International Breastfeeding Journal最新文献

{"title":"Formal and informal human milk donation in New Zealand: a mixed-method national survey.","authors":"Shalee Harris, Frank H Bloomfield, Mariana Muelbert","doi":"10.1186/s13006-024-00667-4","DOIUrl":"10.1186/s13006-024-00667-4","url":null,"abstract":"<p><strong>Background: </strong>Mother's milk provides optimal nutrition for infants. Donor human milk (DHM) is recommended for low birthweight infants when mother's milk is unavailable. Little is known about human milk (HM) donation practices in New Zealand (NZ), where few HM banks are available. This study aimed to investigate parents' and health professionals' (HP) experiences with formal and informal HM donation in NZ.</p><p><strong>Methods: </strong>Two electronic surveys were disseminated in 2022 to parents and HPs involved with HM donation in NZ. The surveys covered respondents' views and experiences with HM donation. HPs were also asked about HM donation practices in their workplace. Chi-squared and Fisher-Freeman-Halton exact tests were used for quantitative analysis and qualitative data were thematically analysed using inductive approach.</p><p><strong>Results: </strong>A total of 232 HP and 496 parents completed the surveys. Most parents either donated (52%) or sought DHM (26%) for their infant and most donations were informal, arranged between individuals (52%) or through hospital staff (22%). HP reported DHM was used in 86% of facilities, with only 20% of donations facilitated by HM banks. Almost half (48%) of HP stated they would like to use DHM in their workplace but access was limited. The most common screening processes undertaken by parents and HP before informal HM donation were lifestyle including smoking status, medication, drug and alcohol intake (44% and 36%, respectively) and serological screening such as CMV, HIV, Hepatitis C or B (30% and 39%, respectively). Pasteurisation of DHM obtained informally was not common. Most donors were satisfied with their HM donation experiences (informal and/or formal, 91%) and most respondents supported use of DHM in hospitals and community. Participants reported HM donation could be improved (e.g., better access) and identified potential benefits (e.g., species-specific nutrition) and risks (e.g., pathogens) for the infant. Potential benefits for the donor were also identified (e.g., altruism), but respondents acknowledged potential negative impacts (e.g., cost).</p><p><strong>Conclusion: </strong>Informal HM donation in NZ is common. Most parents and HP support the use of DHM; however, improvements to current practices are needed to ensure safer and more equitable access to DHM.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"61"},"PeriodicalIF":2.9,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121168","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":"Experiences of breast milk donors in Sweden: balancing the motivation to do something good with overcoming the challenges it entails.","authors":"Ylva Thernström Blomqvist, Emma Olsson","doi":"10.1186/s13006-024-00668-3","DOIUrl":"10.1186/s13006-024-00668-3","url":null,"abstract":"<p><strong>Background: </strong>Infants requiring neonatal care often face initial breastfeeding challenges, leading them to receive expressed breast milk from their mother or donor milk. While emphasizing the mother's own milk as the gold standard for infant nutrition, the utilization of donor milk stands as the preferred alternative over infant formula due to its numerous benefits. To facilitate the provision of donor milk to preterm and ill infants in neonatal units, the active participation of women willing to contribute their breast milk is crucial. This study aims to enhance the understanding of women's experiences in the donation process, thereby contributing to efforts aiming at alleviating the shortage of donated breast milk by improve the care and support for breast milk donors.</p><p><strong>Methods: </strong>This descriptive qualitative study took an inductive approach based on individual semi-structured interviews conducted during 2021 with 15 breast milk donors in Sweden. The data were analysed with thematic analysis.</p><p><strong>Results: </strong>Two themes were identified in the analysis: motivation to donate and challenges to overcome. Many of the women struggled to overcome the apparent challenges of not only starting the process of donating breast milk but also maintaining it. Despite the strain, they were motivated to donate their breast milk and seeking information by themselves to do something important for someone else. Only a few of the women talked about the financial benefits of donating breast milk; donating seemed to be mostly based on altruistic reasons.