This study evaluated the impact of an educational intervention on pediatric residents' knowledge, confidence, and clinical behaviors regarding breastfeeding. The residents completed pre- and post-intervention questionnaires to assess knowledge and confidence. Telephone interviews with breastfeeding mothers after clinic visits evaluated residents' clinical behaviors. The results showed that residents' knowledge scores increased significantly after the intervention. Their clinical behaviors when interacting with breastfeeding mothers also improved substantially. The educational intervention was effective in enhancing residents' support of breastfeeding patients.
Opinions And Practices Of Clinicians Associated With Continuation Of Exclusiv...Biblioteca Virtual
This study examined how clinician opinions and practices are associated with continuation of exclusive breastfeeding. The study prospectively followed 288 low-risk mother-newborn pairs who were breastfeeding at 4 weeks. Mothers completed interviews at 4 and 12 weeks, and their obstetric and pediatric clinicians completed surveys. The primary outcome was exclusive breastfeeding at 12 weeks. The study found that clinicians who recommended formula supplementation if an infant was not gaining weight or who felt their breastfeeding advice was not important were associated with early discontinuation of exclusive breastfeeding. Continued exclusive breastfeeding support from clinicians may help improve breastfeeding rates at 6 months.
Randomized, Controlled Trial Of A Prenatal And Postnatal Lactation ConsultantBiblioteca Virtual
This randomized controlled trial evaluated the effectiveness of a prenatal and postnatal lactation consultant intervention on the duration and intensity of breastfeeding up to 12 months. Over 300 low-income women receiving prenatal care at two community health centers were randomly assigned to an intervention or control group. The intervention group received individualized support from lactation consultants including prenatal meetings, a postpartum hospital visit, and home visits/phone calls. The trial found the intervention group was more likely to breastfeed through 20 weeks and had higher breastfeeding intensity scores at 13 and 52 weeks compared to the control group. US-born women in the control group had the lowest breastfeeding intensity. The study concluded the "best-practices" lactation
Why Do Women Stop Breastfeeding Findings From The Pregnancy RiskBiblioteca Virtual
This study examined breastfeeding behaviors using data from the Pregnancy Risk Assessment and Monitoring System (PRAMS) from 2000-2001. The authors found that 32% of women did not initiate breastfeeding, 4% stopped within the first week, 13% stopped within the first month, and 51% continued for over 4 weeks. Younger women and those with limited socioeconomic resources were more likely to stop breastfeeding early. Common reasons for stopping included sore nipples, perceived inadequate milk supply, and difficulties with breastfeeding. Women's predelivery intentions impacted their likelihood of initiating and continuing breastfeeding.
This study analyzed survey responses from 1,323 mothers who stopped breastfeeding their infants before 12 months to identify the primary reasons for stopping breastfeeding at different infant ages. The researchers conducted factor analysis to group mothers' reasons into seven constructs: lactation issues, psychosocial factors, nutritional concerns, lifestyle interference, medical issues, pumping difficulties, and self-weaning. Across all ages, mothers most frequently cited their infant not being satisfied by breast milk alone as a key reason for stopping. Younger, unmarried, and lower-income mothers tended to stop earlier. Reasons for stopping varied by infant age, from lactation issues in early months to self-weaning in later months.
This study examined early exclusive breastfeeding rates and maternal attitudes towards infant feeding in new mothers in San Francisco. The researchers found that 79.8% of mothers were exclusively breastfeeding between 1-4 days postpartum, with no significant differences by WIC participation status. Independent risk factors for mixed or formula feeding included Asian/Pacific Islander ethnicity and lower education levels. Thinking that breastfeeding was physically painful or uncomfortable was also associated with not breastfeeding. The study suggests future research should address negative attitudes towards breastfeeding in Asian populations and promote breastfeeding as a comfortable practice.
Making it Easier for Women to Work & Breastfeed: The Working Parent Support C...Leith Greenslade
Several leading US companies, universities, medical and media associations are joining forces to offer more support to working women so they can exercise a real choice to breastfeed.
Teenage mothers care practices study in Sierra Leone.
The study examined care practices of 45 teenage mothers in Western Area, Koinadugu and Pujehun districts. It found teenage pregnancy leads to feelings of isolation, rejection and poverty. Most mothers dropped out of school and had complications during delivery due to their young age. Feeding practices like early initiation of breastfeeding and exclusive breastfeeding rates were low. Mothers had poor nutrition knowledge and children lacked balanced diets. Many mothers did not consistently seek healthcare for their children. Hygiene practices around water treatment and handwashing were inadequate. The study concluded teenage mothers would benefit from additional support and education on maternal and child healthcare.
This document discusses approaches to promoting breastfeeding among pregnant women. It begins by outlining the Baby Friendly Hospital Initiative from WHO and UNICEF to advocate increasing breastfeeding rates. Improved breastfeeding could save thousands of children's lives daily. The Innocenti Declaration established breastfeeding as the global goal for health and called on governments to develop breastfeeding policies. Many US agencies and organizations support breastfeeding, though rates remain below goals. The document emphasizes the importance of educational, social and institutional support for breastfeeding mothers.
Opinions And Practices Of Clinicians Associated With Continuation Of Exclusiv...Biblioteca Virtual
This study examined how clinician opinions and practices are associated with continuation of exclusive breastfeeding. The study prospectively followed 288 low-risk mother-newborn pairs who were breastfeeding at 4 weeks. Mothers completed interviews at 4 and 12 weeks, and their obstetric and pediatric clinicians completed surveys. The primary outcome was exclusive breastfeeding at 12 weeks. The study found that clinicians who recommended formula supplementation if an infant was not gaining weight or who felt their breastfeeding advice was not important were associated with early discontinuation of exclusive breastfeeding. Continued exclusive breastfeeding support from clinicians may help improve breastfeeding rates at 6 months.
Randomized, Controlled Trial Of A Prenatal And Postnatal Lactation ConsultantBiblioteca Virtual
This randomized controlled trial evaluated the effectiveness of a prenatal and postnatal lactation consultant intervention on the duration and intensity of breastfeeding up to 12 months. Over 300 low-income women receiving prenatal care at two community health centers were randomly assigned to an intervention or control group. The intervention group received individualized support from lactation consultants including prenatal meetings, a postpartum hospital visit, and home visits/phone calls. The trial found the intervention group was more likely to breastfeed through 20 weeks and had higher breastfeeding intensity scores at 13 and 52 weeks compared to the control group. US-born women in the control group had the lowest breastfeeding intensity. The study concluded the "best-practices" lactation
Why Do Women Stop Breastfeeding Findings From The Pregnancy RiskBiblioteca Virtual
This study examined breastfeeding behaviors using data from the Pregnancy Risk Assessment and Monitoring System (PRAMS) from 2000-2001. The authors found that 32% of women did not initiate breastfeeding, 4% stopped within the first week, 13% stopped within the first month, and 51% continued for over 4 weeks. Younger women and those with limited socioeconomic resources were more likely to stop breastfeeding early. Common reasons for stopping included sore nipples, perceived inadequate milk supply, and difficulties with breastfeeding. Women's predelivery intentions impacted their likelihood of initiating and continuing breastfeeding.
This study analyzed survey responses from 1,323 mothers who stopped breastfeeding their infants before 12 months to identify the primary reasons for stopping breastfeeding at different infant ages. The researchers conducted factor analysis to group mothers' reasons into seven constructs: lactation issues, psychosocial factors, nutritional concerns, lifestyle interference, medical issues, pumping difficulties, and self-weaning. Across all ages, mothers most frequently cited their infant not being satisfied by breast milk alone as a key reason for stopping. Younger, unmarried, and lower-income mothers tended to stop earlier. Reasons for stopping varied by infant age, from lactation issues in early months to self-weaning in later months.
This study examined early exclusive breastfeeding rates and maternal attitudes towards infant feeding in new mothers in San Francisco. The researchers found that 79.8% of mothers were exclusively breastfeeding between 1-4 days postpartum, with no significant differences by WIC participation status. Independent risk factors for mixed or formula feeding included Asian/Pacific Islander ethnicity and lower education levels. Thinking that breastfeeding was physically painful or uncomfortable was also associated with not breastfeeding. The study suggests future research should address negative attitudes towards breastfeeding in Asian populations and promote breastfeeding as a comfortable practice.
Making it Easier for Women to Work & Breastfeed: The Working Parent Support C...Leith Greenslade
Several leading US companies, universities, medical and media associations are joining forces to offer more support to working women so they can exercise a real choice to breastfeed.
Teenage mothers care practices study in Sierra Leone.
The study examined care practices of 45 teenage mothers in Western Area, Koinadugu and Pujehun districts. It found teenage pregnancy leads to feelings of isolation, rejection and poverty. Most mothers dropped out of school and had complications during delivery due to their young age. Feeding practices like early initiation of breastfeeding and exclusive breastfeeding rates were low. Mothers had poor nutrition knowledge and children lacked balanced diets. Many mothers did not consistently seek healthcare for their children. Hygiene practices around water treatment and handwashing were inadequate. The study concluded teenage mothers would benefit from additional support and education on maternal and child healthcare.
This document discusses approaches to promoting breastfeeding among pregnant women. It begins by outlining the Baby Friendly Hospital Initiative from WHO and UNICEF to advocate increasing breastfeeding rates. Improved breastfeeding could save thousands of children's lives daily. The Innocenti Declaration established breastfeeding as the global goal for health and called on governments to develop breastfeeding policies. Many US agencies and organizations support breastfeeding, though rates remain below goals. The document emphasizes the importance of educational, social and institutional support for breastfeeding mothers.
This document summarizes a conference on maternal nutrition and infant feeding practices. The conference was organized to address gaps in understanding how maternal nutrition affects fetal growth, birth outcomes, and infant feeding practices. It covered 3 topics: 1) the effect of maternal nutrition and the placenta on fetal development and birth outcomes, 2) feeding preterm infants, and 3) feeding full-term infants. For topic 1, presentations showed the placenta's role in nutrient transport affects fetal growth and discussed the importance of nutrients like folate and calcium. Research priorities identified included studying nutrient interactions and their effects on different populations. Topic 2 noted a lack of evidence on best practices for preterm infant nutrition. Topic 3 discussed ensuring evidence on human milk
A STUDY OF THE PERCEPTION ON EXCLUSIVE BREASTFEEDING AMONG POSTNATAL MOTHERS ...edianbiir
This document presents a study on the perception of exclusive breastfeeding among postnatal mothers at Legon Hospital in Ghana. It provides background information on the benefits of exclusive breastfeeding for six months and highlights breastfeeding rates in Ghana. While nearly all Ghanaian mothers initiate breastfeeding, exclusive breastfeeding rates drop significantly after the first few months. The study aims to address the lack of record keeping on exclusive breastfeeding and mother support groups at Legon Hospital.
