Increase Breastfeeding Duration Research Articles

Evaluating the outcome of a physiotherapy intervention in the treatment of mastitis, blocked ducts and engorgement in the lactating breast

Physiotherapists are well placed within the multidisciplinary team to offer safe interventions for the management of the symptoms of mastitis, blocked ducts and engorgement (MBE). However, these are not widely utilized in the UK. The purpose of this service evaluation was to evaluate patient satisfaction with treatment and outcomes following a physiotherapy intervention. The World Health Organization recommends that all infants are breastfed exclusively for 6 months. Despite the known benefits, the UK has some of the lowest breastfeeding rates in the world. A primary cause of premature cessation is pain, which can result from MBE, with mastitis alone affecting up to 25% of lactating women. The target population was breastfeeding mothers who had utilized the clinic’s mastitis service for therapeutic treatment of MBE between January 2021 and January 2023. A service evaluation was conducted using telephone questionnaires. Verbal informed consent was obtained prior to data collection. The protocol, which was uniquely developed by the principal clinicians in this service evaluation, included therapeutic ultrasound, manual therapy, advice and education. Ninety-two per cent of participants found the treatment helpful, 76.5% reported an initial improvement in symptoms within 24 h of treatment, and 76% said that the protocol helped them to continue breastfeeding for longer. The participants reported that the protocol was effective for managing the symptoms of MBE, and that it supported an increase in breastfeeding duration.

Breastfeeding During COVID-19 Stay-at-Home Orders: Implications for Future Maternal Work Policies and Health Equity.

This study aimed to explore the impact of the COVID-19 pandemic and associated stay-at-home orders on the breastfeeding experiences of U.S. people a identify facilitators and barriers to breastfeeding during this period, and to assess the effects of maternal stress and misinformation on breastfeeding practices. U.S. women with infants were selected through purposive and convenience sampling. An online survey, distributed during summer 2020, measured changes in infant feeding practices, maternal stress levels, use of lactation support resources, and the influence of misinformation on feeding decisions. Quantitative data were analyzed using descriptive statistics, and qualitative responses underwent thematic analysis. Our sample (n = 1,861) revealed that 34% of U.S. women realized the pandemic affected their feeding practices, 544 women provided qualitative data. Major themes from qualitative analysis included ease of breastfeeding at home, bonding, increased breastfeeding duration, and challenges like limited access to lactation support. Logistic regressions highlighted demographic influences on breastfeeding practices, with no significant effects found related to the child's age or women's income on changes in feeding practices. The COVID-19 pandemic substantially impacted breastfeeding experiences of U.S. women, yielding insights for future policy and healthcare practices. The findings underscore the potential benefits of telehealth lactation support services and flexible remote work environments for breastfeeding people. Clear and scientifically-grounded communication regarding breastfeeding, mental health support, and policy development, are essential to promote equitable and flexible work and maternity leave options for breastfeeding people especially during global health crises.

Development of a complex intervention to strengthen municipality-based breastfeeding support to reduced social inequity in breastfeeding

BackgroundBreastfeeding is the ideal nutrition for infants and protects infants and mothers from a range of adverse health outcomes during their lifespan. In Denmark, while the breastfeeding initiation rate is high, only 14% of mothers meet the World Health Organization’s recommendation of exclusive breastfeeding at six months. Furthermore, a notable social inequity exists among those who achieve this recommendation. Knowledge of effective interventions to reduce breastfeeding inequity is limited. A previous hospital-based intervention succeeded in increasing breastfeeding duration. However, most breastfeeding support is provided in Danish municipalities by health visitors. This called for adapting the intervention to the health visiting program and developing an intensified intervention addressing the social inequity in breastfeeding. This article describes the adaptation and development process of a municipality-based intervention.MethodsDuring a 15-month period in 2020–21, the municipal intervention was iteratively developed using a three-stage framework for developing complex health interventions described by Hawkins et al. The three stages were 1) need assessment and stakeholder consultation, 2) co-production and 3) prototyping. The process was inspired by O’Cathain et al.’s principles for a user-centred, co-created and theory- and evidence-based approach, involving parents and health visitors.ResultsIn stage 1, we identified the needs and priorities of the target groups of the intervention. In stage 2, the intervention was developed through action research design and inspired by Duus’ ‘learning cycles’ as the method to enhance motivation and ownership and to strengthen the implementation process by creating a joint room for learning and reflection with health visitors and developers. In stage 3, the intervention was tested for feasibility and usefulness during a 2.5-month period accompanied by monthly dialogue meetings with health visitors and developers. In this period, the intervention was refined based on the gathered experiences and was subsequently prepared for evaluation.ConclusionThe description of the development of this complex intervention, aimed at increasing breastfeeding duration and reducing inequity, offers breastfeeding practitioners and researchers a transparent foundation for continuously improving breastfeeding support and a methodology for complex intervention development.Trial registrationRegistered at Clinical Trials NCT05311631.

