Why invest, and what it will take to improve breastfeeding practices?

Rollins, Nigel; Bhandari, Nita; Hajeebhoy, Nemat; Horton, Susan; Lutter, Chessa; Martines, José; Piwoz, Ellen; Richter, Linda; Victora, Cesar G

doi:10.1016/s0140-6736(15)01044-2

Cited by 1,697 publications

(2,212 citation statements)

References 75 publications

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“…On average, participants talked/would talk to only two individuals (alters) [2 ± 1.3; median (range):2 (0–9)] to learn about breastfeeding support compared with six alters to learn about other topics [6 ± 4.3; median (range): 5 (1–24); P < 0.001). Alters at the university and affiliated hospitals for breastfeeding advice included (in decreasing order of frequency) OB/GYN attending physicians, attending pediatricians, neonatology fellows, OB/GYN residents, residents in pediatrics, and Med IV-level as well as Med III-level interns.…”

Section: Resultsmentioning

confidence: 99%

“…The health and survival benefits of breastfeeding for both mother and child are well-documented in the scientific literature and have been widely disseminated in guidelines by the World Health Organization and others [7–9]. However, suboptimal uptake of this knowledge by physicians is not uncommon [10,11], and insufficient breastfeeding promotion and support is one contributor to low breastfeeding exclusivity, initiation, and continuation rates [9,12–18].…”

Section: Introductionmentioning

confidence: 99%

“…However, suboptimal uptake of this knowledge by physicians is not uncommon [10,11], and insufficient breastfeeding promotion and support is one contributor to low breastfeeding exclusivity, initiation, and continuation rates [9,12–18]. Physicians may be particularly influential in communities where availability of and access to lactation consultants is limiting or when physicians are culturally considered as the most trusted experts compared with other health professionals [19,20].…”

Section: Introductionmentioning

confidence: 99%

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A case study on breastfeeding education in Lebanon’s public medical school: exploring the potential role of social networks in medical education

Moukarzel

Mamas

Warstadt

et al. 2018

Medical Education Online

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Background: Limited knowledge, negative beliefs, and lack of sufficient breastfeeding promotion and support by physicians contribute to global suboptimal breastfeeding rates. Formal medical education is well-known to influence future physicians’ knowledge, beliefs, and medical practice. However, less understood is the influence of social networks and processes on the exchange and diffusion of knowledge and practices related to breastfeeding. Objectives: We selected the underserved and under-supported public medical school in Lebanon to examine the social side of medical education. Our objectives were to assess knowledge, beliefs, and self-efficacy related to breastfeeding promotion and support among interns and residents. We also examined the social ecosystem surrounding these students concerning the exchange of breastfeeding knowledge. Design: All data were collected during one study visit per participant. First, an interview-administered structured survey was used to assess beliefs, perceived knowledge, basic breastfeeding knowledge, and self-efficacy related to breastfeeding among n = 70 medical interns and residents. Then, social network data were collected during a semi-structured interview and analyzed using an ego-network approach. All interviews were voice-recorded, transcribed, coded, and thematically analyzed. Descriptive statistics were used to analyze quantitative survey and social network results. Results: Although interns and residents had positive beliefs about breastfeeding benefits, they had limited knowledge and low self-efficacy related to the psychosocial and clinical aspects of breastfeeding promotion and support. They did not seem to have a well-connected professional network around breastfeeding knowledge and practices. Several tended to rely on their informal/non-professional network, such as their mothers, partners, and sisters, for knowledge and practice. Conclusions: Our work using breastfeeding as an exemplary case suggests there is a role for better attending to the beliefs of medical students as well as to the social side of medical education. Future studies can use social network theory to help identify and address influences on medical education outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A case study on breastfeeding education in Lebanon’s public medical school: exploring the potential role of social networks in medical education

Moukarzel

Mamas

Warstadt

et al. 2018

Medical Education Online

View full text Add to dashboard Cite

show abstract

“…Intensive industry promotion of breast milk substitutes, limited duration of maternity leave, and inadequate facilities to continue to breastfeed at the workplace also contribute to shorter durations of breastfeeding, particularly in urban China 31. Although there is increasing recognition of the importance of exclusive breastfeeding, genuine commitment from policy makers is needed to implement strategies in the healthcare system, communities and families, and the work environment that promote and support every woman to breastfeed 32. If effective and sustained, such efforts are likely to confer major benefits to the health of children and women, along with substantial cost savings 15, 32…”

Section: Discussionmentioning

confidence: 99%

“…Although there is increasing recognition of the importance of exclusive breastfeeding, genuine commitment from policy makers is needed to implement strategies in the healthcare system, communities and families, and the work environment that promote and support every woman to breastfeed 32. If effective and sustained, such efforts are likely to confer major benefits to the health of children and women, along with substantial cost savings 15, 32…”

Section: Discussionmentioning

confidence: 99%

Breastfeeding and the Risk of Maternal Cardiovascular Disease: A Prospective Study of 300 000 Chinese Women

Peters

Yang

Guo

et al. 2017

JAHA

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BackgroundBreastfeeding confers substantial benefits to child health and has also been associated with lower risk of maternal cardiovascular diseases (CVDs) in later life. However, the evidence on the effects of CVD is still inconsistent, especially in East Asians, in whom the frequency and duration of breastfeeding significantly differ from those in the West.Methods and ResultsIn 2004–2008, the nationwide China Kadoorie Biobank recruited 0.5 million individuals aged 30 to 79 years from 10 diverse regions across China. During 8 years of follow‐up, 16 671 incident cases of coronary heart disease and 23 983 cases of stroke were recorded among 289 573 women without prior CVD at baseline. Cox regression yielded adjusted hazard ratios (HRs) and 95% CIs for incident CVD by breastfeeding. Overall, ≈99% of women had given birth, among whom 97% reported a history of breastfeeding, with a median duration of 12 months per child. Compared with parous women who had never breastfed, ever breastfeeding was associated with a significantly lower risk of CVD, with adjusted HRs of 0.91 (95% CI, 0.84–0.99) for coronary heart disease and 0.92 (95% CI, 0.85–0.99) for stroke. Women who had breastfed for ≥24 months had an 18% (HR, 0.82; 0.77–0.87) lower risk of coronary heart disease and a 17% (HR, 0.83; 0.79–0.87) lower risk of stroke compared with women who had never breastfed. Among women who ever breastfed, each additional 6 months of breastfeeding per child was associated with an adjusted HR of 0.96 (95% CI, 0.94–0.98) for coronary heart disease and 0.97 (95% CI, 0.96–0.98) for stroke.ConclusionsAmong Chinese women, a history of breastfeeding was associated with an ≈10% lower risk of CVD in later life and the magnitude of the inverse association was stronger among those with a longer duration of breastfeeding.

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Implementation of the Ten Steps to Successful Breastfeeding Saves Lives

Meek

Noble

2016

JAMA Pediatr

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Why invest, and what it will take to improve breastfeeding practices?

Cited by 1,697 publications

References 75 publications

A case study on breastfeeding education in Lebanon’s public medical school: exploring the potential role of social networks in medical education

A case study on breastfeeding education in Lebanon’s public medical school: exploring the potential role of social networks in medical education

Breastfeeding and the Risk of Maternal Cardiovascular Disease: A Prospective Study of 300 000 Chinese Women

Implementation of the Ten Steps to Successful Breastfeeding Saves Lives

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