Family planning in nigeria a myth or reality-implications for educationAlexander Decker
The document summarizes a study that investigated family planning practices in Nkanu Local Government Area of Enugu State, Nigeria. The study found that (1) the extent of family planning in the area was low, (2) the most common methods used were traditional ones like abstinence, withdrawal, and prolonged breastfeeding, and (3) education level had a positive influence on family planning practices, with more educated respondents using modern contraceptive methods to a greater extent.
Hospital Practices And Womens Likelihood Of Fulfilling Their Intention To Exc...Biblioteca Virtual
This study examined the relationship between hospital practices and mothers' ability to exclusively breastfeed according to their intentions. The researchers analyzed data from a national survey of over 1500 mothers who gave birth in 2005. They found that primiparas (first time mothers) reported a substantial gap between their intention to exclusively breastfeed (70%) and actually doing so at 1 week postpartum (50%). Primiparas reported hospital practices like supplementation (49%) and pacifier use (45%) that conflict with the Baby-Friendly Hospital Initiative's Ten Steps. Primiparas who delivered at hospitals implementing 6-7 of the Ten Steps were 6 times more likely to achieve their exclusive breastfeeding intention compared to those at hospitals implementing 0-
Do Baby Friendly Hospitals Influence Breastfeeding Duration On ABiblioteca Virtual
This study examined the influence of Baby-Friendly Hospital Initiative (BFHI) compliance on breastfeeding rates and duration in Switzerland. The authors conducted a national survey in 2003 of over 2800 mothers who had given birth in the previous 9 months. They collected data on breastfeeding practices and the hospital of delivery. They found that infants born in hospitals with high BFHI compliance had significantly longer durations of exclusive, full, and any breastfeeding compared to other hospitals, even after controlling for other factors. This supports the hypothesis that increased BFHI implementation in Switzerland has contributed to improved national breastfeeding outcomes since 1994. However, the authors note mothers choosing BFHI hospitals may also breastfeed longer regardless of the hospital practices.
This paper examines how midwifery practices could be integrated into clinical settings in the United States to improve birth outcomes. The United States currently relies heavily on medical interventions during birth and has worse health outcomes compared to the Netherlands, which utilizes midwives and home births. The paper discusses how adopting midwifery techniques like water births, non-drug pain management, and encouraging breastfeeding could help reduce surgical interventions and create a more natural birth experience. Integrating these practices and having midwives collaborate with doctors has the potential to achieve better maternal and infant health as outlined in the Healthy People 2020 goals.
Vita D Supple Breatfed Infants Pediatrics 2010alisonegypt
This document summarizes a study examining the use of supplemental vitamin D among infants who were breastfed for prolonged periods. The study found that among infants who were predominantly breastfed for at least 6 months, the rate of receiving supplemental vitamin D was only 15.9%. Parental decisions about vitamin D supplementation were significantly associated with whether the parent agreed their pediatrician recommended it and whether they believed breast milk contains all needed nutrition. Educational efforts are needed to increase compliance with guidelines recommending all breastfed infants receive vitamin D supplementation.
This paper analyzes research on the benefits of breastfeeding. It summarizes a study by Jenkins and Foster (2014) that examined the relationship between breastfeeding exclusivity and children's health and cognitive outcomes. The study found some positive effects of breastfeeding exclusivity on cognitive skills at age 2 but not at other ages. The paper also summarizes two other studies that found benefits of breastfeeding for both mothers' mental health and likelihood of breastfeeding. It concludes that increasing education about breastfeeding's health benefits can increase rates of breastfeeding and implementing practices like the Baby-Friendly Hospital Initiative can help support breastfeeding.
Speaker presentation from U.S. News Healthcare of Tomorrow leadership summit, Nov. 17-19, 2019 in Washington, DC. Find out more about this forum at www.usnewshot.com.
Breastfeeding Initiation Among Incarcerated Pregnant WomenNatalie Libster
This study examined factors impacting breastfeeding initiation among 182 incarcerated pregnant women across several county jails. Women who delivered while incarcerated, were incarcerated longer during pregnancy, or found out about their pregnancy while incarcerated were less likely to initiate breastfeeding. Those who did not initiate breastfeeding consumed more processed meats and fast food. The findings suggest incarceration negatively impacts breastfeeding decisions, possibly due to lack of support, and unhealthy diets are also linked to lower rates of initiation, potentially from views that unhealthy mothers cannot produce quality breastmilk.
Optimizing Breastfeeding for Better Health Outcomes The Way Forwardijtsrd
Breastfeeding is the clinical gold standard for infant feeding and nutrition, with breast milk uniquely tailored to meet the health needs of a growing baby. However, breastfeeding seems to be under attack by the commercial influence of the baby food industry, supported at work places and in the hospitals where they come to deliver. Artificial baby milk formula cannot meet the gold standards of breast milk. Provisions of IMS Act exists but widespread awareness and effective enforcement is required. Various studies reveal the gaps in the provision and implementation of the laws and awareness programs and to suggest appropriate solutions. It, thus, becomes necessary to emphasize upon the provisions of IMS Act, 2003 and evidently bring forward the commercial influence of baby food industry. Review revealed that the provisions of IMS Act has been violated at various online and offline platforms. Strategies to optimise breastfeeding and overcome breastfeeding barriers in the country are recommended, including community health and education programmes and -˜baby friendly’ hospital initiatives. Advocates of breastfeeding are needed at the national, community and family levels. In addition, more systematic research should be conducted to examine breastfeeding practices and the best strategies to promote breastfeeding in this country. Dr. Ritu Pradhan | Anupreet Kaur Sobti "Optimizing Breastfeeding for Better Health Outcomes: The Way Forward" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45105.pdf Paper URL: https://www.ijtsrd.com/home-science/family-health/45105/optimizing-breastfeeding-for-better-health-outcomes-the-way-forward/dr-ritu-pradhan
This document discusses barriers to providing human milk feedings (HMF) to very low birth weight infants in the NICU. It identifies key barriers as financial constraints, physiological challenges for mothers of preterm infants, and hospital cultures that do not adequately support lactation. The role of nurses is emphasized in establishing and maintaining milk supply through early and frequent pumping and hand expression, education of mothers, and advocating for hospital policies that follow evidence-based practices to promote HMF. Adopting the Baby-Friendly Hospital Initiative is presented as a way to standardize high-quality lactation support.
This document presents a blueprint for advancing high-value maternity care through physiologic childbearing. It outlines six strategies to transform the maternity care system: 1) Improve care delivery and payment through innovative models like episode-based payment and maternity care homes. 2) Advance performance measurement to improve quality. 3) Meaningfully engage women and families in care planning. 4) Transition to interprofessional education for maternity care professionals. 5) Optimize the maternity care workforce composition and distribution. 6) Conduct priority research on physiologic childbearing and its impact on outcomes. The blueprint provides recommendations and action steps within each strategy to increase access to healthy physiologic processes and address barriers to optimal care.
This document reviews factors that influence mothers in the WIC program to choose formula feeding over breastfeeding for their infants. Several studies examined found that parents who formula feed generally have less knowledge of the health benefits of breastfeeding and a less positive attitude towards it. A cohort study found that breastfed infants enrolled in WIC programs saved over $400 in expenses in their first 6 months compared to formula fed infants. A review also showed that education and support services are effective at increasing the duration of breastfeeding. The document suggests WIC programs develop policies to better promote and educate mothers on breastfeeding.
The Potential Role Of Breast Feeding And Other Factors In Helping To Reduce E...Biblioteca Virtual
This study examined the relationship between breastfeeding and early childhood caries (ECC) in 175 children aged 1 to 5 receiving dental care. The researchers found:
1) Children who were exclusively bottle fed for at least 1.5 years had more decayed or filled tooth surfaces than children who were breastfed for some time but less than a year.
2) Children who did not receive bottles at night or juice at irregular times, whose mothers brushed their teeth, and whose mothers had adequate dental care themselves had lower rates of ECC.
3) Too few children were exclusively breastfed to adequately study the relationship between exclusive breastfeeding and ECC. However, the results suggest measures like avoiding nighttime bottles and frequent
This study aimed to describe the risk of HIV transmission in pediatric patients breastfed by HIV-infected mothers in Haiti following the implementation of the 2010 WHO breastfeeding guidelines. The study analyzed data from over 1400 pediatric patients across four sites from 2008-2012. Only two cases of HIV transmission were observed, indicating a minimal risk of transmission for mothers compliant with antiretroviral therapy and exclusive breastfeeding. However, further research is still needed to conclusively determine the impact of the national breastfeeding recommendations on infant morbidity and mortality in Haiti.
Session 14 protecting breastfeeding revised 2016Siwon Lee
This document discusses strategies for protecting breastfeeding, including understanding and implementing the International Code of Marketing of Breast Milk Substitutes. It identifies the health worker's role in educating impartially and preventing marketing practices that undermine breastfeeding. It also stresses the importance of supporting breastfeeding in emergency situations through relief policies and training for humanitarian workers.
Take a look at this professional BSN nursing capstone example to see how it need to look like, if you want to find more samples visit https://www.capstoneproject.net/our-capstone-projects/nursing-capstone-project/
Breastfeeding Rates In The United States By Characteristics Of The Child,Biblioteca Virtual
This study analyzed breastfeeding rates in the United States using data from the 2002 National Immunization Survey. It found that over two-thirds of infants were ever breastfed, but rates of exclusive and continued breastfeeding dropped significantly by 6 and 12 months. Certain groups had lower rates, including non-Hispanic black children, those in daycare, enrolled in WIC, from lower socioeconomic status families, or younger or less educated mothers. The results suggest more efforts are needed to improve and support breastfeeding, especially among disadvantaged populations.
Overcoming Barriers to Increased Human Milk Feeding in the NICUDenise Breheny
This document discusses barriers to providing human milk feeding (HMF) in the NICU. It notes that while HMF provides numerous health benefits, many mothers struggle to establish and maintain an adequate milk supply. Barriers include lack of education for healthcare providers, lack of hospital policies supporting HMF, and demographic factors like low income that correlate with lower breastfeeding rates. Overcoming these barriers is important to maximize the benefits of HMF for vulnerable very low birth weight infants.
