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Educating Health Professionals on Breastfeeding 2
Introduction
Breastfeeding is the mechanism of feeding an infant or young child with milk directly
from female breasts, instead of using a baby bottle or other container. Human breast milk is
regarded as the best source of nourishment for infants. It supposedly helps in preventing them
from diseases and promotes health, thus reduces health care costs. In recent times, artificial
modes of feeding are linked with increase in mortality rates among infants.
recommends exclusive dependence on breastfeeding for the first six months and continued
feeding with other diets for up to two years or beyond. American Academy of Pediatrics
differs in their recommendations and suggests at least one year of breastfeeding, for the first
Below are analyzed and summarized a few studies depicting the current trends of
breastfeeding among the mothers. The obvious or the potential hindrances were also
Synopsis of the article - Johnson,T. S .; Mulder , P. J.; Strube, K. (Jul-Aug 2007). Mother-
Infant Breastfeeding Progress Tool: A Guide for Education and Support of the Breastfeeding
Dyad. Journal of Obstetric, Gynecologic and Neonatal Nursing. Volume 36, Number 4, p.
319-27.
Breastfeeding Progress Tool to be used at the bedside by nurses to guide ongoing support and
education for the mother-baby dyad. It is a cross-sectional study done in community hospital
dyads. For this purpose three nurse raters (two per session) independently scored the eight
Educating Health Professionals on Breastfeeding 3
sessions.
The purpose of the study was to get the percent agreement between raters and
The results obtained support the use of the tool as a checklist for assessment of the
The agreement between raters was high for individual items of the Mother-Infant
checklist for assessing maternal and infant breastfeeding progress, but still additional research
Synopsis of the article - Philipp, B. L.; Merewood, A.; Miller, L. W. Chawla, N.; Murphy-
in a US Hospital Setting.
For this study breast feeding initiation rates were compared at an inner-city teaching
hospital, that provides care primarily to poor, minority and immigrant families, before (1995),
during (1998) and after (1999) Baby-friendly policies were in place. The hospital chosen was
reviewed from each of three years: 1995, 1998 and 1999. Infants were excluded for medical
records missing feeding data, HIV-positive parent, neonatal intensive care unit admission,
maternal substance abuse, adoption, incarceration or hepatitis-C positive mother. All infant
feedings during the hospital postpartum stay were tallied, and each infant was categorized in
Educating Health Professionals on Breastfeeding 4
one of four groups: exclusive breast milk, mostly breast milk, mostly formula and exclusive
formula.
Maternal and infant demographics for all three years were comparable. The
breastfeeding initiation rate increased from 58% (1995) to 77.5% (1998) to 86.5% (1999).
Infants exclusively breastfed increased from 5.5% (1995) to 28.5% (1998) to 33.5% (1999).
Initiation rates increased among US-born African American mothers from 34% (1995) to
hospital settings.
Synopsis of the article - Johnston, M. L.; Esposito, N. Barriers and Facilitators for
The objective of the study is to review the literature and describe the barriers and facilitators
to the continuation of breastfeeding for at least 6 months by working women in the United
States. For this purpose a search of PubMed, CINAHL, Sociological Abstracts, ISI,
PsychInfo, and ProQuest was done and twenty studies based on the inclusion criteria
published between January 1, 1995, and January 2006 were found. An ecologic framework,
which includes the individual (microsystem), social support and relationships (mesosystem),
and the workplace environment (exosystem) was used for data extraction.
The findings have shown that when working mothers possess certain personal characteristics
and develop a strategic plan, breastfeeding is promoted. When social support is available and
when support groups are utilized, lactation is also facilitated. Part-time work, lack of long
Educating Health Professionals on Breastfeeding 5
mother-infant separations, supportive work environments and facilities, and child care
Health care providers can use the findings of this review to promote breastfeeding among
working women by using tactics geared toward the mother, her social network, and the entire
community.
