Journal of Human Lactation最新文献

{"title":"Maternal Breastfeeding Technique and Early Breastfeeding Problems as Predictors of Exclusive Breastfeeding Duration in the Neonatal Period.","authors":"Sergio Agudelo-Pérez, Maria Jose Maldonado, Paola Diaz Ritter, Mónica Fagua Rodríguez, Cristian Leonardo Vargas Fiallo","doi":"10.1177/08903344261426887","DOIUrl":"https://doi.org/10.1177/08903344261426887","url":null,"abstract":"<p><strong>Background: </strong>Globally, exclusive breastfeeding (EBF) rates remain < 50%, with the highest rate of discontinuation occurring within the first 30 days. Early identification of breastfeeding difficulties is essential for timely intervention and extension of the EBF duration.</p><p><strong>Research aim: </strong>To determine the association between early assessment of breastfeeding techniques (within 48 hr postpartum), breastfeeding-related breast complications (e.g., mastitis, fissures, engorgement, and pain), and EBF duration during the first month.</p><p><strong>Method: </strong>This prospective observational study included 120 mother-infant dyads who were followed up for 30 days postpartum. The breastfeeding technique was assessed during rooming-in using the United Nations Children's Fund (UNICEF) Breastfeeding Observation Aid, and breast-related problems were recorded. The EBF duration was tracked through weekly telephone follow-up. Kaplan-Meier survival curves and Cox regression models were used to analyze the associations between breastfeeding technique, breast complications, and EBF duration.</p><p><strong>Results: </strong>At 30 days of age, 43% of the infants were exclusively breastfed. Each additional breastfeeding difficulty was associated with a 17% higher risk of EBF interruption over time (adjusted HR: 1.17; 95% CI [1.08, 1.30]; <i>p</i> < 0.001). Breast-related problems during the first week postpartum, present in 29.2% of dyads, were also linked to early EBF cessation (adjusted HR, 1.77; 95% CI [1.07, 2.92]; <i>p</i> = 0.020).</p><p><strong>Conclusion: </strong>Difficulties in breastfeeding techniques and breast-related problems were significantly associated with a shorter EBF duration in the first month. Structured tools such as the Breastfeeding Observation Aid may support the early identification of at-risk dyads and improve EBF outcomes during the neonatal period.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261426887"},"PeriodicalIF":1.8,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623200","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 Qualitative Investigation of Traditional Breastfeeding Practices Among Lactating Mothers in Northern Ghana.","authors":"Anthony Moro, Dominic Nabil Bodpii, Robert Kuchengye Mokulogo, Awinaba Amoah Adongo, Denis Dekugmen Yar, James Akazili","doi":"10.1177/08903344261419354","DOIUrl":"https://doi.org/10.1177/08903344261419354","url":null,"abstract":"<p><strong>Background: </strong>Infant health is closely linked to feeding practices, with the World Health Organization recommending exclusive breastfeeding for the first 6 months of life. However, in some underprivileged communities in Ghana, this recommendation is not consistently followed, and traditional breastfeeding practices continue to prevail.</p><p><strong>Research aim: </strong>This study aimed to explore the indigenous breastfeeding practices among lactating mothers in Northern Ghana.</p><p><strong>Methods: </strong>A qualitative descriptive design was employed, involving in-depth interviews with 15 participants who had babies younger than 6 months. All interviews were recorded, transcribed verbatim, and analyzed using thematic data analysis.</p><p><strong>Results: </strong>The study revealed that many participants believed colostrum should not be given to babies, as it was considered unsuitable. Some participants perceived the breast milk of first-time mothers as bitter. Also, a common belief was that new-born babies should be given water as their first intake, and there was a consensus that introducing water and food before 6 months was acceptable. The findings highlighted that elderly women in the community play a significant role in preserving and enforcing indigenous practices among lactating mothers.</p><p><strong>Conclusion: </strong>Indigenous breastfeeding practices remain widespread in rural Northern Ghana. There is a need for more robust breastfeeding campaigns to address and modify these traditional practices to align with recommended guidelines.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261419354"},"PeriodicalIF":1.