Breastfeeding Initiation Research Articles

Pengaruh Stimulasi Janin dan Inisiasi Menyusui Dini terhadap Bonding Attachment

Fetal stimulation and early initiation of breastfeeding (IMD) have great benefits for the baby's development. This study aims to examine the effect of fetal stimulation and IMD on attachment bonding. This research used a quasi-experimental design, posttest only control design. The experimental group consisted of carrying out fetal stimulation by pregnant women and IMD, while the control group consisted of IMD. Post test to measure bonding attachment. Research location at PMB Wiwik Sumarni, Wonogiri, Central Java in November 2022 – April 2023. Purposive sampling technique with 15 per group. Respondents: Pregnant women with gestational age > 24 weeks were normal and were observed until the IMD process. The result of the independent t-test is significant with a p value of 0.002 (<0.05), the experimental group's posttest score have a lower mean value of 21.60 compared to the control group of 32.67, both groups are in the strong attachment bonding category. ANACOVA results of fetal stimulation and IMD have an attachment bonding score 7 points lower than the control group (b = -7; 95% CI; -13 to -1; p < 0.001). Adjusted R2 = 48.1%. In conclusion, there is an influence of fetal stimulation and IMD on bonding attachment.

Inequality in breastfeeding and complementary feeding practices in Argentina by household income level in 2018-2019.

Introduction. Diet quality is a right related to survival, healthy growth, prevention of chronic diseases, and malnutrition in all its forms. The objective of this study was to analyze breastfeeding and feeding practices in children younger than 2 years from urban areas of Argentina in 2018-2019 according to their household income level. Population and methods. Secondary analysis of data of the Second National Survey on Nutrition and Health (ENNyS2) of 2018-2019. Breastfeeding and complementary feeding indicators proposed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) were analized. Data were stratified by household income level. Results. The analysis included 5763 children younger than 24 months old. Although 97% was ever breastfed, only 47% of infants younger than 6 months were exclusively breastfed the previous day and 48% continued with breastfeeding after 1 year old, with a higher prevalence in low-income children. The previous day, 23% of children aged 6 to 23 months did not eat any fruit or vegetable, 60% consumed unhealthy foods, and 50% consumed sweet beverages. The consumption of sweet beverages and the absence of fruit and vegetables were higher in low-income households. Conclusion. The quality of children's diet is far from the recommendations and is conditioned by income. Early initiation of breastfeeding, minimum dietary diversity, fruit and vegetable consumption are lower and sweet beverage consumption is greater in impoverished sectors.

Side-Lying and Cross-Cradle Breastfeeding Positions of Mothers Toward Good Health and Well-Being of Young Children

Early initiation of breastfeeding protects newborns from various infections and mortality. Despite its benefits, not all mothers practice this essential feeding method due to various factors. This study addressed breastfeeding concerns in consonance with the Philippine Republic Act. 10028, as it orders optimal breastfeeding practices and aligns with UN Sustainable Development Goal number 3 to ensure good health and well-being. This study aimed to assess the demographic profile of the respondents in terms of educational attainment and number of children; analyze mothers’ perceptions of breastfeeding positions; evaluate the relationship between side-lying and cross-cradle breastfeeding positions and the educational attainment and number of children; and based on the findings of the study, develop a breastfeeding health education program. In this study, a quantitative descriptive research method was employed. The survey questionnaire was validated by professional experts and administered in Barangay Narra, Francisco Homes, City of San Jose Del Monte, Bulacan, Philippines. Data analysis was conducted using a descriptive aspect of frequency, percentage, mean, standard deviation, and anova for a predictive aspect of the research results. The findings indicated a strong preference for the side-lying position for rest and relaxation (mean = 4.3), and a high recommendation for the cross-cradle position (mean = 4.7). It was proved in this study that there was no significant relationship between the cross-cradle position and educational attainment (p-value = 0.62), whereas the side-lying position and educational attainment showed a significant relationship (p-value = 0.047). Furthermore, the study revealed no significant relationship between the cross-cradle and side-lying position and the number of children (p-value = 0.60). It is recommended that lactating mothers have to practice early breastfeeding to attain good health and well-being of young children.

