1
|
Harahsheh MM, Mukattash TL, Al-Shatnawi S, Abu-Farha R, Abuhammad S, D'Arcy D, Jarab A. Community Pharmacists' Current Practice and Educational Needs in Breastfeeding Support in Jordan: A Cross-Sectional Study. J Hum Lact 2024; 40:132-142. [PMID: 37994528 DOI: 10.1177/08903344231206394] [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] [Indexed: 11/24/2023]
Abstract
BACKGROUND Improving breastfeeding practices is a worldwide priority. Pharmacists have the opportunity to actively promote breastfeeding and educate parents as well as the general public about its benefits. RESEARCH AIMS The aims of this study are to investigate Jordanian pharmacists' present breastfeeding support practices and perceptions regarding their need for education and training in breastfeeding support. METHODS To examine sociodemographic characteristics of community pharmacists in Jordan and their current breastfeeding support practices and educational needs, a descriptive cross-sectional online (self-report) survey was conducted. Through social media, pharmacists working in community pharmacies in Jordan were recruited between August 2021 and February 2022. The level of breastfeeding support participants had been provided with was measured using eight items in a 5-point Likert scale ranging from 5 (Always) to 1 (Never). Each participant self-reported the frequency of advice/information given to breastfeeding women in each of these areas. Univariate and multivariable linear regression models were used to identify factors associated with the level of breastfeeding support. RESULTS Participants (N = 381) reported a high level of breastfeeding support, but expressed a need for training and education for further improvement. The breastfeeding support score of female participants was found to be 0.12 higher than that of males (Beta = 0.12, p = .02), 0.16 higher in married participants compared to non-married participants (Beta = 0.16, p = .03), and 0.10 higher in participants working in rural areas compared to those working in urban areas (Beta = 0.10, p = .04). CONCLUSION While community pharmacists generally report a high level of breastfeeding support, our findings revealed demographic differences. Attention to specific areas of need might enhance what pharmacists could offer; however, additional research would be required to guide the specific educational content.
Collapse
Affiliation(s)
- Mea'ad M Harahsheh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Tareq L Mukattash
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Samah Al-Shatnawi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Rana Abu-Farha
- Clinical Pharmacy and Therapeutics Department, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Sawsan Abuhammad
- Department of Maternal and Child Health, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Deirdre D'Arcy
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | - Anan Jarab
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
- Collage of Pharmacy, Al-Ain University, Abu Dhabi, United Arab of Emirates
| |
Collapse
|
2
|
Saucedo Baza A, Mignacca C, Delgado PE, Paterniti TA, Romero de Mello Sa S, Looney S, Zahler-Miller C. A Technological Approach to Improved Breastfeeding Rates and Self-Efficacy: A Randomized Controlled Pilot Study. J Hum Lact 2023; 39:679-687. [PMID: 37571838 DOI: 10.1177/08903344231190625] [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] [Indexed: 08/13/2023]
Abstract
BACKGROUND Breastfeeding confers significant maternal and infant benefits; however, breastfeeding rates remain suboptimal in the United States. A parent's decision to breastfeed is influenced by non-modifiable and modifiable factors, including breastfeeding knowledge and self-efficacy. There is a positive correlation between high maternal self-efficacy and breastfeeding duration. Parents increasingly rely on technology for health information. RESEARCH AIM To determine if a smartphone application affected maternal self-efficacy and breastfeeding exclusivity rates. METHOD This study was a randomized, controlled pilot study examining the effect of an educational program, included in a smartphone application, on breastfeeding self-efficacy (assessed in postpartum Week 1 and Weeks 4-6) and breastfeeding rates (assessed in postpartum Weeks 4-6). Forty participants were recruited using block randomization to intervention (17 of 20 completed the study) and usual care (19 of 20 completed the study) groups. To examine the pre-test/post-test difference in the Breastfeeding Self-Efficacy Scale - Short Form total scores, a change in score (post-intervention minus pre-intervention) was calculated for each parent. RESULT The intervention group (phone application and usual care) showed greater change in self-efficacy scores (M = 7.6, SD = 7.8) compared to the control group (usual care; M = 1.2, SD = 3.7, p = .001). The rate of exclusive breastfeeding was nearly twice as high in the intervention group as in the control group, but did not reach statistical significance (p = .093). CONCLUSION The investigators found enhanced breastfeeding self-efficacy and breastfeeding rates among postpartum women receiving a smartphone educational program in the first 6 weeks postpartum. Further studies on smartphone interventions will develop our understanding of this technology in improving breastfeeding rates.
Collapse
Affiliation(s)
- Areli Saucedo Baza
- Medical College of Georgia, Augusta, GA, USA
- Department of Obstetrics and Gynecology, WellStar Kennestone Regional Medical Center, Marietta, GA, USA
| | | | - Paula E Delgado
- Medical College of Georgia, Augusta, GA, USA
- Department of Obstetrics & Gynecology, University of New Mexico, Albuquerque, NM, USA
| | | | | | | | | |
Collapse
|
3
|
Khanal V. Influence of breastfeeding education and support on predominant breastfeeding: Findings from a community-based prospective cohort study in Western Nepal. Health Sci Rep 2023; 6:e1548. [PMID: 37680209 PMCID: PMC10480414 DOI: 10.1002/hsr2.1548] [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: 05/09/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023] Open
Abstract
Background and Aims Breastfeeding education and support have the potential to improve breastfeeding outcomes. However, there is a lack of research on the impact of breastfeeding education on predominant breastfeeding in Nepal and other South Asian countries. This study aimed to report the rate of predominant breastfeeding at the first, fourth, and sixth months of birth and examine the influence of breastfeeding promotion on predominant breastfeeding. Methods A community-based prospective cohort study was conducted in western Nepal. A total of 735 mother-infant pairs were recruited within 30 days of childbirth and followed up at the fourth and sixth months to collect data on infant feeding practices. Results The rate of predominant breastfeeding at first, fourth, and sixth months were 88.6% (N = 735), 78.2% (N = 715), and 26.3% (N = 711), respectively, showing a significant decline with infant age. Mothers who received support on breastfeeding skills (Adjusted Odds Ratio [AOR]: 2.55; 95% confidence interval [CI]: 1.73-3.75), those who received advice on keeping mother-infant together (AOR: 2.19; 95% CI: 1.14-4.22) and who had initiated breastfeeding within 1 h of childbirth (AOR: 2.55; 95% CI: 1.73-3.75), and who were educated, had higher likelihood of predominant breastfeeding at sixth month. Conclusion This study asserts a need for continuous and focused breastfeeding promotion programs to educate and support lactating mothers.
Collapse
|
4
|
Abraham M, Lak MA, Gurz D, Nolasco FOM, Kondraju PK, Iqbal J. A Narrative Review of Breastfeeding and Its Correlation With Breast Cancer: Current Understanding and Outcomes. Cureus 2023; 15:e44081. [PMID: 37750138 PMCID: PMC10518059 DOI: 10.7759/cureus.44081] [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: 07/05/2023] [Accepted: 08/24/2023] [Indexed: 09/27/2023] Open
Abstract
Breastfeeding has been extensively studied in relation to breast cancer risk. The results of the reviewed studies consistently show a decreased risk of breast cancer associated with breastfeeding, especially for 12 months or longer. This protective effect is attributed to hormonal, immunological, and physiological changes during lactation. Breastfeeding also appears to have a greater impact on reducing breast cancer risk in premenopausal women and specific breast cancer subtypes. Encouraging breastfeeding has dual benefits: benefiting infants and reducing breast cancer risk long-term. Healthcare professionals should provide evidence-based guidance on breastfeeding initiation, duration, and exclusivity, while public health policies should support breastfeeding by creating enabling environments. This review examines the existing literature and analyzes the correlation between breastfeeding and breast cancer risk.
Collapse
Affiliation(s)
- Merin Abraham
- Department of Internal Medicine, Kasturba Medical College, Manipal, IND
| | - Muhammad Ali Lak
- Department of Internal Medicine, Combined Military Hospital, Lahore, PAK
| | - Danyel Gurz
- Department of Internal Medicine, Combined Military Hospital, Lahore, PAK
| | | | | | - Javed Iqbal
- Department of Neurosurgery, Mayo Hospital, Lahore, PAK
| |
Collapse
|
5
|
Gowan M, Langford C. Developing a University Student Lactation Policy in the United States. J Hum Lact 2023; 39:353-357. [PMID: 36879393 DOI: 10.1177/08903344231156445] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Affiliation(s)
- Marcella Gowan
- School of Nursing, Linfield University, Portland, OR, USA
| | | |
Collapse
|
6
|
Carter SK, Stone A, Cox JM. Intersectionality in Breastfeeding Research. J Hum Lact 2023; 39:202-205. [PMID: 36859824 DOI: 10.1177/08903344231156446] [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] [Indexed: 03/03/2023]
Affiliation(s)
- Shannon K Carter
- Department of Sociology, University of Central Florida, Orlando, FL, USA
| | - Ashley Stone
- Department of African and Black Diaspora Studies, DePaul University, Chicago, IL, USA
| | - Jonathan M Cox
- Department of Sociology, University of Central Florida, Orlando, FL, USA
| |
Collapse
|
7
|
Dogan J, Hargons C, Stevens-Watkins D. "Don't Feel Like You Have to Do This All on Your Own": Exploring Perceived Partner Support of Breastfeeding Among Black Women in Kentucky. J Hum Lact 2023; 39:134-145. [PMID: 36511173 DOI: 10.1177/08903344221138101] [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] [Indexed: 12/15/2022]
Abstract
BACKGROUND Few researchers have explored partner breastfeeding support among Black women, who report low breastfeeding rates compared to women of other cultural groups. Ways to encourage partner support of Black women's breastfeeding can be understood from an Afrocentric perspective. RESEARCH AIM To explore perceptions of partner support among Black mothers to develop a culturally relevant framework of partner breastfeeding support. METHODS Secondary data analyses of qualitative data from a larger prospective, cross-sectional mixed methods study were utilized. Participants from Kentucky (N = 14), aged 23-71, who breastfed for at least 6 months, were recruited to participate in individual interviews. Professionally transcribed interviews were analyzed using Braun and Clarke's (2006) thematic analysis. RESULTS By integrating the Breastfeeding Coparenting Framework and Optimal Conceptual Theory, we identified four culturally affirming partner support themes that participants believed impacted their breastfeeding experiences: (a) doing research, (b) offering care, (c) verbalizing praise, and (d) achieving teamwork, and three culturally incongruent partner support barrier themes: (e) withdrawing commitment, (f) politicking bodies, and (g) stripping agency. CONCLUSION Participants who breastfed for at least 6 months largely attributed their breastfeeding success to the support received from their partners. Our findings offer a culturally relevant framework of partner breastfeeding support that can facilitate intervention efforts with participants and their partners to increase breastfeeding rates among this population.
