The document summarizes evidence from multiple studies on the relationship between breastfeeding and infant infection. Three studies are critically appraised: a prospective cohort study from Hong Kong found exclusive breastfeeding for at least 3 months was associated with lower risk of hospitalization for infection in the first 6 months. A UK retrospective cohort study found exclusive breastfeeding was associated with 30-63% lower risk of lower respiratory tract infections and diarrhea hospitalizations. A systematic review of 15 large cohort studies found a protective relationship between breastfeeding and incidence of diarrhea and pneumonia, with a 40% reduction in gastrointestinal illness risk and 4.91 times higher hospitalization for infants never breastfed. The evidence suggests breastfeeding, particularly exclusive breastfeeding, significantly reduces the risk of
Breast feeding and complimentary feeding are two best practices which reduce infant mortality and morbidity.this presentation will be helpful in understanding the art and science of both interventions.
Weaning is when a baby transitions from breast milk to other sources of nourishment. When to wean is a personal decision. Moms may be influenced by a return to work, her health or the baby's, or simply a feeling that the time is right.
Weaning a baby is a gradual process that calls for patience and understanding from both you and your child.
Breast feeding and complimentary feeding are two best practices which reduce infant mortality and morbidity.this presentation will be helpful in understanding the art and science of both interventions.
Weaning is when a baby transitions from breast milk to other sources of nourishment. When to wean is a personal decision. Moms may be influenced by a return to work, her health or the baby's, or simply a feeling that the time is right.
Weaning a baby is a gradual process that calls for patience and understanding from both you and your child.
advantages, anatomy, physiology of lactation, composition of breast milk, techniques of Breastfeeding, contraindications, alternatives to breastfeeding, myths about breastfeeding, problems in breastfeeding and managements, public health concerns of Breastfeeding
World Breastfeeding Week is an annual celebration marked from 1-7 August that highlights this essential practice. This year it is built around the theme of Breastfeeding Support for Mothers. More mothers breastfeed when they receive support, counselling and education in health centres and in their communities
Healthy Mothers Healthy Babies
2014 Annual Meeting & Conference
October 7th, 2014
Presented by: Elizabeth Lee McWilliams, BSN, RN, IBCLC Medical Center, Navicent Health Macon, GA
What to Expect in the early days of breastfeeding, the norms and what to observe to detect abnormalities and finally the optimal practices to successful breastfeeding
Breastfeeding vs Bottle | Go to http://newborn-clothing.net/product-catalog/baby-breastfeeding-pumping for more information about Breastfeeding and Pumping
advantages, anatomy, physiology of lactation, composition of breast milk, techniques of Breastfeeding, contraindications, alternatives to breastfeeding, myths about breastfeeding, problems in breastfeeding and managements, public health concerns of Breastfeeding
World Breastfeeding Week is an annual celebration marked from 1-7 August that highlights this essential practice. This year it is built around the theme of Breastfeeding Support for Mothers. More mothers breastfeed when they receive support, counselling and education in health centres and in their communities
Healthy Mothers Healthy Babies
2014 Annual Meeting & Conference
October 7th, 2014
Presented by: Elizabeth Lee McWilliams, BSN, RN, IBCLC Medical Center, Navicent Health Macon, GA
What to Expect in the early days of breastfeeding, the norms and what to observe to detect abnormalities and finally the optimal practices to successful breastfeeding
Breastfeeding vs Bottle | Go to http://newborn-clothing.net/product-catalog/baby-breastfeeding-pumping for more information about Breastfeeding and Pumping
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3 of 4: Reducing Neonatal Mortality - Prevention, Early Detection and Treatme...JSI
This presentation by Luke C. Mullany of Johns Hopkins University, "Neonatal Infections: Global and Regional Burden and Interventions" was part of a dynamic panel moderated by JSI's Dr. Penny Dawson on February 13, 2015 at the 14th World Congress on Public Health in Kolkata, India. Four speakers summarized evidence for interventions proven to reduce newborn mortality (e.g., chlorhexidine) and shared important policy and programmatic experiences in prevention and treatment of neonatal infections. JSI's Leela Khanal and Dr. Nosa Orobaton spoke about experiences from Nepal and Nigeria in scaling up chlorhexidine use in those countries. Another speaker shared results from the COMBINE trial in Ethiopia, implemented primarily by JSI with support from SAVE/SNL, which evaluated the impact on neonatal mortality of health extension worker-led management of bacterial infections.
