Insufficient Milk Research Articles

Effectiveness of banana flower beverage on breast milk production among mothers of preterm neonates

BackgroundIn Thailand, banana flower is a popular galactagogue used for insufficient breast milk among lactating mothers, especially mothers with preterm neonates. AimTo investigate the effects of banana flower beverages on breast milk production among mothers with preterm neonates. MethodA randomized controlled trial was conducted among mothers with preterm neonates who were recruited and randomized into treatment group (nt = 20) who consumed banana flower beverage and control group (nc = 21) who received only plain water. The amount of expressed breast milk during three days postpartum was recorded and compared between the two groups. ResultsThe results showed that mothers in the treatment group had higher milk production than those in control group on Day 2 (48 ± 2 h) and Day 3 (72 ± 2 h) of postpartum. No adverse effects were reported. ConclusionBanana flower is a promising galactagogue in augmenting breast milk in mothers with preterm neonates with no adverse effects.

Comparing the effects of breastfeeding in the laid-back and cradle position upon the experiences of primiparous women: a parallel randomized clinical trial

Background and aimAppropriate positioning is crucial to successful breastfeeding and its continuation. Positioning can create, prevent, or correct breastfeeding problems. This study aimed to determine and compare the effects of both the laid-back and cradle positions upon the breastfeeding experiences of primiparous (cisgender) women.MethodsA parallel randomized clinical trial was conducted with a sample of primiparous women (n = 168) with a gestational age of between 31 and 34 weeks, referring to the perinatal clinic of Shahid Gharazi Hospital in Malayer (Hamadan Province, Iran). Participants were recruited via convenience sampling and allocated to one of two groups: intervention (laid-back position) (n = 85) and control (cradle position) (n = 83) using the random block method. Breastfeeding education was given to both groups during two sessions (weeks 31–34 and 35-–37 of pregnancy) by “baby-friendly” accredited hospitals in Iran. The intervention group was instructed on how to breastfeed using the laid-back position. The control group was instructed on how to breastfeed using the cradle position. In the immediate postnatal period, breastfeeding positions were assessed in both groups. Breastfeeding experiences were measured once at the time of participants returning home and again at both 1 week and 2 weeks following birth, using the breastfeeding experience scale. Data analysis was undertaken using the SPSS software version 21. A value of P < 0.05 was considered significant.ResultsNo statistically significant difference was observed between the two groups in terms of concerns relating to participants nor their breasts, milk insufficiency, neonate, process, or breastfeeding experience at any time point measured. The means (SDs) of breastfeeding experience at the time of discharge, 1 week, and 2 weeks after childbirth in intervention group were 26.07 (4.533), 26.85 (3.812), and 26.65 (4.632) respectively. The means (SDs) of breastfeeding experience at the time of discharge, 1 week, and 2 weeks after childbirth in control group were 25.42 (3.315), 26.68 (3.872), and 25.41 (4.05) respectively.ConclusionThere is no difference in breastfeeding experiences whether the laid-back or cradle position is used. Thus, broader education on breastfeeding and the provision of comprehensive support may be more effective in optimizing one’s experience of breastfeeding.Trial registrationRegistration date: 2021 July 21, Code: IRCT20180427039436N10, https://irct.ir/user/trial/57054/view

Child Stunting Reduction in Aceh Province: Challenges and a Way Ahead.

