Kvinnans amning har många olika hälsofördelar både för den nya mamman men också för hennes nyfödda. Amning har ett antal olika hälsofördelar, till exempel utvecklingen av barnets immunsystem och tarmflora. Genom kvinnans amning främjas deras första kopplings- och interaktionsfas mellan modern och det nyfödda och därmed en större möjlighet till framgångsrik amning. / The woman's breastfeeding has many different health benefits both for the new mother but also for her newborn. Breastfeeding has a number of different health benefits, such as the development of the baby's immune system and intestinal flora, for example. Through the woman's breastfeeding, their first connection and interaction phase between the mother and the newborn is promoted and thus a greater opportunity for successful breastfeeding.

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Att få barn är en stor livsstilsförändring som kan komma med många utmaningar. Att amma sitt barn anses ofta som en självklarhet och det talas om amningens många fördelar. Däremot talas det sällan om svårigheter som kan uppkomma i samband med amning. Amningsångest och dysforisk mjölkutdrivningsreflex är ett relativt okänt tillstånd vilket kan leda till onödigt lidande för de ammande mödrarna. Syftet med studien var att beskriva mödrars upplevelser och erfarenheter av amningsångest och dysforisk mjölkutdrivningsreflex. Det är en kvalitativ studie med induktiv ansats. Data samlades in genom blogginlägg, kommentarer och publicerade intervjuer där mödrar beskrivit sina upplevelser. Insamlad data analyserades med en kvalitativ innehållsanalys som resulterade i två kategorier: Okunskap om amningssvårigheter hos ammande mödrar och Okunskap om amningssvårigheter hos vårdpersonal. Kategorierna bildade temat: Mödrars behov av förståelse, bekräftelse och hjälp i den postnatala vården. Utifrån denna studie kan vårdpersonal som möter ammande mödrar få förståelse för och kunskap om hur mödrar upplever sin amningsångest och dysforiska mjölkutdrivningsreflex, och även att mödrarna själva kan få kunskap om att det är ett tillstånd som existerar. Studien kan ligga till grund för kunskapsspridning om amningsångest och dysforisk mjölkutdrivningsreflex och resultera i att mödrar upplever mindre ensamhet och lidande. / Having a baby is a lifestyle change that can come with challenges. Breastfeeding is often taken for granted and the many benefits are often talked about. However, it rarely talks about difficulties that can arise. Breastfeeding anxiety and dysphoric milk ejection reflex is a relatively unknown condition which can lead to unnecessary suffering for breastfeeding mothers. The purpose of the study was to describe mothers' experiences of breastfeeding anxiety and dysphoric milk ejection reflex. It is a qualitative study with an inductive approach. Data was collected through blogposts, comments and published interviews where mothers described their experiences. Data were analyzed with a qualitative analysis that resulted in two categories: Ignorance of breastfeeding difficulties in nursing mothers and Ignorance of breastfeeding difficulties in healthcare personnel. The categories formed the theme: Mothers' need for understanding, confirmation and help in postnatal care. Based on this study, healthcare professionals can gain understanding and knowledge of how mothers experience their breastfeeding anxiety and dysphoric milk ejection reflex, but also the mothers themselves gain knowledge that it is a condition that exists. The study can spread knowledge about breastfeeding anxiety and dysphoric milk drive reflex, which can result in mothers experiencing less loneliness and suffering.

This study explored the factors which affect the feeding and weaning practices of Emirati mothers as well as the experiences and perceptions which influence their breastfeeding decisions. It used both quantitative and qualitative methods to examine Emirati mothers’ understanding of infant feeding and to identify the factors which appeared to have a relevant effect and locate them in their cultural context. n the survey, a convenientce sample of 593 mothers with infants aged up to 2 years was interviewed face to face in the maternal and child healthcare centers in Al Ain, Dubai and Abu Dhabi. The interview was based on a pretested structured questionnaire. The results of multiple logistic analysis showed that the time of initiation of the first breastfeed was significantly associated with the infant’s birth weight (OR=2.007; P<0.023), parity (OR=2.139; P<0.001) and rooming in (OR=21.70; P<0.001). As for the feeding patterns, the results of the multiple logistic analysis revealed that rooming in (OR=4.485; P<0.001), feeding on demand (OR=2.290; P<0.005) and feeding more frequently at night (P<0.001) emerged as significant factors associated with exclusive or almost exclusive breastfeeding practices. The duration of breastfeeding rate was significantly influenced by many variables. Concerning the duration of lactational amenorrhea, the, the multiple logistic analysis showed that mother's age, breastfeeding duration and the early introduction of formula milk and solid food emerged as significant variables. Among the 593 infants in the study, 24.1% were predominantly breastfed,25% of the infants were exclusively breastfed, and 49.4% were almost exclusively breastfed since birth. Fifteen Emirati mothers from each city were interviewed about their breastfeeding practices, beliefs and perceptions. The following themes emerged: the influence of others, the sources of information, infants’ behavior, knowledge of and attitudes towards current WHO recommendations and mothers’ perception of the benefits of breastfeeding. Health promotions and healthcare facilities failed to deliver the message of the importance of exclusive breastfeeding. Grandmothers and mothers-in-law appeared to influence the mother's breastfeeding practices. In conclusion, there is a need for a national community-based breastfeeding intervention programme for the promoting exclusive breastfeeding practices as part of a primary public health strategy.