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609234","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 Breastfeeding Outcomes Following Neonatal Hypoxic Ischaemic Encephalopathy: A Mixed Methods Systematic Review.","authors":"Sarah Edney, Anna Basu, Anne Breaks, Nadia Leake, Judith Rankin, Farag Shuweihdi, Mari Viviers, Kirstin Webster, Lindsay Pennington","doi":"10.1177/08903344261426707","DOIUrl":"https://doi.org/10.1177/08903344261426707","url":null,"abstract":"<p><strong>Background: </strong>Hypoxic ischaemic encephalopathy (HIE) is the most frequently occurring neonatal brain injury in term-born infants. Families affected by HIE can face significant breastfeeding and lactation challenges.</p><p><strong>Aims: </strong>This systematic review aims to improve our understanding of these challenges and identify potential solutions by answering the question: What factors influence breastfeeding and lactation outcomes after neonatal HIE?</p><p><strong>Methods: </strong>This systematic review used a convergent integrated analysis mixed methods design. Eleven databases were searched for qualitative, quantitative, and mixed methods papers meeting specified criteria (e.g., born ≥ 34 weeks gestation) in November 2022 and again in July 2023 and April 2025. Full methods are registered on PROSPERO https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023375506. Of the 3393 titles and abstracts screened, 455 were identified for full-text screening and 10 were included in the review. An additional seven papers were found via reference lists and citation checking, resulting in a total of 17 included studies.</p><p><strong>Results: </strong>Five categories of potentially influencing factors were identified: infant medical factors, neuroprotective interventions, feeding during therapeutic hypothermia, support for expressing milk, and parent-infant closeness in the neonatal phase. However, significant evidence gaps were demonstrated, including the influence of environmental and social factors, interventions for lactation support and breastfeeding skills, and qualitative and mixed methods studies specifically focused on breastfeeding and lactation following neonatal HIE.</p><p><strong>Conclusion: </strong>Current research is insufficient to inform our understanding of factors influencing breastfeeding and lactation outcomes following HIE. High-quality breastfeeding and lactation-specific research is urgently needed to inform information sharing and intervention development for HIE-affected families.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261426707"},"PeriodicalIF":1.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609285","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 Care Management: Advancing Rural Health Equity With an Integrated Care Delivery Model.","authors":"Catherine Wightman, Daryl Sharp, Laura Jean Shipley, Alisa Stetzer","doi":"10.1177/08903344261431646","DOIUrl":"https://doi.org/10.1177/08903344261431646","url":null,"abstract":"<p><p>Access to International Board Certified Lactation Consultants (IBCLC) significantly improves infant feeding outcomes and yet there are substantial barriers to accessing such care in rural populations. Guided by a transitions care management model of care delivery and led by an IBCLC committed to improving health equity, a lactation care management program was developed and implemented to serve rural communities within an accountable care organization (ACO) in western New York State in the United States. The program provided patients with access to seamless IBCLC care initiated in their obstetric care setting, and then provided them care during hospital delivery as well as throughout their transition to ambulatory pediatric care. Patients were followed for 6 months postpartum. The IBCLC worked within their scope of practice to provide person and family-centered patient care, and to access community resources as needed; to support and educate patients and health care providers; and to advocate for necessary systemic changes that improve lactation health outcomes. The program was effective in improving human milk feeding initiation and duration rates compared to baseline regional and national benchmarks. Patients and health care providers benefited from the program. Patients reported improved lactation experiences in obstetric, in-patient, and pediatric settings while health care providers in these settings reported more satisfying experiences of care delivery. The program was sufficiently successful to warrant sustained ACO funding, including its replication in another rural community within the region. Implications for adapting and expanding the potential influence of this model are discussed.