Media counseling of breastfeeding practice improved newborn growth outcomes in Ngombol Public Health Center, Purworejo-Indonesia

Exclusive breastfeeding practice in Ngombol public health center is below the regency target which was only 54.4% from 80% in Purworejo in 2019. Program to improve exclusive breastfeeding such as counseling is one of the best ways to increase community participation as this is a crucial phase to fulfill newborn nutrition needs. The aim of this study was to determine the effect of media counseling on increasing breastfeeding practice and improving newborn weight in the first-month-old. We created a quasi-experimental design with one group pre-test and a post-test with a control group design. Of 40 post-partum mothers and newborns were recruited in this study. Data collection was gathered such as socio-demography, breastfeeding observation form, and newborn’s weight both before and after the one-month intervention. The intervention group had been counseled with media such as leaflets, breastfeeding flipcharts, breast props, and newborn dolls. On the other hand, the control group had no received counseling with media. A statistical paired t-test test was created to find the association between those variables using SPSS 20.0 for windows. The mean average of newborn weight after the intervention was 1,005.55 g and 964,50 g for the intervention and control group, respectively. There were differences before and after a month of giving exclusive breastfeeding between the control and intervention groups (p<0.001). Mothers in the intervention group had 80% achieved minimum recommended weight gain (≥800 g/month). Exclusive breastfeeding counseling with media has an impact on improving newborn weight at the first-month-old in Ngombol Public health Center, Purworejo-Indonesia. Using media during breastfeeding counseling regularly may help the awareness and knowledge of exclusive breastfeeding for mothers, yet improve breastfeeding practice.

Design, Development, and Testing of Best4Baby, a Mobile Health Technology to Support Exclusive Breastfeeding in India: A Pilot Study (Preprint)

BACKGROUND Exclusive breastfeeding (EBF) through 6 months of age in most low- and middle-income countries (LMICs) is surprisingly low. In India, an LMIC, EBF rates fall well below the World Health Organization benchmark of 90%. There has been a relative lack of mobile health (mHealth) applications that specifically focus on leveraging the use of peer counselors (PCs) to support mothers as a means of increasing exclusive breastfeeding practices in LMICs. OBJECTIVE A key study objective was to design, develop, and test the usability of BEST4Baby, a mHealth app specifically designed to support PCs in providing in-home breastfeeding counseling support to mothers in rural India around optimal breastfeeding practices. METHODS To develop and test BEST4Baby, we applied behavioral theories (i.e., social cognitive theory and theory of planned behavior) to a user-centered design (UCD) process with an Agile development methodology. The approach involved stakeholders and PCs to guide BEST4Baby’s design and development including the app’s content and features. PCs were engaged through the use of focus groups with interactive wireframes. Their feedback helped finalize the design prior to development. During the 24-month study period, we conducted a feasibility test of the BEST4Baby app with 23 PCs that supported mothers residing in rural India in a pilot study that incorporated an intervention (n=110) and control (n=112) group. The intervention protocol required PCs to provide education and follow mothers using BEST4Baby from the late prenatal stage of pregnancy through 6 months postpartum. BEST4Baby’s usability from the PCs’ perspective was assessed using a translated System Usability Scale (SUS). RESULTS The findings of this study align with best practices in UCD (i.e., understand user experience, context with iterative design with stakeholders) to address EBF barriers. It led to the cultural tailoring and contextual alignment of an evidence-based WHO breastfeeding program with iterative design and Agile development of the BEST4Baby app. The approach translated to a highly usable BEST4BABY app for employment by PCs for breastfeeding counseling that has been shown to statistically increase EBF practices. PCs rated BEST4Baby as highly usable, scoring it over the 95th percentile on the SUS scale. CONCLUSIONS Findings suggest that BEST4Baby was highly usable and accepted by PCs in supporting mothers in their EBF practices and led to positive outcomes in the intervention group’s EBF rates. The pilot demonstrated that the use of the specially designed BEST4Baby app was an important support tool for PCs during the nine home visitations.