Collapse
Affiliation(s)
- Jardin Dogan
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Candice Hargons
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Danelle Stevens-Watkins
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
8
|
|
9
|
Radwan H, Fakhry R, Boateng GO, Metheny N, Bani Issa W, Faris ME, Obaid RS, Al Marzooqi S, Al Ghazal H, Dennis CL. Translation and Psychometric Evaluation of the Arabic Version of the Breastfeeding Self-Efficacy Scale-Short Form Among Women in the United Arab Emirates. J Hum Lact 2023; 39:40-50. [PMID: 35363102 DOI: 10.1177/08903344221084623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Breastfeeding self-efficacy as a construct has been theoretically and empirically linked to exclusive breastfeeding in studies globally using the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). However, its application in the Middle East and North Africa region is limited, as it has not been validated. RESEARCH AIMS To psychometrically validate the BSES-SF among a sample of mothers in the United Arab Emirates. METHODS We psychometrically evaluated the Arabic version of the BSES-SF using a sample of mothers (N = 457) residing in the United Arab Emirates. We used translation techniques, item-test and item-total correlations, confirmatory factor analysis, tests of reliability, and tests of validity. RESULTS Item-test correlations of scale items ranged from 0.67 to 0.84, while item-total correlations ranged from 0.58 to 0.81. The confirmatory factor model assessed the 14-item scale to be unidimensional with satisfactory model fit indices. Our findings suggested the Arabic-language version of the BSES-SF was a reliable measure (α = 0.95) with strong construct and discriminant validity. BSES-SF scores significantly predicted exclusive breastfeeding (aOR = 1.04; 95% CI [1.02, 1.08]) and exclusive duration (β = .06; 95% CI [0.4, 0.08]), which suggested strong predictive, validity after adjusting for parity, maternal age, maternal education, and study site. CONCLUSIONS We have provided rigorous evidence that the BSES-SF is a valid and reliable measure of breastfeeding self-efficacy among Arabic-speaking women in the UAE. Interventions designed specifically to increase breastfeeding self-efficacy among Arabic-speaking women may be a mechanism to increase the suboptimal rates of breastfeeding exclusivity occurring in much of the MENA region.
Collapse
Affiliation(s)
- Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Randa Fakhry
- Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Godfred O Boateng
- Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, TX, USA
| | - Nick Metheny
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA.,Affiliate Scientist, MAP Centre for Urban Health Solutions, St Michael's Hospital, Toronto, ON Canada
| | - Wegdan Bani Issa
- Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - MoezAlIslam E Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Reyad Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Suad Al Marzooqi
- Department of Psychology, Al Ain, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Hessa Al Ghazal
- Sharjah Child-Friendly Office, Sharjah, United Arab Emirates
| | - Cindy-Lee Dennis
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
10
|
Merritt R, Kendall S, Eida T, Dykes F, Pérez‐Escamilla R. Scaling up breastfeeding in England through the Becoming Breastfeeding Friendly initiative (BBF). Matern Child Nutr 2023; 19 Suppl 1:e13443. [PMID: 36330699 PMCID: PMC9835572 DOI: 10.1111/mcn.13443] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 11/06/2022]
Abstract
Breastfeeding is the most accessible and cost-effective activity available to public health and has been shown to be one of the most effective preventive measures mothers can take to protect their children's health. Despite the well-documented benefits, the UK has one of the lowest breastfeeding rates in the world. The Becoming Breastfeeding Friendly (BBF) toolkit was developed through highly structured technical and academic collaboration, led by Yale University. It provides an evidence-based process to help countries assess their breastfeeding status and readiness to scale up, and identifies concrete measures countries can take to sustainably increase breastfeeding rates, based on data-driven recommendations. BBF is grounded in the Breastfeeding Gear Model complex adaptive systems framework which is made up of eight simultaneous conditions that sustain breastfeeding. In 2018, a committee of multi-agency stakeholders implemented the BBF process in England, collecting evidence to score the 'gear' components of England's breastfeeding environment against 54 benchmarks. The Training and Programme Delivery gear received the highest score, attributable to existing learning outcomes for health professionals and practitioners, peer supporters and specialist services, although there is a need for greater coordination and integration. The lowest scores were given for Promotion and Coordination, Goals and Monitoring due to the lack of a dedicated national strategy for breastfeeding and poor sharing of localised strategies and programmes. The process generated clear recommendations highlighting the need for more robust routine infant feeding data collection and reporting, and the necessity for strengthening leadership, monitoring and oversight to scale up and sustain breastfeeding.
Collapse
Affiliation(s)
- Rowena Merritt
- Centre for Health Services StudiesUniversity of KentCanterburyUK
| | - Sally Kendall
- Centre for Health Services StudiesUniversity of KentCanterburyUK
| | - Tamsyn Eida
- Centre for Health Services StudiesUniversity of KentCanterburyUK
| | - Fiona Dykes
- Maternal and Infant Nutrition and Nurture Unit (MAINN)University of Central LancashirePrestonUK
| | - Rafael Pérez‐Escamilla
- Department of Social and Behavioural SciencesYale University School of Public HealthNew HavenConnecticutUSA
| |
Collapse
|
11
|
Mohammed S, Abukari AS, Afaya A. The impact of intrapartum and immediate post-partum complications and newborn care practices on breastfeeding initiation in Ethiopia: A prospective cohort study. Matern Child Nutr 2022; 19:e13449. [PMID: 36319613 PMCID: PMC9749596 DOI: 10.1111/mcn.13449] [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] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 10/06/2022] [Accepted: 10/11/2022] [Indexed: 12/15/2022]
Abstract
This study aimed to investigate the impact of intrapartum and post-partum complications and newborn care practices on early initiation of breastfeeding (EIBF). Data for the study came from a prospective cohort study in Ethiopia that recruited and followed pregnant and post-partum women from 2019 to 2021. Resident enumerators conducted interviews at enrolment in 2019 and follow-ups at 6 weeks, 6 months and 1 year post-partum. The present analysis is based on data from the baseline survey and 6 weeks follow-up. Multivariable logistic regression was used to estimate the effects of newborn care practices and intrapartum and post- partum complications on EIBF (the proportion of newborns who initiated breastfeeding within the first hour of birth). Overall, 2660 mother-infant pairs were included in this analysis. After adjustment, EIBF was less likely among women who experienced intrapartum haemorrhage (adjusted odds ratio [AOR]: 0.76, 95% confidence interval [CI]: 0.59-0.97), malpresentation (AOR: 0.46, 95% CI: 0.30-0.72) and convulsions (AOR: 0.48, 95% CI: 0.34-0.66) during childbirth. Mother-newborn skin-to-skin contact increased the likelihood of EIBF (AOR: 1.47, 95% CI: 1.11-1.94). Women who experienced post-partum haemorrhage (AOR: 0.63, 95% CI: 0.47-0.84), retained placenta for more than 30 min (AOR: 0.36, 95% CI: 0.24-0.52) and convulsions after delivery (AOR: 0.57, 95% CI: 0.41-0.79) were less likely to initiate breastfeeding early. Also, women who had a caesarean birth (AOR: 0.28, 95% CI: 0.18-0.41), delivered outside of a healthcare facility (AOR: 0.70, 95% CI: 0.50-0.99) or had twin birth (AOR: 0.43, 95% CI: 0.22-0.85) were less likely to initiate breastfeeding early. Skin-to-skin contact should be encouraged whenever possible, and women with obstetric complications should be encouraged and supported to initiate breastfeeding early.
Collapse
Affiliation(s)
- Shamsudeen Mohammed
- Department of Non‐communicable Disease Epidemiology, Faculty of Epidemiology and Population HealthLondon School of Hygiene & Tropical MedicineLondonUK
| | - Alhassan S. Abukari
- Department of General Nursing, School of Nursing & MidwiferyWisconsin International University CollegeNorth LegonAccraGhana
| | - Agani Afaya
- Mo‐Im Kim Nursing Research Institute, College of NursingYonsei UniversitySeodaemun‐guSeoulSouth Korea,Department of Nursing, School of Nursing and MidwiferyUniversity of Health and Allied SciencesHoGhana
| |
Collapse
|
12
|
Gyamfi A, Jefferson UT, O'Neill B, Lucas R, Spatz DL, Henderson WA. Disparities in 6 Month Exclusive Breastfeeding in Ghana, Africa: A Scoping Review. J Hum Lact 2022:8903344221130988. [PMID: 36305494 DOI: 10.1177/08903344221130988] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Exclusive breastfeeding practice for 6 months is a critical global public health goal. In 2020, only 44% of infants globally, 31% in Central and West Africa, and 43% in Ghana, were exclusively breastfed for the first 6 months of life. RESEARCH AIM To critically evaluate disparities in exclusive breastfeeding practice for 6 months in Ghana. METHODS The scoping review was guided by Arksey and O'Malley's (2005) six-stage scoping review process. The online databases of American Psychological Association PsychInfo (APA PsychInfo), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Scopus were searched with keywords inclusive of Ghana, exclusive breastfeeding, breastfeeding, infant feeding, lactation, lactating, and exclusive. Eligibility criteria included full-text, peer-reviewed research articles written in the English language without limitation to specific years. Data were analyzed thematically. RESULTS Initially, 317 records were identified, and 15 full-text articles were eligible for the scoping review. Four main themes emerged as disparities in exclusive breastfeeding practice in Ghana. The themes were healthcare (prenatal clinic visits, delivery place, exclusive breastfeeding knowledge), personal (maternal age, Human Immunodeficiency Virus status, parity, type of delivery, breast problem), employment (unemployed, formal, or informal sector worker), and sociocultural (ethnicity/region, family support, religious beliefs, cultural practices). CONCLUSION Disparities in exclusive breastfeeding in Ghana warrant the collaborative efforts of stakeholders for successful mitigation. Future researchers should explore the role of religion and sociocultural practices to protect, promote, and support 6 months of exclusive breastfeeding in Ghana.
