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Professor Joao Aprigio Guerra de Almeida graduated in Food Engineering (UFV-1981) with a Master in Microbiology (UFV-1986) and a doctorate in Women's and Children's Health (Fiocruz/IFF, 1998) He is founder and coordinator of the Brazilian Human Milk Banks Network (Ministry of Health-Brasil/Oswaldo Cruz Foundation-Fiocruz, 1987 to 2024); Head of the National Reference Center for Human Milk Banks at the National Institute of Women, Children and Adolescent Health Fernandes Figueira-IFF (Fiocruz/IFF, 1987 to 2024); Executive Secretary of the Ibero-American Human Milk Banks Network Program (Ibero-American General Secretariat-SEGIB/Brazilian Cooperation Agency-ABC/MS-FIOCRUZ, 2008 to 2020); Coordinator of International Technical Cooperation in Human Milk Banks ABC/Fiocruz/MS (2005 to 2024); and Coordinator of the Human Milk Banks Network of the Community of Portuguese Speaking Countries – CPLP (2017 to 2024). He has been recognized with the Sasakawa Health Prize (World Health Organization [WHO], 2001); as Officer of the Order of Rio Branco (Presidency of the Federative Republic of Brazil, 2001); with Global Health Challenges and Responses of the South in Time of Crisis (WHO, 2009); as Commendator of the Order of Rio Branco-Ministry of Foreign Affairs/Presidency of the Federative Republic of Brazil (2018); and Dr LEE Jong-wook Memorial Prize for Public Health (WHO, 2020). His areas of activity include Public Health, breastfeeding, Human Milk Banks, Public Management, and International Technical Cooperation. [ABSTRACT FROM AUTHOR]

Background: The exclusive breastfeeding condition in China is not optimism now. Maternal breastfeeding self-efficacy stands as a pivotal factor influencing exclusive breastfeeding. Interestingly, studies have suggested that father support breastfeeding self-efficacy is a pivotal mediator in infant breastfeeding. Thus, the current research aimed to investigate the association between father support breastfeeding self-efficacy and exclusive breastfeeding at six weeks postpartum, and the influencing factors of father support breastfeeding self-efficacy. Methods: This research was structured as a multi-centre cross-sectional study, involving 328 fathers, whose partners were six weeks postpartum, and recruited from two public hospitals in Southeast China. Self-designed demographic questionnaires, namely, Father Support Breastfeeding Self-Efficacy Scale-Short Form, Breastfeeding Knowledge Questionnaire, Positive Affect Scale and the 14-item Fatigue Scale, were applied. Descriptive statistics, Chi-square test, logistic regression univariate analysis and multiple linear regression were used to analyse data. Results: Results indicate a significant difference between the infant feeding methods at six weeks postpartum and fathers with different levels of support breastfeeding self-efficacy (p < 0.05). Particularly, father support breastfeeding self-efficacy positively affected exclusive breastfeeding at six weeks postpartum after adjusting all the demographic characteristics of fathers (OR: 2.407; 95% CI: 1.017–4.121). Moreover, results show that the significant influencing factors of father support breastfeeding self-efficacy include breastfeeding knowledge, fatigue, positive affect, successfully experienced helping mothers to breastfeed, spousal relationships and companionship time. Conclusions: High-level father support breastfeeding self-efficacy effectively increased exclusive breastfeeding rate at six weeks postpartum. To enhance the exclusive breastfeeding rate, nurses or midwives can endeavour to design educational programmes or take supportive interventions customised for fathers, such as enhancing their breastfeeding knowledge education, reducing fatigue and mobilising positive emotions, thereby bolstering paternal self-efficacy in breastfeeding. [ABSTRACT FROM AUTHOR]

Abstract Background The exclusive breastfeeding condition in China is not optimism now. Maternal breastfeeding self-efficacy stands as a pivotal factor influencing exclusive breastfeeding. Interestingly, studies have suggested that father support breastfeeding self-efficacy is a pivotal mediator in infant breastfeeding. Thus, the current research aimed to investigate the association between father support breastfeeding self-efficacy and exclusive breastfeeding at six weeks postpartum, and the influencing factors of father support breastfeeding self-efficacy. Methods This research was structured as a multi-centre cross-sectional study, involving 328 fathers, whose partners were six weeks postpartum, and recruited from two public hospitals in Southeast China. Self-designed demographic questionnaires, namely, Father Support Breastfeeding Self-Efficacy Scale-Short Form, Breastfeeding Knowledge Questionnaire, Positive Affect Scale and the 14-item Fatigue Scale, were applied. Descriptive statistics, Chi-square test, logistic regression univariate analysis and multiple linear regression were used to analyse data. Results Results indicate a significant difference between the infant feeding methods at six weeks postpartum and fathers with different levels of support breastfeeding self-efficacy (p

Background/Aims: Training nursing and midwifery students is essential to support breastfeeding reinforcement plans. Various scales have been developed to assess knowledge acquired during training. This study was conducted to explore these instruments. Methods: A systematic review of online databases (Scopus, Web of Science, Science-Direct, Cochrane Library and PubMed) was performed. Studies published in English from 2013 were included. Results: Five studies that used validated instruments were included in the review. An additional scale, the breastfeeding knowledge assessment form, was identified but had only been tested once. Most tools were designed to assess mothers' knowledge, and no instruments were developed for nursing and midwifery students. Factors that influenced knowledge and its acquisition among nursing and midwifery students included the lack of training courses on breastfeeding for undergraduate students. Conclusions: There is a lack of such instruments specifically designed for nursing and midwifery students. A comprehensive training module should be included in undergraduate curricula based on WHO and the UNICEF educational requirements. [ABSTRACT FROM AUTHOR]

Pediatricians need to be knowledgeable to adequately carry out their role in the support of breastfeeding, so assessing their knowledge of breastfeeding is vitally important. There are not English language validated questionnaires for pediatricians in the literature; however, in Spanish and Portuguese, there is the Breastfeeding Knowledge Survey (ECoLa, derived from Encuesta de Conocimientos en Lactancia). Our goal is to translate the ECoLa into English. The original survey consisted of true/false questions, including one with an image of a breastfeeding baby, multiple-choice questions featuring clinical cases, and two open-ended short questions. We used a translation approach that incorporated both forward and backward translations and a multidisciplinary committee to evaluate the translation process. During translation, four Spanish versions and seven English versions were considered prior to consensus approval of the final survey. The intraclass correlation coefficient between the English questionnaire and the original Spanish version was 0.85 (95% CI [0.60, 0.95]). A sample of 51 participants completed the survey, resulting in a Cronbach's alpha of 0.78 for the English version (95% CI [0.70, 0.86]). The Breastfeeding Knowledge Survey is now accessible under a Creative Commons license, permitting its free re-use. [ABSTRACT FROM AUTHOR]

Background: Health professionals need adequate competence to support breastfeeding beyond infancy. There is no established instrument to measure health professionals' competence regarding long-term breastfeeding. To respond to this shortcoming, the Long-Term Breastfeeding Competence Scale (LBCS) was developed. Research Aim: To develop and pilot an instrument that measures public health nurses' competence related to breastfeeding beyond 12 months in order to provide adequate breastfeeding counseling for families. Methods: This study was conducted as a cross-sectional online survey on public health nurses working in maternity and/or child health clinics. The relevance and clarity of the LBCS were assessed by an expert panel (N = 6). Public health nurses (N = 197) completed the LBCS, which consisted of a knowledge and skills dimension and an attitude dimension. Descriptive statistics were used to describe the characteristics of the study sample. The conceptual validity of the knowledge and skills dimension was assessed using the dichotomous Rasch analysis, and attitude dimension using the exploratory factor analysis. Internal consistency was evaluated using Cronbach's alpha. The distribution of the items was summarized by descriptive statistics. Results: According to expert panel evaluations, the LBCS was found to meet the requirements for relevance and clarity (S-CVI 0.90). The internal consistency of the instrument was at a good level (α = 0.796) and met the requirements set for a new instrument. Conclusion: The LBCS is appropriate to determine public health nurses' competence related to breastfeeding beyond 12 months. The LBCS can be used to identify the need for education concerning breastfeeding beyond 12 months. [ABSTRACT FROM AUTHOR]