The Effect Of Delaying Umbilical Cord Cutting On Hemoglobin Levels In Newborn Babies

AbstractIron deficiency anemia, commonly occurring in infants aged 6-24 months, can be prevented by delaying the cutting of the umbilical cord after birth. A quasi-experimental study conducted at the Mother and Child Clinic in Mojo Kediri involved 30 infants, divided into an experimental group (with delayed cord clamping) and a control group. Hemoglobin levels were measured using a Hematology Autoanalyzer, and the data were analyzed using a t-test. The intervention group, with a delay in cord clamping for 1 hour, showed an average increase in Hb levels from 15.444 g/dl to 19.800 g/dl after 24 hours. Meanwhile, the control group, without any delay, increased from 15.544 g/dl to 16.844 g/dl. Delaying the umbilical cord clamping significantly increased hemoglobin levels in newborns (p-value: 0.000). Infants with delayed cord clamping exhibited higher hemoglobin levels, better body iron reserves, and reduced risk of anemia. The higher red blood cell levels supported better cardiopulmonary adaptation and increased breastfeeding duration in early life. The research concludes that delaying the cutting of the umbilical cord for 2 minutes in newborns can enhance Hb levels after 24 hours compared to cord clamping at 15 seconds after birth. This highlights the importance of delaying cord clamping to support hemoglobin health and infant development.Keywords: Delaying Umbilical Cord Clamping, Hemoglobin Levels, Newborns

Breastfeeding duration and brain-body development in 9-10-year-olds: modulating effect of socioeconomic levels.

To investigate relationships of breastfeeding duration with brain structure and adiposity markers in youth and how these relationships are modified by neighborhood socioeconomic environments (SEEs). This was a cross-sectional study of youth enrolled in the Adolescent Brain and Cognitive Development (ABCD) Study® (n = 7511). Mixed effects models examined associations of breastfeeding duration with global brain measures and adiposity markers, adjusting for sociodemographic, pre- and post-natal covariates. Stratified analysis was performed by area deprivation index (ADI) tertiles. Total cortical surface area (SA) (False Discovery Rate - FDR corrected P < 0.001), cortical (FDR corrected P < 0.001) and subcortical gray matter (GM) volume (FDR corrected P < 0.001) increased with increased breastfeeding duration. Body mass index (BMI) z-scores (FDR corrected P = 0.001), waist circumference (FDR corrected P = 0.002) and waist-to-height ratio (WHtR) (FDR corrected P = 0.001) decreased with increased breastfeeding duration. Breastfeeding duration was inversely associated with adiposity in youth from high- and medium- ADI neighborhoods, but positively associated with SA across ADI tertiles. In this cross-sectional study, longer breastfeeding duration was associated with lower adiposity indices, particularly in youth from lower SEEs and greater SA across SEE levels. Longer breastfeeding duration showed long-term associations with brain and body development for offspring. Building on previous findings that longer breastfeeding duration is associated with healthier weight gain, lower obesity risk, and brain white matter development in infancy, our results find longer breastfeeding duration to be associated with lower adiposity indices and greater cortical and subcortical gray matter volume, and cortical surface area during peri-adolescence. Children from lower socioeconomic environments (SEEs) demonstrated stronger negative associations of breastfeeding duration and adiposity indices, and children across SEEs showed positive relationships between breastfeeding duration and cortical surface area. Promoting breastfeeding, particularly among women from lower SEEs would confer long-term benefits to offspring.

