International Breastfeeding Journal最新文献

{"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":2.8,"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":2.8,"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}

{"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":2.8,"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":2.8,"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":2.8,"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 (r² = 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":2.8,"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}

{"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":2.8,"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}

{"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":"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":2.8,"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}

{"title":"Infant feeding knowledge among women living with HIV and their interaction with healthcare providers in a high-income setting: a longitudinal mixed methods study.","authors":"Ellen Moseholm, Inka Aho, Åsa Mellgren, Isik S Johansen, Terese L Katzenstein, Gitte Pedersen, Merete Storgaard, Nina Weis","doi":"10.1186/s13006-024-00677-2","DOIUrl":"10.1186/s13006-024-00677-2","url":null,"abstract":"<p><strong>Background: </strong>Recent changes in the infant feeding guidelines for women living with HIV from high-income countries recommend a more supportive approach focusing on shared decision-making. Limited information is available on the infant feeding knowledge of women living with HIV and how healthcare providers engage with them in this context. This multicenter, longitudinal, mixed methods study aims to get a comprehensive and nuanced understanding of infant feeding knowledge among women living with HIV of Nordic and non-Nordic origin living in Nordic countries, and their interaction with healthcare providers regarding infant feeding planning.</p><p><strong>Methods: </strong>Pregnant women living with HIV in Denmark, Finland, and Sweden were recruited in 2019-2020. The Positive Attitudes Concerning Infant Feeding (PACIFY) questionnaire was completed in the 3rd trimester (T1), three (T2), and six (T3) months postpartum. Women who completed the quantitative survey were also invited to participate in qualitative semi-structured interviews at T1 and T3. Results from the survey and interviews were brought together through merging to assess for concordance, complementarity, expansion, or discordance between the datasets and to draw meta-inferences.</p><p><strong>Results: </strong>In total, 44 women living with HIV completed the survey, of whom 31 also participated in the interviews. The merged analyses identified two overarching domains: Knowledge about breastfeeding in the U = U era and Communications with healthcare providers. The women expressed confusion about breastfeeding in the context of undetectable equals untransmittable (U = U). Women of Nordic origin were more unsure about whether breastfeeding was possible in the context of U = U than women of non-Nordic origin. Increased postpartum monitoring with monthly testing of the mother was not seen as a barrier to breastfeeding, but concerns were found regarding infant testing and infant ART exposure. Infant feeding discussions with healthcare providers were welcome but could also question whether breastfeeding was feasible, and many participants highlighted a need for more information.</p><p><strong>Conclusions: </strong>Healthcare providers caring for women living with HIV must have up-to-date knowledge of HIV transmission risks during breastfeeding and engage in shared decision-making to optimally support infant feeding choices.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"71"},"PeriodicalIF":2.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407143","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":"Perspectives of healthcare workers on the acceptability of donor human milk banking in Southwest Nigeria.","authors":"Ezra Olatunde Ogundare, Odunayo Adebukola Fatunla, Iyabode Olabisi Florence Dedeke, Adekunle Bamidele Taiwo, Akinyemi A Akintayo","doi":"10.1186/s13006-024-00678-1","DOIUrl":"10.1186/s13006-024-00678-1","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization prioritizes Mother's Own Milk (MOM) or donor human milk (DHM) when MOM is unavailable or insufficient. It is also important for healthcare workers (HCWs) to provide adequate support, information, and education to mothers to help improve their milk production and breastfeeding experience. DHM is scarce in developing countries, prompting a need for understanding health workers' perspectives.</p><p><strong>Methods: </strong>This cross-sectional study, conducted in 2021 in Ekiti State, Nigeria, examined the knowledge and attitudes of HCWs regarding human milk banking. A sample of 321 participants from government-owned hospitals completed a self-administered questionnaire.</p><p><strong>Results: </strong>Of the 321 participants (84.7% response rate), the majority were females (69.2%), aged 30-39 (32.1%), Christian (91.9%), and employed in tertiary hospitals (91.9%). About 65% of the HCWs believe that HMB is a safe practice and 42% believe that the DHM has the same quantity of immunological factors as fresh human milk. While 80.4% displayed good DHM knowledge, attitudes varied. The HCWs profession influenced their attitudes and a higher proportion of all female HCWs (71%), except for health assistants (65.4%), expressed willingness to donate their breast milk if needed. Among males HCWs, the majority of those who were doctors (82.8%) and pharmacists (62.5%) expressed willingness to support their spouses to donate breast milk, and they also had higher acceptance of DHM for their infants. In all, more than 80% of the HCWs will encourage mothers to donate their milk and feed babies under their care with DHM, but only 47% would accept DHM to feed their own children. Health assistants had less favourable views, and negative perceptions were linked to the internet and media sources.</p><p><strong>Conclusions: </strong>The study highlights health workers' awareness of DHM but indicates a reluctance to fully embrace it, especially among health assistants. The need for targeted education programs, to address knowledge gaps and negative perceptions, is crucial for the successful implementation of human milk banks in Nigeria. Overcoming challenges, such as safety concerns and sociocultural influences, requires focused efforts from policymakers and healthcare institutions.</p>","PeriodicalId":54266,"journal":{"name":"International Breastfeeding Journal","volume":"19 1","pages":"70"},"PeriodicalIF":2.8,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11456233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382425","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}