Assessment Of Breastfeeding Research Articles

Assessment of Breastfeeding and Weaning Practices and Their Effects on Infant Growth in Western Maharashtra: A Cross-Sectional Study.

Breastfeeding provides nutrients and antibodies crucial for developing infants and their immune systems. Understanding the current breastfeeding and weaning practices helps identify areas requiring improvements to boost infant health outcomes. The World Health Organization and other health bodies recommend that babies be exclusively breastfed for the first six months of life. Then, complementary feeding should be introduced along with breastfeeding, which should be continued for up to two years or more. This study aims to analyze the perception and practices of breastfeeding and weaning among mothers with 9- to 12-month-old infants. This cross-sectional analytical study was conducted at Krishna Hospital and Research Centre, Karad, for a period of six months. A validated questionnaire developed by investigators was used as the study tool.Mothers visiting the immunization clinics with their 9- to 12-month-old infants were enrolled in the study. Infants diagnosed as having inborn metabolic disorders, diabetes, heart diseases, and congenital malformations and those who were on special feeds or diets were not included in the study. The majority of the study participants (28 [33%]) initiated weaning when the infants were six to seven months of age, with the earliest being five months (8 [10%]). Five (6%) mothers could not initiate weaning until the infants were 12 months old. The most common weaning food was dal and rice with ghee (24 [29%]). A total of 50 (60%) participants used plastic bottles for feeding, and among them, 30 (36%) mothers used bottles to give water to their infants. A total of 23 (27%) participants did not feed their infants colostrum. The most common hunger cue was crying (82 [98%]), whereas the least common cue was mouth opening (8 [9%]). The incorrect practices followed by the mothers were late initiation of breastfeeding because of which colostrum could not be fed to the neonate; incorrect breastfeeding technique, that is, feeding little milk from each side of the breast without emptying one breast completely; late or no initiation of weaning foods; and offering less amount of weaning food than that required by the infant according to its nutritional demand. Initiating breastfeeding early and continuing breastfeeds along with complimentary feeds are essential for optimal infant growth.

Study of Different Breastfeeding Parameters by Using Breastfeeding Assessment Tools in Urban Tertiary Care Hospital

Background: In India, only 56% of mothers breastfeed exclusively for the first six months, as recommended. Given India’s extraordinarily high rates of preterm births, infant mortality, neonatal deaths and maternal fatalities, exclusive breastfeeding becomes even more crucial. There are many advantages of breastfeeding, but there are lots of barriers that need to be addressed. These problems need a proper objective assessment. Aims: To assess optimum positioning and attachment in mother-infant dyads, infant breastfeeding behaviour in the early neonatal period and early breastfeeding skills in mothers. Methods: A prospective cross-sectional study was conducted in the postnatal ward of a tertiary care hospital. In total, 208 full-term neonates (Age - 24 hours to 7 days) who were admitted to a postnatal ward of a tertiary care hospital and who were on direct breastfeeding were observed for breastfeeding. Objective assessment of breastfeeding was done by using the Bristol Breastfeeding Assessment Tool, Infant Breast-Feeding Assessment tool and LATCH tool. Statistical analysis was done by using SPSS version 25 with appropriate statistical tests. Result: For the BBAT tool, 110 (52.9%) infants were well supported while feeding and 118 (56.7%) had proper latching or attachment. For IBFAT Score Analysis, 109 (52.4%) infants were effective vigorous feeders and 95 (45.7%) and 4 (1.9%) were moderately effective feeders and poor feeders, respectively. For LATCH Score Analysis, 173 (83.2%) mother-infant dyads achieved a high score and 35 (16.8%) achieved moderate score. Conclusion: Objective assessment of breastfeeding by using these tools will help to identify the problem related to breastfeeding for both baby and mother. Addressing a particular problem in a timely manner will help the mother and the baby to establish, initiate and sustain exclusive breastfeeding. Caesarean-delivered mothers as well as primiparous mothers both needed more focused counselling for breastfeeding positioning, motivation for early initiation breastfeeding, a strong supportive relationship, adequate assistance during the early neonatal period for breastfeeding and proper guidance to sustain exclusive breastfeeding.

