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International Journal of Nursing... Dec 2022The Baby-Friendly Hospital Initiative aims to improve breastfeeding by implementing the Ten Steps to Successful Breastfeeding (Ten Steps) into routine breastfeeding... (Review)
Review
BACKGROUND
The Baby-Friendly Hospital Initiative aims to improve breastfeeding by implementing the Ten Steps to Successful Breastfeeding (Ten Steps) into routine breastfeeding support in birth hospitals. Maternal perspective to breastfeeding support is important to consider as mothers and their infants are in the center of that support.
OBJECTIVES
To review and synthesize the existing literature on maternal perceptions and experiences of breastfeeding support in Baby-Friendly hospitals. A sub-aim was to describe differences in breastfeeding support between Baby-Friendly hospitals and non-Baby-Friendly hospitals from maternal perspective.
DATA SOURCES AND REVIEW METHODS
An integrative literature review. A systematic literature search was conducted in October 2021 in five databases: PubMed, CINAHL, Cochrane, Scopus, Web of Science. Original peer-reviewed studies published in English exploring maternal viewpoints on breastfeeding support in Baby-Friendly hospitals were included. Two reviewers independently screened the titles (n=914), abstracts (n=226), and full texts (n=47). The review comprised of seventeen studies and includes both quantitative studies (n=14) and qualitative studies (n=3). Inductive content analysis and descriptive synthesis were conducted.
RESULTS
Most studies (n=14) measured hospitals' compliance with the Ten Steps practices from maternal perspective. Mothers were provided with breastfeeding information and encouragement, however, a qualitative finding indicated that information focused on positive aspects of breastfeeding. Early skin-to-skin contact between the mother and infant was well facilitated although often not lasting more than 30 min. Breastfeeding was facilitated by practical support but according to findings of two qualitative studies, support was not always adequate to address mothers' problems with breastfeeding. Most mothers were exclusively breastfeeding during the hospital stay and no supplemental milk was offered to infant. Mothers were roomed-in together with their infant and were mostly encouraged to breastfeed on demand. Differences between Baby-Friendly hospitals and non-Baby-Friendly hospitals were observed particularly for steps 6 and 9: supplementary feeding and pacifier use were less common in Baby-Friendly hospitals.
CONCLUSIONS
From the maternal perspective, breastfeeding support in the Baby-Friendly hospitals was mainly but not completely in adherence with the Ten Steps practices. Low compliance with some of the Ten Steps indicates a need for a more frequent assessment of the breastfeeding support practices and consideration of strategies facilitating a more sustainable implementation of the initiative. Regardless of some shortcomings with the breastfeeding support, mothers were mainly satisfied with the support in the hospital. Mothers in the Baby-Friendly hospitals perceived that breastfeeding support was more adherent to the Ten Steps compared to mothers in non-Baby-Friendly hospitals.
PubMed: 38745604
DOI: 10.1016/j.ijnsa.2022.100105 -
Clinical and Experimental Dental... Dec 2022Early childhood caries poses a significant health issue in children under 6 years old. It is determined that Streptococcus mutans is a primary etiological agent, likely...
Streptococcus mutans carriage in the saliva of mothers and its association with dental caries and Streptococcus mutans carriage in the saliva of children between 6 and 30 months old in a low-income setting in Karachi, Pakistan.
BACKGROUND
Early childhood caries poses a significant health issue in children under 6 years old. It is determined that Streptococcus mutans is a primary etiological agent, likely to be transferred through maternal contact.
OBJECTIVES
To determine the association of maternal S. mutans counts with S. mutans counts in their children between 6 and 30 months of age, and to determine the maternal and child DMFT (decayed, missing, and filled teeth) indices.
MATERIAL AND METHODS
A community-based cross-sectional study was conducted in Karachi, Pakistan. A sample of 193 dyads of mother-children (6-30 months of age) was selected via purposive sampling. Saliva samples of the dyads were collected to assess S. mutans count. Caries assessment was performed for both using the DMFT index. A pretested questionnaire was used. The association of bottle-feeding, oral hygiene measures, and other factors with S. mutans counts in children were also explored. Zero-inflated negative binomial regression model at a 5% level of significance was applied using STATA version 12.0.
RESULTS
Out of 193 children, 109 (56.47%) were males and 84 (43.52%) were females. The mean age of mothers and children was 29.4 ± 6.2 years and 19.54 ± 6.8 months, respectively. Maternal S. mutans counts were not statistically associated with child's S. mutans counts (Mean child's S. mutans count ratio: 1; 95% confidence interval [CI]: 1, 1.01; p = .882). Compared with children who were breastfed, S. mutans counts were higher in children who were bottle-fed (mean S. mutans count ratio= 4.85 [95% CI: 1.53, 15.41], p = .007). Age of mother and present caries status of mothers was significantly associated with the child's S. mutans count.
