Breastfeeding Medicine最新文献

Background: Despite many well-documented benefits of breastfeeding, only 44% of babies worldwide are exclusively breastfed for the first 6 months. The aggressive marketing of formula food companies may be contributing to why mothers are choosing artificial feeding over breastfeeding. Objective: To identify when and how mothers become aware of infant formula food and the impact it has on breastfeeding. Methods: Four commonly used formula food logos were modified to unbranded versions using photoshop and shown to 444 participants at a tertiary level hospital. The participants included first-time pregnant women and mothers of infants aged 0-6 months. They were asked if they recognized the logos and how they knew them. Breastfeeding practices and media usage were also examined with a questionnaire. Results: The overall rate of logo recognition was 60.8%, increasing with the baby's age. Of the mothers who had never used formula, 51.6% still recognized them. Of the participants, 70.5% admitted to getting baby care ideas from the media, with the logo recognition rate being higher among them. Exclusive breastfeeding was lower among the mothers who were aware of the logos. Conclusion: The awareness of formula food was quite high among the group that needed to breastfeed exclusively. More than half of those who recognized the logos stated that they saw them through the media, highlighting its role in formula awareness.

Objective: To determine whether women with polycystic ovary syndrome (PCOS) were less likely to initiate breastfeeding or have shorter breastfeeding duration. Materials and Methods: Cross-sectional analysis was performed of the Pregnancy Risk Assessment Monitoring System dataset, a national questionnaire from the Centers for Disease Control and Prevention of postpartum women, from 2016 to 2018. Logistic regression assessed the odds of any breastfeeding initiation. Cox proportional hazards assessed duration of any breastfeeding. Results: Sample included 2,382,290 women (6.1% PCOS). In univariable analysis, PCOS was associated with increased odds of any breastfeeding initiation (89.9% versus 87.9%; odds ratio [OR]: 1.23 [95% confidence interval: 1.02, 1.47]; p = 0.03). This outcome remained significant after controlling for body mass index (BMI; OR_adj:1.3 [1.1, 1.6]; p = 0.005) but not after controlling for education and prior live births (OR_adj:1.10 [0.89, 1.37]; p = 0.37). With increasing BMI, the odds of any breastfeeding initiation decreased, with the lowest odds seen in women with class III obesity (OR_adj: 0.74 [0.60, 0.9]; p = 0.003). In a subanalysis of racial/ethnic groups, PCOS did not impact any breastfeeding initiation in White or Black non-Hispanic groups but increased odds of any breastfeeding initiation in Hispanic women (OR_adj: 2.0 [1.1, 3.7]; p = 0.03). In multivariable models, there was no difference in the duration of any breastfeeding in women with PCOS compared with those without. Conclusions: Understanding predictors of breastfeeding success is paramount. In this national survey measuring any breastfeeding, PCOS did not decrease breastfeeding initiation or duration, despite confirming the association between overweight/obesity and decreased breastfeeding. However, because the data did not distinguish between exclusive breastfeeding and supplementation, we cannot rule out the possibility that PCOS affects breastfeeding exclusivity or necessitates supplementation. This limitation suggests that important trends could be obscured, and therefore, our findings should be interpreted with caution regarding breastfeeding exclusivity. Interventions aimed at increasing breastfeeding should target populations that would benefit the most; our data support that PCOS-specific targeting is not needed. Additional prospective studies are necessary to fully understand the association between different PCOS phenotypes and breastfeeding.

Background: Pain management is an important issue in newborns. This study aimed to compare the effects of three different sensory interventions (mother's voice [hearing], mother's milk smell [smell], and mother's holding [touch]) during heel lance on pain levels in term newborns. Methods: In this randomized controlled trial, 120 term newborns included in the study were divided into four groups. Pain scores were assessed with Neonatal Infant Pain Scale during and after the procedure. Results: When compared in terms of interventions, newborns in mother's voice and mother's holding groups showed statistically significantly less pain response during the procedure compared with the control group (p = 0.005). But no significance was found in terms of mother's milk smell. Conclusion: In conclusion, mother's holding and mother's voice are effective methods to reduce pain during heel prick procedure in newborns. In addition, both maternal smell and maternal touch may have had an effect in the mother's holding group. Nevertheless, future studies with different designs on the effect of breast milk smell are recommended. (Trial registration: https://clinicaltrials.gov/study/NCT05526378.).

Clinical guidelines for infant feeding among people with HIV in the U.S. were updated in 2023 to encourage providers to utilize a shared decision-making approach that includes breastfeeding/chestfeeding (B/CF) when appropriate. Despite this historic shift in policy to support B/CF as an infant feeding choice for people living with HIV, birthing people living with HIV who desire B/CF face many barriers, and there is currently a gap in research identifying best practices for facilitating safe and satisfying B/CF in this population. Lactation support specialists have been identified as a positive factor in successful B/CF and a key resource for supporting B/CF for people with HIV. Recent research has shown that telelactation, the provision of care from a qualified lactation consultant or counselor using telehealth, can increase access to quality lactation support in underserved areas and can effectively improve outcomes, such as increased rates of exclusive breastfeeding and decreased early breastfeeding cessation while maintaining high levels of patient satisfaction. Telelactation is an innovative approach to improving access to B/CF among birthing people living with HIV, but little is currently known about what kind of support lactation support specialists and other perinatal HIV care providers may need to meet the clinical and psychosocial needs of B/CF people living with HIV and their infants. More research is needed to identify possible gaps in knowledge and other needs within the lactation support community so that infant feeding specialists are adequately equipped with evidence-based strategies to support the unique needs of parents living with HIV.

