Background: Breastfeeding is a tremendously important public health topic. Breastfeeding is associated with a myriad of health benefits on nearly all levels within the social ecological model (infants, mothers, families, workplaces, communities and societies). Scientific evidence supports that breastfeeding is associated with decreased obesity and other very costly health conditions that occur across the lifespan. The World Health Organization published 10 guidelines that comprise the Baby Friendly Hospital Initiative [BFHI] standards—which identify birthing facility-level elements that are associated with enhanced breastfeeding adoption rates. Methods: The purpose of this study was to determine the extent to which birthing facilities in Atlanta incorporate BFHI elements. Lactation policies among hospitals in the City of Atlanta with maternity wards were solicited, reviewed, and rated by two independent reviewers. Additional observations about environmental supports for breastfeeding were also noted. Results: Four out of 5 eligible hospitals provided their lactation policies for review (80%). Eight of out 10 BFHI elements were present in the 4 hospital policies. One element not present was distribution of reinforcing/educational materials to new mothers—although it was evident in an appendix. Another element that was not clearly stated in one policy was which states that breastfeeding initiation should occur within the first half hour after birth. Observations by reviewers included that ¾ (75%) of study sample were in the midst of drafting new policies. Another note was that ¾ (75%) of study sample was supported by a Centers for Disease Control and Prevention (CDC)/National Initiative for Children’s Healthcare Quality (NICHQ) effort—Best Fed Beginnings. Conclusions: This study is important as it addresses an unexplored question. Establishing such a baseline reveals that while nearly all the BFHI elements are present within the participating City of Atlanta hospitals, the administrative barriers that pursuit of BFHI accreditation poses should be considered. Given the fact that no hospital in Georgia has BFHI accreditation underscores an important new direction for public health researchers’ attention.

Attitudes and confidence among women can predict the duration of exclusive breastfeeding. The longer duration of breastfeeding, the more advantages there are for both mother and child. Aim: The aim of this study was to explore how the attitudes and the confidence were among Thai mothers and if there was a difference between nuclear families and extended families in these issues. Method: A descriptive comparative cross-sectional study with a quantitative method was performed by using IIFAS (Iowa Infant Feeding Attitude Scale) and BSES (Breastfeeding Self-Efficacy Scale) as measurement tools. Orem´s self-care theory was used as a theoretical framework with 79 voluntary participating women at a well-baby clinic in Bang Pa-In, Ayudhaya, Thailand. Result: The outcome of the study demonstrated that the majority of the women had a neutral attitude towards breastfeeding, 13% had a positive attitude towards formula feeding and 7% had a positive attitude towards breastfeeding. No significance was found between mothers living with nuclear and extended family regarding the attitude. The majority rated high confidence in breastfeeding. Mothers who were living in nuclear families rated lower than mothers living in extended families in “refrain from bottle-feeding for the first 4 weeks” regarding confidence in breastfeeding. Conclusion: The attitude to and the confidence in breastfeeding were relatively good among Thai mothers in Bang Pa-In, Ayudhaya, however improvements are needed. The findings of this study could be useful for Swedish and Thai nurses in their information about breastfeeding to women. Further studies are needed to follow the attitudes and confidence along with the economic development for the improvement of the exclusive breastfeeding rates.

Syftet med studien var att beskriva och jämföra kvinnornas upplevelse och erfarenhet av amningsrådgivning och amningsstöd genom vårdkedjan relaterat till paritet, det vill säga omföderskor och förstföderskor. Studien genomfördes som en retrospektiv tvärsnittsstudie med en kvantitativ ansats. I studien ingick 250 kvinnor varav 103 var förstföderskor och 147 var omföderskor. Studien utfördes med hjälp av enkäter som skickades kvinnorna när barnen var 9 månader gamla. Efter utskick en vecka senare intervjuades kvinnorna per telefon. Materialet till studien var en del ur en större datainsamling. På flertalet frågor kunde ett tydligt samband utläsas mellan dem som var omföderskor eller förstföderskor. Kvinnorna erhöll amningsrådgivning i olika hög grad på de olika instanserna. Främst var det förstföderskorna som fick råd. Amningsråd gavs i störst utsträckning på BB. På MVC och BVC var det lite mer än en tredjedel som erhöll amningsrådgivning och många tillfrågades bara om de skulle amma. Överlag var kvinnorna nöjda med amningsstödet de erhöll. Dock varierade det lite på instanserna och det fanns större grupper av missnöjda kvinnor. Det samma gällde nöjdheten med amningsrådgivningen som påverkades av att det fanns en stor grupp som inte fått rådgivning eller inte ansåg att de kunde uttala sig, främst omföderskor. Inget signifikant samband kunde påvisas mellan paritet och stödet kvinnorna fått, förutom på BB där förstföderskorna var en aning nöjdare. Dock var kvinnans partner det viktigaste stödet. Majoriteten ansåg att amningsrådgivningen hade varit enhetlig genom vårdkedjan förutom på BB. Främst förstföderskor var missnöjda, dock har fler omföderskor angett att de inte kan uttala sig angående enhetligheten varken igenom hela vårdkedjan eller på BB.

