Continued Breastfeeding Research Articles

Knowledge, Intention, and Self-Efficacy Associated with Breastfeeding: Impact of These Factors on Breastfeeding during Postpartum Hospital Stays in Taiwanese Women.

Breastfeeding knowledge, intention, and self-efficacy affect breastfeeding rates during the postpartum period. Insufficient knowledge, lack of intention, and poor breastfeeding self-efficacy reduce the likelihood of breastfeeding postpartum. The purposes of this study were to (1) assess women’s intention to breastfeed and knowledge and self-efficacy regarding breastfeeding following childbirth, and to (2) identify the factors associated with postpartum breastfeeding during women’s hospital stays. This longitudinal study with a pretest and posttest design study recruited pregnant women from the gynecology and obstetrics outpatient departments and inpatient wards at a medical center in northern Taiwan. Demographic and obstetric characteristics were recorded, and participants were assessed using the Numeric Rating Scale, the Breastfeeding Knowledge Questionnaire, the Breastfeeding Self-Efficacy Scale—Short Form, and breastfeeding status postpartum. Of the 120 participants, 25% reported breastfeeding during the postpartum hospital stay. Postpartum breastfeeding was associated with lower levels of education and higher prenatal levels of breastfeeding intention. Establishing a breastfeeding-friendly environment in the family and workplace may effectively increase continued breastfeeding.

Realities and challenges of breastfeeding policy in the context of HIV: a qualitative study on community perspectives on facilitators and barriers related to breastfeeding among HIV positive mothers in Baringo County, Kenya

BackgroundAlthough recent policies have sought to increase the rates of exclusive breastfeeding (EBF) and continued breastfeeding for HIV exposed infants, few programs have considered the multiple social and cultural barriers to the practice. Therefore, to generate evidence for exclusive and continued breastfeeding policies in Kenya, we examined community perspectives on the facilitators and barriers in adherence to EBF for the HIV positive mothers.MethodsQualitative research was conducted in Koibatek, a sub-County in Baringo County Kenya, in August 2014 among 205 respondents. A total of 14 focus group discussions (n = 177), 14 In-depth Interviews and 16 key informant interviews were conducted. Transcribed data was analyzed thematically. NVivo version 10.0 computer qualitative software program was used to manage and facilitate the analysis.ResultsFacilitators to exclusive breastfeeding were perceived to include counselling at the health facility, desire to have a healthy baby, use of antiretroviral drugs and health benefits associated with breastmilk. Barriers to EBF included poor dissemination of policies, knowledge gap, misinterpretation of EBF, inadequate counselling, attitude of mother and health workers due to fear of vertical HIV transmission, stigma related to misconception and misinformation that EBF is only compulsory for HIV positive mothers, stigma related to HIV and disclosure, social pressure, lack of male involvement, cultural practices and traditions, employment, food insecurity.ConclusionsThere are multiple facilitators and barriers of optimal breastfeeding that needs a holistic approach to interventions aimed at achieving elimination of mother to child transmission. Extension of infant feeding support in the context of HIV to the community while building on existing interventions such as the Baby Friendly Community Initiative is key to providing confidential support services for the additional needs faced by HIV positive mothers.

The challenges of medically complex breastfed children and their families: A systematic review.

Exclusive breastfeeding for the first 6 months and then alongside solid food for the first 2 years and beyond is the gold standard in young child nutrition. There is an abundance of literature relating to the preventative nature of breastmilk and breastfeeding against many infectious diseases and chronic conditions. However, despite medically complex infants and children being a group that could benefit most from continued breastfeeding, breastfeeding duration and exclusivity are lower among more complex paediatric populations. The reasons for this are not well known, and there is a paucity of data relating to supporting infants who have acute or chronic illness, disability or congenital anomaly to breastfeed. This systematic review aimed to understand the challenges of breast/chestfeeding the medically complex child and to establish the gaps in healthcare provision that act as barriers to optimal infant and young child feeding. The search was limited to studies published in English, focused on breastfed sick infants in hospital, with no date limits as there is no previous systematic review. Of 786 papers retrieved, 11 studies were included for review, and seven themes identified. Themes included practical and psychological challenges of continuing to breastfeed in a hospital setting, complications of the condition making breastfeeding difficult, lack of specialist breastfeeding support from hospital staff and a lack of availability of specialist equipment to support complex breastfeeding. The findings affirm the lack of consistent high‐quality care for lactation support in paediatric settings and reinforce the need for further focused research in this area.

