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Background Optimal breastfeeding has benefits for the mother-infant dyads. This study investigated the prevalence and determinants of cessation of exclusive breastfeeding (EBF) in the early postnatal period in a culturally and linguistically diverse population in Sydney, New South Wales, Australia. Methods The study used routinely collected perinatal data on all live births in 2014 (N = 17,564) in public health facilities in two Local Health Districts in Sydney, Australia. The prevalence of mother’s breastfeeding intention, skin-to-skin contact, EBF at birth, discharge and early postnatal period (1–4 weeks postnatal) were estimated. Multivariate logistic regression models that adjusted for confounders were conducted to determine association between cessation of EBF in the early postnatal period and socio-demographic, psychosocial and health service factors. Results Most mothers intended to breastfeed (92%), practiced skin-to-skin contact (81%), exclusively breastfed at delivery (90%) and discharge (89%). However, the prevalence of EBF declined (by 27%) at the early postnatal period (62%). Younger mothers (

There is strong evidence that comprehensive sustained home visiting programs, commencing antenatally can improve child and maternal outcomes for vulnerable families. Community child and family health nurses, who traditionally engage with families post-birth, are well placed to provide interventions in the antenatal period. There is, however, little information on what home visiting nurses do, particularly in the antenatal period. An Australian trial of sustained nurse home visiting provides the opportunity to explore what child and family health nurses actually do in this new area of antenatal intervention.Nurses completed a checklist following each home visit detailing the interventions undertaken. Descriptive analysis was undertaken to describe the frequency of each of interventions. Factor analysis was undertaken to group the interventions into clusters. Further analysis was undertaken to determine if the clusters of interventions were associated with the frequency of home visits or characteristics of the mothers/families.Four clusters of interventions were identified: comprehensive range of physical and psychosocial care for most families; ongoing management of lower risk needs for mothers who were young, unsupported or had a history of mental health problems; preventive care for first-time mothers; and management of high risk needs (drugs and alcohol and domestic violence) in conjunction with other professionals.The interventions undertaken reflect the conceptual framework of the program. Nurses are delivering a comprehensive range of physical and psychosocial care to most women and families in the antenatal period, with some groups of women receiving additional support related to differing areas of needs.

Palliative sedation is an effective symptom control strategy for patients who suffer from intractable symptoms at the end of life. Evidence suggests that the use of this practice varies considerably. In order to minimize variation in the practice of palliative sedation within our health region, we developed a clinical practice guideline (CPG) for the use of palliative sedation. Using available evidence from the literature, a five step process was employed to develop the CPG: (1) a working group was charged with the mandate to develop a draft guideline; (2) a working definition for palliative sedation was developed; (3) criteria for use of sedation were determined; (4) critical steps to be taken prior to initiation of sedation were defined; and (5) the CPG was reviewed by local stakeholders. Feedback from the wider group of stakeholders was used to arrive at the final CPG, which subsequently received approval from the local Medical Advisory Board. The process used to develop the CPG served to develop consensus within the local community of palliative care clinicians regarding the practice of palliative sedation. Subsequently, the CPG was used as a tool for educating other health care providers.