Hírolvasó

Maternal employment has been described as a barrier to breastfeeding in many countries. In Japan, many mothers quit breastfeeding after returning to work because they do not know how to continue breastfeeding....

Infant sleep is of great interest to new parents. There is ongoing debate about whether infants fed with breastmilk substitutes sleep longer than those exclusively or partially breastfed, but what does this me...

Emotional distress in mothers inhibits the let-down reflex, thus affecting breastfeeding self-efficacy. A breastfeeding mother may have to cope with both physical discomfort and psychological distress. However...

Breastfeeding duration has declined in the Kingdom of Saudi Arabia (KSA) in recent decades, although accurate national data about different breastfeeding indicators by infant age are lacking. This qualitative ...

This study aims to systematically review the effects of maternal vitamin and/or mineral supplementation on the content of breast milk.

Determinants at several levels may affect breastfeeding practices. Besides the known historical, socio-economic, cultural, and individual factors, other components also pose major challenges to breastfeeding. ...

Breastfeeding is considered the biological norm and essential to reduce infant morbidity and mortality. Mothers are responsible for breastfeeding but the support of others, including their partners is an influ...

Journal of Human Lactation, Ahead of Print.
BackgroundEarly breastfeeding practices are important determinants of later breastfeeding behaviors and can be influenced by multiple factors. Despite the Baby-Friendly Hospital Initiative reported positive influence on breastfeeding initiation, its influence on the association between maternal country of birth and first day in-hospital breastfeeding has not been examined.Research aimsTo determine (1) if association between maternal country of birth and first day in-hospital exclusive breastfeeding exists in Portugal and (2) if any association is affected by giving birth in a Baby-Friendly Hospital.MethodsData were drawn from baMBINO—a longitudinal, 2017–2019 nationwide study designed to assess the perinatal health and healthcare experiences of migrant and native Portuguese women. Data from participants (N = 5,340) were collected during their hospital stay from 32 maternity units. Missing data were handled through multiple imputation. After stratifying by Baby-Friendly Hospital Initiative accreditation, a multivariate logistic regression was performed.ResultsFirst day in-hospital exclusive breastfeeding rates were high among both migrant and native participants (89.2% vs. 87.4%). Migrants were more likely to exclusively breastfeed when compared to natives (OR = 1.19, 95% CI [1.00, 1.41]). In non-Baby-Friendly Hospitals, a positive association was found between participants from Eastern European countries (aOR = 2.46, 95% CI [1.27, 4.78]) and first day in-hospital exclusive breastfeeding. In accredited hospitals, maternal country of birth did not influence exclusive breastfeeding during the first 24 hr.ConclusionsThe Baby-Friendly Hospital Initiative attenuates differences between migrant and native participants, promoting optimal breastfeeding practices among natives.

Journal of Human Lactation, Ahead of Print.
BackgroundThe need for donor human milk has accelerated both locally and globally. To remain sustainable, human milk banks need to maintain effective recruitment including frequent donations of adequate volumes.Research aimsTo determine (1) which factors influenced mothers’ willingness to give or receive donor human milk, and the influence of (2) socio-demographics, (3) pregnancy, (4) breastfeeding history, (5) prior knowledge of human milk banks, and (6) general factors on milk donations.MethodsThis was a cross-sectional, prospective, descriptive study. Interviewer administered questionnaires were used (N = 148). Independent sample t-tests and one-sample t-tests were used to determining differences in variables.ResultsThe sample population consisted of mainly single (n = 104, 70.3%) Black African mothers (n = 127, 85.8%) who identified as Christian (n = 97, 65.6%) with a mean age of 24.8 (SD = 5.63) years. The majority (n = 120, 81.1%) had no prior knowledge of human milk banks; however, most (n = 78, 52.7%) were significantly likely to donate. The main factors that influenced the participants’ willingness to donate were altruism (n = 99, 66.9%), information provided by staff at hospitals/clinics (n = 92, 62.2%), amount of milk produced (n = 69, 46.4%), fear of not having enough milk for their own infant (n = 68, 45.9%), and support from family/friends/partner (n = 67, 45.3%).ConclusionThere is a strong need to increase visibility and information sharing with potential donor mothers to ensure a sustainable supply and system of human milk banks.

