Journal of Human Lactation

We evaluated the single and combined effects of introducing a motivational video and peer counseling into four matched WIC clinics on breastfeeding initiation and continuation at 7-10 days among African-American WIC participants. Of the 242 women with complete data, 48% initiated breastfeeding, but only 31% were still breastfeeding at 7-10 days. Initiation was associated with cesarean delivery, infant feeding instruction, no artificial milk discharge pack, attending the peer counselor only-intervention site, and intention to breastfeed. Continuation was influenced by infant feeding instruction, no artificial milk discharge pack, and intention to breastfeed. Overall, trends toward a positive impact of the breastfeeding promotion activities were evident but weak, and largely gone by 7-10 days postpartum.

The concentration of the anticarcinogenic fatty acid, 9c, lIt-1 8:2, in human milk was determined by gas-liquid chromatography (GLC). The mean concentration of 20 samples from 5 women taken at 1, 7, 14, and 21 days was: 0.18% + 0.02; range, 0.14-0.28%. Identity was confirmed by GLC-mass spectrometry (MS). Conjugated isomers other than 9c, 1 lt-18:2 were not detected. The amounts were not changed by supplementation of the maternal diet with fish oil beginning on day 1 after the milk sample was taken.

This research examines the rate of breastfeeding among mothers of very low birth weight infants (VLBW, <1500 grams), and the correlates of breast milk pumping and transition to nursing at the breast. Eighty-two mothers and their 69 singleton and 21 twin VLBW infants admitted to the Neonatal Intensive Care Unit (January 1-June 30, 1995) of an urban tertiary care hospital. Maternal demographic, infant birth, and neonatal data were compared according to breast or bottle feeding, and a telephone interview was administered retrospectively to mothers pumping breast milk at the time of the infant's discharge home. Of 39 mothers who chose to pump breast milk, 19 were still pumping at the time of the infant's discharge home. Only 8 made a successful transition to nursing at the breast. Mothers who continued pumping tended to be white, married, and older, and their infants had fewer neonatal complications. The rates of prolonged breast milk pumping and of nursing are very low. Specific interventions and better support might improve the success rates.

This study uses data from the NICHD/MMIHS to examine the relationship among maternal characteristics and (a) whether mothers were asked by their prenatal providers to consider breastfeeding and (b) mothers' prenatal plans on how to feed their infants. Only 37% of the study population reported that their providers advised them to consider breastfeeding. Proportions of women who received prenatal advice to breastfeed and who intended to breastfeed were higher among married, Caucasian non-Hispanic, primiparous mothers, and women who were not enrolled in WIC. Women who received advice to breastfeed had significantly higher rates of planning to breastfeed (61.1%) than women who did not receive this advice (³⁴.⁷%;p<0.005). Efforts to meet the DHHS Healthy People 2000 objective for 75% of women to breastfeed in the early postpartum period will require a concentrated effort by prenatal providers to help women overcome their resistance to breastfeeding by offering support and encouragement.

The current worldwide decline in the initiation and duration of breastfeeding has increased the need for effective breastfeeding promotion. Promotion policies and programs need to be sensitive to those factors that may help or hinder a mother in her efforts to breastfeed. Such factors include sociodemographic characteristics, maternal employment, and social support. Social support that increases breastfeeding includes emotional, tangible, and educational components from both informal social network members (male partner, mother, family/friends) and professional network members (health care professionals, lactation consultants). Conversely, negative social support may decrease breastfeeding.

A case report is presented on the experience of breastfeeding a baby with a cleft palate. The importance of breastfeeding for the baby and the mother is discussed as well as the importance of support from health care professionals. Problems are described relating to (a) the long term maintenance of lactation by exclusive breast pumping; and (b) the lack of information available on feeding techniques and devices helpful in breastfeeding prior to and following palate repair. Practical suggestions are proposed for expressing and feeding expressed milk to a baby with a cleft palate.

Effective latch-on is central to comfortable, efficient breastfeeding. Since breastfeeding involves taking a large mouthful of an even larger object, a latch-on teaching model based on bottle-feeding or on suction alone may be inappropriate. A model based on the way in which an adult approaches a large sandwich, using a water balloon to demonstrate, can help a mother and baby achieve an effective latch-on for breastfeeding.