Breastfeeding Education Research Articles

Growth Assessment in Exclusively Breastfed Against Mixed Fed Infants in Two Hospitals of Fako Division, Southwest Region, Cameroon

Background: Improving breastfeeding rates around the world could save the lives of more than 820,000 children under age 5 every year, the majority (87%) being under 6 months of age. The optimal duration of exclusive breastfeeding is one of the crucial public health issues of WHO. Although breastfeeding provides many health benefits to infants, there is not enough information in our setting to support this assertion. Objective: To determine the prevalence of exclusive breastfeeding and evaluate the growth of exclusive breastfed against mixed fed babies in two hospitals of Fako division. Materials and Methods: A hospital-based, analytic cross-sectional study was carried out with 186 mother-infant pairs from February to April 2022. Data collection consisted of the administration of a pretested questionnaire and anthropometric measurements were taken. Nutritional status and prevalence of respiratory and gastrointestinal infections were then assessed. Bivariate and Multiple logistic regression analysis was done with p-value set at <0.05. Results: The prevalence of exclusive breastfeeding in our setting was 43% while the prevalence of mixed feeding was 57%. The main reasons for practicing mixed feeding were: maternal school or work resumption (43.4%) and insufficient breastmilk (34%). The most common reason for practicing exclusive breastfeeding was medical advice (70%). On multivariate analysis, having a paid job (OR: 0.44, 95 % C.I: 0.203-0.968, p= 0.04) was the only significant predictor of mixed feeding. The incidence of diarrhea was significantly more prevalent (OR: 7.583, 95% C.I: 2.527-22.753, p=0.00) in mixed fed infants compared to exclusively breastfed infants. Conclusion: The prevalence of exclusive breastfeeding in our setting is low so there is need to improve and strengthen breastfeeding education during Antenatal visits. Our findings highlight the importance of breastfeeding to protect against diarrhea-specific morbidity and strengthens the current WHO recommendation of exclusive breastfeeding till 6 months. These results prove the relationship between feeding method and infant morbidity and provides more data with the aim of encouraging more mothers to practice exclusive breastfeeding hence reducing infant morbidity and mortality.

A Call to Improve Breastfeeding Education and Counseling in South Africa

Despite the immense body of evidence demonstrating that breastfeeding is a significant predictor of infant, child, and maternal health, rates of exclusive breastfeeding in South Africa remain suboptimal. This paper delves into the importance of breastfeeding, briefly highlights the historical context of breastfeeding in South Africa, explains the roles of the formula market and the HIV/AIDS epidemic in the disparate rates of breastfeeding, and recommends policies to address these issues.

Breastfeeding education training program for healthcare professionals: A narrative review

Lack of knowledge and skills regarding breastfeeding education leads mothers to prefer formula milk over exclusive breastfeeding. Breastfeeding education provided by health professional is needed to support mothers to breastfeed their baby exclusively. Methodology: The methodology employed in this study was a narrative review where the researcher critically examines the ideas presented in several studies regarding breastfeeding education training program for health workers. Articles were selected using inclusion criteria: original research, published in English and Indonesian languages, within the last 5 years (2018-2023). A total of 50 articles were found. Ten articles meeting the inclusion criteria were included in the author's review. Conclusion: Breastfeeding education training programs have an impact on the success of breastfeeding mothers. The more healthcare professionals, especially midwives, understand breastfeeding education, the more breastfeeding mothers will be aware of the importance of breastfeeding for their children.

Importance Assigned to Breastfeeding by Spanish Pregnant Women and Associated Factors: A Survey-Based Multivariate Linear Correlation Study.

