Breastfeeding Difficulties Research Articles

Management of natal tooth of a 2 months old infant: a case report

Natal and neonatal teeth are the type of supernumerary tooth which have various myths and superstitions associated with it. Natal teeth are the teeth which appear at the time of the birth whereas neonatal teeth appear within one month of life. Presence of natal teeth often risks the aspiration of teeth by infant and the mother also has difficulty in breast feeding and comes with the complaint of the same. The present case report of 2-month-old infant describes the management of natal teeth present in mandibular arch with mobility. After the consent of parents, the extraction of the shell-like tooth was done immediately and hemostasis was achieved. The follow up was carried out after 1 week to examine the normal healing of extraction site.

Interdisciplinary Management of an Adolescent Cleft Patient with Skeletal Class III Malocclusion: A Case Report

Cleft lip and palate are the most frequently observed congenital abnormalities affecting the maxillofacial region. They can occur isolated or together in various combinations. These deformities are also associated with features found in over 300 recognised syndromes. Additionally, there are several problems, including social limitations, such as difficulties in breastfeeding resulting in failure to grow properly, speech abnormalities, hearing loss, misalignment of teeth, significant facial abnormalities, and serious aesthetic, psychological, and psychosocial challenges. Treatment modalities involve a number of specialists, such as Maxillofacial and Plastic surgeons, Anaesthetists, Orthodontists, Restorative dentists, Paediatric dentists and Prosthodontists, who collaborate to determine the best treatment plan based on the site of the defect and the patient's age. The present case report discusses the treatment and management of a 16-year-old female patient who presented with cleft lip and palate, along with skeletal class III malocclusion, hypodontia, multiple decayed teeth and dental malformation. The patient had missing lateral incisors and canines in the maxillary arch, along with carious maxillary central incisors. The purpose of this article is to report the multidisciplinary management of a unilateral cleft lip and palate patient with class III malocclusion, utilising orthognathic surgery, as well as, incorporating endodontic and prosthodontic corrections.

Infection of Fetal Membranes with Mycobacterium tuberculosis and Tissue Processing to Isolate RNA for Expression Analysis.

This chapter outlines the methodology employed to infectthe chorionic and amniotic membranes with Mycobacterium tuberculosis during pregnancy. Particularly, congenital tuberculosis, a rare and serious condition associated with cases in neonates and reactivation of latent tuberculosis in pregnant mothers, is interesting to study. Understanding the mechanisms of infection and the response of fetal membranes is crucial for developing effective treatments in these cases, which will promote better neonatal and maternal health in situations of tuberculosis during pregnancy. Establishing a standardized infection model in the chorioamniotic membranes is imperative, followed by a treatment protocol for isolating both cellular and mycobacterial RNA. This will enable the expression analysis during the maternal-fetal interface interaction with M. tuberculosis. The proposed methodology might be invaluable for qRT-PCR, microarrays, and sequencing research.

Breastfeeding outpatient in primary care as an important action to promote breastfeeding: experience report.

This paper describe a successful experience of promotion, prevention and support for breastfeeding developed by professionals from a basic health unit. This is a Breastfeeding Outpatient Clinic, implemented in a health center in Belo Horizonte, in August 2019. The Outpatient Clinic was established based on the perception of the unit's team that many mothers had difficulty breastfeeding, however, due to the work overload of this team, this assistance did not occur in a timely manner, resulting in early weaning. Initially, a meeting was held to sensitize the team on the breastfeeding indicators of the unit. Based on this knowledge, the implementation of a breastfeeding Outpatient clinic was proposed, aimed not only at dyad with difficulties in managing breastfeeding, but at all postpartum women in the area covered by that health center. A flow was created, through which it was established that all postpartum women who brought their children to carry out the heel prick test at the unit would be referred to the Breastfeeding Outpatient Clinic to perform this service. With the improvement of care, the users of the health center started to breastfeed for longer, which reflected in the improvement of the unit's indicators.

Common maternal health problems and their correlates in early post-partum mothers.

