Counseling on the risks of artificial teats nipples and pacifiers Percent of breastfeeding mothers who are taught or shown how to… …understand the use and risks of artificial nipples and pacifiers. Step Discharge. Connect with Nutrition, Physical Activity, and Obesity. To receive email updates about this topic, enter your email address. Email Address. What's this?
Division of Nutrition, Physical Activity, and Obesity. Related Topics. Links with this icon indicate that you are leaving the CDC website. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
You will be subject to the destination website's privacy policy when you follow the link. CDC is not responsible for Section compliance accessibility on other federal or private website.
Cancel Continue. Indicates whether your hospital has a policy requiring… …documentation of medical justification or informed consent for giving non-breast milk feedings to breastfed newborns. Indicates which competency skills are required of nurses: — Placement and monitoring of the newborn skin-to-skin with the mother immediately following birth.
Assesses whether formal assessment of clinical competency in breastfeeding support and lactation management is required of nurses. After vaginal delivery, percent of newborns who remain in uninterrupted skin-to-skin contact with their mothers immediately after birth… …if breastfeeding, until the first breastfeeding is completed.
Email Address. What's this? Division of Nutrition, Physical Activity, and Obesity. Related Topics. Links with this icon indicate that you are leaving the CDC website.
Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
Try out PMC Labs and tell us what you think. Learn More. Midwives were able to score a breast feed consistently using the BBAT and felt that it helped them with advice to mothers about improving positioning and attachment to make breast feeding less painful, particularly with a tongue-tied infant.
The tool showed strong correlation with breast feeding self-efficacy, indicating that more efficient breast feeding technique is associated with increased confidence in breast feeding an infant. Accurate assessment is essential to ensure enhanced breast feeding efficiency and increased maternal self-confidence.
Further research is needed to establish its wider usefulness. The drop off in rates is mostly explained by early feeding difficulties causing introduction of bottles, with the highest levels of problems being experienced by those who used a combination of breast feeding and artificial milk in a bottle.
These studies noted a range of difficulties including poor latch, nipple trauma and inability to feed continuously, all problems which can contribute to mothers feeling that they have insufficient milk and consequently shortening the duration of breast feeding Marmet et al.
The surgical division of tongue tie frenotomy in the early postnatal period aims to improve breast feeding and has become increasingly popular in the UK in recent years, however there is widespread controversy over its effectiveness Messner and Lalakea, Research addressing this issue is hampered by a lack of effective tools both to assess breast feeding and the severity of tongue-tie in sufficient detail. A systematic review Webb et al. Buryk et al. However others have suggested that these assessment tools are too broad to show differences in pre- and post-frenotomy breast feeding scores and that other more subjective assessment should be used Griffiths, In our randomised trial of women comparing breast feeding scores before and after frenotomy we also used both LATCH and IBFAT and found no differences in scores between the intervention frenotomy performed and comparison groups Emond et al.
We concluded that these tools were not sensitive enough to record the changes in breast feeding that might occur following frenotomy, particularly in the details of optimum positioning and attachment to the breast. Psychosocial factors have been shown to have positive correlation with the duration of exclusive breast feeding. A review exploring the psychological correlates of exclusive breast feeding reported on eight studies de Jager et al.
It is important because mothers who feel self-confident about their ability to breast feed successfully are more able to overcome barriers to breast feeding Entwistle et al. During our trial study period we were able to develop and test a tool which we felt might more accurately reflect the effectiveness of a breast feed, the Bristol Breastfeeding Assessment Tool BBAT. This paper reports on the development of the BBAT and its comparison with the previous breast feeding assessment tools.
The tool elements included were:. Achieving all of these and no advice being needed was scored as good 2. Attachment : the infant showed positive rooting; had a wide open mouth; achieved a quick latch with a good amount of breast tissue in the mouth; and stayed attached with a good latch throughout feed. Achieving all of these points scored 2. Sucking : able to establish effective sucking pattern on both breasts initial rapid sucks then slower sucks with pauses ; infant ends feed.