Indonesia ranks the fifth highest in child stunting among Asian countries. Aceh, a westernmost province in Indonesia recorded the highest prevalence of stunting in children under two years old in the nation. Our study investigated the current government efforts on child stunting reduction activities since the introduction of Governor Regulation No. 14/2019. The study investigated the current efforts of Aceh governments and relevant actors on child stunting reduction using in-depth interviews, document reviews and focus group discussions. Thirty-five (35) respondents including policy makers were interviewed, four focus group discussions (15 each group) were conducted, and various official documents were reviewed. Various challenges for reducing child stunting in Aceh were identified: inadequate knowledge and skills of Posyandu cadres on child stunting; reluctance to consume iron and folic acid (IFA), and supplementary foods (PMT Bumil) by many pregnant women due to perceived annoying effects and unappetizing taste; work engagement, insufficient breast milk production and inadequate support from husbands failing to achieve exclusive breastfeeding among nursing women; inadequate provision of complementary fortified foods for children 6-23 months; lack of clean water, waste management and WASH practices. The intervention on both nutrition-specific and nutrition-sensitive factors was found to be insufficient in Aceh. Although WASH (water, sanitation and hygiene) practices are the most important contributors to child stunting, only the health agency plays a singular role in reduction efforts by focussing on specific factors. Coordination between relevant agencies to address both factors is required to achieve the effectiveness of child stunting reduction and prevention in Aceh.

Treatment modalities in breastfeeding babies with marasmus and kwashiorkor associated with ankyloglossia

Introduction: Successful breastfeeding depends on an infant's ability to latch onto the mother's breast correctly. A poor latch will cause insufficient milk transfer which will cause poor growth. Each type of mammal produces different components of milk which make it species-specific and adjusts to their needs, growth rate, and breastfeeding habits. Human breast milk has many benefits for human babies because it contains various substances both nutrition and protection. This study aims to present two infants who suffered from Ankyloglossia, which hindered the baby's ability to breastfeed and eat solid food Case Presentation: The study presented two infants who suffered from Ankyloglossia, which hindered the baby's ability to breastfeed and eat solid food. These babies were diagnosed with marasmus and kwashiorkor. After revision on both the lip- and tongue ties, supplementation with pasteurized human milk donor, and good complementary feeding, the babies finally reach optimal growth and development. Conclusion: The sucking ability of the baby during early breastfeeding was proven to be important and should be examined, to achieve further successful breastfeeding.

Associations of secretory activation breast milk biomarkers with breastfeeding outcome measures.

The objective of this study was to explore associations between day 10 postpartum (D10) secretory activation biomarkers and the breastfeeding outcome measures. This prospective longitudinal descriptive study collected antepartum, D10, and day 60 postpartum (D60) questionnaire data and D10 milk samples. Protein, lactose, and citrate were analyzed with enzymatic spectrophotometric assays. Sodium and potassium were analyzed with inductively coupled plasma optical emission spectrophotometry. Group comparison data were analyzed using χ2, Fisher exact, and independent sample t tests, as appropriate, using SPSS for Mac (version 28). Participants (n=92) provided a D10 breastmilk sample and completed D10 questionnaires, and 83 completed D60 questionnaires. Participants with D10 impaired secretory activation sodium (>23.0mM) were more likely to report D10 perceived insufficient milk supply, χ2=7.002, P<.05; and less D10 feeding/pumping frequency a day, P<.05; and partial breastfeeding at D60, P<.05. Additionally, participants with D10 impaired secretory activation sodium-to-potassium ratio (sodium: potassium)>0.8 were more likely to partially breastfeed at D60, P<.05. Elevated milk sodium and sodium: potassium are biomarkers related to variables indicative of low milk supply. Therefore, immediate milk testing can be useful in identifying lactation compromise and improving breastfeeding duration. Because breastfeeding affords maternal and infant health benefits, clinicians should identify ways to measure lactation compromise in conjunction with an examination and clinical history to provide early interventions to increase breastfeeding duration and exclusivity.