Comparison of the introduction of consistencies in complementary feeding introduction between preterm and full-term newborns - Cohort from 0 to 12 months.

To compare the introduction of consistencies during the period of complementary feeding of preterm and full-term newborns up to 12 months of life, as well as to evaluate the presence of oral motor dysfunction and its relation to difficulty in introducing food consistencies in these groups. This is an observational, analytical, cohort study, with ambispective data collection, carried out at the Municipal Department of Health of Mafra, state of Santa Catarina, Brazil. The study sample consisted of 87 newborns, 41 full-term and 46 preterm. While data was collected, interviews were held with the mothers/guardians. The anthropometric assessment was carried out by a nutritionist by measuring body weight, length, and head circumference, followed by assessment of oral and functional motor skills by the adapted Clinical Evaluation Protocol of Pediatric Dysphagia (PAD-PED), assessment of breastfeeding and neuropsychomotor development, and assessment of the presence of maternal depression and psychological risk of children with up to 12 months of corrected age. We verified oral motor dysfunction in 15 newborns, in both groups, in the liquid consistency in the first assessment, persisting in two cases in the full-term newborns and in three cases in the preterm infants, in the last assessment for the solid consistency. We observed no difference in the introduction of food consistencies between groups. Breastfeeding was more frequent in newborns in the first assessment and similar in other assessments. Regarding the predictors for oral motor dysfunction, bottle feeding increased the odds by about seven times and invasive oral procedures by about six times.

Comparação da introdução das consistências na introdução da alimentação complementar entre recém-nascidos prematuros e a termo - Coorte de 0 a 12 meses

ABSTRACT Purpose To compare the introduction of consistencies during the period of complementary feeding of preterm and full-term newborns up to 12 months of life, as well as to evaluate the presence of oral motor dysfunction and its relation to difficulty in introducing food consistencies in these groups. Methods This is an observational, analytical, cohort study, with ambispective data collection, carried out at the Municipal Department of Health of Mafra, state of Santa Catarina, Brazil. The study sample consisted of 87 newborns, 41 full-term and 46 preterm. While data was collected, interviews were held with the mothers/guardians. The anthropometric assessment was carried out by a nutritionist by measuring body weight, length, and head circumference, followed by assessment of oral and functional motor skills by the adapted Clinical Evaluation Protocol of Pediatric Dysphagia (PAD-PED), assessment of breastfeeding and neuropsychomotor development, and assessment of the presence of maternal depression and psychological risk of children with up to 12 months of corrected age. Results We verified oral motor dysfunction in 15 newborns, in both groups, in the liquid consistency in the first assessment, persisting in two cases in the full-term newborns and in three cases in the preterm infants, in the last assessment for the solid consistency. Conclusion We observed no difference in the introduction of food consistencies between groups. Breastfeeding was more frequent in newborns in the first assessment and similar in other assessments. Regarding the predictors for oral motor dysfunction, bottle feeding increased the odds by about seven times and invasive oral procedures by about six times.

Effectiveness of Using Latch Score as Breastfeeding Assessment and Early Preparation for Breastfeeding

Mothers whose babies have problems and are cared for separately make mothers feel less confident about breastfeeding because they think about the health of their babies. Lack of confidence in breastfeeding is a factor in the failure to breastfeed. An instrument is needed to assess the breastfeeding process as a nurse's initial step to establish nursing interventions in nursing mothers. Objective: Apply the use of the LATCH instrument as an initial assessment of breastfeeding so that it can assist nurses in arranging nursing interventions. Methods: case study with implementation based on Evidence Based Nursing Practice: LATCH SCORE was applied to three nursing mothers in two hospital. Results: four breastfeeding mothers were assessed by LATCH SCORE and then intervention was carried out in the form of education and counseling for breastfeeding mothers. Conclusion: This intervention is very effective in assessing position and attachment during breastfeeding, thus helping nurses to tailor interventions according to the needs of the mother. Suggestion: it is hoped that the maternity nurse can carry out a LATCH SCORE assessment to assist in the assessment and arrange interventions according to the needs of nursing mothers.

