I ett internationellt perspektiv har Sverige hög amningsfrekvens, men under 2000-talet har amningsfrekvensen sjunkit och stora regionala skillnader ses. Kvinnorna rekommenderas att helamma sex månader. Mödravårdcentralen (MVC) informerar om bröstmjölkens hälsoeffekter som till exempel att bröstmjölken skyddar barn mot allergier. Forskning visar att överviktiga och feta kvinnor har kortare amningsduration, men få studier behandlar svenska förhållanden. Syfte: Syfte med fördjupningsarbetet är att studera samband mellan mammans BMI relaterat till amningsduration och mammans skattning av barnets hälsa de tre första levnadsåren. Metod: Studien är en kvantitativ retrospektiv tvärsnittstudie. Data insamlades via enkäter, 418 deltagare inkluderades. Data har analyserats med Statistical Package for the Social Sciences (SPSS). För deskriptiv och jämförande analys har parametriska och icke-parametriska analyser genomförts. Resultat: De kvinnor som inte ammade skattade sitt barns hälsa sämre vid tre års ålder i jämförelse med kvinnor som ammat någon period. Vid tre års ålder skattade kvinnor med övervikt och fetma sitt barns hälsa sämre. Slutsats: Det är viktigt att kunna identifiera kvinnor som är behov av stöd för att initiera amning och kunna bidra till anpassat stöd till dem. AbstractSweden reports high duration of breastfeeding compared to international findings. During the last century, the frequency of breastfeeding duration has decreased in Sweden, with large regional differences. Recommendation for exclusive breastfeeding is six months. Midwives provide information about healthy benefits of breast milk, such as breast milk protecting baby´s against allergies. Research has presented associations between obesity and short duration of breastfeeding. However, there is a lack of knowledge regarding women in a Swedish context. Aim: To investigate the relation between mothers BMI, duration of breastfeeding and maternal valuation of the baby´s health during the first three year of life. Method: The study is a quantitative retrospective cross-sectional study. Data was collected through questionnaires, 418 participants were included. Data was analyzed using the SPSS. For descriptive and comparative analysis parametric and nonparamateric statistics have been used.Results: Women who did not breastfed perceived their baby´s health worse at three years compared with women who did breastfeed. Women with overweight and obesity also perceived the health of their three year old worse than the other maternal group. Conclusions: It´s important to identify women who need support to initiate breastfeeding and give them customized support.

Source: Masters Abstracts International, Volume: 47-01, page: 0343. Adviser: Jacquelyn Slomka. Includes bibliographical references.

Thesis (M.S.)--Florida State University, 2004. / Advisor: Dr. Deborah Frank, Florida State University, School of Nursing. Title and description from dissertation home page (viewed June 17, 2004). Includes bibliographical references.

Thesis (M.N.)--Memorial University of Newfoundland, 2002. / Bibliography: leaves 120-130.

