Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.348
Filtrar
1.
Medicine (Baltimore) ; 98(44): e17737, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689820

RESUMO

The World Health Organization and United Nations Children's Fund's Baby-Friendly Hospital Initiative is aimed at the global promotion, protection and support of breastfeeding. In this study, we compared breastfeeding-related information received, knowledge and behaviours among postpartum women in Baby-Friendly Hospital Initiative accredited and non-accredited hospitals. We selected 10 hospitals: 9 non-accredited hospitals in the Campania region in southern Italy and one accredited hospital in the Piedmont region in northern Italy. In total, 786 women (580 (73.8%) in Campania and 206 (26.2%) in Piedmont) in the hospitals' maternity wards completed a questionnaire comprising 5 sections within 24 to 72hours after giving birth. The questionnaire investigated breastfeeding activities in the days immediately following childbirth, as well as the information provided by health personnel, knowledge about breastfeeding before and during hospitalisation, and participation in antenatal classes. To evaluate the comparison between the 2 regions, we performed at first a bivariate analysis and then a multinomial and a multivariate logistic regression. Compared with Piedmont, in Campania hospitals there was a rate of breastfeeding of 44.3% vs 89.3%, a skin-to-skin contact between mother and child of 74.5% vs 90.7% and first milk feed within 2hours of 15.0% vs 87.2%. The Campania group had fewer problems with child latching. The Campania group reported receiving less information about breastfeeding in general compared with the Piedmont group. In general, both groups showed good basic knowledge about different aspects of breastfeeding. In both regions, about 90% reported that the information received during the antenatal classes simplified the breastfeeding experience. Our study confirms the importance of systematic promotion of breastfeeding and subsequent delivery of adequate support to maternity departments, in accordance with international guidelines.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Fidelidade a Diretrizes/estatística & dados numéricos , Promoção da Saúde/normas , Mães/estatística & dados numéricos , Unidade Hospitalar de Ginecologia e Obstetrícia/estatística & dados numéricos , Adulto , Aleitamento Materno/psicologia , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Humanos , Recém-Nascido , Itália , Modelos Logísticos , Mães/psicologia , Análise Multivariada , Unidade Hospitalar de Ginecologia e Obstetrícia/normas , Gravidez , Avaliação de Programas e Projetos de Saúde , Nações Unidas , Organização Mundial da Saúde
3.
Cochrane Database Syst Rev ; 9: CD012099, 2019 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-31529625

