Breastfeeding Support Practices Research Articles

Exclusive breastfeeding: Relation to gestational age, birth weight, and early neonatal ward admission. A nationwide cohort study of children born after 35 weeks of gestation.

Prematurity, being small for gestational age and early neonatal ward admission are the major neonatal conditions that may interfere with breastfeeding supportive practices in infants born at gestational age ≥35+0 weeks. We aimed to investigate the associations between gestational age, small for gestational age, early neonatal ward admission and exclusive breastfeeding at one and four months. A register-based cohort-study of all Danish singletons with gestational age ≥35+0 weeks born in 2014-2015. In Denmark, health visitors routinely conduct free home visits throughout infants' first year and thereby report breastfeeding data to The Danish National Child Health Register. These data were linked with data from other national registers. Logistic regression models estimated the odds ratio for exclusive breastfeeding at one and four months, adjusted for confounding variables. The study population comprised 106,670 infants. Compared to gestational age 40 weeks, the adjusted odds ratio for exclusive breastfeeding at one month showed a decreasing tendency from gestational age ≥42 (n = 2,282) (1.07; 95% confidence interval (CI) 0.97-1.17) to 36 weeks (n = 2,062) (0.80; 95% CI 0.73-0.88). Small for gestational age (n = 2,342) was associated with decreased adjusted odds ratio for exclusive breastfeeding at one month (0.84; 95% CI 0.77-0.92). Neonatal ward admission was associated with increased adjusted odds ratio for exclusive breastfeeding at one month among late preterm infants (gestational age 35-36 weeks; n = 3,139) (1.31; 95% CI 1.12-1.54), as opposed to among early term (gestational age 37-38 weeks; n = 19,171) (0.84; 95% CI 0.77-0.92) and term infants (gestational age >38 weeks; n = 84,360) (0.89; 95% CI 0.83-0.94). The associations seemed to persist at four months. Decreasing gestational age and small for gestational age were associated with decreased exclusive breastfeeding rates. Neonatal ward admission was associated with increased exclusive breastfeeding rates among late preterm infants, whereas the opposite was observed among early term and term infants.

Breastfeeding rates fell in an Italian baby friendly hospital during the 2020 COVID-19 pandemic year and difficulties increased.

Our aim was to evaluate the impact of the COVID-19 pandemic on breastfeeding at discharge in a Baby Friendly hospital in 2020. This study retrospectively compared healthy neonates born in 2019 with those born in 2020 at the Baby Friendly San Bonifacio Hospital in Verona, Italy. We also compared those born to mothers who tested negative and positive for the virus that causes COVID-19. Breastfeeding support practices, nationality and type of birth were evaluated. The outcomes were type of breastfeeding at discharge and the presence of breastfeeding difficulties. We analysed 2171 healthy neonates, which was 83.5% of those born in the hospital in 2019 and 2020, and 20 were born to mothers with the virus. Exclusive breastfeeding rates were 4.6% lower in 2020 than 2019 and breastfeeding difficulties rose by 10.1%. Mixed feeding, at the mother's request, and formula feeding due to medical indications, increased by 5.9% and 18.1% respectively. Most of the Baby Friendly hospital practices were implemented, but prenatal and intrapartum support decreased. Exclusive breastfeeding fell during the COVID-19 pandemic in 2020 and breastfeeding difficulties rose. These may have been due to the effect of maternal and healthcare factors during the pandemic.

The experiences of trained breastfeeding support providers that influence how breastfeeding support is practised: A protocol for a qualitative evidence synthesis.

