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Thesis (MPH) --University of Limpopo, 2011 / The aim of the study was to assess breastfeeding practices of healthcare providers at level one hospitals in Capricorn District of Limpopo province. Methods: Five level one district hospitals within the Capricorn district of Limpopo province were the study sites. Two focus groups with members ranging from three to nine members were conducted. Two managers per hospital were interviewed. In both focus groups and in-depth interviews an audio tape recorder was used. This was transcribed and from the first transcription categories were developed. These formed a basis for data analysis, although the categories had undergone transformation as the analysis unfolded. Results: The study found that there are three practices that are adopted with regard to breastfeeding practices. Most employees choose to breastfeed as the first choice in baby feeding. Majority succeeded in breastfeeding their babies for sometime. There are those who feed their babies’ breast milk as the only source of milk during infancy. Others practice mixed feeding, where the baby is given breast milk and supplemented by formula. However, others fed their babies formula only. They indicate that this was not the initial choice in baby feeding. Conclusion: Healthcare providers have the same needs as the rest of the population with regard to breastfeeding and work. Their challenges are more work-related; which affect their decision whether to breastfeed or not to.

Research has indicated that adolescents hold both negative and positive attitudes and have common misconceptions about breastfeeding that appear to result from their limited knowledge and reduced exposure to breastfeeding. The purpose of this study was to determine the knowledge and attitudes toward breastfeeding of adolescent male and female secondary school students. The study also sought to elicit information on factors that may influence the decision regarding future infant feeding methods. Self-efficacy theory was the theoretical framework to guide the study. This quantitative descriptive study, using a cross-sectional design, involved consenting secondary school students' completing a self-report questionnaire. The study employed purposive sampling and included 1845 males and females in both year-nine and year-12 at designated metropolitan and rural secondary schools in 2001. Analyses of the data were performed using the Statistical Package for Social Science (version 10.7). Statistical procedures involved chi-square analysis, Student's independent t-test and univariate analysis of variance. Spearman's rank order correlation coefficient was used to describe the relationship between the secondary school student respondents' knowledge of and their attitudes toward breastfeeding. The study results indicate that overall Western Australian adolescent secondary school students have less than ideal knowledge of breastfeeding which is consistent with findings from other studies. Higher breastfeeding knowledge scores were reported in year-12 for both male and female students. For both year groups, female students had higher breastfeeding knowledge scores than male students. With regards to attitudes toward breastfeeding, students had a tendency for neutral responses to attitude questions. / However, overall and for both year groups, female students were found to be more positive towards breastfeeding than male students. The comparison of rural to metropolitan students found that metropolitan students had higher breastfeeding knowledge and were more positive towards breastfeeding than rural students. The metropolitan students were also more inclined to consider breastfeeding future children than rural students. Consideration of breastfeeding future children was similar for both male and female students. Comparison of the combination of gender, year and site revealed higher breastfeeding knowledge and more positive attitudes to breastfeeding in both rural and metropolitan female year-12 respondents. Sources of efficacy information, particularly persuasion/education, were more prominent in female secondary school respondents than male secondary school respondents when considering factors influencing adolescent attitudes toward breastfeeding. The adolescent's acceptance of gender identity could be argued as a reason for the more positive breastfeeding attitudes in female respondents. Students who were breastfed or exposed to breastfeeding either through role models (ie mothers), reading about breastfeeding, media or family influence had greater knowledge and were more positive towards breastfeeding. This study suggests that breastfeeding and lactation information needs to be addressed in the early years of development in order to increase breastfeeding knowledge and promote positive attitudes. Information pertinent to the health benefits of breastfeeding needs to be included in health and nutrition education and addressed through targeted education programs. / Education and health promotion activities could be guided using the four sources of efficacy information in relation to the benefits of breastfeeding. Opportunities for the role modelling of positive breastfeeding attitudes, and consistent support from the school-based health professionals may assist to reduce the adolescent student's unmet informational needs in relation to breastfeeding. A recommendation from this study is the provision of lactation and breastfeeding education for community-based high school nurses as these health professionals are a key element in health education and health promotion in the school setting.

