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Background: Breastfeeding has many benefits for mothers and infants. Lactogenesis II is one of the key steps in the implementation of breastfeeding. If lactogenesis II occurs more than 72 h after delivery, it is termed delayed onset of lactation (DOL). DOL is associated with decreased milk production, shortened breastfeeding time, and pathological neonatal weight loss. A comprehensive summary of the incidence and factors influencing DOL is needed to provide a basis for improving breastfeeding practices and health outcomes. Methods: Studies on the incidence and factors influencing DOL were retrieved from 13 Chinese and English databases (PubMed, Embase, Web of Science, Cochrane Library, CINAHL, etc.) from database inception to August 2023. Two researchers independently conducted the study screening, data extraction and quality evaluation. Stata 16.0 SE software was used for data analysis, and sensitivity analysis and publication bias tests were also performed. The qualitative description method was used to analyse studies that could not be combined quantitatively. Results: A total of 35 studies involving 19,176 parturients, including 4,922 who had DOL, were included. The mean Newcastle‒Ottawa scale score of the included studies was ≥ 6, indicating that the quality was relatively high. Finally, the incidence of DOL was 30%, and 13 factors influencing DOL with robust results and no publication bias were obtained: prepregnancy body mass index (overweight or obesity), gestational diabetes, gestational hypertension, thyroid disease during pregnancy, serum albumin levels (< 35 g/L), parity, (unscheduled) caesarean section, caesarean section history, daily sleep duration, gestational age, birth weight (< 2.5 kg), breastfeeding guidance and daily breastfeeding frequency. However, there were still six influencing factors with undetermined associations: age, gestational weight gain, birth weight (≥ 4 kg), anxiety, time of first breastfeeding session (maternal separation) and breast massage or treatment. Conclusions: The incidence of DOL is high. Clinicians should pay attention to parturients at high risk of DOL and formulate targeted prevention strategies according to the influencing factors to reduce the occurrence of DOL and promote better maternal and infant outcomes. Trial registration: PROSPERO (ID: CRD42023458786), September 10, 2023. [ABSTRACT FROM AUTHOR]

The article focuses on comparing cabergoline and pyridoxine for lactation inhibition in postpartum patients who do not desire to breastfeed. It highlights that cabergoline was more effective than pyridoxine in reducing breast engorgement and pain within the first week postpartum, with higher success rates observed on days 2 and 7.

The adoption of various practices for higher milk production from the animals is very pertinent, which generally increases peripartum disorders. In the period of transition phase (3 weeks before parturition and 3 weeks after parturition), an animal is in huge demand of energy for the developing fetus, colostrum production, and subsequent milk production for the postnatal development of the calf, and thus animals undergo a complex set of physiological and metabolic adaptations. The transition stress drastically has an impact on immunological function which leads the metabolic disorders in animals. In many experiments, it has been reported that immune dysfunction causes early lactation disorders during the period around the dryoff. The stress and dietary changes occur during the period of transition phase which may affect immunity, metabolic and physio-biochemical changes which finally affect the productive efficiency of animals. Several nutritional strategies and mental strategies have been adopted to minimize the detrimental consequences on the immune system during the transition phase. A suitable environment and a healthy balanced diet should be given to the transition cow to minimize transition phase challenges. Just after parturition, Dry matter (DM) consumption increases more slowly than milk energy output, therefore the animals cannot meet their nutritional needs only through feed consumption. During the last 3 weeks of pregnancy, nutrient demands by the fetal calf and placenta are at their greatest, and in a few animals, DM consumption may decrease by 10 to 30% as compared with consumption during the initial phase of the dry period. In such conditions, animals are exposed to negative energy balance and most of the animals attempt to make up energy balance by lipolysis of stored body fat. This leads to an increase in the non-esterified fatty acid (NEFA) in the blood and further, there is an accumulation of NEFAS in the liver causing fatty liver, which in turn stimulates cytokines. Cytokines activate receptors on different target cells leading to systemic inflammatory reactions resulting in several biochemical changes, such as elevated glucocorticoid and adrenocorticotrophic hormone production, the stimulation of the blood clotting process, decreased serum concentrations of calcium, zinc, copper, iron, and vitamin E. Ascorbic acid and vitamin E are typical antioxidant substances that break the chain of lipid radicals and transform them into more stable metabolites. Cu-Zn superoxide dismutase (SOD) and ceruloplasmin are two enzymes that copper and zinc are involved in, and these enzymes participate in the antioxidant system. In the cytosol, superoxide radicals are transformed into hydrogen peroxide by Cu-Zn SOD. Selenium aids in boosting neutrophil activity. Just before parturition, there is an increase in the level of serum cortisol and estrogen, which suppresses the immunity of animals by reducing the phagocytic index and lymphocyte proliferation in the animals. The animals become immune compromised and under such situations animals used to have different types of metabolic diseases viz, metritis, mastitis and retained placenta. The successful transition phase is of prime importance and concern to animal keepers by reducing macro-mineral deficiencies, lipid mobilization and immune suppression. The animal owner can get rid of transition problems of animals by supplementation of Vit E, Se, Cu, Zn, Chromium and 20-25% additional energy. This supplement may help animals to pass the transition phase successfully with minimal incidence of having metabolic diseases like mastitis, metritis and retained placenta. Further, it improves the quality of colostrums and milk and subsequently promotes the growth and health of newborn calves. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciencias de la Salud is the property of Colegio Mayor de Nuestra Senora del Rosario 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.)

Objective: Human milk is the preferred source of nutrition for infants in their first 6 months of life. A majority of American women will initiate breastfeeding, but many will not continue due to the many challenges that arise, creating a significant gap between initiation and the long-term exclusivity rate. This quality improvement project aimed to increase postpartum lactation support encounters, fostering the mother's knowledge and self-efficacy, which are known predictors for breastfeeding success. Methods: Program participants received proactive lactation support via telephone every 24–72 hours throughout the first 2 weeks postpartum. Breastfeeding knowledge, self-efficacy, and exclusivity pre- and postprogram were assessed. Results: All outreach attempts to participants were made as planned. Eight out of 20 enrolled participants completed the program and maintained breastfeeding exclusivity at 2 weeks. Breastfeeding knowledge scores were significantly higher at the completion of program compared with preprogram scores. Pre- and postprogram breastfeeding self-efficacy scores were not statistically significantly different; however, the mean was high for all participants, exceeding 65 both pre- and post-program. Conclusions: Transferrable knowledge from this quality improvement project will support sustainable improvement of lactation support across other institutions. [ABSTRACT FROM AUTHOR]