CONCLUSION
No association between maternal S. mutans and child S. mutans was observed. However, maternal age, children who were breastfed, children who did not use pacifiers, and children with mothers who did not have caries, exhibited low S. mutans counts in their saliva.
Topics: Male; Female; Humans; Child, Preschool; Young Adult; Adult; Infant; Streptococcus mutans; Saliva; Dental Caries; DMF Index; Mothers; Cross-Sectional Studies; Pakistan; Colony Count, Microbial
PubMed: 36177666
DOI: 10.1002/cre2.648 -
International Breastfeeding Journal Sep 2022Childbirth and lactation are intricate processes, involving several hormones, the most important of which are prolactin (a protein hormone) and cortisol (one of the...
BACKGROUND
Childbirth and lactation are intricate processes, involving several hormones, the most important of which are prolactin (a protein hormone) and cortisol (one of the glucocorticoids). The early postpartum period is crucial for both mother and newborn and has an impact on the lactation and breastfeeding process.
METHODS
The study included 78 patients who were admitted to the Gynecology-Obstetrics Clinical Hospital in Poznań for labor induction and/or in the active phase of the first labor stage. The levels of cortisol and prolactin in serum were assessed in these women during admission in labor, during the third labor stage, and on the second day postpartum. The levels of cortisol and prolactin in the umbilical cord serum were assessed immediately after cord clamping. The "Protocol for the assessment of breast-suckling skills" was used to assess the neonatal breast-suckling skills on the second day postpartum. Some additional parameters were evaluated in mothers via a telephone interview at three and six months postpartum. The study was conducted from January to August 2020, however the study was suspended during April-July 2020 due to the SARS-CoV-2 pandemic, which led to restrictions in the hospital limiting access to the hospital wards unless necessary.
RESULTS
Early breastfeeding with skin-to-skin contact was associated with low levels of hormones, cortisol levels were lower in serum (p = 0.0108) and umbilical vein (p = 0.0273) in mothers who breastfed immediately after childbirth. At three months postpartum, 88% of the mothers who did not offer a pacifier to the child during the first few days of life breastfed the child naturally (p = 0.037), and at six months, 96% of those who did not offer a pacifier continued to breastfeed (p = 0.0008). Multiple, statistically significant correlations were observed between the variables assessed according to the "Protocol for the assessment of breast-suckling skills" and breastfeeding after three months.
CONCLUSIONS
Breastfeeding immediately after childbirth, appropriate assessment of the breast-suckling skills of newborns, avoiding pacifiers and infant formula feeding, and offering support to new mothers in the early days after childbirth seem to be important factors for sustaining breastfeeding after three and six months of childbirth.
Topics: Breast Feeding; COVID-19; Child; Female; Humans; Hydrocortisone; Infant; Infant, Newborn; Lactation; Peripartum Period; Pilot Projects; Pregnancy; Prolactin; SARS-CoV-2
PubMed: 36050767
DOI: 10.1186/s13006-022-00508-2 -
Cureus Jun 2022is a facultative anaerobic gram-negative coccobacillus of the genus (the most common ones are serogroups and ). Its incubation period is typically 1-14 days. The...
is a facultative anaerobic gram-negative coccobacillus of the genus (the most common ones are serogroups and ). Its incubation period is typically 1-14 days. The symptoms of infection include fever, abdominal pain (which may mimic appendicitis), and diarrhea (which may be bloody and can persist for several weeks). It is most commonly reported in infants and children due to cross-contamination of their feeds and pacifiers by people handling pork products, especially while cooking chitterlings. Necrotizing enterocolitis has been described in infants following infections. Adults who are immunocompromised or in an iron-overload state can develop sepsis with infection, which has a high fatality rate. Post-infectious sequelae like reactive arthritis and erythema nodosum can occur in certain HLA types. The diagnosis is made by isolating the organism from the body fluids, stool. The gastrointestinal (GI) pathogen panel by polymerase chain reaction(PCR) is helpful in making an early diagnosis. In this report, we discuss a case of an elderly male from a nursing facility who presented with abdominal pain, vomiting, GI bleeding, and sepsis. He required a brief ICU stay and pressor support. GI pathogen panel was instrumental in the early diagnosis of . This condition is not often reported in the Northeastern US. Using GI pathogen PCR testing will lead to the detection of more cases of in geographical regions where it was not considered prevalent.
