Breastfeeding Rates Research Articles

Digital mentoring on expressing breast milk for working mothers

Background/Aims Working mothers may find it difficult to maintain exclusive breastfeeding; this challenge can be addressed through expressing breast milk. However, barriers to expressing breast milk include perceived insufficient milk supply and a lack of knowledge on pumping, storing and giving breast milk to babies. This study's aim was to identify the effectiveness of expressed breast milk assistance, through the ASIPku mobile application, among working mothers in North Sulawesi, Indonesia. Methods This quasi-experimental study involved 100 participants (intervention: n=50, control: n=50), selected using cluster randomised trials. Questionnaires were used to assess exclusive breastfeeding and use of the app in the intervention group. Chi-squared tests were used for data analysis. Results Assistance using mobile applications had a significant effect on exclusive breastfeeding among working mothers in North Sulawesi (P<0.001). Conclusions Digital mentoring was effective in improving the rate of exclusive breastfeeding. By providing information on expressing breast milk, these apps can be used to support women and make exclusive breastfeeding more accessible to working mothers.

Maternal depression, psychosocial stress and race/ethnicity: examining barriers to breastfeeding for young mothers

ABSTRACT Background Breastfeeding has a positive impact on child and maternal health outcomes. Black and Latina women and adolescent mothers have lower rates of breastfeeding initiation and continuance in the U.S. Maternal depression and psychosocial stressors may contribute to reduced rates of breastfeeding. The current study aims to better understand behaviours and associated factors related to breastfeeding in a diverse group of adolescent mothers attending a teen-tot clinic for postpartum and infant well care. Methods Participants were 191 mother-infant dyads. Mother’s age ranged from 13 to 25, and 54% of mothers identified as Latina, 22% Black, 11% more than one race and 5% white. Demographic information and breastfeeding behaviour were abstracted from the medical record. Rates of postpartum mood/anxiety symptoms and psychosocial stressors were obtained from screening measures completed at medical visits. Results Analyses revealed that 87% of adolescent mothers in the sample initiated breastfeeding at birth and the racial/ethnic breakdown of those mothers closely mirrored the overall population (58% Hispanic or Latina, 17% Black, 10% more than one race, 5% white). At 2 months postpartum, only 41% of the population was still breastfeeding. Mothers with significant mood/anxiety symptoms at the newborn visit were more likely to be breastfeeding at the 1- and 2-month visits. Mothers with psychosocial stressors at the newborn visit were less likely to be breastfeeding at the 1- and 2-month visits. Conclusion Efforts to promote health equity through breastfeeding for at-risk mothers must occur within the first few weeks postpartum and must consider associated factors including postpartum mood/anxiety symptoms and psychosocial stressors.

Program Kombinasi Intervensi Stimulasi Motorik Oral dalam Meningkatkan Kesiapan Keterampilan Minum Per-Oral pada Bayi Prematur

This study aims to evaluate the efficacy of integrating multiple oral motor stimulation interventions in facilitating the readiness for oral feeding among premature neonates.. A systematic review methodology was adapted for this inquiry. Extensive literature searches were conducted across prominent databases, including PubMed, EBSCO, Sage Journal, Taylor & Francis, Clinical Key for Nursing, and Proquest. A total of six articles, all randomized controlled trials, were selected and meticulously reviewed. The results of this systematic review indicate that the interventions employed include combinations of oral motor stimulation with supplementary nursing, kinesthetic tactile techniques, non-nutritive sucking (NNS), swallowing exercises, and sensorimotor stimulation. The findings suggest that these interventions are effective in enhancing oral feeding readiness by shortening the transition period to oral feeding and promoting breastfeeding fulfillment. Additionally, they have been shown to increase breastfeeding rates and reduce concurrently the duration of hospitalization. This research provides valuable insight for improving neonatal care and optimizing feeding practices. Keywords: Feeding Readiness, Oral Motor Stimulation, Premature Infants

Impact of baby-friendly hospital initiative on exclusive breastfeeding rates and mother satisfaction

BackgroundBreastfeeding offers numerous benefits for both babies and mothers. Exclusive Breastfeeding for at least the first 6 months of life was encouraged by the World Health Organisation through employing the Baby-Friendly Hospital Initiative. AimsThe study aimed to investigate the impact of this Initiative on maternal satisfaction and exclusive breastfeeding rates. Methodsin this retrospective study 160 participants were divided into group one who experienced the Initiative and group two who did not. Exclusive breastfeeding was measured using the Index of Breastfeeding Status. Maternal satisfaction was measured using the Maternal Breastfeeding Evaluation Scale. ResultsThe results revealed a significant difference in maternal satisfaction between the two groups (p < 0.05). Fisher's exact test indicated a significant association between experiencing the Baby-Friendly Hospital Initiative and exclusive breastfeeding rates (p < 0.001). ConclusionThe findings underscored the role of the Baby-Friendly Hospital Initiative in promoting exclusive breastfeeding and enhancing maternal satisfaction.