Breastfeeding Support in Better Start Bradford

Support for breastfeeding has traditionally been offered by midwives and health visitors in statutory services, and volunteers in third sector organisations. A model that meets service requirements and is also acceptable for mothers and babies has evaded implementation. This article describes an innovative project created to support an increase in breastfeeding duration based on partnership working and utilising trained Breastfeeding Support Workers.

The Pent-Up Demand for Breastfeeding Among US Women: Trends After COVID-19 Shelter-in-Place.

Objectives. To estimate changes in national breastfeeding trends immediately before and after COVID-19‒related workplace closures in early 2020. Methods. The implementation of shelter-in-place policies in early 2020, when 90% of people in the United States were urged to remain at home, represents a unique natural experiment to assess the pent-up demand for breastfeeding among US women that may be stymied by the lack of a national paid leave policy. We used the 2017-2020 Pregnancy Risk Assessment Monitoring System (n = 118 139) to estimate changes in breastfeeding practices for births occurring before and after shelter-in-place policies were implemented in the United States. We did this in the overall sample and by racial/ethnic and income subgroups. Results. There was no change in breastfeeding initiation and a 17.5% increase in breastfeeding duration after shelter-in-place, with lingering effects through late 2020. High-income and White women demonstrated the largest gains. Conclusions. The United States ranks worse than similar countries when it comes to breastfeeding initiation and duration. This study suggests that this is partly attributable to inadequate access to postpartum paid leave. This study also demonstrates inequities introduced by patterns of remote work during the pandemic. (Am J Public Health. 2023;113(8):870-873. https://doi.org/10.2105/AJPH.2023.307313).

Breastfeeding is associated with the intelligence of school-age children in Mexico.

Breastfeeding has been consistently associated with higher intelligence since childhood. However, this relation could be confounded due to maternal selection bias. We estimated the association between predominant breastfeeding and intelligence in school-age children considering potential selection bias and we simulated the intelligence gap reduction between low versus higher socioeconomic status children by increasing breastfeeding. We analysed predominant breastfeeding practices (breastmilk and water-based liquids) of children 0-3 years included in the Mexican Family Life Survey (MxFLS-1). Intelligence was estimated as the z-score of the abbreviated Raven score, measured at 6-12 years in the MxFLS-2 or MxFLS-3. We predicted breastfeeding duration among children with censored data with a Poisson model. We used the Heckman selection model to assess the association between breastfeeding and intelligence, correcting for selection bias and stratified by socioeconomic status. Results show after controlling for selection bias, a 1-month increase in predominant breastfeeding duration was associated with a 0.02 SD increase in the Raven z-score (p < 0.05). The children who were predominantly breastfed for 4-6 months versus <1 month had 0.16 SD higher Raven z-score (p < 0.05). No associations were found using multiple linear regression models. Among low socioeconomic status children, increasing predominantly breastfeeding duration to 6 months would increase their mean Raven z-score from -0.14 to -0.07 SD and reduce by 12.5% the intelligence gap with high socioeconomic status children. In conclusion, predominant breastfeeding duration was significantly associated with childhood intelligence after controlling for maternal selection bias. Increased breastfeeding duration may reduce poverty-driven intelligence inequities.

NON - PARAMETRIC MULTIPLE INPUTS PREDICTION MODEL FOR QUANTITY OF INFANT-FORMULA DEMANDED FOR CHILDREN AGED 0 - 24 MONTHS IN ILORIN-SOUTH, NIGERIA

