Breastfeeding In Communities Research Articles

University campus breastfeeding, knowledge, and perceptions of support: An exploratory study.

Breastfeeding is often considered principally a biological issue but success is impacted by the socio-ecological environment of the lactating parent. Identifying current attitudes towards breastfeeding is essential in the effort toward normalizing breastfeeding in communities, including university campuses. The study explored campus community knowledge, awareness, and attitudes about breastfeeding, including available resources and applicable laws on two university campuses in the southern United States. This cross-sectional, self-reporting study utilized the Iowa Infant Feeding Attitude Scale and an adaptation of the Breastfeeding Behavior Questionnaire to survey a convenience sample. Results revealed decreased awareness of protective laws, availability of private lactation space, and insufficient public appreciation of breastfeeding's unique advantages to both lactating parent and infant as barriers to breastfeeding. These findings will help develop additional breastfeeding strategies to improve university campus community breastfeeding initiatives.

Potential Determinants and Effects of Exclusive Breastfeeding Among Infants at a Tertiary Care Center, Kerala, India.

Background: Exclusive breastfeeding (EBF) is the first fundamental right of the child. Globally less than half of the infants are optimally breastfed. Suboptimal breastfeeding can lead to increased respiratory and gastrointestinal infections. This study was undertaken to assess the potential determinants and effects of EBF among infants at a tertiary care hospital in south India since interventions to improve breastfeeding in communities have to be tailored to the needs of the population.Methods: This cross-sectional study was done among infants at the pediatric unit of a tertiary care hospital in central Kerala, from October 2019 to April 2020, using a structured questionnaire.Results: Two hundred fifty-seven infants were included in the final analysis. 70.4% of babies were exclusively breastfed for the first six months, although 80.9% were breastfed within the first hour after birth. Among determinants of EBF, unemployed mothers and mothers without a post-graduate degree were more likely to continue EBF for six months (OR 2.8 95% CI [1.6-4.9] and OR 2.7 95% CI [1.5-4.9], respectively). Antenatal counseling appeared to have some beneficial effects but the result was not statistically significant. The mean number of respiratory infections, infections requiring hospitalization, and mean antibiotic use was lower in the exclusively breastfed group, though this result was not statistically significant. However, a significantly lower number of breastfed babies had constipation (OR 0.4, 95% CI 0.2-0.9) when compared to formula-fed babies.Conclusion: A higher percentage of infants presenting to our hospital has been exclusively breastfed as compared to the state average. Potential determinants of EBF include maternal education and employment and the potential effect of EBF includes protection against constipation. Further emphasis on counseling mothers antenatally, providing postnatal lactation support and counseling, providing mothers with adequate maternity leave will play a major role in promoting EBF in our community.

Breastfeeding in Public: A Global Review of Different Attitudes towards It

Breast milk is the best diet for infants and exclusive breastfeeding is strongly recommended. In order for breastfeeding to be exclusive, mothers will face situations where they will need to feed in public places whether they are indoors or outdoors. However, acceptance of breastfeeding in public is not always accepted. Many cultural, legal, social and religious factors play a role in acceptance of nursing in public. Public acceptance in turn may have an effect on the rate of breast feeding in communities and regions. Some countries in North Europe and North America have made legislative attempts to establish the legitimacy of breastfeeding in public as well as the right to feed their child or pump milk at the workplace. Moreover, some countries in the Western hemisphere use advertising to promote breastfeeding. On the other hand, some African and Asian countries discourage, or even criminalize public nursing. This review summarizes the different attitudes towards public breastfeeding worldwide and the current advertising campaigns around the world.

Views on the acceptability of financial incentives for breastfeeding: a qualitative study