Chronic consequences of accidental dural puncture and postdural puncture headache in obstetric anaesthesia - sieving through the evidence.

Accidental dural puncture (ADP) and postdural puncture headache (PDPH) are relatively common complications of neuraxial anaesthesia and analgesia in obstetrics. Both may result in acute and chronic morbidity. This review intends to discuss the chronic implications of ADP and PDPH and raise awareness of severe and potentially life-threatening conditions associated with them. ADP may be associated with a high rate of PDPH, prolonged hospitalization and increased readmissions. Studies have shown that PDPH may lead to chronic complications such as post-partum depression (PPD), post-traumatic stress disorder (PTSD), chronic headache, backache and reduced breastfeeding rates. There are many case reports indicating that major, severe, life-threatening neurologic complications may follow PDPH in obstetric patients including subdural haematoma and cerebral venous thrombosis. Many clinicians still believe that ADP and PDPH are benign and self-limiting conditions whereas there may be serious and devastating consequences of both. It is imperative that all women with ADP and PDPH are appropriately diagnosed and treated.

"A Vulnerable Time To Be a Young Family in an Emergency": Qualitative Findings From an Exploration of an Emergency Perinatal and Infant Feeding Hotline in Louisiana.

Birthmark Doula Collective, a cooperative that provides doula and lactation services in the Greater New Orleans area, mounted an emergency response after two Category 4 storms: Hurricane Laura (2020) and Hurricane Ida (2021). The response included activating a no-cost emergency perinatal and infant feeding hotline. Both disasters coincided with a resurgence of COVID-19 infections in Louisiana. The aim of this study is to understand how an emergency perinatal and infant feeding hotline supported infant and young child feeding in emergencies during hurricanes in Louisiana. This study used a cross-sectional, retrospective qualitative design in a population with low breastfeeding rates. We conducted a content analysis of 97 hotline call logs from Hurricanes Laura and Ida, focus groups with lactation support providers who staffed the hotline during either storm (n = 5), and interviews with mothers who called during Hurricane Ida (n = 2). Focus groups and interviews lasted 30 and 60 minutes, respectively. Transcripts were analyzed using thematic analysis techniques. Call logs revealed infant feeding needs (e.g., mastitis, low milk supply, relactation, and infant formula requests) and non-infant feeding needs (e.g., infant supplies, perinatal and infant care referrals, shelter information). Infant formula was the most requested supply during both hurricanes. Maternal participants discussed family vulnerabilities during Hurricane Ida. Staff described training and strategies to provide support while maintaining their own well-being. Providing a free emergency hotline service is one way to support pregnant and postpartum people and their families seeking infant feeding advice, supplies, and support in the immediate aftermath of a disaster.

State paid family leave policies and breastfeeding duration: cross-sectional analysis of 2021 national immunization survey-child

