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Spatz DL, Rodríguez SÁ, Benjilany S, Finderle B, von Gartzen A, Yates A, Brumley J. Having Enough Milk to Sustain a Lactation Journey: A Call to Action. Nurs Womens Health 2024:S1751-4851(24)00090-4. [PMID: 38823783 DOI: 10.1016/j.nwh.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 02/26/2024] [Accepted: 04/18/2024] [Indexed: 06/03/2024]
Abstract
The rates of human milk feeding are suboptimal worldwide. Recommendations for healthy, term mother-infant dyads include early breastfeeding initiation, frequent skin-to-skin contact, and frequent breastfeeding. The normal physiology of lactation can be affected by prenatal factors such as diabetes, obesity, and excessive gestational weight gain. Furthermore, birth-related factors such as early-term gestation, stressful labor, unscheduled cesarean birth, and postpartum hemorrhage can additionally disrupt recommended practices such as early initiation of breastfeeding and skin-to-skin contact. Given that the first 2 to 3 days postpartum are critical to achieving timely secretory activation and establishing an adequate volume of milk, a proactive approach to care can include building awareness of risk factors and development of protocols for the effective early initiation of lactation.
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Zhang M, Qiao H, Yang S, Kwok LY, Zhang H, Zhang W. Human Breast Milk: The Role of Its Microbiota and Metabolites in Infant Health. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2024; 72:10665-10678. [PMID: 38691667 DOI: 10.1021/acs.jafc.3c07690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
This review explores the role of microorganisms and metabolites in human breast milk and their impact on neonatal health. Breast milk serves as both a primary source of nutrition for newborns and contributes to the development and maturation of the digestive, immunological, and neurological systems. It has the potential to reduce the risks of infections, allergies, and asthma. As our understanding of the properties of human milk advances, there is growing interest in incorporating its benefits into personalized infant nutrition strategies, particularly in situations in which breastfeeding is not an option. Future infant formula products are expected to emulate the composition and advantages of human milk, aligning with an evolving understanding of infant nutrition. The long-term health implications of human milk are still under investigation.
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Affiliation(s)
- Meng Zhang
- Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot 010018, China
- Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs, Inner Mongolia Agricultural University, Hohhot 010018, China
- Inner Mongolia Key Laboratory of Dairy Biotechnology and Engineering, Inner Mongolia Agricultural University, Hohhot 010018, China
| | - Hui Qiao
- Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot 010018, China
- Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs, Inner Mongolia Agricultural University, Hohhot 010018, China
- Inner Mongolia Key Laboratory of Dairy Biotechnology and Engineering, Inner Mongolia Agricultural University, Hohhot 010018, China
| | - Shuwei Yang
- Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot 010018, China
- Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs, Inner Mongolia Agricultural University, Hohhot 010018, China
- Inner Mongolia Key Laboratory of Dairy Biotechnology and Engineering, Inner Mongolia Agricultural University, Hohhot 010018, China
| | - Lai-Yu Kwok
- Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot 010018, China
- Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs, Inner Mongolia Agricultural University, Hohhot 010018, China
- Inner Mongolia Key Laboratory of Dairy Biotechnology and Engineering, Inner Mongolia Agricultural University, Hohhot 010018, China
| | - Heping Zhang
- Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot 010018, China
- Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs, Inner Mongolia Agricultural University, Hohhot 010018, China
- Inner Mongolia Key Laboratory of Dairy Biotechnology and Engineering, Inner Mongolia Agricultural University, Hohhot 010018, China
| | - Wenyi Zhang
- Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot 010018, China
- Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs, Inner Mongolia Agricultural University, Hohhot 010018, China
- Inner Mongolia Key Laboratory of Dairy Biotechnology and Engineering, Inner Mongolia Agricultural University, Hohhot 010018, China
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Obeagu EI, Obeagu GU. Breastfeeding's protective role in alleviating breast cancer burden: a comprehensive review. Ann Med Surg (Lond) 2024; 86:2805-2811. [PMID: 38694322 PMCID: PMC11060284 DOI: 10.1097/ms9.0000000000001914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/26/2024] [Indexed: 05/04/2024] Open
Abstract
Breastfeeding, an essential aspect of infant care, has garnered recognition beyond its immediate health benefits, revealing a profound and lasting impact on women's health. Emerging research has unveiled a compelling relationship between breastfeeding and its enduring role in reducing the risk of ovarian cancer. This narrative review aims to comprehensively examine the lifelong impact of breastfeeding on ovarian cancer prevention, transcending infancy and delving into the mechanisms and implications for women's health. Epidemiological evidence consistently demonstrates an inverse association between breastfeeding and the risk of ovarian cancer. Prolonged durations of breastfeeding correlate with a significant reduction in the likelihood of developing ovarian malignancies, underscoring the protective influence of sustained lactation. The mechanisms underlying breastfeeding's impact on ovarian cancer prevention involve hormonal modulation and cellular changes. Breastfeeding contributes to reduced ovulatory cycles and oestrogen exposure, mitigating hormonal influences linked to ovarian cancer development. Moreover, the cellular alterations induced by breastfeeding within the ovarian microenvironment create an environment less conducive to malignant transformations. In conclusion, this paper consolidates evidence demonstrating breastfeeding's enduring impact on reducing ovarian cancer risk. It emphasizes the need for continued research, supportive interventions, and societal engagement to promote breastfeeding practices. Embracing breastfeeding not only provides immediate health benefits but also represents a formidable strategy in lifelong ovarian cancer prevention, offering a promising pathway towards enhanced women's health and well-being.
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Muniz MCR, Lima RV, Maia VQCC, Bezerra AM, Freire IF, Lima MCC, Matos YMT, Pontes LP, Cavalcante ANM. The protective effect of breastfeeding on febrile seizures: a systematic review with meta-analysis. Eur J Pediatr 2024; 183:2049-2058. [PMID: 38456990 DOI: 10.1007/s00431-024-05501-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/09/2024]
Abstract
Several potential risk factors have been identified in the etiopathogenesis of febrile seizures (FS), including the type and extent of breastfeeding (BF). Given the lack of conclusive data, this study aims to systematically evaluate the evidence on the association between BF and FS. We conducted a systematic review and meta-analysis according to PRISMA guidelines. The search was conducted using descriptors for FS, BF, and formula feeding in MEDLINE, Embase, and Web of Science databases. We included observational studies that compared the incidence of FS between those who had ever breastfed and those who were formula fed. The study protocol was registered on the PROSPERO platform under the number CRD42023474906. A total of 1,893,079 participants from 8 datasets were included. Our main analysis showed no significant association of any type of BF on the incidence of FS compared with formula-fed children (OR: 0.84; CI: 0.67-1.04; I2 = 78%; Cochran's Q = 0.0001), although meta-regression showed that BF was associated with a lower incidence of FS in preterm infants. Our secondary outcome showed a significantly reduced incidence of FS in children who received BF exclusively (OR: 0.80; CI: 0.65-0.99; I2 = 70%; Cochran's Q = 0.02). Conclusion: There was no significant reduction in the incidence of FS in those who were breastfed compared to formula feeding. However, our meta-regression analysis indicated an association between BF and a lower incidence of FS in preterm infants. Additionally, children who exclusively received BF had a significantly reduced incidence of FS. These findings should be further investigated in prospective cohorts. What is Known: • Breastfeeding can modify risk factors for febrile seizures, such as susceptibility to viral and bacterial infections, micronutrient deficiencies, and low birth weight. • However, studies have shown conflicting results regarding the impact of breastfeeding on febrile seizures. What is New: • When comparing any breastfeeding pattern with no breastfeeding, there is no significant difference in the incidence of febrile seizures. • When comparing exclusive breastfeeding with no breastfeeding, there may be a decrease in the occurrence of febrile seizures.
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Affiliation(s)
- Maria Carolina Rocha Muniz
- Department of Medicine, University of Fortaleza, Av. Washington Soares, 1321 - Edson Queiroz, Fortaleza - CE, Ceara, 60811-905, Brazil
| | - Rian Vilar Lima
- Department of Medicine, University of Fortaleza, Av. Washington Soares, 1321 - Edson Queiroz, Fortaleza - CE, Ceara, 60811-905, Brazil.
| | | | - Arthur Meneses Bezerra
- Department of Medicine, University of Fortaleza, Av. Washington Soares, 1321 - Edson Queiroz, Fortaleza - CE, Ceara, 60811-905, Brazil
| | - Isabela Franco Freire
- Department of Medicine, University of Fortaleza, Av. Washington Soares, 1321 - Edson Queiroz, Fortaleza - CE, Ceara, 60811-905, Brazil
| | - Manuela Cavalcante Coling Lima
- Department of Medicine, University of Fortaleza, Av. Washington Soares, 1321 - Edson Queiroz, Fortaleza - CE, Ceara, 60811-905, Brazil
| | - Yuri Marques Teixeira Matos
- Department of Medicine, University of Fortaleza, Av. Washington Soares, 1321 - Edson Queiroz, Fortaleza - CE, Ceara, 60811-905, Brazil
| | - Letícia Pinheiro Pontes
- Department of Medicine, University of Fortaleza, Av. Washington Soares, 1321 - Edson Queiroz, Fortaleza - CE, Ceara, 60811-905, Brazil
| | - Ana Nery Melo Cavalcante
- Department of Medicine, University of Fortaleza, Av. Washington Soares, 1321 - Edson Queiroz, Fortaleza - CE, Ceara, 60811-905, Brazil
- PhD in Collective Health By the University of Fortaleza, Neonatologist Pediatrician at Dr. César Cals de Oliveira General Hospital, Fortaleza, Ceara, Brazil
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de Amorim ALB, Rodrigues EF, Sussi EL, Neri LDCL. Carbohydrate restriction during lactation: A systematic review. Nutr Res 2024; 125:91-100. [PMID: 38565002 DOI: 10.1016/j.nutres.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 04/04/2024]
Abstract
The quality of a mother's diet is important to ensure child growth and development and keep women healthy. This systematic review aimed to identify the outcomes of a carbohydrate-restricted diet during lactation. PubMed, EMBASE, Scopus, Web of Science, and LILACS were searched for studies published between 2012 and 2023; 16 studies were selected, all of them case reports or care series. The carbohydrate restriction described in the papers mainly was ketogenic, low-carb, low-carbohydrate and high-fat, and modified ketogenic diets. The main goal of women undertaking these diets was weight loss, with therapeutic purposes (monitored and supervised by health professionals) in only 2 cases: (1) ketogenic diet therapy for treatment of seizures in the infant and (2) to reduce symptoms of mother's gastroesophageal reflux. Most articles reported that lactating women were hospitalized, experiencing symptoms such as vomiting, muscle weakness, nausea, abdominal pain, general malaise, and fatigue. However, articles did not mention poor outcomes for the infants. Most of the studies in this review were published in the past 3 years, indicating a possible increase in cases of women practicing carbohydrate restriction during lactation for weight loss caused by body dissatisfaction. In conclusion, carbohydrate restriction during lactation may be harmful to the lactating woman and contribute to the state of lactational ketoacidosis, but infant outcomes are mainly a change in feeding patterns. Thus, education on food and nutrition is necessary for this population.
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Affiliation(s)
- Ana Laura Benevenuto de Amorim
- Nutrition Department, Santos Metropolitan University, Santos, SP, Brazil; Children's Institute of Faculty of Medicine, Department of Pediatrics, University of São Paulo, São Paulo, Brazil
| | - Ester Ferreira Rodrigues
- Children's Institute of Faculty of Medicine, Department of Pediatrics, University of São Paulo, São Paulo, Brazil
| | - Elizandra Lopes Sussi
- Children's Institute of Faculty of Medicine, Department of Pediatrics, University of São Paulo, São Paulo, Brazil
| | - Lenycia de Cassya Lopes Neri
- Children's Institute of Faculty of Medicine, Department of Pediatrics, University of São Paulo, São Paulo, Brazil; Ketogenic Metabolic Therapy Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy; Laboratory of Food Education and Sport Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
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Alchalel S, Zaitoon H, Gover A, Simmonds A, Toropine A, Riskin A. The Impact of Religious Beliefs on Early Lactation in Israeli Mothers. Breastfeed Med 2024. [PMID: 38686527 DOI: 10.1089/bfm.2024.0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Objective: To explore the influence of religious beliefs and faith on breastfeeding initiation among mothers in Israel. Materials and Methods: The study, conducted from February 2022 to July 2023 at Bnai Zion Medical Center (located in Haifa district) and Laniado hospital (located in Netanya, Sharon plain), included mothers and their partners who voluntarily completed questionnaires. The survey, comprising 26 questions, delves into religion, faith, religiosity, and infant feeding approaches, while considering various socioeconomic and health-related factors. Results: Religious and secular mothers exhibited a higher inclination toward exclusive breastfeeding compared with the traditional mothers (p < 0.001). Notably, more maternal education years were associated with more exclusive breastfeeding (odds ratio [OR] 1.59; 95% confidence interval [CI] 1.09-2.32; p = 0.017). However, older age of youngest sibling (OR 0.56; 95% CI 0.32-0.98; p = 0.041), cesarean delivery (OR 0.64; 95% CI 0.44-0.94; p = 0.023), and no desire to breastfeed during pregnancy (OR 0.67; 95% CI 0.57-0.80; p < 0.001) emerged as significant factors decreasing exclusive breastfeeding. Conclusion: The study indicates that the level of religiosity and prenatal intention to breastfeed impact breastfeeding practices, along with maternal education, age of the youngest sibling, and delivery mode. These insights provide valuable guidance for initiatives aimed at boosting breastfeeding rates, particularly in sectors where rates are comparatively low.
