Breastfeeding Difficulties Research Articles

Mothers with Breastfeeding Difficulty Report Increased Depressive Symptoms and Impaired Maternal-Infant Bonding on Social Media.

Background: Protection against postpartum depression is a commonly cited maternal benefit of breastfeeding. However, recent studies have found that negative breastfeeding experiences may actually increase the risk of depressive symptoms. Objective: To investigate women's self-reported associations between breastfeeding experiences and depressive symptoms on a social media platform. Study Design: An electronic search was conducted on Reddit of all original user posts using keywords "breastfeeding" and "depression" from February 2013 to July 2021. Relevant posts and corresponding comments were manually extracted, evaluated for inclusion and exclusion criteria, and analyzed for thematic content. Results: In total, 584 entries was analyzed. Mothers most frequently described difficulty breastfeeding as the cause of new onset mental health symptoms (53%); however, mothers breastfeeding without difficulty were also susceptible (20%). Mothers also reported exacerbated preexisting mental health symptoms-predominantly related to difficulty breastfeeding (17%), but again, others experienced no difficulty (6%). Common words included among all entries were "guilt" (17%), "fail" (14%), "pressure" (7%), "shame" (6%), and "alone" (6%). Among mothers mentioning bonding (n = 99), 58% reported that breastfeeding inhibited infant bonding, versus 1% enhanced bonding; furthermore, 63% reported increased bonding after switching to formula versus 8% unchanged and 6% decreased bonding. Nearly one-quarter (23%) of all posts described inadequate breastfeeding counseling. Finally, 9% of all posts reported a negative experience with health care providers versus 6% a positive experience. Conclusions: Mothers struggling to breastfeed may not experience the classically described benefits of breastfeeding, instead experiencing increased depressive and other mental health symptoms and impaired maternal-infant bonding. Furthermore, limited provider disclosure about potential breastfeeding challenges and alternatives to breastfeeding may exacerbate mental health symptoms associated with breastfeeding difficulties. Balanced information should be presented to mothers contemplating breastfeeding in order to minimize maternal perceptions of "failure."

Ensuring ethical maternal care: addressing episiotomy trends in Pakistan

Madam, The use of routine episiotomies, particularly those performed without consent, is a concerning and escalating trend during childbirth in Pakistan. An Episiotomy is a surgical incision in the pelvic floor to enlarge the vaginal opening during labour. The incision is performed under local anaesthetic with scissors. It is deemed necessary only under certain conditions: abnormal progression of labour, suspected foetal distress, vacuum or forceps childbirth, and shoulder dystocia.1,2 Despite the WHO’s recommendation of an episiotomy rate of less than 10% to be considered safe, the rates are disproportionately high in Pakistan. This prompts the need for improved maternal care that is responsible, accountable, and consensual.3 The need for respectful maternal care is crucial in Pakistan. A study conducted in Rawalpindi analysed data from 124798 deliveries and found an 80% incidence of routine episiotomies during normal vaginal deliveries in primigravida cases.3 Another cross-sectional study conducted in Karimabad on 235 patients, also revealed an alarming prevalence of episiotomies, with a rate of 78%.4 These rates differ significantly from those of other countries, such as 17% in New Zealand and 36.5% in Norway, underscoring the potential overuse of episiotomies beyond medical need in Pakistan. Cultural beliefs and a lack of adequately trained staff likely exacerbate this disparity.2,3 Furthermore, increasing episiotomy rates can adversely impact emotional well-being, cause perineal trauma, difficulty in breastfeeding, infection, and delayed healing.2 The intensity of these impacts and the high incidence of episiotomy highlight the need for comprehensive reforms in maternal care practices to ensure the safety and well-being of women. To address this issue, it is imperative to adopt a multifaceted approach that prioritizes informed consent and aims to curb the increasing trend of episiotomies. A commonly presumed benefit of an episiotomy is the prevention of advanced tears; yet, a randomized control trial on 676 patients found no association between decreased use of episiotomy and significant prevalence of severe tears.5 This stresses the need to shift to a policy of selective episiotomies like that implemented in Vietnam. The approach encompasses allocating a budget for routine training of staff, regularly recording rates of episiotomy/tears and including updated guidance about the use of episiotomies within the curriculum.2 Furthermore, when performing an episiotomy patients must be fully informed and individually consented, written or verbal. Opt-out consent may apply in emergencies.1 Such interventions can help ensure higher maternal care standards within Pakistan.

