{"title":"Individual- and community-level factors associated with early initiation of breastfeeding in Mozambique: evidence from the 2022-2023 Demographic and Health Survey.","authors":"Enyew Getaneh Mekonen","doi":"10.1186/s13006-024-00691-4","DOIUrl":"10.1186/s13006-024-00691-4","url":null,"abstract":"<p><strong>Background: </strong>Early initiation of breastfeeding is defined as giving breast milk to the newborn within one hour of birth. It strengthens the link between mother and child, promotes cognitive development, and lowers the chance of obesity and non-communicable diseases during the prime years of life. Nowadays, only 50% of newborns worldwide receive breast milk within their first hour of life. This study examined the prevalence and individual- and community-level factors associated with early initiation of breastfeeding using the Demographic and Health Survey data and offers suggestions that can enhance the practice in Mozambique.</p><p><strong>Methods: </strong>Data from the nationally representative Mozambique Demographic and Health Survey were used in this cross-sectional analysis. The study included a weighted sample of 3,548 children born in the two years prior to the survey. Software for statistical analysis, STATA/SE version 14.0, was used to clean, recode, and analyze the data. Utilizing multilevel logistic regression, the factors associated with the outcome variable were identified. Statistical significance was attained by variables having a p-value less than 0.05.</p><p><strong>Results: </strong>The prevalence of early initiation of breastfeeding in Mozambique was 75.03% (95% CI: 73.58%, 76.43%). Factors like non-working [AOR = 0.62; 95% CI (0.50, 0.78)], wanted last pregnancy [AOR = 1.68; 95% CI (1.33, 2.12)], antenatal care attendance [AOR = 0.63; 95% CI (0.43, 0.93)], vaginal birth [AOR = 2.30; 95% CI (1.58, 3.36)], size of the child at birth [AOR = 1.77; 95% CI (1.26, 2.48)], urban residence [AOR = 2.99; 95% CI (1.90, 4.72)], community-level antenatal care utilization [AOR = 0.52; 95% CI (0.35, 0.77)], and community poverty level [AOR = 0.34; 95% CI (0.20, 0.58)] were significantly associated with early initiation of breastfeeding.</p><p><strong>Conclusions: </strong>About three out of four newborn babies in Mozambique have an early initiation of breastfeeding. It is critical to concentrate on developing policies that support the early initiation of breastfeeding, particularly for mothers who have small children, unplanned pregnancies, non-vaginal deliveries, and reside in rural areas.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"81"},"PeriodicalIF":2.9,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900111","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}
Ida Gustafsson, Katarina Karlsson, Aleksandra Jarling, Lina Palmér
{"title":"Women's lived experience of intimate partner violence manifestations during the breastfeeding period: a lifeworld hermeneutic study.","authors":"Ida Gustafsson, Katarina Karlsson, Aleksandra Jarling, Lina Palmér","doi":"10.1186/s13006-024-00690-5","DOIUrl":"10.1186/s13006-024-00690-5","url":null,"abstract":"<p><strong>Background: </strong>One in three women will experience Intimate Partner Violence (IPV). Exposure during breastfeeding endangers women's and children's health and wellbeing, negatively affects breastfeeding, and violates human rights and global sustainability goals. Previous qualitative studies have demonstrated that existential aspects are crucial in the separate experience of both IPV and breastfeeding. However, there is a lack of studies examining the meaning of the concurrent experience of these phenomena. An enhanced understanding of the experience of IPV manifestations during the breastfeeding period may inform the provision of care and support for women exposed to IPV. Accordingly, the study aims to explain and understand women's lived experience of IPV manifestations during the breastfeeding period.</p><p><strong>Methods: </strong>The study adopts a lifeworld hermeneutic approach based on Reflective Lifeworld Research. Data collection was conducted between June 2022 and August 2023. Swedish women with experience of the phenomenon IPV manifestations during the breastfeeding period participated either through written lifeworld stories (forty-nine women) or lifeworld interviews (nine women). Data were analysed interpretatively. The main interpretation was inspired by Liz Kelly's theory 'The continuum of violence'.