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    A complex intervention to support breastfeeding: A feasibility and acceptability study
    (2023)
    Camila Lucchini‐Raies
    ;
    Francisca Marquez‐Doren
    ;
    PÉREZ EWERT, JANET CAROLA  
    ;
    Solange Campos
    ;
    Paulina Beca
    <jats:title>Abstract</jats:title><jats:sec><jats:title>Aims</jats:title><jats:p>The aims of this study are to assess the acceptability and feasibility of a multicomponent intervention to support breastfeeding women and their families and explore its effectiveness.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A pilot study with control and intervention groups was conducted using the complex intervention framework in two primary healthcare centres. Overall, 44 childbearing women, their partners/relatives and 20 healthcare professionals participated in the study. The intervention's feasibility and acceptability were measured. The percentage of exclusive breastfeeding rates and women's self‐efficacy were measured at pre‐intervention, at 10 days postpartum, and again at 2, 4 and 6 months postpartum. Postpartum depression risk was measured at 2 and 6 months postpartum. Professional self‐efficacy was measured at pre‐intervention and 3 months later.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The intervention was feasible and acceptable. No difference in self‐efficacy existed between the intervention and control groups. Preliminary effects of the intervention were found in exclusive breastfeeding percentage and postpartum depression risk in the intervention group.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The intervention is feasible and acceptable. The results are promising not only for breastfeeding maintenance but also for preventing postpartum depression and recovering exclusive breastfeeding during pandemics.</jats:p></jats:sec><jats:sec><jats:title>Trial registration</jats:title><jats:p><jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="http://ClinicalTrials.gov">ClinicalTrials.gov</jats:ext-link> ID: NCT03944642.</jats:p></jats:sec>
      1
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    Salud mental materna y efectos en el recién nacido durante la pandemia por COVID-19
    (2023)
    COO CALCAGNI, SOLEDAD  
    ;
    María Ignacia García
    ;
    Marcia Olhaberry
    <jats:p>Una de las principales consecuencias de la crisis sanitaria por COVID-19 ha sido el deterioro de la salud mental de la población, con variaciones en distintos grupos. En este escenario, la evidencia reporta un mayor riesgo de sintomatología ansiosa y depresiva durante el período perinatal, así como un impacto negativo en el recién nacido. Objetivo: Examinar las diferencias en la salud mental, variables obstétricas y del recién nacido. y experiencia de parto en los sistemas de salud público y privado, en mujeres primíparas chilenas, pre-pandemia y durante la pandemia. Sujetos y Método: Estudio cuantitativo comparando 2 cohortes. La primera incluyó madres con bebés nacidos antes de la pandemia por COVID-19 (N=81) y la segunda, madres con partos durante la pandemia (N = 71). Se evaluaron en ambos grupos antecedentes sociodemográficos y obstétricos, depresión, ansiedad y estrés a partir de cuestionarios de autorreporte. Las diferencias entre grupos fueron evaluadas con ANCOVA, pruebas t y prueba de chi cuadrado. Resultados: Las mujeres con partos durante la pandemia reportaron mayor sintomatología depresiva y sus bebés presentaron menor edad gestacional y, levemente, menor talla que los bebés nacidos antes del COVID-19. Sin embargo, este grupo mantuvo la lactancia exclusiva por más tiempo. No se observaron diferencias en la experiencia de parto entre los grupos, pero sí en relación con el carácter público o privado del hospital donde se atendieron las madres. Conclusiones: La pandemia afectó negativamente la salud mental de las madres, lo que plantea desafíos importantes para la promoción del bienestar emocional de las madres y sus bebés.</jats:p>
    Scopus© Citations 5  1
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    Global research priorities for COVID-19 in maternal, reproductive and child health: Results of an international survey
    (2021)
    Melanie Etti
    ;
    Jackeline Alger
    ;
    Sofía P. Salas
    ;
    Robin Saggers
    ;
    Tanusha Ramdin
    <jats:sec id="sec001"> <jats:title>Background</jats:title> <jats:p>The World Health Organization’s “<jats:italic>Coordinated Global Research Roadmap</jats:italic>: <jats:italic>2019 Novel Coronavirus</jats:italic>” outlined the need for research that focuses on the impact of COVID-19 on pregnant women and children. More than one year after the first reported case significant knowledge gaps remain, highlighting the need for a coordinated approach. To address this need, the Maternal, Newborn and Child Health Working Group (MNCH WG) of the COVID-19 Clinical Research Coalition conducted an international survey to identify global research priorities for COVID-19 in maternal, reproductive and child health.