Level of awareness of the benefits, socio-demographic and cultural factors influencing exclusive breastfeeding among mothers attending MCH clinic in Tudor sub county hospital

Background: Knowledge of exclusive breastfeeding (EBF) among women is essential when promoting optimal breastfeeding practices. Breastfeeding is recommended for the first six months of life and continuation of breastfeeding and adequate complementary foods for up to two years of age or beyond.Methods: A descriptive cross-sectional study design was used. This study utilized a mixed method approach (qualitative and quantitative).Results: The prevalence of exclusive breastfeeding was low at 33.6%. Data revealed that 60.9% of respondents were knowledgeable on the benefits of EBF, while 38.6% were not knowledgeable, the rest of the respondents did not respond or their answers were not valid.Conclusions: Women's knowledge on benefits EBF and intention to practice it is still low. There was significant difference in the participants place of residence (rural versus urban).

Knowledge and Practices Regarding Infant and Young Child Feeding among Mothers Working in Readymade Garments Sector in Bangladesh: A Cross-Sectional Survey

Optimum is. Adequate Infant and young child feeding (IYCF), critical for child’s growth and development, requires a significant amount of time andcan be challenging for working mothers. In Bangladesh, about four million women work long-hours in Readymade Garment (RMG) factories without proper maternity benefits which raises concern regarding optimum IYCF practice. We conducted a descriptive cross-sectional study in Dhaka, Bangladesh to identify the knowledge and common practices of IYCF among mothers working in Readymade Garment sector. Ninety-three women of reproductive age (15-49 years), working in Readymade Garment sector, with children aged 6-23 months, were interviewed. Our study revealed- majority knew about exclusive breast feeding (EBF) (76%), duration to continue breast feeding (73%) and early initiation of breast feeding (53%). The exclusive breast-feeding practice in mothers employed in RMG sector was 44%. Three-fourths of the mothers knew and initiated complementary feeding timely. Both knowledge regarding age-adjusted minimum meal frequency (MMF) (19.4%) and minimum quantity (8.6%) were low; compared to actual practices. Nearly two-fifth of the mothers (40%) had to start working before their child reached six months of age enabling them to provide their baby with breastmilk substitutes. Mothers employed in Readymade Garment sector had better IYCF practice than general population. Proper workplace environment with mandatory breast-feeding corners, daycare facilities and ensuring maternity benefits in these mothers could help achieve an even better IYCF practices for their children.

Intervention Strategies and Lessons Learned From a Student-Led Initiative to Support Lactating Women in the University Setting.

The benefits of breastfeeding for mother and baby are strongly supported by research. However, lactating parents who return to school or work soon after delivery face many barriers to continued breastfeeding. This article presents a student-led initiative to support lactation at a large public university that emerged from advocacy efforts of student mothers of color. The socioecological model was used as a framework to understand and address the multifaceted influences on breastfeeding practices. Project activities included providing breastfeeding education to lactating parents and their partners, measuring availability and accessibility of lactation spaces, improving lactation spaces, connecting university stakeholders, and strengthening university lactation policies. The project achieved the following outcomes: formation of a stakeholder group with members across campus departments, improvement in accessibility and appropriateness of lactation spaces, provision of breastfeeding services through workshops and one-on-one appointments with lactation educators, and creation and dissemination of an online toolkit outlining parents' lactation rights and support available on campus. Comprehensive lactation support at universities is essential to enhance educational and professional equity for women and to promote postpartum and infant health. Throughout the project implementation, the team learned many lessons that can help guide similar university initiatives.

