Breastfeeding Problems Research Articles

The Impact of Moringa Leaves, Katuk Leaves and Oxytocin Massage on Quantity and Quality of Mother's Milk as Patients Health Center in Bali

The problem of breastfeeding is part of the problem of discomfort in postpartum mothers for 2 hours after giving birth. This problem often causes trauma to postpartum mothers during breastfeeding, psychological disturbances, and increases morbidity in the mother and baby due to inadequate breast milk. The practice of Oxytocin massage, Moringa leaves and Katuk leaves at the same time can improve the quantity and quality of breast milk in maternal patients with 36-40 weeks' gestation. This type of research is quantitative research. Respondents numbered 30 were selected by determining purposive sampling in each group consisting of 10 mothers. Data were analyzed using a Paired t-test and Independent sample t-test with an α level of 0.05. The results showed that there was an increase in the quantity of breastfeeding. On the 3rd day, the quantity of breast milk with volume of 45 cc. In the week I with a volume of 10.50 cc, week II 86.50 cc, week III 168.50 cc and week IV as much as 275 cc. It shows that there are differences in quality on days 3 to week IV. The results of data analysis also showed that the 3rd day the quality of breast milk is rather yellow and rather thick, then the first week to the third week rather yellow and thin. At week IV, the quality of breast milk is white and runny. There is an increase in the quality and quantity of breast milk in all three groups.

The prevalence of ankyloglossia in children aged

Despite the low level of evidence supporting the correction of tongue-tie for breastfeeding problems, recognition and treatment has increased substantially over the past 15 years. Prevalence reporting of tongue-tie is variable. The purpose of this study was to quantitatively synthesize the prevalence of tongue-tie in children aged <1 year and to examine the psychometric properties of the assessment tools used for diagnosing tongue-tie in these studies. PRISMA and MOOSE guidelines were followed, with selection of studies and data extraction verified by two authors. Random-effects meta-analyses were performed to determine an overall prevalence rate, prevalence by infant sex, and prevalence by diagnostic method. There were 15 studies that met inclusion criteria. Overall prevalence of tongue-tie (N = 24,536) was 8% (95% CI 6-10%, p < 0.01). Prevalence was 7% in males and 4% in females. Prevalence was 10% when using a standardized assessment tool compared to 7% when using visual examination alone (p = 0.16). Available assessment tools for diagnosis of tongue-tie do not have adequate psychometric properties. Tongue-tie is a common anomaly, which has the potential to impact infant feeding. Development of a psychometrically sound assessment of tongue-tie is needed. The overall prevalence of tongue-tie in infants aged <1 year is 8%. Available diagnostic tools for tongue-tie do not have adequate psychometric testing. Prevalence data can assist health care providers in the recognition of tongue-tie as a potential barrier to infant feeding to promote maternal breastfeeding success.

Patient-reported outcomes of ductoscopy procedures for pathologic nipple discharge

BackgroundPathologic nipple discharge (PND) is a common complaint often associated with breast cancer. However, when ultrasound and mammography are negative, the chances of malignancy are lower than 5%. Currently, major duct excision and microdochectomy are often recommended to alleviate symptoms and definitely rule out malignancy, but can cause infections and breastfeeding problems. Ductoscopy is a minimally invasive endoscopy technique that allows visualization of the mammary ducts and may not only obviate surgery but also detect malignancy. The aim of this study was to determine quality of life (QOL) after ductoscopy in patients with PND.Materials and methodsAll PND patients referred for ductoscopy between 2014 and 2015 to our hospital were included. Ductoscopy procedures were performed under local anaesthesia in the outpatient clinic. Patients were asked to fill out questionnaires (Breast-Q, EQ-5D-5L and SF-36) on the day of ductoscopy, and after 2 weeks, 3 and 6 months. Additionally, we performed reliability analysis to determine if these questionnaires were suitable for PND patients.ResultsFifty consecutive patients underwent ductoscopy of whom 47 patients participated in this study. One domain of SF-36 (vitality) varied significantly over time. Breast-Q, SF-36 and EQ-5D-5L showed that QOL after ductoscopy for PND was unaffected by ductoscopy. Success of the ductoscopy procedure was a significant predictor for satisfaction with the result domain.ConclusionDuctoscopy is a minimally invasive technique that does not seem to impact QoL of PND patients over time. Breast-Q, SF-36 and EQ-5D-5L seem to be suitable existing QOL tests for PND patients undergoing ductoscopy, whereas SF-36 would require modifications.

