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The World Health Organization and the United Nations International Children's Emergency Fund recommends that mothers and newborns have skin-to-skin contact immediately after a vaginal birth, and as soon as the mother is alert and responsive after a Caesarean section. Skin-to-skin contact can be defined as placing a naked infant onto the bare chest of the mother. Caesarean birth is known to reduce initiation of breastfeeding, increase the length of time before the first breastfeed, reduce the incidence of exclusive breastfeeding, significantly delay the onset of lactation and increase the likelihood of supplementation. The aim of this review is to evaluate evidence on the facilitation of immediate (within minutes) or early (within 1 h) skin-to-skin contact following Caesarean section for healthy mothers and their healthy term newborns, and identify facilitators, barriers and associated maternal and newborn outcomes. A range of electronic databases were searched for papers reporting research findings published in English between January 2003 and October 2013. Seven papers met the criteria. This review has provided some evidence that with appropriate collaboration skin-to-skin contact during Caesarean surgery can be implemented. Further evidence was provided, albeit limited, that immediate or early skin-to-skin contact after a Caesarean section may increase breastfeeding initiation, decrease time to the first breastfeed, reduce formula supplementation in hospital, increase bonding and maternal satisfaction, maintain the temperature of newborns and reduce newborn stress. [ABSTRACT FROM AUTHOR]

This review aimed to identify interventions to promote breastfeeding or breast milk feeding for infants admitted to the neonatal unit. The medical electronic databases were searched for papers listed between 1990 and June 2005 which had breastfeeding or breast milk as an outcome and which targeted infants who had been admitted to a neonatal unit, thus including the infant and/or their parents and/or neonatal unit staff. Only papers culturally relevant to the UK were included resulting in studies from the USA, Canada, Europe, Australia and New Zealand. This search was updated in December 2007 to include publications up to this date. We assessed 86 papers in full, of which 27 ultimately fulfilled the inclusion criteria. The studies employed a range of methods and targeted different aspects of breastfeeding in the neonatal unit. Variations in study type and outcomes meant that there was no clear message of what works best but skin-to-skin contact and additional postnatal support seemed to offer greater advantage for the infant in terms of breastfeeding outcome. Galactogogues for mothers who are unable to meet their infants’ needs may also help to increase milk supply. Evidence of an effect from other practices, such as cup-feeding on breastfeeding was limited; mainly because of a lack of research but also because few studies followed up the population beyond discharge from the unit. Further research is required to explore the barriers to breastfeeding in this vulnerable population and to identify appropriate interventions to improve breastfeeding outcomes. [ABSTRACT FROM AUTHOR]

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Aim: This paper integrates clinical expertise to earlier research about the behaviours of the healthy, alert, full-term infant placed skin-to-skin with the mother during the first hour after birth following a noninstrumental vaginal birth.Method: This state-of-the-art article forms a link within the knowledge-to-action cycle, integrating clinical observations and practice with evidence-based findings to guide clinicians in their work to implement safe uninterrupted skin-to-skin contact the first hours after birth.Results: Strong scientific research exists about the importance of skin-to-skin in the first hour after birth. This unique time for both mother and infant, individually and in relation to each other, provides vital advantages to short- and long-term health, regulation and bonding. However, worldwide, clinical practice lags. A deeper understanding of the implications for clinical practice, through review of the scientific research, has been integrated with enhanced understanding of the infant's instinctive behaviour and maternal responses while in skin-to-skin contact.Conclusion: The first hour after birth is a sensitive period for both the infant and the mother. Through an enhanced understanding of the newborn infant's instinctive behaviour, practical, evidence-informed suggestions strive to overcome barriers and facilitate enablers of knowledge translation. This time must be protected by evidence-based routines of staff. [ABSTRACT FROM AUTHOR]

The way mothers feed their babies is, internationally, the subject of research, health policy initiatives, and popular discussion, which commonly affirm the mantra ‘breast is best’. On one level, this mantra reflects scientific evidence about nutrition and maternal and infant health. From a socio-cultural perspective, the pro-breastfeeding message has, however, been considered an aspect of morality, which influences maternal identity in important ways. This article explores this idea. It does so primarily by reporting and discussing some findings from a study about British mothers’ experiences of using formula milk for infant feeding. The paper begins by contextualising this discussion by briefly outlining some aspects of the construction of infant feeding as a social problem in Britain, focusing in particular on the influence of ‘the new paradigm of health’. [ABSTRACT FROM AUTHOR]

Exclusive breastfeeding for the first 6 months of life offers the recommended best start in the life for a newborn baby. Yet, in Australia only a small number of babies receive breast milk exclusively for the first 6 months. Reasons for the introduction of formula milk are multi‐factorial including access to appropriate support and the woman's experience of breastfeeding. The language and practices of health professionals can impact upon how a woman feels about breastfeeding and her breastfeeding body. One aspect of breastfeeding support that has had scarce attention in the literature is the language used by health professionals to describe the behaviour of the breastfeeding infant during the early establishment phase of breastfeeding. This paper reveals some of the ways in which midwives, lactation consultants and breastfeeding women describe the newborn baby during the first week after birth. The study was conducted at two maternity units in New South Wales. Interactions between midwives and breastfeeding women were observed and audio recorded on the post‐natal ward and in women's homes, in the first week after birth. The transcribed data were analysed using discourse analysis searching for recurring words, themes and metaphors used in descriptions of the breastfeeding baby. Repeated negative references to infant personality and unfavourable interpretations of infant behaviour influenced how women perceived their infant. The findings revealed that positive language and interpretations of infant breastfeeding behaviour emerged from more relationship‐based communication. [ABSTRACT FROM AUTHOR]

