Pumped Breast Milk Research Articles

National Trends in Breastfeeding by Gestational Age Category

National breastfeeding (direct breastfeeding and/or provision of pumped breast milk) rates among preterm infants are unclear. We report rates of breastfeeding initiation and continuation at 12 weeks after birth by gestational age category from a nationally representative survey between 2009 to 2019. Breastfeeding rates were lowest among infants born late preterm compared with other gestational age categories.

Dysphoric Milk Ejection Reflex (D-MER): A Novel Neuroendocrine Condition with Psychiatric Manifestations.

• Describe how the symptoms of dysphoric milk ejection reflex (D-MER) affect nursing patients.• Discuss how physicians, psychologists, and clinicians can support their patients experiencing D-MER. Dysphoric milk ejection reflex (D-MER) is characterized by a sudden onset of profoundly negative emotions that are temporally linked to milk letdown when breastfeeding or pumping breast milk. These affective experiences have no psychological precipitants and only last for minutes. D-MER is relatively underappreciated in the physician-oriented medical literature, although there are important clinical and public health consequences when a nursing parent experiences unwanted, negative emotions paired with breastfeeding. D-MER can undermine the parent's confidence and may affect bonding with their infant; it may also contribute to weaning earlier than planned. It is especially important for psychiatrists and other health care professionals who may be called upon to evaluate postpartum patients or nursing parents to be knowledgeable about D-MER. This perspective article aims to provide information about D-MER to the psychiatric and broader medical communities, and to underscore the need for additional research on this topic. Drawing on a literature search, the article first traces historical recognition of D-MER as a clinical entity, then summarizes the clinical characteristics of D-MER and recommends an assessment and management approach that emphasizes psychoeducation. The article also discusses factors that have contributed to the underappreciation of this condition, outlines gaps in our understanding, and suggests next steps for epidemiological and clinical research. D-MER is likely a neuroendocrine condition with psychiatric manifestations. Given that it is episodic but with predictable timing, this condition presents a unique opportunity for scientific investigation.

Time intervals between pumping did not affect breastmilk protein produced by mothers of preterm infants.

Few studies investigate factors that might influence the content of expressed breastmilk. This study aims to investigate the influence of the intervals between breastmilk pumping and the time of the day on protein and fat concentration in breastmilk. Mothers of very preterm infants in a neonatal ward who expressed more than 400 mL per day were included. Expressed breastmilk was obtained from each mother over 30 h who were pumping at strictly planned and varying intervals: 2, 3, 4 and 6 h. All samples were analysed using infrared transmission spectroscopy. Ten mothers participated at a median of 22 days postpartum. A total of 176 milk samples were analysed, and the average protein and fat concentrations in g/100 mL were 1.1 ± 0.23 and 4.2 ± 1.3, respectively. The time intervals between breast pumping sessions did not impact protein content, but fat content decreased by longer intervals (p < 0.01). The time of the day for milk pumping did not influence the protein or fat content. A single milk sample collected after any 2-6 h interval, at any time during the day, represents the protein content in the breastmilk, but not the fat content which decreased with longer intervals.

Women's Perception Regarding Breastfeeding Support in Workplace: A Scoping Review

Background: Newborns mostly require breast milk. Women who choose to work are equally responsible for maintaining breastfeeding. Prior studies have identified variations in the time and intensity of breastfeeding before and after returning to work. Disparities exist in the assistance provided for women to breastfeed in the workplace, with past studies revealing insufficient facilities. This study intends to examine women's views on the support for breastfeeding in the workplace.Method: A scoping review was carried out using the PubMed, Google Scholar, and ScienceDirect databases, following PRISMA procedures. The papers were selected based on specific criteria: they had to be cross-sectional and qualitative studies focusing on women's opinions of breastfeeding in the workplace. Additionally, the articles were to be written in English, give the entire text, and have been done between 2019 and 2023.Results: Ten publications were examined from different workplaces. The research examines different forms of work and workplaces. Women's views on breastfeeding support focus on instrumental support, such as inappropriate or unavailable lactation rooms, work hours and policies, lack of breastfeeding groups, facilities for breastfeeding and breast milk pumping, insufficient storage, inadequate childcare facilities, and lack of caregivers at home, which impede exclusive breastfeeding. Emotional support refers to the assistance provided by colleagues in the workplace. Form of information support, namely the absence of communication and information support. There is a common belief that breastfeeding is seen as a personal issue connected to one's knowledge and self-confidence. Cross-sectoral collaboration needs to be involved, including family, workplace commitment, and government support to support the success of breastfeeding in the workplace.

