Effect of Frenotomy on Maternal Breastfeeding Symptoms and the Relationship Between Maternal Symptoms and Problematic Infant Feeding.
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SUBMITTER: Hill RR
PROVIDER: S-EPMC8771742 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Purpose: The purpose of this study was to examine associations between postpartum obsessive-compulsive (OC) symptoms, infant care and feeding worries, and breastfeeding experiences in a sample of postpartum women. Materials and Methods: Women were recruited via an online U.S. research volunteer database and were eligible if they were aged 18-47 years, their primary language was English, they had an infant 2-6 months old, and tried breastfeeding the infant at least once. Participants completed a survey to assess breastfeeding experiences and practices, OC symptoms and other mental health conditions, and demographics. Modified Poisson regression and linear regression were used to estimate associations between clinically elevated OC symptoms, reported thoughts or worries about infant feeding and care, and breastfeeding experiences, problems, and duration. Results: Of 232 participants, 32 (14%) had clinically elevated OC symptoms. These women had more perinatal OC symptoms (scoring 3.6 points higher on perinatal OC symptoms score [95% confidence interval {CI}: 0.4 to 6.9]), including symptoms specific to infant care and feeding [e.g., adjusted relative risk(repeated washing of baby's bottles, bowl, or plate) = 2.37, 95% CI:1.55 to 3.64], and more breastfeeding problems (adjusted β = 0.3, 95% CI: 0.0 to 0.2) than women with fewer OC symptoms. However, they did not report an overall worse breastfeeding experience (adjusted β = 0.4, 95% CI: -9.3 to 10.1). Adjusted models controlled for depressive symptoms. Conclusions: Obsessive thoughts and compulsions were common in this sample and extended to infant feeding activities. These symptoms were associated with more breastfeeding problems. Interactions in mother-infant dyads are critical because of lasting impacts on parent-child relationships and child development. Treating OC symptoms may foster healthier mother-infant relationships.
| S-EPMC8972019 | biostudies-literature
Project description:ObjectiveThe objective of this study was to examine associations of mother and infant salivary cortisol, measured three times over the course of a day, and assess whether these varied by breastfeeding status.MethodsWe conducted a cross-sectional study of 54 mothers and their infants aged 4-11 months. Mothers collected their own saliva and that of their infants upon awakening, 30min after waking and at bedtime. Breastfeeding status was reported by mothers and cortisol level was measured in saliva in μg/dl using standard techniques. We used generalized linear models to evaluate relationships between maternal and infant cortisol levels, and assessed whether the relationship differed by breastfeeding status: formula only compared to partial and full breastfeeding, adjusting for infant sex, race, age, maternal education, and family income.ResultsThirty-four infants received formula only and 20 were either partially or fully breastfed. Breastfeeding was associated with higher household income, higher maternal education, and white race. Cortisol levels were higher among breastfed infants at all three time points. After adjustment, maternal cortisol levels were related with infant cortisol at bedtime only (regression estimate 0.06; 95% CI: 0.10, 1.1; p=0.02). The adjusted association between bedtime maternal and infant cortisol was stronger among breastfeeding dyads than among formula-feeding dyads (regression estimate 1.0; 95% CI: 0.1, 2.0; p=0.04 vs. 0.6; CI: -0.1, 1.3; p=0.10). In addition, we assessed the influence of maternal education and household income in our adjusted model; income strengthened the observed association, whereas maternal education did not change the estimate.ConclusionsBreastfeeding mothers and infants had significant correlations for cortisol at bedtime, while formula-feeding dyads did not. These data suggest that several factors may contribute to cortisol synchrony observed in mother/infant dyads, including the transfer of cortisol in human milk, physical interaction such as skin-to-skin contact, and shared environment. In addition, our findings support household income as a possible contributor.