This research describes the proportion of children in four low‐ and middle‐income countries with adequate dietary practices at 6, 12, 18 and 24 months of age and how these practices changed over time using the World Health Organisation and UNICEF's infant young child feeding (IYCF) indicators. The associations between the IYCF indicators and anthropometric z‐scores from 6 to 24 months, and between the IYCF indicators and the family care indicators (FCIs) at 24 months are described. This was a longitudinal study of offspring from participants in the Women First Preconception Maternal Nutrition Trial conducted in Sud‐Ubangi, Democratic Republic of Congo; Chimaltenango, Guatemala; Belagavi, North Karnataka, India; and Thatta, Sindh Province, Pakistan. The frequency of the minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum adequate diet (MAD) increased between 6 and 24 months, but even at 24 months MAD remained below 50% at all sites. MDD (β = 0.12; 95% CI = 0.04−0.22) and MMF (β = 0.10; 95% CI = 0.03−0.17) were positively associated with length‐for‐age z‐score at 24 months. All IYCF indicators were positively associated with mean total FCI score: MDD (proportion ratio [PR] = 1.04; 95% CI = 1.02−1.07), MMF (PR = 1.02; 95% CI = 1.01−1.04), MAD (PR = 1.05; 95% CI = 1.02−1.08). Although there are multiple barriers to young children having an adequate diet, our results support a positive association between familial interactions and improved IYCF feeding practices. Key messages: Minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum adequate diet (MAD) increased from 6 to 24 months of age, but MAD remained below 50% frequency at all sites at 24 months.MDD and MMF were positively associated with length‐for‐age z‐scores at 24 months.The total family care indicator score was positively associated with all three infant young child feeding indicators at 24 months. [ABSTRACT FROM AUTHOR]

This paper presents a new conceptual model that generates predictions about breastfeeding decisions and identifies interactions that affect outcomes. We offer a contextual approach to infant feeding that models multi-directional influences by expanding on the evolutionary parent-offspring conflict and situation-specific breastfeeding theories. The main hypothesis generated from our framework suggests that simultaneously addressing breastfeeding costs and benefits, in relation to how they are interpreted by mothers, will be most effective. Our approach focuses on contributors to the attitudes and commitment underlying breastfeeding outcomes, beginning in the prenatal period. We conclude that some maternal-offspring conflict is inherent with the dynamic infant feeding relationship. Guidance that anticipates and addresses family trade-offs over time can be incorporated into breastfeeding support for families. [ABSTRACT FROM AUTHOR]

Purpose: Improving the duration of exclusive breastfeeding is a national and international priority. Insufficient milk supply is one of the most commonly cited reasons for early cessation or decreased exclusivity in women who have initiated breastfeeding. This paper is an integrative review of current research pertaining to perceived insufficient milk (PIM). Design and Methods: CINAHL, MEDLINE, and PubMed were searched combining “human milk” and “milk supply” and “perceived milk supply.” Articles were limited to original research studies related to healthy, full-term breastfeeding dyads conducted over the past 10 years. Critical review indicated robust findings, limitations, and gaps in this body of literature. Findings: A lot of women discontinue breastfeeding during the first few weeks of the post-partum period because of PIM and approximately 35% of all women who wean early report PIM as the primary reason. Many women utilize infant satisfaction cues as their main indication of milk supply and many researchers, clinicians, and breast-feeding women do not evaluate actual milk supply. The relationships between PIM and socioeconomic or demographic variables as well as early breastfeeding behaviors have not been adequately addressed in the literature. Conclusions: Recommendations include improvement of maternal education about behaviors to ensure adequate supply, assessment of milk supply, and infant cues as well as further research into the root causes of PIM. Clinical Relevance: Practitioners involved with maternal child health can improve their care of women and infants by understanding the subjective nature and questionable accuracy of PIM and changing assessment of milk supply. [ABSTRACT FROM AUTHOR]

Australia has high initiation rates of breastfeeding, but the challenges of establishing and maintaining breastfeeding in the first few months of infant life result in many women changing to artificial formula feeding. This paper reports on the impact of a new strategy to improve breastfeeding duration rates in the first 8 weeks post-partum. The Earlybird Program (EBP) combines the professional expertise of child and family health (C&FH) nurses with the expertise of the participating mothers to support each other in establishing breastfeeding in the first 8 weeks. This retrospective study compared the breastfeeding patterns of first-time mothers who attended the EBP, with the breastfeeding patterns of mothers who accessed individual appointments with the nurses in a 12-month period, and examined the predictors of continued breastfeeding at 8 weeks. The total sample comprised 193 infant records. Women who selected the EBP were more likely to be employed and less likely to be categorized as non-English speaking background. These women also had more visits to the C&FH service. Logistic regression was used to determine the factors associated with breastfeeding cessation at 8 weeks post-natal. After adjusting for variables, only exclusive breastfeeding at first visit and attending the EBP were significant predictors of continuing to breastfeed at 8 weeks. Facilitation skills that recognize the expertise of participating women were considered an important aspect of the programme. [ABSTRACT FROM AUTHOR]

The protection, promotion and support of breastfeeding has now become a major international priority as emphasized in the Global Strategy for Infant and Young Child Feeding. Health practitioners, such as midwives, nurses and doctors, have a key role to play in providing support to breastfeeding women. This paper provides a critical discussion of educational requirements of health practitioners to equip them for their supportive role. The effective integration of embodied, vicarious, practice-based and theoretical knowledge requires opportunities for deep critical reflection. This approach should facilitate personal reflection and critical engagement with broader socio-political issues, thus allowing for collective understandings and change. Practitioners also need to understand breastfeeding as a biopsychosocial process that is dynamic, relational and changes over time. Recommendations are outlined with regards to multidisciplinary undergraduate education; mentorship schemes with knowledgeable role models supporting student practitioners; involvement of voluntary and peer supporters; post-registration education; setting of national standards for breastfeeding education; tailored education for specific groups; designated funding; and involvement of breastfeeding specialists. [ABSTRACT FROM AUTHOR]

The insistence that breast feeding confers unique and significant benefits upon children underpins both health policy and professional practice and is part of the context in which women decide how to feed their babies and, in turn, how they display and defend their decisions. This paper applies a framework, drawn from the sociology of deviance, to the accounts which women give of their infant feeding intentions. It draws upon data from a longitudinal qualitative interview study of the food choices made by mothers on behalf of their infants and young children, to show how such choices are irreducibly moral and that the ways in which women can be judged, or indeed judge themselves, to be deviant are legion. However mothers decide to feed their babies, infant feeding is a highly accountable matter. Whether they intend to breast feed or formula feed, women face considerable interactional challenges as they seek to establish that they are not only good mothers but also good partners and good women. [ABSTRACT FROM AUTHOR]

Since their arrival in Britain most Vietnamese mothers have abandoned traditional infant feeding practices for 'modern' methods which are unsatisfactory and expensive. Health staff are not perceived as a source of information or support. This paper emphasizes the need for culturally sensitive initiatives to reverse this trend. [ABSTRACT FROM AUTHOR]

