" He's not beating me"-Socio-cultural construction of intimate partner violence and traditional birth attendants: implications for maternal & child health in rural communities in Hohoe, Ghana.

Introduction: Most research on Intimate Partner Violence (IPV) focuses on the physical, sexual and psychological abuse, with less focus on the financial abuse. This study explores nursing mothers' experiences and perceptions of financial and material support from their significant others and traditional birth attendants' (TBA) observations of support to nursing mothers in their communities. Methods: Using purposive sampling, focus groups and interviews were conducted primarily in Ewe language among nursing mothers and TBAs in rural communities in Hohoe, Volta region, Ghana. All discussions were audio-recorded and transcribed for analysis. Thematic analysis guided by the social constructivist framework was used in data analysis. Results: Twenty-seven women participated in the study, ranging in ages from 19 to 82 (20 nursing mothers; 7 TBAs). Most participants were married (19) and about 65% reported working outside the home (10 nursing mothers; 7 TBAs). Two themes emerged from the data analysis: Lack of support from partners for housekeeping chores and finances; and TBAs as mediators. Nursing mothers who reported lack of financial support did not perceive it as abuse, rather as hinderance to their efforts to care for their children. TBAs act as mediators interceding on behalf of nursing mothers with their husbands and fathers of their children, while also seeking resources to support them. Discussion: Understanding the perceptions and socio-cultural meanings women attached to IPV experience is essential for effective intervention to reduce IPV. In addition, TBAs can be a resource in intervening to alleviate IPV in their communities, thereby improving maternal and child health.

Protective factors for early initiation of breastfeeding among Brazilian nursing mothers.

Objectives: Evaluate the protective factors associated with early initiation of breastfeeding. Methods: Cross-sectional study conducted with Brazilian nursing mothers. Breastfeeding in the first hour of life and difficulty initiating breastfeeding in the birth room were adopted as outcome variables and associated with other maternal and child information. Poisson regression was conducted to synthesize the data. Results: Among 104 nursing mothers evaluated, 56.7% reported breastfeeding in the first hour of life and 43% had difficulty initiating breastfeeding in the birth room. There was a higher prevalence of breastfeeding in the first hour of life among mothers with previous breastfeeding experience (PR = 1.47, 95% CI 1.04-2.07). Difficulty initiating breastfeeding in the birth room was more prevalent among mothers who did not receive breastfeeding guidance during antenatal care (PR = 2.83, 95% CI 1.43-4.32) and those without previous breastfeeding experience (PR = 2.49, 95% CI 1.24-6.45). Conclusion: These findings highlight the importance of adequate professional guidance, especially for primiparous mothers.

The role of doulas in providing breastfeeding support during the COVID-19 pandemic.

BACKGROUND: Doulas have been instrumental in providing breastfeeding support to nursing mothers before and during the COVID-19 pandemic, as they can significantly impact a mother's ability to initiate and maintain breastfeeding. However, the COVID-19 pandemic, subsequent lockdowns, and social isolation created challenges for nursing mothers to access doulas' services, usually provided in person. In this study, we examined the role of doulas in providing breastfeeding support during the COVID-19 pandemic, exploring adaptation to COVID-19 guidelines and the challenges doulas face in providing breastfeeding support during the pandemic. METHODS: A systematic review was conducted following the PRISMA guidelines. Thirteen scientific databases and twenty peer-reviewed journals were searched for journal articles published in English between January 2020 and March 2022 using key search terms (e.g., Doula, Breastfeeding, COVID-19). Studies evaluating the role of doulas in providing breastfeeding support during COVID-19, and the impact of COVID-19 Guidelines on doula services, were included. Two reviewers independently performed the risk of bias assessment and data extraction. Summative content analysis was used to analyze the data. RESULTS: The majority of studies were conducted in developed nations. This systematic review includes eight articles, four qualitative, one survey, two mixed-methods studies, and one prospective research study. Seven of the eight studies were conducted in the United States, and the eighth was conducted in multiple countries. These studies have three main themes: (1) virtual breastfeeding support provided by doulas during the pandemic; (2) remote social support provided by doulas to breastfeeding mothers during the pandemic; and (3) barriers to doula service delivery due to COVID-19 restrictions, primarily the exclusion of doulas as essential workers. The eight studies showed that doulas found innovative ways to serve the needs of birthing and nursing mothers during the difficulties brought on by the pandemic. CONCLUSION: Doulas provided breastfeeding support during the COVID-19 pandemic by utilizing innovative service delivery methods while navigating changes in COVID-19 guidance. However, system-level integration of doulas' work and the acknowledgment of doulas as essential healthcare providers are needed to enhance doula service delivery capacity, especially during a pandemic, to help improve maternal health outcomes.