Synopsis of the article - Lavender, T.; Baker, L.; Smyth, R.; Collins, S.; Spofforth, A.; Dey,
trial. BJOG: an International Journal of Obstetrics and Gynaecology. Vol. 112, p. 1047–1053.
The objective of this study was to evaluate the affect of an antenatal educational
randomized controlled trial design was developed. The primary outcome was the proportion
that fulfilled their antenatal breastfeeding expectation. Secondary outcomes were the number
of women breastfeeding on discharge and at four months. Data were collected using a series
The research was conducted in a teaching hospital in North West of England. Participants
were women who expressed a desire to breastfeed at the start of their pregnancy.
They were allocated to either routine antenatal education or an additional single educational
group session supervised by a lactation specialist and attended by midwives from their
locality.
Originally one thousand three hundred and twelve women were randomized, with 1249
(95%) women available for analysis. There was no difference between the groups in the
proportion of women who attained their expected duration of breastfeeding (OR 1.2; 95% CI
0.89–1.6; m2 ¼ 1.4, df ¼ 1, P ¼ 0.2; mean cluster size 156, design effect 1.6). There were no
Educating Health Professionals on Breastfeeding 6
differences between the groups in the uptake of breastfeeding on discharge (OR ¼ 1.2; 95%
CI 0.8–1.7; m2 ¼ 1.1, df ¼ 1, P ¼ 0.3; mean cluster size 163, design effect ¼ 2.0) or
exclusively at four months (OR ¼ 1.1; 95% CI 0.6–1.8; m2 ¼ 0.07, df ¼ 1, P ¼ 0.8; mean
The provision of a single educational group session supervised by a lactation specialist, and
attended by midwives and women, failed to promote the uptake of breastfeeding. Public
health interventions, which encourage positive attitudes to breastfeeding within the family
Synopsis of the article - Vittoz, J.-P.; Labarere, J.; Castell, M.; Durand, M.; Pons, J.-C.
determine whether a 3-day training program for maternity ward professionals was followed
of 308 mothers (n = 308) who had delivered a healthy singleton infant of 37 weeks’ or more
gestation and 2,500 g or more birth-weight in a level 3 maternity ward in a university hospital
in France. Data were gathered from medical records and postal questionnaire.
Study participants included 169 mothers (54.9%) in the pre-intervention sample and
178 (57.8%) in the post-intervention sample. The prevalence of any breastfeeding at birth
was 77.5 percent (70.5%–83.6%) in the pre-intervention sample and 82.6 percent (76.2%–
87.8%) in the post-intervention sample (p=0.24); the median duration of any breastfeeding
was 13 weeks and 16 weeks, respectively (w2 log-rank test=5.8, p=0.02). The decreased risk
improvement in maternity ward practices that are known to affect the duration of
breastfeeding.
An intensive 3-day training program for maternity ward professionals can be followed
2007). Factors Associated with Low Incidence of Exclusive Breastfeeding for the First 6
The identification of factors that are associated with early cessation of exclusive
breastfeeding. The objective of this study was to identify the determinants of exclusive
breastfeeding cessation before 6 months, including variables that generally receive little
attention, such as the influence of grandmothers, breastfeeding technique, and sore nipples.
This prospective study follows a cohort of 220 healthy mother-baby pairs (n = 220)
from birth to 6 months, living in Porto Alegre, Brazil. Data were collected at the maternity
unit, during a home visit at 30 days, and by telephone interview at 60, 120, and 180 days.
