Research

18 pages, 899 KiB

Open AccessArticle

Effectiveness of a Postpartum Breastfeeding Support Group Intervention in Promoting Exclusive Breastfeeding and Perceived Self-Efficacy: A Multicentre Randomized Clinical Trial

by Isabel Rodríguez-Gallego, Isabel Corrales-Gutierrez, Diego Gomez-Baya and Fatima Leon-Larios

Nutrients 2024, 16(7), 988; https://doi.org/10.3390/nu16070988 - 28 Mar 2024

Viewed by 1122

Abstract

There are numerous recognized benefits of breastfeeding; however, sociocultural, individual, and environmental factors influence its initiation and continuation, sometimes leading to breastfeeding rates that are lower than recommended by international guidelines. The aim of this study was to evaluate the effectiveness of a [...] Read more.

There are numerous recognized benefits of breastfeeding; however, sociocultural, individual, and environmental factors influence its initiation and continuation, sometimes leading to breastfeeding rates that are lower than recommended by international guidelines. The aim of this study was to evaluate the effectiveness of a group intervention led by midwives supporting breastfeeding during the postpartum period in promoting exclusive breastfeeding, as well as to assess the impact of this intervention on perceived self-efficacy. This was a non-blind, multicentric, cluster-randomized controlled trial. Recruitment started October 2021, concluding May 2023. A total of 382 women from Andalusia (Spain) participated in the study. The results showed that at 4 months postpartum there was a higher prevalence of breastfeeding in the intervention group compared to formula feeding (p = 0.01), as well as a higher prevalence of exclusive breastfeeding (p = 0.03), and also at 6 months (p = 0.01). Perceived self-efficacy was similar in both groups for the first two months after delivery, which then remained stable until 4 months and decreased slightly at 6 months in both groups (p = 0.99). The intervention improved the average scores of perceived self-efficacy and indirectly caused higher rates of exclusive breastfeeding (p = 0.005). In conclusion, the midwife-led group intervention supporting breastfeeding proved to be effective at maintaining exclusive breastfeeding at 6 months postpartum and also at increasing perceived self-efficacy. Full article

(This article belongs to the Special Issue Breastfeeding: Benefits to Infant and Mother)

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15 pages, 782 KiB

Open AccessArticle

Factors Influencing Duration of Breastfeeding: Insights from a Prospective Study of Maternal Health Literacy and Obstetric Practices

by Rafael Vila-Candel, Francisco Javier Soriano-Vidal, Cristina Franco-Antonio, Oscar Garcia-Algar, Vicente Andreu-Fernandez and Desirée Mena-Tudela

Nutrients 2024, 16(5), 690; https://doi.org/10.3390/nu16050690 - 28 Feb 2024

Viewed by 795

Abstract

Numerous factors concerning early breastfeeding abandonment have been described, including health literacy (HL). This study’s objective was to analyze factors related to early breastfeeding abandonment (<6 months). This prospective multicentric study examined the duration of breastfeeding at 6 months postpartum and was conducted [...] Read more.

Numerous factors concerning early breastfeeding abandonment have been described, including health literacy (HL). This study’s objective was to analyze factors related to early breastfeeding abandonment (<6 months). This prospective multicentric study examined the duration of breastfeeding at 6 months postpartum and was conducted in four different regions of Spain from January 2021 to January 2023. A total of 275 women participated in this study, which focused on maternal HL and obstetric practices. A decrease in the breastfeeding rate was observed from hospital discharge (n = 224, 81.5%) to the sixth month postpartum (n = 117, 42.5%). A Cox regression analysis revealed that inadequate HL levels, lack of mobilization during labour, and induced labour were significantly associated with early breastfeeding cessation (p = 0.022, p = 0.019, and p = 0.010, respectively). The results highlight that women with adequate HL had a 32% lower risk of early breastfeeding abandonment. In comparison, mobilization during labour and induction of labour were linked to a 32.4% reduction and a 53.8% increase in this risk, respectively. These findings emphasize the importance of considering obstetric and HL factors when addressing the breastfeeding duration, indicating opportunities for educational and perinatal care interventions. Full article

