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Mirzakhani K, Yas A, Khadivzadeh T. Explaining the perception and experiences of breastfeeding in mothers who have a high risk pregnancy: a protocol study. Reprod Health 2024; 21:74. [PMID: 38824530 PMCID: PMC11143571 DOI: 10.1186/s12978-024-01817-x] [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: 05/14/2024] [Accepted: 05/21/2024] [Indexed: 06/03/2024] Open
Abstract
INTRODUCTION Enhancing breastfeeding practices, even in affluent nations, significantly reduces child mortality rates. Nevertheless, three out of five newborns do not receive breastfeeding within the first hour of birth. Research indicates that under high-risk pregnancy circumstances, there may be challenges in initiating and sustaining breastfeeding. Infants born from high-risk pregnancies are particularly vulnerable to illnesses and mortality. Although breastfeeding serves as a protective measure against various infant and post-infancy ailments, many mothers encounter difficulties in commencing or maintaining breastfeeding due to complications associated with their conditions. The present study aims to illuminate the understanding and experience of breastfeeding in mothers with high-risk pregnancies, considering the cultural and social context of Iran. METHOD This study is a qualitative research utilizing a conventional content analysis approach. In this qualitative study, mothers who have undergone a high-risk pregnancy and currently have infants under 6 months old will be chosen through purposeful and snowball sampling. Their breastfeeding experiences will be gathered through individual, semi-structured, and face-to-face interviews. In addition to interviews, observation and focus groups will also be used to collect data. Data analysis was performed using Graneheim and Lundman's method with MAXQDA software version 10, VERBI Software GmbH, Berlin. The study will utilize the criteria of Lincoln and Guba (1985) for validity and reliability. DISCUSSION This qualitative study aims to investigate the experiences and challenges of breastfeeding in mothers with high-risk pregnancies to pinpoint breastfeeding barriers in this demographic and develop essential interventions and strategies to address these obstacles.
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Affiliation(s)
- Kobra Mirzakhani
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atefeh Yas
- Student Research Committee, Mashhad University of Medical Science, Mashhad, Iran
| | - Talat Khadivzadeh
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
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Makwela MS, Mashaba RG, Ntimana CB, Seakamela KP, Maimela E. Barriers and enablers to exclusive breastfeeding by mothers in Polokwane, South Africa. Front Glob Womens Health 2024; 5:1209784. [PMID: 38414908 PMCID: PMC10897026 DOI: 10.3389/fgwh.2024.1209784] [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: 04/21/2023] [Accepted: 01/31/2024] [Indexed: 02/29/2024] Open
Abstract
Background Exclusive breastfeeding (EBF) for six months, with the introduction of appropriate complementary feeding thereafter, and breastfeeding continuing for up to 2 years and beyond, is highly recommended. This could save the lives of up to 1.4 million children each year worldwide. Despite this, breastfeeding rates in South Africa remain sub-optimal, with the recommended target of 50% by the World Health Assembly (WHA) not being achieved. The study aimed to investigate the reasons influencing mothers' practice of exclusive breastfeeding in the Polokwane municipality of Limpopo province in South Africa. Methodology A cross-sectional health facility-based quantitative and descriptive survey was conducted using a validated-structured questionnaire administered to 146 mothers. The data was analyzed using STATA. Chi-square tests were used to determine the relationship between selected demographic variables and their reasons not to breastfeed exclusively. Results Although 94% of the mothers had initiated breastfeeding, at the time of data collection 8% had stopped. Of those who had stopped breastfeeding, 5% did so within one month of starting. Thirty- nine percent of mothers' breastfed exclusively, while 61% practiced mixed feeding. A positive association between exclusive breastfeeding practices and the age of the mother were observed, with older mothers more likely to breastfeed. The reasons mothers stopped breastfeeding were: the mother was ill (45%) or they returned to school or work (27%). Reasons for not breastfeeding were cited as: medical conditions, not enough milk, and infant refusal to breastfeed (33%). Mothers believe that HIV-positive women should breastfeed their infants (57%), and health workers were found to be the main source of HIV information to mothers (77%). Discussion Exclusive breastfeeding during the first six months was less practiced. Infant formula and solid foods were introduced at an early age, usually within the first month of breastfeeding. This study sheds light on factors influencing the early initiation of breastfeeding and the practice of EBF as practiced in Polokwane.
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Affiliation(s)
- Maishataba Solomon Makwela
- Department of Public Health, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
- Department of Human Nutrition and Dietetics, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Reneilwe Given Mashaba
- DIMAMO Population Health Research Centre, University of Limpopo, Polokwane, South Africa
| | - Cairo Bruce Ntimana
- DIMAMO Population Health Research Centre, University of Limpopo, Polokwane, South Africa
| | - Kagiso Peace Seakamela
- DIMAMO Population Health Research Centre, University of Limpopo, Polokwane, South Africa
| | - Eric Maimela
- Department of Public Health, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
- DIMAMO Population Health Research Centre, University of Limpopo, Polokwane, South Africa
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Soltani S, Hosseinzadeh M, Mirghafourvand M, Aghajari P, Burns E. Breastfeeding challenges and the impact of social support in Iranian Muslim mothers: A cross-sectional study. Women Health 2024; 64:142-152. [PMID: 38258420 DOI: 10.1080/03630242.2024.2304898] [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: 05/31/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024]
Abstract
Breast milk is the perfect food during infancy. Adequate support from family and health systems can be helpful to continue breastfeeding. This study aimed to determine the status of breastfeeding challenges and its relationship with social support and socio-demographic factors. In this correlational-descriptive study, 348 breastfeeding mothers were recruited using cluster random sampling from health care centers in Tabriz, Iran in 2022. Socio-demographic, breastfeeding challenges and social support questionnaires were used for data collection. Data were analyzed for descriptive and inferential statistics (Pearson correlation tests, independent t-test, one-way ANOVA and general linear model) using SPSS version 16. Difficulty in completing household tasks and breastfeeding at the same time (32.5 percent) was the most common challenge reported by mothers. There was an inverse and significant correlation between perceived social support and experiencing challenges (r = -0.199؛ p = .001). Based on the adjusted general linear model, with increasing social support, the score of breastfeeding challenges decreased (B = -0.165; 95 percent CI: -0.07-0.25, p < .001). Considering the relationship between perceived social support and the challenges experienced during breastfeeding, it can be concluded that adequate support from family along with training and guidance from health care providers can lead women to have better breastfeeding experiences and overcome breastfeeding problems.
