Breastfeeding Research Articles

Bangladeshi Female Graduate Doctors Leaving Medical Profession: A Real Threat to Health System or a Rumor

Background: Female graduate doctors represent a major part of health care/ educational services in Bangladesh. But a portion of female graduate doctors leaving their profession immediately or after sometimes of completion of their graduation, even some of them never registered themselves under Bangladesh Medical & Dental Council (BM&DC). Objective: This research aimed to find out percentages of female graduate doctors leaving medical profession and different reasons behind it. Methods: This cross sectional descriptive research was carried out in the Centre for Medical Education (CME), Mohakhali, Dhaka from July 2022 to June 2023. Data were collected through one self-administered semi-structured questionnaire among 500 female graduate doctors who got their registration from 2005-2020 and selected by convenient and snowball sampling. Results: Among 500 female graduate doctors, 428 (85.6%) were involved in different health care services and rest 72 (14.4%) were not involved and among rest 14.4%, about 10% never involved in health care services after completion of their graduation. When 72 respondents female graduate doctors who were not involved asked about their current professions, about one fourth (25%) mentioned they were doing ‘online businesses’, 15.02% were ‘purely housewife’ and 12.5% were ‘changing profession to others’. Among 72 respondents female graduate doctors, one third (33.33%) chose other profession for 'better income'. The most two common reasons for not involving were 'to care children' (39.7%) and 'absence of day care centers' (20.5%). Nearly half (45.5%) of the respondents chose 'establishment of day care / breast feeding centers' when they asked what strategies the government should take to utilize female work force effectively. Conclusions: Female graduate doctors who were not involved in health system mentioned different reasons behind their decisions and strategies require to be taken by the Government to overcome such conditions. BJME, Volume-16, Issue-01, January 2025: 15-25

Reasons, associated factors, and attitudes toward breastfeeding mothers’ use of complementary medicine products: a study from Türkiye

BackgroundThe use of Complementary Medicine Products (CMPs) has been increasing worldwide, including among breastfeeding mothers. This study aims to investigate the reasons and associated factors of CMP use among breastfeeding mothers in Turkey, alongside their attitudes and experiences.MethodsA descriptive cross-sectional study was conducted using a self-administered, anonymous online survey between 17 December 2023 and 17 March 2024. Women from diverse regions across Türkiye, aged 18 years or older, with a child aged 36 months or younger, who were currently breastfeeding or had breastfed, were invited to participate in the survey.ResultsAmong 445 mothers who completed the survey, 334 (75.1%) reported using at least one CMP during breastfeeding, with vitamin D, iron supplements, and fennel being the most frequently used. Educational level, employment status, and being a health worker were found to be factors associated with CMP use during breastfeeding, with those having university or higher education, being employed, or working in healthcare showing higher usage rates. The most common reasons for CMP use were “staying healthy” (60.2%) and “supporting immunity” (59.3%). While 91.9% of mothers perceived at least one CMP they used as beneficial, 14.4% of mothers using CMPs experienced adverse effects with at least one product. Safety perceptions of mothers who used CMP varied, with 45.8% believing CMPs were generally safe during breastfeeding. Among CMP users, doctors were chosen as the most trusted (n = 310, 92.8%) information source. A majority of mothers (85.6%) reported that they would like to receive more information about the safety and effectiveness of CMPs.ConclusionsBreastfeeding mothers often use CMPs to stay healthy and support immunity. While healthcare providers are the most trusted source of information, many women get advice from family, friends, or herbalists, and some use CMPs without any recommendations. This underscores the importance of healthcare providers’ role in guiding mothers on the safe and informed use of both prescribed and self-prescribed CMPs.

Macronutrients in Human Milk Exposed to Antidepressant and Anti-Inflammatory Medications

