Search

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.

Introduction: Exclusive breastfeeding is widely recognized as the optimal way to feed infants due to its numerous health benefits for both the child and the mother. Despite its advantages, Ghana is still far from attaining World Health Organization (WHO) recommended rates. This study is aimed at exploring the knowledge attitude and practices, where the practices hinged on facilitators, barriers, and sociocultural perspectives of breastfeeding mothers and significant others on exclusive breastfeeding. Methods: This study employed an ethnographic thematic analysis framed by the socioecological model (SEM). Thematic analysis was paired with focus group discussions (FGDs). The study participants were recruited purposively by employing a snowball sampling technique with the assistance of community health volunteers. Three (3) FGDs were formed, with 10 participants in each group, to gather perspectives from breastfeeding mothers and significant others (partners and grandmothers) in three communities with Community-based Health Planning and Services (CHPS) compounds within the Tamale metropolis. With an interview guide, all FGDs were audio-taped, transcribed verbatim, and translated from local dialects to English. The emerging themes were used in writing a narrative account, guided by the principles of thematic analysis. Results: This study identified three thematic areas: knowledge of exclusive breastfeeding (EBF); attitudes toward EBF and practices of EBF (facilitators, barriers, and sociocultural practices). There was some knowledge disparity among lactating mothers despite the overall high knowledge and subpar attitudes of some mothers. The practice of exclusive breastfeeding was substandard. The major hindrances identified were cultural barriers propagated by partners/husbands and grandmothers; the belief that the weather here does not support EBF; and the need for spiritual herbs in infancy. Supportive healthcare providers helped increase the practice of exclusive breastfeeding. Some support also came from partners and husbands, and some mothers showed unique positive behaviors by exclusively breastfeeding. Conclusion: This study revealed that while exclusive breastfeeding education has been ongoing for decades, sociocultural norms still influence mothers to deviate from WHO recommendations. Public education is recommended to dispel misconceptions surrounding exclusive breastfeeding, develop a food galactagogue to help with breastmilk volumes and create a supportive environment that empowers mothers and families to make informed choices that optimize the health and well-being of both infants and mothers. [ABSTRACT FROM AUTHOR]

Background/Aims: The World Health Organization recommends exclusive breastfeeding, but global rates remain low. The aim of this review was to provide insight into the reasons behind mothers' decisions to cease exclusive breastfeeding in the first 6 months. Methods: Studies published from 2013 on exclusive breastfeeding cessation were eligible for inclusion in the review. A total of 1910 studies were retrieved in the initial search, with 17 included in the final review. Results: There were five main themes encompassing 19 factors that contributed to the decision to cease exclusive breastfeeding. These were challenges related to lactation, the infant, the mother's health, social issues and lifestyle. Lactation issues were the most common reason for stopping exclusive breastfeeding, while returning to work was the main lifestyle-related factor. Conclusions: A clear understanding of why mothers stop exclusive breastfeeding should form the foundation of breastfeeding intervention strategies, as clinical support alone is insufficient for helping mothers achieve their breastfeeding goals. Implications for practice: Healthcare providers should develop targeted interventions tailored to address reasons for early cessation of exclusive breastfeeding. There is a need for improved lactation support services, including education on proper latch techniques, management of nipple pain and injuries, and strategies to address perceived insufficient milk supply. There is also a need for improved education on breastfeeding techniques, expressing milk and storage options. Healthcare providers should involve family members in breastfeeding education to create a supportive environment for breastfeeding mothers. [ABSTRACT FROM AUTHOR]

Breastfeeding improves cognitive ability in childhood, but the long-term impact on socioeconomic outcomes remains unknown. We examined associations between durations of predominant and any breastfeeding and educational attainment, income, and labor force participation in adulthood, and whether these varied by maternal education. Prospective cohort study. We followed 84,255 individuals born 1959–1967 with prospectively collected information on breastfeeding duration and intensity from the Copenhagen Infant Health Nurse Records. Socioeconomic outcome information came from national registers (1980–2020). Linear and Poisson regression were used, and models were adjusted for prenatal and postnatal variables across three levels of maternal education. Durations of being breastfed exhibited associations with all outcomes, with most being more pronounced among mothers with low education. Compared with infants breastfed <1 month, those breastfed ≥5 months had 0.68 (95% confidence interval: 0.60–0.76), 0.55 (0.45–0.65), and 0.65 (0.46–0.84) additional years of education for infants born to mothers with low, medium, or high education, respectively. Moreover, infants breastfed ≥5 months had 4047, 3713, and 1902 US$ higher annual incomes and were 23% less likely to be outside the labor force at age 50 years. These associations were stronger with longer breastfeeding durations and for predominant than any breastfeeding. Prolonged and higher breastfeeding intensity consistently exhibited dose-dependent associations with improved socioeconomic indicators in adulthood. Notably, these relationships were more pronounced among individuals whose mothers had lower educational attainment. Consequently, our findings suggest that breastfeeding may have a lasting positive influence on socioeconomic outcomes, particularly for the most disadvantaged infants. [ABSTRACT FROM AUTHOR]

Background/Objectives: Different international organizations recommend exclusive breastfeeding during the neonate's first six months of life; however, figures of around 38% are reported at the global level. One of the reasons for early abandonment is the mothers' perception of supplying insufficient milk to their newborns. The objective of this research is to assess how mothers' perceived level of self-efficacy during breastfeeding affects their ability to breastfeed and the rates of exclusive breastfeeding up to six months postpartum. Methods: A systematic review for the 2000–2023 period was conducted in the following databases: Cochrane, Web of Science, Scopus, PubMed, Science Direct, and CINAHL. Original articles, clinical trials, and observational studies in English and Spanish were included. Results: The results comprised 18 articles in the review (2006–2023), with an overall sample of 2004 participants. All studies were conducted with women who wanted to breastfeed, used the Breastfeeding Self-Efficacy Scale or its short version to measure postpartum self-efficacy levels, and breastfeeding rates were assessed up to 6 months postpartum. Conclusions: The present review draws on evidence suggesting that mothers' perceived level of self-efficacy about their ability to breastfeed affects rates of exclusive breastfeeding up to 6 months postpartum. High levels of self-efficacy are positively related to the establishment and maintenance of exclusive breastfeeding; however, these rates decline markedly at 6 months postpartum [ABSTRACT FROM AUTHOR]

In recent years, significant progress has been made in treatment access for women living with HIV (WLHIV). For example, option B+, which requires that all pregnant persons who test positive for HIV start on antiretroviral treatment, has been instrumental in reducing the risk of vertical transmission. For birthing individuals who have a low HIV viral load, there is a minimized risk of vertical transmission during breastfeeding. However, an alarming rate of WLHIV in South Africa disengage from care during postpartum. Given that work is intricately linked to individuals' socioeconomic status, and thus health outcomes, and their health-seeking ability, it is important to explore the role of work in decisions that impact HIV-related care for the dyad postpartum. Semi-structured interviews were conducted with 26 women living with HIV at 6–8 weeks postpartum in Cape Town, South Africa. A secondary qualitative data analysis was conducted following thematic content analysis. Three themes were identified, spanning participants' financial considerations, navigating childcare needs, and considerations for exclusive breastfeeding. For many participants, there was often a conflict between returning to work, childcare, and the decision whether or not to breastfeed—in addition to their HIV care. This conflict between participants' commitments suggests an increased pressure that WLHIV may face postpartum, which could impact their ability to remain engaged in their healthcare and adherent to medication. Although exclusive breastfeeding is an important recommendation for the baby's health outcomes; there is a need for structural support for WLHIV as they navigate work re-entry during postpartum. [ABSTRACT FROM AUTHOR]