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Affiliation(s)
- Sapir Alchalel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Hussein Zaitoon
- Department of Pediatrics, Bnai Zion Medical Center, Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ayala Gover
- Department of Neonatology and Neonatal Intensive Care, Bnai Zion Medical Center, Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Aryeh Simmonds
- Department of Neonatology and Neonatal Intensive Care, Laniado Medical Center, The Dr. Miriam and Sheldon G. Adelson School of Medicine, Ariel University, Netanya, Israel
| | - Arina Toropine
- Department of Neonatology and Neonatal Intensive Care, Bnai Zion Medical Center, Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Arieh Riskin
- Department of Neonatology and Neonatal Intensive Care, Bnai Zion Medical Center, Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Obeagu EI, Obeagu GU. Exploring the profound link: Breastfeeding's impact on alleviating the burden of breast cancer - A review. Medicine (Baltimore) 2024; 103:e37695. [PMID: 38608095 PMCID: PMC11018178 DOI: 10.1097/md.0000000000037695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 03/01/2024] [Indexed: 04/14/2024] Open
Abstract
Breastfeeding has emerged as a critical factor in understanding and potentially mitigating the risk of breast cancer among women. This review delves into the intricate relationship between breastfeeding and breast cancer, elucidating the biological mechanisms, protective effects, and broader implications for public health. Epidemiological evidence consistently demonstrates a correlation between breastfeeding and a reduced risk of breast cancer, with longer durations of lactation showing a dose-dependent decrease in risk. The biological nexus between breastfeeding and breast cancer involves hormonal changes and the elimination of potentially damaged cells, influencing breast tissue and potentially mitigating carcinogenesis. Moreover, breastfeeding appears to impact tumor subtypes and aggressiveness, particularly demonstrating associations with lower risks of hormone receptor-negative and certain aggressive breast cancer subtypes. Recognizing the significance of breastfeeding in reducing breast cancer risk has profound public health implications, necessitating comprehensive support, education, and policies to encourage and facilitate breastfeeding.
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Van Neste M, Nauwelaerts N, Ceulemans M, Van Calsteren K, Eerdekens A, Annaert P, Allegaert K, Smits A. Determining the exposure of maternal medicines through breastfeeding: the UmbrelLACT study protocol-a contribution from the ConcePTION project. BMJ Paediatr Open 2024; 8:e002385. [PMID: 38599799 PMCID: PMC11015172 DOI: 10.1136/bmjpo-2023-002385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/20/2024] [Indexed: 04/12/2024] Open
Abstract
INTRODUCTION Breastfeeding is beneficial for the health of the mother and child. However, at least 50% of postpartum women need pharmacotherapy, and this number is rising due to the increasing prevalence of chronic diseases and pregnancies at a later age. Making informed decisions on medicine use while breastfeeding is often challenging, considering the extensive information gap on medicine exposure and safety during lactation. This can result in the unnecessary cessation of breastfeeding, the avoidance of pharmacotherapy or the off-label use of medicines. The UmbrelLACT study aims to collect data on human milk transfer of maternal medicines, child exposure and general health outcomes. Additionally, the predictive performance of lactation and paediatric physiologically based pharmacokinetic (PBPK) models, a promising tool to predict medicine exposure in special populations, will be evaluated. METHODS AND ANALYSIS Each year, we expect to recruit 5-15 breastfeeding mothers using pharmacotherapy via the University Hospitals Leuven, the BELpREG project (pregnancy registry in Belgium) or external health facilities. Each request and compound will be evaluated on relevance (ie, added value to available scientific evidence) and feasibility (including access to analytical assays). Participants will be requested to complete at least one questionnaire on maternal and child's general health and collect human milk samples over 24 hours. Optionally, two maternal and one child's blood samples can be collected. The maternal medicine concentration in human milk will be determined along with the estimation of the medicine intake (eg, daily infant dose and relative infant dose) and systemic exposure of the breastfed child. The predictive performance of PBPK models will be assessed by comparing the observed concentrations in human milk and plasma to the PBPK predictions. ETHICS AND DISSEMINATION This study has been approved by the Ethics Committee Research UZ/KU Leuven (internal study number S67204). Results will be published in peer-reviewed journals and presented at (inter)national scientific meetings. TRIAL REGISTRATION NUMBER NCT06042803.
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Affiliation(s)
- Martje Van Neste
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
- L-C&Y, KU Leuven Child & Youth Institute, Leuven, Belgium
| | - Nina Nauwelaerts
- Drug Delivery and Disposition, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Michael Ceulemans
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
- L-C&Y, KU Leuven Child & Youth Institute, Leuven, Belgium
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, Netherlands
| | - Kristel Van Calsteren
- Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - An Eerdekens
- Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Pieter Annaert
- Drug Delivery and Disposition, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
- BioNotus GCV, Niel, Belgium
| | - Karel Allegaert
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
- L-C&Y, KU Leuven Child & Youth Institute, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Anne Smits
- L-C&Y, KU Leuven Child & Youth Institute, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
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Cronin C, Salzberg N, Woon Y, Wurttele JT. Primary, secondary and tertiary prevention of food allergy: current practices and future directions. Allergol Immunopathol (Madr) 2024; 52:32-44. [PMID: 38459888 DOI: 10.15586/aei.v52i2.1023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/27/2023] [Indexed: 03/11/2024]
Abstract
The incidence of food allergies has risen around the globe, and experts have been exploring methods of preventing such allergies in young children to ease the burden of disease and reduce the morbidity and mortality caused by anaphylaxis to food allergens. Such preventative measures can be categorised as primary, secondary and tertiary prevention, which are discussed in detail in this review. Primary prevention is defined as the prevention of becoming sensitised towards specific allergens. The evidence suggests that avoiding common allergenic foods during pregnancy and breastfeeding is not protective against food allergies, and guidelines recommend weaning from 4 to 6 months of age, with recent studies supporting the early introduction of peanuts at 4 months to prevent peanut allergy. Secondary prevention targets patients who are already sensitised and aims to halt the progression of sensitisation, with evidence for high rates of success and safety in trials of early introduction to milk and peanuts using oral immunotherapy in sensitised infants. Tertiary allergy prevention focuses on reducing the risk of a patient having anaphylaxis, with oral immunotherapy being the most common method of promoting tolerance in allergic children. Several studies have demonstrated successful reintroduction for milk, egg and peanut; however, no such guidelines are recommended for other foods. Finally, dietary advancement therapy in the form of milk and egg ladders has been employed as a method of primary, secondary and tertiary prevention of allergies, particularly in Ireland, the UK and Canada.
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Affiliation(s)
- Caoimhe Cronin
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
- Department of Paediatrics, Cork University Hospital, Cork, Ireland
- Cork University Hospital, Irish Centre for Maternal and Child Health Research (INFANT), HRB Clinical Research Facility Cork (CRF-C), Cork, Ireland
| | - Noah Salzberg
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Yuxin Woon
- Department of Paediatrics, Cork University Hospital, Cork, Ireland
| | - Juan Trujillo Wurttele
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
- Department of Paediatrics, Cork University Hospital, Cork, Ireland
- Cork University Hospital, Irish Centre for Maternal and Child Health Research (INFANT), HRB Clinical Research Facility Cork (CRF-C), Cork, Ireland;
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Nazareth M, Pinto E, Severo M, Graça P, Lopes C, Rêgo C. Early feeding and nutritional status of Portuguese children in the first 36 months of life: EPACI Portugal 2012-a national representative cross-sectional study. Porto Biomed J 2024; 9:250. [PMID: 38681517 PMCID: PMC11049788 DOI: 10.1097/j.pbj.0000000000000250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/07/2024] [Accepted: 02/21/2024] [Indexed: 05/01/2024] Open
Abstract
Background Early feeding practices have a critical role in the future not only in health but also in modulating eating habits. This study aimed to assess breastfeeding and complementary feeding practices and the nutritional status of Portuguese toddlers aged 0-36 months. Methods EPACI Portugal 2012 is a cross-sectional study of a national representative sample. Trained interviewers collected data about early feeding practices and anthropometrics. Body mass index was classified according to World Health Organization criteria. Frequencies and survival analysis were used to characterize variables. Results More than 90% of children were initiated breastfeeding, around 20% were exclusively breastfed for six months, and about 20% were breastfed at 12 months while complementary feeding was taking place. Exclusive breastfeeding was determined by maternal prepregnancy body mass index (HR 1.01; 95% CI 1.00, 1.03, P=.03) and low birth weight (HR 1.61; IC 95% 1.21, 2.15, P=.001) of the infants. About 90% were initiated complementary feeding between four and six months, and almost 10% were introduced to cow's milk before 12 months. In the second year of life, 83.2% and 61.6% of toddlers have already consumed nectars and sweet desserts, respectively. About one-third of Portuguese toddlers showed a body mass index z-score >1, and 6.6% were overweight/obese (z-score >2). No association was found between the duration of breastfeeding or timing of complementary feeding and the body mass index z-score in children. Conclusions Despite the low prevalence of exclusive breastfeeding at six months, Portuguese infants effectively comply with dietary recommendations during the first year of life. The transition to the family diet must be carefully made. There is a high prevalence of Portuguese toddlers at least at overweight risk. The duration of breastfeeding or timing of complementary feeding was not associated with the expression of overweight/obesity.
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Affiliation(s)
- Margarida Nazareth
- Universidade Católica Portuguesa, CBQF—Centro de Biotecnologia e Química Fina-Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
| | - Elisabete Pinto
- Universidade Católica Portuguesa, CBQF—Centro de Biotecnologia e Química Fina-Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
- EPIUnit—Institute of Public Health, University of Porto, Porto, Portugal
| | - Milton Severo
- EPIUnit/ITR—Laboratory for Integrative and Translational Research in Population Health—Institute of Public Health, University of Porto, Porto, Portugal
- ICBAS—School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Pedro Graça
- EPIUnit/ITR—Laboratory for Integrative and Translational Research in Population Health—Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Carla Lopes
- EPIUnit/ITR—Laboratory for Integrative and Translational Research in Population Health—Institute of Public Health, University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Carla Rêgo
- Universidade Católica Portuguesa, CBQF—Centro de Biotecnologia e Química Fina-Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
- Child and Adolescent Centre, CUF Hospital Porto, Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
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Nixarlidou E, Margioula-Siarkou C, Almperis A, Vavoulidis E, Laganà AS, Dinas K, Petousis S. Clinical significance and main parameters promoting the breast‑feeding strategy (Review). MEDICINE INTERNATIONAL 2024; 4:14. [PMID: 38410759 PMCID: PMC10895466 DOI: 10.3892/mi.2024.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 02/02/2024] [Indexed: 02/28/2024]
Abstract
Breastfeeding provides numerous nutritional and immunological benefits, promotes neurological and cognitive development, and protects against chronic and infectious diseases, rendering it beneficial to the survival and well-being of infants. According to international recommendations, infants should be exclusively breastfed for the first 6 months. However, despite global health recommendations and funding initiatives, exclusive breastfeeding rates remain low worldwide. A number of studies attribute the low rates to factors that can be grouped into demographic, psychosocial, economic and midwifery factors, and outline the profile of each mother who opts to exclusively breastfeed her infant. In addition, the number of previous pregnancies, induced labor, the use of epidurals at birth or the possibility of the newborn being delivered prematurely, and the need for admission to an intensive care unit are the factors that reduce the likelihood of exclusive breastfeeding. Further research is required to understand the factors influencing the initiation and maintenance of exclusive breastfeeding, as international interventions have been ineffective. The aim of the present review was to provide an up-to-date summary of these various factors in an aim to assist health care professionals and policy makers in developing effective interventions with which to promote and support exclusive breastfeeding.
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Affiliation(s)
- Eleni Nixarlidou
- 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, 54624 Thessaloniki, Greece
| | - Chrysoula Margioula-Siarkou
- 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, 54624 Thessaloniki, Greece
| | - Aristarchos Almperis
- 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, 54624 Thessaloniki, Greece
| | - Eleftherios Vavoulidis
- 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, 54624 Thessaloniki, Greece
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS 'Civico-Di Cristina-Benfratelli', Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, I-90127 Palermo, Italy
| | - Konstantinos Dinas
- 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, 54624 Thessaloniki, Greece
| | - Stamatios Petousis
- 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, 54624 Thessaloniki, Greece
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Ross A, MacPherson C, Baker L, Kim S, Njau G, Williams AD. Impact of Breastfeeding Barriers on Racial/Ethnic Disparities in Breastfeeding Outcomes in North Dakota. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01943-z. [PMID: 38393463 DOI: 10.1007/s40615-024-01943-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE Exclusive breastfeeding is recommended for the first 6 months of life, but there are racial/ethnic disparities in meeting this recommendation. METHODS 2017-2020 North Dakota Pregnancy Risk Assessment Monitoring System (weighted N = 11,754) data were used to examine racial/ethnic differences in the association between self-reported breastfeeding barriers and breastfeeding duration. Breastfeeding duration was self-reported breastfeeding at 2 and 4 months, and number of weeks until breastfeeding cessation. Self-reported breastfeeding barriers were yes/no responses to 13 barriers (e.g., "difficulty latching," "household duties"). Logistic regression estimated odds ratios and 95% confidence intervals to determine if barriers accounted for breastfeeding disparities by race/ethnicity. Cox proportional hazard models estimated hazard ratios for stopping breastfeeding for American Indian and other race/ethnicity individuals, compared to White individuals. Models were adjusted for birthing parents' demographic and medical factors. RESULTS Logistic regression results suggest American Indian birthing parents had similar odds for breastfeeding duration (2-month duration: OR 0.94 (95%CI 0.50, 1.77); 4-month duration: OR 1.24 (95%CI 0.43, 3.62)) compared to White birthing parents, after accounting for breastfeeding barriers. Cox proportional hazard models suggest American Indian birthing parents had a lower hazard of stopping breastfeeding (HR 0.76 (95%CI 0.57, 0.99)) than White parents, after accounting for breastfeeding barriers. CONCLUSIONS Accounting for breastfeeding barriers eliminated observed disparities in breastfeeding outcomes between American Indian and White birthing parents. Targeted and culturally safe efforts to reduce barriers to breastfeeding are warranted to reduce racial/ethnic disparities in breastfeeding.
