Professional Lactation Support Staffing in the Hospital Setting

An exploration of optimal hospital IBCLCs staffing ratios is needed to validate historical recommendations and promote positive breastfeeding outcomes.

Breastfeeding in Public: Challenges and Evidence-Based Breastfeeding-Friendly Initiatives to Overcome the Barriers

IntroductionBreastfeeding is the safest mode of infant feeding that is readily available at the right temperature and does not require supplies for its preparation. Despite the many benefits of breastfeeding, it is often challenging for breastfeeding mothers to breastfeed in public.MethodsA review of the literature was undertaken to explore challenges hindering breastfeeding in public and ascertain evidence-based breastfeeding-friendly strategies to overcome those barriers.ResultsMajor barriers to breastfeeding in public include negative public perceptions of breastfeeding, sociocultural barriers, embarrassment/lack of comfort, stigmatization, sexualization of breast, and nonconducive environment in public spaces. Evidence-based strategies to support breastfeeding in public include normalization of breastfeeding in public, increasing the visibility of breastfeeding through social media and public events, empowerment of breastfeeding mothers, positive role modeling, social support, and environmental modifications.ConclusionImplementation of evidence-based and innovative breastfeeding-friendly initiatives are essential to combat challenges surrounding breastfeeding in public spaces.

Confirmatory Factor Analysis and Responsiveness to Change of the Persian Version of the Breastfeeding Self-Efficacy Short Form Scale

IntroductionThe Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) is a 14-item measure designed to assess a mother's confidence in successful breastfeeding of her baby. This study aimed to determine the confirmatory factor analyses (CFA) and responsiveness to change of the Persian version of the BSES-SF.MethodsThis study was performed in two phases: In the first phase, 400 women were recruited, and then in another phase, 110 pregnant women at 35–37 weeks gestation were randomly selected and assigned into two equal groups (n = 55). Educational intervention was implemented, and data were gathered in the third trimester and at 2 weeks postpartum.ResultsThe BSES-SF presented a one-dimensional structure with factor loadings of > 0.40 for CFA and Cronbach's alpha coefficient of 0.92. BSES-SF scores in the intervention group (56.76 ± 4.65) were significantly higher than the control group (48.94 ± 4.85).ConclusionBSES-SF can be a valid, responsive, and reliable measure of self-efficacy in response to breastfeeding challenges.

Exploring the Impact of Offering an Undergraduate Lactation Elective Course as a Strategy for Normalizing Breastfeeding

BackgroundMore breastfeeding interventions targeting female and male undergraduates before they become parents are needed to foster accurate breastfeeding knowledge, positive attitudes toward breastfeeding, and a greater intent to breastfeed. This study aimed to assess the impact of completing a lactation elective course on undergraduates' breastfeeding knowledge, attitudes, and intention.MethodsPre- and postcourse surveys were administered to 96 undergraduates from various majors enrolled in a lactation elective.ResultsFrom pre- to postcourse, this study found significant increases in undergraduates' breastfeeding knowledge, attitudes, and intent.ConclusionsBecause most undergraduates in the United States become parents only after graduation, universities have an opportunity to foster the knowledge and attitudes needed to breastfeed successfully. As breastfeeding knowledge and attitudes in men and women are strong predictors of breastfeeding intent, initiation, and duration, offering undergraduate lactation elective courses is a promising strategy to improve future parents' breastfeeding knowledge, attitudes, and intention, helping to normalize breastfeeding and improve breastfeeding rates.

Chrononutrition and Breast Milk: A Review of the Circadian Variation of Hormones Present in Human Milk

IntroductionBreast milk contains a wide range of hormones, nutrients, and bioactive compounds. Chrononutrition looks at the interaction between food, both meal timing and meal composition, and circadian rhythms.MethodThis review is a continuation on series on chrononutrition and breast milk. All human studies published in English were included regardless of location or year of publication.ResultsThis review identifies the hormonal circadian variation researched in breast milk to date for melatonin, cortisol, cortisone, leptin, and insulin.ConclusionThe circadian variation observed in some hormones reinforces the superiority of breast milk over formula milk. Melatonin has been the most studied, but more research for all the hormones is needed due to various gaps in the literature and varying levels of study quality. There is insufficient evidence to make recommendations specifically targeting the lactating mother, but we identify and recommend several ideas for future research.