(This article belongs to the Special Issue Breastfeeding: Benefits to Infant and Mother)

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15 pages, 806 KiB

Open AccessArticle

Evaluation of the Impact of a Midwife-Led Breastfeeding Group Intervention on Prevention of Postpartum Depression: A Multicentre Randomised Clinical Trial

by Isabel Rodríguez-Gallego, Rafael Vila-Candel, Isabel Corrales-Gutierrez, Diego Gomez-Baya and Fatima Leon-Larios

Nutrients 2024, 16(2), 227; https://doi.org/10.3390/nu16020227 - 10 Jan 2024

Cited by 1 | Viewed by 1877

Abstract

Postpartum depression is a significant health issue affecting both mothers and newborns during the postpartum period. Group support interventions during this period have proven effective in helping women cope with depression and improving breastfeeding rates. This study aimed to assess the effectiveness of [...] Read more.

Postpartum depression is a significant health issue affecting both mothers and newborns during the postpartum period. Group support interventions during this period have proven effective in helping women cope with depression and improving breastfeeding rates. This study aimed to assess the effectiveness of a midwife-led breastfeeding support group intervention on breastfeeding rates, postpartum depression and general self-efficacy. This was a multicentric cluster randomised controlled trial with control and intervention groups and was not blinded. It was conducted in Andalusia (southern Spain) from October 2021 to May 2023. A total of 382 women participated in the study. The results showed a significant difference in exclusive breastfeeding rates at 4 months postpartum between the groups (control 50% vs. intervention 69.9%; p < 0.001). Additionally, there was a lower mean score on the Edinburgh Postnatal Depression Scale in the intervention group (12.49 ± 3.6 vs. 13.39 ± 4.0; p = 0.044). Similarly, higher scores of general self-efficacy were observed among breastfeeding women at 2 and 4 months postpartum (77.73 ± 14.81; p = 0.002 and 76.46 ± 15.26; p < 0.001, respectively). In conclusion, midwife-led breastfeeding support groups enhanced self-efficacy, prolonged breastfeeding and reduced postpartum depression 4 months after giving birth. Full article

(This article belongs to the Special Issue Breastfeeding: Benefits to Infant and Mother)

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13 pages, 457 KiB

Open AccessArticle

Previous High-Intensity Breastfeeding Lowers the Risk of an Abnormal Fasting Glucose in a Subsequent Pregnancy Oral Glucose Tolerance Test

by Sarah J. Melov, James Elhindi, Lisa White, Justin McNab, Vincent W. Lee, Kelly Donnolley, Thushari I. Alahakoon, Suja Padmanabhan, N. Wah Cheung and Dharmintra Pasupathy

Nutrients 2024, 16(1), 28; https://doi.org/10.3390/nu16010028 (registering DOI) - 21 Dec 2023

Viewed by 1661

Abstract

Breastfeeding is associated with reduced lifetime cardiometabolic risk, but little is known regarding the metabolic benefit in a subsequent pregnancy. The primary aim of this study was to investigate the association between breastfeeding duration and intensity and next pregnancy oral glucose tolerance test [...] Read more.

Breastfeeding is associated with reduced lifetime cardiometabolic risk, but little is known regarding the metabolic benefit in a subsequent pregnancy. The primary aim of this study was to investigate the association between breastfeeding duration and intensity and next pregnancy oral glucose tolerance test (OGTT) results. A retrospective cohort study was conducted from March 2020 to October 2022. All multiparous women who met inclusion criteria and gave birth during the study period were eligible for inclusion. Analysis was stratified by risk for gestational diabetes (GDM). High GDM risk criteria included previous GDM and BMI > 35 kg/m². The association between breastfeeding duration and high-intensity breastfeeding (HIBF) and subsequent pregnancy OGTT were assessed with multivariate logistic models adjusted for statistically and clinically relevant covariables. There were 5374 multiparous participants who met the inclusion criteria for analysis. Of these, 61.7% had previously breastfed for >6 months, and 43.4% were at high risk for GDM. HIBF was associated with 47% reduced odds of an abnormal fasting glucose in a subsequent pregnancy OGTT (aOR 0.53; 95%CI 0.38–0.75; p < 0.01). There was no association between HIBF and other glucose results on the OGTT. Women who smoked were least likely to breastfeed at high intensity (aOR 0.31; 95%CI 0.21–0.47; p < 0.01). South Asian women had 65% higher odds of HIBF than women who identified as White/European (aOR 1.65; 1.36–2.00; p < 0.01). This study highlights the importance of exclusive breastfeeding to potentially reduce the prevalence of GDM and may also translate into long-term reduction of cardiometabolic risk. Full article