Collapse
Affiliation(s)
- Adwoa Gyamfi
- St Michael's Midwifery Training School, Ashanti Region, Ghana.,School of Nursing, University of Connecticut, Storrs, CT, USA
| | | | - Barbara O'Neill
- School of Nursing, University of Connecticut, Storrs, CT, USA
| | - Ruth Lucas
- School of Nursing, University of Connecticut, Storrs, CT, USA.,School of Medicine, University of Connecticut, Farmington, CT, USA
| | - Diane Lynn Spatz
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Wendy A Henderson
- School of Nursing, University of Connecticut, Storrs, CT, USA.,School of Medicine, University of Connecticut, Farmington, CT, USA
| |
Collapse
|
13
|
Dib S, Kittisakmontri K, Wells JC, Fewtrell M. Interventions to Improve Breastfeeding Outcomes in Late Preterm and Early Term Infants. Breastfeed Med 2022; 17:781-792. [PMID: 36282193 DOI: 10.1089/bfm.2022.0118] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
Background: Late preterm infants (LPIs; born at 340/7 to 366/7 gestational weeks) and early term infants (ETIs; 370/7 to 386/7 gestational weeks) are at higher risk of morbidity and mortality compared with more mature infants. Breastfeeding can reduce these risks, but feeding difficulties are common among these infants and breastfeeding rates are low. We conducted a systematic review to identify the interventions available to improve any breastfeeding, exclusive breastfeeding, or breast milk yield. Methods: A literature search was performed up to February 23, 2022, using MEDLINE, CINAHL, Embase, and Google Scholar, and nine articles were included. Only one article was a randomized controlled trial, and only one included ETIs. The remaining articles were quasi-experimental and included only LPIs. Outcomes included breastfeeding duration, breastfeeding exclusivity, and/or breast milk production (volume) before 6 months actual age. Results: Professional support significantly improved exclusive breastfeeding rates. A breastfeeding education program delivered at the hospital with weekly telephone follow-up postdischarge significantly increased breastfeeding rates. Neither cup feeding nor early discharge (with in-home lactation support) improved breastfeeding rates, whereas rooming-in (versus direct admission to the neonatal intensive care unit) worsened exclusive breastfeeding rates. Discussion: This is the first systematic review to identify interventions available for both LPIs and ETIs. Overall, there are limited studies that investigate interventions promoting breastfeeding in these populations. However, breastfeeding support delivered by health care professionals seems to improve breastfeeding rates. The main limitations are the lack of randomization, blinding, and adjustment for confounding variables. Experimental studies with robust methodological design are needed.
Collapse
Affiliation(s)
- Sarah Dib
- Department of Population, Policy, and Practice, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Kulnipa Kittisakmontri
- Department of Population, Policy, and Practice, UCL Great Ormond Street Institute of Child Health, London, United Kingdom.,Division of Nutrition, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Jonathan C Wells
- Department of Population, Policy, and Practice, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Mary Fewtrell
- Department of Population, Policy, and Practice, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| |
Collapse
|
14
|
Affiliation(s)
- Sara L Gill
- School of Nursing, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| |
Collapse
|
15
|
Hernández‐Cordero S, Pérez‐Escamilla R, Zambrano P, Michaud‐Létourneau I, Lara‐Mejía V, Franco‐Lares B. Countries' experiences scaling up national breastfeeding, protection, promotion and support programmes: Comparative case studies analysis. Matern Child Nutr 2022; 18 Suppl 3:e13358. [PMID: 35438250 PMCID: PMC9113475 DOI: 10.1111/mcn.13358] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/10/2022] [Accepted: 03/22/2022] [Indexed: 12/28/2022]
Abstract
Scaling up effective interventions, policies and programmes can improve breastfeeding (BF) outcomes. Furthermore, considerable interest exists in learning from relatively recent successful efforts that can inform further scaling up, with appropriate adaptations, across countries. The purpose of this four-country case studies analysis was to examine why and how improvements in BF practices occurred across four contrasting countries; Burkina Faso, the Philippines, Mexico and the United States of America. Literature reviews and key informant interviews were conducted to document BF trends over time, in addition to why and how BF protection, promotion and support policies and programmes were implemented at a national level. A qualitative thematic analysis was conducted. The 'Breastfeeding Gear Model' and RE-AIM (Reach; Effectiveness; Adoption; Implementation; and Maintenance) frameworks were used to understand and map the factors facilitating or hindering the scale up of the national programmes and corresponding improvements in BF practices. Each of the studied countries had different processes and timing to implement and scale up programmes to promote, protect and support breastfeeding. However, in all four countries, evidence-based advocacy, multisectoral political will, financing, research and evaluation, and coordination were key to fostering an enabling environment for BF. Furthermore, in all countries, lack of adequate maternity protection and the aggressive marketing of the breast-milk substitutes industry remains a strong source of negative feedback loops that are undermining investments in BF programmes. Country-specific best practices included innovative legislative measures (Philippines), monitoring and evaluation systems (United States of America), engagement of civil society (Mexico) and behavior change communication BF promotion (Burkina Faso) initiatives. There is an urgent need to improve maternity protection and to strongly enforce the WHO Code of Marketing of Breast-Milk Substitutes.
Collapse
Affiliation(s)
- Sonia Hernández‐Cordero
- Instituto de Investigaciones para el Desarrollo con Equidad (EQUIDE)Universidad IberoamericanaMéxico CityMexico
| | - Rafael Pérez‐Escamilla
- Department of Social and Behavioral SciencesYale School of Public HealthNew HavenConnecticutUSA
| | - Paul Zambrano
- Alive & Thrive Southeast Asia/FHI 360ManilaPhilippines
| | - Isabelle Michaud‐Létourneau
- Department of Social and Preventive Medicine, School of Public HealthUniversité de MontréalMontrealQuebecCanada
| | - Vania Lara‐Mejía
- Instituto de Investigaciones para el Desarrollo con Equidad (EQUIDE)Universidad IberoamericanaMéxico CityMexico
| | - Bianca Franco‐Lares
- Instituto de Investigaciones para el Desarrollo con Equidad (EQUIDE)Universidad IberoamericanaMéxico CityMexico
| |
Collapse
|
16
|
Tomori C, Hernández-Cordero S, Busath N, Menon P, Pérez-Escamilla R. What works to protect, promote and support breastfeeding on a large scale: A review of reviews. Matern Child Nutr 2022; 18 Suppl 3:e13344. [PMID: 35315573 PMCID: PMC9113479 DOI: 10.1111/mcn.13344] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 01/08/2023]
Abstract
Globally women continue to face substantial barriers to breastfeeding. The 2016 Lancet Breastfeeding Series identified key barriers and reviewed effective interventions that address them. The present study updates the evidence base since 2016 using a review of reviews approach. Searches were implemented using the Epistomenikos database. One hundred and fifteen reviews of interventions were identified and assessed for quality and risk of bias. Over half of reviews (53%) were high- or moderate quality, with the remaining low or critically low quality due to weaknesses in assessment of bias. A large portion of studies addressed high-income and upper-middle income settings, (41%), and a majority (63%) addressed health systems, followed by community and family settings (39%). Findings from reviews continue to strengthen the evidence base for effective interventions that improve breastfeeding outcomes across all levels of the social-ecological model, including supportive workplace policies; implementation of the Baby-Friendly Hospital Initiative, skin to skin care, kangaroo mother care, and cup feeding in health settings; and the importance of continuity of care and support in community and family settings, via home visits delivered by CHWs, supported by fathers', grandmothers' and community involvement. Studies disproportionately focus on health systems in high income and upper-middle income settings. There is insufficient attention to policy and structural interventions, the workplace and there is a need for rigorous assessment of multilevel interventions. Evidence from the past 5 years demonstrates the need to build on well-established knowledge to scale up breastfeeding protection, promotion and support programmes.
Collapse
Affiliation(s)
- Cecília Tomori
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA.,Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Natalie Busath
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Purnima Menon
- International Food Policy Research Institute, Delhi, India
| | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Rhode Island, USA
| |
Collapse
|
17
|
Douglas CC, Camel SP, Martínez C. A Brief Media Intervention Influences Collegiate Males' Attitude and Knowledge Towards Breastfeeding. Health Commun 2022:1-9. [PMID: 35188011 DOI: 10.1080/10410236.2022.2037873] [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] [Indexed: 06/14/2023]
Abstract
Breastfeeding is the optimal source of infant nutrition, yet the mother's decision to breastfeed is complex and influenced by factors including social support and breastfeeding knowledge and attitudes. This study employed a two-group pretest-posttest design to examine whether brief, online video presentations (<2.5 minutes in length) could improve breastfeeding knowledge and attitude among males and compare the outcomes between a knowledge-based and attitude-based intervention. Collegiate male participants (N = 213, 18-40 years of age) demonstrated high breastfeeding exposure (90.1% had friends/family breastfeed) and positive attitudes (89.2% accepted women could breastfeed and work outside home) yet knowledge deficits concerning breastfeeding health benefits were identified. Breastfeeding exposure was positively associated with baseline attitude (r(212)=.186, p = .006 and knowledge (r(212)=.229, p = .001. Both intervention groups reported similar gains in attitude scores; only the knowledge-based intervention reported significant gains in knowledge (M = 1.5, SD = 2.63 vs M = -.07, SD = 1.44, (t = -5.496, df = 211, p < .05). Brief online video presentations may constitute an additional exposure to or nudging toward breastfeeding, and breastfeeding knowledge and attitudes can be positively influenced in young adult males with similar interventions that are affordable and require a minimal time commitment.
