Breastfeeding Initiation Research Articles

Impact of COVID-19 Pandemic-Related Workflow Changes on a Clinically-Integrated Breastfeeding Peer Counselor Program.

To evaluate whether Covid-19 related workflow changes to a clinically-integrated breastfeeding peer counseling (ci-BPC) program were associated with poorer breastfeeding outcomes for Medicaid-enrolled patients. This retrospective chart review included patients who received ci-BPC care during January 2017-March 2020 ("Pre-Pandemic," N = 318); March 2020-September 2020 ("During-Peak," N = 53); and September 2020-May 2021 ("Post-Peak," N = 97). ANOVA evaluated differences in encounter type frequencies for each time point, as well as differences in breastfeeding initiation, exclusivity during inpatient admission, and continuation of breastfeeding at least 6 weeks post-delivery. In-person prenatal counseling significantly decreased from Pre-Pandemic to During-Peak (43.9-8.2%, p < 0.05). Breastfeeding at 6 weeks postpartum significantly increased from the Pre-Pandemic cohort to the During-Peak cohort (67-85%, p < 0.05), and returned to baseline for the Post-Peak cohort (74%). Covid-19 related workflow changes for the peer counselor did not decrease breastfeeding outcomes as anticipated.

Effect of early essential newborn care on breastfeeding and outcomes of mothers/newborns post-cesarean section: a randomized controlled trial in China

BackgroundThe implementation of early essential newborn care (EENC) is important to maternal and neonatal health. However, few studies have conducted a complete procedure of EENC in cesarean section. This study aimed to systematically evaluate the effects of EENC during and after cesarean section.MethodsA randomized controlled trial was conducted at a tertiary hospital in Wuhan, China. Full-term pregnant women who had no comorbidities and underwent elective cesarean section were recruited and received EENC intervention or routine health care. The Infant Breastfeeding Assessment Tool (IBFAT), the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), a questionnaire of the breastfeeding behavior, the Maternal Postnatal Attachment Scale (MPAS) and the Edinburgh Postnatal Depression Scale (EPDS) were used to collect data. The correlation between EENC implementation and breastfeeding, maternal-infant attachment, postpartum depression, and other maternal and neonatal outcomes was analyzed.ResultsMother-newborn pairs (N = 157) were enrolled in this study, 78 in the EENC group and 79 in the control group. A total of 155 (98.8%) were followed up at 14 days, 144 (91.7%) at 42 days, and 123 (78.3%) at 3 months. For the primary outcomes, generalized linear mixed model analysis showed that implementing EENC during cesarean section was beneficial for initiating breastfeeding (OR = 0.021), shortening the breastfeeding initiation time (β = − 45.321), improving the IBFAT scores (β = 2.740), and enhancing breastfeeding self-efficacy (β = 4.880). These effects were not influenced by time interaction. However, no difference was observed in the rate of exclusive breastfeeding between these two groups (P > 0.05). Implementing EENC during cesarean section significantly improved maternal-infant attachment (β = 9.668). Moreover, univariate analysis showed benefits of EENC in improving postpartum depression (P < 0.001) and decreasing maternal perinatal blood loss (P < 0.05).ConclusionsAccording to our small sample study, there is a trend of improvement in breastfeeding related behavior and maternal infant attachment in women who received EENC during cesarean deliveries. The effects of EENC on exclusive breastfeeding should be further explored in the future.Trial registration: Chinese Clinical Trial Register at www.chictr.org.cn, ChiCTR2300074760, retrospectively registration. Registration Date: August 15, 2023.

Effectiveness of Lactation Counselling and Breast Milk Stimulation Techniques on Relactation and Breastfeeding among Mother-Infant Dyads in a Selected Hospital, Puducherry – An Interventional study

Background: Breast milk has benefits of ensuring a healthy child and the survival of a child. Several studies reported that the initiation of breastfeeding within a day was significantly associated with reducing low birth weight related neonatal mortality and infection related neonatal mortality among all live births. Objectives: The main objectives to determine the effectiveness of lactation counselling and breast milk stimulation techniques on relactation among the mothers of the infants who stopped breastfeeding in Group I and Group II. Methods: The study was conducted in Rajiv Gandhi Government Women and Children Hospital (RGGW&amp;CH), Puducherry, Union territory in the Indian continent. Puducherry among 216 Mother-Infant Dyads using simple random sampling technique who meets the inclusion criteria. Result: The comparison of weight of the baby between pretest and post-test in both groups. In both the groups, there was significant gain in the weight of the baby. The calculated ‘t’ value was highly significant at p&lt;0.001. Conclusion: The level of knowledge of the mothers about relactation was moderately adequate. The study concluded that lactation counselling along with breast milk stimulation techniques is more effective in relactation than merely giving lactation counselling.

