International Breastfeeding Journal最新文献

{"title":"“Work with us… to make it more accessible”. What women with intellectual disabilities want from infant-feeding health resources: an exploratory study","authors":"Emma Douglass, Clare Johnson, Geraldine Lucas, Sally Dowling","doi":"10.1186/s13006-023-00606-9","DOIUrl":"https://doi.org/10.1186/s13006-023-00606-9","url":null,"abstract":"More women with intellectual disabilities are becoming mothers but fewer are known to breastfeed compared with other women. Women with intellectual disabilities are entitled to accessible antenatal and infant feeding information, yet are rarely asked for their views on available resources. This article reports on the final stage of a UK project exploring how women with intellectual disabilities are supported to make infant feeding decisions. The wider project includes a scoping review and interviews with healthcare professionals, here we focus on the voices of the women themselves. Four women with an intellectual disability participated in a focus group where they were asked to give their views on the accessibility of currently available infant feeding resources and on alternative representations of infant feeding. All were interested in women’s health issues, including infant feeding. Photo-elicitation was used to gather views on videos, bespoke ‘Easy Read’ material and several alternative representations of infant feeding. A transcription of the discussion was thematically analysed whilst a critical visual analysis was undertaken of the women’s preferred images/resources. The study took place in Bristol, UK, during 2022. Two themes were identified from the group discussion: ‘The desire for choice’ and ‘How easy is ‘Easy Read’?’ The desire for choice was expressed in terms through agreements and disagreements about preferred imagery, differing tastes, and reasons for these preferences. We identified a challenge to ‘Easy Read’ as a default standard and concerns that some forms of ‘Easy Read’ can confuse rather than inform. Critical visual analysis identified the importance of the story and social setting of the preferred infant feeding image. Findings suggest a need for a suite of resources, avoiding the one-size-fits-all approach, including people with an intellectual disability at every stage of the design and production process. Resources should recognise and embrace differences in terms of understanding, visual literacy and cultural taste, as well as being freely available to support women with intellectual disabilities to make informed infant feeding decisions. An accessible film was co-produced, to disseminate the findings from all three stages of the completed project.","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138555979","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":"Sociodemographic and health-related factors associated with exclusive breastfeeding in 77 districts of Uganda.","authors":"Derrick Kimuli, Florence Nakaggwa, Norah Namuwenge, Rebecca N Nsubuga, Paul Isabirye, Kenneth Kasule, Justine Fay Katwesige, Sheila Nyakwezi, Solome Sevume, Norbert Mubiru, Barbara Amuron, Daraus Bukenya","doi":"10.1186/s13006-023-00604-x","DOIUrl":"10.1186/s13006-023-00604-x","url":null,"abstract":"<p><strong>Background: </strong>Uganda surpasses many African nations and the global average in exclusive breastfeeding (EBF) rates. Yet, malnutrition is a critical issue, with stunting impacting roughly 29% of children under 5 years. Enhancing EBF could mitigate such nutritional challenges. This study focused on determining the current EBF prevalence and identifying associated factors across 77 surveyed districts.</p><p><strong>Methods: </strong>Pooled data from the Lot Quality Assurance Sampling (LQAS) surveys conducted in 77 districts in Uganda during 2021 and 2022 were analyzed. The analysis involved 7,210 mothers of children under 6 months, EBF was considered as the proportion of infants who received breast milk only in the 24 hours before the survey. A mother practicing EBF was (1) currently breastfeeding (2) had not started giving foods other than breastmilk (3) had not given any other probed liquids or (4) semi-solid foods the previous day or night. Multivariable logistic regression was used to identify factors associated with EBF, presenting adjusted odds ratios (aOR) with corresponding 95% confidence intervals at a 5% significance level.