Abstract Objective To investigate the extent of knowledge about breastfeeding and attitudes towards infant feeding among spouses of puerperas at the time of discharge from hospital, and explore the factors influencing spousal attitudes toward breastfeeding. Methods We conducted a questionnaire survey among 204 spouses of puerperas who were admitted in the maternity wards at a tertiary hospital in Shaanxi Province between October 2021 and December 2021. Respondents who fulfilled the inclusion criteria were identified using convenient sampling. Results (1) The score of breastfeeding knowledge among spouses prior to discharge from the hospital was (10.56 ± 3.78), with an accuracy rate of 59.6%, and the lowest accuracy rate was for Item 1 “Newborns should be fed on time, not on demand” (42.6%) and Item 5 “Breastfeeding can prevent infant rickets” (49.5%). (2) The average score of spouses’ infant feeding attitudes was (58.15 ± 5.55), and the lowest scoring was for Item 17 “Daily urine volume of infants is a reliable indicator to judge whether they get enough breast milk” (1.99 ± 1.14). (3) Generalized linear model analysis showed a more positive attitude (higher score) among spousal attitudes towards infant feeding in those who had received breastfeeding education [OR = 4.588, 95% CI (0.160 ∼ 3.598)] and those with a master’s degree or above [OR = 18.278, 95% CI (3.471 ∼ 9.346)]. Conclusion (1) Spouses that received breastfeeding education and those that had a Masters Degree and above had more positive attitude towards infant feeding. (2) Medical staff should focus on puerperas’spouses with degrees below master’s level who had not received breastfeeding education. We recommend using a variety of education methods to enable them to acquire more knowledge on breastfeeding and develop a more positive attitude towards breastfeeding, which will further enhance spousal support for breastfeeding, thus positivizing postpartum co-parenting attitudes and improving the rate of exclusive breastfeeding.

Objective: To investigate the extent of knowledge about breastfeeding and attitudes towards infant feeding among spouses of puerperas at the time of discharge from hospital, and explore the factors influencing spousal attitudes toward breastfeeding. Methods: We conducted a questionnaire survey among 204 spouses of puerperas who were admitted in the maternity wards at a tertiary hospital in Shaanxi Province between October 2021 and December 2021. Respondents who fulfilled the inclusion criteria were identified using convenient sampling. Results: (1) The score of breastfeeding knowledge among spouses prior to discharge from the hospital was (10.56 ± 3.78), with an accuracy rate of 59.6%, and the lowest accuracy rate was for Item 1 "Newborns should be fed on time, not on demand" (42.6%) and Item 5 "Breastfeeding can prevent infant rickets" (49.5%). (2) The average score of spouses' infant feeding attitudes was (58.15 ± 5.55), and the lowest scoring was for Item 17 "Daily urine volume of infants is a reliable indicator to judge whether they get enough breast milk" (1.99 ± 1.14). (3) Generalized linear model analysis showed a more positive attitude (higher score) among spousal attitudes towards infant feeding in those who had received breastfeeding education [OR = 4.588, 95% CI (0.160 ∼ 3.598)] and those with a master's degree or above [OR = 18.278, 95% CI (3.471 ∼ 9.346)]. Conclusion: (1) Spouses that received breastfeeding education and those that had a Masters Degree and above had more positive attitude towards infant feeding. (2) Medical staff should focus on puerperas'spouses with degrees below master's level who had not received breastfeeding education. We recommend using a variety of education methods to enable them to acquire more knowledge on breastfeeding and develop a more positive attitude towards breastfeeding, which will further enhance spousal support for breastfeeding, thus positivizing postpartum co-parenting attitudes and improving the rate of exclusive breastfeeding. [ABSTRACT FROM AUTHOR]

Breast milk is a priceless essential food for the first six months of life and yet sub-Saharan Africa has neonatal deaths attributed to sub optimal breastfeeding. The study assessed the effectiveness of lecture and lecture with demonstration in optimal breastfeeding knowledge among women. The study adopted a quasi-experimental randomized design. A sample of 141 was determined from a population of 191 primigravid women attending antenatal clinics in General Hospitals Enugu Nigeria. A researcher developed validated was used to collect data from 63 intervention and 76 control group. A pretest was conducted and intervention was given to the participants while posttests were conducted at different times after intervention. Data were analyzed using SPSS version 26.0. Descriptive statistics was used to present socio demographic variables and objectives of the study while inferential statistics were used to ascertain the effectiveness of the intervention at 0.05 level of significance. Results showed that most of the participants were in the age range of 21-30 years. The Pre-intervention knowledge level was poor in both groups and after intervention knowledge levels increased over time higher in the intervention than in the control group. Hypotheses tested revealed that educational interventions were effective as those in the intervention groups were significantly more knowledgeable than those in the control group. Antenatal care attendance was a significant predictor of knowledge of optimal breastfeeding. The researcher concluded that lectures with demonstration during antenatal are effective in improving knowledge level of optimal breastfeeding and recommended that authorities implement policy instituting breastfeeding support groups in hospitals. [ABSTRACT FROM AUTHOR]

The remarkable world-changing growth of International Board Certified Lactation Consultants (globally over 35,000 IBCLCs in 2023), as the internationally recognized lactation professional since Chele Marmet conceptualized the field in 1977, demonstrates its importance for society and breastfeeding dyads. The early 1980s was a seminal time in the development of lactation care as a allied health field with specialized knowledge, study, and certification. Chele Marmet played a significant role as an innovator and activist during all these major changes. In this interview, she details these historic events, which she is elaborating further in her upcoming memoir. Although the terms LC and lactation professional have commonly been used to refer to those working clinically with breastfeeding families, in this article both terms refer only to the International Board Certified Lactation Consultant (IBCLC). JHL has a policy not to use the term LC (Dodgson, 2016, 2020); our rationale is that this term is currently too vague and is often misused by those with less education and experience than IBCLCs. However, we have used LC in this article at times when referring to lactation professionals prior to the development of the international board examination. This article is the second part of the interview; Part I was published in the previous JHL issue (February 2014). This interview has been transcribed with minor editing for ease of reading. (CM = Chele Marmet, JD = Joan Dodgson) [ABSTRACT FROM AUTHOR]

Background: Improving breastfeeding practices is a worldwide priority. Pharmacists have the opportunity to actively promote breastfeeding and educate parents as well as the general public about its benefits. Research Aims: The aims of this study are to investigate Jordanian pharmacists' present breastfeeding support practices and perceptions regarding their need for education and training in breastfeeding support. Methods: To examine sociodemographic characteristics of community pharmacists in Jordan and their current breastfeeding support practices and educational needs, a descriptive cross-sectional online (self-report) survey was conducted. Through social media, pharmacists working in community pharmacies in Jordan were recruited between August 2021 and February 2022. The level of breastfeeding support participants had been provided with was measured using eight items in a 5-point Likert scale ranging from 5 (Always) to 1 (Never). Each participant self-reported the frequency of advice/information given to breastfeeding women in each of these areas. Univariate and multivariable linear regression models were used to identify factors associated with the level of breastfeeding support. Results: Participants (N = 381) reported a high level of breastfeeding support, but expressed a need for training and education for further improvement. The breastfeeding support score of female participants was found to be 0.12 higher than that of males (Beta = 0.12, p =.02), 0.16 higher in married participants compared to non-married participants (Beta = 0.16, p =.03), and 0.10 higher in participants working in rural areas compared to those working in urban areas (Beta = 0.10, p =.04). Conclusion: While community pharmacists generally report a high level of breastfeeding support, our findings revealed demographic differences. Attention to specific areas of need might enhance what pharmacists could offer; however, additional research would be required to guide the specific educational content. [ABSTRACT FROM AUTHOR]