Head circumference and leg length are two important markers for disease outcomes in later life. It has been reported that head circumference values in childhood may be closely related to the brain development and future intellectual functioning. Short leg length in childhood is suggested to have association with an increasing risk of coronary heart disease, diabetes and cancer. Given the potential childhood length and adult disease linkage, it is important to identify the determinants of childhood head circumference and leg length. Breastfeeding is suggested to be a potential postnatal factor that affects head circumference and leg length. However, some studies examining impacts of breastfeeding on leg length and head circumference in childhood reported inconsistent or null findings, indicating that the association between breastfeeding, head circumference and leg length remains controversial. Here we reviewed several studies that investigated the relationship between breastfeeding, head circumference and leg length, and in some but not all studies there was controlling for the effects of other potential early life influences, including parental height, prenatal factors and other postnatal factors on head circumference and leg length. Collectively, the illustrations on these relationships would be useful in investigating the leg length/head circumferencelater disease outcomes associations. / text

Background Breastfeeding is beneficial to infant and child health, woman health and society. Breastfeeding is promoted by various strategies in Hong Kong. Although the breastfeeding initiation rate is increasing, the exclusive breastfeeding rate at 4-6 months remains low in Hong Kong. The current policy and interventions are not effective on promoting breastfeeding and addressing the needs of mothers. Aims This systematic review aimed to identify effective interventions to promote breastfeeding initiation, duration and exclusivity and their implications to future change of guidelines or policies in breastfeeding promotion. Method Studies were searched through PubMed, EMBASE, Web of Science and Cochrane Central Register of Controlled Trials up to 13thMay, 2013. Grey literature was searched. English publications with full text, experimental or quasi-experimental design, using World Health Organization definitions of breastfeeding classification, targeting to healthy mothers and infants were selected. Quality assessment was done using Consolidated Standards of Reporting Trials and Quality Assessment Tool for Quantitative Studies by Effective Public Health Practice Project. Result Twenty studies were included in this review. The Baby Friendly Hospital Initiative was found to be the most effective strategy to promote breastfeeding duration and exclusivity. Home visit by peer counselor, a face-to-face intervention, was another effective strategy to increase initiation, duration and exclusivity of breastfeeding. The sole use of educational materials was not effective, but professional breastfeeding support combined with use of educational materials was shown to be effective on lengthening the duration of exclusive and predominant breastfeeding. The evidence of antenatal education programme was not convincing. The inclusion of father with breastfeeding promotion intervention was attempted but the evidence is less strong. The exclusion of infant formula advertisement in the educational package to mothers was effective on increasing breastfeeding rate only before hospital discharge. Findings on professional support interventions were inconsistent. Conclusion The Baby Friendly Hospital Initiative and home visit peer support are effective on promoting breastfeeding duration and exclusivity. Evidence for other strategies was limited due to low methodological quality and/or inconsistent findings. Future research should be conducted to investigate and identify suitable strategies that are applicable to local setting. / published_or_final_version / Public Health / Master / Master of Public Health

