Exclusive Breastfeeding Rates Research Articles

The effect of Moringa oleifera capsule in increasing breast milk volume in early postpartum patients: A double-blind, randomized controlled trial.

Moringa oleifera is an herbal galactagogue that is used to increase the volume of breast milk. The objective of this study was to evaluate the efficacy of Moringa oleifera leaves in increasing the volume of breast milk in early postpartum mothers. A randomized, double-blinded, placebo-controlled trial was conducted. Eighty-eight postpartum women were randomized to either the study group receiving oral Moringa oleifera capsules or to the control group receiving oral placebo capsules. There was no difference in median breast milk volume on the third day of postpartum between the Moringa oleifera leaf group and the control group (73.5 vs 50ml, p=0.19). However, the amount of breast milk in the Moringa oleifera group was 47% more than the one in the control group. The exclusive breastfeeding rate at 6 months in this study was 52.3% in the Moringa oleifera group, which met the goals set by the World Health Organization. Even 900mg/day of the Moringa oleifera leaf could not significantly increase breast milk volume in early postpartum mothers, but the amount of breast milk in the Moringa oleifera group was 47% more than the one in the control group. The exclusive breastfeeding rate at 6 months in the Moringa oleifera group achieved the goals set by the WHO. Therefore, Moringa oleifera leaf may be used as a galactagogue herb to increase the volume of breast milk.

Rate and risk factors of term low birth weight and small-for-gestational-age and planned behavior of breast feeding of lactating mother in rural maternity of lwiro in bukavu, eastern of the democratic republic of the congo

Background: There is paucity of information on cause of Small-for- Gestational Age (weight below the 10th percentile of a sex- and gestational age) (SGA). Beside, Low birth weight (birth weight less than 2500 g) and SGA have not been examined together in the region; while, both have a worst outcome at birth and late in life. Moreover studies regarding nutrition status of infants and mother in earlier post-partum are scarce in South-Kivu. However, the country is facing a double burden of malnutrition in both mother and infant. Furthermore, if breastfeeding initiation is well-timed, the rate of exclusive breastfeeding will increase and the mortality rate of less than five years infants may diminish. Methods: We conducted a cross sectional study in rural area in Bukavu. One hundred forty three mother-infant pairs were randomly selected from February 2018 to October 2018. The data base was entered in Excel and analyzed by SPSS (Statistical Analysis Software) version 26.0. A WHO Anthropometrics measurement helped to calculate Z score. The descriptive statistic was performed to determine the prevalence of independents variables. In addition, a chi-square analysis was performed to establish the association between possible incriminate factors of LBW, SGA, and DIB (Initiation of Breastfeeding) as well, and a logistic regression was performed to determine the key factors of LBW and SGA. Results: Findings showed that (8/143, 5.6%) and (7/143, 4.9%) of infant was weighted low at birth and Smaller for gestational age, respectively. Besides, almost the totality of lactating mothers (139/143, 97.2%) initiated their children in breastfeeding within the first hour of life. More than half (73.8%, 96/130) planned to exclusively breastfeed their children at 6 months. In fact, 14.3%, 20/140, of lactating mothers, planned of giving (foods or drinks or milk) besides breast milk. Of 143, 3(2.1%) mothers were malnourished in the first week after delivery. At birth and at baseline assessments, there was a mere prevalence of underweight (1/141, 2.1%; Vs 6/143, 4.2%), stunting (9/141, 6.5%; Vs 13/139, 9.5%) and wasted (12/142, 8.5%; Vs 12/140, 8.6%), as well. Unmarried women had a delay in initiation of breastfeeding (p=0.043). Mothers with vision problem at twilight during pregnancy was 6.4 times more likely to deliver a LBW baby (OR: 6.400; 95% CI: 1.183-34.630; p<0.031) and mothers who ruled the HH was 20.789 times more likely to deliver a LBW baby (OR: 20.798; 95% CI: 2.144-201.741; p<0.009). Likewise, lactating mothers with vision problem at twilight during pregnancy was 5.333 times more likely to deliver a Small-for-gestational-age baby (OR: 5.333; 95% CI: 1.391-20.449; p<0.015). Also, the mother who was a head of household was 26.796 times more likely to deliver a SGA baby than the mother who was not the head (OR: 26.796; 95% CI: (2.531-283.717; p<0.006). Conclusion: A Vitamin A supplementation and an adequate food intake during pregnancy and in early post partum period may help to solve the matter.

