Introdução-O aleitamento materno promove vantagens para a criança, mulher e sociedade. Entretanto as taxas de amamentação, principalmente o aleitamento materno exclusivo estão abaixo dos níveis desejados em diversos países. A identificação dos determinantes da interrupção precoce e a quantificação da interação destes fatores é crucial para estabelecer, avaliar e promover políticas públicas em prol das práticas de amamentação. Objetivo-Estimar os efeitos dos fatores associados à prevalência do aleitamento materno exclusivo, predominante e continuado no primeiro e segundo anos de vida em países da América Latina e Caribe no período de 2000 a 2016. Métodos-Foram utilizados microdados coletados no projeto Monitoring and Evaluation to Assess and Use Results Demographic and Health Survey. Para complementar as informações foram recolhidos dados agregados do World Bank. Os indicadores analisados foram aleitamento materno exclusivo (AME), aleitamento materno predominante (AMP) e aleitamento materno continuado (AMC) no primeiro e segundo anos de vida; os valores foram expressos em prevalência e estratificados por quintos de riqueza. Selecionou-se o último inquérito disponível de cada país da América Latina e Caribe com dados entre os anos de 2000 e 2016. As variáveis foram selecionadas segundo disponibilidade e enquadramento no modelo conceitual proposto por ROLLINS et al. (2016). O modelo utilizado no estudo foi elegido após análise com Regressão de Poisson e, posteriormente, foi realizada análise logística multinível de efeitos mistos para quantificar o efeito de cada determinante do efeito fixo ajustado pelo efeito randômico. Resultados-A variação das prevalências dos indicadores foi de 7,4% a 60,3% no AME, 13,9% a 71% no AMP, 35,0% a 86,6%no AMC no primeiro ano e 18,9% a 55,0% no AMC no segundo ano de vida. Bolívia e Guatemala se destacam por apresentar as maiores taxas de AME, 60,3% e 54,2%, respectivamente. Os países apresentaram maior prevalência dos indicadores nos quintos inferiores de renda, destacando-se as associações do padrão de aumento da magnitude do efeito negativo à medida que o quinto de renda aumenta. O AME e AMP se associaram diretamente à \"amamentação na primeira hora\", \"estado conjugal\" e \"queria o último filho; \"idade materna\" e \"status de trabalho\" se associaram inversamente aos indicadores AMC no 1º e 2º anos de vida. Na análise de efeitos mistos, os indicadores AME e AMP se associaram diretamente a \"amamentação na primeira hora\" e \"estado conjugal\" e inversamente às variáveis \"local do parto\" e \"status de trabalho\". A escolaridade materna apresentou associação inversa com os indicadores AMP, AMC no 1º e 2º anos de vida e o quinto de riqueza apresentou associação inversa com todos os indicadores estudados. O AME apresenta maior variância explicada pelo nível individual, enquanto o AMC no 2º ano de vida sofre grande influência pelo nível contextual (8,99e-15% e 69,7%, respectivamente). Conclusão-As variáveis relacionadas ao indivíduo foram as que melhor explicaram a variância do modelo para o AME, AMP e AMC no 1º ano de vida. As variáveis relacionadas ao contexto explicam maior variabilidade da prevalência do AMC no 2º ano de vida, exibindo a maior interferência do PIB e de influências de âmbito nacional. / Introduction-Breastfeeding promotes benefits for the child, woman and society. However, breastfeeding rates, especially exclusive breastfeeding, are below desired levels in many countries. The identification of the determinants of the interruption precociated and the quantification of interaction factors are crucial to establish, evaluate and promote public policies in breastfeeding practices. Objective-Estimate the effects of factors associated with the prevalence of exclusive, predominant and continued breastfeeding in the first and second years of life in Latin American and Caribbean countries from 2000 to 2016.Methods- We used microdata collected in the project Monitoring and Evaluation to Assess and Use Results Demographic and Health Survey. In addition to the information, aggregated World Bank data was collected. The indicators analyzed were exclusive breastfeeding (EB), predominant breastfeeding (PB) and continuous breastfeeding (CB) in the first and second years of life; the values were expressed in prevalence and stratified by quintiles of wealth. The last available survey of each Latin American and Caribbean country with data between the years 2000 and 2016 was selected. The variables were selected according to availability and framing in the conceptual model proposed by ROLLINS et. al. (2016). The model used in the study was chosen after analysis with Poisson Regression and later, multi-level mixed-effects logistic analysis was performed to quantify the effect of each determinant of the fixed effect adjusted by the random effect. Results- The prevalence of indicators ranged from 7.4% to 60.3% EB, 13.9% to 71% in PB, 35.0% to 86.6% in CB in the first year, and 18.9% to 55.0% in CB in the second year of life. Bolivia and Guatemala stand out for having the highest rates of EB, 60.3% and 54.2%, respectively. The countries presented a higher prevalence of indicators in the lower quintiles of income, especially the associations of the pattern of increase of the magnitude of the negative effect as the fifth of income increases. EB and PB were directly associated with \"first-time breastfeeding\", \"marital status\" and \"wanted the last child; \"maternal age\" and \"work status\" were inversely associated with the CB indicators in the 1st and 2nd years of life. In the mixed effects analysis, the EB and PB indicators were directly associated with \"first-hour breastfeeding\" and \"marital status\" and inversely to the variables \"place of birth\" and \"work status\".The maternal schooling presented an inverse association with the PB, CB indicators in the 1st and 2nd years of life, and the fifth of the wealth had an inverse association with all the indicators studied. The EB shows greater variance explained by the individual level, while the CB in the second year of life suffers great influence at the contextual level (8.99e-15% and 69.7%, respectively). Conclusion- The variables related to the individual were the ones that best explained the variance of the model for EB, PB and CB in the 1st year of life. The variables related to the context explain a greater variability of the prevalence of CB in the second year of life, showing the greater interference of GDP and national influences.