Effect of the theory of planned behavior on primipara breastfeeding.

Breastfeeding is the most effective way to provide food for the healthy growth and development of babies. It has been reported in the literature that interventions on parturients, with the theory of planned behavior (TPB) as the guiding framework, can achieve good results. The purpose of the present study was to explore the effect of the TPB on primipara breastfeeding. A total of 70 primiparas, who were given regular intervention mode at Haian People's Hospital from May 2017 to May 2018, were selected as the control group, and a total of 70 primiparas, who were given the TPB model from June 2018 to June 2019, were selected as the observation group. Exclusive breastfeeding rates, continuous breastfeeding rates, and breastfeeding confidence and breastfeeding impact factors were compared between the two groups. After the intervention, the pure breastfeeding rates of the observation group at discharge, 1 month after delivery, and 4 months after delivery were higher than those of the control group (P<0.05). After intervention, the continuous breastfeeding rates of the observation group was higher than that of the control group at 4 months after delivery (P<0.05). After intervention, the skill dimension, inner activity dimension, and total score of the observation group were higher than those of the control group (P<0.05). After intervention, scores of attitude, perceptual behavior control, and knowledge in the observation group were higher than those of the control group (P<0.05). The application of the TPB to primipara breastfeeding can significantly increase the rate of exclusive breastfeeding and continuous breastfeeding, and effectively improve the impact factors of breastfeeding.

Assessment of Knowledge and Practice on Breast Feeding Among Mothers of Children Aged Less Than Two Years and Associated Factors in Areka Town, Wolita Zone, Southern Ethiopia, 2018

World health organization guideline recommend that continuous frequent and on-demand breast feeding until two years of age and beyond is essential for the child as well as the mother. Breast feeding aids general health, growth and development of the children. This study will Asses knowledge and practice on breast feeding among mothers of children aged less than two years and associated factors in Araka town, Woliat zone,South Ethiopia community based cross sectional study was conduct among 286 mothers in Areka town on May 2018. By using simple random sampling technique1 kebele was selected from 4 kebeles of Areka town and lottery method was used to get required sample size. structured questionnaire was used for collecting data from respondents .The data was analyzed and processed by SPSS window version 18 and presented in the form of percentage, proportions, and narrative sand associations are identified . From the total of 274 mothers, 56.6% of the mothers have good knowledge about the benefits of breast-feeding 43.6% poor knowledge about child breast feeding. From the total of 274,132 (48.2%) have good practice of breast feeding and 142(51.2%) mothers have poor practice of breast feeding. multivariate logistic regression analysis showed mothers of age20-24 and mothers of age 30-34 practiced appropriate breastfeeding less likely than mothers with age greater than 35 years of age. Mothers who attended higher education were more knowledgeable when compared to mothers not attended formal education. Mothers who are government employ are more likely know about importance of breast feed as compared to students. The result of this study demonstrated that more than half of mothers of children under two years of age have good knowledge about benefit of breast feeding and less than half of respondent have good practice of breast feeding. Keywords: Breast feeding, knowledge, practice DOI: 10.7176/JHMN/88-01 Publication date: April 30 th 2021

Breastfeeding in women with rheumatic diseases

ObjectiveMany rheumatologists and women with rheumatic disease worry that the disease or treatment will prevent breast feeding. International guidelines establish, however, that most antirheumatic medications are compatible with breast feeding....

Breast milk: more than just nutrition!

From an evolutionary and nutritional standpoint, exclusive human milk feeding for the first 6 months of life, with continued breastfeeding for 1 to 2 years of life, is recognized as the gold standard nourishment for the infant: it is a species-specific food, with a composition designed by nature to better respond to the biological and psychological needs of the newborn/infant. Human milk contains many hundreds of bioactive molecules that protect newborn against infection and inflammation and contribute to immune maturation, organ development, and healthy microbial colonization. Compared with formula feeding, breastfeeding has been associated with decreased morbidity and mortality in infants and to lower incidence of gastrointestinal infections and inflammatory, respiratory and allergic disease. Here, we briefly review the nutritional and functional composition of human milk and provide an overview of its varied bioactive factors.

