International Breastfeeding Journal最新文献

{"title":"Collecting real-time infant feeding and support experience: co-participatory pilot study of mobile health methodology.","authors":"Abigail E Page, Emily H Emmott, Rebecca Sear, Nilushka Perera, Matthew Black, Jake Elgood-Field, Sarah Myers","doi":"10.1186/s13006-025-00707-7","DOIUrl":"10.1186/s13006-025-00707-7","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding rates in the UK have remained stubbornly low despite long-term intervention efforts. Social support is a key, theoretically grounded intervention method, yet social support has been inconsistently related to improved breastfeeding. Understanding of the dynamics between infant feeding and social support is currently limited by retrospective collection of quantitative data, which prohibits causal inferences, and by unrepresentative sampling of mothers. In this paper, we present a case-study presenting the development of a data collection methodology designed to address these challenges.</p><p><strong>Methods: </strong>In April-May 2022 we co-produced and piloted a mobile health (mHealth) data collection methodology linked to a pre-existing pregnancy and parenting app in the UK (Baby Buddy), prioritising real-time daily data collection about women's postnatal experiences. To explore the potential of mHealth in-app surveys, here we report the iterative design process and the results from a mixed-method (explorative data analysis of usage data and content analysis of interview data) four-week pilot.</p><p><strong>Results: </strong>Participants (n = 14) appreciated the feature's simplicity and its easy integration into their daily routines, particularly valuing the reflective aspect akin to journaling. As a result, participants used the feature regularly and looked forward to doing so. We find no evidence that key sociodemographic metrics were associated with women's enjoyment or engagement. Based on participant feedback, important next steps are to design in-feature feedback and tracking systems to help maintain motivation.</p><p><strong>Conclusions: </strong>Reflecting on future opportunities, this case-study underscores that mHealth in-app surveys may be an effective way to collect prospective real-time data on complex infant feeding behaviours and experiences during the postnatal period, with important implications for public health and social science research.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"20 1","pages":"23"},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and prevalence of breastfeeding initiation in a tertiary obstetric center and its influencing factors.","authors":"A L Biermann, L Steinkasserer, L Radomsky, C von Kaisenberg, P Hillemanns, Lars Brodowski","doi":"10.1186/s13006-025-00717-5","DOIUrl":"10.1186/s13006-025-00717-5","url":null,"abstract":"<p><strong>Background: </strong>Tertiary obstetric centers are responsible for the care of all their newborns and for supporting mothers during breastfeeding. The aim of this work is to analyze the development and prevalence of breastfeeding initiation in a tertiary obstetric center. Subsequently, factors influencing the initiation of breastfeeding will be investigated.</p><p><strong>Methods: </strong>This is a retrospective study collecting data of all births of a non-selected cohort from 2017 to 2022 of singleton pregnancies at the Medical School of Hannover, Germany. Retrospective data of 16,092 women were used. We examined type of infant nutrition in our maternity unit in mothers by self-report, which was a routine survey conducted by a breastfeeding and lactation consultant within the framework of the perinatal quality assurance initiative. Secondly, factors impacting breastfeeding initiation were investigated (maternal BMI, gestational age, parity, special risk factors and birth mode) using a second cohort of 4,603 mother-child-pairs of live born, singleton full-term newborns.</p><p><strong>Results: </strong>Over the observed period, the rate of ever breastfeeding women was 93% in 2017 and 83% in 2022 indicating decreased adherence to breastfeeding. The rate of exclusively breastfeeding at the breast decreased by 21% over observed period (from 78 to 57%). While the group of feeding infant formula only and breastfeeding cessation before discharge remained stable, the rate of supplementary feeding, and breastfeeding and feeding infant formula, increased significantly. The rate of exclusive breastfeeding at the breast was lower in the groups of obese compared to normal-weight women (59.1% vs. 78.2%), women undergoing a cesarean section in comparison to vaginal birth (62.3% vs. 78.1%) and deliveries at 38 weeks of gestation compared to 40 weeks of gestation (62.7% vs. 77.3%). The infants of women with diabetes mellitus (74.2% vs. 62%) or gestational diabetes (74% vs. 65%) were significantly more likely to require infant formula than those without risk factors.