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Thomsen K, Gonzalez-Nahm S, Benjamin-Neelon SE. Reported Adherence to the 10 Steps to Successful Breastfeeding Is Higher Among Baby-Friendly Hospitals. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:392-398. [PMID: 38483429 DOI: 10.1016/j.jneb.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 02/17/2024] [Accepted: 02/21/2024] [Indexed: 06/09/2024]
Abstract
OBJECTIVE Quantify and compare reported breastfeeding support practices in the Baby-Friendly Hospital Initiative (BFHI) and non-BFHI facilities. DESIGN Cross-sectional survey. SETTING Regions across the US. PARTICIPANTS Two hundred and eighty-six facilities (110 BFHI and 176 non-BFHI) selected by a stratified (by hospital size) random sample of 50% BFHI and 50% non-BFHI facilities. INTERVENTION Emailed survey Fall 2019 through Spring 2020. MAIN OUTCOME MEASURE Reported adherence to the 10 Steps to Successful Breastfeeding. ANALYSIS Wilcoxon rank sum test with continuity correction, Pearson chi-square test of independence, and Fisher's exact test. RESULTS Baby-Friendly Hospital Initiative facilities were more likely to report adherence to the 10 Steps to Successful Breastfeeding. Only 2 of the reported steps were not significantly different: immediate postnatal care and responsive feeding. CONCLUSIONS AND IMPLICATIONS This research supports breastfeeding support interventions within hospitals as both BFHI and non-BFHI facilities have room for improvement. Interventions targeting non-BFHI facilities are an opportunity to close the disparity in breastfeeding care.
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Affiliation(s)
| | - Sarah Gonzalez-Nahm
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA
| | - Sara E Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of International Health, Division of Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Smith AE, Sweigart E, Falatic K, Stuart D, Szugye H, Lam SK, Aly H, Das A. Direct breastfeeding frequency of late preterm and term infants in the neonatal intensive care unit and availability of mother's own milk at six months of age. a retrospective cohort study. J Perinatol 2024:10.1038/s41372-024-01972-w. [PMID: 38678083 DOI: 10.1038/s41372-024-01972-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 04/01/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Mother's Own Milk (MOM) reduces the risk of complications in premature infants. Breastfeeding rates for late preterm and term infants in the neonatal intensive care unit (NICU) are significantly lower than that of breastfed healthy term newborns at 6 months of age. DESIGN This was a retrospective cohort study of neonates born at 34 weeks 0 days or later. Infants who were directly breastfed in the NICU and were discharged on breast milk were included. Logistic regression modeling was used to determine the significance of association. RESULTS 171 mother-infant dyads were included. After adjusting for confounders, the number of breastfeeding attempts during the NICU stay was significantly associated with the availability of MOM at six months of age (p = 0.003, 95% CI 1.02 to 1.14). CONCLUSION This study is the first to show an association between the number of direct breastfeeding attempts in the NICU and availability of MOM at six months of age.
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Affiliation(s)
- Amanda E Smith
- Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, OH, USA.
