Download or read book A Randomized Controlled Trial of an Antenatal Intervention to Increase Exclusive Breastfeeding written by Ka-Lun Wong Cheung and published by Open Dissertation Press. This book was released on 2017-01-27 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation, "A Randomized Controlled Trial of an Antenatal Intervention to Increase Exclusive Breastfeeding" by Ka-lun, Wong Cheung, 黃張嘉倫, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: In Hong Kong, while around 85% of mothers choose to breastfeed their infants, most discontinue within the first one to two months postpartum. This indicates that there is room for improving the current breastfeeding education. A randomized controlled trial was conducted to evaluate the effectiveness of a professional one-to-one antenatal breastfeeding support and education intervention on the exclusivity and duration of breastfeeding. A total of 469 primiparous women who attended the antenatal clinics of two geographically distributed public hospitals in Hong Kong were randomized to receive either standard antenatal care or a one-to-one antenatal breastfeeding support and education session. The primary outcome was the prevalence of exclusive breastfeeding at 6 weeks postpartum. Secondary outcomes were the prevalence of exclusive breastfeeding at 3 and 6 months postpartum, as well as the overall duration of any and exclusive breastfeeding across the first 6 months postpartum. The study had a least 80% power to detect a 50% increase in the rate of exclusive breastfeeding at 6 weeks postpartum. The exclusive breastfeeding rate in the intervention group was 37.8% at 6 weeks postpartum compared with 36.4% in the standard care group (p=0.77; 95% Confidence Interval (CI) -0.08, 0.11). There were no significant differences between the two treatment groups in exclusive breastfeeding rates at 3 and 6 months or in in the overall duration of any (Hazard Ratio (HR) =1.11; 95% CI 0.88, 1.40) or exclusive breastfeeding (HR=0.96; 95% CI 0.79, 1.17). In a setting with a high breastfeeding initiation rate, one-to-one antenatal breastfeeding support and education did not increase the exclusivity or duration of breastfeeding. DOI: 10.5353/th_b5351044 Subjects: Breastfeeding promotion

Download or read book A Randomized Controlled Trial of an Antenatal Intervention to Increase Exclusive Breastfeeding written by 黃張嘉倫 and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book A Randomized Controlled Trial of a Professional Breastfeeding Support Intervention to Increase the Exclusivity and Duration of Breastfeeding written by Chui-Yuk Idy Fu and published by Open Dissertation Press. This book was released on 2017-01-26 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation, "A Randomized Controlled Trial of a Professional Breastfeeding Support Intervention to Increase the Exclusivity and Duration of Breastfeeding" by Chui-yuk, Idy, Fu, 傅翠玉, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Breastmilk is the most natural and complete nutrition for infants, and breastfeeding incurs numerous benefits for both infants and mothers. The World Health Organization recommends that mothers exclusively breastfeed their infants for six months and continue breastfeeding for up to two years of age and beyond. More than 80% of Hong Kong mothers now initiate breastfeeding. However, overall breastfeeding duration remains short and rates of exclusive breastfeeding are low. Premature weaning is influenced by multiple factors, and mothers require additional support from healthcare professionals to overcome various lactation difficulties in the early postpartum period. This study aimed to evaluate the effect of two postnatal professional support interventions on the duration of any and exclusive breastfeeding. We conducted a cluster randomized controlled trial to evaluate the efficacy of in-hospital support and post-discharge telephone support on breastfeeding outcomes among first-time mothers in Hong Kong. Seven hundred and twenty two mother-infant pairs with uncomplicated, full-term pregnancies were recruited from the postnatal units of three large public hospitals. With the hospital as the unit of randomization, participants were allocated to standard care (n=263), in-hospital support (n=191), or post-discharge telephone support (n=268). Mothers in the in-hospital group were given three individualized breastfeeding support sessions during the postnatal hospitalization, with two sessions given in first 24 hours after birth and one the following day, providing lactation knowledge and instructions on breastfeeding techniques. Participants in the telephone group were provided with weekly 30-minute breastfeeding counseling and support sessions for the first four weeks after delivery, with first contact initiated within 72 hours after discharge. The primary study outcomes were the prevalence of any and exclusive breastfeeding at one, two and three months postpartum. Seven hundred (97%) participants completed the six-month follow-up, while eleven had partial follow-up and eleven could not be contacted. The rates of any and exclusive breastfeeding were higher among participants in the two intervention groups at all follow-up points when compared with those who received standard care. Participants receiving the telephone support were significantly more likely to continue any breastfeeding at one month (76.2% vs. 67.3%; OR=1.63, 95% CI 1.10-2.41) and two months (58.6% vs. 48.9%; OR=1.48, 95% CI 1.04-2.10), and to be exclusively breastfeeding at one month (28.4% vs. 16.9%; OR=1.90, 95% CI 1.24-2.91). Participants in the in-hospital support group were also more likely to be breastfeeding at all time points in the first six months but the effect was not statistically significant. Early professional breastfeeding support, especially weekly telephone counseling, significantly increased the rates of any and exclusive breastfeeding in the early postpartum period and significantly increased overall breastfeeding duration in the first six months among first-time mothers. Additional postnatal professional support when given to breastfeeding mothers on a one-to-one basis can improve breastfeeding outcomes. While hospital practices need to be strengthened to further promote and support breastfeeding, more well-designed

