Continued Breastfeeding Research Articles

Effects of the experience of breastfeeding-friendly practices and breastfeeding intention and self-efficacy on breastfeeding behavior: a cohort study in Taiwan

BackgroundApproximately 80% of births in Taiwan occurred in Baby-Friendly accredited facilities, although the trend of exclusively breastfeeding infants until 6 months of age has stagnated in the last ten years. To guide breastfeeding promotion interventions during postnatal stays and encourage mothers to continue breastfeeding for the first 6 months, factors associated with breastfeeding behaviors to 6 months post-delivery must be investigated. This study explored the relationships among breastfeeding intention, experience of breastfeeding-friendly practices, breastfeeding self-efficacy, and breastfeeding behavior at four and 6 months after childbirth.MethodsIn this longitudinal cohort study, women who gave birth to healthy newborns at two Baby-Friendly hospitals in Taiwan and who had initiated breastfeeding were recruited two to 4 days after giving birth. Data were collected three to 5 days after childbirth during hospitalization and at one, two, four, and 6 months after childbirth using a self-developed questionnaire to measure breastfeeding intention and the experience of breastfeeding-friendly practices, and the traditional Chinese version of the Breastfeeding Self-Efficacy Scale-Short Form to measure self-efficacy.ResultsA total of 155 women completed the questionnaires five times within 6 months. The determinants of exclusive breastfeeding at 4 months and any breastfeeding at 6 months were the intention to breastfeed for over 6 months; a higher score for the experience of breastfeeding-friendly practices; and a higher level of breastfeeding self-efficacy during that period. The experience of breastfeeding-friendly practices during hospitalization did not predict breastfeeding behavior at 4 and 6 months. Intending to breastfeed for less than 4 months and lower breastfeeding self-efficacy during the hospital stay were both associated with shorter breastfeeding durations of less than 6 months after childbirth.ConclusionsLonger intended duration of breastfeeding, sustaining breastfeeding-friendly practices after discharge, and maintenance of a higher level of breastfeeding self-efficacy were the determinants of breastfeeding at 4 and 6 months. Healthcare professionals in Taiwan must support breastfeeding-friendly practices and consider interactive interventions to promote continued breastfeeding at different stages during the first 6 months after childbirth on the basis of the mother’s breastfeeding plan and breastfeeding self-efficacy during their postnatal hospitalization.

The association between early introduction of tiny tastings of solid foods and duration of breastfeeding

BackgroundConflicting advice and non-evidence-based recommendations have a negative effect on breastfeeding. Since 2011, the National Food Agency in Sweden has informed parents that they can introduce tiny tastings (1 mL of solid food, i.e. other sources of nutrition than breastmilk/formula) to infants from four months of age. It is unknown how national recommendations, which differ from the Word Health Organisation’s recommendation, affect breastfeeding. We hypothesised that introduction of tiny tastings of solid foods would shorten the duration of continued breastfeeding.MethodsThis retrospective study utilises data from the longitudinal ‘Swedish Pregnancy Planning Study’, in which mothers were recruited at antenatal clinics on a national level. The participants completed three questionnaires up to one year after birth (n = 1,251). Linear regression models were used to analyse the association between the introduction of solid foods and the duration of breastfeeding.ResultsAs hypothesised, introduction of tiny tastings shortened the duration of continued breastfeeding. Half of all infants (48%) were fed with tiny tastings already in the fourth month. The correlation analysis showed that the earlier the infants started with tiny tastings, the earlier they ate larger amounts of solid food. In a multivariate linear regression analysis, five factors were identified as having a negative effect on the duration of breastfeeding: low infant age upon introduction of tiny tastings, low maternal age, low level of maternal education, high maternal BMI and twin birth.ConclusionsEarly introduction of tiny tastings of solid foods shortened the duration of breastfeeding. It is difficult to influence most conditions that affect breastfeeding, for example, the mother’s educational level, BMI, age and if she has given birth to twins. In contrast, national guidelines can always be updated. Recommendations from the Swedish authorities should adhere to the WHO’s recommendation, which states exclusive breastfeeding for six months and continued breastfeeding for at least two years or longer.