</p><p><strong>Conclusions: </strong>Despite the challenges posed by COVID-19 restrictions, time consumption, and the hard work of sterilizing pump utensils, women continued to donate their milk driven by altruism. To enhance donor support and increase milk donation, several improvements are suggested: providing comprehensive information and resources, simplifying the donation process, offering flexible scheduling, and recognizing donors' contributions.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"60"},"PeriodicalIF":2.9,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114771","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":"Incidence and factors influencing delayed onset of lactation: a systematic review and meta-analysis.","authors":"Yijuan Peng, Ke Zhuang, Yan Huang","doi":"10.1186/s13006-024-00666-5","DOIUrl":"10.1186/s13006-024-00666-5","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding has many benefits for mothers and infants. Lactogenesis II is one of the key steps in the implementation of breastfeeding. If lactogenesis II occurs more than 72 h after delivery, it is termed delayed onset of lactation (DOL). DOL is associated with decreased milk production, shortened breastfeeding time, and pathological neonatal weight loss. A comprehensive summary of the incidence and factors influencing DOL is needed to provide a basis for improving breastfeeding practices and health outcomes.</p><p><strong>Methods: </strong>Studies on the incidence and factors influencing DOL were retrieved from 13 Chinese and English databases (PubMed, Embase, Web of Science, Cochrane Library, CINAHL, etc.) from database inception to August 2023. Two researchers independently conducted the study screening, data extraction and quality evaluation. Stata 16.0 SE software was used for data analysis, and sensitivity analysis and publication bias tests were also performed. The qualitative description method was used to analyse studies that could not be combined quantitatively.</p><p><strong>Results: </strong>A total of 35 studies involving 19,176 parturients, including 4,922 who had DOL, were included. The mean Newcastle‒Ottawa scale score of the included studies was ≥ 6, indicating that the quality was relatively high. Finally, the incidence of DOL was 30%, and 13 factors influencing DOL with robust results and no publication bias were obtained: prepregnancy body mass index (overweight or obesity), gestational diabetes, gestational hypertension, thyroid disease during pregnancy, serum albumin levels (< 35 g/L), parity, (unscheduled) caesarean section, caesarean section history, daily sleep duration, gestational age, birth weight (< 2.5 kg), breastfeeding guidance and daily breastfeeding frequency. However, there were still six influencing factors with undetermined associations: age, gestational weight gain, birth weight (≥ 4 kg), anxiety, time of first breastfeeding session (maternal separation) and breast massage or treatment.</p><p><strong>Conclusions: </strong>The incidence of DOL is high. Clinicians should pay attention to parturients at high risk of DOL and formulate targeted prevention strategies according to the influencing factors to reduce the occurrence of DOL and promote better maternal and infant outcomes.</p><p><strong>Trial registration: </strong>PROSPERO (ID: CRD42023458786), September 10, 2023.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"59"},"PeriodicalIF":2.9,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037673","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":"Reliability and validity of the German version of the Iowa infant feeding attitude scale (IIFAS-G) and relations to breastfeeding duration and feeding method.","authors":"Debora Suppiger, Giancarlo Natalucci, Tilman Reinelt","doi":"10.1186/s13006-024-00665-6","DOIUrl":"10.1186/s13006-024-00665-6","url":null,"abstract":"<p><strong>Background: </strong>Public health initiatives (e.g., the Baby Friendly Hospital Initiative) have led to an increase in breastfeeding rates worldwide. However, as (exclusive) breastfeeding duration is still below WHO recommendations, it is crucial to understand the factors that influence decisions on breastfeeding practice. Modifiable psychological factors such as intention to breastfeed have therefore become targets of recent interventions. As the intention to breastfeed is among the strongest predictors of breastfeeding duration, reliable tools for measuring the intention to breastfeed are needed. The Iowa Infant Feeding Attitude Scale (IIFAS) measures attitudes towards infant feeding and is used in various languages and across different cultural contexts. However, there has been no German version of the IIFAS (IIFAS-G) so far. The aim of this study was to investigate reliability, validity, and associations of the IIFAS-G with feeding method and breastfeeding duration.