By Popular Demand! So many enrolled in our Breastfeeding Answers, 2nd Edition book group, we've already covered our basic expenses. Yay! That's why we decided to keep our doors open wide and continue our early-bird pricing through January 1, 2021 as a holiday special. But there's more! For those shipping my book to a US address, through 1/1/21, I will continue our 20% discount on the hardcover edition. (Look for your discount code in your book-group confirmation email.) Register HERE right away, as we have just a few spots left!!!

Our early-bird pricing is:

• 36 CERPs: $299 (2021 price: $350)

• No CERPs: $229 (2021 price: $280)

At this book group we will use Zoom Meeting. and Thinkific, an easy-to-use online learning platform. A day or two after you register, you will get an invitation to join us on Thinkific, where you will see the required reading listed for each of our ten sessions.

You will need to get your own copy of Breastfeeding Answers, 2nd Edition, either a hard copy or an e-book edition: Kindle, ePub, or PDF (available HERE). The 1st edition (or any of the earlier Breastfeeding Answer Books) will not do! So much has changed! You will read the assigned chapters, attend our live Zoom meetings or listen to our recording meeting discussion with Q&A, review any supplemental materials. If you registered for our 36 CERPs version, you will take the quiz at the end of each session.

When will the book group take place? It will meet from 6:30 to 8:30 pm EST on the following dates:

• Session 1: Sunday, January 17, 2021

• Session 2: Sunday, January 24, 2021

• Session 3: Sunday, January 31, 2021

• Session 4: Sunday, February 14, 2021

• Session 5: Sunday, February 21, 2021

• Session 6: Sunday, February 28, 2021

• Session 7: Sunday, March 7, 2021

• Session 8: Sunday, March 14, 2021

• Session 9: Sunday, March 28, 2021

• Session 10: Sunday, April 4, 2021

Each session consists of a 2-hour Zoom meeting where we will discuss the materials and answer questions. Before each session, you will read the assigned chapters (some sessions cover one chapter but others cover two or three) and any supporting materials. If you registered for CERPs, after our Zoom meeting, you will take a short quiz.

You must buy the most recent book: Breastfeeding Answers, 2nd Edition by Nancy Mohrbacher (available HERE).

The Zoom meetings will be recorded so you have the flexibility of missing a session if needed and then listening to the recorded Zoom meeting at your leisure on Thinkific. You will have access to all the materials until 4-15-21.

To learn more about the book group, watch our short video below, or listen HERE to the free 30-minute book-group podcast I recorded with Barbara. Hope you can join us!

As information is rapidly unfolding about the new mRNA COVID vaccines and lactating families, we sat down with Dr. Lori Feldman-Winter to help our community get the information they need to support those with questions right now. Dr. Lori Feldman-Winter is a fellow in the Academy of Breastfeeding Medicine (ABM) and helped to bring their […]

Journal of Human Lactation, Ahead of Print.
BackgroundBreastfeeding is a fundamental component of health care, and health professionals need to be adequately prepared. As part of the system, health care professionals have the ability to influence the establishment and maintenance of breastfeeding. The global literature regarding the curricular approach or established best practices for health professional education in lactation is inconclusive and lacking in rigor.Research aimTo explore the literature for the educational resources, methods, and curriculum used in the education of undergraduate health students related to lactation.MethodsA scoping review examining the curricular programs of health professional students in lactation was undertaken exploring and summarizing evidence from peer reviewed and grey literature. A scoping review with a five-stage review process was followed. The database search between 1982–2018 generated 625 results, 79 full-text articles were reviewed, and 29 articles published in English met the inclusion criteria.ResultsIn general, educational resources, methods, curricular approaches, and foundational topics were based on best practice standards. Some authors incorporated a variety of learning methods and provided experiential learning, with evidence of translation of knowledge into clinical practice. In the studies examined, researchers reported that students had improved their: knowledge and attitudes (59%); breastfeeding support skills (45%); and confidence (10%). However, even in programs that focused on developing students’ breastfeeding support skills, authors reported a lack of change in students’ confidence.ConclusionsAlthough only English articles met the inclusion criteria, this review was unique in its search of multidisciplinary, multilingual, and international studies. Consistency in teaching across disciplines is key and not evident in the studies reviewed.

