Breastfeeding and caring for children: a qualitative exploration of the experiences of mothers with physical impairments in Ghana

Comparison of Breastfeeding Behaviors of Mothers Toward Infants by Ethnic Groups: An Example of a Multicultural City

Introduction: Breastfeeding practices vary widely among different ethnic groups and are influenced by cultural, social, economic, and educational factors. The aim of this study was to compare the breastfeeding behaviors of mothers toward infants in different ethnic groups. Methods: This descriptive cross-sectional study included women of four ethnic groups (Assyrian, Turkish, Arab, and Kurdish) living in Mardin, Turkey. The study was completed with 180 Assyrian, 184 Turkish, 175 Arab, and 169 Kurdish women. In total, 708 women participated in this study. Data were collected between August 12, 2024, and September 22, 2024. Results: The highest rate of traditional breastfeeding practices was seen in Kurdish (99.4%), whereas this rate was 97.3% in Turkish, 96% in Arab, and 84.4% in Assyrian. The highest rate of giving breast milk immediately after birth was in Assyrian (71.7%), while this rate was 69.3% in Turkish, 61.9% in Kurdish, and 47% in Arab (p = 0.000). The rate of those who waited for three calls to prayer to feed the baby was 13.1% in Kurdish, 11.3% in Arab, 9.5% in Turkish, and 7.9% in Assyrian. The rate of those who did not give the first milk (colostrum) to the baby was 15.8% in Assyrian, 11.7% in Turkish, 6.5% in Kurdish, and 6% in Arab. The rate of those who give sugared water as the baby's first nutrient was 37.5% in Arab, 20.8% in Kurdish, 11.7% in Turkish, and 9.2% in Assyrian. Increased education levels were associated with decreased rates of the presence of traditional practices. Conclusion: This study provides novel results regarding the comparison of breastfeeding behaviors among ethnic groups living in the same city. Comparing breastfeeding practices across the four ethnic groups allowed us to better understand different breastfeeding practices, which could lead to the development of culturally sensitive interventions to improve the health of children and mothers. Educating the community about the benefits of breastfeeding and the risks associated with some traditional practices could contribute to public health.

Introduction of Breast Milk Substitutes During the First 3 Days of Life: Results of the Mexican National Survey of Demographic Dynamics, 2018

Background: The introduction of foods or fluids other than breast milk in the first few days after birth interferes with the establishment of breastfeeding. This study aimed to investigate the association of formula introduction during the first 3 days of life with maternal sociodemographic characteristics, hospital practices, and breastfeeding duration. Materials and Methods: Information from the National Survey of Demographic Dynamics, 2018, which includes 17,686 mother-baby pairs was analyzed. Mother-baby pairs were classified into categories according to breastfeeding duration: <5 months and ≥5 months. Statistical methods and a machine learning algorithm (Bayesian network, BN) were used to analyze the data. Results: In general, 3,720 (21%) mothers reported introducing formula during the first 3 days of life. A lower education level, lower sociodemographic stratum, living in a rural area, and considering oneself indigenous were factors associated with not introducing formula during the first 3 days of life. A total of 5,168 (29.2%) mother-baby pairs practiced breastfeeding for <5 months, and 12,518 (70.8%) for ≥5 months. Almost twice as many mothers who practiced breastfeeding for <5 months introduced formula during the first 3 days of life (31.7%) compared with those who practiced breastfeeding for ≥5 months (16.6%). The BN model can sufficiently predict cases with a breastfeeding duration ≥5 months (precision-recall curve area = 0.792). Discussion: Introducing formula during the first 3 days of life was associated with a shorter breastfeeding duration. BN analysis showed a probabilistic dependency between the type of delivery and variables associated with the establishment of breastfeeding.

Disparities in 6 Month Exclusive Breastfeeding in Ghana, Africa: A Scoping Review

BACKGROUND

Exclusive breastfeeding practice for 6 months is a critical global public health goal. In 2020, only 44% of infants globally, 31% in Central and West Africa, and 43% in Ghana, were exclusively breastfed for the first 6 months of life.

