Breastfeeding Research Articles

Assessment of knowledge, attitude, practice and barriers of exclusive breastfeeding among nursing mothers in Makurdi Local Government Area of Benue State

Introduction: Over the years, breastfeeding has been a universal means of feeding infants and a common feature of all cultures since the survival of mankind. It is a phenomenon that is deeply rooted in the tradition of human culture. Although, breastfeeding practices have fluctuated over the years, it is widely regarded as an unequalled way of providing ideal nutrition for the healthy growth and development of infants. This study aims to assess the knowledge, attitude, practice and some barriers of exclusive breastfeeding among nursing mothers in Makurdi Local Government Area of Benue State. Method: This is a descriptive cross-sectional study to assess the knowledge, attitude, practice and barriers of nursing mothers towards Exclusive Breast Feeding (EBF). An interviewer-self-administered pretested questionnaire was used to collect data on maternal knowledge, Attitude, Practice and barriers of EBF. The modified Blooms criteria was adapted to grade knowledge, attitude and practice as either Good or poor. Statistical significance was considered at 95% confidence interval. Results: The results from this study showed that nursing Mother’s knowledge of EBF was good, 84.0% of the respondents displayed good knowledge of EBF, good attitude towards EBF was at 54.7% and the practice of EBF was 67.3%. Notable barriers to EBF includes, poor knowledge of EBF among nursing mothers (75.0%), followed by concurrent breast disease 6 months post-natal (66.7%), next was women who have never attended Antenatal Care Clinic (ANC) 62.5%. Conclusion: These findings suggest good knowledge and practice of EBF, however there is need to institute intervening measures aimed at reducing barriers associated with EBF in the study community.

Determinants of appetite in the first year of life: Results from a prospective study of infants

Abstract Childhood obesity, a growing public health problem, was shown to be associated with appetite traits (ATs) in infancy but little research exists on the determinants of early appetite. We aimed to examine the association between parental, pregnancy and infant variables on ATs during the first year of life. We followed up 450 healthy term infants assessing Enjoyment of Food (EF), Food Responsiveness (FR), Satiety Responsiveness (SR) and Slowness in Eating (SE), using the Baby (at 2-4 weeks (wk) & 6m) and the Child (at 12m) Eating Behaviour Questionnaires. Associations between parental sociodemographic and lifestyle, pregnancy, infant feeding and anthropometric factors, and these ATs were investigated. Multivariable linear regression models were built for each AT, incorporating statistically significant variables from minimally adjusted models (sex, gestational age, and ethnicity). Results primarily focus on ATs at 2-4wks, as later ATs were largely influenced by these values. Higher father’s BMI (β = 0.013, p = 0.022) was associated with increased EF at 2-4wks. Later gestational age (β = 0.106, p = 0.032), and gestational diabetes (β = 0.538, p = 0.002) were associated with higher FR 2-4wk while mixed feeding compared to exclusively breast feeding (β =-0.281, p = 0.013) with lower FR 2-4wk. Female sex (β = 0.174, p = 0.009) was positively, while gestational age (β=-0.076, 0.022), father’s educational attainment (β=-0.199, p = 0.003), father habitual smoking (β=-0.167, p = 0.020) and 4wk WFA z-score (β = 0.087, p = 0.037) were negatively associated with SR 2-4wk. Lastly, higher 4wk WFA z-score (β=-0.151, p = 0.012) and bottle feeding (β=-0.378, p = 0.003) were associated with decreased SE 2-4wk. Acknowledging that a causal association cannot be established in an observational study, this data suggests that parental lifestyle and pregnancy factors could influence infant ATs and hence risk of later obesity, highlighting the importance of preconception health in mitigating the problem of childhood obesity. Key messages • Appetite traits in early infancy are influenced by infant feeding and anthropometric variables, but also by parental and pregnancy characteristics. • The importance of preconception health is paramount in mitigating the problem of childhood obesity.