Breastfeeding Duration and Cardiometabolic Health during Adolescence: A Longitudinal Analysis

ObjectiveTo investigate the longitudinal association between breastfeeding duration and cardiometabolic health, using repeated measures study design among children and adolescents. Study designThis study included 635 offspring aged 10 to 21 years (52% female) from the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) birth cohort followed up to four time points during adolescence. Breastfeeding duration was prospectively quantified using questionnaires during early childhood. Cardiometabolic risk factors, body composition, and weight-related biomarkers were assessed as outcomes during adolescent follow-up visits. Sex-stratified linear mixed-effects models were used to model the association between quartiles of breastfeeding duration and outcomes, adjusting for age and additional covariates. ResultsMedian breastfeeding duration was 7 months (mo) (min=0, max=36). Boys in the 2nd quartile (median breastfeeding= 5 mo) had lower total fat mass % (β (SE) -3.2 (1.5) p= 0.037), and higher lean mass % (3.1 (1.6) p= 0.049) and skeletal muscle mass % (1.8 (0.8) p= 0.031) compared with the reference group (median breastfeeding= 2 mo). A positive linear trend between breastfeeding duration and trunk lean mass % (0.1 (0.04) p= 0.035) was found among girls. No association was found with other cardiometabolic indicators. ConclusionDespite sex-specific associations of breastfeeding duration with body composition, there was a lack of substantial evidence for the protective effects of breastfeeding against impaired cardiometabolic health during adolescence among Mexican youth. Further longitudinal studies with a robust assessment of breastfeeding are recommended.

Does neonatal ankyloglossia interfere in the growth of infants during the first 6 months of life? A case series nested in a cohort study

BackgroundAnkyloglossia is commonly reported as one of the major causes of breastfeeding difficulty. There is a lack of research on infant growth and latching performance with clinical measures.Cases presentationWe describe a series of eight clinical cases (three female and five male infants) in a specialized breastfeeding center in a tertiary hospital in Northeast Brazil. The mothers were of mixed race and ranged from 13 to 41 years of age. Ankyloglossia was diagnosed within the first 48 hours after delivery. We measured the standards of growth, the mothers’ perception of breastfeeding, and a pain indicator, and performed an assessment of breastfeeding. The regularity of breastfeeding was maintained despite the early diagnosis of ankyloglossia. Growth indicators were not affected in the sixth month in any of the babies, with only one measuring below expectations in the third month, with no impact on general health.ConclusionsIn the cases reported in this paper, the infants overcame the initial difficulties in breastfeeding and maintained their normal growth course in the first 6 months of life.

Assessment of Breastfeeding, Weaning, and Complementary Feeding Practices Among Women Attending a Tertiary Care Teaching Hospital in South India.

IntroductionInfants depend exclusively on mothers’ milk for nutrition in their early months of life. However, some infants are given cow/buffalo milk during insufficiency. After six months, the children are supplemented with complementary food, including solid food, to meet the nutritional requirements of a growing infant, a process known as weaning. Therefore, it is important for mothers to have a clear understanding of the nature of food, and the nutritional requirements of the children. This study aimed to understand the knowledge, awareness, and practice of breastfeeding, weaning, and complementary feeding among women.MethodsA cross-sectional questionnaire-based observational study was carried out between May and June 2021. The study included 150 women attending the outpatient department of pediatrics attached to Mahavir Institute of Medical Sciences (MIMS), Vikarabad, Telangana, India. After taking the informed consent, the researcher filled out a pre-validated questionnaire based on the subjects' responses. The data regarding socio-demographic details and information regarding knowledge, timing, practices of weaning, knowledge of nutritional requirements, and child feeding practices were collected as a pre-test. An educational briefing of the essentials of child feeding practices, weaning, and dietary requirements was undertaken using chalk and board and audio-visual aids, among others. In the post-test, the knowledge of mothers regarding weaning practices, the importance of weaning, and understanding of the nutritional requirements and their inclusion in a child’s diet was assessed. The quantitative data were represented as percentages. The Chi-square test was applied to find out the statistical significance of the results obtained from the study.ResultsOf the 150 women who participated in the study, the majority belonged to the age group of 18-23 years (66.7%). Most women were illiterate (34%) and only 12% were graduates. More than 70% of the participants belonged to the middle and lower middle class. The majority of participants (96.7%) had carried out exclusive breastfeeding for the first six months, and 63.35% of mothers had initiated weaning their child between the age of 6-12 months. Only 37.4% of mothers started breastfeeding within hours after the delivery. A combination of all foods (36%), rice/wheat (29%), processed food (18.8%), fruits and vegetables (9.2%), and pulses (6.7%) were chosen for weaning. Many felt that eggs and meat supplementation can be done between 12-18 months.ConclusionThe knowledge of breastfeeding and best practices of weaning and complementary feeding habits significantly affects the child’s growth and overall health. The women in this study had a moderate level of understanding regarding the aspects of breastfeeding, weaning practices, and complementary dietary requirements during weaning.

