Breastfeeding Medicine最新文献

Background: Early identification of breastfeeding difficulties is crucial for targeted interventions. However, the comparative effectiveness of these assessment tools remains unclear. Objective: To compare the predictive validity of the LATCH and Bristol Breastfeeding Assessment Tool (BBAT) scores measured at 24 hours and day 7 postpartum for exclusive breastfeeding at 42 days and to evaluate their combined predictive performance. Methods: This prospective cohort study included 157 mother-infant dyads (September 2024-March 2025) at a university hospital in Turkey. LATCH and BBAT scores were assessed at 24 hours and on day 7 postpartum. The primary outcome was exclusive breastfeeding at 42 days. Receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off values and predictive performance. Results: The rate of exclusive breastfeeding (EBF) was 83.4% (n = 132) in the first 24 hours and 68.8% (n = 108) on day 42 of life. The LATCH score in the first week showed the highest specificity for predicting EBF on day 42. (cut-off value ≥10: area under the curve [AUC] 0.671 (95% CI: 0.582-0.760; p < 0.001), sensitivity 55.6%, specificity 72.3%, false positive rate 27.7%). A multiple ROC analysis was conducted to determine which of the four scores was better at predicting EBF on the 42nd day. The cutoff values were 8 for the first-week Bristol score alone, 10 for the first-week LATCH score, 5 for the first 24-hour Bristol score, and 7 for the first 24-hour LATCH score. Conclusions: Combined early assessment using LATCH and BBAT scores provides a superior prediction of EBF at 42 days compared with single indicators. The implementation of systematic screening using these tools may facilitate targeted lactation support for at-risk dyads.

Background: Low-Intensity Focused Ultrasound (LIFU) may enhance tissue recovery and support breastfeeding post-aspiration. Methods: A total of 60 patients were randomly assigned to either a control group or a treatment group. Fifty-six participants completed the study, with two dropouts per group. The control group received ultrasound-guided aspiration and antibiotics for 3 days, while the treatment group additionally received LIFU therapy. Recovery of tissue structure at the abscess site was assessed. The primary outcome was the recovery time of breast tissue via ultrasound imaging. Secondary outcomes included pain scores, time for disappearance of local induration and abscess cavity, breastfeeding self-efficacy scores, breastfeeding rates, and repeat aspiration rates. Findings: The treatment group exhibited a significantly shorter recovery time for breast tissue compared to the control group. Induration disappearance time was also reduced in the treatment group. Significant differences in pain scores were noted 1 week post-surgery. Breastfeeding self-efficacy scores improved significantly in the treatment group at 2 weeks and 2 months post-surgery. Higher breastfeeding maintenance rates and lower cessation rates were observed in the treatment group. Discussion: The use of LIFU therapy appears to enhance tissue repair and support breastfeeding post-aspiration, offering a promising treatment option for lactating women with breast abscesses. Conclusion: LIFU treatment effectively promotes tissue repair, reduces recovery time, and improves breastfeeding outcomes after breast abscess aspiration. The Clinical Trial registration number: ChiCTR2200060973 (registration date: June 14, 2022). Version Date: 22 May 2025.

Objectives: Mothers of preterm infants who experience mother-infant separation frequently face increased challenges with lactation. This study aims to analyze the critical window for coming to volume (CTV) and its associated risk factors in pump-dependent mothers and to investigate the predictive value of postpartum expressed milk volume for the feeding method at discharge in preterm infants. Study Design: A prospective observational study was conducted between July 2020 and February 2021. Lactation diaries kept by mothers of preterm infants admitted to a neonatal intensive care unit in Guangzhou, China, were collected during this period. Binary multivariable Logistic regression, time-series analysis, Spearman correlation analysis, and K-Prototype cluster analysis were employed to investigate the critical window for CTV and its risk factors. The area under the receiver operating characteristic curves were used to evaluate the ability of expressed milk volume during postpartum days 8-14 to predict the feeding method at discharge for preterm infants. Results: Data from 1,232 diary days completed by 88 mothers were analyzed. 51.14% of mothers of preterm infants failed to CTV. Unscheduled pumping, a lower average pumping frequency on postpartum day 1-7, a lower average expressed breast milk volume on postpartum day 1-7, and a small intra-session bilateral volume discrepancy were identified as independent risk factors for no-CTV. During postpartum days 3-7, both pumping frequency and milk volume increased progressively. The frequency and volume of pumping between postpartum days 3 and 7 positively correlated with the milk volume on postpartum day 14. Clustering analysis based on early postpartum pumping behaviors identified two groups: High-Frequency Timed Group (HFTG) and Low-Frequency Untimed Group. The HFTG exhibited higher pumping frequency and milk volume, indicating a greater likelihood of achieving CTV. The expressed breast milk volume on postpartum day 8 significantly predicted the feeding method at discharge (Area Under the ROC Curve [AUC] [95% confidence interval]: 0.831 [0.746-0.916]), with no statistically significant difference in predictive performance compared to volumes on days 9-14 (p > 0.05). Conclusion: Postpartum days 3-7 represent the critical window for CTV among mothers of preterm infants, during which pumping behavior directly influences CTV. Postpartum day 8, as the first day following the critical window, provides an early and effective prediction of feeding outcomes at discharge.

