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Costello S, Santillan D, Shelby A, Bowdler N. Skin-to-Skin Contact and Breastfeeding After Planned Cesarean Birth Before and During the COVID-19 Pandemic. Breastfeed Med 2024; 19:166-176. [PMID: 38416483 PMCID: PMC10951620 DOI: 10.1089/bfm.2023.0195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Background: Benefits of early skin-to-skin contact (SSC) between mother and newborn are widely documented, including improved breastfeeding outcomes. While promoting immediate SSC is standard practice for vaginal birth, it happens less often after cesarean birth. It is not known how changes in hospital practices and staffing shortages during the COVID-19 pandemic have influenced the practice of SSC in the operating room (OR). This study aims to identify the relationship between SSC after cesarean birth and breastfeeding and compare SSC before and during the COVID-19 pandemic at a single institution. Materials and Methods: This was a retrospective cohort study of 244 subjects who had scheduled cesarean births during 2019 and 2020. The primary outcome was newborn feeding at hospital discharge. Secondary outcomes were time to initiate breastfeeding, newborn feeding at 4-8-weeks postpartum, and location of SSC initiation in 2019 versus 2020. Results: SSC within 3 days of birth was significantly associated with feeding type on discharge and/or 4-8 weeks postpartum. More subjects intending to exclusively breastfeed met this intention at discharge with SSC in the OR. Newborns who had SSC in the OR had significantly earlier initiation of breastfeeding. There was an increase in SSC in the OR between 2019 (27%) and 2020 (39%). Conclusion: SSC in the OR was associated with improved short-term breastfeeding outcomes in our study. If immediate SSC is not possible, SSC within 3 days of birth may have breastfeeding benefits. The increase in SSC in the OR during the COVID-19 pandemic indicates that SSC practices can be implemented, despite challenging circumstances.
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Affiliation(s)
- Sarah Costello
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Donna Santillan
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Alyssa Shelby
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Noelle Bowdler
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
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Jurgelėnė V, Kuzmickienė V, Stonienė D. The Role of Skin-to-Skin Contact and Breastfeeding in the First Hour Post Delivery in Reducing Excessive Weight Loss. CHILDREN (BASEL, SWITZERLAND) 2024; 11:232. [PMID: 38397344 PMCID: PMC10887814 DOI: 10.3390/children11020232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/01/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND AND AIMS An excessive weight loss (EWL) of >10% after birth is associated with serious health outcomes. The aim of this study was to determine factors that can reduce weight loss in full-term, exclusively breastfed infants after birth. METHODS This is a retrospective, observational, single-center study. We included 642 healthy, full-term, exclusively breastfed neonates born in 2019 in a baby-friendly hospital, and their healthy mothers. The exclusion criteria were as follows: supplementation with formula, multiple pregnancies, and neonates or mothers with health issues. RESULTS The mean percentage of neonatal weight loss after 24 h of life was 5.13%, and that after 48 h was 6.34%. Neonates delivered via a caesarean section lost more weight after 24 and 48 h of life than those delivered via vaginal delivery (p < 0.01). There is a noticeable pattern that neonates tend to lose more weight if they do not get skin-to-skin contact (SSC) and breastfeeding within the first hour after birth (p > 0.05). CONCLUSIONS Neonates born via a CS tend to lose more weight after 24 and 48 h of life. Immediate SSC and breastfeeding in the first hour after delivery may decrease the excessive weight loss.
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Affiliation(s)
- Valentina Jurgelėnė
- Department of Neonatology, Faculty of Medicine, Lithuanian University of Health Sciences, LT44307 Kaunas, Lithuania; (V.J.); (V.K.)
- Department of Neonatology, Hospital of Lithuanian University of Health Sciences (LUHS) Kauno Klinikos, LT50161 Kaunas, Lithuania
| | - Vilma Kuzmickienė
- Department of Neonatology, Faculty of Medicine, Lithuanian University of Health Sciences, LT44307 Kaunas, Lithuania; (V.J.); (V.K.)
- Department of Neonatology, Hospital of Lithuanian University of Health Sciences (LUHS) Kauno Klinikos, LT50161 Kaunas, Lithuania
| | - Dalia Stonienė
- Department of Neonatology, Faculty of Medicine, Lithuanian University of Health Sciences, LT44307 Kaunas, Lithuania; (V.J.); (V.K.)
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Sierra-García E, Saus-Ortega C. [Sense of coherence in breastfeeding women: A scoping review]. An Sist Sanit Navar 2024; 47:e1064. [PMID: 38349139 PMCID: PMC10913710 DOI: 10.23938/assn.1064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/06/2023] [Accepted: 12/12/2023] [Indexed: 02/15/2024]
Abstract
BACKGROUND The establishment of breastfeeding may sometimes be stressful. We aimed to analyze the sense of coherence in lactating women to determine the general resistance resources during lactation and the professional interventions that promote a high sense of coherence. METHODS A search of studies in English, Spanish, or Portuguese on lactating women's sense of coherence was carried out in PubMed, PsycINFO, ScienceDirect, and CINAH databases published between May and November 2022. Study quality and risk of bias were examined according to ICROMS and STROBE criteria. RESULTS We identified 316 studies, of which eight -all of adequate quality- were included, three qualitative and five quantitative. A high level of maternal sense of coherence was related to longer duration, self-efficacy, attachment, and enjoyment of the breastfeeding experience. The main general resistance resources were to receive social support, particularly from partners, mothers, and health professionals. The interventions that favored the sense of coherence were mainly those related to a close, empathic, personalized, comprehensive, and family-centered professional support. CONCLUSIONS The detection of the level of sense of coherence in lactating mothers may help identify women with a higher risk of weaning and establish professional intervention strategies that improve the breastfeeding experience.
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Affiliation(s)
| | - Carlos Saus-Ortega
- Escuela de Enfermería La Fé, Centro adscrito a la Universitat de València. València, España..
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Stephan Y, Müller HH, Kühnert M, Meinhold-Heerlein I, Ibrahimi G, Reitz M, Schemmann H, Oehmke F, Köhler S, Renz H. The effect of early skin-to-skin contact after cesarean section on breastfeeding duration and development of atopic-allergic diseases. Eur J Midwifery 2024; 8:EJM-8-04. [PMID: 38269325 PMCID: PMC10807137 DOI: 10.18332/ejm/176213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION Breastfeeding to strengthen the immune system suggests allergy prevention as a possible option. The connection between breastfeeding and the development of atopic-allergic diseases is being discussed. The primary aim of this work was to investigate an association of the first early skin-to-skin contact following cesarean section with the development of atopic diseases within the 1st year of life. METHODS The present study was conducted as a bicentric prospective cohort study in central Germany with a 15-month recruitment period. Data collection was by telephone interviews with a follow-up of 12 months. The statistical evaluation procedure was based on a hierarchical test of the association of early skin-to-skin contact between mother and child with the two main outcome measures. The primary outcome is the duration of breastfeeding. The second outcome is the onset of atopic-allergic disease within the 1st year of life. RESULTS Mothers breastfed longer if they had skin-to-skin contact within the first 30 minutes postpartum [χ²(df=5) = 19.020, p=0.002], if they breastfed their newborns early immediately after birth (p<0.001), and if the first skin-to-skin contact lasted more than one hour [χ²(df=4) = 19.617, p<0.001]. Regarding atopic-allergic diseases, no significant effects of skin-to-skin contact were found in relation to disease development. Regarding breastfeeding, no significant effects of atopic-allergic diseases could be detected either. CONCLUSIONS The results of this study reflect the benefits of skin-to-skin contact in the context of breastfeeding and atopic disease. The current scientific knowledge regarding skin contact and the development of atopic-allergic diseases should be extended and deepened.
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Affiliation(s)
- Yvonne Stephan
- Institute of Laboratory Medicine and Pathobiochemistry Molecular Diagnostics, Philipps University Marburg, Marburg, Germany
- Faculty of Health, Technische Hochschule Mittelhessen, University of Applied Sciences, Giessen, Germany
| | - Hans-Helge Müller
- Institute of Laboratory Medicine and Pathobiochemistry Molecular Diagnostics, Philipps University Marburg, Marburg, Germany
| | - Maritta Kühnert
- Department of Obstetrics and Gynecology, Division of Obstetrics, University Hospital Giessen and Marburg GmbH, Marburg, Germany
| | - Ivo Meinhold-Heerlein
- Department of Obstetrics and Gynecology, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Gentiana Ibrahimi
- Department of Obstetrics and Gynecology, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Maleen Reitz
- Department of Obstetrics and Gynecology, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Hannah Schemmann
- Institute of Laboratory Medicine and Pathobiochemistry Molecular Diagnostics, Philipps University Marburg, Marburg, Germany
| | - Frank Oehmke
- Department of Obstetrics and Gynecology, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Siegmund Köhler
- Department of Obstetrics and Gynecology, Division of Obstetrics, University Hospital Giessen and Marburg GmbH, Marburg, Germany
| | - Harald Renz
- Institute of Laboratory Medicine and Pathobiochemistry Molecular Diagnostics, Philipps University Marburg, Marburg, Germany
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Cordolcini L, Castagna A, Mascheroni E, Montirosso R. Skin-to-Skin Care and Spontaneous Touch by Fathers in Full-Term Infants: A Systematic Review. Behav Sci (Basel) 2024; 14:60. [PMID: 38247712 PMCID: PMC10813587 DOI: 10.3390/bs14010060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/28/2023] [Accepted: 01/13/2024] [Indexed: 01/23/2024] Open
Abstract
A series of studies have shown that mothers' early tactile behaviors have positive effects, both on full-term and preterm infants, and on mothers alike. Regarding fathers, research has focused mostly on paternal skin-to-skin care with preterm infants and has overlooked the tactile behavior effects with full-term newborns on infants' outcomes and on fathers themselves. The current systematic review considered the evidence regarding paternal tactile behaviors with full-term infants, including skin-to-skin care (SSC) and spontaneous touch (ST), during parent-infant interactions, and differentiated biophysiological, behavioral and psychological variables both in fathers and in infants. We also compared fathers' and mothers' tactile behaviors for potential differences. The few available studies suggest that paternal touch-SSC and ST-can have positive effects on fathers and infants alike. They also show that, despite some intrinsic differences, paternal touch is as pleasant as maternal touch. However, given the paucity of studies on the topic, we discuss why this field of research should be further explored.
