Journal of Human Lactation, Ahead of Print.
Background:Establishing a human milk bank for the benefit of premature newborns who are unable to receive their mothers’ milk for various reasons is a common initiative. To date, 19 human milk banks have been established in China; however, data associated with human milk banks are lacking, including information on the operational costs, guidelines, and regulatory systems for human milk banks in China.Research Aim:Our study aim was to conduct a cost analysis for the human milk bank at Shanghai Children’s Hospital.Methods:A management accounting approach, based on the activity-based costing method, was used to develop a cost model for donor human milk. The data were collected retrospectively and included budget plans, financial and expenditure reports, databases, and interviews with the staff and managers at the Shanghai Children’s Hospital Human Milk Bank in 2017.Results:In 2017, the total volume of qualified donor human milk was 933.70 L, of which 842.71 L (90%) was frozen and 90.99 L (10%) was freshly donated on site. The total annual cost to provide milk for 212 high-risk infants in 2017 was US$156,923, and the unit cost was US$168/L.Conclusions:The operating costs of human milk banks in China are similar to those in other countries internationally, but these costs are so large that they require government and society support for funding and milk donation. Therefore, ongoing breastfeeding support for mothers and measures to reduce the operating costs of human milk banks should be advocated.
Initiation of breastfeeding immediately after birth, exclusive breastfeeding, and continuous breastfeeding for at least 2 years lower the risk of newborn deaths. This study was conducted to examine the trends ...
Journal of Human Lactation, Ahead of Print.
Background:Data are limited on the association between the use of donor human milk and improvements in feeding tolerance.Objective:To determine the influence of the duration of parenteral nutrition on the growth and morbidity of the breastfed newborn when using donated human milk in the absence of mother’s own milk.Methods:We conducted a retrospective study before and after the intervention that compared two groups of newborns (N = 284; each group n = 142). We used a convenience sample of all newborns ≤32 weeks gestation consecutively admitted in a single unit before (Group 1 between December 2012 and May 2014) or after (Group 2 between October 2014 and December 2016) the availability of donor human milk. In Group 2, donor human milk was administered at least 3 to 4 weeks or until the baby weighed 1,500 g. Weight was recorded daily and length and head circumference weekly. Parenteral nutrition was continued until enteral feeding volume reached 120 ml/kg/day. Additional variables measured were the number of days with a central venous catheter, age that the enteral feeding volume reached 150 ml/kg/day, and duration of stay.Results:The duration of parenteral feeding was the same before and after: 12 (8.23) and 11 (7.19) days (p = .822). The z scores for weight and height of newborns was lower in Group 2 = −1.8 (1.0) and −2.3 (1.1) and Group 1 = −1.2 (1.1) (p < .001) and −1.8 (1.4) (p = .005).Conclusion:We did not find an association between the administration of donor human milk as a supplement to mother’s own milk and reduced number of days of parenteral nutrition.Back translation by Laurence Grummer-Strawn
By Melissa Bartick, MD, MSc, FABM The Academy of Breastfeeding Medicine has released its updated Bedsharing and Breastfeeding Protocol. The protocol presents evidence-based recommendations synthesized by an international collaboration of authorities on the topic who conducted a rigorous review of the literature. Aimed at physicians and other health care professionals caring for families who have […]
Breastfeeding is a critical, evidence-based intervention that addresses malnutrition, improves early childhood development outcomes, and influences long-term maternal and infant health by reducing the non-comm...
Maternal overweight, infant feeding and early growth velocity are risk factors for obesity later in life. The first one thousand days are a window of opportunity to program health and disease. Exclusive breast...
Journal of Human Lactation, Ahead of Print.
Background:Increasing breastfeeding duration may help physician mothers better counsel their patients. To improve the breastfeeding duration of physician mothers, the factors that may influence their breastfeeding duration should be known.Research Aim:To investigate the breastfeeding behavior and duration among physician mothers and to determine the factors that influence breastfeeding practices.Methods:This was an online prospective cross-sectional self-report survey. A 26-item author-created data-collecting tool inquiring sociodemographic and work characteristics, medical history of delivery, and breastfeeding history was sent to female physicians who had infants between 12 and 60 months of age via an online social group, “Physician Mothers,” with 11,632 members. Participants (N = 615) responded, and descriptive statistics were analyzed.Results:Participants’ mean duration of exclusive breastfeeding was 4.8 months (SD = 1.9). The total breastfeeding length was a mean 15.8 months (SD = 7.6). The rate of breastfeeding duration for at least 24 months was 17.8% (n = 75). The most common reason for weaning from breastfeeding was workplace-related conditions (23.6%, n = 145). Participants reported that the mean time of resuming night shifts after delivery was 8.6 months (SD = 4.7). The rate of participants who were unable to use their breastfeeding leave rights partially or completely was 43.6% (n = 268).Conclusion:Although legislation is in place to allow working mothers to breastfeed their infants, these legal rights were not used properly. Physician mothers should be fully supported in using their breastfeeding leave rights, and workplace conditions should be improved to enable physician mothers to breastfeed their infants for extended periods.