Mothers experience a wide range of maternal health problems after childbirth, which in turn, affect their well-being and ability to care for their newborn. These problems may be influenced by factors such as mode of delivery or socio-economic status. This study aims to investigate the prevalence of common maternal health problems and their correlates in a public primary healthcare institution in Singapore. This was a cross-sectional study, based on a self-administered questionnaire. A total of 373 mothers (mean age 31.9 years) who accompanied their infants for their 4- to 8-week development assessments at a public primary care clinic in Singapore completed a self-administered questionnaire from June 2021 to December 2021. The questionnaire assessed demographic factors, mode of delivery, number of children, number of individuals providing significant help, and the frequency of common physical and mental maternal health problems using a 5-point Likert-type scale. The five most common maternal health problems were fatigue (77.7%), lower back pain (59.3%), Caesarean wound pain (54.3%), upper back pain (53.0%) and vaginal pain (41.2%). The prevalence of depression and anxiety was 22.0% and 11.3%, respectively. With respect to the symptoms' correlates, pain on passing urine was more frequent after assisted vaginal deliveries than all other forms of deliveries (all pairwise p < 0.01), and pain on passing motion was more frequent in vaginal deliveries than in Caesarean deliveries (all pairwise p < 0.05). Mothers having a larger number of children more frequently experienced headaches (β = 0.17, SE = 0.05, p = 0.002) and less frequently experienced breastfeeding difficulties (β = -0.28, SE = 0.08, p < 0.001). Mothers experienced a high prevalence of maternal health problems in multiple domains during the first 8 weeks after childbirth. Mode of delivery and number of children were associated with increased prevalence of certain problems. Mothers' physical and mental well-being should be investigated early after delivery and addressed with adequate treatments and resources.

Congenital tuberculosis: report of one case

La tuberculosis (TB) es una de las principales enfermedades infecciosas a nivel mundial y sigue siendo un grave problema de salud pública en muchos países. La Organización Mundial de la Salud (OMS) estima que un tercio de la población está infectada con TB y la tasa de infección aumenta casi un 1% por año. Esta revisión tiene como objetivo exponer la identidad de la tuberculosis congénita rara y fatal si no se trata y resaltar las características clínicas y la dificultad de diagnóstico y la conciencia entre los pediatras para realizar un manejo terapéutico inmediato desde el inicio de la sospecha. Este estudio se propone detectar que el pronóstico es malo para los recién nacidos, seguido de una evolución fatal cuando el diagnóstico se retrasa. Se presenta a continuación el caso de un recién nacido de sexo masculino de 24 días de vida por parto cesárea, por RPM nacido de una madre que presentó infección por SARS-COV-2 14 días previos al parto. A los 5 días de post parto adormecimiento y debilidad de miembros inferiores, sin síntomas respiratorios, posteriormente fiebre de 5 días de evolución, con diagnóstico de TB cerebral sin síntomas respiratorios, RN con fiebre y tos de 3 días, hepatomegalia de 4.5 cm, sin adenopatías. Ecografía abdominal dentro de parámetros normales, ecocardiograma con despegamiento pericárdico laminar, ecografía cerebral, ecografía abdominal fondo de ojo dentro de parámetros normales. Radiografía de tórax mostró infiltrado nodulillar difuso bilateral compatible con diseminación miliar tuberculosa. Al ingreso se inició cobertura antibiótica con Cefotaxima más Ampicilina a dosis meníngea. Analítica laboratorial al ingreso perfil hepático alterado, glóbulos blancos en rango, presentó granulaciones toxicas 3% y reactantes de fase aguda aumentados. Se realizó punción lumbar con cultivo de LCR negativo para gérmenes comunes y micobacterias por lo cual se descendió antibioticoterapia a completando 9 días totales. En muestras seriadas durante 3 días de líquido gástrico tinción de Ziehl-Neelsen BAAR +++ en las 3 muestras, GENEXPERT M. tuberculosis detectado y secreción traqueal tinción de BAAR +++. Inició terapia antibacilar H10/R20/Z20/E20. Durante su internación presenta alteración de perfil hepático por lo cual se ajusta dosis H5/R10/Z15/E15 en conjunto con Piridoxina. Durante tratamiento antibacilar a los 10 meses presentó en ecografía abdominal múltiples calcificaciones en hígado y ecografía cerebral de control con dilatación leve de los ventrículos laterales en ambos lados. Al finalizar tratamiento al examen físico se constató hígado a 2 cm RCD al año de vida, crecimiento y desarrollo normal para la edad, controles oftalmológicos y auditivos sin hallazgos patológicos. El recién nacido recibió 2 meses de HRZE y 10 meses de HR completando 12 meses totales de tratamiento en conjunto con Piridoxina hasta 10 días posterior a la suspensión de antibacilares y la madre recibió 4 meses de HRZE y 8 meses de HR completando 12 meses de tratamiento antibacilar.

