Breastfeeding Research Articles

SARS-CoV-2 seropositivity in African women living with HIV and their infants

BackgroundSARS-CoV-2 seropositivity data in women living with HIV (WLHIV), their infants and associated factors in this subpopulation remain limited. We retrospectively measured SARS-CoV-2 seropositivity from 07/2020-11/2021 among WLHIV and their children in the PROMOTE observational cohort in Uganda, Malawi, and Zimbabwe prior to widespread SARS-CoV-2 vaccination in those countries.MethodsPlasma stored during 3 waves of the COVID-19 pandemic in East/Southern Africa were tested for SARS-CoV-2 specific IgG antibodies (Ab) using serological assays that detect adaptive immune responses to SARS-CoV-2 spike protein. (EUROIMMUN, Mountain Lakes, New Jersey and Roche Diagnostics, Indianapolis, IN). Modified-Poisson regression models were used to calculate prevalence rate ratios (PRR) and 95% confidence intervals (CI) to identify sociodemographic and clinical risk factors.ResultsPROMOTE samples from 918 mothers and 1237 children were analysed. Overall, maternal SARS-CoV-2 seropositivity was 60.1% (95% CI: 56.9 -63.3) and 41.5% (95%CI: 38.8 – 44.2) for children. Non-breastfeeding mothers had a 31% higher risk of SARS-CoV-2 seropositivity compared to breastfeeding mothers (aPRR=1.31, 95%CI: 1.08-1.59). WLHIV with undetectable viral load had a 10% increased risk of SARS-CoV-2 seropositivity (aPRR=1.10, 95%CI: 0.89-1.37). Moreover, those who were normotensive had 12% increased risk SARS-CoV-2 seropositivity (aPRR= 1.12, 95% CI: 0.68-1.85) compared to women with hypertension. Children between 2 and 5 years had a 19% reduced risk of SARS-CoV-2 seropositivity (aPRR=0.81, 95%CI: 0.64-1.02) when compared to younger children. Mother/infant SARS-CoV-2 serostatuses were discordant in 346/802 (43.1%) families tested: mothers+/children- in 72.3%; mothers-/children+ in 26.3%; child+/sibling+ concordance was 34.6%.ConclusionsThese SARS-CoV-2 seropositivity data indicate that by late 2021, about 60% of mothers and about 40% of children in a cohort of HIV-affected families in eastern/southern Africa had been infected with SARS-CoV-2. More mothers than their infants tested SARS-CoV-2+, likely due to a greater external exposure for mothers linked to daily routines/employment, and school closures. Breastfeeding was protective for mothers, likely because of higher likelihood of staying home with young children, and thus less exposure. Discordant results between children within the same families underscores the need to further understand transmission dynamics within households.

Impact of integrated child development scheme on nutritional and health status of children

The Indian government’s centerpiece initiative, the Integrated Child Development Scheme (ICDS) project, aims to improve the overall growth, wellness, and nutrition of children under six years old and pregnant and breastfeeding mothers’ nutritional and physical well-being. KanyaKumari (KK) district, located in the southern state of Tamil Nadu, has also benefited from this program. Using a questionnaire survey method, valid data were collected from 120 participants, and interviews were subsequently conducted with 52 individuals to gain deeper insights into the research topic. SPSS statistical software was utilized. The program under assessment, the ICDS, targets children under six and pregnant and lactating mothers, offering services like nutrition, healthcare, and early childhood education to improve their health and Nutritional Status (NS). The indicators being assessed include nutritional and Health Status (HS) (e.g., malnutrition, immunization rates) to decrease malnutrition and improve overall health outcomes. The findings of this study indicate that the prevalence of child malnutrition has decreased, suggesting that the ICDS has been effective in improving the NHC. The novelty of this research lies in its specific focus on the KK district, its evaluation of a government program’s impact, and its emphasis on child welfare and development. The study’s insights on integrated child development programs can inform policymakers, healthcare providers, and community groups globally, aiding efforts to improve child health and nutrition implications. The ICDS has had a positive impact on the NHC in the KK district. However, continuous efforts are required to overcome challenges and ensure the sustained success of the program in the district.

Investigating Water Balance as a Nutritional Determinant in Breastfeeding: A Comparative Study of Water Consumption Patterns and Influencing Factors.

