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Medicine › Epidemiology

Breastfeeding Practices and Influences

Works Count: 66471

Description

This cluster of papers explores various aspects of breastfeeding, including its epidemiology, mechanisms, and lifelong effects on both maternal and child health. It covers topics such as the impact of breastfeeding on infant and child mortality, cognitive development, infectious diseases, maternal health outcomes, and the duration of exclusive breastfeeding. Additionally, it delves into factors influencing breastfeeding practices, interventions to promote breastfeeding, and the relationship between breastfeeding and long-term health outcomes.

Keywords

Breastfeeding; Infant Health; Maternal Health; Exclusive Breastfeeding; Breast Milk Composition; Child Development; Breastfeeding Duration; Breastfeeding Promotion; Lactation; Breastfeeding Support

Support for breastfeeding mothers

2007-01-24
Cathryn Britton , Felicia McCormick , Mary J. Renfrew +2 more
Background There is extensive evidence of the benefits of breastfeeding for infants and mothers. In 2003, the World Health Organization (WHO) recommended infants be fed exclusively on breast milk until … Background There is extensive evidence of the benefits of breastfeeding for infants and mothers. In 2003, the World Health Organization (WHO) recommended infants be fed exclusively on breast milk until six months of age. However, breastfeeding rates in many developed countries continue to be resistant to change. Objectives To assess the effectiveness of support for breastfeeding mothers. Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (January 2006), MEDLINE (1966 to November 2005), EMBASE (1974 to November 2005) and MIDIRS (1991 to September 2005). We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 27 July 2009 and added the results to the awaiting classification section. Selection criteria Randomised or quasi‐randomised controlled trials comparing extra support for breastfeeding mothers with usual maternity care. Data collection and analysis Two authors independently assessed trial quality and extracted data. Main results We have included 34 trials (29,385 mother‐infant pairs) from 14 countries. All forms of extra support analysed together showed an increase in duration of 'any breastfeeding' (includes partial and exclusive breastfeeding) (relative risk (RR) for stopping any breastfeeding before six months 0.91, 95% confidence interval (CI) 0.86 to 0.96). All forms of extra support together had a larger effect on duration of exclusive breastfeeding than on any breastfeeding (RR 0.81, 95% CI 0.74 to 0.89). Lay and professional support together extended duration of any breastfeeding significantly (RR before 4‐6 weeks 0.65, 95% 0.51 to 0.82; RR before 2 months 0.74, 95% CI 0.66 to 0.83). Exclusive breastfeeding was significantly prolonged with use of WHO/UNICEF training (RR 0.69, 95% CI 0.52 to 0.91). Maternal satisfaction was poorly reported. Authors' conclusions Additional professional support was effective in prolonging any breastfeeding, but its effects on exclusive breastfeeding were less clear. WHO/UNICEF training courses appeared to be effective for professional training. Additional lay support was effective in prolonging exclusive breastfeeding, while its effects on duration of any breastfeeding were uncertain. Effective support offered by professionals and lay people together was specific to breastfeeding and was offered to women who had decided to breastfeed. Further trials are required to assess the effectiveness (including cost‐effectiveness) of both lay and professional support in different settings, particularly those with low rates of breastfeeding initiation, and for women who wish to breastfeed for longer than three months. Trials should consider timing and delivery of support interventions and relative effectiveness of intervention components, and should report women's views. Research into appropriate training for supporters (whether lay or professional) of breastfeeding mothers is also needed. [Note: The 79 citations in the awaiting classification section of the review may alter the conclusions of the review once assessed.]

The Optimal Duration of Exclusive Breastfeeding

2004-01-01
Michael S. Kramer , Ritsuko Kakuma

Breastfeeding and Human Lactation

2000-05-06
Jan Riordan
(Second Edition) By Jan Riordan and Kathleen B. Auerbach. Sudbury (MA): Jones and Bartlett Publishers, 1999. 874 pages, $89.95 hardcover. Reviewed by : Priscilla Tait, CNM, MS, IBCLC Lactation Consultant … (Second Edition) By Jan Riordan and Kathleen B. Auerbach. Sudbury (MA): Jones and Bartlett Publishers, 1999. 874 pages, $89.95 hardcover. Reviewed by : Priscilla Tait, CNM, MS, IBCLC Lactation Consultant and Infant Mental Health Specialist, Shelby, Michigan.
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Optimal breastfeeding practices and infant and child mortality: a systematic review and meta‐analysis

2015-08-07
Mari Jeeva Sankar , Bireshwar Sinha , Ranadip Chowdhury +4 more
To synthesise the evidence for effects of optimal breastfeeding on all-cause and infection-related mortality in infants and children aged 0-23 months.We conducted a systematic review to compare the effect of … To synthesise the evidence for effects of optimal breastfeeding on all-cause and infection-related mortality in infants and children aged 0-23 months.We conducted a systematic review to compare the effect of predominant, partial or nonbreastfeeding versus exclusive breastfeeding on mortality rates in the first six months of life and effect of no versus any breastfeeding on mortality rates between 6 and 23 months of age. A systematic literature search was conducted in PubMed, Cochrane CENTRAL and CABI.The risk of all-cause mortality was higher in predominantly (RR 1.5), partially (RR 4.8) and nonbreastfed (RR14.4) infants compared to exclusively breastfed infants 0-5 months of age. Children 6-11 and 12-23 months of age who were not breastfed had 1.8- and 2.0-fold higher risk of mortality, respectively, when compared to those who were breastfed. Risk of infection-related mortality in 0-5 months was higher in predominantly (RR 1.7), partially (RR 4.56) and nonbreastfed (RR 8.66) infants compared to exclusive breastfed infants. The risk was twofold higher in nonbreastfed children when compared to breastfed children aged 6-23 months.The findings underscore the importance of optimal breastfeeding practices during infancy and early childhood.
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Members of the who Multicentre Growth Reference Study Group

2004-01-01
Mercedes de Onís , Cutberto Garza , César G. Victora +3 more
The World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) is a community-based, multicountry project to develop new growth references for infants and young children. The design combines a longitudinal … The World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) is a community-based, multicountry project to develop new growth references for infants and young children. The design combines a longitudinal study from birth to 24 months with a cross-sectional study of children aged 18 to 71 months. The pooled sample from the six participating countries (Brazil, Ghana, India, Norway, Oman, and the United States) consists of about 8,500 children. The study subpopulations had socioeconomic conditions favorable to growth, and low mobility, with at least 20% of mothers following feeding recommendations and having access to breastfeeding support. The individual inclusion criteria were absence of health or environmental constraints on growth, adherence to MGRS feeding recommendations, absence of maternal smoking, single term birth, and absence of significant morbidity. In the longitudinal study, mothers and newborns were screened and enrolled at birth and visited at home 21 times: at weeks 1, 2, 4, and 6; monthly from 2 to 12 months; and every 2 months in their second year. In addition to the data collected on anthropometry and motor development, information was gathered on socioeconomic, demographic, and environmental characteristics, perinatal factors, morbidity, and feeding practices. The prescriptive approach taken is expected to provide a single international reference that represents the best description of physiological growth for all children under five years of age and to establish the breastfed infant as the normative model for growth and development.

Support for healthy breastfeeding mothers with healthy term babies

2012-05-10
Mary J. Renfrew , Felicia McCormick , Angela Wade +2 more
There is extensive evidence of important health risks for infants and mothers related to not breastfeeding. In 2003, the World Health Organization recommended infants be exclusively breastfed until six months … There is extensive evidence of important health risks for infants and mothers related to not breastfeeding. In 2003, the World Health Organization recommended infants be exclusively breastfed until six months of age, with breastfeeding continuing as an important part of the infant's diet till at least two years of age. However, breastfeeding rates in many countries currently do not reflect this recommendation.
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Optimal duration of exclusive breastfeeding

2012-08-08
Michael S. Kramer , Ritsuko Kakuma
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Breastfeeding and intelligence: a systematic review and meta‐analysis

2015-07-27
Bernardo Lessa Horta , Christian Loret de Mola , César G. Victora
This study was aimed at systematically reviewing evidence of the association between breastfeeding and performance in intelligence tests.Two independent searches were carried out using Medline, LILACS, SCIELO and Web of … This study was aimed at systematically reviewing evidence of the association between breastfeeding and performance in intelligence tests.Two independent searches were carried out using Medline, LILACS, SCIELO and Web of Science. Studies restricted to infants and those where estimates were not adjusted for stimulation or interaction at home were excluded. Fixed- and random-effects models were used to pool the effect estimates, and a random-effects regression was used to assess potential sources of heterogeneity.We included 17 studies with 18 estimates of the relationship between breastfeeding and performance in intelligence tests. In a random-effects model, breastfed subjects achieved a higher IQ [mean difference: 3.44 points (95% confidence interval: 2.30; 4.58)]. We found no evidence of publication bias. Studies that controlled for maternal IQ showed a smaller benefit from breastfeeding [mean difference 2.62 points (95% confidence interval: 1.25; 3.98)]. In the meta-regression, none of the study characteristics explained the heterogeneity among the studies.Breastfeeding is related to improved performance in intelligence tests. A positive effect of breastfeeding on cognition was also observed in a randomised trial. This suggests that the association is causal.
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EVIDENCE FOR PROTECTION BY BREAST-FEEDING AGAINST INFANT DEATHS FROM INFECTIOUS DISEASES IN BRAZIL

1987-08-01
César G. Victora , J. Patrick Vaughan , Cintia Lombardi +7 more

Breast-feeding and childhood obesity—a systematic review

2004-08-17
S. Arenz , Regina Rückerl , Berthold Koletzko +1 more

Variables Associated With Breastfeeding Duration

2009-05-01
Diane Thulier , Judith Mercer

Centers for Disease Control and Prevention 2000 Growth Charts for the United States: Improvements to the 1977 National Center for Health Statistics Version

2002-01-01
Cynthia L. Ogden , Robert J. Kuczmarski , Katherine M. Flegal +7 more
Objective. To present a clinical version of the 2000 Centers for Disease Control and Prevention (CDC) growth charts and to compare them with the previous version, the 1977 National Center … Objective. To present a clinical version of the 2000 Centers for Disease Control and Prevention (CDC) growth charts and to compare them with the previous version, the 1977 National Center for Health Statistics (NCHS) growth charts. Methods. The 2000 CDC percentile curves were developed in 2 stages. In the first stage, the empirical percentiles were smoothed by a variety of parametric and nonparametric procedures. To obtain corresponding percentiles and z scores, we approximated the smoothed percentiles using a modified LMS estimation procedure in the second stage. The charts include of a set of curves for infants, birth to 36 months of age, and a set for children and adolescents, 2 to 20 years of age. Results. The charts represent a cross-section of children who live in the United States; breastfed infants are represented on the basis of their distribution in the US population. The 2000 CDC growth charts more closely match the national distribution of birth weights than did the 1977 NCHS growth charts, and the disjunction between weight-for-length and weight-for-stature or length-for-age and stature-for-age found in the 1977 charts has been corrected. Moreover, the 2000 CDC growth charts can be used to obtain both percentiles and z scores. Finally, body mass index-for-age charts are available for children and adolescents 2 to 20 years of age. Conclusion. The 2000 CDC growth charts are recommended for use in the United States. Pediatric clinics should make the transition from the 1977 NCHS to the 2000 CDC charts for routine monitoring of growth in infants, children, and adolescents.
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Recommended Dietary Allowances

1991-09-01
L. J. FILER
Dr. Filer if a Professor of Pediatrics, Emeritus at the University of Iowa College of Medicine in Iowa City. His career has involved significant contributions to our understanding of infant … Dr. Filer if a Professor of Pediatrics, Emeritus at the University of Iowa College of Medicine in Iowa City. His career has involved significant contributions to our understanding of infant nutrition, participation in innumerable committees of government, industry and the National Academy of Sciences. Most recently he served as Executive Director of the International Life Sciences Institute/Nutrition Foundation.

A meta‐analysis of the association between Caesarean section and childhood asthma

2007-07-22
Surendran Thavagnanam , Jason C. Fleming , Angela Bromley +2 more
Summary Background Children born by Caesarean section have modified intestinal bacterial colonization and consequently may have an increased risk of developing asthma under the hygiene hypothesis. The results of previous … Summary Background Children born by Caesarean section have modified intestinal bacterial colonization and consequently may have an increased risk of developing asthma under the hygiene hypothesis. The results of previous studies that have investigated the association between Caesarean section and asthma have been conflicting. Objective To review published literature and perform a meta‐analysis summarizing the evidence in support of an association between children born by Caesarean section and asthma. Methods MEDLINE, Web Science, Google Scholar and PubMed were searched to identify relevant studies. Odds ratio (OR) and 95% confidence interval (CI) were calculated for each study from the reported prevalence of asthma in children born by Caesarean section and in control children. Meta‐analysis was then used to derive a combined OR and test for heterogeneity in the findings between studies. Results Twenty‐three studies were identified. The overall meta‐analysis revealed an increase in the risk of asthma in children delivered by Caesarean section (OR=1.22, 95% CI 1.14, 1.29). However, in this analysis, there was evidence of heterogeneity ( I 2 =46%) that was statistically significant ( P <0.001). Restricting the analysis to childhood studies, this heterogeneity was markedly decreased ( I 2 =32%) and no longer attained statistical significance ( P =0.08). In these studies, there was also evidence of an increase ( P <0.001) in the risk of asthma after Caesarean section (OR=1.20, 95% CI 1.14, 12.6). Conclusion In this meta‐analysis, we found a 20% increase in the subsequent risk of asthma in children who had been delivered by Caesarean section.