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

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

Enhancing breast milk production in breastfeeding mothers through oxytocin massage interventions: A systematic review

Enhancing breast milk production in breastfeeding mothers through oxytocin massage interventions: A systematic review

Is domestic violence during COVID-19 in lactating women related to infantile colic? An important question

BackgroundPsychosocial factors such as maternal stress in lactating women were shown to be related to an increased risk of infantile colic because the infants can be affected through breast milk. Therefore, domestic violence against lactating mothers can be effective on the infants’ health. It is also demonstrated that domestic violence against women has increased following the COVID-19 pandemic and quarantine. Therefore, this study aims to assess the relationship between domestic violence against breastfeeding women during COVID-19 and the incidence of infantile colic.MethodsThis was a case-control study that was conducted on 356 lactating mothers who attended Bentolhoda Hospital in Bojnoord-Iran from November 2021 to August 2022. The participants were exclusively breastfeeding mothers who were under 6 months infants. Mothers with and without infantile colic infants were considered the case and control groups, respectively. Two questionnaires were used for data collection including a demographic questionnaire, and a questionnaire to assess domestic violence against women during the quarantine period of Corona pandemic. The data was analyzed using SPSS-V22 and Pearson Spearman correlation and linear regression tests.ResultsThe results showed that women in the case group had a significantly higher score for “sexual violence and restraint” than women in the control group [0.59 ± 0.34 versus 0.62 ± 0.25 (Mean ± SD), respectively] (P < 0.05). The chance of infantile colic was higher among the infants of mothers who experienced domestic violence, but it was not statistically significant (OR = 1.236, P = 0.573). Significant relationships were found between the infantile colic and the history of abortion (OR = 1.430, P = 0.028) and cesarean section (OR = 1.723, P = 0.044).ConclusionDomestic violence during pregnancy can potentially increase infant colic through breast milk. Although our findings need more investigation, it can be recommended to plan the direction of screening for domestic violence and providing the necessary care and counseling to the parents in perinatal care services to prevent infantile colic and improve the infant’s health.

Development of Nutrient-Rich Complementary Food from Sweet Potatoes, Carrots and Crayfish for Combating Infant Malnutrition in Low-income Communities

This study aimed to enhance traditional cereal-based complementary foods in Nigeria by developing and evaluating a nutrient-dense blend of sweet potato, carrot, and crayfish. The objective was to address protein-energy malnutrition in low-resource settings by improving the nutritional profile of local complementary foods. Samples were analyzed in triplicate for proximate composition and selected micronutrients using AOAC standard techniques. Sensory evaluation was conducted using a 5-point hedonic scale with a panel of ten nursing mothers from the Department of Human Nutrition and Dietetics, Lead City University. Results showed that the blend contained 14.74±0.32% crude protein, 72.19±0.51% carbohydrates, and 0.97±0.02% fat. Micronutrient analysis revealed high levels of vitamin C (19.06±0.70 mg/100ml) and phosphorus (497.33±3.37 mg/100ml). Sensory evaluation indicated that the product was well-accepted, with mean scores of 4.2±0.6 for taste (slightly sweet), 4.0±0.7 for color (light brown), and 3.8±0.8 for flavor (mildly fishy). This novel blend significantly improves upon traditional cereal-based complementary foods by providing a more balanced nutrient profile that meets WHO/FAO recommendations. It offers a practical, locally-sourced solution to enhance infant nutrition in low-resource settings, potentially reducing the prevalence of protein-energy malnutrition. Further studies on its long-term effects on child growth and development are recommended.