Ensuring adequate hydration is critical for breastfeeding women, yet their water consumption patterns and hydration status is poorly understood. This study investigates the water consumption patterns and estimated water balance among women, practicing exclusive, mixed, and no breastfeeding methods. 529 healthy women completed the Nursing Water Balanced Questionnaire (N-WBQ). Participants were distributed across breastfeeding groups as follows: exclusive (39.7%), mixed (31.9%), and no breastfeeding (28.4%). Significant differences were noted in water consumption patterns among breastfeeding groups regarding intake from beverages (p < 0.001), juices (p = 0.019), coffee (p < 0.001), and milk (p = 0.015). Water intake from liquids, except for drinking water (p < 0.001), juices (p = 0.024) and coffee (p < 0.001) differed significantly among groups in women with adequate total water intake based on recommendation, with exclusive breastfeeding mothers prioritizing plain water over other beverages. Total water loss (p < 0.001) and estimated water balance (p < 0.001) significantly varied among breastfeeding groups, with exclusive breastfeeding mothers to exhibit the lowest water balance (-475.36 mL/day), indicating potential dehydration risk. Apart from plain water, water from foods, coffee and milk significantly contributed to positive water balance. Our findings highlight a risk of dehydration in this population, while water consumption patterns are influenced by breastfeeding method, likely affected by varying lactational demands and lifestyle factors. Further research to develop more accurate and individualized methods for assessing water balance in breastfeeding women is needed.

The Role of Breastfeeding in Acute Respiratory Infections in Infancy.

Acute respiratory infections (ARIs) affect the respiratory tract, are often caused by viruses such as respiratory syncytial virus and rhinovirus, and present symptoms such as coughing, fever, respiratory distress, and breathing difficulty. The global adherence to exclusive breastfeeding (BF) for the first 6 months of life has reached 44%, supported by the World Health Organization and United Nations International Children's Emergency Fund efforts. BF provides vital nutrients and contributes to infant immune system development, protecting against infections. The role of BF in preventing and reducing complications of ARIs in infants is gaining attention, prompting a review of current data and future research needs. This review aims to summarize the evidence on the role of BF in reducing the risk and severity of ARIs in infants, elucidate the adaptations in breast milk composition during infections, and identify relevant research needs. Human milk (HM) is rich in immunoglobulins, antimicrobial peptides, and immunomodulatory factors that protect against various pathogens, including respiratory viruses. Several studies have demonstrated that BF is associated with a significant reduction in hospitalization, oxygen requirements, and mortality in infants with ARIs. The effectiveness of BF varies according to the specific respiratory virus, and a longer duration of exclusive BF appears to enhance its protective effect. It is documented that the composition of HM adjusts dynamically in response to infections, fortifying the infant's immune defenses. Specific immunological components of HM, including leukocytes and immunoglobulins, increase in response to infection in the infant, contributing to the enhancement of the immune defense in infants. Immune-boosting microRNAs enhance immune transfer to the infants and promote early gut maturation, and the HM microbiome along with other factors modifies the infant's gut microbiome and immune system. BF defends infants from respiratory infections, and the investigation of the microRNAs in HM offers new insights into its antiviral properties. The promotion of BF, especially in vulnerable communities, is of paramount importance in alleviating the global burden of ARIs in infancy.

The Effect of Providing Exclusive Breastfeeding Counseling on the Self-Efficacy of Breastfeeding Mothers

Exclusive breastfeeding is a baby's best food for growth and development in the first six months. Breastfeeding mothers need high confidence and self-efficacy that they can provide breastmilk for their babies. The provision of counseling services allows mothers to gain a comprehensive understanding of proper breastfeeding techniques and the benefits of breast milk for infants. This study aimed to determine the effect of exclusive breastfeeding counseling on breastfeeding mothers' self-efficacy.This study was a pre-experiment study with a one group pretest-postest design. The sample in this study amounted to 33 exclusive breastfeeding mothers ≤ 6 months which is the total pupulation. The data obtained were processed and analyzed with the Wilcoxon Signed Rank test.The results of the statistical test analysis showed a change in efficacy after counseling of 15.50 with a significance value (Sig.) of 0.000. That is, there is an effect of exclusive breastfeeding counseling on the self-efficacy of breastfeeding mothers.The conclusion of this study is that there is an effect of exclusive breastfeeding counseling on the self-efficacy of breastfeeding mothers. It is hoped that this research can be used as information to carry out midwifery care, so that officers can provide maximum services to improve the quality of health services, especially counseling and providing information about the importance of exclusive breastfeeding so that there is no drop out and breastfeeding continues for up to 2 years.

