Medicine and Health Sciences Commons^™

Lactation Clinic: Improving Patient Lactation Support, Iana Johnson

Master's Projects and Capstones

Despite the numerous health benefits and recommendations that breastfeeding is the optimal method for nourishing infants, many still choose other ways to feed their babies during the first year of life. This project considers the initiation and future implementation of a Lactation Clinic as an additional patient support service provided in the inpatient and outpatient settings. A Failure Modes and Effects Analysis (FMEA) was conducted in an effort to evaluate and eliminate “what could go wrong” before such an establishment becomes operational. The Risk Priority Numbers (RPNs) from the analysis reveal the lack of use (RPN 50) and streamlining (RPN …

The Potential Effect Of Breastfeeding On Maternal Senstivity During The First Year Of Life, Sawsan Hammad Hammad

Theses and Dissertations

Background: Poor maternal sensitivity leads to insecure infant attachment, which has been associated with negative consequences in cognitive and mental health in school-aged children that continue into adulthood. Maternal sensitivity is defined as the mother’s ability to recognize and respond to her infant’s cues consistently and appropriately; it is indicative of the interactions between mothers and their infants, which is characterized by mutual and concurrent interchanges, often referred to as the “mother-infant dance” If the mother is able to accurately recognize her infant’s cues, then she can provide an appropriate and secure foundation to encourage the infant’s exploration, watching over …

Cortisol In Human Milk Predicts Child Bmi, Jennifer Hahn-Holbrook, Tran Bao Le, Anna Chung, Elyssia Poggi Davis, Laura M. Glynn

Psychology Faculty Articles and Research

Objective—Breastfeeding is linked to lower rates of childhood obesity. Human milk contains cortisol, known to regulate glucose storage and metabolism. We aimed to test the hypothesis that early exposure to cortisol in human breast milk helps to modulate infant BMI trajectories over the first two years of life.

Methods—Growth curve modeling was used to examine whether infant exposure to cortisol in human milk at 3 months predicted changes in child body mass index percentile (BMIP) at 6, 12, and 24 months of age in 51 breastfeeding mother-child pairs.

Results—Infants exposed to higher milk cortisol levels at 3 …

Impacts On Breastfeeding Practices Of At Scale Strategies That Combine Intensive Interpersonal Counseling, Mass Media, And Community Mobilization: Results Of Cluster Randomized Program Evaluations In Bangladesh And Viet Nam, Purnima Menon, Phuong Hong Nguyen, Kuntal Kumar Saha, Adiba Khaled, Andrew Kennedy, Lan Mai Tran, Tina Sanghvi, Nemat Hajeebhoy, Jean Baker, Silvia Alayon, Kaosar Afsana, Raisul Haque, Edward A. Frongillo Jr., Marie T. Ruel, Rahul Rawat

Faculty Publications

Background

Despite recommendations supporting optimal breastfeeding, the number of women practicing exclusive breastfeeding (EBF) remains low, and few interventions have demonstrated implementation and impact at scale. Alive & Thrive was implemented over a period of 6 y (2009–2014) and aimed to improve breastfeeding practices through intensified interpersonal counseling (IPC), mass media (MM), and community mobilization (CM) intervention components delivered at scale in the context of policy advocacy (PA) in Bangladesh and Viet Nam. In Bangladesh, IPC was delivered through a large non-governmental health program; in Viet Nam, it was integrated into government health facilities. This study evaluated the population-level impact …

Development Of A Breastfeeding Class Specifically For Working Moms, Maryleah S. Needels

Master's Projects and Capstones

Successfully breastfeeding mothers who are planning to return to work and remain exclusively breastfeeding their infants have a knowledge deficit as to the federal law protecting their rights along with the basic skills for pumping, storing, and bottle-feeding of breast milk. There is a significant drop in breastfeeding rates at both the 3 and 6-month marker, which coincides with maternal return to employment. After attending the Working Moms Breastfeeding Class, 100% of mothers reported an increase in knowledge surrounding the law and the CDC’s basic skills for handling pumped breast milk based on a pre/post questionnaire. Bandura’s theory of self-efficacy …

Infant And Young Child Feeding Practices Differ By Ethnicity Of Vietnamese Mothers, Tuan T. Nguyen, Phuong H. Nguyen, Nemat Hajeebhoy, Huan V. Nguyen, Edward A. Frongillo Jr.

Faculty Publications

Background: Limited studies have examined ethnic variation in breastfeeding and complementary feeding practices in developing countries. This study investigated ethnic variation in feeding practices in mothers with children 0–23 months old in Vietnam.