Breastfeeding practices in nursing mothers during COVID-19 pandemic: Dual center study in Karachi, Pakistan.

Objective: To identify the breastfeeding practices in nursing mothers during the COVID-19 pandemic. Methods: This descriptive cross-sectional study was conducted in the Pediatrics and Gynecology & Obstetrics departments at two of the tertiary care hospitals in Pakistan from September 2020 to February 2021. Recently delivered mothers and mothers of children till two years of age on breastfeeding/formula feed were consecutively enrolled. Result: Of 484 participants, breastfeeding was practiced by 180 (37.2%) participants, formula-fed by 85 (17.6%), and mix feed by 219 (45.2%) participants. Out of 185 mothers who had to breastfeed previous babies, 80.2% of mothers still opted to breastfeed their newborns despite the COVID-19 pandemic. Breastfeeding practices exhibited higher incidence in illiterate mothers (aOR 0.229 95% CI 0.05-0.95, p- 0.042), housewives (aOR 0.35 95% CI 0.13-0.95 p-0.040) and shorter length of stay (aOR 0.290 95% CI 0.15-0.57, p- 0.001) while formula /mixed feeding was found higher in mothers with exposure to formula feeding in previous babies (aOR 17.842, 95% CI 8.33-38.19, p- 0.001) and mothers with pain after delivery (aOR 4.526, 95% CI 2.11-9.71, p-<0.001). Conclusion: Mothers who had to breastfeed their babies in a previous pregnancy, who were less educated, and housewives with a shorter stay in hospital have shown a stronger association with breastfeeding whereas mothers who had previous exposure to formula milk and pain after delivery have shown association to formula feed or mixed feed.

Effects of abdominal girdle belt on pulmonary function variables of postpartum women in Enugu, Nigeria: a quasi-experimental study.

This quasi-experimental study was aimed at investigating the effects of wearing an abdominal girdle belt on pulmonary function variables of postpartum women. 40 consenting postpartum women aged between 18 and 35 years were recruited from a post-natal clinic in Enugu, Nigeria. The participants were conveniently assigned into girdle belt and control groups (20 each). Their lung function (forced expiratory volume in first second[FEV1], and %FEV1, forced vital capacity[FVC], peak expiratory flow [PEF], forced expiratory flows [25th, 75th & 25-75th percentiles]) values were measured prior to and after eight weeks of the study intervention period for each participant. Data obtained were analysed using descriptive and inferential statistics. Following the intervention period, 19 and 13 participants completed the study in the girdle belt and control groups, respectively. The main results showed that both groups were comparable at baseline for all the study variables assessed (p > 0.05). Following the intervention period, only the PEF was significantly reduced in the girdle belt group compared to control group participants (p = 0.012). Thus, wearing girdle belts for an extended period of time has no effect on the lung function values of postpartum women.IMPACT STATEMENTWhat is already known on the subject? Postpartum abdominal girdle belts are commonly utilised for resolution of abdominal protrusion and obesity after childbirth. Unfortunately, several adverse effects, including bleeding, compressive pain and discomfort and abnormally increased intra-abdominal pressure, have been associated with this practice. Consistent increase in intra-abdominal pressure of variable duration has been reported to affect pulmonary functions.What do the results of this study add? The study findings indicate that wearing girdle belts for eight weeks by postpartum women has no substantial effect on the pulmonary function variables.What are the implications of these findings for clinical practice and/or further research? Utilisation of abdominal girdle belts of equal or less than 8 weeks duration should not be discouraged for post-partum women due to fear of its potential negative impact on pulmonary function.