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Affiliation(s)
- Anna Ross
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave NW #2, Washington, DC, 20037, USA
| | - Cora MacPherson
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave NW #2, Washington, DC, 20037, USA
| | - Lannesse Baker
- University of North Dakota School of Medicine and Health Sciences, Room E166, 1301 North Columbia Road Stop 9037, Grand Forks, ND, 58202-9037, USA
| | - Soojung Kim
- Department of Communication, University of North Dakota, O'Kelly Hall Room 202, 221 Centennial Drive Stop 7169, Grand Forks, ND, 58202-7169, USA
| | - Grace Njau
- North Dakota Department of Health & Human Services, 600 E Boulevard Ave Dept 325, Bismarck, ND, 58505, USA
| | - Andrew D Williams
- University of North Dakota School of Medicine and Health Sciences, Room E166, 1301 North Columbia Road Stop 9037, Grand Forks, ND, 58202-9037, USA.
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13
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Núñez-Delgado A, Mizrachi-Chávez VM, Welti-Chanes J, Macher-Quintana ST, Chuck-Hernández C. Breast milk preservation: thermal and non-thermal processes and their effect on microorganism inactivation and the content of bioactive and nutritional compounds. Front Nutr 2024; 10:1325863. [PMID: 38455872 PMCID: PMC10919153 DOI: 10.3389/fnut.2023.1325863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/26/2023] [Indexed: 03/09/2024] Open
Abstract
Human Breast Milk (HBM) is widely acknowledged as the best nutritional source for neonates. Data indicates that, in 2019, 83.2% of infants in the United States received breast milk at birth, slightly reducing to 78.6% at 1 month. Despite these encouraging early figures, exclusive breastfeeding rates sharply declined, dropping to 24.9% by 6 months. This decline is particularly pronounced when direct breastfeeding is challenging, such as in Neonatal Intensive Care Units (NICU) and for working mothers. Given this, it is vital to explore alternative breast milk preservation methods. Technologies like Holder Pasteurization (HoP), High-Temperature Short-Time Pasteurization (HTST), High-Pressure Processing (HPP), UV radiation (UV), and Electric Pulses (PEF) have been introduced to conserve HBM. This review aims to enhance the understanding of preservation techniques for HBM, supporting the practice of extended exclusive breastfeeding. It explicitly addresses microbial concerns, focusing on critical pathogens like Staphylococcus aureus, Enterococcus, Escherichia coli, Listeria monocytogenes, and Cytomegalovirus, and explores how various preservation methods can mitigate these risks. Additionally, the review highlights the importance of retaining the functional elements of HBM, particularly its immunological components such as antibodies and enzymes like lysozyme and Bile Salt Stimulated Lipase (BSSL). The goal is to provide a comprehensive overview of the current state of HBM treatment, critically assess existing practices, identify areas needing improvement, and advocate for extended exclusive breastfeeding due to its vital role in ensuring optimal nutrition and overall health in infants.
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Affiliation(s)
- Alejandro Núñez-Delgado
- Tecnologico, de Monterrey, School of Engineering and Sciences, Monterrey, Mexico
- Tecnologico de Monterrey, Institute for Obesity Research, Monterrey, Mexico
| | | | - Jorge Welti-Chanes
- Tecnologico, de Monterrey, School of Engineering and Sciences, Monterrey, Mexico
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Shao Y, Yu Y, Pang S, Ge L, Shi H. Soybean Isoflavones Ameliorates Lactation Performance in Postpartum Mice by Alleviating Oxidative Stress and Regulating Gut Microflora. Mol Nutr Food Res 2024; 68:e2300184. [PMID: 38175853 DOI: 10.1002/mnfr.202300184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/11/2023] [Indexed: 01/06/2024]
Abstract
Postpartum dysgalactiae syndrome (PPDS) is one of the key issues affecting breastfeeding, usually occurring as breast swelling, a low milk yield, and at length a stop of breast milk secretion. Therefore, there is a need to investigate the effectiveness of Traditional Chinese Medicine (TCM) diet therapy in treating or preventing PPDS. This study aims to analyze the effect of soybean isoflavone (SIF), a natural estrogen found in plants, on postpartum lactation performance in mice and to evaluate its potential as a treatment for PPDS. Adult female BALB/c mice at 8 weeks of age (25 ± 3 g) are randomly divided into four groups fed with different levels of SIF and a normal diet for 14 days. SIF (0, 50, 100, 200 mg kg-1 BW) is provided via intra-gastric route to the experimental mice. Using a high-throughput sequencing of microbial diversity and mammary gland metabolites, it is found that SIF-treated mice potentially show an improved milk performance via enhanced antioxidant capacity and altered gut microbiota. SIF from plant sources at a high dosage promotes the lactation in normal postpartum mice.
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Affiliation(s)
- Yuexin Shao
- College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, P. R. China
| | - Yan Yu
- College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, P. R. China
| | - Shilong Pang
- College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, P. R. China
| | - Liyan Ge
- College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, P. R. China
| | - Huaiping Shi
- College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, P. R. China
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Tamaki R, Noshiro K, Furugen A, Nishimura A, Asano H, Watari H, Kobayashi M, Umazume T. Breast milk concentrations of acetaminophen and diclofenac - unexpectedly high mammary transfer of the general-purpose drug acetaminophen. BMC Pregnancy Childbirth 2024; 24:90. [PMID: 38287321 PMCID: PMC10826108 DOI: 10.1186/s12884-024-06287-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/22/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Breastfeeding is considered to be the most effective way of ensuring the health and survival of newborns. However, mammary transfer of drugs administered to mothers to breastfeeding infants remains a pressing concern. Acetaminophen and diclofenac sodium are widely prescribed analgesics for postpartum pain relief, but there have been few recent reports on the mammary transfer of these drugs, despite advances in analytic techniques. METHODS We conducted a study on 20 postpartum mothers from August 2019-March 2020. Blood and milk samples from participants were analyzed using liquid chromatography-electrospray ionization tandem mass spectrometry within 24 hours after oral administration of acetaminophen and diclofenac sodium. The area under the concentration-time curve (AUC) was calculated from the concentration curve obtained by a naive pooled-data approach. RESULTS For acetaminophen, AUC was 36,053 ng/mL.h and 37,768 ng/mL.h in plasma and breast milk, respectively, with a milk-to-plasma drug concentration ratio of 1.048. For diclofenac, the AUC was 0.227 ng/mL.h and 0.021 ng/mL.h, in plasma and breast milk, respectively, with a milk-to-plasma drug concentration ratio of 0.093. CONCLUSIONS While diclofenac sodium showed low mammary transfer, acetaminophen showed a relatively high milk-to-plasma drug concentration ratio. Given recent studies suggesting potential connections between acetaminophen use during pregnancy and risks to developmental prognosis in children, we believe that adequate information regarding the fact that acetaminophen is easily transferred to breast milk should be provided to mothers.
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Affiliation(s)
- Ryo Tamaki
- Department of Obstetrics, Hokkaido University Hospital, Kita-ku N15 W7, Sapporo, 060-8638, Japan
| | - Kiwamu Noshiro
- Department of Obstetrics, Hokkaido University Hospital, Kita-ku N15 W7, Sapporo, 060-8638, Japan
| | - Ayako Furugen
- Laboratory of Clinical Pharmaceutics & Therapeutics, Division of Pharmasciences, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Ayako Nishimura
- Department of Pharmacy, Hokkaido University Hospital, Sapporo, Japan
| | - Hiroshi Asano
- Department of Obstetrics, Hokkaido University Hospital, Kita-ku N15 W7, Sapporo, 060-8638, Japan
| | - Hidemichi Watari
- Department of Obstetrics, Hokkaido University Hospital, Kita-ku N15 W7, Sapporo, 060-8638, Japan
| | - Masaki Kobayashi
- Laboratory of Clinical Pharmaceutics & Therapeutics, Division of Pharmasciences, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
- Education Research Center for Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Takeshi Umazume
- Department of Obstetrics, Hokkaido University Hospital, Kita-ku N15 W7, Sapporo, 060-8638, Japan.
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Fikri LH, As'ad S, Hatta M, Syamsuddin S, Prasetya H, Maddeppungeng M, Aminuddin A, Zainuddin AA, Hasanah I. Hypnotherapy influence on maternal psychological, breastfeeding, mRNA-OXTR expression, and OXTR protein. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2024:1-15. [PMID: 38241176 DOI: 10.1080/00029157.2023.2293288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
Hypnotherapy has emerged as a potential alternative to improve exclusive breastfeeding rates, particularly in countries like Indonesia where they are below optimal levels. This study aims to evaluate the impact of audio hypnotherapy on the psychological, exclusive breastfeeding behavior, the OXTR protein and mRNA expression gene OXTR in mothers of infants aged 0-6 months. This study employed a Pragmatic Randomized Controlled Trial design, conducted from November 2022 to May 2023 in 11 primary health centers. The study population included breastfeeding mothers with infants aged 0-6 months, with a total sample size of 70 respondents who were randomly divided into intervention (received audio hypnotherapy) and control groups (received standard care). The psychological condition was measured using the Depression Anxiety Stress Scale. Exclusive breastfeeding behavior was assessed based on both quality and quantity. Genetic factors were evaluated through mRNA OXTR expression using real-time PCR and protein OXTR levels using ELISA. Analyzing data using linear and logistic regression models. Both bivariate and multivariate analyses revealed significant differences in psychological condition (p < .0001). There were big differences in the exclusive breastfeeding behavior (p < .0001), as well as in the amounts of protein OXTR and mRNA expression of the OXTR gene (p < .0001). We recommend the implementation of audio hypnotherapy as an effective complementary therapeutic approach to manage the psychological well-being, exclusive breastfeeding behavior, the mRNA expression of the OXTR gene and levels of OXTR protein in mothers of infants aged 0-6 months.
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Affiliation(s)
- Lalu Hamzi Fikri
- Hasanuddin University, Makassar, Indonesia
- Provincial Health office, Mataram, West Nusa Tenggara, Indonesia
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Doan DTT, Binns C, Lee A, Zhao Y, Pham MN, Dinh HTP, Nguyen CC, Bui HTT. Factors associated with intention to breastfeed in Vietnamese mothers: A cross-sectional study. PLoS One 2023; 18:e0279691. [PMID: 38085730 PMCID: PMC10715656 DOI: 10.1371/journal.pone.0279691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 12/13/2022] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Breastfeeding has many benefits for mothers, children, and the environment over both the short and longr-term. Prenatal intention to breastfeed is a powerful predictor of short-term breastfeeding outcomes. OBJECTIVE This study aims to analyze breastfeeding intentions, including the intention to feed infants with breastmilk only and to continue exclusive breastfeeding to 6 months among pregnant mothers in Hanoi, Vietnam. METHODS The analysis included 1230 singleton mothers, between 24- and 36-weeks' gestation, who attended antenatal clinics in two hospitals in Hanoi in 2020. RESULTS The proportion of mothers with an "breastfeeding intention" (i.e., intention to feed an infant with breastmilk only) and "exclusive breastfeeding intention" to 6 months was 59.9% and 41.7%, respectively. Mothers who were 25 years or older (aOR = 1.35, 95%CI:1.00-1.81), had an undergraduate educational degree or higher (aOR = 1.38, 95%CI: 1.08-1.76), had observed another woman breastfeeding (aOR = 1.43, 95%CI: 1.03-2.00), were not living with parents-in-law (aOR = 1.34, CI: 1.05-1.70), and were multiparous (aOR = 1.60, 95%CI: 1.16-2.19) had higher odds of "exclusive breastfeeding intention" to 6 months. Among primiparous women, those who thought their husbands support breastfeeding were more likely to intend to feed an infant with breastmilk only. Among multiparous women, feeding the previous child with breastmilk exclusively before the introduction of complementary foods and not giving solid foods together with water until 6 months, were significant predictors for both breastfeeding intentions. CONCLUSION Mothers without exclusive breastfeeding experience should be provided with greater support to promote exclusive breastfeeding intention and outcomes.