Children who are HIV-exposed and uninfected (CHEU) are at increased risk for poor growth, health, and development compared to children who are HIV-unexposed and uninfected. To support families with CHEU, we assessed the acceptability of engaging family members to support women living with HIV (WLWH) with exclusive breastfeeding (EBF) and antiretroviral therapy (ART) adherence and to engage in responsive infant caregiving. We conducted trials of improved practices, a consultative research approach, that follows participants over time as they try recommended behaviors. We enrolled postpartum women in Lusaka, Zambia, who identified home supporters. At visit 1, WLWH were interviewed about current practices. At visit 2, WLWH and home supporters received tailored EBF, responsive care, and ART adherence counseling. At visit 3, WLWH and home supporters were interviewed about their experiences trying recommended practices for 2–3 weeks. Interview transcripts were analyzed thematically. Participants included 23 WLWH, 15 male partners, and 8 female family members. WLWH reported several barriers to EBF. The most common were fear of HIV transmission via breastfeeding—despite high ART adherence—and insufficient breastmilk. After counseling, WLWH reported less fear of HIV transmission and improved breastfeeding practices. Home supporters reported providing WLWH increased support for EBF and ART adherence and practicing responsive caregiving. Both male and female home supporters appreciated being included in counseling and more involved in caregiving, and WLWH valued the increased support. Families with CHEU need focused support. Tailored counseling and family support for WLWH show promise for improving EBF, responsive caregiving, and ART adherence. Resumen: Los niños expuestos al VIH no infectados (ENI) tienen un mayor riesgo de tener un crecimiento, una salud y un desarrollo deficientes. Evaluamos la aceptabilidad de involucrar a los miembros de la familia para apoyar a las madres que viven con el VIH con la lactancia materna exclusiva y el cumplimiento de la terapia antirretroviral y así como para participar en un cuidado cariñoso y sensible. Trials of Improved Practices (TIPs) es un enfoque de investigación consultiva que sigue a los participantes mientras prueban los comportamientos recomendados. Inscribimos a mujeres con bebes menores de 3 meses que viven con el VIH en Lusaka, Zambia, que identificaron miembros de sus familias para que las apoyaban. En la visita 1, se entrevistó a madres sobre las prácticas actuales. En la visita 2, las madres y los miembros de sus familias recibieron asesoramiento personalizada. En la visita 3, se entrevistó a las madres y a los miembros de sus familias sobre sus experiencias al probar los comportamientos recomendados. Las entrevistas se analizaron temáticamente. Los participantes incluyeron 23 madres, 15 esposos y 8 familiares femeninas. Madres informaron sobre obstáculos a la lactancia materna, siendo los más comunes fueron el miedo a la transmisión del VIH a través de la lactancia materna (a pesar del alto cumplimiento de la terapia antirretroviral) y la falta de leche materna. Después del asesoramiento, las mujeres informaron menos miedo a la transmisión del VIH, mejores prácticas de lactancia materna, y más apoyo de sus familiares. El apoyo familiar y el asesoramiento personalizado son estrategias potenciales para apoyar a las madres que viven con el VIH. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) aims to achieve a 50% rate of exclusive breastfeeding (EBF) during the first six months of life by 2025. Continuing breastfeeding up to six months is determined by an individual woman's choice and the availability of breastfeeding-friendly environments. Methods: In this multicenter prospective longitudinal study, we identified breastfeeding-friendly environmental factors that were associated with breastfeeding practices from days 1–5 to six months postpartum. Breastfeeding-friendly environmental factors were assessed using structured questionnaires for mothers who gave birth under a Baby-Friendly Hospital Initiative (BFHI). We evaluated uptake of breastfeeding by asking mothers if they used the indicated practices, as well as their perceived level of acceptance of breastfeeding among their live-in family members and their perceived availability of lactation rooms in public settings. From 2012 to 2016, we recruited 1,870 women at 1–5 days postpartum from obstetrics medical facilities in Taiwan and followed their breastfeeding status at one, two, four, and six months postpartum. The definition of EBF was that the infant had received only breast milk since birth, with no supplemental infant formula. We categorized breastfeeding practices into two groups: continuing EBF and non-continuing EBF at six months. We used logistic regression models to identify factors associated with continuing EBF at six months postpartum. Results: The prevalence of EBF and non-EBF at six months postpartum was 30.9% and 69.1%, respectively. The logistic regression analysis revealed that above university-level education, multiparity, and vaginal delivery were positively associated with continuing EBF. The Ten Step Baby-Friendly Hospital Initiative practices, perceived acceptance of breastfeeding in live-in families, and perceived availability of lactation rooms in public settings, were associated with a higher likelihood of continuing EBF. Postpartum women who returned to work at or after two months postpartum were more likely to report non-continuing EBF than women who did not return to work. Conclusion: Those who promote public health should advocate for breastfeeding-friendly practices, including the adoption of breastfeeding-friendly measures in public and workplace settings and providing increased support for breastfeeding mothers during and after hospitalization. [ABSTRACT FROM AUTHOR]

Background: Despite the benefits of exclusive breastfeeding, the proportion of exclusively breastfed children remains low in rural China. Self-efficacy is one of the most crucial modifiable factors predicting breastfeeding behavior. However, existing instruments in China do not specifically measure self-efficacy for exclusive breastfeeding but rather measure self-efficacy for any breastfeeding. Furthermore, they have been validated only in high-income Chinese settings. We sought to adapt and validate an instrument to measure exclusive breastfeeding self-efficacy within rural Chinese contexts. Methods: We introduced relevant items to Dennis' Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), which can assess maternal self-efficacy for exclusive breastfeeding. It was then implemented in a multistage random cluster sampling design and cross-sectional survey with home-visit interviews among women 0–6 months postpartum (n = 654) in the rural areas of four counties in Sichuan, China. We performed item-total and adjusted item-total correlations, as well as exploratory factor analysis to remove redundant items and determine the latent factor structure. We further applied confirmatory factor analysis to test the dimensionality of the scale. We then assessed the reliability of the scale and conducted tests of predictive and divergent validity. Known group comparisons were made by primiparous status and breastfeeding support level. We compared the validated Exclusive Breastfeeding Self-Efficacy Scale with the BSES-SF in terms of reliability and validity to explore the added value of scale modification. Results: Our modification of the BSES-SF to target exclusive breastfeeding produced 19 items. This was further reduced to 15 items based on adjusted item-total correlations and exploratory factor analysis, forming the Exclusive Breastfeeding Self-Efficacy Scale. This scale had three dimensions: "Breast milk supply and quality," "Breastfeeding skills," and "Exclusive breastfeeding" subscales. The Exclusive Breastfeeding Self-Efficacy Scale demonstrated strong internal consistency and overall reliability with a Cronbach's alpha coefficient of 0.91. Predictive and divergent validity and known group comparison assessments supported its validity. Robust psychometric evaluations demonstrated enhanced validity and reliability compared to the original BSES-SF. Conclusions: Our Exclusive Breastfeeding Self-Efficacy Scale is valid and reliable for measuring exclusive breastfeeding self-efficacy within rural Chinese contexts and is ready for adaptation and validation for clinical and programmatic use elsewhere, particularly within LMICs. [ABSTRACT FROM AUTHOR]

Indonesia as a developing country has many health problems, one of these problems is stunting. According to WHO, stunting is a condition where a child's z-score is less than -2 SD/standard deviation as measured on the WHO growth curve. Many factors cause toddlers to experience stunting, such as poor nutritional status during the mother's pregnancy, parenting patterns, and exclusive breastfeeding. Exclusive breastfeeding is the initial food for babies because it contains essential nutrients for immunity so that babies do not get infected easily. In North Sumatra, the stunting incidence rate is 21.1%, especially in Simalungun Regency, the stunting incidence rate is 17.4%. Seeing the conditions that occurred, interest arose in conducting research in the Simalungun Regency area, specifically in the Panombean Panei area. This research uses observational analytical methods with a cross sectional study research design. The sampling technique used in this research was total sampling with a total of 50 toddlers who met the criteria. The assessment of exclusive breastfeeding was carried out by completing a questionnaire by mothers of toddlers. The statistical test used is Chi-Square. The research results showed that 29 (58%) toddlers were given breast milk non-exclusively, so there were 21 (42%) stunted toddlers and 8 (16%) normal toddlers. There are 21 (42%) toddlers who receive exclusive breast milk, of which 9 (18%) toddlers are stunted and 12 (24%) toddlers are normal. The results of the analysis show a p-value = 0.035, which means there is a relationship between exclusive breastfeeding and the incidence of stunting. The conclusion of this research is that there is a relationship between exclusive breastfeeding and the incidence of stunting in toddlers aged 24-60 months at the Panombean Panei Health Center. [ABSTRACT FROM AUTHOR]

Introduction: Breastfeeding rates in Indonesia remain low, lagging behind global standards. Many factors affect this condition before and after birth. They include social, demographic, biological, and psychological factors. Many studies have shown that breastfeeding is very healthy for the baby and mother, but it's not as expected. Modern development causes shifts that are social, cultural, and economic. They erode support for breastfeeding mothers. This research aims to analyze the association between social determinants of health and exclusive breastfeeding in Palembang city, South Sumatra, Indonesia. These factors include jobs, education, parity, family, ethnicity, knowledge, attitudes, and sources of information. Materials and methods: This research used a cross-sectional approach. It studied eight tribes: Ogan, Bugis, Arab, Chinese, Javanese, Sundanese, Padang, and Batak. The sample for this research was 220 breastfeeding mothers . We collected samples using the cluster random sampling technique. Results: Around 70% of respondents provided exclusive breastfeeding. Multivariate analysis showed that mothers with some children ≤ 2 (aOR=2.050; CI 95%=1.019-4.126; p=0.044), partner support during delivery (aOR=2.280; CI 95%=1.019-4.126; p=0.013), and maternal in-law support (aOR=3.200; 95% CI= 1.725-5.936; p<0.001) have a significant association with exclusive breastfeeding. Conclusion: This research shows that, apart from parity, the relatively low level of exclusive breastfeeding is influenced by social determinants of health perspectives such as maternal and partner support. [ABSTRACT FROM AUTHOR]

Introduction: Stunting is still a health issue in Indonesia. The main factors causing stunting in Toddlers are exclusive breastfeeding and complementary feeding. Stunting is the highest nutritional issues in Trenggalek. Stunting prevalence in Puru Village of Trenggalek is 12.41%. The aim of this research is to study the correlation between exclusive breastfeeding, frequency, and quantity of complementary feeding with stunting among toddlers in Puru Village, Suruh District, Trenggalek. Materials and methods: This research uses observational analytics with a cross-sectional design. The total sample taken is 58 of 137 total population of toddlers by purposive sampling in February 2023. The inclusion criteria are toddlers aged 6 to 59 months. Toddlers who are sick or suffer from birth defects were excluded. Results:There was a relation between exclusive breastfeeding and stunting (p-value=0.019). Toddlers who are not exclusively breastfeeding are 77 times higher risk of stunting than toddlers who are exclusively breastfeeding because Odds Ratio value is 77. It means exclusive breastfeeding reduces the risk of stunting. There was a relation between frequency of complementary feeding with stunting (p value=0.000). Frequency of complementary feeding is being protective factor of stunting which Odds Ratio value is 0.38. There was a relation between quantity of complementary feeding with stunting (p value=0.000). Toddlers do not get the right quantity of complementary feeding according to age have a 3 times greater risk of stunting (Odds Ratio value is 3). Conclusion: There was a relation between exclusive breastfeeding, frequency, and quantity of complementary feeding with stunting. [ABSTRACT FROM AUTHOR]