An interpretive phenomenological analysis of the experiences of mothers who continue to breastfeed despite facing difficulties

BackgroundBreastfeeding offers many health benefits to mother and infant. ProblemBreastfeeding difficulties are common and are linked with postnatal distress. AimTo explore the lived experiences of breastfeeding continuation despite facing difficulties. MethodsQualitative semi-structured interviews were conducted with eight women who had experienced breastfeeding difficulties yet continued breastfeeding. Interviews were analysed using Interpretative Phenomenological Analysis (IPA). FindingsThe first superordinate theme, ‘Radical acceptance of the imperfect’ included sub-themes of: ‘Taking it day-by-day’, ‘Breastfeeding takes a community’, and, ‘Finding what works for you’. The second superordinate theme, ‘Determination and persistence’ included sub-themes of: ‘Adopting a headstrong attitude’ and ‘Transient challenges versus lifelong achievement’. DiscussionParticipants found radical acceptance of breastfeeding as an imperfect, variable process which enabled them to sustain breastfeeding despite challenges. Participants proactively drew on social and personal resources to navigate guidance and to find solutions which worked for their individual circumstances. Finally, open-mindedness, optimism, self-compassion, and being headstrong and determined were all personal qualities which facilitated breastfeeding during exceptionally difficult moments on their breastfeeding journey. ConclusionRecommendations are made for healthcare professionals: to provide emotional counselling during routine care (with an aim to instil breastfeeding self-efficacy) and to encourage breastfeeding advocacy among fathers and the maternal social support network (with an aim to further scaffold successful breastfeeding). Recommendations are also made for mothers: to develop and refine maternal confidence, patience, flexibility, self-compassion, and trust.

Traditional uvulectomy; practice and belief among Sudanese children in Khartoum hospitals: A multi-center cross-sectional study

BackgroundTraditional healing practices are common in Sub-Saharan Africa. Traditional uvulectomy (TU) is the removal of the uvula with a sharp curved knife and is often practised in children under five years old. This practice is believed to have a therapeutic effect on children suffering from sore throat, vomiting or difficulty breastfeeding. ObjectivesThis study aimed to describe the practice of traditional uvulectomy and Sudanese mothers’ perception of it. MethodsA cross-sectional study was conducted in seven teaching hospitals across Khartoum State. We interviewed 385 mothers of children who presented to pediatric units using a semi-structured questionnaire. The study period spanned from July 2022–February 2023. ResultsA total of 385 mothers of children under five participated in this study. 33 % of mothers believed in the practice of traditional uvulectomy, yet only 17.9 % of children under five years had undergone TU. Reasons for performing TU included persistent cough (36.9 %), vomiting (33 %), difficulty in breastfeeding (22.6 %) and TU being a family tradition (25.7 %). Factors significantly associated with these practices were the mother's age, her level of education and the family's regional origin. Mothers reported that no major complications to the children were perceived as a result of the TU procedure. ConclusionThe practice of TU is prevalent among children who present to hospitals seeking medical advice. More than one-third of mothers had misconceptions regarding the uvula. Health education campaigns targeting females of childbearing age, and health practitioners at primary health centres and hospitals must raise awareness related to this practice.

Pathomorphological characteristics of tuberculous placenta and its clinical implication

BackgroundThe study of pathologic diagnosis of placental TB is rare. The aim of this study is analyzing the pathomorphological characteristics of tuberculosis (TB) placenta during pregnancy and its clinical significance.MethodsNineteen cases of placental tissue specimens during pregnancy were collected from June 2015 to February 2022 at Shanghai Public Health Clinical Center, the only inpatient center for pregnant women with TB in Shanghai, China. Hematoxylin-eosin staining, acid-fast staining, and molecular testing were applied to analyze them comprehensively in combination with clinical information.ResultsAmong the 19 cases, 7 cases caused intrauterine stillbirth, 3 cases received artificial abortion required by the pregnant woman, the other 9 cases received standard delivery and the infants survived, however, 3 of them were low-weight preterm infants, and another 1 case suffered mild intrauterine asphyxia. The 9 surviving infants were followed-up, of which 3 cases got congenital TB. For pathological characteristics of placental tissues under light microscopy, there were 3 cases of epithelioid granuloma formation, 13 cases of acute fetal membranitis, 4 cases of caseous necrosis, 7 cases of inflammatory necrosis, 10 cases of coagulative necrosis, and 6 cases with small focal calcifications. All placental tissues were positive for acid-fast staining and polymerase chain reaction (PCR). Molecular pathological diagnosis showed that 18 cases were positive for Mycobacterium tuberculosis, with 1 case not having received examination.ConclusionsCombining acid-fast staining and molecular pathological testing is helpful for accurately diagnosing placental TB.

