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Wallenborn JT, Hyland C, Sagiv SK, Kogut KR, Bradman A, Eskenazi B. Prenatal exposure to polybrominated diphenyl ether (PBDE) and child neurodevelopment: The role of breastfeeding duration. Sci Total Environ 2024; 921:171202. [PMID: 38408669 DOI: 10.1016/j.scitotenv.2024.171202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Prenatal and early-life exposure to polybrominated diphenyl ethers (PBDEs) is associated with detrimental and irreversible neurodevelopmental health outcomes during childhood. Breastfeeding may be a child's largest sustained exposure to PBDE- potentially exacerbating their risk for adverse neurodevelopment outcomes. However, breastfeeding has also been associated with positive neurodevelopment. Our study investigates if breastfeeding mitigates or exacerbates the known adverse effects of prenatal exposure to PBDEs and child neurodevelopment. METHODS Participants included 321 mother-infant dyads from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS), a longitudinal birth cohort in California. PBDE concentrations were measured in maternal serum blood samples collected during pregnancy or at delivery. Using generalized estimated equations (GEE), we estimated associations of PBDE concentrations with children's attention, executive function, and cognitive scores assessed longitudinally between 7 and 12 years of age, stratified by duration of exclusive and complementary breastfeeding. RESULTS We observed that higher maternal prenatal PBDE concentrations were associated with poorer executive function among children who were complementary breastfed for a shorter duration compared to children breastfed for a longer duration; preservative errors (β for 10-fold increase in complementary breastfeeding <7 months = -6.6; 95 % Confidence Interval (CI): -11.4, -1.8; β ≥ 7 months = -5.1; 95 % CI: -10.2, 0.1) and global executive composition (β for 10-fold increase <7 months = 4.3; 95 % CI: 0.4, 8.2; β for 10-fold increase ≥7 months = 0.6; 95 % CI: -2.8, 3.9). CONCLUSIONS Prolonged breastfeeding does not exacerbate but may mitigate some previously observed negative associations of prenatal PBDE exposure and child neurodevelopment.
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Affiliation(s)
- Jordyn T Wallenborn
- Center of Excellence for Maternal and Child Health, School of Public Health, University of California, Berkeley, CA, USA; Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Carly Hyland
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA; Division of Agriculture and Natural Resources, University of California, Berkeley, CA, USA; Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
| | - Sharon K Sagiv
- Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
| | - Katherine R Kogut
- Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
| | - Asa Bradman
- Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, USA
| | - Brenda Eskenazi
- Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
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Brüggemann C, Carlhäll S, Grundström H, Ramö Isgren A, Blomberg M. Cumulative oxytocin dose in spontaneous labour - Adverse postpartum outcomes, childbirth experience, and breastfeeding. Eur J Obstet Gynecol Reprod Biol 2024; 295:98-103. [PMID: 38350309 DOI: 10.1016/j.ejogrb.2024.01.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/11/2024] [Accepted: 01/31/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVES This study aimed to determine the association between the total cumulative oxytocin dose during labour and adverse postpartum outcomes, childbirth experience and breastfeeding in term primiparous women with spontaneous onset of labour. STUDY DESIGN A prospective observational multicentre study, including 1395 women with spontaneous labour, in seven hospitals in Southeast Sweden. Multivariable logistic regression (Crude Odds Ratios (OR) and adjusted OR (aOR) for relevant confounders) was used to analyze the association between oxytocin dose and postpartum outcomes. The exposure was the cumulative oxytocin dose during labour, classified in percentiles (<25th, 25-75th, >75th). The outcomes were occurrence of obstetric anal sphincter injury, postpartum haemorrhage (blood loss > 1000 ml), Apgar score < 7 at five minutes, umbilical cord arterial pH, postpartum bladder overdistension, exclusive breastfeeding at one week and three months, and the woman's perceived birth experience. RESULTS Women receiving high amounts (>75th percentile, >4370 mU) of oxytocin infusion during labour had an increased risk of postpartum haemorrhage (OR 2.73 (1.78-4.19)), an overdistended bladder (OR 2.19 (1.11-4.31)), an infant with an Apgar score < 7 at five minutes (OR 2.89 (1.27-6.57)), a negative birth experience (OR 1.83 (1.25-2.69)), and a decreased chance of exclusive breastfeeding at one week (OR 0.63 (0.41-0.96)). After adjusting for confounders, all outcomes remained statistically significant except risk of low Apgar score and chance of exclusive breastfeeding. CONCLUSION In women with high cumulative oxytocin dose during labour prompt, and prophylactic administration of uterotonics after delivery of the placenta should be considered to reduce the risk of postpartum haemorrhage. The risk for bladder overdistension can be reduced by implementing routines for observation for signs of bladder filling in the early postpartum period, as well as routine use of bladder scans post micturition to assess for successful bladder emptying. As women's birth experience have a major impact on their future mental health, should be routinely assessed postpartum, and support should be offered to women with negative experiences.
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Affiliation(s)
- Cecilia Brüggemann
- Department of Obstetrics and Gynaecology in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, S-58185 Linköping, Sweden.
| | - Sara Carlhäll
- Department of Obstetrics and Gynaecology in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, S-58185 Linköping, Sweden.
| | - Hanna Grundström
- Department of Obstetrics and Gynaecology in Norrköping, and Department of Biomedical and Clinical Sciences, Linköping University, S-58185 Linköping, Sweden; Department of Health, Medicine and Caring Sciences, Linköping University, S-58185 Linköping, Sweden.
| | - Anna Ramö Isgren
- Department of Obstetrics and Gynaecology in Norrköping, and Department of Biomedical and Clinical Sciences, Linköping University, S-58185 Linköping, Sweden.
| | - Marie Blomberg
- Department of Obstetrics and Gynaecology in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, S-58185 Linköping, Sweden.
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Ottria R, Porta MD, Xynomilakis O, Casati S, Cazzola R, Ciuffreda P. Lipids and lipid signaling molecules in human milk and infant formula, a chemical characterization of relevant biochemical components. J Nutr Biochem 2024; 126:109580. [PMID: 38272323 DOI: 10.1016/j.jnutbio.2024.109580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 01/27/2024]
Abstract
Breastfeeding is the gold standard in infant nutrition and continuous researches aim to optimize infant formula composition as the best alternative available. Human milk lipid content provides more than 50% of energy requirements for infants together with essential vitamins, polyunsaturated fatty acids, and other bioactive components. While fatty acids and vitamins human milk content has been extensively studied and, when needed those have been added to infant formulas, less is known about polyunsaturated fatty acids functional derivatives and other bioactive components. Here we describe the comparison of lipid compositions in breast milk from 22 healthy volunteers breastfeeding mothers and the six most common infant formula devoting particular attention to two families of signaling lipids, endocannabinoids, and eicosanoids. The main differences between breast milk and formulas lie in a variety of saturated fatty and unsaturated fatty acids, in the total amount (45-95% less in infant formula) and a variety of endocannabinoids and eicosanoids (2-AG, 5(s)HETE, 15(S)-HETE and 14,15-EET).
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Affiliation(s)
- Roberta Ottria
- Dipartimento di Scienze Biomediche e Cliniche, Università degli Studi di Milano, Milano 20157, Italy.
| | - Matteo Della Porta
- Dipartimento di Scienze Biomediche e Cliniche, Università degli Studi di Milano, Milano 20157, Italy
| | - Ornella Xynomilakis
- Dipartimento di Scienze Biomediche e Cliniche, Università degli Studi di Milano, Milano 20157, Italy
| | - Sara Casati
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milan, Italy
| | - Roberta Cazzola
- Dipartimento di Scienze Biomediche e Cliniche, Università degli Studi di Milano, Milano 20157, Italy
| | - Pierangela Ciuffreda
- Dipartimento di Scienze Biomediche e Cliniche, Università degli Studi di Milano, Milano 20157, Italy
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Geller S, Levy S, Baruch T, Rinot Y, Swami V. Breastfeeding self-efficacy, body image, body acceptance, and partner support: Associations in Israeli postpartum women. Midwifery 2024; 131:103937. [PMID: 38306735 DOI: 10.1016/j.midw.2024.103937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 12/24/2023] [Accepted: 01/23/2024] [Indexed: 02/04/2024]
Abstract
PROBLEM Research suggests that breastfeeding self-efficacy (i.e., a mother's perceived ability and confidence to breastfeed her new-born) is associated with body image experiences and wider psychosocial factors. However, much of this work is focused on negative body image and has relied on samples from predominantly Westernised, industrialised nations. BACKGROUND To extend knowledge, we sought to examine the extent to which indices of positive body image (body appreciation), negative body image (body dissatisfaction, breast size dissatisfaction), and psychosocial factors (body acceptance by others, postpartum partner support) are associated with breastfeeding self-efficacy in sample of mothers from Israel. HYPOTHESIS We hypothesised that body appreciation, body dissatisfaction, breast size dissatisfaction, body acceptance by others, and postpartum partner support would each be significantly associated with breastfeeding self-efficacy in Israeli mothers. METHOD A total of 352 mothers from Israel, with an infant aged six months or younger, were asked to complete an online survey that measured the aforementioned constructs. FINDINGS Correlational and linear model analyses indicated that only body appreciation was significantly associated with breastfeeding self-efficacy. Body acceptance by others was significantly associated with breastfeeding self-efficacy in correlational but not regression analyses. These effects were consistent across primiparous and multiparous mothers. DISCUSSION In Israeli mothers, at least, a limited set of body image and body image-related indices appear to be associated with breastfeeding self-efficacy. CONCLUSION Overall, these findings suggest that positive body image may be associated with breastfeeding self-efficacy in women from Israel, though more research is needed.
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Affiliation(s)
- Shulamit Geller
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Israel.
| | - Sigal Levy
- Statistics Education Unit, The Academic College of Tel Aviv-Yaffo, Israel
| | - Ti Baruch
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Israel
| | - Yarden Rinot
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Israel
| | - Viren Swami
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia
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Harris LR, Lee DH, Mareuil JW, Rakhmanina NY, Koay WLA. The Mental Health Effects and Experiences of Breastfeeding Decision-Making Among Postpartum Women Living with HIV. AIDS Behav 2024; 28:1186-1196. [PMID: 37505338 DOI: 10.1007/s10461-023-04142-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
Prior to January 2023, women living with HIV (WLWH) in the United States (US) were discouraged from breastfeeding due to the potential risk of mother-to-child HIV transmission through breastfeeding. Lack of breastfeeding decision-making and experience among WLWH may negatively affect maternal mental health. We implemented a quality improvement initiative to screen WLWH for postpartum depression (PPD), evaluate their attitudes toward breastfeeding, and assess their experience with breastfeeding decision-making. We collected quantitative data from WLWH using a voluntary, self-administered 6-item breastfeeding decision-making and experience survey (administered 1 month postpartum) and a 10-item Edinburgh Postnatal Depression Scale (EPDS, negative = 0-9; administered 1 and 4 months postpartum) tool. We conducted descriptive statistics and cross tabulation analysis. We analyzed 106 WLWH (93.4% non-Hispanic Black/African American; mean age 33.1 years; 82.1% HIV RNA < 200 copies/mL). One in five (19.1%) WLWH had a positive baseline EPDS screen, with the mean EPDS scores decreasing from 5.3 ± 5.4 (baseline) to 4.6 ± 4.8 (follow-up). Among 55 WLWH who provided baseline and follow-up EPDS scores, only 3/13 with a positive baseline EPDS screen had resolved depressive symptoms at follow-up. Over one-third (37.7%) of WLWH indicated feeling "sadness" when asked whether lack of breastfeeding negatively affected their feelings or emotions. Over half of WLWH (51.9%) were aware of the US breastfeeding recommendations, but the majority (60.4%) had never discussed breastfeeding options with a medical provider. Improved provider-patient discussions on infant feeding options among WLWH is needed to increase awareness of breastfeeding choices and promote informed, autonomous breastfeeding decision-making among WLWH.
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Affiliation(s)
- Leah R Harris
- Division of Infectious Diseases, Children's National Hospital, Washington, DC, USA
- General Dynamics Information Technology, Washington, DC, USA
| | - Do H Lee
- Department of Biostatistics and Bioinformatics, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Joanna W Mareuil
- Division of Infectious Diseases, Children's National Hospital, Washington, DC, USA
| | - Natella Y Rakhmanina
- Division of Infectious Diseases, Children's National Hospital, Washington, DC, USA
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- Technical Strategies and Innovation, Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, USA
| | - Wei Li A Koay
- Division of Infectious Diseases, Children's National Hospital, Washington, DC, USA.
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
- Children's National Hospital, 111 Michigan Ave NW, West Wing Level 3.5 Suite 100, Washington, DC, 20010, USA.
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Eker A, Aslan E. Effect of Lactation Management Model on Breastfeeding Process After Cesarean: A Prospective Randomized Controlled Study. Reprod Sci 2024; 31:1108-1116. [PMID: 38097898 DOI: 10.1007/s43032-023-01409-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/08/2023] [Indexed: 03/24/2024]
Abstract
It is important to implement supportive programs to ensure mothers breast feed for the desired period, and infants are fed by only mother's milk. In the research, it was aimed at evaluating the effects of lactation management model on mothers' breastfeeding process following a caesarean section. Women who gave birth by planned cesarean delivery were divided into two groups, randomized control and experimental. Data collection was performed during gestation, first day after postpartum, pre-discharge, on the 9th day in a face to face interview, and in the form of monthly phone interviews up to 6 months. While the experimental group exercised the lactation management model, the control group received routine lactation practices in clinic. In the scores of Breastfeeding Charting System and Documentation Tool, a significant difference was found between the groups (p<0.001). 87.9% of the experimental group and 48.5% of the control group were determined to apply successful breast-feeding techniques. In addition, it was found that all of the experimental group breast fed 1 month longer than the control group, and for the first month, 90.9% of the experimental group and 78.8% of the control group breast fed with mother's milk only and a higher breastfeeding. Among in the experimental group, it was found that breastfeeding self-efficacy was higher, and breastfeeding techniques were accurate and successful and breastfeeding only and continuity rates were higher while breastfeeding related breast problems developed less frequently. Clinical Trials.gov Protocol Registration Number: NCT04593719.
