Exclusive Breastfeeding Rates Research Articles

Determinants and Factors Associated with the Maintenance of Exclusive Breastfeeding after Hospital Discharge after Birth.

The benefits of exclusive breastfeeding are well known for both mother and baby. Despite this, rates of exclusive breastfeeding remain low. The present study aimed to determine the factors associated with the maintenance of this type of feeding after being discharged from the hospital after childbirth. A cross-sectional study was carried out with 1200 postpartum women in Spain. Sociodemographic, obstetric, and neonatal data were collected. Odds ratios (OR) and adjusted odds ratios (aOR) with 95% confidence intervals were calculated. Early breastfeeding initiation was identified as a factor that favors breastfeeding after hospital discharge (aOR: 2.47; 95%CI: 1.77, 3.45). Other factors that favor breastfeeding after discharge included the woman feeling very supported by her partner during pregnancy, childbirth, and the puerperium (aOR: 2.54; 95%CI:1.30, 5.00) and having previously breastfed other children (aOR: 1.97; 95%CI: 1.40, 2.76). Among the factors that hindered exclusive breastfeeding after discharge were multiple or twin pregnancies (aOR: 0.31; 95%CI 0.12, 0.83), induction of labor (aOR: 0.73; 95%CI: 0.53, 0.99), admission of the newborn to the neonatal intensive care unit (NICU) (aOR: 0.31; 95%CI 0.19, 0.52), using epidural pain relief during labor (aOR: 0.41; 95%CI: 0.27, 0.64), or a preterm newborn (aOR: 0.38; 95%CI: 0.21, 0.69). For all these reasons, it is essential to promote certain practices such as the early start of breastfeeding or the induced onset of labor, among others, in order to promote the maintenance of exclusive breastfeeding beyond hospital discharge after childbirth.

Factors That Influence Posthospital Infant Feeding Practices Among Women Who Deliver at a Baby Friendly Hospital in Southern United States.

Introduction: The Baby Friendly Hospital Initiative has had a positive impact on breastfeeding initiation; however, little is known about posthospital infant feeding practices among women who deliver at baby friendly hospitals. Therefore we sought to evaluate posthospital breastfeeding outcomes among women who deliver at a baby friendly hospital (BFH) by (1) estimating exclusive breastfeeding rates at the postpartum visit (PPV), (2) quantifying the exclusive breastfeeding discontinuation rate, and (3) identifying which factors are associated with breastfeeding discontinuation. Methods: This was a prospective cohort study of women aged 14 and over, who delivered at the University of Alabama at Birmingham. The primary outcome was mode of infant feeding categorized as exclusive breastfeeding (EBF), combination breastfeeding and formula feeding (CF), and exclusive formula feeding (EFF) at the PPV. Secondary outcome was EBF discontinuation rate. Patients who initiated formula and/or who stopped breastfeeding were asked what influenced their decision. Results: At hospital discharge, 71.1% of the participants were EBF, 21.7% were CF, and 7.2% were EFF. At the PPV, the frequency of the primary outcome of EBF was 31.6% (95% confidence interval: 25.2-38.8); 34.6% (28.0-41.9) were CF, and 33.8% (27.3-41.1) were EFF. Therefore, the EBF absolute and relative discontinuation rates were 39.5% and 55.6%, respectively. No demographic factors, delivery characteristics, or maternal medical morbidities were associated with EBF in the multivariable logistic regression. However, women in the EBF group were more likely to report a workplace environment conducive to breastfeeding and partner and friend support. Conclusion: Significant breastfeeding discontinuation rates occur even among women who deliver at a BFH. Our findings suggest that multifactorial interventions, including a focus on the prevention of formula introduction, are needed in the early postpartum period to achieve higher EBF rates at the PPV.