To Study the Knowledge, Attitude and Practice of Postpartum Exercises in Nursing Mothers

Postpartum period has three distinct phases - immediate, early and remote.[1] First six weeks following childbirth known as puerperal period is a stressful for any women due to physiological and psychological adaptation which happens during this period and pelvic organ returns to pre pregnant state.[1] Breastfeeding starts immediately after the birth of the infant and as per the recommendation of WHO it is to be continued exclusively for 6 months.[2] During this period, Postpartum exercises like Kegel’s, abdominal and breathing exercises helps to improve the pelvic floor and abdominal muscle tone, bowel and bladder function and cardiovascular fitness which will have a positive influence on the health of the mother.[3] Two hundred and sixteen postpartum nursing mothers between the time period of six weeks to six months and Women who have given birth in hospitals and have been informed about post- natal exercises during the duration of hospitalization.In conclusion, the findings of this study provided an excellent insight on how many of the participants had knowledge about postnatal exercises and attitude is relatively positive which they were fully aware of the potential benefits of postnatal exercises but most of them did not practice postnatal exercises in their postpartum period regularly because majority of mothers were facing barriers because of household chores and baby care. Key Words: knowledge, attitude and practice of postpartum exercises, nursing mothers, postpartum health.

Macronutrients in Human Milk and Early Childhood Growth-Is Protein the Main Driver?

Infant growth trajectories reflect current health status and may predict future obesity and metabolic diseases. Human milk is tailored to support optimal infant growth. However, nutrient intake rather than milk composition more accurately predicts growth outcomes. Although the role of protein leverage in infant growth is unclear, protein intake is important for early infancy growth. This study of exclusively breastfeeding mothers with allergies (n = 161) from the Infant Fish Oil Supplementation Study assessed relationships between intake of human milk macronutrients and infant growth. Human milk fat, protein and lactose concentrations were measured at 3 months postpartum, and infant daily intakes were estimated using an average milk intake of 800 mL/day. Higher human milk protein:energy ratio was associated with higher weight-for-age z-score at 2.5 years compared to 3 months and higher body mass index-for-age z-score change (6 months to 1 year compared to 3-6 months). Maternal atopy and birth season (summer) were negatively associated with human milk lactose concentration. Passive smoke exposure was associated with reduced energy and fat concentrations and increased lactose:energy ratio. Our results indicate that intake of human milk macronutrients may impact early childhood growth.

Factors associated with modern contraceptive utilization among reproductive age women in Cambodia; evidenced by the recent Cambodia demographic and health survey

IntroductionCambodia is a low-income country with limited access to family planning (FP) in terms of modern contraceptive utilization. Despite several FP programs designed to make contraceptives accessible, adoption of contraceptives has been difficult in Cambodia, which has high rates of fertility and maternal mortality. This gap in essential care can put women and adolescent girls at greater risk of adverse outcomes such as stillbirth, spontaneous abortion, unwanted pregnancy, or even maternal death. One of the goals set by the government to decrease both maternal and child mortality and morbidity was increasing the modern contraceptives utilization. So, the main objective of this study was to evaluate spatial variations in modern contraceptives utilization and its contributing factors among women.MethodsData from the Cambodia 2021–22 Demographic and Health Survey datasets were used for secondary data analysis. A total of 19,496 women of reproductive age participated in the study. A spatial and multilevel mixed effects analysis was done on the factors affecting modern contraceptives utilization among Cambodian women. Finally, the percentage, odd ratio, together with their 95% confidence intervals and the results of the spatial analysis were provided.ResultThe prevalence of modern contraceptive use was 31.2% in Cambodia. Living in an urban area [AOR = 1.224; 95% CI = (1.126.1.330); P = 0.0001]; being married [AOR = 34.131; 95% CI= (12.673, 91.921); P = 0.0001]; and having a history of terminated pregnancy [AOR = 1.137; 95% CI= (1.055, 1.225); P = 0.0001] were found to be positively associated with modern contraceptive utilization. In contrast to this, being between the age range of 46–49 [AOR = 0.421; 95% CI = (0.364, 0.487); P = 0.0001]; being a female-headed household [AOR = 0.784; 95% CI = (0.723, 0.850); P = 0.0001]; and current breast feeding [AOR = 0.84; 95% CI = (0.75, 0.93); P = 0.010] were found to be negatively associated with modern contraceptive utilization. Additionally, the spatial analysis of modern contraceptive utilization showed that a higher proportion was utilized in the southern and southwest regions of Cambodia.ConclusionIn this study, living in urban area, being married and having history of terminated pregnancy were found positively associated with modern contraceptive utilization. In contrast to this, being old age, being female headed household and being currently breast-feeding women were found negatively associated with modern contraceptive utilization. In addition to this, there were geographic (spatial) variations in modern contraceptive utilization among Cambodian’s women across the country.