</p><p><strong>Results: </strong>The results show that women experience IPV manifestations during breastfeeding in terms of being accused, devalued, neglected, controlled, opposed, forced to adapt, and/or punished. The main interpretation suggests that the manifestations are intertwined within a multidimensional continuum where the most frequent IPV manifestations are less commonly recognised as violence. The main interpretation further illustrates that the continuum is dependent on both the subjective lifeworld of the woman and the patriarchal context in which it exists. In relation to the patriarchal context, the breastfeeding intimacy within the mother-child dyad is pivotal to explaining and understanding the phenomenon.</p><p><strong>Conclusions: </strong>The breastfeeding intimacy within the mother-child dyad seems to change the intersubjective power balance in the partner relationship and provoke partners, making breastfeeding women especially vulnerable to IPV. Knowledge of breastfeeding women's lived experience of exposure to IPV is central for carers to strengthen their ability to support women's health and wellbeing.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"80"},"PeriodicalIF":2.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840381","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}
Sergio Agudelo-Pérez, Daniel Botero-Rosas, Laura Rodríguez-Alvarado, Julián Espitia-Angel, Lina Raigoso-Díaz
{"title":"Artificial intelligence applied to the study of human milk and breastfeeding: a scoping review.","authors":"Sergio Agudelo-Pérez, Daniel Botero-Rosas, Laura Rodríguez-Alvarado, Julián Espitia-Angel, Lina Raigoso-Díaz","doi":"10.1186/s13006-024-00686-1","DOIUrl":"10.1186/s13006-024-00686-1","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding rates remain below the globally recommended levels, a situation associated with higher infant and neonatal mortality rates. The implementation of artificial intelligence (AI) could help improve and increase breastfeeding rates. This study aimed to identify and synthesize the current information on the use of AI in the analysis of human milk and breastfeeding.</p><p><strong>Methods: </strong>A scoping review was conducted according to the PRISMA Extension for Scoping Reviews guidelines. The literature search, performed in December 2023, used predetermined keywords from the PubMed, Scopus, LILACS, and WoS databases. Observational and qualitative studies evaluating AI in the analysis of breastfeeding patterns and human milk composition have been conducted. A thematic analysis was employed to categorize and synthesize the data.</p><p><strong>Results: </strong>Nineteen studies were included. The primary AI approaches were machine learning, neural networks, and chatbot development. The thematic analysis revealed five major categories: 1. Prediction of exclusive breastfeeding patterns: AI models, such as decision trees and machine learning algorithms, identify factors influencing breastfeeding practices, including maternal experience, hospital policies, and social determinants, highlighting actionable predictors for intervention. 2. Analysis of macronutrients in human milk: AI predicted fat, protein, and nutrient content with high accuracy, improving the operational efficiency of milk banks and nutritional assessments. 3. Education and support for breastfeeding mothers: AI-driven chatbots address breastfeeding concerns, debunked myths, and connect mothers to milk donation programs, demonstrating high engagement and satisfaction rates. 4. Detection and transmission of drugs in breast milk: AI techniques, including neural networks and predictive models, identified drug transfer rates and assessed pharmacological risks during lactation. 5. Identification of environmental contaminants in milk: AI models predict exposure to contaminants, such as polychlorinated biphenyls, based on maternal and environmental factors, aiding in risk assessment.</p><p><strong>Conclusion: </strong>AI-based models have shown the potential to increase breastfeeding rates by identifying high-risk populations and providing tailored support. Additionally, AI has enabled a more precise analysis of human milk composition, drug transfer, and contaminant detection, offering significant insights into lactation science and maternal-infant health. These findings suggest that AI can promote breastfeeding, improve milk safety, and enhance infant nutrition.