Factors Attributed to Breastfeeding Success in a Tertiary Obstetric Hospital.

Introduction: Increasing breastfeeding rates is a national health objective, however substantial barriers and disparities continue to exist in breastfeeding initiation and continuation. Our study aim is to identify factors associated with birthing persons' breastfeeding "success" (patients admitted to Labor & Delivery desiring to breastfeed and discharged breastfeeding) and breastfeeding "failure" (patients admitted to Labor & Delivery desiring to breastfeed and discharged exclusively formula feeding). Materials and Methods: We conducted a retrospective cohort study between July 2015 and June 2016. Patients were asked infant feeding plan intentions (breast, formula, combination) upon admission for delivery. Feeding plan was reassessed at discharge from delivery stay and validated to serve as proxy for feeding status at discharge. Logistic regression was used to identify the population(s) most likely to voice intent to breastfeed and to identify predictors of altered breastfeeding intent at discharge. Results: Between July 2015 and June 2016, 6690 patients met criteria for analysis. Patients reporting intent to breastfeed before delivery were more likely Caucasian (p < 0.0001), married (p < 0.001), nulliparous (p < 0.01), privately insured (p < 0.0001), educated (p < 0.0001), and older (p < 0.01) compared with patients not intending to breastfeed. These characteristics were similar in those who were "successful breastfeeders," that is, breastfeeding at discharge. The strongest predictor of breastfeeding at discharge was intent to breastfeed before delivery (p < 0.0001). African American race was the strongest predictor of nonbreastfeeding intent at admission (p < 0.0001) and conversion to formula feeding by hospital discharge (p < 0.001). Conclusion: Intent to breastfeed before delivery was the strongest predictor of breastfeeding at discharge; thus, prenatal breastfeeding education within the at-risk population is crucial to increasing breastfeeding rates.

Simulation and theory of flexible equilibrium polymers under poor solvent conditions.

Grand canonical Monte Carlo simulation and simple statistical thermodynamic theory are used to model the aggregation and phase separation of systems of reversibly polymerizing monomers, capable of forming chains with or without the ability to cyclize into rings, with isotropic square-well attractions between nonbonded pairs of monomers. The general trend observed in simulation of chain-only systems, as predicted in a number of published theoretical works, is that the critical temperature for phase separation increases and the critical monomer density decreases with rising polymer bond strength. Introduction of the equilibrium between chains and rings into the theory lowers the predicted critical temperature and increases the predicted critical density. While the chain-only theories predict a vanishing critical density in the limit of complete polymerization, when ring formation is taken into account the predicted critical density in the same limit approaches the density of the onset of the ring-chain transition. The theoretically predicted effect of cyclization on chemical potential is in good qualitative agreement with a subset of simulation results in which chain-only systems were compared with equilibrium mixtures of rings and chains. The influence of attractions on the aggregation number and radius of gyration of chains and rings observed in simulations is also discussed.