Clinical Features, Diagnosis, and Treatment of Congenital and Neonatal Tuberculosis: A Retrospective Study

Introduction: Limited studies have explored the clinical features, treatment, and prognosis of neonatal tuberculosis (TB). Here, we attempted to delineate the clinical characteristics of neonatal TB, which may help clinicians further understand this disease. Methods: A retrospective analysis of neonates diagnosed with congenital and/or neonatal TB disease from January 2010 to December 2020 was performed. Information on the demographic and epidemiological features, clinical symptoms, laboratory and imaging examinations, therapeutic regimens, and outcomes was collected. Kaplan-Meier analysis was used to present the time to disease onset, time to diagnosis, etc. Results: Forty-eight cases of neonatal TB were classified into congenital (n = 33) and postnatal (n = 15). The median time to disease onset in postnatal group was significantly longer than that in congenital group. Positive results for gastric fluid acid-fast bacilli, TB culture, Xpert MTB/RIF, interferon-γ release assay (IGRA), and tuberculin skin test were detected in 26/48 (54.2%), 14/34 (41.2%), 11/18 (61.1%), 19/29 (65.5%), and 8/24 (33.3%) patients, respectively. For lymphadenopathy, computed tomography (CT) scans showed a higher detection rate than did X-ray (80.0% vs. 0). Of the 48 infants, 44/48 (91.7%) received anti-TB therapy, and 33/44 (75%) were clinically improved or cured after 22.1 months (interquartile range: 12.4–27.7) of follow-up. Drug-induced liver injury occurred in 14/44 (31.8%) patients. Discussion/Conclusion: IGRA and Xpert MTB/RIF showed good positive rate in neonatal TB infection/disease. In cases where TB is presumed but etiological evidence is lacking, low-dose CT could be considered. Prompt treatment under careful surveillance is important for preventing mortality and avoiding severe adverse effects.

1882. Contact Investigation of Congenital Tuberculosis in a Neonatal Intensive Care Unit in South Korea

Abstract Background Congenital tuberculosis (TB) is uncommon and difficult to detect in neonates due to its nonspecific symptoms. We conducted a contact investigation of infants and healthcare workers (HCWs) exposed to a neonate with congenital TB in a neonatal ICU (NICU) in Korea. Methods A premature infant born was admitted to NICU on September 16, 2022. On October 24, the infant's mother was diagnosed with miliary TB, and infant’s sputum AFB stain showed 4 positive results. All NICU infants and HCWs during the same period were screened for active pulmonary TB using chest radiography (CXR) immediately. Exposed infants were evaluated with a TST and CXR three months after exposure. Interferon-Gamma Release Assay (IGRA) testing was performed on those with a positive TST or abnormal CXR finding. Prophylactic rifampin was provided to the exposed infants for 3 months, as index had isoniazid-resistant M. tuberculosis infection. Exposed HCWs underwent IGRA testing immediately after exposure (1st IGRA) and at 8 to 10 weeks post-exposure (2nd IGRA), and CXR was performed 6 months after exposure. Results Five out of 82 exposed infants had positive TST (≥ 10 mm) results, while all 31 infants who underwent IGRA testing had negative results. All five with positive TST had received BCG vaccination a median 105 days before. Of the 119 exposed HCWs, three had a conversion; two had negative results (on annual IGRA testing performed according to the national TB prevention Act) before exposure and positive at 1st IGRA test, and one had negative 1st IGRA test then positive 2nd IGRA test. None had active TB during 6-month follow-up. Conclusion We found that 6% of exposed infants had positive TST results and 0% had positive IGRA, while 2.5% of exposed HCWs had conversion. Considering the possibility of false positive TST results due to prior BCG vaccination, the chance of transmission to the infants would be 0%; otherwise, it would be 6.1%. Disclosures All Authors: No reported disclosures