Tendência e correlação de obesidade e aleitamento materno continuado em crianças de seis a 23 meses

Abstract Objectives: to analyze the trend and correlation of obesity and the increase in continued breastfeeding in children aged six to 23 months in Brazil, from 2015-2019. Methods: ecological time series study with data from the Sistema de Vigilância Alimentar e Nutricional (Food and Nutritional Surveillance System). The dependent variable was the prevalence of obesity. Prais-Winsten linear regression was used to verify the trend. Spearman’s correlation was used to verify the relationship between the prevalence of obesity and the increase in continued breastfeeding. Results: there was a trend towards a reduction in the prevalence of obesity in all regions in Brazil (Annual Percentage Variation [APV]: -4.14; CI95%=-4.50; -3.79). The prevalence of continued breastfeeding showed an upward trend in the North (APV=4.89; CI95%=2.92; 6.90), Southeast (APV=3.36; CI95%=2.32; 4 .41) and South (APV=2.67; CI95%=0.98; 4.38). There was a negative and significant correlation between obesity and continued breastfeeding in the North, Northeast, Southeast and South regions. Conclusion: the reduction in the prevalence of obesity and the increase in continued breastfeeding occurred only in some regions, requiring the implementation of effective strategies to be present throughout the country. Actions to promote, protect and support continued breastfeeding and healthy eating should be more prioritized to promote the child’s healthy growth.

Development of an exclusive breastfeeding intervention based on the theory of planned behavior for mothers with preterm infants: Study protocol for a mixed methods study.

Despite the significance and benefits of exclusive breastfeeding, its rate among infants, especially preterm infants, is not optimal. Based on evidence, the mother's attitude toward breastfeeding, the subjective norm, and the mother's perceived behavioral control play a role in initiation and continuation of breastfeeding; so the interventions that consider these factors may be useful for breastfeeding premature infants. The aim of this study is to design and develop an exclusive breastfeeding intervention based on the theory of planned behavior for mothers with preterm infants. This exploratory, sequential, mixed methods study will be conducted in three phases. In the first phase, a qualitative study will be conducted based on the theory of planed behavior, to describe the exclusive breastfeeding beliefs of the mothers with preterm infants, the barriers to breastfeeding, and to explain the ways to overcome them. Moreover, the items of the Predictors Of Exclusive Breastfeeding Questionnaire are prepared based on the theory of planned behavior. In the second phase, the intervention plan is designed based on the literature review and the findings of the qualitative study, and it is approved by a panel of experts. Additionally, the psychometric properties of the questionnaire are evaluated and confirmed qualitatively and quantitatively. In the third phase, the developed intervention is implemented and evaluated. Implementation of supportive educational interventions based on scientific theories can be a step toward improving the rate of onset and continuation of breastfeeding in mothers with preterm infants. Development of interventions based on evidence, identified beliefs, and perceived barriers of the mothers with preterm infants can provide the foundation for more effective interventions according to cultural, social, and religious contexts.

Growth, Nutritional Status, and Dietary Intake Patterns Associated With Prolonged Breastfeeding in Young Korean Children: A Nationwide Cross-Sectional Study.

Although the optimal duration of breastfeeding remains unclear, breastfeeding is generally recommended exclusively for the first 6 months of life, which continues into late infancy. However, the awareness regarding the effects of long-term breastfeeding is relatively low compared with that of breastfeeding in early infancy. We aimed to investigate the growth and nutritional characteristics of the children with prolonged breastfeeding (PBF) over 1 year. This cross-sectional study was based on the data of children aged 12 to 23 months from the National Health and Nutrition Examination Survey (2010-2020) conducted by the Korean Center for Disease Control and Prevention. Data on anthropometric measurements, dietary behavior, and food and nutrient intake were extracted, and the association between PBF and growth, nutritional status, and dietary patterns were analyzed. Of the 872 children with a birth weight of ≥ 2.5 kg in the final analysis, 34.2% continued breastfeeding over 12 months of age, and their median breastfeeding duration was 14.2 months. Children with PBF were more likely to have lower current body weight (P < 0.001) and weight gain (P < 0.001), lower daily protein (P = 0.012), calcium (P < 0.001), and iron (P < 0.001) intake per calorie compared with children weaned by 12 months of age or those who were never breastfed. Furthermore, they were started on complementary food at 6 months or later rather than 4-5 months (P < 0.001), consumed cow's milk earlier (P = 0.012), and consumed probiotics as dietary supplements (P < 0.001) significantly less commonly. When comparing the intake of food groups, children with PBF had a significantly higher intake of cereals and grains (P = 0.023) and fruits (P = 0.020) and a significantly lower intake of bean products (P = 0.020) and milk and dairy products (P = 0.003). Korean children who continued breastfeeding over 12 months of age showed distinct characteristics in terms of growth, nutritional status, and dietary patterns in the second year of life compared to children who did not. Long-term additional research on their growth and nutritional status may be needed; however, these findings are significant as important fundamental data for nutritional counseling to establish healthy PBF.

