The Support Needs and Current Practices of Public Health Nurses in the Republic of Ireland Who Provide Support to Breastfeeding Mothers: A Cross-Sectional Survey

6 nap 14 óra ago
Journal of Human Lactation, Ahead of Print.
Background:Breastfeeding continuation rates are low in Ireland. The Breastfeeding Observation and Assessment Tool (BOAT) was developed to assist public health nurses in assessing breastfeeding challenges; however, little is known of its actual usage, the level of training experienced or desired by public health nurses, or their level of confidence in the support they provide to breastfeeding mothers.Research Aim:To identify the current practices and support needs of public health nurses who provide breastfeeding support in Ireland.Method:An online questionnaire was devised to collect respondents’ confidence with breastfeeding issues, caseload, and practices. It was distributed to public health nurses with a current child health caseload in one Community Healthcare Organization. Mann Whitney U tests were used to ascertain the relationship between public health nurses’ confidence level and those with qualifications in midwifery or as an International Board Certified Lactation Consultant (IBCLC).Results:The survey was completed by 66 public health nurses. Only 14 respondents (21.2%) indicated that they always used the BOAT. The most common reason for not doing so was a lack of education on its use (n = 17, 25.8%). Postholders also certified as IBCLCs were considered by participants to be the most appropriate professionals to resolve certain breastfeeding issues. Confidence levels to manage breastfeeding issues were highest among public health nurses with IBCLC credentialing (U = 12.5, p = .001) while no difference was seen when comparing those with a midwifery degree to those without (U = 184.0, p = .92). Face-to-face workshops and blended-learning approaches were ranked as the preferred formats for breastfeeding education (Median rank = 2).Conclusions:Breastfeeding education incorporating a face-to-face component is needed to support public health nurses who work with breastfeeding mothers, as is prioritization of recruitment in the community of public health nurses with IBCLC credentials.
Annemarie Walsh

Could Education Be the Best Galactagogue? Development and Content Validation of Provider and Patient Checklists to Promote Lactation Among Black Parents

1 hét ago
Journal of Human Lactation, Ahead of Print.
One of the factors contributing to the disparities still present by race in the United States may be inequitable access to lactation education. In order to ensure that all parents receive the education they deserve to make informed infant feeding decisions, two checklists were created for patient and healthcare professional use, respectively. This paper describes the process of creating and validating the healthcare professional and patient checklists. The authors completed a review of the most recent literature surrounding barriers to lactation initiation and retention in the Black community to create the initial version of the checklists. Expert consultation was then utilized to assess their content validity. Local healthcare providers unanimously agreed that pregnant and postpartum parents need more education and support than currently provided. The consulted experts described the two checklists as useful and comprehensive and offered feedback for their revision and optimization. Implementing these checklists offer the possibility of increasing provider accountability in delivering adequate lactation education and enhancing client lactation knowledge and self-efficacy. Further research is needed to assess the effect of implementation of the checklists in a healthcare setting.
Triniti Gorbunova

The Idealization of Infant Formula: A Longitudinal Analysis of Labels in Uruguay

2 hét 1 nap ago
Journal of Human Lactation, Ahead of Print.
Background:Labels are a key element of the marketing strategies of infant formula companies, and often include text or images that idealize their use, undermining efforts to promote breastfeeding.Research Aims:To evaluate the prevalence of marketing cues that idealize infant formula on labels of products commercialized in Uruguay and to assess changes after a periodic monitoring of compliance with the International Code of Marketing of Breast-Milk Substitutes (IC).Method:This study is a descriptive, observational, and longitudinal assessment of the information included on infant formula labels. The first data collection was in 2019, as part of a periodic assessment to monitor the marketing of human-milk substitutes. In 2021, the same products were purchased to evaluate changes in their labels. Thirty-eight products were identified in 2019, of which 33 were still available in 2021. All information available on the labels was analyzed through content analysis.Results:Most products included at least one textual or visual marketing cue idealizing infant formula in both 2019 (n = 30, 91%) and 2021 (n = 29, 88%). This represents a violation of both the IC and national regulations. References to nutritional composition were the most frequent marketing cue, followed by references to child growth and development. No relevant changes were observed after the periodic assessment conducted by the Uruguayan government.Conclusions:Monitoring compliance with the IC per se cannot be expected to trigger changes in the marketing strategies of infant formula companies. More explicit regulations and strong enforcement mechanisms are needed to end the inappropriate marketing practices on infant formula labels.
Raquel Rodríguez

Lactation Induction in a Transgender Woman: Macronutrient Analysis and Patient Perspectives