Breastfeeding counseling based on formative research at primary healthcare Services in Mexico

Background Breastfeeding rates in Mexico are far from World Health Organization (WHO) recommendations with 28.8% of Exclusive Breastfeeding (EBF) under 6 months of age, according to the 2018 National Health and Nutrition Survey. Formative research has shown that culturally appropriate counseling is an effective breastfeeding intervention. The objective of the current study was to evaluate the effect of interpersonal counseling on EBF in a primary healthcare center in Tijuana, México. Methods This was a randomized controlled trial pilot with a sample of mothers with infants under 4 months of age from a primary care center. Participants were randomized into two groups: 1) Control group, received counseling on immunizations and standard infant feeding information, and 2) Intervention group, receiving breastfeeding counseling using a socio-ecological framework. Changes in breastfeeding attitudes, self-efficacy and EBF were evaluated at 2 months post-intervention. Results A total of 80 mothers completed the 2 month follow up assessment (40 in each group). The mean age at baseline was 26.4 years for mothers and 1.4 months for infants. There was a 30% increase in EBF at 2 months follow up in the intervention group and 15% decrease in the control group post-intervention. We observed a significant improvement in breastfeeding attitudes (P = 0.0001), self-efficacy (P = 0.046) and EBF (P = 0.0001) in the intervention group. Reported obstacles were discomfort of breastfeeding in public (23%), infant dissatisfaction (23%), pain (19%), insufficient milk supply (15%) and returning to work (8%). Conclusions Breastfeeding counseling based on previous formative research improved breastfeeding attitudes, self-efficacy and practices in this population. These findings suggest that the promotion of breastfeeding utilizing a socio-ecological framework may improve breastfeeding rates by addressing the needs of women within their varying sociocultural contexts. Trial registration ACTRN: ACTRN12621000915853. Retrospectively registered.

Roles of Midwives and Indonesian Midwives Association in Reducing Risk Factors for Stunting in Indonesia

Background: Stunting is caused by multi-dimensional factors and the most decisive intervention should be carried out in the first 1,000 days of life. Poor parenting practices, lack of knowledge about health and nutrition before and during pregnancy are some of the contributing factors and 60% of children aged 0-6 months do not receive exclusive breastfeeding. Aim: To assess the role of midwives and the Indonesian Midwives Association Professional Organization in reducing the risk of stunting in Indonesia. Method: This type of descriptive research uses an exploratory study approach by assessing the role of midwives and the professional organization of the Indonesian Midwives Association (IBI) in reducing the risk of stunting in Central Sulawesi. The data of 288 midwives were collected using google form from 22 July 2020 to 22 August 2020. Data were analyzed by SPSS. Result: In general, midwives have provided maternal and child health books to pregnant women, recorded complete maternal and child health records, conducted antenatal care for pregnant women, provided nutritional food counseling for pregnant women, gave Fe 90 tablets to pregnant women, provided calcium tablets to pregnant women, conducting classes for pregnant women, delaying umbilical cord cutting (>30 minutes), providing vitamin A to postpartum mothers, conducting exclusive breastfeeding counseling, providing family planning services, providing IYCF counseling. However, for the activities of Implementing a special stunting prevention program, implementing postnatal care and initiating early breastfeeding still need improvement. Conclusion: The role of midwives in efforts to prevent stunting in Indonesia with midwives have provided maternal and child health books to pregnant women. Delaying umbilical cord cutting to 30 minutes, giving vitamin A to postpartum mothers, breastfeeding counseling, providing family planning services, providing IYCF counseling

The Effect of Counseling on Breastfeeding Self-Efficacy (BSFE) in Women with Gestational Diabetes

Background: Different strategies have been suggested to increase successful breastfeeding, including establishing child-friendly hospitals, prenatal training courses, and various counseling models in breastfeeding self-efficacy enhancement in women with gestational diabetes. Objectives: This study aimed to determine the effect of counseling on breastfeeding self-efficacy in women with gestational diabetes. Methods: The present study was a quasi-experimental intervention conducted on 100 pregnant women with gestational diabetes after obtaining informed consent. The intervention group received breastfeeding counseling based on the GATHER approach in the third trimester of pregnancy between 32 and 33 weeks and between 35 and 36 weeks of pregnancy, respectively. The follow-up process was performed in 4 sessions after delivery: 14 to 16 days after delivery and 28 to 30 days after delivery for 60 to 90 minutes. The control group, on the other hand, only received routine care. After counseling, self-efficacy was examined at the end of the study and after the third month. The data were analyzed using statistical independent t-tests and chi-square. Results : The mean score of self-efficacy of breastfeeding at the end of the study was 55.12 in the experimental group, which was higher than that of the control group (46.16) (P =0.0001). The frequency percentage of exclusive breastfeeding was 58% in the experimental group and 22% in the control group (P =0.0001). Conclusion: Considering the effectiveness of breastfeeding counseling on increasing self-efficacy and continuity of breastfeeding in diabetic breastfeeding mothers, it is suggested to use prenatal and continued in postnatal for diabetic mothers.

