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Roczniki Panstwowego Zakladu Higieny 2017Exclusive breastfeeding is the gold standard in infant nutrition. The maternal decision to breastfeed is affected by various factors, including breastfeeding knowledge.
BACKGROUND
Exclusive breastfeeding is the gold standard in infant nutrition. The maternal decision to breastfeed is affected by various factors, including breastfeeding knowledge.
OBJECTIVE
The purpose of this study was the assessment of the breastfeeding knowledge in selected group of mothers of infants under 7 months and its relationship to the exclusivity of breastfeeding.
MATERIAL AND METHODS
The study was carried out using the CAWI method from Dec 2014 till Feb 2015 among 446 mothers (aged 18-42) of infants under 7 months. The most of women lived in towns >100.000 inhabitants, had an university education and normal pre-pregnancy BMI. Breastfeeding knowledge was estimated using 15 questions (both 6 in general and child-related category and 3 in mother-related category). Results were analysed using multivariate logistic analysis and Chi2 and U-Mann Whitney tests.
RESULTS
57% (group A) of women exclusively breastfeed their infants and 43% (group B) did not. Average mean breastfeeding knowledge test score was 11.9±3.4 points. Higher mean was observed in group A compared with group B (12.9±2.8 vs. 10.6±3.7 points; p≤0.001). Predictors of lower score (<11 points) were professional education, overweight and living in the rural area. Each correct answer to questions in general (OR1.93; 95%CI 1.57-2.37) or in child-related (OR1.33; 95%CI 1.10-1.63) category improved the chance of exclusive breastfeeding. Women from group A had a better score in every question.
CONCLUSIONS
Breastfeeding education for mothers may improve breastfeeding rates.
Topics: Adult; Breast Feeding; Female; Health Knowledge, Attitudes, Practice; Humans; Infant, Newborn; Mother-Child Relations; Mothers; Object Attachment; Postpartum Period; Young Adult
PubMed: 28303701
DOI: No ID Found -
Journal of Obstetric, Gynecologic, and... Jul 2022To determine what is known about postpartum education provided by nurses to women before discharge from the hospital after birth and whether current nursing practices... (Review)
Review
OBJECTIVE
To determine what is known about postpartum education provided by nurses to women before discharge from the hospital after birth and whether current nursing practices are effective to prepare women to identify warning signs of complications, perform self-care (physical and emotional), prepare for parenting a newborn, and establish infant feeding.
DATA SOURCES
We conducted a systematic search of CINAHL Plus and MEDLINE for relevant sources, including peer-reviewed articles, conference presentations, and guidelines from professional organizations, that were published in English from January 2010 through November 30, 2020.
STUDY SELECTION
We included sources if participants were women who had given birth to a healthy, liveborn, term infant and were receiving education in whole or in part by a nurse during the maternity hospitalization. We excluded sources with samples of high-risk women or those who gave birth to high-risk infants (preterm, congenital anomalies, neonatal abstinence syndrome). Forty-six of the sources met the inclusion criteria.
DATA EXTRACTION
We extracted citation, type of document, country of origin, context (prenatal/postpartum or both and inpatient/outpatient or both), aim, participants (mother/father or both, sample characteristics), content of education and who provided it, outcomes or key themes, and main results.
DATA SYNTHESIS
Infant topics included breastfeeding and safe sleep, and maternal topics included breastfeeding, postpartum mood, and self-care after birth. Nurses prioritized safety, including safe sleep; preventing infant falls; decreasing infection; screening for postpartum depression; and avoiding adverse outcomes after discharge. Women focused on self-care, pain management, infant care, and parenting. Women and nurses prioritized breastfeeding. Authors of the included sources measured effectiveness by patient satisfaction, chart audit, pre- and posttests of nurses' knowledge, and breastfeeding duration. Women reported barriers to postpartum education such as limited nursing time or conflicting information.
CONCLUSION
Postpartum education is a priority, but its effectiveness is not well studied. Few maternal or infant health-centered outcomes have been measured beyond breastfeeding duration. Nursing care and nurse expertise are not easily quantified or measured. Research is needed to inform best practices for postpartum education.
