Redes de Apoyo a la Lactancia Materna Exclusiva (RALME). Una aproximación conceptual y caracterización en México / Support Networks for Exclusive Breastfeeding (SNEB). A conceptual approach and characterization in Mexico

Resumen Introducción: Este estudio se centra en la conceptualización y la caracterización gráfica de las Redes de Apoyo a la Lactancia Materna Exclusiva (RALME) en México. Métodos: Mediante un diseño muestral estratificado por entidad federativa con significancia estatal al 95%, se aplicó un cuestionario en línea, a través de Microsoft Forms, a una muestra representativa de 2989 mujeres cuya primiparidad fue en México. El cuestionario se enfocó principalmente en datos sociodemográficos de las madres y en la estructura de sus RALME durante la primiparidad. Resultados: En este trabajo se definen las RALME como redes compuestas mayormente por mujeres, cuya función es compartir conocimientos y experiencias sobre la lactancia, así como ofrecer apoyo emocional y físico a madres lactantes, contribuyendo a fortalecer los lazos afectivos y de cuidado entre las madres y sus recién nacidos. Conclusiones: Para la caracterización de las RALME se utilizó el diagrama de Sankey, revelando que la madre de la primípara es generalmente el nodo principal, lo que resulta en una red con mayor flujo y alcance. Por el contrario, cuando el primer nodo no tiene parentesco con la primípara, las redes tienden a ser más reducidas y con menor flujo.

Abstract Background: This study focuses on the conceptualization and graphical characterization of Exclusive Breastfeeding Support Networks (EBSN) in Mexico. Methods: Through a sample design stratified by federal entity with state significance at 95%, a questionnaire was administered online via Microsoft Forms to a representative sample of 2989 women whose primiparity occurred in Mexico. The questionnaire primarily focused on sociodemographic data of the mothers and the structure of their EBSNs during primiparity. Results: In this work, EBSNs are defined as networks mainly composed of women, whose function is to share knowledge and experiences about breastfeeding, as well as to provide emotional and physical support to breastfeeding mothers, contributing to strengthening the emotional and caregiving bonds between mothers and their newborns. Conclusions: Sankey diagrams were employed for the characterization of EBSNs, revealing that the mother of the primipara is generally the main node, resulting in a network with greater flow and reach. Conversely, when the first node is not related to the primipara, the networks tend to be smaller and with less flow.

LATCH Score for Identification and Correction of Breastfeeding Problems- A Prospective Observational Study

Objective: To determine early breastfeeding problems using LATCH tool, and analyze the impact of breastfeeding supportive measures in improving LATCH score. Methods: This prospective study included all inborn term neonates born at our center between September, 2019 and March, 2020. Breastfeeding problems were identified by LATCH score at 6-12h after birth, and were addressed by the study team providing breastfeeding support, education and training to mothers. LATCH scores were reassessed at 24-48h. Results: Among 400 mother-infant dyads, 399 (99.7%) required support to position the neonate, 190 (47.5%) had poor latch and 52 (13%) had nipple problems during initial assessment. Breastfeeding supportive measures improved the LATCH score [median (IQR) 7 (5,8) vs 8 (8,8) at 6-12 and 24-48 hours, respectively; P <0.001], and reduced the number of mothers with LATCH score <8 [288 (72%) vs 63 (15.8%); P <0.001]. Conclusion: LATCH is a comprehensive yet simple tool to identify breastfeeding problems. Given the high incidence of breastfeeding problems during early postpartum period, systematic assessment of breastfeeding related problems using LATCH tool can help timely intervention and improvement in the breastfeeding technique.

Breastfeeding Education: A Scoping Review

@#The aim of this scoping review was to explore the evidence related to breastfeeding education in postpartum mothers from relevant databases (PubMed, Science Direct, and Wiley). There were nine eligible studies in which all of them used quantitative design. The data was organized into seven themes including targets, materials, methods, media, officers and places, time, and the effect or influence of breastfeeding education. Almost all (8/9) articles informed breastfeeding education targets. There were 5/9 articles that reported the methods, 6/9 articles discussed the media, 8/9 articles talked about the officers and places, 7/9 articles concerned about the time of implementation, and all studies reported the effect of breastfeeding education. Breastfeeding education included at least 5 existing components. Breastfeeding education must be planned properly and must be carried out continuously from the antenatal until the postnatal period.

Support experiences of mothers with breastfeeding problems: A qualitative study

Understanding mothers with problems regarding support is important for planning care, directing interventions, and ensuring the continuity of breastfeeding. This is a qualitative analytic study. Data were collected by using questions about socio-demographic characteristics and semi-structured interview questions. The research sample consisted of 15 mothers who met the participation criteria and volunteered to participate. Most of the mothers stated that they want to be supported when they need it, they want positive support, they do not want to be compared with other mothers and they care about professional support. Social support given without ignoring the feelings and expectations of the woman during the breastfeeding process will positively affect the process. (Afr J Reprod Health 2022; 26[7]: 102-111).