Early initiation of breastfeeding and associated factors among post-natal mothers in selected healthcare sectors, Rohtas, Bihar

Background: Breastfeeding is the best natural feeding and breast milk is the best milk. The basic food of an infant is the mother’s milk. The study aimed to determine the estimated time of breastfeeding initiation among normal delivery mothers, identify the contribution factor for delayed initiation of breastfeeding among normal delivery mothers, and to find out the association between the selected demographic variables and initiation timing of breastfeeding. Methods: The present study constituted a cross-sectional research design, involving 100 postnatal mothers from selected healthcare centers. A purposive sampling technique was employed to select the participants, and a semi-structured questionnaire was utilized to collect the data. The data was gathered through a self-administered questionnaire. Subsequently, inferential statistics, such as chi-square, were applied to determine the objective and hypothesis of the study. Results: In the research, it was found that 56% of mothers-initiated breastfeeding within the first hour after giving birth. Furthermore, 30% of mothers-initiated breastfeeding between 1 and 24 hours, and 14% initiated breastfeeding 24 hours after giving birth. The study also revealed a categorical association (as determined via chi-square test, p value <0.005) between the timing of breastfeeding and certain socio-demographic factors, such as the occupational status of mothers (χ2=11.65, p value <0.005), their educational level (χ2=17.7, p value <0.005), and the family’s monthly income (χ2=13.7, p value <0.005). Conclusions: Adopting breastfeeding-friendly policies at scale and utilizing monitoring data to increase accountability and improve service delivery can significantly reduce delayed breastfeeding initiation.

Investigating the Start time and duration of skin-to-skin contact in the delivery or operating room in the hospitals of Khorasan Razavi Province, Iran

Background. Skin-to-skin contact (SSC) plays a significant role in the initiation and continuation of breastfeeding and maintaining and improving the health of infants. The goal of this research was to study the start time and duration of SSC in the labor rooms or operating rooms of the hospitals in Khorasan Razavi province. Methods. This descriptive study has been done on 714 newborn babies in labor rooms and ORs of governmental hospitals in Khorasan Razavi province from 1399 to 1401 through convenience sampling method. A midwife who did not have any role in the delivery process kept a record of the time of the SSC and its duration after the delivery. In the next stage, probable reasons for not having SSC, the connection of the start time of SSC and its duration with the start time and duration of breastfeeding were studied. Results. Based on the results of the study, 65% of the cases had SSC after the delivery in labor rooms under study . The mean start time of the SSC was 5.06±12.30 minutes, and the mean duration of the SSC after the birth was 9.28±13.66 minutes. Non-cooperation of the mother (61.38%), the fear of non-sterile environment (8.62%) and hastening the delivery process by the professionals involved (3.79%) were the most common reasons for not having SSC. Conclusion. In 35% of cases, there was no SSC after birth. Starting the contact early after birth can increase the success rate of breastfeeding. Practical Implications. According to the results of our study, skin-to-skin contact in our maternity hospitals is not done in one-third of the cases, which is necessary after the birth of babies. Babies who received skin-to-skin contact started breastfeeding earlier and held the breast longer, indicating that skin-to-skin contact facilitates the initiation of breastfeeding and increases its duration. The non-cooperation of the mother is the most common reason for not having skin-to-skin contact. Therefore, providing the necessary information and training to mothers about the importance of skin-to-skin contact in maintaining the health of babies, facilitating the initiation of breastfeeding, and changing the attitudes and behaviors of mothers seems necessary.