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261431646"},"PeriodicalIF":1.8,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607968","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 Mothers' Own Milk Provision Among Spanish-Speaking Latina Mothers of Preterm Infants.","authors":"Erika G Cordova-Ramos, Bryanne N Colvin, Rachel E Witt, Maria Estevez, Michelle-Marie Peña, Kirsten Austad, Eve R Colson, Mari-Lynn Drainoni, Margaret G Parker","doi":"10.1177/08903344261427994","DOIUrl":"https://doi.org/10.1177/08903344261427994","url":null,"abstract":"<p><strong>Background: </strong>Lactation support for Latina Spanish-speaking mothers of preterm infants in the United States remains suboptimal.</p><p><strong>Objectives: </strong>We used the theory of planned behavior (TPB) to investigate factors that facilitate or hinder mother's own milk (MOM) provision among Spanish-speaking Latina mothers of preterm infants.</p><p><strong>Methods: </strong>We conducted in-depth interviews in Spanish with mothers of early preterm infants (born < 34 weeks' gestation) from two Level III neonatal units, in Massachusetts and Colorado, 2 to 6 months after hospital discharge. Guided by the TPB domains-attitudes, perceived control, self-efficacy, and social norms-we designed the interview guide and codebook. Themes were developed deductively and iteratively.</p><p><strong>Results: </strong>We interviewed 21 Spanish-speaking mothers from Central America, the Caribbean, and Mexico. Social and cultural factors influencing MOM provision were evident across all TPB domains. For attitudes, mothers valued direct breastfeeding over pumping. For perceived control, unmet social needs hindered continuation of MOM provision, while lack of language-concordant care and suboptimal interpreter services affected hospital lactation education and support. Regarding self-efficacy, mothers viewed making MOM as a duty, and that support from partners and family boosted confidence in their ability to provide MOM. For social norms, cultural customs and beliefs shaped mothers' intent to provide MOM, with both positive and negative customs and beliefs playing a role.</p><p><strong>Conclusion: </strong>Lactation support practices for Spanish-speaking Latina mothers of preterm infants should leverage mothers' social supports and positive cultural norms and address language barriers, misbeliefs, and unmet social needs that hinder continuation of MOM provision.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261427994"},"PeriodicalIF":1.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574069","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":"Development and Psychometric Evaluation of the Breastfeeding Beliefs Scale: A Methodological Study.","authors":"Nülüfer Erbil, Leyla Emirik, Esra Güler, Büşra Nur Geldi, Tuba Çıtak","doi":"10.1177/08903344261426740","DOIUrl":"https://doi.org/10.1177/08903344261426740","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding, recognized as the most effective method for infants to receive human milk, also has significant benefits for maternal health.</p><p><strong>Research aim: </strong>The study aimed to develop a psychometric evaluation of the Breastfeeding Beliefs Scale, constructed based on the Health Belief Model in Türkiye.</p><p><strong>Methods: </strong>This methodological study was conducted with 300 pregnant women attending the Gynecology and Obstetrics Outpatient Clinic of a Ministry of Health State Hospital. Data were collected using a personal information form, the Breastfeeding Beliefs Scale, and the Antenatal Breastfeeding Self-Efficacy Scale-Short Form. Content validity was assessed using the Davis technique. Construct validity was examined through exploratory and confirmatory factor analyses using the Kaiser-Meyer-Olkin measure, Bartlett's test of sphericity, principal component analysis, and model fit indices (χ²/df, GFI, AGFI, CFI, RMSEA, and SRMR). Internal consistency was evaluated using Cronbach's alpha coefficients and item-total correlations.</p><p><strong>Results: </strong>The Breastfeeding Beliefs Scale (<i>Emzirme İnançları Ölçeği</i>) consists of 40 items across six subdimensions. Cronbach's alpha coefficients ranged from 0.706 to 0.924, indicating acceptable to excellent reliability. All items demonstrated adequate item-total correlations, and confirmatory factor analysis supported the six-factor structure, with all item <i>t</i>-values exceeding 1.96. Lower scores on the Barrier subscale and higher scores on other subscales reflect more positive breastfeeding beliefs.</p><p><strong>Conclusion: </strong>The scale can be used with pregnant women in all trimesters and is useful for assessing breastfeeding beliefs. Further studies are recommended to test its applicability in different populations and countries.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261426740"},"PeriodicalIF":1.