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INTRODUCTION: Maternal overweight and obesity during pregnancy have been shown to have multiple negative effects on the mother's health, which can even affect the infant's growth by increasing weight gain and altering various indicators, such as weight for age, length for age and weight for length. While breast milk on the other hand reduces these risks, and it's the best and most complete food for the newborn. It's a dynamic fluid capable of being modified to meet the needs of each stage of the newborn, but despite this capacity and the fact that maternal body mass index can have an impact on its components, through complex biological mechanisms, it manages to reduce the negative effects accumulated during pregnancy and even promotes a healthy state in the baby. In a country like Mexico, where overweight and obesity affect a large part of the population, it is important to study their causes and which could be the effect of this increased maternal overweight during pregnancy and lactation on newborns. OBJECTIVE: Identify the alterations associated with increased maternal body mass index during pregnancy and breastfeeding on mothers' health and their possible effect on the growth of the newborn during the first six months of life. MATERIAL AND METHODS: This was a prospective cohort study. Forty-two healthy binomials (mother and child), without problems during delivery and without serious illnesses during the breastfeeding period, were included. Maternal body mass index at the beginning of pregnancy allowed us to create two comparison groups between mothers: one with adequate weight, another with overweight or obesity. Follow-up was carried out once a month during the first six months of life, evaluating the somatometric development of mothers and children. All mothers completed the six-month period of exclusive breastfeeding. RESULTS: There were differences between both groups of women. The one that included overweight and obese women compared to the group of women with adequate weight had a higher number of pregnancies, abortions, plasma glucose levels in the third trimester of pregnancy, and a lower number of prenatal control visits and plasma platelet levels (all with p<0.05). Regarding the baby's growth, there was a difference between the weight for length classification at 60-, 120-, 150- and 180-day follow-ups. The group to which the mother was assigned with respect to her body mass index at the beginning of pregnancy (adequate weight group and overweight/obese group) was the only factor associated with the risk of the baby being overweight according to weight for length indicator at the 180-day follow-up, with an OR = 5.2 (95%CI 1.02-26.59). CONCLUSIONS: Maternal overweight and obesity during pregnancy have a negative effect on the mother's health and baby's weight gain in its weight-for-length classification during the first six months of life. Although breastfeeding has been shown to have a positive effect on the growth of the baby, exposure to a higher maternal body mass index during pregnancy triggers important metabolic alterations that promote the development of diseases. It is important to establish weight control guidelines in women who wish to become pregnant to reduce the negative effects on the mother and offspring.
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OBJECTIVE: The specific breast milk-derived metabolites that mediate host-microbiota interactions and contribute to the onset of atopic dermatitis (AD) remain unknown and require further investigation. DESIGN: We enrolled 250 mother-infant pairs and collected 978 longitudinal faecal samples from infants from birth to 6 months of age, along with 243 maternal faecal samples for metagenomics. Concurrently, 239 corresponding breast milk samples were analysed for metabolomics. Animal and cellular experiments were conducted to validate the bioinformatics findings. RESULTS: The clinical findings suggested that a decrease in daily breastfeeding duration was associated with a reduced incidence of AD. This observation inspired us to investigate the effects of breast milk-derived fatty acids. We found that high concentrations of arachidonic acid (AA), but not eicosapentaenoic acid (EPA) or docosahexaenoic acid, induced gut dysbiosis in infants. Further investigation revealed that four specific bacteria degraded mannan into mannose, consequently enhancing the mannan-dependent biosynthesis of O-antigen and lipopolysaccharide. Correlation analysis confirmed that in infants with AD, the abundance of Escherichia coli under high AA concentrations was positively correlated with some microbial pathways (eg, 'GDP-mannose-derived O-antigen and lipopolysaccharide biosynthesis'). These findings are consistent with those of the animal studies. Additionally, AA, but not EPA, disrupted the ratio of CD4/CD8 cells, increased skin lesion area and enhanced the proportion of peripheral Th2 cells. It also promoted IgE secretion and the biosynthesis of prostaglandins and leukotrienes in BALB/c mice fed AA following ovalbumin immunostimulation. Moreover, AA significantly increased IL-4 secretion in HaCaT cells costimulated with TNF-α and INF-γ. CONCLUSIONS: This study demonstrates that AA is intimately linked to the onset of AD via gut dysbiosis.