HUBUNGAN TINGKAT PENDIDIKAN TERHADAP PENGGUNAAN LAKTAGOGUM

Lactagogum is a drug that can increase or facilitate the production of milk. Synthetic lactagogums are not widely known and relatively expensive. This causes the need for alternative laktagogum drugs. Efforts to increase breast milk production can be done by carrying out early and routine breast care, improving breastfeeding techniques, or by consuming foods that can affect breast milk production. One of the reasons for the failure of exclusive breastfeeding is the perception of insufficient breast milk, which can be caused by physiological and psychological factors. Education is a very important factor in this life, which is why education is a very important business of all time. Increasing breast milk production can be done in various ways, one of which is increasing the intake of lactagogum. Lactagogum is a drug that can increase or facilitate the production of milk. The sample in this study were breastfeeding mothers who had babies ranging in age from 3 to 6 months spread throughout Indonesia. This study was conducted by distributing a questionnaire to assess education and the use of Lactagogue as a food to increase breast milk production. Dissemination of questionnaires can be done manually or via Google Drive links which are distributed to several regions in Indonesia. The purpose of this study was to determine the relationship between education and the use of laktagogums. The research results are there is a relationship between education and the use of Lactagogum. It is hoped that mothers who are in the process of breastfeeding can make efforts to increase milk production, one of which is by consuming Lactagogum.

Rates of and factors associated with exclusive and any breastfeeding at six months in Canada: an analysis of population-based cross-sectional data

BackgroundBreastfeeding has many health, economic and environmental benefits for both the infant and pregnant individual. Due to these benefits, the World Health Organization and Health Canada recommend exclusive breastfeeding for the first six months of life. The purpose of this study is to examine the prevalence of exclusive and any breastfeeding in Canada for at least six months, and factors associated with breastfeeding cessation prior to six months.MethodsWe performed a secondary analysis of breastfeeding-related questions asked on the cross-sectional 2017–2018 Canadian Community Health Survey. Our sample comprised 5,392 females aged 15–55 who had given birth in the five years preceding the survey. Descriptive statistics were carried out to assess the proportion of females exclusively breastfeeding and doing any breastfeeding for at least six months by demographic and behavioural factors. We also assessed, by baby’s age, trends in the introduction of solids and liquids, breastfeeding cessation and the reasons females stopped breastfeeding. Multivariate log binominal regression was used to examine the association between breastfeeding at six months and selected maternal characteristics hypothesized a priori to be associated with breastfeeding behaviour.ResultsOverall, for at least six months, 35.6% (95% confidence interval (CI): 33.3%-37.8%) of females breastfed exclusively and 62.2% (95% CI: 60.0%-64.4%) did any breastfeeding. The largest decline in exclusive breastfeeding occurred in the first month. Factors most strongly associated with breastfeeding for at least six months were having a bachelor’s or higher degree, having a normal body mass index, being married and daily co-sleeping. Insufficient milk supply was given as the most common reason for breastfeeding cessation irrespective of when females stopped breastfeeding.ConclusionSix-month exclusive breastfeeding rates in Canada remain below targets set by the World Health Assembly. Continued efforts, including investment in monitoring of breastfeeding rates, are needed to promote and support exclusive breastfeeding, especially among females vulnerable to early cessation.

Upaya Peningkatan Pengetahuan Ibu Nifas tentang Kandungan Daun Kelor (Moringa Oleifera) sebagai Pelancar Asi

The Infant Mortality Rate (IMR) in Indonesia is still high. The infant mortality rate is largely due to nutritional factors. Exclusive breastfeeding can reduce infant morbidity and mortality. The most common reason found in breastfeeding mothers who stop breastfeeding is due to insufficient milk production. Utilization of plants/vegetables that function as galactogogue can be used as an alternative to increase milk production. Moringa leaves are one of the plants that people often use to increase milk production. Based on this, it is necessary to carry out health education about the content of Moringa leaves (Moringa Oleifera) as a breast milk booster. The purpose of health counseling is to increase the knowledge of postpartum mothers about the content of Moringa leaves as a breast milk booster. This health education activity was carried out on August 27 2022 in Jempong Baru Village, Sekarbela District, Mataram City. The method used in this devotional activity is using the lecture method, and for the media, namely the media using power point and leaflets. Posttest results obtained by postpartum mothers experienced an increase in knowledge after being given health education about the content of Moringa leaves as a breast milk booster. After the service activities, postpartum mothers are expected to be able to use Moringa leaves as an alternative in improving the smoothness of breastfeeding

Breastfeeding in Canada: predictors of initiation, exclusivity, and continuation from the 2017-2018 Canadian Community Health Survey.

