搜索结果：International breastfeeding journal

Breastfeeding is important for infant and maternal physical and mental health. Despite this, the United Kingdom (UK) and Ireland have the lowest breastfeeding rates in the world with between 34% and 52% of women breastfeeding partially or exclusively at 6-8 weeks across the nations. This is driven by complex biological, social, psychological and economic factors. However, a significant body of evidence shows that mothers who receive skilled breastfeeding support are more likely to breastfeed for longer. Effective breastfeeding support can be delivered by a range of trained professionals and peer supporters depending on need. The highest specialist support is provided by International Board Certified Lactation Consultants (IBCLCs). Research from the USA has shown the positive impact of IBCLC support upon breastfeeding duration and experience. However, there is limited data on this topic from the UK and Ireland. Given significant differences in IBCLC access and health care systems, this review therefore aimed to explore the impact of IBCLCs in the UK and Ireland. Of 5169 papers retrieved, only four studies met the eligibility criteria. Four themes were identified; breast milk feeding rates increased, breastfeeding duration increased, lack of specialised IBCLC support available outside of study and format of support delivery, including group based or 1-1 support. The findings show increased access to IBCLC support may increase breastfeeding rates in the UK and Ireland. However, the findings are limited due to poor quality studies and recruitment bias. The paucity of evidence highlights the need for further research on this topic.

Despite playing a significant role in the development of a child, prevalence of exclusive breastfeeding remains unsatisfactory in both global and low- and middle-income countries' context, which includes Bangladesh. Since women are the primary providers of exclusive breastfeeding, understanding their level of empowerment and autonomy over decision making is critical. This study aims to examine the effect of women's empowerment on exclusive breastfeeding in Bangladesh. A nationally representative data from the 2022 Bangladesh Demographic and Health Survey (BDHS) was analyzed. Data on 884 women of reproductive age whose youngest child was under six months of age, and living with her were extracted. Exclusive breastfeeding was determined from children aged under six months who received only breastmilk during the 24 h preceding the interview and women's empowerment was developed following the DHS guideline. Bivariate relationships were assessed using chi-square tests, while generalized estimating equations (GEE) were used to account for clustering in multivariable analyses. For causal inference, the g-formula, inverse probability weighting (IPW), and doubly robust (DR) estimators were applied, with bootstrap confidence intervals for g-formula and DR methods. Among 884 mothers with infants under six months, 52% practiced exclusive breastfeeding. Multivariable GEE analysis identified mother's employment, division, child's sex, early initiation of breastfeeding, and women's empowerment as significant predictors of exclusive breastfeeding. Empowered mothers were found to have 35% higher odds of exclusively breastfeeding (OR = 1.35, 95% CI = 1.02, 1.79). Causal effect estimation using all the methods showed that women's empowerment significantly increased the odds of exclusive breastfeeding by 33%. Women's empowerment is a significant determinant of exclusive breastfeeding in Bangladesh. Women with agency to take their own decision over health, household, and mobility, awareness regarding their rights, and sense of dignity are more likely to exclusively breastfeed their infants. Therefore, interventions and policies should be designed and executed to enhance women's decision-making autonomy to improve exclusive breastfeeding rates and, consequently, child health outcomes.

Breastfeeding offers well-documented short- and long-term benefits for both infants and mothers, yet Malta lags behind national targets. Only 46.3% of Maltese infants are exclusively breastfed at hospital discharge, and fewer than 10% continue exclusive breastfeeding for 6 months. Determinants of breastfeeding in Malta are not well understood. This study aimed to explore the perspectives of Maltese mothers during the early postpartum period to identify factors influencing the initiation, continuation, and cessation of breastfeeding. An exploratory-descriptive qualitative design was employed. Thirteen recently postpartum mothers attending the Breastfeeding Clinic at Mater Dei Hospital were recruited through purposive sampling. Semi-structured interviews, conducted face-to-face or online, explored reasons for continuation or discontinuation of breastfeeding; experiences of breastfeeding; and perceptions around improvements needed to support breastfeeding in Malta. Audio/video files were transcribed and analyzed thematically. Three overarching themes emerged: (1) internal factors, including maternal determination, perceived benefits, doubts in self-efficacy, and pain; (2) external influences, including family, partners, public perceptions, and healthcare professional advice; and (3) demand for appropriate support, including workplace accommodations, tailored education, and community resources. Maternal determination and supportive healthcare guidance facilitated breastfeeding, whereas inconsistent advice, social pressures, and insufficient workplace policies hindered it. Breastfeeding practices in Malta are limited by systemic, cultural, and practical barriers. Interventions that strengthen maternal self-efficacy, provide consistent professional support, foster familial and societal acceptance, and enhance policy support for parental leave and workplace accommodations may improve breastfeeding initiation, exclusivity, and duration.

