Improve Breastfeeding Practices Research Articles

Comparison of the effect of face-to-face and video-based breastfeeding education methods on breastfeeding success

BackgroundDespite the well-documented benefits of breastfeeding, many first-time mothers encounter challenges. This study compares the efficacy of traditional face-to-face breastfeeding education (FtFE) versus video-based breastfeeding education (VBE) on improving breastfeeding practices and self-efficacy among primiparous mothers.MethodsUsing a sequential, quasi-experimental design, 70 primiparous mothers were enrolled from a State Hospital in Turkey and systematically divided into two groups: FtFE (n = 35) and VBE (n = 35). The study spanned from January to June 2023 and the assessments of statuses of breastfeeding self-efficacy and skilles was performed in two distinct phases for each group. In the first phase, mothers were administered the scale of breastfeeding self-efficacy short (BSES) to measure baseline breastfeeding self-efficacy and the scale of LATCH tool to assess baseline breastfeeding skills. Subsequently, the research groups received FtFE and VBE interventions. In the second phase, 2 weeks later, mothers were interviewed again, and the BSES scale was re-administered to evaluate changes in their breastfeeding self-efficacy levels.ResultsThe pre-test scores of BSES and LATCH tools of the FtFE and VBE groups were found similar (p > 0.05). The post-test score of BSES of the FtFE was significantly higher than that of the VBE group (p > 0.05). In the FtFE group, the post-test score of BSES was significantly higher compared to the pre-test score of BSES (p < 0.05). In the VBE group, the post-test score of BSES was higher compared to the pre-test score of BSES but this difference did not reached statistical significance (p > 0.05).Conclusion and recommendationsFtFE is more effective in informing mothers compared to VBE. However, VBE also positively affectes breastfeeding success. Further research is needed to explore the long-term impacts of these educational approaches on breastfeeding compliance.

Engaging Family Members to Support Exclusive Breastfeeding, Responsive care, and Antiretroviral Therapy Adherence Among Families with Children who are HIV-Exposed and Uninfected.

Children who are HIV-exposed and uninfected (CHEU) are at increased risk for poor growth, health, and development compared to children who are HIV-unexposed and uninfected. To support families with CHEU, we assessed the acceptability of engaging family members to support women living with HIV (WLWH) with exclusive breastfeeding (EBF) and antiretroviral therapy (ART) adherence and to engage in responsive infant caregiving. We conducted trials of improved practices, a consultative research approach, that follows participants over time as they try recommended behaviors. We enrolled postpartum women in Lusaka, Zambia, who identified home supporters. At visit 1, WLWH were interviewed about current practices. At visit 2, WLWH and home supporters received tailored EBF, responsive care, and ART adherence counseling. At visit 3, WLWH and home supporters were interviewed about their experiences trying recommended practices for 2-3 weeks. Interview transcripts were analyzed thematically. Participants included 23 WLWH, 15 male partners, and 8 female family members. WLWH reported several barriers to EBF. The most common were fear of HIV transmission via breastfeeding-despite high ART adherence-and insufficient breastmilk. After counseling, WLWH reported less fear of HIV transmission and improved breastfeeding practices. Home supporters reported providing WLWH increased support for EBF and ART adherence and practicing responsive caregiving. Both male and female home supporters appreciated being included in counseling and more involved in caregiving, and WLWH valued the increased support. Families with CHEU need focused support. Tailored counseling and family support for WLWH show promise for improving EBF, responsive caregiving, and ART adherence.

Effectiveness of a home-based peer support programme for Chinese mothers with low breastfeeding self-efficacy to increase the exclusivity and duration of breastfeeding: study protocol of a randomised control trial

IntroductionBreastfeeding is associated with many health benefits for both women and their newborns. Exclusive breastfeeding has been recommended for at least 6 months to optimise infant growth, development and health....

