International Breastfeeding Journal最新文献

Background: Breastfeeding care and support from healthcare professionals are essential for breastfeeding success. To provide consistent, evidence-based care, healthcare professionals require comprehensive breastfeeding education. However, it is unclear as to how breastfeeding curricula integrate interprofessional education (IPE) across undergraduate health programmes. This scoping review examines and summarises interprofessional breastfeeding curricula designed for undergraduate or pre-registration health students.

Methods: The inclusion criteria for this review are: studies that report on undergraduate breastfeeding curricula that have an IPE component. Guided by the Joanna Briggs Institute scoping review framework, five databases (Medline (Ovid), CINAHL (EBSCO), ERIC (EBSCO), Social Sciences and Cochrane Databases of Systematic Reviews) and three grey literature sources (Google scholar, BASE and NICE website) were searched in September 2024, supplemented by grey literature searches and reference list screening.

Results: Of 1,263 identified articles, 927 underwent title and abstract screening, 46 full texts were assessed, and 14 met inclusion criteria. Data were extracted and presented using tables, figures, and narrative synthesis. Findings indicate that while breastfeeding education was delivered to multiple student groups, interprofessional engagement was limited, and IPE competencies were not consistently embedded. Learning was primarily uniprofessional, with students learning with, but not from and about each other. Assessment strategies were rarely reported, and while knowledge, confidence, and attitudes were measured, long-term behavioral change (e.g. improved breastfeeding rates over time) was not evaluated. Faculty and students acknowledged IPE's potential benefits, yet challenges such as logistical barriers and limited faculty training persisted.

Conclusions: Strengthening IPE integration, faculty development, and structured competency assessment could enhance interprofessional breastfeeding education. This is not only an educational reform but a strategic response to the public health barrier of inconsistent breastfeeding advice. Taking an interprofessional approach to breastfeeding education offers a progressive path to harmonize clinical messaging, improve continuity of care, and build trust between families and healthcare providers.

Background: There is a need to protect, support, and promote breastfeeding for the best interests of children's and mothers' rights. Our study aimed to analyze the Corporate Political Activity (CPA) of the three main Commercial Milk Formula (CMF) industries in Mexico during the COVID-19 pandemic, as such activity may have impacted policymaking to the detriment of breastfeeding. CPA practices may indirectly lead to the early introduction of CMF; these have been a barrier to optimal breastfeeding in Mexico.

Methods: A qualitative study was carried out using multiple data collection techniques, based on public data published between 2020 and 2022 from the three main CMF companies in the country, and semi-structured interviews (n = 11) with actors from government, academic, civil society organizations, and the press. A published conceptual framework was utilized, with data collection and analysis in three stages: (1) mapping of CMF industry actors, (2) identification of relevant information sources, and (3) qualitative and quantitative data analysis.

Results: We identified three main instrumental CPA strategies being used by the CMF industry in Mexico: coalition management, information management, and direct participation and influence in public policy. These companies secure a role in the political system, aiming to position themselves as saviors, while avoiding strict public regulation of their products and marketing. Additionally, three discursive strategies were used: promoting debate on issues related to a healthy diet in the pandemic context, arguing for self-regulation, and highlighting their importance in the economy.

Conclusions: The COVID-19 pandemic represented an opportunity for CMF companies to shape public policy and public discourse in Mexico. Our study highlights their aggressive CPA strategies, strengthened by emergencies, and the need to implement measures to protect breastfeeding, especially in Mexico and other countries that will likely experience other crises in the future. The CPA strategies of CMF industry violate the right to breastfeeding of mothers and children and the right to accurate nutrition information not influenced by commercial interests.

Background: The population of African migrant women in the United States (U.S.) is steadily increasing, yet limited research exists on their breastfeeding experiences, support systems, and sources of breastfeeding information. Migration often results in the loss of culturally embedded support networks that are vital to breastfeeding practices. Additionally, the information available in the U.S. may lack cultural sensitivity. The purpose of this study was to explore breastfeeding practices of African migrant women in the U.S and assess how information sources and support networks impact breastfeeding duration and exclusivity.

Methods: Thirty African migrant mothers from seven African countries, residing in thirteen U.S. states, participated in qualitative interviews between May and August 2024. Using an inductive coding approach, three authors analyzed the data, compared interpretations, and reached consensus to identify key themes.

Results: Fifty-seven (57%) of the mothers in this study breastfed exclusively for six months and 50% reported breastfeeding durations of 12 months or more. Longer breastfeeding duration and breastfeeding exclusivity among African migrant women are facilitated by cultural traditions, awareness of breastfeeding benefits, and the availability of supportive relationships and environments. However, participants also reported significant barriers, including limited practical support (such as help with childcare and household responsibilities), unfavorable return-to-work policies, long working hours, not knowing how to properly use breast pumps and difficulties navigating the healthcare system as impacting their breastfeeding practices. Mothers recommended the need to provide engaging education before and after childbirth, support for navigating resources, spouse involvement, emotional and practical assistance, and unique suggestions such as family visas to strengthen postpartum breastfeeding support.

