very variable. The aim of this work is to determine reference values of Copper (Cu), Zinc (Zn), Selenium (Se), Cobalt (Co), Iron (Fe) and Iodine (I) in human breastmilk according to lactation duration and to study influencing parameters on its elementary composition. Regional Human Milk Bank of Necker Enfants Malades Hospital provided samples that came from breastfeeding woman involved in voluntary milk donation and epidemiologic data. Two hundred thirty-two breastmilk were analysed. After nitric acid mineralization of milk samples, Cu, Zn, Se, Co and I were determined by Inductively Coupled Plasma Mass Spectrometry (ICP-MS) in a standard mode. Fe was measured by Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES). Both assays were validated in terms of sensitivity, repeatability and accuracy.Studied breast milks came from mothers with an average age of 32 years and donation time ranged from one day after childbirth to 974 days (> 2.5 years); mean lactation duration is 59 days (> 8 weeks) while median duration is 29 days (around 4 weeks). In all studied samples, mean results and reference values are for Cu: 6.02 (1.71-13.23), Zn: 43.86 (7.3-107.0), Se: 0.12 (0.07-0.24), I: 0.29 (0.07-1.01) and Fe: 4.72 (1.25-11.49) µmol/L and for Co: 12.28 (5.27-25.82) nmol/L. Important number of studied milks allowed their distribution into seven classes of lactation durations. Samples were divided into four successive classes of fifteen days after childbirth, two other classes corresponding to the 3rd and 4th months and a last class for milks sampled after 4 months of lactation. Results were analysed in each class allowing study of evolution during lactation. That was particularly interesting for Zn, that presented an important variability in the total population (4-132 µmol/L) explained by variation along lactation evolution decreasing from 48 to 17 µmol/L in first and last duration classes respectively. In addition, Cu and Fe concentrations were also significantly correlated with lactation duration while Se and I were in a lesser extent (p = 0.002). In this study, we present reference values for studied trace elements at different lactation stages, allowing a fine interpretation of future breast milk samples results according to their sampling time. By continuing this study, we plan to increase number of samples in some of the classes and to study the influence of premature birth or twin pregnancy on breast milk elementary composition.
Collapse
Affiliation(s)
| | - Gütter Louise
- Toxicology Department, Lariboisière University Hospital, AP-HP, Paris, France
| | | | | | - Labat Laurence
- Toxicology Department, Lariboisière University Hospital, AP-HP, Paris, France; INSERM UMRS1144, Université de Paris, France
| | - Poupon Joël
- Toxicology Department, Lariboisière University Hospital, AP-HP, Paris, France
| | - Rigourd Virginie
- Neonatal Intensive Care Unit, Necker Enfants Malades Hospital, AP-HP, Paris, France; Regional lactarium of Île-de-France, Necker Enfants Malades Hospital, AP-HP, Paris, France
| |
Collapse
|
172
|
Fan HSL, Fong DYT, Lok KYW, Tarrant M. Experiences of expressed human milk feeding: A qualitative study. Sex Reprod Healthc 2023; 38:100903. [PMID: 37657300 DOI: 10.1016/j.srhc.2023.100903] [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: 04/13/2023] [Revised: 07/28/2023] [Accepted: 08/22/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE The objective of this study was to understand and describe the breastfeeding experiences of Chinese women with a high proportion of expressed human milk feeding. METHODS A qualitative descriptive design was used to describe the usual practices of expressed human milk feeding among breastfeeding women. We conducted semi-structured, in-depth, one-to-one interviews with participants (N = 25) who had a high proportion of expressed human milk feeding. Thematic analysis was used to analyze the data. RESULTS We identified three main themes: a sense of control, a sense of security, and milk expression challenges. Participants described that expressed human milk feeding provided a greater sense of control over their time and provided more freedom as they were no longer restricted by their infant's feeding schedule. Furthermore, knowing the amount of milk and having a stored milk supply provided a sense of security. However, providing expressed human milk can be time-consuming and has a lower intimacy level when compared with direct breastfeeding. CONCLUSION Expressed human milk feeding can provide a greater sense of control and was used as an immediate solution to direct breastfeeding problems. However, some participants experienced challenges in expressed human milk feeding, and some preferred breastfeed directly. Therefore, it is crucial to strengthen the breastfeeding support provided in the early postpartum period to ensure that all breastfeeding persons can breastfeed directly.
Collapse
Affiliation(s)
- Heidi Sze Lok Fan
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada.
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR
| | - Marie Tarrant
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
| |
Collapse
|
173
|
Yagiz B, Coskun BN, Halil EY, Dalkilic E, Pehlivan Y. The efficacy and reliability of English YouTube videos as a source of information for pregnant rheumatoid arthritis patients. Clin Rheumatol 2023; 42:3311-3320. [PMID: 37814092 DOI: 10.1007/s10067-023-06780-9] [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] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/25/2023] [Accepted: 09/18/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVES Online platforms are used by many patients to access health care information, but the quality and accuracy of information on these platforms are unknown. Our goal was to assess the quality and reliability of YouTube video content for pregnant rheumatoid arthritis (RA) patients. METHODS YouTube was searched on January 13, 2022, using the keywords "rheumatoid arthritis pregnancy," "rheumatoid arthritis conception," "rheumatoid arthritis fertility" and "rheumatoid arthritis breastfeeding". The top 200 videos were viewed. Two rheumatologists then categorized the videos into useful and misleading groups. Videos were excluded if they were irrelevant or duplicates. To assess the reliability and quality of the videos, a modified DISCERN tool and the Global Quality Score (GQS) were applied. Patient interaction was assessed using predictors of video popularity such as the like ratio, view ratio, and video power index scales. RESULTS A total of 54 videos were examined; the majority (51.8%) of them were uploaded by health information websites. A total of 94.4% of the videos were useful, and 5.5% were misleading. All three misleading videos were uploaded by patients. The GQS, the modified DISCERN score, and usefulness differed significantly by uploader source (p < 0.001 for both). According to the GQS evaluation, health information websites were the source of high-quality videos with more useful information and higher modified DISCERN scores. The GQS and modified DISCERN score had moderately negative (r = -.526, r = -.548, respectively) and very significant (p < 0.001 for both) correlations with the assessment of usefulness. CONCLUSION Almost all YouTube videos for pregnant RA patients were educational and useful. Similar patient interactions in videos with misleading and useful information showed that patients were unable to differentiate between videos based on video quality. Patients should be informed about the importance of video sources when viewing YouTube videos. Key Points • Most YouTube videos for pregnant RA patients were useful, were uploaded by health information websites and had physicians as the speakers • All misleading YouTube videos were uploaded by patients using their own accounts • In terms of patient interactions, there was no noticeable difference between useful and misleading videos • When dealing with a sensitive topic such as pregnancy, patients should be educated on the importance of video sources.
Collapse
Affiliation(s)
- Burcu Yagiz
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Uludag University, Bursa, Turkey.
| | - Belkis Nihan Coskun
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Uludag University, Bursa, Turkey
| | - Esra Yunus Halil
- Department of Internal Medicine, Faculty of Medicine, Uludag University, Bursa, Turkey
| | - Ediz Dalkilic
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Uludag University, Bursa, Turkey
| | - Yavuz Pehlivan
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Uludag University, Bursa, Turkey
| |
Collapse
|
174
|
Yeşildere Sağlam H, Özerdoğan N, Mizrak Şahin B, Gürsoy E. Workplace breastfeeding support for working women: A scale development study. Eur J Obstet Gynecol Reprod Biol X 2023; 20:100239. [PMID: 37766872 PMCID: PMC10520338 DOI: 10.1016/j.eurox.2023.100239] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/20/2023] [Accepted: 09/02/2023] [Indexed: 09/29/2023] Open
Abstract
Objective In this study, authors aimed to develop a scale to evaluate workplace breastfeeding support. Methods The study was carried out with 490 working women who applied to the women's and children's outpatient clinics of a hospital in Turkey. The study data were collected by using a 'Personal Information Form' and the 'Workplace Breastfeeding Support for Working Women Draft Scale'. The data were analyzed on SPSS 25 and AMOS 21 software packages. In the development process of the scale; Content validity, exploratory factor analysis, item-total score correlation methods and Cronbach's Alpha coefficient were used. Results The content validity index of the scale was 0.90, and the Cronbach's alpha value was 0.93. Kaiser-Meyer-Olkin value of the scale was 0.91, Bartlett test values were χ2 = 11,573.924 and p < 0.000. According to the results of the exploratory factor analysis for the construct validity of the scale, the scale consisted of 31 items and 6 factors. Conclusions The developed scale can be used to evaluate workplace breastfeeding support for working women as a valid and reliable measurement tool.