Thai novice nurses’ lived experiences and perspectives of breastfeeding and human milk in the Neonatal Intensive Care Unit (NICU)

BackgroundBreastfeeding and human milk have well-documented health benefits for newborn infants, particularly those who are sick. However, breastfeeding rates and human milk feeding among infants in neonatal intensive units (NICU) in Thailand are still low; thus, breastfeeding promotion and support are required for Thai mothers of premature infants. Newly graduated nurses can play a critical role within the healthcare support system and can have a significant impact on improving breastfeeding practices in the NICU. The objective of this study was to investigate the lived experiences and perspectives of Thai novice nurses on supporting breastfeeding and human milk feeding in the NICU.MethodsThe study was conducted between March 2021 and May 2022 at three medical centers in the central region of Thailand. This study employed a descriptive phenomenological approach to explore Thai novice nurses’ experiences and perspectives on breastfeeding. Purposive sampling was used to invite Thai novice nurses who have work experience in providing breastfeeding support to NICU mothers and their infants to participate in online interviews using a video conference platform (Zoom). Semi-structured questions were used to interview study participants in their native language. Data were analyzed using Colaizzi’s method of data analysis to identify emergent themes. Member checks, peer debriefing, and self-reflection were applied to ensure the validity and trustworthiness of the study results. Back-translation was also used as a quality and accuracy assurance.ResultsA total of thirteen novice nurses agreed to participate in the study. All were female, and their ages ranged from 21 to 24 years old at the time of the interview. The researchers identified five major themes related to the overall study objectives and research questions. They are: positive attitude toward breastfeeding and human milk, facing breastfeeding challenges at work, self-confidence rooted in experience, professional skill needs, and requiring further support.ConclusionsOur results suggest that breastfeeding education plays a vital role in encouraging new nurses to provide breastfeeding support to mothers of preterm infants. Establishing breastfeeding support training and innovative learning strategies can be crucial in developing appropriate breastfeeding practice guidelines and policies to support Thai breastfeeding mothers in the NICU.

Breastfeeding knowledge, attitudes, beliefs and practices of refugee, migrant and asylum seeker women in Portugal

BackgroundThe World Health Organization recommends exclusive breastfeeding for the first six months after childbirth. However, breastfeeding is influenced by organizational, social, geopolitical, and cultural factors, which are understudied in the migrant population. This study aimed to assess the knowledge, attitudes, beliefs, and practices of refugee, migrant, and asylum-seeking mothers living in Lisbon.MethodsA sociodemographic questionnaire and a Breastfeeding Knowledge, Attitudes, and Beliefs, and Practices questionnaire were used to gather information regarding baseline breastfeeding knowledge, attitudes and beliefs, and practices towards breastfeeding.ResultsOnly 40% of the mothers received antenatal counselling regarding the benefits and management of breastfeeding. Of the 20 responses, 10 (50%) mothers were found to have fair breastfeeding knowledge, 14 (70%) had fair attitudes and beliefs, and 12 (60%) had fair breastfeeding practices. Correlation analysis indicated a positive correlation between mothers’ breastfeeding attitudes (r = 0.531, p < 0.05) and their breastfeeding knowledge. There was no statistically significant correlation between the mothers’ breastfeeding attitudes, beliefs, and practices.ConclusionsThe findings of this study suggest that healthy breastfeeding behaviours can be stimulated by receiving proper counselling from health professionals. Countries must focus on improving breastfeeding practices, as they still fail to do all they can to promote, protect, and support breastfeeding globally. Universal interventions are necessary to improve breastfeeding, regardless of migrant or refugee status.

Improvement of Breastfeeding Efficacy Through Small Group Education of Cadres with Pregnant Women

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p class="Default"&gt;&lt;em&gt;WHO recommends that every infant should be exclusively breastfed, but until now the coverage of exclusive breastfeeding is still low due to factors such as knowledge, breastfeeding efficacy, family support, lactation problems, and barriers in the health care system. This study aims to determine the effectiveness of Small group education of cadres with pregnant women on breastfeeding efficacy among third trimester pregnant women on Enggano Island. The research design was a quasi-experimental pre-test and post-test with a control group. The treathird trimesterent group was pregnant women who received Small group education of cadres with pregnant women while the control group was pregnant women who received conventional education. The study was conducted at Enggano Health Centre from January to November 2023 with a sample of 50 pregnant women in the third trimester of pregnancy from 25-36 weeks of age, selected by purposive sampling. The research instruments were modules and leaflets on exclusive breastfeeding, developed through a needs assessment, while breastfeeding efficacy was measured using the Breastfeeding Self-efficacy Scale-Short Form (BSES-SF). Data were analysed univariate, bivariate with wilcoxon and multivariate with spearman rank test. The results showed that there was an effect of Small group education of cadres with pregnant women class education on breastfeeding effectiveness with p=0.00 mean difference of 19.56. There was an effect of conventional class education on breastfeeding effectiveness in the control group with p=0.46 mean difference of 1.12. The class was more effective in improving breastfeeding practices among pregnant women with p=0.00 mean difference of 47.26. Class and education level were the most dominant factors in improving breastfeeding efficiency among pregnant women. The conclusion of this study is that the small group education of cadre with pregnant women is effective in improving breastfeeding efficacy in pregnant women in the third trimester. &lt;/em&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;strong&gt;&lt;em&gt;Keywords: Breastfeeding, Education, Efficacy, Small Group&lt;/em&gt;&lt;/strong&gt;