Methods: We used data on 1875 women who came from the ethnic majority, Kinh (n = 989, randomly sampled from 9875 surveyed Kinh mothers, 10 % from each province) and three ethnic minorities: E De-Mnong (n = 309), Thai-Muong (n = 229) and Tay-Nung (n = 348). Ethnic minorities were compared with the Kinh group using logistic regression model.

Results: Prevalence of breastfeeding initiation within an hour …

Breast Is Best: A Case Study Of Bottom-Up Implementation, Britni Ayers

Graduate Theses and Dissertations

The institutional narrative surrounding breastfeeding is that breast is best. Research on infant feeding practices in the United States are abundant, especially among WIC recipients. Although WIC is championed as being a breastfeeding promotional venue, WIC recipients demonstrate lower breastfeeding rates than non-WIC recipients of similar economic standing suggesting the need for further research into the policies and breastfeeding promotional tools being implemented within WIC. Concurrently, research demonstrates that breastfeeding duration rates among WIC recipients can be prolonged with women’s interaction with a Breastfeeding Peer Counselors (BFPC). However, there has been little exploration into the experiences of BFPC or the …

Proposed Typologies For The Dress Needs Of Nursing Mothers And Babies And Available Nursing Dress: An Evaluation Of The Relationship Between Concepts In These Typologies, Ellen Mckinney, Armine Ghalachyan

Ellen C. McKinney

In the U.S., the majority of babies are weaned from the breast by the time they are three months old (CDC, 2007) in contrast to the recommendation of “exclusive breastfeeding for about 6 months. . ., with continuation of breastfeeding for 1 year or longer” (Eidelman & Schanler, 2012). Women who feel comfortable feeding in public breastfeed longer than women who are not comfortable (Allen & Pelto, 1985). Practical advice on carrying out life roles while breastfeeding is important and requires consideration of clothing (Mulford 2008). The purposes of this study were to (1) identify and organize (a) dress needs …

Proposed Typologies For The Dress Needs Of Nursing Mothers And Babies And Available Nursing Dress: An Evaluation Of The Relationship Between Concepts In These Typologies, Ellen Mckinney, Armine Ghalachyan

Ellen C. McKinney

In the U.S., the majority of babies are weaned from the breast by the time they are three months old (CDC, 2007) in contrast to the recommendation of “exclusive breastfeeding for about 6 months. . ., with continuation of breastfeeding for 1 year or longer” (Eidelman & Schanler, 2012). Women who feel comfortable feeding in public breastfeed longer than women who are not comfortable (Allen & Pelto, 1985). Practical advice on carrying out life roles while breastfeeding is important and requires consideration of clothing (Mulford 2008). The purposes of this study were to (1) identify and organize (a) dress needs …

Proposed Typologies For The Dress Needs Of Nursing Mothers And Babies And Available Nursing Dress: An Evaluation Of The Relationship Between Concepts In These Typologies, Ellen Mckinney, Armine Ghalachyan

Ellen C. McKinney

In the U.S., the majority of babies are weaned from the breast by the time they are three months old (CDC, 2007) in contrast to the recommendation of “exclusive breastfeeding for about 6 months. . ., with continuation of breastfeeding for 1 year or longer” (Eidelman & Schanler, 2012). Women who feel comfortable feeding in public breastfeed longer than women who are not comfortable (Allen & Pelto, 1985). Practical advice on carrying out life roles while breastfeeding is important and requires consideration of clothing (Mulford 2008). The purposes of this study were to (1) identify and organize (a) dress needs …

Factors That Influence Mothers' Decisions Concerning Breastfeeding, Kimberly M. Futrelle

Nursing Theses and Capstone Projects

The purpose of this study was to explore factors that influence decisions concerning breastfeeding in a group of 30 mothers who are employed, place their children in a childcare center, and whose children are five years of age and under. The study utilized Fishbein and Ajzen’s Theory of Reasoned Action as the conceptual framework. The descriptive study allowed for determination of the factors of attitudes, beliefs, and opinions that influence mothers’ decisions concerning breastfeeding. Statistical data compiled from survey results revealed many participants believed that breast milk is less expensive than formula. However, a significant number of mothers were neutral …

Exposure To Mass Media And Interpersonal Counseling Has Additive Effects On Exclusive Breastfeeding And Its Psychosocial Determinants Among Vietnamese Mothers, Phuong H. Nguyen, Sunny S. Kim, Tuan T. Nguyen, Nemat Hajeebhoy, Lan M. Tran, Silvia Alayon, Marie T. Ruel, Rahul Rawat, Edward A. Frongillo Jr., Purnima Menon