Syfte: Att kartlägga mammors erfarenheter av amningsstöd på BB.Metod och Material: Webbaserad tvärsnittsstudie med kvantitativ ansats. Inklusionskriterier; mammor som fått barn och vårdats på en specifik BB-avdelning i Mellansverige under åren 2019–2021 samt valt att amma. Enkäten bestod av 60 slutna frågor och 5 fritextfrågor. Redovisas med deskriptiv statistik samt kvantifiering av fritextsvaren. Resultat: Baserades på n=146 mammor. Både positiva och negativa erfarenheter beskrevs av mammorna. En majoritet av deltagarna önskade högre närvaro av barnmorskan och mer stöd i samband med amning. Det rapporterades erfarenheter av att ha blivit lämnade ensamma med barnet större delen av vårdtiden och fann det bästa stödet i partnern. Få beskrev dock att partnern involverades i amningsstödet. Olika råd gavs av personalen vilket skapade en känsla av otrygghet och tvivel till personalens kompetens. Många beskrev att hands-on metod användes i samband med amningsstöd. Upprättande av amningsplan saknades för majoriteten och bristfällig information om amningssignaler gavs. Slutsatser: Många mammor var missnöjda med amningsstödet och kände en otrygghetmed amningen vid hemgång. Det önskades mer stöd och bekräftelse i samband med amning. Möjligtvis kan det initiala bristande stödet ha påverkat mammornas fortsatta amning och lett till ett tidigare amningsavslut. / Purpose: To map mothers' experiences of breastfeeding support at BB.Method and Material: Web-based cross-sectional study with quantitative approach. Inclusion criteria: mothers that had children and been cared for in a specific BB ward in Central Sweden during the years 2019–2021 and have chosen to breastfeed. The questionnaire consisted of 60 closed questions and 5 free text questions. Reported with descriptive statistics and quantification of the free text answers.Results: Based on n=146 mothers. Both positive and negative experiences were described by the mothers. Most of the participants wanted a higher presence of the midwife and more support with breastfeeding. Experiences of being left alone with the child for most of the care period were reported and found the best support in the partner. Few described that the partner was involved in breastfeeding. Various advice was given by the staff, which created a feeling of insecurity and doubt about the staff's competence. Many described that the hands-on method was used in connection with breastfeeding support. Establishment of a breastfeeding plan was lacking for the majority and inadequate information on breastfeeding signals was provided.Conclusions: Many mothers were dissatisfied with breastfeeding support and felt insecure about breastfeeding at home. More support and confirmation in connection with breastfeeding was desirable. Possibly, the initial lack of support may have affected the mothers' continued breastfeeding and led to an earlier termination of breastfeeding.

