Journal of Human Lactation最新文献

{"title":"Assessment of Breastfeeding Promotion in Maternity Hospitals Based on Specified International Recommendations-Experiences From Germany.","authors":"Merlin Blendermann, Nele Hockamp, Erika Sievers, Thomas Lücke, Mathilde Kersting","doi":"10.1177/08903344251318275","DOIUrl":"https://doi.org/10.1177/08903344251318275","url":null,"abstract":"<p><strong>Background: </strong>The staff of maternity hospitals play an essential role in the start of breastfeeding. This study assessed specific aspects of breastfeeding promotion in German hospitals using the recommendations of the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF).</p><p><strong>Research aim: </strong>To identify specific hospital practices and structures that are in compliance with the recommendations and those that still need to be improved.</p><p><strong>Method: </strong>A cross-sectional survey and descriptive analysis was conducted in 109 German hospitals. This web-based questionnaire examined the structural conditions and usual handling of breastfeeding support. Recommendations were reported using sub-criteria.</p><p><strong>Results: </strong>The implementation of the sub-criteria ranged from less than 25% to more than 90%. Hospitals were more likely to have a breastfeeding policy (85.3%, <i>n</i> = 93) than a breastfeeding coordinator (73.4%, <i>n</i> = 80). Immediate skin-to-skin contact after birth and early breastfeeding initiation were implemented more frequently after a vaginal (89.9%, <i>n</i> = 98 and 71.6%, <i>n</i> = 78) than after Cesarean delivery (45.9%, <i>n</i> = 50 and 54.1%, <i>n</i> = 59). Additional feeding of fluids was usually restricted to a medical indication (70.6%, <i>n</i> = 77), however, the decision to feed formula was rarely made by hospital staff alone (27.5%, <i>n</i> = 30). Large hospitals (> 1000 births/year) had a written breastfeeding policy and a breastfeeding coordinator more frequently than smaller hospitals (<i>p</i> < 0.01, Fisher's exact test).</p><p><strong>Conclusion: </strong>The use of sub-criteria of WHO recommendations helped identify critical parts of breastfeeding promotion in hospitals, providing concrete starting points for targeted interventions. This differentiated approach could be promising for future analyses of breastfeeding promotion.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251318275"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding Measurement-What Does It Mean to \"Wean?\"","authors":"Melissa A Theurich, Laura Fischer, Jelica Gencel-Augusto, Ellen Chetwynd","doi":"10.1177/08903344251320034","DOIUrl":"https://doi.org/10.1177/08903344251320034","url":null,"abstract":"<p><p>The term \"weaning\" is used heterogeneously in scientific and gray literature, with no commonly agreed-upon definition. Weaning can describe the gradual transition in the infant diet, usually from milk feedings to complementary foods, but it is also commonly used to describe any gradual transition between milks, foods, or feeding modalities. In an epidemiological context, it may also refer to changing breastfeeding rates within a cohort. The meaning of weaning has changed over time and may vary by the scientific assumptions applied to this period of human development. For these reasons, we propose that investigators avoid using the term weaning, and substitute it with more precise terminology. We present a series of proposed standard terms with corresponding definitions to guide more precise and accurate reporting of the various potential meanings of the term in the scientific literature. The objective is to improve reporting and reproducibility of research in the field of breastfeeding and human lactation.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251320034"},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Cell Isolation From Human Milk Using Immunomagnetic Beads.","authors":"Noor Radhi, Ayamita Paul, Mariana Muelbert, Gergely Toldi","doi":"10.1177/08903344251316491","DOIUrl":"https://doi.org/10.1177/08903344251316491","url":null,"abstract":"<p><strong>Background: </strong>There is increasing interest in better understanding the immune cell composition of human milk and how these cells interact with neonatal immune development. However, consistent methods for immune cell isolation from human milk are lacking.</p><p><strong>Research aim: </strong>Our aim was to systematically compare available cell isolation techniques to isolate T lymphocytes from human milk samples.