Special Issue "Protecting, Supporting and Promoting Appropriate Breastfeeding in the 21st Century"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: 15 December 2021.

Special Issue Editor

Dr. Felix Akpojene Ogbo
E-Mail Website
Guest Editor
Building 3.1.64, Campbelltown Campus, THRI, School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia
Interests: epidemiology; global health; maternal and child health

Special Issue Information

Dear Colleagues,

Current and emerging global evidence shows that strategic interventions in the first 2000 days of life (from conception to age five) play a significant role in child survival, health, development and early life experiences — one of such interventions is appropriate breastfeeding practices.

Optimal breastfeeding ensures the healthy growth and development of children and also increases child survival by preventing the introduction of contaminated prelacteal foods and protecting against diarrheal diseases and respiratory tract infections — two leading causes of preventable global under-five deaths. Appropriate breastfeeding also has numerous benefits for both the mother and her household, including a lower risk for the mother to experience noncommunicable diseases (e.g., breast and ovarian cancers) and improved household productivity from a reduction in the number of child sick days, respectively. It is against the backdrop of evidence that the World Health Organization/United Nations Children’s Fund (WHO/UNICEF) and partners recommend timely initiation of breastfeeding within the first hour of birth and exclusive breastfeeding in the first six months followed by the introduction of safe, age-appropriate and nutritionally adequate complementary foods along with continued breastfeeding until the child is two years and beyond. The concept of appropriate breastfeeding relates to breastfeeding practices that are consistent with current global recommendations.

In 1989, the WHO/UNICEF developed the Ten Steps to Successful Breastfeeding to support breastfeeding initiation and continuation, and a year later, the Innocenti Declaration was endorsed by global policy decision-makers to protect, support and promote breastfeeding. Three decades on, while remarkable improvements in breastfeeding have been made, breastfeeding rates are still below expected levels globally (both between and within countries). Despite the sustained efforts by global health organizations to galvanise broad-based support for breastfeeding, available evidence suggests that only a handful of countries are on track to meet the current global breastfeeding targets.

Understanding the rationale as to why breastfeeding rates in many countries and/or subnational jurisdictions have remained low and identifying opportunities for improvements would be useful to interested stakeholders. Additionally, breastfeeding research efforts that also focus on structural and system factors, as well as programme implementation and evaluation, are needed if we are to increase the availability of breastfeeding evidence to advocates, organisations and communities who aim to protect, support and promote appropriate breastfeeding.

This Special Issue invites submissions of papers that aim to protect, support and promote appropriate breastfeeding in the 21st century.

Dr. Felix Akpojene Ogbo
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (4 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Research