The document discusses issues with curriculum implementation and innovations in schools. It notes that poor student performance may be linked to inconsistent curriculum delivery among schools and teachers. Additionally, stakeholders often do not feel ownership over curricular changes, and some innovations are adopted without proper support or evaluation. The document then provides responses to address these issues, emphasizing the need for stakeholder involvement, monitoring of changes, and collaboration to promote ownership and success of new curriculums.
Curriculum development curriculum issues, concerns and responses Jerick Teodoro
The document discusses curriculum issues, concerns, and responses. It identifies several issues with implementing curriculum including poor academic performance, overcrowded classrooms, underprepared teachers, and a lack of stakeholder involvement and communication. In response, it recommends involving all stakeholders in curriculum planning, thoroughly studying readiness for innovations, and ensuring proper preparation, materials, and knowledge before implementation. Collaboration is also key to successfully addressing issues and concerns with curriculum changes.
This document summarizes a conference on maternal nutrition and infant feeding practices. The conference was organized to address gaps in understanding how maternal nutrition affects fetal growth, birth outcomes, and infant feeding practices. It covered 3 topics: 1) the effect of maternal nutrition and the placenta on fetal development and birth outcomes, 2) feeding preterm infants, and 3) feeding full-term infants. For topic 1, presentations showed the placenta's role in nutrient transport affects fetal growth and discussed the importance of nutrients like folate and calcium. Research priorities identified included studying nutrient interactions and their effects on different populations. Topic 2 noted a lack of evidence on best practices for preterm infant nutrition. Topic 3 discussed ensuring evidence on human milk
A STUDY OF THE PERCEPTION ON EXCLUSIVE BREASTFEEDING AMONG POSTNATAL MOTHERS ...edianbiir
This document presents a study on the perception of exclusive breastfeeding among postnatal mothers at Legon Hospital in Ghana. It provides background information on the benefits of exclusive breastfeeding for six months and highlights breastfeeding rates in Ghana. While nearly all Ghanaian mothers initiate breastfeeding, exclusive breastfeeding rates drop significantly after the first few months. The study aims to address the lack of record keeping on exclusive breastfeeding and mother support groups at Legon Hospital.
Family planning in nigeria a myth or reality-implications for educationAlexander Decker
The document summarizes a study that investigated family planning practices in Nkanu Local Government Area of Enugu State, Nigeria. The study found that (1) the extent of family planning in the area was low, (2) the most common methods used were traditional ones like abstinence, withdrawal, and prolonged breastfeeding, and (3) education level had a positive influence on family planning practices, with more educated respondents using modern contraceptive methods to a greater extent.
Hospital Practices And Womens Likelihood Of Fulfilling Their Intention To Exc...Biblioteca Virtual
This study examined the relationship between hospital practices and mothers' ability to exclusively breastfeed according to their intentions. The researchers analyzed data from a national survey of over 1500 mothers who gave birth in 2005. They found that primiparas (first time mothers) reported a substantial gap between their intention to exclusively breastfeed (70%) and actually doing so at 1 week postpartum (50%). Primiparas reported hospital practices like supplementation (49%) and pacifier use (45%) that conflict with the Baby-Friendly Hospital Initiative's Ten Steps. Primiparas who delivered at hospitals implementing 6-7 of the Ten Steps were 6 times more likely to achieve their exclusive breastfeeding intention compared to those at hospitals implementing 0-
Do Baby Friendly Hospitals Influence Breastfeeding Duration On ABiblioteca Virtual
This study examined the influence of Baby-Friendly Hospital Initiative (BFHI) compliance on breastfeeding rates and duration in Switzerland. The authors conducted a national survey in 2003 of over 2800 mothers who had given birth in the previous 9 months. They collected data on breastfeeding practices and the hospital of delivery. They found that infants born in hospitals with high BFHI compliance had significantly longer durations of exclusive, full, and any breastfeeding compared to other hospitals, even after controlling for other factors. This supports the hypothesis that increased BFHI implementation in Switzerland has contributed to improved national breastfeeding outcomes since 1994. However, the authors note mothers choosing BFHI hospitals may also breastfeed longer regardless of the hospital practices.
This paper examines how midwifery practices could be integrated into clinical settings in the United States to improve birth outcomes. The United States currently relies heavily on medical interventions during birth and has worse health outcomes compared to the Netherlands, which utilizes midwives and home births. The paper discusses how adopting midwifery techniques like water births, non-drug pain management, and encouraging breastfeeding could help reduce surgical interventions and create a more natural birth experience. Integrating these practices and having midwives collaborate with doctors has the potential to achieve better maternal and infant health as outlined in the Healthy People 2020 goals.
Vita D Supple Breatfed Infants Pediatrics 2010alisonegypt
This document summarizes a study examining the use of supplemental vitamin D among infants who were breastfed for prolonged periods. The study found that among infants who were predominantly breastfed for at least 6 months, the rate of receiving supplemental vitamin D was only 15.9%. Parental decisions about vitamin D supplementation were significantly associated with whether the parent agreed their pediatrician recommended it and whether they believed breast milk contains all needed nutrition. Educational efforts are needed to increase compliance with guidelines recommending all breastfed infants receive vitamin D supplementation.
This paper analyzes research on the benefits of breastfeeding. It summarizes a study by Jenkins and Foster (2014) that examined the relationship between breastfeeding exclusivity and children's health and cognitive outcomes. The study found some positive effects of breastfeeding exclusivity on cognitive skills at age 2 but not at other ages. The paper also summarizes two other studies that found benefits of breastfeeding for both mothers' mental health and likelihood of breastfeeding. It concludes that increasing education about breastfeeding's health benefits can increase rates of breastfeeding and implementing practices like the Baby-Friendly Hospital Initiative can help support breastfeeding.
Speaker presentation from U.S. News Healthcare of Tomorrow leadership summit, Nov. 17-19, 2019 in Washington, DC. Find out more about this forum at www.usnewshot.com.
Breastfeeding Initiation Among Incarcerated Pregnant WomenNatalie Libster
This study examined factors impacting breastfeeding initiation among 182 incarcerated pregnant women across several county jails. Women who delivered while incarcerated, were incarcerated longer during pregnancy, or found out about their pregnancy while incarcerated were less likely to initiate breastfeeding. Those who did not initiate breastfeeding consumed more processed meats and fast food. The findings suggest incarceration negatively impacts breastfeeding decisions, possibly due to lack of support, and unhealthy diets are also linked to lower rates of initiation, potentially from views that unhealthy mothers cannot produce quality breastmilk.
Optimizing Breastfeeding for Better Health Outcomes The Way Forwardijtsrd
Breastfeeding is the clinical gold standard for infant feeding and nutrition, with breast milk uniquely tailored to meet the health needs of a growing baby. However, breastfeeding seems to be under attack by the commercial influence of the baby food industry, supported at work places and in the hospitals where they come to deliver. Artificial baby milk formula cannot meet the gold standards of breast milk. Provisions of IMS Act exists but widespread awareness and effective enforcement is required. Various studies reveal the gaps in the provision and implementation of the laws and awareness programs and to suggest appropriate solutions. It, thus, becomes necessary to emphasize upon the provisions of IMS Act, 2003 and evidently bring forward the commercial influence of baby food industry. Review revealed that the provisions of IMS Act has been violated at various online and offline platforms. Strategies to optimise breastfeeding and overcome breastfeeding barriers in the country are recommended, including community health and education programmes and -˜baby friendly’ hospital initiatives. Advocates of breastfeeding are needed at the national, community and family levels. In addition, more systematic research should be conducted to examine breastfeeding practices and the best strategies to promote breastfeeding in this country. Dr. Ritu Pradhan | Anupreet Kaur Sobti "Optimizing Breastfeeding for Better Health Outcomes: The Way Forward" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45105.pdf Paper URL: https://www.ijtsrd.com/home-science/family-health/45105/optimizing-breastfeeding-for-better-health-outcomes-the-way-forward/dr-ritu-pradhan
This document discusses barriers to providing human milk feedings (HMF) to very low birth weight infants in the NICU. It identifies key barriers as financial constraints, physiological challenges for mothers of preterm infants, and hospital cultures that do not adequately support lactation. The role of nurses is emphasized in establishing and maintaining milk supply through early and frequent pumping and hand expression, education of mothers, and advocating for hospital policies that follow evidence-based practices to promote HMF. Adopting the Baby-Friendly Hospital Initiative is presented as a way to standardize high-quality lactation support.
This document presents a blueprint for advancing high-value maternity care through physiologic childbearing. It outlines six strategies to transform the maternity care system: 1) Improve care delivery and payment through innovative models like episode-based payment and maternity care homes. 2) Advance performance measurement to improve quality. 3) Meaningfully engage women and families in care planning. 4) Transition to interprofessional education for maternity care professionals. 5) Optimize the maternity care workforce composition and distribution. 6) Conduct priority research on physiologic childbearing and its impact on outcomes. The blueprint provides recommendations and action steps within each strategy to increase access to healthy physiologic processes and address barriers to optimal care.
This document reviews factors that influence mothers in the WIC program to choose formula feeding over breastfeeding for their infants. Several studies examined found that parents who formula feed generally have less knowledge of the health benefits of breastfeeding and a less positive attitude towards it. A cohort study found that breastfed infants enrolled in WIC programs saved over $400 in expenses in their first 6 months compared to formula fed infants. A review also showed that education and support services are effective at increasing the duration of breastfeeding. The document suggests WIC programs develop policies to better promote and educate mothers on breastfeeding.
The Potential Role Of Breast Feeding And Other Factors In Helping To Reduce E...Biblioteca Virtual
This study examined the relationship between breastfeeding and early childhood caries (ECC) in 175 children aged 1 to 5 receiving dental care. The researchers found:
1) Children who were exclusively bottle fed for at least 1.5 years had more decayed or filled tooth surfaces than children who were breastfed for some time but less than a year.
2) Children who did not receive bottles at night or juice at irregular times, whose mothers brushed their teeth, and whose mothers had adequate dental care themselves had lower rates of ECC.
3) Too few children were exclusively breastfed to adequately study the relationship between exclusive breastfeeding and ECC. However, the results suggest measures like avoiding nighttime bottles and frequent
This study aimed to describe the risk of HIV transmission in pediatric patients breastfed by HIV-infected mothers in Haiti following the implementation of the 2010 WHO breastfeeding guidelines. The study analyzed data from over 1400 pediatric patients across four sites from 2008-2012. Only two cases of HIV transmission were observed, indicating a minimal risk of transmission for mothers compliant with antiretroviral therapy and exclusive breastfeeding. However, further research is still needed to conclusively determine the impact of the national breastfeeding recommendations on infant morbidity and mortality in Haiti.