Hubungan Pemberian Asi Eksklusif Dengan Pertumbuhan dan Perkembangan Pada Bayi Usia 7-12 Bulan di Puskesmas BP Nauli Kec. Siantar Marihat, Kota Pematang Siantar Tahun 2023

Breast milk is the perfect and best food for babies, especially babies 0-6 months because it contains the nutritional elements needed for optimal growth and development of babies (Ministry of Health, 2021). Exclusive breastfeeding is breastfeeding for 6 months without giving any drinks or food, including clear water, vitamins and medicine (Ministry of Health of the Republic of Indonesia, 2020). Exclusive breastfeeding can be given directly or indirectly. Direct breastfeeding is by breastfeeding, while indirect breastfeeding is done by expressing or pumping breast milk, storing it, and then giving it to the baby. Giving breast milk based on the definition above, the mother is said to give exclusive breast milk if the baby is only given breast milk for the age of 0-6 months, while the mother is said to give non-exclusive breast milk if the baby is given other additional food or drink at the age of 0-6 months (Proverawati, 2015). Exclusive breastfeeding with growth in babies aged 7-12 months at the BP Nauli Community Health Center, Kec. Siantar Marihat Pematangsiantar City In 2023, the majority will be given exclusive breast milk with 18 people growing fat, 15 people will not be given exclusive breast milk with a normal body.The results of the Chi-square test show that with a p-value of 0.000 &lt; 0.05, it can be concluded that there is a relationship between exclusive breastfeeding and growth in babies aged 7-12 months at the BP Nauli District Health Center. Siantar Marihat, Pematangsiantar City in 2023. Based on the results of the research, it can be seen that out of the 62 respondents, 35 babies were given exclusive breast milk (56.6%) and 27 people were not exclusively breastfed (43.5%). There were 27 mothers who did not give exclusive breast milk to their babies (43.5%). This is due to the mother's lack of knowledge about the benefits of exclusive breastfeeding and there are also mothers who work so they say they do not give exclusive breast milk to their babies because of the mother's lack of knowledge about expressed breast milk.

Occupational Factors Associated With Time to Breastfeeding Discontinuation After Return to Work Among Female Anesthesiologists in China: A Nationwide Survey.

Breast milk is of great benefit to both infants and mothers. Due to occupational barriers, female physicians are at high risk of unintentionally discontinuing breastfeeding. However, evidence among anesthesiologists was limited. The purpose of this study was to investigate occupational factors associated with time to breastfeeding discontinuation among female anesthesiologists following maternity leave in China. We conducted a nationwide survey of female anesthesiologists who had given birth since January 1, 2015. A 60-item anonymous questionnaire was developed to collect information regarding breastfeeding practices and related factors. The questionnaire was revised based on the recommendations of 15 experts and feedback from the pilot survey. The survey was distributed by the Chinese Society of Anesthesiology. The completion rate was 57.9%. In total, 1364 responders were analyzed from all 31 provinces of Mainland China. In total, 1311 (96.1%) responders reported a reduction in breast milk supply on returning to work. Among the 1161 responders who discontinued breastfeeding, 836 (72.0%) did not achieve desired goals due to occupational factors. The median [interquartile range] of maternity leave length and breastfeeding duration were 5 [4-6] months and 10 [7-12] months, respectively. The following occupational factors were associated with longer time to breastfeeding discontinuation after adjusting for confounding effects of personal factors: length of maternity leave (hazard ratio [HR] per month 0.44; 95% confidence interval [CI], 0.36-0.54; P < .001), pumping breast milk during work time (HR, 0.04; 95% CI, 0.02-0.08; P < .001), support from colleagues (HR, 0.92; 95% CI, 0.86-0.99; P = .032), and additional nonclinical activities (HR, 0.87; 95% CI, 0.77-0.98; P = .022). Trainees under supervision (HR, 1.20; 95% CI, 1.06-1.43; P = .005) and the need to remain in the operating room during cases (HR, 2.59; 95% CI, 1.09-6.12; P = .031) were associated with shorter time to breastfeeding discontinuation. Approximately 899 (65.9%) responders pumped breast milk during work time. Among them, reduction in pumping frequency (HR, 1.17; 95% CI, 1.00-1.36; P = .049) and difficulty in finding opportunities for pumping (HR, 2.34; 95% CI, 1.36-4.03; P = .002) were associated with shorter time to breastfeeding discontinuation. We identified modifiable occupational factors associated with time to breastfeeding discontinuation. These findings underscored the necessity of facilitating breastfeeding in the workplace, including encouraging longer maternity leave and breastfeeding breaks, considering the feasibility of pumping in daily case assignments, establishing supportive culture, providing lactation rooms, and offering nonclinical activities.