The effect of vitamin D supplementation on body composition in nursing mothers with overweight or obesity: a randomized double-blind placebo-controlled clinical trial.

BACKGROUND: This study aimed to evaluate the effect of vitamin D3 supplementation on body composition and anthropometric measures of nursing mothers. METHODS: In a double-blind, randomized clinical trial, 90 nursing mothers with overweight or obesity were randomized into three groups for 12 weeks: two groups of vitamin D3 supplementation (2000 IU/d (VD1), n = 32 and 4000 IU/d (VD2), n = 29) and placebo (PL) group (n = 29). The information on body composition was obtained using the body impedance analysis (BIA) method. Serum 25-Hydroxy vitamin D (25(OH) D), Intact Parathyroid Hormone (iPTH), calcium, and phosphorus were measured before and after the intervention. Data were analyzed based on the intention-to-treat (ITT) method. Two-way repeated measure ANOVA (mixed ANOVA) was applied to assess whether the mean changes in the results from baseline to 12 weeks differ in the three groups. RESULTS: There was a significant increase in the serum 25(OH) D concentration in the VD2 group compared to VD1 and PL groups (mean change (MC), 12.3 ng/ml; 95% CI, 9.4/15.0, p-value < 0.001). In addition, fat mass (MC, - 4.3 kg; 95% CI, - 7.0/- 1.1, p-value < 0.007), fat mass index (MC, - 1.6; 95% CI, - 2.6/- 0.5, p-value < 0.006) and body fat percentage (MC, - 8.1; 95% CI, - 12.0/- 4.2, p-value < 0.007) reduced in VD2 group as compared with VD1 and PL groups. CONCLUSION: The intake of 4000 IU/d vitamins D3 supplementation would elevate circulating 25(OH) D concentrations in nursing mothers with overweight or obesity and improve some indices of body composition. TRIAL REGISTRATION: Iranian Registry of Clinical Trials ( http://www.irct.ir : IRCT20140413017254N6) registered on 11-04-2018. The graphical abstract of this clinical trial, is a figure that explains the final results of the manuscript in a clear and attractive way.

Sociocultural Factors as Predictor to Exclusive Breastfeeding (EBF) Practice among Nursing Mothers in some Communities in Eastern, Nigeria.

This study examined the demographic and sociocultural influences on the level of exclusive breastfeeding (EBF) practices in Enugu state. The major instrument for data collection was a uniform set of structured questionnaire and in-depth interviews with the husbands, grandmothers/mothers-in-law, health workers, women leaders, and traditional/community leaders. Data were analyzed using frequencies, percentages and chi-squared test. Qualitative data were analyzed with ATLAS.ti. The study established that the prevalence level of EBF practice was relatively low (27%) in all the local government areas in the state. The result also showed that several sociocultural factors affected EBF practice. Some of them were: influence of TBAs (91%); poor nutrition in family menu (82%); campaign/marketing of artificial feed (78.3%), unfavorable conditions in the work place (66.8%); belief that lack of water can kill a baby (64.6%) and influence of grandmothers/mothers-in-law (64.2%). The results further revealed that age, occupation, parity, and educational qualification of the mothers influences the level of EBF practice. The findings also revealed that majority of mothers practice mixed feeding in the name of EBF practice. It is suggested that more efforts are needed in giving proper and adequate education and skilled counseling on EBF practice and sociocultural factors associated with the practice.

Impact of maternal demographics on knowledge of exclusive breastfeeding among nursing mothers in Ifelodun local government, Nigeria.

Background: Breastfeeding remains the recommended feeding plan for infants however; several factors seem to affect its knowledge and practice. Objectives: This study aimed at investigating the impact of maternal demographics of age, educational status, religious affiliation and number of parities on knowledge of exclusive breastfeeding among nursing mothers in Ifelodun Local government area, Nigeria. Methods: The study employed a descriptive survey method. A total of 206 nursing mothers in Ifelodun Local Government were selected through purposive and random sampling techniques. The participants responded to a researcher-designed questionnaire titled Knowledge of Exclusive Breastfeeding Questionnaire. The psychometric properties of the instrument were established. The data collected were analysed using both descriptive and inferential statistics. For the demographic data, percentage was employed while chi-square statistical tool was employed to test the hypotheses at 0.05 significant level. Results: Nursing mothers in Ifelodun Local Government Area have high knowledge of exclusive breastfeeding (N=76.8%). Also, maternal demographics of age (X2= 25P=0.03), educational status (X2= 62.72; P=0.00), religious affiliation (X2= 11.01; P=0.01) and number of parity (X2= 84.01; P=0.02) have significant impact on mothers' knowledge of exclusive breastfeeding. Conclusions: Nursing mothers in Ifelodun Local Government Area, have knowledge of exclusive breast feeding especially those who are older, literate, Christian; and multi-parous. Maternal demographics should be considered when educating nursing mothers on exclusive breastfeeding.

Exclusive breastfeeding knowledge and practice among nursing mothers in selected healthcare facilities in Kaduna Metropolis, Nigeria.

Background: Exclusive breast feeding (EBF) in the first six months of life is recognized as an indispensable component of survival, physical and mental development of children. Despite the enormous benefits of EBF, only 39% of infants less than 6 months of age are exclusively breastfed globally. Objectives: This study assessed EBF knowledge, practice and associated factors among nursing mothers attending health facilities in Kaduna metropolis. Methods: Descriptive and cross-sectional study carried out with the aid of a structured questionnaire at the Barau Dikko Teaching Hospital and Gwamna Awwal General Hospital in Kaduna. The participants were recruited by simple random sampling technique with the assistance of trained research assistants for four consecutive weeks in each of the hospital. Data were analysed using SPSS version 16. Results: Majority of the participants were in the age range of 21-30 years. Their main source of information on breastfeeding was from ante-natal clinics (78.3%). Most (86.6%) of the participants had a good knowledge and awareness about EBF, 69.1% of them initiated breastfeeding immediately after birth (within an hour) and 70% of the participants practiced EBF. Insufficient milk, belief that infants require extra fluid, fear of alteration in the breast figure, cultural practice and societal beliefs were identified as the most common barriers to the practice of EBF. Conclusions: Findings from this study showed that most of the participants had a very good knowledge of EBF and are practicing it.

Impact on Public Health Nutrition Services Due to COVID-19 Pandemic in India: A Scoping Review of Primary Studies on Health and Social Security Determinants Affecting the First 1000 Days of Life.

CONTEXT: COVID-19 was declared 'a global pandemic' by the World Health Organization in March 2020. India's lockdown, one of the harshest in the world, came with additional challenges for women. This paper aims to assess the impact of COVID-19 pandemic-related pathways on the first thousand days of life in the Integrated Child Development Scheme and the public distribution ecosystem in India. DATA SOURCES: Using Cochrane guidelines, electronic databases, namely Google Scholar and PubMed-NCBI, were searched for evidence between 1 March 2020 and 1 May 2022. A total of 73 studies were identified in initial search; 20 met the inclusion criteria and, thus, were included in the research analysis. Primary studies were conducted throughout pan-India in rural, urban, and semi-urban areas to study the impact of COVID-19 pandemic-related pathways on the first 1000 days of life. The impact of social security, food insecurity, service delivery, nutrition of pregnant and nursing mothers (P&NMs), and infant and young child feeding (IYCF) varied between geographies and within geographies. Most of the primary studies were conducted at small scale, while only three studies were pan-Indian. The majority of studies were conducted on the mental health of P&NMs and pre-natal and post-natal service delivery disruption. The paucity of the available literature highlights the need to undertake research on the impact of the COVID-19 pandemic-related pathways on 1000 days of life in India and worldwide. The best implementation practices were observed where cross-sectional programs were carried out in relation to health services and social security for P&NMs and children.

Predictors of exclusive breastfeeding practice among nursing mothers attending a health care facility in a peri-urban setting in Lagos State, Nigeria.

Background: The Nigerian government initiated various national infant and young child feeding programmes (1992-2005) to improve juveniles well-being. Despite these efforts, under-five children feeding related diseases and mortality still escalate. Investigating the drivers of exclusive breastfeeding (EBF) is exigent in tackling this menace. Objective: To investigate maternal socio-demographic and index child variables that serve as predictors of EBF practice among nursing mother attending a healthcare facility in Lagos, western Nigeria. Methods: One hundred and twenty (N=120) consenting nursing mothers (15-49 years) with infants between 0-24 months completed a structured, self-administered questionnaire. Scores of current practice level for EBF was computed and adjusted odd ratios (aORs) generated from a logistic regression model. Results: Respondents mean age was 28.7 ± 2.3 years. Of 120 respondents, 82(68.3%) and 38(31.7%) had good and poor EBF practice respectively. Having an index child <6months age (aOR=5.02, 95% confidence intervalCI=1.28-15.43), being in monogamy (aOR=3.0, 95% CI=1.80-6.73), having tertiary education (aOR=3.12, 95% CI=1.39-8.96), being married (aOR=2.0, 95% CI=0.1-0.8) and vaginal delivery (aOR=2.96, 95% CI=1.75-7.48) increased the odds of EBF practice. Conclusion: Age of index child, marriage type, maternal education, marital status and nature of delivery independently predicted EBF practice.

Neck Muscles' Responses to Cradle, Cross-cradle and Football Breastfeeding Hold Positions in Nursing Mothers: A Preliminary Study.

Background: Breastfeeding-related Neck Pain (BFNP) is prevalent in nursing mothers and cuts across the utilization of different breastfeeding (BF) hold positions. Biomechanical considerations to highlight ergonomically safe BF positions for the prevention of BFNP have not been previously studied. Aim: This study was designed to compare the electrical activities of selected neck muscles across three breastfeeding hold positions [cradle (C1), cross-cradle (C2), and football (FB)]. Materials and Method: Surface electromyographic analyses of four neck muscles (right and left components of each trapezius and sternocleidomastoid) were performed respectively during three BF trials with different BF hold positions (C1, C2, and FB) in 22 nursing mothers. For all the trials, the mothers nursed from the left breast. Results: Across the three BF trials, the electrical activities of each of the neck muscles did not vary significantly (P > 0.05). Furthermore, the left muscular components showed predominantly higher activities, as compared to their right components. Conclusion: The breastfeeding hold position adopted during BF tasks may not be a determinant of BFNP in nursing mothers. Further studies to ascertain the biomechanical implications of the utilized BF holds are recommended.

Prevalencia de la lactancia materna exclusiva en un hospital Best Practice Spotlight Organization / Prevalence of exclusive breastfeeding in a hospital Best Practice Spotlight Organization

Objetivo: Conocer la prevalencia de la lactancia materna exclusiva al alta de los recién nacidos sanos, y determinar el nivel de satisfacción de las mujeres puérperas con las intervenciones realizadas para la promoción de la lactan- cia materna según recomendaciones de la guía Lactancia materna de la Re- gistered Nurses’ Association of Ontario (RNAO) aplicadas desde 2017. Método: Estudio descriptivo transversal, llevado a cabo entre junio de 2018 y junio de 2019. La muestra fue de mujeres puérperas ingresadas en la Unidad de Obstetricia del Hospital de la Mujer del Hospital Universitari Vall d’Hebron de Barcelona. Se analizaron variables sociodemográficas y relacionadas con el grado de satisfacción de las intervenciones de promoción de la lactancia ma- terna que habían recibido todas las madres, tanto si ofrecían el pecho como lactancia artificial, recogidas a través de un cuestionario diseñado ad hoc. Resultados: Se analizaron 337 encuestas realizadas por mujeres que recibie- ron intervenciones de promoción de la lactancia materna. Un total de 306 mu- jeres (90,8 %) alimentaron a su recién nacido con lactancia materna exclusiva en el momento del alta. La proporción de madres que dieron lactancia ma- terna exclusiva al alta fue significativamente superior en el grupo que ya lo había hecho anteriormente. El grado de satisfacción sobre las intervencio- nes de promoción recibidas obtuvo una puntuación media de 5,41 ± 0,88 en la escala de Likert, siendo 1 totalmente insatisfecha y 6 totalmente satisfe- cha. El grado de satisfacción fue alto tanto en el grupo que alimentó con lactancia materna exclusiva como en el que no lo hizo. Conclusiones: Casi la totalidad de las mujeres es dada de alta ofreciendo lactancia materna exclusiva a sus recién nacidos, siendo la lactancia mater- na previa un factor de predisposición hacia la misma. El grado de satisfac- ción con las intervenciones de promoción de la lactancia materna fue alto. (AU)

Objective: To identify the prevalence of exclusive breastfeeding at discharge of healthy newborns and to determine the level of satisfaction of postpartum women with the interventions carried out to promote breastfeeding accord- ing to the recommendations by the Registered Nurses’ Association of Ontario (RNAO) applied since 2017. Methodology: Cross-sectional descriptive study, carried out between June 2018 and June 2019. The sample was postpartum women admitted to the Obstetrics Unit of the Maternity Hospital of Vall d'Hebron University Hospital in Barcelona. Sociodemographic variables and those related to breastfeeding promotion interventions were collected through an ad hoc designed ques- tionnaire and analysed, which included those mothers who were breastfeed- ing and those choosing to bottle feed their newborn neonates. Results: 337 surveys completed by women who received breastfeeding pro- motion interventions were analysed. 306 women (90.8 %) exclusively breast- fed their newborn at discharge. The proportion of mothers who exclusively breastfed at discharge was significantly higher in multiparous women who breastfed previous siblings. The degree of satisfaction with the interventions received had a mean score of 5.41 ± 0.88 on the Likert scale, with 1 being totally unsatisfied and 6 totally satisfied. The degree of satisfaction was high regardless of having breastfed or not. Conclusions: Almost all women are discharged with exclusive breastfeeding, with previous breastfeeding being a predisposing factor towards it. The de- gree of satisfaction with breastfeeding promotion interventions was high. (AU)

The relationship between psychological distress and self-esteem among nursing mothers attending Immunization clinic of a tertiary Hospital in Nigeria

@#Psychological distress is a state of emotional suffering characterized by symptoms of depression and anxiety. There is an association between maternal psychological distress and reduced caregiving behavior. Reduced maternal care to babies is also associated with the low self-esteem of the mothers. The study assesses the prevalence of psychological distress and its relationship with self-esteem among nursing mothers attending the immunization clinic in Ekiti State University Teaching Hospital Ado-Ekiti. This is a descriptive cross-sectional study with 458 nursing mothers recruited. A pretested, adapted, structured interviewer-administered questionnaire was used; data were analyzed using SPSS version 25. Descriptive statistics and inferential statistics were done using the Chi-square and the Spearman correlation coefficient. The level of significance was set at p < 0.05. The mean age of the respondents was 31.7±4.8 years, 398 (86.9%) had tertiary education, 440 (96.0%) were married and 15 (3.3%) were single mothers. Sixty-seven (14.6%), 28 (6.1%), and 24 (5.2%) had mild, moderate, and severe psychological disorders, respectively. Those with low and high self-esteem were 222 (48.5%) and 236 (51.5%) respectively. There was a statistically significant relationship between psychological distress and self-esteem with about 29.6% of the variability in psychological distress being explained by self-esteem alone in the nursing mothers (p< 0.01). Stress of child nursing leads to psychological distress for some nursing mothers and this was significantly associated with self-esteem.

Tandem Breastfeeding: A Descriptive Analysis of the Nutritional Value of Milk When Feeding a Younger and Older Child.

Breastfeeding is a gold standard of feeding of newborns and infants. Tandem breastfeeding (TBF) is feeding two children of different ages at the same time. The knowledge about the composition of human milk in prolonged lactation is still scarce. Milk from tandem breastfeeding women and after weaning was examined. Milk samples were collected from 13 TBF mothers. A 24-h milk collection was done. Analyses of fat, protein, carbohydrate and energy content were performed using MIRIS. Sociodemographic characteristics of TBF mothers was done. Higher fat content, energy value and total protein concentration was found in TBFM milk during tandem breastfeeding, than in milk after weaning the older child. The carbohydrate content remained stable. The composition of breastmilk, in terms of macronutrients, changes after weaning, taking into account the nutritional requirements of the younger child. The milk of nursing mothers in tandem did not show diurnal variability in individual components. These findings suggest an adaptive role of human milk to nutrient requirements of newborn and older children. The results may support the promotion of long breastfeeding, including tandem breastfeeding.

Predictors of infant-survival practices among mothers attending paediatric clinics in Ijebu-Ode, Ogun State, Nigeria.

BACKGROUND: Despite concerted global efforts towards achieving infant-survival, infant mortality lingers as a problem in developing countries. Environmental and personal-level factors are assumed to account for this situation. This study was undertaken to provide better understanding of the dynamics of predictors of infant-survival practices among mothers with infants attending paediatric clinics. METHODS: A cross-sectional survey design was adopted. Data was collected from 386 nursing mothers selected by convenience sampling. Interviewer-administered questionnaires were used for data collection. The questionnaire consisted of 38-items including demographic information of respondents, health-literacy counsels received during antenatal care, social-support from significant others, and self-efficacy to carry-out infant-survival instructions. Responses were transformed into rating scales for each variable and data analysis was conducted by linear regression analysis with test of hypotheses at 5% level of significance. RESULTS: The mean age of respondents was 29.8 ± 5.8 years. Majority (81.6%) were married. Yorubas (83.90%) were predominant. Participants had mean scores of 10.50 ± 3.83, 10.56 ± 3.70 and 16.61 ± 4.56 respectively computed for levels of health-literacy, social-support, and self-efficacy. The dependent variable measured level of infant-survival practices and respondents scored 16.53 ± 4.71. The study found a significant association among variables. Self-efficacy was the major predictor variable of self-reported infant-survival practices (R = 0.466; R2 = 0.217; P<0.05). CONCLUSION: We conclude that participants had average levels of health-literacy, social-support, self-efficacy, and infant-survival practices. Healthcare providers should make efforts to empower pregnant women on activities essential for infant-survival. Family members of nursing mothers should as well be knowledgeable about the advantages of supporting them.

Detection of Hepatitis C virus and the risk of transmission among pregnant and nursing mothers from rural and urban communities in Kogi State, Nigeria.

Hepatitis C virus (HCV) is associated with liver complicated diseases resulting in end-stage hepatocellular carcinoma. Although vertical transmission from mother to child serves as one of the routes of HCV acquisition in children, yet HCV infection in pregnant women and children is still underappreciated in sub-Saharan Africa. Therefore, this study investigated the burden of HCV, associated risk factors, and viremia among antenatal and postnatal clinic attendees in the rural and urban communities of Kogi State, Nigeria. Atotal of 176 blood samples were collected from 78 (44.32%) consenting breastfeeding (nursing) mothers and 98 (55.8%) pregnant mothers (age ranged 18-47 years) (SD = +12.1; Median = 26.3) and tested for anti-HCV by ELISA technique. All anti-HCV-positive samples were retested by Taq one-step RT-PCR technique for viral RNA (viremia) detection. The bio-socio-demographic variables of the participants were correlated with the test results, using an IBM SPSS version 21 and MEOP 2010. Ameasure of goodness was considered significant at P< 0.05 using a95% confidence interval. This study found an overall rate of 4.6% for HCV and 2.2% (4/176) viremia indicating both active and passive infections. HCV rate was higher among the civil servants (2.3%; CI = -0.25-2.91; P= 0.241) and peaked among the age group 31-35 years (2.3%; CI = 0.183-2.182; P= 0.293). Various risk factors identified included, relatively high HCV rates during first trimester (1.7%; CI = -2.2-3.61; P= .047), ear/nose piercing (4.6%; CI = -46.83-54.82; P= 0.157), seropositivity among the married (3.9%; CI = -3.36-7.3567; P= 0.238) and urban dwellers (2.8%; CI = -8.71-16.71; P= 0.157). None of the bio-socio-demographic variables except the stage of pregnancy as arisk factor (P= 0.041) evaluated significantly influenced either HCV rate or viremia. This study showed arelatively high rate of HCV among the participants and also revealed that risk factors-based testing is not effective in ELISA testing alone for pregnant and nursing mothers in the community. Therefore, all HCV seropositive pregnant women and breastfeeding mothers including their babies should be tested using the PCR technique to determine vertical transmission and RNA reevaluated after delivery to assess spontaneous clearance.