Association of antenatal counselling with breastfeeding outcomes: a comparative analysis

Background: Breastfeeding is an art and a skill which needs to be learnt and mastered. Breastfeeding practice gets affected by many factors like Social, cultural, biophysical, demographic and psychological. One of the important factors for ineffective breastfeeding is the lack of adequate knowledge of women regarding breastfeeding, such as the time of initiation of feeding, feeding of colostrum and mother’s position while feeding the baby. Objective of the study was to find out association of antenatal counselling with the preference for breastfeeding positions, early initiation of breastfeeding and feeding of colostrum. Methods: This was a prospective cohort study where 120 primigravida who had taken structured counseling on breastfeeding during their antenatal period and ended up with vaginal delivery at labour room of SSG Hospital, Baroda were recruited. With every such mother, the next woman who delivers vaginally and has not taken structured counselling during ANC was taken as the control. After delivery, all the mothers were observed for early initiation of breastfeeding, feeding of colostrum and adoption of cross-cradle breastfeeding position in comparison with other positions. Results: The rate of early initiation of breastfeeding (EIBF) and number of mothers who fed colostrum to their babies was significantly higher in case group compared to the control group. The number of mothers preferring the cross cradle position was also higher in case group. Conclusions: Antenatal counseling on breastfeeding helps mothers to raise the rate of early initiation of breastfeeding and feeding of colostrum to babies. It also helped mothers to choose cross cradle position as their preferred method of breast feeding.

Geospatial determinants and spatio-temporal variation of early initiation of breastfeeding and exclusive breastfeeding in Ethiopia from 2011 to 2019, a multiscale geographically weighted regression analysis

BackgroundBreastfeeding offers numerous benefits for infants, mothers, and the community, making it the best intervention for reducing infant mortality and morbidity. The World Health Organization (WHO) recommends initiating breastfeeding within one hour after birth and exclusively breastfeeding for the first six months. This study investigated the trend, spatio-temporal variation, and determinants of spatial clustering of early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) in Ethiopia from 2011 to 2019.MethodsData from the Ethiopian Demographic and Health Survey (EDHS), which was conducted in 2011, 2016, and 2019, were analyzed utilizing a weighted sample of 10,616 children aged 0–23 years for EIBF and 2,881 children aged 0–5 months for EBF. Spatial autocorrelation analysis was used to measure whether EIBF and EBF were dispersed, clustered, or randomly distributed and Kriging interpolation was employed to predict the outcome variables in the unmeasured areas. Spatial scan statistics were used to identify spatial clusters with a high prevalence of cases. Both global and local regression modeling techniques were employed to examine the spatial relationships between the explanatory variables and the dependent variables.ResultsThe trend analysis revealed a notable increase in the prevalence of EIBF from 51.8% in 2011 to 71.9% in 2019. Similarly, the prevalence of EBF increased from 52.7% in 2011 to 58.9% in 2019. Spatial analysis demonstrated significant spatial variation in both EIBF and EBF throughout the country. Cold spots or clusters with a low prevalence of EIBF were observed consistently in the Tigray and Amhara regions, and significant cold spot areas of EBF were observed consistently in the Afar and Somali regions. Multiscale geographically weighted regression analysis revealed significant predictors of spatial variations in EIBF, including the religious affiliation of being a follower of the orthodox religion, parity of 1–2, absence of antenatal care visits, and delivery via cesarean section.ConclusionsDespite the increase in both EIBF and EBF rates over time in Ethiopia, these rates still fall below the national target. To address this issue, the government should prioritize public health programs aimed at improving maternal healthcare service utilization and maternal education. It is essential to integrate facility-level services with community-level services to achieve optimal breastfeeding practices. Specifically, efforts should be made to promote breastfeeding among mothers who have delivered via cesarean section. Additionally, there should be a focus on encouraging antenatal care service utilization and adapting maternal healthcare services to accommodate the mobile lifestyle of pastoralist communities. These steps will contribute to enhancing breastfeeding practices and achieving better outcomes for maternal and child health.