Objective: The aim of this study was to investigate the differential effects of breastfeeding practice and having an intention to breastfeed (during pregnancy) on a mother’s maternal responsiveness to her infant after birth. Methods: Using longitudinal data from a subsample of 962 mother-infant dyads from a UK cohort study (Avon Longitudinal Study of Parents and Children), we investigated the influence of intention to breastfeed at 3 months pregnancy and breastfeeding practice and on mother-infant interactions at 12 months after birth. Breastfeeding intent and practice were assessed by questionnaires administered to the mothers. Intention to breastfeed in the first 3 months postpartum was measured at 32 weeks into the pregnancy, while breastfeeding practice (over first 12 months postpartum) was measured retrospectively at 15 months post partum. Results: Using logistic regression analyses, we found that intending to breastfeed at 32 weeks gestation significantly predicted maternal responsiveness, namely that an intention to breastfeed increased the odds of positive maternal responsiveness, independently of breastfeeding practice. However, we found the practice of breastfeeding was not an independent predictor of positive maternal responsiveness once intention to breastfeed was accounted for. Using a life course epidemiology approach we further demonstrated that maternal responsiveness is most positive when both the intention to breastfeed and breastfeeding practice are present. Conclusions: To our knowledge this is the first study to report that having the intention to breastfeed an infant is more strongly associated with positive maternal responsiveness than the act of breastfeeding itself. This may suggest that more responsive mothers choose to breastfeed rather than breastfeeding practice directly causing enhanced responsiveness. Further research will be needed to understand the nature of this intention and its relationships with maternal responsiveness. However, the results may also highlight the potential importance of parenting intentions/ preparations during pregnancy for a mothers developing abilities to be responsive to her infant after birth.

No description available.

In the UK, only 1% of babies are exclusively breastfed to six months: this is one of the lowest breastfeeding rates in the developed world. In response, trials have been set up to financially incentivize mothers to breastfeed for longer. However, we also know that 80% of women who stop breastfeeding in the first 1-2 weeks wanted to continue for longer: they are already incentivized to keep going. This project asks: what if health services invested in promoting breastfeeding more at the start, giving mothers the knowledge, support, and tools they need to continue, instead of incentivizing women at the end? The research methodology started with academic, expert and user research both qualitatively and quantitatively to gain insight and establish the design opportunity. The design direction was developed iteratively with sketches and prototypes, and continued user testing to reach the design solution.   The result of the project is a new service called best start, which addresses the issues mothers face throughout breastfeeding. The service helps to prepare and educate mothers during pregnancy, assists them through the crucial first weeks of breastfeeding, and supports them to the six-month milestone and beyond. Emphasis is placed on involving and educating the mother’s immediate family support network, and building her local peer support. The best start kit gives every mother the essentials to get started, and provides tangible tools to explain the key educational concepts to boost her knowledge to continue breastfeeding confidently.

The purpose of this study was to determine if teaching low income prenatal women about infant feeding cues instead or in addition to the standard WIC education about the benefits of breastfeeding would serve to increase breastfeeding duration. One hundred ninety seven prenatal women who qualified for the federal Women Infants and Children Special Supplemental Feeding Program were divided into an experimental (E, n=51) or a control (C, n=139) group. The C group was given the WIC standard education of the benefits of breastfeeding by a nutritionist or nurse (CPA), the E group was given information about hunger cues that an infant exhibits by a lactation consultant during their WIC nutrition appointments. Data were analyzed by means of survival analyses, Kaplan Meier and Cox Regression. Data for 52 weeks indicate no statistically significant difference between the groups (chi square= 1.548, df=l, p=0.213). However data for 26 weeks indicated a stronger probability of continuing breastfeeding. Breastfeeding duration for C and E groups was 14.3±17.4 weeks and 18.5±17.1 weeks respectively (chi square=2.907,df=l,p=0.088), representing a 28% better duration. Findings suggest that prenatal women need information about infant behavior to help determine if they are adequately feeding their babies in order to maintain breastfeeding for longer duration. / Department of Family and Consumer Sciences

Breastfeeding is encouraged exclusively until the infant is 6 months and then continuing up until the age of two years and further, as a supplement to solid food. Few infants get this opportunity even though positive effects have been seen. In recent days brain imaging techniques has begun to study the differences in brain development between breastfed and formula fed infants. In this essay methods for assessing the cognitive and neurodevelopmental aspect of breastfeeding aspects will be reviewed. The results found in this review suggest that breastfeeding has a benefit in the development of the brain and in addition a beneficial impact on the parents. This can be seen in faster development of crucial brain areas, better cognitive functions and better maternal sensitivity which in turn relates to a child’s better adjustment. However, it is not clear how these benefits develop, if it is due to breastfeeding or parental characteristics related to breastfeeding.