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.
BackgroundStudents returning to school who are breastfeeding face unique challenges. There is limited literature on breastfeeding university students. Several researchers have studied breastfeeding employees in the workplace. Institutions of higher education closely mimic the employment environment. Breastfeeding college students who express their milk while at school share similar challenges to employed mothers. A baccalaureate nursing program is rigorous and little is known about the challenges facing breastfeeding student nurses returning to classes.Research aimTo explore the breastfeeding experience of baccalaureate nursing students.MethodsOur study was a cross-sectional descriptive qualitative design. Purposive sampling was used to enroll participants (N = 12). In depth, semi-structured interviews were conducted. Qualitative thematic analysis was used to analyze the data both manually and using Dedoose QDA software.ResultsAn overarching theme of pervasive conflict between the role of the breastfeeding mother and the role of the student nurse surfaced. Three interrelated organizing themes also emerged; challenging, vulnerability, and resilience. Time constraints, self-care versus role demands, and structural accommodations contributed to the challenges. Only one participant indicated a knowledge of her breastfeeding rights. All of the participants expressed gratitude for faculty and community support, regardless of conflicts.ConclusionBreastfeeding participants were both vulnerable and resilient. Faculty may improve experiences through providing specific areas of support. A breastfeeding support policy outlining student rights and faculty responsibilities is needed to educate, guide, and enforce protections. Health care providers may enhance breastfeeding students’ experiences through anticipatory guidance, education, and continued support.

Journal of Human Lactation, Ahead of Print.
BackgroundInconsistent information exists regarding indicators of secretory activation in mothers delivering very low birth weight infants.Research aimsTo compare time to the onset of secretory activation using three separate indicators. A secondary aim examined the association between indicators of secretory activation and milk production.MethodsIndicators of secretory activation included maternal perception, volume attainment (production of ≥ 20 mL in two consecutive expression sessions) and biomarkers (sodium and lactose) obtained at volume attainment. Milk production was measured on Days 1–7 and then weekly for 6 weeks.ResultsIn 69 mothers of infants born ≤ 32 weeks’ gestation and < 1500 g, we found no correlation in time to secretory activation between indicators. Earlier volume attainment was associated with increased milk production on Days 1–7, 14, 21, and 28 (all p < .007). Participants who exhibited both normal lactose and sodium levels produced more milk on Days 28 and 42 (p = .028 and .011), those with only normal lactose levels produced more on Day 42 (p = .026) and those with only normal sodium levels on Day 28 (p = .036). Earlier secretory activation by volume attainment was associated with increased expression frequency during Days 2–5 (all p < .014) and participants with normal biomarkers expressed more frequently during Days 2–5 (all p < .020).ConclusionMothers of very low birth weight infants are at risk for delayed secretory activation, which may decrease their milk production. Frequent expression during the first 5 days postpartum may promote earlier secretory activation. Valid methods of determining secretory activation are necessary to develop interventions promoting earlier secretory activation.

Journal of Human Lactation, Ahead of Print.
BackgroundAiming to protect breastfeeding, the World Health Organization released the International Code of Marketing of Breastmilk Substitutes in 1981, which was adopted by the vast majority of the 118 member countries, including Brazil. The Brazilian Code regulates the marketing of infant formulas, baby bottles, teats, pacifiers, milk, and processed complementary food.Research aims(1) To determine if retail stores had violated the Brazilian Code and (2) to analyze factors associated with these violations.MethodsThis cross-sectional study included all drugstores, supermarkets, and department stores in the Southern Zone of Rio de Janeiro City, Brazil. Trained health professionals observed retail stores for marketed products and violations of the Brazilian Code and then interviewed their managers. Factors associated with the retail stores violating the Brazilian Code (outcome) were analyzed, employing a logistic regression model with 95% Confidence Interval.ResultsOf the retail stores (N = 349) evaluated, 62.8% violated the Brazilian Code, ranging from 1 to 37 violations per retail store. The most common promotion strategies were price discounts and special displays. Retail stores being part of a chain store (aOR = 4.59) and their manager receiving visits from industry business representatives (aOR = 2.14) were associated with the presence of violations.ConclusionsThe prevalence of Brazilian Code violations was high, especially in chain stores. The association between regular visits by industry representatives and violations suggests an indirect influence of manufacturers on the promotion of human milk substitutes. We recommend strengthening compliance with the Brazilian Code through calling on governmental surveillance agencies and civil society mobilization.