Rates and determinants of breastfeeding initiation in women with and without epilepsy: A 25-year study

PurposeTo examine the rates and determinants of breastfeeding initiation (BFI) amongst women with epilepsy (WWE) and women without epilepsy (WWoE) in Manitoba, Canada. MethodsWe conducted a retrospective cohort study using province-wide health databases from 1995 to 2019. Annual BFI rates for WWE and WWoE were examined. Multivariable logistic regression models were used to quantify the association between maternal and infant characteristics and BFI in both groups. ResultsDuring the study period, 1,331 pregnant WWE and 357,334 WWoE were examined. Among WWE, 70.9 % initiated breastfeeding compared to 81.8 % among WWoE. We observed a significant small increase in yearly trends of BFI in both WWE (β=0.45, p = 0.008) and WWoE (β=0.23, p < 0.001). In WWE, BFI was associated with caesarean delivery (aOR=0.72,95 % CI: 0.53–0.97), chronic pain (aOR=0.67,95 % Cl: 0.46–0.97), lower income (aOR=0.34,95 % Cl: 0.26–0.44), and gestational age (aOR= 1.09,95 % CI:1.01–1.18). In WWoE, BFI was associated with chronic pain (aOR=0.83,95 % Cl: 0.80–0.86), lower income (aOR=0.45, 95 %CI:0.44–0.46), mood and anxiety disorder (aOR=0.84,95 % CI:0.81–0.86), and gestational age (aOR=1.13,95 % Cl:1.12–1.14). The use of any ASM (aOR=0.66,95 % Cl:0.51–0.85), new generation (aOR=0.86,95 % Cl: 0.62–1.20), polytherapy (aOR=0.46,95 % Cl: 0.31–0.69) and gabapentin (aOR=0.49,95 % Cl: 0.17–1.24) reduced the likelihood of BFI among WWE. ConclusionBFI was approximately 10 % lower in WWE compared to WWoE. Determinants such as low income, ASM use, and comorbidities were significant contributors to a reduced BFI in both groups. Targeted counselling for WWE on breastfeeding benefits is essential. Further research is needed to investigate breastfeeding continuation in WWE.

Breastfeeding behaviours in women with obesity; associations with weight retention and the serum metabolome: a secondary analysis of UPBEAT.

Maternal obesity is associated with a decreased intention and initiation of breastfeeding as well as a shortened duration of breastfeeding. This analysis was undertaken to identify breastfeeding behaviours, and relationships with maternal anthropometry and the serum metabolome at 6-months postpartum in an ethnically diverse cohort of women with obesity. A cohort analysis of 715 women from the UK Pregnancies Better Eating and Activity Trial (UPBEAT); a multi-centre randomised controlled trial of an antenatal lifestyle intervention in women with obesity. Maternal data were collected in early pregnancy and included body mass index (BMI), socio-demographic characteristics and anthropometry. At 6-months postpartum, breastfeeding behaviours, anthropometry and 158 maternal metabolic measures from blood samples were recorded. Kaplan-Meier curves of breastfeeding duration were constructed and were stratified by obesity class (I: BMI 30.0-34.9 kg/m2, II: 35.0-39.9 kg/m2, III: ≥40.0 kg/m2). Relationships between breastfeeding behaviours, socio-demographic characteristics, the metabolome, and anthropometry were determined using regression analyses. Eighty-two percent (591/715) of the cohort-initiated breastfeeding and at the 6-month follow-up 40% (283/715) were breastfeeding exclusively or partially. Duration of exclusive breastfeeding decreased with increasing BMI: Compared to BMI class I (mean 90.4 ± 64 days) the difference in mean for classes II and III were -15.8 days (95% confidence interval: -28.5, -3.1, p < 0.05) and -16.7 (95% CI: -32.0 to -1.35, p < 0.05), respectively. Compared to no breastfeeding, any breastfeeding at 6-months postpartum was associated with improvements in metabolites towards a healthier profile, reduced weight retention by -1.81 kg (95% CI -0.75, -2.88, p < 0.05 ) and reduced anthropometric measures, including mid-upper arm and hip circumferences. The breastfeeding related changes in anthropometry were not evident in women of Black ethnicity. Greater emphasis on enabling breastfeeding for women with obesity could improve duration, women's weight management and metabolic health. The lack of breastfeeding related anthropometric effects in Black women requires further investigation. ISRCTN reference 89971375.

Effects of Doula Care on Mother and Infant Health Outcomes in Al-Ahsa Region, Saudi Arabia: A Retrospective Cohort Study.