Supports from place of delivery and mother in-law were associated with successful exclusive breastfeeding

Background and purpose: The 2019 Health Profile of Klungkung District in Bali Province shows that the area of Dawan I Public Health Center has the coverage of exclusive breastfeeding below 80% (72.6%). This study aimed at determining factors associated with the success of exclusive breastfeeding. Methods: This cross-sectional study involved all breastfeeding mothers with children aged 6-11 months old at the time of the data collection who resided in the area of Dawan I Public Health Center. The total number of samples was 105 mothers. Data was obtained from an online survey, using a structured questionnaire. The variables include maternal age, education and working status, parity, birth spacing, mother's attitude and knowledge on breastfeeding, supports from place of delivery and family, including husband and mother-in-law. Data were analyzed using Chi Square Test and Logistic Regression. Results: We found 81.90% of mothers were 20-35 years old, had high education (76.19%) and were working (53.33%). The success rate of exclusive breastfeeding in the working area of Dawan I was only 40.95%. The strongest predictors were the supports from place of delivery and mother-in-law. Mothers who received good supports from the place of delivery had a 4.12 times higher chance (p=0.03; 95%CI: 1.10-15.35) to successful exclusive breastfeeding. Mothers who received good supports from their mother-in-law had a 2.68 times higher chance (p=0.02; 95%CI: 1.13-6.34) to successfully give exclusive breastfeeding to their baby. Conclusion: Supports from place of delivery and mother-in-law are important determinants to be considered in increasing the success rate of exclusive breastfeeding.

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

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

How and Where the Birth Delivery Taking Place Matter towards the Success of Exclusive Breastfeeding

Background: Breast milk is the best nutrition for babies. The coverage of exclusive breastfeeding in Indonesia in 2017 was still low. However, there are many factors that contribute to low rates of exclusive breastfeeding including socio-cultural factors, factors related to the health system, market, environment, and knowledge. Recent studies have shown that there was a relationship between the place and type of delivery with exclusive breastfeeding. Objectives: This study aimed to analyze the correlation between the place and type of delivery with the success of exclusive breastfeeding practice in Indonesia among mothers of infants 0-6 months.Methods: This study was a secondary data analysis using data from the results of the 2017 Indonesia Demographic and Health Survey (IDHS), conducted in 34 provinces in Indonesia with a total sample of 1810 infants aged 0-6 months. The dependent variable was the exclusive breastfeeding. Independent variables were mother’s age, mother’s level of education, parity, place of delivery, and type of delivery. Data collection was carried out for all variables by interviewing using a reproductive woman questionnaire. Data were analyzed using chi square test.Results: The results showed that 48.2% of mothers gave exclusive breastfeeding. The results of the bivariate analysis showed that the variables of place of delivery (p-value=0.045), type of delivery (p-value<0.001), and mother’s age (p-value=0.048) were related to the practice of exclusive breastfeeding.Conclusions: The conclusion of this study was the factors that affecting exclusive breastfeeding in were place of delivery, type of delivery, and mother’s age.Keywords: exclusive breastfeeding, place of delivery, type of delivery, early life nutrition

Association between exclusive breastfeeding and postpartum post-traumatic stress disorder