A study to compare the effects of aerobic exercises and yoga on depression and maternal anxiety orienting among primiparous women

Introduction and Aim: Primiparous women undergo stages of depression or anxiety during pregnancy especially the risk of preterm birth, breast-feeding problems and disruption of the mother-infant attachment. It is a most common psychiatric disorder and is associated with a greater risk of low fetal quality, Pregnancy complication and developmental disorder of the child. During pregnancy 10-15% women were affected with depression and the incidence increases in low economic status. It is associated with greater risk of prenatal and perinatal complication. In recent years the physical therapy is associated with psychological health in pregnant women. Physical activity during pregnancy is more beneficial to the maternal fetal unit and it may prevent recurrence of maternal disorders. The objective of this study is to compare the effects of aerobic exercise and yoga on depression and maternal anxiety orienting among primiparous women.&#x0D; Materials and Methods: This experimental study was conducted with 30 subjects at ACS Medical College and Hospital, from January 2018 to March 2018. The outcome measures of CES-D scale were used to assess the severity of depression and anxiety. Group A received Aerobic exercise for 30 minutes initially started with warm up for 10 minutes and followed by 10 minutes stretching and 10 minutes relaxation. Group B received yoga for 20 minutes up to 3 months. The treatment duration was followed from the 16 to 20 weeks of gestation for 3 months.&#x0D; Results: On comparing the mean values of group A and group B on centre for epidemiological studies depression scale score, it showed significant decrease in the post test mean values of group A (24.60) and group B (24.40) at P ? 0.001. Hence both the groups were equally effective in decreasing the depression and maternal anxiety among primiparous women.&#x0D; Conclusion: This study concluded that the aerobic and yoga showed significant effect in both groups for reducing the symptoms of depression and anxiety among primiparous women.&#x0D; Keywords: Primiparous women; aerobic exercises; yoga; CES - D scale.

Breastfeeding challenges among Thai adolescent mothers: hidden breastfeeding discontinuation experiences

PurposeThe purpose of this study was to explore the experiences of adolescent mothers who wean their babies from breastfeeding before the first six months from the perspective of a psychosocial aspect in the Thai context.Design/methodology/approachA descriptive qualitative design was applied to this study to obtain meaningful data. The adolescent mothers for the primary study and nine supplementary participants were recruited from the largest university hospital in Bangkok, Thailand. Semi-structured in-depth interviews were conducted with 20 adolescent mothers. Descriptive statistics and content analysis were used for data analysis.FindingsThe average breastfeeding duration was 3.1 months while breastfeeding exclusively lasted 1.3 months. More than half of the adolescent mothers encountered breastfeeding problems at hospitalization including sore/cracked nipples (63.6%), one side breastfeeding (27.3%) and exhaustion (9.1%). According to the content analysis, (1) breastfeeding obstacles concealed by the adolescents' dependence and (2) repetitive emotional mistakes encountered were the two main themes that emerged.Originality/valueThe influence of key family members plays a vital role in breastfeeding and psychological outcomes. Therefore, family-adolescent support programs including support from the adolescents' mothers and grandmothers may improve breastfeeding outcomes, yield positive emotions and enhance maternal attachment. Moreover, healthcare professions are important mediators to convince adolescent mothers' key family members to reach an agreement and provide suitable support.

Breastfeeding Monitoring Improves Maternal Self-Efficacy and Satisfaction.