| S-EPMC4544873 | biostudies-literature
Project description:The gut microbiota plays a crucial role in food allergies. We sought to identify characteristics of the maternal gut microbiota in the third trimester and the infant gut microbiota in early life and the association of these microbiotas with infant food allergy. A total of 68 healthy pregnant women and their full-term newborns were selected from a cohort of 202 mother-infant pairs; among them, 24 infants had been diagnosed with food allergy within 1 year of age, whereas 44 infants were healthy without allergic symptoms. We collected 65 maternal fecal samples before delivery and 253 infant fecal samples at five time points following birth. Fecal samples were microbiologically analyzed using 16S rRNA gene sequencing. Holdemania abundance in the maternal gut microbiota in the third trimester was significantly higher in the non-allergy group than in the food allergy group (P = 0.036). In the infant gut microbiota, Holdemania was only found in meconium samples; its abundance did not differ significantly between the two groups. The change in the abundance of Actinobacteria over time differed between the non-allergy and food allergy groups (FA, P = 0.013; NA, P = 9.8 × 10-5), and the change in the abundance of Firmicutes over time differed significantly in the non-allergy group (P = 0.023). The abundances of genera Anaerotruncus, Roseburia, Ruminococcus, and Erysipelotricaceae were significantly different between the non-allergy and food allergy groups at different time points. Our results showed that maternal carriage of Holdemania during the third trimester strongly predicted the absence of food allergies in infants; there was no correlation between the presence of food allergies and the abundance of Holdemania in the infant gut microbiota. More dynamic fluctuations in phyla Actinobacteria and Firmicutes early in life protect against food allergy. Thus, the enrichment of the infant gut microbiota early in life with short-chain fatty acid-producing bacteria may be beneficial in preventing the development of food allergies in infants.
| S-EPMC9676664 | biostudies-literature
Project description:BackgroundDue to the multiple health benefits of breastfeeding, it is essential to identify factors that may negatively interfere with this healthy practice. Among such factors are postpartum depression (PPD) and maternal satisfaction with breastfeeding. The objective of this study was to evaluate the association between maternal satisfaction with breastfeeding and symptoms of PPD in the first month after childbirth.MethodsThis cross-sectional study nested in a cohort study was conducted in Porto Alegre, Brazil, with 287 puerperal women selected at two maternity hospitals, one public and one private. Women were interviewed at their homes the week after the infant completed 30 days of life. A structured questionnaire was applied, as well as instruments to evaluate maternal satisfaction with breastfeeding (Maternal Breastfeeding Evaluation Scale) and to screen for PPD (Edinburgh Postnatal Depression Scale). The association between higher satisfaction with breastfeeding (outcome) and negative PPD screening test was assessed using Poisson regression with robust variance, adjusting for specific covariables. Adjusted prevalence ratios (aPR) and respective 95% confidence intervals (95%CI) were estimated.ResultsThe prevalence of increased satisfaction with breastfeeding (defined as women with scores above the median) was 47% higher among women who screened negative for PPD when compared to those with a positive result (aPR 1.47; 95%CI 1.01-2.16). This result was adjusted for maternal age and skin color, cohabitation with the infant's father, planned pregnancy, type of delivery, exclusive breastfeeding, and occurrence of breastfeeding problems.ConclusionsThe findings of this study showed an association between higher maternal satisfaction with breastfeeding and absence of PPD symptoms, reinforcing the importance of caring for the mental health of pregnant and puerperal women and paying attention to their satisfaction with breastfeeding.
| S-EPMC7671548 | biostudies-literature
Project description:BACKGROUND:Few studies have examined the role of maternal emotions in breastfeeding outcomes. RESEARCH AIM:We aimed to determine the extent to which positive maternal emotions during human milk feeding at 2 months were associated with time to any and exclusive human milk feeding cessation and overall breastfeeding experience. METHODS:A sample of 192 women intending to breastfeed for at least 2 months was followed from the third trimester until 12 months postpartum. Positive emotions during infant feeding at 2 months were measured using the modified Differential Emotions Scale. Cox proportional hazards regression was used to estimate adjusted hazard ratios (aHR) for time to any and exclusive human milk feeding cessation associated with a 1-point increase in positive emotions. Linear regression was used to estimate the association between positive emotions and maternal breastfeeding experience reported at 12 months. RESULTS:Among those human milk feeding at 2 months, positive emotions during feeding were not associated with human milk feeding cessation by 12 months (aHR = 0.94, 95% CI [0.64, 1.31]). However, among women exclusively human milk feeding at 2 months, a 1-point increase in positive emotions was associated with a 35% lower hazard of introducing formula or solid foods by 6 months (aHR = 0.65, 95% CI [0.46, 0.92]). Positive emotions were associated with a significantly more favorable maternal report of breastfeeding experience at 12 months. Results were similar in sensitivity analyses using maternal feelings about breastfeeding in the first week as the exposure. CONCLUSIONS:A positive maternal emotional experience of feeding is associated with breastfeeding outcomes.