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Affiliation(s)
- Duong Thi Thuy Doan
- Hanoi University of Public Health, Hanoi, Vietnam
- School of Public Health, Curtin University, Western Australia, Australia
| | - Colin Binns
- School of Public Health, Curtin University, Western Australia, Australia
| | - Andy Lee
- School of Public Health, Curtin University, Western Australia, Australia
| | - Yun Zhao
- School of Public Health, Curtin University, Western Australia, Australia
| | - Minh Ngoc Pham
- School of Public Health, Curtin University, Western Australia, Australia
- Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
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Augustyn M, Haskins D, Gross S, Resnik AK, Ducharme-Smith K, Orta-Aleman D, Silbert-Flagg J, Rosenblum N, Caulfield LE. Maternity care experiences and breastfeeding at discharge among Maryland WIC participants: A qualitative analysis. Birth 2023; 50:1009-1017. [PMID: 37533361 DOI: 10.1111/birt.12758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 04/18/2023] [Accepted: 07/20/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Breastfeeding imparts numerous health and social benefits for families. Barriers deter some individuals from breastfeeding. Rates are lower among certain populations, including participants of the federally funded Women, Infants, and Children's Program (WIC). Women, Infants, and Children's Program provides low-income pregnant and postpartum women and children under 5 with nutrition education, supplemental foods, breastfeeding education and support, and resource linkages. Investigation of WIC participants' hospital experiences and breastfeeding decisions is limited. We explore qualitative themes associated with breastfeeding-related hospital maternity care practices experienced by WIC participants. METHODS Thirty pregnant individuals intending to breastfeed were recruited at WIC clinics to complete in-depth interviews at 2 weeks, 3 months, and 6 months of postpartum. Using the Thematic Framework methodology, we analyzed data from the two-week interviews of 29 participants with respect to hospital breastfeeding experiences. RESULTS Fourteen participants were exclusively breastfeeding at discharge (EBFD). Fifteen were partially breastfeeding at discharge (PBFD). Differences between groups were found in hospital breastfeeding experiences, particularly in staff support. All participants EBFD reported positive breastfeeding-related staff experiences. Most participants PBFD reported limited and ineffective staff interaction, leading to formula introduction. CONCLUSIONS Individuals EBFD and those PBFD reported about the same rate of hospital breastfeeding difficulties, yet half introduced formula within the first few days postpartum. Results reiterate the importance of hospital staff support to breastfeeding exclusivity at 2-3 days postpartum. The challenges that these individuals faced may have been resolved through available, responsive, and effective intervention. Data-driven breastfeeding education programs for hospital health professionals are critical to affect patient breastfeeding outcomes.
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Affiliation(s)
- Marycatherine Augustyn
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - Danielle Haskins
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - Susan Gross
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - Amy Kovar Resnik
- Maryland WIC Program, Maryland Department of Health, Baltimore, Maryland, USA
| | - Kirstie Ducharme-Smith
- Center for Human Nutrition, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - Dania Orta-Aleman
- Center for Human Nutrition, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - JoAnne Silbert-Flagg
- Pediatric Nurse Practitioner Track, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Nadine Rosenblum
- Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, Maryland, USA
- Adjunct Faculty, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Laura E Caulfield
- Center for Human Nutrition, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
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Pinho-Pompeu M, Nakamura RM, Zambrano E, Surita FG. Improving breastfeeding among adolescent mothers: a prospective cohort. SAO PAULO MED J 2023; 142:e2022647. [PMID: 37991014 PMCID: PMC10665004 DOI: 10.1590/1516-3180.2022.0647.r1.260723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/30/2023] [Accepted: 07/26/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Exclusive breastfeeding is recommended for the first six months, and mother's age impact early weaning. Educational support and relevant information can increase breastfeeding rates. OBJECTIVE To determine whether antenatal education enhances the maintenance, intention, and confidence in breastfeeding among adolescents. DESIGN AND SETTING A prospective cohort study involving primiparous adolescents who gave birth at the Woman's Hospital (CAISM), Universidade Estadual de Campinas, Brazil. METHODS Adolescent mothers were categorized into two groups based on the location of prenatal care: those at the Woman's Hospital (WH) who received antenatal education, and at the Primary Care (PC) who did not receive antenatal education. All adolescents received breastfeeding orientation during their postpartum hospital stay. The groups were compared using the Student's t-test, Mann-Whitney U test, and chi-squared test. Log-binomial models were used to compare the groups at different time intervals. RESULTS The study included 132 adolescents: 59 in the WH group and 73 in the PC group. Six months postpartum, adolescents in the WH group demonstrated higher engagement in breastfeeding (P < 0.005) and exclusive breastfeeding (P = 0.04) than PC group. PC group showed greater lack of confidence in breastfeeding (P = 0.02) and felt less prepared (P = 0.01). Notably, all WH adolescents reported a stronger desire to breastfeed after antenatal education. CONCLUSION Antenatal education significantly improves the maintenance, intention, and confidence of breastfeeding among adolescents. This education approach can be implemented across all healthcare levels and should be made accessible to all women throughout the pregnancy and postpartum period.
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Affiliation(s)
- Maira Pinho-Pompeu
- PhD. Nutritionist, Departamento de Tocoginecologia, Faculdade de
Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas (SP),
Brazil
| | - Renan Massao Nakamura
- MD. Resident Physician, Departamento de Tocoginecologia,
Faculdade de Ciências Médicas Universidade Estadual de Campinas (UNICAMP),
Campinas (SP), Brazil
| | - Erika Zambrano
- PhD. Obstetric nurse, Assistent Professor, Faculdade de
Enfermagem, Universidade Estadual de Campinas (UNICAMP), Campinas (SP),
Brazil
| | - Fernanda Garanhani Surita
- MD, PhD. Obstetrician, Full Professor of Obstetrics,
Departamento de Tocoginecologia, Faculdade de Ciências Médicas, Universidade
Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
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Papadopoulou P, Boka V, Arapostathis K. Integration of Breastfeeding Consultation and Practices in the Scope of Pediatric Dentistry: Collaboration with Lactation Specialists. Int J Clin Pediatr Dent 2023; 16:306-310. [PMID: 38268628 PMCID: PMC10804299 DOI: 10.5005/jp-journals-10005-2698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024] Open
Abstract
Background In recent years, breastfeeding has been largely promoted due to health benefits for the children and the mothers and social, economic, and environmental advantages. World Health Organization (WHO) recommends breastfeeding for at least 2 years and to be continued for as long as this is desired by the mother-child dyad.Despite its advantages, including protection against caries in the 1st year of life, prevention of malocclusions, and development of more normal breathing patterns, there is a great controversy in the literature regarding breastfeeding involvement in elevated risk for early childhood caries (ECC).Breastfeeding and oral health are strongly related. Breastfeeding can influence oral health and development, but oral findings, such as tethered tissues and natal/neonatal teeth, may negatively affect lactation. Conclusion A healthy collaboration between the oral health care provider and the lactation specialist is important in order to identify those oral findings and prevent breastfeeding implications, but also in order to facilitate uneventful breastfeeding by emphasizing oral health care prevention strategies. Clinical significance Information on the advantages of certain lactation aspects and the potential risks for ECC is important for the pediatric dentist to be able to form an individualized treatment/prevention plan that will benefit and promote the oral and general health of young patients. How to cite this article Papadopoulou P, Boka V, Arapostathis K. Integration of Breastfeeding Consultation and Practices in the Scope of Pediatric Dentistry: Collaboration with Lactation Specialists. Int J Clin Pediatr Dent 2023;16(S-3):S306-S310.
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Affiliation(s)
- Pinelopi Papadopoulou
- Department of Paediatric Dentistry, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Central Macedonia, Greece
| | - Vasiliki Boka
- Department of Paediatric Dentistry, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Central Macedonia, Greece
| | - Konstantinos Arapostathis
- Department of Paediatric Dentistry, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Central Macedonia, Greece
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Okhovat S, Janighorban M, Kazemi A. Development of an exclusive breastfeeding intervention based on the theory of planned behavior for mothers with preterm infants: Study protocol for a mixed methods study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:340. [PMID: 38144023 PMCID: PMC10743988 DOI: 10.4103/jehp.jehp_1257_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 12/22/2022] [Indexed: 12/26/2023]
Abstract
BACKGROUND Despite the significance and benefits of exclusive breastfeeding, its rate among infants, especially preterm infants, is not optimal. Based on evidence, the mother's attitude toward breastfeeding, the subjective norm, and the mother's perceived behavioral control play a role in initiation and continuation of breastfeeding; so the interventions that consider these factors may be useful for breastfeeding premature infants. The aim of this study is to design and develop an exclusive breastfeeding intervention based on the theory of planned behavior for mothers with preterm infants. MATERIALS AND METHODS This exploratory, sequential, mixed methods study will be conducted in three phases. In the first phase, a qualitative study will be conducted based on the theory of planed behavior, to describe the exclusive breastfeeding beliefs of the mothers with preterm infants, the barriers to breastfeeding, and to explain the ways to overcome them. Moreover, the items of the Predictors Of Exclusive Breastfeeding Questionnaire are prepared based on the theory of planned behavior. In the second phase, the intervention plan is designed based on the literature review and the findings of the qualitative study, and it is approved by a panel of experts. Additionally, the psychometric properties of the questionnaire are evaluated and confirmed qualitatively and quantitatively. In the third phase, the developed intervention is implemented and evaluated. CONCLUSION Implementation of supportive educational interventions based on scientific theories can be a step toward improving the rate of onset and continuation of breastfeeding in mothers with preterm infants. Development of interventions based on evidence, identified beliefs, and perceived barriers of the mothers with preterm infants can provide the foundation for more effective interventions according to cultural, social, and religious contexts.
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Affiliation(s)
- Shirin Okhovat
- Department of Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojgan Janighorban
- Reproductive Sciences and Sexual Health Research Center, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Department of Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Gribble KD, Smith JP, Gammeltoft T, Ulep V, Van Esterik P, Craig L, Pereira-Kotze C, Chopra D, Siregar AYM, Hajizadeh M, Mathisen R. Breastfeeding and infant care as 'sexed' care work: reconsideration of the three Rs to enable women's rights, economic empowerment, nutrition and health. Front Public Health 2023; 11:1181229. [PMID: 37886047 PMCID: PMC10599145 DOI: 10.3389/fpubh.2023.1181229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 09/11/2023] [Indexed: 10/28/2023] Open
Abstract
Women's lifelong health and nutrition status is intricately related to their reproductive history, including the number and spacing of their pregnancies and births, and for how long and how intensively they breastfeed their children. In turn, women's reproductive biology is closely linked to their social roles and situation, including regarding economic disadvantage and disproportionate unpaid work. Recognizing, as well as reducing and redistributing women's care and domestic work (known as the 'Three Rs'), is an established framework for addressing women's inequitable unpaid care work. However, the care work of breastfeeding presents a dilemma, and is even a divisive issue, for advocates of women's empowerment, because reducing breastfeeding and replacing it with commercial milk formula risks harming women's and children's health. It is therefore necessary for the interaction between women's reproductive biology and infant care role to be recognized in order to support women's human rights and enable governments to implement economic, employment and other policies to empower women. In this paper, we argue that breastfeeding-like childbirth-is reproductive work that should not be reduced and cannot sensibly be directly redistributed to fathers or others. Rather, we contend that the Three Rs agenda should be reconceptualized to isolate breastfeeding as 'sexed' care work that should be supported rather than reduced with action taken to avoid undermining breastfeeding. This means that initiatives toward gender equality should be assessed against their impact on women's ability to breastfeed. With this reconceptualization, adjustments are also needed to key global economic institutions and national statistical systems to appropriately recognize the value of this work. Additional structural supports such as maternity protection and childcare are needed to ensure that childbearing and breastfeeding do not disadvantage women amidst efforts to reduce gender pay gaps and gender economic inequality. Distinct policy interventions are also required to facilitate fathers' engagement in enabling and supporting breastfeeding through sharing the other unpaid care work associated with parents' time-consuming care responsibilities, for both infants and young children and related household work.
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Affiliation(s)
- Karleen D. Gribble
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW, Australia
| | - Julie P. Smith
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Tine Gammeltoft
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark
| | - Valerie Ulep
- Philippine Institute for Development Studies, Quezon City, Philippines
| | - Penelope Van Esterik
- Department of Anthropology, York University, Toronto, ON, Canada
- Department of Sociology and Anthropology, University of Guelph, Guelph, ON, Canada
| | - Lyn Craig
- School of Social and Political Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Catherine Pereira-Kotze
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Deepta Chopra
- Institute of Development Studies, University of Sussex, Brighton, United Kingdom
| | - Adiatma Y. M. Siregar
- Center for Economics and Development Studies, Department of Economics, Faculty of Economics and Business, Universitas Padjadjaran, Bandung, Indonesia
| | - Mohammad Hajizadeh
- School of Health Administration, Dalhousie University, Halifax, NS, Canada
| | - Roger Mathisen
- Alive and Thrive East Asia Pacific, FHI Solutions, Hanoi, Vietnam
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de Faria ER, da Silva DDF, Passberg LZ. Factors related to exclusive breastfeeding in the context of Primary Health Care. Codas 2023; 35:e20210163. [PMID: 37820194 PMCID: PMC10688288 DOI: 10.1590/2317-1782/20232021163pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 01/19/2023] [Indexed: 10/13/2023] Open
Abstract
PURPOSE To identify factors related to exclusive breastfeeding up to the sixth month of life of babies in Primary Health Care services. METHODS Quantitative, cross-sectional study, carried out with 261 mothers with 12-month-old babies, coming from health units in Porto Alegre. Data related to exclusive breastfeeding, sociodemographic characteristics, maternal mental health, family relationships and childcare follow-up were analyzed using t-tests, chi-square and Poisson regression model. RESULTS The rate of exclusive breastfeeding until the sixth month of life was 41%. The mother having a partner increased the rates of exclusive breastfeeding by 46%, while returning to work before six months reduced the chances of exclusive breastfeeding by 31%. No significant association was identified between exclusive breastfeeding and sociodemographic variables, maternal mental health, family relationships, and child health monitoring. CONCLUSION The presence of a maternal partner and the woman's return to work after the baby's six months of life were identified as protectors to exclusive breastfeeding. Health interventions that promote the support network, policies to encourage the practice and transmission of knowledge about breastfeeding are important for better rates of exclusive breastfeeding.
