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Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.

The World Health Organisation states that newborns should receive colostrum as soon as possible after birth. However, among newborns needing neonatal intensive care, initiation of lactation and access to colos...

Non-alcoholic fatty liver disease (NAFLD), characterized by excess liver fat, is common in women with a history of gestational diabetes mellitus (GDM). While breastfeeding improves postpartum lipid levels, its...

Lactoferrin (LF) in human milk has various biological properties and contributes to the prevention of preterm birth complications. Enzyme-linked immunosorbent assay (ELISA) is one of the most commonly used met...

Peripartum cardiomyopathy (PPCM) is a form of heart failure occurring towards the end of pregnancy or in the months following delivery. Concerns regarding the role of prolactin (the polypeptide hormone respons...

There is a growing body of research to suggest that women with gestational diabetes are less likely to initiate and continue breastfeeding than those who have not had however findings are mixed. There is limit...

Recent changes in the infant feeding guidelines for women living with HIV from high-income countries recommend a more supportive approach focusing on shared decision-making. Limited information is available on...

The World Health Organization prioritizes Mother’s Own Milk (MOM) or donor human milk (DHM) when MOM is unavailable or insufficient. It is also important for healthcare workers (HCWs) to provide adequate suppo...

Timely initiation of breastfeeding is crucial for positive health outcomes for babies and mothers. Understanding the factors influencing timely initiation of breastfeeding is vital for reducing child morbiditi...

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.
Background:Psychosocial predictors of breastfeeding and changes in those factors during pregnancy, along with the relationship of those changes with both breastfeeding and smoke use and exposure, are not well explored.Research Aim:The aim of this study was to identify distinct trajectories of psychosocial determinants of breastfeeding and smoking in pregnant women.Methods:We used a longitudinal study design and data from a randomized controlled trial conducted among smoke-exposed pregnant women and their infants. Participants were recruited early in pregnancy and were surveyed at ≤ 16 and 32 weeks gestation, delivery, 3 and 6 months postpartum for breastfeeding intentions, initiation, continuation, and smoke use and exposure. Psychosocial variables associated with breastfeeding were measured at baseline and 32 weeks gestation using the Mitra index, a structured questionnaire that assesses barriers and facilitators of breastfeeding intentions. Latent class growth analysis was performed using Mitra scores to identify distinct subgroups of participants with different trajectories. Sociodemographic characteristics, breastfeeding, and tobacco smoke use and exposure were compared across classes.Results:Three or four trajectories were identified for each of the six Mitra scores. Trajectories for all Mitra scores were associated with breastfeeding intention and initiation. Overall, Mitra, knowledge, self-efficacy, social support, and time barrier classes all differed by tobacco smoke use or exposure.Conclusion:Trajectories of breastfeeding knowledge, self-efficacy, social support, and time to breastfeed/social barriers are associated with tobacco smoke use and exposure during pregnancy. Encouragement to breastfeed and to cease and avoid tobacco smoke should start early in pregnancy, focusing on these determinants to improve health outcomes.

Returning to work is a barrier to breastfeeding. Although the Department of Labour Protection and Welfare (DLPW) in Thailand encourages employers to initiate a breastfeeding corner – a designated area where mo...

The International Code of Marketing of Breast-milk Substitutes, or ‘the Code,’ sets standards to regulate marketing of commercial milk formula (CMF) to protect breastfeeding. World Health Organization member s...

Journal of Human Lactation, Ahead of Print.
Breastfeeding offers significant health benefits for both mothers and infants, particularly preterm infants, where it serves as a therapeutic strategy to reduce mortality and morbidities. However, breastfeeding practices are threatened globally by societal norms and systemic barriers at both micro and macro levels. This paper explores the complex interplay of these barriers and facilitators, focusing on the Neonatal Intensive Care Unit (NICU) setting. Preterm infants face specific feeding challenges due to immature physiological functions, yet evidence supports that strategies like cue-based feeding and individualized care can enhance feeding success and health outcomes. For mothers, initiating and maintaining lactation after preterm birth is critical but challenging, with early lactation support and achieving sufficient milk volume being key predictors of success. Partner support significantly influences lactation outcomes, although more inclusive research is needed for diverse family structures. In the NICU, a multidisciplinary approach to lactation care is vital, emphasizing the need for experienced staff and family-centered practices. NICU design, policies promoting parental presence, and adherence to Baby-friendly Hospital Initiative guidelines further support breastfeeding. This paper aims to provide directives for local breastfeeding policies through an integrated approach, considering societal attitudes and healthcare practices. The findings advocate for improved lactation support in NICUs, inclusive language and policies, and further research into diverse familial and gender roles in breastfeeding.

Journal of Human Lactation, Ahead of Print.
Establishing lactation when mother and infant are separated, such as when the neonate is admitted to the neonatal intensive care unit (NICU), is challenging. The most common clinical advice is to express milk eight or more times per day, every 3 hours, around the clock. Sometimes, the first time that parents hear this is after the birth of their baby. This can be overwhelming and sometimes unachievable. A five-step paradigm shift is proposed that refocuses lactation care on providing evidence-based assistance and ongoing clinical education, and assessment beginning prenatally and extending past maternal discharge, to improve outcomes through curated support. Simple guidelines can begin with expressing milk at least five times a day by Day 5 of life (5 × 5), and expressing milk at least once between 0100 and 0500 (overnight pumping). With these measures, neonatal care in the NICU setting can provide personalized and achievable guidance on pumping schedules.

Journal of Human Lactation, Ahead of Print.
Background:Pasteurized donor human milk provides a safe and desirable alternative when a parent’s own milk is insufficient or unavailable. Currently, the demand for donor human milk exceeds the available supply. Little is known about the beliefs breastfeeding individuals have about milk bank donation.Research Aims:The aims of this exploratory study were to (a) provide a preliminary estimate of how well intention can be predicted, and to suggest which of the global constructs of the Reasoned Action Approach has the most influence on intention; and (b) identify the salient, top-of-the-mind beliefs underlying the intention to donate some of the milk an individual is currently producing to a milk bank.Methods:An exploratory, cross-sectional study design, based on the Reasoned Action Approach, was used to measure the theory’s global constructs and elicit beliefs underlying the intention to donate milk of lactating individuals (N = 118) living in Indiana, Illinois, Missouri, and Kentucky. Thematic and frequency analyses and multiple regression were performed.Results:Quantitative analyses found that injunctive norm and the autonomy component of perceived behavioral control were independently associated with intention. Qualitative analyses identified the advantages (e.g., help and save babies, won’t waste milk), referents who support (e.g., husband, family), and facilitators (e.g., having a convenient, close location, having more knowledge and information) of donating milk.Conclusions:This research provides insight into how milk banks might recruit and retain donors. Additional quantitative research with a larger sample is necessary to confirm the preliminary findings of this study.