Maternal Willingness Research Articles

Mothers' Willingness to Use Workplace Lactation Supports: Evidence from Formally Employed Mothers in Central Kenya

BackgroundFormally employed mothers are vulnerable to early cessation of exclusive breastfeeding. Kenyan national policy requires employer-provided maternity benefits and workplace lactation supports. ObjectiveThe objective of this study was to evaluate willingness to use nationally mandated workplace lactation supports among formally employed women in Kenya. MethodsWe conducted a cross-sectional survey among 304 mothers of children ages ≤12 mo in Naivasha, Kenya, who were currently formally employed and employed before delivery of the most recent child to assess availability of and willingness to use current and potential future workplace lactation supports. ResultsThe most available reported workplace lactation supports were schedule flexibility to arrive late or leave early (87.8%) or visit a child to nurse during lunch (24.7%), followed by company-funded community-based daycare (7.6%). Few (<4.0%) reported the availability of lactation rooms, on-site daycares, transportation to breastfeed during lunch, refrigerators for expressed milk, or manual or electric breastmilk pumps. If made available, >80% of mothers reported moderate or strong willingness to use flexible schedules to arrive late or leave early, break during lunch, and transportation to visit a child to nurse. A moderate proportion reported strong willingness to use on-site daycares (63.8%), company-funded community-based daycare (56.9%), on-site lactation rooms (60.5%), refrigeration for expressed milk (49.3%), manual (40.5%), and electric pumps (27.6%). Mothers expressed fear of missing production targets and reported more willingness to use on-site compared with off-site daycare to save transportation time but noted concerns about chemical exposures and early arrival times with young infants. Hesitations regarding the use of on-site lactation rooms included concerns about privacy, milk identification and storage, and use and sharing of pumps. ConclusionsFlexible schedules were the workplace lactation supports in highest demand among formally employed mothers. Maternal willingness to use lactation rooms, refrigeration, and pumping equipment was moderate to low, suggesting sensitization may help to increase demand as the implementation of Kenyan policies moves forward.

Associations between attachment-related variables in fifth and sixth graders and their mothers in Japan

Obtaining data from non-Western cultural contexts is essential for enhancing the cross-cultural validity of attachment theory. This study investigated the associations among maternal attachment style, maternal willingness to serve as an attachment figure, and children’s attachment security in middle childhood in Japan. Sample 1 included a nationwide web survey of 104 dyads of fifth and sixth graders and their mothers. Sample 2 included 53 dyads in an in-person questionnaire survey conducted in Kyoto. In both Samples 1 and 2, the results revealed (1) negative Spearman’s rank correlation coefficients between maternal attachment anxiety and children’s attachment security, (2) positive Pearson’s product-moment correlation coefficients between maternal willingness to serve as an attachment figure and children’s attachment security, and (3) negative Pearson’s product-moment correlation coefficients between maternal attachment anxiety and maternal willingness to serve as an attachment figure. Our data could enhance the cross-cultural validity of attachment in fifth and sixth graders, and suggest that the influence of maternal attachment styles on parental responsiveness changes in middle childhood.

Maternal drugs and breastfeeding: Risk assessment from pharmacokinetics to safety evidence - A contribution from the ConcePTION project

Human milk is the most appropriate form of nutrition for infants while taking medication during the postpartum period is common. Discontinuation of breastfeeding is sometimes wrongly recommended for fear of adverse effects in the breastfed infant whereas only a few drugs are strictly contraindicated while breastfeeding. Most drugs are transferred from the mother's blood to the milk, but the breastfed infant usually ingests a small drug amount through human milk. As population-based evidence is still scarce on safety of drugs during breastfeeding, risk assessment relies on the little clinical evidence available and on pharmacokinetic principles, as well as on specialized sources of information that are essential for clinical decision-making. Risk assessment should not only be based on the drug's potential risk for the breastfed infant but should always take into account the benefits associated to breastfeeding, the risks of untreated maternal disease and the maternal willingness to breastfeed. Identifying situations with potential for drug accumulation in the breastfed infant is decisive while assessing the risk. Health care providers should always assume that mothers will be concerned and use risk communication as a key to ensure medication adherence and prevent unnecessary interruption of breastfeeding. When a mother still expresses concerns, decision support algorithms may facilitate communication and some strategies can be offered to minimize the drug exposure in the breastfed infant even when clinically not justified.