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Affiliation(s)
| | | | | | - Rosario Montirosso
- 0–3 Center for the at-Risk Infant, Scientific Institute IRCCS “Eugenio Medea”, 22040 Bosisio Parini, Italy; (L.C.); (A.C.); (E.M.)
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Martín-Ramos S, Domínguez-Aurrecoechea B, García Vera C, Lorente García Mauriño AM, Sánchez Almeida E, Solís-Sánchez G. [Breastfeeding in Spain and the factors related to its establishment and maintenance: LAyDI Study (PAPenRed)]. Aten Primaria 2024; 56:102772. [PMID: 37741187 PMCID: PMC10520303 DOI: 10.1016/j.aprim.2023.102772] [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: 05/02/2023] [Revised: 08/21/2023] [Accepted: 08/26/2023] [Indexed: 09/25/2023] Open
Abstract
OBJECTIVE To find out actual statistics on breastfeeding in Spain, as well as sociocultural and perinatal factors that affect its initiation and maintenance. DESIGN Prospective, multicentre, longitudinal, nationwide study (XXX study). SITE: Primary care paediatricians' office. PARTICIPANTS Cohort of newborns born between April 2017 and March 2018 in Spain who were followed up to two years of age in 8 visits. MAIN MEASURES Rates of different types of breastfeeding were analysed at each visit and variables related to gestation, delivery, neonatal period, social, economic and biological variables were also analysed. RESULTS Initial sample of 1946 (50.1% male). 90.7% decided to initiate breastfeeding at birth. Exclusive breastfeeding (EBF) was 66.4% at 15days and 35.2% at 6months. Any type of breastfeeding (total breastfeeding [TBF]) at 6months was 61.7%. Median survival from TBF was 6.0months (95%CI: 6.0-6.1). Variables related to EBF at 15days: previous children, mother's level of education, absence of illness during pregnancy, no separation of mother and child at birth, no dummy use, no nipple problems, and time of decision to breastfeed. Variables related to longer duration of TBF: relationship of parents older than 5years, no dummy use, co-sleeping at one month of life, deciding to breastfeed before pregnancy, receiving information on breastfeeding during pregnancy and using support from associations. CONCLUSIONS Early abandonment of breastfeeding is a major problem in Western societies. There are factors that can be worked on to improve outcomes.
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Affiliation(s)
- Silvia Martín-Ramos
- Servicio de Pediatría, Unidad de Neonatología, Hospital Río Hortega, Valladolid, España.
| | - Begoña Domínguez-Aurrecoechea
- Pediatría de Atención Primaria, Miembro del equipo coordinador PAPenRed, Instituto de investigación sanitaria del Principado de Asturias (ISPA), Oviedo, España
| | - César García Vera
- Pediatría, Centro de Salud «José Ramón Muñoz Fernandez», Coordinador de la red de investigación PAPenRED, Profesor Asociado de la Facultad de Medicina de la Universidad de Zaragoza, Zaragoza, España
| | - Ana María Lorente García Mauriño
- Pediatría de Atención Primaria, Centro de Salud Juan de la Cierva, Miembro del Equipo Coordinador nacional de PAPenRED y Coordinadora autonómica de PAPenRED por la Comunidad de Madrid, Getafe, Madrid, España
| | - Elena Sánchez Almeida
- Pediatría de Atención Primaria, Centro de Salud La Guancha-San Juan de la Rambla, Miembro del Equipo Coordinador nacional de PAPenRED y Coordinadora autonómica por la Comunidad de Canarias, Formadora en lactancia materna por la IHAN, Miembro de la Comisión de lactancia materna de atención primaria de Tenerife, Presidenta de la Asociación de Pediatría de atención primaria de Canarias, La Guancha, Santa Cruz de Tenerife, España
| | - Gonzalo Solís-Sánchez
- Servicio de Pediatría, Unidad Neonatología, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Universidad de Oviedo, Oviedo, España
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Amezcua López JA, García Morales E, Pérez-Rulfo Ibarra D, Solís Pacheco JR, Aguilar Uscanga BR. Effects of maternal toxic substance consumption during breastfeeding on lactic acid bacteria abundance and nutritional content. Int J Med Sci 2023; 20:1513-1526. [PMID: 37859696 PMCID: PMC10583185 DOI: 10.7150/ijms.87995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/01/2023] [Indexed: 10/21/2023] Open
Abstract
Breast milk is widely recognized as the primary source of nourishment for newborns, making it an unparalleled and indispensable provider of essential nutrients, microbiological components, immunological factors, and energy content. To investigate this further, a cohort comprising 254 breastfeeding women participated in interviews, and milk samples were aseptically collected for subsequent analysis involving bromatological, microbiological, and clinical analysis. The investigation focused on the identification of specific microorganisms in breast milk and their susceptibility to the exposure of toxic substances and controlled medications. Notably, this study places particular emphasis on the significant decline in lactic acid bacteria observed in breast milk when influenced by substances such as cocaine, cannabis, crystal, and morphine. These detrimental agents have been found to adversely affect the growth of microorganisms within breast milk. On the contrary, the outcomes of this study indicate that the utilization of toxic substances does not exert a noteworthy impact on the nutritional quality of breast milk.
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Affiliation(s)
- Jesús Alonso Amezcua López
- Universidad de Guadalajara. University Center of Exact Sciences and Engineering. Division of Basic Sciences, Department of Pharmacology. Laboratory of Industrial Microbiology Research. Guadalajara, Jalisco, México
| | - Elisa García Morales
- Universidad de Guadalajara. University Health Sciences Centre. Department of Human Reproduction Clinics, Child Growth and Development, Pediatrics Specialty. Guadalajara, Jalisco, México
- O.P.D. Hospital Civil de Guadalajara "Fray Antonio Alcalde". Division of Pediatrics, Neonatology Service. Guadalajara, Jalisco, México
| | - Daniel Pérez-Rulfo Ibarra
- Universidad de Guadalajara. University Health Sciences Centre. Department of Human Reproduction Clinics, Child Growth and Development, Pediatrics Specialty. Guadalajara, Jalisco, México
- O.P.D. Hospital Civil de Guadalajara "Fray Antonio Alcalde". Division of Pediatrics, Neonatology Service. Guadalajara, Jalisco, México
| | - Josué Raymundo Solís Pacheco
- Universidad de Guadalajara. University Center of Exact Sciences and Engineering. Division of Basic Sciences, Department of Pharmacology. Laboratory of Industrial Microbiology Research. Guadalajara, Jalisco, México
| | - Blanca Rosa Aguilar Uscanga
- Universidad de Guadalajara. University Center of Exact Sciences and Engineering. Division of Basic Sciences, Department of Pharmacology. Laboratory of Industrial Microbiology Research. Guadalajara, Jalisco, México
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Zhang X, Wang X, Juan J, Yang H, Sobel HL, Li Z, Narayan A, Huang X, Tian X, Zhang L, Cao Y, Tan L, Gao Y, Qiu Y, Liu J. Association of duration of skin-to-skin contact after cesarean delivery in China: a superiority, multicentric randomized controlled trial. Am J Obstet Gynecol MFM 2023; 5:101033. [PMID: 37244638 PMCID: PMC10410304 DOI: 10.1016/j.ajogmf.2023.101033] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/03/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND In China, the rates of early initiation and exclusive breastfeeding are low. The high cesarean delivery rates further contribute to low breastfeeding outcomes. Skin-to-skin contact, a key component of early essential newborn care, is known to be associated with improved breastfeeding initiation and exclusivity; however, the necessary duration has not been subjected to a randomized control trial. OBJECTIVE This study aimed to determine the association of the duration of skin-to-skin contact after cesarean delivery with breastfeeding outcomes and maternal and neonatal health outcomes in China. STUDY DESIGN This was a multicentric randomized controlled trial that was conducted at 4 hospitals in China. A total of 720 participants at ≥37 gestational weeks with a singleton pregnancy and who received an elective cesarean delivery with epidural anesthesia or spinal anesthesia or combined spinal-epidural anesthesia were randomly divided into 4 groups at a ratio of 1:1:1:1. The control group received routine care. Intervention group 1 (G1), 2 (G2), and 3 (G3) received 30, 60, and 90 minutes of skin-to-skin contact immediately after the cesarean delivery, respectively. RESULTS Between January 3 and October 14, 2021, 659 participants were recruited, including 173 in the control group, 176 in G1, 146 in G2, and 164 in G3. Among G1, G2, and G3, the rate of early initiation of breastfeeding within 60 minutes of birth was 56%, 71%, and 72%, respectively, compared with 22% in the control group (P<.001). The exclusive breastfeeding rate at discharge was 69%, 62%, and 71%, respectively, compared with 57% in the control group (P=.003). Early essential newborn care practices were associated with a reduction in postpartum blood loss and neonatal intensive care unit or neonatal ward admission (P<.001; P=.022) . CONCLUSION Our findings highlight that prolonged skin-to-skin contact after a cesarean delivery was associated with higher initiation and exclusive breastfeeding at discharge rates. It also found associations with reduced postpartum blood loss and neonatal intensive care unit or neonatal ward admission.