</p><p><strong>Results: </strong>The prevalence of EBF was 62.3%. In the adjusted analysis, EBF was more common among older mothers 20-24 years, 25-29 years and 30 + years (aOR 1.4; 95% CI 1.2,1.6), (aOR 1.4; 95% CI 1.1, 1.6) and (aOR 1.3; 95% CI 1.1, 1.5) respectively compared to teenage mothers. Also, EBF was more likely among mothers who lived in rural areas compared to urban areas (aOR 1.1; 95% CI 1.0, 1.3) and those who attended antenatal care (ANC) (aOR 2.2; 95% CI 1.5, 3.1). On the contrary, EBF was less common for children aged 3-5 months compared to younger (aOR 0.5; 95% CI 0.5, 0.6) and children who had received Vitamin A supplementation (aOR 0.7; 95% 0.6, 0.8).</p><p><strong>Conclusion: </strong>The study suggests that most districts in Uganda might not have made significant strides in improving EBF rates over the last twenty years, pointing to possible ongoing hurdles that need urgent attention. Particularly, there's a pressing need to focus on teenage mothers. Maintaining and strengthening programs that advocate EBF, such as ANC, is crucial to bridge the gaps and bring about more equitable rates among different groups.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138489105","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 success and perceived social support in lactating women with a history of COVID 19 infection: a prospective cohort study.","authors":"Ashraf Moini, Fatemeh Heidari, Mitra Eftekhariyazdi, Reihaneh Pirjani, Marjan Ghaemi, Nasim Eshraghi, Maryam Rabiei","doi":"10.1186/s13006-023-00601-0","DOIUrl":"10.1186/s13006-023-00601-0","url":null,"abstract":"<p><strong>Background: </strong>Given the limited availability of research on the association between COVID-19 infection and breastfeeding success, the primary objective of this study is to conduct a comprehensive evaluation of this relationship.</p><p><strong>Methods: </strong>This prospective cohort study included 260 women who were on the postnatal ward of an academic hospital affiliated with Tehran University of Medical Sciences during the COVID-19 pandemic (between March and August 2021). Among these women, 130 had tested positive for COVID-19 in pregnancy, while the remaining 130 were considered healthy. The study aimed to assess various factors, including sociodemographic characteristics and the results of four validated questionnaires: The Bristol Breastfeeding Questionnaire, The Multidimensional of Perceived Social Support (MPSS), The Breastfeeding Self-Efficacy Scale (BSES), and The Postpartum Partner Support Scale (PPSS). These questionnaires were administered to each participant to gather relevant data. After eight weeks, a telephone follow-up was carried out to assess the success of breastfeeding. The evaluation focused on determining if exclusive breastfeeding was maintained or not. Data was collected by questioning mothers about their infants' feeding habits in the past 24 h. Exclusive breastfeeding refers to the exclusive use of breast milk without the introduction of other liquids or solid foods.</p><p><strong>Results: </strong>Women with a previous COVID-19 infection (case group) had a lower mean infant gestational age (P < 0.001) and a higher prevalence of cesarean section (P = 0.001) compared to the control group. The proportion of women who exclusively breastfed was higher in the control group (98.5%) than in women with a history of COVID-19 infection (89.2%) (P = 0.011). Furthermore, the case group reported lower scores in perceived social support and the Breastfeeding Self-Efficacy Scale, in contrast to the control group. Notably, there was a significant correlation between breastfeeding success and women's breastfeeding self-efficacy score.</p><p><strong>Conclusions: </strong>The findings of this study offer valuable insights for healthcare professionals, enabling them to promote early initiation of breastfeeding in mothers with a history of COVID-19 infection, while ensuring necessary precautions are taken.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138483442","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":"\"It has changed my life\": unconditional cash transfers and personalized infant feeding support- a feasibility intervention trial among women living with HIV in western Kenya.","authors":"Emily L Tuthill, Ann E Maltby, Belinda C Odhiambo, Thomas J Hoffmann, Maureen Nyaura, Rosemary Shikari, Craig R Cohen, Sheri D Weiser","doi":"10.1186/s13006-023-00600-1","DOIUrl":"10.1186/s13006-023-00600-1","url":null,"abstract":"<p><strong>Background: </strong>The syndemic effects of poverty, food insecurity and living with HIV are recognized as global health priorities, including through the United Nations Sustainability Goals 1, 2 and 3. Today, women and girls account for 63% of all new HIV infections in eastern and southern Africa, including Kenya. Pregnant and postpartum women living with HIV in this setting face unique challenges including increased financial insecurity as women leave the work force to care for their newborn infants. This contributes to poverty, food scarcity and stress.