Profile of calls to a breastfeeding clinic information and help telephone line

Breastfeeding mothers need orientation and help in order to succeed with breastfeeding. Lack of support from health professionals and societal barriers result in a median duration of breastfeeding in Puerto Rico of only 3 weeks. A telephone warm line at our breastfeeding clinic tries to provide some much-needed support and orientation. The purpose of this study was to determine the principal reasons for calls to the warm line and the action taken by the counselor. Five hundred and thirty three calls were received in a 4-month period. They were handled by certified lactation educators who gathered demographic and feeding information from the mother and registered the action taken. Descriptive analysis was used with crosstabs tables and multi-response analysis; chi-square test was used to establish the association between variables. 78.7 of callers were breastfeeding fully, while 21.3 were breastfeeding partially or formula feeding, 62.8 of the babies were 2 months old or less. 68.8 of the calls originated in the metropolitan San Juan area. The source of the referral was family/friend in 64.2 of calls, while only 9.8 of the callers were referred by a physician, 3.0 by hospital personnel and 2.0 by other health care providers. Significant differences between full breastfeeders and partial or artificial feeders were found in calls related to position (p = 0.01), engorgement (p = 0.04), breast refusal (p = 0.001), product information (p = 0.02), medications (p = 0.009), breastmilk management and storage (p = 0.001), and relactation (p = 0.02). Actions taken by the counselor included orientation, referral to breastfeeding specialist physician and referral to breastfeeding support groups or classes. Results indicate that more active promotion of referral to breastfeeding support groups or classes is warranted since this action was taken in only 14.5 of fully breastfeeding mothers and 12.6 of partial breastfeeding or formula users. Promotion of the warm line among physicians, hospitals and other health care professionals is also needed.

The management of labor and delivery and its implications for breastfeeding

The main professional organizations of obstetrical and pediatric care providers in the United States and Puerto Rico have issued official position papers in favor of breastfeeding. Routine labor and delivery practices, however, constitute frequent barriers for the initiation, type and duration of breastfeeding. Many of these practices, moreover, lack the scientific basis to justify their routine use. We analyze in this article some of the most common obstetrical practices and their impact on breastfeeding.

La lactancia materna en Puerto Rico: patrones tradicionales, tendencias nacionales e estrategias para el futuro / Breast feeding in Puerto Rico: traditional patterns, national trends and future strategies

The Puerto Rican society has gone through profound transformations during the past 50 years. Industrialization and the incorporation of women into the labor force have been accompanied by medicalization of the reproductive process and a progressive reduction in the prevalence of breastfeeding as the cultural norm for nutrition of infants. The data base for 1990 places Puerto Rico significantly below Latin America and the United States in the percentage of reastfed infants. The authors report their experience in the promotion of reastfeeding during the last 5 years. The principal negative factors which inder the beginning and maintenance of successful breastfeeding are of a social nature. The orientation of physicians towards technology underrates the benefits of breastfeeding. The marketing strategies of the corporations which manufacture artificial milk continuously violate the International Code for Marketing of breast Milk Substitutes and disfigure the community's perception on the benefits of breastfeeding. The lack of social and legal support for the breastfeeding working mother frequently prevents her from carrying out successful breastfeeding for the recommended period of time. Strategies are presented for the overturn of the existent barriers which have reduced breastfeeding in Puerto Rico to the present precarious levels