Collapse
Affiliation(s)
- Havva Yeşildere Sağlam
- Kütahya Health Sciences University, Faculty of Health Sciences, Department of Nursing, Kütahya, Turkey
| | - Nebahat Özerdoğan
- Eskisehir Osmangazi University, Faculty of Health Sciences, Department of Midwifery, Eskisehir, Turkey
| | - Berrak Mizrak Şahin
- Bilecik Şeyh Edebali University, Faculty of Health Sciences, Department of Nursing, Bilecik, Turkey
| | - Elif Gürsoy
- Eskisehir Osmangazi University, Faculty of Health Sciences, Department of Nursing, Eskisehir, Turkey
| |
Collapse
|
175
|
Esfarjani SV, Alaei S, Saki A. Breastfeeding pattern and its relationship with weight gain in children older than 6 months. J Family Med Prim Care 2023; 12:3249-3253. [PMID: 38361836 PMCID: PMC10866249 DOI: 10.4103/jfmpc.jfmpc_694_23] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/14/2023] [Accepted: 08/01/2023] [Indexed: 02/17/2024] Open
Abstract
Introduction According to the World Health Organization (WHO), breastfeeding is the best way to feed infants. Adoption of some inappropriate nutritional patterns along with breast milk, especially in infants older than 6 months, may lead to a delay in the child's growth. Therefore, the present study was conducted to investigate the relationship between breastfeeding and weight gain in children aged 6-24 months. Materials and Methods This case-control study was conducted on 120 infants aged 6-24 months and their mothers recruited from health centers of Ahvaz, southwest of Iran. The data collection tool in the present study included a questionnaire to record demographic information and information in the child's medical records in health centers. Statistical analysis of the data was done by SPSS 23 using the Chi-square test and t-test. Results No significant difference was observed between the control and case groups in terms of the infant's age (P = 0.741) and gender (P = 0.564) and the mothers' age (P = 0.614), her educational attainment (P = 0.389), and socioeconomic status of the infant's family (P = 0.563). The type of delivery (P = 0.650), mothers' opinion (P = 0.133), and the interval between breastfeeding and complementary feeding (P = 0.144) had no significant relationship with the infant's growth disorder. On the other hand, duration of breastfeeding per meal (P = 0.007) and frequent breastfeeding (dependency on the mother's breast) (P = 0.049) had a significant relationship with children's developmental disorders. Conclusion According to the results of the present study, growth disorders in infants in the case group could be attributed to their mothers' inappropriate breastfeeding patterns.
Collapse
Affiliation(s)
- Shahla V. Esfarjani
- Department of Community Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeid Alaei
- Department of Orthopedic Surgery, Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azadeh Saki
- Department of Epidemiology and Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
176
|
Nerius L, Vogel M, Ceglarek U, Kiess W, Biemann R, Stepan H, Kratzsch J. Bone turnover in lactating and nonlactating women. Arch Gynecol Obstet 2023; 308:1853-1862. [PMID: 37707552 PMCID: PMC10579129 DOI: 10.1007/s00404-023-07189-0] [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] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/07/2023] [Indexed: 09/15/2023]
Abstract
PURPOSE During lactation, bone turnover increases, reflecting the mobilization of Calcium from maternal skeletal stores and resulting in bone loss. However, mechanisms are not yet fully understood, and previous studies have been comparatively small. We aim to assess bone metabolism during lactation by comparing bone-metabolism-related-parameters between large cohorts of lactating and nonlactating women. METHODS In a retrospective cohort study, we recruited 779 postpartum women and 742 healthy, nonpregnant, nonlactating controls. Postpartum women were examined 3 and 6 months after delivery and retrospectively assigned to either the exclusively breastfeeding (exc-bf) group if they had exclusively breastfed or the nonexclusively breastfeeding (nonexc-bf) group if they had not exclusively breastfed up to the respective visit. Serum levels of PTH, Estradiol, total Calcium, Phosphate, and bone turnover markers (ßCTX, P1NP, Osteocalcin) were compared between the groups. RESULTS Bone turnover markers were significantly increased in exc-bf and nonexc-bf women compared with the controls (all ps < .001). ßCTX was approximately twice as high in exc-bf women than in the controls. PTH levels were marginally higher in exc-bf (p < .001) and nonexc-bf women (p = .003) compared with the controls (6 months). Estradiol was suppressed in exc-bf women compared with the controls (p < .001, 3 months). CONCLUSION Exc-bf and even nonexc-bf states are characterized by an increase in bone formation and resorption markers. The PTH data distribution of exc-bf, nonexc-bf, and control groups in the underpart of the reference range suggest that lactational bone loss is relatively independent of PTH.
Collapse
Affiliation(s)
- Lena Nerius
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103, Leipzig, Germany
| | - Mandy Vogel
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103, Leipzig, Germany
| | - Uta Ceglarek
- Institute for Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics (ILM), University of Leipzig, Paul-List-Str. 13-15, 04103, Leipzig, Germany
| | - Wieland Kiess
- LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research, University of Leipzig, 04103, Leipzig, Germany
| | - Ronald Biemann
- Institute for Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics (ILM), University of Leipzig, Paul-List-Str. 13-15, 04103, Leipzig, Germany
| | - Holger Stepan
- Department of Obstetrics, University of Leipzig, 04103, Leipzig, Germany
| | - Jürgen Kratzsch
- Institute for Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics (ILM), University of Leipzig, Paul-List-Str. 13-15, 04103, Leipzig, Germany.
| |
Collapse
|
177
|
Reed A, Redmon-Greene J, Thompson H, Lusero I. Drug Use and Human Milk: Legal and Child Welfare Considerations. Matern Child Health J 2023; 27:2059-2063. [PMID: 37548911 DOI: 10.1007/s10995-023-03743-z] [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: 06/09/2023] [Indexed: 08/08/2023]
Abstract
INTRODUCTION Preventing new parents who use drugs from bonding with and bodyfeeding their babies undermines public health. Because U.S. culture treats substance use as a moral failing rather than a health concern, punitive responses to perinatal substance use continue to dominate. This is particularly true for families of color, who are more likely to be targeted by the family regulation system. These approaches fail to protect families, and cause their own, separate harm. This article will lay out existing evidence surrounding bodyfeeding. Then, it will debunk harmful mythologies about drug use and human milk, and compare the risks associated with using drugs while bodyfeeding to those inherent in family separation. Finally, it will make the case for harm-reduction approaches over criminal ones. OBJECTIVES The health risks associated with family separation are only rarely weighed against those associated with drug exposure through human milk. Our objective for this paper is to contribute new ways of framing the importance of keeping families together at birth, even when perinatal substance use is detected. METHODS This manuscript is not based upon clinical study or patient data, and exclusively references studies and research publications that have been approved by the appropriate ethics committee and which have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. RESULTS Significant research data support the position that the risks associated with family separation are arguably greater than those associated with exposure to substance use in human milk. CONCLUSIONS FOR PRACTICE Harm reduction approaches should be favored over criminal approaches when perinatal substance use is detected or confirmed.
Collapse
|
178
|
Knox O, Parker D, Johnson D, Dombrowski SU, Thomson G, Clarke J, Hoddinott P, Jolly K, Ingram J. Text message conversations between peer supporters and women to deliver infant feeding support using behaviour change techniques: A qualitative analysis. Midwifery 2023; 127:103838. [PMID: 37839159 DOI: 10.1016/j.midw.2023.103838] [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: 10/19/2022] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE To analyse text message conversations between peer supporters (called Infant Feeding Helpers - IFHs) and new mothers using qualitative methods to understand how peer support can influence and support women's feeding experiences. DESIGN Qualitative analysis of text messages conversations using both inductive thematic and deductive content approaches to coding. Thematic analysis of the text message transcripts and deductive content analysis was used to code if Behaviour Change Techniques (BCTs) were employed by IFHs in their interactions with women. BCTs coded in text messages were then compared with those tabulated from antenatal meeting recordings and documented in interview transcripts. PARTICIPANTS AND SETTING 18 primiparous women and 7 Infant Feeding Helpers from one community site in South-West England. FINDINGS Three key themes were identified in the18 text message conversations (1679 texts): 'breastfeeding challenges', 'mother-centred conversations', and 'emotional and practical support'. The core BCTs of 'social support' and 'changing the social environment' were found at least once in 17 (94 %) and 18 (100 %) text message conversations respectively. Meanwhile, 'instruction to perform the behaviour' was used at least once in over 50 % of conversations. Generally, the use of BCTs was greatest between birth and two weeks during a period of daily texts when women reported many feeding challenges. The number and range of BCTs used in text messages were similar to those documented in audio-recorded meetings and interview accounts. CONCLUSION AND IMPLICATIONS Infant Feeding Helpers were able to provide engaging and successful breastfeeding peer support through text messages. Messaging was shown to be an appropriate and accessible method of delivering BCTs focussing on 'social support' and 'changing the social environment'. Peer supporters delivering BCTs via text messages is acceptable and appropriate to use if in-person support is limited due to unforeseen circumstances such as the COVID-19 pandemic.