Collapse
Affiliation(s)
- Crystal Clark Douglas
- College of Health Sciences, Family and Consumer Sciences, Sam Houston State University
- Department of Nutrition and Metabolism, School of Health Professions, The University of Texas Medical Branch
| | - Simone P Camel
- College of Health Sciences, Family and Consumer Sciences, Sam Houston State University
- Department of Human Ecology, College of Applied and Natural Sciences, Louisiana Tech University
| | - Christian Martínez
- College of Health Sciences, Family and Consumer Sciences, Sam Houston State University
| |
Collapse
|
18
|
Affiliation(s)
- Leah S Aldridge
- National Lactation Consultant Alliance, Inc., Atlanta, GA, USA
| |
Collapse
|
19
|
Wu TY, Ford O, Rainville AJ, Bessire R, Yang X, Jackson-Dyer T, Haimout A. Reducing Lactation Support Disparities for a Marginalized Community Through a Policy, Systems, and Environmental Change Approach: A Case Study in Michigan. J Hum Lact 2022; 38:53-60. [PMID: 34971319 DOI: 10.1177/08903344211066836] [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] [Indexed: 11/15/2022]
Affiliation(s)
- Tsu-Yin Wu
- Eastern Michigan University, Center for Health Disparities Innovations and Studies, Ypsilanti, MI, USA
| | - Olivia Ford
- Eastern Michigan University, School of Health Sciences, Ypsilanti, MI, USA
| | - Alice Jo Rainville
- Eastern Michigan University, School of Health Sciences, Ypsilanti, MI, USA
| | - Rachel Bessire
- Eastern Michigan University, Center for Health Disparities Innovations and Studies, Ypsilanti, MI, USA
| | - Xining Yang
- Department of Geography and Geology, Eastern Michigan University, Ypsilanti, MI, USA
| | - Tameka Jackson-Dyer
- Eastern Michigan University, Center for Health Disparities Innovations and Studies, Ypsilanti, MI, USA
| | - Amaal Haimout
- Wayne County Healthy Communities, Hamtramck, Michigan, MI, USA
| |
Collapse
|
20
|
Chetwynd EM. The WHO Code for Marketing of Breast Milk Substitutes: Private Sector Power and Industry Accountability. J Hum Lact 2022; 38:61-63. [PMID: 34763563 DOI: 10.1177/08903344211057481] [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] [Indexed: 11/16/2022]
Affiliation(s)
- Ellen M Chetwynd
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
21
|
De Souza CB, Venancio SI, da Silva RPGVC. Breastfeeding Support Rooms and Their Contribution to Sustainable Development Goals: A Qualitative Study. Front Public Health 2022; 9:732061. [PMID: 35004566 PMCID: PMC8733197 DOI: 10.3389/fpubh.2021.732061] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Breastfeeding support rooms are low-cost interventions that may prolong breastfeeding and improve work performance. Thus, we sought to understand the experiences and perceptions of working women who use breastfeeding support rooms and the potential contribution to sustainable development goals. Methods: Descriptive and exploratory research was conducted through convenience sampling of women working in companies with breastfeeding support rooms in the state of Paraná, Brazil. A semi-structured questionnaire was applied through interviews and online self-completion. Results: Fifty-three women between 28 and 41 years old participated in the study. In addition, 88.7% had graduated from college, and 96% were married. From the women's experiences and perceptions, we identified that breastfeeding support rooms contribute to prolonged breastfeeding, improve physical and emotional well-being, allow women to exercise their professional activities comfortably, contribute to women's professional appreciation for the excellent relationship between employees and employers. Conclusion: In this novel study, we demonstrate how, from a female point of view, breastfeeding support rooms can contribute to 8 of the 17 sustainable development goals and should therefore be encouraged and promoted.
Collapse
|
22
|
Oliveira MGD, Valle Volkmer DDF. Factors Associated With Breastfeeding Very Low Birth Weight Infants at Neonatal Intensive Care Unit Discharge: A Single-Center Brazilian Experience. J Hum Lact 2021; 37:775-783. [PMID: 33351685 DOI: 10.1177/0890334420981929] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND The mothers of very low birth weight infants face many challenges to achieve breastfeeding at hospital discharge, especially during long stays. RESEARCH AIM The aim of this study was to describe the incidence and factors associated with breastfeeding rates (exclusive or with formula) at discharge, for very low birth weight infants, in a private Neonatal Intensive Care Unit in southern Brazil. METHODS We conducted a prospective longitudinal cohort study of infants (N = 335) with very low birth weight and/or less than 30 weeks gestational age, who survived to discharge and had no contraindication to mother's own milk. Participants were initially divided into three groups (exclusive breastfeeding, some breastfeeding, and no breastfeeding) based on their feedings at discharge; however, later, two groups were analyzed (any breastfeeding, no breastfeeding). RESULTS Most (93.4%; n = 313) were breastfeeding directly at least once daily at discharge, of which 16.1% (n = 54) were receiving exclusive mother's milk and 77.3% (n = 259) mixed feeding (mother's milk and formula). Breastfeeding at discharge was associated with gestational age ≥ 28 weeks, higher birth weight, not developing neonatal sepsis or bronchopulmonary dysplasia during the hospital stay, shorter lengths of stay, and lower weight at discharge. After Poisson regression, breastfeeding at discharge was associated only with a shorter length of stay (RR 0.98; CI 95% [0.95, 0.99], p < .05). CONCLUSIONS In our single unit experience in Brazil, most infants were breastfeeding at discharge. NICU staff might address mothers of infants who have prolonged hospitalization with specific strategies. Mothers and infants at risk can be identified early and personalized interventions can be developed for improving breastfeeding rates at discharge.
Collapse
Affiliation(s)
- Mariana González de Oliveira
- 156417 Neonatal Intensive Care Unit, Hospital Moinhos de Vento, RS, Brazil.,Federal University of Health Sciences of Porto Alegre, RS, Brazil
| | | |
Collapse
|
23
|
Abstract
BACKGROUND The continuity of maternal depressive symptoms throughout the perinatal period and breastfeeding problems have adverse influences on breastfeeding. RESEARCH AIM To compare the feeding patterns and breastfeeding experiences, maternal health and mental health, and breastfeeding self-efficacy between women with depressive symptoms who participated in a prenatal individualized mixed management intervention and those who received usual care. METHODS Chinese primigravida (N = 182) with an Edinburgh Postnatal Depression Scale score ≥ 9 in late pregnancy (≥ 28 weeks and < 35 weeks) were randomly assigned to the intervention group (n = 84) or the control group (n = 84). Intervention group participants received four sessions of individualized mixed management combining psycho-education and breastfeeding education. Breastfeeding self-efficacy, feeding patterns, maternal depression, and health status were evaluated in both groups. RESULTS Significant differences were noted between the groups in breastfeeding self-efficacy at 42 days postpartum (p < .05) and feeding patterns at 3 months and 6 months postpartum (p < .05). Repeated measures analysis of variance showed significant differences in the EPDS scores between groups at three postpartum time points (p < .05). The intervention group had significantly lower postpartum depression as diagnosed by the MINI (p < .05). CONCLUSIONS A prenatal individualized mixed management intervention holds promise as an effective prevention and health promotion program addressing breastfeeding outcomes and maternal mental health.This RCT was registered (ChiCTR-IOR-17013761) with Chinese Clinical Trial Registry, http://www.chictr.org.cn/enIndex.aspx on 12/7/2017.
Collapse
Affiliation(s)
- Ying Zhao
- 12478 School of Nursing, Fudan University, Shanghai, PR China
| | - Qiping Lin
- 92276 Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| | - Xinli Zhu
- 92276 Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| | - Jing Wang
- 92276 Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| |
Collapse
|
24
|
|
25
|
Witkowska-Zimny M, Majczyna D. How Knowledge about Stem Cells Influences Attitudes towards Breastfeeding: Case Study of Polish Women. Int J Environ Res Public Health 2021; 18:2382. [PMID: 33804414 DOI: 10.3390/ijerph18052382] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 11/22/2022]
Abstract
Maternal breastfeeding is associated with multiple health benefits, both for the child and the mother. Since breastfeeding rates are declining, finding new, future-oriented strategies to strengthen and support mothers’ positive attitudes towards breastfeeding need to be developed. In this paper, we describe how information about the presence of stem cells in breast milk can influence the willingness to breastfeed in the population of Polish pregnant women. A cross-sectional study involving a group of 150 pregnant women was conducted to assess the correlation between their knowledge about stem cells and their attitude towards breastfeeding. Among the respondents, only 6% claimed that they did not know anything about stem cells, but general knowledge about stem cells in the research group was poor. The survey results indicated that city residence, university degree, maternal experience and advanced pregnancy correlated with higher general knowledge regarding stem cells. Most respondents (77.3%) had no knowledge regarding the presence of stem cells in breast milk. Approximately two-thirds of mothers with earlier negative breastfeeding experience declared that information about the presence of stem cells in breast milk could have influenced the decision to continue and extend the time of breastfeeding. Hence highlighting the presence of stem cells in breast milk can be used to encourage breastfeeding as a unique activity.
Collapse
|
26
|
Abstract
BACKGROUND Negative attitudes toward breastfeeding in public have consistently been identified as a key barrier to breastfeeding continuation. In order to design effective social marketing campaigns to improve public attitude toward breastfeeding in public, it is critical to identify segments of the population who are less likely to support this activity, their underlying reasons, and the medium through which they can be reached. RESEARCH AIM The aims were to (a) identify the underlying dimensions that drive acceptance or opposition to breastfeeding in public, (b) test whether specific population segments were more or less likely to support breastfeeding in public, and (c) identify suitable media outlets to reach them. METHODS A cross-sectional survey testing agreement with 60 statements was administered online between May 2016 and May 2017 and was completed by 7190 respondents. Exploratory factor analysis was used to identify 12 dimensions driving acceptance or opposition to breastfeeding in public. The influence of demographics and media consumption on attitudes toward breastfeeding in public was tested using Welch's t tests and one-way analyses of variance (ANOVAs). RESULTS Acceptance of breastfeeding in public was found to differ with gender, age, religion, and parental and breastfeeding status, but not household income. Support for breastfeeding in public also varied with media consumption habits. CONCLUSIONS This work lays the foundation to design effective social marketing campaigns aimed at increasing public support for breastfeeding in public.