Timing and pattern of growth faltering in children up-to 18\xa0months of age and the associated feeding practices in an urban setting of Sri Lanka

BackgroundGrowth faltering is commonly encountered in breastfed infants during 4—6 months of age in low socioeconomic communities. The objective of this study was to describe the changes of growth indices with age, timing of growth faltering and its association with the feeding practices in children up-to 18 months of age.MethodsA cross sectional descriptive study was conducted in 254 children aged 12 and 18 months attending an immunization clinic. Data on growth were extracted from the Child Health Development Record. Weight and length were measured using standard methods. Feeding practices were assessed using interviewer-administered questionnaire. A drop of > 0.25 in weight-for-age Standard Deviation Score (SDS) from birth SDS was defined as weight faltering.ResultsWeight faltering occurred at some point in 64.2% (n = 163) during first 18 months of life, and 78.5% of whom, had the onset ≤ 4 months of age. Majority (76.6%, n = 98) with weight for age faltering by 4 months remained so at 12 months (p = 0.497), while 29.7% (n = 38) had a weight-for-length below-2SD (p < 0.001). Prevalence of weight faltering was 50.4%, 46.1%, 48.4% and 48% at 4, 6, 9 and 12 months respectively. Exclusive breastfeeding was given at least until 4 months in 88% (n = 223) and up to 6 months in 60% (n = 153) while 92.9% (n = 236) were breastfed at 12 months, with 38.2% (n = 97) were breastfed on demand after six months. Complementary feeding (CF) was started before 6 months in 40.6% (n = 52) with early weight faltering, but only 20.3% received it with proper consistency. Breastfeeding throughout the night was significantly associated with current weight-for-length being < -1SD (OR = 1.89, CI, 1.04—3.45; p = 0.037).ConclusionsEarly growth faltering was found in this population with high exclusive breastfeeding rates and persisting growth faltering was associated with poor feeding practices. Therefore, timely individualized interventions need to be taken to improve long term growth.

Providing Equitable Postpartum Breastfeeding Support at an Urban Academic Hospital

ObjectiveTo equitably increase exclusive breastfeeding at hospital discharge among obstetrician/gynecologist resident service clients by 20% over 8 weeks. DesignThis quality improvement project used a plan–do–study–act format to implement interventions with patients and staff based on the Baby-Friendly Hospital Initiative. Run charts were used to evaluate intervention effects over time according to Institute for Healthcare Improvement criteria, and outcome data informed tests of change for subsequent cycles. Setting/Local ProblemPostpartum clients of an obstetrician/gynecologist resident service were found to be less likely to exclusively breastfeed compared to the hospital average (7% vs. 34%) at baseline. A baseline resident client survey (n = 20) showed that 75% believed it best to give human milk plus formula. ParticipantsOf 186 postpartum participants, 65% identified as breastfeeding at the time of birth (53% of Hispanic participants [n = 99], 52% of non-Hispanic Black participants [n = 44], and 73% of non-Hispanic White participants [n = 33]). Interventions/MeasuresThe World Health Organization’s revised Implementation Guidance for the Baby-Friendly Hospital Initiative provided the basis for all interventions, which included a prenatal infant feeding plan, postpartum educational video with teach-back, cue-based feeding log, breastfeeding education guidelines for postpartum nurses, and team engagement via huddles. Measures assessed whether each intervention met the intended goals. ResultsRates of exclusive breastfeeding at hospital discharge were 7% at baseline and 13% after implementation. Rates of exclusive breastfeeding among Black clients were 0% at baseline and 16% after implementation. Clients demonstrated Baby-Friendly knowledge (teach-back average, 89%) but continued to supplement with formula, most often related to supply concerns (65%). ConclusionIntentionally equitable implementation of the Baby-Friendly steps may ameliorate racial disparities in breastfeeding during the early postpartum period. Preparing families to exclusively breastfeed should begin prenatally.