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Affiliation(s)
- Xiaosong Zhang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China (Drs X Zhang, Wang, Juan, and Yang and Ms Liu)
| | - Xueyin Wang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China (Drs X Zhang, Wang, Juan, and Yang and Ms Liu)
| | - Juan Juan
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China (Drs X Zhang, Wang, Juan, and Yang and Ms Liu)
| | - Huixia Yang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China (Drs X Zhang, Wang, Juan, and Yang and Ms Liu).
| | - Howard Lawrence Sobel
- Maternal and Child Health and Quality and Safety, World Health Organization Regional Office for the Western Pacific, Metro Manila, Philippines (Dr Sobel and Ms Li).
| | - Zhao Li
- Maternal and Child Health and Quality and Safety, World Health Organization Regional Office for the Western Pacific, Metro Manila, Philippines (Dr Sobel and Ms Li)
| | - Anuradha Narayan
- United Nations Children's Fund China, Beijing, China (Ms Narayan, Dr Huang, and Mr Tian)
| | - Xiaona Huang
- United Nations Children's Fund China, Beijing, China (Ms Narayan, Dr Huang, and Mr Tian)
| | - Xiaobo Tian
- United Nations Children's Fund China, Beijing, China (Ms Narayan, Dr Huang, and Mr Tian)
| | - Lin Zhang
- Save the Children International (United Kingdom) Beijing Representative Office, Beijing, China (Ms L Zhang)
| | - Yinli Cao
- Department of Obstetrics and Gynecology, Northwest Women's and Children's Hospital, Shaanxi, China (Ms Cao)
| | - Ling Tan
- Department of Obstetrics and Gynecology, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, China (Mses Tan and Gao)
| | - Yan Gao
- Department of Obstetrics and Gynecology, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, China (Mses Tan and Gao)
| | - Yinping Qiu
- Department of Neonatology, General Hospital of Ningxia Medical University, Yinchuan, China (Ms Qui)
| | - Jun Liu
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China (Drs X Zhang, Wang, Juan, and Yang and Ms Liu)
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Krupa-Kotara K, Grajek M, Grot M, Czarnota M, Wypych-Ślusarska A, Oleksiuk K, Głogowska-Ligus J, Słowiński J. Pre- and Postnatal Determinants Shaping the Microbiome of the Newborn in the Opinion of Pregnant Women from Silesia (Poland). Life (Basel) 2023; 13:1383. [PMID: 37374165 DOI: 10.3390/life13061383] [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: 04/19/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Pre- and postnatal factors influence the formation of the newborn's microbiome as early as birth and the intrauterine period has a substantial impact on the composition of the baby's gastrointestinal microbiota and its subsequent development. This study intends to measure pregnant women's knowledge of the importance of microbiota for the health of the newborn. The sample was selected based on defined inclusion and exclusion criteria. The assessment of women's knowledge was assessed by the Kolmogorov-Smirnov and Kruskal-Wallis statistical tests. This study population comprised 291 adult pregnant women with a mean age of 28.4 ± 4.7 years. A total of 34% (n = 99), 35% (n = 101), and 31.3% (n = 91) were at the 1-3 trimester, respectively. The results showed that 36.4% of the women were aware that the intrauterine period changes the makeup of the gastrointestinal microbiota, whereas 5.8% exhibited awareness of the composition of the child's normal gut microbiota. Most of the women surveyed-(72.1%)-know that colonization of the tract occurs as early as the birth period. Women with student status (those who will pursue higher education in the future) and those who had given birth to the most children exhibited higher levels of knowledge.
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Affiliation(s)
- Karolina Krupa-Kotara
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Mateusz Grajek
- Department of Public Health, Department of Public Health Policy, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Martina Grot
- Student Scientific Society, Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
- Doctoral School, Medical University of Silesia in Katowice, 40-055 Katowice, Poland
| | - Martina Czarnota
- Student Scientific Society, Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Agata Wypych-Ślusarska
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Klaudia Oleksiuk
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Joanna Głogowska-Ligus
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Jerzy Słowiński
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
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10
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Stipelman CH, Stoddard GJ, Bennion J, Young PC, Brown LL. Real-Time Breastfeeding Documentation: Timing of Breastfeeding Initiation and Outpatient Duration. Acad Pediatr 2023; 23:351-358. [PMID: 35863738 PMCID: PMC10516406 DOI: 10.1016/j.acap.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Current breastfeeding guidelines promote initiating breastfeeding ≤1 h after birth to establish long-term breastfeeding. Previous studies dichotomized initiation to ≤1 h versus subsequent hours combined. There are limited data evaluating the effect of initiation in each subsequent hour on breastfeeding duration. Our objective was to evaluate the association between breastfeeding initiated at ≤1 h versus the subsequent 23 hours after birth and outpatient breastfeeding duration. METHODS In this retrospective cohort study, we analyzed real-time, discretely documented electronic health record (EHR) breastfeeding data for 3315 infants born at a university center and followed to age ≥12 mo at 27 university primary care clinics. The primary outcome was breastfeeding duration. The exposure variable was hour of breastfeeding initiation within 24 h postnatally. Data were analyzed by univariable and multivariable linear regression separately for infants born by vaginal versus cesarean delivery. RESULTS In adjusted models, initiating breastfeeding during each hour from age >1 to ≤6 h and during ages >6 to ≤24 h was not associated with decreased breastfeeding duration versus initiating breastfeeding at ≤1 h after birth for infants born via vaginal or cesarean delivery. CONCLUSIONS Delaying breastfeeding initiation to >1 to ≤24 h after birth is not associated with decreased breastfeeding duration compared with initiating breastfeeding at ≤1 h after birth. Integration of breastfeeding measures into inpatient and outpatient EHR discrete data fields may clarify best practices that support long-term breastfeeding as a public health imperative.
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Affiliation(s)
- Carole H Stipelman
- University Pediatric Clinic, Department of Pediatrics (CH Stipelman, PC Young, and LL Brown), University of Utah School of Medicine, Salt Lake City; Sugar House Health Center, Department of Pediatrics (CH Stipelman), University of Utah School of Medicine, Salt Lake City; University Information Technology (CH Stipelman and J Bennion), University of Utah, Salt Lake City.
| | - Gregory J Stoddard
- Department of Internal Medicine (GJ Stoddard), University of Utah School of Medicine, Salt Lake City
| | - Jeff Bennion
- University Information Technology (CH Stipelman and J Bennion), University of Utah, Salt Lake City
| | - Paul C Young
- University Pediatric Clinic, Department of Pediatrics (CH Stipelman, PC Young, and LL Brown), University of Utah School of Medicine, Salt Lake City
| | - Laura L Brown
- University Pediatric Clinic, Department of Pediatrics (CH Stipelman, PC Young, and LL Brown), University of Utah School of Medicine, Salt Lake City
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11
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Mena-Tudela D, Soriano-Vidal FJ, Vila-Candel R, Quesada JA, Martínez-Porcar C, Martin-Moreno JM. Is Early Initiation of Maternal Lactation a Significant Determinant for Continuing Exclusive Breastfeeding up to 6 Months? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3184. [PMID: 36833878 PMCID: PMC9966801 DOI: 10.3390/ijerph20043184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND The World Health Organization (WHO) recommends early initiation of breastfeeding (EIBF) within the first hour after birth. However, certain perinatal factors, namely caesarean section, may prevent this goal from being achieved. The aim of our study was to examine the relationship between EIBF (maternal lactation in the first hours and degree of latching before hospital discharge) and the maintenance of exclusive breastfeeding (MBF) up to the recommended 6 months of age (as advocated by the WHO). METHODS This observational, retrospective cohort study included a random sample of all births between 2018 and 2019, characterising the moment of breastfeeding initiation after birth and the infant's level of breast latch (measured by LATCH assessment tool) prior to hospital discharge. Data were collected from electronic medical records and from follow-up health checks of infants up to 6 months postpartum. RESULTS We included 342 women and their newborns. EIBF occurred most often after vaginal (p < 0.001) and spontaneous births with spontaneous amniorrhexis (p = 0.002). LATCH score <9 points was associated with a 1.4-fold relative risk of abandoning MBF (95%CI: 1.2-1.7) compared with a score of 9-10 points. CONCLUSIONS Although we were unable to find a significant association between EIBF in the first 2 h after birth and MBF at 6 months postpartum, low LATCH scores prior to discharge were associated with low MBF, indicating the importance of reinforcing the education and preparation efforts of mothers in the first days after delivery, prior to the establishment of an infant feeding routine upon returning home.
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Affiliation(s)
- Desirée Mena-Tudela
- Department of Nursing, Universitat Jaume I, 12071 Castellón de la Plana, Spain
| | - Francisco Javier Soriano-Vidal
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
- Department of Obstetrics and Gynaecology, Xàtiva-Oninyent Health Department, 46800 Xàtiva, Spain
| | - Rafael Vila-Candel
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, 46600 Alzira, Spain
| | - José Antonio Quesada
- Department of Clinical Medicine, Universidad Miguel Hernández, 03202 Elche, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 03550 Alicante, Spain
| | - Cristina Martínez-Porcar
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, 46600 Alzira, Spain
| | - Jose M. Martin-Moreno
- Department of Preventive Medicine and Public Health, Universitat de València, 46010 Valencia, Spain
- Biomedical Research Institute INCLIVA, Clinic University Hospital, 46010 Valencia, Spain
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12
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Lee HK, Joo E, Kim S, Cho I, Lee KN, Kim HJ, Kim B, Park JY. A Comparison of Ultrasound Imaging Texture Analyses During the Early Postpartum With the Mode of Delivery. J Hum Lact 2023; 39:59-68. [PMID: 35272509 DOI: 10.1177/08903344221081866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Breastfeeding is beneficial to infants. However, cesarean section is reported to be a risk factor for unsuccessful breastfeeding. RESEARCH AIMS (1) To extract discriminating data from texture analysis of breast ultrasound images in the immediate postpartum period; and (2) to compare the analysis results according to delivery mode. METHODS A cross-sectional, prospective non-experimental design with a questionnaire and observational components was used. Participants (N = 30) were women who delivered neonates at a center from September 2020 to December 2020. The participants underwent ultrasound examination of bilateral breasts 7-14 days after delivery. Ultrasound images were collected for texture analysis. A questionnaire about breastfeeding patterns was given to the participants on the day of the ultrasound examination. RESULTS No significant differences were found in texture analysis between the breasts of participants who had undergone Cesarean section and vaginal deliveries. The mean volume of total human milk produced in 1 day was significantly greater in the vaginal delivery group than in the cesarean section group (M = 350.87 ml, SD = 183.83 vs. M = 186.20 ml, SD = 184.02; p = .017). The pain score due to breast engorgement measured subjectively by participants was significantly lower in the vaginal delivery group than in the cesarean section group (M = 2.8, SD = 0.86 vs. M = 3.4, SD = 0.63; p = .047). CONCLUSION Texture analysis of breast ultrasound images did not demonstrate difference between the cesarean section and vaginal delivery groups in the immediate postpartum period; nevertheless, cesarean section was independently associated with less successful breastfeeding.