Bakgrund: Trots att amning har många fördelar och de flesta mödrar väljer att amma sina barn så sjunker amningsfrekvensen både globalt och i Sverige. Trots WHO ́s rekommendationer så väljer många mödrar att avsluta amningen innan rekommenderad tid. Detta skulle kunna bero på att mödrarna stöter på problem med amningen och inte får den hjälp de behöver för att välja att fortsätta amma. Amningen väljs bort när det finns alternativ som bröstmjölksersättning. BVC-sjuksköterskan har en viktig uppgift då hen blir den första kontakten för mödrarna efter förlossningen. Syfte: Syftet med studien var att belysa mödrars upplevelse av BVC-sjuksköterskans stöd vid amningsproblem. Metod: Studien har en kvalitativ design och datainsamlingen genomfördes via semistrukturerade intervjuer med tio mödrar från olika delar av Sverige. Dataanalysen skedde utifrån en kvalitativ innehållsanalys med en manifest ansats. Resultat: I den dataanalys som gjordes framkom tre huvudkategorier: Önskan om ökat engagemang, Bristande kunskap orsakade minskat förtroende och Uteblivet stöd skapade inre stress.  Konklusion: Studiens resultat har påvisat att BVC-sjuksköterskan spelar en stor roll för mödrar som ammar och har problem med amningen. BVC-sjuksköterskan är den som mödrarna vänder sig till för att få amningsstöd. Det engagemang och intresse som BVC-sjuksköterskan visar har stor betydelse för hur upplevelsen av stödet blir, men även den kunskap om amning som BVC-sjuksköterskan besitter spelar stor roll. Bristande stöd resulterade i att mödrarna tvivlade på sig själva. / Background: Although breastfeeding has many advantages and most mothers choose to breastfeed their children, the breastfeeding rate is declining both globally and in Sweden. Despite the WHO's recommendations, many mothers choose to end breastfeeding earlier. This could be due to the mothers encountering problems with breastfeeding and don’t get the help they need to choose to continue. Breastfeeding is opted out when there are alternatives such as breast milk substitutes. The child-healthcare center (CHC-)nurse has an important task as she becomes the first point of contact for mothers after childbirth. Aim: The aim of the study was to shed light on mothers' experience of the CHC-nurse's support during breastfeeding problems. Method: The study has a qualitative design and the data collection was carried out via semi-structured interviews with ten mothers from different parts of Sweden. The data analysis was based on a qualitative content analysis with a manifest approach. Results: In the data analysis that was carried out, three main categories emerged: The desire for increased commitment, Lack of knowledge caused reduced trust  and Lack of support created internal stress. Conclusion: The results of the study have shown that the CHC-nurse plays a major role for mothers who are breastfeeding and have problems with breastfeeding. The CHC-nurse is the one the mothers turn to for breastfeeding support. The commitment and interest that the CHC-nurse shows is of great importance to how the support is experienced, but also that the knowledge of breastfeeding that the CHC-nurse possesses, is important. The lack of support made the mothers doubt themselves.

This quasi-experimental study, using Orem's Nursing Systems Construct as a theoretical base, was conducted to determine the effects of education and support given by a lactation consultant on early breastfeeding problem incidence and resolution. Mothers were recruited in the hospital and interviewed by telephone two to three weeks postpartum to determine problem incidence, rate of resolution, perception of the problems' interference, self-care measures, and support network characteristics. The study sample consisted of 16 first-time breastfeeding mothers placed in naturally occurring experimental (n = 7) and control (n = 9) groups. The groups did not differ significantly in age, education, ethnicity, mode of birth, or presence of a support person in the home. The groups did not differ significantly in number of problems, problem resolution length, or perceptions regarding problems' severity. A significant difference was found in the use of formula supplements, with the control group using supplementation more than the experimental group.

The purpose of this study was to measure post-weaning feelings i n women planning employment within one year post-partum and to examine the effects of factors related to duration and employment on these feelings. Subjects were recruited from obstetric clinics and prenatal classes throughout Indiana. Fifty-three women were interviewed prenatally and at 6 weeks, 3 months, and 6 months post-partum (or until weaning occurred in those who breastfed less than 6 months). Those women who weaned their infants during the study period were asked to describe their reasons for cessation and to quantify their feelings of sadness/ depression, madness /anger, relief, and guilt using Likert-type scales. The majority of subjects were Caucasian, had attended college, and were 26 years of age or older. No significant relationship existed between duration of lactation and age or education. Thirty-one women had weaned their infants by 6 months, 20 due to mother-led reasons, 9 due to baby-led reasons, and 2 due to other reasons. The most common reasons given for weaning were "baby won't suck" (6) and "returning to work" (6). No significant differences (p>.05) in feelings were found between women who weaned due to mother-related and baby-related reasons or between women who met or did not meet their breastfeeding goals. Women who did not feed their babies as planned when returning to work felt significantly more sadness/depression (p=.03) and guilt (p=.004) compared to those who fed their infants as planned. The results of this study suggest breastfeeding is not only a physiological vehicle for infant nutrition, but also an emotional phenomena. Understanding a woman's emotional response to the weaning process will assist health care professionals in providing perinatal education and support to the breastfeeding woman. / Department of Family and Consumer Sciences

