Journal of Human Lactation最新文献

Background: Media and advertising significantly shape mothers' infant feeding decisions, influencing whether to breastfeed or formula feed. Understanding these influences is crucial for promoting informed feeding practices.

Research aim: This study explored how media and advertisements influence Turkish mothers' decisions regarding breastfeeding or formula feeding.

Methods: This qualitative study, in which a phenomenological design was used, was conducted with 20 mothers of 0-12-month-old infants who were followed up in the healthy child clinic of a public hospital in the Bursa province located in the South Marmara region of Turkey. Descriptive characteristics were collected and semi-structured interviews were carried out and analyzed thematically.

Results: We identified four main themes: mothers' use of media apps, factors influencing breastfeeding, the influence of media and advertising on feeding choices, and mothers' expectations of media and health professionals. Mothers reported using the media to share their experiences of infant development and breastfeeding. They reported that the media often showed celebrities promoting infant formula, and this, combined with advice from health professionals and family members, strongly influenced their feeding decisions. Mothers emphasized the need for the media to take a more positive approach to promoting breastfeeding.

Conclusion: Reducing the impact of formula advertisements and offering accurate breastfeeding information through social media could better support mothers' feeding decisions. Health information would be clearer if policymakers and healthcare professionals prioritized regulating infant formula advertising and promoting breastfeeding on social platforms. Family health center professionals play a crucial role in comprehensive breastfeeding counseling.

Background: Antimicrobial resistance is a global concern. It is particularly impactful during breastfeeding infections when identifying risk factors and protective mechanisms is crucial.

Research aim: This study aimed to assess the prevalence of antibiotic resistance among breastfeeding women diagnosed with mastitis and breast abscesses.

Methods: A cross-sectional analysis of longitudinal data was conducted at a Level III medical center in Italy from January 2016 to December 2020. A total of 203 women were enrolled following diagnoses of mastitis or breast abscesses.

Results: Among the 156 women who tested positive for Staphylococcus aureus infection, culture antibiograms identified 29.6% as methicillin-resistant Staphylococcus aureus (MRSA). Additionally, six women exhibited clindamycin-resistant S. aureus. Exclusive breastfeeding at discharge (OR = 0.40, 95% CI [0.26, 0.84], p = 0.01) and rooming-in (OR = 0.34, 95% CI [0.15, 0.79], p = 0.01) were significantly associated with reduced odds of methicillin-resistant infections; although these findings are based on unadjusted odds ratios. Conversely, the use of breastfeeding aids in-hospital was not significantly associated with odds of resistant bacterial infections (OR 2.02, 95% CI [0.97, 4.18], p = 0.06).

Conclusion: This study underscores the antibiotic resistance scenario of microorganisms causing mastitis and abscesses in our setting. Implementing microbiological surveillance in mother-child settings could aid in identifying local resistance patterns.

Background: Human milk protects very preterm infants from many complications. While quality indicators are crucial for evaluating and improving breastfeeding practices, those specifically tailored for very preterm infants are lacking.

Research aim: To develop a set of practical and reliable indicators for evaluating and improving the quality of breastfeeding for very preterm infants.

Methods: This study employed a longitudinal, prospective survey design utilizing a two-round Delphi method employing the RAND Corporation/University of California Los Angeles Appropriateness Method. A systematic search of the literature was performed across multiple databases, including PubMed, Cochrane, Embase, and Wanfang, to identify potential quality indicators for breastfeeding in very preterm infants. A multidisciplinary expert panel then evaluated these through two Delphi rounds to establish relevance and feasibility.

Results: Twenty-two candidate quality indicators of breastfeeding were extracted for the Delphi process. The experts' authority coefficients for the two rounds were 0.84 and 0.83, respectively. Eleven indicators, encompassing breastfeeding outcome indicators (n = 1), mother's lactation status indicators (n = 3), the breastfeeding process indicators (n = 3), and balancing indicators (n = 4), were considered relevant and feasible and were incorporated into the set of quality indicators for breastfeeding.

Conclusions: This study developed a set of practical and reliable indicators for evaluating and improving the quality of breastfeeding for very preterm infants, based on the collective opinion of content experts. These quality indicators may facilitate an objective and quantitative assessment of breastfeeding quality for this vulnerable population.

Background: Adolescent mothers face unique psychosocial and breastfeeding challenges, and their problem-solving strategies, especially in Thailand, remain poorly understood.

Research aims: To explore Thai adolescent mothers' barriers to breastfeeding and their problem-solving processes in overcoming breastfeeding issues during the first 6 months postpartum.

Methods: A descriptive qualitative approach using purposive sampling was utilized. Thai mothers aged 15-19 years (N = 48) with babies under 6 months, living with their child, and without a history of mental illness were recruited for six focus group discussions. Thematic analysis was applied to analyze and interpret the qualitative data patterns.

Results: The barriers to achieving breastfeeding success varied at each month postpartum for the study participants. These barriers were divided into three phases: initial adaptation and difficulties (first month), adapting with concerns about milk supply (2-3 months), and balancing maternal and infant needs (4-6 months). Their problem-solving processes for breastfeeding challenges involved seeking online solutions, following advice from surrounding adults, and resolving breastfeeding issues independently from consultations with healthcare providers.

Conclusions: Thai adolescent mothers rely on independent decision-making over healthcare consultation to manage breastfeeding difficulties. Providing reliable and accessible support tailored to their needs is crucial for promoting successful breastfeeding in this vulnerable population.

Background: Human milk contains a diverse community of microbes. The composition of this microbiota varies across different regions, and there is ongoing debate regarding its determinants.

Research aim: To profile the bacterial composition of donor human milk samples from Shanghai, China, and to explore the factors influencing its composition.