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PURPOSE: To examine the rates and determinants of breastfeeding initiation (BFI) amongst women with epilepsy (WWE) and women without epilepsy (WWoE) in Manitoba, Canada. METHODS: We conducted a retrospective cohort study using province-wide health databases from 1995 to 2019. Annual BFI rates for WWE and WWoE were examined. Multivariable logistic regression models were used to quantify the association between maternal and infant characteristics and BFI in both groups. RESULTS: During the study period, 1,331 pregnant WWE and 357,334 WWoE were examined. Among WWE, 70.9 % initiated breastfeeding compared to 81.8 % among WWoE. We observed a significant small increase in yearly trends of BFI in both WWE (ß=0.45, p = 0.008) and WWoE (ß=0.23, p < 0.001). In WWE, BFI was associated with caesarean delivery (aOR=0.72,95 % CI: 0.53-0.97), chronic pain (aOR=0.67,95 % Cl: 0.46-0.97), lower income (aOR=0.34,95 % Cl: 0.26-0.44), and gestational age (aOR= 1.09,95 % CI:1.01-1.18). In WWoE, BFI was associated with chronic pain (aOR=0.83,95 % Cl: 0.80-0.86), lower income (aOR=0.45, 95 %CI:0.44-0.46), mood and anxiety disorder (aOR=0.84,95 % CI:0.81-0.86), and gestational age (aOR=1.13,95 % Cl:1.12-1.14). The use of any ASM (aOR=0.66,95 % Cl:0.51-0.85), new generation (aOR=0.86,95 % Cl: 0.62-1.20), polytherapy (aOR=0.46,95 % Cl: 0.31-0.69) and gabapentin (aOR=0.49,95 % Cl: 0.17-1.24) reduced the likelihood of BFI among WWE. CONCLUSION: BFI was approximately 10 % lower in WWE compared to WWoE. Determinants such as low income, ASM use, and comorbidities were significant contributors to a reduced BFI in both groups. Targeted counselling for WWE on breastfeeding benefits is essential. Further research is needed to investigate breastfeeding continuation in WWE.
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BACKGROUND: Progestin-only pills (POPs) have been used for contraception in breastfeeding women for years. The existing guidelines allow the use of these contraceptives. METHODS: Multicenter study with a single visit and retrospective data review. The study involved 100 women who used a drospirenone-only pill (DRSP) for contraception for at least 5 months during breastfeeding. The study aimed to analyze for those successful users the impact on new-born development, the bleeding profile and evaluate user satisfaction. RESULTS: Analysis of the newborns showed that their growth parameters length and weight, were within the expected range of standard development. The mean birth weight was 3368 g, with the lowest recorded weight being 2860 g and the highest 5040 g. The median length of the newborns was 55 cm, ranging from 35 to 65 cm. All new-borns demonstrated appropriate growth within the established percentiles. Acceptability with the bleeding profile was rated with a VAS score: the mean acceptability rating was 82.8. Women aged 35 years or older reported significantly higher acceptability compared to younger women (≥35 years: mean = 88.4, SD = 16.5; <35 years: mean = 80.3, SD = 20.2) (p = 0.02). Sixty-one patients (N = 61; 61.0%; 95% CI: 50.7 - 70.4%) expressed willingness to continue using DRSP after breastfeeding. CONCLUSION: Among those patients who continued the use of the DRSP only-pill for 5 months, this study shows no negative impact for new-borns, with no clinical influence observed on their growth. Additionally, those users expressed high satisfaction with the bleeding profile of the pill.Clinical trial registration number: DRKS00028438 .