Beyond survival: Improving long-term outcomes for survivors of serious newborn illness in Asia and the Pacific
Dr Kate Milner
Centre for International Child Health, Department of Paediatrics
University of Melbourne
[[IAA JSR 10(1)49-60, 2023.Awareness and Practice of Breast Feeding among Mot...PUBLISHERJOURNAL
Breastfeeding is a key tool for nourishing a baby, preventing childhood illnesses like obesity, and hypertension later on in life. In addition, it reduces the cost to the family and the entire country. Uganda to some extent faces a great deal of challenges, particularly in the health sector. The aim of this study was to assess the knowledge, attitude and practices of exclusive breastfeeding in mothers with infants between 1 day to 2 years of age attending the immunization and the pediatric inpatient in Kiryandongo Hospital and to identify factors that affect exclusive breastfeeding (EBF). A cross-section descriptive survey design was used. 187 respondents were selected randomly. The data were collected using a questionnaire and the data was analyzed using descriptive statistics of frequency and percentages. The result of this study showed that 71.2 % knew the correct definition and duration of exclusive breastfeeding, 59.7% exclusively breastfeeds for the first six (6) months of life, 100% gave colostrum to their babies because they believed it provides nutrition and protection to their babies, 87% breastfed on demand. The result also showed that there is a positive attitude of mothers toward exclusive breastfeeding as 86.6% of them agreed that breast milk alone is sufficient to the baby during the first six (6) months of life as well as believed that EBF has benefits to both the infants and the mother. 51% of respondents weaned their babies between 15-18 months and 41% weaned between 19 months to 2 years. It was concluded that there was a high level of knowledge on breastfeeding among the respondents, more than half of the respondents practiced exclusive breastfeeding as recommended and relatively all the respondents had positive attitude toward exclusive breastfeeding.
Keywords: knowledge, attitude, practice, breastfeeding, mothers
1. • Worldwide, over three million newborns die each year in their
first four weeks of life, with the number one cause of death
being infections
• Up to two thirds of these deaths are preventable with the proper
care during and after birth, including exclusive breastfeeding
• The American Academy of Pediatrics recommends babies
should be breastfed exclusively for the first six months
• In 2014 79% of U.S. new mothers started to breastfeed in 2011,
but only 41% were still exclusively breastfeeding at 3 months
and 18% at 6 months
• Respiratory infections alone, are one of the leading causes of
pediatric hospitalization and outpatient visits in the U.S., with
influenza causing over 200,000 hospitalizations and 36,000
deaths each year
• Infections cost the U.S. over $120 billion each year
• In 2013, Medicaid alone spent over $438 billion on healthcare
Background
• Population. Studies that include full-term newborns from birth
to 1 year of age.
• Intervention. Studies that include breastfeeding or bottle
feeding with breast milk.
• Comparison. Studies that include any infant formula,
including soy milk and cow’s milk-based formulas.
• Outcome. Studies that include any contagious infection
caused by bacteria, virus, or fungi.
Inclusion Criteria
Critical Appraisal
“Breast-feeding and Childhood Hospitalizations” by Tarrant et
al. (2010)
• Addresses clearly focused issue
• Cohort recruited in acceptable way
• Parental recall bias present when measuring exposure
• Bias minimized when measuring outcome
• Missing some follow-up information from parents
• Answers from parents contradictory at times
• Identified all important confounding factors
• No follow-up of subjects mentioned
• Results are precise to a confidence interval of 0.47-0.91
• Results are believable
• Study done in Hong Kong so unknown if results applicable to
USA
• JBI Level of Evidence: Level 3.c—cohort study with control group
“Breastfeeding and Hospitalizations for Diarrheal and
Respiratory Infection in the United Kingdom Millennium
Cohort Study” by Quigley, Kelly, and Sacker (2007)
• Addresses clearly focused issue
• Cohort recruited in acceptable way by random sampling
• Parental recall bias present when measuring exposure and
outcome
• Important confounding factors not specified, but it is stated a
wide range of confounders were adjusted for
• Follow-up of subjects not detailed
• Results are precise to a confidence interval of 0.47-0.92 for lower
respiratory tract infections (LRTI) and 0.18-0.78 for diarrheal
hospitalizations
• Results are believable
• Study done in UK so results can be applied to USA
• JBI Level of Evidence: Level 3.c—cohort study with control group
“Breastfeeding Helps Prevent Two Major Infant Illnesses” by
Story and Parish (2008)
• Addresses clearly focused question