The The Relationship between Family Support and Maternal Attitude with Early Initiation of Breastfeeding in Infants Aged &lt;6 Months in the Working Area of Tanjung Seloka Community Health Center, Kotabaru Regency

One of the other things that causes high IMR is giving MP ASI too early. The high provision of Complementary Food for Early Breastfeeding is influenced by family support. The internal factor that influences early complementary feeding is the mother's attitude. Tanjung Seloka Health Center, Kotabaru Regency, is the health center with the third lowest coverage of exclusive breastfeeding, namely 83.7%. The aim of this research is to determine the relationship between family support and mother's attitude with early complementary breastfeeding to infants aged &lt;6 months in the work area of the Tanjung Seloka Health Center, Kotabaru District. The results show that 18 respondens (85.7%) who gave MP-ASI early to infants aged &lt;6 months did not receive adequate family support. Statistical analysis reveals a significant relationship between family support and early complementary feeding (p-value = 0,000 &lt; 0,005). Furthermore, all 15 respondents (100%) who gave MP-ASI early complementary feeding (p-value = 0,000 &lt; 0.005). The conlusion: family support and maternal attitude significantly influence the early provision of complementary feeding to infants aged &lt;6 months in the working area of the Tanjung Seloka Health Center, Kotabaru Distric. Strengthening family support and fostering positive maternal attitudes are essential to promoting exclusive breastfeeding practices.

Anishininew Infant Feeding Experiences in Sandy Lake, Canada: A Story of Waabeequanee.

Global public health recommendations for optimal infant nutrition include exclusive breastfeeding for the first 6 months of life. Breastfeeding has several benefits; however, breastfeeding initiation rates and duration remain below recommendations in Northwestern Ontario, Canada. Sandy Lake First Nation is particularly interested in understanding infant feeding experiences of community members to support increased breastfeeding initiation and duration. Therefore, this project aims to understand Indigenous caregiver infant feeding experiences using qualitative and Indigenous methodologies. As part of the Sandy Lake Health and Diabetes Project (SLHDP), a community-based participatory project focused on the prevention of Type 2 Diabetes Mellitus (T2DM), qualitative semi-structured interviews were conducted with 32 Anishininew caregivers living in Sandy Lake, Ontario. These interviews were tape recorded and transcribed verbatim. The Anishininew medicine wheel and situational analysis were used to inform our methods throughout this work. We recruited 32 co-creators, ages 18 to 57, who contributed knowledge through 26 individual and group interviews which occurred between August and October 2019. Two overarching themes, community context and caregiver identities, were identified that encompass 6 and 8 specific themes, respectively, representing infant feeding experiences in Sandy Lake. Community members provided a variety of recommendations to help support infant nutrition in Sandy Lake, including a focus on structural needs like higher income and water security. This work highlights the need for birthing supports within remote Indigenous communities, and the inclusion of local and Indigenous knowledge in programming.

Analysis of the Success of Early Breastfeeding Initiation on Stunting in Infants Aged Less Than 12 Months

Introduction: The incidence of stunting in Tasikmalaya Regency has decreased from 41.7% to 24.4%, but in 2022 there will be an increase of 2.7 points to 27.2%. The Tasikmalaya Regency Government has designated 67 villages as special locations for stunting intervention convergence in 2023. Cikunir Village, Singaparna District, Tasikmalaya Regency is one of the villages with a stunting prevalence that exceeds the set limit of 20%. Objective: The aim of this research is to determine the success of implementing of early breastfeeding initiation in Cikunir Village, Singaparna District, Tasikmalaya Regency on 2024. Method: This research method is qualitative with the aim of knowing the implementation of early breastfeeding initiation, mother's knowledge about early breastfeeding initiation, family motivation and the implementation of early breastfeeding initiation in stunted babies less than 12 months. Result: Based on the results of interviews during the implementation of early breastfeeding initiation, it is known that not a single baby succeeded in finding and sucking its mother's nipple, most did not exclusively breastfeed their babies, most did not know about early breastfeeding initiation, some most do not get motivation from their husbands and families in implementing early breastfeeding initiation and most do not prepare themselves for breastfeeding such as not taking care of their breasts during pregnancy. Conclusion: This research is expected to increase mothers' knowledge and motivation in carrying out early breastfeeding initiation.