Breastfeeding and Maternal and Infant Health Outcomes In Developed Countries

2007-08-01
Wendelin Slusser
Breastfeeding| August 01 2007 Breastfeeding and Maternal and Infant Health Outcomes In Developed Countries AAP Grand Rounds (2007) 18 (2): 15–16. https://doi.org/10.1542/gr.18-2-15 Views Icon Views Article contents Figures & tables … Breastfeeding| August 01 2007 Breastfeeding and Maternal and Infant Health Outcomes In Developed Countries AAP Grand Rounds (2007) 18 (2): 15–16. https://doi.org/10.1542/gr.18-2-15 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Breastfeeding and Maternal and Infant Health Outcomes In Developed Countries. AAP Grand Rounds August 2007; 18 (2): 15–16. https://doi.org/10.1542/gr.18-2-15 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: breast feeding, developed countries, infant health Source: Ip S, Chung M, Raman G, et al. Breastfeeding and maternal and infant health outcomes in developed countries. Evidence Report/Technology Assessment No. 153. AHRQ Publication No. 07-E007. Rockville, MD: Agency for Healthcare Research and Quality. April 2007. Retrieved from http://www.ahrq.gov/downloads/pub/evidence/pdf/brfout/brfout.pdf on June 10, 2007. In this 400-page report, prepared for the Agency for Healthcare Research and Quality, the authors evaluate studies of the effects or associations of breastfeeding on various child and maternal outcomes. In a screening of over 9,000 abstracts, researchers from the Tufts-New England Medical Center Evidence-Based Practice Center identified 43 primary studies on infant health outcomes, 43 primary studies on maternal health outcomes, and 29 systematic reviews or meta-analyses to be included in the review. The primary studies were observational, randomized controlled trials, and comparative studies. The systematic reviews were included since it was not deemed feasible for all of the primary studies to be reviewed. The authors relied on the recommendations of the technical expert panel and the Office on Women's Health to develop an approach to grade the reviews. This approach graded the meta-analyses and the primary studies included in the review as A for good, B for fair to moderate, and C for poor. "A" studies presented the least bias and the most valid results. "B" studies were susceptible to some bias but were still considered valid, and the "C" studies had significant biases that may have resulted in invalid results. In addition, screening for the meta-analyses and systematic reviews included standards for reporting for meta-analysis in observational studies in epidemiology and a checklist developed specifically for this review to evaluate the quality of the reviews of observational studies. The checklist included such questions as whether the study included an appropriate search strategy, justification for inclusion/exclusion criteria for studies, and a description of a well-defined population. The inclusion criteria required studies to have a comparative arm of formula feeding or different durations of breastfeeding, and studies had to have been conducted in developed countries. For topics that included the systematic reviews/meta-analyses, any additional primary studies were reviewed if they were published subsequent to those reviews. Studies that only included formula-fed infants were not included in the review. Definition of breastfeeding was varied across studies reviewed, so the authors elected to use the definition of exclusive breastfeeding as provided by the authors of the studies reviewed and to qualify the conclusions based on these definitions. Data were presented as a reduction in relative risk, estimated as (1–odds ratio) x 100%, along with the corresponding 95% confidence interval (CI). For the full-term infant, breastfeeding was associated with a reduced risk of acute otitis media, atopic dermatitis, gastrointestinal infections, lower respiratory tract diseases, asthma, obesity, childhood leukemia, and sudden infant death syndrome. There was a 23% (95% CI, 9–36%) reduction of otitis media when breastfeeding was compared to exclusive formula feeding. When exclusive breastfeeding for three or six months' duration was compared to exclusive formula feeding, there was a reduction of otitis media of 50%... You do not currently have access to this content.

Reasons for Earlier Than Desired Cessation of Breastfeeding

2013-02-19
Erika Odom , Ruowei Li , Kelley S. Scanlon +2 more
To describe the prevalence and factors associated with not meeting desired breastfeeding duration.Data were analyzed from 1177 mothers aged ≥18 years who responded to monthly surveys from pregnancy until their … To describe the prevalence and factors associated with not meeting desired breastfeeding duration.Data were analyzed from 1177 mothers aged ≥18 years who responded to monthly surveys from pregnancy until their child was 1 year old. When breastfeeding stopped, mothers were asked whether they breastfed as long as they wanted (yes or no) and to rate the importance of 32 reasons for stopping on a 4-point Likert scale. Multiple logistic regressions were used to examine the association between the importance of each reason and the likelihood of mothers not meeting their desired breastfeeding duration.Approximately 60% of mothers who stopped breastfeeding did so earlier than desired. Early termination was positively associated with mothers' concerns regarding: (1) difficulties with lactation; (2) infant nutrition and weight; (3) illness or need to take medicine; and (4) the effort associated with pumping milk.Our findings indicate that the major reasons why mothers stop breastfeeding before they desire include concerns about maternal or child health (infant nutrition, maternal illness or the need for medicine, and infant illness) and processes associated with breastfeeding (lactation and milk-pumping problems). Continued professional support may be necessary to address these challenges and help mothers meet their desired breastfeeding duration.
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The Breastfeeding Self‐Efficacy Scale: Psychometric Assessment of the Short Form

2003-11-01
Cindy‐Lee Dennis

Development and psychometric testing of the Breastfeeding Self-Efficacy Scale

1999-10-01
Cindy‐Lee Dennis , Sandra A. Faux
Many new mothers discontinue breastfeeding prematurely. Researchers have shown that maternal confidence is an important factor in the continuation of breastfeeding. The purpose of this methodological study was to develop … Many new mothers discontinue breastfeeding prematurely. Researchers have shown that maternal confidence is an important factor in the continuation of breastfeeding. The purpose of this methodological study was to develop and conduct preliminary psychometric assessment of an instrument to measure confidence in new breastfeeding mothers. Using self-efficacy theory as a conceptual framework, the Breastfeeding Self-Efficacy Scale (BSES) was developed and content validity was judged by a panel of experts and through interviews with experienced breastfeeding mothers. Following a pilot test, the revised BSES was assessed with 130 in-hospital breastfeeding mothers for reliability and validity, including internal consistency, principal components factor analysis, comparison of contrasted groups, and correlations with measures of similar constructs. Support for predictive validity was demonstrated with positive correlations between BSES scores and infant feeding patterns at 6 weeks postpartum. Following further testing, this instrument may be used to identify new mothers with low breastfeeding confidence who are at high risk to prematurely discontinue breastfeeding.

Factors that positively influence breastfeeding duration to 6 months: A literature review

2010-03-18
Shahla Meedya , Kathleen Fahy , Ashley Kable

Breastfeeding Initiation and Duration: A 1990-2000 Literature Review

2002-01-01
Cindy‐Lee Dennis
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Toward Consistency in Breastfeeding Definitions

1990-07-01
Miriam H. Labbok , Katherine Krasovec
On 28 April 1988, the Interagency Group for Action on Breastfeeding met to develop and agree upon a set of definitions that could be used as standardized terminology for the … On 28 April 1988, the Interagency Group for Action on Breastfeeding met to develop and agree upon a set of definitions that could be used as standardized terminology for the collection and description of cross-sectional information on breastfeeding behavior. The schema and potential framework suggested at the meeting were reviewed extensively by breastfeeding researchers and program personnel, revised at subsequent meetings by a variety of organizations, and compared against published research on patterns of breastfeeding and their effects on infant nutrition, health, and fertility. This schema and framework: (1) acknowledge that the term "breastfeeding" alone is insufficient to describe the numerous types of breastfeeding behavior, (2) distinguish full from partial breastfeeding, (3) subdivide full breastfeeding into categories of exclusive and almost exclusive breastfeeding, (4) differentiate among levels of partial breastfeeding, and (5) recognize that there can be token breastfeeding with little to no nutritional impact. The schema and framework should assist researchers and agencies in their efforts to accurately describe and interpret breastfeeding practices.On April 28.1988, the Interagency Group for Breastfeeding met to develop and agree on definitions that can be used as standard terminology for the description and collection of cross-sectional information on breastfeeding behavior. The potential framework and scheme were much reviewed by breastfeeding researchers and program personnel, revised at subsequent meetings by many organizations, and compared against published research. The schema divides breastfeeding into 2 categories: 1) full; and 2) partial. Partial includes 3 levels of feeding--medium, high, and low. Full breastfeeding is divided into exclusive and almost exclusive. Token breastfeeding, a 3rd category, is not for nutritive purposes. The framework includes additional parameters: 1) time postpartum or child's age; 2) frequency; 3) intervals; 4) duration; 5) artificial nipples or other devices; 6) type, timing, and amount of other feedings; 7) expression of breast milk and later use and 8) other influences. Using the framework and schema, one can fully describe breastfeeding behavior at a single point in time. This schema has made major contributions: 1) distinction between "full" and "partial" breastfeeding; 2) the differentiation among partial breastfeeding levels; 3) the subdivision of full breastfeeding into categories of "exclusive" and "almost exclusive" 4) the recognition that there is "token" breastfeeding with little or no nutritional impact. Additional refinements in the framework and schema can still take place. Comparisons and meta-analyses would be improved if more researchers used this framework and schema.

Risk Factors for Suboptimal Infant Breastfeeding Behavior, Delayed Onset of Lactation, and Excess Neonatal Weight Loss

2003-09-01
Kathryn G. Dewey , Laurie Nommsen‐Rivers , M. Jane Heinig +1 more
Objective. Some mothers have difficulty initiating lactation even when highly motivated to breastfeed. The purpose of this study was to determine the incidence of and risk factors for suboptimal infant … Objective. Some mothers have difficulty initiating lactation even when highly motivated to breastfeed. The purpose of this study was to determine the incidence of and risk factors for suboptimal infant breastfeeding behavior (SIBB), delayed onset of lactation, and excess neonatal weight loss among mother-infant pairs in a population with high educational levels and motivation to breastfeed. Methods. All mothers residing in Davis, California, who gave birth to a healthy, single, term infant at 1 of 5 area hospitals during the 10-month recruitment period in 1999 were invited to participate if they were willing to attempt to breastfeed exclusively for at least 1 month. Lactation guidance was provided and data were collected in the hospital (day 0) and on days 3, 5, 7, and 14. Infant breastfeeding behavior was evaluated by trained lactation consultants using the Infant Breastfeeding Assessment Tool. Onset of lactation was defined based on maternal report of changes in breast fullness. Infant weight loss was considered excessive if it was ≥10% of birth weight by day 3. Results. Of the 328 eligible mothers, 280 (85%) participated in the study. The prevalence of SIBB was 49% on day 0, 22% on day 3, and 14% on day 7. SIBB was significantly associated with primiparity (days 0 and 3), cesarean section (in multiparas, day 0), flat or inverted nipples, infant status at birth (days 0 and 3), use of nonbreast milk fluids in the first 48 hours (days 3 and 7), pacifier use (day 3), stage II labor >1 hour (day 7), maternal body mass index >27 kg/m2 (day 7) and birth weight <3600 g (day 7). Delayed onset of lactation (>72 hours) occurred in 22% of women and was associated with primiparity, cesarean section, stage II labor >1 hour, maternal body mass index >27 kg/m2, flat or inverted nipples, and birth weight >3600 g (in primiparas). Excess weight loss occurred in 12% of infants and was associated with primiparity, long duration of labor, use of labor medications (in multiparas), and infant status at birth. The risk of excess infant weight loss was 7.1 times greater if the mother had delayed onset of lactation, and 2.6 times greater if the infant had SIBB on day 0. Conclusions. Early lactation success is strongly influenced by parity, but may also be affected by potentially modifiable factors such as delivery mode, duration of labor, labor medications, use of nonbreast milk fluids and/or pacifiers, and maternal overweight. All breastfeeding mother-infant pairs should be evaluated at 72 to 96 hours’ postpartum.

Exclusive Breastfeeding Reduces Acute Respiratory Infection and Diarrhea Deaths Among Infants in Dhaka Slums

2001-10-01
Shams El Arifeen , Robert E. Black , Gretchen Antelman +3 more
To describe breastfeeding practices and investigate the influence of exclusive breastfeeding in early infancy on the risk of infant deaths, especially those attributable to respiratory infections (ARI) and diarrhea.A prospective … To describe breastfeeding practices and investigate the influence of exclusive breastfeeding in early infancy on the risk of infant deaths, especially those attributable to respiratory infections (ARI) and diarrhea.A prospective observational study was conducted on a birth cohort of 1677 infants who were born in slum areas of Dhaka in Bangladesh and followed from birth to 12 months of age. After enrollment at birth, the infants were visited 5 more times by 12 months of age. Verbal autopsy, based on a structured questionnaire, was used to assign a cause to the 180 reported deaths. Proportional hazards regression models were used to estimate the effect of breastfeeding practices, introduced as a time-varying variable, after accounting for other variables, including birth weight. Overall neonatal, postneonatal and infant mortality, and mortality attributable to ARI and diarrhea were measured.The proportion of infants who were breastfed exclusively was only 6% at enrollment, increasing to 53% at 1 month and then gradually declining to 5% at 6 months of age. Predominant breastfeeding declined from 66% at enrollment to 4% at 12 months of age. Very few infants were not breastfed, whereas the proportion of partially breastfed infants increased with age. Breastfeeding practices did not differ between low and normal birth weight infants at any age. The overall infant mortality rate was 114 deaths per 1000 live births. Compared with exclusive breastfeeding in the first few months of life, partial or no breastfeeding was associated with a 2.23-fold higher risk of infant deaths resulting from all causes and 2.40- and 3.94-fold higher risk of deaths attributable to ARI and diarrhea, respectively.The important role of appropriate breastfeeding practices in the survival of infants is clear from this analysis. The reduction of ARI deaths underscores the broad-based beneficial effect of exclusive breastfeeding in prevention of infectious diseases beyond its role in reducing exposure to contaminated food, which may have contributed to the strong protection against diarrhea deaths.

Breast‐feeding: A Commentary by the ESPGHAN Committee on Nutrition

2009-06-22
Carlo Agostoni , Christian Braegger , Támas Décsi +7 more
ABSTRACT This medical position article by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition summarises the current status of breast‐feeding practice, the present knowledge on the composition of human … ABSTRACT This medical position article by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition summarises the current status of breast‐feeding practice, the present knowledge on the composition of human milk, advisable duration of exclusive and partial breast‐feeding, growth of the breast‐fed infant, health benefits associated with breast‐feeding, nutritional supplementation for breast‐fed infants, and contraindications to breast‐feeding. This article emphasises the important role of paediatricians in the implementation of health policies devised to promote breast‐feeding. The European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition recognises breast‐feeding as the natural and advisable way of supporting the healthy growth and development of young children. This article delineates the health benefits of breast‐feeding, reduced risk of infectious diarrhoea and acute otitis media being the best documented. Exclusive breast‐feeding for around 6 months is a desirable goal, but partial breast‐feeding as well as breast‐feeding for shorter periods of time are also valuable. Continuation of breast‐feeding after the introduction of complementary feeding is encouraged as long as mutually desired by mother and child. The role of health care workers, including paediatricians, is to protect, promote, and support breast‐feeding. Health care workers should be trained in breast‐feeding issues and counselling, and they should encourage practices that do not undermine breast‐feeding. Societal standards and legal regulations that facilitate breast‐feeding should be promoted, such as providing maternity leave for at least 6 months and protecting working mothers.

Promotion of Breastfeeding Intervention Trial (PROBIT)

2001-01-24
Michael S. Kramer , Beverley Chalmers , Ellen Hodnett +7 more
ContextCurrent evidence that breastfeeding is beneficial for infant and child health is based exclusively on observational studies. Potential sources of bias in such studies have led to doubts about the … ContextCurrent evidence that breastfeeding is beneficial for infant and child health is based exclusively on observational studies. Potential sources of bias in such studies have led to doubts about the magnitude of these health benefits in industrialized countries.ObjectiveTo assess the effects of breastfeeding promotion on breastfeeding duration and exclusivity and gastrointestinal and respiratory infection and atopic eczema among infants.DesignThe Promotion of Breastfeeding Intervention Trial (PROBIT), a cluster-randomized trial conducted June 1996–December 1997 with a 1-year follow-up.SettingThirty-one maternity hospitals and polyclinics in the Republic of Belarus.ParticipantsA total of 17 046 mother-infant pairs consisting of full-term singleton infants weighing at least 2500 g and their healthy mothers who intended to breastfeed, 16491 (96.7%) of which completed the entire 12 months of follow-up.InterventionsSites were randomly assigned to receive an experimental intervention (n = 16) modeled on the Baby-Friendly Hospital Initiative of the World Health Organization and United Nations Children's Fund, which emphasizes health care worker assistance with initiating and maintaining breastfeeding and lactation and postnatal breastfeeding support, or a control intervention (n = 15) of continuing usual infant feeding practices and policies.Main Outcome MeasuresDuration of any breastfeeding, prevalence of predominant and exclusive breastfeeding at 3 and 6 months of life and occurrence of 1 or more episodes of gastrointestinal tract infection, 2 or more episodes of respiratory tract infection, and atopic eczema during the first 12 months of life, compared between the intervention and control groups.ResultsInfants from the intervention sites were significantly more likely than control infants to be breastfed to any degree at 12 months (19.7% vs 11.4%; adjusted odds ratio [OR], 0.47; 95% confidence interval [CI], 0.32-0.69), were more likely to be exclusively breastfed at 3 months (43.3% vs 6.4%; P<.001) and at 6 months (7.9% vs 0.6%; P = .01), and had a significant reduction in the risk of 1 or more gastrointestinal tract infections (9.1% vs 13.2%; adjusted OR, 0.60; 95% CI, 0.40-0.91) and of atopic eczema (3.3% vs 6.3%; adjusted OR, 0.54; 95% CI, 0.31-0.95), but no significant reduction in respiratory tract infection (intervention group, 39.2%; control group, 39.4%; adjusted OR, 0.87; 95% CI, 0.59-1.28).ConclusionsOur experimental intervention increased the duration and degree (exclusivity) of breastfeeding and decreased the risk of gastrointestinal tract infection and atopic eczema in the first year of life. These results provide a solid scientific underpinning for future interventions to promote breastfeeding.