Session 14 protecting breastfeeding revised 2016Siwon Lee
This document discusses strategies for protecting breastfeeding, including understanding and implementing the International Code of Marketing of Breast Milk Substitutes. It identifies the health worker's role in educating impartially and preventing marketing practices that undermine breastfeeding. It also stresses the importance of supporting breastfeeding in emergency situations through relief policies and training for humanitarian workers.
Take a look at this professional BSN nursing capstone example to see how it need to look like, if you want to find more samples visit https://www.capstoneproject.net/our-capstone-projects/nursing-capstone-project/
Breastfeeding Rates In The United States By Characteristics Of The Child,Biblioteca Virtual
This study analyzed breastfeeding rates in the United States using data from the 2002 National Immunization Survey. It found that over two-thirds of infants were ever breastfed, but rates of exclusive and continued breastfeeding dropped significantly by 6 and 12 months. Certain groups had lower rates, including non-Hispanic black children, those in daycare, enrolled in WIC, from lower socioeconomic status families, or younger or less educated mothers. The results suggest more efforts are needed to improve and support breastfeeding, especially among disadvantaged populations.
Overcoming Barriers to Increased Human Milk Feeding in the NICUDenise Breheny
This document discusses barriers to providing human milk feeding (HMF) in the NICU. It notes that while HMF provides numerous health benefits, many mothers struggle to establish and maintain an adequate milk supply. Barriers include lack of education for healthcare providers, lack of hospital policies supporting HMF, and demographic factors like low income that correlate with lower breastfeeding rates. Overcoming these barriers is important to maximize the benefits of HMF for vulnerable very low birth weight infants.
The document discusses issues with curriculum implementation and innovations in schools. It notes that poor student performance may be linked to inconsistent curriculum delivery among schools and teachers. Additionally, stakeholders often do not feel ownership over curricular changes, and some innovations are adopted without proper support or evaluation. The document then provides responses to address these issues, emphasizing the need for stakeholder involvement, monitoring of changes, and collaboration to promote ownership and success of new curriculums.
Curriculum development curriculum issues, concerns and responses Jerick Teodoro
The document discusses curriculum issues, concerns, and responses. It identifies several issues with implementing curriculum including poor academic performance, overcrowded classrooms, underprepared teachers, and a lack of stakeholder involvement and communication. In response, it recommends involving all stakeholders in curriculum planning, thoroughly studying readiness for innovations, and ensuring proper preparation, materials, and knowledge before implementation. Collaboration is also key to successfully addressing issues and concerns with curriculum changes.
This document outlines the learning areas, time allotments, and curricula for Music, Arts, Physical Education, and Health (MAPEH) in the K to 12 basic education program in the Philippines. It discusses that MAPEH focuses on developing artistic expression, cultural literacy, and lifelong fitness and wellness. The curricula are student-centered and performance-based. They aim to develop skills like critical thinking, creative expression, and health literacy. The document also provides sample content matrices that outline the focus areas for each grade level in subjects like Music, Arts, Physical Education, and Health.
This document provides an overview of a teacher induction program module focusing on curriculum and instruction for Music, Art, Physical Education, and Health Education (MAPEH/MSEP). It discusses five different teaching methods for music - Kodaly, Orff-Schulwerk, Dalcroze Eurythmic, Carabo-Cone, and Justine Ward. It also covers contents and activities for art, as well as teaching strategies for physical education and health education. The module aims to enhance teachers' skills and competence in providing varied learning experiences for students in these subject areas. It includes objectives, lessons, activities, sample lesson plans, and assessments to help new teachers deliver quality MAPEH/MSEP education.
The International Code In Relation To Agreements Of The World Trade Organisat...Biblioteca Virtual
This document discusses the relationship between international trade agreements through the World Trade Organization (WTO) and the International Code of Marketing of Breast-milk Substitutes. Specifically, it addresses concerns that WTO priorities of facilitating international trade could undermine the implementation and enforcement of the International Code, which aims to protect public health by regulating the marketing of breastmilk substitutes. The document concludes that explicitly exempting the International Code from WTO agreements would help prevent it from being challenged as a "barrier to trade." It also discusses potential risks of trying to include the Code in WTO agreements, as that could transform it from a minimum health requirement to a maximum requirement that prioritizes trade over public health protections.
The document discusses trips taken by the author and their family members, with the author having gone to Miramar twice and their parents having gone to Salta once while their sister has never been, and the author having bought a folder for school and discussed the movie Avatar with their sisters who haven't seen it yet.
Learn how to create smart, user friendly and efficient mobile applications in three simple steps for use in the field, in the warehouse or in your office - on any device, anywhere.
My school is a big, old normal school with two floors. The first floor contains assembly hall, bathrooms, technology room, video room, and classrooms for first and second year students. The second floor has more bathrooms, seating areas, and a small garden. There are fourteen classrooms total. Students have subjects like math, technology, language, English, geography, history, and PE. The school day includes three breaks and PE in the afternoon. The headmaster is Guillermo Tevez and there is also a caretaker named Anibal plus teachers and a psychopedagogist. My class has twenty-nine students. Although the exams are difficult, I enjoy normal school and am lucky to have good
Test-Driven Development e sua influência no designMaurício Aniche
O documento discute como o Test-Driven Development (TDD) influencia positivamente o design de software através de três frases: TDD guia o design de software por meio de testes automatizados escritos antes do código de produção e usados para dirigir a implementação de pequenas funcionalidades de cada vez; à medida que os testes expõem problemas de design, eles também fornecem feedback para refatorar e melhorar continuamente o código e os testes; dessa forma, TDD ajuda a evitar designs complexos e acoplados.
Professor Forsyth studied the health outcomes of 543 children from lower and higher socioeconomic groups. He found that (1) in the lower socioeconomic group, breastfed children had similar or significantly better health outcomes than formula-fed children, even compared to formula-fed children in the higher socioeconomic group. Subsequent studies discussed in the document found that (2) exclusive breastfeeding for at least 15 weeks reduced respiratory illness and that (3) one month of exclusive breastfeeding conferred protection against allergies and respiratory issues into childhood and adolescence. Overall, the document reviews extensive evidence that breastfeeding leads to improved health outcomes related to infectious disease, cognitive development, cardiovascular risk factors, obesity, and diabetes among others.
Breastfeeding And Early Weaning Practices In Northeast BrazilBiblioteca Virtual
This study examined breastfeeding practices in 4 towns in northeast Brazil by interviewing 364 mothers. The researchers found:
1) While mothers were positive about breastfeeding, exclusive breastfeeding was rare and the median duration of exclusive breastfeeding was 0 days.
2) The median age for introducing other milk was 24 days, and the median duration of breastfeeding was 65 days for mothers who introduced other milk within the first month compared to 165 days for other mothers.
3) Pacifier use in the first week, intention to introduce other milk in the first month, giving water/tea in the first week, and leaving the maternity ward before breastfeeding was established were associated with introducing other milk within the first month
Dealing With Fears Of Chemical Pollution Of BreastmilkBiblioteca Virtual
This document discusses fears about chemical pollution in breastmilk, specifically related to dioxins. It summarizes several studies that have found:
1) The majority (90-95%) of human exposure to dioxins comes from food, while only 5-10% comes from air.
2) Effects from dioxin exposure were more strongly associated with transplacental (in utero) exposure rather than breastmilk exposure.
3) Ongoing studies support the recommendation that breastfeeding should continue to be promoted due to its overall health benefits for infants, and concerns about dioxin exposure should not unduly influence a mother's decision to breastfeed.
Cape Town has been working towards becoming a more responsible tourism destination since 2004. This included creating a Tourism Development Framework in partnership with stakeholders and adopting a Responsible Tourism Policy and Action Plan in 2009. The policy focuses on seven priorities for sustainable tourism development. Cape Town received an award in 2009 for being the best responsible tourism destination. However, implementing responsible tourism practices across the industry remained a challenge due to issues like lack of resources and incentives. Efforts continued through 2012 to engage operators and collect data on responsible tourism indicators.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
Clinician Support And Psychosocial Risk Factors Associated With BreastfeedingBiblioteca Virtual
This study examined factors associated with breastfeeding discontinuation at 2 and 12 weeks postpartum in a cohort of 1007 low-risk mothers who initiated breastfeeding. The study found that breastfeeding rates declined over time, with 13% discontinuing by 2 weeks and 45% discontinuing by 12 weeks. Factors associated with earlier discontinuation included lack of breastfeeding confidence, early breastfeeding problems, Asian race, lower education, and depressive symptoms. Receiving encouragement from clinicians was associated with lower risk of discontinuing by 12 weeks, as was not returning to work or school by 12 weeks. The results suggest clinician support and addressing maternal mental health could help promote longer breastfeeding duration.
The document is an issue of Cabling Installation & Maintenance from October 2007. It features articles on UTP cabling performance, using an OTDR, fusion splicing, enclosures for thermal management, and the surveillance market transitioning to IP. The cover article previews these topics. The issue also includes an editorial on LEED certification, new product announcements, and an industry spotlight section.
We recently polled our nurses on fun statistics about their scrubs, and would like to share this infographic with you on the results. Please feel free to use on your company blog or anywhere you want to share these fun scrub statistics.
Este documento lista diferentes tipos de ropa, calzado, accesorios, artículos de higiene personal, maquillaje, artículos médicos, tecnología y documentación que pueden ser útiles para un viaje. Incluye detalles sobre camisas, pantalones, vestidos, zapatos, bolsos, joyería, cepillos de dientes, protector solar, cámaras, pasaportes y más. Proporciona nombres en inglés y español para cada categoría.
Swine influenza, also known as swine flu, is a virus that infects pigs and can be transmitted to humans. It is caused by the H1N1 strain of the influenza virus and was first identified in pigs in the 1930s. Major outbreaks of swine flu occurred in humans in 1918, 1999-2002, and 2009. Symptoms of swine flu in humans are similar to regular flu and include congestion, headache, and possible respiratory failure. Treatment involves vaccinations, antibiotics to prevent bacterial infections, and antiviral drugs like Tamiflu and Relenza.