RESUMO

BACKGROUND: Exclusive breastfeeding is recommended for all infants until six months of age due to the many health benefits for both the mother and infant.Evidence suggests that mothers who are overweight (body mass index (BMI) 25.0 to 29.9 kg/m²) or obese (BMI ≥ 30.0 kg/m²) are less likely to initiate breastfeeding and to breastfeed for a shorter duration. Considering the rising prevalence of overweight and obesity globally and the known benefits of breastfeeding particularly in reducing the long-term risks of obesity and diabetes for infants, establishing effective ways to support and promote breastfeeding in women who are overweight or obese is paramount in achieving the goal of healthier communities. OBJECTIVES: To assess the effectiveness of interventions to support the initiation or continuation of breastfeeding in women who are overweight or obese. SEARCH METHODS: On 23 January 2019 we searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry Platform (ICTRP) and reference lists of retrieved trials. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-RCTs that compared interventions to support the initiation and continuation of breastfeeding in women who are overweight or obese. Interventions included social support, education, physical support, or any combination of these. Interventions were compared either with each other or against a control group. DATA COLLECTION AND ANALYSIS: We assessed all potential trials identified from the search strategy. Two review authors extracted data from each included trial and assessed risk of bias. We resolved discrepancies through discussion with the third review author. We assessed the quality of the evidence using the GRADE approach. MAIN RESULTS: We found no trials comparing one type of support versus another. We included seven RCTs (including one cluster-RCT) involving 831 women. The number of women in each trial ranged from 36 to 226. The trials were conducted in high-income countries: USA (5 trials); Denmark (1 trial) and Australia (1 trial), between 2006 and 2015. Three trials only included women who were obese prior to pregnancy and four trials included both women who were overweight and women who were obese. We judged risk of bias in the included trials to be mixed; only one trial was judged to be low risk of bias for random sequence generation, allocation concealment and attrition bias.Physical breastfeeding support (manual or electric breast pump) versus usual care (no breast pump)Very low-certainty evidence from one small trial (39 women) looking at a physical support intervention (manual or electric breast pump) versus usual care (no pump) means it is unclear whether physical support improves exclusive breastfeeding at four to six weeks (risk ratio (RR) 0.55, 95% confidence interval (CI) 0.20 to 1.51) or any breastfeeding at four to six weeks (RR 0.65, 95% CI 0.41 to 1.03). The trial did not report other important outcomes of interest in this review: non-initiation of breastfeeding, exclusive or any breastfeeding at six months postpartum.Multiple methods of breastfeeding support versus usual care Six trials (involving 792 women) used multiple methods of support including education and social support through telephone or face-to-face contact. One of these trials also provided physical support through providing a breast pump and a baby sling and one trial provided a small gift to the women at each trial visit. Support in the trials was provided by a professional (four trials) or a peer (two trials). One trial provided group support, with the other five trials supporting women individually. One trial (174 women) did not report on any of our main outcomes of interest.We are unclear about the effects of the intervention because we identified very low-certainty evidence for all of the important outcomes in this review: rate of non-initiation of breastfeeding (average RR 1.03, 95% CI 0.07 to 16.11; 3 trials, 380 women); exclusive breastfeeding at four to six weeks (average RR 1.21, 95% CI 0.83 to 1.77; 4 trials, 445 women); any breastfeeding at four to six weeks (average RR 1.04, 95% CI 0.57 to 1.89; 2 trials, 103 women); rate of exclusive breastfeeding at six months postpartum (RR 7.23, 95% CI 0.38 to 137.08; 1 trial, 120 women); and any breastfeeding at six months postpartum (average RR 1.42, 95% CI 1.08 to 1.87; 2 trials, 223 women).The included trials under the above comparisons also reported on some of this review's secondary outcomes but very low-certainty evidence means that we are unclear about the effects of the intervention on those outcomes. AUTHORS' CONCLUSIONS: There is insufficient evidence to assess the effectiveness of physical interventions, or multiple methods of support (social, educational or physical) for supporting the initiation or continuation of breastfeeding in women who are overweight or obese. We found no RCTs comparing one type of support to another type of support. All of our GRADE assessments resulted in very low-certainty evidence, with downgrading decisions based on limitations in trial design (e.g. risk of attrition bias), imprecision, inconsistency. The available trials were mostly of variable quality with small numbers of participants, confounded by poor adherence within both the intervention and control groups.Well designed, adequately powered research is needed to answer questions about the social, educational, physical support, or any combination of these interventions that could potentially help mothers who are overweight or obese to achieve optimal breastfeeding outcomes. We need trials that examine interventions designed specifically for women who are overweight or obese, delivered by people with training about how to overcome some of the challenges these women face when establishing and maintaining breastfeeding. Particular attention could be given to the assessment of antenatal interventions aimed at improving breastfeeding initiation in women with a raised BMI, and not just focusing on recruiting women who have an intention to breastfeed. Given that the majority of current trials were undertaken in the USA, further trials in a diverse range of countries and settings are required. Future trials need to give consideration to the theoretical basis of the intervention using established frameworks to enable replicability by others and to better determine the components of effective interventions.


Assuntos
Aleitamento Materno/psicologia , Promoção da Saúde/métodos , Mães/psicologia , Obesidade , Sobrepeso , Feminino , Humanos , Lactente , Mães/educação , Obesidade/prevenção & controle , Sobrepeso/prevenção & controle , Período Pós-Parto , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo
4.
Soins Pediatr Pueric ; 40(310): 10-13, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31543228

RESUMO

The reflexive approach supported by interdisciplinarity enables the professional to approach the breastfeeding experience from a perspective which takes into account the family as a whole. The interdisciplinary input aims to support reflexive practices around this global perspective of the family and possibly benefit from interventions which are more focused on the psycho-social aspects of the breastfeeding experience.


Assuntos
Aleitamento Materno , Equipe de Assistência ao Paciente , Aleitamento Materno/psicologia , Feminino , Humanos , Lactente , Relações Profissional-Família
5.
MMWR Morb Mortal Wkly Rep ; 68(34): 745-748, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31465319