Topics: Breast Feeding; Clinical Competence; Female; Humans; Infant; Infant, Newborn; Male; Mothers; Nurses; Patient Discharge; Postpartum Period; Pregnancy
PubMed: 35483423
DOI: 10.1016/j.jogn.2022.03.002 -
Canadian Journal of Public Health =... May 2014To explore the reasons why women stop breastfeeding completely before their infants are six months of age and to identify the factors associated with cessation and the...
OBJECTIVES
To explore the reasons why women stop breastfeeding completely before their infants are six months of age and to identify the factors associated with cessation and the timing of cessation.
METHODS
For all singleton live newborns born between January 1, 2008 and December 31, 2009 in two district health authorities in Nova Scotia, Canada, mother's self-reported breastfeeding status was collected at hospital discharge and at five follow-up visits until infants were six months of age. Mothers who stopped breastfeeding before six months were also questioned about the time of weaning and the reason they discontinued all breastfeeding. Eleven categories were created from the open-ended responses women provided. These data were linked with the Nova Scotia Atlee Perinatal Database in order to obtain information on maternal and neonatal characteristics. The relationship between maternal, obstetrical, and neonatal characteristics and each reason for stopping breastfeeding completely were examined.
RESULTS
Of the 500 mothers who stopped breastfeeding completely before six months and provided a reason for discontinuing, the majority (73.6%) stopped within the first six weeks. The most common reasons cited were inconvenience or fatigue associated with breastfeeding (22.6%) and concerns about milk supply (21.6%). Return to work or school was associated with length of time that infants were breastfed: 20% of women who stopped after six weeks citing this as the reason. Most of the reasons, however, were not found to be associated with a specific duration of breastfeeding or with the examined maternal and infant characteristics.
CONCLUSION
This study highlights factors associated with the reasons why women stop breastfeeding completely before six months and how these reasons varied with weaning age. The results will help inform future research aimed at identifying interventions to reduce early breastfeeding cessation.
Topics: Adult; Breast Feeding; Choice Behavior; Fatigue; Female; Humans; Infant; Infant, Newborn; Lactation; Mothers; Nova Scotia; Return to Work; Schools; Time Factors; Weaning; Young Adult
PubMed: 25165836
DOI: 10.17269/cjph.105.4244 -
The Cochrane Database of Systematic... Oct 2022There is extensive evidence of important health risks for infants and mothers related to not breastfeeding. In 2003, the World Health Organization recommended that... (Review)
Review
BACKGROUND
There is extensive evidence of important health risks for infants and mothers related to not breastfeeding. In 2003, the World Health Organization recommended that infants be breastfed exclusively until six months of age, with breastfeeding continuing as an important part of the infant's diet until at least two years of age. However, current breastfeeding rates in many countries do not reflect this recommendation.
OBJECTIVES
1. To describe types of breastfeeding support for healthy breastfeeding mothers with healthy term babies. 2. To examine the effectiveness of different types of breastfeeding support interventions in terms of whether they offered only breastfeeding support or breastfeeding support in combination with a wider maternal and child health intervention ('breastfeeding plus' support). 3. To examine the effectiveness of the following intervention characteristics on breastfeeding support: a. type of support (e.g. face-to-face, telephone, digital technologies, group or individual support, proactive or reactive); b. intensity of support (i.e. number of postnatal contacts); c. person delivering the intervention (e.g. healthcare professional, lay person); d. to examine whether the impact of support varied between high- and low-and middle-income countries.
SEARCH METHODS
We searched Cochrane Pregnancy and Childbirth's Trials Register (which includes results of searches of CENTRAL, MEDLINE, Embase, CINAHL, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform (ICTRP)) (11 May 2021) and reference lists of retrieved studies.
SELECTION CRITERIA
Randomised or quasi-randomised controlled trials comparing extra support for healthy breastfeeding mothers of healthy term babies with usual maternity care. Support could be provided face-to-face, over the phone or via digital technologies. All studies had to meet the trustworthiness criteria. DATA COLLECTION AND ANALYSIS: We used standard Cochrane Pregnancy and Childbirth methods. Two review authors independently selected trials, extracted data, and assessed risk of bias and study trustworthiness. The certainty of the evidence was assessed using the GRADE approach.