Breastfeeding education, across all disciplines, is often inconsistent and lacking in expertise and confidence. However, recommendations from health professionals, the sociocultural environment, and previous knowledge and experiences significantly influence women's decision to breastfeed. This study aimed to identify factors that promote the assignment of greater importance to breastfeeding and associated practical benefits. This retrospective cross-sectional study included 276 participants who completed a self-administered questionnaire. Descriptive and bivariate analyses were performed, and multivariate linear models were applied to identify factors influencing the importance assigned to breastfeeding. Most participants were married or in a relationship, were native Spaniards, had secondary or higher education, and had an average age of 32.6 years. Seventy percent met the physical activity recommendations, and 91% felt comfortable with their body image during pregnancy. The importance assigned to breastfeeding was high across various aspects, except for postpartum weight loss and body image. Group prenatal care was only significantly associated with the importance assigned to the breastfeeding technique (how to breastfeed). The obesogenic environment and the importance assigned to nutritional aspects and physical activity also turned out to be predictors, although not for all models. In our region, the educational strategy of antenatal care groups could contain gaps regarding the mother's health, which should be addressed in the future to improve results regarding the initiation and continuation of breastfeeding.

EFEKTIVITAS MODEL EDUKASI DAN DUKUNGAN MENYUSUI UNTUK MENINGKATKAN BREASTFEEDING SELF-EFFICACY DAN PEMBERIAN ASI EKSKLUSIF: SCOPING REVIEW

WHO and UNICEF data state that the level of exclusive breastfeeding in the world is below the target of 40%. Breastfeeding self-efficacy was identified as one of the strongest modifiable predictors. This scoping review aimed to analyze the effectiveness of breastfeeding education models to increase breastfeeding self-efficacy and exclusive breastfeeding. The design of this article is a systematic review using the Preferred Reporting Items for Literature Review and Meta-Analyses (PRISMA) method. Article searches used electronic databases from Scopus, Science Direct, PubMed and Sage. The keywords in the article search are "Exclusive Breastfeeding", "Breastfeeding Education", and "Self-Efficacy". The inclusion criteria in this literature review were studies that have samples of pregnant women ≥ 30 weeks, normal pregnancies without complications. Criteria for babies to be born at term and have normal weight. The results of the scoping review show that the most effective breastfeeding education and support models are prenatal counselling, integrated breastfeeding education program and breastfeeding education with grandmothers' attention. The main characteristic is education carried out from antenatal to breastfeeding. Education is provided involving family members. Education is carried out in a multicomponent manner through breastfeeding training, home visits and post-natal telephone follow-up. The theoretical framework uses self-efficacy theory. The minimum educational frequency consists of 2-4 sessions with a minimum length of 40 minutes. It is hoped that the results of this review will serve as a guide for designing an effective exclusive breastfeeding education model by applying the five main characteristics to increase breastfeeding self-efficacy and exclusive breastfeeding.

The effect of breastfeeding education given through the teach-back method on mothers’ breastfeeding self-efficacy and breastfeeding success: a randomized controlled study