A score of 2 was given if an effective sucking pattern was achieved. Swallowing : audible, regular soft swallowing with no clicking was given a score of 2. Comfort : mother reports breasts and nipples comfortable; no visible damage. This combination of mother report with visible inspection of the nipples was only scored as 2 if she reported complete comfort with no obvious damage. The main aim was to develop an assessment tool that could be used effectively and consistently by midwives, lactation consultants, breast feeding counsellors and others assessing breast feeding as a measure of breast feeding proficiency both for research studies and in practice more generally.
We also wanted the tool to enable comparison before and after a procedure such as frenotomy, or to compare a breast feeding dyad at different time points, whilst keeping it simple and easy to use.
During the BBAT assessments, breast feeds were documented. One hundred and six breast feeds were observations from 48 mother—infant dyads who were part of the feasibility trial Emond et al. Some of the assessments in the trial were for the same infant at different time points after frenotomy or several days later. During the trial, infants who were under two weeks old and experiencing breast feeding difficulties thought to be due to tongue-tie were referred to the research team midwives Emond et al.
The BBAT was developed and introduced part way through recruiting infants into the trial. Forty-one paired assessments were obtained from seven midwives who had been taught the BBAT. All statistical analysis was carried out in SPSS. Mann Whitney non-parametric tests were used to test for differences between the groups in the trial. An intraclass correlation coefficient was used to assess the consistency in BBAT scores obtained from pairs of assessors for 41 breast feeds carried out by 34 different mother—infant pairs.
Seven different assessors were involved in these comparisons. Midwives were interviewed to explore their views of using the tool in their clinical practice. A short telephone interview was conducted by the trial manager or senior researcher, recorded and transcribed. Content analysis methods Julien, were used to code the text and the codes were grouped together under the categories of using the tool, teaching it to others and its use in daily practice.
Two researchers coded the interviews and agreed the categories emerging from the texts. Comments made by the midwives are reported to illustrate views of the wider group of midwives and not just those who were involved in developing the tool. BBAT scores were recorded for assessments within the trial and a further not in the trial giving a total of assessments.
The internal consistency and correlations are shown in Table 1. For of the BBAT assessments, self-efficacy was also recorded and 41 breast feeds were assessed by two midwives together. These scores were recorded after a short period of discussion between each midwife and the main assessor during which they agreed the interpretation of the levels of scoring.
The final BBAT showed a strong and significant correlation 0. In the trial of frenotomy for tongue-tie, we showed that mothers whose infants were randomised to the intervention group to have an immediate frenotomy had a significantly greater increase in self-efficacy using the BSES-SF over the following five days compared to the usual care group who did not have a frenotomy Emond et al.
Change in scores for Bristol Breastfeeding Assessment Tool for some trial participants and for Breast feeding Self-Efficacy for all trial participants. It was not possible to explore the longer relationships between BBAT and breast feeding self-efficacy in the non-trial mothers. All seven midwives who routinely used the BBAT in their daily practice were interviewed and their comments illustrate that they all found the elements of the tool self-explanatory, it was easy to use and helped them with their advice to mothers, particularly around positioning and attachment:.
I would use it for checking breastfeeding, perhaps if a baby was readmitted for weight loss and I would observe a breastfeed using the tool — to remind me about all the positioning and attachment points. The positioning and attachment elements help me to clarify my advice, they help to trigger conversations about what to tell mothers to improve the feed. The mother feels the feed is more comfortable and so feels better.
It is good for evaluating general breastfeeding — good for Mums to look at to evaluate the breastfeed to work out what might be improved MW 5. They found it easy to teach to others and to achieve similar scores to other assessors when watching a breast feed together:.
I found the tool easy to use; a fast learning process; my scores were similar to others using the tool.
0コメント