Breast-feeding and cognitive development: a meta-analysis

1999-10-01
James W. Anderson , Bryan M. Johnstone , Daniel Remley

Long‐term consequences of breastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: a systematic review and meta‐analysis

2015-07-20
Bernardo Lessa Horta , Christian Loret de Mola , César G. Victora
Abstract Aim To systematically review the evidence on the associations between breastfeeding and overweight/obesity, blood pressure, total cholesterol and type 2 diabetes. Methods Two independent literature searches were carried out … Abstract Aim To systematically review the evidence on the associations between breastfeeding and overweight/obesity, blood pressure, total cholesterol and type 2 diabetes. Methods Two independent literature searches were carried out using the MEDLINE , LILACS , SCIELO and Web of Science databases. Studies restricted to infants and those without an internal comparison group were excluded. Fixed‐ and random‐effects models were used to pool the estimates. Results Breastfed subjects were less likely to be considered obese/overweight [pooled odds ratio: 0.74 (95% confidence interval ( CI ): 0.70; 0.78)] (n = 113). Among the 11 high‐quality studies, the association was smaller [pooled odds ratio: 0.87 (95% CI : 0.76; 0.99)]. Total cholesterol (n = 46) was independent of breastfeeding [pooled mean difference: −0.01 mmol/L (95% CI : −0.05; 0.02)]. Systolic blood pressure (n = 43) was lower among breastfed subjects [mean difference: −0.80 (95% CI : −1.17; −0.43)], but no association was observed among larger studies, and for diastolic blood pressure (n = 38) [mean difference: −0.24 (95% CI : −0.50; 0.02)]. For type 2 diabetes (n = 11), the odds ratio was lower among those subjects who had been breastfed [pooled odds ratio: 0.65 (95% CI : 0.49; 0.86)]. Conclusion Breastfeeding decreased the odds of type 2 diabetes and based on high‐quality studies, decreased by 13% the odds of overweight/obesity. No associations were found for total cholesterol or blood pressure.
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Breastfeeding and the risk for diarrhea morbidity and mortality

2011-04-13
Laura Lamberti , Christa L. Fischer Walker , Adi Noiman +2 more
Abstract Background Lack of exclusive breastfeeding among infants 0-5 months of age and no breastfeeding among children 6-23 months of age are associated with increased diarrhea morbidity and mortality in … Abstract Background Lack of exclusive breastfeeding among infants 0-5 months of age and no breastfeeding among children 6-23 months of age are associated with increased diarrhea morbidity and mortality in developing countries. We estimate the protective effects conferred by varying levels of breastfeeding exposure against diarrhea incidence, diarrhea prevalence, diarrhea mortality, all-cause mortality, and hospitalization for diarrhea illness. Methods We systematically reviewed all literature published from 1980 to 2009 assessing levels of suboptimal breastfeeding as a risk factor for selected diarrhea morbidity and mortality outcomes. We conducted random effects meta-analyses to generate pooled relative risks by outcome and age category. Results We found a large body of evidence for the protective effects of breastfeeding against diarrhea incidence, prevalence, hospitalizations, diarrhea mortality, and all-cause mortality. The results of random effects meta-analyses of eighteen included studies indicated varying degrees of protection across levels of breastfeeding exposure with the greatest protection conferred by exclusive breastfeeding among infants 0-5 months of age and by any breastfeeding among infants and young children 6-23 months of age. Specifically, not breastfeeding resulted in an excess risk of diarrhea mortality in comparison to exclusive breastfeeding among infants 0-5 months of age (RR: 10.52) and to any breastfeeding among children aged 6-23 months (RR: 2.18). Conclusions Our findings support the current WHO recommendation for exclusive breastfeeding during the first 6 months of life as a key child survival intervention. Our findings also highlight the importance of breastfeeding to protect against diarrhea-specific morbidity and mortality throughout the first 2 years of life.
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Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil

2015-03-18
César G. Victora , Bernardo Lessa Horta , Christian Loret de Mola +5 more
Breastfeeding has clear short-term benefits, but its long-term consequences on human capital are yet to be established. We aimed to assess whether breastfeeding duration was associated with intelligence quotient (IQ), … Breastfeeding has clear short-term benefits, but its long-term consequences on human capital are yet to be established. We aimed to assess whether breastfeeding duration was associated with intelligence quotient (IQ), years of schooling, and income at the age of 30 years, in a setting where no strong social patterning of breastfeeding exists.A prospective, population-based birth cohort study of neonates was launched in 1982 in Pelotas, Brazil. Information about breastfeeding was recorded in early childhood. At 30 years of age, we studied the IQ (Wechsler Adult Intelligence Scale, 3rd version), educational attainment, and income of the participants. For the analyses, we used multiple linear regression with adjustment for ten confounding variables and the G-formula.From June 4, 2012, to Feb 28, 2013, of the 5914 neonates enrolled, information about IQ and breastfeeding duration was available for 3493 participants. In the crude and adjusted analyses, the durations of total breastfeeding and predominant breastfeeding (breastfeeding as the main form of nutrition with some other foods) were positively associated with IQ, educational attainment, and income. We identified dose-response associations with breastfeeding duration for IQ and educational attainment. In the confounder-adjusted analysis, participants who were breastfed for 12 months or more had higher IQ scores (difference of 3·76 points, 95% CI 2·20-5·33), more years of education (0·91 years, 0·42-1·40), and higher monthly incomes (341·0 Brazilian reals, 93·8-588·3) than did those who were breastfed for less than 1 month. The results of our mediation analysis suggested that IQ was responsible for 72% of the effect on income.Breastfeeding is associated with improved performance in intelligence tests 30 years later, and might have an important effect in real life, by increasing educational attainment and income in adulthood.Wellcome Trust, International Development Research Center (Canada), CNPq, FAPERGS, and the Brazilian Ministry of Health.
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Systematic review and meta-analyses of risk factors for childhood overweight identifiable during infancy

2012-10-29
Stephen Weng , Sarah Redsell , J. A. Swift +2 more
Objective To determine risk factors for childhood overweight that can be identified during the first year of life to facilitate early identification and targeted intervention. Design Systematic review and meta-analysis. … Objective To determine risk factors for childhood overweight that can be identified during the first year of life to facilitate early identification and targeted intervention. Design Systematic review and meta-analysis. Search strategy Electronic database search of MEDLINE, EMBASE, PubMed and CAB Abstracts. Eligibility criteria Prospective observational studies following up children from birth for at least 2 years. Results Thirty prospective studies were identified. Significant and strong independent associations with childhood overweight were identified for maternal pre-pregnancy overweight, high infant birth weight and rapid weight gain during the first year of life. Meta-analysis comparing breastfed with non-breastfed infants found a 15% decrease (95% CI 0.74 to 0.99; I 2 =73.3%; n=10) in the odds of childhood overweight. For children of mothers smoking during pregnancy there was a 47% increase (95% CI 1.26 to 1.73; I 2 =47.5%; n=7) in the odds of childhood overweight. There was some evidence associating early introduction of solid foods and childhood overweight. There was conflicting evidence for duration of breastfeeding, socioeconomic status at birth, parity and maternal marital status at birth. No association with childhood overweight was found for maternal age or education at birth, maternal depression or infant ethnicity. There was inconclusive evidence for delivery type, gestational weight gain, maternal postpartum weight loss and ‘fussy’ infant temperament due to the limited number of studies. Conclusions Several risk factors for both overweight and obesity in childhood are identifiable during infancy. Future research needs to focus on whether it is clinically feasible for healthcare professionals to identify infants at greatest risk.
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The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis

2010-04-06
Melissa Bartick , Arnold G. Reinhold
A 2001 study revealed that $3.6 billion could be saved if breastfeeding rates were increased to levels of the Healthy People objectives. It studied 3 diseases and totaled direct and … A 2001 study revealed that $3.6 billion could be saved if breastfeeding rates were increased to levels of the Healthy People objectives. It studied 3 diseases and totaled direct and indirect costs and cost of premature death. The 2001 study can be updated by using current breastfeeding rates and adding additional diseases analyzed in the 2007 breastfeeding report from the Agency for Healthcare Research and Quality.Using methods similar to those in the 2001 study, we computed current costs and compared them to the projected costs if 80% and 90% of US families could comply with the recommendation to exclusively breastfeed for 6 months. Excluding type 2 diabetes (because of insufficient data), we conducted a cost analysis for all pediatric diseases for which the Agency for Healthcare Research and Quality reported risk ratios that favored breastfeeding: necrotizing enterocolitis, otitis media, gastroenteritis, hospitalization for lower respiratory tract infections, atopic dermatitis, sudden infant death syndrome, childhood asthma, childhood leukemia, type 1 diabetes mellitus, and childhood obesity. We used 2005 Centers for Disease Control and Prevention breastfeeding rates and 2007 dollars.If 90% of US families could comply with medical recommendations to breastfeed exclusively for 6 months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants ($10.5 billion and 741 deaths at 80% compliance).Current US breastfeeding rates are suboptimal and result in significant excess costs and preventable infant deaths. Investment in strategies to promote longer breastfeeding duration and exclusivity may be cost-effective.

Prolonged and Exclusive Breastfeeding Reduces the Risk of Infectious Diseases in Infancy

2010-06-22
Liesbeth Duijts , Vincent W. V. Jaddoe , Albert Hofman +1 more
To examine the associations of duration of exclusive breastfeeding with infections in the upper respiratory (URTI), lower respiratory (LRTI), and gastrointestinal tracts (GI) in infancy.This study was embedded in the … To examine the associations of duration of exclusive breastfeeding with infections in the upper respiratory (URTI), lower respiratory (LRTI), and gastrointestinal tracts (GI) in infancy.This study was embedded in the Generation R Study, a population-based prospective cohort study from fetal life onward in the Netherlands. Rates of breastfeeding during the first 6 months (never; partial for <4 months, not thereafter; partial for 4-6 months; exclusive for 4 months, not thereafter; exclusive for 4 months, partial thereafter; and exclusive for 6 months) and doctor-attended infections in the URTI, LRTI, and GI until the age of 12 months were assessed by questionnaires and available for 4164 subjects.Compared with never-breastfed infants, those who were breastfed exclusively until the age of 4 months and partially thereafter had lower risks of infections in the URTI, LRTI, and GI until the age of 6 months (adjusted odds ratio [aOR]: 0.65 [95% confidence interval (CI): 0.51-0.83]; aOR: 0.50 [CI: 0.32-0.79]; and aOR: 0.41 [CI: 0.26-0.64], respectively) and of LRTI infections between the ages of 7 and 12 months (aOR: 0.46 [CI: 0.31-0.69]). Similar tendencies were observed for infants who were exclusively breastfed for 6 months or longer. Partial breastfeeding, even for 6 months, did not result in significantly lower risks of these infections.Exclusive breastfeeding until the age of 4 months and partially thereafter was associated with a significant reduction of respiratory and gastrointestinal morbidity in infants. Our findings support health-policy strategies to promote exclusive breastfeeding for at least 4 months, but preferably 6 months, in industrialized countries.

Duration of Breastfeeding and Risk of Overweight: A Meta-Analysis

2005-08-03
Thomas Harder , Renate L. Bergmann , Gerd Kallischnigg +1 more
Observational studies suggest a longer duration of breastfeeding to be associated dose dependently with a decrease in risk of overweight in later life. The authors performed a comprehensive meta-analysis of … Observational studies suggest a longer duration of breastfeeding to be associated dose dependently with a decrease in risk of overweight in later life. The authors performed a comprehensive meta-analysis of the existing studies on duration of breastfeeding and risk of overweight. Studies were included that reported the odds ratio and 95% confidence interval (or the data to calculate them) of overweight associated with breastfeeding and that reported the duration of breastfeeding and used exclusively formula-fed subjects as the referent. Seventeen studies met the inclusion criteria. By meta-regression, the duration of breastfeeding was inversely associated with the risk of overweight (regression coefficient=0.94, 95% confidence interval (CI): 0.89, 0.98). Categorical analysis confirmed this dose-response association (<1 month of breastfeeding: odds ratio (OR)=1.0, 95% CI: 0.65, 1.55; 1-3 months: OR=0.81, 95% CI: 0.74, 0.88; 4-6 months: OR=0.76, 95% CI: 0.67, 0.86; 7-9 months: OR=0.67, 95% CI: 0.55, 0.82; >9 months: OR=0.68, 95% CI: 0.50, 0.91). One month of breastfeeding was associated with a 4% decrease in risk (OR=0.96/month of breastfeeding, 95% CI: 0.94, 0.98). The definitions of overweight and age had no influence. These findings strongly support a dose-dependent association between longer duration of breastfeeding and decrease in risk of overweight.