</p><p><strong>Methods: </strong>This repeated measures study design compared three cell isolation methods using human milk samples: (1) centrifugation, (2) immunomagnetic bead isolation, and (3) a combination of both methods. We assessed the proportion and viability of CD3+, CD4+, CD25+ and regulatory T cells using flow cytometry in isolated cells to compare the performance of these isolation methods.</p><p><strong>Results: </strong>Immunomagnetic separation is a feasible method to isolate T lymphocytes in human milk, similar to blood. It improves target cell enrichment and cell viability compared to centrifugation, which may be an advantage when the goal is to characterize rare cell types or when cells are further used in functional assays. No excess cell activation (CD25 positivity) was observed with the use of magnetic beads.</p><p><strong>Conclusion: </strong>Immunomagnetic separation of human milk T lymphocytes may have advantages over centrifugation depending on the intended downstream use of cells.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251316491"},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the Field - The Case for a Paradigm Shift in Lactation Care for NICU Families: A Comprehensive Lactation Care Model.","authors":"Joanie Randle","doi":"10.1177/08903344241299722","DOIUrl":"10.1177/08903344241299722","url":null,"abstract":"<p><p>The importance of a child receiving their mother's own milk (MOM) in the care and treatment of preterm infants is undisputed in the literature. Despite this, lactation support in the Neonatal Intensive Care Unit is often fragmented. Gaps in adequate lactation care for infants receiving MOM, and barriers to that lactation care, can contribute to healthcare disparities and outcome inequalities. Here, I outline a comprehensive lactation care manager model based on the concepts of continuity of care and care management. This is a starting point for discussion that may be helpful in informing future research and adequate lactation care options.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"34-38"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"About Research - The Utility of Secondary Data Analysis in Breastfeeding Research: Opportunities and Challenges.","authors":"Zelalem T Haile","doi":"10.1177/08903344241304623","DOIUrl":"10.1177/08903344241304623","url":null,"abstract":"<p><p>Secondary data analysis has emerged as an important approach for researchers seeking to explore new research questions using existing datasets. These datasets often comprise large and diverse, as well as longitudinal data, enabling comprehensive analyses that might be impractical through primary data collection alone. This paper discusses the importance of secondary data analysis in breastfeeding research, provides examples of publicly available and restricted datasets containing breastfeeding variables, outlines the methodological steps in conducting secondary data analysis, and discusses common limitations associated with this approach. By emphasizing both the utility and challenges of secondary data analysis, the paper aims to encourage informed use of secondary data analysis to advance knowledge and address important research questions in breastfeeding.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"16-21"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding Measurement - Considerations When Measuring Exclusive Breastfeeding.","authors":"Ellen Chetwynd, Jill Demirci, Jennifer Yourkavitch","doi":"10.1177/08903344241305669","DOIUrl":"10.1177/08903344241305669","url":null,"abstract":"<p><p>Exclusive breastfeeding, as recommended by the World Health Organization (WHO) for the first 6 months of life, is a critical metric for evaluating maternal and infant feeding practices and health outcomes. Despite its importance, inconsistencies in defining and measuring breastfeeding exclusivity present challenges for research comparability and interpretation. Equally, research design, outcomes of interest, and study resources are necessary considerations when collecting and analyzing exclusive breastfeeding data, and may require the adaption of standardized questions and techniques to individual situations. This paper explores key considerations for researchers when operationalizing and measuring exclusive breastfeeding. We address the nuances of point prevalence and since-birth measures, highlighting their influence on study outcomes and data interpretation. Statistical approaches for analyzing exclusivity data, including logistic regression, survival analysis, and Kaplan-Meier methods, are also discussed. By outlining best practices for precise definitions, tailored data collection, and transparent reporting, this paper aims to provide an overview for precise definition, effective data collection, and clear interpretation.