4 hét ago
Journal of Human Lactation, Ahead of Print.
IntroductionInduction of lactation in a non-gestational parent has numerous potential benefits including parent–child bonding, optimal nutrition, and health benefits to the child and breast- or chest-feeding parent. For transgender women and nonbinary people on estrogen-based, gender-affirming hormone therapy, the ability to nourish their infants through production of their own milk may also be a profoundly gender-affirming experience. Two prior case studies have been published describing induced lactation in transgender women, but analysis of the nutritional quality of the milk produced has not been previously described.Main issueHere we describe the experience of a transgender woman who underwent successful induction of lactation in order to breastfeed her infant, who was gestated by her partner.ManagementThrough modification of exogenous hormone therapy, use of domperidone as a galactogogue, breast pumping, and ultimately direct breastfeeding, the participant was able to co-feed her infant for the first 4 months of life. We provide a detailed description and timeline of the medications used, laboratory and electrocardiographic measurements, results of the participant’s milk analysis showing robust macronutrient content, and description of the participant’s experience in her own words.ConclusionThese findings provide reassurance about the adequacy of nutrition from human milk produced by non-gestational transgender female and nonbinary parents on estrogen-based, gender-affirming hormone therapy, and support the importance of this experience on a personal level.
Amy K. Weimer

Building an Evidence Base for the Protection and Support of Breastfeeding: An Interview With Adriano Cattaneo

4 hét ago
Journal of Human Lactation, Ahead of Print.
Adriano Cattaneo holds an MD degree from the University of Padua, Italy, and an MSc from the London School of Hygiene and Tropical Medicine. He spent most of his professional career in low-income countries, including 4 years as medical officer with the World Health Organization (WHO) in Geneva. After returning to Italy, he worked for 20 years as an epidemiologist at the Unit for Health Services Research and International Health, the Institute for Maternal and Child Health (IRCCS Burlo Garofolo) in Trieste, a WHO Collaborating Centre for Maternal and Child Health. He is the author of more than 220 publications in scientific journals and books, more than 100 of which are in peer reviewed journals. He has been affiliated with International Baby Food Action Network (IBFAN) in Italy since it was created in 2001. As project coordinator of two European Union funded projects, he played an important role in the development of the document Protection, Promotion and Support of Breastfeeding in Europe: A Blueprint for Action, a tool tested and used for the development of national breastfeeding policies and programs. He retired in 2014.
Adriano Cattaneo

Exploring Tandem Breastfeeding Motivations Via Self-Determination Theory: An Interpretative Phenomenological Study

1 hónap ago
Journal of Human Lactation, Ahead of Print.
Background:Tandem breastfeeding is defined as a situation in which a mother continues breastfeeding her child through a subsequent pregnancy, including after the new baby is born. In some countries where motherhood may be delayed and the time between births may be reduced, support for the promotion of tandem breastfeeding is necessary to help mothers continue to breastfeed their eldest child and avoid early weaning. There is no existing research about mothers’ motivations to breastfeed in tandem.Research Aim:To explore the motivations of women to initiate and maintain tandem breastfeeding, based on their lived experience, framed within the self-determination theory.Methods:A prospective, cross-sectional, interpretive, phenomenological study was carried out through in-depth interviews with 15 mothers in Madrid, who had practiced tandem breastfeeding for more than 6 months, and whose weaning of their eldest child had occurred within the previous year. Convenience and snowball sampling were used. The data were analyzed using an established interpretive phenomenological analysis process.Results:Among the motivations for initiating tandem breastfeeding, the following themes were identified: “avoid wasting the effort invested,” “desire such life experience,” and “exercise the freedom to decide.” The motivations for maintaining tandem breastfeeding were classified as “pass on parenting values” and “benefits of teamwork.”Conclusion:The participants based their motivation to tandem breastfeed to follow their freely chosen motherhood model. They discovered the advantages of its implementation, forming a team of themselves and their children, and healing their traumatic perinatal experiences.
Rocío Rodríguez Vázquez

Vaccination Beliefs and Attitudes of Lactating People During the SARS-CoV-2 Pandemic

