Journal of Human Lactation最新文献

{"title":"Designing Baby-Friendly Hospital Step 2 Training A Hospital Case Study.","authors":"Cassandra P Leahy","doi":"10.1177/08903344251319363","DOIUrl":"https://doi.org/10.1177/08903344251319363","url":null,"abstract":"<p><p>Maintaining Baby-Friendly Hospital Initiative (BFHI) standards within a complex healthcare system presents unique challenges. This case study from a regional perinatal center in the northeast United States details the design and implementation of a program to address BFHI Step 2, which requires ongoing competency assessment and team member training to ensure breastfeeding support. The shift of BFHI competencies to continuous professional development introduced logistical challenges, compounded by staff turnover and budget constraints. To address these, the hospital team developed an in-house learning management system tailored to BFHI requirements. The learning management system offered modular, role-specific content, self-paced learning, and interactive assessments, ensuring adaptability, cost-effectiveness, and scalability. Administrative tools supported compliance tracking and reviews of test results, which assisted with timely resolution of knowledge gaps. A hybrid approach, including in-person training and team meetings, further reinforced staff competence. This sustainable, integrated system fostered continuous learning, and enhanced staff preparedness toward supporting breastfeeding families.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251319363"},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604923","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":"Relationship and Determinants of Breastfeeding Self-Efficacy Among Postpartum Mothers and Fathers in Malawi: A Cross-Sectional Study.","authors":"Roselyn Chipojola, Mega Hasanul Huda, Kaboni Whitney Gondwe, Nyanyiwe Masingi Mbeye, Shu-Yu Kuo","doi":"10.1177/08903344251318274","DOIUrl":"https://doi.org/10.1177/08903344251318274","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding self-efficacy among both mothers and fathers is critical in enhancing exclusive breastfeeding rates. However, the interrelationship between maternal and paternal breastfeeding self-efficacy and their determinants remains unknown.</p><p><strong>Research aims: </strong>We aimed to (a) investigate the relationship between breastfeeding self-efficacy scores postpartum for mothers and fathers; (b) explore factors associated with breastfeeding self-efficacy in this group; and (c) examine determinants of combined self-efficacy scores among breastfeeding parents in Malawi.</p><p><strong>Methods: </strong>We conducted a cross-sectional study on postpartum mother-father couples at a tertiary maternity facility in central Malawi. Breastfeeding self-efficacy was measured using the Breastfeeding Self-Efficacy Scale Short-Form. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. A structured questionnaire was used to collect demographic and health variables. Data were analyzed using multivariable logistic regression and multinomial logistic regression.</p><p><strong>Results: </strong>Mothers demonstrated a higher score of self-efficacy (<i>M</i> = 55.7, <i>SD</i> = 6.5) in comparison to fathers (<i>M</i> = 50.2, <i>SD</i> = 11.9). A significant moderate positive correlation was identified between mothers' and fathers' breastfeeding self-efficacy (<i>r</i> = 0.32). Age, employment status, mode of birth, and practicing exclusive breastfeeding were significantly associated with maternal and paternal breastfeeding self-efficacy. Factors including advanced age, Cesarean delivery, and depressive symptoms emerged as significant determinants of combined breastfeeding self-efficacy scores among couples.</p><p><strong>Conclusion: </strong>Breastfeeding self-efficacy is highly correlated between mothers and fathers, with a relatively higher score in mothers. Importantly, sociodemographic, obstetric, and psychological determinants play a substantial role in influencing parental breastfeeding efficacy. This highlights the necessity of incorporating both mothers and fathers into future breastfeeding promotion strategies.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251318274"},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604969","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: Clinical Versus Statistical Significance.","authors":"Kathryn Wouk, Kathleen Kenny, Ellen Chetwynd","doi":"10.1177/08903344251320587","DOIUrl":"https://doi.org/10.1177/08903344251320587","url":null,"abstract":"","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251320587"},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604840","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":"Comparison Between Antenatal and Postnatal Colostrum From Women With and Without Type 1 Diabetes.","authors":"Alexandra Goldberg, Hans Pettersson, Cecilia Ekéus, Carina Ursing, Eva Wiberg-Itzel, Joanna Tingström","doi":"10.1177/08903344251318285","DOIUrl":"https://doi.org/10.1177/08903344251318285","url":null,"abstract":"<p><p>BackgroundSupplementary feeding, colostrum or, in some countries, commercial milk formula, is given to newborns of women with Type 1 diabetes to prevent neonatal hypoglycemia. Few studies have explored the content of colostrum from women with Type 1 diabetes.Research AimsThis study aimed to investigate the macronutrients in colostrum collected during pregnancy and in the early postpartum period to compare colostrum contents in women with and without Type 1 diabetes.MethodsIn this cohort study, we collected colostrum among 20 women, 10 with and 10 without Type 1 diabetes, at 10 different time points in gestational weeks 36-40 and postpartum Days 