Perspectives From a Career in Breastfeeding Research, Mentorship, and Advocacy: An Interview With Karen Wambach

1 év ago
Journal of Human Lactation, Ahead of Print.
Karen Wambach recently retired from a distinguished career in nursing education and breastfeeding research in the United States, practicing her craft during the formative years of the field of lactation consulting. Her research focused on the description of biopsychosocial influences on breastfeeding initiation and duration, as well as interventions for promoting and supporting breastfeeding among vulnerable childbearing populations, for example, adolescent mothers. Her research career trajectory mirrors the development of breastfeeding research more broadly. She began with descriptive studies and theory testing, which included the development of the Breastfeeding Experience Scale quantifying early breastfeeding problems. She then moved on to randomized clinical trials of breastfeeding education/support for adolescent mothers, and finished her funded research using a multi-behavioral, technology-based education and support intervention to promote breastfeeding, healthy lifestyle, and depression prevention in adolescent mothers. As researcher and educator in a clinical science area, she has supported evidence-based practice and translational science through her work as lead editor of many editions of the textbook Breastfeeding and Human Lactation. She is a consummate teacher, having mentored many upcoming researchers during her teaching career, and directed the undergraduate nursing honors program and PhD program at the University of Kansas School of Nursing in the United States. She also believes in serving her profession and has been an active member of American Academy of Nursing, the Midwest Nursing Research Society, the Association of Women’s Health, Obstetric, and the Neonatal Nursing and the International Lactation Consultant Association, including serving on JHL’s Editorial Review Board for many years. (This conversation was recorded on October 14, 2022 then transcribed and edited for readability. EC = Ellen Chetwynd; KW = Karen Wambach)
Karen Wambach

Milk Calcium and Phosphorus in Ugandan Women with HIV on Tenofovir-Based Antiretroviral Therapy

1 év 1 hónap ago
Journal of Human Lactation, Ahead of Print.
Background:Breastfed infants depend on human milk calcium and phosphorus for bone mineral accretion and growth. We reported greater mobilization of bone mineral and delayed skeletal recovery in lactating Ugandan women with HIV initiated on tenofovir-based antiretroviral therapy during pregnancy compared to HIV-uninfected counterparts in the Gumba Study. However, it is unknown if these disruptions in maternal bone metabolism affect milk mineral concentrations.Research Aim:To compare concentrations and patterns of change in milk calcium and phosphorus between lactating women with and without HIV.Methods:A longitudinal observational study was conducted to compare milk mineral concentrations between women with HIV receiving tenofovir-based ART and uninfected women in the Gumba Study. Milk collected at 2, 14, 26, and 52 weeks lactation was analyzed for calcium and phosphorus. Sodium and potassium were measured at 2 and 14 weeks to detect sub-clinical mastitis. Differences in milk composition between 84 women with HIV and 81 uninfected women were investigated.Results:Women with HIV had higher milk calcium than uninfected women at 14 weeks. The percent difference was +10.2% (SE = 3.0, p = .008) and there was a tendency to greater values at 2 and 26 weeks. Milk calcium decreased in both groups during lactation (p ≤ .001) but was more pronounced in women with HIV. The magnitude of change within individuals in the 1st year of lactation from 2 to 52 weeks was −28.3% (SE 3.9) versus −16.5% (SE 3.5), p for interaction = .05. Differences in milk phosphorus and calcium-to-phosphorus ratio were smaller and mostly not significant.Conclusions:Participants with HIV on tenofovir-based antiretroviral therapy had altered milk mineral composition. Studies are needed to investigate mechanisms and health implications for the woman and infant.
Florence Nabwire

The Current State of Breastfeeding in Ukraine: An Interview With Lidiia Romanenko and Olha Shlemkevych