DOES KANGAROO MOTHER CARE IMPROVE BREASTFEEDING PRACTICES? A SINGLE INSTITUTION EXPERIENCE ON HEALTHY TERM NEONATES

Early initiation of breastfeeding following birth has several advantages such as weight gain, improved immune status and better development. However, for exclusive breastfeeding to be successful, appropriate latching is necessary. Several studies across the globe have noted that improper feeding techniques have resulted in early breastfeeding cessation.Kangaroo mother care is a tool to help provide skin-to-skin contact, especially in preterm infants, to develop bonding, prevent hypothermia and allow adequate breastfeeding. KMC is seldom practiced in healthy term neonates. However, we propose that KMC can help improve breastfeeding practices in this subgroup of infants. The aim of this study is to compare the LATCH scores in term neonates that receive KMC (group A) and dont receive KMC (group B).

Behavior Change Communication and Breastfeeding Practices Measured by Deuterium-Oxide Turnover Method Among Infants Aged 4-5 Months in Rural Senegal

Breastfeeding promotion is widely recognized as one of the most cost-effective investments in promoting optimal child health, growth, and development. Several studies have shown that breastfeeding education and counseling interventions have a significant impact on improving breastfeeding practices, including exclusive breastfeeding (EBF) rates. However, very few studies have evaluated the association between breastfeeding education and infant breast milk intake. The objective of this study was to assess the contribution of behavior change communication provided by the Nutrition Enhancement Program (NEP) on improving infant breast milk intake and breastfeeding practices. A comparative cross-sectional study was conducted in 12 Local Communities in rural Senegal, of which 6 were located in the NEP intervention area and the remaining, in the non-intervention area. Breast milk intake and EBF were measured using the deuterium dose-to-mother isotope dilution (DTM) in 140 mother-infant (4-5 mo.) pairs. Breastfeeding and complementary feeding practices were also assessed by questionnaire. Student's t-test, ANOVA, chi-square test and McNemar test were used to compare means and percentages. A mixed model linear regression was performed to identify the associated factors of breast milk intake, measured by DTM. Breast milk intake was significantly higher in infants from the NEP area (994.7 ±197.3 g/d), compared to those from the non-NEP area (913.6 ± 222.8) g/d), p=0.023. Consumption of water from sources other than breast milk was not different between the groups. EBF rates measured by DTM were 37.0% and 28.4% in the NEP area and the non-NEP area, respectively. There was no difference on exclusive breastfeeding rate between the two areas regardless of evaluation method. Stunting and wasting were associated with lower milk intake of 107.1 g/d and 211.9 g/d, respectively. Mothers' participation in behavior change communication activities improved infants' breast milk intake, but not EBF rates. Lower breast milk consumption was associated with stunting and wasting.

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.

Reproductive factors and the risk of breast cancer among Nigerian women by age and oestrogen receptor status

The aim of the study was to investigate the association between reproductive factors and breast cancer risk in Nigeria. This has not been widely investigated in sub-Saharan Africa. We conducted a hospital-based case-control study involving participants from five hospitals in Lagos and Abuja. Women were interviewed in-person between October 2016 and May 2017 using a semi-structured questionnaire. We collected data on parity, breastfeeding, age at first and last birth, age at menarche, oral contraceptive use and history of abortion. The data were analysed using multivariable logistic regression adjusting for relevant confounders. Every additional 6months of breastfeeding over a lifetime reduced breast cancer odds by: 7% (95% CI: 1%, 12%) in all women, 15% (95% CI: 5%, 24%) in women < 50years, and 8% (95% CI: 0%, 12%, p for trend = 0.043) in oestrogen receptor negative (ER-) cases. Each additional 1-year delay before the first full-term pregnancy increased oestrogen receptor positive breast cancer odds by 9% (95% CI: 2%, 17%). Each additional 1-year delay before the last full-term pregnancy increased breast cancer odds by: 7% (95% CI: 2%, 12%) in all women, 12% (95% CI: 4%, 21%) in ER- breast cancer patients, and 14% (95% CI: 4%, 25%) in triple negative breast cancer patients. Other reproductive factors did not significantly increased breast cancer odds. While advanced age at first and last full-term pregnancies increased breast cancer odds, breastfeeding reduced it. These associations varied by age and oestrogen receptor status. Improved breastfeeding practices and timely births should be promoted in Nigeria.