Fathers' perspectives and assessment of breastfeeding at a private maternity center in the City of Buenos Aires. A qualitative study.

Introduction. The evidence about the effectiveness of fathers' or partners' involvement in breastfeeding interventions to promote initiation, duration, and exclusiveness rates has increased in recent years. To identify the perspectives and assessments of breastfeeding among partners of breastfeeding women and develop information to create adequate interventions that favor the inclusion of fathers in care spaces and in the support of breastfeeding. Qualitative study with a grounded theory design. Four focus groups were held with fathers. Data were processed defining free flow analysis units, coded in 2 levels, an open code, with emerging categories, and such categories grouped into 5 main topics. A total of 16 fathers participated. Five main topics were identified: fathers' knowledge about breastfeeding, feelings towards breastfeeding, partner's involvement in breastfeeding, development of the concept of fatherhood, breastfeeding in society. Breastfeeding was positively assessed. Although breastfeeding support was considered a shared family responsibility, there were not enough co-participation actions identified. Participants expressed their desire to play a more involved fatherhood role; however, they stated that these transformations are not supported at workplaces. The evidence showed a positive assessment of breastfeeding, adequate knowledge, and concern about difficulties. Breastfeeding support was considered a shared responsibility, but not enough specific coparticipation actions were mentioned.

Cross-Cultural Adaptation and Psychometric Evaluation of the Neonatal Eating Assessment Tool–Breastfeeding Into Tamil

ObjectiveTo adapt the Neonatal Eating Assessment Tool–Breastfeeding (NeoEAT-Breastfeeding) into Tamil, a language spoken in several South Asian countries, to identify the tool’s factor structure, and to assess its psychometric properties. DesignCross-sectional. SettingTertiary care hospital in South India. ParticipantsA cohort of 323 mothers of infants ages 1 week to 7 months, including infants with and without feeding difficulties. MethodTo adapt the English tool to Tamil, we followed standard procedures specified by the tool developers and international guidelines for tool translation and adaptation, including pilot testing and personal interviews with participants who had infants younger than 7 months. Participants completed the NeoEAT-Breastfeeding (Tamil) after assessment of breastfeeding by professionals. The 62-item tool involves rating each item on a 6-point scale, and higher scores indicate increased feeding difficulties. ResultsAfter exploratory factor analysis, we divided the tool into five subscales in the Tamil version compared to the seven subscales in the original English version. The Tamil version demonstrated high internal consistency reliability (Cronbach’s α = 0.97) and test–retest reliability (intraclass correlation = 0.99) for the total scores. Infants with feeding concerns demonstrated significantly higher total and subscale scores on the NeoEAT-Breastfeeding (Tamil) than infants without feeding concerns (p = .000; construct validity). ConclusionThe NeoEAT-Breastfeeding (Tamil) holds promise as a culturally appropriate, clinically useful parent-report tool with evidence for initial reliability and validity for identifying feeding-related concerns among infants younger than 7 months in the Tamil-speaking population.

