Prevalence of breastfeeding in a baby-friendly pediatric practice in Trieste, Italy: follow up to 36 months of age

Background A breastfeeding-friendly physician’s office that applies the 13 recommendations of the Academy of Breastfeeding Medicine can help increase the exclusivity and duration of breastfeeding. Having already published the results up to five months of age of this intervention in our pediatric practice, we now report on the follow up to 36 months. Methods A cohort of 252 newborn infants was enrolled with our pediatric office in Trieste, Italy, between 1 January 2016 and 31 December 2016. The office implemented baby-friendly pediatric practices and a biological nurturing approach to the support of breastfeeding. In addition to the services offered by two pediatricians, support was provided by a peer counselor. Data on breastfeeding were collected at periodic healthy child visits up to 36 months of age. The outcome of interest for this follow up was the rate of any breastfeeding, defined as the percentage of infants and children who had received breastmilk in the previous 24 h. Results The rates of any breastfeeding at discharge and at 1, 3 and 5 months (n = 252) were 95.2, 95.8, 89.3 and 86.5%, respectively. At 8, 12, 18, 24 and 36 months of age, the rates of breastfeeding were 70.6% (163/231), 59% (135/229), 35% (78/224), 24.6% (55/224) and 7.2% (16/224), respectively. Conclusions The rates of any breastfeeding recorded in our pediatric practice up to age 36 months, are much higher than those reported elsewhere in high income countries and are likely to be associated with our baby-friendly and biological nurturing approach.

PELATIHAN PEER COUNSELOR DAN PENGENALAN MEDIA PROMOTIF UNTUK PEER COUNSELOR

Medical students as early adults have different challenges from high school, especially medical students. Based on the results of the previous study, it was found that medical students experienced anxiety, stress, and even depression with various levels. Ranging from mild to moderate-severe. Various efforts have been made, starting with increasing early detection of students from the first year, to the training stage to increase the role of academic advisory lecturers, to solving student problems that are sent to the counseling guidance section. The purpose of this training is that peer guidance services can be used as a form of guidance and counseling services provided to adolescents or early adults who have low social interaction. Before the training, it was started with the selection stage for peer counselors using an empathy questionnaire, based on the results of the questionnaire 28 students were found to be candidates for peer counselors. The training begins with a pretest then presentation material and case discussions then end with a post-test. Based on the results of the pre-test and post-test, there was an increase in knowledge about peer counselors, their roles, the benefits of counseling, and media that can be used as promotions as part of the peer counselor's duties. It is hoped that from this training, students can increase the role of assistance to students from the early stages so that severe cases experienced by students both in terms of academic and non-academic can be resolved.

PELATIHAN KONSELOR SEBAYA PADA SISWA KELAS XI SMAN 1 WONOGIRI MENGGUNAKAN ZOOM MEETING DI ERA PANDEMI COVID-19

<p><strong><em>Abstract.</em></strong> <em>The purpose of peer counselor training activities for class XI students of SMAN 1 Wonogiri using a zoom meeting in the Covid-19 pandemic era is to provide information about peer counselors and provide peer counselor skills to students at SMAN 1 Wonogiri. This training also provides information on guidance and counseling services, increases the ability to become peer counselors, and makes peer counselors an extension of counseling services in schools to help solve peer problems. Peer counselor training were carried out in 4 stages. Phase 1, by sharing and questioning, several training participants were asked to share their experiences while receiving guidance and counseling services during the Covid-19 pandemic. Stage 2 is the provision of material about peer counselors. The material is delivered in the form of lectures on peer counselor materials, discussions, provides examples of peer counselor activities through videos and carries out practices in the form of role-playing as a counselor and counselee. Stage 3 is the practice and implementation of peer counselor guidance and stage 4 is to evaluate the results of the peer counselor practice. The results of peer counselor training include improving the image of counseling guidance services through peer counseling activities, providing interpersonal skills to students, increasing knowledge and skills to become peer counselors so that students can become partners for guidance and counseling teachers.</em></p><p> </p><p><strong><em> </em></strong></p><p><strong>Abstrak.</strong> <em>Tujuan dari kegiatan pelatihan konselor sebaya pada siswa kelas XI SMAN 1 Wonogiri menggunakan zoom meeting di era pandemi covid-19 adalah memberikan informasi mengenai konselor sebaya dan memberikan ketrampilan konselor sebaya kepada siswa di SMAN 1 Wonogiri. Pelatihan ini juga memberikan informasi mengenai layanan bimbingan dan konseling, meningkatkan kemampuan menjadi konselor sebaya, dan menjadikan konselor sebaya sebagai perpanjang tangan layanan BK di sekolah untuk membantu memecahkan permasalahan teman sebaya. Pelatihan konselor sebaya dilaksanakan dalam 4 tahap. Tahap 1 dengan dengan sharing dan tanya jawab beberapa peserta pelatihan diminta untuk menyampaikan pengalaman selama menerima layanan bimbingan dan konseling di masa pandemi covid-19. Tahap 2 yaitu pemberian materi mengenai konselor sebaya. Materi disampaikan dalam bentuk ceramah mengenai materi konselor sebaya, diskusi, memberikan contoh kegiatan konselor sebaya melalui video dan melaksanakan praktik dalam bentuk role-playing sebagai konselor dan konseli. Tahap 3 yaitu praktik dan pendampingan pelaksanaan konselor sebaya dan tahap 4 yaitu mengevaluasi hasil dari praktik konselor sebaya. Hasil kegiatan pelatihan konselor sebaya antara lain meningkatkan citra layanan bimbingan konseling melalui kegiatan konseling sebaya, memberikan ketrampilan interpersonal kepada siswa, menambah pengetahuan dan keterampilan menjadi konselor sebaya sehingga siswa dapat menjadi partner guru bimbingan dan konseling.</em></p><p> </p><div id="gtx-trans" style="position: absolute; left: 28px; top: 565px;"> </div>