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581469","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":"The Effects of Therapeutic Ultrasound on Human Milk Composition: A Quasi-Experimental Pre-Post Design Study.","authors":"Leanda Jane McKenna, Kristin Eu, Renee McGregor, Stephanie Melanko, Aik Ping Tay, Patricia Gaunt, Ching Tat Lai, Donna Tracy Geddes, Angela Jacques, Adelle McArdle","doi":"10.1177/08903344261430154","DOIUrl":"https://doi.org/10.1177/08903344261430154","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic ultrasound generates heating within tissues and is a popular treatment option for inflammatory conditions of the lactating breast, but it is unknown if therapeutic ultrasound alters breastmilk composition.</p><p><strong>Research aim: </strong>This study aimed to determine the effect of therapeutic ultrasound on the protein, lactose and fat concentrations of human milk in healthy lactating mothers.</p><p><strong>Method: </strong>This was a single session quasi-experimental, non-superiority, pre-post design study. Twenty-six Western Australian mothers with infants aged 1-6 months and exclusively breastfeeding were included. Mothers with inflammatory conditions of the lactating breast or contraindicated from receiving therapeutic ultrasound, were excluded. Therapeutic ultrasound was applied for 10 minutes to the right breast and samples of 5 ml expressed human milk were collected pre and post ultrasound application. Protein, lactose, and fat concentrations were measured by the Bradford method, enzymatic spectroscopy, and creamatocrit. Statistical analysis included general linear mixed modelling.</p><p><strong>Results: </strong>There was no significant difference in human milk protein composition between measures taken pre and post ultrasound (mean difference, -0.64g/L; 95% CI [-1.93, 0.64], <i>p</i> = 0.328). There was no significant difference in human milk lactose composition (mean difference, -4.77g/L; 95% CI [-11.57, 2.03], <i>p</i> = 0.169) between measures taken pre and post ultrasound. There was a significant increase in human milk fat composition between measures taken pre and post ultrasound (mean difference, 1.36%; 95% CI [0.97, 1.75], <i>p</i> <0.001).</p><p><strong>Conclusion: </strong>Therapeutic ultrasound applied to the healthy lactating breast does not adversely affect the protein, lactose, or fat concentrations of human milk.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261430154"},"PeriodicalIF":1.8,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574007","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":"The COVALAC Study: The Impact of COVID-19 Vaccination During Lactation on SARS-CoV-2-Specific Antibodies in Human Milk-A Prospective Cohort Study.","authors":"Joke Muyldermans, Stefan Embacher, Kirsten Maertens, Sereina Annik Herzog, Isabelle Desombere, Stephane De Craeye, Joeri Aerts, Eline Tommelein","doi":"10.1177/08903344261428225","DOIUrl":"https://doi.org/10.1177/08903344261428225","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19-pandemic prompted global vaccination campaigns, raising important questions about vaccine-induced immune responses in lactating women and the transfer of SARS-CoV-2-specific antibodies through human milk. This study investigated the presence of SARS-CoV-2-specific IgA and IgG antibodies in breastmilk for up to 6 months following COVID-19 vaccination and booster doses with either mRNA or adenoviral vector (AVV) vaccines.</p><p><strong>Method: </strong>The COVALAC-study was a prospective cohort study conducted in Belgium. Women were recruited between February and March 2021, followed for 180 days post-vaccination and 28 days post-booster. Breastmilk samples were collected at multiple timepoints and analyzed for IgA and IgG antibodies. Participants received either mRNA (BNT162b2, mRNA-127) or AVV (ChAdOx1 nCoV-19) vaccines. Antibody concentrations were measured using an in-house immunoassay, and analyses compared responses between vaccine types.</p><p><strong>Results: </strong>Of the 115 participants, 40% received BNT162b2, 4.3% mRNA-1273, and 55.7% ChAdOx1-S as their primary vaccination. Of these, 31 participants received an mRNA booster (11 homologous, 20 heterologous boosters). IgA and IgG antibody levels were monitored pre- and post-vaccination, showing a stronger antibody response after mRNA vaccination compared to AVV, after roughly 14 days (IgA receptor binding domain [RBD] 1.13 BAU/mil; 0.61-1.67; IgG RBD 2.56 BAU/mil; 0.76-4.71, up to 1 month, for most antibodies. Both homologous and heterologous boosters further increased antibody titers (IgA RBD 0,85 BAU/ml; 1.09-1.72).</p><p><strong>Conclusion: </strong>COVID-19 vaccination during lactating induces SARS-CoV-2 specific IgA and IgG antibodies in human milk. Antibody levels were higher following mRNA vaccination compared to AVV vaccination, with booster doses enhancing these levels further.