BackgroundAn individualized education using visual aids, allowing the woman to demonstrate what she has learned, and providing the opportunity for the woman to ask questions are important in terms of breastfeeding self-efficacy, breastfeeding success, and the sustainability of the education. This study is original in evaluating the effectiveness and sustainability of breastfeeding education provided through the teach-back method in terms of breastfeeding self-efficacy and success in a short period of time. Therefore, the aim of this study is to examine the impact of teach-back method on mothers’ breastfeeding self-efficacy and breastfeeding success.Materials and methodsThis is a randomized controlled study. The population of this study consisted of women who gave birth in the obstetrics and gynecology department of a state hospital located in Çorlu, in the northwest region of Turkey, between March 2022 and August 2022. The sample of this study consisted of a total of 100 postpartum women, with 50 participants in the experimental group and 50 participants in the control group, who gave birth in the obstetrics and gynecology department of Çorlu State Hospital. Computer-assisted simple randomization was employed to ensure the homogeneous distribution of the women into the experimental and control groups. The women in the experimental group received education and counseling services using the Teach-Back Method, based on the content of the prepared Breastfeeding Education Guide. The control group mothers, on the other hand, received standard breastfeeding education and counseling services. The data were collected through face-to-face interviews during the first 24 h postpartum and at the 1-month follow-up visits. In the study, the data collection tools used were a Personal Information Form, LATCH Breastfeeding Assessment and Evaluation Scale, Postpartum Breastfeeding Self-Efficacy Scale (short form), and the Teach-Back Observation Tool. In the evaluation of the research findings, the SPSS (Statistical Package for the Social Sciences) version 25.0 (IBM Corp., Armonk, NY, USA) program was used for statistical analyses. Descriptive, graphical, and statistical methods were employed to examine whether the scores obtained from each continuous variable followed a normal distribution. The Kolmogorov-Smirnov test was used to assess the normality of the scores derived from a continuous variable using statistical methods.ResultsIn the study, no significant difference was found in the distribution of the socio-demographic characteristics of the participants according to the study groups. In the experimental group, which received training with the tell-what-you-learned method, the mothers’ average EÖYÖ scores before the training, at the 24th hour after the training and at the 1st month after the training were 46.41 ± 11.26, respectively; It was determined to be 66.23 ± 6.94 and 67.84 ± 6.27. In the measurements made during the follow-up, it was determined that there was a significant difference in the study group’s EÖYÖ score averages (p < 0,001). For mothers in the experimental group, the average LATCH score of the mothers before training, 24 h after training and 1 month after training was 7.73 ± 1.81, respectively; It was determined that these values were 8.66 ± 1.61 and 9.95 ± 0.30, and there was a significant difference in the mean LATCH scores of the study group in the measurements made during the follow-up (p < 0.001).ConclusionsBreastfeeding education provided through the teach-back method is more effective in increasing both breastfeeding success and breastfeeding self-efficacy when compared to standard breastfeeding education.Trial registrationIran Randomized Clinical Trial Center IRCT20220509054795N2 Date of first registration: 10/11/2022.

Standardizing Patient and Provider Education to Address Breastfeeding Inequity

Introduction: Breastfeeding provides many infant, maternal and societal benefits. Breastfeeding reduces maternal and infant risks for a number of diseases, encourages maternal-infant bonding, is more environmentally friendly and lowers healthcare costs. Based on the most recent Women, Infants and Children (WIC) program data, the obstetrical patient population served by the Department of Ob/Gyn at Southern Illinois University School of Medicine (SIU-SM) was significantly lacking in breastfeeding initiation rates (~16% in 2020) when compared to the Healthy People 2020 goal for ever breastfed infants of 81.9%. We aimed to assess areas of patient care that could be improved upon when counseling our patients about breastfeeding. Purpose: Our primary goal was to evaluate current breastfeeding initiation rates and whether these improved after implementation of the standardized breastfeeding education materials that were to be provided to both healthcare professionals and patients. Methods: In partnership with the Illinois Public Health Institute (IPHI), all patients who received prenatal care at SIU-SM, Department of Ob/Gyn were offered standardized brochures that supplemented our prenatal counseling regarding breastfeeding. Nurses, residents, and other healthcare providers were also provided information on counseling patients. Breastfeeding rates were assessed in our prenatal population prior to and after implementing standardized breastfeeding educational materials (IRB# 22-133) and compared with Chi-square tests. Results: Patient demographics were as follows: 55.9% White, 31.8% Black/African American; 95.7% non-Hispanic; 93.4% utilized Medicaid services for insurance; the mean age was 26.8 ± 6.1 years of age. Baseline breastfeeding initiation rates of ever breastfed infants were significantly higher in the interventional group compared to the control group (75% vs.60%; p=0.002). Breastfeeding rates at the first postpartum visit were also significantly increased after the intervention (65% vs. 43%; p=0.008). A significant increase in the percentage of breast pumps provided in the prenatal clinic was also noted (28.4% vs. 0%; p&lt;0.0001). Conclusions: Breastfeeding rates in our patient population were significantly lower than the Healthy People’s 2020 goal. Raising awareness through this initiative and improving our educational tools via the partnership with IPHI improved breastfeeding initiation rates. As obstetrical providers, we are optimistic about this data, but acknowledge additional interventions may be necessary to improve health equity across our disadvantaged patient population. Future directions include looking at data for ever breastfed infants vs. continuation of breastfeeding through the American Academy of Pediatrics recommended 6 months of exclusive breastfeeding. We would also like to explore how partner involvement and occupation type might impact breastfeeding initiation rates.