Peningkatan Pengetahuan dan Ketrampilan Kader melalui Pelatihan Konseling Menyusui di Puskesmas Nania Kota Ambon

The low coverage of exclusive breastfeeding is due to the lack of public understanding of the benefits and importance of exclusive breastfeeding for infant aged 0–6 months, so it is necessary to empower posyandu cadre as breastfeeding counsellor who provide counselling for mothers to Nania health center as counsellor breastfeeding. The purpose of this study is to improving the knowledge and skills of cadres through counseling training of breastfeeding at Nania Health Center Ambon. The community service partner is Nania Health center. The method used is training, assistance, monitoring and evaluation. The number of cadres trained was 40 people. The training took place at Nania health care, on 23–27 October 2019. There was an increase in the knowledge level of cadres about breastfeeding after being given breastfeeding counseling training, where most of the knowledge levels were good (67.5%). Cadres are skilled in providing breastfeeding counselling to mothers who have babies aged 0-6 months or pregnant women.

Breastfeeding Peer Counseling Experiences Among Low-Income Women in the US: A Qualitative Evaluation

Objectives Positive experiences with breastfeeding counseling is a key, but often overlooked aspect of high-quality, person-centered, and equitable breastfeeding services. We explored the experiences of women enrolled in the Breastfeeding Heritage and Pride program (BHP), an evidence-based breastfeeding peer counseling program serving predominately low-income minority women in Connecticut and Massachusetts throughout pregnancy and up to one year postpartum. Methods In-depth interviews were conducted with a purposive sample of 28 women receiving counseling from BHP peer counselors, community health workers who have successfully breastfed and completed specialized training on lactation management. Women were asked to describe their experiences with BHP and to share examples of when good quality counseling was and/or was not provided. Each interview was conducted in the woman's preferred language (English or Spanish), audio-recorded, and transcribed verbatim. Data were analyzed using thematic analysis, and findings were organized according to the World Health Organization quality of care framework for maternal and newborn health, which describes three domains important for promoting positive experiences: effective communication; respect and dignity; and emotional support. Results Peer counselors were described as “friendly,” “warm,” and “genuine” in their interactions, which encouraged open communication. Peer counselors provided timely, credible breastfeeding information and used everyday words that facilitated understanding. Women appreciated that peer counselors respected their infant feeding decisions, including choices to supplement breast milk with infant formula or stop breastfeeding, and did not raise their voices, use rude language, or make judgmental comments that would constitute “mom shaming.” Women felt peer counselors gave them the “strength” to continue breastfeeding through consistent encouragement, especially when they lacked support from friends and family. Conclusions Positive experiences with BHP were valued by women and empowered them to meet their breastfeeding goals, suggesting that efforts to expand access to high-quality breastfeeding peer counseling should measure and promote positive breastfeeding counseling experiences. Funding Sources NIH/NHLBI; CDC; W.K. Kellogg Foundation.

PENGARUH KONSELING GIZI TENTANG KONSUMSI DAUN KATUK DAN KACANG HIJAU DENGAN MEDIA BOOKLET TERHADAP PERILAKU IBU MENYUSUI DI KECAMATAN PERCUT SEI TUAN

ABSTRACT Breastmilk (ASI) is the best life fluid that is needed by babies, containing various important substances for the baby's growth and development according to their needs. The success of breastfeeding is influenced by the nutrients consumed by the mother during pregnancy and breastfeeding. This study was conducted to determine the effect of breastfeeding counseling using bookletters on breastfeeding behavior in Percut Sei Tuan District. This type of research is a quasi-experimental (Quasy experiment) with a pre-test research design and a post-test design with a comparison group. Conducted in March - August 2020, the samples were breastfeeding mothers in Percut Sei Tuan District in Cinta Rakyat Village as an intervention group and breastfeeding mothers in Cinta Damai Village as a comparison group. Samples and controls were selected by "purposive sampling" each of 30 samples. The data consisted of primary data and secondary data, processed and univariate analysis was carried out to see the frequency distribution based on knowledge and attitudes in the menu selection of breastfeeding mothers followed by bivariate analysis using the dependent t-test to compare knowledge, attitudes and actions of respondent eating before (pre) and after (post) counseling. From the research conducted, there were differences in the knowledge of mothers from the intervention group and the comparison group, there were differences in attitudes in the two groups, and there were differences in actions in the two groups after counseling using booklet media. Booklet-based counseling influences the mother's actions in breastfeeding her baby. Keywords: breastfeeding, counseling, booklets, breastfeeding behavior