| | - Erin Sweigart
- Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, OH, USA
| | - Kimberly Falatic
- Department of Childbirth Education, Cleveland Clinic, Cleveland, OH, USA
| | - Dena Stuart
- Department of Childbirth Education, Cleveland Clinic, Cleveland, OH, USA
| | - Heidi Szugye
- Breastfeeding Medicine, Department of Primary Care Pediatrics, Cleveland Clinic Children's, Cleveland, OH, USA
| | - Suet Kam Lam
- Breastfeeding Medicine, Department of Primary Care Pediatrics, Cleveland Clinic Children's, Cleveland, OH, USA
| | - Hany Aly
- Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, OH, USA
| | - Anirudha Das
- Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, OH, USA
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Elgersma KM, McKechnie AC, Sommerness SA, Tanner LR, Swanson NM. Wayfinding through the "ocean of the great unknown": how lactating parents establish a direct breastfeeding relationship with an infant with critical CHD. Cardiol Young 2023; 33:2000-2011. [PMID: 36484129 DOI: 10.1017/s1047951122003808] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Lactating parents of infants hospitalised for critical congenital heart disease (CHD) face significant barriers to direct breastfeeding. While experiences of directly breastfeeding other hospitalised neonates have been described, studies including infants with critical CHD are scarce. There is no evidence-based standard of direct breastfeeding care for these infants, and substantial practice variation exists. AIM To explain how direct breastfeeding is established with an infant hospitalised for critical CHD, from lactating parents' perspectives. MATERIALS & METHODS This study is a qualitative grounded dimensional analysis of interviews with 30 lactating parents of infants with critical CHD who directly breastfed within 3 years. Infants received care from 26 United States cardiac centres; 57% had single ventricle physiology. Analysis included open, axial, and selective coding; memoing; member checking; and explanatory matrices. RESULTS Findings were represented by a conceptual model, "Wayfinding through the 'ocean of the great unknown'." The core process of Wayfinding involved a nonlinear trajectory requiring immense persistence in navigating obstacles, occurring in a context of life-and-death consequences for the infant. Wayfinding was characterised by three subprocesses: navigating the relationship with the healthcare team; protecting the direct breastfeeding relationship; and doing the long, hard work. Primary influencing conditions included relentless concern about weight gain, the infant's clinical course, and the parent's previous direct breastfeeding experience. CONCLUSIONS For parents, engaging in the Wayfinding process to establish direct breastfeeding was feasible and meaningful - though challenging. The conceptual model of Wayfinding explains how direct breastfeeding can be established and provides a framework for research and practice.
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Affiliation(s)
| | | | | | - Lynn R Tanner
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
- Children's Minnesota, Minneapolis, MN, USA
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Moumin NA, Grieger JA, Netting MJ, Makrides M, Green TJ. Iron-Fortified Foods Are Needed To Meet the Estimated Average Requirement for Iron in Australian Infants Aged 6 to 12 Months. J Nutr 2023; 153:3101-3109. [PMID: 37604385 DOI: 10.1016/j.tjnut.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Meeting iron intake recommendations is challenging for infants 6-12 mo, especially breastfed infants. Three-quarters of Australian infants 6-12 mo have iron intakes below the estimated average requirement (7 mg), placing them at risk of iron deficiency. After 6 mo, breastmilk is no longer sufficient to meet the increased demand for iron, and iron-rich complementary foods are recommended. Iron-fortified foods may be a means of improving iron intake in infants, particularly those that are breastfed. OBJECTIVES The aims of the study were as follows: 1) to examine the effect of milk-type and fortified foods on iron intake and the prevalence of inadequacy in infants 6-12 mo; 2) to model the effect of fixed amounts of iron-fortified infant cereal (IFIC) at 6 levels of iron fortification on total iron intake and the prevalence of inadequacy; and 3) to assess the effect IFIC on the intake of other nutrients in the diet. DESIGN Secondary analysis of cross-sectional dietary intake data of infants 6-12 mo (n = 286) participating in the Australian Feeding Infants and Toddlers Study (OzFITS) 2021. RESULTS Median (interquartile range) iron intake was 8.9 (7.5, 10.3); 6.3 (4.5, 8.2); and 2.7 (1.5, 4.4) mg/d in formula-fed, combination-fed, and breastfed infants, respectively. The corresponding prevalence of inadequacy was 19%, 67%, and 96%. Infants who consumed fortified foods had higher median iron intakes than those who did not, 6.2 compared with 1.9 mg/d. Dietary modeling showed that consuming 18 g (300 kJ) of IFIC, fortified at 35 mg/100 g dry weight, reduces the prevalence of inadequacy for iron from 75% to 5% for all infants. CONCLUSIONS Iron intakes are low in Australian infants, especially for breastfed infants in the second half of infancy. Modeling shows that 300 kJ of IFIC, the current manufacturer-recommended serving, fortified at 35 mg/100 g dry weight, added to infant diets would be an effective means to reduce the prevalence of inadequacy for iron.