Download or read book Global Strategy for Infant and Young Child Feeding written by World Health Organization and published by World Health Organization. This book was released on 2003 with total page 70 pages. Available in PDF, EPUB and Kindle. Book excerpt: WHO and UNICEF jointly developed this global strategy to focus world attention on the impact that feeding practices have on the nutritional status, growth and development, health, and thus the very survival of infants and young children. The strategy is the result of a comprehensive two-year participatory process. It is based on the evidence of nutrition's significance in the early months and years of life, and of the crucial role that appropriate feeding practices play in achieving optimal health outcomes. The strategy is intended as a guide for action; it identifies interventions with a proven positive impact; it emphasizes providing mothers and families the support they need to carry out their crucial roles, and it explicitly defines the obligations and responsibilities in this regards of governments, international organizations, and other concerned parties.

Download or read book Improving Breastfeeding Outcomes written by Karen Ann McQueen and published by . This book was released on 2009 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Breastfeeding is recommended as the optimal source of nutrition for newborns for the first 6 months of life and beyond with the addition of complementary foods. While breastfeeding initiation rates have been increasing, duration rates remain a concern as many women prematurely discontinue due to difficulties encountered rather than maternal choice. In addition, there is a sizable gap between rates of exclusive breastfeeding and current recommendations. Targeting modifiable variables that may be amenable to intervention is one strategy to improve breastfeeding outcomes. One such modifiable variable is breastfeeding self-efficacy. Although research has clearly shown that breastfeeding self-efficacy is predictive of breastfeeding duration and exclusivity, it is unknown whether it can be enhanced to improve breastfeeding outcomes. The purpose of this pilot randomized controlled trial was to examine the feasibility and compliance of a newly developed trial protocol and the acceptability of an intervention to increase breastfeeding self-efficacy in the immediate postpartum period. Secondary outcomes included determining whether there were any trends between groups related to breastfeeding self-efficacy, duration, and exclusivity. Participants included 150 primiparous mothers who were breastfeeding their healthy, full-term infants. Eligible and consenting mothers were randomized to either a control group (standard postpartum care) or an intervention group (standard postpartum care plus the self-efficacy intervention). Participants allocated to the intervention group received three individualized, self-efficacy enhancing sessions with the researcher; two sessions were conducted in hospital, and one was administered via telephone 1 week following hospital discharge. A research assistant blinded to group allocation collected outcome data at 4 and 8 weeks postpartum. The results suggested that the administration of the intervention was feasible and that there was a high degree of protocol compliance; the majority of participants reported that the intervention was beneficial. Secondary outcomes identified that there was a trend among participants in the intervention group to have improved breastfeeding outcomes, including higher rates of breastfeeding self-efficacy, duration, and exclusivity at 4 and 8 weeks postpartum. Preliminary evidence also suggested that the self-efficacy intervention may have assisted to decrease perceptions of insufficient milk supply among the intervention group participants. Overall, the findings from this pilot trial indicated that a larger trial is warranted.

Download or read book Disease Control Priorities Third Edition Volume 2 written by Robert Black and published by World Bank Publications. This book was released on 2016-04-11 with total page 419 pages. Available in PDF, EPUB and Kindle. Book excerpt: The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.

