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Nutrients
Introduction: The admission of neonates to Neonatal Intensive Care Units (NICUs) has been identified as a primary inhibiting factor in the establishment of breastfeeding. The aims of this study were to (1) estimate the prevalence and duration of breastfeeding in infants/toddlers who had been admitted to an NICU in Greece and (2) to investigate factors, associated with the NICU stay, which affected the establishment and maintenance of breastfeeding in infants/toddlers previously admitted to the NICU. Materials and methods: Data for this cohort study were retrieved from interviews with mothers of infants/toddlers who had been admitted to our NICU as neonates during the period of 2017–2019. Interviews were conducted based on a questionnaire regarding the child’s nutrition from birth to the day of the interview, including previous maternal experience with breastfeeding. Information related to the prenatal period, gestation age, delivery mode, duration of NICU stay, and neonatal feeding ...
Acta Paediatrica, 2005
Aim: To assess breastfeeding practices, focusing on the prevalence and the determinants of exclusive breastfeeding during hospital stay. Methods: A cross-sectional study of 1603 healthy women, who delivered healthy infants weighing more than 2500 g, was conducted in the area of Athens, Greece. Participants completed a self-administered questionnaire on the day they were discharged from the maternity ward. Classification of breastfeeding and recall period from birth to discharge were in accordance with the WHO criteria. Hierarchical logistic regression analysis was used to study determinants of exclusive breastfeeding initiation. Results: Breastfeeding initiation was reported by 96.1% of the participants. However, exclusive breastfeeding was initiated only in 19.1% and predominant breastfeeding in 7.2% of the cases. The univariate analysis showed that maternal younger age, low educational level, unemployment, vaginal delivery, infant birthweight 43000 g, multiparity, early initiation of breastfeeding, rooming-in and awareness on the existence of breastfeeding centres were associated with higher rates of exclusive breastfeeding. Logistic regression analysis revealed that rooming-in (OR 3.72, p50.01), demand feeding (OR 2.18, p50.01), type of delivery (OR 1.61, p50.01) and the source of information received about breastfeeding are more important determinants of exclusive breastfeeding than the socio-demographic parameters.
Nutrients, 2018
Breastfeeding is the normative standard for infant feeding. Despite its established benefits, different factors can affect breastfeeding rates over time. The purpose of this study was to evaluate breastfeeding determinants in healthy term newborns during the first three months of life. A prospective, observational, single-center study was conducted in the nursery of Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico in Milan, Italy. The mother-baby dyads that were admitted to the Clinic in January and February 2017 were enrolled. Only healthy term babies with birth weight ≥10th percentile for gestational age were included. Data were collected through medical records and questionnaires administered during the follow-up period. Then, we fitted univariate and multivariate logistic models and calculated odds ratios. 746 dyads were included but 640 completed the study. The factors found to be favoring breastfeeding were a previous successful breastfeeding experience, a higher ...
Public Health Nutrition
Objective: To estimate breast-feeding prevalence in Greece in 2007 and 2017, compare breast-feeding indicators and maternity hospital practices between these years, and investigate breast-feeding determinants. Design: Two national cross-sectional studies (2007 and 2017) using systematic cluster sampling of babies with the same sampling design, data collection and analysis methodology. Setting: Telephone interview with babies’ mothers or fathers. Participants: Representative sample of infants who participated in the national neonatal screening programme (n 549 in 2017, n 586 in 2007). Results: We found that breast-feeding indicators were higher in 2017 compared with 10 years before. In 2017, 94 % of mothers initiated breast-feeding. Breast-feeding rates were 80, 56 and 45 % by the end of the 1st, 4th and 6th completed month of age, respectively. At the same ages, 40, 25 and <1 % of babies, respectively, were exclusively breast-feeding. We also found early introduction of solid foo...
