8 results on '"Rumbold, Alice R."'
Search Results
2. Women’s experiences with using domperidone as a galactagogue to increase breast milk supply: an australian cross-sectional survey
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McBride, Grace M., Stevenson, Robyn, Zizzo, Gabbie, Rumbold, Alice R., Amir, Lisa H., Keir, Amy, and Grzeskowiak, Luke E.
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- 2023
- Full Text
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3. Effect of Neonatal Unit Interventions Designed to Increase Breastfeeding in Preterm Infants: An Overview of Systematic Reviews.
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Hilditch, Cathie, Rumbold, Alice R., Keir, Amy, Middleton, Philippa, and Gomersall, Judith
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PREMATURE infants , *SEVERANCE pay , *BREAST milk , *BREASTFEEDING , *GESTATIONAL age - Abstract
Introduction: This overview aims to systematically review evidence regarding effects of interventions undertaken in neonatal units to increase breastfeeding in preterm infants. Methods: We followed Cochrane methodology. Systematic reviews published to October 31, 2022, reporting meta-analysis of effects from original studies on breastfeeding rates in preterm infants of neonatal unit interventions designed to increase breastfeeding were included. Results: Avoidance of bottles during breastfeed establishment (comparator breastfeeds with bottle-feeds) demonstrated clear evidence of benefit for any breastfeeding at discharge and exclusive breastfeeding 3 months post-discharge, and possible evidence of benefit for exclusive breastfeeding at discharge, and any breastfeeding post-discharge. Kangaroo mother care (KMC) (comparator usual care) demonstrated clear evidence of benefit for any and exclusive breastfeeding at discharge and possible benefit for any breastfeeding post-discharge. Quality improvement (QI) bundle(s) to enable breastfeeds (comparator conventional care) showed possible evidence of benefit for any breastfeeding at discharge. Cup feeding (comparator other supplemental enteral feeding forms) demonstrated possible evidence of benefit for exclusive breastfeeding at discharge and any breastfeeding 3 months after. Early onset KMC (commenced <24 h post-birth), oral stimulation, and oropharyngeal colostrum administration, showed no evidence of benefit. No meta-analyses reported pooled effects for gestational age or birthweight subgroups. Conclusion: There is ample evidence to support investment in KMC, avoidance of bottles during breastfeed establishment, cup feeding, and QI bundles targeted at better supporting breastfeeding in neonatal units to increase prevalence of breastfeeding in preterm infants and promote equal access to breastmilk. Stratifying effects by relevant subgroups is a research priority. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Knowledge of Galactagogue Use During Breastfeeding in Australia: A Cross Sectional Online Survey.
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McBride, Grace McKenzie, Stevenson, Robyn, Zizzo, Gabriella, Rumbold, Alice R, Amir, Lisa H, Keir, Amy K, and Grzeskowiak, Luke Edward
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Background: Galactagogues have been used for centuries to induce, maintain, or increase a mother's milk supply. Recently, there has been an apparent increase in utilization and promotion of galactagogues, largely in the absence of data regarding their efficacy and safety. However, there is limited contemporary evidence about knowledge of these substances in the community or how and where individuals seek information. Research Aim: To evaluate knowledge about galactagogue use during breastfeeding among birth parents, including recognition of specific substances, perceptions of safety, and common information sources. Method: An online, prospective, cross-sectional survey of Australian birthing parents (N = 2055) who were currently breastfeeding or had previously breastfed their infants was conducted from September to December 2019. The survey included questions about recognition of galactagogues, perceptions of safety, and information-seeking behaviors. Results: Among participants, 47% (n = 882) were primiparous and 65% (n = 1,219) were currently breastfeeding. The most recognized galactagogues included lactation cookies (89%; n = 1,828), brewer's yeast (79%; n = 1,629), fenugreek (74%; n = 1,519), and domperidone (69%; n = 1,420). Respondents cited the internet (52%; n = 1,066), lactation support providers (46%; n = 951), midwives (42%; n = 873), general practitioners (39%; n = 802), and social media (35%; n = 714) as common information sources. Lactation support providers and breastfeeding helplines were commonly rated as helpful; whereas, general practitioners and community pharmacists were often rated as unhelpful. While most participants perceived galactagogues to be safe, herbal or dietary galactagogues were perceived to be safer than pharmaceutical galactagogues. Conclusions: Our Australian community survey of individuals with current or previous breastfeeding experience identified widespread recognition of galactagogue use, with participants reporting a broad range of information-seeking behaviors and generally perceiving galactagogues as being safe to use. [ABSTRACT FROM AUTHOR]
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- 2022
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5. "Fear of stopping" vs "wanting to get off the medication": exploring women's experiences of using domperidone as a galactagogue - a qualitative study.
