Psychometric Properties of the Lactation Assessment and Comprehensive Intervention Tool (LAT).

Background: Despite the short- and long-term acknowledged benefits of breastfeeding for mothers and their infants, worldwide rates trail behind international goals. Prior research confirms that breastfeeding is a nurse sensitive indicator and that problems with latching the baby and painful breastfeeding rank high among the reasons given for not continuing to breastfeed. The Lactation Assessment Tool (LAT) was previously evaluated in a study conducted in Latvia by nurse midwives.

Does an early hands-on breastfeeding intervention by midwives affect nipple pain incidence? An observational pilot study.

Aim: To describe the timing and characteristics of midwives' hands-on interruptions of newborns' behavior while in skin-to-skin contact during the first hour after birth and to elucidate the relationship between these hands-on interruptions and the incidence of nipple pain during the first 4 days postpartum.

Methods: An observational pilot study was conducted at a Baby-Friendly® hospital in Japan from 2016 to 2018. Iterative analysis of video recordings from a larger study of the behavior of newborns while skin-to-skin with their mothers in the first hour after birth found 16 full-term newborns who were born vaginally and that met the inclusion criteria of a midwife's hands-on intervention (HOI) interrupting the infant's progress toward breast self-attachment.

Rescinding evidence-based care and practices during the initial COVID-19 outbreak in the United States: a qualitative study of the experiences of lactation support providers.

Background: The COVID-19 pandemic disrupted healthcare systems and services including along the childbearing continuum. The aim of this study was to explore the experiences and perceptions of professional lactation support providers who cared for breastfeeding families during the early months of the pandemic (March 2020 - August 2020) in the United States.

Design/methods: We conducted a qualitative survey among active lactation support providers in the United States.

Skin-to-skin contact after birth: Developing a research and practice guideline.

Aim: Skin-to-skin contact immediately after birth is recognised as an evidence-based best practice and an acknowledged contributor to improved short- and long-term health outcomes including decreased infant mortality. However, the implementation and definition of skin-to-skin contact is inconsistent in both practice and research studies. This project utilised the World Health Organization guideline process to clarify best practice and improve the consistency of application.

Powdered Baby Formula Sold in North America: Assessing the Environmental Impact.

According to the Intergovernmental Panel on Climate Change, Greenhouse Gas emissions must decline by around 45% by 2030 and reach net zero in 2050. Biofuels, solar, and wind energy are obvious choices for reduction of the 75% of emissions from the energy sector (including transportation), but making reductions in the remaining 25%, the food sector, is more of a challenge. One way is to change our diets to increase low-carbon food alternatives.

The nine stages of skin-to-skin: practical guidelines and insights from four countries.

Incorporating systematic evidence with clinical expertise is a key element in the quest to improve quality of care and patient outcomes. The evidence supporting skin-to-skin contact in the first hour after birth is robust and includes significantly improved outcomes for both mother and infant. This paper compares available iterative data about newborn behaviour in the first hour after birth to further describe the observable behaviour pattern and to provide clinical insight for further research.

A Survey of Knowledge, Attitudes, and Practices of Providers and Staff at Al-Zahraa University Hospital Regarding the Baby-Friendly Hospital Initiative and the International Code of Marketing Breast Milk Substitutes.

Four hundred eight providers and staff members who care for breastfeeding mothers and babies at Al-Zahraa University Hospital, Cairo, Egypt were randomly selected to assess their knowledge, attitudes, and practices regarding the Baby-Friendly Hospital Initiative. The majority of the participants scored above 50% on the knowledge and attitude questions, however, on the practice questions only 45.3% scored above 50%, similar to the result obtained 10 years prior.

A plausible pathway of imprinted behaviors: Skin-to-skin actions of the newborn immediately after birth follow the order of fetal development and intrauterine training of movements.

We hypothesize that the competence of a newborn in the first hours after birth is the direct result of behavior training that begins during the first 12 weeks of fetal life. Correlation of Widström's 9 Instinctive Stages (behaviors of the full-term newborn during the first hours after birth) with the developmental movements during fetal life demonstrate that the fetus is invested in learning specific tasks, in a specific order, that are evolutionarily necessary for survival during the first hour and beyond.

The effect of labor medications on normal newborn behavior in the first hour after birth: A prospective cohort study.