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"79"},"PeriodicalIF":2.9,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787536","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":"Association between breastfeeding-friendly environmental factors and breastfeeding practices at 6 months in mothers in Taiwan.","authors":"Tzu-Ling Chen, Li-Li Chen, Meei-Ling Gau","doi":"10.1186/s13006-024-00681-6","DOIUrl":"10.1186/s13006-024-00681-6","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization (WHO) aims to achieve a 50% rate of exclusive breastfeeding (EBF) during the first six months of life by 2025. Continuing breastfeeding up to six months is determined by an individual woman's choice and the availability of breastfeeding-friendly environments.</p><p><strong>Methods: </strong>In this multicenter prospective longitudinal study, we identified breastfeeding-friendly environmental factors that were associated with breastfeeding practices from days 1-5 to six months postpartum. Breastfeeding-friendly environmental factors were assessed using structured questionnaires for mothers who gave birth under a Baby-Friendly Hospital Initiative (BFHI). We evaluated uptake of breastfeeding by asking mothers if they used the indicated practices, as well as their perceived level of acceptance of breastfeeding among their live-in family members and their perceived availability of lactation rooms in public settings. From 2012 to 2016, we recruited 1,870 women at 1-5 days postpartum from obstetrics medical facilities in Taiwan and followed their breastfeeding status at one, two, four, and six months postpartum. The definition of EBF was that the infant had received only breast milk since birth, with no supplemental infant formula. We categorized breastfeeding practices into two groups: continuing EBF and non-continuing EBF at six months. We used logistic regression models to identify factors associated with continuing EBF at six months postpartum.</p><p><strong>Results: </strong>The prevalence of EBF and non-EBF at six months postpartum was 30.9% and 69.1%, respectively. The logistic regression analysis revealed that above university-level education, multiparity, and vaginal delivery were positively associated with continuing EBF. The Ten Step Baby-Friendly Hospital Initiative practices, perceived acceptance of breastfeeding in live-in families, and perceived availability of lactation rooms in public settings, were associated with a higher likelihood of continuing EBF. Postpartum women who returned to work at or after two months postpartum were more likely to report non-continuing EBF than women who did not return to work.</p><p><strong>Conclusion: </strong>Those who promote public health should advocate for breastfeeding-friendly practices, including the adoption of breastfeeding-friendly measures in public and workplace settings and providing increased support for breastfeeding mothers during and after hospitalization.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"78"},"PeriodicalIF":2.9,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717659","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}
Sara Hellström, Karolina Linden, Verena Sengpiel, Anders Elfvin
{"title":"Implementing a colostrum-kit reduces the time to first colostrum for neonates admitted to the NICU - a retrospective observational study.","authors":"Sara Hellström, Karolina Linden, Verena Sengpiel, Anders Elfvin","doi":"10.1186/s13006-024-00682-5","DOIUrl":"10.1186/s13006-024-00682-5","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organisation states that newborns should receive colostrum as soon as possible after birth. However, among newborns needing neonatal intensive care, initiation of lactation and access to colostrum might be delayed. At the centre of this study, a tertiary care hospital in Sweden (10,000 deliveries/year), few admitted infants received colostrum within the day of birth, warranting a quality improvement. In order to reduce the time from birth to first colostrum received by infants admitted to the Neonatal Intensive Care Unit (NICU), a new clinical routine including a colostrum-kit, was implemented as standard care in June 2018. The colostrum-kit contained information about hand expression of breastmilk as well as material for collecting, labelling and transporting the colostrum. The kit should be handed to all birthing parents with infants admitted to the NICU.