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Affiliation(s)
- Najma A Moumin
- Women and Kids Theme, South Australia Health and Medical Research Institute, Adelaide South Australia, Australia; Discipline of Paediatrics, Faculty of Health and Medical Sciences, Adelaide Medical School, The University of Adelaide, Adelaide South Australia, Australia
| | - Jessica A Grieger
- Discipline of Obstetrics and Gynaecology, Faculty of Health and Medical Sciences, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia; Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia; Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Merryn J Netting
- Women and Kids Theme, South Australia Health and Medical Research Institute, Adelaide South Australia, Australia; Discipline of Paediatrics, Faculty of Health and Medical Sciences, Adelaide Medical School, The University of Adelaide, Adelaide South Australia, Australia; Nutrition Department, Women's and Children's Health Network, Adelaide, South Australia, Australia
| | - Maria Makrides
- Women and Kids Theme, South Australia Health and Medical Research Institute, Adelaide South Australia, Australia; Discipline of Paediatrics, Faculty of Health and Medical Sciences, Adelaide Medical School, The University of Adelaide, Adelaide South Australia, Australia
| | - Tim J Green
- Women and Kids Theme, South Australia Health and Medical Research Institute, Adelaide South Australia, Australia; College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia.
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Vizzari G, Morniroli D, D’Auria A, Travella P, Bezze E, Sannino P, Rampini S, Marchisio P, Plevani L, Mosca F, Giannì ML. Feeding Difficulties in Late Preterm Infants and Their Impact on Maternal Mental Health and the Mother-Infant Relationship: A Literature Review. Nutrients 2023; 15:2180. [PMID: 37432319 PMCID: PMC10180855 DOI: 10.3390/nu15092180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/19/2023] [Accepted: 04/28/2023] [Indexed: 07/12/2023] Open
Abstract
Late preterm infants constitute the largest subset of premature infants and are more likely to experience feeding issues leading to delayed oral feeding independence and low breastfeeding rates. Considering the increased parental concern about their infants' nutrition and growth, we performed a literature review to provide an update on the feeding challenges faced by late preterm infants and the impact of these issues on maternal mental health and the mother-infant relationship. Based on our findings, late preterm infants have a high prevalence of feeding difficulties which need to be addressed by targeted support interventions to promote breastfeeding success and the establishment of a harmonious dyadic interaction between the mother and her infant, all of which contribute to the prevention of altered feeding behavior later in life. There is still a need for additional research to develop a standardized and shared strategy that can be proven to be effective. Should this be accomplished, it will be possible to offer appropriate support for mothers, encourage the oral skills and maturation of late preterm infants, and improve the relationship quality within the dyad.
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Affiliation(s)
- Giulia Vizzari
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy; (G.V.); (L.P.); (F.M.)
| | - Daniela Morniroli
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (D.M.); (P.T.)
| | - Arianna D’Auria
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (D.M.); (P.T.)
| | - Paola Travella
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (D.M.); (P.T.)
| | - Elena Bezze
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Direzione Professioni Sanitarie, 20122 Milan, Italy; (E.B.); (P.S.); (S.R.)
| | - Patrizio Sannino
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Direzione Professioni Sanitarie, 20122 Milan, Italy; (E.B.); (P.S.); (S.R.)
| | - Serena Rampini
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Direzione Professioni Sanitarie, 20122 Milan, Italy; (E.B.); (P.S.); (S.R.)
| | - Paola Marchisio
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, 20122 Milan, Italy;
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Laura Plevani
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy; (G.V.); (L.P.); (F.M.)
| | - Fabio Mosca
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy; (G.V.); (L.P.); (F.M.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (D.M.); (P.T.)
| | - Maria Lorella Giannì
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, NICU, 20122 Milan, Italy; (G.V.); (L.P.); (F.M.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (D.M.); (P.T.)