Breastmilk, a natural and optimal source of infant nutrition since human creation, remains integral to infant feeding. However, various factors can influence breastfeeding practices, such as insufficient milk, subsequent pregnancies, feeding fatigue, breastfeeding discomfort, medication usage and employment commitments. In the context of the COVID-19 pandemic, a cross-sectional observational study was undertaken to investigate the breastfeeding practices of 125 Saudi mothers between February 2020 and February 2021. The study utilised a survey questionnaire encompassing socio-demographic information, antenatal and postnatal practices and feeding behaviors during partial and total quarantine periods. The study's findings indicate that a significant proportion, 91.2% (n=114), of mothers continued breastfeeding during the COVID-19 pandemic, 80.8% (n=101) adhered to their established feeding plans despite the pandemic and 77.6% (n=97) maintained the same feeding method for their infants during quarantine. The study suggests that the pandemic did not specifically influence exclusive breastfeeding among Saudi mothers in Dammam during home lockdowns. Findings emphasise the positive impact of the COVID-19 pandemic on mothers' breastfeeding continuation for children aged 0 to 2 years. This study recommends that mothers with suspected or confirmed COVID-19 infections continue breastfeeding with proper hand hygiene and the use of a facemask while breastfeeding to support their newborn's immature immunity. The benefits of breastfeeding outweigh the potential risks of COVID-19 transmission, emphasising its continued importance for infant wellbeing. [ABSTRACT FROM AUTHOR]

Background: Although breast milk provides the most robust human nutrition and offers extensive immunological protection, many mothers are still hesitant to breastfeed exclusively, and the rate of exclusive breastfeeding declines significantly over time in the postpartum period. Objective: The objective is to educate nurses on the practice of exclusive breastfeeding. Methods: Breastfeeding education was provided to nurses (n = 11) at an urban academic medical center. The education included hands-on skills training, case scenarios, and interactive games. Knowledge was measured using an eight-item multiple choice pre- and posttest. Exclusive breastfeeding rates were measured before and after the 10-week intervention period using a report on infant feeding practices. Results: Comparison of pre- and posttest scores revealed nurses' knowledge increased by 25%; however, exclusive breastfeeding rates were not impacted. Conclusion: Several limitations may have impacted the rates of exclusive breastfeeding. Other strategies may be needed to provide a holistic and effective approach. Barriers related to the lack of exclusive breastfeeding should be explored further. Implications for Nursing: Ongoing education is an effective method to increase nurses' knowledge. Advanced practice nurses, in a unique position to impact nursing practice and influence health, are encouraged to continue to identify and evaluate methods to increase rates of exclusive breastfeeding. [ABSTRACT FROM AUTHOR]

Background: There is growing evidence that supports the role of breastfeeding in reducing the burden of non-communicable diseases (NCDs). There are considerable gaps in breastfeeding outcomes in mothers with chronic diseases due to a lack of knowledge and support in the postpartum period. Mothers who have NCDs and pregnancy complications are at risk of breastfeeding failure. Aim: To compare breastfeeding outcomes in mothers with NCDs with healthy mothers and determine the underlying challenges that lead to poor outcomes. Methods: A prospective cohort study was conducted among 150 women (50 with high-risk pregnancies (HRP) and 100 with normal pregnancies (NP)). They were recruited from those attending the immunization and outpatient clinics at Sohag General Hospital. Mothers were recruited at 34 weeks gestation and were followed up at 2 weeks, 6 weeks, and 6 months after delivery. A pretested and validated questionnaire was used to collect detailed epidemiological, personal, health-related status, medications, hospitalizations, reproductive history, current delivery, and previous breastfeeding experiences. On follow-up they were assessed for breastfeeding practices, their health and health and growth of their children, and social support. Results: Delivery by cesarean section and postpartum bleeding were commoner among HRP patients. Initiation of breastfeeding in the 1st hour of delivery was significantly lower among women with HRP than those with normal pregnancies (48.0% versus 71.0%, p = 0.006). The most common reason for not initiating breastfeeding among the NP group was insufficient milk (34.5%), while in the HRP group, it was the mother's illness (80.8%). Skin-to-skin contact with the baby after birth was significantly less practiced in the HRP than in the NP group (38.0% vs 64.0% at p = 0.003). Herbs (such as cumin, caraway, cinnamon, aniseed, and chamomile) were the most common pre-lacteal feeds offered (63.0% in NP vs 42.0% in HRP). Artificial milk was more used in HRP than NP (24.0% vs 4.0%). Breast engorgement was 3 times more common in the HRP compared to the NP group (61.5% vs19.6%). Stopping breastfeeding due to breast problems was 2.5 times higher in the HRP than in the NP group (38.5% vs. 15.2%, p = 0.003). Nipple fissures were twice as common among the NP than among the HRP group ((73.0%) vs. (38.5%), p = 0.026). Exclusive breastfeeding during the period of follow-up was lower in the HRP than in the NP group (40.0% vs 61.0%, p < 0.05) and formula feeding was twice as common in the HRP as in the NP group (34.0% vs. 18.0%, p = 0.015). Child illness was significantly higher among women with HRP than those with NP (66.0% vs 48.0%, p = 0.037). Conclusions: Women with HRP are at a high risk of poor breastfeeding outcomes with increased lactation problems and formula feeding rates. Encouraging women especially those with HRP to achieve optimal breastfeeding practices is a simple intervention that can be included in daily practice and may have a positive impact on mothers' health. [ABSTRACT FROM AUTHOR]

ABSTRACT: Introduction: Although various policies have been framed to improve exclusive breastfeeding outcomes in India, the father's role in breastfeeding is grossly ignored. Gender inequalities are still predominant in several parts of India. Fathers' involvement in breastfeeding decision-making plays a significant role in improving the outcome. However, till now, this domain has been neglected in India. Henceforth, we aimed to see the knowledge and attitudes of fathers regarding breastfeeding in a community setting. Methods: It was a community-based cross-sectional study done in the urban slums of Bhubaneswar, Odisha. One hundred seventy-one fathers with their children between six months and one year were recruited by simple random sampling. Knowledge was assessed with a semi-structured questionnaire, and attitude was measured with the Iowa Infant Feeding Attitude Scale (IIFA). Results: In the present study, 1.18% of fathers had good knowledge regarding breastfeeding. 46.2% had average knowledge regarding breastfeeding, and 57.3% had positive attitudes toward formula feeding. Discussion: We have found that most fathers had a positive attitude toward formula feeding, and very few fathers had good knowledge of breastfeeding. Henceforth, further focus in this area is required to improve breastfeeding outcomes. [ABSTRACT FROM AUTHOR]

Breastfeeding offers ideal food and nutrition for infants; however, structural barriers may amplify breastfeeding inequities. We aimed to identify whether household food insecurity (HFI) is associated with exclusive and continued breastfeeding (EBF and CBF) as recommended by the World Health Organization/United Nations Children's Fund (UNICEF) Following the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis, literature searches using 'breastfeeding', 'food insecurity' and 'infant' terms were conducted in PubMed/MEDLINE, Embase, CINAHL, Global Health and LILACS from inception through November 2023, without language restrictions, yielding 1382 publications (PROSPERO:CRD42022329836). Predetermined eligibility criteria yielded the 12 included studies (nine cross‐sectional and three cohorts). The risk of bias was assessed through the Effective Public Health Practice Project. Meta‐analysis was performed for studies assessing EBF (n = 10), and metaregression was used to explore heterogeneity across studies. Prevalence of EBF ranged from 1.6% to 85.3%, with a lower prevalence among HFI. The pooled effect of the association between HFI and EBF presented an odds ratio (OR) of 0.61 (95% CI = 0.49–0.76) with consistent results across marginal (OR = 0.72, 95% CI = 0.55–0.94), moderate (OR = 0.59, 95% CI = 0.41–0.84) and severe HFI (OR = 0.49, 95% CI = 0.32–0.76). High heterogeneity was found only when HFI was dichotomized. The prevalence of CBF ranged from 35.4% to 78.0%, with inconsistent prevalence among HFI; a meta‐analysis was not performed due to the low number of studies (n = 3). We concluded that HFI levels are associated with lower odds of EBF. Integrating service and policy‐level strategies, such as screening, referrals, skilled breastfeeding counseling and access to comprehensive nutrition and social programs, could reduce structural inequities and promote adherence to the World Health Organization/UNICEF breastfeeding recommendations among food‐insecure families. Key messages: Breastfeeding, particularly exclusive breastfeeding (EBF), could be a strategy to protect socially and economically vulnerable infants from household food insecurity (HFI). However, inequities in breastfeeding practices can be amplified by structural barriers contributing to HFI, such as limited access to food, lack of or unstable employment, financial constraints and limited access to health care.Evidence from quantitative and qualitative studies investigating the impact of HFI on exclusive and continued breastfeeding (CBF) practices across different geocultural contexts have found inconsistent results.Our study found that HFI levels are associated with lower EBF practices; high heterogeneity was present only when HFI was dichotomized. Associations with CBF practices could not be assessed due to the low number of studies.A bundle of service and policy‐level strategies, such as universal screening, timely referrals to address the structural causes of HFI, culturally appropriated skilled breastfeeding counseling and access to comprehensive nutrition and social programs, could reduce structural inequities and promote adherence to the World Health Organization/United Nations Children's Fund breastfeeding recommendations among food‐insecure families. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to analyze the relationship between perceived breast milk supply and breastfeeding self-efficacy among mothers whose newborns were hospitalized in the neonatal intensive care unit (NICU). Methods: Designed as an analytical and cross-sectional study, this study was performed from March 2021 to May 2022 with 237 mothers in Türkiye. A Mother-Infant Information Form, the Breastfeeding Self-Efficacy Scale (BSES), and the Perception of Insufficient Milk (PIM) Questionnaire were used in the collection of data. The Shapiro-Wilk test, kurtosis and skewness coefficients, t-tests, analysis of variance, post hoc tests, Pearson's correlation analysis, and linear regression analyses were used in statistical analyses. Results: In our study, being older, having high levels of education, having a high-level income, having a planned pregnancy, and having a vaginal delivery influenced breastfeeding self-efficacy and perceptions of breast milk sufficiency. The breastfeeding self-efficacy levels and breast milk sufficiency perceptions of the participants were also positively affected by receiving breastfeeding training, breastfeeding the newborn in the first 24 hours after birth, having a long-term breastfeeding plan, and feeding the newborn exclusively with breast milk. The mean BSES and PIM scores of the participants were 58.97 ± 11.11 and 39.15 ± 10.39, respectively. It was also found that 66.7% of the participants believed they produced enough breast milk to feed their newborns. A statistically significant strong positive relationship was found between breastfeeding self-efficacy and perceptions of breast milk sufficiency (r=0.854, P=.000). The independent variable of breastfeeding self-efficacy accounted for 72.8% of the total variance in the dependent variable of perceptions of sufficient milk (R2=0.728). Conclusion: In this study, mothers whose newborns were hospitalized in the NICU were found to have above-average breastfeeding self-efficacy levels and breast milk sufficiency perceptions. In addition, it was found that as the level of breastfeeding self-efficacy of the mothers and their perception of the sufficiency of breast milk increased. [ABSTRACT FROM AUTHOR]