Download or read book Primary Care Interventions to Support Breastfeeding written by Carrie D. Patnode and published by . This book was released on with total page 142 pages. Available in PDF, EPUB and Kindle. Book excerpt: OBJECTIVE: We conducted this systematic review to support the U.S. Preventive Services Task Force (USPSTF) in updating its 2008 recommendation on counseling to promote and support breastfeeding. Our review addressed three questions: 1) What are the effects of prenatal, peripartum, and postpartum individual- and health care system-level interventions to promote and support breastfeeding on child and maternal health outcomes? 2) What are the effects of interventions on the initiation, duration, and exclusivity of breastfeeding? 3) Are there adverse events associated with interventions to promote and support breastfeeding? DATA SOURCES: We performed a search of MEDLINE, PubMed Publisher-Supplied, Cumulative Index for Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, and PsycInfo for studies published between January 1, 2008, and September 25, 2015. Studies included in the original USPSTF review were re-evaluated for inclusion. We supplemented searches by examining bibliographies from retrieved articles and consulting outside experts. We searched federal and international trial registries for ongoing trials. STUDY SELECTION: Two researchers reviewed 2,769 abstracts and 211 articles against the prespecified inclusion criteria. Eligible studies included English-language studies conducted in a developed country that evaluated the effectiveness of an individual- or system-level breastfeeding intervention among pregnant women or mothers of full- or near-term infants. We included randomized or cluster randomized, controlled trials for individual-level interventions and controlled before-after or prospective cohort studies for health system or policy interventions that reported health or breastfeeding outcomes. We conducted dual, independent critical appraisal of all provisionally included studies and abstracted all important study details and results from fair- and good-quality studies. Data were independently abstracted by one reviewer and confirmed by another. DATA ANALYSIS: We narratively synthesized the results for health outcomes and adverse events. For breastfeeding outcomes, we synthesized the results by population (adults separately from adolescents or young adults) and intervention focus (individual- vs. system-level approaches). Because of the small number of system-level interventions, we report those results narratively and do not pool the data. For individual-level interventions, we conducted random effects meta-analyses using the DerSimonian and Laird method and calculated pooled risk ratios (RRs) for breastfeeding initiation and for any or exclusive breastfeeding at postpartum time points of less than 3 months, 3 to less than 6 months, and 6 months. We explored potential effect modification by various population and intervention characteristics, such as intention to breastfeed and intervention type, and timing through stratified analyses and meta-regression. We generated funnel plots and conducted tests for small-study effects for all pooled analyses. RESULTS: We included 52 studies that were reported in 57 publications. Thirty one studies were newly identified while 21 studies were carried forward from the previous review. The included studies were highly variable in terms of the country, study population, intervention and control conditions, specific outcome measures, and timing of measurements. Infant and maternal health outcomes. Six trials reported inconsistent effects of the interventions on a range of infant health outcomes, such as gastrointestinal illness, otitis media, respiratory tract illness, and health care use. None of the studies reported maternal health outcomes. Breastfeeding outcomes. On the basis of 43 trials, breastfeeding support and education interventions targeting individuals were associated with a statistically significant higher likelihood of any and exclusive breastfeeding for less than 3 months and at 3 to less than 6 months compared with usual care among adults. Pooled estimates indicated beneficial associations for any breastfeeding for less than 3 months (RR, 1.07 [95% confidence interval (CI), 1.03 to 1.11]; k=26; n=11,588) and at 3 to less than 6 months (RR, 1.11 [95% CI, 1.04 to 1.18]; k=23; n=8,942) and for exclusive breastfeeding for less than 3 months (RR, 1.21 [95% CI, 1.11 to 1.33]; k=22; n=8,246) and at 3 to less than 6 months (RR, 1.20 [95% CI, 1.05 to 1.38]; k=18; n=7,027). At 6 months, individual-level interventions among adults were associated with a 16 percent higher likelihood of exclusive breastfeeding (RR, 1.16 [95% CI, 1.02 to 1.32]; k=17; n=7,690) but not any breastfeeding. Absolute differences in the rates of any breastfeeding ranged from 14.1 percent in favor of the control group to 18.4 percent in favor of the intervention group. The association between individual-level interventions and breastfeeding initiation was not statistically significant based on the pooled point estimate, but the CI did not rule out potential benefit (RR, 1.00 [95% CI, 0.99 to 1.02]; k=14; n=9,428). There was some suggestion that interventions that took place during a combination of prenatal, peripartum, or postpartum time periods were more effective than those that took place only during one time period. There was no indication of effect modification by other intervention characteristics or by population subgroups. All four trials of individual-level interventions among adolescents or young adults reported higher rates of breastfeeding among intervention versus control group participants. There was limited, mixed evidence from well-controlled studies of an association between system-level interventions and rates of breastfeeding. Adverse events. Two trials among adults reported on adverse events related to a breastfeeding support intervention. One trial found no significant differences between groups in maternal anxiety at 2 weeks. The other reported that a few mothers expressed feelings of anxiety and decreased confidence in their breastfeeding abilities despite breastfeeding going well and therefore discontinued their participation in the peer counseling intervention. LIMITATIONS: There were a number of threats to internal validity within the included studies. Details regarding the measurement of breastfeeding outcomes, sociodemographic and breastfeeding-related population characteristics, and intervention and usual care characteristics were lacking. Our pooled analyses relied on unadjusted breastfeeding rates and did not control for potential confounding. CONCLUSIONS: The body of fair- to good-quality evidence related to primary care interventions to support breastfeeding has nearly doubled since the release of the 2009 USPSTF review and recommendation. The updated evidence confirms that breastfeeding support and education provided by professionals and peers to individual women, regardless of the mother's age, is associated with an increase in the duration of any and exclusive breastfeeding. There are limited well-controlled studies examining the effectiveness of system-level policies and practices on rates of breastfeeding, as well as on child health, and none for maternal health.