Introduction Continued supportive care during childbirth may be the key to preventing unfavorable outcomes for both mother and child. It is important to assess and comprehend the sources of assistance available during pregnancy in order to enhance the birthing process and promote favorable outcomes. Objectives The current study aimed to assess the impact of ongoing doula support on mother and infant health outcomes compared to standard care. Methods A retrospective cohort study using both medical records and direct interviews based on information in the data collection form was carried out in the Eastern Province of Saudi Arabia, Al-Ahsa Region. The data that were collected included demographic information, obstetric history, delivery data, and postpartum outcome. Results A total of 50 pregnant women receiving doula care and 100 pregnant women receiving standard care were included. Regarding the mode of delivery, 43 (86%) of the doula group had vaginal deliveries compared to 73 (73%) of the standard care group, while CSs were needed for seven (14%) and 27 (27%), respectively (P = 0.78). Only seven (14%) neonates in the doula group required neonatal intensive care unit admission, versus 22 (22%) in the standard care group (P = 0.246). Additionally, initial breastfeeding within the golden hour occurred in 27 (54%) of the doula group compared to 16 (16%) of the standard care group, while exclusive breastfeeding was reported in 32 (64%) of the doula group compared to 26 (26%) of the standard care group (P < 0.001). Conclusion The current study showed more advantageous delivery and postpartum outcomes among doula care women and their infants compared to standard care, mainly for increasing the rate of initiated breastfeeding within the golden hour, exclusive breastfeeding, and reducing postpartum depression.

Specialized nutritious foods and behavior change communication interventions during the first 1000 d of life to prevent stunting: a quasi-experimental study in Afghanistan

BackgroundConsiderable evidence supports the effectiveness of nutritional supplementation with or without nutrition education in preventing stunting in developing countries, but evidence from Afghanistan is scarce. ObjectivesThis project aimed to assess the effectiveness of specialized nutritious food (SNF), social and behavior change communication (SBCC) intervention to prevent stunting among children under 2 y during the first 1000 d of life in Badakhshan, Afghanistan. MethodsWe used a community-based quasi-experimental pre–post study design with a control group. Pregnant and lactating women received a monthly ration of 7.5 kg of super cereal (250 g/d) during pregnancy and the first 6 mo of breastfeeding. Children aged 6–23 mo received 30 sachets of medium-quantity lipid-based nutrient supplement (50 g/sachet/d) monthly. We compared pre- and postintervention assessments of the intervention and control groups to isolate the effect of the intervention on key study outcomes at the endline by difference-in-differences (DID) estimates. ResultsA total of 2928 and 3205 households were surveyed at baseline and endline. DID estimates adjusted for child, maternal, and household characteristics indicated a significant reduction in stunting (DID: −5% (95% confidence interval [CI]: −9.9, −0.2) and underweight (DID: −4.6% (95% CI: −8.6, −0.5) among children <2 y of age. However, DID estimates for wasting among children in the intervention and control groups were not significantly different (DID: −1.7 (95% CI: −5.1, 1.6). Furthermore, exposure to the SBCC messages was associated with improvements in the early initiation of breastfeeding (DID: 19.6% (95% CI: 15.6, 23.6), exclusive breastfeeding under 6 mo (DID: 11.0% (95% CI: 2.3, 19.7), minimum meal frequency (DID: 23% (95% CI: 17.7, 28.2), and minimum acceptable diet (DID: 13% (95% CI: 9.8, 16.3). ConclusionsThe provision of SNF in combination with SBCC during the first 1000 d of life was associated with reduction in stunting and underweight and improvements in infant and young child feeding practices among children under 2 y of age.This trial was registered at clinicaltrials.gov as NCT04581993.