According to SSGI 2020, 33.9% of babies aged 0-6 months do not receive exclusive breastfeeding. The success of exclusive breastfeeding is influenced by various factors, including the support of the husband. This study aims to explore the influence of husband support on the success of exclusive breastfeeding, using the method of reviewing the literature from relevant articles. Of the five articles reviewed, four showed the influence of husband support, while one did not. This shows that the husband's support is not the only factor; Other factors such as knowledge, perception, maternal attitude, parity, economic status, IMD, and support of health workers also play an important role. [ABSTRACT FROM AUTHOR]

Background: The exclusive breastfeeding condition in China is not optimism now. Maternal breastfeeding self-efficacy stands as a pivotal factor influencing exclusive breastfeeding. Interestingly, studies have suggested that father support breastfeeding self-efficacy is a pivotal mediator in infant breastfeeding. Thus, the current research aimed to investigate the association between father support breastfeeding self-efficacy and exclusive breastfeeding at six weeks postpartum, and the influencing factors of father support breastfeeding self-efficacy. Methods: This research was structured as a multi-centre cross-sectional study, involving 328 fathers, whose partners were six weeks postpartum, and recruited from two public hospitals in Southeast China. Self-designed demographic questionnaires, namely, Father Support Breastfeeding Self-Efficacy Scale-Short Form, Breastfeeding Knowledge Questionnaire, Positive Affect Scale and the 14-item Fatigue Scale, were applied. Descriptive statistics, Chi-square test, logistic regression univariate analysis and multiple linear regression were used to analyse data. Results: Results indicate a significant difference between the infant feeding methods at six weeks postpartum and fathers with different levels of support breastfeeding self-efficacy (p < 0.05). Particularly, father support breastfeeding self-efficacy positively affected exclusive breastfeeding at six weeks postpartum after adjusting all the demographic characteristics of fathers (OR: 2.407; 95% CI: 1.017–4.121). Moreover, results show that the significant influencing factors of father support breastfeeding self-efficacy include breastfeeding knowledge, fatigue, positive affect, successfully experienced helping mothers to breastfeed, spousal relationships and companionship time. Conclusions: High-level father support breastfeeding self-efficacy effectively increased exclusive breastfeeding rate at six weeks postpartum. To enhance the exclusive breastfeeding rate, nurses or midwives can endeavour to design educational programmes or take supportive interventions customised for fathers, such as enhancing their breastfeeding knowledge education, reducing fatigue and mobilising positive emotions, thereby bolstering paternal self-efficacy in breastfeeding. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Exclusive breastfeeding (EBF) provides numerous health benefits to children. However, the EBF rate is unsatisfactory among young mothers because they often experience difficulties. Thus, interventions during the postnatal period are imperative to encouraging EBF practices in these populations. Postnatal care (PNC) should be delivered appropriately to ensure a positive postnatal experience; however, there has been little discussion of evidence therein to date. Purpose This study investigated the association between proper PNC and EBF practices among young Indonesian mothers. Methods This cross-sectional study analyzed data from the 2017 Indonesia Demographic Health Survey. All mothers aged 15–24 years who delivered an infant within the 2 years preceding the survey were included. Mothers were considered to be receiving proper PNC if they started breastfeeding soon after delivery, attended a PNC appointment within 2 days after giving birth, and received breastfeeding counseling and observation during the PNC visit. Results Approximately 51.6% of infants under 6 months of age born to young mothers (those aged 15–24 years) were exclusively breastfed. Appropriate PNC was received by approximately 24.3% of the total population. The correlation between proper PNC and EBF practices was significant among adolescent mothers aged 15–19 years after an age stratification analysis (odds ratio, 8.22; 95% confidence interval, 1.957–34.524). Maternal age became a noticeable confounder after a risk-stratification analysis. Conclusion Our findings imply the importance of breastfeeding service delivery during the early postnatal period in continuing EBF. Ensuring high PNC quality helps ensure positive postnatal experiences, particularly for adolescent mothers.

This study investigates the relationship between early initiation of breastfeeding (EIBF) and exclusive breastfeeding to mothers in the Banjarangkan II Public Health Center, Regional Technical Implementation Unit (RTIU). This study employs the correlative analytical method of cross-sectional design, utilizing a retrospective approach. This study lasted from February to April 2024. The random proportional sample method consists of 58 individuals. We collected data through questionnaires and used the Fisher exact test for data analysis. The results of the study showed that the majority (89.7%) of mothers of babies aged 7–12 months had EIBFs, and most (82.8%) had exclusive breastfeeding. Studies show that mothers who perform EIBF in the Banjarangkan II Public Health Center's Regional Technical Implementation Unit work area and have babies aged 7–12 months are more likely to provide breast milk as the only source of nutrition for babies, often called exclusive breastfeeding. The results indicate a correlation between the history of EIBF and exclusive breastfeeding among mothers, with a contingency coefficient value of 0.597. To implement EIBF, midwives must continue to promote pregnant mothers’ health.

Abstract Background The World Health Organization (WHO) aims to achieve a 50% rate of exclusive breastfeeding (EBF) during the first six months of life by 2025. Continuing breastfeeding up to six months is determined by an individual woman’s choice and the availability of breastfeeding-friendly environments. Methods In this multicenter prospective longitudinal study, we identified breastfeeding-friendly environmental factors that were associated with breastfeeding practices from days 1–5 to six months postpartum. Breastfeeding-friendly environmental factors were assessed using structured questionnaires for mothers who gave birth under a Baby-Friendly Hospital Initiative (BFHI). We evaluated uptake of breastfeeding by asking mothers if they used the indicated practices, as well as their perceived level of acceptance of breastfeeding among their live-in family members and their perceived availability of lactation rooms in public settings. From 2012 to 2016, we recruited 1,870 women at 1–5 days postpartum from obstetrics medical facilities in Taiwan and followed their breastfeeding status at one, two, four, and six months postpartum. The definition of EBF was that the infant had received only breast milk since birth, with no supplemental infant formula. We categorized breastfeeding practices into two groups: continuing EBF and non-continuing EBF at six months. We used logistic regression models to identify factors associated with continuing EBF at six months postpartum. Results The prevalence of EBF and non-EBF at six months postpartum was 30.9% and 69.1%, respectively. The logistic regression analysis revealed that above university-level education, multiparity, and vaginal delivery were positively associated with continuing EBF. The Ten Step Baby-Friendly Hospital Initiative practices, perceived acceptance of breastfeeding in live-in families, and perceived availability of lactation rooms in public settings, were associated with a higher likelihood of continuing EBF. Postpartum women who returned to work at or after two months postpartum were more likely to report non-continuing EBF than women who did not return to work. Conclusion Those who promote public health should advocate for breastfeeding-friendly practices, including the adoption of breastfeeding-friendly measures in public and workplace settings and providing increased support for breastfeeding mothers during and after hospitalization.

Abstract Background Despite the benefits of exclusive breastfeeding, the proportion of exclusively breastfed children remains low in rural China. Self-efficacy is one of the most crucial modifiable factors predicting breastfeeding behavior. However, existing instruments in China do not specifically measure self-efficacy for exclusive breastfeeding but rather measure self-efficacy for any breastfeeding. Furthermore, they have been validated only in high-income Chinese settings. We sought to adapt and validate an instrument to measure exclusive breastfeeding self-efficacy within rural Chinese contexts. Methods We introduced relevant items to Dennis’ Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), which can assess maternal self-efficacy for exclusive breastfeeding. It was then implemented in a multistage random cluster sampling design and cross-sectional survey with home-visit interviews among women 0–6 months postpartum (n = 654) in the rural areas of four counties in Sichuan, China. We performed item-total and adjusted item-total correlations, as well as exploratory factor analysis to remove redundant items and determine the latent factor structure. We further applied confirmatory factor analysis to test the dimensionality of the scale. We then assessed the reliability of the scale and conducted tests of predictive and divergent validity. Known group comparisons were made by primiparous status and breastfeeding support level. We compared the validated Exclusive Breastfeeding Self-Efficacy Scale with the BSES-SF in terms of reliability and validity to explore the added value of scale modification. Results Our modification of the BSES-SF to target exclusive breastfeeding produced 19 items. This was further reduced to 15 items based on adjusted item-total correlations and exploratory factor analysis, forming the Exclusive Breastfeeding Self-Efficacy Scale. This scale had three dimensions: “Breast milk supply and quality,” “Breastfeeding skills,” and “Exclusive breastfeeding” subscales. The Exclusive Breastfeeding Self-Efficacy Scale demonstrated strong internal consistency and overall reliability with a Cronbach’s alpha coefficient of 0.91. Predictive and divergent validity and known group comparison assessments supported its validity. Robust psychometric evaluations demonstrated enhanced validity and reliability compared to the original BSES-SF. Conclusions Our Exclusive Breastfeeding Self-Efficacy Scale is valid and reliable for measuring exclusive breastfeeding self-efficacy within rural Chinese contexts and is ready for adaptation and validation for clinical and programmatic use elsewhere, particularly within LMICs.