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Foster SF, Vazquez C, Cubbin C, Nichols AR, Rickman RR, Widen EM. Breastfeeding, socioeconomic status, and long-term postpartum weight retention. Int Breastfeed J 2023; 18:1. [PMID: 36600252 PMCID: PMC9814482 DOI: 10.1186/s13006-022-00534-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 12/18/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Almost half of all pregnant women in the United States gain weight above Institute of Medicine gestational weight gain guidelines. Breastfeeding has been shown to reduce weight retention in the first year postpartum; however, women with lower socioeconomic status (SES) tend to initiate breastfeeding less often than women with higher SES. We investigated associations between duration of breastfeeding with mother's long-term postpartum weight status at 4-10 years and evaluated whether the associations varied by SES. METHODS Maternal and infant dyads (N = 2144 dyads) are from the Geographic Research on Wellbeing survey (GROW), 2012-2013, a long-term, cross-sectional follow-up of the Maternal and Infant Health Assessment (MIHA) based in California, USA. Pre-pregnancy body mass index (BMI) was obtained from self-report of height and weight during MIHA, while breastfeeding history and self-report of current body weight was collected at the 4-10 year GROW postpartum visit. SES score was derived from a composite score of percent federal poverty level and education and was dichotomized into High and Low SES groups at a score of three. Multivariable linear regression was used to examine association between breastfeeding and maternal weight status, and to examine for effect modification by SES. RESULTS Average long-term weight retention 4-10 years postpartum was 4.0 kg. Fewer lower SES vs. higher SES women breast fed at least six months (51% versus 70%, p < .001) or ever breastfed (74% versus 89%, P < .001). Women who breastfed at least six months had lower long-term postpartum weight retention compared to those who did not (b = -1.06 kg, (-1.93, 0.25); p = 0.01); however, these association did not vary by SES. CONCLUSION Six months of breastfeeding is associated with lower BMI at 4-10 years and lower body weight, and effects do not vary by SES. Future policies and guidelines should consider building an infrastructure that is supportive of longer breastfeeding duration. Moreover, further research is needed to identify the impact of additional behavioral and environmental factors on long-term maternal weight status. Understanding the drivers of excessive weight retention pospartum can help us not only improve the pregnant person's health but the health of their children.
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Affiliation(s)
- Saralyn F. Foster
- grid.89336.370000 0004 1936 9924Department of Nutritional Sciences, The University of Texas at Austin, 200 W. 24th Street, A2703, Austin, United States
| | - Christian Vazquez
- grid.89336.370000 0004 1936 9924Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, United States ,grid.267315.40000 0001 2181 9515School of Social Work, The University of Texas at Arlington, 211 S Cooper St Arlington, Arlington, United States
| | - Catherine Cubbin
- grid.89336.370000 0004 1936 9924Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, United States ,grid.89336.370000 0004 1936 9924Departments of Population Health and Health Social Work, Dell Medical School, The University of Texas at Austin, 1601 Trinity Street, Austin, United States
| | - Amy R. Nichols
- grid.89336.370000 0004 1936 9924Department of Nutritional Sciences, The University of Texas at Austin, 200 W. 24th Street, A2703, Austin, United States
| | - Rachel R. Rickman
- grid.89336.370000 0004 1936 9924Department of Nutritional Sciences, The University of Texas at Austin, 200 W. 24th Street, A2703, Austin, United States
| | - Elizabeth M. Widen
- grid.89336.370000 0004 1936 9924Department of Nutritional Sciences, The University of Texas at Austin, 200 W. 24th Street, A2703, Austin, United States ,grid.89336.370000 0004 1936 9924Departments of Women’s Health & Pediatrics, Dell Pediatric Research Institute, The University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, United States
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Dib S, Wells JCK, Eaton S, Fewtrell M. A Breastfeeding Relaxation Intervention Promotes Growth in Late Preterm and Early Term Infants: Results from a Randomized Controlled Trial. Nutrients 2022; 14:nu14235041. [PMID: 36501071 PMCID: PMC9737302 DOI: 10.3390/nu14235041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/29/2022] Open
Abstract
Breastfeeding involves signaling between mother and offspring through biological (breast milk) and behavioral pathways. This study tested this by examining the effects of a relaxation intervention in an understudied infant population. Breastfeeding mothers of late preterm (340/7-366/7 weeks) and early term (370/7-386/7 weeks) infants were randomized to the relaxation group (RG, n = 35), where they were asked to listen to a meditation recording while breastfeeding from 3 weeks post-delivery, or the control group (CG, n = 37) where no intervention was given. Primary outcomes-maternal stress and infant weight-were assessed at 2-3 (baseline) and 6-8 weeks post-delivery. Secondary outcomes included infant length, infant behavior, maternal verbal memory, salivary cortisol, and breast milk composition. Infants in the RG had significantly higher change in weight-for-age Z-score compared to those in CG (effect size: 0.4; 95% CI: 0.09, 0.71; p = 0.01), and shorter crying duration [RG: 5.0 min, 0.0-120.0 vs. CG: 30.0 min, 0.0-142.0; p = 0.03]. RG mothers had greater reduction in cortisol (effect size: -0.08 ug/dL, 95% CI -0.15, -0.01; p = 0.03) and better maternal verbal learning score (effect size: 1.1 words, 95% CI 0.04, 2.1; p = 0.04) than CG mothers, but did not differ in stress scores. A simple relaxation intervention during breastfeeding could be beneficial in promoting growth of late preterm and early term infants. Further investigation of other potential biological and behavioral mediators is warranted.