BACKGROUND: In view of the lack of attention and predictability in postpartum breastfeeding in primiparas, health education on breastfeeding during pregnancy should be carried out to publicize the benefits of breastfeeding. OBJECTIVE: To investigate how well the primiparas during pregnancy are known of breastfeeding knowledge, and to provide a basis for developing health education measures for them. METHODS: With the adoption of the objective sampling method and the principle of saturation, 10 primiparas in the obstetrics outpatient department of the Hunan Provincial People's Hospital were selected as the study participants. Semi-structured in-depth interviews combined with the observation method were used for data collection. The interview data were analyzed and the theme was refined by Colaizzi's seven-step method. RESULTS: The results of the four themes of the cognition of breastfeeding knowledge among primiparas were as follows: Lack of knowledge and curiosity about breastfeeding in some women, lack of access to correct breastfeeding knowledge, insufficient support from family members for postpartum breastfeeding, and lack of approach to solve problems during breastfeeding among primiparas. CONCLUSION: Due to the current problems of the cognition of breastfeeding knowledge in primiparas, it was imperative to build a health education model suitable for primiparas to improve this knowledge. [ABSTRACT FROM AUTHOR]

Abstract Background In general, people tend to support private breastfeeding more than public breastfeeding, and discomfort surrounding public breastfeeding may contribute to sub-optimal rates of breastfeeding in the United States. Few studies have systematically examined situational factors that contribute to (negative) reactions to public breastfeeding. It is unclear whether the physical location or the presence of others is more influential in shaping people’s evaluations of public breastfeeding. This study aimed to experimentally investigate the influence of location, bystander presence, bystander gender, and the breastfeeding woman’s use of a cover on people’s evaluations of breastfeeding images. Method A sample of adults residing in the United States was randomly assigned to view an image of a breastfeeding woman in an experimental study that examined four independent variables: breastfeeding location (public vs. private), bystander presence (present vs. not present), gender of bystander (male vs. female), and use of a cover (cover vs. no cover). Participants then reported their emotional reactions to, perceptions of, and behavioral intentions toward the breastfeeding woman. In addition, participants completed measures of sexism, traditional gender role endorsement, sexual comfort, body gaze, and breastfeeding knowledge and experience. Results Hierarchical regressions revealed no differences between private and public breastfeeding images. Perceptions of the breastfeeding woman were more favorable when she was alone than with others, and when she was covered than when she was not covered. Evaluations tended to be more favorable among participants who scored lower on hostile sexism, higher on benevolent sexism, higher on sexual comfort, and higher on breastfeeding knowledge. Conclusion The presence of bystanders may be more consequential than the physical location in shaping reactions to public breastfeeding. These findings can be applied to improve support for public breastfeeding, which may contribute to higher breastfeeding rates and the associated public health benefits.

One of the factors contributing to the disparities still present by race in the United States may be inequitable access to lactation education. In order to ensure that all parents receive the education they deserve to make informed infant feeding decisions, two checklists were created for patient and healthcare professional use, respectively. This paper describes the process of creating and validating the healthcare professional and patient checklists. The authors completed a review of the most recent literature surrounding barriers to lactation initiation and retention in the Black community to create the initial version of the checklists. Expert consultation was then utilized to assess their content validity. Local healthcare providers unanimously agreed that pregnant and postpartum parents need more education and support than currently provided. The consulted experts described the two checklists as useful and comprehensive and offered feedback for their revision and optimization. Implementing these checklists offer the possibility of increasing provider accountability in delivering adequate lactation education and enhancing client lactation knowledge and self-efficacy. Further research is needed to assess the effect of implementation of the checklists in a healthcare setting. [ABSTRACT FROM AUTHOR]

Background: Exclusive breastfeeding (EBF) describes infants who were only breastfed for 6 months. Many Saudi mothers have suboptimal breastfeeding practices. Therefore, this study aims to assess breastfeeding knowledge and determine barriers to EBF among mothers attending primary health care centers in Jazan City. Methods: A descriptive cross-sectional study was done that included all mothers attending the PHC centers. Data were collected through a self-administered questionnaire. Results: Most study participants understand breastfeeding’s health benefits for babies and mothers, but most believe that synthetic milk is the best alternative for working mothers to feed their babies. A percentage of 66.7 of mothers practiced breastfeeding during the first 6 months of the child’s life. EBF shows a significant relationship with knowledge and barriers. Sixty percent of mothers have never had any information about breastfeeding; the primary source was from their mothers and only 31.4% from hospital staff. Most respondents disagreed with statements of barriers to EBF, which elicits an unexpected response. Conclusions: Most participants have good knowledge concerning breastfeeding benefits for both mother and infant and disagreed on the mentioned barriers for EBF that include lack of breastmilk, deficiency of information, and working conditions.

Background: Lactation support for mother–baby dyads significantly impacts breastfeeding initiation and duration (Busch et al., 2014). Implementing breastfeeding-specific curricula for nurse practitioner (NP) students is fundamental for providing evidence-based lactation care (Webber & Serowoky, 2017). Method: This quality improvement project evaluated the efficacy and satisfaction of an online breastfeeding education module implemented into NP courses. Surveys assessed the demographics, knowledge change, and satisfaction with the experience of online breastfeeding education. Results: Participants completed the optional module and two surveys. A 3% increase in knowledge scores was seen in the postintervention survey. Participants provided actionable feedback. Implementing breastfeeding education into the NP curriculum is feasible and desired by the students. Discussion: Population-focused NP core competencies and knowledge of current breastfeeding education in NP programs are obsolete. Innovation to establish breastfeeding education best practices is needed to produce NPs prepared to support the breastfeeding or lactating patient. [ABSTRACT FROM AUTHOR]

Copyright of Balikesir Health Sciences Journal / Balıkesir Sağlık Bilimleri Dergisi is the property of Balikesir Health Sciences Journal (BAUN Health Sci J) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

AimBreastfeeding generates short-term and long-term benefits for both mother and child. Exclusive breastfeeding (EBF) is promoted in China for years, but its practice still lags far behind the international average, even among low- and middle- income countries. This study aimed to investigate factors associated with EBF during postpartum.MethodsThis study was conducted in a tertiary referral hospital in Gansu Province, Northwest China from October 2019 to April 2020. 3,738 postnatal women were finally included and each of them completed an elaborately designed questionnaire. Infant feeding patterns (EBF or not) and reasons for NEBF (non-exclusive breastfeeding) were collected. The feeding knowledge score was based on 17 questions in relation to breastfeeding. The total score ranges from 0 to 17. Higher score means better understanding about breastfeeding knowledge. Multivariate logistic regression models were used to determine associated factors of EBF during postpartum. A subgroup analysis was conducted to investigate the association between feeding knowledge score and exclusive breastfeeding.ResultsSix weeks after childbirth, 1891 mothers (50.6%) maintained EBF. Among the NEBF mothers, 57.01% (n = 1,053) of them stopped exclusive breastfeeding due to self-perceived lack of breast milk production. Factors associated with NEBF were higher maternal age, ethnic minorities and cesarean section. Protective factors of EBF included multipara, positive feeding attitude and high breastfeeding knowledge score. In subgroup analysis, we found the breastfeeding knowledge score had a significant impact on the mothers of Han nationality, underwent cesarean or natural delivery, both primiparous and multiparous, and those with positive attitude towards breastfeeding (p