Outcomes for women with diabetes admitted for labour care to midwifery units in the UK: a national prospective cohort study and survey of practice using the UK Midwifery Study System (UKMidSS)

ObjectivesTo describe outcomes in women admitted for labour care to midwifery units with gestational or pre-existing diabetes, compare outcomes with other women admitted to the same units and describe admission...

Breastfeeding Support for All: Narrowing Inequalities for Nurturing a Future That Is Fair and Sustainable

Early initiation of breastfeeding, duration, and exclusivity are internationally recommended practices to maximize impact in preventing and reducing the double burden of malnutrition, reducing child mortality and other morbidities, improving child development, and reducing health costs. The protection, promotion, and support of breastfeeding are also central to countries' commitments to the 2030 Agenda for Sustainable Development. Global progress in breastfeeding rates has been reported in past years. However, many children are still left behind and are not receiving the numerous benefits of breastfeeding. There are also relevant inequities in breastfeeding rates across global regions and countries and between groups from different socioeconomic statuses and cultural backgrounds within countries. These inequities are also extended to the frequency and availability of comparable standardized indicators worldwide. In 2023, globally, only 39% of the countries provided information on exclusive breastfeeding rates to the age of six months, and 7% assessed their overall breastfeeding support programs in the past five years. The increase in the coverage and frequency of monitoring globally agreed breastfeeding targets and the assessment of the impact of breastfeeding programs are imperative to providing breastfeeding support for all and increasing breastfeeding prevalence equitably. Breastfeeding can be an equalizer in society; no one should be left behind. Only this way can breastfeeding mums be celebrated in all their diversity and journeys, attending the 2024 World Breastfeeding Week call.

Influence of Food Desert Residence on Breastfeeding Initiation.

Introduction: Breastfeeding is associated with improved health outcomes. Several social drivers of health impact breastfeeding initiation (BFI). Prior research using ecological data demonstrated that food desert residence (FDR) is associated with lower rates of BFI. The primary objective was to assess the relationship between FDR and BFI using individual-level data. The secondary objective was to assess the relationship between FDR and BFI at the county level. Methods: Individual-level birth data from the Florida Department of Health were linked to food access data from the United States Department of Agriculture Food Access Research Atlas in 2010, 2015, and 2019. Food deserts were identified per the United States Department of Agriculture definition. Adjusted risk ratios (aRR) and 95% confidence intervals (CI) were calculated using modified Poisson regression models in 573,368 births. Models were adjusted for confounders and stratified by race/ethnicity. We assessed the association between the percent of the population in low-income and low-access census tracts aggregated to the county level and the percent of mothers initiating breastfeeding per county in Florida (Center for Disease Control and Prevention) using Pearson's correlation and a bivariate map. Results: FDR was associated with BFI (aRR: 1.23, CI: 1.20-1.27). The adjusted risk of not-initiating breastfeeding for those living in a food desert was greatest among non-Hispanic Black women (aRR: 1.29, CI: 1.24-1.35) and Hispanic women (aRR: 1.29, CI: 1.21-1.37). Maternal education was the most significant predictor of BFI. Women who had 9th through 12th-grade education but without a diploma were five times (aRR: 4.96, CI: 4.72-5.20) less likely to initiate breastfeeding relative to college graduates. There was no association between FDR and BFI at the county level, though regional trends were noted. Conclusions: FDR is an important risk factor for not-initiating breastfeeding. Among Floridians, education was the most significant risk factor. Understanding how FDR influences breastfeeding can help target interventions to improve breastfeeding outcomes.