Gestational weight gain and patterns of breastfeeding among patients with class III obesity

Background Maternal obesity is associated with delayed lactogenesis and shorter duration of breastfeeding compared to patients with a normal BMI. Research aim/question We investigated the impact of excessive gestational weight gain, defined as greater than the Institute of Medicine guidelines (>9.1 kg), on the initiation and duration of breastfeeding in patients with class III obesity. Methods Retrospective cohort of patients with body mass index ≥40 in first trimester, delivering a singleton term infant at a tertiary care center between July 2013 and December 2017. Primary outcome was exclusive breastfeeding at discharge and at postpartum visit. Secondary outcomes included any breastfeeding at discharge and postpartum visit, and cessation of breastfeeding by the postpartum visit. Descriptive statistics were used to compare those whose gestational weight gain exceeded (eIOM) versus met (mIOM) Institute of Medicine guidelines. Regression models were performed to adjust for baseline confounding factors. Results Of 294 women included, 117(39.8%) were in the eIOM group. These women were more likely to be primigravida, have a higher delivery BMI, greater delivery blood loss, and have a neonate admitted to the intensive care unit. Exclusive breastfeeding at discharge was not different between eIOM and mIOM (66.7% vs 70.9%, p = .44), nor did eIOM impact likelihood of exclusive breastfeeding at postpartum visit (40.1% vs 34.2%, p = .31). When controlling for confounding factors, breastfeeding at discharge (aOR 1.54 95% CI [0.68–3.49]) or postpartum visit (aOR 0.67[0.31–1.47]) did not differ between eIOM compared to mIOM. Conclusions Among women with class III obesity, excessive gestational weight gain did not impact the rate of exclusive breastfeeding at discharge or postpartum visit.

Policy limitations and constraints to exclusive breastfeeding among working mothers in low- and middle-income countries: the Nigeria case

Background/Aims The rapid increase in Nigeria's female labour participation poses a risk to exclusive breastfeeding. Exclusive breastfeeding is the beneficial process of feeding an infant with breastmilk only during the first 6 months. This study aims to assess the extent to which Nigerian policy addresses barriers and contributes to improved exclusive breastfeeding rates among working mothers in Nigeria. Methods The study used a dual qualitative methodological approach, consisting of a literature review and policy analysis. The literature review identified barriers to exclusive breastfeeding among working mothers while the policy analysis evaluated the content of the national policy on infant and young child feeding in Nigeria (2010) and the Labour Act (2004). Results The findings revealed work-related, maternal and social factors were barriers to exclusive breastfeeding. The policy documents addressed these barriers to an extent but showed minimal coherence. Conclusions There are still disparities between policies and their implementation, which are attributable to inadequate clarity and insufficient mechanisms to spur policy compliance. The government should adopt evidence-based mechanisms and engage nutritionists in policy formulation and implementation. In addition, maternity leave in Nigeria should be increased to 6 months to allow working mothers to breastfeed. Myths on child nutrition should also be debunked.

The relationship between skin-to-skin contact and rates of exclusive breastfeeding at four months among a group of mothers in Nova Scotia: a retrospective cohort study.

Exclusive breastfeeding is the ideal source of nutrition for the first 6 months of life. Although skin-to-skin contact (SSC) has been shown to be associated with greater rates of exclusive breastfeeding, the results are heterogeneous. SSC involves placing a naked infant on its mother's bare chest immediately after birth. We examined the association between SSC immediately after birth and exclusive breastfeeding at 4 months. A retrospective cohort of healthy, term, singleton infants who were liveborn from 2008 to 2019 was constructed from the Nova Scotia Atlee Perinatal Database. Our main outcome was exclusive breastfeeding at 4 months, available for a subset of the cohort through linkage to a primary care database (n=256). Our secondary outcome was exclusive breastfeeding at hospital discharge, available for the broader cohort (n=56,459). Odds ratios (OR) for the association between SSC and exclusive breastfeeding at 4 months were estimated from logistic regression models. The odds of breastfeeding exclusively at 4 months were 4.14 (95% confidence interval (CI) 1.89-9.25) times greater among those who had SSC thanamong those who did not. The odds of breastfeeding exclusively at hospital discharge were 3.81 (95% CI 3.64-3.99) times greater among those who had SSC than among those who did not. The association between SSC and exclusive breastfeeding at hospital discharge was heterogeneous by birth year (OR 4.35, CI 4.07-4.65 in 2008-2011; OR 2.81, CI 2.57-3.07 in 2012-2015; OR 1.89, CI 1.63-2.10 in 2016-2019). Skin-to-skin contact appears to be associated with greater odds of exclusive breastfeeding at discharge and 4 months postpartum. Early SSC should continue to be supported for breastfeeding promotion.