An evidence-based nipple care pathway for new breastfeeding mothers: a Delphi study

Background/Aims Only 1% of UK mothers maintain exclusive breastfeeding for the first 6 months, as per global recommendations. Early breastfeeding cessation often involves complex issues, with nipple-related injuries being a common cause. This study aimed to develop an evidence-based tool for early identification and management of breastfeeding-related nipple injuries through expert consensus. Methods A mixed method approach was used, including a 5-stage scoping review and a modified Delphi consensus technique with 26 UK-based maternal health experts and experienced breastfeeding mothers. Results Consensus (80% agreement) was reached on recommendations, including the provision of realistic information, early peer support engagement and Lanolin use. Some commonly recommended practices, such as letting the nipple air dry, did not reach consensus, highlighting a misalignment between expert consensus and published guidance. Conclusions This study generated evidence-based, expert-validated self-management guidance, emphasising the need for improved stakeholder engagement in policy development.

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.

Empowering Health Cadres Through Oxytocin Massage Training Activities as an Effort to Increase Milk Production

Breast milk is the best source of nutrition for babies, providing nutrients, growth factors and antibodies in sufficient quantities for baby nutrition. However, the lack of breast milk is one of the causes of not achieving exclusive breastfeeding coverage in several areas. One effort that can be made to increase breast milk production is through oxytocin massage. Oxytocin massage is a massage carried out along the spine (vertebrae) to the fifth-sixth ribs. This massage is done to stimulate the oxytocin reflex or breast milk reflex. Mothers who receive this oxytocin massage will feel more relaxed. The method used in this community service activity is through providing materials and training on oxytocin massage to 30 cadres in the Pegerngumbuk Village area, Wonoayu District, Sidoarjo Regency. The results obtained from this activity were an increase in cadres' knowledge about oxytocin massage and almost all cadres were able to do oxytocin massage. So that after this training activity cadres can apply oxytocin massage periodically to breastfeeding mothers in their area and teach these skills to the families of breastfeeding mothers.

Application of The Tri Core Breastfeeding Model Using Audiovisual-Based E-Modules to Increase The Motivation Of Working Mothers in Exclusive Breastfeeding in The Working Area of The Wonoayu Sidoarjo Health Center

The tri core breastfeeding model is a health education model for breastfeeding mothers that includes three main aspects: lactation education, self-efficacy or increased confidence in breastfeeding mothers, and support from the surrounding environment. The importance of increasing self-confidence when breastfeeding, especially in working mothers, is something that needs to be considered. The government's efforts to increase exclusive breastfeeding coverage are contained in Government Regulation No.33/2012 on breastfeeding. This study aims to analyze the application of tri core breastfeeding models using audiovisual-based e-modules to increase the motivation of working mothers in exclusive breastfeeding. This study used a quasy experiment method with a non-equivalent control group design. The intervention group (18 people) used e-modules, while the control group used e-leaflets (18 people). The results of this study obtained ρvalue 0.000 &lt; α = 0.05. It can be concluded that there is a significant difference between the use of audiovisual-based e-module media and e-leaflets on increasing motivation for exclusive breastfeeding in working mothers. Data analysis in this study used marginal homogeneity test and mann whitney test. The application of tri core breastfeeding models using audiovisual-based e-modules is expected to be able to increase exclusive breastfeeding coverage in working mothers.

Ann Yearsley and the Poetics and Politics of Breastfeeding

ABSTRACT This article argues that Ann Yearsley, a milkwoman, mother, and poet, not yet fully recovered into the British literary canon, challenges stereotypical representations of breastfeeding mothers created and perpetuated primarily by male authors in Romantic poetry, philosophy, and medical discourse. Her poem “To Mira, on the Care of Her Infant” depicts breastfeeding as a complex labor that requires skill, intelligence, empathy, and discipline. In this poem, Yearsley rejects the arguments of Romantic writers such as William Wordsworth, Jean-Jacques Rousseau, and William Cadogan, who depict nursing mothers as passive vessels of milk or substitutes for a nurturing “mother nature.” I further locate Yearsley in rich networks of subscribers, printers, and periodicals adjacent to canon authors and texts. Thinking particularly about the conventions of epic and georgic forms, and their relationship to nationalism, labor, and motherhood, I ultimately show how Yearsley recasts the nursing mother as a subject rather than an object.

The Phenomenon of Human Migration on the Breastfeeding Practices of Migrant Women: A Scoping Review.