Background Benefits of breastfeeding for infants and mothers are well recognized. South Africa has a very low breastfeeding rate. Strategies to improve and promote exclusive breastfeeding rates include implementation of human milk banks (HMB). The North West Province started its first HMB in 2012 and the success and sustainability will depend on numerous factors, including identification of possible barriers to donation or receiving donor human milk. In support of such an intervention, the attitudes of each relevant stakeholders, mothers, community members and health care providers on acceptability of donating and receiving donated breastmilk is therefore important for the success of such an intervention Objectives The objective of this dissertation was determining the attitudes on acceptability regarding the donation and receiving of human breast milk for key stakeholders, namely mothers, healthcare workers and the elderly representing grandmothers. Methods This study was conducted at a public hospital and nearby clinics in North West province, South Africa using qualitative research methodology of focus group discussions (FGDs) for data collection. Eight focus groups discussed the attitudes, 3 of mothers of 0 to 12 month old infants (n=13), 3 of elderly participants older than 60 years (n=17) and 2 of healthcare professionals, working with infants younger than 1 year (n=11). Results Important attitudes on acceptability of receiving and donating human donor milk were identified from the literature and this research project. Stakeholders had safety and cultural concerns regarding donation and receiving of donated human milk. Participants also indicated the need for education that may improve the attitudes. These findings may inform future policy planning and HMB promotion in communities. The identified attitudes reflected barriers to exclusive breast feeding, donating and receiving breast milk. These included, the need for HIV screening; cultural beliefs relating to transfer of personality traits and bonding and fears of not having enough milk for their own infants; perceived changes in quality of donated milk during pasteurisation and transportation as well as HIV transmission. Conclusion The study identified important attitudes that may be possible barriers and fears to accepting or donating human breast milk. Some of the identified attitudes could also limit exclusive breast feeding. Further research is recommended to determine how prevalent the identified attitudes are in this and similar community settings. / MSc (Dietetics), North-West University, Potchefstroom Campus, 2015

Background Benefits of breastfeeding for infants and mothers are well recognized. South Africa has a very low breastfeeding rate. Strategies to improve and promote exclusive breastfeeding rates include implementation of human milk banks (HMB). The North West Province started its first HMB in 2012 and the success and sustainability will depend on numerous factors, including identification of possible barriers to donation or receiving donor human milk. In support of such an intervention, the attitudes of each relevant stakeholders, mothers, community members and health care providers on acceptability of donating and receiving donated breastmilk is therefore important for the success of such an intervention Objectives The objective of this dissertation was determining the attitudes on acceptability regarding the donation and receiving of human breast milk for key stakeholders, namely mothers, healthcare workers and the elderly representing grandmothers. Methods This study was conducted at a public hospital and nearby clinics in North West province, South Africa using qualitative research methodology of focus group discussions (FGDs) for data collection. Eight focus groups discussed the attitudes, 3 of mothers of 0 to 12 month old infants (n=13), 3 of elderly participants older than 60 years (n=17) and 2 of healthcare professionals, working with infants younger than 1 year (n=11). Results Important attitudes on acceptability of receiving and donating human donor milk were identified from the literature and this research project. Stakeholders had safety and cultural concerns regarding donation and receiving of donated human milk. Participants also indicated the need for education that may improve the attitudes. These findings may inform future policy planning and HMB promotion in communities. The identified attitudes reflected barriers to exclusive breast feeding, donating and receiving breast milk. These included, the need for HIV screening; cultural beliefs relating to transfer of personality traits and bonding and fears of not having enough milk for their own infants; perceived changes in quality of donated milk during pasteurisation and transportation as well as HIV transmission. Conclusion The study identified important attitudes that may be possible barriers and fears to accepting or donating human breast milk. Some of the identified attitudes could also limit exclusive breast feeding. Further research is recommended to determine how prevalent the identified attitudes are in this and similar community settings. / MSc (Dietetics), North-West University, Potchefstroom Campus, 2015

