Effect of Obesity and Early Breastfeeding Initiation on Exclusive Breastfeeding Rates.

Objective: To compare the 6-week postpartum, exclusive breastfeeding rates between obese mothers and mothers with a normal body mass index (BMI), with early breastfeeding initiation. Material and Method: The subjects were 415 singleton, postpartum, obese mothers who delivered without complications at the HRH Princess Maha Chakri Sirindhorn Medical Center in the Nakhon Nayok province between the years of 2013 through 2015 and the same number of matched normal body mass index mothers. The early breastfeeding initiation of both the obese mothers and the normal BMI mothers was recorded. The exclusive breastfeeding rates were collected at the second day postpartum. Following discharge, telephone follow-ups were used for the collection of breastfeeding data at the 7th, 14th day and six weeks postpartum. The exclusive breastfeeding rates of the obese mothers were analyzed and compared with the exclusive breastfeeding rates of normal BMI mothers at the 2nd, 7th, 14th day and 6 weeks postpartum. The data was analyzed by Chi-square, relative risk and 95% confidence interval. Results: At the 2nd, 7th, 14th day and 6th week postpartum; the exclusive breastfeeding rates of the obese mothers' group were 94.5, 71.1, 64.8 and 51.3%, respectively. The exclusive breastfeeding rates of the normal BMI mothers' group for the same periods were 95.7, 79.3, 75.4 and 63.1%, respectively. There are statistically significant differences between the exclusive breastfeeding rates of the obese mothers' group and the normal BMI groups at the 7th day, 14th day and 6th week postpartum. In the situation of early breastfeeding initiation, the exclusive breastfeeding rates of the obese mothers at the 2nd, 7th, 14th day and 6th week postpartum were 96.3, 77.0, 71.2 and 58.4%, respectively. The exclusive breastfeeding rates of the normal BMI mothers who had early breastfeeding initiation were 96.2, 81.3, 77.4 and 67.2% at the 2nd, 7th, 14th day and 6th week postpartum, respectively. No significant differences were seen between the two groups in the exclusive breastfeeding rates at the 2nd, 7th and 14th day postpartum. Conclusion: The obesity had negative effect on exclusive breastfeeding rates during six weeks postpartum after mothers' discharge. But the exclusive breastfeeding rates of both the obese and normal BMI mothers were not significantly different during two weeks postpartum in early breastfeeding initiation situation. The obese mothers could be advised about early breastfeeding initiation.

Comparisons of Latching on between Newborns Fed with Feeding Tubes and Cup Feedings.

BACKGROUND: Feeding tubes and cup feedings were used as alternative feedings. There is scant data regarding the facilitation of latching on by newborns with the use of these alternative supporting techniques. OBJECTIVE: The comparison of the latching on of newborns when fed with the additional support of feeding tubes or cup feedings. MATERIAL AND METHOD: The subjects were 120 normal, postpartum women, who delivered without complications at the HRH Princess Maha Chakri Sririndhorn Medical Center in the Nakhon Nayok Province between October 2012 and September 2013. No breast milk was expressed by the mothers at day 2, postpartum. They were divided into two groups by simple randomization. In the first group, the newborns were fed with a feeding tube in support of breastfeeding. In the second group, the newborns were fed by cup feedings. Latch scores were assessed at the end of postpartum day 3. Demographic data and latch scores were collected and analyzed by Chi-square, t-test and Mann-Whitney U test. RESULTS: No differences in the demographic data of mothers and newborns between the two groups were found. Latch scores for the feeding tube group were significantly higher than the latch scores in the cup feeding group (p < 0.05). CONCLUSION: Latching of newborn after feeding tube method is better than latching of newborn after cup feeding.

Teenage pregnancy and exclusive breastfeeding rates.

BACKGROUND: Teenage pregnancy is an important health issue globally and in Thailand Younger age mothers decide on the breastfeeding practices ofthe first 6-month. OBJECTIVE: To find the rates of 6-month exclusive breastfeeding practices of teenage mothers and compare them with the rates of 6-month exclusive breastfeeding practices in mothers who are 20 years of age or more. MATERIAL AND METHOD: Three thousand five hundred sixty three normal, postpartum women, who delivered without complications at the HRH Princess Maha Chakri Sirindhorn Medical Center in the Nakhon Nayok Province between 2010 and2013 were included in this study. At the second daypostpartum, the data of latch scores and the data of the practice of exclusive breastfeeding were collected Telephone follow-ups on the seventh, fourteenth, and forty-fifth postpartum days and at the second, fourth, and sixth month postpartum month were collected and used for exclusive breastfeeding data following discharge. Demographic data included the maternal age, parity, gestational age, marital status, occupation, religion, route ofdelivery, estimated blood loss, body mass index, nipple length, and the childs birth weight. The collected data was analyzed by the t-test, Chi-square, and odds ratio with 95% confidence interval. RESULTS: The percentage of teenage pregnancies was at 14.8% (527 cases). On postpartum day 2, the percentage of latch scores of 8 or less was 66.4%. At the seventh, fourteenth, and forty-fifth day and at the second, fourth, and sixth months postpartum, the exclusive breastfeeding rates were 88.5, 78.5, 57.6, 43.1, 32.9, and27.0%, respectively. Comparison of the 6-month exclusive breastfeeding rates between teenage mothers and mothers 20 years ofage or older were not statistically significant (p<0.05). CONCLUSION: The 6-month exclusive breastfeeding rate of teenage mothers was at 27.0% and had no significant differences from the rates of mothers 20 years of age or more.

Nipple length and its relation to success in breastfeeding.

OBJECTIVE: To find the critical cut-off point of nipple length that facilitates success in breastfeeding. MATERIAL AND METHOD: The subjects were 449 postpartum women, who delivered at HRH Princess Maha Chakri Sirindhorn medical center in Nakhon Nayok province between October, 2010 and March, 2011. Data regarding nipple length and its relation to success in breastfeeding were collected and analyzed by a receiver operating characteristic curve (ROC curve). This is a graphical method of assessing the characteristics of a diagnostic test. RESULTS: The data shows that 7-millimeters in nipple length had been shown to be the cut-off point that facilitates successful breastfeeding. Sensitivity was at 72.5%. Specificity was at 46.2%. The positive predictive value was at 97.8% and the negative predictive value was at 4.9%. CONCLUSION: The cut-off point for nipple length that facilitates successful breastfeeding has been measured at 7 millimeters. Nurses and health personnel may use 7 millimeters of nipple length as a criteria for a successful breastfeeding screening test and give close breastfeeding support if postpartum women have less than 7 millimeters in nipple length.