Determinants of fathers’ involvement in breastfeeding practices in Kuala Selangor

@#Introduction: Fathers’ knowledge, attitude, and involvement in breastfeeding practices are crucial factors to determine the success of breastfeeding outcomes such as decision-making on breastfeeding, successfulness of exclusive breastfeeding, and continuation of breastfeeding practices. This study aimed to identify the determinants of fathers’ involvement in breastfeeding practices. Methods: This cross-sectional study involved 203 fathers attending Maternal and Child Health Clinics in Kuala Selangor. Self-administered questionnaires were used to obtain information regarding fathers’ sociodemography, breastfeeding knowledge, attitudes, and involvement towards breastfeeding practices. Results: Mean age of the fathers was 32.1±5.9 years, ranging between 21 to 50 years. Findings showed that majority of the fathers were involved in breastfeeding practices (52.7%; n=107, 57.0±6.2), had fair knowledge in breastfeeding (62.6%; n=127, 13.8±3.2), and showed low attitude towards breastfeeding (68.0%; n=138, 61.9±6.7). Multiple logistic regression analysis revealed factors with significant influence on fathers’ involvement towards breastfeeding practices were: (1) fathers’ breastfeeding knowledge, (2) fathers’ attitudes towards breastfeeding practices, and (3) mode of infant delivery. Conclusion: These significant predictors may help healthcare professionals to establish effective strategies by advocating the role of fathers in the breastfeeding process such as by offering continuous support, active involvement, and effective participation.

Associations of Father’s Breastfeeding Attitude and Support With the Duration of Exclusive Breastfeeding Among First-time Mothers

@#Introduction: Initiating and sustaining breastfeeding are influence by many factors including involvement, attitude and support from the partner. Research on breastfeeding mostly investigate maternal factors, although the father’s behaviour and role may influence the success of breastfeeding. Hence, this study aimed to determine the associations of father’s attitude and support with the duration of exclusive breastfeeding new parents. Methods: The study involved 104 new parents in Kuala Lumpur, Malaysia, recruited at three randomly selected antenatal clinics using purposive sampling. Fathers’ breastfeeding attitude was measured using Iowa-Infant-Feeding-Attitude-Scale, whereas paternal support using Subjective Norms and Paternal-Breastfeeding-Influence-Scale questionnaires. Mothers were asked about breastfeeding practice. Results: Exclusive breastfeeding duration rates at six months was 27.9%. The average score for paternal attitude on breastfeeding was 61.0 ±6.3, indicating father’s positive attitude towards breastfeeding. The mean score of paternal breastfeeding supports for subjective norms surrounding breastfeeding and overall support score were 4.3+0.6 and 4.06+0.6, respectively, demonstrating frequent paternal engaging and support in breastfeeding. Duration of exclusive breastfeeding were positively associated with the paternal attitude (β=0.235, p=0.027) and overall mean score for breastfeeding support (β=2.166, p=0.028), but negatively associated with support strategies score (β= -2.203, p=0.026). Conclusion: Overall, paternal support and positive attitude were associated with breastfeeding duration. It is important to increase public awareness on the important roles of fathers during the breastfeeding process such as emphasizing the husband’s role in supporting their wives to breastfeed, as well as the importance of paternal role in caring the baby, especially among new couples.

Inserção de um grupo virtual na rede social de apoio ao aleitamento materno exclusivo de mulheres após a alta hospitalar / Inclusion of a virtual group in a social support network to exclusive breastfeeding after hospital discharge / Inserción de un grupo virtual en la red social de apoyo a la lactancia materna exclusiva de mujeres después de recibir el alta del hospital

Apesar dos benefícios do aleitamento materno exclusivo para a saúde materno-infantil, sua interrupção precoce ainda é muito frequente. O período após a alta hospitalar é o momento em que a mulher se depara com a maioria das dificuldades, sendo importante fortalecer as ações de apoio à amamentação. Este trabalho teve por objetivo desvelar as contribuições da inserção de uma comunidade virtual na rede social de apoio ao aleitamento materno exclusivo de mulheres após a alta hospitalar. Trata-se de um estudo qualitativo, realizado em um grupo privado da rede social Facebook, gerenciado por profissionais de saúde, utilizando-se como referencial metodológico a Pesquisa Participativa Baseada na Comunidade. O grupo foi um instrumento de promoção de diálogo e interação entre mulheres a partir de experiências contextualizadas com a realidade, propiciando a construção de novas relações interpessoais e ampliando suas redes sociais de apoio.(AU)