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Androstenos , Aleitamento Materno , Humanos , Feminino , Adulto , Recém-Nascido , Estudos Retrospectivos , Androstenos/administração & dosagem , Androstenos/efeitos adversos , Androstenos/uso terapêutico , Satisfação do Paciente , Adulto Jovem , Peso ao Nascer/efeitos dos fármacosRESUMO
Introduction: Among clinical healthcare personnel, nurses face the highest proportion of workplace violence, which has a significant impact on their physical and mental well-being as well as their personal and professional lives. However, little is known about the effects of workplace violence on inexperienced breastfeeding nurses and their experiences during and after breastfeeding when they return to work. This study aimed to explore the experiences of inexperienced breastfeeding nurses who encountered workplace violence and its resulting impacts. Methods: This study employed a descriptive qualitative design. Semi-structured in-depth interviews were conducted with 20 nurses working in various positions and departments at three tertiary hospitals. Purposive and maximum variation sampling techniques were employed. The interview data were analyzed using Colaizzi's method, and the research findings were reported according to Consolidated Criteria for Reporting Qualitative Studies (COREQ)standards. Results: Inferences regarding workplace violence and risks for inexperienced breastfeeding nurses included physical labor (such as lifting heavy objects and performing cardiopulmonary resuscitation), conflicts, inadequate job skills, role confusion, occupational exposure risks, patient violence, and pressure from older adults. An inductive thematic investigation revealed the "Challenges faced during breastfeeding," "Conflicting professional and family roles," "Out of balance," and "Coping strategies." Conclusion: Inexperienced breastfeeding nurses experience several negative consequences due to workplace violence. Therefore, it is essential to plan and implement preventive strategies and management programs that specifically target workplace violence among inexperienced breastfeeding nurses.
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Aleitamento Materno , Pesquisa Qualitativa , Violência no Trabalho , Humanos , Feminino , Adulto , Violência no Trabalho/psicologia , Violência no Trabalho/estatística & dados numéricos , Aleitamento Materno/psicologia , Entrevistas como Assunto , Enfermeiras e Enfermeiros/psicologia , Recursos Humanos de Enfermagem Hospitalar/psicologia , Recursos Humanos de Enfermagem Hospitalar/estatística & dados numéricos , Lactação/psicologia , Local de Trabalho/psicologiaRESUMO
Breastfeeding education, across all disciplines, is often inconsistent and lacking in expertise and confidence. However, recommendations from health professionals, the sociocultural environment, and previous knowledge and experiences significantly influence women's decision to breastfeed. This study aimed to identify factors that promote the assignment of greater importance to breastfeeding and associated practical benefits. This retrospective cross-sectional study included 276 participants who completed a self-administered questionnaire. Descriptive and bivariate analyses were performed, and multivariate linear models were applied to identify factors influencing the importance assigned to breastfeeding. Most participants were married or in a relationship, were native Spaniards, had secondary or higher education, and had an average age of 32.6 years. Seventy percent met the physical activity recommendations, and 91% felt comfortable with their body image during pregnancy. The importance assigned to breastfeeding was high across various aspects, except for postpartum weight loss and body image. Group prenatal care was only significantly associated with the importance assigned to the breastfeeding technique (how to breastfeed). The obesogenic environment and the importance assigned to nutritional aspects and physical activity also turned out to be predictors, although not for all models. In our region, the educational strategy of antenatal care groups could contain gaps regarding the mother's health, which should be addressed in the future to improve results regarding the initiation and continuation of breastfeeding.
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Aleitamento Materno , Humanos , Feminino , Aleitamento Materno/psicologia , Adulto , Gravidez , Estudos Transversais , Espanha , Estudos Retrospectivos , Inquéritos e Questionários , Gestantes/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Exercício Físico , Cuidado Pré-Natal/métodos , Adulto Jovem , Análise Multivariada , Imagem Corporal/psicologia , Modelos LinearesRESUMO
Objective: To analyze the duties of wet nurses at the Hospital Real in Santiago de Compostela (Spain). The secondary objectives were to compare the mortality rate and distribution by parish of the foundlings under the care of the Royal House between 1803 and 1808; and to determine the origin of the Galician foundlings who participated in the Royal Philanthropic Expedition of the Smallpox Vaccine in 1803. Methods: Historiographic study that analyzed sorted and not sorted in series indirect positional and quantitative historical sources. Results: The duties of wet nurses during the studied period were to provide basic care and cultural instruction. The mortality rate of foundlings fluctuated during that period and their distribution by parish (functional unit of healthcare services at that time) was similar in those years, with a predominance in the provinces of A Coruña and Pontevedra. A total of 5 Galician foundlings from the House analyzed were part of the smallpox vaccine expedition, their names were Juan Antonio, Jacinto, Gerónimo María, Francisco Florencio and Juan Francisco. Conclusion: During the observed period the wet nurses of the Hospital Real of Santiago de Compostela were in charge of pediatric care. Wet nurses were vital in the role of keeping the foundlings alive and can be considered as one of the forerunners of the pediatric nurse profession at that time.
