Teaching breastfeeding on the Web.

Teaching breastfeeding on the Internet breaks down geographic barriers and draws students from all over the globe for a rich learning experience. This article describes the development and teaching strategies of a successful university-based graduate breastfeeding Internet course. A discussion forum, electronic visiting professors, case studies, and online exams enhance this global learning experience. The drawbacks of online learning are also presented.     

Evaluating the association of two breastfeeding assessment tools with breastfeeding problems and breastfeeding satisfaction.

This pilot study evaluated how the scores from each of two breastfeeding assessment tools correlated with breastfeeding satisfaction and problems. A convenience sample of 30 first-time breastfeeding mothers participated. Mothers were randomly assigned to use either the LATCH or Infant Breastfeeding Assessment Tool (IBFAT). The Maternal Breastfeeding Evaluation Scale (MBFES) and Potential Early Breastfeeding Problem Tool (PEBPT) were used to evaluate the association of the scores of each assessment tool with breastfeeding satisfaction and breastfeeding problems. As scores on the both the LATCH and IBFAT increased, maternal satisfaction scores tended to increase, but not significantly, and breastfeeding problem scores tended to decrease (r = -0.5, p = 0.06 and r = -0.49, p = 0.06; respectively.     

Is breastfeeding fair? Tensions in feminist perspectives on breastfeeding and the family.

Breastfeeding is widely acknowledged to have health benefits for mothers and infants. Because it is sex-specific, it challenges the feminist principle of gender-neutral childbearing. Various feminist theories addressing breastfeeding from the perspective of gender ideology, cultural feminism, and history are reviewed and contrasted. Employment and race disparities are addressed within feminist contexts. Feminist health activism is suggested as a unifying perspective.     

Randomized controlled trial to determine effects of prenatal breastfeeding workshop on maternal breastfeeding self-efficacy and breastfeeding duration

OBJECTIVE: To determine the effects of a prenatal breastfeeding workshop on maternal breastfeeding self-efficacy and breastfeeding duration. DESIGN: Randomized controlled trial. SETTING: Large tertiary hospital in Ontario, Canada. PARTICIPANTS: 110 primiparous women expecting a single child, an uncomplicated birth, and planning to breastfeed. Intervention: 2.5-hour prenatal breastfeeding workshop based on adult learning principles and self-efficacy theory. MAIN OUTCOME MEASURE: Maternal breastfeeding self-efficacy and the numbers of days and amount of breastfeeding were measured at four and eight weeks postpartum. RESULTS/DATA ANALYSIS: Over time, maternal breastfeeding self-efficacy scores increased in both groups. Women who attended the workshop had higher self-efficacy scores and a higher proportion were exclusively breastfeeding compared to women who did not attend the workshop. There was little difference in the average number of days of breastfeeding, but the intervention group had less weaning. CONCLUSIONS: The workshop increased maternal breastfeeding self-efficacy and exclusive breastfeeding.     

Predicting breastfeeding duration using the LATCH breastfeeding assessment tool.

The authors tested the validity of the LATCH breastfeeding assessment tool, controlling for intervening variables in 133 dyads. LATCH scores, mother's evaluation of an index feed, and intended duration of breastfeeding were assessed postpartum and followed 6 weeks. Women breastfeeding at 6 weeks postpartum had higher LATCH scores (mean +/- SD = 9.3 +/- 0.9) than those who weaned (mean +/- SD = 8.7 +/- 1.0), due to only one measure, breast/nipple comfort. Women who weaned before 6 weeks reported lower breast/nipple comfort (1.5 +/- 0.5) than those who were still breastfeeding at 6 weeks (1.7 +/- 0.5, P < .05). Total LATCH scores accounted for 7.3% of variance in breastfeeding duration. Total LATCH scores positively correlated with duration of breastfeeding (n = 128; r = .26, P = .003) and to mothers' scores (n = 132; r = .58, P = .001). Correlations among LATCH measures ranged from .02 to .51. The LATCH tool is a useful identifies the need for follow-up with breastfeeding mothers at risk for early weaning because of sore nipples.     