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Zizzo, Gabriella, Rumbold, Alice R., and Grzeskowiak, Luke E.
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THERAPEUTICS , *DRUG efficacy , *ATTITUDES of mothers , *HERBAL medicine , *CONFIDENCE , *ATTITUDE (Psychology) , *LACTATION disorders , *RESEARCH methodology , *FEAR , *INTERVIEWING , *TREATMENT duration , *EXPERIENCE , *PIPERIDINE , *QUALITATIVE research , *PREVENTIVE health services , *BREASTFEEDING , *DRUG therapy , *HEALTH attitudes , *FOOD , *THEMATIC analysis , *PHARMACY information services , *DOPAMINE antagonists , *GOAL (Psychology) - Abstract
Background: Domperidone is the most frequently prescribed medicine used to increase breast milk supply. There is considerable controversy surrounding the use of domperidone in lactation, due to limited evidence about efficacy and concerns about rare but life-threatening side-effects. Despite this, in many high-income settings such as Australia, use of domperidone among breastfeeding mothers appears to be increasing. The aim of this paper was to explore women's experiences of using domperidone during breastfeeding. Methods: Semi-structured interviews were conducted in 2019 with 15 women in Australia who reported using domperidone as a galactagogue during breastfeeding. Interviews were recorded, transcribed and analysed thematically. Results: Women reported a wide variety of practices concerning the timing of initiation of domperidone use, including prophylactic use, as well as the dose and duration of use. Prolonged periods of use and unsupervised dosing were commonly reported, these practices were sometimes associated with a fear of the consequences of stopping, insufficient provision of information about the drug or feeling dismissed by health professionals. Some women indicated that when doctors refused to prescribe domperidone they responded by doctor shopping and seeking anecdotal information about benefits and risks online, leading to unsupervised practices. Women often reported high expectations surrounding the effectiveness of domperidone, and most used the medication in conjunction with food/herbal galactagogues and non-galactagogue support. Positive outcomes following domperidone use included having greater confidence in breastfeeding and pride at achieving breastfeeding goals. Conclusions: This study identified a variety of practices concerning domperidone use, including potentially unsafe practices, linked in some cases to inconsistent advice from health professionals and a reliance on online, anecdotal information sources. These findings emphasise the urgent need for development of clinical practice guidelines and a greater focus on translating existing evidence concerning domperidone into clinical practice, including clinical support that is tailored to women's needs. [ABSTRACT FROM AUTHOR]
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- 2021
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6. Use and experiences of galactagogues while breastfeeding among Australian women.
- Author
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McBride, Grace M., Stevenson, Robyn, Zizzo, Gabriella, Rumbold, Alice R., Amir, Lisa H., Keir, Amy K., and Grzeskowiak, Luke E.