Collapse
Affiliation(s)
- Olivia Knox
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol UK
| | - Denise Parker
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol UK
| | - Debbie Johnson
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol UK
| | | | - Gill Thomson
- School of Community Health & Midwifery, University of Central Lancashire, UK
| | - Joanne Clarke
- Institute of Applied Health Research, University of Birmingham, UK
| | - Pat Hoddinott
- Nursing, Midwifery and Allied Health Professionals Research Unit, University of Stirling, UK
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, UK
| | - Jenny Ingram
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol UK.
| |
Collapse
|
179
|
Collins IC, Blanchard CT, Oben A, Robinson A, Kako T, Joly JM, Cribbs MG, Casey B, Tita A, Sinkey R. Breastfeeding practices among patients managed by a comprehensive cardio-obstetrics program. J Matern Fetal Neonatal Med 2023; 36:2253485. [PMID: 37691234 PMCID: PMC10580703 DOI: 10.1080/14767058.2023.2253485] [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] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/18/2023] [Accepted: 08/25/2023] [Indexed: 09/12/2023]
Abstract
Objective: To evaluate breastfeeding intent, rates at discharge, and continued breastfeeding at follow-up in patients managed in a comprehensive cardio-obstetrics program stratified by severity of maternal cardiac disease.Study Design: Retrospective cohort of patients managed by a comprehensive cardio-obstetrics program at the University of Alabama at Birmingham (UAB). Patients were included if they had ≥1 prenatal visit with the Cardio-Obstetrics team and delivered at UAB. The primary outcome was the breastfeeding rate on discharge from the delivery-associated hospitalization. Secondary outcomes included intent to breastfeed on admission and breastfeeding at the postpartum visit. Baseline characteristics and rates were compared between patients with less severe (mWHO I - II/III) vs. more severe (mWHO III - IV) maternal cardiac disease.Results: 147 patients were included: 85 (57.8%) mWHO class I - II and 62 (42.2%) mWHO class III-IV. Patients with more severe maternal cardiac disease had higher rates of chronic hypertension (22.6% vs. 9.4%; p = 0.027), lower gestational age at delivery (36.4 vs 37.7 weeks; p = 0.008), and higher rates of NICU admission (31.2% vs. 14.1%; p = 0.013). There were no significant differences between mWHO class I-II vs. mWHO class III-IV in intent to breastfeed upon admission to the delivery-associated hospitalization (84.7% vs. 82.3%; p = 0.67), breastfeeding rates upon discharge from the delivery-associated hospitalization (90.6% vs. 87.1%; p = 0.50), or breastfeeding rates at the postpartum visit (54.1% vs. 48.5%; p = 0.60).Conclusions: Despite potential barriers in this high-risk population, over 85% of patients breastfed upon discharge from the delivery-associated hospitalization. However, breastfeeding rates dropped by 40% at the postpartum visit. Strategies to support breastfeeding in the post-partum period in patients with maternal cardiac disease are imperative.
Collapse
Affiliation(s)
- Isabel C Collins
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL
- Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL
| | - Christina T Blanchard
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL
| | - Ayamo Oben
- Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL
| | - Ashton Robinson
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL
- Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL
| | - Tavonna Kako
- Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL
| | - Joanna M Joly
- Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, AL
| | - Marc G Cribbs
- Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, AL
| | - Brian Casey
- Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL
| | - Alan Tita
- Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL
| | - Rachel Sinkey
- Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL
| |
Collapse
|
180
|
Abstract
PURPOSE OF REVIEW Postpartum depression (PPD) and breastfeeding are important, interrelated health factors. It is established that women who breastfeed exclusively have lowered likelihood of developing significant PPD. Yet, many questions remain around what factors are involved. The purpose of this review is to provide updated information about the relationship between PPD and breastfeeding. RECENT FINDINGS Both psychological and physiological factors have emerged as important moderators and mechanisms of the relationship between postpartum depression and breastfeeding. Breastfeeding self-efficacy, self-compassion, and engagement with the infant during feeding all modify or mediate the relationship, and a complex dynamic relationship among cortisol, oxytocin, progesterone, and estrogen is involved. Importantly, recent intervention studies suggest psychosocial interventions may impact both breastfeeding and mood. Providers and researchers should recognize the interrelationship between the breastfeeding and PPD and apply this understanding to patient care through integrated education and care for both mood and breastfeeding enhancement.
Collapse
Affiliation(s)
- Erin J Henshaw
- Department of Psychology, Denison University, 100 West College Street, Granville, OH, 43023, USA.
| |
Collapse
|
181
|
Abstract
OBJECTIVES Women of childbearing age often experience mental health problems, receive psychotropic medication and are admitted to mental health units. Approximately 40% of pregnancies are unplanned and many women experience perinatal mental health problems. It is therefore vital that consideration is given to reproductive health in mental health policy. We aimed to evaluate the consideration of pregnancy and breastfeeding in the policies of an inpatient mental health service. METHODS The policies of a regional inpatient psychiatric unit were independently reviewed by two researchers. Policies that had implications for pregnancy and breastfeeding for patients were identified. Whether or not these policies considered pregnancy and breastfeeding and the detail of this consideration was evaluated. RESULTS One hundred and thirteen policies were evaluated. Forty had implications for pregnancy but only 10 of these mentioned pregnancy and only 3 in detail. Only 3 of the 28 policies that had relevance to breastfeeding mothers mentioned it and none discussed it in detail. Key areas of omission included prescribing, seclusion and restraint and cultural and religious considerations. CONCLUSION Pregnancy and breastfeeding were almost entirely absent in the ward policies of our inpatient unit. Their consideration in the acute setting is vital. An individual or group of individuals should be responsible for ensuring that reproductive health is considered in all policies as well as in a larger specific policy suitable for referencing. The rights of the reproductive woman should be comprehensively considered in inpatient mental health care policy.
Collapse
Affiliation(s)
- E McGuire
- Mayo Mental Health Service, Castlebar, Co. Mayo, Ireland
| | - C Curtis
- Mayo Mental Health Service, Castlebar, Co. Mayo, Ireland
| | - R M Duffy
- Specialist Perinatal Mental Health Service
| |
Collapse
|
182
|
Felipe-Dimog EB, Dumalhin YJB, Liang FW. Factors of early breastfeeding initiation among Filipino women: A population-based cross-sectional study. Appl Nurs Res 2023; 74:151732. [PMID: 38007244 DOI: 10.1016/j.apnr.2023.151732] [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: 10/07/2022] [Revised: 08/03/2023] [Accepted: 08/14/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Early breastfeeding initiation (EBI) within the first hour after birth has the potential to reduce neonatal mortality. However, the prevalence of EBI still falls short of the 70 % target set by the WHO for 2030. Limited research has been conducted on this issue. Therefore, the study aimed to assess the prevalence and factors of EBI in the Philippines. METHODS This study is a secondary analysis of the data from the Philippine National Demographic and Health Survey (PNDHS) in 2017. Women survey participants aged 15 to 49 (n = 3750) who had given birth within the two years prior to the survey were included in this study. A p-value < 0.05 was used to define statistical significance when identifying the factors associated with EBI using hierarchical logistic regression analysis. RESULTS Women who were more likely to practice EBI were those from the Cordillera Administrative Region, who read newspaper/magazines, and delivered infants at 2 or later birth order. On the contrary, women from Central Luzon, CALABARZON (Cavite, Laguna, Batangas, Rizal, and Quezon provinces), Central Visayas, Eastern Visayas, and the Autonomous Region of Muslim Mindanao; who listen to the radio at least once a week; and give birth through cesarean section were less likely to practice EBI. CONCLUSION Channeling breastfeeding messages through printed mass media and provision of specialized breastfeeding support to mothers with cesarean section delivery may help in reducing the barriers to early breastfeeding initiation. Targeted interventions and strategies that promote breastfeeding practices, particularly among primigravida women and in regions with lower rates of EBI contribute to increased rate of optimal breastfeeding.
Collapse
Affiliation(s)
- Eva Belingon Felipe-Dimog
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Sanmin District, Kaohsiung 807, Taiwan; Nursing Department, Mountain Province State Polytechnic College, Bontoc 2616, Mountain Province, Philippines.
| | - Yvette Joy B Dumalhin
- Nursing Department, Mountain Province State Polytechnic College, Bontoc 2616, Mountain Province, Philippines
| | - Fu-Wen Liang
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Sanmin District, Kaohsiung 807, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road, Sanmin District, Kaohsiung 807, Taiwan; Center for Big Data Research, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Sanmin District, Kaohsiung 807, Taiwan.
| |
Collapse
|
183
|
Pac J, Bartel A, Ruhm C, Waldfogel J. Paid family leave and parental investments in infant health: Evidence from California. Econ Hum Biol 2023; 51:101308. [PMID: 37812832 DOI: 10.1016/j.ehb.2023.101308] [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: 10/10/2022] [Revised: 07/28/2023] [Accepted: 09/26/2023] [Indexed: 10/11/2023]
Abstract
This paper evaluates the effect of Paid Family Leave (PFL) on breastfeeding and immunizations- two critical parental investments in infant health - which we identify using California's 2004 PFL policy that ensured mothers up to six weeks of leave at a 55% wage replacement rate. We employ difference-in-difference and difference-in-difference-in-differences models for a large, representative sample of children (N = 314,532) born between 2000 and 2013 drawn from the restricted-use versions of the 2003-2014 National Immunization Surveys. Our most conservative estimates indicate that access to PFL is associated with at least a 15% increase in breastfeeding exclusively for at least six months. We find substantially large effects for disadvantaged mothers, adding to the existing evidence that access to state-sanctioned paid family leave might benefit children overall and disadvantaged children in particular.
Collapse
Affiliation(s)
- Jessica Pac
- University of Wisconsin-Madison Institute for Research on Poverty and Sandra Rosenbaum School of Social Work, 1350 University Ave., Madison, WI 53706, USA.
| | - Ann Bartel
- Columbia University, Columbia Business School, 623 Uris, New York, NY 10027, USA
| | - Christopher Ruhm
- University of Virginia, Frank Batten School of Leadership and Public Policy, Garrett Hall 108, Charlottesville, VA 22904, USA
| | - Jane Waldfogel
- Columbia School of Social Work, Columbia University, 1255 Amsterdam Ave, New York, NY 10027, USA
| |
Collapse
|
184
|
Stoner MCD, Hawley I, Mathebula F, Horne E, Etima J, Kemigisha D, Mutero P, Dandadzi A, Seyama L, Fabiano Z, Scheckter R, Noguchi L, Owor M, Balkus JE, Montgomery ET. Acceptability and Use of the Dapivirine Vaginal Ring and Daily Oral Pre-exposure Prophylaxis (PrEP) During Breastfeeding in South Africa, Malawi, Zimbabwe, and Uganda. AIDS Behav 2023; 27:4114-4123. [PMID: 37432541 PMCID: PMC10615878 DOI: 10.1007/s10461-023-04125-w] [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] [Subscribe] [Scholar Register] [Accepted: 07/01/2023] [Indexed: 07/12/2023]
Abstract
This study examines qualitative acceptability of the dapivirine vaginal ring (DVR) and oral daily pre-exposure prophylaxis (PrEP) among breastfeeding persons participating in Microbicide Trials Network 043/B-PROTECTED, a phase 3B safety and drug detectability study of DVR and oral PrEP in breastfeeding. A subsample of 52 participants were purposively sampled to participate in an in-depth interview (IDI). Breastfeeding participants found both study products to be acceptable, and easy to use. A common motivation for product use was to protect the baby from HIV, although participants' understanding of how the study drug would work to protect their babies was often unclear. While most participants did not report experiencing side effects, fears about side effects were common as both initial worries about how the study products would affect their health and the health of their baby, and increased anxiety that health issues experienced by them, or their baby were from the products.
