Evaluation of a breastmilk hand expression toolkit: the M.I.L.K survey study

Background Breastmilk hand expression (BMHE) is recommended to promote lactation, relieve breast engorgement, and collect milk for future infant feedings. Resources to teach this skill are limited and infrequently developed in partnership with the obstetrical population. In collaboration with maternity care experts and individuals with recent breastfeeding experience, we designed a one-page toolkit that describes the process of BMHE and includes step-by-step instructions and images to illustrate the technique. This study aimed to evaluate the readability, clarity of content, layout, and informational value of this BMHE toolkit. Methods Individuals who intended to breastfeed, were currently breastfeeding, or had recently breastfed were electronically surveyed and completed a two-part survey that consisted of radio, multi-select, Likert scale, and open-ended questions. Part one captured sociodemographic factors, obstetrical history, and breastfeeding practices. Part two collected feedback on the BMHE toolkit. Participants were recruited electronically through social media and posters were circulated in antenatal and postnatal care settings in Ottawa, Canada between November 2020 and February 2021. Results Of the 123 participants, 117 (95.1%) had heard of hand expression prior to reviewing the toolkit and 99 (80.5%) had hand expressed before. Among the 48 participants who were no longer exclusively breastfeeding at the time of the survey, 22 (45.8%) had exclusively breastfed their infant for at least six months and 7 (14.6%) had discontinued exclusive breastfeeding within the first month. When asked about the BMHE toolkit, 118 (95.9%) participants said it was informative, 115 (93.5%) said it was easy to understand, and 114 (92.7%) said it was well laid-out. When asked about information seeking behaviours, participants indicated a preference for online resources (58.5%) and video resources (22.0%). Conclusions The BMHE toolkit was well received by participants and the feedback was favourable overall. The survey feedback will be used to create a revised version of the toolkit that has been validated by the obstetrical patient population. Future research should focus on identifying implementation strategies to optimize the use of the toolkit and increase its effectiveness as an educational resource to teach participants correctly BMHE.

Study of Knowledge of Breastfeeding Practices in Infants from 0 to 6 Months

The rate of exclusive breastfeeding from 0 to 6 months in Côte d'Ivoire was 16.67 % in 2014. The objective of this study is to identify the difficulties related to the practice of exclusive breastfeeding of infants from birth to 6 months with a view to finding sustainable solutions for its implementation. A survey study was carried out on a sample of 200 women in the municipality of Bingerville from 7 October 2020 to 7 February 2021. After analysis, the results of the survey show that in the Bingerville locality of Côte d'Ivoire, the difficulties relating to the decline in exclusive breastfeeding are largely linked to the insufficient production of breast milk. The results have made it possible to record some species of food plants. They undoubtedly possess lactogenic properties, which make it possible to cope with the insufficient production of milk in the udder. Thus, after 24 hours, these food plants have made it possible to increase the production of breast milk in the udders intended for infants. The registered food plants will help to ensure the food security of the infant through the improvement of milk production in breastfeeding mothers.

Skin-to-skin contact and breastfeeding practices in Nigeria: a study of socioeconomic inequalities

Background The effects of breastfeeding practices on children’s health are undoubtedly of great interest. However, inequalities in breastfeeding practices and mother and newborn skin-to-skin contact (SSC) exist in many resource-constrained settings. This study examined the regional prevalence and socioeconomic inequalities in exclusive breastfeeding (EBF), early initiation of breastfeeding and SSC in Nigeria. Methods Data on 2936 infants under six months were extracted from the 2018 Nigeria Demographic and Health Survey (NDHS) to determine EBF. In addition, data on 21,569 children were analysed for early initiation of breastfeeding and SSC. Concentration index and curves were used to measure socioeconomic inequalities in EBF, early initiation of breastfeeding and SSC. Results The prevalence of EBF, early initiation of breastfeeding and SSC were 31.8, 44.2 and 12.1% respectively. Furthermore, Ogun state had the highest prevalence of EBF (71.4%); while Bayelsa state had the highest prevalence of SSC (67.8%) and early initiation of breastfeeding (96.2%) respectively. Urban dwellers had higher prevalence of EBF, SSC and early initiation of breastfeeding across household wealth quintile and by levels of mothers’ education in contrast to their rural counterparts. We quantified inequalities in early initiation of breastfeeding, EBF, and SSC according to household wealth and maternal education. The study outcomes had greater coverage in higher household wealth, in contrast to the lower household wealth groups; early initiation of breastfeeding (concentration index = 0.103; p = 0.002), EBF (concentration index = 0.118; p < 0.001), and SSC (concentration index = 0.152; p < 0.001) respectively. Furthermore, early initiation of breastfeeding (concentration index = 0.091; p < 0.001), EBF (concentration index = 0.157; p < 0.001) and SSC (concentration index = 0.156; p < 0.001) had greater coverage among mothers with higher educational attainment. Conclusion Low prevalence and socioeconomic inequalities in early initiation of breastfeeding, EBF and SSC were identified. We recommend that health promotion programs targeted and co-designed with disadvantaged mothers are critical to meet global breastfeeding targets. Also, future researchers should conduct further studies especially clinical control trials and qualitative studies to unravel the possible reasons for differences in the indicators.