BackgroundResearch on the association between breastfeeding and postpartum post-traumatic stress disorder (PTSD) is sparse. This study aimed to examine the association between exclusive breastfeeding up to 42 days after childbirth and postpartum PTSD.MethodsAn epidemiologic study was conducted in a tertiary hospital in China between October 2019 and October 2020. Eligible mothers were recruited at 3 days after childbirth and assessed using the Post-Traumatic Stress Disorder Checklist – Civilian version (PCL-C) for PTSD at 42 days postpartum. The independent association between exclusive breastfeeding up to 42 days after childbirth and postpartum PTSD was estimated using log-binomial regression models, after adjusting for potential confounders.ResultsNinety-two of 759 (12.1%) mothers developed postpartum PTSD within 42 days after childbirth. Compared with partially breastfeeding mothers, exclusively breastfeeding mothers had lower risks of postpartum PTSD (relative risk [RR] 0.28; 95% confidence interval [CI] 0.13, 0.59), re-experience (RR 0.48; 95% CI 0.30, 0.76), avoidance (RR 0.55; 95% CI 0.32, 0.97), and hyperarousal (RR 0.52; 95% CI 0.34, 0.78). After adjustment for family support, parity, mode of delivery, perceived birth trauma, early contact / suckling, and rooming-in, associations between exclusive breastfeeding and postpartum PTSD remained significant: the overall PTSD adjusted relative risk [aRR] was 0.31; (95% CI 0.15, 0.66), with a re-experience aRR of 0.48; (95% CI 0.30, 0.77) and hyperarousal aRR of 0.56; (95% CI 0.37, 0.85).ConclusionExclusive breastfeeding up to 42 days after childbirth was associated with reduced risk of postpartum PTSD. While the potential for reverse causation cannot be ruled out, strategies to improve rates of exclusive breastfeeding through teaching, counselling, and support may benefit mothers and their infants by reducing the risk of postpartum PTSD.

The Rates of Breastfeeding in Baby-Friendly Hospitals in Greece: A Nationwide Survey.

Exclusive breastfeeding (EBF) remains the cornerstone of infant nutrition for the first six months of life, presenting multiple short and long term benefits. The purpose of this study is the demonstration of EBF rates of infants born in baby-friendly hospitals (BFH) and the factors that positively influence EBF. The study was conducted in all four of the BFH that exist in Greece, between 2020 and 2022. The study sample consisted of 1200 mothers, taken from the 7101 that delivered at those hospitals during the time of the study. A questionnaire was used that included questions to evaluate the infant's nutrition after birth, after exiting the maternity hospital and during the 2nd, 4th and 6th month of age. The WHO guidelines on EBF and breastfeeding (BF), as well as the "Infant and Young Child Feeding" indicators, were used. The EBF rate within 1 h after birth was 71.3%, which gradually declined to 21.2% in the 6th month. The respective rate of BF was 94.5% and declined to 66.1%. The logistic regression revealed that attending antenatal breastfeeding courses, vaginal delivery, full-term pregnancies and the mothers' advanced education level constitute independent positive prognostic factors for increased EBF rates. The results of the first national study on BFH are presented. Despite the improvement of EBF rates in Greece, compared to the latest available data from 2018, reinforcement of EBF promotion measures is required in order to approach the WHO's targets by 2025.

Challenges of exclusive breast feeding for new born, a problem-solving approach to improve percentage during hospital stay: A quality improvement perspective

Exclusive breast feeding for six months is the intended target for every newborn, but even after decades of efforts by WHO, UNICEF, UN, it still stands at 44% globally. Ground reality was no different in our set up. NICU admission was the major reason. But heathy newborn roomed in with mother were also found to be not exclusively breast fed. Individualized reasons always cropped up for giving formula milk and situation was not changing in spite of exclusive breast-feeding policy in place. Task was taken up with a quality improvement perspective. Magnitude of problem was studied, Root cause analysis done. Two reasons were found, issue of non protactile /retracted nipples in mother creating a latching issue. Late interference or unsuccessful interference resulted in formula feeds to baby. Other was complain of non production of milk/colostrum in early postpartum period by mother. Three interventions were adopted, i.e., nipple examination by pediatric team in labor room, 20 cc inverted syringe pump at outset, traditional nutrition supplement of galactogogues addressing three different issues. As a result, we were able to improve our exclusive breast-feeding rates during hospital stay of newborn from 66 % to 100 % when both baby and mothers’ condition was considered. When only infants’ heath was considered as prerequisite it improved to 95%. We concluded that simple process of reassignment of job, anticipation and redecided remedial measures as standard operating procedure, led to quick rise in exclusive breast-feeding rates in our setup and they may be easily adopted at other places also.