Many women stop breastfeeding before they intend to as they cannot overcome breastfeeding difficulties. Breastfeeding support, as an evidence-based intervention by trained lay or professional breastfeeding support providers, can prevent early unintended cessation. Yet some women report dissatisfaction with support and reluctantly stop breastfeeding despite receiving this intervention. Understanding the experiences which shape how support is provided can inform effective implementation of breastfeeding support interventions. This review aims to synthesise experiences of trained breastfeeding support providers in high income settings and how these may influence their breastfeeding support practices. A qualitative systematic review of trained breastfeeding supporters' experiences of supporting women to breastfeed, as part of a generic healthcare role or focused breastfeeding support role, will be conducted. A systematic search will be performed of the databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL +), MEDLINE ALL, Maternity and Infant Care, EMBASE, APA PsycINFO, Web of Science and Scopus. Title and abstract screening using eligibility criteria will be conducted using Covidence software. Eligible papers will be agreed by the review team following full text screening and reported using PRISMA guidelines. CASP and COREQ tools will assess study methodological quality and quality of reporting. Data will be extracted using a bespoke form and coded, using Excel software for data management. Analysis will involve the three stages of thematic synthesis: initial free coding, development of descriptive and subsequent analytical themes. Confidence in findings will be assessed using the CERQual framework. This review is the first to date to synthesise qualitative evidence on experiences which influence how trained lay and professional providers support women with breastfeeding. Findings will enable deeper understanding of the underpinning mechanisms of breastfeeding support provision and inform the development of tailored interventions to improve breastfeeding rates. PROSPERO registration number: CRD42020207380.

Breastfeeding support practices in designated workplaces in the Breede Valley sub-district, Western Cape, South Africa

Background. Globally, mothers have identified employment as one of the leading barriers to exclusive and continued breastfeeding. The workplace and employment setting has been highlighted as one component of an enabling environment for breastfeeding. Objectives. To assess breastfeeding support practices in designated workplaces in the Breede Valley sub-district, Western Cape, South Africa. Methods. A quantitative, cross-sectional design study was used. An online survey was conducted amongst human resource managers and/or company managers to determine breastfeeding support practices in designated workplaces. Results. Fourteen participants completed the online survey. Breastfeeding support practices in designated workplaces were limited and inadequate, with few supportive breastfeeding practices. Onsite or nearby crèche facilities ( n =2; 14.3%), breastfeeding counsellors ( n =1; 7.1%), promotion of the benefits of breastfeeding to employees ( n =2; 14.3%) and provision of private space for expressing ( n =2; 14.3%) were not common practices. Workplace breastfeeding policies ( n =4; 28.6%) were not common practice, and were mostly found in the public sector. Forty-three percent of workplaces ( n =6; 42.9%) did not provide time for expressing at work. Conclusion. There is an urgent need to create advocacy regarding the benefits of breastfeeding support in the workplace for employers, employees and society as well as the breastfeeding rights of women in the workplace. The legislated breastfeeding break times need to be monitored to ensure better compliance in workplaces.

Современные подходы к оценке практики поддержки грудного вскармливания в неонатологических стационарах

Современные подходы к оценке практики поддержки грудного вскармливания в неонатологических стационарах

Health Professionals' Perspectives on Breastfeeding Support Practices.

Background:The decrease in rates of exclusive breastfeeding has resulted in increased rates of infant mixed feeding. The WHO Baby-Friendly Hospital Initiative (BFHI) has been associated with significant increases in breastfeeding initiation and duration in maternity hospitals. However, little is known about whether or not the teaching hospital of the University of Dammam, Saudi Arabia, followed the ten steps recommended in the BFHI.Objectives:This study was carried out to assess healthcare professionals' perspectives and opinions about the breastfeeding support practices at the teaching hospital.Materials and Methods:This research is a mixed methodology cross-sectional study carried out in the King Fahd Hospital of the University, Al-Khobar, Saudi Arabia. The first phase used a self-administered questionnaire to assess professionals' awareness and opinions about actual breastfeeding practices. The first phase results led to a qualitative interview design for the second phase. Descriptive statistics were used to describe and summarize the data. The chi-square test was used to examine the difference between the observed and expected frequencies of normal data.Results:There were no breastfeeding supporting policies followed at the hospital as per those recommended by BFHI. Mothers with breastfeeding problems were not referred for help and follow-up phone calls were not made to postpartum women after discharge. Healthcare professionals indicated that there were no hospital-based breastfeeding support groups, lactation consultants/specialists or lactation management unit available.Conclusions:There is a need for breastfeeding support policies, practices and staff education to facilitate care consistent with the ten steps of the BFHI. Further study is needed to assess mothers' perspectives on breastfeeding approaches at the King Fahd Hospital of the University.