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Vacina Antivariólica , Humanos , Espanha , História do Século XIX , Vacina Antivariólica/história , Recursos Humanos de Enfermagem Hospitalar/história , Recursos Humanos de Enfermagem Hospitalar/organização & administraçãoRESUMO
Weaning is a critical phase in an infant's life, during which there is a transition from exclusive breastfeeding or formula feeding to consuming solid foods. Weaning is a critical step in determining a child's nutritional status, growth, and general health. India is a multiethnic and culturally diverse nation and has a variety of weaning practices that are affected by local customs, religious beliefs, and socioeconomic concerns. Malnutrition brought on by inadequate weaning methods used in infancy and early childhood may have an impact on cognitive, motor and social, development and productivity of the child, more importantly manifesting in later ages. Weaning customs in India have a long history of being ingrained in both family and cultural traditions. The variety of Indian cuisine is reflected in the meals that are offered to the infant during weaning. Homemade food commonly prepared like mashed fruits and vegetables, lentil soups, and rice porridge are the most popular. However, the inclination by parents toward professionally produced infant foods and formulas has increased because of urbanization and globalization; there have been observable changes in weaning practices over the past few decades because of changing lifestyles and easier access. These foods are frequently thought of as more convenient but may not be as nutrient-dense as homemade alternatives. Not following the medically recommended mandate of an exclusive diet of mother's breast milk to the infant, many parents often begin introducing complementary foods as early as four months. Still most concerningly also the timing of weaning commencement varies significantly across areas and communities. Overall, this review offers valuable insights into the current trends and practices of weaning in infants across India, underscoring the importance of culturally sensitive and informed strategies to ensure the well-being of the nation's youngest population.
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PURPOSE: This study aimed to evaluate the effects of a mobile-based breastfeeding promotion program (M-BFGDM) that helps mothers with gestational diabetes. METHODS: Forty-seven mothers participated in the study, of whom 22 were in the experimental group and 25 in the control group. To verify the effects, a lag design before and after the non-equivalence control group was used. The data collection for the experimental group was done before and after the intervention. RESULTS: In the results, breastfeeding knowledge showed a significant difference in the interaction between measurement period and group (χ² = 8.14, p = .017), whereas breastfeeding intention did not show a significant difference in the interaction (χ² = 4.73, p = .094). There was no difference in self-efficacy interaction (F = 0.13, p = .856). The breastfeeding method showed no difference in interaction (F = 0.04, p = .952), whereas cross-analysis showed a significant difference in breastfeeding practice rate between the experimental group and the control group at 1 month postpartum (χ² = 7.59, p = .006). CONCLUSION: A mobile-based breastfeeding promotion program was developed and applied for gestational diabetic mothers, resulting in an increase in breastfeeding knowledge and an improvement in breastfeeding practice rate one month after childbirth. In addition, M-BFGDM managed to create a breastfeeding practice environment with fewer time and place restrictions. A program study that complements motivation is needed to improve breastfeeding in pregnant diabetic mothers in the future.
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Aleitamento Materno , Diabetes Gestacional , Promoção da Saúde , Mães , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Autoeficácia , Humanos , Feminino , Gravidez , Adulto , Mães/psicologia , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em Saúde , Aplicativos MóveisRESUMO
BACKGROUND: The exclusive breastfeeding (EBF) rate in Indonesia is lower than expected. Among the key factors affecting breastfeeding practices, paternal support has been suggested. PURPOSE: To explore the role of paternal support in EBF failure among 3-month-old infants. METHODS: This sequential mixed-methods study, part of an ongoing cohort study in West Java in early 2022, included 225 infants. The parents of 3-month-old infants were interviewed. Paternal support was assessed using a 15-point validated questionnaire for a total score of 15-60 points. Multivariate binary regression was used to determine adjusted odds ratios (aORs). The qualitative exploration was based on in-depth interviews (IDIs) and forum group discussions (FGDs) following the quantitative survey. RESULTS: Of the 225 infants, 52.2% were no longer EBF. High paternal support (greater than the mean score) of breastfeeding was determined in 52.9% of cases (mean± standard deviation, 38.7±6.7 for the overall population vs. 37.5±6.3 and 40.2±6.8 for infants who were and were not EBF at 3 months of age, respectively). Low paternal support was associated with an increased EBF failure rate (aOR, 2.84; 95% confidence interval [CI], 1.46-5.54). Other variables that remained as predictors in the final model were a low birth rate (aOR, 7.35; 95% CI, 1.73-31.20), negative maternal attitude (aOR, 3.31; 95% CI, 1.63-6.75), lower self-efficacy (aOR, 4.82; 95% CI, 2.43-9.57), and lower maternal education level (aOR, 2.87; 95% CI, 1.03- 8.03). The IDIs and FGD observed the importance of the father's support of the mother and EBF. The qualitative exploration revealed a lack of knowledge about EBF as a parental support barrier. CONCLUSION: Paternal support is important for EBF. Paternal involvement in EBF planning encouraged themother to continue. Plans that include fathers in breastfeeding education may help increase paternal support.