The purpose of this study was to determine the effects of an interactive web-based breastfeeding monitoring system on breastfeeding self-efficacy and satisfaction among mothers of full-term infants at 1, 2, and 3 months after hospital discharge. We conducted a secondary data analysis of our two-arm, repeated-measures randomized controlled trial that took place in three Midwestern hospitals. Participants were assigned to either control or intervention groups using random numbers. Of the 141 mother-baby dyads enrolled and randomized, 35 dropped out of the study, leaving 57 mothers in the control group and 49 in the intervention group. Mothers in both groups received care based on the hospital protocol, but mothers in the intervention group were also given access to an interactive web-based breastfeeding monitoring system prior to discharge. Participants were asked to enter breastfeeding data, receive educational messages for 30 days, and complete the Breastfeeding Self-Efficacy Scale (BFSE) at 1, 2, and 3 months and the Maternal Breastfeeding Evaluation Scale (MBFES) at 3 months. Mothers received feedback in case of breastfeeding problems. A significant difference between groups in BFSE at the 2 and 3 months (p = 0.04; p = 0.04) with medium effect size (0.52, 0.53) was found. There was a significant difference between groups in the total score of MBFES (p = 0.02, effect size 0.53). Mean scores were 122.2, SD = 17.68 for intervention and 112.8, SD = 18.03 for control group. The MBFES scores were positively correlated to BFSE scores among intervention group at all time points (r = .714, n = 45, p < .00; r = .611, n = 41, p < .00; r = .637, n = 39, p < .00). Interactive web-based breastfeeding monitoring improved maternal breastfeeding self-efficacy and satisfaction and may be a promising innovation to promote maternal breastfeeding self-efficacy and satisfaction.

Características da gravidez e lactação de mulheres atendidas em um banco de leite humano

Objetivo: identificar as características da gravidez e da lactação de mulheres que procuraram um banco de leite humano e as razões que motivaram essas mães a recorrerem ao serviço. Métodos: Trata-se de um estudo realizado no Banco de Leite Humano (BLH) da Fundação Santa Casa da Misericórdia de Franca. Foram recrutadas 60 mulheres que responderam a um questionário para a obtenção de informações a respeito da gestação, da amamentação e dos motivos que as levaram ao banco de leite. Resultados: As participantes realizaram o pré-natal em número adequado de consultas e tinham em média 25(6,1) anos. Os sintomas gestacionais mais relatados foram náuseas/vômitos (71,7%) e picamalácia (60%). A maior aversão alimentar referida foi à ingestão de carnes (42,3%). Dentre os fatores que levaram as mulheres a buscarem o BLH, destacaram-se o auxílio para estimular a produção do leite ou para doação do mesmo. 58% das mulheres estavam em aleitamento materno exclusivo e as demais referiram estar aguardando a descida do leite ou estarem distantes dos bebês, que se encontravam no centro de terapia intensiva. Alguns bebês menores de 2 meses receberam água, chás e papas precocemente. Conclusão: As nutrizes recorreram ao BLH por problemas na amamentação, apesar das orientações no pré-natal. Algumas necessitaram de apoio para o estímulo da produção de leite. A importância do BLH vai além de possibilitar o leite às crianças que não puderam ser amamentadas por suas mães, mas também por proporcionar instrução e apoio às lactantes, além do incentivo ao aleitamento materno.

Causes of perception of insufficient milk supply in Western Australian mothers.