Background: Collodion baby syndrome (CBS) is a rare neonatal dermatological disorder characterized by a restrictive membrane covering the infant's skin, impairing thermoregulation, increasing infection risk, and causing significant pain. Early parent-infant bonding and breastfeeding are challenging due to the fragile skin barrier, with limited evidence on safe approaches to enable these critical interventions. This report explores the use of sterile polyethylene wrap to facilitate kangaroo care (KC) and breastfeeding in a neonate with CBS. Materials and Methods: A full-term female newborn diagnosed with CBS was admitted to the NICU in stable condition. Skin was encased by a shiny, tight membrane with mild ectropion. Initial management included humidified incubator care, fluid and electrolyte monitoring, and topical emollients. From day two, KC was initiated using sterile polyethylene wrap as a protective barrier to prevent skin trauma. Pain was assessed systematically using the EDIN and N-PASS scales at baseline, during, and after KC sessions. Results: Kangaroo care sessions under polyethylene wrap were safely conducted with continuous cardiorespiratory monitoring. Both pain scales demonstrated a significant reduction in pain scores during KC compared to baseline. The polyethylene wrap maintained thermal stability and skin integrity while allowing safe breastfeeding and enhancing parental bonding. No adverse events or infections occurred and the neonate was discharged with good clinical condition after progressive skin healing. Conclusion: Sterile polyethylene wrap is a feasible, safe, and effective method to enable early kangaroo care and breastfeeding in neonates with CBS, addressing the unique challenges of skin fragility and pain management. This approach supports optimal pain control, thermal stability, and parental bonding, bridging medical care with psychosocial needs. Further studies are warranted to establish standardized protocols for this vulnerable population.

Objectives: Breast milk is an ideal food for newborns born term and preterm. The short-term storage of human milk (HM) involves freezing at low temperatures; however, its effects on macronutrients remain unclear. The macronutrients in HM are generally thought to be unaffected by short-term freezing. This study aimed to analyze the impact of freezing HM from preterm infants at -20°C for 5 days on macronutrient content. Methods: HM samples were collected from 54 mothers of preterm infants. Each sample was divided into three aliquots and stored at -20°C for 1 and 5 days. After thawing and homogenization, energy and macronutrient contents were measured using a HM infrared spectroscopy analyzer. Results: We analyzed 162 samples (from 54 mothers of preterm infants). Mean baseline concentrations in fresh milk were protein 1.55 ± 0.61 g/100 mL, carbohydrates 6.87 ± 0.81 g/100 mL, fat 4.29 ± 2.16 g/100 mL, and energy 75.9 ± 27.3 kcal/100 mL. Freezing at -20°C reduced protein to 1.33 ± 0.35 g/100 mL after 24 hours and 1.21 ± 0.38 g/100 mL after 5 days (14.2% and 21.9% decrease, p < 0.001), fat to 3.23 ± 1.15 g/100 mL and 3.04 ± 1.40 g/100 mL (24.7% and 29.1% decrease, p < 0.001), and energy to 64.3 ± 12.8 kcal/100 mL and 61.7 ± 16.1 kcal/100 mL, respectively (p < 0.001); carbohydrate content remained unchanged (p = 0.41). Conclusions: Freezing HM at -20°C for 5 days can significantly reduce critical nutrients, including fat and protein, suggesting the need for individualized fortification strategies to ensure optimal growth in preterm infants.

Objective: In the present study, the effects of prayer frequency and knowledge of prayer on breastfeeding self-efficacy were examined for the first time while controlling for variables such as psychological resilience and method of delivery. Method: For this purpose, a sample of 232 women was analyzed by using multiple linear regression analysis. Results: The results indicate that regular prayer has a higher level of positive impact on breastfeeding self-efficacy, that it is a stronger predictor in comparison with psychological resilience, and that this effect is pronounced among Muslim mothers. Conclusion: These insights could inform interventions aimed at improving breastfeeding practices by incorporating spiritual dimensions alongside psychological support.