This study aims to describe the internalisation of justice based on Pancasila in the concept of criminalization and analyse the criminal provisions of the exclusive breastfeeding program from the perspective of criminalization based on Pancasila justice. This study is included in normative legal research. The results of the study show that the handling of criminalization must be in accordance with the concept of justice from the Pancasila perspective which contains two main elements, namely proportionality and the principle of kinship to maintain unity. The crime of exclusive breastfeeding programs is related to the denial of obligations carried out by families or corporations to provide time and facilities to support exclusive breastfeeding. Criminal sanctions for actions that do not support the implementation of the exclusive breastfeeding program in the form of imprisonment, fines or additional penalties as regulated in Article 430, Article 447 and Article 448 of Law Number 17 of 2023 are not in accordance with the concept of justice based on the Pancasila perspective because they do not meets the aspect of proportionality and does not reflect the principle of kinship.

Introduction Although various policies have been framed to improve exclusive breastfeeding outcomes in India, the father’s role in breastfeeding is grossly ignored. Gender inequalities are still predominant in several parts of India. Fathers’ involvement in breastfeeding decision-making plays a significant role in improving the outcome. However, till now, this domain has been neglected in India. Henceforth, we aimed to see the knowledge and attitudes of fathers regarding breastfeeding in a community setting. Methods It was a community-based cross-sectional study done in the urban slums of Bhubaneswar, Odisha. One hundred seventy-one fathers with their children between six months and one year were recruited by simple random sampling. Knowledge was assessed with a semi-structured questionnaire, and attitude was measured with the Iowa Infant Feeding Attitude Scale (IIFA). Results In the present study, 1.18% of fathers had good knowledge regarding breastfeeding. 46.2% had average knowledge regarding breastfeeding, and 57.3% had positive attitudes toward formula feeding. Discussion We have found that most fathers had a positive attitude toward formula feeding, and very few fathers had good knowledge of breastfeeding. Henceforth, further focus in this area is required to improve breastfeeding outcomes.

Abstract Background There is growing evidence that supports the role of breastfeeding in reducing the burden of non-communicable diseases (NCDs). There are considerable gaps in breastfeeding outcomes in mothers with chronic diseases due to a lack of knowledge and support in the postpartum period. Mothers who have NCDs and pregnancy complications are at risk of breastfeeding failure. Aim To compare breastfeeding outcomes in mothers with NCDs with healthy mothers and determine the underlying challenges that lead to poor outcomes. Methods A prospective cohort study was conducted among 150 women (50 with high-risk pregnancies (HRP) and 100 with normal pregnancies (NP)). They were recruited from those attending the immunization and outpatient clinics at Sohag General Hospital. Mothers were recruited at 34 weeks gestation and were followed up at 2 weeks, 6 weeks, and 6 months after delivery. A pretested and validated questionnaire was used to collect detailed epidemiological, personal, health-related status, medications, hospitalizations, reproductive history, current delivery, and previous breastfeeding experiences. On follow-up they were assessed for breastfeeding practices, their health and health and growth of their children, and social support. Results Delivery by cesarean section and postpartum bleeding were commoner among HRP patients. Initiation of breastfeeding in the 1st hour of delivery was significantly lower among women with HRP than those with normal pregnancies (48.0% versus 71.0%, p = 0.006). The most common reason for not initiating breastfeeding among the NP group was insufficient milk (34.5%), while in the HRP group, it was the mother’s illness (80.8%). Skin-to-skin contact with the baby after birth was significantly less practiced in the HRP than in the NP group (38.0% vs 64.0% at p = 0.003). Herbs (such as cumin, caraway, cinnamon, aniseed, and chamomile) were the most common pre-lacteal feeds offered (63.0% in NP vs 42.0% in HRP). Artificial milk was more used in HRP than NP (24.0% vs 4.0%). Breast engorgement was 3 times more common in the HRP compared to the NP group (61.5% vs19.6%). Stopping breastfeeding due to breast problems was 2.5 times higher in the HRP than in the NP group (38.5% vs. 15.2%, p = 0.003). Nipple fissures were twice as common among the NP than among the HRP group ((73.0%) vs. (38.5%), p = 0.026). Exclusive breastfeeding during the period of follow-up was lower in the HRP than in the NP group (40.0% vs 61.0%, p

Abstract Background The exclusive breastfeeding condition in China is not optimism now. Maternal breastfeeding self-efficacy stands as a pivotal factor influencing exclusive breastfeeding. Interestingly, studies have suggested that father support breastfeeding self-efficacy is a pivotal mediator in infant breastfeeding. Thus, the current research aimed to investigate the association between father support breastfeeding self-efficacy and exclusive breastfeeding at six weeks postpartum, and the influencing factors of father support breastfeeding self-efficacy. Methods This research was structured as a multi-centre cross-sectional study, involving 328 fathers, whose partners were six weeks postpartum, and recruited from two public hospitals in Southeast China. Self-designed demographic questionnaires, namely, Father Support Breastfeeding Self-Efficacy Scale-Short Form, Breastfeeding Knowledge Questionnaire, Positive Affect Scale and the 14-item Fatigue Scale, were applied. Descriptive statistics, Chi-square test, logistic regression univariate analysis and multiple linear regression were used to analyse data. Results Results indicate a significant difference between the infant feeding methods at six weeks postpartum and fathers with different levels of support breastfeeding self-efficacy (p

Maternal secretor status has been shown to be associated with the presence of specific fucosylated human milk oligosaccharides (HMOs), and the impact of maternal secretor status on infant gut microbiota measured through 16s sequencing has previously been reported. None of those studies have confirmed exclusive breastfeeding nor investigated the impact of maternal secretor status on gut microbial fermentation products. The present study focused on exclusively breastfed (EBF) Indonesian infants, with exclusive breastfeeding validated through the stable isotope deuterium oxide dose-to-mother (DTM) technique, and the impact of maternal secretor status on the infant fecal microbiome and metabolome. Maternal secretor status did not alter the within-community (alpha) diversity, between-community (beta) diversity, or the relative abundance of bacterial taxa at the genus level. However, infants fed milk from secretor (Se+) mothers exhibited a lower level of fecal succinate, amino acids and their derivatives, and a higher level of 1,2-propanediol when compared to infants fed milk from non-secretor (Se-) mothers. Interestingly, for infants consuming milk from Se+ mothers, there was a correlation between the relative abundance of Bifidobacterium and Streptococcus, and between each of these genera and fecal metabolites that was not observed in infants receiving milk from Se- mothers. Our findings indicate that the secretor status of the mother impacts the gut microbiome of the exclusively breastfed infant.

Exclusive breastfeeding for the first 6 months and continued breastfeeding for 24 months or longer is recommended for all mothers world-wide, including women living with HIV (WLWH). Given evidence of suboptimal infant feeding and the need to understand context specific barriers, we explored experiences of perinatal WLWH in Kisumu, Kenya. We applied a longitudinal qualitative approach (4 in-depth interviews) with 30 women from pregnancy to 14-18 months postpartum. Cross-sectional profiling led to a narrative description of infant feeding across time. The majority of women breastfed exclusively for 6 months and weaned by 18 months. Severe financial and food insecurity were primary challenges as women worked through when/how to breastfeed or stop breastfeeding in the setting of multiple competing priorities/pressures across time. Financial and food support and increased support for breastfeeding beyond 18 months have the potential to reduce women's stress and uncertainty associated with infant feeding as well as optimize infant health and nutrition in this setting.

Background: Suboptimal breastfeeding practices cause 823,000 deaths in children under 5 years of age and 20,000 deaths in women due to breast cancer in the world every year. The Government's program to increase coverage of exclusive breastfeeding is contained in the 10 Steps Towards Successful Breastfeeding (LMKM) which states that health workers are required to provide exclusive breastfeeding education to mothers from the antenatal period. An Emo Demo is a way to convey nutritional messages with a behavior change communication strategy that uses Behavior Centered Design (BCD).Objectives: This literature review aims to analyze the effect of exclusive breastfeeding education using the emotional demonstration method (EMO DEMO) on exclusive breastfeeding.Methods: This research method is a literature review using PRISMA analysis with the PUBMED, Science Direct, Proquest, Springer, and Google Scholar databases from 2019-2023. The inclusion criteria in this Literature Review are using a period from 2019-2023. the type of article is original research. The exclusion criteria in this literature review are research subjects other than pregnant women, mothers who have children under 2 years old, and health cadres.Results: Exclusive breastfeeding education using the emo demo method increases knowledge, attitudes, self-efficacy, and exclusive breastfeeding. Emotional demonstration training increases cadres' knowledge and skills in providing exclusive breastfeeding education.Conclusions: Exclusive breastfeeding education innovations with emotional demonstration methods will help the government accelerate optimal breastfeeding practices to improve maternal and child health in Indonesia. It is hoped that health workers can apply the emo demo method in providing exclusive breastfeeding education.

