Breastfeeding Medicine

Publications in this journal

• Article: Breastfeeding Mitigates a Disaster.

  Arthur I Eidelman
  Breastfeeding Medicine 05/2013;
• Article: Delaying the Bath and In-Hospital Breastfeeding Rates.

  Genevieve Preer, Jessica M Pisegna, John T Cook, Anne-Marie Henri, Barbara L Philipp
  [show abstract] [hide abstract]
  ABSTRACT: Abstract Background and Objective: Until 2010, newborns at our institution were bathed in the nursery at approximately 2 hours of life. In May 2010, infant baths were delayed until at least 12 hours of life. Infants are now bathed in the hospital room with parents' participation and are placed skin-to-skin immediately after the bath. This study explored whether delaying the newborn's first bath correlates with increased in-hospital breastfeeding rates at our Baby-Friendly, urban safety-net hospital. Subjects and Methods: We performed a retrospective chart review comparing in-hospital breastfeeding rates during the 6 months before and the 6 months after the bath was delayed. Results: Of the infants, 702 met inclusion criteria. Before the bath was delayed, infants were bathed at an average of 2.4 hours of life. Afterward, infants were bathed at an average of 13.5 hours of life. In-hospital exclusive breastfeeding rates increased from 32.7% to 40.2% (p<0.05) after the bath was delayed. Multivariate logistic regression analysis showed that infants born after implementation of delayed bathing had odds of exclusive breastfeeding 39% greater than infants born prior to the intervention (adjusted odds ratio [AOR]=1.39; 95% confidence interval [CI] 1.02, 1.91) and 59% greater odds of near-exclusive breastfeeding (AOR=1.59; 95% CI 1.18, 2.15). The odds of breastfeeding initiation were 166% greater for infants born after the intervention than for infants born before the intervention (AOR=2.66; 95% CI 1.29, 5.46). Conclusions: In our cohort, a delayed newborn bath was associated with increased likelihood of breastfeeding initiation and with increased in-hospital breastfeeding rates.
  Breastfeeding Medicine 05/2013;
• Article: Breastfeeding in Obstetrics Residency: Exploring Maternal and Colleague Resident Perspectives.

  Teresa A Orth, David Drachman, Patricia Habak
  [show abstract] [hide abstract]
  ABSTRACT: Abstract Background: Pregnancy is becoming more common in residency, and about 80% of residents are female. This leads to questions of breastfeeding, work demands, and perception of burden by colleagues. This study was designed to assess experiences of (1) breastfeeding obstetrics residents and (2) their colleagues. Materials and Methods: This was a cross-sectional study of obstetrics and gynecology residents. Residents were categorized into experience with or no experience with breastfeeding to determine differences. Results: Responses were obtained from 404 residents in obstetrics. Breastfeeding is common, with 90% of residents knowing a breastfeeding resident and 22% of residents reporting personal experience with breastfeeding. Breastfeeding residents (n=89) felt support from their faculty and fellow residents. More than one in three breastfeeding mothers felt they placed extra demands on colleagues, despite 80% of colleagues reporting that they did not feel that breastfeeding colleagues placed extra demands. A breastfeeding policy was important to 85% of residents, but only 7% believed their program had one. Two-thirds of breastfeeding residents struggled with low milk supply and stopped breastfeeding early. Conclusions: Despite high levels of perceived support from faculty/fellow residents, breastfeeding residents struggle with low milk supply and work demands that lead to early discontinuation.
  Breastfeeding Medicine 04/2013;
• Article: Is It Time to Celebrate?

  Ruth A Lawrence
  Breastfeeding Medicine 04/2013;
• Article: Breastfeeding Intentions Among Pregnant Adolescents and Young Adults and Their Partners.