Introduction: Subjective social status (SSS), which describes one's perceived hierarchical rank, may provide a more accurate prediction of health than traditional socioeconomic measures. The specific relationship between SSS and breastfeeding outcomes is understudied. Our objectives were to: (1) investigate factors associated with SSS, (2) assess the relationship between prenatal SSS and any or exclusive breastfeeding at 3 and 6 months, and (3) evaluate the relationship between prenatal SSS and breastfeeding duration. Methods: Overall, 2,870 participants from the Canadian Healthy Infant Longitudinal Development birth cohort data were included. Prenatal SSS was self-ranked at 18 weeks' gestation using the MacArthur Scale and categorized as low (1-5), moderate (6-7), and high (8-10) SSS. Any and exclusive breastfeeding were categorized at 3 and 6 months postpartum, along with breastfeeding duration. Multivariable logistics and linear regression were conducted. Results: After adjusting for race, education, income, marital status, employment, and parity, the odds of exclusive breastfeeding at 3 months were 1.51 times higher [95% confidence interval (CI): 1.18, 1.94] in the high SSS group than in the low SSS group. The likelihood of any breastfeeding at 6 months was 1.45 times higher [95% CI: 1.10, 1.92] in the moderate SSS group than the low SSS group. Women with high SSS breastfed for approximately 42 days longer than women with low SSS. Conclusion: SSS was associated with exclusive breastfeeding at 3 months, any breastfeeding at 6 months, and breastfeeding duration. SSS may offer a more patient-centered indicator of health, informing targeted interventions for individuals at risk of suboptimal breastfeeding outcomes.

Objective: This study aimed to investigate the association between infant gender and both postpartum depression and breastfeeding duration at multiple time points during the postpartum period. Methods: A prospective longitudinal study was conducted between March and December 2022 in Turkey with a sample of 311 postpartum women. Data were collected using a sociodemographic questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), and the Breastfeeding Characteristics Form within the first 24 hours postpartum. The Breastfeeding Characteristics Form was readministered via telephone at 3 and 6 months postpartum. Results: Of the infants born, 50.5% (n = 157) were female and 49.5% (n = 154) were male. In the first 24 hours postpartum, 87.8% (n = 273) of mothers scored below 12 on the EPDS, while 12.2% (n = 38) scored 12 or above. Mothers who knew the infant's gender before birth had significantly lower EPDS scores than those who did not. Similarly, planned pregnancies and immediate postnatal contact with the infant were associated with significantly lower EPDS scores (p < 0.05). However, no statistically significant association was found between infant gender and either postpartum depression or breastfeeding duration at any time point. Conclusions: Infant gender was not found to have a significant association with postpartum depression or breastfeeding duration. These findings suggest that other maternal and perinatal factors may have a greater impact on postpartum mental health and breastfeeding outcomes. Implications and Contributions: This study examines the association of infant gender with postpartum depression and breastfeeding duration in women who give birth. In traditional societies, there has been a strong focus on determining the gender of the unborn baby due to pressures related to preserving inheritance, ensuring the continuation of the lineage, and similar factors. This study is important to highlight that infant gender does not show a significant association with maternal postpartum depression or breastfeeding, thereby emphasizing the need to focus on other maternal and perinatal factors that may play a more critical role in supporting mother-infant bonding and breastfeeding during the postpartum period.

Background: Breast pumps can support breastfeeding continuation in the United States, where federal law permits only 12 weeks of unpaid maternity leave. Despite widespread use, research on individuals' experiences with breast pumps is limited. Methods: An interdisciplinary research team developed a cross-sectional Qualtrics survey to explore the perspectives of breast pump users in the United States. Participants were recruited online over a 30-day period in 2021. Descriptive statistics summarized breast pump attributes valued by users, while open-ended responses were analyzed using content analysis. Results: A total of 641 participants completed 906 pump evaluations. Respondents were located across the United States, with the majority from the Midwest (42%) and South (29%). Most participants were non-Hispanic White (85%) and highly educated (60% held a master's or doctoral degree). Eight thematic categories with positive, negative, and neutral/mixed experiences emerged: flange fit (user cited need for better sizing guidance and access to multiple sizes), mobility (wearable pumps improved flexibility; electric pumps required accessories for hands-free use), cost and insurance (coverage often excluded replacement parts or alternate flanges), efficacy (some pumps emptied breasts efficiently, others lacked adjustable suction or cycle), longevity (durability was valued for frequent use), manufacturer support (experiences from helpful to inadequate information available to maximize pump efficacy and fit), noise (quiet pumps were preferred), and discomfort (proper fit reduced pain, though soreness and nipple trauma were reported). Conclusions: Centering users' experiences can inform improvements in pump design, insurance coverage, and professional support to reduce barriers to breast milk expression and promote breastfeeding success.