A perception of insufficient milk supply (PIMS) is associated with early discontinuation of breastfeeding. Ideally, an objective measure of milk supply would either dispel or confirm this perception and provide reassurance or guide professional advice. Clinical signs of sufficient milk intake (steady growth, sufficient elimination, infant alertness and breasts feeling full before breastfeeds and soft after breastfeeds) should provide confidence in milk supply. We surveyed 423 mothers in early lactation who had breastfeeding problems to determine the proportion that had PIMS and to determine if the mothers with PIMS relied on these clinical signs or other perceptions of their infants' behaviour as indications of insufficient milk supply. By 3 weeks after birth, we found that the rate of PIMS among mothers with breastfeeding problems was 44%. Supplementary infant formula was being given to 66% of the infants, so the clinical indications were that milk intake was sufficient, but 74% of the mothers with PIMS cited concerns that their infants did not appear satisfied after breastfeeds. After targeted advice from lactation consultants, mothers with PIMS showed positive changes in their perceptions of their milk supply, underlining the value of professional guidance soon after birth. We conclude that an appearance of infant dissatisfaction is the major cause of PIMS in Western Australia.

Knowledge, Practice and Problems of Exclusive Breastfeeding among Mothers Attending the Outpatient Clinic of a Baby Friendly Hospital Initiative Designated Hospital in Port Harcourt, Nigeria

Background: Exclusive breastfeeding (EBF) provides all an infant requires for optimal growth and development in the first six months of life. Although most babies are breastfed in Nigeria, only 23% are exclusively breastfed. This study was carried out to ascertain the knowledge, practice and problems associated with EBF amongst mothers attending the Rivers State University Teaching Hospital (RSUTH).&#x0D; Methods: A 5-month cross sectional study was carried out in the Paediatric outpatient clinic (POPC) of RSUTH. A total of 343 mothers were randomly recruited and a pre-tested structured questionnaire administered after obtaining informed consent.&#x0D; Results: Ninety eight percent of the mothers had heard of EBF, 88% knew of its content and 80.2% knew that the duration of EBF was for 6 months. Only 46.4% exclusively breastfed their babies for 6 months and about 66% of participants knew of its benefits to both mother and child. Breastfeeding was commenced within 1 hour of delivery by 40.8% of mothers and pre-lacteal feeds given by 34.1% of mothers. Tertiary education, attending antenatal clinic and hospital delivery were significantly associated with good knowledge of EBF, while hospital delivery and multiparous women with at least 4 pregnancies were significantly associated with good EBF practice. Common challenges to EBF were perception that breast milk was insufficient for the babies (17.5%) and the need for mothers to return to work (9.3%).&#x0D; Conclusion: Knowledge of EBF was high among mothers attending the POPC in RSUTH but the EBF rate was suboptimal. Increased health education on the importance of EBF, the provision of creches at work places and the extension of maternity leave is advocated.

Breastfeeding Practices among Mothers in Southwest Nigeria

This study was conducted to determine the breastfeeding practices among parous antenatal attendees in two teaching hospitals in Southwest Nigeria. A cross-sectional study was carried out on 340 parous antenatal clinic attendees in two teaching hospitals in Ogun State, Nigeria. A structured questionnaire was used to obtain data on breastfeeding practices. Data were analyzed using Statistical Package for Social Sciences (SPSS) windows version 21.0 (IBM Corp., Armonk, NY, USA). Out of a total of 340 women, 319 (93.8%) breastfed their last babies. The median duration of breastfeeding was 15 months. One hundred and thirty two women (38.8%) initiated breastfeeding within 30 minutes of delivery, and 200 women (58.8%) exclusively breastfed their babies for six months. The majority of the women, 299(87.9%k) did not report any problem associated with breastfeeding. Logistic regression analysis showed that women who had no breastfeeding problems were more likely to exclusively breastfeed their infants for six months compared to those with breastfeeding problems (AOR 3.4; CI 1.6-7.1; P=0.001). Similarly, women who got breastfeeding information from mass media were more likely to practice exclusive breastfeeding for six months compared to those that got breastfeeding information from other sources (AOR42.2; CI 3.1-568.5; P=0.005). Exclusive breastfeeding is suboptimal in Ogun State, Nigeria. Provision of breastfeeding information via mass media will assist in improving breastfeeding practice. Educating mothers on the techniques that help to prevent breastfeeding complications will also be beneficial.

