Turkish Women’s Beliefs Concerning Human Milk Banking

6 nap 8 óra ago
Journal of Human Lactation, Ahead of Print.
Background:A donor milk bank provides an alternative source of human milk for mothers who cannot breastfeed or provide their own milk. Although wet-nursing is a common practice, there is currently no donor milk bank in Turkey.Research Aims:The aims of our study were (1) to determine the knowledge and opinions of Turkish women in regard to donor milk banking; and (2) to raise awareness of donor milk banking.Methods:This was a prospective cross-sectional descriptive study, in which the data were collected with an online survey consisting of 22 questions. The link to the online survey was distributed through the social media accounts of the researchers, with a statement inviting women aged 18–64, who were literate and actively using social media, to participate in the survey. There were 648 female participants.Results:Of those who responded to the questionnaire, 54.1% had not previously given birth, and 54.2% had heard about donor milk banks before. The implementation of donor milk banks in Turkey was desired by 56.4% of the participants, and 50.8% of the participants considered donating their milk. It was determined that the reasons why the women did not want to benefit from donor milk banks were the risk of disease transmission to the baby and the possibility of their child marrying his or her milk sibling in the future.Conclusion:It appears that Turkish women lack information about donor milk banking. We recommend public awareness activities to be organized concerning donor milk banking.
Suzi Özdemir

Breastfeeding Experiences During the COVID-19 Lockdown in the United Kingdom: An Exploratory Study Into Maternal Opinions and Emotional States

1 hét 6 nap ago
Journal of Human Lactation, Ahead of Print.
BackgroundThe COVID-19 pandemic has hugely impacted upon people’s psychological and physical wellbeing; however, the effects of the COVID-19 lockdown on mothers of young children, with particular regard to breastfeeding, are unknown.Research AimsTo explore: (1) Sources of advice and support available to breastfeeding mothers during and prior to the COVID-19 lockdown; (2) Mothers’ opinions on statements and recommendations made by the World Health Organization on the importance of breastfeeding and breastfeeding during the COVID-19 pandemic; (3) Maternal emotional states (i.e., anxiety and depression symptoms) experienced by breastfeeding mothers during the COVID-19 lockdown; and (4) influence of breastfeeding duration and number of children on breastfeeding opinions and emotional states.MethodsMothers of children aged 0–36 months (N = 4018) took part in an online survey. The survey included demographic questions, as well as the Generalised Anxiety Disorder Questionnaire and the Patient Health Questionnaire. Mothers were further probed on opinions regarding breastfeeding practices during the COVID-19 pandemic.ResultsParticipants strongly agreed with the importance of breastfeeding, even if a mother showed symptoms of COVID-19. Differences in opinions on breastfeeding practices (e.g., the use of donor human milk and relactation), were found between participants in relation to breastfeeding duration and number of children. Participants with more than one child showed higher negative emotional states, namely anxiety symptoms. Except for Internet usage, participants indicated a decline in all sources of advice and support for breastfeeding during the COVID-19 lockdown.ConclusionsHealth bodies and professionals should consider maternal viewpoints and opinions regarding breastfeeding during the COVID-19 pandemic. Interventions are urgently needed in order to support breastfeeding mothers and prevent the development of mental health issues.
Cristina Costantini

Hepatitis B Viral Markers in the Human Milk of HBsAg-Positive Mothers: An Observational Study

1 hét 6 nap ago
Journal of Human Lactation, Ahead of Print.
Background:Quantification of viral antigens and viral loads in human milk samples from mothers infected with hepatitis B virus is largely unknown.Research Aim:The aim of the study was to quantitatively measure the levels of viral antigens and deoxyribonucleic acid of hepatitis B virus in human milk from mothers infected with hepatitis B virus.Methods:Fifty-five pairs of milk and serum samples from mothers with positive hepatitis B surface antigen, including 11 hepatitis B e antigen positive, were quantitatively tested to measure viral antigens by microparticle enzyme immunoassay and viral loads by real-time polymerase chain reaction assay.Results:The median level of hepatitis B surface antigen in the human milk samples of mothers with positive or negative hepatitis B e antigen was each lower than that in the sera, respectively (1.10 vs. 4.32 log10 IU/ml, t = 10.693, p < .001; -0.77 vs. 2.53 log10 IU/ml, t = -25.135, p < .001). The titers of hepatitis B surface antigen or hepatitis B e antigen in the human milk samples were each correlated with that in maternal serum. The detectable level of deoxyribonucleic acid of hepatitis B virus in human milk ranged from 1.42–5.27 log10 IU/ml, whereas that in maternal sera was 1.44–8.66 log10 IU/ml. The viral level in human milk was not correlated with that in maternal circulation.Conclusion:The present study data illustrate the relatively low titers of viral markers in the milk of mothers with positive hepatitis B surface antigen.
Hongyu Huang