(This article belongs to the Special Issue Breastfeeding: Benefits to Infant and Mother)

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10 pages, 490 KiB

Open AccessArticle

Women’s Satisfaction with Breastfeeding and Risk of Exclusive Breastfeeding Interruption

by Agnes Meire Branco Leria Bizon, Camila Giugliani and Elsa Regina Justo Giugliani

Nutrients 2023, 15(24), 5062; https://doi.org/10.3390/nu15245062 - 11 Dec 2023

Viewed by 868

Abstract

This prospective cohort study was conducted to evaluate the association between women’s satisfaction with breastfeeding at 1 month post-partum and the risk of exclusive breastfeeding (EBF) interruption before 6 months. 287 mother–infant dyads randomly selected from two maternity hospitals were followed from birth [...] Read more.

This prospective cohort study was conducted to evaluate the association between women’s satisfaction with breastfeeding at 1 month post-partum and the risk of exclusive breastfeeding (EBF) interruption before 6 months. 287 mother–infant dyads randomly selected from two maternity hospitals were followed from birth to 24 months of infant’s age. Women’s satisfaction with breastfeeding was assessed using the Maternal Breastfeeding Evaluation Scale (MBFES) at 1 month. The association between women’s satisfaction with breastfeeding and risk of EBF interruption before 6 months was estimated using Cox proportional hazards model. Kaplan–Meier survival curves for EBF were compared between women with lower satisfaction with breastfeeding (MBFES score < median 124) and those with higher satisfaction (MBFES score ≥ 124). Median EBF duration in women with higher satisfaction was 120 days (95%CI 109–131), vs. 26 days (95%CI 19–33) in less satisfied women. Each additional point on MBFES promoted a reduction of 2.0% in the risk of EBF interruption. Among women with satisfaction scores < 124, the risk of EBF interruption was 86% higher when compared with those ≥ 124 (adjusted hazard ratio 1.86; 95%CI 1.41–2.46). Lower maternal satisfaction with breastfeeding in the first month post-partum is associated with a higher risk of EBF interruption before 6 months. Full article

(This article belongs to the Special Issue Breastfeeding: Benefits to Infant and Mother)

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15 pages, 1208 KiB

Open AccessArticle

Full Breastfeeding and Allergic Diseases—Long-Term Protection or Rebound Effects?

by Lars Libuda, Birgit Filipiak-Pittroff, Marie Standl, Tamara Schikowski, Andrea von Berg, Sibylle Koletzko, Carl-Peter Bauer, Joachim Heinrich, Dietrich Berdel and Monika Gappa

Nutrients 2023, 15(12), 2780; https://doi.org/10.3390/nu15122780 - 16 Jun 2023

Viewed by 2148

Abstract

A previous follow-up of the GINIplus study showed that breastfeeding could protect against early eczema. However, effects diminished in adolescence, possibly indicating a “rebound effect” in breastfed children after initial protection. We evaluated the role of early eczema until three years of age [...] Read more.

