New mothers struggle to combine breastfeeding and employment. Employers may not realize the benefits of breastfeeding for mothers, their infants, or the businesses themselves. A cross-sectional, descriptive design was used to investigate the characteristics of Central Texas small business employers, their attitude toward supporting breastfeeding in the workplace and explored factors that may mediate or moderate employers' support of breastfeeding in the workplace. Rogers’ Diffusion of Innovation theory guided the study. Data were collected using a Business Characteristics Survey and the Employer Intention to Support Breastfeeding Questionnaire (ESBQ). The final response rate was 148 complete surveys out of the 3817 sent, resulting in a 3.8% response rate. Descriptive statistics showed that 65.5% had some type of lactation support (n = 97) in place for their breastfeeding employees; however only 34.5% provided a designated, private room/place to pump breast milk. Logistic regression of the independent variables attitude (b = .034, p = .535), centralization (b = .045, p = .222), and interconnectedness (b = .002, p = .695) did not predict the presence of lactation support. Business size was not a significant predictor of the presence of lactation support (b = .001, p = .921). The moderator of intent was added to the model and interaction terms created by multiplying intent with each of the following variables: business size, attitude, centralization, and interconnectedness. These results did not support the presence of a moderating effect. Finally, mediator effects were only tested with the independent variable attitude. A significant direct association between attitude and the presences of lactation support was found (p = .045). Attitude appears to be a significant predictor of relative advantage (b = 4.583, p <.001). Relative advantage, while controlling for attitude, was not a significant predictor of presence of lactation support (b = .013, p = .220); however, the direct relationship of attitude to the presence of lactation support was less significant than before (b = .029, p = .655). Attitude appears to be a significant predictor of complexity (b = .407, p <.001). Complexity, while controlling for attitude, was not a significant predictor of presence of lactation support (b = .059, p = .285); however, the direct relationship of attitude to the presence of lactation support was less significant than before (b = .065, p = .181). Attitude appears to be a significant predictor of observability (b = .916, p = .003). Observability, while controlling for attitude, was not a significant predictor of presence of lactation support (b = -.003, p = .834); however, the direct relationship of attitude to the presence of lactation support was less significant than before (b = .091, p = .047). The implications and recommendations based on these findings can help to guide future studies and the planning and implementation of workplace lactation programs. / text

Introduktion: Att dia är ett medfött beteende, forskning påvisar stora hälsomässiga och ekonomiska fördelar med amning. Att skydda, stödja och främja amning är en folkhälsofråga. Distriktssköterskans arbete ska vara hälsofrämjande. Syfte: Att beskriva vilket amningsstöd ammande föräldrar uttrycker behov av. Metod: En kvalitativ, systematisk litteraturstudie med induktiv ansats som bygger sitt resultat på 11 vetenskapliga artiklar. Resultat: Föräldrarna behövde tidigt amningsstöd som fortsatte under hela amningsperioden. De önskade få ett lugnt och empatiskt bemötande från vårdpersonal med erfarenhet och kunskap om amning. Individuellt stöd gav styrka, beslutsamhet och självförtroende. De önskade samstämmig information som följde rådande rekommendationer. Föräldrar hade behov av praktisk amningsrådgivning, särskilt vid amningsdebut. De behövde positiv uppmuntran och stöd för sin upplevda självtillit för att lyckas amma. Konklusion: Vårdpersonal kan stödja nyblivna föräldrar genom att vägleda föräldern i en första lyckad amning; visa amning som fungerar i mötet med andra föräldrar i amningsgrupp, samt genom positiv respons och en uppmuntran som lär föräldern att se att amningen fungerar. Allt detta leder till förhöjd upplevd självtillit som i sin tur ökar sannolikheten att föräldern lyckas amma. / Introduction: Suckling is an innate behavior, and research shows great advantages in breastfeeding. To protect, support and advance breastfeeding is a public health issue. Public health care should be the district nurse’s main focus. Purpose: To describe what breastfeeding parents express a need for regarding lactation support. Method: A qualitative systematic literature review with inductive approach which is based on 11 scientific papers. Result: The parents needed early breastfeeding support that lasted the whole breastfeeding period. They needed support in a calm and empathetic manner from experienced, knowledgeable healthcare staff. Parents needed individual support that gave strength, determination, and confidence. They wished for unanimous information that was supported by current recommendations. The parents needed practical breastfeeding counseling, especially at the beginning. They needed encouragement and support for their perceived self-efficacy to succeed. Conclusion: Health care staff can give new parents guidance to an early successful breastfeeding experience; show functioning breastfeeding through breastfeeding groups and give positive response while giving encouragement that leads the parent to see that their own breastfeeding is successful and thereby gain increased self-efficacy.