Undernutrition before two years in Algeria: Repeated cross-sectional analyses (2012-13 to 2018-19)

Background Algeria has made significant progress in addressing childhood undernutrition. Despite improvements, nearly 12% of Algerian children under five years of age suffered from stunting in 2022. This study aimed to evaluate the prevalence of three indicators of undernutrition (stunting, wasting, and underweight) and their associated variables in children aged 0–23 months in Algeria between 2013 and 2019. Methods Pooled data from Multiple Indicator Cluster Surveys (MICS) (2012-13 and 2018-19) covering 14,498 children were used. Univariate and multiple logistic regression analyses were performed to test the associations. Results Stunting decreased significantly, but wasting and being underweight showed no significant reductions from 2013 to 2019. Stunting, wasting, and underweight decreased by 2.2%, 1.3%, and 0.3%, respectively, with an overall prevalence of 10.1%, 5.4%, and 3.6%, respectively. Factors associated with undernutrition included child age and small size at birth, whereas stunting was linked to the poorest households, male children, higher maternal body mass index (BMI), and low antenatal care (ANC) visits. Wasting was associated with younger age and paternal age, fewer maternal ANC visits, underweight male sex, low maternal education, high maternal BMI, and delayed breastfeeding initiation. Conclusion Public health experts and stakeholders must adopt a comprehensive community-centered approach to achieve long-term improvements in child nutrition in Algeria. This strategy should focus on key factors including high maternal BMI, low maternal education, male children, and infrequent ANC visits. This action can help Algeria progress towards achieving the UN’s goal of eradicating malnutrition.

ANALISIS REGRESI LOGISTIK BINER PADA KARAKTERISTIK DEMOGRAFI SOSIAL EKONOMI DAN INTERVENSI GIZI SPESIFIK BALITA STUNTING DI WILAYAH KERJA PUSKESMAS JAMBULA KOTA TERNATE

Stunting is a chronic nutritional problem that results from prolonged malnutrition. It is also considered a malnutrition status not only due to the height of the parents but also because of various socio-economic and demographic factors. These factors include family sizes, birth spacing of children, family socio-economic status, parental education levels, parental occupations, and specific nutritional interventions, such as Early Initiation of Breastfeeding (IMD), iron and folic acid supplementation (TTD), exclusive breastfeeding, complementary feeding (MP ASI), and immunization. This research aimed to analyze the influence of socio-economic demographic characteristics and specific nutritional interventions on families with stunted toddlers in the working area of the Jambula Community Health Center. The study employed an analytical survey design, with total sampling (non-probability sampling) involving a population of stunted toddlers. The results of this research showed the following associations between socio-economic demographic characteristics and stunting: number of family members (OR = 0.842, p = 0.043 &lt; 0.05), birth spacing (OR = 9.3, p = 0.013 &lt; 0.05), family socioeconomic status (OR = 11.8, p = 0.045 &lt; 0.05), father’s education (OR = 0.49, p = 0.445 &gt; 0.05), mother’s education (OR = 1.0, p = 0.979 &gt; 0.05), and parental occupation (OR = 0.324, p = 0.11 &gt; 0.05). Regarding specific nutritional interventions, significant factors were Early Initiation of Breastfeeding (IMD) (OR = 0.76, p = 0.024 &lt; 0.05), iron and folic acid supplementation (TTD) (OR = 5.9, p = 0.02 &lt; 0.05), exclusive breastfeeding (OR = 0.6, p = 0.015 &lt; 0.05), complementary feeding (MP ASI) (OR = 0.678, p = 0.039 &lt; 0.05), and immunization (OR = 1.6, p = 0.016 &lt; 0.05). In conclusion, factors that significantly influence the incidence of stunting in toddlers in the Jambula Health Center working area include the number of family members, birth spacing, family socio-economic status, Early Initiation of Breastfeeding, iron and folic acid supplementation, exclusive breastfeeding, complementary feeding, and immunization

Prelacteal Feeding and Associated Factors Among Mothers of Children Aged Less Than Six Months in Gozamen District, 2019: A Community Based Cross Sectional Study