</p><p><strong>Methods: </strong>Between August and November 2022, a total of 353 mothers (M_age = 35 years, SD_age = 4.2 years) of singleton infants (47.3% female (1 undetermined), M_age = 10.8 months, SD_age = 4.7 months, age range: 3-547 days; 90.4% living in Switzerland) participated in an online survey. The IIFAS-G was administered as a part of a larger study on early child development and infant feeding method.</p><p><strong>Results: </strong>The translated IIFAS-G showed unsatisfactory model fit for the two factor 17-item solution. Four items showed low factor loadings. After item reduction, a 13-item two factor solution showed satisfactory model fit (CFI = 0.92, TLI = 0.90, RMSEA = 0.07) and high internal consistency (Cronbach's α = 0.85). The IIFAS-G score was higher for mothers who exclusively breastfed their infants compared to mothers who additionally or exclusively fed infant formula. Moreover, mothers with higher IIFAS-G scores were less likely to stop breastfeeding their child over the course of 1.5years (HR = 0.87).</p><p><strong>Conclusion: </strong>A shorter two-factor IIFAS-G is proposed to investigate attitudes towards breastfeeding and formula feeding in German-speaking mothers.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"58"},"PeriodicalIF":2.9,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11337571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019591","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":"LATCHES - a memory aide for the principles of attachment for effective breastfeeding: findings of a regional pilot in the Northeast of England and North Cumbria.","authors":"Lynette Harland Shotton, Cheryl Elliot, Roslyn Nunn, Kathryn Lane","doi":"10.1186/s13006-024-00663-8","DOIUrl":"10.1186/s13006-024-00663-8","url":null,"abstract":"<p><strong>Background: </strong>This paper outlines a pilot of a new memory aide for breastfeeding conducted in the Northeast of England and North Cumbria between April and August 2023. The United Kingdom has some of the lowest rates of breastfeeding, particularly in the Northeast of England, and as such more needs to be done to support mothers to breastfeed for as long as they would like to. Good support from health professionals can be effective in influencing decisions to breastfeed as well as helping to ensure initiation and continuation of breastfeeding but there is evidence to suggest that professionals and students do not always feel adequately trained and it is here, where memory aides may have value.</p><p><strong>Methods: </strong>Key breastfeeding practitioners and educators were brought together to select one of two memory aides for principles of attachment for effective breastfeeding. The selected memory aide, LATCHS, was piloted with 57 participants with a key role in promotion and support of breastfeeding in the Northeast of England and North Cumbria.</p><p><strong>Results: </strong>Participants conveyed mixed views about the proposed memory aide with more experienced staff reporting more favourable opinions than student midwives and early years practitioners. Experienced staff felt the new memory aide would complement an early memory aide, CHINS, which focused on principles of positioning.</p><p><strong>Discussion: </strong>Findings of the pilot indicate there is a role for a mnemonic to help practitioners understand, recall, and retain theory around attachment for effective breastfeeding and that memory aides can play an important role in complementing existing approaches to education and practice. The participants felt the proposed memory aide had some limitations and suggested important ways for it to be improved, particularly in adding an E to reflect the expecting wording. This produced the final memory aide: LATCHES.</p><p><strong>Conclusion: </strong>Using data from the pilot, the memory aide was refined, and the final version LATCHES agreed for wider dissemination. Future research is needed to understand the value of LATCHES on the wider breastfeeding workforce and whether any future improvements can be made to enhance its utility.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"57"},"PeriodicalIF":2.9,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11325656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989571","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":"Beneficial effects of short-term breastfeeding versus non-breastfeeding in early life against childhood obesity: findings from the US-based population study NHANES.","authors":"Menglin Zhou, Luyao Hu, Fan Li, Jie Wen, Zhaoxia Liang, Danqing Chen","doi":"10.1186/s13006-024-00659-4","DOIUrl":"10.1186/s13006-024-00659-4","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding is widely recognized for its potential to reduce childhood obesity. However, research investigating these benefits in children breastfed for a short duration (up to 6 months) remains limited despite this being a common practice globally.