J hum lact 2012-ilca 2011 abstracts-77-85

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J hum lact 2012-ilca 2011 abstracts-77-85

  1. 1. Journal of Human Lactation http://jhl.sagepub.com/Abstracts of Research Oral and Poster Presentations at the 2011 ILCA Conference J Hum Lact 2012 28: 77 DOI: 10.1177/0890334411428583 The online version of this article can be found at: http://jhl.sagepub.com/content/28/1/77.citation Published by: http://www.sagepublications.com On behalf of: International Lactation Consultant Association Additional services and information for Journal of Human Lactation can be found at: Email Alerts: http://jhl.sagepub.com/cgi/alerts Subscriptions: http://jhl.sagepub.com/subscriptions Reprints: http://www.sagepub.com/journalsReprints.nav Permissions: http://www.sagepub.com/journalsPermissions.nav >> Version of Record - Jan 19, 2012 What is This? Downloaded from jhl.sagepub.com by guest on February 26, 2013
  2. 2. 428588 JHLXXX10.1177/0890334411428583</alt-title><alt-title alt-title-type="right-running">J Hum Lact / Vol. XX, No. X, Month XXXXJ Hum Lact / Vol. XX, No. X, Month XXXX ILCA 2011 Abstracts Journal of Human Lactation 28(1) 77­–85 © The Author(s) 2012 Abstracts of Research Oral and Reprints and permission: http://www. sagepub.com/journalsPermissions.nav Poster Presentations at the 2011 DOI: 10.1177/0890334411428583 http://jhl.sagepub.com ILCA Conference 2011 ILCA Conference Outstanding Aim Research Poster To determine whether surveyed maternity staff could correctly The recipients of the 2011 Outstanding Research Poster are: identify their hospitals’ status with regard to Baby-Friendly. •• Pamela Ann Hendrix, BA, RN, IBCLC; Susan Lynn Welke, RNC-MNN, BAHCS; Kerry Sue Methods Foligno, RN, BSN, CLC; and Angelina Rodriguez, The authors called 1206 hospitals (Baby-Friendly and not) in ARNP, MSN, CNM, for their work titled, “The 20 states and asked to be connected to the maternity service. Lived Experience of Lactation Following Bariatric The authors then asked the person answering that phone, “Is Surgery.” your hospital a Baby-Friendly hospital?” and recorded the respondent’s job title. 2011 Wilson Clay & Hoover Poster Prize Results The recipients of the 2011 Wilson Clay & Hoover Poster According to Baby-Friendly USA, 41 of the 1206 hospitals Prize are: (3%) were Baby-Friendly. However, staff at 644 hospitals (53%) incorrectly said their hospitals were Baby-Friendly. By •• Pamela Ann Hendrix, BA, RN, IBCLC; Susan contrast, staff at all 41 Baby-Friendly hospitals correctly Lynn Welke, RNC-MNN, BAHCS; Kerry Sue identified their status. Respondents’ positions were 53% RNs, Foligno, RN, BSN, CLC; and Angelina Rodriguez, 20% nurse managers/unit directors, 8% medical/technical ARNP, MSN, CNM, for their work titled, “The assistants, 12% secretaries, and 7% other. Accuracy of response Lived Experience of Lactation Following Bariatric did not vary dependent on the respondent’s position (P = .09), Surgery.” but respondents in the 9 states with Baby-Friendly hospitals were significantly more likely to be accurate than were respondents in the 11 states with no Baby-Friendly hospitals. *** There was no linear relationship between the number of Baby- Friendly hospitals in a state and accuracy of response. Are You Baby-Friendly™? After 20 Years, Do US Maternity Staff Know the Answer? Conclusion Stephanie Santana,1 Radha Sadacharan, BA, MA,2 Although the Baby-Friendly Hospital Initiative was estab- Emily Sanchez,1 Gregory Makrigiorgos,1 li­shed 20 years ago, more than half of maternity staff Xena Grossman, MS, RD,2 responding to a comprehensive telephone survey were either and Anne Merewood, PhD, MPH, IBCLC2 not aware of the meaning of “Baby-Friendly hospital” or 1 Boston University and 2Boston incorrectly believed their hospitals to be Baby-Friendly Medical Center, Boston, Massachusetts certified. Staff response is an unreliable way to measure Baby-Friendly status. Background Breastfeeding Knowledge and Attitudes The World Health Organization launched the Baby-Friendly Among Egyptian Nursing Students Hospital Initiative in 1991; 99 US hospitals were Baby- Friendly certified. When answering questions in related Shadia Riad El Guindy, DNS, IBCLC, and Azza H. Ahmed, studies, staff have erroneously described their hospitals as DNSc, IBCLC, CPNP Baby-Friendly certified. Cairo University, Cairo, Egypt Downloaded from jhl.sagepub.com by guest on February 26, 2013
