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Mudau AG, Mabunda JT, Mushaphi LF. Challenges and strategies to implement exclusive breastfeeding in the selected Districts of Limpopo Province, South Africa: professional nurses´ perspectives. Pan Afr Med J 2023; 46:75. [PMID: 38282783 PMCID: PMC10819839 DOI: 10.11604/pamj.2023.46.75.31408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/11/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction despite the efforts of professional nurses, exclusive breastfeeding rate is very low in South Africa. Per statistic South Africa, EBF rate is 32% with Limpopo Province being rated 8% as one of the lowest in South Africa. Implementation of exclusive breastfeeding required professional nurses´ efforts, lactating mothers, families, and community need information and support from the health care system. The purpose of this study aimed at exploring professional nurses´ challenges regarding implementation of exclusive breastfeeding in Limpopo Province. Methods qualitative research involving phenomenological design was employed to explore professional nurses´ challenges using one on one, unstructured, in-depth interview with 30 professional nurses; 27 females and three males, working in the six birthing facilities of two selected districts; Vhembe and Waterberg, in Limpopo Province. Results the three higher order themes emerged were challenges experienced by nurses during promotion of exclusive breastfeeding; findings revealed challenges as cultural and religious beliefs, lack of family/community and health professional support, teen and HIV positive mothers, nurses found to have challenges to implement exclusive breastfeeding. Healthcare system and services such as shortage of staff and lack of proper training on lactation management and perceived measures to promote exclusive breastfeeding suggested by health professionals, which include ongoing health education, door to door campaigns, implementation of policy by health care professionals would promote exclusive breastfeeding strategies that are in place and encourage families and community to support lactating mothers to improve their confident on breastfeeding. Conclusion professional nurses had challenges in promoting exclusive breastfeeding. An intervention is needed to promote exclusive breastfeeding.
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Affiliation(s)
- Azwinndini Gladys Mudau
- Department of Public Health, Faculty of Health Sciences, University of Venda, Thohoyandou, South Africa
| | - Jabu Tsakani Mabunda
- Department of Public Health, Faculty of Health Sciences, University of Venda, Thohoyandou, South Africa
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Alahmed S, Win K, Frost S, Al Mutair A, Fernandez R, Meedya S. Cultural and linguistic appropriateness of a web-based breastfeeding educational resource for Saudi women: Consensus development conference approach. Nurse Educ Pract 2023; 71:103717. [PMID: 37453369 DOI: 10.1016/j.nepr.2023.103717] [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: 03/06/2023] [Revised: 07/02/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
AIM The purpose of this study was to investigate the cultural and linguistic appropriateness of the content, images and layout of the web-based breastfeeding educational resource for Saudi women using a consensus development approach. BACKGROUND Although the World Health Organization highly recommends exclusive breastfeeding, there is a decline in breastfeeding rates in Saudi Arabia, especially during hospital stay. The combining of health professional support with e-technology tools has been proposed as a method to increase exclusive breastfeeding. However, the cultural and linguistic appropriateness of an e-technology-based approach has not been explored in Saudi women. METHODS After developing a content draft of the web-based breastfeeding educational resource specific to Saudi culture, an online consensus development conference was organised with ten participants including two university researchers and eight health care providers to investigate the cultural and linguistic appropriateness of the educational content. The participants from Saudi Arabia were Saudi mothers who had breastfeeding experiences and were key maternity health professionals employed at the Maternity and Children Hospital of Dammam, Saudi Arabia. The SQUIRE checklist was used in the reporting of this study. RESULTS Feedback received prior to the meeting showed that 81% of the content was acceptable and minor changes were required. Changes were made to the content based on the suggestions and feedback received. The consensus group accepted all the changes and the content was finalised. CONCLUSIONS The online consensus development conference was found to be a very convenient way to decide on the cultural and linguistic appropriateness of the content of the web-based breastfeeding educational resource allowing the participation of experts from different countries; this was considered a critical step in ensuring the successful implementation of the intervention.
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Affiliation(s)
- Salma Alahmed
- School of Nursing, University of Wollongong, Australia; College of Nursing, King Saud University, Riyadh, Saudi Arabia.
| | - Khin Win
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Australia
| | - Steve Frost
- School of Nursing, University of Wollongong, Australia
| | - Abbas Al Mutair
- School of Nursing, University of Wollongong, Australia; College of Nursing, Princess Nourah Bent Abdulrahman University, Riyadh, Saudi Arabia; Research Center, Almoosa Specialist Hospital, Princess Nourah Bent Abdulrahman University, Riyadh, Saudi Arabia
| | - Ritin Fernandez
- School of Nursing and Midwifery, University of Newcastle, Australia
| | - Shahla Meedya
- School of Nursing, University of Wollongong, Australia; School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Australia, University of Wollongong, Australia
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Hassounah M, Dabbagh R, Younis A. Is the Frequency of Postpartum Breastfeeding Counseling Associated with Exclusive Breastfeeding at Six Months? An Analytical Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1141. [PMID: 37508637 PMCID: PMC10377769 DOI: 10.3390/children10071141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023]
Abstract
Breastfeeding counseling is an essential public health tool in postpartum maternal and infant health. In this study, we aimed to explore the relationship between the frequency of postpartum breastfeeding counseling and the type of feeding outcome at six months. The study design was an analytical, cross-sectional study on mothers of 6-24-month-old children living in Riyadh, Saudi Arabia. We conducted an analysis with descriptive statistics as well as logistic regression models. The findings from our study can be summarized in the following points: First, only 31.9% of the women in our study received postnatal breastfeeding counseling in the first six months after delivery, with the majority receiving fewer than four sessions. Second, there seemed to be a drop in exclusive breastfeeding with time: from 35.3% in the first two months to 29.7% in the second two months and then 20.7% in the final two months. Third, previous exclusive breastfeeding increased the odds of exclusive breastfeeding in the proceeding delivery. Finally, exposure to one or more postnatal breastfeeding counseling sessions increased the odds of exclusive or predominant breastfeeding in the first six months. This study helps to guide decision makers in planning maternal child health services and relevant community-based efforts.