Collapse
Affiliation(s)
- Cecile Morris
- Food and Nutrition Group, Sheffield Business School, Sheffield Hallam University, Sheffield, UK
| | - Peter Schofield
- Department of Service Sector Management, Sheffield Business School, Sheffield Hallam University, Sheffield, UK
| | - Craig Hirst
- Food and Nutrition Group, Sheffield Business School, Sheffield Hallam University, Sheffield, UK
| |
Collapse
|
27
|
Dall'Oglio I, Marchetti F, Mascolo R, Amadio P, Gawronski O, Clemente M, Dotta A, Ferro F, Garofalo A, Salvatori G, Tarantino A, Tiozzo E, Giusti A. Breastfeeding Protection, Promotion, and Support in Humanitarian Emergencies: A Systematic Review of Literature. J Hum Lact 2020; 36:687-698. [PMID: 32032499 DOI: 10.1177/0890334419900151] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Infants, young children, and their mothers are vulnerable in humanitarian emergencies. The health benefits of optimal breastfeeding practices in emergency settings have been demonstrated by many researchers. Infant and Young Children Feeding in Emergency guidelines illustrate a series of interventions to protect, promote, and support breastfeeding, but unfortunately, these recommendations are still scarcely applied. RESEARCH AIMS (1) To review the literature describing the effectiveness of breastfeeding protection, promotion, and support interventions in humanitarian emergency contexts; (2) to describe the influence of interventions on breastfeeding initiation, exclusivity, and duration; and (3) to evaluate relevant mother and infant/child outcomes available in the literature. METHODS PubMed, CINAHL, Cochrane Library, Psychology Database, JSTOR, Web of Science, EMBASE, and Ovid were searched for articles that examined breastfeeding protection, promotion, or support interventions and the resulting outcomes without any time limits (N = 10). Articles that did not include the interventions and related outcomes were excluded (n = 1,391). RESULTS Improved breastfeeding outcomes were reported in four (40%) papers, and three (30%) highlighted a behavioral change in infant and young child feeding practices following the implementation of the interventions. Increased knowledge about appropriate infant and young child feeding practices among mothers and humanitarian/health staff was reported in eight (80%) papers. However, outcomes were sometimes only generically reported, and some of the included papers had a low strength of evidence. CONCLUSION In the literature, there is a great dearth of studies evaluating the influence of interventions aimed at improving breastfeeding in emergency settings. More evidence is urgently needed to encourage and implement optimal breastfeeding practices.
Collapse
Affiliation(s)
- Immacolata Dall'Oglio
- Health Professions Development, Continuing Education and Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesca Marchetti
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Rachele Mascolo
- Health Professions Development, Continuing Education and Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Patrizia Amadio
- Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Orsola Gawronski
- Health Professions Development, Continuing Education and Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maria Clemente
- Neonatology, Department of Life and Reproduction Science, University of Verona, Italy
| | - Andrea Dotta
- Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Federico Ferro
- Health Professions Development, Continuing Education and Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Antonio Garofalo
- Health Professions Development, Continuing Education and Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Guglielmo Salvatori
- Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Antonella Tarantino
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Emanuela Tiozzo
- Health Professions Development, Continuing Education and Research Service, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | |
Collapse
|
28
|
Singletary N, Goodell LS, Fogleman A. Exploring North Carolina Family and Consumer Sciences Teachers' Attitudes Towards Breastfeeding and Infant Feeding Education Practices. J Hum Lact 2020; 36:766-775. [PMID: 31412211 DOI: 10.1177/0890334419867104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND The World Health Organization (WHO) and the United Kingdom Committee for UNICEF recommend that secondary schools include infant feeding education in the curriculum. However, little attention has been given to the study of educators' views and practices regarding infant feeding education. AIMS The aims of this research were to (1) explore North Carolina Family and Consumer Sciences teachers' attitudes towards infant feeding education in secondary schools and (2) describe North Carolina Family and Consumer Sciences teachers' infant feeding education practices. METHODS Researchers conducted interviews (N = 19) and a survey (N = 137) using a sequential mixed methods design. The constant comparative method was used to analyze interview transcripts. Subsequently, a 33-item survey was developed to assess teachers' attitudes and practices, and this survey was tested for validity and reliability. RESULTS The majority of participants supported including infant feeding (n = 119, 86.9%) and breastfeeding (n = 116, 84.7%) education in high school. Approximately half of the participants supported including infant feeding (n = 71, 51.9%) and breastfeeding (n = 64, 46.7%) education in middle school. Participants reported that they taught infant feeding at both levels; topics taught included complementary foods, patterns of infant feeding, and the safe preparation of infant formula. Breastfeeding content was covered primarily in the high school Parenting and Child Development course. CONCLUSIONS North Carolina Family and Consumer Sciences teachers have positive attitudes towards teaching about breastfeeding at the secondary school level. Content about infant nutrition and breastfeeding is currently included in courses that cover child development and human nutrition.
Collapse
|
29
|
|
30
|
Kyenkya MI, Marinelli KA. Being There: The Development of the International Code of Marketing of Breast-milk Substitutes, the Innocenti Declaration and the Baby-Friendly Hospital Initiative. J Hum Lact 2020; 36:397-403. [PMID: 32544016 DOI: 10.1177/0890334420926951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 11/15/2022]
Abstract
Margaret Isabirye Kyenkya (photo) grew up in Uganda with five bothers and six sisters. Her Bachelor of Arts was in Social Work and Social Administration (Makerere University, Uganda), and was followed by a Masters in Sociology, (Nairobi University), and a Certificate in Mother and Child Health (International Child Health Institute, London). Her PhD focused on Hospital Administration inspired by the WHO/UNICEF Baby Friendly Hospital Initiative. She has worked as a researcher, the founder of Non-Governmental Organizations, a Senior United Nations Officer (New York Headquarters and several regions), a Manager in the United States Agency for International Development-funded National Health and Nutrition Projects, and a governmental Health and Nutrition Adviser. A certified trainer in a number of health and nutrition areas, a breastfeeding counselor, and a retired La Leche League Leader, Dr. Kyenkya has significantly influenced the course of lactation support and promotion globally. She stated, "My most precious and valued occupation is that of a mother [of five] and grandmother [of eight]." Dr. Kyenkya currently lives in Atlanta, Georgia, in the United States. (This interview was conducted in-person and transcribed verbatim. It has been edited for ease of readability. MK refers to Margaret Kyenkya; KM refers to Kathleen Marinelli.).
Collapse
Affiliation(s)
| | - Kathleen A Marinelli
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, USA.,20425Division of Neonatology, Connecticut Children's' Medical Center, Hartford, CT, USA
| |
Collapse
|
31
|
Davanzo R, Moro G, Sandri F, Agosti M, Moretti C, Mosca F. Breastfeeding and coronavirus disease-2019: Ad interim indications of the Italian Society of Neonatology endorsed by the Union of European Neonatal & Perinatal Societies. Matern Child Nutr 2020; 16:e13010. [PMID: 32243068 PMCID: PMC7296820 DOI: 10.1111/mcn.13010] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 03/30/2020] [Accepted: 03/30/2020] [Indexed: 12/16/2022]
Abstract
The recent COVID-19 pandemic has spread to Italy with heavy consequences on public health and economics. Besides the possible consequences of COVID-19 infection on a pregnant woman and the fetus, a major concern is related to the potential effect on neonatal outcome, the appropriate management of the mother-newborn dyad, and finally the compatibility of maternal COVID-19 infection with breastfeeding. The Italian Society on Neonatology (SIN) after reviewing the limited scientific knowledge on the compatibility of breastfeeding in the COVID-19 mother and the available statements from Health Care Organizations has issued the following indications that have been endorsed by the Union of European Neonatal & Perinatal Societies (UENPS). If a mother previously identified as COVID-19 positive or under investigation for COVID-19 is asymptomatic or paucisymptomatic at delivery, rooming-in is feasible, and direct breastfeeding is advisable, under strict measures of infection control. On the contrary, when a mother with COVID-19 is too sick to care for the newborn, the neonate will be managed separately and fed fresh expressed breast milk, with no need to pasteurize it, as human milk is not believed to be a vehicle of COVID-19. We recognize that this guidance might be subject to change in the future when further knowledge will be acquired about the COVID-19 pandemic, the perinatal transmission of SARS-CoV-2, and clinical characteristics of cases of neonatal COVID-19.
Collapse
Affiliation(s)
- Riccardo Davanzo
- Institute for Maternal and Child HealthIRCCS “Burlo Garofolo”TriesteItaly
- Technical Panel on BreastfeedingMinistry of HealthRomeItaly
| | - Guido Moro
- Human Milk Banking Association of Italy (AIBLUD)MilanItaly
| | | | | | - Corrado Moretti
- President of Union of European Neonatal and Perinatal Societies; Emeritus Consultant in Pediatrics, Policlinico Umberto ISapienza UniversityRomeItaly
| | - Fabio Mosca
- President of Italian Society of Neonatology; Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoUniversity of MilanItaly
| |
Collapse
|
32
|
Reat A, Matthews KJ, Carver AE, Perez CA, Stagg J, Byrd-Williams CE. Support for Breastfeeding Employees: Assessing Statewide Worksite Lactation Support Recognition Initiatives in the United States. J Hum Lact 2020; 36:328-336. [PMID: 31437403 DOI: 10.1177/0890334419865902] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although the reasons for discontinued breastfeeding are multifactorial, an unsupportive work environment is consistently reported as a barrier to continued breastfeeding. In the United States, several state breastfeeding advocates have taken a distinctive approach to promote worksite lactation support by developing statewide recognition initiatives aimed at incentivizing employers to support breastfeeding employees by offering public recognition for the worksites' efforts. RESEARCH AIM To identify and describe statewide worksite lactation support recognition initiatives in the United States. METHODS Between May 2016 and June 2017, semi-structured phone interviews were conducted with breastfeeding experts in each U.S. state (N = 60 participants) for this cross-sectional study. Experts in states with a recognition initiative were asked about the background, structure, and requirements of the initiative. RESULTS Twenty-six states had a current initiative, and some had requirements for providing a private space (n = 19; 73%) and time (n = 18; 69%) for employees to express human milk, as well as a written worksite lactation support policy (n = 10; 38%). CONCLUSIONS This was the first study in which researchers systematically identified ongoing worksite lactation support recognition initiatives in the United States. The results of this work also served to highlight both the similarities and the variety between initiatives. Future researchers should aim to determine the components of an initiative that increase employer support and, in turn, breastfeeding rates.