Background: Exclusive breastfeeding (EBF) describes infants who were only breastfed for 6 months. Many Saudi mothers have suboptimal breastfeeding practices. Therefore, this study aims to assess breastfeeding knowledge and determine barriers to EBF among mothers attending primary health care centers in Jazan City. Methods: A descriptive cross-sectional study was done that included all mothers attending the PHC centers. Data were collected through a self-administered questionnaire. Results: Most study participants understand breastfeeding's health benefits for babies and mothers, but most believe that synthetic milk is the best alternative for working mothers to feed their babies. A percentage of 66.7 of mothers practiced breastfeeding during the first 6 months of the child's life. EBF shows a significant relationship with knowledge and barriers. Sixty percent of mothers have never had any information about breastfeeding; the primary source was from their mothers and only 31.4% from hospital staff. Most respondents disagreed with statements of barriers to EBF, which elicits an unexpected response. Conclusions: Most participants have good knowledge concerning breastfeeding benefits for both mother and infant and disagreed on the mentioned barriers for EBF that include lack of breastmilk, deficiency of information, and working conditions. [ABSTRACT FROM AUTHOR]

Background: Severe Acute Respiratory Syndrome Coronavirus 2 has spread globally, causing the coronavirus disease 2019 (COVID-19) pandemic. To control the pandemic and to achieve herd immunity, four vaccines have obtained market authorization in Europe. Researchers have reported that the sequence of administration of the vaccines depends on the risk of exposure to COVID-19 and age, recommending the vaccine to pregnant and breastfeeding women. Research Aim: To examine the knowledge, willingness and attitudes of breastfeeding women in Spain regarding the possibility of receiving the COVID-19 vaccine. Methods: An observational descriptive cross-sectional study in two tertiary-level hospitals from Valencia was conducted. Breastfeeding women (N = 301) were recruited by non-probability sampling of consecutive cases. Questionnaires were collected in June 2021. Results: More than one in every two participants would accept a COVID-19 vaccine, and the percentage rose in participants who were older, more educated, or worked in high-risk jobs. Their main source of information was the Internet, and midwives were the professionals who most recommended vaccination. Participants who would not accept vaccination during lactation reported reasons linked to lack of information regarding vaccination in their condition and how it might affect newborns. Conclusion: It is of primary concern for healthcare professionals to foster a greater understanding by providing updated information regarding the need, safety, and efficacy of the vaccine for both lactating mothers and their newborns. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization identifies exclusive breastfeeding as the gold standard for child nutrition. Breastfeeding provides many benefits to both the baby and the mother. First days after birth are crucial for breastfeeding and determining its further path. Unfortunately, very often it is also the time of facing the first breastfeeding problems. The aim of this study was to analyse selected factors influencing a mother's decision to breastfeed. Methods: This is a cross-sectional study conducted between March 2019 and November 2019 in selected Polish maternity wards. Data were collected through completion of author's questionnaire and a standardised questionnaire and the Multidimensional Perceived Social Support Scale and also through informal interviews with mothers. During statistical analysis, the chi-square test of independence and the Kolmogorov–Smirnov test as well as the non-parametric Mann–Whitney U test in addition to Fisher's exact test were performed. Results: The results showed that there is no correlation between the mode of delivery and the mother's choice of infant feeding method. Knowledge of the benefits of breastfeeding and received support affects the mother's decision on infant feeding method. The study also showed that the 83% of newborns were put to the breast within the first 2 h after birth. However, only 58% continued to be breastfed in the subsequent days. As many as 42% of the newborns were supplemented with formula despite early initiation of breastfeeding. Analyses showed that exclusive breastfeeding was more often chosen by mothers with higher education. And the most common breastfeeding problem reported by 62% of the respondents was perceived insufficient milk supply and also breastfeeding pain, reported in 48.5% mothers. Conclusions: It is extremely important to continually promote breastfeeding among women. The role of midwives is crucial in this regard, as they should encourage the initiation of breastfeeding, support mothers during the perinatal and postnatal periods, and increase their sense of competence and confidence in their ability to breastfeed. Accessible, professional, and empathetic support can help reduce the number of women supplementing with modified milk. Undoubtedly, the postpartum period is important for breastfeeding outcomes, but it is significant that breastfeeding education and promotion begin during pregnancy. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the knowledge, attitude, and practices of parents about breastfeeding, complementary food, and infant nutrition who have healthy infants born at term and under 2 years of age. Materials and Methods: This is a cross-sectional study conducted among the parents of infants who came for well-child visits to pediatric clinics of 4 hospitals. Healthy infants under 2 years of age and who had been born at term were interviewed. The questionnaire included 35 questions to evaluate parents' knowledge, attitude, and practices about breastfeeding and infant nutrition in addition to sociodemographic data. Data were obtained via questionnaire and were analyzed using Statistical Package for the Social Sciences 20.0 package program. Results: The study group consisted of 679 infants and their parents. The median durations of exclusive breastfeeding and total breastfeeding time were found to be 4 months and 10 months. Although 75% of the participants stated that infants must be exclusively breastfed for 6 months, the rate of exclusive breastfeeding for the first 6 months was 44%. The 393 (58%) participants used formula for infant nutrition and 47 (12%) of those started with complementary feeding. 90% of the participants stated that formula advertisements did not affect their decision on starting formula but the rate of thinking that other people may be affected by the advertisements was 80%. Conclusion: The knowledge of parents on human milk is not insufficient but they need to be supported especially to continue exclusive breastfeeding during the first 6 months and appropriate complementary food during the weaning period. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Human Lactation is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Breastfeeding is a fundamental component of health care, and health professionals need to be adequately prepared. As part of the system, health care professionals have the ability to influence the establishment and maintenance of breastfeeding. The global literature regarding the curricular approach or established best practices for health professional education in lactation is inconclusive and lacking in rigor. Research aim: To explore the literature for the educational resources, methods, and curriculum used in the education of undergraduate health students related to lactation. Methods: A scoping review examining the curricular programs of health professional students in lactation was undertaken exploring and summarizing evidence from peer reviewed and grey literature. A scoping review with a five-stage review process was followed. The database search between 1982–2018 generated 625 results, 79 full-text articles were reviewed, and 29 articles published in English met the inclusion criteria. Results: In general, educational resources, methods, curricular approaches, and foundational topics were based on best practice standards. Some authors incorporated a variety of learning methods and provided experiential learning, with evidence of translation of knowledge into clinical practice. In the studies examined, researchers reported that students had improved their: knowledge and attitudes (59%); breastfeeding support skills (45%); and confidence (10%). However, even in programs that focused on developing students' breastfeeding support skills, authors reported a lack of change in students' confidence. Conclusions: Although only English articles met the inclusion criteria, this review was unique in its search of multidisciplinary, multilingual, and international studies. Consistency in teaching across disciplines is key and not evident in the studies reviewed. [ABSTRACT FROM AUTHOR]

Abstract Background In Jordan, the rate of exclusive breastfeeding is declining. The trend variation in breastfeeding practice is determined by different factors including antenatal women’s attitude and planning which are affected by their awareness and the support they receive. This study aims to assess knowledge, attitude, support, and planning of breastfeeding among Jordanian women. Methods A face-to-face cross-sectional semi-structured questionnaire survey was conducted among healthy women in the antenatal clinic and postpartum ward at three hospitals in Northern Jordan during the period August 2019 to December 2019. Data were collected about demographic characteristics, women’s knowledge and attitude towards breastfeeding, antenatal and postnatal support and counseling, and feeding planning. Customized scales were utilized to assess knowledge and attitude. Factors associated with planning to breastfeed were reported. Results 660 women completed the survey questionnaire. The majority were 20 to 35 years of age, 10% were primiparous, and 30% were employed. 78% were knowledgeable about breastfeeding benefits and aware of WHO recommendations. 72% had a positive attitude towards breastfeeding. More than half received support from their husbands to breastfeed their infants, while less than 20% received any counseling from their obstetric providers. 97% reported their intention to breastfeed, and more than half indicated their willingness to breastfeed exclusively. With multivariable logistic regression modelling, predictors of EBF planning include: primiparity (AOR 1.79; 95% CI 1.1, 3.25), positive attitude (AOR 1.80; 95% CI 1.05, 3.1) and positive husband’s support (AOR 1.92; 95% CI 1.18, 3.15). Barriers include women’s employment (AOR 0.43; 95% CI 0.26, 0.70) and low birthweight (AOR 0.46; 95% CI 0.25, 0.84). Conclusion Jordanian women are highly knowledgeable about breastfeeding benefits, and they exhibit a positive attitude towards breastfeeding resulting in a very high percentage intending to breastfeed their infants. Limited counseling about breastfeeding is a major gap in antenatal care. As intentions might not reflect the actual practice after delivery, gaps and barriers affecting the determinants of successful breastfeeding should be identified, and corrective tools should be implemented accordingly. Allocating a specific time for antenatal or postnatal counseling and support is expected to promote breastfeeding practice in our population.