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261428225"},"PeriodicalIF":1.8,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147529748","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":"Design and Implementation of a Physician-Run Breastfeeding Medicine Clinic for High-Risk Dyads Embedded Within a Pediatric Practice.","authors":"Piper Sandel, Michelle Leff, Eyla Boies","doi":"10.1177/08903344261431666","DOIUrl":"https://doi.org/10.1177/08903344261431666","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding and the feeding of human milk is widely accepted as the standard for infant nutrition, but early discontinuation or mixed feeding with human milk substitutes is common in the United States. Breastfeeding difficulties from complex health needs including chronic illness of the mother or infant, and infant prematurity can play a role in early discontinuation. Improving breastfeeding support can improve breastfeeding duration. Physicians with expertise in management of chronic health conditions, infant prematurity, and breastfeeding medicine distinct from the lactation consultant's scope of practice are uniquely equipped to address the needs of medically complex dyads. Integrating a breastfeeding medicine clinic within the general pediatric clinic potentially allows for more timely breastfeeding medicine support in a familiar setting where newborns usually receive care within the first few days of their life. Physicians with expertise in breastfeeding medicine have been providing this care, but it is not widely available, and there are few reports documenting this model, or the impact of this model, including the care of adult patients within a pediatric practice.</p><p><strong>Innovation: </strong>Our aim was to design and implement a physician-run breastfeeding medicine clinic caring for both adult and pediatric patients, embedded within a pediatric practice specializing in high-risk dyads, and to begin the work of documenting use and successes of this type of care.</p><p><strong>Conclusion: </strong>The establishment of this breastfeeding medicine clinic increased access to breastfeeding medicine care and provides a first step towards describing clinical models and their impact in the growing field of breastfeeding medicine.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261431666"},"PeriodicalIF":1.8,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147529523","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":"Improving Colostrum Administration to Newborns Within the First 6 Hours of Life in the Neonatal Intensive Care Unit.","authors":"Gonca Karataş Baran, Kadriye Kiziltepe, Elif Yildizhan, Satı Kürkçü, Yaprak Engin-Üstün","doi":"10.1177/08903344261428358","DOIUrl":"https://doi.org/10.1177/08903344261428358","url":null,"abstract":"<p><strong>Background and aim: </strong>Colostrum, given to newborns early in extrauterine life, provides essential nutrition, immunity, and growth support, offering a strong start for healthy development. This study aims to reduce barriers to colostrum administration and increase colostrum administration for all newborns in the Neonatal Intensive Care Unit (NICU) within the first 6 hours of life, using the Apollo Root Cause Analysis (ARCA) method.</p><p><strong>Methods: </strong>A pre-post quality improvement study was done prospectively in the NICU of a maternity hospital from July 15, 2022 to July 15, 2023. The study group consisted of 301 newborns. The ARCA method (systematic analysis and intervention guidance method) was used to identify the reasons for barriers to colostrum administration to newborns in the NICU and to optimize the solution processes.</p><p><strong>Results: </strong>The reasons for the inadequate rate of colostrum given to newborns in the first 6 hours of life were classified as lack of awareness, knowledge and skills about colostrum and disruptions in expressing colostrum, delivering it to the newborn, and applying it. With the interventions, it was determined that 93.6% of the mothers expressed their colostrum, 74.4% of the newborns received colostrum within the first 6 hours, and 85.8% were discharged with only breastfeeding.</p><p><strong>Conclusion: </strong>With the ARCA method, a gradual increase of up to four times the mean rate of giving colostrum to newborns in the first 6 hours of life was achieved. Nurses can use problem-solving techniques to ensure optimal delivery of breast milk, which has an important impact on newborn health.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"8903344261428358"},"PeriodicalIF":1.8,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147529520","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}