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"22-25"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic Monitoring of Mom's Schedule (eMOMS™): A Feasibility Randomized Controlled Trial Targeting Postpartum Weight Retention and Breastfeeding Duration Among Populations With Overweight/Obesity.","authors":"Lisette T Jacobson, Christie Befort, Hayrettin Okut, Rosey Zackula, Jolynn Dowling, Judy E Stern, David C Robbins, Michael D Wolfe, Patricia Kluding, David A Grainger","doi":"10.1177/08903344241297604","DOIUrl":"10.1177/08903344241297604","url":null,"abstract":"<p><strong>Background: </strong>Globally, rising trends in gestational diabetes and body mass index contribute to maternal and neonatal morbidity and mortality. Lifestyle modifications and breastfeeding may reverse this effect, although few studies combine these into one intervention.</p><p><strong>Research aims: </strong>To measure postpartum weight retention, breastfeeding duration, hemoglobin A1C, and mean arterial blood pressure at 6 months postpartum among women with elevated pre-pregnancy body mass index.</p><p><strong>Methods: </strong>The electronic Monitoring of Mom's Schedule study (eMOMS™) was a feasibility, three-arm, randomized controlled trial modeled after a Diabetes Prevention Program and breastfeeding support. A health coach delivered a 12-month virtual intervention. Study arm results were compared using Wilcoxon signed-ranks exact test reporting from a two-sided test and bootstrapped samples with 95% confidence intervals.</p><p><strong>Results: </strong>Between September 2019 and May 2021, 100 individuals were screened, and 35 were randomized: nine to Group 1, 14 to Group 2, and 12 to Group 3. At baseline, participants averaged 13.0 (<i>SD</i> = 2.5) weeks gestation, with a mean pre-pregnancy body mass index of 29.7 (<i>SD</i> = 3.0). With 5,000 bootstrapped samples, mean weight retention from baseline to 6 months postpartum was: 4.0 kg, 95% CI [1.6, 6.2] for Group 1; 3.7 kg, CI [-1.8, 9.8] for Group 2; and 7.5 kg, CI [4.1, 11.6] for Group 3. Mean (exclusive) breastfeeding duration was 9.3 weeks, 95% CI [0.43, 26.1]; 9.6 weeks, CI [4.4, 15.7]; and 15.1 weeks, CI [6.5, 23.3] for each group, respectively.</p><p><strong>Conclusion: </strong>Our intervention was positively associated with postpartum weight retention and breastfeeding duration. Future research is needed to assess intervention components.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"115-131"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mothers' Gender-role Ideologies and Exclusive Breastfeeding in Western Rural China: A Cross-Sectional Study.","authors":"Jingchun Nie, Yangyuan Li, Nan Wang, Yunjie Liu, Junhao Wu, Jinbiao Ye, Zulihumaer Reheman, Jie Yang, Hao Xue, Yaojiang Shi","doi":"10.1177/08903344241300302","DOIUrl":"10.1177/08903344241300302","url":null,"abstract":"<p><strong>Background: </strong>Shifts in women's maternal roles may contribute to the global low prevalence of exclusive breastfeeding.</p><p><strong>Research aim: </strong>To investigate the association between maternal gender-role ideologies and exclusive breastfeeding in rural China.</p><p><strong>Methods: </strong>Cross-sectional studies were conducted in 10 counties in Shaanxi Province using random sampling in 2021 and 2023. Data on breastfeeding practices, maternal gender-role ideology, and expected educational attainment from 586 rural participants were collected through structured questionnaires. Multivariable regression analysis was employed to explore the association between maternal gender-role ideology and exclusive breastfeeding.</p><p><strong>Results: </strong>The prevalence of exclusive breastfeeding within 6 months in rural western China was 18.8%. Women with more egalitarian gender-role ideologies were more likely to engage in exclusive breastfeeding (<i>OR</i> = 1.34, 95% CI [1.04, 1.72]), particularly for female infants (<i>OR</i> = 1.63, 95% CI [1.09, 2.43]). Furthermore, women with stronger egalitarian gender-role ideologies were found to exhibit a greater propensity for financial investment in their children (<i>Beta</i> = 0.20, 95% CI [0.01, 0.40]) and hold higher educational expectations for their daughters (<i>OR</i> = 1.50, 95% CI [1.00, 2.25]).