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BREASTFEEDING ,AUSTRALIANS ,BREAST milk ,PREMATURE labor ,GENERAL practitioners ,MILK yield - Abstract
Background: Galactagogues are substances thought to increase breast milk production, however evidence to support their efficacy and safety remain limited. We undertook a survey among Australian women to examine patterns of use of galactagogues and perceptions regarding their safety and effectiveness. Methods: An online, cross-sectional survey was distributed between September and December 2019 via national breastfeeding and preterm birth support organisations, and networks of several research institutions in Australia. Women were eligible to participate if they lived in Australia and were currently/previously breastfeeding. The survey included questions about galactagogue use (including duration and timing), side effects and perceived effectiveness (on a scale of 1 [Not at all effective] to 5 [Extremely effective]). Results: Among 1876 respondents, 1120 (60%) reported using one or more galactagogues. Women were 31.5 ± 4.8 years (mean ± standard deviation) at their most recent birth. Sixty-five percent of women were currently breastfeeding at the time of the survey. The most commonly reported galactagogues included lactation cookies (47%), brewer's yeast (32%), fenugreek (22%) and domperidone (19%). The mean duration of use for each galactagogue ranged from 2 to 20 weeks. Approximately 1 in 6 women reported commencing galactagogues within the first week postpartum. Most women reported receiving recommendations to use herbal/dietary galactagogues from the internet (38%) or friends (25%), whereas pharmaceutical galactagogues were most commonly prescribed by General Practitioners (72%). The perceived effectiveness varied greatly across galactagogues. Perceived effectiveness was highest for domperidone (mean rating of 3.3 compared with 2.0 to 3.0 among other galactagogues). Over 23% of domperidone users reported experiencing multiple side effects, compared to an average of 3% of women taking herbal galactagogues. Conclusions: This survey demonstrates that galactagogues use is common in Australia. Further research is needed to generate robust evidence about galactagogues' efficacy and safety to support evidence-based strategies and improve breastfeeding outcomes. [ABSTRACT FROM AUTHOR]
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- 2021
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7. The risk-risk trade-offs: Understanding factors that influence women's decision to use substances to boost breast milk supply.
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Zizzo, Gabriella, Amir, Lisa H., Moore, Vivienne, Grzeskowiak, Luke E., and Rumbold, Alice R.
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BREAST milk ,MILK supply ,INFLUENCE ,SUBSTANCE abuse ,MEDICAL personnel ,BREASTFEEDING ,INFANT development ,MATERNAL age - Abstract
Galactagogues are foods, herbs or medications thought to support or increase breast milk supply. The use of galactagogues during lactation is becoming increasingly common despite limited evidence regarding effectiveness and safety, and no definitive recommendations for use in clinical practice. The aim of this study is to explore factors influencing women's decisions to use galactagogues during lactation. Twenty-two semi-structured interviews were conducted in October and November 2019 (over the telephone or in person) with participants located in most Australian states and territories, including metro and regional areas. Interviews were audio-recorded, transcribed verbatim and thematically analysed using NVivo. Analysis revealed that following a concern about breast milk supply, the decision to use galactagogues was influenced by three core and interrelated domains: access to and quality of breastfeeding support, maternal agency and determination to provide breast milk. Women revealed many problematic experiences with health care professionals that left them feeling dismissed and confused due to provision of inconsistent and insufficient information that was sometimes at odds with their desire to provide breast milk. In this instance, some women turned to galactagogues to regain agency. A range of broader dimensions influencing decision-making also emerged. These were separated into categories that emphasise distinctions relating to breast milk supply, which included: maternal emotional wellbeing, social norms and pressures, concerns about infant development, maternal physical health and lactation history, as well as those relating specifically to galactagogue use, including: desire for a guaranteed/urgent response, risk-risk trade-off, acceptance and trust, and accessibility and cost. In understanding the complexity of decision-making concerning these substances, we identify opportunities to improve breastfeeding counselling and support. We recommend that support be individually tailored to manage conflicting information, adopt communication styles that encourage trust and processes that enable shared decision-making to enhance or restore maternal agency. There is also considerable need to address evidence gaps regarding the effectiveness and safety of commonly used galactagogues, so that women can be appropriately counselled about potential benefits and harms. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
