90 versus 60 min of early skin-to-skin contact on exclusive breastfeeding rate in healthy infants' ≥35 weeks: A randomised controlled trial.

AIM: To compare the effect of 90 versus 60 min of early skin-to-skin contact (SSC) among vaginally born healthy infants ≥35 weeks of gestation on their exclusive breastfeeding rates and breastfeeding behaviour. METHODS: This parallel-group, open-label, randomised controlled trial enrolled healthy term and late preterm infants born vaginally. Infants in the intervention group received early SSC for 90 min compared to 60 min in the control group. The primary outcome was the proportion of infants on exclusive breastfeeding at 60 ± 12 h. RESULTS: One hundred ninety-eight mother-infant dyads were randomised (99 in each group). The infants in the 90-min SSC group were more likely to be exclusively breastfed at 60 ± 12 h as compared to the 60-min SSC group (RR, 95% CI-1.44, [1.15-1.79], p < 0.01). The modified infant breastfeeding assessment tool score at 60 ± 12 h was significantly higher in the 90-min SSC group (median [IQR]-9, [8, 10] versus 8 [7, 10], p = 0.03]. The proportion of infants on exclusive breastfeeding at 6, 10, and 14 weeks of age was also significantly higher in the 90-min SSC group (RR, 95% CI-1.39 [1.11-1.74], 1.36 [1.08-1.07], and 1.38 [1.08-1.75], respectively). CONCLUSION: Increasing the duration of early SSC showed a dose-response benefit on exclusive breastfeeding rates and breastfeeding behaviour. TRIAL REGISTRATION: CTRI/2018/09/015632, registered on 06/09/2018.

Breastfeeding in primiparous women - expectations and reality: a prospective questionnaire survey.

BACKGROUND: Breastfeeding provides the optimal nutrition for infants and offers numerous benefits for both mother and child. The World Health Organisation recommends exclusive breastfeeding during the first 6 months of life and the introduction of complementary feeding between the fifth and seventh months of life. There is a discrepancy between breastfeeding recommendations and the actual duration of breastfeeding. The aim of this study was to analyse breastfeeding behaviour in primiparous women in order to be able to provide support for mothers. METHODS: In this prospective, questionnaire-based study conducted between 2020 and 2022, primiparous women were asked to complete three questionnaires at three defined survey time points (routine prepartum presentation, postpartum hospitalization, completed sixth month of life). RESULTS: A total of 140 women were included and returned all three questionnaires. Fifty-eight percent performed breastfeeding exclusively at least until their baby had reached the age of 6 months, whereas 20% already stopped within the first 6 months. The main reasons given for early cessation were insufficient milk supply and inadequate infant weight gain. A comprehensive level of prepartum knowledge had a significant positive effect on participants' sense of confidence with breastfeeding. Sociodemographic factors such as age and educational level were also associated with breastfeeding behaviour, but significant corresponding differences in the duration of breastfeeding were not observed. Women with postpartum midwifery care breastfed significantly longer (p < 0.05). CONCLUSIONS: Breastfeeding behaviour and duration are influenced by multiple factors. Although certain sociodemographic factors are unalterable, comprehensive prepartum knowledge transfer and postpartum midwifery care have a positive impact on breastfeeding behaviour. TRIAL REGISTRATION: The study was retrospectively registered at the German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS) on 6 December 2022 (DRKS00030763).

Does the Degree of Acculturation Influence Breastfeeding Intention and Start or the Frequency of Early Weaning? Results of a Prospective Observational Study.

OBJECTIVES: Recent breastfeeding studies from immigration countries have found that acculturation factors influence breastfeeding behaviour in women with a migration background. To date, there has been no systematic investigation for Germany. Therefore, we study whether and how the degree of acculturation within a population of migrant women influences the start, time and duration of breastfeeding. PATIENT POPULATION AND METHODOLOGY: Pregnant women who were admitted to one of the three participating maternity clinics in Berlin for the birth of their child in the one-year study period were surveyed (including sociodemographic details, data on migration/acculturation). These women were interviewed again two or three days post partum (including start of breastfeeding, planned breastfeeding duration, reasons for not breastfeeding). In a subgroup, a telephone interview took place 6 months post partum about the actual breastfeeding duration, contraceptive behaviour post partum and availing of midwife services following delivery. Breastfeeding behaviour was analysed using multivariate regression models, among other things. RESULTS: The prepartum survey included 7100 women, 6884 women were contacted in the postnatal wards, and the subgroup six months after delivery comprised 605 women. No acculturation-related differences were found in the start of breastfeeding. In the adjusted model, a medium and higher degree of acculturation diminished the chance of planning a long breastfeeding period. More acculturated women show a greater risk of weaning within the first six months than less acculturated women. CONCLUSION: The degree of acculturation has relevant significance for some aspects of breastfeeding behaviour in women with a migration background. This should be considered both in breastfeeding promotion programmes and in further national breastfeeding studies.