Long-term relation between breastfeeding and development of atopy and asthma in children and young adults: a longitudinal study

2002-09-01
Malcolm R. Sears , Justina M. Greene , Andrew R. Willan +5 more

Breastfeeding and Child Cognitive Development

2008-05-01
Michael S. Kramer , Frances E. Aboud , Elena Mironova +7 more
<h3>Context</h3> The evidence that breastfeeding improves cognitive development is based almost entirely on observational studies and is thus prone to confounding by subtle behavioral differences in the breastfeeding mother's behavior … <h3>Context</h3> The evidence that breastfeeding improves cognitive development is based almost entirely on observational studies and is thus prone to confounding by subtle behavioral differences in the breastfeeding mother's behavior or her interaction with the infant. <h3>Objective</h3> To assess whether prolonged and exclusive breastfeeding improves children's cognitive ability at age 6.5 years. <h3>Design</h3> Cluster-randomized trial, with enrollment from June 17, 1996, to December 31, 1997, and follow-up from December 21, 2002, to April 27, 2005. <h3>Setting</h3> Thirty-one Belarussian maternity hospitals and their affiliated polyclinics. <h3>Participants</h3> A total of 17 046 healthy breastfeeding infants were enrolled, of whom 13 889 (81.5%) were followed up at age 6.5 years. <h3>Intervention</h3> Breastfeeding promotion intervention modeled on the Baby-Friendly Hospital Initiative by the World Health Organization and UNICEF. <h3>Main Outcome Measures</h3> Subtest and IQ scores on the Wechsler Abbreviated Scales of Intelligence, and teacher evaluations of academic performance in reading, writing, mathematics, and other subjects. <h3>Results</h3> The experimental intervention led to a large increase in exclusive breastfeeding at age 3 months (43.3% for the experimental group vs 6.4% for the control group;<i>P</i> &lt; .001) and a significantly higher prevalence of any breastfeeding at all ages up to and including 12 months. The experimental group had higher means on all of the Wechsler Abbreviated Scales of Intelligence measures, with cluster-adjusted mean differences (95% confidence intervals) of +7.5 (+0.8 to +14.3) for verbal IQ, +2.9 (−3.3 to +9.1) for performance IQ, and +5.9 (−1.0 to +12.8) for full-scale IQ. Teachers' academic ratings were significantly higher in the experimental group for both reading and writing. <h3>Conclusion</h3> These results, based on the largest randomized trial ever conducted in the area of human lactation, provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development. <h3>Trial Registration</h3> isrctn.org Identifier:ISRCTN37687716

Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis

2000-02-01

Delayed Breastfeeding Initiation Increases Risk of Neonatal Mortality

2006-03-01
Karen Edmond , Charles Zandoh , Maria Quigley +3 more
BACKGROUND. Breastfeeding promotion is a key child survival strategy. Although there is an extensive scientific basis for its impact on postneonatal mortality, evidence is sparse for its impact on neonatal … BACKGROUND. Breastfeeding promotion is a key child survival strategy. Although there is an extensive scientific basis for its impact on postneonatal mortality, evidence is sparse for its impact on neonatal mortality. OBJECTIVES. We sought to assess the contribution of the timing of initiation of breastfeeding to any impact. METHODS. This study took advantage of the 4-weekly surveillance system from a large ongoing maternal vitamin A supplementation trial in rural Ghana involving all women of childbearing age and their infants. It was designed to evaluate whether timing of initiation of breastfeeding and type (exclusive, predominant, or partial) are associated with risk of neonatal mortality. The analysis is based on 10947 breastfed singleton infants born between July 2003 and June 2004 who survived to day 2 and whose mothers were visited in the neonatal period. RESULTS. Breastfeeding was initiated within the first day of birth in 71% of infants and by the end of day 3 in all but 1.3% of them; 70% were exclusively breastfed during the neonatal period. The risk of neonatal death was fourfold higher in children given milk-based fluids or solids in addition to breast milk. There was a marked dose response of increasing risk of neonatal mortality with increasing delay in initiation of breastfeeding from 1 hour to day 7; overall late initiation (after day 1) was associated with a 2.4-fold increase in risk. The size of this effect was similar when the model was refitted excluding infants at high risk of death (unwell on the day of birth, congenital abnormalities, premature, unwell at the time of interview) or when deaths during the first week (days 2–7) were excluded. CONCLUSIONS. Promotion of early initiation of breastfeeding has the potential to make a major contribution to the achievement of the child survival millennium development goal; 16% of neonatal deaths could be saved if all infants were breastfed from day 1 and 22% if breastfeeding started within the first hour. Breastfeeding-promotion programs should emphasize early initiation as well as exclusive breastfeeding. This has particular relevance for sub-Saharan Africa, where neonatal and infant mortality rates are high but most women already exclusively or predominantly breastfeed their infants.

Breastfeeding and the Use of Human Milk

2005-02-01
This Policy Statement was revised. See https://doi.org/10.1542/peds.2022-057988. Considerable advances have occurred in recent years in the scientific knowledge of the benefits of breastfeeding, the mechanisms underlying these benefits, and in … This Policy Statement was revised. See https://doi.org/10.1542/peds.2022-057988. Considerable advances have occurred in recent years in the scientific knowledge of the benefits of breastfeeding, the mechanisms underlying these benefits, and in the clinical management of breastfeeding. This policy statement on breastfeeding replaces the 1997 policy statement of the American Academy of Pediatrics and reflects this newer knowledge and the supporting publications. The benefits of breastfeeding for the infant, the mother, and the community are summarized, and recommendations to guide the pediatrician and other health care professionals in assisting mothers in the initiation and maintenance of breastfeeding for healthy term infants and high-risk infants are presented. The policy statement delineates various ways in which pediatricians can promote, protect, and support breastfeeding not only in their individual practices but also in the hospital, medical school, community, and nation.

The Long-Term Public Health Benefits of Breastfeeding

2016-01-01
Colin Binns , Mi Kyung Lee , Wah Yun Low
Breastfeeding has many health benefits, both in the short term and the longer term, to infants and their mothers. There is an increasing number of studies that report on associations … Breastfeeding has many health benefits, both in the short term and the longer term, to infants and their mothers. There is an increasing number of studies that report on associations between breastfeeding and long-term protection against chronic disease. Recent research evidence is reviewed in this study, building on previous authoritative reviews. The recent World Health Organization reviews of the short- and long-term benefits of breastfeeding concluded that there was strong evidence for many public health benefits of breastfeeding. Cognitive development is improved by breastfeeding, and infants who are breastfed and mothers who breastfeed have lower rates of obesity. Other chronic diseases that are reduced by breastfeeding include diabetes (both type 1 and type 2), obesity, hypertension, cardiovascular disease, hyperlipidemia, and some types of cancer.
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Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect

2016-01-01
César G. Victora , Rajiv Bahl , Aluísio J. D. Barros +7 more
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Why invest, and what it will take to improve breastfeeding practices?

2016-01-01
Nigel Rollins , Nita Bhandari , Nemat Hajeebhoy +6 more

Review of Infant Feeding: Key Features of Breast Milk and Infant Formula

2016-05-11
Camilia R. Martin , Pei‐Ra Ling , George L. Blackburn
Mothers' own milk is the best source of nutrition for nearly all infants. Beyond somatic growth, breast milk as a biologic fluid has a variety of other benefits, including modulation … Mothers' own milk is the best source of nutrition for nearly all infants. Beyond somatic growth, breast milk as a biologic fluid has a variety of other benefits, including modulation of postnatal intestinal function, immune ontogeny, and brain development. Although breastfeeding is highly recommended, breastfeeding may not always be possible, suitable or solely adequate. Infant formula is an industrially produced substitute for infant consumption. Infant formula attempts to mimic the nutritional composition of breast milk as closely as possible, and is based on cow's milk or soymilk. A number of alternatives to cow's milk-based formula also exist. In this article, we review the nutritional information of breast milk and infant formulas for better understanding of the importance of breastfeeding and the uses of infant formula from birth to 12 months of age when a substitute form of nutrition is required.
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Breast-Feeding: A Guide for the Medical Profession

1981-01-01
Lawrence M. Gartner
Although several well-written, mother-oriented texts offering practical advice on breast-feeding have been available for many years, few physicians look to them for guidance. This book attempts to meet the urgent … Although several well-written, mother-oriented texts offering practical advice on breast-feeding have been available for many years, few physicians look to them for guidance. This book attempts to meet the urgent need for a readily accessible source of information on both the science and the practice of breast-feeding that will be acceptable to physicians. Although not responsible for physicians' generally negative attitudes toward breast-feeding, the absence of a good reference work is certainly a contributing factor. As strong supporters of human-milk-feeding, we welcomed the arrival of a book promising a comprehensive, up-to-date review of both the science of human lactation and its application. Dr Lawrence intends an extremely comprehensive text, with nearly 100 pages devoted to basic issues of anatomy, biochemistry, immunology, and physiology and 200 pages devoted to clinical considerations. A 57-page appendix includes a variety of material, ranging from growth curves to suggested history forms to lists of organizations

Optimal duration of exclusive breastfeeding

2002-01-21
Michael S. Kramer , Ritsuko Kakuma
Background Although the health benefits of breastfeeding are widely acknowledged, opinions and recommendations are strongly divided on the optimal duration of exclusive breastfeeding. Much of the debate has centered on … Background Although the health benefits of breastfeeding are widely acknowledged, opinions and recommendations are strongly divided on the optimal duration of exclusive breastfeeding. Much of the debate has centered on the so‐called 'weanling's dilemma' in developing countries: the choice between the known protective effect of exclusive breastfeeding against infectious morbidity and the (theoretical) insufficiency of breast milk alone to satisfy the infant's energy and micronutrient requirements beyond four months of age. Objectives To assess the effects on child health, growth, and development, and on maternal health, of exclusive breastfeeding for six months versus exclusive breastfeeding for three to four months with mixed breastfeeding (introduction of complementary liquid or solid foods with continued breastfeeding) thereafter through six months. Search methods We searched the following databases: MEDLINE (as of 1966), Index Medicus (before 1966), CINAHL, HealthSTAR, BIOSIS, CAB Abstracts, EMBASE‐Medicine, EMBASE‐Psychology, EconLit, Index Medicus for the WHO Eastern Mediterranean Region, African Index Medicus, LILACS (Latin American and Caribbean Health Sciences), EBM Reviews‐Best Evidence, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials. The two searches yielded a total of 2668 unique citations. Contacts with experts in the field yielded additional published and unpublished studies. The updated review extended the literature searched until December 2006 and yielded 835 additional unique citations. Selection criteria We selected all internally‐controlled clinical trials and observational studies comparing child or maternal health outcomes with exclusive breastfeeding for six or more months versus exclusive breastfeeding for at least three to four months with continued mixed breastfeeding until at least six months. Studies were stratified according to study design (controlled trials versus observational studies), provenance (developing versus developed countries), and timing of compared feeding groups (three to seven months versus later). Data collection and analysis We independently assessed study quality and extracted data. Main results We identified 22 independent studies meeting the selection criteria: 11 from developing countries (two of which were controlled trials in Honduras) and 11 from developed countries (all observational studies). Definitions of exclusive breastfeeding varied considerably across studies. Neither the trials nor the observational studies suggest that infants who continue to be exclusively breastfed for six months show deficits in weight or length gain, although larger sample sizes would be required to rule out modest differences in risk of undernutrition. In developing‐country settings where newborn iron stores may be suboptimal, the evidence suggests that exclusive breastfeeding without iron supplementation through six months may compromise hematologic status. Based on studies from Belarus, Iran, and Nigeria, infants who continue exclusive breastfeeding for six months or more appear to have a significantly reduced risk of gastrointestinal and (in the Iranian and Nigerian studies) respiratory infection. No significant reduction in risk of atopic eczema, asthma, or other atopic outcomes has been demonstrated in studies from Finland, Australia, and Belarus. Data from the two Honduran trials and from observational studies from Bangladesh and Senegal suggest that exclusive breastfeeding through six months is associated with delayed resumption of menses and, in the Honduran trials, more rapid postpartum weight loss in the mother. Authors' conclusions We found no objective evidence of a 'weanling's dilemma'. Infants who are exclusively breastfed for six months experience less morbidity from gastrointestinal infection than those who are mixed breastfed as of three or four months, and no deficits have been demonstrated in growth among infants from either developing or developed countries who are exclusively breastfed for six months or longer. Moreover, the mothers of such infants have more prolonged lactational amenorrhea. Although infants should still be managed individually so that insufficient growth or other adverse outcomes are not ignored and appropriate interventions are provided, the available evidence demonstrates no apparent risks in recommending, as a general policy, exclusive breastfeeding for the first six months of life in both developing and developed‐country settings. Large randomized trials are recommended in both types of setting to rule out small effects on growth and to confirm the reported health benefits of exclusive breastfeeding for six months or beyond.

Breastfeeding and the Use of Human Milk

2012-02-28
Arthur I. Eidelman , Richard J. Schanler , Margreete Johnston +4 more
This Policy Statement was revised. See https://doi.org/10.1542/peds.2022-057988. Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Given the documented short- and long-term medical and neurodevelopmental advantages … This Policy Statement was revised. See https://doi.org/10.1542/peds.2022-057988. Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Given the documented short- and long-term medical and neurodevelopmental advantages of breastfeeding, infant nutrition should be considered a public health issue and not only a lifestyle choice. The American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant. Medical contraindications to breastfeeding are rare. Infant growth should be monitored with the World Health Organization (WHO) Growth Curve Standards to avoid mislabeling infants as underweight or failing to thrive. Hospital routines to encourage and support the initiation and sustaining of exclusive breastfeeding should be based on the American Academy of Pediatrics-endorsed WHO/UNICEF “Ten Steps to Successful Breastfeeding.” National strategies supported by the US Surgeon General’s Call to Action, the Centers for Disease Control and Prevention, and The Joint Commission are involved to facilitate breastfeeding practices in US hospitals and communities. Pediatricians play a critical role in their practices and communities as advocates of breastfeeding and thus should be knowledgeable about the health risks of not breastfeeding, the economic benefits to society of breastfeeding, and the techniques for managing and supporting the breastfeeding dyad. The “Business Case for Breastfeeding” details how mothers can maintain lactation in the workplace and the benefits to employers who facilitate this practice.

Policy Statement: Breastfeeding and the Use of Human Milk

2022-06-27
Joan Younger Meek , Lawrence Noble
Breastfeeding and human milk are the normative standards for infant feeding and nutrition. The short- and long-term medical and neurodevelopmental advantages of breastfeeding make breastfeeding, or the provision of human … Breastfeeding and human milk are the normative standards for infant feeding and nutrition. The short- and long-term medical and neurodevelopmental advantages of breastfeeding make breastfeeding, or the provision of human milk, a public health imperative. The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond. These recommendations are consistent with those of the World Health Organization (WHO). Medical contraindications to breastfeeding are rare. The AAP recommends that birth hospitals or centers implement maternity care practices shown to improve breastfeeding initiation, duration, and exclusivity. The Centers for Disease Control and Prevention (CDC) and The Joint Commission monitor breastfeeding practices in US hospitals. Pediatricians play a critical role in hospitals, their practices, and communities as advocates of breastfeeding and, thus, need to be trained about the benefits of breastfeeding for mothers and children and in managing breastfeeding.

Guiding principles for complementary feeding of the breastfed child

2003-01-01
Kathryn G. Dewey

Does elimination of dairy in the breastfeeding mother reduce GERD in infants?

2025-06-25
Alexandria Hofmann , Jennifer Phillips , Natalie Long | Evidence-Based Practice

Telenursing in promoting maternal self-efficacy and exclusive breastfeeding / Telenfermagem na promoção da autoeficácia materna e aleitamento materno exclusivo

2025-06-24
Mariana Mistrinel , Vanessa Macedo Dias , Michelle Cristine de Oliveira Minharro +1 more | Revista de Pesquisa Cuidado é Fundamental Online
Objetivo: identificar na literatura qual o impacto da telenfermagem na promoção da autoeficácia materna e aleitamento materno exclusivo. Método: trata-se de uma revisão integrativa da literatura, em que os artigos … Objetivo: identificar na literatura qual o impacto da telenfermagem na promoção da autoeficácia materna e aleitamento materno exclusivo. Método: trata-se de uma revisão integrativa da literatura, em que os artigos foram pesquisados a partir da chave de busca utilizando-se os descritores “telenfermagem”, “autoeficácia”, “aleitamento materno”, “tecnologia da informação” e “lactente”. Resultados: foram encontrados 101 artigos. Concluiu-se que apenas seis cumpriam os critérios estabelecidos. Os artigos foram desenvolvidos em três categorias: a) Dificuldades associadas à prática do aleitamento materno; b) Mudanças ocasionadas pelo acompanhamento da amamentação e c) Ações educativas a serem implementadas. Conclusão: o suporte através de Tecnologias da Informação e Comunicação pode interferir na duração da amamentação.