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8. Assessing the quality of maternal health care in Indigenous primary care services
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Rhonda Cox, Sandra C. Thompson, Helen E. Liddle, Ru Kwedza, Alice R. Rumbold, Hugh Burke, Ross Bailie, Christine Connors, Catherine M. Kennedy, Alex Brown, Damin Si, Michelle Dowden, Tarun Weeramanthri, Lynette R. O'Donoghue, Rumbold, Alice R, Bailie, Ross S, Si, Damin, Dowden, Michelle C, Kennedy, Catherine M, Cox, Rhonda J, O'Donoghue, Lynette, Liddle, Helen E, Kwedza, Ru K, Thompson, Sandra C, Burke, Hugh P, Brown, Alex D, Weeramanthri, Tarun, and Connors, Christine
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Postnatal Care ,Clinical audit ,medicine.medical_specialty ,Native Hawaiian or Other Pacific Islander ,Breastfeeding ,Psychological intervention ,general medicine ,Indigenous ,Pregnancy ,Health care ,medicine ,Humans ,Maternal Health Services ,Intensive care medicine ,Quality of Health Care ,Primary Health Care ,Indigenous health ,business.industry ,General Medicine ,Sudden infant death syndrome ,women's health ,Family medicine ,Female ,Queensland ,business ,Health care quality - Abstract
TO THE EDITOR: Improving access to appropriate, good-quality care in the antenatal and postnatal period is a key part of closing the acknowledged gap between Indigenous and other Australians in perinatal outcomes. Previous research in a large Aboriginal medical service in Queensland demonstrated sustained improvements in perinatal outcome ssociated with a quality improvement approach. Here we describe patterns of the delivery of maternity care and service gaps on a broad scale, using data from baseline clinical audits in 34 Indigenous primary health centres participating in a national quality improvement intervention. Participating services were located across the Northern Territory (Top End and Central Australia), North Queensland, Far West New South Wales and Western Australia. Details of the audit methods have been described previously. Briefly, a random sample of up to 30 clinical records in each service was assessed to determine the degree of adherence to recommended protocols and procedures in the antenatal and postnatal periods. Records of women with an infant aged 2–14 months and who had been resident in the community for at least 6 months of the infant’s gestation were considered eligible for our study. The study was approved by the human research ethics committees in each region, and their Indigenous subcommittees where required. Clinical records of 535 women were assessed. Eighty-nine per cent of the women were Indigenous. However, compared with services in the NT, WA and North Queensland, services in Far West NSW had a higher proportion of nonIndigenous women presenting for antenatal or postnatal care (34% v 0–6%; P < 0.05). Overall, less than half of all women presented for care in the first trimester of pregnancy (Box, page 598). Documentation of routine antenatal investigations and brief interventions or advice regarding health behaviour varied, but generally these services appeared to be underutilised. There was relatively good documentation of follow-up of identified problems relating to hypertension or diabetes, with over 70% of identified women being referred to a general practitioner or obstetrician. However, follow-up of other identified problems, such as inadequate rubella immunity, was poor. Although 53% of women had a recorded postnatal visit, documentation of advice regarding health risk factors during the postnatal period was poor. For about half of all women there was documentation about breastfeeding advice and contraception. But advice about smoking, nutrition or mood (depression) was recorded for only 19%–21% of all women, and advice about sudden infant death syndrome prevention, injury prevention or infection/ hygiene was recorded for only 4%–5% of all women. The clinical audit data presented here indicate that participating services had both strengths and weaknesses in delivering maternal health care. Nevertheless, improving adherence to recommended screening investigations and brief interventions or advice about health behaviours, particularly smoking cessation, in the antenatal and postnatal period were identified as clear areas for improvement across all services. This information represents baseline data to inform the long-term monitoring of a quality improvement intervention. More broadly, it should be useful for informing local, regional and national efforts to promote and assess the quality of primary maternal health care for Indigenous women, and thus help address the persisting unacceptably high rates of poor Indigenous perinatal outcomes in Australia.
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- 2010
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