ABSTRACT
BACKGROUND: The current breastfeeding initiation rate in Canada is approximately 87%. By one month, about 21% of women have stopped breastfeeding. Engorgement and edema in breast tissue can lead to breastfeeding challenges which may contribute to early weaning. The aims of this pilot research study were to explore the relationship between intrapartum intravenous fluids given to mothers and postpartum breast swelling in the first 10 days postpartum and to determine if a larger study was warranted and feasible. METHODS: A prospective, longitudinal, observational cohort pilot study with repeated measures and a within-subjects design was completed. Participants were first time mothers who have a single, healthy newborn and had a spontaneous vaginal birth. Daily data collection from admission into the study until postpartum day 10 took place. Descriptive statistics are reported and linear regression analysis was used to model the relationship between IV therapy and postpartum breast edema. RESULTS: Women who received intravenous fluids during labour had higher levels of breast edema postpartum and rated their breasts as firmer and more tender than women who did not receive intravenous fluids. Participants who had intravenous fluids described patterns of fullness that appeared to be related to edema as opposed to fullness associated with engorgement and lactogenesis II. CONCLUSIONS: The findings demonstrate that mothers in this pilot study who received intravenous fluids in labour and postpartum had higher levels of breast edema. These results suggest a larger study is warranted to more fully examine the effects of intravenous fluids on postpartum breast swelling.
ABSTRACT
BACKGROUND: Infant feeding categories, often referred to as breastfeeding definitions, form the basis to describe infant feeding patterns; especially, breastfeeding duration and degree of breastfeeding exclusivity. Researchers use a variety of algorithms and no validated tool exists to measure feeding patterns for research purposes. The goal of this research project was to develop and test a tool to measure patterns of infant feeding for breastfeeding and lactation research. METHODS: We used a literature review, survey methods, and statistical analysis to develop and test this health measurement tool. The work was completed in three phases: 1) development of the tool; 2) assessment of content validity with a panel of experts; and 3) testing for inter-rater reliability by comparing the conclusions of 2 independent research assistants (RAs) and by comparing mothers' feeding diaries with the RAs' findings. For the third phase, an a priori analysis determined we needed to recruit 75 participants. Inclusion criteria were women who had given birth to a single healthy newborn, planned to breastfeed and were able to breastfeed freely, were able to read and write in English or French, were willing and able to maintain a weekly feeding diary for 6 weeks and to answer 6 English telephone questionnaires (twice within 24 hrs x 3 times over 6 months. To measure inter-rater reliability, we used intraclass correlation coefficient. RESULTS: THE FINAL TOOL, THE FEEDCAT TOOL, CONTAINS TWO PARTS: 1) questions asked to determine what and how the baby was fed and 2) a chart to indicate the feeding category for each time point and recall period. We recruited 75 breastfeeding mothers to measure inter-rater reliability. Inter-rater reliability for classification of feeding categories by the two RAs and for agreement between the RAs' findings at 1 month and mothers' diaries at 4 weeks indicated excellent agreement. CONCLUSION: We produced a feeding categories tool that can be used by researchers to describe the type, amount, and mode of feeding, and we tested the tool for content validity and reliability. Researchers should consider The FeedCat Tool for lactation and research projects requiring data about infant feeding patterns.
ABSTRACT
BACKGROUND: The aim of this paper is to examine how breastfeeding is defined for research purposes. DISCUSSION: Current breastfeeding definitions focus on the amount of breast milk an infant receives and do not encompass how a baby is fed. Our concerns are that key variables are not measured when mothers are pumping or expressing their milk and bottle feeding. It seems the breastfeeding relationship is not considered in the definition. CONCLUSION: While we appreciate the implications of full versus partial breastfeeding in research studies, we also believe the method of infant feeding to be significant. Researchers should develop new definitions.
ABSTRACT
Research ethics guidelines do not provide sufficient direction for breastfeeding and human lactation studies. This article presents the principles of consent for research studies and discusses rationales for who should consent for infants in lactation and breastfeeding research studies.
