Breastfeeding Medicine最新文献

Background: Usage of some medications while breastfeeding is supported with many clinical studies and proven to be safe for the mother-infant dyad, whereas knowledge on many medications' safety depends on pharmacokinetic data that are supported with only case series of real-life results. As data on rosuvastatin usage are limited, we present our case report with safe use of rosuvastatin in a breastfeeding mother of a 13-month-old infant. Case: Pretreatment assessments of the infant were performed. Complete blood count, kidney, and liver function tests were normal. The infant's lipid profile was evaluated before starting the mother's treatment, at 1 month of treatment, and at the fifth month of treatment in which the infant reached 18 months of age. All three evaluations resulted in normal ranges. At the 18-month follow-up of the infant of breastfeeding mother using rosuvastatin, no issues were detected in the child's development. Conclusions: In order for mothers with hypercholesterolemia not to neglect their own treatment while continuing to breastfeed, case reports should be included in the literature. In this case, it was shown that rosuvastatin treatment given to the mother did not affect the lipid profile and neurological development of the baby.

Background: Breastfeeding provides essential nutrition and disease protection for infants while reducing the risk of type 2 diabetes and breast cancer in mothers. Despite these benefits, significant racial and ethnic disparities exist in breastfeeding initiation, particularly among Black women. This study examines racial differences in the receipt of breastfeeding information from varying sources and their association with breastfeeding initiation. Methods: Data were obtained from the Phase 8 Core Pregnancy Risk Assessment Monitoring System for 2016-2020 (n = 163,724). The analysis focused on comparing the likelihood of breastfeeding initiation (yes/no) across racial groups and the impact of receiving breastfeeding information from varying clinical (mother's doctor/nurse/baby's doctor, etc.) and social sources (support group/family/friends, etc.). Univariate and multivariable analysis was conducted in SAS 9.4. Results: Black women consistently exhibited lower odds of breastfeeding initiation compared with other racial groups, across all informational sources. The study found that while information from both clinical and social sources increased breastfeeding initiation overall, Black women remained less likely to initiate breastfeeding than White women (p < 0.0001). Conclusion: Systemic barriers, including racism and bias in health care, contribute to the racial disparities in breastfeeding initiation. Culturally tailored interventions and improved health care provider training are necessary to address these gaps. Future efforts should aim to bridge the divide between clinical and social breastfeeding information sources to improve breastfeeding rates among minority women.

Introduction: Many breastfeeding mothers fast during Ramadan month despite being exempted from fasting. This study aims to estimate the prevalence rate of Ramadan fasting during breastfeeding and detect its associated factors among Egyptian Muslim mothers. Methods: A cross-sectional study was conducted on 1,130 lactating mothers selected through a multistage stratified random sampling technique in Dakahlia Governorate, Egypt. The data were collected through a structured questionnaire including sociodemographic data, the Arabic Scale of Intrinsic Religiosity (ASIR), and data about breastfeeding and fasting practices during Ramadan. Binary logistic regression analysis was used to detect the significant predictors of fasting among lactating mothers. Results: Of 1,130 study participants, more than half (53.5%) were aged ≥27 years old and had secondary education (54.6%). About four in every five (83.7%) of them fasted during Ramadan. Secondary education (adjusted odds ratio [AOR] = 2.71, p ≤ 0.001), university and postgraduate education (AOR = 4.88, p ≤ 0.001), non-working (AOR = 1.88, p = 0.011), being in debt and just meeting routine expenses (AOR = 1.75, p = 0.007), having high intrinsic religiosity (AOR = 2.70, p ≤ 0.001), having infants aged 6 months and more (AOR = 2.60, p ≤ 0.001), giving prelacteal feeding (AOR = 2.56, p ≤ 0.001), giving supplements (AOR = 2.11, p ≤ 0.001), and breastfeeding on demand (AOR = 1.92, p = 0.01) were the significant predictors of the higher fasting rates among the lactating mothers. Conclusion: Fasting is a prevalent practice among breastfeeding mothers of infants during Ramadan. Ramadan fasting does not significantly influence maternal outcomes or infant weight. Therefore, it is advisable for lactating mothers to consult with healthcare professionals prior to deciding to fast during Ramadan.

Background: Social determinants of health account for racial inequities in breastfeeding rates in the United States. There is a gap in the role of neighborhood socioeconomic status (NSES) as it relates to breastfeeding disparities. Methods: Using longitudinal data from the Black Women's Health Study, we assessed associations of NSES with breastfeeding initiation and duration in a cohort of primiparous U.S. Black women. We also explored associations within strata of important economic indicators, including education, occupation, and marital status. Results: Breastfeeding initiation (n = 2,705) increased with NSES quartile, from 75.2% in the lowest quartile to 88.3% in the highest quartile (p < 0.0001). Compared with women living in the highest NSES quartile, those in the lowest quartile had a 41% (odds ratio: 0.59 [95% confidence interval: 0.43, 0.81]) decreased odds of initiating breastfeeding. For breastfeeding duration (n = 2,172), women residing in NSES quartiles 1-3 were significantly less likely (p < 0.0001) to breastfeed (44.4%) for 6+ months compared with those living in the highest quartile (62.8%). Adjusted relative risks for those in quartiles 1-3 compared with 4 (highest) were 0.63 (0.45, 0.87), 0.50 (0.37, 0.68), and 0.64 (0.47, 0.86), respectively (p = 0.0001). There was no statistically significant evidence of effect modification by education, occupation, marital status, and region (P_interaction = >0.05). Conclusion: Living in a lower NSES environment was associated with reduced breastfeeding initiation and duration compared with a higher NSES environment. Research is needed to understand the mechanisms by which neighborhood-level factors influence breastfeeding initiation and duration for Black women in the United States.