Lingual frenotomy for ankyloglossia in infants with breastfeeding difficulties: a longitudinal observational study.

Ankyloglossia, or tongue-tie, is a variation in the anatomy of the lingual frenulum that restricts tongue movement. It is recognised as a cause of breastfeeding difficulty. We prospectively collected data from a specialist tongue-tie assessment clinic and evaluated mothers' experience using a questionnaire. We prospectively collected data from the specialist tongue-tie assessment clinic from January 2023 to October 2023 to assess factors that may influence a lingual frenotomy in an infant. Mothers were invited to complete two questionnaires, one baseline in the clinic waiting room and one follow-up, 4weeks after their clinic visit. These self-reported questionnaires assessed breastfeeding challenges, the mother's motivation for seeking an opinion regarding ankyloglossia, and the continuity of breastfeeding 4weeks following the clinic visit. During these 10months, 157 infants attended the clinic, and 96 frenotomies were performed. One hundred one participants completed baseline questionnaires, and 34 participants completed follow-up questionnaires. When mothers were asked why they wanted their baby assessed for a tongue-tie, the most common answers were difficulty with latch and nipple pain, reported by 45% and 40%, respectively. The average reported pain while breastfeeding was scored at 2.53, graded from 0 to 5 in the baseline questionnaire. This improved to 1.47 amongst women whose infants had a frenotomy. Conclusion: Our study suggests that performing a frenotomy in infants diagnosed with ankyloglossia may positively impact breastfeeding.

Interesting Case Of Congenital Tuberculosis

Background: Mycobacterium tuberculosis (TB) is a global public health problem and is the causative organism of TB. There were 234,000 deaths of children due to tuberculosis. Since most of the pregnant women who have active TB are symptomless, diagnosis of TB is usually delayed2,3. It is difficult to differentiate between true congenital TB and postnatally acquired TB. High suspicion is needed for early diagnosis and treatment. Case: A 30-day-old girl had abdominal distension 1 week before admission and refusal to feed appeared on the 30th day. Clinically, sepsis, TORCH infection was suspected. USG abdomen showed multiple hypoechoic lesions in liver. Ct chest and abdomen showed multiple discrete non-calcified nodules in bilateral lung fields and liver. Gastric aspirate for AFB was negative. Mother was screened for TB; the TSTwas positive and TB QuantiFERON gold came positive. Hence, Tru-cut Liver biopsy was done for neonate and Biopsy for Genexpert showed low level Mycobacterium TB detected. Cerebrospinal fluid analysis for acid-fast bacilli was negative. 4 drug ATT regimen was started. Two weeks after anti-TB medication, the distension completely disappeared. Conclusion: Early diagnosis and treatment is the key for the survival of neonatal TB

