Journal of Human Lactation, Ahead of Print.
Background:With the advancement of antiretroviral therapy scale-up, it is possible for women living with HIV to breastfeed safely. However, this practice has not been adopted in Malaysia. Instead, infants are provided with subsidized human milk substitutes for their first 2 years of life.Research Aim:This study describes the infant feeding experiences of women living with HIV in Malaysia.Methods:From August to October 2021, a nationwide, community-based qualitative study was conducted among women living with HIV and who received care from the Malaysian Ministry of Health. Using purposive sampling, participants who met the inclusion criteria were recruited. Interview and focus group transcripts were coded based on a secondary thematic analysis.Results:Six in-depth interviews and five focus group discussions were conducted among 32 participants. Study participants were mostly Malay secondary school graduates in their 30s and 40s. Due to the fear of vertical transmission, which was explained by healthcare providers to the participants, none of the women breastfed their infants. The three primary themes that emerged from analyzing the women’s infant feeding experiences were (1) a human milk substitute was the only option and was encouraged; (2) feeding infants with a human milk substitute made the women feel incomplete as mothers; and (3) the women encountered difficulties in obtaining the subsidized human milk substitute.Conclusion:Women living with HIV in Malaysia have been advised to provide human milk substitutes to their infants in fear of HIV transmission.
Journal of Human Lactation, Ahead of Print.
Background:Accurate measurement of exclusive breastfeeding is important in maternal and child health research. Exclusive breastfeeding is often measured using the 24-hour recall or the since birth method for the first 6 months. These methods can produce different estimates, introducing problems in interpreting breastfeeding behavior and making accurate comparisons across settings or countries.Research Aim:Our aim was to compare the exclusive breastfeeding rates between the 24-hour recall and since birth methods among a diverse cohort of birthing people using the ecological momentary assessments method. In addition, we compared the exclusive breastfeeding rates between the two methods across race and other maternal characteristics.Methods:This study is a secondary analysis using data from the Postpartum Mothers Mobile Study (PMOMS), a prospective longitudinal study which recruited participants during pregnancy and followed them for 12 months after delivery. Participants completed surveys in real-time via ecological momentary assessment. Individual exclusive breastfeeding rates from months 1–6 were computed using 24-hour recall and since birth methods for 284 participants. We calculated the percentage point difference between the two methods across child age and maternal characteristics. We used a two-sample test of proportions to determine if the differences observed in the proportions were significant.Results:Exclusive breastfeeding rates from the 24-hour recall were higher than the since birth rates across all ages and maternal characteristics. The difference between the two methods at 3 months was 25.7 percentage points and at 6 months was a 17.2 percentage points. Irrespective of the method used to measure exclusive breastfeeding, White participants had higher exclusive breastfeeding rates than Black participants.Conclusion:The 24-hour recall and the since birth methods of assessing exclusive breastfeeding provided substantially different estimates. These findings highlight the importance of specificity in measuring and reporting exclusive breastfeeding.
In 2022 the Academy of Breastfeeding Medicine (ABM) published Clinical Protocol #36: The Mastitis Spectrum, which aims to update clinical approaches to management of benign lactation-related breast inflammatio...
Journal of Human Lactation, Ahead of Print.
Background:Mother’s breastmilk is the gold standard for feeding preterm infants. Preterm delivery may be precipitated by inflammatory maternal states, but little is known about milk cytokine profiles and how they correlate with markers of infant gut inflammation (i.e., stool calprotectin) in this vulnerable population.Research Aim:To assess cytokines and inflammatory markers in milk from parents of very preterm infants over time as well as correlations between milk and infant’s stool calprotectin.Method:This is a secondary analysis of milk samples collected during OptiMoM, a triple-blind randomized clinical trial of infants born < 1250 g (NCT02137473). Longitudinally collected samples were analyzed for cytokines, choline, and inflammatory markers (C-reactive protein [CRP], IFN-γ, IL-10, IL-1β, IL-1ra, IL-6, IL-8, TNF-α). Infant stools were collected for longitudinal calprotectin analysis. Generalized estimating equations quantified longitudinal profiles of milk markers and stool calprotectin, their associations, and the correlation between free choline and C-reactive protein over follow-up.Result:Participants included 92 parents and infants (median weeks of gestation 27.3, median birth weight 845 g, and prevalence of male infants 45%). In all, 212 milk samples and 94 corresponding stool calprotectin levels were collected 1–11 weeks postpartum. C-reactive protein was present in much higher concentrations than other markers, and was highest in Week 1 postpartum. It decreased over time. IL-8 and free choline also changed over time while other markers did not. There was no correlation between any milk markers and stool calprotectin.Conclusion:Milk from mothers of very preterm infants has detectable inflammatory markers, some of which change over time. Research is needed to determine if infant outcomes are associated with these markers.