Introduction: To evaluate the traditional practices of breastfeeding, complementary feeding, and increasing breast milk in mothers with 0-24 month-old infants. Material and methods: The study sample includes 215 mothers with 0-24 month-old infants. The mothers’ socio-demographic characteristics, knowledge and behaviors regarding breast milk, complementary feeding, and traditional practices for increasing breast milk were questioned. Results: 60.0% of the infants were exclusively breastfed in the first six months. There was a significant difference between the mothers’ educational levels and the frequency of breastfeeding (p

Background: Inappropriate marketing of human milk substitutes negatively influences efforts to protect breastfeeding. Although healthcare professionals can positively influence infant feeding decisions, government regulations permit manufacturers to communicate messages to them through advertising. Research Aims: (1) To identify the extent of human milk substitute advertising in publications aimed at United Kingdom healthcare professionals and (2) to describe compliance with the International Code of Marketing of Breast-Milk Substitutes and United Kingdom Formula and Follow-on Formula Regulations. Methods: This was a cross-sectional observational study. We reviewed publications targeting healthcare professionals working with families in the United Kingdom (N = 19). Quantity and type of human milk substitute advertisements, as a proportion of all advertising, in each publication were recorded. All unique advertisements were double assessed for compliance. Results: Human milk substitute advertising was found in nine (47%) of the 19 publications (four affiliated with professional associations), making up 10.3% (n = 196) of these publications' total advertising. Of human milk substitute advertisements found, 65.4% (n = 110) were for products used to manage cows' milk protein allergy. Of the 32 unique human milk substitute advertisements found, none complied with the International Code of Marketing of Breast Milk Substitutes or United Kingdom Formula and Follow-on Formula Regulations. Conclusions: Many healthcare professionals' publications had non-compliant human milk substitute advertisements. There is an urgent need to ensure full compliance with international and local regulation in future advertisements and to consider whether advertisements are justified at all. [ABSTRACT FROM AUTHOR]

Background: Breast/Chestfeeding remains a public health issue for African Americans, and increased rates would mitigate many health disparities, thus promoting health equity. Research Aims: To explore the interplay of generational familial roles and meaning (or value) ascribed to communicating infant feeding information across three generations. Method: This prospective, cross-sectional qualitative study used an asset-driven approach and was guided by Black Feminist Thought and Symbolic Interactionism. African American women (N = 35; 15 family triads/dyads), residing in the southeastern United States were interviewed. Data were analyzed using thematic analysis. Results: The older two generations described their role using assertive yet nurturing terms, while the younger generation carefully discussed the flexibility between their familial roles. Emergent themes described the meaning each generation attributed to communicating infant feeding information: "My Responsibility," "Comforting," "Bonding Experience," "She Cared," and "Gained Wisdom." Conclusions: Our findings have potential to contribute to achieving health equity in African American families. Future breast/chestfeeding promotion efforts may benefit from reframing the current approach to including protection language and not solely support language. Lactation professionals should further recognize and support strengths and resource-richness of intergenerational infant feeding communication within African American families using strength-based, empowerment-oriented, and ethnically sensitive approaches. [ABSTRACT FROM AUTHOR]

Introduction: Fathers' knowledge, attitude, and involvement in breastfeeding practices are crucial factors to determine the success of breastfeeding outcomes such as decision-making on breastfeeding, successfulness of exclusive breastfeeding, and continuation of breastfeeding practices. This study aimed to identify the determinants of fathers' involvement in breastfeeding practices. Methods: This cross-sectional study involved 203 fathers attending Maternal and Child Health Clinics in Kuala Selangor. Self-administered questionnaires were used to obtain information regarding fathers' sociodemography, breastfeeding knowledge, attitudes, and involvement towards breastfeeding practices. Results: Mean age of the fathers was 32.1±5.9 years, ranging between 21 to 50 years. Findings showed that majority of the fathers were involved in breastfeeding practices (52.7%; n=107, 57.0±6.2), had fair knowledge in breastfeeding (62.6%; n=127, 13.77±3.2), and showed low attitude towards breastfeeding (68.0 %; n=138, 61.9±6.7). Multiple logistic regression analysis revealed factors with significant influence on fathers' involvement towards breastfeeding practices were: (1) fathers' breastfeeding knowledge, (2) fathers' attitudes towards breastfeeding practices, and (3) mode of infant delivery. Conclusion: These significant predictors may help healthcare professionals to establish effective strategies by advocating the role of fathers in the breastfeeding process such as by offering continuous support, active involvement, and effective participation. [ABSTRACT FROM AUTHOR]

Background: Donor milk is the preferred substitute to mother's own milk, which can protect high-risk infants from many complications. Several milk banks have been established in China. However, the small number of donors and insufficient milk donated have become the primary obstacles for these milk banks. Research aims: To explore the level of, and the factors influencing, knowledge and attitude about donor milk among currently lactating women across mainland China and to provide a reference for the development of Chinese milk banks. Methods: A brief, self-reporting, prospective, cross-sectional, online survey was conducted in 2018 using The Knowledge and Attitude Questionnaire of Human Donor Milk for Hospitalized Women. Lactating women aged >18 years and willing to consent to study participation were recruited throughout China. Results: All completed questionnaires (N = 489) were included. 40.1% (n = 196) of the participants had heard of donor milk or milk banks, and 76.7% (n = 375) were willing to donate their milk. In the multiple linear regression analysis, educational level, cohabitation status, parity, history of delivering preterm or low-birth-weight infants, education provided by health professionals, and infants' gestational age, weight, and feeding patterns were associated with the participants' knowledge about donor milk (F = 12.387, p <.001). The parity, delivery mode, mothers' milk production, history of delivering preterm or low-birth-weight infants, education provided by health professionals, and infants' age were associated with their attitude (F = 9.420, p <.001). Conclusion: The participants' attitudes about donor milk were positive. However, there were gaps in their knowledge about donor milk. [ABSTRACT FROM AUTHOR]

Abstract Background World Health Organization (WHO) recommends exclusive breastfeeding (EBF) as the optimal way to feed infants below 6 months of age. The benefits of EBF are well documented. However, in Tanzania, EBF is still rarely practised. This study explored the knowledge, attitudes and practises of EBF among mothers in Kilimanjaro region of northern Tanzania. Methods This is a qualitative research study. The three districts in Kilimanjaro region namely Same, Moshi Municipal Council and Rombo districts were selected. In each district, three focus group discussions (FGDs) with mothers of infants aged 0–12 months were conducted. A total of 78 mothers participated in the focus group discussion. Results The main result is that most of the mothers had a theoretical knowledge of the benefits of EBF but were not able to practise this knowledge for a range of reasons. The reasons for not practising EBF in real life included poor maternal nutrition, the pressure for women to return to work, inadequate knowledge about expressing breast milk, and perceived insufficiency of milk supply. Additionally, mothers received conflicting advice from a range of sources including close relatives, community members and health care providers, and they often choose the advice of their elders. Mothers also offered suggestions on ways to improve EBF including educating the community on the benefits of EBF. Conclusion The results show that the women need support from close relatives and employers to successfully practise EBF. This presents a need for involving close relatives in EBF interventions, as they are important sources of breastfeeding information in the community. Additionally, behavioural interventions that promote optimal breastfeeding practises might help to improve exclusive breastfeeding.