The effect of family integrated care on the prognosis of premature infants

BackgroundThe purpose of this study was to investigate the effect of family integrated care (FICare) on the prognosis of children hospitalized with preterm infants.MethodsTwo hundred thirty preterm infants admitted to our hospital from January 2019 to April 2021 were enrolled in a prospective randomized study and divided into 115 cases in the intervention group and 115 cases in the control group according to the random number table method, and given the FICare and the conventional care, respectively. The duration of nasogastric tube retention, time to achieve total enteral nutrition, rate of weight gain, exclusive breastfeeding rate, length of hospital stay, growth and development, readmission rate, parental self-efficacy, family functioning and complications related to prematurity were compared between the two groups.ResultsCompared with the control group, the intervention group had shorter nasogastric tube retention time, shorter time to achieve total enteral nutrition, higher exclusive breastfeeding rate, shorter time of hospital stay and better growth rate. Before the intervention, there was no difference in parental self-efficacy and family functioning between the two groups; after the intervention, the intervention group had higher parental self-efficacy and higher ratings of family functioning, and the difference was statistically significant. Compared with the control group, the intervention group had a lower readmission rate and significantly lower incidence of infection and choking.ConclusionThe FICare can shorten the time of nasogastric tube retention, shorten time to achieve total enteral nutrition and hospital stay, increase the rate of exclusive breastfeeding and the rate of weight gain, finally improve the prognosis of preterm infants and have a positive effect on parents.

Dukungan Suami, Orang Tua, dan Mertua dalam Pemberian ASI Ekslusif di Kota Tasikmalaya

Low breastfeeding is a problem that must be faced together because it can affect children's lives in the future. The lack of exclusive breastfeeding can interfere with child growth and development. Based on several studies in Indonesia, one of the factors that influence the low rate of exclusive breastfeeding is the lack of family support. Exclusive breastfeeding in West Java province in 2018 reached 57.97%. This number is still below the national target (65.16%). Based on the information from the Tasikmalaya City Health Office, the coverage of exclusive breastfeeding in Tasikmalaya City in 2018 reached 69.00%, but has not reached the target. The purpose of this study was to determine the support of husbands, parents, and in-laws in exclusive breastfeeding. This study used a qualitative method of focus group discussions (FGD). This method presented a direct relationship between the researcher and the person providing the information, making it possible to gain insight into the attitudes, motivations and behavior of the target towards the support and barriers to exclusive breastfeeding. There were four informants in this study. The results of this study indicated that the factors that support the success of exclusive breastfeeding in this study were the wishes of the baby's own mother, support from her husband, the baby's grandmother, and health workers who assisted in childbirth.

Current Food Behaviors and Nutritional Status of Children Aged 6 to 24 Months in Douala (Cameroon)