Background: Skin-to-skin contact after birth between mother and baby has immediate and long-term advantages. Widström's 9 Stages of Newborn Behavior offer an opportunity to evaluate a baby in the natural, expected and optimal habitat. Intrapartum drugs, including fentanyl administered via epidural and synthetic oxytocin (synOT), have been studied in relation to neonatal outcomes with conflicting results.

Skin-to-skin contact the first hour after birth, underlying implications and clinical practice.

Aim: This paper integrates clinical expertise to earlier research about the behaviours of the healthy, alert, full-term infant placed skin-to-skin with the mother during the first hour after birth following a noninstrumental vaginal birth.

Method: This state-of-the-art article forms a link within the knowledge-to-action cycle, integrating clinical observations and practice with evidence-based findings to guide clinicians in their work to implement safe uninterrupted skin-to-skin contact the first hours after birth.

Results: Strong scientific research exists about the importance of skin-to-skin in the first hour after birth.

A plausible causal relationship between the increased use of fentanyl as an obstetric analgesic and the current opioid epidemic in the US.

Drug poisoning deaths have more than doubled in the United States since 2000 with fentanyl and fentanyl analogues primarily responsible for the jump in opioid deaths. Robust data indicate a convincing correlation between the exposure of the fetus to other labor medications (morphine, pethidine hydrochloride, barbiturates, phenobarbitone, meperidine, and secobarbital) and the later addiction of young adults to the same category of drug. We present the hypothesis that this effect is also true of the opioid, fentanyl: there is a causal relationship between the increased popularity of fentanyl as a labor anesthetic in the United States since the 1980's and the current epidemic of fentanyl abuse.

Mapping, Measuring, and Analyzing the Process of Skin-to-Skin Contact and Early Breastfeeding in the First Hour After Birth.

Background: Although the benefits of immediate, continuous, uninterrupted skin-to-skin contact (SSC) and early breastfeeding have been widely researched and confirmed, the challenge remains to improve the consistency of this practice. Fewer than half of newborns worldwide are breastfed in the first hour.

Design: Cross-sectional descriptive study utilizing iterative review and analysis of video ethnography as well as data extracted from patient records.

How Does the United States Rank According to the World Breastfeeding Trends Initiative?

The World Breastfeeding Trends Initiative is an assessment process designed to facilitate an ongoing national appraisal of progress toward the goals of the United Nations Children's Fund (UNICEF)/World Health Organization (WHO) Global Strategy for Infant and Young Child Feeding. More than 80 countries have completed this national assessment, including the United States of America. This article describes the process undertaken by the US World Breastfeeding Trends Initiative team, the findings of the expert panel related to infant and young child feeding policies, programs, and practices and the ranking of the United States compared with the 83 other participating nations.

An implementation algorithm to improve skin-to-skin practice in the first hour after birth.

Evidence supporting the practice of skin-to-skin contact and breastfeeding soon after birth points to physiologic, social, and psychological benefits for both mother and baby. The 2009 revision of Step 4 of the WHO/UNICEF "Ten Steps to Successful Breastfeeding" elaborated on the practice of skin-to-skin contact between the mother and her newly born baby indicating that the practice should be "immediate" and "without separation" unless documented medically justifiable reasons for delayed contact or interruption exist. While in immediate, continuous, uninterrupted skin-to-skin contact with mother in the first hour after birth, babies progress through 9 instinctive, complex, distinct, and observable stages including self-attachment and suckling.

The Association Between Common Labor Drugs and Suckling When Skin-to-Skin During the First Hour After Birth.

Background: Intrapartum drugs, including fentanyl administered via epidural and synthetic oxytocin, have been previously studied in relation to neonatal outcomes, especially breastfeeding, with conflicting results. We examined the normal neonatal behavior of suckling within the first hour after a vaginal birth while in skin-to-skin contact with mother in relation to these commonly used drugs. Suckling in the first hour after birth has been shown in other studies to increase desirable breastfeeding outcomes.

Effect of intermittent kangaroo mother care on weight gain of low birth weight neonates with delayed weight gain.

Objective: To evaluate intermittent Kangaroo Mother Care (KMC) with additional opportunities to breastfeed on weight gain of low birth weight (LBW) neonates with delayed weight gain.