</p><p><strong>Conclusion: </strong>Maternal gender-role ideology positively correlates with exclusive breastfeeding. More policies should be implemented on gender equality in rural China, and cultural perspectives should be incorporated into the analysis of breastfeeding practice.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"70-81"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Live Online Prenatal Educational Model: Association With Exclusive Breastfeeding at Discharge.","authors":"Julia M Gabhart, Lina N Wasio, Panupong U-Thaiwat, Yi W Chen, James Main","doi":"10.1177/08903344241297607","DOIUrl":"10.1177/08903344241297607","url":null,"abstract":"<p><strong>Background: </strong>Web-based prenatal education is increasingly employed, but its association with increased breastfeeding and predictors of breastfeeding success is uncertain.</p><p><strong>Research aims: </strong>Our primary aim was to evaluate our live, online intervention's association with exclusive breastfeeding at hospital discharge. Secondarily, we aimed to describe participants' reports of the intervention on predictors of breastfeeding success.</p><p><strong>Method: </strong>We used a retrospective quasi-experimental cohort design to assess the association between our intervention and exclusive breastfeeding at discharge. The intervention consisted of an evidence-based live, online, 2-hour class open to all prenatal patients and supporters at our urban community medical center from June 2020 through April 2022. Patient characteristics and breastfeeding rates were extracted from the electronic medical record. Samples were drawn using stratified random sampling. Three logistic regression models were conducted to assess the associations between the intervention and exclusive breastfeeding. Two surveys assessed the participant reports of the intervention.</p><p><strong>Results: </strong>Samples of the first model, comprised of 160 participants and 160 non-participants, were similar in important characteristics. Participants were 2.12 times (95% CI [1.12, 3.69]) more likely to exclusively breastfeed. Participants reported positively on the impacts of the intervention on breastfeeding predictors.</p><p><strong>Conclusions: </strong>Our live, online intervention was significantly associated with an increased likelihood of exclusive breastfeeding at hospital discharge. A randomized, prospective examination of the intervention's association with breastfeeding duration would further define its impact.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"145-155"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing Lactation Acuity to Improve Lactation Services in a U.S. Hospital.","authors":"Rebecca Mannel","doi":"10.1177/08903344241299402","DOIUrl":"10.1177/08903344241299402","url":null,"abstract":"<p><p>National staffing guidelines for hospital lactation services do not account for the lactation acuity of breastfeeding patients. Higher acuity breastfeeding couplets require a higher level of knowledge and skill from lactation care providers. In these cases, a referral to an International Board Certified Lactation Consultant (IBCLC) is recommended for appropriate management. Use of a lactation acuity classification system as a clinical practice innovation was implemented at Oklahoma University Medical Center to improve the distribution of staff resources for optimal care of breastfeeding patients. Lactation service reports from this facility, a tertiary care teaching hospital, were reviewed to evaluate staffing, number of lactation consults, reason for and acuity of consults, and time spent. The review included over 10,000 lactation consults completed over a 1-year period. Once the lactation acuity system for IBCLC staff was in place, there was an increased mean direct consult time and acuity level with 85% of IBCLC time allocated to high acuity consults. Trained bedside nurses handled most low-acuity patients. The percentage of patients needing a lactation consult who received one increased along with the number of consults per patient. Data on time spent per consult were stratified by acuity, location, and reason for consult, including details on priority consults for neonatal intensive care unit patients. The productivity of the lactation team was higher with the use of a lactation acuity system compared to without it. The data reported support the use of lactation acuity in making recommendations for staffing of hospital lactation services.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"97-104"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}