Diss. (sammanfattning) Uppsala : Univ., 2001. / Härtill 5 uppsatser.

Thesis (Ph. D.)--University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, 1998. / Includes bibliographical references.

Thesis (M.S.)--University of Wisconsin--Madison, 1981. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 108-111).

Thesis (M.S.)--University of Wisconsin--Madison, 1983. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 168-172).

Breastfeeding is widely considered the healthiest way to feed an infant. Promoting breastfeeding and increasing breastfeeding rates has become a global strategy to improve children’s health. However the latest rate of exclusive breastfeeding at six months in 2014 in China was 30% in rural areas and 16% in urban areas. Support from skilled practitioners can positively influence breastfeeding initiation rates, duration and women’s breastfeeding experience. This research aims to develop and evaluate a new breastfeeding training programme for professionals to improve support for breastfeeding mothers in China. Mixed research methods were used in the research which included qualitative and quantitative studies. Two qualitative studies provided the evidence for the importance of training professionals in two essential skills of positioning and attachment (P & A) and hand expression (HE). This study further applied a 15-minute breastfeeding DVD training intervention to train Chinese professionals in P & A and HE. At the meantime, the research developed two valid breastfeeding assessment tools, including knowledge assessment tool and confidence assessment tool. Two quantitative studies of the pilot study and RCT study evaluated the effectiveness of DVD training intervention on improving professionals’ knowledge and confidence before and after DVD training by the two breastfeeding assessment tools. The findings in both studies indicated that the DVD training intervention significantly improve the professionals’ knowledge and confidence in P & A and HE with a big effect size. The semi-structured interviews conducted after the RCT study showed the feasibility and applicability of DVD training for professionals in China. This first evidence-based new training programme is likely to be widely implemented in China due to its effectiveness, convenience and ease of access. However, the long-term effectiveness of the DVD training at improving professionals’ knowledge, confidence and breastfeeding outcome needs to be further examined in the future.

MSc (Med), Community Paediatrics, Faculty of Health Sciences, University of the Witwatersrand / Background: Although breastfeeding is a key child survival strategy, breastfeeding practices in South African health institutions can generally be categorised as being poor. The global Baby-Friendly Hospital Initiative (BFHI), led by UNICEF and the WHO, aims to create a health care environment that promotes breastfeeding as the norm. This study aimed to document practices around breastfeeding support and compliance with the BFHI’s “10 steps to successful breastfeeding” in both baby-friendly accredited and non-accredited facilities. Methods: This was a cross-sectional study, conducted in nine facilities in Gauteng, including tertiary, secondary and districts hospitals, and midwife obstetric units. Convenience sampling was used. Study questionnaires were based on the generic BFHI assessment tool, but were modified to include more detailed investigation of HIV related factors. The questionnaire was verbally administered on-site to 165 mothers of well infants, and 65 nursing staff. Results: Suboptimal practices were identified in both baby-friendly and non-baby-friendly accredited facilities, but more so in the latter. None of the facilities passed all of the 10 BFHI steps. None of the baby-friendly certified institutions achieved a score sufficient to be still deemed baby-friendly. Steps that required advice and support from nursing staff, viz. step 5 (showing mothers how to breastfeed), step 8 (encouraging breastfeeding on demand), and step 10 (breastfeeding support after discharge from the facility), were particularly poorly done in the majority of facilities. Baby-friendly certified institutions were significantly better than non-accredited facilities for steps 2 (training), 4 (initiating breastfeeding within 1 hour), and 7 (rooming-in). Conclusion: Although baby-friendly accredited facilities generally performed better than non-accredited facilities, their performance failed to justify maintenance of their accredited status based on this assessment. However, some positive practices were sustained over time. There is a dire need for greater attention to be directed to the promotion of good breastfeeding practices by health professionals and institutions.

The aim of this study was to determine whether breast milk had a stimulating effect on the development of immune responses in infants. Breast- and bottle- fed infants were studied from birth to 9 months of age. Several significant differences in immune responses were found between the groups. These differences were related to age and fell into two main time periods. In the early neonatal period, lymphocytes from breast-fed infants showed significantly greater spontaneous proliferation and proliferative responses to the T cell mitogen PHA to vitro than cells from bottle-fed infants. This may be due to a stimulatory effect to vivo of the growth factors and lymphokines in human milk acting on T cells and/or their precursors. Serum immunoglobulin levels did not however, reflect this increased lymphocyte responsiveness and although salivary IgM and IgA levels were significantly increased in the breast-fed infants at 6 days of age, this may have been due to residual milk immunoglobulins. In contrast, by 3 to 9 months of age, the cells from the bottle-fed group showed significantly greater to vitro proliferation of all classes of lymphocytes than the cells from the breast- fed infants. Salivary IgM and IgA levels and serum IgM antibodies to commensal gut organisms were also significantly higher in bottle-fed infants at this time. This indicated a higher rate of to vivo stimulation of the immune system in bottle-fed infants. It is suggested that this is due to an increased exposure of bottle-fed 'infants to antigenic material at mucosal surfaces and a greater uptake of these local antigens into the systemic circulation. Breast-feeding may therefore have contrasting effects on the development of immune responses, a stimulating effect by growth factors, particularly in the early immature period, and a suppressive effect resulting indirectly from exclusion of antigens (including those of a potentially harmful nature).

Thesis (M.S.)--University of Michigan, 1980.

Thesis (M.S.)--University of Michigan, 1990.

Thesis (M.S.)--University of Michigan, 1980.