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AIMS: To assess the effect of the education programme on three constructs of health visitors' breastfeeding support: knowledge, self-efficacy and action competence. Furthermore, the study aimed to confirm the factor structure of these three constructs. BACKGROUND: Health professionals are key in supporting breastfeeding women but studies report gaps in health professionals' breastfeeding support knowledge and competences. The present intervention study aimed to strengthen the breastfeeding support of families to improve breastfeeding rates. Health visitors received an interactive education programme to enhance their breastfeeding support knowledge, self-efficacy and action competence, including e-learning and a two-day course of lectures, role plays and discussions. DESIGN: A pre- and post-test study was applied in a cluster randomised trial METHODS: Cluster units were Danish municipal health visiting programmes, randomised by stratifying for region and annual births per cluster. Health visitors from 21 clusters (11 intervention, 10 control) participated. The knowledge, self-efficacy and action competence were assessed in self-reported questionnaires before and after education (n=368; intervention n=176, control n=196). To analyse the effects, the intention-to-treat principle and linear mixed models were applied. Confirmatory Factor Analysis was used to confirm the factor structures of the hypothesised knowledge, self-efficacy and action competence constructs. RESULTS: 158 health visitors in the control arm and 157 in the intervention arm completed the baseline questionnaire and were analysed in intention-to-treat analyses. 125 and 116, respectively, completed the follow-up questionnaire and were analysed in sensitivity analyses. Health visitors in both trial arms had high levels of self-efficacy and action competence at baseline. Mean treatment effect of the education programme was 0.5 points (CI95â¯% 0.1-0.8) for knowledge, 2.4 points (CI95â¯% 1.6-3.3) for self-efficacy and 1.4 points (CI95â¯% 0.7-2.0) for action competence. The factor structure of the items used to measure knowledge, self-efficacy and action competence were confirmed. CONCLUSIONS: The education programme improved the self-reported breastfeeding support knowledge, self-efficacy and action competence of health visitors. The factor structures of the instruments used to measure effects were confirmed by confirmatory factor analysis. TRIAL REGISTRATION: Clinical Trials: NCT05311631. First posted April 5, 2022.
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Aleitamento Materno , Enfermeiros de Saúde Comunitária , Humanos , Aleitamento Materno/psicologia , Feminino , Inquéritos e Questionários , Adulto , Enfermeiros de Saúde Comunitária/educação , Dinamarca , Autoeficácia , Análise por Conglomerados , Conhecimentos, Atitudes e Prática em Saúde , Masculino , Apoio Social , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Australian Aboriginal and Torres Strait Islander (referred to hereafter as Aboriginal) women breastfeed at lower rates than non-Aboriginal women, and rates vary across and within Aboriginal populations. AIM: To determine rates of breastfeeding initiation and maintenance and compare individually collected survey data with existing routinely collected state and national breastfeeding data for Aboriginal women. METHODS: CINAHL, Medline, EMBASE, SCOPUS, PsycINFO, and the Cochrane library were searched for peer-reviewed literature published between 1995 and 2021. Quantitative studies written in English and reporting breastfeeding for Aboriginal women or women having an Aboriginal infant were included. Screening and quality assessment included co-screening 10â¯% of papers. Two reviewers completed data extraction. A proportional meta-analysis was undertaken for breastfeeding initiation and narrative data synthesis used to summarise breastfeeding maintenance. FINDINGS: The initial search identified 12,091 records, with 31 full text studies retrieved, and 27 reports from 22 studies met inclusion criteria. Breastfeeding initiation was 79â¯% (95â¯% CI 0.73, 0.85), however, rates were lower than non-Aboriginal women. Maintenance ranged between one week and five years. Rates and definitions varied significantly between studies, with inconsistencies in government collection and reporting of breastfeeding. CONCLUSION: Significant variation in definitions and reporting make comparisons difficult. Breastfeeding rates were below recommended targets. Future pattern and trend analyses require standardised measures and definitions. Current collection and reporting of breastfeeding data, particularly routinely collected state-based data, is inadequate to present an accurate picture of current breastfeeding in Australia for Aboriginal women and infants, and to effectively inform interventions and policies.