The association between maternal medications and the macronutrient composition of human milk has not been studied. To compare macronutrient levels in milk samples from mothers treated with long-term medications with samples from untreated healthy and disease-matched control mothers (DMCs). A cross-sectional study using samples collected between October 2014 and January 2024 from breastfeeding mothers in the US and Canada invited to participate to the Mommy's Milk Human Milk Research Biorepository at the University of California, San Diego. Of 3974 samples from unique individuals in the biorepository, 310 were from mothers treated with 1 of 4 categories of medications, 151 from DMCs with the same underlying disorders, and 73 from healthy untreated mothers, frequency matched on infant age and sex. Of these, 150 were excluded because they had more than 1 medication exposure or were outliers. Data were analyzed from March to June 2024. Continuous treatment with selective serotonin reuptake inhibitors (SSRIs), monoclonal antibodies (MABs), systemic steroids, and other anti-inflammatory drugs (ADs) in the 14 days before milk sample collection. Levels of protein, fat, carbohydrate, and total energy were measured with SpectraStar 2400 near infrared analyzer and compared across groups with analysis of covariance adjusted for infant and maternal age, parity, maternal body mass index, infant sex, exclusive breastfeeding, feeding frequency, collection time, maternal cannabis use, and occupation. A total of 384 samples were collected; 194 infants (50.5%) were female; the mean (SD) age of the maternal cohort was 33.5 (4.4) years, and infant age at collection was 6.6 (5.4) months. Mean (SD) protein levels were 15% to 21% lower in samples from exposed mothers (0.92 [0.56] g/100 mL for 63 SSRIs, 0.85 [0.51] g/100 mL for 63 MABs, 0.88 [0.37] g/100 mL for 33 steroids, and 0.85 [0.54] g/100 mL for 20 other ADs) compared with 64 samples from healthy mothers (1.08 [0.50] g/100 mL). Adjusted differences were significant for SSRIs and steroids (F1, 91 = 4.32; P = .04 and F1,59 = 5.00, P = 0.03, respectively). Mean (SD) fat and energy were 10% to 22% lower in samples from mothers with other ADs (3.40 [1.21] g/100 mL for fat and 69.56 [15.35] kcal/100 mL for energy) than from healthy (3.85 [1.66] g/100 mL for fat and 77.16 [22.08] kcal/100 mL for energy) and DMC (4.38 [1.90] g/100 mL for fat and 80.60 [24.70] kcal/100 mL for energy) mothers. Adjusted differences were only significant for fat compared with DMC (F1,88 = 6.22; P = .01). In this cross-sectional study, some maternal medications were associated with lower levels of protein and fat in milk, which could impose health risks for breastfed infants. Other factors that could influence macronutrient levels need to be clarified before the clinical implications of these findings can be confirmed.

Evaluation and adaptation of a two-way text messaging intervention in the WIC breastfeeding peer counseling program: A qualitative analysis.

Breastfeeding (BF) is vital for maternal and infant health, yet post-hospital discharge support remains a challenge. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides BF peer counseling prenatally and up to 1-year postpartum among low-income women in the United States. The Lactation Advice Through Texting Can Help (LATCH) intervention is an evidence-based two-way text messaging intervention that provides BF education and support in the WIC peer counseling program. The intervention is implemented by peer counselors (PCs) in the WIC program, with the supervision and support of a lactation consultant. The aim of this qualitative study was to assess the barriers and facilitators to the implementation of LATCH during the feasibility trial and to investigate strategies for adapting and scaling up the intervention. In-depth interviews with LATCH and PC program key informants aimed to evaluate the intervention and explore its adaptation and scale-up. Interviews were analyzed using line by line inductive thematic analysis. Findings were mapped to the Model for Adaptation Design and Impact (MADI) framework to describe the proposed adaptations, and to the Program Impact Pathways (PIP) framework to identify causal pathways and critical quality control points. Results demonstrate that LATCH facilitates continued engagement between PCs and WIC mothers; however, implementation feasibility issues remain. Suggested adaptations to LATCH include the use of an integrated comprehensive platform, ensuring continuity of care through an expanded spectrum of communication options, the need to develop a PC support model for "off hours" (non-business hours), and the need to obtain local WIC office management's buy-in for the communications platform and the off-hours PC model. Critical quality control points were identified when results were mapped to the MADI and PIP frameworks. Implementing these changes has the potential to expand access to BF peer counseling support and improve BF equity among low-income women.

Exploring the relationship between child temperament, maternal psychiatric symptoms, family environment and infant feeding.