Influence of the birth clinic on breastfeeding

A decrease of breastfeeding culture could be observed since the 1950's. However in the 1980's the WHO and UNICEF began engaging in campaigns for breastfeeding since the benefits for mother and child are evident. In 1990 UNICEF set up the "10 steps to successful breastfeeding" that gave birth clinics around the world "guidelines" that would initiate an unproblematic breastfeeding relationship between mother and child. These guidelines can be understood as measures toward increasing staff motivation, training and instruction as well as actually helping parents and increasing their motivation. Further points cover the optimal beginning of breastfeeding and aspects of complementary feeding. Certification of departments by internationally renowned observers is a means of implementing and securing best quality breastfeeding encouragement in the birth clinics. The positive effects of this promotion on the ratio of mothers breastfeeding and thus in respect to childreńs health could be proved by randomised studies. The experience gained in the Obstetrical Department of the Vivantes Humboldt Clinic is described.     

The effect of prenatal breastfeeding education on breastfeeding success and maternal perception of the infant

A quasi-experimental design was used to determine the effect of prenatal breastfeeding education on maternal reports of success in breastfeeding and maternal perception of the infant. The sample consisted of 40 primiparous women who desired to breastfeed their infants. All subjects were enrolled to attend childbirth education classes and vaginally delivered full-term, healthy infants without complication. Twenty subjects attended a prenatal breastfeeding education class and 20 served as controls. Data revealed that primiparous women who received prenatal breastfeeding education reported a significantly higher frequency of success in breastfeeding than those who did not (P = 0.01). There was a significant difference in the Neonatal Perception Inventory (NPI) I scores of experimental and control subjects at one to two days postpartum (P = 0.05). The NPI II scores of the experimental mothers were significantly more positive at one month postpartum (P = 0.001). Primiparous women who received prenatal breastfeeding education reported significantly more positive NPI II scores than the control group (P = 0.001).     

Impact of birthing practices on the breastfeeding dyad

For breastfeeding to start and continue, the newborn must be able to suck, swallow, and breathe; the mother must be able and willing to let her infant breastfeed; and surroundings must support the biological unit: the mother-baby dyad. This article reviews how birth practices, including epidural anesthesia, cesarean surgery, forceps, and vacuum extraction, can affect the newborn's ability to feed, the mother's motivation and lactation capacity, and the mother-baby relationship.     

Effect of intervention to improve breastfeeding technique on the frequency of exclusive breastfeeding and lactation-related problems.

This randomized clinical trial compared frequencies of exclusive breastfeeding and lactation-related problems during the first 30 days among 74 mothers who received a 30-minute counseling session on breastfeeding technique in the maternity ward, and 137 controls. The frequency of exclusive breastfeeding among mothers who had received intervention was similar to controls by 7 days (79.7% vs 82.5%, respectively) and 30 days (60.8% vs 53.3%). There was no difference between groups in the frequency of sore nipples at 7 and 30 days, in breast engorgement and mastitis, and in the quality of breastfeeding technique at 30 days. Therefore, a single intervention at maternity was not sufficient to improve breastfeeding technique, increase exclusive breastfeeding rates, and reduce the incidence of breastfeeding problems during the first month.     

Assisting the employed breastfeeding mother

Breastfeeding and employment are often viewed as mutually exclusive activities. However, women who choose to breastfeed are more likely than other mothers to return to paid employment outside the home, and many of these mothers want to continue breastfeeding. The midwife is in a unique position to assist these mothers as they make plans for infant feeding during their pregnancy, while they are learning how to breastfeed, and after they have returned to the labor force. This paper presents relevant research findings and specific guidelines designed to assist the midwife in counseling mothers who are planning to breastfeed while employed outside the home. The author suggests that establishing lactation before the return to employment is a key to enabling breastfeeding to continue as long as the mother wishes. The importance of expressing milk during periods of separation is discussed. Key questions to ask when recommending breast pumps are identified.     

Supporting the employed breastfeeding mother

The number of women in the workforce is continuing to increase and surveys suggest that one-fourth of employed women with a child less than 1 year of age will be concurrently breastfeeding and working for at least 1 month. Combining breastfeeding and employment is a complex process in American society. Women will be seeking practical, sound advice on how to be successful in this combination. This article offers suggestions for promoting its success, describes the preplanning that needs to occur, and provides current lactation recommendations and resources. It also offers information about working with employers, the importance of a support network, decisions that each family must make, the use of breast pumps; milk storage, lactation enhancement including the use of herbs, and practical tips for the mother's working day.