Continued breastfeeding is important for infants' health, but it is unclear whether mixed feeding increases the risk of breastfeeding cessation. We aimed to explore associations of mixed feeding and lactation problems with early cessation of breastfeeding. We analysed data from mothers who completed the Scottish National Maternal and Infant Feeding Survey and had previously breastfed their infants. At age 8–12 weeks, mothers (N = 1974) reported their feeding history and intentions, lactation problems and reasons for giving formula milk. The main outcome measure was cessation of breastfeeding before 6–8 weeks and time to cessation. By 6 weeks, 65% had mixed fed at some point, 32% had ceased breastfeeding, 22% were currently mixed feeding and 46% were exclusively breastfeeding. Lactation problems before 2 weeks were common (65%), and strongly associated with stopping breastfeeding (relative risk [RR]: 3.23, 95% confidence interval [CI]: 2.0–5.3) and with mixed feeding (RR: 3.14, 95% CI: 2.5–4.0). However, even after adjustment for breastfeeding problems mothers who planned to mixed feed (RR: 3.39, 95% CI: 2.4–4.9) and those who introduced formula for practicalities (RR: 3.21, 95% CI: 2.3–4.4) were more likely to stop breastfeeding. These variables also predicted later lactation insufficiency (planned mixed feeding RR: 1.39, 95% CI: 1.0–2.0; formula for practicalities RR: 1.76, 95% CI: 1.3–2.3). Mothers who received specialist lactation support were less likely to cease breastfeeding (RR: 0.63, 95% CI: 0.5–0.9) but nonspecialist input was unrelated to risk of cessation (RR: 1.06, 95% CI: 0.2–4.9). In conclusion, choosing to mix feed an infant is strongly associated with stopping breastfeeding, even in the absence of lactation problems. Key messages: According to the Scottish Maternal and Infant Feeding Survey, most mothers did not intend to mixed feed but a large proportion eventually mixed fed at some time.Lactation problems were commonly present during the first 2 weeks after birth, and those mothers who initially planned to mix feed were more likely to have had early and late lactation problems compared to mothers who maintained exclusive breastfeeding.After adjusting for early problems, mothers who planned to mixed feed or introduce formula were more likely to stop breastfeeding than those who did not.Specialist breastfeeding support was associated with a reduced risk of breastfeeding cessation. [ABSTRACT FROM AUTHOR]

Simple Summary: Ketosis (KET), a metabolic disorder frequently observed in dairy cows, is characterized by increased levels of ketone bodies. The "gold standard" for diagnosing ketosis is the concentration of blood β-hydroxybutyrate (BHB). The increasing number of studies focusing on BHB highlights the increasing significance of metabolic disorders in both the dairy industry and the scientific community. Additionally, the surge in research on the genetic and economic facets of the KET is likely correlated with the recent accessibility of extensive datasets containing blood BHB concentrations as routinely recorded traits in certain production systems. Such data are essential to accurately estimating the genetic parameters associated with these traits. Consequently, the objective of this study was to estimate genetic parameters and identify candidate genes related to blood BHB through genome-wide association analysis to provide research directions for dairy ketosis. Ketosis is a common metabolic disorder in the early lactation of dairy cows. It is typically diagnosed by measuring the concentration of β-hydroxybutyrate (BHB) in the blood. This study aimed to estimate the genetic parameters of blood BHB and conducted a genome-wide association study (GWAS) based on the estimated breeding value. Phenotypic data were collected from December 2019 to August 2023, comprising blood BHB concentrations in 45,617 Holstein cows during the three weeks post-calving across seven dairy farms. Genotypic data were obtained using the Neogen Geneseek Genomic Profiler (GGP) Bovine 100 K SNP Chip and GGP Bovine SNP50 v3 (Illumina Inc., San Diego, CA, USA) for genotyping. The estimated heritability and repeatability values for blood BHB levels were 0.167 and 0.175, respectively. The GWAS result detected a total of ten genome-wide significant associations with blood BHB. Significant SNPs were distributed in Bos taurus autosomes (BTA) 2, 6, 9, 11, 13, and 23, with 48 annotated candidate genes. These potential genes included those associated with insulin regulation, such as INSIG2, and those linked to fatty acid metabolism, such as HADHB, HADHA, and PANK2. Enrichment analysis of the candidate genes for blood BHB revealed the molecular functions and biological processes involved in fatty acid and lipid metabolism in dairy cattle. The identification of novel genomic regions in this study contributes to the characterization of key genes and pathways that elucidate susceptibility to ketosis in dairy cattle. [ABSTRACT FROM AUTHOR]

Essential thrombocythemia (ET) is a malignant hematological disease that has the ability to progress to acute leukemia or transform into other myeloproliferative neoplasms (MPNs). The coexistence of ET and other MPNs with pituitary adenoma (PA) is rare. There are no reports of cases of secretory PA of prolactin hormone in combination with ET. This case was reported in a young woman from Saudi Arabia who had the secretory PA present in combination with ET. The 20-year-old patient was treated for a micro-PA with hyperprolactinemia. The patient was referred to the hematological service for thrombocytosis. There was no history of thrombosis, cardiovascular risk factors, or constitutional symptoms. Laboratory tests showed that platelet levels consistently lagged from 700 × 103/µL to 1000 × 103/µL for 1 year. Hemoglobin 13 g/dL, white blood cells (WBCs) 6 × 103/µL, and normal WBC differential. The peripheral blood smear was inconclusive. A peripheral blood sample was sent for the cytogenetic study of myeloproliferative diseases, which came to be positive for c.1849G>T p.(V617F) mutation in the EXON 14 Janus kinase 2 (JAK2) gene. The patient was diagnosed with a MPN, ET with positive exon 14 JAK2, at low-risk category. Evidence suggests that MPNs in combination with endocrinological diseases are rare. However, there is a high incidence of MPN and unrelated tumors such as PA. Further research is recommended to thoroughly investigate endocrine tumors and look beyond secondary thrombocytosis that leads to thrombocythemia as in ET. [ABSTRACT FROM AUTHOR]

Prolactinoma is the most common secreting pituitary adenoma. It has different clinical presentation in men and women which varies with age. Young women present with menstrual problems, infertility and galactorrhoea, whilst older women and men may present with loss of libido, visual disturbances and in late cases, with osteoporosis. In approaching a young woman with secondary amenorrhoea, other causes such as pregnancy, functional hypothalamic amenorrhea, pituitary adenoma, Polycystic Ovarian Syndrome (PCOS) or primary ovarian insufficiency should be ruled out. Prolactinoma can be confirmed in the presence of high serum prolactin level and adenoma on pituitary gland magnetic resonance imaging (MRI). Dopaminergic agonist, cabergoline is efficacious in restoring gonadal and sexual functions by normalising prolactin levels. We presented a case report on an 18-year-old girl who presented with secondary amenorrhoea for six months. On further evaluation she was noted to have galactorrhoea with substantially high prolactin level of 466.9 ng/mL (normal range: 4.0- 23) and the MRI showed a pituitary tumour measuring 1.2 x 1.1 x 1.4 cm. A diagnosis of macroprolactinoma was made and she was managed with cabergoline with gradual dose increment. At 6 months of treatment, her menstrual cycle and serum prolactin had normalised. A repeat MRI pituitary one year later showed reduction in tumour size. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) 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.)