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Affiliation(s)
- Marwah Hassounah
- Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
| | - Rufaidah Dabbagh
- Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
| | - Afnan Younis
- Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
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Walsh A, Pieterse P, Mishra N, Chirwa E, Chikalipo M, Msowoya C, Keating C, Matthews A. Improving breastfeeding support through the implementation of the Baby-Friendly Hospital and Community Initiatives: a scoping review. Int Breastfeed J 2023; 18:22. [PMID: 37061737 PMCID: PMC10105160 DOI: 10.1186/s13006-023-00556-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/26/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND Improved breastfeeding practices have the potential to save the lives of over 823,000 children under 5 years old globally every year. The Baby-Friendly Hospital Initiative (BFHI) is a global campaign by the World Health Organization and the United Nations Children's Fund, which promotes best practice to support breastfeeding in maternity services. The Baby-Friendly Community Initiative (BFCI) grew out of step 10, with a focus on community-based implementation. The aim of this scoping review is to map and examine the evidence relating to the implementation of BFHI and BFCI globally. METHODS This scoping review was conducted according to the Joanna Briggs Institute methodology for scoping reviews. Inclusion criteria followed the Population, Concepts, Contexts approach. All articles were screened by two reviewers, using Covidence software. Data were charted according to: country, study design, setting, study population, BFHI steps, study aim and objectives, description of intervention, summary of results, barriers and enablers to implementation, evidence gaps, and recommendations. Qualitative and quantitative descriptive analyses were undertaken. RESULTS A total of 278 articles were included in the review. Patterns identified were: i) national policy and health systems: effective and visible national leadership is needed, demonstrated with legislation, funding and policy; ii) hospital policy is crucial, especially in becoming breastfeeding friendly and neonatal care settings iii) implementation of specific steps; iv) the BFCI is implemented in only a few countries and government resources are needed to scale it; v) health worker breastfeeding knowledge and training needs strengthening to ensure long term changes in practice; vi) educational programmes for pregnant and postpartum women are essential for sustained exclusive breastfeeding. Evidence gaps include study design issues and need to improve the quality of breastfeeding data and to perform prevalence and longitudinal studies. CONCLUSION At a national level, political support for BFHI implementation supports expansion of Baby-Friendly Hospitals. Ongoing quality assurance is essential, as is systematic (re)assessment of BFHI designated hospitals. Baby Friendly Hospitals should provide breastfeeding support that favours long-term healthcare relationships across the perinatal period. These results can help to support and further enable the effective implementation of BFHI and BFCI globally.
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Affiliation(s)
- Aisling Walsh
- RCSI, University of Medicine and Health Sciences, Dublin, Ireland.
| | | | | | - Ellen Chirwa
- Kamuzu University of Health Sciences, Blantyre, Malawi
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Al-Thubaity DD, Alshahrani MA, Elgzar WT, Ibrahim HA. Determinants of High Breastfeeding Self-Efficacy among Nursing Mothers in Najran, Saudi Arabia. Nutrients 2023; 15:nu15081919. [PMID: 37111138 PMCID: PMC10145845 DOI: 10.3390/nu15081919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Many factors have been found to correlate with satisfactory Exclusive Breastfeeding (EBF) practices. The relationships between EBF practices and associated factors are complex and multidimensional; Breastfeeding Self-Efficacy (BSE) is the most important psychological factor that may help the mother to overcome any expected barriers. This study investigates the determinants of high breastfeeding self-efficacy among Saudi nursing mothers. METHODS This is a descriptive cross-sectional study investigating the determinant of BSE among 1577 nursing mothers in primary health centers in Najran City, Saudi Arabia. The study uses a cluster random sampling technique. Data collection was performed from June 2022 to January 2023 using a self-reported questionnaire that encompasses the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), Gender Friendly Breastfeeding Knowledge Scale (GFBKS), Iowa Infant Feeding Attitude Scale (IIFAS), and a basic data questionnaire to assess women's demographic factors and obstetric history. RESULTS The mean score for all BSES-SF items was between 3.23-3.41, the highest mean score was in mothers who felt comfortable breastfeeding with family members present (3.41 ± 1.06), and the lowest mean was in mothers who could breastfeed their baby without using formula as a supplement (3.23 ± 0.94). The overall BSE score was high among 67% of the study participants. Binary logistic regression showed that being a housewife, being highly educated, having breastfeeding experience, and being multiparous are positive predictors for high BSE (p ≤ 0.001). In addition, having adequate breastfeeding knowledge and positive breastfeeding attitudes were positively associated with higher BSE (p = 0.000). CONCLUSION BSE can be predicted by modifiable predictors such as mothers' education, working status, parity, breastfeeding experience, adequate breastfeeding knowledge, and positive attitudes toward breastfeeding. If such predictors are considered during breastfeeding-related educational interventions, it could lead to more effective and sustainable effects in community awareness regarding breastfeeding.
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Affiliation(s)
- DaifAllah D Al-Thubaity
- Department of Maternity and Childhood Nursing, Nursing College, Najran University, Najran 66441, Saudi Arabia
| | - Mohammed A Alshahrani
- Department of Clinical Laboratory Sciences, Applied Medical Sciences College, Najran University, Najran 66441, Saudi Arabia
| | - Wafaa T Elgzar
- Department of Maternity and Childhood Nursing, Nursing College, Najran University, Najran 66441, Saudi Arabia
- Department of Obstetrics and Gynecologic Nursing, Nursing College, Damanhour University, Damanhour 22514, Egypt
| | - Heba A Ibrahim
- Department of Maternity and Childhood Nursing, Nursing College, Najran University, Najran 66441, Saudi Arabia
- Department of Obstetrics and Woman Health Nursing, Benha University, Benha 13511, Egypt
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Mäkelä H, Axelin A, Kolari T, Niela-Vilén H. Exclusive breastfeeding, breastfeeding problems, and maternal breastfeeding attitudes before and after the baby-friendly hospital initiative: A quasi-experimental study. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 35:100806. [PMID: 36521260 DOI: 10.1016/j.srhc.2022.100806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/02/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Breastfeeding practices remain globally suboptimal despite many known maternal and neonatal health benefits and the Baby-Friendly Hospital Initiative as a global effort to support breastfeeding. OBJECTIVE We aimed to evaluate the effects of the implementation of the Baby-Friendly Hospital Initiative for a proportion of mothers who exclusively breastfed during a 6-month period, including breastfeeding problems, and maternal breastfeeding attitudes. METHODS Using a quasi-experimental non-equivalent two-group design, we recruited two independent samples of postpartum mothers in a maternity hospital to compare the situation before (N = 162) and after (N = 163) the implementation. We measured breastfeeding status and possible breastfeeding problems via text-message questions at 2 weeks, 1, 4 and 6 months after birth. We measured Mothers' attitudes toward breastfeeding at the maternity hospital and 4 months after birth using the Iowa Infant Feeding Attitude Scale. RESULTS The implementation of the Baby-Friendly Hospital Initiative had no effect on the proportion of mothers who exclusively breastfed, and we found no significant differences in exclusive breastfeeding at 6 months (41.3 % vs 52.9 %, p =.435). The intervention did not influence the reported number of breastfeeding problems (p =.260) or maternal breastfeeding attitudes (p =.354). More favourable breastfeeding attitudes (p <.001) and less problematic breastfeeding (p <.001) were associated positively with exclusive breastfeeding. CONCLUSION Exclusive breastfeeding rates did not increase after the intervention; however, the rates at baseline were already high. Ensuring the Baby-Friendly Hospital Initiative practices through pre- and postnatal periods and preparing mothers to manage common breastfeeding problems might improve breastfeeding rates. This trial was registered (0307-0041) with ClinicalTrials.gov on 03/03/2017.