RESUMO

Surveillance of U.S. breastfeeding duration and exclusivity has historically reported estimates among all infants, regardless of whether they had initiated breastfeeding. These surveillance estimates have consistently shown that non-Hispanic black (black) infants are less likely to breastfeed, compared with other racial/ethnic groups.* Less is known about disparities in breastfeeding duration when calculated only among infants who had initiated breastfeeding, compared with surveillance estimates based on all infants. CDC analyzed National Immunization Survey-Child (NIS-Child) data for infants born in 2015 to describe breastfeeding duration and exclusivity at ages 3 and 6 months among all black and non-Hispanic white (white) infants, and among only those who had initiated breastfeeding. When calculated among all infants regardless of breastfeeding initiation, breastfeeding differences between black and white infants were 14.7 percentage points (95% confidence interval [CI] = 10.7-18.8) for any breastfeeding at age 3 months and were significantly different for both any and exclusive breastfeeding at both ages 3 and 6 months. Among only infants who had initiated breastfeeding, the magnitude of black-white differences in breastfeeding rates were smaller. This was most notable in rates of any breastfeeding at 3 months, where the percentage point difference between black and white infants was reduced to 1.2 (95% CI = -2.3-4.6) percentage points and was no longer statistically significant. Black-white disparities in breastfeeding duration result, in part, from disparities in initiation. Interventions both to improve breastfeeding initiation and to support continuation among black mothers might help reduce disparities.


Assuntos
Afro-Americanos/psicologia , Aleitamento Materno/etnologia , Grupo com Ancestrais do Continente Europeu/psicologia , Mães/psicologia , Adulto , Afro-Americanos/estatística & dados numéricos , Aleitamento Materno/psicologia , Aleitamento Materno/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Humanos , Lactente , Mães/estatística & dados numéricos , Fatores de Tempo , Estados Unidos , Adulto Jovem
6.
BMC Public Health ; 19(1): 993, 2019 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-31340787

RESUMO

BACKGROUND: Breastfeeding has important positive long-term health consequences for infants and mothers. The World Health Organization recommends that all infants should be exclusively breastfed for six months or longer, and advises continuation of breastfeeding for two years or beyond. However, these recommendations are not met in many countries. This study examined whether a comprehensive, evidence-based breastfeeding intervention, the Breastfeeding Support Programme (BSP), promotes prolonged duration and exclusivity of breastfeeding among its participants. METHODS: A quasi-experimental design was used to compare breastfeeding duration and exclusivity in the BSP group (N = 66) to breastfeeding duration and exclusivity in a control group (N = 72). Participants who followed the BSP were provided with 6 consults delivered by a lactation consultant. The consults started during pregnancy and continued up until 10 weeks after delivery. Participants in the control group did not follow the BSP. Pretest and posttest questionnaires were administered through the internet. A Cox proportional hazards regression analysis was used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for cessation of any and exclusive breastfeeding, while controlling for differences at baseline. RESULTS: The effect of the BSP on survival rates for any and exclusive breastfeeding were significant while controlling for differences between the two groups at baseline (respectively HR = 0.34, p < .001 [95% CI = 0.18-0.61] and HR = 0.46, p < .001 [95% CI = 0.29-0.72]). Among mothers in the BSP group there was on average 66% less risk of cessation of any breastfeeding and on average 54% less risk of cessation of exclusive breastfeeding at any point in time compared to those in the control group. CONCLUSIONS: The BSP appears to be an effective means to delay cessation of any and exclusive breastfeeding cessation and therefore to increase breastfeeding duration and exclusivity. This is an important finding, because earlier cessation of breastfeeding than desired is a common problem in many countries. Future research into the effectiveness of the BSP could consider random assignment to conditions and test the effectiveness of the intervention in other populations to investigate further whether wide-scale implementation of this intervention could be useful to promote breastfeeding.


Assuntos
Aleitamento Materno/psicologia , Mães/psicologia , Grupos de Autoajuda , Fatores de Tempo , Adulto , Aleitamento Materno/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Ensaios Clínicos Controlados não Aleatórios como Assunto , Gravidez , Avaliação de Programas e Projetos de Saúde , Modelos de Riscos Proporcionais
7.
BMC Public Health ; 19(1): 570, 2019 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-31088541

RESUMO

BACKGROUND: The most recent World Health Organization (WHO) guidelines on Human Immunodeficiency Virus (HIV) and infant feeding promotes exclusive breastfeeding (EBF) in resource limited settings for the prevention of mother to child transmission (PMTCT) of HIV. Literature reveals poor uptake of WHO feeding guidelines, with mixed feeding being a regular practice. In light of the limited success in EBF promotion, a realist review was conducted, analysing the use of feeding counselling to increase exclusive breastfeeding by HIV-positive women in sub Saharan-Africa, where the majority of HIV childhood infections occur. We considered what mechanisms were at play, for whom and in what circumstances they led to exclusive breastfeeding. METHODS: Because infant feeding counselling is a complex social intervention with a non-linear causal pathway for preventing mother to child HIV transmission, a realist methodology was chosen for this study. Using Pawson's five stage sequence for conducting realist reviews, the results are presented as a set of identified and refined context-mechanism-outcome (CMO) configurations. These CMO configurations were used to show how particular outcomes occurred in specific contexts due to a generative mechanism and were developed through identifying a review question and program theory, searching for primary studies, quality appraisal, data extraction and data synthesis. RESULTS: From an initial 1010 papers, 27 papers met the inclusion criteria and were used to refine the program theory. Exclusive breastfeeding occurred when a woman was motivated regarding motherhood, had correct learning and understanding about infant feeding practices through counselling, no fear of breastfeeding or the impact of opposing feeding related cultural beliefs, and the support from others to be assertive about their feeding choices when faced with pressure to mix-feed. An additional CMO configuration was added during the refinement of the program theory identifying that mothers needed to not just understand but also prioritize EBF advice over cultural beliefs and stigma. CONCLUSION: The intended audience for this review are researchers and health care workers in PMTCT, particularly sub-Saharan Africa, who may benefit from the work that has been done to identify contexts for the success and failures of EBF.


