Breast milk is well recognized as the best natural food for infants and is also known to provide immediate and long-term health benefits for infants. According to the Baby- Friendly Hospital Initiative Hong Kong Association, the breastfeeding initiation rate in Hong Kong has been continuously increasing. For duration of breastfeeding, World Health Organization recommends exclusive breastfeeding for six months and the introduction of complementary food should start since the age of two. Despite active promotion of breastfeeding up to 6 months, the exclusive breastfeeding rate is still low and women in Hong Kong generally stop breastfeeding within the first few months. The Department of Health in Hong Kong facilitates a supportive environment in all Maternal and Child Health centres to promote breastfeeding. To support mothers exclusively breastfeed for the first six months, a structured individualized lactation counseling and support is worth to implement when mothers are discharged from hospital around 48 hours and transfer to primary care. The individualized lactation counseling provides latching technique to ensure proper attachment and positioning to prevent early complications at the early postnatal. It also continues to follow up until 1-to-2 weeks after delivery. The objective of this study is to evaluate the effectiveness of the individualized professional lactation counseling and support at early postnatal periods to prolong the duration of breastfeeding. Eight studies were identified after comprehensive literature review and the quality of these studies was assessed. An evidence-based guideline was developed based on the analyzed research findings. The implementation and evaluation of the proposed guideline were compiled in this translational research. An evidence-based guideline for providing individualized lactation counseling and support was developed to help health professionals to provide competent and effective breastfeeding counseling to mothers. The purpose of the guideline is to encourage mothers to breastfeed up to six months. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Breast milk provides optimal nutrition for babies and exhibits short and long-term health benefits for mothers and babies. Comparing the breastfeeding figures worldwide, Hong Kong has lower breastfeeding rates compared with other developed countries. Clinically and locally, inadequate skill support from nurses decreases breastfeeding rates. This thesis introduces evidenced-based guidelines of breastfeeding focused on skill training for improving duration and exclusiveness of breastfeeding. Based on available evidence, the guidelines aim to improve breastfeeding rates. The guidelines focus on skill training (position and attachment) as major component. Transferability and feasibility to apply the guidelines clinically was assessed. Lastly, an implementation plan was discussed. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Breastmilk is the most natural and complete nutrition for infants, and breastfeeding incurs numerous benefits for both infants and mothers. The World Health Organization recommends that mothers exclusively breastfeed their infants for six months and continue breastfeeding for up to two years of age and beyond. More than 80% of Hong Kong mothers now initiate breastfeeding. However, overall breastfeeding duration remains short and rates of exclusive breastfeeding are low. Premature weaning is influenced by multiple factors, and mothers require additional support from healthcare professionals to overcome various lactation difficulties in the early postpartum period. This study aimed to evaluate the effect of two postnatal professional support interventions on the duration of any and exclusive breastfeeding. We conducted a cluster randomized controlled trial to evaluate the efficacy of in-hospital support and post-discharge telephone support on breastfeeding outcomes among first-time mothers in Hong Kong. Seven hundred and twenty two mother-infant pairs with uncomplicated, full-term pregnancies were recruited from the postnatal units of three large public hospitals. With the hospital as the unit of randomization, participants were allocated to standard care (n=263), in-hospital support (n=191), or post-discharge telephone support (n=268). Mothers in the in-hospital group were given three individualized breastfeeding support sessions during the postnatal hospitalization, with two sessions given in first 24 hours after birth and one the following day, providing lactation knowledge and instructions on breastfeeding techniques. Participants in the telephone group were provided with weekly 30-minute breastfeeding counseling and support sessions for the first four weeks after delivery, with first contact initiated within 72 hours after discharge. The primary study outcomes were the prevalence of any and exclusive breastfeeding at one, two and three months postpartum. Seven hundred (97%) participants completed the six-month follow-up, while eleven had partial follow-up and eleven could not be contacted. The rates of any and exclusive breastfeeding were higher among participants in the two intervention groups at all follow-up points when compared with those who received standard care. Participants receiving the telephone support were significantly more likely to continue any breastfeeding at one month (76.2% vs. 67.3%; OR=1.63, 95% CI 1.10-2.41) and two months (58.6% vs. 48.9%; OR=1.48, 95% CI 1.04-2.10), and to be exclusively breastfeeding at one month (28.4% vs. 16.9%; OR=1.90, 95% CI 1.24-2.91). Participants in the in-hospital support group were also more likely to be breastfeeding at all time points in the first six months but the effect was not statistically significant. Early professional breastfeeding support, especially weekly telephone counseling, significantly increased the rates of any and exclusive breastfeeding in the early postpartum period and significantly increased overall breastfeeding duration in the first six months among first-time mothers. Additional postnatal professional support when given to breastfeeding mothers on a one-to-one basis can improve breastfeeding outcomes. While hospital practices need to be strengthened to further promote and support breastfeeding, more well-designed trials are required to determine the most effective mode and intensity of intervention that improves the longer-term breastfeeding rates. / published_or_final_version / Nursing Studies / Doctoral / Doctor of Nursing

In Hong Kong, while around 85% of mothers choose to breastfeed their infants, most discontinue within the first one to two months postpartum. This indicates that there is room for improving the current breastfeeding education. A randomized controlled trial was conducted to evaluate the effectiveness of a professional one-to-one antenatal breastfeeding support and education intervention on the exclusivity and duration of breastfeeding. A total of 469 primiparous women who attended the antenatal clinics of two geographically distributed public hospitals in Hong Kong were randomized to receive either standard antenatal care or a one-to-one antenatal breastfeeding support and education session. The primary outcome was the prevalence of exclusive breastfeeding at 6 weeks postpartum. Secondary outcomes were the prevalence of exclusive breastfeeding at 3 and 6 months postpartum, as well as the overall duration of any and exclusive breastfeeding across the first 6 months postpartum. The study had a least 80% power to detect a 50% increase in the rate of exclusive breastfeeding at 6 weeks postpartum. The exclusive breastfeeding rate in the intervention group was 37.8% at 6 weeks postpartum compared with 36.4% in the standard care group (p=0.77; 95% Confidence Interval (CI) -0.08, 0.11). There were no significant differences between the two treatment groups in exclusive breastfeeding rates at 3 and 6 months or in in the overall duration of any (Hazard Ratio (HR) =1.11; 95% CI 0.88, 1.40) or exclusive breastfeeding (HR=0.96; 95% CI 0.79, 1.17). In a setting with a high breastfeeding initiation rate, one-to-one antenatal breastfeeding support and education did not increase the exclusivity or duration of breastfeeding. / published_or_final_version / Nursing Studies / Master / Master of Philosophy

Thesis (M.Nurs.)--University of Hong Kong, 2008. / Includes bibliographical references (p. 45-54)

published_or_final_version / Nursing Studies / Master / Master of Nursing

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

Thesis (M.S.) -- University of Tennessee, Knoxville, 2005. / Title from title page screen (viewed on Sept. 6, 2005). Thesis advisor: Sonya Jones. Document formatted into pages (x, 117 p. : ill. (some col.), col. map). Vita. Includes bibliographical references.

Thesis (Ph. D. in Sociology)--Vanderbilt University, May 2010. / Title from title screen. Includes bibliographical references.

Factors that influence exclusive breastfeeding in Namibia are important, especially in light of the implementation of the Baby and Mother Friendly Initiative. Infant feeding practices, especially breastfeeding, are important public health issues, particularly in the prevention of HIV transmission from mother to child. This thesis determined the prevalence of exclusive breastfeeding and measures the association of demographic and service-related factors on exclusive and non-exclusive breastfeeding practices.