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Early infancy growth, body composition and type of feeding in late and moderate preterms. Pediatr Res 2022:10.1038/s41390-022-02317-z. [PMID: 36183005 PMCID: PMC9526212 DOI: 10.1038/s41390-022-02317-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Late and moderate preterm (LMPT) infants are at risk for adverse later life outcomes. We determined the association between feeding method at enrolment and growth and body composition of LMPT infants until 3 months corrected age (3mCA). METHODS Infants born between 32+0 and 36+6 weeks of gestation (n = 107) were enrolled up to 4 weeks corrected age and stratified according to feeding at enrolment. We performed anthropometric measurements at enrolment, term equivalent age (TEA) and 3mCA, including skinfold measurements and body composition using dual X-ray absorptiometry (DEXA). RESULTS Feeding method at enrolment was associated with fat mass (FM) (breast 554.9 g, mixed 716.8 g, formula 637.7 g, p = 0.048), lean body mass (LM) (2512 g, 2853 g, 2722 g, respectively, p = 0.009) and lean mass index (LMI) (10.6 kg/m2, 11.6 kg/m2,11.2 kg/m2 respectively, p = 0.008) at TEA, but not 3mCA. Breastfed infants demonstrated greater increase in LM (breast 1707 g, mixed 1536 g, formula 1384 g, p = 0.03) and LMI (1.23 kg/m2, 0.10 kg/m2, 0.52 kg/m2, respectively, p = 0.022) between TEA and 3mCA. CONCLUSIONS Breastfed LMPT infants have lower FM and greater LM increase and LMI increase up to 3mCA compared to formula or mixed-fed infants. These findings stress the importance of supporting breastfeeding in this population. IMPACT Infants born late and moderate preterm age who are exclusively breastfed soon after birth gain more lean mass up to 3 months corrected age compared to mixed- or formula-fed infants. Breastfed infants have lower lean and fat mass at term equivalent age compared to mixed- and formula-fed infants. This is the first study exploring this population's growth and body composition in detail at 3 months corrected age. Our results underline the importance of supporting mothers to initiate and continue breastfeeding at least until 3 months corrected age.
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Innovations in Breastfeeding Support. Clin Obstet Gynecol 2022; 65:648-662. [PMID: 35894738 DOI: 10.1097/grf.0000000000000736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Despite the numerous benefits that breastfeeding confers to those who breastfeed and their infants, the United States' exclusive breastfeeding rates and any breastfeeding rates at 12 months remain low and inequitable. This public health crisis has been prioritized in the US Healthy People 2030 goals. Current evidence-based practices to support lactation have afforded limited progress, thus, achieving national breastfeeding goals requires innovative ideas in thinking, technology, and care. This article highlights potential innovative strategies in the field of lactation to improve outcomes and work toward achieving health equity, while underscoring the critical role that perinatal caregivers play in lactation support.
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