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Affiliation(s)
- Sepideh Soltani
- Department of Community Health Nursing, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mina Hosseinzadeh
- Department of Community Health Nursing, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parvaneh Aghajari
- School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Elaine Burns
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
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El-Gamel N, El-Nemer A. Assessment of knowledge and practices of exclusive breastfeeding among rural women during the COVID-19 pandemic in Egypt: a cross sectional study. BMC Womens Health 2023; 23:673. [PMID: 38110927 PMCID: PMC10729492 DOI: 10.1186/s12905-023-02831-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 12/06/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Worldwide exclusive breastfeeding is still recommended as a successful strategy even during the COVID -19 pandemic to lower infant morbidity and mortality. This study aimed to assess the knowledge and practices of exclusive breastfeeding among rural women during the COVID-19 pandemic. METHODS A descriptive cross-sectional study was conducted at EL-Morabeen Family Medicine Center in rural Damietta, Egypt among 178 lactating women who were chosen by using the purposive sampling technique. A developed structured questionnaire consisting of four parts was used to gather data from March to May 2022. Univariate analysis for descriptive data and bivariate analysis through the chi-square test were performed. RESULTS The current study revealed that 73% of the studied rural women did not receive any breastfeeding counseling during antenatal visits and 61.2% of them believed that coronavirus was transmitted through breastmilk. Only 15.2% of them breastfed their infant exclusively for 6 months, 88.2% of mothers delayed breastfeeding initiation after delivery and 48.3% administered the prelacteal feeds. A total of 98.3% of rural women had never made skin-to-skin contact, and 79.2% of them had not been vaccinated against COVID-19. Additionally, a statistically significant association between good knowledge and practice with highly educated women aged 26-30 years, with a monthly income of 4000-6000 L.E was found. Furthermore, only 26.4% and 26.1% of rural women had good knowledge and practice scores respectively. CONCLUSION Suboptimal breastfeeding practices, such as delayed onset of breastfeeding, low percentages of exclusivity, early weaning, prelacteal feeding administration, and lack of skin-to-skin contact during the COVID -19 pandemic were prevalent among the studied rural mothers. Breastfeeding counseling for all pregnant women and implementation of evidence-based practices in the health care system, such as the early initiation of breastfeeding and skin-to-skin contact, are recommended.
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Affiliation(s)
- Noura El-Gamel
- Woman' s Health and Midwifery Nursing, Faculty of Nursing, Mansoura University, Damietta, Egypt.
| | - Amina El-Nemer
- Woman' s Health and Midwifery Nursing ,Faculty of Nursing, Mansoura University, Mansoura, Egypt
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Okhovat S, Janighorban M, Kazemi A. Development of an exclusive breastfeeding intervention based on the theory of planned behavior for mothers with preterm infants: Study protocol for a mixed methods study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:340. [PMID: 38144023 PMCID: PMC10743988 DOI: 10.4103/jehp.jehp_1257_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 12/22/2022] [Indexed: 12/26/2023]
Abstract
BACKGROUND Despite the significance and benefits of exclusive breastfeeding, its rate among infants, especially preterm infants, is not optimal. Based on evidence, the mother's attitude toward breastfeeding, the subjective norm, and the mother's perceived behavioral control play a role in initiation and continuation of breastfeeding; so the interventions that consider these factors may be useful for breastfeeding premature infants. The aim of this study is to design and develop an exclusive breastfeeding intervention based on the theory of planned behavior for mothers with preterm infants. MATERIALS AND METHODS This exploratory, sequential, mixed methods study will be conducted in three phases. In the first phase, a qualitative study will be conducted based on the theory of planed behavior, to describe the exclusive breastfeeding beliefs of the mothers with preterm infants, the barriers to breastfeeding, and to explain the ways to overcome them. Moreover, the items of the Predictors Of Exclusive Breastfeeding Questionnaire are prepared based on the theory of planned behavior. In the second phase, the intervention plan is designed based on the literature review and the findings of the qualitative study, and it is approved by a panel of experts. Additionally, the psychometric properties of the questionnaire are evaluated and confirmed qualitatively and quantitatively. In the third phase, the developed intervention is implemented and evaluated. CONCLUSION Implementation of supportive educational interventions based on scientific theories can be a step toward improving the rate of onset and continuation of breastfeeding in mothers with preterm infants. Development of interventions based on evidence, identified beliefs, and perceived barriers of the mothers with preterm infants can provide the foundation for more effective interventions according to cultural, social, and religious contexts.
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Affiliation(s)
- Shirin Okhovat
- Department of Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojgan Janighorban
- Reproductive Sciences and Sexual Health Research Center, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Department of Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Mashayekh-Amiri S, Hosseinzadeh M, Jafarabadi MA, Soltani S, Mirghafourvand M. Examining psychometric properties of the Iranian version of exclusive breastfeeding social support scale (EBFSS). BMC Psychol 2023; 11:234. [PMID: 37587499 PMCID: PMC10433609 DOI: 10.1186/s40359-023-01262-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 07/26/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND The exclusive breastfeeding (EBF) is undeniably proven significant in mothers' health and infants' growth and survival. Its persistence has many familial, social, and economical benefits. Social support is known to be an effective factor in EBF's success and sustainability. However, Exclusive breastfeeding social support (EBFSS) scale validity and reliability is not evaluated in Iran. This study aimed to determine the psychometric properties of EBFSS during postpartum period in Tabriz city, Iran. METHODS It is a cross-sectional study with descriptive survey method performed between March 2021 and August 2022. Psychometric properties were determined for the Persian version of EBFSS in six stages: translation process, evaluating content validity, face validity, construct validity, discriminant validity, and reliability. A group of experts (n = 10), followed by a group of women with EBF (n = 10), evaluated the instrument's items based on content and face validities, respectively. A cross-sectional study using the multi-stage cluster random sampling method on 348 women with EBF in the first four months after delivery was conducted to determine the construct validity. The internal consistency and repeatability (test-retest on 30 women, 2 weeks apart) were used to find out the reliability. RESULTS Content validity ratio (CVR), content validity index (CVI), and impact score were 0.98, 0.98, and 3.54 for EBFSS, respectively. This indicates a good content and face validity. Exploratory factor analysis (EFA) was performed on 16 items to examine the construct validity identified emotional, instrumental, and informational factors. These factors explained 59.26% of the cumulative variance. The fit indices (CFI = 0.98، TLI = 0.95، χ2/df = 4.20، RMSEA = 0.07 and SRMSEA = 0.05) confirmed the validity of the model in a confirmatory factor analysis (CFA). The internal consistency was examined through Cronbach's alpha and McDonald's omega coefficients that were 0.90 and 0.92, respectively. Finally, Repeatability and reproducibility were found 0.97 (95% CI: 0.92 to 0.99) using Intra-class correlation. This shows an appropriate reliability of the instrument. CONCLUSIONS The research findings indicate that the Persian version of the EBFSS has appropriate psychometric properties for evaluating the social support in Iranian women with EBF. This means healthcare providers can use it for screening social support in EBF. Researchers also can use it as a valid instrument.