1 hónap 4 hét ago
Journal of Human Lactation, Ahead of Print.
Background:Pregnant and recently pregnant people have lower vaccination rates against SARS-CoV-2 than the general population, despite increased risk of adverse outcomes from infection. Little is known about vaccine hesitancy in this population.Research Aim:To characterize SARS-CoV-2 and other vaccine attitudes of lactating people who accepted the SARS-CoV-2 vaccine, describing their vaccine experiences to further contextualize their beliefs.Methods:A prospective cross-sectional online survey design was used. We administered the survey to 100 lactating people in Pennsylvania from April to August 2021, upon enrollment into a longitudinal study investigating SARS-CoV-2 vaccine antibodies in human milk. This survey assessed SARS-CoV-2 vaccine attitudes, vaccine counseling from providers, and vaccine decision making. Associations between vaccination timing and beliefs were analyzed by Pearson chi-square.Results:Of 100 respondents, all received ≥ 1 SARS-CoV-2 vaccine before or shortly after enrollment, with 44% (n = 44) vaccinated in pregnancy and 56% (n = 56) while lactating. Participants reported vaccination counseling by obstetric (n = 48; 70%) and pediatric (n = 25; 36%) providers. Thirty-two percent (n = 32) received no advice on SARS-CoV-2 vaccination from healthcare providers, while 69% (n = 69) were counseled that vaccination was safe and beneficial.While 6% (n = 6) and 5% (n = 5) reported concerns about the safety of maternal vaccines for lactating people or their infants, respectively, 12% (n = 12) and 9% (n = 9) expressed concerns about the safety of maternal SARS-CoV-2 vaccination in particular.Conclusions:Despite high uptake of SARS-CoV-2 vaccine among participants, safety concerns persisted, with many reporting a lack of direct counseling from providers. Future research should investigate how variability in provider counseling affects SARS-CoV-2 vaccine uptake in perinatal populations.
Elyse G. Mark

Influence of Defatting and Pasteurization on Nutrients and Oxidative Stress Markers in Human Milk

2 hónap 1 hét ago
Journal of Human Lactation, Ahead of Print.
Background:It is well known that the best nutritional option for infants is human milk, and that when breastfeeding is not possible, human milk banks are a possible alternative. However, in the case of infants with fat transport disorder like chylothorax, defatting of human milk is mandatory.Research Aim:The aim of the study was to reduce milk fat content without reducing other nutrients, increasing oxidative stress, or introducing harmful microorganisms.Methods:In this prospective, cross-sectional, observational study, we examined the influence of defatting and pasteurization of 50 donor samples on fat, macro- and micronutrients, as well as on oxidative stress markers.Results:Low-temperature centrifugation proved to be very efficient in defatting, reducing the concentration of triglycerides by 85% and cholesterol by 50%. The macronutrients (proteins, albumin, and Immunoglobulin A) did not undergo significant changes due to defatting and pasteurization procedures, while iron decreased by 36%. However, as the majority of iron is retained, this result does not remarkably change the milk composition. Furthermore, oxidative stress markers and antioxidant levels were unchanged, and the milk result was microbiologically safe.Conclusions:Cold milk centrifugation proved to be an effective technique that allows the reduction of human milk lipids. The determination of triglycerides and cholesterol can be used as an indicator of skimming. This procedure is not accompanied by substantial modifications of other components present in the milk.
Annamaria D’Alessandro

Tethered Oral Tissue Release Among Breastfed Infants: Maternal Sources of Information and Treatment

2 hónap 1 hét ago
Journal of Human Lactation, Ahead of Print.
Background:Despite limited clinical consensus regarding surgery for tethered oral tissues (“tongue-tie”) for resolving breastfeeding-related issues, the procedure has been increasing in the United States. Greater understanding of maternal experiences with obtaining surgical release may help to improve breastfeeding outcomes.Research Aim:To explore experiences of breastfeeding mothers with infants having undergone “tongue-tie” surgery.Method:This online, cross-sectional, observational survey occurred between August and September 2020. Eligibility included being ≥ 18 years of age and previously or currently breastfeeding an infant with ≥ 1 tissue surgically released. Of 463 screens, 318 mothers were eligible and 115 consented. The final sample was 90.Results:The sample was predominantly white (n = 86; 95%), non-Hispanic (n = 84; 93%), married/cohabitating (n = 85; 94%), and currently providing their own milk (n = 81; 89%).Difficult latch was the primary reason for seeking help. Participants reported lingual (n = 84; 93%), labial (n = 79; 88%), and buccal (n = 16; 17%) tissue-release, with 80% (n = 73) reporting > 1 released. For each tissue released, > 80% (n = 72) of participants felt “very confident” in their ability to correctly identify it and 97% (n = 87) felt “very involved” and “strongly agreed” with surgical release. International Board Certified Lactation Consultants® were the most frequently identified source of information (n = 45; 50%) and referrals (n = 38; 42%), while pediatric dentists most frequently performed interventions (n = 60; 67%).Conclusions:Participants reported being confident, involved, and in agreement with surgical release and lactation support professionals were frequent information and referral sources.
Taylor Winkel