&amp;lt;i&amp;gt;Background&amp;lt;/i&amp;gt;: Prelacteal feeding (PLF) is administration of any food or fluid other than breast milk before initiation of breast feeding. Optimal breastfeeding including discouraging prelacteal feeding could save 823,000 lives per year among children ages five years old and younger. Despite of this mothers give prelacteal feeding to their child in different part of Ethiopia. However, there is a paucity of information on prevalence of prelacteal feeding and associated factors in the study area. Thus, the current study aimed at determining of the prevalence of prelacteal feeding and associated factors among mothers of children aged less than six months in Gozamen district, East Gojjam zone, North West Ethiopia, 2020. &amp;lt;i&amp;gt;Methods&amp;lt;/i&amp;gt;: A community based cross-sectional study was conducted among seven hundred forty-one (741) mothers of children aged less than six months in Gozamen district from August 1 to September 12 /2019. Stratified cluster sampling technique was used to select study participants. Data were collected by face to face interviewer-administered, pretested and semi-structured questionnaire. Descriptive analysis, bi-variable and multivariable logistic regression model were employed. Adjusted odds ratio with 95% confidence interval was used to identify factors associated with prelacteal feeding. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: In this study the prevalence of prelacteal feeding was found to be 17.1%with 95%CI [14.3, 20]. Mothers who had no ANC follow up [AOR: 7.53, CI; 3.32, 17.05], those mothers who did not discard colostrum [AOR: 0.12, CI; 0.07, 0.12] time of breast feeding initiation [AOR: 3.53, CI; 2.05, 6.11] and mothers who had single ANC visit [AOR: 2.98, CI; 1.52, 5.85] were significant independent factors associated with prelacteal feeding. &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: This study concluded that prelacteal feeding was high in the study area. Therefore, in order to tackle this problem strengthening antenatal follow up, timely initiation of breastfeeding, health education and awarenes creation of the communities are recommended interventions.

Perinatal Depression and Breastfeeding Outcomes: A Systematic Review from South Asian Countries

Background: Breastfeeding is very beneficial to both mothers and infants. However, perinatal depression, encompassing both antenatal and postnatal depression, can significantly impact breastfeeding. Prior research suggests a link between postpartum depression and breastfeeding difficulties. This systematic review focuses on the duration of breastfeeding, the duration of exclusive breastfeeding (EBF), initiation, as well as the early cessation of breastfeeding among mothers in South Asian countries with unique sociocultural practices and mental health experiences. Methodology: The searched databases were PubMed, Ovid MEDLINE, ProQuest PsycINFO, EBSCOhost CINAHL, and Bielefeld Academic Search Engine (gray literature) for relevant records till February 2024. Studies conducted in South Asian countries with cross-sectional, cohort, or case–control designs were included, and all interventional studies, qualitative studies, case reports, and case series were excluded. The review examined breastfeeding duration among mothers with perinatal depression. Two reviewers independently screened and selected studies, extracted data, and used the Newcastle–Ottawa Scale for quality assessment. Results: This systematic review identified 109 records, of which 14 were eligible. Ten studies were cross-sectional and 4 were cohort studies. It involved 11,944 perinatal women, with sample sizes ranging from 100 to 8189 participants. Conclusion: Perinatal depression was associated with shorter breastfeeding duration, especially EBF and early cessation of all breastfeeding. However, any association between perinatal depression and the initiation of breastfeeding was unclear. Overall, supporting mothers suffering from perinatal depression is crucial for successful breastfeeding practice. Certain limitations of the review were data heterogeneity, risk of recall bias in breastfeeding practices, and different data collection time points. Future research could study the various sociocultural and economic factors and biological mechanisms in breastfeeding and maternal depression.

Individual and community level determinants of minimum meal frequency among breastfeeding children aged 6-23 months in Ethiopia: a multilevel analysis of 2019 Ethiopian Demographic Health Survey data.

Minimum meal frequency (MMF) is a vital indicator of whether a child's energy needs are being met. Previous studies in Ethiopia on MMF have primarily focused on individual factors, often using basic logistic regression models with limited scope and small sample sizes. In contrast, this study aims to identify the key determinants of MMF among breastfed children aged 6-23 months in Ethiopia, examining both individual and community-level factors through multilevel logistic regression analysis, utilizing nationally representative data. The study utilized a community-based cross-sectional design with a sample of 1,245 6-23 month breastfed children in Ethiopia, using data from the 2019 Ethiopian Mini Demographic Health Survey. Mixed effect logistic regression was used to identify factors associated with MMF. Adjusted odds ratios (AOR) with 95% confidence intervals were used to assess variable associations, while Intra-cluster correlation (ICC), median odds ratio (MOR), and proportional change in variance (PCV) were employed to gauge random variation. The proportion of 6-23-month breastfeeding children with MMF was found to be 55.9% (95% CI: 53.2, 58.6). In mixed effect logistic regression; breastfeeding initiation time within days after birth [AOR = 0.44; 95%CI: (0.24, 0.80)], maternal primary educational level [AOR = 1.46; 95%CI: (1.03, 2.05)], maternal higher level education [AOR = 2.43; 95%CI: (1.22, 4.81)] and children from wealthiest household wealth index [AOR = 2.13; 95%CI: (1.04, 4.33)] were individual-level factors and children from city-based regions [AOR = 1.75; 95%CI: (1.10, 2.77)] was community level factors significantly associated with MMF. The final model indicates that 50.8% of the variation in MMF was explained by combined factors at both individual and community levels and also the variation across clusters remained statistically significant (ICC = 8.1% and variance = 0.29 with p < 0.001). Minimum meal frequency is a proxy for meeting energy requirements and it is a key indicator of infant and young child feeding (IYCF) practice. According to this study finding, the prevalence of MMF among 6-23-month children in Ethiopia was found to be low. The study also suggest that time of breastfeeding initiation, women's educational level, household wealth index, and contextual region were factors significantly associated with MMF. It is recommended that IYCF strategies should be implemented widely through women's education and empowerment and promoting early initiation of breast feeding to increase the proportion of children to be fed with MMF appropriate for their age.