MAIN RESULTS
This updated review includes 116 trials of which 103 contribute data to the analyses. In total more than 98,816 mother-infant pairs were included. Moderate-certainty evidence indicated that 'breastfeeding only' support probably reduced the number of women stopping breastfeeding for all primary outcomes: stopping any breastfeeding at six months (Risk Ratio (RR) 0.93, 95% Confidence Interval (CI) 0.89 to 0.97); stopping exclusive breastfeeding at six months (RR 0.90, 95% CI 0.88 to 0.93); stopping any breastfeeding at 4-6 weeks (RR 0.88, 95% CI 0.79 to 0.97); and stopping exclusive breastfeeding at 4-6 (RR 0.83 95% CI 0.76 to 0.90). Similar findings were reported for the secondary breastfeeding outcomes except for any breastfeeding at two months and 12 months when the evidence was uncertain if 'breastfeeding only' support helped reduce the number of women stopping breastfeeding. The evidence for 'breastfeeding plus' was less consistent. For primary outcomes there was some evidence that 'breastfeeding plus' support probably reduced the number of women stopping any breastfeeding (RR 0.94, 95% CI 0.91 to 0.97, moderate-certainty evidence) or exclusive breastfeeding at six months (RR 0.79, 95% CI 0.70 to 0.90). 'Breastfeeding plus' interventions may have a beneficial effect on reducing the number of women stopping exclusive breastfeeding at 4-6 weeks, but the evidence is very uncertain (RR 0.73, 95% CI 0.57 to 0.95). The evidence suggests that 'breastfeeding plus' support probably results in little to no difference in the number of women stopping any breastfeeding at 4-6 weeks (RR 0.94, 95% CI 0.82 to 1.08, moderate-certainty evidence). For the secondary outcomes, it was uncertain if 'breastfeeding plus' support helped reduce the number of women stopping any or exclusive breastfeeding at any time points. There were no consistent findings emerging from the narrative synthesis of the non-breastfeeding outcomes (maternal satisfaction with care, maternal satisfaction with feeding method, infant morbidity, and maternal mental health), except for a possible reduction of diarrhoea in intervention infants. We considered the overall risk of bias of trials included in the review was mixed. Blinding of participants and personnel is not feasible in such interventions and as studies utilised self-report breastfeeding data, there is also a risk of bias in outcome assessment. We conducted meta-regression to explore substantial heterogeneity for the primary outcomes using the following categories: person providing care; mode of delivery; intensity of support; and income status of country. It is possible that moderate levels (defined as 4-8 visits) of 'breastfeeding only' support may be associated with a more beneficial effect on exclusive breastfeeding at 4-6 weeks and six months. 'Breastfeeding only' support may also be more effective in reducing women in low- and middle-income countries (LMICs) stopping exclusive breastfeeding at six months compared to women in high-income countries (HICs). However, no other differential effects were found and thus heterogeneity remains largely unexplained. The meta-regression suggested that there were no differential effects regarding person providing support or mode of delivery, however, power was limited. AUTHORS' CONCLUSIONS: When 'breastfeeding only' support is offered to women, the duration and in particular, the exclusivity of breastfeeding is likely to be increased. Support may also be more effective in reducing the number of women stopping breastfeeding at three to four months compared to later time points. For 'breastfeeding plus' interventions the evidence is less certain. Support may be offered either by professional or lay/peer supporters, or a combination of both. Support can also be offered face-to-face, via telephone or digital technologies, or a combination and may be more effective when delivered on a schedule of four to eight visits. Further work is needed to identify components of the effective interventions and to deliver interventions on a larger scale.
