Breastfeeding Medicine最新文献

Background: The premature infant oral motor intervention (PIOMI) has demonstrated benefits in improving oral feeding abilities and reducing hospitalization duration in preterm neonates. However, evidence from rural health care settings, particularly in India, remains sparse. Objective: This study aimed to evaluate the effect of PIOMI combined with routine neonatal care versus routine care alone on the transition time from gavage feeding initiation to full breastfeeding in preterm neonates. Methods: A randomized controlled trial was conducted with 202 hemodynamically stable preterm neonates of 28-32 weeks' gestation admitted to the NICU and SNCU of a rural tertiary care center in India. Participants were randomized into an intervention group receiving PIOMI plus routine care-which included Kangaroo Mother Care and non-nutritive sucking-and a control group receiving routine care alone. Neonates were stratified by gestational age into four categories: 28-29, 29-30, 30-31, and 31-32 weeks. The primary outcomes were times to achieve full katori spoon feeding and full breastfeeding. Secondary outcomes included weight gain from day 14 to day 20 of life. Results: The intervention group achieved initial katori spoon feeding earlier by 0.71 days (95% CI: -1.30 to -0.12; p = 0.017), full katori spoon feeding 6.89 days sooner (95% CI: -8.13 to -5.65; p < 0.001), and full breastfeeding 5.71 days earlier (95% CI: -7.02 to -4.40; p < 0.001) than the control group. Average weight gain between days 14 and 20 was modestly lower in the intervention group by 5.36 g/day (95% CI: -6.48 to -4.25; p < 0.001). Conclusions: PIOMI significantly shortened the transition from gavage to full breastfeeding in preterm neonates in a rural Indian setting, although with a slight reduction in weight gain during the latter hospital stay period.

Background: Feeding difficulties in premature infants often delay the transition to breastfeeding, prolong hospitalization, and impact oral motor development. While non-nutritive finger feeding (NNFF) has been studied in maternal care, limited evidence exists on paternal involvement. This randomized controlled trial examined the effect of father-administered NNFF on breastfeeding transition, sucking success, and hospitalization outcomes in premature infants. Methods: This single-blind, parallel-group randomized controlled trial was conducted in a Level III NICU in eastern Turkey. Sixty-seven premature infants born at 29-32 weeks of gestation and their fathers were randomized into intervention (n = 34) and control (n = 33) groups. Fathers in the intervention group performed standardized NNFF for 5 minutes, three times daily over 7 consecutive days. The control group received routine care without NNFF. Primary outcome was time to first successful breastfeeding. Secondary outcomes included sucking success (LATCH scores) and hospitalization duration. Statistical analyses included t-tests, Mann-Whitney U tests, repeated measures ANOVA, and logistic regression. Results: The intervention group achieved earlier breastfeeding initiation (9.65 ± 5.78 versus 13.88 ± 6.27 days, p = 0.005), faster breastfeeding acceptance (8.94 ± 5.59 versus 12.61 ± 5.74 days, p = 0.010), and shorter hospitalization (11.79 ± 7.19 versus 15.85 ± 6.76 days, p = 0.021). Logistic regression confirmed the predictive value of NNFF on breastfeeding initiation, hospital stay, and LATCH scores. Conclusion: Father-led NNFF is a safe, feasible intervention that accelerates breastfeeding transition, improves early sucking success, and reduces hospitalization in premature infants.