BackgroundPaid parental leave policies may promote breastfeeding, which can have short- and long-term health benefits for both members of the birthing person-infant dyad. In the United States, where 56% of the workforce qualifies for unpaid federal medical leave, certain states have recently enacted paid parental and family leave policies. We aimed to assess the extent to which living in states with versus without paid family leave was associated with feeding regimens that included breastfeeding.MethodsIn this cross-sectional analysis of the 2021 National Immunization Survey-Child, we assessed feeding outcomes: (1) exclusively breastfed (only fed breastmilk—never infant formula—both before and after six months of age), (2) late mixed breastfeeding (formula after six months), (3) early mixed breastfeeding (breastfed, formula before six months), and (4) never breastfed. We conducted Pearson χ2 to compare social-demographic characteristics and multivariable nominal regression to assess extent to paid family leave was associated with breastfeeding regimens, compared with never breastfeeding.ResultsOf the 35,995 respondents, 5,806 (25% of weighted respondents) were from states with paid family leave policies. Compared with never breastfeeding, all feeding that incorporated breastfeeding—exclusive breastfeeding, late mixed feeding (breastfed, formula introduced after six months), and early mixed feeding (breastfed, formula introduced before six months)—were more prevalent in states with paid family leave policies. The adjusted prevalence ratio (aPR) and differences in adjusted prevalence compared with never breastfeeding in states with versus without paid family leave policies were: aPR 1.41 (95% CI 1.15, 1.73), 5.36% difference for exclusive breastfeeding; aPR 1.25 (95% CI 1.01, 1.53), 3.19% difference for late mixed feeding, aPR 1.32 (95% CI 1.32, 1.97), 5.42% difference for early mixed feeding.ConclusionStates with paid family leave policies have higher rates of any breastfeeding and of exclusive breastfeeding than states without such policies. Because all feeding types that incorporate breastfeeding were higher in states with paid family leave policies, expansion of paid family leave may improve breastfeeding rates.

A case-control study of the risk factors for fistula-in-ano in infants and toddlers

BackgroundLimited data are available regarding the risk factors for fistula-in-ano (FIA) in infants and toddlers, potentially affecting their daily lives.ObjectivesThe purpose of this study was to identify potential risk factors for FIA in infants and toddlers, in order to implement early preventive interventions, avoid disease progression, and develop therapeutic strategies.Design and settingsA retrospective case-control study was conducted, comparing 41 infants and toddlers diagnosed with FIA with 41 healthy controls, between August 2020 and December 2021.Independent variables(a) maternal characteristics during pregnancy and delivery, (b) perinatal characteristics, dietary behaviors, and defecation-related behaviors in infants and toddlers, (c) family dietary behaviors.ResultsMothers of infants and toddlers with FIA had given birth more times in the past, while the infants and toddlers themselves had less mealtime, a higher rate of exclusive breastfeeding, frequent loose stools, and a larger proportion of used wipes, experiencing perianal skin anomalies. The logistic regression analysis revealed that there are four significant risk factors associated with the development of FIA in infants and toddlers, including the number of previous deliveries by the mother (OR 6.327), defecation frequency score (OR 5.351), stool consistency score (OR 5.017), and cleaning with wipes after defecation (OR 8.089).ConclusionBased on our data, it appeared that FIA in infants and toddlers could be attributed to several factors. These included an increased number of previous deliveries by mothers, frequent loose stools, and repeated wipe use. To prevent the occurrence and worsening of the disease, it is important to improve the frequency and consistency of stooling and provide proper care. Further research is required to verify these findings in other clinical settings.

Does the 3C (Counselling, Checking and Certification) Initiative Prevent Hypoglycemia Among At-Risk Stable Late Preterm and Term Neonates? - A Randomized Controlled Trial.

To evaluate whether the 3C (Counselling, Checking, Certification) initiative helps in preventing hypoglycemia among at-risk neonates compared to standard care. This randomised controlled trial included 222 mother-newborn dyads with risk factors for neonatal hypoglycemia-Small for gestational age (SGA) babies, infants of diabetic mothers (IDM), large for gestational age (LGA) babies and late preterm infants (LPI). They were randomized to two groups. Group A received standard care while mothers in group B were administered 3C intervention. Early initiation of breastfeeding, incidence of neonatal hypoglycemia within 24h, and exclusive breastfeeding rate at 6 mo were evaluated. Early initiation of breastfeeding was higher in the 3C group compared to standard care group (94.6% vs. 55.9% p <0.001). The incidence of hypoglycemia within 24h was lower in the intervention group compared to standard care (3.6% vs. 15.3%, p <0.05). However, there was no significant difference in exclusive breastfeeding rates at 6 mo between the two groups (61% and 66% in group A and B respectively). The 3C intervention decreases the incidence of hypoglycemia among at-risk neonates. Early initiation of breast-feeding is higher among mothers who receive the 3C intervention.

Maternal and neonatal outcomes associated with illness severity of maternal COVID-19.