Effectiveness of peer counseling and membership in breastfeeding support groups in promoting optimal breastfeeding behaviors in the Philippines

Background The prevalence of early initiation of breastfeeding and exclusive breastfeeding (EBF) at 6 months remain low in the Philippines. To help meet the 90% early initiation of breastfeeding target and to improve infant and young child feeding practices in the Philippines, the Millennium Development Goals - Fund 2030 Joint Programme (JP) on Ensuring Food Security and Nutrition for Children 0–24 months old was implemented. We aimed to determine the effectiveness of visits by peer counselors during pregnancy and after delivery, and membership in breastfeeding support groups in promoting these optimal breastfeeding practices. Methods We used data from the Endline Survey of the JP to study the effects of prenatal and postnatal peer counselor visits, and membership in breastfeeding support groups, and their possible interactions with initiation of breastfeeding within 1 hour of birth among children aged 0 to 24 months and EBF at 6 months among children aged 6 to 24 months, while adjusting for confounding. We used logistic regression methods for survey data to assess these associations. Results Of the 2343 mother-infant pairs, only 1500 (63.1%) practiced early initiation of breastfeeding. Of the 1865 children aged 6 months or older, only 621 (34.7%) were exclusively breastfed at 6 months. After adjusting for confounding variables, there was no strong evidence that peer counselor visits were associated with early initiation or EBF at 6 months. However, members of breastfeeding support groups had 1.49 times higher odds of early initiation of breastfeeding (95% CI [Confidence Interval] 1.12, 1.98) and 1.65 times higher odds of EBF (95% CI 1.20, 2.24) compared to those who were not members of breastfeeding support groups. There was no interaction between the different exposure variables and early initiation and EBF at 6 months. Conclusions Our findings suggest breastfeeding support groups may be institutionalized to promote both early initiation of breastfeeding and EBF in the Philippines, while the role of peer counselors in promoting optimal breastfeeding behaviors should be further reviewed. Our suggestion to integrate non-healthcare professionals to promote early initiation of breastfeeding and EBF could be tested in future intervention studies.

Pendampingan Milennial Peer Counselor (MPC) melalui Konseling Realitas dalam Meneguhkan Karakter Santri di Pondok Nurul Jannah Kudus

The purpose of community service (PKlM) with the format of Millennial Peer Counselor (MPC) through reality counseling at Islamic Boarding School (Pondok Pesantren) Nurul Jannah, Kudus are as follow (1) provides insight into the importance of counseling services and the process of providing assistance to the needy; (2) equip the students of Islamic Boarding School (santri) with Reality counseling skills in finding alternative solutions for the ones who want to consult; (3) generate the peer counselor agents so that students can be referrals to friends. Soon after the program finished Santri has a special ambassador or cadre who will share and work together to solve their daily psychological problems. The results of community service include (a) Santri get insight about communication techniques and counseling that can be provided as peer counselors; (b) Institutions can map psychological problems in order to improve the quality of learning and social in Islamic Boarding School; (c) Through Millenial Peer Counselor, institutions are able to establish special bureaus or special units related to various psychological services aimed at students such as Islamic Counseling Centers, and (d) institutions have a broader opportunity to develop students with additional competencies to millennial peer counselor ambassadors such as Muslim motivator, young instructors, and self-development trainers for fellow students and the environment around the cottage. Abstrak Tujuan pengabdian kepada masyarakat (PKlM) dengan format pendampingan Milenial Peer Counselor (MPC) melalui konseling realitas di Pondok Pesantren Nurul Jannah, Kudus antara lain (1) memberikan wawasan tentang pentingnya layanan konseling dan proses pemberian bantuan kepada yang membutuhkan; (2) membekali santri dengan keterampilan konseling Realitas dalam menemukan alternatif solusi bagi konselinya; (3) mencetak agen-agen konselor sebaya agar para santri dapat menjadi rujukan teman curhat. Hal tersebut sesuai dengan hasil yang didapatkan setelah kegiatan pengabdian dilaksanakan yakni Santri memiliki duta atau kader khusus yang dapat menjadi rujukan mereka dalam menyelesaikan masalah sehari-hari (Daily Problem) terutama yang bersifat psikologis. Hasil pelaksanaan pengabdian kepada masyarakat antara lain (a) Santri memperoleh wawasan tentang teknik komunikasi dan konseling yang dapat menjadi bekal menjadi konselor sebaya; (b) Lembaga dapat melakukan pemetaan terhadap permasalahan psikologis santri demi meningkatkan kualitas pembelajaran dan sosial di pesantren; (c) Melalui Millenial Peer Counselor lembaga mampu mendirikan biro khusus atau unit khusus berkaitan dengan berbagai layanan psikologis yang ditujukan untuk santri seperti Pusat Konseling Islam, dan (d) Lembaga mempunyai kesempatan yang lebih luas untuk mengembangkan santri dengan kompetensi tambahan kepada duta konselor sebaya milenial seperti kompetensi motivator muslim, instruktur muda, dan trainer pengembangan diri bagi sesama santri dan lingkungan sekitar pondok.