Effects of Positive Psychological Nursing Combined with Free Posture on the Prognosis of Primipara with Singleton Spontaneous Delivery.

Objective To explore the effects of positive psychological nursing combined with free posture on the prognosis of primipara with singleton spontaneous delivery. Methods 106 cases of primipara with singleton spontaneous delivery who were admitted to the obstetrics department of our hospital from January 2017 to December 2019 were selected as the research subjects and they were divided into the observation group and control group according to the random number table method and maternal willingness, with 53 cases in each group. The control group received routine nursing, and the observation group was given positive psychological nursing combined with free posture on the basis of the control group. The stress degree during delivery (Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD)), the time of first stage of labor, the time of second stage of labor, the time of third stage of labor, pain level during the active period of the first stage of labor, and delivery outcomes were observed and compared between the two groups. Results The degree of anxiety and depression during childbirth in the observation group was significantly lower than that in the control group (P < 0.05). The time of first stage of labor and the time of second stage of labor in the observation group were shorter than those in the control group (P < 0.05), and there was no significant difference in the time of the third stage of labor (P > 0.05). The pain degree in the active stage of the first stage of labor in the observation group was lower than that in the control group (P < 0.05). The pain degree in the active stage of the first stage of labor in the observation group was lower than that in the control group (P < 0.05). Conclusion Positive psychological nursing combined with free posture for primipara with singleton spontaneous delivery can shorten the stages of labor, reduce the pain, relieve psychological stress, and improve the delivery outcomes.

The willingness to attend the first dental visit within 1 year of age: An analysis applying Andersen's behavioral model of health service utilization.

BackgroundThe first dental visit (FDV) within 1 year of age is important for establishing good oral health behaviors for young children, but delayed FDVs are common.AimThis study aimed to investigate the predisposing, enabling, and need factors of maternal willingness to attend the FDV for infants.DesignA cross‐sectional survey was conducted among mothers of infants aged 11‐14 months. A questionnaire was developed based on Andersen's behavioral model of health service utilization. Data regarding the FDV, FDV willingness, and reasons for not attending the FDV were collected. Logistic regression models were used to investigate the associated factors.ResultsOf 658 infants, only 2.7% (18) had a Thirty percent (191/640) of mothers reported their willingness to attend the FDV in the next 3 months. Nearly two‐thirds of mothers reported not attending the FDV since their children's teeth were healthy. Maternal perceptions of their infants’ oral health status were negatively associated with willingness to undergo the FDV, whereas family social support was positively associated with willingness to undergo the FDV.ConclusionsNeed factors play a key role in the utilization of FDV. Improving parental awareness of FDV might help parents voluntarily attend the FDV, and offering support from the family and healthcare system levels enables access to paediatric dental care.

Screening Adult Children of Hepatitis C-Infected Baby Boomers: Barriers to Testing and Prevalence Estimates.

Screening Adult Children of Hepatitis C-Infected Baby Boomers: Barriers to Testing and Prevalence Estimates.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KESEDIAAN IBU BERSALIN UNTUK PEMASANGAN IUD POST PLACENTA

Intra Uterine Device post placenta is the installation in the first 10 minutes to 48 hours after the birth placenta plays a role in reducing maternal mortality through prevention of pregnancy, delaying pregnancy, and spacing pregnancies, the effectiveness of use up to 99.4% can prevent 5-10 years of pregnancy. This study aims to determine the factors associated with maternal willingness to post Post Placenta IUD. The study used a questionnaire with a population of third trimester pregnant women who examined their pregnancies and a sample of 98 people by purposive sampling. Analyze data with Chi Square. The results showed that the majority of pregnant women were not willing to do post placenta IUD installation of 58.2% which was influenced by age, parity, knowledge and support of the husband.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KESEDIAAN IBU BERSALIN UNTUK PEMASANGAN IUD POST PLACENTA