Feeding status of 0～23-month-old infants in poor rural areas of Gansu Province from 2018 to 2019

To investigate the feeding status of infants and their feeder&apos;s feeding literacy in poor rural areas of Gansu Province. From November 2018 to January 2019, a multi-stage cluster random sampling method was used to select 1200 infant and child families aged 0 to 23 months in 40 villages of Gansu Province. A standardized questionnaire from the Chinese Nutrition Society(CNS)was used to investigate the basic situation of infant and young children&apos;s families, the situation of breastfeeding and the addition of supplementary food, and parents feeding knowledge, attitude behavior(KAP). Using chi-square test, logistic regression and other method to statistically describe and infer the collected data. A total of 1193 infants and 1165 feeders were investigated. The exclusive breastfeeding rate of infants and young children under the age of 6 months was 39. 02%. The rate of continuous breastfeeding at 1 year old was 37. 40%, and the rate of continuous breastfeeding at 2 years old was 20. 88%, the difference between the two was significant(χ~2=13. 498, P&lt;0. 01). The supplementary food supplement rate of infants and children over 6 months was 94. 37%, the highest supplementary supplement for cereals and potatoes(98. 01%), and the lowest percentage for beans and nuts(23. 51%), and the distribution of supplementary foods at different ages was significantly different(χ~2=52. 336, P&lt;0. 01). The qualification rate of infants and young children&apos;s minimum dietary diversity was 64. 13%, the minimum eating frequency qualification rate was 70. 64%, the minimum acceptable dietary intake qualification rate was 42. 16%, and the qualification rates of various indicators were significantly different between different months(χ~2=85. 421, P&lt;0. 01;χ~2=19. 66, P&lt;0. 01; χ~2=17. 261, P&lt;0. 01). The KAP score passing rate of infant caregivers was 37. 34%, and there was a statistical difference between the age of infants and young children, the education level and the sex of the caregiver(χ~2=9. 411, P&lt;0. 05;χ~2=25. 901, P&lt;0. 01;χ~2=3. 874, P&lt;0. 05). Taking low-month-old infants and young children, low education and male caregivers as controls, infants and young children aged over 12 months, high school education and female caregivers were the protective factors of KAP scores(P&lt;0. 05). The problems of infant breastfeeding and supplementary feeding in poor rural areas of Gansu Province were serious, and the knowledge and skills of raising people were scarce, which were related to the age of infants and young children, the education and the sex of raising people.

Predictors of exclusive breastfeeding in Roma and non-Roma population in Serbia

Abstract Background Exclusive breastfeeding is essential for early childhood development, although the use of adaptive milk formulas instead of breastfeeding is widespread nowadays. This study examined the prevalence of exclusively breastfed infants under the age of 6 months in non-Roma and Roma population and factors associated with this practice. Material and Methods This study is a secondary analysis of the Serbian Multiple Indicator Cluster Survey investigating non-Roma and Roma infants under the age of 6 months. The study included mothers of 321 non-Roma and 164 Roma infants younger than 6 months. Univariate and multivariate logistic regression served to analyze factors associated with the practice of exclusive breastfeeding. Results The prevalence of exclusive breastfeeding was almost the same among mothers in both non-Roma and Roma population (13.3% vs. 13%). Exclusive breastfeeding was significantly more often (p &amp;lt; 0.001) among wealthier women, multipara, and women who had not established menstrual cycle among both populations. Unexpectedly, in the non-Roma population, not staying in the same room with the newborn in the maternity ward increases the chance for the baby to be exclusively breastfed (OR 7.19, CI 95% 1.80-28.68). The same pattern has been observed in Roma population. Non-Roma mothers multipara are more likely to exclusively breastfeed their children than primipara (OR 7.78, CI 95% 1.09-20.93), while among Roma mothers, the inverse association has been found although not significant. Attending a childbirth preparation program more than 18 times increases the chances of infants being exclusively breastfed (OR 18.65, CI 95% 1.34-53.67). In the Roma population, there was no single woman that attended a childbirth preparation program. Conclusions The pattern of exclusive breastfeeding significantly differs between non-Roma and Roma populations. Preventive work should have a focus on strengthening support to mothers and medical staff in maternity wards. Key messages Understanding the predictors of exclusive breastfeeding can help in the process of creating health promotion programs that lead to more infants exclusively breastfed according to the WHO guidelines. Decision-makers and public health authorities should acknowledge the existing breastfeeding problems.