Association News August 2025: ILCA and International Organizations in Lactation Advocacy

2025-06-24
Lisa Mandell | Journal of Human Lactation

Mother and newborn skin to skin contact in East Africa: Prevalence and predictors (2019–2023)

2025-06-24
Alemneh Tadesse Kassie , Tadesse Tarik Tamir , Astewil Moges Bazezew +3 more | PLOS Global Public Health
Skin-to-skin contact (SSC) between newborns and mothers is crucial for reducing hypothermia complications and enhancing mother-baby bonding. This study aimed to examine the prevalence rates and risk factors for SSC … Skin-to-skin contact (SSC) between newborns and mothers is crucial for reducing hypothermia complications and enhancing mother-baby bonding. This study aimed to examine the prevalence rates and risk factors for SSC in five East African countries. Data from the most recent Demographic and Health Surveys covering five East African countries from 2019 to 2023 were utilized for secondary data analysis. A total of 37,140 newborns were included in the weighted sample sizes. The factors contributing to SSC prevalence were assessed using a multilevel mixed-effects logistic regression model, with significance declared at p-values &lt;0.05. Adjusted odds ratios (AOR) and confidence intervals (CI) were used for interpretation. In East Africa, nearly half of newborns did not receive SSC. Individual-level factors associated with SSC included: immediate breastfeeding (IBF) (AOR = 2.24, 95% CI: (1.86, 2.69)), primary education (AOR = 1.60, 95% CI: (1.24, 2.07)), more than four antenatal care visits (AOR = 2.15, 95% CI: (1.37, 3.36)), low birth weight (AOR = 1.35, 95% CI: (1.04, 1.76)), multiple births (AOR = 0.41, 95% CI: (0.24, 0.73)), and cesarean section deliveries (AOR = 0.26, 95% CI: (0.20, 0.34)). Community-level factors included rural residence (AOR = 0.63, 95% CI: (0.48, 0.82)), with significant country-level variations: Kenya (AOR = 2.45, 95% CI: (1.72, 3.49)), Mozambique (AOR = 1.21, 95% CI: (0.91, 1.62)), and Tanzania (AOR = 3.14, 95% CI: (2.29, 4.31)). The findings indicate a low prevalence of mother-newborn SSC in East African countries, with particularly high rates observed in Rwanda and lower rates in Madagascar. Policymakers and ministries of health should prioritize initiatives aimed at improving SSC, particularly for newborns and mothers with low educational levels, limited media exposure, and those living in rural areas, to enhance maternal and neonatal care during delivery.

Developing a Framework for Culturally Sensitive Breastfeeding Interventions: A Community Needs Assessment of Breastfeeding Experiences and Practices in a Black Immigrant Community

2025-06-24
Temitope Awelewa , Alexandra C. Murra , William T. Story | Nutrients
Background/Objectives: Despite high breastfeeding initiation rates nationwide, disparities in breastfeeding continuation among Black mothers remain a public health issue. The BreastFeed Iowa Black Immigrant Project aimed to improve breastfeeding rates … Background/Objectives: Despite high breastfeeding initiation rates nationwide, disparities in breastfeeding continuation among Black mothers remain a public health issue. The BreastFeed Iowa Black Immigrant Project aimed to improve breastfeeding rates among low-income Black immigrant mother-infant dyads in Johnson County, Iowa by exploring factors influencing breastfeeding retention and developing a framework for culturally sensitive breastfeeding interventions. Methods: Using a descriptive cross-sectional study design, we employed a convergent, parallel mixed-methods approach to explore factors that influence breastfeeding duration among Black immigrant mothers with children 0–2 years old. Nine focus group discussions (FGDs) were conducted on Zoom among 40 participants with a semi-structured guide on breastfeeding beliefs, experiences, and feeding practices. Additionally, a 22-item survey was administered to 33 participants. Results: Based on the survey, one out of five participants indicated that they were unable to breastfeed for as long as they had planned. The top five reasons why mothers stopped breastfeeding included having received formula from the Supplemental Nutrition Program for Women, Infants and Children; being sick and having to take medicine; the baby was hungry too often; the baby was sick and could not breastfeed; and not producing enough milk. The top five themes that emerged from FGDs as barriers to breastfeeding included lack of lactation support, knowledge gaps on breastfeeding benefits, perception of inadequate milk supply, lack of comfort with breast milk expression, and work-related barriers. Conclusions: The community needs assessment identified the elements needed to develop a culturally sensitive framework with targeted interventions to address breastfeeding barriers in the Black immigrant community.

Prática de atividade física de mulheres no período de amamentação: protocolo de revisão de escopo

2025-06-23
Dilson Rodrigues Belfort , Demilto Yamaguchi da Pureza , Stephanie Vanessa Penafort Martins Cavalcante +2 more | Contribuciones a las Ciencias Sociales
Objetivo: mapear a prática de atividade física de mulheres no período de amamentação na atenção primária e secundária à saúde. Método: revisão de escopo, atendendo à metodologia do JBI e … Objetivo: mapear a prática de atividade física de mulheres no período de amamentação na atenção primária e secundária à saúde. Método: revisão de escopo, atendendo à metodologia do JBI e ao checklist do Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (Prisma-ScR). Tem como pergunta de revisão: como se dará a prática de atividade física em mulheres no período de amamentação? A busca preliminar foi realizada nas bases de dados Biblioteca Virtual de Saúde, Cinahl, Embase, Pubmed, Scopus e Web of Science. Finalizada a busca nas demais bases, os estudos serão agrupados no software Rayyan e as duplicatas serão removidas. As citações selecionadas serão avaliadas, seguindo os critérios de inclusão, por dois revisores independentes. Espera-se ampliar o conhecimento acerca da atividade física de mulheres no período da amamentação, auxiliando em estratégias de enfrentamento voltadas para esse público na atenção primária e secundária à saúde, considerando os condicionantes sociais aos quais estejam sendo expostas.

The Relationship Between Prenatal Stressful Life Events and Breastfeeding Initiation Among Mississippi Mothers

2025-06-23
Candon Garbo , Katie Hall , Disha Jhaveri +4 more | Deleted Journal

USO DA CANNABIS SATIVA DURANTE A GESTAÇÃO: EFEITOS NA MÃE E NO FETO

2025-06-23
Antonio Reynaldo Meneses Moura , Charlyan de Sousa Lima , Luciana Sirqueira Viana +5 more | Revista Acadêmica Online
O presente trabalho investiga os efeitos do uso da Cannabis sativa durante a gestação, com foco nas repercussões para a mãe e o feto. Por meio de revisão bibliográfica em … O presente trabalho investiga os efeitos do uso da Cannabis sativa durante a gestação, com foco nas repercussões para a mãe e o feto. Por meio de revisão bibliográfica em bases científicas como SciELO, LILACS e Google Acadêmico, foram analisados estudos que abordam as alterações neurológicas, comportamentais e fisiológicas decorrentes do uso da substância. A pesquisa destaca que o uso de maconha na gravidez é uma prática crescente e preocupante, que atravessa tabus e barreiras sociais, impactando o acesso das gestantes a um pré-natal adequado. A exposição do recém-nascido à cannabis via amamentação também representa riscos, mesmo em níveis aparentemente baixos. Embora alguns estudos sugiram efeitos terapêuticos da cannabis, os dados ainda são insuficientes e contraditórios no contexto da gestação. Além disso, os canabinóides podem interferir em processos neurológicos críticos do desenvolvimento fetal, impactando funções cognitivas e comportamentais a longo prazo. Conclui-se que o uso de cannabis durante a gravidez deve ser abordado com rigor científico e sensibilidade social, sendo essencial a capacitação dos profissionais de saúde para o acolhimento humanizado e intervenção precoce. O papel do enfermeiro é enfatizado como fundamental na identificação, orientação e encaminhamento de gestantes usuárias, visando proteger a saúde materno-infantil e promover estratégias eficazes de prevenção e cuidado. A inclusão de ações educativas, campanhas públicas e protocolos específicos pode contribuir para a redução dos riscos associados ao uso de substâncias durante a gravidez.

Impact of Breastfeeding Duration on Infant Health Outcomes in Türkiye: A Cross-Sectional Analysis

2025-06-23
Öykü Özbörü Aşkan , İlker Kayı | Namık Kemal Tıp Dergisi

Determinants of Independence in Exclusive Breastfeeding among Mothers with Diabetes Mellitus: A Cross-Sectional Study from Indonesia

2025-06-22
Emi Yulita , Chrismis Novalinda Ginting , Linda Chiuman +1 more | Journal of Current Health Sciences
The global rise in diabetes mellitus (DM) among women of reproductive age poses significant challenges to achieving optimal exclusive breastfeeding (EBF) rates, especially in low- and middle-income countries such as … The global rise in diabetes mellitus (DM) among women of reproductive age poses significant challenges to achieving optimal exclusive breastfeeding (EBF) rates, especially in low- and middle-income countries such as Indonesia. This study aimed to examine the relationship between knowledge and experience of mothers with DM and their independence in providing EBF, addressing an urgent need for targeted intervention and policy support for this vulnerable population. An analytic observational study with a cross-sectional design was conducted at community health centers in Pekanbaru from June to November 2024, involving 98 breastfeeding mothers diagnosed with DM, recruited through convenience sampling. Structured questionnaires measured maternal knowledge, prior breastfeeding experience, and independence in EBF. The results showed that 57.1% of mothers had good knowledge and 53.1% had adequate breastfeeding experience, while 69.4% demonstrated independence in providing EBF. Bivariate analysis revealed significant relationships between knowledge and independence (p = 0.026) as well as experience and independence (p = 0.001). These findings underscore the importance of enhancing education and support for mothers with DM to improve EBF practices. It is recommended that healthcare policies and programs prioritize continuous, tailored education and counseling to empower mothers with DM and increase EBF coverage.

CONCEITOS PRÉ-ESTABELECIDOS SOBRE AMAMENTAÇÃO E AS REPERCUSSÕES NO ALEITAMENTO MATERNO

2025-06-22
Laylla Hortencia da Silva Santone , Marcelo de Oliveira Soares , Marisa Siqueira Brandão Canuto | Revista fisio&terapia.
Introdução: A amamentação é a prática de alimentar o bebê com o leite materno, diretamente do seio da mãe, sendo de suma importância para saúde de ambos, fornecendo nutrientes fundamentais … Introdução: A amamentação é a prática de alimentar o bebê com o leite materno, diretamente do seio da mãe, sendo de suma importância para saúde de ambos, fornecendo nutrientes fundamentais e reduzindo riscos de doenças. Segundo o Ministério da Saúde, a prática reduz casos de mortalidade infantil por causas evitáveis, a manifestação de complicações relacionadas ao trato digestivo, melhora o desenvolvimento cognitivo, reduz o risco de câncer de mama em mulheres, além de atuar como método contraceptivo temporário e auxiliar na recuperação uterina. Objetivo: Elencar os conceitos pré- estabelecidos sobre a amamentação e correlacionar com as repercussões no aleitamento materno e vínculo mãe/bebê. Métodos: Trata-se de um estudo quantitativo, analítico e descritivo, realizado presencialmente por meio de um questionário de autoria própria, respondido por puérperas hospitalizadas no local de estudo. Resultados: Foram analisados 30 prontuários. Sendo encontradas maiores evidências sobre os conceitos pré-estabelecidos durante a amamentação e como podem interferir no aleitamento materno, sejam eles conceitos estéticos, familiares ou relacionados à rede de apoio da puérpera. Além disso, identificou-se diferença nas dificuldades de amamentação entre as mães que estavam amamentando pela primeira vez e as que estavam amamentando pela segunda vez. Conclusão: Os conceitos pré-estabelecidos sobre amamentação foram desmistificados durante os anos, embora, ainda se façam presentes no relato das considerações estéticas e falta de rede de apoio. O trabalho evidenciou também a necessidade de serem revistas as políticas públicas para as puérperas no auxílio do aleitamento materno exclusivo até os seis meses.

Exclusive breastfeeding practices in Afghanistan: evidence from the 2022–2023 multiple indicator cluster survey

2025-06-21
Muhammad Haroon Stanikzai , Essa Tawfiq , Massoma Jafari +6 more | Journal of Health Population and Nutrition
National prevalence estimates of exclusive breastfeeding practices could serve as the basis for future policy efforts and specific interventions. However, little is known about the prevalence and factors associated with … National prevalence estimates of exclusive breastfeeding practices could serve as the basis for future policy efforts and specific interventions. However, little is known about the prevalence and factors associated with exclusive breastfeeding practices in Afghanistan. This study aims to determine the prevalence and factors associated with exclusive breastfeeding practices among infants aged 0-5 months in Afghanistan. Multiple Indicator Cluster Survey (MICS) data collected between 2022 and 2023 were used for this analysis. Data from 3,141 mother-infant dyads were included in the study. The outcome variable was exclusive breastfeeding (EBF), defined as the proportion of infants 0-5 months of age who were fed only breast milk in the past 24 h. Binary logistic regression models were applied to examine the likelihood of EBF across the categories of independent variables. In the studied population, 67.0% (95%CI 65%-69%) of the infants were exclusively breastfed. The likelihood of EBF was higher in infants born to mothers with secondary or higher education [AOR = 1.35, 95%CI 1.04-1.76] and in infants with timely initiation of breastfeeding [AOR = 1.25, 95%CI 1.07-1.46]. However, the female sex of the infant was associated with lower odds of EBF practices [AOR = 0.83, 95%CI 0.72-0.97]. The practice of exclusive breastfeeding is at a good level (67%) in Afghanistan. Higher maternal education level, timely breastfeeding initiation, and being a male infant increased the likelihood of EBF practices. Policy efforts and interventions focused on these factors could enhance EBF practices in Afghanistan.

Impact of Husband Support on the Success of Early Initiation of Breastfeeding: A Systematic Review

2025-06-21
Aida Fitriani , Adelia Indrianti , Rania Herdiani Putri +3 more | Genius Journal
Introduction: Early Initiation of Breastfeeding defined as breastfeeding within the first hour after birth, is crucial for infant health and long-term breastfeeding success. Husband support plays a vital role in … Introduction: Early Initiation of Breastfeeding defined as breastfeeding within the first hour after birth, is crucial for infant health and long-term breastfeeding success. Husband support plays a vital role in facilitating this process. Objective: This study aimed to evaluate the influence of husband support on the success of Early Initiation of Breastfeeding among postpartum mothers. Methods: A systematic review was conducted by searching scientific databases including PubMed, ProQuest, Garuda, and JSTOR, covering publications from January 2014 to December 2024. The population included postpartum mothers regardless of delivery method. Husband support was assessed through questionnaires, in-depth interviews, and observation sheets. Three independent reviewers conducted article selection following the PRISMA flowchart, data extraction, and quality assessment using the CASP checklist. Extracted data comprised author details, interventions, settings, facilitators, session number and duration, methods or media used, and topics addressed. Results: Nine studies with a total of 752 participants were reviewed. The success rate of EIB with husband support ranged from 3.7% to 85.71%. Husband support involved encouragement, creating a comfortable breastfeeding environment, and jointly seeking information on EIB. Maternal knowledge and healthcare professional support were also important contributors. Conclusion: Husband support significantly influences the success of Early Initiation of Breastfeeding in postpartum mothers. Incorporating husband involvement through emotional, informational, and practical support in prenatal education programs is recommended to improve EIB outcomes.

