Hírolvasó

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.

Exclusive breastfeeding is an essential need for mothers and newborn babies, but cultural practices and employment demands significantly influence feeding practices. The association between neonatal intensive ...

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.
Background:Exclusive breastfeeding practice for 6 months is a critical global public health goal. In 2020, only 44% of infants globally, 31% in Central and West Africa, and 43% in Ghana, were exclusively breastfed for the first 6 months of life.Research Aim:To critically evaluate disparities in exclusive breastfeeding practice for 6 months in Ghana.Methods:The scoping review was guided by Arksey and O’Malley’s (2005) six-stage scoping review process. The online databases of American Psychological Association PsychInfo (APA PsychInfo), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Scopus were searched with keywords inclusive of Ghana, exclusive breastfeeding, breastfeeding, infant feeding, lactation, lactating, and exclusive. Eligibility criteria included full-text, peer-reviewed research articles written in the English language without limitation to specific years. Data were analyzed thematically.Results:Initially, 317 records were identified, and 15 full-text articles were eligible for the scoping review. Four main themes emerged as disparities in exclusive breastfeeding practice in Ghana. The themes were healthcare (prenatal clinic visits, delivery place, exclusive breastfeeding knowledge), personal (maternal age, Human Immunodeficiency Virus status, parity, type of delivery, breast problem), employment (unemployed, formal, or informal sector worker), and sociocultural (ethnicity/region, family support, religious beliefs, cultural practices).Conclusion:Disparities in exclusive breastfeeding in Ghana warrant the collaborative efforts of stakeholders for successful mitigation. Future researchers should explore the role of religion and sociocultural practices to protect, promote, and support 6 months of exclusive breastfeeding in Ghana.

Human milk banks (HMB) play an essential role by providing human milk to infants who would otherwise not be able to receive mother’s milk. There is currently no donor milk bank in Turkey. For any new health in...

Journal of Human Lactation, Ahead of Print.

Cyclosporine is widely used for immunosuppressive treatment of various systematic and local autoimmune diseases. Breastfeeding is conventionally contraindicated when treating with cyclosporine due to its excre...

Exclusive breastfeeding (EBF) for six months is recommended as one of the most important ways to support child health and survival, particularly during the COVID-19 pandemic. However, breastfeeding women encou...

I'm thrilled to share with you my new venture. I recently joined forces with Barbara Robertson, an IBCLC and educator from Michigan, to form a new lactation education entity for providers, LactaLearning.

Best Practices in Lactation AND Education
What makes LactaLearning a more enjoyable and effective way to learn? When Barbara and I began co-hosting an online Book Group at the height of the Covid pandemic during the dark, cold Chicago winter of 2020-2021, I discovered in Barbara more than just a kindred spirit in lactation. With her Masters degree in Curriculum Development and a special interest adult education, Barbara impressed me with her innovative educational methods and insights. When we began discussing new and better ways to train lactation providers, I got excited!

No More Endless PowerPoint Talks
Barbara knew from her graduate studies that passive listening to PowerPoint talks (online or in-person) isn’t the most effective way to learn or to change behavior. Yet this is how nearly all current course providers structure their courses.
What if instead we incorporated into lactation training the many ways students LIKE to learn and are most effective for retention: short videos, quick reads, infographics, animation, podcasts, interactive discussions? The possibilities were unlimited, and so desperately needed!

Many Courses to Meet Your Needs
Thus, LactaLearning was born. Visit LactaLearning.com to find:

• Courses for aspiring IBCLCs both a self-study course—described in the video below—and a group version of the 95-hour course required to sit for the IBLCE exam

• Professional Book Groups featuring interactive discussions with top authors in lactation

• Comprehensive trainings for WIC staff

• Trainings for hospital staff to support the Baby-Friendly Initiative

• 5-CERPs courses on communication skills and ethics

• Coming soon: recertification courses that make it easy for IBCLCs to tailor their topics to the specific areas required in the 2023 IBCLC Detailed Content Outline.
  
  Is there a better way to learn? Yes there is. By incorporating best practices in both lactation and education, LactaLearning gives you a better learning experience and better results for your hard-earned money. Check us out at LactaLearning.com!