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Affiliation(s)
- Heli Mäkelä
- University of Turku, Department of Nursing Science, Turku, Finland; Satakunta Hospital District, Satasairaala, Pori, Finland.
| | - Anna Axelin
- University of Turku, Department of Nursing Science, Turku, Finland
| | - Terhi Kolari
- University on Turku, Department of Biostatistics, University of Turku, Turku, Finland
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Alahmed S, Meedya S, Mutair AA, Fernandez R. Saudi Women's Breastfeeding Knowledge, Attitude, and Practices: A Systematic Review and Meta-analysis. J Transcult Nurs 2023; 34:68-82. [PMID: 36239560 DOI: 10.1177/10436596221129228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Despite the health benefits of breastfeeding, Saudi women do not exclusively breastfeed their babies. The purpose of this article was to synthesize Saudi women's breastfeeding knowledge, attitude, and practices and identify the factors that women reported for their breastfeeding cessation. METHODOLOGY A systematic review and meta-analysis of randomized clinical trials and cross-sectional studies was undertaken. RESULTS Saudi women reported poor knowledge in managing breastfeeding challenges and had a positive attitude toward formula feeding. Giving premade formula and sugar water was a common practice. The breastfeeding initiation rate (31.5%, 95% confidence interval [CI]: [22%, 41.8%]) and exclusive breastfeeding at 6 months were low (15.15, 95% CI: [8%, 24%]). Perceived low milk supply, returning to work, and using contraception were the main reasons for early breastfeeding cessation. DISCUSSION The integration of Islamic, political, and economic cultures in Saudi Arabia can influence women's breastfeeding practices. There is a need for culturally appropriate breastfeeding educational programs for Saudi women.
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Affiliation(s)
- Salma Alahmed
- University of Wollongong, NSW, Australia.,King Saud University, Riyadh, Saudi Arabia
| | | | - Abbas Al Mutair
- University of Wollongong, NSW, Australia.,Almoosa Specialist Hospital, Al Mubarraz, Saudi Arabia.,Princess Nourah Bent Abdulrahman University, Riyadh, Saudi Arabia
| | - Ritin Fernandez
- University of Wollongong, NSW, Australia.,Joanna Briggs Centre of Excellence, Wollongong, NSW, Australia
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Lojander J, Mäkelä H, Niela-Vilén H. Maternal perceptions and experiences of breastfeeding support in Baby-Friendly hospitals: An integrative review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100105. [PMID: 38745604 PMCID: PMC11080567 DOI: 10.1016/j.ijnsa.2022.100105] [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: 03/09/2022] [Revised: 09/10/2022] [Accepted: 10/04/2022] [Indexed: 11/05/2022] Open
Abstract
Background The Baby-Friendly Hospital Initiative aims to improve breastfeeding by implementing the Ten Steps to Successful Breastfeeding (Ten Steps) into routine breastfeeding support in birth hospitals. Maternal perspective to breastfeeding support is important to consider as mothers and their infants are in the center of that support. Objectives To review and synthesize the existing literature on maternal perceptions and experiences of breastfeeding support in Baby-Friendly hospitals. A sub-aim was to describe differences in breastfeeding support between Baby-Friendly hospitals and non-Baby-Friendly hospitals from maternal perspective. Data sources and review methods An integrative literature review. A systematic literature search was conducted in October 2021 in five databases: PubMed, CINAHL, Cochrane, Scopus, Web of Science. Original peer-reviewed studies published in English exploring maternal viewpoints on breastfeeding support in Baby-Friendly hospitals were included. Two reviewers independently screened the titles (n=914), abstracts (n=226), and full texts (n=47). The review comprised of seventeen studies and includes both quantitative studies (n=14) and qualitative studies (n=3). Inductive content analysis and descriptive synthesis were conducted. Results Most studies (n=14) measured hospitals' compliance with the Ten Steps practices from maternal perspective. Mothers were provided with breastfeeding information and encouragement, however, a qualitative finding indicated that information focused on positive aspects of breastfeeding. Early skin-to-skin contact between the mother and infant was well facilitated although often not lasting more than 30 min. Breastfeeding was facilitated by practical support but according to findings of two qualitative studies, support was not always adequate to address mothers' problems with breastfeeding. Most mothers were exclusively breastfeeding during the hospital stay and no supplemental milk was offered to infant. Mothers were roomed-in together with their infant and were mostly encouraged to breastfeed on demand. Differences between Baby-Friendly hospitals and non-Baby-Friendly hospitals were observed particularly for steps 6 and 9: supplementary feeding and pacifier use were less common in Baby-Friendly hospitals. Conclusions From the maternal perspective, breastfeeding support in the Baby-Friendly hospitals was mainly but not completely in adherence with the Ten Steps practices. Low compliance with some of the Ten Steps indicates a need for a more frequent assessment of the breastfeeding support practices and consideration of strategies facilitating a more sustainable implementation of the initiative. Regardless of some shortcomings with the breastfeeding support, mothers were mainly satisfied with the support in the hospital. Mothers in the Baby-Friendly hospitals perceived that breastfeeding support was more adherent to the Ten Steps compared to mothers in non-Baby-Friendly hospitals.
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Affiliation(s)
- Jaana Lojander
- Department of Nursing Science, University of Turku, 20014, Finland
| | - Heli Mäkelä
- Department of Nursing Science, University of Turku, 20014, Finland
- Satakunta Hospital District, Satasairaala, Pori, Finland
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Alghamdi K. Saudi Hospitals Compliance With the (Baby-Friendly Hospitals Initiative) Evaluation Study. Cureus 2022; 14:e27914. [PMID: 36110481 PMCID: PMC9464353 DOI: 10.7759/cureus.27914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction National surveys from Saudi Arabia have shown that the breastfeeding rate in Saudi Arabia is lagging behind the global recommendations. The UNICEF and WHO have launched the 10-step Baby-Friendly Hospital Initiative (BFHI) for encouraging healthcare facilities across the world to support breastfeeding in a better way. In this study, we validated the Arabic version of the self-appraisal and monitoring tool based on the BFHI as well as assessed the determinants of breastfeeding practice in Saudi Arabia. Methods This was an analytical cross-sectional study. We used the free validated tool-Questionnaire for Breastfeeding Mother based on the BFHI Session 4.2 Guidelines. The tool was translated and validated in Arabic. A nonprobability sample included mothers of children based on the following inclusion criteria: 1) mothers living in Saudi Arabia; 2) mothers of children aged 0-12 months. The Arabic version was modified into six parts, and the questionnaire was left open for respondents for a period of six months. Descriptive statistics were performed using the Statistical Package for the Social Sciences, version 21 (IBM Corp., Armonk, NY). Results The sample size was 584, and during prenatal visits, 23.6% of mothers were provided with information about skin-to-skin contact immediately after childbirth. Of these, 40% started breastfeeding immediately and 43% were encouraged to breastfeed postnatally. On discharge, 34.6% of mothers received help for feeding-related issues. Conclusion Our hospitals are well set to adopt the BFHI in terms of policy making and coordinated postnatal care. However, prenatal care should be more focused on promoting breastfeeding. Massive and coordinated quality improvement steps are highly indicated to completely implement the initiative.