  3. 3. 78 Journal of Human Lactation 28(1)Background BackgroundNurses play a crucial role in promoting breastfeeding. Studies Physician-mothers’ breastfeeding behavior is being studiedin Western countries have found inadequate breastfeeding because it is believed to affect their anticipatory guidance toknowledge among undergraduate nursing students. their patients, which in turn influences patients’ breastfeeding initiation and continuation.Aim AimsTo assess the breastfeeding knowledge, attitudes, perceivedadequacy of breastfeeding education, and self-confidence to To assess the breastfeeding practices of physician-mothersprovide breastfeeding support among baccalaureate nursing and their reasons for stopping breastfeeding.students in Cairo, Egypt. MethodsMethod The study was cross-sectional in design. A self-administeredAn exploratory descriptive study used a convenience sample semistructured questionnaire was given to all registered 56of baccalaureate nursing students from Cairo, Egypt. physician-mothers in government-owned primary, secondary,Students who had completed maternal/child nursing didactic and tertiary health facilities, whose youngest child was agedand clinical courses were eligible to participate. A sample of 5 years. Informed consent was obtained. Outcome measures92 students completed the survey during spring 2009. The were time of initiation of breastfeeding, duration of exclusiveauthors used the Breastfeeding Knowledge Questionnaire and continued breastfeeding, introduction of prelacteal food,adapted from Brodribb et al (2008) to measure breastfeeding and reasons for stopping breastfeeding. Data were analyzedknowledge and the Iowa Infant Feeding Attitude Scale to test using SPSS version 17.students’ breastfeeding attitudes. ResultsResults Fifty (89.3%) physicians responded; 70% of these initiatedStudents’ ages ranged from 18 to 21 years (mean, breastfeeding within 1 hour after birth. Duration for exclusive19.5 ± 1.2 years), with 75% female students. The mean breastfeeding was ≥6 months in 28.6%, >6 months in 71.4%breastfeeding knowledge score was 12.41 points out of 24, of which 8% did not breastfeed exclusively, 37% continuedwhich represents 52% of the total score. The attitudes mean breastfeeding for <15 months, whereas 26.1%, 26.1% ,andscore was 3.13 ± 0.64. There was a significant relationship 6.5% breastfed for 15, 18, and 24 months, respectively.between the students’ knowledge and attitudes scores (r = Thirty-six percent had prelacteal feeds given to their babies.0.236, P = .011). Eighty percent of the students reported that A weak negative correlation (–0.253) existed between givingthey got adequate breastfeeding knowledge and skills in their prelacteal feeds and duration of exclusive breastfeeding.nursing program, and 70% were confident in their ability to Reasons for stopping continued breastfeeding included babyprovide breastfeeding support. old enough (49%), return to work (18.4%), and hungry baby or teething and biting (16.3%).Conclusion ConclusionResults revealed weak breastfeeding knowledge scoresamong students and neutral breastfeeding attitudes. Breastfeeding practices of physician-mothers do notStrategies to improve breastfeeding education in nursing conform to the World Health Organization standards. Thecurriculum focusing on breastfeeding management skills impact of this on their clients need to be measured in furtherare warranted. studies.Breastfeeding Practices of Physician-Mothers Early Weight Loss in Breastfeeding Newbornsin Ife-Ijesa Zone, Osun State, South West, Nigeria Carol Traa, MSN, RN, IBCLC, Oluwaseun Taiwo Esan, MBchB, MPH, Florence Omekara, MSN, MHPM, RN, and Bridget Omisore, MBBS Lori Irwin, BSN, MS, CNS, Obafemi Awolowo University Teaching Hospitals, and Deborah Eldredge, PhD, RN Ile-Ife, Ijesa, OsunState, Nigeria Oregon Health Sciences University,Portland, Oregon, Downloaded from jhl.sagepub.com by guest on February 26, 2013