Human Milk Storage Information For Home Use For Healthy Full Term InfantsBiblioteca Virtual
The guidelines are intended for healthy full-term infants, with different guidelines for hospitalized, sick, or preterm infants. A variety of storage containers and temperatures are addressed
Mothers And Clinicians Perspectives On Breastfeeding Counseling During Routin...Biblioteca Virtual
This document summarizes a study examining breastfeeding counseling provided during routine preventive visits from the perspectives of both mothers and their clinicians. The study involved surveying 429 mother-newborn pairs and their 121 obstetric and pediatric clinicians. The results identified several areas of disagreement between what mothers reported discussing with clinicians regarding breastfeeding duration, continuation after returning to work, and specific advice provided, highlighting potential unintentional gaps in communication around breastfeeding counseling during routine visits.
This document from the American Academy of Pediatrics outlines their policy statement on breastfeeding and the use of human milk. The key points are:
1) Extensive research has demonstrated significant health benefits for infants and mothers from breastfeeding, including reduced risk of infectious diseases, sudden infant death syndrome, diabetes, obesity, and improved cognitive development.
2) The policy statement provides recommendations for pediatricians and healthcare professionals to promote, protect, and support breastfeeding through individual practice, hospitals, medical schools, and communities.
3) Certain infectious diseases like HIV may preclude breastfeeding in some situations, but exclusive breastfeeding for the first 6 months does not increase HIV transmission risk according to some studies in developing countries.
A Home Visit Program For Breastfeeding Education And SupportRachel Doty
A home visit program was developed to provide breastfeeding education and support to mothers at risk of breastfeeding failure. The program aimed to increase breastfeeding rates and support mothers discharged within 24 hours after delivery. Nurses conducted home visits and assessments to help mothers breastfeed successfully. Evaluation found lower readmission rates for infants receiving home visits compared to those who did not. Patient satisfaction with the program was positive.
Characteristics Of Breastfeeding Practices Among Us MothersBiblioteca Virtual
1) More than half of breastfeeding mothers exclusively breastfed (breast milk only) until 4 months of age, after which exclusive breastfeeding declined sharply. Formula supplementation peaked at 42% at 1 month and declined to 15% at 1 year.
2) Around 6% of mothers reported exclusively pumping breast milk rather than directly breastfeeding.
3) Maternal reports showed considerable variation in behaviors related to common breastfeeding advice on frequency, duration, and intervals of feedings over the infant's first year.
Peripartum Breastfeeding Management For The Healthy Mother And Infant At Term...Biblioteca Virtual
This document provides guidelines for peripartum breastfeeding management for healthy mothers and infants. It recommends:
1) Prenatal breastfeeding education and support.
2) Skin-to-skin contact immediately after birth and rooming-in to facilitate breastfeeding.
3) Assessment and support for breastfeeding mothers to ensure effective latching and milk transfer.
4) Avoidance of supplemental feedings unless medically necessary to avoid breastfeeding difficulties.
The Timing And Predictors Of The Early Termination Of BreastfeedingBiblioteca Virtual
This study examined the early termination of breastfeeding among low-income mothers enrolled in the Women, Infants, and Children (WIC) program. The researchers found that over 70% of mothers stopped breastfeeding within the first 2 months. Through interviews, the researchers identified a lack of confidence in continuing to breastfeed at 2 months and a belief that the baby prefers formula as predictors of stopping breastfeeding within the first 2 weeks. The results suggest interventions should focus on boosting mothers' confidence in breastfeeding rather than only providing information.
The document discusses the revised training package for the Baby Friendly Hospital Initiative (BFHI). Some key points:
- The BFHI was launched in 1991 to promote breastfeeding. Over 15,000 facilities in 134 countries have achieved Baby-Friendly status.
- However, progress in designating new hospitals has slowed since 1996. On average, less than seven hospitals per country are designated each year.
- WHO and UNICEF have developed a revised 20-hour training course package to revitalize the BFHI both quantitatively and qualitatively.
- The package includes updates to certain steps and new/optional criteria on areas like HIV/AIDS, labor/childbirth care, and compliance with
NURS 412 Prenatal Care Education Nursing PICOT Question.pdfbkbk37
Prenatal care education is important for both educated and uneducated mothers. Studies show that providing basic prenatal education to first-time mothers in the late stages of pregnancy can improve knowledge of newborn care and increase test scores on prenatal care knowledge across all education levels. Prenatal care education is also associated with reducing risks of negative outcomes for both mother and child like low birth weight, preterm birth, and pregnancy complications. The main focus of this paper is on how providing health education and guidance during prenatal care can help address minor pregnancy issues, provide effective screening, and promote healthy behaviors.
Association Of Breastfeeding Intensity And Bottle Emptying Behaviors At Early...Biblioteca Virtual
This study examined the relationship between breastfeeding intensity, bottle emptying behaviors, and risk of excess weight in infants. The study found:
1) Infants who were breastfed at low (20% of milk feeds) or medium (20-80% of milk feeds) intensities in early infancy were over twice as likely to have excess weight in late infancy compared to infants breastfed at high (80% of milk feeds) intensities.
2) Infants who often emptied bottles in early infancy were 69% more likely to have excess weight in late infancy than infants who rarely emptied bottles.
3) Mothers' encouragement of bottle emptying was negatively associated with infants' risk of
This document provides an introduction and background for a study examining the effectiveness of a Breastfeeding Empowerment Programme (BEP) on knowledge, skills, self-confidence, and breastfeeding outcomes among first-time mothers in India. The study aims to evaluate the impact of the BEP, correlate outcomes with domains, and associate outcomes with background variables. It outlines the objectives, hypotheses, variables, sample size, population, sampling technique, data collection tools, and data analysis methods for the randomized controlled study.
Exclusive Breastfeeding Reduces Acute Respiratory Infection And DiarrheaBiblioteca Virtual
This study examined the relationship between breastfeeding practices and infant mortality in Dhaka, Bangladesh. The researchers followed over 1600 infants from birth to 12 months. They found that exclusive breastfeeding declined from 53% at 1 month to 5% at 6 months. Partial or no breastfeeding was associated with a 2-3 times higher risk of infant death from all causes, acute respiratory infection (ARI), and diarrhea compared to exclusive breastfeeding. The study suggests that exclusive breastfeeding in early infancy reduces infant mortality, particularly from ARI and diarrhea.
A "Academy of Breastfeeding Medicine" é uma organização mundial de médicos dedicados à promoção, proteção, e apoio da amamentação e lactação humana.
Nossa missão é unir em uma associação membros das várias especialidades médicas com este propósito comum.
Gostaria que a SBP - Sociedade Brasileira de Pediatria firma-se um MANIFESTO com esse mesmo conteúdo, principalmente em relação ao conflito de interesses.
Prof. Marcus Renato de Carvalho, IBCLC
The Infant Feeding Practices Study II (IFPS II) was a longitudinal study that collected data from over 4,900 pregnant women from 2005 to 2007 regarding infant feeding practices, health, and related issues during the first year of the infant's life. Questionnaires were administered prenatally and monthly during the first year. The study aimed to understand infant feeding in the context of changes since the previous IFPS study in the 1990s. It provided detailed information on breastfeeding, formula feeding, complementary foods, and other factors to help evaluate infant feeding recommendations and policies.
This study assessed how mothers learn about proper handling of infant formula and whether they follow safe practices. The study found that most mothers did not receive instruction from health professionals on formula preparation or storage. Many mothers did not fully read or understand package label instructions. While most believed following safety directions was important, many mothers engaged in unsafe practices like not always washing hands before preparing formula or heating bottles in microwaves. No consistent maternal traits predicted unsafe practices. More education is needed to promote proper formula handling and reduce risks of illness.
Breastfeeding Friendly Physician’S Office Optimizing Care For Infants And C...Biblioteca Virtual
This document provides recommendations for making a physician's office more breastfeeding-friendly. It begins with background information on the importance of physician support for breastfeeding. It then lists 19 specific recommendations for optimizing care for breastfeeding infants and children. The recommendations address establishing office policies, educating staff and patients, avoiding promotion of breastmilk substitutes, supporting breastfeeding in the office, and collaborating with local hospitals and resources. The document concludes with recommendations for future research.
The Effects Of Early Pacifier Use On Breastfeeding DurationBiblioteca Virtual
This study examined the effects of pacifier use on breastfeeding duration in a cohort of 265 breastfeeding mother-infant dyads in the United States. The researchers found that:
1) Pacifier introduction by 6 weeks was associated with a 53% increased risk of shortened duration of full breastfeeding and a 61% increased risk of shortened overall breastfeeding duration.
2) Mothers who introduced pacifiers tended to breastfeed less frequently, with statistically significant differences at 2 and 12 weeks.
3) At 12 weeks, mothers using pacifiers were more likely to report breastfeeding being inconvenient and having insufficient milk supply.
4) Pacifier use begun before 2 weeks or 6 weeks was not significantly associated
This document summarizes a national survey of breastfeeding rates in US hospitals designated as "Baby-Friendly" in 2001. The survey found that Baby-Friendly hospitals had higher rates of breastfeeding initiation (83.8% vs national rate of 69.5%) and exclusive breastfeeding during hospital stay (78.4% vs national rate of 46.3%) compared to national averages. The 3 Steps to Successful Breastfeeding that were most difficult for hospitals to meet were paying for infant formula (Step 6), training staff (Step 2), and limiting formula marketing (Step 7). Overall, the results suggest that Baby-Friendly designation is associated with higher breastfeeding rates, regardless of hospital demographic factors.
A study to assess the effectiveness of planned teaching programme on water bi...Apollo Hospitals
The experience of pain during labour is a complex, individual and multifaceted response to sensory stimuli generated during childbirth. Despite the fact that labour is painful for most women, a powerful myth of painless childbirth still prevails. Many alternative methods of pain relief are available that are safe and inexpensive. One of them is water birth. Water birth is the process of giving birth in a tub of warm water. The theory behind water birth is that the baby has been in the amniotic sac for nine months and birthing into a similar environment is gentler for the baby and less stressful for the mother. Adolescence is the time to prepare for understanding great responsibilities, a time for exploration and widening horizons, and a time to ensure healthy all round development. Puberty is also a time of behavioural changes when the reproductive capacities get established. Midwives are ‘with woman’, providing the family with supportive and helpful relationships as they share the deep and profound experiences of childbirth. To become skilled helpers nursing students need to develop reflective skills and valid midwifery knowledge grounded in their personal experiences and practice.
This study examined the association between phototherapy treatment for neonatal jaundice and breastfeeding duration and exclusivity. The study analyzed data from a national survey of over 4,000 mothers who initiated breastfeeding. Around 5% of infants received phototherapy for jaundice. The study found phototherapy was associated with decreased exclusive breastfeeding at 1-4 months but did not find significant decreases in any breastfeeding until 12 months. The results suggest greater breastfeeding support may help mothers maintain confidence in exclusive breastfeeding during and after phototherapy treatment.