Collapse
Affiliation(s)
- Marie C D Stoner
- Women's Global Health Imperative, RTI International, 2150 Shattuck Avenue, Berkeley, CA, 94104, USA.
| | - Imogen Hawley
- Women's Global Health Imperative, RTI International, 2150 Shattuck Avenue, Berkeley, CA, 94104, USA
| | - Florence Mathebula
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Elizea Horne
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Juliane Etima
- Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda
| | - Doreen Kemigisha
- Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda
| | - Prisca Mutero
- Clinical Trials Research Centre, University of Zimbabwe, Harare, Zimbabwe
| | - Adlight Dandadzi
- Clinical Trials Research Centre, University of Zimbabwe, Harare, Zimbabwe
| | - Linly Seyama
- Johns Hopkins Project, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Zayithwa Fabiano
- Johns Hopkins Project, College of Medicine, University of Malawi, Blantyre, Malawi
| | | | - Lisa Noguchi
- Division of Reproductive, Maternal, Newborn, Child and Adolescent Health, Jhpiego/Johns Hopkins University, Washington, DC, USA
| | - Maxensia Owor
- Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda
| | - Jennifer E Balkus
- Department of Epidemiology, University of Washington School of Public Health, Seattle, USA
- Vaccine and Infectious Disease Division, Fred Hutch Cancer Center, Seattle, USA
| | - Elizabeth T Montgomery
- Women's Global Health Imperative, RTI International, 2150 Shattuck Avenue, Berkeley, CA, 94104, USA
| |
Collapse
|
185
|
Whaites Heinonen E, Tötterman K, Bäck K, Sarman I, Forsberg L, Svedenkrans J. High lithium concentration at delivery is a potential risk factor for adverse outcomes in breastfed infants: a retrospective cohort study. Int J Bipolar Disord 2023; 11:36. [PMID: 38032417 PMCID: PMC10689698 DOI: 10.1186/s40345-023-00317-4] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/08/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Neonatal effects of late intrauterine and early postpartum exposure to lithium through mother's own milk are scarcely studied. It is unclear whether described symptoms in breastfed neonates are caused by placental lithium transfer or postnatal exposure to lithium through breastfeeding. We aimed to investigate lithium clearance and neonatal morbidity in breastfed infants with high versus low serum lithium concentrations at birth. METHODS This retrospective study focused on breastfed infants to women treated with lithium during and after pregnancy, born between 2006 and 2021 in Stockholm, Sweden. Information on serum lithium concentrations and adverse neonatal outcomes was obtained from medical records. Neonatal symptoms and lithium clearance were compared between a high exposure group (HEG, lithium concentrations ≥ 0.6 meq/l) and a low exposure group (LEG, < 0.6 meq/l). RESULTS A total of 25 infant-mother dyads were included. Median lithium serum concentration at birth was 0.90 meq/l in the HEG as compared with 0.40 meq/l in the LEG (p < 0.05). The difference was still significant at follow-up (0.20 meq/l vs 0.06 meq/l, p < 0.05), despite reduction in maternal dose. The rate of neonatal symptoms was 85.7% in HEG and 41.2% in LEG (p = 0.08) at birth and 28.6% vs 11.8% at follow-up (p = 0.55). Furthermore, 28.6% of infants in HEG were admitted to neonatal care, vs 5.9% in LEG (p = 0.19). Two infants in the HEG had therapeutic lithium levels at follow-up. All infants with symptoms at follow-up were either in the HEG or exposed to additional psychotropic medication. CONCLUSIONS Neonatal symptoms are common after late intrauterine lithium exposure, however transient, treatable and mostly mild. In this study, a high lithium concentration at birth was a risk factor for an increased lithium level at follow-up. Polypharmacy may constitute an additional risk factor. This study suggests that the late intrauterine exposure to lithium might add to the adverse effects in lithium-exposed, breastfed infants. Consequently we recommend breastfed infants with therapeutic lithium concentrations at birth to be followed up promptly to avoid lithium toxicity.
Collapse
Affiliation(s)
- Essi Whaites Heinonen
- Department of Clinical Science, Intervention and Technology (CLINTEC), Div of Pediatrics, Karolinska Institutet, Blickagången 6A, 14157, Huddinge, Stockholm, Sweden.
- Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden.
| | | | - Karin Bäck
- Department of Neonatology, St Goran Hospital, Stockholm, Sweden
| | - Ihsan Sarman
- Department of Clinical Science and Education Stockholm South Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Lisa Forsberg
- Department of Clinical Science, Intervention and Technology (CLINTEC), Div of Pediatrics, Karolinska Institutet, Blickagången 6A, 14157, Huddinge, Stockholm, Sweden
| | - Jenny Svedenkrans
- Department of Clinical Science, Intervention and Technology (CLINTEC), Div of Pediatrics, Karolinska Institutet, Blickagången 6A, 14157, Huddinge, Stockholm, Sweden
- Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
186
|
Giang HTN, Hieu LTM, Duy DTT, Phuong MT, Trung TD. The effect of skin-to-skin contact on early initiation of breastfeeding among women in Vietnam. Pediatr Neonatol 2023:S1875-9572(23)00215-2. [PMID: 38057258 DOI: 10.1016/j.pedneo.2023.07.007] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 06/13/2023] [Accepted: 07/18/2023] [Indexed: 12/08/2023] Open
Abstract
AIM To describe prevalence of early initiation of breastfeeding and associated factors among Vietnamese mothers. METHODS A self-administered questionnaire was used to survey 1812 mothers whose infants were aged 0 to less than 30 months in multi-center Vietnam. Multivariate logistic regression was performed to identify factors associated independently with early initiation of breastfeeding. RESULTS Prevalence of early initiation of breastfeeding was 57.2 % and this prevalence was higher in female infants compared with male infants (p = 0.004). Factors associated with increased odds of early initiation of breastfeeding include female infants (aOR: 1.33; 95%CI: 1.06 to 1.68) living in urban areas (aOR: 1.34, 95%CI: 1.05 to 1.71), giving birth in private hospitals (aOR: 1.94, 95%CI: 1.25 to 3.03), vaginal birth (aOR: 1.70, 95%CI: 1.34 to 2.16). Factors associated with decreased odds of early initiation of breastfeeding include higher educational level, mother's weight gain during pregnancy, and infant complication at birth. Compared with mothers who had not experienced skin-to-skin contact with their babies, the prevalence of early initiation of breastfeeding was higher in mothers who experienced <15 min (aOR: 2.03, 95%CI: 1.32 to 3.14), 15-90 min (aOR: 6.33, 95%CI: 4.11 to 9.76), and >90 min (aOR: 10.98, 95%CI: 6.79 to 17.75). CONCLUSION Focusing on modifiable factors should be a key priority to help improve early initiation of breastfeeding practice.
Collapse
Affiliation(s)
- Hoang Thi Nam Giang
- School of Medicine and Pharmacy, The University of Danang, Danang, Viet Nam.
| | - Le Tho Minh Hieu
- School of Medicine and Pharmacy, The University of Danang, Danang, Viet Nam
| | - Do Thi Thuy Duy
- School of Medicine and Pharmacy, The University of Danang, Danang, Viet Nam
| | | | - Tran Dinh Trung
- Faculty of Public Health, Danang University of Medical Technology and Pharmacy, Danang, Viet Nam
| |
Collapse
|
187
|
裘 梦, 胡 晓. [Latest Findings on the Suck-Swallow-Breathe Mechanism of Direct Breastfeeding From the Breast to an Infant]. Sichuan Da Xue Xue Bao Yi Xue Ban 2023; 54:1306-1311. [PMID: 38162076 PMCID: PMC10752769 DOI: 10.12182/20231160503] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Indexed: 01/03/2024]
Abstract
A mother's breast milk is the best nourishing food for infants. No only does it provide sufficient nutrition, but it is also well suited to infants' immature digestive function, thus promoting their growth and organ maturation. A 6-month period of breastfeeding can provide infants with the necessary nutrients, energy, and fluids. The best feeding method is direct breastfeeding from the breast to an infant, yet the difficulties involved in breastfeeding should not be overlooked. Approximately 1/3 the mothers who are performing direct breastfeeding from the breast to an infant experience moderate or higher levels of feeding difficulties. Difficulties in direct breastfeeding from the breast to an infant can lead to decreased feeding efficiency, hamper the growth and development of infants, and affect the emotional communication between mothers and infants. At present, many relevant studies have focused on topics such as the mothers' psychology, family and social support, and the immature development of infants. However, little research has been done to investigate suck-swallow-breathe, a physiological mechanism that infants undertake during the process of direct breastfeeding from the breast to an infant. In this paper, we summarized published literature, research parameters, measurement instruments, and physical intervention methods of the suck-swallow-breathe mechanism in infants, aiming to facilitate the early identification of breastfeeding difficulties and the subsequently provision of early intervention measures and to promote the early identification of neurodevelopmental abnormalities and other developmental abnormalities in infants.