Stakeholders’ views of the Baby Friendly Initiative implementation and impact: a mixed methods study

BackgroundThe Baby Friendly Hospital Initiative (BFHI) was launched in 1991 as an intervention to support healthy infant feeding practices, but its global coverage remains around 10%. This study aimed to explore stakeholders’ views of the Baby Friendly Initiative (BFI) programme, the barriers and facilitators to accreditation and its perceived impact.MethodsA mixed methods approach was used. An online survey was distributed through numerous professional networks from September 2020 to November 2020. Quantitative data were analyzed using descriptive statistics, with simple content analysis undertaken on open-ended responses. Individual semi-structured interviews were also undertaken and analyzed using inductive thematic analysis.ResultsA total of 322 respondents completed the survey in part or in full, mainly from the United Kingdom. Fifteen key stakeholders and two maternity service users undertook interviews. Respondents were from various professional backgrounds and currently worked in different roles including direct care of women and their families, public health, education and those responsible for purchasing health services. Survey respondents viewed the BFI to have the greatest impact on breastfeeding initiation, duration, and infant health outcomes. Three overall themes were identified. The first was “BFI as an agent for change”. Most participants perceived the need to implement the whole package, but views were mixed regarding its impact and the accreditation process. Secondly, BFI was regarded as only “one part of a jigsaw”, with no single intervention viewed as adequate to address the complex cultural context and social and health inequities that impact breastfeeding. Finally, “cultural change and education” around breastfeeding were viewed as essential for women, staff and society.ConclusionsThe BFI is not a magic bullet intervention. To create a more supportive breastfeeding environment within society a holistic approach is required. This includes social and cultural changes, increased education ideally starting at school age, and advancing positive messaging around breastfeeding within the media, as well as fully banning breastmilk substitute advertising. Although the BFI comprises a whole package, few survey respondents rated all aspects as equally important. Additional evidence for the effectiveness of each element and the importance of the whole package need to be established and communicated.

Spatial distribution of inadequate meal frequency and its associated factors among children aged 6-23 months in Ethiopia: Multilevel and spatial analysis.

More than two-third of global child death is occurred due to inappropriate feeding practice that happened during early childhood period. Evidence on meal frequency status among infant and young children at national level can be used to design appropriate interventions to improve the recommended feeding frequency. Therefore, this study was aimed to explore the spatial distribution and identify associated factors of inadequate meal frequency among children aged 6-23 months in Ethiopia. Secondary data analysis was conducted using the 2019 mini Ethiopian Demographic and Health Survey data. A total weighted sample of 1,532 children aged 6-23 months were included. To identify significant factors associated with of inadequate meal frequency, multilevel binary logistic regression model was fitted. Variables with p-value < 0.25 from the bi-variable model were exported to multivariable analysis. In the multivariable model, variables with p-value < 0.05 were declared as significantly associated factors and adjusted odds ratio (AOR) with its 95% confidence interval were reported. Multilevel models were compared using deviance and log-likelihood. Spatial analysis tools were utilized to visualize the distribution of inadequate meal frequency. Bernoulli model was fitted using SaTScan V.9.6 to identify most likely clusters and ArcGIS V.10.8 was used to map the hotspot areas. Ordinary least square and geographic weighted regression models were used and compared using information criteria and adjusted-R2. Local coefficients of factors associated with hotspots of inadequate meal frequency were mapped. The prevalence of inadequate meal frequency was 47.03% (95% CI: 44.54%, 49.53%) in Ethiopia. Age of the child, sex of the household head, timely initiation of breastfeeding, current breastfeeding status, number of antenatal care visit, maternal education, and region were significantly associated with inadequate meal frequency. The spatial distribution of inadequate meal frequency was showed significant variation across Ethiopia (Global Moran's I = 0.164, p-value <0.001). A total of 38 significant clusters were detected through SaTScan analysis, from these the 22 primary clusters were located in Somali and Harari. The prevalence of inadequate meal frequency was high in Ethiopia and had significant clustering patter. Significant hotspot clusters were located in Somali, northern Afar, Harari, Amhara, Gambela, and eastern South nation nationalities and peoples' region. Therefore, public health interventions which enhance breastfeeding practice, optimal number of antenatal care visits, educational empowerments should target hotspot areas to decrease inadequate meal frequency practice.