BREASTFEEDING PRACTICES AMONG INFANTS PRESENTING WITH ACUTE DIARRHEA

Objectives: To determine the frequency of different feeding practices among infants presenting with acute diarrhea.&#x0D; Material and Methods: This cross sectional study was carried out from October 2019 to March 2020 in the Paediatrics Out-Patient Department of Khyber Teaching Hospital, Peshawar. Infants with acute diarrhea were included in the study after meeting the inclusion and exclusion criteria. Sampling was done by consecutive (non-probability) sampling. Sample size was 141, under WHO sample size calculator.&#x0D; &#x0D; Results: Out of 141 infants who presented with acute diarrhea in our study, 26(18.4%) were exclusively breastfed, 79(56%) were partially breastfed, while 36(25.5%) were non breastfed. Out of 141, 80(56.7%) were male and 61(43.3%) were female, with frequency of exclusive breastfeeding in males being 17.5% and in females being 19.7%. The mean age of the infant presenting with diarrhea was 3.25 months, while the mean age of the mother in the study was found to be 26.4 years. The rate of exclusive breastfeeding was 7.7% in working mothers compared to 19.5% in housewives.&#x0D; &#x0D; Conclusion: The most common feeding practice among infants presenting with acute diarrhea is partial breastfeeding which is not as effective as exclusive breastfeeding in preventing and reducing morbidity from diarrheal diseases.&#x0D; &#x0D; Key Words: Feeding practices, Exclusive breastfeeding, Partial breastfeeding, Non breastfeeding and Acute Diarrhea.

Identifying Workplace Lactation Room Design Gaps

Exclusive breastfeeding among employed mothers in Malaysia remains low despite numerous health benefits to mothers and children. Inadequate provision of a lactation room at the workplace contributed to the low rate of exclusive breastfeeding among working mothers. The objective of this paper is to identify the design gaps in the lactation room at the workplace in Selangor. The results suggest that adopting the first step of the user-centred design (UCD) method enables the identification of design gaps in the lactation room: location, room size, allocation of table and chair, milk storage, sink, and additional storage facilities. Keywords: breastfeeding, working mothers, lactation room, user-centred design eISSN: 2398-4287 © 2022. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning &amp; Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v7i19.3126

Breastfeeding Patterns and Stress Among Lactating Women in Pune During the COVID-19 Pandemic

Lactating mothers (n=126) residing in Pune, Maharashtra were interviewed to assess the prevalence of stress, rate of exclusive breastfeeding (EBF), and its association with different demographic factors. 75.4% mothers were found to be moderately stressed. Rate of EBF was 62.7%. Moderate stress and testing positive for COVID—19 were significantly negatively associated with EBF (P<0.001).

Assessment of Exclusive Breast-Feeding Practice among HIV-Positive Mothers in Abuja Nigeria