Topics: Infant; Child; Female; Pregnancy; Humans; Child, Preschool; Maternal Health Services; Breast Feeding; Mothers; Diet; Telephone
PubMed: 36282618
DOI: 10.1002/14651858.CD001141.pub6 -
International Breastfeeding Journal Aug 2020Exclusive breastfeeding (EBF) is recommended for the first six months of age by the World Health Organization. Mothers' good knowledge and positive attitude play key... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Exclusive breastfeeding (EBF) is recommended for the first six months of age by the World Health Organization. Mothers' good knowledge and positive attitude play key roles in the process of exclusive breastfeeding practices. In this study, we report on a systematic review of the literature that aimed to examine the status of mothers' knowledge, attitude, and practices related to exclusive breastfeeding in East Africa, so as to provide clues on what can be done to improve exclusive breastfeeding.
METHODS
A systematic review of peer-reviewed literature was performed. The search for literature was conducted utilizing six electronic databases, Pub med, Web of Science, Google Scholar, Embase, Science Direct, and Cochrane library, for studies published in English from January 2000 to June 2019 and conducted in East Africa. Studies focused on mothers' knowledge, attitudes, or practices related to exclusive breastfeeding. All papers were reviewed using a predesigned data extraction form.
RESULTS
Sixteen studies were included in the review. This review indicates that almost 96.2% of mothers had ever heard about EBF, 84.4% were aware of EBF, and 49.2% knew that the duration of EBF was the first six months only. In addition, 42.1% of mothers disagreed and 24.0% strongly disagreed that giving breast milk for a newborn immediately and within an hour is important, and 47.9% disagreed that discarding the colostrum is important. However, 42.0% of mothers preferred to feed their babies for the first six months breast milk alone. In contrast, 55.9% of them had practiced exclusive breastfeeding for at least six months.
CONCLUSIONS
Exclusively breastfeeding among our sample is suboptimal, compared to the current WHO recommendations. Thus, it is important to provide antenatal and early postpartum education and periodical breastfeeding counseling, to improve maternal attitudes and knowledge toward breastfeeding practices.
Topics: Adult; Africa, Eastern; Breast Feeding; Female; Health Knowledge, Attitudes, Practice; Humans; Mothers; Pregnancy; Young Adult
PubMed: 32795377
DOI: 10.1186/s13006-020-00313-9 -
BMC Pregnancy and Childbirth May 2020Mothers' reports about pregnancy, maternity and their experiences during the perinatal period have been associated with infants' later quality of attachment and...
BACKGROUND
Mothers' reports about pregnancy, maternity and their experiences during the perinatal period have been associated with infants' later quality of attachment and development. Yet, there has been little research with mothers of very preterm newborns. This study aimed to explore mothers' experiences related to pregnancy, premature birth, relationship with the newborn, and future perspectives, and to compare them in the context of distinct infants' at-birth-risk conditions.
METHODS
A semi-structured interview was conducted with women after birth, within the first 72 h of the newborn's life. A total of 150 women participated and were divided in three groups: (1) 50 mothers of full-term newborns (Gestational Age (GA) ≥ 37 weeks; FT), (2) 50 mothers of preterm newborns (GA 32-36 weeks; PT) and (3) 50 mothers of very preterm newborns (GA < 32 weeks; VPT).
RESULTS
Mothers of full-term infants responded more often that their children were calm and that they did not expect difficulties in taking care of and providing for the baby. Mothers of preterm newborns although having planned and accepted well the pregnancy (with no mixed or ambivalent feelings about it) and while being optimistic about their competence to take care of the baby, mentioned feeling frightened because of the unexpected occurrence of a premature birth and its associated risks. Mothers of very preterm newborns reported more negative and distressful feelings while showing more difficulties in anticipating the experience of caring for their babies.
CONCLUSION
The results indicate that Health Care Systems and Neonatal Care Policy should provide differentiated psychological support and responses to mothers, babies and families, taking into account the newborns' GA and neonatal risk factors.