Pregnancies among people with cystic fibrosis (PwCF) have increased in the CFTR modulator (CFTRm) era. However, pregnant PwCF were excluded from CFTRm trials, limiting evidence on offspring outcomes after in utero and breast milk exposure. Follow-up practices for exposed children vary, and no widely accepted recommendations exist. We aimed to develop the first international recommendations for clinical follow-up of children exposed to CFTRm in utero and/or via breastfeeding. An international survey of follow-up practices and a literature review informed item generation for a Delphi consensus survey. We recruited panellists from four clinician groups (paediatric CF, adult CF, non-CF physicians, and other healthcare professionals) and a group of PwCF. An a priori consensus threshold was set at ≥70 % overall agreement and ≥50 % agreement within each group, with up to three survey rounds. The Imperial College Research Ethics Committee granted ethical approval. The protocol was prospectively registered (DOI:10.17605/OSF.IO/VJ2Z8). Completed responses were submitted by 106, 101 and 107 panellists in rounds 1-3, respectively, representing 26 countries. Clinician panellists had a median of 18 years' clinical experience (IQR 10-25). Eight PwCF participated. Consensus was reached on 73 items, including follow-up setting, liver function monitoring, cataract screening, and potential false-negative CF newborn screening. In total, we received 941 free-text comments which we used to refine existing items and generate new ones for subsequent rounds. International consensus recommendations are now available to support consistent, implementable follow-up of children exposed to CFTRm in utero and/or via breastfeeding, adaptable to local practice.

This study aimed to determine whether healthcare professionals' breastfeeding-related training and certification are associated with breastfeeding support knowledge, self-efficacy, and attitudes. An online survey was created by modifying existing instruments. Items assessed Alabama healthcare professionals' certification in breastfeeding support, breastfeeding support-related training experience, knowledge, self-efficacy, and attitudes. Participants were healthcare providers and administrators serving infants and expectant or new mothers in Alabama, recruited by e-mailing through Alabama professional organization listservs and personal contacts. Multiple linear regression models were used to examine the relationship between breastfeeding support-related variables. A total of 82 surveys were analyzed. Multiple linear regression showed that higher perceived training preparation was associated with higher self-efficacy (&#x3b2;=0.53, P<0.001) and attitudes (&#x3b2;=0.27, P=0.040), but not higher knowledge (&#x3b2;=0.22, P=0.072), after controlling for sex and experience in breastfeeding their own infant. Certification status was associated with higher knowledge (&#x3b2;=0.34, P=0.005) and higher self-efficacy (&#x3b2;=0.32, P=0.003). Enhancing breastfeeding training for healthcare professionals in Alabama may help address the state's low breastfeeding rates and improve health equity for mothers and infants. Certification in breastfeeding support provides an additional level of training and should be encouraged. These findings underscore the need for targeted training interventions among healthcare professionals in Alabama.

Exclusive breastfeeding rates in Iran remain below international recommendations, while gestational diabetes mellitus (GDM) rates are increasing. Evidence from Western countries suggests GDM and postnatal psychological distress may hinder breastfeeding. We assessed associations between postnatal distress and breastfeeding in women with and without GDM in a Southwest Asia and North Africa (SWANA) population where cultural, social, and health system contexts differ. Data were from the Isfahan site of the Prospective Epidemiological Research Studies in Iran (PERSIAN) Birth Cohort (n&#x2009;=&#x2009;2,823). GDM was self-reported during pregnancy. Postnatal psychological distress was assessed at two months postnatal using a single-item measure of sadness/helplessness, which, although limited, may reflect the challenges in measuring mental health status in Iran. Breastfeeding outcomes were reported retrospectively at 12&#x2009;months. Logistic and linear regressions adjusted for maternal age and education. Women with GDM were less likely to initiate breastfeeding (adjusted OR&#x2009;=&#x2009;0.25, 95% CI&#x2009;=&#x2009;0.16-0.40) and reported shorter exclusive breastfeeding (adjusted &#x3b2;&#x2009;=&#x2009;-0.47&#x2009;months, 95% CI&#x2009;=&#x2009;-0.68 to -0.25). Psychological distress was not associated with breastfeeding initiation but was associated with shorter exclusivity (mild distress: &#x3b2;&#x2009;=&#x2009;-0.32&#x2009;months; moderate - severe distress: &#x3b2;&#x2009;=&#x2009;-0.48&#x2009;months). Interaction analyses suggested a stronger negative effect of GDM on exclusivity in women without distress, though this finding was exploratory. GDM was associated with reduced breastfeeding initiation and shorter exclusivity, while distress modestly reduced exclusivity. The interpretation is limited by lack of validation for the psychological distress measure.