[Abstract]: Only a minority of Australian women continue to breastfeed for what is known to be the optimal duration for the health of the mother and her baby. This mixed method study of the determinants of breastfeeding duration is situated within the post-positivist paradigm, and uses both qualitative and quantitative data in a triangulated study design. The study aimed to identify the psychological factors which influence the duration of breastfeeding, in the hope that modifiable factors would arise which may assist women to meet their longer term breastfeeding goals. This two-phase study was conducted in Toowoomba, Queensland and began with a qualitative enquiry involving three groups of mothers separated according to their various experiences of breastfeeding, and one group of experienced breastfeeding clinicians (n = 21). Using the nominal group technique, these women were asked to generate a list of the psychological factors they believed influenced the duration of breastfeeding. Group results were considered individually and collectively, and comparisons between groups were made. The groups generated a list of 53 psychological factors they believed may have an influence on the duration of breastfeeding. In Phase 2, these data and the extant literature were used to inform the content of a questionnaire constructed to measure the relevant individual psychological characteristics of a sample of postnatal women, and the relationship between these factors and breastfeeding duration to 6 months postpartum. Participants for Phase 2 were recruited from one public and one private hospital in the regional city of Toowoomba, Queensland (n = 372), and completed a self-report questionnaire during the 14 days following the birth. Telephone interviews at 6 months postpartum gathered data regarding the woman’s current feeding method and time of weaning. The duration of breastfeeding was associated with psychological factors including dispositional optimism, breastfeeding self-efficacy, faith in breastmilk, breastfeeding expectations, anxiety, planned duration of breastfeeding and the time of the infant feeding decision. After removing the effect of socio-demographic variables, the woman’s faith in breastmilk and her planned breastfeeding duration were unique predictors of the duration of Fully breastfeeding. Analysis of the data for the duration of Any breastfeeding revealed three unique predictors including faith in breastmilk, planned breastfeeding duration and breastfeeding self-efficacy. The data also showed that 44% of the sample experienced some form of postnatal distress in the 14 days following the birth in the form of anxiety, stress and/or depression. Of these three distinct states, only anxiety was associated with breastfeeding duration. This enhanced knowledge of the psychological variables which influence breastfeeding duration may be used to construct a tool capable of identifying women at risk of early weaning for additional support or interventions. Additionally, this knowledge may form the basis of an intervention designed to modify psychological variables known to place breastfeeding at risk, thereby assisting women to breastfeed for longer.

Sammanfattning Den blivande mamman möter många olika enheter i vårdkedjan och var och en av dessa enheter spelar stor roll för amningen. All vårdpersonal som på ett eller annat sätt arbetar med amning ska ha kunskap om WHO:s " Tio steg till lyckad amning" och arbeta efter denna amningsstrategi för att skapa gynnsamma förutsättningar för att kunna hjälpa, stödja och uppmuntra mamman vid amningen. Syfte: Att undersöka vårdpersonals inställning till amningsstödet de ger. Design/Metod: För att genomföra studien valdes en kvantitativ, deskriptiv och jämförande design som genomfördes i form av en tvärsnittsstudie. Mätningen utfördes med hjälp av webbenkäter innehållande frågor med fokus på inställningar till det amningsstöd man ger. De faktorer som mättes var faciliterande, engagerande, följsam och amningsvänlig. Sammanlagt var det 81 personal som svarade på enkäten. Resultat: Resultatet visade att det fanns en signifikant skillnad mellan de respondenter som genomgått extra amningsutbildning utöver sin yrkesutbildning och de som inte hade gjort det. Dessa respondenter hade högre poäng på det faciliterande förhållningssättet. Det fanns också en skillnad mellan Barnkliniken och Kvinnokliniken hur de skattades sig själva på det faciliterande och engagerande förhållningssättet, på så vis att Kvinnoklinikens personal skattade sig högre på det faciliterande och Barnkliniken på det engagerande. Slutsats: Studien visade att vårdpersonals inställning till amning varierade beroende på om man hade extra amningsutbildning eller inte. Det förfaller som att amningsutbildning kan påverka vårdpersonalens amningsstöd till att bli mer evidensbaserat. Nyckelord: Amning, amningsstöd, vårdpersonal, inställningar. / Abstract The expecting mother is exposed to a variety of different units within the healthcare system and each one of them plays a major role in breastfeeding support. All healthcare professionals who are involved in breastfeeding support should have knowledge of WHO’s "Ten steps to successful breastfeeding" and work in accordance with this strategy to create favorable conditions to be able to help, support and encourage the mother during breastfeeding. Aim: To examine healthcare professional’s attitude toward the breastfeeding support they provide. Method: To conduct the study, a quantitative, descriptive and comparative design was chosen in the form of a cross- sectional study. The measuring was conducted using online questionnaires containing questions with focus on the attitudes toward the breastfeeding support one provides. The factors that were measured were facilitative, engaging, responsive and breastfeeding friendly. Overall, 81 staff completed the questionnaire. Results: The result showed that there was a significant difference between the respondents who had participated in additional breastfeeding training in addition to their professional training and the ones who had not. Respondents with additional breastfeeding training had higher scores on the facilitative approach. These was also a difference between the Children’s Clinic and the Women’s Clinic on how they scored their own facilitative and engaging approach, the staff at the Women’s Clinic scored themselves higher in facilitative and the Children’s Clinic in the engaging approach. Conclusion: The study showed that healthcare professional’s attitude toward breastfeeding varied depending on if they had additional breastfeeding training or not. It appears that breastfeeding training can affect healthcare professional’s breastfeeding support to become more evidence-based. Keywords: Breastfeeding, breastfeeding support, healthcare personal, attitudes