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Affiliation(s)
- Hyun Kyoung Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Eunwook Joo
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seongbeen Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Iseop Cho
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Kyong-No Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyeon Ji Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Bohyoung Kim
- Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Gyeonggi-do, Republic of Korea
| | - Jee Yoon Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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13
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Nieto-Calvache AJ, Hidalgo A, Maya J, Sánchez B, Blanco LF, Sinisterra-Díaz SE, Benavides-Calvache JP, Padilla I, Aldana I, Jaramillo M, Gómez AM, Castillo AMO, Bryon AM. Is There a Place for Family-centered Cesarean Delivery during Placenta Accreta Spectrum Treatment? REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:925-929. [PMID: 36067798 DOI: 10.1055/s-0042-1751060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE Placenta accreta spectrum (PAS) is a cause of massive obstetric hemorrhage and maternal mortality. The application of family-centered delivery techniques (FCDTs) during surgery to treat this disease is infrequent. We evaluate the implementation of FCDTs during PAS surgeries. METHODS This was a prospective, descriptive study that included PAS patients undergoing surgical management over a 12-month period. The patients were divided according to whether FCDTs were applied (group 1) or not (group 2), and the clinical outcomes were measured. In addition, hospital anesthesiologists were surveyed to evaluate their opinions regarding the implementation of FCDTs during the surgical management of PAS. RESULTS Thirteen patients with PAS were included. The implementation of FCDTs during birth was possible in 53.8% of the patients. The presence of a companion during surgery and skin-to-skin contact did not hinder interdisciplinary management in any case. CONCLUSION Implementation of FCDTs during PAS care is possible in selected patients at centers with experience in managing this disease.
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Affiliation(s)
| | | | - Juliana Maya
- Universidad Icesi, Programa de Medicina, Cali, Colombia
| | - Beatriz Sánchez
- Clínica de Espectro de Acretismo Placentario, Fundación Valle del Lili, Cali, Colombia.,Departamento de Anestesiología, Fundación Valle del Lili, Cali, Colombia
| | - Luisa Fernanda Blanco
- Clínica de Espectro de Acretismo Placentario, Fundación Valle del Lili, Cali, Colombia.,Departamento de Anestesiología, Fundación Valle del Lili, Cali, Colombia
| | | | | | - Iván Padilla
- Unidad de Cuidad Intensivo Neonatal, Fundación Valle del Lili, Cali, Colombia
| | - Ivonne Aldana
- Unidad de Cuidad Intensivo Neonatal, Fundación Valle del Lili, Cali, Colombia
| | - Martha Jaramillo
- Unidad de Cuidad Intensivo Neonatal, Fundación Valle del Lili, Cali, Colombia
| | - Ana Maria Gómez
- Unidad de Cuidad Intensivo Neonatal, Fundación Valle del Lili, Cali, Colombia
| | | | - Adriana Messa Bryon
- Clínica de Espectro de Acretismo Placentario, Fundación Valle del Lili, Cali, Colombia
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14
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Monteiro BR, Silva VGFD, Andrade ASDS, Machado LS, Pinto ESG, Souza NLD. Elements that influenced immediate mother-neonate contact during the golden hour. Rev Esc Enferm USP 2022; 56:e20220015. [PMID: 36018826 PMCID: PMC10111386 DOI: 10.1590/1980-220x-reeusp-2022-0015en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/21/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To characterize the elements that influenced the immediate mother-neonate contact during the golden hour. METHOD A cross-sectional observational study with a quantitative approach. A total of 105 parturient women hospitalized in two maternity hospitals with usual risk were observed. The instrument was based on Brazilian National Normal Childbirth Care Guidelines and World Health Organization good obstetric practices, totaling 36 questions. The analysis took place in a descriptive way using the Chi-Square Test for proportion comparison. RESULTS Of the parturient women, 2.8% (n = 3) experienced the golden hour, and 82.9% (n = 87), immediate contact between 1 and 5 minutes. In 85.7% (n = 90) of the group, there were no causes that contraindicated immediate contact. For 48.0% (n = 49) of participants, contact was re-established by the nursing staff within 31-60 minutes. CONCLUSION Immediate contact during the golden hour had low hospital care compliance. Neonatal procedures that can be postponed predominated as influencing elements of the golden hour. The assistance observed in the birth rooms investigated reflects the need to reduce interventions in labor and birth.
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Affiliation(s)
- Bruna Rodrigues Monteiro
- Universidade Federal do Rio Grande do Norte, Programa de Pós-Graduação em Enfermagem, Natal, RN, Brazil
| | | | | | - Luciara Silva Machado
- Universidade Federal do Rio Grande do Norte, Programa de Graduação em Enfermagem, Natal, RN, Brazil
| | - Erika Simone Galvão Pinto
- Universidade Federal do Rio Grande do Norte, Programa de Pós-Graduação em Enfermagem, Natal, RN, Brazil
| | - Nilba Lima de Souza
- Universidade Federal do Rio Grande do Norte, Programa de Pós-Graduação em Enfermagem, Natal, RN, Brazil
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15
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Wang X, Zhang X, Sobel HL, Li Z, Juan J, Yang H. Early essential newborn care for cesarean section newborns in China: study protocol for a multi-centered randomized controlled trial. Trials 2022; 23:696. [PMID: 35986372 PMCID: PMC9389737 DOI: 10.1186/s13063-022-06615-z] [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] [Received: 08/16/2021] [Accepted: 08/02/2022] [Indexed: 11/26/2022] Open
Abstract
Background Early essential newborn care (EENC) is a package of evidence-based and cost-effective interventions delivered around birth mainly including delayed cord clamping, immediate and sustained skin-to-skin contact, and early initiation of exclusive breastfeeding. EENC is proven effective in promoting breastfeeding and improving women’s and newborns’ health. However, there is little evidence on implementation of EENC on newborns born by cesarean section in China. Therefore, the objective of this study is to assess the effectiveness of EENC intervention on rates of exclusive breastfeeding and early initiation of breastfeeding for cesarean section newborns in China. Methods This is a multi-centered, randomized controlled trial conducted in 4 tertiary hospitals in China. A total of 720 eligible women who will receive cesarean section are being randomized into four groups: control group (n=180), intervention group 1 (skin-to-skin contact for 30 min, n=180), intervention group 2 (skin-to-skin contact for 60 min, n=180), and intervention group 3 (skin-to-skin contact for 90 min, n=180). The control group will receive routine care, whereas the intervention groups will receive EENC with different duration of skin-to-skin contact. Demographic characteristics, clinical information, and breastfeeding outcomes will be collected. The primary outcome is rates of exclusive breastfeeding and early initiation of breastfeeding, and the secondary outcomes include maternal and neonatal morbidity and admissions. Discussion This study will provide evidence of the impact of EENC on improvement of breastfeeding outcomes and maternal and neonatal health for cesarean section newborns in China, and evidence-based recommendation to inform optimal duration of skin-to-skin contact for cesarean deliveries. The results of this study have potential to inform national-level guidelines and policy-making for optimizing EENC implementation for cesarean section newborns. Trial registration Chinese Clinical Trial Registry ChiCTR2100048997. Retrospectively registered on 19 July 2021 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06615-z.
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Martínez-Vázquez S, Hernández-Martínez A, Rodríguez-Almagro J, Peinado-Molina RA, Martínez-Galiano JM. Determinants and Factors Associated with the Maintenance of Exclusive Breastfeeding after Hospital Discharge after Birth. Healthcare (Basel) 2022; 10:healthcare10040733. [PMID: 35455909 PMCID: PMC9028310 DOI: 10.3390/healthcare10040733] [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] [Received: 03/02/2022] [Revised: 03/30/2022] [Accepted: 04/12/2022] [Indexed: 11/26/2022] Open
Abstract
The benefits of exclusive breastfeeding are well known for both mother and baby. Despite this, rates of exclusive breastfeeding remain low. The present study aimed to determine the factors associated with the maintenance of this type of feeding after being discharged from the hospital after childbirth. A cross-sectional study was carried out with 1200 postpartum women in Spain. Sociodemographic, obstetric, and neonatal data were collected. Odds ratios (OR) and adjusted odds ratios (aOR) with 95% confidence intervals were calculated. Early breastfeeding initiation was identified as a factor that favors breastfeeding after hospital discharge (aOR: 2.47; 95%CI: 1.77, 3.45). Other factors that favor breastfeeding after discharge included the woman feeling very supported by her partner during pregnancy, childbirth, and the puerperium (aOR: 2.54; 95%CI:1.30, 5.00) and having previously breastfed other children (aOR: 1.97; 95%CI: 1.40, 2.76). Among the factors that hindered exclusive breastfeeding after discharge were multiple or twin pregnancies (aOR: 0.31; 95%CI 0.12, 0.83), induction of labor (aOR: 0.73; 95%CI: 0.53, 0.99), admission of the newborn to the neonatal intensive care unit (NICU) (aOR: 0.31; 95%CI 0.19, 0.52), using epidural pain relief during labor (aOR: 0.41; 95%CI: 0.27, 0.64), or a preterm newborn (aOR: 0.38; 95%CI: 0.21, 0.69). For all these reasons, it is essential to promote certain practices such as the early start of breastfeeding or the induced onset of labor, among others, in order to promote the maintenance of exclusive breastfeeding beyond hospital discharge after childbirth.