Download or read book Infant and young child feeding written by and published by . This book was released on 2009 with total page 99 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Model Chapter on Infant and Young Child Feeding is intended for use in basic training of health professionals. It describes essential knowledge and basic skills that every health professional who works with mothers and young children should master. The Model Chapter can be used by teachers and students as a complement to textbooks or as a concise reference manual.

Download or read book Interventions in Primary Care to Promote Breastfeeding written by Mei Chung and published by . This book was released on 2008 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: CONTEXT: Breastfeeding decreases the risks of many diseases in mothers and infants. About 70 percent of US children have ever been breastfed. Thus, it is important to examine interventions that could promote and support breastfeeding in an effort to increase the breastfeeding rates and impact the public health. OBJECTIVE: To systematically review evidence for the effectiveness of primary care initiated interventions to promote and support breastfeeding. DATA SOURCES: We searched MEDLINE, the Cochrane Controlled Trials Registry, CINAHL, and Cochrane Database of Systematic Reviews for articles from September, 2001 to January, 2007 using the MeSH terms and keywords, such as "breastfeeding", "breast milk feeding", "breast milk", "human milk", "nursing", "lactation", "counseling", and "health education". For additional studies, we also examined the bibliographies in existing systematic reviews. STUDY SELECTION: We identified 21 RCTs, two clustered RCTs, two quasi-RCTs, four controlled, non-randomized studies, two before-and-after experimental studies (Baby Friendly Hospital Initiative (BFHI) only), four prospective observational studies with concurrent or historical (BFHI only) control, and one Cochrane systematic review. Seventeen studies were of good or fair internal validity according to US Preventive Services Task Force (USPSTF) criteria. DATA EXTRACTION: Data elements were abstracted on to standardized forms and included information about the setting, study design, population characteristics, types of interventions, comparators, methods of analyses, loss to followup, breastfeeding outcomes in regards to initiation, duration, and exclusivity, and maternal or infant health outcomes. In addition to assessing the internal validity of the studies, we also assessed the applicability of the studies to the US primary care population. DATA SYNTHESIS: Comparing breastfeeding interventions to the control (usual care): prenatal breastfeeding intervention increased the rate of any short-term breastfeeding (pooled RR: 1.39; 95%CI 1.16-1.67); combination of pre- and postnatal breastfeeding interventions increased both the rate of intermediate and long-term any breastfeeding (pooled RR: 1.15; 95%CI 1.00-1.32, 1.38; 95%CI 1.33-1.43, respectively); postnatal breastfeeding interventions increased the rate of exclusive short-term breastfeeding (pooled RR: 1.21; 95%CI 1.08-1.36); structured breastfeeding education with or without other components increased the rate of any breastfeeding initiation (pooled RR: 1.15; 95%CI 1.02-1.30); individual level professional support with or without other components significantly increased the rate of any intermediate breastfeeding (pooled RR: 1.12; 95%CI 1.02-1.30); lay support with or without other components increased the rate of any short- and long-term breastfeeding (pooled RR: 1.26; 95%CI 1.07-1.48, 1.38; 95%CI 1.00-1.92, respectively) and the rate of short-term exclusive breastfeeding duration (pooled RR: 1.66; 95%CI 1.05-2.56); and BFHI increased the exclusive breastfeeding rates at 3 (43.3% vs. 6.4% (P

Download or read book Impact of Peer Counseling on Exclusive Breastfeeding written by Alex Kojo Anderson and published by . This book was released on 2005 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Breastfeeding Handbook for Physicians written by American Academy of Pediatrics and published by . This book was released on 2013-10-25 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: A complete resource for any health-care professional to provide expectant and nursing mothers with the most current medical advice on breastfeeding and related topics. Contains additional information on supporting breastfeeding mothers and meeting their specific physical and emotional needs.