Nonexclusive breastfeeding is a major risk factor for childhood lower respiratory infections, yet its global burden remains unquantified. Although exclusive breastfeeding is widely recommended, the attributable burden of early infancy lower respiratory infections linked to nonexclusive breastfeeding and cross-country performance gaps have not been systematically assessed. This analysis fills that gap by combining burden estimates with frontier benchmarking. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 database, we estimated deaths, disability-adjusted life years, age-standardized mortality rates, age-standardized disability-adjusted life-year rates, and population attributable fractions of lower respiratory infections attributable to nonexclusive breastfeeding across 204 countries and territories from 1990 to 2021. Temporal trends were assessed with joinpoint regression, and frontier analysis was applied to identify efficiency gaps. In 2021, nonexclusive breastfeeding accounted for 37,890 lower respiratory infection deaths and 3.41&#x2009;million disability-adjusted life years globally, with boys carrying a higher burden. India, Nigeria, and Pakistan had the largest absolute numbers, whereas Chad, Somalia, and South Sudan had the highest standardized rates. Neonates (<28&#x2009;days old) showed the highest mortality and disability-adjusted life-year rates, indicating greater vulnerability than with infants aged 1-5&#x2009;months. Globally, age-standardized mortality rates and age-standardized disability-adjusted life-year rates declined significantly from 1990 to 2021 (average annual percentage change -4.87%), although sub-Saharan Africa and South Asia still bore the heaviest burden. Frontier analysis revealed substantial potential for further reduction in low- and low-middle sociodemographic index countries through improved breastfeeding and health system strengthening. Despite global progress, nonexclusive breastfeeding remains a major contributor to childhood lower respiratory infections, particularly among neonates and in low-sociodemographic index settings. Strengthening breastfeeding promotion and maternal-child health services is critical to reducing mortality, morbidity, and regional inequities. To achieve this, scaling evidence-based policies, such as Baby-Friendly practices, community lactation support, maternity protection, and strong enforcement of the International Code of Marketing of Breast Milk Substitutes is essential.

Use of International Board Certified Lactation Consultants (IBCLCs) is associated with higher breastfeeding rates. However, little is known regarding mothers' perceptions of satisfaction with IBCLC encounters. Database and ancestry searches resulted in 511 reports published between 2000 and 2025 about qualitative research conducted in the United States. Forty-one articles progressed to full review, and six articles satisfied all inclusion criteria for this integrative review. All research teams used the descriptive qualitative design to analyze data collected between 4 weeks and 8 months postpartum across a diverse representation of U.S. mothers. The body of evidence reveals that the assistance received from IBCLCs is multifaceted, because various aspects play crucial roles in ensuring that mothers feel supported. Findings highlight the importance of IBCLCs' practical expertise, hand in hand with their reassuring support. Mothers perceived satisfaction with consultation when the IBCLC offered sufficient time, provided encouragement, demonstrated knowledge, addressed their concerns, showed empathy for their struggles, and shared information that empowered them to breastfeed their infants with confidence.

The human tongue is a major player for breathing, swallowing, sucking, chewing and speech. Breastfeeding is the initial training for its subsequent tasks. Thus, we aimed to explore the tongue's anatomy and biomechanics with conclusions on breastfeeding, essential for healthy development. Literature on human and animal tongue anatomy and physiology was searched using relevant keywords in the Internet, literature lists from lectures and papers, anatomy and lactation textbooks. As data on tongue anatomy/physiology during breastfeeding is limited, transfer from other research areas was necessary. Own visual material was analysed. We identified and represented contracting and relaxing muscles for three selected tongue movements relevant for breastfeeding and compared them with literature findings. The tongue as a muscular hydrostat creates different shapes. Simultaneously different muscle fibres need to contract, while others relax. The complex movements require excellent neuronal control. Clear conclusions for protection and support of breastfeeding and physiological tongue resting position are drawn from tongue anatomy and function. Known breastfeeding recommendations, like frequent breastfeeding in relaxed circumstances, prone position, avoiding artificial nipples and supporting nasal breathing during sleep ('suction-to-palate') are confirmed by tongue anatomy and function as well as by the learning process in neuronal feedback-loops.