Exploration of Breastfeeding Practices in India: A Systematic Review

Introduction: Breastfeeding is essential and a unique way of providing food to infants for development and healthy growth. Various breastfeeding practices are followed in different regions of India. Objective: This study aims to collect the information for practices related to prelacteal feed, early initiation of breastfeeding, exclusive breastfeeding, and weaning in India. Materials and Methods: A systematic search was conducted in PubMed, MEDLINE, Embase, Google Scholar, Clinical key, the Cochrane Library, and Science Direct databases to identify studies on practices related to the initiation of early breastfeeding, prelacteal feed, Exclusive Breastfeeding (EBF) practices, and weaning as outcomes. Quality assessment of each study was done by the Newcastle-Ottawa scale. Results: Twenty-four studies were included in this systematic review. Seven studies reported an early initiation of breastfeeding within 1-6 hours of birth. Six studies reported various prelacteal foods given to infants, such as tea, boiled water, honey, sugar, jaggery, or glucose with plain water and diluted animal milk. Four studies stated that exclusive breastfeeding was a suboptimal practice, often continued for less than six months for reasons like working mothers (not enough time for breastfeeding), traditional beliefs, and inadequate milk output. Four studies explored the causes of early onset of weaning, and the most common reasons were initiation of supplementary feeding before six months, insufficient breastmilk, and lack of knowledge. Conclusion: Overall, the results of the individual studies indicate that unhealthy breastfeeding practices such as prelacteal feeding, suboptimal exclusive breastfeeding, and early initiation of weaning practices were prevalent and almost the same across India.

What does early initiation and duration of breastfeeding have to do with childhood mortality? Analysis of pooled population-based data in 35 sub-Saharan African countries

Background Breastfeeding practices and their impact on infant health and survival are unquestionably of global interest. The aim of this study was to examine the link between breastfeeding initiation within one hour of birth, breastfeeding duration and childhood mortality in sub-Saharan Africa. Methods This study used data from the Demographic and Health Survey, which was conducted in 35 Sub-Saharan African countries between 2008 and 2017. Early initiation and duration of breastfeeding, food consumption indices, and infant mortality were all important variables. Analysis used percentage, median/interquartile range, and regression models (logistic, linear, Cox). Results Early initiation of breastfeeding within one hour after birth was lowest in Chad (23.0%) and highest in Burundi (85.0%). The pooled median duration of breastfeeding was 12 months. Female children had 3% significant lower odds of consuming tinned, powdered or fresh milk, compared with male children (OR 0.97; 95% CI 0.94, 0.99). Conversely, female children were more likely to be put to breast within one hour after birth, compared with male children (OR 1.03; 95% CI 1.01, 1.05). Results from the pooled sample showed approximately 20% (HR 0.80; 95% CI 0.67, 0.96) and 21% (HR 0.79; 95% CI 0.77, 0.80) reduction in infant mortality for children breastfed within one hour after birth and for every unit increase in the months of breastfeeding respectively. In addition, countries with the leading infant mortality rate include; Sierra Leone (92 deaths per 1000 live births), Chad (72 deaths per 1000 live births), Nigeria (69 deaths per 1000 live births), Cote d’ Ivoire (68 deaths per 1000 live births), Guinea (67 deaths per 1000 live births), Burkina-Faso (65 deaths per 1000 live births) and Mozambique (64 deaths per 1000 live births) respectively. Conclusions The findings from this study underscores the need for early breastfeeding initiation and prolong breastfeeding to be considered in programmes on improving childhood survival. Efforts should be made to improve optimal breastfeeding practices as only about half of children in the pooled sample had best practices of breastfeeding.

Cohort profile: Japanese human milk study, a prospective birth cohort: baseline data for lactating women, infants and human milk macronutrients

PurposeThe Japanese Human Milk Study, a longitudinal prospective cohort study, was set up to clarify how maternal health, nutritional status, lifestyle and sociodemographic and economic factors affect breastfeeding practices and human milk composition. This would eventually determine factors affecting the growth and development of infants and children.ParticipantsA total of 1210 Japanese lactating women who satisfied the inclusion criteria, were invited across the country at various participating sites, between 2014 and 2019. Finally a total of 1122 women were enrolled in this study.Findings to dateAmong 1122 eligible participants, mean age at delivery was 31.2 (SD 4.4) years and mean prepregnancy BMI was 20.8 (SD 2.7). Among these women, 35% were previously nulliparous and 77.7% had college, university or higher education. The mean gestational period was 39.0 (SD 1.3) weeks. Caesarean section was reported among 11.9%; mean infant birth weight was 3082 (SD 360) g. Of the infants, 53.7% were male. Overall, our participants appeared to be healthier than the general population in Japan. Analyses of the 1079 eligible human milk samples obtained at the first and second months postpartum showed the following composition: carbohydrate, 8.13 (SD 0.32) g/100 mL; fat, 3.77 (SD 1.29) g/100 mL; and crude protein, 1.20 (SD 0.23) g/100 mL. We also analysed osteopontin, fatty acid, vitamin D and phospholipid levels in limited subcohorts of the samples.Future plansFollow-up surveys will be conducted to obtain milk samples every 2 months for 12 months and to investigate mother and child health until the children reach 5 years of age. These will be completed in 2024. We plan to longitudinally analyse the composition of macronutrients and various bioactive factors in human milk and investigate the lifestyle and environmental factors that influence breastfeeding practices, maternal and child health, and child development.Trial registration numberUMIN000015494; pre-results.

A DESCRIPTIVE CROSS-SECTIONAL STUDY OF BREAST FEEDING PRACTICE

Background: This study was describe the breastfeeding practices and factors affected initiation and duration of breastfeeding Methods: The cross sectional study was conducted on mothers with infants less than 1 year who came to immunization center for vaccination was included in the study. Total 1000 mothers include in this study. Results: Only 35.40% of the mothers did the exclusive breastfeeding until 6 months and started weaning after 6 months. A total 55.00% of mothers in our study prematurely started weaning. Conclusions: The study emphasizes the need for breastfeeding intervention programs especially for the mothers during antenatal and postnatal check-ups. Keywords: Breastfeeding, Immunization, Infants.