Initiation of Gender-Affirming Testosterone Therapy in a Lactating Transgender Man

2 hét 1 nap ago
Journal of Human Lactation, Ahead of Print.
Introduction:Transgender and gender diverse individuals may choose to provide their infants with human milk. Lactating transgender men may experience gender dysphoria and desire to initiate or reinitiate gender-affirming testosterone therapy. However, there is limited safety data regarding use of testosterone during lactation.Main Issue:A 30-year-old G2P2 transgender man with gender dysphoria sought to initiate gender-affirming testosterone therapy while lactating.Management:Subcutaneous testosterone was self-administered beginning at 13 months post-partum. We prospectively collected data on circulating testosterone concentrations in parent serum, milk, and infant serum over 5 months until the infant self-weaned. The infant was monitored for growth and development at routine pediatric outpatient appointments. Parent serum testosterone concentrations rose with the initiation of testosterone therapy, reaching therapeutic concentrations by Day 14. Milk testosterone concentrations also increased with a maximum concentration of 35.9 ng/dl when the lactating parent was on a dose of 80 mg subcutaneous testosterone cypionate weekly. The calculated milk/plasma ratio remained under 1.0 and the calculated relative infant dose remained under 1%. The infant had no observable side effects, and his serum testosterone concentrations remained undetectable throughout the study period.Conclusion:This is the first study with data regarding human milk and infant serum testosterone concentrations during the initiation of gender-affirming testosterone therapy in a lactating individual. This evidence can help families and clinicians with decisions regarding lactation and testosterone use.
Sara Oberhelman-Eaton

Baby Friendly Hospital Initiative Breastfeeding Outcomes in Mothers with COVID-19 Infection During the First Weeks of the Pandemic in Spain

1 hónap 1 hét ago
Journal of Human Lactation, Ahead of Print.
Background:Adherence to the Ten Steps of the Baby-Friendly Hospital Initiative has been shown to have a protective role for the initiation and maintenance of breastfeeding.Research Aims:(1) To determine the breastfeeding rate during the first 6 months of life in children of mothers diagnosed with COVID-19 infection at the time of birth; and (2) to assess the possible influence of being born in a center with Baby-Friendly Hospital Initiative accreditation.Methods:This was a two-group comparative longitudinal observational study of infants born to mothers with COVID-19 at the time of birth, between March 13–May 31, 2020 (the first wave of the pandemic) in Spain. Fourteen Spanish hospitals participated, five (35.7%) were Baby-Friendly Hospital Initiative accredited. Type of feeding was assessed prospectively at discharge, 1, 3, and 6 months of age. A total of 248 newborns were included in the study.Results:A total of 117 (47.3%) newborns were born in Baby-Friendly Hospital Initiative (BFHI) accredited centers. These centers applied skin-to-skin contact with greater probability (OR = 1.9; 95% CI [1.18, 3.29]) and separated the newborns from their mothers less frequently (OR = 0.46; 95% CI [0.26, 0.81]) than non-accredited centers. No differences were observed in relation to the presence of a companion at the time of birth. At discharge, 49.1% (n = 57) of newborns born in BFHI-accredited centers received exclusive breastfeeding versus 35.3% (n = 46) in non-accredited centers (p = .03). No differences were observed in breastfeeding rates throughout follow-up.Conclusions:The exclusive breastfeeding rate at discharge in children of mothers with COVID-19 infection at birth was higher in Baby-Friendly Hospital Initiative accredited centers, which most frequently applied skin-to-skin contact at birth as well as rooming-in.
Miguel A Marín Gabriel