PENGARUH PEMBERIAN JUS DAUN TORBANGUN DENGAN PENINGKATAN PRODUKSI ASI PADA IBU NIFAS DI PMB Ny. N KOTA BEKASI TAHUN 2023

Background: In exclusive breastfeeding, 349,968 infants aged 0-6 months out of 754,438 infants aged 0-6 months (46.4%) this figure is still below the National coverage of 52.3%, especially the National target of 80%. This problem can be reduced by giving torbangun leaf juice so that nursing mothers give breast milk to their babies at least until the age of 6 months. The mechanism of torbangun leaves in increasing milk production is by increasing the proliferation of breast glandular cells in secreting milk. West Java Health Department Data 2020.&#x0D; Objective: This research aims to find out the analysis of the effect of giving Torbangun leaf juice by increasing breast milk expenditure in breastfeeding mothers at the PMB in Bekasi city..&#x0D; Methodology: The type and method of this research is quantitative research using quasy experimental designs. The sample in this study amounted to 20 nursing mothers. Research instrument with checklist sheet about increasing breastmilk expenditure in infants 0-3 days and breastmilk pump. This checklist sheet has been tested for validity. Data were analyzed using paired T-Test, obtained p-value of 0,000.&#x0D; Research Results: The results showed the average volume of breast milk before being given torbangun leaf juice was 3.35 cc, the average volume of breast milk after being given torbangun leaf juice post test one day was 36.50 cc, the average volume of breast milk after being given juice torbangun leaf post test the second day was 71.00 cc, and the average volume of breast milk after being given juice the third day post torbangun leaf was 108.25 cc which means an increase in breast milk expenditure. Paired T-Test test results obtained p-value of 0,000.&#x0D; Conclusions and suggestions: torbangun leaf juice can increase milk production in nursing mothers 0-3 days. The results of this study can be used as an alternative to increase milk production and as a reference for further research.

A quality improvement project to increase breast milk feeding of hospitalized late preterm infants in China

BackgroundThe breastfeeding rates of late preterm infants are lower than both term and extremely preterm infants. To explore the interventions of increasing full breast milk feeding rate of hospitalized late preterm infants on the 7th day after birth (D7) and evaluate the effect of these quality improvement (QI) interventions.MethodsThe full breast milk feeding (amount of enteral breast milk reached 120ml/kg/d on D7) rate of hospitalized late preterm infants during May 2017 and November 2017 was set as the baseline before intervention, and the specific aim of promoting breast milk feeding was put forward. The Pareto Chart was used to analyze the factors that affect breast milk feeding process, as well as the discussion of multidisciplinary experts. Key drivers were constructed, including informational materials and education about breast milk feeding, consultations and support on optimal breast milk initiation, initiating breast milk expression within one hour after birth, accurate measurement and recording of expressed breast milk, stimulating continuous and effective lactation, proper breast pump selection in and out of hospital and sending and preserving of expressed milk to NICU. Control chart was used to monitor the monthly change of full breast milk feeding rate until the aim was achieved and sustained.ResultsThe baseline of full breast milk feeding rate of late preterm infants was 10%, and the aim of QI was to increase the rate to 60% within a two-year period. Control chart dynamically showed the full breast milk feeding rate increased to 80% with the implementation of the interventions, achieved and made the aim of QI sustained.ConclusionQI interventions including breast milk feeding education, early postpartum breast milk pumping, kangaroo care to stimulate breast milk secretion, and convenient way of transporting breast milk to NICU, could significantly improve the full breast milk feeding rate of hospitalized late preterm infants.

