Journal of Human Lactation最新文献

{"title":"Barriers and Facilitators in Lactation Support for the Preterm Mother-Infant Dyad: An Integrated Approach.","authors":"An Eerdekens, Anne Debeer","doi":"10.1177/08903344241273450","DOIUrl":"10.1177/08903344241273450","url":null,"abstract":"<p><p>Breastfeeding offers significant health benefits for both mothers and infants, particularly preterm infants, where it serves as a therapeutic strategy to reduce mortality and morbidities. However, breastfeeding practices are threatened globally by societal norms and systemic barriers at both micro and macro levels. This paper explores the complex interplay of these barriers and facilitators, focusing on the Neonatal Intensive Care Unit (NICU) setting. Preterm infants face specific feeding challenges due to immature physiological functions, yet evidence supports that strategies like cue-based feeding and individualized care can enhance feeding success and health outcomes. For mothers, initiating and maintaining lactation after preterm birth is critical but challenging, with early lactation support and achieving sufficient milk volume being key predictors of success. Partner support significantly influences lactation outcomes, although more inclusive research is needed for diverse family structures. In the NICU, a multidisciplinary approach to lactation care is vital, emphasizing the need for experienced staff and family-centered practices. NICU design, policies promoting parental presence, and adherence to Baby-friendly Hospital Initiative guidelines further support breastfeeding. This paper aims to provide directives for local breastfeeding policies through an integrated approach, considering societal attitudes and healthcare practices. The findings advocate for improved lactation support in NICUs, inclusive language and policies, and further research into diverse familial and gender roles in breastfeeding.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"539-549"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348148","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 Basic Competence in Primary Care: A Spanish Translation and Cross-Cultural Validation of the CAPA Questionnaire.","authors":"Victor Romero-Domínguez, Anna Ponjoan, Mireia Vidal, Lia Alves-Cabratosa, Anna Pol-Pons","doi":"10.1177/08903344241271360","DOIUrl":"10.1177/08903344241271360","url":null,"abstract":"<p><strong>Background: </strong>The number of validated questionnaires that assess the level of breastfeeding competence of primary care professionals who attend lactating mothers is limited.</p><p><strong>Research aim: </strong>To validate the CAPA (Competència en l'Atenció Primària sobre Alletament [Breastfeeding Competence in Primary Care]) questionnaire into Spanish in collaboration with professionals from the primary care services of the Comunidad de Madrid (Spain).</p><p><strong>Methods: </strong>In this multicentric study, four bilingual healthcare professionals translated the CAPA questionnaire into Spanish and back-translated it into Catalan. The cross-cultural adaptation included a discussion by an expert committee, a review by a philologist, and a pilot study that involved 13 healthcare residents. We randomly selected professionals from specialties involved in breastfeeding. The re-test was conducted 3 weeks later, aiming to avoid changes in the studied population. We performed a factor analysis to identify underlying constructs and hypothesis-testing to assess the validity of the questionnaire and estimated the Cronbach Alpha and intraclass correlation coefficient (ICC) to assess its reliability.</p><p><strong>Results: </strong>A total of 198 professionals participated by responding to the questionnaire. Factorial analysis showed that the questionnaire was unidimensional. Hypothesis testing showed that, of all the considered professional groups, midwives achieved the highest mean score (<i>M</i> = 131.7, <i>SD</i> = 10.9, <i>p</i> < 0.001). Amongst the other professionals, only 26.5% achieved a basic level of breastfeeding competence. The Cronbach alpha and ICC were 0.852 (95% CI [0.821, 0.880]) and 0.890 (95% CI [0.800. 0.937]).</p><p><strong>Conclusions: </strong>The Spanish CAPA questionnaire is a valid and reliable tool for assessing breastfeeding basic competence among primary care professional groups who attend lactating mothers.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"512-521"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289107","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":"Trajectories of Breastfeeding-Related Thoughts and Attitudes Among Low-Income Smoke-Exposed Pregnant Women: A Latent Class Growth Analysis.","authors":"Ruth G St Fleur, Tayla von Ash, Anna Alikhani, Shira I Dunsiger, Patricia Markham Risica","doi":"10.1177/08903344241274748","DOIUrl":"10.1177/08903344241274748","url":null,"abstract":"<p><strong>Background: </strong>Psychosocial predictors of breastfeeding and changes in those factors during pregnancy, along with the relationship of those changes with both breastfeeding and smoke use and exposure, are not well explored.</p><p><strong>Research aim: </strong>The aim of this study was to identify distinct trajectories of psychosocial determinants of breastfeeding and smoking in pregnant women.