Collapse
Affiliation(s)
- Amanda Reat
- 12340 Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health in Austin, Austin, TX, USA
| | - Krystin J Matthews
- 12340 Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health in Austin, Austin, TX, USA
| | - Alma E Carver
- 12340 Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health in Austin, Austin, TX, USA
| | - Cristell A Perez
- 12340 Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health in Austin, Austin, TX, USA
| | - Julie Stagg
- 8193 Texas Department of State Health Services, Austin, TX, USA
| | - Courtney E Byrd-Williams
- 12340 Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health in Austin, Austin, TX, USA
| |
Collapse
|
33
|
Chen CH, Chen RC, Chen MS, Chen LC, Wei HY. Challenges and Outcomes of Using the Ten Steps to Successful Breastfeeding in the Mother-Baby Friendly Institute Program in Taiwan. J Hum Lact 2020; 36:187-191. [PMID: 31084568 DOI: 10.1177/0890334419839366] [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] [Indexed: 11/15/2022]
Affiliation(s)
- Chao-Huei Chen
- Center for Faculty Development, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Medicine, National Yang-Ming University, Taiwan
| | - Ran-Chou Chen
- Health Promotion Administration, Ministry of Health and Welfare, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taiwan
| | - Miauh-Shin Chen
- Health Promotion Administration, Ministry of Health and Welfare, Taiwan
| | - Li-Chuan Chen
- Health Promotion Administration, Ministry of Health and Welfare, Taiwan
| | - Hsing-Yu Wei
- Health Promotion Administration, Ministry of Health and Welfare, Taiwan
| |
Collapse
|
34
|
Martinez-Brockman JL, Harari N, Goeschel L, Bozzi V, Pérez-Escamilla R. A qualitative analysis of text message conversations in a breastfeeding peer counselling intervention. Matern Child Nutr 2019; 16:e12904. [PMID: 31823503 PMCID: PMC7083457 DOI: 10.1111/mcn.12904] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 09/16/2019] [Accepted: 09/25/2019] [Indexed: 11/28/2022]
Abstract
The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) breastfeeding peer counselling (BFPC) program supports optimal early life nutrition by providing evidenced‐based breastfeeding protection, promotion, and support. The Lactation Advice Through Texting Can Help (LATCH) study was a randomized controlled trial that tested the effectiveness of a text messaging intervention designed to augment the BFPC program. The purpose of the present study was to understand the topics discussed during the text message exchanges between breastfeeding peer counsellors (PCs) and their clients in the intervention arm of the LATCH study, from the time of enrollment up to two‐weeks postpartum. Text messaging data were first coded and analysed for one‐ and two‐way text message exchanges. Text messages of participants with a high volume of two‐way exchanges were then analysed qualitatively. Four domains were identified in both the prenatal and postpartum periods: the mechanics of breastfeeding, social support, baby's nutrition, and PCs maintaining contact with participants. Additional themes and subthemes identified in the postpartum period included the discussion of breastfeeding problems such as latching trouble engorgement, plugged ducts, pumping, other breastfeeding complications, and resuming breastfeeding if stopped. Two‐way text messaging in the context of the WIC BFPC program provides an immediate and effective method of substantive communication between mothers and their PC.
Collapse
Affiliation(s)
| | - Nurit Harari
- Chinle Comprehensive Health Care Facility, Indian Health Service, Chinle, Arizona
| | - Lori Goeschel
- Connecticut Special Supplemental Nutrition Program for Women, Infants, and Children, Community, Family and Health Equity Section, Connecticut Department of Public Health, Hartford, Connecticut
| | - Valerie Bozzi
- Breastfeeding Heritage and Pride Program, Yale New Haven Hospital, New Haven, Connecticut
| | - Rafael Pérez-Escamilla
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
| |
Collapse
|
35
|
Abstract
BACKGROUND Researchers exploring breastfeeding attitudes and knowledge among women suggest the decision to breastfeed is influenced by the male partner, yet few studies address males. Because collegiate males will soon enter fatherhood, assessment of their attitudes and knowledge may inform interventions aimed at increasing intention to breastfeed. RESEARCH AIM This study aimed to describe collegiate males' exposure to, attitude toward, and knowledge about breastfeeding. METHODS A cross-sectional online survey was used with males ≥ 18 years of age enrolled at a Texas public university. Attitude indices measured included social limitations, public displays of breastfeeding, and employer accommodations. Descriptive statistics, correlational and regression analyses were employed. RESULTS The participants' (N = 949) average age was 25.48 years; > 80% reported not being fathers. Exposure to breastfeeding was high; > 80% witnessed breastfeeding and/or had someone close breastfeed. High attitude scores indicated social acceptability of breastfeeding. Knowledge appeared limited: only 16% identified the recommendation of exclusive breastfeeding for the first 6 months of life; > 50% overlooked the reduced risk for overweight/obesity, ear infections, diarrhea, or food allergies. Correlations between knowledge, exposure, total attitude, and index scores were positive (p < .01) except for the public displays index. Stepwise multiple regression determined that breastfeeding exposure, knowledge scores, and father's educational level predicted total attitude score, (R2 = 0.13, F (3,851) = 44.02, p < .01). CONCLUSION The positive attitudes outcome among this male population is promising for breastfeeding support and advocacy. Education efforts improving knowledge will likely increase behavioral intention, resulting in increased breastfeeding rates and duration.
Collapse
Affiliation(s)
- Leslie Heathman
- Huntsville Memorial Hospital, Food & Nutrition Services, Huntsville, TX, USA
| | - Crystal Clark Douglas
- Sam Houston State University, College of Health Sciences, Family and Consumer Sciences, Huntsville, TX, USA
| | - Simone P Camel
- Sam Houston State University, College of Health Sciences, Family and Consumer Sciences, Huntsville, TX, USA
| |
Collapse
|
36
|
Lebron CN, St George SM, Eckembrecher DG, Alvarez LM. "Am I doing this wrong?" Breastfeeding mothers' use of an online forum. Matern Child Nutr 2019; 16:e12890. [PMID: 31568669 PMCID: PMC6937377 DOI: 10.1111/mcn.12890] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/27/2019] [Accepted: 08/29/2019] [Indexed: 01/06/2023]
Abstract
As mothers seek out information around breastfeeding, many are turning to online message boards, listservs, or social media for advice. Babycenter.com, a parenting website with widespread use, hosts a Breastfeeding Support and Help community forum with over 140,000 users and more than one million conversation threads. The purpose of this study is to examine this online support forum to understand the information seeking and sharing practices of its users. We extracted a total of 258 original posts and 1,445 corresponding comments from Babycenter.com's breastfeeding forum posted over a 10-day period. Using content analysis, we coded the posts into 15 categories reflective of the types of information users were seeking. We then randomly selected 45 conversation threads across the most popular categories to further understand how users were sharing information. The most popular breastfeeding topics for which users sought out information included feeding challenges, supply issues, feeding schedule and duration, pumping, physical health, excretion issues, storing milk, nipple issues, and general breastfeeding questions. Participants elicited information from others using interviewing questions and built consensus around issues by agreeing with previous posts. They shared their knowledge and personal breastfeeding experiences and also provided encouragement to continue breastfeeding and overcome challenges. Online support forums are actively being used by breastfeeding mothers seeking information from others with similar experiences. This presents an important resource for breastfeeding mothers and may, therefore, be an important component of future breastfeeding interventions.
Collapse
Affiliation(s)
- Cynthia N Lebron
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Sara M St George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Daphne G Eckembrecher
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lucia M Alvarez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| |
Collapse
|
37
|
Abstract
BACKGROUND Numerous efforts to promote breastfeeding resulted in a steady increase in the rates of breastfeeding initiation and duration. Increasing numbers of breastfeeding interventions are focused on breastfeeding maintenance and exclusivity and based on behavioral theories. Few studies critically analyzed the use of theories in breastfeeding intervention development and evaluation. RESEARCH AIM The aim of this critical review was to examine the existing literature about breastfeeding intervention, and investigate the role of theory in its development, implementation, and evaluation to provide future directions and implications for breastfeeding interventions. METHODS This critical review examined the existing breastfeeding intervention studies that used self-efficacy theories (SE), theory of planned behavior (TPB), and social cognitive theory (SCT) and were published during the past decade. Using five databases, studies in which researchers explicitly applied these three theories to frame the intervention were selected. Studies were critically reviewed for fidelity to theory in intervention design, delivery, and evaluation. RESULTS Eighteen studies were reviewed: nine SE-, five TPB-, and four SCT-based. Most interventions were focused on building mothers' breastfeeding self-efficacy to improve breastfeeding exclusivity and duration. To achieve this goal, researchers who developed SE-based interventions used individual approaches, whereas other researchers who based studies on TPB incorporated social and environmental changes. SE-based studies were more likely to include theory-based instruments, but TPB- and SCT-based studies demonstrated less consistent choices of measurement. Researchers in most studies did not test the relationships between the proposed theoretical constructs and breastfeeding outcomes as guided by theories. Inconsistent outcomes resulted among the studies due to variations in study follow-ups. CONCLUSION Sound applications of single or multiple theories demonstrate a great potential to help practitioners and researchers develop effective breastfeeding interventions and evaluate true impacts on positive breastfeeding outcomes.