</p><p><strong>Conclusions: </strong>Those women with the potentially highest benefit of breastfeeding to not exert their potential for risk reduction. Adequate awareness among healthcare professionals is imperative to capitalize on the brief but substantial opportunity to influence breastfeeding behavior in a tertiary obstetric center.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"20 1","pages":"24"},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a novel self-assessment tool for breastfeeding mothers.","authors":"Chengsi Ong, See Ling Loy, Cynthia Pang, Sharon Lee, Shamini Krishnan, Jin Ting Tan, Daniel Chan, Chee Wai Ku, Jerry Kok Yen Chan, Fabian Yap, Mei Chien Chua","doi":"10.1186/s13006-025-00715-7","DOIUrl":"10.1186/s13006-025-00715-7","url":null,"abstract":"<p><strong>Background: </strong>Difficulties with breastfeeding can lead to early breastfeeding cessation. Empowering mothers through self-assessment and education of breastfeeding skills can help support them. We aimed to develop and validate a tool for self-screening and education on breastfeeding skills.</p><p><strong>Methods: </strong>A six-item tool was developed through literature review and expert interviews, covering domains of breastfeeding position, nipple shape, breast engorgement, infant latch, swallowing and intake. Eight experts assessed the tool's relevance, clarity, simplicity and ambiguity. Scores were used to determine item-level content validity index (I-CVI) and scale-level content validity index (S-CVI). Items with values ≤ 0.83 (best possible score = 1.00) were revised. Following revision, a convenience sample of breastfeeding mothers were recruited from maternity wards and clinics to determine the tool's internal consistency, face, criterion and construct validity. Participants and lactation consultants (LC) independently completed the tool based on the same breastfeeding episode. Internal consistency was determined by Cronbach's alpha. Criterion validity was assessed by comparing participant and LC scores using Bland-Altman plots. Construct validity was determined by comparing scores in participants who were and were not referred to a LC. Receiver operating characteristic (ROC) curve was used to determine a cut-off score for LC referral by optimizing sensitivity and specificity.</p><p><strong>Results: </strong>The tool demonstrated acceptable content validity, with I-CVI and S-CVI values for relevance, clarity, simplicity and ambiguity above the threshold, except for S-CVI of simplicity and ambiguity, and the tool was revised accordingly. Most mothers who completed the tool (n = 58) found it easy to understand (87.9%), relevant (91.4%) and useful (86.2%). Cronbach's alpha was 0.66, which improved to 0.74 with the removal of the item on \"engorgement\". With the remaining five items, ROC analysis showed an area under the curve of 0.79 [(95%CI 0.67-0.90), p < 0.001], with a score of ≤ 6 indicative of an LC referral (sensitivity = 86%, specificity = 55%). Bland-Altman plots showed acceptable agreement between participant and LC scores with a mean difference of 0.22 (95%CI -3.02-3.47).</p><p><strong>Conclusions: </strong>We developed and validated a simple five-item tool for mothers to assess and be educated about breastfeeding skills. Further study on the tool's predictive validity and effectiveness within a clinical pathway is warranted.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"20 1","pages":"25"},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of infant feeding practices by maternal HIV status, and associated factors, in a rural district, South Africa 2019.","authors":"Victoria Temwanani Mukhula, Moleen Zunza, Thandiwe Elsie Mbira, Vundli Ramokolo, Andrew J Prendergast, Thorkild Tylleskär, Phillippe Van de Perre, Ameena Ebrahim Goga, Nobubelo K Ngandu","doi":"10.1186/s13006-025-00716-6","DOIUrl":"10.1186/s13006-025-00716-6","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of exclusive breastfeeding (EBF) during the first 6 months and breastfeeding up to 24 months in all mothers, regardless of HIV status, in high HIV prevalence settings of South Africa is not frequently evaluated. This study aimed to describe practices of EBF and breastfeeding beyond 12 months, compare these between HIV exposed (HE(s)) and unexposed infants (HU(s)), and determine associated factors.