The Correct Breastfeeding Education on the Knowledge and Behavior of Postpartum Mothers in the NNICU Room

Background: In new mothers there is often a failure of administration early in life. The first day of birth becomes a very vulnerable day because breast milk usually has not come out or only slightly confuses the mother and gives drinks other than breast milk. Purpose of the study was to Analysis of the influence of education on the right way of breastfeeding on the knowledge and behavior of breastfeeding postpartum mothers in the NNICU room of RSUD dr. Soedono, East Java Province. Methods: Research design: Pretest-Posttest Experiment Design. Independent variable: proper breastfeeding education: Dependent variable in: knowledge and behavior of postpartum mothers on proper breastfeeding. How to collect data: questionnaires for knowledge of how to breastfeed and observation sheets to measure appropriate breastfeeding behavior. Population: all postpartum mothers whose babies are being treated in the NNICU room in August – October 2023 is 165 people. Sample: a portion of a population of 28 people. Random random sampling technique. Statistical test using Chi Square test technique. Results: The results of the study before education were carried out almost all (82.1%) postpartum mothers had good knowledge and most (67.9%) had proper breastfeeding behavior. After education: all (100%) postpartum mothers have good knowledge and proper breastfeeding behavior. The results of the Chi Square test analysis with α= 0.05 ρ knowledge=0.018 and ρ attitude=0.007 there is an influence of breastfeeding education on knowledge and appropriate breastfeeding behavior in postpartum mothers Conclusion: Breastfeeding education to postpartum mothers using a leaflet containing interesting pictures, carried out at any time before breastfeeding mothers and always practiced directly with the assistance of officers makes it easier for mothers to remember. Direct practice accompanied by officers makes mothers quickly able to breastfeed appropriately.

Building a baby-friendly community: Development, strategy, implementation and evaluation of a BFCI program.

The aim of the study was to investigate the impact of the use of baby-friendly community initiative (BFCI) model on various stakeholders in the community. Quasi-experimental research design. The study was conducted in public premises and online workshops from April 2019 to September 2022. Participants were followed up for a period of 1 month, except for those employed at public premises. The program involved training based on an accredited BFCI framework to cultivate a breastfeeding-friendly attitude and knowledge. A paired sample t-test was used to examine breastfeeding attitude and knowledge scores before and after BFCI training among staff employed from public premises. An analysis of variance was conducted to examine the breastfeeding self-efficacy and attitude scores, measured repeatedly at different timepoints over 1-month timepoint (T0, T1 and T2) among pregnant and postpartum women. A total of 2340 perinatal women and 1339 staff from public premises were recruited. For staff, there was an increase in the mean score of breastfeeding knowledge and attitude by 5.8 and 6.1, respectively, at T1. Similarly, for perinatal women, there was an increase in the mean score of breastfeeding self-efficacy and attitude by 6.6 and 3.3, respectively, at T1. In summary, a BFCI model, with active community participation, accreditation and an award system, has been effective in promoting breastfeeding. Adapting the baby-friendly hospital initiative to local contexts and employing a social theory model can enhance breastfeeding promotion and improve infant health outcomes. Prioritizing culturally sensitive breastfeeding education is crucial for successful BFCI implementation. Healthcare professionals should consider clients' culture and socio-economic backgrounds when providing breastfeeding education to maximize effectiveness. The target audience for breastfeeding education should be expanded to include various community stakeholders beyond families. What problem did the study address? This study addressed the problem of knowledge gaps among stakeholders in building a breastfeeding-friendly community, particularly in implementing a baby-friendly community initiative (BFCI) as part of a baby-friendly hospital initiative (BFHI). The research filled a service gap by providing effective interventions targeting community stakeholders and assessing the impact of a BFCI program on their knowledge and attitudes towards breastfeeding. What were the main findings? The findings highlighted the effectiveness of a BFCI program in enhancing breastfeeding knowledge and attitudes among frontline staff and increasing breastfeeding confidence among mothers. These findings contribute to the understanding of the program's impact on different stakeholders in the community. Where and on whom will the research have an impact? It impacts on global policymakers by providing insights for developing comprehensive guidelines for future BFCI implementations. It also contributes to the creation of a more baby-friendly community, benefiting breastfeeding families and their infants by promoting and supporting breastfeeding families. This study has adhered to relevant EQUATOR guidelines using the TREND reporting guideline. No patient or public contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: This study provides an overview of the establishment of a localized BFCI program. It also opens up a new direction for the community to investigate BFCI strategies for community stakeholders. It also provides evidence to support other countries in following a similar process, as each country approaches becoming breastfeeding-friendly in its own unique way. No protocol.