Women's status, breastfeeding support, and breastfeeding practices in the United States.

The objective of this study is to examine associations between state-level breastfeeding support and breastfeeding practices, controlling for women’s status, in the U.S. We used publicly available data on state-level breastfeeding practices and support (international board-certified lactation consultants (IBCLC), births in Baby-Friendly hospitals, and La Leche League Leaders) for births in 2015 from the CDC Breastfeeding Report Card (2018) and other CDC reported data, and indicators of women’s status from the Institute for Women’s Policy Research reports (2015). We conducted an ecological study to estimate incidence rate ratios of exclusive breastfeeding at six months and breastfeeding at 12 months with breastfeeding supports using bivariate and multivariable Poisson regression. Political participation, poverty, and employment and earnings were associated with breastfeeding practices, as was each breastfeeding support in bivariate analyses. After controlling for women’s status, only IBCLCs were positively associated with rates of exclusive breastfeeding at 6 months and continued breastfeeding at 12 months. For every additional IBCLC per 1000 live births, the rate of exclusive breastfeeding at 6 months increased by 5 percent (95% CI 1.03, 1.07) and the rate of breastfeeding at 12 months increased by 4 percent (95% CI 1.02, 1.06). Political participation, poverty, and employment and earnings were associated with breastfeeding practices, indicating a relationship between women’s political and economic status and their breastfeeding practices in the U.S. Given the influence of women’s status, increasing the number of IBCLCs may improve breastfeeding practices.

Breastfeeding mobile application for mothers with gestational diabetes mellitus: designed by mothers and experts

BackgroundMothers and babies with gestational diabetes have an increased risk of diabetes, obesity, and cardiovascular complications. Breastfeeding is known to help reduce complications in mothers and babies with gestational diabetes. However, the rate of breastfeeding among mothers with gestational diabetes is still low due to various barriers. Therefore, the purpose of this study was to develop a mobile application to improve the breastfeeding barrier of pregnant women with gestational diabetes.MethodsThe Method of App Selection based on Users’ Needs is a method used in designing app structure and user interface by considering user needs. This method was used to develop the Breastfeeding for Gestational Diabetes Mellitus App, reflecting the needs of target users. Four personas were created based on the experiences of four mothers with gestational diabetes mellitus, and these personas’ needs were assessed and prioritized. Two professors and a clinical instructor in women’s health nursing conducted an expert review and revised the contents.ResultsOur “Breastfeeding for Gestational Diabetes Mellitus App” included the following components to promote breastfeeding in mothers with gestational diabetes mellitus: baby growth, breastfeeding records, information about mothers with gestational diabetes mellitus, information about breastfeeding, videos demonstrating breastfeeding methods and breast massage techniques, breastfeeding success stories, a message board, a section for frequently asked questions and answers, and links to breastfeeding education centers.ConclusionsUse of our App is expected to help prevent complications in mothers with diabetes mellitus and their babies and to promote maternal and child health through improved breastfeeding practices, especially in social distancing situations resulting from COVID-19.

A Cross-Sectional Study to Estimate the Proportion of Early Initiation and Exclusive Breastfeeding Practices in Rural Field Practice Area, Mysore

Introduction: Breastfeeding is the healthiest and easily accessible nutrient to the infants Malnutrition is more prevalentin India and inappropriate feeding practices are the one of the reason. So the current study is conducted to estimate theprevalence of early initiation and exclusive beastfeeding practices and factors influencing on these practices.Methods: A cross sectional study was conducted among 198 mothers of children less than 24 months in the field practicearea of Mysore Medical College and Research Institute, Mysore by using simple random sampling method during March2015 to August 2015 by using pretested and semi-structured questionnaire. In our study we found that 70.2% mothersinitiated breastfeeding within 1 hour of delivery, the most common reason for delay was LSCS, 14.6% mothers practicethe prelacteal feed, 92.9% mothers fed colostrum, exclusive breastfeeding(EBF) was practiced in 105 (53%) mothers themost common reason for non-EBF was lack of knowledge 78 (47.6%). Gender, fathers education, socio-economic statusand number of antenatal visits had an influence on breastfeeding practices.Conclusion: Majority of the women not practiced EBF. The knowledge regarding proper breastfeeding practices should beemphasized on each antenatal and postnatal visits. Improved socio-economic status can improve breastfeeding practices.