</p><p><strong>Methods: </strong>A secondary objective analysis of data from a cross-sectional study conducted during September-December-2019 in a rural South African district, was performed. Mothers living with HIV (MLHIV) paired with their infants in the following age groups: 0 to 3, > 3 to 6, > 6 to 12, and > 12 to 24 months; and mother-infant pairs without HIV with infants aged > 3 to 6 months and > 12 to 24 months, were enrolled. Descriptive statistics and bivariate and multivariable binomial regression were used for analyses.</p><p><strong>Results: </strong>A total of 771 mother-infant pairs, 62% being MLHIV, were enrolled. Among HEs (including 10 living with HIV), the prevalence of EBF was 41.0% and 16.7% in 0-3, and, 3-6 months age-groups, respectively, and breastfeeding prevalence was 19% in 12-24 months age-group. Among HUs, the prevalence of EBF was 7.9% among 3-6 months old and breastfeeding prevalence was 38.0% among > 12-24 months old. Overall, 79.8% and 45.5% HUs and HEs aged 3-6 months were still breastfeeding, respectively. HEs were more likely to exclusively breastfeed at 3-6 months age compared to HUs (adjusted prevalence ratio [aPR] 3.84; 95% confidence interval (CI) 1.55, 9.53). Breastfeeding practice at 12-24 months age was significantly less likely among HEs (versus HUs) and in infants with unmarried/non-cohabiting mothers (versus married/co-habiting) (aPR 0.42; 95% CI 0.27, 0.63 and aPR 0.66; 95% CI 0.47, 0.92), respectively). Among HEs, breastfeeding beyond 6 months was more likely among MLHIV with known HIV-negative male partners (versus known HIV concordant relationships).</p><p><strong>Conclusion: </strong>In this study population, EBF was comparably more likely among HEs while breastfeeding beyond 12 months was more likely among HUs. Maternal marital status, frequency of antenatal care attendance and male partner's HIV status also influenced breastfeeding practice. Overall, there is still room for improvement regardless of infant HIV status, requiring continued client-sensitive strengthening of the implementation of the recommended breastfeeding practices.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"20 1","pages":"22"},"PeriodicalIF":2.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Axial spondyloarthritis and breastfeeding: a prospective study.","authors":"Emma Hortemo Grøntvedt, Ingrid Mørdre, Marianne Wallenius, Hege Svean Koksvik, Carina Gøtestam Skorpen","doi":"10.1186/s13006-025-00714-8","DOIUrl":"10.1186/s13006-025-00714-8","url":null,"abstract":"<p><strong>Background: </strong>There is sparse literature on the topic of breastfeeding in women with axial spondyloarthritis (axSpA). Our aim was to obtain more knowledge about variables affecting breastfeeding for women with axSpA.</p><p><strong>Methods: </strong>This prospective study used data from the nationwide quality register RevNatus, which collects pregnancy-related data in women with inflammatory rheumatic diseases from Norwegian outpatient clinics in rheumatology. Data were collected during January 2016 to August 2023, reporting on 436 pregnancies in 363 patients with axSpA. The study eventually included 417 births in 350 women. Breastfeeding and non-breastfeeding women were compared at six weeks, six and twelve months postpartum. We compared the groups regarding demographic and obstetric data, neonatal outcome, disease characteristics, medical treatment and self-reported data on pain, fatigue and disease burden. Information on breastfeeding was registered at least once during the follow-up postpartum. Disease activity was measured by Ankylosing Spondyloarthritis Disease Activity Index-CRP (ASDAS-CRP) and Bath Ankylosing Disease Activity Index (BASDAI).</p><p><strong>Results: </strong>The proportion of patients breastfeeding at the postpartum follow ups was 86% (347 women) at six weeks, 70% (221 women) at six months, and 38% (104 women) at twelve months, respectively. A larger proportion of the non-breastfeeding group had delivered with caesarean section (C-section), 24 of 59 (41%) non-breastfeeding vs 70 of 347 (20%) breastfeeding women. ASDAS-CRP was higher for the non-breastfeeding group at six weeks (2.6 vs 2.2) and at six months (2.6 vs 2.1), and BASDAI was higher for the same group at six months (4.1 vs 3.2). CRP (mg/L) was significantly higher among the non-breastfeeding at six months (5.3 vs 3.3). VAS pain scores were higher for the non-breastfeeding group at six weeks (41.0 vs 31.6) and six months (43.9 vs 31.0). VAS fatigue was higher for the same group at six months (46.8 vs 37.8).</p><p><strong>Conclusion: </strong>Our results suggest that particular attention should be given regarding breastfeeding to women with active inflammatory disease and those who have undergone C-section.