The Birth and Development of the Lactation Consultant Profession (1980–2007): An Interview With Chele Marmet (Part II)

3 hét 1 nap ago
Journal of Human Lactation, Ahead of Print.
The remarkable world-changing growth of International Board Certified Lactation Consultants (globally over 35,000 IBCLCs in 2023), as the internationally recognized lactation professional since Chele Marmet conceptualized the field in 1977, demonstrates its importance for society and breastfeeding dyads. The early 1980s was a seminal time in the development of lactation care as a allied health field with specialized knowledge, study, and certification. Chele Marmet played a significant role as an innovator and activist during all these major changes. In this interview, she details these historic events, which she is elaborating further in her upcoming memoir.Although the terms LC and lactation professional have commonly been used to refer to those working clinically with breastfeeding families, in this article both terms refer only to the International Board Certified Lactation Consultant (IBCLC). JHL has a policy not to use the term LC (Dodgson, 2016, 2020); our rationale is that this term is currently too vague and is often misused by those with less education and experience than IBCLCs. However, we have used LC in this article at times when referring to lactation professionals prior to the development of the international board examination. This article is the second part of the interview; Part I was published in the previous JHL issue (February 2014). This interview has been transcribed with minor editing for ease of reading. (CM = Chele Marmet, JD = Joan Dodgson)
Chele Marmet

Relationship Between Sex-Specific Labor Market Performance and Breastfeeding Prevalence

1 hónap ago
Journal of Human Lactation, Ahead of Print.
Background:Prior research has explored the association between women’s employment status and breastfeeding at the individual level, however; a notable gap in scholarly inquiry exists regarding the relationship between labor market performance and breastfeeding at the population level.Research Aim:The aim of this paper is to investigate the association between labor market performance and breastfeeding prevalence in the United States.Methods:This study is a cross-sectional analysis of the association between labor market performance and the prevalence of breastfeeding. Our analysis is conducted at the state level using data published up to late 2021 from the Current Population Survey and the National Immunization Survey. The first dataset was used to construct aggregate and sex-specific state level indicators of labor market performance for both males and females. The second dataset supplied the proportion of mothers breastfeeding for the corresponding birth cohort from each state.Results:Higher average weekly hours worked by females in the year before giving birth was associated with a lower prevalence of breastfeeding, but employment rates among females did not significantly affect breastfeeding prevalence. Among males, current employment rates were positively associated with breastfeeding prevalence; however, no significant relationship was observed between breastfeeding prevalence and average weekly work hours worked.Conclusion:Sex-specific labor market performance may play a role in breastfeeding decisions and the timing of labor market performance relative to childbirth is important. Furthermore, these results highlight that employment rates and hours worked might be associated with child health through breastfeeding prevalence.
Francisco Beltran-Silva

Effect of Reflexology on Pain, Fatigue, Sleep Quality, and Lactation in Postpartum Primiparous Women After Cesarean Delivery: A Randomized Controlled Trial

1 hónap 1 hét ago
Journal of Human Lactation, Ahead of Print.
Background:Mothers commonly experience pain, fatigue, sleep disruption, and breastfeeding problems after cesarean delivery. To date, no follow-up study has examined all of these variables to evaluate the utility of reflexology in reducing these problems and supporting breastfeeding.Research Aim:This study aimed to determine the effect of foot reflexology performed in the postpartum period on pain, fatigue, sleep quality, and lactation in primiparous women who underwent cesarean delivery.Methods:This is a two-arm, parallel-group randomized controlled trial. Data were collected between January 1, 2020, and January 31, 2021, with a sample of 80 women who were randomly assigned to the reflexology (n = 40) and control (n = 40) groups. The reflexology group received 40 minutes of foot reflexology once a week for 8 weeks. The primary outcomes of the study were pain, fatigue, sleep quality, and breastfeeding efficacy.Results:Pain scores in the reflexology group decreased by 90.9% in week 1, 90.2% in week 2, and 59.8% in week 3 compared to the control group. Pain resolved at week 4 in the reflexology group and week 7 in the control group. The reflexology group showed a 36.9% decrease in fatigue level, a 48.0% increase in energy level, a 70.7% increase in sleep quality, and a 20.2% increase in breastfeeding efficacy compared to the control group (p < 0.05).Conclusions:Foot reflexology reduces postpartum symptoms and positively affects breastfeeding and can be used safely in postnatal care practices.
Ayşegül Kiliçli ID