Baby Friendly Hospital Designation and Breastfeeding Outcomes Among Maryland WIC Participants.

The Baby-Friendly HospitalInitiative is an effective intervention to support maternal practices around breastfeeding. However, little is known about its impact on participants of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). The purpose of this study was to evaluate whether Baby Friendly Hospital (BFH) designation in Maryland improved breastfeeding practices among Special Supplemental Nutrition Program forWomen, Infants and Children (WIC) participants. Breastfeeding practices of WIC participants (22,543 mother-infant dyads) were analyzed utilizing WIC management information system de-identified data from four Maryland WIC agencies during 2010-12 and 2017-19. Participants lived in areas served by a hospital that became BFH in 2016 or remainednon-BFH. Pre-post implementation breastfeeding practices (breastfeeding initiation, at 3months and 6months) of women associated with a BFH were compared to women associated with a non-BFH usingpropensity score weighting and a difference-in-difference modeling. From pre to post interventionno differences in breastfeeding initiation or any breastfeeding at 6 months were attributable to BFH status. There was some evidence that BFH designation in 2016 was associated with an absolute percent change of 2.4% (P=0.09) for any breastfeeding at 3months. Few differences in breastfeeding outcomes among WIC participants were attributable to delivery in a BFH.Results from this study inform policy about maternity practices impacting WIC breastfeeding outcomes. More study needed to determine the impact of BFH delivery on differences in breastfeeding outcomes between sub-groups of women.

Breastfeeding practices among Syrian refugees in Turkey

BackgroundWe evaluated (a) opinion of Syrian and Turkish healthcare workers (HCWs), and perceptions and attitudes of Syrian refugee mothers, pregnant women, fathers and grandmothers on age-appropriate breastfeeding, (b) the effect of cultural characteristics, migration and pandemics on Syrian’s infant nutrition, and (c) the suggestions of HCWs and Syrian family members to improve breastfeeding practices in the Syrian refugee society in a qualitative study.MethodsThe qualitative study consisting of structured focus group discussions (FGDs) was held in four provinces in Turkey where Syrian refugees live intensely in September and October 2020. Seven different types of online FGDs were held with Turkish HCWs working in maternity hospitals, Syrian HCWs working in Refugee Health Centers (RHCs), Syrian pregnant women, mothers, fathers, and grandmothers. In total, we carried out 46 FGDs with 335 individuals. Thematic analysis of the transcripts in a deductive-inductive fashion was carried out with MAXQDA 11.ResultsMost Syrian HCWs did not get any training on breastfeeding counseling. The short duration of breastfeeding in Syrian refugees was seen to be related to the cultural characteristics, and migration. Some cultural characteristics can be summarized as “believing that breastfeeding harms mother’s health”, “adolescent marriages”, “wanting to have as many children as possible”, “giving anise to infants and not breastfeeding at night”, “prelacteal feeding”, “believing that milk is not enough”, “over controlling mother–child interaction by grandmothers, which limits the interaction”, “short pregnancy intervals”, and “not using modern family planning techniques”. We found out that migration increased the tendency for adolescent pregnancies, deepened the poverty, and decreased family social support. We did not observe any change in breastfeeding practices during pandemics.ConclusionsBreastfeeding counseling programs should be designed in consideration of cultural characteristics of Syrian HCWs and family members. Continuing health education programs for family members with socially appropriate interventions to prevent adolescent marriages are important.

Effectiveness of prenatal lactation counseling on breastfeeding practices, breast engorgement, and newborn feeding behavior among postnatal mothers at a teaching institution.