Abstract Background Exclusive breastfeeding is significantly associated with strong infant immunity and optimal development. The importance of breastfeeding is underestimated. Parental lack of knowledge and unhealthy practices regarding breastfeeding deprive infants of their basic right to mother’s milk. In developing countries, including Pakistan, with high child mortality and malnutrition, healthy breastfeeding practices can bring positive changes in child health status. From this perspective, the present study aims to understand parents’ knowledge, attitudes and practical encounters with breastfeeding practices and the factors that prevent them from adopting such practices. Methods A qualitative study was carried out in both rural and urban settings in Rajanpur District of Punjab Province, Pakistan. We conducted 12 focus-group discussions (FGDs) that involved 38 mothers and 40 fathers with children aged under two years who were being breastfed. A thematic content analysis of data collected through FGDs was performed manually. The themes were both inductive and deductive in nature. Results The study found that a majority of participants believed that the first thing given to an infant after birth should not be breast milk but honey, rose flower, or goat’s milk from the hands of an elder in the family or a religious person. No cleanliness measures were practised in this regard. The participants had misconceptions about the benefits of colostrum, which frequently prevented it being given to newborns. Participants reported many factors, such as: insufficient milk syndrome (slow growth of infants due to insufficient daily breast milk intake), a mother’s high workload, lack of social support, the influence of culturally designated advisors, and the promotion and marketing strategies of infant formula companies, that undermined exclusive breastfeeding efforts and encouraged mothers to switch to infant formula. Conclusions Culturally acceptable and integrated public health interventions are needed to improve the breastfeeding-related health literacy and practices of parents, grandparents and communities. This will ultimately reduce the high infant mortality and malnutrition rates in Pakistan.

Abstract Background The World Health Organization recommends continued breastfeeding up to 2 years of age or beyond. This study assessed breastfeeding knowledge, attitudes, and practices among women residing on the island of Abu Dhabi and identified associated factors. Methods We conducted a cross-sectional study using a self-administered questionnaire among mothers visiting primary healthcare clinics in Abu Dhabi between November 2014 and 2015. Participants were women aged at least 18 years who had at least one child aged 2 years or younger at the time of the study. Breastfeeding knowledge, attitudes, and practices were assessed on the basis of experience with last child. Selected questions were used to develop a scaled scoring system to categorize these aspects as good, fair, or poor. Exclusive breastfeeding is defined as the act of feeding infants only breast milk since birth, without providing water, formula, or other liquid supplements. Results The participants were 344 women. Exclusive breastfeeding for 6 months was reported by only 46 (16.9%, 95% CI 0.10, 0.17, n = 272). 79 (28.7%, n = 275) of the participants were breastfeeding and planning to continue after the child was ≥24 months. Multivariate logistic regression analysis revealed that the following factors were associated with exclusive breastfeeding: mothers with female children (adjusted OR [AOR] 2.42; 95% CI 1.18, 4.97) and better breastfeeding knowledge scores (AOR 1.25; 95% CI 1.04, 1.50). The following factors were associated with less likelihood of exclusively breastfeeding: working mothers (AOR 0.29; 95% CI 0.12, 0.72), living with relatives (AOR 0.21; 95% CI 0.05, 0.81), no past exclusive breastfeeding experience (AOR 0.23; 95% CI 0.09, 0.58) and being offered readymade liquid formula in hospital (AOR 0.33; 95% CI 0.15, 0.72). The most common reason for stopping breastfeeding was insufficient breast milk production (68/89, 76%), and the most common work related reason was inadequate maternity leave (24/89, 15%). Conclusion Although breastfeeding knowledge was generally good, breastfeeding practice was still suboptimal. Modifiable factors found to predict exclusive breastfeeding included breastfeeding knowledge and mothers’ employment status.

Abstract Background Breastfeeding support from health professionals can be effective in influencing a mother’s decision to initiate and maintain breastfeeding. However, health professionals, including nursing students, do not always receive adequate breastfeeding education during their foundational education programme to effectively help mothers. In this paper, we report on a systematic review of the literature that aimed to describe nursing and other health professional students’ knowledge and attitudes towards breastfeeding, and examine educational interventions designed to increase breastfeeding knowledge and attitudes amongst health professional students. Methods A systematic review of peer reviewed literature was performed. The search for literature was conducted utilising six electronic databases, CINAHL, MEDLINE, ProQuest, PubMed, Scopus, and Cochrane, for studies published in English from January 2000 to March 2017. Studies focused on nursing students’ or other health professional students’ knowledge, attitudes or experiences related to breastfeeding. Intervention studies to improve knowledge and attitudes, were also included. All papers were reviewed using the relevant Critical Appraisal Skills Programme (CASP) checklist. Results Fourteen studies were included in the review. This review indicates that in some settings, health professional students demonstrated mid-range scores on breastfeeding attitudes, and their knowledge of breastfeeding was limited, particularly in relation to breastfeeding assessment and management. All of the studies that tested a specialised breastfeeding education programme, appeared to increase nursing students’ knowledge overall or aspects of their knowledge related to breastfeeding. Several factors were found to influence breastfeeding knowledge and attitudes, including timing of maternal and child health curriculum component, previous personal breastfeeding experience, gender, cultural practices and government legislation. Conclusions Based on this review, it appears that nursing curriculum, or specialised programmes that emphasise the importance of breastfeeding initiation, can improve breastfeeding knowledge and attitudes and students’ confidence in helping and guiding breastfeeding mothers.

Background: Physicians and nurses are expected to support breastfeeding mothers. However, there is a lack of standardized lactation education throughout training programs and hospitals. As a result, providers lack the necessary confidence and skills to guide mothers throughout the breastfeeding experience. The hands-on nature of breastfeeding management demands the implementation of application-based learning tools to improve skills retention and patient breastfeeding outcomes. Research aim: In this scoping review, we aimed to critically assess the types of application-based breastfeeding management learning tools reported within medical and nursing professions and the evaluation methods of learner and patient outcomes. Methods: The authors searched the literature to identify peer-reviewed articles published between 2000 and 2018 with medical or nursing students, residents, or professionals as the target learner group in an application-based educational intervention. Both authors independently assessed the content in the resulting articles, with specific focus on teaching methods, curricular development, and the learning outcomes reported within each study. Results: Ten articles matched the inclusion criteria and were included in the final review, including five studies from the medical field and five from the field of nursing. Use of real patients was a common method for application-based skills training, followed by role playing and use of standardized patients. Teaching and evaluation methods varied widely across the studies. Conclusion: The results align with existing literature in finding a dearth of high-quality studies assessing breastfeeding education among physicians and nurses. The variability in teaching and evaluation methods indicates a lack of standardization in breastfeeding education between institutions. [ABSTRACT FROM AUTHOR]

We examined the association between breastfeeding practices and associated factors using cross‐sectional data from face‐to‐face interviews with 9,745 mother–child dyads in China. The study collected information on breastfeeding practices and potential associated factors at the individual, family, health facility and environmental levels in China. We used survey commands in Stata to consider sampling weight and survey design effects. Although breastfeeding was the norm (97.4% ever breastfed), the prevalence of early initiation of breastfeeding (EIBF) in 0–11 months old was 8.2%, exclusive breastfeeding (EBF) in 0–5 months old was 27.8% and breastfeeding on the previous day in 6–11 months old was 77.5%. The prevalence of EIBF was lower for caesarean delivery and among mothers belonging to ethnic minority groups. The prevalence of EBF was higher among mothers who practiced EIBF, received information that encouraged breastfeeding and knew that a baby should be breastfed on demand and exclusively. By contrast, the prevalence of EBF was lower in mothers who received infant formula advice or felt uneasy breastfeeding in public places. The prevalence of breastfeeding on the previous day was higher among mothers whose partners supported breastfeeding and who knew about timing of colostrum production, EBF for 6 months, and to nurse more to stimulate milk production. The prevalence of breastfeeding on the previous day was lower in mothers who received infant formula advice or felt uneasy breastfeeding in public places. In conclusion, we found that the prevalence of EIBF and EBF practices in China was low and associated with factors at individual, family, health facility and environmental levels. [ABSTRACT FROM AUTHOR]