Breastfeeding in the public sphere is known to be experienced as a problem for many women. It has been shown to arouse negative feelings among the public, depending on the attitude of those in the immediate su...
Although breastfeeding is strongly recommended, the breastfeeding rate of preterm infants in China remains significantly low. In addition to the global structural challenges to breastfeeding and the physiologi...
Journal of Human Lactation, Ahead of Print.
Sofia Quintero Romero graduated as a medical doctor at Universidad del Rosario, Bogotà, Colombia, in 1977. She spent a compulsory rural year working in a remote indigenous community in the Sierra Nevada de Santa Marta in Columbia. In 1979 she worked in Bolivia for Terre des Hommes and Oxfam, evaluating their health projects with the Aymara Indians and in the tin mines. She had to leave Colombia for political reasons and went to England, where she obtained, in 1981, an MSc in Community Health at the London School of Hygiene & Tropical Medicine (LSHTM). That’s where she met her husband, Adriano Cattaneo. She then worked in Mozambique and Nicaragua where she was in charge of maternal and child health services at the regional level. Since 1990, she devoted her time to the protection, promotion, and support of breastfeeding. Sofia obtained a PhD in Maternal and Child Health at the University of Bologna, Italy, and a Diploma in Breastfeeding Theory and Practice at the Child Health Institute in London UK. She taught hundreds of breastfeeding courses for health professionals and peer counsellors in Italy and in dozens of countries abroad, using the World Health Organization/United Nations Children’s Fund (WHO/UNICEF) manuals. In the past 15 years, she changed her approach for breastfeeding education to biological nurturing. Sofia has been a member of the International Baby Food Action Network (IBFAN) since 1992 and coordinated the Nestlé Boycott in Italy. She retired in 2018.
Although breastfeeding is practiced by 98% of mothers in Vietnam, infant breastfeeding behaviors remain far from World Health Organization recommendations and continues to decline. This study aims to explore t...
Global and Indonesian guidelines suggest that breastfeeding should continue for at least the first two years of life. While many studies have focused on six-month exclusive breastfeeding practices, little is k...
Journal of Human Lactation, Ahead of Print.
Background:Although WhatsApp can be used to provide continuous lactation support, there are few studies on this subject.Research Aims:To determine the influence of lactation support provided through WhatsApp on the duration and exclusivity of breastfeeding, initiation of complementary feeding, breastfeeding problems, breastfeeding difficulties score, and the use of bottles and pacifiers.Methods:We conducted a randomized controlled trial assessing the efficacy of education and support provided through the cell phone based WhatsApp application. There were 129 primiparous participants recruited while attending a Baby-Friendly Hospital in Istanbul, Turkey. Participants were randomized to intervention (n = 64) and control (n = 65) groups. All participants received the same routine postpartum breastfeeding education in the hospital, and the intervention group received additional continuous breastfeeding education for 6 months. For both groups, data was collected by telephone interview on Days 7 and 15, and Months 1, 2, 4, and 6 months. T-tests were used to assess inter-group differences in duration of exclusivity of breastfeeding. Mixed-model ANOVA was used to compare breastfeeding difficulties scores. Chi-square tests were used to compare breastfeeding problems, feeding practices, and the proportion of the use of bottles and pacifiers.Results:The mean duration of exclusive breastfeeding for groups receiving breastfeeding support was higher (4.75, SD = 1.72) than that of the control group (2.21, SD = 1.98; p = 0.001). The change in the mean breastfeeding difficulties severity score between the initial and final measurements (17.03, SD = 8.66) was more in the intervention group than the control group (11.42, SD = 10.34, F = 4.081, p = 0.001). The proportion of exclusive breastfeeding in the 6th month was higher in the intervention group (62.5%) than in the control group (10.8%; p = 0.001).Conclusions:The use of cellphone applications are accessible to both patients and health workers and offer a low-cost alternative for providing uninterrupted breastfeeding support.
