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BACKGROUND: Early formula supplementation (EFS, formula on birthdate or day after) is associated with maternal obesity and reduced breastfeeding, but the effect of prenatal breastfeeding intention on these relationships is understudied. OBJECTIVES: We evaluated how EFS affected breastfeeding outcomes after controlling for obesity, sociodemographic and health factors. METHODS: Multivariable regression modeling, stratified by prenatal breastfeeding intention. CONCLUSIONS: Our findings suggest that EFS may be less disruptive to breastfeeding in mothers with strong intention to meet breastfeeding recommendations, regardless of maternal BMI.

Background: Early formula supplementation (EFS, formula on birthdate or day after) is associated with maternal obesity and reduced breastfeeding, but the effect of prenatal breastfeeding intention on these relationships is understudied. Objectives: We evaluated how EFS affected breastfeeding outcomes after controlling for obesity, sociodemographic and health factors. Methods: Multivariable regression modeling, stratified by prenatal breastfeeding intention. Conclusions: Our findings suggest that EFS may be less disruptive to breastfeeding in mothers with strong intention to meet breastfeeding recommendations, regardless of maternal BMI.

Background: Exclusive breastfeeding (EBF) remains the cornerstone of infant nutrition for the first six months of life, presenting multiple short and long term benefits. The purpose of this study is the demonstration of EBF rates of infants born in baby-friendly hospitals (BFH) and the factors that positively influence EBF. Methods: The study was conducted in all four of the BFH that exist in Greece, between 2020 and 2022. The study sample consisted of 1200 mothers, taken from the 7101 that delivered at those hospitals during the time of the study. A questionnaire was used that included questions to evaluate the infant's nutrition after birth, after exiting the maternity hospital and during the 2nd, 4th and 6th month of age. The WHO guidelines on EBF and breastfeeding (BF), as well as the "Infant and Young Child Feeding" indicators, were used. Results: The EBF rate within 1 h after birth was 71.3%, which gradually declined to 21.2% in the 6th month. The respective rate of BF was 94.5% and declined to 66.1%. The logistic regression revealed that attending antenatal breastfeeding courses, vaginal delivery, full-term pregnancies and the mothers' advanced education level constitute independent positive prognostic factors for increased EBF rates. Conclusion: The results of the first national study on BFH are presented. Despite the improvement of EBF rates in Greece, compared to the latest available data from 2018, reinforcement of EBF promotion measures is required in order to approach the WHO's targets by 2025. [ABSTRACT FROM AUTHOR]

Background: Exclusive breastfeeding (EBF) remains the cornerstone of infant nutrition for the first six months of life, presenting multiple short and long term benefits. The purpose of this study is the demonstration of EBF rates of infants born in baby-friendly hospitals (BFH) and the factors that positively influence EBF. Methods: The study was conducted in all four of the BFH that exist in Greece, between 2020 and 2022. The study sample consisted of 1200 mothers, taken from the 7101 that delivered at those hospitals during the time of the study. A questionnaire was used that included questions to evaluate the infant’s nutrition after birth, after exiting the maternity hospital and during the 2nd, 4th and 6th month of age. The WHO guidelines on EBF and breastfeeding (BF), as well as the “Infant and Young Child Feeding” indicators, were used. Results: The EBF rate within 1 h after birth was 71.3%, which gradually declined to 21.2% in the 6th month. The respective rate of BF was 94.5% and declined to 66.1%. The logistic regression revealed that attending antenatal breastfeeding courses, vaginal delivery, full-term pregnancies and the mothers’ advanced education level constitute independent positive prognostic factors for increased EBF rates. Conclusion: The results of the first national study on BFH are presented. Despite the improvement of EBF rates in Greece, compared to the latest available data from 2018, reinforcement of EBF promotion measures is required in order to approach the WHO’s targets by 2025.

