Unintended Consequences of Current Breastfeeding Initiatives

Bass, Joel L.; Gartley, Tina; Kleinman, Ronald E.

doi:10.1001/jamapediatrics.2016.1529

Cited by 40 publications

(29 citation statements)

References 6 publications

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“…Despite the benefits of rooming-in, as it has become more of a common practice, safety issues have been raised 33 because of the potential concern for infant falls 34,35 and accidental suffocation. 36 Labor and delivery are arduous processes, often leaving the new mother exhausted.…”

Section: | Discussionmentioning

confidence: 99%

“…12 Despite these and other barriers hospitals have faced, challenges to rooming-in may often be overcome by implementing creative solutions, such as described, and by explaining the benefits of 12,13,28 and providing educational materials on rooming-in to mothers and their families. 12,28 Despite the benefits of rooming-in, as it has become more of a common practice, safety issues have been raised 33 because of the potential concern for infant falls 34,35 and accidental suffocation. 36 Labor and delivery are arduous processes, often leaving the new mother exhausted.…”

Section: Percentage Of Hospitals Reporting Removing >50% Of Infants Fmentioning

confidence: 99%

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Trends in rooming‐in practices among hospitals in the United States, 2007‐2015

Barrera

Boundy

Perrine

2018

Birth

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Background Rooming-in, or keeping mothers and infants together throughout the birth hospitalization, increases breastfeeding initiation and duration, and is one of the Ten Steps to Successful Breastfeeding. Methods The Centers for Disease Control and Prevention’s (CDC) Maternity Practices in Infant Nutrition and Care (mPINC) survey is a biennial census of all birth facilities in the United States and its territories. Data from the 2007–2015 mPINC surveys were used to assess trends in the prevalence of hospitals with most (≥90%) infants rooming-in more than 23 hours per day (ideal practice). Hospital practices among breastfed infants not rooming-in at night and reasons why hospitals without ideal rooming-in practices removed healthy, full-term, breastfed infants from their mothers’ rooms were also analyzed. Results The percentage of hospitals with ideal practice increased from 27.8% in 2007 to 51.4% in 2015. Most breastfed infants who were not rooming-in were brought to their mothers at night for feedings (91.8% in 2015). Among hospitals without ideal rooming-in practices, the percentage removing 50% or more of infants from their mothers’ rooms at any point during the hospitalization decreased for all reasons surveyed during 2007–2015; however, in 2015, hospitals still reported regularly removing infants for hearing tests (73.2%), heel sticks (65.5%), infant baths (40.2%), pediatric rounds (35.5%), and infant photos (25.4%). Conclusions Hospital implementation of rooming-in increased 23.6 percentage points during 2007–2015. Continued efforts are needed to ensure that all mothers who choose to breastfeed receive optimal lactation support during the first days after giving birth.

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Section: | Discussionmentioning

confidence: 99%

Section: Percentage Of Hospitals Reporting Removing >50% Of Infants Fmentioning

confidence: 99%

Trends in rooming‐in practices among hospitals in the United States, 2007‐2015

Barrera

Boundy

Perrine

2018

Birth

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“…Currently, 22·12 % of all US infants are born in BFHI hospitals ( 46 ) – exceeding the Healthy People 2020 goal of 8·1 % ( 47 ) . Although the BFHI is not without controversy ( 48 ) , major change has transpired. This change was likely the result of numerous new metrics and regulatory changes requiring new organizational behaviour.…”

Section: Discussionmentioning

confidence: 99%

‘Why do we need a policy?’ Administrators’ perceptions on breast-feeding-friendly childcare

Marhefka¹,

Sharma²,

Schafer³

et al. 2018

Public Health Nutr.

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ObjectiveMothers’ return to work and childcare providers’ support for feeding expressed human milk are associated with breast-feeding duration rates in the USA, where most infants are regularly under non-parental care. The objective of the present study was to explore Florida-based childcare centre administrators’ awareness and perceptions of the Florida Breastfeeding Friendly Childcare Initiative.DesignSemi-structured interviews were based on the Consolidated Framework for Implementation Research and analysed using applied thematic analysis.SettingChildcare centre administrators in Tampa Bay, FL, USA, interviewed in 2015.ParticipantsTwenty-eight childcare centre administrators: female (100 %) and Non-Hispanic White (61 %) with mean age of 50 years and 13 years of experience.ResultsMost administrators perceived potential implementation of the Florida Breastfeeding Friendly Childcare Initiative as simple and beneficial. Tension for change and a related construct (perceived consumer need for the initiative) were low, seemingly due to formula-feeding being normative. Perceived financial costs and relative priority varied. Some centres had facilitating structural characteristics, but none had formal breast-feeding policies.ConclusionsA cultural shift, facilitated by state and national breast-feeding-friendly childcare policies and regulations, may be important for increasing tension for change and thereby increasing access to breast-feeding-friendly childcare. Similar to efforts surrounding the rapid growth of the Baby Friendly Hospital Initiative, national comprehensive evidence-based policies, regulations, metrics and technical assistance are needed to strengthen state-level breast-feeding-friendly childcare initiatives.

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“…. The majority of the cases occur in early skin‐to‐skin care, without observance of the child, or when sleeping with accidentally covered respiratory tract . A review of Sudden Unexpected Early Neonatal Deaths (SUENDs) in Sweden shows that a higher incidence of SUENDs was reported before the practice of early skin‐to‐skin contact was introduced .…”

Section: The 9 Stages – a Breastfeeding Start Led By The Newborn Infantmentioning

confidence: 99%

Skin‐to‐skin contact the first hour after birth, underlying implications and clinical practice

Brimdyr²,

et al. 2019

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Aim This paper integrates clinical expertise to earlier research about the behaviours of the healthy, alert, full‐term infant placed skin‐to‐skin with the mother during the first hour after birth following a noninstrumental vaginal birth. Method This state‐of‐the‐art article forms a link within the knowledge‐to‐action cycle, integrating clinical observations and practice with evidence‐based findings to guide clinicians in their work to implement safe uninterrupted skin‐to‐skin contact the first hours after birth. Results Strong scientific research exists about the importance of skin‐to‐skin in the first hour after birth. This unique time for both mother and infant, individually and in relation to each other, provides vital advantages to short‐ and long‐term health, regulation and bonding. However, worldwide, clinical practice lags. A deeper understanding of the implications for clinical practice, through review of the scientific research, has been integrated with enhanced understanding of the infant's instinctive behaviour and maternal responses while in skin‐to‐skin contact. Conclusion The first hour after birth is a sensitive period for both the infant and the mother. Through an enhanced understanding of the newborn infant's instinctive behaviour, practical, evidence‐informed suggestions strive to overcome barriers and facilitate enablers of knowledge translation. This time must be protected by evidence‐based routines of staff.

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Unintended Consequences of Current Breastfeeding Initiatives

Cited by 40 publications

References 6 publications

Trends in rooming‐in practices among hospitals in the United States, 2007‐2015

Trends in rooming‐in practices among hospitals in the United States, 2007‐2015

‘Why do we need a policy?’ Administrators’ perceptions on breast-feeding-friendly childcare

Skin‐to‐skin contact the first hour after birth, underlying implications and clinical practice

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