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"20 1","pages":"21"},"PeriodicalIF":2.9,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding of Aboriginal and/or Torres Strait Islander infants from a small rural cohort in Australia.","authors":"Oyepeju M Onifade, Saije K Endacott, Tracy Schumacher, Kym M Rae, Kirsty G Pringle","doi":"10.1186/s13006-025-00708-6","DOIUrl":"10.1186/s13006-025-00708-6","url":null,"abstract":"<p><strong>Background: </strong>Exclusive breastfeeding is recommended during an infant's first six months of life as it is the optimal way to meet the infants nutritional needs. The aim of this study was to describe the breastfeeding intentions and practices of mothers carrying First Nations babies in the Gomeroi Gaaynggal longitudinal cohort.</p><p><strong>Methods: </strong>This study uses a subset of data from participants recruited between 2010-2018. Mothers carrying First Nations babies were recruited to the study at any stage during pregnancy (N = 425) at the Tamworth Rural Referral Hospital by First Nations research assistants. Breastfeeding intentions and previous pregnancy history data were obtained from participant survey and/or hospital antenatal records (n = 246). Infant breastfeeding details were obtained from mothers who agreed to participate in the follow-up study (n = 131/182) using participant surveys at approximately 3-, 6-, 9-, 12- and 24-months.</p><p><strong>Results: </strong>Most of the mothers (72.8%; 179/246) indicated an intention to breastfeed their infants exclusively after birth. Most infants (83.9%; 104/124) received some form of breast milk (either directly from the breast or as expressed breast milk). The median breastfeeding duration of infants in this study was 35 days/5 weeks (IQR: 14-150 days/2-21.4 weeks). 35.8% (19/53) of mothers reported having trouble with breastfeeding.</p><p><strong>Conclusion: </strong>Findings from this study show that breastfeeding initiation rates are similar to those reported for First Nations people living in non-remote areas of Australia. Further investigations are required to identify factors contributing to the short breastfeeding duration observed in this cohort.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"20 1","pages":"20"},"PeriodicalIF":2.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The global burden of childhood diarrheal diseases attributable to suboptimal breastfeeding from 1990 to 2021: an exploratory analysis of estimates from the global burden of disease study.","authors":"Shuai Wang, Tao Zhang, Kaixin Wang, Dongming Li, Xueyuan Cao","doi":"10.1186/s13006-025-00713-9","DOIUrl":"10.1186/s13006-025-00713-9","url":null,"abstract":"<p><strong>Background: </strong>Understanding the spatial and temporal patterns of the disease burden of childhood diarrhea attributable to suboptimal breastfeeding (including non-exclusive and discontinued breastfeeding) is crucial for global health policy and intervention strategies. This study aimed to comprehensively assess the global, regional, and national burden of childhood diarrheal diseases attributable to suboptimal breastfeeding in 204 countries and territories from 1990 to 2021.</p><p><strong>Methods: </strong>This study utilized data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to estimate deaths, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) of childhood diarrheal diseases attributable to suboptimal breastfeeding. Suboptimal breastfeeding was assessed as a combination of non-exclusive breastfeeding and discontinued breastfeeding. And the average annual percentage change (AAPC) from 1990 to 2021 was calculated to determine long-term trends. Additionally, frontier analyses were conducted to evaluate the efficiency of different countries in reducing the disease burden relative to their socio-demographic index (SDI) levels.</p><p><strong>Results: </strong>By 2021, the global number of deaths and DALYs attributable to childhood diarrheal diseases due to suboptimal breastfeeding was 63,133 and 573,430, respectively. Between 1990 and 2021, the number of deaths and DALYs, as well as ASMR (AAPC: -5.40) and ASDR (AAPC: -5.38), declined by approximately 80%. However, significant disparities persist across regions. Low-SDI regions, particularly in Western Sub-Saharan Africa, continued to bear the highest disease burden. At the countries or territories level, Nigeria, India, and Chad recorded the highest number of deaths and DALYs, while Chad, South Sudan, and Lesotho exhibited the highest ASMR and ASDR values. Similar patterns were observed for non-exclusive and discontinued breastfeeding, with the greatest burden concentrated in resource-limited settings.