Exploring Plant and Behaviour on Usada Herbal Galactagogue Usage among Lactating Mothers in Bali

Background: Breastfeeding is essential for the health of newborn infants and mothers. Basic health research in 2018 shows that exclusive breastfeeding in Bali has not reached the national target. High rates of cesarean section delay breastfeeding initiation, the important predictor of continued breastfeeding. Main concern for lactating mothers about medications, increase the use of herbal galactagogue to aid lactation. The use of traditional medicinal plant in Bali is 40% higher than national average and its existence is strengthened by the issuance of Bali Governor Regulation No. 55 of 2019 concerning Traditional Balinese Health Services. Despite increasing popularity of traditional medicine, there are currently limited data available on the plant list and pattern of use herbal galactagogue. Objectives: to explore the galactagogue plants, pattern of use, perceived effectiveness of herbal galactagogues during breastfeeding among lactating mother’s in Bali. Material and Methods: This study was conducted using a questionnaires and in-depth interviews. The questionnaire and interview guideline was validated by lactation consultants and traditional health practitioners in Bali. The study was approved by Human Research Ethic Committee of Bina Usada Bali. Results: The use of herbal galaktagogue is mostly practiced by highly educated mothers, mother’s occupation as health workers and primiparous. There are 26 types of plants that are often used by lactating mothers in Bali. Majority of respondent begin to use herbal galactagogue after giving birth (82%) for approximately &lt; 1 month. Majority of lactating mothers in Bali perceived effectiveness of herbal galactagogue usage based on breastfeeding adequacy indicators. About 95% respondents feel confidence and have self-empowerment after use herbal galactagogue, resultes in psychological benefits. Conclusions: The use of herbal galactagogue is common amongst lactating mothers in Bali, while information about efficacy and safety is lacking. Futher research is needed to give evidence-based information to support exclusive breastfeeding.

Understanding Black Matriarchal Role Models in the U.S. Attitudes and Beliefs About Breastfeeding.

Introduction: Despite the tremendous health benefits for both mother and infant, black women (including African Americans and those who self-identify as black) have lower rates of breastfeeding than all other racial groups. Historically, matriarchal role models have been essential within the black family structure. The purpose of this study was to explore matriarchal role models' attitudes and beliefs about breastfeeding. Methods: Thirty-eight black women between the ages of 46-82 years were surveyed regarding their perceptions of breastfeeding. Results: Our results revealed that 44.1% of the participants believed that breastfeeding is a better infant feeding method. However, 52.6% of the participants did not demonstrate confidence in their ability to breastfeed overall. Conclusions: These findings suggest that while black matriarchal role models have positive attitudes about breastfeeding behaviors, they may need to be educated along with postpartum and/or prenatal women about breastfeeding benefits and techniques to better support and improve black women's initiation and continuation of breastfeeding.

Factors influencing exclusive breastfeeding rates until 6\xa0months postpartum: the Japan Environment and Children\u2019s Study

This research aimed to examine the efficacy of the early initiation of breastfeeding within 1 h of birth, early skin-to-skin contact, and rooming-in for the continuation of exclusive breastfeeding until 6 months postpartum. The research used data from the Japan Environment and Children’s Study (JECS), a nationwide government-funded birth cohort study. A total of 80,491 mothers in Japan between January 2011 and March 2014 who succeeded or failed to exclusively breastfeed to 6 months were surveyed in JECS. Multiple logistic regression model was used to analyse the data. The percentage of mothers who succeeded in exclusively breastfeeding to 6 months is 37.4%. Adjusted odds ratios were analysed for all 35 variables. Early initiation of breastfeeding (adjusted odds ratio [AOR]: 1.455 [1.401–1.512]), early skin-to-skin contact (AOR: 1.233 [1.165–1.304]), and rooming-in (AOR: 1.567 [1.454–1.690]) affected continuation of exclusive breastfeeding. Regional social capital (AOR: 1.133 [1.061–1.210]) was also discovered to support the continuation of breastfeeding. In contrast, the most influential inhibiting factors were starting childcare (AOR: 0.126 [0.113–0.141]), smoking during pregnancy (AOR: 0.557 [0.496–0.627]), and obese body type during early pregnancy (AOR: 0.667 [0.627–0.710]).