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Affiliation(s)
| | - Antonio Hernández-Martínez
- Department of Nursing, Faculty of Nursing of Ciudad Real, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (A.H.-M.); (J.R.-A.)
| | - Julián Rodríguez-Almagro
- Department of Nursing, Faculty of Nursing of Ciudad Real, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (A.H.-M.); (J.R.-A.)
| | | | - Juan Miguel Martínez-Galiano
- Department of Nursing, University of Jaen, 23071 Jaen, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-953-211-740
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17
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Ghiringhelli JP, Lacassie H. Anesthesia and breastfeeding. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2022. [DOI: 10.5554/22562087.e1031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The importance of breastfeeding with its positive impact on the wellbeing of the mother-infant pair is well established. Anesthesiologists should encourage the promotion of lactation by being willing to give reassurance during the preoperative period and preparing a plan that does not interfere with safe breastfeeding. There is concern regarding the transfer of drugs into breast milk, which may lead to inconsistent advice from many health professionals and to early discontinuation. However, evidence shows that most anesthetic drugs are safe in terms of transfer into breast milk, and hence, compatible with breastfeeding, which should be resumed after anesthesia as soon as the mother is alert and feels well enough to hold her infant, without the need to “pump and dump”. This review provides pharmacokinetic information on commonly used anesthesia drugs and their passage into breast milk, to help practitioners discuss risks and benefits with the mother, emphasizing that anesthesia should not interfere with the benefits of breastfeeding. Four practical clinical scenarios are presented: pregnant women concerned about the effect of epidural analgesia on subsequent breastfeeding, spinal anesthesia for c-section and lactation, patients who will receive general anesthesia during cesarean section, and finally women who are breastfeeding and require anesthesia for elective or urgent surgery. Neuraxial anesthesia allows for better pain control and immediate skin-to-skin contact at the time of childbirth. Also, it interferes the least with the woman’s ability to care for her infant. Regional techniques, opioid-sparing techniques and outpatient surgery are preferred. Drugs such as opioids and longer-acting benzodiazepines should be administered cautiously, particularly in repeat doses.
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18
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Monteiro BR, Silva VGFD, Andrade ASDS, Machado LS, Pinto ESG, Souza NLD. Elementos Que Influenciaram No Contato Imediato Entre Mãe E Bebê Na hora dourada. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2022-0015pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: Caracterizar os elementos que influenciaram no contato imediato entre mãe e bebê na hora dourada. Método: Estudo observacional transversal, com abordagem quantitativa. Foram observadas 105 parturientes internadas em duas maternidades de risco habitual. O instrumento teve como base as Diretrizes Nacionais de Assistência ao Parto Normal e as boas práticas obstétricas da Organização Mundial da Saúde, totalizando 36 questões. A análise ocorreu de forma descritiva mediante o Teste do Qui-Quadrado para comparação de proporção. Resultados: Das parturientes, 2,8% (n = 3) vivenciaram a hora dourada, e 82,9% (n = 87), o contato imediato entre 1 e 5 minutos. Em 85,7% (n = 90) do grupo, não houve causas que contraindicassem o contato imediato. Para 48,0% (n = 49) das participantes, o contato foi restabelecido pela enfermagem entre 31–60 minutos. Conclusão O contato imediato na hora dourada teve baixa adesão na assistência hospitalar. Os procedimentos neonatais passíveis de serem adiados predominaram como elementos influenciadores da hora dourada. A assistência observada nas salas de parto investigadas reflete a necessidade de reduzir as intervenções no parto e nascimento.
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19
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Li L, Wan W, Zhu C. Breastfeeding after a cesarean section: A literature review. Midwifery 2021; 103:103117. [PMID: 34425257 DOI: 10.1016/j.midw.2021.103117] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 06/27/2021] [Accepted: 07/30/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Breast milk is recognized as the best source of nutrition for babies. The World Health Organization (WHO) recommends exclusive breastfeeding in the first six months after birth and continued breastfeeding for up to two years. According to the reported literature, breastfeeding and exclusive breastfeeding rates worldwide are relatively low, especially after a cesarean section (C-section). Therefore, this review aims to summarize existing data on C-section and breastfeeding performance worldwide to interpret their relationship further. METHODS Research articles related to C-section and breastfeeding were retrieved from electronic databases, including CINAHL Complete, Health Source: Nursing/Academic Edition, Academic Search Complete, MEDLINE, PubMed, and Google Scholar. Only full-text English articles reported from 2015 to 2020 are summarized in this review. RESULTS Among a total of 389 articles identified, 18 papers met our inclusion criteria, which reported that the C-section was associated with the initiation of breastfeeding and the duration of exclusive breastfeeding. Furthermore, these studies also discussed factors and experiences related to breastfeeding difficulties in mothers who have a C-section. Besides, several studies investigated effective initiatives that support breastfeeding in mothers who have a C-section. CONCLUSION C-section is thought to be related to the initiation and duration of breastfeeding. In comparison with natural childbirth, C-section can delay the start of breastfeeding and shorten the duration of exclusive breastfeeding. Moreover, the planned C-section is considered the most critical factor affecting breastfeeding. Also, breastfeeding initiatives are highly recommended to support mothers who have a C-section. According to the literature, different regions and populations may have distinct experiences of breastfeeding. Therefore, future research is required to identify breastfeeding support for diverse populations with higher quality.
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Affiliation(s)
- Leixi Li
- The People's Hospital of Leshan, Sichuan, China.
| | - Wenlin Wan
- The People's Hospital of Leshan, Sichuan, China
| | - Chan Zhu
- The People's Hospital of Tongren, Guizhou, China
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20
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Donate-Manzanares M, Rodríguez-Cano T, Rodríguez-Almagro J, Hernández-Martínez A, Santos-Hernández G, Beato-Fernández L. Mixed-method study of women's assessment and experience of childbirth care. J Adv Nurs 2021; 77:4195-4210. [PMID: 34297861 DOI: 10.1111/jan.14984] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/24/2021] [Accepted: 07/11/2021] [Indexed: 11/28/2022]
Abstract
AIM To examine women's evaluations of quality of care from their perspectives. BACKGROUND Assessing women's satisfaction with the quality of care they receive during childbirth is an important component of care quality that should be analysed. Evidence suggests that childbirth experience has an important impact on women's health. Therefore, taking into account the perceptions of women about quality is a means to improve care. However, studies examining care quality in this setting remain scarce. DESIGN Mixed-methods explanatory sequential design. METHODS A national survey with a sample of 1082 participants, and 15 semi-structured interviews. Data collection occurred between January 2017 and January 2019. Quantitative data were obtained through a validated scale, the Quality from the Patient's Perspective-Intrapartal questionnaire, whose score can range from 1 (minimum satisfaction) to 4 (maximum satisfaction). Semi-structured interviews were conducted for qualitative data. Descriptive statistics, group comparison and qualitative content analysis were included in data analysis. RESULTS The mean score on the QPP-I tool was high (3.13; SD 0.74). Variables that had the most influence on the experience were type of birth, type of perineal trauma, admission of the baby, time since birth, home-birth, parity and duration of labour. Data from the qualitative interviews identified five themes that explained women's experiences with the quality of care. Previous expectations influence the emotions they have regarding the experience. Relationships with professionals and their social skills are fundamental for the evaluation of quality. The separation of the newborn appears as a factor that worsens the appreciation of women. Good pain management and continuity of care by specialists are also named as key elements of the quality of care. CONCLUSION Findings demonstrate that experience with childbirth care is of utmost importance for women. They also show the indisputable need to listen to their opinions and assessments when lines of improvement of quality are identified. IMPACT This study provides information that can improve the care that women receive during their childbirths. Using their opinions will make them feel an active part of the system and in this way, we will be closer to achieve excellence in our services.