</p><p><strong>Methods: </strong>We used a longitudinal study design and data from a randomized controlled trial conducted among smoke-exposed pregnant women and their infants. Participants were recruited early in pregnancy and were surveyed at ≤ 16 and 32 weeks gestation, delivery, 3 and 6 months postpartum for breastfeeding intentions, initiation, continuation, and smoke use and exposure. Psychosocial variables associated with breastfeeding were measured at baseline and 32 weeks gestation using the Mitra index, a structured questionnaire that assesses barriers and facilitators of breastfeeding intentions. Latent class growth analysis was performed using Mitra scores to identify distinct subgroups of participants with different trajectories. Sociodemographic characteristics, breastfeeding, and tobacco smoke use and exposure were compared across classes.</p><p><strong>Results: </strong>Three or four trajectories were identified for each of the six Mitra scores. Trajectories for all Mitra scores were associated with breastfeeding intention and initiation. Overall, Mitra, knowledge, self-efficacy, social support, and time barrier classes all differed by tobacco smoke use or exposure.</p><p><strong>Conclusion: </strong>Trajectories of breastfeeding knowledge, self-efficacy, social support, and time to breastfeed/social barriers are associated with tobacco smoke use and exposure during pregnancy. Encouragement to breastfeed and to cease and avoid tobacco smoke should start early in pregnancy, focusing on these determinants to improve health outcomes.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"593-601"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348151","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":"Beliefs About Donating Human Milk to a Milk Bank: A Theory-Based Salient Belief Elicitation.","authors":"Lydia J Hamilton, Susan Middlestadt","doi":"10.1177/08903344241274348","DOIUrl":"10.1177/08903344241274348","url":null,"abstract":"<p><strong>Background: </strong>Pasteurized donor human milk provides a safe and desirable alternative when a parent's own milk is insufficient or unavailable. Currently, the demand for donor human milk exceeds the available supply. Little is known about the beliefs breastfeeding individuals have about milk bank donation.</p><p><strong>Research aims: </strong>The aims of this exploratory study were to (a) provide a preliminary estimate of how well intention can be predicted, and to suggest which of the global constructs of the Reasoned Action Approach has the most influence on intention; and (b) identify the salient, top-of-the-mind beliefs underlying the intention to donate some of the milk an individual is currently producing to a milk bank.</p><p><strong>Methods: </strong>An exploratory, cross-sectional study design, based on the Reasoned Action Approach, was used to measure the theory's global constructs and elicit beliefs underlying the intention to donate milk of lactating individuals (<i>N</i> = 118) living in Indiana, Illinois, Missouri, and Kentucky. Thematic and frequency analyses and multiple regression were performed.</p><p><strong>Results: </strong>Quantitative analyses found that injunctive norm and the autonomy component of perceived behavioral control were independently associated with intention. Qualitative analyses identified the advantages (e.g., help and save babies, won't waste milk), referents who support (e.g., husband, family), and facilitators (e.g., having a convenient, close location, having more knowledge and information) of donating milk.</p><p><strong>Conclusions: </strong>This research provides insight into how milk banks might recruit and retain donors. Additional quantitative research with a larger sample is necessary to confirm the preliminary findings of this study.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"582-592"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289106","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":"Factors Influencing Health Professionals’ Decisions Regarding the Indication of Infant Formula: A Qualitative Exploration in Uruguay","authors":"Alejandra Girona, Gerónimo Brunet, Gastón Ares, Raquel Rodríguez, Carolina de León, Mónica Lozano, Leticia Vidal","doi":"10.1177/08903344241271346","DOIUrl":"https://doi.org/10.1177/08903344241271346","url":null,"abstract":"Background:Health systems are fundamental to the promotion and protection of breastfeeding. Health professionals have a pivotal influence on families’ infant feeding decisions and may act as facilitators or barriers to adequate breastfeeding practices.Research Aim:To explore factors influencing health professionals’ decisions regarding the indication of infant formula in Montevideo, the capital of Uruguay, an emerging Latin American country.Method:This was a qualitative study based on semi-structured interviews with 30 health professionals (neonatologists, pediatricians, family doctors, and nurses) working in primary and secondary care in both private and public health institutions. The interviews were audio-recorded, transcribed, and analyzed using content analysis based on deductive-inductive