  4. 4. ILCA 2011 Abstracts 79Background BackgroundEarly weight loss may reflect feeding problems leading to Exclusive breastfeeding has been proven to be a key tool forbreastfeeding discontinuance and loss of host protection and improving maternal and child health. Recent studies fromdevelopmental outcomes benefits. Lactation consultation Nigeria (a developing country) show a declining rate ofand postdischarge follow-up are provided for newborns exclusive breastfeeding despite a high infant mortality rate.experiencing above average weight loss (>7% in 48 hours).Many patients return to a remote domicile without follow-up Aimcare at the authors’ hospital. They determined early (inpa-tient) intervention would benefit establishment and continu- This study assessed the perceptions about breastfeeding andance and is needed to identify their population’s contributing infant feeding practices among nursing mothers in a poorfactors to early weight loss. resource community.Aims MethodsDevelop and implement early breastfeeding support based A cross-sectional study carried out in Ile-Ife, South Westernon identified factors leading to weight loss in the first 48 Nigeria. Three hundred eighty nursing mothers were inter-hours of inpatient life. viewed using a pretested semistructured questionnaire. The results were collated and analyzed using SPSS version 16.0.Methods ResultsIn this descriptive correlation study, data were abstracted ret-rospectively from the charts of 200 mother-infant pairs. Many of the nursing mothers (60.7%) did not believe babiesDescriptive statistics were used to describe infant (sex, ges- should be put to breast immediately after delivery, and abouttational age, number of breastfeedings) and maternal charac- a third (31.9%) did not believe that breast milk only could beteristics (gravity, parity, delivery mode, epidural use, hospital enough for a child less than 4 months. About a quarterlength of stay, or depression). Hierarchical multiple regres- (23.5%) were not practicing exclusive breastfeeding,sion techniques determined contributions of infant and whereas 98% said they would not breastfeed their babies upmaternal characteristics to percentage of weight loss. to 2 years of age for various reasons like sex of the child, nature of mothers’ job, and to enforce intake of adult food on the baby. Level of education and marital status had signifi-Results cant effects on the practice of exclusive breastfeeding.Babies born by cesarean section lost more weight than did thosedelivered vaginally (6.7% vs 4.2%). There was no difference in Conclusionweight loss by gender, epidural use, or maternal depression. Twenty years after the “Innocenti declaration,” incorrect beliefs about exclusive breastfeeding and poor infant feedingConclusions practices are still predominant among nursing mothers in thisThere may be differences in maternal or infant feeding behav- community.ior related to mode of delivery. The expected differences dueto maternal depression were not found. Early intervention Experiences of Lactating Working Mothers at awith breastfeeding mothers experiencing cesarean section is Private Tertiary Care Setting of Karachi, Pakistanappropriate. Further study is needed to measure and analyzefeeding behaviors and determine how postsurgical recovery, Shela Akbar Ali Hirani, MScN, BScN,including pain management, influences breastfeeding estab- and Rozina Karmaliani, PhD, MPHlishment and maternal confidence to continue. Aga Khan University, School of Nursing, Karachi, PakistanExclusive Breastfeeding and InfantFeeding Practices in a Resource Poor Community Background Folakemi Olajumoke Olajide, MB, ChB, FWACP, Abim- Pakistan has the second-highest child mortality rates in South bola Olaniyi Olajide, MB, ChB, FWACS, Asia, and in this region, gradual decline in breastfeeding and Olusegun Temitope prevalence has been reported especially among urban and Afolabi, MB, ChB, FMCPH, MPH working mothers. In Pakistan, very little attention has been Obafemi Awolowo University, Ile-Ife, Nigeria paid towards offering workplace support to breastfeeding Downloaded from jhl.sagepub.com by guest on February 26, 2013
  5. 5. 80 Journal of Human Lactation 28(1)working mothers. Review of published literature confirmed Aimthat previously no such research has been conducted to unveilthe experiences of lactating working mothers in Pakistan. To understand the effect of infant tongue-tie on women’s breastfeeding experiences.Aims MethodsTo describe experiences of lactating working mothers and togain insight about the facilitators of and barriers to breast- Phenomenology using semistructured interviews. The par-feeding among these mothers, as well as to seek recommen- ticipants were 10 women whose infants were diagnosed withdations from the lactating working mothers to improve their tongue-tie at their first breastfeeding clinic visits.breastfeeding practices. ResultsMethods Analysis revealed several themes describing the story ofThe authors used a qualitative descriptive design; 9 full-time breastfeeding a tongue-tied infant: expectations; somethinglactating working mothers