Topics: Adult; Female; Gestational Age; Humans; Infant, Extremely Premature; Infant, Newborn; Intensive Care Units, Neonatal; Male; Mother-Child Relations; Mothers; Parturition; Pregnancy; Premature Birth
PubMed: 32375667
DOI: 10.1186/s12884-020-02934-8 -
Journal of Affective Disorders Apr 2022Maternal childhood maltreatment (MCM) is linked to poor perinatal outcomes but the evidence base lacks cohesion. We explore the impact of MCM on four perinatal outcome... (Review)
Review
BACKGROUND
Maternal childhood maltreatment (MCM) is linked to poor perinatal outcomes but the evidence base lacks cohesion. We explore the impact of MCM on four perinatal outcome domains: pregnancy and obstetric; maternal mental health; infant; and the quality of the care-giving environment. Mechanisms identified in the included studies are discussed in relation to the maternal programming hypothesis and directions for future research.
METHOD
We completed a comprehensive literature search of eight electronic databases. Independent quality assessments were conducted and PRISMA protocols applied to data extraction.
RESULTS
Inclusion criteria was met by N = 49 studies. MCM was consistently associated with difficulties in maternal and infant emotional regulation and with disturbances in the mother-infant relationship. Directly observed and maternal-reported difficulties in the mother-infant relationship were often mediated by mothers' current symptoms of psychopathology. Direct and mediated associations between MCM and adverse pregnancy and obstetric outcomes were suggested by a limited number of studies. Emotional and sexual abuse were the most consistent MCM subtype significantly associated with adverse perinatal outcomes.
LIMITATIONS
A meta-analysis was not possible due to inconsistent reporting and the generally small number of studies for most perinatal outcomes.
CONCLUSIONS
MCM is associated with adverse perinatal outcomes for mothers' and infants. Evidence suggests these associations are mediated by disruptions to maternal emotional functioning. Future research should explore biological and psychosocial mechanisms underpinning observed associations between specific subtypes of MCM and adverse perinatal outcomes. Services have a unique opportunity to screen for MCM and detect women and infants at risk of adverse outcomes during the perinatal period.
Topics: Child; Child Abuse; Female; Humans; Infant; Mothers; Parturition; Pregnancy
PubMed: 35041871
DOI: 10.1016/j.jad.2022.01.062 -
Journal of Adolescence Aug 2022Maternal characteristics and mother-adolescent relationships are thought to affect the emotional development of adolescents. Adolescents can learn to regulate their...
INTRODUCTION
Maternal characteristics and mother-adolescent relationships are thought to affect the emotional development of adolescents. Adolescents can learn to regulate their emotions by observing their mothers, and this is further facilitated by maternal autonomy support. Therefore, this study longitudinally examined the associations among maternal emotion dysregulation, maternal autonomy support, and adolescent emotion dysregulation.
METHOD
Participants were 466 Dutch adolescents (54.51% males; M = 14.03, SD = 0.45) and 462 mothers (M = 45.49, SD = 4.47), who completed self-reports of emotion dysregulation and maternal autonomy support for five consecutive years.
RESULTS
Random Intercept-Cross Lagged Panel Model analyses showed that at the between-family level, maternal emotion dysregulation was correlated with adolescent emotion dysregulation, adolescent-reported maternal autonomy support, and mother-reported maternal autonomy support; and adolescent emotion dysregulation was correlated with adolescent-reported maternal autonomy support. At the within-family level, higher than usual maternal emotion dysregulation was positively related to adolescent emotion dysregulation at Time 1, yet, was negatively related to adolescent emotion dysregulation at other time points concurrently, and predicted lower adolescent emotion dysregulation in the next year. Also, higher than usual adolescent emotion dysregulation was related to lower adolescent-reported maternal autonomy support both concurrently and the next year.
CONCLUSIONS
Both mothers and adolescents played an important role in adolescent emotional development. To promote adolescent emotional development, it is important to target both maternal emotion dysregulation to understand the development of adolescent emotion dysregulation, and adolescent emotion dysregulation to prevent mothers from providing less autonomy support to their adolescents.
Topics: Adolescent; Adolescent Behavior; Emotions; Female; Humans; Male; Middle Aged; Mother-Child Relations; Mothers
PubMed: 35754358
DOI: 10.1002/jad.12065 -
Reproductive Health Jun 2019Recently WHO researchers described seven dimensions of mistreatment in maternity care that have adverse impacts on quality and safety. Applying the WHO framework for...