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Affiliation(s)
- Evelise Rigoni de Faria
- Programa de Pós-graduação em Avaliação de Tecnologias para o SUS, Gerência de Ensino e Pesquisa, Grupo Hospitalar Conceição – GHC - Porto Alegre (RS), Brasil.
| | - Daniel Demétrio Faustino da Silva
- Programa de Pós-graduação em Avaliação de Tecnologias para o SUS, Gerência de Ensino e Pesquisa, Grupo Hospitalar Conceição – GHC - Porto Alegre (RS), Brasil.
| | - Luísa Zadra Passberg
- Residência Multiprofissional em Saúde, Programa Atenção Materno-Infantil e Obstetrícia, Gerência de Ensino e Pesquisa, Grupo Hospitalar Conceição – GHC - Porto Alegre (RS), Brasil.
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Phetruang A, Kusol K, Eksirinimit T, Jantasuwan R. The Relationship Between Personal Factors, Smoke Exposure at Home, and Respiratory Problems in Early Childhood in Nakhon Si Thammarat Province, Thailand. J Multidiscip Healthc 2023; 16:2499-2511. [PMID: 37664801 PMCID: PMC10473245 DOI: 10.2147/jmdh.s414172] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 08/16/2023] [Indexed: 09/05/2023] Open
Abstract
Purpose The purpose of this study was to examine the relationship between personal factors, smoke exposure at home, and respiratory problems in early childhood in Nakhon Si Thammarat Province, Thailand. Samples and Methods This study was retrospective. There was a total of 414 samples in the study. The instruments included the questionnaire about the personal data of early childhood and their caregivers, the smoke exposure assessment form, and the early childhood respiratory problem assessment form. The relationship between personal factors, smoke exposure at home, and respiratory problems in early childhood was analyzed by the Chi-squared test and binary logistic regression. Results The results revealed that smoke exposure at home in early childhood was moderate (52.2%). There 68.8% had respiratory problems. The relationship between birth weight, and smoke exposure at home in early childhood was found to be significantly related to respiratory problems (X2 =5.014 p< 0.05 and X2 = 85.711 p< 0.001, respectively). It was found that children with a birth weight ≤2500g had respiratory problems at 2.55 times of the samples with birth weight >2500g (AOR = 2.55, 95% CI: 1.10-5.96), and moderate-high smoke exposure had respiratory problems at 8.86 times of the samples with low smoke exposure (AOR = 8.86, 95% CI: 5.39-14.60). Nutritional status and breastfeeding were not significantly related to respiratory problems in early childhood p > 0.05. Conclusion The birth weight and smoke exposure at home factors were found to be related to their respiratory problems in early childhood. Thus, it is necessary to reduce stimuli, especially smoking at home. Moreover, the standard birth weight of their early childhood will reduce the rate of respiratory problems.
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Affiliation(s)
- Apinya Phetruang
- Chulabhorn Hospital, and Graduated Master of Nursing Science Program in Community Nurse Practitioner, School of Nursing, Walailak University, Nakhon Si Thammarat, Thailand
| | - Kiatkamjorn Kusol
- School of Nursing, and the Excellence Center of Community Health Promotion, Walailak University, Nakhon Si Thammarat, Thailand
| | - Thidarat Eksirinimit
- School of Nursing, and the Excellence Center of Community Health Promotion, Walailak University, Nakhon Si Thammarat, Thailand
| | - Rachadaporn Jantasuwan
- School of Nursing, and the Excellence Center of Community Health Promotion, Walailak University, Nakhon Si Thammarat, Thailand
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Nunes LM, Pinheiro RDS, Lopes IMD, Bonetto DVDS, Azevedo AEBI. What does a doctor need to know about breastfeeding and adolescent health and pregnancy? REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e2023S122. [PMID: 37556641 PMCID: PMC10411711 DOI: 10.1590/1806-9282.2023s122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/20/2023] [Indexed: 08/11/2023]
Affiliation(s)
- Leandro Meirelles Nunes
- Universidade Federal do Rio Grande do Sul, Graduate Program in Child and Adolescent Health, Medicine School, Department of Pediatrics – Porto Alegre (RS), Brazil
- Pediatric Brazilian Society, Breastfeeding Department Scientific – Rio de Janeiro (RJ), Brazil
| | - Rossiclei de Souza Pinheiro
- Pediatric Brazilian Society, Breastfeeding Department Scientific – Rio de Janeiro (RJ), Brazil
- Universidade Federal do Amazonas, Medicine School, Maternal and Child Health Department – Manaus (AM), Brazil
| | - Izailza Matos Dantas Lopes
- Pediatric Brazilian Society, Breastfeeding Department Scientific – Rio de Janeiro (RJ), Brazil
- Santa Isabel Hospital and Maternity, Department of Pediatrics – Aracaju (SE), Brazil
| | - Darci Vieira da Silva Bonetto
- Universitario Evangelico Mackenzie Hospital, Department of Pediatrics – Curitiba (PR), Brazil
- Pediatric Brazilian Society, Adolescent Medicine Department Scientific – Rio de Janeiro (RJ), Brazil
| | - Alda Elizabeth Boehler Iglesias Azevedo
- Pediatric Brazilian Society, Adolescent Medicine Department Scientific – Rio de Janeiro (RJ), Brazil
- Universidade Federal de Mato Grosso, Medicine School, Department of Pediatrics – Cuiabá (MT), Brazil
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Čatipović M, Mikšić Š, Fureš R, Puharić Z, Pavlović D. Deficiencies in the Intentions, Attitudes, and Knowledge of Future Healthcare Professionals Regarding Breastfeeding. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1256. [PMID: 37508753 PMCID: PMC10378666 DOI: 10.3390/children10071256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/11/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023]
Abstract
The aim of this study was to determine the level of knowledge, positive intentions, and attitudes regarding breastfeeding among university students. A validated questionnaire collected data from 236 students of the Faculty of Dental Medicine and Health Osijek about breastfeeding intentions, attitudes, and knowledge. Descriptive methods were used to present the students' results in terms of their intentions, attitudes, and knowledge. For each question included in the questionnaire, the maximum possible and maximum achieved numbers of points were calculated, as well as the percentage of points achieved in relation to the maximum possible number. Correlations between the results on individual scales of the questionnaire and the total results of the questionnaire are shown by Spearman's correlation coefficient. Questionnaire answers that were least in line with professional recommendations were selected and analyzed. We found that the areas that should be given special attention in the education of students are: the intention of breastfeeding for more than a year; the use of breaks for breastfeeding in the workplace; attitudes and knowledge about the quality of breast milk in relation to substitutes; attitudes about breastfeeding in public places and breastfeeding for more than two years; and the feeling of maternity and breastfeeding (compared to bottle feeding). The relationship between the results was considered in terms of intentions, attitudes, and knowledge in relation to the overall results of the questionnaire, and the authors' thoughts on the reasons behind the poorer results achieved for certain questions were presented.
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Affiliation(s)
- Marija Čatipović
- Department of Nursing, Bjelovar University of Applied Sciences, Trg E. Kvaternika 4, 43000 Bjelovar, Croatia
- Pediatric Office Marija Čatpović, 43000 Bjelovar, Croatia
| | - Štefica Mikšić
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Rajko Fureš
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Gynecology and Obstetrics, Zabok General Hospital and Croatian Veterans Hospital, 49210 Zabok, Croatia
| | - Zrinka Puharić
- Department of Nursing, Bjelovar University of Applied Sciences, Trg E. Kvaternika 4, 43000 Bjelovar, Croatia
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Dragica Pavlović
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
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27
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Wang ZL, Ryu SH, Bae KH, Kim SJ, Cho HJ. Association between breastfeeding and periodontitis in Korean women using Korea National Health and Nutrition Examination Survey (KNHANES): a cross-sectional study. BMC Oral Health 2023; 23:496. [PMID: 37461022 DOI: 10.1186/s12903-023-03213-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 07/07/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVES The effect of breastfeeding on periodontal disease in women remains unclear. This cross-sectional study used data from the Korean National Health and Nutrition Examination Survey to explore the association between breastfeeding and periodontitis in Korean women using data from the Korean National Health and Nutrition Examination Survey (KNHANES VII). MATERIALS AND METHODS Cross-sectional data was analyzed from the KNHANES 2016-2018. The study population included 5,587 parous women aged ≥ 30 years. The outcome variable was the presence or absence of periodontitis. The explanatory variable, period of breastfeeding, was defined as "none", "1-11 months", and "more than 12 months". Confounder variables (socio-educational, personal healthcare practice, and systemic medical characteristics) were adjusted for in the logistic regression analysis. RESULTS Approximately 60% of the participants breastfed for ≥ 12 months. In all statistical models, the prevalence of periodontitis was approximately 60% greater in women that did not breastfeed compared to women that had breastfed for 12 months or longer. When adjusted for age, statistical significance was only present in the 50-59 years age group (adjusted odds ratio [aOR], 1.678; 95% confidence interval [CIs], 1.046-2.691). CONCLUSION Our study shows that women that breastfed for a relatively long duration had a lower risk of periodontitis. Therefore, breastfeeding may be beneficial for women's periodontal health. These results are expected to be helpful in oral health education for pregnant women.
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Affiliation(s)
- Zi-Lan Wang
- Department of Preventive Dentistry & Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, Daehak-Ro, Jongro-Gu, Seoul, South Korea
| | - Seung-Hee Ryu
- Department of Preventive Dentistry & Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, Daehak-Ro, Jongro-Gu, Seoul, South Korea
| | - Kwang-Hak Bae
- Seoul SUN Dental Hospital, Paju-Si, Gyeonggi-Do, Seoul, South Korea
| | - Seon-Jip Kim
- Department of Preventive Dentistry & Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, Daehak-Ro, Jongro-Gu, Seoul, South Korea.
| | - Hyun-Jae Cho
- Department of Preventive Dentistry & Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, Daehak-Ro, Jongro-Gu, Seoul, South Korea.
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Zareei S, Behrasi F, Naghizadeh MM, Talebzadeh F, Kharmandar A, Farjam M, Homayounfar R. The relationship between pregnancy count and duration of breast-feeding with metabolic syndrome (Fasa Persian cohort study). BMC Womens Health 2023; 23:371. [PMID: 37443023 PMCID: PMC10339557 DOI: 10.1186/s12905-023-02528-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Changes that occur during pregnancy and after that during breastfeeding induce some symptoms similar to metabolic syndrome (MetS) risk factors. This study aims to determine the relationship between pregnancy, as well as the duration of breastfeeding and MetS controlling the effect of other risk factors like hypertension, glucose intolerance, triglyceride, central obesity, and reduction of high-density lipoprotein in women of Fasa Persian Cohort Study. MATERIALS AND METHODS In this cross-sectional study, 5015 women aged 35-70 years were investigated in the Sheshdeh region from 2016 to 2021, and the information related to the disease symptoms was collected through questionnaires, examinations, and laboratory tests. MetS was calculated based on two guidelines according to adult treatment panel III (ATP III) and international diabetes federation (IDF) methods. For reporting the data, the odds ratio with its 95% confidence interval was used. In order to eliminate the effect of confounders, logistic regression was used. RESULTS Prevalence of MetS showed a descending trend in women with up to two pregnancies and it reached 22.6% and 22.4% using ATPIII and IDF methods respectively, while with an increase in the number of pregnancies of more than two, MetS prevalence was ascending. The prevalence of MetS did not have any specific trend across various breastfeeding duration groups. Multivariate analysis approved that the odds ratio of developing MetS in comparison with women who had two pregnancies was significantly increasing trend when the pregnancy counts increased. CONCLUSION The chance of developing MetS based on both IDF and ATP III methods after adjustment for confounding effects would grow with an increase in the number of pregnancies to more than two and breast-feeding of more than seven years. It is recommended that women with more than two pregnancies or the long duration of breast-feeding women undergo a specialized examination to investigate and control MetS problems so that future diseases could be prevented.
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Affiliation(s)
- Saeideh Zareei
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Fatemeh Behrasi
- Department Of Nutrition, School Of Medicine, Zahedan University Of Medical Sciences, Zahedan, Iran
| | | | - Fatemeh Talebzadeh
- Student's research committee, Fasa University of medical sciences, Fasa, Iran
| | - Ali Kharmandar
- Student's research committee, Fasa University of medical sciences, Fasa, Iran
| | - Mojtaba Farjam
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Reza Homayounfar
- Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Cardoso E, Guidi M, Nauwelaerts N, Nordeng H, Teil M, Allegaert K, Smits A, Gandia P, Edginton A, Ito S, Annaert P, Panchaud A. Safety of medicines during breastfeeding - from case report to modeling : A contribution from the ConcePTION project. Expert Opin Drug Metab Toxicol 2023. [PMID: 37269321 DOI: 10.1080/17425255.2023.2221847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 06/01/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Despite many research efforts, current data on the safety of medicines during breastfeeding are either fragmented or lacking, resulting in restrictive labeling of most medicines. In the absence of pharmacoepidemiologic safety studies, risk estimation for breastfed infants is mainly derived from pharmacokinetic (PK) information on the medicine. This manuscript provides a description and a comparison of the different methodological approaches that can yield reliable information on medicine transfer into human milk and the resulting infant exposure. AREA COVERED Currently, most information on medicine transfer in human milk relies on case reports or traditional PK studies, which generate data that can hardly be generalized to the population. Some methodological approaches, such as population PK (popPK) and physiologically-based PK (PBPK) modeling, can be used to provide a more complete characterization of infant medicine exposure through human milk and simulate the most extreme situations, while decreasing the burden of sampling in breastfeeding women. EXPERT OPINION PBPK and popPK modeling are promising approaches to fill the gap of knowledge in medicine safety in breastfeeding, as illustrated with our escitalopram example.