who met the inclusion criteria is wrong; questioning, seeking advice, no real answers;were selected via purposive sampling. Researchers collected symptoms and perseverance; approaching the wall—it’s alldata until they reached saturation. Study participants were too much; relief.recruited from 9 subunits of a private tertiary care setting ofKarachi, Pakistan. A semistructured interview guide was Conclusionsused to collect data from the participants. The findings describe mothers’ experiences as being a har- rowing journey. Initially, they are excited, enthusiastic, andResults determined. When they begin to realize something is wrong,Most study participants verbalized that it was challenging to they seek answers from various people but find no explana-combine breastfeeding with employment. Analysis of data tions or solutions. Despite their distress, pain, and concernindicated that along with workplace environmental support, for their children, they persevere. However, as their prob-maternal characteristics and her family support were equally lems breastfeeding escalate, they become more despondent,essential to enable lactating working mothers to continue to the point that they feel they have no choice but to give up.breastfeeding with employment. The findings further Some mothers are relieved when tongue-tie is identified.revealed that inadequate workplace support leads towards Breastfeeding support is provided, which in some casesadverse outcomes for the breastfeeding working mothers and includes recommendation for tongue-tie separation. Fortheir babies. some women, their breastfeeding experience improves. For a few mothers, there are anger and disappointment that tongue- tie was not identified sooner as they have already ceasedConclusion breastfeeding. Further education of health professionalsThis study suggests a need to extend workplace and social regarding tongue-tie problems is required. This will enhancesupport for working mothers in Pakistan to promote their their ability to inform and refer mothers on the basis of cur-breastfeeding practices. rent evidence, while supporting them with breastfeeding.Experiences of Mothers Geospatial Mapping of LactationBreastfeeeding an Infant With Tongue-Tie Services in Maricopa County, Arizona, USA Janet Elizabeth Edmunds, RN, CM, IBCLC, Amanda L. Watkins, MS, RD, IBCLC, Paul Fulbrook, RN, BSc, PHD, and Joan E. Dodgson, PhD, MPH, RN and Sandra Miles, RN, BNsg, MNsg Arizona State University, Phoenix, Arizona Sinnamon Park, Australia BackgroundBackground For many breastfeeding mothers, lactation services areAustralian initial exclusive breastfeeding rates (80%) fall at 6 essential for overcoming challenges. An often cited contrib-months (14%). One factor linked to breastfeeding difficulties uting factor to the sharp decline in breastfeeding after hospi-that contributes to early breastfeeding cessation is infant tal discharge is the lack of community lactation services.tongue-tie. Research focused on lactation services has been specific to a Downloaded from jhl.sagepub.com by guest on February 26, 2013
  6. 6. ILCA 2011 Abstracts 81single agency or single type of agency. A broader public feeding can transmit infection. Exclusivity, however, ishealth perspective that targets a whole community is needed notoriously difficult to measure accurately, and cross-sec-if resources are to be used effectively. tional data may be unreliable.Aims AimTo geographically describe breastfeeding duration in relation To compare “exclusivity rates” when collected by 2 differentto available lactation resources within Maricopa County, Ari- methods in the same infants at 4 months.zona, the fourth largest county in the United States (popula-tion, ~4 million). The specific aims were to (1) describe Methodsbreastfeeding rates in Maricopa County and (2) geographi-cally compare these rates with all available breastfeeding The authors collected feeding data on infants born at anresources (hospitals, WIC clinics, private clinics, and peer inner-city Boston hospital between 2008 and 2010. Theysupport groups). recorded all feeds in week 1 and then collected feeding data by regular phone calls to the mother for 4 months. At 4 months, they calculated 2 “exclusive breastfeeding rates”:Methods one based on cross-sectional data (a single answer gainedThe design was population level, cross-sectional, and from maternal 24-hour recall at 4 months) and one based ondescriptive. All available resources (N = 66) were surveyed longitudinal