Efficacy of a breastfeeding support education program for nurses and midwives: a randomized controlled trial.

BACKGROUND: Nutritional support influences the growth and development of late preterm infants (LPIs) and their long-term health status. However, healthy LPIs have a shorter hospital stay and may not receive adequate care after discharge. In this study, we developed and evaluated the effectiveness of an educational program for nurses and midwives to enable them to support breastfeeding of healthy LPIs. METHODS: A randomized controlled trial was conducted in Japan from July 2018 to April 2019. The participant pool consisted of nurses and midwives working at midwiferies and obstetric centers in Tokyo, Japan. A total of 395 candidates were recruited for participation across 79 facilities. The final participants were assigned to two groups: the breastfeeding support for LPIs program (BSLPI group; n = 36) or the non-technical skills program (NTS group; n = 33). The measures included the Self-Efficacy of Breastfeeding Support scale (SBS), the Social Skills in Nursing Interactions with Mothers (SS) scale, and the Knowledge and Skills Necessary for Breastfeeding Support for LPIs test (K-S). Scores for each measure were collected before, after, and one-month after the intervention. Repeated-measures ANOVA was used to identify differences (main effects) according to program (BSLPI and NTS) and time (before, immediately after, and one month after intervention). RESULTS: All 69 participants attended the program. Main effects of the program were observed only for K-S scores (F[1,58] = 78.57, p = 0.01). No significant differences were found for SBS (F[1,58] = 0.63, p = 0.43) or SS scores (F[1,58] = 1.51, p = 0.23). CONCLUSIONS: Participation in the BSLPI was related to improved breastfeeding support knowledge and skills but was not related to improvements in nurses' self-efficacy or social skills. TRIAL REGISTRATION: Registered 12 December 2018, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000040145 (UMIN: UMIN000035227).

Breastfeeding support and barriers to women with gestational diabetes mellitus: a nationwide cross-sectional survey of hospitals in Japan.

BACKGROUND: Despite the benefits of breastfeeding for women with Gestational Diabetes Mellitus (GDM) and their infants, breastfeeding is less likely to be performed by this group. This study aimed to examine the current levels of implementation of breastfeeding support to women with GDM in Japan and to clarify barriers to promoting breastfeeding among this population. METHODS: A 25-item questionnaire was developed by the authors to investigate the current levels of implementation of breastfeeding support for women with GDM provided in hospitals, and to explore barriers for promoting breastfeeding among these women. The questionnaire was sent to all 1046 hospitals facilitating childbirth in Japan. Descriptive statistics were used to analyze the quantitative data, and content analysis was used to analyze qualitative data from the open-ended questions. RESULTS: All 296 respondents were included in this study. Regarding breastfeeding support, 95.2% of the respondents provided general information on breastfeeding to GDM women during antenatal midwife consultations. However, the benefits of breastfeeding for preventing type 2 diabetes were addressed by only 48.0%. Likewise, although follow-up services (e.g., telephone support or breastfeeding consultations) were conducted in 88.9% of hospitals, only 50.7% of hospitals informed women that breastfeeding decreases the risk of developing type 2 diabetes after GDM. Regarding barriers, seven categories and 20 subcategories about promoting breastfeeding for women with GDM were extracted and abstracted into the following three themes: Barriers associated with mother and infant, Barriers associated with health professionals, and Organizational barriers. CONCLUSIONS: In Japan, most hospitals that responded provided general breastfeeding support from the antenatal to postpartum periods. However, the benefits of breastfeeding in terms of preventing the incidence of type 2 diabetes following GDM were insufficiently communicated to women with GDM. Furthermore, there were numerous barriers to promoting breastfeeding among women with GDM.

[Pharmacology education on women's health, pregnancy, childbirth and breastfeeding in Midwifery education].

