Journal of Human Lactation, Ahead of Print.
There has, historically, been a lack of consistency in the use and definition of terms and their associated measurement in breastfeeding research. The purpose of this paper is to promote consistency through a taxonomy and lexicon for population-based breastfeeding research with the modern nursing dyad. The taxonomy organizes concepts in categories related to research on feeding human milk to infants, noting the perspective from the provider of human milk (parent or alloparent) and the receiver of human milk (child). The taxonomy includes these categories: psychology, physiology, behavior, and modality. The intensity of behaviors and modalities can be characterized qualitatively or quantitatively. Other terms are introduced or defined for the modern era and measurement standards are posed. These suggestions invite discussion and debate, in an effort to move researchers toward consistent measurement, documentation, and presentation, to build a credible evidence base for breastfeeding and practices related to the provision and consumption of human milk.
Journal of Human Lactation, Ahead of Print.
Background:International Board Certified Lactation Consultants (IBCLC) are healthcare professionals who are highly trained in lactation science; however, little is known about the efficacy of IBCLC-specific support on breastfeeding outcomes.Research aims:This systematic review and meta-analysis aimed to describe interventions containing direct support by IBCLCs during the postpartum period and to analyze the association between study characteristics and the prevalence breastfeeding outcomes.Methods:Electronic databases were searched for studies published between January 2001 and December 2018. Meta-analysis and meta-regression were performed on studies containing breastfeeding prevalence data at 3 or 6 months postpartum.Results:Seventeen interventions met all inclusion and exclusion criteria and eight research teams reported the prevalence of any or exclusive breastfeeding at 3 and/or 6 months. For any breastfeeding at 6 months, the pooled difference was 0.08 [0.04, 0.12] meaning we’d expect to observe 1 additional case of any breastfeeding at 6 months postpartum for every 12 women who received an IBCLC intervention, 95% CI [8, 25] rather than control conditions. Results differed depending on which outcome variable was used to measure breastfeeding and the timing of that measurement.Conclusions:Breastfeeding interventions that include IBCLC support in the postpartum period have potential for improving breastfeeding outcomes; however, when designing interventions, the timing and method of data collection for measures of breastfeeding are instrumental to study sensitivity and need to be based on the aims of the intervention itself.
Journal of Human Lactation, Ahead of Print.
Breastfeeding is critical for the healthy growth and development of infants. A diverse range of infant-feeding methods are used around the world today. Many methods involve feeding infants with expressed human milk obtained through human milk exchange. Human milk exchange includes human milk banking, human milk sharing, and markets in which human milk may be purchased or sold by individuals or commercial entities. In this review, we examine peer-reviewed scholarly literature pertaining to human milk exchange in the social sciences and basic human milk sciences. We also examine current position and policy statements for human milk sharing. Our review highlights areas in need of future research. This review is a valuable resource for healthcare professionals and others who provide evidence-based care to families about infant feeding.
It may be tempting for breastfeeding advocates to respond to challenges of breastfeeding older children or breastfeeding in public, by pointing out the nutritional or developmental benefits of breastfeeding, o...
Journal of Human Lactation, Ahead of Print.
Breastfeeding and the place of sleep for the mother and the infant have been controversial internationally due to reported concerns regarding infant deaths despite the known benefits of exclusive and prolonged breastfeeding, which are increased by breastfeeding at night. The aims of this integrated analysis were to (a) review breastfeeding and maternal and infant sleep research literature via historical, epidemiological, anthropological, and methodological lenses; (b) use this information to determine where we are currently in safeguarding both infant lives and breastfeeding; and (c) postulate the direction that research might take from this point forward to improve our knowledge and inform our policy and practice. Despite well-meaning but unsuccessful campaigns in some countries to dissuade parents from sleeping with their babies, many breastfeeding mothers and caregivers do sleep with their infants whether intentionally or unintentionally. Taking cultural contexts and socio-ecological circumstances into consideration, data supports policies to counsel parents and caregivers on safe sleep practices, including bed-sharing in non-hazardous circumstances, particularly in the absence of parental smoking, recent parental alcohol consumption, or sleeping next to an adult on a sofa. Further research with appropriate methodology is needed to drill down on actual rates of infant deaths, paying close attention to the definitions of deaths, the circumstances of the deaths, and confounding factors, in order to ensure we have the best information with which to derive public health policy. Introduction and use of the concept of “breastsleeping” is a plausible way to remove the negative connotations of “co-sleeping” and redirect ongoing data-driven discussions and education of best practices of breastfeeding and sleep.
Decisions about infant feeding are embedded and are continuously made within a woman’s social and cultural context. Despite the benefits of breastfeeding to both women and infants, and government policies and ...
In 2015, the popular online parenting forum, Netmums, named breastfeeding selfies as the number one parenting trend in the UK for that year. Public reaction to the rise in popularity of this practice is polarised...
Significant efforts by governments at a global and national level have not resulted in a significant increase in the duration of breastfeeding to six months. The views of family and social networks, and commun...
Authored by: Sarah Shubeck, MD and Megan Pesch, MD, MS The culture of medical training and demands of residency work is often regarded as not conducive to the needs of lactating physicians. The need for “breaks” or perceived lack of dedication to workplace can lead to misperception of lactating trainees and pressures to stop milk […]
With an increasing demand for mother’s own milk to be viewed as a primary source of nutritional support in the care of very small and preterm infants, mothers of preterm infants may be at risk of expressing su...
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Reducing maternal mortality is a key focus of development strategies and one of the indicators used to measure progress towards achieving the Sustainable Development Goals. In the absence of medical certificat...
The relevance of registries as a key component for developing clinical research for rare diseases (RD) and improving patient care has been acknowledged by most stakeholders. As recent studies pointed to severa...
The clinical heterogeneity of the 22q11.2 Deletion Syndrome (22q11.2DS – OMIM, #188400 and #192430) is a universal challenge leading to diagnostic delay. The aim of this study was to evaluate a low cost strate...
Accurate and timely diagnosis of malaria is essential for disease management and surveillance. Thin and thick blood smear microscopy and malaria rapid diagnostic tests (RDTs) are standard malaria diagnostics, ...
Williams Beuren syndrome (WBS) is a multiple malformations/intellectual disability (ID) syndrome caused by 7q11.23 microdeletion and clinically characterized by a typical neurocognitive profile including exces...
Patients undergoing cardiac surgery with cardiopulmonary bypass are at an increased risk of developing postoperative pulmonary complications, potentially leading to excess morbidity and mortality. It is likely...
Successful stroke trials require adequate recruitment. In this observational study, we assessed reasons for refusal to provide informed consent in eligible patients approached for clinical trial participation ...
Taurine (Tau) is involved in many biochemical functions such as regulation of glucose and lipid metabolism, enhancement of energy expenditure, anti-inflammatory effects and appetite control. The most important...
A malaria vaccine as part of the integrated malaria control and elimination efforts will have a major impact on public health in sub-Sahara Africa. The first malaria vaccine, RTS,S, now enters pilot implementa...