RESEARCH AIM

To critically evaluate disparities in exclusive breastfeeding practice for 6 months in Ghana.

METHODS

The scoping review was guided by Arksey and O'Malley's (2005) six-stage scoping review process. The online databases of American Psychological Association PsychInfo (APA PsychInfo), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Scopus were searched with keywords inclusive of Ghana, exclusive breastfeeding, breastfeeding, infant feeding, lactation, lactating, and exclusive. Eligibility criteria included full-text, peer-reviewed research articles written in the English language without limitation to specific years. Data were analyzed thematically.

RESULTS

Initially, 317 records were identified, and 15 full-text articles were eligible for the scoping review. Four main themes emerged as disparities in exclusive breastfeeding practice in Ghana. The themes were healthcare (prenatal clinic visits, delivery place, exclusive breastfeeding knowledge), personal (maternal age, Human Immunodeficiency Virus status, parity, type of delivery, breast problem), employment (unemployed, formal, or informal sector worker), and sociocultural (ethnicity/region, family support, religious beliefs, cultural practices).

CONCLUSION

Disparities in exclusive breastfeeding in Ghana warrant the collaborative efforts of stakeholders for successful mitigation. Future researchers should explore the role of religion and sociocultural practices to protect, promote, and support 6 months of exclusive breastfeeding in Ghana.

Parenting with a physical disability: A scoping review of assessment methods

INTRODUCTION

Daily childcare can be challenging for parents with a physical disability who have young children. Occupational therapists are valuable facilitators to family participation. However, occupational therapists have reported significant gaps in knowledge when documenting the parenting role of parents with a physical disability in occupational therapy practice. This study explored and described the parenting assessment methods used with parents with a physical disability in the scientific literature.

METHODS

A scoping review was conducted, and search results were reviewed by two separate reviewers. The search strategy was applied to five databases (Embase, CINAHL, MEDLINE, HaPI, PsycInfo). Numerical and thematic analyses were conducted.

RESULTS

Four thousand one hundred fifty articles were screened, and 73 relevant scientific articles were included. Seventy-six assessment methods were identified, including 20 assessment instruments with few reported population-specific psychometric studies. Most assessments were conducted via interviews (n = 45), followed by questionnaires (n = 27), and only six were performance based. Parenting practices and experience were the two dimensions most assessed, with little attention given to parenting responsibility. Mothers with multiple sclerosis, spinal cord injury, rheumatoid arthritis, and cerebral palsy were the most assessed.

CONCLUSION

Further research is needed to develop specific, multidimensional, and validated parenting assessments for all parents with a physical disability, including performance-based assessments. Formal assessments should be conducted by professionals, including occupational therapists, who have the necessary training.

Experiences of Breastfeeding Mothers With Visual Disabilities

BACKGROUND

Parents with visual impairment can have difficulty in breastfeeding their babies. This situation may cause mothers to have negative feelings towards the care of their babies and to have problems during breastfeeding process.

RESEARCH AIMS

To examine in detail (1) the breastfeeding experiences of mothers with visual impairment, and (2) the factors that facilitate and prevent these mothers from continuing to breastfeed.

METHODS

This study was a cross-sectional, prospective generic qualitative design. The study sample (N = 15) consisted of mothers with visual impairment aged 18 and over, residing in Turkey, speaking Turkish, having an infant under the age of 2, and with breastfeeding experience. The analysis process was a content analysis approach. Data were collected through video or audio interviews using a semi-structured interview form.

RESULTS

Three main themes and 12 subthemes were determined: (1) negative emotions caused by breastfeeding, (2) barriers to initiating and maintaining breastfeeding, and (3) facilitators in initiating and maintaining breastfeeding.

CONCLUSION

The participants in our study stated that health personnel had limited information on how to communicate with and support them. For this reason, it is important that breastfeeding counselors and health care providers receive training about breastfeeding counseling for mothers with visual impairment so that they can provide information and advice to these mothers.