Context:Breastfeeding is the best way of providing nutrients to young infants for their healthy growth and development. World Health Organization (WHO) and UNICEF recommend that breastfeeding should be initiated as early as possible after delivery and exclusive breastfeeding should be continued till 6 months of age. The proper positioning of the baby and mother makes breastfeeding effective.Aim:The study aimed to determine the effect of lactation counseling on breastfeeding practices, breast engorgement, and newborn feeding behavior among postnatal mothers.Methods:A quasi-experiment posttest-only control group research design was used and the setting of the study was antenatal OPD and postnatal ward at a teaching institution. A sample of 60 primigravidae in the age group of 18–35 years with gestational age ≥ 36 weeks seeking antenatal care at antenatal OPD were selected by consecutive sampling technique. The experimental group received two lactation counseling sessions of 30 min each 1 week apart (in person/video call), whereas control group received routine care. Breastfeeding practices, breast engorgement, and newborn feeding behavior were assessed on the 3rd postnatal day using breastfeeding practices checklist, breast engorgement scale, and newborn feeding behavior assessment tool, respectively. Descriptive and inferential statistics were used to analyze the data.Result:There was significant improvement in breastfeeding practices (t = 7.18, P = 0.00), breast engorgement (t = 2.41, P = 0.01), and newborn feeding behavior (t = 5.24, P = 0.00) in the experimental group, which proves that the prenatal lactation counseling was effective in improving breastfeeding practices, newborn feeding behavior, and reducing breast engorgement.Conclusion:The study concluded that prenatal lactation counseling was effective in improving breastfeeding practices, breast engorgement, and newborn breastfeeding behavior among primigravidae. These findings suggest that if proper lactation counseling is provided to the mothers even at the primary health centers and periphery level it can contribute to improving the breastfeeding practices, newborn feeding behavior and can prevent breast engorgement.

Continuing breastfeeding for at least two years after birth in rural Vietnam: prevalence and psychosocial characteristics

BackgroundThe World Health Organization recommends breastfeeding for at least two years (24 months or more) after birth. In Vietnam, 22% of women continue breastfeeding for at least two years. The aim of this study was to determine the sociodemographic and psychosocial characteristics of mother-baby dyads associated with breastfeeding for 24 months or more in a rural setting in Vietnam.MethodsA secondary analysis was conducted on existing data obtained from a prospective study in Ha Nam, Vietnam. Women were recruited when they were pregnant and were followed up until 36 months after giving birth. The data were collected between 2009 and 2011. The associations between sociodemographic and psychosocial characteristics and continued breastfeeding for 24 months or more were examined using a multivariable logistic regression model.ResultsOverall, 363 women provided complete data which were included in the analyses. Among those, 20.9% breastfed for 24 months or more. Women who were 31 years old or older were more likely to breastfeed for 24 months or more than women who were 20 years old or younger (adjusted odds ratio, AOR, 9.54 [95% CI 2.25, 40.47]). Women who gave birth to girls were less likely to breastfeed for 24 or more months than women who had boys (AOR 0.44; 95% CI 0.25, 0.80).ConclusionsThis study provides evidence that may be useful for policy-makers to help improve breastfeeding practices for all children in Vietnam by targeting policy towards younger women and women with girls to promote continued breastfeeding for at least 24 months.

Socioeconomic inequality in exclusive breastfeeding behavior and ideation factors for social behavioral change in three north-western Nigerian states: a cross-sectional study

BackgroundSocioeconomic inequalities could mitigate the impact of social and behavior change (SBC) interventions aimed at improving positive ideation towards the practice of exclusive breastfeeding. This study explores the empirical evidence of inequalities in the practice of exclusive breastfeeding (EBF) and associated ideational dimensions and domains of the theory of Strategic Communication and Behavior Change in three north-western Nigeria states.MethodsWe used cross-sectional data from 3007 randomly selected women with under-two-year-old children; the convenient regression method was applied to estimate the concentration indexes (CIxs) of exclusive breastfeeding behavior, ranked by household wealth index. Inequality was decomposed to associated ideational factors and sociodemographic determinants. Avoidable inequalities and the proportion of linear redistribution to achieve zero inequality were estimated.ResultsWomen from wealthier households were more likely to practice exclusive breastfeeding CIx = 0.1236, p-value = 0.00). Attendance of at least four antenatal clinic visits (ANC 4+) was the most significant contributor to the inequality, contributing CIx = 0.0307 (p-value = 0.00) to the estimated inequality in exclusive breastfeeding practice. The elasticity of exclusive breastfeeding behavior with respect to partners influencing decision to breastfeed and ANC4+, were 0.1484 (p-value = 0.00) and 0.0825 (p-value = 0.00) respectively. Inequality in the regular attendance at community meetings (CIx = 0.1887, p-value =0.00); ANC 4+) (CIx = 0.3722, p-value = 0.00); and maternal age (CIx = 0.0161, p-value = 0.00) were pro-rich. A 10.7% redistribution of exclusive breastfeeding behavior from the wealthier half to the poorer half of the population could eliminate the inequality (line of zero inequality). Inequalities were mainly in the cognitive and social norms dimension and were all pro-poor.ConclusionSocioeconomic inequalities exist in exclusive breastfeeding behaviors and in associated ideation factors in the three states but are mostly avoidable. A 10.7% redistribution from wealthier to the poorer half of the population will achieve elimination. Messaging for SBC communication interventions to improve breastfeeding practices could be more effective by targeting the mitigation of these inequalities.