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Affiliation(s)
- Evelina Cardoso
- Service of Pharmacy, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Monia Guidi
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Nina Nauwelaerts
- Drug Delivery and Disposition Lab, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Hedvig Nordeng
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, PharmaTox Strategic Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Karel Allegaert
- Child and Youth Institute, KU Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
- Department of Hospital Pharmacy,erasmus MC, Rotterdam, GA, The Netherlands
| | - Anne Smits
- Child and Youth Institute, KU Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Peggy Gandia
- Laboratory of Pharmacokinetics and Toxicology, Purpan Hospital, University Hospital of Toulouse
| | - Andrea Edginton
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Shinya Ito
- Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, ON, Canada
| | - Pieter Annaert
- Drug Delivery and Disposition Lab, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Alice Panchaud
- Service of Pharmacy, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
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Alemie K, Eshete T, Ashebir W, Gedif G, Desta M, Ayenew T, Alamneh AA, Ketema DB, Tsega TD, Telayneh AT. Ineffective breastfeeding techniques and associated factors among breastfeeding mothers who gave birth in the last 6 months in Sinan Woreda, Northwest Ethiopia. J Public Health Res 2023; 12:22799036231181184. [PMID: 37440796 PMCID: PMC10334002 DOI: 10.1177/22799036231181184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 05/20/2023] [Indexed: 07/15/2023] Open
Abstract
Background Optimal infant feeding is critical for children's growth and development during their first years of life. Plenty of evidence on ineffective breastfeeding techniques, yet the problem is still deep-rooted and requires further research in Ethiopia. Objective To determine the proportion of ineffective breastfeeding techniques and associated factors among breastfeeding mothers who gave birth in the last 6 months in Sinan Woreda. Design and methods A community-based cross-sectional study was conducted from March 10 to April 8, 2021 with a total of 389 samples. A computer-generated simple random sampling was used to select mothers. An observational checklist and interviewer-administered questionnaires were used. EpiData 4.2 for data entry and SPSS 25 for cleaning and analysis were used. Variables with a p-value < 0.05 and 95% confidence interval (CI) corresponding adjusted odds ratio (AOR) were used to identify factors of ineffective breastfeeding techniques. Results The proportion of ineffective breastfeeding techniques was 66.8%. The mean (SD) age of mothers was 29.4 ± 5.95 years. No formal education [AOR: 5.88 (95% CI: (2.97, 11.65)], primipara [AOR: 4.34 (95% CI: 2.25, 8.36)], home delivery [AOR: 3.02 (95% CI: 1.12, 8.14)], not received breastfeeding counseling during antenatal care [AOR: 4.94 (95% CI: 1.83, 13.36)], breast problem [AOR: 2.62 (95% CI: 1.25, 5.48)], and breastfeeding experience [AOR: 1.82 (95% CI: 1.01, 3.28)] were statistically significant factors. Conclusions The proportion of ineffective breastfeeding techniques 66.8% was unacceptable. Socio-demographic and maternal health care services were identified factors. Strengthening maternal care, improving health education and promotions, and designing appropriate strategies were required.
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Affiliation(s)
- Kelemu Alemie
- Sinan Woreda Helth Office, East Gojjam
Zone, Amhara, Ethiopia
| | - Tewodros Eshete
- Department of Health Informatics,
College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Wassachew Ashebir
- Department of Public Health, College of
Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Getnet Gedif
- Department of Public Health, College of
Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Melaku Desta
- Department of Midwifery, College of
Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Temesgen Ayenew
- Department of Nursing, College of
Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Alehegn Aderaw Alamneh
- Department of Human Nutrition, College
of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Daniel Bekele Ketema
- Department of Public Health, College of
Health Sciences, Debre Markos University, Debre Markos, Ethiopia
- The George Institute for Global Health,
University of New South Wales (UNSW), Sydney, Australia
| | | | - Animut Takele Telayneh
- Department of Public Health, College of
Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Vik ES, Kongslien S, Nedberg IH, Mariani I, Valente EP, Covi B, Lazzerini M. Women's experiences and views on early breastfeeding during the COVID-19 pandemic in Norway: quantitative and qualitative findings from the IMAgiNE EURO study. Int Breastfeed J 2023; 18:15. [PMID: 36895002 PMCID: PMC9998246 DOI: 10.1186/s13006-023-00553-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 02/25/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Little is known about women's experience of care and views on early breastfeeding during the COVID-19 pandemic in Norway. METHODS Women (n = 2922) who gave birth in a facility in Norway between March 2020 and June 2021 were invited to answer an online questionnaire based on World Health Organization (WHO) Standard-based quality measures, exploring their experiences of care and views on early breastfeeding during the COVID-19 pandemic. To examine associations between year of birth (2020, 2021) and early breastfeeding-related factors, we estimated odds ratios (ORs) with 95% confidence intervals (CIs) using multiple logistic regression. Qualitative data were analysed using Systematic Text Condensation. RESULTS Compared to the first year of the pandemic (2020), women who gave birth in 2021 reported higher odds of experiencing adequate breastfeeding support (adjOR 1.79; 95% CI 1.35, 2.38), immediate attention from healthcare providers when needed (adjOR 1.89; 95% CI 1.49, 2.39), clear communication from healthcare providers (adjOR 1.76; 95% CI 1.39, 2.22), being allowed companion of choice (adjOR 1.47; 95% CI 1.21, 1.79), adequate visiting hours for partner (adjOR 1.35; 95% CI 1.09, 1.68), adequate number of healthcare providers (adjOR 1.24; 95% CI 1.02, 1.52), and adequate professionalism of the healthcare providers (adjOR 1.65; 95% CI 1.32, 2.08). Compared to 2020, in 2021 we found no difference in skin-to-skin contact, early breastfeeding, exclusive breastfeeding at discharge, adequate number of women per room, or women's satisfaction. In their comments, women described understaffed postnatal wards, early discharge and highlighted the importance of breastfeeding support, and concerns about long-term consequences such as postpartum depression. CONCLUSIONS In the second year of the pandemic, WHO Standard-based quality measures related to breastfeeding improved for women giving birth in Norway compared to the first year of the pandemic. Women's general satisfaction with care during COVID-19 did however not improve significantly from 2020 to 2021. Compared to pre-pandemic data, our findings suggest an initial decrease in exclusive breastfeeding at discharge during the COVID-19 pandemic in Norway with little difference comparing 2020 versus 2021. Our findings should alert researchers, policy makers and clinicians in postnatal care services to improve future practices.
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Affiliation(s)
- Eline Skirnisdottir Vik
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
| | - Sigrun Kongslien
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Ilaria Mariani
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", WHO Collaborating Centre for Maternal and Child Health, Trieste, Italy
| | - Emanuelle Pessa Valente
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", WHO Collaborating Centre for Maternal and Child Health, Trieste, Italy
| | - Benedetta Covi
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", WHO Collaborating Centre for Maternal and Child Health, Trieste, Italy
| | - Marzia Lazzerini
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", WHO Collaborating Centre for Maternal and Child Health, Trieste, Italy
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Farahmand M, Rahmati M, Azizi F, Ramezani Tehrani F. Lactation duration and lifetime progression to metabolic syndrome in women according to their history of gestational diabetes: a prospective longitudinal community-based cohort study. J Transl Med 2023; 21:177. [PMID: 36879241 PMCID: PMC9987076 DOI: 10.1186/s12967-023-04005-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/16/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Despite the many signs of progress in pharmacotherapies, metabolic syndrome (MetS) is one of the main public-health burdens worldwide. Our study aimed to compare the effect of breastfeeding (BF) in women with and without gestational diabetes mellitus (GDM) on MetS incidence. METHODS Of females who participated in the Tehran Lipid and glucose study, women who met our inclusion criteria were selected. The Cox proportional hazards regression model, with adjustment of potential confounders, was done to evaluate the relationship between duration of BF and incident of MetS in women with a GDM history compared to non-GDM. RESULTS Out of 1176 women, there were 1001 non-GDM and 175 GDM. The median follow-up was 16.3 (11.9, 19.3) years. Results of the adjusted model illustrated that the total BF duration was negatively associated with MetS incidence risk (hazard ratio (HR) 0.98, 95% CI 0.98-0.99) in total participants indicating that per one-month increase of BF duration, the hazard of MetS reduced by 2%. The HR of MetS in Comparison between GDM and non-GDM women demonstrated significantly more reduced MetS incidence with a longer duration of exclusive BF (HR 0.93, 95% CI 0.88-0.98). CONCLUSIONS Our findings illustrated the protective effect of BF, especially exclusive BF, on MetS incidence risk. BF is more effective in reducing the risk of MetS among women with a history of GDM than among women without such a history.
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Affiliation(s)
- Maryam Farahmand
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rahmati
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Cardoso E, Monfort A, Ferreira E, Nordeng H, Winterfeld U, Allegaert K, Gandia P, Guidi M, Panchaud A. Maternal drugs and breastfeeding: Risk assessment from pharmacokinetics to safety evidence - A contribution from the ConcePTION project. Therapie 2023; 78:149-156. [PMID: 36804048 DOI: 10.1016/j.therap.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/24/2023] [Indexed: 02/01/2023]
Abstract
Human milk is the most appropriate form of nutrition for infants while taking medication during the postpartum period is common. Discontinuation of breastfeeding is sometimes wrongly recommended for fear of adverse effects in the breastfed infant whereas only a few drugs are strictly contraindicated while breastfeeding. Most drugs are transferred from the mother's blood to the milk, but the breastfed infant usually ingests a small drug amount through human milk. As population-based evidence is still scarce on safety of drugs during breastfeeding, risk assessment relies on the little clinical evidence available and on pharmacokinetic principles, as well as on specialized sources of information that are essential for clinical decision-making. Risk assessment should not only be based on the drug's potential risk for the breastfed infant but should always take into account the benefits associated to breastfeeding, the risks of untreated maternal disease and the maternal willingness to breastfeed. Identifying situations with potential for drug accumulation in the breastfed infant is decisive while assessing the risk. Health care providers should always assume that mothers will be concerned and use risk communication as a key to ensure medication adherence and prevent unnecessary interruption of breastfeeding. When a mother still expresses concerns, decision support algorithms may facilitate communication and some strategies can be offered to minimize the drug exposure in the breastfed infant even when clinically not justified.
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Affiliation(s)
- Evelina Cardoso
- Service of Pharmacy, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland.
| | - Anaëlle Monfort
- Platform of Biopharmacy, Faculty of Pharmacy, University of Montreal, Montreal, H3T 1J4 QC, Canada; CHU Sainte-Justine, Montreal, H3T 1C5 QC, Canada; Faculty of Pharmacy, University of Montreal, Montreal, H3C 3J7 QC, Canada
| | - Ema Ferreira
- CHU Sainte-Justine, Montreal, H3T 1C5 QC, Canada; Faculty of Pharmacy, University of Montreal, Montreal, H3C 3J7 QC, Canada
| | - Hedvig Nordeng
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, PharmaTox Strategic Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, 0316 Oslo, Norway; Department of Child Health and Development, Norwegian Institute of Public Health, 0473 Oslo, Norway
| | - Ursula Winterfeld
- Swiss Teratogen Information Service, Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland
| | - Karel Allegaert
- Child and Youth Institute, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium; Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium; Department of Hospital Pharmacy, Erasmus MC, 3000 GA Rotterdam, the Netherlands
| | - Peggy Gandia
- Laboratory of Pharmacokinetics and Toxicology, Purpan Hospital, University Hospital of Toulouse, 31073 Toulouse, France
| | - Monia Guidi
- Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland; Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland
| | - Alice Panchaud
- Service of Pharmacy, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland; Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
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Bowden ER, Chang AB, McCallum GB. Interventions to improve enablers and/or overcome barriers to seeking care during pregnancy, birthing and postnatal period for vulnerable women in high-income countries: a systematic review and meta-analysis. Midwifery 2023; 121:103674. [PMID: 37027983 DOI: 10.1016/j.midw.2023.103674] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 03/10/2023] [Accepted: 03/26/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE To reduce maternal morbidity and mortality, World Health Organization recommendations include: commencing pregnancy care before 12-weeks', at least eight antenatal and four postnatal visits, and attendance of skilled care at birthing. While lower adherence to the recommendation predominates in low- and middle-income countries, it also occurs in some settings in high-income countries. Globally, various strategies are used to optimise maternity care, in line with these recommendations. This systemic review aimed to determine if enhanced care improves maternal care-seeking, thus improving clinical outcomes for women and babies living with vulnerabilities, in high-income countries. DESIGN, SETTING AND PARTICIPANTS We searched the Cochrane Central Registers of Controlled Trials and Cochrane Pregnancy and Childbirth, MEDLINE, CINAHL, Proquest Dissertation and Thesis and reference lists of relevant articles. The latest search was performed June 20, 2022. Randomised controlled trials, non-randomised intervention trials and cohort studies comparing effects of interventions designed to increase utilisation of maternal health services with routine care, for women at increased risk of maternal mortality and severe maternal morbidity in high-income countries were included. Two authors selected, extracted, assessed and analysed data. Additional information was sought from study authors. This systematic review and meta-analysis was registered with PROSPERO(CRD42021256811). FINDINGS Nine studies with 5,729 participants were included. Interventions to enhance care significantly increased utilisation of health services, increasing attendance at antenatal classes (Odds Ratio[OR]=15·23, 95%Confidence Interval[CI] 10·73-21·61, p<0·0001) and postnatal visits by 6-8 weeks (OR=2·66, 95%CI 1·94-3·64, p<0·0001), compared to routine care. Infants in the intervention groups were significantly less likely to be: born preterm (OR=0·68, 95%CI 0·56-0·82, p<0·0001); low birthweight (OR=0·78, 95%CI 0·64-0·95, p = 0·01) or; require neonatal intensive care (OR=0·80, 95%CI 0·66-0·96, p = 0·02). CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Among women living with vulnerabilities in high-income countries, interventions to enhance care increases utilisation of maternal health services and improves outcomes.