Latest Findings on the Suck-Swallow-Breathe Mechanism of Direct Breastfeeding From the Breast to an Infant

A mother's breast milk is the best nourishing food for infants. No only does it provide sufficient nutrition, but it is also well suited to infants' immature digestive function, thus promoting their growth and organ maturation. A 6-month period of breastfeeding can provide infants with the necessary nutrients, energy, and fluids. The best feeding method is direct breastfeeding from the breast to an infant, yet the difficulties involved in breastfeeding should not be overlooked. Approximately 1/3 the mothers who are performing direct breastfeeding from the breast to an infant experience moderate or higher levels of feeding difficulties. Difficulties in direct breastfeeding from the breast to an infant can lead to decreased feeding efficiency, hamper the growth and development of infants, and affect the emotional communication between mothers and infants. At present, many relevant studies have focused on topics such as the mothers' psychology, family and social support, and the immature development of infants. However, little research has been done to investigate suck-swallow-breathe, a physiological mechanism that infants undertake during the process of direct breastfeeding from the breast to an infant. In this paper, we summarized published literature, research parameters, measurement instruments, and physical intervention methods of the suck-swallow-breathe mechanism in infants, aiming to facilitate the early identification of breastfeeding difficulties and the subsequently provision of early intervention measures and to promote the early identification of neurodevelopmental abnormalities and other developmental abnormalities in infants.

Hypotheses and facts about congenital tuberculosis

Congenital tuberculosis is a rare disease that occurs during intrauterine infection transmission from a mother with an active tuberculosis process to a child. Symptoms and signs may be minimal and non-specific. Unfortunately, it is not always possible to find evidence to confirm congenital children tuberculosis. Early diagnosis and adequate treatment have a significant positive effect on the disease course and outcome. An analysis of 9 articles, published in the domestic literature, describing clinical cases of 11 patients, diagnosed with congenital tuberculosis, the criteria and validity of such a diagnosis were made and considered.

Risk Factors Associated With Maternity Blues and Postpartum Depression in Ecuadorian Women Going Through Their Immediate Puerperium During 2021: A Cross-sectional Study

IntroductionPerinatal factors such as lack of breastfeeding, complications during pregnancy or childbirth, and psychosocial factors such as maternal psychiatric history or socioeconomic status have been associated with the development of postpartum mood disorders. The combination of these factors during the peripartum can predict the development of maternity blues (MB) and postpartum depression (PD). ObjectiveTo characterize risk factors associated with MB and PD in Ecuadorian women going through their immediate puerperium in the gynecology and obstetrics service of “Hospital General San Francisco” in Quito-Ecuador. MethodA cross-sectional study was conducted, with a sample of 250 women attending their immediate puerperium. Data was collected using a self-applied questionnaire during the first 24 postpartum hours. Stein blues scale (SBS) was applied for MB screening and the Edinburgh Postpartum Depression Scale (EPDS) for PD screening. Informed consent and data confidentiality were explained to all participants. ResultsUsing the SBS, a probability of MB of 32.4% (n=81) was observed, while applying the EPDS, a PD probability of 17.6% (n=44) was established. MB and PD protective factors were rooming-in (OR .21, p<.001) (OR .21, p<.001), pregnancy planning (OR .13, p<.001) (OR .25, p<.001) and breastfeeding (OR .20, <.001) (OR .23, p<.001). Meanwhile MB and PD risk factors found were: breastfeeding difficulties (OR 5.88, p<.001) (OR 5.14, p<.001), complications during pregnancy (OR 8.39, p<.001) (OR 7.02, p<.001), complications during delivery (OR 5.29, p<.001) (OR 5.58, p<.001) and economic instability (OR 2.10, p .023) (OR 2.61, p .009). Discussion and conclusionThe risk and protective factors associated with MB and PD in the Ecuadorian population are similar to those described internationally. The recognition of risk factors by health personnel can improve early identification and timely management of puerperal mood disorders.