Background: The breastfeeding aversion response (BAR) is defined as the compulsion to remove the baby from the breast in response to negative physical sensations experienced during breastfeeding. This phenomenon is characterized by involuntary and overwhelming feelings of disgust that arise during breastfeeding or at various stages of the breastfeeding process. Objectives: The aim of the study is to evaluate the frequency of BAR and affecting factors in mothers with breastfeeding experience in Türkiye. Methods: The survey was conducted online using the Google Forms® tool, accessible from November 2, 2023, to January 5, 2024. A total of 1,046 mothers with breastfeeding experience were included in the research. Results: A total of 9.8% (n = 103) of mothers participating in the study stated that they experienced BAR. Fatigue (23.3%), breastfeeding a toddler (19.4%), and breast pain (18.4%) were the most frequently reported risk factors for BAR. The BAR rate was higher among working mothers (p = 0.037), those lacking spousal support (p = 0.001), mothers diagnosed with postpartum depression (p = 0.009), and those encountering breastfeeding problems (p = 0.007). Conclusion: Further research on the factors that trigger BAR, its severity, and what symptoms it may cause may provide guidance on how midwives and nurses working with breastfeeding mothers can support these mothers, how to prevent BAR, and possible treatment options. The findings of our study revealed that BAR is especially affected by psychological processes. For this reason, it is recommended to approach breastfeeding in the postpartum period as a holistic experience that also includes psychological and sociocultural processes rather than solely from a physiological perspective.

Introduction: Dysphoric milk ejection reflex (D-MER) is a condition affecting lactating women, characterized by abrupt emotions of dysphoria that start shortly before or during milk let-down and progress for several minutes. Research on D-MER, especially with quantitative methodology, is minimal. This study aimed to validate an instrument for D-MER-related emotions, examine its prevalence and clinical features, and explore differences in maternal mental health and mother-infant bonding between mothers with and without D-MER. Methods: A total of 711 women up to 12 months postpartum participated in an online cross-sectional study. Participants fulfilled the D-MER Questionnaire (D-MERq), Edinburgh Postnatal Depression Scale, Depression, Anxiety, and Stress Scales, and the Postpartum Bonding Questionnaire. Results: The analysis showed that D-MERq had high reliability and good discriminant and divergent validity. The prevalence of D-MER was 5.9%. For the majority, D-MER manifested intensely, accompanied mostly by agitation- and anxiety-related emotions, and 45% of mothers discontinued breastfeeding due to D-MER. Mothers experiencing D-MER had higher levels of depression, anxiety, stress, previous psychiatric diagnoses, and more mother-infant bonding difficulties compared with mothers without D-MER. Conclusion: These findings demonstrate that D-MERq is a valuable tool with good psychometric properties and suitable for clinical and research use to facilitate early identification and better understanding of this phenomenon. D-MER affects a noteworthy number of women and is associated with impaired mental health, bonding difficulties, and breastfeeding discontinuation. This highlights the importance of health care providers recognizing D-MER to ensure better outcomes and a more positive breastfeeding experience.

Introduction: Breastfeeding is associated with improved health outcomes. Several social drivers of health impact breastfeeding initiation (BFI). Prior research using ecological data demonstrated that food desert residence (FDR) is associated with lower rates of BFI. The primary objective was to assess the relationship between FDR and BFI using individual-level data. The secondary objective was to assess the relationship between FDR and BFI at the county level. Methods: Individual-level birth data from the Florida Department of Health were linked to food access data from the United States Department of Agriculture Food Access Research Atlas in 2010, 2015, and 2019. Food deserts were identified per the United States Department of Agriculture definition. Adjusted risk ratios (aRR) and 95% confidence intervals (CI) were calculated using modified Poisson regression models in 573,368 births. Models were adjusted for confounders and stratified by race/ethnicity. We assessed the association between the percent of the population in low-income and low-access census tracts aggregated to the county level and the percent of mothers initiating breastfeeding per county in Florida (Center for Disease Control and Prevention) using Pearson's correlation and a bivariate map. Results: FDR was associated with BFI (aRR: 1.23, CI: 1.20-1.27). The adjusted risk of not-initiating breastfeeding for those living in a food desert was greatest among non-Hispanic Black women (aRR: 1.29, CI: 1.24-1.35) and Hispanic women (aRR: 1.29, CI: 1.21-1.37). Maternal education was the most significant predictor of BFI. Women who had 9th through 12th-grade education but without a diploma were five times (aRR: 4.96, CI: 4.72-5.20) less likely to initiate breastfeeding relative to college graduates. There was no association between FDR and BFI at the county level, though regional trends were noted. Conclusions: FDR is an important risk factor for not-initiating breastfeeding. Among Floridians, education was the most significant risk factor. Understanding how FDR influences breastfeeding can help target interventions to improve breastfeeding outcomes.