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Öz E, Küçükkelepçe O, Kurt O, Kapıcı Y. The relationship between earthquake-induced post-traumatic stress disorder and breastfeeding attitude and behavior. BMC Psychiatry 2024; 24:343. [PMID: 38714972 PMCID: PMC11075360 DOI: 10.1186/s12888-024-05803-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND This study aimed to investigate the prevalence and severity of post-traumatic stress disorder (PTSD) and analyze the relationship between PTSD and breastfeeding attitudes and behaviors among breastfeeding mothers and women with children aged 0-24 months, all of whom had experienced the earthquake. METHODS In this cross-sectional survey, a face-to-face questionnaire was administered to 173 earthquake survivors in Adıyaman, Turkey, during June and July 2023. The PTSD Checklist-Civilian scale was used to assess the presence of PTSD, while the Breastfeeding Attitudes of the Evaluation Scale (BAES) was employed to evaluate breastfeeding behaviors in mothers. RESULTS Significantly higher PTSD scores (47.6 ± 17.4) were found among women staying in tents, while lower scores (37.0 ± 16.4) were observed in those who continued breastfeeding. 78.6% of women reported decreased breast milk because of the earthquake. Mothers with reduced milk supply had higher PTSD scores (46.1 ± 17.3). Breastfeeding training was associated with higher BAES scores (106.8 ± 56.8) and lower PTSD scores (32.5 ± 11.0). A significant negative correlation was observed between the PTSD score and BAES (r = -0.742; p < 0.001). CONCLUSIONS The study demonstrated that breastfeeding may protect mothers against PTSD in the aftermath of earthquakes, emphasizing the importance of breastfeeding education. The higher frequency and severity of PTSD observed among earthquake survivor mothers residing in tents underscores the importance of promptly transitioning to permanent housing after the earthquake.
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Affiliation(s)
- Erdoğan Öz
- Adıyaman Provincial Health Directorate, Adıyaman, Türkiye
| | | | - Osman Kurt
- Adıyaman Provincial Health Directorate, Adıyaman, Türkiye
| | - Yaşar Kapıcı
- Faculty of Medicine, Department of Psychiatry, Adıyaman University, Adıyaman, Türkiye.
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Francese R, Peila C, Donalisio M, Lamberti C, Cirrincione S, Colombi N, Tonetto P, Cavallarin L, Bertino E, Moro GE, Coscia A, Lembo D. Viruses and Human Milk: Transmission or Protection? Adv Nutr 2023; 14:1389-1415. [PMID: 37604306 PMCID: PMC10721544 DOI: 10.1016/j.advnut.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 07/14/2023] [Accepted: 08/15/2023] [Indexed: 08/23/2023] Open
Abstract
Human milk (HM) is considered the best source of nutrition for infant growth and health. This nourishment is unique and changes constantly during lactation to adapt to the physiological needs of the developing infant. It is also recognized as a potential route of transmission of some viral pathogens although the presence of a virus in HM rarely leads to a disease in an infant. This intriguing paradox can be explained by considering the intrinsic antiviral properties of HM. In this comprehensive and schematically presented review, we have described what viruses have been detected in HM so far and what their potential transmission risk through breastfeeding is. We have provided a description of all the antiviral compounds of HM, along with an analysis of their demonstrated and hypothesized mechanisms of action. Finally, we have also analyzed the impact of HM pasteurization and storage methods on the detection and transmission of viruses, and on the antiviral compounds of HM. We have highlighted that there is currently a deep knowledge on the potential transmission of viral pathogens through breastfeeding and on the antiviral properties of HM. The current evidence suggests that, in most cases, it is unnecessarily to deprive an infant of this high-quality nourishment and that the continuation of breastfeeding is in the best interest of the infant and the mother.
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Affiliation(s)
- Rachele Francese
- Department of Clinical and Biological Sciences, Laboratory of Molecular Virology and Antiviral Research, University of Turin, Orbassano (TO), Italy
| | - Chiara Peila
- Department of Public Health and Pediatrics, Neonatal Intensive Care Unit, University of Turin, Turin, Italy
| | - Manuela Donalisio
- Department of Clinical and Biological Sciences, Laboratory of Molecular Virology and Antiviral Research, University of Turin, Orbassano (TO), Italy
| | - Cristina Lamberti
- Institute of the Science of Food Production - National Research Council, Grugliasco, TO, Italy
| | - Simona Cirrincione
- Institute of the Science of Food Production - National Research Council, Grugliasco, TO, Italy
| | - Nicoletta Colombi
- Biblioteca Federata di Medicina "Ferdinando Rossi", University of Turin, Turin, Italy
| | - Paola Tonetto
- Department of Public Health and Pediatrics, Neonatal Intensive Care Unit, University of Turin, Turin, Italy
| | - Laura Cavallarin
- Institute of the Science of Food Production - National Research Council, Grugliasco, TO, Italy
| | - Enrico Bertino
- Department of Public Health and Pediatrics, Neonatal Intensive Care Unit, University of Turin, Turin, Italy
| | - Guido E Moro
- Italian Association of Human Milk Banks (AIBLUD), Milan, Italy.
| | - Alessandra Coscia
- Department of Public Health and Pediatrics, Neonatal Intensive Care Unit, University of Turin, Turin, Italy.
| | - David Lembo
- Department of Clinical and Biological Sciences, Laboratory of Molecular Virology and Antiviral Research, University of Turin, Orbassano (TO), Italy.
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Abstract
BACKGROUND AND SIGNIFICANCE Breastfeeding problems are common; however, health care providers vary widely in their ability to address them effectively. PURPOSE The purpose of this study was to identify the relative frequencies of common breastfeeding challenges and their associations with maternal well-being. STUDY DESIGN AND METHODS Women completed an online survey in which they described breastfeeding problems. Factor analysis was used to identify problems that co-occurred frequently, as well as the problems most strongly associated with maternal distress, maternal perceptions of greater severity, and postpartum depression or postpartum anxiety. RESULTS There were 535 responses to the online survey; of these, 457 answered the question about the nature of their breastfeeding difficulties. Pain with breastfeeding was the most common breastfeeding problem. Difficulties with milk supply and milk intake were most strongly associated with heightened maternal distress and perceptions of severity. CLINICAL IMPLICATIONS Coordinated care for breastfeeding dyads, in which providers acknowledge the complex and reciprocal nature of many breastfeeding problems, has the potential to improve maternal satisfaction with breastfeeding as well as breastfeeding metrics.
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Affiliation(s)
- Jamie Mahurin-Smith
- Jamie Mahurin-Smith is an Associate Professor, Department of Communication Sciences and Disorders, Illinois State University, Normal, IL. Dr. Mahurin-Smith can be reached via email at
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Parlak ME, Öz E, Küçükkelepçe O. COVID-19 Vaccination and Breastfeeding Mothers in Kahta District, Turkey. Vaccines (Basel) 2023; 11:vaccines11040813. [PMID: 37112725 PMCID: PMC10143137 DOI: 10.3390/vaccines11040813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/29/2023] Open
Abstract
We aimed to determine the attitudes and behaviors of breastfeeding mothers regarding the vaccine by examining their knowledge of the COVID-19 virus vaccine and their hesitations about it. The research is a cross-sectional and descriptive study conducted in the Kahta district of Adıyaman, a southeastern province in Turkey, between January and May 2022. The study population consisted of 405 mothers who applied to the Kahta State Hospital Pediatrics outpatient clinic. A questionnaire form was used as a data collection tool, and a consent form was obtained from the participants. The vaccination rate (89%) of those who graduated from high school and above was significantly higher than that of those who graduated from secondary school or below (77.7%). As the economic situation worsened, the vaccination rate decreased. The vaccination rate (85.7%) of mothers whose breastfed child was 0-6 months old was found to be significantly higher than that of those with 7-24-month-olds (76.4%) (p:0.02). The rate of being vaccinated (73.3%) of those who had a new type of COVID-19 virus infection was significantly lower than the rate of being vaccinated (86.3%) of those who did not have a COVID-19 virus infection. The vaccination rate of those who received information from their family doctor and the internet was higher than that of those who received information from radio/TV and people around. The rate of mothers thinking babies should stop breastfeeding who graduated from secondary school or below was higher (53.2%) than the rate of mothers who graduated from high school or above (30.2%) to be vaccinated against the COVID-19 virus. To eliminate the hesitancy about vaccination in mothers, it is necessary to inform and educate the whole society correctly, starting with families with low education and economic levels.