This study aims to analysis adverse drug events (ADE) related to Brexpiprazole from the third quarter of 2015 to the first quarter of 2023 from FAERS database. The ADE data related to Brexpiprazole from 2015 Q3 to 2023 Q1 were collected. After standardizing the data, a variety of signal quantification techniques, including ROR, PRR, BCPNN, and MGPS were used for analysis. Among the 8559 ADE reports with Brexpiprazole as the primary suspected drug, 178 preferred terms (PT) of adverse reactions spanning 27 different system organ classes (SOC) were identified. Specifically, Metabolism and nutrition disorders and Reproductive system and breast disorders were unique adverse reactions to Brexpiprazole, with the latter not mentioned in the official drug label. Moreover, uncommon but significantly strong ADE signals, such as Egocentrism, Pharmacophobia, and Compulsions were observed. Notably, Tardive dyskinesia (n = 317, ROR 103.87, PRR 102.21, IC 6.21, EBGM 96.17) and Extrapyramidal disorder (n = 104, ROR 31.17, PRR 31.00, IC 4.57, EBGM 30.44) exhibited relatively high occurrence rates and signal strengths. Additionally, Lactation disorder (n = 6, ROR 48.09, PRR 48.07, IC 2.63, EBGM 46.71) and Breast discharge (n = 10, ROR 23.18, PRR 23.17, IC 2.94, EBGM 22.86) were observed, both presenting strong ADE signals. Brexpiprazole poses risks of various adverse reactions while providing therapeutic effects. In clinical applications, practitioners should closely monitor occurrences of Psychiatric disorders, Metabolism and nutrition disorders, Reproductive system and breast disorders, and other events. • From 2015 Q3 to 2023 Q1, 8,559 ADE reports with Brexpiprazole were identified, spanning 27 different SOC with 178 PTs. • Unique adverse reactions to Brexpiprazole included Metabolism and nutrition disorders and Reproductive system and breast disorders. • Tardive dyskinesia and Extrapyramidal disorder exhibited high occurrence rates and signal strengths. [ABSTRACT FROM AUTHOR]

Objectives: Physicians may be asked to prescribe, recommend, or discuss foods, herbs, and medications for low milk supply. It is unclear how factors such as education, experience, and regulations influence clinical practice. The objective was to document physicians' clinical practice surrounding pharmacologic, nutritional, and herbal products for the management of low milk supply. Methods: Physicians from two Facebook groups completed an anonymous, online survey about their clinical use of pharmaceutical, supplemental, and nutritional substances perceived to increase milk production. The association between practice patterns and lactation medicine expertise or country for different perceived galactagogues was determined. Results: A total of 307 physicians completed the primary portion of the survey. There was no difference in the proportion of physicians in Canada or the United States (U.S.) who were defined as lactation medicine experts. Canadian physicians were more likely to prescribe metformin, levothyroxine, and domperidone for low milk supply compared with U.S.-based physicians. Canadians and experts were more likely than U.S.-based and nonexpert physicians, respectively, to include herbs in their practice. Patient request, personal and clinical experience, and lack of education, research, or access were frequently selected as reasons for or against using a specific substance. Conclusions: The U.S. Food and Drug Administration ban on domperidone affects low milk supply management in North America. Though Canadian physicians prescribed domperidone without limitations, U.S. physicians were less likely to incorporate it into clinical practice. Despite a lack of evidence, physicians in North America frequently used herbs and foods to increase milk production. [ABSTRACT FROM AUTHOR]

Background: Milk provides a readily available diagnostic fluid collected daily or more frequently on an individual animal or herd basis. Milk, as an aggregated sample in bulk tank milk (BTM) represents the status of a herd instead of a single animal. In this review, we examine the potential for milk to predict risks to efficient production, reproductive success, and health on the individual cow and herd level. Findings: For many conditions related to disorders of metabolism including hyperlipdaemia and ketonaemia, improved individual cow milk testing may allow a temporally useful detection of metabolic disorder that can target intervention. However, the extension of these tests to the BTM is made more difficult by the tight temporal clustering of disorder to early lactation and the consequent mixing of cows at even moderately different stages of lactation. Integrating herd recording demographic information with Fourier‐transformed mid‐infrared spectra (FT‐MIR) can provide tests that are useful to identify cows with metabolic disorders. The interpretation of BTM urea and protein content provides useful indications of herd nutrition. These may provide indicators that encourage further investigations of nutritional influences on herd fertility but are unlikely to provide strong diagnostic value. The fat‐to‐protein ratio has a high specificity, but poor sensitivity for detection of fibre insufficiency and acidosis on an individual cow basis. Selenium, zinc, β‐carotene, and vitamin E status of the herd can be determined using BTM. Conclusions: There appears to be increasing potential for the use of milk as a diagnostic fluid as more in‐parlour tests become available for individual cows. However, the BTM appears to have under‐utilised potential for herd monitoring. [ABSTRACT FROM AUTHOR]

Copyright of Ahi Evran Medical Journal is the property of Ahi Evran University 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.)

