Development and Interrater Reliability of the Lactation Assessment Care Tool

1 év 6 hónap ago
Journal of Human Lactation, Ahead of Print.
Background:There have been no comprehensive predictive measurement instruments published that account for the dynamic interaction between maternal, infant, and functional factors related to breastfeeding difficulty. The Lactation Care Assessment Tool (LACT) was developed by the authors as a predictive measure of lactation acuity to identify families at risk for breastfeeding difficulty and facilitate access to the most effective level of care.Research Aim:To describe the development, content validation, and interrater reliability of the LACT.Methods:This study was a cross-sectional, online survey. Upon reading a standardized case scenario reflective of common experiences among families with goals to breastfeed, participants (N = 82) anonymously completed the LACT, which consisted of 16 measures based upon research relevant to maternal, infant, and functional factors affecting breastfeeding success. Descriptive statistics were used to summarize and describe the characteristics of the study sample. Interrater reliability was evaluated using Krippendorff’s alpha.Results:An acceptable degree of interrater reliability (α = 0.70) among participants was detected for the 16 measures included in the instrument.Conclusion:This instrument supports Baby-Friendly Hospital Initiative Step 10 to facilitate more precise and timely continuity of care after discharge from the hospital by identifying families in need of referral to a level of care consistent with their lactation acuity. Future research is necessary to determine appropriate levels of care and support based on the instrument scores in diverse breastfeeding dyads during early lactation and through the duration of breastfeeding.
Allyson Wessells

Associations Between Mothers’ Adverse Childhood Experiences, Material Hardship, and Breastfeeding Challenges in the United States

1 év 6 hónap ago
Journal of Human Lactation, Ahead of Print.
Background:Breastfeeding is the biological norm and is associated with numerous superior health outcomes for children and mothers when compared to human milk substitutes. Yet, breastfeeding difficulties and the inability to meet one’s breastfeeding goals are common in the United States and maybe more common among mothers who have experienced trauma.Research Questions:(1) Are mothers’ adverse childhood experiences, and current experiences of discrimination, material hardship, and decreased social support associated with breastfeeding challenges; and (2) are these experiences associated with the number of breastfeeding challenges reported?Methods:A prospective, non-probability, cross-sectional study design with a diverse sample who had delivered a live baby within the previous year (N = 306) was conducted.Results:Over 70% of participants reported breastfeeding challenges and 45.2% reported material hardship. Among those who attempted breastfeeding (n = 286), 74.1% had at least one adverse childhood experience; 30.3% had four or more. Logistic and negative binomial regression models determined that adverse childhood experiences, experiences of discrimination, material hardship, and decreased social support were not associated with experiencing any breastfeeding challenges. However, adverse childhood experiences were associated with the number of breastfeeding challenges reported. (The adjusted rate ratio was 1.05; 95% CI [1.00, 1.09], p = .034).Conclusion:We recommend further research on adverse childhood experiences and potential relationships with discrimination, material hardship, and social support to prevent and intervene in cases of breastfeeding challenges to maximize infant, maternal, and public health.
Rebecca J. McCloskey

The Power of Consumer Activism From the Kennedy Hearings to the International Code: An Interview With Leah Margulies (Part II)

1 év 7 hónap ago
Journal of Human Lactation, Ahead of Print.
Leah Margulies was Director of the Infant Formula Program at the Interfaith Center on Corporate Responsibility in New York City (NYC) from 1975 to 1985. She is a founder of the International Nestle Boycott, Corporate Accountability (formerly INFACT), and one of the founders of the International Baby Food Action Network (IBFAN). She was hired at UNICEF in 1982 to set up the legal office for implementation of the International Code of Marketing Breastmilk Substitutes, as part of the Baby Friendly Hospital Initiative. Previously, she was legal advisor to the Environment Unit of the United Nations Centre on Transnational Corporations. From 2006 to 2016, she was Project Director of LawHelpNY at the NYC Bar Association. Currently, she works for a legal non-profit, representing low-income Brooklynites, defending them against eviction. She is a lawyer, a Second Wave Feminist, and a member of Veteran Feminists of America. She is also a musician and founding member of a pioneering women’s rock band that played at the first national women’s march for abortion rights in Washington, DC, 1972.
Leah Margulies

Influence of Maternal Body Fat on Levels of Insulin, Insulin-Like Growth Factor-1, and Obestatin

1 év 7 hónap ago
Journal of Human Lactation, Ahead of Print.
Background:Insulin, insulin-like Growth Factor-1 (IGF-1), and obestatin in human milk originate from the circulation. There is also limited knowledge about the influence of body fat on the levels of these hormones in human milk.Research Aim:To determine (1) the influence of body fat on levels of insulin, IGF-1, and obestatin in human milk and serum/plasma during the postpartum period; (2) the changes in the levels of these hormones in human milk and serum/plasma postpartum; and (3) the presence of IGF-1 mRNA in human milk.Methods:In this prospective, longitudinal, observational cohort study, levels of insulin, IGF-1, and obestatin were measured up to 30 days postpartum in milk and serum/plasma of 58 participants with adequate (≤ 32%) or excess (> 32%) total body fat determined by electrical bioimpedance. Student’s t test and repeated-measures analysis of variance were used to evaluate the differences between groups. Pearson’s test was used to analyze the associations.Results:The milk from participants with excess body fat had higher insulin and IGF-1 levels and lower obestatin levels than that of participants with adequate body fat at 3–7, 14–15, and 30 days postpartum (adjusted p < .001). The levels of insulin, IGF-1, and obestatin were significantly higher in human milk than in serum/plasma (p < .05) and correlated with maternal body fat (p < .001).Conclusions:Maternal body fat was associated with elevated insulin and IGF-1 levels and decreased obestatin levels in human milk up to 30 days postpartum.
Pilar A. Badillo-Suárez