Sostegno all’allattamento nei primi giorni di vita: lo strumento del “semaforo”

Breastfeeding is the safest, most effective and economical method for nourishing the newborn from birth to six months of life and beyond. The benefits of breastfeeding for mothers and babies have long been known, as well as the primary role that exclusive breastfeeding plays as a determinant of short and long-term health. For these reasons, since the 1980s, international and national institutions, together with those responsible for providing care in the maternal and child environment, have collaborated through implementation strategies in the promotion, protection and support of breastfeeding. For this reason, starting from 2012, at the Castelli Hospital of the ASL VCO (BFHI certified since 2010), we worked on the development of a tool for the qualitative assessment of breastfeeding that can be used at the discharge of the mother-newborn dyad, with the goal of identifying mothers in need of greater support and therefore of a clinical re-evaluation.

Effect of an Integrated Package of Nutrition Behavior Change Interventions on Infant and Young Child Feeding Practices and Child Growth from Birth to 18 Months: Cohort Evaluation of the Baduta Cluster Randomized Controlled Trial in East Java, Indonesia.

The need for a multisectoral approach to tackle stunting has gained attention in recent years. Baduta project aims to address undernutrition among children during their first 1000 days of life using integrated nutrition-specific and nutrition-sensitive interventions. We undertook this cohort study to evaluate the Baduta project’s effectiveness on growth among children under 2 years of age in two districts (Sidoarjo and Malang Districts) in East Java. Six subdistricts were randomly selected, in which three were from the intervention areas, and three were from the control areas. We recruited 340 pregnant women per treatment group during the third trimester of pregnancy and followed up until 18 months postpartum. The assessment of breastfeeding and complementary feeding practices used standard infant and young child feeding (IYCF) indicators in a tablet-based application. We measured weight and length at birth and every three-months after that. The enumerators met precision and accuracy criteria following an anthropometry standardization procedure. Among the breastfed children, the percentage of children who achieved the minimum dietary diversity score (DDS) and minimum acceptable diet (MAD) was higher for the intervention group than the comparison group across all age groups. The odd ratios were 3.49 (95% CI: 2.2–5.5) and 2.79 (95% CI: 1.7–4.4) for DDS and 3.49 (95% CI: 2.2–5.5) and 2.74 (95% CI: 1.8–5.2) for MAD in the 9–11 month and 16–18-month age groups, respectively. However, there was no significant improvement in growth or reduction in the prevalence of anemia. The intervention was effective in improving the feeding practices of children although it failed to show significant improvement in linear growth of children at 18 months of age.

Factor Structure and Psychometric Properties of the Neonatal Eating Assessment Tool–Breastfeeding

The purpose of this study was to identify the factor structure of the Neonatal Eating Assessment Tool–Breastfeeding (NeoEAT–Breastfeeding) and to assess its psychometric properties, including internal consistency reliability, test–retest reliability, and construct validity as measured by concurrent and known-groups validity. Exploratory factor analysis conducted on responses from 402 parents of breastfeeding infants younger than 7 months old showed a 62-item measure with seven subscales and acceptable internal consistency reliability (Cronbach's α = .92). Test–retest reliability was also acceptable (r = .91). The NeoEAT–Breastfeeding has evidence of concurrent validity with the Infant Gastroesophageal Reflux Questionnaire (r = .69) and Infant Gastrointestinal Symptoms Questionnaire (r = .62). The NeoEAT–Breastfeeding total score and all subscale scores were higher in infants with feeding problems than in typically feeding infants (p < .001, known-groups validity). The NeoEAT–Breastfeeding is a parent-report assessment of breastfeeding in infants from birth to 7 months old with good initial evidence of reliability and validity.

‘From the mouths of babes’: A subadult dietary stable isotope perspective on Roman London (Londinium)

Londinium (48–410CE) was the focus for Roman administration and trade in Britain; it was established and inhabited by people from across the Empire who continued to practice their diverse food-ways. Roman London was a unique settlement, whose fluctuating economic and political fortunes throughout Roman occupation are clearly evidenced in the archaeological and historical records. This study conducts stable isotope analysis of the diet of a large sample of subadults (0–20years old) dating from the 1st to 4th centuries AD in London. It includes an assessment of breastfeeding and weaning practices, but aims to focus more on the diets of older children and the transition to ‘adult’ dietary behaviours. The rib bones of 100 subadults and 20 adults were sampled for carbon and nitrogen isotopes. Using these data, we identified an infant feeding pattern that differed from contemporaneous sites in Italy and which remained unchanged over time, a special diet for nursing females, and temporal changes in diet, whereby subadults consumed greater quantities of freshwater resources compared to adults during periods of economic instability.