Infant temperament is assumed to be primarily innate. However, newer research suggests that maternal affection impacts ratings of temperament and environmental factors, including feeding method, can also influence infant temperament. This study investigates child temperament and its relationships with maternal psychiatric symptoms, environmental variables and feeding method longitudinally in a cohort of children followed from 6 to 72 months. Differences in temperament by feeding group are also investigated. We hypothesized that maternal psychiatric symptoms, environmental stressors, and impaired family dynamics would have negative impact on child temperament, whereas breastfeeding would have a positive impact on child temperament. Mothers' ratings of child's temperament, own psychiatric symptomatology, environmental stresses and family cohesion were obtained in 504 mother-infant dyads via rating scales completed by mothers. Infants were breastfeed (BF), fed soy-based infant formula (SF) or dairy-based infant formula (MF). Linear mixed effect models investigated the relationship of variables on child's temperament while controlling for significant covariates and repeated measurements. Mothers in this study did not endorse clinical-level psychiatric symptomatology; however, when adjusted for significant covariates, higher psychiatric symptomatology significantly correlated with environmental stressors, impaired family dynamics and elevations in temperament ratings of infants' adaptability and mood. There were no lasting differences for temperament between feeding groups. However, some significant transient increases in rhythmicity and adaptability were found between SF and BF children. Positive relationships between family environment stressors and maternal psychiatric ratings were found. Transient differences were found in child temperament based upon feeding method.

Breastfeeding Attitudes and Milk Production of Mothers Staying in Single and Double Rooms after Birth: A Cross-Sectional Comparative Study.

Background: There is limited evidence on whether the interaction of mothers staying in double rooms (DRs) in the hospital after birth affects breastfeeding attitudes and milk production. Research Aim: To compare the breastfeeding attitudes and milk production of mothers staying in a DR in the hospital after birth with mothers staying in a single room (SR). Materials and Methods: In the study, 181 mothers who gave birth at term were included. Of them, 92 stayed in SRs, and 89 stayed in DRs. The milk production and breastfeeding attitudes of the mothers were considered as dependent variables. Results: The mothers staying in SRs needed health care professional support more (83.7%) than did the mothers staying in DRs (71.9%; p < 0.05). Milk production was more in the mothers staying in SRs (χmean: 14.16 ± 3.34) than it was in the mothers staying in DRs (χmean: 10.13 ± 2.42; p < 0.05). There were no significant differences between the breastfeeding attitudes of the participants in terms of the type of the room they stayed in. Conclusions: While most mothers prefer staying in a SR in terms of privacy and comfort, some mothers prefer staying in a multiple-bed room because social interactions they have positively affect their breastfeeding attitudes. Health care institutions may consider incorporating shared or DRs into their postpartum care protocols, which creates comfortable and supportive environments for breastfeeding mothers.

Effectiveness of Administration of Papaya Leaf Capsule Extract (Carica Papaya) and Moringa Leaves (Moringa Oleifera) on Increasing Prolactin Hormones in Breastfeeding Mothers

This research aimed to determine the effectiveness of administering papaya (Carica Papaya) and Moringa leaf (Moringa oleifera) capsule extracts on prolactin hormone levels in breastfeeding mothers in PMB M Palangka Raya City. The research used was Quasy Experimental, Two Group Pretest – Posttest design (two groups pretest – posttest). The sampling technique used was purposive sampling, with a total sample of 66 respondents who met or met the inclusion criteria. The statistical test used is the Independent T-test. Based on the significance results, the resulting Z statistic is -3.531 with a probability of 0.000. This means that probability &lt; significance level (alpha = 5%). Thus, it can be stated that there is a significant difference in the levels of the hormone prolactin in breastfeeding mothers in PMB M Palangka Raya City before and after administering Moringa leaf capsule extract.

EFEKTIVITAS PENYULUHAN TENTANG ASI EKSKLUSIF TERHADAP PERUBAHAN PENGETAHUAN IBU MENYUSUI DI WILAYAH KERJA UPTD PUSKESMAS PAHANDUT

Breast milk (ASI) is the main and best food for babies, because it contains many nutrients that babies need. Breast milk can protect babies from allergies, obesity, digestive tract infections and respiratory tract infections. Apart from that, breast milk can also shape the development of intelligence and emotional development, can increase the body's endurance and can reduce the risk of death in babies. This activity aims to determine the effectiveness of education about exclusive breastfeeding on changes in knowledge of breastfeeding mothers. The method used is quasi-experimental research (quasi-experimental design) using a one group pre-posttest design. Based on the results of the paired t test, the mean in the pre-test group was 64 and in the post-test group was 85 with a mean differential between the two groups of 15.1. The p value is 0.00, so the p value is &lt;0.05, so we get the difference in the average (mean) before and after the counseling about exclusive breastfeeding is given, so it can be interpreted that there is an influence of providing counseling about exclusive breastfeeding on the knowledge of breastfeeding mothers in the work area. Pahandut Health Center, Palangka Raya City.