Prenatal Provider Breastfeeding Toolkit: Results of a Pilot to Increase Women’s Prenatal Breastfeeding Support, Intentions, and Outcomes

Background Breastfeeding rates for United States women with lower incomes fall below the government’s Healthy People 2020 Goals. Breastfeeding recommendations combined with support from providers and peer counselors help women decide to begin and sustain breastfeeding, but peer counselor uptake is low. Research Aim To evaluate changes in referrals to Women, Infants, and Children’s Supplemental Nutrition Program peer counselors, reported prenatal provider education and support, and breastfeeding outcomes (intention, initiation, 1-month duration of any and exclusive breastfeeding) after a prenatal breastfeeding promotion intervention. Method In this pre-post intervention study (2015–2016; upstate New York), providers implemented a Toolkit to discuss infant feeding recommendations and initiate peer counselor referral. We surveyed women pre- and post-implementation (after delivery; 1 month postpartum) about prenatal breastfeeding intentions, provider support, and breastfeeding outcomes. Analyses controlled for secular trends. Results Pre-intervention ( n = 71) and post-intervention ( n = 70) participants were 49% Black, 61% publicly insured, and 16% uninsured. More post-intervention participants had > 1 Toolkit use (76%), peer counselor program referrals (60.0% post vs. 36.6% pre, p < .01), reported any breastfeeding intention (89% vs. 72%, p = .013), and intended to breastfeed for > 1 year (31% vs. 14%, p = .014). Post-intervention breastfeeding initiation and exclusivity were higher, but not significantly different. Post-intervention participants reported better prenatal breastfeeding support. Conclusions Implementing a prenatal Breastfeeding Toolkit, including facilitating peer counselor referral, was associated with increases in provider counseling, participants’ breastfeeding intentions, and uptake of peer counselors. Replicating this approach may reinforce efforts to support breastfeeding in similar practices serving women with lower incomes.

Effectiveness of peer counseling and membership in breastfeeding support groups in promoting optimal breastfeeding behaviors in the Philippines

Background: The prevalence of early initiation of breastfeeding (EIBF)and exclusive breastfeeding (EBF) remain low in the Philippines. To help meet the 90% EIBF target and to improve infant and young child feeding practices in the Philippines, the Millennium Development Goals - Fund 2030 Joint Programme (JP) on Ensuring Food Security and Nutrition for Children 0-24 months old was implemented. We aimed to determine the effectiveness of visits by a peer counselor during pregnancy and after delivery, and membership in breastfeeding support groups in promoting these optimal breastfeeding practices. We also aimed to examine the interaction between these two activities to assess their joint effects on both EIBF and EBF.Methods: We used data from the Endline Survey of the Joint Program , which collected socioeconomic data from the households of the mother-infant dyads, demographic characteristics of the mothers, and their particular infant and young child feeding practices. We used logistic regression methods for survey data to study these associations.Results: Out of the 2,343 mother-infant dyads, only 1,500 (63.1%) practiced EIBF and only 624 (27.9%) practiced EBF. After controlling for confounders, those who were visited by a peer counselor during the prenatal period had 1.32 times greater odds of practicing EIBF (95%CI: 0.96, 1.80) and 0.91 times lower odds (aOR: 0.91; 95% CI: 0.68, 1.22) of practicing EBF compared to those who were not visited. The association between visits by a peer counselor and EIBF was weak and statistically insignificant. The odds of EBF was also 26% higher among those who were visited by peer counselors after delivery (aOR: 1.26; 95% CI: 0.90, 1.75), but this association was also weak and statistically not significant. Members of breastfeeding support groups had 1.49 times higher odds of EIBF (95% CI: 1.12, 1.98) and 1.59 times higher odds of EBF (95% CI: 1.21, 2.10) compared to those who were not members of breastfeeding support groups; both associations were statistically significant. However, there was no interaction between the different exposure variables on their effects on EIBF and EBF. Conclusions: Breastfeeding support groups may be institutionalized to promote both EIBF and EBF in the Philippines. The role of peer counselors in promoting optimal breastfeeding behaviors should be further reviewed in light of the findings of this study.