Breastfeeding is a key issue found in ancient sources that resonates with public debates today, affecting women in different parts of the world and of all social classes. The aim of this research was to identify breastfeeding narratives in ancient medical and philosophical texts from the 1st to the 6th century CE that address ethical issues in the medical management and social perception of new mothers. We examined 15 literary sources and one funerary inscription on lactation and critically evaluated the ancient idea of the perfect breastfeeding mother versus the non-breastfeeding mother. We then discussed our historical data in terms of objectivity and significance in relation to contemporary attitudes towards motherhood and lactation, e.g., (1) the cult of the perfect, breastfeeding mother in contemporary lactation education and (2) the onset of conditions which may affect normal breastfeeding, such as dysphoric milk ejection reflex (D-MER), breastfeeding aversion response (BAR) or post-partum depression. The analysis of the results showed that in both ancient and contemporary postnatal health care: (1) good mothering is associated with breastfeeding and (2) alternative feeding methods are acknowledged, but never as the best, natural option. Finally, our analysis shows that public health policies on breastfeeding and mothers' own knowledge of their bodies are contested between nursing theories, social expectations and economic factors. [ABSTRACT FROM AUTHOR]

Background and objectives: Belief and experience of insufficient milk supply (IBMS) are important and modifiable factors for optimal breastfeeding. However, very few people know about maternal belief, experience about breast milk supply, and how it impacts breastfeeding practice. The aim of the study is to identify the prevalence and association between mothers' belief and experience of insufficient breast milk supply with mother's knowledge regarding breast feeding. Methods: This descriptive cross-sectional study was conducted on (1,000) participants who took six months postpartum in the primary health care centers (PHCC) and Raparin Teaching Hospital for children (RTHC) in Erbil city/Iraq. Data were collected via direct interview. The question used in the interview were developed after a review of the relevant literature. Frequency, percentage, and Chi-square were used for the purpose of data analysis. Results: In general, the study showed the prevalence of mothers' belief regarding insufficient breast milk supply was 59.8%. Also, the prevalence of a mother's experience was 78.6%. Mothers who had a poor level of knowledge regarding breastfeeding got the highest percentage, 62.2%. However, it showed the highly significant association between mothers' knowledge and mode of the last delivery with mothers' belief of insufficient breast milk supply. Moreover, there was a highly significant association between mother's experience with socio economic status. Conclusion: The majority of the mothers had belief and experience of insufficient breast milk supply (IBMS). The current study showed a significant association between mothers' belief with mother's knowledge regarding the benefits of breastfeeding. [ABSTRACT FROM AUTHOR]

Simple Summary: Early lactation health disorders and their treatment are an important cause of welfare issues and production losses in dairy herds. These losses could be mitigated if cows at greater risk of health problems can be identified prior to calving. Cow mounted devices designed to monitor certain aspects of cow behavior may offer the opportunity to predict prior to calving which cows are likely to be at greater risk post calving by providing an alert based on each cow's behavior. This study attempted to determine the level and accuracy of alerts provided by one such monitoring system. Results revealed an alert level of 38.7% with an accuracy of prediction of 62.5%. These findings reflect the level of early health disorders observed in commercial dairy herds. Further research is required to improve the accuracy of prediction for cows receiving treatments for ill health and to develop effective measures to prevent the occurrence of those treatments. Identifying cows that are at greater risk for disease prior to calving would be a valuable addition to transition management. Prior to the commercial release of software features in an automated behavioral monitoring system, designed to identify cows in the dry period at greater risk of disease postpartum, a retrospective analysis was carried out in five dairy herds to evaluate whether the software could identify prepartum cows that subsequently received health treatments postpartum and whether prepartum alerts (transition alerts) are associated with a reduction in milk production in the subsequent lactation. Herd management and production records were analyzed for cows receiving treatment in the first 21 d of lactation (days in milk, DIM) for clinical mastitis, reproductive tract disease (metritis, retained fetal membranes), metabolic disease (hypocalcemia, ketosis and displaced abomasum) and for cows exiting the herd by 60 DIM. Data was gathered for 986 cows, 382 (38.7%) of which received a transition alert and 604 (61.3%) that did not. During the first 21 DIM 312 (31.6%) cows went on to receive a disease treatment, of these 51.9% (n = 162/312) were transition alert cows and 48.1% (n = 150/312) non-transition alert cows, while 8.6% (n = 33/382) alert cows exited the herd by 60 DIM compared to 4.8% (n = 29/604) of cows that did not receive an alert. A cow receiving a transition alert (OR = 1.76, 95% confidence interval (CI) = 1.27–2.44) and increasing parity (OR = 2.03, 95% CI = 1.44–2.86) were both associated with increased risk of receiving a disease treatment in the first 21 DIM. The occurrence of a transition alert was negatively associated with both week 4 milk yield (daily average yield in fourth week of lactation) and predicted 305 d yield. Transition alerts correctly predicted 62.5% (95% CI: 59.3–65.5) of treatments with a sensitivity of 42.4% (95% CI: 37.4–45.5) and a specificity of 75.2% (95% CI: 71.5–78.6). Associations were identified between postpartum health and production outcomes and prepartum behavioral measures from an automated activity monitoring system. [ABSTRACT FROM AUTHOR]

Raw area on the breast, especially when it is lactating, can lead to complications, including hyperprolactinemia and development of milk fistulae. A 25-year-old female presented with raw area over the left breast after 2 months of childbirth. She had history suggestive of necrotizing disease, which had primarily been managed elsewhere with debridement and dressings. We excised the raw area and applied split thickness skin grafts with minimal meshing. Bulky dressing prevented breastfeeding. On postoperative day 3, there were blebs containing milk underneath the graft. The blebs were drained and oral cabergoline was administered for 3 months. The skin graft healed well. If expression of breast milk is not possible then suppression of lactation should be considered before definitive cover of the raw area of breast. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Several factors may affect the production of breast milk - among them, the difficulty in breastfeeding per se, the reduction of oxytocin due to stress, and the use of medication. In this study, a systematic review of the subject has been made through the use of the following databases: PubMed, Scielo, and LILACS. OBJECTIVE: To evaluate the factors medicated that influence breas tmilk production. DISCUSSION: Medications such as galactagogues and lactation inhibitors interfere in the process - either increasing or decreasing the volume of milk produced by the mothers. CONCLUSÃO: On the other hand, medications like metoclopramide, sulpiride, and domperidone are galactagogues, that is, they increase milk production. Among the medications that may inhibit lactation, pseudoephedrine stands out. However, further studies are necessary to evaluate the actual safety of mothers use of medication while breastfeeding.