Awareness of the diet of breastfeeding mothers. Survey and review of the latest recommendations

Awareness of the diet of breastfeeding mothers. Survey and review of the latest recommendations

BREAST MILK PRODUCTION AND DETERMINING FACTORS

Good maternal nutrition and exclusive breastfeeding, optimal nutrition for infants and toddlers is important for good growth and development, this can reduce the risk of non-communicable diseases (NCDs) for both mothers and children. The purpose of this study is This study aims to determine the relationship between the nutritional status of breastfeeding mothers and breast care with the adequacy of breast milk. Cross-sectional research design. The population is 74 people. The sampling technique uses Purposive Sampling. The number of samples is 34 breastfeeding mothers. The results of the study showed that there was a relationship between food variation and breast care with the adequacy of breast milk with a p-value of 0.000. and there is a relationship between breast care with the adequacy of breast milk with a p-value of 0.003. Conclusion Breastfeeding mothers need a variety of foods and good breast care, the growth and development of babies are supported by good nutritional intake. Suggestions provide a variety of nutritious foods and carry out routine breast care for breastfeeding mothers.

Coaching Nenek ASI dalam Penerapan Massage Effleurage menggunakan Jitu Oil dengan Terapi Murottal Al-Qur'an untuk Mendukung Pemberian ASI Eksklusif

Background: Choosing Breastfeeding Grandmothers is an effort to maximize the role of grandmothers in making exclusive breastfeeding a success. So far, grandmothers are the people in the family who are considered more capable and have a lot of experience, especially in caring for babies. This is the basis for this service in order to maximize the role of grandmothers in helping breastfeeding mothers provide good nutrition to their babies. Objectives There is an increase in knowledge, changing attitudes and behavior of breastfeeding grandmothers in the application of effleurage massage using Jitu oil to support exclusive breastfeeding and interaction and sharing of information through coaching breastfeeding grandmothers in the application of Effleurage Massage using Jitu Oil to support exclusive breastfeeding. Method Training implementation time January 26, 2024, mentoring implementation January 27 - February 26, 2024. The location of the activity is at the Lamongan Arjasa Village Hall. Method using PAR (Participatory Action Research), Results: This activity was attended by 19 grandmothers and 19 breastfeeding mothers. At the time of Choosing 12 people had good knowledge, 4 had sufficient knowledge, and 3 people had less. At the time of post-mentoring, 14 people had good skills, 3 people had sufficient knowledge and 2 people had less. Conclusion: The Choosing and mentoring activities carried out can increase knowledge and improve the skills of Grandmothers in performing Massage Effluerage massage to help relax the body of breastfeeding mothers.

Knowledge, Practice and Attitude of Women Regarding Breastfeeding in Thi-Qar Governorate-Iraq

Breastfeeding (BF) is the natural way for infants’ nutrition, it provides the ideal nutrients they need for healthy development and growth. The purpose of this study was to evaluate mothers' knowledge and practice of BF and its determinants and to determine the association between knowledge and certain characteristics. 200 moms who were patients at the Bint Al-Huda teaching hospital between November 1, 2021, and February 1, 2021, were chosen at random with their consent for this cross-sectional study, and their answers to a standardized questionnaire were analyzed. Of the 200 women, 26% were between the ages of 20 and 25, with a mean and SD of 29.24±7.829 and 24.5% having completed elementary school. Prior to our study, nearly (67%) mothers had received education on BF. A mother who practices breast cancer has a low risk of developing the disease (62.5%). Proper positioning is also important for achieving effective breast cancer (68.5%). Breastfeeding should begin within 30 minutes of delivery (62%), and once the baby begins taking complementary foods (54.5%), mothers can combine breastfeed and formula feeding. We found that most mothers had engaged in exclusive BF and knew only a moderate amount about its benefits. Better educational initiatives are required to raise public awareness of its long-term benefits for the nation's health status.