data (all data collected since birth for each(100% participation rate) between July 2009 and March infant).2010. Existing breastfeeding rate data were triangulated andgeographically mapped using GIS software. Results According to cross-sectional data, maternal 24-hour recallResults at 4 months, 13% (33/248) of 4-month-olds were exclu-Geographic distributions were displayed in a series of maps sively breastfed. However, according to longitudinal data,that highlighted the relationships between availability of ser- only 6% (16/248) of the same 4-month-olds were exclu-vices and breastfeeding rates. Pockets of disparity occur in sively breastfed; as many (48%, 17/33) had received for-breastfeeding rates and were demonstrated both demograph- mula at other data collection points in the past 4 months.ically and geographically. True rates of exclusivity may be far lower, as the longitudi- nal data did not record all feeds and probably missed other non–breast milk feeds.ConclusionsAlthough geographic distributions have been widely used in Conclusionpublic health, this methodology has not been applied tobreastfeeding promotion activities. Geographic descriptions Exclusive breastfeeding rates may be significantly overre-of breastfeeding services are a viable method for determin- ported in cross-sectional studies based on 24-hour recall,ing where to target breastfeeding support and promotion leading to exaggerated rates of exclusivity. This has majorefforts and resources. implications for health-related outcomes, especially in areas where exclusivity is paramount.How Exclusive Is Exclusivity? Accuracyof Cross-sectional and Longitudinal Data Introducing Solids: How Accurate: Is Maternal Recall at 1 Year? Magdalena Buczek,1 Julia Margaret Coit, BA,1 Xena Grossman, MS, RD,2 Julia Margaret Coit, BA, Lori Feldman-Winter, MD, MPH,2 Magdalena Buczek, Xena Grossman, MS, RD, and Anne Merewood, PhD, MPH, IBCLC2 Lori Feldman-Winter, MD, MPH, 1 Boston University and 2Boston Medical and Anne Merewood, PhD, MPH, IBCLC Center, Division of General Pediatrics, Boston Medical Center, Division of General Boston, Massachusetts Pediatrics, Boston, MassachusettsBackground BackgroundExclusive breastfeeding maximizes health outcomes; in dis- The American Academy of Pediatrics recommends exclu-eases like HIV, exclusivity is protective, whereas mixed sive breastfeeding for 6 months. Early introduction of solids Downloaded from jhl.sagepub.com by guest on February 26, 2013
  7. 7. 82 Journal of Human Lactation 28(1)can interfere with breastfeeding and is associated with Aimadverse health outcomes like obesity. Many studies usematernal recall to identify the age when infants start solids. To examine whether higher maternal body mass index (BMI), lack of childbirth support (no DOULA), and in-hos- pital formula supplementation (FORMULA) predict shorterAim full breastfeeding (full BF) after adjusting for breastfeedingTo determine accuracy of maternal recall regarding starting intentions.solids, at 1-year postpartum. MethodsMethods Low-income, first-time mothers giving birth to a single-termBetween 2008 and 2010, the authors telephoned mothers infant were systematically enrolled in the maternity unit (N =of infants enrolled in a cohort study monthly for 6 months 170) and followed up at 4 days, 6 weeks, and 6 months. Whenand asked if they had given their babies any solids in the available, participants received childbirth support from apast month. The first month a mother answered yes was doula (25%). Participants completed the Infant Feeding Inten-considered the month solids were started. At 1 year, the tions Scale at 25 ± 15 hours postpartum. The authors recordedauthors asked the same mothers when their children were the number of formula feeds given to the newborn during thefirst given solids. Percentage agreement and the kappa sta- hospital stay. They used proportional hazards regression totistic (κ) were used to measure agreement between examine the hazard of increasing BMI, no DOULA, and FOR-responses. MULA on the hazard of stopping full BF (defined as date started other milks >1/wk). They adjusted for maternal breast-Results feeding intentions, ethnicity, education, and age.The authors obtained data on 148 women. At 1 year, 8% Results(12/148) accurately described the month they first gave sol-ids; however, 90% (133/148) reported starting solids later Estimated median duration of full BF was 23 days. In thethan they were actually started (κ = 0.05) (for example, the adjusted