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Affiliation(s)
- Sepideh Mashayekh-Amiri
- Students Research Committee, Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical sciences, Tabriz, Iran
| | - Mina Hosseinzadeh
- Department of Community Health Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Cabrini Research, Cabrini Health, Melbourne, VIC, 3144, Australia
- School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, 3004, Australia
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sepideh Soltani
- Students Research Committee, Department of Community Health Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
- Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Quebu SR, Murray D, Okafor UB. Barriers to Exclusive Breastfeeding for Mothers in Tswelopele Municipality, Free State Province, South Africa: A Qualitative Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1380. [PMID: 37628379 PMCID: PMC10453665 DOI: 10.3390/children10081380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
Despite the numerous advantages of exclusive breastfeeding (EBF), the practice remains infrequently adopted in certain countries and is also associated with context-specific obstacles. Consequently, this study explores the experiences and opinions of mothers about the barriers and support systems of exclusive breastfeeding (EBF), in a bid to promote this practice in the Tswelopele Municipality of the Free State Province of South Africa. In-depth individual, semi-structured interviews were conducted with 16 mothers, using an audio recorder after receiving their permission to record the interviews. The analysis of the collected data revealed that opinions clustered around four topics: mother-related barriers to EBF, baby-related barriers to EBF, support systems to enhance EBF, and complications caused by barriers to EBF. The findings from these themes and sub-themes imply that the maternal factor is strongly influenced by other factors regarding the success or failure of this practice. These include extreme breast discomfort, maternal illness, the fear that the mother's milk supply is insufficient, a lack of understanding about EBF, and the influence of different cultural factors. When mothers encounter difficulties with breastfeeding, these challenges may impede their ability to practice EBF. In addition, while some participants were eager to breastfeed their babies and continued EBF for a period of six months, their infant's health and behavioral issues prevented them from doing so. Some of these problems included infant sickness and crying. From the prenatal to the postnatal period, mothers and their families should have access to breastfeeding education and counseling, along with sufficient time to make informed infant nutrition decisions. During counseling sessions, conversations with these stakeholders should focus on fostering a realistic understanding regarding what to expect when breastfeeding for the very first time, debunking breastfeeding-related misconceptions, and addressing inaccurate information and concerns. In addition, health professionals must be empathic and respectful of the mother's traditions and cultures and must also educate mothers and their families on the importance of EBF. Our list of themes and sub-themes could be utilized to enlighten exclusive breastfeeding challenges and potential mitigation efforts, not only in Tswelopele Municipality, South Africa but also in a number of other geographical contexts.
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Affiliation(s)
- Simthandile Rebecca Quebu
- Department of Public Health, University of Fort Hare, 5 Oxford Street, East London 5201, South Africa;
| | - Daphne Murray
- Department of Nursing Science, University of Fort Hare, 50 Church Street, East London 5201, South Africa;
| | - Uchenna Benedine Okafor
- Faculty of Health Sciences, University of Fort Hare, 5 Oxford Street, East London 5201, South Africa
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Gebeyehu NA, Tegegne KD, Shewangashaw NE, Biset G, Abebaw N, Tilahun L. Knowledge, attitude, practice and determinants of exclusive breastfeeding among women in Ethiopia: Systematic review and meta-analysis. PUBLIC HEALTH IN PRACTICE 2023; 5:100373. [PMID: 36941951 PMCID: PMC10023906 DOI: 10.1016/j.puhip.2023.100373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 01/31/2023] [Accepted: 02/09/2023] [Indexed: 03/07/2023] Open
Abstract
Objective This study aimed to assess the pooled estimate of Ethiopia's women's knowledge, attitudes, practices, and determinants of exclusive breastfeeding. Methods PubMed, Google Scholar, Scopus, Science Direct, and Addis Ababa University online library were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Publication bias was checked by forest plot, Begg's rank test, and Egger's regression test. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by region, study setting, and publication. The pooled odds ratio for associated factors was also computed. Results Out of 995 studies reviewed, 33 met our eligibility criteria and were included in this meta-analysis study. The total number of study participants was 13,397. The pooled prevalence of good knowledge, positive attitude, and poor practice of kangaroo mother care were 74.2% (95% CI: 62.9-85.4), 77.2% (95%CI: 68.3-86.0), and 58.3% (95% CI: 49.9-66.6), respectively. In sub-group analysis, the highest prevalence of knowledge was in institution-based studies (78.3%) and unpublished studies (76.3%). A positive attitude was also highest in institutional-based studies (81%). The highest practice prevalence was in Afar (68%) and the lowest was in Addis Ababa (34.6%).Women who had a secondary level of education (AOR = 3.3; 95%CI: 1.8-6.0) were a housewife (AOR = 3.1; 95%CI: 2.1-4.7), delivered vaginally (AOR = 2.0; 95%CI: 1.4-2.9), health facility delivery (AOR = 3.3; 95%CI: 2.1-5.1) and attending antenatal care were predictors of exclusive breastfeeding. Conclusion Although women have good knowledge and positive attitude toward exclusive breastfeeding, there is a significant gap in exclusive breastfeeding practice. Maternal education, occupation, vaginal delivery, institutional delivery, and antenatal care visit were predictors of exclusive breastfeeding. It is recommended to strengthen maternal and child health services.
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Affiliation(s)
- Natnael Atnafu Gebeyehu
- School of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia
- Corresponding author.
| | - Kirubel Dagnaw Tegegne
- Department of Comprehensive Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | | | - Gebyaw Biset
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Nigussie Abebaw
- Department of Midwifery, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Lehulu Tilahun
- Department of Emergency Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Salarvand S, Ghazvineh S, Mousivand F, Ahmadi Gharaei H, Bitaraf S. Health literacy and its related factors as predictors for the breastfeeding self-efficacy in a western province in Iran. BMC Public Health 2023; 23:593. [PMID: 36997892 PMCID: PMC10061825 DOI: 10.1186/s12889-023-15522-0] [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: 12/08/2022] [Accepted: 03/24/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND One of the effective factors on BF (Breastfeeding) continuation is Breastfeeding self-efficacy (BFSE). This study was conducted to determine the relationship between Health Literacy (HL) and BFSE in lactating mothers referring to primary health care centers. METHODS This cross-sectional descriptive study was carried out on lactating mothers referring to primary health care centers in 2022. Multi-stage cluster sampling was done with 160 samples. The data were collected using demographic questionnaire, Persian shortened form of the BSES is a self-reported instrument for measuring a mother's Breastfeeding self-efficacy and Health Literacy for Iranian Adults (HELIA). Data were analyzed using ANOVA, independent t-test, correlation test and liner regression by SPSS version 16, with a significance level of 5%. RESULTS There was a significant positive correlation between the HL score and its four domains( Reading, Behaviour and decision making, Accessing, and Understanding) except for the appraisal domain with BFSE score. The variables of use of formula, HL, duration of breastfeeding, and education were considered predictors of BFSE. CONCLUSION In general, the results indicate a possible relationship between BFSE and mothers' HL. Therefore, improving mother's HL can have a positive effect on promoting infants' nutrition.
