ABSTRACT Statistics show that breastfeeding prevalence for Sweden has fallen since the mid 90´s. Studies show that breastfeeding offers health benefits to both mother and child and that the mothers' belief and confidence in their ability to breastfeed is a key factor to having a positive breastfeeding outcome. In 2010, Amningshjälpen in collaboration with Sensus studieförbund, started a nursing course, for mothers-to-be, who wished to breastfeed their babies and its aim was to prepare them for a successful and enjoyable experience. Objective: To examine whether a preparatory breastfeeding course can affect mothers' confidence in their ability to breastfeed and if that ability can affect the breastfeeding outcome when the child reaches four months. A further aim is to investigate the experience of  perceived problems surrounding breastfeeding and what affect these might have on the mothers' confidence in breastfeeding when the child reaches four months. Design/Methods: A quantitative approach with prospective experimental design was used to evaluate the study. The questionnaire Breastfeeding Self-Efficacy Scale Short Form (BSES-SF) was used three times to measure women's trust in lactation. The first and second assessment were performed prenatally and a third when the child was four months old. Results:Sensus breastfeeding course was shown to raise women's average BSES -SF, from 43,14 before training to 55,86 after (p> 0.001). The third assessment, taken when the child has reached four months, provided a positive result on the mothers confidence to breastfeed compared to the results from the two prenatal assessments (m =58.98) (p <0.001). The breastfeeding rate of the women who participated in the study was high in percentage terms if compared to average situation in Sweden. The higher the mothers estimated problems around the child regarding wailing, sleeping and eating, the lower they estimated their self-efficacy regarding breastfeeding in the assessment at four months of age (p <0.001). Conclusion: The study demonstrates that a preparatory breastfeeding course in pregnancy increased women's confidence in their ability to breastfeed, and the breastfeeding rate within the study when the babies were four months old was high compared to the national Swedish statistics. The study also shows that women who estimated low on self-efficacy experienced more problems with their child at around the age of four months. All mothers´ rated their partners as most important support person whilst breastfeeding and in second place came The Sensus nursing course.

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It is widely accepted that breast milk is the optimal source of infant nutrition. Despite the World Health Organization (WHO) recommendation of exclusive breastfeeding for the first 6 months of infant life, many women discontinue breastfeeding as a result of perceived difficulties. Nipple pain is a highly prevalent, significant reason for breastfeeding cessation. Among the numerous interventions for nipple pain, the application of lanolin is commonly recommended, with endorsement by Health Canada, The La Leche League, and International Board Certified Lactation Consultants. The few studies that have evaluated the effectiveness of lanolin on nipple pain have lacked methodologic rigor, and are thus not reliable or generalizable. As such, the purpose of this trial was to rigourously evaluate the effect of lanolin for the treatment of nipple pain among breastfeeding women. This single-site randomized controlled trial (RCT) compared the application of lanolin (treatment) to usual postpartum care (not applying lanolin) for the treatment of nipple pain. The primary outcome for this trial was the effect on pain severity, as measured by a numeric rating scale (NRS) at 4 days post-randomization. Of 186 participants, 93 were randomized to the treatment group and 93 to the usual care group. At 4 and 7 days post-randomization there were no statistically significant differences in pain scores between groups. It is noteworthy that by 7 days post-randomization there were clinically relevant decreases in nipple pain in both groups. However, there were no statistically significant differences between groups for other outcomes, including pain measured with the short-form McGill Pain Questionnaire, breastfeeding duration, breastfeeding exclusivity, and breastfeeding self-efficacy. Despite these findings, women in the treatment group were significantly more satisfied receiving lanolin for their nipple pain than those receiving usual care. Since the use of lanolin is no more effective than applying nothing to the nipples for the management of nipple pain, the widespread use of lanolin is questionable. Further research is required on the role of interventions to prevent nipple pain and damage, and the effect of anticipatory guidance on improving breastfeeding outcomes for those experiencing nipple pain in the early postpartum period.

Clinical Issue Health Canada recommends exclusive breastfeeding for the first 6 months post birth and then the addition of complementary foods with breastfeeding extending to a minimum of two years. Breastfeeding initiation rates in Canada are currently at around 87% but, by one month, about 21% of women have stopped breastfeeding. Engorgement and edema in breast tissue can lead to breastfeeding challenges which may contribute to early weaning. Purpose The purpose of this pilot research study was to explore the relationship between intravenous (IV) fluids given to mothers during the peripartum period and postpartum breast or nipple swelling in the first ten days postpartum and determine if a larger study was warranted and feasible. The research question for this pilot study was, "What is the relationship between the amount of IV fluids given to labouring women and edema of the breast and areola complex experienced by breastfeeding women in the first 10 days postpartum?" Methods It is a prospective, longitudinal, observational cohort pilot study with repeated measures and a within-subjects design. Participants are first time mothers who planned to exclusively breastfeed and gave birth to a single, healthy newborn by means of a spontaneous vaginal birth, Mother and baby were discharged home together with no contraindications to exclusive unrestricted breastfeeding. Descriptive statistics are reported and linear regression analysis is used to model the relationship between IV therapy and postpartum breast edema. Results Women who received IV fluids during labour had higher levels of edema postpartum and rated their breasts as firmer as and more tender than women who did not receive IV fluids. Participants who had IV fluids appeared to be less aware of the fullness associated with lactogenesis II, and the pattern of fullness they described appeared to be related to edema noted. Participants who did not have IV fluids appeared to have unrelated patterns of fullness and edema, and therefore appeared more aware of the onset of lactogenesis II. The results support a larger study about the relationships between maternal perinatal IV fluids and breast or nipple changes.

Thesis (Ph.D.)--University of Melbourne, Centre for Health and Society, 2007. / Typescript. Includes bibliographical references (leaves 250-266).

Thesis (M.A.)--Northern Kentucky University, 2008. / Made available through ProQuest. Publication number: AAT 1459937. ProQuest document ID: 1622198771. Includes bibliographical references (p. 38-40)

Thesis (M. Mid.)--University of Sheffield, 2007. / "June, 2007." Issued as part of the Canadian electronic library documents collection. Includes bibliographical references (p. 45-55).

Thesis (M.A. (Ed.)) - Simon Fraser University, 2004. / Theses (Faculty of Education) / Simon Fraser University.

Thesis (M.S.)--University of Michigan, 1985.

Thesis (M.A.)--Memorial University of Newfoundland, 2002. / Bibliography: leaves 149-169.