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Affiliation(s)
| | - Teresa Rodríguez-Cano
- Servicio de Psiquiatría del Hospital General Universitario de Ciudad Real, Calle Obispo Rafael Torija, Ciudad Real, Spain
| | - Julián Rodríguez-Almagro
- Facultad de Enfermería de Ciudad Real, Campus de Ciudad Real, Calle de Camilo José Cela, Ciudad Real, Spain
| | - Antonio Hernández-Martínez
- Facultad de Enfermería de Ciudad Real, Campus de Ciudad Real, Calle de Camilo José Cela, Ciudad Real, Spain
| | - Gloria Santos-Hernández
- Servicio de Obstetricia y Ginecología del Hospital Virgen de la Salud de Toledo, Toledo, Spain
| | - Luis Beato-Fernández
- Servicio de Psiquiatría del Hospital General Universitario de Ciudad Real, Calle Obispo Rafael Torija, Ciudad Real, Spain
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21
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Machold CA, O'Rinn SE, McKellin WH, Ballantyne G, Barrett JFR. Women's experiences of skin-to-skin cesarean birth compared to standard cesarean birth: a qualitative study. CMAJ Open 2021; 9:E834-E840. [PMID: 34465580 PMCID: PMC8428890 DOI: 10.9778/cmajo.20200079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Skin-to-skin contact between mother and infant immediately after birth is recommended regardless of delivery method; however, it is less common after cesarean delivery. We aimed to describe and compare women's experiences of cesarean birth with and without skin-to-skin contact at an urban tertiary care hospital. METHODS In this hermeneutic phenomenologic study, we used semistructured telephone interviews from 2015 to 2018 to interview a convenience sample of women who delivered at term by scheduled skin-to-skin cesarean birth at an urban tertiary care hospital in Toronto, Ontario. Women were invited to participate if they had had a previous planned or unplanned cesarean birth and a scheduled skin-to-skin cesarean birth between 2013 and 2017. Participants were excluded if they had antenatally diagnosed conditions, they delivered before 37 weeks, they had general anesthesia, their condition was unstable at the time of surgery, a skin-to-skin cesarean birth was not possible or they declined skin-to-skin cesarean birth. Interviews were recorded, transcribed and analyzed by means of thematic analysis. RESULTS Ten women were interviewed 1-19 months postpartum. Four central themes emerged: support for skin-to-skin cesarean birth (women feeling supported by their families and health care providers); control (participants experiencing greater control during their skin-to-skin cesarean birth); connection with the infant, which enabled women to be active participants in their delivery, enhanced bonding and intimacy, facilitated breastfeeding and bolstered confidence during early parenthood; and logistic considerations, with participants recognizing that skin-to-skin cesarean birth required additional resources. INTERPRETATION These findings refine what is known about skin-to-skin cesarean birth and provide a critical perspective, that of mothers. They support the transformation of traditional operating room dynamics to a more patient-centred environment.
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Affiliation(s)
- Clea A Machold
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont.
| | - Susan E O'Rinn
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont
| | - William H McKellin
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont
| | - Gillian Ballantyne
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont
| | - Jon F R Barrett
- Collingwood General and Marine Hospital (Machold), Collingwood, Ont.; Sunnybrook Research Institute (O'Rinn) and Aubrey & Marla Dan Centre for Women & Babies (O'Rinn), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Anthropology (McKellin), University of British Columbia, Vancouver, BC; Birthing Unit (Ballantyne), Aubrey & Marla Dan Centre for Women & Babies, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Obstetrics and Gynecology (Barrett), McMaster University, Hamilton, Ont
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Mallick L, Wang W, Farid S, Pullum T. Initiation of Breastfeeding in Low- and Middle-Income Countries: A Time-to-Event Analysis. GLOBAL HEALTH: SCIENCE AND PRACTICE 2021; 9:308-317. [PMID: 34019481 PMCID: PMC8324198 DOI: 10.9745/ghsp-d-20-00361] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 03/23/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Early breastfeeding has numerous benefits for both the mother and her baby. Previous research typically analyzes breastfeeding initiation in binary terms (within the first hour or day). Although delays are associated with cesarean delivery and skin-to-skin contact may facilitate early breastfeeding, a more nuanced understanding of these relationships is needed. METHODS With data from 31 countries that had a Demographic and Health Survey since 2015, we described breastfeeding initiation among babies most recently born in the last 2 years to women aged 15-49 years. In a subset of 21 countries, we conducted survival analysis with multivariable log-logistic accelerated failure time (AFT) regressions to examine factors associated with time to initiation of breastfeeding, specifically the mode of delivery and skin-to-skin contact, controlling for receipt of health care as well as socioeconomic and demographic characteristics of mothers and babies. FINDINGS Babies in most countries began breastfeeding within a few hours after birth. The mean time to initiation of breastfeeding ranged from 1.7 hours in Burundi to 32 hours in Pakistan and 40 hours in Chad. In most countries (24 of 31), the median time was 0.5 hours. Median time to initiation was greater for births by cesarean delivery compared with vaginal births at health facilities. After controlling for covariates, AFT models showed significant delays in breastfeeding among cesarean deliveries in most countries, with as much as a 9-fold delay in Senegal. Immediate skin-to-skin contact was significantly associated with a shorter time to initiation. CONCLUSION Efforts to promote early breastfeeding should encourage skin-to-skin and target cesarean deliveries.
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Affiliation(s)
- Lindsay Mallick
- University of Maryland School of Public Health, College Park, MD, USA. .,Avenir Health, Glastonbury, CT, USA
| | - Wenjuan Wang
- ICF, Rockville, MD, USA.,The Demographic and Health Surveys Program, Rockville, MD, USA
| | | | - Thomas Pullum
- ICF, Rockville, MD, USA.,The Demographic and Health Surveys Program, Rockville, MD, USA
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Uchoa JL, Barbosa LP, Mendonça LBDA, Lima FET, Almeida PCD, Rocha SSD. Influence of social determinants of health on skin to skin contact between mother and newborn. Rev Bras Enferm 2021; 74:e20200138. [PMID: 34133704 DOI: 10.1590/0034-7167-2020-0138] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/24/2020] [Indexed: 08/23/2023] Open
Abstract
OBJECTIVE to analyze the association of skin-to-skin contact and social determinants of health. METHODS this is a cross-sectional study with 187 medical records of newborns from a reference rooming in in northeastern Brazil. An instrument with maternal and neonatal data was used. Analysis was descriptive and inferential statistics. For the associations, a chi-square test was used to measure strength, an Odds Ratio was calculated, with a 95% confidence interval. RESULTS 62% of newborns who made skin-to-skin contact at birth were eutrophic, full-term, Apgar > 7, mothers with prenatal care and without abortion. The determinants associated with non-skin-to-skin contact were preterm (CR=3.2;95%CI: 2.72-18.98); 1st minute Apgar < 7 (CR:2.9;95%CI: 2.38-3.06), cesarean section (CR:8.4;95%CI: 4.29-16.57), and unhealthy NB (CR 12.7;95%CI: 4.9-32.67). We used STROBE guidelines. CONCLUSION skin-to-skin contact was influenced by gestational age, Apgar, delivery, and newborn health.
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Affiliation(s)
- Janaiana Lemos Uchoa
- Universidade Federal do Ceará, Hospital Universitário Walter Cantídio. Fortaleza, Ceará, Brazil
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Deys L, Wilson PV, Meedya DS. What are women's experiences of immediate skin-to-skin contact at caesarean section birth? An integrative literature review. Midwifery 2021; 101:103063. [PMID: 34157585 DOI: 10.1016/j.midw.2021.103063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/02/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Skin-to-skin is a well-established practice at vaginal births promoting the health of women and babies. Facilitation of skin-to-skin at caesarean section birth is growing despite environmental and historical challenges. This is led by the expectancy of women and of health professionals increasingly understanding its importance. OBJECTIVE To synthesise original research that explores the experience of women having immediate and uninterrupted skin-to-skin contact at caesarean section when woman and baby are well. DESIGN Integrative literature review. DATA SOURCES The databases of SCOPUS, PubMed, CINAHL plus, Wiley Online, Cochrane Library, Web of Science and MIDIRS were used to identify studies from 2010-2020. Hand searching of library journals, reference and citation lists were also used. METHODS The framework of Whittemore and Knafl (2005) was used to guide the literature search, thematic analysis, and synthesis of original research. Initial screening against inclusion criteria was utilised for English-published papers of full-term, well, woman and baby dyads who experienced skin-to-skin at caesarean section birth. Papers were not limited by methodology. The validated Mixed Methods Appraisal Tool (MMAT) was used for critical quality appraisal (Bartlett et al., 2018). FINDINGS In total, 750 results were returned in the initial search and a final 13 papers were included in this review including quantitative (6), qualitative (5) and mixed method (2) designs. Immediate and uninterrupted skin-to-skin at caesarean section birth, when mother and baby are well, is safe, appropriate and desired by women, improving birth experience and satisfaction. Three main themes were identified with sub-themes - Positive birth experience (satisfaction; breastfeeding goals); Sense of control (empowered; birth, not a procedure); Natural (wanting to hold their baby; becoming a mother). CONCLUSIONS The findings of this review show that skin-to-skin improves the experience for women, and particularly empowers women having a caesarean section giving them a sense of a more natural birth. Women see skin-to-skin as an opportunity to maintain control and not be separated from their baby. Many studies have focused on the benefits of skin-to-skin but less so on the wants and choices of women. Women want to see, hold and feed their babies but are unable to achieve this of their own volition during a surgical birth. Understanding how women value this close physical contact can seek to inform further research on the impact of separation. This can inform policy and practice development in maternity care services to ensure best outcomes for both women and infants. IMPLICATIONS FOR PRACTICE The practice of skin-to-skin and keeping mother and baby together is valued by women and justified by research as best-practice for health and well-being. The findings of this paper highlight the importance of maternity settings facilitating both skin-to-skin and non-separation for all women and their newborns, even more so at caesarean section births.
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Affiliation(s)
- Linda Deys
- School of Nursing, University of Wollongong, Northfields Avenue, Wollongong, NSW 2500 Australia; Clinical Midwife Consultant/IBCLC/RN, Illawarra Shoalhaven Local Health District, Australia; Maternal & Women's Health, Locked Bag 8808, South Coast Mail Centre, NSW 2521, Australia.
| | - Professor Valerie Wilson
- University of Wollongong School of Nursing and Illawarra Shoalhaven Local Health District, Australia.