Forceful Milk Ejection Reflex and Tongue-Tied Neonates’ Breastfeeding Behaviour

Background: Forceful milk ejection reflex in mothers and tongue-tie in infants often cause breastfeeding difficulties. Our purpose was to observe the breastfeeding behavior of tongue-tied neonates, in the presence of forceful milk ejection of their mother versus tongue-tied infants without forceful milk ejection or in the presence of forceful milk ejection in non-tongue-tied infants. Methods: This is an observational, prospective, cohort study. The study was undertaken at the Lactation Institute, in Cluj-Napoca, Romania, between 2012 and 2018. We studied the breastfeeding behavior of neonates attending the Institute. The study includes 80 tongue-tied new-borns of mothers with forceful milk ejection (Group I), compared with the breastfeeding behavior of 40 tongue-tied neonates of mothers with normal let-down (Group II) and 29 neonates without tongue-tie in the presence of forceful let-down (Group III). Descriptive statistics, including numbers and percentages, and SAS software were utilized. Categorical data are presented as counts and percentages and analyzed with chi-square tests, utilizing R and Python software. Statistical significance was set at p-value ≤ 0.001, in some cases at p-value ≤ 0.05 using a chi-square test, sometimes validating the results with Fisher’s Exact Test. Proportional Analysis and Post-Hoc Analysis (pairwise Z-tests for proportions) were also carried out to demonstrate the frequency of cases. Results: From Group I, the majority (92.50%) were breastfed effectively in the first week, significantly different from infants in Group II (20%), where frenotomy was more frequent (92.50%) and performed mainly for suckling difficulties (86.48%). The difficult latch had a higher percentage in infants in Group II (92.50%). “Reflux-like syndrome” (93.10%), breast refusal (24.13%), and, choking (93.10%) were more frequent in infants in Group III. Conclusions: The majority of tongue-tied infants, whose mothers had early forceful milk ejection, were able to effectively breastfeed after birth. In this cohort, frenotomy might not be necessary or could be postponed. The presence of tongue-tie only, without fast milk flow, led to suckling difficulties and the need for frenotomy. Reflux-like syndrome, choking, and breast refusal were more present in infants without tongue-tie but with fast milk flow.

Academy of Breastfeeding Medicine Position Statement: Breastfeeding in Emergencies.

Background: During emergencies, including natural disasters and armed conflict, breastfeeding is critically important. Breastfeeding provides reliable nutrition and protection against infectious diseases, without the need for clean water, feeding implements, electricity, or external supplies. Key Information: Protection, promotion, and support of breastfeeding should be an integral part of all emergency preparedness plans. Breastfeeding specialists should be part of plan development. Emergency protocols should include breastfeeding specialists among emergency relief personnel, provide culturally sensitive environments for breastfeeding, and prioritize caregivers of infants in food/water distribution. Emergency relief personnel should be aware that dehydration and missed feedings can impact milk production, but stress alone does not. Emergency support should focus on keeping mothers and infants together and providing private and/or protected spaces for mothers to breastfeed or express milk. Emergency support should also focus on rapidly identifying mothers with breastfeeding difficulties and breastfeeding mothers and infants who are separated, so their needs can be prioritized. Breastfeeding support should be available to all women experiencing difficulties, including those needing reassurance. Nonbreastfed infants should be identified as a priority group requiring support. Relactation, wet-nursing, and donor milk should be considered for nonbreastfed infants. No donations of commercial milk formula (CMF), feeding bottles or teats, or breast pumps should be accepted in emergencies. The distribution of CMF must be highly controlled, provided only when infants cannot be breastfed and accompanied by a comprehensive package of support. Recommendations: Protecting, promoting, and supporting breastfeeding should be included in all emergency preparedness planning and in training of personnel.

Identification and Management of Ankyloglossia and Its Effect on Breastfeeding in Infants: Clinical Report.

Ankyloglossia refers to a congenitally tight lingual frenulum that limits the motion of the tongue. Whether the release of a tight lingual frenulum in neonates improves breastfeeding is not clear. Because many of the symptoms of ankyloglossia overlap those of other breastfeeding difficulties, a team partnership is necessary.