Health impact evaluation of Aspirational Districts Program in India: Evidence from National Family Health Survey

The Aspirational District Program (ADP) is a unique initiative of Government of India launched in 2018 that aims to reduce inter-district multidimensional inequality. ADP aims to bring the least developed districts to catch up with the rest of the other districts in the country. The program is comprehensive in its scope as it targets improvement of several key development indicators spanning health and nutrition, education, agriculture and water resources, financial inclusion and skill development and basic infrastructure indicators. Aspirational districts (ADs) are eligible for enhanced funding and priority allocation of various initiatives undertaken by the central and the state governments. Our research estimates the causal impact of ADP on the targeted health and nutrition indicators using a combination of propensity score matching and difference-in-differences (PSM-DID). We use the fourth and fifth rounds of National Family Health Survey (NFHS) data collected in 2015–16 and 2019–21 respectively which serve as the pre and post-treatment data for our analysis. Moreover, we take advantage of the transparent mechanism outlined for the identification of ADs under ADP, which we use for propensity score matching for our PSM-DID. While we observe negative impact of ADP on early initiation of breastfeeding, we believe that the impact is confounded with the effects of Covid-19 since part of NFHS-5 data was collected during the pandemic. However, the negative impact of ADP on early initiation of breastfeeding disappears when we only use pre-covid data (i.e. data for districts from states surveyed before the pandemic). Additionally, using pre-covid data we find a reduction in the prevalence of underweight children younger than 5 years to an extent of 2 to 4 percentage points in ADs as an impact of ADP, which is robust across multiple specification. We do not find evidence of a positive or a negative impact of ADP on any other health and nutrition indicators. Future research efforts should be made towards impact evaluation of all the targeted indicators in order to get a comprehensive unbiased evaluation of ADP.

Hubungan Inisiasi Menyusu Dini Terhadap Pemberian ASI Eksklusif

According to the World Health Organization, the gold standard for child nutrition is exclusive breastfeeding. WHO states that babies, mothers and families greatly benefit from exclusive breastfeeding. Even though breastfeeding has many benefits, only twenty percent of mothers in Indonesia exclusively breastfeed. The performance of the hormone prolactin, which produces breast milk, and the hormone oxytocin, which produces breast milk, can influence the success of exclusive breastfeeding. Early initiation of breastfeeding (IMD) is the first step for successful exclusive breastfeeding. The aim of this research is to analyze the relationship between IMD and exclusive breastfeeding in the Mojo Community Health Center Area. This research is observational analytic using a cross sectional research design. The research sample was mothers with babies aged 6 - 12 months who were selected using the purposive sampling method. Data collection through interviews using questionnaires. Data analysis using the Chi Square test and Fisher's Exact Test with α = 0.05. The results of statistical tests show that there is no relationship between IMD and exclusive breastfeeding (p = 0.094), which means that respondents with IMD and without IMD predominantly give exclusive breastfeeding.

Physiology of Human Lactation and Strategies to Support Milk Supply for Breastfeeding

Despite advances across the globe in breastfeeding initiation rates, many families continue to report they are not meeting their breastfeeding goals. Concerns about milk supply, infant nutritional intake, and infant weight gain are among the most commonly cited reasons for early breastfeeding cessation. Nurses working with individuals during the perinatal period are uniquely positioned to educate families and offer evidence-based interventions to promote optimal milk supply, infant growth, and maternal mental and physical health. Such interventions include early and frequent skin-to-skin care, emptying of the breast, and professional lactation support. By implementing such evidence-based practices in the first hours after birth and connecting families to lactation support in the first 14 days, nurses can begin to help families achieve their breastfeeding goals.

Increased BMI associated with decreased breastfeeding initiation in Million Veteran Program participants.

