Hírolvasó

Fathers can be a critical source of breastfeeding support for their partner, but little is known about what fathers would like to learn about breastfeeding. Partner’s support and encouragement enhances mother’...

The Baby Friendly Hospital Initiative (BFHI) was launched in 1991 as an intervention to support healthy infant feeding practices, but its global coverage remains around 10%. This study aimed to explore stakeho...

Breastfeeding is recognized as the gold standard of infant feeding and nutrition. The World Health Organization recommends exclusive breastfeeding (EBF) of infants for the first 6 months of life. A variety of ...

Breastfeeding is the biological norm for feeding infants and young children. When mothers’ breastmilk is unavailable, donor human milk (DHM) from a human milk bank (HMB) becomes the next option for small vulne...

Limited research has explored the associations of gestational age (GA) and breastfeeding practices with growth and nutrition in term infants.

Despite global public health organizations endorsing breastfeeding or human milk (HM) as the optimal source of nutrition for infants, detailed knowledge of how HM composition influences infant growth is lackin...

Exclusive breastfeeding (EBF) in the first six months remains low globally, despite known benefits of lower morbidity and mortality among breastfed infants. It is important to understand factors associated wit...

Many individuals who experience preterm birth struggle with early breast milk supply, which can translate into suboptimal longer-term breastfeeding outcomes. Further investigations into the potential role of e...

Early initiation of breastfeeding is the initiation of breastfeeding within one hour of birth, which plays a significant role in a born baby’s growth and survival, however its prevalence and predictors among u...

Journal of Human Lactation, Ahead of Print.
We discuss the evolution and composition of breast milk and briefly describe how mammalian evolution resulted in lactation, which played a crucial role in infant growth and development. We focus on three teleological factors that significantly contribute to breast milk composition: (1) biological sex at birth, (2) gestational age, and (3) circadian rhythms. We also explain how these factors lead to variability in human milk composition. We emphasize the importance of standardizing the definitions of “preterm” and “term” to accurately study the effects of gestational age on milk composition. Finally, we discuss the role of the circadian clock in regulating lactation and the impact of breast milk on fetal and infant sleep. Investigators may integrate these critical factors when designing a research study that involves the collection of breast milk samples. Teleological factors greatly influence milk composition, and these factors may be considered when designing a study that requires breast milk. We provide both the rationale and application of solutions to address these factors.

Journal of Human Lactation, Ahead of Print.
Background:Donor human milk is recommended when infants are unable to be fed their mother’s own milk or require supplementation. For-profit companies use technologies to create human milk products for infants in the neonatal intensive care setting without consistent guidelines and regulatory frameworks in place. This commercialization of human milk is inadequately conceptualized and ill-defined.Research Aims:The aim of this study is to conceptualize and define the commercialization of human milk and discuss the need for policy guidelines and regulations.Method:Using a concept analysis framework, we reviewed the literature on the commercialization of human milk, analyzed the antecedents and potential consequences of the industry, and developed a conceptual definition. The literature review resulted in 13 relevant articles.Results:There has been a surge in the development and availability of human milk products for vulnerable infants developed by for-profit companies. Commercialized human milk can be defined as the packaging and sale of human milk and human milk components for financial gain. Factors contributing to the commercialization of human milk include an increased demand for human milk, and consequences include potential undermining of breastfeeding. The lack of guidelines and regulations raises concerns of equity, ethics, and safety.Conclusion:The industry is rapidly growing, resulting in an urgent need for consistent guidelines and regulatory frameworks. If left unaddressed, there could be potential risks for donor milk banking, the future of breastfeeding, and infant and maternal health.

Journal of Human Lactation, Ahead of Print.
Background:The benefits of breastfeeding for mothers and infants are well known. However, in Taiwan, the average breastfeeding rate remains below the World Health Organization recommendations. Breastfeeding self-efficacy is a known predictor of breastfeeding.Research Aims:To determine: (1) the relationship of sociodemographic factors to prenatal breastfeeding self-efficacy, and (2) the relationship of sociodemographic factors and prenatal breastfeeding self-efficacy to breastfeeding behavior at 8 weeks postpartum among women living in Taiwan.Methods:This was a prospective cohort study of 206 pregnant women collected in an outpatient clinic located in Taiwan. The validated Chinese version of the Prenatal Breastfeeding Self-Efficacy Scale (PBSES) was used to measure self-efficacy for breastfeeding during pregnancy. At 8 weeks postpartum, participants were contacted by telephone to obtain information regarding infant feeding method and duration.Results:The mean age of the pregnant women was 32 years, and the mean prenatal breastfeeding self-efficacy score was 78.6 (SD = 10.6). Scores differed across levels of maternal education, previous breastfeeding experience, and support systems. Prenatal breastfeeding self-efficacy scores were highest among participants reporting spouse support versus other types of support. Maternal age and prenatal breastfeeding self-efficacy were predictive of breastfeeding duration. A 1-year increase in maternal age was associated with a 6% lower likelihood of breastfeeding for at least 2 months postpartum, and a 1-point increase in the prenatal breastfeeding self-efficacy score was associated with a 14% increase in the likelihood of breastfeeding for at least 2 months postpartum.Conclusions:Prenatal breastfeeding self-efficacy may help predict breastfeeding continuation among Taiwanese women in the first 2 months postpartum.