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BACKGROUND: Food taboos and cultural beliefs among pregnant and breast-feeding women influence their food consumption patterns and hence the health of women and unborn children. Cognizant of their neglect in programs aimed to ameliorate hidden hunger among pregnant and breast-feeding women in Buyende and other resource-poor communities in sub-Saharan Africa, we opted for a study to unravel them to inform program design. METHODS: We documented food taboos and beliefs amongst pregnant and breast-feeding women from six sub-counties of Buyende district in Eastern Uganda. A mixed-methods approach was used, which was comprised of questionnaire interviews with 462 women, eight focus group discussions with 6-10 participants in each and a total of 15 key informant interviews. RESULTS: The present study revealed that 129 (27.9%) of the respondents practice food taboos and adhere to cultural beliefs related to their dietary habits during pregnancy and breast-feeding that are fuelling the prevalence of hidden hunger. The most tabooed foods during pregnancy were sugarcane (17.8%), fishes which included lung fish, catfish and the Lake Victoria sardine (Rastrineobola argentea) (15.2%), oranges (6.6%), pineapples (5.9%), eggs (3.3%), chicken (3.3%) and cassava, mangoes and Cleome gynandra (each at 3%). Most foods were avoided for reasons associated with pregnancy and labour complications and undesirable effects on the baby. Most women learnt of the taboos and beliefs from the elders, their own mother, grandparents or mother-in-law, but there was also knowledge transmission in social groups within the community. CONCLUSIONS: The taboos and cultural beliefs in the study area render pregnant and breast-feeding women prone to micronutrient deficiency since they are denied consumption of a diversity of nutritious foods. There is a need to educate such women about consumption of nutrient-rich foods like fish, eggs, fruits and vegetables in order to improve their health, that of the unborn and children being breast fed. Additionally, culturally appropriate nutrition education may be a good strategy to eliminate inappropriate food taboos and beliefs with negative impact on the health of pregnant and breast-feeding women.
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Aleitamento Materno , Fome , Tabu , Humanos , Feminino , Aleitamento Materno/psicologia , Gravidez , Uganda , Adulto , Adulto Jovem , Cultura , Comportamento Alimentar/psicologia , Adolescente , Conhecimentos, Atitudes e Prática em Saúde , DietaRESUMO
Human milk improves neurodevelopment for preterm infants, but relationships between human milk and neurodevelopment for infants with critical CHD are unknown. We aimed to (1) explore associations between human milk/direct breastfeeding and neurodevelopment at 1-year and 2-year follow-up and (2) describe patterns of human milk (maternal, donor) and commercial formula during hospitalisation in the first year of life.This retrospective cohort study included infants who underwent surgery for CHD < 6 months old. The primary outcome was neurodevelopment via Bayley Scales of Infant Development-IV. Analysis included adjusted linear regression for associations between exclusive human milk while inpatient during the first 6 months or any direct breastfeeding while inpatient during the first year of life and 1-year Bayley-IV scores. Models were adjusted for race, insurance type, genetic diagnosis, and length of stay.Of 98 eligible infants, 40% followed up at 1 year; 27% at 2 years. There were differences in follow-up related to demographics (race, ethnicity) and social determinants of health (insurance type, distance from clinic). In adjusted models, infants who directly breastfed had 13.18 points higher cognition (95% CI: 0.84-25.53, p = 0.037); 14.04 points higher language (2.55-25.53, p = 0.018); and 15.80 points higher motor scores (3.27-28.34, p = 0.015) at 1-year follow-up. Infants fed exclusive human milk had 12.64 points higher cognition scores (-0.53-25.82, p = 0.059).Future investigation into nutrition and neurodevelopment in the context of critical CHD is warranted. As neurodevelopmental follow-up becomes standard of care in this population, efforts are needed to mitigate disparities in access to this care.