The longevity of high productivity sows in the herd has become a challenge in pig production. Several factors may contribute to increased mortality rates observed over the past few years as well as lower retention rates of young sows. Chronic inflammation and metabolic disorders are conditions that sows had evolved over the years together with the greater productivity. This dissertation underlines the immunomodulatory effects of using yeast fermentation product fed to lactating sows. In the interest of determining patterns of local and systemic immune response, a new methodology to access cytokine profiles in puerperium sows was developed. In Chapter 2, one hundred-forty sows were used to evaluate the effects of two different <i>Saccharomyces cerevisiae</i> fermentation product (SCFP), a liquid source (LIQ) and a dry source (XPC®; Diamond V), on sow and litter performance. Sows were fed a common gestation diet until d 112 of pregnancy and then allotted to one of four treatments: 1) Control diet (CON), 2) CON + 15 mL/d of LIQ from d 112 to weaning (LIQ), 3) CON + 0.20% of XPC from d 112 to weaning (DRY), and 4) DRY + 15 mL/d of LIQ from d 112 to d 7 post-farrowing (D+L). Colostrum immunoglobulin concentrations were estimated using Brix refractometer. Plasma of piglets (2/sow) was collected 24 h after birth for immunocrit ratio analysis and for determination of plasma IgA and IgG concentrations. Lactation water and feed intake (ADFI) were recorded daily. Post-weaning follicle growth was evaluated by transrectal ultrasonography. Sows had the same initial BW (P > 0.13) but those fed any SCFP were heavier at weaning (P = 0.03) while not affecting sow backfat and loin depth (P>0.05). Overall, sows fed SCFP had greater ADFI than CON fed pigs (P < 0.01) while water intake, reproductive performance (total born, stillborn, weaned) did not differ among treatments (P > 0.05). Sows fed LIQ had the greatest ADFI on weeks 1, 2, 3, and overall compared to CON (P < 0.05). Litter ADG from SCFP treatments tended to be greater than CON (P = 0.10) and litter weight variability was lower (P = 0.10). No treatment effects were observed in colostrum Brix values (P > 0.77), in the piglet plasma IgG and IgA, and serum immunocrit ratio (P > 0.21). The average daily post-weaning follicle growth was greater for SCFP treatments than CON (P = 0.05). The wean to estrus interval was shorter for sows fed LIQ than CON and DRY (P < 0.01).<br><div><br></div><div>In Chapter 3 a non-invasive methodology to assess cytokine profiles from post-partum uterine lavage is described. The uteri of fourteen second and third parity sows were flushed with sterile saline solution (0.9%) on days 2, 4, and 14 post-parturition. Uterine fluid collected was immediately centrifuged and the supernatant stored at -20°C. Samples were freeze-dried, re-suspended in sterile saline (2 mL), and stored at -80°C. Cytokine profiles of the uterine fluid were evaluated using a multiplex ELISA panel including interleukin (IL)-1β, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ). Cytokine concentrations were calculated relative to protein content (pg/mg of protein). IFN-γ and TNF-α were lower than the limit of detection in most samples (5/38 and 1/38, respectively). IL-4 and IL-10 concentrations did not differ among days of collection (P>0.14). IL-8 was greater on day 4 than on days 2 or 14 (P<0.05). IL-1β and IL-6 were greater on days 2 and 4 than on day 14 (P<0.05).<br></div><div><br></div><div>The study presented in Chapter 4 refers to a subsample of sows (n=40) from the entire group of sows used in the study presented in Chapter 2. In this case, the methodology presented in Chapter 3 was used to evaluate SCFP effects on blood and uterine cytokine profiles in sows. A similar set of cytokines from Chapter 3 were evaluated on d 112 of gestation, d 2 and 6 post-farrowing in the plasma, and from uterine fluid collected on d 2, 4, and 6 post-farrowing. Serum C-Reactive protein (CRP) and haptoglobin concentrations were evaluated. No interactions between treatments and day of collection were observed (P>0.13). LIQ and D+L sows had the greatest serum IL-10 concentration (P<0.001) and sows fed CON tended to have lower serum concentration of IL-8 (P<0.06) vs. other treatments. Serum CRP concentrations were greatest on d 2 (P<0.001), serum IL-10 (P<0.04) and IL-4 (P<0.07) linearly decreased while serum haptoglobin (P<0.02) and IFN-γ (P<0.001) linearly increased post-farrowing. In the uterine fluid, LIQ and D+L sows had greater IFN-γ (P=0.04) concentrations and CON tended to have the least concentration of TNF-α (P=0.08). Uterine fluid IL-1 tended to linearly increase (P<0.07) and IL-6 linearly decrease (P<0.01) post-farrowing. LIQ sows had the greatest daily feed intake and CON the least during the first week of lactation (P=0.04).<br></div><div><br></div><div>In conclusion, feeding SCFP to lactating sows improved feed intake and litter growth while not affecting milk yield and colostrum quality. Besides improvements on litter ADG, the uniformity was better for all sources of SCFP. The liquid sources had slightly better results over the other sources and CON, including the greatest feed intake, less body weight mobilization, and a reduction in WEI. The method proposed to evaluate cytokine profiles in the uterine fluids of sows after farrowing, accomplished the objective of being a non-invasive procedure to be applied in puerperium sows. This new procedure was applied to analyze the immunomodulatory effects of SCFP. The correlations observed between the uterine and serum cytokines lead to a refined description of immune response in puerperium sows. Feeding SCFP to lactating sows stimulates the immune system allowing sows to build a desirable immune responses. Thus, the quicker resolution of acute phase reaction as demonstrated by greater daily feed intake in the first week post-farrowing can be attributed to SCFP immunomodulatory effects, ensuring better lactation performance.<br></div>