Breastfeeding Women’s Attitudes About the SARS-COV-2 Vaccine in Spain

1 év 8 hónap ago
Journal of Human Lactation, Ahead of Print.
Background:Severe Acute Respiratory Syndrome Coronavirus 2 has spread globally, causing the coronavirus disease 2019 (COVID-19) pandemic. To control the pandemic and to achieve herd immunity, four vaccines have obtained market authorization in Europe. Researchers have reported that the sequence of administration of the vaccines depends on the risk of exposure to COVID-19 and age, recommending the vaccine to pregnant and breastfeeding women.Research Aim:To examine the knowledge, willingness and attitudes of breastfeeding women in Spain regarding the possibility of receiving the COVID-19 vaccine.Methods:An observational descriptive cross-sectional study in two tertiary-level hospitals from Valencia was conducted. Breastfeeding women (N = 301) were recruited by non-probability sampling of consecutive cases. Questionnaires were collected in June 2021.Results:More than one in every two participants would accept a COVID-19 vaccine, and the percentage rose in participants who were older, more educated, or worked in high-risk jobs. Their main source of information was the Internet, and midwives were the professionals who most recommended vaccination. Participants who would not accept vaccination during lactation reported reasons linked to lack of information regarding vaccination in their condition and how it might affect newborns.Conclusion:It is of primary concern for healthcare professionals to foster a greater understanding by providing updated information regarding the need, safety, and efficacy of the vaccine for both lactating mothers and their newborns.
Ruben Alfaro Blazquez

Legislation and Policies for the Right to Maternity Protection in South Africa: A Fragmented State of Affairs

1 év 8 hónap ago
Journal of Human Lactation, Ahead of Print.
Background:Maternity protection rights incorporate comprehensive benefits that should be available to pregnant or breastfeeding working women.Research Aim:To describe South Africa’s maternity protection legal and policy landscape and compare it to global recommendations.Method:A prospective cross-sectional comparative policy analysis was used to review and describe national policy documents published from 1994–2021. Entitlements were mapped and compared to International Labour Organization standards. The document analysis was supplemented by interviews conducted with key national government department informants. Thematic analysis was used to evaluate policy and interview content.Results:Elements of maternity protection policy are incorporated into South Africa’s constitutional dispensation, and some measures are consistent with international labor and social security standards. However, the policy framework is fragmented and difficult to interpret. The fragmented policy environment makes it challenging for employees to know their maternity rights’ entitlements and for employers to understand their responsibilities. Confusion regarding maternity protection rights is amplified by the complexity of ensuring access to different forms of maternal protection in pre- and postnatal stages, oversight by multiple government departments, and heterogenous working environments.Conclusions:Maternity protection in South Africa is fragmented and difficult to access. Overcoming these challenges requires legislative and implementation measures to ensure greater policy coherence and comprehensive guidance on maternity protection rights. Addressing gaps in maternity protection in South Africa may provide insights for other countries with shortcomings in maternity protection provisions and could contribute to improved breastfeeding practices.
Catherine Pereira-Kotze

Successful Co-Lactation by a Queer Couple: A Case Study

1 év 8 hónap ago
Journal of Human Lactation, Ahead of Print.
Introduction:With cultural and social evolution and improvements in reproductive technology, an increasing number of babies are born to lesbian, gay, bisexual, transgender, intersex, queer and/or questioning, and asexual and/or ally parents. As parental roles and gender expression become more expansive, the role of breastfeeding a baby must naturally also expand to include the option of sharing of breastfeeding among parents, called co-lactation (Bamberger & Farrow, 2021). In most cases, co-lactation involves a gestational parent and a non-gestational parent. If a non-gestational parent desires to produce milk for the purpose of breastfeeding, they do so by inducing lactation. While interest in and research about induced lactation are developing quickly, little information is currently available about co-lactation.Main Issue:A couple identifying as queer presented with concerns about inducing lactation in the non-gestational parent, as well as seeking assistance in managing a successful sharing of the breastfeeding relationship.Management:Breast massage, milk expression, acupuncture, hormone therapy, and galactagogues, including domperidone, goat’s rue, and malunggay (moringa oleifera) were used to initiate and establish lactation by the non-gestational parent. Parents shared the breastfeeding relationship equally and carefully managed milk expression when the other parent was breastfeeding to maintain or increase lactation.Conclusion:With professional lactation support, commitment to a lactation plan, responsive parenting, and strong communication and cooperation between parents, two parents were able to successfully co-lactate for more than a year. Breastfeeding was shared equally and supplementation of breastfeeds was rarely needed.
Alyssa Schnell