Designing a Scale to Assess Breastfeeding Support among Public Health Nurses in Japan

Background: Promoting breastfeeding support by public health nurses (PHN) requires first that the support which they currently provide to be assessed. However, there is no assessment tool for this purpose. The aim of this study was therefore to develop a scale to assess breastfeeding support currently provided by PHN. Methods: We developed the Practice of Breastfeeding Support Scale (PBSS) for PHN based on the results of a previous study. The content validity of the PBSS was established through discussion with three other researchers. A pilot study was conducted to confirm face validity. To confirm reliability and validity, an anonymous, self-reported questionnaire was sent to PHN working in municipal offices. The statistical analyses included the Kaiser-Meyer-Olkin (KMO), Barlett’s Test of Sphericity, exploratory factor analysis (EFA), Cronbach’s alpha and correlation coefficient. Results: 768 PHN participated in this study. Cronbach’s alpha of PBSS was 0.85. The KMO measure was 0.892, and Bartlett’s Test of Sphericity was p < 0.01. Three factors together accounted for 59.3% of the variance in EFA. Construct validity was confirmed through comparison with categories from a previous study. The correlation coefficient of PBSS and Self-efficacy of Breastfeeding Support Scale were r = 0.56 (p < 0.01). PBSS comprised 15 questions and three factors including “Collecting information and assessment,” “Direct and individual support,” and “Support for group and community.” Conclusion: The reliability and validity of PBSS were confirmed. These findings suggested that the PBSS has the potential to help promote breastfeeding support by PHN by clarifying their current breastfeeding support practices and related factors.

Knowledge, Attitudes and Practices Regarding Breastfeeding Support among Village Health Volunteers in Nakhon Nayok, Thailand

Background: In Thailand, village health volunteer play an important role for breastfeeding support in the community. Objective: to assess the knowledge, attitudes and breastfeeding support practices provided by village health volunteers. Materials and Methods : The subjects were 72 village health volunteers from three sub-districts; Klong Yai, Buangsan and Chomphol of the Ongkharak district in the Nakhon Nayok province. The study was done during the period from the beginning of March to the end of June, 2014. The questionnaire has been designed to assess the knowledge, attitudes and breastfeeding support practice provided by the village health volunteers. The questionnaires were distributed to the village health volunteers and the data analyzed. The 6-month exclusive breastfeeding rates of each area were determined by home visitation. The data was collected and analyzed by the Chi square and Kruskal-Wallis test. Results: The knowledge score totaled 8 points. The median of the knowledge scores of Klong Yai, Buangsan and Chomphol were 7, 8 and 7 points, respectively. The attitude score totaled 30 points. The median of attitude scores of Klong Yai, Buangsan and Chomphol were 26, 30 and 28 points; percentages of the village health volunteer’s home visits and breastfeeding support were 75.0, 90.5 and 87.5; and the exclusive breastfeeding rates for six months were 33.3%, 39.3% and 37.0%, respectively. Conclusion: The knowledge, attitudes and breastfeeding support practices among village health volunteers in the three sub-districts were high and were consistent with the 6-month, exclusive breastfeeding rates for each area.

Engaging Chicago Hospitals in the Baby-Friendly Hospital Initiative

Breastfeeding is now widely recognized as a vital obesity prevention strategy and hospitals play a primary role in promoting, supporting and helping mothers to initiate and maintain breastfeeding. The Baby-Friendly Hospital Initiative (BFHI) provides an evidence-based model that hospitals can use to plan and implement breastfeeding quality improvement (QI) projects. Funding under Communities Putting Prevention to Work (CPPW), administered by the CDC, brought together key Chicago partners to provide individualized support and technical assistance with breastfeeding QI projects to the 19 maternity hospitals in Chicago. A community organizing approach was taken to mobilize hospital interest in breastfeeding QI projects, leading to successes, e.g. 12/19 (63%) Chicago hospitals registered with Baby-Friendly USA, Inc. (BFUSA) to pursue official Baby-Friendly designation. Key factors that fostered this success included: involving all levels of hospital staff, financial incentives, and ongoing tailored technical assistance. To assist other communities in similar work, this article discusses the approach the project took to mobilize hospitals to improve breastfeeding support practices based on the BFHI, as well as successes and lessons learned.