Using citizen science to engage the public in monitoring workplace breastfeeding support in Australia.

Returning to work is a major barrier to continued breastfeeding. While many large organisations in Australia have policies to support breastfeeding and expressing at work, it is not known how these are implemented in practice, what support is available in smaller workplaces or to what extent workplace support meets the needs of breastfeeding mothers. This pilot study trialled a citizen science approach where members of the public provided photographs and descriptions of breastfeeding facilities and support within their workplaces. The study was promoted through community networks and social media, and data were submitted via an online survey. Data were analysed inductively to identify key themes. Thirty-seven participants provided data on breastfeeding support in their workplace. Three key themes were identified: physical features and facilities; workplace culture; and organisational and occupational characteristics. There was considerable variation in workplace support and around half of the participants indicated that they had to use communal, poorly equipped and/or unhygienic spaces to breastfeed or express at work. While some employers have taken important steps towards supporting mothers to combine breastfeeding and work, there is room for improvement. Through this pilot study, we have demonstrated the feasibility and value of using a citizen science approach to obtain data from a range of workplaces along with perceptions of workplace characteristics that support or hinder breastfeeding and expressing at work. SO WHAT?: Citizen science is a useful approach to capturing data on workplace support for breastfeeding and could be scaled up to enable ongoing monitoring. The findings raise important issues around the interpretation and implementation of current legislation to support mothers in the workplace.

The World Health Organisation’s recommendation on breastfeeding: Assessing knowledge and practice among mothers in Abuja, Northern Nigeria

Despite the fact that breastfeeding remains the healthiest, simplest and least expensive means of meeting the nutritional needs of newborns and infants, the knowledge and practice as recommended by WHO remain low in most low-and middle-income countries. This study aims at exploring the gap in the knowledge of exclusive breastfeeding among mothers in Northern Nigeria as well as comparing their practises with the WHO recommendations. This was a cross-sectional facility-based study among 343 mothers in Abuja, Northern Nigeria. Data was collected over 8 weeks using a structured interviewer-administered questionnaire assessing knowledge and practise of breastfeeding based on the WHO recommendations. Data collected were analyzed using SPSS version 22. Chi square test of statistical significance was used to measure the degree of bivariate associations at a level of p &lt; 0.05. Only 42.6% of the mothers had good general knowledge of breastfeeding. Exclusive breastfeeding for 6 months was practised by 232 (75.1%) mothers. Having more than one child was associated with good knowledge of breastfeeding (χ2 = 7.331, p = 0.007) while having poor knowledge of breastfeeding (χ2=5.722, p=0.017) was associated with exclusive breastfeeding practise. Commonest reasons for not practising exclusive breastfeeding were insufficient breast milk (38.7%) and resumption of work (19.8%). In this study, the practise of initiating breastfeeding within an hour after birth and exclusive breastfeeding are both in line with WHO recommendations. Continuous breastfeeding awareness campaigns are needed to improve knowledge and sustain the practise of exclusive breastfeeding.&gt;

Management of idiopathic granulomatous mastitis in lactation: case report and review of the literature