Several reports demonstrated that perinatal SARS-CoV-2 has significant impact on maternal and neonatal health outcomes. However, the relationship between severity of maternal illness with outcomes remains less clear. This is a single-center retrospective cohort study of mother/infant dyads with positive maternal test for SARS-CoV-2 between 14 days prior and 3 days after delivery from 3/30/2020 to 12/28/2021. Among 538 mothers, those with moderate/severe/critical illness were more likely to undergo induction, receive oxygen, mechanical ventilation or ECMO. Mortality was significantly higher among the mothers with severe illness than asymptomatic and those with mild illness (6% vs 0% and 0%, respectively, P < 0.05). Neonates born to mothers with moderate/severe/critical illness were more likely to be preterm with lower birth weight, and to be admitted to the NICU (P < 0.05) but not to be small for gestational age. Mild maternal illness was only associated with NICU admission for isolation precaution and decreased rate of breastfeeding. Maternal illness severity was significantly associated with prematurity and several adverse maternal and neonatal outcomes.

Effect of One-on-one Structured Counselling of Mothers and Family Members Using GALPAC Technique Compared to Standard Counselling on Post-discharge Kangaroo Mother Care and Related Outcomes in Low-birth-weight Infants: A Quasi-randomised Controlled Trial

Background and Objectives Kangaroo mother care (KMC) improves low-birth-weight neonatal survival. It is recommended for low-birth-weight babies in all settings and should be continued at home as well. Counselling of mothers and family members is necessary for successful initiation and continuation of KMC. This study aims to use the greet, ask, listen, praise, advise, check understanding (GALPAC) method of counselling to improve the outcome of home-based KMC. Methods This quasi-randomised controlled trial was done in 266 stable low-birth-weight neonates born in the hospital. In the intervention group, GALPAC counselling was done by trained nurses and paediatricians during the hospital stay, through telephone after discharge and by local ASHA during home visits. The control group received routine counselling during discharge and on follow-up visits by the treating paediatrician. Both groups were examined on the 15th, 30th and 60th day post-discharge for weight changes and were monitored for morbidity, mortality, breastfeeding and continuation of KMC. Results The neonates were divided randomly in two groups: 132 in the intervention group and 134 in the control group. The basic demographic parameters were comparable in both the groups. On the 15th day of follow-up, breastfeeding rate was 86% in the intervention group and 80% in the control group, morbidity was 13.4% and 15.7%, KMC continuation was 84% and 71.3% and re-admission rate was 6.1% and 7.04%, respectively. By the 60th day, the breastfeeding rate was 67.6% and 55.05%, morbidity 3.8% and 19.1%, KMC continuation 65% and 47% and re-admission rate 1.8% and 20.2% in the intervention and control groups, respectively. Mortality was 11.2% in the control group and 1.8% in the intervention group by the 60th day. Weight gain was more in the intervention group than in the control group (1,055.30 ± 122.46 g and 745.77 ± 99.34 g) by day 60. Interpretation and Conclusion The outcome of KMC in the intervention group was better in comparison to the control group for all parameters studied. Therefore, one-on-one structured counselling with regular communication and follow-up is an effective intervention to improve maintenance of KMC at home.

Effect of exclusive breastfeeding and other infant and young child feeding practices on childhood morbidity outcomes: associations for infants 0–6 months in 5 South Asian countries using Demographic and Health Survey data

BackgroundDespite growing evidence of the impacts of exclusively breastfeeding infants during the first 6 months of life on preventing childhood infections and ensuring optimal health, only a small number of studies have quantified this association in South Asia.MethodsWe analyzed data from the Demographic and Health Surveys in Afghanistan (2015; n = 3462), Bangladesh (2017–2018; n = 1084), India (2019–2021; n = 26,101), Nepal (2022; n = 581), and Pakistan (2017–2018; n = 1,306), including babies aged 0–6 months. Multivariate logistic regression models were used to determine the association between exclusive breastfeeding in the last 24 h and diarrhoea, acute respiratory infections, and fever in the two weeks before the survey. We also examined the association between other infant and young feeding indicators and these outcomes.ResultsInfants who were exclusive breastfed had decreased odds of diarrhoea in Afghanistan (AOR: 0.49, 95% CI 0.35, 0.70), India (AOR: 0.80, 95% CI 0.70, 0.91), and Nepal (AOR: 0.42, 95% CI 0.20, 0.89). Compared with infants who were not exclusive breastfed, infants who were exclusively breastfed were less likely to have fever in Afghanistan (AOR: 0.36, 95% CI 0.26, 0.50) and India (AOR: 0.75, 95% CI 0.67, 0.84). Exclusive breastfeeding was associated with lower odds of acute respiratory infections in Afghanistan (AOR: 0.57, 95% CI 0.39, 0.83). Early initiation of breastfeeding was protective against diarrhoea in India. Bottle feeding was a risk factor for diarrhoea in India and for fever in Afghanistan and India. Bottle feeding was also a risk factor for acute respiratory infection in Afghanistan and India.ConclusionsNot exclusive breastfeeding is a risk factor for diarrhoea, acute respiratory infections, and fever in some South Asian countries. These findings could have substantial implications for global and national efforts to increase exclusive breastfeeding rates. More support, advocacy, and action are required to boost breastfeeding rates as a crucial public health measure.