Assessing the Landscape of Lactation Education: Results of a Pilot Survey

1 hónap 1 hét ago
Journal of Human Lactation, Ahead of Print.
Background:The field of lactation currently uses breastfeeding rates to measure effectiveness. While monitoring breastfeeding outcomes can provide insight into the successes of lactation consulting as a profession, the improvement of breastfeeding outcomes is a multifactorial issue. In order to facilitate the growth of lactation education processes, understanding experiences during training and perceptions of readiness of current International Board Certified Lactation Consultants (IBCLC) for clinical practice is necessary.Research Aim:The aim of this survey was to provide a baseline assessment of the current landscape of the lactation profession through data related to certification, job market, practice confidence after passing the International Board of Lactation Consultant Examiners (IBLCE) certifying examination, and perceptions of specializations.Methods:A cross-sectional study design was used to assess the experiences of practicing IBCLCs. Non-probability convenience sampling was implemented from December 2021 through January 2022. A total of 281 unique responses were recorded with complete data on variables of interest.Results:The majority of respondents were white females under age 50 located in the United States. The majority of respondents were certified through a Pathway 1. The largest barrier to certification was reported to be a lack of clinical/mentorship opportunities. Respondents were significantly more confident in providing entry-level support to dyads when mentored by four or more preceptors.Conclusion:Diversification of the field of lactation is necessary to provide appropriate support to lactating families in the United States. Additionally, addressing the barrier of accessing clinical/mentorship opportunities is essential for continued growth of the field of lactation.
Hope Katherine Lima

Relationship Between Maternal Age and Macronutrient Content of Colostrum

1 hónap 2 hét ago
Journal of Human Lactation, Ahead of Print.
Background:Little is known about the relationship between maternal age and the macronutrient content of colostrum.Research Aims:This study aimed to evaluate the relationship between maternal age and human milk macronutrient content by comparing the concentrations of lactose, proteins, and lipids in the colostrum of women with younger, moderate, and advanced maternal age.Methods:An observational, cross-sectional study was designed to compare the macronutrient concentrations in the colostrum of women aged < 20 years, 20 to 34 years, and > 34 years (younger, moderate, and advanced maternal age, respectively; n = 33 per group). For each participant, 3 ml of colostrum was collected by manual extraction from the right breast at 10 am, 39–48 hr after delivery, and analyzed using a Miris Human Milk Analyzer. Macronutrient concentrations were compared between the groups using analysis of variance. P < 0.05 was considered significant.Results:Mothers with moderate maternal age had a higher colostrum lipid concentration than those with younger or advanced maternal age (2.3 mg, SD = 1.4 mg vs. 1.5 mg, SD = 1.0 mg vs. 1.6 mg, SD = 0.9 mg, respectively; p = 0.007). Lactose and protein contents in the analyzed samples did not differ among the three study groups.Conclusion:This study lends support to the potential variation of lipids in colostrum by maternal age and suggests individual adaptation to the nutritional components of milk to the needs of the infant may be beneficial.
Virginia Gontijo Abreu Hochman

Caffeine Concentrations in Human Milk Donated to a Human Milk Bank in Japan

1 hónap 2 hét ago
Journal of Human Lactation, Ahead of Print.
Background:Human milk banks have been established to provide human milk to preterm infants who are unable to obtain milk from their mothers. Donor screening methods vary, and prospective donors are commonly screened for drug and recreational substance use through behavioral screening. Although the risk of illegal drug consumption in Japan is extremely low, caffeine may be consumed unknowingly and can be found in human milk. To date, only a few reports have been conducted on the concentration of caffeine in donor milk.Research Aim:This study aimed to examine the pre-pasteurization levels of caffeine in human milk donated to a milk bank in Japan.Methods:This was a cross-sectional, observational study of caffeine concentrations in human milk donated to a human milk bank in Japan. Caffeine concentration in the donor milk was measured using high-performance liquid chromatography.Results:Caffeine was detected in 70% of the donor milk samples (N = 350). The median (range) of caffeine concentration was 0.46 [< 0.10, 7.54] mg/L, and 64.0% of the samples had less than 1 mg/L of caffeine. The caffeine concentration varied widely among as well as within individuals.Conclusion:The average caffeine concentration in Japanese donor milk samples was higher than that previously reported in samples from Spain, but the range was similar. Donors should be informed that caffeine intake should be within a moderate range, to further increase the safety of donor milk.
Shoko Kozai

Influence of Maternal Dietary Pattern on the Pro-Oxidant and Antioxidant Status of Mother’s Own Milk