</jats:p> </jats:sec> <jats:sec id="sec002"> <jats:title>Method</jats:title> <jats:p>This project was undertaken using a modified Delphi method. An electronic questionnaire was disseminated to clinicians and researchers in three different languages (English, French and Spanish) via MNCH WG affiliated networks. Respondents were asked to select the five most urgent research priorities among a list of 17 identified by the MNCH WG. Analysis of questionnaire data was undertaken to identify key similarities and differences among respondents according to questionnaire language, location and specialty. Following elimination of the seven lowest ranking priorities, the questionnaire was recirculated to the original pool of respondents. Thematic analysis of final questionnaire data was undertaken by the MNCH WG from which four priority research themes emerged.</jats:p> </jats:sec> <jats:sec id="sec003"> <jats:title>Results</jats:title> <jats:p>Questionnaire 1 was completed by 225 respondents from 29 countries. Questionnaire 2 was returned by 49 respondents. The four priority research themes which emerged from the analysis were 1) access to healthcare during the COVID-19 pandemic, 2) the direct and 3) indirect effects of COVID-19 on pregnant and breastfeeding women and children and 4) the transmission of COVID-19 and protection from infection.</jats:p> </jats:sec> <jats:sec id="sec004"> <jats:title>Conclusion</jats:title> <jats:p>The results of these questionnaires indicated a high level of concordance among continents and specialties regarding priority research themes. This prioritized list of research uncertainties, developed to specifically highlight the most urgent clinical needs as perceived by healthcare professionals and researchers, could help funding organizations and researchers to answer the most pressing questions for clinicians and public health professionals during the pandemic. It is hoped that these identified priority research themes can help focus the discussion regarding the allocation of limited resources to enhance COVID-19 research in MNCH globally.</jats:p> </jats:sec>
      3Scopus© Citations 8
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    Infant Feeding and Information Sources in Chilean Families Who Reported Baby-Led Weaning as a Complementary Feeding Method
    (2021)
    Daiana Quintiliano-Scarpelli
    ;
    Nicole Lehmann
    ;
    Bárbara Castillo
    ;
    Estela Blanco
    <jats:p>Baby-Led Weaning (BLW) is a new and emerging method of introducing complementary feeding in solid consistency, without the use of a spoon and entirely guided by the baby. This study aims to analyze the implementation of the BLW approach in relation to compliance with basic components and sources of information in Chilean families. Using a cross-sectional design, we assessed early nutrition, including breastfeeding and foods offered, maternal/child characteristics and sources of information on BLW among a non-probabilistic sample of mothers of children &lt;24 months who reported practicing BLW (n = 261, median age = 28 years) in Chile. We found that 57.5% of mothers reported their child ate the same food as the family, 44.1% shared ≥3 meals with the family, 84.7% offered ≥3 foods at each meal and 75.6% reported only occasionally offering food with a spoon. The majority reported obtaining information on BLW from social media (82%). Moreover, 56% had offered cookies, 32% added salt and 9% sugar in the first 2 years. Exclusive breastfeeding for 6 months related to higher odds of consuming family foods (OR = 2.45, 95% CI 1.24–4.84), while having received information from professional sources and social media related to lower odds (OR = 0.45, 95% CI 0.22–0.88 and OR = 0.31, 95% CI 0.15–0.66, respectively). Those who had appropriate weight gain had lower odds of consuming ≥3 foods in meals (OR = 0.35, 95% CI 0.13–0.96). Among mothers who reported practicing BLW with their children, we observed a wide variety of feeding habits, sources of information and low compliance with the studied components. Eating the same food as the family was the most prevalent component and social media was the main source of information on BLW.</jats:p>
      6Scopus© Citations 13
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    Scopus© Citations 8  10
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    Trayectoria del desarrollo psicomotor según estado nutricional en niños alimentados con lactancia materna
    (2022)
    Margarita Salinas
    ;
    SCHONHAUT, LUISA  
    ;
    Sergio Muñoz
    ;
    Gerardo Weisstaub
    <jats:p>Objetivo: Describir trayectorias del desarrollo psicomotor (DSM) y nutricionales en niños alimentados con lactancia materna (LM) y evaluar asociaciones. Sujetos y Método: Cohorte prospectiva de lactantes nacidos a término, sin patologías conocidas, alimentados con LM predominante o exclusiva. La ingesta de LM se evaluó con técnica isotópica a los 3 meses. En 6 edades sucesivas se evaluó estado nutricional según índice de masa corporal (IMC) y DSM mediante Ages and Stages Questionnaire (ASQ-3). Se incluyeron niños con al menos 2 evaluaciones de seguimiento. Se realizó análisis multivariado de las trayectorias por dominio o área del DSM según IMC y LM, controlando por variables bio-socio-demográficas. Resultados: Ingresaron 53 niños (60% hombres), 76% eutróficos, 62% alimentados con LM exclusiva. Las trayectorias nutricionales y DSM fueron estables y en rango de normalidad, no hubo lactantes en rango de obesidad. En el análisis multivariado, en el dominio Comunicación, los niños con una trayectoria IMC normal con valores más altos y con LM exclusiva presentaron desarrollo superior (p = 0,049 y p = 0,032). En el área Resolución de Problemas, tener trayectorias de IMC normal con valores más altos se asoció a mejor trayectoria del desarrollo (p = 0,040). No se encontraron asociaciones significativas en las trayectorias de dominios motrices y nutricionales. Conclusión: Las trayectorias nutricionales y del DSM fueron estables y en rangos de normalidad. La LM exclusiva en comparación con la predominante se asoció con mejor trayectoria en Comunicación, mientras que tener valores altos de IMC dentro de la normalidad se asoció con mejor trayectoria en Comunicación y Resolución de Problemas.</jats:p>