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Affiliation(s)
- Aslı Eker
- Midwifery Department, Mersin University Icel Health School, Mersin, Turkey.
| | - Ergül Aslan
- Department of Women's Health and Diseases Nursing, Istanbul University-Cerrahpasa Florence Nightingale Nursing Faculty, Istanbul, Turkey
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Beaudry M, Bustinza R, Michaud-Létourneau I. Alimentation infantile et changements climatiques : une opportunité prometteuse. Can J Public Health 2024:10.17269/s41997-024-00869-7. [PMID: 38526809 DOI: 10.17269/s41997-024-00869-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 02/12/2024] [Indexed: 03/27/2024]
Abstract
The method of infant feeding has consequences for the production of greenhouse gases (GHG) as well as for the risks to infants posed by climate change. Breastfeeding can reduce the carbon footprint associated with the use of commercial infant formula by nearly 50% while reducing its water footprint and waste. It is also an excellent way of coping with emergencies associated with climate change, such as water shortages, since breastfed children are better protected than those fed with formula. To ensure that the protection offered by breastfeeding can be realized, we present elements that can help decision-makers seize a promising opportunity: improve infant feeding support for women and families.
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Affiliation(s)
| | - Ray Bustinza
- Institut national de santé publique du Québec, Québec, Québec, Canada
| | - Isabelle Michaud-Létourneau
- Mouvement allaitement du Québec, Montréal, Québec, Canada
- Département de médecine sociale et préventive, École de santé publique de l'Université de Montréal, Montréal, Québec, Canada
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Fu S, Ke H, Yuan H, Xu H, Chen W, Zhao L. Dual role of pregnancy in breast cancer risk. Gen Comp Endocrinol 2024:114501. [PMID: 38527592 DOI: 10.1016/j.ygcen.2024.114501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/15/2024] [Accepted: 03/20/2024] [Indexed: 03/27/2024]
Abstract
Reproductive history is one of the strongest risk factors for breast cancer in women. Pregnancy can promote short-term breast cancer risk, but also reduce a woman's lifetime risk of breast cancer. Changes in hormone levels before and after pregnancy are one of the key factors in breast cancer risk. This article summarizes the changes in hormone levels before and after pregnancy, and the roles of hormones in mammary gland development and breast cancer progression. Other factors, such as changes in breast morphology and mammary gland differentiation, changes in the proportion of mammary stem cells (MaSCs), changes in the immune and inflammatory environment, and changes in lactation before and after pregnancy, also play key roles in the occurrence and development of breast cancer. This review discusses the dual effects and the potential mechanisms of pregnancy on breast cancer risk from the above aspects, which is helpful to understand the complexity of female breast cancer occurrence.
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Affiliation(s)
- Shiting Fu
- Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang 330031, China; Department of Medical Oncology, The Third Hospital of Nanchang, Nanchang 330009, China
| | - Hao Ke
- Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang 330031, China; Department of Medical Oncology, The Third Hospital of Nanchang, Nanchang 330009, China
| | - Huozhong Yuan
- Ganzhou People's Hospital, Ganzhou 341000, China; Department of Medical Oncology, The Third Hospital of Nanchang, Nanchang 330009, China
| | - Haimeng Xu
- Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang 330031, China; Department of Medical Oncology, The Third Hospital of Nanchang, Nanchang 330009, China
| | - Wenyan Chen
- Ganzhou People's Hospital, Ganzhou 341000, China
| | - Limin Zhao
- Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang 330031, China; Department of Medical Oncology, The Third Hospital of Nanchang, Nanchang 330009, China.
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Jobarteh ML, Conway-Moore K, Yadav D, Tata DT, Fahmida U, Faye B, Kulkarni B, Saxena D, Heffernan C. Unpacking the intractability of childhood stunting: an introduction to the UKRI GCRF Action Against Stunting Hub. BMJ Paediatr Open 2024; 8:e002333. [PMID: 38519064 PMCID: PMC10961497 DOI: 10.1136/bmjpo-2023-002333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/28/2023] [Indexed: 03/24/2024] Open
Affiliation(s)
- Modou Lamin Jobarteh
- Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Kaitlin Conway-Moore
- Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Dinesh Yadav
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Darius Testa Tata
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Umi Fahmida
- Southeast Asian Ministry of Education Organisation Regional Centre for Food and Nutrition (SEAMEO RECFON), Central Jakarta, DKI Jakarta, Indonesia
| | - Babacar Faye
- Faculté de médecine, Université Cheikh Anta Diop (UCAD), Dakar, Senegal
| | | | - Deepak Saxena
- Indian Institute of Public Health Gandhinagar, Gandhinagar, India
| | - Claire Heffernan
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
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Campanha PDPA, de Magalhães-Barbosa MC, Prata-Barbosa A, Rodrigues-Santos G, da Cunha AJLA. Exclusive breastfeeding and length of hospital stay in premature infants at a Brazilian reference center for kangaroo mother care. J Pediatr (Rio J) 2024:S0021-7557(24)00028-7. [PMID: 38522479 DOI: 10.1016/j.jped.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 03/26/2024] Open
Abstract
OBJECTIVE To evaluate exclusive breastfeeding at discharge and hospital length-of-stay in preterm infants undergoing or not the Kangaroo-Mother Care Method (KMC). METHODS A retrospective cohort study was conducted including preterm infants < 1800 g admitted to the neonatal unit of a KMC reference center. The infants were grouped into the KMC group and the non-KMC group. Multiple logistic and Poisson regressions were performed to evaluate the association between the KMC and two outcomes, exclusive breastfeeding at discharge, and hospital length-of-stay, adjusted for potential confounders. RESULTS 115 mother-infant dyads were included, 78 in the KMC group and 37 in the non-KMC group. In the bivariate analysis, the KMC group had a lower prevalence of maternal adverse conditions (6% vs. 32%, p < 0.001), a higher number of prenatal visits (median 6 vs. 3.5, p < 0.001), higher gestational ages (median 32 vs. 31 weeks, p < 0.05), higher birth weights (median 1530 vs. 1365 g, p < 0.01), a lower prevalence of necrotizing enterocolitis (3.8% vs. 16.2%, p < 0.05), parenteral nutrition (50% vs. 73%, p < 0.05), and deep vascular access (49.7% vs. 78.4%, p < 0.01), a higher prevalence of exclusive breastfeeding (65% vs. 8%, p < 0.001) and a shorter length of hospital stay (median 28 vs. 42 days, p < 0.001). In the multiple regression analysis, the KMC group was 23 times more likely to be exclusively breastfed at discharge (OR = 23.1; 95% CI = 4,85-109,93) and had a 19% reduction in the hospital length-of-stay (IDR = 0.81; 95% CI = 0.76-0.86) compared to the non-KMC group. CONCLUSIONS The KMC is associated with better short-term neonatal outcomes and should be encouraged in all Brazilian maternity hospitals.
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Affiliation(s)
- Patrícia de Padua Andrade Campanha
- Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Medicina, Rio de Janeiro, RJ, Brazil; Secretaria Municipal de Saúde do Rio de Janeiro - Maternidade Leila Diniz, Rio de Janeiro, RJ, Brazil.
| | - Maria Clara de Magalhães-Barbosa
- Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil; Universidade Federal do Rio de Janeiro (UFRJ), Instituto de Puericultura e Pediatria Martagão Gesteira, Rio de Janeiro, RJ, Brazil
| | - Arnaldo Prata-Barbosa
- Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Medicina, Rio de Janeiro, RJ, Brazil; Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil
| | | | - Antônio José Ledo Alves da Cunha
- Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Medicina, Rio de Janeiro, RJ, Brazil; Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil
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11
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Mokhlesi SS, Vasilevski V, Sweet L. Breastfeeding and pre-pregnancy bariatric surgery: A scoping review. Women Birth 2024; 37:101600. [PMID: 38513305 DOI: 10.1016/j.wombi.2024.101600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/09/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Bariatric surgery is a procedure for people with class II and III obesity who are unable to lose weight using traditional methods. The incidence rate of bariatric surgery in reproductive-age women is increasing rapidly, so the number of women who become pregnant after bariatric surgery is rising. AIM To collate and synthesise available literature regarding breastfeeding following bariatric surgery. METHODS This review was reported by the preferred reporting items for systematic reviews and meta-analysis extension for scoping reviews (PRISMA-Scr). The review included peer-reviewed research studies and research-based conference abstracts on breastfeeding outcomes in mothers who have undergone bariatric surgery before pregnancy. Health databases were searched from 1990 to December 2023. Included studies were analysed using a narrative synthesis. FINDINGS From 1506 abstracts, 16 papers were identified. Three themes emerged from the analysis: challenges in exclusive breastfeeding, nutritional composition in breast milk, and breastfeeding experience. There was a tendency for lower breastfeeding rates and shorter durations in mothers who had bariatric surgery. Most studies focussed on the nutritional composition of breast milk however these results were mixed. Only three articles were qualitative, and their findings showed that women wanted more information and support about breastfeeding following bariatric surgery. DISCUSSION Our review indicates breastfeeding challenges in post-bariatric surgery mothers and reduced breastfeeding rates. It is unclear whether bariatric surgery impacts the nutritional quality of breast milk due to inconsistent study outcomes. CONCLUSION Future research is essential, specifically on understanding the breastfeeding concerns and experiences of women who have undergone bariatric surgery.
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Affiliation(s)
| | - Vidanka Vasilevski
- School of Nursing and Midwifery, Deakin University, Victoria, Australia; Center for Quality and Patient Safety Research, Institute for Health Transformation, Western Health Partnership, Victoria, Australia
| | - Linda Sweet
- School of Nursing and Midwifery, Deakin University, Victoria, Australia; Center for Quality and Patient Safety Research, Institute for Health Transformation, Western Health Partnership, Victoria, Australia
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Srichalerm T, Jacelon CS, Sibeko L, Granger J, Briere CE. Thai novice nurses' lived experiences and perspectives of breastfeeding and human milk in the Neonatal Intensive Care Unit (NICU). Int Breastfeed J 2024; 19:20. [PMID: 38509594 PMCID: PMC10956329 DOI: 10.1186/s13006-024-00620-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 02/03/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Breastfeeding and human milk have well-documented health benefits for newborn infants, particularly those who are sick. However, breastfeeding rates and human milk feeding among infants in neonatal intensive units (NICU) in Thailand are still low; thus, breastfeeding promotion and support are required for Thai mothers of premature infants. Newly graduated nurses can play a critical role within the healthcare support system and can have a significant impact on improving breastfeeding practices in the NICU. The objective of this study was to investigate the lived experiences and perspectives of Thai novice nurses on supporting breastfeeding and human milk feeding in the NICU. METHODS The study was conducted between March 2021 and May 2022 at three medical centers in the central region of Thailand. This study employed a descriptive phenomenological approach to explore Thai novice nurses' experiences and perspectives on breastfeeding. Purposive sampling was used to invite Thai novice nurses who have work experience in providing breastfeeding support to NICU mothers and their infants to participate in online interviews using a video conference platform (Zoom). Semi-structured questions were used to interview study participants in their native language. Data were analyzed using Colaizzi's method of data analysis to identify emergent themes. Member checks, peer debriefing, and self-reflection were applied to ensure the validity and trustworthiness of the study results. Back-translation was also used as a quality and accuracy assurance. RESULTS A total of thirteen novice nurses agreed to participate in the study. All were female, and their ages ranged from 21 to 24 years old at the time of the interview. The researchers identified five major themes related to the overall study objectives and research questions. They are: positive attitude toward breastfeeding and human milk, facing breastfeeding challenges at work, self-confidence rooted in experience, professional skill needs, and requiring further support. CONCLUSIONS Our results suggest that breastfeeding education plays a vital role in encouraging new nurses to provide breastfeeding support to mothers of preterm infants. Establishing breastfeeding support training and innovative learning strategies can be crucial in developing appropriate breastfeeding practice guidelines and policies to support Thai breastfeeding mothers in the NICU.
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Affiliation(s)
- Tippawan Srichalerm
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Cynthia S Jacelon
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, MA, USA
| | - Lindiwe Sibeko
- School of Public Health & Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Jumpee Granger
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Carrie-Ellen Briere
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, MA, USA.
- Institute for Nursing Research and Evidence-Based Practice, Connecticut Children's, Hartford, CT, USA.
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Holstad Y, Johansson B, Lindqvist M, Westergren A, Poromaa IS, Christersson C, Dellborg M, Trzebiatowska-Krzynska A, Sörensson P, Thilén U, Wikström AK, Bay A. Breastfeeding in primiparous women with congenital heart disease - a register study. Int Breastfeed J 2024; 19:19. [PMID: 38509505 PMCID: PMC10956229 DOI: 10.1186/s13006-024-00627-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/07/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND The number of pregnant women with congenital heart disease (CHD) is rising, and the disease poses increased risks of cardiovascular and obstetric complications during pregnancy, potentially impacting breastfeeding success. This study aimed to investigate breastfeeding in primiparous women with CHD compared to primiparous women without CHD, and to examine potential hindering factors for breastfeeding in women with CHD. METHODS The data were gathered between 2014 and 2019 and obtained by merging the Swedish Congenital Heart Disease Register (SWEDCON) with the Swedish Pregnancy Register. Primiparous women ≥ 18 years of age with CHD (n = 578) were matched by age and municipality to 3049 women without CHD, giving birth after 22 gestational weeks. Multivariable logistic regression analysis was used to identify factors associated with non-breastfeeding in women with CHD. RESULTS Fewer women with CHD breastfed than women without CHD two days (94% vs. 97%, p = 0.001) and four weeks after birth (84% vs. 89%, p = 0.006). When all women were analysed, having CHD was associated with non-breastfeeding at both two days and four weeks after birth. For women with CHD, body mass index (BMI) ≥ 30 (OR 3.1; 95% CI 1.4, 7.3), preterm birth (OR 6.4; 95% CI 2.1, 19.0), self-reported history of psychiatric illness (OR 2.4; 95% CI 1.2, 5.1), small for gestational age (OR 4.2; 95% CI 1.4, 12.2), and New York Heart Association Stages of Heart Failure class II - III (OR 6.0; 95% CI 1.4, 26.7) were associated with non-breastfeeding two days after birth. Four weeks after birth, factors associated with non-breastfeeding were BMI ≥ 30 (OR 4.3; 95% CI 2.1, 9.0), self-reported history of psychiatric illness (OR 2.2; 95% CI 1.2, 4.2), and preterm birth (OR 8.9; 95% CI 2.8, 27.9). CONCLUSIONS The study shows that most women with CHD breastfeed, however, at a slightly lower proportion compared to women without CHD. In addition, factors related to the heart disease were not associated with non-breastfeeding four weeks after birth. Since preterm birth, BMI ≥ 30, and psychiatric illness are associated with non-breastfeeding, healthcare professionals should provide greater support to women with CHD having these conditions.
