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Charafeddine L, Masri S, Shamsedine L, Ghandour L, Tamim H, El Khoury N, Hachem Z, Nabulsi M. Validation of the Arabic version of the breastfeeding behavior questionnaire among Lebanese women. Int Breastfeed J 2020; 15:54. [PMID: 32517707 PMCID: PMC7282113 DOI: 10.1186/s13006-020-00296-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 06/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Breastfeeding Behavior Questionnaire (BBQ) assesses women's perceptions of their breastfeeding behavior. It was adapted to several languages and used in different settings, but has not been validated in Arabic-speaking populations. None of the previous studies that used the BBQ in other cultures examined its ability to predict the actual breastfeeding behaviors of mothers postpartum. This study validated the BBQ in a cohort of Lebanese pregnant women between December 2013 and January 2016, and examined whether it can predict exclusive breastfeeding at one, three and six months. METHODS The internal consistency reliability and construct validity of the Arabic BBQ (BBQ-A) were tested on 354 pregnant women. Its predictive ability was assessed by correlating the women's BBQ-A scores with their breastfeeding outcomes at one, three and six months post-delivery. RESULTS The BBQ-A had a good internal consistency reliability (Cronbach's alpha = 0.78). Exploratory factor analysis revealed that it is unidimensional. Inter-item correlations ranged between - 0.016 and 0.934, with corrected-item total correlations ranging from 0.273 to 0.678. Perceived positive breastfeeding behavior correlated with positive breastfeeding attitudes, good breastfeeding knowledge and stronger breastfeeding intention supporting its external validity. However, in binomial multivariate logistic regression analysis, the BBQ-A did not predict exclusive breastfeeding at one, three or six months. CONCLUSIONS The BBQ-A is a reliable and valid instrument to assess women's perceptions of their breastfeeding behavior in an Arab context. Availability of this instrument is important for investigators conducting breastfeeding research in the Arab world. However, the BBQ-A does not predict exclusive breastfeeding at one, three or six months. Further research on the Breastfeeding Behavior Questionnaire is needed to examine its predictive validity in other cultures.
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Affiliation(s)
- Lama Charafeddine
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Saadieh Masri
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Lama Shamsedine
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Lilian Ghandour
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Hani Tamim
- Clinical Research Institute, Biostatistics Unit, American University of Beirut, Beirut, Lebanon
| | - Nathalie El Khoury
- Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Zahraa Hachem
- Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Mona Nabulsi
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon.
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Casal CS, Lei A, Young SL, Tuthill EL. A Critical Review of Instruments Measuring Breastfeeding Attitudes, Knowledge, and Social Support. J Hum Lact 2017; 33:21-47. [PMID: 28135474 PMCID: PMC6377936 DOI: 10.1177/0890334416677029] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Breastfeeding provides beneficial health outcomes for infants and their mothers, and increasing its practice is a national priority in many countries. Despite increasing support to exclusively breastfeed, the prevalence at 6 months remains low. Breastfeeding behavior is influenced by a myriad of determinants, including breastfeeding attitudes, knowledge, and social support. Effective measurement of these determinants is critical to provide optimal support for women throughout the breastfeeding period. However, there are a multitude of available instruments measuring these constructs, which makes identification of an appropriate instrument challenging. Research aim: Our aim was to identify and critically examine the existing instruments measuring breastfeeding attitudes, knowledge, and social support. METHODS A total of 16 instruments was identified. Each instrument's purpose, theoretical underpinnings, and validity were analyzed. RESULTS An overview, validation and adaptation for use in other settings was assessed for each instrument. Depth of reporting and validation testing differed greatly between instruments. CONCLUSION Content, construct, and predictive validity were present for most but not all scales. When selecting and adapting instruments, attention should be paid to domains within the scale, number of items, and adaptation.