Çölyak Hastalığı Olan Çocuk ve Adölesanların Anne Sütü Alma ve Tamamlayıcı Beslenmeye Geçme Durumlarının Değerlendirilmesi

Çölyak Hastalığı Olan Çocuk ve Adölesanların Anne Sütü Alma ve Tamamlayıcı Beslenmeye Geçme Durumlarının Değerlendirilmesi

Relationship between General and Spinal Anesthesia and Its Impact upon Breast Feeding: Comparative Study

&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Objective: To identified the relationship between general and spinal Anesthesia upon breastfeeding and (demographic &amp;reproductive) : Comparative Study. Methodology: The present study employs a descriptive comparative design held at the labor and delivery room , operational room for cesarean section and maternity word in maternity department at Al Emamain Al Kadhamain Medical City in Baghdad city. Data collection was initiated on 2nd January to end of March /2014. Purposive sample consisted of (150) mother and her neonate, The study sample divided into three groups:(50) under general anesthesia , (50) under spinal anesthesia ,(50) normal vaginal delivery and considered control group. An assessment tool was constructed for the purpose of the study, it was comprised of socio-demographic data, mother reproductive history, information about neonate age, weight, Apgar score, anesthesia effect on neonate after delivery and assessment of breast feeding immediately after birth and anesthesia effect on bonding. Results : The main results of the study shows that the highest percentage of neonate age at ( 1 &amp; 2) hours after delivery, , Neonate weight 3000 gm., general group had illustrated low Apgar scoring scale comparing with others groups. Mother choice of anesthesia, odds ratio indicator showed that choice of general anesthesia twice times of choice spinal anesthesia .Regarding mother practice of breast feeding, mother in general anesthesia started breastfeeding after two attempts or more ,while in N.V.D. started from first attempt, for the reasons of inability to achieve breast feeding, all items in general reported failure assessment, also in and spinal groups all items reported failure except in Feeling severe pain after the operation", " The mother in recovery room immediately after the operation", and "Lack of milk flow as a result of anesthesia" which reported pass assessment. Finally, N.V.D. has reported pass assessment in light of preceding part. Reasons related to child", general and spinal groups are reported failure assessments in light of "A child needs to transfer to the intensive care unit, and Baby feeling tired and not being able to breast feeding" items, and the leftover items are reported pass assessments. While, N.V.D. has reported pass assessment in all items. Effectiveness of anesthesia on breastfeeding shows failure assessment in general and spinal group in mother practice , reasons related to mother and newborn, while pass in N.V.D. group. Regarding mother-neonate bonding ,results of effectiveness shows failure assessment in general and pass in spinal and N.V.D. group.. Recommendations: Early mother-neonate bonding appears to offer some clinical benefit, particularly for breastfeeding. Supportive policies are needed in hospitals and birthing centers to help implement this intervention, which might be regarded as "natural".&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Ultrasound Imaging of Breastfeeding--A Window to the Inside: Methodology, Normal Appearances, and Application.

Ultrasound imaging has been employed as a noninvasive technique to explore the sucking dynamics of the breastfeeding infant over the past 40 years. Recent improvements in the resolution of ultrasound images have allowed a more detailed description of the tongue movements during sucking, identification of oral structures, and measurements of nipple position and tongue motion. Several different scanning planes can be used and each show sucking from a different perspective. Ultrasound techniques and image anatomy are described in detail in this review and provide the basis for implementation in the objective assessment of breastfeeding.