Article
The Effect of a Structured Individualized Educational Intervention on Breastfeeding Rates in Greek Women
Int. J. Environ. Res. Public Health 2021, 18(21), 11359; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111359 - 28 Oct 2021
Viewed by 518
Abstract
Breastfeeding rates remain extremely low in Greece and women with gestational diabetes mellitus and hypothyroidism may experience additional difficulties. The aim of the study was to investigate the effect of a structured individualized lactation educational intervention by a midwife on increasing breastfeeding rates [...] Read more.
Breastfeeding rates remain extremely low in Greece and women with gestational diabetes mellitus and hypothyroidism may experience additional difficulties. The aim of the study was to investigate the effect of a structured individualized lactation educational intervention by a midwife on increasing breastfeeding rates in women with endocrine disorders and low-risk women compared to women receiving standard care, 24 months after delivery. Two-hundred women made up the study population. Half of them were experiencing endocrine pregnancy disorders and 100 women constituted the low-risk pregnancy standard care control group. Women who were breastfeeding exclusively were significantly higher in the midwifery intervention group with endocrine disorders, namely breastfeeding continued at four months (breastfeeding: 20% vs. 12%, exclusive breastfeeding: 50% vs. 26%, p = 0.0228), and at six months after childbirth (breastfeeding: 54% vs. 28%, exclusive breastfeeding: 32% vs. 12%, p = 0.0011), compared to the standard care control group with endocrine disorder. The low-risk midwifery intervention group breastfed at four months (22% vs. 14%, p = 0.0428) and at six months (52% vs. 26%, p = 0.0018) at higher rates compared to the standard care control group. In addition, exclusive breastfeeding was significantly higher in the low-risk midwifery intervention group at four months (46% vs. 20%, p = 0.0102) and six months (38% vs. 4%, p < 0.0001) compared to the standard care control group. This study was the first attempt of a structured midwifery breastfeeding education in Greece and its major contribution reflects a significant positive impact on breastfeeding rates in terms of duration and exclusivity in women with gestational endocrine disorders as well as in low-risk women, and could possibly be applied and instituted in everyday clinical practice to increase the low breastfeeding rates in Greece. Full article
Article
The Association between the Type of Delivery and Factors Associated with Exclusive Breastfeeding Practice among Polish Women—A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2021, 18(20), 10987; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182010987 - 19 Oct 2021
Viewed by 465
Abstract
The type of delivery influences breastfeeding, both in terms of initiation and duration. The aim of the study was to determine the association between the type of delivery and factors associated with exclusive breastfeeding (EBF) practice among Polish women. Data on sociodemographic variables, [...] Read more.
The type of delivery influences breastfeeding, both in terms of initiation and duration. The aim of the study was to determine the association between the type of delivery and factors associated with exclusive breastfeeding (EBF) practice among Polish women. Data on sociodemographic variables, pre-pregnancy weight, height, course of pregnancy, type of delivery and duration of breastfeeding were collected using a Computer-Assisted Web Interview. Of the 1024 breastfeeding women who participated in the study, 59.9% gave birth vaginally and 40.1% gave birth by caesarean section. The chance of starting EBF [OR: 0.478; 95% Cl: 0.274, 0.832] and continuing it for four months [OR: 0.836; 95% Cl: 0.569, 0.949] was lower in the case of caesarean delivery. Starting EBF was negatively affected by pre-pregnancy overweight status and obesity in the case of caesarean delivery. EBF practice for four months was negatively affected by age [18–24 years and 25–34 years], elementary education and average income [2001–4000 PLN] in the case of caesarean delivery. A negative impact on the chance of EBF for six months was also observed for younger age [18–24 years], elementary and secondary education and average income [2001–4000 PLN] in the case of caesarean delivery. There was no association between starting EBF and age, net income, place of living, pregnancy complications or the child′s birth weight category in the case of both subgroups, as well as between education and previous pregnancies in the case of vaginal delivery. These results suggest that women who deliver by caesarean section need additional breastfeeding support. Full article
Show Figures