Extending maternal nutrition to the neonate: The value of initiation and exclusive breastfeeding

SynopsisRetaining the mother–neonatal dyad with initiation, exclusive, and continuation of breastfeeding provides an opportunity for both their survival and long‐term benefits.

Continued breastfeeding and work: scenario of maternal persistence and resilience.

to understand the challenges in mothers' daily life and strategies adopted to reconcile activities outside the home and continued breastfeeding. a cross-sectional, qualitative study. Theoretical-methodological assumptions were discursive practices and production of meanings in everyday life. Participants were 22 women from a specific social media group who had breastfed at least one child for >7 months. Data were collected between November 2020 and March 2021. themes: Around the world of activities outside the home; Work environment: routines, opportunities and difficulties to maintain breastfeeding. women's experiences reveal a daily life with difficulties in reconciling the desire to breastfeed and the work scenario. Support network and adaptation to children's food routine were strategies adopted to minimize risks of weaning. The results show the need to consolidate policies to encourage continued breastfeeding in the labor market.

Nutrition transition in Brazilian children under 5 years old from 2006 to 2019.

This manuscript aims to report the nutrition transition in Brazilian children under 5 years old from 2006 to 2019. Microdata from the Brazilian National Survey on Demography and Health of Women and Children (PNDS 2006) and the Brazilian National Survey on Child Nutrition (ENANI-2019) were analyzed. The indicators considered were: micronutrient status (anemia and vitamin A deficiency), anthropometric status (stunting and excessive weight), and breastfeeding practice (exclusive breastfeeding among children < 6 months and continued breastfeeding among children 12-23 months). We also analyzed minimum dietary diversity (MDD), consumption of ultra-processed foods, consumption of meat or eggs, and not consuming fruits or vegetables in children 6-59 months of age only for ENANI-2019. Equiplot charts were generated according to geographic region, maternal schooling level, and maternal race/skin color. From 2006 to 2019, the prevalence rates of anemia and vitamin A deficiency decreased from 20.5% to 10.1% and 17.2% to 6%, respectively. The prevalence of stunting remained at 7%, and excessive weight rates increased from 6% to 10.1%. The prevalence of exclusive breastfeeding among children < 6 months increased from 38.6% to 45.8%, and of continued breastfeeding among children 12-23 months from 34.6% to 43.6%. In 2019, 61.5% of children achieved the MDD, 88.8% consumed ultra-processed foods, 83.1% consumed meat or egg, and 25.7% did not consume fruits or vegetables the day before the survey. Trends of decreased micronutrient deficiencies, increased breastfeeding, and excessive weight rates, as well as reductions in disparities related to geographic region, maternal schooling level, and maternal race/skin color, were observed for most of the indicators.

Factors Associated With Initiating Breastfeeding and Continuing it for At Least 4 Months in Consuelo, a Rural Town in the Dominican Republic.