Familiar but neglected: identification of gaps and recommendations to close them on exclusive breastfeeding support in health facilities in Malawi

Background

Exclusive breastfeeding is widely accepted as a key intervention with proven efficacy for improving newborn survival. Despite international commitments and targets to support and promote breastfeeding, there are still gaps in meeting and maintain coverage in many sub-Saharan African countries. This paper aimed to triangulate the perspectives of health workers, mothers, and their family members with facility assessments to identify gaps to improve breastfeeding support in in Malawi.

Methods

The study on breastfeeding barriers and facilitators was conducted in 2019 at one tertiary hospital and three secondary-level hospitals in Malawi. We conducted 61 semi-structured interviews with health workers, postnatal mothers, grandmothers, aunts, and fathers. In 2017, we carried out a neonatal care facility assessment using the World Health Organization (WHO) Integrated Maternal, Neonatal, and Child Quality of Care Assessment and Improvement Tool. Qualitative data were analysed using a thematic analysis approach within the Systems Framework for Health Policy.

Results

The district-level hospitals rated high with an average score of 4.8 out of 5 across the three facilities indicating that only minor improvements are needed to meet standards of care for early and exclusive breastfeeding. However, the score fell to an average of 3.5 out of 5 for feeding needs with sick neonates indicating that several improvements are needed in this area. The qualitative data demonstrated that breastfeeding was normalized as part of routine newborn care. However, the focus on routine practice and reliance on breastfeeding knowledge from prenatal counselling highlights inequities and neglect in specialized care and counselling among vulnerable mothers and newborns. Revitalisation of breastfeeding in Malawian facilities will require a systems approach that reinforces policies and guidelines; contextualises knowledge; engagement and empowerment of other relatives to the baby and task-sharing among health workers.

Conclusions

Breastfeeding is accepted as a social norm among health workers, mothers, grandmothers, aunts, and fathers in Malawi, yet vulnerable groups are underserved. Neglect in breastfeeding support among vulnerable populations exacerbates health inequities. Health systems strengthening related to breastfeeding requires a concerted effort among health workers, mothers, grandmothers, aunts, and fathers while remaining grounded in contexts to support family-centered hospital care.

Self-Reported Work-Related Musculoskeletal Disorders and Associated Factors among Restaurant Workers in Gondar City, Northwest Ethiopia, 2020

Introduction

Globally, work-related musculoskeletal disorders (WMSDs) have resulted in occupational disability and injury. Of these, restaurant workers are among the high-risk professionals usually affected by WMSDs. In Ethiopia, evidence on the burden of musculoskeletal disorder and contributing factors among restaurant workers were very limited. Therefore, this study was aimed at assessing the prevalence of self-reported WMSDs and contributing factors among restaurant workers in Gondar city, northwest Ethiopia, 2020.

Methods

An institutional-based cross-sectional study was conducted from February 2020 to March 2020 among restaurant workers in Gondar city. A two-stage sampling technique was used to choose 633 study subjects. A structured Nordic questioner was used to collect the data. Data was entered into EpiData version 3.1 and exported to Stata version 14.0 for analysis. Both bivariable and multivariable logistic regression analyses were computed. An adjusted odds ratio with a 95% confidence interval was used to measure the association between WMSDs and independent variables. In the multivariable analysis, a P value of <0.05 was used to declare a statistically significant association. To check the goodness of fit, the Hosmer and Lemeshow test was used.

Results

The prevalence of WMSDs among restaurant workers in the past 12 months was 81.5% [95% CI (78.18-84.44)]. Attending primary education [AOR: 2.14, 95% CI (1.17-3.90)], attending secondary education [AOR: 1.71 (1.02-2.86)], and job satisfaction [AOR: 1.90, 95%CI (1.13-3.19)] were significantly associated with WMSDs.

Conclusion

In this study, the prevalence of WMSDs among restaurant workers was high. The upper back, lower back, elbow, and wrist were the most affected body parts. Age above 30 years, educational status being primary and secondary, and being dissatisfied by their job were positively associated with a high prevalence of WMSDs.