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Affiliation(s)
- Mehmet Emin Parlak
- Adıyaman University Training and Research Hospital, Adıyaman 02100, Turkey
| | - Erdoğan Öz
- Adıyaman Province Health Directorate, Adıyaman 02100, Turkey
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Palmquist AE, Asiodu IV, Tucker C, Tully KP, Asbill DT, Malloy A, Stuebe AM. Racial Disparities in Donor Human Milk Feedings: A Study Using Electronic Medical Records. Health Equity 2022; 6:798-808. [PMID: 36338802 PMCID: PMC9629910 DOI: 10.1089/heq.2022.0085] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The aim of this study was to evaluate differences in the use of pasteurized donor human milk (PDHM) by maternal race-ethnicity during postpartum hospitalization using electronic medical records (EMRs). MATERIALS AND METHODS A retrospective cohort study of all live-born infants at our academic research institution from July 1, 2014, to June 30, 2016, was conducted. EMR data were used to determine whether each infant received mother's own milk (MOM), PDHM, or formula. These data were stratified based on whether the infant received treatment in the Neonatal Critical Care Center. Generalized estimating equation models were used to calculate the odds of receiving PDHM by maternal race-ethnicity, adjusting for gestational age, birth weight, insurance, preferred language, nulliparity, and mode of delivery. RESULTS Infant feeding data were available for 7097 infants, of whom 49% were fed only MOM during their postpartum hospitalization. Among the 15.9% of infants admitted to neonatal critical care, infants of non-Hispanic Black (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.31-0.72), Hispanic (OR 0.65, 95% CI 0.36-1019), and Other (OR 0.63, 95% CI 0.32-1.26) mothers had lower rates of PDHM feedings than infants of non-Hispanic White mothers in the adjusted models. Among well infants, the use of PDHM was lower among non-Hispanic Black and Hispanic mothers (OR 0.25, 95% CI 0.18-0.36, and OR 0.38, 95% CI 0.26-0.56) compared with non-Hispanic White mothers. CONCLUSIONS Inequities in exclusive human milk feeding and use of PDHM by maternal race-ethnicity were identified. Antiracist interventions are needed to promote equitable access to skilled lactation support and counseling for PDHM use.
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Affiliation(s)
- Aunchalee E.L. Palmquist
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Address correspondence to: Aunchalee E.L. Palmquist, PhD, MA, IBCLC, Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB-7445, Chapel Hill, NC 27599-7400, USA.
| | - Ifeyinwa V. Asiodu
- Department of Family Health Care Nursing, University of California, San Francisco, California, USA
| | - Christine Tucker
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kristin P. Tully
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Angela Malloy
- Momma's Village of Fayetteville, Fayetteville, North Carolina, USA
| | - Alison M. Stuebe
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Teague MS, Trotter KJ. HUG Your Baby: Preparing Nurse Practitioner Students to Support Breastfeeding. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Jackson JR, Moreno L, Carmen M, Dadiz R. What are LGBTQI+ parental experiences of healthcare support and decision-making regarding infant feeding options? A grounded theory study. J Perinatol 2022; 42:1083-90. [PMID: 34725448 DOI: 10.1038/s41372-021-01259-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/20/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To explore LGBTQI+ parental experiences regarding their interactions with healthcare professionals as a resource for feeding options during the prenatal-to-neonatal period. STUDY DESIGN This single-center, interview-based qualitative study of LGBTQI+ parents utilized grounded theory to identify and verify emergent themes and subthemes. We developed a conceptual framework to illustrate relationships among themes and subthemes, as well as opportunities for healthcare professionals and families to improve LGBTQI+ parental support. RESULTS Thematic saturation was attained after interviewing 21 parents from 12 families. Analyses revealed four main themes representing opportunities for improvement: education, continuity of care, parental engagement and open communication. Personal and interpersonal factors influenced parental experiences and decisions, which shaped ultimate feeding outcomes. CONCLUSIONS LGBTQI+ parents revealed challenges of establishing feeding practices that best aligned with their values and goals. Recognizing these factors can help healthcare professionals improve their counseling, engagement and support of LGBTQI+ parents.
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Nassar L, Van Zandt SN, Nassar G, Nassar R. Increasing Breastfeeding Rates Through Continuity of Care. Clin Lactation 2022. [DOI: 10.1891/cl.2021-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BackgroundContinuity of care is important in many aspects of medicine, as evidenced by the patient-centered medical home model. The newborn period is an especially important time for continuity of care, as this time sets the stage for lifelong health. Breastfeeding, which is known for its positive health benefits for both mother and child, is the gold standard for infant feeding. While inpatient lactation support is a common amenity available during hospital admission, support can be more difficult to obtain once a patient is discharged. To help eliminate this barrier, a process was put in place within an Eastern Pennsylvania health network’s seven office locations to standardize outreach to the mother-infant dyad.MethodsA quality improvement retrospective chart review comparing pre- and post-intervention rates of exclusive and non-exclusive breastfeeding was completed using one health system’s Electronic Health Record (EHR). A referral process was established to capture dyads born within the health network’s hospital who were going to be followed at one of the seven pediatric offices outpatient. Mothers were called and followed to see how they were progressing with their breastfeeding goals. Any problems were addressed by the health network’s International Board-Certified Lactation Consultants (IBCLCs) and Certified Lactation Counselor (CLC).ResultsLactation rates at the pediatric practice were observed to have increased at both 6 months and 12 months post-intervention compared to pre-intervention.ConclusionProactively scheduling and providing outreach immediately following birth may promote increased breastfeeding rates.
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Borger C, Weinfield NS, Paolicelli C, Sun B, May L. Prenatal and Postnatal Experiences Predict Breastfeeding Patterns in the WIC Infant and Toddler Feeding Practices Study-2. Breastfeed Med 2021; 16:869-877. [PMID: 34265220 PMCID: PMC8817732 DOI: 10.1089/bfm.2021.0054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To examine pre- and postnatal experiential factors associated with desirable breastfeeding patterns in a nationally representative population of low-income women who prenatally enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and initiated breastfeeding. Materials and Methods: Using data from the longitudinal WIC Infant and Toddler Feeding Practices Study-2, multivariable, hierarchical logistic regression analyses identified prenatal and postnatal experiential factors associated with three breastfeeding patterns: (1) breastfeeding at 6 months, (2) breastfeeding at 1 year, and (3) breastfeeding at 1 year without introducing formula through age 6 months. Results: After controlling for covariates, one prenatal factor, breastfeeding intentions, and one postnatal factor, receipt of a doctor's recommendation to breastfeed, raised the odds of exhibiting the patterns analyzed. Another postnatal factor, returning to full-time employment before infant age 3 months, lowered the odds of exhibiting the patterns. Prior WIC participation significantly increased the odds of breastfeeding at 1 year, while postnatal employment before infant age 3 months significantly decreased the odds of exhibiting this pattern. Conclusions: Health care providers and those working in public health programs, including WIC, play an important role in helping low-income women mitigate shorter breastfeeding durations. Their efforts should continue focusing on bolstering women's prenatal breastfeeding intentions, reducing structural barriers to breastfeeding in the early postnatal period, particularly among those women returning to work, and connecting low-income families with WIC if they are not already enrolled in the program. This study is registered at clinicaltrials.gov as Feeding My Baby-A National WIC Study, NCT02031978.
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Affiliation(s)
| | - Nancy S Weinfield
- Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, Maryland, USA
| | - Courtney Paolicelli
- Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, Virginia, USA
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10
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Aros-Vera F, Chertok IRA, Melnikov S. Emergency and disaster response strategies to support mother-infant dyads during COVID-19. Int J Disaster Risk Reduct 2021; 65:102532. [PMID: 34458086 PMCID: PMC8386097 DOI: 10.1016/j.ijdrr.2021.102532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/05/2021] [Accepted: 08/21/2021] [Indexed: 06/06/2023]
Abstract
The COVID-19 pandemic has produced an unprecedented global health crisis. Vulnerable populations, such as breastfeeding mother-infant dyads, are in a particularly delicate situation. Before, during, and after birth mothers and their infants could be exposed to the virus. Due to fear of infection transmission, there has been an increase in separation of COVID-positive mothers and their infants and a decline in breastfeeding, despite research supporting the provision of mother's milk for her infant. During this crisis, evidence-based education counseling and resources can support healthful infant feeding which is necessary for short- and long-term infant growth and development. Using a framework of disaster preparedness and response, we delineate operational guidelines and policy recommendations to support maternal-infant dyads during the COVID pandemic outbreak. Key recommendations include promotion of breastfeeding and milk expression, avoiding the use of formula, engaging healthcare providers in supporting lactation, and incorporating evidence-based breastfeeding and lactation protocols and practices in disaster preparedness and disaster response plans.