Background/Objectives: Breastfeeding represents a critical developmental window during which maternal biology, environmental exposures, and nutrition converge to influence infant gastrointestinal health and long-term developmental trajectories. From a One Health perspective, breastfeeding can be conceptualized not as a static nutritional act, but as a dynamic and modifiable biological system in which maternal factors shape early-life microbiota assembly and immune programming. This narrative review explores how microbiota-oriented strategies during breastfeeding may foster a favorable trajectory of infant health, potentially extending to transgenerational outcomes. Methods: This narrative review is structured around a ten-point decalogue addressing interconnected domains relevant to the maternal-milk-infant microbiota axis, including maternal diet, microbial diversity, environmental exposures, psychological stress and probiotic use. Current mechanistic and clinical evidence was examined to evaluate how these domains may modulate microbiota composition and function during breastfeeding. Attention was given to probiotic supplementation, including strain specificity, timing of administration, and clinical context, as well as to the broader implications of a One Health framework. Results: Available evidence suggests that maternal nutritional patterns, environmental and psychosocial exposures, and targeted microbiota-modulation strategies may influence the composition and functional properties of human milk and the developing infant microbiota. Probiotic use during breastfeeding appears to have strain-specific and context-dependent effects, with potential benefits in selected clinical scenarios. However, findings remain heterogeneous, and uncertainties persist regarding optimal strains, timing, and long-term outcomes. Conclusions: Breastfeeding can be understood as a dynamic biological interface shaped by maternal and environmental factors. Integrating microbiota-oriented strategies within a One Health framework may support infant gastrointestinal health and possibly contribute to longer-term developmental trajectories. Nevertheless, careful interpretation of the current evidence is warranted to avoid reductionist, supplement-centered approaches and to prevent maternal overmedicalization or blame.

Climate change is a growing threat to human health, yet infant feeding is rarely included in sustainability discussions. Breastfeeding (BF) and commercial milk formula (CMF) have very different environmental and health impacts. Since infant nutrition is linked to planetary health, paediatricians can help promote feeding practices that support both child health and environmental goals. We conducted a narrative review of scientific literature and international reports to summarize evidence on the environmental impacts of CMF production and consumption, the sustainability advantages of BF, and the barriers that influence feeding choices. BF is the most sustainable first-food system, requiring no industrial processing, packaging, or transport and producing minimal waste, whereas CMF is resource-intensive. Life cycle assessments show that CMF has higher environmental impacts than BF in areas such as global warming potential, land use, and water eutrophication, mainly due to dairy production. CMF manufacture also contributes to antimicrobial resistance and biodiversity loss. Social and workplace barriers, including limited parental leave, inadequate lactation support, and CMF marketing, reduce BF rates. Supporting BF within climate and health policies can not only&#xa0;improve maternal and child outcomes but also contribute to planetary health. 1. The article shows that breastfeeding, beyond its clinical benefits, represents a substantially more sustainable first-food system than commercial milk formula and should be regarded as a meaningful climate-mitigation strategy. 2. The review integrates and updates life-cycle evidence on the environmental footprint of commercial milk formula (carbon, water, land, and waste) highlighting the persistent exclusion of breastfeeding from climate-policy frameworks. 3. By reframing breastfeeding as a climate-relevant intervention, the article supports its incorporation into environmental and public health strategies with the potential for significant resource conservation and emission reduction.

This consensus aims to standardize the diagnosis and management of neonatal lactose intolerance (LI). A multidisciplinary working group was established under the auspices of the Preterm Birth International Collaborative (Australasia Branch). The development process included a comprehensive literature review of databases, which identified 61 publications. Recommendations were formulated using the Grading of Recommendations, Assessment, Development and Evaluation system for evidence evaluation. A modified Delphi method was used to achieve consensus. The consensus establishes that neonatal LI presents with nonspecific gastrointestinal symptoms, requiring stool assessment for diagnosis. Screening tests include fecal reducing sugar or urinary galactose tests, and the diagnosis is confirmed through elimination testing while excluding mimics. Treatment prioritizes lactase-supplemented breastfeeding; formula-fed infants receive lactase or reduced-lactose formulas. Probiotics with &#x3b2;-galactosidase activity can be used as an adjuvant therapy, and evidence-based lactase preparations are recommended, particularly for preterm infants. Treatment duration should be individualized, with a general minimum of 2&#xa0;weeks; however, the routine use of lactose-free formula to prevent LI in preterm infants is not recommended. This consensus provides practical evidence-based guidance to standardize the diagnosis and management of neonatal LI, aiming to reduce variation in practice and improve patient outcomes. It emphasizes the importance of maintaining breastfeeding while incorporating lactase supplementation and highlights the need for further high-quality research, particularly randomized controlled trials, to refine diagnostic criteria and therapeutic strategies for preterm and very preterm infants. The recommendations are intended to support clinicians in making informed decisions while promoting family-centered care. International Practice Guidelines Registry Platform (PREPARE-2024CN606).

