Journal of Human Lactation - online first articles

Journal of Human Lactation, Ahead of Print.
Background:Breastfeeding self-efficacy has been shown to be a strong predictor of breastfeeding initiation and duration; however, factors associated with breastfeeding self-efficacy in China are unclear.Research aims:The aims were (a) to describe the breastfeeding self-efficacy of parturient women in Shanghai, China and (b) to identify the sociodemographic factors associated with mothers’ breastfeeding self-efficacy.Methods:This is a cross-sectional retrospective descriptive study. Through convenience sampling, breastfeeding mothers (N = 801) were recruited to assess breastfeeding self-efficacy before discharge from the hospital. Descriptive statistics were used to analyze the sociodemographic and perinatal characteristics, level of breastfeeding self-efficacy, and correlations between them.Results:In the process of breastfeeding, 52.2% (n = 418) of participants encountered breastfeeding problems, 37.1% (n = 297) perceived an insufficient milk supply, 82.4% (n = 660) reported attending breastfeeding classes, but only 37.1% (n = 297) chose exclusive breastfeeding. Chinese mothers reported a moderate level of breastfeeding self-efficacy, with an item mean score of 3.67 (score = 1–5). Whether or not encountering breastfeeding problems, infant feeding pattern (fully breastfeeding, partial breastfeeding, no breastfeeding) in the previous 24 hours, whether or not perceiving insufficient milk, and main caregiver’s positive attitude toward breastfeeding (ranging from 1 to10, higher score indicating more positive attitude) were correlated with participants’ breastfeeding self-efficacy score. (The correlation coefficients were −0.432, 0.377, −0.364, and 0.353, respectively.)Conclusion:The misperception of insufficient milk and main caregiver’s attitude toward breastfeeding were important factors for breastfeeding self-efficacy. Greater efforts should be made during breastfeeding education and support.

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.
Background:Insufficient milk production is among the most cited reasons by mothers for discontinuing breastfeeding. Medications that can increase milk production, such as domperidone, an off-label galactagogue, are often prescribed. Domperidone is controversial as it is not approved for any purpose in the United States and is approved only for gastrokinetic purposes in Canada and other countries.Research aim:The aim was to update the existing literature on the efficacy of domperidone as a galactagogue compared to placebo when given to mothers with insufficient human milk production. The primary outcome is the change in expressed human milk volume per day from baseline.Methods:The authors independently searched the literature from inception to May 2018. The search included any randomized controlled trials examining the efficacy of domperidone increasing mothers’ expressed human milk, measured via a human milk pump. Both authors independently assessed quality and risk of bias and extracted relevant data. Meta-analysis on expressed human milk volume per day was performed.Results:Seven studies met the inclusion criteria for review; two were excluded from the meta-analysis due to quality grading and insufficient reporting of the outcome of interest. Five studies (N = 239) were combined in the meta-analysis. The effect size showed an increase in the mean difference of expressed human milk volume in mothers given domperidone, 93.97 mL per day (95% CI [71.12, 116.83 mL]; random effect, T2 0.00, I2 0%).Conclusion:This meta-analysis reports a significant improvement in expressed human milk volume per day with the use of domperidone in mothers experiencing insufficient human milk production.

Journal of Human Lactation, Ahead of Print.
Background:Little information has been documented regarding interventions for mastitis by Australian physiotherapists. It is currently not known if physiotherapy interventions vary across Australian regions and types of healthcare facilities.Research aims:(1) To identify the interventions used by Australian physiotherapists treating mothers with mastitis and (2) to determine the variability in interventions used across regions and facilities.Methods:A retrospective observational design was used. A sample of case records of mothers with mastitis was identified (N = 192). These case records documented physiotherapy interventions for mastitis in hospitals and private physiotherapy practices in Western Australia (n = 77; 40.1%), Victoria (n = 76; 39.6%), and New South Wales (n = 39; 20.3%). An electronic data collection tool was designed to examine intervention variables.Results:The physiotherapy interventions received by mothers included therapeutic ultrasound (n=175; 91.1%), education and advice (n = 160; 83.3%), and massage (n = 103; 53.6%). Therapeutic ultrasound parameters varied across regions and types of healthcare facilities. Mean documented therapeutic ultrasound intensity was approximately twice as high in New South Wales and Victoria than in Western Australia.Conclusions:Regional and facility differences exist in physiotherapy interventions for mastitis in Australia. Healthcare professionals who refer to physiotherapists for mastitis should be aware that interventions received may differ across regions and facility types.

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.