 

Journal of Human Lactation, Ahead of Print.
Background:Exclusive breastfeeding to 6 months postpartum has been related to breastfeeding self-efficacy in diverse populations. Globally, this is measured using the Breastfeeding Self-Efficacy Scale–Short Form (BSES-SF).Research Aim:To evaluate the psychometric properties of the BSES-SF among women in Malawi; and to examine the relationship between breastfeeding self-efficacy and demographic and health factors.Methods:The study design was a prospective, cross-sectional survey with a 2 week follow-up reliability check. Postpartum women (N = 180) were recruited at a maternity hospital in Lilongwe, Malawi. In addition to the BSES-SF, the World Health Organization's Quality of Life Scale (QoL) was also administered. Furthermore, confirmatory factor analysis, Cronbach's alpha, and Pearson's correlations were used to examine the construct validity, reliability, test-retest reliability, and convergent validity.Results:The confirmatory factor analysis supported a unidimensional structure of the Malawian version of the 12-item BSES-SF. Cronbach's alpha and the intra-class correlation coefficient were 0.79 and 0.75, respectively. BSES-SF scores had significant correlation with QoL domains (physical QoL: r = 0.31, p < .001; and environmental QoL: r = 0.22, p < .01). Participants’ age, parity, and mode of delivery were positively correlated with breastfeeding self-efficacy scores.Conclusion:The findings of our study confirmed that the 12-item BSES-SF is a reliable and valid scale for assessing women’s breastfeeding self-efficacy in Malawi.

Journal of Human Lactation, Ahead of Print.
Background:The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life and that breastfeeding should continue for 2 years and beyond. Most women initiate breastfeeding, but many do not continue for the recommended duration. While midwife-led continuity of antenatal care is linked to improved mother and infant outcomes, the influence on breastfeeding duration has not been previously reviewed.Research Aim:To critically analyze the literature that compared midwife-led continuity of antenatal care with other models of care where researchers have measured breastfeeding duration beyond postpartum hospital discharge.Methods:A systematic literature review with critical analysis was used to answer the research aim. We systematically searched and screened five databases for quantitative studies where researchers had reported breastfeeding duration beyond postpartum hospital discharge after midwife-led continuity of antenatal care, compared with another model of antenatal care. Methodological quality was assessed using tools from the Cochrane Collaboration (RoB2 and ROBINS-I). In total, nine studies met the inclusion criteria.Results:Clear conclusions about the association between midwife-led continuity of antenatal care and breastfeeding duration were not found. The risk of bias within non-randomized studies ranged from serious to critical, and a judgement of “some concerns” of risk of bias in the one randomized study.Conclusion:To date, the question of whether midwife-led continuity of antenatal care improves breastfeeding duration has not been established. There has been a lack of consistency in definitions of breastfeeding and descriptions of models of care, which has weakened the evidence-based of literature reviewed.Our review protocol was registered with PROSPERO; although due to COVID-19, this registration was not checked for eligibility by the PROSPERO team (CRD42020151276). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020151276

Journal of Human Lactation, Ahead of Print.
Background:The American Academy of Pediatrics recommends exclusive breastfeeding for the first 6 months of life; however, a lack of access to breastfeeding (BF) resources influences BF initiation and continuation. Tele-lactation services may reduce some of these barriers to access.Research Aims:To identify facilitators and barriers of two modes of tele-health service utilization and to compare the differences between two modes of providing tele-lactation services on BF knowledge, BF intention, perceived social support, and 3-month BF continuation behavior.Methods:We conducted a mixed method, longitudinal pilot study utilizing prospective convenience sampling and random assignment of postpartum women recruited from two medical centers in Little Rock, Arkansas. Participants (N = 43) were randomized into telephone-only (n = 23) or audio-visual (n = 20) intervention groups. Participants completed a self-administered pre- and post-intervention survey, as well as a semi-structured qualitative phone interview at 4–6 weeks post-discharge.Results:No significant difference in demographic characteristics across groups was found. At 3 months after discharge, both groups reported continued BF (telephone-only: n = 17, 81%; audio-visual: n = 18, 90%) with no significant difference between the two groups (p = .663). Additionally, no group differences were found for BF knowledge or perceived social support. Overall, participants reported positive experiences with tele-lactation, emphasizing the convenience, accessibility, education, and support provided.Conclusion:We found that both telephone-only and audio-visual delivery of tele-lactation services were equally effective. Both methods of tele-lactation services should be considered by health care providers to encourage and sustain BF behavior in mothers.