Amningsfrekvensen i Värmland sjunker och är låg jämfört med riket. En bidragande faktor till den sjunkande amningsfrekvensen är bristen på tillit till amning. Det är viktigt att kunna identifiera kvinnor med låg tillit till amning för att vända den sjunkande amningsfrekvensen och stärka kvinnan i rollen som moder. Syfte: Syftet med denna studie var att undersöka kvinnors tillit till amning på Barnbördshuset (BB) och Eftervårdsmottagningen i Värmland. Med enkäten BSES-SF identifieras kvinnor med låg tillit till amning och kvinnor som behöver ett ökat amningsstöd efter förlossning. Design/Metod: Studien utfördes med kvantitativ ansats. Data inhämtades från enkäten BSES-SF som besvarats av 70 kvinnor på BB och Eftervårdsmottagningen i Värmland. All data analyserades genom SPSS. Resultat: De flesta kvinnor ansåg att det var mycket viktigt med en fungerande amning och när kvinnorna skattade amningens betydelse framkom ett medelvärde på 8,66 där 0=inte alls viktigt och 10=mycket viktigt. Kvinnor som ammat tidigare skattade sin upplevda amningserfarenhet som mycket god. Varje enskild fråga på BSES-SF jämfördes mellan kvinnorna som vårdats på BB och Eftervårdsmottagningen. Det framkom en skillnad på åtta frågor där kvinnorna på Eftervårdsmottagningen skattade en högre tillit till amning jämfört med kvinnorna på BB. Utifrån totalsumman på BSES-SF med ett poängintervall mellan 14-70, framkom det att tilliten till amning skattades högre hos kvinnorna på Eftervårdsmottagningen (M=56,54) än på BB (M=49,88). Slutsats och klinisk tillämpbarhet: BSES-SF kan utifrån studiens resultat vara ett användbart verktyg, framförallt på BB där kvinnorna skattat en lägre tillit till amning. Förstföderskor och omföderskor som upplevt en komplicerad förlossning kan vara i behov av större insatser av amningsstöd. Studiens resultat kan medföra att barnmorskan blir extra uppmärksam på de kvinnor vars amning inte fungerar och där extra stöd behövs för att öka tilliten. / Breastfeeding frequency in Värmland decreases and is low compared with the national average. A contributing factor to the decline in breastfeeding rates is the lack of confidence in breastfeeding. It is important to identify women with low confidence to reverse the decline in breastfeeding frequency and strengthen her in her role as a mother. Objective: The aim of this study was to investigate breastfeeding and self-efficacy in the Postnatal ward and Postnatal carecenter in Värmland. Using BSES-SF survey, women with low confidence in breastfeeding and women who need an increased breastfeeding support after delivery were identified. Design/Methods: The study was conducted with a quantitative approach. Data whas collected from BSES-SF, answered by 70 women in Postnatal ward and Postnatal carecenter in Värmland. All data were analyzed by SPSS. Results: Most women felt that it was very important to have a functioning breastfeeding and when the women estimated the importance of breastfeeding it showed a mean of 8.66, where 0 = not at all important and 10 = very important. Women who breastfed previously rated their perceived breastfeeding experience as very good. Every single question on BSES-SF whas compared between women who were treated in Postnatal ward and Postnatal carecenter. It showed a difference in eight questions, the women on the Postnatal carecenter estimated a higher confidence in breastfeeding compared with women in the Postnatal ward. The total sum of BSES-SF with a score range between 14-70, showed that trust in lactation whas estimated higher among women in the Postnatal carecenter (M = 56.54) than in the Postnatal ward (M = 49.88). Conclusion and clinical applicability: Primaparas and women with prior deliveries who now experienced a complicated childbirth may need extra breastfeeding support. The result of the study may leed to extra attention from the midwife to those women whose breastfeeding does not work and where additional support is needed to increase confidence. Based on the studys result BSES-SF can be a useful tool, especially in the Postnatal ward where women estimated a lower confidence in breastfeeding.