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BACKGROUND: Breastfeeding technique is a combination of positioning, attachment, and breast milk suckling. Breastfeeding problems are caused by incorrect breastfeeding practices, which lead to premature discontinuation of breastfeeding. Therefore, this study aimed to determine the proportion of breastfeeding techniques and associated factors among lactating primiparous mothers during the postpartum period in the Debre Markos town health facility in 2021. METHODS: An institutional-based cross-sectional study was conducted from November 1st to December 30, 2021. A systematic sampling technique was utilized to select study participants. An observational checklist developed by WHO and an interviewer-administered questionnaire were used to collect data from 409 mothers. The collected data were entered into Epi-Data version 4.6.0.4 statistical software and then exported to SPSS version 24.0 for cleaning and analysis. Binary and multivariable logistic regression was carried out to identify the factors associated with the practice of effective breastfeeding techniques. A variable that has a p-value of ≤0.2 was transferred to a multivariable for further analysis. The strength of association was identified using an adjusted odds ratio with a 95% confidence interval, and a p-value <0.05 was taken as statistically significant. RESULTS: The proportion of practicing effective breastfeeding techniques among lactating primipara mothers was 29.1% (CI: 24.7, 33.3). Baby aged ≥29 days, mothers who were living in urban, mothers who attended college or higher education, mothers who have heard about BFT practices, mothers who received counseling on BFT after delivery, and mothers whose breast nipples had everted were variables that were significantly associated with the practice of effective breastfeeding techniques. CONCLUSION: The findings of this study revealed that the practice of effective breastfeeding techniques among lactating primipara mothers was lower in the study area. Therefore, healthcare providers should have to counsel mothers on how to position and attach their infants during breastfeeding. PRACTICE IMPLICATION: The provision of breast-feeding method counseling to nursing mothers is one way to enhance the practices of breast feeding.
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Aleitamento Materno , Lactação , Humanos , Feminino , Aleitamento Materno/estatística & dados numéricos , Etiópia , Estudos Transversais , Adulto , Lactação/fisiologia , Período Pós-Parto , Mães/psicologia , Mães/estatística & dados numéricos , Recém-Nascido , Adulto Jovem , Inquéritos e Questionários , Paridade , GravidezRESUMO
BACKGROUND & AIMS: Breastfeeding is critical for offspring health and development. Although many observational studies report a protective effect between breastfeeding and inflammatory bowel disease (IBD), the relationship is not well-understood. METHODS: We used prospectively collected data from 3 population-based birth cohorts (Danish National Birth Cohort, Norwegian Mother, Father, and Child Cohort, and All Babies in Southeast Sweden) and cross-linked national registers to ascertain the impact of breastfeeding duration on offspring IBD risk in each country, using adjusted Cox proportional regression analyses. We performed meta-analyses to determine pooled estimates. RESULTS: We included 148,737 offspring and 169,510 offspring in analyses of exclusive and any breastfeeding duration, respectively. During median follow-up of 16.3-22.3 years, between 1996 and 2021, 543 offspring were diagnosed with IBD. In each country, there was no association between exclusive breastfeeding duration and offspring IBD risk after adjusting for birth year (Denmark), offspring sex, parental IBD status, maternal education, smoking during pregnancy, age at delivery, mode of delivery, preterm birth, and small for gestational age. The pooled adjusted hazard ratio for IBD was 1.24 (95% confidence interval, 0.94-1.62; Q = 0.16, I2 = 0.0%) and 1.02 (95% confidence interval, 0.85-1.21; Q = 1.45, I 2= 0.0%) among offspring breastfed exclusively for ≥6 months and <4 months, respectively, compared with 4-5 months. Similarly, we found null associations in pooled analyses of any breastfeeding duration and IBD, subtypes Crohn's disease and ulcerative colitis, as well as in cohort-specific analyses. CONCLUSIONS: In prospectively collected data from 3 population-based birth cohorts, the duration of exclusive or any breastfeeding was not associated with offspring IBD risk.