Background: In 2022 the Academy of Breastfeeding Medicine (ABM) published Clinical Protocol #36: The Mastitis Spectrum, which aims to update clinical approaches to management of benign lactation-related breast inflammation. The protocol has been timely because of the exponential increase in knowledge about the human milk microbiome over the past decade. This Commentary aims to continue respectful debate amongst clinicians and researchers within the Academy of Breastfeeding Medicine and more broadly, confident that we share a fundamental commitment to promote breastfeeding and support the well-being of lactating women, their infants and their families. Analysis: Although Clinical Protocol #36 offers advances, it does not fulfil the principles of best practice implementation science for translation of evidence into clinical guidelines. Clinical Protocol #36 inaccurately represents studies; misrepresents theoretical models as proven aetiologies; does not consistently attribute sources; does not reliably apply the SORT taxonomy; and relies upon single case reports. As a result, various recommendations in Clinical Protocol #36 lack an evidence-base or credible underlying theoretical model. This includes recommendations to use 'lymphatic drainage' massage, therapeutic ultrasound, and oral lecithin. Similarly, based on a contestable theoretical model which is presented as fact, Clinical Protocol #36 makes the recommendation to either reduce frequency of milk removal or to maintain current frequency of milk removal during an episode of breast inflammation. Although Clinical Protocol #36 limits this advice to cases of 'hyperlactation', the diagnosis 'hyperlactation' itself is undefinable. As a result, this recommendation may put breastfeeding women who present with breast inflammation at risk of worsened inflammation and decreased breast milk production. Conclusion: Clinical Protocol #36 offers some advances in the management of breast inflammation. However, Clinical Protocol #36 also exposes clinicians to two international trends in healthcare which undermine health system sustainability: overdiagnosis, including by over-definition, which increases risk of overtreatment; and antibiotic over-use, which worsens the crisis of global antimicrobial resistance. Clinical Protocol #36 also recommends unnecessary or ineffective interventions which may be accessed by affluent patients within advanced economies but are difficult to access for the global majority. The Academy of Breastfeeding Medicine may benefit from a review of processes for development of Clinical Protocols. [ABSTRACT FROM AUTHOR]

Copyright of Enfermagem Brasil is the property of Atlantica Editora 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.)

The article focuses on the effectiveness of cabergoline in reducing lactation-related breast symptoms after second-trimester uterine evacuation. It explores a double-blind, randomized controlled trial found that a one-time dose of 1 milligram of cabergoline significantly reduced breast symptoms compared to a placebo, providing an evidence-based remedy for patients experiencing unwanted lactation after pregnancy loss or induced abortion.

Dopamine agonists are the first-line treatment of prolactinomas. The risk of developing de novo psychiatric symptoms during dopamine agonist therapy is low. Herein, we report the case of a 42-year-old woman with a giant prolactinoma who developed a psychiatric disorder after 1 day of cabergoline therapy initiation. She presented with amenorrhea, galactorrhea, headaches, and disturbed vision. Biological investigations revealed hyperprolactinemia (2975 ng/ml) with gonadotropin deficiency. Pituitary MRI showed a giant pituitary adenoma. The patient was treated with cabergoline at the dose of 1 mg twice weekly. One day after the treatment initiation, she developed acute delirium with temporospatial disorientation and compulsive medication use. These symptoms disappeared 1 week after the reduction of the dose of cabergoline. Patients with hyperprolactinemia receiving an initial high dose of cabergoline may develop changes in mood and behavior regardless of prior psychiatric history. [ABSTRACT FROM AUTHOR]

Objective of this study is to explore the predisposing factors for GLM.Patients and methods: This case-control study was conducted from 2018 to 2021 at Beijing Hospital of Traditional Chinese Medicine, Capital Medical University. Patients with GLM (cases) were matched with healthy examinees (controls) in a 1:1 ratio according to gender and living area. We analyzed their demographic features and investigated 75 factors that may be relevant to GLM using a standard questionnaire. Univariate and multivariable binary conditional logistic regression analyses were used to compare the differences between the two groups and evaluate the predisposing factors that may induce GLM.Results: There were 594 female GLM patients and 594 matched controls included in the study. The average age of the cases was 32.78 years (mainly 20 to 40). The incidence was high within five years after childbirth, and lesions were mainly in the unilateral breast. Univariate and multivariable conditional logistic regression analyses obtained six relevant factors and six high-risk factors. The six relevant factors included age, marriage, emotional abnormality, high prolactin, psychiatric drug intake, and sex hormone intake. Additionally, the independent high-risk factors for GLM included gestation, nipple invagination, blunt trauma, non-iatrogenic massage, lactation disorder, and nipple discharge (odds ratio (OR)=17.378, 8.518, 4.887, 3.116, 2.522, 1.685, P< 0.05). Menopause was an independent protective factor (OR=0.249, P< 0.05).Conclusion: The factors that increase milk and secretion production in the mammary duct are the main risk factors of GLM, especially when the nipples are invaginated. These factors can obstruct the duct and induce inflammation. Additionally, hormonal disorders, extrinsic trauma, and emotional abnormalities can accelerate the occurrence of GLM. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to assess the effectiveness of lukewarm water compress on breast pain and breast engorgement among postcesarean primiparous mothers. Materials and Methods: This quasi-experimental posttest-only design was conducted with 60 post-cesarean section primiparous mothers between October 2018 and January 2019. A simple random sampling technique was used to allocate 30 participants to both experimental and control groups. The experimental group received lukewarm water compress using a sponge cloth for 20 min twice a day on the second, third, and fourth postnatal days. The control group received routine hospital care. Breast pain and engorgement were assessed using the Visual Analog Pain Scale and Breast Engorgement Assessment Scale on the third, fourth, and fifth postnatal days. Results: Significant differences were observed between the experimental and control groups on day 1 and day 3 in terms of breast pain and engorgement scores among post-cesarean section mothers (P < 0.001). In addition, no statistically significant differences were found between sociodemographic and breastfeeding parameters and breast pain and engorgement (P > 0.05). Conclusion: Lukewarm water compress is effective in reducing breast pain and engorgement in post-cesarean primiparous mothers. Future research can include randomized controlled trials to evaluate the effectiveness of different therapies in treating breast pain and engorgement. [ABSTRACT FROM AUTHOR]