Human milk is the ideal source of nutrition for infants; however, adherence to breastfeeding recommendations is suboptimal and availability of Canadian breastfeeding data are limited. Using the 2017-2018 Canadian Community Health Survey Public Use Microdata File (Maternal Experiences Module, n=5558, weighted n=1 669 462) we computed breastfeeding indicators and explored sociodemographic, health, and geographical predictors of breastfeeding with univariate logistic regression models. Nationally, of all participants who gave birth in the preceding 5 years, 91% initiated breastfeeding, 43% exclusively breastfed to≥5 months and 35% to≥6 months, 56% reported any breastfeeding at≥6 months, and 31% reported breastfeeding at≥12 months. Breastfeeding cessation was most commonly attributed to insufficient milk supply (25%), but reasons differed significantly by breastfeeding duration. Breastfeeding initiation, exclusivity for≥5 months, and extendedbreastfeeding ≥12 months all differed by geographic region, and by most sociodemographic and health characteristics. Positive breastfeeding outcomes were highest in British Columbia, and lowest in Quebec and the Atlantic region, and generally higher if caregivers had recently immigrated to Canada, were married, were >30 years of age, were not White, were nonsmoking, had completed postsecondary education, and had an annual household income >$40 000. These disparities indicate the need for tailored, equitable approaches to breastfeeding support, and continued regional monitoring of breastfeeding outcomes.

Exclusive breastfeeding for the first six months after birth: A cross-sectional study in health care centers in Khartoum, Sudan

Background: Encouraging exclusive breastfeeding (EBF) practices for the first 6 months of life is the most effective intervention for lowering childhood morbidity and death. However, compliance with breastfeeding recommendations is lacking in many developing countries. Thus, this study aimed to analyze mothers’ breastfeeding knowledge, attitudes, and practices, as well as factors that impact EBF at 6 months. Methods: This cross-sectional survey was conducted on 128 mothers who came for children’s vaccination at primary health care centers using a structured questionnaire in form of dichotomous, multiple choice, and open and scaling questions. Results: Of all mothers, 80.5% previously received information about breastfeeding. Of them, 38 (29.7%) initiated breastfeeding within 1 hour of delivery. Of the participants, &lt;50% knew (46.1% and 44.5%, respectively) about breastfeeding, and 92.2% of mothers (118) had a negative view of EBF. The length of EBF for 1–2 months, 3–4 months, and 5–6 months were 3.9%, 82.8%, and 13.3%, respectively. Other foods are introduced before 6 months of age because of insufficient breast milk (15.6%) and the mother has work (11.7%). Conclusion: EBF for up to 6 months was not recommended despite the high percentage of mothers who initiated breastfeeding right after birth or within a few hours. Sustained health and community-based nutritional education are recommended for pregnant and lactating mothers to promote optimal breastfeeding for the initiation and continuation of breastfeeding practices. More counseling and support are needed for working mothers. Key words: exclusive breastfeeding, first six months, Khartoum, Sudan

Breastfeeding Practices and Associated Factors among Immigrant Muslim Arab Women Living in a Metropolitan Area of the Southwest of United States.