MUDANÇA NO NÍVEL DE CONHECIMENTO SOBRE ALEITAMENTO MATERNO APÓS PALESTRAS INFORMATIVAS DIRIGIDAS ÀS MÃES NA CLÍNICA BIENESTAR DURANTE A GESTÃO DE 2024

2025-06-20
Nicol Mildred Gomez Condori , Daniela Condori Tancara Luz , Camila Lino Villazante +3 more | Revista fisio&terapia.
ABSTRACT Introduction: Exclusive breastfeeding during the first six months of life is essential for optimal newborn development, providing nutritional, immunological, emotional, and preventive benefits for both the baby and the … ABSTRACT Introduction: Exclusive breastfeeding during the first six months of life is essential for optimal newborn development, providing nutritional, immunological, emotional, and preventive benefits for both the baby and the mother. However, its practice is still limited in many communities, despite widespread awareness of its advantages. This study seeks to assess mothers’ knowledge about exclusive breastfeeding and strengthen it through an educational intervention. Methods: A quasi-experimental, quantitative, cross-sectional study was conducted, with pretest and posttest surveys among a group of 57 mothers attending the Bienestar Clinic. The intervention consisted of an interactive educational talk, with didactic support and answering questions, focusing on the benefits, techniques, and appropriate duration of breastfeeding. Results: The initial assessment revealed significant gaps in the participants’ knowledge. After the intervention, a significant improvement in the understanding of key concepts about exclusive breastfeeding was observed, as well as a more favorable attitude toward its continued practice up to six months. Conclusion: The implemented educational strategy proved effective in increasing knowledge and awareness about the importance of exclusive breastfeeding. The results highlight the need to continue promoting accessible, scientifically based educational opportunities that strengthen maternal and child health from a community-based and preventative perspective. Keywords: Educational intervention, maternal and child health, breastfeeding, knowledge, benefits, breastfeeding.

Breastfeeding beyond infancy

2025-06-20
Neena Modi | Pediatric Research

Exploration of Beliefs about Exclusive Breastfeeding: An Elicitation study with Low-income Women in South Korea

2025-06-20
Yeon Bai , Yoonna Lee , Jung E. Lee | International Journal Of Nutrition
The benefits of exclusive breastfeeding are well-known. Despite the legislative and systemic efforts to promote breastfeeding in South Korea, the nation’s current rate of exclusive breastfeeding (5.2%) during the infant’s … The benefits of exclusive breastfeeding are well-known. Despite the legislative and systemic efforts to promote breastfeeding in South Korea, the nation’s current rate of exclusive breastfeeding (5.2%) during the infant’s first six months is alarming. Under the framework of the theory of planned behavior (TPB), this study elicited the beliefs around exclusive breastfeeding commonly held by low-income women participating in NutriPlus, the community nutrition program. Using a convenient sampling method, online open-ended surveys were conducted with two program clinics in Seoul during spring of 2024. The survey included questions about their demography and beliefs regarding indirect theoretical constructs of the exclusive breastfeeding behavior by listing top three things that came to their mind. A total of 120 NutriPlus clients participated in this survey. Though 53.1% of postpartum women were breastfeeding, only 28.1% were breastfeeding exclusively. Based on most frequently mentioned beliefs, we classified them to behavioral, normative, and control beliefs under TPB. Modal behavioral beliefs were healthy babies (n=87) and mother-baby bonding (n=71) and feeding issues (n=96) and inconvenience resulting from the act of breastfeeding (n=86). Family members seemed to shape both positive (n=122) and negative (n=37) normative beliefs. The presence of support (n=84) mattered to facilitate breastfeeding, while feeding issues (n=98) played as barriers. Promotion efforts need to emphasize breastfeeding knowledge and skill building and include family members and society at large to improve the awareness and transform barriers of breastfeeding to facilitators.

An assessment of the impact of a new-type of doctor–nurse joint prenatal breastfeeding clinic attendance on women’s breastfeeding duration and feeding-related breast problems: A cohort observational study

2025-06-20
Xingxing Liu , Xiangping He , Guihua Xiao +2 more | Medicine
To promote breastfeeding, a new-type of doctor-nurse joint prenatal breastfeeding clinic was carried out in Haidian District Maternal and Child Health Hospital, Beijing, China. Actual improvement in the duration of … To promote breastfeeding, a new-type of doctor-nurse joint prenatal breastfeeding clinic was carried out in Haidian District Maternal and Child Health Hospital, Beijing, China. Actual improvement in the duration of breastfeeding and feeding-related breast problems for women using these clinics remains unknown. This observational study assesses the impact of doctor-nurse joint prenatal breastfeeding clinic's interventions on breastfeeding duration and feeding-related breast problems in comparison with women who did not receive clinic services. Pregnant women with more than 36 weeks of gestation in Haidian District Maternal and Child Health Hospital were enrolled from July 2023 to September 2023. Patients were grouped based on whether they attended the doctor-nurse joint prenatal breastfeeding clinic. Telephone follow-up calls were conducted at 1 and 6 months postpartum. A total of 90 sets of valid data were collected, including 37 in the target group and 53 in the comparison group. There were no statistically significant differences between the 2 groups with respect to the following metrics: the rate of exclusive breastfeeding at 1 and 6 months postpartum, incidence of nipple injury and mastitis at 1 month postpartum, duration of exclusive and overall breastfeeding, and costs of breast treatment. The main reason for ceasing breastfeeding was milk insufficiency. The modality of lactation suppression was mainly natural cessation. Breast discomforts were mainly milk stasis. There is no significant advantage of doctor-nurse joint prenatal breastfeeding clinic. The promotion of breastfeeding still needs to explore new ways or comprehensive methods.

The effectiveness of postpartum education and support models in enhancing mothers’ self-efficacy after cesarean section

2025-06-19
Elin Supliyani , Ina Handayani , Novita Dewi Novita Dewi Pramanik +1 more | Healthcare in Low-resource Settings
Mothering self-efficacy refers to a parent’s belief in their ability to care for a child, which can be influenced by experience, knowledge, and physical condition after giving birth by cesarean … Mothering self-efficacy refers to a parent’s belief in their ability to care for a child, which can be influenced by experience, knowledge, and physical condition after giving birth by cesarean section (CS). Education and postpartum support for mothers after a CS are essential for enhancing their knowledge, skills, and confidence in caring for their babies, helping them feel more prepared and capable. This study examined the effectiveness of a postpartum education and assistance model on the mothering self-efficacy of mothers who have undergone CS. This research was conducted at Bogor City Hospital (Indonesia) using a quasi-experimental method with a non-equivalent control group design, employing pre-test and post-test assessments. The sample obtained through purposive sampling consisted of 44 post-CS mothers, with 22 in the intervention group and 22 in the control group. The Wilcoxon test was used for data analysis. Mothers’ self-efficacy in caring for babies was measured before and after education and assistance using the Perceived Maternal Parenting Self-Efficacy (PMPSE) questionnaire with a Likert scale. The results showed that the median self-efficacy of post-CS mothers before the intervention was 64.50 (range 48-79), while after education and mentoring, the median increased to 81 (range 61-93). Education and mentoring significantly influenced maternal self-efficacy in caring for infants (p&lt;0.001). It is hoped that this education and mentoring model can be applied in health facilities, particularly hospitals, to enhance the readiness of post-CS mothers to care for their babies and strengthen their confidence.

Role of Silver Nipple Protectors in Treating Nipple Trauma: A Non-Randomized Comparative Trial

2025-06-19
Maya Nakamura , Hiroyuki Sugimori , Yoko Asaka +1 more | Journal of Human Lactation
Background: Breastfeeding is crucial for infant health, but nipple trauma remains a common challenge. In particular, nipple trauma can lead to the onset of mastitis and psychological distress for mothers. … Background: Breastfeeding is crucial for infant health, but nipple trauma remains a common challenge. In particular, nipple trauma can lead to the onset of mastitis and psychological distress for mothers. Silver nipple protectors have been suggested to alleviate this issue, but detailed research is needed. Research Aim: This study aims to clarify the effectiveness of silver nipple protectors in treating nipple trauma in Japanese women. Methods: A non-randomized comparative trial compared 47 participants (94 nipples) using silver nipple protectors with a control group of 50 participants (100 nipples) from historical data. The assessment included chronological changes in nipple condition, level of nipple pain, and safety, among other factors. Data collection spanned from 2023 to 2024. Results: The group using silver protectors experienced fewer instances of severe nipple trauma and showed a higher frequency of healing patterns. Many of these patterns involved a transition from mild erythema or swelling toward a healing state. Specifically, the level of nipple pain on the 4th postpartum day was significantly lower. No safety issues from the use of silver protectors were noted. Conclusion: This study suggests that silver nipple protectors may prevent the occurrence of severe nipple trauma and are safe and beneficial for Japanese women. Future research should focus on the mechanism of silver protectors, their long-term effects, regional differences, practical challenges for implementation, and comparisons with other common treatments.

Knowledge on Breast Engorgement and Its Management Among Postnatal Mothers Admitted in Selected Hospitals of Guwahati, Assam in a View to Develop an Information Booklet

2025-06-19
Mamta Dulom | International Journal for Research in Applied Science and Engineering Technology
Background: Breast feeding is an unequal way of providing ideal food for the healthy growth and development of a baby.The main reason for considering the breast feeding as important is … Background: Breast feeding is an unequal way of providing ideal food for the healthy growth and development of a baby.The main reason for considering the breast feeding as important is that, it is an essential time of bonding between mother and baby. However many mothers experience painful, sore nipples during breast feeding and stops nursing before they intended. Breast engorgement is the most common complication during the postnatal period.Breast engorgement typically occurs during the transition from producing colostrum to mature milk. It can also happen if nursing mothers miss several feedings or don't express enough milk.So, it is important to follow proper breast feeding techniques to prevent breast engorgement, the commonest problem in the early postnatal period. Title of the study: “A study to assess the Knowledge on Breast engorgement and its Management among Postnatal Mothers admitted in selected Hospitals of Guwahati, Assam in a view to develop and Information booklet.” Methodology: A descriptive design was adopted for the study. The sample consists of 136 postnatal mothers who were selected using convenience sampling technique from three conveniently selected hospitals namely, Pratiksha hospital, Satribari Christian hospital and Marwari Maternity hospital of Guwahati, Assam. Data were collected using a structured interview schedule to assess the knowledge on breast engorgement and its management. Results: The findings of the study revealed that out of 136 postnatal mothersmajority i.e. 105 (77.2%) had moderate knowledge, 21 (15.4%) had adequate knowledge and 10 (7.4%) had inadequate knowledge with mean score 9.79 and SD 2.38.The overall statistical findingsshowssignificant association in regards to educational qualification and previous knowledgeon breastengorgement.Whereas, demographic variables such as age, religion, area of residence and occupational status of postnatal mothers were found non significant at 0.05 level ofsignificance. Conclusion: The findings clearly suggest that the majority of the postnatal mothers had moderate knowledge redarding breast engorgement and its management. Therefore keeping in the mind the study findings, the researcher developed and distributed an information booklet to improve the knowledge on breast engorgement and its management

Human milk banking services: An umbrella review protocol

2025-06-19
Róisín O’Donovan , Aoife Long , Elaine Lehane +6 more | HRB Open Research
<ns3:p>Objective To review the current state of the art of human milk banking including evidence on development and implementation of human milk banking services in middle- and high-income countries; models … <ns3:p>Objective To review the current state of the art of human milk banking including evidence on development and implementation of human milk banking services in middle- and high-income countries; models of delivery; and the roles of key stakeholders in supporting and sustaining human milk banking services. Introduction Donor Human Milk (DHM) is human milk in excess of an infant's current and future needs that is donated for use by another infant. The World Health Organisation recommends that it should be available to all preterm and low birthweight infants. Human Milk Banks (HMB) require operational sustainability to ensure all year-round consistency and equity of DHM supply. This review will inform the co-design of an evidence framework for a national human milk banking resource network. Inclusion criteria Systematic reviews of studies reporting on the development, implementation and sustainability of a milk banking service in middle- and high-income counties. Methods The guidelines for umbrella reviews from the JBI Manual for Evidence Synthesis will be followed. A key word search strategy will be used to search: CINAHL (EBSCO), MEDLINE (EBSCO), PsycINFO (EBSCO), Embase (Ovid), JBI Evidence Synthesis, Epistemonikos, and the PROSPERO register. A grey literature search will be undertaken on Google scholar, BASE and the National Institute for Health and Care Excellence (NICE) website. English language and date restrictions (2000-current) will be used. Titles and abstracts and full-text articles will be independently screened by two reviewers. The reference lists of the included studies will be searched. Studies will be screened in Covidence by two independent reviewers. All reviewers will agree on the included studies. Data will be extracted and presented graphically using figures and tables. Narrative summary text will accompany the tables and figures. This protocol has been registered on PROSPERO</ns3:p>

Infant feeding practices in first time mothers: a cross-sectional study

2025-06-19
Anam Hiranmayi , M. G. Ravanagomagan , S. Jagadeeswari | International Journal of Research in Medical Sciences
Background: Optimal infant nutrition during the early months of life is essential for growth, development, and disease prevention. Exclusive breastfeeding (EBF) is recommended for the first six months by World … Background: Optimal infant nutrition during the early months of life is essential for growth, development, and disease prevention. Exclusive breastfeeding (EBF) is recommended for the first six months by World Health Organization (WHO) and United Nations Children's Fund (UNICEF). However, in many low- and middle-income countries, including India, actual breastfeeding practices are influenced by socio-cultural and economic factors, especially among first-time mothers. This study aimed to assess the knowledge, attitudes, and practices (KAP) regarding infant feeding among first-time mothers in an urban healthcare setting in India. Methods: A cross-sectional descriptive study was conducted between January and March 2025 at the Department of Pediatrics, Sree Balaji Medical College and Hospital, Chennai. A total of 383 first-time mothers with infants aged 0–6 months were selected using purposive sampling. Data were collected using a self-structured and pre-tested KAP questionnaire in English and Tamil. Descriptive and inferential statistics were used for analysis via statistical package for the social sciences (SPSS) version 21. Results: While 85% of participants were aware of the recommended duration for EBF, only 52.2% practiced it. Formula feeding was reported by 31.3%, and 15.7% had introduced animal milk before six months. Prelacteal feeding and bottle-feeding were practiced by 10.4% and 13.1%, respectively. Major barriers included perceived insufficient milk (31.3%), return to work (23.5%), and lack of support (20.9%). Health professionals (65%) were the primary source of breastfeeding information. Conclusions: Despite high awareness, a significant gap exists between knowledge and actual feeding practices among first-time mothers. Targeted educational interventions and support systems are essential to improve adherence to optimal infant feeding guidelines.