</p><p><strong>Methods: </strong>This study focused on a population breastfed for 6 months or less to determine the potential benefits of short-term breastfeeding for preventing childhood obesity. Data were collected from five survey cycles of an US-based population study (the National Health and Nutrition Examination Survey (NHANES)), spanning 2009-2020. A sample of 3,211 children aged 2-6 years was selected, including 1,373 never breastfed and 1,838 ever breastfed. Logistic regression analysis examined the direct association between short-term breastfeeding and childhood obesity. Subsequent subgroup analyses were conducted. Additionally, stratified logistic regression explored the relationship between childhood obesity and the introduction of other early nutrition in both ever-breastfed and never-breastfed children.</p><p><strong>Results: </strong>Overall, breastfeeding for 6 months or less did not directly prevent childhood obesity. However, among participants with older mothers (aged 35 or above), short-term breastfeeding was associated with a lower risk of childhood obesity compared to never being breastfed (OR 0.31, 95% CI: 0.17, 0.59). Similarly, children aged 3-4 years who were breastfed for > 3 ~ 6 months exhibited a lower obesity risk (OR 0.56, 95% CI: 0.35, 0.89). In ever-breastfed children, delayed infant formula introduction was linked to a lower risk of obesity (P-trend < 0.05: introduction at age ≤ 1 vs. >1 ~ 3 vs. >3 months). Conversely, for non-breastfed children, introducing milk (other than breast milk or formula) later (≥ 12 versus < 12 months) and introducing alternatives to whole cow's milk were associated with lower obesity risks (OR 0.54, 95% CI: 0.37, 0.78; OR 0.21, 95% CI: 0.08, 0.60, respectively). Notably, these trends were not observed in ever-breastfed children.</p><p><strong>Conclusions: </strong>Short-term breastfeeding may offer some benefits in preventing childhood obesity for specific populations. Additionally, it could potentially mitigate risks associated with the introduction of formula and cow's milk at inappropriate times.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"56"},"PeriodicalIF":2.9,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11308696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903526","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":"Donor and newborn profiles and their influence on donation volume and duration: a cross-sectional study in a Spanish human milk bank.","authors":"Katherine Flores-Rojas, Mercedes Gil-Campos, Isabel Lacort-Peralta, María José Párraga-Quiles, Belén Pastor-Villaescusa","doi":"10.1186/s13006-024-00661-w","DOIUrl":"10.1186/s13006-024-00661-w","url":null,"abstract":"<p><strong>Background: </strong>Human milk banks are essential facilities to provide donated human milk (DHM) to preterm and term infants with health complications. Little is known regarding milk bank donors and how their characteristics may influence the particularities of the donation process. The present study aims to assess characteristics of donors and their newborns to identify associations with the amount of DHM and initiation and donation time, during the first and second year of the milk bank operation in Córdoba, Spain.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in three periods: pre-opening of the milk bank (PRE) including all women who gave birth to a newborn between January - May 2017 and were hospital users; donors in the first year after the opening (Period 1 (P1): April 2019 - March 2020); and in the second year (P2: April 2020 - March 2021). For P1 and P2, DHM data were recorded. The relationships between donor and newborn characteristics and the donation process were examined using univariable and regression models.</p><p><strong>Results: </strong>From 391 women interviewed in the PRE period, 55 (14%) showed intention to donate. In P1 and P2, there were 51 and 25 human milk (HM) donors, respectively. Age, gestational age (GA) and parity were similar between periods. In P2, a higher proportion of donors had higher education (P1: 46%; P2: 70.8%, p = 0.045). Around 40% of donors in both periods were on maternity leave. In P1, donors who had low birth weight infants (< 2500 g) donated more HM than those with infants weighing ≥ 2500 g (p = 0.020). In P2, women whose GA was < 37 weeks donated a higher volume vs. those with ≥ 37 weeks (p = 0.002). Maternity leave was linked to a shorter initiation time for donations in both periods (P1: p = 0.002; P2: p < 0.001).