PubMed: 35928788
DOI: 10.7759/cureus.26431 -
European Journal of Pediatrics Sep 2022The purpose of this study is to assess whether pacifier use is associated with breastfeeding success in term and preterm newborns and whether it influences... (Meta-Analysis)
Meta-Analysis
The purpose of this study is to assess whether pacifier use is associated with breastfeeding success in term and preterm newborns and whether it influences hospitalization time in preterm newborns. Four databases were searched for randomized controlled trials (RCTs), and a systematic review and meta-analysis were conducted. The risk of bias and evidence quality, according to the GRADE methodology, were analyzed. Risk ratios with 95% confidence intervals (CI) for dichotomous outcomes and mean difference (MD) for continuous outcomes were used. The random effect model was used if heterogeneity was high (I over 40%). We screened 772 abstracts, assessed 44 full texts, and included 10 studies, of which 5 focused on term and 5 on preterm newborns. There were a few concerns about the risk of bias in 9 of the 10 studies. Breastfeeding rates were analyzed at 2, 3, 4, and 6 months, and the success rates were similar between the restricted and free pacifier use groups (evidence quality was moderate to high). In preterm neonates, the use of a pacifier shortened the duration of hospitalization by 7 days (MD 7.23, CI 3.98-10.48) and the time from gavage to total oral feeding by more than 3 days (MD 3.21 days, CI 1.19-5.24) (evidence quality was ranked as moderate). Conclusions: Based on our meta-analysis, pacifier use should not be restricted in term newborns, as it is not associated with lower breastfeeding success rates. Furthermore, introducing pacifiers to preterm newborns should be considered, as it seems to shorten the time to discharge as well as the transition time from gavage to total oral feeding. What is Known: • Observational studies show that infants who use a pacifier are weaned from breastfeeding earlier. • Previous randomized studies have not presented such results, and there have been no differences in the successful breastfeeding rates regardless of the use of pacifier. What is New: • Term and preterm newborns do not have worse breastfeeding outcomes if a pacifier is introduced to them, and additionally preterm newborns have shorter hospitalization times. • The decision to offer a pacifier should depend on the caregivers instead of hospital policy or staff recommendation, as there is no evidence to support the prohibition or restriction.
Topics: Breast Feeding; Enteral Nutrition; Female; Hospitals; Humans; Infant; Infant, Newborn; Pacifiers; Patient Discharge
PubMed: 35834044
DOI: 10.1007/s00431-022-04559-9 -
Revista Paulista de Pediatria : Orgao... 2022To analyze if milk and complementary foods are being sold under the Brazilian Code of Marketing of Infant and Toddler's Food, Teats, Pacifiers and Baby Bottles (NBCAL),...
OBJECTIVE
To analyze if milk and complementary foods are being sold under the Brazilian Code of Marketing of Infant and Toddler's Food, Teats, Pacifiers and Baby Bottles (NBCAL), Law 11265/2006 of breastfeeding protection.
METHODS
Epidemiological survey that analyzed the marketing practices of pharmacies, supermarkets, and department stores in the Southern region of the city of Rio de Janeiro, Brazil, by direct observation.
RESULTS
Among the 349 stores in Rio de Janeiro's South Region, 339 traded milk and complementary foods and, among them, 60.8% were not complying with NBCAL. Infractions to NBCAL were more common for the selling of milk (58.6%) than complementary foods (22.8%). The most recurrent promotion strategy infringing NBCAL was discount pricing without the Ministry of Health disclaimer.
CONCLUSIONS
Most retail stores infringe NBCAL in the commercialization of milk and complementary foods in the city of Rio de Janeiro, Brazil, a violation of the right to information that may impact mothers' choice regarding their child's feeding.
Topics: Animals; Brazil; Breast Feeding; Female; Humans; Infant; Infant Food; Marketing; Milk
PubMed: 35830162
DOI: 10.1590/1984-0462/2023/41/2021228 -
Turkish Archives of Pediatrics May 2022Breastfeeding is the principal feeding source in the first years of life. Its targeted rates are not achieved properly, globally. Multifactorial reasons have been...
OBJECTIVE
Breastfeeding is the principal feeding source in the first years of life. Its targeted rates are not achieved properly, globally. Multifactorial reasons have been reported, but the effect of the facilities in the hospitals including lactation consultation clinics have rarely been discussed. The aim of this study was to assess the effects of breastfeeding education in a first officially organized clinic. This may further help authorities make any necessary interferences and improve public health strategies.
MATERIALS AND METHODS
A cross-sectional, interventional study was performed in 100 mothers who were given breastfeeding education and was compared with 100 mothers without education. All of the mothers were interviewed to assess breastfeeding attitudes after 6 months.
RESULTS
The study group demonstrated higher exclusive breastfeeding rates than controls (76% and 28%, respectively). Having an education was the most significant factor affecting exclusive breastfeeding duration (P < .05). Complementary feeding, bottles, and pacifiers were introduced significantly earlier in the control group (P < .05) There was a negative association between breastfeeding duration and both bottle and pacifier use (P < .05).