• 15 published articles retrieved from 5 reliable databases
• Majority of articles included are large-scale, ranging from
170-2602 people, with seemingly high reliability and validity
• Assessment of quality of included studies is not discussed
• Reasonable to combine results from each study because all
concluded breastmilk can reduce infection rate in infants
• No confidence intervals listed for each included study, so
unknown how precise results are
• Included studies took place in USA, UK, Bangladesh, India, and
Brazil, so unknown if results applicable to local population
• All important outcomes were considered
• Benefits worth the harms and costs
• JBI Level of Evidence: Level 3.b—systematic review of
comparable cohort and other lower study designs
“Breast-feeding and Childhood Hospitalizations” by Tarrant et al. (2010)
• Study design: prospective population-based birth cohort
• Participants: 8327 children born in 1997 from one of 49 publicly funded Maternal
and Child Health Centers in Hong Kong
• Sampling design: cluster sampling unrelated to exposure
• Intervention: exposure to exclusive breastfeeding
• Comparison group: partial breastfeeding or never breastfed
• Outcome measures: viewed public hospital admission records
• Results: Exclusive breastfeeding for at least 3 months was associated with lower
risk of hospital admissions for infection in first 6 months (hazard ratio=0.61)
• Author conclusions: Breastfeeding provides substantial protection from
hospitalization for infectious disease in infancy
“Breastfeeding and Hospitalizations for Diarrheal and Respiratory Infection in
the United Kingdom Millennium Cohort Study” by Quigley, Kelly, and Sacker
(2007)
• Study design: retrospective cohort study
• Participants: 15890 singleton, term infants born in England, Wales, Scotland, and
Northern Ireland in 2000-2002
• Sampling design: random 2-stage sample
• Intervention: exposure to exclusive breastfeeding
• Comparison group: partial breastfeeding or never breastfed
• Outcome measures: parental report of hospitalizations for diarrhea and LRTIs in
first 8 months of life
• Results: monthly prevalence of LRTI in those exclusively breastfed was 30%,
compared to 49% of those never breastfed; 34% lower risk of getting an LRTI from
exclusive breastfeeding (OR=0.66); 63% lower risk of diarrheal hospitalization
from exclusive breastfeeding (OR=0.37)
• Author conclusions: Breastfeeding, particularly when exclusive and prolonged,
protects against severe morbidity in the UK
“Breastfeeding Helps Prevent Two Major Infant Illnesses” by Story and Parish
(2008)
• Study design: systematic review
• Participants: 15 large-scale studies, majority cohort studies, discussing effects of
breastfeeding on the incidence of GI and respiratory illnesses from 1997-2007
• Sampling design: identifying study eligibility criteria and completing extensive
search review among 5 databases
• Intervention: exposure to exclusive breastfeeding
• Comparison group: partial breastfeeding or never breastfed
• Outcome measures: parental questionnaires and in-person interviews on the
occurrence of hospitalizations and illness for diarrhea, pneumonia, and LRTIs
• Results: 5 included studies statistically significant for breastmilk decreasing
infection rate (p<0.05); 40% reduction in risk for GI illness in first year of life for
those breastfed; hospital admissions 4.91 times higher among infants never
breastfed
• Author conclusions: Protective relationship exists between breastfeeding and the
incidence of diarrhea and pneumonia
Extraction of Findings
• Advise soon-to-be and new mothers to breastfeed
their infants
• Educate new mothers on the importance of breast
milk on reducing infections
• Be aware that majority of the summarized
evidence is from parental questionnaires
• Increase knowledge on this topic by reviewing
other observational studies and evidence
summaries that discuss the biological effects of
breast milk on reducing infection
Implications for APNs
Effect of Breastfeeding on Infant Infection
Karissa Braden, RN, BSN
Purdue University Calumet
Synthesis of Findings
• After reviewing the extracted findings from each
study, it can be concluded from the summarized
evidence that breastfeeding’s effect on reducing
infant infections is significant compared to formula
feeding
• Exclusive breastfeeding significantly reduces the
incidence of infection in infants compared to
infants that have never breastfed
• The level of confidence in the evidence, related to
the critical appraisal of each study, is high
What is the effectiveness of breastfeeding, compared to formula feeding, in reducing infant infection?
Implications for Research
• Further research with more objective
measurements of exposure and outcomes to
minimize parental bias
• Further research that controls all possible
confounding factors
• Systematic reviews of comparable large-scale
cohort studies can be conducted to expand our
confidence in the results