</p><p><strong>Conclusions: </strong>Data obtained from a Spanish human milk bank indicate that prematurity and low birth weight appear to influence the amounts of DHM. Employment status might be a decisive factor in initiating HM donation. Additional efforts are required to identify shared donor characteristics that influence the initiation and volume of donation.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"55"},"PeriodicalIF":2.9,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894882","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":"Prenatal intention to human milk feed in the native Hawaiian population: predictors of any human milk feeding from birth to six months postpartum","authors":"Méabh Murray, Jessie Kai, Amanda Dentinger, Leah Kaplan, Meliza Roman, Eileen O’Brien, John Kearney, Bliss Kaneshiro, Fengqing Zhu, Marie K. Fialkowski","doi":"10.1186/s13006-024-00660-x","DOIUrl":"https://doi.org/10.1186/s13006-024-00660-x","url":null,"abstract":"Rates of non-communicable diseases are disproportionately high among Native Hawaiian (NH) people, and the proportion of NH infants being fed human milk (HM) is the lowest among all ethnicities within the state of Hawaiʻi. The aim of this study was to explore biological, socio-economic, and psychosocial determinants of the initiation and duration of human milk feeding (HMF) among a study of NH mothers and infants. A sample of 85 NH mother-infant dyads who were participating in a larger prospective study were involved in this research. Recruitment for the parent was delayed due to the COVID-19 pandemic. Recruitment started in November 2020 and continued until April 2022. Questionnaires were distributed at birth, two-months, four-months, and six-months postpartum. Questionnaires addressed topics relating to maternal and infant characteristics and infant feeding practices. Descriptive statistics, comparative analysis, and multivariate logistic regression tests were conducted. The majority of participating mothers were aged between 31 and 35 years, had some college education or more, were employed, and multiparous. The majority of infants were receiving HM at each timepoint (94% at birth, 78% at two-months postpartum, and 76% at four and six-months postpartum). Factors found to be significantly associated with HMF initiation and duration were prenatal intention to HMF, maternal educational attainment, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation, and Supplemental Nutrition Assistance Program (SNAP) recipiency. A prenatal intention to HMF was found to be a strong predictor of HMF at birth (aOR = 64.18, 95% CI 2.94, 1400.28) and at two-months postpartum (aOR = 231.55, 95% CI 2.18, 2418.3). Participants not involved with WIC were more likely to be HMF at four-months postpartum (aOR = 6.83, 95% CI 1.01, 46.23). This research supports existing evidence that prenatal intention to HMF and higher maternal educational attainment are positive predictors of HMF. WIC participation and being a SNAP recipient were found to be negatively associated with HMF which suggests a need for more culturally tailored support. Further research is required to reduce the gap in knowledge related to the determinants of HMF in NH.","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"57 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141885996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of an intervention for perinatal anxiety on breastfeeding: findings from the Happy Mother-Healthy Baby randomized controlled trial in Pakistan.","authors":"Anum Nisar, Haoxue Xiang, Jamie Perin, Abid Malik, Ahmed Zaidi, Najia Atif, Atif Rahman, Pamela J Surkan","doi":"10.1186/s13006-024-00655-8","DOIUrl":"10.1186/s13006-024-00655-8","url":null,"abstract":"<p><strong>Background: </strong>The study examined the effects of Happy Mother-Healthy Baby (HMHB), a cognitive-behavioural therapy (CBT) intervention on breastfeeding outcomes for Pakistani women with prenatal anxiety.</p><p><strong>Methods: </strong>Breastfeeding practices were evaluated in a randomized controlled trial between 2019 and 2022 in a public hospital in Pakistan. The intervention group was randomized to receive six HMHB sessions targeted towards prenatal anxiety (with breastfeeding discussed in the final session), while both groups also received enhanced usual care. Breastfeeding was defined in four categories: early breastfeeding, exclusive early breastfeeding, recent breastfeeding, and exclusive recent breastfeeding. Early breastfeeding referred to the first 24 h after birth and recent breastfeeding referred to the last 24 h before an assessment at six-weeks postpartum. Potential confounders included were mother's age, baseline depression and anxiety levels, stress, social support, if the first pregnancy (or not) and history of stillbirth or miscarriage as well as child's gestational age, gender. Both intent-to-treat and per-protocol analyses were examined. Stratified analyses were also used to compare intervention efficacy for those with mild vs severe anxiety.