Despite the health benefits of exclusive breastfeeding to moms and their children, its early interruption is still quite common. After hospital discharge is the period when women face the most challenges, being important to strengthen breastfeeding support actions. This study aimed at unveiling the contributions of including a virtual community in a social support network to exclusive breastfeeding after hospital discharge. This qualitative study was conducted in a private Facebook group managed by health professionals using a Community-Based Participatory Research as methodological reference. The group was used to foster dialog and interaction among women based on experiences contextualized in the real world, being possible to build new interpersonal relationships and expand their support networks.(AU)

A pesar de los beneficios de la lactancia materna exclusiva para la salud materno-infantil, su interrupción precoz todavía es muy frecuente. El período después de recibir el alta en el hospital es el momento en el que la mujer se depara con la mayoría de las dificultades, siendo importante fortalecer las acciones de apoyo a la lactancia. Este trabajo tuvo el objetivo de desvelar las contribuciones de la inserción de una comunidad virtual en la red social de apoyo a la lactancia materna exclusiva de mujeres después de recibir el alta del hospital. Se trata de un estudio cualitativo, realizado en un grupo privado de la red social facebook, administrado por profesionales de la salud, utilizando como referencial metodológico la Encuesta Participativa Basada en la Comunidad. El grupo fue un instrumento de promoción de diálogo e interacción entre mujeres a partir de experiencias contextualizadas con la realidad, propiciando la construcción de nuevas relaciones interpersonales, ampliando sus redes sociales de apoyo.(AU)

Clínica de lactancia materna en domicilio, intervención integral de apoyo para el éxito del proceso de lactancia / Clinic breastfeeding in home, integral intervention of support for the success of the breastfeeding process

En este artículo se relatará la experiencia profesional en torno a la Clínica de Lactancia en modalidad visita domiciliaria, cuyo propósito es brindar apoyo y acompañamiento a la familia para el inicio, mantención y recuperación de la lactancia, como una estrategia de intervención integral de enfermería. La lactancia materna es una de las mejores inversiones en salud para las personas, sus beneficios y duración en manera exclusiva hasta los 6 meses y luego complementada hasta los 24 meses o hasta que lo deseen, ha sido respaldado por múltiples asociaciones científicas nacionales e internacionales. La clínica de lactancia domiciliaria permite realizar intervenciones de salud en el contexto de la vida cotidiana de las personas, realizar una valoración individual, del binomio y de la familia, considerando aspectos de la salud física, psicológica, afectiva, social y contextual que pudieran estar influyendo en el fenómeno de la lactancia. Parte del éxito de una clínica de lactancia domiciliaria, está en el lazo terapéutico de confianza que se pueda formar entre la enfermera(o) consultora en lactancia y la familia, pero especialmente con la madre, quien que se encuentra en un proceso de adaptación a su nuevo rol. Desde nuestra experiencia profesional como enfermeras, podemos contribuir al cuerpo de conocimientos propios de la disciplina en lo relacionado a los cuidados de la madre y su hijo(a) en periodo de amamantamiento.

This article describes the experience of nurses delivering Nursing Clinics within a home visit modality. The purpose of this service is to provide support and company to the newborn's family for the initiation, maintenance and recovery of breastfeeding, as a comprehensive nursing intervention. Breastfeeding is one of the best investmentsin health for people. Its benefits for the newborn and the mother have been supported by multiple national and international scientific associations, which have highlighted its exclusivity up to six months of age and then its continuation as complementary of solids up to 24 months of age. Nursing clinics at home allow for situated health interventions according to people's everyday lives; for carrying out individual, binomial and family assessments, considering aspects of physical, psychological, emotional, social and contextual health that may impact upon the experience of breastfeeding. Part of the success of a nursing clinicat home, relies upon the therapeutic relationship of trust and rapport that can be developed between the nurse (or consultant in breastfeeding) and the family, but especially upon the one developed with the mother, who is in a process of adaptation to her new role. From our professional experience as nurses, we can contribute to the body of knowledge of the discipline in relation to the care of the mother and her child during breastfeeding.

