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McKinley EM, Knol LL, Turner LW, Burnham JJ, Graettinger KR, Hernandez-Reif M, Leeper JD. Enhancing Patient-Provider Breastfeeding Conversations: Breastfeeding Intention and Prenatal Breastfeeding Self-Efficacy among a Sample of Pregnant Women. South Med J 2021; 114:223-230. [PMID: 33787936 DOI: 10.14423/smj.0000000000001238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate and identify which sociodemographic factors may be associated with breastfeeding intention and breastfeeding self-efficacy among pregnant women. METHODS Pregnant women at a medical center in Alabama completed a cross-sectional survey. The Prenatal Rating of Efficacy in Preparation to Breastfeed Scale (PREP to BF) was used to assess prenatal breastfeeding self-efficacy. A valid 3-item breastfeeding intention scale and the Fetal Health Locus of Control Scale also were used. Nonparametric tests were used to assess differences in breastfeeding intention, locus of control subscales, and PREP to BF scores by history with breastfeeding, planned mode of delivery, and sociodemographic factors. RESULTS The participants in the final analysis (N = 124) had a mean prenatal breastfeeding self-efficacy score of 299.5 (±92.33), with a range of 0 to 390. Significantly lower scores related to intention and PREP to BF were found among Black women (P ≤ 0.05), those with a high school education or less (P ≤ 0.019), single women (P ≤ 0.028), and those who had no breastfeeding experience (P ≤ 0.035). CONCLUSIONS Identifying pregnant women with low breastfeeding self-efficacy and intention and recognizing the effects of social and cultural influences on breastfeeding are vital. Healthcare providers can engage in meaningful dialog to address ways to increase social support, communication, goal-setting skills, and overcoming mental and emotional barriers.
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Affiliation(s)
- Erin M McKinley
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - Linda L Knol
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - Lori W Turner
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - Joy J Burnham
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - Kristine R Graettinger
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - Maria Hernandez-Reif
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - James D Leeper
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
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Porta F, Ponzone A, Spada M. Neonatal phenylalanine wash-out in phenylketonuria. Metab Brain Dis 2020; 35:1225-1229. [PMID: 32661828 DOI: 10.1007/s11011-020-00602-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 07/09/2020] [Indexed: 11/24/2022]
Abstract
Phenylketonuria (PKU) is the most common inborn error of amino acids metabolism. PKU management aims to keep as soon as possible blood phenylalanine (Phe), a non-acutely neurotoxic metabolite, within safe ranges through a dietary Phe restriction tailored to individual dietary Phe tolerance. Information on initial neonatal management of PKU, when Phe tolerance is still unknown, is scanty. We reviewed the metabolic data from 304 patients with PAH deficiency detected at newborn screening within the last 37 years. In keeping with the general neonatal management of intoxication-type inborn errors of metabolism, initial management consisted in a Phe wash-out through the exclusive administration of normocaloric Phe-free formulas until normalization of blood Phe. Based on genotype and Phe tolerance assessed at follow-up, 55 patients had classic PKU (18%), 50 mild PKU (17%), and 199 non-PKU hyperphenylalaninemia (HPA) (65%). The duration of Phe wash-out amounted to 7 ± 2 days in classic PKU, 4 ± 2 days in mild PKU, and < 24 h in non-PKU HPA (p < 0.001). After the wash-out, dietary Phe re-introduction and its upwardly titration allowed the assessment of individual metabolic phenotype. During the first 6 years of life, Phe tolerance was stable in classic PKU (~ 200 mg/day) but increased in milder forms, allowing unrestricted diet in non-PKU HPA. Neonatal Phe wash-out in PKU ensures the earliest correction of HPA. This metabolic reset also facilitates the prompt definition of individual Phe tolerance, allowing anticipation of dietary personalization and optimization of longitudinal metabolic control.
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Affiliation(s)
- Francesco Porta
- Department of Pediatrics, AOU Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.
- Department of Pediatrics, University of Torino, Piazza Polonia 94, Turin, 10126, Italy.
| | - Alberto Ponzone
- Department of Pediatrics, AOU Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - Marco Spada
- Department of Pediatrics, AOU Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
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Finnbogadóttir H, Thies-Lagergren L. Breastfeeding in the context of domestic violence-a cross-sectional study. J Adv Nurs 2017; 73:3209-3219. [PMID: 28513055 DOI: 10.1111/jan.13339] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2017] [Indexed: 11/30/2022]
Abstract
AIMS To determine the differences in breastfeeding among women who did and did not experience domestic violence during pregnancy and postpartum in a Swedish context. In addition, to identify possible differences regarding breastfeeding between groups with or without a history of violence. Further, determine the relationship between exclusive breastfeeding and symptoms of depression. BACKGROUND History of violence may increase the risk of depression and a decrease in, or cessation of, breastfeeding. DESIGN The study has a cross-sectional design. METHODS Data were collected prospectively from March 2012 - May 2015. A cohort of 731 mothers answered a questionnaire from a larger project (1.5 years postpartum). RESULTS Breastfeeding was reported by 93.7% of participants. Women exposed to domestic violence during pregnancy and/or postpartum (4.5%) were just as likely to breastfeed as women who had not reported exposure to domestic violence. There were no statistically significant differences between the groups with or without a history of violence regarding exclusive breastfeeding. Women reporting several symptoms of depression breastfed exclusively to a lesser extent compared with women who had a few symptoms of depression. CONCLUSION Domestic violence did not influence breastfeeding prevalence or duration. Breastfeeding did not differ in women with or without a history of violence. Symptoms of depression influenced duration of exclusive breastfeeding. Beyond recognizing women who are exposed to violence, it is important to identify and to support pregnant women and new mothers with symptoms of depression as their health and the health of their infants depends on the mothers' mental well-being.
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The Effect of Exclusive Breastfeeding on Hospital Stay and Morbidity due to Various Diseases in Infants under 6 Months of Age: A Prospective Observational Study. Int J Pediatr 2016; 2016:7647054. [PMID: 27190526 PMCID: PMC4852128 DOI: 10.1155/2016/7647054] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 03/01/2016] [Accepted: 03/27/2016] [Indexed: 12/22/2022] Open
Abstract
Background. Mother's milk is the best for the babies. Protective and preventive role of breast milk was evaluated in this study by assessing the relation of type of feeding and duration of hospital stay or morbidity. Methods. This prospective study was conducted in a tertiary care hospital and 232 infants in the age group of 14 weeks to 6 months formed the sample. There are two groups of infants, that is, one for breastfed and one for top fed infants. Statistical analysis was done and results were calculated up to 95% to 99% level of significance to find effect of feeding pattern on hospital stay due to various diseases and morbidity. Results. Prolonged hospital stay, that is, >7 days, was lesser in breastfed infants and results were statistically significant in case of gastroenteritis (p value < 0.001), bronchopneumonia (p value = 0.0012), bronchiolitis (p value = 0.005), otitis media (p value = 0.003), and skin diseases (p value = 0.047). Lesser morbidity was seen in breastfed infants with gastroenteritis (p value 0.0414), bronchopneumonia (p value 0.03705), bronchiolitis (p value 0.036706), meningitis (p value 0.043), and septicemia (p value 0.04). Conclusions. Breastfed infants have shorter hospital stay and lesser morbidity in regard to various diseases as compared to top fed infants.
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