First Hour Initiation of Breast Feeding &Associated Factors, among Mothers at Post Natal Ward in Fort Portal Referral Hospital, Uganda

Background: Breast milk is recommended as the best feeding option to neonates and infants for it confers immunological benefits that help to reduce neonatal and infant morbidities and mortalities. WHO recommends that all infants should start breast feeding within one hour of birth i.e. early initiation of breast feeding (EIBF). Unfortunately, studies show that less than 40% of infants in resource limited settings Uganda inclusive are initiated on breast feeding practice, with no documented study done in Kabarole district to assess the problem. This study therefore, set out to establish the prevalence and associated factors with the practice of first hour initiation of breast feeding at Fort Portal Regional Hospital, Kabarole district, Uganda. Methods: With a cross-sectional design, we collected data from 330 post natal mothers and their live-born infants at Fort Portal Regional Referral hospital from 5th-20th August 2019. With a standard interviewer administered tool, mothers who initiated breast feeding within the first hour after delivery of their newly born babies responded with yes and those that did not with a no. Prevalence of one hour initiation was got considering infants that were initiated on breast within one hour over the total live birth times 100 to get the percent prevalence. With Stata version 13 software, statistically significant relationships of the predisposing factors were determined at a p-value (p ≤ 0.05) at bivariate and at multivariate regression coefficient. Results: A total of 330 postnatal mothers targeted for this study, 100% response rate was covered. Mothers’ age ranged from 18 - 45 years with mean age 31 SD ± 6. The prevalence of initiation of breast feeding in the first hour of birth was 68%, a third of (32%) mothers had not initiated breast feeding in the first hour. A half (50%) of the direct predisposing factors for non-initiation of timely breastfeeding were due to birth asphyxia, almost a quarter 23% due to mother’s ill health and 7% due mother not being guided by the health worker on what to do. In this study mothers’ knowledge and awareness of the practice were very low at 20% while that of health workers was fair at 53%. Social demographic factors that influence 1st hour breast feeding practice were;young maternal age being less than 34 years, mothers occupation being self-employed (83%) or unemployed (73%) with 3 times higher odds of initiating breastfeeding within 1st (OR = 3, p = 0.003) than working class mothers (civil servants). Marital status of mothers being married (73%) significantly influenced early breastfeeding practice (p = 0.001). Health workers’ knowledge of the practice was significantly associated (OR = 2.7, X2 = 11.32, *p = 0.00078) with enforcement of mother initiation of breast feeding in first hour compared to the less knowledgeable ones. Conclusion: The practice of timely initiation of breastfeeding at Fort Portal Regional Referral hospital at 68.2% was sub-optimal against WHO universal practice recommendations. Mothers’ low knowledge on timely initiation of breast feeding practice was the most deterrent factor for first hour initiation of breastfeeding practice. Providing breastfeeding counselling to all mothers during ANC and training on best breastfeeding practices and counselling skills for health staff at Fort Portal Referral hospital are urgent recommendation in this study to improve the practice.

Successful management of a breastfeeding mother with severe eczema of the nipple beginning from puberty:A case report

BACKGROUND Nipple eczema is the most common presentation of atopic dermatitis of the breast,which seriously influences breastfeeding of mothers.We here present a case of severe nipple eczema that started in puberty and received continuous care and interventions during pregnancy.The patient succeeded in breastfeeding after the interventions.CASE SUMMARY A 36-year-old woman at 16 wk of gestation(gestation 1 parturition 0),visited the breastfeeding consultation clinic,complaining of excessive nipple secretion,severe itching,and concerns about breastfeeding.She was diagnosed with severe nipple eczema.Health education,consultation with dermatologists,topical medication,psychological support,and postpartum care were carried out.Through continuous interventions,her nipple eczema significantly improved,lactating confidence enhanced,anxiety symptoms were reduced,and exclusive breastfeeding was achieved.CONCLUSION For lactating women with nipple eczema,breastfeeding consultants should play an important role in patient education and provide whole-process and individual guidance.

Breast Feeding Cuts Infant Death 20 Percent

[提示]母乳喂养,英语叫breast-fed。母乳喂养婴儿,好处可谓多矣!首先在诞生一年之內,婴儿的死亡率就比非母乳喂养者降低了20％。别的好处也很多,比如:Other studies have shown breast-fed babies are less likely to be overweight,have fewer behavioral problems and may show differences in intelligence.They also may grow up to have lower blood pressure(血压).调查还证明,当今美国母乳喂养的婴儿占婴儿总数之70％!笔者甚至怀疑,我国是否达到了这个标准,尤其是都市年轻母亲。

The Application of Billings for Fertility RegulationMethod during the Period of Breastfeeding

In order to adopt Billings Method for fertility regulation during the period of breast feeding, cervical mucus was observed and monitored in 61 breast feeding mothers.Urine estrogen and /or pregnanediol were/was measured in 15 breast feeding mothers. Observations on cervical mucus during 244 months were collected. The type of dry or no mucus was observed in 75.27% fully breast feeding mothers. Constant unchanging mucus was observed in 69.39% partially breast feeding mothers. Developmental changing mucus was observed in 79.25% of mothers bottle feeding their infants. According to the record on cervical mucus within 6 months postpartum, 97.14% of the cervical mucus was consistent with normal menstrual cycles. Urine estrogen and /or pregnanediol were/was measured in 15 breast feeding mothers. The level of estrogen in urine averaged 0.08 μmol/24 h in fully breast feeding mothers and 0.14 μmol/24 h in partially breast feeding mothers.The peak level averaged 0.21 μmol/24 h in bottle feeding mothers.The pregnanediol level was determined to confirm ovulation in bottle feeding mothers. The average levels of cut off and the period of ovulation in 6 bottle feeding mother were 7 μmol/24 h and 9 μmol/24 h respectively.Measurement of urine estrogen and pregnanediol level all matched with cervical mucus appearances. Conclusion: Billings Method is a simple, scientific method for contraception without side effects during breast feeding period.