  Heather L Sipsma, Anna A Divney, Urania Magriples, Nathan Hansen, Derrick Gordon, Trace Kershaw
  [show abstract] [hide abstract]
  ABSTRACT: Abstract Background: Rates of breastfeeding remain disproportionately low among young mothers in the United States. Although breastfeeding behavior may be most directly related to breastfeeding intention, little is known about breastfeeding intentions among young women who are expecting a baby. Subjects and Methods: Pregnant adolescents and young adults (14-21 years old) and their male partners were recruited for participation. Females were asked if they intended to breastfeed, and their partners were asked if they wanted their partners to breastfeed; participants indicated reasons for their responses. Logistic regression modeling was used to determine the associations between breastfeeding intentions and sociodemographic characteristics, relationship characteristics, and partner's intention to breastfeed. Results: Approximately 73% of females reported intending to breastfeed, and 80% of males reported wanting his partner to breastfeed, most commonly because it is "healthier for the baby" and "a more natural way to feed the baby." Sociodemographic and relationship characteristics explained a small amount of variance of breastfeeding intention (15% and 4% among females, respectively, and 8% and 4% among males, respectively). Partner intention explained an additional 23% and 24% of the variance in individual intention for females and males, respectively. Females who had experienced intimate partner violence (IPV) from their current partner had lower odds of intending to breastfeed (odds ratio=0.37; 95% confidence interval=0.16, 0.84). Race/ethnicity modified associations among both genders. Conclusions: These findings emphasize the importance of dyadic approaches and suggest strategies for improving breastfeeding intentions and behavior among young couples expecting a baby. These results are also among the first to document the relationship between IPV and breastfeeding intentions among young women.
  Breastfeeding Medicine 04/2013;
• Article: Outcome of Non-protractile Nipple Correction with Breast Cups in Pregnant Women: A Randomized Controlled Trial.

  Pharuhas Chanprapaph, Jinda Luttarapakul, Somprasong Siribariruck, Srisawat Boonyawanichkul
  [show abstract] [hide abstract]
  ABSTRACT: Abstract Objective: The benefit of antenatal nipple correction remains inconclusive. This study aims to demonstrate the value of breast cups in lengthening of short nipples and to compare the breastfeeding rate between the users and the nonusers. Subjects and Methods: Singleton pregnant women with at least one short nipple (<7.0 mm) were enrolled at a gestational age (GA) of 16-20 weeks. All participants were randomly allocated into the breast cup group (BC group) and the expectant group (EX group). The first group was requested to wear breast cups for at least 8 hours during the daytime, whereas the second group was not. The nipple length was evaluated prior to the study and at every visit until GA of 36 weeks by the same blinded evaluator. Results: Among 90 eligible participants (43 in the BC group, 47 in the EX group), the nipple elongation in the BC group was significantly higher than in the EX group (2.37±1.29 mm versus 1.84±0.98 mm; p=0.032), with a mean difference of 0.53±0.24 mm (95% confidence interval 0.05, 1.01). On Day 3, there was an insignificantly higher number of mothers with a LATCH score of ≥7 in the BC group. The 3-month exclusive breastfeeding rate in the BC group was insignificantly greater than that of the EX group (65.39% versus 50.0%; p=0.35). Conclusions: Breast cups are safe and well tolerated by users and evidently increase the length of short nipples and enhance the exclusive breastfeeding rate.
  Breastfeeding Medicine 04/2013;
• Article: Prevalence and Causes of Exclusive Breastfeeding Failure in 6 Months After Birth in Iranian Infants.

  Saeedi Reza, Shaghayegh Rahmani, Jafar-Zadeh Isfahani Mohsen, Raouf Yazdi-Nejad Saeedeh
  Breastfeeding Medicine 04/2013;
• Article: Baby-Friendly Hospitals and Cesarean Section Rate: A Survey of Italian Hospitals.