Breastfeeding – a survey of fathers’ support needs and preferred sources of information

BackgroundFathers can be a critical source of breastfeeding support for their partner, but little is known about what fathers would like to learn about breastfeeding. Partner’s support and encouragement enhances mother’s breastfeeding confidence and boost the capacity to address breastfeeding difficulties effectively. The aims of this study were to explore what fathers regard as important to learn around breastfeeding, and their current and preferred sources of information.MethodsA structured online survey was conducted, between September 2022 and November 2022, with fathers containing three sections: (1) sociodemographic variables; (2) perceived importance of 26 breastfeeding topics; and (3) sources of breastfeeding information. A convenience sample of expectant and current fathers aged 18 years or older, who were expecting a baby or had a child aged one year or younger, living in Australia, and able to complete survey in English was recruited. Participants were recruited on Facebook advertisement.ResultsA total of 174 fathers participated in the study, majority (75%) were aged 30–39 years, current dads (74%), and university educated (69%). The breastfeeding topics that fathers perceived as the most important/ important to learn about were how to work with their partner to overcome breastfeeding challenges, how fathers can be involved with their breastfed baby, the types of support fathers can provide to breastfeeding mothers, what to expect in the first week and the benefits of breastfeeding. The most preferred health professional sources of breastfeeding information were midwives, child and family nurses and doctors. Among non-health professional sources of support, mobile app, friends and family were most popular.ConclusionBreastfeeding information to enhance fathers’ knowledge and awareness of common breastfeeding challenges, and fathers’ role in supporting their breastfeeding partner, appear to be (most) important for fathers. Mobile app appears to be among the most preferred non-health professional ways to provide breastfeeding information to fathers.

Medical Findings in Infants Prenatally Identified with Sex Chromosome Trisomy in Year One of Life.

Sex chromosome trisomies (SCT), including XXY, XYY, and XXX syndromes, have been historically underdiagnosed. Noninvasive prenatal cell-free DNA screening has significantly increased identification of these conditions, leading to a need for pediatric care for a growing population of newborns with SCT. Our goal was to analyze and compare perinatal features, medical diagnoses, and physical features in infants with prenatal identification of SCT conditions through the first year of life. The eXtraordinarY Babies Study is an ongoing, prospective natural history study of prenatally identified children with SCT conducted by interdisciplinary teams in Colorado and Delaware. Participants were enrolled prior to 12 months of age and had pregnancy, birth, medical histories, and physical exams completed by board-certified pediatricians at 2, 6, and/or 12-month visits. Descriptive statistics were followed by comparisons between SCT groups using t-tests or ANOVA, Fisher exact, and correlations between medical features with alpha of 0.05. Relative risks were calculated compared to general population rates. 327 infants were included in the analysis (XXY=195, XXX=79, XYY=53). Major congenital anomalies were rare (1.7%). Relative risk compared to general population was elevated for breastfeeding difficulties (51.7%;RR 2.7), positional torticollis (28.2%;RR 7.2), eczema (48.0%;RR 3.5), food allergies (19.3%;RR 2.4), constipation requiring intervention (33.9%;RR 7.6), small cardiac septal defects (7.7%;RR 17.2), and structural renal abnormalities (4.4%;RR 9.7). Inpatient hospitalization was required for 12.4%, with 59.5% of hospitalizations attributable to respiratory infections. These findings of medical conditions with a higher prevalence can inform anticipatory guidance and medical management for pediatricians caring for infants with SCT. Medical findings in largest cohort of prenatally identified infants with XXY, Trisomy X, and XYY from birth to 12 months and implications for pediatric care.What's Known on This Subject: One in ∼500 individuals have an extra X or Y chromosome, or sex chromosome trisomy (SCT). Prenatal screening is now routinely identifying SCT, however there are few studies to guide perinatal and infant care for these individuals.What This Study Adds: This prospective observational study presents medical features for 327 infants with prenatally identified SCT from birth through the first year of life. Results identify where proactive screenings and/or interventions may be warranted for infants with SCT.

Exploring prevalence and factors associated with postpartum depression among Ukrainian women.