This paper outlines an ethological study of the development of infant feeding. Firstly, a framework for analyzing the practice of infant feeding is presented from which five sources of faulty feeding and possible infant obesity are identified. Then there is a discussion of the research design which attempts to disentangle the various contributions of environmental, developmental and constitutional factors. This focuses on the infant's feeding behaviour and mother-infant interaction during feeding, and the appropriate observational methods developed by ethologists are described. Finally data from a part of the study concerned with early food regulation and the mother's concept of feeding are presented. It appears that at 3 days of age bottle fed babies are having more to eat than breast fed babies, that mothers are muddled about demand feeding and that mothers who are breast feeding are probably overemphasizing the psychological aspects of the feeding environment. [ABSTRACT FROM AUTHOR]

This paper reports on two male infants with abnormally high levels of serum triacylglycerols (>15.00  mmol/l) and massive accumulation of chylomicrons. Pathological lipidograms were observed during breastfeeding only and were typical of a  rare chylomicronaemia syndrome. Laboratory abnormalities were detected accidentally in the otherwise healthy infants. An unrecognized modulating factor in fresh mother's milk caused transitory decreased activity of hydrolytic complex for chylomicrons and very-low-density lipoproteins, probably due to a dysfunction of lipoprotein lipase. The normalization of lipidograms suggested that the catalytic activity of lipoprotein lipase rapidly recovered after weaning. Pathogenesis moved more towards an immune disorder, to the production of (auto)antibodies against a component of the lipolytic system. Mother's milk should be substituted with banked donor human milk, but this is not an unambiguous demand. Conclusion: Fresh mother's milk caused a decrease in the activity of lipolytic enzyme (lipoprotein lipase). The massive hypertriacylglycerolaemia quickly disappeared after weaning. Two infants with this transient chylomicronaemia syndrome were asymptomatic. [ABSTRACT FROM AUTHOR]

The article focuses on the research findings conducted to women who do breastfeeding. It has been showed that the number of women who performs breastfeeding declines because of factors which includes cultural trends, fashion and professional lack of involvement. It has also shows that societal attitude to breastfeeding results in organizational and employment arrangements which embarrass women and promotes the health giving effects of breastfeeding.

Presents a response to a criticism on an article about maternal attitudes as a stronger predictor of infant feeding choice than sociodemographic factors. Discussion on an alleged failure of the authors to include parental infant feeding attitudes in multivariate analysis model; Maternal sociodemographic characteristics considered in the paper.

This study investigated the association between maternal smartphone use during breastfeeding and the quality of mother–infant interactions and maternal visual responsiveness to the infant's bids for attention. We observed 13 mother–infant dyads and video‐recorded breastfeeding under the experimental (smartphone use) and control (no smartphone use) conditions on separate days. To evaluate the quality of mother–infant interactions between the two conditions, we used the Japanese revised version of the Assessment of Mother–Infant Sensitivity (AMIS) scale. The mothers' visual responses to their infants' bids for attention were categorized into two groups. In this study, although smartphone use clearly increased distracted feeding times, we found no significant associations between maternal smartphone use and the quality of mother–infant interactions or bonding during breastfeeding. However, smartphone use during breastfeeding was found to interfere with the mother's ability to respond visually to the infant's bid for her attention. The results of this study can be applied while developing resources regarding smartphone use for nursing mothers. [ABSTRACT FROM AUTHOR]

Background Breastfeeding/breastmilk feeding of infants in neonatal units is vital to the preservation of short- and long-term health, but rates are very low in many neonatal units internationally. The aim of this review was to evaluate the effectiveness of clinical, public health and health promotion interventions that may promote or inhibit breastfeeding/breastmilk feeding for infants admitted to neonatal units. Methods Systematic review with narrative synthesis. Studies were identified from structured searches of 19 electronic databases from inception to February 2008; hand searching of bibliographies; Advisory Group members helped identify additional sources. Inclusion criteria: controlled studies of interventions intended to increase breastfeeding/feeding with breastmilk that reported breastmilk feeding outcomes and included infants admitted to neonatal units, their mothers, families and caregivers. Data were extracted and appraised for quality using standard processes. Study selection, data extraction and quality assessment were independently checked. Study heterogeneity prevented meta-analysis. Results Forty-eight studies were identified, mainly measuring short-term outcomes of single interventions in stable infants. We report here a sub-set of 21 studies addressing interventions tested in at least one good-quality or more than one moderate-quality study. Effective interventions identified included kangaroo skin-to-skin contact, simultaneous milk expression, peer support in hospital and community, multidisciplinary staff training, and Unicef Baby Friendly accreditation of the associated maternity hospital. Conclusions Breastfeeding/breastmilk feeding is promoted by close, continuing skin-to-skin contact between mother and infant, effective breastmilk expression, peer support in hospital and community, and staff training. Evidence gaps include health outcomes and costs of intervening with less clinically stable infants, and maternal health and well-being. Effects of public health and policy interventions and the organization of neonatal services remain unclear. Infant feeding in neonatal units should be included in public health surveillance and policy development; relevant definitions are proposed. [ABSTRACT FROM AUTHOR]

The study examined the training needs of paediatricians and general practitioners (GPs). Respondents rated their competence on 23 breastfeeding support skills, importance of update in the next 2 years, actual and potential helpfulness of different forms of professional updates, and accessibility in the next 2 years. The perception of organizational barriers to breastfeeding support and practitioners’ knowledge of policies and guidance on breastfeeding were also examined. The sample comprised 120 paediatricians and 57 GPs. Response rates were estimated as between 4% and 29%, depending upon the method of recruitment. Although both groups rated themselves as fairly competent in most of the skill areas, they welcomed training in key areas of practice. Paediatricians identified more areas for update than GPs ( t = 3.44; d.f. = 178; P < 0.00001). Those who believed that they were less competent in clinical skills were least likely to seek update ( r = 0.35; P < 0.00001). Practical forms of training were most often welcomed. Only 47% of GPs and 62.5% of paediatricians had access to a local breastfeeding policy. There were evident gaps in knowledge on key aspects of public health policy, which could influence local practice; for example, 50.8% of GPs and 47.5% of paediatricians identified a younger age for introducing solids than the minimum according to current government guidance. Organizational barriers to breastfeeding support were experienced by all respondents. Recommendations include purposively targeting training to those least likely to seek training, and developing effective self-study and observational methods of learning. All training should be evaluated and implemented alongside breastfeeding policies and clinical leadership to improve the practice of all healthcare practitioners. [ABSTRACT FROM AUTHOR]