Background: Studies have identified the link between hypertension (HTN) during pregnancy and breastfeeding, but the role of prepregnancy HTN and breastfeeding practices remains unexplored. This study aims to investigate the association between prepregnancy HTN and breastfeeding duration. Methods: We used data from the Pregnancy Risk Assessment Monitoring System, 2016-2022 (n  = 127,510). The outcome of interest was breastfeeding for at least 3 months. The main independent variable was prepregnancy HTN. Multivariable logistic regression was used to examine the independent association between prepregnancy HTN and breastfeeding for at least 3 months. Cox proportional hazards models were used to determine whether the hazards of breastfeeding cessation before 3 months differed by prepregnancy HTN. Results: Overall, 71.5% (n  = 71,211) of women breastfed for at least 3 months, and 3.3% (n  = 4,543) had prepregnancy HTN. The proportion of breastfeeding for at least 3 months was significantly lower in women with prepregnancy HTN compared with those without prepregnancy HTN (66.1% versus 71.6% p < 0.001). In the multivariable logistic regression model, the odds of breastfeeding for at least 3 months were significantly lower among women with prepregnancy HTN compared with those without prepregnancy HTN (adjusted odds ratio, 0.86; 95% confidence interval [CI], 0.78-0.95; p = 0.003). The adjusted hazard ratio (aHR) for breastfeeding cessation before 3 months among women with prepregnancy HTN was significantly higher compared with those without prepregnancy HTN (aHR, 1.25; 95% CI: 1.16-1.35; p < 0.001). Conclusion: In addition to preventing other adverse pregnancy outcomes, identifying and treating women with prepregnancy HTN during the preconception care encounter may improve breastfeeding outcomes.

Background: Mothers in the early postpartum period may be negatively affected from the properties of light stimuli in the environment. Aim: The aim of the study is to determine the effect of reduced (medium warm white) light color temperature after cesarean section on the tranquility, breastfeeding motivation, and psychological well-being of postpartum mothers. Methods: This study was conducted as randomized-controlled experimental research with 80 mothers in their postpartum period between 07.05.2025 and 03.07.2025. The data were collected using a Personal Information Form, the Tranquility Scale (TS), the Psychological Well-being Scale (PWBS), and the Primipara Breastfeeding Motivation Scale. The mothers in the intervention group were exposed to dimmed room light between the first 12 and 24 hours of the postpartum period. Results: When the intervention and control groups were compared, a significant difference was found between the posttest TS and PWBS mean scores in the intervention group (p < 0.05). The difference between the posttest mean scores of the mothers in the intervention and control groups on the value ascribed to breastfeeding, expectation of success, self-effectiveness, and perceived midwife support subscales of the PBMS was found to be significant (p < 0.05). Conclusion: A positive effect of reduced light color temperature after cesarean section on the tranquility, breastfeeding motivation, and psychological well-being of postpartum mothers was found.

Background: Early and regular pump use is increasingly observed in clinical practice. The prevalence, motives, and clinical impact of these practices remain poorly understood. We aim to characterize pump use initiation, intensity, motivations, and challenges following U.S. term deliveries. Methods: This cross-sectional study used online survey data from U.S. individuals who delivered a term infant within the previous 13 months and ever provided pumped breast milk to their infant. Descriptive analyses characterize participant demographics, pump use initiation, intensity, motivations, and challenges. Chi-square tests compare key experiences between individuals who pumped above versus below the sample's median pumping sessions per day. Results: We included 877 individuals from 49 states with median maternal and infant ages of 30 years and 6 months, respectively. Most participants (73%) were providing pumped milk to their infant currently. Pumping was most often initiated on day-of-delivery (38%); 67% initiated pumping by day 3 postpartum. Most participants (72%) had a pumping schedule; a median of four daily pumping sessions was reported. Breastfeeding challenges that motivated pumping included issues with supply (51%), engorgement (38%), and latch (26%). Participants also experienced oversupply (25%) and mastitis (15%). Stress/fatigue (40%) was a top pumping-related challenge. Those who pumped ≥4 times daily felt significantly more upset about discarding breast milk compared with those who pumped <4 times daily (22% vs.15%, p = 0.03). Conclusions: Among our participants with term infants, shifts toward early (day-of-delivery) and regular (routine or scheduled) postpartum pumping practices were observed. Examination of how early and/or regular pumping influences breastfeeding outcomes and maternal well-being following term deliveries is needed.