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Affiliation(s)
- Ylva Holstad
- Department of Nursing, Umeå University, Umeå, Sweden.
| | - Bengt Johansson
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Maria Lindqvist
- Department of Nursing, Umeå University, Umeå, Sweden
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | | | | | | | - Mikael Dellborg
- Department of Clinical and Molecular Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Peder Sörensson
- Department of Medicine, Solna, Department of Cardiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Ulf Thilén
- Department of Clinical Sciences, Cardiology, Lund University, Lund, Sweden
| | - Anna-Karin Wikström
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Annika Bay
- Department of Nursing, Umeå University, Umeå, Sweden
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14
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Shah MD, Robinson DT. Breastfeeding the Infant Born Premature: Opportunity and Optimism. Neonatology 2024:1-3. [PMID: 38503275 DOI: 10.1159/000537899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 03/21/2024]
Affiliation(s)
- Malika D Shah
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Daniel T Robinson
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
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Rahati S, Hashemi M, Orooji A, Afshari A, Sany SBT. Health risk assessments of heavy metals and trace elements exposure in the breast milk of lactating mothers in the Northeastern Iran. Environ Sci Pollut Res Int 2024:10.1007/s11356-024-32795-z. [PMID: 38488912 DOI: 10.1007/s11356-024-32795-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 02/29/2024] [Indexed: 03/17/2024]
Abstract
Mother's breast milk is a natural and complete food for infants but can be a main source of exposure to toxic pollutants. These pollutants can negatively affect the health of the infant. Therefore, conducting biomonitoring surveys is essential to evaluate such health effects in toxicological research. This study aimed to estimate the probable health risks for infants exposed to essential and non-essential trace elements through breast milk ingestion. This descriptive-analytical, cross-sectional study was performed on 90 breastfeeding mothers referred to the health centers in Mashhad, Iran in January 2021. The health risk assessments (carcinogenic and non-carcinogenic risk) were estimated using chronic daily intake (CDI), hazard quotient (HQ), hazard index (HI), and lifetime carcinogenic risk (CR), which were recommended by the US Environmental Protection Agency (US EPA). The results of the HQ values of trace elements through ingestion exposure for arsenic (90%), copper (90%), zinc (40%), and iron (10%) exceeded the threshold of HQ, and arsenic (66.59%), copper (16.91%), and zinc (9.68%) and iron (4.57%) had the highest contribution to increasing the HI index. The average value of CR was 5. 08 × 10-3. Chromium and iron showed significant relationships (P<0.05) with education level and disease background in this study, and the concentration of chromium, iron, and zinc in the breast milk samples significantly changed during lactation stages (P<0.05). Overall, the risk of carcinogenicity through exposure to breast milk for infants was higher than the safety level of US EPA risk. Therefore, there could be a potential health risk of trace elements, particularly arsenic, copper, and zinc for infants in Mashhad, Iran through the consumption of mothers' breast milk. More efforts are required to control and reduce routes of receiving trace elements in breastfeeding mothers by the competent authorities.
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Affiliation(s)
- Shiva Rahati
- Department of Food Sciences and Technology, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hashemi
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Arezoo Orooji
- Department of Epidemiology and Biostatistics, Faculty of Health Sciences, Mashhad University of Medical Sciences, Mashhad, 13131-99137, Iran
| | - Asma Afshari
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyedeh Belin Tavakoly Sany
- Department of Health, Safety, Environment Managment, School of Health Mashhad University of Medical Sciences, Mashhad, Iran.
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, 13131-99137, Iran.
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Marfo M, Acheampong AK, Asare C. Financial burden faced by breastfeeding mothers caring for children diagnosed with cancer in Ghana; an exploratory qualitative study. BMC Womens Health 2024; 24:177. [PMID: 38486146 PMCID: PMC10938724 DOI: 10.1186/s12905-024-02931-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 01/25/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND When children are diagnosed of cancer, parents face varied financial issues. Among some of the identifiable factors that cause financial challenges among breastfeeding mothers include the high cost of childhood cancer care. The high cost of childhood cancer care could impede the sustainability of access to prompt care. There is paucity of literature on the financial burdens faced by breastfeeding mothers with children diagnosed with cancer in Ghana. Therefore, this study sought to explore the financial burden faced by mothers with breastfeeding children diagnosed with cancer. METHODS The study employed qualitative exploratory descriptive design. One-on-one interviews were conducted among 13 mothers with breastfeeding children diagnosed of cancer. Permission was sought for data to be recorded, transcribed concurrently and inductive content analysis done. RESULTS Three main themes emerged after data analysis: High cost (sub-themes; expensive medications, laboratory investigation fees, and cost of mothers' feeding), Public support (sub-themes; appeal for funds, national health insurance scheme) and Self-financing (loans, personal savings). Most of the breastfeeding mothers narrated that high cost of childhood cancer care generated financial distress to them. They shared that the cost involved in purchasing their children's cancer medications, paying for laboratory investigations and feeding themselves to produce adequate breastmilk to feed their children were challenging. Some of the mothers self-financed the cost of their children's cancer care through loans and personal savings. CONCLUSION Government and other stakeholders should allocate annual budget and funds towards childhood cancer care to lessen the financial burden breastfeeding mothers caring for children with cancer experience.
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Affiliation(s)
- Margaret Marfo
- School of Nursing and Midwifery, Wisconsin International University College-Ghana, Accra, Ghana
| | | | - Comfort Asare
- School of Nursing and Midwifery, Wisconsin International University College-Ghana, Accra, Ghana
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Barry S, Buckle H, Newhook LAA, Roebothan B, Howell B, Gates H, Twells LK. High rates of International Code violations: a cross-sectional study in a region of Canada with low breastfeeding rates. BMC Res Notes 2024; 17:71. [PMID: 38475867 DOI: 10.1186/s13104-024-06725-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Exposure to marketing and promotion of commercial milk formula is associated with an increased likelihood of formula-feeding. In 1981, the International Code (IC) of Marketing of Breastmilk Substitutes was adopted by the 34th World Health Assembly to restrict the promotion, marketing and advertising of commercial milk formula and protect breastfeeding. RESEARCH AIM The current study examines mothers' exposure to violations of the IC in Newfoundland and Labrador, a province of Canada with low breastfeeding rates. METHODS A cross-sectional online survey measured exposure to IC violations (e.g., marketing, advertising and promotion of commercial milk formula) by mothers of infants less than two years old (n = 119). Data were collected on type, frequency, and location of violation. RESULTS Most participants (87%, n = 104/119) reported exposure to at least one IC violation. Of this group (n = 104): 94% received coupons or discount codes for the purchase of commercial milk formula; 88% received free samples of commercial milk formula from manufacturers, and 79% were contacted directly by commercial milk formula companies via email, text message, mail or phone for advertising purposes. One-third (n = 28/104, 27%) observed commercial milk formula promotional materials in health care facilities. The most frequent locations were violations occurred were doctors' offices (79%), supermarkets(75%), and pharmacies (71%). CONCLUSION The majority of mothers of young infants were exposed to violations of the IC involving the marketing, advertising and promotion of commercial milk formula. Companies producing commercial milk formula reached out directly to new mothers to offer unsolicited promotions and free samples of commercial milk formula.
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Affiliation(s)
- Susan Barry
- Division of Population Health and Applied Health Sciences, Faculty of Medicine| Memorial University of Newfoundland, A1B 3V6, St. John's, Newfoundland and Labrador, Canada
| | - Hannah Buckle
- Division of Population Health and Applied Health Sciences, Faculty of Medicine| Memorial University of Newfoundland, A1B 3V6, St. John's, Newfoundland and Labrador, Canada
- Labrador-Grenfell Health, Happy Valley-Goose Bay, NL, Canada
| | | | - Barbara Roebothan
- Division of Population Health and Applied Health Sciences, Faculty of Medicine| Memorial University of Newfoundland, A1B 3V6, St. John's, Newfoundland and Labrador, Canada
| | - Brittany Howell
- Division of Population Health and Applied Health Sciences, Faculty of Medicine| Memorial University of Newfoundland, A1B 3V6, St. John's, Newfoundland and Labrador, Canada
| | - Heather Gates
- Baby-Friendly Council of NL, Baby-Friendly Newfoundland and Labrador, St. John's, Newfoundland and Labrador, Canada
| | - Laurie K Twells
- Division of Population Health and Applied Health Sciences, Faculty of Medicine| Memorial University of Newfoundland, A1B 3V6, St. John's, Newfoundland and Labrador, Canada.
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Singhal A, Singh A, Sharma D, Bose KS. Correlation between maternal and infant vitamin B12 levels in severe malnutrition in infants under 6 months. Ir J Med Sci 2024:10.1007/s11845-024-03662-0. [PMID: 38462591 DOI: 10.1007/s11845-024-03662-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 02/27/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Malnutrition poses a significant global health challenge, affecting various age groups, with infants under 6 months being particularly vulnerable. Vitamin B12, an essential micronutrient critical for neurological development, has been identified as a key player in the overall health of both mothers and infants. AIM To find the correlation between serum vitamin B12 levels in infants, 1-6 months of age with severe malnutrition and maternal levels at tertiary care hospitals in western Rajasthan. METHODS The cross-sectional study was conducted in the UNICEF Regional Center of Excellence-supported Nutrition Rehabilitation Center in Rajasthan, India, through simple random sampling. One hundred ten infants with their mothers were enrolled after consent and approval from the Institutional Ethics Committee. RESULTS Severe malnutrition predominantly affected infants aged 1-2 months, with 77% born small for gestational age and 66.4% belonging to the multiple birth order group. Serum vitamin B12 levels showed a significant positive correlation between mothers and infants (p < 0.001), while exclusive breastfeeding correlated positively with age-appropriate milestones (p = 0.033). CONCLUSION The findings emphasize the importance of targeted interventions addressing maternal and infant nutrition, with a focus on ensuring adequate vitamin B12 levels.
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Affiliation(s)
- Arushi Singhal
- Department of Paediatrics, Dr SN Medical College and Hospital, Jodhpur, India
| | - Anurag Singh
- Department of Paediatrics, Dr SN Medical College and Hospital, Jodhpur, India
| | - Damini Sharma
- Department of Paediatrics, Dr SN Medical College and Hospital, Jodhpur, India
| | - Kritanjali Sahu Bose
- Department of Community Medicine, Rajiv Gandhi Medical Collegeand, Chhatrapati Shivaji Medical College, Kalwa, Thane, India.
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van Amesfoort JE, Van Mello NM, van Genugten R. Lactation induction in a transgender woman: case report and recommendations for clinical practice. Int Breastfeed J 2024; 19:18. [PMID: 38462609 PMCID: PMC10926588 DOI: 10.1186/s13006-024-00624-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/27/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND We present a case of non-puerperal induced lactation in transgender woman. Medical literature on lactation induction for transgender women is scarce, and the majority of literature and protocols on lactation induction is based on research in cisgender women. Healthcare professionals may lack the precise knowledge about lactation induction and may therefore feel insecure when advice is requested. Subsequently, there is a rising demand for guidelines and support. METHODS Patient medical record was consulted and a semi-structured interview was conducted to explore the motive for lactation induction, the experience of lactation induction, and to gather additional information about the timeline and course of events. CASE PRESENTATION In this case a 37-year-old transgender woman, who was under the care of the centre of expertise on gender dysphoria in Amsterdam, and in 2020 started lactation induction because she had the wish to breastfeed her future infant. She was in a relationship with a cisgender woman and had been using gender affirming hormone therapy for 13 years. Prior to initiating gender affirming hormone therapy she had cryopreserved her semen. Her partner conceived through Intracytoplasmic Sperm Injection, using our patient's cryopreserved sperm. To induce lactation, we implemented a hormone-regimen to mimic pregnancy, using estradiol and progesterone, and a galactogogue; domperidone. Our patient started pumping during treatment. Dosage of progesterone and estradiol were significantly decreased approximately one month before childbirth to mimic delivery and pumping was increased. Our patient started lactating and although the production of milk was low, it was sufficient for supplementary feeding and a positive experience for our patient. Two weeks after birth, lactation induction was discontinued due to suckling problems of the infant and low milk production. CONCLUSIONS This case report underlined that lactation induction protocols commonly used for cisgender women are also effective in transgender women. However, the amount of milk produced may not be sufficient for exclusive nursing. Nevertheless, success of induced lactation may be attributed to its importance for parent-infant bonding, rather than the possibility of exclusive chestfeeding.
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Affiliation(s)
- Jojanneke E van Amesfoort
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centres, Reproduction and Development Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Norah M Van Mello
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centres, Reproduction and Development Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Centre of Expertise On Gender Dysphoria, Amsterdam University Medical Centres, Location VUmc, Amsterdam, the Netherlands
| | - Renate van Genugten
- Department of Internal Medicine and Endocrinology, Radboud University, Nijmegen, the Netherlands
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Avendaño-Vásquez CJ, Villamizar-Osorio ML, Niño-Peñaranda CJ, Medellín-Olaya J, Reina-Gamba NC. Sociodemographic determinants associated with breastfeeding in term infants with low birth weight in Latin American countries. World J Clin Pediatr 2024; 13:89086. [DOI: 10.5409/wjcp.v13.i1.89086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/06/2024] [Accepted: 02/18/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND A progressive decrease in exclusive breastfeeding (BF) is observed in Latin America and the Caribbean compared with global results. The possibility of being breastfed and continuing BF for > 6 months is lower in low birth weight than in healthy-weight infants.
AIM To identify factors associated with BF maintenance and promotion, with particular attention to low- and middle-income countries, by studying geographic, socioeconomic, and individual or neonatal health factors.