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Affiliation(s)
- Shahin Salarvand
- Hepatitis Research Center, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Sepideh Ghazvineh
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Fatemeh Mousivand
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Hasan Ahmadi Gharaei
- Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Saeid Bitaraf
- Epidemiology Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Bashiri A, Amiri-Farahani L, Salehiniya H, Pezaro S. Comparing the effects of breastfeeding in the laid-back and cradle position upon the experiences of primiparous women: a parallel randomized clinical trial. Trials 2023; 24:109. [PMID: 36782308 PMCID: PMC9926697 DOI: 10.1186/s13063-023-07143-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 02/07/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND AND AIM Appropriate positioning is crucial to successful breastfeeding and its continuation. Positioning can create, prevent, or correct breastfeeding problems. This study aimed to determine and compare the effects of both the laid-back and cradle positions upon the breastfeeding experiences of primiparous (cisgender) women. METHODS A parallel randomized clinical trial was conducted with a sample of primiparous women (n = 168) with a gestational age of between 31 and 34 weeks, referring to the perinatal clinic of Shahid Gharazi Hospital in Malayer (Hamadan Province, Iran). Participants were recruited via convenience sampling and allocated to one of two groups: intervention (laid-back position) (n = 85) and control (cradle position) (n = 83) using the random block method. Breastfeeding education was given to both groups during two sessions (weeks 31-34 and 35--37 of pregnancy) by "baby-friendly" accredited hospitals in Iran. The intervention group was instructed on how to breastfeed using the laid-back position. The control group was instructed on how to breastfeed using the cradle position. In the immediate postnatal period, breastfeeding positions were assessed in both groups. Breastfeeding experiences were measured once at the time of participants returning home and again at both 1 week and 2 weeks following birth, using the breastfeeding experience scale. Data analysis was undertaken using the SPSS software version 21. A value of P < 0.05 was considered significant. RESULTS No statistically significant difference was observed between the two groups in terms of concerns relating to participants nor their breasts, milk insufficiency, neonate, process, or breastfeeding experience at any time point measured. The means (SDs) of breastfeeding experience at the time of discharge, 1 week, and 2 weeks after childbirth in intervention group were 26.07 (4.533), 26.85 (3.812), and 26.65 (4.632) respectively. The means (SDs) of breastfeeding experience at the time of discharge, 1 week, and 2 weeks after childbirth in control group were 25.42 (3.315), 26.68 (3.872), and 25.41 (4.05) respectively. CONCLUSION There is no difference in breastfeeding experiences whether the laid-back or cradle position is used. Thus, broader education on breastfeeding and the provision of comprehensive support may be more effective in optimizing one's experience of breastfeeding. TRIAL REGISTRATION Registration date: 2021 July 21, Code: IRCT20180427039436N10, https://irct.ir/user/trial/57054/view.
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Affiliation(s)
- Asefe Bashiri
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Amiri-Farahani
- Nursing and Midwifery Care Research Center, Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Sally Pezaro
- The University of Notre Dame, Australia and Assistant Professor, The Centre for Healthcare Research, Coventry University, Coventry, UK
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Khalili S, Amiri-Farahani L, Haghani S, Bordbar A, Shojaii A, Pezaro S. The effect of Pimpinella Anisum herbal tea on human milk volume and weight gain in the preterm infant: a randomized controlled clinical trial. BMC Complement Med Ther 2023; 23:19. [PMID: 36681821 PMCID: PMC9862552 DOI: 10.1186/s12906-023-03848-6] [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: 07/01/2022] [Accepted: 01/16/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND AND AIMS Human milk supports pre-term infants to thrive. Yet human milk production can be inhibited when infants are born prematurely. Pimpinella Anisum has been evidenced to increase milk production and infant weight gain in previous animal studies. The present study aimed to determine the effect of Pimpinella Anisum herbal tea on human milk volume and preterm infant weight in human populations for the first time. METHODS Human milk supports pre-term infants to thrive. Yet human milk production can be inhibited when infants are born prematurely. Pimpinella Anisum has been evidenced to increase milk production and infant weight gain in previous animal studies. The present study aimed to determine the effect of Pimpinella Anisum herbal tea on human milk volume and preterm infant weight in human populations for the first time. RESULTS There was a statistically significant difference in terms of milk volume in the first, third, fourth, fifth, sixth and seventh days between the three groups of intervention, placebo, and control (p < 0.05). On the first day, the mean volume of pumped milk in the intervention group was significantly higher than the control group (p = 0.008). On the second day, there was no statistically significant difference between groups. On the third, fourth, fifth, sixth and seventh days, the mean volume of pumped milk in the intervention group was significantly higher than the placebo and control groups (p < 0.05). There was no statistically significant difference in terms of preterm infant weight on days 0, 3 and 7 between the three groups. CONCLUSION The use of Pimpinella Anisum or 'Anise' tea can increase the volume of human milk and since no specific side effects have been reported in its use, it may be incorporated easily, cheaply, and effectively in practice where appropriate to the benefit of preterm infant nutrition worldwide.
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Affiliation(s)
- Sona Khalili
- grid.411746.10000 0004 4911 7066Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Amiri-Farahani
- grid.411746.10000 0004 4911 7066Department of Reproductive Health and Midwifery, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Shima Haghani
- grid.411746.10000 0004 4911 7066Department of Biostatistics, Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Arash Bordbar
- grid.411746.10000 0004 4911 7066Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Asie Shojaii
- grid.411746.10000 0004 4911 7066School of Persian Medicine, Research Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sally Pezaro
- grid.8096.70000000106754565The Centre for Healthcare research, Coventry University, Coventry, United Kingdom
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Yamunaque-Carranza M, Medina-Ramirez SA, Mamani-García CS, Caira-Chuquineyra B, Fernandez-Guzman D, Urrunaga-Pastor D, Bendezu-Quispe G. Factors Associated with Adequate Breastfeeding: Evidence from the Peruvian Demographic and Health Survey, 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13607. [PMID: 36294187 PMCID: PMC9602776 DOI: 10.3390/ijerph192013607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To assess the factors associated with adequate breastfeeding (ABF) among Peruvian mothers during 2019. MATERIALS AND METHODS We performed a secondary analysis of the 2019 Demographic and Family Health Survey (ENDES) database of Peru. ABF was defined based on the recommendations of the World Health Organization, which defined it as starting breastfeeding within the first hour of life and continuing with exclusive breastfeeding for up to 6 months. To determine the factors associated with ABF, a Poisson generalized linear models with log-link function was used. Adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95% CI) were calculated. RESULTS A prevalence of ABF of 48.1% was identified among 11,157 women who reported at least one child in the last five years. Most of them were young (68.6%) and lived in urban areas (65.5%). Furthermore, being unemployed (aPR:1.02; 95% CI:1.00-1.04); residing on the coast, except for Metropolitan Lima (aPR:1.08; 95% CI:1.04-1.11), the highlands (aPR:1.14; 95% CI:1.11-1.18), and the jungle (aPR:1.20; 95% CI: 1.16-1.24); having had a vaginal delivery (aPR:1.30; 95% CI:1.27-1.05); and having two children (aPR:1.03; 95% CI:1.01-1.05) or three or more children (aPR:1.03; 95% CI:1.01-1.05) were associated with a higher frequency of ABF. CONCLUSIONS One out of two women between 18-59 with children performed ABF. The factors associated with ABF were the current occupation, region of residence, type of delivery, and parity. Health policies and strategies should be implemented, considering our results, to promote maternal counseling by health personnel in order to increase the prevalence of ABF in the Peruvian population.