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Affiliation(s)
- Corrine S Casal
- 1 Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, USA
| | - Ann Lei
- 1 Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, USA
| | - Sera L Young
- 1 Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, USA.,2 Department of Anthropology, Northwestern University, Evanston, IL, USA
| | - Emily L Tuthill
- 3 School of Nursing, University of California, San Francisco, CA, USA
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St Fleur R, Petrova A. Knowledge and perception of breastfeeding practices in Hispanic mothers in association with their preferred language for communication. Breastfeed Med 2014; 9:261-5. [PMID: 24784835 DOI: 10.1089/bfm.2013.0145] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Economically disadvantaged minority mothers with limited proficiency in English show suboptimal breastfeeding rates. In the present survey, the knowledge and perception of Hispanic mothers regarding their breastfeeding practices were analyzed in association with their language preference for communication. Among the mostly Hispanic-origin Special Supplemental Nutrition Program for Women, Infants, and Children-eligible mothers surveyed at our pediatric clinic, 109 were Spanish-respondent Hispanics (Group 1), 31 were English-respondent Hispanics (Group 2), and 56 were U.S.-born non-Hispanics (Group 3). Overall, 70-90% of mothers reported understanding the beneficial effect of breastmilk, thought breastfeeding was good to do, and had discussed breastfeeding with their obstetricians and pediatricians. Groups 1 and 2 mothers were more likely to have predecided to breastfeed their infant, to feel comfortable about breastfeeding at the doctor's office, and to have discussed with their mothers about how they had been fed. However, they were less likely to be able to identify who to approach for breastfeeding advice. A higher proportion of the Group 1 mothers admitted to inadequate breastfeeding knowledge, unfamiliarity with "latch on," and inability to identify who had educated them about breastfeeding. We conclude that in economically disadvantaged Hispanic mothers, a preference for communication in Spanish is associated with limited breastfeeding knowledge and lack of breastfeeding-related educational networks. Language preference should be addressed while providing breastfeeding education and support for Hispanic mothers to help improve their understanding and breastfeeding networks.
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Affiliation(s)
- Rose St Fleur
- 1 Department of Pediatrics, Jersey Shore University Medical Center , Neptune, New Jersey
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Nabulsi M, Hamadeh H, Tamim H, Kabakian T, Charafeddine L, Yehya N, Sinno D, Sidani S. A complex breastfeeding promotion and support intervention in a developing country: study protocol for a randomized clinical trial. BMC Public Health 2014; 14:36. [PMID: 24428951 PMCID: PMC3898488 DOI: 10.1186/1471-2458-14-36] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 01/12/2014] [Indexed: 11/16/2022] Open
Abstract
Background Breastfeeding has countless benefits to mothers, children and community at large, especially in developing countries. Studies from Lebanon report disappointingly low breastfeeding exclusivity and continuation rates. Evidence reveals that antenatal breastfeeding education, professional lactation support, and peer lay support are individually effective at increasing breastfeeding duration and exclusivity, particularly in low-income settings. Given the complex nature of the breastfeeding ecosystem and its barriers in Lebanon, we hypothesize that a complex breastfeeding support intervention, which is centered on the three components mentioned above, would significantly increase breastfeeding rates. Methods/Design A multi-center randomized controlled trial. Study population: 443 healthy pregnant women in their first trimester will be randomized to control or intervention group. Intervention: A “prenatal/postnatal” professional and peer breastfeeding support package continuing till 6 months postpartum, guided by the Social Network and Social Support Theory. Control group will receive standard prenatal and postnatal care. Mothers will be followed up from early pregnancy till five years after delivery. Outcome measures: Total and exclusive breastfeeding rates, quality of life at 1, 3 and 6 months postpartum, maternal breastfeeding knowledge and attitudes at 6 months postpartum, maternal exclusive breastfeeding rates of future infants up to five years from baseline, cost-benefit and cost-effectiveness analyses of the intervention. Statistical analysis: Descriptive and regression analysis will be conducted under the intention to treat basis using the most recent version of SPSS. Discussion Exclusive breastfeeding is a cost-effective public health measure that has a significant impact on infant morbidity and mortality. In a country with limited healthcare resources like Lebanon, developing an effective breastfeeding promotion and support intervention that is easily replicated across various settings becomes a priority. If positive, the results of this study would provide a generalizable model to bolster breastfeeding promotion efforts and contribute to improved child health in Lebanon and the Middle East and North Africa (MENA) region. Trial registration Current Controlled Trials ISRCTN17875591
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Affiliation(s)
- Mona Nabulsi
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon.