METHODS A scoping review was conducted in 2018 using the conceptual model of social determinants of health published by the Commission on Equity and Health Inequalities in the United States. The extracted data with common characteristics were synthesized and categorized into two main themes: (1) Sociodemographic factors and proximal determinants involved in the initiation and maintenance of BF in low-birth-weight term infants in Latin America; and (2) individual characteristics related to the self-efficacy capacity for BF maintenance and adherence in low-birth-weight term infants.
RESULTS This study identified maternal age, educational level, maternal economic capacity, social stratum, exposure to BF substitutes, access to BF information, and quality of health services as mediators for maintaining BF.
CONCLUSION Individual self-efficacy factors that enable BF adherence in at-risk populations should be analyzed for better health outcomes.
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Suksantilerd S, Thawatchai R, Rungrojjananon N. Prevalence of vitamin D deficiency in exclusively breastfed infants at Charoenkrung Pracharak Hospital. World J Clin Pediatr 2024; 13:86693. [DOI: 10.5409/wjcp.v13.i1.86693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 01/02/2024] [Accepted: 02/02/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Vitamin D deficiency is a common problem in exclusively breastfed infants, with supplementation recommended by various international medical organizations. However, in Thailand, no advice for routine vitamin D supplementation is available. Thus, this study investigated the prevalence of vitamin D deficiency and its associated factors in exclusively breastfed infants in Bangkok, Thailand.
AIM To investigated the prevalence of vitamin D deficiency and its associated factors in exclusively breastfed infants in Bangkok, Thailand.
METHODS This descriptive observational cross-sectional study assessed 109 4-month-old infants at Charoenkrung Pracharak Hospital from May 2020 to April 2021. The 25-OH vitamin D level of the infants was measured using an electrochemiluminescence binding assay. Vitamin D deficiency was defined as 25-OH level < 20 ng/mL, with vitamin D insufficiency 20-30 ng/mL. The sun index and maternal vitamin D supplementation data were collected and analyzed using the independent t-test, univariate logistic regression, and multivariate logistic regression to identify the associated factors.
RESULTS The prevalences of vitamin D deficiency and vitamin D insufficiency were 35.78% and 33.03%, respectively with mean serum 25-OH vitamin D levels in these two groups 14.37 ± 3.36 and 24.44 ± 3.29 ng/mL. Multivariate logistic regression showed that the main factors associated with vitamin D status were maternal vitamin D supplementation and birth weight, with crude odds ratios 0.26 (0.08–0.82) and 0.08 (0.01–0.45), respectively. The sun index showed no correlation with the 25-OH vitamin D level in exclusively breastfed infants (r = −0.002, P = 0.984).
CONCLUSION Two-thirds of healthy exclusively breastfed infants had hypovitaminosis D. Vitamin D supplementation prevented this condition and was recommended for both lactating women and their babies.
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Affiliation(s)
- Supawut Suksantilerd
- Department of Pediatrics, Charoenkrung Pracharak Hospital, Bangkok 10120, Krung Thep Maha Nakhon Bangkok, Thailand
| | - Rotchanart Thawatchai
- Department of Pediatrics, Charoenkrung Pracharak Hospital, Bangkok 10120, Krung Thep Maha Nakhon Bangkok, Thailand
| | - Nattapol Rungrojjananon
- Department of Pediatrics, Charoenkrung Pracharak Hospital, Bangkok 10120, Krung Thep Maha Nakhon Bangkok, Thailand
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Murillo Galvis M, Ortegon Ochoa S, Plata García CE, Valderrama Junca MP, Inga Ceballos DA, Mora Gómez DM, Granados CM, Rondón M. Exclusive breastfeeding greater than 50%, success of education in a university hospital in Bogotá: Case-control study. World J Clin Pediatr 2024; 13:87713. [DOI: 10.5409/wjcp.v13.i1.87713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/10/2023] [Accepted: 12/28/2023] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Maintenance rates of exclusive breastfeeding (EBF) worldwide are low, thus, one of the objectives of the summary of policies on breastfeeding (BF) in world nutrition goals for 2025 are that at least 50% of infants under six months of age receive EBF that year. The Objective of this study is to document the rates of EBF in children born in San Ignacio University Hospital (HUSI) and identify factors associated with maintenance.
AIM To document the percentages of EBF in those that were born at HUSI and identify factors associated to their maintenance.
METHODS This is a study of cases and controls in an analytic, retrospective cohort that took children born alive between January 2016 and January 2019 at HUSI located in the city of Bogotá, Colombia.
RESULTS Receiving information about BF at HUSI was able to maintain EBF up until 4 mo (OR = 1.65; 95%CI: 1.02-2.66). The presence of gynecologic and obstetric comorbidities (OR = 0.32; 95%CI: 0.12-0.83), having mastitis (OR = 0.56; 95%CI: 0.33-0.94), and receiving information from mass media (OR = 0.52; 95%CI: 0.31-0.84) are factors associated with not maintaining EBF.
CONCLUSION Receiving education at a Women- and Child-Friendly Institution was the only significant factor to achieve EBF until 4 mo, with a frequency greater than the one reported in the country, which matches multiple studies where counseling and individualized support on BF achieve this purpose. Knowledge about BF and early detection of obstetric/gynecologic complications must be strengthened among the healthcare staff in charge of mothers during post-partum. Additionally, strategies must be promoted to continue BF such as creating milk banks with the objective of increasing BF rates even when mothers return to work.
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Affiliation(s)
| | - Sofia Ortegon Ochoa
- Department of Pediatrics, Hospital Universitario San Ignacio, Bogotá 110111, Colombia
| | | | | | | | | | - Claudia M Granados
- Department of Clinical Epidemiology and Biostatistics, Pontifica Universidad Javeriana, Bogotá 110111, Colombia
| | - Martin Rondón
- Department of Clinical Epidemiology and Biostatistics, Pontifica Universidad Javeriana, Bogotá 110111, Colombia
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Muniz MCR, Lima RV, Maia VQCC, Bezerra AM, Freire IF, Lima MCC, Matos YMT, Pontes LP, Cavalcante ANM. The protective effect of breastfeeding on febrile seizures: a systematic review with meta-analysis. Eur J Pediatr 2024:10.1007/s00431-024-05501-x. [PMID: 38456990 DOI: 10.1007/s00431-024-05501-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/09/2024]
Abstract
Several potential risk factors have been identified in the etiopathogenesis of febrile seizures (FS), including the type and extent of breastfeeding (BF). Given the lack of conclusive data, this study aims to systematically evaluate the evidence on the association between BF and FS. We conducted a systematic review and meta-analysis according to PRISMA guidelines. The search was conducted using descriptors for FS, BF, and formula feeding in MEDLINE, Embase, and Web of Science databases. We included observational studies that compared the incidence of FS between those who had ever breastfed and those who were formula fed. The study protocol was registered on the PROSPERO platform under the number CRD42023474906. A total of 1,893,079 participants from 8 datasets were included. Our main analysis showed no significant association of any type of BF on the incidence of FS compared with formula-fed children (OR: 0.84; CI: 0.67-1.04; I2 = 78%; Cochran's Q = 0.0001), although meta-regression showed that BF was associated with a lower incidence of FS in preterm infants. Our secondary outcome showed a significantly reduced incidence of FS in children who received BF exclusively (OR: 0.80; CI: 0.65-0.99; I2 = 70%; Cochran's Q = 0.02). Conclusion: There was no significant reduction in the incidence of FS in those who were breastfed compared to formula feeding. However, our meta-regression analysis indicated an association between BF and a lower incidence of FS in preterm infants. Additionally, children who exclusively received BF had a significantly reduced incidence of FS. These findings should be further investigated in prospective cohorts. What is Known: • Breastfeeding can modify risk factors for febrile seizures, such as susceptibility to viral and bacterial infections, micronutrient deficiencies, and low birth weight. • However, studies have shown conflicting results regarding the impact of breastfeeding on febrile seizures. What is New: • When comparing any breastfeeding pattern with no breastfeeding, there is no significant difference in the incidence of febrile seizures. • When comparing exclusive breastfeeding with no breastfeeding, there may be a decrease in the occurrence of febrile seizures.
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Affiliation(s)
- Maria Carolina Rocha Muniz
- Department of Medicine, University of Fortaleza, Av. Washington Soares, 1321 - Edson Queiroz, Fortaleza - CE, Ceara, 60811-905, Brazil
| | - Rian Vilar Lima
- Department of Medicine, University of Fortaleza, Av. Washington Soares, 1321 - Edson Queiroz, Fortaleza - CE, Ceara, 60811-905, Brazil.
| | | | - Arthur Meneses Bezerra
- Department of Medicine, University of Fortaleza, Av. Washington Soares, 1321 - Edson Queiroz, Fortaleza - CE, Ceara, 60811-905, Brazil
| | - Isabela Franco Freire
- Department of Medicine, University of Fortaleza, Av. Washington Soares, 1321 - Edson Queiroz, Fortaleza - CE, Ceara, 60811-905, Brazil
| | - Manuela Cavalcante Coling Lima
- Department of Medicine, University of Fortaleza, Av. Washington Soares, 1321 - Edson Queiroz, Fortaleza - CE, Ceara, 60811-905, Brazil
| | - Yuri Marques Teixeira Matos
- Department of Medicine, University of Fortaleza, Av. Washington Soares, 1321 - Edson Queiroz, Fortaleza - CE, Ceara, 60811-905, Brazil
| | - Letícia Pinheiro Pontes
- Department of Medicine, University of Fortaleza, Av. Washington Soares, 1321 - Edson Queiroz, Fortaleza - CE, Ceara, 60811-905, Brazil
| | - Ana Nery Melo Cavalcante
- Department of Medicine, University of Fortaleza, Av. Washington Soares, 1321 - Edson Queiroz, Fortaleza - CE, Ceara, 60811-905, Brazil
- PhD in Collective Health By the University of Fortaleza, Neonatologist Pediatrician at Dr. César Cals de Oliveira General Hospital, Fortaleza, Ceara, Brazil
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Decelles S, Nardocci M, Mildon A, Salameh B, Sebai I, Arasimowicz S, Batal M. Determinants of continued breastfeeding in children aged 12-23 months in three regions of Haiti. Rev Panam Salud Publica 2024; 48:e6. [PMID: 38464872 PMCID: PMC10921905 DOI: 10.26633/rpsp.2024.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 03/12/2024] Open
Abstract
Objectives To identify the prevalence and determinants of continued breastfeeding in Haitian children aged 12-23 months. Methods Three cross-sectional surveys were conducted yearly during the summers of 2017 to 2019 as part of a 4-year (2016-2020) multisectoral maternal and infant health initiative in the regions of Les Cayes, Jérémie, and Anse d'Hainault in Haiti. A total of 455 children 12-23 months of age and their mothers participated in the study. A child was considered to be continuing breastfeeding if the mother reported giving breast milk in the 24-hour dietary recall. Unadjusted and adjusted prevalence ratios were estimated, and associations were assessed between continued breastfeeding and explanatory factors related to sociodemographic characteristics, household food security, maternal nutrition, and breastfeeding knowledge and practices. Results The prevalence of continued breastfeeding was 45.8%. Continued breastfeeding was significantly more prevalent among younger children, children who did not have a younger sibling, children whose mother was not pregnant, those living in the Jérémie region, children who had been exclusively breastfed for less than 1 month, and children whose mother knew the World Health Organization's recommendation for continued breastfeeding up to 2 years or beyond. Conclusions The study results highlight the need for geographically equitable access to tailored and adequate health services and education that support breastfeeding in a way that is compatible with the local context.
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Affiliation(s)
- Stéphane Decelles
- Université de MontréalMontrealCanadaUniversité de Montréal, Montreal, Canada.
| | - Milena Nardocci
- Université de MontréalMontrealCanadaUniversité de Montréal, Montreal, Canada.
| | - Alison Mildon
- Independent consultantTorontoCanadaIndependent consultant, Toronto, Canada.
| | - Bana Salameh
- Université de MontréalMontrealCanadaUniversité de Montréal, Montreal, Canada.
| | - Ines Sebai
- Université de MontréalMontrealCanadaUniversité de Montréal, Montreal, Canada.
| | - Sabrina Arasimowicz
- Université de MontréalMontrealCanadaUniversité de Montréal, Montreal, Canada.
| | - Malek Batal
- Université de MontréalMontrealCanadaUniversité de Montréal, Montreal, Canada.
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Ni D, Tan J, Macia L, Nanan R. Breastfeeding is associated with enhanced intestinal gluconeogenesis in infants. BMC Med 2024; 22:106. [PMID: 38454391 PMCID: PMC10921696 DOI: 10.1186/s12916-024-03327-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/28/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Breastfeeding (BF) confers metabolic benefits to infants, including reducing risks of metabolic syndrome such as obesity and diabetes later in life. However, the underlying mechanism is not yet fully understood. Hence, we aim to investigate the impacts of BF on the metabolic organs of infants. METHODS Previous literatures directly studying the influences of BF on offspring's metabolic organs in both animal models and humans were comprehensively reviewed. A microarray dataset of intestinal gene expression comparing infants fed on breastmilk versus formula milk was analyzed. RESULTS Reanalysis of microarray data showed that BF is associated with enhanced intestinal gluconeogenesis in infants. This resembles observations in other mammalian species showing that BF was also linked to increased gluconeogenesis. CONCLUSIONS BF is associated with enhanced intestinal gluconeogenesis in infants, which may underpin its metabolic advantages through finetuning metabolic homeostasis. This observation seems to be conserved across species, hinting its biological significance.
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Affiliation(s)
- Duan Ni
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- Sydney Medical School Nepean, Nepean Hospital, The University of Sydney, Level 5, South Block, Penrith, Sydney, NSW, 2751, Australia
- Nepean Hospital, Nepean Blue Mountains Local Health District, Penrith, NSW, Australia
| | - Jian Tan
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Laurence Macia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Sydney Cytometry Core Research Facility, Charles Perkins Centre, The University of Sydney and Centenary Institute, Sydney, NSW, Australia
| | - Ralph Nanan
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
- Sydney Medical School Nepean, Nepean Hospital, The University of Sydney, Level 5, South Block, Penrith, Sydney, NSW, 2751, Australia.
- Nepean Hospital, Nepean Blue Mountains Local Health District, Penrith, NSW, Australia.