Breastfeeding technique was assessed and breasts examined at the maternity unit and during
home visits. Cox regression was employed to estimate the degree of association between the
before 6 months: adolescent mother (hazard ratio [HR] = 1.48, 95% CI 1.01–2.17), fewer
than six prenatal visits (HR=1.60, 95%CI 1.10–2.33), use of a pacifier within the first month
Educating Health Professionals on Breastfeeding 8
(HR= 1.53, 95% CI 1.12–2.11), and poor latch-on (HR= 1.29, 95% CI 1.06–1.58 for each
unfavorable parameter).
mothers and for those whose prenatal care was less than ideal. These activities should
reinforce the ill effects of pacifiers and should also include appropriate instruction for these
The experiences of 107 Australian women (n = 107) who were breastfeeding a child
two years or older were gathered via a written questionnaire with open-ended questions.
Eighty-seven percent (87%) of women had not originally intended to breastfeed long-term
and many had initially felt disgust for breastfeeding beyond infancy.
Mothers changed their opinion about long-term breastfeeding as they saw their child
enjoy breastfeeding, as their knowledge about breastfeeding increased and as they were
exposed to long-term breastfeeding role models. It was common for mothers to be shocked
the first time they saw a non-infant breastfeed but this exposure was also a part of the process
Women often found long-term breastfeeding role models as well as information and
moral support for breastfeeding continuance within a peer breastfeeding support organization
relationship. Mothers had overcome many challenges in order to continue breastfeeding and
breastfeeding was sometimes discontinuous, with children weaning from days to years before
resuming breastfeeding.
Educating Health Professionals on Breastfeeding 9
Synopsis of the article - Bigger, M. T.; Long, A. (March 2008). Breastfeeding education for
This paper presents a study that investigated the efficacy of a three-day University-
based workshop on breastfeeding education for professionals. The paper begins with the
literature review and continues with an overview of the methodology. It concludes with a
discussion on the findings and forwards recommendations for management, education and
professional practice with the aim of promoting the health and well-being of all families
March 2003, which encompassed the main electronic sources of medical, nursing and
literature' together with internet searches were carried out to enhance the scope and range of
breastfeeding, support, and education. Over 2000 hits were obtained, with 135 hits meeting
the inclusion criteria that had been set to match the research aims.
Only one randomized controlled trial (RCT) was identified in the systematic search,
which evaluated the effectiveness of breastfeeding training for health professionals. Pre-test
analysis indicated that there was no significant difference between knowledge and skills in
Educating Health Professionals on Breastfeeding 10
the intervention and control groups. In contrast, a significant difference in favor of the
intervention group (p> 0.001) was identified following post-test analysis. Of the respondents,
100 % {n=70) responses were received pre-test and 98.6% {n=69) posttest. The researchers
concluded that the intervention significantly improved clinical and counseling skills for the
support of breastfeeding. The evidence from this small study shows that health professionals
require consistent education and training on breastfeeding, therefore standards should be set,
which ensure that all health professionals who support breastfeeding mothers are continue to
be professionally developed.
Conclusion
The benefits of breastfeeding to both mothers and infants have been widely
nutritional advantages, it protects against a wide range of illnesses and infections through
specific and non-specific immune factors. It provides long-term positive consequences for
disease later in life. Scientific evidence demonstrates a wide range of benefits for infants to
Overall the evidence supports the practice of exclusive breastfeeding for the first six
Reference
Progress Tool: A Guide for Education and Support of the Breastfeeding Dyad. Journal
Philipp, B. L.; Merewood, A.; Miller, L. W. Chawla, N.; Murphy-Smith, M. M. et al. Baby-
Setting.
Johnston, M. L.; Esposito, N. Barriers and Facilitators for Breastfeeding Among Working
Women in the United States. Journal of Obstetric, Gynecologic and Neonatal Nursing.
Lavender, T.; Baker, L.; Smyth, R.; Collins, S.; Spofforth, A.; Dey, P. (August 2005).
1053.
Vittoz, J.-P.; Labarere, J.; Castell, M.; Durand, M.; Pons, J.-C. (December 2004). BIRTH.
with Low Incidence of Exclusive Breastfeeding for the First 6 Months. BIRTH.
Bigger, M. T.; Long, A. (March 2008). Breastfeeding education for health professionals.