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Affiliation(s)
- Felipe Aros-Vera
- Department of Industrial and Systems Engineering, Ohio University, 1 Ohio University, Athens, OH, 45701, USA
| | - Ilana R Azulay Chertok
- Associate Director of Nursing Research and Scholarship, Ohio University, 1 Ohio University, Athens, OH, 45701, USA
| | - Semyon Melnikov
- Department of Nursing, Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Tauritz Bakker LA, van Dijk L, van den Bemt PMLA. Exploring the Prescribing Process of Domperidone for Low Milk Supply: A Qualitative Study Among Mothers, IBCLCs, and Family Doctors. J Hum Lact 2021; 37:748-760. [PMID: 33180685 PMCID: PMC8641033 DOI: 10.1177/0890334420964070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND When mothers are confronted with milk supply problems, taking domperidone is regularly suggested. However, domperidone has been associated with sudden cardiac death and caution in prescribing is advised. In 2016, a multidisciplinary group of authors from a tertiary academic hospital (Erasmus MC) published a clinical protocol in a leading Dutch physicians' journal to support Dutch family physicians in prescribing domperidone to stimulate lactation. RESEARCH AIM To explore consumer and health care provider perspectives and experiences regarding the prescribing of domperidone for lactation insufficiency following publication of a national clinical protocol. METHODS A cross-sectional qualitative study was performed using semi-structured interviews (N = 40) based on a topic list covering the prescribing process. Participants were mothers (n = 18) who had been advised to try domperidone to boost their milk supply between November 2016 and May 2018, their International Board Certified Lactation Consultants (n = 9), and their family physicians (n = 15). Another group of participants (mothers; n = 6) answered short questionnaires. All interviews were recorded, transcribed and analyzed using ATLAS.ti software. The resulting list of codes was organized according to the topics. RESULTS In the process leading to domperidone use to stimulate lactation, participant family physicians relied on the IBCLC, pharmacist, or mother to guide the prescription of domperidone, often citing the published national clinical protocol as back up. The medical safeguards incorporated in the protocol (e.g., taking medical history, physical exam, performing electrocardiograms, limiting dosage) were usually not implemented. CONCLUSIONS Though the availability of a national clinical protocol in which the prescribing of domperidone for lactation is supported appeared to increase the willingness of participant family physicians to prescribe, gaps were identified between clinical practice and this clinical protocol for prescribing domperidone.
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Affiliation(s)
| | - Liset van Dijk
- 8123 NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.,Faculty of Science and Engineering, Groningen Research Institute of Pharmacy, Groningen, The Netherlands
| | - Patricia M L A van den Bemt
- 10173 Hospital Pharmacist and Professor of Medication Safety, Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, The Netherlands
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Brown LL, Talker R, Stoddard GJ, Clayton J, Millar MM, Jo Y, Bardsley T, Stipelman CH. Breastfeeding Attitudes and Practices in a Rural Utah Navajo Community. Matern Child Health J 2021; 26:397-406. [PMID: 34633615 DOI: 10.1007/s10995-021-03247-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Despite known health benefits of breastfeeding, the Navajo have low reported frequency of breastfeeding initiation and support. We evaluated breastfeeding frequencies and practices in the predominately Navajo community of rural San Juan County, Utah, to identify factors that affect breastfeeding decisions and duration. METHODS We performed retrospective chart review for 135 infants aged 0 to 12 months, and surveys of 85 mothers of infants aged 0 to 2 years, and eight primary care providers. We characterized demographic factors using counts/percentages and medians/inter-quartile ranges, and compared mothers who breastfed for 6 months or less versus greater than 6 months. RESULTS In 96 infants with complete feeding documentation, 86 infants (90%) received some breast milk and 36 infants (38%) were exclusively breastfed at age 2 months. In 67 infants with complete feeding documentation at ≥ 6 months, 22 infants (33%) were exclusively breastfed 6 months. Most mothers knew about breastfeeding benefits. In 56 mothers whose infants were aged ≥ 6 months at the time of the survey, breastfeeding for more than 6 months had been planned by 44 mothers (79%) but performed by only 29 mothers (52%). Mothers who breastfed for > 6 months were more likely to have been influenced by WIC and less likely to have introduced formula at an early age. Barriers to breastfeeding included maternal pain, latch difficulties, and concerns about inadequate milk supply. Primary care providers reported limited confidence in providing breastfeeding support but would support telehealth-driven interventions. CONCLUSIONS FOR PRACTICE Practical, culturally sensitive interventions, including telehealth and improved provider education, may improve breastfeeding outcomes and community health in this underserved population.
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Affiliation(s)
- Laura L Brown
- Division of General Pediatrics, Department of Pediatrics, School of Medicine, University of Utah, PO Box 581289, Salt Lake City, UT, 84158, USA.
| | - Revina Talker
- Navajo Mountain Community Health Clinic, Utah Navajo Health Services, Inc., P.O. Box 10100, Tonalea, AZ, 86044, USA
| | - Gregory J Stoddard
- Department of Internal Medicine, University of Utah School of Medicine, 30 N 1900 E, Room 4C104, Salt Lake City, UT, 84132, USA
| | - Jessica Clayton
- Division of General Pediatrics, Department of Pediatrics, School of Medicine, University of Utah, PO Box 581289, Salt Lake City, UT, 84158, USA
| | - Morgan M Millar
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Williams Building, 295 South Chipeta Way, Salt Lake City, UT, 84158, USA
| | - Yeonjung Jo
- Department of Population Health Sciences, University of Utah School of Medicine, Williams Building, 295 South Chipeta Way, Salt Lake City, UT, 84158, USA
| | - Tyler Bardsley
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Williams Building, 295 South Chipeta Way, Salt Lake City, UT, 84158, USA
| | - Carole H Stipelman
- Division of General Pediatrics, Department of Pediatrics, School of Medicine, University of Utah, PO Box 581289, Salt Lake City, UT, 84158, USA
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13
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Ossai CR, McDonnell J, Behairy M, Schelzig C, Larkin L, Jones J, Liu W, Das A. Association of Parental Use of Patient Portals with Breastfeeding Rates in Infants. Journal of Consumer Health on the Internet 2021. [DOI: 10.1080/15398285.2021.1943635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Chionye R. Ossai
- Department of Pediatric Hospital Medicine, Cleveland Clinic Children’s, Cleveland, Ohio, USA
| | - John McDonnell
- Department of Allergy and Immunology, Cleveland Clinic Children’s, Cleveland, Ohio, USA
| | - Mohga Behairy
- Department of Pediatric Hospital Medicine, Cleveland Clinic Children’s, Cleveland, Ohio, USA
| | - Colleen Schelzig
- Department of Pediatric Hospital Medicine, Cleveland Clinic Children’s, Cleveland, Ohio, USA
| | - Lauren Larkin
- Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
| | - Jessica Jones
- Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
| | - Wei Liu
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Anirudha Das
- Department of Neonatology, Cleveland Clinic Children’s, Cleveland, Ohio, USA
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McKinley EM, Knol LL, Turner LW, Burnham JJ, Graettinger KR, Hernandez-Reif M, Leeper JD. Enhancing Patient-Provider Breastfeeding Conversations: Breastfeeding Intention and Prenatal Breastfeeding Self-Efficacy among a Sample of Pregnant Women. South Med J 2021; 114:223-230. [PMID: 33787936 DOI: 10.14423/smj.0000000000001238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate and identify which sociodemographic factors may be associated with breastfeeding intention and breastfeeding self-efficacy among pregnant women. METHODS Pregnant women at a medical center in Alabama completed a cross-sectional survey. The Prenatal Rating of Efficacy in Preparation to Breastfeed Scale (PREP to BF) was used to assess prenatal breastfeeding self-efficacy. A valid 3-item breastfeeding intention scale and the Fetal Health Locus of Control Scale also were used. Nonparametric tests were used to assess differences in breastfeeding intention, locus of control subscales, and PREP to BF scores by history with breastfeeding, planned mode of delivery, and sociodemographic factors. RESULTS The participants in the final analysis (N = 124) had a mean prenatal breastfeeding self-efficacy score of 299.5 (±92.33), with a range of 0 to 390. Significantly lower scores related to intention and PREP to BF were found among Black women (P ≤ 0.05), those with a high school education or less (P ≤ 0.019), single women (P ≤ 0.028), and those who had no breastfeeding experience (P ≤ 0.035). CONCLUSIONS Identifying pregnant women with low breastfeeding self-efficacy and intention and recognizing the effects of social and cultural influences on breastfeeding are vital. Healthcare providers can engage in meaningful dialog to address ways to increase social support, communication, goal-setting skills, and overcoming mental and emotional barriers.