Midwives are responsible professionals who support the sexual and reproductive health, rights, and welfare of individuals, families, and communities. In particular, midwives work in partnership with women to provide the necessary support, care and advice needed during pregnancy, childbirth and the postpartum period. Midwives conduct normal births on her own responsibility, support breastfeeding, provide care for newborns and infants, and fully release mother-infant's latent strengths. Midwives also contribute in adopting appropriate preventative measures to promote normal birth and breastfeeding, detecting early signs of complications, and carrying out emergency measures or transferring the patient to other medical care or assistance as needed. In order to provide the best care to mother and infant, midwives should first learn the biological foundations of women's health, pregnancy, childbirth, postpartum, breastfeeding, and infant health. They must also understand the in vivo mechanisms and actions of the key hormones and neurotransmitters in play during the reproductive period. Additionally, midwives need to learn pharmaceutical treatments to complement and support biological function in cases of disorders or impairments occurring in women and infants. Midwives should also be competent in life support skills in obstetrics and neonatal cardiopulmonary resuscitation. The directors of Japanese Maternity Centers sign a contract with obstetricians that permits them to purchase and use emergency medicines. We facilitate midwifery students in their studies of medicine and pharmacology in order to train them to cope with such emergency situations. In this revision of the midwifery curriculum and the continuing education, we hope to create a new midwifery educational program focusing on personalized, client-centered pharmacology, with the ultimate objective to support and maintain the health of women, mothers, infants, child-rearing families, and communities.

Do postpartum anxiety and breastfeeding self-efficacy and bonding at early postpartum predict postpartum depression and the breastfeeding method?

We investigated whether postpartum anxiety (PPA) and breastfeeding self-efficacy and bonding at the early postpartum period can be used to predict postpartum depression and the breastfeeding method, and we sought to identify factors related to postpartum depression. Of the 510 eligible women, 185 (36%) returned the questionnaire on all three occasions (1 day, 3 days, and 1 month after childbirth). The mothers' progress on the State-Trait Anxiety Inventory (STAI), Breastfeeding Self-Efficacy Scale Short Form (BFSES-SF), and Postnatal Bonding Questionnaire (PBQ) was observed over three periods. A repeated-measures ANOVA revealed that the mothers at high risk of developing postpartum depression (PPD) were those who did not show an increase in BFSES-SF score at early postpartum, and mothers whose bonding disorders have deteriorated rapidly. The results of the logistic regression analysis revealed a significant difference in employment as a factor related to postpartum depression. Compared to Regular, Part-time status was 4.4 times more likely and Unemployed status was 2.3 times more likely to cause postpartum depression. For the early detection of PPD, it is necessary to identify (1) mothers who do not show an increase in the BFSES-SF score, (2) mothers whose bonding disorders have deteriorated rapidly, and (3) part-time or unemployed mothers as characteristic of postpartum depression.

Investigamos si la ansiedad posterior al parto (PPA) y la autoeficacia de amamantar y establecer afectividad en el período posterior al parto pueden usarse para predecir la depresión posterior al parto y el método de amamantar, así como también nos propusimos identificar factores relacionados con la depresión posterior al parto. De las 510 mujeres elegibles, 185 (36%) devolvieron el cuestionario en todas las tres ocasiones (1 día, 3 días y 1 mes después de haber dado a luz). A lo largo de tres períodos, se observó el progreso de las madres en el Inventario para Medir el Estado y Características de la Ansiedad (STAI), el Formulario Corto de la Escala de Autoeficacia de Amamantar (BFSES-SF) y el Cuestionario de Afectividad Postnatal (PBQ). Medidas repetidas ANOVA revelaron que las madres bajo alto riesgo de desarrollar depresión posterior al parto (PPD) eran aquellas que no mostraron un incremento en los puntajes BFSES-SF en el temprano período de postparto, y las madres cuyos trastornos de afectividad habían mejorado rápidamente. Los resultados de los análisis de regresión logística revelaron una diferencia significativa en el empleo como factor relacionado con la depresión posterior al parto. Comparado con el empleo regular, la condición de empleo de tiempo parcial fue 4.4 veces más probable y la condición de desempleo fue 2.3 veces más probable de ser causa de la depresión posterior al parto. Para la detección temprana de PPD, es necesario identificar (1) madres que no muestran un incremento en el puntaje BFSES-SF, (2) madres cuyos trastornos de afectividad han mejorado rápidamente, y (3) madres con empleos de tiempo parcial o desempleadas como característica de la depresión posterior al parto. Palabras claves: Autoeficacia de amamantar, afectividad, depresión posterior al parto, método de amamantar.