Changes in Policy Supports for Healthy Food Retailers, Farmers Markets, and Breastfeeding Among US Municipalities, 2014-2021: National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living (CBS-HEAL).

Policies and practices at the local level can help reduce chronic disease risk by providing environments that facilitate healthy decision-making about diet. We used data from the 2014 and 2021 National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living to examine prevalence among US municipalities of policies to support access to healthier food in supermarkets, convenience stores, and farmers markets, as well as policies to support breastfeeding among government employees. Chi-square tests were conducted to compare prevalence estimates from 2021 to 2014 overall and according to municipal characteristics. In 2021, 29% of municipalities had at least 1 policy to encourage full-service grocery stores to open stores, which was not significantly different from 31% in 2014. Prevalence of having at least 1 policy to help corner stores sell healthier foods declined significantly from 13% in 2014 to 9% in 2021. Prevalence of policies providing all local government employees who were breastfeeding breaktime and space to pump breast milk increased significantly from 25% in 2014 to 52% in 2021. The percentage of municipalities that provided 8 or more weeks of paid maternity leave for employees increased significantly from 16% in 2014 to 19% in 2021. Prevalence of supports for supermarkets, convenience stores, and farmers markets generally did not increase among US municipalities from 2014 to 2021, while some supports for breastfeeding among municipal employees increased during this time. Opportunities exist to improve municipal-level policies that support healthy eating and breastfeeding among community residents and employees.

Edukasi Ibu Rumah Tangga Menfaatkan Potensi Lokal Untuk Meningkatkan Imunitas Tubuh

Utilization of local potential in this case is papaya fruit, both young and ripe. Not many people know about young papaya as a snack, because residents know that young papaya is only made as a vegetable. Consuming young papaya is very good for digestive health, pumping breast milk for nursing mothers. because young papaya contains vitamins and minerals that are quite complete. The participation of related parties to provide input to the community utilizes young papaya as a snack in the form of chips and can be used as a family household business. A variety of snacks in the form of healthy chips is really needed by the community, especially housewives so that the family can be healthy, considering that papaya plants are very easy to cultivate in the yard and can be harvested in a short time. The results of this activity were, (1) Increased knowledge of housewives/PKK about the benefits of papaya fruit for body health seen from the pretest 86.75% and posttest 91% (2) Community education on the importance of increasing body immunity, followed by 20 participants consisting of PKK mothers and Lonjoboko Village staff. (3) The demonstration of chips processing was attended by 16 housewives/PKK and 4 village staff by distributing household tools in the form of 10 grated sticks, 10 sticks of shavings and 10 sticks of filter countainer.

1383-P: Prevalence of Municipal Policies to Help Reduce Type 2 Diabetes Risk by Providing Environments That Facilitate Healthy Eating and Breastfeeding