Bottle‐fed infants are at higher risk for rapid weight gain compared with breastfed infants. Few studies have attempted to disentangle effects of feeding mode, milk composition and relevant covariates on feeding interactions and outcomes. The objective of the present study was to compare effects of breastfeeding directly at the breast versus bottle‐feeding expressed breast milk on feeding interactions. Mothers with <6‐month‐old infants (n = 47) participated in two counterbalanced, feeding observations. Mothers breastfed their infants directly from the breast during one visit (breast condition) and bottle‐fed their infants expressed breast milk during the other (bottle condition). Masked raters later coded videos using the Nursing Child Assessment Parent–Child Interaction Feeding Scale. Infant intake was assessed. Mothers self‐reported sociodemographic characteristics, infant feeding patterns (i.e. percentage of daily feedings from bottles) and level of pressuring feeding style. Mother and infant behaviours were similar during breast and bottle conditions. Percent bottle‐feeding moderated effects of condition on intake (P = 0.032): greater percent bottle‐feeding predicted greater intake during the bottle compared with breast condition. Effects of feeding mode were not moderated by parity or pressuring feeding style, but, regardless of condition, multiparous mothers fed their infants more than primiparous mothers (P = 0.028), and pressuring feeding style was positively associated with infant intake (P = 0.045). Findings from the present study do not support the hypothesis that feeding mode directly impacts dyadic interaction for predominantly breastfeeding mothers and infants, but rather suggest between‐subject differences in feeding experiences and styles predict feeding outcomes for this population. [ABSTRACT FROM AUTHOR]

The World Health Organization recommends deworming to reduce soil‐transmitted helminth (STH)‐attributable morbidity in women of reproductive age, including pregnant and lactating women, to reduce blood loss, iron deficiency anaemia and nutrient malabsorption. This study assessed the impact of maternal postpartum deworming with albendazole approximately 1 day after delivery on infant milk intake among a subset of 216 randomly selected mother–infant pairs recruited into a large trial in Peru. Infant milk intake was measured using the deuterium‐oxide method at 1‐ and 6‐month postpartum. Maternal STH infection was measured at 6‐month postpartum. At 1‐month postpartum, mean intake was 756 ± 16 and 774 ± 18 mL day−1 in the albendazole and placebo groups, respectively (mean difference: −18 mL day−1; 95% CI: −65, 30). At 6‐month postpartum, mean intake was 903 ± 16 and 908 ± 18 mL day−1 in the albendazole and placebo groups, respectively (mean difference: −5 mL day−1; 95% CI: −52, 43). There was no statistically significant difference in milk intake between groups at either time point. At 6‐month postpartum, mothers infected with Trichuris trichiura had infants with higher milk intakes (adjusted mean difference: 70 mL day−1; 95% CI: 20, 120) compared with uninfected mothers. However, there was no statistically significant difference in infant milk intake between mothers who had moderate‐and‐heavy intensity infection compared with the comparison group (mothers with no and light intensity infection). A lower prevalence and intensity of infection, and inclusion of uninfected mothers in both arms of the trial, resulting in effect dilution, may explain the null findings. [ABSTRACT FROM AUTHOR]

Breastfeeding, as a unique behavior of the postpartum period and an ideal source of nourishment, is profoundly impacted by the physiology and behavior of both mothers and infants. For more than three‐quarters of a century, there has been an ongoing advancement of instruments that permit insight into the complex process of latching during breastfeeding, which includes coordinating sucking, swallowing, and breathing. Despite the available methodologies for understanding latching dynamics, there continues to be a large void in the understanding of infant latching and feeding. The causes for many breastfeeding difficulties remain unclear, and until a clearer understanding of the mechanics involved is achieved, the struggle will continue in the attempts to aid infants and mothers who struggle to breastfeed. In this review, the history of development for the most prominent tools employed to analyze breastfeeding dynamics is presented. Additionally, the importance of the most advanced instruments and systems used to understand latching dynamics is highlighted and how medical practitioners utilize them is reported. Finally, a controversial argument amongst pediatric otolaryngolo gists concerning breastfeeding difficulties is reviewed and the urgent need for quantification of latching dynamics in conjunction with milk removal rate through prospective controlled studies is discussed. [ABSTRACT FROM AUTHOR]

The effects of Cesarean delivery on father-infant and mother-infant interaction were studied in a sample of 30 Swedish, two-parent families with a full-term healthy first-born infant. Fifteen infants were delivered vaginally, and 15 infants were delivered under full anesthesia by Cesarean section. The infants and parents were observed at home when the infants were 3 and 8 months old. The findings indicate that mothers of infants delivered by Cesarean section treated less positively when they saw their infants for the first time and encountered more difficulties breastfeeding than did mothers of vaginally delivered infants. At 3 months post-partum, fathers of infants who were Cesarean-delivered participated in a greater amount of caregiving activities. There were no differences between Cesarean and vaginally delivered mothers at 3 months after delivery, At 8 months, there were no differences between the two groups (Cesarean and vaginal) on either the interview questions or on any of the behavioral measures. Results from this study do not support reports from the USA of long-lasting effects of Cesarean delivery on parent-infant interaction. The results suggest the need to study cultural variations that surround Cesarean section delivery so as to understand in what way the subsequent parent-infant relationship is influenced by this event. [ABSTRACT FROM AUTHOR]

The author discusses the legitimate functions and affirmed benefits of breastsleeping which is beneficial to infants. It cites that sleep position, pacifier use, and drug or alcohol use are risk factors for the sudden infant death syndrome (SIDS). The article also presents epidemiological, laboratory and observational data as evidence that mother's presence and skin to skin contact with infants is not a risk of SIDS.

