Factors related to breastfeeding discontinuation between hospital discharge and 2 weeks postpartum

Although breastfeeding is known to be beneficial to both mother and infant, many women encounter barriers to breastfeeding, even after successful breastfeeding initiation, which may put them at greater risk for early cessation of breastfeeding. The objectives of this study were to conduct a secondary analysis of data from a longitudinal study of postpartum depression to (a) examine factors related to very early discontinuation of breastfeeding (at 2 weeks postpartum) following hospital discharge and (b) identify women's reasons for very early cessation of breastfeeding. The results of this study support findings from previous research. Having a perceived support system, whether it is personal or professional, may have an effect on both the initiation and duration of breastfeeding. Educating expectant and new mothers, especially women who encounter multiple barriers and are at risk for very early cessation of breastfeeding, of the benefits of breastfeeding and supporting them in developing efficient techniques and problem-solving skills can help increase the duration of breastfeeding.     

Modified breastfeeding attrition prediction tool: prenatal and postpartum tests

In earlier studies, the Breastfeeding Attrition Prediction Tool (BAPT) demonstrated predictive validity in the postpartum period. The purpose of this study was to compare the effectiveness of a modified version of the BAPT when given in the last trimester (BAPT1) and following delivery (BAPT2) in predicting breastfeeding attrition among 117 women who planned to breastfeed for at least 8 weeks. Subjects completed the BAPT during a prenatal breastfeeding class and again at delivery, and they received a phone call at 8 weeks to determine breastfeeding status. In this study, neither of the two administrations of the BAPT was predictive of breastfeeding status at 8 weeks. Findings here may differ because subjects in the current study were all committed enough to attend breastfeeding class and, thus, varied less on commitment than women in earlier studies. Significant associations were found with level of education and having a close relative who breastfed. To assist the perinatal educator in identifying women most at risk for early cessation of breastfeeding, the use of three questions regarding level of education, family support, and breastfeeding preparation is suggested.     

When Parents Ask ... about Preterm Birth, Breastfeeding Success, Breast Cancer, or Waterbirth

IN THIS COLUMN, THE AUTHOR REVIEWS RESEARCH ON FOUR SEPARATE TOPICS: the prevention of preterm birth, the effect of epidurals on breastfeeding success, the possible protective effect of lactation on breast cancer, and laboring in water. In two separate studies-a multisite study in the United States and a second study from Brazil-natural progesterone was shown to significantly reduce the incidence of preterm birth in women at high risk. A third study conducted in the United Kingdom examined the effect of clindamycin on preventing infection that can lead to preterm birth. A group of studies related to lactation found that early breastfeeding was more successful in women who did not have epidural anesthesia. In a Korean study, the lifetime duration of breastfeeding was associated with a significant reduction in breast cancer. Concerning waterbirth, Swiss researchers found that, when a woman labored in water, she regulated both water temperature and bathing duration to ensure that her body temperature and that of the fetus remained within a normal physiological range.     

A Grandmothers’ Tea: Evaluation of a Breastfeeding Support Intervention

This study’s purpose was to evaluate an intervention to facilitate grandmothers’ knowledge and support of breastfeeding. A pilot study with a quasi-experimental two-group posttest design was used to evaluate whether the intervention made a difference in grandmothers’ knowledge, attitudes, and intent to recommend breastfeeding. The 26 grandmothers in the intervention group attended A Grandmothers’ Tea program; the 23 grandmothers in the control group received written information. The intervention group had greater posttest knowledge scores than the control group but had no significant differences in attitudes or intent. However, a significant difference was evident between the attitude scores of grandmothers who breastfed their infants and of grandmothers who did not breastfeed their infants regardless of receiving the intervention.     

Breastfeeding Prevalence among an Alaskan Inupiat Eskimo Population

Breastfeeding provides valuable immunologic, nutritional, and psychological advantages to infants and is the most desirably complete diet for the infant during the first 6 months of life. The purpose of this exploratory study was to determine the prevalence of breastfeeding in a group of Alaskan Inupiat Eskimos, who live in northern Alaska. A convenience sample of 36 women making up three age cohorts was utilized (women ages 18 to 25, N=11; ages 26 to 40, N=14; ages 41 to 60, N=11). Data collected from these women on their choice of infant-feeding method contributed to measuring the prevalence of breastfeeding. Prevalence was also measured by categorizing the children of these women into three age groups and further classifying them as to how they were fed when they were infants. Statistical analysis was performed utilizing 95% confidence intervals. Results revealed that, in this sample and over the past 20 years, a substantial decline has occurred in the percentage of Inupiat infants exclusively breastfeeding for 6 months or longer. Data also indicated a downward trend in the percentage of mothers between the ages of 26 and 39 who initiate breastfeeding; however, among the mothers aged 18 to 25, data reflected a rising trend.     