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Chary AN, Messmer SE, Rohloff PJ. Male influence on infant feeding in rural Guatemala and implications for child nutrition interventions. Breastfeed Med 2011; 6:227-31. [PMID: 21631252 DOI: 10.1089/bfm.2011.0015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND AIMS Guatemala has one of the highest rates of child stunting in the world, which especially impacts rural indigenous agricultural communities. Despite decades of intensive nutrition research and interventions, only rarely have nutrition programs successfully lowered the rate of stunting in these settings. The bulk of nutritional interventions in Guatemala are targeted at the education of female caregivers. However, women's ability to implement best practices in infant breastfeeding and complementary feeding are often constrained by external factors. This study evaluated the knowledge, beliefs, and practices of female caregivers, as well as the attitudes of fathers, toward breastfeeding and infant feeding in a rural Guatemalan village. METHODS Clinical work, participant-observation, surveys, interviews, and focus groups were conducted in a rural Guatemalan village in conjunction with a child feeding program from August 2008 to January 2011. RESULTS Male employment status, mental health, and attitudes towards child rearing and parenting responsibilities are often principal factors in infant growth failure. CONCLUSIONS Successful child feeding programs must include educational elements for men and should consider structural elements that provide a safety net for unexpected changes in domestic finances.
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Affiliation(s)
- Anita N Chary
- School of Medicine & Department of Anthropology, Washington University in St. Louis, Missouri, USA.
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Tenfelde S, Finnegan L, Hill PD. Predictors of breastfeeding exclusivity in a WIC sample. J Obstet Gynecol Neonatal Nurs 2011; 40:179-89. [PMID: 21314715 DOI: 10.1111/j.1552-6909.2011.01224.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To examine predictors of breastfeeding exclusivity in low-income women who received services from a Chicago area clinic of the Special Supplemental Nutrition Program for Women, Infants and Children Program (WIC). DESIGN A secondary data analysis of existing clinical and administrative data. SETTING An urban community health center serving low-income families. PARTICIPANTS Two hundred and thirty-five (235) low-income women who initiated breastfeeding and received WIC services. METHODS Logistic regression models were fit to existing prenatal and postpartum data to determine predictors of breastfeeding exclusivity during the immediate postpartum period. RESULTS Only 23% of the sample breastfed exclusively. Women who received first-trimester prenatal care were more likely to exclusively breastfeed than women who entered prenatal care in later trimesters (OR = 2.02, p ≤ 0.05). Women who declared intentions prenatally to exclusively breastfeed were more likely to exclusively breastfeed than women who did not intend to breastfeed (OR = 3.85, p ≤ 0.001). Overweight/obese women were less likely to exclusively breastfeed than normal/underweight women (OR = 0.50, p ≤ 0.05). CONCLUSION Findings from this study can be used to develop tailored interventions to promote breastfeeding exclusivity among low-income WIC recipients.
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Affiliation(s)
- Sandi Tenfelde
- Marcella Niehoff School of Nursing, Loyola University, Maywood, IL, USA.
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Laanterä S, Pölkki T, Ekström A, Pietilä AM. Breastfeeding attitudes of Finnish parents during pregnancy. BMC Pregnancy Childbirth 2010; 10:79. [PMID: 21126368 PMCID: PMC3003624 DOI: 10.1186/1471-2393-10-79] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Accepted: 12/02/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breastfeeding attitudes are known to influence infant feeding but little information exists on the prenatal breastfeeding attitudes of parents. The purpose of this study was to describe Finnish parents' prenatal breastfeeding attitudes and their relationships with demographic characteristics. METHODS The electronic Breastfeeding Knowledge, Attitude and Confidence scale was developed and 172 people (123 mothers, 49 fathers) completed the study. The data were analysed using factor analysis and nonparametric methods. RESULTS Breastfeeding was regarded as important, but 54% of the respondents wanted both parents to feed the newborn. The mean rank values of breastfeeding attitudes differed significantly when parity, gender, education, age, breastfeeding history and level of breastfeeding knowledge were considered. The respondents who were expecting their first child, were 18-26 years old or had vocational qualifications or moderate breastfeeding knowledge had more negative feelings and were more worried about breastfeeding than respondents who had at least one child, had a higher vocational diploma or academic degree or had high levels of breastfeeding knowledge. Respondents with high levels of breastfeeding knowledge did not appear concerned about equality in feeding. CONCLUSIONS Both mothers and fathers found breastfeeding important. A father's eagerness to participate in their newborn's life should be included in prenatal breastfeeding counselling and ways in which to support breastfeeding discussed. Relevant information about breastfeeding should focus on the parents who are expecting their first child, those who are young, those with low levels of education or those who have gaps in breastfeeding knowledge, so that fears and negative views can be resolved.