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Gaus V, Ilyas-Feldmann M, Schmitz B. [Epilepsy and pregnancy]. Nervenarzt 2024:10.1007/s00115-024-01626-4. [PMID: 38451327 DOI: 10.1007/s00115-024-01626-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Regarding treatment of women of childbearing potential with epilepsy, several aspects of family planning and desire to have children have to be taken into account. OBJECTIVE Overview of current data on mutual implications of epileptic seizures, antiseizure medication (ASM), pregnancy and child development. METHOD Review of the current literature, discussion and presentation of resulting treatment recommendations. RESULTS Many ASMs bear the potential for clinically relevant interactions with both contraceptives and altered concentrations of sexual hormones and modified pharmacokinetics during pregnancy. All ASMs show an increased risk for congenital malformations; however, due to seizure-related risks for the mother and child effective ASM treatment during pregnancy is crucial. CONCLUSION When considering the special aspects of consultation and treatment of women of childbearing potential with epilepsy most pregnancies are uncomplicated.
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Affiliation(s)
- Verena Gaus
- Epilepsie-Zentrum Berlin-Brandenburg, Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
| | - Maria Ilyas-Feldmann
- Epilepsie-Zentrum Berlin-Brandenburg, Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - Bettina Schmitz
- Klinik für Neurologie und Zentrum für Epilepsie, Vivantes Humboldt Klinikum Berlin, Berlin, Deutschland
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Severinsen C, Neely E, Hutson R. Resisting stigma: the role of online communities in young mothers' successful breastfeeding. Int Breastfeed J 2024; 19:17. [PMID: 38448916 PMCID: PMC10918889 DOI: 10.1186/s13006-024-00626-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 03/01/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Breastfeeding initiation and continuation rates are shaped by complex and interrelated determinants across individual, interpersonal, community, organisational, and policy spheres. Young mothers, however, face a double burden of stigma, being perceived as immature and incompetent in their mothering and breastfeeding abilities. In this study, we aimed to understand the experiences of young mothers who exclusively breastfed for six months and beyond and explore their experiences of stigma and active resistance through social media. METHODS In 2020, in-depth telephone interviews about breastfeeding experiences were conducted with 44 young mothers under age 25 in Aotearoa New Zealand who breastfed for six months or longer. Participants were recruited via social media. Interviews were audio-recorded, transcribed and analysed thematically. RESULTS Analysis yielded four themes on young mothers' negotiation of breastfeeding and support. The first three themes revealed young mothers' encounters with socio-cultural contexts. They faced negative judgments about maturity and competence, adverse guidance to supplement or cease breastfeeding, and an undermining of their breastfeeding efforts. The fourth theme showed how young mothers sought alternative support in online environments to avoid negative interactions. Online spaces provided anonymity, convenience, experiential knowledge and social connections with shared values. This facilitated identity strengthening, empowerment and stigma resistance. CONCLUSION Our research highlights the importance of online communities as a tool for young mothers to navigate and resist the societal stigmas surrounding breastfeeding. Online spaces can provide a unique structure that can help counteract the adverse effects of social and historical determinants on breastfeeding rates by fostering a sense of inclusion and support. These findings have implications for the development of breastfeeding promotion strategies for young mothers and highlight the potential of peer support in counteracting the negative impacts of stigma. The research also sheds light on the experiences of young mothers within the health professional relationship and the effects of stigma and cultural health capital on their engagement and withdrawal from services. Further research should examine how sociocultural barriers to breastfeeding stigmatise and marginalise young mothers and continue to reflect on their socio-political and economic positioning and how it can exacerbate inequities.
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Affiliation(s)
- Christina Severinsen
- School of Health Sciences, Massey University, Palmerston North, Aotearoa, New Zealand.
| | - Eva Neely
- School of Health, Victoria University of Wellington, Wellington, Aotearoa, New Zealand
| | - Rochelle Hutson
- School of Health Sciences, Massey University, Palmerston North, Aotearoa, New Zealand
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LoCasale-Crouch J, Wallace MK, Heeren T, Kerr S, Yue Y, Deeken G, Turnbull K, Jaworski B, Mateus MC, Moon R, Hauck FR, Kellams A, Colson E, Corwin MJ. The importance of community resources for breastfeeding. Int Breastfeed J 2024; 19:16. [PMID: 38448983 PMCID: PMC10916149 DOI: 10.1186/s13006-024-00623-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/18/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Breastfeeding has long-lasting effects on children's cognition, behavioral, mental and physical health. Previous research shows parental characteristics (e.g., education, race/ethnicity, income level) are associated with breastfeeding initiation and duration. Further, research shows significant variation in access to community resources by race/ethnicity. It is unclear how community resources may impact breastfeeding practices and how this might intersect with maternal race/ethnicity. METHODS This study combined nationally-representative data from the Study of Attitudes and Factors Effecting Infant Care (SAFE), which surveyed US mothers immediately after the infant's birth and at two to six months of infant age, with the Child Opportunity Index (COI) 2.0, a census tract measure of community resources associated with child development, to explore the association between community resources and breastfeeding initiation and whether this varies based on maternal race/ethnicity and country of birth. The SAFE Study used a stratified, two-stage, clustered design to obtain a nationally representative sample of mothers of infants, while oversampling Hispanic and non-Hispanic (NH) Black mothers. The SAFE study enrolled mothers who spoke English or Spanish across 32 US birth hospitals between January 2011 and March 2014. RESULTS After accounting for individual characteristics, mothers residing in the highest-resourced communities (compared to the lowest) had significantly greater likelihood of breastfeeding. Representation in higher-resourced communities differed by race/ethnicity. Race/ethnicity did not significantly moderate the association between community resources and breastfeeding. In examining within race/ethnic groups, however, community resources were not associated with non-US born Black and Hispanic mothers' rates of breastfeeding, while they were with US born Black and Hispanic mothers. CONCLUSIONS Findings suggest that even health behaviors like breastfeeding, which we often associate with individual choice, are connected to the community resources within which they are made. Study implications point to the importance of considering the impact of the contextual factors that shape health and as a potential contributor to understanding the observed race/ethnicity gap.
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Affiliation(s)
| | | | - Timothy Heeren
- School of Public Health, Boston University, Boston, MA, USA
| | - Stephen Kerr
- Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA
| | - Yitong Yue
- School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
| | - Genevieve Deeken
- Department of Global Public Health- Global Studies, University of Virginia, Charlottesville, VA, USA
| | - Khara Turnbull
- School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
| | - Brianna Jaworski
- School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
| | - Mayaris Cubides Mateus
- School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
| | - Rachel Moon
- School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Fern Robin Hauck
- School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Ann Kellams
- School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Eve Colson
- School of Medicine, Washington University in St. Louis, Saint Louis, MO, USA
| | - Michael Jay Corwin
- Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA
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Pye H. Nursing Considerations for Emergency Department Care of the Breastfeeding Dyad. J Emerg Nurs 2024:S0099-1767(24)00046-1. [PMID: 38456865 DOI: 10.1016/j.jen.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 03/09/2024]
Abstract
Although postpartum dyads frequently present to the emergency department, treatment of the lactating parent and breastfeeding child is often driven by medical misconceptions. Incorrect advice about continuation or cessation of breastfeeding for medical reasons can lead to maternal and infant harm. In lactation, demand begets supply; missing a feed can be detrimental to short- and long-term breastfeeding outcomes. The purpose of this Clinical Nurses Forum article is to argue the importance of appropriate care of the breastfeeding dyad in the emergency department setting and to interpret current evidence-based information on lactation for the emergency staff nurse. High-quality care for the breastfeeding dyad requires knowledge of lactation physiology, contraindications for breastfeeding, and safe medications and diagnostic procedures. The well-informed emergency nurse must advocate for evidence-based care of the breastfeeding dyad within the emergency department.
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Carlsson RR, Pommerencke LM, Pant SW, Jørgensen SE, Madsen KR, Bonnesen CT, Kierkegaard L, Pedersen TP. Trends in social inequality in breastfeeding duration in Denmark 2002-2019. Scand J Public Health 2024:14034948241234133. [PMID: 38445352 DOI: 10.1177/14034948241234133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
AIMS The aim of the present study was to analyse trends in full breastfeeding for at least 4 months across socioeconomic position in Denmark over a 17-year-long period from 2002 to 2019 using parental education as the indicator of socioeconomic position. METHODS The study used data on full breastfeeding collected between 2002 and 2019 by community health nurses in the collaboration Child Health Database, n=143,075. Data were linked with five categories of parental education from population registers. Social inequality was calculated as both the relative (odds ratio) and absolute social inequality (slope index of inequality). A trend test was conducted to assess changes in social inequality over time. RESULTS A social gradient in full breastfeeding was found for the entire study period. The odds ratio for not being fully breastfed for at least 4 months ranged from 3.30 (95% confidence interval 2.83-3.84) to 5.09 (95% confidence interval 4.28-6.06) during the study period for infants of parents with the lowest level of education (primary school) compared with infants of parents with the highest level of education (5+ years of university education). The slope index of inequality was between -38.86 and -48.81 during the entire study period, P=0.80. This indicated that both the relative and absolute social inequality in full breastfeeding to at least 4 months of age was unchanged in the study period from 2002 to 2019. CONCLUSIONS This study showed a persistent relative and absolute social inequality in full breastfeeding for at least 4 months from 2002 to 2019 in Denmark.
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Affiliation(s)
- Rikke R Carlsson
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lis Marie Pommerencke
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Sofie W Pant
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Sanne E Jørgensen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Katrine R Madsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Camilla T Bonnesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lene Kierkegaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Trine P Pedersen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Morrison J, Malik SMMR. Health equity in Somalia? An evaluation of the progress made from 2006 to 2019 in reducing inequities in maternal and newborn health. Int J Equity Health 2024; 23:46. [PMID: 38443921 PMCID: PMC10916226 DOI: 10.1186/s12939-023-02092-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/29/2023] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Every human being has the right to affordable, high-quality health services. However, mothers and children in wealthier households worldwide have better access to healthcare and lower mortality rates than those in lower-income ones. Despite Somalia's fragile health system and the under-5 mortality rate being among the highest worldwide, it has made progress in increasing reproductive, maternal, and child health care coverage. However, evidence suggests that not all groups have benefited equally. We analysed secondary 2006 and 2018-19 data to monitor disparities in reproductive, maternal, and child health care in Somalia. METHODS The study's variables of interest are the percentage of contraceptive prevalence through modern methods, adolescent fertility rate, prenatal care, the rate of births attended by midwives, the rate of births in a health care facility, the rate of early initiation of breastfeeding, stunting and wasting prevalence and care-seeking for children under-five. As the outcome variable, we analysed the under-five mortality rate. Using reliable data from secondary sources, we calculated the difference and ratio of the best and worst-performing groups for 2006 and 2018-19 in Somalia and measured the changes between the two. RESULTS Between 2006 and 2018-19, An increase in the difference between women with high and low incomes was noticed in terms of attended labours. Little change was noted regarding socioeconomic inequities in breastfeeding. The difference in the stunting prevalence between the highest and lowest income children decreased by 20.5 points, and the difference in the wasting prevalence of the highest and the lowest income children decreased by 9% points. Care-seeking increased by 31.1% points. Finally, although under-five mortality rates have decreased in the study period, a marked income slope remains. CONCLUSIONS The study's findings indicate that Somalia achieved significant progress in reducing malnutrition inequalities in children, a positive development that may have also contributed to the decrease in under-five mortality rate inequities also reported in this study. However, an increase in inequalities related to access to contraception and healthcare for mothers is shown, as well as for care-seeking for sick children under the age of five. To ensure that all mothers and children have equal access to healthcare, it is crucial to enhance efforts in providing essential quality healthcare services and distributing them fairly and equitably across Somalia.
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Kassir R, Ghani R. Comments on "Association Between Bariatric Surgery and Breastfeeding Outcomes in Women: A Retrospective Case-Control Study". Obes Surg 2024:10.1007/s11695-024-07149-w. [PMID: 38438669 DOI: 10.1007/s11695-024-07149-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 03/06/2024]
Affiliation(s)
- Radwan Kassir
- Department of Digestive and Bariatric Surgery, The View Hospital, Legtaifiya, Doha, Qatar.
| | - Rauf Ghani
- Department of Obstetrics and Gynecology, The View Hospital, Legtaifiya, Doha, Qatar
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Harrison D, Bueno M. [Translating evidence: pain treatment in newborns, infants, and toddlers during needle-related procedures : German version]. Schmerz 2024:10.1007/s00482-024-00797-y. [PMID: 38436744 DOI: 10.1007/s00482-024-00797-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Treatment of pain in preterm, sick, and healthy newborns and infants and toddlers (up to 2 years of age) is consistently reported to be inadequate, and effective strategies are poorly implemented. OBJECTIVES To present existing evidence of effective pain treatment strategies during needle-related procedures and to highlight initiatives focused on translating evidence into practice. METHODS This Clinical Update focuses on the 2022 International Association for the Study of Pain Global Year for Translating Pain Knowledge to Practice in the specific population of newborns, infants, and toddlers. Best evidence is reviewed, and existing knowledge translation strategies and programs available to implement evidence into practice are presented. RESULTS Effective strategies for newborn and young infants during frequently occurring needle procedures include small volumes of sweet solutions, breastfeeding, or skin-to-skin care when feasible and culturally acceptable. In addition, strategies such as nonnutritive sucking, positioning, swaddling, gentle touch, facilitated tucking, and secure holding can be used. For toddlers, the evidence is less robust, and discerning between pain and distress is challenging. However, strategies recommended for needlerelated procedures include upright secure comfort holding by parents/caregivers, age-appropriate distraction, and topical anesthetics. Translation of effective pain management needs to involve the family, who need to be supported and empowered to comfort their child during painful procedures. Organizational, nationwide, and global initiatives aimed at improving implementation of effective pain treatments exist. CONCLUSION There is evidence of effective pain management strategies for newborns, infants, and toddlers, and a great deal of effort is being made to translate knowledge into action.
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Affiliation(s)
- Denise Harrison
- Department of Nursing, The University of Melbourne, Grattan St, Parkville, 3010, Melbourne, Victoria, Australien.
- School of Nursing, The University of Ottawa, Ottawa, Ontario, Kanada.