Delayed Lactogenesis II in High-Risk Pregnancies: What Should We Care.

Background: The timely initiation of lactogenesis II is crucial for postpartum women, with delays having significant clinical implications. This study aimed to evaluate the determinants of delayed lactogenesis II (DOL II) in high-risk pregnant women to guide clinical interventions and postnatal care protocols. Methods: We conducted a study involving high-risk pregnant women who gave birth and were admitted to our hospital''s obstetric intensive care unit for postpartum surveillance and treatment from February 1, 2023, to April 30, 2024. We utilized Pearson correlation analysis and logistic regression to determine factors linked to DOL II. Results: Our study included 206 high-risk pregnant women, with 85 (41.26%) experiencing DOL II. Pearson correlation analysis indicated strong associations between DOL II and maternal age (r = 0.452), gestational hypertension (r = 0.514), gestational diabetes (r = 0.487), and delayed colostrum secretion (r = 0.506), all statistically significant (p < 0.05). Logistic regression analysis identified age 35 years or older (OR = 2.115, 95%CI: 1.785-2.466), gestational hypertension (OR = 2.404, 95%CI: 2.125-3.107), gestational diabetes (OR = 2.556, 95%CI: 2.008-2.879), and colostrum secretion later than one hour postpartum (OR = 3.126, 95%CI: 2.682-3.605) as independent risk factors for DOL II, all with p < 0.05. Conclusions: The incidence of DOL II is significantly elevated in high-risk pregnant women, especially those aged 35 or older, those with gestational diabetes and hypertension, and those who delay the initiation of breastfeeding. It is imperative that clinical practices prioritize enhanced prenatal care and health education, robust lactation support, and improved lactation awareness among postpartum women to reduce the prevalence of DOL II.

Timely initiation of breastfeeding and its associated factors among immediate postpartum mother-newborn pairs in Debre Tabor comprehensive specialized hospital, South Gondar Zone, North West, Ethiopia

BackgroundInitiation of breast feeding within one hour of birth is the easiest and most cost-effective intervention to reduce the risk of neonatal morbidity and mortality. Conducting studies immediately after an hour of birth for the timely initiation of breastfeeding has the significance of initiating breastfeeding and acting immediately. However, there was a paucity of information in the region as well as in the country at large. Therefore, the aim of this study was to assess the magnitude of timely initiation of breastfeeding and its associated factors among immediate postpartum mother-newborn pairs in Debre Tabor comprehensive specialized hospital, northwest Ethiopia, in 2024.MethodAn institutional-based cross-sectional study was conducted from October 25, 2023, to January 25, 2024, at Debre Tabor Comprehensive Specialized Hospital. A total of 478 immediate postpartum mothers were selected at birth using systematic random sampling techniques. Data were collected using chart reviews, interviewer-administered questionnaires, and through observation. Data entry and analysis was performed by Epi-Data version 4.6.02 and Statistical Package for Social Sciences version 25(SPSS) soft war respectively. Descriptive statistics were computed to determine the frequency of variables. After doing a binary logistic regression analysis, a p-value less than 0.25 indicated a potential candidate for multivariable analysis aimed at identifying statistically relevant factors. Both crude and adjusted odds ratios (AOR) were computed, and the levels of significance were declared based on the AOR with a 95% confidence interval (CI) at a p-value < 0.05.ResultsIn this study, the prevalence of timely initiation of breastfeeding was 73.7% with a 95% CI (69.65%, 77.67%). Being multiparous (AOR: 2.25, 95% CI: 1.32, 3.84), receiving counseling immediately after delivery (AOR: 4.19, 95% CI: 2.20, 7.98), receiving support and guidance from health care providers (AOR: 1.95, 95% CI: 1.01, 3.77), having no obstetric complications during and immediately after delivery (AOR: 4.44, 95% CI: 2.34, 8.42), and practicing rooming-in (AOR: 3.65, 95% CI: 2.05, 6.51) were significantly associated variables with timely initiation of breast feeding.ConclusionThe overall timely initiation of breastfeeding in this study was lower than the World Health Organization’s recommendations. Therefore, interventions need to focus on mothers who developed obstetric complications, primiparous mothers, improper rooming-in, a lack of advice immediately after delivery, and the support and guidance of mothers on the timely initiation of breastfeeding to improve the timely initiation of breastfeeding practice.