BACKGROUND
Recently WHO researchers described seven dimensions of mistreatment in maternity care that have adverse impacts on quality and safety. Applying the WHO framework for quality care, service users partnered with NGOs, clinicians, and researchers, to design and conduct the Giving Voice to Mothers (GVtM)-US study.
METHODS
Our multi-stakeholder team distributed an online cross-sectional survey to capture lived experiences of maternity care in diverse populations. Patient-designed items included indicators of verbal and physical abuse, autonomy, discrimination, failure to meet professional standards of care, poor rapport with providers, and poor conditions in the health system. We quantified the prevalence of mistreatment by race, socio-demographics, mode of birth, place of birth, and context of care, and describe the intersectional relationships between these variables.
RESULTS
Of eligible participants (n = 2700), 2138 completed all sections of the survey. One in six women (17.3%) reported experiencing one or more types of mistreatment such as: loss of autonomy; being shouted at, scolded, or threatened; and being ignored, refused, or receiving no response to requests for help. Context of care (e.g. mode of birth; transfer; difference of opinion) correlated with increased reports of mistreatment. Experiences of mistreatment differed significantly by place of birth: 5.1% of women who gave birth at home versus 28.1% of women who gave birth at the hospital. Factors associated with a lower likelihood of mistreatment included having a vaginal birth, a community birth, a midwife, and being white, multiparous, and older than 30 years. Rates of mistreatment for women of colour were consistently higher even when examining interactions between race and other maternal characteristics. For example, 27.2% of women of colour with low SES reported any mistreatment versus 18.7% of white women with low SES. Regardless of maternal race, having a partner who was Black also increased reported mistreatment.
CONCLUSION
This is the first study to use indicators developed by service users to describe mistreatment in childbirth in the US. Our findings suggest that mistreatment is experienced more frequently by women of colour, when birth occurs in hospitals, and among those with social, economic or health challenges. Mistreatment is exacerbated by unexpected obstetric interventions, and by patient-provider disagreements.
Topics: Adult; Attitude of Health Personnel; Cross-Sectional Studies; Female; Health Facilities; Health Personnel; Health Services Accessibility; Humans; Maternal Health Services; Mothers; Parturition; Physical Abuse; Pregnancy; Quality of Health Care; Social Stigma; United States
PubMed: 31182118
DOI: 10.1186/s12978-019-0729-2 -
Philosophical Transactions of the Royal... Jun 2021It has long been acknowledged that women with children require social support to promote their health and wellbeing, as well as that of their children. However, the...
It has long been acknowledged that women with children require social support to promote their health and wellbeing, as well as that of their children. However, the dominant conceptualizations of support have been heavily influenced by Western family norms. The consequence, at best, has been to stifle our understanding of the nature and consequences of support for mothers and children. At worst, it has led to systematic discrimination negatively impacting maternal-child health. To fully engage with the complexities of social support, we must take multidisciplinary or interdisciplinary approaches spanning diverse cultural and geographical perspectives. However, multidisciplinary knowledge-processing can be challenging, and it is often unclear how different studies from different disciplines relate. To address this, we outline two epistemological frameworks-the scientific approach and Tinbergen's four questions-that can be useful tools in connecting research across disciplines. In this theme issue on 'Multidisciplinary perspectives on social support and maternal-child health', we attempt to foster multidisciplinary thinking by presenting work from a diverse range of disciplines, populations and cultures. Our hope is that these tools, along with papers in this issue, help to build a holistic understanding of social support and its consequences for mothers and their children. Overall, a multidisciplinary perspective points to how the responsibility of childrearing should not fall solely onto mothers. Indeed, this multidisciplinary issue demonstrates that successful childrearing is consistently an activity shared beyond the mother and the nuclear family: an insight that is crucial to harnessing the potential of social support to improve maternal-child health. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'.
Topics: Child Health; Humans; Maternal Health; Mothers; Social Support
PubMed: 33938274
DOI: 10.1098/rstb.2020.0019