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Affiliation(s)
- Mariela Yamunaque-Carranza
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo 14012, Peru
- Sociedad Científica de Estudiantes de Medicina Veritas (SCIEMVE), Chiclayo 14012, Peru
| | - Sebastian A. Medina-Ramirez
- Departamento de Ciencias Básicas, Facultad de Medicina Humana, Universidad Peruana Unión (UPeU), Lima 15464, Peru
| | - Carlos S. Mamani-García
- Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, Arequipa 04001, Peru
- Sociedad Científica de Estudiantes de Medicina Agustinos (SOCIEMA), Arequipa 04001, Peru
| | - Brenda Caira-Chuquineyra
- Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, Arequipa 04001, Peru
- Sociedad Científica de Estudiantes de Medicina Agustinos (SOCIEMA), Arequipa 04001, Peru
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15074, Peru
| | - Daniel Fernandez-Guzman
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15074, Peru
- Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco, Cusco 08000, Peru
| | - Diego Urrunaga-Pastor
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Carrera de Medicina Humana, Lima 15067, Peru
| | - Guido Bendezu-Quispe
- Centro de Investigación Epidemiológica en Salud Global, Universidad Privada Norbert Wiener, Lima 15046, Peru
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SefidHaji S, Aziznejadroshan P, Mojaveri MH, Nikbakht HA, Qujeq D, Amiri SRJ. Effect of lullaby on volume, fat, total protein and albumin concentration of breast milk in premature infants' mothers admitted to NICU: a randomized controlled trial. Int Breastfeed J 2022; 17:71. [PMID: 36175904 PMCID: PMC9523992 DOI: 10.1186/s13006-022-00511-7] [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: 07/28/2021] [Accepted: 09/19/2022] [Indexed: 11/21/2022] Open
Abstract
Background Listening to music can reduce or manage stress, fatigue, and accompanying symptoms in mothers. Music increases oxytocin secretion which affects breast milk. This study aimed to examine the effect of lullaby on volume, fat, total protein and albumin concentration of breast milk in mothers of premature infants admitted to the NICU. Methods This clinical trial was performed on 100 primiparous mothers whose premature infants were hospitalized in the NICU of Ayatollah Rouhani Hospital from January 2020 to December 2020. Using block randomization method, the participants were divided into three groups: control (A), playing lullaby for mother (B) and playing lullaby for a mother while holding a photo of her own baby (C). The mothers of the intervention groups listened to lullabies through headphones for 30 minutes every morning for 6 days. On the first and the sixth day of birth, the volume of breast milk (ml) and two milliliters of breast milk samples of all three groups were measured and compared in terms of fat, albumin concentration and total protein (mg/DL). ANOVA, Paired T-Test and ANCOVA model (the included variables were: basic value of dependent variable, group type, Maternal age, Birth weight, Gestational age and Maternal weight) was used for analytical statistics. Results The difference between the mean compositions of breast milk before and after the intervention in three groups of A, B and C: in terms of the breast milk volume were 66.33 ± 4.80, 71.30 ± 4.18 and 75.91 ± 6.80 ml; in terms of triglyceride level was 177.84 ± 50.57, 210.72 ± 34.55 and 224.17 ± 12.97 mg/DL, cholesterol level was 14.57 ± 3.70, 21.96 ± 3.82 and 26.26 ± 5.16 mg/DL, albumin concentration was 0.90 ± 0.30, 1.22 ± 0.19 and 1.46 ± 0.28 mg/DL and total protein level was 1.61 ± 0.61, 2.20 ± 0.57 and 2.72 ± 0.30 mg/DL. Finally, the results of ANCOVA analysis for the effects of the intervention, taking into account the baseline values, showed that the intervention was effective and had the greatest effect on cholesterol levels. Conclusion In this small trial, there was a statistically significant association between trial arm and biochemical composition of breastmilk though further studies are needed to see if these changes result in meaningful clinical outcomes to the infant. Trial registration IRCT, IRCT20191114045439N1. Registered 14 January 2020- prospective, https://en.irct.ir/trial/43671 Supplementary Information The online version contains supplementary material available at 10.1186/s13006-022-00511-7.
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Affiliation(s)
- Somayeh SefidHaji
- Student Research Committee, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Parvin Aziznejadroshan
- Non-Communicable Pediatric Disease Research Center, Health Research Institute, School of Nursing and Midwifery, Babol University of Medical Sciences, Babol, Islamic Republic of Iran.
| | - Mohsen Haghshenas Mojaveri
- Non-Communicable Pediatric Disease Research Center, Health Research Institute, School of Medicine, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Hossein-Ali Nikbakht
- Social Determinants of Health Research Center, Health Research Institute, Department of Biostatistics & Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Durdi Qujeq
- Department of Biochemistry, School of Medicine, Babol University of Medical Sciences, Babol, Iran
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Seddighi A, Khalesi ZB, Majidi S. The effect of mobile-based training on maternal breastfeeding self-efficacy: a randomized clinical trial. Afr Health Sci 2022; 22:648-655. [PMID: 36910415 PMCID: PMC9993313 DOI: 10.4314/ahs.v22i3.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The Aim of this study is to determine the effect of mobile-based training on maternal breastfeeding self-efficacy. Materials and Methods This trial was conducted from November May to December 2020 on 198 women referring to healthcare centers in Guilan, Iran. The samples of this study were selected using the convenience sampling method, and random block sampling was used for the allocation of groups. The data collection tool was a two-part questionnaire including questions about demographic data and Dennis's self-efficacy. The questionnaires were completed before and 8 weeks after the intervention in both groups. Results The mean and standard deviation of self-efficacy before the education in the experiment and control group were 48.26+ 6.49 and 49.11 + 7.36, respectively. After the education, the experimental group was 53.78 + 12.61 and control group was 41.90 + 17.98. The difference between the pretest and posttest scores indicated that the breastfeeding educational intervention increased the women's self-efficacy in breastfeeding (p<0/001). Conclusion The results showed that mobile-based training could improve maternal breastfeeding self-efficacy. It is therefore recommended, this training program as an available and convenient method to improve breastfeeding self-efficacy.
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Affiliation(s)
- Aazam Seddighi
- Student Research Committee, school of nursing and midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Bostani Khalesi
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Soheila Majidi
- Department of Midwifery and Reproductive Health, Nursing and Midwifery School, Guilan University of Medical Sciences, Langroud, Iran
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Effect of maternal nutrition education on early initiation and exclusive breast-feeding practices in south Ethiopia: a cluster randomised control trial. J Nutr Sci 2022; 11:e37. [PMID: 35720173 PMCID: PMC9161038 DOI: 10.1017/jns.2022.36] [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] [Indexed: 11/06/2022] Open
Abstract
Abstract
Introduction: Optimal breast-feeding practices make a major contribution to the promotion of healthy growth and development through much prevention of diarrheal and respiratory diseases which majorly cause morbidity and mortality in under-five children. However, breast-feeding practices remain suboptimality in Ethiopia. Objective: The study objective was to determine the effect of maternal nutrition education on early initiation and exclusive breast-feeding practice in the Hawela Tulla sub-city. Methods: A cluster randomised, parallel-group, single-blinded trial was used. About 310 pregnant women (155 for the intervention group and 155 for the control group) were included. Result: An early initiation of breast-feeding was significantly higher among women who received breast-feeding education than those who did not receive (104(72·7 %) v. 85(59·9 %), P = 0·022) and exclusive breast-feeding practice was also significantly higher among women who received breast-feeding education than those who did not receive (106(74·1 %) v. 86(60·6 %), P = 0·015). Breast-feeding education [AORs 1·55, 95 % CI (1·02, 2·36)], institutional delivery [AOR 2·29, 95 % CI (1·21, 4·35)], vaginal delivery [AOR 2·85, 95 % CI (1·61, 5·41)] and pre-lacteal feeding [AOR 0·47, 95 % CI (0·25, 0·85)] were predictors of early initiation of breast-feeding. Breast-feeding education [AOR 1·72, 95 % CI (1·12, 2·64)] and institutional delivery [AOR 2·36, 95 % CI (1·28, 4·33)] were also determinants of exclusive breast-feeding practices. Conclusion: Breast-feeding education improved early initiation of breast-feeding and exclusive breast-feeding practices. Providing sustained education to women regarding early initiation and exclusive breast-feeding practice should be strengthened.