Background :Stunting is a developmental growth disorder experienced by children due to poor nutrition, recurrent infections, inadequate psychosocial stimulation, and the child's height for his age is below the average of SD STKA WHO. Indonesia has a prevalence of 36.4%. Stunting prevention involves priority interventions, namely specific nutrition interventions and sensitive interventions. Exclusive breastfeeding, including specialized interventions, plays a very important role in preventing stunting. Indonesia's Health Profile in 2019, Indonesia's exclusive breastfeeding coverage is 37.3%, while the national target is 80%, West Java 57.9% and Tasikmalaya City 56.0%, of course this will cause problems in the future related to stunting events, especially in cities. Tasikmalaya. The current problem is the low access to information obtained by mothers in increasing knowledge and literacy about breastfeeding. As an innovative product, it is used as an educational medium about breastfeeding preparation, breastfeeding attachment positions, problems and solutions in breastfeeding, breastfeeding tutorial videos and breastfeeding management as well as online consultations with breastfeeding counselors. Objectives : The purpose of this study is the influence of the golden1000 application to increase maternal efficacy literacy related to breastfeeding so that it can be successfully breastfed exclusively. Methods : This study uses a quasi-experimental design method, with a posttest only control group design approach. In this study, the treatment group was given an intervention in the form of the golden1000 menu application about breastfeeding including an educational menu about breastfeeding, video tutorials on attachment positions and an online consultation feature with a breastfeeding counselor for pregnant women in the third trimester up to 6 months of breastfeeding. Results : The results of the study found that there was a statistically different difference in the success of exclusive breastfeeding between the golden1000 application group and the KIA book group.Conclusions : The use of the golden1000 application can increase the success of breast milk givers exclusively.

Background: Early initiation of breastfeeding reduces infant mortality and morbidity and prolongs the duration of breastfeeding. OBJECTIVE: The present study was conducted to assess the prevalence of early initiation of breastfeeding and factors associated with early initiation of breastfeeding in the urban area of Jabalpur district of Madhya Pradesh. Methodology: The present community-based cross-sectional study was conducted in an urban area of Jabalpur district of Madhya Pradesh from March 2017 to July 2018 on 370 recently delivered mothers. Data were collected by interview, using the pretested structured questionnaire and analyzed using SPSS, version 20. Significance was set at the value of P < 0.05. Results: The prevalence of early initiation of breastfeeding was found to be 45.4%. The percentage of mothers initiating breastfeeding earlier increased when they belonged to the higher age group, nuclear family, were educated, employed, counseled during antenatal visits, non-primigravida and delivered in health institutions. It was also observed that type of delivery, socioeconomic status of mothers, birth weight of baby and occupation of husband are not significantly associated with the early initiation of breastfeeding. Conclusion: Increasing literacy amongst the population, promoting marriages at an appropriate age, counseling pregnant women regarding early initiation of breastfeeding during antenatal care visits and institutional deliveries can significantly increase the prevalence of early initiation of breastfeeding in the mothers of urban areas of Jabalpur district, Madhya Pradesh.

Abstract Background The birth of a preterm infant is considered a crisis for the mother and the family. Given the significance of breastfeeding for these high-risk infants, failure to initiate and maintain exclusive breastfeeding in this group of infants is a prevalent and serious problem. The aim of this research was to investigate the impact of Theory of Planned Behavior based intervention on breastfeeding patterns of the mothers with preterm infants: a randomized trial. Materials and methods This study is a field trial conducted in Isfahan, Iran in 2021–2022. It included 72 mothers of late preterm infants, divided into the intervention (n = 36) and control (n = 36) groups. The intervention group received four training sessions focused on breastfeeding patterns based on the Theory of Planned Behavior. Before, immediately after, and two and four months after the intervention, the constructs of the Theory of Planned Behavior related to breastfeeding patterns were assessed using a researcher-made questionnaire, and the infant’s breastfeeding pattern was recorded. Statistical analysis was performed using SPSS version 19, g repeated measures ANCOVA, Bonferroni post hoc test, and chi-square test. Results The results indicated that immediately after the intervention, as well as two and four months later, the mean scores for attitude (P

Abstract Background Despite the many benefits of exclusive breastfeeding to infants and mothers, only 33% of Jamaican infants are exclusively breastfed up to the recommend six months. This study was conducted to identify factors affecting mothers’ feeding choices focusing on barriers to exclusive breastfeeding of infants six weeks to less than six months old. Methods A qualitative study consisting of four focus group discussion sessions was conducted among 22 mothers attending postnatal clinics in western Jamaica from May to August 2016. The transcripts were coded by three independent coders and content analysis conducted to generate themes. Results Four themes were identified namely, perceived advantages of breastfeeding centered mainly on the benefits of breastfeeding for the infant and mother, perceived barriers of breastfeeding highlighting physical pain and fatigue, supplementing culturally acceptable complementary foods and herbal remedies, and cultural norms including perception of how breastfeeding affects a woman’s body, societal sources of breastfeeding information, satiation of infants, and family and other support. Mothers overwhelmingly agreed that breastfeeding was inexpensive, allowed them to bond with their infants and was good for the overall health and intellectual development of the infants. They identified painful nipples, engorged breasts, lack of sleep, physical exhaustion and pressure to return to work as barriers to breastfeeding. Mothers named a number of complementary foods, such as pumpkin, carrots, potato, banana, and chocho (Chayote), that were culturally accepted for feeding infants in Jamaica and discussed herbs that were considered to aid in infants’ nutrition and overall health. Other cultural factors that were noted to influence exclusive breastfeeding were mothers feeling that breastfeeding would help their bodies, especially their bellies, go back to their pre-maternity figure, sources of breastfeeding information in the society including the internet, belief that breast milk alone does not satisfy babies, and family and other support. Conclusion Mothers in this study identified unique challenges to exclusive breastfeeding that if addressed, would help to increase exclusive breastfeeding so that the World Health Organization’s exclusive breastfeeding recommendations can be achieved.

Abstract Background The benefits of exclusive breastfeeding (EBF) have been universally documented, with evidence of positive impacts on a child’s optimal growth, development, and survival. However, EBF practices in Nepal have fluctuated and declined over the last 25 years. In addition to the individual factors of mothers and infants, EBF practices are affected by multiple community-level factors. Understanding these factors is essential for designing breastfeeding promotion programs to improve child nutritional status in Nepal. This study investigated the individual- and community-level determinants of EBF practices among young infants aged 0–5 months in Nepal. Method We used the dataset from the Nepal Demographic and Health Survey 2022. Information on EBF in the past 24 h was available for 540 infants aged 0–5 months. A multilevel mixed-effect logistic regression was used to identify individual- and community-level factors associated with EBF among infants aged 0–5 months in Nepal. Results The 24-hour prevalence of EBF among infants aged 0–5 months was 57.46% (95% confidence interval (CI): 52.18, 62.57). The infant’s age was inversely associated with EBF prevalence at the individual level. Compared with infants aged

The rate of six-month-old infants exclusively breastfed in Spain remains below the recommended rate. This study aimed to explore in detail the evolution of feeding during the first six months of life of a group of newborns, as well as to identify the reasons reported by the mothers for feeding change. A secondary analysis of two prospective longitudinal observational studies was conducted. In both studies, women participants, during the clinical puerperium, opted for exclusive breastfeeding for their newborns. The participants were followed up during the infants’ first six months. A sample size of 314 participants was obtained, of which 77.1% (n = 232) were of Spanish origin, and 51% (n = 160) were primiparous. The prevalence of exclusive breastfeeding at six months was 55.4% (n = 174). During the first four months of life, the main reason for early abandonment of breastfeeding was the perception of insufficient milk production. After the fourth month, the predominant reason was starting work. Statistically significant differences were observed between the reasons for giving up and the total weeks of exclusive breastfeeding (p < 0.001) and total weeks of breastfeeding (p = 0.002). Early weaning from breastfeeding is a multifactorial phenomenon. However, depending on the moment cessation occurs, some reasons predominate over others and, in many cases, can be prevented. These results indicate the need to continue investing efforts to promote and protect breastfeeding in Spain.

Background: Exclusive breastfeeding provides many benefits for mothers and babies, including protecting the baby's digestive system and preventing diarrhea and infection. In everyday life, exclusive breastfeeding has an impact on a mother's psychological condition, as a result of which breastfeeding mothers cause stress. Family support, especially the husband, can provide motivation for breastfeeding activities. Objectives: To find out the role of husbands in supporting exclusive breastfeeding and its relationship to reducing stress in breastfeeding mothers. Methods: This research uses a literature review method with 5 related scientific articles. Husband's support consists of several forms, such as emotional, physical, planning and informational support. Discussion: A wife must have all this support so that she can maximize exclusive breastfeeding for her child, although several studies show that support from a man is not the only factor in the absence of breast milk, because there are other factors that can reduce it. Husband's support can provide a wife with a feeling of comfort, love and respect so that children's growth and development becomes optimal, stress is reduced or disappeared and household harmony is maintained. Conclusion: Husbands have an important role in supporting the process of exclusive breastfeeding, especially in reducing stress levels in breastfeeding mother. Latar Belakang: ASI Eksklusif adalah pemberian ASI saja kepada bayi tanpa makanan atau minuman lain, kecuali vitamin, mineral, obat-obatan, dan garam rehidrasi oral. Pemberian ASI eksklusif memberikan banyak manfaat bagi ibu dan bayi, termasuk melindungi sistem pencernaan bayi serta mencegah diare dan infeksi. Pemberian ASI ekslusif berdampak pada keadaan psikis seorang ibu akibatnya ibu menyusui menjadi stres. Pentingnya dukungan keluarga terhadap suami dapat memberikan motivasi terhadap kegiatan menyusui. Tujuan: untuk mengetahui peran suami dalam mendukung ASI ekslusif dan kaitannya terhadap penurunan stres pada ibu menyusui. Metode: Penelitian ini menggunakan metode literature review dengan 5 artikel ilmiah terkait. Dukungan suami terdiri dari beberapa bentuk, seperti dukungan emosional, fisik, perencanaan, dan informasional. Diskusi: Segala dukungan tersebut harus dimiliki oleh seorang istri agar dirinya dapat memaksimalkan pemberian ASI eksklusif kepada anaknya, meskipun beberapa penelitian menunjukkan bahwa dukungan dari seorang pria bukanlah satu-satunya faktor tidak adanya ASI, karena ada faktor lain yang dapat menurunkannya. Dukungan suami dapat memberikan rasa nyaman, dicintai, dan dihargai bagi istri sehingga tumbuh kembang anak menjadi optimal, stres menjadi berkurang ataumenghilang dan terjaganya keharmonisan rumah tangga. Kesimpulan: Suami memiliki peran penting dalam mendukung proses pemberian ASI ekslusif terutama dalam menurunkan angka stres pada istri yang menyusui.