Postpartum depression negatively impacts maternal mental health and child development. The high prevalence of postpartum depression (PPD) in low and lower middle-income countries raises questions about its predictors. This study examines the association between PPD and breastfeeding experience, child death, unresolved pregnancy, forced displacement, COVID-19 pandemic lockdown, marital, and financial status among Ukrainian women. This online study recruited 1634 Ukrainian mothers of children aged 0-5 years through non-governmental organizations providing services to them. The Edinburgh Postnatal Depression Scale (EPDS), with a cut-off of ≥13, was used to assess depressive symptoms in the postpartum period. Independent t-tests, chi-squared tests, one-way ANOVA, non-parametric correlations, and logistic regression tests were used to analyze the data. The prevalence of depressive symptoms was 39.0% (n=1631). There was a positive association between EPDS scores and breastfeeding difficulties, pandemic lockdown, and financial difficulties. We did not find an association between PPD symptoms and unresolved pregnancy, death of a child, being affected by COVID-19, and forced displacement. We found that EPDS scores for women who did not experience forced displacement (n=1528) were significantly higher compared to displaced mothers (n=74). The present study of Ukrainian women shows that women experienced depressive symptoms influenced by various factors including breastfeeding difficulties, pandemic lockdown, and financial difficulties. There is a need for additional research into such factors as unresolved pregnancy, the death of a child, being affected by COVID-19, and forced displacement.

BREASTFEEDING BARRIERS THAT CONTRIBUTE TO EXCLUSIVE BREASTFEEDING FAILURE

Background: Breast milk is the best nutrition for children, but many children in Indonesia do not receive exclusive breastfeeding. According to SSGI data, only 48.58% of babies in Bogor district are exclusively breastfed. This is due to various obstacles in the breastfeeding process, which can stem from both maternal and infant factors. If this situation continues, the child's nutritional needs may not be adequately met. Objective: To determine the most dominant factor in exclusive breastfeeding failure. Method: A cross-sectional study was conducted with a random sample of 182 individuals in Bogor Regency. Data were analyzed using the chi-square test and logistic regression. Result: There was no significant association between exclusive breastfeeding failure and mothers having difficulty managing time between work and breastfeeding, difficulties in positioning the baby, or experiencing nipple blisters (p≤0.05). Additionally, no significant associations were found between exclusive breastfeeding failure and infants remaining fussy even after breastfeeding, mothers experiencing depression during initial breastfeeding, feeling embarrassed while breastfeeding, infants having difficulty breastfeeding, or mothers experiencing swollen breasts (p>0.05). Conclusion: Infants who remained fussy despite breastfeeding were found to be the most dominant factor contributing to exclusive breastfeeding failure, with an odds ratio (OR) of 2.308.

Frenotomy for Ankyloglossia: Conventional technique under general anesthesia in pediatric patients

Introduction: Ankyloglossia, commonly known as tongue-tie, is a prevalent birth defect characterized by a shortened and taut lingual frenulum, resulting in various complications. It occurs more frequently in males and can lead to breastfeeding difficulties, poor weight gain, and challenges in oral hygiene. The purpose of this article is to discuss frenotomy as a surgical intervention for ankyloglossia, involving the removal of the lingual frenulum under general anesthesia. Case History: a 9-year-old male patient with class III ankyloglossia, experiencing difficulty in pronouncing words and maintaining oral hygiene due to a short lingual frenulum. Despite initial behavioral challenges, comprehensive dental treatment, including frenectomy under general anesthesia, was successfully performed. Discussion: Ankyloglossia, or tongue-tie, results from cellular degeneration of the lingual frenulum, often associated with a genetic mutation in the MTHFR gene, affecting folate processing. Tongue development involves the migration of muscles from pharyngeal arches, leading to attachment issues at the lingual frenulum, causing ankyloglossia. Untreated consequences include feeding difficulties, dental decay, and speech articulation challenges. Conventional frenotomy, a simple and efficient technique, offers rapid, cost-effective symptom relief, promoting smooth recovery and improved outcomes compared to laser procedures. Conclusion: frenotomy for ankyloglossia under general anesthesia effectively improves tongue mobility and alleviates associated symptoms. General anesthesia ensures patient comfort and facilitates precise execution of the procedure. The conventional frenotomy technique enhances tongue movements, highlighting the efficacy of surgical intervention for this condition.