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Mohammadi S, Shafiee M, Faraji SN, Rezaeian M, Ghaffarian-Bahraman A. Contamination of breast milk with lead, mercury, arsenic, and cadmium in Iran: a systematic review and meta-analysis. Biometals 2022; 35:711-728. [PMID: 35575819 DOI: 10.1007/s10534-022-00395-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/29/2022] [Indexed: 12/29/2022]
Abstract
Breast milk is a complete food for the development of the newborn, but it can also be an important route for environmental pollutants transmission to the infants. This study was aimed to evaluate the status of heavy metals including lead (Pb), mercury (Hg), cadmium (Cd) and arsenic (As) in the breast milk of Iranian mothers. The international databases including Scopus, PubMed, Web of Science and the Persian electronic databases including Scientific Information Database, IranMedex and Magiran were examined to find relevant articles published until July 2021. A total of 23 studies examined the levels of toxic metals in Iranian breast milk samples. According to the findings, the pooled average concentrations (µg/L) of Pb, Cd, Hg and As were 25.61, 2.40, 1.29 and 1.16, respectively. The concentration of Hg and Pb in colostrum milk was more than twice of mature milk. The Hg mean concentration in the breast milk of mothers with at least one amalgam-filled tooth was approximately three times that of mothers without amalgam-filled teeth. Risk assessment analysis indicated that the intake of Pb and Hg by infants through breastfeeding can be considered a health concern in Iran. It seems necessary to reduce the Pb exposure of pregnant and lactating women in Iran. However, more extensive studies are needed to clarify the toxic metals' exposure status of infants through breast milk in other parts of the country.
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Affiliation(s)
- Salman Mohammadi
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Maryam Shafiee
- Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Nooreddin Faraji
- School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Rezaeian
- Department of Epidemiology and Biostatistics, Occupational Environment Research Center, Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ali Ghaffarian-Bahraman
- Occupational Environment Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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Panahi F, Rashidi Fakari F, Nazarpour S, Lotfi R, Rahimizadeh M, Nasiri M, Simbar M. Educating fathers to improve exclusive breastfeeding practices: a randomized controlled trial. BMC Health Serv Res 2022; 22:554. [PMID: 35468827 PMCID: PMC9040207 DOI: 10.1186/s12913-022-07966-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 04/20/2022] [Indexed: 02/08/2023] Open
Abstract
Background Fathers’ involvement is crucial for promoting breastfeeding. There are a few studies on the effectiveness of fathers’ educational programs to promote exclusive breastfeeding. This study aims to assess the effectiveness of a fathers’ educational program on their support for breastfeeding, mothers’ breastfeeding practice, and exclusive breastfeeding status. Methods This was a randomized controlled trial on 76 fathers who were randomly assigned to two groups of intervention and control, in a selected health center in Iran, 2018. The tools for data collection were: 1) a questionnaire for “Demographic and Maternal-Infant Information”; 2) a questionnaire to assess “Fathers’ support for Breastfeeding”, and 3) an observational checklist to assess “Mothers’ Breastfeeding Practice”; and 4) a questionnaire to assess “Exclusive Breastfeeding Status”. The questionnaires were filled up through an interview. The checklist was completed through observation by the researcher. The fathers (with the mothers) of the intervention group were educated using individual face-to-face education and counseling, in two sessions, with the duration of about 40 min and one-week interval, whereas, the fathers of the control group did not receive any education and only mothers were educated with the same instruction. The content of the education was: fathers’ education about “benefits of breast milk” and “the supporting ways for breastfeeding including the women encouragement”. Then, the scores of “father’s support for breastfeeding”, “mothers’ breastfeeding practice” and “exclusive breastfeeding status” were compared before and after 4 months of intervention in each group, and also between groups. Data were analyzed using SPPS-23, and t- and paired-tests, Chi-square, and Generalized-Estimating-Equations (GEE) tests. Results The results showed two groups were not significantly different regarding the demographic and any other possible confounding variables before the intervention (P < 0.05). The before and after comparisons also demonstrated significant improvements in the two variables including “father’s support for breastfeeding”, and “mothers’ breastfeeding practice after 4 months, in the intervention group (Paired t-test: P<0.001 and P<0.0001, respectively) however, there was a significant decrease in “father’s support for breastfeeding” and no improvement in “mothers’ breastfeeding practice” after 4 months in the control group (Paired t-test: P < 0.001 and P = 0.07, respectively). Between groups comparison showed also significant higher scores for “father’s support for breastfeeding”, “mothers’ breastfeeding practice” and “exclusive breastfeeding status” in the intervention group comparing to the control group, after 4 months (T-test: P < 0.001 and P < 0.0001; Chi2: P < 0.001, respectively). The interaction effects of time and group were significant in the GEE test for the fathers’ support for breastfeeding (B-group = 31.93, B-time = 22.15, p < 0.001) and mothers’ breastfeeding practice (B-group = 26.32, B-time = 12.86, p < 0.0). Conclusion The results showed that the father’s education improves mothers’ breastfeeding practice and increases the rate and continuity of exclusive breastfeeding. Trial registration IRCT201508248801N10. “31/08/2016”. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07966-8.
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Affiliation(s)
- Farideh Panahi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh Rashidi Fakari
- Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences-Bojnurd, Bojnurd, Iran
| | - Soheila Nazarpour
- Department of Midwifery, Chalous Branch, Islamic Azad University, Chalous, Iran
| | - Razieh Lotfi
- Department of Midwifery, School of Nursing and Midwifery, Alborz University of Medical Sciences-Karaj, Karaj, Iran
| | - Mitra Rahimizadeh
- Department of Biostatistics, Social Determinant of Health Research Center, Alborz University of Medical Sciences-Karaj, Karaj, Iran
| | - Maliheh Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery Shahid Beheshti University of Medical Sciences Tehran, Tehran, Iran
| | - Masoumeh Simbar
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Vali-Asr Avenue, Cross of Vali-Asr and Hashemi Highway, Opposite to Rajaee Heart Hospital, Tehran, 1996835119, Iran.
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Taghizadeh S, Khodayari-Zarnaq R, Farhangi MA. Childhood obesity prevention policies in Iran: a policy analysis of agenda-setting using Kingdon's multiple streams. BMC Pediatr 2021; 21:250. [PMID: 34044800 PMCID: PMC8155654 DOI: 10.1186/s12887-021-02731-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pediatric obesity is one of the most important health challenges of the twenty-first century. Primary prevention of childhood obesity, can lessen its consequences. This study aims to assess childhood obesity prevention policies in Iran through a policy analysis of agenda-setting using Kingdon's multiple streams. METHODS A qualitative study was conducted using in-depth interviews with 39 key informants and document review from different stages of the policymaking process of childhood and adolescent obesity prevention programs in Iran. The analysis of documents and interviews were guided based on Kingdon's multiple streams (problem, policy and political streams). RESULTS The important factors of the problem stream were the high prevalence of childhood and adolescent obesity and its risk factors in Iran. In the policy stream, a focus on preventing non-communicable diseases in the health system, increasing the workforce in health centers, promoting health school programs, and creating healthy eating buffets in schools was identified. Under the political stream, the impact of the WHO ECHO program in 2015 and the implementation of the health system transformation plan in Iran in the new government took place after 2013, caused the Iran ECHO program entered the agenda and implemented from 2016. CONCLUSIONS Now that a window of opportunity for childhood and adolescent obesity prevention policymaking has been created, the problems such as the therapeutic approach in the health system, the existence of sanctions against Iran and outbreak of coronavirus disease-19 (COVID-19), have hindered the successful implementation of this policy and the opportunity window has not been well used. However, actors need political support from the high levels of government to keep this policy on the agenda.