Analysis of Determinants of Exclusive Breastfeeding in Breastfeeding Mothers

Exclusive breastfeeding for babies aged 0-6 months, which continues until the age of 2 years accompanied by adequate complementary feeding, has an essential meaning, especially regarding the fulfillment of nutritional needs and other substances to form the body's immunity to disease, because at that age the baby's condition is still precarious. This study uses an analytic survey research cross-sectional design. The aim was to analyze the relationship between determinants of exclusive breastfeeding. The population of all mothers with babies aged 6-12 months amounted to 127, using a purposive random sampling technique. Sample calculation, according to Slovin, obtained a sample of 84. Data collection using a questionnaire. Univariate analysis with percentages, bivariate analysis with chi-square test. There is a relationship between knowledge (p-value=0.026), Early initiation breastfeeding (EIBF) history (p-value=0.005), breastfeeding self-efficacy (p-value=0.042), breastfeeding motivation (p-value=0.016), cultural customs (p-value=0.012), and family support (p-value=0.036) with exclusive breastfeeding in mothers who have babies aged 6-12 months at the Tanjung Sari Health Center, South Lampung Regency in 2024. A relationship exists between breastfeeding self-efficacy knowledge, motivation, and exclusive breastfeeding. There is a relationship between breastfeeding self-efficacy knowledge, breastfeeding motivation, cultural customs, and family support with exclusive breastfeeding. Suggested improving IEC (Communication, Information, and Education), implementing lactation management programs, making behavioral changes, and providing support for exclusive breastfeeding.

HUBUNGAN ANTARA ASI EKSKLUSIF DENGAN PERKEMBANGAN BAYI USIA 6-12 BULAN

Child’s development in the early of life will effect children wellbeing in the future. Early child development will be optimal if their nutritional need has been fullfiled. Breast Milk is the best food for baby in their early life. The purpose of this research was to know the association between duration of breast feeding with baby development age 6-12th month in Puskesmas Jambon work area district Ponorogo. This study was quantitative researches with cross sectional design which was done to 141 baby age 6-12th month in Puskesmas jambon work area. The result of this study was 47,5% baby who was not receiving exclusive breast feeding suspected had delayed developmental status, 26,2% baby who had been exclusively breast feeding for 6 month suspected had delayed developmental. Statistical analyze with logistic regression showed there are positif correlation between nutrional status with baby’s development p=0,020. Baby who was not exclusively breast feeding until 6-month 2,5 time higher to have delayed development (95% CI 1,158-5,308).

Effect of Consuming Papaya Leaves, Almond Milk, Green Beans, Moringa Leaves, Ajwa Dates, Soy Milk, and Fennel Leaves on Breast Milk Production in Postpartum Mothers

Exclusive breastfeeding rates are often low due to suboptimal breast milk production, which impedes infants' nutritional needs. This issue is frequently attributed to poor maternal nutrition, unbalanced diets, and irregular food consumption. Breast milk production relies on hormonal changes, notably the dominance of prolactin over progesterone and estrogen during childbirth. To address this, a study was conducted to evaluate the impact of specific foods boiled papaya leaves, almond milk, green beans, moringa leaves, ajwa dates, soy milk, and fennel leaves—on breast milk production. Employing a quasi-experimental design with a one-group pretest-posttest approach, the study involved 56 postpartum mothers whose milk production was substandard. These participants were selected in March 2023 using purposive non-probability sampling. A paired t-test was performed for bivariate analysis. Results indicated a significant improvement in milk production, with a p-value of 0.000, demonstrating that the consumption of these foods positively affects lactation. Consequently, it is recommended that breastfeeding mothers incorporate these foods into their diet to enhance milk production and support exclusive breastfeeding. Regular consumption of these specific foods can help meet infants' nutritional needs more effectively.

Clinical And Socio-Demographic Profile Of Chidren Aged 6-59 Month With Severe Acute Malnutrition Presenting In A Tertiary Care Hospital In Nuh, Haryana