Background: Health Canada recommends exclusive breastfeeding for the first 6 months postpartum with continued breastfeeding up to 2 years and beyond. While 88% of Canadian mothers initiate breastfeeding, only 70% of mothers continue to do so at 4 weeks postpartum and only 14% are exclusively breastfeeding at 6 months. Breastfeeding self-efficacy is a potentially modifiable variable that has been associated with mothers’ breastfeeding practices. The Breastfeeding Self-Efficacy Scale (Short-Form) is an instrument that could potentially identify women with low breastfeeding self-efficacy during the in hospital period. Purpose: To describe the breastfeeding practices of new mothers in the Kingston, Frontenac and Lennox & Addington area and to assess the association between in-hospital scores on the Breastfeeding Self-Efficacy Scale (Short-Form) and duration of breastfeeding. Methods: This study was a secondary analysis of a dataset from the 2008 Infant Feeding Survey, a prospective study of 463 mothers with 12-month longitudinal follow-up. Data were weighted according to the maternal age distribution of the general population of new mothers. Breastfeeding practices were described using Kaplan-Meier survival distributions. Four outcomes were described: ‘exclusive breastfeeding from birth’, ‘exclusive breastfeeding from discharge’, ‘high breastfeeding’, and ‘any breastfeeding’. Using logistic regression, scores from the Breastfeeding Self-Efficacy Scale (Short-Form) were assessed for association with duration of ‘exclusive breastfeeding from birth’ and duration of ‘any breastfeeding’ (dichotomized as ‘less than 6 weeks’ and ‘6 weeks or beyond’). Results: The sample was highly educated (75% had post-secondary education) and reported high levels of household income (37% reported >$80,000/year). Six percent of mothers exclusively breastfed to 6 months. Close to one quarter (24%) of women sustained some extent of breastfeeding for 12 months. The relationship between scores on the Breastfeeding Self-Efficacy Scale (Short-Form) and duration of ‘exclusive breastfeeding from birth’ and the relationship between self-efficacy scores and duration of ‘any breastfeeding’ were identical (OR = 1.05) and non-significant (95% CI 1.0-1.1). Conclusion: This study did not show a significant relationship between in-hospital scores on the Breastfeeding Self-Efficacy Scale (Short-Form) and duration of breastfeeding. Given the high socioeconomic status of women in this study, further studies are warranted to confirm these results. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2011-12-06 14:46:41.103

Demographic Characteristics And Breastfeeding Confidence Of Mothers Who Choose To Exclusively Breastfeed And Combination Feed Their Infants Subjects were recruited from physicians' offices and public clinics in a metropolitan area (n=71). Fifteen (21%) of the subjects were planning to combination feed while 56 (79%) were planning to exclusively breastfeed. Subjects completed the Maternal Confidence Survey (O'Campo et al, 1992) and provided demographic information. A higher proportion of women planning to exclusively breastfeed were married (p=0.003), Caucasian (p=0.005), and educated beyond the high school level (p=0.04). Subjects in the exclusively breastfeeding group were significantly older (mean age = 26.7) than those in the combination feeding group (mean age = 22.8) (p=0.009). Confidence scores were significantly higher (mean score = 4.7) among women planning to exclusively breastfeed compared to women planning to combination feed (mean score = 4.3) (p=0.04). Results of this study suggest women who intend to combination feed are distinctly different from those who intend to exclusively breastfeed. Women planning to combination feed may benefit from prenatal intervention to enhance breastfeeding confidence. / Department of Family and Consumer Sciences

