Comparing breastfeeding experiences between mothers spending the traditional Chinese confinement period in a confinement centre and those staying at home: a cohort study

Foong, Siew Cheng; Tan, May Loong; Foong, Kelvin Weng Chiong; Ho, Jacqueline J; Rahim, Fairuz Fadzilah

doi:10.21203/rs.3.rs-26168/v3

Cited by 2 publications

(7 citation statements)

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“…We found many mothers who stayed at CCs were discouraged from rooming-in with their babies, and their babies spent most of the time in the nursery [7]. Since there is a body of evidence showing that both mother-infant rooming-in and breastfeeding prevent infection [21-24], ways to improve these practices could also be looked at.…”

Section: Discussionmentioning

confidence: 99%

“…Details of the study methods are published in Foong 2021 [7] and we describe these in brief here. Malaysian mothers of Chinese ethnicity who intended to spend their confinement period in a CC, who had delivered term healthy infants and had the intention to breastfeed, were recruited prior to discharge.…”

Section: Methodsmentioning

confidence: 99%

“…A sample size of 188 was calculated based on the primary objectives of the primary study. Details of this are published in Foong 2021 [7]. This study received ethical approval from the Joint Penang Independent Ethics Committee (JPEC No 08-17-0103).…”

Section: Methodsmentioning

confidence: 99%

“…CC staff are generally women who are familiar with the Chinese cultural confinement requirements and diet, similar to a TPC. Although some CCs do employ qualified nurses and midwives [6], others may employ untrained staff to help [7].…”

Section: Introductionmentioning

confidence: 99%

“…Mothers who had employed a TPC to help them at home were also asked about the TPC’s hygiene practice. This is part of a larger study where we looked at mothers’ breastfeeding experiences in CCs and compared these with a cohort of women who had their traditional confinement period at home [7].…”

Section: Introductionmentioning

confidence: 99%

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Mothers’ hygiene experiences in confinement centres: a cohort study

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Ethnic Malaysian Chinese used to observe the 1-month postpartum confinement period at home and many families would engage a traditional postpartum carer (TPC) to help care for the mother and newborn. A recent trend has been the development of confinement centres (CCs) which are private non-healthcare establishments run by staff not trained in health care. Concerns about hygiene in CCs arose after infections were reported. We describe the practice of hand hygiene observed in CCs, the availability of resources for hygiene and to determine the prevalence of health related problems in CCs. Methods This is a cohort study of ethnic Chinese mothers intending to breastfeed their healthy infants. They were recruited post-delivery along with a comparison group who planned to spend their confinement period at home, then all were telephone interviewed after their 1-month confinement period about their experience. To avoid any alteration in behaviour, mothers were not told at recruitment that they had to observe hygiene practices. Multiple logistic regression was used to assess the effect of place of confinement on rates of infant health problems. Results Of 187 mothers, 88 (47%) went to 27 different CCs while 99 (53%) stayed at home. Response rates for the 1-month interviews were 88% (CC) versus 97% (home). Mothers in CC group stayed in one to four-bedded rooms and 92% of them had their baby sleeping separately in a common nursery described to have up to 17 babies at a time; 74% of them spent less than six hours a day with their babies; 43% noticed that CC staff had inadequate hand hygiene practices; 66% reported no hand-basins in their rooms; 30% reported no soap at hand-basins; 28% reported inexperienced or inadequate staff and 4% reported baby item sharing. Of mothers staying at home, 35% employed a TPC to care for her baby; 32% did not room-in with their babies, but only 11% spent less than 6 hours a day with their babies. 18% of mothers who employed TPCs reported that their TPC had unsatisfactory hand hygiene practices. Health problems that were probably related to infection (HPRI) like fever and cough were similar between the groups: 14% (CC) versus 14% (home) (p=0.86). Multiple logistic regression did not show that CCs were a factor for HPRI: aOR 1.28 (95% CI 0.36 to 4.49). Three mothers reported events that could indicate transmission of infection in CCs. Conclusion We found unsatisfactory hygiene practices in CCs as reported by mothers who spent their confinement period there. Although we were not able to establish any direct evidence of infection transmission but based on reports given by the mothers in this study, it is likely to be happening. Therefore, future studies, including intervention studies, are urgently needed to establish an appropriate hygiene standard in CCs as well as the best method to implement this standard. Empowering CC staff with hygiene knowledge so that they can be involved and contribute to the development of the development of these standards would be important.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mothers’ hygiene experiences in confinement centres: a cohort study

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The Impact of Covid-19 On Maternal Delivery Experiences and Breastfeeding Practices in China: A Cross-Sectional Study

Gao

Zhuang

et al. 2021

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Background The COVID-2019 pandemic has placed extensive pressure on health systems and posed a severe public health challenge worldwide. Lockdown measures implemented in many countries have delayed virus spread. However, a considerable number of people have faced unprecedented pressure, especially the pregnant and breast-feeding women, because face-to‐face professional support has been reduced during the lockdown in many countries. Objectives To compare the delivery and infant feeding experiences of women who delivered before (BL) versus during (DL) the Covid-19 pandemic in Beijing, China. Methods Women aged ≥ 18 years with an infant ≤ 18 months of age completed an anonymous survey. Information/links were shared online and via local clinics in Beijing. Logistic regression was performed to assess predictors of breastfeeding during the first 6-months. Results 2233 women provided data; BL 1241 (55.6%), DL 992 (44.4%). The 6-month mostly breastfeeding (MBF, mainly breastfeeding with few non-formula fluids added) rate was significantly higher in the DL mothers (71.6%), compared to the BL mothers (60.6%). MBF was predicted by delivery during the lockdown period (OR1.42, 95% confidence interval 1.06, 1.90), younger maternal age, discussing infant feeding in a feeding support group, and getting support from friends or relatives. Moreover, relative to those little affected by COVID, those who were much affected were less likely to MBF. Conclusion The COVID-19 pandemic and lockdown measures influenced mothers’ planned birth location and breastfeeding intention. However, breastfeeding practice was maintained during the pandemic. The reported breastfeeding rates were high and our results highlight the importance of feeding support as well as potential beneficial effects of increased mother-infant contact during the lockdown period which is relevant even under normal circumstances.

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Comparing breastfeeding experiences between mothers spending the traditional Chinese confinement period in a confinement centre and those staying at home: a cohort study

Cited by 2 publications

References 8 publications

Mothers’ hygiene experiences in confinement centres: a cohort study

Mothers’ hygiene experiences in confinement centres: a cohort study

The Impact of Covid-19 On Maternal Delivery Experiences and Breastfeeding Practices in China: A Cross-Sectional Study

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