</p><p><strong>Methods: </strong>To address financial insecurity, improve infant feeding and reduce stress among mothers living with HIV in this setting, we developed a multilevel intervention, Supporting Healthy Mothers, consisting of 10 monthly unconditional cash transfers (10,000 KES, ~$75 USD/month) and personalized infant feeding support from pregnancy to 7 months postpartum. We conducted a non-randomized feasibility trial of this intervention among women engaged in HIV care in Kisumu, Kenya. From February 23, 2022 to March 23, 2022, we enrolled a total of 40 women who were 20-35 weeks pregnant-20 women to the intervention group at a public clinic, and 20 women to the control group at a similar clinic. Our aim was to assess feasibility, acceptability, and the potential impact of the intervention on food security, infant feeding and maternal mental health.</p><p><strong>Results: </strong>Analyzing data from all 40 participants, we found a significant reduction in food insecurity scores from baseline for the intervention group when compared to the control group at 6 weeks and 6 months postpartum (p = 0.0008 and p < 0.0001, respectively). Qualitative exit interviews with intervention group participants confirmed women felt more financially secure and had newly acquired practical knowledge and skills related to infant feeding. Women found the two intervention components highly acceptable and described an overall positive impact on wellbeing.</p><p><strong>Conclusions: </strong>The Supporting Healthy Mothers intervention has potential to positively impact women across the perinatal period and beyond by increasing financial security and supporting women to overcome infant feeding challenges and should be assessed in larger trials.</p><p><strong>Trial registration: </strong>Supporting Healthy Mothers was registered with ClinicalTrials.gov Protocol Registration and Results System, initially published on February 1, 2022.</p><p><strong>Clinicaltrials: </strong>gov ID: NCT05219552 Protocol ID: K23MH116807.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10680175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138447059","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 relationship between creamatocrit and cumulative percentage of total milk volume: a cross-sectional study in mothers of very preterm infants in Bangkok, Thailand.","authors":"Walaiporn Bowornkitiwong, Chulaluk Komoltri, Sopapan Ngerncham","doi":"10.1186/s13006-023-00599-5","DOIUrl":"10.1186/s13006-023-00599-5","url":null,"abstract":"<p><strong>Background: </strong>Human hindmilk contains higher concentrations of fat than foremilk and is more desirable for growth in preterm infants who can tolerate limited volumes of breastmilk. There is currently no clear demarcation between foremilk and hindmilk. This study characterized the change in breastmilk's fat content from the start to end of milk flow and defined this demarcation.</p><p><strong>Methods: </strong>Mothers of infants born at ≤ 32 weeks gestational age and ≥ 14 days after childbirth in a University hospital in Bangkok, Thailand between July, 2011, and April, 2012 were included in this cross-sectional study. Breastmilk samples were sequentially collected from the start to end of milk flow in 5-mL aliquots using breast pumps. The fat content of each aliquot from each breast was determined through creamatocrit. The average creamatocrit of foremilk and hindmilk were compared in predefined foremilk to hindmilk ratios of 20:80, 25:75, 33:67, and 50:50. Creamatocrit of the first and last aliquots were compared for mothers who expressed low- (≤ 25-mL per breast) and high-volumes (> 25-mL per breast) of breastmilk.</p><p><strong>Results: </strong>Of the 25 mothers enrolled, one was excluded due to unsuccessful creamatocrit measurement. The last aliquot of breastmilk had a significantly higher creamatocrit than the first from the same breast (median [interquartile range] of 12.7% [8.9%, 15.3%] vs. 5.6% [4.3%, 7.7%]; test statistic 1128, p < 0.001). Mean creamatocrit in hindmilk portions (9.23%, 9.35%, 9.81%, and 10.62%, respectively) was significantly higher than foremilk portions (6.28%, 6.33%, 6.72%, and 7.17%, respectively) at all predefined ratios. Creamatocrit increased by 1% for every 10% incremental increase in expressed breastmilk volume until the breast was emptied. Low-volume mothers had a significantly higher creamatocrit in the first aliquot compared with high-volume mothers (U = 437, p = 0.002). No significant difference in breastmilk volume was observed between mothers with and without breastfeeding experience.