Background: Empirically, exclusive breastfeeding has proved invaluable in the reduction of mother-to-child transmission of human immunodeficiency virus and infant mortality particularly of children under-five years. Regrettably, breastfeeding practice is not widespread in most resource-poor sub-Saharan countries in Africa including Nigeria.&#x0D; Objective: This study assessed the practice of exclusive breastfeeding of infants for the first-six months of life by HIV-positive mothers after receiving care for prevention of mother-to-child transmission.&#x0D; Methods: Between February 2019 and September 2021, a cross-sectional descriptive study was conducted among 388 HIV-positive mothers receiving care for prevention of mother-to-child transmission of HIV at the Gwarinpa General Hospital in Abuja Municipal Area Council. HIV-positive mothers were enrolled and assessed for their practice of exclusive breastfeeding for the first-six months of the infant life. Structured questionnaires were used to survey for their socio-demographics, reproductive history, HIV and exclusive breastfeeding characteristics. Data were analyzed using Statistical Package for Social Science version SPSS 24.&#x0D; Results: Overall, 68% of the HIV-positive mothers practiced exclusive breastfeeding for the first six months of life. Majority, 83% of the HIV-positive mothers had knowledge of the nutritional benefits of breast milk in the first-six months of infant’s life. In addition, 75% of them are aware that babies exclusively breastfed are healthier than those not so breastfed. Religious beliefs and education status positively influenced exclusive breastfeeding in 82% and 55% of the mothers respectively. However, 69% of HIV-positive mothers attest they had no communal norms and taboos against exclusive breastfeeding. In contrast, mothers’ occupation negatively influenced exclusive breastfeeding in 36% of the studied subjects.&#x0D; Conclusion: This study found a significant increase in the rate of exclusive breastfeeding by HIV-positive mothers. It is evident that the practice of exclusive breastfeeding by HIV-positive mothers is dependent on their level of knowledge and awareness of its benefits in the first-six months of infant’s life.

The Effectiveness of Dialectical Behavioral Therapy on the Success of Breast Feeding in Traumatic Childbirth: A Randomized Controlled Trial.

Objective: Traumatic childbirth may expose mothers to physical and psychological postpartum disorders. The reduced rate of exclusive breast feeding is an essential consequence of this problem. The goal of this study was to see if dialectical behavioral therapy could help with the onset and duration of exclusive breast feeding after a traumatic delivery. Method : This clinical trial study included, 210 primiparous women with traumatic vaginal births were admitted to Bahar hospital in Shahroud. A standard protocol was designed and administered. The group allocation imbalance happened by chance and was averted by utilizing block randomization with a size of four and sequentially numbering the intervention or control groups with a sealed concealed envelope Participants in the intervention group had one individual session and four group counseling sessions by the researcher, while the control group participants obtained a routine care. Breast feeding self-efficacy was measured using a related questionnaire before the intervention, six and 12 weeks postpartum. Exclusive breast feeding was determined using a related form at the end of each month until the fourth month. Results: The outcome of repeated measure ANOVA Before the intervention, based on the greenhouse geisser test indicated no statistically significant difference in breast feeding self-efficacy (P = 0.07) or infant weight between the two groups. (P = 0.98). Nevertheless, a statistically significant difference between the mean score of breast feeding self-efficacy and infant's weight was discovered by a post hoc test utilizing the Bonferroni correction, (P = 0.001) between the two groups after the intervention. Therefore, in the intervention group, the level of exclusive breast feeding was higher than in the control group, and four months after birth, more infants in the intervention group were exclusively breastfed (58% vs 32%) (P < 0.001). The analysis of data using the GEE model showed that the odds of adherence to exclusive breast feeding in the intervention group were 3.4 (0.95 CI: 2.04-5.7). Conclusion: Dialectical behavior therapy is a powerful tool for minimizing the negative features of traumatic childbirth and increase the success of breast feeding mothers. Therefore, it can be used as a supportive method for mothers.

CORRELATION BETWEEN MOTHER’S KNOWLEDGE AND ATTITUDE TOWARDS EXCLUSIVE BREASTFEEDING IN KEDIRI

Background: The coverage rate of exclusive breastfeeding in Indonesia is still relatively low from the achievement of the national target. Kabupaten Kediri decreased in exclusive breastfeeding coverage from 62.4% to 56.3%. Kecamatan Ringinrejo is one of the sub-districts with the lowest proportion of exclusive breastfeeding, which is 58.6%. The most influential thing in decreasing the exclusive breastfeeding coverage rate in this region is the mother's knowledge and attitude towards exclusive breastfeeding. Methods: This study used a cross-sectional approach. The number of samples studied were 77 people who had babies aged 6-12 months, lived with their children, and with mother’s own care in the Kecamatan Ringinrejo. Samples were taken using purposive sampling. The independent variables are knowledge and attitudes of mothers. The dependent variable is exclusive breastfeeding. Data were collected using interviews according to the questionnaire. Data analysis using fisher exact test. Results: Knowledge does not affect exclusive breastfeeding with p-value = 0.619 and attitudes do not affect exclusive breastfeeding with p-value = 0.531 Conclusion: there is no relationship between knowledge on exclusive breastfeeding and there is no relationship between attitudes towards exclusive breastfeeding in the Ringinrejo, Kediri. Support from health workers and families need to be increased so that mothers are more committed to exclusive breastfeeding.Keywords: Knowledge, attitude, and exclusive breastfeeding

Rooming-In Practice During the Pandemic: Results From a Retrospective Cohort Study.