</p><p><strong>Methods: </strong>Data on time in minutes from birth to first colostrum administered to the infant (oral mouth care, oral feeding or gavage feeding) was retrieved for all infants born between 1 September 2016 and 31 October 2023, admitted to the NICU within 1h from birth. Infants were divided into four time-cohorts, compared with nonparametric ANOVA.</p><p><strong>Results: </strong>The study included 3618 infants born at 22 + 0 - 43 + 0 weeks gestational age, of whom 2814 (78%) had available data on time to colostrum. Median (IQR) time in hours was 35 (20-36) pre-implementations, followed by 18 (7-38), 11 (4-26) and 8 (3-22) in the subsequent follow-up cohorts, p < 0.001. Subgroups of mode of delivery had median (IQR) pre-implementation of 30 (19-54) for vaginal and 47 (23-72) for caesarean section that reached 7 (2-18) and 9 (3-26) in the last follow-up. Subgroups of gestational age (< 28, 28-31, 32-36, > 36 weeks) had a pre-implementation time of 48 (26-80), 46 (23-73), 33 (20-60) and 32 (19-57), that in the last follow-up was reduced to 4 (2-20), 7 (2-29), 9 (2-33) and 9 (4-19).</p><p><strong>Conclusions: </strong>Implementing a colostrum-kit for infants admitted to the NICU significantly reduced the time to first colostrum administered to the infant in all gestational ages. The difference between subgroups of gestational age or mode of delivery was reduced. The effect persisted over time.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"77"},"PeriodicalIF":2.9,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644759","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":"Correction: New latex agglutination assay for the determination of lactoferrin in human milk.","authors":"Miori Tanaka, Midori Date, Katsumi Mizuno","doi":"10.1186/s13006-024-00683-4","DOIUrl":"10.1186/s13006-024-00683-4","url":null,"abstract":"","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"76"},"PeriodicalIF":2.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632592","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":"Relationship between breastfeeding and hepatic steatosis in women with previous gestational diabetes mellitus.","authors":"Supatsri Sethasine, Chadakarn Phaloprakarn","doi":"10.1186/s13006-024-00684-3","DOIUrl":"10.1186/s13006-024-00684-3","url":null,"abstract":"<p><strong>Background: </strong>Non-alcoholic fatty liver disease (NAFLD), characterized by excess liver fat, is common in women with a history of gestational diabetes mellitus (GDM). While breastfeeding improves postpartum lipid levels, its impact on NAFLD in these women is not well studied. We aimed to investigate the relationship between the duration and intensity of breastfeeding and the amount of liver fat and prevalence of NAFLD in women with previous GDM at approximately 1 year postpartum.</p><p><strong>Methods: </strong>This prospective cohort study was conducted at a university hospital in Bangkok, Thailand between November 2021 and February 2024. Overall, 130 women who had experienced GDM in their most recent pregnancy were followed up for 1 year postpartum. We collected data on breastfeeding practices and quantified liver fat using controlled attenuation parameters (CAPs) during transient elastography. NAFLD was defined as a CAP of ≥ 302 dB/m. Women were divided into three groups according to the duration and intensity of breastfeeding: group 1 (breastfeeding for < 6 months), group 2 (breastfeeding for ≥ 6 months and exclusive breastfeeding [EBF] for < 6 months), and group 3 (breastfeeding for ≥ 6 months and EBF for 6 months).</p><p><strong>Results: </strong>Overall, 57 (43.8%), 26 (20.0%), and 47 (36.2%) participants were categorized into groups 1, 2, and 3, respectively. Group 3 had the lowest CAPs, followed by groups 2 and 1. The median values (interquartile ranges) of the CAPs were 219.0 (189.0-271.0) dB/m, 257.5 (205.3-317.3) dB/m, and 279.0 (191.5-324.0) dB/m for groups 3, 2, and 1, respectively (p = 0.034). NAFLD prevalence was significantly lower in group 3 compared to groups 2 and 1 (19.1% vs. 38.5% vs. 43.9%, respectively; p = 0.026). Multivariate analysis showed that breastfeeding for ≥ 6 months and EBF for 6 months reduced the risk of NAFLD, with an adjusted odds ratio of 0.34 (95% confidence interval 0.14, 0.95).</p><p><strong>Conclusions: </strong>Breastfeeding for ≥ 6 months, particularly EBF for the first 6 months, may offer a practical strategy to reduce the risk of NAFLD in women with prior GDM.