Infant-formula is recommended by the World Health Organisation as the safest form of complementary food to human breast milk. Breastfeeding duration and other imperative input-factors that govern quantity of infant-formula demanded (a modulus variable) is difficult to model and predict with high precision. However, infants based on their conventional rights have to be given good nutrition. This study is necessitated by the challenging process of complex modulus prediction of quantity of infant-formula demanded to complement human breast milk, which may be attributed to differences in maternal characteristics at various maternal geographical settlement areas. Owning to complex nature of the differences, we propose a data-driven approach for handling larger-scale scenarios which may be limited in the conventional parametric modelling methods. This study aims at investigating the association of maternal characteristics with quantity of infant -formula demanded among breastfeeding mothers who have children aged 0 – 24 months in Ilorin-South Local Government Area, Nigeria. Primary data were collected from 744 breastfeeding mothers. We adopted appropriate non-parametric tests to determine the impact of different independent groups of maternal covariate factors considered on quantity of infant -formula demanded. Multi-associations were assessed and negative binomial model was formulated to predict estimated quantity of infant-formula demanded for various breastfeeding durations. The results show that increase in breastfeeding duration leads to increase in quantity of infant-formula demanded. In future intervention studies, factors that have significant effect on demand for infant-formula might be considered for proper monitoring of infant feeding.

A Quantitative Assessment on Perceived Physiological Comfort of Clothing during Lactation

Background: Physiological comfort refers to sensorial comfort including temperature, fit and fabric weight. Because pregnant and lactating women undergo various physiological changes, it is important to identify optimal comfort features regarding clothing. This will promote and increase breastfeeding duration. The purpose of this research is to compare physiological comfort of two types of clothing. They include designed clothing (DC) ,such as side flaps to access breasts and a strap which gets unhooked ), and conventional clothing(CC), like center front button closure, center front zipper, knitted V-neck shirt, and a t-shirt.&#x0D; Methods: This was a quantitative research study conducted to examine perceived physiological comfort of clothing during lactation (IRB# 1-1056432-1). Data were collected from 217 lactating women who were on lactated related social media sites (e.g., BabyCenter blog). A validated and reliable survey was developed by interviewers. It was a series of questions including demographic ones and assessed seven physiological features. Data were analyzed using descriptive statistics, frequencies (number and percent), and, a sample t-test. &#x0D; Results: After comparing DC with CC, authors found that DC provided greater physiological comfort. Statistically significant differences (p≤ .05) were found between garment coverage in reference to temperature (i.e. warmth) and satisfaction with the length of the garment.&#x0D; Conclusions: The results have practical implications for a variety of professions including apparel designers and lactation health care providers. Currently, there is little to no research which investigated physiological comfort of outerwear clothing for lactating mothers.&#x0D;

Breastfeeding duration is associated with higher adiposity at 6-8 months of age.

Breastfeeding (BF) has been identified as a protective factor against childhood obesity. However, evidence ofthe association between BF duration and adiposity remains inconclusive. Few studies have been conducted among Southeast Asian infants that have measured body composition during infancy using the gold standard stable isotope method. This study aimed to evaluate the association between BF duration and body composition during infancy. Healthy full-term Thai infants aged 6-8 months (n = 60) receiving exclusive or predominant BF for at least 3 months were recruited. Skinfold thickness (SFT) was measured by well-trained investigators. Body composition was assessed by the deuterium dilution technique. Infants with longer BF duration (>6 months; mean 7.5 ± 0.5 months, n = 29) had a higher subscapular SFT z-score than those with shorter BF duration (≤6 months; mean 5.3± 0.9 months, n = 31) by 0.48 (95% confidence interval [CI]: 0.01-0.94). After adjustment for age and sex, BF duration and age at introduction of complementary feeding (CF) were positively associated with fat mass and fat mass index at 6-8 months. One month increase in BF duration and CF age was associated with a 0.37 (95% CI: 0.05, 0.69) kg/m2 and 0.76 (95% CI: 0.18, 1.34) kg/m2 increase in the fat mass index, respectively. After adjusting for infant body mass index (BMI) during the earlier infancy period, the strength of the association was attenuated. This finding may reflect reverse causality where infants with lower BMI received formula or CF earlier. A longitudinal study with follow-up into childhood is warranted to confirm the effects of BF on adiposity in infancy and childhood.

Factors associated with postpartum contraception in Togo, West Africa.