Sugar Consumption and Breastfeeding Practices in Children from Mexico and Bolivia

2025-06-19
Daphne Lopez | Journal of Clinical Medical Research
Dental caries remains a public health problem, with sugar consumption from an early age being the main associated factor. Although the WHO recommends delaying its introduction into the diet until … Dental caries remains a public health problem, with sugar consumption from an early age being the main associated factor. Although the WHO recommends delaying its introduction into the diet until after two years of age, this guideline does not appear to be followed. This study aimed to examine sugar consumption, dietary habits and breastfeeding patterns among infants in Mexico and Bolivia. A cross-sectional study was conducted involving 555 children aged 12-35 months, comprising 294 from Bolivia and 261 from Mexico, as part of a complementary study by the Dental Caries Research Observatory of the Latin American Region (OICAL). The mothers of the participating children were interviewed and a food frequency questionnaire, previously validated in various Latin American countries and utilized in OICAL, was administered. Additional data on breastfeeding and the introduction of sugary foods and beverages were collected. Statistical analysis included Chi-square test for qualitative variables. The Mann-Whitney test was used to examine the association between total breastfeeding duration and the age of introduction of sugary foods. Poisson regression calculated mean ratios adjusted to 95% confidence. The mean age of introduction of sugary foods and beverages was 9.7 months (95% CI 9.3-9.9) and 9.9 months (95% CI 9.4-10.3), respectively, with a significant difference observed between countries (p&lt;0.001). The average daily frequency of sugary foods and beverages for both groups was 3.1 times per day (95% CI 2.9-3.3), with no significant difference detected. Breastfeeding duration ranged from 16.2 to 17.7 months and was practiced by 78.7% of children over 12 months, with 46.3% of these children receiving breastfeeding on demand and sleeping next to their mothers throughout the night. It was concluded that most infants in both countries initiate consumption of sugary products during the first year of life and a high daily frequency of consumption was also observed.

Exploring Determinants of Exclusive Breastfeeding among Mothers in Jiangsu, China

2025-06-19
Qian Wu , Chintana Wacharasin , Tang Yan | Maternal and Child Health Journal

About Research Intervention Study

2025-06-18
Jung Eun Lee | Journal of Human Lactation

Práticas avançadas, tecnologias e instrumentos no manejo da amamentação: revisão integrativa

2025-06-18
Maria Maísa Rodrigues de Oliveira , João Paulo Assunção Borges , Ana Patrícia Araújo Torquato Lopes +1 more | Enfermagem Brasil
Introdução: O aleitamento materno é um cuidado essencial na saúde da criança. Entretanto, há entraves para iniciar e manter a amamentação, ocasionando o desmame precoce e suas complicações. A utilização … Introdução: O aleitamento materno é um cuidado essencial na saúde da criança. Entretanto, há entraves para iniciar e manter a amamentação, ocasionando o desmame precoce e suas complicações. A utilização de práticas avançadas e tecnologias pode auxiliar o profissional de saúde neste cuidado. Objetivo: sintetizar as evidências científicas sobre práticas avançadas, tecnologias e instrumentos utilizados no manejo da amamentação. Métodos: Trata-se de revisão integrativa da literatura, com análise crítica das evidências e foco nos instrumentos de avaliação. A revisão fundamentou-se em seis etapas: formulação da questão de pesquisa; busca nas bases de dados realizadas por dois revisores independentes; categorização; avaliação dos estudos; interpretação dos resultados; e síntese da revisão. Foram incluídos artigos dos últimos cinco anos, em língua portuguesa, sendo excluídos os duplicados e aqueles com outras temáticas, totalizando 12 artigos. Foi realizada uma combinação entre os descritores “Aleitamento Materno” AND “Avaliação de Tecnologias de Saúde”, por meio do operador booleano “AND”. O processo de busca foi realizado por dois pesquisadores independentes, nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Base de Dados em Enfermagem (BDENF) e Medical Literature and Retrieval System Online (MEDLINE) por meio da Biblioteca Virtual em Saúde (BVS). Resultados: Os artigos foram analisados quanto ao ano de publicação; base de dados; título do artigo/autores; objetivo principal; tecnologias apresentadas/pesquisadas; contribuições para manejo da amamentação e possíveis lacunas. Os achados desta revisão de literatura revelaram que as práticas avançadas de suporte à amamentação são uma realidade e podem impactar positivamente no início, na duração e na exclusividade do AM. Conclusão: A simulação clínica e uso de tecnologias digitais, como aplicativos móveis e comunidades virtuais, foram as práticas mais comuns para aprimorar a formação profissional, melhorando habilidades e práticas no apoio às lactantes. As inovações e educação permanente são fundamentais para promoção de boas práticas de amamentação e da saúde materno-infantil.

Socio-cultural factors affecting breastfeeding in Northern Mexico: insufficiency and dissatisfaction

2025-06-18
Diana Bueno‐Gutiérrez , Fernanda Tejeda-López , Ana Lilia Armendariz-Anguiano +2 more | Deleted Journal

The Importance of Breastfeeding for Life-Long Health

2025-06-18
Alison M. Stuebe | Obstetrics and Gynecology

Tecnologia educativa para indução da lactação em pessoas não gestantes

2025-06-18
Daniele C. Nascimento , Rayanne Marcela Mendonça Meireles , Socorro Alana Ramalho Rocha +3 more | Contribuciones a las Ciencias Sociales
O aleitamento materno é essencial para a saúde infantil e pode prevenir inúmeras mortes. A indução da lactação surge como alternativa importante para pessoas que não gestaram, possibilitando que também … O aleitamento materno é essencial para a saúde infantil e pode prevenir inúmeras mortes. A indução da lactação surge como alternativa importante para pessoas que não gestaram, possibilitando que também amamentem. Este estudo teve como objetivo desenvolver um folder educativo sobre essa técnica, voltado a pessoas não gestantes. Trata-se de um estudo metodológico com proposição de tecnologia educativa, baseado no protocolo da Academy of Breastfeeding Medicine. A construção envolveu tradução, síntese de informações, elaboração de conteúdo e diagramação, seguindo orientações sobre materiais educativos em saúde. O folder, feito na plataforma Canva®, foi estruturado em papel A4, frente e verso, com três dobras, na orientação paisagem. Aborda definição, público-alvo, métodos, indicações, contraindicações e benefícios da indução. Usaram-se cores ligadas à maternidade (roxo, rosa e branco), fonte que equilibra seriedade e leveza, além de imagens que facilitam a compreensão e engajam o leitor. A proposta foi fundamentada na literatura científica, contribuindo para práticas humanizadas e resolutivas no aleitamento. Conclui-se que essa tecnologia educativa pode beneficiar mães adotivas, casais homoafetivos e outros públicos, promovendo o cuidado integral e reforçando a importância da capacitação de profissionais de enfermagem nesse processo.

Factors associated with breastfeeding in women with a history of bariatric surgery: A cross-sectional survey study

2025-06-18
Samira Mokhlesi , Vidanka Vasilevski , Linda Sweet | Midwifery
As bariatric surgery rates rise among women of reproductive age, more are becoming pregnant post-surgery. These mothers have lower breastfeeding rates than those without bariatric surgery. Evidence on breastfeeding after … As bariatric surgery rates rise among women of reproductive age, more are becoming pregnant post-surgery. These mothers have lower breastfeeding rates than those without bariatric surgery. Evidence on breastfeeding after bariatric surgery is limited, and the factors contributing to early cessation are not fully understood. Identify the factors associated with exclusive breastfeeding and breastfeeding duration among mothers who have undergone bariatric surgery before pregnancy. A cross-sectional online survey was conducted among women in Australia who had pre-pregnancy bariatric surgery. Data were collected using a demographic questionnaire and the Breastfeeding after Bariatric Surgery Scale (BBSS). Descriptive statistics and association analysis were conducted. A total of 221 mothers completed the survey. Most participants (81.4 %) intended to exclusively breastfeed, with 59 % planning to continue for at least six months. However, only 47 % exclusively breastfed during the first three months. Intention to breastfeed was significantly associated with exclusive breastfeeding during the first three months postpartum (OR=5.41, 95 % CI: 1.30-22.41, p = 0.02) and with lower odds of stopping breastfeeding before six months (OR=0.16, 95 % CI: 0.03-0.71, p = 0.01). Mothers with real or perceived milk supply issues were 82 % less likely to exclusively breastfeed (OR = 0.18, 95 % CI: 0.07 - 0.45, p < 0.001), and those with loose breast skin were 75 % less likely to continue breastfeeding beyond 6-month (OR=0.24, 95 % CI: 0.08-0.77, p = 0.01), compared to those without these breastfeeding challenges. A gap exists between breastfeeding intention and practice among post-bariatric surgery mothers. Unique challenges related to bariatric surgery can impact breastfeeding outcomes.

Monitoring and enforcement of Code-based legal measures to protect breastfeeding in South Asia: opportunities and bottlenecks

2025-06-18
Constance Ching , Vani Sethi , David Clark +7 more | Frontiers in Public Health
Objective To examine the bottlenecks and opportunities associated with Code monitoring and enforcement at the national level in the eight countries of South Asia region (Afghanistan, Bhutan, Bangladesh, India, Maldives, … Objective To examine the bottlenecks and opportunities associated with Code monitoring and enforcement at the national level in the eight countries of South Asia region (Afghanistan, Bhutan, Bangladesh, India, Maldives, Nepal, Pakistan, and Sri Lanka). Design Data was collected following a workshop-as-research methodology. Deductive content analysis was used to review, categorize, and analyze data. A semi-structured categorization matrix containing three main categories (background, opportunities, and bottlenecks) was developed as a guide for categorizing data on areas relevant to monitoring and enforcement. Findings Overarching themes in bottlenecks include: (1) There is insufficient monitoring across countries, (2) Monitoring is not well-integrated into relevant enforcement mechanisms, as there is a lack of established system to efficiently ‘feed’ monitoring findings to the designated enforcement agencies, (3) Uncertainty regarding enforcement in the context of digital marketing, (4) Lack of coordination and collaboration regarding enforcement, (5) Inadequate sanctions and penalties, sometimes due to a lack of identified legal structure and adjudication system and functional administrative or enforcement mechanisms. Overarching themes in opportunities include: (1) Product registration or licensing as entry points for monitoring and enforcement, (2) authority provided in legal measures for designated agencies to carry out monitoring and enforcement actions, (3) civil society as government partners in monitoring including developing monitoring tools and strengthening systems to integrate monitoring with enforcement. Inadequately imposed.

‘Breastfeeding Is Not the Sole Responsibility of Women’: A Qualitative Examination of the Supportive Environment for Breastfeeding in Nigeria Across Levels of the Socioecological Model

2025-06-17
Elizabeth Costenbader , Mackenzie Green , Kate Litvin +4 more | Maternal and Child Nutrition
ABSTRACT Breastfeeding is the optimal method of infant and young child feeding. In Nigeria, breastfeeding rates have struggled to markedly improve over past decades. Prior efforts to understand the determinants … ABSTRACT Breastfeeding is the optimal method of infant and young child feeding. In Nigeria, breastfeeding rates have struggled to markedly improve over past decades. Prior efforts to understand the determinants of breastfeeding have heavily focused on women themselves, with lesser attention on the complex interplay of cultural, economic and health system factors affecting breastfeeding. Given the struggle to sustain improvements in optimal feeding practices, a deeper, updated understanding of the supportive environment for breastfeeding in Nigeria is needed. This subset analysis stems from a formative study that conducted semi‐structured interviews and focus group discussions in urban and rural communities in Nigeria's six geo‐political zones. The analysis explored barriers and facilitators to breastfeeding at different levels of a socioecological model (SEM). Discussions with pregnant women and mothers of young children focused on the supportive environment for breastfeeding beyond the individual level, exploring facilitators and barriers in women's nuclear and multi‐generational families, their communities, and institutions that provide health and nutrition services. At the household level, participants highlighted the influence of family elders. In their communities, widespread traditional practices and beliefs helped and hindered breastfeeding, along with varying sources of community‐level support and influence. At the service level, women elaborated on the effect of healthcare service access, service availability, and the quality of health and nutrition services. This formative analysis deepens understanding of factors crucial for developing multilevel and multicomponent interventions across the SEM in Nigeria that can simultaneously support mothers and improve infant health outcomes nationwide.

Breastfeeding promotion: maternal empowerment interventions during the pregnancy-parturition cycle / Promoção da amamentação: intervenções para a capacitação materna durante o ciclo gravídico-puerperal

2025-06-17
Ana Moreira , Márcio Tavares | Revista de Pesquisa Cuidado é Fundamental Online
Objetivo: identificar as intervenções realizadas pelo enfermeiro obstetra no ciclo gravídico-puerperal, que visem a capacitação das mulheres para a amamentação. Método: revisão Scoping segundo modelo do Joanna Briggs Institute, abrangendo … Objetivo: identificar as intervenções realizadas pelo enfermeiro obstetra no ciclo gravídico-puerperal, que visem a capacitação das mulheres para a amamentação. Método: revisão Scoping segundo modelo do Joanna Briggs Institute, abrangendo estudos publicados nas plataformas EBSCOhost, B. On, Web of Science e Scopus. Resultados: incluídos e analisados 12 estudos que permitiram a identificação de seis categorias de intervenções: 1) educação pré-natal; 2) apoio pós-natal individualizado; 3) promoção da autoeficácia materna; 4) intervenções durante o parto e internamento na maternidade; 5) envolvimento familiar e apoio social e 6) intervenções complementares e alternativas. Conclusões: Programas educativos abrangentes do pré-natal ao pós-parto, sessões em grupo, acompanhamento telefónico, visitas domiciliárias, grupos de apoio online e envolvimento familiar evidenciaram-se como estratégias eficazes na capacitação materna para amamentar. O enfermeiro obstetra tem um papel crucial na promoção da amamentação. A formação contínua e a adesão a políticas públicas são essenciais para garantir a eficácia das suas intervenções.

SUPLEMENTAÇÃO DE CÁLCIO NA GESTAÇÃO: EVIDÊNCIAS, RECOMENDAÇÕES E BENEFÍCIOS PARA A SAÚDE MATERNO-FETAL

2025-06-17
PAULA ENGEL MARTINI , ISADORA GRINGS PEREIRA , ⁠MARIANA GUIDOUX LEAL TRINDADE +7 more | Editora Pasteur eBooks

Implementing the practice of early skin-to-skin contact among infants ≥34 weeks gestation born by caesarean section: A quality improvement study

2025-06-17
Md Habibullah Sk , Saugata Chaudhuri , Bijan Saha | Journal of Neonatal-Perinatal Medicine
Background Separating mothers and newborns after caesarean delivery prevents early skin-to-skin contact (SSC), despite WHO recommendations to initiate SSC immediately at birth. Early SSC promotes breastfeeding success, enhances thermoregulation, reduces … Background Separating mothers and newborns after caesarean delivery prevents early skin-to-skin contact (SSC), despite WHO recommendations to initiate SSC immediately at birth. Early SSC promotes breastfeeding success, enhances thermoregulation, reduces maternal postpartum complications, and fosters bonding. In our hospital, SSC was not practiced after caesarean deliveries, prompting this quality improvement (QI) initiative. Methods Conducted in the operating theatre of a tertiary care hospital over 4 months (January–April 2024), with a 3-month sustenance phase. Inborn infants ≥34 weeks gestation and ≥1.8 kg delivered via caesarean section, with good tone and breathing at birth, were eligible. Sequential Plan-Do-Study-Act (PDSA) cycles were implemented to introduce SSC within 5 minutes of birth, aiming for ≥90% compliance. Interventions included staff training, SSC protocol development, operating room reorganization, and maternal support during recovery. Results SSC compliance increased from 0% at baseline to 100% by cycle 4. Breastfeeding initiation improved from 48% to 95%, and exclusive breastfeeding at discharge increased from 77% to 97%. Deferred weighing and vitamin K administration rates increased from 10% to 100%. Conclusion Through systematic interventions, we achieved and sustained 100% SSC compliance for caesarean births. This study demonstrates that with a structured, multidisciplinary approach, SSC can be successfully integrated into caesarean delivery routines, potentially enhancing maternal-infant bonding and early breastfeeding initiation.