[Breastfeeding behaviour in Germany-News from KiGGS Wave 2]. / Stillverhalten in Deutschland ­ Neues aus KiGGS Welle 2.

Breast milk is the optimal nutrition for babies in their first six months of life and provides health benefits for both children and mothers. As part of the Robert Koch Institute's health monitoring, the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) regularly collects population-based data on the health situation of children and adolescents living in Germany, including information on breastfeeding. This article describes breastfeeding behaviour based on the results of KiGGS Wave 2 (2014-2017). The prevalence of breastfeeding and the duration of breastfeeding in the birth cohorts 2009-2016 as well as information on intention to breastfeed and reasons for weaning are described. The results from KiGGS Wave 2 show that breastfeeding proportions for any type of breastfeeding tended to increase between the birth cohorts 2009/2010 and 2013/2014, while the prevalence for full and exclusive breastfeeding show no change. The average duration of breastfeeding has remained constant. Almost 90% of mothers intended to breastfeed their baby after birth and 97% of these mothers actually started breastfeeding. Having insufficient breast milk has often been mentioned as a problem, both by mothers who intended to breastfeed but did not start breastfeeding and by mothers who have been breastfeeding their infants for less than six months. Despite some limitations, the KiGGS study is an important part of breastfeeding monitoring. Regular data collection and the largely consistent study design make it possible to map trends in time and to measure the impact of breastfeeding promotion on the population. KiGGS Wave 2 shows that breastfeeding promotion measures are still necessary.

Breastfeeding monitoring in Germany - What contribution can the data from KiGGS provide?

A continuous breastfeeding monitoring is essential as it enables reports on changes in breastfeeding behaviour. The German Health Interview and Examination Survey for Children and Adolescents (KiGGS), which is conducted by the Robert Koch Institute, periodically collects data about the health of children and young people living in Germany, including data on breastfeeding. Moreover, KiGGS is mentioned within the approach developed by the National Breastfeeding Committee as a possible source of data for breastfeeding monitoring. The data from KiGGS can be used to develop retrospective indicators on breastfeeding for particular birth cohorts. The data demonstrate that the prevalence of children who were ever breastfed tended to rise between the 2001/2002 and 2007/2008 cohorts; however, no significant changes were identified for the 2001-2008 cohorts with respect to breastfeeding duration. Breastfeeding monitoring relies on reports about current trends in the field; due to the periodicity with which the KiGGS study waves are conducted, data on current birth cohorts cannot be provided. Therefore, data on breastfeeding needs to be collected throughout Germany in relation to direct environmental and other factors. This data should be collected during health screenings and regular check-ups so that it can be used as a further measure in breastfeeding monitoring.

Weight loss and low age are associated with intensity of rooting behaviours in newborn infants.

AIM: Little is known about the developing breastfeeding behaviour of newborn infants. This study describes infants' prebreastfeeding behaviour during the second day of life and explores possible associations with infant characteristics. METHODS: We studied 13 mothers and healthy full-term infants after normal births. At 24-48 hours of life, the newborns were placed in skin-to-skin contact with their mothers for breastfeeding and were video-filmed. The order, frequency and duration of predefined infant prefeeding behaviours and suckling were coded and analysed using computer-based video software. RESULTS: Prefeeding behaviours occurred in the following order: rooting, hand to mouth movements, licking of the nipple and hand to breast to mouth movements. The infants started to suckle at a median of one to two minutes. Rooting was the most common behaviour, observed in 12 infants. The duration of rooting movements during the last minute before breastfeeding was inversely related to neonatal age (p ≤ 0.001) and positively related to neonatal weight loss (p = 0.02) after birth. CONCLUSION: Infants exhibited a distinct sequence of prefeeding behaviours during the second day of life, and our findings suggest that rooting movements were governed by mechanisms involved in the regulation of food intake and weight gain.