Muslim Arab immigrants are a fast-growing, under-studied, and underserved minority population in the United States. Little is known about breastfeeding practices in this population. The objective of this study was to describe infant feeding practices and factors associated with these practices among immigrant Muslim Arab women. A nonexperimental-one group, cross-sectional, descriptive, prospective design was used to identify infant feeding practices among immigrant Muslim Arab women. A convenience sample of one hundred sixteen immigrant Muslim Arab women with at least one child five years or younger was recruited from a large metropolitan area in the Southwestern region. Participants completed the social ecological model of health promotion self-reported questionnaire. Descriptive statistics were performed to identify infant feeding practices and logistic regression was used to identify factors associated with these practices. Immigrant Muslim Arab mothers demonstrate high breastfeeding initiation rates (99.2%) and lengthy breastfeeding duration (M = 11.86, SD = 8.04), but low rates of exclusive breastfeeding at six months (21.6%). The most frequent reasons for early termination of breastfeeding were perceived insufficient milk (44.4%), child was still hungry after breastfeeding (37.5%), and the belief that the child was old enough to stop breastfeeding (32.9%). Development of educational interventions are needed to improve breastfeeding exclusivity and raise women's awareness of the importance of exclusive breastfeeding. Healthcare providers should help women gain confidence in their ability to produce enough milk to successfully continue breastfeeding.

Consequences of the Ignored Insufficient Milk Syndrome

The Ignored Insufficient Milk Syndrome is the sum of mothers with low colostrum production and babies with birth weight loss, which is a sign of neonatal dehydration due to low intake (small volume) of colostrum in infants from mothers with Delayed Lactogenesis II. If neonatal dehydration is severe, and is not detected early, it can cause neurological damage to the newborn in the short, medium, and long term. Accepting weight loss as normal, means exposing them, unnecessarily, to a progressive risk of dehydration and brain damage of varying degrees, in the first 10 days of puerperium and exclusive breastfeeding. When the volume of colostrum ingested is insufficient, instead of conditioning growth and development, in terms of weight gain and adequate neurological functions, it conditions the opposite, weight loss and manifestations of neurological malfunction. In the other hand, it is been proven that all stressful factors in mothers, further inhibit and delay the onset of lactogenesis II. We do not doubt the unquestionable benefits of breastfeeding and that it is the best “Quality” food for neonates, but we insist that it is not enough in “Quantity” to satisfy neonatal nutritional needs during the first ten days of life. There is evidence that some of the “ten steps to successful breastfeeding”, like prohibiting supplementing babies with formula, and omitting step 6, while milk coming in occurs, do not provide the benefits highlighted and expected, they even have more risks than benefits for most infants and mothers.

Perceived breast milk insufficiency: Prevalence and associated factors among women attending a young child clinic in Uganda

BackgroundThe most cited reason for early cessation or reduced exclusivity of breastfeeding is perceived breastmilk insufficiency. However, minimal work has been reported on perceived breast milk insufficiency, especially in Africa, where the practice of EBF remains low, hence the need to conduct the study. ObjectiveThis study aimed at identifying the prevalence and factors associated with perceived breast milk insufficiency. MethodsThis cross-sectional study was conducted among 180 mother-baby dyads with infants less than six months of age. The mothers attended an infant and young child clinic (IYCC) at an urban facility in Kampala. Data were collected using a structured interviewer-administered questionnaire using a systematic sampling procedure. Descriptive statistics and logistic regression were the major analysis techniques. ResultsThe prevalence of perceived breast milk insufficiency was (26 %). The reported indicators for PMI were; infant not gaining enough weight (38 %) and infant crying even after breastfeeding (38 %). Mothers who were unmarried (aOR = 0.18; 95 % CI = 0.05–0.61), and mothers who consumed less than two liters of fluid daily (aOR = 0.045; 95 % CI = 0.005–0.37) were more likely to experience perceived breast milk insufficiency. There is a need for continued reassurance and professional support for women to breastfeed their babies successfully.