Background: Malnutrition adversely affects achievement of all the milestones namely motor, sensory, cognitive and social. Methods: The records of 150 patients with severe acute malnutrition over a period of one year (July 2022-July 2023) were reviewed, and a statistical comparison of various variables were made. Results: As per study, mean weight(kg) 7.48 ± 2.02, mostly i.e.78.67% were having weight &lt;-3 SD. Mean height or length(cm) was 77.5 ± 11.14 ,majority was in between 2SD to -3SD i.e. 48.00%, MUAC was &lt; 11.5 among 123 (82%), 11.6-12.5 among 10 (6.67%), 12.6-13.5 among 17 (11.33%).There were 41.33% males and 58.67% females.Of study population, Birth order was 1st among 9 (6.0%), 2nd among 11 (7.33%), 3rd among 38 (25.33%) and 4th and above among 92 (61.34%) subjects with a mean of 4.05± 1.52.Among my study most of children were mixed Feeding 53.34%,while only 13.33% were Exclusive breast feed while 33.33% were Top feed .Immunization was Complete among 10.67%, Incomplete among 62.67% and Unimmunized among 26.67% subjects. Pedal Edema was present among 44 (29.33%) subjects and absent in 106(70.67%).The presenting complaint reported were anemia (38.67%), pneumonia (26.67%), acute gastroenteritis (12.67%), hypoglycemia (10.00%), Dehydration (8.0%) and UTI (4.00%) and most common presenting complication wasanemia (80%), followed by pneumonia (52%), acute gastroenteritis (34.00%), dehydration (29.67%), Lethargy/hypoglycaemia (30%), meningitis (8.00%), tuberculosis(5.33%)and UTI (4.00%)As per my study, complication are more severe unvaccinated children, however effect is statistically insignificant (p&gt; 0.05) Conclusion: SAM was most common in 13-24 months age group and with increasing age, a lesser proportion of children were affected with SAM. There was a strong correlation between adverse outcomes and dietary risk factors such as the length of time spent nursing exclusively, using a bottle, and delaying the introduction of supplementary foods. Most common co-morbidities were anaemia and pneumonia.

Enhanced recovery protocol for congenital duodenal obstruction – initial experiences with development and implementation

BackgroundThe experience with Enhanced Recovery After Surgery® (ERAS®) protocols in neonatal intestinal surgery is very limited. We present the development and implementation of an Enhanced Recovery Protocol (ERP) designed specifically for neonates treated for congenital duodenal obstruction (CDO), and early outcome after implementation.MethodsAn ERP for CDO was developed and implemented. Experiences with ERP development and implementation are described. Early clinical outcome in patients treated before (January 2015–Descember 2020) and after (February 2022–September 2024) implementation were compared. Ethical approval was obtained.ResultsA multidisciplinary ERP team was established. The ERP for CDO was developed with stakeholder involvement. Implementation was challenging, but with close follow-up and frequent meetings with the involved medical disciplines, an overall ERP compliance of 80% was achieved for the 21 patients treated after implementation. Compared to 40 patients treated before ERP implementation (January 2015-Descember 2020), the use of minimally invasive surgery increased and time to first postoperative enteral and breast feed were reduced, without increasing the rate of postoperative complications.ConclusionsThis study presents an ERP specifically designed for CDO with a unique description of our experiences with the development and implementation process. Early results suggest that this ERP for CDO is feasible and safe.

Determinants of formula feeding among mothers with infants and young children in six Sub Sahara African countries: Multilevel analysis of data from demographic and health survey.

Formula feeding is providing infants with prepared formula as an alternative to or alongside breastfeeding. While breast milk is widely regarded as the optimal source of nutrition for infants, formula feeding is a common practice. The recommended approach is exclusive breastfeeding for the first six months, followed by the introduction of complementary foods after that period, which is crucial for child growth and development. Formal feeding has a negative impact on an infant's health, causing malnutrition and other illnesses. Therefore, this study was investigated to assess formula feeding and determinant factors among mothers with infants in six sub-Saharan African countries. A total weighted sample of 26,119 mothers with infants and young children less than two years was included in this study. The data were taken from a recent demographic and health survey in six sub-Sahara African countries. A multilevel, multivariable logistic regression model was used to identify the determinant factors associated with formula feeding. In the multivariable analysis, the adjusted odds ratio with a 95% CI was used to declare a statistically significant association with formula feeding among mothers with infants. In this study, the proportion of mothers with infants who use formula feeding was 17.1%. In multilevel logistic analysis (model III), the significant factors associated with formula feeding were the age of the mothers; 25-34 years (AOR = 1.3; 95% CI (1.2-1.41)), 35-49 years (AOR = 1.4; 95% CI (1.22-1.54)), multiple children (AOR = 1.4; 95% CI (1.23-1.77)), maternal educational status; secondary and higher (AOR = 2.4; 95% CI (2.11-2.66)), mother's employment status; (AOR = 1.24; 95% CI (1.14-1.5));, richer households (AOR = 1.2; 95% CI (1.10-1.36)), place of delivery (AOR = 2.1; 95% CI (1.83-2.44)), household media exposure (AOR = 1.5; 95% CI (1.3-1.68))place of residence (AOR = 1.97; 95% CI (1.79-2.17)), community illiteracy level (AOR = 1.17; 95% CI (1.02-1.34)), and community media exposure (AOR = 1.2; 95% CI (1.03-1.38)). Formula feeding among mothers with infants in Sub-Saharan Africa has emerged as a public health concern. The recommended approach is to promote exclusive breastfeeding for the first six months, followed by the introduction of complementary feeding after that period. Factors associated with formula feeding include older maternal age, secondary and higher education, delivery in health institutions, employment status, higher household income, twin births, urban residence, low community illiteracy rates, and increased community media exposure. Stakeholders and health policymakers should be focused on strategies to improve breast feeding and discourage infant formula feeding.