The national health promotion goals for increasing breastfeeding initiation rates to at least 75% of all mothers and six month breastfeeding continuation rates of at least 50% by the year 2000 do not seem to be obtainable. These goals require new insight into what motivates a new mother to continue to breastfeed. This study identified perceived social support and interpersonal dependency as potential factors associated to lactation duration, based upon the previous breastfeeding experience of the mother. Inexperienced breastfeeding mothers perceived more total support, task support and informational support than mothers with previous breastfeeding experience. This study did not correlate the amount of perceived support to lactation duration. An ancillary finding was that women providing a combination of breast milk and artificial baby milk feeds had a significantly higher lack of social self-confidence than mothers providing breastmilk exclusively. / Department of Family and Consumer Sciences

Amningsförekomsten har minskat i Sverige de senaste åren. Studier har visat att amning ger flera hälsovinster hos barn och mammor samt att mammornas tillit till sin förmåga att amma har betydelse för amningsutfallet.   Syfte: Att undersöka mammors tillit till sin förmåga att amma samt att se om mammornas tillit påverkade amningsutfallet när barnet var fyra månader, efter att mammorna genomgått Sensus förberedande amningskurs under graviditeten.   Design/ Metod: En kvantitativ, experimentell och prospektiv design valdes för att genomföra studien. En interventionsstudie utformades med en före-efter design. Interventionen utgjordes av totalt fyra kurstillfällen. Enkäten Breastfeeding Self-Efficacy Scale Short Form (BSES-SF) användes för att mäta kvinnornas tillit till amning och fylldes i av kvinnorna vid tre tillfällen, den sista när barnet var fyra månader gammalt. När barnet var fyra månader svarade kvinnorna även på en enkät om barnets mat och sömn.   Resultat: Sensus amningskurs höjde kvinnornas medelvärde på BSES-SF, från 42,92 innan utbildningen, till 55,82 efter utbildningen (p<0,001). Mammornas tillit till sin förmåga att amma kvarstod när barnet var fyra månader (m=58,10) (p<0,001). Amningsförekomsten bland kvinnorna i studien var hög procentuellt sett jämfört med hur kvinnor ammar i Sverige.   Slutsats: Studien visade att förberedande amningskurs under graviditeten höjde mammornas (förstföderskor/omföderskor) tillit till sin förmåga att amma, samt ledde till hög amningsförekomst när barnet var fyra månader. Dessutom visade studien att de kvinnor som ammade i någon omfattning skattade tilliten till sin förmåga att amma högre än de kvinnor som inte ammade alls.  Det stöd som kvinnorna skattade som mest betydelsefullt för sin amning var stödet från hennes partner, därefter kom Sensus amningskurs och efter det Amningshjälpen. / In Sweden, the occurrence of breastfeeding has decreased over recent years. Research has shown that breastfeeding is beneficial health wise for both the child and the mother. It has also shown that the mothers’ self-efficacy in their ability to breastfeed is relevant in regards to the actual act of breastfeeding.   Aim: To investigate mothers’ confidence in their ability to breastfeed and if this confidence effected the frequency in which mothers breastfed once the child had reached four months of age after the mothers had undergone the Sensus breastfeeding program during pregnancy.   Design/ Method: A quantitative, experimental and prospective design was chosen to carry out this study. An intervention study was created which consisted of a pre and post design. This intervention was utilized on a total of four occasions. The questionnaire Breastfeeding Self-Efficacy Scale Short Form (BSES-SF) was used to measure the women’s confidence in their ability to breastfeed. This questionnaire was filled in three times by the women, the last time being when the child was four months old. During this final occasion they also filled in another questionnaire concerning the child’s feeding and sleeping habits.   Results: The Sensus breastfeeding program raised the women’s mean in BSES-SF, from     42, 92 before the program to 55, 82 after the program (p<0,001). The women’s confidence in their ability to breastfeed remained the same when the child was four month’s old (m=58, 10) (p<0,001). The frequency of breastfeeding among the women in the study, percentage wise, was high in comparison to the overall population of Swedish women who breastfeed.   Conclusion: This study presented that breastfeeding programs during pregnancy can increase women’s confidence in their ability to breastfeed. It can also have a positive effect on the frequency of breastfeeding. This study also showed that mothers who breastfed to some extent had better confidence in their ability to breastfeed, compared with the mothers who didn’t breastfeed at all. Furthermore, the support that the mothers claimed as being most important in regards to breastfeeding was firstly the support received from her partner, then secondly the Sensus studieförbund and finally Amningshjälpen. / Sensus Amningskurs

Typescript. Includes vita and abstract. Includes bibliographical references (leaves 163-169). Also available online in Scholars' Bank; and in ProQuest, free to University of Oregon users.