    Scopus© Citations 4  1
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    Discrepancies in infant feeding recommendations between grandmothers and healthcare providers in rural Mexico
    (2022)
    Paulina Luna
    ;
    Nerli Paredes-Ruvalcaba
    ;
    Tania Valdes
    ;
    Barbara Guerrero
    ;
    Angélica García-Martínez
    <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Infant feeding practices are rapidly changing within rural areas in Mexico, including indigenous communities. The aim of this study was to compare infant feeding recommendations between grandmothers and healthcare providers, to better understand the factors that may influence these practices within these communities. This study builds on research that recognizes the legacy of colonization as an ongoing process that impacts the lives of people through many pathways, including the substandard healthcare systems available to them.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Qualitative study based on secondary data analysis from interviews and focus groups guided by a socioecological framework conducted in 2018 in two rural, Indigenous communities in Central Mexico. Participants were purposively selected mothers (<jats:italic>n</jats:italic> = 25), grandmothers (<jats:italic>n</jats:italic> = 11), and healthcare providers (<jats:italic>n</jats:italic> = 24) who offered care to children up to two years of age and/or their mothers. Data were coded and thematically analyzed to contrast the different perspectives of infant feeding recommendations and practices between mother, grandmothers, and healthcare providers.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Grandmothers and healthcare providers differed in their beliefs regarding appropriate timing to introduce non-milk foods and duration of breastfeeding. Compared to grandmothers, healthcare providers tended to believe that their recommendations were superior to those from people in the communities and expressed stereotypes reflected in negative attitudes towards mothers who did not follow their recommendations. Grandmothers often passed down advice from previous generations and their own experiences with infant feeding but were also open to learning from healthcare providers through government programs and sharing their knowledge with their daughters and other women. Given the contradictory recommendations from grandmothers and healthcare providers, mothers often were unsure which advice to follow.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>There are important differences between grandmothers and healthcare providers regarding infant feeding recommendations. Healthcare providers may perceive their recommendations as superior given the neocolonial structures of the medical system. Public health policies are needed to address the different recommendations mothers receive from different sources, by harmonizing them and following an evidence-informed approach. Breastfeeding programs need to value and to seek the participation of grandmothers.</jats:p> </jats:sec>
    Scopus© Citations 2  2
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    Deficiencia e insuficiencia de vitamina D en lactantes sanos recibiendo suplementación estándar
    (2022)
    Paulina Bravo
    ;
    Ernesto Navarro
    ;
    Marcela Mora
    ;
    Marlene Calvanese
    ;
    Marianne Taub
    <jats:p>La vitamina D (VD) es indispensable para el metabolismo del calcio y fósforo, su deficiencia puede causar raquitismo. En Chile se suplementa con 400 UI /diarias desde el primer mes hasta el año de vida. Objetivo: Describir las concentraciones plasmáticas de VD en lactantes sanos suplementados y secundariamente, evaluar la asociación del estatus de VD con estacionalidad y estado nutricional. Sujetos y Método: Estudio de corte transversal. Se evaluó a lactantes con lactancia materna exclusiva o mixta que acudían a controles pediátricos mensuales y recibían suplementación de VD a dosis de 400 UI diarias. A los 6 meses de edad se midió la concentración plasmática de VD, el peso y la talla. Posteriormente se clasificó el estado nutricional (peso/edad y peso/talla) según los referentes de la OMS. De acuerdo a la concentración plasmática de VD, se definió como normal ≥ 30 ng/ml, insuficiencia si esta fue entre 20 y 29 ng/ml y deficiencia &lt; 20 ng/ml. Resultados: Se estudiaron 40 lactantes, 40% tuvieron concentraciones de VD insuficientes y 40% deficientes. En el modelo de regresión lineal múltiple, las variables que se asociaron, de modo significativo, con una menor concentración de VD fueron: el periodo del año invierno-primavera (p = 0,007) y el riesgo de desnutrición (p = 0,038). Conclusiones: La frecuencia de deficiencia e insuficiencia de VD es elevada en nuestra población suplementada, dicho déficit es mayor durante el invierno y la primavera y en sujetos con riesgo de desnutrición.</jats:p>
    Scopus© Citations 5  2
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    Scopus© Citations 43  1