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Affiliation(s)
- Erin M McKinley
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - Linda L Knol
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - Lori W Turner
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - Joy J Burnham
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - Kristine R Graettinger
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - Maria Hernandez-Reif
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
| | - James D Leeper
- From the School of Nutrition and Food Sciences, Louisiana State University (LSU) and the LSU AgCenter, Baton Rouge, the Departments of Human Nutrition & Hospitality Management, Health Science, Educational Studies in Psychology, Research Methodology, and Counseling, Human Development and Family Studies, and Community Medicine and Population Health, University of Alabama, Tuscaloosa, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee
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15
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Zhu B, Zheng S, Lin K, Xu X, Lv L, Zhao Z, Shao J. Effects of Infant Formula Supplemented With Prebiotics and OPO on Infancy Fecal Microbiota: A Pilot Randomized Clinical Trial. Front Cell Infect Microbiol 2021; 11:650407. [PMID: 33854983 PMCID: PMC8039316 DOI: 10.3389/fcimb.2021.650407] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 02/26/2021] [Indexed: 12/15/2022] Open
Abstract
Several lines of evidence suggest that the intestinal microbiota plays crucial roles in infant development, and that it is highly influenced by extrinsic and intrinsic factors. Prebiotic-containing infant formula may increase gastrointestinal tolerance and improve commensal microbiota composition. However, it remains unknown whether supplementation of milk-formulas with prebiotics and 1,3-olein-2-palmitin (OPO) can achieve feeding outcomes similar to those of breastfeeding. In the present study, we investigated the effects of two kinds of infant formula with different additives on the overall diversity and composition of the fecal microbiota, to determine which was closer to breastfeeding. A total of 108 infants were enrolled, including breastfeeding (n=59) and formula feeding group (n=49). The formula feeding infants were prospectively randomly divided into a standard formula group (n=18), and a supplemented formula group(n=31). The fecal samples were collected at 4 months after intervention. Fecal microbiota analysis targeting the V4 region of the 16S rRNA gene was performed using MiSeq sequencing. The overall bacterial diversity and composition, key functional bacteria, and predictive functional profiles in the two different formula groups were compared with breastfeeding group. We found that the alpha diversity of the gut microbiota was not significantly different between the OPO and breastfeeding groups with Chaos 1 index (p=0.346). The relative abundances of Enhydrobacter and Akkermansia in the OPO group were more similar to those of the breastfeeding group than to those of the standard formula group. The gut microbiota metabolism function prediction analysis showed that the supplemented formula group was similar to the breastfeeding group in terms of ureolysis (p=0.297). These findings suggest that, when formula supplemented with prebiotics and OPO was given, the overall bacterial diversity and parts of the composition of the fecal microbiota would be similar to that of breastfeeding infants.
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Affiliation(s)
- Bingquan Zhu
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Shuangshuang Zheng
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Kexin Lin
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Xin Xu
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Lina Lv
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Zhengyan Zhao
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jie Shao
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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16
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Ahmad KA, Darcy-Mahoney A, Kelleher AS, Ellsbury DL, Tolia VN, Clark RH. Longitudinal Survey of COVID-19 Burden and Related Policies in U.S. Neonatal Intensive Care Units. Am J Perinatol 2021; 38:93-98. [PMID: 33075846 PMCID: PMC7869047 DOI: 10.1055/s-0040-1718944] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This study aimed to determine the prevalence of confirmed novel coronavirus disease 2019 (COVID-19) disease or infants under investigation among a cohort of U.S. neonatal intensive care units (NICUs). Secondarily, to evaluate hospital policies regarding maternal COVID-19 screening and related to those infants born to mothers under investigation or confirmed to have COVID-19. STUDY DESIGN Serial cross-sectional surveys of MEDNAX-affiliated NICUs from March 26 to April 3, April 8 to April 19, May 4 to May 22, and July 13 to August 2, 2020. The surveys included questions regarding COVID-19 patient burden and policies regarding infant separation, feeding practices, and universal maternal screening. RESULTS Among 386 MEDNAX-affiliated NICUs, responses were received from 153 (42%), 160 (44%), 165 (45%), 148 (38%) across four rounds representing an active patient census of 3,465, 3,486, 3,452, and 3,442 NICU admitted patients on the day of survey completion. Confirmed COVID-19 disease in NICU admitted infants was rare, with the prevalence rising from 0.03 (1 patient) to 0.44% (15 patients) across the four survey rounds, while the prevalence of patients under investigation increased from 0.8 to 2.6%. Hospitals isolating infants from COVID-19-positive mothers fell from 46 to 20% between the second and fourth surveys, while centers permitting direct maternal breastfeeding increased 17 to 47% over the same period. Centers reporting universal severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) screening for all expectant mothers increased from 52 to 69%. CONCLUSION Among a large cohort of NICU infants, the prevalence of infants under investigation or with confirmed neonatal COVID-19 disease was low. Policies regarding universal maternal screening for SARS-CoV-2, infant isolation from positive mothers, and direct maternal breastfeeding for infants born to positive mothers are rapidly evolving. As universal maternal screening for SARS-CoV-2 becomes more common, the impact of these policies requires further investigation. KEY POINTS · In this cohort, neonatal COVID-19 is rare.. · Policies regarding isolation and breastfeeding for infants are rapidly evolving.. · Most hospitals are now providing universal screening for expectant mothers for SARS-CoV-2..
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Affiliation(s)
- Kaashif A. Ahmad
- MEDNAX Center for Research, Education, Quality, and Safety, Sunrise, Florida,Department of Pediatrics, Baylor College of Medicine, San Antonio, Texas,Pediatrix Medical Group of San Antonio, San Antonio, Texas,Address for correspondence Kaashif Ahmad, MD, MSc Pediatrix Medical Group of San Antonio5430 Fredericksburg Road, Suite 508, San Antonio, TX 78229
| | - Ashley Darcy-Mahoney
- MEDNAX Center for Research, Education, Quality, and Safety, Sunrise, Florida,George Washington University School of Nursing, Washington, District of Columbia,Baptist Children's Hospital, Miami, Florida
| | - Amy S. Kelleher
- MEDNAX Center for Research, Education, Quality, and Safety, Sunrise, Florida
| | - Dan L. Ellsbury
- MEDNAX Center for Research, Education, Quality, and Safety, Sunrise, Florida
| | - Veeral N. Tolia
- MEDNAX Center for Research, Education, Quality, and Safety, Sunrise, Florida,Department of Pediatrics, Baylor University Medical Center, Dallas, Texas
| | - Reese H. Clark
- MEDNAX Center for Research, Education, Quality, and Safety, Sunrise, Florida
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17
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Norholt H. Revisiting the roots of attachment: A review of the biological and psychological effects of maternal skin-to-skin contact and carrying of full-term infants. Infant Behav Dev 2020; 60:101441. [PMID: 32603951 DOI: 10.1016/j.infbeh.2020.101441] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 03/19/2020] [Accepted: 03/19/2020] [Indexed: 12/18/2022]
Abstract
During the early period of hypothesis building and empirical testing of attachment theory, a major emphasis was placed on mother-infant physical contact. In spite of this, mother-infant contact has received scant attention amongst attachment and child development researchers in the past decades. Here, a brief theoretical framework for mother-infant contact is presented, drawing on animal studies as well as human studies of preterm infants and neonates. Salient mechanisms may include an extended sensitive period during early infancy, requiring specific somatosensory stimuli for bio-behavioral homeorhesis; oxytocinergic and epigenetic pathways; kinesthetic stimuli and face-to-face proximity allowing for increased social interaction. Studies of extended human mother-full-term infant physical contact have demonstrated positive effects in multiple domains. For infants, these include sleep organization, temperature and heart rate regulation, behavioral response, crying/colic, socio-emotional development, attachment quality, speech development opportunities and mother-child interactions. For mothers, studies demonstrate improved depressive symptomatology, physiological stress regulation, contingent responsivity, breastfeeding and mother-child interactions. Parent-infant attachment quality has gained prominence as a trauma-resilience factor as well as a predictor of adult physical health. The potential role of mother-infant contact as an attachment promoting intervention as well as future research subjects are discussed. Current evidence supports the original attachment research that early maternal touch provision may influence infant socio-emotional development and attachment quality, with positive implications for mother-child relationship functioning.