UPAYA PENINGKATAN PENGETAHUAN IBU HAMIL TENTANG PEMANFAATAN TANAMAN LOKAL SEBAGAI PELANCAR ASI

Infant and toddler mortality rates are still high in Indonesia. The high mortality rate in Indonesia is caused by nutritional factors. Exclusive breastfeeding is able to reduce infant mortality, but the achievement of exclusive breastfeeding is still below the scope. Insufficient milk production is one of the causes of the low achievement of exclusive breastfeeding. In Indonesia, there are many plants that can promote breast milk, but cases of insufficient milk production are still high. The use of local plants as breast milk stimulants must be supported by comprehensive information so that they have a beneficial effect. Therefore, it is necessary to conduct health education on the use of local plants as breast milk promoters. The activity of providing health education on the use of local plants as an effort to increase breast milk production was carried out in Terong Tawah Village, Labuapi District, West Lombok Regency on November 8, 2021 and was attended by 09 respondents. The results of the participants' pretest and posttest showed an increase in knowledge about the use of local plants as an effort to increase breast milk production. After this community service activity, it is expected that pregnant women, especially pregnant women in the third trimester, can begin to apply all the material obtained about the use of local plants as breast milk, as an effort to prepare for breastfeeding.&#x0D;

Association of labor epidural analgesia use with exclusive breastfeeding up to six months: a online-based cross sectional survey in Jiaxing, China

BackgroundThe impact of labor epidural analgesia (LEA) on breastfeeding remains controversial. The aim of this study was to assess the relationship between LEA use and exclusive breastfeeding (EBF) up to 6 months.MethodsThis was a cross-sectional survey on healthy mothers who had vaginal delivery with infants aged 7-12 months from seven maternal health WeChat groups in Jiaxing, China. Data including EBF status up to 6 months, maternal sociodemographic characteristics, LEA use in labor, breastfeeding supports during hospitalization and reasons for stopping EBF were collected using online self-administered questionnaires in October 2021. A multivariable logistic regression model was used to determine the potential association of LEA use with EBF up to 6 months by the adjusted odds ratio (AOR) and 95% confidence interval (CI).ResultsOf a total of 537 surveyed mothers, 408 (76.0%) delivered with LEA and 398 (74.1%) exclusively breastfed their infants until 6 months. All mothers delivered in the hospitals with active breastfeeding policies. There was no statistical difference in the rate of EBF up to 6 months between mothers with and without LEA (73.8% versus 75.2%, P = 0.748). Multivariable logistic regression analysis indicated that only increased maternal age (AOR = 0.906, 95% CI 0.854-0.961, P = 0.001) and perceived insufficient breast milk (AOR = 0.129, 95% CI 0.082-0.204, P < 0.001) were associated with lower odds of EBF up to 6 months. The top three reasons for non-EBF were no or insufficient breast milk (41.7%), inability to breastfeed infants after return to work (27.3%), and maternal related factors (24.4%).ConclusionsLEA does not affect EBF up to 6 months. Other factors such as health education and breastfeeding-friendly hospital strategies may be much more important to breastfeeding outcomes compared to LEA use.

The effect of postpartum sleep quality on the perception of insufficient milk and attitude to breastfeeding: a cross-sectional study

ABSTRACT The aim of this study was to determine the effect of sleep quality of postpartum women on perception of insufficient milk and attitude to breastfeeding. The research was designed as a cross-sectional study. It was carried out with 347 mothers in a university hospital between December 2021 and July 2022. Data was collected via a personal informational form, the Postpartum Sleep Quality Scale (PSQS), the Perception of Insufficient Milk (PIM) Questionnaire and the Breastfeeding Attitude Rating Scale (BAAS). According to the results of the correlation analysis, there was a statistically significant negative relationship between the total mean score of the Postpartum Sleep Quality Scale and the mean total score of both the Perception of Insufficient Milk and the Breastfeeding Attitude Assessment Scale (r = -.340, p = .000 and r = -.153, p = .002 respectively). Examining the variables relating to the PIM score, a statistically significant correlation was found between age, PSQS, education level (bachelor's graduates and above), mode of birth (general anesthesia and cesarean) and breastfeeding experience (previously having given birth or having breastfed a baby) [(R = .448; R2 = ,200; F(5.341) = 17,096; p < .001)]. Mothers often need support to improve their sleep quality, as inadequate milk perception develops due to inadequate milk perception in the early postpartum period and changes their breastfeeding attitudes.