Collapse
Affiliation(s)
- Yeon K Bai
- 1 Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ, USA
| | - Soyoung Lee
- 2 Department of Family Science and Human Development, Montclair State University, Montclair, NJ, USA
| | - Kaitlin Overgaard
- 1 Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ, USA
| |
Collapse
|
38
|
Robert E, Michaud-Létourneau I, Dramaix-Wilmet M, Swennen B, Devlieger R. A comparison of exclusive breastfeeding in Belgian maternity facilities with and without Baby-friendly Hospital status. Matern Child Nutr 2019; 15:e12845. [PMID: 31106522 DOI: 10.1111/mcn.12845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 04/26/2019] [Accepted: 05/08/2019] [Indexed: 11/30/2022]
Abstract
A retrospective cross-sectional study was carried out in Wallonia (the southern region of Belgium) in which a 20-question breastfeeding (BF) module was included in an immunization survey. The purpose of this paper is to compare exclusive breastfeeding (EBF) prevalences and BF practices for mothers giving birth in Baby-friendly Hospital Initiative (BFHI) and non-BFHI maternity facilities. A total of 557 mothers responded to BF questions when their child was 18-24 months old; 26.7% of them delivered in a BFHI maternity facility. At discharge, a larger proportion of children were exclusively breastfed if they were born in a BFHI maternity facility (76.5% vs. 65.8%, p = .02). The median duration of EBF (15.0 vs. 12.9 weeks, p = .3), and the proportion of children exclusively breastfed at 5 months (16.8% vs 15.8%, p = 1.0) were similar in both groups. Few mothers knew that EBF was recommended for the first 6 months of life (28.6% in BFHI vs 23.1% in non-BFHI, p = .2). For most groups of the population examined, the rates of BF tended to be higher in BFHI facilities, but many differences were not significant. More specifically, BFHI seemed to boost BF practices among mothers more likely to breastfeed, but the Initiative did not seem to trigger enhanced BF practices in mothers traditionally less likely to breastfeed (except for indifferent/negative partner's attitude and mothers of Belgian origin). Influencing the BF practices of mothers less likely to breastfeed requires a special attention with complementary actions in maternity facilities as well as in community services.
Collapse
Affiliation(s)
- Emmanuelle Robert
- School of Public Health, Research Center of Epidemiology, Biostatistics and Clinical Research, Université libre de Bruxelles, Brussels, Belgium
| | - Isabelle Michaud-Létourneau
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada
| | - Michèle Dramaix-Wilmet
- School of Public Health, Research Center of Epidemiology, Biostatistics and Clinical Research, Université libre de Bruxelles, Brussels, Belgium
| | - Béatrice Swennen
- School of Public Health, Research Center of Health Policy and Systems - International Health, Université libre de Bruxelles, Brussels, Belgium
| | - Roland Devlieger
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.,Department of Obstetrics, Gynecology and Fertility, Gasthuiszusters Antwerpen, Wilrijk, Belgium
| |
Collapse
|
39
|
Kair LR, Nickel NC, Jones K, Kornfeind K, Sipsma HL. Hospital breastfeeding support and exclusive breastfeeding by maternal prepregnancy body mass index. Matern Child Nutr 2019; 15:e12783. [PMID: 30659747 DOI: 10.1111/mcn.12783] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 01/13/2023]
Abstract
Overweight and obese mothers in the United States have disproportionately lower rates of exclusive breastfeeding than mothers of normal weight. The Ten Steps to Successful Breastfeeding (Ten Steps), a series of evidence-based practices designed to support breastfeeding initiation, duration, and exclusivity, demonstrate effectiveness at the population level. It is unknown, however, whether they are consistently provided to women across all maternal body mass index (BMI) categories. We sought to determine whether pre-pregnancy BMI is associated with the implementation and effectiveness of the Ten Steps. We used data from Listening to Mothers III, a cross-sectional survey administered to a sample of mothers who delivered in U.S. hospitals between July 2011 and June 2012. Measures of the Ten Steps were based on maternal self-report on Listening to Mothers III. Our analytic sample was limited to mothers of term infants intending to breastfeed (N = 1,506, weighted). We conducted chi-square testing and constructed weighted multivariable logistic regression models to account for potential confounders. Results suggest that two practices (i.e., holding their babies skin-to-skin for the first time and being encouraged to breastfeed on demand) were more strongly associated with exclusive breastfeeding among mothers with obesity than other mothers. Additionally, mothers with obesity reported holding babies skin-to-skin significantly less often than other mothers. Thus, interventions aimed at helping mothers with obesity to hold their babies skin-to-skin in the first hour and teaching them to breastfeed on demand have the potential to decrease the breastfeeding disparities in this population.
Collapse
Affiliation(s)
- Laura R Kair
- Department of Pediatrics, University of California Davis, Sacramento, California, USA
| | - Nathan C Nickel
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Krista Jones
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Katelin Kornfeind
- Department of Public Health, Benedictine University, Lisle, Illinois, USA
| | - Heather L Sipsma
- Department of Public Health, Benedictine University, Lisle, Illinois, USA
| |
Collapse
|
40
|
Grant GJ, Agoliati AP, Echevarria GC, Lax J. Epidural Analgesia to Facilitate Breastfeeding in a Grand Multipara. J Hum Lact 2019; 35:165-167. [PMID: 29986159 DOI: 10.1177/0890334418784269] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Gilbert J Grant
- 1 Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University School of Medicine, New York, NY, USA
| | - Andrew P Agoliati
- 1 Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University School of Medicine, New York, NY, USA
| | - Ghislaine C Echevarria
- 1 Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University School of Medicine, New York, NY, USA
| | - Jerome Lax
- 1 Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University School of Medicine, New York, NY, USA
| |
Collapse
|
41
|
McGlothen KS, Cleveland LM. The Right to Mother's Milk: A Call for Social Justice That Encourages Breastfeeding for Women Receiving Medication-Assisted Treatment for Opioid Use Disorder. J Hum Lact 2018; 34:799-803. [PMID: 30040908 DOI: 10.1177/0890334418789401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Indexed: 11/16/2022]
Affiliation(s)
- Kelly S McGlothen
- 1 School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Lisa M Cleveland
- 1 School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| |
Collapse
|
42
|
Munn AC, Newman SD, Phillips SM, Mueller M, Taylor SN. Factors Influencing Southeastern U.S. Mothers' Participation in Baby-Friendly Practices: A Mixed-Methods Study. J Hum Lact 2018; 34:821-834. [PMID: 29432703 DOI: 10.1177/0890334417750143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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] [Indexed: 12/11/2022]
Abstract
BACKGROUND Mothers in the southeastern United States, including rural-dwelling and African American mothers, have historically had low rates of breastfeeding; however, no studies have investigated these mothers' experiences of breastfeeding support processes associated with the Baby-Friendly Hospital Initiative. Research aim: This study aimed to determine factors influencing southeastern U.S. mothers' participation in Baby-Friendly practices and breastfeeding decisions. METHODS Using a convergent parallel mixed-methods design, medical record review of mother-infant dyads ( n = 234) provided data to determine if those who participated in more than half of the Ten Steps to Successful Breastfeeding had improved breastfeeding outcomes. Logistic regression was conducted to determine whether maternal demographic/clinical characteristics were predictive of Baby-Friendly practice participation. Qualitative methods included in-depth interviews ( n = 16). Directed content analysis was conducted to identify themes. Results of the analysis of the two data sets were triangulated to enhance understanding of mothers' barriers to and facilitators of participation in Baby-Friendly practices. RESULTS Rural-dwelling and African American mothers had greater odds of nonparticipation in Baby-Friendly practices relative to other groups (odds ratios = 5 and 10, respectively; p ≤ .01). Mothers who received lactation consultation and had moderate (15-44 min) or completed (≥ 45 min) skin-to-skin contact had greater odds of participation in Baby-Friendly practices (both odds ratios ≥ 17.5; p < .05). Directed content analysis revealed six themes: maternal desire to breastfeed, infant state, maternal state, milk supply concerns, provider support, and access to breastfeeding equipment and support services. CONCLUSION Rural-dwelling African American mothers had limited knowledge of Baby-Friendly practices; however, culturally tailored services could improve Baby-Friendly practice participation and breastfeeding success.
Collapse
Affiliation(s)
- Allison C Munn
- 1 Department of Nursing, Francis Marion University, Florence, SC, USA
| | - Susan D Newman
- 2 College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Shannon M Phillips
- 2 College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Martina Mueller
- 2 College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Sarah N Taylor
- 3 Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| |
Collapse
|
43
|
Abstract
In response to suboptimal breastfeeding rates, North Dakota added a provision to SB 2344 (public indecency legislation) creating an Infant Friendly business designation for employers providing specified lactation accommodations to employees. However, there has been no evaluation of this designation to determine effectiveness. The purpose of this article is to examine the impact of the Infant Friendly business designation in North Dakota on breastfeeding continuation rates within the context of the social ecological model (SEM). Between November 2016 and March 2017, an 85-item online questionnaire, designed using the SEM, was distributed to working women across the state using various sampling methods. T tests, analysis of variance, and regression were used to analyze results. Designated (intervention) and nondesignated (control) businesses were targeted. There was no statistically significant difference in breastfeeding duration between designated and nondesignated businesses. There was a 2-month difference in duration between continually designated businesses and those with lapsing designations. Twenty-eight percent of the women working for Infant Friendly businesses were aware that their businesses were designated, indicating a lack of awareness regarding the designation. The designation is a starting point for worksite breastfeeding support. A policy promotion plan based on the SEM targeting individual awareness and employee education may improve the designation's effectiveness.
Collapse
|
44
|
|
45
|
Abstract
BACKGROUND Increasing breastfeeding rates among low-income African American women may work toward the achievement of health equity. The dynamic breastfeeding assessment process (D-BAP) is a community-grounded, equity-focused intervention designed to increase prenatal breastfeeding self-efficacy. Research aim: The aims of the pilot study were (a) to determine the effect of the D-BAP on breastfeeding self-efficacy among pregnant, low-income African American women, (b) to examine the findings among women with no previous breastfeeding experience, and (c) to compare the findings between women with prior breastfeeding experience and those without it. METHODS A pre/post, paired-samples design was utilized. Convenience sampling was used to recruit pregnant, low-income African American women ( N = 25). Participants completed the Breastfeeding Self-Efficacy Scale-Short Form prior to and following the D-BAP. RESULTS The Wilcoxon signed rank test indicated that participation in the D-BAP had a statistically significant influence on breastfeeding self-efficacy ( z = -2.01, p = .04). Among a subsample of participants with no previous breastfeeding experience ( n = 12), completion of the D-BAP resulted in a statistically significant increase in breastfeeding self-efficacy ( z = -2.36, p = .02). There was no statistically significant difference between those with prior breastfeeding experience and those without it. CONCLUSION Breastfeeding among low-income African American women is a health equity issue for which culturally responsive, effective breastfeeding interventions are needed. This research demonstrates an association between completion of the D-BAP and an increase in prenatal breastfeeding self-efficacy.
