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Background: Although nutrition is an essential contributor to the quality of pregnancy outcomes, little is known about the experiences and influences affecting dietary behaviors during pregnancy among migrant women, particularly those from Myanmar, the largest immigrant population in Thailand. To fill this gap, we conducted a descriptive qualitative study to explore Myanmar immigrant women's perceptions, beliefs, and information-seeking behaviors concerning nutrition and food practices during pregnancy. Methods: We conducted focus group discussions (FGDs) with fifty Myanmar immigrant pregnant women aged 18–45 years across all trimesters, who were recruited using purposive sampling from a public tertiary hospital. The FGDs were conducted in Thai or Myanmar using semi-structured guides that probed women's pregnancy perceptions and experiences about nutrition and food patterns during pregnancy. The FGDs were audio-recorded, translated, and transcribed. Direct content analysis was used to guide the analysis through an ecological perspective framework. Results: The seven FGDs with fifty women revealed four major themes involving perceptions, beliefs, and information-seeking behaviors. The qualitative results consisted of (1) a positive attitude toward better changes under difficult conditions (setting goals for infant health; uncertainty about changes); (2) beliefs about eating patterns and dietary practices during pregnancy (taboos aimed at protecting women's health and ensuring safe childbirth; taboos aimed at guaranteeing infant safety); (3) limited access to appropriate information about nutrition (unclear dietary information from healthcare providers; ease of learning from experiences in informal social networks); and (4) difficult living conditions in a non-native setting (work-related influences on dietary behaviors; lack of comprehensible language to gain food literacy). In addition, the results were highlighted across four levels of ecological perspectives. Conclusions: Immigrant pregnant women are a vulnerable population that should be treated with equity to ensure quality of life through optimal nutrition throughout pregnancy. Respectful care requires that healthcare providers develop culturally sensitive nutrition interventions to increase nutrition literacy, accessibility, and pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding brings about a positive impact on both child and maternal health in the short and long terms. However, adolescent mothers have a lower breastfeeding initiation rate and a shorter breastfeeding duration than adult mothers. Although mobile applications have been found to be the most widely used platform for breastfeeding support, there is still a lack of design specific for adolescents. Aim: To explore the experiences, perspectives and needs of adolescent mothers and professional nurses using smartphone applications for breastfeeding support and the influence of this technology on healthcare in Thailand. Methods: This formative qualitative research of the 'Development of smartphone application for promoting breastfeeding and learning of infant responsiveness for Thai teenage pregnant women' study intends to design a smartphone application and develop an implementation plan. A purposive sample was used to elicit experiences from adolescent mothers and nurses. Data were collected from 48 adolescent mothers through in-depth interviews with six focus group discussions and 12 nurses, following the data saturation principle. Thematic analysis was conducted, and potential factors and needs were mapped to the capability, opportunity, and motivation model of behaviour change (COM-B). Results: Most adolescent mothers perceived the usefulness of smartphone apps as breastfeeding support resources. The qualitative findings of adolescent mothers were grouped into the following three themes: a friendly breastfeeding tool; allows them to manage their breastfeeding activities; and enhances the accessibility and equality of breastfeeding support. The professional nurses perceived the benefits of using smartphone applications in their work, which included the following three themes: reducing workload and making their work easier; preparation is always better; and increasing the standards of breastfeeding support. Conclusion: Adolescent mothers and professional nurses showed favourable attitudes toward smartphone apps for breastfeeding support. These smartphone apps should be tailored to these groups to achieve optimal BF outcomes. [ABSTRACT FROM AUTHOR]

Background: Inappropriate working conditions during pregnancy can negatively affect health-promoting behaviors and pregnancy outcomes. This study aimed to explore the experiences of health-promoting behavior in the workplace among Thai pregnant women. Materials and Methods: Giorgi's phenomenological methodology was used, and data were gathered through semi-structured interviews with 21 working-pregnant women in large industries in two regions of Thailand. Data were collected from December 2019 to June 2020. Purposive and snowball sampling were used to recruit pregnant women at 13–42 weeks of gestation. To analyze the data, three steps of Giorgi's phenomenological approach were employed. Results: The pregnant women described their lived experiences with health-promoting behaviors in the workplace into four major categories. Firstly, "positive attitude toward work in promoting health behaviors" contained three subcategories ("self-discipline," "social interaction," and "self-esteem"). Secondly, the idea that "changing temporary health behaviors is worthwhile for infants" was expressed into two subcategories ("eating adaptation" and "managing negative emotions"). Thirdly, "insufficient support from workplace policy" had three subcategories ("inconvenient accommodations," "inflexible break times," and "lack of healthcare support"). Finally, "negative perception of new work positions" consisted of two subcategories ("stress" and "low self-efficacy"). Conclusions: Positive attitudes toward work and infant health may encourage pregnant women to engage in healthy behaviors, while workplace support and policies are important in promoting healthy behavior and avoiding negative emotions. Health promotion interventions should encourage the value of work, promote maternal–fetal attachment, and increase health support policy to avoid mental health issues and promote healthy behaviors among working-pregnant women. [ABSTRACT FROM AUTHOR]