Examining Exclusive Breastfeeding Practice in Indonesia, and its Association to Maternal Socio-demographic Determinants, to Inform Intervention Efforts Aimed at Reducing Infant Mortality Introduction Exclusive breastfeeding, the gold standard of infant feeding practices, has been identified as the single most effective strategy to improve child survival. However, this recommendation is not highly practiced in Indonesia, while Indonesia’s infant and under five mortality is still high. Interventions to promote, protect, and support breastfeeding practice are critical public health needs in Indonesia. Aim The current study examined socio-demographic factors associated with exclusive breastfeeding practice in Indonesia: whether maternal age, level of education, occupation status, wealth index, and region of residence, as well as breastfeeding initiation are associated with exclusive breastfeeding practice in Indonesia for mothers having infants up to age five months. Methods This study analyzed 1695 women having infant aged 0-5 month old data from the 2012 Indonesia Demographic Health Survey. Chi-square test was used for preliminary analysis and logistic regression analyses were used to primary analysis by using SAS 9.4 program. Results Exclusive breastfeeding practice in Indonesia was low (36.1%). Mothers aged 30-39 years old were more likely to exclusively breastfeed compare to mothers under 20 years old (OR=1.56, 95% CI 1.04-2.35). Mothers with high education level had higher odds to exclusively breastfeed compare to low education mothers. Unemployed mother were more likely to exclusively breastfeed than working mothers (OR=1.65, 95% CI 1.28-2.13). Mothers coming from richer wealth index were less likely to exclusively breastfeed compare to mothers having poorest wealth index (OR= 0.49, 95% CI 95% 0.34-0.72). Those who initiated breastfeeding early had increased odds to exclusively breastfeed than mothers who delayed breastfeeding initiation (OR=1.47 95% CI 1.19-1.83). Finally, mothers who lived in Eastern Indonesia were more likely to exclusively breastfeed compare to mothers who lived in Sumatera and Kalimantan (OR=1.82, 95% CI 1.30-2.55). Conclusion This study found characteristics of Indonesian mothers who were more likely to exclusively breastfeed compared to the reference group: aged 30-39 years old, high education level, unemployed, richer wealth index, and those who live in Eastern Indonesia; as well as, mother who initiate breastfeeding early. Having tailored strategies and interventions to targeted at-risk populations may increase the likelihood of exclusive breastfeeding practices, and ultimately, decreasing infant mortality rates in Indonesia.

Thesis (MCur)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Breastfeeding is considered as the most preferable method of infant feeding to fulfill babies’ nutritional needs important to the growth and development of babies. Unfortunately, there were babies not breastfed due to numerous reasons including infant illness and hospitalization. The purpose of this research was to describe the experiences and perceptions of nurses regarding breastfeeding in a pediatric setting of an academic hospital in the Province of the Western Cape. A descriptive study design with a qualitative approach was used to explore the experiences and perceptions of auxiliary nurses regarding breastfeeding. Purposive sampling was utilized to consciously select thirteen auxiliary nurses to participate in the study. Semi-structured interviews were used to collect data. Data analysis involved the transcribing of tape recorded interviews, the generating of themes and sub-themes, coding of the data, interpretation and organization of data and the drawing of conclusions. According to the auxiliary nurses’ perceptions, most of the babies in the pediatric setting were not being breastfed. Breastfeeding was being supplemented with formula milk when mothers chose not to breastfeed, experienced breastfeeding problems, were not with the baby or the baby was too sick to breastfeed. The babies’ illness, the hospital environment and lack of resources were challenging auxiliary nurses when supporting breastfeeding mothers. Not all health professionals were supportive of breastfeeding. Interrelated factors including, shortage of staff, time constraints, heavy work-loads, auxiliary nurses’ breastfeeding knowledge and experience, their confidence to support breastfeeding and communication regarding breastfeeding, influenced auxiliary nurses’ ability to support breastfeeding babies and mothers. The research findings indicate that there was a need for breastfeeding promotion in the pediatric setting. Recommendations included a written breastfeeding policy, breastfeeding training for all health care professionals, better breastfeeding education and support for mothers, the maintenance and of breastfeeding during the babies’ illness, adequate accommodation for breastfeeding mothers and the support of breastfeeding mothers who are HIV positive. / AFRIKAANSE OPSOMMING: Borsvoeding is beskou as die mees verkieslike voeding metode vir babas om hul te voorsien aan die nodige voedingsbehoeftes belangrik vir die groei en ontwikkeling van babas. Die doel van hierdie studie was om die ervarings en persepsies van verpleeg assistente met betrekking tot borsvoeding in ‘n pediatriese instelling in ‘n akademiese hospitaal in die Provinsie van die Weskaap te beskryf. ‘n Beskrywende studie ontwerp met ‘n kwalitatiewe benadering was gebruik ver die doel van die studie. Streekproeftrekking was gebruik om doelbewus drie assistant verpleegkundiges te selekteer om deel te neem aan die studie. Semi-gestruktureerde onderhoude was gebruik om data in te samel. Die data-analise behels die transkibering van band opgeneemde onderhoude, die opwekking van temas en subtemas onderverdeel, kodering van die data, interpretasie an organisasie van die data en die opstel van gevolgtrekkings. Dit was bevind na gelang van die assistant verpleegkundiges se persepsies, dat meeste van die babas in die hospitaal was nie geborsvoed. Borsvoeding was aangevul met formule melk wanneer moeders verkies om nie te borsvoed, ervaar borsvoeding probleme, was nie met die babas, of die baba was te siek om the voed aan die bors. Baba siektes, die hospitaal omgewing en die gebrek aan hulpbronne was uitdagend vir assistant verpleegkundiges om borsvoeding moeders te ondersteun. Interafhanklike faktore insluitend, ‘n tekort aan personeel, tyd beperkinge, swaar werk-vragte, borsvoeding kennis en ondervinding, die vertroue om borsvoeding te ondersteun en kommunikasie met betrekkking tot borsvoeding, het die borsvoeding ondersteuning van assistant verpleegkundiges beinvloed. Die navorsingsbevindinge dui daarop dat daar ‘n behoefte was aan borsvoeding bevordering in die hospitaal. Aanbevelings sluit in ‘n skriftelike borsvoeding beleid, borsvoeding opleiding vir alle gesondheidspersoneel, beter borsvoeding inligting en ondersteuning vir moeders, die instandhouding van borsvoeding tydens hospitalisasie, voldoende akkomodasie vir borsvoeding moeders and die ondersteuning van borsvoeding moeders wat MIV-positief is.