Journal of Human Lactation, Ahead of Print.
Background:Human milk is an essential source of nutrition for an infant’s health. When breastfeeding working mothers or students, for example, are unable to breastfeed, storing their milk is recommended. Therefore, it is crucial to know the storage conditions to ensure their antioxidant capacity and avoid oxidative damage.Research Aim:To evaluate the stability of the antioxidant and pro-oxidant profiles and the amount of total protein in fresh human milk after different storage times (1, 2, 7, 14, and 21 days) and temperatures (4 ºC and -20 ºC).Methods:This was a prospective, longitudinal, and observational study with milk samples grouped according to age for comparisons, which included 20 lactating women. The antioxidant activity was evaluated using the colorimetric methods of free radical scavenging 2,2’-azinobis-3-ethylbenzothiazoline-6-sulfonic acid and the decrease of ferric ion. Oxidative stress was determined by the lipid peroxidation product formation through malondialdehyde concentration, and the total protein content was assessed by the Bradford method.Results:The antioxidant profile of human milk was maintained with minimal losses until the 14th day when stored at 4 ºC and -20 ºC. The evolution of malondialdehyde concentration over storage revealed significant changes only 21 days after human milk storage at 4 ºC. There was no change in the value of total protein content.Conclusions:To sum up, there is no difference in the storage of human milk at a temperature of 4 °C or -20 °C over 14 days. Therefore, the lactating woman may choose the most convenient way of storage.

Journal of Human Lactation, Ahead of Print.
Background:There are different approaches to breastfeeding interventions, but the global 6-month exclusive breastfeeding rates remain suboptimal. The COVID-19 pandemic has brought extra difficulties in promoting breastfeeding.Research Aim:To test the feasibility and effectiveness of a theory-based, real-time online educational and support program for breastfeeding related outcomes.Methods:An assessor-blinded, prospective pilot randomized controlled trial with parallel-group, repeated-measures design was used. The sample was low-risk primiparous mothers (N = 40) who delivered in the local public hospitals. Study outcomes consisted of exclusive breastfeeding rate, breastfeeding self-efficacy, and other breastfeeding outcomes measured by a self-reported questionnaire, including the Breastfeeding Self-Efficacy Scale and the Edinburgh Postnatal Depression Scale. Comparisons between the differences in the intervention and control groups were carried out.Results:Thirteen participants in the intervention group successfully completed the program. They had a higher exclusive breastfeeding rate, breastfeeding self-efficacy, breastfeeding initiation rate, and longer exclusive breastfeeding duration than the control group. Additionally, the intervention group had a lower partial breastfeeding rate, and a higher maternal postnatal depression score and infant’s morbidity at postnatal 2 months. However, all the results were not statistically significant (p > .050). Overall, the intervention was highly valued by all participants who appreciated the regular postnatal follow-ups.Conclusions:Despite showing the satisfactory feasibility of the program, no significant improvements were found in all study outcomes. Considering the participants’ comments, we suggest refining and further testing the intervention with a larger sample size over a longer-term follow-up to confirm its effectiveness.This study has been registered at ClinicalTrials.gov (NCT04741425)

Journal of Human Lactation, Ahead of Print.
IntroductionA 28-year-old woman was able to maintain lactation for her 21-month-old child through the process of an En Bloc Total Capsulectomy Breast Implant Removal. This case study is important as it exemplifies collaborative care to achieve maintenance of lactation through a surgical procedure.Main IssueThe participant was providing human milk to her 21-month-old child 4 times per day through breastfeeding and pumping and bottle feeding, and desired to continue lactation through explant surgery. The participant was experiencing Breast Implant Illness, yellowing of the skin and whites of the eyes, bottoming out of the right implant, severe capsular contracture of the right implant causing constant pain, limited mobility of the right arm and shoulder, and concern about an active recall on the brand implant she received.ManagementThe lactation management began 3 weeks prior to the procedure with the participant expressing enough milk prior to the surgery to allow for human milk feeding from a bottle during the 7-day recovery period as desired. The surgical team and IBCLC selected an appropriate bra for recovery to allow for both appropriate surgical site healing and ease of access for pumping. Exclusive pumping was utilized until surgical drains were removed, after which the participant was able to reintroduce breastfeeding.ConclusionEn Bloc Total Capsulectomy Breast Implant Removal can be performed while an individual is lactating without complication, given the appropriate multidisciplinary support. A temporary reduction of ease and efficiency of milk removal is possible post-operatively, in this case resolving within 24 hr.