The health benefits of postpartum contraception are well established. Using 2013/14 Togo Demographic and Health Survey (DHS) data, we examine the association between contraceptive use among women who gave birth within 24 months of the DHS and four health service use indicators - antenatal care, institutional delivery, postpartum care, and immunization of the last child - in addition to socio-demographic factors. Factors associated with postpartum contraceptive use in Togo included having their last birth in a health facility, having a postnatal check within two months of birth, youngest child receiving the first diphtheria-pertussis-tetanus vaccine, wanting to space children more than two years from last birth or not have more children, living outside the Savanes region, husband's desire for number of children agreeing with the woman's, and increasing breastfeeding duration. These findings highlight the need for programming which strengthens the integration of contraception into reproductive and immunization services in Togo.

Predicting intention and maintenance of breastfeeding up to 2-years after birth in primiparous and multiparous women

Objectives Breastfeeding up to 2-years has been associated with short and long-term health benefits for both newborns and mothers. However, few women breastfeed up to 2-years after birth. This study extends previous research on the theory of planned behaviour (TPB) examining the predictors of intention and maintenance of breastfeeding up to 2-years in both primiparous and multiparous women. Design 155 pregnant women participated in this longitudinal study. Methods Expectant mothers completed a questionnaire and then 2-years after the child’s birth were asked to report breastfeeding behaviour. Interactions among parity and TPB constructs were examined. Results Attitudes, descriptive and injunctive norms, and perceived behavioural control (PBC) explained 58% of the variance in mothers’ intention to breastfeed. Attitudes were the strongest predictor, followed by PBC, descriptive norms and parity. A significant interaction was found between parity and PBC, showing that PBC was only a significant predictor of intention to breastfeed at 2-years in multiparous women. Intentions predicted breastfeeding behaviour at 2-years. Conclusion Promoting intentions may be a useful way to increase breastfeeding duration to 2-years and targeting attitudes and norms may be one way to increase intentions. Further, targeting PBC may also be useful to increase intentions, but only in multiparous women.

Team-Based Breastfeeding Support at a Federally Qualified Health Center: Efficacy, Utilization, and Patient Satisfaction.

Background: A team-based, integrated lactation consultant (LC) and primary care provider (PCP) program improves breastfeeding rates in some outpatient settings, but only a limited number of studies have assessed efficacy in socioeconomically and racially diverse communities. Objectives: Following implementation of team-based LC/PCP care at a Federally Qualified Health Center (FQHC), quality improvement efforts assessed utilization, breastfeeding rates, and patient satisfaction. Method: A retrospective chart review examined feeding status pre- and postimplementation. Analysis compared feeding rates at the 2-week, 2-month, 4-month, and 6-month well visits (well child care). Subanalysis of patients who initiated breastfeeding postimplementation examined feeding status and LC support. Patient survey evaluated satisfaction. Results: Among patients who initiated breastfeeding, those who received a LC/PCP visit were significantly more likely to be breastfeeding at 2 weeks (94% versus 80%, p = 0.004) and 4 months (68% versus 45%, p = 0.01). However, breastfeeding rates for the whole practice were not significantly different before and after implementation. Seventy-two percent of breastfeeding families saw a LC (n = 204). Median LC visit per breastfeeding patient was 1.18 (standard deviation [SD] +1.2). Patient survey reported that the three most commonly helpful aspects of the visit were "latch instruction" (60%), "breastfeeding questions answered" (80%) and "learning about massage and hand expression" (50%). Discussion: Team-based LC/PCP care is feasible at a FQHC. Patients found it helpful. Among families who initiated breastfeeding, receiving LC/PCP care was associated with increased breastfeeding duration through 4 months.

