Factors related to exclusive breastfeeding in Thai adolescent mothers: Concept mapping approach.

The advantages of exclusive breastfeeding for the first 6 months are well-known. Unfortunately, adolescent mothers have lower rates of breastfeeding exclusivity and shorter duration of breastfeeding. There is limited evidence regarding exclusive breastfeeding determinants in adolescent mothers. The purpose of this study was to obtain adolescent mother-generated factors related to exclusive breastfeeding at 6 months. A mixed-methods design was conducted through concept mapping. Thirty adolescent mothers aged 15-19 years who had wide range of exclusive breastfeeding experiences brainstormed about specific factors. They then sorted and rated the statements into key clusters. Finally, half of the participants were involved in the interpretation of the mapping results and the creation of pathway diagrams. Data were analysed by multivariate statistics in the Concept System Global MAX program. The results showed that the adolescent mothers brainstormed about 104 statements on the factors related to exclusive breastfeeding at 6 months. These factors can be categorized into the following six key clusters: (a) breastfeeding advantages; (b) facilitating factors and necessary skills; (c) promotion and support needed; (d) community and social influence; (e) internal and external barriers; and (f) key problems in families. The pattern matching provided understanding of how key clusters are important to successful breastfeeding through comparing three groups of exclusive breastfeeding durations. Finally, the relationships of the stated factors were drawn in pathway diagrams. Exclusive breastfeeding experiences among Thai adolescent mothers showed complexity involving multilevel influences of social systems. The promotion of optimal breastfeeding should recognize the influences of both personal and environmental factors.

Comparison of the protein composition of breast milk and the nutrient intake between Thai and Japanese mothers.

This study compared the protein composition of breast milk and the nutrient intake between Thai and Japanese lactating mothers. The breast milk was collected from 15 Thai and 14 Japanese mothers at the fifth day post-partum. Twenty-four-hour dietary records were performed from the second-to-the-fourth day post-partum. The nutrient intake was calculated by using the nutrient content of a food table. The protein composition of the whey was separated by gel electrophoresis and was identified by mass spectrometry and two-dimensional electrophoresis. The results showed that the concentrations of the major protein types in the breast milk were not significantly different between the two groups. The concentrations of the minor protein types varied markedly with the individuals, with higher concentrations in the breast milk of the Thai mothers. There were no significant differences in terms of the energy and protein intake; however, the sources of energy were different. The results indicate that the total protein and lactoferrin concentrations in the breast milk could be predicted by the maternal daily energy and fat intake.

Self-Efficacy in Infant Care Scale: development and psychometric testing.

The Self-Efficacy in Infant Care Scale (SICS) is a self-administered measure to assess maternal judgments about the ability to care for the baby during the first year of life. The SICS was initially composed of 67 items and was tested on 397 Thai mothers with infants < 12 months old. The test demonstrated adequate internal consistency and test-retest reliability. Factor analysis yielded 42 items with five dimensions of self-efficacy in infant care. With an acceptable model fit using confirmatory factor analysis, a final version of the SICS contained 40 items with four dimensions of self-efficacy in infant care: developmental promotion, general health care, safety, and diet. This preliminary test for the psychometric properties revealed that the SICS has potential uses for both research and clinical purposes. However, the model selected must be viewed as tentative; further refinement is suggested.