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Affiliation(s)
| | - Tarja Pölkki
- Institute of Health Sciences, Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014 University of Oulu, Finland
| | - Anette Ekström
- School of Life Sciences, University of Skövde, PO Box 408, SE-54128 Skövde, Sweden
| | - Anna-Maija Pietilä
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Social and Health Care Center of Kuopio, PO Box 1627, FI-70211, Kuopio, Finland
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Abstract
PURPOSE To synthesize research regarding the low breastfeeding rates in Hispanic women living in the United States, particularly those who immigrate to this country and become acculturated. DATA SOURCES Extensive review of global literature on the subject. CONCLUSIONS Exclusive and continued breastfeeding rates in the United States have increased in recent years but remain low, and no state in the United States currently meets the Healthy People 2010 recommendations. Due to the increasing number of Hispanic women immigrating to the United States and having children, it is imperative to develop appropriate culturally specific guidelines in breastfeeding promotion programs. When providing care to a Hispanic mother, clinicians can best assist this population by holistically reviewing all aspects of a woman's life including her environment and relationships with others to provide positive outcomes that ultimately benefit Hispanic mothers and their newborns. IMPLICATIONS FOR PRACTICE Guidelines and interventions for initiating and continuing breastfeeding in Hispanic women are proposed, including providing a bilingual personal breastfeeding advocate, as well as group classes that incorporate traditional Hispanic cultural beliefs and allow the women to devise personal breastfeeding plans.
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Affiliation(s)
- Asefeh Faraz
- Yale University School of Nursing, New Haven, Connecticut 06536-0740, USA.
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Abstract
PURPOSE The purpose of this study was to describe breastfeeding knowledge of childbearing parents as well as to discover the demographic variables related to it, and evaluate the use of a web-based survey. SUBJECTS AND METHODS The electronic Breastfeeding Knowledge, Attitude and Confidence scale was developed, and the data were collected at eight maternity healthcare clinics in Finland. All the families who visited those clinics between March 2 and April 3, 2009 were invited to the study, and 123 pregnant mothers and 49 fathers completed the survey. FINDINGS AND CONCLUSIONS The respondents correctly answered 68% of the items related to breastfeeding knowledge. The most usual lack of knowledge concerned how to increase lactation, sufficiency of breast milk in hot weather, sufficiency of breast milk for 4 months after birth, and the need to pump the breasts after alcohol consumption. Differences in the breastfeeding scores existed when gender, parity, age, living with spouse, educational level, smoking, time of pregnancy and breastfeeding history were considered. The web-based survey was well suited to the data collection, but the weak response rate requires attention. Parents need more information about ways to increase lactation and reasons to start complementary feeding.
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Petrova A, Ayers C, Stechna S, Gerling JA, Mehta R. Effectiveness of exclusive breastfeeding promotion in low-income mothers: a randomized controlled study. Breastfeed Med 2009; 4:63-9. [PMID: 19239405 DOI: 10.1089/bfm.2008.0126] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of a breastfeeding promotion program in the Women, Infant and Children (WIC) Supplemental Nutrition Program participants. STUDY DESIGN This randomized clinical trial included 52 women in the intervention group who received one-to-one pre- and postnatal breastfeeding education and support from a lactation consultant. Women (n = 52) randomized to controls received standard breastfeeding services. Data regarding their infants' feeding (classified as exclusive, partial, and bottle) during the first 7 days, 1, 2, and 3 months of age were compared. Additionally, the mothers were surveyed to assess their knowledge, attitude, and beliefs regarding breastfeeding. RESULTS Among the 104 enrolled women, 91 (87.5%) were Hispanic. Almost all the pregnant women had planned to breastfeed their infants. Although the majority of women reported breastfeeding their infants, 45.6% in the intervention group and 28.9% of controls practiced exclusive breastfeeding during the first 7 days. By 3 months, the rate of exclusive breastfeeding in the intervention and control groups had dropped to 13.9% and 10.5%, respectively. Parity, mode of delivery, previous experience with breastfeeding, rooming in, and return to work did not significantly affect the exclusive breastfeeding rate. Maternal knowledge, attitude, and beliefs regarding breastfeeding were comparable between the study groups at the baseline stage as well as 3 months postpartum. CONCLUSIONS Participation in the proposed breastfeeding promotion program by the low-income mothers was associated with an insignificant increase in the exclusive breastfeeding rate during the first 3 postpartum months.