Objective. We assessed the proportion of and factors associated with mothers initiating and continuing breastfeeding (BF) for ≥4 months in a rural town of the Dominican Republic. Methods. A survey was administered to 190 mothers of children cared for at a free clinic in Consuelo. Modified bivariate and multivariable Poisson regressions were utilized in data analysis. Results. BF was initiated in 89.5% of cases and continued ≥4 months in 81.7% of cases. Maternal education beyond secondary school [adjusted RR = 1.13, 95% CI: (1.04-1.24), 0.010], and visiting both public and private antenatal clinics [adjusted RR = 1.25; 95% CI: (1.10-1.37), 0.010] were associated with BF initiation. Public and private antenatal clinic attendance [adjusted RR = 1.01, 95% CI: (0.45-2.23), 0.020], Cesarean section [adjusted RR = 0.81, 95% CI: (0.68-0.98), 0.026], number of biological children [adjusted RR = 0.95, 95% CI: (0.90-1.00), 0.032] and maternal employment [adjusted RR = 0.89, 95% CI: (0.79-0.99), 0.048] were associated with BF continuation. Conclusions. These results provide valuable insights for targeting specific populations in future breastfeeding education interventions.

Determinants of Breastfeeding Practices among Working Mothers in Solwezi District of Zambia

Background: As one of the strategies to reduce infant morbidity and mortality, the World Health Organization recommends early initiation of exclusive breastfeeding and timely introduction of complementary feeding with continued breastfeeding for up to two years or beyond. Although breastfeeding is a natural process, it is influenced by different socio-cultural factors, habits, standards, and behaviours. Rapid industrialization and changes in lifestyle have seen increasing numbers of women in the labour force, and associated poor Exclusive Breastfeeding practices among working mothers. The aim of this study was to identify the determinants of breastfeeding practices among working mothers in Solwezi District of Zambia. Methods: This was a cross-sectional comparative survey comparing determinants of breastfeeding practices among working mothers aged 15 - 49 years in urban and rural areas of Solwezi District. The study was carried out in the Under-five Clinics at Solwezi, Kimasala and Mushitala Urban Clinics, as well as St. Francis, Kapijimpanga and Kisalala Rural Health Centers. Eighty-seven participants were successfully recruited using convenience sampling. A researcher-assisted questionnaire was used to collect data. Data analysis was done using SPSS version 27.0. Descriptive statistical analysis was done using numerical measures such as measures of central tendency and dispersion. The Pearson Chi Square test, correlation and linear regression analysis were performed to test association between the variables at the 0.05 level of significance. Are you assessing exclusive breastfeeding alone or what? Results: The mean age of respondents was 27.44 years (SD = 6.042 years) and the majority of the respondents were married (71.3%, n = 62). Forty-three percent of the respondents were self-employed while the rest were in formal government or private sector employment. Overall, 97.7% of the respondents had heard of exclusive breastfeeding, with health facilities being the most frequent source of information (64.4%). Attitude towards exclusive breastfeeding was generally positive. Fifty-eight percent of respondents exclusively breastfed while the rest were on mixed feeding. Seventy-one percent of respondents reported that their workplaces did not have breastfeeding facilities at work. Only 11.5% of the respondents reported having cultural beliefs restricting breastfeeding. Statistically significant associations were obtained from cross-tabulation analysis between respondent’s occupation and baby feeding type (p 0.001); workload and feeding type (0.024); as well as knowledge of EBF and feeding type (p 0.001). Conclusion: Majority of the respondents demonstrated good knowledge and positive attitude towards exclusive breastfeeding. This study recommends sensitization campaigns in communities to raise awareness about the importance of breastfeeding, and foster behaviour change that promotes breastfeeding.

Evaluation of Breastfeeding Applications Through the Eyes of Saudi Mothers.

Breastfeeding is crucial for an infant's health and plays a significant role in mothers' well-being. The recommendation from WHO is to breastfeed your baby for the first six months exclusively, then complementary food is introduced with the continuity of breastfeeding until 24 months or more. Breastfeeding can be challenging, especially for a first-time mom; some mothers also lack knowledge about breastfeeding benefits. Thus, mobile health (mHealth) intervention can raise awareness, provide educational information and emotional support, and offer consultation. Saudi mothers seek an application designed based on their needs. The objective of this study was to analyze the most common breastfeeding application, then extract standard and valuable features. The most useful features were added to the survey and distributed among Saudi mothers. Next, participants' responses to these features were evaluated for recommendation when building a breastfeeding application for Saudi mothers. This is a quantitative cross-sectional study designed to analyze and explore what Saudi women need in a breastfeeding application to help them make better decisions and provide support. The data was collected through a questionnaire instrument designed after collecting the most valuable features in mobile breastfeeding applications. The number of Saudi mothers enrolled in this study was 492. Most mothers (90%) were currently breastfeeding or had previous experience with breastfeeding. The participant responses divided results into three categories: essential, recommended, and nice-to-be-added features. One of the highest percentages of important features was adding a section for baby food recipes and how to introduce food. Saudi mothers need a trustable source of information, consultation, support, and tools to guide them through breastfeeding. With the help of the mHealth application, the breastfeeding experience can be improved.