Nous nous sommes interrogés si l'anxiété postpartum (PPA) et l'auto-efficacité de l'allaitement au sein et du lien au début de la période postpartum peuvent être utilisées afin de prédire la dépression postpartum et la méthode d'allaitement au sein, et nous avons essayé d'identifier les facteurs liés à la dépression postpartum. Sur 510 femmes admissibles, 185 (36%) ont renvoyé le questionnaire aux trois occasions (1 jour, 3 jours, et 1 mois après la naissance). Le progrès des mères sur l'Inventaire de l'Etat et du Trait d'Anxiété (en anglais State-Trait Anxiety Inventory, soit STAI), le Formulaire Court de l'Echelle d'Auto-Efficacité de l'Allaitement (Breastfeeding Self-Efficacy Scale Short Form, soit BFSES-SF), et le Questionnaire de Lien Postnatale (Postnatal Bonding Questionnaire, soit PBQ) ont été observés au fil de trois périodes. Des mesures répétées ANOVA ont révélé que les mères à haut risque de développer une dépression postpartum (PPD) étaient celles qui n'avaient pas fait preuve d'une augmentation dans le score BFSES-SF dans la première période postpartum, et les mères dont les troubles du lien s'étaient améliorés rapidement. Les résultats de l'analyse de régression logistique ont révélé une différence importante dans l'emploi en tant que facteur lié à la dépression postpartum. Comparé à un statut d'Emploi Normal, le statut de Temps partiel était 4,4 fois plus à même de causer une dépression postpartum et le statut de Sans emploi était 2,3 fois plus à même de causer une dépression postpartum. Pour la détection précoce de la PPD il est nécessaire d'identifier (1) les mères qui ne font pas preuve d'une augmentation dans le score BFSES-SF, (2) les mères dont les troubles du lien se sont améliorés rapidement et (3) les mères travaillant à temps partiel ou sans emploi comme caractéristiques de la dépression postpartum. Mots clés: auto-efficacité de l'allaitement au sein, Lien, EPDS, dépression postpartum, méthode d'allaitement au sein.

Changes in balance strategy in the third trimester.

[Purpose] The purpose of this study was to elucidate changes in balance strategy during pregnancy from a kinematics perspective. [Subjects] Eight pregnant women and eight non-pregnant women participated. [Methods] A 3D motion analysis system, two force plates, and 10 infrared cameras were used to measure the kinematics of the balance strategy. The 3D motion analysis system was used to analyze performance of the functional reach test (FRT). Parameters were compared between non-pregnant women and pregnant women during each trimester, and between pregnant women in the second and third trimesters. [Results] The FRT of pregnant women was shorter than that of non-pregnant women. Bilateral hip joint extension moments were smaller in pregnant women in the second and third trimesters compared to non-pregnant women. Bilateral ankle plantar flexion moments were larger in pregnant women in their third trimester compared to non-pregnant women. In pregnant women, the right ankle plantar flexion moment was larger in the third trimester than in the second trimester. [Conclusion] These results suggest that forward reach distance is reduced, and that the ankle joint strategy takes precedence over the hip joint strategy in maintaining balance during pregnancy compared to non-pregnancy.

The psychological effects of aromatherapy-massage in healthy postpartum mothers.

This study examined the effect of aromatherapy-massage in healthy postpartum mothers. A quasi-experimental between-groups design was used. Mothers who received aromatherapy-massage were compared with a control group who received standard postpartum care. Thirty-six healthy, first-time mothers with vaginal delivery of a full-term, healthy infant participated in this study. Sixteen mothers received a 30-minute aromatherapy-massage on the second postpartum day; 20 mothers were in the control group. All mothers completed the following four standardized questionnaires before and after the intervention: 1) Maternity Blues Scale; 2) State-Trait Anxiety Inventory; 3) Profile of Mood States (POMS); and 4) Feeling toward Baby Scale. In the aromatherapy-massage group, posttreatment scores significantly decreased for the Maternity Blues Scale, the State-Anxiety Inventory, and all but one of the Profile of Mood States subscales. Posttreatment scores in the intervention group significantly increased in Profile of Mood States-Vigor subscale and the Approach Feeling toward Baby subscale. Scores in the intervention group significantly decreased in Conflict Index of Avoidance/Approach Feeling toward Baby subscale. Our results suggest that aromatherapy-massage might be an effective intervention for postpartum mothers to improve physical and mental status and to facilitate mother-infant interaction.