A history of depression and prenatal depression are associated with a lower likelihood of breastfeeding initiation and maintenance, and more breastfeeding problems.

This study tests the hypotheses that lifetime history of depression, and prenatal depression, are associated with a reduced likelihood of breastfeeding initiation (giving the baby any breastmilk during the first week of life) and breastfeeding maintenance (giving the baby breastmilk for at least 6 months), and a greater likelihood of reporting breastfeeding problems. We analyzed data from the Norwegian Mother, Father, and Child cohort study (MoBa), N = 78,307. Mothers reported a lifetime history of depression during the second trimester of pregnancy, and current symptoms of depression during the third trimester using the Hopkins Symptoms Checklist short version (SCL-8). At six months postpartum, mothers self-reported breastfeeding initiation, maintenance, and difficulties. Using binary logistic regression analyses, we report that a lifetime history of depression is associated with a lower likelihood of breastfeeding initiation (OR = 0.751, 95%CI = 0.650-0.938), breastfeeding maintenance (OR = 0.712, 95%CI = 0.669-0.785), and a greater likelihood of breastfeeding difficulties (OR = 1.86, 95%CI = 1.72-2.06). Similarly, prenatal depression was associated with a lower likelihood of breastfeeding initiation (OR = 0.904, 95%CI = 0.878-0.929), breastfeeding maintenance (OR = 0.929, 95%CI = 0.920-0.938), and a greater likelihood of breastfeeding difficulties (OR = 1.10, 95%CI = 1.09-1.12). Results remained largely unchanged when covaried for several confounding variables, including medication use. We provide novel evidence that pre-conception and prenatal symptoms of depression are associated with breastfeeding outcomes. This information could be used to identify women very early in pregnancy who may need additional support with breastfeeding. There is also a need to fully understand the biopsychosocial mechanisms that mediate the relationship between depression prior to birth and breastfeeding outcomes.

Preventing Postpartum Anxiety and Obsessive-Compulsive Disorder Over the Internet: An Open-Trial Pilot Study

Anxiety disorders are the most common postpartum psychiatric conditions, yet limited research exists on the prevention of postpartum anxiety and obsessive-compulsive disorder (OCD). Postpartum anxiety leads to significant problems in both mother and child, such as maternal depression, difficulty breastfeeding, interference with parent-infant bonding, and childhood anxiety. In the current study, we tested the feasibility, acceptability, and initial efficacy of an Internet-delivered postpartum anxiety and OCD prevention program, “Preventing Postpartum Onset Distress” (P-POD), in a sample of 15 pregnant women in their third trimester. Geared toward at-risk pregnant people, P-POD includes seven 30-minute educational, interactive modules that teach skills derived from cognitive-behavioral treatment for anxiety and OCD. P-POD also includes three additional modules for partners, with strategies for supporting their partners. Findings suggest that P-POD is acceptable and feasible. Participants experienced reductions in postpartum anxiety risk factors. However, this was a small, open-trial pilot study with a relatively homogeneous sample. Future research should compare P-POD to an active control condition, use more diverse samples, include qualitative interviews, and assess symptoms postpartum.

Frenectomy management for Ankyloglossia in a 1-Year-old patient under general anesthesia: A case report

Introduction: Ankyloglossia is defined as a congenital disorder that alters tongue mobility and function. It is listed as one of the possible reasons behind breastfeeding issues. The WHO currently recommends mothers to breastfeed exclusively up to 6 months of age, emphasizing the importance of promptly identifying any breastfeeding obstacles and determining the root cause of the problems as the primary focus. The purpose of writing this article is to describe a frenectomy as a surgical procedure that addresses ankyloglossia by excising the lingual frenulum with general anesthesia. Case History: A 1-year-old male patient presented at Dr. Saiful Anwar Regional General Hospital with complaints of difficulty in breastfeeding and consuming complementary foods, as well as prolonged pain experienced by the mother during breastfeeding. The patient had no history of systemic diseases such as heart disease or blood disorders, and there were no known allergies to food or medications. The patient was uncooperative (Frankl scale number 1). After analyzing the ankyloglossia, the choice of frenectomy with general anesthesia was chosen to treat this case. Discussion: Dental examinations and treatments for uncooperative 1-year-old children can be challenging in regular dental offices. Effective behavioral management, such as general anesthesia (GA), is required for safe and efficient treatment. GA involves a multidisciplinary team to oversee the procedure stages, allowing for one-visit treatment, reduced anxiety, and a safer, less painful dental experience. Conclusion: Frenectomy procedure under GA has been performed as an option to facilitate restorative therapy, improve nutritional intake, and quality of life.