1 év 2 hónap ago
Journal of Human Lactation, Ahead of Print.
In this issue, we are featuring an interview with two medical doctors from Ukraine, who are specialists in breastfeeding, and work with the implementation of the Baby-Friendly Hospital Initiative (BFHI) in Ukraine. The authors met during the Eleventh BFHI Network Meeting of Country Coordinators from Industrialized Countries, Eastern Europe, and the Commonwealth of Independent States, in Brussels in June 2022 (Hernández-Aguilar, M. T., 2022). Ukrainian citizens have lived in a war situation since February 24, 2022, when Russia first attacked; this has had a huge impact on infant feeding issues.
Lidiia Romanenko

“Don’t Feel Like You Have to Do This All on Your Own”: Exploring Perceived Partner Support of Breastfeeding Among Black Women in Kentucky

1 év 3 hónap ago
Journal of Human Lactation, Ahead of Print.
Background:Few researchers have explored partner breastfeeding support among Black women, who report low breastfeeding rates compared to women of other cultural groups. Ways to encourage partner support of Black women’s breastfeeding can be understood from an Afrocentric perspective.Research Aim:To explore perceptions of partner support among Black mothers to develop a culturally relevant framework of partner breastfeeding support.Methods:Secondary data analyses of qualitative data from a larger prospective, cross-sectional mixed methods study were utilized. Participants from Kentucky (N = 14), aged 23–71, who breastfed for at least 6 months, were recruited to participate in individual interviews. Professionally transcribed interviews were analyzed using Braun and Clarke’s (2006) thematic analysis.Results:By integrating the Breastfeeding Coparenting Framework and Optimal Conceptual Theory, we identified four culturally affirming partner support themes that participants believed impacted their breastfeeding experiences: (a) doing research, (b) offering care, (c) verbalizing praise, and (d) achieving teamwork, and three culturally incongruent partner support barrier themes: (e) withdrawing commitment, (f) politicking bodies, and (g) stripping agency.Conclusion:Participants who breastfed for at least 6 months largely attributed their breastfeeding success to the support received from their partners. Our findings offer a culturally relevant framework of partner breastfeeding support that can facilitate intervention efforts with participants and their partners to increase breastfeeding rates among this population.
Jardin Dogan

Comparison of Lanolin and Human Milk Treatment of Painful and Damaged Nipples: A Randomized Control Trial

1 év 4 hónap ago
Journal of Human Lactation, Ahead of Print.
Background:Painful and damaged nipples are frequently associated with breastfeeding cessation in the early postpartum period. The results of researchers’ studies utilizing different treatments have been inconclusive.Research Aim:To compare the intensity of nipple pain and the healing of damaged nipples during the first 10 days postpartum using either lanolin or human milk treatments.Methods:This single-blind randomized controlled trial included participants (N = 206) who were primiparous with painful and damaged nipples. Participants were recruited from the tertiary teaching hospital within the first 72 hr after delivery and randomized to the intervention group with lanolin (n = 103) and a human milk control group (n = 103). Data were collected in the maternity ward, 3 and 7 days after randomization. The primary outcome was nipple pain intensity and quality measured 3 and 7 days after randomization by the McGill Pain Questionnaire – short form. The nipple damage self-assessment questionnaire was used for the assessment of nipple healing. Breastfeeding self-efficacy, breastfeeding duration, and exclusivity were assessed as secondary outcomes.Results:Participants in both groups reported a statistically nonsignificant reduction in pain (quality and intensity of pain) as well as improved nipple healing 7 days after randomization. Participants in the lanolin group exclusively breastfed their infants 3 days after randomization—significantly more often than participants in the control group (p = .026). The study did not reveal any statistically significant differences for other secondary outcomes.Conclusion:Both lanolin and human milk are equally effective in treating painful and damaged nipples.Registered with Clinicaltrials.gov (NCT04153513)
Olivera Perić

Ellenőrizve

23 óra 36 perc ago
Table of Contents for Journal of Human Lactation. List of articles from ahead of print issues.
SubscribeFeliratkozás a következőre: Journal of Human Lactation - online first articles hírcsatorna