Objective  The study compares the short-term outcomes of late preterm infants (LPI) at an academic center in San Diego, California after a change in protocol that eliminated a previously mandatory 12-hour neonatal intensive care unit (NICU) observation period after birth. Study Design  This is a retrospective observational study examining all LPI born with gestational age 35 to 36 6/7  weeks between October 1, 2016 and October 31, 2017. A total of 189 infants were included in the review. Short-term outcomes were analyzed before and after the protocol change. Results  Transfers to the NICU from family-centered care (FCC) were considerably higher (23.2%) following the protocol change, compared to before (8.2%). More infants were transferred to the NICU for failed car seat tests postprotocol compared to preprotocol. Length of stay before the protocol change was 5.13 days compared to 4.80 days after. Conclusion  LPI are vulnerable to morbidities after delivery and through discharge. We found an increase in failed car seat tests in LPI cared for in FCC after elimination of a mandatory NICU observation after birth. The transitions of care from delivery to discharge are key checkpoints in minimizing complications. [ABSTRACT FROM AUTHOR]

The Baby Friendly Health Initiative (BFHI) aims to improve breastfeeding initiation and continuation. Teaching antenatal colostrum expression (ACE] may also promote positive breastfeeding outcomes. However, there is concern that this may impact birth outcomes. This study was a retrospective audit of medical records from 294 women attending a general public hospital in Western Australia. The aim was to assess breastfeeding and birth outcomes before and after provision of ACE education and BFHI care as standard hospital practice. Breastfeeding, infant and obstetric outcomes were assessed across three time periods representing different situations: no routine ACE education or BFHI accreditation (n = 98); ACE education only (n = 100); and both ACE education and BFHI accreditation (n = 96). Results showed that mothers were more likely to see a lactation consultant after introduction of ACE education (p = 0.045) and with BFHI care (p = 0.053); and increased initiation of breastfeeding as the first feed was also observed (p = 0.049). ACE education was not associated with significantly increased rates of special care nursery admission, or lower gestational age at birth. No significant differences in infant formula use were detected. Further research is warranted to investigate the impact of antenatal education on rates of ACE performance, and explore both antenatal expressing and the BFHI care in relation to longer-term outcomes, including exclusive breastfeeding duration. [ABSTRACT FROM AUTHOR]

Objective: To demonstrate the applications of the principles of Quality Improvement (QI) in a tertiary-care centre with the aim to improve the breastfeeding practices during hospital stay.Methods: An operational team was formulated to identify the reasons for low proportion of exclusive breast feeding (EBF) in healthy neonates. Reason specific solutions were proposed, discussed, prioritized and tested using Plan-Do-Study-Act Cycle (PDSA Cycle). Strategies included clear departmental policy plan and creation of Breastfeeding support package (BFSP). PDSA cycles were tested and implemented over 6 weeks period and its sustainability was measured monthly for five months duration.Results: After implementation of PDSA cycles, the proportion of neonates receiving early breastfeeding within one hour of birth increased from 55% to 95%, and the proportion of neonates on EBF during hospital stay increased from 72% to 98%.Conclusion: Quality Improvement principles are feasible and effective to improve breastfeeding practices in the hospital setting. [ABSTRACT FROM AUTHOR]

Breast milk feeding (BMF) is associated with lower neonatal morbidity in the very preterm infant (<32 weeks gestation) and breastfeeding is beneficial for maternal health. Previous studies show large variations in BMF after very preterm birth and recognize the need for targeted breastfeeding support in the neonatal intensive care units (NICU). In a European collaboration project about evidence-based practices after very preterm birth, we examined the association between maternal, obstetric, and infant clinical factors; neonatal and maternal care unit policies; and BMF at discharge from the NICU. In multivariable analyses, covariates associated with feeding at discharge were first investigated as predictors of any BMF and in further analysis as predictors of exclusive or partial BMF. Overall, 58% (3,826/6,592) of the infants received any BMF at discharge, but there were large variations between regions (range 36-80%). Primiparity, administration of antenatal corticosteroids, first enteral feed <24 hr after birth, and mother's own milk at first enteral feed were predictors positively associated with any BMF at discharge. Vaginal delivery, singleton birth, and receiving mother's own milk at first enteral feed were associated with exclusive BMF at discharge. Units with a Baby Friendly Hospital accreditation improved any BMF at discharge; units with protocols for BMF and units using donor milk had higher rates of exclusive BMF at discharge. This study suggests that there is a high potential for improving BMF through policies and support in the NICU. [ABSTRACT FROM AUTHOR]