Interaction of Passive Smoking and Diet Habits on Vitamin D Deficiency among Women of Reproductive Age in Rural Central China.

Maternal dietary undernutrition is known to be associated with the risk of vitamin D (VD) deficiency. However, whether the risk of VD deficiency in women of reproductive age is influenced by the interaction between passive smoking and inadequate nutrition remains unknown. The aim of this study is to explore the interaction between passive smoking and dietary undernutrition on the risk of VD deficiency. A population-based case-control study including 1151 non-pregnant women of reproductive age between 18 and 40 years old was conducted in Henan Province, China from 2009 to 2010. Blood samples and information on exposure factors were collected. The prevalence of VD deficiency was estimated based on a result of serum 25-hydroxyvitamin D [25(OH)D] &lt; 26.0 ng/mL. A multivariate logistic regression analysis was performed to explore the risk of VD deficiency. The prevalence of VD deficiency was 61.5%. After adjusting for potential confounding factors, the interactions between passive smoking and no nutritional supplementation, passive smoking and insufficient egg intake, and passive smoking and insufficient milk dairy products intake were associated with the risk of VD deficiency, and the adjusted ORs were 3.40 (95% CI 2.26-5.13), 2.87 (95% CI 2.20-4.10), and 2.18 (95% CI 1.33-3.58), respectively. The interaction coefficients were calculated to be 2.35, 2.79, and 1.70, respectively, indicating there were significant interaction effects, as all of the coefficients were higher than 1. Our findings present that the risk of VD deficiency was potentially influenced by interactions between passive smoking and inadequate nutrition. Passive smoking might strengthen the effect of inadequate nutrition on the risk of VD deficiency among rural women of reproductive age. More attention should be paid to the health education and nutritional status improvement of women of reproductive age, especially in rural areas of developing countries.

Fatty Acid Transfer from Blood to Milk Is Disrupted in Mothers with Low Milk Production, Obesity, and Inflammation

Obesity is associated with chronic inflammation and is a risk factor for insufficient milk production. Inflammation-mediated suppression of LPL could inhibit mammary uptake of long-chain fatty acids (LCFAs; >16 carbons). In an ancillary case-control analysis, we investigated whether women with low milk production despite regular breast emptying have elevated inflammation and disrupted transfer of LCFAs from plasma into milk. Data and specimens from a low milk supply study and an exclusively breastfeeding control group were analyzed, with milk production measured by 24-h test-weighing at 2-10 wk postpartum. Low milk supply groups were defined as very low (VL; <300mL/d; n=23) or moderate (MOD; ≥300mL/d; n=20) milk production, and compared with controls (≥699mL/d; n=18). Serum and milk fatty acids (weight% of total) were measured by GC, serum and milk TNF-α by ELISA, and serum high-sensitivity C-reactive protein (hsCRP) by clinical analyzer. Group differences were assessed by linear regression models, chi-square exact tests, and Kruskal-Wallis nonparametric tests. VL cases, as compared with MOD cases and controls, had higher prevalence of elevated serum hsCRP (>5mg/L; 57%, 15%, and 22%, respectively; P=0.004), detectable milk TNF-α (67%, 32%, and 33%, respectively; P=0.04), and obesity (78%, 40%, and 22%, respectively; P=0.003). VL cases had lower mean±SD LCFAs in milk (60%±3%) than MOD cases (65%±4%) and controls (66%±5%) (P<0.001). Milk and serum LCFAs were strongly correlated in controls (r=0.82, P<0.001), but not in the MOD (r=0.25, P=0.30) or VL (r=0.20, P=0.41) groups (Pint<0.001). Mothers with very low milk production have significantly higher obesity and inflammatory biomarkers, lower LCFAs in milk, and disrupted association between plasma and milk LCFAs. These data support the hypothesis that inflammation disrupts normal mammary gland fatty acid uptake. Further research should address impacts of inflammation and obesity on mammary fatty acid uptake for milk production.