Breastfeeding has many health benefits for the mother and infant. Women who are breastfeeding may require anaesthesia or sedation. Concerns regarding the passage of drugs into breast milk may lead to inconsistent advice from professionals. This can sometimes result in the interruption of feeding for 24 hours or longer after anaesthesia, or expressing and discarding ('pumping and dumping') breast milk; this may contribute to early cessation of breastfeeding. However, there are data regarding the transfer of most anaesthetic drugs into breast milk. We advise that breastfeeding is acceptable to continue after anaesthesia and should be supported as soon as the woman is alert and able to feed, without the need to discard breast milk. We provide evidence-based information on the pharmacokinetics of drugs commonly used during anaesthesia so that professionals can undertake a risk-benefit discussion with the woman. We advise the development of local policies that aid logistical planning and guide staff to facilitate breastfeeding during the woman's hospital stay. [ABSTRACT FROM AUTHOR]

Unlabelled: Infant-mother bodily contact is believed to be the species-typical pattern of immediate postpartum child care. Mothers and newborns engage in mutually beneficial interactions. Maternal odours stimulate breastfeeding activity and are implicated in individual recognition. Conclusion: Skin-to-skin contact and exposure to maternal odours facilitate infants' adaptation to the early postnatal environment. [ABSTRACT FROM AUTHOR]

This article is a discussion of the recently emerging critique of pro‐breastfeeding discourses in academic literature, and what this means for midwives and other professionals who find themselves promoting breastfeeding because of professional expectations or indeed workplace policies. Various strands in the debate are explored, starting with dominant and familiar 'evidence' and descriptions of breastfeeding and breastmilk that are carried through to international policies that advocate breast over formula feeding. We then consider evidence predominantly from social science literature that has found some women's experiences of infant feeding to be at variance with the dominant pro‐breastfeeding ideology. We argue that midwives and others delivering maternity care are the means to deliver the policy aspirations contained in the World Health Organization (WHO, 2018) Baby Friendly Hospital Initiative document that makes selective positive claims about breastfeeding without adequately considering its potential drawbacks. We conclude that although the benefits of breastfeeding tend to be exaggerated in promotional material, on balance the weight of evidence still favours breast over formula feeding. We challenge the charge that breastfeeding jeopardises women's financial position by arguing that it is not breastfeeding per se that impacts negatively on women's economic prospects, but rather the way in which society is socially organised. [ABSTRACT FROM AUTHOR]

Objective: Knowledge of the breastfeeding swallow is limited by practical challenges. Radiation exposure to both mother and infant and the radiolucent properties of breastmilk make videofluoroscopy an unsuitable imaging modality. Furthermore, ultrasound is not ideal for capturing the complex 3‐dimensional functional anatomy of swallowing. In this study we explore the feasibility of using real‐time MRI to capture the breastfeeding swallow. Methods: Prospective observational study: Review of imaging from 12 normal infants (<5 months of age) and their mothers while breastfeeding using real‐time MRI. Results: Static images were successfully captured in 11 infants and dynamic images in nine infants. This imaging modality confirms the dorsal surface of the infant's tongue elevates the maternal nipple to the hard palate, closing the space around the nipple with no air visible in the oral cavity during sucking and swallowing. We obtained dynamic imaging of mandibular movement with sucking, palatal elevation and pharyngeal constriction with swallowing, diaphragm movement with breathing and milk entering the stomach. Breastmilk was easily visualized, being high intensity on T2 sequences. Technical challenges were encountered secondary to infant movement and difficulties acquiring and maintaining midsagittal orientation. The similarity in tissue densities of the lips, tongue, nipple and hard palate limited definition between these structures. Conclusion: Real‐time MRI imaging was successful in capturing dynamic images of the breastfeeding swallow. However, technical and practical challenges make real‐time MRI unlikely at present to be suitable for swallow assessment in clinical practice. Advances in technology and expertise in dynamic image capture may improve the feasibility of using MRI to understand and assess the breastfeeding swallow in the near future. Level of evidence: 4. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding rates are typically low for women with a substance‐use disorder. This is despite the specific benefits of breastfeeding to alleviate the severity of neonatal abstinence syndrome and the well‐documented generic advantages. This study explored the feasibility of in‐hospital, tailored breastfeeding support for the substance‐exposed mother and baby. Methods: This was a mixed‐methods feasibility study undertaken in Scotland from April 2014 to May 2015. Women with a substance‐use disorder either received standard Baby‐Friendly Initiative care only or were given additional support which included a dedicated breastfeeding support worker, personalized capacity‐building approach, and a low‐stimuli environment for 5 days. Feasibility outcome measures were maternal recruitment, satisfaction and acceptability of support, breastfeeding on fifth postnatal day, and severity of neonatal abstinence syndrome. Results: Fourteen mother‐infant dyads participated. Intervention participants demonstrated higher rates of continued breastfeeding and reported a greater degree of satisfaction with support and confidence in their breastfeeding ability. Maternal experience of health care practices, attitudes, and postnatal environment influenced their perceptions of breastfeeding support. Breastfed infants were less likely to require pharmacotherapy for neonatal withdrawal and had a shorter hospital stay. Conclusions: The findings highlight the feasibility of tailored breastfeeding support for the substance‐exposed mother and baby and endorse the promotion and support of breastfeeding for this group. Future research should include a statistically powered randomized controlled trial to evaluate clinical efficacy. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Previous research has established population variation in anti‐inflammatory immunological biomarkers in human milk. This immunity is potentially ecology‐dependent and may alter the life history trade‐off between growth and maintenance in infants. The current study has two aims: (1) to assess the ecological differences in milk immunity in two populations, one from the urban U.S. and one from rural Kenya; and (2) to test the hypothesis that milk immunity can affect infant growth indicators. Materials and Methods: Kenyan Ariaal (n = 233) and U.S. (n = 75) breastfeeding mother‐infant pairs participated in a cross‐sectional study at two separate field sites. Laboratory analysis was performed on milk for the anti‐inflammatory biomarkers TGF‐β2, sTNF‐αRI, sTNF‐αRII, and IL‐1ra using ELISA. Multiple imputation was used to extrapolate data below the limit of detection before multivariate analysis. Results: There were significant differences between U.S. and Kenyan mothers on all four milk biomarkers, with Kenyan mothers having significantly higher sTNF‐αRI and sTNF‐αRII and lower TGF‐β2 and IL‐1ra than U.S. mothers. U.S. mothers with higher milk TGF‐β2 and IL‐1ra have infants that are significantly longer and heavier for their age, while Kenyan mothers with higher sTNF‐αRI have significantly longer and heavier infants for their age, and those with higher TGF‐β2 have marginally significantly longer infants. Discussion: There were significant differences in ecological milk immunity between U.S. and Kenyan mothers. These differences potentially play a role in the growth of their infants. Further research in milk immunity should consider the possibility of shared maternal–infant life histories. [ABSTRACT FROM AUTHOR]