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18
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Feldman-Winter L, Kellams A, Peter-Wohl S, Taylor JS, Lee KG, Terrell MJ, Noble L, Maynor AR, Meek JY, Stuebe AM. Evidence-Based Updates on the First Week of Exclusive Breastfeeding Among Infants ≥35 Weeks. Pediatrics 2020; 145:peds.2018-3696. [PMID: 32161111 DOI: 10.1542/peds.2018-3696] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/06/2019] [Indexed: 11/24/2022] Open
Abstract
The nutritional and immunologic properties of human milk, along with clear evidence of dose-dependent optimal health outcomes for both mothers and infants, provide a compelling rationale to support exclusive breastfeeding. US women increasingly intend to breastfeed exclusively for 6 months. Because establishing lactation can be challenging, exclusivity is often compromised in hopes of preventing feeding-related neonatal complications, potentially affecting the continuation and duration of breastfeeding. Risk factors for impaired lactogenesis are identifiable and common. Clinicians must be able to recognize normative patterns of exclusive breastfeeding in the first week while proactively identifying potential challenges. In this review, we provide new evidence from the past 10 years on the following topics relevant to exclusive breastfeeding: milk production and transfer, neonatal weight and output assessment, management of glucose and bilirubin, immune development and the microbiome, supplementation, and health system factors. We focus on the early days of exclusive breastfeeding in healthy newborns ≥35 weeks' gestation managed in the routine postpartum unit. With this evidence-based clinical review, we provide detailed guidance in identifying medical indications for early supplementation and can inform best practices for both birthing facilities and providers.
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Affiliation(s)
- Lori Feldman-Winter
- Department of Pediatrics, Cooper Medical School, Rowan University and Children's Regional Hospital at Cooper, Cooper University Health Care, Camden, New Jersey;
| | - Ann Kellams
- Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, Virginia
| | | | - Julie Scott Taylor
- American University of the Caribbean School of Medicine, Sint Maarten, Netherlands Antilles.,Department of Family Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Kimberly G Lee
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - Mary J Terrell
- Division of Neonatology, Department of Pediatrics, University of North Carolina Hospitals, Chapel Hill, North Carolina
| | - Lawrence Noble
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Angela R Maynor
- Department of Food and Nutrition, University of North Carolina Health Care, Chapel Hill, North Carolina; and
| | - Joan Younger Meek
- Department of Clinical Sciences, College of Medicine, Florida State University, Tallahassee, Florida
| | - Alison M Stuebe
- Obstetrics and Gynecology, School of Medicine and.,Department of Maternal and Child Health and Carolina Global Breastfeeding Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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19
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Quinn P, Tanis SL. Attitudes, Perceptions, and Knowledge of Breastfeeding Among Professional Caregivers in a Community Hospital. Nurs Womens Health 2020; 24:77-83. [PMID: 32112725 DOI: 10.1016/j.nwh.2020.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 12/17/2019] [Accepted: 01/01/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To explore the knowledge, attitudes, and perceptions of exclusive breastfeeding among professional caregivers in a suburban community hospital who typically provide, or influence, the care of parturient women. DESIGN Cross-sectional quantitative study. SETTING Acute care community hospital in suburban New Jersey with 3,500 births per year. PARTICIPANTS Obstetricians, midwives, neonatologists, pediatricians, and registered nurses. INTERVENTIONS/MEASUREMENTS We designed a survey using two instruments-the Iowa Infant Feeding Attitudes Scale and the Breastfeeding Attitudes Scale-to explore concepts of breastfeeding knowledge, attitudes, and perceptions. Data were analyzed by using descriptive and inferential statistics with SPSS (Version 19). Independent sample t tests, Pearson's correlation coefficient, and Pearson's chi-square test (×2) were used to assess differences between the groups. RESULTS When the physician scores were separated out by specialty, statistically significant differences in mean scores were found (p = .002). Pediatricians had lower scores on attitude toward breastfeeding. In contrast, mean scores for perceptions and knowledge of breastfeeding were positive for physicians and nurses, regardless of area of specialization, with no statistically significant differences found. CONCLUSION Although pediatricians' attitudes, perceptions, and knowledge of breastfeeding cannot be deemed the sole cause for our organization's low rates of sustained exclusive breastfeeding in the postpartum period, this study provided an avenue for exploration that we did not immediately consider as we dissected our performance metrics related to exclusive breastfeeding. We encourage teams at other organizations to replicate and build on this work to explore influences surrounding low rates of exclusive breastfeeding.
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20
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Abstract
BACKGROUND Donor human milk supplementation for healthy newborns has increased. Racial-ethnic disparities in supplementation have been described in the neonatal intensive care unit but not in the well newborn setting. RESEARCH AIM The aim of this study was to identify maternal characteristics associated with donor human milk versus formula supplementation in the well newborn unit. METHODS This retrospective cohort study includes dyads of well newborns and their mothers (N = 678) who breastfed and supplemented with formula (n = 372) or donor human milk (n = 306) during the birth hospitalization at a single hospital in the midwestern United States. Maternal characteristics and infant feeding type were extracted from medical records. Chi-square and logistic regression were used to examine associations between maternal characteristics and feeding type. RESULTS Nonwhite women were less likely to use donor human milk. Compared to non-Hispanic white women, the largest disparity was with Hispanic (adjusted odds ratio [OR] = 0.28, 95% CI [0.12, 0.65]), then non-Hispanic black (adjusted OR = 0.32, 95% CI [0.13, 0.76]) and Asian women (adjusted OR = 0.34, 95% CI [0.16, 0.74]). Lower donor human milk use was associated with primary language other than English and public versus private insurance. CONCLUSION The goal of improving public health through breastfeeding promotion may be inhibited without targeting donor human milk programs to these groups. Identifying the drivers of these disparities is necessary to inform person-centered interventions that address the needs of women with diverse backgrounds.
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Affiliation(s)
- Laura R Kair
- University of California, Davis, Sacramento, CA, USA.,University of Iowa, Iowa City, IA, USA
| | - Nichole L Nidey
- University of Iowa, Iowa City, IA, USA.,Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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21
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Yonke N, Jimenez EY, Leeman L, Leyva Y, Ortega A, Bakhireva LN. Breastfeeding Motivators and Barriers in Women Receiving Medications for Opioid Use Disorder. Breastfeed Med 2020; 15:17-23. [PMID: 31692370 DOI: 10.1089/bfm.2019.0122] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: Women with opioid use disorder (OUD) are encouraged to breastfeed, but have lower breastfeeding rates than the general population. Objective: We examined self-reported barriers and motivators for breastfeeding in women with OUD and the relationship between maternal/postnatal factors and breastfeeding noninitiation/discontinuation. Materials and Methods: A cross-sectional design was used; 40 women with OUD who were eligible to breastfeed were included. Information about breastfeeding initiation, duration, barriers/motivators, demographic characteristics, and self-efficacy was obtained through semi-structured interviews at 4-8 weeks postpartum. Wilcoxon rank sum or Fisher's exact test was used to examine the relationship between maternal/postnatal factors and never-initiated/discontinued breastfeeding. Results: Respondents were 29.3 ± 5.3 years old; most were prescribed buprenorphine (77.5%); and 36.8% of infants were treated for neonatal opioid withdrawal syndrome with methadone or morphine. Most (75.0%) participants initiated breastfeeding; 50.0% continued breastfeeding at 4-8 weeks. The most common motivators included infant health (100%) and bonding (45.0%). On average, women reported discontinuing breastfeeding at 3.3 ± 1.1 weeks postpartum. The most common barriers were concerns regarding transfer of medications or other substances to the infant (50.0%) and concerns about breast milk supply (35.0%). Mean self-efficacy scores were similar among those who continued versus never-initiated/discontinued breastfeeding (33.5 versus 33.0; p = 0.388). Neonatal intensive care unit admission was associated with never-initiated/discontinued breastfeeding (p = 0.047). Conclusion: Women with OUD share many similar motivators and barriers to breastfeeding with the general population. Unique concerns include infant exposure to medications or substances, even in those who are eligible to breastfeed, which should be addressed by targeted education for patients and providers.