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Lojander J, Axelin A, Bergman P, Niela-Vilén H. Maternal perceptions of breastfeeding support in a birth hospital before and after designation to the Baby-Friendly Hospital Initiative: A quasi-experimental study. Midwifery 2022; 110:103350. [DOI: 10.1016/j.midw.2022.103350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 01/24/2022] [Accepted: 04/20/2022] [Indexed: 10/18/2022]
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Scoping Review of Baby-Friendly Hospital Initiative Compliance and Breastfeeding Initiation in Sri Lanka. J Obstet Gynecol Neonatal Nurs 2022; 51:153-165. [DOI: 10.1016/j.jogn.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 11/22/2022] Open
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Shahrani ASA, Hushan HM, Binjamaan NK, Binhuwaimel WA, Alotaibi JJ, Alrasheed LA. Factors associated with early cessation of exclusive breast feeding among Saudi mothers: A prospective observational study. J Family Med Prim Care 2021; 10:3657-3663. [PMID: 34934662 PMCID: PMC8653446 DOI: 10.4103/jfmpc.jfmpc_852_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/22/2021] [Accepted: 07/04/2021] [Indexed: 12/01/2022] Open
Abstract
CONTEXT World Health Organization recommending initiation of breastfeeding within hour of birth, exclusive breastfeeding for the first 6 months. In Saudi Arabia, there is a paucity of studies on the factors associated with early cessation of exclusive breastfeeding. AIMS We aimed to assess the exclusive breastfeeding rates and to identify the risk factors for early breastfeeding cessation at maternal and institutional levels. SETTINGS AND DESIGN A prospective observational study carried out at King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia. METHODS AND MATERIALS It included all postpartum women who had given birth to full term, singleton, healthy newborns, and were breastfeeding before discharge. Data were collected before discharge, 2 weeks, and 8 weeks postpartum using an adapted instrument. STATISTICAL ANALYSIS Using JMP14 software with appropriate statistical tests. RESULTS The study included 136 mothers, of whom 37.5% were exclusively breastfeeding in the first 2 weeks; this rate dropped to 19% with a statistically significant difference (P < 0.0001). Early breastfeeding cessation was significantly associated with maternal age, health status, mother's knowledge, and attitude, in addition to other modifiable factors that was encountered during hospital stay such as latching difficulties and introduction of formula feeding. CONCLUSIONS This study reported low exclusive breastfeeding rates in the first 2 months postpartum among Saudi mothers. Multiple factors were associated with breastfeeding, and some are modifiable. Breastfeeding promotion and support for is a critical role required from healthcare workers in all settings, including primary health care. Healthcare professionals play a major role in promoting, protecting, and supporting exclusive breastfeeding.
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Affiliation(s)
- Abeer Salem Al Shahrani
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Hessah Mamdouh Hushan
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Noura Khalid Binjamaan
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Wajd Abdulrahman Binhuwaimel
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Jawaher Jazaa Alotaibi
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Lama Ali Alrasheed
- Health Sciences Research Center, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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Clermont A, Gemayel JE, Hammoud R, Wang J, Beciu H, Sinno M, Berends W, Rosenblum N, Bienstock JL, Byrnes K, Samuels R. Effects of a 'Baby-Friendly Hospital Initiative' on exclusive breastfeeding rates at a private hospital in Lebanon: an interrupted time series analysis. BMC Pregnancy Childbirth 2021; 21:385. [PMID: 34011312 PMCID: PMC8132377 DOI: 10.1186/s12884-021-03816-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 04/20/2021] [Indexed: 11/28/2022] Open
Abstract
Background Exclusive breastfeeding (EBF) through six months of age has been scientifically validated as having a wide range of benefits, but remains infrequent in many countries. The WHO/UNICEF Baby-Friendly Hospital Initiative (BFHI) is one approach to improve EBF rates. Methods This study documents the implementation of BFHI at Clemenceau Medical Center (CMC), a private hospital in Lebanon, and analyzes data on EBF practices among CMC’s patients before, during, and after the implementation period. The process of launching the BFHI at CMC is discussed from the perspective of key stakeholders using the SQUIRE guidelines for reporting on quality improvement initiatives. As an objective measure of the program’s impact, 2,002 live births from July 2015 to February 2018 were included in an interrupted time series analysis measuring the rates of EBF at discharge prior to, during, and following the bundle of BFHI interventions. Results The steps necessary to bring CMC in line with the BFHI standards were implemented during the period between November 2015 and February 2016. These steps can be grouped into three phases: updates to hospital policies and infrastructure (Phase 1); changes to healthcare staff practices (Phase 2); and improvements in patient education (Phase 3). The baseline percentage of EBF was 2.4 % of all live births. Following the BFHI intervention, the observed monthly change in EBF in the “Follow-Up” period (i.e., the 24 months following Phases 1–3) was significantly increased relative to the baseline period (+ 2.0 % points per month, p = 0.006). Overall, the observed rate of EBF at hospital discharge increased from 2.4 to 49.0 % of all live births from the first to the final month of recorded data. Conclusions Meeting the BFHI standards is a complex process for a health facility, requiring changes to policies, practices, and infrastructure. Despite many challenges, the results of the interrupted time series analysis indicate that the BFHI reforms were successful in increasing the EBF rate among CMC’s patients and sustaining that rate over time. These results further support the importance of the hospital environment and health provider practices in breastfeeding promotion, ultimately improving the health, growth, and development of newborns. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03816-3.
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Affiliation(s)
- Adrienne Clermont
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Josianne El Gemayel
- Department of Obstetrics and Gynecology, Clemenceau Medical Center, Clemenceau St, Beirut, Lebanon
| | - Rola Hammoud
- Department of Quality Management, Clemenceau Medical Center, Clemenceau St, Beirut, Lebanon
| | - Jiangxia Wang
- Department of Biostatistics, Johns Hopkins Biostatistics Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Mona Sinno
- Department of Obstetrics and Gynecology, Clemenceau Medical Center, Clemenceau St, Beirut, Lebanon
| | - Wilma Berends
- Johns Hopkins Medicine International, Baltimore, MD, USA
| | - Nadine Rosenblum
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jessica L Bienstock
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kristen Byrnes
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Roger Samuels
- Johns Hopkins Medicine International, Baltimore, MD, USA. .,Department of Medicine, Division of Pulmonary/Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Moraes BA, Strada JKR, Gasparin VA, Espirito-Santo LCD, Gouveia HG, Gonçalves ADC. Breastfeeding in the first six months of life for babies seen by Lactation Consulting. Rev Lat Am Enfermagem 2021; 29:e3412. [PMID: 33852684 PMCID: PMC8040780 DOI: 10.1590/1518-8345.3538.3412] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 08/10/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to identify breastfeeding patterns, survival of exclusive breastfeeding and factors associated with its interruption, in the first six months of life of babies seen by Lactation Consulting. METHOD a prospective cohort, with 231 mother-babies in a Baby-Friendly Hospital. An initial questionnaire was applied after 24 hours of birth, after consulting, as well as a follow-up questionnaire, applied by telephone at 15, 30, 60, 120 and 180 days, with sociodemographic and obstetric variables, maternal habits, father's schooling, birth data and baby feeding. Survival Analysis was carried out. RESULTS at 180 days of age, exclusive breastfeeding was 12.7% and the probability was 19.6% in the analysis of the survival curve. The factors associated with its interruption were smoking during pregnancy (HR 1.66; CI 1.05 - 2.61), age ≥ 35 years old (HR 1.73; CI 1.03 - 2.90), difficulty in breastfeeding after hospital discharge (HR 2.09; CI 1.29 - 3.41), search for professional assistance (HR 2.45; CI 1.69 - 3.54) and use of a pacifier (HR 1.76; IC 1.21 - 2.58). CONCLUSION lactation consultancy contributed to the improvement of the exclusive breastfeeding rates, although there are opportunities for advances.