Thesis (PhD (Interdisciplinary Health Sciences. Human Nutrition))--Stellenbosch University, 2008. / Objectives: To determine the impact of facility-based semi-intensive and home-based intensive counseling strategies to improve exclusive breastfeeding rates and to identify factors associated with exclusive breastfeeding. Methods: This was a randomized trial in which villages in the Kibera slum, Nairobi Kenya were assigned to two intervention groups and a control group. Study participants from among 34-36 week pregnant, HIV-negative women, attending antenatal clinic at Lang’ata health centre, were assigned to study groups and followed up in their homes until 6 months postpartum. Experimental group 1, the Home-Based Intensive Counseling Group (HBICG)] received 7 counseling sessions; 1 prenatally and 6 postnatally. Experimental group 2, the Facility-Based Semi-Intensive Counseling Group (FBSICG) received 1 counseling session prenatally. The control group (Control Group) received irregularly provided health education by health personnel. Information on infant feeding practices, using a validated 24-hour recall questionnaire was collected monthly at participant homes; observations were conducted on a random 10% sub-sample to verify the reported information. Qualitative data from focus group discussions provided information on the rationale for feeding choices. Information on infant morbidity and weight measurements were taken on a monthly basis. Results: At six months, exclusive breastfeeding rate was 23.6% in HBICG; 9.2% in FBSICG; and 5.6% in CG. Mothers from HBICG had a 4.2 increased likelihood to exclusively breastfeed compared to those in the CG (RR=4.20; 95% CI; 1.66-10.64; p=0.002). Cumulative exclusive breastfeeding rate for 6 months was 3.2% in the CG; and 6.9% and 15.6% in the FBSICG and HBICG respectively (p<0.00001). Mothers from HBICG had a 3.4 increased likelihood to practice exclusive breastfeeding for 6 months compared to those in CG (RR=3.4; 95% CI: 1-34-8.80; p=0.010). Exclusive breastfeeding rates in FBSICG were insignificantly higher than those in the CG. The median duration of exclusive breastfeeding was one month in both the CG and FBSICG and three months in the HBICG. The predictors of exclusive breastfeeding were non-giving of post-lacteal feeds; planned long breastfeeding duration; living in smaller households; non-ownership of telephones and televisions; absence of breast health problems; and correct knowledge of breastfeeding duration. The major hindrances to exclusive breastfeeding were: inadequate knowledge of exclusive breastfeeding; cultural perceptions about infant feeding; and absence of mother from home for long periods. The prevalence of acute respiratory infections and diarrhoea were significantly lower among exclusively breastfed infants than those non-exclusively breastfed. The prevalence of underweight was significantly lower among the exclusively breastfed infants than those non-exclusively breastfed at one month (p=0.006) and three months (p=0.005). Conclusions: It is feasible to promote and sustain exclusive breastfeeding for six months in low socioeconomic conditions, using the home-based intensive counseling strategy. Breastfeeding promotion programmes should adopt strategies to allow for wider dissemination of information, targeting both mothers and the community at large, as this study showed family members were major decision-makers in the choice of infant feeding practices. Hospital-based breastfeeding education should offer detailed information on a consistent basis. Breastfeeding promotion messages should be re-packaged to address cultural perceptions in infant feeding practices.