Behavioural change communication interventions have been shown to be effective at improving infant and young child nutrition knowledge and practices. However, evidence in humanitarian response contexts is scarce. Using data on secondary outcomes of breastfeeding, water treatment, and knowledge from a cluster randomized control trial of the Yemen Cash for Nutrition programme's impact on child nutritional status, this paper shows that the programme significantly improved knowledge and practices for poor women with young children in the pilot districts. The intervention consisted of cash transfers and monthly group nutrition education sessions led by locally recruited community health volunteers. Data are based on self‐reports by participants. Estimating impacts among all 1,945 women in 190 clusters randomly assigned to treatment versus control and controlling for baseline levels and community characteristic and adjusting for noncompliance with randomization, the programme increased the probability of breastfeeding initiation within the first hour after delivery by 15.6% points (p <.05; control = 74.4% and treatment = 83.6%), the probability of exclusive breastfeeding during the first 6 months by 14.4% points (control = 13.5% and treatment = 25.3%), the probability of households treating water consumed by adults by 16.7% points (p <.01; control = 13.9% and treatment = 23.4%), and treating water consumed by children under two by 10.3% points (p <.10; control = 31.2% and treatment = 37.9%). Impacts on knowledge and breastfeeding are similar for both literate and illiterate women, and water treatment impacts are significantly larger for literate women. This study was registered at 3ie (RIDIE‐STUDY‐ID‐5b4eff881b29a) and funded by the Nordic Trust Fund and Consultative Group on International Agricultural Research programme on Policies, Institutions, and Markets. [ABSTRACT FROM AUTHOR]

Background: In Jordan, the rate of exclusive breastfeeding is declining. The trend variation in breastfeeding practice is determined by different factors including antenatal women's attitude and planning which are affected by their awareness and the support they receive. This study aims to assess knowledge, attitude, support, and planning of breastfeeding among Jordanian women. Methods: A face-to-face cross-sectional semi-structured questionnaire survey was conducted among healthy women in the antenatal clinic and postpartum ward at three hospitals in Northern Jordan during the period August 2019 to December 2019. Data were collected about demographic characteristics, women's knowledge and attitude towards breastfeeding, antenatal and postnatal support and counseling, and feeding planning. Customized scales were utilized to assess knowledge and attitude. Factors associated with planning to breastfeed were reported. Results: 660 women completed the survey questionnaire. The majority were 20 to 35 years of age, 10% were primiparous, and 30% were employed. 78% were knowledgeable about breastfeeding benefits and aware of WHO recommendations. 72% had a positive attitude towards breastfeeding. More than half received support from their husbands to breastfeed their infants, while less than 20% received any counseling from their obstetric providers. 97% reported their intention to breastfeed, and more than half indicated their willingness to breastfeed exclusively. With multivariable logistic regression modelling, predictors of EBF planning include: primiparity (AOR 1.79; 95% CI 1.1, 3.25), positive attitude (AOR 1.80; 95% CI 1.05, 3.1) and positive husband's support (AOR 1.92; 95% CI 1.18, 3.15). Barriers include women's employment (AOR 0.43; 95% CI 0.26, 0.70) and low birthweight (AOR 0.46; 95% CI 0.25, 0.84). Conclusion: Jordanian women are highly knowledgeable about breastfeeding benefits, and they exhibit a positive attitude towards breastfeeding resulting in a very high percentage intending to breastfeed their infants. Limited counseling about breastfeeding is a major gap in antenatal care. As intentions might not reflect the actual practice after delivery, gaps and barriers affecting the determinants of successful breastfeeding should be identified, and corrective tools should be implemented accordingly. Allocating a specific time for antenatal or postnatal counseling and support is expected to promote breastfeeding practice in our population. [ABSTRACT FROM AUTHOR]

Background: In 2015, the median duration of exclusive breastfeeding was 2.2 months in Armenia, and only 15% of 4–5-month-old children were exclusively breastfed, indicating an issue with breastfeeding knowledge and practices. Research aim: To identify the main barriers to optimal breastfeeding practices in Armenia. Methods: We used qualitative research methods via focus group discussions and in-depth interviews with four groups of providers from different levels of care, and mothers of young children, from Yerevan city and two provinces, Lori and Shirak. Overall, eight in-depth interviews and 13 focus group discussions were conducted with a total of 99 participants. Qualitative content analysis was applied, with elements of both inductive and deductive approaches. Results: We identified two main categories of barriers to optimal breastfeeding—systemic barriers and knowledge deficiencies. The main themes within systemic barriers were lack of skilled breastfeeding support services and low motivation of providers—mainly related to inadequate recognition of their role in breastfeeding counseling and low remuneration. The main knowledge-related barriers were insufficient counseling of mothers, lack of reliable information sources about infant feeding, and misconceptions among both mothers and providers. Conclusion: Optimal breastfeeding is crucial for the best start to an infant's life; however, there were a number of barriers to optimal breastfeeding practices in Armenia. Our findings and recommendations could help policymakers apply effective strategies for improving breastfeeding rates in Armenia. Considering the similar historical backgrounds of the post-Soviet countries, our findings could also be applicable to other Commonwealth of Independent States countries. [ABSTRACT FROM AUTHOR]

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) breastfeeding peer counselling (BFPC) program supports optimal early life nutrition by providing evidenced‐based breastfeeding protection, promotion, and support. The Lactation Advice Through Texting Can Help (LATCH) study was a randomized controlled trial that tested the effectiveness of a text messaging intervention designed to augment the BFPC program. The purpose of the present study was to understand the topics discussed during the text message exchanges between breastfeeding peer counsellors (PCs) and their clients in the intervention arm of the LATCH study, from the time of enrollment up to two‐weeks postpartum. Text messaging data were first coded and analysed for one‐ and two‐way text message exchanges. Text messages of participants with a high volume of two‐way exchanges were then analysed qualitatively. Four domains were identified in both the prenatal and postpartum periods: the mechanics of breastfeeding, social support, baby's nutrition, and PCs maintaining contact with participants. Additional themes and subthemes identified in the postpartum period included the discussion of breastfeeding problems such as latching trouble engorgement, plugged ducts, pumping, other breastfeeding complications, and resuming breastfeeding if stopped. Two‐way text messaging in the context of the WIC BFPC program provides an immediate and effective method of substantive communication between mothers and their PC. [ABSTRACT FROM AUTHOR]

Background: Prenatal care providers play a central role in breastfeeding outcomes. A survey on obstetricians' support of breastfeeding was conducted in 1993 in Monroe County, NY. Since the landscape of prenatal care and breastfeeding support has changed significantly in the past 2 decades, we repeated and extended this survey in 2015. Research aim: To determine changes in breastfeeding support by prenatal care providers over a 20 year period. Methods: We sent a 46-item on-line or paper questionnaire to all categories of prenatal care providers identified by an online search. A breastfeeding support score was created based on the prior survey, with a maximum score of 3. One point was awarded for: (1) personally discussing breastfeeding; (2) generally suggesting breastfeeding; and (3) commonly receiving questions from patients. Data were analyzed using Chi-square. Results: We had 164 participants (response rate 80%). More current participants, compared to 1993, reported discussing (97% vs. 86%, p <.001) and recommending (93% vs. 80%, p =.001) breastfeeding. Only 10% of 2015 participants gave infant formula samples, compared with 34% in 1993 (p <.0001). Improvement in the support score was seen, with 98% of current participants having high scores compared to 87% in 1993 (p <.001). Similar numbers reported receiving breastfeeding education, though more reported that the education was inadequate (54% vs. 19%, p <.0001). Conclusion: Breastfeeding support improved significantly over time, even though breastfeeding education has not improved in quality or quantity. Improving education of prenatal care providers may help future providers be more prepared to support breastfeeding. [ABSTRACT FROM AUTHOR]