Malnutrition and micronutrient deficiencies among infant and young children remain a public health problem in Cameroon. This study was designed to assess the current food behaviors and nutritional status of children aged 6 to 24 months in Douala (Cameroon). A descriptive cross sectional study was carried out for a period of 9 months at a Health Care Center and four district hospitals in Douala. The study was conducted among 333 children aged 6-24 months of both sexes together with their mothers or caregivers. Data were collected using a modified questionnaire developed by the FAO/WHO. Information on socio-demographic status, feeding habits and anthropometric parameters were recorded. Anthropometric measurements taken included weight, length, brachial perimeter and age. Subsequently, a blood sample was taken to measure the hemoglobin level in children whose mothers had given their consent, using the Hemocue Hb 301 method. Data were analysed using SPSS version 22.0. A P value ≤0.05 was considered as significant. Z-score classifications for malnutrition: weight for length, length for age and weight for age were compared with reference data from WHO standards. This study showed that: only 19.53%, 27.33% and 30.6% respectively of the children had a high dietary diversity score, a high meal frequency. Exclusive breastfeeding rate was 22.52% and 26.43% of children were breastfed within one hour after birth. Furthermore, the study showed that, 25.8%, 23.1%, 27% and 35.1% of children were underweight, wasted, stunted and anemic respectively. Among them, 28.8% and 6.3% were suffering of mild anemia and moderate anemia respectively. Moreover, no significant relationship was observed between nutritional status of children and socio-demographic characteristics of mothers (P>0.05). Some of the feeding practices were associated with poor nutritional status and could be improved with good nutrition education programs.

Association between Skin-to-Skin Contact Duration after Caesarean Section and Breastfeeding Outcomes.

We aimed to explore the association between skin-to-skin contact (SSC) duration after caesarean sections (CSs) and breastfeeding outcomes. A prospective study was conducted in four hospitals in China during January and August 2021. A total of 679 participants with singleton pregnancy who delivered by elective CS after 37 gestational weeks using epidural or spinal anesthesia were included. Logistic regression was applied to assess the association between SSC duration and early initiation of breastfeeding (EIBF), as well as the promoting factors for exclusive breastfeeding (EBF) at hospital discharge. Immediate SSC after CSs was strongly associated with higher rates of EIBF (p < 0.001) and EBF at hospital discharge (p = 0.002). The EIBF rates increased with longer duration of SSC, with the at least 90 min SSC group having the highest EIBF rate (74.5%). Skin-to-skin contact durations of at least 90 min, 60-89 min and 30-59 min were significantly associated with 8.53 times (OR = 8.53, 95%CI: 4.94-14.72, Padj < 0.001), 8.04 times (95%CI: 4.68-13.80, Padj < 0.001) and 6.28 times (95%CI: 3.75-10.51, Padj < 0.001), respectively, higher EIBF rates compared to those without immediate SSC. After multiple-testing correction, the rates of EBF at hospital discharge were found to be independent of the duration of SSC (Padj = 0.12). Early initiation of breastfeeding was not a significant predictor of EBF. Our results suggested that SSC is important for EIBF in Chinese baby-friendly hospitals. Skin-to-skin contact should be practiced after CS to promote breastfeeding and providing SSC with longer duration is encouraged to obtain the full benefit; if it is not feasible, a minimum of 30 min SSC could achieve improved EIBF and EBF at discharge.

Exclusive Breastfeeding and Childhood Morbidity: A Narrative Review.

Globally, diarrheal diseases and acute respiratory infections are the leading causes of morbidity and mortality in children under 5 years old. The benefits of exclusive breastfeeding in reducing the risk of gastrointestinal and respiratory infections are well documented. Optimal breastfeeding may potentially save the lives of about 800,000 children in low-income settings. Despite the evidence, around 63% of infants from birth to 6 months are not exclusively breastfed worldwide. We searched the literature published between 2010 and 2022 in Medline, Embase, and Scopus on the association between exclusive breastfeeding and infectious diseases. We selected and reviewed 70 relevant studies. Our findings expand and confirm the positive association between exclusive breastfeeding and reduced risk of a number of gastrointestinal, respiratory, and other infections in 60 out of 70 studies observed in both low- and high-income settings. Several studies analyzing exclusive breastfeeding duration reported that a longer exclusive breastfeeding duration is protective against many infectious diseases. This review also reported a lack of standardized definition for measuring exclusive breastfeeding in many studies. Overall, the results highlight the benefits of exclusive breastfeeding in many studies and suggests reporting exclusive breastfeeding in future studies using a consistent definition to enable better monitoring of exclusive breastfeeding rates.