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Affiliation(s)
- Nicole Yonke
- Department of Family and Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Elizabeth Yakes Jimenez
- Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.,Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Lawrence Leeman
- Department of Family and Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.,Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Yuridia Leyva
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Alyssa Ortega
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Ludmila N Bakhireva
- Department of Family and Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.,Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.,Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
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22
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Abstract
Introduction: Among the OMICS technologies, that have emerged in recent years, metabolomics has allowed relevant step forwards in clinical research. Several improvements in disease diagnosis and clinical management have been permitted, even in neonatology. Among potentially evaluable biofluids, breast milk (BM) results are highly interesting, representing a fluid of conjunction between mothers newborns, describing their interaction.Areas covered: in this review, updating a previous review article, we discuss research articles and reviews on BM metabolomics and found in MEDLINE using metabolomics, breast milk, neonatal nutrition, breastfeeding, human milk composition, and preterm neonates as keywords.Expert opinion: Our research group has a profound interest in metabolomics research. In 2012, we published the first metabolomic analysis on BM samples, reporting interesting data on its composition and relevant differences with formula milk (FM), useful to improve FM composition. As confirmed by successive studies, such technology can detect the specific BM composition and its dependence on several variables, including lactation stage, gestational age, maternal or environmental conditions. Moreover, since BM contaminants or drug levels can be detected, metabolomics also results useful to determine BM safety. These are only a few practical applications of BM analysis, which will be reviewed in this paper.
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Affiliation(s)
- Flaminia Bardanzellu
- Neonatal Intensive Care Unit, Department of Surgical Sciences, AOU University of Cagliari, Monserrato, Italy
| | - Chiara Peila
- Neonatology Unit, Department of Public Health and Pediatrics, Università degli Studi di Torino, Turin, Italy
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, Department of Surgical Sciences, AOU University of Cagliari, Monserrato, Italy
| | - Alessandra Coscia
- Neonatology Unit, Department of Public Health and Pediatrics, Università degli Studi di Torino, Turin, Italy
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23
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Abstract
The World Health Organization and United Nations Children's Fund's Baby-Friendly Hospital Initiative is aimed at the global promotion, protection and support of breastfeeding. In this study, we compared breastfeeding-related information received, knowledge and behaviours among postpartum women in Baby-Friendly Hospital Initiative accredited and non-accredited hospitals. We selected 10 hospitals: 9 non-accredited hospitals in the Campania region in southern Italy and one accredited hospital in the Piedmont region in northern Italy. In total, 786 women (580 (73.8%) in Campania and 206 (26.2%) in Piedmont) in the hospitals' maternity wards completed a questionnaire comprising 5 sections within 24 to 72hours after giving birth. The questionnaire investigated breastfeeding activities in the days immediately following childbirth, as well as the information provided by health personnel, knowledge about breastfeeding before and during hospitalisation, and participation in antenatal classes. To evaluate the comparison between the 2 regions, we performed at first a bivariate analysis and then a multinomial and a multivariate logistic regression. Compared with Piedmont, in Campania hospitals there was a rate of breastfeeding of 44.3% vs 89.3%, a skin-to-skin contact between mother and child of 74.5% vs 90.7% and first milk feed within 2hours of 15.0% vs 87.2%. The Campania group had fewer problems with child latching. The Campania group reported receiving less information about breastfeeding in general compared with the Piedmont group. In general, both groups showed good basic knowledge about different aspects of breastfeeding. In both regions, about 90% reported that the information received during the antenatal classes simplified the breastfeeding experience. Our study confirms the importance of systematic promotion of breastfeeding and subsequent delivery of adequate support to maternity departments, in accordance with international guidelines.
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Affiliation(s)
- Alessandra Marinelli
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples
| | - Viola Del Prete
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples
| | - Enrico Finale
- Department of Maternal and Child Health, Castelli Hospital, Verbania, Italy
| | - Andrea Guala
- Department of Maternal and Child Health, Castelli Hospital, Verbania, Italy
| | | | - Francesco Attena
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples
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24
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Addicks SH, McNeil DW. Randomized Controlled Trial of Motivational Interviewing to Support Breastfeeding Among Appalachian Women. J Obstet Gynecol Neonatal Nurs 2019; 48:418-432. [PMID: 31181186 DOI: 10.1016/j.jogn.2019.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2019] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To determine the effectiveness of a single session of prenatal motivational interviewing (MI) to enhance breastfeeding outcomes. DESIGN A randomized controlled trial with two groups (MI and psychoeducation) with repeated measures: preintervention, postintervention, and at 1 month postpartum. SETTING The intervention was conducted at a university-associated clinic, community locations, and participants' homes. Postpartum follow-up was conducted by telephone. PARTICIPANTS A total of 81 women with low-risk pregnancies enrolled at 28 to 39 weeks gestation who lived in Appalachia. METHODS Participants were randomly assigned to MI or psychoeducation on infant development. Pre- and postintervention outcome measures included intention to breastfeed, confidence in and importance of breastfeeding plan, and breastfeeding attitudes. At 1 month postpartum, participants completed a telephone interview to assess actual breastfeeding initiation, exclusivity, and plans to continue breastfeeding. RESULTS At 1 month postpartum, women in the MI group were more likely to report any current breastfeeding than women in the psychoeducation group, regardless of parity, χ2(1, N = 79) = 4.30, p = .040, Φ = .233. At the postintervention time point, the MI intervention had a significant effect on improving attitudes about breastfeeding among primiparous women only (p < .05). CONCLUSION One session of MI was effective to promote breastfeeding at 1 month postpartum and to enhance positive attitudes toward breastfeeding among primiparous women in Appalachia.
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25
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Hahn-Holbrook J, Saxbe D, Bixby C, Steele C, Glynn L. Human milk as "chrononutrition": implications for child health and development. Pediatr Res 2019; 85:936-42. [PMID: 30858473 DOI: 10.1038/s41390-019-0368-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 02/25/2019] [Accepted: 03/01/2019] [Indexed: 12/12/2022]
Abstract
Human biology follows recurring daily rhythms that are governed by circadian cues in the environment. Here we show that human milk is a powerful form of "chrononutrition," formulated to communicate time-of-day information to infants. However, 85% of breastfed infants in the US consume some milk that does not come directly from the breast but is pumped and stored in advance of feeding. Expressed milk is not necessarily circadian-matched (e.g., an infant might drink breastmilk pumped in the evening on the following morning). Ingesting mistimed milk may disrupt infants' developing circadian rhythms, potentially contributing to sleep problems and decreased physiological attunement with their mothers and environments. Dysregulated circadian biology may compromise infant health and development. Despite wide-ranging public health implications, the timing of milk delivery has received little empirical study, and no major pediatric or public health organization has issued recommendations regarding the circadian-matching of milk. However, potential adverse developmental and health consequences could be ameliorated by simple, low-cost interventions to label and circadian-match stored milk. The current paper reviews evidence for human milk as chrononutrition and makes recommendations for future research, practice, and policy.
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Abstract
With rare exception, breastfeeding is the optimal way to feed infants, and has special benefits for women and infants with perinatal opioid exposure. Infants breastfed and/or fed their mother's own breastmilk experience less severe opioid withdrawal symptoms, have shorter hospital stays, and are less likely to be treated with medication for withdrawal. The specific impact of mothers' milk feeding on opioid withdrawal may be related to the act of breastfeeding and associated skin-to-skin contact, qualities of breastmilk, healthier microbiome, small amounts of opioid drug in breastmilk, or a combination of these. Women with opioid use disorder face significant breastfeeding obstacles, including psychosocial, behavioral, concomitant medications, and tobacco use and thus may require high levels of support to achieve their breastfeeding goals. They often don't receive information to make informed infant feeding decisions. Hospital practices such as prenatal education, rooming-in and having a policy that minimizes barriers to breastfeeding are associated with increased breastfeeding rates.