Conclusions: Insights from this study will aid health professionals in providing culturally sensitive communications and targeted interventions to better support the breastfeeding goals of African migrant mothers in the U.S. Making healthcare supports and information available in an engaging, easy to digest format, so the information is easy to follow, remains an area for improving health communication with African Migrant women.

Background: Exclusive breastfeeding (EBF) for the first six months is a cornerstone of optimal infant nutrition and development. However, sustaining EBF beyond early infancy remains a major challenge globally, including in Iran. This study aimed to examine early feeding patterns, determinants of EBF, and associated growth outcomes among infants in northeastern Iran.

Methods: This population-based cross-sectional study analyzed data from 548,318 neonates registered in the National Electronic Health System between 2018 and 2024. EBF status was assessed at two time points: during the first week of life and at six months of age, based on caregiver-reported feeding practices recorded by health workers during routine health visits. Continuous exclusive breastfeeding since birth was defined according to WHO criteria as the infant receiving only breast milk-with no intake of formula, other types of milk, liquids, or solid foods-except for oral rehydration solutions, or drops and syrups containing vitamins, minerals, or medicines. Independent variables included maternal education, occupation, place of residence, mode of delivery, neonatal hospitalization, prematurity, and infant anthropometric indicators.

Results: This study included a total of 548,318 neonates over seven years. While EBF prevalence was 95.9% in the first week of life, it declined to 52.3% at six months. Rural residence, full-term birth, vaginal delivery, and maternal unemployment were positively associated with sustained EBF. Conversely, prematurity (OR 3.21; 95% CI 3.07,3.42), cesarean section (OR 2.26; 95% CI 2.21,2.33), urban residence (OR 1.83; 95% CI 1.63,2.13), history of neonatal hospitalization (OR 1.61; 95% CI 1.55,1.67), maternal employment (OR 1.52; 95% CI 1.46,1.59), and lower education (OR 1.25; 95% CI 1.23,1.31) significantly predicted non-EBF. Infants exclusively breastfed demonstrated better growth metrics up to six months, though differences narrowed by two years.

Conclusion: Despite high initiation rates, sustained EBF sharply declines by six months, particularly among urban, employed, less-educated, and immigrant mothers, as well as in cases of cesarean delivery or neonatal hospitalization. Tailored interventions including postpartum support, breastfeeding education, and workplace accommodations are critical to improve EBF continuation.

Clinical trial number: Not applicable.

Background: Globally, evidence shows that exclusive breastfeeding (EBF) for the first six months of an infant's life has health benefits for families, communities, and the nation. However, many employed women discontinue EBF before six months, while others succeed. This study aims to identify and explain the factors that enable EBF success among employed mothers in the formal sector.

Methods: The study employed a sequential explanatory mixed-methods design. Quantitative phase used questionnaires administered to collect EBF data from 224 mothers with children 6-18 months. EBF was measured as self-reported by a mother who EBF her current infant/child for six months. Data was analyzed to guide the case study, where key-informant interviews were used to collect data from 10 mothers. Both phases lasted from November 2021 to February 2022. Multivariable logistic regression analysis of quantitative data established associated factors with EBF. Qualitative data was coded, grouped, and categorized to generate themes explaining EBF success.

Results: The majority (76.3%) of mothers were ≥ 25 years. Their mean age was 27.3 ± 3.65 years. Most (66%) were married. 87.4% had 3 ≥ months of maternity leave. Overall EBF prevalence at six months was 31.7%. Significant factors were: Bachelor's degree (AOR = 3.04; 95% CI. 1.04, 8.86), Financial support (AOR = 6.62; 95% CI. 2.27, 19.31), domestic support (AOR = 5.23; 95% CI. 1.88, 14.52), psychological support (AOR = 5.45; 95% CI. 1.47, 20.20), and workmate support (AOR = 2.95; 95% CI. 1.54, 5.67). Prelacteal feeding (AOR = 0.16; 95% CI, 0.06, 0.45). More than four ANCs (AOR = 0.18: 95% CI. 0.04, 0.82). The qualitative phase generated five themes, these were: context, social support system, breastfeeding-friendly hospitals and workplace, and maternal EBF mindset. These themes fit theory-relevant concepts: social cognition and institutional factors, individual cognition, and EBF behavior. These concepts align with Social Cognitive theory.

Conclusion: A third of the mothers had EBF. Significant factors for EBF included, bachelor's degree, supportive environments at family, healthcare, and workplace, and a woman's mindset. This implies mothers, practitioners, managers, and policy-makers to optimize EBF rates among employed Ugandan working women, they need to integrate supportive environments at family, create breastfeeding-friendly environments, and empower women to a breastfeeding mindset.