</p><p><strong>Trial registration: </strong>Thai Clinical Trials Registry: Registration no. TCTR20211027008. Date of registration: October 27, 2021. Date of initial participant enrollment: November 1, 2021.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"75"},"PeriodicalIF":2.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632593","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":"New latex agglutination assay for the determination of lactoferrin in human milk.","authors":"Miori Tanaka, Midori Date, Katsumi Mizuno","doi":"10.1186/s13006-024-00680-7","DOIUrl":"10.1186/s13006-024-00680-7","url":null,"abstract":"<p><strong>Background: </strong>Lactoferrin (LF) in human milk has various biological properties and contributes to the prevention of preterm birth complications. Enzyme-linked immunosorbent assay (ELISA) is one of the most commonly used methods to measure LF in human milk, but this method is time-consuming and laborious. In Japanese human milk banks, the concentration of LF in donor human milk (DHM) is measured routinely. Here, we reported a rapid, simple, and accurate method for determining LF in human milk using a new reagent based on a latex agglutination assay.</p><p><strong>Methods: </strong>We obtained 208 human milk pools from 148 mothers, and samples were collected before and after Holder pasteurization. Milk samples were diluted 100- or 200-fold and LF concentrations were measured by a latex agglutination assay using an automated analyzer. The reagent was validated in terms of repeatability, linearity, detection limit, recovery, and comparison with ELISA.</p><p><strong>Results: </strong>The coefficient of variation (CV) for intra-assay precision ranged from 0.6 to 5.0% in human milk with high, medium, and low LF concentrations. The linearity was also tested by serial sample dilution and was confirmed up to 16 µg/mL with a detection limit of 0.2 µg/mL. The recovery rates in a spiked recovery test were ranged from 90 to 120% at high, medium, and low concentrations of LF. Furthermore, a strong correlation was observed between LF levels determined by the latex agglutination assay and ELISA (r = 0.978, p < 0.001, n = 255). The regression equation was y = 0.991x + 0.545 (r<sup>2</sup> = 0.974, p < 0.001). Compared with ELISA, the latex agglutination assay reduces the measurement time by 160 min and the cost by 55%.</p><p><strong>Conclusions: </strong>The latex agglutination assay used to determine LF in human milk is rapid, simple, and accurate enough to be used routinely. Its use may contribute to the quick and easy provision of appropriate DHM to preterm infants.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"74"},"PeriodicalIF":2.9,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559440","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}
Angelina Noll, Kris R Kawamoto, Maya T Dassanayake, Laura Leuenberger, Stephanie M Spehar, Jenny Wu, Elizabeth Langen, Melinda B Davis
{"title":"Breastfeeding in patients with peripartum cardiomyopathy: clinical outcomes and physician counseling.","authors":"Angelina Noll, Kris R Kawamoto, Maya T Dassanayake, Laura Leuenberger, Stephanie M Spehar, Jenny Wu, Elizabeth Langen, Melinda B Davis","doi":"10.1186/s13006-024-00673-6","DOIUrl":"10.1186/s13006-024-00673-6","url":null,"abstract":"<p><strong>Background: </strong>Peripartum cardiomyopathy (PPCM) is a form of heart failure occurring towards the end of pregnancy or in the months following delivery. Concerns regarding the role of prolactin (the polypeptide hormone responsible for lactation) driving the pathogenesis of PPCM have led experts to discourage patients from breastfeeding; however, limited clinical data exist. We sought to (1) determine whether lactation was associated with less cardiac recovery and (2) assess the counseling about breastfeeding given to patients at the time of their initial diagnosis.</p><p><strong>Methods: </strong>Patients diagnosed with PPCM from 1999 to 2019 were identified through detailed chart review and demographic characteristics, comorbidities, outcomes, and lactation status were collected. Cardiac recovery was defined as left ventricular ejection fraction (LVEF) 55% or higher. A survey about breastfeeding and patient experience was administered by mail. Patients were only included in this analysis if definitive information about lactation status was documented.