Assuntos
Aleitamento Materno/psicologia , Aconselhamento/métodos , Infecções por HIV/psicologia , Pessoal de Saúde/psicologia , Mães/psicologia , Adulto , África ao Sul do Saara , Comportamento Alimentar/psicologia , Feminino , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Soropositividade para HIV/psicologia , Soropositividade para HIV/transmissão , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Motivação
9.
Sex Reprod Healthc ; 19: 88-94, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30928141

RESUMO

OBJECTIVE: Mothers who have negative breastfeeding experiences due to initial breastfeeding difficulties are in demanding existential situations. Therefore, it is important for healthcare professionals to identify and address such breastfeeding problems. The aim of this study was to develop an instrument designed to assess existential aspects of mothers' initial breastfeeding difficulties and evaluate its psychometric properties. METHODS: This study reports on the development of a new instrument and was carried out in three steps: (1) a questionnaire about various existential aspects of initial breastfeeding difficulties, based on 66 items derived from two phenomenological studies, was developed; (2) information was collected using the questionnaire; (3) and the resulting data were statistically analysed. Spearman's correlation coefficient was used to assess comparative validity; exploratory factor analysis with principal axis factoring and varimax rotation were used to assess construct validity; and Cronbach's alfa was used to assess internal consistency and reliability. Three hundred and nine Swedish-speaking mothers aged 20-46 participated in the study. RESULTS: Correlation and factor analysis of the 66 items revealed that 16 of the items were of psychometric value and valid. Factor analysis generated three factors that accounted for 62.9% of the total variance: Mother-Child Interdependency, Exposure and Vulnerability and Security and Trust. The instrument shows adequate sensitivity to identify existential aspects of mothers' initial breastfeeding difficulties. CONCLUSION: The instrument satisfactorily assesses existential aspects of initial breastfeeding difficulties and can be used as a sensitive tool by healthcare professionals to screen for and identify mothers who have negative breastfeeding experiences.


Assuntos
Aleitamento Materno/psicologia , Mães/psicologia , Inquéritos e Questionários , Adulto , Existencialismo , Análise Fatorial , Humanos , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Autoeficácia , Confiança , Adulto Jovem
10.
Pediatrics ; 143(5)2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31015374

RESUMO

OBJECTIVES: To determine mediators of improvements in infant safe-sleep (SS) practices in a mobile health intervention. METHODS: In a cluster-randomized controlled trial, mothers received SS intervention or breastfeeding control videos for 60 days. Maternal responses about infant sleep position and location (outcomes) and mediators (attitudes, perceived social norms, and perceived control) from the theory of planned behavior were assessed. Intervention effects on mediators and association between mediators and outcomes were examined. RESULTS: Of 1600 recruited, 1263 mothers participated. Mothers receiving SS videos were more likely to have positive attitudes and norms for supine sleep (attitudes: adjusted odds ratio [aOR] = 2.35 [95% confidence interval (CI) 1.72 to 3.20]; norms: aOR = 1.75 [95% CI 1.27 to 2.42]) and recommended sleep location (attitudes: aOR = 1.91 [95% CI 1.54 to 2.36]; norms: aOR = 1.37 [95% CI 1.13 to 1.66]). Positive attitudes and norms toward supine sleep and room-sharing without bed-sharing were associated with higher odds of both practices (supine: aOR = 8.25 [95% CI 4.72 to 14.43] for positive attitudes and aOR = 6.67 [95% CI 4.25 to 10.46] for norms; room-sharing: aOR = 7.14 [95% CI 5.35 to 9.53] for positive attitudes and aOR = 4.44 [95% CI 3.03 to 6.51] for norms). Both positive attitudes and positive norms mediated the effect of the intervention. CONCLUSIONS: The intervention achieved success in improving adherence to SS recommendations by changing maternal attitudes and norms about supine sleeping and room-sharing without bed-sharing. Recognition that these attitudes and norms appear to be the main drivers of mothers' choices regarding infant-sleep practices should inform health messaging strategies to promote SS.