Evidence suggested that inequalities based on education, wealth status, place of residence, and geographical regions significantly influence the key breastfeeding indicators including early initiation of breas...
Exclusive breastfeeding in the initial six months of infancy plays a significant role in the physical and cognitive development of the child. One in two children below six months of age in India is not receivi...
The breastfeeding rates of late preterm infants are lower than both term and extremely preterm infants. To explore the interventions of increasing full breast milk feeding rate of hospitalized late preterm inf...
Journal of Human Lactation, Ahead of Print.
Background:Breastfeeding self-efficacy has been proven to play a predictive role in enhancing breastfeeding initiation and continuation. Breastfeeding self-efficacy measurement tools have facilitated healthcare professionals’ early identification and support of women at higher risk of early discontinuation of breastfeeding.Research Aim:The aim of this study was to assess the psychometric properties of breastfeeding self-efficacy measurement tools.Method:A systematic review was carried out in three phases. Phase One comprised a systematic literature review performed in PubMed, SCOPUS, Web of Science, and Cochrane Database of Systematic Reviews from February 2021 to January 2023, including 36 studies for final analysis. Phase Two provided a quality appraisal of the psychometric properties of each of the seven breastfeeding self-efficacy measurement tools, according to COnsensus-based Standards for the selection of health Measurement Instrument checklist (COSMIN) guidelines. Phase Three summarized and graded the overall quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) modified approach.Result:The included articles comprised 9,225 participants and seven breastfeeding self-efficacy measurement tools. The Breastfeeding Self-Efficacy Scale, Breastfeeding Self-Efficacy Scale – Short Form (BSES-SF), and Prenatal Breastfeeding Self-Efficacy Scale were supported by Grade A evidence sustaining their validity and reliability to assess breastfeeding self-efficacy in the continuum of maternity care. The BSES-SF is the most feasible tool in clinical practice and the most utilized internationally, available in 15 languages.Conclusion:This systematic review provided a Grade A recommendation on breastfeeding measurement tools that will be helpful both for clinical and research purposes.Registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021238450)
Sri Lanka is an upper-middle-income country with excellent health statistics. However, 2016 Demographic and Health Survey data have shown 82% and 64% of mothers exclusively breastfed infants aged 0–6 months an...
Despite benefits of exclusive breastfeeding (EBF) and its strategic place in the national guidelines for infant and young child feeding, its practice remains insufficient in Cote d’Ivoire. It is therefore impo...
Journal of Human Lactation, Ahead of Print.
Background:Breastfeeding confers significant maternal and infant benefits; however, breastfeeding rates remain suboptimal in the United States. A parent’s decision to breastfeed is influenced by non-modifiable and modifiable factors, including breastfeeding knowledge and self-efficacy. There is a positive correlation between high maternal self-efficacy and breastfeeding duration. Parents increasingly rely on technology for health information.Research Aim:To determine if a smartphone application affected maternal self-efficacy and breastfeeding exclusivity rates.Method:This study was a randomized, controlled pilot study examining the effect of an educational program, included in a smartphone application, on breastfeeding self-efficacy (assessed in postpartum Week 1 and Weeks 4–6) and breastfeeding rates (assessed in postpartum Weeks 4–6). Forty participants were recruited using block randomization to intervention (17 of 20 completed the study) and usual care (19 of 20 completed the study) groups. To examine the pre-test/post-test difference in the Breastfeeding Self-Efficacy Scale – Short Form total scores, a change in score (post-intervention minus pre-intervention) was calculated for each parent.Result:The intervention group (phone application and usual care) showed greater change in self-efficacy scores (M = 7.6, SD = 7.8) compared to the control group (usual care; M = 1.2, SD = 3.7, p = .001). The rate of exclusive breastfeeding was nearly twice as high in the intervention group as in the control group, but did not reach statistical significance (p = .093).Conclusion:The investigators found enhanced breastfeeding self-efficacy and breastfeeding rates among postpartum women receiving a smartphone educational program in the first 6 weeks postpartum. Further studies on smartphone interventions will develop our understanding of this technology in improving breastfeeding rates.
To investigate the relationship between infant feeding practices and autism spectrum disorder (ASD) among children aged 2–5 years in the United States (US).
The World Health Organization and the government of China have made many efforts to improve breastfeeding practices. The evidence of breastfeeding practices over the past decade in China is limited. The curren...
Journal of Human Lactation, Ahead of Print.