Introduction: Communities with high diabetes burden may benefit from local policies that facilitate healthy eating and breastfeeding. Methods: Data from the 2021 National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living (CBS HEAL; n=1,927 municipalities) were linked to 2019 county level small area estimates of adult diabetes prevalence (the most recent available) from the Centers for Disease Control and Prevention. We estimated the percentage of US municipalities reporting policies to support healthier food access in supermarkets, convenience stores, and farmers markets and policies to support breastfeeding for municipal employees. Chi-Square tests were used to determine if the presence of policies differed by community diabetes burden. Results: Among municipalities with the highest diabetes burden (≥10.1%), 33.8% had a policy for supermarkets, 9.3% had a policy for convenience stores, and 62.9% had a policy for farmers markets and the percent of municipalities reporting these policies did not differ significantly by diabetes burden. The percentage of municipalities that provided breastfeeding employees time and space to pump breast milk differed by diabetes burden (p=0.006) and ranged from 47.7% among those with the highest diabetes burden to 69.3% among municipalities with the lowest burden (≤6.5%). Among municipalities with the highest diabetes burden, 38.2% provided any paid maternity leave, and 19.9% provided ≥8 weeks of maternity leave. Frequency of maternity leave policies did not differ significantly by diabetes burden. Conclusion: Among US municipalities healthy food retail policies did not differ by diabetes burden. Less than half of municipalities with the greatest burden reported policies to support breastfeeding for municipal employees. Opportunities exist to improve support for healthy eating and breastfeeding among communities with high burden of diabetes. Disclosure S.J.Onufrak: None. D.Galuska: None. S.L.Pierce: None. C.A.Macgowan: None. L.Moore: None.

Socialization of the Implementation of the Education Package using Pocket Book Media "Dairy Breast Milk"

Working mothers can breastfeed directly while on maternity leave. After coming to work breastfeeding activities cannot be carried out immediately. However, working mothers continue to breastfeed in a different way while working. To continue to provide breast milk, mothers must express milk. Expressing breast milk can use hands directly with massage techniques and with the help of a breast pump. Working mothers are not free to breastfeed directly like mothers who live at home every day. Working mothers can breastfeed by giving expressed milk. Working mothers have to spend time between working hours to pump breast milk. The result is expressed breast milk that can be packaged and stored in such a way that it can be given to the baby. This activity was comprehensively discussed in the community service activities which were held on March 30, 2021 at the Faculty of Health Sciences Campus. Socialization activities started from registration, pre-test, counseling on breastfeeding, post-test and results recapitulation. Followed by pregnant and lactating women as many as 28 people. In this activity the midwives, pregnant women and breastfeeding mothers were very enthusiastic as evidenced by the many questions that were included in the question-and-answer session because so far many mothers did not understand how to give. This community service is to produce an educational product in the form of a pocket book on how to express breast milk to breastfeeding mothers who work to increase the knowledge of breastfeeding mothers. In this community service, it was found that there was an increase in the knowledge of pregnant and lactating women by using the ASI pocket book media.

Breastfeeding and pumping as maladaptive weight control behaviors.

It is well recognized by the general public that breastfeeding expends calories. In our clinical practice, a number of postpartum women with a history of or a current eating disorder (ED) report using breastfeeding and/or pumping breast milk to influence their body shape and weight. This appears to be either a form of weight control behavior or, in some cases, a compensation for perceived overeating or binge eating. Breastfeeding and pumping have not generally been identified as maladaptive weight control behaviors, nor have they been a subject of research to date. We suggest that this practice should be investigated to determine how common it is, its potential role in maintaining EDs or contributing to relapse in the postpartum period, and to better understand other potential harms it may cause to both the mother and infant/child. PUBLIC SIGNIFICANCE: Breastfeeding and pumping may be used as maladaptive methods of weight control by women with EDs. This behavior is under-recognized in clinical practice and has received little research attention. We argue that maladaptive breastfeeding and pumping warrant further investigation, as the behaviors may play an important role in maintaining an ED or in contributing to relapse during the postpartum period and may also indirectly harm the infant/child.

Skin to Skin Contact Correlated with Improved Production and Consumption of Mother's Own Milk.

Background: Human milk diet, preferably mother's own milk (MOM) over donor milk (DM), is recommended for preterm infants. Expression of MOM in proximity to preterm infants, especially during or immediately after skin-to-skin contact (SSC), is associated with greater milk production. However, the correlation between SSC and MOM production during hospital admission in preterm infants has not yet been studied. Our study investigated the relationship between SSC and MOM production and consumption in preterm infants during the first postnatal month of life. Materials and Methods: This was a prospective cohort study. Mothers and their preterm infants born at <35 weeks by gestational age (GA) and eligible for SSC within the first 5 postnatal days were eligible for the study. Mothers were given a binder to document pumped breast milk volumes and SSC sessions. Pumped breast milk volumes, enteral feeding type and volume, and SSC duration and frequency were collected daily over the first 28 days of life, along with demographic, perinatal, and feeding data from electronic medical records (EMR). Results: Mean birth GA and weight were 30 ± 3 weeks and 1,443 ± 576 g, respectively. SSC duration was inversely correlated with GA and weight. The SSC duration was positively correlated with ingested MOM volume after correcting for birth GA. The SSC duration was predictive of increased volumes of pumped MOM. Conclusion: Our findings suggest that SSC duration is associated with improved MOM production and consumption. SSC can be a useful tool to increase MOM exposure and improve long-term health outcomes in preterm infants.