Little is known about whether perceptions in Samoa of human milk composition and quality play a role in the decline in exclusive breastfeeding with age, the introduction of solid foods, or the degree to which mothers are utilizing responsive feeding practices. To explore this topic, we qualitatively explored feeding practices in Samoan families to identify areas in which the introduction of responsive feeding education may support and supplement the current breastfeeding promotion success. In 2020-2021 we conducted one-on-one structured interviews with n&#x2009;=&#x2009;100 mothers of infants aged 2-4&#x2009;months. A subset of the sample (n&#x2009;=&#x2009;25) was asked to take part in focus groups approximately a year later to gain further information regarding their overall infant feeding experience and behaviors, including breastfeeding and complementary feeding, related to responsive feeding methods and weaning. Three themes emerged from the interviews-Human Milk Contents, Nurturing Qualities and Hunger/Satiety Cues, while the focus groups generated seven themes-Human Milk Attitudes, Weaning Age, Weaning Foods, Introduction of New Foods, Mealtimes, Crying/Fussiness Response, and Sweet Food/Candy. While, to the best of our knowledge, responsive feeding practices are not taught in Samoa, some of the themes highlighted responsive feeding practices already being utilized in Samoan families. The information gained from the interviews and focus groups can be used to develop evidence-based messaging that strives to educate parents and caregivers to successfully identify hunger and satiety signals in infants and encourage the introduction of healthy and age-appropriate foods that complement current Samoan breastfeeding practices and childhood dietary patterns.

Breast milk is the preferred source of enteral nutrition for neonates and is particularly important for premature neonates because it promotes growth and development, and reduces the incidence of many diseases to which premature neonates are susceptible. To assess the prevalence and duration of breastfeeding among very preterm infants (VPIs) with a gestational age <32 weeks admitted to the neonatal intensive care unit (NICU) of XiJing Hospital. A retrospective record review was conducted to collect data on clinical characteristics and feeding methods of 235 VPIs born in XiJing Hospital from January 2017 to December 2023 and admitted to the NICU within 24 hours of birth. Of the 235 eligible VPIs, 177 (75.3%) were delivered by cesarean section, 102 (43.4%) did not receive any breast milk during their hospitalization, and 133 (56.6%) received a mixture of breast milk and formula. Compared with the cesarean-section group, the vaginal-delivery group was significantly more likely to breastfeed (12% vs. 0.3%; P=.004) and had a significantly higher median daily breast milk intake (5.81 vs. 0.17&#xa0;mL/kg; P=.003) during hospitalization; however, the duration of parenteral nutrition did not differ significantly between groups. Overall, these results indicate that measures are required to increase breastfeeding among VPIs, particularly those born by cesarean section.

In response to the drastic complications that resulted from Coronavirus-19 (COVID-19) infection, vaccines were developed to contain its rapid spread. However, concerns were raised regarding the safety of COVID-19 vaccines for pregnant and breastfeeding women. This study aimed to explore the perceptions and practices of Lebanese obstetricians regarding the COVID-19 vaccine, highlighting the barriers to recommending it. A cross-sectional study was implemented using a questionnaire. Descriptive statistics in the form of frequencies and percentages were utilized to get an overview of obstetricians' characteristics and responses. Inferential statistics were employed to examine plausible barriers to recommending the vaccine. A total of 265 obstetricians were included in the study. Most of the physicians had received the vaccine themselves (254 (95.8%)) and were recommending the vaccine to all of their pregnant patients (238 (89.8%)). Lack of data about the safety of the vaccine and that of clear guidelines were the main reasons for not recommending it to all patients. Receiving the vaccine, having sufficient data about the vaccine, adequate knowledge about COVID-19 infection and vaccination, the type of vaccine, and managing patients who were exposed to COVID-19 were significant predictors of offering the vaccine. Our results provided an overview of Lebanese obstetricians' attitudes and practices regarding the COVID-19 vaccine and identified some of the factors that hinder the recommendation of the vaccine. Such information might be helpful to overcome the obstacles that prevent obstetricians from abiding by international recommendations, thus increasing the uptake of vaccines by pregnant women in any potential future pandemic.

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