Benefits of a Dedicated Breastfeeding Facility and Support Program for Exclusive Breastfeeding among Workers in Indonesia / 대한소아소화기영양학회지

PURPOSE: A mother's working environment is believed to be a major determinant of exclusive breastfeeding (EBF) practice. We aimed to define the influence of a facility dedicated to breastfeeding and a breastfeeding support program at the workplace on breastfeeding practice. METHODS: A cross-sectional study was performed in five workplaces. The inclusion criteria were female workers whose last child was between 6 and 36 months old. Observational data were obtained and a questionnaire was filled out. The World Health Organization definition for EBF was used. RESULTS: Data from 186 subjects (74 office workers and 112 factory workers) were collected. Just over half (52%) of the mothers were between 20 and 46 years old, 75.3% had graduated from high school and university, 12.9% had more than two children and 36.0% owned a house. The prevalence of EBF during the last 6 months was 32.3%. A proper dedicated breastfeeding facility was available for 21.5% of the mothers, but only 7.5% had been in contact with a breastfeeding support program. The presence of a dedicated breastfeeding facility increased EBF practice almost threefold, by an odds ratio (OR) of 2.74 and a 95% confidence interval (CI) of 1.34-5.64 (p<0.05). Knowledge of the breastfeeding support program increased EBF practice by almost six times (OR, 5.93; 95% CI, 1.78-19.79) (p<0.05). CONCLUSION: Our findings suggest that Governments should make it obligatory for employers to offer a breastfeeding support program and a dedicated breastfeeding facility at the workplace as these simple measures significantly increase EBF.

Breastfeeding pattern in mothers who had problems in breastfeeding.

Objective: The main purpose of this study was to determine the exclusive breastfeeding rate in mothers who had problems in breastfeeding and were closely taken care by the well-trained breastfeeding team. The second purpose was to define the causes of non-exclusive breastfeeding. The third purpose was to compare the exclusive breastfeeding rate with the previous study of routine postpartum care. Methods: A prospective observational study was conducted. From January to July 2005, there were 4,344 mothers delivered at Siriraj Hospital. 847 of them, mothers (19.5%) had the problems in breastfeeding, therefore, they were cared and supported to breastfeed their babies by well-trained clinicians either at a service ward or at a Lactation clinic. To obtain the data of method of feeding and the problems in breastfeeding, the subjects were contacted by phone during 7 days, 1, 4 and 6 months postpartum period. Results: The rates of the exclusive breastfeeding in 7 days, 1, 4 and 6 months during postpartum period in this study were 84.6%, 76%, 41% and 27.7%, respectively. The important problems of the breastfeeding were tongue tie of the infants and the short maternal nipples (57.5% and 31.6%, respectively). Compared with the previous study, in this study, breastfeeding lasted longer and had a higher rate. Conclusion: Successful breastfeeding would be achieved if mothers receive the continuous support from the care team and their families in detecting and solving the problems of breastfeeding in early period.

Information and Social Support Regarding Breastfeeding: A Survey of Mothers in Seoul, South Korea / 간호학회지

BACKGROUND: Pediatric societies throughout the world recommend breastfeeding as the optimal form of infant nutrition. This recommendation is based on extensive epidemiologic research that documents the health, developmental, psychological, social, economic, and environmental benefits to infants, mothers, families, and society. The purpose of this study was to examine breastfeeding information and emotional support received by mothers prenatally, hospital breastfeeding practices, and the relationship between information and support received and breastfeeding initiation and planned feeding method post discharge from the hospital. METHODS: A 36-item questionnaire was distributed during the Spring 2000 to mothers who delivered babies at maternity centers in Seoul, South Korea. A sample of 52 mothers was surveyed at the time of hospital discharge. The questionnaire was developed based on the literature and reviewed by experts including internationally board certified lactation consultants, a nutritionist, and perinatal nurses. The survey instrument consists of five components: sociodemographic information, breastfeeding information received by mothers prenatally, emotional support regarding the mothers' infant feeding choice, breastfeeding initiation and supplementation, and hospital breastfeeding practices. RESULTS: Fifty-two breastfeeding mothers at three hospitals completed the survey. The majority of the mothers were 26 to 35 years of age, college graduates, married, had uncomplicated vaginal or planned cesarean deliveries, and primiparas. Forty-nine mothers responded that they decided to breastfeed during their pregnancy. Mothers reported that the information they received during pregnancy was provided primarily by their mothers, or friends and other relatives. The majority of mothers reported that others influenced their infant-feeding decision. Forty mothers reported receiving emotional support for their infant feeding choice during their pregnancy with mothers or mothers-in-law and friends providing the greatest support. DISCUSSION: Women obtain information prenatally about breastfeeding from many sources-family, friends, written materials, prenatal classes, and health care professionals. There are benefits and drawbacks to information received from multiple sources. Additionally, research has shown that a woman's infant-feeding decision is affected by the type of professional and social support the mother receives. Postpartum professional support for new breastfeeding mothers encompasses multiple dimensions ranging from a follow-up telephone call from the hospital nursing staff to referral to a community resource. Prenatal breastfeeding education on a community-wide basis can provide essential information for future mothers, families, and community support networks. Additional research needs to be done exploring the impact of prenatal, postpartum, and post-discharge support for women on breastfeeding initiation and duration rates.