</p><p><strong>Conclusion: </strong>While the global burden of childhood diarrheal diseases attributable to suboptimal breastfeeding has significantly declined over the past three decades, the disease burden remains disproportionately high in less developed regions. These findings underscore the urgent need for targeted public health policies and interventions to promote exclusive and continued breastfeeding, especially in high-burden regions, to further reduce preventable childhood morbidity and mortality.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"20 1","pages":"19"},"PeriodicalIF":2.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-exclusive breastfeeding is associated with pneumonia and asthma in under-five children: an umbrella review of systematic review and meta-analysis.","authors":"Biruk Beletew Abate, Biruk Shalmeno Tusa, Ashenafi Kibret Sendekie, Freweyni Gebreegziabher Araya, Molla Azmeraw Bizuayehu, Getachew Tesfaw Walle, Tegene Atamenta Kitaw, Befkad Derese Tilahun, Addis Wondmagegn Alamaw, Alemu Birara Zemariam, Amare Kassaw, Ayelign Mengesha Kassie, Gizachew Yilak, Fassikaw Kebede Bizuneh, Berihun Dachew","doi":"10.1186/s13006-025-00712-w","DOIUrl":"10.1186/s13006-025-00712-w","url":null,"abstract":"<p><strong>Background: </strong>Despite numerous reviews examining the impact of exclusive breastfeeding on preventing childhood pneumonia and asthma, a comprehensive and up-to-date synthesis is lacking. This umbrella review aims to consolidate the current evidence on the link between non-exclusive breastfeeding and the risk of pneumonia and asthma in under-five children.</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed, Embase, Scopus, Web of Science, the Cochrane Database of Systematic Reviews, and Google Scholar to identify systematic review and meta-analysis (SRM) studies evaluating the effect of exclusive breastfeeding on preventing childhood pneumonia and asthma globally. The latest search was conducted on January 25/2025. The quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews Two (AMSTAR-2) tool. A weighted inverse variance random-effects model was employed to generate pooled estimates. Summary effect estimates were expressed using odds ratios (OR) with 95% confidence intervals (CI). We evaluated the quality of evidence for each association using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework, categorising it as convincing (class I), highly suggestive (class II), suggestive (class III), and weak (class IV).</p><p><strong>Results: </strong>Twelve SRMs, including 270 primary studies with over ten million participants, were analysed. The random-effects model revealed a highly suggestive association between non-exclusive breastfeeding and an increase in the risk of pneumonia (OR 2.34; 95% CI 1.89, 2.78, GRADE: highly suggestive). Similarly, there was highly suggestive evidence that non-exclusive breastfeeding was associated with a 29% higher risk of childhood asthma (OR 1.21; 95% CI 1.07, 1.34, GRADE: highly suggestive).</p><p><strong>Conclusion: </strong>Our results highlighted that non-exclusive breastfeeding is associated with an increased risk of pneumonia and asthma in under-five children. These findings emphasise the critical role of exclusive breastfeeding in reducing the risk of respiratory health issues, highlighting the need for policies and initiatives that promote breastfeeding as a key strategy for improving children's health outcomes.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"20 1","pages":"18"},"PeriodicalIF":2.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a theory-based educational intervention on enhancing milk donation behavior: a cluster randomized controlled trial.","authors":"Shirin Shahbazi Sighaldeh, Maryam Moridi, Anoshirvan Kazemnejad, Vafa Ghorban Sabagh, Fatemeh Shateranni","doi":"10.1186/s13006-025-00711-x","DOIUrl":"10.1186/s13006-025-00711-x","url":null,"abstract":"<p><strong>Background: </strong>This study aims to assess the impact of an educational intervention based on the theory of planned behavior (TPB) on breastfeeding mothers' knowledge, attitude, subjective norms, perceived behavioral control regarding donor human milk (DHM), intention to donate milk and milk donation behavior.</p><p><strong>Method: </strong>This cluster randomized controlled trial (CRT) was performed on 67 breastfeeding mothers (intervention, n = 33; control, n = 34) in health centers affiliated to Tehran University of Medical Sciences (TUMS) from April 2023 to October 2023. Four weekly 60-min educational sessions were conducted based on the TPB through lectures, group discussions, psychodrama method, videos and pictures display for mothers in the intervention group, while the control group received only routine care. The data collection tool was a researcher-made questionnaire based on the TPB. It assessed breastfeeding mothers' knowledge, attitudes, subjective norms, perceived behavioral control regarding milk donation, intention to donate milk, and actual milk donation behavior. The questionnaire was completed by participants in both groups before, immediately and three months after the intervention.