Intra Uterine Device post placenta is the installation in the first 10 minutes to 48 hours after the birth placenta plays a role in reducing maternal mortality through prevention of pregnancy, delaying pregnancy, and spacing pregnancies, the effectiveness of use up to 99.4% can prevent 5-10 years of pregnancy. This study aims to determine the factors associated with maternal willingness to post Post Placenta IUD. The study used a questionnaire with a population of third trimester pregnant women who examined their pregnancies and a sample of 98 people by purposive sampling. Analyze data with Chi Square. The results showed that the majority of pregnant women were not willing to do post placenta IUD installation of 58.2% which was influenced by age, parity, knowledge and support of the husband.

Acceptability of Reminders for Immunization Appointments via Mobile Devices by Mothers in Ilorin, Nigeria: A Cross-sectional Study.

Immunization coverage in Nigeria remains low despite the protection it confers. Reminders via mobile phones may be deployed as a means of improving vaccination coverage but requires the participation and cooperation of the caregiver. Therefore, we evaluated the acceptability of reminders for immunization appointment by mothers in Ilorin, Nigeria. This descriptive cross-sectional study recruited 526 mothers from two public hospitals in Ilorin. Semi-structured questionnaires were used to collect information on ownership and access to phones, willingness to receive reminders, household, antenatal, and delivery characteristics. The majority (92.7%) of mothers had a personal phone, and all willingly provided contact details. Over half (69.0%) of mothers were willing to receive reminders. Postsecondary education (odds ratio (OR) = 1.958; 95% confidence interval (CI): 1.232-3.111) and antenatal care attendance by mothers (OR = 8.381; 95% CI: 2.495-28.170) were significant determinants of mothers willingness to receive reminders. Mothers with less than or equal to four children had a three-fold increased odds of wanting reminders. Artisan mothers were less likely to want reminders compared with unemployed mothers (OR = 0.506; 95% CI: 0.291-0.847). Most mothers are willing to receive reminders on immunization appointments via their mobile phone. Determinants of maternal willingness to receive reminders include mothers with less than four children, postsecondary education, and antenatal care attendance. Program planners should consider utilizing reminders as a strategy to increase the immunization uptake with access to contact details making this feasible.

Factors influencing mothers' decision to enroll their HIV-negative children in a hypothetical HIV vaccine trial.

This study explored the factors influencing mothers' decision-making about enrolling their HIV negative infants in a hypothetical HIV vaccine trial. Methods: HIV infected and uninfected mothers (n = 22) were interviewed. Several factors were identified as influencing the mothers' decisions, including perceptions and knowledge of HIV and vaccines. Maternal concerns about protecting their infants from HIV were also identified and mothers indicated that they were eager to vaccinate their children. Insufficient information and reassurance regarding vaccine trial safety and efficacy influenced maternal reluctance to enroll their child.

Maternal willingness to pay for infant and young child nutrition counseling services in Vietnam

BackgroundAlive & Thrive Vietnam, a 6-year initiative (2009–2014), has developed and incorporated elements of social franchising into government health services to provide high-quality nutrition counseling services to improve infant and young child feeding practices. One element of franchising that has not yet been implemented is fee for service, which is a potential financing mechanism for sustaining services in the long run.ObjectiveThis research aims to estimate maternal willingness to pay (WTP) for nutrition counseling services and to examine potential factors associated with their WTP.Design and methodsData were drawn from an impact evaluation survey of 2,511 women with a child <2 years old from four provinces in Vietnam. An iterative bidding technique was employed to explore individual WTP. The first bid was defined as VND 20,000 (~US$ 1), which was approximately the level of the actual service cost. Depending on the participant response, the bid increased or decreased. Finally, the respondents were asked about the highest price they would be willing to pay for the service.ResultsOverall, 92.6% of clients reported a need for nutrition counseling services for children <2 years. The WTP rates at bid levels of VND 5,000, 10,000, 20,000, 40,000, and 100,000 were 95.2, 94.4, 90.7, 68.9, and 33.4%, respectively. The mean and median of the maximum WTP were VND 58,500 and 50,000, respectively. In multiple regression models, WTP rates were higher among younger women, the Kinh majority group, and better educated and wealthier women.ConclusionA high demand for nutrition counseling coupled with a WTP by almost all segments of society would potentially cover costs of delivery for nutrition counseling services in Vietnam.