Collapse
Affiliation(s)
- 梦凡 裘
- 复旦大学护理学院 (上海 200032)School of Nursing, Fudan University, Shanghai 200032, China
- 复旦大学附属儿科医院 (上海 201102)Children's Hospital of Fudan University, Shanghai 201102, China
| | - 晓静 胡
- 复旦大学护理学院 (上海 200032)School of Nursing, Fudan University, Shanghai 200032, China
| |
Collapse
|
188
|
Lin KY, Shao W, Tsai YJ, Yang JF, Wu MH. Physical therapy intervention for breast symptoms in lactating women: a randomized controlled trial. BMC Pregnancy Childbirth 2023; 23:792. [PMID: 37964187 PMCID: PMC10647054 DOI: 10.1186/s12884-023-06114-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/08/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Therapeutic ultrasound, education, and massage are the most common physical therapy interventions provided to mothers with breast symptoms. However, there is insufficient evidence on the effectiveness of the combination of these interventions. This study aimed to explore the effects of the combination of therapeutic ultrasound, education, and massage on breast symptoms in lactating women. METHODS This study was a single-blind randomized controlled trial. Postpartum lactating women aged from 21 to 45 with breast symptoms were recruited and randomly allocated to one of three groups (ultrasound group, sham group, and usual care group). The severity of breast symptoms (pain, redness, lump, general malaise), breast engorgement, breast hardness, body temperature, breast temperature, and milk volume were assessed at baseline (T1), immediately post-intervention (T2), and at 3 months following baseline (T3). RESULTS A total of 37 participants were included in the study (ultrasound group n = 12; sham group n = 12; usual care n = 13). The severity of breast symptoms (i.e., pain, lump, and general malaise) as well as breast engorgement, were significantly improved in the ultrasound group at T2 when compared to T1, and these improvements were sustained at T3. The severity of breast engorgement was significantly lower in the ultrasound group when compared to the usual care group at T2. However, no statistically significant differences were found between the ultrasound and sham groups for all outcomes at any assessment time points. CONCLUSIONS Physical therapy interventions may be beneficial in relieving breast symptoms in lactating women. Larger randomized controlled trials are needed to confirm the findings of this study. TRIAL REGISTRATION ClinicalTrials.gov (NCT04569136); Date of registration: 29/09/2020.
Collapse
Affiliation(s)
- Kuan-Yin Lin
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Wei Shao
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ju Tsai
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jeng-Feng Yang
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Physical Therapy Center, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Meng-Hsing Wu
- Department of Obstetrics and Gynecology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Obstetrics and Gynecology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| |
Collapse
|
189
|
Sohn JA, Chang JY, Oh S, Hong J. Differences in Growth and Dietary and Nutrient Intake Patterns by Breastfeeding Status Over One Year Among Korean Children Aged 24-35 Months. J Korean Med Sci 2023; 38:e363. [PMID: 37967877 PMCID: PMC10643245 DOI: 10.3346/jkms.2023.38.e363] [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: 05/31/2023] [Accepted: 08/06/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND A previous national study found that Korean children who were breastfed for at least one year had lesser weight gain, lower protein, calcium, and iron intake relative to calories, and different dietary patterns in the second year of life, compared with children weaned before 12 months of age or those who were never breastfed. Therefore, this study aimed to investigate whether growth status, dietary and nutrient intake patterns differed by prolonged breastfeeding (PBF) experience even in the third year of life, when weaning is considered complete. METHODS This cross-sectional study was based on the data of children aged 24 to 35 months from the National Health and Nutrition Examination Survey (2010-2020). Data on anthropometry, dietary behavior, food and nutrient intake, maternal education, and household income were extracted to analyze the association between PBF and growth, dietary and nutrient intake patterns. RESULTS In the final analysis, 31.6% of the 931 children with a birth weight of ≥ 2.5 kg continued to breastfeed for at least 12 months of age, and their mean breastfeeding (BF) duration was 15.9 months. Children with PBF had significantly less postnatal weight gain than those without (P = 0.006). Regarding food group intake, PBF was significantly associated with lower legume and soy product intake (β [95% confidence interval], -10.688 [-19.314, -2.062], P = 0.015) and higher fruit intake (32.978 [3.349, 62.608], P = 0.029), after adjusting for sex, age in month, total caloric intake, maternal education and household income. Regarding nutrient intake, after adjusting for these variables, PBF had significantly associated with higher dietary fiber (β [95% CI], 1.607 [0.218, 2.996], P = 0.023), iron (0.848 [0.317, 1.380], P = 0.002) and niacin (0.728 [0.222, 1.235], P = 0.005) intake and was significantly associated with lower saturated fatty acid intake (-1.217 [-2.364, -0.071], P = 0.037) and percentage of energy from fat (-1.351 [-2.666, -0.035], P = 0.044). CONCLUSION Even in the third year of life, children who have been breastfed for over one year continue to have relatively slow growth. However, they do appear to have better intake of some beneficial nutrients, which may be attributed to healthier dietary intake patterns in children with PBF. The results of this study can be used to support the recommendation of long-term BF for Korean infants and toddlers.
Collapse
Affiliation(s)
- Jin A Sohn
- Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Ju Young Chang
- Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
| | - Sohee Oh
- Medical Research Collaborating Center, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jeana Hong
- Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea
| |
Collapse
|
190
|
Maramag CC, Samaniego JAR, Castro MC, Zambrano P, Nguyen TT, Cashin J, Datu-Sanguyo J, Mathisen R, Weissman A. Maternity protection policies and the enabling environment for breastfeeding in the Philippines: a qualitative study. Int Breastfeed J 2023; 18:60. [PMID: 37950248 PMCID: PMC10638739 DOI: 10.1186/s13006-023-00594-w] [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: 01/30/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The Philippines has enacted maternity protection policies, such as the 105-Day Expanded Maternity Leave Law and the Expanded Breastfeeding Promotion Act of 2009, to protect, promote, and support breastfeeding. This study aimed to review the content and implementation of maternity protection policies in the Philippines and assess their role in enabling recommended breastfeeding practices. It also identified bottlenecks to successful implementation from the perspectives of mothers and their partners, employers, and authorities from the government and non-government organizations involved in developing, implementing, monitoring, and enforcing maternity protection policies. METHODS This study employed a desk review of policies, guidelines, and related documents on maternity protection, and in-depth interviews. Of the 87 in-depth interviews, there were 12 employed pregnant women, 29 mothers of infants, 15 partners of the mothers, 12 employers and 19 key informants from the government and non-government organizations. Respondents for the in-depth interviews were from the Greater Manila Area and were recruited using purposive snowball sampling. Data were collected from December 2020 to April 2021. RESULTS The study shows that maternity protection policies in the Philippines are mostly aligned with the maternity protection standards set by the International Labour Organization. However, their role in improving breastfeeding practices is limited because: (1) not all working women have access to maternity protection entitlements; (2) the duration of maternity leave entitlements is inconsistent with the World Health Organization's recommended duration of exclusive breastfeeding; (3) there are gaps in policy implementation including: a lack of monitoring systems to measure the availability, functionality, and usage of lactation spaces; limited workplace support for breastfeeding; poor communication of maternity and paternity entitlements; and limited breastfeeding advocacy and promotion; and (4) there is limited integration between maternity protection and breastfeeding promotion interventions. CONCLUSIONS There is a need to (1) strengthen communication about and promotion of maternity and paternity entitlements for mothers, fathers and employers, (2) improve monitoring and enforcement mechanisms to ensure utilization of entitlements among mothers, (3) develop modalities to extend the coverage of maternity entitlements to the informal sector, (4) fully cover paid leave entitlements from social insurance or public funding sources in line with International Labour Organization recommendations, and (5) revisit the limitations on the coverage of paternity entitlement.