BackgroundIdiopathic Granulomatous Mastitis (IGM) is a benign chronic inflammatory breast condition that mimics two common breast disorders: breast carcinoma and breast abscess. It can form breast masses, fistulae, and fluid collections, resulting in breast disfigurement with retraction and nipple areolar complex (NAC) inversion. IGM most often presents in women of childbearing age within a few years of pregnancy, and can significantly impact lactation. Despite the prevalence of this disease, no current literature describes an approach to managing IGM during breastfeeding.Case presentationA 28-year-old G3P2 patient of Native American origin presented to her obstetrician at 7 months pregnant with worsening left breast swelling and redness. She underwent a mammogram, ultrasound and core needle biopsy that confirmed the diagnosis of Idiopathic Granulomatous Mastitis. During the postpartum period, she underwent intralesional triamcinolone injections of her left breast. Due to the contraindication of breastfeeding after local steroid injection, the patient stopped breastfeeding from the affected breast and continued breastfeeding unilaterally.ConclusionsIdiopathic Granulomatous Mastitis is a challenging chronic inflammatory breast disease that affects women primarily in the reproductive years, with a higher incidence in patients of Hispanic, Native American, Middle Eastern, and African descent. Treatment of IGM during pregnancy and lactation has thus far not been addressed. We review the literature on the treatment of IGM in the non-lactating population, and propose considerations for treating breastfeeding women affected by this disease. Traditional treatment has included systemic immunosuppression and surgery, but newer literature demonstrates that intralesional injection of steroid can provide significant symptomatic relief to patients. A diagnosis of IGM does not preclude breastfeeding, though patients may experience challenges with milk production and latch on the affected breast. Individualized care should be provided, with considerations given to the following: side effects of systemic steroids, the need to wean a breast being treated with intralesional steroids, and augmentation of milk production on the unaffected breast to promote continued breastfeeding.

Complementary feeding of infants and young children 6 to 23 months of age.

Complementary feeding, when foods are introduced to complement a milk-based diet, generally occurs between 6 and 23 months of age. It is a critical period for both physical and cognitive development. During this period, the growth rate of the brain is one of the fastest during the life span and, consequently, the timing, dose, and duration of exposure to specific nutrients can result in both positive and negative effects. Complementary feeding is more than ensuring an adequate intake of nutrients; it also is about avoiding excess intakes of calories, salt, sugars, and unhealthy fats. Meals are cultural and social events where young children observe, imitate, learn about foods to like or dislike, and form lifelong eating habits and practices. Meals are also when a child learns to touch foods and connect food tastes to how foods look and feel. Ideally, complementary feeding is responsive and promotes child autonomy, but it can also be used to manage behavior problems or overly indulge a child, resulting in long-term consequences for nutrition and health. Therefore, in addition to what a child is fed, attention to how a child is fed is also important. In this review, 12 topics relevant for updating global guidance on complementary feeding were identified: age of introduction of complementary foods; continued breastfeeding; responsive feeding; safe preparation and storage of complementary foods; food textures, flavors, and acceptance; energy and meal and snack frequency; fats, protein, and carbohydrates; dietary diversity; milks other than breast milk; fluid needs; unhealthy foods and beverages; and use of vitamin and mineral supplements or supplementary foods.

Factors associated with breastfeeding in the first year of life in Cruzeiro do Sul, Acre

Abstract Objectives: to investigate the factors associated with continued breastfeeding (BF). Methods: All the parturients at a local maternity from July 2015 to June 2016 were invited to participate in a cohort study in Cruzeiro do Sul, Acre. Data on socioeconomic, demographic, obstetric and neonatal of the babies were obtained for the interview. Multiple Poisson regression models with robust variance were used to estimate the prevalence ratio (PR) and 95% confidence intervals (95%CI). Results: among the 1551 mothers contacted, 305 lived in the rural area, leaving 1,246 eligible mothers living in urban area. For the 1-year cohort follow-up, 74 non-twin babies were assessed. Most of the mothers reported to have mixed skin color (79%), are over 21 years old (72°%o), more than 10 years of schooling (72%&gt;) and with unpaying job (54%). The children’s age ranged from 10 to 15 months. The frequency of continued breastfeeding was 69,4%&gt; (95%oCI=66.0-72.6). The factors negatively associated with continued breastfeeding were the use of bottle feeding (PR=1.44; CI95%&gt; =1,33-1.56) and pacifier (PR=2.54; CI95%&gt; =1.98-3.27), after adjusting for maternal age and socioeconomic variables. Conclusion: the frequency of continued breastfeeding in Cruzeiro do Sul was higher than the national estimates, but below the WHO recommendations for breastfeeding up to two years of age.