Male partner involvements in PMTCT: a cross sectional study, Mekelle, Northern Ethiopia

BackgroundMale partner participation is a crucial component to optimize antenatal care/prevention of mother to child transmission of HIV(ANC/PMTCT) service. It creates an opportunity to capture pregnant mothers and their male partners to reverse the transmission of HIV during pregnancy, labour and breast feeding. Thus involving male partners during HIV screening of pregnant mothers at ANC is key in the fight against mother to child transmission of HIV(MTCT). So, the aim of this study is to determine the level of male partner involvement in PMTCT and factors that affecting it.MethodsA Cross-sectional study was conducted among 473 pregnant mothers attending ANC/PMTCT in Mekelle town health facilities in January 2011. Systematic sampling was used to select pregnant mothers attending ANC/PMTCT service after determination of the client load at each health facility. Clinic exit structured interviews were used to collect the data. Finally multiple logistic regression was used to identify factors that affect male involvement in ANC/PMTCT.ResultsTwenty percent of pregnant mothers have been accompanied by their male partner to the ANC/PMTCT service. Knowledge of HIV sero status [Adj.OR (95% CI) = 0.43 (0.18- 0.66)], maternal willingness to inform their husband about the availability of voluntary counselling and testing services in ANC/PMTCT [Adj.OR (95% CI) =3.74(1.38-10.17)] and previous history of couple counselling [Adj.OR (95% CI) =4.68 (2.32-9.44)] were found to be the independent predictors of male involvement in ANC/PMTCT service.ConclusionMale partner involvement in ANC/PMTCT is low. Thus, comprehensive strategy should be put in place to sensitize and advocate the importance of male partner involvement in ANC/PMTCT in order to reach out male partners.

Pediatric HIV Type 1 Vaccine Trial Acceptability among Mothers in Kenya

Vaccination of infants against human immunodeficiency virus type 1 (HIV-1) may prevent mother-to-child HIV-1 transmission. Successful trials and immunization efforts will depend on the willingness of individuals to participate in pediatric vaccine research and acceptance of infant HIV-1 vaccines. In a cross-sectional study, pregnant women presenting to a Nairobi antenatal clinic for routine care were interviewed regarding their attitudes toward participation in research studies and HIV-1 vaccine acceptability for their infants. Among 805 women, 782 (97%) reported they would vaccinate their infant against HIV-1 and 729 (91%) reported willingness to enroll their infant in a research study. However, only 644 (80%) would enroll their infants if HIV- 1 testing was required every 3 months and 513 (64%) would agree to HIV-1 vaccine trial participation. Reasons for not wanting to enroll in a pediatric HIV-1 vaccine trial included concerns about side effects (75%), partner objection (34%), and fear of discrimination (10%), HIV-1 acquisition (8%), or false-positive HIV-1 results (5%). The strongest correlate of pediatric vaccine trial participation was maternal willingness to be a vaccine trial participant herself; in univariate and multivariate models this was associated with a 17-fold increased likelihood of participation (HR 17.1; 95% CI 11.7-25; p < 0.001). We conclude from these results that immunizing infants against HIV-1 and participation in pediatric vaccine trials are generally acceptable to women at high risk for HIV-1 infection. It will be important to address barriers identified in this study and to include male partners when mobilizing communities for pediatric HIV-1 vaccine trials and immunization programs.