A Study to Assess the Effectiveness of Educational Package in Terms of Knowledge Regarding Essential New Born Care among Mother in the Postnatal Wards of Selected Hospital, Nadiad

BACKGROUND: The neonatal period, covering the first 28 days of life is a vital stage marked by significant physiological changes and the new borns adjustment to the crucial for the baby’s survival and long term health. Proper new born care is essential in decreasing neonatal illness and death promoting healthy growth and development. Worldwide neonatal mortality is a major public issue, especially in low and middle income nations. The World Health Organization (WHO) reports that nearly 2.4 million children die within their first month of life annually, with most of these deaths happening within the first week. Infection are a leading cause of neonatal mortality, responsible for about one-third all neonatal deaths. New born are practically vulnerable to infection due to their underdeveloped immune system. Education on essential new-born care, covering aspects like infection prevention, breastfeeding thermal care, and immunization, plays a critical role in decreasing these fatalities. Postnatal wards offer a special chances to educate mothers about essential new-born care. During this period mothers are typically more open to learning and incorporating new practice that can benefit their infants. Tailored educational programs designed for postnatal mothers of essential new-born care practice and encourage their adoption. AIM This study assess the effectiveness of an educational package design to enhance mothers' knowledge regarding essential new born care in selected hospital in Nadiad. OBJECTIVE: To evaluate the impact of an educational package on mothers' knowledge about essential new born care in post natal wards. METHODS A quasi experimental study design was employed. The study include 40 mothers in post natal wards from selected hospital in Nadiad. Participants were divided into two groups: An experimental group receiving the educational package and a control group receiving standard care. Pre-test and post- test knowledge assessments were conducted using a structured questionnaire. INTERVENTION: The educational package comprised informative flip book interactive session focus on essential new born care such as breast feeding, hygiene, immunization and recognizing dangerous sign.RESULTS: The pre-test knowledge scores of both groups were comparable. Post intervention, the group showed a significant increase on knowledge scores compared to the pre- test. Statistical analysis using paired T test revealed that the educational package effectively improved mother’s knowledge of essential new born care (p&lt; 0.05). The educational package significantly enhanced mother’s knowledge regarding essential new born care in post natal wards. Implementing such educational interventions can improve new born health outcomes by empowering mothers which crucial care. Further studies are recommended to assess long term retention of knowledge and its impact on new born health.

Pemberdayaan Masyarakat Melalui Pelatihan Membuat Makanan Olahan Dari jantung Pisang Untuk Kelancaran Produksi ASI di Link. Temu Putih Kota Cilegon Tahun 2024

Breast milk is the primary and most essential food for newborn babies aged 0-6 months. Several factors can affect the amount of breast milk production, including nutritional patterns, support, breast care, baby's sucking, and socio-cultural factors. It is important to understand the nutritional factors for breastfeeding mothers because their nutritional needs must be increased to enhance breast milk production. One effort to boost breast milk production is through the consumption of foods that influence lactation, such as banana blossom preparations. The dietary fiber in banana blossoms is beneficial for increasing milk production because it contains lactagogum, which has the potential to stimulate oxytocin and prolactin hormones. These components, such as alkaloids, polyphenols, steroids, flavonoids, and other substances, are effective in enhancing and facilitating breast milk production. The purpose of this community service, in the form of training to make food preparations from banana blossoms, is to empower the community, particularly pregnant and postpartum women, by enhancing their skills in utilizing banana blossoms as a food that can be processed to increase breast milk production. This community service is carried out by providing training on how to make banana blossom-based food, specifically turning it into nuggets, for pregnant and postpartum women in the Temu Putih area, Cilegon City.