Objective: Low-carbohydrate diets are a popular approach to weight loss, including among breastfeeding women. Seventeen published case reports show that inadequate carbohydrate intake while breastfeeding can contribute to lactation ketoacidosis. While these case reports describe the clinical markers of lactation ketoacidosis, no studies describe these women's experiences in more detail. This study sought to provide insight into how and why women follow low-carbohydrate diets while breastfeeding. Methodology: This study was exploratory in nature, involving an online survey and follow-up phone interviews. Quantitative data were analyzed using simple descriptive statistics, while qualitative data were analyzed by thematic analysis. Results: Every respondent reported limiting carbohydrates to some degree, with the majority describing their diet as "ketogenic" (18 of 21 respondents). Qualitative results revealed that women approached such diets after what each believed had been thorough research of available resources. While these diets can be stringent, liberalizing carbohydrate and energy intake helped mothers maintain their milk supply. One interviewee described her own experience with hospitalization for lactation ketoacidosis. Conclusion: Given low-carbohydrate diets' appeal for both weight loss and other reported health benefits, it behooves healthcare providers to recognize that carbohydrate restriction and its potential consequences may be more common than existing research demonstrates. Case studies comprise a large part of this research area thus far, and until more research is conducted, healthcare providers who care for breastfeeding mothers can use this study's insights to cultivate a more detailed understanding of how and why this population follows low-carbohydrate diets. [ABSTRACT FROM AUTHOR]

Traditional Chinese medicine breast massage, also known as breast Tuina or manual expression of breast milk, is a technique of using certain manipulations to act on specific positions or acupoints of the breast to promote blood and lymphatic circulation of breast and facilitate the discharge of stagnant milk. This technique is widely used in China to treat breastfeeding problems such as breast engorgement, mastitis, and postpartum hypogalactia. In this article, we introduce the definition and standardization process of breast massage, elaborate the operating procedures of breast massage in detail, and summarize and discuss the current situation of its clinical application, so as to provide a reference for its wide application and in-depth research. [ABSTRACT FROM AUTHOR]

Milk lipid secretion is a critical process for the delivery of nutrition and energy from parent to offspring. However, the underlying molecular mechanism is less clear. Here we report that TDP-43, a RNA-binding protein, underwent positive selection in the mammalian lineage. Furthermore, TDP-43 gene (Tardbp) loss induces accumulation of large lipid droplets and severe lipid secretion deficiency in mammary epithelial cells to outside alveolar lumens, eventually resulting in lactation failure and pup starvation within three weeks postpartum. In human milk samples from lactating women, the expression levels of TDP-43 is positively correlated with higher milk output. Mechanistically, TDP-43 exerts post-transcriptional regulation of Btn1a1 and Xdh mRNA stability, which are required for the secretion of lipid droplets from epithelial cells to the lumen. Taken together, our results highlights the critical role of TDP-43 in milk lipid secretion, providing a potential strategy for the screening and intervention of clinical lactation insufficiency.

Study objectives were to evaluate the effects of feeding rumen-protected Met (RPM) in pre- and postpartum total mixed rations (TMR) on health disorders and the interactions of health disorders with lactation and reproductive performance. Multiparous Holstein cows [470; 235 cows at University of Wisconsin (UW) and 235 cows at Cornell University (CU)] were enrolled at approximately 4 wk before parturition and housed in close-up dry cow (n = 6) and replicated lactation pens (n = 16). Pens were randomly assigned to treatment diets (pre- and postpartum, respectively): (1) control (CON): basal diet = 2.30% and 2.09% Met as % of metabolizable protein (MP) (UW) or 2.22% and 2.19% Met as % of MP (CU); (2) RPM: basal diet fed with RPM with 2.83% and 2.58% Met (Smartamine M, Adisseo Inc.; 12 g prepartum and 27 g postpartum), as % of MP (UW) or 2.85% and 2.65% Met (Smartamine M; 13 g prepartum and 28 g postpartum), as % of MP (CU). Total serum Ca was evaluated at the time of parturition and on d 3 ± 1 postpartum. Daily rumination was monitored from 7 d before parturition until 28 d postpartum. Health disorders were recorded during the experimental period until the time of first pregnancy diagnosis (32 d after timed artificial insemination; 112 ± 3 d in milk). Uterine health was evaluated on d 35 ± 3 postpartum. Time to pregnancy and herd exit were evaluated up to 350 d in milk. Treatment had no effect on the incidence of most health disorders and did not alter daily rumination. Cows fed RPM had reduced subclinical hypocalcemia (13.6 vs. 22%; UW only) on day of parturition relative to CON. Percentage of cows culled (13.1 vs. 19.3%) and hazard of herd exit due to culling [hazard ratio = 0.65, 95% confidence interval (CI): 0.42–1.02] tended to be reduced for cows fed RPM compared with CON. Moreover, cows fed RPM had greater milk protein concentration and protein yield overall, although retrospective analysis indicated that RPM only significantly increased protein yield in the group of cows with one or more health disorders (1.47 vs. 1.40 kg/d), not in cows without health disorders (1.49 vs. 1.46 kg/d) compared with CON. Overall, treatment had no effect on pregnancy per timed artificial insemination; however, among cows with health disorders, those fed RPM had reduced time to pregnancy compared with CON (hazard ratio = 0.71, 95% CI: 0.53–0.96). Thus, except for subclinical hypocalcemia on the day of parturition, feeding RPM in pre- and postpartum TMR did not reduce the incidence of health disorders, but our retrospective analysis indicated that it lessened the negative effects of health disorders on milk protein production and time to pregnancy. [ABSTRACT FROM AUTHOR]

Screening for drug-induced hyperprolactinaemia, a condition characterised by higher-than-normal levels of serum prolactin induced by drug treatments, requires a comprehensive understanding of the clinical presentations and long-term complications of the condition. Using two databases, Embase and MEDLINE, we summarised the available evidence on the clinical presentations and long-term complications of drug-induced hyperprolactinaemia. Clinical and observational studies reporting on drug treatments known or suspected to induce hyperprolactinaemia were included. Database searches were limited to the English language; no date or geographic restrictions were applied. Fifty studies were identified for inclusion, comprising a variety of study designs and patient populations. Most data were reported in patients treated with antipsychotics, but symptoms were also described among patients receiving other drugs, such as prokinetic drugs and antidepressants. Notably, the diagnosis of drug-induced hyperprolactinaemia varied across studies since a standard definition of elevated prolactin levels was not consistently applied. Frequent clinical presentations of hyperprolactinaemia were menstrual cycle bleeding, breast or lactation disorders, and sexual dysfunctions, described in 80% (40/50), 74% (37/50), and 42% (21/50) of the included studies, respectively. In the few studies reporting such symptoms, the prevalence of vaginal dryness impacted up to 53% of females, and infertility in both sexes ranged from 15 to 31%. Clinicians should be aware of these symptoms related to drug-induced hyperprolactinaemia when treating patients with drugs that can alter prolactin levels. Future research should explore the long-term complications of drug-induced hyperprolactinaemia and apply accepted thresholds of elevated prolactin levels (i.e., 20 ng/mL for males and 25 ng/mL for females) to diagnose hyperprolactinaemia as a drug-induced adverse event. Trial Registration PROSPERO International Prospective Register Of Systematic Reviews (CRD42021245259). [ABSTRACT FROM AUTHOR]