</p><p><strong>Results: </strong>Of 220 patients with confirmed PPCM, lactation status was known definitively in 54 patients; of these, 18 (33%) had breastfed for at least 6 weeks and 36 (67%) did not breastfeed. There were no significant differences in the breastfeeding and non-breastfeeding groups related to baseline LVEF, age, race, gestational diabetes, smoking, hypertensive disorders of pregnancy, and medication treatments. Despite similar baseline LVEF at the time of diagnosis, there was no statistically significant difference in cardiac recovery based on lactation status. In a subset of patients with severe cardiac dysfunction at the time of diagnosis, there remained no significant differences in recovery based on lactation status. Of the 34 survey respondents, 62% were told not to breastfeed due to their diagnosis or concerns regarding safety of medications, and none were encouraged to breastfeed.</p><p><strong>Conclusion: </strong>In this retrospective cohort, lactation was not associated with lower rates of myocardial recovery. Importantly, a majority of patients had received counseling that they should not breastfeed. Future studies of the role of lactation in PPCM are needed in order to better understand the impact of breastfeeding and improve patient counseling.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"73"},"PeriodicalIF":2.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548933","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}
Claire Eades, Pat Hoddinott, Dawn Cameron, Josie Evans
{"title":"Breastfeeding frequency and incidence of type 2 diabetes among women with previous gestational diabetes compared to those without: a historical cohort study in the UK.","authors":"Claire Eades, Pat Hoddinott, Dawn Cameron, Josie Evans","doi":"10.1186/s13006-024-00679-0","DOIUrl":"https://doi.org/10.1186/s13006-024-00679-0","url":null,"abstract":"<p><strong>Background: </strong>There is a growing body of research to suggest that women with gestational diabetes are less likely to initiate and continue breastfeeding than those who have not had however findings are mixed. There is limited research in the UK assessing the frequency of breastfeeding in women with gestational diabetes, none reporting the association of breastfeeding with incidence of type 2 diabetes and existing research has not adequately adjusted for potential confounders. This study aims to assess frequency of breastfeeding among women with gestational diabetes compared to those without, and to explore how breastfeeding influences risk of future type 2 diabetes in women with gestational diabetes while adjusting for known confounders.</p><p><strong>Methods: </strong>Historical cohort study using routinely collected health care data from Fife and Tayside Health Boards, Scotland, UK including all women diagnosed with gestational diabetes between 1993 and 2015 and a matched comparator cohort (n = 4,968). Women with gestational diabetes were followed up until a diagnosis of type 2 diabetes, the end of the study, or date of death. Multinomial logistic regression was used to estimate odds ratios for breastfeeding for the whole sample and the association between breastfeeding and development of type 2 diabetes in women with gestational diabetes was assessed by Cox regression.</p><p><strong>Results: </strong>Women with a diagnosis of gestational diabetes, who were younger, overweight/obese or living in the most deprived areas were significantly less likely to exclusively breastfeed for a duration of longer than eight weeks. Risk of developing type 2 diabetes among women with gestational diabetes was significantly higher for those who exclusively breastfed less than 8 weeks, lived in the most deprived areas or had a family history of diabetes.</p><p><strong>Conclusions: </strong>This study confirms the important role of a short duration of exclusive breastfeeding in protecting women with gestational diabetes against type 2 diabetes but highlights the challenges to breastfeeding in this group. Interventions are needed to support breastfeeding among women with gestational diabetes that are acceptable to younger, overweight/obese women living in deprived areas.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"72"},"PeriodicalIF":2.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480695","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}