Association of healthy eating index (HEI), alternative healthy eating index (AHEI) with antioxidant capacity of maternal breast milk and infant’s urine: a cross-sectional study

Maternal dietary quality may alter the nutrient content of breast milk. In this study, we aimed to investigate the relationship between the healthy eating index (HEI) and alternative healthy eating index (AHEI) of a breastfeeding mother’s diet with the antioxidant profile of her breast milk and her infant’s urine. This study included 300 healthy mother-infant pairs. The participants’ dietary intake was estimated using a validated semi-quantitative food frequency questionnaire. The diet quality of participants was assessed using the HEI and AHEI. The total antioxidant content of the breast milk and infant’s urine was evaluated using ferric reducing antioxidant power (FRAP), 2, 2′-diphenyl-1-picrylhydrazyl (DPPH), thiobarbituric acid reactive substances (TBARs), and Thiol quantification assays. After adjusting for confounding factors, the odds of a low malondialdehyde (MDA) content of breast milk were significantly higher in the highest quartile of HEI than in the lowest quartile. The odds of low DPPH and FRAP in infant urine decreased in the highest quartile of HEI compared to the lowest quartile. No significant relationship was found between AHEI and antioxidant levels of breast milk and the infant’s urine. Our findings demonstrate that a high quality diet of breastfeeding mothers, identified by a higher HEI, can affect the oxidant-antioxidant balance of a mother’s breast milk and her infant’s urine.

Part II: Enhancing Breastfeeding Experience and Self-Efficacy in Opioid-Dependent Breastfeeding Mothers—Results From the PeriWell Intervention

Objective:The PeriWell project integrates the Positive Direction Model and the Tri-Core Breastfeeding Model into a virtual support program tailored to peripartum mothers in substance use recovery. PeriWell addresses the unique challenges this population faces by offering tailored, wraparound support. This manuscript, part of a two-part series, highlights the project’s outcomes, demonstrating significant implications for maternal health practices by fostering an environment of empowerment and lactation wraparound support.Methods:This longitudinal quality improvement (QI) project spanned 24 months (2019–2021) during the COVID-19 pandemic. It involved 15 peripartum mothers in substance use recovery engaging in a virtual, single-site program. The project was approved as a QI initiative by the Institutional Review Board (IRB reference 2018-19, #89), ensuring ethical adherence and participant safety. Participants provided voluntary consent and were recruited from obstetrics and gynecology offices in Upstate New York. To evaluate participants’ confidence and belief in their breastfeeding abilities, we received author permission and utilized the validated Breastfeeding Self-Efficacy Scale-Short Form (Dennis &amp; Faux, 1999; Dennis, 2010), guiding the tailored support provided.Results:Results indicated a significant increase in prenatal breastfeeding confidence correlated with the PeriWell approach (r= .782,n= 14,p&lt; .001). Participants reported improved self-confidence in latching techniques and a greater appreciation of the time commitment required for successful breastfeeding. Correlational relationships provided valuable insight to enhance and amplify breastfeeding support. The findings advocate for the inclusion of targeted specialized interventions in maternal care to better meet the needs of expecting individuals.Conclusion:Cultivating a supportive peripartum environment is fundamental to maternal-child healthcare, and the PeriWell project demonstrated the efficacy of integrating tailored, virtual peripartum and breastfeeding support for expecting and postpartum mothers in substance use recovery. This quality improvement project improved maternal and infant health outcomes, such as breastfeeding self-efficacy, and highlighted the importance and value of specialized, wraparound lactation support for vulnerable populations. These findings underscore the need for continued innovation in maternal health services, particularly through empowerment and promoting breastfeeding success in recovery settings.

Evaluation of the effect of the father's support on the mother's breastfeeding motivation.