model, the hazard of stopping full BF increased asmonthly records indicated solids were started at 2 months, but follows: 24% (P = .01) for every 5-unit increase in BMI (kg/at 1 year, the mother recalled starting at 6 months). On aver- m2); 80% (P = .03) if no DOULA; and 14% (P = .0002) forage, incorrect responders overestimated by 2.3 months (range, every FORMULA feed.1-8 months); 15.5% (23/148) overestimated by 4 or moremonths. Conclusions Modifiable factors predicted full BF duration. The resultsConclusion support multidimensional approaches to increasing breast-At 1 year postpartum, only 8% of women accurately recalled feeding duration, including the consideration of the currentwhen they first started solids. Similar errors in breastfeeding maternal obesity epidemic (BMI), improving the childbirthstudies could compromise the validity of reported health out- experience (DOULA), and minimizing the use of in-hospitalcomes, especially if women consistently report starting solids formula supplements (FORMULA).later than they were actually started. Monitoring Code Adherence:Maternal, Childbirth, and Maternity Unit Accuracy of a National WebsiteFactors in Duration of Exclusive Breastfeeding Gregory Makrigiorgos,1 Stephanie Santana,1Among US Low-Income First-Time Mothers Emily Sanchez,1 Radha Sadacharan, BA, MA,2 Laurie Anne Nommsen-Rivers, PhD, RD, IBCLC Alison Stuebe, MD, MSc,2 Cincinnati Children’s Hospital Medical Center, and Anne Merewood, PhD, MPH, IBCLC2 1 Cincinnati, Ohio Boston University and 2Boston Medical Center, Division of General Pediatrics, Boston, MassachusettsBackgroundMaternal obesity and maternity care practices have been Backgroundshown to influence breastfeeding duration. It is not knownto what extent maternal infant feeding intentions confound Hospital distribution of formula sample packs to new moth-these findings. ers violates the World Health Organization Code. A national Downloaded from jhl.sagepub.com by guest on February 26, 2013
  8. 8. ILCA 2011 Abstracts 83US campaign, Ban the Bags, was launched in 2006 to encour- Backgroundage discontinuation of this practice. The Web site, www.ban-thebags.org, lists US hospitals that self-report discontinua- Recent trends reveal a record-high C-section rate of 31.8% intion of sample pack distribution. Given the major resources the United States (Centers for Disease Control and Preven-required to track national trends in discontinuation proac- tion, 2009). C-section is a risk for suboptimal infant breast-tively, for example, through telephone surveys, a reliable feeding, but few studies explore the relationship of painself-reporting system would be a useful, cost-effective tool management to breastfeeding after C-section.to monitor adherence to this part of the code. AimsAim To identify (1) the relationship of pain score after C-section withTo assess the accuracy of hospital self-report to www.ban- time to initiation and frequency of breastfeeding in the first 24thebags.org. hours postpartum and (2) the odds of successful breastfeeding adjusting for confounders.Methods MethodsHospitals self-report compliance by completing an onlineform; this information is verified by a research assistant A retrospective cohort design. The sample was all C-sectionsbefore appearing on the Web site. In 2009, the authors per- 34+ weeks’ gestation during 2007 at a community hospital.formed a separate, proactive telephone survey, calling all The final sample size was 621. Data were extracted from com-birthing hospitals in 20 states to determine if they distrib- puterized medical and inpatient records. Successful breast-uted sample packs. They compared the number of pack- feeding was 6+ feedings in the first 24 hours postpartum.free hospitals identified in the telephone survey with thaton the Web site. Hospitals reporting to the Web site after Resultsthe authors completed the survey were not counted in thestudy. More than one half of the sample breastfed (54.4%), with a mean time of 4.2 hours to initiation of breastfeeding. Statisti- cally significant negative correlations were found for meanResults total pain score with number of breastfeeding sessions (P =The telephone survey determined that 28% (350/1242) of .023). Using logistic regression, women with mild pain hadhospitals were pack free; the Web site listed 76% (267/350) 2.4 times (P = .03), breastfeeding within 2 hours of birth hadof these hospitals. Reliability varied by state; in Oregon, and 3.5 times (P = .000), term infants had 3.2 