Journal of Human Lactation, Ahead of Print.
Introduction:Breastfeeding offers the optimal feeding option for newborns in terms of nutritional content and reinforces mother-infant bonding. As a physiological process intrinsically linked to parturition, breastfeeding is no longer reserved for puerperal mothers. Progress in understanding the intricacies of lactogenesis and breastfeeding has further paved the way for artificially induced lactation in recent years.Main issues:We describe the case of a mother through surrogacy with XY karyotype and complete androgen insensitivity syndrome who wished to breastfeed her child.Management:Through a combination of estrogen therapy, galactagogues, and mechanical breast stimulation she was able to partially breastfeed her child for one month.Conclusion:This case further shifts the concept that breastfeeding is a physiological process confined to only puerperal mothers and offers an opportunity to a wider group of nontraditional mothers to take part in the unique experience of breastfeeding.
Journal of Human Lactation, Ahead of Print.
Background:Numerous researchers have evaluated the influence of federal and workplace lactation policies on breastfeeding duration, however few have considered the experiences of breastfeeding people returning to school.Research aim:The aim of this study was to evaluate the availability, accessibility, acceptability, and quality of existing on-campus lactation spaces.Methods:In-depth interviews were conducted with student-parents (N = 18) who had expressed milk on campus. Data collection and thematic analysis were based on the availability, accessibility, acceptability, and quality framework for evaluating health services from the human rights literature and adapted for this study.Results:For most participants with proximal access to a designated lactation space, room availability was exceptional and quality was marginally adequate. The provision of breast pumps, in-room sinks, and study desks were important aspects of quality discussed by the participants. Not all participants made use of the university’s designated lactation spaces due to either physical or informational inaccessibility. If designated lactation spaces were not convenient, participants found closer alternatives (e.g., bathroom, staff offices, or during the academic session).Conclusion:Breastfeeding parents who return to school experience obstacles similar to those reported by employed parents who return to work. They require convenient access to appropriate spaces and sufficient privacy to express milk for their infants. In order to best support all learners, university leaders must consider the needs of this unique student population.
Journal of Human Lactation, Ahead of Print.
Background:Recommendations to avoid breastfeeding for women living with HIV in high income countries has resulted in a gap in the literature on how healthcare professionals can provide the highest standard of lactation counseling.Research aims:(1) Describe social and emotional experiences of infant feeding for women living with HIV in high income countries; (2) raise ethical considerations surrounding the clinical recommendation in high income countries to avoid breastfeeding.Methods:A systematic literature search was conducted between January 1, 2008 and June 20, 2019. A total of 900 papers were screened and six met the inclusion criteria: (a) the sample was drawn from a high-income country regardless of the nativity of participants; (b) some or all participants were women living with HIV. Metasynthesis, according to Noblit and Hare (1988), was used to synthesize the experiences of women living with HIV in high-income countries and their experiences in infant feeding decisions.Results:Participants in this sample suffered a substantial emotional burden associated with infant feeding experiences potentially leading to risk of internalized stigma, suggesting that infant feeding considerations may contribute to HIV stigma in unique ways. Four overarching themes were identified expressing the meaning of avoidance of breastfeeding: maternal self-worth, deculturalization, surveillance, and intersectionality.Conclusion:Women in high-income countries living with HIV deserve the highest standard of lactation care and counseling available. Healthcare professionals in high-income countries are ethically obligated to provide evidenced-based lactation care and counseling to women living with HIV.
Journal of Human Lactation, Ahead of Print.
Journal of Human Lactation, Ahead of Print.
Journal of Human Lactation, Ahead of Print.
Background:Recommendations to avoid breastfeeding for women living with HIV in high income countries has resulted in a gap in the literature on how healthcare professionals can provide the highest standard of lactation counseling.Research aims:(1) Describe social and emotional experiences of infant feeding for women living with HIV in high income countries; (2) raise ethical considerations surrounding the clinical recommendation in high income countries to avoid breastfeeding.Methods:A systematic literature search was conducted between January 1, 2008 and June 20, 2019. A total of 900 papers were screened and six met the inclusion criteria: (a) the sample was drawn from a high-income country regardless of the nativity of participants; (b) some or all participants were women living with HIV. Metasynthesis, according to Noblit and Hare (1988), was used to synthesize the experiences of women living with HIV in high-income countries and their experiences in infant feeding decisions.Results:Participants in this sample suffered a substantial emotional burden associated with infant feeding experiences potentially leading to risk of internalized stigma, suggesting that infant feeding considerations may contribute to HIV stigma in unique ways. Four overarching themes were identified expressing the meaning of avoidance of breastfeeding: maternal self-worth, deculturalization, surveillance, and intersectionality.Conclusion:Women in high-income countries living with HIV deserve the highest standard of lactation care and counseling available. Healthcare professionals in high-income countries are ethically obligated to provide evidenced-based lactation care and counseling to women living with HIV.