This document summarizes the benefits of breastfeeding for public health. It discusses how breastfeeding improves infant and maternal health outcomes, provides economic benefits, and is environmentally friendly. It also reviews barriers to breastfeeding and policies to support breastfeeding, such as at worksites, in healthcare settings, and through legislation. The document presents breastfeeding rates in the US and goals to increase rates.
Similar to Effect Of An Educational Intervention About Breastfeeding On The Knowledge, (20)
Este documento fornece informações sobre a anatomia e fisiologia da glândula mamária. Resume que a mama é composta de tecido glandular, gordura e tecido conjuntivo, e descreve o desenvolvimento da mama desde a embriogênese até a puberdade. Também aborda a anatomia da mama adulta e a fisiologia da produção de leite, incluindo os hormônios envolvidos.
The 2008 IBLCE examination saw the largest candidate population in its history with 3,323 candidates taking the exam across 37 countries and territories. The exam was administered in 13 languages and saw continued growth in candidates from outside the United States, Canada, and Australia. Analysis of exam results found a pass rate of 93.56% with a mean score of 77.87% and standard deviation of 8.21%.
This document provides an overview of the Third Edition (Revised) of the Wellstart International Lactation Management Self-Study Modules, Level I. It was developed by Wellstart International, a nonprofit organization focused on educating healthcare providers about optimal infant and young child feeding. The Third Edition was reviewed by 30 volunteer experts from around the world and updated to ensure the information is current and internationally relevant. It is intended to be available at low or no cost globally to support breastfeeding education.
AvaliaçãO Do Impacto De Um Programa De Puericultura Na PromoçãO Da Amamentaçã...Biblioteca Virtual
1) O estudo avaliou o impacto de um programa de puericultura na promoção da amamentação exclusiva em uma coorte de 112 crianças no Sul do Brasil.
2) A prevalência de amamentação exclusiva no primeiro mês foi de 95%, caindo progressivamente para 81%, 64%, 53%, 39% e 35% nos meses seguintes.
3) A mediana da duração da amamentação exclusiva foi de 4 meses, maior do que as taxas nacionais brasileiras, indicando a eficácia do programa.
AnáLise Da Efetividade De Um Programa De Incentivo Ao Aleitamento Materno Exc...Biblioteca Virtual
O documento analisa a efetividade de um programa de incentivo ao aleitamento materno exclusivo em uma comunidade carente de São Paulo. Os principais resultados são: 100% das mulheres eram desempregadas, 51,8% aderiram ao programa mas 48,2% abandonaram por motivos desconhecidos, e no momento da alta apenas 17,3% relataram aleitamento exclusivo até os seis meses.
The 2008 IBLCE examination saw the largest candidate population in its history with 3,323 candidates taking the exam across 37 countries and territories. The exam was administered in 13 languages and saw continued growth in candidates from outside the United States, Canada, and Australia. Analysis of exam results found a pass rate of 93.56% with a mean score of 77.87% and standard deviation of 8.21%.
The document summarizes monitoring results from the Baby Feeding Law Group (BFLG) project on marketing practices of baby formula companies in the UK. It finds that Danone, maker of Aptamil and Cow & Gate formulas, continues advertising claims promoting follow-on formulas and undermining breastfeeding, despite rulings against such claims from the Advertising Standards Authority. The report provides examples of non-compliant magazine and television ads, and calls on Trading Standards offices to take action against illegal marketing practices.
The document summarizes statistics from the 2008 IBLCE lactation consultant examination. It reported that:
- 3,323 candidates took the exam across 37 countries, representing the largest candidate population in the exam's history.
- Less than half of candidates were from the US, with over 30% from other countries, indicating the credential has become a global standard.
- The exam was administered in 13 languages across 5 continents, and was taken online or on paper.
- 771 candidates took the exam for recertification purposes after 5 years of practice.
PromoçãO, ProtecçãO E Apoio. Apoio RepresentaçõEs Sociais Em Aleitamento MaternoBiblioteca Virtual
Este documento resume uma dissertação de mestrado sobre representações sociais em aleitamento materno. O trabalho analisou as percepções de profissionais de saúde e puérperas de dois hospitais sobre o aleitamento materno, comparando um hospital credenciado pela Iniciativa Hospital Amigo da Criança e outro não credenciado. Entre os principais achados, destacam-se a culpabilização da mulher no desmame, os efeitos das rotinas médicas no aleitamento e diferenças nas percepções entre os profissionais dos dois hosp
O Ensino De Aleitamento Materno Na GraduaçãO Em Medicina Um Estudo De CasoBiblioteca Virtual
Este documento descreve uma dissertação de mestrado sobre o ensino de aleitamento materno na graduação em medicina da Universidade Federal de Juiz de Fora. O estudo avaliou o nível de formação teórica e prática dos alunos, sua confiança em lidar com o tema e em transmitir informações às futuras mães. Os resultados sugerem que é necessária uma reavaliação do ensino teórico com foco prático para preparar melhor os médicos.
No Seio Da FamíLia AmamentaçãO E PromoçãO Da SaúDe No Programa De SaúDe Da ...Biblioteca Virtual
Este documento apresenta os resultados de uma pesquisa sobre a implementação da promoção da saúde no Programa de Saúde da Família em cinco municípios brasileiros. A pesquisa avaliou os conhecimentos e atividades de profissionais de saúde em relação à promoção do aleitamento materno, e entrevistou mães sobre sua experiência com o programa. Os resultados mostraram que os programas capacitaram bem suas equipes, que demonstraram conhecimentos acima da média sobre aleitamento materno. No entanto, as at
This document is the third edition of Wellstart International's self-study modules on lactation management at level 1. It contains pre-tests and post-tests, 3 modules that cover the basics of breastfeeding and common problems, and annexes with additional resources. The modules are designed to teach health care providers about promoting and supporting breastfeeding.
AnáLise Da Efetividade De Um Programa De Incentivo Ao Aleitamento Materno Exc...Biblioteca Virtual
O documento analisa a efetividade de um programa de incentivo ao aleitamento materno exclusivo em uma comunidade carente de São Paulo. Os principais resultados foram: 100% das mulheres eram desempregadas, 51,8% aderiram ao programa mas 48,2% abandonaram por motivos desconhecidos, e no momento da alta apenas 17,3% relataram aleitamento exclusivo até os seis meses.
AvaliaçãO Do Impacto De Um Programa De Puericultura Na PromoçãO Da Amamentaçã...Biblioteca Virtual
1) O estudo avaliou o impacto de um programa de puericultura na promoção da amamentação exclusiva em uma coorte de 112 crianças acompanhadas desde o nascimento.
2) A prevalência de amamentação exclusiva no primeiro mês foi de 95%, caindo progressivamente para 81%, 64%, 53%, 39% e 35% nos meses seguintes.
3) A mediana da duração da amamentação exclusiva foi de 4 meses, maior do que as taxas nacionais brasileiras, indicando a eficácia do programa.
Iblce Regional Office In Europe Candidate Information GuideBiblioteca Virtual
This document provides information for candidates applying to take the International Board Certified Lactation Consultant (IBCLC) certification exam. It outlines the eligibility requirements including the necessary educational background, clinical experience providing breastfeeding counseling, and professional lactation education. Candidates must meet the eligibility criteria for one of several pathways that differ in their required hours of clinical experience depending on a candidate's educational background and profession. The document reviews the application process and provides sample exam questions to help candidates prepare for the rigorous international certification exam.
A ImportâNcia Da AmamentaçãO Para A SaúDe Da Mulher Que AmamentaBiblioteca Virtual
O documento discute os benefícios da amamentação para a saúde da mulher, incluindo proteção contra câncer de mama e ovário, recuperação pós-parto mais rápida, e prevenção de osteoporose. A amamentação também ajuda no controle de natalidade através da produção de hormônios que inibem a ovulação.
AmamentaçãO E Uso De AntiinflamatóRios NãO EsteróIdes Pela Nutriz InformaçõEs...Biblioteca Virtual
1) O documento analisa as informações contidas nas bulas de medicamentos antiinflamatórios não esteróides em comparação com as evidências científicas sobre seu uso durante a amamentação.
2) Foi encontrada referência à segurança de uso durante a amamentação em apenas 14 de 27 medicamentos, e 9 de 10 medicamentos considerados seguros aconselhavam evitar o uso ou suspender a amamentação.
3) As bulas são discordantes das evidências científicas sobre a compatibilidade desses medicamentos com a amamentação, sendo necess
Este documento descreve a anatomia e fisiologia da amamentação. Resume a estrutura da mama, incluindo lobos, alvéolos e ductos, e explica os processos de mamogénese, mastogénese e lactogénese, que envolvem o desenvolvimento da mama durante a puberdade, gravidez e após o parto.
Contribution Of Environmental Factors To The Risk Of Male InfertilityBiblioteca Virtual
This study investigated the relationship between environmental exposures and male infertility in 225 men seeking infertility treatment in Argentina. The men were grouped based on reported exposures to pesticides, solvents, heat, or a mixture. Semen analysis and hormone levels were compared between exposure groups. Results showed that exposure to pesticides was associated with lower sperm counts and higher estrogen levels, while solvent exposure was linked to lower LH levels, with effects being more pronounced in men with primary infertility. The study suggests environmental factors contribute to male infertility severity and may worsen genetic or medical risk factors.
This document provides information on contraindications and conditions where breastfeeding may or may not be advised. It lists situations where breastfeeding is not recommended, such as if the baby has galactosemia or the mother has active untreated tuberculosis. It also outlines conditions where the benefits of breastfeeding outweigh the risks, such as if the mother is a hepatitis B carrier or smokes, as long as she takes certain precautions. The document is intended as a factsheet for GPs and pharmacists on breastfeeding recommendations.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Our backs are like superheroes, holding us up and helping us move around. But sometimes, even superheroes can get hurt. That’s where slip discs come in.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
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3. support for breastfeeding in their clinical encounters awareness of the benefits of breastfeeding and management of
with pediatric residents. common lactation issues. Correct answers to knowledge questions
were determined based on information provided in a standard
breastfeeding text.2 The questionnaire also solicited demographic
METHODS information including resident gender, age, race, year of training,
A 4-session educational intervention was designed to have an months of newborn nursery experience, and personal breastfeed-
effect on the knowledge, confidence, and behaviors of pediatric ing experience. The questionnaire administered after the interven-
residents about breastfeeding. Measurements were obtained be- tion was identical to the one administered before the intervention,
fore and after the educational intervention in 2 ways. Knowledge except that demographic information was omitted on the postint-
and confidence were assessed using a questionnaire administered ervention questionnaire, and questions about changes in confi-
to residents. Behaviors were evaluated by interviewing breast- dence were added. To ensure clarity of interpretation, the ques-
feeding mothers after a clinic visit with a pediatric resident. tionnaire was piloted with a sample of practicing pediatricians.
