Journal of Human Lactation最新文献

{"title":"From Mother-Infant Dyad to Mother-Father-Infant Triad: A Cross-Sectional Study on Fathers' Breastfeeding Attitudes and Participation.","authors":"Zehra Çerçer, Fadime Biçer Şahin, Tuğba Kanarya","doi":"10.1177/08903344261434532","DOIUrl":"10.1177/08903344261434532","url":null,"abstract":"<p><strong>Background and aim: </strong>It is important to include fathers in the evaluation of the breastfeeding process. This study aimed to assess fathers' breastfeeding attitudes and participation.</p><p><strong>Methods: </strong>The cross-sectional study data were collected between March and June 2024 in a maternity and child hospital and completed with the participation of 194 fathers. The study data were collected using the Personal Information Form, Fathers' Breastfeeding Attitude Scale (F-BA), and Fathers' Participation in Breastfeeding Process Scale (F-PB). Descriptive statistics, one-way ANOVA, independent t-tests, and Pearson correlation were used in the analysis.</p><p><strong>Results: </strong>It was determined that the fathers' total F-BA mean score was 58.24 ± 5.62, and the total F-PB mean score was 57.09 ± 6.84. A total of 81% of fathers stated that breastfeeding was healthy for the baby. No statistical significance was found between the fathers' sociodemographic and breastfeeding characteristics and F-BA (<i>p</i> > 0.05). A statistical significance was found between the child's age, the child's nutritional method in the first 6 months, the effect of the father figure during the breastfeeding process, and F-PB (<i>p</i> < 0.05). A positive, moderate, highly significant correlation was found between the total F-BA and the total F-PB (<i>r</i> = 0.476, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Fathers in this study exhibited generally favorable attitudes toward breastfeeding. However, mean scores were close to the scale's cutoff value. Their level of participation varied based on contextual factors. These findings emphasize that positive attitudes are not necessarily associated with higher levels of active participation and highlight the importance of a deeper understanding of fathers' roles in the breastfeeding process.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"648-659"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773527","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 Validation of the Lactation Psychological Needs Scale.","authors":"Kelsie R Barta, Misty M Richmond, Becky Spencer, Sandra K Cesario","doi":"10.1177/08903344261430141","DOIUrl":"10.1177/08903344261430141","url":null,"abstract":"<p><strong>Background: </strong>According to self-determination theory, when an individual's psychological needs for autonomy, competence, and relatedness are satisfied, human flourishing can occur. The simultaneous satisfaction of the three needs has not yet been examined in the context of lactation and offers a potential explanation for variations in breastfeeding outcomes and well-being among lactating individuals.</p><p><strong>Research aim: </strong>To develop and preliminarily validate an instrument measuring lactation-related psychological need satisfaction.</p><p><strong>Method: </strong>Initial items for the Lactation Psychological Needs Scale were developed based on a literature review, and refined based on content validity testing. An online cross-sectional survey was administered in two phases to lactating individuals in the United States (<i>n</i> = 634) to assess validity and reliability.</p><p><strong>Results: </strong>Exploratory (<i>n</i> = 388) and confirmatory factor analyses (<i>n</i> = 246) in separate samples yielded a three-factor solution with excellent goodness-of-fit (chi-square Bollen-Stine adjusted <i>p =</i> 0.05, root mean square error of approximate: ≤ 0.06, comparative fit index > 0.95, and Tucker-Lewis Index > 0.95). The new instrument includes 12 items on three subscales: autonomy, competence, and relatedness. Internal consistency reliability was acceptable for the full scale (0.856) and subscales (0.790-0.861). The full instrument scores and subscale scores were positively correlated with maternal satisfaction with lactation, and negatively correlated with Edinburgh Postnatal Depression Scale scores.</p><p><strong>Conclusion: </strong>The results of this study provide preliminary psychometric support for the novel instrument. Self-determination theory provides an opportunity for a new paradigm in understanding behavior and well-being among lactating individuals. Further validation of the instrument is required.