Human migrations and different migratory flows have been as old as the practice of breastfeeding (BF). The reasons for migrating, the conditions, and its protagonists are so diverse, often constituting situations of vulnerability and risk for health decision-making at both the individual and collective levels. The relationship between BF and human migration is totally dynamic and includes multiple factors, which is why there is a need to characterize territorially its prevalence rate and variability depending on the context. The migration profiles that can be configured from factors, such as schooling, employment, the host country's health system, and support networks, among others, have heterogeneity between countries that make it necessary to identify them. This study is an in-depth review of the report on the practice of BF in migrant women.The Arksey and O'Malley method was used to perform the PubMed and SciELO searches. The search terms were "exclusive breastfeeding (EBF)," "breastfeeding," "migrant women," and "human migration," and original articles published in English, Spanish, and Portuguese were included.Of the 43 selected articles, differences were found between the various migrant groups, in variables such as socioeconomic level, education, access to health services, maternal knowledge, father factor, culture, and intention to breastfeed. The heterogeneity of the practice of BF between countries, as well as in intraregional migratory flows, establishes different protective or risk factors depending on where the phenomenon develops and its conditions.

Perception and Practice of Sub-Himalayan Region Mothers for Breastfeeding: A Cross-Sectional Survey

Abstract Background: Breast milk is an ideal food for neonates, which is also beneficial for mothers. Nowadays, modern mothers choose not to breastfeed their babies. The World Health Organization also recommends continuous breastfeeding of babies for up to 2 years. The present study focuses on assessing the perception and practice of mothers for exclusive breastfeeding in the sub-Himalayan region of India. Materials and Methods: A cross-sectional study was conducted among postnatal mothers who were attending pediatric outpatient departments (OPDs) and immunization clinics at All India Institute of Medical Sciences, Rishikesh, India. Interview schedules were conducted to assess knowledge and skills, and data related to breastfeeding were collected from 210 mothers. Purposive sampling techniques were used to select each participant. Results: The mean age of mothers was 26.8 years, 56% had previous experience of breastfeeding, 76% had a cesarean delivery, and 70% had started breastfeeding within 1 h. More than half (53%) of the mothers had inadequate knowledge of breastfeeding. On the Iowa Scale, only 8% of mothers reported a very positive attitude toward breastfeeding. On the Bristol scale, 81% of mothers reported that they were following good breastfeeding practices. Conclusions: The study concludes that sub-Himalayan mothers have inadequate knowledge of breastfeeding, but their practices are still suboptimal. We recommend more public health awareness programs to promote breastfeeding in this region.

Domestic fish for more versatile and safer consumption EU‐fish IV

Abstract Fish is an important part of nutrition and well‐being. The challenge of Finnish wild fish is contaminants which accumulate in some species in higher concentrations, partially limit the usability of the fish in the food/feed market and weaken the assessment of the state of the marine environment. The aim of this study was to obtain data on the amounts of nutrients and contaminants in domestic fish species that are commercially important or should be increased in use according to national plans. The aim was also to produce information for updating the national fish use recommendations. The concentrations of contaminants in Finnish fish were mostly below the maximum levels set by the EU. The trend of dioxin and PCB compound concentrations in the Baltic Sea has been declining since the 1980s, and the concentrations in Baltic herring appear to have settled around or below the maximum levels in all sea areas and size classes. The PFAS concentrations in the studied fish samples were within the maximum limits, except for Baltic herring in the Archipelago Sea and the Bothnian Sea. Additionally, the PFAS concentrations in Baltic herring rose quite sharply between 2009 and 2023. During the current study, PFAS concentrations in Baltic herring from the same sea area and size classes increased significantly from autumn 2022 to spring 2023. The seasonal trend was suspected to be related to the fish's diet, but factors affecting PFAS concentrations in fish, such as the impact of seasons and fitness (function of weight and size of the fish), need further investigation, and PFAS concentrations in Baltic herring should be monitored. PBDE concentrations in Finnish fish were found to be very low, although they exceeded the environmental quality standard. Mercury concentrations in fish, except for two samples, were lower than the maximum levels set by Commission Regulation (EU) 2023/915. The proportion of methylmercury in total mercury was 56–94% in different fish species. Inorganic arsenic concentrations in all fish samples were below the detection limit of 0.01 mg/kg. The highest concentrations of omega‐3 fatty acids were measured in Baltic herring and vendace. Fish caught from marine areas had higher vitamin D concentrations than those from inland waters, and there was significant variation in concentrations within fish species. With current food consumption and concentration data, the health benefits of fish consumption outweigh the health risks associated with contaminants in fish for all age groups. The greatest health benefits are seen in those over 45 years old, where fish consumption reduces the burden of diseases such as cardiovascular diseases and breast cancer, as well as overall mortality. On a national scale, the current use of domestic and imported fish is estimated to reduce the disease burden annually by nearly 70,000 disability‐adjusted life years (DALYs). As a conclusion, the health benefits of fish consumption outweigh the harms of contaminants in all age groups. Increasing the consumption of fish in accordance with nutritional recommendations would benefit the health of the population. For children and expectant or breastfeeding mothers, a diverse fish consumption is useful. The safe use recommendations of the Finnish Food Authority help this risk group to direct their fish consumption to fishing areas and fish species with the lowest amounts of contaminants.