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The prevalence of distraction among breastfeeding mothers is on the rise, primarily attributed to the escalating use of media technologies. This study aimed to assess the influence of family-oriented counselling on the continuity of breastfeeding in mothers experiencing distractions. This randomized controlled trial included 120 eligible lactating mothers who accessed postpartum services at comprehensive health centers in Zanjan, a city in northwest Iran from August 21, 2022 to May 10, 2023. Participants were assigned to two groups through block randomization with a block size of four. The intervention group received Family-Oriented Counselling in three sessions at weekly intervals, and the control group received standard postpartum care. The study measured outcomes using the Maternal Distraction Questionnaire and breastfeeding patterns before, monthly, and up to 4 months after counselling. Data analysis employed statistical methods, including the Chi-square test, independent t-test, repeated measures ANOVA, and the Kaplan-Meier method, with a significance level set at P < 0.05. The results showed that the continuation of exclusive breastfeeding was 33 (55 %) in the intervention group and 21 (35 %) in the control group. This difference was statistically significant (p = 0.001). The reduction in distraction scores over time was more pronounced in the intervention group compared to the control group. The between-group effect was found to be statistically significant with an eta effect size of 0.73 (p = 0.001). In conclusion, the study suggests that the implementation of a family-centered intervention was effective in promoting the continuation of breastfeeding and reducing maternal distractions both during breastfeeding and non-breastfeeding activities. This approach proves to be a valuable step in enhancing the health of both mother and child. The findings underscore the importance of considering such interventions in health policymaking.
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BACKGROUND: The breast cancer is common cancer in women globally. The risk of breast cancer is strongly associated with women's menstrual and reproductive factors that have been established in different countries. Therefore present study was aim to explore the association between menstrual and reproductive factors and the risk of breast cancer screening in Indian women. METHODS: The present study data has been used fifth round of the National Family Health Survey (NFHS-V) with 724,115 women in aged 15-49 in 2019-21. The self-reported ever screened of breast cancer for women aged 30-49 was the main outcome variable of the study. Logistic regression models were used to estimate odds ratios and 95% confidence intervals for breast cancer by menstrual and reproductive factors adjusted for potential confounders. RESULTS: Late menarche (OR = 2.20, 95% CI: 1.48-3.28), irregular menstrual cycle (OR = 1.29, 95% CI: 1.08-3.53)), delay age at first birth (OR = 1.93, 95% CI: 1.11-3.04) and contraceptive pill used (OR = 1.11, 95% CI: 0.74-2.10) were significantly associated to increases the uptake of screening breast cancer. While, a higher number of birth (OR = 0.52, 95% CI: 0.10-1.03), and long duration of breast-feeding practice (OR = 0.75, 95% CI: 0.63-0.91) were reduced to participate for screening breast cancer. CONCLUSION: The results of the study confirm the role of menstrual and reproductive factors in breast cancer in Indian women. Therefore, our findings are imperative for developing breast cancer prevention strategies and better preparedness. Creating awareness and providing knowledge on cancer could be key strategies for the reduction of breast cancer in Indian reproductive age group women.
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Background: This study explored the approaches of Jordanian community pharmacists to identifying and counseling breastfeeding mothers regarding medication usage. Methods: This cross-sectional study used self-administered questionnaires. A convenience sample (n=381) of Jordanian community pharmacists was recruited through social media. The responses were statistically analyzed using IBM SPSS ver. 25.0 (IBM Corp., USA). Results: The majority of recruited pharmacists were female (n=329, 86.4%). Asking every woman was Jordanian pharmacists' preferred approach to identifying breastfeeding women (n=211, 55.4%). The study showed that around one-third of the pharmacists (n=128, 33.6%) reported that they currently experienced queries regarding medication use during breastfeeding on a daily basis. Additionally, the majority (n=325, 85.3%) of pharmacists reported feeling confident, and 67.2% of them (n=256) reported feeling comfortable while giving advice to breastfeeding women. The surveyed pharmacists relied on different resources during their course of practice to answer queries related to medicine usage by breastfeeding mothers. Conclusion: Community pharmacists have continuous interactions with breastfeeding women. Pharmacists require reliable and updated data access to answer queries related to medication use while breastfeeding.