2022
Background: In Morocco the breast feeding (exclusive) prevalence has decreased from 51% in 1992 to 35% in 2018. This prevalence was lower in neonatal intensive care unit (NICU) with 12.4% in 2014. The aim of this study was to estimate the prevalence and identify the associated factors of breastfeeding (BF) practice in NICU of Casablanca Ibn Rochd teaching hospital.Method:A cross sectional study was performed between 04 January and 26 June 2021 in NICU. We included Moroccan couples mother/newborn who can practice the BF presents during the study period. We used face to face interview using pretested questionnaire. Logistic regression was used to test association between breastfeeding (BF) practice and potential associated factors. Factors with p ≤ 0.05 were considered as associated factors of BF practice. Data were analyzed using R 3.6.3 Findings: We included 170 couple mother/newborn. Around 74% of mothers practiced partial breastfeeding. The mother factors associated with BF practi...
Journal of Human Lactation, 2013
Benefits of human milk (including mother's and donor's milk) and breastfeeding (feeding at the breast) for the NICU population are well documented. Limited data are available regarding feeding status at NICU discharge, particularly for different birth weight categories. Newly Expressed Our study found that, at NICU discharge, human milk feeding was low in all birth weight classes and breastfeeding was rare. Exclusive breastfeeding was not associated with increased birth weight, and the rate of exclusive breastfeeding was lowest in the 1500 to 2499 g category.
European Journal of Pediatrics, 2020
The benefits of human milk in preterm infants, a population at high risk for developing adverse outcomes for which breast milk is a protective factor, are widely acknowledged. However, preterms' admission in a neonatal intensive care unit (NICU) and newborn's clinical conditions have been described as significant barriers, leading to lower rates of breastfeeding initiation and duration. Healthcare workers play a crucial role in encouraging breastfeeding. We conducted a cross-sectional survey among nurses working in six Italian NICUs, exploring their knowledge and attitude towards breastfeeding. Although the majority of nurses had a specific breastfeeding education, our results show still some variations among answers regarding aspects of breastfeeding support in this setting. Specifically, family-centered care, transition feeding to the breast, and skin-to-skin practice, despite being extensively addressed by the Neo Baby-Friendly Hospital Initiative, are the items that highlighted a range of answers that could result in conflicting information to mothers. Conclusion: By underlining the gaps of knowledge and attitude towards breastfeeding of nurses working in NICUs, this study provides an insight into what needs to be improved, with the aim of promoting higher rates of breastfeeding in the preterm population.
2021
The objective of this study was to explore the availability of expressed breast milk (EBM) volume for the premature neonates born from mothers in different gestational age groups during neonatal intensive care unit (NICU) stay. All preterm infants (extreme-preterm infant [EPTI, <28 weeks], very-preterm infant [VPTI, 28–316/7 weeks], and moderate-preterm infant [MPTI, 32–336/7 weeks]) and their mothers were included in the study. Infants not receiving mother's own milk and neonates deceased or discharged against medical advice, and the mother with illness during postpartum period were excluded from the study. A predesigned tool was used to collect information on maternal characteristics, neonatal characteristics, and milk diary for preterm neonates from the NICU case records. The primary outcome variable EBM volume available on day 7 was compared across three gestational groups. Logistic regression was used to predict EBM availability. A total of 78 preterm neonates, including...
Maternal & child nutrition, 2008
This review aimed to identify interventions to promote breastfeeding or breast milk feeding for infants admitted to the neonatal unit.