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Affiliation(s)
- Bruna Alibio Moraes
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | | | - Vanessa Aparecida Gasparin
- Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
- Universidade do Estado de Santa Catarina, Departamento de Enfermagem, Chapecó, SC, Brazil
| | | | - Helga Geremias Gouveia
- Universidade Federal do Rio Grande do Sul, Departamento de Enfermagem Materno Infantil, Porto Alegre, RS, Brazil
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15
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Dadich A, Piper A, Coates D. Implementation science in maternity care: a scoping review. Implement Sci 2021; 16:16. [PMID: 33541371 PMCID: PMC7860184 DOI: 10.1186/s13012-021-01083-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 01/11/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Despite wide recognition that clinical care should be informed by the best available evidence, this does not always occur. Despite a myriad of theories, models and frameworks to promote evidence-based population health, there is still a long way to go, particularly in maternity care. The aim of this study is to appraise the scientific study of methods to promote the systematic uptake of evidence-based interventions in maternity care. This is achieved by clarifying if and how implementation science theories, models, and frameworks are used. METHODS To map relevant literature, a scoping review was conducted of articles published between January 2005 and December 2019, guided by Peters and colleagues' (2015) approach. Specifically, the following academic databases were systematically searched to identify publications that presented findings on implementation science or the implementation process (rather than just the intervention effect): Business Source Complete; CINAHL Plus with Full Text; Health Business Elite; Health Source: Nursing/Academic Edition; Medline; PsycARTICLES; PsycINFO; and PubMed. Information about each study was extracted using a purposely designed data extraction form. RESULTS Of the 1181 publications identified, 158 were included in this review. Most of these reported on factors that enabled implementation, including knowledge, training, service provider motivation, effective multilevel coordination, leadership and effective communication-yet there was limited expressed use of a theory, model or framework to guide implementation. Of the 158 publications, 144 solely reported on factors that helped and/or hindered implementation, while only 14 reported the use of a theory, model and/or framework. When a theory, model or framework was used, it typically guided data analysis or, to a lesser extent, the development of data collection tools-rather than for instance, the design of the study. CONCLUSION Given that models and frameworks can help to describe phenomenon, and theories can help to both describe and explain it, evidence-based maternity care might be promoted via the greater expressed use of these to ultimately inform implementation science. Specifically, advancing evidence-based maternity care, worldwide, will require the academic community to make greater explicit and judicious use of theories, models, and frameworks. REGISTRATION Registered with the Joanna Briggs Institute (registration number not provided).
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Affiliation(s)
- Ann Dadich
- Western Sydney University, School of Business, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Annika Piper
- Western Sydney University, School of Business, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Dominiek Coates
- University of Technology Sydney, Broadway, PO Box 123, Ultimo, NSW, 2007, Australia
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Aldalili AYA, El Mahalli AA. Research Title: Factors Associated with Cessation of Exclusive Breastfeeding. J Multidiscip Healthc 2021; 14:239-246. [PMID: 33564240 PMCID: PMC7866906 DOI: 10.2147/jmdh.s277819] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/12/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The study aimed to determine the prevalence of exclusive breastfeeding (EBF), measure the association between EBF and sociodemographic and obstetric characteristics of lactating mothers, and determine challenges of EBF. Methods The study was cross-sectional and was conducted in four primary health care centres (PHCCs) at Alehsa region in Saudi Arabia (SA). Lactating mothers coming to vaccinate their babies (0–6 months) were recruited. Sample size totalled 372, where 93 were randomly selected from each centre. Sociodemographic and obstetric characteristics of participants, breastfeeding (BF) status, and challenges of EBF were collected. Basic univariate descriptive statistics were conducted to explore the sociodemographic and obstetric characteristics, BF status and challenges of BF. Bivariate analyses were done to explore the association between the dependent and independent variables. Binary logistic regression models were then executed. A 2-tailed p-value < 0.05 was considered significant. Results EBF rate was nearly 60%. Cessation of EBF was associated with younger age, inconvenience/fatigue due to BF, sore breasts or nipples/too painful, perceived low milk quantity, BF skills were not effective, maternal choice, and baby-centred factors. Conclusion and Recommendations EBF was associated with problems/difficulties in BF technique. It is recommended that health care professionals like doctors, nurses, and midwives should train mothers during and after pregnancy regarding BF technique or pumping breast milk in case of BF difficulties, improve mothers’ confidence about the ability to breastfeed and enhance mothers’ knowledge on the normal process of lactation. Secondly, it is the role of policymakers to ensure implementation of Baby-Friendly Hospital Initiative (BFHI) guidelines in hospitals to meet the WHO’s global target of infants being exclusively breastfed until six months of age.
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Affiliation(s)
| | - Azza Ali El Mahalli
- Department of Public Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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17
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Jerin I, Akter M, Talukder K, Talukder MQEK, Rahman MA. Mobile phone support to sustain exclusive breastfeeding in the community after hospital delivery and counseling: a quasi-experimental study. Int Breastfeed J 2020; 15:14. [PMID: 32131865 PMCID: PMC7057619 DOI: 10.1186/s13006-020-00258-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 02/21/2020] [Indexed: 11/27/2022] Open
Abstract
Background Rapid increases in hospital and cesarean deliveries threaten an already falling exclusive breastfeeding rate (EBR) in Bangladesh. There is neither a sustained Baby-Friendly Hospital Initiative (BFHI) nor any community support for breastfeeding mothers. Our aim was to find out whether breastfeeding support after hospital delivery and subsequently by mobile phone at home is effective in improving EBR in infants under six-months of age. Methods A quasi-experimental study was carried out in 2010 at the Centre for Woman and Child Health (CWCH), Savar, Bangladesh. A total of 129 mothers delivered at CWCH were recruited in pre-intervention phase and their infants followed up between 0 and 5 months of age in the community for exclusive breastfeeding (EBF), anthropometry and illness. An intervention package was then implemented with postpartum support for first hour breastfeeding initiation, correction of position and attachment and face-to-face counseling in hospital followed by mobile phone support by two trained Research Assistants once every 15 days after discharge up to six months of age. During the intervention phase, 164 pregnant women delivered at CWCH were recruited and followed up as in the pre-intervention phase. Results In the pre-intervention phase among 114 infants, 66 (58%) were found to be exclusively breastfed. In the intervention phase among 151 infants, 118 (78%) were exclusively breastfed (p = 0.000). In the pre-intervention phase EBR at less than one month and five months were 85 and 42% as in the intervention phase these EBR were 89 and 71% respectively. Wasting (weight-for-height Z-score < − 2.00), stunting (height-for-age Z-score < − 2.00), and underweight (weight-for-age Z-score < − 2.00) was 17 (15%), 7 (6%), and 14 (13%) respectively in the pre-intervention phase. In the intervention phase wasting, stunting, and underweight was 16 (11%), 16 (11%), and 15 (10%) respectively. Therefore, there was no statistically significant differences in nutritional status of the infants in the two phases. There was also no significant differences in child morbidity (pneumonia and diarrhea) between the two phases. Conclusion A combination of hospital support and mobile phone counseling in the community sustained higher rates of EBF in the community after hospital delivery.