Protection from environmental enteric dysfunction and growth improvement in malnourished newborns by amplification of secretory IgA

Environmental enteric dysfunction (EED) is a condition associated with malnutrition that can progress to malabsorption and villous atrophy. Severe EED results in linear growth stunting, slowed neurocognitive development, and unresponsiveness to oral vaccines. Prenatal exposure to malnutrition and breast feeding by malnourished mothers replicates EED. Pups are characterized by deprivation of secretory IgA (SIgA) and altered development of the gut immune system and microbiota. Extracellular ATP (eATP) released by microbiota limits T follicular helper (Tfh) cell activity and SIgA generation in Peyer's patches (PPs). Administration of a live biotherapeutic releasing the ATP-degrading enzyme apyrase to malnourished pups restores SIgA levels and ameliorates stunted growth. SIgA is instrumental in improving the growth and intestinal immune competence of mice while they are continuously fed a malnourished diet. The analysis of microbiota composition suggests that amplification of endogenous SIgA may exert a dominant function in correcting malnourishment dysbiosis and its consequences on host organisms, irrespective of the actual microbial ecology.

The impact of exclusive breastfeeding on breastfeeding duration

BackgroundWhile breastfeeding is globally recommended, its duration still represents a public health issue. AimTo examine the association between the period of exclusive breastfeeding (EBF) and the duration of overall human milk nutrition, and to identify determinants associated with the duration of EBF and overall human milk nutrition length. Study designThe presented study is a cross-sectional study. A total of 209 healthy Polish women of Caucasian origin, aged 19–42 years, who were the mother of a child aged 3–12 months, were enrolled in the study. Data were collected from 2018 to 2020 using an anonymous questionnaire. Statistical analyses included one way ANOVA and liner regression. ResultsAfter birth almost all newborns were exclusively breastfed (96.7 %), but the supply of mother's milk declined as the children's ages increased. The duration of breastfeeding is strongly associated with EBF, especially until the child is six months old (p < 0.001). Mother's breastfeeding self-efficiency and her will for breastfeeding, comfortable latch, younger infant age, avoiding of a pacifier and excluding additional food may explain 36 % of variation of EBF duration (p < 0.001) and could be useful information for exclusive breastfeeding support. ConclusionsThe practice of exclusive breastfeeding strongly affects overall breastfeeding duration. The promotion of exclusive breastfeeding, rather than of overall breast milk supply, is crucial.

Effectiveness of a home-based peer support programme for Chinese mothers with low breastfeeding self-efficacy to increase the exclusivity and duration of breastfeeding: study protocol of a randomised control trial

IntroductionBreastfeeding is associated with many health benefits for both women and their newborns. Exclusive breastfeeding has been recommended for at least 6 months to optimise infant growth, development and health....

Prevalence of Breastfeeding among Working versus Nonworking Mothers in Saudi Arabia: A Regional Cross-sectional Study

Background: Breastfeeding practices in Saudi Arabia may vary between working and non-working mothers. Working hours and work-related responsibilities may be obstacles to exclusive breastfeeding (EBF). Objectives: This study aims to investigate the prevalence of breastfeeding among working versus non-working mothers in Jeddah, Saudi Arabia and to investigate barriers to EBF among working mothers. Methods: This was a cross-sectional survey-based study, in which 507 women were surveyed, predominantly aged 26–33 years. The data were collected through an online self-administered questionnaire sent randomly through social media. The Chi-squared test was employed to assess the prevalence and the factors influencing the choice of breastfeeding methods in these groups. Results: EBF rate was 82% and 85.5% in non-working and working mothers, respectively. Exclusively breastfeeding mothers favored direct breastfeeding (54%) and mostly breastfed for over 6 months of their infants’ age (92%), whereas non-EBF mothers favored a combination of milk pumps and direct breastfeeding (P ≤ 0.001). The majority of working mothers strongly agree with the continuation of breastfeeding for the first 6 months of the child’s life if the workplace provides special breastfeeding facilities, provides paid maternity leave, or if they get help with housework. Conclusion: There was no difference in the duration of breastfeeding in working mothers compared to nonworking mothers. Working mothers report many barriers to breastfeeding, and those strategies should be targeted by governmental programs to enhance EBF practices.