Paracetamol versus ibuprofen for early postpartum pain control: a randomized controlled trial.

To evaluate the effectiveness of paracetamol and ibuprofen as non-opioid treatments for postpartum pain control after vaginal delivery. This randomized controlled study at a university-affiliated medical center involved parturient who received blindly oral tablets of either 1000 mg of paracetamol or 400 mg of ibuprofen, post-vaginal birth. Pain levels were assessed using a numeric rating scale (NRS) at four time points: before treatment, and 1, 4, and 6 h post-treatment (T0, T1, T4, and T6, respectively). We also compared the need for additional analgesia, breastfeeding initiation, mobilization, and urination following the delivery between the groups. To ensure statistical power, the study was designed to detect differences of one point on the NRS with at least 37 women per group. A total of 107 women participated, including paracetamol (n = 52) and ibuprofen (n = 55) groups. Demographics and perinatal outcomes were similar across groups. No significant differences were found in the interval between delivery and request for pain control (8 ± 6-10.5 and 11 ± 6-16h for the paracetamol and the ibuprofen, respectively, P = .13). Pain levels on the NRS were similar for both groups at all intervals. There were also no group differences in the time to the initiation of breastfeeding, mobilization, urination, or the need for additional analgesia. Both, paracetamol and ibuprofen, can be considered equivalent and effective non-opioid alternatives for postpartum pain control. REGISTRY AT CLINICALTRIALS.GOV: (NCT04653506), https://register. gov/prs/beta/studies/S000AFOR00000066/recordSummary .

Spatiotemporal patterns and factors contributing to neonatal mortality in Ethiopia: Data from EDHS 2000 to 2019.

Although Ethiopia has substantial improvements in various health indicators such as maternal and child mortality, the burden of neonatal mortality remains high. Between 2016 and 2019, neonatal mortality increased from 29 deaths per 1,000 live births to 33 deaths per 1,000 live births. This study aimed to explore the spatial patterns and factors contributing to neonatal mortality in Ethiopia. Data from the Ethiopian Demographic and Health Surveys (EDHS) for the years 2000, 2005, 2011, 2016, and 2019 were analyzed. The EDHS sampling design uses a two-stage cluster sampling technique, considering census enumeration areas as primary sampling units and households as secondary sampling units. We used the Spatial Scan analysis in SaTScan and Getis-Ord Gi* statistic in Geographic Information System (GIS), to analyse the spatiotemporal patterns of neonatal mortality. Maternal, newborn and health service-related factors contributing to neonatal mortality were also analyzed using a multilevel logistic regression model. Adjusted Odds Rios (AOR) with corresponding 95% CI were presented as a measure of association and a P-value of 0.05 was used to declare statistical significance. During the initial three consecutive surveys, there was a consistent pattern of hot spot clusters in the Amhara and Benshangul Gumuz regions, along with certain parts of the Oromia region. However, in later surveys, these clusters shifted to the eastern parts of the country, notably including the Somali region. Early initiation of breast feeding was associated with reduced chances of neonatal death (Adjusted Odds Ratio [AOR]) = 0.27; 95% Confidence Interval [CI]: 0.23, 0.32). Neonates born at home (AOR = 1.46; 95% CI: 1.16, 1.82) and male babies had a higher likelihood of mortality during the neonatal period compared to their counterparts (AOR = 1.36; 95% CI: 1.24, 1.51). The odds of neonatal mortality increased with the number of children a mother had ever given birth to (AOR = 1.36; 95% CI: 1.24, 1.51). In contrast, longer birth intervals were associated with a reduced risk of neonatal mortality (AOR = 0.76; 95% CI: 0.68, 0.83). The central southern, central-western, north-western, and northern parts of Ethiopia had most of the neonatal death clusters in the first three rounds of DHS while eastern Ethiopia had the highest neonatal mortality clusters in the latest two surveys. Our results underscore the importance for policymakers and health administrators to reassess intervention approaches and reallocate resources to regions identified as hot spots for neonatal mortality. Enhancing the initiation of breastfeeding within the first hour of birth would improve newborn survival rates. Special attention and care need to be given to babies born of smaller sizes.