Masalah Menyusui sebagai Determinan Terjadinya Risiko Depresi Postpartum pada Ibu Nifas Normal

&#x0D; &#x0D; &#x0D; &#x0D; Postpartum women who had mild postpartum depression range from 10/1000 live births and moderate/severe postpartum depression ranging from 30-200 /1000 live births. This study aims to analyze factors that influence the risk of postpartum depression in postpartum mothers. Research Methods: This research is a quantitative study with a cross-sectional design. The population in this study were postpartum women aged 2-6 weeks with 121 respondents, selected by two-stage Cluster sampling, followed by random sampling. The research was conducted at the primary health center in Central Jakarta area using the Edinburgh Postpartum Depression Scale (EPDS) questionnaire. It was found that mothers who had breastfeeding problems had a greater risk of developing postpartum depression (OR; 39.3), the greater the husband's support, the lower the risk of postpartum depression (OR; 0.13), and it was found that lower-income resulted in a greater risk of depression postpartum (OR; 14.7). In conclusion, the risk of post-partum depression is influenced by three factors: breastfeeding, husband support, and income. Of the three factors, the more dominant cause of postpartum depression risk is breastfeeding problems.&#x0D; &#x0D; &#x0D; &#x0D;

Three spirals: Breastfeeding problems, growth spurts, and postpartum depression.

The inadequacy experienced in maintaining breastfeeding was tried to be understood within the framework of Meleis' theory, and its relationship with growth spurts and postpartum depression was attempted to be revealed. The study was planned in a case-control type web-based descriptive research design. Mothers (n = 572), who thought that they experienced breastfeeding problems, constituted the case group of the study, and mothers (n = 524), who thought that they did not experience breastfeeding problems, constituted the control group. A statistically significant relationship was found between the case and control groups in terms of growth spurts and depression risk. It is recommended to determine mothers' mood changes and breastfeeding problems they experience on the first postpartum days, to provide counseling to them.

Retrospective Cohort Study on Effect of Frenulotomy Techniques on Breastfeeding

Objective: The aim of this study was to compare the outcomes between frenulotomy by bedside technique and surgery under general anesthesia to successful breastfeeding in ankyloglossia infants.Methods: A quantitative research of retrospective cohort study was conducted in Naresuan University Hospital, Thailand between July 2012 and June 2017. We enrolled all infants born and identified the infants diagnosed with ankyloglossia. The severity of ankyloglossia was assessed. The outcome of two types of frenulotomy were compared.Results: Ankyloglossia was diagnosed in 187 (6.3%) of 2,968 infants born. The main breastfeeding problems in both groups were maternal sore nipples, cracked nipples and poor latch on. The infants in the bedside technique group had more successful rate of exclusive breastfeeding at day 7 when compared with the surgical group (87.3% and 39% respectively, p&lt;0.001). More percent increment of infant’s body weight at day 7 in the bedside technique group than the surgical group (60% and 20.8% respectively, p&lt;0.001). Overall maternal satisfaction in the bedside technique group was notably higher than that in the surgical group (96.4% and 59.7% respectively, p&lt; 0.001). The length of hospital stay was less in the bedside group for 1.22 days. More weight gain was found in the bedside group.Conclusion: Frenulotomy is the procedure that should be performed in indicated ankyloglossia infants. The bedside technique frenulotomy is preferable than surgery under general anesthesia attributed to a more satisfactory outcome.

Not enough breast milk? Why?