One of the factors affecting mothers' breastfeeding success is the father's support and the other is the mother's breastfeeding motivation. This study was conducted to determine the effect of partner breastfeeding support perceived by mothers and reported by fathers on mothers' breastfeeding motivation. The research was conducted using the face-to-face interview method with couples presenting to Family Health Centers in a city in Türkiye. The sample consisted of 114 breastfeeding women in 6 weeks to 6 months postpartum and their partners. Data were collected with a 'Personal Information Form', the 'Breastfeeding Support Scale (BSS)', the 'Breastfeeding Motivation Scale (BMS)', and the 'Partner Breastfeeding Influence Scale (PBIS)'. Participants' mean score was 119.19 ± 23.97 on the PBIS and 11.51 ± 2.94 on the BSS. A moderate-level, significant positive relationship was found between the BSS and PBIS scores of primiparous and multiparous mothers (r = 0.647; r = 0.567). A one-unit increase in fathers' breastfeeding support scores increased integrative regulation motivation scores by 0.548 units in primiparas and 0.458 units in multiparous mothers and by 0.309 units in intrinsic motivation scores and 0.351 units in external regulation-baby health motivation scores in multiparous mothers. It was found that father support affected the autonomous motivation of both primiparous and multiparous mothers at a moderate level. Perceived partner breastfeeding support affected only the autonomous motivation of multiparous mothers at a moderate level, and the types of controlled motivation, namely infant health and social approval, at a weak level.

Validity and reliability of the Turkish version of the Self-Efficacy Tool for the Ability to Support Breastfeeding Mothers.

The aim of the study is to investigate the validity and reliability of the Turkish version of the Self-Efficacy Tool for the Ability to Support Breastfeeding Mothers. In the current methodological study, research data were collected using a Descriptive Information Form and the Self-Efficacy Tool for the Ability to Support Breastfeeding Mothers. Validity analysis was conducted using the content validity index, exploratory factor analysis, and confirmatory factor analysis. The Pearson product-moment correlation and Cronbach alpha reliability coefficients were performed for reliability analysis. High scores indicate a higher ability to support breastfeeding mothers. To evaluate the tool's invariance over time, test-retest measurements were made at an interval of at least two weeks and showed no difference in mean scores (p > 0.05). Corrected item-total score correlations varied between 0.43 and 0.77. The Cronbach alpha value was determined to be 0.97, which indicated high internal consistency. The results of the present study show that the Turkish version of the Self-Efficacy Tool for the Ability to Support Breastfeeding Mothers is valid and reliable. It can be utilised as a measurement tool to determine the degree of self-efficacy in the ability to support breastfeeding mothers.

Ready-to-use therapeutic food as a promising therapy for the prevention and cure of undernutrition in pre-school children: A review

The nutritional status of pre-school children is a reflection of health of children in the world and forms the basis for the development of success-oriented interventional programs. This study indicates the prevalence of under-nutrition in under five children in the world, Africa and Nigeria. It also showed the prevalence of under-nutrition in the six geopolitical regions in Nigeria, with the Northern regions reported to have the highest burden of under-nutrition compared to the other regions due to several factors such as inadequate breast feeding, lack of access to healthcare, lack of clean water, armed conflict, inadequate dietary intake, inappropriate feeding, foetal growth restriction, inadequate sanitation, lack of parental education, large family size, incomplete vaccination, poverty and low socio-economic status and desire to have more children. Several nutritional interventions have been put in place to prevent and cure under-nutrition in pre-school children, which include Promotion of exclusive breastfeeding, Micronutrient supplementation, Food fortification, Nutrition education, Complimentary feeding, and Cash transfer programs, Ready-to-use therapeutics foods (RUTF), Nutritional rehabilitation centers, Parenteral nutrition, and Nutritional counseling and education. However, RUTF has been reported to have an effective intervention in the prevention and treatment of severe acute malnutrition (SAM) in pre-school children. It is an energy dense, shelf stable and ready to eat food which composed of peanut butter, sugar, full fat milk and mineral-vitamin premix. Other plant-based ingredients such as chickpea, soybean, sesame, maize, oats, sorghum and sunflower oil have also, been used in the production of RUTF and reported to be effective for complete recovery of SAM children.