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Affiliation(s)
- Debra L Bogen
- University of Pittsburgh School of Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, 3414 Fifth Ave, Pittsburgh, PA, 15213, USA.
| | - Bonny L Whalen
- Geisel School of Medicine at Dartmouth, Children's Hospital at Dartmouth-Hitchcock, Dartmouth-Hitchcock Medical Center, DHMC Pediatrics, One Medical Center Drive, Lebanon, NH, 03756, USA.
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Abstract
Breastfeeding is the safest mode of infant feeding during disasters and displacement. Although challenges associated with breastfeeding during humanitarian emergencies are global, they are particularly problematic in low- and middle-income countries such as Pakistan. To examine the factors that affect breastfeeding practices of displaced mothers in disaster relief camps, an integrative review of literature was undertaken. The review suggests that the breastfeeding experiences, behaviors, and practices of displaced mothers are shaped by a combination of gender-based, sociocultural, economic, and geopolitical factors. A thorough understanding of these factors will assist nurses and other stakeholders to improve breastfeeding practices and decrease child deaths in disaster relief camps.
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Kair LR, Nickel NC, Jones K, Kornfeind K, Sipsma HL. Hospital breastfeeding support and exclusive breastfeeding by maternal prepregnancy body mass index. Matern Child Nutr 2019; 15:e12783. [PMID: 30659747 DOI: 10.1111/mcn.12783] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 01/13/2023]
Abstract
Overweight and obese mothers in the United States have disproportionately lower rates of exclusive breastfeeding than mothers of normal weight. The Ten Steps to Successful Breastfeeding (Ten Steps), a series of evidence-based practices designed to support breastfeeding initiation, duration, and exclusivity, demonstrate effectiveness at the population level. It is unknown, however, whether they are consistently provided to women across all maternal body mass index (BMI) categories. We sought to determine whether pre-pregnancy BMI is associated with the implementation and effectiveness of the Ten Steps. We used data from Listening to Mothers III, a cross-sectional survey administered to a sample of mothers who delivered in U.S. hospitals between July 2011 and June 2012. Measures of the Ten Steps were based on maternal self-report on Listening to Mothers III. Our analytic sample was limited to mothers of term infants intending to breastfeed (N = 1,506, weighted). We conducted chi-square testing and constructed weighted multivariable logistic regression models to account for potential confounders. Results suggest that two practices (i.e., holding their babies skin-to-skin for the first time and being encouraged to breastfeed on demand) were more strongly associated with exclusive breastfeeding among mothers with obesity than other mothers. Additionally, mothers with obesity reported holding babies skin-to-skin significantly less often than other mothers. Thus, interventions aimed at helping mothers with obesity to hold their babies skin-to-skin in the first hour and teaching them to breastfeed on demand have the potential to decrease the breastfeeding disparities in this population.
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Affiliation(s)
- Laura R Kair
- Department of Pediatrics, University of California Davis, Sacramento, California, USA
| | - Nathan C Nickel
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Krista Jones
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Katelin Kornfeind
- Department of Public Health, Benedictine University, Lisle, Illinois, USA
| | - Heather L Sipsma
- Department of Public Health, Benedictine University, Lisle, Illinois, USA
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Abstract
Background: Many women initiate breastfeeding but do not meet their duration goals, and low-income women initiate and continue breastfeeding at lower rates than their counterparts. One-on-one counseling is associated with increased breastfeeding but requires significant resources. In contrast, video education, which requires fewer resources and is effective in other health care settings, such as vaccine uptake, has gone untested for prolonging breastfeeding duration among low-income women. Objective: To determine whether use of an educational breastfeeding video shown individually to low-income pregnant women in the prenatal clinic would prolong duration of any and exclusive breastfeeding. Methods: A multicenter, randomized, controlled trial was conducted in four prenatal clinics. Low-income pregnant women were randomized to view the intervention (breastfeeding education) or control (prenatal nutrition) video in the third trimester and interviewed by telephone at 1, 3, and 6 months postpartum about infant feeding practices. Kaplan-Meier survival curves with log-rank tests and Cox proportional hazards regression were utilized to compare groups. Results: Of the 816 eligible women approached, 64% participated: 263 assigned to the intervention, and 259 assigned to the control. Six-month data were obtained for 211 (80%) and 220 (85%) women, respectively. Rate of breastfeeding cessation did not differ by group (hazard ratios; HR = 1.00, 95% confidence interval [CI]: 0.81-1.24 and HR = 0.93, 95% CI: 0.76-1.14, for any and exclusive breastfeeding, respectively). Conclusion: A single viewing of a breastfeeding education video shown in the prenatal clinic did not impact breastfeeding duration or exclusivity among low-income women in this study. Although not sufficient alone, educational videos may be useful as one component of a comprehensive program to promote breastfeeding.
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Affiliation(s)
- Ann L Kellams
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia
| | - Kelly K Gurka
- Department of Epidemiology, University of Florida, Gainesville, Florida
| | - Paige P Hornsby
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia
| | - Emily Drake
- School of Nursing, University of Virginia, Charlottesville, Virginia
| | - Mark R Conaway
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia
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Mukunya D, Tumwine JK, Nankabirwa V, Ndeezi G, Odongo I, Tumuhamye J, Tongun JB, Kizito S, Napyo A, Achora V, Odongkara B, Tylleskar T. Factors associated with delayed initiation of breastfeeding: a survey in Northern Uganda. Glob Health Action 2018; 10:1410975. [PMID: 29243560 PMCID: PMC5738649 DOI: 10.1080/16549716.2017.1410975] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Initiation of breastfeeding later than 1 hour after birth is associated with increased neonatal morbidity and mortality. Objective: To determine the prevalence and factors associated with delayed initiation of breastfeeding. Methods: We conducted a survey in 2016 of 930 children under the age of 2 years in Lira district, northern Uganda. Mothers of the children were interviewed and data was collected on mobile phones using Open Data Kit software (https://opendatakit.org). Multivariable logistic regression was used to determine factors associated with delayed initiation of breastfeeding. Results: Almost half [48.2%, 95% confidence interval (CI) (44.3–52.1)] of the mothers delayed initiation of breastfeeding. Factors significantly associated with delayed initiation of breastfeeding in multivariable analysis included caesarean delivery [Adjusted Odds Ratio (AOR) 11.10 95% CI (3.73–33.04)], discarding initial breast milk [AOR 2.02 95% CI (1.41–2.88)], home delivery [AOR 1.43 95% CI (1.04–1.97)] and mother being responsible for initiating breastfeeding as compared to a health worker or relative [AOR 1.73 95% CI (1.33–2.26)]. Mothers having a secondary education were less likely [AOR 0.54 95% CI (0.30–0.96)] to delay initiation of breastfeeding as compared to those with no education. Conclusion: About half the mothers delayed initiation of breastfeeding until after 1 hour after birth. Programs to promote, protect and support breastfeeding in this post conflict region are urgently needed.