Global academic journal of medical sciences, 2023
Introduction: Breast milk is a natural and nutritious food which is considered to be the safest food for neonates and infants. It boosts immune system, controls gastrointestinal infections, pneumonia, UTI and provides proper nutrients like protein, fat, vitamins, and minerals. Aim of the Study: The study aimed to find out the factors of early discontinuation of exclusive breastfeeding (EBF) during the first 6 months of life of hospitalized babies. Methods: It is an observational prospective study conducted at the Bangladesh Shishu Hospital and Institute. The sample size was 191 infants and their mothers. Data was collected through a structured questionnaire prepared by the researchers and applied to the mothers of infants. The study was conducted during the period of 1 July 2020-31 December 2020. Result: Most of the infants 111(52.3%) were aged<20 days and most of the mothers 154(80.6%) were aged more than 20 years. Majority of the mothers 107(56.1%) were housewives and 14(7.3%) infants were preterm. Most of the babies 125(65.4%) weighted more than 2500g. In this study majority of the babies 161(84.29%) were healthy cried immediately after the birth. Majority of the babies 105(55%) could suck breast milk properly after the birth. In 103(53.9%) cases, breastfeeding was initiated within an hour after the birth. Normal vaginal delivery was done in 98(51.3%) cases and caesarean section was done in 93(48.7%) cases. Majority of the mothers113 (59.2%) had misconception about quantity of milk they believed that they don't have enough milk. Only 32(16.8%) mothers doesn't like breastfeed the baby and 65(34%) mothers believed that formula is better than breast milk and 107(56%) mothers had lack of knowledge about advantages of breast milk. Conclusion: This prospective study found that the level of the discontinuation of exclusive breastfeeding is high having several factors like having misconception about quantity of milk, lack of knowledge about advantages of breast milk, preference of formula milk over breast milk. More over low socio-economic background, less educational level of mothers, working mothers having no breast feeding corner in work place, and mothers having various breast problem (inverted nipple, flat nipple, cracked nipple, Mastitis, breast abscess, Faulty technic of breast feeding ) were also included.
Revista De Saude Publica, 2011
OBJECTIVE: To identify factors associated with breastfeeding in the fi rst hour of life (Step 4 of the Baby-Friendly Hospital Initiative). METHODS: A cross-sectional study was conducted with a representative sample of mothers who gave birth in maternity wards in the city of Rio de Janeiro, Southeastern Brazil, between 1999 and 2001. Newborns or mothers with restriction to breastfeeding were excluded, resulting in a sample of 8,397 pairs. A random effect-at maternity hospital level-Poisson model was employed in a hierarchical approach with three levels: distal, intermediate and proximal for characteristics of the mother, of the newborn, and of prenatal and hospital assistance. RESULTS: Only 16% of the mothers breastfed in the fi rst hour of life. Breastfeeding in this period was less prevalent among neonates with immediate intercurrences after birth (PR = 0.47; CI99% 0.15;0.80); among mothers who did not have contact with their newborns in the delivery room (PR = 0.62; CI99% 0.29;0.95); among mothers submitted to cesarean section delivery (PR = 0.48; CI99% 0.24;0.72); and among mothers who gave birth at private maternity hospitals (PR = 0.06; CI99% 0.01;0.19) or at maternity hospitals contracted out to National Health System (SUS) (PR = 0.16; CI99% 0.01;0.30). The context effect of maternity wards was statistically signifi cant. CONCLUSIONS: At an individual level, breastfeeding within one hour after birth was constrained by inappropriate practices in private or SUS-contracted maternity hospitals. The group effect of maternity hospitals and the absence of individual maternal-related factors that explain the outcome suggest that mothers have little or no autonomy to breastfeed their babies within the fi rst hour of life, and depend on the institutional practices that prevail at the maternity hospitals.
BMJ open, 2016
There are indications that the prevalence of exclusively breastfed preterm infants is decreasing in Sweden. The objective was to investigate trends in exclusive breast feeding at discharge from Swedish neonatal units and associated factors in preterm infants. This is a register study with data from the Swedish Neonatal Quality Register. Data from 29 445 preterm infants (gestational age (GA) <37 weeks) who were born during the period 2004-2013 were retrieved. Data included maternal, perinatal and neonatal characteristics. Data were analysed for the whole population as well as for 3 GA groups. From 2004 to 2013, the prevalence of exclusive breast feeding decreased, in extremely preterm (GA 22-27 weeks) from 55% to 16%, in very preterm (GA 28-31 weeks) from 41% to 34% and in moderately preterm infants (GA 32-36 weeks) from 64% to 49%. The decline was statistically significant (p<0.001) in all 3 GA groups. This decline remained significant when adjustments were made for factors ne...