BackgroundBreastfeeding is good for both baby and mother, and the associated health benefits persist. However, in many communities breastfeeding is not the norm. Financial incentives are a potentially powerful method to achieve health-related behaviour change, and these incentives have been used with varying success in a range of settings. The use of financial incentives to promote breastfeeding is controversial, and there has been little research in this area. A street intercept survey with women from areas of low breastfeeding rates showed that financial incentives were acceptable to 80% (95% CI 67–88; n=54) of those sampled. In this study, we aimed to investigate in depth the acceptability of financial incentives for breastfeeding both in principle and in practice among a range of key stakeholders. Our research is part of a wider study to develop and trial a financial incentive scheme for breastfeeding in areas with 6–8-week rates below 40%. MethodsWe undertook semistructured individual interviews (n=54) and focus groups (n=8) with two stakeholder groups based in south Yorkshire and north Derbyshire: mothers who had breastfed or formula fed, or both (n=38) and health-care staff with infant feeding roles (n=53). A sampling frame was developed to purposively sample for maximum variation in the range of infant feeding preferences and experiences in different age groups. Stakeholders were recruited from children's centres, breastfeeding support groups, parent and toddler groups, and community or hospital maternity services. Health-care staff were midwives, health visitors, breastfeeding peer support workers, children's centre managers, charity or voluntary sector workers, public health leads, and commissioners. Interviews were analysed by thematic analysis, drawing on the principles of framework analysis. NVivo was used to support the analytical process. Interviewer bias was minimised by use of inter-rater reliability, peer debriefing, and reflexivity. Ethics approval for the study was obtained from ScHARR Research Ethics Committee, NHS R&D, and Sheffield Local Authority Research Governance. FindingsAlthough a wide range of views about financial incentives were expressed, both mothers and health-care staff had similar views about the potential benefits, emotional effect, and ethical implications of a financial incentive scheme. The common key emergent themes were the scheme's potential to encourage, reward, and support breastfeeding; ethical concerns about financial incentives for breastfeeding; potential negative effects; and concerns about the practical implementation of a scheme. Many interviewees felt that financial incentives might encourage more women to attempt breastfeeding. Health-care staff, particularly, felt that a financial incentive might help to normalise breastfeeding in communities with low breastfeeding rates. Some viewed the incentive as being a reward for breastfeeding and that breastfeeding would be perceived as valuable and good. Both groups were concerned about moral implications, perception of incentives as bribery, penalising those unable to breastfeed, and how such interventions would be policed. Many considered the moral implications of how a financial incentive would be spent and whether the incentive should be cash or vouchers. Further, financial incentives could affect women negatively—in particular, if it reduced the intrinsic motivation to breastfeed. Additionally, an incentive could add pressure on the woman to breastfeed and might not help if she ran into difficulties. Both groups made suggestions for the practical implementation of the scheme that would make it more acceptable. There was low acceptability for verification methods that required the mother to perform in order to prove that she was breastfeeding. InterpretationThere was difficulty in recruiting primiparous women to the study, which limits the generalisability of these results. Although a wide range of views were expressed within and between stakeholder groups, financial incentives for key stakeholders were broadly acceptable, in principle. Issues were identified that need consideration when implementing a financial incentive scheme in practice. FundingMedical Research Council—National Prevention Research Initiative (MR/J000434/1).

Using community maternity care assistants to facilitate family-focused breastfeeding support.

Increasing breastfeeding rates, particularly in lower socio-economic areas, would have considerable impact upon public health. Social support has been found to have direct and positive effects on breastfeeding rates, and fathers' attitudes have an important influence on the initiation and continuation of breastfeeding. In the UK, trained maternity care assistants (MCAs) are increasingly being used to support community midwives by providing post-natal women with breastfeeding support. The current study aimed to evaluate the feasibility and acceptability of MCAs involving fathers from economically deprived communities in antenatal breastfeeding discussions to equip them to provide support and encouragement. Eleven couples who took part in the intervention were interviewed post-natally. MCAs, midwives and midwifery managers gave their views on the intervention and role of MCAs in the community. The study showed that MCAs with appropriate training are very effective at delivering antenatal breastfeeding information, which both mothers and other family members value. MCAs found giving such breastfeeding support both enjoyable and fulfilling, while involving fathers and family members proved a practical way of encouraging them to be more supportive. Midwives and midwifery managers were positive about involving MCAs in giving the antenatal intervention, but did not see the routine introduction of this type of session for couples being possible at present due to current staffing problems. Involving fathers in breastfeeding support may start to increase knowledge and change attitudes towards breastfeeding in communities where formula feeding is seen as the normal way to feed a baby.

Proposed Strategies for Promoting Breastfeeding in the Community

To protect, promote and support breastfeeding in communities is an important primary health care task. One of the Australian health targets set for the year 2000 and beyond is that 80% of infants up to six months of age will be breastfed. However, both the 1989-90 National Health Survey (Lund-Adams & Heywood, 1994) and the 1993 national births' data (Australian Bureau of Statistics, 1994) indicate that breastfeeding rates at age six months are far below this target. Therefore, there is a clear need to develop strategies to promote breastfeeding in Australian communities. Breastfeeding promotion needs to address locally researched barriers and should be integrated with appropriate health care. Proposed strategies for promoting breastfeeding in the community include: monitoring of prevalence and maintenance of breastfeeding; assessment of possible barriers; design of an intervention program; implementation of the intervention program; evaluation; and communication with the community. The Australian breastfeeding target set for the year 2000 can only be achieved through an integrated approach that enhances concerted efforts to promote primary health care and breastfeeding in the community.

Infant Feeding in Emergencies

Recent experience of emergency relief operations in middle-income countries has shown that infant feeding issues can greatly complicate attempts to protect infant health. The two main problems are: how to protect and support breastfeeding in communities where it is no longer the norm and how to assist artificially fed infants without exposing them to the dramatically increased risks associated with artificial feeding under disaster conditions. This article explores the underlying issues and makes a number of recommendations for policy and programmes.