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"769-780"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674069","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":"Accuracy, Readability, and Clinical Applicability of AI-Generated Breastfeeding Education Brochures: A Mixed-Methods Evaluation.","authors":"Özen İnam, Yahya Kahvecioğlu, Samet Okay","doi":"10.1177/08903344261446830","DOIUrl":"10.1177/08903344261446830","url":null,"abstract":"<p><strong>Background: </strong>Generative artificial intelligence (AI) is increasingly used in health communication and nursing education; however, its clinical reliability remains uncertain. Breastfeeding education requires accurate, readable, and clinically applicable materials.</p><p><strong>Aim: </strong>The purpose of this explanatory sequential mixed-methods study was to evaluate AI-generated breastfeeding education brochures in terms of accuracy, readability, suitability, and clinical applicability as assessed by women's health nurses and midwives.</p><p><strong>Methods: </strong>A total of 26 women's health nurses and midwives (13 per group) were recruited using convenience sampling from obstetric and neonatal units. Participants independently evaluated AI-generated brochures using a researcher-developed 20-item instrument scored on a 3-point scale (0-2). Content validity was established through expert review by five academic specialists in women's health nursing. Internal consistency reliability was high (α = .94 and α = .72). Domain comparisons were conducted using Mann-Whitney U tests for independent groups. Semi-structured interviews (approximately 20 min) were thematically analyzed to contextualize quantitative findings.</p><p><strong>Results: </strong>Readability received the highest mean scores (<i>M</i> = 1.68-1.71), whereas clinical applicability yielded the lowest scores (<i>M</i> = 1.18-1.44). Although slight differences in mean scores were observed across domains, no statistically significant differences were found between groups (<i>p</i> > 0.05). Qualitative findings indicated strengths in clarity and structure but highlighted insufficient safety warnings and lack of source citation.</p><p><strong>Conclusion: </strong>AI-generated breastfeeding brochures demonstrate strong readability but require expert oversight to ensure clinical safety and applicability. These findings support the integration of AI tools with professional validation in women's health education.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"717-725"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973078","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' Perceptions of Climate Change and Its Effects on Breastfeeding in Türkiye: A Qualitative Study.","authors":"Havva Yesildere Saglam, Berrak Mizrak Sahin","doi":"10.1177/08903344261431657","DOIUrl":"10.1177/08903344261431657","url":null,"abstract":"<p><strong>Background: </strong>Climate change is a global issue that poses potential risks to breastfeeding practices and outcomes. Therefore, it is important for breastfeeding mothers to understand the changes caused by climate change and what they mean.</p><p><strong>Research aim: </strong>This study aimed to examine in depth the effects of climate change on breastfeeding mothers' experiences and to explore their perspectives on how environmental changes are reflected in their breastfeeding processes.</p><p><strong>Methods: </strong>This study used a qualitative descriptive design and an inductive approach. The interviews continued until data saturation was reached, and 19 breastfeeding mothers living in Türkiye completed the study. The interviews were conducted via telephone. Thematic analysis was used to analyse the data.</p><p><strong>Results: </strong>Through the thematic analysis of the interviews, four main themes and 14 subthemes were identified. The themes were: 1) impacts of climate crisis, 2) breastfeeding negatively affected by climate crisis, 3) increasing breastfeeding to mitigate the effects of climate crisis, and 4) coping with climate crisis.</p><p><strong>Conclusion: </strong>Our study found that climate change and related events affect mothers' breastfeeding experiences and cause them to worry about long-term negative health outcomes such as food insecurity and economic and psychological problems. In line with the goals of combating climate change and reducing resource consumption, breastfeeding promotion should be strengthened through policy development and awareness-raising strategies.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"895-906"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773639","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":"Linking Early Infant Growth With Milk-Derived Antibodies, Hormones, and Macronutrients During Exclusive Breastfeeding.","authors":"Laura Herrera-Astorga, Julieta Pomi, Carolina Farías, Arturo Puyol, Valentina Colistro, Karina Machado, Paula Arbildi, Claudio Rodríguez-Camejo, Ana Hernández","doi":"10.1177/08903344261430138","DOIUrl":"10.1177/08903344261430138","url":null,"abstract":"<p><strong>Background: </strong>The relevance of exclusive breastfeeding to infant development is widely recognized. However, evidence linking the contents of specific milk components during lactation and infant growth is limited and sometimes controversial.