</p><p><strong>Conclusions: </strong>Fat content in breastmilk increased on an incremental basis. More fluid definitions of foremilk and hindmilk should be adopted. Mothers should prepare their breastmilk into aliquots based on the required feeding volume of their infant. Hindmilk aliquots can be prioritized over foremilk aliquots to ensure infants obtain optimal caloric intake.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300626","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":"Factors associated with early initiation of breastfeeding in central Saudi Arabia: a hospital-based survey.","authors":"Ameinah Thamer Alrasheedi","doi":"10.1186/s13006-023-00598-6","DOIUrl":"10.1186/s13006-023-00598-6","url":null,"abstract":"<p><strong>Background: </strong>Early initiation of breastfeeding is central to the success of infant feeding. The World Health Organization (WHO) therefore recommends breastfeeding within the first hour of birth and has set a target to increase the rate to 70% globally by 2030. This suggests the necessity of systematic investigations to capture trends in early initiation of breastfeeding to avail health systems of up-to-date information in the interest of appropriate policy making. Hence, this study was designed to investigate the factors associated with early initiation among mothers who delivered babies in public healthcare facilities in the Al-Qassim Region, Saudi Arabia.</p><p><strong>Methods: </strong>The research was a hospital-based, cross-sectional study which featured the recruitment of 546 mothers from March 2021 to June 2021 in five public hospitals. A questionnaire was the tool used for data collection and this was administered via face-to-face, structured interviews. Data were analyzed using binary logistic regression including unadjusted (UOR) and adjusted odds ratio (AOR) with a 95% confidence interval (CI).</p><p><strong>Results: </strong>The prevalence of early initiation of breastfeeding was 23.1% (120 of 519 respondents). Maternal and paternal socio-demographic variables, household characteristics, parity, age of the previous child, breastfeeding the previous child or otherwise and the sex of the newborn were not associated with the early initiation of breastfeeding. Mode of delivery and antenatal education about breastfeeding were significant factors. Postnatal care practices were also significant: the provision of help in positioning babies for breastfeeding (AOR 3.5; 95% CI 1.62, 7.57), 24-hour rooming-in (AOR 6.26; 95% CI 1.31, 29.8) and encouragement to practice early initiation of breastfeeding (AOR 3.05; 95% CI 1.71, 5.43) were good, better and the best factors associated with early initiation of breastfeeding respectively.</p><p><strong>Conclusion: </strong>The prevalence of early initiation of breastfeeding is poor and represents a threat to child survival in the study area. Postnatal care practices are crucial factors strongly predisposing mothers to early initiation of breastfeeding and should therefore be institutionalized in health policy frameworks to promote the same in Saudi Arabia.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10655455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136400249","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: Infant feeding practices and autism spectrum disorder in US children aged 2-5 years: the national survey of children's health (NSCH) 2016-2020.","authors":"Xiao-Ling Zhan, Ning Pan, Shamshad Karatela, Lei Shi, Xin Wang, Zhao-Yan Liu, Jin Jing, Xiu-Hong Li, Li Cai, Li-Zi Lin","doi":"10.1186/s13006-023-00595-9","DOIUrl":"10.1186/s13006-023-00595-9","url":null,"abstract":"","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92157304","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":"Maternity protection policies and the enabling environment for breastfeeding in the Philippines: a qualitative study.","authors":"Cherry C Maramag, Jyn Allec R Samaniego, Mary Christine Castro, Paul Zambrano, Tuan T Nguyen, Jennifer Cashin, Janice Datu-Sanguyo, Roger Mathisen, Amy Weissman","doi":"10.1186/s13006-023-00594-w","DOIUrl":"10.1186/s13006-023-00594-w","url":null,"abstract":"<p><strong>Background: </strong>The Philippines has enacted maternity protection policies, such as the 105-Day Expanded Maternity Leave Law and the Expanded Breastfeeding Promotion Act of 2009, to protect, promote, and support breastfeeding. This study aimed to review the content and implementation of maternity protection policies in the Philippines and assess their role in enabling recommended breastfeeding practices. It also identified bottlenecks to successful implementation from the perspectives of mothers and their partners, employers, and authorities from the government and non-government organizations involved in developing, implementing, monitoring, and enforcing maternity protection policies.