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Affiliation(s)
- Iftia Jerin
- Centre for Woman and Child Health (CWCH), Savar, Dhaka, 1349, Bangladesh.,Nutrition International, Gulshan, Dhaka, 1212, Bangladesh
| | - Monira Akter
- Centre for Woman and Child Health (CWCH), Savar, Dhaka, 1349, Bangladesh.
| | - Khurshid Talukder
- Centre for Woman and Child Health (CWCH), Savar, Dhaka, 1349, Bangladesh
| | | | - Mohammad Abdur Rahman
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
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18
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Abdulghani N, Edvardsson K, Amir LH. Health care providers’ perception of facilitators and barriers for the practice of skin-to-skin contact in Saudi Arabia: A qualitative study. Midwifery 2020; 81:102577. [DOI: 10.1016/j.midw.2019.102577] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 10/23/2019] [Accepted: 11/16/2019] [Indexed: 12/13/2022]
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The effect of maternal health service utilization in early initiation of breastfeeding among Nepalese mothers. Int Breastfeed J 2019; 14:33. [PMID: 31384286 PMCID: PMC6668139 DOI: 10.1186/s13006-019-0228-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 07/22/2019] [Indexed: 11/10/2022] Open
Abstract
Background The World Health Organization (WHO) recommends early initiation of breastfeeding and exclusive breastfeeding for six months. Understanding the association of maternal health services and early initiation of breastfeeding might be useful on prioritizing the health services to promote early breastfeeding practices. The purpose of this study was to examine the association between utilization of maternal health services and early initiation of breastfeeding among Nepalese mothers. Methods Nationally representative data from the 2016 Nepal Demographic Health Survey (NDHS) was used to determine the association between early initiation of breastfeeding and variables related to maternal health services utilization. Association was measured by using Chi-square test followed by calculation of adjusted odds ratio (AOR) and 95% confidence intervals (CI) using multivariable logistic regression analysis. Results Out of 1,978 children, 55% were breastfed within an hour of birth. Early initiation of breastfeeding was associated among mothers who delivered at the health facilities (AOR 2.22; 95% CI 1.36, 3.60). Mothers who had a vaginal birth (AOR 6.70; 95% CI 4.30, 10.42) were significantly more likely to breastfeed within an hour of birth compared to mothers who had caesarean delivery. The odds of initiating early breastfeeding were higher among mothers from Province 5 (AOR 1.59; CI 1.02, 2.48), Province 6 (AOR 2.58; 95% CI 1.41,4.69) and Province 7 (AOR 2.30; CI 1.36, 3.87). Conclusions Health facility delivery and a vaginal delivery were strongly associated with early initiation of breastfeeding. It is vital to intensify maternal health service up to the community to aware pregnant women to utilize maternal health services to improve breastfeeding practices. Skilled Birth Attendant (SBA) training should include comprehensive breastfeeding counselling package to motivate mothers to initiate early breastfeeding especially for mothers having caesarean delivery.
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20
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Ahmed AE, Salih OA. Determinants of the early initiation of breastfeeding in the Kingdom of Saudi Arabia. Int Breastfeed J 2019; 14:13. [PMID: 30984282 PMCID: PMC6444675 DOI: 10.1186/s13006-019-0207-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 03/20/2019] [Indexed: 11/25/2022] Open
Abstract
Background National surveys in the Kingdom of Saudi Arabia continue to show rates of breastfeeding below global recommendations. Delay of timely or early initiation of breastfeeding is common in the community. Current approaches are not addressing the major constraints. Objectives of this study were to study the pattern and determinants associated with the early and delayed initiation of breastfeeding practices among infants aged less than 24 months. Also to assess regional differences to facilitate targeted actions. Methods This cross-sectional study was conducted from May to August 2016, based on a sample of 1700 mothers of children aged less than 24 months. The sample was randomly selected from over 165 health centers distributed across the country, at least 33 centers in each of the five geographical regions. World Health Organization standardized questionnaire for infant and young child feeding indicators was used to prepare structured questionnaire (in English translated later to Arabic) to collect the information on breastfeeding along with general sociodemographic data. Results The breastfeeding initiation rate was 97.3% (1559/1700 mothers). Only 8.3% (141) of mothers never breastfeed their children. Early initiation of breastfeeding within 1 h of birth was 43.6% (742) among all mothers surveyed while, breastfeeding initiation rates for 1-24 h and that for more than 24 h were 27 and 21% respectively. The overall prevalence of early initiation of breastfeeding (43.6%) is considered ‘fair’. Regional variation showed poor prevalence 26% (79/300 mothers) in Northern region; fair 38.4% (192/500 mothers), 45% (135/300 mothers), 49% (148/300 mothers) in the Central, Western and Eastern regions respectively; and good 63% (188/300 mothers) in the Southern region. Significant associations were indicated between early initiation of breastfeeding and mode of delivery, knowledge of the mother about the right time for early initiation, receipt of breastfeeding information, the region of residence, and educational level of the mother. Conclusion Whilst some barriers to breastfeeding initiation manifest similarity across the regions some factors were context-specific thus, tailored interventions are imperative. Appropriate behavior change interventions, are needed attain optimal breastfeeding practices.