Evaluation of a Mobile-based Maternal Feeding Education Program for Overweight Prevention in Infants

The purpose of this study was to evaluate a mobile-based maternal feeding education program for overweight prevention in infants based on breastfeeding attitude, breastfeeding self-efficacy, breastfeeding duration, recognition of hunger and satiety cues of infants, and knowledge regarding providing solids foods. A nonequivalent control group pretest-posttest design was used for the study. Participants included 15 primiparas in the experimental group and 14 primiparas in the control group in all the follow-up tests. Using self-reported questionnaires in electronic format, data were collected four times (before the intervention, 1month after childbirth, 3months after childbirth, and 6months after childbirth). Using SPSS 24 version, independent t-test and repeated-measures analysis of variance were used to test the effects of the mobile-based maternal feeding education program. The experimental group showed significantly more positive breastfeeding attitude (F=5.28, p=.008), higher breastfeeding self-efficacy (F=3.50, p=.041), and increased breastfeeding duration (t=-2.09, p=.046) than the control group. In addition, the experimental group showed significantly improved knowledge regarding providing solid foods to the infants (F=4.86, p=.009) in comparison with the control group. However, for education on recognizing hunger and satiety cues of infants, the mobile-based maternal feeding education program was not effective (F=0.23, p=.878). According to the results of this study, the mobile-based maternal feeding education program has the potential to contribute to overweight prevention in infants.

Impact of maternal dietary counseling in the first year of life on DNA methylation in a cohort of children.

Epigenetic modifications established during prenatal and early life, including DNA methylation, have been suggested as potential mediators of the interaction between environmental exposures during the perinatal period and adult metabolic health adverse outcomes, especially cardiometabolic complications and overweight. The effect of a dietary intervention in the first year of life on global methylation levels in leukocyte samples from a cohort of children born between 2001 and 2002 in southern Brazil was examined. Overall methylation measurements were performed using enzyme-linked immunosorbent assays on DNA samples from 237 children at 4 years old. Mean methylation values were higher in the intervention group (mean: 2.20 ± 1.31%) than in the control group (mean: 1.65 ± 1.11%; P = 0.001). It was observed that nutritional counseling in the first year increased breastfeeding duration and stimulated the development of healthier eating habits. Therefore, these factors might have contributed to increase global DNA methylation. The findings of the present study reinforce the notion that performing nutritional interventions in the early stages of life is important and provide further evidence of the interaction between the environment and epigenetic traits.

Evaluation of the association between mammographic density and the risk of breast cancer using Quantra software and the BI-RADS classification.

To determine the association between mammographic density (MD) and the risk of breast cancer (BC) in Chinese women and to investigate the role of fertility risk factors in regulating the relationship between MD and BC.We used Quantra software and the BI-RADS classification to assess MD in 466 patients and 932 controls. Conditional matched logistic multiple regression analysis was used to determine the relationship between MD and BC, and risk was evaluated with the odds ratio (OR) and 95% confidence interval (CI).The ORs for category 4 versus category 2 were 1.95 (95% confidence interval [95% CI] (1.42∼2.66)) and 1.76 (95% CI (1.28∼2.42)) for the BI-RADS and Quantra classifications, respectively. The ORs for category 5 volumetric breast density (VBD) versus category 2 VBD and 5 fibroglandular tissue volume (FGV) versus category 2 FGV were 1.63 (95% CI (1.20∼2.23)) and 1.92 (95% CI (1.40∼2.63)), respectively. Females with category 5 VBD whose age at menarche was ≤13 years had the highest risk of BC (OR = 2.16, 95% CI (1.24∼3.79)), and females with category 5 FGV whose age at menarche was = 15 years had the lowest risk of BC (OR = 1.65, 95% CI (1.05∼2.62)). Females with categories 3–5 VBD and categories 3–5 FGV had reduced risks of BC with increasing number of births. Females with category 5 VBD had an increased risk of BC with increasing age at first childbirth (the OR increased from 1.49 to 1.95). Those with category 5 VBD had a reduced risk of BC with increasing breastfeeding duration (the OR decreased from 2.08 to 1.55). Females with category 5 FGV had a reduced risk of BC with increasing breastfeeding duration (the OR decreased from 4.12 to 1.62).Both the BI-RADS density classification and Quantra measures indicated that MD is positively associated with the risk of BC in Chinese women and that associations between MD and BC risk differ by age at menarche, parity, age at first childbirth and breastfeeding duration.