Journal of Human Lactation, Ahead of Print.
Background:Numerous researchers have evaluated the influence of federal and workplace lactation policies on breastfeeding duration, however few have considered the experiences of breastfeeding people returning to school.Research aim:The aim of this study was to evaluate the availability, accessibility, acceptability, and quality of existing on-campus lactation spaces.Methods:In-depth interviews were conducted with student-parents (N = 18) who had expressed milk on campus. Data collection and thematic analysis were based on the availability, accessibility, acceptability, and quality framework for evaluating health services from the human rights literature and adapted for this study.Results:For most participants with proximal access to a designated lactation space, room availability was exceptional and quality was marginally adequate. The provision of breast pumps, in-room sinks, and study desks were important aspects of quality discussed by the participants. Not all participants made use of the university’s designated lactation spaces due to either physical or informational inaccessibility. If designated lactation spaces were not convenient, participants found closer alternatives (e.g., bathroom, staff offices, or during the academic session).Conclusion:Breastfeeding parents who return to school experience obstacles similar to those reported by employed parents who return to work. They require convenient access to appropriate spaces and sufficient privacy to express milk for their infants. In order to best support all learners, university leaders must consider the needs of this unique student population.
Journal of Human Lactation, Ahead of Print.
Background:Increasing breastfeeding duration may help physician mothers better counsel their patients. To improve the breastfeeding duration of physician mothers, the factors that may influence their breastfeeding duration should be known.Research Aim:To investigate the breastfeeding behavior and duration among physician mothers and to determine the factors that influence breastfeeding practices.Methods:This was an online prospective cross-sectional self-report survey. A 26-item author-created data-collecting tool inquiring sociodemographic and work characteristics, medical history of delivery, and breastfeeding history was sent to female physicians who had infants between 12 and 60 months of age via an online social group, “Physician Mothers,” with 11,632 members. Participants (N = 615) responded, and descriptive statistics were analyzed.Results:Participants’ mean duration of exclusive breastfeeding was 4.8 months (SD = 1.9). The total breastfeeding length was a mean 15.8 months (SD = 7.6). The rate of breastfeeding duration for at least 24 months was 17.8% (n = 75). The most common reason for weaning from breastfeeding was workplace-related conditions (23.6%, n = 145). Participants reported that the mean time of resuming night shifts after delivery was 8.6 months (SD = 4.7). The rate of participants who were unable to use their breastfeeding leave rights partially or completely was 43.6% (n = 268).Conclusion:Although legislation is in place to allow working mothers to breastfeed their infants, these legal rights were not used properly. Physician mothers should be fully supported in using their breastfeeding leave rights, and workplace conditions should be improved to enable physician mothers to breastfeed their infants for extended periods.
Journal of Human Lactation, Ahead of Print.
Introduction:Breastfeeding offers the optimal feeding option for newborns in terms of nutritional content and reinforces mother-infant bonding. As a physiological process intrinsically linked to parturition, breastfeeding is no longer reserved for puerperal mothers. Progress in understanding the intricacies of lactogenesis and breastfeeding has further paved the way for artificially induced lactation in recent years.Main issues:We describe the case of a mother through surrogacy with XY karyotype and complete androgen insensitivity syndrome who wished to breastfeed her child.Management:Through a combination of estrogen therapy, galactagogues, and mechanical breast stimulation she was able to partially breastfeed her child for one month.Conclusion:This case further shifts the concept that breastfeeding is a physiological process confined to only puerperal mothers and offers an opportunity to a wider group of nontraditional mothers to take part in the unique experience of breastfeeding.
On topics ranging from addressing disparities to trends in research on human milk exchange, our community tapped into the top-accessed resources of Journal of Human Lactation (JHL) nearly 180,000 times last year. As we wrap up 2019, we compiled this list of the year’s top ten most accessed JHL articles. Planning on using research to guide […]
Exclusive breastfeeding (EBF) is one of the key strategies to ensure infants and young children survive and grow. However, a 2010 study showed that it was only practiced by 50% of Tanzanian women. That study a...
Journal of Human Lactation, Ahead of Print.
Journal of Human Lactation, Ahead of Print.