Welcoming pregnant women as a strategy for adherence to dental prenatal care and health promotion in early childhood

This research deals with implementing Dental Prenatal Care as a public policy in the Brazilian Unified Health System (SUS) to care for pregnant women and their future babies. The legal framework that assures pregnant women's rights of priority in accessing services is usually not enough to guarantee the health promotion coverage goals for this population group, who frequently have low adherence to dental care. Brazilian Unified Healthcare System (SUS) recommends monitoring pregnant women through eight mensal consultations during healthy pregnancy. Oral health is usually not monitored to the same extent, and many pregnant women still go through pregnancy without any dental consultation. This study was proposed to improve dental prenatal care and program adherence by mothers and children in the Basic Healthcare Unit Amaro José de Souza, in the municipality of Barueri, through the increased participation of the dental surgeon in the pregnant women welcoming team. A cross-sectional cohort study was designed to identify and meet the demands of low-risk pregnant women. For six months, all the women attending prenatal care at BHU Amaro José de Souza in Barueri were invited to participate and receive personal guidance from the multi-professional team. Information on dental health was investigated through questions targeting previous knowledge about the recommended moments for the first dental appointment of a child, the importance of exclusive nasal respiration, the identification of craniofacial asymmetries at birth, and general baby care. Attitudes and self-care were also investigated, including prenatal program adherence. Answers were collected in a Google Form platform and analyzed to characterize the group's literacy about prenatal care and breastfeeding and identify information needs about dental health care during pregnancy. At the same time, a welcoming expanded listening, educational, and preventive health action was developed: conversation and sharing experience groups were promoted monthly for pregnant women, breastfeeding mothers, and their families. 90 pregnant women out of the 104 attending the BHU in the six months of the research were invited, and 83 agreed to participate. All the participants declared at least one previous appointment with the healthcare team, 92.8 % of them, with a gynecologist. The nursing team was involved in 53.0 % of the appointments, but only 6.0 % were reported to have been conducted exclusively by a nurse. A dental surgeon appointment was mentioned by 30.1 % of the research participants. The dental health literacy investigation revealed that 57.8 % believed they should only take their babies to a dental appointment after teething, and 27.7 % were aware of the child's craniofacial asymmetries at birth. Only 28.9 % had previous knowledge about the importance of exclusive nasal respiration. Despite only 34.9 % having their first pregnancy, 78.3 % declared they would appreciate receiving information about pregnancy. After the guidance, 72.0 % of the pregnant women had undergone dental prenatal care. Workshops for pregnant women and breastfeeding mothers provided a convenient welcoming space, to listen and provide guidance to pregnant women and their families, in addition to demystifying the fear of dental care during pregnancy and breastfeeding. The intervention to guide pregnant women to perceive the BHU as an educational and health promotion space, not just a curative intervention, effectively increased adherence to dental prenatal care. The contact with the Specialist in Functional Jaw Orthopedics in this first phase of life facilitated dental health education and access to more complex cases. The prenatal program adherence, the pregnant woman’s self-care, and the care of the baby were favored by the welcoming, expanded listening, and personalized service.

A Comprehensive Assessment of the Environmental Impact of Different Infant Feeding Types: The Observational Study GREEN MOTHER.