Expanding and Sustaining Breastfeeding in the Sick and Premature Babies in Thailand

The clinical guidance for human milk (HM) feeding for sick and premature babies in Thailand was developed in 2013 to help improve their breastfeeding rates.ObjectiveTo expand breastfeeding (BF) for sick and premature babies using the clinical guidance, develop a monitoring system, and to integrate the practice into the national routine newborn care for sick babies.MethodVolunteer tertiary care hospitals were recruited to implement the clinical guidance. The development of a monitoring and evaluation system was done by the multidisciplinary team and volunteer hospitals. The integration into routine national care practice was done by including it in the national neonatal service plan of Thailand.ResultsThirty-eight pilot tertiary care hospitals volunteered for implementing the program. The proposed outcome indicators of rate of exclusive BF sick babies at hospital discharge and at 6 months of life for the volunteer hospitals were 62.97% and 41.76%, respectively. Since its integration into the national service plan in 2019, a total of 98 hospitals have been included in the program.ConclusionThe integration of the clinical guidance into the national service plan is essential for sustaining BF of sick, premature babies in the country.

Patient Satisfaction With a COVID-19 Telehealth Lactation Care Model

ObjectiveThe objective of this study was to determine if patient satisfaction with teleconsults during the COVID-19 pandemic, both with and without corresponding car-side weight measurements, was different from satisfaction with in-person visits prior to the pandemic.MethodsRetrospective descriptive and quantitative analysis was used to examine existing patient satisfaction data collected via email survey from patients who completed at least one in-person visit from March 2019 to February 2020 or at least one teleconsult during April or May 2020.ResultsRespondents reported high levels of satisfaction with teleconsults. Approximately 97% of respondents found teleconsults helpful. Satisfaction with teleconsults during the pandemic, both with and without car-side weight measurements, was similar to satisfaction with in-person visits prior to the pandemic.ConclusionProviding families with teleconsults in conjunction with car-side weight measurements was a successful model for providing lactation services to patients during the COVD-19 pandemic.

Chrononutrition and Breast Milk: A Review of Circadian Variation in Breast Milk Nutrient Composition

ObjectiveThe objective of this literature review was to identify and summarize the current knowledge on the circadian variation of breast milk nutrients and the implications of these findings.MethodA review of literature was conducted, including all relevant studies regardless of location and year of publication.ResultsThe amino acids tyrosine, histidine, aspartic acid and phenylalanine and energy were observed to be higher during the day. Fat and the vitamins B-1, B-2, B-3, B-6, and B-12 were higher at night. Other studies have shown conflicting results or no circadian variation for certain nutrients. Poor reproducibility and small sample sizes affect the quality of existing research.ConclusionMore research is needed, and longitudinal studies would help assess the effect of breast milk chrononutrition on the long-term health outcomes of infants.

Education and Support: Tilting the Scale Toward Exclusive Breastfeeding

The Hispanic population in the United States is growing, and healthcare providers are challenged to design targeted, culturally appropriate programs to improve health outcomes related to breastfeeding.ObjectivesThis study was designed to detect the exclusive breastfeeding (EBF) rate among Hispanic women who chose education plus peer support versus peer support only. In addition, this study further evaluates ¡Tengo Leche!, an educational program previously evaluated in the literature.MethodsThe sample (n = 103) consisted of Hispanic pregnant, low-income, and uninsured women. A two-group quasi-experimental design was used to test the educational intervention combined with peer support (n = 35) versus stand-alone peer support (n = 68). The education-plus group (n = 35) voluntarily participated in the education portion. All participants received the inpatient peer counseling. The participants' breastfeeding intention was gathered through chart review.ResultsEBF at discharge was significantly higher (c2 = 4.51, p = .02) among mothers in the education plus peer support group, who were more likely to be exclusively breastfeeding at discharge (46.7%) versus the peer-support-only group (24.6%).ConclusionsThe outcomes of this study may provide guidance for designing culturally competent interventions with a focus on cost-effective and outcome-driven interventions to increase EBF.