coding.Results:The narratives of the participants identified maternity wards as the healthcare sites where the indication of infant formula occurs most frequently. Motives underlying the indication of infant formula by health professionals were diverse. The type of birth and the conditions of the child and the mother were the most relevant in secondary care, whereas maternal work was the main determining factor in primary care. A wide range of factors encouraging and discouraging the indication of infant formula were identified by health professionals in primary and secondary healthcare locations, which were related to all the levels of influence of the socioecological model.Conclusions:Strategies to reduce the use of infant formula in Uruguay should include improving the support and guidance provided to families in the maternity ward, strengthening the implementation and monitoring of the Baby-Friendly Hospital Initiative, and improving the current maternity leave regulations.","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":"18 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255634","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":"Stakeholder Perspectives on Research, Policy and Practice Priorities to Increase Human Milk Feeding Rates in the United Kingdom","authors":"Amy Elizabeth Burton, Alison Owen, Jennifer Taylor, Isobel Lindsay-Wiles, Joanna Heyes, Fiona Cust, Sarah Page","doi":"10.1177/08903344241271411","DOIUrl":"https://doi.org/10.1177/08903344241271411","url":null,"abstract":"Background:Human milk feeding rates in the United Kingdom are a public health concern. Changes to United Kingdom policy and practice are needed to improve lactation support. These should be informed by those with lived experience of human milk feeding and those who provide support.Research Aim:The aim of this study was to identify research, policy, and practice priorities for increasing human milk feeding rates using insights from a wide range of stakeholders. A secondary aim was to evaluate the influence of a World Café on individual attendees and their interactions within the organizations and communities of which they are a part.Methods:The research employed a participatory qualitative design, incorporating a cross-sectional survey and World Café discussions. World Café is a novel approach to engaging stakeholders in discussion, resulting in consensus-building and participatory-driven recommendations. A pre-event survey was completed by a self-selected sample of 67 participants; 37 of these (55%) took part in World Café discussions or an online focus group. World Café discussions and the online focus groups were recorded and transcribed verbatim. Following the World Café, 12 participants (32%) completed a post-event survey, and eight (22%) completed an additional follow-up survey at 2 months.Results:Priority policy and practice changes were identified, including enhancing education, the need for dedicated funding for human milk feeding support, the need to include family within support provision, and the need to change policy regarding media representations of infant feeding. In addition, World Café methodology proved valuable for facilitating networking and instigating changes in relation to support.Conclusion:World Café generated stakeholder agreed-on priorities for research and policy. Many of the recommendations from historical policy and guidance continue to be areas for further development.","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":"53 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255635","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":"Telelactation Within the Landscape of Breastfeeding Support: Experiences of Latina Parents","authors":"Gabriela Alvarado, Khadesia Howell, Molly Waymouth, Jill Demirci, Rhianna Rogers, Kristin Ray, Lori Uscher-Pines","doi":"10.1177/08903344241274760","DOIUrl":"https://doi.org/10.1177/08903344241274760","url":null,"abstract":"Background:Despite increasing breastfeeding initiation rates in the United States, disparities in breastfeeding continuation and exclusivity by race and ethnicity persist.Research Aim:We aimed to understand the perceptions and experiences of Latina parents who received access to telelactation, and assessed the implications of integrating telelactation into pediatric settings.Methods:This cross-sectional qualitative study drew from participants enrolled in a randomized controlled trial about breastfeeding support. We recruited 20 participants from among those participating in a randomized controlled trial assessing the effect of telelactation on breastfeeding outcomes. The study design was informed by an Equity-Centered Model and authentic entry. We conducted a thematic content analysis through an iterative approach, where we systematically generated themes to describe code application patterns.Results:We identified three themes: (1) telelactation within the broader landscape of breastfeeding support; (2) perceptions of telelactation support; and (3) recommendations on the use of telelactation in the context of pediatric care. We found that participants had an escalation approach for seeking breastfeeding support and propose a new model: Breastfeeding Support Escalation Protocol, which can be applied to lactation support in pediatric care. Parents’ perceptions and recommendations highlighted their desire for care coordination, expanded options for telelactation engagement, and care continuity, which are important reflections for pediatric offices considering integrating telelactation services into their practice.Conclusions:Latina parents found telehealth to be helpful and an acceptable alternative to in-person services. Pediatric offices can take steps toward becoming Breastfeeding-Friendly by partnering with telelactation services. More research is needed on the logistical implications and cost-effectiveness of telelactation services as part of the pediatric practice.","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":"74 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255633","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":"Baby-Friendly Hospitals, Social Determinants of Health, and Disparities in Breastfeeding Initiation in a Low-Income Population, 2017–2020","authors":"Rebecca C. Robert, Amira A. Roess, Doris Kuehn, Swathi Vinjamuri","doi":"10.1177/08903344241274306","DOIUrl":"https://doi.org/10.1177/08903344241274306","url":null,"abstract":"Background:Organizational-level interventions (i.e., Baby-Friendly Hospital Initiative) that support breastfeeding and target breastfeeding initiation are critical to reducing breastfeeding disparities and promoting breastfeeding equity.Research Aim:To determine the association between delivery in a Baby-Friendly accredited hospital and breastfeeding initiation among United States recipients of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Washington DC, the majority of whom report their race as Black.Method:We conducted a secondary analysis of de-identified program data collected as part of routine WIC visits from the Washington DC WIC program, 2017–2020. Women who delivered a firstborn, singleton infant were included ( N = 8,225). Multivariable logistic regression models accounted for social determinants of health and other factors. One set of models included a binary exposure variable (Baby-Friendly accredited vs. non-accredited hospitals), and another set included a categorical exposure variable for hospitals (1) Baby-Friendly accredited, (2) Baby-Friendly activities but not accredited, and (3) neither Baby-Friendly activities nor accredited.Results:Breastfeeding initiation was 57.4% ( n = 1988) for women delivering in accredited hospitals versus 55.4% ( n = 2540) in non-accredited hospitals and multivariable model results were non-significant ( OR = 0.95, 95% CI [0.86, 1.05]). However, more women initiated breastfeeding who delivered in either accredited hospitals (57.4%, n = 1988) or hospitals with Baby-Friendly activities but not accredited (55.9%, n = 2430) compared to those delivering in hospitals with neither (45.3%, n = 110), and multivariable models results concurred (Baby-Friendly accredited hospitals OR = 1.44, 95% CI [1.07, 1.94]; Baby-Friendly activities but not accredited, ( OR = 1.55, 95% CI [1.16, 2.09]).Conclusion:Organizational-level interventions that create hospital environments supportive of breastfeeding initiation are important to promote equity in breastfeeding, but underlying social determinants of breastfeeding outcomes must be addressed.","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":"27 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255637","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":"Cultural Domain Analysis","authors":"Zelalem T. Haile, Dawit O. Woldu","doi":"10.1177/08903344241279006","DOIUrl":"https://doi.org/10.1177/08903344241279006","url":null,"abstract":"Cultural Domain Analysis (CDA) is a theoretical and methodological approach rooted in cognitive anthropology that investigates how people in a particular culture organize, structure, and perceive ideas. Beginning in the 1960s, CDA developed into a powerful tool for collecting and analyzing data, with applications extending beyond anthropology into other fields, including public health and other social sciences. This paper outlines the procedures and methods used in CDA, its strengths and limitations, and its potential utility in breastfeeding studies. Basic features of key techniques within CDA that include free listing, pile sorting, and cultural consensus analysis are discussed. The paper also highlights how CDA seamlessly combines qualitative and quantitative data to generate culturally meaningful social theories that can inform the development of contextually relevant policies and interventions.","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":"48 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255636","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":"Advocating for Sharia-Compliant Wet Nurse System: A Culturally Sensitive Alternative to Human Milk Banks in Pakistan","authors":"Wajiha Rizwan","doi":"10.1177/08903344241276519","DOIUrl":"https://doi.org/10.1177/08903344241276519","url":null,"abstract":"","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":"12 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255638","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}