Factors Affecting Non Compliance with Exclusive Breastfeeding Among Mothers: A Survey at District Hospital Dadu

Background: According to standard guideline for breastfeeding, t is mandatory to practice exclusive breastfeeding during the first six months of a baby's life to provide the finest physiological support for all neonates. In Pakistan there is visible underuse of exclusive breastfeeding among lactating mothers. This study aims to assess the variables affecting the non-compliance to exclusive breastfeeding among mothers at a district hospital in Pakistan. Materials and methods: A descriptive cross sectional study design was conducted to in Pediatric OPD at the district hospital Dadu from January to June 2022, breast feeding mothers were the study population, Using a total population sampling method, 224 breastfeeding mothers were interviewed regarding their practice towards exclusive breast feeding. Chi square test of association was used to evaluate the association of variables. Results: We observed that only 29. 5% mothers practiced exclusive breast feeding. All the mothers in the study had a breastfeeding child. Most of the mothers in this study were aged between 20 to 40 years (62%). Nearly 2/3rd of the mothers in the study had no formal education, only 5.8% mothers had higher secondary education. More than 1/5th of the mothers had more than 5 children. The most common reason for non-compliance with the exclusive breastfeeding was the use of formula milk by the mothers followed by insufficient breast milk Conclusion: Inclination to use formula milk, insufficient breast milk, early weaning and lack of the education among mothers were most common causes of non-compliance towards exclusive breastfeeding. Maternal education level was significantly associated with exclusive breastfeeding. Mass level health education for maternal and child health are recommended. Keywords Breast feeding, Exclusive breastfeeding, Neonate, Maternal factors,

Exclusive breastfeeding rate and related factors among mothers within maternal health WeChat groups in Jiaxing, Zhejiang province, China: a cross-sectional survey

BackgroundThe health workers in Jiaxing of China have established maternal health WeChat groups for maternal health education and management since 2019. Pregnant women in Jiaxing are invited to join the WeChat groups and a health worker as the group manager provides health education and individual counselling for women within the group. This study aimed to investigate the exclusive breastfeeding (EBF) status up to six months and its associated factors among the mothers of infants aged 7-12 months within the WeChat groups.MethodsThis was a cross-sectional survey on healthy mothers with infants aged 7-12 months from seven maternal health WeChat groups in October 2021 in Jiaxing, China. EBF was defined as breastfeeding infants exclusively up to six months. Data including breastfeeding practice from birth to six months, maternal sociodemographic and obstetric characteristics, hospitalization information, work related factors and reasons for non-EBF up to six months were collected using an online self-administered questionnaire. A multivariable logistic regression analysis was performed to identify the factors independently associated with EBF up to 6 months.ResultsA total of 822 mothers were included in this study. Among them, 586 mothers (71.3%) exclusively breastfed infants up to six months. Multivariable logistic regression analysis showed that older maternal age (adjusted odds ratio [AOR] 0.956; 95% confidence interval [CI] 0.917, 0.997) and perceived insufficient breast milk (AOR 0.104; 95% CI 0.072, 0.149) were associated with lower odds of EBF up to six months. The five of common reasons for non-EBF up to six months were no or insufficient breast milk (59.8%), return to work (23.9%), no flexible nursing breaks at work (18.2 %), infant crying or feeling tired or troubled with breastfeeding (9.7%), and nipple and breast problems (9.3%).ConclusionAbout 71.3% of infants were exclusively breastfed until six months of age in our WeChat groups. Perceived insufficient breast milk and work related factors are the main barriers to EBF up to six months in this setting. However, further comparative study is needed to confirm the effect of WeChat groups on breastfeeding.