Assessing Urinary 8-OHdG: A Comparative Analysis between Benign Breast Diseases and Healthy Participants

Background: Benign breast problems account for a considerable share of diagnoses for breast diseases, which is a major global health concern. The study investigates the correlation between urinary 8-OHdG levels and benign breast illnesses, aiming to identify oxidative stress variations, aid in developing targeted therapies and personalized healthcare plans. Methods: This comparative study evaluated urinary 8-OHdG levels in patients with clinically suspected breast lump cases at Bangabandhu Sheikh Mujib Medical University, Dhaka. The sample included 30 healthy individuals and 30 patients with benign breast disorders. Important variables included oestrogen replacement medication, alcohol intake, age of menarche, menopause, obesity, and urinary 8-OHdG levels. Results: The study analysed 60 participants with benign breast diseases, revealing significant differences in age distribution, menarche age, BMI categories, demographic and reproductive factors, and urine 8-OHdG levels. Multiple logistic regression analysis revealed significant associations between urinary 8-OHdG concentrations and factors like age, OCP consumption history, marital status, age of menarche, breast feeding history, menopausal status, family history of breast cancer, and histopathological grading. However, body mass index and number of parities did not show significant associations with urinary 8-OHdG concentrations.

Husband Support and Coping Stress on Exclusive Breastfeeding in Primipara

Breastfeeding is the best strategy to ensure optimal growth and development for infants. Social support, fatigue, and stress are the main factors that hinder breastfeeding for primiparous mothers. This cross-sectional study analyzes husband support and coping stress of exclusive breastfeeding for primiparous mothers with a quantitative approach. The samples were 70 respondents taken with a total sampling technique. The research instruments were the husband support questionnaire and coping strategies inventory. The researchers analyzed the data with chi-square and multiple logistic regression. The results found 48 (68.5%) mothers with excellent husband support and exclusive breastfeeding. Meanwhile, mothers with excellent husband support but without exclusive breastfeeding were 18 respondents (25.71%). The results of statistical tests with a significance level of 5% obtained a sig value (p-value) of husband support (p=0.002) and coping stress p=0.000. The result indicates a correlation between husband support and coping stress on exclusive breastfeeding with OR value = (3.667). On the other hand, mothers with excellent husband support could provide exclusive breastfeeding 4 times higher than those with poor husband support. Husband support and coping stress affect exclusive breastfeeding of primiparous mothers in the employed area of Puskesmas Dinoyo Malang City. Coping stress is the dominant factor influencing exclusive breastfeeding in primiparous mothers in the employing area of Puskesmas Dinoyo Malang City. The research recommends public health centers improve programs that support maternal care in helping to improve skills in managing stress, on exclusive breastfeeding both at the public health center, the integrated public health service, and the auxiliary health center.

Counseling Regarding Stunting Prevention in Toddlers

Stunting is a serious challenge because it can hinder a child's growth and development. This condition is triggered by malnutrition, repeated infections, and lack of adequate psychosocial stimulation, and is characterized by the child's height being below the appropriate standard. The main causes of stunting are poor parenting patterns, unhealthy eating patterns for pregnant and breastfeeding mothers, lack of nutritional and protein intake, and children's high vulnerability to disease. This community service activity was carried out in Sidoharjo Village – I Pasar Miring, Pagar Merbau District, Deli Serdang Regency with a total of 26 participants. The aim of this activity is to provide education regarding stunting prevention in Sidoharjo Village – I Pasar Miring. The main target of this counseling is mothers who have children under five. Implementation of this activity involves collaboration with village officials and village midwives. The method used was presentation of material through lectures and giving leaflets. The material presented includes the concept of stunting, its causes, symptoms, and how to prevent it, including information regarding the contents of my plate. The results of this activity show an increase in participants' understanding of stunting, its causes, symptoms and how to prevent it. In addition, there is increased awareness in dealing with the symptoms of stunting, with the hope of reducing the risk of stunting in children. It is hoped that in the future, activities like this will continue to be carried out so that stunting in toddlers can be avoided.