Download or read book Core Curriculum for Lactation Consultant Practice written by Rebecca Mannel and published by Jones & Bartlett Learning. This book was released on 2008 with total page 793 pages. Available in PDF, EPUB and Kindle. Book excerpt: Core Curriculum for Lactation Consultant Practice, Second Edition allows aspiring and established lactation consultants to assess their knowledge, experience, and expertise in developing an effective study plan for certification. The Second Edition of this text, contributed to by Rebecca Mannel, Patricia J. Martins, and Marsha Walker, has been updated and is the perfect resource to study for the certification exam. This updated resource takes you through the areas that appear in the lactation consultant certification exam administered by the International Board of Lactation Consultant Examiners (ILCA). The comprehensive coverage will allow you to develop an effective plan to optimize your study time. The curriculum also serves as a convenient, evidence-based source for daily reference. Specifically the Second Edition: * Follows the IBLCE exam blueprint, reviewing all topics and areas covered on the lactation consultant certification exam. * Provides a "road map" that allows you to pinpoint areas of particular interest or identified need. * Presents a useful reference for staff development, new staff orientation, and curriculum development. * Presents extensive references to direct you to further study. * Provides extensive references to direct you to further study. * Presents the core knowledge needed to practice as an IBCLC.

Download or read book The Optimal Duration of Exclusive Breastfeeding written by Department of Child and Adolescent Health and published by World Health Organization. This book was released on 2002 with total page 53 pages. Available in PDF, EPUB and Kindle. Book excerpt: The longstanding debate over the optimal duration of exclusive breastfeeding has centered on the so-called "weanling's dilemma" in developing countries: the choice between the known protective effect of exclusive breastfeeding against infectious morbidity and the (theoretical) insufficiency of breast milk alone to satisfy the infant's energy and micronutrient requirements beyond 4 months of age. The primary objective of this review is to assess the effects on child health, growth, and development, and on maternal health, of exclusive breastfeeding for 6 months vs exclusive breastfeeding for 3-4 months with mixed breastfeeding (introduction of complementary liquid or solid foods with continued breastfeeding) thereafter through 6 months.

Download or read book What Mothers Say written by Sharon Bartholomew and published by . This book was released on 2009 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Maternal and Child Nutrition written by Jatinder Bhatia and published by Karger Medical and Scientific Publishers. This book was released on 2013 with total page 258 pages. Available in PDF, EPUB and Kindle. Book excerpt: How to prevent and manage low birth weight Growth and nutrition during the fetal period and the first 24 months after birth are important determinants of development in early childhood. Optimal nutrition and health care of both the mother and infant during these first 1000 days of an infant's life are closely linked to growth, learning potential and neurodevelopment, in turn affecting long-term outcomes. Children with low birth weight do not only include premature babies, but also those with intrauterine growth restrictions who consequently have a very high risk of developing metabolic syndrome in the future. Epidemiology, epigenetic programming, the correct nutrition strategy and monitoring of outcomes are thus looked at carefully in this book. More specifically, two important nutritional issues are dealt with in depth: The first being the prevention of low birth weight, starting with the health of adolescent girls, through the pre-pregnancy and pregnancy stages and ending with lactation. The second point of focus concerns the nutritional follow-up and feeding opportunities in relation to dietary requirements of children with low birth weight.

Download or read book Nutrient Adequacy of Exclusive Breastfeeding for the Term Infant During the First Six Months of Life written by Nancy Felicia Butte and published by . This book was released on 2002-01-01 with total page 47 pages. Available in PDF, EPUB and Kindle. Book excerpt: This review evaluates the nutrient adequacy of exclusive breastfeeding for term infants during the first 6 months of life.

Download or read book Hidden Hunger written by H.K. Biesalski and published by Karger Medical and Scientific Publishers. This book was released on 2016-05-24 with total page 254 pages. Available in PDF, EPUB and Kindle. Book excerpt: Malnutrition caused by deficiencies of vitamins and minerals - also called hidden hunger - impairs both the intellectual and physical development of a child. Due to the absence of clinical symptoms and assessments, no intervention can be staged. The tragedy is that this, in turn, decreases the child’s chance to escape from poverty. This book looks at malnutrition in high-income countries, the nutrition transition and nutritional deficiencies in low-income countries, consequences of hidden hunger, and interventions to improve nutrition security. Written by leading experts in the field, it clearly stresses that national governments and international organizations must make malnutrition one of their top priorities in order to provide children with optimal conditions for a healthy future.