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Affiliation(s)
- David Mukunya
- a Center for International Health , University of Bergen , Bergen , Norway
| | - James K Tumwine
- b Department of Pediatrics and Child Health , Makerere University , Kampala , Uganda
| | - Victoria Nankabirwa
- c Department of Epidemiology and Biostatistics, School of Public Health , Makerere University , Kampala , Uganda
| | - Grace Ndeezi
- b Department of Pediatrics and Child Health , Makerere University , Kampala , Uganda
| | - Isaac Odongo
- d Department of Pediatrics and Child Health , Makerere University , Kampala , Uganda
| | | | | | - Samuel Kizito
- f Clinical Epidemiology Unit , Makerere University , Kampala , Uganda
| | - Agnes Napyo
- g Department of Public Health , Busitema University , Mbale , Uganda
| | - Vincentina Achora
- h Department of Obstetrics and Gynecology , University of Gulu , Gulu , Uganda
| | | | - Thorkild Tylleskar
- a Center for International Health , University of Bergen , Bergen , Norway
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Abstract
Objective The aim of the study was to outline breastfeeding barriers faced by women residing in the State of Qatar. Methods A cross-sectional study through a telephone interview was conducted at Hamad Medical Corporation, the only tertiary care and accredited academic institution in the State of Qatar. Mothers of children born between the period of January 1, 2012 and December 31, 2012 in the State of Qatar were contacted. Results Of the total 840 mothers who were contacted for the telephone survey, 453 mothers agreed to be interviewed (response rate 53.9%), while 364 (43.3%) did not answer the phone, and 21 (2.5%) answered the phone but refused to participate in the study. The overall breastfeeding initiation rate among the mothers was 96.2%, with 3.8% mothers reporting that they had never breastfed their baby. The percentage of mothers who exclusively breastfed their children in the first 6 months was 24.3%. The most common barriers to breastfeeding as perceived by our participants were the following: perception of lack of sufficient breast milk after delivery (44%), formula is easy to use and more available soon after birth (17.8%), mom had to return to work (16.3%), lack of adequate knowledge about breastfeeding (6.5%), and the concept that the infant did not tolerate breast milk (4.9%). Conclusion Exclusive breastfeeding barriers as perceived by women residing in the State of Qatar, a wealthy rapidly developing country, do not differ much from those in other nations. What varies are the tremendous medical resources and the easy and comfortable access to health care in our community. We plan to implement a nationwide campaign to establish a prenatal breastfeeding counseling visit for all expecting mothers.
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Affiliation(s)
- Mohamed A Hendaus
- Department of Pediatrics, section of academic general Pediatrics, Hamad general corporation, Doha, Qatar, .,Department of Pediatrics, section of academic general Pediatrics, sidra Medicine, Doha, Qatar, .,Department of clinical Pediatrics, Weill-cornell Medicine, Doha, Qatar,
| | - Ahmed H Alhammadi
- Department of Pediatrics, section of academic general Pediatrics, Hamad general corporation, Doha, Qatar, .,Department of Pediatrics, section of academic general Pediatrics, sidra Medicine, Doha, Qatar, .,Department of clinical Pediatrics, Weill-cornell Medicine, Doha, Qatar,
| | - Shabina Khan
- Department of Pediatrics, section of academic general Pediatrics, Hamad general corporation, Doha, Qatar,
| | - Samar Osman
- Department of Pediatrics, section of academic general Pediatrics, Hamad general corporation, Doha, Qatar,
| | - Adiba Hamad
- Department of Pediatrics, section of academic general Pediatrics, Hamad general corporation, Doha, Qatar, .,Department of Pediatrics, section of academic general Pediatrics, sidra Medicine, Doha, Qatar,
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Thibeau S, Ginsberg HG. Bioethics in Practice: The Ethics Surrounding the Use of Donor Milk. Ochsner J 2018; 18:17-19. [PMID: 29559863 PMCID: PMC5855414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Affiliation(s)
- Shelley Thibeau
- Mothers' Milk Bank of Louisiana, Ochsner Baptist Medical Center, New Orleans, LA
| | - Harley G Ginsberg
- Mothers' Milk Bank of Louisiana, Ochsner Baptist Medical Center, New Orleans, LA
- Department of Neonatology, Ochsner Baptist Medical Center, New Orleans, LA
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Kiełbratowska B, Michałek-kwiecień J, Kaźmierczak M, Bandurska E. What promotes and hinders success in breastfeeding in hospital care? – the role of social support and anxiety. hpr 2018; 6:252-60. [DOI: 10.5114/hpr.2018.73051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
BACKGROUND Many breastfed infants receive supplemental feeds during the birth hospitalization, either by maternal request or due to medical indications. Donor milk from a certified milk bank has become increasingly available and is now used in some settings for term and late preterm infants. No studies have explored maternal opinions about donor milk and formula as options for supplementary feedings. Research aim: This study aimed to explore maternal perceptions about donor milk and formula supplementation and implications for continued breastfeeding. METHODS The authors conducted semistructured interviews with 30 postpartum mothers of healthy newborns who breastfed and gave supplementary feedings with pasteurized donor milk and/or formula during the birth hospitalization. They analyzed transcripts using the constant comparative method and identified four major themes. RESULTS Identified themes included the following: (a) Donor milk is seen as temporary whereas formula is seen as an ongoing plan, (b) formula is viewed as familiar whereas donor milk is viewed as unfamiliar, (c) donor milk is costly and challenging logistically, and (d) donor milk is "healthier." CONCLUSION For mothers who view donor milk as temporary and formula as permanent, the provision of donor milk rather than formula when supplementation is medically indicated may have the potential to promote the return to exclusive maternal breastfeeding. Barriers to the use of donor milk include cost and lack of familiarity and access.
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Affiliation(s)
- Laura R Kair
- 1 Stead Family Department of Pediatrics, University of Iowa, Carver College of Medicine, Iowa City, IA, USA.,2 Department of Pediatrics, University of California Davis Medical Center, Sacramento, CA, USA
| | - Valerie J Flaherman
- 3 Department of Pediatrics and Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
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Guala A, Boscardini L, Visentin R, Angellotti P, Grugni L, Barbaglia M, Chapin E, Castelli E, Finale E. Skin-to-Skin Contact in Cesarean Birth and Duration of Breastfeeding: A Cohort Study. ScientificWorldJournal 2017; 2017:1940756. [PMID: 29082306 DOI: 10.1155/2017/1940756] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 07/17/2017] [Accepted: 07/31/2017] [Indexed: 11/22/2022] Open
Abstract
Early skin-to-skin contact (SSC) after birth is a physiological practice that is internationally recommended and has well-documented importance for the baby and for the mother. This study aims to examine SSC with a cohort of mothers or fathers in the operating room after a Cesarean section (C-section) and its relationship with duration of breastfeeding. From January 1, 2012, to December 31, 2012, at the Castelli Hospital in Verbania, Italy, a Baby Friendly designated hospital, 252 consecutive women who had a C-section were enrolled in the study and followed for 6 months. The sample was later divided into three groups depending on the real outcomes in the operating room: SSC with the mother (57.5%), SSC with the father (17.5%), and no SSC (25%). Our study showed a statistical association between skin-to-skin contact with the mother and the exclusive breastfeeding rates on discharge. This effect is maintained and statistically significant at three and six months, as compared to the groups that had paternal SSC or no SSC. After a C-section, skin-to-skin contact with the mother can be an important practice for support, promotion, and duration of breastfeeding.
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Chung EK, Gable EK, Golden WC, Hudson JA, Hackman NM, Andrews JP, Jackson DS, Beavers JB, Mirchandani DR, Kellams A, Krevitsky ME, Monroe K, Madlon-Kay DJ, Stratbucker W, Campbell D, Collins J, Rauch D. Current Scope of Practice for Newborn Care in Non-Intensive Hospital Settings. Hosp Pediatr 2017; 7:471-482. [PMID: 28694290 DOI: 10.1542/hpeds.2016-0206] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Esther K Chung
- Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania and Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware;
| | - E Kaye Gable
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina and Cone Health, Greensboro, North Carolina
| | - W Christopher Golden
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jennifer A Hudson
- Department of Pediatrics, Greenville Health System, Greenville, South Carolina
| | - Nicole M Hackman
- Department of Pediatrics, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Jennifer P Andrews
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - DeeAnne S Jackson
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jessica B Beavers
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Dipti R Mirchandani
- Department of Pediatrics, Hofstra Northwell School of Medicine at Hofstra University, Hempstead, New York and Cohen Children's Medical Center of New York, New Hyde Park, New York
| | - Ann Kellams
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Meredith E Krevitsky
- Department of Pediatrics, Hofstra Northwell School of Medicine at Hofstra University, Hempstead, New York and Cohen Children's Medical Center of New York, New Hyde Park, New York
| | - Kimberly Monroe
- Department of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital and University of Michigan, Ann Arbor, Michigan
| | - Diane J Madlon-Kay
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
| | - William Stratbucker
- Department of Pediatrics, Michigan State University and Helen DeVos Children's Hospital, Grand Rapids, Michigan
| | - Deborah Campbell
- Department of Pediatrics, Albert Einstein College of Medicine, New York, New York and Children's Hospital at Montefiore, Bronx, New York
| | - Jolene Collins
- Department of Pediatrics, University of Southern California Keck School of Medicine and Children's Hospital Los Angeles, Los Angeles, California; and
| | - Daniel Rauch
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Elmhurst, New York
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