Class of 2009 Abstract / OBJECTIVES: The objectives of this study were 1) to review the University of Arizona College of Pharmacy’s curriculum to assess if courses cover pertinent topics in the use of prescription and over-the-counter (OTC) medications by pregnant and lactating women based on The American Association of Colleges of Pharmacy (AACP) Gender and Sex-Related Health Care Pharmacy Curriculum Guide and 2) to assess pharmacy students’ knowledge and abilities to counsel women during pregnancy and breastfeeding. METHODS: The curriculum review was a retrospective, descriptive analysis to assess how well the required curriculum addressed eight pertinent topics in the use of prescription and OTC medications by pregnant and lactating women. The self-assessment questionnaire was a cross-sectional, descriptive analysis that measured student pharmacists’ comfort level with counseling pregnant and lactating women, their perception of how well pharmacy school has prepared them for this role, and their familiarity with and use of available resources. RESULTS: The College of Pharmacy was not in compliance with AACP’s Pharmacy Curriculum Guide. This was reinforced by the questionnaire, which showed that the majority of students, regardless of year in school, did not feel they had been adequately prepared to counsel or to make recommendations to this population. CONCLUSIONS: It is recommended that the curriculum be amended by adding a lecture on teratogenicity. A list of gender and sex- related topics should be provided as well as a handout with available resources. In addition, case studies in each course should be revised to include critical decision-making, recommendations, and counseling if the patient were pregnant or breastfeeding.

Online social support is reported to be used by a number of people to obtain social interaction and exchange communication as a way to buffer stressful situations. Breastfeeding women experience a significant change in their lives and routine which a number of women find it stressful for various reasons. Research shows that breastfeeding women use the Internet to obtain support, however little is known about how breastfeeding women use online social support and their perceptions, concerns and expectations about using it. An interpretive approach using qualitative methods was adopted in this research to obtain and analyse the data acquired through interviews and observations. The framework proposed by the Social Cognitive theory was used to conduct this research and to provide insights into online social support in a breastfeeding peer support context. The results in this research indicate that in spite of face-to-face interventions being favoured, online social support is perceived as a helpful alternative support with the potential to positively influence breastfeeding self-efficacy. A number of similar characteristics of face-to-face support were found to be present in online social support, such as emotional and informational support, empathy and empowerment. Online social support was perceived as offering additional features to traditional support including convenience of use, connection with peers and supporters at any time of the day, and the opportunity to express emotions and issues textually. Certain concerns were also associated to using online social support to support breastfeeding women, which need to be taken into consideration by providers of online social support. These included the need for training volunteers in this type of media, confidentiality and trustworthiness of the information available online and issues related to digital divide. These findings are useful to further the understanding of the implications of online social support in self-efficacy and the associated outcomes. Policy makers, social scientists and breastfeeding support organisations can use the findings in this research to develop future breastfeeding promotion strategies and interventions. Ultimately, breastfeeding women benefit from the findings of this research, through the implementation of online social support interventions addressing the issues raised in this research. These women will consequently have access to more services and applications, as well as engage with volunteers or clinicians trained to fulfil their needs over an alternative channel.

Estudou-se a prática do aleitamento materno nas mulheres com filhos menores de três anos de idade, na população de Icapara, Município de Iguape, Estado de São Paulo. Procurou-se determinar, entre as famílias selecionadas, a frequência e duração dos tipos de aleitamento do último filho, no primeiro ano de vida. Em seguida, fez-se um estudo comparativo do aleitamento do primeiro e último filhos nas mesmas famílias. Com a finalidade de situar a prática do aleitamento materno num contexto social, caracterizou-se sócio-economicamente a população estudada, privilegiando-se as atividades ocupacionais. A técnica de pesquisa empregada foi o formulário aplicado aos pais. Concluiu-se que no primeiro ano de vida, o aleitamento materno total é frequente e prolongado, enquanto que o aleitamento materno exclusivo é frequente apenas em torno do período neo-natal. O aleitamento artificial apresenta-se com frequências ascendentes, atingindo-se mais da metade das crianças ao final do período. O aleitamento misto aparece com frequências variáveis, cedendo lugar ao aleitamento materno exclusivo em torno do período neo-natal e ao aleitamento artificial na forma exclusiva, no primeiro ano de vida. Verificou-se que as frequências de aleitamento materno são, em geral, mais baixas nos último filho do que nos primogênitos. / The breast-feeding practice among women with children under 3 years of age in the population of Vila de Icapara, Iguape County, State of São Paulo, was studied. The author tried to determine the rate of occurrence and duration of different types of feeding offered to the last child of the selected families, in his first year of life. A comparative study between the feeding of the first and the last child in the same family was also carried out. In order to situate the breast-feeding practice within a social context, the chosen population was social and economically studied taking into consideration especially occupational activities. A questionnaire was applied as the researdh technique. The author concluded that, total breast-feeding is frequent and prolonged in the child\'s first year of life, while the exclusive breast-feeding is frequent only during the neo-natal period. The bottle-feeding presents a increasing occurence totalizing more than half of the children up to 1 (one) year of age. The mixed feeding varies giving ground to the exclusive breast-feeding during the neo-natal period, and to bottle-feeding (exclusively) during the child\'s first year of life.