Corrigendum to “Perinatal care and breastfeeding education during the COVID‐19 pandemic: Perspectives from Kenyan mothers and healthcare workers”

Corrigendum to “Perinatal care and breastfeeding education during the COVID‐19 pandemic: Perspectives from Kenyan mothers and healthcare workers”

Case Report: Pengaruh Edukasi Menyusui terhadap Produksi Asi dalam Program Asi Ekslusif di NICU RSUD DR.Tjitrowardojo Purworejo

Introduction: Mother's milk (ASI) is a very good nutritional intake for newborn babies. Natural breast milk produced by mothers has important nutrients for babies. Breast milk contains various microbial materials. Nutrition for mothers who are breastfeeding must be given optimally. Oxytocin massage is a non-pharmacological technique that functions to overcome substandard breast milk production. Objective: This study aims to determine the effect of breastfeeding education on breast milk production. Method: This research uses a descriptive observational method using a case study method approach. The subject used was a postpartum mother patient with breast milk production problems in the NICU room at Dr. Tjitrowardojo Hospital, Puroworejo. Data collection was carried out by interviewing Mrs. V and also looked at the medical records in the PICU/NICU room using the neonate assessment format developed by the UMY FKIK Nurse Professional Education. Results: After being given intervention for 5 days, there was an effect of breastfeeding education on breast milk production. Conclusion: Breastfeeding education can influence breast milk production.

Breastfeeding Perceptions and Decisions among Hispanic Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children: A Qualitative Study.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a nutrition assistance program in the U.S. WIC served 2.5 million eligible Hispanic women, infants, and children under the age of five in 2021, which is WIC's largest racial/ethnic group. However, limited research has been conducted to understand Hispanic WIC participants' perceptions of WIC breastfeeding recommendations and their breastfeeding decisions. For this qualitative study, we interviewed 18 of these pregnant and postpartum WIC participants on their experiences and decision-making processes related to breastfeeding. Hispanic cultures and home country norms were identified as prominent influences on breastfeeding decisions, along with perceptions of WIC's breastfeeding support. These results can help the WIC program to refine its breastfeeding education to better meet the needs of Hispanic participants.

Knowledge and attitude of spouses of puerperas towards breastfeeding

ObjectiveTo investigate the extent of knowledge about breastfeeding and attitudes towards infant feeding among spouses of puerperas at the time of discharge from hospital, and explore the factors influencing spousal attitudes toward breastfeeding.MethodsWe conducted a questionnaire survey among 204 spouses of puerperas who were admitted in the maternity wards at a tertiary hospital in Shaanxi Province between October 2021 and December 2021. Respondents who fulfilled the inclusion criteria were identified using convenient sampling.Results(1) The score of breastfeeding knowledge among spouses prior to discharge from the hospital was (10.56 ± 3.78), with an accuracy rate of 59.6%, and the lowest accuracy rate was for Item 1 “Newborns should be fed on time, not on demand” (42.6%) and Item 5 “Breastfeeding can prevent infant rickets” (49.5%). (2) The average score of spouses’ infant feeding attitudes was (58.15 ± 5.55), and the lowest scoring was for Item 17 “Daily urine volume of infants is a reliable indicator to judge whether they get enough breast milk” (1.99 ± 1.14). (3) Generalized linear model analysis showed a more positive attitude (higher score) among spousal attitudes towards infant feeding in those who had received breastfeeding education [OR = 4.588, 95% CI (0.160 ∼ 3.598)] and those with a master’s degree or above [OR = 18.278, 95% CI (3.471 ∼ 9.346)].Conclusion(1) Spouses that received breastfeeding education and those that had a Masters Degree and above had more positive attitude towards infant feeding. (2) Medical staff should focus on puerperas’spouses with degrees below master’s level who had not received breastfeeding education. We recommend using a variety of education methods to enable them to acquire more knowledge on breastfeeding and develop a more positive attitude towards breastfeeding, which will further enhance spousal support for breastfeeding, thus positivizing postpartum co-parenting attitudes and improving the rate of exclusive breastfeeding.