Breastfeeding has been associated with maternal and infant health benefits but has been inversely associated with body mass index (BMI) prepartum. Breastfeeding and BMI are both linked to socioeconomic factors. Data from parous female participants with available breastfeeding information from the Million Veteran Program cohort was included. BMI at enrollment and earliest BMI available were extracted, and polygenic scores (PGS) for BMI were calculated. We modeled breastfeeding for one month or more as a function of BMI at enrollment; earliest BMI where available pre-pregnancy; and PGS for BMI. We conducted Mendelian randomization for breastfeeding initiation using PGS as an instrumental variable. A higher BMI predicted a lower likelihood of breastfeeding for one month or more in all analyses. A +5 kg/m 2 BMI pre-pregnancy was associated with a 24% reduced odds of breastfeeding, and a +5 kg/m 2 genetically predicted BMI was associated with a 17% reduced odds of breastfeeding. BMI predicts a lower likelihood of breastfeeding for one month or longer. Given the high success of breastfeeding initiation regardless of BMI in supportive environments as well as potential health benefits, patients with elevated BMI may benefit from additional postpartum breastfeeding support.

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.

Supporting breastfeeding for women with low education levels, psychosocial problems, and/or socioeconomic constraints: a scoping review protocol

Objective: This scoping review aims to identify and map interventions and/or strategies used to support the initiation and continuation of breastfeeding for women at risk of delaying initiation, early cessation, or not breastfeeding due to low levels of education, psychosocial problems, and/or socioeconomic challenges in high-income countries. Introduction: While breastfeeding has lifelong beneficial health effects for women and infants, there is a risk of delaying initiation, early cessation, or not initiating breastfeeding at all due to factors related to health inequalities, such as low levels of education, psychosocial problems, and/or socioeconomic constraints. Inclusion criteria: This review will include eligible quantitative, qualitative, and mixed methods studies, as well as systematic reviews and gray literature. We will encompass studies conducted in high-income countries, focusing on interventions and/or strategies to support women with low levels of education, psychosocial problems, and/or socioeconomic constraints in the initiation and continuation of breastfeeding for up to 6 months postpartum. Methods: This review will follow the JBI methodology for scoping reviews, using the Participants, Concept, and Context framework. The primary search will be performed in the following databases: MEDLINE (PubMed), PsycINFO (EBSCOhost), Embase (Ovid), and CINAHL (EBSCOhost). We will include publications in English, Swedish, Norwegian, Danish, German, Bulgarian, Arabic, and Spanish, published from 1991 until the present. A data charting form will be developed and applied to all the included articles. Review Registration: The study is registered in Open Science Framework, DOI 10.17605/OSF.IO/TMP4V

Comparison of Paladai Cup Against Nifty Cup Feeding in Preterm Low-Birth-Weight Infants: An Open-Labeled Randomized Controlled Trial.

Background: Neonatal Intuitive Feeding Technology (NIFTY) cup feeding has been found to be feasible in preterm low-birth-weight babies. However, literature on direct comparison of the same with paladai feeding is lacking. Methods: In this open-labeled, randomized controlled trial, preterm infants (<34 weeks/<1800 g) on full oral gastric tube feeding for at least 3 consecutive days, eligible to be given a trial of suck and swallow cup feeding, prior to initiation of direct breastfeeding, were randomized to the two feeding intervention groups: paladai cup and Nifty cup. The primary outcome was the time taken from initiation of oral cup feeds to reaching complete gavage-free cup feeds for at least 24 hours. Secondary outcomes were the ease of use of both instruments, the adverse effects during and within 10 minutes after feeding, and anthropometric parameters (head circumference and weight gain). Results: The median (IQR) time taken from initiation to complete transition to full cup feeding for at least 24 hours was not significantly different [4(3,7) days in Nifty cup group versus 3(2,6) days in paladai cup group, p = 0.25]. Mean ± SD weight gain from intervention to discharge was also similar in both the groups (16 ± 6 g/kg/day in Nifty cup group versus 17 ± 5 g/kg/day in paladai cup group, p = 0.18). Adverse events did not differ (32.9% in group A versus 27.1% in group B, p = 0.580). Nurses did not find any difference in ease of teaching caregivers [median (IQR) Nifty cup group 4(4,5) versus paladai cup group 4(4,5), p = 0.13]. Conclusion: The efficacy and adverse event rates were similar between Nifty cup feeding and paladai cup feeding in preterm infants. Both feeding modalities can be used prior to transition to direct breastfeeding in preterm low-birth-weight infants.