- Murdoch Children's Research Institute, Melbourne, Victoria, Australien.
- Royal Children's Hospital, Melbourne, Victoria, Australien.
| | - Mariana Bueno
- The Hospital for Sick Children, Toronto, Ontario, Kanada
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Cato K, Funkquist EL, Karlsson Rosenblad A. Instrument development and an intervention to increase parents' self-efficacy regarding their infant's sleep. Sex Reprod Healthc 2024; 39:100944. [PMID: 38183709 DOI: 10.1016/j.srhc.2023.100944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/13/2023] [Accepted: 12/21/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVE Many Swedish parents experience that their infant has sleeping problems. Parents' self-efficacy regarding their infants' sleep may play an important role in how they perceive these problems. This pilot study aimed to develop an instrument measuring parents' self-efficacy regarding their infant's sleep and to examine if parents' self-efficacy was affected by an intervention focusing on parental education. METHOD Mothers and fathers, at a maternity unit in Sweden, were drawn into either an intervention (n = 46) or a control (n = 42) group. The intervention group received a home visit from a nurse who provided information about infant sleep; the importance of attachment; and advice regarding sleep, breastfeeding and bed sharing, including guidelines for safe bed sharing. Three months later, the participants answered questions on background data, breastfeeding, sleep and self-efficacy. RESULTS The 11-item two-factor Uppsala Parental Self-Efficacy about Infant Sleep Instrument (UPPSEISI) was constructed to measure parents' perceived self-efficacy. In adjusted analyses, being in the intervention group was associated with a higher self-efficacy (P = 0.035), as were being a mother (P = 0.003) and being satisfied with one's own sleep (P = 0.007), while parents' own sleeping problems were associated with a lower self-efficacy (P = 0.015). CONCLUSION Importantly, parental education may increase parents' self-efficacy regarding their infant's sleep.
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Affiliation(s)
- Karin Cato
- Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14 B, 752 37 Uppsala, Sweden.
| | - Eva-Lotta Funkquist
- Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14 B, 752 37 Uppsala, Sweden
| | - Andreas Karlsson Rosenblad
- Department of Medical Sciences, Division of Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden; Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden; Department of Statistics, Uppsala University, Uppsala, Sweden
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Alexe A, Garg A, Kovacs B, Abramova N, Apara O, Eisele O, Fernandes MFS, Balramsingh-Harry L, Wurst K, Lewis D. Regulations Governing Medicines for Maternal and Neonatal Health: A Landscape Assessment. Ther Innov Regul Sci 2024; 58:242-257. [PMID: 38105314 PMCID: PMC10850206 DOI: 10.1007/s43441-023-00593-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/27/2023] [Indexed: 12/19/2023]
Abstract
Limited evidence related to the safety or efficacy of medicines in pregnancy and during breastfeeding is available to inform patients and healthcare professionals. Understanding the current regulatory landscape in the clinical trial and postmarketing settings is critical to facilitate the development of applicable processes and tools for studying medicine use during pregnancy and breastfeeding and comply with health authority expectations. This review summarizes key findings from a landscape assessment of regulations, guidelines, and guidance on the use of medicines in pregnancy and breastfeeding issued by health authorities in various territories (including the Americas, Europe, Africa, and Asia Pacific) and outlines relevant initiatives undertaken by health authorities, academic institutions, industry consortia, and public-private organizations. While global pharmacovigilance legislation regarding medication use during pregnancy and breastfeeding exists and continues to evolve, the landscape assessment revealed that there is a lack of global legislative harmonization in both the clinical trial and postmarketing surveillance settings and regulatory gaps still exist in many countries/regions. Despite ongoing efforts from health authorities and public and private organizations, intensive efforts for legislation harmonization and stakeholder collaboration are required to improve the current environment of medication safety in pregnancy and breastfeeding.
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Affiliation(s)
- Amalia Alexe
- Novartis, Rue de La Tour de L`Ile 4, 1204, Geneva, Switzerland.
| | | | | | | | | | | | | | | | | | - David Lewis
- Novartis, Rue de La Tour de L`Ile 4, 1204, Geneva, Switzerland
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Rodgers RF, Campagna J, Hayes G, Sharma A, Runquist E, Fiuza A, Coburn-Sanderson A, Zimmerman E, Piran N. Sociocultural pressures and body related experiences during pregnancy and the postpartum period: A qualitative study. Body Image 2024; 48:101643. [PMID: 38101272 DOI: 10.1016/j.bodyim.2023.101643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 10/17/2023] [Accepted: 10/26/2023] [Indexed: 12/17/2023]
Abstract
Sociocultural pressures to pursue unrealistic appearance expectations and control body shape and weight during pregnancy and postpartum periods have been increasing. Little is known about messages from different sources that may constitute unhelpful or protective influences. The aim of this study was to qualitatively examine messages women received from the sociocultural environment during pregnancy and postpartum and their association with experiences of living in their bodies and body change behaviors. Twenty women, mean age (SD)= 31.85, (2.3) years, 95% White, 60% with a Master's degree or higher, participated in individual interviews and completed online surveys. Women described appearance pressure from multiple sources during and after pregnancy, that increased their concerns related to their weight and shape. For a small number, these concerns were associated with efforts to control weight. Others described protective influences from friends and family that promoted body attunement, functionality appreciation, and positive body image. Findings highlight the importance of sociocultural influences during the peripregnancy period yet how many women derive elements of positive body image from this period. These findings have implications for interventions to support body image among women during the peripregnancy period and positive outcomes among mothers and infants.
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Affiliation(s)
- Rachel F Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, France.
| | - Jenna Campagna
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, USA
| | - Gabriella Hayes
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, USA
| | - Aditi Sharma
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, USA
| | - Edwards Runquist
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, USA
| | - Angelica Fiuza
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, USA
| | | | - Emily Zimmerman
- Department of Communication Sciences & Disorders, Northeastern University, Boston, USA
| | - Niva Piran
- Department of Applied Psychology and Human Development, OISE/University of Toronto, Canada
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Mendoza-Gordillo MJ. A qualitative analysis of the breastfeeding experiences of mothers who are nurses and nutritionists. J Commun Healthc 2024; 17:84-91. [PMID: 36927478 DOI: 10.1080/17538068.2023.2189366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
BACKGROUND From a medical standpoint, breastmilk is the optimal option for feeding a baby, relegating the cultural, social, and material determinants to breastfeeding. Worldwide, breastfeeding rates are low, especially among working mothers. Healthcare providers have low breastfeeding rates due to several barriers to lactation, i.e. work schedule andlack of private places for pumping. METHOD A descriptive qualitative methodology was applied to examine the breastfeeding experiences of Ecuadorian mothers who are healthcare professionals. Twenty healthcare professionals who breastfed their babies took part in the research. Data gathering employed synchronous semi-structured interviews in Spanish. The data analysis followed the Phronetic Iterative Approach. RESULTS Women shifted the preconceived idea of the ideal breastfeeding scenario concerning duration, promotion, and support, ideals which are constructed in their training as healthcare professionals. Although these women believe that breast milk and breastfeeding is the best way to feed a baby, the internalized ideal of breastfeeding shifted with the experience of motherhood. Although they had that clash between the ideal and the external reality, they continued breastfeeding their babies, and those experiences resulted in them improving their professional practice. CONCLUSIONS This study demonstrated that breastfeeding for this group of women appears to be a unique relational and identity negotiation process. The findings emphasize that experiencing breastfeeding for this group of healthcare providers positively shifted how they communicate breastfeeding with their patients in the clinical encounter. Ensuring that healthcare professionals acquire a different approach for educating and communicating about lactation is an essential determinant in efforts to improve breastfeeding rates in Ecuador.
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Affiliation(s)
- Maria J Mendoza-Gordillo
- Center for Research on Health in Latin America, School of Nursing, Pontifical Catholic University of Ecuador, Quito, Ecuador
- Graduate College, Ohio University, Athens, OH, USA
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Madar AA, Kurniasari A, Marjerrison N, Mdala I. Breastfeeding and Sleeping Patterns Among 6-12-Month-Old Infants in Norway. Matern Child Health J 2024; 28:496-505. [PMID: 37980699 PMCID: PMC10914878 DOI: 10.1007/s10995-023-03805-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Parental behavior and infant sleep patterns can vary widely both within and between cultures and settings. Breastfeeding during the second half-year of infancy has been associated with frequent night waking, which is perceived as sleep problem among the Western societies. An understanding of sleeping patterns among breastfed infants during the second half-year of infancy is important in supporting continued breastfeeding. OBJECTIVES The study aimed to investigate the sleeping patterns among breastfed infants during second half-year of infancy. METHODS This is a cross-sectional study. Three hundred and forty-two mothers of 6-12 months old breastfed infants completed the questionnaires on socio-demographic factors, breastfeeding practices, and infant sleeping patterns, which were assessed by using the Brief Infant Sleep Questionnaire (BISQ). The Cox regression model was used to assess the factors that were associated with night sleep duration whereas demographic factors and breastfeeding practices that were associated with night waking frequency were investigated using the Poisson regression model. RESULTS On average, the breastfed infants slept for 11 h during the night and most infants were reported to have night waking (96.8%) and were breastfed at least once at night (93.5%). In the adjusted analyses, infants in the age group 9-12 months were less likely to sleep longer compared to infants in the 6-8 months age group [HR 1.52 95% CI (1.17, 1.98)]. A one-hour increase in daytime sleep and in night wakefulness increased the likelihood of waking up at night by 19% and 24%, respectively. Infants who had been vaccinated within the last 7 days and infants who were breastfed to sleep were more likely to have a shorter nighttime sleep duration. Nighttime breastfeeding frequency was significantly associated with a 17% increase in the likelihood of night waking [IRR 1.17 95% CI (1.13, 1.22)]. Infants who slept on their parents' bed were 1.28 times more likely to wake up at night compared to infants who slept in a separate room [IRR 1.28 95% CI (1.05, 1.59)]. Infants of parents who reported that their infants' sleep was not a problem were 34% less likely to wake up compared to infants of parents who reported that their infants' sleep was a problem [IRR 0.66 95% CI (0.49, 0.87)]. CONCLUSIONS FOR PRACTICE: Frequent night waking, bed sharing and night breastfeeding were common among 6-12 months old breastfed infants. Frequent night breastfeeding may lengthen an infant's nighttime sleep duration. The study findings indicate that adequate information and support should be given to breastfeeding mothers in relation to the sleeping pattern of breastfed infants in order to promote continued breastfeeding practices.
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Affiliation(s)
- Ahmed A Madar
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway.
| | - Astrid Kurniasari
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Niki Marjerrison
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ibrahimu Mdala
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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Sezer HK, Ceran MA, Demirsoz M, Kucukoglu S. Development and psychometric evaluation of the paternal support scale of breastfeeding. J Pediatr Nurs 2024; 75:149-157. [PMID: 38159480 DOI: 10.1016/j.pedn.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/05/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Social support positively affects the adaptation process of the woman to the maternal role during pregnancy and the postpartum period and increases her sensitivity to her baby. It is known that the support provided by fathers to their wives during this process positively affects their decision to breastfeed and continue. PURPOSE The aim of this study is to contribute to the literature by the Paternal Support Scale of Breastfeeding, testing its validity, reliability and psychometric properties. METHODS The study, which included 203 fathers with babies 0-6 months of age who were actively breastfed between January and June 2022, was completed in a Medical Faculty Hospital at Konya in Turkey. The psychometric properties of the scale were evaluated with exploratory factor analysis and confirmatory factor analysis. In addition, number/percentage, t-test for dependent and independent groups and correlation analysis were used in the evaluation of the data. RESULTS Total item correlation coefficient of this scale was found to vary between 0.63 and 0.81. According to the confirmatory factor analysis results the goodness-of-fit index values of the scale indicated that the model has an acceptable fitness, and the 21-item one-dimensional scale has confirmed validity. CONCLUSION Our findings showed that this scale is a good reliable measurement tool that can be used to evaluate levels of paternal support in breastfeeding. The scale can be adapted to different cultures, and cross-cultural comparisons can be planned in future studies. PRACTICE IMPLICATIONS Spouse and family support increases breastfeeding success. Due to their active role in the decisions made within the family, fathers positively influence mothers' breastfeeding decisions and increase mothers' motivation to continue breastfeeding. This measurement tool, developed to measure partner support in breastfeeding, helps nurses, to determine fathers' support levels in breastfeeding. In this way, nurses can contribute to increasing the duration of breastfeeding by making effective interventions for the solution of partner support problems related to breastfeeding.
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Affiliation(s)
- Hilal Kurt Sezer
- Niğde Ömer Halisdemir University, Zubeyde Hanim Faculty of Health Sciences, Türkiye.
| | - Merve Aşkin Ceran
- KTO Karatay University, Vocational School of Health Services, Konya, Türkiye
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Peris Vidal A, Ferrando Monleón S, Marín Serra J, Quiñones-Torrelo C, Hervás Andrés A, Fons Moreno J, Hernández Marco R. Urinary excretion of calcium, phosphate, magnesium, and uric acid in healthy infants and young children. Influence of feeding practices in early infancy. Pediatr Nephrol 2024; 39:761-770. [PMID: 37755464 DOI: 10.1007/s00467-023-06145-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Reference values for urinary calcium (Ca) and other solutes/creatinine (Cr) ratios in infants and young children are scarce. Its variation with type of lactation administered, breastfed (BF) or formula (F), is incompletely known. METHODS A total of 511 spot urine samples from 136 children, aged 6 days to < 5 years, was collected. Urine was collected no fasting in infants < 18 months and first morning fasting in children aged 2.5-4 years. Urinary osmolality, Cr, urea, Ca, phosphate (P), magnesium (Mg), and uric acid (UA) were determined. Values are expressed as solute-to-Cr ratio. RESULTS Urinary values were grouped according to the child's age: 6-17 days (G1), 1-5 months (G2), 6-12 months (G3), 13-18 months (G4), and 2.5-4 years (G5). G1 was excluded; Ca/Cr and UA/Cr (95th percentile) decreased with age (G2 vs. G5) from 1.64 to 0.39 and 2.33 to 0.83 mg/mg, respectively. The P/Cr median rises significantly with age from 0.31 (G2) to 1.66 mg/mg (G5). Mg/Cr was similar in all groups (median 0.20, 95th percentile 0.37 mg/mg). Ca/Cr (95th percentile) of BF infants was 1.80 mg/mg (< 3 months) and 1.63 mg/mg (3-5 months), much higher than F infants (0.93 and 0.90 mg/mg, respectively). P/Cr and P/Ca were lower in BF infants. CONCLUSIONS Values for urinary Ca/Cr, P/Cr, Mg/Cr, and UA/Cr in infants and children < 5 years were updated. BF infants < 6 months showed higher Ca/Cr and lower P/Cr than F infants. New cutoff values to diagnose hypercalciuria in infants < 6 months, according to the type of lactation, are proposed.