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.

Implementation of a clinically integrated breastfeeding peer counselor program.

Reflecting disparities across the US, in 2015 publicly insured patients of the NorthShore Community Health Center (NSCHC) in Evanston, Illinois had lower breastfeeding rates than commercially insured patients. We used the Replicating Effective Programs framework to describe the design and implementation of a clinically-integrated breastfeeding peer counseling (ci-BPC) program to address these disparities. Patient focus groups and surveys informed program design, and a multidisciplinary clinical support team developed workflows that integrated the breastfeeding peer counselor (BPC) into the clinic and the postpartum unit. ci-BPC improved breastfeeding intensity and duration by providing every NSCHC patient with (1) prenatal lactation education; (2) hands on lactation care in the hospital; and (3) on-demand postpartum support. Total cost per patient was $297-386. The program was sustained after demonstrating potential cost-savings. An evidence-based, multidisciplinary collaboration resulted in a sustainable clinically integrated breastfeeding peer counseling program that improved breastfeeding outcomes.

Evolution of Exclusive Breastfeeding Practices According to Continuous Demographic and Health Surveys (DHS-C) from 2010-2011 to 2019 and Associated Factors in Senegal

Introduction: The first two years of a child&amp;apos;s life are particularly important. Inadequate breastfeeding practices during this period considerably compromise the health, development and survival of infants, children and mothers. Several studies have assessed the impact of breastfeeding on infant mortality. The objectives of our study were to investigate changes in exclusive breastfeeding practices during the first six months of life according to DHS data from 2010-2011 to 2019 and to identify the various associated factors. Methodology: This is a quantitative analysis of secondary data based on cross-sectional data from the DHS from 2010-2011 to 2019 on changes in exclusive breastfeeding practices for infants under six months of age. Our study focused on women aged 15 to 49 years interviewed during the DHS and residing in Senegal at the time of the various surveys who had children under two years of age. Data were collected on exclusive breastfeeding rates in different years, the socio-demographic and gyneco-obstetric characteristics of mothers, and the characteristics of newborn children. A multivariate analysis was performed to identify factors associated with exclusive breastfeeding. Results: showed that exclusive breastfeeding rates remained below 50% from 2010-11 to 2019. Analysis by region showed a disparity between the different regions. The associated factors were: ethnic group: Wolof are less likely to practice EBF with an adjusted AOR of 0.59 with a CI&amp;lt;sub&amp;gt;95&amp;lt;/sub&amp;gt;: [0.38, 0. 90], maternal literacy: mothers who could not read were less likely to perform EBF with an adjusted AOR of 0.71 and a CI&amp;lt;sub&amp;gt;95&amp;lt;/sub&amp;gt;: [0.53-095], birth order: mothers with 6 or more children were more likely to perform EBF, with an AOR of 3.20 and a CI&amp;lt;sub&amp;gt;95&amp;lt;/sub&amp;gt;: [1.68-6.17], maternal occupation: Working mothers were less likely to practice EBF than non-working mothers, with an AOR of 0.60 and a CI&amp;lt;sub&amp;gt;95&amp;lt;/sub&amp;gt; [0.46-0.79], access to the media: Mothers with access to the media were less likely to practice assisted fertilization, with an AOR of 0.57 and a CI&amp;lt;sub&amp;gt;95&amp;lt;/sub&amp;gt;: [0.37-0.90] and use of modern contraception: Mothers using modern contraception were less likely to practice exclusive breastfeeding, with an AOR of 0.53 and a CI&amp;lt;sub&amp;gt;95&amp;lt;/sub&amp;gt;: [0.38-0.72]. Conclusion: Despite all the efforts made by the Senegalese government and its technical and financial partners, rates are still low. To strengthen the practice of exclusive breastfeeding, it is important and urgent to design and implement innovative evidence-based interventions covering the different levels of the socio-ecological model (individuals, families, communities and public policies).

