No abstract

Background: Perceived milk supply is an important modifiable factor for optimal breastfeeding. However, little is known about maternal perception of milk supply or how it impacts breastfeeding practices. The aim of this study was to examine relationships of perceived milk supply, maternal breastfeeding self-efficacy, and skin-to-skin contact with early initiation and exclusive breastfeeding among mothers of infants less than 6 months of age in Indonesia. Methods: This was a cross-sectional study conducted in Yogyakarta City, Indonesia between August and October 2015. Maternal perception of milk supply was assessed using the Hill and Humenick Lactation Scale. Data on breastfeeding practices, and maternal and infant factors were collected using a structured questionnaire. Multiple regression and multivariate logistic regression analyses were performed to obtain estimates of associations. Results: Thirty four percent of mothers had initiated breastfeeding within an hour after birth, and 62.4% of mothers were exclusively breastfeeding. High levels of perceived breast milk supply were reported in mothers who practiced skin-to-skin contact or rooming-in with their infants, experienced positive infant sucking behavior, or had high breastfeeding self-efficacy (p < 0.05). Mothers with a higher level of perceived milk production (Odds Ratio [OR] 3.20; 95% Confidence Interval [CI] 1.76, 5.83) or practicing skin-to-skin contact (OR 2.36; 95% CI 1.13, 4.91) were more likely to exclusively breastfeed, while employed mothers were less likely to breastfeed their infants exclusively (OR 0.47; 95% CI 0.24, 0.93). Conclusions: In this study, skin-to-skin contact and breastfeeding self-efficacy are important determinants of perceived milk supply. Higher perception of milk supply was positively linked with exclusive breastfeeding. Our study highlights the importance of the assessment for mother's perception of milk supply, maternal breastfeeding self-efficacy, and skin-to-skin contact in achieving optimal breastfeeding outcomes.

No abstract

Background Breast engorgement and breast pain are the most common reasons for the early cessation of exclusive breastfeeding by mothers. Research Aims (1) To examine the influence of breastfeeding educational interventions on breast engorgement, breast pain, and exclusive breastfeeding; and (2) to identify effective components for implementing breastfeeding programs. Methods Randomized controlled trials of breastfeeding educational interventions were searched using five English and five Chinese databases. Eligible studies were independently evaluated for methodological quality, and data were extracted by two investigators. In total, 22 trials were identified, and 3,681 participants were included. A random-effects model was used to pool the results, and a subgroup analysis and meta-regression analysis were conducted. Results Breastfeeding education had a significant influence on reducing breast engorgement at postpartum 3 days (odds ratio [OR]: 0.27, 95% CI [0.15, 0.48] p < .001), 4 days (OR: 0.16, 95% CI [0.11, 0.22], p < .001), and 5–7 days (OR: 0.24, 95% CI [0.08, 0.74], p = .013) and breast pain (standardized mean difference: −1.33, 95% CI [−2.26, −0.40]) at postpartum 4–14 days. Participants who received interventions had higher odds of exclusive breastfeeding. Breastfeeding educational interventions provided through lecture combined with skills practical effectively reduced breast engorgement (OR: 0.21; 95% CI [0.15, 0.28]; p = .001) and improved exclusive breastfeeding at postpartum 1–6 weeks (OR: 2.16; 95% CI [1.65, 2.83]; p = .001). Conclusions Breastfeeding educational interventions have been effective in reducing breast engorgement, breast pain, and improved exclusive breastfeeding. A combination of knowledge and skill-based education has been beneficial for sustaining exclusive breastfeeding by mothers.

Background: The benefits of breastfeeding in promoting child survival are well recognized. As one of the nutritional interventions for children, exclusive breastfeeding protects babies from various diseases that contribute to infant morbidity and mortality. However, no systematic review and meta-analysis has examined the influence of breastfeeding promotion programs on exclusive breastfeeding rates in sub-Saharan Africa. Research Aim: We examined the influence of breastfeeding promotion programs on exclusive breastfeeding rates at < 1 month, and at 1–5 months of breastfeeding in sub-Saharan countries including Ghana, Burkina Faso, Uganda, South Africa, Guinea-Bissau, Kenya, Tanzania, and the Democratic Republic of Congo. Methods: A systematic review and meta-analyses study of randomized controlled trials and quasi-experimental studies was conducted by searching in electronic databases and articles’ reference lists. Two investigators independently evaluated and extracted the data. A total of 131 studies were identified using five databases. Of the 10 studies meeting the inclusion criteria for systematic review, seven studies were included in the meta-analysis. We used a random-effects model to pool studies together and performed a subgroup analysis. Results: Breastfeeding promotion programs resulted in significantly higher exclusive breastfeeding rates at < 1 month ( OR = 1.60, 95% CI [1.36,1.86]). However, there was no significant effect observed for exclusive breastfeeding at 1–5 months. Combined interventions were more effective in improving exclusive breastfeeding rates than individual counseling or home-based counseling alone. Conclusion: Breastfeeding promotion programs in sub-Saharan Africa are effective in increasing exclusive breastfeeding rates at 6 months after birth.