Breastfeeding outcomes, experiences and challenges, among breast cancer survivors: A systematic review of qualitative studies

Introduction: Breast cancer in pregnancy is diagnosed during pregnancy, during the first year after delivery or during lactation. It is one of the most common malignancies found in women. Although most women with breast cancer are postmenopausal, the number of premenopausal patients has been increasing in recent years. There are many issues related to the psychological management of gestational cancer that need to be addressed. Inadequate receipt of information and limited understanding of treatment options and outcomes may contribute to psychological distress in women. The purpose of this work was to record as closely as possible the data regarding the experiences and difficulties of breastfeeding in breast cancer patients, as well as breastfeeding outcomes. Materials and Methods: A systematic review of articles was performed in Pubmed and Google Scholar databases, with language restrictions (only English papers) and without time limitation. Results: The study included 7 qualitative studies. The participants invovlved were breast cancer survivors. They expressed all the difficulties related to breastfeeding and their need for emotional and psychological support. Conclusions: The general conclusion that emerges is fear and uncertainty both for the mother herself and for her child, as well as anxiety, physical and psychological fatigue and changes in relationships in the family.

Pengaruh Pemberian Buah Kurma Terhadap Kelancaran Produksi Asi Ibu Nifas Di PMB Hernita, AMD.KEB Bandar Lampung

Background: The coverage of infants receiving exclusive breastfeeding in Lampung Province in 2020 is 70.1%, which is still below the expected target of 80%. One of the foods that can facilitate the production of breast milk is dates, dates contain galactogogues which are capable of inducing lactation with dopamine pressure, resulting in an increase in prolactin production. Dates contain a hormone similar to the hormone oxytocin, which is a hormone produced by the neurohypophysia so that it stimulates the mammary glands to produce breast milk. Objective: To determine the effect of giving dates on the smooth production of breast milk in postpartum mothers. Methods: This type of research is a Quasy Experiment Design with a Non Equivalent Control Group Design study with a sample of 40 subjects. The instruments used in this study were SOP sheets for giving dates and observation sheets for signs of assessing the smoothness of breastfeeding. The intervention of giving dates was given 7 eggs per day which were consumed for 4 days. Results: All respondents before being given treatment experienced breastfeeding difficulties as many as 20 respondents (100%) and after being given the date palm treatment the respondents were in the smooth category as many as 18 respondents (90%). Conclusion: There is an Effect of Giving Dates on the Smooth Production of Breast Milk for Postpartum Mothers.

Standardizing Care of the Late Preterm Infant.

Late preterm infants are infants born between 34 and 36 6/7 weeks gestation. Compared to term infants, late preterm infants are at increased risk for breastfeeding difficulties, hypoglycemia, hyperbilirubinemia, and hypothermia due to their relative physiologic and metabolic immaturity. Medical record reviews performed at a level III maternal and newborn hospital in central Illinois revealed only 64% of late preterm infants admitted to the newborn nursery received care per the unit late preterm infant policy. The aim of this quality improvement project was to increase nurse adherence to the policy to 80%. Between May 2022 and September 2022, several interventions were implemented for maternal-child nurses and support clinicians: an education offering, creation of a late preterm infant-specific breastfeeding log, and electronic medical record updates. Post-intervention medical record reviews measured policy adherence through documentation of feeding sessions, hypoglycemia, hypothermia, and hyperbilirubinemia. Descriptive statistics were performed to determine improvement. Nurse adherence to the late preterm infant policy increased to 90% over the period of the project. Late preterm infant care protocols should be in place in all newborn nurseries. Late preterm infant policy adherence can be supported through electronic medical record prompts, use of a late preterm infant-specific breastfeeding log, and continuing education.

Breast feeding Status of Infants Born in a Baby Friendly Hospital Up to 180 days of life