The researchers' aims are to determine the effect of cold cabbage leaf application on breast engorgement and pain during the postpartum period through a systematic review and meta-analysis. Between June and September 2021, researchers systematically searched Turkish and English databases using a combination of keywords. We calculated individual and general effect sizes of the studies to evaluate effect sizes. We obtained 25,996 results with the databases search and we included a total of eight studies for analysis. According to the pooled results, we determined that cold cabbage leaf application caused a significant reduction in breast pain, though no significant reduction was seen in breast engorgement. In this systematic review and meta-analysis, we found that cold cabbage leaf application was effective in reducing breast pain, but that more experimental studies are needed to determine its effect on breast engorgement. Breast engorgement is a common physiological problem for lactating mothers. Researchers state that the results of the eight studies included in the analysis suggested that cold cabbage leaf application was effective in reducing breast pain. More studies are needed to evaluate the effect of cold cabbage application on reducing breast engorgement. [ABSTRACT FROM AUTHOR]

Background: Better understanding of the factors associated with formula feeding during the hospital stay can help in identifying potential lactation problems and promote early intervention. Our aim was to ascertain factors associated with exclusive formula feeding in newborns of low‐risk pregnancies. Methods: A population‐based, retrospective study using the United States vital statistics datasets (2014‐2018) evaluating low‐risk pregnancies with a nonanomalous singleton delivery from 37 to 41 weeks. People with hypertensive disorders, or diabetes, were excluded. Primary outcome was newborn feeding (breast vs exclusive formula feeding) during hospital stay. Adjusted relative risks (aRRs) with 95% confidence intervals (CI) were calculated. Results: Of the 19 623 195 live births during the study period, 11 605 242 (59.1%) met inclusion criteria and among them, 1 929 526 (16.6%) were formula fed. Factors associated with formula feeding included: age < 20 years (aRR 1.31 [95% CI 1.31‐1.32]), non‐Hispanic Black (1.42, 1.41‐1.42), high school education (1.69, 1.69‐1.70) or less than high school education (1.94, 1.93, 1.95), Medicaid insurance (1.52, 1.51, 1.52), body mass index (BMI) < 18.5 (1.10, 1.09‐1.10), BMI 25‐29.9 (1.09, 1.09‐1.09), BMI 30‐34.9 (1.19, 1.19‐1.20), BMI 35‐39.9 (1.31, 1.30‐1.31), BMI ≥ 40 (1.43, 1.42‐1.44), multiparity (1.29, 1.29‐1.30), lack of prenatal care (1.49, 1.48‐1.50), smoking (1.75, 1.74‐1.75), and gestational age (ranged from 37 weeks [1.44, 1.43‐1.45] to 40 weeks [1.11, 1.11‐1.12]). Conclusions: Using a large cohort of low‐risk pregnancies, we identified several modifiable factors associated with newborn feeding (eg, prepregnancy BMI, access to prenatal care, and smoking cessation). Improving the breast feeding initiation rate should be a priority in our current practice to ensure equitable care for all neonates. [ABSTRACT FROM AUTHOR]

Purpose: Supportive interventions to improve breastfeeding practice are needed in nursing. This study investigated the effects of pectoralis major myofascial release massage (MRM) on breast pain and engorgement among breastfeeding mothers and on breast milk intake and sleep patterns among newborns. Methods: Breastfeeding mothers who had delivered between 37 and 43 weeks and had 7-to 14-day-old newborns were recruited from a postpartum care center in Gunpo, Korea. Participants were randomized to the MRM or control group. The outcome variables were breast pain and breast engorgement among breastfeeding mothers and breast milk intake and sleep time among newborns. The experimental treatment involved applying MRM to separate the pectoralis major muscle and the underlying breast tissue in the chest. After delivery, the first MRM session (MRM I) was provided by a breast specialist nurse, and the second (MRM II) was administered 48 hours after MRM I. Results Following MRM, breast pain (MRM I: t=-5.38, _p<.001; MRM II: t=-10.05, p<.001), breast engorgement (MRM I: right, t=-1.68, p =.100; left, t=-2.13, p=.037 and MRM II: right, t=-4.50, p<.001; left, t=-3.74, p<.001), and newborn breast milk intake (MRM I: t=3.10,p=.003; MRM II: t=3.09, p=.003) differed significantly between the groups. Conclusion MRM effectively reduced breast engorgement and breast pain in breastfeeding mothers, reducing the need for formula supplementation, and increasing newborns' breast milk intake. Therefore, MRM can be utilized as an effective nursing intervention to alleviate discomfort during breastfeeding and to improve the rate ofbreastfeeding practice (clinical trial number: KCT0002436). [ABSTRACT FROM AUTHOR]

Background: Improved health outcomes for critically ill infants including neurodevelopmental, immunological, and cost benefits are dependent upon the dose and duration of mother's own milk feedings. However, mothers of infants admitted to the neonatal intensive care unit (NICU) must express their milk (pump-dependent) and often struggle with milk production. Purpose: To examine the state of the science on nonpharmacologic modifiable expression factors that may influence milk production in pump-dependent mothers of critically ill infants admitted to the NICU. Data Sources: PubMed, Embase, and CINAHL databases from 2005 to 2020. Search Strategy: Guided by the lactation conceptual model, the authors searched for peer-reviewed studies with terms related to milk volume, pump dependency, critically ill infants, and modifiable factors, which may influence milk volume and assessed 46 eligible studies. Data Extraction: Data were extracted by 3 reviewers with a systematic staged review approach. Results: Evidence from 26 articles found expressed milk volume may be influenced by multiple potentially modifiable factors. Simultaneous expression with a hospital-grade electric pump at least 5 times per day beginning 3 to 6 hours after delivery, and adding complementary techniques including hand expression, hands-on-pumping, music, breast massage, warm compresses, skin-to-skin care, and the mother expressing near her infant may promote increased milk volume. Implications for Practice and Research: Healthcare providers should assist pump-dependent mothers with early initiation and frequent milk removal with a hospital-grade breast pump. Further research is needed to explore optimal frequency of expressions, dose and timing of skin-to-skin care, and other targeted strategies to improve expressed milk volume. [ABSTRACT FROM AUTHOR]