Background. Although there is a lack of strong evidence for the association between ankyloglossia in newborns and impaired breastfeeding, screening for ankyloglossia using the Neonatal Tongue Screening Test (NTST) is mandated by law in Brazilian maternities. Aim. To assess the reliability and validity of the NTST. Design. cohort study; baseline sample comprised 268 mother-newborn dyads. At follow-up, 169 mothers were contacted by telephone. Interviews with the mothers for data collection were performed up to 48 h and at 1-3 months after childbirth. Trained and calibrated personnel performed the oral examinations of the newborns. Thirty newborns were examined for inter-reproducibility assessment. Results. Of the 268 newborns included, 212 had a lingual frenulum that could be visually inspected and their NTST scores ranged from zero to nine (mean = 2.0, ± 2.0). Interexaminer reproducibility was acceptable (Intraclass correlation coefficient = 0.77). Internal consistency of the NTST was poor (Cronbach's alpha = 0.28). Construct validity was investigated through the association between NTST scores and difficulties in breastfeeding at baseline and follow-up, and infants' weight gain at follow-up (mean age 32 ± 6.7 days). No statistically significant associations were found. Conclusion. NTST is neither reliable nor valid for detecting ankyloglossia that may interfere with breastfeeding in newborns. [ABSTRACT FROM AUTHOR]

Background Mothers with intellectual disability are less likely than mothers without intellectual disability to breastfeed their infants, but there is little literature that addresses infant-feeding decisions among this population. This study explores experiences of mothers with intellectual disability in making and carrying out infant-feeding decisions. Methods Using a phenomenological approach, in-depth interviews were conducted with four mothers with intellectual disability. Results Analysis focused on making and carrying out infant-feeding decisions. Three sub-themes of making infant-feeding decisions emerged: being familiar with benefits of breastfeeding, owning the initial decision and preparing for infant-feeding. Two sub-themes of carrying out infant-feeding decisions transpired: facing challenges and receiving support. Conclusions The prenatal period was a crucial time for the mothers regarding infant-feeding decisions. It is the time in which they felt the most decision-making power, yet opportunities to prepare for possible challenges were missed. [ABSTRACT FROM AUTHOR]

A medical report is presented on the Survey of healthcare professional and parental experience in accessing support for breastfeeding during an acute hospital admission. The article mentions about the advantages Breastmilk to infants and mothers as well as promoting the formation of the parental bond; and breastmilk should be the preferred choice of feed for infants, and with current guidelines from the World Health Organization (WHO).

Purpose The purpose of this article is to analyze the concept of maternal autonomy in the context of breastfeeding and propose a clearer definition of the concept. Methods A concept analysis was undertaken using Walker and Avant's eight-stage approach. Findings The concept analysis suggests that maternal autonomy in the context of breastfeeding refers to a mother's ability to make autonomous decisions using her control, agency, independence, and ethical reasoning. The antecedents are maternal competence, availability of support, nature of the setting, and available alternatives with respect to breastfeeding. The consequences are improvement in child health, maternal-child bonding, breastfeeding decisions, and maternal healthcare-seeking behavior. Conclusions A clearer understanding of maternal autonomy in the context of breastfeeding will guide the development of a conceptual framework and expand nursing knowledge development. Clinical Relevance A clearer definition of the concept of maternal autonomy in the context of breastfeeding will guide clinicians, researchers, and policy makers in protecting, promoting, and supporting breastfeeding globally towards achieving the United Nations Sustainable Development Goals, 2015-2030. [ABSTRACT FROM AUTHOR]

Unlabelled: Instinctive behaviours have evolved favouring the mother-infant dyad based on fundamental processes of neurological development, including oral tactile imprinting and latchment. Latchment is the first stage of emotional development based on the successful achievement of biological imprinting. The mechanisms underpinning imprinting are identified and the evolutionary benefits discussed.Conclusion: It is proposed that the oral tactile imprint to the breast is a keystone for optimal latchment and breastfeeding, promoting evolutionary success. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is widespread; yet research is thin and equivocal regarding its potential adverse effects on infant feeding practices. With a national sample of 3552 mothers and infants aged 180 days or younger from the 2005–2006 National Family Health Survey for India, we used logistic regression to estimate the unadjusted and adjusted associations of maternal reported lifetime exposure to any IPV and to physical or sexual IPV with feeding practices at birth and in the prior 24 h. Compared with their unexposed counterparts, mothers exposed to any IPV and to any physical or sexual IPV had higher adjusted odds of giving their infant liquids [aOR 1.32, 95% confidence interval (CI) 1.04–1.66; aOR 1.37, 95% CI 1.08–1.75, respectively], and thus lower adjusted odds of exclusively breastfeeding their infant in the prior 24 h (aOR 0.78, 95% CI 0.62–0.98; aOR 0.74, 95% CI 0.58–0.95). Mothers exposed to physical or sexual IPV also had higher adjusted odds of feeding their infant solids in the prior 24 h (aOR 1.50, 95% CI 1.01–2.23). Exposure to IPV was not significantly associated with breastfeeding immediately after birth or with bottle feeding in the prior 24 h. Perinatal screening for IPV, and addressing IPV and feeding practices in exposed mothers, may improve maternal health and infant nutrition in similar settings. [ABSTRACT FROM AUTHOR]

Infants of mothers of low educational background display consistently poorer outcomes, including suboptimal weaning diets. Less is known about the different causal pathways that relate maternal education to infants' diet. The present study aimed to test the hypothesis that the relationship between maternal education and infants' diet is mediated by mothers' diet. The analyses included 421 mother–infant pairs from the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program. Dietary intakes were collected from mothers when infants were aged 3 months, using a validated food frequency questionnaire relating to the past year, and in infants aged 9 months using 3 × 24‐h recalls. Principal component analysis was used to derive dietary pattern scores, based on frequencies of 55 food groups in mothers, and intakes of 23 food groups in infants. Associations were assessed with multivariable linear regression. We tested the product ‘ab’ to address the mediation hypothesis, where ‘a’ refers to the relationship between the predictor variable (education) and the mediator variable (mothers' diet), and ‘b’ refers to the association between the mediator variable and the outcome variable (infants' diet), controlling for the predictor variable. Maternal scores on the ‘Fruit and vegetables’ dietary pattern partially mediated the relationships between maternal education and two infant dietary patterns, namely ‘Balanced weaning diet’ [ab = 0.11; 95% confidence interval (CI): 0.04; 0.18] and ‘Formula’ (ab = −0.08; 95%CI: −0.15; −0.02). These findings suggest that targeting pregnant mothers of low education level with the aim of improving their own diet may also promote better weaning diets in their infants. [ABSTRACT FROM AUTHOR]