Faculty Publications

The pathways through which behavior change interventions impact breastfeeding practices have not been well studied. This study aimed to examine: (1) the effects of exposure to mass media and interpersonal counseling on exclusive breastfeeding (EBF) and hypothesized psychosocial determinants (i.e. knowledge, intention, beliefs, social norms, and self-efficacy); and (2) the pathways through which exposure to mass media and interpersonal counseling are associated with EBF. We used survey data from mothers with children< 2 year (n = 2045) from the 2013 process evaluation of Alive & Thrive’s program in Viet Nam. Multiple linear regression analyses and structural equation modeling were used to estimate effects. Exposure to mass media only, interpersonal counseling only, both or neither was 51%, 5%, 19% and 25%, respectively. Exposure to both mass media and interpersonal counseling had additive effects on EBF as well as on related psychosocial factors, compared with no exposure. For example, EBF prevalence was 26.1 percentage points (pp) higher in the group that received interpersonal counseling only, 3.9 pp higher in the mass media group and 31.8 pp higher in the group that received both interventions. As hypothesized, more than 90% of the total effect of the two interventions on EBF was explained by the psychosocial factors measured. Our findings suggest that combining different behavior change interventions leads to greater changes in psychosocial factors, which in turn positively affects breastfeeding behaviors.

Early Infant Feeding And Adiposity Risk: From Infancy To Adulthood, W H. Oddy, T A. Mori, R C Huang, J A. Marsh, C E. Pennell, Paola Chivers, Beth Hands, P Jacoby, P Rzehak, B V. Koletzko, L J. Beilin

Beth Hands

Introduction: Systematic reviews suggest that a longer duration of breast-feeding is associated with a reduction in the risk of later overweight and obesity. Most studies examining breast-feeding in relation to adiposity have not used longitudinal analysis. In our study, we aimed to examine early infant feeding and adiposity risk in a longitudinal cohort from birth to young adulthood using new as well as published data. Methods: Data from the Western Australian Pregnancy Cohort (Raine) Study in Perth, W.A., Australia, were used to examine associations between breast-feeding and measures of adiposity at 1, 2, 3, 6, 8, 10, 14, 17, and …

Breastfeeding: The Illusion Of Choice, Yeon Bai, Lauren Dinour

Department of Nutrition and Food Studies Scholarship and Creative Works

Background

Breastfeeding is frequently described as a woman's decision, yet this choice is often illusionary owing to suboptimal social and structural supports. Despite the passage of the Patient Protection and Affordable Care Act (2010) that requires all qualifying employers to provide mothers “reasonable” break time and a private, non-bathroom space to express breast milk, the majority of women in the United States still do not have access to both accommodations.

The Problem

At least three issues may be influencing this suboptimal implementation at workplaces: 1) federal law does not address lactation space functionality and accessibility, 2) federal law only …

Early Infant Feeding And Adiposity Risk: From Infancy To Adulthood, W H. Oddy, T A. Mori, R C Huang, J A. Marsh, C E. Pennell, Paola Chivers, Beth Hands, P Jacoby, P Rzehak, B V. Koletzko, L J. Beilin

Paola Chivers

Introduction: Systematic reviews suggest that a longer duration of breast-feeding is associated with a reduction in the risk of later overweight and obesity. Most studies examining breast-feeding in relation to adiposity have not used longitudinal analysis. In our study, we aimed to examine early infant feeding and adiposity risk in a longitudinal cohort from birth to young adulthood using new as well as published data.

Methods: Data from the Western Australian Pregnancy Cohort (Raine) Study in Perth, W.A., Australia, were used to examine associations between breast-feeding and measures of adiposity at 1, 2, 3, 6, 8, 10, 14, 17, and …

Breast Milk Exposure And The Incidence Of Necrotizing Enterocolitis In Very Low Birth Weight Pre-Term Infants, Meaghan Sullivan

Honors Scholar Theses

Purpose: To determine what degree of exposure to breast milk feeding is protective against Necrotizing Enterocolitis (NEC) in very low birthweight (VLBW) preterm infants.

Data Sources: This is a secondary data analysis of 56 VLBW preterm infants diagnosed with NEC and 56 age-matched VLBW infants who served as controls. All infants were born between 1997 and 2009 and cared for in the Newborn Intensive Care Unit (NICU). Infants were born at or before 29 weeks gestation and with a birth weight less than 1500 grams. Data included the volume fed daily and type of feeding along with demographic birth data. …

Medication Use While Breastfeeding With Multiple Sclerosis: A Systematic Literature Review, Brittany Edralin

Chancellor’s Honors Program Projects

No abstract provided.