Journal of Neonatal Nursing, 2007
Background: The World Health Organisation (WHO) and a substantial body of literature recommend breastfeeding from birth until at least 6 months of age. The nutritional, gastrointestinal, immunological, neurodevelopmental and psychosocial benefits of breastfeeding have been shown for term and preterm infants. Meeting the WHO recommendations for breastfeeding is problematic in the cohort of infants requiring hospitalisation in a neonatal intensive care unit (NICU) for management of complex medical and surgical conditions. Method: A retrospective audit of medical records of all infants admitted to the neonatal unit of the Royal Children's Hospital, Melbourne, Australia between 2001 and 2003 was conducted. Results: One thousand, one hundred and sixty-three babies were admitted during the audit period. Babies discharged directly home were of significantly greater gestational age, higher birthweight and had a shorter length of stay than those babies transferred to another facility (P < 0.05). Fifty-six percent of the cohort was receiving breast milk on discharge from the neonatal unit. Babies exclusively breastfed on discharge were of greater gestational age and had a shorter length of stay in the NICU than those babies discharged on a combination of breast milk and formula, or formula alone (P < 0.001). Babies transferred to another facility, rather than discharged directly home, were less likely to be breastfed and more likely to receive enteral nutrition via intragastric tube feeds or a combination of bottle and tube feeds. Conclusion: Birthweight, gestational age, and length of stay in a neonatal intensive care unit are factors likely to influence breastfeeding in the cohort of babies requiring tertiary level care.
Journal of Obstetric, Gynecologic, & Neonatal Nursing, 2013
Keywords breastfeeding medical record neonatal intensive care units preterm birth tube feeding qualitative research ABSTRACT Objective: To evaluate the effects of estimated breastfeeding on infant outcomes in comparison to test weighing and to describe staff members' experiences of estimated breastfeeding as a method for supporting the transition from tube feeding to breastfeeding.
Journal of Pediatric and Neonatal Individualized Medicine (JPNIM), 2020
Background: Human milk is recognized to be excellent nutrition for neonates. However, supporting breastfeeding in these hospitalized vulnerable infants entails many challenges. Data are lacking on breastfeeding duration and associated factors for breastfeeding continuation until 6 months, especially in a low-resource setting. Objectives: To determine the prevalence of breastfeeding for previously hospitalized neonates at least 6 months post-discharge and examine the factors associated with successful breastfeeding. Methods and study design: This is a prospective study. Mothers were eligible if their infant(s) had been admitted to Neonatal Units within the first 7 days of life. General demographic data and maternal perception scores were collected during admission. Telephone interviews on feeding practices were conducted every 2 months until 6 months post-discharge or at discontinuation of breastfeeding. Results: Of 87 mothers who completed follow-up, 91%, 71% and 57% were breastfeeding at 2, 4 and 6 months, respectively. The main reasons for discontinuation were maternal perceptions of insufficient milk supply and difficulty in returning to work. Mothers being the main caregivers, above-average family income and maternal perception on breastfeeding benefits and barriers were significant factors for successful breastfeeding for 6 months. Conclusions: Strategies to encourage breastfeeding are needed for all mothers who return to work and especially for low-income families.
BMJ open, 2015
To explore differences in approaches to supporting lactation and breastfeeding for very preterm infants in neonatal intensive care units (NICU) in 3 European regions. Qualitative cross-sectional study carried out by means of face-to-face semistructured interviews. Verbatim transcripts were coded using a theoretical framework derived from the literature and supplemented by data-driven concepts and codes. 4 purposively selected NICUs in each of 3 European regions in 2010 (Ile-de-France in France, Lazio in Italy, and the former Trent region in the UK). NICU staff members (n=22). Policies and practices for managing mother's own milk for very preterm babies differed between regions, and were much more complex in Ile-de-France than in the Trent or Lazio regions. Staff approaches to mothers to initiate lactation differed by region, with an emphasis on the nutritional and immunological value of human milk in the Trent region and on the 'normalising' effect of breastfeeding on th...