Figure 1

Article
Delayed Initiation of Breastfeeding and Role of Mode and Place of Childbirth: Evidence from Health Surveys in 58 Low- and Middle- Income Countries (2012–2017)
Int. J. Environ. Res. Public Health 2021, 18(11), 5976; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115976 - 02 Jun 2021
Viewed by 1064
Abstract
Background: Timely initiation of breastfeeding is the first step towards achieving recommended breastfeeding behaviours. Delayed breastfeeding initiation harms neonatal health and survival, including infection associated neonatal mortality. Eighty percent of neonatal deaths occur in the low-and middle-income countries (LMICs), where delayed breastfeeding initiation [...] Read more.
Background: Timely initiation of breastfeeding is the first step towards achieving recommended breastfeeding behaviours. Delayed breastfeeding initiation harms neonatal health and survival, including infection associated neonatal mortality. Eighty percent of neonatal deaths occur in the low-and middle-income countries (LMICs), where delayed breastfeeding initiation is the highest. Place and mode of childbirth are important factors determining the time of initiation of breastfeeding. In this study, we report the prevalence of delayed breastfeeding initiation from 58 LMICs and investigate the relationship between place and mode of childbirth and delayed breastfeeding initiation in each country. Methods: We analysed data from the most recent Demographic and Health Survey (DHS) and Multiple Indicator Cluster Survey (MICS) collected between 2012 and 2017 and reported by 2019. The study sample comprised all women who had a live birth in the 24 months preceding the survey. ‘Delayed’ initiation of breastfeeding was defined using WHO recommendations as starting breastfeeding after one hour of birth. We coded the stratifying variable for the place and mode of childbirth as “vaginal birth at a facility (VBF)”, “caesarean section birth (CSB) “, and “vaginal birth at home (VBH)”. We used respondent-level sampling weights to account for individual surveys and de-normalised the standard survey weights to ensure the appropriate contribution of data from each country. We report the prevalence and population attributable fractions with robust standard errors. The population attributable risk identifies the proportion of delayed initiation that we could avert among VBH and CSB if everyone had the same risk of delaying breastfeeding as in VBF. Results: The overall prevalence of delayed initiation of breastfeeding was 53.8% (95% CI 53.3, 54.3), ranging from 15.0% (95% CI 13.8, 16.2) in Burundi to 83.4% (95% CI 80.6, 86.0) in Guinea. The prevalence of delayed initiation of breastfeeding was consistently high among women who experienced caesarean section births; however, there was no direct association with each country’s national caesarean section rates. The prevalence of delayed initiation among women who experienced VBF was high in Sub-Saharan Africa and South Asia, even though the CSB rates were low. In some countries, women who give birth vaginally in health facilities were more likely to delay breastfeeding initiation than women who did not. In many places, women who give birth by caesarean section were less likely to delay breastfeeding initiation. Population attributable risk percent for VBH ranged from −28.5% in Ukraine to 22.9% in Moldova, and for CSB, from 10.3% in Guinea to 54.8% in Burundi. On average, across all 58 countries, 24.4% of delayed initiation could be prevented if all women had the same risk of delaying breastfeeding initiation as in VBF. Discussion: In general, women who give birth in a health facility were less likely to experience delayed initiation of breastfeeding. Programs could avert much of the delayed breastfeeding initiation in LMICs if the prevalence of delayed initiation amongst women who experience CSB were the same as amongst women who experience VBF. Crucial reforms of health facilities are required to ensure early breastfeeding practices and to create pro-breastfeeding supportive environments as recommended in intervention packages like the Baby-friendly hospital initiative and Early essential newborn care. The findings from this study will guide program managers to identify countries at varying levels of preparedness to establish and maintain a breastfeeding-friendly environment at health facilities. Thus, governments should prioritise intervention strategies to improve coverage and settings surrounding early initiation of breastfeeding while considering the complex role of place and mode of childbirth. Full article
Show Figures

Figure 1

Article
Barriers and Facilitators for Exclusive Breastfeeding in Women’s Biopsychosocial Spheres According to Primary Care Midwives in Tenerife (Canary Islands, Spain)
Int. J. Environ. Res. Public Health 2021, 18(7), 3819; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073819 - 06 Apr 2021
Cited by 1 | Viewed by 1299
Abstract
(1) The objective of our study is to determine, from a primary care midwife’s perspective, which biopsychosocial factors can favour or be detrimental to exclusive breast feeding. (2) The study was carried out in Tenerife (Canary Islands, Spain) and is based on qualitative [...] Read more.
(1) The objective of our study is to determine, from a primary care midwife’s perspective, which biopsychosocial factors can favour or be detrimental to exclusive breast feeding. (2) The study was carried out in Tenerife (Canary Islands, Spain) and is based on qualitative methodology. Twenty in-depth interviews were carried out with midwives working in primary care centres in Tenerife, using a content analysis approach. The transcript data was then encoded following an inductive approach. (3) According to the perceptions of the primary care midwives who were interviewed, the barriers and facilitators that influence exclusive breastfeeding related to the biopsychosocial spheres of women are, at an individual level, the physical and emotional aspects during the postnatal period; at the relationship level, the presence or not of support from the close family and partner; at the community level, the environment and social networks the new mothers may have; and at the work level, characteristics of jobs and early return to work. (4) The findings of our research can help healthcare professionals to approach the promotion and encouragement of exclusive breast feeding at each of the levels studied, with the aim of increasing rates following recommendations issued by The World Health Organization. Full article
Show Figures

Figure 1

Back to TopTop