Breastfeeding Education For Fathers: An Intervention To Increase Breastfeeding Rates, Jill Marie Frisz

Evidence-Based Practice Project Reports

If every infant were breastfed within an hour of birth, exclusively breastfed until six months, and given breastmilk up to two years, almost 800,000 lives would be saved annually (who, 2014). Nationally, breastfeeding rates drop significantly from three to six months. A search of literature yielded significant evidence as fathers for facilitators to increase breastfeeding rates. The purpose of this evidence based practice (EBP) project was to determine the effects of best practice measures to educate fathers about breastfeeding to increase anytime breastfeeding rates. The social support theory and ACE Star model guided the literature search and implementation of this …

Breastfeeding Intention Within A Rural Postpartum Population: Does Education Matter?, Brooke Hawkins

DNP Scholarly Projects

Purpose: The purpose of this scholarly project was to determine breastfeeding intention in a rural population after receiving education from a certified lactation consultant.

Review of the Literature: The benefits of breastfeeding for both mother and child are clearly stated in the literature. Despite the known benefits, rates of breastfeeding are decreased within rural populations. Previous research suggests education about breastfeeding benefits is beneficial in increasing these rates. In particular, previous studies focused on the contributing factors affecting a mother’s decision to breast or formula feed. However, few studies were found strictly evaluating breastfeeding intention after receiving formal …

Application Of The Breastfeeding Personal Efficacy Beliefs Inventory And Acknowledgment Of Barriers For Improving Breastfeeding Initiation Rates In An Urban Population, Diwata Bose, Callie Cox Bauer, Kiley A. Bernhard, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

Introduction: Breastfeeding (BF) is recognized as the preferred method of infant nutrition by American Academy of Pediatricians, American College of Obstetricians and Gynecologists, and the World Health Organization. Despite the benefits of BF, in 1998 only 69% of new mothers in the United States initiated BF and 29% continued to breastfeed at 6 months. Objective: To assess perceived breastfeeding confidence (BFC) and determine barriers in regards to BF in an urban population. Methods: The Breastfeeding Personal Efficacy Beliefs Inventory (BPEBI) was used to determine perceived BFC. The survey was distributed to 271 women during prenatal appointments at an urban Milwaukee …

Breastfeeding Effects With Early Intervention For Ankyloglossia (Tongue-Tie), Hope L. Adams

All Electronic Theses and Dissertations

Background: Anklyoglossia or tongue-tie in infants often goes undiagnosed primarily due to the lack of knowledge for assessing tongue-tie thus disrupting a successful breastfeeding experience. Education, diagnosis, and treatment of ankyloglossia are vital in order to create a successful breastfeeding outcome. Purpose: To determine the effects of breastfeeding with early intervention for ankyloglossia (tongue-tie). Theoretical/Conceptual Framework: Benner’s concept of Novice to Expert allows nurses to develop skills over time through education and personal experiences. Weidenbach’s concept of The Helping Art of Clinical Nursing applies to direct patient care, teaching, and advice. Methods: Cumulative Index to Nursing and Allied Health Literature …

Progesterone Vaginal Ring: Beneficial Role In Supporting Breastfeeding, Population Council

Reproductive Health

This brief provides evidence for the benefits of the Progesterone Vaginal Ring (PVR), as it supports (and even promotes) breastfeeding so that infants and children are well nourished, protected from a host of illnesses, and benefit from nursing that is uninterrupted by a pregnancy. In addition, the PVR enhances contraceptive protection for the mother so that she has ample time to recover from the previous pregnancy and delivery, while devoting her attention to the newly delivered baby. In this context, when breastfeeding has been recognized as a health behavior that impacts both mother and child and has the potential to …

The Effect Of Nurse Dose On Breastfeeding Exclusivity - A Patient Level Analysis, Gwen Moreland

DNP Projects

Background: Breastfeeding is strongly associated with health benefits for children and their mothers. Despite this knowledge, breastfeeding rates in the United States have increased only slightly. Current research examines the relationship between nurse characteristics and patient outcomes in adult intensive care and acute care settings. To date there is very limited research examining nurse variables and outcomes in women and children, and very little knowledge regarding the characteristics of the nurse in relation to patient’s breastfeeding success.

Purpose: The purpose of this practice inquiry project was to evaluate the relationship between the attributes of nurse dose and the immediacy and …

Community Level Assessment For Breastfeeding In The Gateway District, Vanessa Flannery

DNP Projects

Purpose: To assess community level support for breastfeeding in the Gateway District of eastern Kentucky.