times (P = .006), andRhode Island, for example, 100% of hospitals self-reported not receiving supplemental feeds had 6.9 times (P = .002) the(range, 33%-100%). odds of successful breastfeeding in the first 24 hours.Conclusion ConclusionsHospital self-report to a national Web site captured 76% of Pain control after C-section is an important predictor of suc-sample pack-free hospitals in 20 states. This can be usefully cessful breastfeeding in the first 24 hours. Anesthesiaextrapolated to all 50 states. With additional publicity, self- implemented increased use of more effective pain modali-report could be an accurate national tool to monitor this aspect ties. Additional nursing support was provided in the postan-of code compliance. esthesia care unit. Follow-up data revealed mean time to first breastfeed of 2 hours.Post C-section Pain and BreastfeedingSuccess in the First 24 Hours Postpartum Results of a Survey to Assess the Experiences of Women Who Induced Lactation Anne B. Woods, PhD, MPH, CNM, Joan Robertson, MA, BSN, RN, Lenore Goldfarb, PhD, IBCLC Grace Bourke, BSN, RNC, Union Institute and University Doctoral Program, Joyce Carroll, BSN, RNC, Montreal, Quebec, Canada Barbara Crist, BSN, RN, IBCLC, Jennifer Duff, RN, Shirley Kowalewski, BSN, RNC, Staci Background Moore, RNC, Judy Zacharias, RNC, Selena Thomas, MD, and Donovan Dietrich, MD There exists a paucity of published studies on women who Franklin Square Hospital, Gettysburg, Pennsylvania breastfed infants to whom they did not give birth. The last Downloaded from jhl.sagepub.com by guest on February 26, 2013
  9. 9. 84 Journal of Human Lactation 28(1)study to evaluate a population of mothers who induced lac- suburban pediatric practice with lactation services. Bothtation/relactated/adoptive breastfed took place more than 30 groups of infants were born in the same hospital. The firstyears ago. group (n = 38) was followed in the hospital by pediatricians who supplemented with formula at a rate of 10.25%. TheAims second group (n = 39) was followed by neonatal hospitalists who formula supplemented at 7% weight loss and thus sup-The purpose of this research was to survey women who had plemented 44.74% of their infants. At the first outpatientinduced lactation recently. visit, the liberally supplemented group was at 94.2% of their birth weight compared to 94.1% of birth weight in the otherMethods group. At 1 month, the liberally supplemented group reached 128.7% of birth weight compared to 131.5% of birth weightParticipants (N = 228) were asked to complete an Internet- in the other group. In examining impact of liberal supple-based survey designed to elicit their experiences. A mixed- mentation, it was found that 72.7% of infants who were fedmethod approach facilitated the collection of quantitative only breast milk in the hospital were still exclusivelyand qualitative data. breastfeeding at 6 months compared to 18.8% of formula- supplemented infants.Results Telehealth Services to SupportParticipants were primarily white/Caucasian, well-educated, Breastfeeding Mothers: A Pilot StudyChristian, married, high-income mothers, aged 23 to 58years, and located in North America. Successful participants Wilaiporn Rojjanasrirat, PhD, RNC, IBCLC,who reported they produced the largest milk supplies had Karen Ann Wambach, PhD, RN, IBCLC,larger breasts and tended to follow a process that involved and Eve-Lynn Nelson, PhDdomperidone, a suitable birth control pill, and pumping. Par- Graceland University School of Nursing, Olathe, Kansasticipants with history of 1 or more pregnancies did not tendto produce larger peak milk supplies. Participants with his- Backgroundtory of 1 or more births before inducing lactation/relactationtended to produce larger peak milk supplies. Participants Telehealth, the use of telecommunication technology toreported a successful (71%) and satisfactory (71%) overall remotely monitor patients’ health status, is a promising strat-experience, and given the opportunity 83% would repeat it. egy to provide continuing support for breastfeeding mothers after hospital discharge. At present, the use of telehealth for assessing and supporting breastfeeding in postpartum womenConclusion has not been adequately explored.Although successful participants who produced the largestbreast milk supplies in the present study tended to follow a Aimsself-reported protocol or procedure that involved domperi-done as 1 of the ingredients, it is not possible within this To determine the feasibility