Background : Initiation of breast-feeding (BF) within 1 hour after birth has been associated with reduced neonatal mortality. Baby Friendly Hospital Initiative has profound effects on appropriate practice of BF and thus helps to reduce infant mortality and morbidity.&#x0D; Objective : This study was conducted in the Department of Gynae and Obstetrics and Department of Paediatrics of Shaheed Suhrawardy Medical College Hospital (ShMCH), Dhaka, to observe the rate of exclusive breast feeding and home-based compliance.&#x0D; Methodology : Hundred (100) term babies of normal birth weight irrespective of sex, born in ShSMCH by normal vaginal delivery (NVD) or caesarian section were included. Data was collected from the mother with a pretested questionnaire at the postnatal period, at 6th week, 14th week and 6th month (180 days) of age.&#x0D; Result : The mean age of studied newborn (100) was 20±19.5 hours. All the infants started breast feeding after birth and among them 56% initiated with in 1 hour. Difficulty in breast feeding was found in 36(36.0%) infants, which was resolved mostly (94%) by nurse. Exclusive breastfeeding (EBF) was found in 100% of infants during discharge from hospital. During 1st and 2nd follow up we found 95 (95.0%) and 89 (89.0%) infants respectively were exclusively breastfed. In 3rd follow up at completed 6th month (180 days) 78 (78.0%) infants were exclusively breast fed. In our study 5 (5%) and 6 (6%) infants received supplementary food in 1st follow up and in 2nd follow up respectively. In the last follow up the number were 11 (11%) and the total number was 22 (22%).&#x0D; Conclusion : Exclusive breast feeding up to completion of 6 months (180 days) was found in 78.0% of infants. Maternal and relative’s misperception of baby’s crying due to insufficient breast milk and joining to job outside home were the causes of introduction of formula milk in the 1st, 2nd and 3rd visit respectively.&#x0D; Northern International Medical College Journal Vol. 12 No.2 Jan 2021, Page 530-534

Quantitative impact of frenotomy on breastfeeding: a systematic review and meta-analysis.

Symptoms related to infant ankyloglossia/tongue-tie may deter mothers from breastfeeding, yet frenotomy is controversial. Databases included PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Google Scholar from 1961-2023. Controlled trials and cohort studies with validated measures of surgical efficacy for breastfeeding outcomes were eligible. Meta-analyses synthesized data with inverse-variance weighting to determine standardized mean differences (SMD) between pre-/postoperative scores. Twenty-one of 1568 screened studies were included. Breastfeeding self-efficacy improved significantly post-frenotomy: medium effect after 5-10 days (SMD 0.60 [95% CI: 0.48, 0.71; P < 0.001]), large effect after 1 month (SMD 0.91 [CI: 0.79, 1.04; P < 0.001]). Nipple pain decreased significantly post-frenotomy: large effect after 5-15 days (SMD -1.10 [CI: -1.49, -0.70; P < 0.001]) and 1 month (SMD -1.23 [CI: -1.79, -0.67; P = 0.002]). Frenotomy had a medium effect on infant gastroesophageal reflux severity at 1-week follow-up (SMD -0.63 [CI: -0.95, -0.31; P = 0.008]), with continued improvement at 1 month (SMD -0.41 [CI: -0.78, -0.05; P = 0.04]). From LATCH scores, breastfeeding quality improved after 5-7 days by a large SMD of 1.28 (CI: 0.56, 2.00; P = 0.01). Providers should offer frenotomy to improve outcomes in dyads with ankyloglossia-associated breastfeeding difficulties. PROSPERO identifier CRD42022303838 . This systematic review and meta-analysis showed that breastfeeding self-efficacy, maternal pain, infant latch, and infant gastroesophageal reflux significantly improve after frenotomy in mother-infant dyads with breastfeeding difficulties and ankyloglossia. Providers should offer frenotomy to improve breastfeeding outcomes in symptomatic mother-infant dyads who face challenges associated with ankyloglossia.

Working Mother’s Breastfeeding Experience: A Phenomenology Qualitative Approach

&lt;p&gt;Breast milk is a diet that satisfies all of a baby’s physical, psychological, social and spiritual needs because it contains nutrients, hormones, immunological components and growth factors. Unfortunately, many working mothers choose to stop breastfeeding due to various factors. The purpose of this study was to explore the experiences of working mothers in exclusive breastfeeding. This study used a qualitative research design with a phenomenological descriptive approach. Data were collected using in-depth interviews and then analyzed using the Colaizzi method. The study results show that children who receive exclusive breastfeeding are healthier and have adequate nutrition. However, working mothers have difficulty in breastfeeding. So, support from partners, family members, supervisors and colleagues influences a mother’s decision to breastfeed. In addition, leave regulations and child care facilities at work affect breastfeeding ability of working mothers. This study provides information about breastfeeding challenges and the support needed by breastfeeding mothers working to formulate better policies that support breastfeeding. Policies covering employee rights and privileges, such as extended maternity leave, support facilities and child care services, are critical to the success of exclusive breastfeeding by working mothers.&lt;/p&gt;