The Influence of Human-Milk Substitutes Marketing on Breastfeeding Intention and Practice among Native and Immigrant Brazilians

1 év 8 hónap ago
Journal of Human Lactation, Ahead of Print.
BackgroundThe International Code of Marketing of Breast-Milk Substitutes is a global public health policy aiming to protect breastfeeding from the influence of human-milk substitutes marketing. Brazil is one of the few countries substantially implementing it. Most countries adopted selected provisions, including Portugal.Research AimTo explore whether Brazilians’ perspectives about breastfeeding intention and practice are influenced by human-milk substitutes marketing upon migration to Portugal.MethodsA qualitative, prospective, cross-sectional survey design was conducted in Brazil and Portugal (2018–2019). Qualitative semi-structured interviews were performed with native (n = 16) and immigrant (n = 15) Brazilians. Women aged 18 or above, mothers of 0–12 month infants, and without contraindications to breastfeed, were eligible for the study. Heterogeneity sampling was employed based on socioeconomic status and infants’ age. Content analysis was conducted using NVivo.ResultsBrazilian immigrants were more aware of the potential negative influence of human-milk substitutes marketing than natives. Sociocultural factors contributed to Brazilian immigrants being less permeable to the influence of human-milk substitutes marketing in the host country, where a less protective breastfeeding environment was perceived.ConclusionsSociocultural factors including breastfeeding promotion strategies and a strong breastfeeding culture in the home country appear to play a protective role on breastfeeding intention and practice among Brazilians migrating to Portugal.
Cosima Lisi

“We All Believe in Breastfeeding”: Australian Midwives’ Experience of Implementing the Baby Friendly Hospital Initiative

1 év 8 hónap ago
Journal of Human Lactation, Ahead of Print.
Background:The education and support of new mothers during the in-hospital stay for childbirth is a critical time to establish breastfeeding. The Baby-Friendly Hospital Initiative was launched in 1991 to encourage maternity services to support and educate mothers to breastfeed by implementing Ten Steps to Successful Breastfeeding.Research Aim:To explore midwives’ experiences of implementing the Baby-Friendly Hospital Initiative in a Baby-Friendly accredited public hospital in Australia.Methods:In this prospective, cross-sectional qualitative study we used focus groups to explore midwives’ experiences. Midwives (N = 26) participated in two focus groups conducted between October and November 2019. Data were analyzed using thematic analysis.Results:Time as a critical resource, and continuity of care, were crosscutting themes that framed midwives’ experiences in supporting mothers to breastfeed their babies. Time constraints were experienced both through the health system structure and the BFHI accreditation process. Despite the challenges, the overarching theme—that we all believe in breastfeeding—fueled midwives’ motivation.Conclusion:Health services policy and practice need to consider ways to enable continuity of midwifery care and adequate time for midwives to support women to breastfeed their babies.
Andini Pramono

Breastfeeding Perceptions and Behavior Among Postpartum Women Initiating Different Hormonally Systemic Contraceptive Methods

1 év 8 hónap ago
Journal of Human Lactation, Ahead of Print.
Background:There continues to be controversy regarding the simultaneous encouragement of both breastfeeding and immediate postpartum contraception.Research Aim:To explore postpartum women’s perspectives about breastfeeding and their breastfeeding behaviors, while using one of three different hormonally systemic contraceptive methods immediately postpartum over a 6 month period of time.Methods:This was a retrospective, longitudinal, three group comparative, secondary analysis of a prospective cohort study (N = 471) of immediate postpartum contraception. Breastfeeding, for this study, was defined as providing any human milk to the infant. Participants who chose one of three different hormonally systemic forms of contraception immediately postpartum (a long-acting hormonal reversible contraceptive (n = 200), depot medroxyprogesterone acetate 150 mg (n = 98), or a non-hormonal method (n = 173)) were compared at hospital discharge, 6 weeks, 3 months, and 6 months postpartum. The primary outcome was any breastfeeding at 6 months. Secondary outcomes included any and exclusive breastfeeding, concerns about breastfeeding while using contraception, and reasons for breastfeeding discontinuation.Results:There was no significant difference in the rate of any breastfeeding between the two hormonal and the non-hormonal contraceptive groups at 6 months postpartum (long-acting hormonal 20.1%, non-hormonal 21.7%, depot medroxyprogesterone acetate 13.9%, p = .77, 0.28, respectively). The number of participants who reported stopping breastfeeding due to decreased milk supply was not significantly different between any groups at all time points (total number who discontinued at 6 months postpartum was long-acting hormonal 24.7%, non-hormonal 25.1%, depot medroxyprogesterone acetate 19.3%, p = .30).Conclusions:Breastfeeding perspectives and behavioral outcomes over the first 6 months postpartum were not influenced by participants chosen form of immediate postpartum contraception.
Susan Frances Wilson

Ellenőrizve

5 óra 23 perc ago
Table of Contents for Journal of Human Lactation. List of articles from ahead of print issues.
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