Breast feeding assessment in early neonatal period

Background: Breast feeding will have a profound impact on child’s survival, health, nutrition and development. Optimal breastfeeding practices can save lives of more than 1.5 million under five children every year. Therefore, adequate breast feeding in new-borns is important for proper growth & development. The objective of the study was to assess the breast feeding adequacy for early neonates using the UNICEF breastfeeding assessment tool and to provide early and appropriate intervention for breast feeding inadequacy. Methods: A cross-sectional study was conducted in the post natal wards of 2 hospitals i.e., Kempegowda Institute of Medical Sciences Hospital and Corporation Referral Hospital, Bangalore, India. 234 mothers and infants were included in the study. Breast feeding assessment was done using UNICEF assessment tool and appropriate intervention was provided. Results: The present study showed that 12.2% and 6.4% of mothers from KIMS and corporation referral hospital respectively had inadequate breast feeding. All the mothers were given health education regarding correct feeding practices. Conclusions: UNICEF breast feeding assessment tool is an easy and good indicator to assess the breast feeding in early neonates. Assessment of breast feeding during early neonatal period is essential to intervene at the earliest possible, if there are any problems with regards to milk secretion, feeding and sucking practices.

Early initiation of breast feeding in baby friendly hospital initiative set up - how feasible is it?

Background: The baby friendly hospital initiative (BFHI) was started in India in 1993. Under this, the hospital with maternity services, have to follow the ten steps to successful breastfeeding. The World Health Organization also recommends early initiation of breastfeeding. IMNCI strategy recommended systematic assessment of breastfeeding and emphasized counseling of mothers. Breast feeding in India is universal, but the initiation of breast feeding is late. Objectives: To assess the pattern of breast feeding in a baby friendly hospital initiative setup. Methods: A cross sectional study was conducted among 209 post-partum women of aged 18-35 years delivered in Obstetrics and Gynaecology Department, Guwahati Medical College. Analysis of collected data was done using software Epi Info 7, Chi-square test and percentages. Results: It was observed that only 5.26% women initiated breast feeding within one hour, of which majority 3.38% were illiterate (p<0.05). Late initiation of breast feeding was high amongst mothers (42.1%) kept too long under observation. Most of the Primiparous (55.98%) knew about the advantage of early and exclusive breast feeding than Multiparus (24.88%), which was statistically significant (p<0.05). 80.86% women had received antenatal counseling on breastfeeding but only 58.85% knew that exclusive breastfeeding should be continued for 6 months. Conclusions: Awareness on early initiation of breastfeeding was low despite most of the women received antenatal counseling on breastfeeding. Single strategies, such as providing breastfeeding support or written materials to women or educating health professionals, are unlikely to increase breast feeding initiation as stand-alone measures.

A community based assessment study of positioning, attachment and suckling during breastfeeding among 0-6 months aged infants in rural area of Gandhinagar district, Gujarat, India

Background: Effective breastfeeding is a function of the proper positioning of mother and baby and attachment of child to the mother's breast. Integrated Management of Neonatal and Childhood Illness (IMNCI) strategy recommended systematic assessment of breastfeeding and emphasized counselling of the mother on proper positioning and attachment of infant to the breast. Objective of the study was to assess the correct position, attachment and effective suckling in the breastfeeding of infants as practiced by mothers in rural community . Methods: An observational, descriptive study was done at field practice area of rural health training centre, Dabhoda, from January 2013 to December 2013. One hundred twenty mothers of 0-6 months of aged infant were interviewed and observed for baby's position, attachment and effective suckling using pre-tested semi-structured questionnaire through random selection. Grading of positioning, attachment and suckling was done according to the score of various characteristics. Data thus collected were analyzed using MS Excel 2007 and also Epi info. Results: There was poorer positioning among primipara (41.7%) than multipara (20.9%) mothers. Poorer attachment was also more evident among primipara (45.8%) compared to multipara (10.9%) mothers. Parity was significantly linked with poor positioning of infant (P value = 0.001) and attachment (P value <0.001). Maternal occupation was also significantly associated with attachment (p value = 0.028) and positioning (p value = 0.009). Preterm delivery was significantly associated with poor attachment (P value = 0.023) and poor effective suckling (P value <0.0001) . Conclusions: Primipara mothers require help and support for correct breastfeeding techniques as poor positioning and attachment was found among primipara mothers.