Journal of Human Lactation

This secondary data analysis examined if time of initiation of milk expression and pumping frequency influenced milk weight weeks 2-5 postpartum. Of the 39 subjects in the convenience sample, 20 were in the early initiating (EI) group, (n = 12 high frequency [HF], n = 8 lowfrequency [LF]), and 19 were in the late initiating (LI) group, (n= 7HF, n = 12LF). The EI group initiated pumping = 48 hours after birth; the HF group pumped a minimum of 6.25 times daily. A two-way analysis of variance indicated that milk weight was significantly higher in the HF as compared to the LF group. While there was no significant difference in milk weight between the EI and LI groups, therewas a significant interaction between frequency and initiation. Milk weight for the LF group appeared to be positively influenced by the initiation of mechanical expression soon after birth.

The beliefs of low-income mothers regarding breastfeeding compared to formula feeding, according to feeding method, were investigated. Interviews were conducted with 154 women who were assigned to one of two groups. Four health benefits of breastfeeding were rated significantly higher than for infant formula within both the breastfeeding (BF) and formula-feeding (FF) groups. Breastfeeding was seen as less convenient than formula feeding by the FF group (x= 2.3 ± 1.7 versus 3.8 ± 1.5 for formula feeding and breastfeeding, respectively; P< .001). Both groups rated formula feeding as more likely to enable others to help in infant care, easier in terms of the mother's time control, and less likely to tie the mother down than breastfeeding. The findings show that, despite formula-feeding mothers' beliefs in the health benefits of breastfeeding, they perceive that it limits their activities. Therefore, breastfeeding promotion must address not only benefits but also lifestyle issues.

The authors tested the validity of the LATCH breastfeeding assessment tool, controlling for intervening variables in 133 dyads. LATCH scores, mother's evaluation of an index feed, and intended duration of breastfeeding were assessed postpartum and followed 6 weeks. Women breastfeeding at 6 weeks postpartum had higher LATCH scores (x± SD= 9.3 ± 0.9) than those who weaned (x± SD = 8.7 ± 1.0), due to only one measure, breast/nipple comfort. Women who weaned before 6 weeks reported lower breast/nipple comfort (1.5 ± 0.5) than those who were still breastfeeding at 6 weeks (1.7 ± 0.5, P< .05). Total LATCH scores accounted for 7.3% of variance in breastfeeding duration. Total LATCH scores positively correlated with duration of breastfeeding (n = 128; r= .26, P= .003) and to mothers' scores (n = 132; r= .58, P= .001). Correlations among LATCH measures ranged from .02 to .51. The LATCH tool is a useful identifies the need for follow-up with breastfeeding mothers at risk for early weaning because of sore nipples.

A prospective study of 556 women from Perth, Western Australia, and 503 women from the Darling Downs area, Queensland, Australia, was conducted to identify factors associated with the abandonment of breastfeeding prior to hospital discharge. In total, 88% ofwomen initiated breastfeeding, but 5% discontinued breastfeeding while still in the hospital. Discontinuation of breastfeeding prior to discharge was associated with a number of psychosocial factors, namely, infant feeding method being chosen after becoming pregnant, a perception by the mother that the infant%’s father either preferred formula feeding or was ambivalent about how the infant was fed, and whether the mother's own mother had ever breastfed. Judicious questioning prenatally regarding a woman's commitment to, social support for, and prior exposure to breastfeeding will help identify thosewomen most at risk of abandoning breastfeeding prematurely. Such women should be targeted for additional support while in the hospital.

This two-part field study compared researchers’ recorded observations to mothers’ perceptions of attention they received while publicly breastfeeding. In part 1, four breastfeeding and four bottle-feeding mothers each made eight restaurant visits. On average, there were more neutral looks from customers (P = .01) during breastfeeding visits, but no differences in the amount of overtly negative or positive attention given during breastfeeding versus bottle feeding. In part 2, four breastfeeding mothers made a total of 24 visits to shopping malls. There were more neutral looks given while mothers were breastfeeding and more smiles and comments while they were not feeding, but no difference in total amount of attention received. Breastfeeding mothers acknowledged they had anticipated some undesirable attention but instead received little attention. Nevertheless, they felt “vulnerable” nursing in public. Certain proactive behaviors and personal attributes as well as support from otherwomen enabled them to breastfeed successfully in public.

Human resource professionals from different industries participated in focus groups in Austin, Texas. From a social marketing perspective, employers’ knowledge, attitudes, and practices in providing breastfeeding support for lactating employees were explored. Employers knew about the benefits of breastfeeding for mothers and children. However, they did not place a high priority on providing breastfeeding support. Employers identified the barriers to and motivators for providing breastfeeding support, as well as effective communication and marketing strategies for the dissemination of breastfeeding support messages and materials for employers. Participants revealed important employer variables, such as the size of the company or agency, that must be considered when designing social marketing campaigns that target employers. This research provided in-depth, qualitative data useful for designing social marketing campaigns that target employers and for further investigation using qualitative and quantitative research methods.

The first International Congress of Human Milk Banks—Excellence in Human Milk Banking: A Vision of the Future, held in Brazil in June 2000 and sponsored by the Brazilian Association of Milk Banks, had representation from milk banks in Argentina, Chile, Costa Rica, Venezuela, France, the United Kingdom, and North America as well as Brazil. Arecurring theme in the discussion of donor milk banking was the role of each country's milk banks in the promotion and support of breastfeeding. The Brazilian National Reference Milk Bank and the growth of donor milk banking in Brazil over the past 15 years were described, including federal regulation that all milk bank directors be trained and certified. Milk banking systems in France, the United Kingdom, Venezuela and the Caribbean, and North America were also discussed. Similarities and differences in the donor screening process and the regulation of milk banks in the countries is presented.

Because many antibiotics are excreted into breast milk, it can be difficult for a practitioner to choose an antibiotic for a lactating patient that will have minimal risks to her nursing infant. This article is the second of a three-part series discussing the use of anti-infective agents during lactation. The authors review general information regarding use and common side effects for several classes of antibiotics. They also summarize information, including documented milk concentrations, milk-to-plasma ratios, and other pharmacokinetic properties, in a table that can help practitioners choose antibiotics that may be considered safe to use in the lactating mother.