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Cummins L, Meedya S, Wilson V. Factors that positively influence in-hospital exclusive breastfeeding among women with gestational diabetes: An integrative review. Women Birth 2021; 35:3-10. [PMID: 33745821 DOI: 10.1016/j.wombi.2021.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 01/03/2023]
Abstract
PROBLEM Women with gestational diabetes have higher rates of introducing infant formula before leaving hospital. BACKGROUND Despite health professional support, less women with gestational diabetes exclusively breastfeed in hospital. AIM To find factors that positively influence in-hospital exclusive breastfeeding practices among women with gestational diabetes. METHODS An online search was performed in Medline, Scopus, Pubmed, CINAHL and Cochrane databases. Studies containing the keywords gestational diabetes and breastfeeding were retrieved. FINDINGS Authors identified 1935 papers from search criteria. Twenty-six papers with no restrictions on research design met inclusion criteria and were included in the review. Factors were divided into personal, antenatal, intrapartum and postnatal factors. The main modifiable factors that were associated with improved in-hospital exclusive breastfeeding rates were having a strong intention to breastfeed, being confident, feeling supported and having continuity of education and support. Women's main reasons to introduce formula were related to baby's hypoglycaemia, delayed lactogenesis II and perceived low milk supply. Skin-to-skin contact after birth combined with frequent breastfeeds were effective ways to improve in-hospital exclusive breastfeeding rates. CONCLUSION Influencing factors such as women's breastfeeding intention, confidence and ongoing support are no different to the general population of women. However, promoting skin-to-skin contact after birth combined with frequent feeds are crucial for women with gestational diabetes who are more likely to introduce formula due to delayed lactogenesis II and fear of neonatal hypoglycaemia. There is a need for developing educational and supportive interventions that are tailored specifically for women who have gestational diabetes.
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Affiliation(s)
- Leanne Cummins
- School of Nursing, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia; Illawarra Shoalhaven Local Health District, Wollongong Hospital, Loftus St, Wollongong, NSW, 2500, Australia.
| | - Shahla Meedya
- School of Nursing, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia
| | - Valerie Wilson
- School of Nursing, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia; Illawarra Shoalhaven Local Health District, Wollongong Hospital, Loftus St, Wollongong, NSW, 2500, Australia
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Araújo KEDAS, Santos CCD, Caminha MDFC, Silva SLD, Pereira JDCN, Batista Filho M. SKIN TO SKIN CONTACT AND THE EARLY INITIATION OF BREASTFEEDING: A CROSS-SECTIONAL STUDY. TEXTO & CONTEXTO ENFERMAGEM 2021. [DOI: 10.1590/1980-265x-tce-2020-0621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to identify the prevalence and factors associated with the occurrence of skin-to-skin contact and the early initiation of breastfeeding in a Baby-friendly hospital in northeastern Brazil. Method: cross-sectional study, composed of pregnant women, in which delivery occurred at the Baby-friendly Hospital. Data were collected between April 2017 and May 2019 through forms containing sociodemographic variables, obstetric history and data on the delivery and birth of the newborn. The possible associated factors were analyzed through the chi-square test, adopting the significance level of 0.05. Result: among the 727 pregnant women, skin-to-skin contact occurred in 83.6% and breastfeeding in 58.3%. Full-term birth, birth weight ≥ 2500g, Apgar index >7 in the first minute, vaginal delivery, 6 or more prenatal consultations and years of study >9 were the factors associated with the practice of skin-to-skin contact. Regarding breastfeeding, in addition to the first five factors related to skin-to-skin contact, a statistical relationship with the beginning of prenatal care in the first trimester, skin-to-skin contact and multiparity was also evidenced. Conclusions: this study found a prevalence rate of skin-to-skin contact appropriate to a Baby-friendly Hospital and a direct association of this practice with breastfeeding.
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Affiliation(s)
| | | | | | - Suzana Lins da Silva
- Instituto de Medicina Integral Prof. Fernando Figueira, Brasil; Faculdade Pernambucana de Saúde, Brasil
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Shiferaw R, Tadesse SE, Mekonnen TC, Zerga AA. Timely Initiation of Breast Feeding and Associated Factors among Caesarian Section Delivered Mothers in Health Facilities of Dessie City Administration, North Eastern Ethiopia. Pediatr Rep 2020; 13:1-8. [PMID: 33374654 PMCID: PMC7838866 DOI: 10.3390/pediatric13010001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/21/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To assess the magnitude and associated factors of timely initiation of breastfeeding among cesarean section delivered mothers. METHODS A health facility-based cross-sectional study was employed among 421 systematically selected mothers from February to June, 2017. Data were collected by a structured questionnaire. Data entry and analysis was done using Epi Data and SPSS version 24. Binary logistic regression was computed to identify factors. Adjusted odds ratio with a 95% confidence interval was used to declare statistical significance. RESULT The magnitude of timely initiation of breast feeding (among mothers who gave birth by cesarean section was 57%. Counseling during antenatal care (AOR = 3.32; 95% CI: 1.80, 6.13), facility where cesarean section (CS) was performed (AOR = 2.55; 95% CI: 1.57, 4.14), and post-CS counseling (AOR = 6.93; 95% CI: 3.99, 12.02) were factors that contributed for the practice of timely initiation among cesarean section delivered mothers. CONCLUSIONS The magnitude of TIBF was good. Counseling during ANC, the facility where CS was performed and post-natal advice were factors associated with TIBF. Implementation of baby-friendly hospital initiatives should be strengthened in order to promote timely initiation of breast feeding.
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Affiliation(s)
- Roza Shiferaw
- Dessie Zonal Health Department, Dessie 6000, Ethiopia;
| | - Sisay Eshete Tadesse
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie 1145, Ethiopia; (T.C.M.); (A.A.Z.)
| | - Tefera Chane Mekonnen
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie 1145, Ethiopia; (T.C.M.); (A.A.Z.)
| | - Aregash Abebayehu Zerga
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie 1145, Ethiopia; (T.C.M.); (A.A.Z.)
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Bašková M, Chabanová B, Škodová Z, Malinovská N, Urbanová E. Promotion and support of breastfeeding within the baby-friendly hospital initiative programme in Slovakia. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2020. [DOI: 10.15452/cejnm.2020.11.0031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Hashim S, Ishak A, Muhammad J. Unsuccessful Exclusive Breastfeeding and Associated Factors among the Healthcare Providers in East Coast, Malaysia. Korean J Fam Med 2020; 41:416-421. [PMID: 33242382 PMCID: PMC7700827 DOI: 10.4082/kjfm.19.0060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Breastfeeding is widely recognized as the optimal and natural method of feeding infants. However, there are obstacles that can limit exclusive breastfeeding practices during the first 6 months of an infant's life. This study aimed to determine the prevalence of unsuccessful exclusive breastfeeding and its associated factors among mothers who work as healthcare providers at Universiti Sains Malaysia Hospital. METHODS A cross-sectional study was conducted among 295 medical doctors and staff nurses from June to December 2015. Simple random sampling was applied. The data were collected using a self-administered questionnaire and analyzed using IBM SPSS ver. 22.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics and logistic regression analysis were performed. RESULTS The prevalence of unsuccessful exclusive breastfeeding among the study participants was 58.3%. Mothers who preferred formula milk (odds ratio [OR], 4.40; 95% confidence interval [CI], 1.45-13.31) delivered via lower segment cesarean section (OR, 2.31; 95% CI, 1.07-4.98) and produced inadequate breast milk (OR, 4.06; 95% CI, 2.40- 6.89) were significantly associated with unsuccessful exclusive breastfeeding. CONCLUSION The prevalence of unsuccessful exclusive breastfeeding among the study participants was high. Maternal characteristics such as preference towards formula milk, mode of delivery and adequacy of breast milk must be assessed to prevent unsuccessful exclusive breastfeeding among healthcare providers.
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Affiliation(s)
- Saodah Hashim
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian, Malaysia
| | - Azlina Ishak
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian, Malaysia
| | - Juliawati Muhammad
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian, Malaysia
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30
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Crenshaw JT, Adams ED, Gilder RE, DeButy K, Scheffer KL. Effects of Skin-to-Skin Care During Cesareans: A Quasiexperimental Feasibility/Pilot Study. Breastfeed Med 2019; 14:731-743. [PMID: 31738574 PMCID: PMC6918851 DOI: 10.1089/bfm.2019.0202] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introduction: Our aim was to describe feasibility and outcomes of skin-to-skin care (SSC) that began during cesarean surgery and continued, uninterrupted, for about 5 hours. We described maternal/newborn measures of physiologic stability and stress; maternal measures of comfort; maternal satisfaction with surgery and SSC; and exclusive breast milk feeding at discharge. Materials and Methods: We used a quasiexperimental, time-interrupted design and randomly assigned women to receive SSC that began during surgery (Group 1, intervention; n = 20) or after surgery, before transfer to recovery (Group 2, standard care; n = 20). We analyzed differences across time and for five observations: before transfer to the operating room (OR); in the OR, about 20 minutes after birth; in the recovery room, about 1 hour after admission; in the New Family Center (NFC), about 1 hour after admission; and in the NFC, about 2 hours after admission. Results: Group 1 began SSC an average of 0.89 minutes after birth and continued an average of 300 minutes and Group 2 began an average of 46 minutes after birth and continued an average of 126 minutes. Women who began SSC during surgery were more satisfied with the experience (p = 0.015) and had lower levels of salivary cortisol across time (p = 0.003). We found no negative effects on maternal or newborn measures of physiologic stability and no difference in exclusive breast milk feeding rates at discharge. Conclusion: Immediate and uninterrupted SSC during medically uncomplicated cesarean surgery is a feasible, low-cost intervention that can safely begin during surgery and continue, uninterrupted, for extended durations.