Key biologically active components of breast milk and their beneficial effects

Maternal breast milk is the penultimate nutritional source for term and preterm neonates. Its composition is highly complex and includes multiple factors that enhance the development of nearly every neonatal organ system leading to both short- and long-term health benefits. Intensive research is focused on identifying breast milk components that enhance infant health. However, this research is complicated by the significant impact of maternal factors and the processing of pumped breast milk on bioactive ingredients. Optimizing enteral nutrition is particularly important for preterm neonates who miss the transplacental acquisition of nutrients in the third trimester of pregnancy and are at risk for illnesses associated with gut barrier dysfunction, including sepsis and necrotizing enterocolitis. In this review, we will discuss the health benefits of breast milk and its bioactive components.

Examining the Role of Interpersonal Violence in Racial Disparities in Breastfeeding in North Dakota (ND PRAMS 2017-2019).

The 2019 overall breastfeeding initiation rate in the US was 84.1%, yet only 76.6% of American Indian (AI) women initiated breastfeeding. In North Dakota (ND), AI women have greater exposure to interpersonal violence than other racial/ethnic groups. Stress associated with interpersonal violence may interfere with processes important to breastfeeding. We explored whether interpersonal violence partially explains racial/ethnic disparities in breastfeeding in ND. Data for 2161 women were drawn from the 2017-2019 ND Pregnancy Risk Assessment Monitoring System. Breastfeeding questions in PRAMS have been tested among diverse populations. Breastfeeding initiation was self-report to "Did you ever breastfeed or pump breast milk to feed your new baby, even for a short period?" (yes/no). Breastfeeding duration (2 months; 6 months) was self-reported how many weeks or months of breastmilk feeding. Interpersonal violence for both 12 months before and during pregnancy based on self-report (yes/no) of violence from a husband/partner, family member, someone else, or ex-husband/partner. An "Any violence" variable was created if participants reported "yes" to any violence. Logistic regression models estimated crude and adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for breastfeeding outcomes among AI and Other Race women compared to White women. Sequential models were adjusted for interpersonal violence (husband/partner, family member, someone else, ex-husband/partner, or any). AI women had 45% reduced odds of initiating breastfeeding (OR: 0.55, 95% CI: 0.36, 0.82) compared to white women. Including interpersonal violence during pregnancy did not change results. Similar patterns were observed for all breastfeeding outcomes and all interpersonal violence exposures. Interpersonal violence does not explain the disparity in breastfeeding in ND. Considering cultural ties to the tradition of breastfeeding and the role of colonization may provide a better understanding of breastfeeding among AI populations.

Informing the acoustical privacy of mothers’ rooms with measurement data

Mothers’ rooms (also referred to as lactation rooms) have become more prominent in workplaces in the United States in recent decades. Since the amendment of Fair Labor Standards Act in 2010, employers in the United States with more than 50 employees have been required to provide a non-restroom space for mothers to nurse or pump breast milk. Such spaces are often designed to offer privacy and comfort—however, little consideration has been given to the acoustical criteria that would be appropriate for these spaces. To inform the development of best practice criteria for sound isolation, a sample of different breast pump models from different manufacturers has been measured to estimate the range of sound power levels and spectral content associated with lactation pump noise. Comparisons are then made between pump noise levels and common workplace wall constructions to test the efficacy of published sound isolation criteria. Additional consideration is given to the unique usage of this space type in comparison to common adjacency types to propose a data-driven sound isolation criteria for mothers’ rooms. Results from this effort also aim to inform further work towards developing criteria for reverberation time and background noise levels in mothers’ rooms.