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Affiliation(s)
| | - Susana Ferrando Monleón
- Pediatric Service, Hospital Clínico, Valencia, Spain
- Department of Pediatrics, Obstetrics and Gynecology, Universidad de Valencia, Valencia, Spain
| | - Juan Marín Serra
- Pediatric Service, Hospital Clínico, Valencia, Spain
- Department of Pediatrics, Obstetrics and Gynecology, Universidad de Valencia, Valencia, Spain
| | | | | | | | - Roberto Hernández Marco
- Department of Pediatrics, Obstetrics and Gynecology, Universidad de Valencia, Valencia, Spain
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Encinas B, Benito R, Rojo S, Reina G, Montiel N, Aguilera A, Eiros JM, García-Costa J, Ortega D, Arco I, Hernánez-Batancor A, Soriano V, de Mendoza C. Human T-lymphotropic virus-1 infection among Latin American pregnant women living in Spain. IJID Reg 2024; 10:146-149. [PMID: 38304758 PMCID: PMC10831283 DOI: 10.1016/j.ijregi.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 02/03/2024]
Abstract
Objectives Human T-lymphotropic virus (HTLV) antenatal screening is not mandatory in Spain. Surveys conducted decades ago reported HTLV-1 seroprevalence rates of 0.2% among foreign pregnant women in Spain. The migrant flow to Spain from HTLV-1 endemic regions in Latin America and sub-Saharan Africa has increased during the last decade. Currently, 25% of pregnant women in Spain are foreigners. Methods From January 2021 to October 2023 a cross-sectional study was carried out in all consecutive pregnant women attended at eleven Spanish clinics. A commercial enzyme immunoassay (EIA) was used for screening of serum HTLV-1/2 antibodies. Reactive samples were confirmed by immunoblot. Results A total of 9813 pregnant women with a median age of 34 years-old were examined. Native Spaniards were 6977 (76.5%). Of 2147 foreigners (23.5%), 903566 (9.9%) were Latin Americans, 416 (4.5%) North Africans, 293 (3.2%) from Romania, and 196 (2.1%) from sub-Saharan Africa. A total of 47 samples were EIA reactive but only five were confirmed as HTLV-1 positive using immunoblot. Infected women came from Paraguay, Colombia, the Dominican Republic, Venezuela and Peru. All but one were primigravida, with ages ranging from 20 to 33 years-old. One was HIV-1 positive, and another was infected with Chlamydia trachomatis. Conclusion The overall seroprevalence for HTLV-1 among pregnant women in Spain is 0.05% but rises ten-fold (0.55%) among Latin Americans. This rate is higher than in surveys conducted decades ago. Our results support that anti-HTLV testing should be part of antenatal screening in Spain in pregnant women coming from Latin America, as it is already done with Chagas disease.
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Affiliation(s)
- Begoña Encinas
- Gynecology & Obstetrics Department, Puerta de Hierro University Hospital, Madrid, Spain
| | - Rafael Benito
- Microbiology Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Silvia Rojo
- Microbiology Department, Hospital Clínico Universitario, Valladolid, Spain
| | - Gabriel Reina
- Microbiology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Natalia Montiel
- Microbiology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Antonio Aguilera
- Microbiology Department, University of Santiago, Santiago de Compostela, Spain
| | - José María Eiros
- Microbiology Department, Rio Hortega University Hospital, Valladolid, Spain
| | - Juan García-Costa
- Microbiology Department, Complejo Hospitalario de Ourense, Ourense, Spain
| | - Diego Ortega
- Microbiology Department, Hospital Miguel Servet, Zaragoza, Spain
| | - Irene Arco
- Microbiology Department, General University Hospital of Alicante, Pintor Baeza, Alicante, Spain
| | - Araceli Hernánez-Batancor
- Microbioligy Department, Hospital insular Unidad De Traslados, Avenida Maritima del Sur, Las Palmas de Gran Canaria, Spain
| | - Vicente Soriano
- International University of La Rioja (UNIR) Health Sciences School & Medical Center, Madrid, Spain
| | - Carmen de Mendoza
- Puerta de Hierro University Hospital & Research Foundation-IDIPHISA, Madrid, Spain
| | - Spanish HTLV Network
- Gynecology & Obstetrics Department, Puerta de Hierro University Hospital, Madrid, Spain
- Microbiology Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
- Microbiology Department, Hospital Clínico Universitario, Valladolid, Spain
- Microbiology Department, Clínica Universidad de Navarra, Pamplona, Spain
- Microbiology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain
- Microbiology Department, University of Santiago, Santiago de Compostela, Spain
- Microbiology Department, Rio Hortega University Hospital, Valladolid, Spain
- Microbiology Department, Complejo Hospitalario de Ourense, Ourense, Spain
- Microbiology Department, Hospital Miguel Servet, Zaragoza, Spain
- Microbiology Department, General University Hospital of Alicante, Pintor Baeza, Alicante, Spain
- Microbioligy Department, Hospital insular Unidad De Traslados, Avenida Maritima del Sur, Las Palmas de Gran Canaria, Spain
- International University of La Rioja (UNIR) Health Sciences School & Medical Center, Madrid, Spain
- Puerta de Hierro University Hospital & Research Foundation-IDIPHISA, Madrid, Spain
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Rahimparvar FV, Nayebian S, Kalan ME, Haghani S, Sighaldeh SS. Mother's milk-mother's gift: Mobile-based training to increase self-efficacy of nursing women during postpartum and puerperium: A quasi-experimental study. J Pediatr Nurs 2024; 75:e10-e15. [PMID: 38302399 DOI: 10.1016/j.pedn.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/07/2023] [Accepted: 12/07/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND The World Health Organization recommends exclusive breastfeeding for 6 months followed by continued breastfeeding with complementary food up to 2 years of age or beyond. This study aimed to investigate the effect of mobile -based education on the self-efficacy of lactating women in the postpartum period. METHODS A quasi-experimental study was carried out in 2018 in Shirvan, Iran among 69 postpartum women. Participants were assigned to intervention (n = 33) and control (n = 36) groups on the first day after delivery by random allocation. Intervention group received the mobile-based training for 4 weeks in the form of text messages, photos, video clips, and audio files. The control group received routine hospital care and training. Data were collected on demographic characteristics, delivery information, and the breastfeeding self-efficacy. Self-efficacy was measured in two groups at three time points; the first day after delivery, 4 weeks after delivery and 8 weeks after delivery. FINDINGS The mean and standard deviation of breastfeeding self-efficacy score was higher in the intervention than control group 4 weeks (155.30 ± 10.93 vs 132.52 ± 19.70, P < 0.001) and 8 weeks after delivery (160.18 ± 11.33 vs 132.30 ± 24.09, P < 0.001). Compared to the control group, the rate of exclusive breastfeeding in the intervention group was significantly higher 4 and 8 weeks after the delivery (Pall < 0.05). DISCUSSION The findings from this study showed a substantial increase in breastfeeding self-efficacy and exclusive breastfeeding in the group who received training through mobile-based education compared to the group that received routine care. APPLICATION TO PRACTICE Mobile-based breastfeeding education might be a promising strategy to increase breastfeeding self-efficacy. It is suggested that midwives include the design of mobile-based educational programs as part of their educational strategies and use the advantages of this educational method during pregnancy and after childbirth. TRAIL REGISTRATION This article has been registered in Iran's Clinical Trial Center with the code: 2 N20171024036972 IRCT.
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Affiliation(s)
- Fatemeh Vasegh Rahimparvar
- Midwifery and Reproductive Health Department, School of Nursing and Midwifery, Tehran Universities of Medical Sciences, Tehran, Iran
| | - Sahar Nayebian
- Midwifery and Reproductive Health Department, School of Nursing and Midwifery, Tehran Universities of Medical Sciences, Tehran, Iran.
| | | | - Shima Haghani
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Shirin Shahbazi Sighaldeh
- Midwifery and Reproductive Health Department, School of Nursing and Midwifery, Tehran Universities of Medical Sciences, Tehran, Iran; Breastfeeding Research Center-Family Health Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Lee TA, Bishop J, Drover A, Midodzi WK, Twells LK. A cross-sectional study of breastfed infants referred for tongue tie assessment and frenotomy in one Canadian health region. Pediatr Investig 2024; 8:53-60. [PMID: 38516135 PMCID: PMC10951488 DOI: 10.1002/ped4.12416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/31/2023] [Indexed: 03/23/2024] Open
Abstract
Importance Tongue tie (TT) is a condition that can cause infant feeding difficulties due to restricted tongue movement. When TT presents as a significant barrier to breastfeeding, a frenotomy may be recommended. Universally accepted diagnostic criteria for TT are lacking and wide prevalence estimates are reported. New referral processes and a Frenotomy Assessment Tool were implemented in one Canadian health region to connect breastfeeding dyads with a provider for TT evaluation and frenotomy. Objective To determine the proportion of babies with TT as well as the frequency of frenotomy. Methods This cross-sectional study included infants who initiated breastfeeding at birth and were referred for TT evaluation over a 14-month period. Data were collected retrospectively by chart review and analyzed using SPSS. Factors associated with frenotomy were examined using logistic regression. Results Two hundred and forty-one babies were referred. Ninety-two percent (n = 222) were diagnosed with TT and 66.0% (n = 159) underwent frenotomy. In the multivariate model, nipple pain/trauma, inability to latch, inability to elevate tongue, and dimpling of tongue on extension were associated with frenotomy (P < 0.05). Most referrals in our region resulted in a diagnosis of TT; however, the number of referrals was lower than expected, and of these two-thirds underwent frenotomy. Interpretation TT is a relatively common finding among breastfed infants. Future research should examine whether a simplified assessment tool containing the four items associated with frenotomy in our multivariate model can identify breastfed infants with TT who require frenotomy.
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Affiliation(s)
- Tiffany A. Lee
- School of PharmacyMemorial University of Newfoundland (MUN)St. John'sCanada
| | - Jessica Bishop
- Faculty of MedicineMemorial University of Newfoundland (MUN)St. John'sCanada
| | - Anne Drover
- Faculty of MedicineMemorial University of Newfoundland (MUN)St. John'sCanada
| | - William K. Midodzi
- Faculty of MedicineMemorial University of Newfoundland (MUN)St. John'sCanada
| | - Laurie K. Twells
- Faculty of MedicineMemorial University of Newfoundland (MUN)St. John'sCanada
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Yıldırım Gökşen DF, Özkan S. The effect of online breastfeeding education on breastfeeding motivation: A randomized controlled study. J Pediatr Nurs 2024; 75:e42-e48. [PMID: 38182483 DOI: 10.1016/j.pedn.2023.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 12/24/2023] [Accepted: 12/24/2023] [Indexed: 01/07/2024]
Abstract
PURPOSE The aim of this study was to examine the effect of online breastfeeding education on breastfeeding motivation. DESIGN AND METHODS The study had a single blind randomized, controlled, experimental design. The women in the online education group were primipara and in their postpartum 4-8 weeks and fulfilled inclusion criteria for the study. The study population comprised of the women presenting to the pregnancy outpatient clinic or giving birth in the gynecological and obstetrics clinic of a university hospital hospital in the West of Turkey and hearing about the Online Breastfeeding Education through social media. The sample size was calculated through a similar study. Data were collected between February 2022-November 2022. Simple random sampling was used and the study sample comprised of 50 women, of whom 25 were in the online breastfeeding education group and 25 were in the control group. Online breastfeeding education was given in groups of three or two, depending on availability, via the video communication platform (Zoom Video Communications). The control group received routine care. Data analysis was made with descriptive statistics, Wilcoxon rank sum test and Mann Whitney U test. RESULTS Integrative motivation (U = 284, p < .05) and intrinsic motivation-identified regulation (U = 196, p < .05) significantly increased compared to the control group. CONCLUSION Online breastfeeding education offered in the postpartum period can help to increase breastfeeding rates. PRACTICE IMPLICATIONS It is recommended that nurses monitor breastfeeding status in the postpartum period and motivate mothers with online breastfeeding training in cases where access is not available. TRIAL REGISTRATION Registered 12 February 2022 on www. CLINICALTRIALS gov (NCT05262231).
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Affiliation(s)
| | - Sevgi Özkan
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey.
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Üstündağ G, Karadag-Oncel E, Kara-Ulu N, Polat M, Salı E, Çakır D, Şahin A, Akaslan-Kara A, Kaçar P, Işık AD, Erdemli PC, Durmuş SY, Özdemir A, Çelik B, Sütçü M, Kara M, Kandemir-Gülmez T, Çelikyurt A, Ümit Z, Aktürk H, Arıkan K, Kaba Ö, Caymaz C, Bayhan C, Aygün D, Penezoğlu DN, Alataş ŞÖ, Özdemir H, Türel Ö, Akça M, Çelebi-Çongur E, Kepenekli E, Çelik Ü, Ecevit İZ, Belet N, Dalgıç N, Yılmaz N, Yılmaz D, Kuyucu N, Çiftçi E. COVID-19 in hospitalized infants aged under 3 months: multi-center experiences across Turkey. Eur J Pediatr 2024; 183:1153-1162. [PMID: 37971516 DOI: 10.1007/s00431-023-05329-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
To investigate coronavirus disease 2019 (COVID-19) in infants aged 0 to 3 months because there is currently a significant gap in the literature on the subject. A cross-sectional study was conducted with the involvement of 19 medical centers across Turkey and 570 infants. The majority of the patients were male (58.2%), and the three most common symptoms were fever (78.2%), cough (44.6%), and feeding intolerance (39.9%). The results showed that a small percentage of infants had positive blood (0.9%) or urine cultures (10.2%). Most infants presented with fever (78.2%). Children without underlying conditions (UCs) had mostly a complicated respiratory course and a normal chest radiography. Significant more positive urine culture rates were observed in infants with fever. A higher incidence of respiratory support requirements and abnormal chest findings were seen in infants with chronic conditions. These infants also had a longer hospital stay than those without chronic conditions. Conclusions: Our study discloses the clinical observations and accompanying bacterial infections found in infants aged under 3 months with COVID-19. These findings can shed light on COVID-19 in infancy for physicians because there is limited clinical evidence available. What is Known: • COVID-19 in infants and older children has been seen more mildly than in adults. • The most common symptoms of COVID-19 in infants are fever and cough, as in older children and adults. COVID-19 should be one of the differential diagnoses in infants with fever. What is New: • Although most infants under three months had fever, the clinical course was uneventful and respiratory complications were rarely observed in healthy children. • Infants with underlying conditions had more frequent respiratory support and abnormal chest radiography and stayed longer in the hospital.