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Affiliation(s)
- Emily R Bowden
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, SA.
| | - Anne B Chang
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, SA; Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, SA; Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, SA
| | - Gabrielle B McCallum
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, SA
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Wu JL, Jiang XM, Zheng QX, Chen XQ, Liu GH. Mothers' breastfeeding six weeks postpartum and factors influencing exclusive breastfeeding during the first six months. Health Care Women Int 2023; 44:262-275. [PMID: 34346293 DOI: 10.1080/07399332.2021.1947287] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We aimed to assess the feeding pattern and influencing factors within six weeks postpartum on exclusive breastfeeding duration among Chinese mothers. This study was conducted using 2:1 matched case-control study. Cases and controls were matched for maternal age, parity and mode of birth. A total of 210 women were included. Approximately 67.9% of women stopped exclusive breastfeeding within the first six weeks postpartum. Maternal non-exclusive breastfeeding intention, lower maternal educational level, mother-infant skin to skin contact over one hour, unsatisfied breastfeeding self-evaluation and maternal unhealthy condition within the first six weeks were risk factors for ceasing exclusive breastfeeding early.
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Affiliation(s)
- Jing-Ling Wu
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiu-Min Jiang
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Qing-Xiang Zheng
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Xiao-Qian Chen
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Gui-Hua Liu
- Department of Child Health, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
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Lee HK, Joo E, Kim S, Cho I, Lee KN, Kim HJ, Kim B, Park JY. A Comparison of Ultrasound Imaging Texture Analyses During the Early Postpartum With the Mode of Delivery. J Hum Lact 2023; 39:59-68. [PMID: 35272509 DOI: 10.1177/08903344221081866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Breastfeeding is beneficial to infants. However, cesarean section is reported to be a risk factor for unsuccessful breastfeeding. RESEARCH AIMS (1) To extract discriminating data from texture analysis of breast ultrasound images in the immediate postpartum period; and (2) to compare the analysis results according to delivery mode. METHODS A cross-sectional, prospective non-experimental design with a questionnaire and observational components was used. Participants (N = 30) were women who delivered neonates at a center from September 2020 to December 2020. The participants underwent ultrasound examination of bilateral breasts 7-14 days after delivery. Ultrasound images were collected for texture analysis. A questionnaire about breastfeeding patterns was given to the participants on the day of the ultrasound examination. RESULTS No significant differences were found in texture analysis between the breasts of participants who had undergone Cesarean section and vaginal deliveries. The mean volume of total human milk produced in 1 day was significantly greater in the vaginal delivery group than in the cesarean section group (M = 350.87 ml, SD = 183.83 vs. M = 186.20 ml, SD = 184.02; p = .017). The pain score due to breast engorgement measured subjectively by participants was significantly lower in the vaginal delivery group than in the cesarean section group (M = 2.8, SD = 0.86 vs. M = 3.4, SD = 0.63; p = .047). CONCLUSION Texture analysis of breast ultrasound images did not demonstrate difference between the cesarean section and vaginal delivery groups in the immediate postpartum period; nevertheless, cesarean section was independently associated with less successful breastfeeding.
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Affiliation(s)
- Hyun Kyoung Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Eunwook Joo
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seongbeen Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Iseop Cho
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Kyong-No Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyeon Ji Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Bohyoung Kim
- Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Gyeonggi-do, Republic of Korea
| | - Jee Yoon Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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Factors Which May Contribute to the Success or Failure of the Use of Mother's Own Milk in a Level IV Neonatal Intensive Care Unit. Adv Neonatal Care 2023; 23:81-92. [PMID: 35670723 DOI: 10.1097/anc.0000000000001003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Benefits of mother's own milk (MOM) for infants in neonatal intensive care units (NICUs) are well known. Many mothers provide for their infant's feedings during their entire hospitalization while others are unable. Knowledge is limited about which infant and maternal factors may contribute most to cessation of MOM feedings. PURPOSE Study aims were to (1) identify which maternal and infant risk factors or combination of factors are associated with cessation of provision of MOM during hospitalization, (2) develop a lactation risk tool to identify neonatal intensive care unit infants at higher risk of not receiving MOM during hospitalization, and (3) identify when infants stop receiving MOM during hospitalization. METHODS A data set of 797 infants admitted into a level IV neonatal intensive care unit before 7 days of age, whose mothers chose to provide MOM, was created from analysis of data from the Children's Hospital Neonatal Database. Maternal and infant factors of 701 dyads who received MOM at discharge were compared with 87 dyads who discontinued use of MOM by discharge using χ 2 , t tests, and Wilcoxon rank tests. Logistic regression was used to build a risk-scoring model. RESULTS The probability of cessation of MOM increased significantly with the number of maternal-infant risk factors. A Risk Calculator was developed to identify dyads at higher risk for cessation of MOM by discharge. IMPLICATIONS FOR PRACTICE Identifying mothers at risk for cessation of MOM can enable the healthcare team to provide optimal lactation management and outcomes. IMPLICATIONS FOR RESEARCH Although the Risk Calculator has potential to identify dyads at risk of early MOM cessation, further research is needed to validate these results.
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Shafie F, Tajadod S, Aslany Z, Allahyari P, Vahdat M, Shekari S, Mohseni GK, Gholamalizadeh M, Mohammadi S, Bahar B, Shafaei H, Doaei S. Breast cancer and dietary fat quality indices in Iranian women: A case-control study. Front Oncol 2023; 12:993397. [PMID: 36741722 PMCID: PMC9895810 DOI: 10.3389/fonc.2022.993397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 12/30/2022] [Indexed: 01/21/2023] Open
Abstract
Background The association between breast cancer (BC) and different indices of dietary fats has not been well-studied. Thus, this study aimed to investigate the association between BC and dietary fat quality (DFQ) indices in Iranian women. Methods This case-control study was conducted on 120 women with breast cancer and 240 healthy women in Tehran, Iran. Food Frequency Questionnaire and nutritionist IV software were used to assess the intake of dietary fats and to calculate the DFQ indices. Results The patients with BC had a higher total fat (TF) (P < 0.01) and a lower ratio of polyunsaturated fatty acids (PUFAs) omega-3 to PUFAs omega-6 (ω-3/ω-6) compared with the controls (P < 0.001). TF had a significant association with BC risk (OR: 1.16; 95% CI: 1.01-1.33, P < 0.001). No significant association was found between BC and PUFA/saturated fatty acid ratio or the ω-3/ω-6 ratio. Conclusion The patients with BC had a lower ω-3/ω-6 ratio and a higher total dietary fat intake than the healthy women. Total dietary fat intake was also directly associated with the risk of BC. Thus, low-fat diets may have beneficial effects for BC prevention. Further longitudinal studies are warranted.
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Affiliation(s)
- Fatemeh Shafie
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shirin Tajadod
- Department of Nutrition, School Of Public Health, International Campus, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Aslany
- The Ohio State University Interdisciplinary ph.D. program in Nutrition (OSUN), Columbus, United States,The Ohio State University Comprehensive Cancer Center, Columbus, United States
| | - Pooneh Allahyari
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Islamic Azad University, Central Tehran Branch, Tehran, Iran
| | - Mahsa Vahdat
- Aboozar Children’s Medical Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Soheila Shekari
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Golsa Khalatbari Mohseni
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Gholamalizadeh
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeideh Mohammadi
- Department of Nutrition, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Bojlul Bahar
- Nutrition Sciences and Applied Food Safety Studies, Research Centre for Global Development, School of Sport and Health Sciences, University of Central Lancashire, Preston, United Kingdom
| | - Hanieh Shafaei
- Nursing and Midwifery School, Guilan University of Medical Sciences, Rasht, Iran
| | - Saeid Doaei
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran,*Correspondence: Saeid Doaei,
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Kemp A, Garland K, Graham E, Simpson A, Symonette C. Family Planning Among Canadian Plastic Surgeons and Trainees. Plast Surg (Oakv) 2023. [DOI: 10.1177/22925503221151187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Introduction: Despite increasing advocacy for family leave policies, few studies have described the current landscape and attitudes around family planning in Canadian plastic surgery. The purpose of this study was to survey Canadian plastic surgeons and trainees to examine their experience with family planning, parental leave, and breastfeeding. Methods: An anonymized survey was distributed to all members of the Canadian Society of Plastic Surgeons and all Canadian Plastic Surgery residents through their program administrators. Survey responses were recorded and analyzed through a customized REDCap™ database. Results were reported using descriptive statistics. Results: A total of 87 plastic surgeons and trainees completed the surgery. We found 72.3% of respondents had children; 67.8% felt their colleagues were supportive of parental leave; 45.6% felt that financial concerns affected their decision to take parental leave; 61.6% felt that their career did not influence the number of children they chose to have; 21.0% accessed fertility services and 9.8% used assisted-reproductive technologies; 80% of respondents who breastfeed felt they did not have enough time to pump at work, however, 79% did not experience any discrimination or criticism for pumping at work. Conclusion: Canadian plastic surgeons most often have children after completing training and choose to take shorter parental leaves as their careers progress. Parental leave and breastfeeding practices in the workplace are reported to have increased support from colleagues compared to previous literature. However, Canadian plastic surgeons continue to struggle with infertility and seek fertility services at rates higher than the general population.
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Affiliation(s)
- Austin Kemp
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Katie Garland
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Division of Plastic and Reconstructive Surgery, Western University, London, ON, Canada
| | - Elise Graham
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Division of Otolaryngology, Western University, London, ON, Canada
| | - Andrew Simpson
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Division of Plastic and Reconstructive Surgery, Western University, London, ON, Canada
| | - Caitlin Symonette
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Division of Plastic and Reconstructive Surgery, Western University, London, ON, Canada
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Miolski J. Benefits of breastfeedinig for mother and child. SANAMED 2023. [DOI: 10.5937/sanamed0-41390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Breastfeeding is the best way to feed a child from the first six months until the end of the second year. The unbreakable bond during pregnancy between a mother and her child continues during the lactation process, providing numerous benefits for both the mother and the child. Due to the effects of many hormones after childbirth, lactation offers numerous advantages for the mother. Oxytocin causes reduction of the uterus and bleeding, absence of menstruation, faster return of body weight, lower risk of cancer of the reproductive organs, and prevents the occurrence of osteoporosis and the development of the metabolic syndrome. Breastfeeding certainly ensures a better emotional bond with the child. Specificity in the composition of human milk provides the newborn with short-term and long-term protective effects. Thanks to human oligosaccharides, immunoglobulins, and polyunsaturated fatty acids that influence the composition of the microbiome of the newborn's intestine, as well as the formation of its immune response, breastfed children suffer less from respiratory and digestive infections, food allergies, autoimmune diseases and have been proven to have a higher IQ. Breastfeeding is the best form of feeding for mother and child. The specificity of the composition of human milk ensures optimal growth and development of the child and a healthier life for its mother.
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Fucile S, Heath J, Dow K. Impact of the Covid-19 Pandemic on Breastfeeding Establishment in Preterm Infants: An Exploratory Study. Neonatal Netw 2023; 42:7-12. [PMID: 36631265 DOI: 10.1891/nn-2022-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 01/12/2023]
Abstract
Purpose: To evaluate breastfeeding outcomes in preterm infants born during the Covid-19 pandemic. Design: An observational cohort study of 33 infants born ≤34 weeks' gestation was conducted. Sample: The study sample consisted of 33 infants divided into 2 groups: infants born during the Covid-19 pandemic (Covid group, n = 11) and those born prior to the pandemic (pre-Covid group, n = 22). Main Outcome Variable: Breastfeeding at hospital discharge. Results: Fewer infants in the Covid group received breastfeeds at full oral feed (p = .015) and none breastfeeding at hospital discharge (p = .001). In addition, fewer infants in the Covid group received non nutritive sucking (p = .612) and more infants in the Covid group required milk supplementation (p = .032). Study results suggest that breastfeeding establishment at hospital discharge in preterm infants is significantly impacted by the Covid-19 pandemic. There is a critical need, in low-risk disease transmission areas, to enhance parental access and to increase in-hospital lactation supports to help safeguard breastfeeding outcomes in preterm infants.