Assuntos
Aleitamento Materno/psicologia , Fidelidade a Diretrizes/normas , Cuidado do Lactente/normas , Mães/psicologia , Morte Súbita do Lactente/prevenção & controle , Telemedicina/normas , Adulto , Análise por Conglomerados , Feminino , Humanos , Lactente , Cuidado do Lactente/métodos , Masculino , Mães/educação , Mídias Sociais , Decúbito Dorsal/fisiologia , Telemedicina/métodos
11.
BMC Pregnancy Childbirth ; 19(1): 125, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30975095

RESUMO

BACKGROUND: Bonding refers to emotions and cognitions towards one's infant. Breastfeeding is believed to facilitate bonding, yet only a handful of studies have empirically tested this assertion. This study aimed to confirm whether a positive association between breastfeeding and bonding exists and whether breastfeeding may be protective against the negative consequences of mood and sleep disturbances on bonding. METHOD: A cross-sectional survey was administered to a convenience sample of Israeli mothers of infants ages 1-9 months. The main outcome measures were breastfeeding history, bonding (Postpartum Bonding Questionnaire, PBQ), mood (Edinburgh Postnatal Depression Scale, EPDS) and sleep (Pittsburgh Sleep Quality Index, PSQI). RESULTS: Two hundred seventy-one mothers (21-46 years) completed the survey. 65.7% reported current breastfeeding, 22.1% past breastfeeding, 12.2% never nursed. The PBQ correlated with both the EPDS and PSQI. Breastfeeding was associated with greater daytime fatigue, but not with any other sleep problem, and was not associated with bonding. This negative result was confirmed with Bayesian analysis demonstrating that the probability for the null hypothesis was 4.5 times greater than the hypothesized effect. Further, hierarchical regression revealed a positive relationship between bonding, daytime fatigue and depression symptoms only among women who were currently breastfeeding. CONCLUSIONS: These findings suggest that among healthy mothers, breastfeeding may not be a central factor in mother-infant bonding, nor is it protective against the negative impact of mood symptoms and bonding difficulties. Theoretical and methodological bases of these findings are discussed.


Assuntos
Aleitamento Materno/psicologia , Relações Mãe-Filho/psicologia , Mães/psicologia , Apego ao Objeto , Período Pós-Parto/psicologia , Adulto , Afeto , Teorema de Bayes , Estudos Transversais , Emoções , Feminino , Humanos , Lactente , Recém-Nascido , Gravidez , Escalas de Graduação Psiquiátrica , Sono , Transtornos do Sono-Vigília/psicologia , Inquéritos e Questionários
12.
BMC Res Notes ; 12(1): 215, 2019 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-30961638

RESUMO

OBJECTIVE: This study was aimed to assess appropriate complementary feeding practice and associated factors among mothers having children aged 6-24 months in Debre Tabor Hospital, North West Ethiopia, 2016. RESULTS: In this study, 37.2% of mothers had appropriate complementary feeding practice. Mothers' level of education above grade 12 (AOR = 2.96, CI 1.2-7.62), husbands' occupation (AOR = 4.01, CI 1.3-12.44), mothers 'having exclusive breast feeding practice (AOR = 6.12, CI 3.04-12.3), health education about exclusive breast feeding during antenatal care visit (AOR = 5.59, CI 1.24-25.17) and advice on appropriate complementary feeding practice during antenatal care visit (AOR = 6.34, CI 1.5-26.91), and mothers who have got under 5 unit service due to infant and young children illness (AOR = 0.44, CI 0.22-0.89) were statistically significant variables for appropriate complementary feeding practice.


Assuntos
Aleitamento Materno/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Fenômenos Fisiológicos da Nutrição do Lactente/fisiologia , Mães/psicologia , Adulto , Pré-Escolar , Estudos Transversais , Escolaridade , Etiópia , Comportamento Alimentar/fisiologia , Feminino , Educação em Saúde , Hospitais , Humanos , Lactente , Masculino , Mães/educação , Gravidez , Cuidado Pré-Natal , Fatores Socioeconômicos
13.
MCN Am J Matern Child Nurs ; 44(3): 164-169, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30855282

RESUMO

Investigation of the needs of same-sex mothers practicing lactation is limited in the nursing literature. The heteronormative structure of the healthcare system has stigmatized these postpartum women and minimized the level of nursing care provided. Case reports demonstrate that same-sex mothers value inclusivity and understanding of their healthcare needs that is missing in healthcare settings. Perinatal nurses must listen attentively and think critically about their words and actions to avoid inappropriate judgments when providing care to this population. Active engagement and ongoing competence education builds the foundation that will provide perinatal nurses the knowledge they need to best support the unique needs of same-sex mothers in their lactation experience.