Evaluation of environmental features that support breastfeeding: A photovoice study

The United Kingdom (UK) has some of the lowest breastfeeding rates in the world, and Stoke-on-Trent has some of the lowest breastfeeding rates and highest infant mortality rates in the UK. Vicarious experience of formula feeding, formula feeding culture, and a lack of physical environments to support breastfeeding are known barriers to uptake and maintenance. Improving physical environments and increasing the visibility of breastfeeding in public would help to challenge these barriers. This research employs a participatory approach to understand the facilitators and barriers to breastfeeding in public. Nine breastfeeding peer supporters were recruited as co-researcher for a photovoice study. Co-researchers collated images of features in environments which they felt either supported or acted as a barrier to public breastfeeding. An analysis workshop was held to review the data collected and produce collaboratively agreed findings. Various environmental features were highlighted as facilitators to breastfeeding including family rooms, welcoming signage, supportive staff members, and displays of information about breastfeeding. In addition, poorly designed family rooms, lack of inclusivity within breastfeeding spaces, breastfeeding spaces within toilets and a lack of information were barriers to public breastfeeding. This research illustrates that while some environments are well designed to support breastfeeding many others are not. Environments often lack basic provision and/or make token gestures towards breastfeeding support, such as welcome signage, without providing the infrastructure needed to support breastfeeding. More education about breastfeeding friendly spaces and resources for putting this information into practice are needed for environment owners, managers, and policy makers.

Experience of Breastfeeding And Exclusive Breastfeeding For Women With Physical Disabilities: Scoping Review

The study aims to investigate the scientific evidence concerning breastfeeding and exclusive breastfeeding experiences among women with physical disabilities. Exclusive breastfeeding entails providing only breast milk to infants from birth to 6 months old, excluding any other food or drinks except medications and vitamins. However, breastfeeding is not halted after exclusive breastfeeding; it continues until the child is two years old. Utilising the scoping review method, the research employed the Population, Concept, and Context (PCC) framework. Six articles meeting the inclusion criteria were identified from a pool of 1,553 articles from PubMed, ScienceDirect, Wiley, and Research Rabbit databases. These articles shed light on the challenges, experiences, barriers, and support systems related to breastfeeding and childcare encountered by women with physical disabilities. The research on breastfeeding experiences among women with physical disabilities reveals both facilitators and barriers. Facilitators include adaptations, peer support, and necessary equipment, while barriers encompass insufficient support, health considerations, and milk production and latching challenges. These findings underscore the importance of tailored support and access to information for women with physical disabilities who aim to breastfeed effectively. Implementing such support mechanisms can contribute to improving breastfeeding rates among this demographic, thus promoting the health and well-being of both mothers and infants while addressing societal attitudes toward disability issues.

Client-centered flexible planning of home-based postpartum care: A randomized controlled trial on the quality of care.

Standardization of health systems often hinders client-centered care. This study investigates whether allowing more flexibility in the planning range of the Dutch home-based postpartum care service improves its quality of care, as innovative approach to client-centered care. A randomized controlled trial was conducted (2017-2019), in which pregnant women who intended to breastfeed were assigned into two groups (1:1). The intervention group was allowed to receive care up to the 14th-day postpartum, instead of the first 8-10 consecutive days ("usual care"). Primary outcome measure was the proportion of newborns still receiving exclusively breastmilk on final caring day of the service. This so-called successful breastfeeding rate is currently used by the Dutch health sector to measure the quality of care. Secondary outcome measures were self-care experience, overall care experience, and exclusive breastfeeding duration rate. Based on data from 1275 participants, there was no difference in exclusive breastfeeding on final caring day (86,7% intervention group vs. 88,9% control group, RR: 1.03, 95% CI: 0.98-1.07). Both groups showed similar self-care experiences. Women in the intervention group had slightly poorer overall care experience and lower exclusive breastfeeding duration rates. This study found no effect on the quality of care when allowing more flexibility in the planning range of home-based postpartum care. Women can, therefore, be offered more flexibility to suit them. Given the confusion in interpreting the sector's current main quality indicator, we call for an inclusive dialogue on how to best measure the quality of home-based postpartum care.