The Consequences of A History of Violence on Women's Pregnancy and Childbirth in the Nordic Countries: A Scoping Review.

Violence against women (VAW) is a global challenge also in the childbearing period. Despite high gender equality, there is a high prevalence of VAW in the Nordic countries. This scoping review aims to explore predictors for and consequences of a history of violence on women's pregnancy and childbirth in the Nordic countries, including women's experience of the impact of violence and the interventions used to detect, address consequences, and prevent further violence. The framework by Arksey and O'Malley was followed, and English, Finnish, Icelandic, Norwegian, Danish, and Swedish literature was included. The population was women aged ≥18 residing in the Nordic countries during the perinatal period. Eight databases were searched: MEDLINE, CINAHL, PubMed, PsycINFO, Web of Science, ASSIA, Social Services-, and Sociological abstracts. There was no limitation of the search time frame. The initial screening resulted in 1,104 records, and after removing duplicates, 452 remained. Finally, 61 papers met the inclusion criteria. The results covering the past 32 years indicated that childbearing women with a history of violence are at greater risk of common complaints and hospitalization during pregnancy, fear of childbirth, Cesarean section, breastfeeding difficulties, and physical and mental health problems. While extensive research was found on the associations between a history of and current violence and outcomes related to pregnancy, there was a lack of intervention studies and studies from Finland. Efforts must be made to scientifically test the methods used to reduce and treat the adverse effects of a history of violence and prevent further violence.

Breastfeeding mother’s experiences with breastfeeding counselling: a qualitative study

BackgroundMothers are recommended to breastfeed their children but can find it challenging and experience breastfeeding problems. Qualified breastfeeding counselling from healthcare professionals can help mothers master breastfeeding, but there is a need to explore mothers’ lived experiences with receiving breastfeeding counselling. We aimed to reveal breastfeeding mothers’ experiences with receiving breastfeeding counselling from midwives and public health nurses (PHNs) to provide a deeper insight into the phenomenon of breastfeeding counselling, which may improve breastfeeding counselling in practice.MethodsA qualitative design with a hermeneutic phenomenological approach was used. Individual interviews of 11 breastfeeding mothers from Norway were conducted from September 2021 to 2022. Van Manen’s guided existential inquiry guided the reflective process to provide deeper insights into the phenomenon of breastfeeding counselling.ResultsThe study captured the meaning of breastfeeding mothers’ lived experiences with breastfeeding counselling. Three themes and eight sub-themes were found. Breastfeeding was at stake for the mothers because breastfeeding could be reduced or stopped, and qualified breastfeeding counselling from midwives and PHNs was essential for them to establish and continue breastfeeding. They needed to be perceived as both breastfeeding mothers and as women with their own needs to master everyday life during the breastfeeding period.ConclusionsThis study offers insights to midwives, PHNs and others offering breastfeeding counselling by facilitating an understanding of being a breastfeeding mother receiving breastfeeding counselling. Qualified breastfeeding counselling and a trusting relationship with midwives and PHNs are essential for mothers to establish and continue breastfeeding, while deficient counselling may cause breastfeeding difficulties. Mothers need to be treated as whole and competent persons to avoid objectification and fathers/partners need to be included in breastfeeding counselling. The ‘Baby-Friendly Hospital Initiative’ should be continued, and guidelines should align with the mothers’ need to incorporate breastfeeding into their daily lives during the breastfeeding period.

