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Friesen C.A.,Ball State University | Hormuth L.J.,Indianapolis | Petersen D.,Indianapolis | Babbitt T.,Breastfeeding Center
Journal of Human Lactation | Year: 2015

The Tele-Lactation Pilot Project (TLPP), 1 of 13 community-based breastfeeding projects implemented in Indiana in 2013 using Centers for Disease Control and Prevention grant funds, explored the feasibility of using videoconferencing technology to provide breastfeeding education and support to low-income women by a centrally located International Board Certified Lactation Consultant (IBCLC). The IBCLC was housed at the Breastfeeding Center at the hospital where the women would deliver; the women receiving the education and support were located at an inner-city community health center (CHC) where they received their primary care. The videoconferencing sessions were juxtaposed with the women's regularly scheduled prenatal and postnatal visits at the CHC. After delivery, the lactation consultant visited the mother and infant in person at the hospital to offer additional support. Overall, 35 mothers were served by the TLPP during the 9-month project period. A total of 134 visits (30-45 minutes each) were conducted (3.8 sessions per woman). At the conclusion of the project, interviews with key participants indicated that the tele-lactation videoconferencing sessions were easy to implement, allowed the IBCLC to reach a wider client base, and allowed the women to receive expert support that they might not have otherwise received. Comments indicated that, in addition to providing education and increasing the women's confidence, the tele-lactation sessions appeared to have decreased the mothers' anxiety about the birthing process and the hospital experience. The TLPP demonstrated that incorporating videoconferencing technology into routine care can help foster collaboration among health care providers and provide mothers with continuous, easily accessible breastfeeding education and support. © 2015 International Lactation Consultant Association.

Feldman-Winter L.,Cooper University Hospital | Grossman X.,Boston University | Palaniappan A.,Cooper University Hospital | Kadokura E.,Breastfeeding Center | And 3 more authors.
Journal of Human Lactation | Year: 2012

Background: Most US hospitals distribute industry-sponsored formula sample packs. No research has examined outcomes associated with sample pack removal as part of a hospital intervention to eliminate sample distribution postpartum. Objective: To examine prospectively hospital-based and breastfeeding outcomes associated with removal of industry-sponsored formula sample packs from the hospital. Methods: We enrolled mothers postpartum at Cooper University Hospital, an urban New Jersey hospital, in 2009-2010. For the first 6 months, all women received industry-sponsored formula samples packs (control group); for the next 6 months, all postpartum women received hospital-sponsored bags with no formula at source (intervention group). Research assistants blinded to the design called subjects weekly for 10 weeks to determine feeding practices. Results: We enrolled 527 breastfeeding women (284 control; 243 intervention). At 10 weeks postpartum, 82% of control and 36% of intervention women (P < .001) reported receiving formula in the "diaper discharge bag." Kaplan-Meyer curves for any breastfeeding showed the intervention was associated with increased breastfeeding (P = .03); however, exclusive breastfeeding was not significantly different between intervention and controls (P = .46). In post hoc analysis, receiving no take-home formula in bottles from the hospital was associated with increased exclusive breastfeeding in control (P = .02) and intervention (P = .03) groups at 10 weeks. Conclusion: Although the hospital-branded replacement contained no formula at source, many women reported receiving bottles of formula from the hospital. Change in practice to remove industry-sponsored formula sample packs was associated with increased breastfeeding over 10 weeks, but the intervention may have had a greater impact had it not been contaminated. © The Author(s) 2012.

Burnham L.,Breastfeeding Center | Buczek M.,Christ House | Braun N.,Breastfeeding Center | Feldman-Winter L.,Rowan University | And 3 more authors.
Journal of Human Lactation | Year: 2014

Background: Infant feeding data are often collected retrospectively through maternal report. Validation studies show that maternal report of initiation and duration of any breastfeeding is accurate but that report of duration of exclusive breastfeeding may be less accurate. Objective: This study aimed to compare infant feeding data collected longitudinally throughout the first 6 months of life with maternal report of duration of exclusive breastfeeding collected 2 years postpartum. Methods: Infant feeding data were collected prospectively throughout the first 6 months of life from medical records and maternal report, including maternal 24-hour recall. At 2 years postpartum, we asked mothers of these same infants how long they exclusively breastfed their infants. Their responses were compared to the prospectively collected data. Simple and multiple linear regressions tested for any significant predictors of the difference between the prospectively collected data and maternal report at 2 years. Results: Of the 292 mothers included in the final analysis, only 88 (30.1%) mothers reported a duration of exclusive breastfeeding at 2 years postpartum that matched the prospectively collected data. Sixty-four women reported exclusively breastfeeding for the recommended 6 months (21.9%), but according to the prospectively collected data, only 2 women (0.7%) breastfed exclusively through 6 months. The median difference between the prospectively collected data and maternal report at 2 years was 1 month (IQR, 0-4). Conclusion: In this sample of mothers, report of exclusive breastfeeding practices 2 years after birth was often inaccurate and mothers tended to overestimate duration. © The Author(s) 2014.

Sadacharan R.,Breastfeeding Center | Grossman X.,Breastfeeding Center | Sanchez E.,Breastfeeding Center | Merewood A.,Boston Medical Center
Pediatrics | Year: 2011

OBJECTIVE: To describe trends in the proportion of US hospitals that distribute industry-sponsored formula sample packs between 2007 and 2010. METHODS: This is a follow-up of a 2007 study. In 2007, we surveyed all 50 US states to determine the proportion of hospitals that distributed infant formula samples to new mothers. In 2010, we selected the 10 best-record and 10 worst-record states with regard to industrysponsored formula sample-pack distribution in 2007. We called all hospitals in these 20 states and asked if the maternity service distributed a "formula company-sponsored diaper discharge bag" to new mothers. We also recorded the respondent's job title. RESULTS: We contacted 1239 hospitals in 20 states. In 2007, 14% of these hospitals were sample-pack-free. In 2010, 28% of the same hospitals were sample-pack-free; the proportion of sample-pack-free hospitals per state ranged from 0% (5 states) to 86% (Rhode Island). In the 10 best-record states, the weighted proportion of sample-pack-free hospitals increased by a mean difference of 18% between 2007 and 2010 (P < .0001). In the 10 worst-record states, the weighted proportion of sample-pack-free hospitals increased by a mean difference of 6% (P < .01). CONCLUSION: Most US hospitals continue to distribute industrysponsored formula sample packs, but trends indicate a significant change in practice; increasing proportions of hospitals eliminate these packs. Change was more significant in states where higher proportions of hospitals had already eliminated packs in 2007. Copyright © 2011 by the American Academy of Pediatrics.

Merewood A.,Breastfeeding Center | Grossman X.,Boston University | Cook J.,Boston University | Sadacharan R.,Boston University | And 3 more authors.
Journal of Human Lactation | Year: 2010

The World Health Organizations International Code of Marketing of Breast-Milk Substitutes, as well as most major medical authorities, opposes hospital-based distribution of free infant formula at discharge. The goal of this cross-sectional telephone survey of 3209 US maternity sites, conducted from 2006 to 2007, was to determine the extent of this practice. It was found that 91% of hospitals distributed formula sample packs, and a trend toward discontinuation of the practice was statistically significant (P <.001). It was concluded that most US hospitals distribute infant formula samples, in violation of the WHO Code and the recommendations of organizations including the US Government Accountability Office, the American Academy of Pediatrics, and the Centers for Disease Control and Prevention. © Copyright 2010 International Lactation Consultant Association.

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