</p><p><strong>Methods: </strong>This study employed a desk review of policies, guidelines, and related documents on maternity protection, and in-depth interviews. Of the 87 in-depth interviews, there were 12 employed pregnant women, 29 mothers of infants, 15 partners of the mothers, 12 employers and 19 key informants from the government and non-government organizations. Respondents for the in-depth interviews were from the Greater Manila Area and were recruited using purposive snowball sampling. Data were collected from December 2020 to April 2021.</p><p><strong>Results: </strong>The study shows that maternity protection policies in the Philippines are mostly aligned with the maternity protection standards set by the International Labour Organization. However, their role in improving breastfeeding practices is limited because: (1) not all working women have access to maternity protection entitlements; (2) the duration of maternity leave entitlements is inconsistent with the World Health Organization's recommended duration of exclusive breastfeeding; (3) there are gaps in policy implementation including: a lack of monitoring systems to measure the availability, functionality, and usage of lactation spaces; limited workplace support for breastfeeding; poor communication of maternity and paternity entitlements; and limited breastfeeding advocacy and promotion; and (4) there is limited integration between maternity protection and breastfeeding promotion interventions.</p><p><strong>Conclusions: </strong>There is a need to (1) strengthen communication about and promotion of maternity and paternity entitlements for mothers, fathers and employers, (2) improve monitoring and enforcement mechanisms to ensure utilization of entitlements among mothers, (3) develop modalities to extend the coverage of maternity entitlements to the informal sector, (4) fully cover paid leave entitlements from social insurance or public funding sources in line with International Labour Organization recommendations, and (5) revisit the limitations on the coverage of paternity entitlement.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10638739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72211851","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":"Facilitators, barriers, and key influencers of breastfeeding among low birthweight infants: a qualitative study in India, Malawi, and Tanzania.","authors":"Linda Vesel, Emily Benotti, Sarah Somji, Roopa M Bellad, Umesh Charantimath, Sangappa M Dhaded, Shivaprasad S Goudar, Chandrashekhar Karadiguddi, Geetanjali Mungarwadi, Sunil S Vernekar, Rodrick Kisenge, Karim Manji, Nahya Salim, Abraham Samma, Christopher R Sudfeld, Irving F Hoffman, Tisungane Mvalo, Melda Phiri, Friday Saidi, Jennifer Tseka, Mercy Tsidya, Bethany A Caruso, Christopher P Duggan, Kiersten Israel-Ballard, Anne Cc Lee, Kimberly L Mansen, Stephanie L Martin, Krysten North, Melissa F Young, Eliza Fishman, Katelyn Fleming, Katherine Ea Semrau, Lauren Spigel, Danielle E Tuller, Natalie Henrich","doi":"10.1186/s13006-023-00597-7","DOIUrl":"10.1186/s13006-023-00597-7","url":null,"abstract":"<p><strong>Background: </strong>Low birthweight (LBW) infants are at increased risk of morbidity and mortality. Exclusive breastfeeding up to six months is recommended to help them thrive through infection prevention, growth improvements, and enhancements in neurodevelopment. However, limited data exist on the feeding experiences of LBW infants, their caregivers and key community influencers. The qualitative component of the Low Birthweight Infant Feeding Exploration (LIFE) study aimed to understand practices, facilitators, and barriers to optimal feeding options in the first six months for LBW infants in low-resource settings.</p><p><strong>Methods: </strong>This study was conducted in four sites in India, Malawi, and Tanzania from July 2019 to August 2020. We conducted 37 focus group discussions with mothers and family members of LBW infants and community leaders and 142 in-depth interviews with healthcare providers, government officials, and supply chain and donor human milk (DHM) experts. Data were analyzed using a framework approach.