Improving Reading Skills in Predominantly Hispanic Title 1 First‐Grade Classrooms: The Promise of Peer‐Assisted Learning Strategies

The purpose of this study was to examine the efficacy of a supplemental peer‐tutoring reading program on phonological and reading fluency skills of first graders (N= 78) who were in predominantly Hispanic Title 1 classrooms. Sixty‐eight percent of the students were Hispanic, all were English speaking. Six classrooms were randomly assigned to either the peer‐assisted learning strategies (PALS) program or a control condition. PALS students participated in a peer‐mediated early literacy intervention three times a week for 20 weeks for a total of 30 hours. Reading fluency measures taken at fall, winter, and spring showed statistically significant differences favoring PALS on phoneme segmentation and nonsense word fluency. Additionally, results analyzed by ethnic subgroups (Hispanic and non‐Hispanic) revealed a differential pattern of response to PALS intervention. Social validity questionnaires reported that teachers and students viewed PALS in a positive light.     

Rhetorical Agency, Resistance, and the Disciplinary Rhetorics of Breastfeeding

Drawing on interviews from a qualitative study, this article extends theorizing about rhetorical agency and resistance by analyzing how breastfeeding advocates and their clients resist medical regulatory rhetoric. The resistant acts that interviewees describe begin with a negotiation of discursive alternatives and subject positions framed by the grid of disciplinary rhetoric about breastfeeding. But in some acts of resistance, breastfeeding women use both discursive and bodily actions to disrupt the intelligibility of this grid and what it deems possible. When such disruption occurs, the results are unpredictable and so must be understood as more than the occupation of preexisting subject positions.     

Story time: not just for children anymore

Sharing breastfeeding stories has enormous value for both teller and listener. In a culture that often misunderstands and devalues breastfeeding and the nursing relationship, stories reduce women's anxiety and insecurity, validate their experiences, reveal the social and cultural roots of these experiences, and illuminate why breastfeeding matters so much to women.     

A review of instruments used to predict early breastfeeding attrition

Few women breastfeed for 6 months or longer, and many who stop breastfeeding do so in the early postpartum period. To increase the number of breastfeeding mothers, health-care providers need to identify women at greatest risk for early breastfeeding attrition. This integrative review describes instruments used to assess breastfeeding in the early postpartum period and reports the results of studies using these tools. The instruments are then evaluated for similarities in variables and usefulness for clinical practice.     

Smoking hygiene: an educational intervention to reduce respiratory symptoms in breastfeeding infants exposed to tobacco

The American Academy of Pediatrics recently removed nicotine from the category of drugs contraindicated during breastfeeding. Little evidence demonstrates that infants exposed to nicotine through breastfeeding experience increased health risks beyond the airborne risks associated with passive smoking. The purpose of this longitudinal, five-week, quasi-experimental pilot study was to determine whether "smoking hygiene," an educational intervention, reduces the frequency of respiratory symptoms experienced by infants whose mothers both smoke and breastfeed. Twenty-nine mother-infant pairs entered the study with 28% dropping out. Of the 21 mother-infant pairs who completed the study, 66% of the nine infants in the control group experienced respiratory illness, compared to 42% of the 12 infants in the intervention group (x2 = .814; p > .05). Thus, the difference was statistically nonsignificant in this small sample, but the trend worsened the anticipated direction. The study demonstrates some of the difficulties of intervening with this group of mothers.     

Childbirth and Breastfeeding Over Three Decades: One Mother's Story

This article describes one mother's selected childbirth and breastfeeding experiences that transpired over the span of three decades. Her story is a source of inspiration and encouragement for breastfeeding mothers and health-care professionals who provide maternity care for today's childbearing women. Furthermore, this personal account reveals that, although breastfeeding support and childbirth services have improved over the past 30 years, more needs to be done to promote positive birth experiences and breastfeeding outcomes.     

Interaction of factors related to lactation duration

Perceived social support and interpersonal dependency were studied as potential factors associated with lactation duration based upon previous breastfeeding experience. Inexperienced breastfeeding mothers perceived more social support than experienced breastfeeding mothers did. Perceived social support was not significantly correlated with lactation duration. An ancillary finding was that women providing a combination of breast milk and human milk substitutes had significantly lower social self-confidence than did mothers providing breast milk exclusively.     

Evaluation of a Practice-Development Initiative to Improve Breastfeeding Rates

The benefits of breastfeeding for infant, mother, family, and community are well recognized, and increasing breastfeeding rates is considered an important health-promotion strategy. Improving breastfeeding knowledge and practice among individuals caring for breastfeeding women is considered an important aspect of this strategy. The practice-development initiative described in this article aimed to improve hospital-based breastfeeding rates through the implementation of The Ten Steps to Successful Breastfeeding. The initiative included the development and implementation of an education program aimed at changing and improving breastfeeding practices. The program was evaluated in three ways: changes in breastfeeding rates at hospital discharge; client preparation for breastfeeding and satisfaction during the postnatal period; and staff knowledge and skills.     