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Affiliation(s)
- Adam E Ahmed
- 1College of Agriculture and Food Sciences, King Faisal University, Al-Hafouf, Kingdom of Saudi Arabia.,2Department of Agribusiness and Consumer Sciences, University of Khartoum, Shambat, Sudan
| | - Osama A Salih
- 3Department of Community Health, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
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21
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Alnasser Y, Almasoud N, Aljohni D, Almisned R, Alsuwaine B, Alohali R, Almutairi O, Alhezayen R. Impact of attitude and knowledge on intention to breastfeed: Can mHealth based education influence decision to breastfeed exclusively? Ann Med Surg (Lond) 2018; 35:6-12. [PMID: 30258626 PMCID: PMC6153120 DOI: 10.1016/j.amsu.2018.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 09/06/2018] [Accepted: 09/12/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Exclusive breastfeeding has been endorsed as the healthiest feeding choice for newborns. This study aims to assess impact of expecting mothers' knowledge and attitude toward intention to breastfeed exclusively. Utilizing mobile health (mHealth) as educational tool can offer a widely distributed and affordable platform to promote exclusive breastfeeding. RESEARCH AIMS AND QUESTIONS This study aims to assess impact of expecting mothers' knowledge, attitude and beliefs on decision to breastfeed exclusively. Furthermore, it purposes mobile health (mHealth) as educational tool offering a widely distributed, affordable and accessible platform to promote exclusive breastfeeding. METHODS The study was conducted in prenatal clinics' waiting areas to interview expecting mothers utilizing a translated version of Infant Feeding Practices Survey II (IFPS II, CDC). After completing the survey, an educational video was shown utilizing a tablet and the question was re-asked about intention toward breastfeeding exclusively. RESULTS Most expecting mothers indicated having some awareness about breastfeeding (67%) but only 46.1% intended to initiate exclusive breastfeeding early in life prior to the intervention. Moreover, only 53.7% believed breastfeeding is the best nutritional choice. Actually, 39.5% of participants considered breastfeeding equal to formula. Most working mothers complained of lack of workplace support to breastfeed. Also, they were not comfortable breastfeeding in front of others except spouse. Additionally, most participants found nurses and media as poor information resources. Resources utilizing social media and Internet were found useful. After watching the educational video, the majority expressed positive intention to breastfeed exclusively (80.8%). Positive intentions were associated with advance maternal age, prior breastfeeding knowledge and willingness to hear experts' opinions. CONCLUSION Saudi women have limited knowledge about exclusive breastfeeding and early initiation. They feel unprepared, unsupported, lack resources and socially challenged. An educational material utilizing mHealth can alter intentions to breastfeed exclusively.
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Affiliation(s)
- Yossef Alnasser
- Pediatric Department, King Saud University, Saudi Arabia
- British Columbia Children Hospital, University of British Columbia, Canada
| | - Nouf Almasoud
- School of Medicine, King Saud University, Saudi Arabia
| | | | | | | | - Rawa Alohali
- School of Medicine, King Saud University, Saudi Arabia
| | - Ohoud Almutairi
- School of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Reem Alhezayen
- Pediatric Department, King Saud University, Saudi Arabia
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22
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Nakano S, Suzuki M, Minowa K, Hirai S, Takubo N, Sakamoto Y, Ishijima M, Hoshino E, Tokita A, Shimizu T. Current Vitamin D Status in Healthy Japanese Infants and Young Children. J Nutr Sci Vitaminol (Tokyo) 2018; 64:99-105. [PMID: 29710038 DOI: 10.3177/jnsv.64.99] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study aimed to characterize serum 25-hydroxyvitamin D (25OH-D) values among Japanese children aged ≤48 mo. The study included 290 healthy infants and young children aged 0-48 mo (males/females=166/124) living in Shizuoka or Tokyo. The subjects were divided into three groups by age (Low Age: 0-5, Middle Age: 6-15, High Age: 16-48 mo). The vitamin D deficient state was defined as 25OH-D <12 ng/mL, the insufficient state as 12-20 ng/mL, and the sufficient state as >20 ng/mL. The seasonal variation of serum 25OH-D levels was also analyzed. The median serum 25OH-D levels in each group were: Low Age (n=50), 19 ng/mL; Middle Age (n=94), 30 ng/mL; and High Age (n=146), 30 ng/mL. The serum 25OH-D level was significantly lower in the Low Age group than in the other groups (p<0.01). Serum 25OH-D levels in summer and autumn (n=149) were significantly higher than in winter and spring (n=141) (33 vs. 25 ng/mL, p<0.01). In the Low Age group, there was a significant difference in serum 25OH-D levels between breast-fed infants (n=26) and formula-fed or mixed-fed infants (n=19) (12 vs. 32 ng/mL, p<0.01). However, there were no significant differences in 25OH-D levels between the two season classifications in either breast-fed or formula-fed and mixed-fed infants. Although clinical symptoms were not available, more than 75% of the breast-fed infants and 14.6% of infants and young children to whom food had been introduced were defined as having a vitamin D deficient or insufficient state. Breastfeeding seems one of the contributing factor to lower serum 25 OH-D levels among infants ≤5 mo of age.
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Affiliation(s)
- Satoshi Nakano
- Department of Pediatrics, Juntendo University Faculty of Medicine
| | | | - Kei Minowa
- Department of Pediatrics, Juntendo University Faculty of Medicine
| | - Saeko Hirai
- Department of Pediatrics, Juntendo University Faculty of Medicine
| | - Noriyuki Takubo
- Department of Pediatrics, Juntendo University Faculty of Medicine
| | - Yuko Sakamoto
- Department of Orthopedic Surgery, Juntendo University Nerima Hospital
| | - Muneaki Ishijima
- Department of Orthopedics Surgery, Juntendo University Faculty of Medicine
| | - Eri Hoshino
- Graduate School of Public Health, St. Luke International University
| | | | - Toshiaki Shimizu
- Department of Pediatrics, Juntendo University Faculty of Medicine
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The uptake and implementation of the Baby Friendly Health Initiative in Australia. Women Birth 2018; 32:e323-e333. [PMID: 30098980 DOI: 10.1016/j.wombi.2018.07.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 06/21/2018] [Accepted: 07/30/2018] [Indexed: 11/24/2022]
Abstract
PROBLEM Despite evidence that implementation of the Initiative has been effective in increasing breastfeeding rates and duration of breastfeeding worldwide; the uptake is low with only 70 Baby Friendly accredited maternity facilities across Australia (approximately 23% of facilities). BACKGROUND The Ten Steps to Successful Breastfeeding and International Code of Marketing of Breastmilk Substitutes shaped the foundation for the Initiative to implement practices that protect, promote and support breastfeeding. There is evidence that implementation of the Initiative is impacted by individual and organisational culture, organisational support, and education. Organisational change is also identified as playing an important role in the successful implementation of the Initiative. Despite policy and guideline support for the Initiative at national and state levels in Australia the uptake of the Initiative is low. AIM The aim of this research was to explore health practitioners' perspectives about the uptake and implementation of the Initiative in Australia. METHODS Semi-structured, face-to-face, telephone and Skype interviews were conducted with 12 health practitioners. Thematic analysis was used to analyse data. RESULTS Participants identified that the uptake and implementation of the Initiative in Australia is complex. This complexity was related to six themes: (1) policy and guideline support for the Initiative, (2) leadership support to implement the Initiative, (3) improving breastfeeding and Initiative-related knowledge, (4) improving communication between stakeholders regarding the Initiative, (5) accreditation and reaccreditation processes, and (6) implementation complexity. CONCLUSION Using organisational change theories as a guide to implementation of the Initiative may be useful for facilities intending to become accredited.
