The Effectiveness of the Internet in Improving Breastfeeding Outcomes: A Systematic Review

Breastfeeding is the normal and safest way to nurture an infant, and prolonged exclusive breastfeeding duration to 6 months will yield the greatest gains in optimum infant development. Despite this knowledge fewer than 35% of infants worldwide are exclusively breastfed during the first 4 months of life. With the advent of the Internet has been the development of many varied e-Health interventions. Using the Internet to support breastfeeding is a relatively novel method of health intervention in an area which has traditionally always been face-to-face. The aim of this article is to review the literature on the provision of Internet-based breastfeeding information and support intervention programs. A systematic literature review of current evidence was conducted using the electronic databases CINAHL (via EBSCOhost), Medline, Current Contents, PsycINFO, and Web of Knowledge for English-language publications from 2000 to May 2013. Inclusion criteria limited interventions to those delivered to women of childbearing age who accessed the Internet to source breastfeeding information and support. Only studies reporting breastfeeding outcomes (eg, breastfeeding duration) were included. A total of 1379 articles with citations and abstracts were identified as potentially relevant after searching the identified databases. One study was eligible for inclusion and reported positive outcomes, however methodological issues limit the interpretation of these results. Numerous study limitations and problems with scientific rigor make it difficult to extend study findings to antenatal and postnatal care. More rigorous evidence is needed before breastfeeding Internet interventions replace traditional methods of support and education for women intending to breastfeed

Prevalence and Predictors of Exclusive Breastfeeding among Women in Kilimanjaro Region, Northern Tanzania: A Population Based Cross-Sectional Study.

Exclusive breastfeeding (EBF) is a simple and cost-effective intervention to improve child health and survival. Effective EBF has been estimated to avert 13% - 15% of under-five mortality and contribute to reduce mother to child transmission of HIV. The prevalence of EBF for infant less than six months is low in most developing countries, including Tanzania (50%). While the Tanzania Demographic Health Survey collects information on overall EBF prevalence, it does not evaluate factors influencing EBF. The aim of this paper was to determine the prevalence and predictors of exclusive breastfeeding in urban and rural areas in Kilimanjaro region. A population-based cross-sectional study was conducted between June 2010 to March 2011 among women with infants aged 6-12 months in Kilimanjaro. Multi-stage proportionate to size sampling was used to select participants from all the seven districts of the region. A standardized questionnaire was used to collect socio-demographic, reproductive, alcohol intake, breastfeeding patterns and nutritional data during the interviews. Estimation on EBF was based on recall since birth. Multivariable logistic regression was used to obtain independent predictors of EBF. A total of 624 women participated, 77% (483) from rural areas. The prevalence of EBF up to six months in Kilimanjaro region was 20.7%, without significant differences in the prevalence of EBF up to six months between urban (22.7%) and rural areas (20.1%); (OR = 0.7, 95% CI 0.5,1.4).In multivariable analysis, advice on breastfeeding after delivery (Adjusted odds ratio, AOR = 2.6, 95% CI 1.5, 4.6) was positively associated with EBF up to six months. Compared to married/cohabiting and those who do not take alcohol, single mothers (AOR = 0.4, 95% CI 0.2, 0.9) and mothers who drank alcohol (AOR = 0.4, 95% CI 0.3, 0.7) had less odds to practice EBF up to six months. Prevalence of EBF up to six months is still low in Kilimanjaro, lower than the national coverage of 50%. Strengthening of EBF counseling in all reproductive and child health clinics especially during antenatal and postnatal periods may help to improve EBF rates

The effect of low-to-moderate-dose ethanol consumption on rat mammary gland structure and function and early postnatal growth of offspring

High levels of alcohol consumption during pregnancy can lead to growth deficits in early postnatal life. However, the effects of low to moderate alcohol consumption during pregnancy are less clearly defined. The aim of this study was to determine if low-moderate ethanol (EtOH) consumption throughout pregnancy in the rat alters maternal mammary gland morphology and milk protein levels, thereby affecting lactation and the growth of pups after birth. Sprague-Dawley rats were fed an ad-libitum liquid diet ± 6% v/v EtOH throughout pregnancy. Mammary glands from dams were collected at embryonic day (E) 20 or postnatal day (PN) 1 and expression of milk proteins (α-lactalbumin, β-caesin and whey acidic protein) examined. In addition, relative amounts of alveoli, lactiferous ducts, adipose tissue and blood vessels were determined at PN1. A subset of rats littered down and offspring growth and milk intake recorded. Mammary gland weight was unaltered by EtOH and stereological analysis showed no differences in gland structure compared to Control. Although there were no significant changes in mammary gland gene expression at the RNA level, protein levels of α-lactalbumin were increased and whey acidic protein were decreased by EtOH. Offspring of EtOH-fed dams consumed less milk than controls in the lactational period however, this did not alter their early postnatal growth. Overall, it appears that low-moderate dose prenatal EtOH exposure does not significantly alter mammary gland development but may alter the composition of the various proteins found within the milk in a manner that maintains overall pup growth