</p><p><strong>Results: </strong>All participants believed that mother's own milk was best for LBW infants. Direct breastfeeding was predominant and feeding expressed breast milk and infant formula were rare. DHM was a new concept for most. Adequate maternal nutrition, lactation support, and privacy in the facility aided breastfeeding and expression, but perceived insufficient milk, limited feeding counseling, and infant immaturity were common barriers. Most believed that DHM uptake could be enabled through community awareness by overcoming misconceptions, safety concerns, and perceived family resistance.</p><p><strong>Conclusion: </strong>This study fills an evidence gap in LBW infant feeding practices and their facilitators and barriers in resource-limited settings. LBW infants face unique feeding challenges such as poor latching and tiring at the breast. Similarly, their mothers are faced with numerous difficulties, including attainment of adequate milk supply, breast pain and emotional stress. Lactation support and feeding counseling could address obstacles faced by mothers and infants by providing psychosocial, verbal and physical support to empower mothers with skills, knowledge and confidence and facilitate earlier, more and better breast milk feeding. Findings on DHM are critical to the future development of human milk banks and highlight the need to solicit partnership from stakeholders in the community and health system.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10634072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523377","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":"Beyond mothers: the crucial role of family caregivers' knowledge on exclusive breastfeeding in rural western China.","authors":"Jingchun Nie, Jinbiao Ye, Shichong Wu, Nan Wang, Yangyuan Li, Yunjie Liu, Zulihumaer Reheman, Junhao Wu, Jie Yang, Yaojiang Shi","doi":"10.1186/s13006-023-00596-8","DOIUrl":"10.1186/s13006-023-00596-8","url":null,"abstract":"<p><strong>Background: </strong>The exclusive breastfeeding rate in China remains significantly low. Numerous studies have identified the impact of maternal characteristics on exclusive breastfeeding; however, the correlation between primary family caregivers' characteristics, such as health and nutrition knowledge, and exclusive breastfeeding still lacks clarity. The aim of this study is to investigate the association between the health and nutrition knowledge of primary family caregivers and exclusive breastfeeding in rural China.</p><p><strong>Methods: </strong>In 2019, a cross-sectional study was conducted in two prefectures within the Qinba Mountains area, located in the southern region of Shaanxi province. Data on knowledge of health and nutrition, breastfeeding practices, breastfeeding family support, breastfeeding self-efficacy, and conflict frequency were collected via structured questionnaires from 372 caregiver-infant pairs. Infant feeding practices were assessed based on the caregivers' recall of the previous day (within the 24 h before the interview). The mother was interviewed first, followed by a brief questionnaire for the primary family caregiver, both conducted individually to minimize disruptions from other family members. Univariate and multivariate regression analyses were conducted to explore the correlation between knowledge of mothers and primary family caregivers and exclusive breastfeeding.</p><p><strong>Results: </strong>The exclusive breastfeeding rate for six-month-old infants in the sample was 15.7%. On average, mothers scored 4.6 (SD 1.4) for health and nutrition knowledge, while primary family caregivers scored 3.6 (SD 1.4). Both maternal (OR 1.48; 95% CI 1.16, 1.88) and primary family caregiver's (OR 1.34; 95% CI 1.05, 1.70) health and nutrition knowledge were significantly associated with exclusive breastfeeding. A positive correlation (OR 1.98; 95% CI 1.40, 2.80) existed between the average health and nutrition knowledge of the mother and primary family caregiver and exclusive breastfeeding. The primary family caregiver's health and nutrition knowledge was positively correlated with the practical family support perceived by the mother (OR 1.23; 95% CI 1.02, 1.49) and breastfeeding self-efficacy of the mother (β = 1.40; 95% CI 0.29, 2.50).</p><p><strong>Conclusions: </strong>The characteristics of the primary family caregiver play a large role in exclusive breastfeeding. To promote exclusive breastfeeding, interventions should address the needs of the whole family instead of just mothers.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488937","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}