Breastfeeding Motivation Predicts Infant Feeding Intention and Outcomes: Evaluation of a Novel Adaptation of the Treatment Self-Regulation Questionnaire

1 hónap 3 hét ago
Journal of Human Lactation, Ahead of Print.
Background:Identifying those at risk for suboptimal breastfeeding outcomes remains critical for improving maternal and child health. Prenatal breastfeeding motivation may be a key predictor useful for identifying those who would benefit from additional breastfeeding support.Research Aims:To (1) validate a breastfeeding-specific adaptation of the Treatment Self-Regulation Questionnaire (TSRQ-BF); and (2) determine if breastfeeding motivation predicts prenatal breastfeeding intentions and early breastfeeding outcomes.Methods:Participants in their third trimester of pregnancy (N = 150) completed several instruments, including the TSRQ-BF and infant feeding intention, and could opt to participate in an assessment of early breastfeeding outcomes (by medical record review). TSRQ-BF subscales were derived from factor analysis, and multivariable regression was used to evaluate the association between TSRQ-BF subscale scores and breastfeeding intention and outcomes during the birth hospitalization.Results:Autonomous (related to personal values/beliefs regarding self) and Autonomous-Baby (values/benefits for the infant) subscale scores were positively associated with intended exclusivity (aOR [95% CI]: 2.22 [1.57, 3.30], 4.94 [2.49, 11.07], respectively) while higher scores on these subscales predicted longer time to planned cessation (aHR [95% CI]: 0.72 [0.61, 0.84],0.52 [0.34, 0.81]). Higher Amotivation (lack of motivation) scores were negatively associated with intended exclusivity (0.45 [0.26, 0.74]). Higher scores on Autonomous, Autonomous-Baby, and Controlled (avoidance of negative feelings/punishment or gaining reward) subscales were associated with greater odds of hospital exclusivity (aOR [95% CI]: 3.39 [1.75, 8.00], 3.44 [1.66, 9.04] and 6.05 [1.88, 29.04]) and lower odds of 2-day formula supplementation (aOR [95% CI]: 0.31 [0.14, 0.59],0.28 [0.11, 0.59], 0.19 [0.04, 0.62]).Conclusions:The TSRQ-BF predicted breastfeeding intent and outcomes, and may be helpful for identifying patients at risk for suboptimal breastfeeding outcomes before delivery.
Hayley Martin

Realigning Expectations With Reality: A Case Study on Maternal Mental Health During a Difficult Breastfeeding Journey

1 hónap 3 hét ago
Journal of Human Lactation, Ahead of Print.
Introduction:Many mothers have the goal to breastfeed. However, more than 50% will have breastfeeding difficulty by the 3rd day of life. Mothers who are unable to meet their breastfeeding goals are at higher risk for anxiety, depression, embarrassment, and guilt. Those who stop breastfeeding need support and help resolving these feelings. This case study aims to describe one woman’s difficulty with mental health surrounding breastfeeding, her decision to bottle feed, and her successful transition back to direct breastfeeding.Main Issue:Barriers to the participant’s success with breastfeeding were pre-existing history of depression/anxiety, forceps delivery, uncontrolled perineal pain, infant physical trauma, and nipple/flow confusion. The decision to discontinue direct breastfeeding and start bottle feeding came after 2 months of anxiety, frustration, and persistence.Management:The participant followed her healthcare team’s recommendations of triple feeding, lactation support groups, pediatric chiropractic adjustments, and prescribed galactagogues. After 2 months of exhaustion and deliberation, she made the difficult decision to stop breastfeeding for nutritional benefits and switched to breastfeeding only for her infant’s pleasure and comfort. Lowered expectations allowed the dyad to heal and her son to transition to nearly exclusive breastfeeding at 4 months of life.Conclusion:Clinicians must be aware of the delicate balance between promoting breastfeeding for its nutritional value and health benefits and supporting a struggling mother with mental health needs.
Mason Elder


7 óra 4 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