1-5. We measured carbohydrates, protein, fat, and kilocalories in colostrum using a human milk analyzer; and we analyzed data using linear mixed models. In a follow-up analysis, we compared the content of colostrum from Day 1 with the nutritional values provided on the commercial milk formula, using a one-sample <i>t</i> test.ResultsThere were no mean differences in carbohydrates (6.6 g/100 ml; 95% CI [6.3, 6.9] vs. 6.7 g/100 ml; 95% CI [6.4, 7.0] <i>p</i> = 0.29); kilocalories (71.1 kcal/100 ml; 95% CI [62.9, 79.3] vs. 85.3 kcal/100 ml; 95% CI [77.2, 93.3] <i>p</i> = 0.21], and fat (2.7 g/100 ml; 95% CI [1.8, 3.6] vs. 2.3 g/100 ml; 95% CI [1.4, 3.2] <i>p</i> = 0.55) in colostrum when comparing women with and without Type 1 diabetes. However, antenatal protein differed at all timepoints tested (<i>p</i> = 0.01). Colostrum macronutrients on Day 1 differed from that of commercial milk formula and all other colostrum time points, except Gestational Week 38.ConclusionsOur study provides insights into antenatal and postnatal colostrum macronutrients among women with and without Type 1 diabetes. Further studies are needed to understand the effects of supplementary feeding using antenatal or postnatal colostrum or commercial milk formula on neonatal hypoglycemia.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251318285"},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604847","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":"Experiences of Breastfeeding Mothers of Infants With Ankyloglossia: A Qualitative Study.","authors":"Gemma López-Segura, Raquel Alarcón-Rodríguez, Raúl Romero-Del Rey, María Del Mar Murillo-de Las Heras, Mar Requena-Mullor, Jessica García-González","doi":"10.1177/08903344251319299","DOIUrl":"https://doi.org/10.1177/08903344251319299","url":null,"abstract":"<p><strong>Background: </strong>Ankyloglossia, or limited tongue mobility due to a restrictive sublingual frenulum, can complicate breastfeeding. Treatment typically involves a frenotomy, a procedure that cuts the restrictive tissue parallel to the tongue.</p><p><strong>Research aim: </strong>To describe the experiences of breastfeeding mothers with children affected by ankyloglossia, before any treatment for the condition.</p><p><strong>Method: </strong>This was a qualitative descriptive study. Using purposive sampling, 20 participants were recruited. Data were collected through individualized semi-structured interviews. The interviews were recorded and transcribed verbatim. Thematic analysis was used for data analysis with ATLAS.ti computer software.</p><p><strong>Results: </strong>Four main themes were identified: (1) Breastfeeding: An idyllic and intuitive process; (2) When idyllic becomes problematic; (3) Looking for a solution; and (4) Recommendations based on experience. During pregnancy, the participants perceived breastfeeding as an idealized process. After delivery, participants described physical and emotional difficulties with breastfeeding that they attributed to ankyloglossia. Although the care received by midwives in the hospital was satisfactory, the participants described shortcomings, including the lack of breastfeeding training for healthcare professionals and the lack of specialized physiotherapists.</p><p><strong>Conclusions: </strong>This study shows the difficulties experienced by breastfeeding mothers of children with ankyloglossia prior to treatment, emphasizing the importance of a comprehensive approach. Despite satisfaction with midwifery care, shortcomings in the hospital were described.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251319299"},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604961","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":"Lactation Newsmakers: Elaine Petitat-Côté: Making Good Use of Two UN Conventions to Advocate for Breastfeeding Rights.","authors":"Elaine Petitat-Côté, Maryse Arendt","doi":"10.1177/08903344251318961","DOIUrl":"https://doi.org/10.1177/08903344251318961","url":null,"abstract":"<p><p>Elaine Petitat-Côté was born in Canada and has lived for the greatest part of her life in Geneva. She has consistently worked with development, health, and women's organizations and non-governmental organizations (NGOs), advocating for a public health approach to medicine that considers the social and economic realities of communities, and emphasizes the creation of healthy living conditions to ensure long-term, sustainable health outcomes This perspective supports a horizontal approach to medicine, in contrast to the narrower, vertical approach typically employed. As a member of the International Baby Food Action Network (IBFAN) she worked for the Geneva Infant Feeding Association (GIFA) on two main issues related to breastfeeding: maternity protection at work, and the rights of children to the highest attainable standard of health and nutrition, in particular by protecting breastfeeding. In this article, she explains her work at IBFAN-GIFA as it focused on the adoption and implementation of the International Labour Organization (ILO) Convention 183 and Recommendation 191 on maternity protection. She also explains how she was able to use the review process built into the Convention on the Rights of the Child (CRC) to develop a rights-based approach to promote, protect, and support breastfeeding and make way to improving the legal, social, and institutional situation of breastfeeding in all countries examined by the Committee on the rights of the child.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344251318961"},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604965","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 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}