Assuntos
Mães/psicologia , Minorias Sexuais e de Gênero/psicologia , Aleitamento Materno/efeitos adversos , Aleitamento Materno/métodos , Aleitamento Materno/psicologia , Competência Clínica/normas , Feminino , Humanos , Casamento/psicologia , Casamento/estatística & dados numéricos , Leite Humano/metabolismo , Mães/estatística & dados numéricos , Gravidez , Minorias Sexuais e de Gênero/estatística & dados numéricos
14.
Rev Esc Enferm USP ; 53: e03433, 2019 Feb 28.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30843928

RESUMO

OBJECTIVE: Determine the level of knowledge about maternal breastfeeding and analyze to what extent this influences the intention to breastfeed after the introduction of infant feeding at the 6th and 16th weeks and at 6 months postpartum. METHOD: Prospective descriptive study conducted with pregnant women in Galicia (Spain). By means of a self-filling questionnaire, data were collected on the intention of the woman to feed the newborn and their knowledge about breastfeeding. Pregnant women were also contacted at the 6th and 16th weeks and at 6 months postpartum to know the type of feeding they gave their child. RESULTS: 297 pregnant women participated in the study, of which 90.4% wanted to exclusively breastfeed their baby, however, only 28.2% continued up to 6 months. The level of knowledge about breastfeeding was regular and it was observed that it influences both the intention and the type of feeding of the newborn, thus it is an element to be considered when developing educational strategies aimed at increasing breastfeeding rates. CONCLUSION: The level of pregnant women's knowledge about breastfeeding is regular and influences the choice of how to feed their babies and the duration of exclusive breastfeeding. Strategies should be implemented to increase knowledge and improve breastfeeding rates.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Mães/psicologia , Adolescente , Adulto , Aleitamento Materno/psicologia , Feminino , Humanos , Lactente , Recém-Nascido , Intenção , Gravidez , Prevalência , Estudos Prospectivos , Espanha , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
15.
Int J Qual Stud Health Well-being ; 14(1): 1588034, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30893016

RESUMO

PURPOSE: Experiencing breastfeeding difficulties poses a risk for early cessation of breastfeeding and decreases the likelihood of breastfeeding a future child. To further understand breastfeeding outcomes, the aim of this study is to explain the phenomenon of breastfeeding difficulties in order to understand how women's previous experiences of breastfeeding difficulties relate to their decisions about future breastfeeding. METHODS: A reflective lifeworld hermeneutical approach was adopted. The study consisted of 15 lifeworld interviews with eight women who had previously experienced difficulties with initial breastfeeding. RESULTS: Previously experienced breastfeeding difficulties represent an existential breastfeeding trauma in an individual woman's life, from which there are two intertwined pathways for future breastfeeding: a fear of breastfeeding, which renders the idea of future breastfeeding unthinkable, and a longing for breastfeeding, which increases the likelihood of future breastfeeding. Fear and longing are intertwined in ambiguous ways in an individual woman's life. CONCLUSION: Women with previous breastfeeding difficulties may bring negative breastfeeding experiences with them, which are etched into the woman's being as a mother as an embodied memory. A lifeworld-led caring science perspective as a foundation for care can contribute to the development of caring practices, which grasp the existential nature of the breastfeeding trauma.


Assuntos
Aleitamento Materno/psicologia , Tomada de Decisões , Emoções , Existencialismo , Mães/psicologia , Trauma Psicológico , Adulto , Empatia , Medo , Feminino , Hermenêutica , Humanos , Inquéritos e Questionários , Adulto Jovem
16.
Res Nurs Health ; 42(3): 176-188, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30835887