Collapse
Affiliation(s)
- Rebecca Reno
- 1 Center of Excellence in Maternal and Child Health, University of California, Berkeley, CA, USA
| |
Collapse
|
46
|
Abstract
BACKGROUND Few breastfeeding education programs focus on primiparas and the importance of family members on exclusive breastfeeding in China. Research aim: This study aimed to explore the influence of a family-centered breastfeeding education program in promoting exclusive breastfeeding up to 6 months postpartum and to improve women's attitude and knowledge, family members' knowledge, and family support. METHODS This was a two-group quasi-experimental design with multiple comparisons. Participants ( N = 59) were randomized to either the intervention ( n = 29) or the control ( n = 30) group. The intervention group received two prenatal breastfeeding education lectures that included important family members, three home visits, eight telephone calls, text or video/audio support, and quality online resources during lactation. The control group received in-hospital care and follow-up by community nurses after discharge. RESULTS Compared with the control group, the intervention group was more likely to exclusively breastfeed in the first 6 months, odds ratio = 0.44, 95% confidence interval [0.20, 0.98]. The mean knowledge level of the intervention group improved more across time ( p < .05) and was higher than the control group ( p < .05). Perceived family support within the intervention group was significantly higher than the control group from 1 to 6 months ( p < .05). CONCLUSION The breastfeeding education program is an effective strategy to promote exclusive breastfeeding in China.
Collapse
Affiliation(s)
- Jian Ke
- 1 School of Health Sciences, Wuhan University, Wuhan, China
| | | | | |
Collapse
|
47
|
Abstract
BACKGROUND Breastfeeding is fundamental to maternal and child health and is the most cost-effective intervention to reduce child mortality. Pasteurized human donor milk (HDM) is increasingly provided for term newborns requiring temporary supplementation. Few studies examine maternal perspectives on supplementation of term newborns. MATERIALS AND METHODS We conducted semistructured in-person interviews with mothers of term newborns (n = 24) during postpartum hospitalization. Mothers were asked whether they had chosen or would choose to supplement with HDM versus infant formula, if medically indicated, and why. Data were gathered to saturation and analyzed inductively by consensus. Emerging semantic themes were compared between mothers who chose or would choose HDM and those who chose or would choose infant formula. RESULTS Most mothers had concerns about HDM, including uncertainty regarding screening and substances passed through HDM. Experiences with prior children influenced decision-making. Mothers who chose or would choose HDM (56%, n = 14) praised it as "natural," and some felt suspicious of infant formula as "synthetic." Mothers who chose or would choose infant formula (44%, n = 10) did not know enough about HDM to choose it, and many viewed infant formula as a short-term solution to supply concerns. Mothers unanimously mistrusted online milk purchasing sources, although the majority felt positively about using a friend or family member's milk. CONCLUSIONS Counseling regarding term newborn supplementation should focus on HDM education, specifically on areas of greatest concern and uncertainty such as donor selection, screening, transmission of substances, and mother's milk supply. Research is needed to assess the long-term impact of attitudes and choices on breastfeeding.
Collapse
Affiliation(s)
- Molly R Rabinowitz
- 1 Department of Pediatrics, Oregon Health and Science University , Portland, Oregon
| | - Laura R Kair
- 2 Department of Pediatrics, University of California Davis Medical Center , Sacramento, California
| | - Heather L Sipsma
- 3 Department of Public Health, Benedictine University , Lisle, Illinois
| | - Carrie A Phillipi
- 1 Department of Pediatrics, Oregon Health and Science University , Portland, Oregon
| | - Ilse A Larson
- 1 Department of Pediatrics, Oregon Health and Science University , Portland, Oregon
| |
Collapse
|
48
|
Al-Jawaldeh A, Abul-Fadl A. Assessment of the Baby Friendly Hospital Initiative Implementation in the Eastern Mediterranean Region. Children (Basel) 2018; 5:E41. [PMID: 29534482 DOI: 10.3390/children5030041] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The Baby-Friendly Hospital Initiative (BFHI) is a global program for promoting support and protection for breastfeeding. However, its impact on malnutrition, especially in countries of the Eastern Mediterranean region (EMR) that are facing the turmoil of conflict and emergencies, deserves further investigation. Having said that, this paper aims to discuss the status and challenges to BFHI implementation in the EMR countries. Data on BFHI implementation, breastfeeding practices, and nutritional status were collected from countries through structured questionnaires, personal interviews, and databases. The 22 countries of the EMR were categorized as follows: 8 countries in advanced nutrition transition stage (group I), 5 countries in early nutrition transition stage (group II), 4 countries with significant undernutrition (group III), and 5 countries in complex emergency (group IV). The challenges to BFHI implementation were discussed in relation to malnutrition. BFHI was not implemented in 22.7% of EMR countries. Designated Baby-Friendly hospitals totaled 829 (group I: 78.4%, group II: 9.05%; group III: 7.36%; group: IV5.19%). Countries with advanced nutrition transition had the highest implementation of BFHI but the lowest breastfeeding continuity rates. On the other hand, poor nutritional status and emergency states were linked with low BFHI implementation and low exclusive breastfeeding rates but high continuity rates. Early initiation and longer duration of breastfeeding correlated negatively with overweight and obesity (p < 0.001). In countries with emergency states, breastfeeding continues to be the main source of nourishment. However, suboptimal breastfeeding practices prevail because of poor BFHI implementation which consequently leads to malnutrition. Political willpower and community-based initiatives are needed to promote breastfeeding and strengthen BFHI in the region.
Collapse
|
49
|
Patterson JA, Keuler NS, Olson BH. The effect of Baby-friendly status on exclusive breastfeeding in U.S. hospitals. Matern Child Nutr 2018; 14:e12589. [PMID: 29411938 DOI: 10.1111/mcn.12589] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/21/2017] [Accepted: 12/11/2017] [Indexed: 01/26/2023]
Abstract
In 2014, a leading hospital accreditation agency, mandated hospitals publicly report their exclusive breastfeeding (EBF) rates. This new regulation provided an opportunity to explore differences in EBF outcomes using a standardized definition across a large hospital sample in the United States. The purpose of this study was to examine the relationships between population demographics and the Baby-friendly (BF) hospital designation on EBF rates in hospitals throughout the United States. We obtained EBF rates from 121 BF hospitals and 1,608 hospitals without the BF designation. Demographic variables were computed using census tract data for the population surrounding each hospital. Relationships were explored using linear regression. We found that EBF rates were positively correlated with a bachelor's degree, log income, and those who identified as White or Asian and negatively correlated with those without college attendance, individuals living below the poverty line, and those who identified as African American or Hispanic. For all models, the BF designation of a hospital was associated with higher EBF rates (p < 0.01; effect sizes, 0.11-0.49) with the exception of the model containing log income. Using a multiple linear regression model that was allowed to contain more than one independent variable, we were able to explain 22% of the variability in EBF rates. The BF hospital designation was associated with significantly higher EBF rates independent of demographic variables. Support for hospitals to attain the BF hospital designation is a meaningful public health goal.
Collapse
Affiliation(s)
- Julie A Patterson
- College of Agricultural and Life Sciences, Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Nicholas S Keuler
- College of Letters and Science, Department of Statistics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Beth H Olson
- College of Agricultural and Life Sciences, Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| |
Collapse
|
50
|
Kamoun C, Spatz D. Influence of Islamic Traditions on Breastfeeding Beliefs and Practices Among African American Muslims in West Philadelphia: A Mixed-Methods Study. J Hum Lact 2018; 34:164-175. [PMID: 28609217 DOI: 10.1177/0890334417705856] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Little is known regarding the influence of religion on breastfeeding in African American communities. In particular, whether Islamic traditions influence breastfeeding beliefs and practices among African American Muslims has not been studied. Research aim: This study sought to gain understanding of breastfeeding attitudes, rates, and education among African American Muslims in West Philadelphia and to examine if engaging Islamic teachings in breastfeeding education can positively influence breastfeeding attitudes. METHODS Open-ended, in-person, digitally recorded qualitative interviews were conducted with 10 community leaders and analyzed by conventional content analysis. A study tool distributed to a convenience sample of 44 community members and 11 leaders was used to gather information about education received from community leaders, breastfeeding attitudes and practices, and the potential for Islamic teachings to positively affect breastfeeding attitudes and practices. To obtain further data on this last topic, preliminary data analysis guided the creation of an education pamphlet, about which feedback was gathered through another study tool. RESULTS Education surrounding Islamic perspectives on breastfeeding was not prevalent. African American Muslims in West Philadelphia view breastfeeding favorably and have higher rates of breastfeeding than African Americans as a whole. Community education about breastfeeding that engaged Islamic teachings improved respondents' breastfeeding attitudes. CONCLUSION Increasing education among providers and African American Muslims about Islamic perspectives on breastfeeding may improve breastfeeding exclusivity and duration. Healthcare providers who care for Muslim women should be aware of Islam's tradition of positive attitudes toward breastfeeding and partner with Muslim leaders to improve breastfeeding rates and duration among such women.
Collapse
Affiliation(s)
- Camilia Kamoun
- 1 Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,2 Cincinnati Children's Hospital Medical Center Residency Program, Cincinnati, OH, USA
| | - Diane Spatz
- 3 University of Pennsylvania School of Nursing, Philadelphia, PA, USA.,4 Children's Hospital of Philadelphia, Philadelphia, PA, USA
| |
Collapse
|