Collapse
Affiliation(s)
- Cherry C Maramag
- Nutrition Center of the Philippines, Muntinlupa City, Philippines
| | | | | | - Paul Zambrano
- Alive & Thrive, Global Nutrition, FHI 360, Manila, Philippines
| | - Tuan T Nguyen
- Alive & Thrive, Global Nutrition, FHI 360, Hanoi, Vietnam
| | - Jennifer Cashin
- Alive & Thrive, Global Nutrition, FHI 360, Washington, District of Columbia, USA
| | | | - Roger Mathisen
- Alive & Thrive, Global Nutrition, FHI 360, Hanoi, Vietnam
| | - Amy Weissman
- Asia Pacific Regional Office, FHI 360, Bangkok, Thailand
| |
Collapse
|
191
|
Cecchini L, Barmaz C, Cea MJC, Baeschlin H, Etter J, Netzer S, Bregy L, Marchukov D, Trigo NF, Meier R, Hirschi J, Wyss J, Wick A, Zingg J, Christensen S, Radan AP, Etter A, Müller M, Kaess M, Surbek D, Yilmaz B, Macpherson AJ, Sokollik C, Misselwitz B, Ganal-Vonarburg SC. The Bern Birth Cohort (BeBiCo) to study the development of the infant intestinal microbiota in a high-resource setting in Switzerland: rationale, design, and methods. BMC Pediatr 2023; 23:560. [PMID: 37946167 PMCID: PMC10637001 DOI: 10.1186/s12887-023-04198-5] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 07/17/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Microbiota composition is fundamental to human health with the intestinal microbiota undergoing critical changes within the first two years of life. The developing intestinal microbiota is shaped by maternal seeding, breast milk and its complex constituents, other nutrients, and the environment. Understanding microbiota-dependent pathologies requires a profound understanding of the early development of the healthy infant microbiota. METHODS Two hundred and fifty healthy pregnant women (≥20 weeks of gestation) from the greater Bern area will be enrolled at Bern University hospital's maternity department. Participants will be followed as mother-baby pairs at delivery, week(s) 1, 2, 6, 10, 14, 24, 36, 48, 96, and at years 5 and 10 after birth. Clinical parameters describing infant growth and development, morbidity, and allergic conditions as well as socio-economic, nutritional, and epidemiological data will be documented. Neuro-developmental outcomes and behavior will be assessed by child behavior checklists at and beyond 2 years of age. Maternal stool, milk, skin and vaginal swabs, infant stool, and skin swabs will be collected at enrolment and at follow-up visits. For the primary outcome, the trajectory of the infant intestinal microbiota will be characterized by 16S and metagenomic sequencing regarding composition, metabolic potential, and stability during the first 2 years of life. Secondary outcomes will assess the cellular and chemical composition of maternal milk, the impact of nutrition and environment on microbiota development, the maternal microbiome transfer at vaginal or caesarean birth and thereafter on the infant, and correlate parameters of microbiota and maternal milk on infant growth, development, health, and mental well-being. DISCUSSION The Bern birth cohort study will provide a detailed description and normal ranges of the trajectory of microbiota maturation in a high-resource setting. These data will be compared to data from low-resource settings such as from the Zimbabwe-College of Health-Sciences-Birth-Cohort study. Prospective bio-sampling and data collection will allow studying the association of the microbiota with common childhood conditions concerning allergies, obesity, neuro-developmental outcomes , and behaviour. Trial registration The trial has been registered at www. CLINICALTRIALS gov , Identifier: NCT04447742.
Collapse
Affiliation(s)
- Luca Cecchini
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Colette Barmaz
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Maria José Coloma Cea
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Hannah Baeschlin
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Julian Etter
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Stefanie Netzer
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Leonie Bregy
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Dmitrij Marchukov
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Nerea Fernandez Trigo
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Rachel Meier
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Jasmin Hirschi
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Jacqueline Wyss
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Andrina Wick
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Joelle Zingg
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Sandro Christensen
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Anda-Petronela Radan
- Department of Obstetrics and Gynaecology, Bern University Hospital, Inselspital, University of Bern, Friedbühlstrasse 19, 3010, Bern, Switzerland
| | - Annina Etter
- Department of Obstetrics and Gynaecology, Bern University Hospital, Inselspital, University of Bern, Friedbühlstrasse 19, 3010, Bern, Switzerland
| | - Martin Müller
- Department of Obstetrics and Gynaecology, Bern University Hospital, Inselspital, University of Bern, Friedbühlstrasse 19, 3010, Bern, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Haus A, 3000, Bern, Switzerland
| | - Daniel Surbek
- Department of Obstetrics and Gynaecology, Bern University Hospital, Inselspital, University of Bern, Friedbühlstrasse 19, 3010, Bern, Switzerland
| | - Bahtiyar Yilmaz
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Andrew J Macpherson
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Christiane Sokollik
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital, Inselspital, University of Bern, Freiburgstrasse 15, 3010, Bern, Switzerland
| | - Benjamin Misselwitz
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland.
| | - Stephanie C Ganal-Vonarburg
- Department for BioMedical Research (DBMR), Department of Visceral Surgery and Medicine, University of Bern, Inselspital, Bern University Hospital, Freiburgstr. 18, 3010, Bern, Switzerland
| |
Collapse
|
192
|
Nalugga EA, Kukundakwe M, Tibakanya R, Tindyebwa E, Baluku W, Mulindwa K, Asiimwe SP, Twimukye A, Waitt C. It Takes A Village; Involvement of Village Health Teams to Develop Tools and Resources to Communicate about Antiretroviral Use in Pregnancy and Breastfeeding at Community Level in Uganda. Wellcome Open Res 2023; 8:510. [PMID: 38292066 PMCID: PMC10825416 DOI: 10.12688/wellcomeopenres.19088.1] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 02/01/2024] Open
Abstract
Background Research findings must be communicated to the populations who will benefit from them, in a manner that is accessible and understandable. Aims We recently generated novel data on medication use in breastfeeding. A Faculty of Health and Life Sciences (Liverpool) grant enabled work with a team of Village Health Teams (VHTs) in Hoima, rural Uganda, to co-create related communication materials for use in their house-to-house visitation and health education. Methods After an initial workshop from 24th to 26th March 2021, training and review of draft materials, 10 VHT pairs visited 50 households in Hoima district. Basic demographic data were collected alongside preferred communication methods. VHTs provided feedback and re-design of materials commenced. This included dramatization of scenarios and photography. A second round of house-to-house visitation informed final adjustments. We conducted focused group discussions and a dissemination workshop attended by VHTs, local healthcare leaders and journalists was hosted on 16th - 17th June 2022. Results Most households (74%) had a breastfeeding baby. Majority could read and had access to radios (60%), but not to smartphones (58%) or television (86%). Most preferred verbal and visual aids for health education, and requested images of "people who look like us".Final co-created materials included posters in English and Runyoro and laminated 'job aids' in both languages . These continue to be in active use. VHTs and community members requested future projects of this nature. Conclusion Healthcare communication to communities must be accessible and clear. Representation of images that the public can identify with is important. Co-creation workshops were successful in rural Uganda, and pave the way for future collaborative, participatory research.
Collapse
Affiliation(s)
- Esther Alice Nalugga
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Mercy Kukundakwe
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Elizabeth Tindyebwa
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - William Baluku
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Kenneth Mulindwa
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Simon Peter Asiimwe
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Adelline Twimukye
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Catriona Waitt
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| |
Collapse
|
193
|
Vesel L, Benotti E, Somji S, Bellad RM, Charantimath U, Dhaded SM, Goudar SS, Karadiguddi C, Mungarwadi G, Vernekar SS, Kisenge R, Manji K, Salim N, Samma A, Sudfeld CR, Hoffman IF, Mvalo T, Phiri M, Saidi F, Tseka J, Tsidya M, Caruso BA, Duggan CP, Israel-Ballard K, Lee AC, Mansen KL, Martin SL, North K, Young MF, Fishman E, Fleming K, Semrau KE, Spigel L, Tuller DE, Henrich N. Facilitators, barriers, and key influencers of breastfeeding among low birthweight infants: a qualitative study in India, Malawi, and Tanzania. Int Breastfeed J 2023; 18:59. [PMID: 37940987 PMCID: PMC10634072 DOI: 10.1186/s13006-023-00597-7] [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: 11/06/2022] [Accepted: 11/02/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Low birthweight (LBW) infants are at increased risk of morbidity and mortality. Exclusive breastfeeding up to six months is recommended to help them thrive through infection prevention, growth improvements, and enhancements in neurodevelopment. However, limited data exist on the feeding experiences of LBW infants, their caregivers and key community influencers. The qualitative component of the Low Birthweight Infant Feeding Exploration (LIFE) study aimed to understand practices, facilitators, and barriers to optimal feeding options in the first six months for LBW infants in low-resource settings. METHODS This study was conducted in four sites in India, Malawi, and Tanzania from July 2019 to August 2020. We conducted 37 focus group discussions with mothers and family members of LBW infants and community leaders and 142 in-depth interviews with healthcare providers, government officials, and supply chain and donor human milk (DHM) experts. Data were analyzed using a framework approach. RESULTS All participants believed that mother's own milk was best for LBW infants. Direct breastfeeding was predominant and feeding expressed breast milk and infant formula were rare. DHM was a new concept for most. Adequate maternal nutrition, lactation support, and privacy in the facility aided breastfeeding and expression, but perceived insufficient milk, limited feeding counseling, and infant immaturity were common barriers. Most believed that DHM uptake could be enabled through community awareness by overcoming misconceptions, safety concerns, and perceived family resistance. CONCLUSION This study fills an evidence gap in LBW infant feeding practices and their facilitators and barriers in resource-limited settings. LBW infants face unique feeding challenges such as poor latching and tiring at the breast. Similarly, their mothers are faced with numerous difficulties, including attainment of adequate milk supply, breast pain and emotional stress. Lactation support and feeding counseling could address obstacles faced by mothers and infants by providing psychosocial, verbal and physical support to empower mothers with skills, knowledge and confidence and facilitate earlier, more and better breast milk feeding. Findings on DHM are critical to the future development of human milk banks and highlight the need to solicit partnership from stakeholders in the community and health system.
