Overcoming barriers to breastfeeding

Tomori, Cecília

doi:10.1016/j.bpobgyn.2022.01.010

Cited by 39 publications

(26 citation statements)

References 66 publications

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“…In research among low‐income women, those who intended to breastfeed had higher breastfeeding knowledge, higher self‐efficacy, and reported fewer barriers, compared with those who did not (Mitra et al, 2004). It has also been acknowledged that financial constraints may limit women's ability to access timely breastfeeding support (Tomori, 2022). This highlights the importance of accessible freely available interventions targeting psychosocial factors during the antenatal period to improve breastfeeding outcomes.…”

Section: Introductionmentioning

confidence: 99%

Perinatal support for breastfeeding using mHealth: A mixed methods feasibility study of the My Baby Now app

Laws

Cheng

Rossiter

et al. 2023

Maternal & Child Nutrition

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Despite the well-known benefits of breastfeeding, breastfeeding rates remain suboptimal, particularly for women with lower socioeconomic position. Although popular, breastfeeding apps are often poor quality; their impact on breastfeeding knowledge, attitudes, confidence and intentions is unknown. A mixed method prepost feasibility study was conducted to: 1) explore the feasibility of the My Baby Now app in providing perinatal breastfeeding support; 2) examine the impact on breastfeeding knowledge, attitudes, confidence and intentions; 3) to examine any differences in acceptability and impact of the app according to maternal education.The My Baby Now app was offered to pregnant women 20-30 weeks gestation.Breastfeeding knowledge and intentions were collected at baseline (T1) and 36-38 weeks gestation (T2); attitudes and confidence were collected at baseline, T2 and T3 (8-12 weeks post-partum). App engagement was measured via app analytics.Qualitative interviews were conducted with a purposeful sample following T3. Of 266 participants recruited, 169 (64%) completed T2 and 157 (59%) completed T3.Mothers without university education rated the app to be higher quality, more useful and impactful than mothers with university education. From T1-T2, breastfeeding knowledge (59.6% vs. 66.5%, p < 0.001) and exclusive breastfeeding intentions (76.6% vs. 80.9%, p < 0.001) increased. Breastfeeding attitudes and confidence scores also increased significantly across T1-T2 and T1-T3. App engagement during pregnancy predicted changes in breastfeeding attitudes from T1-T2 among participants without university education. App engagement did not predict changes in breastfeeding knowledge, confidence or intentions. Future randomised controlled studies should examine the effectiveness of mHealth interventions on breastfeeding outcomes.

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Section: Introductionmentioning

confidence: 99%

Perinatal support for breastfeeding using mHealth: A mixed methods feasibility study of the My Baby Now app

Laws

Cheng

Rossiter

et al. 2023

Maternal & Child Nutrition

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“…Not exclusively breastfeeding is associated with short- and long-term health issues. Overall, inadequate breastfeeding leads to substantial morbidity and approximately 600,000 child deaths and an additional 100,000 maternal deaths annually [ 6 ]. During lactation, because infant formula lacks protective compounds in natural human milk, the rates of otitis media and diarrhea in nonbreastfed infants are 8% and 17% higher, respectively, than those in exclusively breastfed infants [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

The Association of Formula Protein Content and Growth in Early Infancy: A Systematic Review and Meta-Analysis

Ren¹,

Li²,

Sun³

et al. 2022

Nutrients

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This systematic review aimed to examine differences in growth outcomes between breastfed infants and infants fed with formula with different protein/energy ratios during the first six months of life. We conducted a systematic review in the PubMed, Web of Science, and Springer databases. Twenty clinical trials qualified for inclusion. We extracted data about the growth outcomes of infants who were exclusive breastfed or exclusively infant formula fed in the first six months and used a meta-analysis to pool the finding data. We categorized study formulas into four groups according to their protein content: <1.8, 1.8–2.0, 2.1–2.2, and >2.2 g/100 kcal. In the first month of life, growth was not different between formula- and breastfed infants. During 2–3 months of life, growth was faster in infants who consumed formulas with protein contents higher than 2.0 g/100 kcal. After 3 months, formula-fed infants grew faster than breastfed infants. Our meta-analysis indicated that the growth outcomes of infants fed with infant formula with a relatively low protein/energy ratios, compared with that a relatively high protein/energy ratio, were close to those of breastfed infants.

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“…"Disappointed" women were also more likely to experience negative support from healthcare professionals, both within the hospital and the community. The detrimental impact of inappropriate and conflicting information and support from healthcare staff is well-reported (Schmied et al, 2009;Thomson and Dykes, 2011;Johnson et al, 2016;Tomori, 2022). While healthcare professionals may lack the confidence, knowledge, and skills to provide breastfeeding support (Yang et al, 2018), others argue that health professionals are influenced by the formula industry (Van Tulleken, 2018).…”

Section: Discussionmentioning

confidence: 99%

Who Gets to Breastfeed? A Narrative Ecological Analysis of Women's Infant Feeding Experiences in the UK

et al. 2022

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The early post-natal period is a critical period in women's infant feeding journeys, often marked by high levels of unintended breastfeeding cessation. Previous research has argued that infant feeding should be perceived within a complex system whereby factors operating at different ecological levels (i.e., individual, social/community networks, cultural/institutional) interact to affect individual behaviors. However, currently, more work needs to be done to implement an ecological approach in breastfeeding programs. We adopted a complex-systems lens approach to explore how multi-level factors—individual, mother-infant dyad, health service, family and social networks, and wider community infrastructure—interacted with women's motivations and experiences of breastfeeding. We undertook a secondary analysis of 24 women's interviews; all the women had a strong antenatal intention to breastfeed and were expecting their first baby. The interviews were collected during the UK-based Assets-based feeding help Before and After birth (ABA) feasibility trial when their infant was aged between 4 and 21 weeks. Categorical content analysis was used to explore the interrelationships between key factors and to identify different infant feeding typologies. Two different typologies emerged: “disappointed” (n = 7) and “by hook or by crook” (n = 17). “Disappointed” women had stopped breastfeeding early; women classified as “by hook or by crook” continued breastfeeding despite facing challenges. Sociodemographic, social, and service level differences between the typologies were noted. “Disappointed” women were more likely to be younger, White-British, to have considered mixed-feeding antenatally and experienced negative breastfeeding support from healthcare professionals and personal networks. Infants of “disappointed” women were more likely to have received unexpected “top-ups” and to be perceived as having infant feeding difficulties. Women classified as “by hook or by crook” were just as likely as “disappointed” women to experience birth-related complications, but demonstrated more proactive help-seeking behaviors, had positive experiences of personal/professional support and accessed wider support. While further research is needed to consolidate and/or refute the typologies, the ecological approach shifts the focus away from mothers' decisions to consider the multi-level factors that need to be in place to enable women to breastfeed successfully. Further work to encourage help-seeking behaviors and toward improving facilities, support, and services is needed.

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Overcoming barriers to breastfeeding

Cited by 39 publications

References 66 publications

Perinatal support for breastfeeding using mHealth: A mixed methods feasibility study of the My Baby Now app

Perinatal support for breastfeeding using mHealth: A mixed methods feasibility study of the My Baby Now app

The Association of Formula Protein Content and Growth in Early Infancy: A Systematic Review and Meta-Analysis

Who Gets to Breastfeed? A Narrative Ecological Analysis of Women's Infant Feeding Experiences in the UK

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