Determinants of low birth weight and its effect on childhood health and nutritional outcomes in Bangladesh

BackgroundThe high incidence of low birth weight (LBW) is associated with an increased risk of infant mortality, adverse pregnancy outcomes for mothers, and a decline in overall health and well-being. The current study aimed to identify the various determinants of LBW and its effect on adverse health and nutritional outcomes of children aged 0–23 months in Bangladesh.MethodsBangladesh Demography and Health Survey (BDHS) 2017-18 data was used. A chi-square test and multivariable logistic regression analysis were used to find out the associations between independent variables and outcomes (e.g., LBW, child illness and undernutrition).ResultsThe overall prevalence of LBW among was 16.3%. Mother with no formal education (AOR = 2.64, 95% CI = 0.55–3.30, p = 0.01), female child (AOR = 1.31, 95% CI = 1.04–1.65, p = 0.023); and poorest economic status (AOR = 1.69, 95% CI = 1.13–2.51, p = 0.010), were identified significant determinants of LBW. Of home environment and hygiene factors, unimproved toilet facilities (AOR = 1.38, 95% CI = 1.03–1.84, p = 0.030) had a significant effect on LBW. In addition, children born with LBW were more likely to suffer fever (AOR = 1.26, 95% CI = 1.05–1.60, p = 0.050), stunting (AOR = 2.42, 95% CI = 1.86–3.15, p = < 0.001), wasting (AOR = 1.47, 95% CI = 1.02–2.25 p = 0.049), and underweight (AOR = 3.19, 95% CI = 2.40–4.23, p = < 0.001).ConclusionOne out of five children was LBW in Bangladesh. Maternal education, sex of child, wealth index, and toilet facilities had significant effects on LBW. In addition, LWB contributed to children’s poor health and nutritional outcomes. Enhancing maternal pregnancy, and child health outcomes necessitates policies addressing poverty, gender inequality, and social disparities. Key strategies include promoting regular prenatal care, early medical intervention, reproductive health education, and safe hygiene practices. To combat the negative impacts of LBW, a comprehensive strategy is vital, encompassing exclusive breastfeeding, nutritional support, growth monitoring, accessible healthcare, and caregiver education.

The relationship between earthquake-induced post-traumatic stress disorder and breastfeeding attitude and behavior

BackgroundThis study aimed to investigate the prevalence and severity of post-traumatic stress disorder (PTSD) and analyze the relationship between PTSD and breastfeeding attitudes and behaviors among breastfeeding mothers and women with children aged 0–24 months, all of whom had experienced the earthquake.MethodsIn this cross-sectional survey, a face-to-face questionnaire was administered to 173 earthquake survivors in Adıyaman, Turkey, during June and July 2023. The PTSD Checklist-Civilian scale was used to assess the presence of PTSD, while the Breastfeeding Attitudes of the Evaluation Scale (BAES) was employed to evaluate breastfeeding behaviors in mothers.ResultsSignificantly higher PTSD scores (47.6 ± 17.4) were found among women staying in tents, while lower scores (37.0 ± 16.4) were observed in those who continued breastfeeding. 78.6% of women reported decreased breast milk because of the earthquake. Mothers with reduced milk supply had higher PTSD scores (46.1 ± 17.3). Breastfeeding training was associated with higher BAES scores (106.8 ± 56.8) and lower PTSD scores (32.5 ± 11.0). A significant negative correlation was observed between the PTSD score and BAES (r = -0.742; p < 0.001).ConclusionsThe study demonstrated that breastfeeding may protect mothers against PTSD in the aftermath of earthquakes, emphasizing the importance of breastfeeding education. The higher frequency and severity of PTSD observed among earthquake survivor mothers residing in tents underscores the importance of promptly transitioning to permanent housing after the earthquake.