Current studies on two separate topics: breastfeeding postpartum length of hospital stay

IN THIS COLUMN, THE AUTHOR EXAMINES RECENT RESEARCH ON TWO SEPARATE TOPICS: 1) breastfeeding; 2) postpartum length of hospital stay. Recent studies suggest long-term effects of breastfeeding that benefit both mother and infant. Benefits include a reduced risk of breast cancer in breastfeeding mothers and a reduced level of total and LDH cholesterol in adults who were breastfed as infants. Infants of mothers with maternal asthma had lower rates of asthma if the mother breastfed. In a study of women in the United States who planned to breastfeed, those mothers who breastfed exclusively and planned to breastfeed more than three months were more likely to achieve their goals than mothers who planned to combine breast and human-milk substitute feeds and to breastfeed less than three months.In a Canadian study, shortened postpartum stays led to increased re-admission to hospital for mothers with cesarean births. In contrast, in a Massachusetts study, shortened postpartum stays did not lead to an increase in infant visits for urgent care. However, the Massachusetts study did not reflect a decrease in maternity-related costs associated with shortened length of postpartum stay.     

Assessing infant breastfeeding beliefs among low-income mexican americans

Focus groups were conducted with low-income, pregnant women and new mothers receiving services from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program) along with their male partners and their mothers. All participants were Hispanics of Mexican American origin. The topics for the focus-group discussions were breastfeeding beliefs and perceptions. All participants were aware of the benefits of breastfeeding. Participants identified time, embarrassment, and pain as barriers to breastfeeding; discussed decision-making efforts regarding breastfeeding; identified cultural beliefs related to breastfeeding; and discussed the lack of care-provider support for breastfeeding.     

Parenting Teamwork: The Impact of a Fathering Intervention on Mothers and Infants in Vietnam

A multifaceted, relationally focused intervention involving group and individual pre- and postnatal counseling, print resources, and community resources encouraged 390 fathers of newborn infants in Vietnam to responsively support mothers and work with them as a parenting team. Both partners completed questionnaires prebirth and 1-, 4-, and 9-months postbirth on measures of breastfeeding support, exclusive breastfeeding duration, relationship quality, and infant development. Compared to 412 comparison group couples, intervention couples evidenced greater father support, especially in terms of helping and responsiveness to the mother's needs. This support predicted longer exclusive breastfeeding duration, improved relationship quality, and higher levels of infant development at 9 months. Sensitively working together with mothers as a coordinated team enhanced couple's relationship functioning and improved children's developmental outcomes.     

Identifying Health Beliefs Influencing Hispanic College Men's Willingness to Vaccinate against HPV

This study identifies health beliefs influencing Hispanic college men's human papillomavirus (HPV) vaccine uptake decision making processes. Hispanic college men were interviewed about their HPV vaccine knowledge, and information seeking behaviors. Overall, participants did not view HPV infection or vaccination as an immediate concern or priority; belief that it was a virus that only affected women, and a sense of invulnerability informed their positions. Despite these issues, most men were willing to consider getting the HPV vaccine if they received more education from health care providers, and cost concerns were addressed. These findings pointed to gaps in our understandings of Hispanic college men's HPV vaccination beliefs and provided insight into the importance of integrating this population's unique beliefs into campus health providers efforts aimed at increasing vaccination rates.     

Sex and Breastfeeding: An Educational Perspective

Expectant and new parents have many concerns regarding the relationship between sexuality and breastfeeding. How is a new mother''s libido affected by breastfeeding? Why do some women get sexually excited when breastfeeding? Is this frequent or normal? How does the partner feel about breasts full of milk? Why do breasts leak during a woman''s orgasm? Perinatal educators are in a privileged position to reassure these parents about this relationship while promoting the breastfeeding bond between the mother and child and the intimacy bond between the parents.     

Sources of infant feeding information used by pregnant women

Selecting an infant feeding method is one of the most important decisions a mother-to-be makes. Little information is available to characterize women who plan to use both formula and breast milk. In this study, 89 pregnant women indicated their anticipated feeding method and the sources and initiator of infant feeding information. No differences were found in the type of resources used by women who planned to breastfeed, formula feed, or combination feed. Women in the study were four times more likely to initiate a conversation about infant feeding methods with a family member or friend than with a health care provider. Involving these key individuals in perinatal education classes and support programs is a simple, but powerful, strategy that childbirth educators can use to promote breastfeeding.     

Four research findings that will change what we think about perinatal depression

Research by health psychologists is changing what we know about perinatal depression. In this guest editorial, the author examines depression in pregnant and breastfeeding women in light of this recent research and describes four major findings that are influencing how we think about depression in new mothers: inflammation has an etiologic role in depression, a relationship exists between sleep disturbances and depression, breastfeeding protects maternal mental health, and all effective treatments for depression are anti-inflammatory interventions.