Background: Breastfeeding frequency decrease in Sweden and infants born preterm is a particularly vulnerable group to not be breastfed according to current recommendations. Mothers of preterm infants have an extra need of support from the health care system. Mothers' self-efficacy in breastfeeding affects the outcome of breastfeeding. Health professionals' attitudes to breastfeeding have an impact on the breast feeding support they provide to the mothers.Aim: To investigate whether an intervention could strengthen self-efficacy in breastfeeding among mothers of premature babies. A further aim was to investigate whether the intervention influenced health professionals' attitudes to breastfeeding.Method/Design: An experimental study with quantitative approach in the form of questionnaire survey was conducted. The selection consisted of 14 mothers who were divided into control group and intervention group, in the health professional group the selection was 20 respondents.Results: Health professionals ' attitudes to breastfeeding was significantly more positive after the intervention. Also two statements on the survey demonstrated significantly more positive attitudes to breastfeeding among health professionals. Regarding mothers' breastfeeding self-efficacy no significant difference was detected between the control group and the intervention group.Conclusion: An evidence based intervention influenced the health professionals´ attitudes to breastfeeding. Further research is needed to demonstrate the connection between the intervention and mothers´ self-efficacy to breastfeed premature babies. / Bakgrund: Amningsfrekvensen sjunker i Sverige och prematurfödda barn är en extra sårbar grupp för att inte bli ammade efter rådande rekommendationer och mammor till prematurfödda barn har ett extra stort behov av stöd från hälso- och sjukvården. Mammors tillit till sin förmåga att amma påverkar utfallet av amningen och vårdpersonalens attityder till amning påverkar amningsstödet de ger. Syfte: Att undersöka om en intervention kunde stärka tilliten till att amma hos mammor till prematurfödda barn. Ett ytterligare syfte var att undersöka om interventionen påverkade vårdpersonals attityder till amning. Metod/design: En experimentell studie med kvantitativ ansats i form av enkätundersökning genomfördes. Urvalet bestod av 14 mammor som fördelades i jämförelsegrupp och interventionsgrupp, i vårdpersonalgruppen bestod urvalet av 20 personer. Resultat: Vårdpersonalens attityder till amning var signifikant mer positiva efter interventionen. Även på två påståenden på attitydformuläret visades en signifikant mer positiv attityd till amning hos vårdpersonalen. Gällande mammors tillit till sin förmåga att amma kunde ingen signifikant skillnad påvisas mellan jämförelsegrupp och interventionsgrupp. Slutsats: En evidensbaserad intervention förbättrade vårdpersonalens attityder till amning. Ytterligare forskning krävs för att undersöka om interventionen kan påverka mammors till att amma prematurfödda barn.

In this dissertation, I argue that the maternal body is a chief site of discursive political and cultural struggle over gender, family, and work in a neoliberal America. I consider contemporary discourses of maternity, an aggregate I call maternity culture, as cultural products and rhetorical expressions of the antagonistic arrangements in contemporary capitalism since the neoliberal turn. The complexities of maternity culture discourses can therefore be better understood when they are historicized alongside changing economic and political realities. Using materialist feminism as my primary methodology, I contend that maternity culture discourses express the ethics of neoliberalism including the privatization of social/political responsibility and self-actualization through entrepreneurialism and labor, while simultaneously justifying the intensification of maternal labor and the continued surveillance of women's bodies. I argue that maternity culture discourses are, therefore, rhetorics of reproduction and reproducing rhetorics. That is to say, they are a part of a larger set of discourses about the reproductive function that are themselves caught in the logics of capital that may result in the reproduction of unequal arrangements in material and symbolic life. In order to illuminate how maternity culture operates in neoliberal public life as a reproducing rhetoric, I provide a historical analysis of rhetorics of women's health, and analyze two case studies involving discourses surrounding breastfeeding and natural childbirth, major sites of struggle within maternity culture. / text

Background Vitamin D deficiency is prevalent in many places across the world. Breastfeeding has been suggested to be a significant predictor of vitamin D deficiency during infancy, which is preventable through proper supplementation. However, whether Hong Kong should adopt the international recommendation for supplementation of exclusive breastfed infants is still not yet answered. Objective: To review the available evidence regarding the association between breastfeeding and vitamin D deficiency during infancy, as well as the effectiveness of vitamin D supplementation of breastfed infants as an intervention measure. Methods A total of 5112 potentially relevant articles were searched and identified from MEDLINE (OVID, Pubmed), Science Citation Index Expanded (ISI Web of Science), Cochrane Central Register of Controlled Trials, EMBASE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Chinese database (CNKI) without restriction from inception to July-06-2012. 5065 articles were excluded after the initial scanning of title and abstracts. 36 were subsequently excluded due to methodological issues. A total of 11 studies were included and reviewed by two independent reviewers. Results This review pooled together a total of 1126 exclusively breast-fed infants for less than one year old from 11 studies. The pooled average prevalence of vitamin D deficiency was 54.2%. The association between breastfeeding and vitamin D deficiency during infancy has been reported consistently, and it was found to be one of the strongest predictors of vitamin D deficiency for infants less than one year old. Sunlight exposure, season, and skin pigmentation were also found to be important affecting factors. Supplementation to breastfed infants with the dosages as recommended by American Academy of Pediatrics (AAP) seem to be effective in lifting up the vitamin D levels. Conclusions The Hong Kong Government and relevant health sectors should conduct local epidemiological study to investigate the problem of concern among our breast-fed infants, and seriously consider or evaluate the AAP recommendation of supplementation. / published_or_final_version / Public Health / Master / Master of Public Health