Experiences of Breastfeeding Mothers With Visual Disabilities

2 hónap 1 hét ago
Journal of Human Lactation, Ahead of Print.
Background:Parents with visual impairment can have difficulty in breastfeeding their babies. This situation may cause mothers to have negative feelings towards the care of their babies and to have problems during breastfeeding process.Research Aims:To examine in detail (1) the breastfeeding experiences of mothers with visual impairment, and (2) the factors that facilitate and prevent these mothers from continuing to breastfeed.Methods:This study was a cross-sectional, prospective generic qualitative design. The study sample (N = 15) consisted of mothers with visual impairment aged 18 and over, residing in Turkey, speaking Turkish, having an infant under the age of 2, and with breastfeeding experience. The analysis process was a content analysis approach. Data were collected through video or audio interviews using a semi-structured interview form.Results:Three main themes and 12 subthemes were determined: (1) negative emotions caused by breastfeeding, (2) barriers to initiating and maintaining breastfeeding, and (3) facilitators in initiating and maintaining breastfeeding.Conclusion:The participants in our study stated that health personnel had limited information on how to communicate with and support them. For this reason, it is important that breastfeeding counselors and health care providers receive training about breastfeeding counseling for mothers with visual impairment so that they can provide information and advice to these mothers.
Merve Can

Social Support for Breastfeeding Practice During the COVID-19 Second Wave in Thailand: A Cross-Sectional Study

2 hónap 2 hét ago
Journal of Human Lactation, Ahead of Print.
Background:Since December 2020, the second wave of COVID-19 in Thailand has had a considerable impact, and mothers have struggled to receive breastfeeding support in hospitals. In this situation, there has been limited research that addresses social support for breastfeeding and the influences of support in determining breastfeeding outcomes.Research Aims:(1) To describe the influence of COVID-19 on social support for breastfeeding and breastfeeding practices in the Thai context, and (2) to examine breastfeeding duration with different levels of social support from families and healthcare providers.Method:This descriptive, cross-sectional online survey design was part of a larger multi-methods project about breastfeeding behaviors and experiences among postpartum mothers during the COVID-19 pandemic. Online questionnaires were administered from August to November 2021 to participants (N = 390) who were from three provinces in Thailand and had given birth 6–12 months prior to the survey.Results:Exclusive breastfeeding for 6 months was observed in less than half of the participants (n = 146, 37.4%). Perceptions of breastfeeding support were generally high overall among both family (Mdn = 45, IQR = 7) and healthcare providers (Mdn = 43, IQR = 7). Participants who perceived more breastfeeding support from families than the median had significantly longer exclusive breastfeeding durations than those who perceived less breastfeeding support than the median (z = −2.246, p = .025). The same pattern was present for breastfeeding support from healthcare providers (z = −2.380, p = 0.017).Conclusions:While the exclusive breastfeeding rate was better than the pre-pandemic rate, successful breastfeeding was more common when participants perceived that they had received breastfeeding support. Policymakers should execute breastfeeding support systems along with COVID-19 management.
Sasitara Nuampa

The Human Milk Metabolome: A Scoping Literature Review

2 hónap 2 hét ago
Journal of Human Lactation, Ahead of Print.
Background:Human milk is a complex source of nutrition and other bioactives that protects infants from disease, holding a lifetime of beneficial effects. The field of metabolomics provides a robust platform through which we can better understand human milk at a level rarely examined.Research Aim:To Identify, describe, synthesize, and critically analyze the literature within the past 5 years related to the human milk metabolome.Methods:We conducted a scoping literature review and quality analysis of the recent science reflecting untargeted metabolomic approaches to examining human milk. We searched six databases using the terms “breast milk,” “metabolome,” “metabolite,” and “human milk,” Out of more than 1,069 abstracts, we screened and identified 22 articles that met our inclusion criteria.Results:We extracted data related to the study author, geographic location, research design, analyses, platform used, and results. We also extracted data related to human milk research activities, including collection protocol, infant/maternal considerations, and time. Selected studies focused on a variety of phenotypes, including maternal and infant disease. Investigators used varying approaches to evaluate the metabolome, and differing milk collection protocols were observed.Conclusion:The human milk metabolome is informed by many factors—which may contribute to infant health outcomes—that have resulted in disparate milk metabolomic profiles. Standardized milk collection and storage procedures should be implemented to minimize degradation. Investigators may use our findings to develop research questions that test a targeted metabolomic approach.
Kelley Baumgartel

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

2 hónap 3 hét 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


5 óra 49 perc ago
Table of Contents for Journal of Human Lactation. List of articles from ahead of print issues.
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