Aim Bed-sharing with an infant is controversial due to the increased risk of sudden unexpected death in infancy versus postulated benefits of the practice such as enhanced breastfeeding and maternal-infant bonding. This study evaluated the association between bed-sharing and maternal-infant bonding. Methods Four hundred randomly selected mothers who had delivered in a large maternity unit in Auckland and whose infants were between the ages of 6 weeks and 4 months were sent a postal questionnaire asking about their bed-sharing practices last night, usually, and in the last 2 weeks. Included in the questionnaire were factors 1 and 2 questions from the Postpartum Bonding Questionnaire to assess maternal-infant bonding. Results Responders totalled 172 (43%), and infants were a mean age of 11 weeks. Fourteen per cent of infants slept in a bed-sharing situation last night, 8% usually, and 41% had slept with an adult in the last 2 weeks. Nine per cent of mothers scored above the cut-off for factor 1 for impaired maternal-infant bonding. Infants of these mothers were more likely to bed-share last night, usually, and in the last 2 weeks, and were less likely to use a pacifier and to breastfeed. Bed-sharing mothers scored more highly on individual questions relating to being annoyed or irritated by their baby. Conclusion There is an inverse association between bed-sharing and maternal-infant bonding, which is contrary to the often expressed belief that bed-sharing enhances maternal-infant bonding. [ABSTRACT FROM AUTHOR]

Aim This study aims to examine the influence of formula milk promotion via the media from Thailand to Lao People's Democratic Republic ( PDR), where a cultural and linguistic proximity are shared. Methods A cross-sectional study was conducted through a structured questionnaire survey and focus group discussion ( FGD) with mothers who had children under 2 years of age and lived in Vientiane Capital, Lao PDR. Multivariate logistic regression models were constructed for quantitative data analysis. Content analysis was used for qualitative data analysis. Results Among infants aged 6-23 months, exclusive breastfeeding ( EBF) rate for 6 months was 16.1% ( n = 106/658). Among infants aged 0-5 months, 17.6% ( n = 61/346) was exclusively breastfed at the time of survey (24 h recall). Of 1022 mothers, 89.9% reported frequent exposure to the Thai media's promotion of formula milk through TV commercials and 79.1% identified TV commercial as influential for them to develop a positive attitude towards the use of formula milk. In multivariate logistic regression analyses, mothers who reported a positive attitude towards Thai TV commercial on the formula use ( n = 449) were approximately 75% less likely to practice EBF for 6 months than those who reported a negative attitude ( n = 64). FGD further revealed that the participants tend to believe in the information in TV commercial for formula milk. Conclusion The promotion of formula milk via media from Thailand negatively affects breastfeeding mothers in Lao PDR. Cross-border impacts of promoting formula milk should be addressed globally. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore from the Middle-Eastern mothers' perspective, the experience of breastfeeding and their perceptions of attributes of the health care system, community and society on their feeding decisions after migration to Canada. New immigrant mothers from the Middle East ( n = 22) were recruited from community agencies in Edmonton, Canada. Qualitative data were collected through four focus groups using an ethnographic approach to guide concurrent data collection and analysis. Survey data were collected on socio-demographic characteristics via pre-tested questionnaires. All mothers, but one who was medically exempt, breastfed their infants from birth and intended to continue for at least 2 years. Through constant comparison of data, five layers of influence emerged which described mothers' process of decision making: culture/society, community, health care system, family/friends and mother-infant dyad. Religious belief was an umbrella theme that was woven throughout all discussions and it was the strongest determining factor for choosing to breastfeed. However, cultural practices promoted pre-lacteal feeding and hence, jeopardising breastfeeding exclusivity. Although contradicted in Islamic tradition, most mothers practised fasting during breastfeeding because of misbeliefs about interpretations regarding these rules. Despite high rates of breastfeeding, there is a concern of lack of breastfeeding exclusivity among Middle-Eastern settlers in Canada. To promote successful breastfeeding in Muslim migrant communities, interventions must occur at different levels of influence and should consider religious beliefs to ensure cultural acceptability. Practitioners may support exclusive breastfeeding through cultural competency, and respectfully acknowledging Islamic beliefs and cultural practices. [ABSTRACT FROM AUTHOR]

It is well established that breast milk is the ideal food for infants and that breastfeeding has short- and long-term health benefits for the mother and child. However, there is variation in breastfeeding patterns between populations. Women's work is thought to influence breastfeeding patterns and timing of supplementation and it is often assumed that women in subsistence-oriented societies can more easily integrate their productive and reproductive activities. This article reports longitudinal data, collected in three rounds ( resguardo [<40 days], peak [2-4 months], and late [14-16 months] lactation), on breastfeeding structure, infant care, and work patterns of 17 rural Amazonian women in an effort to understand how breastfeeding structure and maternal time allocation changed over time, as well as the strategies women used to integrate their productive and reproductive roles. Women breastfed 10.6 ± 3.1, 9.4 ± 3.4, and 9.6 ± 5.5 times per 9-h period in the three rounds, respectively. Breastfeeding structure, specifically session duration, changed over time ( P < 0.05). As lactation progressed, women spent less time breastfeeding and in infant care and more time in subsistence work. In peak lactation, subsistence work was negatively correlated with infant care ( r = −0.4, P = 0.01), breastfeeding ( r = −0.29, P = 0.05) and session duration ( r = −0.39, P < 0.01) and in late lactation was negatively correlated with time spent breastfeeding ( r = −0.39, P < 0.01) and in infant care ( r = −0.50, P < 0.01) and positively correlated with inter-session interval ( r = 0.40, P < 0.01). Generally, women reduced time in subsistence work when breastfeeding was more intense and returned to normal activity patterns once infants were being supplemented. The costs and benefits associated with women's strategies are discussed. Am J Phys Anthropol, 2011. © 2010 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Aim: To investigate the relationship between breastfeeding and infant health and to describe growth in the first 9 months. Methods: Mothers delivering a baby in April 2005 were recruited throughout Bavaria, Germany, for a prospective birth cohort study. These mothers reported breastfeeding data, health and growth data of 1901 infants assessed by a physician in questionnaires on day 2–6, and in months 2, 4, 6 and 9. Subjects were healthy term infants with a birth weight ≥2500 g. We compared 475 infants breastfed exclusively for ≥6 months (group A), 870 infants breastfed fully/exclusively ≥4 months, but not exclusively ≥6 months (group B) and 619 infants not breastfed/breastfed <4 months (group C). Results: In multivariate analysis ≥6 months of exclusive breastfeeding reduced significantly the risk for ≥1 episode of gastrointestinal infection(s) during months 1–9 compared to no/<4 months breastfeeding (adjusted odds ratio [OR]: 0.60; 95% confidence interval [CI]: 0.44–0.82). The application of the World Health Organization (WHO) – child growth standards showed lower weight-for-length z-scores in first days of life in group C versus groups A and B, whereas in months 6/7 group C showed the highest scores. Conclusion: Differences in child growth depending on breastfeeding duration should be investigated further. Concerning health outcomes our findings support the recommendation for ≥6 months of exclusive breastfeeding. [ABSTRACT FROM AUTHOR]