CONCLUSION
Lactation consultation at a breastfeeding clinic improved the breastfeeding rate. Extending this project to maternity and children's hospitals will help to achieve the desired national targets in exclusive breastfeeding.
PubMed: 35781231
DOI: 10.5152/TurkArchPediatr.2022.21250 -
The Angle Orthodontist Jun 2022To evaluate the association between malocclusion characteristics in the mixed dentition stage, breastfeeding, and past nonnutritive sucking habits in school-age children.
OBJECTIVES
To evaluate the association between malocclusion characteristics in the mixed dentition stage, breastfeeding, and past nonnutritive sucking habits in school-age children.
MATERIALS AND METHODS
A total of 547 school children in the mixed dentition, in the age range between 7 and 13 years, were evaluated by means of questionnaire and clinical examination. Binomial and multinomial logistic regression models were used to evaluate the associations between breastfeeding and finger and pacifier sucking habits, the malocclusion characteristics of posterior crossbite, and excessive or deficient overjet and overbite.
RESULTS
Individuals who had nonnutritive sucking habits had 2.16 times greater chance of having anterior open bite (odds ratio [OR] 2.16; 95% confidence interval [CI], 1.07-4.33) and 2.39 times greater chance of having posterior crossbite (OR 2.39; 95% CI, 1.56-5.49). Children who were exclusively breastfed up to at least 6 months of age had a higher frequency of normality for overjet and overbite and the lowest posterior crossbite index. However, in adjusted analysis, breastfeeding showed no association with malocclusion characteristics in the mixed dentition stage.
CONCLUSIONS
Breastfeeding was not associated with the presence of malocclusion in the mixed dentition, whereas past nonnutritive sucking habits were associated with the occurrence of malocclusion.
PubMed: 35759270
DOI: 10.2319/111821-848.1 -
JPMA. the Journal of the Pakistan... Jun 2022To determine the frequency of malocclusion features, convex facial profile and non-nutritive sucking habits among children with and without early weaning.
OBJECTIVE
To determine the frequency of malocclusion features, convex facial profile and non-nutritive sucking habits among children with and without early weaning.
METHODS
The cross-sectional study was conducted at the National Institute of Child Health, Karachi, from June to December 2020, and comprised of either gender aged 3-6 years. The subjects were clinically examined, and details of lactation period, bottle feeding, thumb and pacifiers sucking were gathered from the parents to assess association with malocclusion. Data was analysed using SPSS 20.
RESULTS
Of the 180 subjects, 100(55.5%) were boys and 80(45.5%) were girls. There was significant association of early weaning with non-nutritive sucking habits, absent primate spaces, deviated midlines, and complete overbite (p<0.05). Breastfeeding <2 years was significantly associated with anterior crossbite (p<0.05). Early weaning had no association with convex facial profile, distoclusion, anterior and posterior crossbite and increased overjet (p>0.05). Non-nutritive sucking habits had significant relationship with deviated dental midlines (p>0.05).
CONCLUSION
Early weaning was found to be a factor in establishing non-nutritive sucking habits, and was strongly associated with crowding, disturbed vertical overlapping of incisors and developing decreased facial height. Breastfeeding for less than the recommended duration had a tendency to lead to anterior cross-bite.
Topics: Breast Feeding; Cross-Sectional Studies; Female; Fingersucking; Habits; Humans; Male; Malocclusion; Pacifiers; Weaning
PubMed: 35751320
DOI: 10.47391/JPMA.3249 -
Children (Basel, Switzerland) May 2022This retrospective case-control study is the first to examine the spatial conformity between pacifiers and palates in 39 preterm infants (12 females, 27 males) and 34...
This retrospective case-control study is the first to examine the spatial conformity between pacifiers and palates in 39 preterm infants (12 females, 27 males) and 34 term infants (19 females, 15 males), taking into account the facial-soft-tissue profile and thickness. The shape of 74 available pacifiers was spatially matched to the palate, and conformity was examined using width, height, and length measurements. In summary, the size concept of pacifiers is highly variable and does not follow a growth pattern, like infant palates do. Pacifiers are too undersized in width, length, and height to physiologically fit the palate structures from 0 to 14 months of age. There are two exceptions, but only for premature palates: the palatal depth index at 9−11 months of age, which has no clinical meaning, and the nipple length at <37 weeks of age, which bears a resemblance to the maternal nipple during non-nutritive sucking. It can be concluded that the age-size concept of the studied pacifiers does not correspond to any natural growth pattern. Physiologically aligned, pacifiers do not achieve the age-specific dimensions of the palate. The effects attributed to the products on oral health in term infants cannot be supposed.
PubMed: 35740710
DOI: 10.3390/children9060773