Successful breastfeeding following a level II NICU stay in Qatar – a longitudinal study

BackgroundExclusive breastfeeding is an essential need for mothers and newborn babies, but cultural practices and employment demands significantly influence feeding practices. The association between neonatal intensive care unit (NICU) admission and breastfeeding outcomes are variable. Data for Qatar and Middle East, in particular, are limited. Hence, this study aims to estimate the rate of breastfeeding at the time of NICU discharge and the rate of successful breastfeeding after NICU discharge in Qatar during well-baby follow-ups.MethodsThis quantitative longitudinal study was conducted over 18 months from January 2019 and included neonates born in Al Wakra Hospital admitted to the NICU. Demographic data, feeding during NICU stay and at discharge were obtained from lactation charts. Data regarding feeding practices after discharge were obtained through a questionnaire administered at 4 weeks and 8 weeks in well-baby clinics. Descriptive statistics and logistic regression analyses were performed to determine the rates of breastfeeding and the association between the various factors.ResultsOf the 678 participants screened, 364 were eligible for analysis. The rates of exclusive breastfeeding were 20% (73/364), 54% (197/364) and 42% (153/364) at discharge, 4 weeks and 8 weeks, respectively. Any breastfeeding was 64% (233/364), 40% (146/364) and 43% (157/364) at discharge, 4 weeks and 8 weeks, respectively. Logistic regression analysis showed that neonates who had NICU stays longer than 4 days had a higher rate of exclusive breastfeeding at discharge (adjusted odds ratio 3.000; 95% CI 1.25, 7.198) but had a reduced rate of breastfeeding and higher rate of formula feeding during follow-ups. Although breastfeeding rates were better in preterm infants at NICU discharge, regression analysis showed that none of the other factors, including gestation and maternal education had a significant association with the rate of exclusive breastfeeding at the time of discharge or during follow-ups.ConclusionsThe overall breastfeeding rates from this level II NICU in Qatar are better than previously available data. Studies with extended follow-up and assessment of intervention methods should be planned to improve and sustain the practice of exclusive breastfeeding.

Beyond early initiation: A qualitative study on the challenges of hospital-based postpartum breastfeeding support.

Improving breastfeeding practices is key to reducing child mortality globally. Sub-optimal exclusive breastfeeding rates may be associated with inadequate hospital-based postpartum breastfeeding support, particularly in resource-limited health settings such as Malawi. While almost all children in Malawi are breastfed, it is a concern that exclusive breastfeeding rates in Malawi are declining. The objective of this study is to understand postpartum breastfeeding support after delivery at Malawian hospitals from the perspectives of health workers and caregivers. We conducted a secondary analysis of a descriptive qualitative study on health worker and caregiver experiences of breastfeeding support at health facilities in southern Malawi as part of the Innovating for Maternal and Child Health in Africa Initiative. In-depth interviews following a semi-structured topic guide were conducted at three secondary-level district hospitals and one tertiary-level central hospital. Interviews were thematically analysed in NVivo 12 software (QSR International, Melbourne, Australia). We interviewed a total of 61 participants, including 30 caregivers and 31 health care workers. Participants shared the following themes: 1) a focus on early initiation of breastfeeding, 2) inadequate follow-up on breastfeeding practice, and 3) feasibility challenges and local solutions. There was an emphasis on early initiation of breastfeeding, which was challenged by maternal exhaustion after delivery. Study participants reported poor follow-up on breastfeeding practice after initial counselling and reacting to adverse outcomes in lieu of adequate monitoring, with a reliance on caregivers to follow-up on challenges. There was poor support for facility-based breastfeeding after initial counselling post-delivery, which revealed an overall neglect in hospital postpartum care for those considered to be in good health after initial assessment. We recommend the development of indicators to track continued facility-based breastfeeding, identify vulnerable infants at-risk of feeding problems, and strengthening care in postnatal wards, which is currently as neglected component of maternity care.

Impact of Donor Human Milk in an Urban NICU Population.