To assess the impact of the intervention on resident behaviors
when counseling breastfeeding mothers, post-visit telephone in-
Subjects and Setting
terviews of mothers were conducted before and after the interven-
Pediatric and Medicine-Pediatric Residents (hereafter referred tion. Subjects for the interviews were breastfeeding mothers
to as “residents”) in training with the University Health Systems whose infants were evaluated by a pediatric resident at a well-
of Eastern Carolina were eligible to participate. The residency child visit from birth to 1 month of age in the pediatric outpatient
programs are located in a small southern university city and center. Excluded were breastfeeding mothers whose infants pre-
provide primary care for residents of the city and the surrounding sented for acute care, mothers who did not accompany their
rural area. The majority of the population served is insured by infants during the visit, and mothers without phones. Breastfeed-
Medicaid, or is underinsured or uninsured. Fifty residents were ing mothers who brought their infants to the clinic more than once
enrolled in the 2 residencies during the study period. during the study period were contacted only once. Mothers were
All residents who participated in outpatient clinics during the contacted within 5 working days of the clinic visit. Two investi-
study period were eligible. In addition, residents who were gators performed the telephone interviews using a script; Spanish
present for both the preintervention and postintervention ques- language interpreters interviewed Hispanic mothers who did not
tionnaire, even if they participated in no clinics, were included for speak or understand English well. Consent was obtained from the
analysis of changes in knowledge and confidence. Residents were mother for the telephone interview and for review of the infant’s
excluded from analysis if they neither took the preintervention medical record.
knowledge test nor saw any breastfeeding infants in the outpa- The telephone interview contained questions to determine
tient clinics during the study period. whether the resident had performed each of 9 behaviors identified
All residents participated in the surveys voluntarily; informed as important (Table 1). Interviews were scored from 0 to 9 based
consent was waived because it was expected that the process of on the number of behaviors addressed. A minimum acceptable
obtaining consent might modify behavior of the subjects indepen- performance was defined as demonstrating at least 6 of the 9
dent of the study intervention. Data were analyzed collectively behaviors. The phone interview also contained questions to deter-
without individual identification of subjects. Approval for the mine whether the mother was confused by anything the resident
study was granted by the University and Medical Center Institu- said about breastfeeding, whether the discussion was helpful, and
tional Review Board. her degree of satisfaction on a 5-point Likert scale.
Educational Intervention Analysis
The intervention consisted of a 4-part educational series about Data were analyzed using SPSS (Chicago, IL). Knowledge ques-
breastfeeding, presented over 4 consecutive days. Attendance was tions from the questionnaires were assessed as being answered
recorded at each session. The educational sessions were internally correctly or incorrectly. The frequency of correct responses to
developed by the authors using standard texts and review articles, individual questions on the preintervention and postintervention
with additional input from local lactation consultants and pedia- questionnaire was compared using 2 (or Fisher exact test when
trician colleagues.1,2,10 –14 Residents were assigned standard re- expected frequencies were small). A composite knowledge score,
view articles and other readings before and during the interven- representing the percent correct of 21 knowledge questions, was
tion to facilitate their participation in the activities.1,10 –14 The calculated; preintervention and postintervention composite
series was structured as follows: knowledge scores for each individual were compared using the
DAY 1 Lecture/group discussion: current statistics, recommen- paired t test. Each of the 9 desired behaviors was assessed as being
dations about breastfeeding, benefits of breastfeeding, perceived present or absent on the preintervention and postintervention
barriers, physiology, and resources. telephone surveys. The frequency of each behavior performed by
DAY 2 Role-playing exercise, group practice, and video: initi- the preintervention group was compared with that of the postint-
ating breastfeeding, assessing position and latch-on, evaluating ervention group using 2 (or Fisher exact test when expected
the adequacy of breastfeeding, and maternal medication use while frequencies were small). All statistical tests were 2-tailed. Statisti-
breastfeeding. cal significance was defined as P .05.
DAY 3 Role playing exercise and demonstration: management Sample size calculations were performed before study initia-
of common lactation problems including cracked, bleeding, or tion. Calculation to determine the necessary number of resident
sore nipples, maternal nutrition, maintenance of breastfeeding participants used estimations of knowledge from previous studies
after return to school or work, and use of a breast pump. of pediatric residents, which suggested a baseline knowledge
DAY 4 Panel discussion: with breastfeeding mothers, focusing about breastfeeding of 60 percentage points.8,9,15 To detect an
on lactation problems, sources of support, and identified needs. improvement in knowledge score of 20 percentage points with an
estimated standard deviation of 20 points, a 2-tailed error of 0.05
Measures and a power of 0.80, sample size was calculated at a minimum of
16 resident participants. The number of phone interviews needed
Residents’ knowledge and confidence about breastfeeding was based on a “best guess” estimation from previous observation
were assessed using a questionnaire, and their behaviors for coun- and chart review looking for desired behaviors performed by
seling and support of breastfeeding mothers were assessed with residents. Estimating that 10% of residents preintervention would
telephone interviews of the mothers. The questionnaire was ad- perform an acceptable number of desired behaviors and 50% of
ministered to all participating pediatric residents before the edu- residents postintervention would perform an acceptable number
cational intervention, and a similar questionnaire was adminis- of desired behaviors, and using a 2-tailed of 0.05 and power of
tered 4 weeks later. The questionnaire was a modification of a 0.80, a minimum of 19 phone interviews was needed before and
previously validated and reliable survey instrument used by after the intervention.
Freed et al8 to assess knowledge and attitudes of pediatric resi-
dents about breastfeeding. The modified instrument contained 11 RESULTS
questions evaluating resident attitudes about their role in coun-
seling breastfeeding mothers and feelings of competence in pro- Fifty residents participated in clinics and were
viding those services. Twenty-one knowledge questions evaluated present at the study institution during at least part of
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4. TABLE 1. Behaviors Assessed by Telephone Interview, and Sample Questions Used to Identify Each
Behavior Sample Questions
1. Assess amount, adequacy of feeding* Did the doctor. . . .
. . . ask how many times a day your baby feeds?
. . . ask about wet diapers?
. . . check your baby’s weight?
2. Reassure the mother about adequacy of feeding*† Have you been worried that your baby isn’t getting enough milk?
Did the doctor tell you signs that your baby is getting enough?
What did (s)he tell you?
3. Identify problems, if they exist Did the doctor ask if you were having problems?
Do you have sore nipples? trouble with latch-on? a jaundiced baby?
Did the doctor talk to you about it?
4. Manage problems appropriately, if they exist and What did the doctor tell you to do about. . .
are identified† . . . jaundice?
. . . sore nipples?
. . . trouble with latch-on?
5. Give advice about maternal nutrition† Did the doctor talk to you about what you should eat or drink while
breastfeeding?
What did (s)he tell you?
6. Discuss maternal use of medications† Did the doctor talk to you about taking medicines while you are
breastfeeding?
What did (s)he tell you?
7. Discuss feasibility of breastfeeding after return to Are you planning to go back to work or school?
work/school Did the doctor talk to you about continuing breastfeeding when you do?
8. Encourage exclusive breastfeeding Did the doctor tell you not to give your baby other food or drink
besides breast milk?
9. Encourage continued breastfeeding Did the doctor tell you to continue breastfeeding?
Did the doctor tell you breastfeeding is good for your baby?
* For behaviors that could be performed in 1 way, residents were given credit for performing the behavior if they addressed it in at least
1 accepted way.
† For questions involving delivery of advice, residents were given credit if the advice they gave was correct, based on standard
breastfeeding texts and resources.
the study. One resident was excluded because she the clinic, was included in the behaviors analysis
was absent for the preintervention test, and saw no only. For the behaviors analysis, 27 residents had
breastfeeding infants in the clinics during the study clinical visits with 40 different breastfeeding moth-
period. Forty-nine residents were included for eval- er/infant pairs; 8 residents were evaluated on 1
uation. Characteristics of the participating residents occasion. Thirty-six residents attended 1 or more of
are included in Table 2. Forty-eight residents com- the 4 sessions of the educational intervention.
pleted both the preintervention and postintervention The mean composite knowledge score was 69%
questionnaires. One additional resident, who did not preintervention, and 80% postintervention; the mean
complete the preintervention and postintervention % difference was 11% with a standard deviation of
questionnaires but who saw breastfeeding infants in 8.95 (t 8.7; df: 47; P .001). Pediatric residents
demonstrated increased knowledge both about the
TABLE 2. Characteristics of Pediatric Resident Study Partici- benefits of breastfeeding and about the management
pants (N 49) of common lactation problems (Table 3). Residents
Characteristic n were already aware of many of the benefits of breast-
feeding before the intervention; however, they dem-
Gender
Male 20 onstrated increased awareness of the relative protec-
Female 29 tion breastfeeding may offer against otitis media
Age (P .045) and against some forms of cancer in moth-
30 y 32
30–35 y 17
ers (P .001). Residents showed significant knowl-
Race edge increases in advising mothers concerned about
African American 7 low milk supply (P .049), mothers with infections
Asian 4 including mastitis (P .002) or abscess (P .044),
Caucasian 38
Residency and mothers taking medications (P .001).