Resumption of Smoking by Women after Childbirth: Influence of Spousal Smoking

To investigate factors related to resumption of smoking by women after childbirth, the smoking habits of 241 postnatal women, who initially had stopped smoking after pregnancy, in a rural city in Aomori Prefecture, Japan, were studied at 5 - 6 days, 1 month, and 12 months after childbirth. At 1 month after childbirth, only nine women had resumed smoking, but a total of 40 women had resumed smoking after 12 months. Factors related to smoking resumption after childbirth included the switching from breast feeding to bottle feeding and the influence of smoking by their spouses. Spousal smoking is an important factor in the resumption of smoking by women after childbirth.

Knowledge, Attitudes and Practices of Caregivers of Children 0 - 23 Months in Eastern and Central Uganda

Introduction: Appropriate feeding and consequently good nutritional status of young children largely depends on their caregivers. Aim: The current study aimed at assessing maternal/caregivers’ current knowledge, attitudes, practices, and beliefs regarding different aspects of infant and young child feeding in Eastern and Central Uganda. Methodology: A cross-sectional survey design with mixed methods employing both qualitative and quantitative methods was used for data collection. Results: The study participants included 556 caregivers and 572 children. Results indicate that most caregivers (77%) were knowledgeable about key infant and young child feeding practices such as breastfeeding, complementary feeding and meal frequency. However, culture and economic hardships were a major barrier to the applicability of this knowledge. Nearly all (98%) children were ever breastfed with 41% having been initiated on breast milk in the first hour after birth and 68% of all the children below 6 months exclusively breastfed. Three percent of the children aged 6 - 23 months were classified as having either Moderate (2%) or Severe (1%) Acute malnutrition. The median birth weight was 3.2 Kgs with nine percent of the children classified as underweight at birth. The majority (78%) of the children consumed foods from at least four food groups however only 44% consumed heme-rich animal flesh food such as meat, poultry, organ meats and fish, 29% consumed milk and milk products while only 11% consumed eggs. The barriers to improved nutritional status and health-seeking behaviour in children from both regions were largely similar. Some of these included cultural practices which prohibit children from eating certain foods and lack of drugs in the health facilities. Lack of male involvement was a key barrier to health-seeking behaviour and the nutritional well-being of children. Males were, however, more knowledgeable about the key childcare practices that are critical to positive outcomes because they listen to radios, have access to social media and usually congregate at bars where this information is disseminated and exchanged. Conclusion: There should be continuous sensitization of mothers on the benefits of breastfeeding with special focus on early initiation and exclusive breastfeeding as well as child feeding practices during illness. To increase protein intake in children 6 - 23 months, interventions aimed at increasing consumption of these vital nutrients such as promotion of nutrition-sensitive agricultural enterprises like rearing of small livestock and chickens should be emphasized. Consumption of these foods is critical, especially during pregnancy and infancy. Finally, male involvement in maternal and child feeding should be encouraged.

Feeding methods, sleep arrangement, and infant sleep patterns: a Chinese population-based study

Background:Findings from prior research into the effect of feeding methods on infant sleep are inconsistent.The objectives of this study were to examine infants'sleep patterns by feeding methods and sleep arrangement from birth to eight months old.Methods:This longitudinal cohort study enrolled 524 pregnant women at 34-41 weeks of gestation and their infants after delivery in 2006 and followed up until eight months postpartum.The study subjects were recruited from nine women and children hospitals in nine cities in China(Beijing,Chongqing,Wuhan,Changsha,Nanning,Xiamen,Xi'an,Jinan,and Hailin).Participating infants were followed up weekly during the first month and monthly from the second to the eighth month after birth.Twenty-four hour sleep diaries recording infants'sleeping and feeding methods were administered based on caregiver's self-report.Multivariable mixed growth curve models were fi tted to estimate the effects of feeding methods and sleep arrangement on infants'sleep patterns over time,controlling for maternal and paternal age,maternal and paternal education level,household income,supplementation of complementary food,and infant birth weight and length.Results:Exclusively formula fed infants had the greatest sleep percentage/24 h,followed by exclusively breast milk fed infants and partially breast milk fed infants(P<0.01).Night waking followed a similar pattern.However,the differences in sleep percentage and night waking frequency between exclusively formula and exclusively breast milk fed infants weakened over time as infants developed.In addition,compared to infants with bed-sharing sleep arrangement,those with room sharing sleep arrangement had greater daytime and 24-hour infant sleep percentage,whereas those with sleeping alone sleep arrangement had greater nighttime sleep percentage.Conclusions:Our data based on caregiver's selfreport suggested that partial breastfeeding and bedsharing may be associated with less sleep in infants.Health care professionals need to work with parents of newborns to develop coping strategies that will help prevent early weaning of breastfeeding.