Effect of maternal vaccination on infant morbidity in Bangladesh

BackgroundRisk factors of infant mortality in Africa and south Asian countries have been broadly discussed. However, infant morbidity is largely underestimated. We analyzed the data from a randomized vaccine trial in Bangladesh to identify and assess the effect of risk factors on infant morbidity.MethodsPregnant women were randomly assigned to receive either inactivated influenza vaccine or pneumococcal polysaccharide vaccine and the infants were randomly assigned to receive 7-valent pneumococcal conjugate vaccine or Hib conjugate vaccine at week 6, 10 and 14. The data were collected from August 2004 through December 2005. Each pair of infant and mother were followed for 24 weeks after birth with weekly visits. Generalized estimating equations (GEE) for repeated measurements and Poisson regression models were used to identify the risk factors and evaluate their effect on the longitudinal incidence and total number of episodes of respiratory illness with fever (RIF), diarrhea disease, ear problem and pneumonia.ResultsA total of 340 pregnant women were randomized with mean age of 25 years. The baseline mother and infant characteristics were similar between two treatment groups. Exclusive breastfeeding and higher paternal education level were common factors associated with lower infant morbidity of RIF (adjusted OR = 0.40 and 0.94 with p < 0.01 and p = 0.02, respectively), diarrhea disease (adjusted OR = 0.39 and 0.95 with p < 0.01 and p = 0.04, respectively), and ear problem (adjusted OR = 0.20 and 0.76 with p < 0.01 and p < 0.01, respectively). Maternal influenza vaccine significantly reduced the incidence of RIF (adjusted OR = 0.54; p < 0.01) but not diarrhea disease or ear problem (p > 0.05). Female infants had lower incidence of diarrhea disease (adjusted OR = 0.67; p = 0.01) and ear problem (adjusted OR = 0.12; p = 0.01).ConclusionsMaternal influenza vaccination, exclusive breastfeeding, female children, and higher paternal education level significantly reduced the infant morbidity within the 24 weeks after birth in Bangladesh.

Feeding Practices of Stable Term and Late Preterm Neonates Born at a Tertiary Hospital in the Philippines during the COVID-19 Pandemic.

We aimed to evaluate the impact of maternal COVID-19 infection and separation of the mother-baby dyad on feeding practices by determining modes of feeding upon discharge and following up at 2-3 days, 14 days, and 1 month post-discharge. This was a prospective observational cohort study conducted at the Philippine General Hospital, a tertiary government COVID-19 referral center in Manila. Mothers who delivered between the months of July and August 2021, and whose COVID-19 status was known were followed up on their baby's mode of feeding at 2-3 days, 14 days, and 1 month post-discharge via phone call. For babies of COVID-19 positive mothers, presence of any symptoms (up to the 14-day time point only) as well as adherence to infection prevention and control practices were also identified. For all time points post-discharge, breastfeeding rates were higher in babies born to COVID-19-negative mothers and in those who were roomed in. However, the differences were not statistically significant. Of the 108 infants, 72.90% remained exclusively breastfed by 1 month of age, with 4.67% formula-fed and 22.43% on mixed feeding. Perception of insufficient milk supply was the most common reason for shifting to formula or mixed feeding. We found a significantly higher direct breastfeeding rate upon discharge in the roomed-in population compared to those admitted to the NICU. Risk factors affecting breastfeeding at 1 month of age was the presence of COVID-19 infection in the mother and mother-baby separation due to NICU admissionCOVID-19-positive mothers were 66.02% less likely (p=0.016, 95% CI 0.1411 to 0.8183) to still be breastfeeding at 1 month, and separation was not found to be a significant risk factor. Feeding practices can be affected not only by COVID-19 infection in the mother and its attendant difficulties such as prolonged hospital stay and physical and social isolation, but also by limitations in the hospital environment that can have an impact on breastfeeding education, support, and opportunities for mother-child bonding.