A previous follow-up of the GINIplus study showed that breastfeeding could protect against early eczema. However, effects diminished in adolescence, possibly indicating a “rebound effect” in breastfed children after initial protection. We evaluated the role of early eczema until three years of age on allergies until young adulthood and assessed whether early eczema modifies the association between breastfeeding and allergies. Data from GINIplus until 20-years of age (N = 4058) were considered. Information on atopic eczema, asthma, and rhinitis was based on reported physician’s diagnoses. Adjusted Odds Ratios (aOR) were modelled by using generalized estimating equations. Early eczema was associated with eczema (aORs = 3.2–14.4), asthma (aORs = 2.2–2.7), and rhinitis (aORs = 1.2–2.7) until young adulthood. For eczema, this association decreased with age (p-for-interaction = 0.002–0.006). Longitudinal models did not show associations between breastfeeding and the respective allergies from 5 to 20 years of age. Moreover, early eczema generally did not modify the association between milk feeding and allergies except for rhinitis in participants without family history of atopy. Early eczema strongly predicts allergies until young adulthood. While preventive effects of full breastfeeding on eczema in infants with family history of atopy does not persist until young adulthood, the hypothesis of a rebound effect after initial protection cannot be confirmed. Full article

(This article belongs to the Special Issue Breastfeeding: Benefits to Infant and Mother)

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13 pages, 311 KiB

Open AccessArticle

Breastfeeding-Related Practices in Rural Ethiopia: Colostrum Avoidance

by M. Ascensión Olcina Simón, Rosita Rotella, Jose M. Soriano, Agustin Llopis-Gonzalez, Isabel Peraita-Costa and María Morales-Suarez-Varela

Nutrients 2023, 15(9), 2177; https://doi.org/10.3390/nu15092177 - 03 May 2023

Viewed by 1673

Abstract

The practices of colostrum avoidance and prelacteal feeding, which are common in many developing countries, including Ethiopia, are firmly rooted in ancient traditions. The main objective of this work is to identify the prevalence of colostrum avoidance and study its associated factors among [...] Read more.

The practices of colostrum avoidance and prelacteal feeding, which are common in many developing countries, including Ethiopia, are firmly rooted in ancient traditions. The main objective of this work is to identify the prevalence of colostrum avoidance and study its associated factors among mothers of children aged less than 2 years old in the Oromia region of Ethiopia. A cross-sectional study on the practice of colostrum avoidance/prelacteal feeding was conducted in a rural community with 114 mothers of children under 2 years old. Our results reflected that colostrum avoidance and prelacteal feeding were practiced by 56.1% of mothers. The percentage of women who started breastfeeding in the first hour after birth, as recommended by the WHO, was 2.6%. Of the women who practiced colostrum avoidance, 67.2% gave birth at home, and 65.6% were attended by relatives. The likelihood of avoiding colostrum increases in mothers who have a lower educational level, who did not receive health care at the time of delivery, who think that colostrum is dirty and dangerous and who did not receive information about breastfeeding from healthcare professionals. The knowledge emanating from this work may be useful in designing new breastfeeding education programs and/or interventions in Ethiopia and other developing countries. Full article

(This article belongs to the Special Issue Breastfeeding: Benefits to Infant and Mother)

13 pages, 490 KiB

Open AccessArticle

Determinants of High Breastfeeding Self-Efficacy among Nursing Mothers in Najran, Saudi Arabia

by DaifAllah D. Al-Thubaity, Mohammed A. Alshahrani, Wafaa T. Elgzar and Heba A. Ibrahim

Nutrients 2023, 15(8), 1919; https://doi.org/10.3390/nu15081919 - 15 Apr 2023

Cited by 4 | Viewed by 1653

Abstract

Many factors have been found to correlate with satisfactory Exclusive Breastfeeding (EBF) practices. The relationships between EBF practices and associated factors are complex and multidimensional; Breastfeeding Self-Efficacy (BSE) is the most important psychological factor that may help the mother to overcome any expected [...] Read more.