| S-EPMC6832776 | biostudies-literature
Project description:Smartphone use during parent-child interactions is highly prevalent, however, there is a lack of scientific knowledge on how smartphone use during breastfeeding or face-to-face interactions may modulate mothers' attentive responsiveness towards the infant as well as maternal physiological arousal. In the present study, we provide the first evidence for the influence of the smartphone on maternal physiological responses and her attention towards the infant during breastfeeding and face-to-face interactions. Twenty breastfeeding mothers and their infants participated in this lab study during which electrodermal activity, cardiograph impedance, and gaze patterns were monitored in breastfeeding and face-to-face interactions with three conditions manipulating the level of maternal smartphone involvement. We report that mothers' gaze toward their infants decreased when breastfeeding while using the smartphone compared to face-to-face interaction. Further, we show that greater maternal electrodermal activity and cardiac output were related to longer maternal gaze fixation toward the smartphone during breastfeeding. Finally, results indicate that mothers' smartphone addiction levels were negatively correlated with electrodermal activity during breastfeeding. This study provides an initial basis for much required further research that will explore the influence of smartphone use on maternal biobehavioral responses in this digital age and the consequences for infant cognitive, emotional, and social development.
| S-EPMC8500426 | biostudies-literature
Project description:In 2010, the WHO recommended women living with HIV breastfeed for 12 months while taking antiretroviral therapy (ART) to balance breastfeeding benefits against HIV transmission risks. To inform the 2016 WHO guidelines, we updated prior research on the impact of breastfeeding duration on HIV-free infant survival (HFS) by incorporating maternal ART duration, infant/child mortality and mother-to-child transmission data.Using the Cost-Effectiveness of Preventing AIDS Complications (CEPAC)-Infant model, we simulated the impact of breastfeeding duration on 24-month HFS among HIV-exposed, uninfected infants. We defined "optimal" breastfeeding durations as those maximizing 24-month HFS. We varied maternal ART duration, mortality rates among breastfed infants/children, and relative risk of mortality associated with replacement feeding ("RRRF"), modelled as a multiplier on all-cause mortality for replacement-fed infants/children (range: 1 [no additional risk] to 6). The base-case simulated RRRF = 3, median infant mortality, and 24-month maternal ART duration.In the base-case, HFS ranged from 83.1% (no breastfeeding) to 90.2% (12-months breastfeeding). Optimal breastfeeding durations increased with higher RRRF values and longer maternal ART durations, but did not change substantially with variation in infant mortality rates. Optimal breastfeeding durations often exceeded the previous WHO recommendation of 12 months.In settings with high RRRF and long maternal ART durations, HFS is maximized when mothers breastfeed longer than the previously-recommended 12 months. In settings with low RRRF or short maternal ART durations, shorter breastfeeding durations optimize HFS. If mothers are supported to use ART for longer periods of time, it is possible to reduce transmission risks and gain the benefits of longer breastfeeding durations.