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.
Introduction:The benefits of human milk for preterm infants are well documented. Complex medical conditions can limit the extremely premature infant’s ability to breastfeed and to receive human milk directly, yet these vulnerable infants may benefit most from receiving it.Main Issue:Extremely preterm infants are at risk for infections, digestive challenges, and chronic lung disease, and occasionally require a tracheostomy to facilitate weaning from mechanical ventilation. There is a risk of aspiration when orally feeding a child with a tracheostomy. This case study describes a tertiary neonatal team supporting a family’s direct breastfeeding goal in an extremely premature infant with a diagnosis of bronchopulmonary dysplasia requiring a tracheostomy.Management:Initially, the infant participant (born at 24 weeks and 3 days of gestation, with a birthweight of 540 g) was gavage fed with human milk. The interdisciplinary team collaborated with the family to guide the infant’s feeding goals, providing positive oral stimulation with soothers, oral immune therapy, and frequent skin-to-skin contact to prepare for future oral feeding. Within a month of the tracheotomy procedure, oral feeding was initiated, and direct breastfeeding with the tracheostomy tubing in place was achieved at 50 weeks and 1 day of age as a primary source of nutrition.Conclusion:The open dialogue between the family and healthcare team was the foundation for trialing direct breastfeeding for an extremely premature infant with a tracheostomy. While direct breastfeeding of full-term infants with tracheostomies has been previously described in the literature, this is the first case study of an extremely premature infant with a tracheostomy transitioning to direct breastfeeding.

Surgery is the primary treatment for benign breast disease and causes some disruption to the normal physiology of the breast, even when this disruption is localised, it remains unclear whether it affects women...

Journal of Human Lactation, Ahead of Print.
Background:German-speaking mothers have breastfeeding rates below the international breastfeeding recommendations. Previous research has found that breastfeeding self-efficacy is an important and modifiable predictor of breastfeeding outcomes, thus improving breastfeeding rates. The Breastfeeding Self-Efficacy Scale–Short Form (BSES-SF) is used in many countries to assess maternal breastfeeding self-efficacy. This instrument has not been available in German.Research Aims:To translate the BSES-SF into German and assess its psychometric properties among breastfeeding mothers up to 12 weeks postpartum.Methods:This cross-sectional study was conducted online with 355 breastfeeding mothers recruited from breastfeeding groups through Facebook. The BSES-SF was translated into German using forward and back-translation. To test reliability, item-total characteristics, including Cronbach’s alpha, were examined. We used principal component analysis, as well as known-groups comparisons for evaluating construct validity, and examined the relationship between breastfeeding self-efficacy and demographic variables.Results:The mean age of participants was 32.4 years (SD = 4.32). The Cronbach’s alpha coefficient was .88 and corrected item-total correlations ranged between .37 and .73. Principal components analysis yielded one component with factor loadings >.40 and an eigenvalue of 5.62, which explained 40% of the total variance. In addition, known group comparisons provided further evidence for construct validity. There was no significant difference in BSES-SF scores in terms of demographic and obstetrics characteristics.Conclusion:Our results provide evidence that the German version of the BSES-SF is a reliable and valid tool for measuring breastfeeding self-efficacy among mothers in German-speaking countries.

The 24-h rooming-in policy is crucial to the Baby-Friendly Hospital Initiative (BFHI) for promoting breastfeeding. However, this policy may restrict maternal autonomy. In 2018, to integrate women’s preferences...

Journal of Human Lactation, Ahead of Print.
Pediatricians need to be knowledgeable to adequately carry out their role in the support of breastfeeding, so assessing their knowledge of breastfeeding is vitally important. There are not English language validated questionnaires for pediatricians in the literature; however, in Spanish and Portuguese, there is the Breastfeeding Knowledge Survey (ECoLa, derived from Encuesta de Conocimientos en Lactancia). Our goal is to translate the ECoLa into English. The original survey consisted of true/false questions, including one with an image of a breastfeeding baby, multiple-choice questions featuring clinical cases, and two open-ended short questions. We used a translation approach that incorporated both forward and backward translations and a multidisciplinary committee to evaluate the translation process. During translation, four Spanish versions and seven English versions were considered prior to consensus approval of the final survey. The intraclass correlation coefficient between the English questionnaire and the original Spanish version was 0.85 (95% CI [0.60, 0.95]). A sample of 51 participants completed the survey, resulting in a Cronbach’s alpha of 0.78 for the English version (95% CI [0.70, 0.86]). The Breastfeeding Knowledge Survey is now accessible under a Creative Commons license, permitting its free re-use.