Background: The stunting prevalence in Central Java Province remains high. Six key messages, i.e. iron tablet supplementation, healthy latrines, exclusive breastfeeding, Integrated Health Care Post (Posyandu) visit, hand washing, and Antenatal Care visit are the efforts to reduce the prevalence of stunting. Objectives: This study aimed to analyse the relationship between the behaviour of the six key messages and the stunting prevalence in four districts of Central Java Province. Methods: This cross-sectional study was conducted in Brebes Regency, Tegal Regency, Banyumas Regency, and Semarang City with 424 mothers who have under two-year-old children randomly selected as sample. Data were collected by interview using a structured questionnaire with the results grouped into attitude and practices categories. The body’s weight and length were measured by a digital scale and infantometer. Data were analysed using the chi-square test. Results: The findings indicated that 21.5% of children under two had stunting. Besides, behaviour regarding six key messages were mostly good. There was no association between mothers' iron tablet consumption behaviour and the nutritional status of under-two children. There was an association between maternal attitudes about exclusive breastfeeding and knowledge about hand washing with length for age index (p=0.004). There was also an association between antenatal care and Posyandu visits practice with weight for age index (p=0.004 and 0.018). There was a relationship between attitude regarding the use of latrines and the weight for length index (p=0.001). Conclusions: Only the key messages of exclusive breastfeeding attitude, antenatal care visit practice, Posyandu visit practice, and hand washing attitude were associated with the nutritional status of under-two children.

Background: The World Health Organization (WHO) recommends exclusive breastfeeding for six months. Many intervention programs to increase the coverage of exclusive breastfeeding have been carried out, but the coverage of exclusive breastfeeding has not increased significantly. A systematic review analyzed several factors that influence exclusive breastfeeding in developing countries. Mother's occupation was found to be the most frequently mentioned obstacle. Objective: These studies show that the working status of the mother is something that greatly influences the success of exclusive breastfeeding. Methods: This research is a qualitative phenomenological study to see the support and barriers to exclusive breastfeeding for mothers who work in Sukoharjo. Results: The theme found in this study is the support and inhibition of exclusive breastfeeding for working mothers as seen from the Theory of Planned Behavior and Social Cognitive Theory. The obstacles are: 1) incorrect knowledge about exclusive breastfeeding, 2) barriers from some health workers/institutions, 3) families do not support exclusive breastfeeding, 4) there is no regulation on exclusive breastfeeding in the workplace, 5) the workplace does not yet have a special place for pumping and storing breast milk, 6) does not have a role model, 7) breast milk is reduced by working, 8) already has the intention to mix with formula milk, 9) low self-efficacy, and 10) barriers from the baby's internal factors. The supports are: 1) support from health workers/institutions, 2) the workplace provides a special room for pumping and/or storing breast milk, 3) there is an opportunity for pumping breast milk in the workplace, 4) peer support, 5) there is a high expectation of health. good, 6) intention to exclusively breastfeed, 7) good self-efficacy, 8) family support, 9) leave from work and light workload, 10) skills in breastfeeding, 11) no obstacles from the leadership, and 12) smooth mother's milk. Conclusion: This shows that SCT and TPB can be used as a theory to see the variables that influence the practice of exclusive breastfeeding. There is one finding that cannot be directly included in the SCT and/or TPB constructs, namely: skills in providing breast milk.

Abstract Background This study aims to investigate the measurement of breastfeeding prevalence indicators using Demographic and Health Surveys (DHS) data, focusing on early initiation, exclusive breastfeeding, and continued breastfeeding indicators as reported by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) and on the discrepancies arising from small changes in their definition. Methods Two hundred sixty DHS samples from 78 countries were analyzed to re-calculate usual indicators reported by WHO and UNICEF: early initiation of breastfeeding (EIB), exclusive breastfeeding under 6 months (EBF), and continued breastfeeding between 1 and 2 years (CBF12 and CBF24). Additionally, alternative estimates of the same indicators, slightly changing their definition, were calculated to test their robustness. Results The WHO and UNICEF indicators for early initiation (EIB) primarily capture cases where breastfeeding is initiated “immediately” after birth, omitting those initiated within 0 or 1 hour. This discrepancy leads to substantial underestimation of levels in some regions, particularly South Asia, and in trends. Furthermore, sizable discrepancies between exclusive breastfeeding (EBF) indicators arise from the inclusion or exclusion of plain water in the definition, with significant variations across regions, especially in West and Middle Africa. However, continued breastfeeding indicators showed consistency across definitions, proving them robust for international comparisons and time trend estimations. Conclusion This study highlights the importance of understanding how breastfeeding indicators are defined and calculated using DHS data. Researchers should be cautious when using WHO and UNICEF indicators for early initiation and exclusive breastfeeding, as they may underestimate prevalence due to their narrow definition. Continued breastfeeding indicators, on the other hand, are less affected by small changes in definitions and provide reliable measures for cross-country comparisons and trend analyses. These findings underscore the need for standardized robust definitions and transparent reporting of breastfeeding indicators in global health assessments.

Abstract Background Breast milk is the first, highly valuable, and solely natural food recommended for infants in their first six months of life, which is critical for children's overall growth and development. Evidence suggests that exclusive breastfeeding differs by geographic area in Ethiopia. However, little is known regarding the geographic distribution of exclusive breastfeeding practice. Hence, this study aimed to assess exclusive breastfeeding practice, its geographic variation and associated factors among Ethiopian mothers. Method The study used the 2019 Ethiopian mini demographic and health survey data. All living children born 0–23 months before the survey were included. Global Moran’s I statistics on Arc-GIS and Getis Ord Gi* statistics was used to visualize the spatial pattern and hotspot and cold spot areas, respectively. Kulldorff SaTScan was used to show purely significant spatial clusters. The associated factors were identified using a multilevel mixed-effects logistic regression model. Statistically significant factors were reported using the AOR with a 95% CI and a p-value of

Objective: To determine the incidence of fever after vaccination with the first dose of diphthe r ia -pe r tus s i s - te tanus (DPT) among exclusively breastfed and non-exclusively breastfed infants in Ibadan, Nigeria. Methods: A prospective study was conducted on a cohort of 710 infants who received first dose of DPT vaccine at the Immunisation Clinic of a tertiary health institution in Ibadan, between July and October 2011. Based on the feeding pattern in a 24-hour feeding recall by mothers, infants were classified into exclusive and nonexclusive breastfeeding groups. Each of the infant's mothers was provided with a digital thermometer and instructed on how to measure the temperature of her infant. The information about the incidence of fever was obtained by telephone on the third day after vaccination. Results: Only 682 completed the study. The overall rates of exclusive and non-exclusive breastfeeding were 48% and 52%, respectively. Compared with the infants who were non-exclusively breastfed, those who were breastfed exclusively had a risk for fever of 0.675 (95% CI, 0.558-0.817). The place of delivery and the highest level of education were confounders and effect modifiers of the association between breastfeeding and fever. Conclusions: These findings suggest that exclusive breastfeeding is associated with a decreased incidence of fever after immunisation.

Abstract Background Breastfeeding offers numerous benefits for infants, mothers, and the community, making it the best intervention for reducing infant mortality and morbidity. The World Health Organization (WHO) recommends initiating breastfeeding within one hour after birth and exclusively breastfeeding for the first six months. This study investigated the trend, spatio-temporal variation, and determinants of spatial clustering of early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) in Ethiopia from 2011 to 2019. Methods Data from the Ethiopian Demographic and Health Survey (EDHS), which was conducted in 2011, 2016, and 2019, were analyzed utilizing a weighted sample of 10,616 children aged 0–23 years for EIBF and 2,881 children aged 0–5 months for EBF. Spatial autocorrelation analysis was used to measure whether EIBF and EBF were dispersed, clustered, or randomly distributed and Kriging interpolation was employed to predict the outcome variables in the unmeasured areas. Spatial scan statistics were used to identify spatial clusters with a high prevalence of cases. Both global and local regression modeling techniques were employed to examine the spatial relationships between the explanatory variables and the dependent variables. Results The trend analysis revealed a notable increase in the prevalence of EIBF from 51.8% in 2011 to 71.9% in 2019. Similarly, the prevalence of EBF increased from 52.7% in 2011 to 58.9% in 2019. Spatial analysis demonstrated significant spatial variation in both EIBF and EBF throughout the country. Cold spots or clusters with a low prevalence of EIBF were observed consistently in the Tigray and Amhara regions, and significant cold spot areas of EBF were observed consistently in the Afar and Somali regions. Multiscale geographically weighted regression analysis revealed significant predictors of spatial variations in EIBF, including the religious affiliation of being a follower of the orthodox religion, parity of 1–2, absence of antenatal care visits, and delivery via cesarean section. Conclusions Despite the increase in both EIBF and EBF rates over time in Ethiopia, these rates still fall below the national target. To address this issue, the government should prioritize public health programs aimed at improving maternal healthcare service utilization and maternal education. It is essential to integrate facility-level services with community-level services to achieve optimal breastfeeding practices. Specifically, efforts should be made to promote breastfeeding among mothers who have delivered via cesarean section. Additionally, there should be a focus on encouraging antenatal care service utilization and adapting maternal healthcare services to accommodate the mobile lifestyle of pastoralist communities. These steps will contribute to enhancing breastfeeding practices and achieving better outcomes for maternal and child health.