Background: The Baby-Friendly Hospital Initiative was launched by the World Health Organization and UNICEF in 1989 to promote, protect, and support breastfeeding worldwide. The objective of this study was to report breastfeeding rates and adherence to the Baby Friendly Hospital Initiative of the World Health Organization and UNICEF in Canada, as reported by participants in the Maternity Experiences Survey of the Canadian Perinatal Surveillance System. Methods: Eligible women (n = 8,244) were identified from a randomly selected sample of infants born 3 months before the May 2006 Canadian Census, and stratified by province or territory. Birth mothers living with their infants at the time of interview were invited to participate in a computer-assisted telephone interview conducted by Statistics Canada on behalf of the Public Health Agency of Canada. Interviews took approximately 45 minutes and were completed when infants were between 5 and 10 months old (between 9 and 14 months in the territories). Completed responses were obtained from 6,421 women (78% response rate). Nineteen of 309 questions concerned early mother-infant contact and breastfeeding practices. Results: Breastfeeding intention (90.0%) and initiation (90.3%) rates were high, although exclusive breastfeeding rates at 6 months after birth (14.4%) were lower than desirable. The findings suggested a low adherence to several best practices advocated by the Baby-Friendly Hospital Initiative. Conclusion: Although breastfeeding initiation rates were relatively high in Canada, exclusive breastfeeding duration fell short of globally recommended standards. [ABSTRACT FROM AUTHOR]

Background: Despite numerous benefits of exclusive breastfeeding (EBF) for infants and mothers, a significant decrease in the EBF rate in the USA at six months compared to the rate at birth suggests that reasons for initiation and continuation of EBF may differ. The purpose of this qualitative study was to explore psychosocial factors underlying the continued EBF behaviour for six months, in order to identify salient belief structures according to the theory of planned behaviour. Methods: Participants were recruited from central Indiana in the USA. They were asked to respond to an open-ended questionnaire designed to elicit positive/negative consequences, approving/disapproving social referents, and easy/difficult circumstances in continuing EBF for six months. Responses were translated into behavioural, normative, and control beliefs of the theory. Results: Findings suggest that respondents (1) value emotional and health benefits of continued EBF for six months; (2) feel the approval from family and friends but disapproval from the society; (3) view health professional’s position as positive and negative. Conclusions: Breastfeeding educators can more likely improve the EBF duration by addressing these salient beliefs. Identified beliefs provide a basis for the development of a quantitative instrument to further study the EBF behaviour. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the relationships between alcohol consumption and breastfeeding initiation and duration. Methods: Design and Setting: A 12-month longitudinal study was conducted in two public hospitals in Perth, Australia between September 2002 and July 2003. Intervention: Participating mothers completed a self-administered baseline questionnaire. Follow-up telephone interviews were conducted at 4, 10, 16, 22, 32, 40 and 52 weeks. Main outcome measures: Association of the relationships between alcohol consumption and breastfeeding initiation and duration. Results: After 6 months of follow-up, women who consumed alcohol at levels of more than two standard drinks per day were almost twice as likely to discontinue breastfeeding than women who drank below these levels (HR 1.9, 95% CI 1.1, 3.0). Conclusion: Consuming alcohol in excess of two standard drinks per day during lactation was found to be independently associated with shorter breastfeeding duration, even after consideration of previously identified predictors of breastfeeding duration. Guidelines that provide direction on safe alcohol consumption for lactating mothers may help support extended breastfeeding duration. [ABSTRACT FROM AUTHOR]

The article analyzes the effectiveness of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) in the U.S. at improving the health of infants. Participants from nine different U.S. states took part in the Pregnancy Nutrition Surveillance System to address limitations in previous work. The study analyzed whether less smoking, improved weight gain during pregnancy, better childbirth results and improved ability to breast feed is associated with greater exposure to WIC. It found only modest effect of WIC on health behavior than that has been claimed by policy analysts.

The recent release of new growth charts by the World Health Organization (WHO) heralds a fresh understanding of what constitutes normal infant growth and development. The Multicenter Growth Reference Study that underpins these new growth standards ‘establish[es] breastfed infants as the normative model for growth and development’. This is in contrast to past practice, which treated breastfeeding as the optimal, rather than the normal, way to feed babies. This idealization of breastfeeding has been counterproductive, because it has reinforced a perception that formula feeding is the standard way of feeding babies. It is, therefore, suggested that breastfeeding promotion and education programmes should abandon the ‘breast is best’ message in favour of messages that normalize breastfeeding, and that future research ought to use infants breastfed according to WHO recommendations as the norm reference or control group in every instance. [ABSTRACT FROM AUTHOR]

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Objectives To examine the association between mothers education, complementary feeding practices and malnutrition amongst mothers attending outpatient clinics in Islamabad. Methods Mothers of 500 Pakistani infants attending the Paediatric Outpatient department at the Federal Government Services Hospital, Islamabad completed pretested questionnaires on mother's educational status and complementary feeding practices. Results A positive relationship was found between the nutritional status of infants and educational status of mothers ( P < 0.001). The study revealed that the majority of infants with evidence of malnutrition belonged to the mothers with virtually no school education. A similar relationship was observed between the educational status of respondents and the introduction of complementary foods at an appropriate age (6 months) of infants ( P < 0.001). Conclusion Mother's education plays a vital role in increased receptivity to knowledge and awareness related to nutritional requirements of their infants. [ABSTRACT FROM AUTHOR]