Objective: To know the actions developed by nurses, in the promotion, encouragement and support of breastfeeding, in the scope of primary health care. Methods: This is a cross-sectional, descriptive, quantitative study. The study participants were 13 nurses active in primary care. Data collection occurred through a form and were analyzed descriptively by simple frequency and compared with the literature. Results: The question of the orientations developed by the nurse regarding breastfeeding was observed with greater relevance. The main complications attended in the units are nipple fissures, difficulty in the handle and breast engorgement. Most participants reported not having a written standard on breastfeeding in the health unit. Conclusion: Nurses advise on how to prevent complications in breastfeeding, but institutionally there is no implementation of these actions. There is a fragility in the actions developed in groups and to promote the participation of the family and the support network of the pregnant woman. [ABSTRACT FROM AUTHOR]

Background: Breast feeding is not easy but it is worthy; since it provides all nourishment to baby needs, the primi women need to be responsible mother, so as to best support the health of her generation. Objective: Thus this article studies about the effective strategies of planned teaching program on Breast engorgement among primi mothers. Research Design: A pre-quasi experiment with one group pre-test and post-test design was used to evaluate the structured teaching programme knowledge regarding prevention of breast engorgement among primi mothers conducted at G.V. Annai hospital, Villapakkam, (2021-2022). Methodology: 160 primi mothers who satisfied the inclusion criteria were selected as sample using probability sampling techniques; planned teaching was given the pre-test and post-test level of knowledge on Breast Engorgement assessed by using structured questionnaire. Results: The major findings indicated that primi mothers had inadequate knowledge. The findings revealed that the mean pre-test level of knowledge of Breast Engorgement among the primi mothers was 20 with the SD of 5.84 and mean post-test level of knowledge among the primi mothers 28 with the SD of 5.06 the calculated 't' value was 31.84 which was significant at p<0.05 level. The findings revealed that there was a high statistical SD is level of knowledge of Breast Engorgement among primi mother, further the analysis revealed that the demographic variables showed statistically no significant association of mean difference level of knowledge of Breast Engorgement among primi at p>0.05 level. Conclusion: The results revealed that there was an enhancement with the level of knowledge after giving the planned teaching program on Breast Engorgement among primi mothers. Thus the planned teaching program on Breast Engorgement among primi was an effective technique, further more intervention studies should be carried out for improving the knowledge regarding prevention of breast engorgement. [ABSTRACT FROM AUTHOR]

Objectives: To retrospectively evaluate the effectiveness of ultrasonic therapy for severe breast engorgement or blocked mammary ducts, and to report the change in the mode of feeding after ultrasonic therapy and lactation consultation for mothers. Methods: Medical records of mothers who underwent ultrasonic therapy for blocked milk ducts between November 2017 and 2020 at the Princess Margaret Hospital were retrieved. The physiotherapist assessed the visual analogue scale score for pain before and after therapy. The mode of feeding was recorded at the first consultation and at 2 weeks after the latest therapy. Results: A total of 285 women aged 17 to 44 years underwent ultrasonic therapy for blocked milk ducts. 20.7% and 79.3% of women had one and both breasts affected, respectively. The total number of breasts included for analysis was 511. The number of ultrasonic therapies per breast varied from one to 13. After the first ultrasonic therapy, the mean pain score improved from 5.5 to 2.8, with a mean reduction of 2.7, which represented a mean of 54.7% reduction in pain score. Similarly, reduction of pain score was significant in subsequent ultrasonic therapy sessions (p<0.001). There was a trend towards association between the number of therapies and reduction in pain score (r= -0.07, p=0.079). At 2 weeks after the latest therapy, mothers who practised exclusive breastfeeding increased from 49.1% to 64.3%. Conclusion: Ultrasonic therapy is effective for treatment of symptomatic postpartum breast engorgement and blocked milk ducts. It should be promulgated to all lactating mothers. [ABSTRACT FROM AUTHOR]

Introduction: In addition to delayed breastfeeding, inappropriate breastfeeding techniques such as difficulties in holding the baby, improper posture, and poor sucking, poor knowledge and skills on breastfeeding lead to breast engorgement and poor feeding. The breastfeeding support initiative is a unique program encouraging lactation to improve breastfeeding and prevent complications. Objectives: To determine the effect of the breastfeeding support initiative on knowledge of breastfeeding, breast engorgement, and newborn feeding behaviour among postcaesarean mothers. Methods: We conducted a quasi-experimental study among 60 postcaesarean mothers at a selected tertiary hospital in Bhubaneswar, India. A consecutive sampling technique included postnatal mothers (30 in the experimental group and 30 in the control group) who underwent caesarean section and satisfied the inclusion criteria. We assessed pre- and post-test knowledge using a knowledge questionnaire, breast engorgement using a standardized six-point breast engorgement scale, and newborn feeding behaviour using a standardized Latch scale. Results: The findings revealed a significant difference between the groups' post-test knowledge level, breast engorgement, and latch score. There was a negative correlation between breast engorgement and newborn feeding behaviour (r=-0.404 p<0.05). There was a significant association of parity and breast engorgement (ρ2=15.333, p<0.001). Conclusions: The present study implies that the Breastfeeding Support Initiative enhanced knowledge regarding breastfeeding, which helps prevent breast engorgement and improve newborn feeding behaviour. [ABSTRACT FROM AUTHOR]

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Breastfeeding is a key issue found in ancient sources that resonates with public debates today, affecting women in different parts of the world and of all social classes. The aim of this research was to identify breastfeeding narratives in ancient medical and philosophical texts from the 1st to the 6th century CE that address ethical issues in the medical management and social perception of new mothers. We examined 15 literary sources and one funerary inscription on lactation and critically evaluated the ancient idea of the perfect breastfeeding mother versus the non-breastfeeding mother. We then discussed our historical data in terms of objectivity and significance in relation to contemporary attitudes towards motherhood and lactation, e.g., (1) the cult of the perfect, breastfeeding mother in contemporary lactation education and (2) the onset of conditions which may affect normal breastfeeding, such as dysphoric milk ejection reflex (D-MER), breastfeeding aversion response (BAR) or post-partum depression. The analysis of the results showed that in both ancient and contemporary postnatal health care: (1) good mothering is associated with breastfeeding and (2) alternative feeding methods are acknowledged, but never as the best, natural option. Finally, our analysis shows that public health policies on breastfeeding and mothers’ own knowledge of their bodies are contested between nursing theories, social expectations and economic factors.