</p><p><strong>Research aims: </strong>(a) To examine a set of nutritional and bioactive milk components at two time points during exclusive lactation, and their potential influence on child growth, in a well-defined cohort of Uruguayan mothers. (b) To analyze the association between the content of these components and the anthropometric growth parameters during the first year of life.</p><p><strong>Methods: </strong>This observational study comprises 49 Uruguayan mother/child dyads. Macronutrients, cortisol, adiponectin, leptin, and antibodies were measured by ELISA in two sequential milk samples after 2.5 and 5.5 months post-delivery. The maternal perceived stress was self-reported using standardized questionnaires simultaneously. The core child's anthropometric growth parameters (body weight gain and weight-to-length ratio) were considered for simple and multivariable analysis.</p><p><strong>Results: </strong>The levels of most milk components analyzed were similar between the two time points studied, and all of them were independent of the delivery type and infant sex. The prepregnancy BMI was positively correlated with the leptin content. The cortisol level was inversely correlated with infant growth at 6 months age and was significantly lower in the group of infants with overweight/obesity at this time.</p><p><strong>Conclusion: </strong>Maternal metabolic status influences leptin levels in mature milk, while cortisol content emerges as a key factor associated with infant growth during exclusive lactation, suggesting a potential protective effect against early overweight.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"546-557"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773475","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":"Early Initiation of Breastfeeding and Exclusive Breastfeeding Practices Among Highly Educated Mothers in Indonesia: Evidence From the National Nutrition Status Survey 2022.","authors":"Yuly Astuti, Agung Dwi Laksono, Ratu Matahari, Zainal Fatoni","doi":"10.1177/08903344261425438","DOIUrl":"10.1177/08903344261425438","url":null,"abstract":"<p><strong>Background: </strong>Despite increasing levels of women's education in Indonesia, exclusive breastfeeding (EBF) rates remain stagnant and lower than in neighboring Southeast Asian countries. Early initiation of breastfeeding (EIBF) plays a crucial role in determining EBF success, yet its impact among highly educated mothers-who face distinct sociodemographic challenges-has not been fully examined.</p><p><strong>Research aim: </strong>This study aimed to analyze the association between EIBF and EBF practices among highly educated mothers in Indonesia, and to identify sociodemographic factors influencing breastfeeding outcomes.</p><p><strong>Method: </strong>A cross-sectional analysis was conducted using data from the 2022 Indonesian Nutritional Status Survey, including 24,064 children aged 0-23 months. Binary logistic regression was used to assess the relationship between EIBF and EBF, controlling for place of residence, maternal age, marital status, employment, household wealth, antenatal care visits, birthplace, and the child's sex.</p><p><strong>Results: </strong>Mothers who practiced EIBF had 1.577 times higher odds of achieving EBF (95% CI [1.566, 1.588]) than those who did not. Higher EBF rates were also observed among urban residents, younger and married mothers, unemployed women, those from wealthier households, mothers without antenatal care visits, non-institutional births, and mothers of female infants.</p><p><strong>Conclusion: </strong>EIBF significantly increases the likelihood of EBF among highly educated mothers in Indonesia. Strengthening postpartum support, workplace policies, and partner involvement is crucial to transforming maternal knowledge into sustained breastfeeding practices and promoting equitable child nutrition nationwide.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"526-534"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512640","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":"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":"807-817"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","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}