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Affiliation(s)
- Anna Petrova
- Department of Pediatrics, University of Medicine and Dentistry, One Robert Wood Johnson Place, MEB 236, New Brunswick, NJ 08903-0019, USA.
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Heinig MJ, Ishii KD, Bañuelos JL, Campbell E, O'Loughlin C, Vera Becerra LE. Sources and acceptance of infant-feeding advice among low-income women. J Hum Lact 2009; 25:163-72. [PMID: 19136396 DOI: 10.1177/0890334408329438] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study is to identify sources and acceptability of infant-feeding advice among participants in the US-based Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Focus groups are used to identify sources of infant-feeding advice and factors that contribute to acceptance of or resistance to that advice among 65 WICeligible mothers (34 English speaking and 31 Spanish speaking). The mothers primarily rely on experienced family and friends for advice and frequently use their own intuition to find solutions that work to solve real or perceived infant-feeding problems. Professional advice is perceived as credible when caregivers exhibit characteristics similar to those of experienced family and friends: confidence, empathy, respect, and calm. Using this information, it may be possible for WIC staff to make programmatic modifications to increase their ability to promote optimal infant-feeding behaviors in this population, thereby contributing to the reduction in the prevalence of childhood overweight.
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Affiliation(s)
- M Jane Heinig
- Department of Nutrition, Human Lactation Center, Maternal Infant Nutrition Group, Division of Agriculture and Natural Resources, University of California, Davis, CA 95616, USA.
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Rivera-Lugo M, Parrilla-Rodríguez AM, Dávila-Torres RR, Albizu-García C, Rios-Motta R. Full breastfeeding during the postpartum hospitalization and mothers' report regarding baby friendly practices. Breastfeed Med 2007; 2:19-26. [PMID: 17661616 DOI: 10.1089/bfm.2006.0025] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The objective of this study was to describe the opinion of a group of postpartum women about compliance with the Ten Steps in a hospital with the intention to be certified as a Baby Friendly Hospital. METHODS Two hundred (200) postpartum women age 20 or greater who had delivered a healthy full-term baby (37 weeks gestation) participated in the study. Data were gathered by means of a semi-structured questionnaire in the Spanish language. Descriptive and inferential statistics (Chi-square) were used for data analysis. RESULTS Thirty percent (30%) of participants were 21 to 26 years of age. Primiparas comprised 51% and legally or consensually married mothers comprised 89% of the study participants. Monthly family incomes with the highest frequencies were $0 to $2000 and $2001 to $3000, respectively. Full breastfeeding was being practiced by 43.5% of the mothers in the study, whereas 53.0% were breastfeeding partially. Compliance with the Ten Steps was perceived as deficient by 52% of the mothers, whereas only 5.5% perceived compliance as excellent. The perceived level of compliance with the Ten Steps is significantly associated with the type of breastfeeding (full or partial) in the inferential analyses (X(2) [3, n = 193] = 33.74, p = 0.00) and in the multiple logistic regression analyses (OR = 1.27, confidence interval [CI] = 1.14 - 1.43, p = 0.00). As the level of perceived compliance with the Ten Steps increases, the probability of full or exclusive breastfeeding also increases. CONCLUSION Compliance with the Ten Steps of the Baby Friendly Hospital from the perspective of the postpartum mother has an impact on the type of breastfeeding.
