Hospital Infant Formula Discharge PackagesDo They Affect the Duration of Breast-feeding?

Objective: To determine whether the duration of breastfeeding is affected by the contents of the hospital discharge package. Design: A randomized clinical trial with 2 experimental interventions (a discharge package containing a manual breast pump only and a discharge package containing a commercially prepared infant formula and a manual breast pump) and a control group who received a commercially prepared infant formula discharge package only. Sociodemographic characteristics and information concerning prior births (including feeding methods) were obtained from each mother within 48 hours of her infant\u27s birth. Sources of influence on the mother\u27s feeding decision, maternal attitudes concerning breastfeeding, and maternal feeding preferences were also assessed. Participants: The sample consisted of 763 women who had given birth who were admitted to the maternal-fetal unit of a midwestern community hospital. Main Outcome Measures: Information concerning current method of infant feeding was obtained from telephone interviews conducted at 2-week intervals until the infant was 16 weeks old. The data were analyzed using descriptive statistics, multivariate analysis of variance, logistic regression analysis, and survival analysis. Results: The content of the hospital discharge package did not affect whether the mother engaged in exclusive or partial breast-feeding during the 16-week follow-up interval. However, there was some evidence that providing formula samples at discharge from the hospital increased the duration of exclusive breast-feeding compared with providing a manual breast pump. Conclusion: This study does not support the assumption that inclusion of infant formula in hospital discharge packages decreases the duration of breastfeedin

Postpartum-specific anxiety as a predictor of infant-feeding outcomes and perceptions of infant-feeding behaviours: new evidence for childbearing specific measures of mood

Studies of pregnancy-specific anxiety suggest that it is a distinct construct which predicts perinatal outcomes more effectively than other general measures of anxiety. In response, a novel measure of postpartum-specific anxiety (PSAS) has been developed and validated, but it is not yet clear whether it possesses the same predictive power as its pregnancy-specific counterparts. The aim of this short-term prospective study was to (a) test the predictive validity of the PSAS in the context of one specific perinatal outcome, infant-feeding, and (b) examine whether the PSAS may be more efficacious at predicting infant-feeding outcomes and behaviours than the more commonly used general measures. Eight hundred mothers of infants aged between 0 and 6 months completed the PSAS alongside general measures of anxiety and depression at baseline. A subsample (n = 261) returned to complete a follow-up questionnaire examining infant-feeding outcomes and behaviours two weeks later. Hierarchical regression models revealed that the PSAS was associated with lower odds of breastfeeding exclusively, and breastfeeding in any quantity in the first 6 months postpartum. PSAS scores were also significantly associated with infant-feeding behaviours including a lower perceived enjoyment of food, and greater perceived food responsiveness and satiety responsiveness in the infant. As hypothesised, the PSAS was a stronger predictor of infant-feeding outcomes and behaviours than general anxiety and depression. The findings provide evidence for the predictive validity of the PSAS and call for the use of childbearing specific measures of mood when attempting to predict perinatal outcomes. Replication of these findings across other indices of maternal and infant health is now necessary

Diet or exercise, or both, for weight reduction in women after childbirth

Background: Weight retention after pregnancy may contribute to obesity. It is known that diet and exercise are recommended components of any weight loss programme in the general population. However, strategies to achieve healthy body weight among postpartum women have not been adequately evaluated. Objectives: The objectives of this review were to evaluate the effect of diet, exercise or both for weight reduction in women after childbirth, and to assess the impact of these interventions on maternal body composition, cardiorespiratory fitness, breastfeeding performance and other child and maternal outcomes.: Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2012) and LILACS (31 January 2012). We scanned secondary references and contacted experts in the field. We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 30 April 2013 and added the results to the awaiting classification section of the review. Selection criteria: All published and unpublished randomised controlled trials (RCTs) and quasi‐randomised trials of diet or exercise or both, among women during the postpartum period. Data collection and analysis: Both review authors independently assessed trial quality and extracted data. Results are presented using risk ratio (RR) for categorical data and mean difference (MD) for continuous data. Data were analysed with a fixed‐effect model. A random‐effects model was used in the presence of heterogeneity. Main results: Fourteen trials were included, but only 12 trials involving 910 women contributed data to outcome analysis. Women who exercised did not lose significantly more weight than women in the usual care group (two trials; n = 53; MD ‐0.10 kg; 95% confidence interval (CI) ‐1.90 to 1.71). Women who took part in a diet (one trial; n = 45; MD ‐1.70 kg; 95% CI ‐2.08 to ‐1.32), or diet plus exercise programme (seven trials; n = 573; MD ‐1.93 kg; 95% CI ‐2.96 to ‐0.89; random‐effects, T² = 1.09, I² = 71%), lost significantly more weight than women in the usual care group. There was no difference in the magnitude of weight loss between diet alone and diet plus exercise group (one trial; n = 43; MD 0.30 kg; 95% CI ‐0.06 to 0.66). The interventions seemed not to affect breastfeeding performance adversely. Authors' conclusions: Evidence from this review suggests that both diet and exercise together and diet alone help women to lose weight after childbirth. Nevertheless, it may be preferable to lose weight through a combination of diet and exercise as this improves maternal cardiorespiratory fitness and preserves fat‐free mass, while diet alone reduces fat‐free mass. This needs confirmation in large trials of high methodological quality. For women who are breastfeeding, more evidence is required to confirm whether diet or exercise, or both, is not detrimental for either mother or baby

Hospital Infant Formula Discharge PackagesDo They Affect the Duration of Breast-feeding?

Objective: To determine whether the duration of breastfeeding is affected by the contents of the hospital discharge package. Design: A randomized clinical trial with 2 experimental interventions (a discharge package containing a manual breast pump only and a discharge package containing a commercially prepared infant formula and a manual breast pump) and a control group who received a commercially prepared infant formula discharge package only. Sociodemographic characteristics and information concerning prior births (including feeding methods) were obtained from each mother within 48 hours of her infant's birth. Sources of influence on the mother's feeding decision, maternal attitudes concerning breastfeeding, and maternal feeding preferences were also assessed. Participants: The sample consisted of 763 women who had given birth who were admitted to the maternal-fetal unit of a midwestern community hospital. Main Outcome Measures: Information concerning current method of infant feeding was obtained from telephone interviews conducted at 2-week intervals until the infant was 16 weeks old. The data were analyzed using descriptive statistics, multivariate analysis of variance, logistic regression analysis, and survival analysis. Results: The content of the hospital discharge package did not affect whether the mother engaged in exclusive or partial breast-feeding during the 16-week follow-up interval. However, there was some evidence that providing formula samples at discharge from the hospital increased the duration of exclusive breast-feeding compared with providing a manual breast pump. Conclusion: This study does not support the assumption that inclusion of infant formula in hospital discharge packages decreases the duration of breastfeedingThis is an article from Archives of Pediatrics and Adolescent Medicine Journal, July 1997, 151(7); 724-729. DOI: 10.1001/archpedi.1997.02170440086015.</p