Status and influencing factors of breastfeeding behavior in rural areas of Han, Tibetan and Yi nationalities in Sichuan Province

To evaluate the status of breastfeeding among infants aged 0-18 months in rural areas of Han, Tibetan and Yi ethnic in Sichuan Province, and to explore the relevant impact factors. Using multistage sampling method, choose two Han county, two Tibetan county and two Yi county rural 0-18 months infants and young children with their mother as the subjects in Sichuan Province, to collect mothers and infants and young children&apos;s demography, family status, the information such as breastfeeding knowledge and behavior through questionnaires. Unconditional Logistic regression was used to analyze the influencing factors of breastfeeding. Among the 1087 infants, early initiation of breastfeeding rate was 22. 45%, among the 985 infants aged 6 months and above, the rate of exclusive breastfeeding under 6 months was 35. 94%, among the 658 infants aged 12 months and above, the rate of continued breastfeeding at 1 year was 34. 50%. The favorable factors for early initiation of breastfeeding were that normal delivery(OR=2. 80, 95% CI 1. 82-4. 30) and mothers with knowledge of early initiation of breastfeeding behavior(OR=2. 48, 95% CI 1. 69-3. 64). Tibetan mother(OR=1. 56, 95% CI 1. 02-2. 39), very good family economic status(OR=2. 70, 95% CI 1. 47-4. 98), mother&apos;s knowledge of exclusive breastfeeding under 6 months(OR=1. 47, 95% CI 1. 07-2. 02) were favorable factors for exclusive breastfeeding behavior under 6 months. Second birth and above(OR=1. 67, 95% CI 1. 11-2. 52) and mothers&apos; knowledge of weaning(OR=3. 96, 95% CI 2. 65-5. 93) were favorable factors for continued breastfeeding at 1 year. The status of breastfeeding in the multi-ethnic rural areas of Sichuan Province is poor. The mother&apos;s ethnicity, delivery method, and whether they have relevant knowledge, parity and family economic status will affect the breastfeeding behavior of infant mothers.

A mixed methods study of perinatal sleep and breastfeeding outcomes in women at risk for postpartum depression

IntroductionPregnant and postpartum women experience significant sleep disruption, but the role of perinatal sleep disturbances in breastfeeding is understudied. MethodsIn this observational cohort study, we used mixed methods to examine associations between perinatal sleep and breastfeeding. Forty-eight women (mean age 28.2 ± 4.9 years) who were euthymic at enrollment but had a history of major depression (n = 43) or bipolar disorder (n = 5) had sleep recorded with wrist actigraphy. We determined feeding status through daily diaries and used semi-structured interviews to identify themes regarding participants’ experiences, breastfeeding decisions, and behaviors. To examine whether sleep disturbance during pregnancy predicted breastfeeding (BF) rates, we defined “lower sleep efficiency” (LSE) and “higher sleep efficiency” (HSE) groups based on the median split of actigraphic SE at 33 weeks’ gestation (cutoff SE = 84.9%) and classified mothers as No-BF, Mixed-BF (BF + formula), and Exclusive-BF at 2 weeks postpartum. ResultsPercentages of women who did any breastfeeding were: Week 2 = 72.3%, Week 6 = 62.5%, Week 16 = 50%. LSE mothers were less likely than HSE mothers to initiate breastfeeding (percent No-BF: LSE = 45.8%, HSE = 16.7%, P < .05). Average actigraphic sleep onset, sleep offset, time in bed, sleep duration, and SE did not differ based on breastfeeding status at any time point. Qualitative themes included insufficient preparation for the demands of breastfeeding, interrupted and nonrestorative sleep, and unrelenting daytime tiredness. ConclusionsIn our sample, preserved actigraphic SE during pregnancy was associated with initiation and continuation of breastfeeding. Future work should examine whether improving sleep in pregnancy improves mothers’ feeding experiences.