Latch-related nipple pain in breastfeeding women: the impact on breastfeeding outcomes

Background Nipple pain is a common issue experienced by breastfeeding mothers and if not resolved, can contribute to early cessation of breastfeeding. Aims To investigate mothers experiences of nipple pain, the solutions used to manage their issues, and the perceived impact on breastfeeding outcomes with particular focus on latch-related nipple pain with no clear underlying cause (LRNP). Methods Data was collected via an online survey of UK-based women (n=1084). Findings LRNP was the most common issue as experienced by 52% of mothers surveyed. Various solutions were utilised to try to manage LRNP. Use of Highly Purified Anhydrous (HPA) Lanolin to manage LRNP was associated with a substantial increase in breastfeeding duration (average 33.2 weeks compared to 26.5 weeks for those who didn't report using HPA Lanolin). Discussion HPA Lanolin is a key solution used by mothers in the management of latch-related nipple pain and one which they perceive as having a significant positive effect on the physical symptoms and pain associated with nipple trauma. Use of HPA Lanolin was also associated with a substantial increase in breastfeeding duration which ultimately aids women in meeting their personal breastfeeding goals and improves overall breastfeeding rates.

Validation of Association Between Breastfeeding Duration, Facial profile, Occlusion of Children in Chennai Population:-A Cross Sectional Study

Introduction: Malocclusion is not a disease and is considered as a developmental disorder of the craniofacial complex.It may cause functional and esthetic disturbances in affected individuals.Environmental factors like dietary habits,nonnutritive sucking habits, bottlefeeding, and reduced duration of breastfeeding have often been implicated with various developmental disorders1. The .increased breastfeeding duration in preventing the development of malocclusion,and establishing a correct occlusal relationship by stimulating the facial muscles during suckling have a great importance. Aim: The aim of this study is to assess the relationships among breastfeeding duration,nonnutritive sucking habits,convex facial profile,nonspaced dentition,and distoclusion in the deciduous dentition. Materials and methods: A sample of 250 children aged 4 to 6 years from south Indian population was clinically examined. Information about breastfeeding duration and nonnutritive sucking habits was obtained from the parents and data was compiled. Results: From this study it was found that a statistically significant association was observed between breastfeeding duration and nonnutritive sucking habits. Nonnutritive sucking habits had a statistically significant association with distoclusion and convex facial profile. But the occurrence of convex facial profile and distoclusion was not associated with breastfeeding duration. Conclusion: Thus this study hypothesize that nonnutritive sucking habits may act as a dominant variable in the relationship between breastfeeding duration and occurrence of convex facial profile and distoclusion in deciduous dentition.

The significance of early breastfeeding experiences on breastfeeding self-efficacy one week postpartum.

Many new mothers do not reach their breastfeeding goals. Breastfeeding self‐efficacy is a modifiable determinant influenced by prior and new breastfeeding experiences. More knowledge about factors associated with early breastfeeding experiences and breastfeeding self‐efficacy would allow us to qualify breastfeeding counselling and increase breastfeeding duration. This study aimed to identify prevalence and factors associated with early negative breastfeeding experience, low breastfeeding self‐efficacy in the first week postpartum, and drop in self‐efficacy from late pregnancy to early postpartum period. A prospective longitudinal study was performed in Denmark from 2013 to 2014, including 2, 804 mothers.Results showed that 1 week postpartum almost 10% of mothers had negative breastfeeding experiences, 36% had low breastfeeding self‐efficacy, and 26% drop in self‐efficacy from pregnancy. Negative breastfeeding experiences were significantly associated with epidural analgesia, interrupted skin‐to‐skin contact immediately postpartum, short previous breastfeeding duration, and lacking social support. Low breastfeeding self‐efficacy was associated with low breastfeeding intention, short previous breastfeeding duration, and negative breastfeeding experiences in the first week postpartum. Finally, significant associations of drop in breastfeeding self‐efficacy from late pregnancy were no or short education, early negative breastfeeding experiences, prior short breastfeeding duration, and low general breastfeeding self‐efficacy in pregnancy. Negative breastfeeding experiences in the first week postpartum is crucial for maternal breastfeeding self‐efficacy 1 week following birth. It is important to identify and support mothers at risk of negative breastfeeding experiences in the first week following birth and address factors that might increase the probability of early successful breastfeeding experiences.