RESUMO

The majority of women experience pain during breastfeeding initiation with few strategies to manage breast and nipple pain. In fact, women cite breast and nipple pain as among the most common reasons for breastfeeding cessation. To address this important issue, we developed a breastfeeding self-management (BSM) intervention, based on the Individual and Family Self-Management Theory Framework. In this framework, self-management is conceptualized as a process in which women use knowledge, beliefs, and social facilitation to achieve breastfeeding goals. The purpose of this longitudinal pilot randomized controlled trial was to test the feasibility, acceptability, and preliminary efficacy of the BSM intervention with women initiating breastfeeding. Recruitment of 60 women intending to breastfeed occurred within 48 hr of delivery and women were randomized to either the intervention or usual care group. The BSM intervention group received BSM education modules that included information of how to manage breast and nipple pain and self-management support through biweekly texting from the study nurse, and were asked to complete a daily breastfeeding journal. Primary outcomes measured at baseline, 1, 2, and 6 weeks will be used to (a) evaluate feasibility, acceptability, and preliminary efficacy of the BSM intervention, and (b) assess the influence of protective and risk factors of breastfeeding pain (including individual genetic polymorphisms related to pain sensitivity) on process variables for self-management of breastfeeding and breastfeeding pain, and on proximal (breastfeeding pain severity and interference, breastfeeding frequency) and distal outcomes (breastfeeding exclusivity and duration and general well-being).


Assuntos
Aleitamento Materno/psicologia , Mães/educação , Mamilos , Cuidado Pós-Natal/métodos , Autogestão/educação , Adulto , Aleitamento Materno/efeitos adversos , Feminino , Humanos , Estudos Longitudinais , Satisfação do Paciente , Projetos Piloto , Autocuidado/métodos
17.
Nurs Res ; 68(2): E1-E10, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30829925

RESUMO

BACKGROUND: Over 90% of women experience pain during breastfeeding initiation and lack strategies to self-manage breast and nipple pain. Guided by the Individual and Family Self-Management Theory, a breastfeeding self-management (BSM) intervention targeted women's knowledge, beliefs, and social facilitation to manage their breast and nipple pain and achieve their breastfeeding goals. OBJECTIVES: The purpose of this longitudinal pilot randomized control trial (RCT) was to test the preliminary efficacy of the BSM intervention on general and specific pain related to breastfeeding. METHODS: Sixty women intending to breastfeed were approached within 48 hours of delivery to participate in this pilot RCT (30 randomized to the BSM intervention and 30 randomized to the control group). All participants provided baseline data before discharge and pain and breastfeeding measures at 1, 2, and 6 weeks. Participants in the BSM intervention group received educational modules addressing breast and nipple pain and biweekly, text-based nurse coaching and completed a daily breastfeeding journal. RESULTS: Women in the BSM intervention group reported significantly less breast and nipple pain at 1 and 2 weeks using a visual analog scale (p < .014 and p < .006) and at 2 weeks using the Brief Pain Inventory intensity scale (p < .029), but no difference in breastfeeding duration. DISCUSSION: The BSM intervention pilot demonstrates a positive effect on breastfeeding specific and overall generalized pain. Future investigation is needed to identify at-risk women of ongoing breastfeeding pain and develop precision interventions to sustain this beneficial health behavior for mothers and infants.


Assuntos
Aleitamento Materno/psicologia , Mães/educação , Manejo da Dor/métodos , Cuidado Pós-Natal/métodos , Autogestão/educação , Adulto , Feminino , Humanos , Lactente , Estudos Longitudinais , Projetos Piloto , Autocuidado/métodos
18.
Midwifery ; 74: 68-75, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30927634

RESUMO

OBJECTIVE: To examine the mothers' knowledge and attitudes toward breastfeeding and highlight barriers to exclusive breastfeeding in Chinese postpartum mothers. DESIGN: Cross sectional survey SETTING: Maternity wards of two large, multi-service teaching hospitals, Wuhan, China. PARTICIPANTS: 324 postnatal mothers completed a structured questionnaire during their stay at hospital from October 2016 to January 2017. MEASUREMENTS AND FINDINGS: Descriptive and inferential statistics revealed that most mothers showed neutral attitude on breastfeeding and neutral knowledge level as well. The average score for the total Iowa Infant Feeding Attitude Scale (IIFAS) was 56.55±4.77 M±SD, and 10.83±2.77, M±SD for the knowledge section. The mothers who had poor knowledge were less likely to initiate breastfeeding within an hour after birth. CONCLUSIONS: The results of this study are applicable to nurses and nurse midwives to assist in identification of women who may be at-risk to not initiate breastfeeding. Maternal positive attitude and good knowledge play key roles in the process of breastfeeding. Thus, it is important to provide antenatal and early postpartum education and periodical breastfeeding counselling, especially for new mothers, to improve maternal attitudes and knowledge toward breastfeeding practices.