Energy and nutrient contribution of different food groups to the dietary intake of 6- to

Objective: A study was undertaken to determine the energy and nutrient contribution of different food groups to the dietary intake of 6- to <9-month-old infants. Design: An observational study was conducted using baseline data of a preliminary randomised controlled trial that aimed to determine the effect of egg consumption on infant growth. Setting and subjects: Participants resided in a peri-urban community (Jouberton) in North West province, South Africa. The study included 6- to <9-month-old infants (n = 155); 24-hour dietary recall data were available for n = 144. Results: Most infants consumed either two (29.2%) or three (42.4%) out of eight food groups. The grains/roots/tubers group was consumed by 95.8% of infants; for consumers thereof, it contributed 75.5% of iron, 53.0% of thiamine and 42.5% of folate. Breast milk and dairy were consumed respectively by 64.4% of infants. For breastfed infants, breast milk was the major contributor of energy and fat, and some micronutrients (calcium, zinc, vitamin A, vitamin C, niacin and riboflavin); but they had lower intakes (p < 0.05) for all micronutrients except vitamin A compared with non-breastfed infants. For consumers (16.7%) of animal-source foods (ASFs), these contributed 42.8% for vitamin B12 and 33.4% for protein; and intake of protein, riboflavin and vitamin B12 was higher (p < 0.05) for consumers compared with non-consumers. The least consumed food groups were legumes (0.7%), flesh foods (6.9%) and eggs (10.4%). Conclusion: Grains/roots/tubers, dairy and breast milk made a major contribution to the intake of key nutrients. Animal-source foods were not consumed frequently, but for consumers thereof made a substantial contribution as well. Recommendation: Strategies to improve dietary diversity should encourage continued breastfeeding, aim to increase intake of food groups not frequently consumed and promote locally available food.

Food-based dietary guidelines for children and adolescents.

This study aimed at reviewing food-based dietary guidelines (FBDGs) with content targeted at children and adolescents to present their main characteristics, thus enabling comparisons among countries. We conducted a search of the FBDGs available on the Food and Agriculture Organization (FAO) website, followed by a scoping review with a gray literature search to find FBDGs for children or adolescents non-listed on the FAO's website. Data extraction included the year of publication, language, and guidelines for the target group. From FAO website searches, 109 documents were found, and 17 of them could not be translated. The Scoping review search conducted in 5,190 articles, and none led to new guidelines, nor from the gray literature. Regarding the 92 FBDGs explored, 41 were specific for infants under 24 months old, children, and/or adolescents, and 51 were for the general population with information for the studied group. Twelve percent of the general FBDG and 35% of the specific ones have food icons. All of the guidelines were published after 2001. Latin America and the Caribbean were the regions that presented more specific FBDGs and the majority of countries with guidelines for fruits and vegetables. The information about fat (15 countries) and sugar (26 countries) consumption reduction is frequent. Reduction of sodium intake appears to be in the majority of guidelines after 2015. Food hygiene guidelines are recurrent in Latin American documents. NOVA classification was adopted in five countries and 21 countries approach recommendations for mealtimes. Both exclusive and continued breastfeeding guidance and healthy complementary feeding orientation are present in over 50% of the specific FBDG for infants and children under 24 months old. Food-based dietary guidelines are diverse due to both the nutritional and political aspects of each region. Latin America stands out for its orientations for the studied group. Further studies should measure the possible impacts and comprehension of FBDGs.