Abstract Background Under-nutrition is a public health problem in Myanmar. Despite current efforts, the exclusive breastfeeding rate (EBF) for children under six months is only 24%. Intention to breastfeed is a strong predictor for long-term breastfeeding, however, little is known about pregnant women’s breastfeeding intentions in Myanmar. We, therefore, aimed to identify the factors associated with women’s intention to EBF. Method Data in this article was collected in a baseline survey for a randomized controlled trial, which aimed to assess the impact of mobile text messages on the breastfeeding practices of women in Yangon, Myanmar. A total of 353 pregnant women at 28–34 weeks of gestation, recruited into the trial from the antenatal clinics of the Central Women’s Hospital, Yangon, Myanmar, responded to the baseline survey questions, which included background information and breastfeeding related characteristics. To determine factors associated with women’s intention to EBF logistic regression was used to analyse individual demographic, household economic and breastfeeding characteristics. In-depth interviews were performed with a sub-sample of 24 women who participated in the survey, to gain a further understanding of these associated factors. Results After adjusting for potential confounders, working women were less likely to intend to EBF (adjusted odds ratio (AOR) = 0.30, CI 0.17–0.53). Women from rich households (AOR = 2.43, CI 1.08–5.47) and middle income households (AOR = 1.79, CI 1.01–3.16); those who had high (AOR = 10.19, CI 3.43–30.23) and medium (AOR = 5.46, CI 1.79–16.72) breastfeeding knowledge levels, and received information from health professionals (AOR = 2.29, CI 1.29–4.03) and mobile internet (AOR 3.62, CI 2.04–6.41) had a higher intention to EBF. These findings were supported by qualitative analysis, which revealed that returning to work was the main barrier; health staff and printed media are reliable sources and; women with higher knowledge had high intentions to EBF. Conclusions EBF intention was influenced by many factors. Breastfeeding promotion programs should target the poor, working women and women with lower breastfeeding knowledge. Breastfeeding education via health staff and the Internet, breastfeeding facilities at the work place and longer maternity leave in the private sector should all be encouraged. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12615000063516 .

Background It is generally accepted that breastfeeding is a practice that provides valuable health benefits to both mother and baby. However, the COVID-19 pandemic unveiled questions regarding the safety of breastfeeding, leading to potential hesitation among the public. Our study seeks to appreciate the public's understanding and attitudes toward breastfeeding during the COVID-19 pandemic. Methods An anonymous survey was distributed online through social media platforms. Demographic information was collected with questions specifically analyzing the knowledge and attitude of each participant. Calculations were performed using Spearman's rho correlations to determine significant differences. Results Thirty-nine women were recruited. The average overall knowledge score was 93% correct. 87% of participants believe breastfeeding is better than formula feeding, and 92% stated they would breastfeed their infant if they knew it could protect their child from COVID-19. Discussion The results of our study indicated that although overall knowledge of breastfeeding during the COVID-19 pandemic was well understood, higher levels of education may play a role in the depth of one's knowledge. In addition, while participants were reporting high levels of education about breastfeeding from their healthcare providers, few were receiving data specific to the pandemic. The data gathered from this study may help to target future educational initiatives., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Tiarks et al.)

Although peer-led education and support may improve breastfeeding practices, there is a paucity of evidence on the effectiveness of such interventions in the Ethiopian context. We designed a cluster-randomized trial to evaluate the efficacy of a breastfeeding education and support intervention (BFESI) on infant growth, early initiation (EI), and exclusive breastfeeding (EBF) practices. We randomly assigned 36 clusters into either an intervention group (n = 249) receiving BFESI by trained Women’s Development Army (WDA) leaders or a control group (n = 219) receiving routine care. The intervention was provided from the third trimester of pregnancy until five months postpartum. Primary study outcomes were EI, EBF, and infant growth; secondary outcomes included maternal breastfeeding knowledge and attitude, and child morbidity. The intervention effect was analysed using linear regression models for the continuous outcomes, and linear probability or logistic regression models for the categorical outcomes. Compared to the control, BFESI significantly increased EI by 25.9% (95% CI: 14.5, 37.3%; p = 0.001) and EBF by 14.6% (95% CI: 3.77, 25.5%; p = 0.010). Similarly, the intervention gave higher breastfeeding attitude scores (Effect size (ES): 0.85SD; 95% CI: 0.70, 0.99SD; p < 0.001), but not higher knowledge scores (ES: 0.15SD; 95% CI: −0.10, 0.41SD; p = 0.173). From the several growth and morbidity outcomes evaluated, the only outcomes with significant intervention effect were a higher mid-upper arm circumference (ES: 0.25cm; 95% CI: 0.01, 0.49cm; p = 0.041) and a lower prevalence of respiratory infection (ES: −6.90%; 95% CI: −13.3, −0.61%; p = 0.033). Training WDA leaders to provide BFESI substantially improves EI and EBF practices and attitude towards breastfeeding.

Background: Researchers exploring breastfeeding attitudes and knowledge among women suggest the decision to breastfeed is influenced by the male partner, yet few studies address males. Because collegiate males will soon enter fatherhood, assessment of their attitudes and knowledge may inform interventions aimed at increasing intention to breastfeed. Research aim: This study aimed to describe collegiate males' exposure to, attitude toward, and knowledge about breastfeeding. Methods: A cross-sectional online survey was used with males ≥ 18 years of age enrolled at a Texas public university. Attitude indices measured included social limitations, public displays of breastfeeding, and employer accommodations. Descriptive statistics, correlational and regression analyses were employed. Results: The participants' (N = 949) average age was 25.48 years; > 80% reported not being fathers. Exposure to breastfeeding was high; > 80% witnessed breastfeeding and/or had someone close breastfeed. High attitude scores indicated social acceptability of breastfeeding. Knowledge appeared limited: only 16% identified the recommendation of exclusive breastfeeding for the first 6 months of life; > 50% overlooked the reduced risk for overweight/obesity, ear infections, diarrhea, or food allergies. Correlations between knowledge, exposure, total attitude, and index scores were positive (p <.01) except for the public displays index. Stepwise multiple regression determined that breastfeeding exposure, knowledge scores, and father's educational level predicted total attitude score, (R2 = 0.13, F (3,851) = 44.02, p <.01). Conclusion: The positive attitudes outcome among this male population is promising for breastfeeding support and advocacy. Education efforts improving knowledge will likely increase behavioral intention, resulting in increased breastfeeding rates and duration. [ABSTRACT FROM AUTHOR]

Objective  Sound breastfeeding (BF) knowledge among health professionals is vital for proper institutional support of BF mothers. This study aims to measure both BF knowledge and self-efficacy (SE) of pediatric nurses in supporting BF and to determine their associated factors. Study Design  A cross-sectional study was conducted in Mansoura University Children's Hospital and Mansoura New General Hospital during the period from January to March 2017. A total of 186 nurses completed a predesigned self-administered questionnaire developed by the investigators to measure BF knowledge and SE in BF counseling. Results  The overall total means of BF knowledge and SE scores were 26.8 (6.4) and 3.8 (0.6), respectively. Linear regression showed that having bachelor education, working in neonatal department, having a child (aged 2–5 years) were significant independent predictors of BF knowledge score (R 2  = 0.448, p  ≤ 0.001), while BF knowledge score is the only significant independent predictor of SE in BF counseling (R 2 = 0.36, p  ≤ 0.001). Conclusion  Higher pregraduation education, working in neonatal department, having children aged 2 to 5 years are independent predictors of BF knowledge. Improving BF knowledge may improve nurses' SE in supporting BF. [ABSTRACT FROM AUTHOR]