Assuntos
Aleitamento Materno/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Mães/psicologia , Adulto , Alimentação Artificial/psicologia , China , Estudos Transversais , Feminino , Humanos , Gravidez , Inquéritos e Questionários
19.
BMC Pregnancy Childbirth ; 19(1): 78, 2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-30791873

RESUMO

BACKGROUND: The Cord Pilot Trial compared two alternative policies for cord clamping at very preterm birth at eight UK maternity units: clamping after at least 2 min and immediate neonatal care (if needed) with cord intact, or clamping within 20 s and neonatal care after clamping. This paper reports follow-up of the women by two self-completed questionnaires up to one year after the birth. METHODS: Women were given or posted the first questionnaire between four and eight weeks after birth, usually before their baby was discharged, and were posted a second similar questionnaire at one year. The questionnaire included the Hospital Anxiety and Depression Scale; the Preterm Birth Experience and Satisfaction Scale (P-BESS) and questions about their baby's feeding. RESULTS: Of 261 women randomised (132 clamping ≥2 min, 129 clamping ≤20 s), six were excluded as birth was after 35+ 6 weeks (2, 4 in each group respectively). Six were not sent either questionnaire. The first questionnaire was given/sent to 244 and returned by 186 (76%) (79, 74%). The second, at one year, was sent to 242 and returned by 133 (55%) (66, 43%). On the first questionnaire, 89 (49%) had a score suggestive of an anxiety disorder, and 55 (30%) had a score suggestive of depression. Satisfaction with care at birth was high: median total P-BESS score 77 [interquartile range 68 to 84] (scale 17 to 85). There was no clear difference in anxiety, depression, or satisfaction with care between the two allocated groups. The median number of weeks after birth women breastfed/expressed was 16 (95% confidence interval (CI) 13 to 20, n = 119) for those allocated clamping ≥2 min and 12 (95% CI 11 to 16, n = 103) for those allocated clamping ≤20 s. CONCLUSIONS: The response rate was higher for the earlier questionnaire than at one year. A high proportion of women reported symptoms of anxiety or depression, however there were no clear differences between the allocated groups. Most women reported that they had breastfed or expressed milk and those allocated deferred cord clamping reported continuing this for slightly longer. TRIAL REGISTRATION: ISRCTN 21456601, registered 28th February 2013, http://www.isrctn.com/ISRCTN21456601.


Assuntos
Protocolos Clínicos , Nascimento Prematuro/terapia , Fatores de Tempo , Cordão Umbilical , Ansiedade/etiologia , Aleitamento Materno/psicologia , Constrição , Depressão Pós-Parto/etiologia , Feminino , Seguimentos , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Satisfação do Paciente , Projetos Piloto , Período Pós-Parto/psicologia , Gravidez
20.
J Clin Nurs ; 28(11-12): 2340-2350, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30786086

RESUMO

BACKGROUND: Improving breastfeeding support to mothers has been the focus of several national and international health organisations. There is evidence that theoretical and clinical education improves breastfeeding knowledge and attitudes among nursing and other health professional students prior to clinical placement, to support women who are breastfeeding. AIMS AND OBJECTIVES: To explore the expectations and experiences of Taiwanese nursing students in supporting breastfeeding on clinical placement. To gain additional insight into student experience, we also sought the perspectives of mothers, nursing staff and teachers about the role of nursing students in supporting breastfeeding mothers. DESIGN: A qualitative descriptive approach guided this study. METHODS: Focus groups and small group interviews were conducted with four participant groups in southern Taiwan. Ethical approval was obtained prior to data collection. The consolidated criteria for reporting qualitative research checklist was used. FINDINGS: Three main themes emerged from the data that captured the nursing students' experiences during clinical practice, which were "High expectations"; "The reality is different"; and "Improving confidence in students." The study found that students lacked confidence in supporting breastfeeding in the clinical setting. Students were expected to support women to achieve their breastfeeding goals under the supervision. The students highlighted the importance of establishing trust to effectively support mothers, and for the students to feel confident to provide the breastfeeding information. CONCLUSIONS: Despite structured theoretical breastfeeding education prior to clinical placement, students did not feel they were adequately prepared to support women who are breastfeeding during their clinical placement. The findings demonstrated the need for further support in developing effective communication skills and building confidence prior to clinical placement. RELEVANCE TO CLINICAL PRACTICE: Enhancing the content of theoretical and simulated breastfeeding education to incorporate women's breastfeeding experience combined with realistic clinical student allocation could serve to improve students' confidence in supporting breastfeeding.


Assuntos
Aleitamento Materno/psicologia , Bacharelado em Enfermagem/métodos , Estudantes de Enfermagem/psicologia , Adulto , Feminino , Grupos Focais , Humanos , Masculino , Mães/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Cuidado Pós-Natal/métodos , Pesquisa Qualitativa , Taiwan , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA