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Perception of Not Having Enough Milk and Actual Milk Production of First-Time Breastfeeding Mothers: Is There a Difference?
Abstract
Objective:
This study aimed to determine the relationship between perceived insufficient milk supply (PIMS) and actual insufficient milk supply (AIMS) and the relative contributions of physiological and psychosocial variables on both PIMS and AIMS of first-time breastfeeding mothers.
Participants and methods:
Data were collected among 123 breastfeeding mothers at a Canadian, French-speaking maternal care hospital. Birth events, breastfeeding practices, infant and maternal capacities, and PIMS and AIMS were collected at 48 hours after birth, postnatal weeks 2 and 6.
Results:
No significant relationship was found between PIMS and AIMS. Maternal breastfeeding self-efficacy and number of feeds were related to PIMS at week 2, and skin-to-skin contact at birth and number of feeds were related to AIMS as measured by 24-hour milk production at week 2.
Conclusion:
Maternal breastfeeding self-efficacy impacts PIMS. Interventions should be directed to increase maternal confidence in breastfeeding, which in turn influences breastfeeding duration.
... This can be done if the baby sucks well, the breasts are healthy and can produce breast milk, and the secretion of breast milk is smooth. Furthermore, the indicators that can be seen are the well-sleeping baby and after breastfeeding baby's sleep [33]. In addition, the baby's weight has increased according to the baby's growth chart, more or less five times defecation, and 7-10 times urination. ...
... In addition, previous studies also mentioned that the smoothness of breast milk production was examined by babies not losing 10% of the baby's birth weight during the first week of the birth [24]. Weight gain is one gram equivalent to 1 mL of breast milk intake [33]. ...
... However, the production of breast milk in lactogenesis II and III, particularly the first two weeks of breastfeeding, is a marker of successful breastfeeding. In addition, early initiation of breastfeeding, quality foods, such as Moringa leaf and Sauropus Androgynus, and the frequency of breastfeeding are the factor that influences the success of breastfeeding, and it can be associated with the results of the 48-hour baby weight [33]. A sort of advantage is obtained for nursing mothers to consume galactagogue, especially moringa leaf jelly. ...
The failure of exclusive breastfeeding and the increased use of milk formulas is one of the results of a shortage of breast milk production. Moringa leaf contains phytosterol to increase milk production. Fortification of moringa leaf with jelly will increase the nutritional value of moringa leaf so that the prolactin increases and the production and quality of breast milk get better for babies. This study aimed to determine the effect of moringa leaf jelly on increasing milk production (prolactin, breast milk volume), and the outcome for the baby. Quasi-experimental research using pre-postest with control group design. The study respondents were taken with a purposive sampling technique of 58 people. Outcome indicators for babies are seen from the baby’s weight, the baby's urination frequency, the baby's defecation, and the baby's sleep duration. There was a significant effect on the increase in prolactin score by 23.3%, breast milk volume by 47%, and outcome babies by 3.3% in respondents given moringa leaf jelly. Meanwhile, respondents who were not given Moringa leaf jelly had a risk of decreasing prolactin levels 10.5 times, breast milk supply was 3.8 times lower and the outcomes for babies were 15 than those given Moringa leaf jelly. The moringa leaf jelly significantly effects increasing milk production and outcomes for babies compared to standard interventions.
... Infants wt/age from both groups were above the NCHS mean. (Galipeau et al., 2017;Graffy, 1992;Hill & Aldag, 1991;McCann & Bender, 2006;Mohebati et al., 2021;Moll Pons et al., 2012;Monteiro et al., 2011;Perez-Escamilla et al., 1992;Segura-Millán et al., 1994;Tully & Dewey, 1985;Wood et al., 2017), baby's loss of interest in breastfeeding or breast refusal (Amir & Cwikel, 2005;Hill & Aldag, 1991;O'Sullivan et al., 2015), baby not satisfied with feeding (Cooke et al., 2003;Moll Pons et al., 2012;Monteiro et al., 2011), or perceived poor sucking (three out of three studies) (Galipeau et al., 2017;Hill & Aldag, 1991;Mizuno et al., 2004) identified them as SRIM risk factors . ...
... Infants wt/age from both groups were above the NCHS mean. (Galipeau et al., 2017;Graffy, 1992;Hill & Aldag, 1991;McCann & Bender, 2006;Mohebati et al., 2021;Moll Pons et al., 2012;Monteiro et al., 2011;Perez-Escamilla et al., 1992;Segura-Millán et al., 1994;Tully & Dewey, 1985;Wood et al., 2017), baby's loss of interest in breastfeeding or breast refusal (Amir & Cwikel, 2005;Hill & Aldag, 1991;O'Sullivan et al., 2015), baby not satisfied with feeding (Cooke et al., 2003;Moll Pons et al., 2012;Monteiro et al., 2011), or perceived poor sucking (three out of three studies) (Galipeau et al., 2017;Hill & Aldag, 1991;Mizuno et al., 2004) identified them as SRIM risk factors . ...
... BF self-efficacy was protective against SRIM in all studies examining it (n = 10)(Galipeau et al., 2017; Gokceoglu & Kucukoglu, 2017;Gumussoy et al., 2020;Hill & Aldag, 1991;T. Li, Guo et al., 2019;McCarter-Spaulding & Kearney, 2001;Menekse et al., 2021;Otsuka et al., 2008;Sandhi et al., 2020;Segura-Millán et al., 1994). ...
The objective of this systematic review was to identify multifactorial risk factors for self-reported insufficient milk (SRIM) and delayed onset of lactation (DOL). The review protocol was registered a priori in PROSPERO (ID# CDR42021240413). Of the 120 studies included (98 on SRIM, 18 on DOL, and 4 both), 37 (31%) studies were conducted in North America, followed by 26 (21.6%) in Europe, 25 (21%) in East Asia, and Pacific, 15 (12.5%) in Latin America and the Caribbean, 7 (6%) in the Middle East and North Africa, 5 (4%) in South Asia, 3 (2.5%) in Sub-Saharan Africa, and 2 (1.7%) included multiple countries. A total of 79 studies were from high-income countries, 30 from upper-middle-income, 10 from low-middle-income countries, and one study was conducted in a high-income and an upper-middle-income country. Findings indicated that DOL increased the risk of SRIM. Protective factors identified for DOL and SRIM were hospital practices, such as timely breastfeeding (BF) initiation, avoiding in-hospital commercial milk formula supplementation, and BF counselling/support. By contrast, maternal overweight/obesity, caesarean section, and poor maternal physical and mental health were risk factors for DOL and SRIM. SRIM was associated with primiparity, the mother's interpretation of the baby's fussiness or crying, and low maternal BF self-efficacy. Biomedical factors including epidural anaesthesia and prolonged stage II labour were associated with DOL. Thus, to protect against SRIM and DOL it is key to prevent unnecessary caesarean sections, implement the Baby-Friendly Ten Steps at maternity facilities, and provide BF counselling that includes baby behaviours.
... [1][2][3] Various presentations of insufficient milk supply can be described, including a primary, secondary, or perceived insufficient milk supply. 4,5 A primary insufficient milk supply results when a woman is physiologically unable to make a full milk supply to meet her infant's needs, while a secondary insufficient milk supply results from suboptimal breastfeeding management. 4,5 A perceived insufficient milk supply is defined as when a woman believes she is not making sufficient breast milk to satisfy her infant's needs regardless of whether a primary or secondary insufficient milk supply exists or not. ...
... 4,5 A primary insufficient milk supply results when a woman is physiologically unable to make a full milk supply to meet her infant's needs, while a secondary insufficient milk supply results from suboptimal breastfeeding management. 4,5 A perceived insufficient milk supply is defined as when a woman believes she is not making sufficient breast milk to satisfy her infant's needs regardless of whether a primary or secondary insufficient milk supply exists or not. 5 It is unknown what proportion of women who report ceasing breastfeeding early due to an insufficient milk supply have a primary, secondary, or perceived insufficient milk supply. ...
... 4,5 A perceived insufficient milk supply is defined as when a woman believes she is not making sufficient breast milk to satisfy her infant's needs regardless of whether a primary or secondary insufficient milk supply exists or not. 5 It is unknown what proportion of women who report ceasing breastfeeding early due to an insufficient milk supply have a primary, secondary, or perceived insufficient milk supply. ...
Introduction:
Insufficient milk supply is the most common reason for premature breastfeeding cessation. Breast hypoplasia is one reason why women may be inherently unable to make a full milk supply. This review aimed to systematically explore the relationship between breast hypoplasia and breastfeeding duration, milk supply, and lactation onset.
Materials and Methods:
Medline, CINAHL, ProQuest Central, and the Cochrane Library databases were searched using the keywords "insufficient glandular tissue" or "mammary hypoplasia" or "breast hypoplasia" or "mammary gland hypoplasia" or "droopy breasts" or "snoopy deformity" or "tubular breast*" or "tuberous breast*" AND breastfeeding or "breast feeding" or breast-feeding or lactation. After initially screening 20 records, including reference lists, 9 full texts were assessed for eligibility; 2 were excluded as no breastfeeding outcomes were reported, leaving 7 studies (N = 42 women).
Results:
The studies in this review drew on results from the oldest included study and plastic surgery literature to define breast hypoplasia. Most women in this review (40/42) ceased exclusive breastfeeding before 1 month postpartum. One case study reported 24-hour milk production, which was 52 mL at 26 weeks postpartum.
Conclusion:
The relationship between breast hypoplasia and breastfeeding outcomes is underresearched. The co-occurring medical conditions (e.g., polycystic ovary syndrome) of some women provide avenues for future research into the possible pathogenesis of breast hypoplasia resulting in insufficient milk supply. Research is needed to evaluate the reliability of measuring and classifying markers of breast hypoplasia, and prospective studies can help determine the role of breast hypoplasia in milk production. PROSPERO registration number CRD42020191228.
... Women are said to make a full milk supply if they produce sufficient human milk to fully meet their infant's growth and development needs without the need for any supplementary milk. Insufficient milk supply can be categorized into primary, secondary, and perceived insufficient milk supply (Galipeau et al., 2017). A primary insufficient milk supply refers to when women are inherently unable to produce a full milk supply. ...
... A primary insufficient milk supply refers to when women are inherently unable to produce a full milk supply. Secondary insufficient milk supply results from factors that limit the frequency or effectiveness of milk removal from women's breasts (Galipeau et al., 2017). A perceived insufficient milk supply occurs when women believe they are not making enough human milk to satisfy their infant regardless of whether an insufficient milk supply actually exists (Galipeau et al., 2017). ...
... Secondary insufficient milk supply results from factors that limit the frequency or effectiveness of milk removal from women's breasts (Galipeau et al., 2017). A perceived insufficient milk supply occurs when women believe they are not making enough human milk to satisfy their infant regardless of whether an insufficient milk supply actually exists (Galipeau et al., 2017). Although breastfeeding mothers commonly report insufficient milk supply for ceasing breastfeeding earlier than desired (Hornsby et al., Huggins et al. (2000). ...
Background
Breast hypoplasia is one reason for insufficient milk supply. Case reports use wide intra-mammary width and certain breast appearances as markers of breast hypoplasia. However, the reliability of these variables has not been determined.
Research aims
To test the (i) interrater and intrarater reliability of intra-mammary width measurement and interrater reliability of categorizing women’s breasts into breast types, and (ii) feasibility and acceptability of study procedures for the participants.
Methods
This was a prospective, longitudinal, non-experimental design with survey and observational components of a convenience sample of early postpartum women ( N = 31). Interrater and intrarater reliability were measured using intraclass correlation coefficient for agreement for intra-mammary width measurements. Interrater reliability was measured using weighted kappa for agreement for categorizing breast type. Feasibility and acceptability of study procedures were collected 1 month later.
Results
Excellent intrarater and interrater reliability for the intra-mammary width measurement (ICC = 0.99, 95% CI [0.99, 0.997] and ICC = 0.88, 95% CI [0.74, 0.94], respectively) and fair interrater reliability for breast type categorization (k = 0.35, 95% CI [−0.05, 0.75]) with high level of agreement between raters (97%) were achieved. Proportions of participants agreeing to breast photography and acceptability of study procedures were 68% (21/31) and 100% (28/28) respectively.
Conclusion
The excellent reliability for the intra-mammary width measurement means it provides a useful measure for future research. Since the “fair” reliability of categorizing breast type was due to lack of breast shape range in our sample, future research could assess the breasts of women with different medical profiles.
... If another milk is not introduced and the breast is adequately stimulated, PIM may be limited to a perception, rather than a self-fulfilling prophecy. This is suggested by a study which showed no significant association between PIM and 24-h milk production at week 2 (Galipeau, Dumas, & Lepage, 2017). ...
... Decreased breast milk sodium is a marker for the onset of lactation and has been associated with increased breastfeeding frequency (Galipeau, Goulet, & Chagnon, 2012). Decreased breastfeeding frequency is therefore associated both with DOL as well as PIM (Galipeau, Dumas, & Lepage, 2017) and cannot be ignored in a more detailed exploration of PIM. ...
... Lactation problems including nipple soreness and infant latching problems can lead to inadequate and/or infrequent removal of milk from the breast, lowering milk production in the fine-tuned demand and supply process that characterizes breastfeeding (Neifert, 2004). Previous literature also suggested that factors such as infant crying (Sacco, Caulfield, Gittelsohn, & Martinez, 2006;Segura-Millan, Dewey, & Perez-Escamilla, 1994), DOL (Perez-Escamilla, Buccini, Segura-Perez, & Piwoz, 2019; Segura-Millan, Dewey, & Perez-Escamilla, 1994) and number of breastfeeds (Galipeau, Dumas, & Lepage, 2017) were likely to be significantly associated with PIM, but this was not the case for our data. We considered that women who experienced the initial hurdles of DOL and/or PIM and were not giving any formula at 1 week may have been more committed to breastfeeding their infant. ...
Breastfeeding mothers often report perceived insufficient milk (PIM) believing their infant is crying too much, which leads to introducing formula and the early abandonment of breastfeeding. We sought to determine if infant crying was associated with reported PIM (yes/no) and number of problems associated with lactation (lactation problem score [LPS] 6‐point Likert scale) before formula introduction. Primiparous breastfeeding mothers were recruited at birth and visited at 1, 2 and 4 weeks. Among those fully breastfeeding at 1 week (N = 230), infant crying variables based on maternal reports were not associated with PIM at 1 week, but LPS was. However, a mother's expectation that her infant would cry more than other infants was associated with increased odds of reporting PIM at 2 and 4 weeks, as were delayed onset of lactation and previous LPS. At 1 week, crying variables (frequency, difficulty in soothing) were associated with LPS along with percent weight change. Delayed onset of lactation, infant care style, number of breastfeeds and previous LPS were longitudinally associated with change in LPS from 1 to 2 weeks and 2 to 4 weeks. Our data suggest that reported infant crying is associated with PIM and LPS in the first 4 weeks of life. Guidance on what to expect in crying behaviour and the impact of infant care style may be beneficial in reducing PIM and LPS in the first month.
... Apoio à mama em "C" (como taça) (100102) 15 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)40,48,53,56) Reconhecimento da deglutição do lactente (100106) 14 (17)(18)(19)(20)(21)25,(30)(31)(32)(33)35,37,43,54) Reconhecimento de sinais precoces de fome (100113) 14 (17)(18)(19)(20)(21)25,(30)(31)(32)(33)35,37,43,54,55) Técnicas para prevenir a sensibilidade do mamilo (100121) 13 (17,(21)(22)(23)(24)26,28,32,35,40,48,53,56) Evita uso de mamilo artificial com o lactente (100109) 11 (12,19,20,24,30,32,40,45,53,54,57) Ingestão de líquido pela mãe (100120) 7 (30,33,39,40,44,50,54) Bombeamento da mama (100123) 7 (27,32,39,41,48,50,57) Armazenamento seguro do leite materno (100115) 6 (27,32,39,41,48,50) Resposta ao temperamento do lactente (100112) 2 (18,31) Sucção interrompida antes da retirada do lactente da mama (100107) 0 Estabelecimento da Amamentação: lactente (1000) n=43 ...
... Apoio à mama em "C" (como taça) (100102) 15 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)40,48,53,56) Reconhecimento da deglutição do lactente (100106) 14 (17)(18)(19)(20)(21)25,(30)(31)(32)(33)35,37,43,54) Reconhecimento de sinais precoces de fome (100113) 14 (17)(18)(19)(20)(21)25,(30)(31)(32)(33)35,37,43,54,55) Técnicas para prevenir a sensibilidade do mamilo (100121) 13 (17,(21)(22)(23)(24)26,28,32,35,40,48,53,56) Evita uso de mamilo artificial com o lactente (100109) 11 (12,19,20,24,30,32,40,45,53,54,57) Ingestão de líquido pela mãe (100120) 7 (30,33,39,40,44,50,54) Bombeamento da mama (100123) 7 (27,32,39,41,48,50,57) Armazenamento seguro do leite materno (100115) 6 (27,32,39,41,48,50) Resposta ao temperamento do lactente (100112) 2 (18,31) Sucção interrompida antes da retirada do lactente da mama (100107) 0 Estabelecimento da Amamentação: lactente (1000) n=43 ...
... Apoio à mama em "C" (como taça) (100102) 15 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)40,48,53,56) Reconhecimento da deglutição do lactente (100106) 14 (17)(18)(19)(20)(21)25,(30)(31)(32)(33)35,37,43,54) Reconhecimento de sinais precoces de fome (100113) 14 (17)(18)(19)(20)(21)25,(30)(31)(32)(33)35,37,43,54,55) Técnicas para prevenir a sensibilidade do mamilo (100121) 13 (17,(21)(22)(23)(24)26,28,32,35,40,48,53,56) Evita uso de mamilo artificial com o lactente (100109) 11 (12,19,20,24,30,32,40,45,53,54,57) Ingestão de líquido pela mãe (100120) 7 (30,33,39,40,44,50,54) Bombeamento da mama (100123) 7 (27,32,39,41,48,50,57) Armazenamento seguro do leite materno (100115) 6 (27,32,39,41,48,50) Resposta ao temperamento do lactente (100112) 2 (18,31) Sucção interrompida antes da retirada do lactente da mama (100107) 0 Estabelecimento da Amamentação: lactente (1000) n=43 ...
O objetivo foi identificar na literatura os indicadores dos Resultados de Enfermagem relacionados ao “Estabelecimento da amamentação”. Revisão Integrativa da literatura, que abrangeu estudos das bases de dados LILACS, PUBMED, CINAHL, SCOPUS, Web of Science, BDENF e EMBASE, em Português, Inglês e Espanhol, publicados de 2013 a 2017. Identificados 43 estudos, que contemplaram 17 dos 18 indicadores do “Estabelecimento da amamentação: mãe” e 12 dos 13 indicadores do “Estabelecimento da amamentação: lactente”. Quatro indicadores poderiam ser incluídos, segundo a análise dos dados. A maioria dos indicadores propostos pela Classificação dos Resultados de Enfermagem apresentou suporte na literatura, embora alguns demandem ajustes para descrição mais objetiva dos aspectos avaliados. Indicadores podem orientar a avaliação da amamentação de forma contínua, bem como da efetividade das intervenções, além de tornarem o registro padronizado e poderem auxiliar o processo educativo de estudantes e enfermeiros.
... Furthermore, 'perceived low supply' refers to when a woman believes her milk production is insufficient regardless of whether a true low supply exists or not. [6] In Huang and colleagues' systematic review, quantitative and qualitative data demonstrated that infant crying is a common factor in women's perception of low supply. [7]. ...
... (5) RLK then applied the draft template to the full dataset. (6) The team met regularly to discuss the template, adding new codes and editing codes as necessary. (7) To confirm that each response had been accurately coded in accordance with the final template, RLK reviewed the responses allocated to each code. ...
... Breast milk production remains one of the di culties encountered by these women. Galipeau et al. explained that the perception of insu cient milk production was reinforced when the infant's ability to suck was not effective [41]. Genetic variations [42], breast capacity to produce milk [43] and low frequency of mammary gland stimulation in uence the amount of milk transferred to the child. ...
... Genetic variations [42], breast capacity to produce milk [43] and low frequency of mammary gland stimulation in uence the amount of milk transferred to the child. In fact, addressing milk insu ciency remains di cult because of lack of accurate tools to diagnose that the causes affect their lactation performance [41]. ...
Background
Pregnancy and breastfeeding periods have linked to some dietary modification that can potentially impact maternal and offspring health. Therefore, maternal nutrition during these periods is essential. The objective of this study was to assess dietary changes during pregnancy and breastfeeding, and the reasons behind these changes.
Methods
The study adopted a qualitative approach by submitting a questionnaire to 140 breastfeeding and 45 pregnant women to investigate dietary intake and any changes during these stages. The survey was conducted in 8 villages in rural areas, with groups of women farmers, on a voluntary basis. Data analysis was done manually using the thematic framework analysis method.
Results
62% of women reported having reduced or eliminated their intake of at least one food group (cereals, starchy roots, tubers, or nuts) during pregnancy. The reasons of these changes were gastrointestinal issues. 92% increased their intake of at least one food group (cereals, starchy roots, tubers, or eggs) to satisfy cravings during pregnancy. 42% of breastfeeding women eliminated fruits like mango and cashew apple from their diet. This reduction of fruits was because of concerns for the health of baby and breastmilk quality. To stimulate breast milk production, women increase their intake of cow's milk and dairy products.
Conclusion
Our findings have shown that during these stages many women change dietary intake for various reasons including gastrointestinal issues and health concerns. These results call for a need to focus on education and counselling, to improve women's nutritional knowledge and address any concerns they may have on food choices and impact on either pregnancy or breastfeeding.
... Galipeau ve ark. (37) tarafından yapılan çalışmada kadınların yetersiz süt algısının gerçek süt üretimi eksikliği ile ilişkili olmadığı, emzirme özyeterliliği ile ilişkili olduğu belirtilmektedir (37,38) . ...
... Galipeau ve ark. (37) tarafından yapılan çalışmada kadınların yetersiz süt algısının gerçek süt üretimi eksikliği ile ilişkili olmadığı, emzirme özyeterliliği ile ilişkili olduğu belirtilmektedir (37,38) . ...
Özet
Amaç: Günümüzde emzirme danışmanlığı hizmetleri laktasyon poliklinikleri kapsamında sürdürülmektedir. Yürütülen hizmetin niteliğini artırmada bu birimlerden hizmet alan annelerin başvuru nedenlerini ve hizmetten nasıl faydalandıklarını bilmek önemlidir. Bu nedenle çalışma Laktasyon Polikliniği’nden hizmet alan annelerin özelliklerini ve başvuru nedenlerini belirlemek için yapılmıştır.
Yöntem: Retrospektif ve tanımlayıcı olarak yapılan araştırmada veriler Ekim 2019- Ocak 2020 tarihleri arasında bir hastanenin Laktasyon Polikliniği’nden danışmanlık hizmeti almış 88 annenin poliklinik kayıtlarından elde edilmiştir.
Bulgular: Annelerin yaş ortalaması 28.8 ± 5.5 yıl olup, %69.3’ü ev hanımı ve %53.4’ü lise ve üzeri eğitime sahipti. Annelerin polikliniğe başvuru yaptıkları sırada bebeklerinin ortalama 17.1±14.8 günlük olduğu, %34.1’inin sadece anne sütü ile beslendiği ancak bebeklerin % 63.6’sının anne sütünün yanı sıra formül mama desteği de aldığı belirlenmiştir. Annelerin %48.3’ünün anne sütünün yetersiz olduğunu düşündükleri için formül mamaya başladıkları görülmüştür. Katılımcıların %43.9’unun emzirme ile ilgili konularda bilgi almak, %23.8’inin meme reddi ve meme sorunları nedeniyle polikliniğe başvurduğu belirlenmiştir.
Sonuç: Bebeklerin yarıdan fazlasına anne sütü ile beraber formül mama verildiği ve formül mama başlamanın en önemli nedeninin anne sütünün yetersiz olduğunu düşünme olduğu belirlenmiştir.
Anahtar Kelimeler: Anne sütü; emzirme; emzirme danışmanlığı; laktasyon; hemşire
... Women have reported persistent infant crying as a major symptom of PIMS (Sacco et al., 2006). Ineffective sucking also contributes to doubts over whether milk is enough for the infants (Galipeau et al., 2017). On the contrary, breastfeeding self-efficacy and having sufficient access to information are the two main factors that prevent reports of PIMS (Galipeau et al., 2017;Nurhayati & Fikawati, 2019;Safon et al., 2017). ...
... Ineffective sucking also contributes to doubts over whether milk is enough for the infants (Galipeau et al., 2017). On the contrary, breastfeeding self-efficacy and having sufficient access to information are the two main factors that prevent reports of PIMS (Galipeau et al., 2017;Nurhayati & Fikawati, 2019;Safon et al., 2017). ...
Perceived insufficient milk supply (PIMS) is one of the major reasons for discontinued breastfeeding. We aimed to estimate the rates and evaluate related factors of PIMS. We searched four databases for relevant articles published from January 2000 to March 2021. We then performed a meta‐analysis of the pooled data to estimate the rates and related factors of PIMS using Stata 15.0. Descriptive analyses of textual data were performed to summarise the related factors of PIMS if data could not be synthesised quantitatively. The quality of included studies was assessed using Newcastle–Ottawa scale (NOS), AHRQ checklist or Consolidated Criteria for Reporting Qualitative Research (COREQ). Overall, 27 studies were included in this review. At different periods after delivery, approximately 50% of mothers reported PIMS as the reason for stopping breastfeeding, while for breastfeeding mothers, the incidence of PIMS ranged from 10% to 25%. Breastfeeding initiation (OR 4.22, 95%CI 1.57–11.34) and breastfeeding knowledge (OR 7.10, 95%CI 2.00–25.26) were two factors influencing PIMS. Besides, PIMS had a strong negative relationship with breastfeeding self‐efficacy (r = −0.57); moderate negative association with infant suck ability (r = −0.46) and planned breastfeeding duration (r = −0.45); and a moderate positive correlation with formula supplementation (r = 0.42). Descriptive analyses revealed that infant crying was reported to be a sign of PIMS, and inadequate intake of energy/liquids was a reported cause of it. This review identified a high proportion of women reporting PIMS, particularly among those who stopped breastfeeding. Deliberate interventions were needed to improve breastfeeding for mothers at risk.
... In this study, more than three-quarters of the participants perceived their milk to be sufficient, which is the highest value in the literature in terms of similar studies. When other studies conducted in the literature using the same scale (PIMS) were examined, these rates were 73.1% in Japan (20), 60.2% in Pakistan (21), 50-55.7% in Australia (22), 41.1% in China (23), 37.3% in Singapore (24), 18.4% in the USA (25), 14.9-23.6% in Mexico (26), and 7.5-18% in Canada (27). The fact that the value in this study is higher than in other studies suggests that studies conducted to increase breast milk have started to yield results, and women have started to see their milk as sufficient since the data are recent. ...
... Pediatricians and general practitioners caring for infants should be able to make a rational assessment of infants' weight gain and, if necessary, refer them to a lactation consultant instead of prescribing formula. Perceived insufficient milk supply and actual insufficient milk supply may have no significant correlation according to Galipeau et al., who suggest that interventions in lactation should aim to increase the confidence of the breastfeeding mother, which affects the duration of breastfeeding [23]. Although, Evans, Hilditch and Keir [24] as well as Dib et al. [25] in their systematic reviews came to a conclusion that there is a lack of evidence for what kind of intervention would help to improve breastfeeding rates in LPIs, Estalella et al. performed a quasi-experimental study, which defined that specific support among LPIs, such as promoting parents' involvement, bringing in a multidisciplinary approach and keeping the mother-infant dyad inseparable, resulted in a higher breastfeeding rate at discharge [26]. ...
Background: The aim of this study is to identify factors associated with successful breastfeeding in late preterm infants (LPIs) and explore the initiation of complementary feeding; Methods: Prospective cohort study was conducted of infants born at 34+0 to 36+6 weeks gestational age in the Hospital of the Lithuanian University of Health Sciences Kaunas Clinics during 2020–2021. Families were followed up until the infants reached 12 months of age. Average breastfeeding initial time, average breastfeeding duration time, prevalence of exclusive breastfeeding and average solid-food feeding initiation time were examined. The correlations among factors that might affect breastfeeding rates were calculated using the chi-square test (p < 0.05); Results: In our study with 222 eligible participants, we observed a statistically significant delay in breastfeeding initiation only in the 34+0+6 gestational age group (p < 0.001). At discharge, the 36+0+6 group exhibited a significantly higher exclusive breastfeeding rate (p < 0.001). Over the first year, breastfeeding rates varied, with no correlation found between duration of exclusive breastfeeding and gestational age. Initial solid-food feeding times were similar across groups, and all infants were introduced to vegetables first; Conclusions: Vaginal delivery, skin-to-skin contact after birth, early rooming-in, and breastfeeding within 2 h after birth statistically significantly causes earlier breastfeeding initiation and longer duration of breastfeeding in LPIs. All infants began solid-food feeding at an average age of 5 months, with vegetables being the primary food choice.
... So that the mothers introduce complementary feeding early. Particularly primipara mothers (Initiated complementary feeding more earlier than multipara mothers in this study) have a lower level of confidence on their breast milk sufficiency than multipara mothers [45,46]. These two factors together increased the early initiation of complementary feeding in opposite to the WHO and UNICEF recommendation [5,26,47]. ...
Introduction Despite strategies and recommendations for complementary feeding initiation were applied globally, mothers initiated complementary feeding to the infants on time was low. Previous works of literatures were not identified the effect of parity on time to initiate complementary feeding. Particularly, evidences regarding to this in Ethiopia is scanty. Therefore, this study aimed to identify the effect of parity on time to initiate complementary feeding among mother-infants pairs in Northwest Ethiopia. Methods A community-based prospective cohort study was carried out among 732 primipara, and 1464 multipara mothers who had a live birth in Northwest Ethiopia. Data were collected using Kobo collect software at the start of and on a monthly bases until the end of the follow up period. Parity as exposure variable and other confounders were analyzed using cox proportional hazard regression. Kaplan-Meier survival curve and the Schoenfeld residuals global test (P-value = 0.4861) was performed. Hazard ratio (HR) with 95% confidence intervals (CI) was used to declare statistical significance of predictors. Results The overall incidence rate of initiation of complementary feeding among primipara and multipara mothers were 16.27 (95%CI: 15.04, 17.61) and 13.30 (95%CI: 12.53, 14.12) person months' observations respectively. The median time to initiate complementary feeding among primipara and multipara mothers for their infants was 5 and 6 months respectively. Primipara mothers had a 30% higher rate to initiate complementary feeding early (AHR = 1.30, 95%CI: 1.17, 1.43). Age from 15 to 24 and 25-34 years (AHR = 1.69, 95%CI: 1.36, 2.09; and AHR = 1.45, 95%CI: 1.17, 1.81) and Birth type (twin) (AHR = 1.29, 95%CI: 1.02, 1.64) were statistically significant predictors for time to initiate complementary feeding. Conclusions Parity was identified as a statistically significant predictor for time to initiate complementary feeding. The incidence rate of early and late initiation of complementary feeding was higher among primipara than multipara mothers. Besides, the median time to initiate complementary feeding was earlier among primipara than multipara mothers. So, a parity based complementary feeding practice education should be advocated to tackle the gap
... So that the mothers introduce complementary feeding early. Particularly primipara mothers (Initiated complementary feeding more earlier than multipara mothers in this study) have a lower level of confidence on their breast milk sufficiency than multipara mothers [45,46]. These two factors together increased the early initiation of complementary feeding in opposite to the WHO and UNICEF recommendation [5,26,47]. ...
Introduction:
Despite strategies and recommendations for complementary feeding initiation were applied globally, mothers initiated complementary feeding to the infants on time was low. Previous works of literatures were not identified the effect of parity on time to initiate complementary feeding. Particularly, evidences regarding to this in Ethiopia is scanty. Therefore, this study aimed to identify the effect of parity on time to initiate complementary feeding among mother-infants pairs in Northwest Ethiopia.
Methods:
A community-based prospective cohort study was carried out among 732 primipara, and 1464 multipara mothers who had a live birth in Northwest Ethiopia. Data were collected using Kobo collect software at the start of and on a monthly bases until the end of the follow up period. Parity as exposure variable and other confounders were analyzed using cox proportional hazard regression. Kaplan-Meier survival curve and the Schoenfeld residuals global test (P-value = 0.4861) was performed. Hazard ratio (HR) with 95% confidence intervals (CI) was used to declare statistical significance of predictors.
Results:
The overall incidence rate of initiation of complementary feeding among primipara and multipara mothers were 16.27 (95%CI: 15.04, 17.61) and 13.30 (95%CI: 12.53, 14.12) person months' observations respectively. The median time to initiate complementary feeding among primipara and multipara mothers for their infants was 5 and 6 months respectively. Primipara mothers had a 30% higher rate to initiate complementary feeding early (AHR = 1.30, 95%CI: 1.17, 1.43). Age from 15 to 24 and 25-34 years (AHR = 1.69, 95%CI: 1.36, 2.09; and AHR = 1.45, 95%CI: 1.17, 1.81) and Birth type (twin) (AHR = 1.29, 95%CI: 1.02, 1.64) were statistically significant predictors for time to initiate complementary feeding.
Conclusions:
Parity was identified as a statistically significant predictor for time to initiate complementary feeding. The incidence rate of early and late initiation of complementary feeding was higher among primipara than multipara mothers. Besides, the median time to initiate complementary feeding was earlier among primipara than multipara mothers. So, a parity based complementary feeding practice education should be advocated to tackle the gap and further reduce infants and children malnutrition. Relatively younger age and twin delivered mothers initiated complementary feeding against the recommendation. Therefore, intervention considering such statistically significant predictors could have a public health importance.
... The proportion of women ceasing breastfeeding early who have a perceived versus an actual insufficient milk production is unknown. A perceived low supply occurs when a mother believes her supply is insufficient regardless of whether an actual low supply exists or not [4]. An actual low supply can result from breastfeeding challenges (secondary low supply) or can inherently exist (primary low supply) [5]. ...
Objectives
To estimate the proportions of anatomical breast characteristics suggestive of breast hypoplasia among breastfeeding women self-reporting low milk supply. We also explored breast hypoplasia risk factors.
Design
Online survey conducted between October 2021 and January 2022.
Setting
Five low milk supply Facebook groups.
Participants
487 women reporting low milk supply with their first child born ≥ 37 weeks gestation within 5 years of participation in this study, and residing in the USA, Australia or the UK. We present data on the primary outcome (‘breast type’) for 399 women. Women were excluded if the dyad was separated for more than 24 hours during the hospital stay, or if the mother reported removing milk less than 6 times per day from each breast on most days before being aware of having insufficient milk production.
Primary and secondary outcome measures
The proportions of proposed breast hypoplasia markers including atypical breast type, widely spaced breasts, breast asymmetry, stretch marks on the breast and lack of pregnancy breast growth. We also estimated the odds of having breast hypoplasia markers in at-risk groups compared to reference groups, adjusting for covariates.
Results
Approximately 68% reported at least one atypical breast (270/399; 95% CI: 62.9%, 72.1%). Around 47% reported widely spaced breasts (212/449; 95% CI: 42.7%, 52.7%), 72% a lack of pregnancy breast growth (322/449; 95% CI: 68.3%, 77.4%), and 76% stretch marks on the breast (191/250; 95% CI: 70.7%, 81.3%). Multiple logistic regression analyses identified being overweight during pubertal years as a risk factor for atypical breast type and lack of pregnancy breast growth.
Conclusions
Participants in low milk supply Facebook groups reported high rates of breast hypoplasia markers. Being overweight during adolescence was a risk factor for breast hypoplasia markers. These findings should be confirmed in well-conducted large cohort studies to determine the strongest combination of hypoplasia markers in predicting low supply.
... 25,47,62,64,66,101 In the USA, the more widespread use of formula may be due to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the lower cost. 34,57,76,82,86,102,103 In contrast, mothers with higher education 104 and those not entering WIC programs more frequently choose MMF. This same result was found by Henninger et al, and even these MMF mothers introduced FF later. ...
Context: Combining or supplementing breastfeeding with formula feeding, also
called mixed milk feeding (MMF), is a common infant feeding practice. However,
there is no well-established MMF evidence-base for informing and guiding parents.
A better understanding of the reasons why mothers practice MMF may facilitate
identification of efficient strategies for supporting exclusive breastfeeding, and/or
opportunities to prolong breastfeeding, at least partially. Objective: An updated systematic
literature review was undertaken with the primary aim of gaining a deeper
understanding of the reasons why mothers choose MMF. Data Sources: Six databases
were searched for relevant articles published in English from January 2012 to
January 2022. Data Extraction: Two reviewers independently performed the screenings
and data extraction, and any differences were resolved by a third reviewer. Data
from 138 articles were included, 90 of which contained data on MMF reasons/drivers,
and 60 contained data on infant age and/or maternal demographic factors associated
with MMF. Data Analysis: A total of 13 different unique MMF drivers/reasons
were identified and categorized according to whether the drivers/reasons related to
perceived choice, necessity, or pressure. Risk of bias was evaluated using the Quality
Assessment Tool of Diverse Studies and the JBI Systematic Reviews tool. Several different
terms were used to describe and classify MMF across the studies. The most commonly
reported reasons for MMF were related to a perception of necessity (39% of
drivers, eg, concerns about infant’s hunger/perceived breast milk insufficiency or
breastfeeding difficulties), followed by drivers associated with perceived choice (34%;
eg, having more flexibility) and perceived pressure (25%; eg, returning to work or
healthcare professionals’ advice). This was particularly true for infants aged 3months
or younger. Conclusion: The key global drivers for MMF and their distribution across
infant age and regions were identified and described, providing opportunities for the
provision of optimal breastfeeding support. A unified definition of MMF is needed in
order to enable more comparable and standardized research.
Systematic Review Registration: PROSPERO registration no. CRD42022304253.
... The problem often encountered related to failure in exclusive breastfeeding is the mother's perception of little or less milk production, causing fear of not being able to meet the needs of the baby. This situation is called perceived insufficient milk (PIM) [7], [8]. Researchers have tried to make mothers' milk production sufficient for babies so mothers do not feel worried that their babies are starving by innovating to increase breast milk production using local plants that contain lactogogues, such as banana flowers and moringa leaves in powder form packaged into capsules. ...
The problem often encountered concerning failed exclusive breastfeeding is the insight of the mothers into little or less milk production, causing fear of being incapable to satisfy the baby’s needs. The quasi-experimental research design was used in this study. There was a control group and two intervention groups. The intervention group was given moringa leaf extract and banana flower extract for 14 days. Mother’s milk was examined with atomic absorption spectrophotometry (AAS) at Labkesda (regional health laboratory) Jambi Province, Indonesia. Data were analyzed using 1-way- ANOVA. The zinc levels variable in breast milk obtained a p-value of 0.160, indicating that the zinc level in mother’s milk between the control group, moringa leaf extract, and banana flower extract did not show any meaningful difference. The iron levels variable in breast milk obtained a p-value of 0.497, indicating that the Fe levels of mother’s milk in the control group, moringa leaf extract, and banana flower extract did not show considerable distinctions. As a result, zinc and iron levels in the mother’s milk showed no prominent differentiation in the control, moringa leaf extract, as well as banana flower extract groups.
... As such, mothers were able to visualize and track some (but not all) of their milk output, and thus judge its perceived adequacy based on the measured amount rather than infant's growth and behaviour. Importantly, recent Canadian research found no significant correlation between actual and perceived insufficient milk supply with the latter being linked with maternal self-efficacy (39) . In the future education programming, realistic expectations for milk output, as well as evidence-based strategies to increase milk supply and address common concerns, such as nipple confusion, should be identified and clearly communicated. ...
Objective
Dual modality feeding (DMF)—feeding human milk interchangeably from the breast and from a bottle—comes with unique practical, emotional, and relational challenges, as well as support needs. Yet, there is little research that explores the experiences of individuals who use DMF in the Canadian context. The aim of this study is to explore the practices, challenges, reasons, and enablers of DMF.
Design
Repeat, semi-structured one-on-one interviews were conducted at 8 weeks and 22 weeks postpartum. Interview transcripts were thematically analyzed using a critical feminist lens.
Setting
Nova Scotia, Canada.
Participants
10 DMF mothers.
Results
DMF practices were influenced by a mix of social and material circumstances including breastfeeding challenges, the involvement of support persons, finances, and access to lactation support. Individuals who predominantly fed at the breast expressed milk strategically to mitigate transitory breastfeeding challenges, for convenience under specific circumstances, and to share feeding responsibilities with other caregivers for personal and practical reasons. Individuals who mainly bottle-fed did so due to long-term breastfeeding challenges or a need to return to employment. Enablers of successful DMF were consistent between the two groups and included practical, personal, and relational aspects.
Conclusions
DMF is a unique practice compared to feeding human milk solely from the breast or bottle. Despite the potential growing prevalence of DMF, it is currently understudied and inadequately addressed in existing support programs in Nova Scotia. Tailored programing and public messaging are needed to support DMF families.
... Breast hypoplasia, hormonal irregularities, or breast surgery (e.g. breast reduction) are primary reasons for hypogalactia-the physical inability to develop the milk production required for adequate infant growth (Galipeau et al., 2017). Breast hypoplasia can present with characteristics that include widely separated, tubular, or asymmetrical breasts (Grella et al., 2022). ...
Introduction
Human lactation should be taken into account as an important issue for the international agenda. Despite advances in lactation information and knowledge, insufficient milk production is still a concern for mothers and health practitioners, including International Board Certified Lactation Consultants and others. Primary hypogalactia, or insufficient milk production is uncommon, but should be considered when there is poor weight gain and decreased urine output in infants despite good latch-on and suckling, or anatomic differences in the physical exam of the lactating breast.
Main Issue
This case series presents three cases illustrating insufficient milk production resulting in infants who experienced significant dehydration and poor weight gain.
Management
Primary hypoplasia was diagnosed by means of a thorough interview and physical examination that entailed a consultation with a physician who was also an International Board Certified Lactation Consultant.
Conclusion
Awareness of an infant’s feeding needs and proper evaluation of a child’s health status is paramount if health care providers are to identify the important factors contributing to breastfeeding problems. In some instances, breastfeeding goals cannot be achieved, and then the provider’s role becomes support in coming to terms with persistent insufficient milk production, and coordinating appropriate supplementation to meet each baby’s nutritional needs.
... In general, it is necessary to teach effective methods to increase breastfeeding, including breast massage training in the early stages [33] of childbirth, to mothers who do not have sufficient experience and information about breastfeeding. [34] In this regard, doctors, [35] midwives, nurses, and other health professionals must identify mothers with breastfeeding risks and provide them with the necessary training to improve breastfeeding self-efficacy and perceived stress. Exclusive breastfeeding should also be increased. ...
Background:
Breastfeeding is a highly efficacious, health-promoting activity that prevents many disorders and diseases. Successful breastfeeding depends on various maternal physiological and psychological factors, among which breastfeeding self-efficacy is an adjustable framework. This study investigates the effect of breast massage training on self-efficacy and perceived stress in primiparous women.
Materials and methods:
This study is a clinical trial study on 132 eligible primiparous mothers referred to Bahar Hospital from August 15, 2019, to December 15, 2020. The women were randomly divided into intervention and control groups. The massage was performed in the intervention group before breastfeeding. The data were collected using a standard breastfeeding self-efficacy questionnaire and the Sheldon Perceived Standard Questionnaire. Data were entered into SPSS 18 and analyzed using descriptive statistics, Chi-square, and analysis of variance.
Results:
The results of this study showed that the mean (SD) breastfeeding self-efficacy in the breast massage training group with direct midwife involvement was 61.63 (9.21), higher than the one in the control group 51.51 (11.62). In addition, perceived stress was 19.81 in the intervention group and 24.84 in the control group, which was also statistically significant.
Conclusions:
Due to the increase in self-efficacy scores and decrease in stress scores after breast massage, this method can improve breastfeeding performance in women. Therefore, educational strategies should be developed in this area.
... Although there are many studies in the literature on the possible causes that influence the initiation and maintenance of breastfeeding, there are not enough studies that assess the cognitive abilities (cognitive abilities such as concentration ability and forgetfulness) of the mother in the peripartum period. [4][5][6][7][8][9] The main objective of our study is to show the relationship between the level of maternal cognitive functions in the peripartum period and the exclusive breastfeeding of the infant. Specifically, we hypothesize that mothers' cognitive complaints decrease due to increased levels of anxiety and depression in the postpartum period, which negatively affects exclusive breastfeeding of the infant. ...
Aim: In this study, we aimed to examine the effects of peripartum mother's cognitive functioning, anxiety, and postpartum depression of mothers on the practice of exclusive breastfeeding.
Material and Method: The pregnant women in the last trimester who were attended in the outpatient department of obstetrics and gynecology were included in the study as the study group. A total of three follow-ups were conducted in the study group. In our study Mini-Mental State Examination (MMSE) was used to assess cognitive functioning, State-Trait Anxiety Inventory (STAI) 1,2 to assess anxiety, Edinburgh Postnatal Depression Scale (EPDS) to assess postpartum depression, Breastfeeding Self-Efficacy Scale (BSES) to assess mother's self- efficacy in breastfeeding, LATCH Breastfeeding Assessment Tool to assess mother's and baby's breastfeeding technique.
Results: All of 158 pregnant and 96 non-pregnant women were enrolled in the study. After delivery, there was a significant decrease in STAI 2 scores compared to the prenatal period (p=0.001) and a significant increase in MMSE scores (p=0.001). There was no difference in STAI 1,2 , and MMSE scores between the groups with and without successful breastfeeding (p >0.05). LATCH scores were statistically significantly higher in the group that successfully breastfed (p =0.001). LATCH (r=-0.427, p
... Evidence for factors that cause physiological insufficiency of milk production due to hormonal or genetic predisposition, or ignorance of early breastfeeding, is still unclear (Galipeau et al., 2017). At the same time, exclusive breastfeeding can improve the nutritional status of infants and toddlers and can reduce infant mortality (Moon et al., 2022). ...
Introduction: The problem of perception of insufficient breast milk, anxiety, and concerns about breastfeeding practices are closely related to the mother's psychological condition, so a solution must be found. This study focuses on mothers with problems regarding breastfeeding, such as perceived insufficient milk supply, anxiety, and fear of breastfeeding. Methods: This study is a quasi-experimental pre-post-test study on 30 breastfeeding mothers. Participants were searched online through social media and Facebook and given a questionnaire regarding screening for breastfeeding problems. Each respondent received NLP method therapy with sub modality techniques and anchoring as needed starting 1-2 hours and evaluated on days three and six after therapy. The evaluation was carried out immediately after therapy, three days after therapy, and six days after therapy. Results: The results of this study estimated that neurolinguistic programming for six weeks reduced feelings of perceived insufficient milk supply (P < 0.001). These results also show that neurolinguistic programming has a very large effect (Cohen, 1988) on reducing feelings of perceived insufficient milk supply (1.00). During the six weeks of implementing neuro linguistic programming, respondents' feelings about perceived insufficient milk supply of respondents. PIM experience also decreases over time. PIMS feelings will decrease 0.17 to 0.57 points shortly after neurolinguistic programming up to 6 days later. Conclusion: Perceived insufficient milk supply caused by maternal stress factors, maternal malnutrition, and traditional beliefs about food and eating can be treated with neurolinguistic programming because NLP with communication and persuasive concepts to change behaviour can increase endorphin production, which further increases the release of the hormone oxytocin so that breast milk production will not decrease and reduce the prevalence of early weaning in the first six months. We suggest that this method be implemented in every health facility by a certified health worker in the field of NLP.
... Nonetheless, we found several factors were related to a shorter breastfeeding duration. Perceived low milk supply was associated with a shorter duration of breastfeeding, consistent with our cross-sectional study [19] and previous literature [34][35][36]. This finding highlights the need for professional lactation support for women with perceived milk supply issues across lactation. ...
The COVID-19 pandemic has impacted new mothers’ wellbeing and breastfeeding experience. Women have experienced changes in birth and postnatal care and restricted access to their support network. It is unclear how these impacts may have changed over time with shifting rates of infection and policies restricting movement and access to services in Australia and New Zealand. This study investigated the longitudinal effect of the COVID-19 pandemic on breastfeeding and maternal wellbeing in Australia and New Zealand. Mothers ( n = 246) completed an online survey every 4 weeks for 6 months that examined feeding methods, maternal mental wellbeing, worries, challenges, and positive experiences during the pandemic. Mothers maintained high full breastfeeding rates at 4 months (81%) which decreased to 37% at 6 months. Perceived low milk supply contributed to the earlier cessation of full breastfeeding. Poor infant sleep was associated with stress, perinatal anxiety, mental wellbeing, and breastfeeding status. Although mothers initially reported that lockdowns helped with family bonding and less pressure, prolonged lockdowns appeared to have adverse effects on access to social networks and extended family support.
Conclusion : The results highlight the changing dynamic of the pandemic and the need for adaptable perinatal services which allow mothers access to in-person services and their support network even in lockdowns. Similarly, access to continuous education and clinical care remains critical for women experiencing concerns about their milk supply, infant sleep, and their own wellbeing. What is Known: • The COVID-19 pandemic and lockdown restrictions have significantly affected perinatal mental health, disrupted maternal services, and subsequent breastfeeding.
What is New: • In Australia and New Zealand, breastfeeding women experienced challenges to their mental wellbeing, sleep, and breastfeeding, which was likely exacerbated over time by the pandemic. Lockdowns, while initially beneficial for some families, became detrimental to maternal support and wellbeing.
... The indicator Proper areolar compression (100003), evaluated through the interview with the mother, presented low frequency for scores 4 and 5. This can be related to the mother's difficulty to describe the areolar compression at the establishment of breastfeeding, especially in cases of preterm infants (13)(14) . Another possibility would be difficulty comprehending the magnitudes to measure the Likert scale. ...
Objective
to analyze clinical changes in the breastfeeding process in the Neonatal Intensive Unit Care using the Nursing Outcomes Classification.
Methods
this longitudinal and prospective study was conducted in a public hospital at Neonatal Intensive Unit Care in Brazil. The sample consisted of 61 mother-infant dyads evaluated three times during breastfeeding by trained nurses who applied the Nursing Outcomes Classification scales. Statistical analysis was performed using Generalized Estimating Equation Models.
Results
most indicators of the two Nursing Outcomes studied presented a similar frequency of scores of 4 and 5. It was observed that in most indicators, there were clinical changes throughout the evaluations over time; however, the indicators related to the mother presented a higher risk of scoring 4 and 5 on the Likert scale.
Conclusion
the Nursing Outcomes Classification outcomes and indicators included successfully evaluated the clinical evolution of mother-infant dyads and proved to be applicable for use in Neonatal Intensive Unit Care. Contributions to practice: nurses can use the indicators to assess the quality of the proposed interventions.
... 7,8 But, it is also reported that there was no significant relationship between perceived and actual insufficient milk supply. 9 Although it is not known exactly, the prevalence of actual biological milk insufficiency is thought to be low. 10 If the healthcare professionals differentiate the perceived and the actual insufficient milk supply and support the mother to continue exclusive breastfeeding, it will probably prevent unnecessary formula supply in this critical period. ...
Objective:
This study aimed to evaluate the knowledge, attitude, and practices of parents about breastfeeding, complementary food, and infant nutrition who have healthy infants born at term and under 2 years of age.
Materials and methods:
This is a cross-sectional study conducted among the parents of infants who came for well-child visits to pediatric clinics of 4 hospitals. Healthy infants under 2 years of age and who had been born at term were interviewed. The questionnaire included 35 questions to evaluate parents' knowledge, attitude, and practices about breastfeeding and infant nutri- tion in addition to sociodemographic data. Data were obtained via questionnaire and were analyzed using Statistical Package for the Social Sciences 20.0 package program.
Results:
The study group consisted of 679 infants and their parents. The median durations of exclusive breastfeeding and total breastfeeding time were found to be 4 months and 10 months. Although 75% of the participants stated that infants must be exclusively breastfed for 6 months, the rate of exclusive breastfeeding for the first 6 months was 44%. The 393 (58%) participants used formula for infant nutrition and 47 (12%) of those started with complementary feeding. 90% of the participants stated that formula advertisements did not affect their decision on starting formula but the rate of thinking that other people may be affected by the advertisements was 80%.
Conclusion:
The knowledge of parents on human milk is not insufficient but they need to be supported especially to continue exclusive breastfeeding during the first 6 months and appro- priate complementary food during the weaning period.
... Our findings demonstrate that those breastfeeding are actively seeking out information on galactagogues. This behavior may be motivated by anxiety about milk supply or lack of knowledge about common behaviors of newborns, rather than true low milk production (Galipeau et al., 2017). Widespread recognition of galactagogues, as seen in this survey, may suggest that a substantial proportion of breastfeeding parents are spending time and money on products with little evidence of effectiveness that may not be entirely risk-free (Foong et al., 2020). ...
Background:
Galactagogues have been used for centuries to induce, maintain, or increase a mother's milk supply. Recently, there has been an apparent increase in utilization and promotion of galactagogues, largely in the absence of data regarding their efficacy and safety. However, there is limited contemporary evidence about knowledge of these substances in the community or how and where individuals seek information.
Research aim:
To evaluate knowledge about galactagogue use during breastfeeding among birth parents, including recognition of specific substances, perceptions of safety, and common information sources.
Method:
An online, prospective, cross-sectional survey of Australian birthing parents (N = 2055) who were currently breastfeeding or had previously breastfed their infants was conducted from September to December 2019. The survey included questions about recognition of galactagogues, perceptions of safety, and information-seeking behaviors.
Results:
Among participants, 47% (n = 882) were primiparous and 65% (n = 1,219) were currently breastfeeding. The most recognized galactagogues included lactation cookies (89%; n = 1,828), brewer's yeast (79%; n = 1,629), fenugreek (74%; n = 1,519), and domperidone (69%; n = 1,420). Respondents cited the internet (52%; n = 1,066), lactation support providers (46%; n = 951), midwives (42%; n = 873), general practitioners (39%; n = 802), and social media (35%; n = 714) as common information sources. Lactation support providers and breastfeeding helplines were commonly rated as helpful; whereas, general practitioners and community pharmacists were often rated as unhelpful. While most participants perceived galactagogues to be safe, herbal or dietary galactagogues were perceived to be safer than pharmaceutical galactagogues.
Conclusions:
Our Australian community survey of individuals with current or previous breastfeeding experience identified widespread recognition of galactagogue use, with participants reporting a broad range of information-seeking behaviors and generally perceiving galactagogues as being safe to use.
... Mothers' perceived low milk supply has been found to be related to perceived hunger of the child, which is expressed by crying and number or frequency of feedings (Gatti, 2008). Professional support that guides mothers to early optimal latching and informs signs of efficacious infant suckling may help to reduce mothers' perceived low milk supply and other related factors that potentially lead to infant formula supplementation (Galipeau et al., 2017;Gatti, 2008). In addition, some hospitals reported that many of the lactation management-related issues arise during the Note: Theme subcategories do not total to 100% because hospitals were counted once for frequency of themes and were counted more than once if applicable for each subcategory. ...
In-hospital infant formula supplementation of breastfed infants reduces breastfeeding duration, yet little is known about common reasons for infant formula supplementation. We examined the three most common reasons for in-hospital infant formula supplementation of healthy, term, breastfed infants in the US reported by hospital staff. Hospital data were obtained from the 2018 Maternity Practices in Infant Nutrition and Care survey (n = 2045), which is completed by hospital staff. An open-ended question on the top three reasons for in-hospital infant formula supplementation was analyzed using thematic qualitative analysis and the frequencies for each reason were reported. The top three most common reasons for in-hospital infant formula supplementation reported by hospital staff included medical indications (70.0%); maternal request/preference/feelings (55.9%); lactation management-related issues (51.3%); physical but non-medically indicated reasons (36.1%); social influences (18.8%); perceived cultural/societal/demographic factors (8.2%) and medical staff/institutional practices (4.7%). These findings suggest that a variety of factors should be considered to address unnecessary infant formula supplementation. Lactation management support delivered in a timely and culturally sensitive manner and targeted to mother-infant dyads with potential medical and physical indications may reduce unnecessary in-hospital infant formula supplementation.
... The two weeks after delivery are critical to determining the success of breastfeeding; since the mother may feel fatigued and painful nipples, at the same time the baby shows dissatisfaction with breast milk. Evidence proved that in the 48 hours after delivery, the infants often experience reduced weight, showed satiety rather than sleep well, produced insufficient urine and stool (Galipeau et al. 2017). These conditions can lead to anxiety and lack of self-confidence among mothers on their capacity to exclusively breastfeed their infants. ...
This study explored the effect of Sauropus androgynus, papaya leaves, and mung beans as mixed galactagogue drinks on breastmilk volume, frequency, and duration among urban postpartum mothers in Jakarta. A quasi-experimental study with 60 postpartum mothers divided in intervention and control groups was conducted. The intervention group was administered with a 400-cc traditional galactagogue drink daily within 4 weeks of postpartum, while the control group received 3 times breastfeeding counselling. The breastmilk volume was measured using the evaporative water loss method on mothers’ weight at the first, second, third-, and fourth-week consumption. The mean difference of breastmilk volume, breastfeeding frequency, and duration between the intervention and control groups was calculated by bivariate analysis using an independent sample t-test. The breastmilk volume was not different between both groups on the first and second week (1st:622.93±289.24 and 507.68±231.28, p=0.094; 2nd:683.00±252.42 and 582.58±225.42, p=0.110), however, the intervention group had higher volume than the control group in the third and fourth week (3rd:801.43±273.35 and 656.24±214.43, p=0.026; 4th=908.52±271.27 and 756.69±196.29, p=0.016). No significant difference was observed in the breastfeeding frequency and duration among the groups. In conclusion, the new galactagogue mixed drink consumption has the potential to increase breastmilk production and enhance a mother’s confidence to continue breastfeeding.
... Although only 9% experienced perceived low milk supply, which was subjectively reported by participants, it was associated with partial breastfeeding, as were older infant age and maternal perception of infant sleep as 'not a problem'. Perceived low milk supply is known to negatively influence breastfeeding self-efficacy and duration [49][50][51]. In a recent Australian cohort [44] assessing breastfeeding problems after birth, up to 44% of women reported low milk supply. ...
During the COVID-19 pandemic, breastfeeding women have experienced restricted access to support, placing them at increased risk of mental health concerns and limited breastfeeding assistance. This study investigated the effect of the pandemic on feeding choices and maternal wellbeing amongst breastfeeding mothers living in Australian and New Zealand. We conducted a cross-sectional online survey that examined feeding methods, maternal mental wellbeing, worries, challenges, and positive experiences during the pandemic. Most women were exclusively breastfeeding (82%). Partial breastfeeding was associated with perceived low milk supply and longer pregnancy duration during the pandemic. Reduced mental health and wellbeing was associated with lower levels of family functioning, increased perceived stress, and perinatal anxiety. Longer pregnancy duration during the pandemic was associated with lower mental health wellbeing scores, while higher perceived stress scores were reported for regions with higher COVID-19 infection rates and women with perceived low milk supply. Women reported that the pandemic resulted in less pressure and more time for family bonding, while worries about the pandemic, family health, and parenting challenges were also cited. Mental health concerns of breastfeeding women appear to be exacerbated by COVID-19, highlighting a critical need for access to mental health and broader family support during the pandemic.
... While the highest drop off from breastfeeding for this reason is during the first 1-4 weeks after initiation, it also continues to be the most common problem cited for several months (Binns and Scott, 2002;Ahluwalia et al, 2005;Gatti, 2008). This is despite true milk undersupply being unusual; one study investigating perceived milk insufficiency monitored actual milk production and reported that some women who had proven adequate supply at six weeks postpartum still reported that they felt their supply was insufficient (Hill and Aldag, 2007), while a second study to determine the relationship between perceived insufficient milk supply and actual insufficient milk production found no significant relationship between the two (Galipeau et al, 2017). ...
... Ibu mengalami perceived insufficient milk (PIM) yaitu keadaan ibu yang memiliki perasaan bahwa air susunya tidak mencukupi kebutuhan bayinya (Galipeau, et al., 2017). Selain itu, jumlah produksi ASI yang rendah dan persepsi ibu terhadap ketidakcukupan ASI menjadi alasan sebagian besar ibu tidak memberikan ASI secara eksklusif kepada bayinya sehingga ibu lebih memilih untuk menggunakan susu formula (Jara-Palacios, et al., 2015). ...
Menyusui tidak hanya melibatkan ibu dan bayi melainkan ayah (suami). Ayah memiliki peranan yang penting dalam mendukung keberhasilan menyusui. Ibu menyusui sering merasa cemas dan khawatir ASI yang keluar sedikit. Hal ini menjadi permasalahan bagi ibu termasuk ayah atau suami. Dukungan suami sangat diperlukan dalam membantu mengatasi permasalahan menyusui, masih di temukan ayah tidak mengetahui apa yang harus dilakukan terhadap keberhasilan menyusui bagi ibu. Peran ayah masih kurang sehingga dukungan terhadap keberhasilan pemberian ASI eksklusif juga mengalami kegagalan. Tujuan pengabdian masyarakat untuk membantu ayah dalam mengurangi kecemasan ibu karena produksi ASI yang kurang dan memberdayakan ayah dalam pemanfaatan teknologi OKSITOMOM. Metode yang digunakan yaitu tahap persiapan, pelaksanaan, penerapan teknologi OKSITOMOM, dan evaluasi. Hasil dari pengabdian masyarakat yaitu ayah memperoleh persepsi yang positif sehingga dapat mendukung ibu dalam kenyamanan dan rileks sehingga membantu kelancaran pengeluaran ASI. Ada peningkatan pemahaman ayah yang semula tidak mengetahui metode, manfaat, evaluasi, keberhasilan ASI, dan sangat mendukung penerapan OKSITONMOM.
... Because the few studies that have analyzed emotional or psychological IPV have been cross-sectional and cannot determine casual pathways, the mechanism of the association remains unclear. Experience of IPV has been associated with poor self-esteem [24] and both low selfefficacy and low confidence have been identified as barriers to optimal breastfeeding practices [25,26]. That delayed initiation of breastfeeding among Tanzanian mothers was associated both with those who experienced emotional IPV often or sometimes and those who had experienced emotional IPV in the past illustrates the potential long-term negative influence of emotional IPV on breastfeeding. ...
Background
Despite widespread suboptimal breastfeeding practices and maternal experiences of intimate partner violence (IPV), the association of IPV and breastfeeding practices remains unclear. This study investigated the associations between maternal experience of physical, sexual, emotional violence, and controlling behaviors with suboptimal breastfeeding practices in Malawi, Tanzania, and Zambia.
Methods
Data included mother-infant dyads from the most recent Demographic and Health Surveys for Malawi ( n = 1878), Tanzania ( n = 3184), and Zambia ( n = 3879). Intimate partner violence (physical, sexual, and emotional) was measured using the Revised Conflict Tactics Scale. Breastfeeding practices were early initiation of breastfeeding (within 1 h of birth), exclusive breastfeeding (in previous 24 h), and continued breastfeeding. Associations between experience of physical, sexual, or emotional violence or controlling behaviors and breastfeeding practices, as well as associations between the frequency of IPV and breastfeeding practices were assessed.
Results
Many Malawian (77.6%) and Zambian (67.7%) and just over half (53.6%) of Tanzanian mothers, initiated breastfeeding within 1 h of birth. Exclusive breastfeeding was 70.6% in Zambia and 60.1% in Malawi, while 55.0% of Tanzanian mothers breastfed exclusively. Continued breastfeeding to at least 1 year was high in Malawi 92.2%, Tanzania 93.4%, and Zambia 95.0%. Most mothers reported experiences of IPV in Tanzania 79.1%, Zambia 78.9%, and Malawi 73.9%. Mothers who experienced sexual IPV were significantly more likely to delay breastfeeding (Malawi [AOR 1.55 (1.14, 2.10)]; Tanzania [AOR 1.30 (1.04, 1.62)]; and Zambia [AOR 1.28 (1.06, 1.54)]). Sexual IPV in Malawi and Zambia was associated with greater odds of not exclusively breastfeeding (Malawi [AOR 1.90 (1.05, 3.45)]; Zambia [AOR 1.75 (1.15, 2.67)]). Tanzanian mothers who experienced IPV often or sometimes were two times more likely not to breastfeed at one-year post-delivery [AOR 2.23 (1.09,4.57)].
Conclusions
In the three countries investigated maternal experience of IPV was associated with suboptimal breastfeeding practices. Policies and programs targeting improved breastfeeding practices should consider screening during antenatal and postnatal care for experience of violence and support initiatives to reduce IPV.
Background: Most women can produce enough milk to exclusively breastfeed. However, a small cohort are prevented from doing so due to a condition known as primary low milk supply.
Aim: To provide new insights into how mothers with primary low milk supply experience help and support from professionals, volunteers, and partners.
Methods: Interpretative phenomenological analysis was used to explore the lived experiences of nine breastfeeding mothers with primary low milk supply. Hour-long interviews were conducted over Zoom.
Results: Being with Others is one of four superordinate themes identified in this study. This theme concerned the participants’ experiences of receiving professional, peer, and voluntary breastfeeding supports. It also considers how participants were supported by their partners. Four sub-themes were identified: Disconnected Encounters, Perceiving Judgement from Others, Being in a Safe Space and Having a Saviour.
Conclusion: The interactions that mothers with primary low milk supply have with various others in their world (health care professionals, lactation consultants, peer breastfeeding supporters, and partners) can shape how they view themselves and can have a profound impact on their breastfeeding journey. The encounters of participants with healthcare professionals revealed a lack of rapport, intrusive hands-on support, poor perceived quality of breastfeeding support and a heightened sensitivity to language and tone. Mothers with primary low milk supply value empathy and emotional support from lactation professionals as much as they value skilled lactation support. We recommend that healthcare professionals receive education concerning primary low milk supply and communication skills training on the provision of sensitive person-centred breastfeeding support.
Background/Aims
Exclusive breastfeeding duration remains suboptimal among Chinese mothers. Understanding the factors that influence exclusive breastfeeding is essential for developing targeted interventions to promote breastfeeding practices. This study aimed to identify determinants of exclusive breastfeeding in the first 6 months after birth in Xuzhou City, China.
Methods
This prospective study enrolled 178 mothers, using structured questionnaires for data collection. Subsequent analysis used multiple linear regression to explore factors associated with exclusive breastfeeding duration.
Results
On average, participants exclusively breastfed for 67 days. Influencing factors included breastfeeding intention, perception of insufficient milk and maternity leave.
Conclusions
Targeted interventions have the potential to prolong exclusive breastfeeding duration, such as ensuring women develop accurate perceptions of their breast milk supply and extending maternity leave. Implementing these interventions is crucial to achieving the target of 6 months of exclusive breastfeeding, consequently contributing to optimal health benefits for mother–infant dyads in China.
The child's right to breast milk is human right that should be guaranteed, protected and fulfilled; However, this right has not been fully implemented yet. A study in Langsa City Indonesia in 2022 shows that the percentage of babies who get exclusive breast milk up to six months is only 60.29% out of the total 3,447 babies. Therefore, the main question in the article is the obstacles that arise in breastfeeding children in Langsa City. The method applied in this study is the juridical sociological method. Data collection was conducted through in-depth interviews and document studies. The informants interviewed were health workers, family planning officials, and religious leaders, while the documents analyzed were related articles, scientific reports, and books. Collected data were analyzed by using qualitative analysis. The result shows that the obstacles that arise in the implementation of breastfeeding, among others, are a lack of mother’s confidence to feed breastfeeding, lack of understanding about the benefits of breast milk, lack of understanding about cultural characters that have been passed down from generation to generation in the community. Therefore, it is suggested that some efforts need to be done, among others to provide health services, consultation, training, advocacy, and socialization about the importance of breast milk to mothers and the community as well. This includes involving religious leaders or scholars in socializing the importance of breastfeeding children.
Background: Primary low milk supply (PLMS) prevents mothers from producing sufficient milk to breastfeed exclusively. However, limited evidence exists regarding women's experiences of breastfeeding with PLMS. Objective: This article aims to investigate the emotional experiences of mothers breastfeeding with PLMS in the first 3 months postpartum. Materials and Methods: The study was conducted in Ireland and used a phenomenological methodology to investigate the lived experiences of breastfeeding mothers with PLMS. Nine first-time breastfeeding mothers with PLMS participated, and data collection took the form of unstructured interviews. Data analysis was completed using Interpretative Phenomenological Analysis. Results: Being in the Whirlwind is one of four superordinate themes identified in this study. This theme relates to participants' internalized experiences of breastfeeding with PLMS in the first 3 months postpartum. During this time, participants struggled to come to terms with having PLMS and became caught up in all-consuming efforts to increase their milk supply. They experienced guilt, sadness, confusion, anger, and anxiety, with many describing the early months postpartum as traumatic. Participants revealed how triple-feeding (a regime of breastfeeding, pumping, and supplementing) negatively affected their mental health and reported that supplementing with infant formula was emotionally upsetting. Conclusions: Our findings reveal that the combination of PLMS and triple feeding can negatively impact a mothers' mental health. A greater understanding among health care professionals of the emotional impact of having PLMS and triple-feeding could enhance the provision of sensitive and person-centered support for those with PLMS. Antenatal breastfeeding education should acknowledge that PLMS is a challenge for a small cohort of women and place greater emphasis on the emotional aspects of breastfeeding challenges.
Background:
Per- and polyfluoroalkyl substances (PFAS) may disrupt mammary gland development and function; thereby inhibiting milk supply and breastfeeding duration. However, conclusions on the potential effects of PFAS and breastfeeding duration are limited by prior epidemiologic studies that inconsistently adjusted for past cumulative breastfeeding duration and by a lack of examination of the joint effects of PFAS mixtures.
Methods:
In Project Viva, a longitudinal cohort that enrolled pregnant participants from 1999 to 2002 in the greater Boston, MA area, we studied 1079 women who ever attempted to lactate. We investigated associations of plasma concentrations of select PFAS in early pregnancy (mean: 10.1 weeks gestation) with breastfeeding termination by 9 months, after which women typically cite self-weaning as the reason for terminating breastfeeding. We used Cox regression for single-PFAS models and quantile g-computation for mixture models, adjusting for sociodemographics, prior breastfeeding duration, and weeks of gestation at the time of blood draw.
Results:
We detected 6 PFAS [perfluorooctane sulfonate; perfluorooctanoate (PFOA); perfluorohexane sulfonate; perfluorononanoate; 2-(N-ethyl-perfluorooctane sulfonamido) acetate (EtFOSAA); 2-(N-methyl-perfluorooctane sulfonamide) acetate (MeFOSAA)] in >98 % of samples. Sixty percent of lactating women terminated breastfeeding by 9 months postpartum. Women with higher plasma concentrations of PFOA, EtFOSAA, and MeFOSAA had a greater hazard of terminating breastfeeding in the first 9 months postpartum [HR (95 % CI) per doubling concentration: 1.20 (1.04, 1.38) for PFOA; 1.10 (1.01, 1.20) for EtFOSAA; 1.18 (1.08, 1.30) for MeFOSAA]. In the quantile g-computation model, simultaneously increasing all PFAS in the mixture by one quartile was associated with 1.17 (95 % CI: 1.05, 1.31) greater hazard of terminating breastfeeding in the first 9 months.
Conclusion:
Our findings suggest that exposure to PFAS may be associated with reduced breastfeeding duration and draw further attention to environmental chemicals that may dysregulate human lactation.
Background:
Perceived insufficient milk is a primary reason for early breastfeeding cessation. Some breastfeeding mothers may use galactagogues (i.e., foods, beverages, herbal supplements, and pharmaceuticals) to try to increase milk supply. However, milk production requires frequent and effective milk removal, and there is limited evidence on the safety and efficacy of galactagogues. Additional research on the use of galactagogues is needed to inform breastfeeding support.
Objective:
Describe the prevalence of use and perceived effects of galactagogues and compare galactagogue use by maternal characteristics.
Design:
Cross-sectional online survey.
Participants/setting:
A convenience sample of 1294 adult women breastfeeding a singleton child and living in the US were recruited using paid Facebook advertisements between December 2020 - February 2021.
Main outcome measures:
Self-reported current or previous use of galactagogues and their perceived effects on milk production.
Statistical analyses performed:
Frequencies and percentages described the use and perceived effects of galactagogues. Chi-square tests of independence and independent t-tests compared galactagogue use by select maternal characteristics.
Results:
More than half of participants (57.5%) reported using any galactagogues, 55.4% reported consuming foods or beverages, and 27.7% reported using herbal supplements. Few participants (1.4%) reported using pharmaceuticals. Participants reported varying effects of specific galactagogues on milk production. Reported galactagogue use was higher among participants who reported first-time breastfeeding (Yes: 66.7% vs. No: 49.3%; p < 0.001; Cramer's V = .18), breastfeeding pumped milk (Yes: 63.1% vs No: 50.4%; p < 0.001; Cramer's V = .13), formula supplementation (Yes: 66.8% vs No: 50.4%; p < 0.001; Cramer's V = .16), and perceived insufficient milk (Yes: 78.8% vs. No: 53.8%; p = <0.001; Cramer's V = .19).
Conclusions:
Breastfeeding mothers in the US commonly reported using galactagogues to increase milk production, highlighting the need for research on the safety and efficacy of galactagogues and enhanced breastfeeding support.
Among mammals, primipara who initiate reproduction before full maturity can be constrained in their maternal investment, both due to fewer somatic resources and tradeoffs between their own continued development and reproductive effort. Primipara are particularly limited in their capacity to synthesize milk during lactation, the costliest aspect of reproduction for most mammals, especially primates due to long periods of postnatal development. Due to reduced milk transfer, Firstborns may be at elevated risk for long-term consequences of deficits in early life endowment from their primiparous mothers. Here we investigated mass, growth, stature, and lactation performance among N = 273 adult daughters across N = 335 reproductions, who were their own mother's Firstborn or Laterborn progeny, among rhesus macaques (Macaca mulatta) at the California National Primate Research Center. We further explored mass during infancy of the offspring of Firstborn and Laterborn mothers. Firstborns had accelerated growth during infancy, but had slowed growth during juvenility, compared to Laterborns. Although both Firstborns and Laterborns were the same age at reproductive debut, Firstborns had lower body mass, an effect that persisted throughout the reproductive career. Available milk energy, the product of milk energetic density and milk yield, was on average 16% lower for Firstborns compared to Laterborns, a difference that was only partially mediated by their lower mass. Despite differences in their mothers' energy provision through milk, the mass of infants of Firstborn and Laterborn mothers did not differ at peak lactation, suggesting that infants of Firstborns devote a higher proportion of milk energy to growth than infants of Laterborns. To date few studies have explored how early life conditions shape capacities to synthesize milk and milk composition. Our findings contribute new information among primates on how early life maternal endowments are associated with persistent effects long after the period of maternal dependence well into reproductive maturity.
Psycho-social factors are key factors to the powerlessness of infant mothers who breastfeed. As the theory of planned behavior (TPB) is widely used to investigate the correlation between psycho-social factors and breastfeeding behavior, this study aims to examine the utility of TPB constructs to predict breastfeeding behavior and understand TPB-based psycho-social factors’ effectiveness on breastfeeding behavior. A narrative review consulting Web of Science, Scopus, Ebsco, PubMed, and PsycInfo in English and Chinese has been conducted, with the inclusion of twenty studies published between January 2000 and May 2022. It is reported that psycho-social factors based on TPB for breastfeeding such as affective attitude, instrumental attitude, subjective norm, perceived behavioral control (including self-efficacy), moral norm, breastfeeding knowledge, and self-identity can effectively explain the breastfeeding behavior. Future research should improve the theoretical model of TPB-based breastfeeding and implement more localized prediction and intervention studies on breastfeeding.
This chapter reviews the role of responsive feeding in supporting breastfeeding, as well as the ways in which breastfeeding can reinforce responsive feeding. First, the demand and supply nature of lactation is outlined as a foundation for understanding the role of responsive feeding in supporting breastfeeding success. Next, connections between perceived insufficient milk supply and responsive feeding are elucidated. Finally, effects of breastfeeding on mothers’ responsiveness to infant cues via hormonal, neural, and behavioral mechanisms are discussed. Overall, this chapter highlights the importance of promoting caregivers’ engagement in responsive feeding during the perinatal period as a critical support for breastfeeding and the benefits of breastfeeding for infant feeding and weight outcomes.
Objective
To equitably increase exclusive breastfeeding at hospital discharge among obstetrician/gynecologist resident service clients by 20% over 8 weeks.
Design
This quality improvement project used a plan–do–study–act format to implement interventions with patients and staff based on the Baby-Friendly Hospital Initiative. Run charts were used to evaluate intervention effects over time according to Institute for Healthcare Improvement criteria, and outcome data informed tests of change for subsequent cycles.
Setting/Local Problem
Postpartum clients of an obstetrician/gynecologist resident service were found to be less likely to exclusively breastfeed compared to the hospital average (7% vs. 34%) at baseline. A baseline resident client survey (n = 20) showed that 75% believed it best to give human milk plus formula.
Participants
Of 186 postpartum participants, 65% identified as breastfeeding at the time of birth (53% of Hispanic participants [n = 99], 52% of non-Hispanic Black participants [n = 44], and 73% of non-Hispanic White participants [n = 33]).
Interventions/Measures
The World Health Organization’s revised Implementation Guidance for the Baby-Friendly Hospital Initiative provided the basis for all interventions, which included a prenatal infant feeding plan, postpartum educational video with teach-back, cue-based feeding log, breastfeeding education guidelines for postpartum nurses, and team engagement via huddles. Measures assessed whether each intervention met the intended goals.
Results
Rates of exclusive breastfeeding at hospital discharge were 7% at baseline and 13% after implementation. Rates of exclusive breastfeeding among Black clients were 0% at baseline and 16% after implementation. Clients demonstrated Baby-Friendly knowledge (teach-back average, 89%) but continued to supplement with formula, most often related to supply concerns (65%).
Conclusion
Intentionally equitable implementation of the Baby-Friendly steps may ameliorate racial disparities in breastfeeding during the early postpartum period. Preparing families to exclusively breastfeed should begin prenatally.
The researchers’ aims were to determine the effect of perceived insufficient milk supply on the transition to supplementary food and the factors affecting it. This is a cross-sectional design study, we were conducted between April and August 2019 and included 335 mothers and their babies in a baby-friendly hospital in Turkey. It was shown that mothers with perceived insufficient milk switched to supplementary food 6.538 times more frequently (p < 0.05). It was shown that some maternal, lactational, and infant (baby’s age) factors affected the perception of insufficient milk (p < 0.05). The perception of insufficient milk is an important factor contributing to the transition to supplementary food.
Both exclusivity and duration of breastfeeding are increased when support is offered to breastfeeding women. This article provides an overview of best practice information and practical ways for primary care practitioners to support mothers to navigate common breastfeeding challenges. We also consider what is likely to be most effective when providing support during the covid-19 pandemic.
Background: Many small and malnourished infants under 6 months of age have problems with breastfeeding and restoring effective exclusive breastfeeding is a common treatment goal. Assessment is a critical first step of case management, but most malnutrition guidelines do not specify how best to do this. We aimed to identify breastfeeding assessment tools for use in assessing at-risk and malnourished infants in resource-poor settings.
Methods : We systematically searched: Medline and Embase; Web of Knowledge; Cochrane Reviews; Eldis and Google Scholar databases. Also the World Health Organization (WHO), United Nations International Children’s Emergency Fund (UNICEF), CAse REport guidelines, Emergency Nutrition Network, and Field Exchange websites. Assessment tool content was analysed using a framework describing breastfeeding ‘domains’ (baby’s behaviour; mother’s behaviour; position; latching; effective feeding; breast health; baby’s health; mother’s view of feed; number, timing and length of feeds).
Results : We identified 29 breastfeeding assessment tools and 45 validation studies. Eight tools had not been validated. Evidence underpinning most tools was low quality and mainly from high-income countries and hospital settings. The most comprehensive tools were the Breastfeeding, Evaluation and Education Tool, UNICEF Baby-Friendly Hospital Initiative tools and CARE training package. The tool with the strongest evidence was the WHO/UNICEF B-R-E-A-S-T-Feed Observation Form.
Conclusions : Despite many possible tools, there is currently no one gold standard. For assessing malnourished infants in resource-poor settings, UNICEF Baby-Friendly Hospital Initiative tools, Module IFE and the WHO/UNICEF B-R-E-A-S-T-Feed Observation Form are the best available tools but could be improved by adding questions from other tools. Allowing for context, one tool for rapid community-based assessment plus a more detailed one for clinic/hospital assessment might help optimally identify breastfeeding problems and the support required. Further research is important to refine existing tools and develop new ones. Rigorous testing, especially against outcomes such as breastfeeding status and growth, is key.
Objective:
To assess whether in-hospital infant formula supplementation impacts later successful breastfeeding among healthy mother-infant dyads in the United States who are not intending to exclusively use infant formula.
Study Design:
Using secondary analysis of a national longitudinal survey (Infant Feeding Practices Study II, n = 2,399), we estimated effects of in-hospital infant formula supplementation on later breastfeeding success by matching mothers whose infants received in-hospital formula supplementation with mothers whose infants did not. Estimates were compared across four matching methods. Outcomes of breastfeeding success included likelihood of following a sustained breastfeeding trajectory for the first year postpartum; feelings of favorability and breastfeeding as long as desired postweaning; and breastfeeding intention, initiation, and duration for subsequent children.
Results:
In-hospital formula supplementation halved the likelihood of following a breastfeeding trajectory characterized by sustained exclusive breastfeeding. Supplementation decreased feelings of favorability toward breastfeeding postweaning but did not impact the likelihood of feeling that one breastfed as long as desired. Supplementation did not impact intention to breastfeed a future child; it did, however, decrease the likelihood of breastfeeding initiation with a subsequent child by >66% and reduced average duration of breastfeeding any subsequent children by >6 weeks.
Conclusion:
A lack of experimental methodologies in previous studies makes it difficult to determine a causal link between infant formula in the hospital and less breastfeeding success. Assuming we have accounted for all appropriate confounders, this study provides evidence for such a causal link. Birth hospital policies and practices should speak of this risk of harm.
Kader kesehatan masyarakat adalah pihak dari masyarakat desa yang merupakan lini terdepan dalam membantu masyarakat di desa mengatasi permasalahan kesehatan termasuk membantu keberhasilan ibu menyusui memberikan ASI ekslusif selama enam bulan dan melanjutkan sampai dua tahun, namun belum banyak penelitian yang menggali bagaimana kebutuhan serta kendala yang dihadapi kader dalam membantu keberhasilan ibu menyusui. Tujuan penelitian ini yaitu untuk mengetahui kebutuhan kader kesehatan desa dalam menyukseskan menyusui eksklusif dan menyusui sampai dua tahun serta kendala yang dihadapi. Penelitian ini menggunakan pendekatan cross sectional study dengan metode deskriptif eksploratif terhadap 47 orang kader kesehatan dari 6 desa di kecamatan Darussalam Aceh Besar yang diambil secara acak. Hasil penelitian menunjukkan bahwa 63,8% kader sangat setuju bahwa mereka berperan dalam keberhasilan ibu menyusui. Selain itu, 66% kader membutuhkan kelompok diskusi dengan pertugas kesehatan tentang menyusui secara tatap muka. Dalam melaksanakan perannya, juga terdapat kendala yang dihadapi kader kesehatan dalam membantu ibu menyusui yaitu merasa gagal dalam berkomunikasi dan meyakinkan ibu untuk menyusui bayinya (21,3%), belum memiliki pengetahuan yang memadai ketika ibu menyusui mengeluhkan ASI nya sedikit, puting kecil, dan bayi tidak mau menyusu (17%). Oleh karena itu, dibutuhkan pengetahuan yang mumpuni dari kader serta forum diskusi yang dapat memotivasi kader serta berkonsultasi terhadap permasalahan yang belum diketahuinya untuk membantu keberhasilan ibu menyusui. Community health workers are village structures that are at the frontline of helping communities overcome health problems including helping successful mothers to breastfeed exclusively for six months and continue for up to two years. However, very little research has discussed the needs and constraints faced by the community health worker in helping breastfeeding mothers succeed. The purpose of this study was to determine the needs of village community health workers in the success of exclusive breastfeeding and breastfeeding for up to two years and the obstacles faced. This study used a cross-sectional study approach with a descriptive exploratory method on 47 community health workers from 6 villages in the Darussalam Aceh Besar sub-district who were taken randomly. The results showed that 63.8% of the community health worker strongly agreed that they played a role in the success of breastfeeding mothers. Besides, 66% of community health workers need a face-to-face discussion group with health workers about breastfeeding. In carrying out their role, there are also obstacles faced by the community health worker in helping breastfeeding mothers, namely feeling that they fail to communicate and convince mothers to breastfeed their babies (21.3%), do not have adequate knowledge when breastfeeding mothers complain about their low milk, small nipples, and babies do not want to breastfeed (17%). Therefore, it requires qualified knowledge from community health workers as well as discussion peer group with the breastfeeding counselor that can motivate them and consult on unknown problems to help the success of breastfeeding mothers.
Background: Many small and malnourished infants under 6 months of age have problems with breastfeeding and restoring effective exclusive breastfeeding is a common treatment goal. Assessment is a critical first step of case management, but most malnutrition guidelines do not specify how best to do this. We aimed to identify breastfeeding assessment tools for use in assessing at-risk and malnourished infants in resource-poor settings.
Methods : We systematically searched: Medline and Embase; Web of Knowledge; Cochrane Reviews; Eldis and Google Scholar databases. Also the World Health Organization (WHO), United Nations International Children’s Emergency Fund (UNICEF), CAse REport guidelines, Emergency Nutrition Network, and Field Exchange websites. Assessment tool content was analysed using a framework describing breastfeeding ‘domains’ (baby’s behaviour; mother’s behaviour; position; latching; effective feeding; breast health; baby’s health; mother’s view of feed; number, timing and length of feeds).
Results : We identified 29 breastfeeding assessment tools and 45 validation studies. Eight tools had not been validated. Evidence underpinning most tools was low quality and mainly from high-income countries and hospital settings. The most comprehensive tools were the Breastfeeding, Evaluation and Education Tool, UNICEF Baby-Friendly Hospital Initiative tools and CARE training package. The tool with the strongest evidence was the WHO/UNICEF B-R-E-A-S-T-Feed Observation Form.
Conclusions : Despite many possible tools, there is currently no one gold standard. For assessing malnourished infants in resource-poor settings, UNICEF Baby-Friendly Hospital Initiative tools, Module IFE and the WHO/UNICEF B-R-E-A-S-T-Feed Observation Form are the best available tools but could be improved by adding questions from other tools. Allowing for context, one tool for rapid community-based assessment plus a more detailed one for clinic/hospital assessment might help optimally identify breastfeeding problems and the support required. Further research is important to refine existing tools and develop new ones. Rigorous testing, especially against outcomes such as breastfeeding status and growth, is key.
Background
The majority of new mothers in Sweden initiate breastfeeding and many experience initial difficulties. This experience is an important cause of early breastfeeding cessation. To increase understanding, there is a need to explore the lived experiences of the decision to continue or cease breastfeeding. The aim of this study is therefore to explain and understand how this decision is influenced by the meaning of severe initial difficulties.
Methods
A lifeworld hermeneutical approach was used for the study. The study was conducted in Sweden with eight mothers who experienced severe difficulties with initial breastfeeding. All except one were interviewed on two different occasions resulting in fifteen interviews. The interviews were conducted between 2010 and 2013.
Results
Mothers who experience severe difficulties with initial breastfeeding feel both overtaken and violated not only by their own infants and their own bodies but also by their anger, expectations, loneliness and care from health professionals. These feelings of being overtaken and invaded provoke an existential crisis and place mothers at a turning point in which these feelings are compared and put in relation to one another in the negotiation of the decision to continue or cease breastfeeding. This decision thus depends on the possibility of feeling secure with the breastfeeding relationship. If insecurity dominates, this can, in severe cases, create a feeling of fear of breastfeeding that is so great that there is no alternative but to stop breastfeeding.
Conclusions
Existential security in the breastfeeding relationship seems to be an underlying factor for confidence and therefore a necessary condition for continued breastfeeding when having severe initial breastfeeding difficulties. Unresolved feelings of insecurity may be a serious barrier to further breastfeeding that can result in a fear of breastfeeding. Such fear can force the mother to cease breastfeeding. This study highlights how women are situated in a complex cultural and biological context of breastfeeding that has existential consequences for them. An existential crisis forces mothers into a turning point for the breastfeeding decision. In the existential crisis, mothers’ responsibility for the mother-infant relationship guides continuing or ceasing breastfeeding.
Exclusive breastfeeding is the most widely known and effective intervention for preventing early-childhood deaths. Optimum breastfeeding practices can prevent 1.4 million deaths worldwide among children under five every year. The aim of this study was to assess the prevalence of exclusive breastfeeding and associated factors among mothers who have an infant less than six months old in Debre Markos, Northwest Ethiopia.
A community based cross-sectional study was conducted from April 1 to 30, 2013. A simple random sampling technique was used from a list of all mothers who had an infant less than six months old obtained from the health extension workers (HEWs) registration book in all kebeles (neighbourhoods) of the city. A total of 423 mothers with infants less than six months old were included in this study. Data were collected using questionnaires administered at interview. Both bivariate and multivariate logistic regression analyses were carried out to identify factors associated with exclusive breastfeeding.
The prevalence of exclusive breastfeeding during the seven days before the survey was 60.8% (95% CI: 55.8%, 65.8%). Those mothers who were unemployed [AOR = 1.98 (1.21, 3.22)], received breastfeeding counseling during antenatal care (ANC) [AOR = 2.44 (1.53, 3.91)], received infant feeding counseling during postnatal care (PNC) [AOR = 5.03 (3.04, 8.31)], didn't give prelacteal feeding [AOR = 3.44 (1.88, 6.33)] and had adequate knowledge about breastfeeding [AOR = 2.57 (1.57, 4.19)] were more likely to practice EBF than their counterparts.
Although the prevalence of exclusive breastfeeding was lower in the study area than international recommendations, rates were higher than found in other studies. Recommendations for improving exclusive breastfeeding include better support for working mothers through extending maternal leave and establishing work-site day care centers for infants, expanding the urban health extension program so that more pregnant women and mothers can be taught about appropriate infant and young child feeding practices and how to express their milk, thereby increasing their breastfeeding knowledge.
The aim of this study was to provide a more detailed analysis of the infant's behavioural sequence that begins immediately after birth and terminates with grasping the nipple, suckling and then falling asleep.
Twenty-eight full-term infants were videotaped immediately after birth. A video protocol was developed to examine infant behaviours identified from five random videotapes.
When birth crying had stopped, the babies showed a short period of relaxation and then successively became alert. They went through an 'awakening phase', an 'active phase' with movements of limbs, rooting activity and looking at the mother's face, a 'crawling phase' with soliciting sounds, a 'familiarization phase' with licking of the areola, and a 'suckling phase' and last a 'sleeping phase'. Five factors related to the time spent to locate the breast: more number of looks at the breast 10-20 min after birth (p < 0.0001); and exposure to meperidine (p = 0.0006) related to increased time. Early start of crawling (p = 0,0040); increased number of 'soliciting sounds' (p = 0.0022); and performing hand-breast-mouth movements (p = 0.0105) related to shorter time.
Inborn breastfeeding reflexes were depressed at birth, possibly because of a depressed sensory system. It is hypothesized that when the infant is given the option to peacefully go through the nine behavioural phases birth cry, relaxation, awakening, activity, crawling, resting, familiarization, suckling and sleeping when skin-to-skin with its mother this results in early optimal self-regulation.
Improving the duration of exclusive breastfeeding is a national and international priority. Insufficient milk supply is one of the most commonly cited reasons for early cessation or decreased exclusivity in women who have initiated breastfeeding. This paper is an integrative review of current research pertaining to perceived insufficient milk (PIM).
CINAHL, MEDLINE, and PubMed were searched combining "human milk" and "milk supply" and "perceived milk supply." Articles were limited to original research studies related to healthy, full-term breastfeeding dyads conducted over the past 10 years. Critical review indicated robust findings, limitations, and gaps in this body of literature.
A lot of women discontinue breastfeeding during the first few weeks of the post-partum period because of PIM and approximately 35% of all women who wean early report PIM as the primary reason. Many women utilize infant satisfaction cues as their main indication of milk supply and many researchers, clinicians, and breast-feeding women do not evaluate actual milk supply. The relationships between PIM and socioeconomic or demographic variables as well as early breastfeeding behaviors have not been adequately addressed in the literature.
Recommendations include improvement of maternal education about behaviors to ensure adequate supply, assessment of milk supply, and infant cues as well as further research into the root causes of PIM.
Practitioners involved with maternal child health can improve their care of women and infants by understanding the subjective nature and questionable accuracy of PIM and changing assessment of milk supply.
The idea that difficult newborn behaviour reflects an inborn disposition was tested by comparing measures from different circumstances, occasions and observers. Correlations between researcher measures from separate settings and occasions were statistically significant but modest, indicating a "rudimentary" constitutional trait contribution to difficult newborn behaviour. Little evidence of a discrete subgroup of particularly difficult newborns was obtained. Maternal assessments were internally consistent but weakly explained by baby constitutional factors or nurses' reports. The importance of contextual and development variables is discussed. Alternative methodological strategies for studying constitutional and social-developmental contributions to difficult behaviour are needed.
Newborns placed skin-to-skin with their mothers show an inborn sequence of behavior similar to that seen in other mammals. The purpose of this study was to make a detailed exploration of hand movements and sucking behavior in healthy term newborns who were placed skin-to-skin on their mothers' chests, and to study maternal oxytocin release in relation to these behaviors.
Ten vaginally delivered infants whose mothers had not been exposed to maternal analgesia were video-recorded from birth until the first breastfeeding. Video protocols were developed based on observations of the videotapes. Each infant's hand, finger, mouth, and tongue movements, positions of the hand and body, and sucking behavior were assessed every 30 seconds. Maternal blood samples were collected every 15 minutes, and oxytocin levels were analyzed by radioimmunoassay. A statistical test for establishing the relationship between maternal oxytocin levels and infants' hand movements or sucking behavior was developed.
Infants used their hands to explore and stimulate their mother's breast in preparation for the first breastfeeding. A coordinated pattern of infant hand and sucking movements was also identified. When the infants were sucking, the massagelike hand movements stopped and started again when the infants made a sucking pause. Periods of increased massagelike hand movements or sucking of the mother's breast were followed by an increase in maternal oxytocin levels (p < 0.005).
The findings indicate that the newborns use their hands as well as their mouths to stimulate maternal oxytocin release after birth, which may have significance for uterine contraction, milk ejection, and mother-infant interaction.