Breastfeeding Comfort Research Articles

Bantal Menyusui Memengaruhi Motivasi, Produksi ASI, dan Musculoskeletal Disorder pada Ibu Menyusui

Breastfeeding in a sitting position for 30 minutes with the mother's hand supporting the baby causes maternal fatigue. One way to increase motivation, breast milk production and reduce musculoskeletal disorder is by using a breastfeeding pillow. The purpose of this study was to determine the effect of using a breastfeeding pillow on motivation, milk production, and musculoskeletal disorder of breastfeeding mothers in the Pringsewu Regency in 2020. This study is a quasi-research. experiment with post-test design with control group design. The sampling technique was purposive sampling, the number of samples was 48 breastfeeding mothers 0-1 months. The intervention group used a redesigned breastfeeding pillow, the control group used a regular breastfeeding pillow. The data were processed with univariate (mean) and bivariate analysis with Independent T-Test and Hotelling T-Test. The results showed that on average the respondents had the motivation to breastfeed in the high category, breast milk production in the good category, and musculoskeletal disorder in the not sick category. There were significant differences in motivation for breastfeeding, milk production, and musculoskeletal disorders between the group of mothers who used the redesigned breastfeeding pillow and the group that used the regular breastfeeding pillow. To midwives to promote the use of redesigned breastfeeding pillows to help increase motivation, milk production, and breastfeeding comfort so that musculoskeletal disorders do not occur and researchers can conduct further research with other variables that can affect motivation, milk production, and musculoskeletal disorders in breastfeeding mothers.

Effect of Introduction of a Lactation Counselor on Breastfeeding Uptake and Satisfaction in an Urban Prenatal Clinic [39A

INTRODUCTION: To assess the association between introduction of a full-time lactation counselor (LC) and breastfeeding outcomes. METHODS: This is a prospective observational study of low-income, minority women receiving care in a publicly funded prenatal clinic 6 months before and after introduction of a LC. The LC provided inpatient and outpatient one-on-one antenatal and postpartum lactation education and support. Chart review and survey data were collected to compare women receiving care before versus after LC introduction. The primary outcome was breastfeeding continuation (exclusive or partial) at 6 weeks postpartum; secondary outcomes included breastfeeding comfort, confidence,and training satisfaction. Bivariable and multivariable analyses were utilized as appropriate. RESULTS: Of 218 women, 54.6% were post-LC introduction; there were no demographic differences between cohorts. Factors associated with breastfeeding continuation included greater maternal education (aOR 4.10, 95% CI 1.73-9.69) and breastfeeding comfort and confidence (aOR 3.04, 95% CI 1.34-6.91; aOR 4.56, 95% CI 1.81-11.46). Women with LC were more likely to be satisfied with BF training (98.2% vs 84.5%, p=.01), and were more likely to have performed any breastfeeding (89.7% vs 73.6%, p=.007), which remained significant on regression analysis (aOR 3.41, 95% CI 1.35-8.63). However, LC was not associated with continued BF at 6 weeks (aOR 1.28, 95% CI 0.69-2.38). CONCLUSION: Continued breastfeeding at 6 weeks postpartum among low-income, minority women was associated with greater maternal education and with breastfeeding comfort and confidence. Lactation counselor introduction was associated with improved breastfeeding training satisfaction and increased rates of any breastfeeding, but was not associated with continued breastfeeding at 6 weeks.

Cesarean analgesia using levobupivacaine continuous wound infiltration: a randomized trial

ObjectiveNeuraxial morphine is considered as a “gold standard” for pain relief after cesarean section, however it causes bothersome side effects. Alternative analgesia including nonsteroidal antiinflammatory drugs (NSAID) has been proposed. We aimed to assess the morphine sparing effect of continuous wound infiltration with a local anesthetic, when added to multimodal systemic analgesia including NSAID without subarachnoid morphine. Study designSixty-eight women scheduled for elective cesarean section under spinal anesthesia were included in a randomized controlled open-label trial. Patients received bupivacaine spinal anesthesia without intrathecal morphine. Postoperative analgesia consisted for all patients in multimodal systemic analgesia with acetaminophen, nefopam, celecoxib, and patient-controlled intravenous morphine for 24h. The intervention group also received subfascial levobupivacaine infiltration through a multi-holed catheter, at 6.25mg/h for 48h. The primary endpoint was total morphine consumption at 24h postoperatively; and secondary endpoints were pain scores, side effects, breastfeeding comfort, maternal satisfaction, and nurse workload. Student t test, Mann–Whitney test or χ2 test were used when appropriate. ResultsThe intervention group had 6.7mg less morphine consumption (95%CI −1.3mg; −12mg, P=0.02), and 0.8 pain point less at rest on the numerical rating scale 0–10 (95%CI −0.3; −1.3, P=0.002). The intervention was associated with significantly better breastfeeding comfort (+1.7 at numerical rating scale score 0–10, 95%CI +0; +3.3, P=0.0498). Wound dressing changes were required in a significantly higher proportion of intervention-group women (12/34 vs. 1/34, P=0.002). ConclusionAdding continuous levobupivacaine infiltration to multimodal analgesia after cesarean section without subarachnoid morphine decreased postoperative morphine consumption and pain, facilitated breastfeeding initial comfort, and slightly increased nurse workload.

Comfort with the Idea of Formula Feeding Helps Explain Ethnic Disparity in Breastfeeding Intentions Among Expectant First-Time Mothers

Little is known regarding modifiable factors that may explain sociodemographic disparities in breastfeeding rates among women in the United States. Using a mediation model approach, we examined the relative contributions of breastfeeding and formula feeding psychosocial factors in explaining disparities in breastfeeding intentions. We interviewed 532 expectant first-time mothers regarding exposure to breastfeeding by others (breastfeeding exposure), comfort with ideas of breastfeeding (breastfeeding comfort) and formula feeding (formula feeding comfort), and breastfeeding self-efficacy. We used logistic regression to evaluate the independent and mediating effects of these variables on strength of intention to fully breastfeed for 6 months (breastfeeding intention). The ethnic distribution of the sample was 41% white, non-Hispanic; 27% Hispanic; 14% African-American; 12% Asian; and 6% mixed or other ethnicity. In the overall sample, formula feeding comfort, breastfeeding comfort, and breastfeeding self-efficacy all independently predicted breastfeeding intention (p < 0.0001), but formula feeding comfort had the largest effect: adjusted odds of stronger breastfeeding intention increased threefold for each 1-level decrease (among four levels) in formula feeding comfort. The unadjusted odds (95% confidence interval) of stronger breastfeeding intention were 0.37 (0.24-0.58) for African-American versus non-African-American women; African-American women had higher formula feeding comfort (2.08 [1.32-3.29]) but similar breastfeeding comfort, breastfeeding self-efficacy, and breastfeeding exposure. Formula feeding comfort mediated 37% of the disparity in breastfeeding intentions between African-American and non-African-American women. Formula feeding comfort strongly predicted and substantially mediated ethnic disparity in breastfeeding intention. These results suggest that research and public health efforts aimed at increasing exclusive breastfeeding rates should include consideration of formula feeding attitudes.