A myriad of factors influence the sub-optimal breastfeeding rates in the U.S. Among these factors is maternal obesity (BMI > 30 kg/m2), which has been found to negatively impact breastfeeding initiation and duration for some women. Obesity increases women’s risk for various complications throughout the perinatal period, which may impact breastfeeding and the long-term health and well-being of women and their children. However, adequate lactation support that upholds a respectful consciousness regarding the potential breastfeeding challenges of women with obesity can assist these women to successfully meet their breastfeeding goals. This review summarizes the literature on the impact of maternal BMI on breastfeeding duration, and maternal and infant risk factors that may complicate lactation for women with obesity. Recommendations for assessing and supporting the needs of mothers with obesity to best achieve their breastfeeding goals are provided.
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- Go to article: Maternal Obesity and Breastfeeding A Review of the Evidence and Implications for PracticeSource:
After losing an infant, grieving mothers may still have to cope with postpartum issues, including lactation. This article reviews and addresses care options for lactation concerns after pregnancy, neonatal, or infant loss. Currently, lactation care and advice after loss varies greatly. Lactation consultants are instrumental in providing mothers with anticipatory guidance and evidence-based care. Implementing system-wide training and education regarding this topic will help families receive the information they need to deal with the physiological aftermath of infant loss.
Breastfeeding should be encouraged for every baby with few exceptions, classic galactosemia being one of them. Classic galactosemia causes death in newborns and can be identified early with newborn screening, or through the careful assessments of physicians, midwives, and lactation consultants in the first 4 days of life. All practitioners that assess newborns within the first 4 days of life should have a clear understanding of when to halt breastfeeding and when to support continuation of breastfeeding while keeping babies safe.
If a tongue-tie is to be revised, what is the best technique for accomplishing that? There is some debate in the field about whether scissors or laser is most effective. Both techniques seem efficacious. This section also addresses which professionals should be performing the revision. Our panelists represent a wide range of disciplines, so some refer, and others perform the revisions themselves.
- Go to article: Improving Exclusive Breastfeeding Behavior of Primipara Mothers With Lactation Education and Individualized Counseling Intervention
Improving Exclusive Breastfeeding Behavior of Primipara Mothers With Lactation Education and Individualized Counseling Intervention
New mothers often need support to establish and maintain breastfeeding, and they may find it difficult to access breastfeeding resources locally. Therefore, postpartum lactation education and counseling of primipara mothers were given by integrating into their routine follow-ups in the family health center. This study was conducted to determine the effect of lactation education and individual counseling intervention integrated into the routine follow-up visits of primipara mothers in family health centers on exclusive breastfeeding rates and breastfeeding behaviors during the first 6 months postpartum.
A two-factor, pretest–posttest, controlled, semi-experimental, prospective study was conducted. The study was conducted in three family health centers in a city on the north coast of Turkey. The interviews with the primipara mothers were performed between the 24th and 72nd hours and at the 1st, 3rd, 4th, 6th months postpartum.
The rates of giving exclusive breastfeeding to the infants in the first 6 months were 68% in the study group and 38% in the control group, exhibiting a statistically significant difference between the groups with regard to breastfeeding frequency (p =.001).
It was determined that the education and counseling integrated into the existing health system were effective in increasing the EBF rates and breastfeeding behaviors of primipara mothers in the first 6 months after birth.
The clinical guidance for human milk (HM) feeding for sick and premature babies in Thailand was developed in 2013 to help improve their breastfeeding rates.
To expand breastfeeding (BF) for sick and premature babies using the clinical guidance, develop a monitoring system, and to integrate the practice into the national routine newborn care for sick babies.
Volunteer tertiary care hospitals were recruited to implement the clinical guidance. The development of a monitoring and evaluation system was done by the multidisciplinary team and volunteer hospitals. The integration into routine national care practice was done by including it in the national neonatal service plan of Thailand.
Thirty-eight pilot tertiary care hospitals volunteered for implementing the program. The proposed outcome indicators of rate of exclusive BF sick babies at hospital discharge and at 6 months of life for the volunteer hospitals were 62.97% and 41.76%, respectively. Since its integration into the national service plan in 2019, a total of 98 hospitals have been included in the program.
The integration of the clinical guidance into the national service plan is essential for sustaining BF of sick, premature babies in the country.
Editor’s note: One of the editorial goals for Clinical Lactation was to provide a forum where IBCLCs could respectfully discuss emerging, and sometimes controversial, issues that arise in our field. The issue of peer-to-peer milk sharing is one such issue. Social media has greatly facilitated this practice. Given the rise in milk-sharing behavior, it is appropriate for IBCLCs to acknowledge its existence, understand why it occurs, and decide on an appropriate course of action. This article presents a roundtable discussion of Karleen Gribble’s recent article, Biomedical Ethics and Peer-to-Peer Milk Sharing.
The use of peer support as a tool to increase breastfeeding exclusivity and duration can be facilitated by innovative community strategies. This is especially important in a binational environment where healthcare clients are served by providers on both sides of the U. S.–Mexico border. A successful adoption of the Baby Café model of peer-to-peer breastfeeding support, developed in the U.K., has been carried out by the El Paso Baby Café and its sister Baby Cafés in Ciudad Juárez and Northern Chihuahua, Mexico.
When we asked for mothers to tell us their stories of tongue-tie, responses flooded in. A theme in many of these stories is health-care providers not listening when mothers said they were in pain. The mothers’ related stories of painful nipples, babies breastfeeding “all the time,” and failure to thrive because of low milk production. Mothers’ voices were not heard because health-care providers minimized their concerns. Most of these mothers persisted with breastfeeding despite the problems. Eventually, the tongue-ties were correctly identified and revised, and the difficulties resolved. Other mothers were not able to continue breastfeeding. A smaller percentage of mothers described revisions that had harmful effects on their babies and that did not fix the breastfeeding problems. (Editor’s Note: We, unfortunately, received too many stories to include in this issue, but we will include all of them in the Clinical Lactation Monograph.)
Parents often perceive infant gastroesophageal reflux (GER) as a serious problem. Frequently, GER is explained as a normal process, but there are instances where parents’ concerns are valid. Provided are 3 case studies from the private practice of an IBCLC. Each case initially presented with what sounded like normal infant GER. Upon further evaluation, with close follow-up and more detailed history taking, each case required advanced medical attention. These cases highlight the unique role of the IBCLC in helping to assess GER, the value of working as a team member with baby’s physicians, and the importance of listening carefully to parental instincts and concerns.