Supporting breastfeeding for women with low education levels, psychosocial problems, and/or socioeconomic constraints: a scoping review protocol

Objective: This scoping review aims to identify and map interventions and/or strategies used to support the initiation and continuation of breastfeeding for women at risk of delaying initiation, early cessation, or not breastfeeding due to low levels of education, psychosocial problems, and/or socioeconomic challenges in high-income countries. Introduction: While breastfeeding has lifelong beneficial health effects for women and infants, there is a risk of delaying initiation, early cessation, or not initiating breastfeeding at all due to factors related to health inequalities, such as low levels of education, psychosocial problems, and/or socioeconomic constraints. Inclusion criteria: This review will include eligible quantitative, qualitative, and mixed methods studies, as well as systematic reviews and gray literature. We will include studies conducted in high-income countries, focusing on interventions and/or strategies to support women with low levels of education, psychosocial problems, and/or socioeconomic constraints in the initiation and continuation of breastfeeding for up to 6 months postpartum. Methods: This review will follow the JBI methodology for scoping reviews, using the Participants, Concept, and Context framework. The primary search will be performed in MEDLINE (Ovid), PsycINFO (EBSCOhost), Embase (Ovid), and CINAHL (EBSCOhost). We will include publications in English, Swedish, Norwegian, Danish, German, Bulgarian, Arabic, and Spanish, published from 1991 until the present. A data charting form will be developed and used for all the included articles. Review registration: Open Science Framework https://osf.io/tmp4v/

Gender, gestation, and birthweight-based differences in the timing of passage of first urine and meconium in neonates: A prospective observational study

ABSTRACT Introduction: The cut-off for referral to a higher center and further investigations for the delayed passage of first urine and meconium by a neonate have been traditionally kept after 48 hours of birth. There are very few studies regarding this in Indian neonates, and previous studies have relied primarily on the mother’s recall of the event which may have led to recall bias. Therefore, through this study, we wanted to use hospital intake/output records to identify the risk factors that affect the timing of passage of first urine and stool in neonates delivered at our center and to find out if the cut-off of 48 hours to call it a delay is justifiable. Methodology: This was a single-center, prospective observational study conducted in Eastern India. After obtaining ethics committee approval, the eligible neonates delivered at the center were prospectively enrolled between June 2020 to December 2022. The timing of passage of first urine and meconium was noted using 3 hourly collected information from the input/output charts maintained by the nursing staff in the postnatal wards. The median time of passage of first urine and meconium was compared across gender, gestation, and birth weight. To find the factors associated independently with delayed passage of meconium, multivariable logistic regression was used. Result: A total of 330 neonates were enrolled prospectively in the study. Approximately two-thirds of them passed first urine (69.7%) and meconium (62.7%) within 6 hours after delivery. The median and interquartile range (IQR) of the time of passage of the first urine was 4 (1-7) hours of life. This did not vary significantly for gender, gestation, and birthweight categories. The median (IQR) of time of passage of meconium was 4 (1-8) hours of life, which was significantly higher for male [5 (2-8.5), (P = 0.029)] and preterm neonates [6.3 (2.5-12), (P = 0.001)], but did not vary significantly for birthweight categories. On multivariable logistic regression, twin gestation [OR 4.15 (95% CI 1.09-15.76); P = 0.036] and preterm birth [OR 2.97 (95% CI 1.18-7.43); P = 0.02] increased the odds of passage of meconium beyond 12 hours’ postnatal age. 99.39% and 98.77% of the neonates passed urine and meconium respectively within 24 hours. Conclusion: The median time of passage of first urine was not influenced by gender, gestation at birth, and birthweight categories. The median time of passage of meconium was significantly higher for male and preterm neonates. Also, with early initiation of direct breastfeeding and good feeding support most neonates pass their first urine and stool by 24 hours of life. So, maybe it’s time to revise the cut-off for referrals or investigations from 48 hours to 24 hours of life. However, further studies with larger sample sizes will be required to confirm this cut-off.