Analysis of the Elemental Composition of Milk Formulae: Impact on the Nutritional Status of Infants From Birth to 1 Year of Age

2025-06-17
Małgorzata Dobrzyńska , Zofia Wojciechowska , Karol Jakubowski +4 more | Biological Trace Element Research
Abstract Inappropriate concentrations of elements in infant formulae may lead to adverse health effects, so this study was designed to determine the concentration of selected basic (Na, K, Ca, P, … Abstract Inappropriate concentrations of elements in infant formulae may lead to adverse health effects, so this study was designed to determine the concentration of selected basic (Na, K, Ca, P, Mg, Fe, Zn, Cu, and Mn) and toxic or potentially toxic elements (As, Cd, Co, Cr, Hg, Sn, and Ni) in formulae for infants from birth to 12 months currently available on the Polish market. The concentrations of these elements were assessed using inductively coupled plasma mass spectrometry (ICP-MS), and the estimated daily intake (EDI) of elements was calculated. The concentrations of most analyzed elements in formulae were in good agreement with the recommended EU limits, except for Cu (median 72 µg/100 kcal, range 0 − 338 µg/100 kcal) and K (155 µg/100 kcal, 103 − 316 µg/100 kcal) in some formulae did not meet the guidelines for minimum and maximum levels. Additionally, there were large differences in Mn concentrations between the various formulae (range 1 − 91 µg/100 kcal). The Ni EDI exceeded 4.3 µg in some formulae, which EFSA established as the lowest observed adverse effect level (LOAEL) for eczematous skin reactions. Therefore, regular monitoring of the composition of formulae for infants is recommended.

Reproducibility of SOHO-5applied to 5-year-oldstudents from public schools in a region from Paraíba sertão area

2025-06-17
Marcos Alexandre Casimiro de Oliveira , A. H. Vieira , Raulison Vieira de Sousa +3 more | Brazilian journal of oral sciences/Brazilian Journal of Oral Sciences
Aim: This paper aimed to evaluate the reproducibility of the Scale Oral Health Outcomes for Five-Year-Old Children (SOHO-5) applied to public school students in a sertão area in the Paraíba. … Aim: This paper aimed to evaluate the reproducibility of the Scale Oral Health Outcomes for Five-Year-Old Children (SOHO-5) applied to public school students in a sertão area in the Paraíba. Methods: The study population consisted of the census of all children in the city with a 5-year-old child (59 students) who underwent a clinical examination based on World Health Organization criteria for dental care (dmft) and application of an oral health-related questionnaire quality of life (SOHO-5). This process was repeated 30 and 60 days after the initial test under the same application conditions for two calibrated examinators. To assess the reproducibility of the SOHO-5 instrument, the concordance correlation coefficient (ρc) was used and a Bland-Altman concordance analysis was performed to assess the variability (limit of concordance) existing between the time points of questionnaire administrations. Results: For the study scenario, there was no agreement between students’ answers regarding their quality of life, as indicated by low values of the concordance coefficient. Furthermore, the 95% confidence intervals of these measures show that these values are not significant because the intervals in the t0 x t2 (-0.11) and t1 x t2 (-0.04) scenarios have “zero”, while the lower bound for the t0 x t1 scenario is 0.29. Conclusions: Therefore, there was no agreement between the standard response of 5-year-old children at three points in time when the questionnaire was administered.

Exploring breastfeeding knowledge and practices among mothers by socio-demographic profile and mode of delivery

2025-06-16
Muhammad Tariq , Wajeha Najeeb , Naqib Ullah Khan +3 more | Journal of Rehman Medical Institute
Introduction: Breastfeeding is vital for maternal and infants’ health, yet many women lack knowledge and face challenges in practice, particularly in diverse socio-economic contexts. Objective: To generate evidence of current … Introduction: Breastfeeding is vital for maternal and infants’ health, yet many women lack knowledge and face challenges in practice, particularly in diverse socio-economic contexts. Objective: To generate evidence of current breastfeeding practices and knowledge in our population. Materials and Methods: It was A cross sectional study conducted in the Department of Pediatrics at Pakistan Institute of Medical Sciences, Islamabad Pakistan from May-October 2021. A sample of 320 was calculated using convenient sampling. Total of 80 women currently breastfeeding were enrolled in each of the four modes of childbirth (spontaneous vaginal delivery, induced vaginal delivery, elective caesarean section and emergency caesarean section). A self-administered questionnaire was used to assess participants breastfeeding knowledge and practices. Results: Regarding breastfeeding, 56.6% had insufficient knowledge, 28.4% had average and 15% were well-informed. In terms of breastfeeding practices, 54.1% performed poorly, while only 9.7% performed well. Ordinal logistic regression indicated that factors like age, mode of delivery, and knowledge significantly influenced breastfeeding practices. Each one-year increase in age raised the likelihood of well-executed practices by 1.2 times (p=0.02). Women with emergency caesarean sections were less likely to have good practices (OR=0.04, p=0.01). Moreover, those with average breastfeeding knowledge had an 87-fold greater chance of satisfactory practices compared to well-executed ones (p=0.001). Conclusion: A concerning gap was found in breastfeeding knowledge and practices among majority of the women enrolled in this study.

Educational booklet on breastfeeding for health professionals: creation and validation / Cartilha educativa sobre aleitamento materno para profissionais da saúde: criação e validação

2025-06-16
Rielle Herrera Brandli , Michael Vieira do Amarante , Lisie Alende Prates | Revista de Pesquisa Cuidado é Fundamental Online
Objetivo: criar e validar uma cartilha educativa sobre aleitamento materno voltada para profissionais de saúde. Método: estudo metodológico realizado entre março e novembro de 2024, a partir de três fases: … Objetivo: criar e validar uma cartilha educativa sobre aleitamento materno voltada para profissionais de saúde. Método: estudo metodológico realizado entre março e novembro de 2024, a partir de três fases: revisão da literatura, elaboração do material e validação por especialistas. Resultados: a cartilha, com 30 páginas em formato A4, abordou temas essenciais sobre aleitamento materno com linguagem científica acessível. Foi avaliada por 10 especialistas, alcançando um Índice de Validação de Conteúdo de 0,85, com sugestões de ajustes em estrutura, conteúdo e ortografia. Após revisões, a cartilha foi disponibilizada para profissionais de um hospital no norte do Rio Grande do Sul. Conclusão: a validação do conteúdo e da aparência da tecnologia demonstra a possibilidade de utilização desta ferramenta no apoio à prática do aleitamento materno, contribuindo para a formação contínua dos profissionais de saúde.

Initiation of breastfeeding among mothers attending a regional referral hospital in central uganda: a cross-sectional study

2025-06-16
Vivianne Nakayiza , Jonathan Izudi , Esther Nasuuna +1 more | Archives of Public Health
Breastfeeding initiation within the first hour of birth is beneficial in reducing the risk of maternal and neonatal mortality. However, a significant proportion of mothers delay initiating breastfeeding within an … Breastfeeding initiation within the first hour of birth is beneficial in reducing the risk of maternal and neonatal mortality. However, a significant proportion of mothers delay initiating breastfeeding within an hour of birth, but the association with age has not been rigorously studied. We examined the association between maternal age and delayed initiation of breastfeeding in a large urban referral hospital in central Uganda. This analytic cross-sectional study was conducted at the Entebbe Regional Referral Hospital in Central Uganda. Data were collected using a researcher-administered questionnaire between October 1, 2019, and December 20, 2019. Delayed initiation of breastfeeding was the primary outcome, defined as putting the newborn to the breast after one hour of birth. The primary exposure was maternal age categorized as 15-24, 25-34, and 35-45 years. We performed a modified Poisson regression analysis to determine the independent association between maternal age and delayed initiation of breastfeeding, adjusting for other confounders. We stated the findings as an adjusted prevalence ratio (aPR) and 95% confidence interval (CI). We studied 384 participants with a mean age of 27.5 ± 5.5 years. Of the 384 participants studied, 275 (71.6%) had delayed initiating breastfeeding, with the majority aged 15-24 years. In a multivariable analysis, delayed initiation of breastfeeding was significantly associated with maternal age groups of 15-24 years (aPR 1.28, 95% CI 1.01,1.63) and 25-34 years (aPR 1.28, 95% CI 1.01-1.60) compared to the reference group of 35-45 years. Additionally, delivery through cesarean section compared to spontaneous vaginal delivery was associated with delayed initiation of breastfeeding (aPR 1.93, 95% CI 1.49-2.49). Delayed initiation of breastfeeding is common and is associated with maternal age (15-24 and 25-34 years) as well as delivery through cesarean section. Routine health education and staff mentoring are needed to enhance early initiation of breastfeeding to prevent maternal and neonatal morbidity and mortality.

Rol del profesional de enfermería en el fortalecimiento del vínculo madre-hijo en mujeres con depresión posparto y su relación con la lactancia materna efectiva

2025-06-16
María Fernanda Maroto-Vega | Revista Hispanoamericana de Ciencias de la Salud
Objetivo: Analizar el rol del profesional de enfermería en la promoción del vínculo madre-hijo en mujeres con depresión posparto y su impacto en una lactancia materna efectiva. Metodología: Se realizó … Objetivo: Analizar el rol del profesional de enfermería en la promoción del vínculo madre-hijo en mujeres con depresión posparto y su impacto en una lactancia materna efectiva. Metodología: Se realizó una revisión sistemática con enfoque cualitativo, de tipo descriptivo-correlacional y diseño no experimental de corte transversal. La búsqueda se llevó a cabo en las bases de datos PubMed, SciELO y BVS, considerando estudios publicados entre 2014 y 2024. La muestra final incluyó cuatro investigaciones realizadas en Brasil y Corea del Sur, cuyos sujetos de estudio fueron mujeres con diagnóstico de depresión posparto y sus hijos. Resultados: Los hallazgos evidencian que el acompañamiento emocional y práctico del personal de enfermería es determinante para favorecer la lactancia materna y fortalecer el vínculo afectivo madre-hijo. La intervención temprana contribuye a superar barreras emocionales como la ansiedad y la baja autoeficacia materna. Asimismo, se destaca el impacto positivo del contacto piel con piel en el éxito de la lactancia materna exclusiva. Conclusiones: El profesional de enfermería cumple un rol esencial en la mejora del bienestar emocional de las madres con depresión posparto, promoviendo una lactancia materna efectiva y un vínculo afectivo saludable. Las intervenciones oportunas, individualizadas y empáticas son clave para superar las dificultades asociadas a esta condición.

History of breastfeeding in relation to circulating inflammatory and metabolic biomarkers

2025-06-16
Lin Nan , Allison F. Vitonis , Jennifer M. Mongiovi +7 more | Cancer Epidemiology Biomarkers & Prevention
Abstract Background: Breastfeeding history has been associated with reduced risk of chronic diseases, although the underlying biological link is unclear. Methods: The study included 16,165 parous women in the Nurses’ … Abstract Background: Breastfeeding history has been associated with reduced risk of chronic diseases, although the underlying biological link is unclear. Methods: The study included 16,165 parous women in the Nurses’ Health Studies who reported lactation history and biomarkers measured using plasma samples collected at mid-life. We calculated multivariable-adjusted geometric means of ten inflammatory biomarkers [high sensitivity C-reactive protein(hsCRP), interleukin-6 (IL6), IL8, IL10, insulin-like growth factor-1 (IGF1), soluble tumor necrosis factor α receptor 2 (sTNFR2), B-cell activating factor, C-X-C motif chemokine ligand 13 (CXCL13), sIL2-receptor-α (Rα), sIL6Rα] and eight metabolic biomarkers[triglyceride, total cholesterol, high- and low-density lipoprotein (HDL and LDL), leptin, soluble leptin receptor, adiponectin, retinol-binding protein 4] by self-reported history of breastfeeding prior to blood collection. False discovery rate (FDR) was used for multiple testing corrections. Results: Average age at blood collection was 52.6 years. Ever breastfeeding was associated with higher IGF1 (149.22 vs. 143.76 ng/mL, p-value=0.0002/FDR=0.004) compared with never breastfeeding. Longer breastfeeding duration was associated with lower IL10 (p-trend=0.001/FDR=0.01) and higher IGF1 (p-trend=0.0005/FDR=0.01). No significant associations were observed for other biomarkers. Longer breastfeeding duration was associated with higher IGF1 among premenopausal women but not among postmenopausal women (p-interaction=0.02). Longer breastfeeding duration was associated with lower soluble leptin receptor levels among those with BMI≥25kg/m2 (p-trend=0.01/FDR=0.09) but not among those with BMI&amp;lt;25 kg/m2 (p-interaction=0.0002). Conclusion: Ever breastfeeding and longer breastfeeding duration was associated with higher IGF1 levels measured in mid-life. Impact: Our results support the potential long-term systemic impact of breastfeeding on circulating IGF1 levels, which may influence future chronic disease risk.

Práctica de la lactancia materna en el puerperio inmediato en un hospital de Norte de Santander (Colombia)

2025-06-16
J. Duran , Lina Maria Guio Matheus , A. Antolínez +2 more | Salud Uninorte
Objetivo: Describir la práctica de la lactancia materna en el binomio madre-hijo en el puerperio inmediato en un hospital de Norte de Santander (Colombia). Materiales y métodos: Estudio cuantitativo, descriptivo … Objetivo: Describir la práctica de la lactancia materna en el binomio madre-hijo en el puerperio inmediato en un hospital de Norte de Santander (Colombia). Materiales y métodos: Estudio cuantitativo, descriptivo de corte transversal; se evaluó las prácticas de lactancia materna en los binomios madre-hijo en el periodo de puerperio inmediato, primeras 24 horas posterior al parto. Participaron en el estudio puérperas que se encontraban hospitalizadas en el servicio de ginecopediatría de un hospital en el municipio de Pamplona, Norte de Santander (Colombia). Resultados: Respecto a la práctica de lactancia materna, el 77 % de las madres lactantes adopta prácticas adecuadas y 23 % prácticas consideradas inadecuadas. Conclusiones: Las madres lactantes de menor edad, las madres primerizas, aquellas con menos de 37 semanas de gestación y las que tuvieron parto por cesárea son quienes presentan con mayor frecuencia prácticas inadecuadas de lactancia materna.

Exclusive breastfeeding modifies the association between maternal education and child development

2025-06-01
Cecília Tomori | PubMed