1 hónap 2 hét ago
Journal of Human Lactation, Ahead of Print.
Background:Human milk is essential for a child’s best development. However, what a mother eats while breastfeeding can directly influence the composition of mother’s milk.Research Aim:This study aimed to assess the antioxidant-oxidant profile of human milk and establish a connection between this profile and the dietary habits of the mothers.Methods:A cross-sectional study was conducted at the Hospital Infantil e Maternidade Alzir Bernardino Alves (HIMABA), located in the municipality of Vila Velha-ES, Brazil. The sample included 98 participants. All volunteers completed a structured interview and a Food Frequency Questionnaire. Approximately 5–10 ml of colostrum, transitional milk, and mature milk were manually collected. The antioxidant activity of human milk was assessed using the colorimetric method for free radical scavenging with 2,2’-azinobis-3-ethylbenzothiazoline-6-sulfonic acid. Oxidative stress was determined by measuring lipid peroxidation through malondialdehyde concentration, evaluating advanced oxidation protein products, and assessing total protein content using the Bradford method.Results:The antioxidant profile of colostrum was higher than that observed in later phases of milk, whereas pro-oxidants increased in later phases. Maternal dietary patterns influenced the pro-oxidant status of human milk. Participants with a higher daily intake of milk, dairy products, vegetable oils, olive oils, and legumes exhibited lower levels of lipid peroxidation in colostrum, transition milk, and mature milk, respectively.Conclusions:Our study highlights the vital role of a balanced maternal diet in shaping the pro-oxidant status of human milk, with implications for infant health.
Racire Sampaio Silva

Dysphoric Milk Ejection Reflex in Human Lactation: An Integrative Literature Review

1 hónap 2 hét ago
Journal of Human Lactation, Ahead of Print.
Background:Dysphoric Milk Ejection Reflex is an understudied condition of lactation involving emotional dysregulation during letdown or milk ejection. Affected individuals may experience transient feelings of helplessness, melancholy, and general unhappiness.Research Aim:To evaluate the scope of published literature on Dysphoric Milk Ejection Reflex.Method:Whittemore and Knafl’s methodology guided this integrative review. Five databases were searched for primary research, summaries, and editorials on Dysphoric Milk Ejection Reflex in lactating individuals. Literature searched also included websites, pamphlets, and conference proceedings via Google and Google Scholar. A total of 11 articles, from five different countries, met inclusion criteria for review.Results:Studies on Dysphoric Milk Ejection Reflex and negative emotional sensations during lactation were synthesized under five conceptual umbrellas: (1) Experiences, Sensations, and Symptom Management; (2) Biological Underpinnings; (3) Influence on Maternal Role and Breastfeeding Self-Efficacy; (4) Support, Understanding, and Awareness; and (5) Reduction and Cessation of Breastfeeding.Conclusion:Dysphoric Milk Ejection Reflex is a neurobiological condition characterized by low mood and negative feelings during milk ejection throughout lactation. Dysphoric Milk Ejection Reflex is linked to maternal psychological distress and breastfeeding discontinuation. Priority areas for future research include biological origins and interventions aimed at prevention, symptom control, and greater awareness of the condition on a more international scope.
Stephanie Lynn Herr

Culture, Cultural Competence, and Clinical Care

1 hónap 2 hét ago
Journal of Human Lactation, Ahead of Print.
Culture competence is a concept that can be traced back to health care considerations in the 1960s and 1970s, and in particular to nursing education. Critics of the concept have argued that this was not simple a listing of cultural facts, behaviors, and practices, but instead follow a more ethnographic understanding of culture. In this article, I recognize that culture is not simply about the other, but something we all possess, and is also always changing throughout our lives. Understanding and respecting diversity and culture is key to improving services, including lactation support.
Tanya M. Cassidy

Auricular Acupressure on Breast Pain Among Breastfeeding Mothers Receiving Gentle Hand Techniques: A Randomized, Single-Blind, Sham-Controlled Trial