Many factors have been found to correlate with satisfactory Exclusive Breastfeeding (EBF) practices. The relationships between EBF practices and associated factors are complex and multidimensional; Breastfeeding Self-Efficacy (BSE) is the most important psychological factor that may help the mother to overcome any expected barriers. This study investigates the determinants of high breastfeeding self-efficacy among Saudi nursing mothers. Methods: This is a descriptive cross-sectional study investigating the determinant of BSE among 1577 nursing mothers in primary health centers in Najran City, Saudi Arabia. The study uses a cluster random sampling technique. Data collection was performed from June 2022 to January 2023 using a self-reported questionnaire that encompasses the Breastfeeding Self-Efficacy Scale—Short Form (BSES-SF), Gender Friendly Breastfeeding Knowledge Scale (GFBKS), Iowa Infant Feeding Attitude Scale (IIFAS), and a basic data questionnaire to assess women’s demographic factors and obstetric history. Results: The mean score for all BSES-SF items was between 3.23–3.41, the highest mean score was in mothers who felt comfortable breastfeeding with family members present (3.41 ± 1.06), and the lowest mean was in mothers who could breastfeed their baby without using formula as a supplement (3.23 ± 0.94). The overall BSE score was high among 67% of the study participants. Binary logistic regression showed that being a housewife, being highly educated, having breastfeeding experience, and being multiparous are positive predictors for high BSE (p ≤ 0.001). In addition, having adequate breastfeeding knowledge and positive breastfeeding attitudes were positively associated with higher BSE (p = 0.000). Conclusion: BSE can be predicted by modifiable predictors such as mothers’ education, working status, parity, breastfeeding experience, adequate breastfeeding knowledge, and positive attitudes toward breastfeeding. If such predictors are considered during breastfeeding-related educational interventions, it could lead to more effective and sustainable effects in community awareness regarding breastfeeding. Full article

(This article belongs to the Special Issue Breastfeeding: Benefits to Infant and Mother)

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16 pages, 645 KiB

Open AccessArticle

The Relationship between Maternal Ideation and Exclusive Breastfeeding Practice among Saudi Nursing Mothers: A Cross-Sectional Study

by Wafaa T. Elgzar, DaifAllah D. Al-Thubaity, Mohammed A. Alshahrani, Rasha M. Essa and Heba A. Ibrahim

Nutrients 2023, 15(7), 1719; https://doi.org/10.3390/nu15071719 - 31 Mar 2023

Cited by 5 | Viewed by 1962

Abstract

All mortality risk factors are higher in non-breastfed infants compared to infants under five months of age who receive Exclusive Breastfeeding (EBF). Examining the predicting role of maternal ideation in EBF practices can help to direct and strengthen the cooperation between multidisciplinary healthcare [...] Read more.

All mortality risk factors are higher in non-breastfed infants compared to infants under five months of age who receive Exclusive Breastfeeding (EBF). Examining the predicting role of maternal ideation in EBF practices can help to direct and strengthen the cooperation between multidisciplinary healthcare providers to formulate multidisciplinary breastfeeding enhancement strategies. Methods: This correlational cross-sectional study investigates the relationship between maternal ideation and EBF practice among Saudi nursing mothers at Maternal and Children’s Hospital (MCH) in Najran, Saudi Arabia. The study incorporated 403 Saudi nursing mothers aged 6–12 months with healthy infants. The data collected using a questionnaire comprises demographic characteristics and obstetric history, the EBF Practice scale, and a maternal ideation scale. The data was collected from the beginning of November 2022 to the end of January 2023 and analyzed using I.B.M. version 22. Results: Breastfeeding initiation within one hour occurred among 85.1% of women, while 39.2% fed their newborn only colostrum during the first three days. EBF until six months was practiced by 40.9% of the participants day and night and on-demand (38.7%). Furthermore, 60.8% of the study participants had satisfactory overall EBF practices. The cognitive part of maternal ideation shows that 68.2% of the participants had adequate knowledge and 63.5% had positive beliefs regarding EBF practice. The maternal psychological ideation dimensions show that 81.4% had high EBF self-efficacy. The maternal social ideation dimensions showed that high injunctive and descriptive norms were present among 40.9% and 37.5%, respectively. In addition, healthcare providers (39.2%) had the most significant social influence, followed by husbands (30.5%). Binary logistic regression shows that the mother’s age, occupation, and education are the significant demographic predictors of satisfactory EBF practices (p < 0.05). All maternal ideation constructs were positive predictors of satisfactory EBF practices (p < 0.05). Conclusion: Maternal ideation constructs are positive predictors of satisfactory EBF practice and can be used to predict high-risk groups and plan for further intervention. Full article

(This article belongs to the Special Issue Breastfeeding: Benefits to Infant and Mother)

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