Breastfeeding Communication Strategies, Challenges and Opportunities in the Twitter-Verse: Perspectives of Influencers and Social Network Analysis.

Using social media is one important strategy to communicate research and public health guidelines to the scientific community and general public. Empirical evidence about which communication strategies are effective around breastfeeding messaging is scarce. To fill this gap, we aimed to identify influencers in the largest available Twitter database using social network analysis (n = 10,694 users), inductively analyze tweets, and explore communication strategies, motivations, and challenges via semi-structured interviews. Influencers had diverse backgrounds within and beyond the scientific health community (SHC; 42.7%): 54.7% were from the general public and 3% were companies. SHC contributed to most of the tweets (n = 798 tweets), disseminating guidelines and research findings more frequently than others (p < 0.001). Influencers from the general community mostly tweeted opinions regarding the current state of breastfeeding research and advocacy. Interviewees provided practical strategies (e.g., preferred visuals, tone, and writing style) to achieve personal and societal goals including career opportunities, community support, and improved breastfeeding practices. Complex challenges that need to be addressed were identified. Ideological differences regarding infant feeding may be hampering constructive communication, including differences in influencers’ interpretation of the WHO International Code of Marketing of Breast-milk Substitutes and in perspectives regarding which social media interactions encompass conflict of interest.

Robust estimation of infant feeding indicators by data quality assessment of longitudinal electronic health records from birth up to 18 months of life

Background and objectiveThe Baby-Friendly Hospital Initiative (BFHI) is an international strategy aimed at improving breastfeeding practices in health care services. Regular monitoring of indicators is key for BFHI implementation and maintenance. Currently, routine data collected from electronic health records (EHR) is an excellent source for infant feeding monitoring, however data quality (DQ) assessment should be undertaken. The aim of this research is to enable robust estimations of infant feeding indicators through DQ assessment of routine EHR data. Materials and methodsWe use the longitudinal series of healthcare contacts belonging to 6427 children born from 2009 to 2018 in the Health Area V of Murcia (Spain). Longitudinal data came from EHR at hospital discharge and community infant health reviews up to 18 months. The data of each healthcare contact contained a 24-h recall of infant feeding. We perform a DQ process in three phases: (1) an assessment of each-single-contact and the definition of their infant feeding status; (2) a longitudinal DQ assessment of completeness and consistency of the series of contacts to obtain meta-information that guides the duration calculus, for each case, of the different types of breastfeeding: exclusive breastfeeding (EBF), full breastfeeding (FBF) and any breastfeeding (ABF); and finally (3) a robust estimation of indicators and description of DQ of each indicator. ResultsWe found deficiencies of DQ in 30.42% of single contacts for EBF, 19.02% for FBF and 22.50% for ABF that were used to establish the infant feeding status. However, after longitudinal DQ assessment, we obtained valid and reliable data rates for most indicators such as “median duration of breastfeeding” nearly 90%, both for FBF and ABF, not so for EBF. ConclusionsDespite the DQ deficiencies found in raw data, the DQ assurance approach by indicators proposed in this work, allowed us to obtain a robust estimation of indicators with a significant percentage of subjects with valid information for ABF and FBF monitoring. The estimations were consistent with results previously published. The methodology provided with this study allows a continuous and reliable population monitoring of infant feeding indicators of BFHI from routine EHR data.