Background: The World Health Organization (WHO) recommends exclusive breastfeeding (EBF) up to the age of 6 months for its well-known beneficial effects. Objectives: The objectives of the study were to know the profile of cases wherein the complaint of not enough breast milk exists, to find out the causes of such problem, and to find out the areas to be addressed in breastfeeding education programs. Materials and Methods: Data were collected from infants up to 180 days of age, not exclusively breastfed, attending a private clinic from April 2015 to March 2020. Very low birth weight babies and those with anatomical problems interfering with breastfeeding were excluded. Mothers were interviewed, infants examined, and breastfeeding observed for some time to find out the problems. Results: Out of total 940 infants, 63.51% had excessive cry only, 3.19% had only unsatisfactory fullness of abdomen following a feed, and 1.38% a combination of these leading to presumed insufficient breast milk. Another 12.13% of infants had difficulty suckling, mostly because of improper attachment to breast (43.86%) and lack of mother’s patience and motivation (40.35%). A good number (9.47%) of infants did not have any breastfeeding problem at all. Conclusion: Excessively crying infant is usually not because of inadequate breast milk. Refusal to suck is due to improper attachment, lack of motivation, or improper mother-baby bonding. These issues including the WHO recommended idea of EBF need to be addressed in different health education and breastfeeding education programs.

How much can Mexican healthcare providers learn about breastfeeding through a semi-virtual training? A propensity score matching analysis

BackgroundMexico has shown a worrisome decrease in breastfeeding indicators, especially in the lowest socioeconomic level. Improving breastfeeding protection, promotion, and support services through workforce development is a key area of intervention. The objective of this study is to assess the influence on breastfeeding knowledge and abilities of a semi-virtual training for primary healthcare providers assisting beneficiaries of PROSPERA in Mexico, which is one of the largest conditional cash-transfer programs in the world.MethodsTwo independent cross-sectional samples of healthcare providers were drawn at baseline and post-intervention in three states of Mexico. Baseline data were collected among primary physicians, registered nurses and nurse technicians (i.e. unit of analysis) on July 2016 (n = 529) and post-training between March and April 2017 (n = 211). A 19-item telephone questionnaire assessed providers’ general knowledge about breastfeeding, breastfeeding benefits and clinical aspects of breastfeeding, clinical ability to solve problems and abilities to overcome breastfeeding challenges. The effects of the training were assessed through a propensity score matching (PSM) stratified by types of providers (i.e. physicians, registered nurses, nurse technicians).ResultsThe PSM analysis showed significant improvements among all providers in the general knowledge about breastfeeding (around 20 percentage points [pp]) and knowledge about breastfeeding benefits (approximately 50 pp). In addition, physicians improved their knowledge about clinical aspects of breastfeeding (7 pp), while registered nurses improved in their ability to solve breastfeeding problems (14 pp) and in helping mothers overcome breastfeeding challenges (12 pp).ConclusionsPromoting a breastfeeding enabling environment in Mexico to improve breastfeeding rates will require improving the knowledge and skills of healthcare providers. While a semi-virtual training showed large improvements in knowledge, developing skills among providers may require a more intensive approach.

Primum non nocere: lingual frenotomy for breastfeeding problems, not as innocent as generally accepted.

The frenotomy or surgical release of the lingual frenulum is performed with increasing frequency. Restricted tongue mobility, ankyloglossia, is the main indication for this procedure. This clinical diagnosis is often used as synonym for tongue-tie which is blamed for many feeding difficulties resulting in an increase in performed frenotomies. Until recently, little was known about the anatomical structure and normal variation of the tongue-tie. Different grading systems have been developed. Some are exclusively based on appearance of the tongue-tie; others also include functional elements. There is, however, no established relation between the tongue-tie score and the observed feeding problems or outcomes following frenotomy. Therefore, caution is warranted before submitting babies to this procedure.Conclusion: This narrative review aims to give an overview of current knowledge and concerns regarding the tongue-tie, which need to be considered before referral for a frenotomy. What is Known: • The presence of a tongue-tie is associated with a higher frequency of breastfeeding problems. • Hence, frenotomy is advocated and increasingly performed in infants with breastfeeding problems. Current tongue-tie classifications do not allow to predict breastfeeding problems. What is New: • New anatomy insights caution for possible complications resulting from this seemingly innocent practice of frenotomy. • Frenotomy should only be performed after multidisciplinary evaluation of feeding problems, following exclusion and remediation of other causative factors.