Journal of Human Lactation, Ahead of Print.
BackgroundMother’s own milk does not provide enough nutrients to feed a preterm baby born before 32 weeks’ gestation; therefore, human milk fortifiers are needed. However, human milk fortifiers increase the osmolality, and enteral administration of high osmolality fluids has been associated with gastrointestinal symptoms. For this reason, it is necessary for laboratories to have a validated system in order to measure human milk osmolality.Research aimThe aim of this study was to validate the OM-6050 Station System for measuring the osmolality of fortified mother’s milk samples.MethodsOsmolality was measured using the osmometer OM-6050 Station System. Milk samples from healthy mothers (N = 3) unfortified and with two fortifiers (Almirón Fortifier® or NAN FM85®), as well as a nutritional supplement (Duocal MCT®) were used in the validation study through precision and linearity analysis.ResultsIn the precision study the mean intra-assay coefficient of variation was 1.2% and 1.7% for mother’s milk and fortified mother’s milk, respectively. The mean inter-assay coefficient of variation was ≤ 1% in both cases. In the linearity study the regression analysis had a linear response to fortified mother’s milk osmolality between 294 mOsm/kg and 539 mOsm/kg.ConclusionThe osmometer OM-6050 Station was reliable for determining the osmolality of fortified and unfortified mother’s milk. It may be useful in the clinical practices within Neonatal Intensive Care Units.

Journal of Human Lactation, Ahead of Print.
BackgroundThe mothers of very low birth weight infants face many challenges to achieve breastfeeding at hospital discharge, especially during long stays.Research aimThe aim of this study was to describe the incidence and factors associated with breastfeeding rates (exclusive or with formula) at discharge, for very low birth weight infants, in a private Neonatal Intensive Care Unit in southern Brazil.MethodsWe conducted a prospective longitudinal cohort study of infants (N = 335) with very low birth weight and/or less than 30 weeks gestational age, who survived to discharge and had no contraindication to mother’s own milk. Participants were initially divided into three groups (exclusive breastfeeding, some breastfeeding, and no breastfeeding) based on their feedings at discharge; however, later, two groups were analyzed (any breastfeeding, no breastfeeding).ResultsMost (93.4%; n = 313) were breastfeeding directly at least once daily at discharge, of which 16.1% (n = 54) were receiving exclusive mother’s milk and 77.3% (n = 259) mixed feeding (mother’s milk and formula). Breastfeeding at discharge was associated with gestational age ≥ 28 weeks, higher birth weight, not developing neonatal sepsis or bronchopulmonary dysplasia during the hospital stay, shorter lengths of stay, and lower weight at discharge. After Poisson regression, breastfeeding at discharge was associated only with a shorter length of stay (RR 0.98; CI 95% [0.95, 0.99], p < .05).ConclusionsIn our single unit experience in Brazil, most infants were breastfeeding at discharge. NICU staff might address mothers of infants who have prolonged hospitalization with specific strategies. Mothers and infants at risk can be identified early and personalized interventions can be developed for improving breastfeeding rates at discharge.

Journal of Human Lactation, Ahead of Print.
BackgroundDefinitive criteria for microbial screening of pasteurized donor human milk are not well established and international recommendations vary.Aims(1) To review pasteurized donor human milk batch discard due to failed microbial screening criteria at our milk bank (following United Kingdom National Institute of Clinical Excellence guidelines), and (2) to compare our known milk discard proportion with estimated milk discard proportions that would be required by other international milk bank guidelines.MethodsWe reviewed our microbial screening results (N = 783) over 18-months (July 2018-December 2019) and compared our known milk discard proportion with estimated milk discard proportions using other international milk bank guidelines.ResultsOf samples, n = 50 (6.4%) failed pre-pasteurization screening, most commonly due to the presence of >104 CFU/mL Enterobacterales in the pre-pasteurization sample (n = 30; 3.8%). Two (0.3%) samples failed post-pasteurization screening, with Bacillus cereus identified in both cases, resulting in total discard proportion of 6.7% (n = 52) of batches. Applying European Milk Bank Association recommended bacterial screening criteria, approximately 23.3% (n = 183) of milk batches would have been discarded.ConclusionsFurther research is required to justify the stringent European Milk Bank Association recommendations for pre-pasteurization discard criteria, although we believe that a post-pasteurization acceptance criterion of <1 CFU/mL is appropriate and aligns with international guidance. Further work is needed to understand pasteurized donor human milk microbiological safety risks, to better integrate screening criteria within current food standards regulation, and to consider risk-based assessment including the impact on availability and affordability.

With countries in the process of authorizing distribution of the first COVID-19 vaccines, lactation consultants may have questions about accessing the immunization as well as available safety information for breastfeeding and chestfeeding clients. In this rapidly changing environment, ILCA is continuing to gather and disseminate international and regional updates about lactation-related COVID information here. Please […]