{"title":"Unveiling Milk Kinship: Profiling MicroRNAs in Milk Siblings for Epigenetic Insights.","authors":"Wan Alif Afiq Wan Nor Ruddin, Hamizah Ismail, Mohd Arifin Kaderi, Nurul Yaqin Mohd Nor, Normadiah Daud, Norafiza Zainuddin","doi":"10.1177/08903344261430156","DOIUrl":"10.1177/08903344261430156","url":null,"abstract":"<p><strong>Background: </strong>Milk kinship, in some cultures, posits that infants who receive breast milk from non-biological mothers establish a consanguinity, prohibiting future marriage between the recipient infants and the biological children of the breastfeeding mother. This kinship may be influenced by specific miRNAs in breast milk that modulate gene expression epigenetically, leaving marks within the recipient infants.</p><p><strong>Research aim: </strong>This study aims to identify lactation-specific miRNAs shared among milk siblings, compare miRNA similarity between a breastfeeding mother's milk and milk siblings' plasma, and determine their persistence post-infancy.</p><p><strong>Methods: </strong>RNA was extracted from plasma and breast milk samples, followed by NanoString miRNA analysis to profile individual miRNAs. Differential Gene Expression (DGE) analysis using the R studio NOISeq package identified significantly expressed miRNAs across all samples.</p><p><strong>Results: </strong>Detailed comparisons revealed that several similarly detected miRNAs in milk siblings were present in their corresponding breastfeeding mother's milk. DGE analysis identified five miRNAs: hsa-let-7b-5p, hsa-miR-223-3p, hsa-miR-873-3p, hsa-miR-23a-3p, and hsa-miR-378e, with hsa-miR-23a-3p exhibiting the most consistent expression pattern throughout the study.</p><p><strong>Conclusion: </strong>This study successfully identifies potential lactation-specific miRNAs that may be shared between milk siblings, providing valuable insights and laying a foundation for future identification of milk kinship biomarkers. However, despite promising findings, current evidence remains insufficient to establish a definitive link between these miRNAs and milk kinship. Further research is required to confirm these findings.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"850-864"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773431","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":"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":"751-768"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","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":"Factors Influencing Exclusive Breastfeeding Up to 6 Months Among Underserved Immigrant Women in New York City.","authors":"Jin Young Seo, Angelica Sanchez, Jeannette Safford, Stacey Whaley, William Samuels","doi":"10.1177/08903344261429803","DOIUrl":"10.1177/08903344261429803","url":null,"abstract":"<p><strong>Background: </strong>Exclusive breastfeeding for an infant's first 6 months is recommended for maternal and infant health benefits. Despite rising breastfeeding rates in the United States, the 6-month exclusive breastfeeding rate remains low, particularly among underserved women.</p><p><strong>Research aim: </strong>This study aimed to identify factors influencing exclusive breastfeeding rates during the first 6 months postpartum in a public community hospital serving underserved immigrant populations in New York City.</p><p><strong>Method: </strong>This retrospective cohort study analyzed electronic medical records of 1,510 mother-infant dyads who gave birth in 2021. Data were examined over 6 months postpartum to assess breastfeeding initiation, continuation, and associated factors. Descriptive statistics and multivariate logistic regression analyses were conducted.</p><p><strong>Results: </strong>The sample was predominantly composed of low-income women (80.3%), Medicaid recipients (94.4%), non-English speakers (63.7%), and Hispanic/Latino individuals (62.5%). Exclusive breastfeeding rates were 18.5% at discharge, 37.2% at 1 month, and 24.6% at 6 months. Maternal, newborn, and hospital-related factors were identified as key determinants. Among maternal factors, age, ethnicity, marital status, mode of delivery, and prior breastfeeding experience predicted adherence. Higher birth weight and elevated bilirubin levels were positively associated with exclusive breastfeeding, while neonatal intensive care unit admission was negatively associated. Postpartum lactation consultation was also a significant hospital-level factor.</p><p><strong>Conclusion: </strong>Exclusive breastfeeding rates in this underserved, immigrant population fell below national averages and declined over time. Key maternal, newborn, and hospital-related factors shaped breastfeeding outcomes, revealing critical gaps in lactation support and access to care. Targeted, culturally responsive interventions are essential to improve breastfeeding equity.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"511-525"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147498855","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}