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Affiliation(s)
- Shahnaz Taghizadeh
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rahim Khodayari-Zarnaq
- Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Abbasalizad Farhangi
- Department of Community Nutrition, Tabriz University of Medical Sciences, 5166614711, Attar Nishabouri St, PO BOX: 14711, Tabriz, I. R Iran
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19
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Syam A, Musni M, Amin AN, Iskandar I. Potential Loss among Infant Feeding Options. JURNAL NERS 2021. [DOI: 10.20473/jn.v16i1.23285] [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
Introduction: The conceptual relationship between economics and breastfeeding is still mathematically invaluable, while the family's economic burden increases along with babies born. Indicating potential loss when a family chooses other than breastmilk is a progressive way to manage campaign messages about exclusive breastmilk and prolonged breastfeeding. Descriptive studies are needed to magnify all of these indicators and transform them into measuring instruments generalized to assess family expenditures related to infant feeding.Methods: This study uses a quantitative descriptive design, questionnaire draft upon qualitative open questions containing all micro indicators impacted financially during the baby’s first year. Data collection was carried out in Makassar based on telephone surveys with 330 preliminary samples. After structural analysis and data reduction, the expenditure indicators were divided into medical and non-medical expenses.Results: The study show there is a difference in the average amount of family expenses of those who provide formula milk compared to breastmilk. This outcome is 21.1 times higher in non-medical components and 2.5 times higher in the medical component. One of the highest contributions in medical expenses is the cost of a recurrent visit to a pediatrician due to a history of illness such as allergies, respiratory infections, and diarrhea.Conclusion: This empirical fact stated the strong affirmation of how families should consider wisely to choose the best feeding pattern for babies aged 0-12 months.
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Mekaoui N, Belkouchi FZ, Chajai I, Dakhama BSB, Kerboubi L. How are newborns fed in their first day of life in Morocco? a survey. Pan Afr Med J 2021; 37:375. [PMID: 33796188 PMCID: PMC7992432 DOI: 10.11604/pamj.2020.37.375.25250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 12/13/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Nour Mekaoui
- Laboratory of Biostatistics, Clinical Research and Epidemiology, Faculty of Medicine and Pharmacy, Mohammed V University of Rabat, Rabat, Morocco
| | - Fatima Zahra Belkouchi
- Department of Gynecology, Obstetrics, Oncology and High-Risk Pregnancy, Souissi Maternity Hospital Rabat, Rabat, Morocco
| | - Idriss Chajai
- Pediatric Medical Emergency Department, Rabat´s Children´s Hospital Rabat, Rabat, Morocco
| | | | - Lamya Kerboubi
- Pediatric Medical Emergency Department, Rabat´s Children´s Hospital Rabat, Rabat, Morocco
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Alshammari MB, Haridi HK. Prevalence and Determinants of Exclusive Breastfeeding Practice among Mothers of Children Aged 6-24 Months in Hail, Saudi Arabia. SCIENTIFICA 2021; 2021:2761213. [PMID: 33854807 PMCID: PMC8019643 DOI: 10.1155/2021/2761213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 03/14/2021] [Accepted: 03/17/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The WHO recommends that infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development, and health. Nonadherence to exclusive breastfeeding (EBF) depends largely on the individual, sociocultural context, and institutional factors. The aim of this study is to estimate coverage and factors associated with adherence to EBF among mothers in the urban Hail region, Saudi Arabia. METHODS A cross-sectional study was carried out during February-June 2019 among 450 mothers of children aged 6-24 months attending immunization and well-baby clinics in 6 primary healthcare centers in Hail city. A pretested structured questionnaire was used to interview the consented participants. RESULTS The majority of mothers (72.9%) were aware of EBF; 24% reported initiation of breastfeeding within one hour after delivery; however, 71.1% did during the first 24 hours. The majority (76.8%) fed colostrum to their newborn; nevertheless, 50.1% had given a prelacteal feeding. Mothers who reported EBF practice were 50.7% (CI 45.9-55.4). The adjusted logistic regression analysis revealed that mother's awareness about EBF (aOR 3.03; 95% CI 1.78-5.18), antenatal care received at the governmental facility (aOR 2.63; 95% CI 1.28-5.41), breastfeeding a previous child (aOR 2.42; 95% CI 1.46-4.03), counseling received after delivery (aOR 2.47; 95% CI 1.34-4.53), and colostrum feeding given (aOR 4.24; 95% CI 2.31-7.77) were positively associated with EBF practice. On the other hand, mother's education (OR 0.39; 95% CI 0.15-0.99), higher family income (aOR 0.04; 95% CI 0.00-0.31), and practice prelacteal feeding (aOR 0.61; 95% CI 0.38-0.97) were negatively associated with EBF practice. CONCLUSION EBF rate in urban Hail is still far below WHO recommendations. Efforts to strengthen mothers' counseling/support during antenatal care and immediately after delivery are needed to promote EBF practice, especially in the private sector.
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Affiliation(s)
| | - Hassan Kasim Haridi
- The Designated Institutional Official (DIO) for Academic Affairs & Postgraduate Studies, Health Affairs, Najran, Saudi Arabia
- Research Department, Health Affairs, Hail Region, Saudi Arabia
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Aldalili AYA, El Mahalli AA. Research Title: Factors Associated with Cessation of Exclusive Breastfeeding. J Multidiscip Healthc 2021; 14:239-246. [PMID: 33564240 PMCID: PMC7866906 DOI: 10.2147/jmdh.s277819] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/12/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The study aimed to determine the prevalence of exclusive breastfeeding (EBF), measure the association between EBF and sociodemographic and obstetric characteristics of lactating mothers, and determine challenges of EBF. Methods The study was cross-sectional and was conducted in four primary health care centres (PHCCs) at Alehsa region in Saudi Arabia (SA). Lactating mothers coming to vaccinate their babies (0–6 months) were recruited. Sample size totalled 372, where 93 were randomly selected from each centre. Sociodemographic and obstetric characteristics of participants, breastfeeding (BF) status, and challenges of EBF were collected. Basic univariate descriptive statistics were conducted to explore the sociodemographic and obstetric characteristics, BF status and challenges of BF. Bivariate analyses were done to explore the association between the dependent and independent variables. Binary logistic regression models were then executed. A 2-tailed p-value < 0.05 was considered significant. Results EBF rate was nearly 60%. Cessation of EBF was associated with younger age, inconvenience/fatigue due to BF, sore breasts or nipples/too painful, perceived low milk quantity, BF skills were not effective, maternal choice, and baby-centred factors. Conclusion and Recommendations EBF was associated with problems/difficulties in BF technique. It is recommended that health care professionals like doctors, nurses, and midwives should train mothers during and after pregnancy regarding BF technique or pumping breast milk in case of BF difficulties, improve mothers’ confidence about the ability to breastfeed and enhance mothers’ knowledge on the normal process of lactation. Secondly, it is the role of policymakers to ensure implementation of Baby-Friendly Hospital Initiative (BFHI) guidelines in hospitals to meet the WHO’s global target of infants being exclusively breastfed until six months of age.