Home Office And Breastfeeding: Perspectives On Breastfeeding Rates During And After The COVID-19 Pandemic

The World Health Organization (WHO) recommends exclusive breastfeeding/chestfeeding for the first six months of life, encouraging its continuation as long as the mother and infant desire. European rates of breast-milk feeding quickly decrease after four months, suggesting that there are other determinants, including personal characteristics and parental leave, which work against breastfeeding continuation. Recently, new working practices have been adopted since the COVID-19 pandemic that might reduce this decline in breastfeeding. There are some objective elements supporting teleworking as a new breastfeeding-friendly option for both parents to adopt.

Impact of the COVID-19 pandemic on expectant and new parents’ experience of pregnancy, childbirth, breast feeding, parental responsiveness and sensitivity, and bonding and attunement in high-income countries: a systematic review of the evidence

ObjectivesTo review the evidence on how pregnancy, birth experience, breast feeding, parental responsiveness and sensitivity, and bonding and attunement were impacted by COVID-19.MethodsWe searched eight literature databases and websites of...

Racial and Ethnic Disparities in Breastfeeding Continuation Among U.S. Hispanic Mothers: Identification of Mechanisms.

Objective: We examined the extent to which social, maternal, and infant factors and Theory of Planned Behavior (TPB) domains-attitudes, perceived control, and subjective norms-mediate the relationship between maternal race and ethnicity and birth country, and breastfeeding continuation. Materials and Methods: A nationally representative cohort of 2,810 mothers with self-reported race, ethnicity, and birth country was used. Main outcomes included any and exclusive breastfeeding at 2-6 months of infant age. A conceptual framework with the aforementioned mediators of interest was developed. Logistic regression was used to examine main associations, and structural equation modeling was used to identify the extent to which proposed mediators explained the relationship between independent and dependent variables. Results: One thousand two hundred twenty-one mothers were U.S.-born non-Hispanic white (NHW), 432 U.S.-born Hispanic, 329 Mexico-born Hispanic, 107 Central- or South America-born Hispanic, 33 Caribbean-born Hispanic, and 688 U.S.-born non-Hispanic black (NHB). No differences in breastfeeding continuation among U.S.-born NHW and U.S.-born Hispanic mothers were found. In contrast, compared with U.S.-born NHW mothers, Mexico-born (odds ratio [OR] 1.99, 95% confidence interval [CI] 1.46-2.72) and Central- or South America-born (OR 3.42, 95% CI 1.89-6.17) Hispanic mothers had higher odds, and Caribbean-born Hispanic mothers had lower odds (OR 0.45, 95% CI 0.26-0.76) of any breastfeeding. These relationships were mediated by attitudes and subjective norms. Conclusions: Breastfeeding continuation among U.S. Hispanic mothers varied by birth country, highlighting the heterogeneity of breastfeeding populations of Hispanic mothers in the United States. Tailored interventions should strengthen policies supportive of positive attitudes toward and subjective norms around breastfeeding.

Factors Affecting Knowledge And Practice towards Breastfeeding in Women Who Have Recently Delivered in Duhok City

Background: Breastfeeding has been found to have a positive influence on a child's health even after 12 months of postpartum. The World Health Organization and United Nation Children Fund recommend a continued breastfeeding for up 2 years or beyond. Breastfeeding is widely known for its benefits to both mother and infant. The aim of this study was to evaluate the factors that affect breastfeeding knowledge and practice of women who recently delivered in Duhok city. Method: A cross-sectional study, using a self-administered questionnaire among women who attended Duhok Hospital of Obstetrics and Gynecology between 14 November 2021 and 14 February 2022. All the participants were women aged 18-40 years. Result: All the participants were married women and multiparas ≥2 babies, aged 18-40 years with mean age of 29.22±5.6, more than one third (38.5%) was below 30 years old, and (33.5%) were having primary school educational levels. The women knowledge about breastfeeding in all of 400 recruited women were good in (91%) of them with a positive practice in (58.8%). The most common factors for discontinuing breastfeeding completely before 2 years in the previous deliveries were "insufficient breast milk production" in (36%), "felt it was the time to stop" in (34.3%), and "became pregnant or wanted to become pregnant again" was in (24.8%) of the study sample. The relation between the mode of delivery and women’s practices toward breastfeeding was a highly significance (P= 0.001). Conclusion: The most common barriers or factors responsible for stopping breastfeeding were the “felt it was time to stop" as lactating factors and "insufficient breast milk production" as psychological factor. Breastfeeding knowledge and practice were found to be modifiable factors that affect breastfeeding. The vast majority of the study sample had good knowledge about breastfeeding, with positive practices toward breastfeeding in half of the study sample

Beyond early initiation: A qualitative study on the challenges of hospital-based postpartum breastfeeding support.