HUBUNGAN POLA ASUH DAN PEMBERIAN ASI EKSKLUSIF DENGAN STATUS GIZI BAYI DI KLINIK SARGIATI Amd.Keb TAHUN 2023

The focus on improving public nutrition in Indonesia remains centered on addressing the nutritional status of Indonesian children. According to the 2014 Global Nutrition Report (GNR), Indonesia is one of 17 out of 117 countries facing the triple burden of stunting, wasting, and overweight among infants or toddlers within the first days of life. Despite efforts, exclusive breastfeeding rates in Indonesia have not met the targeted 80%. In 2016, exclusive breastfeeding rates for infants aged 0-5 months were at 54.0%, while only 29.5% were exclusively breastfed up to 6 months. Although South Sumatra province has surpassed the national average with a rate of 60.4%, it still falls short of the desired 80%. Researchers focused on the Sargiati Amd clinic, particularly exploring the correlation between parenting styles, exclusive breastfeeding, and infant nutritional status. Among the 19 respondents, the majority exhibited a certain parenting style. Among them, 11 individuals had good nutritional status (36.7%), while 8 had poor nutritional status (36.7%). Only a minority (6.7%) had poor nutritional status. Surprisingly, among those with good parenting habits, the majority had poor nutritional status (23.3%), while the minority had good nutritional status (13.3%). Statistical analysis using a chi-square test with a significance level of 0.05 yielded a p-value of 0.256 (P &gt; 0.05), indicating acceptance of the null hypothesis (Ho) and rejection of the alternative hypothesis (Ha). Thus, no significant relationship was found between parenting style and nutritional status. However, there was a significant relationship between parents' eating habits and healthy habits with nutritional status (p = 0.014; p = 0.006).

Implementation of early essential neonatal care for newborns delivered by cesarean section in Jiaxing: a single-center prospective randomized controlled trial

BackgroundAs an essential part of Early Essential Newborn Care, 90 minutes of mother-infant skin-to-skin contact is significant in improving maternal and infant outcomes. However, due to human resource constraints and the consideration of maternal and infant safety, it is difficult to achieve continuous uninterrupted skin-to-skin contact for at least 90 minutes during and after cesarean delivery. The aim of this study was to investigate the efficacy and safety of the continuous uninterrupted skin-to-skin contact for at least 90 minutes during and after cesarean section for exclusive breastfeeding rate during hospitalization and maternal and infant health indicators during and after cesarean delivery.MethodsThis is a single-center, prospective randomized controlled trial conducted in one tertiary care hospital in China. We selected 280 cases of elective cesarean delivery in a tertiary maternal and child specialty hospital in Zhejiang Province from September 2018 to August 2022, which were randomly divided into two groups: in the conventional group, doulas performed at least 30 minutes for early continuous SSC within 10–30 minutes during and after cesarean delivery. In the EENC group, with immediate continuous SSC within 5–10 minutes of neonatal delivery until surgery is completed and continued SSC after returning to the ward. Exclusive breastfeeding rate during hospitalization and maternal and infant health indicators were compared between the groups.ResultsA total of 258 cases were analyzed. Compared with the control group, the EENC group had earlier first breastfeeding initiation (13.7 ± 3.6 vs 62.8 ± 6.5 minutes, P < 0.001), longer duration of first breastfeeding (42.6 ± 9.0 vs 17.9 ± 7.5 minutes, P < 0.001), earlier onset of lactogenesis II (73.7 ± 3.6 vs 82.5 ± 7.4 hours, P < 0.001), higher breastfeeding self-efficacy score (128.6 ± 8.9 vs 104.4 ± 8.5, P < 0.001), higher Exclusive breastfeeding rate during hospitalization (88% vs 81%, P = 0.018), higher maternal satisfaction scores (18.9 ± 1.1 vs 14.0 ± 2.7, P < 0.001). Meanwhile the EENC group showed lower incidence of neonatal hypothermia (0% vs 4.6%, P = 0.014), lower neonatal hypoglycemia (0% vs 5.4%, P = 0.007) and less cumulative blood loss within 24 hours postpartum (254.2 ± 43.6 vs 282.8 ± 63.8 ml, P < 0.001).ConclusionThe implementation of EENC up to 90 minutes by caesarean doula company nurses is feasible and beneficial to maternal and infant health.Trial RegistrationChiCTR1800018195(2018-09-04).