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Affiliation(s)
| | - Ellise D Adams
- College of Nursing, University of Alabama in Huntsville, Huntsville, Alabama
| | - Richard E Gilder
- School of Nursing, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Kristine DeButy
- Women and Children's Services, Baylor University Medical Center, Dallas, Texas
| | - Kristin L Scheffer
- Perinatal Education, Women and Children's Services, Baylor University Medical Center, Dallas, Texas
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Lu P, Ye ZQ, Qiu J, Wang XY, Zheng JJ. Acupoint-tuina therapy promotes lactation in postpartum women with insufficient milk production who underwent caesarean sections. Medicine (Baltimore) 2019; 98:e16456. [PMID: 31464890 PMCID: PMC6736488 DOI: 10.1097/md.0000000000016456] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Breast milk is recognized and strongly recommended by the World Health Organization (WHO) as the optimal feeding for all babies. Breastfeeding is associated with better nutritional and non-nutritional outcomes when compared to formula feeding, and has proven health benefits to both infants and their mothers. This clinical research is to examine the feasibility and efficacy of Acupoint-Tuina therapy in treating postpartum women who underwent C-sections and suffered from insufficient milk production.The patients in the control group received standard medical care, while the patients in the Tuina group received Tuina therapy during the next 48 hours in addition to standard care, given once daily for 2 days. To evaluate the efficacy of Tuina therapy, patients of both groups were assessed for surface temperature of breasts, volume of breasts, volume of breast milk production, serum PRL level, and uterus recovery at various time points.Tuina therapy significantly increased the milk production when compared to the control group, for as much as 13-fold and 10-fold of that in the control group on the third and fourth postpartum days. In addition, Tuina therapy also significantly increased the full breast enlargement and the serum PRL level change, and decreased the breast surface temperature rise. Last but not the least, Tuina therapy also accelerated the post-surgery recovery of uterus.During the early postpartum days, Tuina therapy increases the milk production and promotes other physiological changes supporting lactation for postpartum women with C-section delivery and insufficient breast milk production. The novel intervention is warranted for further investigation and validation.
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Affiliation(s)
- Ping Lu
- Teaching and Research Office of Basic Tuina Science, Shanghai University of Traditional Chinese Medicine School of Acupuncture-Moxibustion and Tuina, Shanghai
| | - Zhi-qi Ye
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
| | - Jin Qiu
- Shanghai Tenth People's Hospital, Tenth People's Hospital of TongJi University
| | | | - Juan-juan Zheng
- Teaching and Research Office of Basic Tuina Science, Shanghai University of Traditional Chinese Medicine School of Acupuncture-Moxibustion and Tuina, Shanghai
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Chiu HC, Wang HY, Hsiao JC, Tzeng IS, Yiang GT, Wu MY, Chang YK. Early breastfeeding is associated with low risk of postpartum depression in Taiwanese women. J OBSTET GYNAECOL 2019; 40:160-166. [PMID: 31215282 DOI: 10.1080/01443615.2019.1603216] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Breastfeeding during the first week postpartum is recognised as essential, affecting the mother's mental health. The human milk from early breastfeeding also protects against infections via the secretory IgA antibodies and plays an important role in the newborn's development. At a Baby-Friendly Hospital, early breastfeeding was promoted to increase the benefits for the newborn, but few focussed on the mother's health. The association between breastfeeding and postpartum depression (PPD) has not been fully addressed. This study aimed to investigate the relationship between breastfeeding and postpartum depression (PPD) and it included 333 Taiwanese pregnant women. Women who had a higher score of Edinburgh Postnatal Depression Scale (EPDS) were significant older (age ≥ 35, p < .037), had a caesarean section delivery (p < .001), and a higher score of Brief Symptom Rating Scale-5 (p < .001). Higher scores on EPDS were significantly associated with lower rates of breastfeeding, which reflected cessation of breastfeeding as an important risk factor for PPD (Odds ratio: 2.159, CI: 1.220-3.821, p = .008). Other risk factors included caesarean section delivery (Odds ratio: 2.814, CI: 1.617-4.899, p < .001) and age ≥35 years (Odds ratio: 1.821, CI: 1.057-3.137, p = .031).IMPACT STATEMENTWhat is already known on this subject: Breastfeeding during the first week postpartum is recognised as essential, affecting the mother's mental health. The human milk from early breastfeeding also protects against infections via the secretory IgA antibodies and plays an important role in the newborn's development. The detail association between breastfeeding and postpartum depression has not yet been fully addressed.What the results of this study add: Higher scores on EPDS were significantly associated with lower rates of breastfeeding, which reflected cessation of breastfeeding as an important risk factor for PPD (Odds ratio: 2.159, CI: 1.220-3.821, p = .008). Other risk factors included caesarean section delivery (Odds ratio: 2.814, CI: 1.617-4.899, p < .001) and age ≥35 years (Odds ratio: 1.821, CI: 1.057-3.137, p = .031).What the implications are of these findings for clinical practice and/or further research? The early breastfeeding was significantly associated with postpartum depression. Other risk factors included caesarean section delivery and age ≥35 years.
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Affiliation(s)
- Hsiao-Chen Chiu
- Department of Obstetrics and Gynecology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.,Department of Obstetrics and Gynecology, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Han-Yun Wang
- School of Medicine, Tzu Chi University, Hualien City, Taiwan
| | - Jun-Chin Hsiao
- Department of Obstetrics and Gynecology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan
| | - I-Shiang Tzeng
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan
| | - Giou-Teng Yiang
- Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.,Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Meng-Yu Wu
- Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.,Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yin-Kuang Chang
- Department of Obstetrics and Gynecology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.,Department of Obstetrics and Gynecology, School of Medicine, Tzu Chi University, Hualien, Taiwan
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Crenshaw JT. Healthy Birth Practice #6: Keep Mother and Newborn Together-It's Best for Mother, Newborn, and Breastfeeding. J Perinat Educ 2019; 28:108-115. [PMID: 31118548 DOI: 10.1891/1058-1243.28.2.108] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Mothers and newborns have an emotional and physiological need to be together at the moment of birth and during the hours and days that follow. Keeping mothers and newborns together is a safe and healthy birth practice. Evidence supports immediate, undisturbed skin-to-skin care after vaginal birth and during and after cesarean surgery for all medically stable mothers and newborns, regardless of feeding preference; and, no routine separation during the days after birth. Childbirth educators and other health-care professionals have an ethical responsibility to support this essential healthy birth practice through education, advocacy, and implementation of evidence-based maternity practices.
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Ng CA, Ho JJ, Lee ZH. The effect of rooming-in on duration of breastfeeding: A systematic review of randomised and non-randomised prospective controlled studies. PLoS One 2019; 14:e0215869. [PMID: 31022227 PMCID: PMC6483355 DOI: 10.1371/journal.pone.0215869] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 04/05/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The benefits of six months exclusive breastfeeding are well established for both mother and infant. One of the 10 steps of the Baby Friendly Hospital Initiative is rooming-in (mother and baby together in the same room throughout hospitalisation). A Cochrane review found only one randomised controlled trial (RCT) examining the effects of continuous rooming-in versus nursery care on breastfeeding duration, and concluded there was insufficient evidence to support or refute either practice. We aimed to examine the effect of continuous or intermittent rooming-in on breastfeeding duration. METHODS AND FINDINGS We included all prospective controlled studies (randomised and non-randomised) comparing rooming-in to nursery care that reported full or partial breastfeeding up to six months. We used the 2016 search results of the Cochrane review and updated the search to August 2018 using OVID MEDLINE. Duplicate data extraction and assessment of risk of bias were performed. Meta-analyses were performed using REVMAN 5. The GRADE approach was used to assess quality of evidence. Seven studies were included, five had 24-hour-per-day, one daytime only and one 8-hours-per-day rooming-in. Four studies had at least one additional co-intervention: Differences in delivery room management, and educational packages. All studies contributing to meta-analyses had 24-hour rooming-in. There was no difference in the proportion of infants on full breastfeeding at 3 months (RR 1.14; 95% CI 0.84 to 1.54; very-low-quality evidence), 4 months (RR 0.99; 95% CI 0.73 to 1.33; very-low-quality evidence) and 6 months (RR 0.95; 95% CI 0.57 to 1.58; low-quality evidence). The proportion of infants on partial breastfeeding at 3-4 months was higher with rooming-in (RR 1.31; 95% CI 1.06 to 1.61; very-low-quality evidence). CONCLUSION The addition of non-randomised prospective controlled studies to existing evidence did not add further information on the effects of rooming-in on breastfeeding duration but resulted in lower quality of evidence. Uncertainty about the effects of rooming-in on breastfeeding duration remains.
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Affiliation(s)
- Chin Ang Ng
- C/O Department of Paediatrics, RSCI & UCD Malaysia Campus, George Town, Penang, Malaysia
| | - Jacqueline J. Ho
- Department of Paediatrics, RSCI & UCD Malaysia Campus, George Town, Penang, Malaysia
- * E-mail:
| | - Zcho Huey Lee
- C/O Department of Paediatrics, RSCI & UCD Malaysia Campus, George Town, Penang, Malaysia
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Hernández-Aguilar MT, Bartick M, Schreck P, Harrel C, Noble L, Calhoun S, Dodd S, Elliott-Rudder M, Lappin S, Larson I, Lawrence RA, Marinelli KA, Marshall N, Mitchell K, Reece-Stremtan S, Rosen-Carole C, Rothenberg S, Seo T, Wonodi A. ABM Clinical Protocol #7: Model Maternity Policy Supportive of Breastfeeding. Breastfeed Med 2018; 13:559-574. [PMID: 30457366 DOI: 10.1089/bfm.2018.29110.mha] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.
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Affiliation(s)
- Maria-Teresa Hernández-Aguilar
- 1 Breastfeeding Clinical Unit Dr. Peset, University Hospital Dr. Peset, National Health Service, Valencia, Spain .,2 National Coordinator of Spain Baby-Friendly Initiative (IHAN-España Iniciativa para la Humanización de la Asistencia al Nacimiento y la Lactancia), Madrid, Spain
| | - Melissa Bartick
- 3 Department of Medicine, Cambridge Health Alliance , Cambridge, Massachusetts.,4 Harvard Medical School, Boston, Massachusetts
| | - Paula Schreck
- 5 Department of Pediatrics, Ascension St. John , Detroit, Michigan
| | - Cadey Harrel
- 6 Department of Family Medicine, University of Arizona , Tucson, Arizona
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