The Effect of Hot Application Applied to the Breast with the Help of the Thera Pearl in the Postpartum Period on Mothers' Milk Perception and Postpartum Breastfeeding Self-Efficacy: A Randomized Controlled Study.

Breastfeeding difficulties are often present in the first weeks of the postpartum period, and various factors can cause a mother's early cessation of breastfeeding. Such factors include mothers' self-efficacy and perception of insufficient milk. This study aimed to examine the effect of a hot application on the breast with the help of the Thera Pearl in the postpartum period on milk perception and breastfeeding self-efficacy. This was a randomized controlled trial. This study was completed with 64 puerperal mothers, 31 of whom were control and 33 were experimental. A Personal Information Form, Breastfeeding Observation Form, Breastfeeding Self-Efficacy Scale, and Insufficient Milk Perception Scale were used to collect data. The average breastfeeding self-efficacy scale scores of the experimental group were 42.46 and 62, respectively, at the first and last follow-up, while the control group's mean scores were 57.42 and 47. The average scores of the experimental group on the insufficient milk perception scale were 19, 28, and 48, respectively, from the first to the last follow-up, while those of the control group were 28, 24, and 34, respectively. As a result, self-efficacy and milk perception are important factors affecting breastfeeding. In this study, we found that Thera Pearl application increased breastfeeding self-efficacy but did not affect milk perception.

The Efficacy of Early Osteopathic Therapy in Restoring Proper Sucking in Breastfed Infants: Preliminary Findings from a Pilot Study.

Despite the care provided, some newborns, who are perfectly healthy, show functional alterations that impair a good breast attack in the first few days. This situation often leads to the early failure of lactation. We conducted a randomized single-blind controlled trial to evaluate whether four weeks of osteopathic treatment can normalize the sucking score in a group of neonates with impaired lactation ability. Forty-two healthy full-term neonates were enrolled in this study. On the basis of the sucking score and the assessment of the infant's breastfeeding skills, infants who had intrinsic breastfeeding difficulties were selected. The inclusion criteria were healthy infants born > 37 weeks, a suction score ≤ 6, and any breast milk at enrolment. At the end of the study, the sucking score was significantly greater in the osteopathic group than in the untreated group; the median sucking score in the treated group was in the normal range, while it remained lower in the untreated group. At the end of the follow-up, the percentage of exclusively breastfeeding infants in the treatment group increased by +25%. This pilot study demonstrates the efficacy of early osteopathic intervention to relieve breastfeeding difficulties in newborns in the first few weeks of life.

Thoughts and experiences of well-educated fathers about their role when breastfeeding difficulties arose

ObjectiveTo investigate how fathers or partners perceive their roles as new parents when confronted with early breastfeeding challenges, how they navigate these difficulties, and the specific type of support they seek from the Child Health Care Centre (CHCC). MethodIn-depth, individual interviews conducted with 12 partners of women for whom breastfeeding was difficult. Reflexive thematic analysis was applied on the interview data. ResultsInterviews resulted in three themes: 1) ‘It is a revolutionary time to be a new father’ represented a tumultuous time when fathers wanted to be involved in all decisions and part of a strong team with their partners. 2) ‘When a breastfeeding problem arose’; fathers questioned the sovereignty of breast milk and began to seek more knowledge. They experienced a strong social norm about breastfeeding that led to feelings of guilt for their partners. They felt helpless when their partners suffered and lacked support. 3) ‘Child Health Care Centre’s duty’; was instrumental, as knowledge and competence were found to be important for trust. The fathers wanted concrete solutions to breastfeeding problems and more conversations of support with the CHCC nurse. ConclusionWell-educated fathers desire to protect their partners as they experience suffering due to a robust social norm telling them that breastfeeding is best. This can result in them starting to question the sovereignty of breast milk. Fathers need support to help their partners successfully during breastfeeding. They want counselling to strengthen their role as parents and help them build trusting teams with their partners.