OBJETIVO: Avaliar as taxas e o padrão de aleitamento materno dos recém-nascidos internados em berçário de alto risco no momento de sua alta hospitalar e analisar os potenciais fatores que interferem na prática do aleitamento materno exclusivo. MÉTODOS: Foram estudados prontuários médicos de 495 recém-nascidos internados no berçário de alto risco da Maternidade Odete Valadares, Minas Gerais, antes e após receber o título de Hospital Amigo da Criança. Foram excluídos os nascidos fora da maternidade e durante o período de transição, crianças ou mães que foram a óbito ou transferidas da instituição e crianças abandonadas e/ou de mães com contra-indicação para amamentar. Foram calculadas razões de chance (odds ratio, OR) e intervalos de confiança de 95% a partir de análises bivariadas e multivariadas utilizando a técnica da regressão logística. RESULTADOS: A taxa de aleitamento materno exclusivo na alta passou de 36% no período anterior para 54,6% no período posterior à implementação da Iniciativa Hospital Amigo da Criança. Os fatores de risco independentemente associados com ausência de aleitamento exclusivo foram: uso da dieta por sonda (OR = 3,01), número de consultas pré-natais menor que seis (OR = 2,21), uso de translactação (OR = 2,66), peso ao nascer < 2.500 g (OR = 2,64) e internação em período anterior ao recebimento do título de Hospital Amigo da Criança pela maternidade (OR = 2,75). CONCLUSÃO: Este estudo mostra que, entre outros fatores, as mudanças nas práticas hospitalares com a implementação da Iniciativa Hospital Amigo da Criança foram determinantes para o aumento das taxas de aleitamento materno exclusivo na alta em crianças de alto risco.OBJECTIVE: To study the rate of exclusive breastfeeding at the moment of hospital discharge of newborns admitted to a neonatal Intensive Care Unit and to analyze potential risk factors. METHODS: Four hundred and ninety-five medical records were studied, pertaining to neonates born between 1998 and 1999, admitted to a neonatal intensive care unit, before and after the implementation of the Baby Friendly Hospital Initiative policies. Babies born during the Baby Friendly Hospital Initiative transition period and outside the Maternity ward were excluded from the study, as were children or mothers who were transferred from the institution, abandoned children and also mothers unfit to breastfeed. Risk factors for non-exclusive breast-feeding at discharge were studied. Odds ratio and 95% confidence intervals were calculated using multivariate logistic regression. RESULTS: The exclusive breastfeeding rate increased from 36% at discharge (before the Baby Friendly Hospital Initiative) to 54.7% (after CFHI). The independent risk factors associated with non-exclusive breastfeeding were the use of enteral feeding (OR = 3.01), ante-natal consultations < 6 (OR = 2.75), relactation use (OR = 2.66), birth weight < 2,500 g (OR = 2.64) and being born during the period before Baby-Friendly policies were implemented (OR = 2.75) CONCLUSION: This research shows the potential efficiency of adopting Baby-Friendly policies to increase the chance of successful breastfeeding at the point of discharge for high-risk newborns.