| S-EPMC5904528 | biostudies-other
Project description:Breastfeeding rates fall short of public health goals, but barriers are poorly understood. We examined whether excessive sleepiness during pregnancy and the postpartum period was associated with breastfeeding intentions, attitudes, initiation, and continuation in a tobacco-exposed sample participating in a randomized controlled trial to reduce smoke exposure (n = 399). We used the Epworth Sleepiness Scale (ESS) to examine associations between excessive sleepiness in early (12-16 weeks gestation) and late (32 weeks gestation) pregnancy and at 6 months postpartum, with breastfeeding attitudes using the Mitra index, intentions, initiation, and continuation, as well as other infant feeding practices using the Infant Feeding Questionnaire. Logistic regression models adjusted for age, racial/ethnic identity, parity, marital status, and maternal education showed that excessive sleepiness in late pregnancy was associated with less favorable attitudes toward breastfeeding. In addition, in unadjusted models, excessive sleepiness at 6 months postpartum was associated with less of a tendency to use feeding to calm a fussy infant. Excessive sleepiness was not associated with intent, initiation, or continuation of breastfeeding. Assessing excessive sleepiness in late pregnancy may assist in identifying individuals with negative attitudes to breastfeeding and lead to novel approaches to promoting breastfeeding in populations with lower breastfeeding rates.
| S-EPMC10421484 | biostudies-literature
Project description:ObjectivesTo assess the Efficacy of Frenotomy with regard to Breastfeeding and Reflux Improvement (BRIEF) in infants with breastfeeding problems.Materials and methodsA cohort of 175 consecutive breastfeeding women with breastfeeding and reflux problems related to a tongue-tie or lip-tie fulfilling the inclusion criteria was longitudinally followed for 6 months. The effect of frenotomy on these problems was studied by a standardized oral assessment and completing the validated Breastfeeding Self-Efficacy Short Form (BSES-SF), nipple pain score (Visual Analogue Scale, VAS), and Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R) questionnaires pre-frenotomy and at 1 week, 1 month, and 6 months' post frenotomy.ResultsAll 175 women completed the 1-month follow-up and 146 women the 6 months' follow-up. Frenotomy resulted in a significant improvement of BSES-SF, nipple pain score, and I-GERQ-R after 1 week, which improvement maintained to be significant after 1 month for BSES-SF and I-GERQ-R, and after 6 months for I-GERQ-R. The improvements were irrespective of the type lip-tie or tongue-tie underlying the breast feeding and reflux problems. No post-operative complications were observed. About 60.7% of infants still was breastfed 6 months after treatment.ConclusionsFrenotomy is a safe procedure with no post-operative complications and resulting in significant improvement of breastfeeding self-efficacy, nipple pain, and gastro-oesophageal reflux problems.Clinical relevanceFrenotomy of a tongue-tie and or lip-tie can lead to improvement of breastfeeding and reflux problems irrespective of the type of tongue-tie or lip-tie and should be considered by clinicians as a proper tool to resolve these problems if non-interventional support did not help.International trial registerISRCTN64428423.
| S-EPMC8137608 | biostudies-literature
Project description:This study aimed to quantify the relationship between postpartum depression and anxiety, oxytocin, and breastfeeding. We conducted a longitudinal prospective study of mother-infant dyads from the third trimester of pregnancy to 12 months postpartum. A sample of 222 women were recruited to complete the Beck Depression Inventory II and Spielberger State-Trait Anxiety Inventory-state subscale, participate in observed infant feeding sessions at 2 and 6 months postpartum, and provide venous blood samples during feeding. Maternal venous oxytocin levels in EDTA-treated plasma and saliva were determined by enzyme immunoassay with extraction and a composite measure of area under the curve (AUC) was used to define oxytocin across a breastfeeding session. Linear regression was used to estimate associations between postpartum depression and anxiety as predictors and oxytocin AUC during breastfeeding as the outcome at both 2 and 6 months postpartum. Mixed models accounting for correlations between repeated oxytocin measures were used to quantify the association between current depression and/or anxiety symptoms and oxytocin profiles during breastfeeding. We found no significant differences in oxytocin AUC across a feed between depressed or anxious women and asymptomatic women at either 2 or 6 months postpartum. Repeated measures analyses demonstrated no differences in oxytocin trajectories during breastfeeding by symptom group but possible differences by antidepressant use. Our study suggests that external factors may influence the relationship between oxytocin, maternal mood symptoms, and infant feeding.
| S-EPMC8117182 | biostudies-literature