Background: This study aims to compare the macronutrient content of mature breast milk expressed by three different methods: hand expression, manual pump, and electric pump. Methods: This experimental study includes 31 mothers of term infants who met the inclusion criteria. Milk samples were collected on three different days using each expression method, following randomization and standardized procedures. All samples were frozen and later analyzed using the Miris® Human Milk Analyzer (HMATM) to determine fat, protein, carbohydrate, and energy values. Statistical analysis was conducted using R software (version 4.4.1). Results: The mean age of the mothers was 23 ± 4 years, and 35.5% were middle school graduates. The average energy content was 74.5, 72.3, and 71.7 kcal/100 mL for hand, electric pump, and manual pump expression, respectively. Lactose levels were 7.2, 7.1, and 7.2 g/100 mL; fat content was 4.3, 4.0, and 3.9 g/100 mL; and true protein was 1.2 g/100 mL across all methods. There were no statistically significant differences in any of the measured macronutrients among the three expression methods (p > 0.05). Conclusions: This study found no significant differences in the energy, lactose, fat, or true protein content of breast milk expressed by hand, manual pump, or electric pump. This finding indicates that, regardless of mothers' economic status or access to equipment, any method of milk expression can be effectively used to provide breast milk, provided that the technique is applied correctly.

Background: Diaper dermatitis (DD) is a common inflammatory skin condition in infants, typically managed with supportive care and anti-inflammatory treatments. This study aimed to evaluate the efficacy of topical breast milk combined with zinc oxide versus zinc oxide alone in treating DD in infants. Methods: A randomized clinical trial was conducted at Bahrami Children's Hospital from 2022 to 2023. Forty-two infants with clinically diagnosed DD were randomly assigned to two groups: the control group received 25% zinc oxide ointment, while the case group received 25% zinc oxide combined with topical breast milk. Both treatments were applied for 7 consecutive days. The severity of DD was assessed daily using the Buckley Diaper Dermatitis Severity Scale, and lesion improvement was documented. Results: The mean age of the infants was 2.93 ± 7.41 months, and 52.4% were male. No significant differences were observed between the two groups in baseline characteristics. Complete and partial recovery rates in the case group were 61.9% and 38.1%, respectively, compared to 66.6% and 19.1% in the control group. Notably, no non-responders were found in the case group, while 14.3% in the control group showed no response to treatment. The case group experienced faster lesion resolution (2.52 ± 0.67 days vs. 3.28 ± 1.14 days, p = 0.012). Conclusion: Topical breast milk combined with zinc oxide may reduce recovery time in treating diaper dermatitis. This approach is safe, cost-effective, and accessible. Larger randomized trials are needed to confirm these results and establish standardized treatment protocols.

Objective: In this study, it was aimed to investigate the effects of listening to music, including nature sounds, on mothers' breastfeeding self-efficacy in the postpartum period and on their exclusive breastfeeding behaviors before discharge. Method: This quasi-experimental study with a control group was conducted between April 2024 and October 2024. The mothers in the music group (n = 55) listened to 30 minutes of instrumental music, including nature sounds, at 6 and 12 hours postpartum in addition to the standard breastfeeding counseling, while the mothers in the control group (n = 64) received only standard breastfeeding counseling. Measurements were made using the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). The exclusive breastfeeding rate was determined according to the World Health Organization criteria. Differences between groups were analyzed using the chi-square and independent samples t tests. Results: The mean score obtained from the BSES-SF by the participants in the music group before discharge was significantly higher (63.65 ± 4.91) than that obtained by the participants in the control group (56.07 ± 7.08) (p = 0.017; Cohen's d = 1.23). The exclusive breastfeeding rate was significantly higher in the music group (65.5%) than it was in the control group (26.6%) (p < 0.001). Conclusion: Music therapy, including nature sounds, increased mothers' breastfeeding self-efficacy levels and exclusive breastfeeding rates. Integration of music-based interventions into postpartum care is recommended since it is a clinically applicable, low-cost, and non-invasive support method.