The American Academy of Pediatrics recommends the use of donor human milk in infants when mother's own milk is not available. Our objective was to analyze whether the use of donor human milk in preterm, very-low-birth-weight (VLBW, <1500 g) infants affected the rates of necrotizing enterocolitis, duration of parenteral nutrition (PN), growth, culture-positive sepsis, length of hospital stay, and mortality in an urban NICU population with low exclusive breast-feeding rates. A retrospective cohort study was conducted comparing two 2-year epochs of VLBW neonates before and after the introduction of donor breast milk in our neonatal intensive care unit (NICU). With the introduction of donor human milk, there was a significant reduction in the rate of necrotizing enterocolitis (NEC) (5% vs. 13%; p = 0.04) and less severe NEC as defined by Stage III based on the Modified Bell Staging Criteria (10% to 3%; p = 0.04). In the donor milk era, there was earlier initiation of enteral feeding (2.69 days vs. 3.84; p = 0.006) and a more rapid return to birthweight (9.5 days. 10.9 days; p = 0.006). In this study, a change in practice to the use of donor breast milk in a population with low rates of human milk provision was associated with earlier initiation of enteral feeding, faster return to birth weight, and a reduced incidence of NEC.

Infant and Young Child Feeding Practices and Determinants of Exclusive Breastfeeding: A Study at the Bono Regional Hospital, Sunyani, Ghana

Optimal nutrition plays a key role in the survival and overall health outcome of young children. This study sought to assess infant and young child feeding (IYCF) practices and maternal socio-demographic factors and health-seeking behaviors affecting exclusive breastfeeding (EBF) practice. A descriptive cross-sectional study was conducted at the Child Welfare Clinic of the Bono Regional Hospital, Sunyani, Ghana. Two hundred and forty-five mothers with 6-23 months old infant pairs were recruited for the study through convenience sampling. Data were collected using semi-structured, interviewer-administered questionnaires. Statistical Package for Social Sciences (SPSS) version 25 was used to analyze the data. All infants (245) in the study had been breastfed at some point in time. Approximately, 5 in 10 infants (54.3%) were introduced to breast milk within the first hour of birth. EBF rate was 49.4%. More than 7 in 10 children (75.5 percent) were predominantly breastfed in their first 6 months of life. Eight in 10 infants (80.8%) were being fed complementary foods. In a multiple logistic regression analysis, maternal age and health education/counseling on EBF significantly predicted EBF practice. Mothers aged 35-49 years were more likely to practice EBF compared to those aged 15-24 years (AOR 0.47; 95% CI 0.24, 0.92). Also, mothers who received education/counseling on EBF during antenatal care were more likely to practice EBF than those who did not (AOR 2.68; 95% CI 1.29, 5.53). The rate of EBF was below the World Health Assembly approved target for 2025 (≥ 50%), suggesting a need for intervention.

Disease activity at conception predicts lupus flare up to two years after birth: A multicentre long term follow-up study

ObjectiveTo assess predicting factors that might influence systemic lupus erythematosus (SLE) disease activity in women in an extended follow-up period of two years after giving birth with clinical assessments every three months. MethodsThe study was design as an international retrospective study, enrolling 119 women with a first birth and with a two years follow-up. ResultsJoint involvement was present in 80% of patients, acute cutaneous in 64%, haematological in 54%, renal in 41% and 75% of patients were positive for anti-dsDNA. The mean SLE disease activity index 2000 (SLEDAI-2K) at diagnosis was 13.5±6.8 and at first birth was 2.8±4.4.At follow-up, 51.3% of patients had at least one flare after a mean time after birth of 9±6.3 months (mean flare per patient 0.94±1.1). The most frequent flare manifestations were joint involvement (48%), renal (33%), cutaneous (28%) and haematologic (20%).Patients with remission of disease (SLEDAI-2K=0; no clinical or laboratory manifestations of SLE) at conception had significantly lower rates of flares (18/49–37% vs. 43/70–61%; p=0.008).Patients who experienced a flare during pregnancy (17 patients) had higher rates of flares during follow-up (76% vs. 47%; p=0.019), lower time for first flare (4.4±2.3 months vs. 10.3±6.5; p<0.001), lower rate of remission of disease at conception (12% vs. 46%; p<0.001), lower rates of SLEDAI-2K at conception (5.9±5.6 vs. 2.3±4; p<0.001) and lower rates of exclusive breastfeeding (24% vs. 57%: p=0.009). Results were confirmed after performing multivariate analysis. ConclusionRemission at conception can influence SLE disease positively, even at long-term. Planned pregnancy counseling is fundamental when managing SLE patients.