The Coronavirus disease 2019 (COVID-19) pandemic emerged in December 2019 and spread rapidly worldwide. So far, evidence regarding the breastfeeding and rooming-in management of mothers with COVID-19 and their newborn infants is scarce. 1) To assess the rate of exclusive breastfeeding at discharge among mothers with COVID-19 and their newborn infants managed either using a rooming-in or a separation regimen; and 2) to evaluate different neonatal outcomes, including the need for re-hospitalization related to COVID-19 among newborn infants in the two groups. We conducted a retrospective two-group comparative observational study. The sample was participants with COVID-19 and their newborn infants (N = 155 dyads) between March 1, 2020, and April 30, 2021. Two time periods were outlined resulting from the two different clinical practices of mother-infant separation and rooming-in. Within the sample, 145 (93.5%) were asymptomatic. All neonates had documented Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) test results, and six tested positive by reverse transcriptase polymerase chain reaction within 48 hr of life. The rate of exclusive breastfeeding was significantly higher (p < .0001) within the rooming-in group. Length of hospital stay was significantly lower (p = .001) within the rooming-in group. Protected rooming-in practice has proven to be safe and effective in supporting breastfeeding: None of the infants enrolled were hospitalized due to COVID-19 infection and the rate of exclusive breastfeeding at discharge was increased compared to those infants separated from their mothers.

Gearing up to improve exclusive breastfeeding practices in South Africa.

South Africa has one of the lowest breastfeeding rates on the African continent. Globally, just 44% of infants are breastfed soon after birth, and 40% of those less than six months old are exclusively breastfed. To improve infant nutrition by 2025, the United Nations established targets to eliminate malnutrition and increase exclusive breastfeeding (EBF) rates to at least 50%. Despite the WHO Code regulations endorsed by the World Health Assembly since 1981, breaches continue to be prevalent due to a combination of weak implementation, monitoring and enforcement in low-to-middle income countries. Over the years, infant formula sales in LMICs (including South Africa) have skyrocketed contributing to excess infant morbidity and mortality. To that end, the specific aims of this study was to gain an understanding of priority actions and strategies necessary to improve breastfeeding outcomes in South Africa in the context of the HIV pandemic. The team used a qualitative study design based on a semi-structured interview guide. The guide consisted of eight open-ended questions addressing the WHO HIV-related infant feeding guidelines, the WHO International Code of Marketing of Breastmilk Substitutes, political will, and advocacy. Of the 24 individuals contacted, 19 responded and 15 agreed to participate. The Breastfeeding Gear Model guided the thematic analysis. The three main themes identified were 1) WHO guidelines on HIV and infant feeding, 2) Improving exclusive breastfeeding, and 3) Advocacy. Key informants identified issues that need to be addressed to improve breastfeeding outcomes in South Africa. Strong political will is a key ingredient to harness the resources (human, financial) needed to implement, monitor, and act against Code violators. South Africa and other countries with similar challenges should consider using the WHOs Network for Global Monitoring and Support for Implementation of the International Code of Marketing of Breast-milk Substitutes and Subsequent relevant World Health Assembly Resolutions (NetCode) methodology.

The Influencing Factors of Breastfeeding for Full-Term Singleton Within Six Months of Birth in Xi'an Before the Covid-19 Pandemic.