The effect of prenatal counseling on breastfeeding self-efficacy and frequency of breastfeeding problems in mothers with previous unsuccessful breastfeeding: a randomized controlled clinical trial

BackgroundBreastfeeding is one of the most important interfering factors in infants’ health. Monitoring mothers’ performance and providing them with the feedback helps to increase their self-efficacy, interest in learning, and level of performance. The present research evaluates the effect of prenatal counseling on the breastfeeding self-efficacy and frequency of breastfeeding problems in mothers with previous unsuccessful breastfeeding.MethodsThis randomized controlled clinical trial was conducted on 108 pregnant women with unsuccessful breastfeeding in Tabriz health centers during 2017–2018. The participants were randomly assigned to intervention and control groups. The intervention group had four prenatal counseling sessions and the controls only received routine care. Then, the mothers who gave birth to their children received a counseling session up to 4 months after the delivery. The Breastfeeding Self-Efficacy (BSES) questionnaire and the frequency of breast feeding problems checklist on the 15th day, and 2nd and 4th month were completed both by the intervention and control groups.ResultsThe mean (SD) of breastfeeding self-efficacy was 119.3 (10.5), 128.3 (8.3) and 133.8 (10.3) in the intervention group and 105.3 (16.1), 105.7 (19.7) and 109.4 (24.7) in the control group on the 15th day, 2nd and 4th month after the delivery, respectively. There was a significant difference in terms of breastfeeding self-efficacy between intervention and control group on the 15th day (p < 0.001), and 2nd (p < 0.001) and 4th (p < 0.001) month after the delivery. The frequency of breastfeeding problems on the 15th (p = 0.008), 2nd (p < 0.001) and 4th (p < 0.001) after the delivery was significantly different in most cases of the intervention group when compared to the controls.ConclusionThe results indicated that prenatal counseling can increase mothers’ breastfeeding self-efficacy and solves most breastfeeding problems during postpartum period.Trial registrationIRCT20100109003027N19.

Examining the Baby Café Model and Mothers' Breastfeeding Duration, Meeting of Goals, and Exclusivity.

Objective: Accessible community lactation support impacts a woman's breastfeeding success by offering timely intervention and solutions, thereby allowing mothers to achieve breastfeeding goals and improve overall breastfeeding rates. Although the impact of breastfeeding support has been well established, there is a lack of consistency in the development and evaluation of support models. This report examines two differing populations of Baby Café attendees. The study evaluated the mother's achievement of personal and nationally recommended breastfeeding goals, the frequency of attending a Baby Café, and their ratings of the program as helpful in solving breastfeeding problems.Methods: A total of 559 mothers attending two Baby Cafés, one in Massachusetts and the other in southern Texas, were surveyed when their babies were 6 months old and again over age 12 months. Actual breastfeeding duration was compared with the mothers' initially stated goals and American Academy of Pediatrics (AAP) recommended goals, and then evaluated against the number of Café attendances. The mother's rating of the Café for helpfulness was measured using a 1–5 effectiveness scale.Results: Results show that mothers attending either of the surveyed Baby Cafés that served distinctly different populations reported higher breastfeeding exclusivity rates and higher rates of 12-month breastfeeding duration than national rates reported by the Centers for Disease Control and Prevention (CDC). More than 70% of all mothers surveyed rated the Café as most effective.Conclusions: The Baby Café model was shown to be effective at helping mothers reach breastfeeding goals regardless of the Café's different geographical settings and the socioeconomic characteristics of the populations served.