Pediatrics 30 Ninety-two percent of residents agreed that breast-
Medicine/Pediatrics 19 feeding promotion is an important use of their time,
Year in training
1st 13
and 84% agreed that breastfeeding is the most ben-
2nd 15 eficial form of infant nutrition. Before the interven-
3rd 17 tion, only 48% believed they had adequate training
4th 4 about breastfeeding, and 53% reported low levels of
Newborn nursery rotation(s) completed
0 mo 5 confidence in meeting the needs of breastfeeding
1 mo 35 mothers. Residents reported increased confidence as
2 mo 9 a result of attending breastfeeding education ses-
Has breastfed, or spouse has breastfed 8 sions. Of 36 residents who attended at least 1 session
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5. TABLE 3 Pediatric Residents’ Knowledge of Breastfeeding Benefits and Treatment for Common
Problems (Percentage Providing Correct Information)
Before Intervention After Intervention P
(N 48) (N 48)
n (%) n (%)
Benefit
Overall superior to formula 40 (83) 41 (85) NS
Decreased otitis media 40 (83) 46 (96) .045
Decreased early allergic disease 44 (92) 44 (92) NS
Decreased gastroenteritis 32 (67) 40 (83) NS
Increased immune function 47 (98) 47 (98) NS
Decreased infant obesity 17 (35) 24 (50) NS
Decreased maternal cancer 20 (42) 39 (81) .001
Problem
Maternal concern of low milk supply 28 (58) 37 (77) .049
Breastfeeding jaundice 35 (73) 38 (79) NS
Sore nipples 43 (90) 46 (96) NS
Mastitis 25 (52) 39 (81) .002
Breast abscess 6 (13) 14 (29) .044
Mother with HIV 45 (94) 46 (96) NS
Mother with chronic hepatitis B 2 (4) 6 (13) NS
Infant teething 44 (92) 44 (92) NS
Infant with loose stools 46 (96) 48 (100) NS
Mother taking over-the-counter medicine 27 (56) 43 (90) .001
Mother using cocaine 41 (85) 46 (96) NS
Use of early supplements 18 (38) 24 (50) NS
NS indicates not significant.
and completed the postintervention questionnaire, vention compared with preintervention interviews
14 reported “a little increase” in overall confidence in of mothers. Although improvement was noted for
talking to breastfeeding mothers, and 20 reported each measured behavior, statistical significance was
that their “confidence increased a lot.” Residents re- achieved only for discussing signs of breastfeeding
ported increased confidence in their abilities to man- adequacy with mothers (P .012) and for managing
age common clinical lactation situations after the lactation problems correctly (P .004; Fig 1). Before
intervention sessions. In some cases, increase in con- the intervention residents performed at or above the
fidence was related to session participation. For ex- acceptable threshold (demonstrating 6 of 9 behav-
ample, 32 residents reported they were “not at all iors) in 22% of encounters. After the intervention
confident” in discussing use of a breast pump before residents performed at or above the threshold for
the intervention. Fourteen reported the same lack of 65% of encounters (P .006; Fig 2). Performance of
confidence after the intervention, but 13 of the 14 did acceptable behaviors was higher postintervention
not attend the session, which included demonstra- even if no educational sessions were attended (22%
tion and hands-on practice with pumps. before and 40% after), with incremental performance
Interviews of breastfeeding mothers after clinical improvement noted with increasing attendance (Fig
encounters with residents showed substantial in- 3). No change was noted in reported satisfaction of
creases in active counseling behaviors after the inter- breastfeeding mothers being seen by residents: 91%
Fig 1. Change in resident behaviors: per-
centage of residents demonstrating each be-
havior before and after the educational inter-
vention.
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6. recognition of protection against some forms of ma-
ternal cancer, but few recognized the relative protec-
tion against obesity. One explanation for this is that
breastfed infants typically grow more rapidly in
weight during the first several months but less rap-
idly during months 3 to 12, ultimately becoming
leaner than their bottle-fed counterparts.2 In the pop-
ulation served by the study residents, breastfeeding
beyond 2 months of age is rare, and residents are
likely to observe the early rapid weight gain associ-
ated with breastfeeding without the subsequent
slowing of weight gain, leading to a misperception
that breastfed infants may be at more risk for obesity
than bottle-fed infants.
Physicians surveyed in other studies have often
responded to concerns about inadequate milk supply
by recommending interruption of breastfeeding or
Fig 2. Performance of desirable behaviors, before and after edu- early supplementation.22 In addressing clinical man-
cational intervention. agement questions before the intervention, residents
in this study often incorrectly chose to interrupt
breastfeeding. Of concern, many residents both be-
fore and after the intervention disagreed with the
statement that early supplementation is a cause of
breastfeeding failure, although previous studies
have clearly demonstrated this relationship.22,23 This
misconception will need to be corrected to maximize
success and prolong duration of breastfeeding.
The measured increase in confidence among resi-
dents after the intervention is of uncertain meaning.
Although it might be inferred that confidence in
addressing the needs of breastfeeding mothers trans-
lates into better clinical management of breastfeed-
ing issues, the number of residents in this study was
Fig 3. Percentage of residents with “acceptable performance” of too small to correlate the performance of individual
desired behaviors (at least 6 of 9) compared with number of residents in the clinical setting with their reported
sessions attended.
confidence level. Other studies have reported a lack
of correlation between confidence and knowledge or
reported being “satisfied” or “very satisfied” in both between confidence and clinical practices regarding
the preintervention and postintervention groups. breastfeeding.15,18
With respect to changes in the performance of
DISCUSSION behaviors when counseling breastfeeding mothers,
In this study, we confirmed that an interactive the most significant improvements were noted in
educational intervention about breastfeeding results discussing signs of breastfeeding adequacy with the
in improved knowledge and confidence of pediatric mother and in managing lactation problems (Fig 1).
residents. In addition, and of more obvious benefit to The increased number of residents providing reas-
patients, we demonstrated that appropriate counsel- surance of adequacy is particularly important, be-
ing behaviors with breastfeeding mothers in the clin- cause many mothers express concerns about low
ical setting increase after the intervention. milk supply and consider early supplementation. In-
Most health care practitioners have positive views ability to reassure a breastfeeding mother about the
about breastfeeding but report inadequate knowl- adequacy of her milk supply may lead to supple-
edge and desire additional training about lactation mentation and failure of breastfeeding. It is reason-
management.15–18 Studies have suggested that small, able to expect that reassurance from a physician
interactive workshops can increase the knowledge of about the adequacy of breastfeeding early in lacta-
general practitioners about breastfeeding.19 –21 In this tion and a discussion of signs of adequacy observ-
study, resident knowledge about the benefits of able by the mother might result in longer duration of
breastfeeding showed a modest increase following breastfeeding for some infants.
the intervention. In many cases, residents were al- Although resident performance improved for each
ready aware of the well-established benefits, partic- of the 9 behaviors assessed, 3 behaviors were per-
ularly those associated with overall immune func- formed by less than half the residents even after the
tion, protection against otitis media, and early intervention (Fig 1). These 3— discussion of appro-
allergic disease (Table 3). Fewer residents were fa- priate nutrition while breastfeeding, advice about
miliar with the protective effects of breastfeeding use of medications while breastfeeding, and ques-
against infant obesity or maternal cancer. After the tions about plans to return to work—may indicate
intervention residents demonstrated an increased areas for additional emphasis and education. In par-
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7. ticular, many mothers quit breastfeeding on return to days of the visit, this may not have accurately re-
work, so addressing this issue early may be an im- flected the actual performance of the resident. This
portant step toward prolonging breastfeeding. recall bias should be similar for mothers interviewed
A surprising finding was an observed increase in before and after the intervention. Assessment of
the performance of desired behaviors from 22% to what the mother remembered or perceived to have
40% among residents who attended none of the ed- happened may be more likely to affect her behavior
ucational sessions. The improved performance may than what actually happened but was not recalled.
have stemmed from assigned readings given to all Alternative techniques to gather similar information
residents, or from heightened awareness and discus- without reliance on recall might include videotaped
sions about breastfeeding among resident colleagues visits, in-room observers, or simulated patient en-
who had attended sessions. Residents may also have counters.21
responded to a perception that with a week of lecture In this study we demonstrated that interactive ed-
sessions devoted to breastfeeding education, it must ucational opportunities increased knowledge and
be an issue of importance for their training, or at least confidence and improved behaviors. A more impor-
was important to the faculty. The finding might also tant question is whether these changes will have an
represent regression to the mean. A larger study, impact on the health of mothers and infants. Will
with randomization to intervention and control mothers whose physicians are knowledgeable, con-
groups might help define whether changes were at- fident, and capable in managing breastfeeding issues
tributable to the intervention, to differences at base- have fewer problems, breastfeed longer, or have
line, or to other influences. healthier infants? Additional studies should evaluate
When questioned about their degree of satisfaction whether increased competence in caring for breast-
with the resident’s counseling about breastfeeding, feeding mothers and infants correlates with longer
mothers reported satisfaction before and after the duration of breastfeeding or fewer reported prob-
intervention at equal rates. In most cases mothers lems. Studies should also be done to measure the
reported being “satisfied” or “very satisfied” even if durability of these changes as the time from an ed-
the interview revealed that the resident had ad- ucational intervention increases.
dressed few important behaviors, been unable to
answer their questions, or provided incorrect advice. CONCLUSION
Mothers’ reports of satisfaction may have been influ- The value of breastfeeding has been clearly docu-
enced by the perception of the increased attention mented. Pediatricians, in their traditional role as ad-
they were receiving, created by a follow-up tele- vocate for the child and family, are ideally situated to
phone call. Reported satisfaction level— clearly a positively influence the breastfeeding experiences of
multifactorial issue—is not likely to be helpful in the mother and young infant. In this role, it is essen-
determining which interventions are useful to pro- tial that they have adequate knowledge and ability to
mote and support breastfeeding. counsel the breastfeeding mother. At least in the
The strength of the study was limited by the small short term, innovative and interactive educational
number of breastfeeding mothers available to be seen experiences can enhance resident knowledge, confi-
by residents. The number of visits was not adequate dence, and behaviors, with the possibility for a pos-
to allow for paired preintervention and postinterven- itive change in the duration of breastfeeding among
tion comparisons of individual residents when see- their patients.
ing breastfed infants and their mothers. Some resi-
dents were evaluated on 1 occasion during each ACKNOWLEDGMENTS
phase of the study period; each resident/mother en- This study was conducted under the guidance of the Primary
counter was considered independently for purposes Care Faculty Development Fellowship Program at Michigan State
of analysis. Future studies with larger numbers of University.
We acknowledge Lorrie Basnight, MD, for her participation in
breastfeeding mothers could allow for paired com- the educational sessions; Gary Freed, MD, MPH, for the use of his
parisons before and after an intervention, as well as survey instrument; and the East Carolina University Physicians
analysis of the impact of independent variables like Spanish Language Interpreters for their assistance in interviewing
gender, year of training, age, or previous breastfeed- Hispanic mothers.
ing experience.
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9. Effect of an Educational Intervention About Breastfeeding on the Knowledge,
Confidence, and Behaviors of Pediatric Resident Physicians
Karin M. Hillenbrand and Pamela G. Larsen
Pediatrics 2002;110;e59
DOI: 10.1542/peds.110.5.e59
Updated Information including high-resolution figures, can be found at:
& Services http://www.pediatrics.org/cgi/content/full/110/5/e59
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