ObjectiveThe study is designed to understand the situation of full-term infants breastfeeding within 6 months of birth in Xi'an before the Covid-19 pandemic and analyze the influencing factors of exclusive breastfeeding.MethodsFive hospitals in Xi'an province have been selected as research centers. Full-term infants who met the inclusion and exclusion criteria were recruited from these centers between January 1 and February 28, 2019. The feeding situation at 10 days, 42 days, 3 months, and 6 months after birth were investigated. A self-designed breastfeeding questionnaire was used for investigation and follow-up. SPSS 22.0 was applied for statistical analysis of the data.ResultsThe exclusive breastfeeding rate of full-term infants on days 10 and 42 and at months three and six after birth was 61.38%, 54.78%, 48.83%, and 38.78%, respectively, with a decreasing trend over time. During breastfeeding within 48 h after delivery, 1,653 cases (91.83%) of puerpera had different grades of pain, including 1,325 cases (80.16%) of mild discomfort, 321 cases (19.42%) of moderate pain, and seven cases (0.42%) of severe pain. Within 24–48 h postpartum, 1,607 (89.27%) mothers faced problems related to postpartum breastfeeding. Among them, 694 (43,19%) neonates could not be fed effectively; 665 (41.38%) mothers had wound pain and had inconvenience to turn over; 598 (37.21%) neonates were difficult to wake up; 439 (27.32%) mothers had incorrect feeding posture; 181 (11.26%) mothers experienced other problems. The Cox risk regression model showed that weight gain during pregnancy was higher than the recommended standard. Living in suburban counties was a risk factor of exclusive breastfeeding for full-term infants. Participation in breastfeeding courses during pregnancy, feeding more than eight times daily after delivery, were the protective factors of exclusive breastfeeding for full-term infants.ConclusionThe body weight gain of parturients should be controlled within a reasonable range during pregnancy. Parturients were encouraged by medical staff to participate in breastfeeding courses or watch the breastfeeding process during pregnancy to increase their self-confidence and improve the rate of exclusive breastfeeding for full-term infants. In addition, it is necessary to strengthen the publicity of breastfeeding in suburban areas to promote breastfeeding.

Hubungan Persepsi Ibu, Dukungan Suami, dan Dukungan Tenaga Kesehatan terhadap Pemberian Asi Ekslusif pada Ibu Menyusui di Wilayah Kerja Puskesmas Cahya Maju Lempuing Oki Tahun 2021

Exclusive breastfeeding is breast milk that is given to babies from birth for 6 months, without adding and or replacing with other food or drinks. WHO reports globally that the average rate of exclusive breastfeeding in the world in 2017 is only 38%. The purpose of the study was to determine the relationship between mother's perception, husband's support, and support from health workers on exclusive breastfeeding in the Cahya Maju Lememburu PublicHealth Center Work Area OKI. Data from the Cahya Maju Lemrubuk Public Health Center OKI in 2018, from 157 mothers who had babies 0-6 months, 85.35% (134 mothers) gave exclusive breastfeeding and 14.65% (23 people). In 2019, out of 235 mothers, only 49.79% (117 mothers) gave exclusive breastfeeding and 50.21% (118 mothers). In the initial study at the Cahya Maju Public Health Center, Lemrubuk OKI, data was obtained from 240 mothers who had babies 0-6 months, only 17.5% (42 mothers) exclusively breastfed and 82.5% (198 mothers). The population in this study were 240 mothers who had babies aged 6 months. The sampling technique used simple random sampling with 71 mothers. Analysis using chi-square test. The results show that there is a relationship between mother's perception and P-value = 0.003, husband's support P-value = 0.004, health worker support P-value = 0.000. It can be concluded that there is a relationship between mother's perception, husband's support and support from health workers with exclusive breastfeeding for breastfeeding mothers in the Cahya Maju Lemembur Public Health Center Work Area OKI 2021. The results of this study are expected to be input for providing input to improve health worker services to the community, especially in providing information about exclusive breastfeeding.