</p><p><strong>Results: </strong>Out of the 1307 eligible women invited to participate, 107 declined to participate and 480 were lost to follow-up, resulting in 720 women who completed the postpartum assessment. Both intervention and control arms were similar on demographic characteristics (e.g. sex, age, income, family structure). In the primary intent-to-treat analysis, there was a marginal impact of the intervention on early breastfeeding (OR 1.38, 95% CI: 0.99-1.92; 75.4% (N = 273) vs. 69.0% (N = 247)) and a non-significant association with other breastfeeding outcomes (OR1.42, 95% CI: 0.89-2.27; (47) 12.9% vs. (34) 9.5%, exclusive early breastfeeding; OR 1.48, 95% CI: 0.94-2.35; 90% (N = 327) vs. 86% (N = 309), recent breastfeeding; OR1.01, 95% CI: 0.76-1.35; 49% (N = 178) vs 49% (N = 175) exclusive recent breastfeeding). Among those who completed the intervention's six core sessions, the intervention increased the odds of early breastfeeding (OR1.69, 95% CI:1.12-2.54; 79% (N = 154) vs. 69% (N = 247)) and recent breastfeeding (OR 2.05, 95% CI:1.10-3.81; 93% (N = 181) vs. 86% (N = 309)). For women with mild anxiety at enrolment, the intervention increased the odds of recent breastfeeding (OR 2.41, 95% CI:1.17-5.00; 92% (N = 137) vs. 83% (N = 123).</p><p><strong>Conclusions: </strong>The study highlights the potential of CBT-based interventions like HMHB to enhance breastfeeding among women with mild perinatal anxiety, contingent upon full participation in the intervention.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT03880032.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"53"},"PeriodicalIF":2.9,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879782","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":"Kangaroo mother care enhances exclusive breastmilk feeding and shortens time to achieve full enteral feeding in extremely preterm infants requiring non-invasive assisted ventilation.","authors":"Jiaxin Li, Huiyan Wang, Jiaming Yang, Xueyu Chen, Aifen Cao, Chuanzhong Yang, Xiaoyun Xiong","doi":"10.1186/s13006-024-00662-9","DOIUrl":"10.1186/s13006-024-00662-9","url":null,"abstract":"<p><strong>Background: </strong>Extremely preterm infants (EPIs) frequently encounter challenges in feeding due to their underdeveloped digestive systems. Attaining full enteral feeding at the earliest possible stage can facilitate the removal of vascular catheters and decrease catheter-related complications.</p><p><strong>Methods: </strong>We performed a retrospective cohort study comprising 145 extremely preterm infants with a gestational age < 28 weeks who underwent non-invasive mechanical ventilation at Shenzhen Maternity & Child Healthcare Hospital between January 2019 and June 2020. The KMC group received standard nursing care along with KMC, while the control group received standard nursing care without KMC. KMC initiation took place three weeks after admission and continued for a period of two weeks or more while maintaining stable vital signs. We evaluated the rate of exclusive breastmilk feeding within 24 h prior to discharge and the time to full enteral feeding throughout hospitalization. Additionally, we conducted a multiple linear regression analysis to identify the independent factors associated with exclusive breastmilk feeding rates and the time to full enteral feeding.</p><p><strong>Results: </strong>The KMC group exhibited a significantly higher rate of exclusive breastmilk feeding in the 24 h before discharge in comparison to the Non-KMC group (52.8% vs. 31.5%, OR 2.43; 95% CI 1.24, 4.78). Moreover, the KMC group achieved full enteral feeding in a shorter duration than the Non-KMC group (43.1 ± 9.6 days vs. 48.7 ± 6.9 days, p < 0.001). Multiple linear regression analysis revealed that KMC was an independent protective factor associated with improved exclusive breastmilk feeding rates (OR 2.43; 95% CI 1.24, 4.78) and a reduction in the time to full enteral feeding (β -5.35, p < 0.001) in extremely preterm infants.</p><p><strong>Conclusion: </strong>Kangaroo Mother Care (KMC) can expedite the achievement of full enteral feeding and enhance exclusive breastmilk feeding rates in extremely preterm infants receiving non-invasive assisted ventilation. These findings highlight the beneficial effects of KMC on the feeding outcomes of this vulnerable population, underscoring the importance of implementing KMC as a part of comprehensive care for extremely preterm infants.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"52"},"PeriodicalIF":2.9,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861612","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}