  Simona Di Mario, Adriano Cattaneo, Carlo Gagliotti, Claudio Voci, Vittorio Basevi
  [show abstract] [hide abstract]
  ABSTRACT: Abstract Background: The Baby-Friendly Hospital Initiative aims at protecting, promoting, and supporting breastfeeding. Cesarean section is known to represent an obstacle to breastfeeding. In this observational study we compared Baby-Friendly and non-Baby-Friendly hospitals (BFHs and non-BFHs, respectively) in terms of cesarean section rate. Materials and Methods: Italian BFHs were compared with non-BFHs located in the same regions. Data used for analysis were type of hospital, annual deliveries, annual cesarean section deliveries, region of location, and BFH status. The primary outcome was a cesarean section rate below a threshold specific for the identified regions; because of skewed distribution, the median rate was chosen. Descriptive and comparative univariate and multivariate analyses were carried out. Results: In 2009, in Italy, there were 20 BFHs located in eight regions. Compared with the 207 non-BFHs with more than 200 annual deliveries located in the same regions, BFHs had a cesarean section rate below the median of the eight regions (30.4%; interquartile range 14.6%), even after adjustment for confounders (adjusted odds ratio, 12.71; 95% confidence interval, 1.84, 87.72). In addition, being a public hospital, performing a higher number of deliveries, and being located in specific regions also predicted a cesarean section rate below the median. Overall, the regions with at least one BFH showed a lower cesarean section rate, compared with regions without BFHs. Discussion: In Italy there are few BFHs, but regions with at least one BFH show a cesarean section rate below the national median. Several factors impact on the cesarean section rate, causing huge variation among regions. Nevertheless, within the same region, BFHs have a lower cesarean section rate compared with non-BFHs.
  Breastfeeding Medicine 04/2013;
• Article: Factors Affecting the Demarketing of Breastmilk Substitutes in Palestine.

  Mohammad Zedan Yehia Salem
  [show abstract] [hide abstract]
  ABSTRACT: Abstract Background: Although medical research has proven that breastfeeding is unparalleled in providing the ideal nutrition for infants, "the demarketing of breastmilk substitutes" is a little-known concept. This empirical study tackled the origin and definition of demarketing, examined the different factors affecting the demarketing of breastmilk substitutes in Palestine from the breastfeeding woman's point of view, and developed an appropriate model for the demarketing of breastmilk substitutes. The article subsequently concludes with recommendations for areas of further academic research in the World Health Assembly, for policy makers in Palestine, and for the breastfeeding women themselves. Subjects and Methods: An empirical study was conducted to collect the primary data using a questionnaire as a tool in order to test the hypotheses. The questionnaire was distributed to 400 breastfeeding women who were randomly selected from the population. Results: The findings proved that there is a relationship between independent variables (i.e., product, price, place, and promotion) and the dependent variable (i.e., demarketing of breastmilk substitutes) based on several reasons discussed thoroughly in this article. Conclusions: Product, price, place, and promotion affect the demarketing of breastmilk substitutes in Palestine.
  Breastfeeding Medicine 04/2013;
• Article: Development of the Breastfeeding Quality Improvement in Hospitals Learning Collaborative in New York State.

  Eileen Fitzpatrick, Barbara A Dennison, Sara Bonam Welge, Stephanie Hisgen, Patricia Simino Boyce, Patricia A Waniewski
  [show abstract] [hide abstract]
  ABSTRACT: Abstract Exclusive breastfeeding is a public health priority. A strong body of evidence links maternity care practices, based on the Ten Steps to Successful Breastfeeding, to increased breastfeeding initiation, duration and exclusivity. Despite having written breastfeeding policies, New York (NY) hospitals vary widely in reported maternity care practices and in prevalence rates of breastfeeding, especially exclusive breastfeeding, during the birth hospitalization. To improve hospital maternity care practices, breastfeeding support, and the percentage of infants exclusively breastfeeding, the NY State Department of Health developed the Breastfeeding Quality Improvement in Hospitals (BQIH) Learning Collaborative. The BQIH Learning Collaborative was the first to use the Institute for Health Care Improvement's Breakthrough Series methodology to specifically focus on increasing hospital breastfeeding support. The evidence-based maternity care practices from the Ten Steps to Successful Breastfeeding provided the basis for the Change Package and Data Measurement Plan. The present article describes the development of the BQIH Learning Collaborative. The engagement of breastfeeding experts, partners, and stakeholders in refining the Learning Collaborative design and content, in defining the strategies and interventions (Change Package) that drive hospital systems change, and in developing the Data Measurement Plan to assess progress in meeting the Learning Collaborative goals and hospital aims is illustrated. The BQIH Learning Collaborative is a model program that was implemented in a group of NY hospitals with plans to spread to additional hospitals in NY and across the country.
  Breastfeeding Medicine 04/2013;
• Article: Low-income Inner-City Fathers and Breastfeeding-Where's the Program for Us?

  Elizabeth Banks, Steve Killpack, Lydia Furman
  Breastfeeding Medicine 04/2013;
• Article: Breastfeeding May Protect from Developing Attention-Deficity/Hyperactivity Disorder.

  Aviva Mimouni-Bloch, Anna Kachevanskaya, Francis Benjamin Mimouni, Avinoam Shuper, Eyal Raveh, Nehama Linder
  [show abstract] [hide abstract]
  ABSTRACT: Abstract Introduction: Breastfeeding has a positive influence on physical and mental development. Attention-deficit/hyperactivity disorder (ADHD) is a common neurobehavioral disorder with major social, familial, and academic influences. The present study aimed to evaluate whether ADHD is associated with a shorter duration of breastfeeding. Subjects and Methods: In this retrospective matched study, children 6-12 years old diagnosed at Schneider's Children Medical Center (Petach Tikva, Israel) with ADHD between 2008 and 2009 were compared with two control groups. The first one consisted of healthy (no ADHD) siblings of ADHD children; the second control group consisted of children without ADHD who consulted at the otolaryngology clinic. A constructed questionnaire about demographic, medical, and perinatal findings, feeding history during the first year of life, and a validated adult ADHD screening questionnaire were given to both parents of every child in each group. Results: In children later diagnosed as having ADHD, 43% were breastfed at 3 months of age compared with 69% in the siblings group and 73% in the control non-related group (p=0.002). By 6 months of age 29% of ADHD children were breastfed compared with 50% in the siblings group and 57% in the control non-related group (p=0.011). A stepwise logistic regression that included the variables found to be significant in univariate analysis demonstrated a significant association between ADHD and lack of breastfeeding at 3 months of age, maternal age at birth, male gender, and parental divorce. Conclusions: Children with ADHD were less likely to breastfeed at 3 months and 6 months of age than children in the two control groups. We speculate that breastfeeding may have a protective effect from developing ADHD later in childhood.
  Breastfeeding Medicine 04/2013;
• Article: Breastfeeding Attitudes: Association Between Maternal and Male Partner Attitudes and Breastfeeding Intent.

  Kristen Mitchell-Box, Kathryn L Braun, Eric L Hurwitz, Donald K Hayes
  [show abstract] [hide abstract]
  ABSTRACT: Abstract Breastfeeding is considered the best infant feeding method, yet initiation and duration rates in the United States are lower than recommended by medical and public health professionals. Positive attitudes toward breastfeeding of the male partner are important in a mother's success at initiating and maintaining breastfeeding. This study measured the infant feeding attitudes of low-income women and their male partners using the Iowa Infant Feeding Attitude Scale (IIFAS), investigated the reliability and validity of the measure in male partners, and examined the associations of the partner's attitudes with the mother's attitudes and intention to breastfeed. A convenience sample of 112 pregnant women and their male partners completed a survey including sociodemographic items, the IIFAS, and their intended infant feeding method in the hospital and in the first few weeks after the infant's birth (breastfeeding, formula feeding, mixed, and don't know). Mother's and partner's IIFAS scores were highly correlated, and higher scores of both mothers and partners were significantly associated with their intentions to breastfeed. With each increased point on mother's and partner's IIFAS scores, the odds that the mother and her partner intended to breastfeed in the first few weeks increased 12% and 20%, respectively. This is the first U.S. study to validate the IIFAS with male partners. Future research on breastfeeding attitudes and attitude-changing interventions is needed to see if improving partners' attitudes toward breastfeeding will also improve mothers' attitudes and if that increases initiation and duration of breastfeeding.
  Breastfeeding Medicine 04/2013;
• Article: Can Excessive Breastfeeding Be the Cause for the Upside-Down Rotation of a Breast Implant? A Case Report.

  Saime Irkoren, Nazan Sivrioglu
  Breastfeeding Medicine 04/2013;
• Article: Longitudinal Changes in Breastfeeding Patterns from 1 to 6 Months of Lactation.

  Jacqueline C Kent, Anna R Hepworth, Jillian L Sherriff, David B Cox, Leon R Mitoulas, Peter E Hartmann
  [show abstract] [hide abstract]
  ABSTRACT: Abstract Objective: The most common reason given for discontinuation of exclusive breastfeeding is perceived insufficient milk supply. Breastfed infants show more variation in feeding frequency than bottle-fed infants, and this may lead to a mother lacking confidence in her milk supply if the frequency of breastfeeding sessions does not match expectations based on bottle feeding. We aimed to assist clinicians in supporting breastfeeding mothers by providing evidence-based information on expected changes in breastfeeding patterns and milk intake during exclusive breastfeeding for 6 months. Subjects and Methods: Mothers and their healthy infants who were exclusively breastfeeding (total 24-hour milk intake within the normal range) were studied during two to five 24-hour periods between 1 and 6 months of lactation. Results: Between 1 and 3 months of lactation, the frequency of breastfeeding sessions decreased, whereas both the median and maximum breastmilk intakes during each breastfeeding session increased. These parameters remained constant between 3 and 6 months. The duration of each breastfeeding session decreased steadily from 1 to 6 months, but the total 24-hour milk intake remained constant. Conclusions: Breastfeeding becomes more efficient between 1 and 3 months of lactation, although milk intake remains constant. Clinicians can give mothers confidence that these changes in breastfeeding behavior do not indicate insufficient milk supply, but may be a result of the increase in the stomach capacity of the infants and are an expected outcome of a healthy, normal breastfeeding relationship.
  Breastfeeding Medicine 04/2013;
• Article: It takes a village and beyond to support breastfeeding.

  Arthur I Eidelman
  Breastfeeding Medicine 04/2013; 8:243-4.
• Article: A tribute: honorary academy of breastfeeding medicine founder C. Everett koop, MD.

  Ruth A Lawrence
  Breastfeeding Medicine 04/2013; 8:149-50.
• Article: With gratitude to our global protocol reviewers.

  Kathleen A Marinelli
  Breastfeeding Medicine 04/2013; 8:245.
• Article: ABM Clinical Protocol #14: Breastfeeding-Friendly Physician's Office: Optimizing Care for Infants and Children, Revised 2013.

  Amy E Grawey, Kathleen A Marinelli, Alison V Holmes And The Academy Of Breastfeeding Medicine
  [show abstract] [hide abstract]
  ABSTRACT: A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.
  Breastfeeding Medicine 04/2013; 8:237-42.
• Article: Breastfeeding Initiation in the Context of a Home Intervention to Promote Better Birth Outcomes.

  Sharon M Karp, Abigail Howe-Heyman, Mary S Dietrich, Melanie Lutenbacher
  [show abstract] [hide abstract]
  ABSTRACT: Abstract Objective: This secondary analysis examined breastfeeding initiation rates and factors related to initiation in a sample of multiparous women with a history of a prior preterm birth. Subjects and Methods: Data for a subsample of women (n=130) were derived from a randomized clinical trial testing a home visit intervention to improve birth outcomes. The subsample included women who gave birth to an infant greater than 35 weeks of gestation. All participants received standard prenatal care. Intervention participants (n=73) also received home visits by certified nurse-midwives. Visits were guided by protocols to improve factors associated with poor birth outcomes and maternal and infant health. Descriptive and logistic regression analyses were used, controlling for factors previously associated with breastfeeding. Results: Although 85% of women reported an intention to breastfeed, only 65% reported initiating breastfeeding at 48 hours postpartum. After controlling for race, income, marital status, smoking, and age, higher maternal education and lower pregravid body mass index were associated with higher rates of initiation (odds ratio [OR]=1.30, p=0.010 and OR=0.94, p=0.007, respectively). Lower levels of depressive symptoms (OR=0.95, p=0.039) and higher levels of prenatal stress (OR=1.11, p=0.042) increased the likelihood of initiating breastfeeding. No difference between groups emerged, although women in the intervention group with more home visit time were more likely to report breastfeeding (p=0.007). Conclusions: Modifiable risk factors were associated with rates of breastfeeding initiation. It may be possible to use protocols delivered via nurse-midwife home visits within a global intervention to increase breastfeeding initiation.
  Breastfeeding Medicine 03/2013;