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Affiliation(s)
- Mirza Rivera-Lugo
- Health Services Research Program, and Sciences Campus, Graduate School of Public Health, San Juan, Puerto Rico
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Abstract
This article focuses on assisting nurses with the promotion of exclusive breastfeeding in Hispanic women through the understanding of their heritage, cultural traditions, and acculturation. Nurses can incorporate these traditions into daily nursing practice in order to enhance the breastfeeding experience of Hispanic mothers. Because exclusive breastfeeding is low in minority groups in the United States, it is essential that nurses use the initial postpartum period to help educate women about exclusive breastfeeding. In order to accomplish this, nurses need culturally specific information, which promotes cultural traditions and also encourages breastfeeding.
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Abstract
Breastfeeding rates remain low, especially among low-income minority women. The objective of this qualitative study was to assess barriers to breastfeeding and reasons for combination feeding among low-income Latina women and their families. Meetings were held with key informants to inform the sampling plan and develop questions for focus groups. Data were collected from eight qualitative focus groups with primiparous mothers postpartum, mothers breastfeeding at 4 to 6 months, mothers formula feeding at 4 to 6 months, grandmothers and fathers, and 29 individual interviews with formula- and combination-feeding mothers. Transcripts of focus groups and interviews were content coded and analyzed for thematic domains and then compared for concurrence and differences. Four main domains with 15 categories were identified: (a) Best of both: Mothers desire to ensure their babies get both the healthy aspects of breast milk and "vitamins" in formula. (b) Breastfeeding can be a struggle: Breastfeeding is natural but can be painful, embarrassing, and associated with breast changes and diet restrictions. (c) Not in Mother's Control: Mothers want to breastfeed, but things happen that cause them to discontinue breastfeeding. (d) Family and cultural beliefs: Relatives give messages about supplementation for babies who are crying or not chubby. Negative emotions are to be avoided so as to not affect mother's milk. Those counseling Latina mothers about infant feeding should discourage and/or limit early supplementation with formula, discuss the myth of "best of both," understand the fatalism involved in problem-solving breastfeeding issues, and enlist the altruism embedded in the family unit for support of the mother-infant pair.
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Abstract
This article reports on breastfeeding intentions of Hispanic and black women by country of origin (continental US born or foreign born) in a low-income population that has experienced demographic shifts. Data were derived from prenatal interviews with 382 women from 2 community clinics. Primary outcome measures were intentions to formula feed, breastfeed, or formula and breastfeed. Foreign-born women were significantly more likely to intend to only breastfeed (42% vs 24% for continental US born, P < .05). In multivariate analyses, country of origin and having breastfed a previous child were the only significant predictors of breastfeeding intention. In contrast to previous work, black (non-Hispanic) and Hispanic women's breastfeeding plans were similar. This finding coincides with dramatic increases in the numbers of blacks from West Indian countries-where breastfeeding is the norm-in the study locale.
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Affiliation(s)
- Karen A Bonuck
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine/Montefiore Medical Center, the Bronx, New York 10467, USA
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Schlickau J, Wilson M. Development and testing of a prenatal breastfeeding education intervention for Hispanic women. J Perinat Educ 2005; 14:24-35. [PMID: 17273450 PMCID: PMC1595264 DOI: 10.1624/105812405x72302] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Many immigrant Hispanic women in the United States choose to bottle-feed rather than breastfeed. This article describes an intervention that was developed and tested in a two-step process. Two studies were undertaken. First, a qualitative inquiry explored the breastfeeding beliefs, attitudes, meanings, and practices of Hispanic women. Results informed the design of a culturally appropriate prenatal breastfeeding education intervention. Secondly, the researchers undertook a quantitative study of the intervention's success in increasing breastfeeding duration among Hispanic women. Methodology and findings of this study have implications for future interventions that promote breastfeeding.
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Affiliation(s)
- Jane Schlickau
- JANE SCHLICKAU is an associate professor of nursing at Southwestern College in Winfield, Kansas
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McKee M, Zayas L, Jankowski K. Breastfeeding intention and practice in an urban minority population: relationship to maternal depressive symptoms and mother–infant closeness. J Reprod Infant Psychol 2004. [DOI: 10.1080/02646830410001723751] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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