The effect of hospital-based breastfeeding group education given early perinatal period on breastfeeding self-efficacy and breastfeeding status

AimThis study was conducted to examine the effect of hospital-based group breastfeeding education provided to mothers before discharge from the hospital on mothers’ self-efficacy and on the increase of breastfeeding rates. MethodsThis randomized controlled educational research was conducted in the hospital is located in the West of Turkey. Ninety mothers who had healthy and term babies, and an intent to breastfeed their babies participated in the study. The questionnaire forms were collected by the researcher using face to face interview technique. Chi-square, dependent and independent groups t-test and ANOVA analysis were used along with descriptive statistics in analyzing the data. ResultsCompared to the control group, the scores obtained from the Breastfeeding Self-Efficacy Scale were higher in the education group in all the follow-ups. Similarly, status of exclusive breastfeeding was higher in the education group compared to the control group. In the twelfth week, the rate of exclusive breastfeeding was 80.0% in the education group, while it was 47.5% in the control group. ConclusionThese results show that breastfeeding group education and follow-up counseling given before discharge from the hospital were effective. This is evidence in favor of increasing the use of group education.This RCT was registered NCT04515862 with www.clinicaltrials.gov on 2020.

The possible mediating relationship promoted by the self-efficacy of breastfeeding associated with the Kangaroo Method on indicators of exclusive breastfeeding

ObjectiveAssess the mediating role of breastfeeding self-efficacy in the association between the Kangaroo Neonatal Intermediate Care Unit and exclusive breastfeeding. MethodCross-sectional study nested in a cohort, carried out in the Neonatal Unit of a Brazilian university hospital between September 2018 and March 2020. The sample consisted of 114 newborns weighing ≤1800 g and their mothers who were divided into those who participated in the first and second stages of the Kangaroo Method and those who only passed through the first stage, categorized as the Conventional group. To assess the self-efficacy of breastfeeding, the Breastfeeding Self Efficacy Scale - Short-Form was used. The Mann-Whitney test was used to compare the breastfeeding self-efficacy score between the groups, and Fisher's exact test to compare rates of exclusive breastfeeding. The adjusted structural equation model was used to check for the mediating effect of breastfeeding self-efficacy. The significance level adopted was 5%. ResultsThe kangaroo group had a higher rate of exclusive breastfeeding at hospital discharge (p = 0.000). There was a positive association between having remained in the kangaroo (p = 0.003) and the breastfeeding self-efficacy score (p = 0.025) with the rate of exclusive breastfeeding at hospital discharge. Breastfeeding self-efficacy did not act as a mediator. ConclusionThe self-efficacy of breastfeeding and the stay of the low birth weight newborn baby in the kangaroo unit acted positively and independently in exclusive breastfeeding, and the self-efficacy of breastfeeding did not act as a mediator in this association.

Health Education Using Mobilephone Application To Prevent Breastfeeding Problems

Background: Low exclusive breastfeeding rate in Indonesia is influenced by several factors. Exclusive breastfeeding rate in Indonesia is 65.16%. Breastfeeding problems affected exclusive breastfeeding duration among Indonesian breastfeeding women. Health education is needed to prevent and manage breastfeeding problems. This study aimed to analyze the effect of providing education using a mobile phone to improve mother’s knowledge about breastfeeding problems prevention.&#x0D; Methods: This study used a true experiment with control group pretest and posttest design. The sampling techniques used in this study was simple random sampling, consisted of 54 respondents which divided into intervention group and control group. This study was conducted in Banyumas District, Central Java province, Indonesia. The population in this study was breastfeeding mothers. The demographic characteristic questionnaire and the Breastfeeding Experience Scale (BES) were used to collect the data. All data were normally distributed and analyzed using paired t-test and independent t-test.&#x0D; Results: There was a significant difference between pretest and posttest scores in the intervention group (t=0.03, p&lt;0.05) and no significant difference between in the control group (t=0.161, p&gt;0.05). Mean of post-test scores in intervention and control group were 28.18 and 30.19, respectively. There was a difference of post-test scores between the intervention and control groups (t=0.000, p&lt;0.05).&#x0D; Conclusion: The results of this study revealed that a mobilephone application has been proven effective in reducing the breastfeeding problems. We recommend develop the application to address more complex breastfeeding problems.