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Azzeh FS, Alazzeh AY, Hijazi HH, Wazzan HY, Jawharji MT, Jazar AS, Filimban AM, Alshamrani AS, Labani MS, Hasanain TA, Obeidat AA. Factors Associated with Not Breastfeeding and Delaying the Early Initiation of Breastfeeding in Mecca Region, Saudi Arabia. CHILDREN-BASEL 2018; 5:children5010008. [PMID: 29301353 PMCID: PMC5789290 DOI: 10.3390/children5010008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 12/29/2017] [Accepted: 12/31/2017] [Indexed: 11/16/2022]
Abstract
The objective of the study was to find the determinants related to not breastfeeding (BF) and others related to the delay in the early initiation of BF in the Mecca region, Saudi Arabia. A cross-sectional study in the Maternity and Children Hospital and primary healthcare centers was performed. A questionnaire was filled by dietitians to 814 asymptomatic Saudi mothers. Determinants related to not BF and the delay in the early initiation of BF were determined by binary logistic regression, and the odds ratio (OR) and 95% confidence interval (CI) were determined. Significant factors associated with not BF were not rooming-in infants in the mother’s room (OR: 2.37; 95% CI: 1.66–3.41) and using a pacifier (OR: 1.62; 95% CI: 1.13–2.33). The most significant determinant of the early initiation of BF was the initiation of bottle feeding (OR: 18.16; 95% CI: 10.51–31.4), followed by not rooming-in infants in the mother’s room (OR: 2.2; 95% CI: 1.52–3.18), initiation of partial feeding (OR: 1.89; 95% CI: 1.3–2.74), uninformed mothers regarding the importance of BF (OR: 1.56; 95% CI: 1.04–2.35), and cesarean sections (OR:1.42; 95% CI: 1.02–1.98). Risk factors affecting BF and the early initiation of BF in Mecca City should be highlighted in national campaigns to increase mothers’ awareness and promote BF practice.
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Affiliation(s)
- Firas S Azzeh
- Department of Clinical Nutrition, Collage of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia.
| | - Awfa Y Alazzeh
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, University of Ha'il, Ha'il 21955, Saudi Arabia.
| | - Haifa H Hijazi
- Department of Clinical Nutrition, Collage of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia.
| | - Haneen Y Wazzan
- Department of Clinical Nutrition, Collage of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia.
| | - Monya T Jawharji
- Department of Clinical Nutrition, Collage of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia.
| | - Abdelelah S Jazar
- Department of Clinical Nutrition, Collage of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia.
| | - Amira M Filimban
- Nutrition General Department, Awareness and Nutrition Education Division, Ministry of Health, Makkah 21955, Saudi Arabia.
| | - Ali S Alshamrani
- Pediatric Department, Maternity and Children Hospital, Makkah 21955, Saudi Arabia.
| | - Mai S Labani
- Medical Nutrition Therapy Department, Maternity and Children Hospital, Makkah 21955, Saudi Arabia.
| | - Taghreed A Hasanain
- Medical Nutrition Therapy Department, Maternity and Children Hospital, Makkah 21955, Saudi Arabia.
| | - Ahmad A Obeidat
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Taibah University, Yanbu 21911, Saudi Arabia.
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Raheel H, Tharkar S. Why mothers are not exclusively breast feeding their babies till 6 months of age? Knowledge and practices data from two large cities of the Kingdom of Saudi Arabia. Sudan J Paediatr 2018; 18:28-38. [PMID: 30166760 PMCID: PMC6113778 DOI: 10.24911/sjp.2018.1.5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 05/07/2018] [Indexed: 11/11/2022]
Abstract
The noble practice of breast feeding is on the decline across the globe. Our objective was to research why women stop feeding their infants before the recommended 6 months of exclusive breast feeding and to assess the mothers' knowledge regarding importance and benefits of breast feeding. A cross-sectional study was conducted in two cities of Riyadh and Dammam using a structured questionnaire to 614 Saudi females in reproductive age group (15-45 years) from February to April 2016. Majority of the respondents were <30 years old, housewives and multiparous. The breast feeding initiation rate was 76% while only 37% continued to exclusively breast feed the infants until 6 months. Mothers of Dammam city showed higher rates of overall breast feeding, higher initiation of breast feeding within 24 hours of delivery and longer duration of breast feeding practices. Mothers older than 30 years (p < 0.014), residents of Dammam city (P < 0.000) and receiving information on breast feeding during antenatal care (P < 0.001) were associated with higher knowledge scores. Residents of Riyadh, working mothers, delayed initiation of breast feeding after 24 hours of giving birth, and those who did not get information on breast feeding during antenatal classes were at higher risk of stopping exclusive breast feeding before 6 months. Regional differences exist with Dammam city having greater awareness and better compliance to breast feeding practices. There is a need to strengthen the education facilities at ANC clinics in Riyadh regarding duration and benefits of breast feeding along with nationwide promotion of breast feeding practices as per guidelines.
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Affiliation(s)
- Hafsa Raheel
- Department of Family and Community Medicine, College Of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Shabana Tharkar
- Prince Sattam Chair for Epidemiology and Public Health Research, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Alzaheb RA. Factors Influencing Exclusive Breastfeeding in Tabuk, Saudi Arabia. CLINICAL MEDICINE INSIGHTS-PEDIATRICS 2017; 11:1179556517698136. [PMID: 28469519 PMCID: PMC5398646 DOI: 10.1177/1179556517698136] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 02/01/2017] [Indexed: 01/06/2023]
Abstract
Background: Breast milk contains all the nutrients infants need for their first 6 months of life. However, only a minority of Saudi Arabian mothers exclusively breastfeed, so the influencing factors must be examined to encourage more to do so. The study aimed to determine the prevalence of exclusive breastfeeding at 6 months and its associated factors in Tabuk, North West Saudi Arabia. Methods: A total of 589 mothers of healthy infants aged between 6 and 24 months were interviewed while attending Well-Baby Clinics within 5 primary health care centers. Interviews deployed a structured questionnaire to collect sociodemographic information and detailed data concerning breastfeeding practices. A logistic regression analysis was then performed on the data to identify the factors independently associated with exclusive breastfeeding practice for infants at 6 months. Results: Exclusive breastfeeding was practiced by 31.4% of mothers for the first 6 months of their infant’s life. The logistic regressions indicated that exclusive breastfeeding at 6 months was less likely to be practiced by working mothers, Saudi nationals, and for babies born via cesarean delivery or at low birth weights. Conversely, the mother’s awareness of the recommended exclusive breastfeeding duration was positively associated with exclusive breastfeeding. Conclusions: Programs promoting 6 months of exclusive breastfeeding should target high-risk groups. Two factors identified by this study are modifiable: working mothers and mothers’ awareness of the exclusive breastfeeding duration recommendation. Strategies to improve exclusive breastfeeding rates should therefore focus on workplace facilities and increasing awareness of the exclusive breastfeeding recommendation.
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Affiliation(s)
- Riyadh A Alzaheb
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia
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