Improving breastfeeding practices is key to reducing child mortality globally. Sub-optimal exclusive breastfeeding rates may be associated with inadequate hospital-based postpartum breastfeeding support, particularly in resource-limited health settings such as Malawi. While almost all children in Malawi are breastfed, it is a concern that exclusive breastfeeding rates in Malawi are declining. The objective of this study is to understand postpartum breastfeeding support after delivery at Malawian hospitals from the perspectives of health workers and caregivers. We conducted a secondary analysis of a descriptive qualitative study on health worker and caregiver experiences of breastfeeding support at health facilities in southern Malawi as part of the Innovating for Maternal and Child Health in Africa Initiative. In-depth interviews following a semi-structured topic guide were conducted at three secondary-level district hospitals and one tertiary-level central hospital. Interviews were thematically analysed in NVivo 12 software (QSR International, Melbourne, Australia). We interviewed a total of 61 participants, including 30 caregivers and 31 health care workers. Participants shared the following themes: 1) a focus on early initiation of breastfeeding, 2) inadequate follow-up on breastfeeding practice, and 3) feasibility challenges and local solutions. There was an emphasis on early initiation of breastfeeding, which was challenged by maternal exhaustion after delivery. Study participants reported poor follow-up on breastfeeding practice after initial counselling and reacting to adverse outcomes in lieu of adequate monitoring, with a reliance on caregivers to follow-up on challenges. There was poor support for facility-based breastfeeding after initial counselling post-delivery, which revealed an overall neglect in hospital postpartum care for those considered to be in good health after initial assessment. We recommend the development of indicators to track continued facility-based breastfeeding, identify vulnerable infants at-risk of feeding problems, and strengthening care in postnatal wards, which is currently as neglected component of maternity care.

Maternal socioeconomic status and infant feeding practices underlying pathways to child stunting in Cambodia: structural path analysis using cross-sectional population data

ObjectivesTo identify and investigate complex pathways to stunting among children aged 6–24 months to determine the mediating effects of dietary diversity and continued breast feeding on the association between socioeconomic...

Adverse Drug Reactions in Breastfed Infants: A Cross-Sectional Study of Lactating Mothers.

Background: Breastfeeding-related adverse drug reactions (ADRs) are thought to be uncommon as reported cases are globally low. The nonspecific nature of these reactions and a lack of awareness and difficulty in identification of ADRs by mothers and clinicians may result in these ADRs being underreported. Aims: This study hypothesized that breastfeeding-related infant ADRs are more frequent than reported. As a first-hand account of breastfeeding mothers, this study aimed to evaluate the impact of the perceived ADRs on the continuation of breastfeeding and maternal treatment. Methods: Women currently breastfeeding or having breastfed in the last 12 months were invited to complete an online survey. The survey comprised 42 questions in 5 sections to obtain data from breastfeeding mothers, including their use of medicines during lactation, perceptions of infant adverse reactions attributable to maternal medication use and its potential impact on breastfeeding. Results: This online survey was completed by 339 women, 42% of whom reported taking at least one medication during breastfeeding. ADRs were reported in 23 infants where a possible or probable causal relationship indicated by a Naranjo score of 1-8 was established in 16 (11.3%). Antibiotics (n = 12) and opioids (n = 2), including tramadol and oxycodone were identified as the most common adverse reaction-causing drugs. The average age of infants at the time of the perceived ADR was 25.6 days (95% confidence interval; 4-85 days; median age 17.5 days). Conclusion: Suspected ADR reporting in this study was significantly greater than those reported to the regulatory body, the Australian Therapeutics Goods Administration, which shows that common breastfeeding-related infant ADRs are underreported.