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Affiliation(s)
| | - Azza Ali El Mahalli
- Department of Public Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Silva MDB, de Oliveira RDVC, da Silveira Barroso Alves D, Melo ECP. Predicting risk of early discontinuation of exclusive breastfeeding at a Brazilian referral hospital for high-risk neonates and infants: a decision-tree analysis. Int Breastfeed J 2021; 16:2. [PMID: 33397423 PMCID: PMC7783998 DOI: 10.1186/s13006-020-00349-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 12/09/2020] [Indexed: 12/01/2022] Open
Abstract
Background Determinants at several levels may affect breastfeeding practices. Besides the known historical, socio-economic, cultural, and individual factors, other components also pose major challenges to breastfeeding. Predicting existing patterns and identifying modifiable components are important for achieving optimal results as early as possible, especially in the most vulnerable population. The goal of this study was building a tree-based analysis to determine the variables that can predict the pattern of breastfeeding at hospital discharge and at 3 and 6 months of age in a referral center for high-risk infants. Methods This prospective, longitudinal study included 1003 infants and was conducted at a high-risk public hospital in the following three phases: hospital admission, first visit after discharge, and monthly telephone interview until the sixth month of the infant’s life. Independent variables were sorted into four groups: factors related to the newborn infant, mother, health service, and breastfeeding. The outcome was breastfeeding as per the categories established by the World Health Organization (WHO). For this study, we performed an exploratory analysis at hospital discharge and at 3 and at 6 months of age in two stages, as follows: (i) determining the frequencies of baseline characteristics stratified by breastfeeding indicators in the three mentioned periods and (ii) decision-tree analysis. Results The prevalence of exclusive breastfeeding (EBF) was 65.2% at hospital discharge, 51% at 3 months, and 20.6% at 6 months. At hospital discharge and the sixth month, the length of hospital stay was the most important predictor of feeding practices, also relevant at the third month. Besides the mother’s and child’s characteristics (multiple births, maternal age, and parity), the social context, work, feeding practice during hospitalization, and hospital practices and policies on breastfeeding influenced the breastfeeding rates. Conclusions The combination algorithm of decision trees (a machine learning technique) provides a better understanding of the risk predictors of breastfeeding cessation in a setting with a large variability in expositions. Decision trees may provide a basis for recommendations aimed at this high-risk population, within the Brazilian context, in light of the hospital stay at a neonatal unit and period of continuous feeding practice. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-020-00349-x.
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Affiliation(s)
- Maíra Domingues Bernardes Silva
- Human Milk Bank at the National Institute of Women, Children and Adolescents Health Fernandes Figueira (IFF) of the Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, Brazil.
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Gharaei T, Amiri-Farahani L, Haghani S, Hasanpoor-Azghady SB. The effect of breastfeeding education with grandmothers' attendance on breastfeeding self-efficacy and infant feeding pattern in Iranian primiparous women: a quasi-experimental pilot study. Int Breastfeed J 2020; 15:84. [PMID: 33046115 PMCID: PMC7552372 DOI: 10.1186/s13006-020-00325-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 09/24/2020] [Indexed: 11/18/2022] Open
Abstract
Background One of the most important factors that affects breastfeeding self-efficacy and exclusivity is breastfeeding support provided by the family. The aim of this study was to determine the effect of breastfeeding education sessions for primiparous women, with and without the attendance of maternal grandmothers, on breastfeeding self-efficacy and infant feeding patterns. Methods This quasi-experimental study was conducted on 64 primiparous women who referred to the Antenatal Clinic of Amiralmomenin Hospital, Tehran, Iran from June to December, 2018. Eligible pregnant women were allocated into two groups; either with and without grandmothers in attendance. Group assignments were determined according to the week the women had prenatal care at the hospital. All eligible women seen in the clinic during 1 week were assigned to one group and women who presented in the alternating week were assigned to the other group. In the education group with grandmothers in attendance, each woman participated in two prenatal education programs with her mother and one postpartum program approximately 3 h before discharge. In the other group, participating mothers attended breastfeeding education sessions without the grandmother’s attendance. The participating mothers answered questions from the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) at the time of the hospital discharge, and 4 and 8 weeks after delivery. Questions about the infants’ feeding patterns were asked by telephone contact with the participating mothers from both groups at the same time periods. Results The mean BFSE scores were signficantly different between the groups with grandmothers and without grandmothers at the time of the hospital discharge (60.15 ± 4.47 vs. 56.84 ± 6.22, independent t-test; p = 0.017), and at 4 weeks (61.71 ± 2.66 vs. 56.62 ± 9.12, p = 0.004) and 8 weeks after delivery (63.68 ± 2.14 vs. 60.03 ± 6.32, p = 0.003). No significant difference existed in infant feeding patterns between the groups at the same time periods. Conclusions This study suggests that breastfeeding education with grandmothers’ attendance is effective in improving the mothers’ breastfeeding self-efficacy. A family-centered program should be considered in beastfeeding education for increasing of exclusive breastfeeding.
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Affiliation(s)
- Tayebeh Gharaei
- Department of Reproductive Health and Midwifery, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Amiri-Farahani
- Department of Reproductive Health and Midwifery, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
| | - Shima Haghani
- Department of Biostatistics, Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Syedeh Batool Hasanpoor-Azghady
- Department of Reproductive Health and Midwifery, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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Azizi E, Maleki A, Mazloomzadeh S, Pirzeh R. Effect of Stress Management Counseling on Self-Efficacy and Continuity of Exclusive Breastfeeding. Breastfeed Med 2020; 15:501-508. [PMID: 32503365 DOI: 10.1089/bfm.2019.0251] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background: Self-efficacy is an important motivational factor that can be affected by physiological responses such as stress. Objective: The study aimed to determine the effect of stress management counseling on self-efficacy and continuity of exclusive breastfeeding in mothers. Materials and Methods: This randomized controlled trial was carried out on 46 pregnant women recruited at three Childbirth Preparation Centers of Zanjan (Iran) in 2018. The eligible women were allocated into two intervention and control groups according to the block design. Stress management counseling was carried out individually in four sessions, twice a week at 35 and 36 weeks of gestation. The control group only received routine cares. The self-efficacy and continuity of exclusive breastfeeding were measured monthly up to 4 months after childbirth. Results: Breastfeeding self-efficacy showed a statistically significant difference between the two study groups at 1 and 4 months after childbirth (p = 0.001). More women in the control group terminated exclusive breastfeeding compared to those in the intervention group (16 (72.7%) versus 8 (34.8%), p = 0.013). Conclusion: The results showed that integration of stress management counseling in breastfeeding education package can improve the self-efficacy and continuation of breastfeeding in mothers.
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Affiliation(s)
- Elmira Azizi
- Department of Midwifery, Social Determinants of Health Research Center, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Azam Maleki
- Department of Midwifery, Social Determinants of Health Research Center, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Saeideh Mazloomzadeh
- Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Reza Pirzeh
- Department of Psychiatry, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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