EVALUATION AND PHYSICAL STABILITY OF EFFERVESCENT GRANULE KATUK LEAF EXTRACT (Saorupus androgynus L.) WITH PVP K-30 AS BINDER

Katuk leaf extract contains sterols and alkaloids which can increase milk production. To increase the practicality and interest of breastfeeding mothers is to make preparations of katuk leaf extract effervescent granules. The binder used in the manufacture of katuk leaf extract effervescent granules is PVP K30. The purpose of this study was to determine the effect of varying concentrations of PVP as a binder on the physical properties and stability of effervescent granules. The effervescent granule formulation used consisted of katuk leaf extract, PVP with various concentrations of 2.5%, Stability testing was carried out on this formula by testing at room temperature (25o±2oC) and hot temperature (40o±2oC) for 28 days with testing every 2 weeks. From the results of the study, it was obtained that the preparation was stable until the 28th day, namely organoleptic color, taste, aroma, shape, at room temperature (25o±2oC) and hot temperature (40o±2oC). Research data obtained preparations that were not stable until the 28th day, namely the dissolving time test, pH at room temperature (25o±2oC) and hot temperature (40o±2oC). The flow rate test was stable on day 14 to day 28 at room temperature (25o±2oC) and unstable at hot temperature (40o±2oC), and moisture content was stable on day 14 at room temperature (25o±2oC) and hot temperature (40o±2oC) and unstable on day 28 at room temperature (25o±2oC) and hot temperature (40o±2oC).

Trajectory of breastfeeding among Chinese women and risk prediction models based on machine learning: a cohort study.

Breastfeeding is the optimal source of nutrition for infants and young children, essential for their healthy growth and development. However, a gap in cohort studies tracking breastfeeding up to six months postpartum may lead caregivers to miss critical intervention opportunities. This study conducted a three-wave prospective cohort analysis to examine maternal breastfeeding trajectories within the first six months postpartum and to develop risk prediction models for each period using advanced machine learning algorithms. Conducted at a leading Maternal and Children's hospital in China from October 2021 to June 2022, data were gathered via self-administered surveys and electronic health records. Of the 3307 women recruited, 3175 completed the surveys, yielding a 96% effective response rate. Breastfeeding(BF) rates were observed at 100%, 96%,93% and 83% at discharge, 42day, 3month and 6month postpartum, respectively. Exclusively breastfeeding(EBF) rates were recorded at 91%, 64%,72% and 58% for the same intervals. Among the five machine learning methods employed, Random Forest (RF) demonstrated superior accuracy in predicting breastfeeding patterns, with classification accuracies of 0.629 and an area under the receiver operating characteristic curve (AUC) of 0.8122 at 42days, 0.925 and an AUC of 0.9800 at 3months, and 0.836 and an AUC of 0.9463 at 6months postpartum, respectively. Key predictive factors for breastfeeding at 42days postpartum included the newborn's birth weight and the mother's pre-delivery and prenatal weights. Predictors for feeding type at 3months and 6months postpartum included early feeding types and the scores from the Breastfeeding Self-Efficacy Scale-short Form (BSES-SF) at 6months. The predictive model based on follow-up data showed strong performance. Breastfeeding rates slightly declined from discharge to 6months postpartum. The breastfeeding context in this region is comparatively optimistic both within China and internationally. Factors such as newborn's birth weight, gestational age, maternal weight management before and during pregnancy, early support and breastfeeding success, breastfeeding knowledge and self-efficacy are intricately linked to long-term breastfeeding outcomes. This study highlights critical, modifiable risk factors for early breastfeeding stages, providing valuable insights for enhancing breastfeeding intervention programs and informed decision-making.