Journal of Neonatal Nursing, 2017
Aim: To identify the determinants of breastfeeding initiation, duration and exclusivity in Cyprus. Methods: A cross-sectional study was conducted that included 128 mothers of infants aged 6e18 months. Data was collected using a questionnaire. A chi-square test and multivariate logistic regression were performed for statistical analysis. Results: The only factor associated with breastfeeding initiation was care in the Neonatal Intensive Care Unit. In-hospital formula supplementation and use of a pacifier were negatively associated with breastfeeding duration, whereas previous breastfeeding experience for more than one month and father's tertiary educational level were positively associated. In-hospital formula supplementation and free formula samples were negatively associated, and father's tertiary educational level was positively associated with breastfeeding exclusivity. Conclusions: Although breastfeeding initiation rates were high, breastfeeding duration was far from the international recommendations. The role of the healthcare professionals and the father could be important for breastfeeding outcomes.
2014
Although breastfeeding is the normative standards for infant nutrition, exclusive breastfeeding rates at hospital discharge in the general population of newborns are still suboptimal. Besides many other psychological, social, economical, cultural factors, breastfeeding success is also significantly influenced by maternity practices that have the potential to foster or otherwise to hinder breastfeeding physiology during postpartum hospital stay. On their part, health professionals need to improve their knowledge on lactation, to acquire better skills to manage breastfeeding problems and to commit themselves to prepare evidence based clinical protocols that support breastfeeding and the use of human milk. At the Institute for Maternal and Child Health in Trieste (Italy), we have developed two surveillance protocols related to situations that commonly challenge health professionals to give their qualified advice to the breastfeeding dyad. Particularly, we have documented the feasibilit...
International Journal of Pediatrics, 2016
Background. Mother’s milk is the best for the babies. Protective and preventive role of breast milk was evaluated in this study by assessing the relation of type of feeding and duration of hospital stay or morbidity.Methods. This prospective study was conducted in a tertiary care hospital and 232 infants in the age group of 14 weeks to 6 months formed the sample. There are two groups of infants, that is, one for breastfed and one for top fed infants. Statistical analysis was done and results were calculated up to 95% to 99% level of significance to find effect of feeding pattern on hospital stay due to various diseases and morbidity.Results. Prolonged hospital stay, that is, >7 days, was lesser in breastfed infants and results were statistically significant in case of gastroenteritis (pvalue < 0.001), bronchopneumonia (pvalue = 0.0012), bronchiolitis (pvalue = 0.005), otitis media (pvalue = 0.003), and skin diseases (pvalue = 0.047). Lesser morbidity was seen in breastfed infa...
Public health nutrition, 2018
To assess the prevalence and sociodemographic determinants of breast-feeding (BF) and exclusive breast-feeding (EBF) in Cyprus up to the sixth month. Cross-sectional and longitudinal descriptive study. BF and EBF were estimated based on mothers' self-reported BF status in line with Step 7 of the WHO/UNICEF Baby-Friendly Hospital Initiative questionnaire and based on 24 h recall. Maternity wards in all public hospitals and twenty-nine (of thirty-five) private maternity clinics nationwide. Consecutive sample of 586 mothers recruited within 48 h from birth, followed up by telephone interview at the first, fourth and sixth month. Although 84·3 % of mothers initiated BF before discharge, prevalence of BF at the sixth month was 32·4 %, with the highest reduction observed between the first and fourth months. Prevalence of EBF at 48 h was 18·8 % and fell gradually to 5·0 % at the sixth month. Mothers with higher educational attainment or higher family income were more likely to breast-f...
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