</p><p><strong>Results: </strong>The findings indicated that both the intervention and control groups were similar in terms of demographic and obstetrics variables. Additionally, before the intervention, there were no significant differences between the two groups regarding knowledge (P = 0.552), attitude (P = 0.734), subjective norms (P = 0.813), perceived behavioral control (P = 0.453), intention to donate milk (P=0.476) and actual milk donation behavior (P = 0.105). However, the intervention group showed significant improvements in the mean score of noted variables immediately and three months after the intervention (P < 0.05). Moreover, regarding the frequency of milk donations, three months after the intervention, eight mothers in the intervention group had donated milk, whereas none of the mothers in the control group had done so (P = 0.002).</p><p><strong>Conclusion: </strong>Our findings showed that the TPB-based educational intervention significantly enhanced milk donation behavior among breastfeeding mothers. Given that donor mothers are crucial for the establishment and sustainability of human milk banks (HMBs), such programs should be implemented to increase milk donation rates and support the development of HMBs.</p><p><strong>Trial registration: </strong>irct.ir (IRCT20230124057203N1) registered February 14, 2023.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"20 1","pages":"17"},"PeriodicalIF":2.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions and experiences related to use of breastmilk from another mother in central Nepal: a qualitative study.","authors":"Akina Shrestha, Natalie Gulrajani, Amy Sarah Ginsburg, Victoria Laleau, Soujanya Gade, Valerie Flaherman, Mahesh C Puri, Srijana Dongol","doi":"10.1186/s13006-025-00706-8","DOIUrl":"10.1186/s13006-025-00706-8","url":null,"abstract":"<p><strong>Background: </strong>When maternal breastmilk is unavailable in sufficient quantity for infant needs, the World Health Organization (WHO) recommends the use of donor breastmilk if safe, affordable, and available. However, in Nepal and most other low- and middle-income countries (LMICs), there are significant barriers to accessing safe and affordable donor breastmilk, including a paucity of milk banks. An in-depth understanding of perceptions and experiences in Nepal related to use of donor breastmilk could inform the development of interventions to address identified barriers.</p><p><strong>Methods: </strong>From December 2019 to January 2020, we conducted a qualitative study, including focus group discussions (FGDs) with parents and community health workers (CHW), and key informant interviews (KIIs) with public health stakeholders in Dhulikhel municipality, Kavrepalanchowk district in Nepal. In total, 44 individuals participated in five FGDs, including two with mothers, one with fathers, and two with CHW. Nine KIIs were conducted with stakeholders. Thematic analyses of translated transcripts were undertaken to explore perceptions and experiences of participants related to use of human donor breastmilk.</p><p><strong>Results: </strong>Participants in this study reported that informal breastmilk sharing between relatives and neighbors is common when a mothers' breastmilk is unavailable or insufficient and such sharing can occur via direct breastfeeding or milk expression. Numerous potential benefits with breastmilk sharing were described, including overcoming initial difficulties with milk supply in the postpartum period, convenience when mothers are unavailable, and reduced risk of infant infection and gastrointestinal distress. Hesitancies to breastmilk sharing included the risk of disease transmission from donor to infant and the possibility of decreased bonding between mother and infant. Some participants stated that animal milk is preferable to breastmilk sharing when mothers own milk is not available.</p><p><strong>Conclusion: </strong>Participants were aware of the potential benefits of donor breastmilk but identified numerous barriers to widespread adoption, including concerns about infectious diseases and mother-infant bonding, and preference for animal milks over another mother's milk. Addressing these concerns may help increase the acceptance and practice of donating and using donor breastmilk among mothers in Nepal.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"20 1","pages":"16"},"PeriodicalIF":2.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}