Collapse
Affiliation(s)
- Linda Vesel
- Ariadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Emily Benotti
- Ariadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sarah Somji
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Roopa M Bellad
- KLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India
| | - Umesh Charantimath
- KLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India
| | - Sangappa M Dhaded
- KLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India
| | - Shivaprasad S Goudar
- KLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India
| | - Chandrashekhar Karadiguddi
- KLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India
| | - Geetanjali Mungarwadi
- KLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India
| | - Sunil S Vernekar
- KLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India
| | - Rodrick Kisenge
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Karim Manji
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Nahya Salim
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Abraham Samma
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Christopher R Sudfeld
- Departments of Global Health and Population and Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Irving F Hoffman
- Institute for Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Tisungane Mvalo
- University of North Carolina Project Malawi, Lilongwe, Malawi
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Melda Phiri
- University of North Carolina Project Malawi, Lilongwe, Malawi
| | - Friday Saidi
- University of North Carolina Project Malawi, Lilongwe, Malawi
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer Tseka
- University of North Carolina Project Malawi, Lilongwe, Malawi
| | - Mercy Tsidya
- University of North Carolina Project Malawi, Lilongwe, Malawi
| | - Bethany A Caruso
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Christopher P Duggan
- Departments of Global Health and Population and Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Center for Nutrition, Boston Children's Hospital, Boston, MA, USA
| | - Kiersten Israel-Ballard
- Ariadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Anne Cc Lee
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Kimberly L Mansen
- Maternal, Newborn, Child Health and Nutrition Program, PATH, Seattle, WA, USA
| | - Stephanie L Martin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Krysten North
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Melissa F Young
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Eliza Fishman
- Ariadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Katelyn Fleming
- Ariadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Katherine Ea Semrau
- Ariadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Lauren Spigel
- Ariadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Danielle E Tuller
- Ariadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Natalie Henrich
- Ariadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
194
|
Oyedele OK. Correlates of non-institutional delivery to delayed initiation of breastfeeding in Nigeria: logit-decomposition and subnational analysis of population-based survey. J Health Popul Nutr 2023; 42:121. [PMID: 37932844 PMCID: PMC10629092 DOI: 10.1186/s41043-023-00466-3] [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] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 10/28/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Studies have connected newborn delivery settings and modality to optimal breastfeeding, but how it influences untimely initiation, mostly prevalent in sub-Saharan Africa is unknown. Hence, the role of home delivery on delay initiation of breastfeeding (DIBF) in Nigeria was investigated to inform evidence-based strategy for improved breastfeeding practice. METHODOLOGY This is a secondary analysis of births (11,469 home and 7632 facility delivery) by 19,101 reproductive age women in the 2018 NDHS. DIBF is the outcome, home birth is the exposure, and explanatory variables were classified as: socio-demographics, obstetrics and economic factors. Descriptive statistics (frequencies and percentages) were reported, and bivariate (chi-square) analysis was carried out at 20% (p < 0.20) cutoff point. Multivariable logistic regression assessed the probability and significance of the outcome per place of birth. Multivariate decomposition further evaluated the endowment and coefficient effect contribution by independent factors to the outcome. Analysis was carried out at p < 0.05 (95% confidence level) on Stata. RESULTS 56.6% of mothers DIBF, with 37.1% and 19.5% from home and facility delivery, respectively. Home delivery (AOR = 1.34, 95% CI 1.17-1.52) increase the chance of DIBF by 34%, while DIBF probability reduces by 26% in facility delivery (AOR = 0.74, 95% CI 0.65-0.85). DIBF is 5 times more likely in caesarian section delivery (AOR = 5.10, 95% CI 4.08-6.38) compared to virginal birth in facility delivery. Skilled antenatal provider, parity and wealth are negatively associated with DIBF in home birth, while undesired pregnancy, rural residency, partial/no skin-to-skin contact and large child size positively influence DIBF in both home and facility delivery. Skilled antenatal provider (C = - 66.3%, p < 0.01) and skin-to-skin contact (C = - 60.6%, p < 0.001) contributed most to reducing the negative DIBF effect with 69% and 31% overall characteristics and coefficient effect component, respectively. DIBF is more likely in Bauchi and Sokoto but less likely in Bayelsa. CONCLUSIONS High DIBF prevalent in Nigeria was largely due to elevated rate of home birth, positively associated with DIBF. Caesarian section delivery though heightens the chance of DIBF in facility delivery. Strengthening utilization of skilled provider and skin-to-skin contact can eliminate two-third of the adverse DIBF effect and improve early initiation rate. Adopting this strategy will bridge home-facility delivery gap to achieve optimal breastfeeding practice.
Collapse
Affiliation(s)
- Oyewole K Oyedele
- International Research Centre of Excellence, Institute of Human Virology, Nigeria (IHVN), Abuja, FCT, Nigeria.
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
| |
Collapse
|
195
|
Sun Y, Gao Y, Zhu Z, Zhu L. Effect of online intervention mode on breastfeeding results: a systematic review and meta-analysis. Reprod Health 2023; 20:164. [PMID: 37926827 PMCID: PMC10626799 DOI: 10.1186/s12978-023-01701-0] [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] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/15/2023] [Indexed: 11/07/2023] Open
Abstract
OBJECTIVE To evaluate the effect of Internet based intervention model on breastfeeding knowledge, attitude, self-confidence and breastfeeding rate. METHODS An electronic literature search of PubMed, Embase, Web of Science, Cochrane Library, CINAHL, CNKI, Wanfang, CBM and VIP database was performed using combinations of the keywords "Breastfeeding," "Breastfeeding, Exclusive," "Internet," "Online," and "Website". The retrieval period was from their inception to March 31, 2023. Quality appraisal was performed using the Cochrane 5.1 for randomized controlled trials (RCTs). RevMan5.3 was used for data analysis. RESULTS Thirty-two studies were included in the review, with a total of 9514 samples. The results of Meta-analysis showed that, compared with routine nursing, the intervention model based on the Internet can effectively improve breastfeeding knowledge and attitude of pregnant women, improve breastfeeding self-confidence (P < 0.05), and improve the rate of exclusive breastfeeding in the short term (within 6 weeks) and the long-term postpartum (3-6 months) had a positive effect on the rate of exclusive breastfeeding (P < 0.05). CONCLUSIONS The Internet breastfeeding intervention model may be an effective intervention to improve the effect of exclusive breastfeeding. In the future, more high-quality, large-sample randomized controlled trials can be carried out to further explore the effect of the Internet intervention model on breastfeeding.
Collapse
Affiliation(s)
- Yue Sun
- Department of Nursing, School of Nursing, Xinxiang Medical University, Xinxiang, Henan, China
| | - Yutong Gao
- Department of Nursing, School of Nursing, Xinxiang Medical University, Xinxiang, Henan, China
| | - Zhiling Zhu
- Xinxiang Central Hospital, Xinxiang, Henan, China
| | - Lili Zhu
- Department of Nursing, School of Nursing, Xinxiang Medical University, Xinxiang, Henan, China.
| |
Collapse
|
196
|
Singh P, Al Mohannadi N, Murugesan S, Almarzooqi F, Kabeer BSA, Marr AK, Kino T, Brummaier T, Terranegra A, McGready R, Nosten F, Chaussabel D, Al Khodor S. Unveiling the dynamics of the breast milk microbiome: impact of lactation stage and gestational age. J Transl Med 2023; 21:784. [PMID: 37932773 PMCID: PMC10629158 DOI: 10.1186/s12967-023-04656-9] [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] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 10/24/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Breast milk (BM) provides complete nutrition for infants for the first six months of life and is essential for the development of the newborn's immature immune and digestive systems. While BM was conventionally believed to be sterile, recent advanced high throughput technologies have unveiled the presence of diverse microbial communities in BM. These insights into the BM microbiota have mainly originated from uncomplicated pregnancies, possibly not reflecting the circumstances of mothers with pregnancy complications like preterm birth (PTB). METHODS In this article, we investigated the BM microbial communities in mothers with preterm deliveries (before 37 weeks of gestation). We compared these samples with BM samples from healthy term pregnancies across different lactation stages (colostrum, transitional and mature milk) using 16S rRNA gene sequencing. RESULTS Our analysis revealed that the microbial communities became increasingly diverse and compositionally distinct as the BM matured. Specifically, mature BM samples were significantly enriched in Veillonella and lactobacillus (Kruskal Wallis; p < 0.001) compared to colostrum. The comparison of term and preterm BM samples showed that the community structure was significantly different between the two groups (Bray Curtis and unweighted unifrac dissimilarity; p < 0.001). Preterm BM samples exhibited increased species richness with significantly higher abundance of Staphylococcus haemolyticus, Propionibacterium acnes, unclassified Corynebacterium species. Whereas term samples were enriched in Staphylococcus epidermidis, unclassified OD1, and unclassified Veillonella among others. CONCLUSION Our study underscores the significant influence of pregnancy-related complications, such as preterm birth (before 37 weeks of gestation), on the composition and diversity of BM microbiota. Given the established significance of the maternal microbiome in shaping child health outcomes, this investigation paves the way for identifying modifiable factors that could optimize the composition of BM microbiota, thereby promoting maternal and infant health.
Collapse
Affiliation(s)
- Parul Singh
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
- Research Department, Sidra Medicine, Doha, Qatar
| | | | | | | | | | | | | | - Tobias Brummaier
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | | | - Rose McGready
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - François Nosten
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Damien Chaussabel
- Research Department, Sidra Medicine, Doha, Qatar
- The Jackson Laboratories, Farmington, CT, USA
| | - Souhaila Al Khodor
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar.