To observe and compare the environmental impacts of different types of infant feeding, considering the use of formula, infant feeding accessories, potentially increased maternal dietary intake during breastfeeding (BF) and food consumption habits. An observational cross-sectional multicentre study conducted in the Barcelona Metropolitan Area of the Catalan Institute of Health. Data were collected from 419 postpartum women on infant feeding type (formula milk and accessories), maternal dietary intake (24-h register) and food consumption habits from November 2022 to April 2023. The environmental impacts (climate change (CC), water consumption and water scarcity) of the infant feeding types and maternal diet were calculated using the IPCC, ReCiPE and AWARE indicators, respectively. The differences in impacts were calculated by Kruskal-Wallis test. Significant differences for the three environmental impacts were observed. The CC impact of formula milk and feeding accessories was 0.01 kg CO2eq for exclusive BF, 1.55 kg CO2eq for mixed feeding and 4.98 kg CO2eq for formula feeding. While BF mothers consumed an extra 238 kcal, no significant differences were found related to maternal diet across feeding types. Exclusive BF was the most sustainable type of infant feeding, considering formula and infant feeding accessories. In our study, the difference between the impacts of BF and non-BF mothers' diet was insignificant. Offer informative and educational support for midwives and other healthcare professionals on BF and a healthy, sustainable diet to transfer this knowledge to the general public. Raise the general public's awareness about BF and a healthy, sustainable diet. To reduce environmental impacts through behavioural changes. STROBE. Patients of the Catalan Health Service reviewed the content of the data collection tools. (for the whole GREEN MOTHER project): NCT05729581 (https://clinicaltrials.gov).

Accessing Trauma- and Violence-Informed Breastfeeding Support from Primary Care Providers among Women with Histories of Intimate Partner Violence: An Exploratory Interpretive Description Study.

Intimate partner violence (IPV) is a wicked social problem affecting women of all social strata and geographical location, globally. Pregnancy may be a time of heightened risk of IPV and more deleterious outcomes. Breastfeeding - a protective factor for maternal and child well-being - may be jeopardized or more challenging for women experiencing IPV. This study explored the experiences of postpartum women with histories of IPV who sought trauma- and violence-informed breastfeeding support from primary care providers. Using interpretive description and philosophically underpinned by intersectionality, in-depth semi-structured interviews were completed at 12-weeks postpartum with five breastfeeding mothers with a history of IPV who sought breastfeeding support from a family physician clinic employing a trauma- and violence-informed (TVIC) model of care. Four themes and two sub-themes shed light onto the experience of accessing breastfeeding support for women with a history of IPV and the perceived barriers that they faced when attempting to accesses this support, including: 1) The (demoralizing) navigation of the perinatal system; 2) Fostering trust: i) "It's support, but it's also knowledge"; and ii) TVIC: feeling safe and feeling "I mattered"; 3) Informal support: partners, family, and friends; and 4) Baby in focus: overcoming challenges and building confidence. TVIC may aid in the development of trusting therapeutic relationships, in turn improving access to breastfeeding support, breastfeeding self-efficacy, and breastfeeding success for women who experience violence. Further research on the implementation and evaluation of TVIC for perinatal breastfeeding education and care among women is required.

Effects of gestational diabetes mellitus, parity and mode of delivery on polar lipids compositions of mature human milk

Polar lipids in human milk such as glycerophospholipids, sphingomyelin and plasmalogen play important role in growth and development of healthy infants. This work aims to investigate the effects of gestational diabetic mellitus (GDM), parity, delivery mode on the polar lipids’ compositions of human milk. A total of 56 mature human milk samples (1–6 months postpartum) were collected from breastfeeding mothers using electric breast pump from Ningbo, Zhejiang Province of China. Our results showed GDM and parity have limited effect on polar lipid content and composition. Delivery mode was found to significantly affect the polar lipids compositions in human milk with significantly higher total polar lipids in human milk of mothers who had cesarean delivery (938 nmol/mL) as compared to that of mothers who had vaginal delivery (740 nmol/mL). Discriminatory analysis shows human milk of mothers who have cesarean delivery demonstrated up-regulation of glycerophospholipids (GPL) and plasmalogen (PLG) esterified with unsaturated fatty acids (USFAs) [such as plasmenyl-ethanolamine 40:5 and 36:4].