Effect of a mobile app on breastfeeding among cesarean deliveries: A randomized controlled trial

Abstract Aim Cesarean section has negative impacts on breastfeeding rates. This study is to evaluate the effect of a mobile application on breastfeeding outcomes among mothers who had cesarean section using a randomized control trial in Vietnam in 2020 - 2022. Methods A triple-blinded randomized trial of a mobile application was conducted. The mobile application was tailored to Vietnamese culture with two separate versions for the intervention and the control group. The intervention version auto-generated three messages per week and linked the information in the library content to improve breastfeeding while the control version sent messages on maternal and child health care. Pregnant mothers were recruited during their antenatal visits and randomly assigned to two groups. Outcomes of interest included early initiation of breastfeeding and exclusive breastfeeding rates. Results A total of 275 mothers in the control and 293 in the intervention group who had undergone a cesarean section were included in the analyses. Significant increases were observed for early initiated breastfeeding within two hours (aOR= 1.51, 95%CI: 1.01 to 2.27) and exclusive breastfeeding during hospital stay (aOR=1.59, 95%CI: 1.02 to 2.49). Conclusions Our results support the use of a theory-based design mobile phone application as a part of a promising intervention to improve breastfeeding outcomes. Key messages • A mobile phone application could be a widely accessible, acceptable, and effective intervention to improve breastfeeding outcomes. • To improve exclusive breastfeeding rates, comprehensive interventions at different levels of sociocultural and market contexts, settings, and individuals are needed.

Barriers To Exclusive Breastfeeding Among Mothers With Children Aged 6-9 Months In Mogadishu City, Somalia

Exclusive breastfeeding (EBF) in the first six months of life is the most effective way to satisfy a baby's nutritional and psychologicalneeds. It is a simple intervention to improve a child's health and development. Despite its advantages, there is a low global rate ofexclusive breastfeeding (EBF), and in Mogadishu, Somalia, EBF is rarely practised. This research identified social and cultural factorsthat might influence the practice of exclusive breastfeeding among mothers with babies aged between 6-9 months in Mogadishu, toinform and support redress.MethodsA community-based cross-sectional study was conducted among mothers of 280 infants aged six months to 9 months. Mothers wererecruited using a consecutive sampling method. Data were collected using questionnaires, and the analysis was done using SPSS version23. Logistic regression was used to determine the factors associated with exclusive breastfeeding, and statistical significance wasdetermined at a 5% significance level.ResultsTwo hundred eighty mothers participated in the study. The mothers' average age was 27.8 (±4.12) years, while the babies were, onaverage aged 7.6(±1.2) months. About 63% of the mothers were married, and 67% had 2 to 5 children. The level of exclusivelybreastfeeding was at 30% (95%CI: 25.2-36.03). Being married/cohabiting (OR=2.877, 95%CI: 1.21-6.90), acquiring up tosecondary/tertiary education level (OR=4.282, 95%CI: 1.78-10.30), is not advised to give their children food/drinks with the first six(OR=0.04; 95%CI (12.94 – 51.19); P&lt;0.001).CONCLUSION AND RECOMMENDATIONThe percentage of exclusive breastfeeding in Somalia is below the level recommended by WHO and National Infant and Young Childfeeding practices (IYCF). Interventions from the Somali government regarding policies, guidelines and protocols are highly needed.