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Taylor VJ. Lactation from the inside out: Maternal homeorhetic gastrointestinal adaptations regulating energy and nutrient flow into milk production. Mol Cell Endocrinol 2023; 559:111797. [PMID: 36243202 DOI: 10.1016/j.mce.2022.111797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 08/30/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Abstract
Lactation invokes homeorhetic processes to ramp up and supply milk synthesis components to fulfil nutritional, immunological and microbiological requirements of developing offspring, overseen by complex neuroendocrine networks. The maternal gut meets these intense metabolic demands, supported by hyperphagia and rapid adjustments to process larger food quantities. Enteroplasticity describes an inherent ability of the gastrointestinal tract to harness metabolic and structural adaptations that increase nutrient absorption. Most shifts in response to increased demands are transitory and by secreting milk, the continuous energetic drain out of the maternal body avoids development of pathological metabolic diseases. Lactation has various positive benefits for long-term maternal health but many females do not lactate for long post pregnancy and younger women are increasingly pre-disposed to excessive body mass and/or metabolic complications prior to reproducing. Inadvertently invoking intestinal adaptations to harvest and store excess nutrients has negative health implications with increased risks for both mother and offspring.
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Affiliation(s)
- Vicky J Taylor
- School of Life, Health and Chemical Sciences (LHCS), Faculty of Science, Technology, Engineering and Mathematics (STEM), The Open University, United Kingdom.
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Ajuzie S. Evaluating the Challenges and Potential Complications of Breastfeeding in Naval Aviation. Mil Med 2022; 188:usac396. [PMID: 36545809 DOI: 10.1093/milmed/usac396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 09/13/2022] [Accepted: 11/28/2022] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION Active duty flight crew plays a critical role in military operations. The occupational demands of the flying environment require a certain level of medical suitability. Additionally, such an environment could be more hazardous for certain populations. While the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and the World Health Organization strongly support exclusive breastfeeding for the health benefit of both the mother and the child in the first 6 months of life, the aeromedical implications of lactating are not widely discussed. Breastfeeding is inherently challenging for many women, in part because of the frequent emptying required to maintain breastmilk supply and avoid complications such as engorgement, clogged ducts, and mastitis. This pilot study evaluated the experiences of individuals concurrently breastfeeding while on active duty Naval flying status to (1) assess whether these individuals experience frequent challenges or complications associated with lactating and (2) establish the need for future expanded studies. MATERIALS AND METHODS This survey-based, retrospective, descriptive study evaluated the experiences of 17 lactating individuals on active duty Naval flying status. Women were recruited using word of mouth and social media platforms. Responses were tabulated and summarized from the survey, which included yes/no questions and free-response sections regarding flying position, breastfeeding history, and breastfeeding challenges. This trial was approved by the Naval Air Warfare Center Aircraft Division (NAWCAD) Institutional Review Board (Protocol Number NAWCAD.2021.0004-IR-EP7). RESULTS Of the 27 women who received study materials after expression of interest, 17 individuals completed the informed consent and survey protocols. Although limited by sample size and the demographics of respondents, the results highlight that the active duty flying environment did impact the breastfeeding experiences of the participants, with 88% of respondents reporting some difficulty or complication associated with breastfeeding and the operational flying environment. Difficulty in maintaining breastmilk supply, engorgement, and the need for supplementation were some of the concerns discussed. CONCLUSIONS This study hypothesizes that occupational demands associated with aviation result in a decreased ability to maintain exclusive breastfeeding, an increased risk for engorgement and clogged ducts, and a higher likelihood of early weaning among Naval aviators. It included only the perspectives of Naval officers, thereby lacking the input of enlisted aircrew on flight status, who comprise a large population of active duty flyers. The responses, although limited by a lack of controls and survey limitations, indicate that a future study to expand understanding of the aeromedical implications on lactating individuals would be valuable for improving workplace support and the ultimate success of lactating women in meeting their breastfeeding goals.
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Gálvez-Adalia E, Bartolomé-Gutiérrez R, Berlanga-Macías C, Rodríguez-Martín B, Marcilla-Toribio I, Martínez-Andrés M. Perceptions of Mothers about Support and Self-Efficacy in Breastfeeding: A Qualitative Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1920. [PMID: 36553363 PMCID: PMC9776413 DOI: 10.3390/children9121920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022]
Abstract
Breastfeeding is a complex process influenced by different personal and social factors which will determine both the initiation and the resilience for its maintenance. The aim is to identify the beliefs and expectations of mothers concerning breastfeeding to determine the perception of their self-efficacy and the influence on the management of their babies' feeding. A qualitative study through semi-structured interviews was carried out. The sample size was defined by the saturation criteria. Twenty-two women participated, eleven were from an urban environment and eleven were from a rural environment. Mothers' knowledge of breastfeeding, their expectations of that process, their experience, and their strategies for overcoming problems associated with initiating, establishing, and continuing breastfeeding were influenced by the role of nurses and midwives in supporting their perception of self-efficacy. Likewise, maternity policies are important for the continuance of exclusive breastfeeding. This study shows the complexity of the initiation and establishment of breastfeeding and the existence of several social factors surrounding these moments. Furthermore, it demonstrates the importance and reference of nurses and midwives and the role of State maternity policies.
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Affiliation(s)
| | | | - Carlos Berlanga-Macías
- Faculty of Nursing, Universidad de Castilla-La Mancha, 02071 Albacete, Spain
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
| | - Beatriz Rodríguez-Martín
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, 45600 Talavera de la Reina, Spain
| | - Irene Marcilla-Toribio
- Health, Gender and Social Determinants Research Group, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
| | - María Martínez-Andrés
- Faculty of Nursing, Universidad de Castilla-La Mancha, 02071 Albacete, Spain
- Health, Gender and Social Determinants Research Group, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
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Aderoba AK, Adu-Bonsaffoh K. Antenatal and Postnatal Care. Obstet Gynecol Clin North Am 2022; 49:665-692. [DOI: 10.1016/j.ogc.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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McCloskey RJ, Pei F. Associations Between Mothers' Adverse Childhood Experiences, Material Hardship, and Breastfeeding Challenges in the United States. J Hum Lact 2022; 38:651-660. [PMID: 36062620 DOI: 10.1177/08903344221120596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Breastfeeding is the biological norm and is associated with numerous superior health outcomes for children and mothers when compared to human milk substitutes. Yet, breastfeeding difficulties and the inability to meet one's breastfeeding goals are common in the United States and maybe more common among mothers who have experienced trauma. RESEARCH QUESTIONS (1) Are mothers' adverse childhood experiences, and current experiences of discrimination, material hardship, and decreased social support associated with breastfeeding challenges; and (2) are these experiences associated with the number of breastfeeding challenges reported? METHODS A prospective, non-probability, cross-sectional study design with a diverse sample who had delivered a live baby within the previous year (N = 306) was conducted. RESULTS Over 70% of participants reported breastfeeding challenges and 45.2% reported material hardship. Among those who attempted breastfeeding (n = 286), 74.1% had at least one adverse childhood experience; 30.3% had four or more. Logistic and negative binomial regression models determined that adverse childhood experiences, experiences of discrimination, material hardship, and decreased social support were not associated with experiencing any breastfeeding challenges. However, adverse childhood experiences were associated with the number of breastfeeding challenges reported. (The adjusted rate ratio was 1.05; 95% CI [1.00, 1.09], p = .034). CONCLUSION We recommend further research on adverse childhood experiences and potential relationships with discrimination, material hardship, and social support to prevent and intervene in cases of breastfeeding challenges to maximize infant, maternal, and public health.
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Affiliation(s)
| | - Fei Pei
- School of Social Work, Syracuse University, Syracuse, NY, USA
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Pramono A, Smith J, Bourke S, Desborough J. "We All Believe in Breastfeeding": Australian Midwives' Experience of Implementing the Baby Friendly Hospital Initiative. J Hum Lact 2022; 38:780-791. [PMID: 35792378 DOI: 10.1177/08903344221106473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The education and support of new mothers during the in-hospital stay for childbirth is a critical time to establish breastfeeding. The Baby-Friendly Hospital Initiative was launched in 1991 to encourage maternity services to support and educate mothers to breastfeed by implementing Ten Steps to Successful Breastfeeding. RESEARCH AIM To explore midwives' experiences of implementing the Baby-Friendly Hospital Initiative in a Baby-Friendly accredited public hospital in Australia. METHODS In this prospective, cross-sectional qualitative study we used focus groups to explore midwives' experiences. Midwives (N = 26) participated in two focus groups conducted between October and November 2019. Data were analyzed using thematic analysis. RESULTS Time as a critical resource, and continuity of care, were crosscutting themes that framed midwives' experiences in supporting mothers to breastfeed their babies. Time constraints were experienced both through the health system structure and the BFHI accreditation process. Despite the challenges, the overarching theme-that we all believe in breastfeeding-fueled midwives' motivation. CONCLUSION Health services policy and practice need to consider ways to enable continuity of midwifery care and adequate time for midwives to support women to breastfeed their babies.
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Affiliation(s)
- Andini Pramono
- Department of Health Services Research and Policy, National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Julie Smith
- Department of Health Services Research and Policy, National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Siobhan Bourke
- Department of Health Services Research and Policy, National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Jane Desborough
- Department of Health Services Research and Policy, National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
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Purkiewicz A, Czaplicki S, Pietrzak-Fiećko R. The Occurrence of Squalene in Human Milk and Infant Formula. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12928. [PMID: 36232224 PMCID: PMC9566149 DOI: 10.3390/ijerph191912928] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: The aim of the conducted research was to analyze the squalene content in infants' food. (2) Methods: The experimental material included human milk collected from 100 women from Poland and three different infant formulas. The breast milk fat was extracted according to the Rose-Gottlieb method (AOAC), while the squalene content was determined using the high-performance liquid chromatography (HPLC) method. (3) Results: The highest amount of squalene was identified in the milk of women aged 18-25 (p < 0.05), and its content in milk decreased with the age of lactating women. Moreover, the greatest amount of squalene was identified in milk from the first lactation period (colostrum), while in mature milk, its content was more than two times lower. There was a correlation between breastfeeding BMI and the squalene content in milk (r = 0.78). (4) Conclusions: The conducted research shows that the level of squalene in human milk depends on physiological factors such as the lactation period and individual factors (age, BMI). The results of the conducted research indicate that breast milk is richer in squalene than modified milk. This study shows the importance of breastfeeding and indicates the superiority of breast milk over infant formulas.
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Affiliation(s)
- Aleksandra Purkiewicz
- Department of Commodity Science and Food Analysis, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, Cieszyński 1 Sq, 10-719 Olsztyn, Poland
| | - Sylwester Czaplicki
- Department of Food Plant Chemistry and Processing, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, Cieszyński 1 Sq, 10-719 Olsztyn, Poland
| | - Renata Pietrzak-Fiećko
- Department of Commodity Science and Food Analysis, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, Cieszyński 1 Sq, 10-719 Olsztyn, Poland
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Li R, Zhang LX, Tian C, Ma LK, Li Y. Successful management of a breastfeeding mother with severe eczema of the nipple beginning from puberty: A case report. World J Clin Cases 2022; 10:10155-10161. [PMID: 36246829 PMCID: PMC9561575 DOI: 10.12998/wjcc.v10.i28.10155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/28/2022] [Accepted: 08/25/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Nipple eczema is the most common presentation of atopic dermatitis of the breast, which seriously influences breastfeeding of mothers. We here present a case of severe nipple eczema that started in puberty and received continuous care and interventions during pregnancy. The patient succeeded in breastfeeding after the interventions.
CASE SUMMARY A 36-year-old woman at 16 wk of gestation (gestation 1 parturition 0), visited the breastfeeding consultation clinic, complaining of excessive nipple secretion, severe itching, and concerns about breastfeeding. She was diagnosed with severe nipple eczema. Health education, consultation with dermatologists, topical medication, psychological support, and postpartum care were carried out. Through continuous interventions, her nipple eczema significantly improved, lactating confidence enhanced, anxiety symptoms were reduced, and exclusive breastfeeding was achieved.
CONCLUSION For lactating women with nipple eczema, breastfeeding consultants should play an important role in patient education and provide whole-process and individual guidance.
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Affiliation(s)
- Rui Li
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Li-Xia Zhang
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Ce Tian
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Liang-kun Ma
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Ying Li
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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Agrawal J, Chakole S, Sachdev C. The Role of Fathers in Promoting Exclusive Breastfeeding. Cureus 2022; 14:e30363. [PMID: 36407167 PMCID: PMC9665906 DOI: 10.7759/cureus.30363] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023] Open
Abstract
The cornerstone of a newborn's nutrition is breastfeeding. Due to its well-known benefits for mothers, children, and society in the short and long term, the World Health Organization (WHO) and United Nations Children's Fund (UNICEF) recommend it as the best way of feeding the baby during the first six months of life. The family, particularly the spouse, may significantly influence the baby's quality of nursing. On a global scale, previous studies have demonstrated that family members (such as a mother's spouse, partner, or grandmother) not only affect her choice to start and endure breastfeeding but also significantly contribute to the early postnatal period's cessation of appropriate breastfeeding. A father's knowledge and attitude are fundamental in this regard, as he has the most critical role in helping women with parenting and feeding their babies. Furthermore, because the father's role is considered important in a family, the partner's or wife's perception of the father's attitude may alter her subjective criteria about exclusive breastfeeding (EBF). Future initiatives should target new mothers and their spouses to see how they may provide the most beneficial assistance to new mothers. The main focus should be on targeting newly married couples. The father's lack of involvement may be due to the hierarchical structure of power within households. Because of this hierarchical aspect, partners or fathers may significantly influence a mother's choice to nurse their child correctly. Household chores, childcare for grown-up children, guaranteeing the well-being of their spouse, preparing meals, recognizing a newborn's hunger cues, burping, and changing the infant's diaper after feedings, all these factors indirectly support the mother in initiating and enduring the nursing of a child.
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Affiliation(s)
- Jayesh Agrawal
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Swarupa Chakole
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Chetna Sachdev
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
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