Background: Exclusive breastfeeding (EBF) for six months is recommended as one of the most important ways to support child health and survival, particularly during the COVID-19 pandemic. However, breastfeeding women encountered several obstacles during the pandemic. The purpose of this study was to conduct a survey to document breastfeeding practices, EBF rates and associated factors with six month exclusive breastfeeding during the second wave of the coronavirus outbreak in Thailand. Methods: A mixed-methods design that included a cross-sectional survey (n = 390) and semi-structured in-depth interviews (n = 15) was carried out between August and November 2021. Participants were women aged ≥ 15 years who had given birth within 6–12 months before data collection and delivered in three public hospitals in the top three provinces with the most severe COVID-19 outbreaks. Results: The median duration of EBF was four months (interquartile range, IQR: 1–6 months) and 37.4% of women exclusively breastfed for six months. From binary logistic regression models, several personal factors were associated with exclusive breastfeeding for six months including being a housewife (AOR 2.848; 95% CI 1.512, 5.367), perceived sufficiency of family income (AOR 2.502; 95% CI 1.362, 4.594), working from home/business (AOR 2.071; 95% CI 1.074, 3.995), breastfeeding intention (AOR 1.162; 95% CI 1.116, 1.210), and maternal age (AOR 0.932; 95% CI 0.882, 0.986). From qualitative interviews, women who were able to exclusively breastfed during the outbreak explained five themes that were a protective shield; I have to save money, I could spend all my time with my baby and breastfeed, spousal support is valuable, and opportunity to avoid the obstructed beliefs about exclusive breastfeeding. Conclusions: Mothers with higher socioeconomic status and who were unemployed/worked from home and had support structures in place were able to successfully EBF during the COVID-19 outbreak. Healthcare providers can better support breastfeeding if they provide informational support and allow family members to participate in breastfeeding programs, especially spouses who provided key emotional and tangible support during pandemic. [ABSTRACT FROM AUTHOR]

The prevalence of exclusive breastfeeding in Thailand is the lowest in all of Asia. This study aimed to examine if breastfeeding-friendly policies in a factory influenced breastfeeding behaviors among Thai working mothers. Descriptive data was collected from 216 eligible factory-working mothers of children aged 6-12 months. Data collected included the Demographic Characteristic Questionnaire and the Breastfeeding in the Workplace Survey. Questions included: awareness of factory breastfeeding-friendly policies, breastfeeding behaviors, pumping in the workplace, social support for breastfeeding behaviors during work. Data were analyzed by descriptive statistics. The majority of mothers (93.1%) intended to breastfeed with 93.1% also reporting shift work. Most of them rated the factory's support as excellent and very good. The rate of exclusive breastfeeding declined from 76.9% at one month to 46.3% at three months, then sharply dropped to 16.2% at four months and 7.4% at six months. Reasons for breastfeeding discontinuation included: maternal report of insufficient milk (36%), infant sent to live with grandmother in other areas (31%), and returning to work (12%). Breastfeeding-friendly policies in factories could improve breastfeeding rates during first three months. However, working mothers may need continued information and resources such as why continued breastfeeding is important, how to maintain sufficient milk supply, on-site child care facilities, and managing family life. Occupational health nurses could provide onsite breastfeeding training and/or intervention programs to improve exclusivity and duration of breastfeeding, instructions on use of breast pumps, and lactation support programs in the workplace, especially for women who work shifts. [ABSTRACT FROM AUTHOR]

The benefits of breastfeeding for the health of mothers and their infants are well-recognized. In comparison to other age groups of mothers, however, adolescent mothers have lower rates of breastfeeding duration and exclusivity. To develop unique breastfeeding intervention, it is crucial to understand what adolescent mothers perceive about breastfeeding. This study explored Thai adolescent mothers' experiences related to breastfeeding for the first six months. A descriptive qualitative design was conducted using semi-structured, in-depth interviews. Twenty adolescent mothers were purposively recruited. Descriptive statistics and content analysis were used for data analysis. The findings revealed that adolescent mothers explained their breastfeeding experiences through the following five themes: identifying positive aspects of breastfeeding; breastfeeding challenges; social support; returning to work/studies, and breastfeeding in public. These themes were found to be related to breastfeeding decisions, duration, and exclusivity. Breastfeeding experiences among Thai adolescent mothers showed complex factors involving multilevel influences of social systems. Therefore, promotion and support of successful breastfeeding should recognize the influences of personal factors of adolescent mothers and their environments simultaneously, particularly complexity of family problems. Nurse professionals should provide breastfeeding knowledge and skills during the antenatal period adding family involvement, especially infants' grandmothers. Moreover, understanding unique adolescents and their needs should be emphasized in breastfeeding promotion programs in order to reduce breastfeeding difficulties and increase breastfeeding sustainability. Planning to overcome breastfeeding barriers within schools, workplaces and the public should be supported and encouraged among adolescent mothers and their families. [ABSTRACT FROM AUTHOR]

The advantages of exclusive breastfeeding for the first 6 months are well‐known. Unfortunately, adolescent mothers have lower rates of breastfeeding exclusivity and shorter duration of breastfeeding. There is limited evidence regarding exclusive breastfeeding determinants in adolescent mothers. The purpose of this study was to obtain adolescent mother‐generated factors related to exclusive breastfeeding at 6 months. A mixed‐methods design was conducted through concept mapping. Thirty adolescent mothers aged 15–19 years who had wide range of exclusive breastfeeding experiences brainstormed about specific factors. They then sorted and rated the statements into key clusters. Finally, half of the participants were involved in the interpretation of the mapping results and the creation of pathway diagrams. Data were analysed by multivariate statistics in the Concept System Global MAX program. The results showed that the adolescent mothers brainstormed about 104 statements on the factors related to exclusive breastfeeding at 6 months. These factors can be categorized into the following six key clusters: (a) breastfeeding advantages; (b) facilitating factors and necessary skills; (c) promotion and support needed; (d) community and social influence; (e) internal and external barriers; and (f) key problems in families. The pattern matching provided understanding of how key clusters are important to successful breastfeeding through comparing three groups of exclusive breastfeeding durations. Finally, the relationships of the stated factors were drawn in pathway diagrams. Exclusive breastfeeding experiences among Thai adolescent mothers showed complexity involving multilevel influences of social systems. The promotion of optimal breastfeeding should recognize the influences of both personal and environmental factors. [ABSTRACT FROM AUTHOR]

Breastfeeding is essential for the survival, nutrition, and development of infants and young children. As a result of COVID-19’s effects of economic crises and psychological difficulties, breastfeeding outcomes have declined. The purpose of this study was to examine the association between socioeconomic and psychological factors with breastfeeding duration in the first year of life during the COVID-19 pandemic. Cross-sectional online surveys (n = 390) were conducted between August and November 2021. The participants were women aged 15 years and above who had given birth within 6−12 months before data collection and delivered in public hospitals in the top three provinces with the worst COVID-19 outbreaks during the second wave in Thailand. The average breastfeeding duration in this study was 6.20 months (±2.5) with a range of 1−12 months. Of mothers, 44.9% continued to breastfeed until between 6 and 12 months of age. In a multiple regression analysis, family income (Beta = 0.112, t = 1.988, p < 0.05), breastfeeding intention (beta = 0.097, t = 2.142, p < 0.05), intended breastfeeding duration (beta = 0.391, t = 8.355, p < 0.05), intention to receive vaccination (beta =0.129, t = 2.720, p < 0.05), and anxiety (beta = 0.118, t = 2.237, p < 0.05) were associated with breastfeeding duration in the first year of life (F (7, 382) = 20.977, p < 0.05, R2 = 0.278, R2 Adjusted = 0.264). During COVID-19, psychological factors were more strongly associated with breastfeeding duration in the first year of life than socioeconomic factors. Healthcare providers should promote breastfeeding intention, motivate COVID-19 vaccination intention, and support mental health among lactating mothers, particularly in the event of a pandemic.

Objective: To determine associations between Thai fathers' self-efficacy to support exclusive breastfeeding and exclusive breastfeeding duration., Design: A descriptive quantitative design was used., Participants and Settings: The study sample consisted of 205 father-mother couples (410 participants) with an infant who was 6 months old. Data were conducted from well-baby clinics of two hospitals in Thailand's Chiang Mai province from January to March 2020., Measurement: Each participant completed a sociodemographic questionnaire and Breastfeeding Self-Efficacy Scale (Short-Form). Father participants also completed the Father's Attitude toward Exclusive Breastfeeding questionnaire., Findings: Bivariate correlation analyses of survey data showed that paternal and maternal breastfeeding self-efficacy scores were positively associated with longer duration of exclusive breastfeeding (ρ=0.19 and ρ=0.54, respectively). Paternal self-efficacy scores were also positively correlated with maternal self-efficacy scores (ρ=0.30, p=.01). However, the results of Tobit regression analyses indicated that paternal self-efficacy scores did not moderate the relationship between maternal self-efficacy scores and exclusive breastfeeding duration. Only maternal self-efficacy scores were significantly associated with duration of exclusive breastfeeding (B=.16, p<.01)., Key Conclusions: This is the first Thai study to assess the relationship between fathers' breastfeeding support self-efficacy and exclusive breastfeeding duration. The results increase our understanding of paternal factors that impact exclusive breastfeeding duration. Although paternal self-efficacy did not moderate the effects of maternal self-efficacy on exclusive breastfeeding duration in this study, paternal self-efficacy positively related to maternal self-efficacy and breastfeeding duration., Implication for Practice: Paternal breastfeeding support self-efficacy should be promoted in co-parenting breastfeeding interventions both antenatal care clinics and postpartum units to promote exclusive breastfeeding and increase Thailand's overall exclusive breastfeeding rate., Competing Interests: Declaration of Competing Interest The authors have no conflict of interest to declare, (Copyright © 2022 Elsevier Ltd. All rights reserved.)