A systematic review and meta-analysis was conducted to evaluate the efficacy of different infant antiretroviral (ARV) prophylaxis regimens for prevention of mother to child transmission (MTCT) of human immunodeficiency virus (HIV) infection in breastfeeding infants who were born to HIV positive mothers but were HIV uninfected at birth. The systematic review of the literature published during January 2000 to April 2012 resulted in ten randomized and controlled clinical studies which met the study inclusion criteria. Two datasets were identified from the ten selected clinical trials. One dataset contains six studies evaluating short-course ARV prophylaxis regimens, and the second dataset contains four studies evaluating short-course versus extended ARV prophylaxis regimens. The odds ratio was used as the effect size to measure the efficacy between two comparative infant ARV prophylaxis regimens. Meta-analyses were conducted to assess the overall (pooled) treatment effect of the two comparative infant ARV prophylaxis regimens of the two datasets. The pooled ARV treatment effect was calculated as a weighted average of the effect estimated in the individual studies. If no heterogeneity was identified, a fixed-effect meta-analysis by the Mantel-Haenszel method was used. The random-effects method was used when there was heterogeneity in the meta-analysis. The inverse-variance method was used in the random-effects method of meta-analysis. Heterogeneity in the meta-analysis was accessed by the Chi-squared (χ2) test and I2 test. The combined sample size of all ten clinical trials was a total of 10,316 breastfeeding infants, and the overall postnatal HIV transmission rate regardless of ARV regimens and the timing of HIV infection status was approximately 8.7%. The overall HIV transmission rates of the short-course ARV prophylaxis regimen groups were 10.3% at 4-8 weeks and 9.0% at 6-9 months, respectively. The overall late postnatal HIV transmission rate (at 6-9 months after birth) was 5.5% in the extended ARV prophylaxis regimen group. The first dataset contains six randomized and controlled studies to evaluate the efficacy outcome (defined as the unadjusted HIV infection status at 4-8 weeks after birth) of two short-course infant ARV prophylaxis regimens, the nevirapine (NVP) regimen and the zidovudine (ZDV) with or without combination of lamivudine (3TC) or NVP regimen. Due to the existence of substantial heterogeneity, a random-effects method was used to test for the overall treatment effect. The results show that there was no significant difference between the two short-course infant ARV prophylaxis regimens (odds ratio:1.07; 95% CI: 0.69-1.66; Z=0.31, p=0.76). The results of the meta-analysis of five comparative short-course versus extended infant ARV prophylaxis regimens from four randomized and controlled clinical trials, demonstrate a favorable efficacy outcome (defined as the unadjusted HIV infection status at 6-9 months after birth), of the extended ARV regimens. There was no heterogeneity found in this dataset. There was a highly significant difference in the overall effect between the two ARV prophylaxis regimens by a fixed-effect model (odds ratio: 1.72; 95% CI:1.45-2.04; Z=0.68, p<0.00001). In summary, there was no significant difference in the overall treatment effect in reducing the early postnatal MTCT of HIV infection by infant short-course regimens of ARV prophylaxis, which include NVP, ZDV and their combination regimens. In comparison with the short-course ARV regimens, the extended ARV prophylaxis further reduced the risk of the late postnatal MTCT of HIV infection in breastfeeding infants. / published_or_final_version / Public Health / Master / Master of Public Health

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