- Research Department, Sidra Medicine, Doha, Qatar.
| |
Collapse
|
197
|
Jagarapu J, Diaz MI, Lehmann CU, Medford RJ. Twitter discussions on breastfeeding during the COVID-19 pandemic. Int Breastfeed J 2023; 18:56. [PMID: 37925408 PMCID: PMC10625257 DOI: 10.1186/s13006-023-00593-x] [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: 09/08/2022] [Accepted: 10/22/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Breastfeeding is a critical health intervention in infants. Recent literature reported that the COVID-19 pandemic resulted in significant mental health issues in pregnant and breastfeeding women due to social isolation and lack of direct professional support. These maternal mental health issues affected infant nutrition and decreased breastfeeding rates during COVID-19. Twitter, a popular social media platform, can provide insight into public perceptions and sentiment about various health-related topics. With evidence of significant mental health issues among women during the COVID-19 pandemic, the perception of infant nutrition, specifically breastfeeding, remains unknown. METHODS We aimed to understand public perceptions and sentiment regarding breastfeeding during the COVID-19 pandemic through Twitter analysis using natural language processing techniques. We collected and analyzed tweets related to breastfeeding and COVID-19 during the pandemic from January 2020 to May 2022. We used Python software (v3.9.0) for all data processing and analyses. We performed sentiment and emotion analysis of the tweets using natural language processing libraries and topic modeling using an unsupervised machine-learning algorithm. RESULTS We analyzed 40,628 tweets related to breastfeeding and COVID-19 generated by 28,216 users. Emotion analysis revealed predominantly "Positive emotions" regarding breastfeeding, comprising 72% of tweets. The overall tweet sentiment was positive, with a mean weekly sentiment of 0.25 throughout, and was affected by external events. Topic modeling revealed six significant themes related to breastfeeding and COVID-19. Passive immunity through breastfeeding after maternal vaccination had the highest mean positive sentiment score of 0.32. CONCLUSIONS Our study provides insight into public perceptions and sentiment regarding breastfeeding during the COVID-19 pandemic. Contrary to other topics we explored in the context of COVID (e.g., ivermectin, disinformation), we found that breastfeeding had an overall positive sentiment during the pandemic despite the documented rise in mental health challenges in pregnant and breastfeeding mothers. The wide range of topics on Twitter related to breastfeeding provides an opportunity for active engagement by the medical community and timely dissemination of advice, support, and guidance. Future studies should leverage social media analysis to gain real-time insight into public health topics of importance in child health and apply targeted interventions.
Collapse
Affiliation(s)
- Jawahar Jagarapu
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- School of Biomedical Informatics, University of Texas, Houston, TX, USA.
- Division of Neonatal-Perinatal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Suite F3.118, Dallas, TX, 75390, USA.
| | - Marlon I Diaz
- Center for Clinical Informatics, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Christoph U Lehmann
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Center for Clinical Informatics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Richard J Medford
- Center for Clinical Informatics, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
198
|
Yu PJ, Wu WR, Liu CY. Public policy on breastfeeding among working mothers in Taiwan: comparison between two national surveys. BMC Pregnancy Childbirth 2023; 23:768. [PMID: 37924019 PMCID: PMC10623794 DOI: 10.1186/s12884-023-06069-4] [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: 07/08/2023] [Accepted: 10/15/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Creating a supportive breastfeeding environment after childbirth and enabling women to work with reassurance are essential in maternal care services. The study aimed to explore the effectiveness of the utilization rate of public and workplace lactation rooms in relation to the breastfeeding rate among postpartum women returning to work in Taiwan. METHODS The study involved a secondary data analysis on 6,992 and 7,350 postpartum women surveyed in 2011 and 2016, respectively. Interviews were conducted with women six months postpartum. Logistic regression analysis was employed to calculate the odds ratio and investigate the differences in the utilization rates of public lactation rooms (PLR) and workplace lactation rooms (WLR) among working mothers over a five-year period, to confirm the effectiveness of public strategies. RESULTS Comparing the years 2011 and 2016, significant differences in the rates of exclusive breastfeeding (EBF) and any breastfeeding (ABF) among working mothers returning to work after an 8-week maternity leave, depending on whether they used PLR or WLR. The rates were higher in 2016 than in 2011. For mothers who used PLR, the breastfeeding rates for EBF at the second, fourth, and sixth months (2011 vs. 2016: 67.6% vs. 81.1%, 75.0% vs. 86.4%, 77.5% vs. 86.2%) and ABF at the second, fourth, and sixth months (2011 vs. 2016: 60.3% vs. 73.9%, 68.8% vs. 81.3%, 73.7% vs. 85.6%). For mothers who used WLR, the breastfeeding rates for EBF at the second, fourth, and sixth months (2011 vs. 2016: 51.3% vs. 58.7%, 54.7% vs. 61.4%, 57.5% vs. 59.3%) and ABF at the second, fourth, and sixth months (2011 vs. 2016: 48.4% vs. 57.0%, 52.3% vs. 60.5%, 54.1% vs. 62.4%). When comparing 2011 to 2016 from the second to the sixth month postpartum, adjusted odds ratios for EBF (PLR: 4.17-5.23 vs. 4.06-6.22, WLR: 1.71-1.83 vs. 1.30-1.61) and ABF (PLR: 6.44-7.02 vs. 9.27-9.90, WLR: 1.91-1.98 vs. 1.97-1.99) showed differences. CONCLUSION Lactation support rooms play a vital role in motivating working mothers to sustain breastfeeding upon their return to work. Incentivizing businesses to build additional lactation rooms and offering breastfeeding resources is essential in striving to enhance the global breastfeeding rate.
Collapse
Affiliation(s)
- Pei-Jung Yu
- Mackay Medical College, New Taipei City, Taiwan, R.O.C
| | - Wan-Ru Wu
- Tzu Chi University, Hualien City, Taiwan R.O.C
| | - Chieh-Yu Liu
- National Taipei University of Nursing and Health Science, Taipei City, Taiwan R.O.C..
| |
Collapse
|
199
|
Wang Y, Wang J, Feng J. Multiple sclerosis and pregnancy: Pathogenesis, influencing factors, and treatment options. Autoimmun Rev 2023; 22:103449. [PMID: 37741528 DOI: 10.1016/j.autrev.2023.103449] [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: 08/27/2023] [Accepted: 09/18/2023] [Indexed: 09/25/2023]
Abstract
Multiple sclerosis (MS) is an autoimmune-mediated degenerative disease of the central nervous system, characterized by inflammatory demyelination. It is primarily found in women of childbearing age, making pregnancy a significant concern for both patients with MS and clinicians. To assist these patients in achieving their desire for pregnancy, reducing MS relapses during all stages of pregnancy, preventing the progression of MS, mitigating the impact of MS treatment on the course and outcome of pregnancy, and a thorough understanding of the relationship between pregnancy and MS, as well as specific management and the application of relevant medications for MS patients at each stage of pregnancy, are essential. This article provides an update on pregnancy-related issues in women with MS, including the general recommendations for management at each stage of pregnancy.
Collapse
Affiliation(s)
- Yinxiang Wang
- Department of Neurology, Shengjing Hospital of China Medical University, 36 Sanhao St., Shenyang 110004, China
| | - Jue Wang
- Department of Neurology, Shengjing Hospital of China Medical University, 36 Sanhao St., Shenyang 110004, China
| | - Juan Feng
- Department of Neurology, Shengjing Hospital of China Medical University, 36 Sanhao St., Shenyang 110004, China.
| |
Collapse
|
200
|
Ramírez-Silva I, Ariza AC, Barragán-Vázquez S, Mendoza Jiménez M, Ortiz-Panozo E, Batis C, Burguete-García A, Ávila-Jimenez L, Zambrano E, Rivera JA. Longitudinal patterns of breastfeeding and its association with adiposity and subjective indicators of satiety/appetite in the first 2 years of life. Appetite 2023; 190:107030. [PMID: 37678585 DOI: 10.1016/j.appet.2023.107030] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/18/2023] [Accepted: 09/04/2023] [Indexed: 09/09/2023]
Abstract
Evidence about the association between breastfeeding and its duration with growth, appetite and satiety indicators, and adiposity in low and middle-income countries facing nutritional transition is scarce. The aim of this study was to evaluate the association between longitudinal patterns of breastfeeding (exclusive [EBF] and continued [CBF]) with adiposity and growth, and the mediating role of appetite and satiety indicators in these associations in Mexican children during the first 2 years of life. Information from 378 mother-child pairs from the MAS-Lactancia birth cohort was analysed. Information was collected at birth and at months 1, 3, 6, 9, 12, 18 and 24 of life. Duration of EBF and CBF was computed. Linear mixed models were used to assess the association of EBF and CBF with growth and adiposity. Path analysis was used for mediation analysis. Compared with the reference group (EBF duration <1 month), males with >3 to ≤6 months of EBF had less abdominal circumference (β = -0.66, p = 0.05), Z-score weight-for-length (β = -0.17, p = 0.19) and length-for-age (β = -0.49, p < 0.01). Participants without CBF beyond 6 months had higher BMI Z-score (β = 0.19, p < 0.01), abdominal circumference (β = 0.62, p < 0.01) and skinfold sum (β = 0.80, p = 0.09), and o difference in length-for-age. For EBF, mediation was confirmed for satiety responsiveness on the association with BMI Z-Score, for food fussiness for the association with abdominal circumference and length-for-age Z-score, and enjoyment of food on the association with length-for-age Z-score. For CBF, mediation was confirmed for food fussiness in the association with length-for-age. This study suggests that a longer exposure to EBF and CBF is associated with lower adiposity in children under 2 years of age, and that this association could be partially mediated by appetite and satiety indicators.
Collapse
Affiliation(s)
- Ivonne Ramírez-Silva
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Ana Carolina Ariza
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Sofía Barragán-Vázquez
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Melanie Mendoza Jiménez
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Eduardo Ortiz-Panozo
- Center for Population Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Carolina Batis
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Ana Burguete-García
- Center for Research in Infectious Diseases, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Laura Ávila-Jimenez
- Coordinación Auxiliar Médica de Investigación en Salud, Delegación Estatal Morelos, Instituto Mexicano Del Seguro Social, Mexico
| | - Elena Zambrano
- Department of the Biology of Reproduction, Salvador Zubiran National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
| | - Juan A Rivera
- Center for Population Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, Mexico.
| |
Collapse
|