Methods: A descriptive study was conducted to identify institutional support of breastfeeding women. Data collected during interviews included community level support based on the framework of the Ten Step program from the Baby-Friendly Hospital Initiative (BFHI) (WHO & UNICEF, 2009) and the Mother-Friendly Worksite Initiative (Texas Department of State Health Services, 2012). Respondents answered questions to determine breastfeeding support from the healthcare, education and business communities.

Results: Of the ten organizations whose representatives were interviewed, 100% perceived health benefits for mothers and infants from breastfeeding. …

A Systematic Review: Effects Of Breastfeeding On Early And Late Childhood, Kara Campbell, Samantha Fritz

Williams Honors College, Honors Research Projects

Abstract

The topic of the long-term impact of breast milk and formula milk composition on the health status of children continues to be a focus of discussion and research. The aim of this systematic review is to describe and critically appraise current evidence regarding the lasting effects of breastfeeding on health outcomes in children throughout early and late childhood. Twenty-one studies focusing on infant feeding were identified using PubMed, CINAHL, and Medline databases. These studies were then categorized according to health outcomes such as: weight, developmental, and immune system effects. Through a critical appraisal of this evidence, it was found …

Delivering Contraceptive Vaginal Rings To Breastfeeding Women, Population Council

Reproductive Health

The Progesterone Vaginal Ring (PVR) is a user-controlled contraceptive that helps breastfeeding women safely and effectively space, delay, or limit their next pregnancy. The Population Council and partners developed the PVR to help address the unmet need for contraception among breastfeeding women. The ring provides a convenient option that adds choices for new mothers and promotes optimal infant nutrition and health. This two-page brief provides fast facts for advancing nutrition and infant health with the PVR.

Breastfeeding In Nigeria: A Systematic Review, Emmanuel O. Adewuyi, Kazeem Adefemi

Research outputs 2014 to 2021

Breastfeeding confers numerous benefits on babies and mothers. Early initiation, ‘exclusive breastfeeding’ and breastfeeding for at least two years post-delivery are the recommended practices. This study aims to examine the trends of breastfeeding practice in Nigeria by reviewing available published studies. The online databases of PubMed, Science Direct and the Web of Knowledge were searched using relevant terms. Studies identified were screened for eligibility and those that met the inclusion criteria were included in this review. Graphs and regression equations were generated using Microsoft Excel® to illustrate the duration of and trends in, breastfeeding practices in Nigeria. This review adopts …

In-Hospital Factors Associated With Supplementation Among Healthy, Full-Term, Breastfed Infants, Jodi Kae O'Brien

Dissertations

Background: Formula supplementation of healthy, term, breastfed infants born to mothers who plan to exclusively breastfeed persists at high rates, in spite of global reduction efforts. The identification of modifiable risk factors for supplementation and effective nursing care for successful breastfeeding is understudied.

Purpose: This study aimed to better understand the obstetrical, hospital, and nursing factors associated with supplementation during the hospital stay. The aims were: (1) examine the relationships between aspects of hospital care of infants who are supplemented compared to infants exclusively breastfed and (2) determine what in-hospital risk factors increase the odds of formula supplementation among a …

Communicating Social Support: Understanding Complexities Of Breastfeeding Communication Among African American Mothers, Nicole Rachael Peritore

Theses and Dissertations--Communication

Breast milk is the best choice for meeting the nutritional needs for an infant whenever possible. Despite the knowledge that this nutritional choice is the best choice for an infant, data demonstrates that there is a sharp decline in the rates of breastfeeding mothers. Among African Americans, breastfeeding rates are significantly lower than the national averages. Despite many of the applications of social support in communication research, there is a gap in knowledge on the social support systems in the context of breastfeeding, especially for African Americans. With the social ecological model as a framework, social support theory provides understanding …

Influence Of Overweight, Obesity, Social Support, And Self-Efficacy On Breastfeeding Outcomes Among African-American Women, Elizabeth Hoo

Walden Dissertations and Doctoral Studies

Breastfeeding reduces morbidity and mortality among mothers and children, yet African-American women breastfeed at lower rates than women of other racial and ethnic groups do. Higher rates of overweight, obesity, and low socioeconomic status may be contributing factors in this population; however, limited research exists regarding the roles of maternal overweight and obesity on breastfeeding outcomes. The purpose of this study was to examine whether social support and self-efficacy positively influence breastfeeding outcomes among overweight and obese African American women. Self-efficacy and social support theories provided the theoretical framework for the study. Research questions examined whether (a) maternal overweight and …