Methods: A cross-sectional study was conducted from February 2018 to July 2022, involving 252 participants from the Shanghai Donor Human Milk Bank, Shanghai Children's Hospital. 16S rRNA sequencing was performed, and the microbiota composition was analyzed using K-means clustering, multiple linear regression, and sparse estimation of correlations among microbiomes.

Results: The majority of detected taxa belonged to the phyla Firmicutes, Proteobacteria, Bacteroidota, and Actinobacteriota. Four clusters enriched with Staphylococcus, Staphylococcus and Achromobacter, Achromobacter, Streptococcus, Streptococcus, and Acinetobacter were identified. Multivariable linear regression showed that at least some indirect breastfeeding was independently associated with lower bacterial diversity. Also, at least some indirect breastfeeding, preterm birth, and Cesarean section were associated with a higher relative abundance of Staphylococcus. Higher milk protein content was linked to increased levels of Lactobacillus and Enterococcus, while lactation stage at sample collection inversely related to these genera. More linear and nonlinear relationships among the predominant genera of the direct breastfeeding group were found compared to the indirect breastfeeding group.

Conclusion: Breastfeeding mode was identified as a pivotal determinant of human milk microbial composition. Investigation of the milk microbiota composition may provide clues for optimizing donor human milk collection, processing, and utilization practices.

Background: Exclusive breastfeeding for 6 months is recommended, but breastfeeding safety data is insufficient for several medications.

Aim: To determine if mothers treated with chronic medications are less likely to breastfeed.

Methods: For this secondary analysis, 6383 pregnant women in the MotherToBaby cohort recruited from the United States and Canada between 2010 and 2022 were included. Participants treated with antirheumatic medications (ARM), selective serotonin reuptake inhibitors (SSRIs), and asthma medications during pregnancy were divided into two groups based on their medication use: continuers and discontinuers. Breastfeeding initiation, supplementation with commercial milk formula, and discontinuation of breastfeeding before 6 months were compared between those exposed and unexposed to medication use. Adjusted risk and hazard ratios (aRR, aHR) and 95% Confidence Intervals (CI) were calculated with modified Poisson and Cox regressions adjusted for year, parity, socioeconomic status, body mass index, smoking, illicit drug use, race and ethnicity.

Results: The sample included 799 (12.5%) continuers and 475 (7.4%) discontinuers of ARM, 293 continuers (4.6%) and 63 (1.0%) discontinuers of SSRIs, and 217 (3.4%) continuers and 97 (1.5%) discontinuers of asthma medications. There were 4,439 (69.6%) participants who were unexposed to the study medications. Both ARM continuers and discontinuers were more likely to not breastfeed (aRRs 95% CI: 3.92 [3.03, 5.07] and 3.08 [2.19, 4.33]), to supplement (aRRs 95% CI: 1.12 [1.01, 1.26] and 1.25 [1.10, 1.43]) and stop breastfeeding before 6 months (aHRs 95% CI: 1.72 [1.29, 2.31] and 1.41 [0.92, 2.15]). SSRI continuers were more likely to supplement (aRR 95% CI: 1.26 [1.08, 1.47]).

Conclusion: Participants treated with chronic medications, primarily ARMs, were less likely to breastfeed. Targeted lactation support for mothers with chronic illnesses is recommended along with development of breastfeeding safety data for these medications.

Background: Limited research exists on breastfeeding among women with systemic lupus erythematosus, despite known benefits of human milk.

Research aim: To investigate reasons for breastfeeding avoidance among postpartum women with systemic lupus erythematosus.

Methods: This is a descriptive study, conducted in January 2023, combining retrospective pregnancy outcome data collection with a structured telephone questionnaire.

Results: Almost half of respondents (n = 22; 54.5%) experienced a disease flare within 24 months post-delivery. Reasons given by participants for breastfeeding avoidance included healthcare professional advice (n = 8; 36.4%), fear of medication harm (n = 5; 22.7%), and maternal/neonatal complications (n = 10; 45%). Most participants (n = 21; 95.5%) expressed a willingness to breastfeed if possible.

Conclusion: Breastfeeding rates and breastfeeding specific care could be enhanced for patients with systemic lupus erythematosus through patient networks and appropriate practitioner education.

Background: Nurses' breastfeeding knowledge plays a significant role in promoting breastfeeding. Assessing nursing students' breastfeeding knowledge is crucial to devise effective educational strategies.

Research aims: To assess breastfeeding knowledge among nursing students in mainland China and identify the factors associated with it.

Methods: A cross-sectional study was conducted to investigate the status of breastfeeding knowledge and its associated factors among Chinese nursing students (N = 1606). Data were collected through a network survey platform (WJX), utilizing a researcher-designed questionnaire and the Nursing Student's Knowledge about Breastfeeding Questionnaire. The associated factors were analyzed using independent sample t tests, one-way ANOVA, Pearson correlations, and multiple linear regression analyses.

Results: The mean score for breastfeeding knowledge was 52.37 (SD = 27.39) out of 100. Passing is considered > 60. The breastfeeding knowledge score was higher in participants in their 3rd (β = 0.11, p < 0.001) and 4th year of study (β = 0.08, p = 0.006), and when participants reported deep breastfeeding-related learning (β = 0.21, p < 0.001). Lower knowledge levels were associated with incomplete breastfeeding related courses (β = -0.11, p < 0.001), no reported exposure to seeing breastfeeding (β = -0.08, p = 0.001), low confidence in effectively supporting breastfeeding (β = -0.11, p < 0.001), and a lack of enthusiasm for the profession of nursing (β = -0.06, p = 0.018).

Conclusion: This study suggests there is a need to adopt a more comprehensive approach to breastfeeding education in order to enhance nursing students' breastfeeding knowledge. This could improve what they can offer in practical experience towards supporting breastfeeding.