1 hónap 2 hét ago
Journal of Human Lactation, Ahead of Print.
Background:Auricular acupressure influences pain reduction in patients with diseases. However, study results on its influence on breast pain, common among breastfeeding mothers, are insufficient.Research Aim:This study aimed to explore the effectiveness of auricular acupressure on breast pain among breastfeeding mothers who also received a standard gentle hand technique.Methods:This was a placebo-controlled study wherein auricular acupressure was provided for 4 weeks to 52 breastfeeding mothers consulting a local breastfeeding clinic. In the intervention group, auricular acupressure was applied to specific acupoints, including Shenmen, central rim, breast, and endocrine, which are related to breast pain and postpartum lactation. For the placebo control group, auricular acupressure was applied to acupoints not related to breast pain. The degree of breast pain was assessed using a numeric rating scale and a pressure algometer.Results:After 4 weeks of auricular acupressure, numeric rating scale pain scores did not show a significant change. However, the pressure pain threshold for the upper left (Z = −2.202, p = .028) and upper right (t = 2.613, p = .012) areas of the right breast increased significantly in the intervention group.Conclusion:This study employed subjective and objective measurements to evaluate the efficacy of auricular acupressure in alleviating breast pain. The intervention shows potential as a nursing measure. Further research is required to determine the optimal intervention duration and frequency, particularly for breastfeeding parents with severe pain, and to evaluate long-term outcomes.
Shinae Han

Prolonged Jaundice in a Premature Breastfed Infant With Gilbert’s Syndrome

2 hónap ago
Journal of Human Lactation, Ahead of Print.
Introduction:Neonatal jaundice and prematurity pose significant barriers to breastfeeding in the first days of life. There is limited literature exploring the relationship between prolonged jaundice in breastfed infants and Gilbert’s (Meulengraght) syndrome. This case study describes the diagnostic and therapeutic challenges associated with Gilbert’s syndrome in a late preterm breastfed infant born in Germany.Main Issue:In this case report, an infant born to a primipara woman presented at 3 weeks postpartum to an International Board Certified Lactation Consultant. The initial assessment revealed a late preterm infant with inadequate weight gain and jaundice. The dyad received breastfeeding support and eventually achieved adequate weight gain; however, the infant’s jaundice persisted.Management:The consulting midwife suggested that the persistent jaundice was “breastmilk jaundice” and recommended temporarily interrupting breastfeeding. Due to a suspected family history of Gilbert’s Syndrome, the dyad was referred, instead, to a pediatric gastroenterologist. Pathologic liver disease was excluded, and genetic testing confirmed Gilbert’s Syndrome. At 6 months of age, the dyad was successfully breastfeeding and beginning complementary feeding.Conclusion:Genetic testing for Gilbert’s Syndrome should be considered for infants with prolonged jaundice and positive family history. Interruption or cessation of breastfeeding are not evidence-based recommendations, and current guidelines do not support these practices. Lactation professionals play a critical role in the management of breastfeeding for preterm infants with prolonged jaundice and should refer to specialists to rule out pathologic etiologies.
Frances Strobl

A Systemic Review of the Difference Between Diets for Preterm Infants Containing Raw Mother’s Own Milk and Frozen or Pasteurized Mother’s Own Milk

2 hónap ago
Journal of Human Lactation, Ahead of Print.
Background:Raw, never stored or pasteurized mother’s own milk (MOM) is not always available to feed preterm infants; however, storage and pasteurization of MOM diminishes some bioactive components. It can be difficult to feed raw MOM to preterm infants due to transportation and storage of small volumes that might be pumped away from the infant, and a concern that they might harbor bacteria. However, the higher availability of bioactive components in raw MOM may provide benefits to preterm infants compared to frozen or pasteurized MOM.Research Aim:To systematically review and summarize the results of studies on feeding raw MOM versus frozen or pasteurized MOM to preterm infants born at less than 37 weeks of gestation.Methods:Four databases were searched (Cochrane, Embase, Ovid MEDLINE, and Web of Science) for this systematic review. Of 542 studies identified, nine met inclusion criteria and were critically evaluated using the quality assessment tool for quantitative studies by the Effective Public Health Practice Project. Studies were organized using the Breastfeeding Challenges Facing Preterm Mother–Infant Dyads theoretical framework.Results:Included studies evaluated the outcomes of preterm infants fed raw versus pasteurized MOM (n = 7, 77.8%) or raw versus frozen MOM (n = 2, 22.2%). Researchers found that raw MOM did not increase infant infections and may have improved health and growth outcomes for study participants.Conclusion:There is laboratory evidence supporting the safety and efficacy of the use of raw MOM for preterm infants. A raw MOM diet is recommended for preterm infants by professional organizations. Despite this, it may not be universally prioritized and could require purposeful implementation by each institution. Further research is needed to pursue the potential benefits of a raw MOM diet for preterm infants.
Jessica Ann Gomez

Ellenőrizve

14 óra 54 perc ago
Table of Contents for Journal of Human Lactation. List of articles from ahead of print issues.
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