Breastfeeding Medicine最新文献

Aim: This study aimed to compare the effectiveness of theorical education, standardized patients, and high-fidelity mannequins in improving nursing students' breastfeeding counseling skills. Design and Methods: A single-center randomized controlled trial was conducted in a nursing faculty in Türkiye with final-year students who had completed women's and child health courses. A total of 157 final-year nursing students participated. Students were randomly assigned to one of three groups: control group (theoretical education), standardized patient training, or high-fidelity mannequin-based simulation. Data were collected at three time points using four measurement tools. One-way ANOVA and post hoc tests were used for analysis. Results: Both simulation groups scored significantly higher than the control group in knowledge and preparedness (p < 0.001). The highest self-efficacy and counseling scores were observed in the high-fidelity simulation group. No significant difference was found between the two simulation groups (p > 0.05). Conclusions: Innovative, hands-on educational strategies can enhance clinical competence in breastfeeding counseling and contribute to improved postpartum maternal and infant care quality. [Figure: see text].

Background: International Board-Certified Lactation Consultants play a crucial role in protecting and promoting breastfeeding. Their specialized training and advanced practice skills enhance care quality and contribute to improved breastfeeding outcomes. However, evidence regarding their long-term impact on breastfeeding maintenance remains limited. Aim: This systematic review and meta-analysis aim to evaluate the effectiveness of lactation consultants' interventions on exclusive breastfeeding (EBF) at 6 months and to identify the most effective strategies in sustaining EBF through that period. Methods: A systematic review was conducted using electronic databases to identify studies published until March 2024. Eligible studies assessed prenatal, intranatal, and postnatal programs involving pregnant women intending to breastfeed or postpartum women in the lactation period. Findings: Nineteen studies involving 1,475 women were included. Interventions combining intranatal and postnatal support from lactation consultants showed a positive effect on EBF maintenance at 6 months (risk ratio [RR] for EBF vs. not EBF at 6 months = 2.04; 95% confidence interval [CI], 1.27-3.27). Individual face-to-face intranatal care had a positive effect (RR for EBF vs. not EBF at 6 months = 1.42; 95% [CI], 1.19-1.70). Discussion and Conclusions: Lactation consultant support initiated during hospitalization and continued through the postnatal period has the potential to improve breastfeeding outcomes. A dose-response relationship was observed, with interventions offering extended follow-up up to 6 months showing more favorable results. Face-to-face interventions that ensure direct contact and build trust with the mother appear to foster better breastfeeding outcomes. Standardization and rigorous monitoring of such programs are critical priorities.

Background: Social media platforms, particularly Instagram, are increasingly used by new and expecting parents to seek health-related information, including guidance on breastfeeding. While this offers opportunities for accessible support, concerns persist regarding the accuracy and quality of content shared online. Objective: This study aimed to evaluate the accuracy and general quality of breastfeeding-related information shared on Instagram and to examine how these attributes vary by post characteristics, including format, content topic, and account type. Methods: A cross-sectional observational study was conducted using 80 top-performing Instagram posts identified through four popular breastfeeding-related hashtags. Posts were manually screened and assessed for eligibility. Accuracy was evaluated against official guidelines from the Centers for Disease Control and Prevention, World Health Organization, and American Academy of Pediatrics using a 4-point scale. General quality was assessed using the Global Quality Scale (GQS), a validated 5-point tool. Ordered logistic regression was used to assess associations between post characteristics and outcomes. Results: Overall, 38.8% of posts were completely accurate, while 36.3% were either mostly or completely inaccurate. The mean accuracy score was 3.7 (SD = 1.41), and the mean GQS was 4.0 (SD = 1.03). Image-based posts were significantly more accurate than videos (odds ratio [OR] = 2.52; 95% CI: 1.11-5.74), and posts by health care professionals had significantly higher quality scores (OR = 5.23; 95% CI: 1.66-16.54). Accuracy and quality scores were strongly correlated (ρ = 0.68, p < 0.001). Conclusion: While Instagram can serve as a valuable platform for breastfeeding education, content quality and accuracy vary widely. Posts by health care professionals tend to be more reliable. Public health efforts should focus on amplifying evidence-based content and mitigating misinformation to better support maternal and child health online.

Introduction: Cardiovascular disease remains the leading cause of maternal mortality in the United States. While breastfeeding offers long-term protection against maternal cardiovascular disease, its influence on cardiovascular health (CVH) behaviors during the postpartum period remains less understood. Objective: To conduct a scoping review to understand the extent and nature of evidence regarding infant feeding methods (including direct and indirect breastfeeding) and their relationship to maternal CVH behaviors (i.e., physical activity, sleep, diet, and nicotine exposure) within 2 years postpartum from peer-reviewed quantitative primary research. Methods: Electronic bibliographic databases searched were MEDLINE (PubMed), Scopus, and CINAHL (EBSCO) on January 2, 2025. Source selection, data charting, and data presentation were conducted according to Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review checklist. No restrictions were placed on year, language, or geographical region. Results: This review included 60 studies and 57,489 participants. Postpartum sleep (n = 27) was the most frequently examined CVH behavior, followed by diet (n = 19), nicotine exposure (n = 15), and physical activity (n = 7). Breastfeeding was associated with longer and better quality sleep, higher intake of energy and dietary quality, and a lower likelihood of smoking or smoking relapse. Associations between breastfeeding and sleep efficiency as well as breastfeeding and physical activity were mixed. Conclusions: Breastfeeding was associated with favorable sleep duration and quality, better diet quality, and healthier smoking behaviors in the postpartum period, whereas significant gaps in knowledge remain regarding breastfeeding and maternal physical activity. The available data suggest infant feeding practices should be considered when promoting CVH during postpartum.

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.