Trend over 25 years of risk factors of mother's own milk provision to very low birth weight infants at discharge

BackgroundFeeding mother's own milk (MOM) is associated with reduced morbidity of very low birth weight (VLBW) infants (<1500 g), but not all mothers are able to provide pumped breast milk or breastfeed until discharge. AimsTo investigate the duration of MOM feeding and identify risk factors for cessation. Study designSingle-center retrospective cohort study. Subjects307 VLBW infants born 2012 and 2019 surviving beyond 7 days of life. Outcome measuresAnalysis of MOM feeding at discharge, including comparison with a historical cohort of infants born 1992–1994. ResultsMOM feeding was initiated in 178/180 infants (98.9 %) born in 2012 and in 123/127 infants (96.9 %) born in 2019 (p = 0.132), as compared to 73/89 (82 %) infants born 1992–1994 (p < 0.001). Median [range] duration of MOM feeding was similar for infants born in 2012 (45 [0–170] days) and 2019 (50 [0–190] days) (p = 0.396), but much longer than in the historical cohort (36 [0–152] days) (p < 0.001). The overall breastfeeding rate increased up to 69.2 % and 77.2 %. Factors associated with cessation of MOM feeding were smoking during pregnancy, single-mother status, short (<12 years) duration of maternal or paternal school education (all p ≤ 0.001), natural conception, birth weight ≥ 1000 g, and gestational age ≥ 29 weeks (p < 0.05). In Cox proportional hazard multivariate analysis, smoking during pregnancy and single-mother status remained independent risk factors. ConclusionsDuration of MOM feeding and breastfeeding rates of VLBW infants during hospital stay have increased significantly during the last 30 years, while smoking and indicators of low socioeconomic status remain dominant predictors of cessation of MOM feeding.

TEKNIK MARMET TERHADAP KELANCARAN ASI PADA IBU POST PARTUM

Breastfeeding failure is often caused by psychological factors of the mother in the early days of the breastfeeding process. Mothers often feel afraid that the milk produced is not sufficient for their baby's needs. If breastfeeding in the early period of birth cannot be done, the next best alternative is to express or pump breast milk for 10 - 20 minutes every two to three hours until the baby can suckle. This action can help maximize prolactin receptors and minimize the side effects of delayed breastfeeding in infants. This study uses a Quasy Experiment Design (Pseudo Experimental Design) by using the One Group Pretest-Postest Design. The population and sample in this study were all postpartum mothers totaling 40 people. This study uses a Porposive Sampling technique with univariate and bivariate analysis with T test. Research obtained from data analysis with the Wilcoxon test. The purpose of this study was to determine the effect of the marmet technique on the smoothness of breast milk in post partum mothers. The results in the table show that the P-Value (0.001) &lt;0.05 then Ho is rejected and Ha is accepted, which means that there is an effect of marmet technique on the smoothness of breastfeeding in postpartum mothers. The recommendation in the researcher is that the marmet technique is effective to carry out breastfeeding in postpartum mothers and the marmet technique can stimulate an increase in the hormones prolaksin and oxytocin which has a relaxing effect on postpartum mothers so that this can be practiced for postpartum mothers.

Continuing breastfeeding upon returning to work: feelings, challenges and strategies of breastfeeding nurses.

To describe feelings, challenges and strategies related to the continuity of breastfeeding after returning to work in the perception of lactating nurses. Descriptive, exploratory, qualitative study, with snowball sampling. Data collection occurred virtually between August and September 2020 in the State of Rio de Janeiro. Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires software and a thematic analysis were used. 42 breastfeeding nurses participated and cited fear, missing the child, anguish, and pleasure in returning to work. Challenges such as lack of infrastructure for pumping the breast in health services, unfavorable scales, and multiple jobs were reported. Support networks, listening spaces, and appropriate times and places for breast milk pumping were mentioned as strategies. Different feelings and challenges for the continuity of breastfeeding upon returning to work were identified; some strategies found were common to other working women while others related to the specific nursing work context.