The Effect of Exclusive Breastfeeding Education on Mothers' Knowledge About Exclusive Breastfeeding

Mother's milk is the best food for babies, considering that the nutritional content in it is very complex and complete. Exclusive breastfeeding coverage in the Rw 5 area of ​​Karngroto Village is still relatively low so there is a need for increased knowledge to increase exclusive breastfeeding coverage. Community service is carried out to increase mothers' knowledge of the importance of exclusive breastfeeding in the RW 05 Karangroto Village area. The method used in this community service activity was outreach using leaflet media and direct demonstrations which were attended by 14 participants. The results of community service activities show that there has been an increase in mothers' knowledge regarding exclusive breastfeeding. It is hoped that this activity can increase insight and knowledge as well as provide support to mothers in providing exclusive breastfeeding.

Latching Medical Students onto a Virtual Breastfeeding Elective During the COVID-19 Pandemic.

Objectives: To describe the implementation of a successful two-week virtual breastfeeding elective for medical students during the COVID-19 pandemic and characterize student demographics, objective knowledge, and perspectives on breastfeeding before and after the elective. Study Design: We adapted the Santa Rosa Kaiser Permanente Family Medicine breastfeeding residency curriculum to create a two-week virtual medical student elective using Kern's six steps of curriculum development and a competency-based education framework. Educational components included self-paced modules, shadowing experiences, and group didactics. Objective knowledge was assessed with multiple-choice tests before and after the elective compared using a paired t-test. Reflective writing pieces were qualitatively analyzed using the six phases of thematic analysis developed by Braun and Clarke. Results: From 2020 to 2023, 40 medical students completed the elective. Breastfeeding knowledge increased significantly from the pre-test 72% (95% CI: 52-92%) to post-test 91% (95% CI: 81-100%) (p < 0.001). Over 90% of students felt that learning objectives were met well or very well and agreed or strongly agreed that the elective increased their knowledge and confidence in providing anticipatory guidance to breastfeeding parents. Similar themes were shared across students' reflective writing pieces, with nearly 30% (n = 23) of the student essays addressing socio-cultural and racial differences in beliefs surrounding breastfeeding. Conclusion: A virtual breastfeeding curriculum for medical students is well-received by stakeholders (patients, lactation consultants, students, etc.) and improves breastfeeding knowledge and confidence. A virtual elective is an innovative and effective way to deliver breastfeeding education and can be used even when institutional breastfeeding or lactation support is unavailable.

The Effect of Breastfeeding Education Using Leaflet Media on the Knowledge and Attitudes of Pregnant Women

Breast milk (BM) is one of the most important nutrients for baby needs. This is the best baby food for the perfection of growth and development. Increasing the knowledge and attitude of mothers is considered necessary because it contributes to parenting for their children. This research aims to determine the effect of breastfeeding education using leaflet media on the knowledge and attitudes of pregnant women. The research is a quasi-experiment with a pre-test and post-test with a control group research design conducted in March – April 2023 in the working area of the South Sangatta Health Center, East Kutai Regency, East Kalimantan, Indonesia. A total of 32 samples were involved in random sampling by taking into account inclusion and exclusion criteria. The data is analyzed with the Paired-Sample T-test. The research shows the influence of exclusive breastfeeding education using leaflet media on the knowledge of pregnant women (p = 0.000), and the influence of exclusive breastfeeding education using non-leaflet media on the knowledge of pregnant women (p = 0.006). There is an influence of exclusive breastfeeding education using leaflet media on the attitude of pregnant women (p = 0.000), and the influence of exclusive breastfeeding education using non-leaflet media on the attitude of pregnant women (p = 0.006). Education using leaflets is much more effective than non-leaflet education. This finding is empirical evidence that nutrition education in the form of media is encouraged to welcome changes in public perception