Objective: This study analyzes the impact and experiences of hospitalization for any reason on breastfeeding women. Methods: Cross-sectional online survey (November 2019-March 2020). Adults admitted to a Spanish hospital for at least one night, when actively breastfeeding, were included. The questionnaire aimed at assessing breastfeeding, breast complications, and support and perceived health care workers' attitudes to breastfeeding. Results: Of the 266 included participants, 70 (26%) stopped breastfeeding during hospitalization, and 13 (5%) interrupted it permanently. A total of 24 (10%) participants reported that hospitalization meant problems for later breastfeeding, and 67 (25%) reported experiencing breast complications. The most common negative comment was that the child was too old to be breastfed (median age, 15 months [interquartile range (IQR) 11-25]). Problems for later breastfeeding due to the hospitalization were more likely if breastfeeding was interrupted (odds ratio [OR] 3.68, 95% confidence interval [CI] 1.32-10.5) or breast problems were experienced (OR 4.11, 95% CI 1.51-11.7). Problems were less likely when patients felt encouraged (OR 0.38, 95% CI 0.21-0.69) and hospitalized in a surgical inpatient area (OR 0.15, 95% CI 0.03-0.65). Conclusions: Hospitalizations can cause breastfeeding and breast problems. Hospital services must update protocols to integrate breastfeeding into usual care.

Objectives: Rapid weight gain in infancy is associated with an increased risk of later adiposity. Very rarely, however, exclusively breastfed infants experience excessive weight gain (EWG) during the period of exclusive breastfeeding (EBF) when breast milk is the only source of nutrition. We investigated growth and body composition at 36 months in children experiencing EWG during EBF. Methods: Ten infants with EWG during the first 6 months of EBF were followed up at 36 months. The infants had been followed from age 5 months. Examinations included anthropometry, body composition by bioimpedance, and blood samples. Body composition and plasma leptin concentrations were available for eight and five children, respectively. Results: From 5 to 36 months, body mass index-for-age z-scores (BAZ) decreased from (mean ± standard deviation) 2.33 ± 0.94 to 1.48 ± 0.57, and only one child still being overweight (BAZ >2). Fat mass and fat mass index (FMI) decreased from 18 to 36 months (4.71 ± 0.56 to 3.57 ± 0.67 kg and 6.50 ± 0.34 to 3.66 ± 0.72 kg/m², respectively) with a concurrent 45% decrease in leptin. The increase in lean mass was higher than the increase in weight (5.27 versus 3.65 kg, respectively) due to fat loss. There was substantial conformity within the sample in the patterns of body composition change. Conclusion: This unusual group of children continued to decrease in BAZ and FMI with a concomitant increase in fat-free mass, indicating an ongoing normalization of body weight and composition.

Background: Breastfeeding is vital for infant nutrition, especially for multiple babies (twins) born prematurely, yet breastfeeding rates among mothers of twins are lower compared with mothers of singleton babies. This review presents a synthesis of research findings on breastfeeding challenges experienced by mothers following twins' births. Methods: The electronic databases of CINAHL, MEDLINE, PsycINFO, EMBASE, and Web of Science were systematically searched in August 2023. All eligible quantitative, qualitative, and mixed-methods studies reported on breastfeeding challenges experienced by mothers of twins were included. The review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and followed Lucas et al.'s framework for thematic synthesis. Two reviewers independently screened all studies by title, abstract, and full text. The methodological quality of studies was independently assessed by two reviewers using the Joanna Briggs Institute critical appraisal tool and mixed-methods appraisal tool based on study design. Results: The review included 16 studies: quantitative (n = 5), qualitative (n = 8), and mixed methods (n = 3), published between 1980 and 2022, involving 3,351 mothers from 16 countries. Three main themes were generated as follows: (1) transitioning to a new role, finding the balance between self and the newborns' needs; (2) the inevitability of emotional challenges; and (3) navigating support and information. Conclusion: The integrated findings of quantitative, qualitative, and mixed-methods studies on challenges experienced by mothers of twins will have scope for researchers to address the challenges through tailored intervention, education, and support and can help health care professionals revisit policy and practices to extend support services for mothers of twins beyond the initial postpartum and to the community for improving breastfeeding practices among mothers following multiple births.

Objectives: To review current knowledge of the association between bed-sharing and breastfeeding behaviors during infancy. Methods: A systematic review methodology was employed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses method and utilizing the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies for quality assessment. Inclusion criteria were quantitative or mixed-methods studies published between 1993 and 2022 that provided data on the association between bed-sharing and breastfeeding for postpartum mothers of infants 0-12 months. We excluded studies that utilized breastfeeding as the independent variable and bed-sharing as the dependent variable. Results: A total of 24 studies met the inclusion criteria, 11 of which were prospective/longitudinal and 13 of which were cross sectional. Eight of the longitudinal studies found a significant positive association between bed-sharing and breastfeeding (73%), and nine of the cross-sectional studies (69%) found a positive association. Conclusion: Many postpartum women bed-share with their infants. Bed-sharing is associated with an increase in breastfeeding for most women. There does not appear to be such a relationship between bed-sharing and breastfeeding in U.S. African American women, who have overall lower rates of breastfeeding. Policy Implications: The public health principle of risk reduction could be applied to those who plan to bed-share such as recommending that health care providers educate women about bed-sharing without hazards. Bed-sharing without hazards may be considered one strategy to promote breastfeeding.