Methods: 40 LBW neonates were followed to see whether KMC with additional opportunities to breastfeed improved weight gain.

Results: In the KMC group, the mean age of regaining birth weight was significantly less (15.

A Realistic Evaluation of Two Training Programs on Implementing Skin-to-Skin as a Standard of Care.

The authors used realistic evaluation to examine the real-world effectiveness of two 5-day training techniques on sustained optimal skin-to-skin practices that support Step 4 of the revised Baby-Friendly Hospital Initiative (BFHI). The authors found that education alone was insufficient to effect sustainable practice change. Exposure to the 5-day immersion model (Practice, Reflection, Education and training, Combined with Ethnography for Sustainable Success, or PRECESS) alone or combined with education was an effective strategy to change and sustain the standard of care for skin-to-skin practice (p < 0.

Evaluation of mothers' knowledge, attitudes, and practice towards the ten steps to successful breastfeeding in Egypt.

Background: Despite the proven effectiveness of the Ten Steps to Successful Breastfeeding of the Baby-Friendly Hospital Initiative (BFHI), its impact on community practices in Egypt has yet to be assessed. The aim of this investigation was to evaluate the knowledge, attitudes, and practice (KAP) of Egyptian mothers towards the Ten Steps. We interviewed 1,052 breastfeeding mothers with infants less than 24 months of age from 12 governorates representing Upper Egypt (UE) and Lower Egypt (LE).

Use of a video-ethnographic intervention (PRECESS Immersion Method) to improve skin-to-skin care and breastfeeding rates.

Purposes: Skin-to-skin care after birth often is absent, interrupted, or delayed for routine procedures. The purposes of this project were to improve skin-to-skin care and exclusive breastfeeding at hospital discharge.

Methods: For Part 1, we used a descriptive observational design, with video-ethnography and interaction analysis (PRECESS-Practice, Reflection, Education and training, Combined with Ethnography for Sustainable Success), during a 5-day quality improvement pilot study in a U.

The effect of kangaroo mother care on the duration of phototherapy of infants re-admitted for neonatal jaundice.

Objective: We investigated the effect of kangaroo mother care (KMC) on the duration of phototherapy of jaundiced neonates.

Methods: Fifty Egyptian newborns hospitalized for jaundice were investigated through a prospective observational study to determine whether intermittent KMC would reduce the duration of phototherapy required.

Results: The babies who received KMC recovered earlier from jaundice and needed a shorter duration of phototherapy than the control group (68.

Effect of components of a workplace lactation program on breastfeeding duration among employees of a public-sector employer.

The purpose of this study was to evaluate the impact of the individual services offered via a workplace lactation program of one large public-sector employer on the duration of any breastfeeding and exclusive breastfeeding. Exclusive breastfeeding was defined as exclusive feeding of human milk for the milk feeding. A cross-sectional mailed survey approach was used.

Latching-on and suckling of the healthy term neonate: breastfeeding assessment.

Increasing breastfeeding duration and exclusivity is an acknowledged public health priority. Breastfeeding problems, especially with the healthy term neonate latching-on or feeding with a suboptimal latch, are common reasons for early breastfeeding termination when they result in inadequate breastfeeding, poor milk transfer, and sore nipples. This article describes clinical strategies for systematic latch-on and suckling assessment with the goal of improving the skills of clinicians who provide care for breastfeeding women.

Pain reduction and treatment of sore nipples in nursing mothers.

Health-promotion goals include increasing the duration of breastfeeding because of its irrefutable advantages to the mother and baby, society, and the environment. However, many mothers experience painful, sore nipples during breastfeeding and stop nursing before they intended (Livingstone & Stringer, 1999). The experimental trial described in this paper randomized 94 breastfeeding women with sore nipples into three treatment groups.

The relationship between positioning, the breastfeeding dynamic, the latching process and pain in breastfeeding mothers with sore nipples.

In recognition of the irrefutable disadvantages of not breastfeeding to the mother, baby, society and the environment, increasing the duration of breastfeeding has become a focus of national and international health objectives. However, many mothers experience such painful sore nipples that they stop breastfeeding before they intended. The purpose of this study is to examine the relationship between various aspects of optimal breastfeeding (e.