Challenges and Coping Strategies of Student Nursing Mothers in University of Ibadan, Oyo State, Nigeria.

The rigor of combining motherhood with education poses great challenge to student nursing mothers (SNMs). This study identified the challenges experienced by the SNMs and determined the factors associated with the challenges experienced in University of Ibadan, Ibadan Oyo State, Nigeria. This study utilized a nonprobability sampling technique of snowballing. Responses were elicited from 250 consenting SNMs using the pretested semistructured questionnaire. The SNM challenges were measured on 15-point scale. Challenges scores were classified as moderate (≤9) and severe (≥10). The mean age of the SNMs was 29.5 ± 2.8 years. Majority of the respondents (70.0%) reported facing severe challenges which included economic, childcare, and academic challenges (43.2%, 37.2%, and 24.8%, respectively). χ2 test showed significant associations between ages, course of study, and level of study of the SNMs (χ2 = 10.520, p = .005; χ2 = 14.934, p = .002; and χ2 = 9.523, p = .002, respectively) and the overall challenges experienced. Research findings reveal that childhood health problems occurred mostly among SNMs having problems breastfeeding their babies.

Supporting Breastfeeding Mothers by Transforming Library Space: A Nursing Mothers Room Project.

Librarians at Rowland Medical Library collaborated with individuals from across the campus of the University of Mississippi Medical Center (UMMC) to transform an unused library office to a nursing mothers room. This project resulted in a functional and attractive room for breastfeeding students and employees to pump breast milk.

Low vitamin D status in nursing Pakistani mothers in an environment of ample sunshine: a cross-sectional study.

BACKGROUND: The maternal 25-hydroxy vitamin D (25OHD) insufficiency is related to adverse maternal and neonatal outcome. The 25OHD content of breast milk is dependent on 25OHD status of the mothers. We undertook this study to ascertain the 25OHD status and its determinants in the nursing mothers of the south Punjab, Pakistan. METHODS: We recruited 67 mothers for this cross-sectional study by convenience sampling from August 2010 to June 2011 to ascertain their serum 25OHD level & its determinants. We used SPSS 23.0 for analyses. RESULTS: The mean age of the mothers was 25.75 ± 4.4 years. The median age (and mode) was 25 years (range 18-37 years). The majority of mothers were less than 25 years of age (62.7%), uneducated (68.7%), from rural area (70.1%), lived in open houses with ample sun exposure (85.1%) and belonged to low socioeconomic strata (71.6%). Serum 25OHD ranged from 7.2 to 43.8 nmol/L with a mean of 20.87 ± 7.69 nmol/L. The median and mode were 21.8 nmol/L & 24.0 nmol/L, respectively. The proportion of mothers with 25OHD < 20 nmol/L (severe deficiency) was 44.8%, < 30 nmol/L (deficiency) 49.3% and < 50 nmol/L (insufficiency) 5.9%. All had 25OHD below 50 nmol/L. The oral supplementation with vitamin D (vD) was the only significant determinant of vitamin D sufficiency. CONCLUSIONS: The majority of Pakistani mothers in south Punjab are vD deficient & universal vD supplementation is the need of the hour to improve health outcomes in mothers & infants.