Exclusive breastfeeding for the first six months of life has been shown to decrease morbidity and mortality of women and infants. Organizations such as the United Nations Children’s Fund (UNICEF, 2018), American Academy of Pediatrics (AAP, 2012), and the World Health Organization (WHO, 2017a) have universally endorsed exclusive breastfeeding for the first six months of life, and then continuation of breastfeeding for a minimum of one to two years, with only supplementation of other liquid or solid food sources. Breastfeeding rates in the United States have not met the minimum goals set forth by Healthy People 2020 (n.d.). Although 81% of U.S. mothers initiated breastfeeding after the birth of their infant, only 22% of mothers were found to be exclusively breastfeeding at six months postpartum (Centers for Disease Control and Prevention [CDC], 2016a). This prospective, longitudinal, structural equation modeling study examined millennial-aged, exclusively breastfeeding women within one month postpartum who were followers of at least one of 17 social media breastfeeding support groups. Relationships of the conceptual constructs within Pender’s (1996) revised health promotion model (RHPM); House’s (1981) dimensions of social support; and the added constructs of breastfeeding knowledge, breastfeeding confidence, and breastfeeding attitude were analyzed in an effort to better understand the variables that lead to sustained exclusive breastfeeding to six months. Data supported the use of the integrated model for breastfeeding women. The normed referenced chi-square (2) of 1.9 (CFI =.94, IFI =.94, NFI =.89, RMSEA =.06, CFI [PCFI] >.5) indicated a good model fit. Additionally, there were statistically significant gains in the confidence, knowledge, and attitude scores from pretest to follow-up at six months. Exclusive breastfeeding to six months was reported to be three times (66%) higher than the U.S. national average (22%) (CDC, 2016a). Future use of the integrated model has great potential to impact public health by the exploration of variables that promote exclusive breastfeeding to six months. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2018. / FAU Electronic Theses and Dissertations Collection

O presente trabalho propõe-se analisar a forma como os fatores sociais, associados à prática do aleitamento materno, vêm sendo tratados na literatura científica. Num primeiro momento, procura identificar o comportamento do volume da produção científica, seguindo-se à identificação e análise dos fatores sociais arrolados nos estudos sobre a prática do aleitamento materno. O material de estudo compreende os trabalhos indexados na \"Nutrition Abstracts and Reviews\", no período de 1945 a 1985. Concluiu-se que a produção de conhecimento científico sobre o aleitamento materno faz-se presente em todo o desenvolvimento científico sobre nutrição infantil, no período estudado, com importância relativa acentuada em determinados momentos históricos. Destaca-se a produção de trabalhos sobre a prática do aleitamento materno dentre os estudos sobre o aleitamento materno. Identificam-se, como mais freqÜentes, entre os fatores sociais associados, o nível socio-econômico, o nível educacional, a distribuição urbano-rural e o trabalho da mulher. Os fatores sociais, arrolados nos estudos sobre a prática do aleitamento materno, caracterizam-se numa abordagem predominantemente multicausal. / The purpose of this work is to analyse how social factors associated with breast-feeding have dealt with scientifical literature. At first it outlines the behavior of the total scientific production and then it identifies and analyses the social factors connected up with the practice of breast-feeding. The material for this study encloses all the papers indexed in Nutrition Abstracts and Reviews throughout the period comprised between 1945 and 1985. There is concluded that the production of scientific knowledge on breast-feeding has been present throughout the general scientific development of child nutrition in the studied period with relative more deeper importance at certain historical moments. The practive of breast-feeding has been more dealt with studying breast-feeding at large. The most frequently associated social factors that were identified in this work were the socio-economic level, the educational level, the urban-rural distribution and women employment. These social factors connected up with breast-feeding practice have been approached essentialy from a multicausal angle.