of using telehealth equipment forstudy to establish if it is the key variable to explain such assessing and providing breastfeeding support in women’soutcomes. Further study using a different methodological homes.approach such as a randomized controlled trial is needed. MethodsSupplementation of Breastfed A descriptive study was conducted with 13 mother-babyInfants in the Early Neonatal Period dyads. Observational data, collected twice during the first 4 Laura Duke, CPNP, IBCLC postpartum weeks by telehealth and home visit interna- Pediatric Associates of Richmond, Inc, tional board certified lactation consultants (IBCLC) using Midlothian, Virginia the LATCH, were compared to calculate interrater reliabil- ity. The quality of pictures, sound, and participants’ satisfac-According to the Centers for Disease Control and Preven- tion with home telehealth and equipment use were analyzedtion, up to 25% of breastfed infants receive formula supple- using descriptive statistics.mentation in the first few days of life without adequate medi-cal indication. New perinatal core measures released by the ResultsJoint Commission advocate that no more than 10% of healthyterm and late preterm infants receive supplementation in the The telehealth IBCLC was able to observe infant latching/early newborn period. This small retrospective study suckling, milk transfer, types of nipple, and mother/infantreviewed records of 2 groups of infants followed by a large positioning using telehealth equipment. The percentage Downloaded from jhl.sagepub.com by guest on February 26, 2013
  10. 10. ILCA 2011 Abstracts 85agreement of LATCH category scores between the tele- decreased protein consumption, decreased vitamin absorption,health and home IBCLC ranged from 40% to 100%. Inter- and increased risk of iron deficiency. After identification ofrater reliability using Spearman correlation coefficients was increasing rates of pregnancy after bariatric surgery, the.76 and .67 for the total LATCH scores during the first and authors found minimal resources available for their patientssecond visits, respectively. Most participants reported high who wanted to breastfeed.satisfaction with using telehealth in their homes. AimsConclusions To understand the lactation experience of the individual whoProviding early postpartum support for breastfeeding moth- has undergone bariatric surgery for the treatment of obesity.ers and infants via telehealth was acceptable and feasible. The Understanding the lactation experience of postbariatricreliability of the LATCH score needs further assessment in a women may provide evidence to assist in designing strate-larger sample and more rigorous study design. Further gies to meet the needs of these women.research for application of telehealth to lactation support ser-vice is warranted. Methods This was a qualitative study with a phenomenologicalThe Lived Experience of Lactation approach. The research team selected Van Manen’s methodFollowing Bariatric Surgery for this study due to the human science emphasis and practical Pamela Ann Hendrix, BA, RN, IBCLC, implications of everyday life. Data were collected from 8 Susan Lynn Welke, RNC-MNN, BAHCS, women who met the inclusion criteria. Kerry Sue Foligno, RN, BSN, CLC, and Angelina Rodriguez, ARNP, MSN, CNM Results Memorial Hospital West Family Birthplace, Pembroke Pines, Florida Five themes emerged: nutritional issues, emotional roller- coaster, lacking specialty care, patient as “expert,” and seek-Background ing support.The purpose of this study was to understand the lactation Conclusionsexperience of the individual who has undergone bariatric sur-gery for the treatment of obesity. Memorial Hospital West The team noted implications leading to the need for furtherFamily Birthplace had 4916 live births from May 2007 to education prenatal and postnatal for nurses, physicians, lac-April 2008. On initial assessment, 85% stated that they tation consultants/counselors, and other health care person-planned to breastfeed. The literature suggests increasing nel, opening the door to more research possibilities andnumbers of bariatric surgeries are being performed yearly. changes in public policy to help promote better outcome forPostbariatric surgery effects include marked caloric reduction, these women. Answers 1. A 4. B 7. B 10. C 13. A 2. C 5. A 8. B 11. C 14. A 3. A 6. C 9. D 12. D 15. C Downloaded from jhl.sagepub.com by guest on February 26, 2013

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