AIM: Low level of knowledge and practice of exclusive breast feeding have been reported in Nigeria especially in rural communities. The purpose of this study is to identify factors contributing to low knowledge and practice of exclusive breast feeding (E B F) in rural communities of Abia State, Nigeria and apply health promotion intervention (H P I) to address these factors in order to increase knowledge and practice of E B F. METHOD: A quasi-experimental study design was used. Four communities formed the unit of allocation to experimental and control groups for the purpose of introducing health promotion intervention. A multi-stage sampling procedure was used in selecting the study sample. A sample size of 400 households out of 1978 enumerated from the four communities was used for the survey, two as experimental and two as control. Data were collected using a pretested structured questionnaire that was interviewer administered. Data were analyzed quantitatively and qualitatively. Chi-square and Mc Nemar statistic were used in determining statistical significance. Analysis of knowledge and practice of EBF was taken before and after H P I and compared in both experimental and control groups. RESULTS: The results indicated increase in knowledge of E B F from 28(14%) to 200(98.5%). Correspondingly, practice of E B F increased from 21 (10%) to 162(80%) in the experimental group. No significant increase was made in the control group both in knowledge and practice of EBF. Factors contributing to low level of practice of EBF in the study area included low level of knowledge about ten steps to successful breast feeding, illusory fears about EBF, ignorance, resistance to change, cultural imperatives and medical reasons. Health promotion intervention directed at the rural women helped to scale up the practice of EBF to 70% within nine months. CONCLUSION: The study recommends health promotion intervention as a proven method for scaling up knowledge and practice of EBF in rural communities. [ABSTRACT FROM AUTHOR]

The article focuses on the study which evaluates the sex ratio of older population in rural areas of India. According to the research, most of the morbidity cases were in dental problems, visual acuity disorder, hypertension and hearing impairment. It found that women have the highest statistical rates of arthritis, skin diseases and eye disorders.

Objective. To evaluate the influence of a program to promote breast-feeding on the consumption of infant formulas. Material and methods. We reviewed the reports of consumption of infants formulas during the 22 months previous to (period A) and after (period B) the beginning of the campaign. The total number of tins consumed and the number of liters prepared was recorded, and the quantity consumed and the cost per child was calculated. The data were analyzed by non-paired Student's t test, and the level of statistical significance was fixed at p < 0.05. Results. There were statistically significant differences regarding the number of tins, kilograms of formula, liters of prepared milk, total cost of the product, consumption of formula per child and cost of feeding per child. The differences in all variables were favorable to period B. Discussion. Our results suggest that breast-feeding campaigns decrease the consumption of infant formulas and the cost of feeding the newborn. [ABSTRACT FROM AUTHOR]

Background: Excessive weight loss enhances the incidence of neonatal hypernatremic dehydration (NHD). We compared the effect of a new breastfeeding policy against an old breastfeeding policy on neonatal weight change and the incidence of NHD., Methods: This was a QA project between two sets of breastfeeding (BF) protocols for exclusively BF newborns. Under our old BF policy, a number of neonates had a significant loss of weight after birth and were admitted to the NICU due to NHD. We implemented a new BF policy that was used when a newborn loses > 5% of previously recorded weight within a 24-h interval. Two groups were compared: the preintervention group (old BF policy) and postintervention group (new BF policy). Additionally, characteristics of newborns admitted to NICU were separately compared with the subgroup of pre- and post intervention dehydration groups., Results: Preintervention = 1320 and postintervention = 1450. Neonates with weight loss of ≥ 5% within the first 24-h time interval were higher in the postintervention group (19.7%) as compared to the preintervention group (10.2%) ( P  < .05). However, the number of infants diagnosed to have NHD was lower in the postintervention group (0.68%) than in the preintervention group (1.66%), ( P  < .03). Neonatal characteristics were comparable between subgroups of dehydration., Conclusion: An intervention at ≥ 5% neonatal weight loss markedly reduces the incidence of NHD-associated NICU admissions., Competing Interests: We declare that none of the authors have any conflict of interest or have received support for any of the products described., (© 2021 Publishing services provided by Elsevier B.V. on behalf of King Faisal Specialist Hospital & Research Centre (General Organization), Saudi Arabia.)

The article presents studies which compared birth practices in Northwest Russia in 2000 and 2002 and in Northern Norway in 2000. The studies used the "Women's Experience of Birth" questionnaire. The mode of delivery and social support experienced by women involved in the studies are discussed. The importance of designated baby friendly Hospital Initiative is stressed.