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Affiliation(s)
- Gülnihan Üstündağ
- Izmir Tepecik Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Izmir, Turkey
| | - Eda Karadag-Oncel
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey.
| | - Nursel Kara-Ulu
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Gazi University, Ankara, Turkey
| | - Meltem Polat
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Gazi University, Ankara, Turkey
| | - Enes Salı
- Ümraniye Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Istanbul, Turkey
| | - Deniz Çakır
- Ümraniye Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Istanbul, Turkey
| | - Aslıhan Şahin
- Izmir Tepecik Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Izmir, Turkey
| | - Aybüke Akaslan-Kara
- Izmir Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Izmir, Turkey
| | - Pelin Kaçar
- Izmir Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Izmir, Turkey
| | - Aylin Dizi Işık
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Marmara University, Istanbul, Turkey
| | - Pınar Canizci Erdemli
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Marmara University, Istanbul, Turkey
| | - Sevgi Yaşar Durmuş
- Clinic of Pediatric Infectious Disease, Kayseri City Hospital, Kayseri, Turkey
| | - Ahmet Özdemir
- Clinic of Neonatal Intensive Care Unit, Kayseri City Hospital, Kayseri, Turkey
| | - Binnaz Çelik
- Clinic of Pediatrics, Kayseri City Hospital, Kayseri, Turkey
| | - Murat Sütçü
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Istinye University, Istanbul, Turkey
| | - Manolya Kara
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Istinye University, Istanbul, Turkey
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Yeditepe University, Istanbul, Turkey
| | | | - Aydın Çelikyurt
- Faculty of Medicine, Department of Pediatrics, Koç University, Istanbul, Turkey
| | - Zühal Ümit
- Clinic of Pediatric Infectious Diseases, Manisa City Hospital, Manisa, Turkey
| | - Hacer Aktürk
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Koç University, Istanbul, Turkey
| | - Kamile Arıkan
- Clinic of Pediatric Infectious Diseases, Buca Seyfi Demirsoy Training and Research Hospital, Izmir, Turkey
| | - Özge Kaba
- Clinic of Pediatric Infectious Disease, Başakşehir Çam Ve Sakura City Hospital, Istanbul, Turkey
| | - Canan Caymaz
- Clinic of Pediatric Infectious Disease, Başakşehir Çam Ve Sakura City Hospital, Istanbul, Turkey
| | - Cihangül Bayhan
- Gülhane Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Ankara, Turkey
| | - Deniz Aygün
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Cerrahpaşa University Istanbul, Istanbul, Turkey
| | - Döndü Nilay Penezoğlu
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara University, Ankara, Turkey
| | - Şilem Özdem Alataş
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Halil Özdemir
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara University, Ankara, Turkey
| | - Özden Türel
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Bezmialem Foundation University, Istanbul, Turkey
| | - Mehtap Akça
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Mersin University, Mersin, Turkey
| | - Emel Çelebi-Çongur
- Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Istanbul, Turkey
| | - Eda Kepenekli
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Marmara University, Istanbul, Turkey
| | - Ümit Çelik
- Clinic of Pediatric Infectious Diseases, Adana City Hospital, Adana, Turkey
| | - İsmail Zafer Ecevit
- Gülhane Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Ankara, Turkey
| | - Nurşen Belet
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Nazan Dalgıç
- Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Istanbul, Turkey
| | - Nisel Yılmaz
- Department of Medical Microbiology, Izmir Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Dilek Yılmaz
- Izmir Tepecik Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Izmir, Turkey
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Izmir Katip Çelebi University, Izmir, Turkey
| | - Necdet Kuyucu
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Mersin University, Mersin, Turkey
| | - Ergin Çiftçi
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara University, Ankara, Turkey
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Brandt KG, da Silva GAP. Marketing and child feeding. J Pediatr (Rio J) 2024; 100 Suppl 1:S57-S64. [PMID: 37918811 PMCID: PMC10960183 DOI: 10.1016/j.jped.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE To carry out a narrative review on the use of marketing strategies in child nutrition, as well as potential implications for health professionals and children. DATA SOURCE Searches were carried out on the PubMed, SciELO, and Google platforms, using the terms "child nutrition" or "industrialized baby food" or "infant formula" or "breast milk" or "breastfeeding" and "marketing", with original articles, review articles, institutional reports, institutional position documents and websites considered relevant to the topic being analyzed. DATA SYNTHESIS Children's food marketing started with the industrialization of food and the resulting actions aimed at increasing sales and meeting commercial interests. Since its inception to the present, infant formulas have been the most widely used products, which has impacted breastfeeding practices. International and national institutions, that care for children's health, are searching for strategies to limit the abusive marketing of industrialized children's foods. Marketing strategies interfere with medical knowledge and actions, potentially influencing the guidance provided by pediatricians to families, and finally, compromising healthy eating practices at a critical period in life, with possible long-term effects. CONCLUSIONS Health professionals, especially pediatricians, must provide the best care for children and families, and need to maintain the search for quality scientific information, not influenced by conflicts of interest. Updated and critical knowledge on the part of healthcare professionals can curb marketing strategies that aim to influence their actions.
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Affiliation(s)
- Kátia Galeão Brandt
- Universidade Federal de Pernambuco (UFPE), Centro de Ciências Médicas, Área Acadêmica de Pediatria, Recife, PE, Brazil; Universidade Federal de Pernambuco (UFPE), Centro de Ciências Médicas, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Recife, PE, Brazil; Universidade Federal de Pernambuco (UFPE), Hospital das Clínicas, Serviço de Gastroenterologia Pediátrica, Recife, PE, Brazil.
| | - Giselia Alves Pontes da Silva
- Universidade Federal de Pernambuco (UFPE), Centro de Ciências Médicas, Área Acadêmica de Pediatria, Recife, PE, Brazil; Universidade Federal de Pernambuco (UFPE), Centro de Ciências Médicas, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Recife, PE, Brazil
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Mays EJ, Diggs S, Vesoulis ZA, Warner B. The Effects of Health Disparities on Neonatal Outcomes. Crit Care Nurs Clin North Am 2024; 36:11-22. [PMID: 38296368 DOI: 10.1016/j.cnc.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
The history of racism in the United States was established with slavery, and the carry-over effect continues to impact health care through structural and institutional racism. Racial segregation and redlining have impacted access to quality health care, thereby impacting prematurity and infant mortality rates. Health disparities also impact neonatal morbidities such as intraventricular hemorrhage and necrotizing enterocolitis and the family care experience including the establishment of breastfeeding and health care provider interactions.
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Affiliation(s)
- Erin J Mays
- St. Louis Children's Hospital NICU, 1 Childrens Place, St Louis, MO 63110, USA.
| | - Stephanie Diggs
- Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, 1 Childrens Place, #8116-NWT 8, St Louis, MO 63110, USA
| | - Zachary A Vesoulis
- Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, 1 Childrens Place, #8116-NWT 8, St Louis, MO 63110, USA
| | - Barbara Warner
- Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, 1 Childrens Place, #8116-NWT 8, St Louis, MO 63110, USA
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Rossi E, Levasseur P, Clément M. "Mother's milk": Is there a social reversal in breastfeeding practices along with economic development? Soc Sci Med 2024; 345:116444. [PMID: 38044247 DOI: 10.1016/j.socscimed.2023.116444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 11/13/2023] [Accepted: 11/17/2023] [Indexed: 12/05/2023]
Abstract
Previous studies suggest that macro- and micro-level factors jointly influence breastfeeding (BF) practices, but empirical evidence on the dynamics of such interactions along with the process of a country's economic development remains limited. Based on 42 Demographic Health Surveys (DHS) conducted in 15 Asian countries with a large time window (1990-2017), we thus test the existence of a reversal in the association between household wealth and BF practices throughout the development process. Four BF indicators (early initiation of BF, exclusive BF, continued BF at one year and two years) are examined, along with a standardized asset-based household wealth index allowing for cross-wave and cross-country comparisons. To highlight the dynamics of the wealth-BF association, we carry out econometric estimations, including interaction terms between household wealth and the country's level of economic development (low, medium, and high) or time. Instrumental variable estimations are also performed to limit suspected endogeneity issues. Our results confirm a transition in the wealth gradient of exclusive BF and continued BF in Asian countries. More precisely, while these practices are pro-poor in the poorest countries of the sample, they progressively spread to wealthier households along with the level of economic development. For exclusive BF, this transition has resulted in a reversal of the wealth gradient at the end of the period (i.e., exclusive BF prevalence among the rich overpassing that of the poor). We fail, however, to observe this kind of transition for early initiation of BF, this practice remaining pro-poor, whatever the level of economic development. To sum up, our results provide robust evidence of a transition in the wealth gradient of some BF practices along with economic development and time, and thus largely echo the literature exploring the social reversal hypothesis in the case of non-communicable diseases.
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Dharod JM, Black MM, McElhenny K, Labban JD, DeJesus JM. Es Niño o Niña?: Gender Differences in Feeding Practices and Obesity Risk among Latino Infants. Curr Dev Nutr 2024; 8:102100. [PMID: 38425439 PMCID: PMC10904161 DOI: 10.1016/j.cdnut.2024.102100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/26/2024] [Accepted: 02/02/2024] [Indexed: 03/02/2024] Open
Abstract
Background Obesity prevalence is significantly higher among Latino boys than girls. Weight status at 12 mo, a significant predictor of childhood obesity, is associated with feeding practices during infancy. Objectives The objectives were to examine breastfeeding and formula-feeding practices overall and by infant gender and to examine relations among infant gender, milk-feeding practices, and obesity risk among Latino infants over the first year of life. Methods Latino mother-infant dyads (n = 90) were recruited from a pediatric clinic. Mothers were interviewed at regular intervals (infants aged 2, 4, 6, and 9 mo), and 24-h feeding recalls were conducted when infants were aged 6 and 9 mo. Infants' lengths and weights were retrieved from clinic records to calculate weight-for-length percentiles. A bivariate analysis was conducted to compare feeding practices by gender and mediation analysis to test whether feeding practices mediated the relation between gender and obesity risk. Results The majority (80%) of mothers were born outside the United States. In early infancy, mixed feeding of formula and breastfeeding was common. At 6 and 9 mo of age, milk-feeding practices differed, with formula feeding more common for boys than girls. At 12 mo, 38% of infants experienced obesity risk (≥85th weight-for-length percentile). Infants' obesity risk increased by 18% per 1 oz increase in powdered formula intake. Formula intake among boys was on average 1.42 oz (in dry weight) higher than that among girls, which, in turn, mediated their increased obesity risk (IERR = 1.27, 95% confidence interval: 1.02, 1.90). Conclusions The increased obesity risk among Latino boys compared with girls at 12 mo was explained by higher rates of formula feeding at 6 and 9 mo of age. Future investigations of cultural values and beliefs in gender-related feeding practices are warranted to understand the differences in obesity risk between Latino boys and girls.
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Affiliation(s)
- Jigna M Dharod
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Maureen M Black
- RTI International, Research Triangle Park, NC, United States
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Kristen McElhenny
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Jeffrey D Labban
- Office of Research, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Jasmine M DeJesus
- Department of Psychology, College of Arts and Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
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Bektas IL, Oktay SŞ, Köylü P, Ulu H, Akdeniz Kudubeş A. The Effect of Breastfeeding on the Newborn's Comfort and Pain Levels During Heel Blood Collection. Compr Child Adolesc Nurs 2024; 47:20-30. [PMID: 37747770 DOI: 10.1080/24694193.2023.2259991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023]
Abstract
This research was planned to determine the effect of breastfeeding on newborns' behavioral pain and comfort scores during heel blood collection. A pretest/posttest experimental-control group design was used. The research was conducted between August 2021 and June 2022. A total of 50 newborns, including 25 in each of the experimental and control groups, were included in the study. An Infant Descriptive Information Form, the COMFORTneo Behaviour Scale, the NIPS-Neonatal Infant Pain Scale, and the LATCH Breastfeeding Diagnosis and Assessment Tool were used in the study. The comfort behaviors and pain scores of infants in the experimental and control groups were evaluated during the heel blood collection process. The comparison of the comfort behaviors (comfort, pain, and distress), differences between pretest-posttest scores on the NIPPS pain score, and crying duration of the newborns in the experimental and control groups indicated a significant difference (p 0.05). The intra-group differences between the mean pretest and posttest scores of both the intervention and control groups were found to be statistically significant (p 0.05). Breastfeeding is an important nursing intervention for reducing procedural pain in newborns. The breastfeeding method reduces pain and distress and increases comfort for newborns during the heel blood collection process.
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Affiliation(s)
- I Lknur Bektas
- Department of Nursing, Faculty of Health Science İzmir Bakirçay University, İzmir, Türkiye
| | - Serap Şule Oktay
- Department of Gynecology and Obstetrics, Gaziemir Nevvar Salih İşgören State Hospital, İzmir, Türkiye
| | - Pınar Köylü
- Department of Gynecology and Obstetrics, Gaziemir Nevvar Salih İşgören State Hospital, İzmir, Türkiye
| | - Handan Ulu
- Department of Gynecology and Obstetrics, Gaziemir Nevvar Salih İşgören State Hospital, İzmir, Türkiye
| | - Aslı Akdeniz Kudubeş
- Department of Nursing, Faculty of Health Science, Bilecik Şeyh Edebali University, Bilecik, Türkiye
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