Abstract Background Breastfeeding is recognized as the gold standard of infant feeding and nutrition. The World Health Organization recommends exclusive breastfeeding (EBF) of infants for the first 6 months of life. A variety of factors may impact breastfeeding practices in-hospital which may continue after hospital discharge, such as the use of breastmilk substitutes (BMS). The Baby-Friendly Initiative (BFI), which aims to promote and support breastfeeding practices, established a target rate of 75% for EBF from birth to hospital discharge. Currently, this target is not being met at The Ottawa Hospital (TOH), indicating there is room for improvement in EBF rates. The purpose of this study is to explore health care professionals (HCP) decision-making around use of BMS and identify factors that drive the use of BMS with and without medical indications. Methods In this qualitative study, semi-structured interviews were conducted with HCPs within TOH from January to June 2022. All participants had experience in maternity or postpartum care and were probed on factors influencing use of BMS at this institution. Interview transcripts were coded using an inductive approach. Results A total of 18 HCPs were interviewed including physicians, midwives, lactation consultants, and registered nurses. Multilevel barriers influencing the use of BMS were categorized into patient, HCP, and institution-level factors. Subthemes that emerged ranged from parental preferences, training differences amongst HCPs, to budget and staffing issues. Over half of HCPs were prepared to answer questions on EBF and were familiar with the BFI. Although most were supportive of this institution receiving BFI designation, a few providers raised concerns of its impact on parents who would like to supplement. Conclusions Several modifiable factors influencing decision-making for use of BMS were identified. These findings will be used to inform unit leads, help identify effective strategies to address modifiable barriers, and develop tailored breastfeeding supports to improve EBF rates.

Background: The birth of a preterm infant is considered a crisis for the mother and the family. Given the significance of breastfeeding for these high-risk infants, failure to initiate and maintain exclusive breastfeeding in this group of infants is a prevalent and serious problem. The aim of this research was to investigate the impact of Theory of Planned Behavior based intervention on breastfeeding patterns of the mothers with preterm infants: a randomized trial. Materials and methods: This study is a field trial conducted in Isfahan, Iran in 2021–2022. It included 72 mothers of late preterm infants, divided into the intervention (n = 36) and control (n = 36) groups. The intervention group received four training sessions focused on breastfeeding patterns based on the Theory of Planned Behavior. Before, immediately after, and two and four months after the intervention, the constructs of the Theory of Planned Behavior related to breastfeeding patterns were assessed using a researcher-made questionnaire, and the infant's breastfeeding pattern was recorded. Statistical analysis was performed using SPSS version 19, g repeated measures ANCOVA, Bonferroni post hoc test, and chi-square test. Results: The results indicated that immediately after the intervention, as well as two and four months later, the mean scores for attitude (P < 0.001), subjective norms (P < 0.001), perceived behavioral control (P < 0.001), and behavioral intention (P < 0.001) were significantly higher in the intervention group than in the control group. Additionally, the results showed that, the rate of breastfeeding immediately, two months, and four months after the intervention was significantly higher in the intervention group than before the intervention (P < 0.001). However, in the control group, the rate of breastfeeding immediately, two months, and four months after the intervention was significantly lower than before the intervention (P < 0.001). Conclusion: Interventions based on the Theory of Planned Behavior can improve exclusive breastfeeding in late preterm infants by changing the attitudes, subjective norms, perceived behavioral control and the behavioral intentions of the mothers of preterm infants. Trial registration: "IRCTID: IRCT20210524051392N1", 13/06/2021. [ABSTRACT FROM AUTHOR]

Background: Exclusive breastfeeding (EBF) of infants during the first 6 months of their life is strongly recommended. Video‐based communication is an innovative method that could promote EBF. The present study is aimed at assessing the effectiveness of video‐based intervention in promoting breastfeeding practices from birth to 6 months postpartum. This was evaluated through maternal reports, as well as EBF of infants at 3 and 5 months of age, using the deuterium oxide dose‐to‐mother (DTM) technique. Methods: In a cluster randomized community trial, 16 communities were assigned to receive a video‐based behavior change communication (Video‐Health) or standard health care messages (Control). Pregnant women in their first trimester (12 ± 2 weeks) were enrolled and followed up, together with their infants, until 6 months postpartum. Data on breastfeeding practices were collected by questionnaire, monthly, in all the participants (n = 508). Human milk intake (HMI) and nonmilk oral intake (NMOI) were measured in a subsample of 60 mother–infant pairs at 3 and 5 months postpartum using DTM. Mixed models and logistic regression were used to examine the difference in continuous and discrete breastmilk practices between the intervention and the control arms, respectively. Results: The majority of mothers initiated breastfeeding early (92.1%), 82.4% reported colostrum feeding, and 17.5% provided prelacteal feeding. No significant differences were found between Video‐Health and Control arms (p > 0.05). The intervention significantly improved reported EBF rates at 4 and 5 months postpartum (p < 0.05). DTM results showed that the proportion of women practicing EBF was 50%–67% less than reported at 3 months for both arms and at 5 months in the intervention arm. The intervention did not significantly affect measured EBF at 3 and 5 months postpartum but did improve HMI at 3 months. Non significant differences in NMOI were observed at 3 months, but at 5 months, there was a significant difference between the study arms. Conclusions: Video‐based behavior change communication did not result in significant improvements in reported breastfeeding practices, except for a higher reported adherence to EBF beyond 3 months. Additionally, the intervention had no effect on EBF as measured by the DTM. Early introduction of non‐breastmilk foods and liquids persisted, despite self‐reported EBF extending up to 6 months postpartum. Trial Registration: ClinicalTrials.gov identifier: NCT04414527 [ABSTRACT FROM AUTHOR]

Background: Breastfeeding provides vital nutrients and fosters maternal–infant bonding, benefiting both mother and child. However, breastfeeding duration is influenced by various factors, especially in women of high-risk pregnancy. This study aims to identify predictors of breastfeeding duration among women of high-risk and low-risk pregnancy, focusing on exclusive and mixed feeding practices. Methods: Conducted at a public hospital in Attica, Greece, this 20-month prospective cohort study (May 2020–January 2022) included 380 pregnant women, divided into high-risk and low-risk groups. The final sample of 157 women, after excluding non-breastfeeding participants, was assessed across five phases from prenatal to six months postpartum using interviews, calls, and surveys. Multiple linear regression identified key predictors, with statistical methods applied. Results: Results revealed birth weight as a consistent significant predictor of breastfeeding duration. For women with high-risk pregnancy, additional factors like infant gender, jaundice, and early introduction of solid foods influenced breastfeeding duration. The mixed breastfeeding model for women with high-risk pregnancy explained 72.9% of the variance. Exclusive and mixed breastfeeding models for women with low-risk pregnancy also highlighted birth weight's influence. Conclusion: The findings highlight the important role of birth weight and other specific factors in determining breastfeeding duration among women of high-risk and low-risk pregnancy. Further research is needed to validate these findings across diverse populations. [ABSTRACT FROM AUTHOR]

Background: Despite the many benefits of exclusive breastfeeding to infants and mothers, only 33% of Jamaican infants are exclusively breastfed up to the recommend six months. This study was conducted to identify factors affecting mothers' feeding choices focusing on barriers to exclusive breastfeeding of infants six weeks to less than six months old. Methods: A qualitative study consisting of four focus group discussion sessions was conducted among 22 mothers attending postnatal clinics in western Jamaica from May to August 2016. The transcripts were coded by three independent coders and content analysis conducted to generate themes. Results: Four themes were identified namely, perceived advantages of breastfeeding centered mainly on the benefits of breastfeeding for the infant and mother, perceived barriers of breastfeeding highlighting physical pain and fatigue, supplementing culturally acceptable complementary foods and herbal remedies, and cultural norms including perception of how breastfeeding affects a woman's body, societal sources of breastfeeding information, satiation of infants, and family and other support. Mothers overwhelmingly agreed that breastfeeding was inexpensive, allowed them to bond with their infants and was good for the overall health and intellectual development of the infants. They identified painful nipples, engorged breasts, lack of sleep, physical exhaustion and pressure to return to work as barriers to breastfeeding. Mothers named a number of complementary foods, such as pumpkin, carrots, potato, banana, and chocho (Chayote), that were culturally accepted for feeding infants in Jamaica and discussed herbs that were considered to aid in infants' nutrition and overall health. Other cultural factors that were noted to influence exclusive breastfeeding were mothers feeling that breastfeeding would help their bodies, especially their bellies, go back to their pre-maternity figure, sources of breastfeeding information in the society including the internet, belief that breast milk alone does not satisfy babies, and family and other support. Conclusion: Mothers in this study identified unique challenges to exclusive breastfeeding that if addressed, would help to increase exclusive breastfeeding so that the World Health Organization's exclusive breastfeeding recommendations can be achieved. [ABSTRACT FROM AUTHOR]