Effects of Stress on Lactation

With the benefits of human milk well recognized, it is an opportune time to focus attention on how to optimize lactation for the benefit of newborns. Availability of mother's milk is conceivable only if lactation is sustained. To achieve this, mothers must be willing first to breastfeed or pump to initiate lactation, and their lactation must be reasonably adequate if they are to maintain an interest in breastfeeding or pumping. Therefore, to safeguard lactation, one must understand not only the physiology of lactation but also how to initiate and maintain maternal interest in breastfeeding or pumping, particularly in times of stress. Lactation insufficiency frequently is blamed on stresses, such as those imposed by preterm delivery, infant medical condition, or maternal lifestyle. To address these issues, information pertinent to the effect of stress on lactation, the mechanisms by which stress may hamper lactation, and the factors that may alter maternal willingness to breastfeed or pump are reviewed. The various interventions developed to help mothers with lactation difficulties also are presented. Proper glandular development of the breast may be presumed for mothers of full-term infants 69 ; however, the extent to which the degree of mammary development after a preterm delivery affects lactation performance is unclear. Nevertheless, the initiation and maintenance of lactation require appropriate hormonal changes and maternal behavior. Figure 1 outlines three major interplays between mother and infant that need to develop to preserve lactation. First, the primary function of lactation is to provide nutrition to the newborn. As such, lactation performance is a function of supply and demand, that is, the greater the infant's needs, the greater the milk production and the more prolonged the lactation. Second, lactation is affected by maternal interest in providing milk to infants. This can be reinforced positively or negatively depending on maternal perception of whether she meets her infant's nutritional needs. Third, maternal interest in initiating and maintaining breastfeeding or pumping also is a function of her relationship with her infant. A constructive interaction will influence positively her drive to provide milk for her child. A negative experience, on the other hand, quickly ends with the breakup of the nursing dyad and cessation of lactation.

Maternal Acceptability of a Dietary Intervention Designed to Lower Children's Intake of Saturated Fat and Cholesterol: The Dietary Intervention Study in Children (DISC)

Objective This report examined the acceptability to mothers of a dietary educational and behavioral intervention for preadolescent children with elevated levels of serum low-density lipoprotein cholesterol (LDL-C) who were enrolled in the Dietary Intervention Study in Children (DISC). Design DISC is a randomized, controlled clinical trial. Subjects were randomly assigned to either an intervention or usual-care (control) group. Subjects/setting To be eligible for the study, participants were required to have the average of 2 fasting LDL-C values fall between the 80th and 98th sex-specific percentiles. Three hundred thirty-four 8- to 10-year-old children and their families were randomly assigned to an intervention group, and 329 were assigned to a usual-care (control) group. This study examined data from 232 subjects in the intervention group. Data were collected at 6 intervention sites around the United States. Intervention Those assigned to the intervention group participated in a multidisciplinary dietary intervention that included a series of group and individual sessions over a 3-year period. Children and their caretakers were taught to follow a nutritionally adequate diet that was low in total fat, saturated fat, and cholesterol and high in polyunsaturated fat. Main outcome measures Three nonconsecutive 24-hour diet recalls were collected at baseline and at 1 year by trained and certified dietitians. A questionnaire designed to assess diet acceptability was administered at months 4, 8, 11, and 15. Demographic measures were collected at the onset of the study. Statistical analysis performed Statistical procedures included factor analysis and regression analysis. Results Regression analysis suggested that perceived effectiveness of the dietary intervention and mothers’ having few concerns about disadvantages of the diet were significantly related to higher overall fat intake in children in one-parent families. Maternal willingness to implement the diet was significantly related to lower saturated fat intake. Applications/conclusions In attempts to change eating behavior of children, interest and cooperation of the parents are essential to achieving successful results. These analyses further suggest that maternal acceptability translates into willingness to implement the diet and may facilitate changes that are associated with reduced saturated fat intake in children. J Am Diet Assoc. 1998;98:31-34.