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    Disparities in 6 Month Exclusive Breastfeeding in Ghana, Africa: A Scoping Review
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    Abstract:
    Exclusive breastfeeding practice for 6 months is a critical global public health goal. In 2020, only 44% of infants globally, 31% in Central and West Africa, and 43% in Ghana, were exclusively breastfed for the first 6 months of life.To critically evaluate disparities in exclusive breastfeeding practice for 6 months in Ghana.The scoping review was guided by Arksey and O'Malley's (2005) six-stage scoping review process. The online databases of American Psychological Association PsychInfo (APA PsychInfo), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Scopus were searched with keywords inclusive of Ghana, exclusive breastfeeding, breastfeeding, infant feeding, lactation, lactating, and exclusive. Eligibility criteria included full-text, peer-reviewed research articles written in the English language without limitation to specific years. Data were analyzed thematically.Initially, 317 records were identified, and 15 full-text articles were eligible for the scoping review. Four main themes emerged as disparities in exclusive breastfeeding practice in Ghana. The themes were healthcare (prenatal clinic visits, delivery place, exclusive breastfeeding knowledge), personal (maternal age, Human Immunodeficiency Virus status, parity, type of delivery, breast problem), employment (unemployed, formal, or informal sector worker), and sociocultural (ethnicity/region, family support, religious beliefs, cultural practices).Disparities in exclusive breastfeeding in Ghana warrant the collaborative efforts of stakeholders for successful mitigation. Future researchers should explore the role of religion and sociocultural practices to protect, promote, and support 6 months of exclusive breastfeeding in Ghana.
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    Breast milk is considered the normative nutrition for human infants, and exclusive breastfeeding for the first 6 months of life is recommended by several national and global societies. Female physicians are a high-risk group for early unintended weaning. We aimed to assess and compare the most common barriers to successful breastfeeding perceived by female physicians in various stages of training and practice.Female faculty physicians and trainees (medical students, resident physicians, and fellows) affiliated with a large medical university in 2016 were surveyed via an anonymous web-based survey distributed through institutional e-mail lists. The three-item survey assessed role, breastfeeding experience, and perceived barriers to successful breastfeeding. Comparisons between groups were performed using Wilcoxon rank-sum tests or Fisher's exact tests.The survey was distributed to 1,301 women with 223 responses included in analysis. The majority (57%) of respondents had never breastfed; of those, 87% reported plans to breastfeed in the future. Ninety-seven percent of women with breastfeeding experience reported at least one perceived barrier to successful breastfeeding. Trainees identified more barriers compared with faculty physicians (median count 5 versus 3, p = 0.014). No individual barrier reached statistical significance when comparing between faculty and trainees. The most frequently identified barriers to breastfeeding were lack of time and appropriate place to pump breast milk, unpredictable schedule, short maternity leave, and long working hours.Physicians and medical students who breastfeed face occupation-related barriers that could lead to early unintended weaning. Trainees and faculty report similar barriers. Institutional support may help improve some barriers to successful breastfeeding in female physicians.
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    Aim This article provides a concept analysis of anticipatory guidance regarding breastfeeding-related pain and establishes a definition to inform the concept's practical use. Background Breastfeeding-related pain is a barrier to achieving optimal breastfeeding outcomes, which can impede maternal and infant health. Education through anticipatory guidance that addresses breastfeeding-related pain can improve breastfeeding outcomes, but no formal definition is currently available for practitioner use. Design Walker and Avant's protocol for concept analyses was employed. Data Source A comprehensive literature review was conducted using CINAHL, PubMed, Scopus, and OMNI. Search terms included anticipatory guidance, breastfeeding, pediatrics, nursing, and lactating. This identified 379 articles, of which six addressed anticipatory guidance for breastfeeding-related pain. Review Methods Inclusion criteria asked that literature be available in English and published between 2000 and 2020. Results Three key characteristics of anticipatory guidance regarding breastfeeding-related pain were identified: timing, content, and intention. Antecedents included maternal intention to breastfeed and interaction with a healthcare provider. Consequences included improved breastfeeding outcomes, enhanced maternal understanding of challenges, and maternal empowerment in relation to pain management. Conclusions Anticipatory guidance about breastfeeding-related pain can empower women to sustain breastfeeding in spite of challenges, thus prolonging the breastfeeding period, and subsequently improving infant nutrition and health outcomes.
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    Breastfeeding is being abandoned as the preferred feeding method in the early months of baby's life, and many early failures take place among the few mothers who attempt to breastfeed their babies. For that reason, sanitation professionals must encourage breastfeeding and convince mothers to keep it up, at least, for 4-6 months after giving birth. Analysis of pregnancy, delivery and after delivery sociocultural and sanitary conditions may help sanitation workers to elaborate an educational strategy that considers breastfeeding as healthy behavior that should he encouraged. The support of sanitation professionals is considered fundamental for breastfeeding maintenance, and a more profound training of these professionals about every aspect of breastfeeding is necessary. More active sanitary policies supporting this healthy behavior should also be established.
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    Aim: Including fathers in breastfeeding education programs may raise infant breastfeeding rates and durations. The aim of the study was to assess the effect on breastfeeding of breastfeeding education and/or psychosocial interventions in which fathers are included. Method: The study is based on the PRISMA method, the technique that is used in systematic reviews. A search was conducted in the literature over the period November 1, 2021-December 1, 2021 using keywords and without imposing any time restrictions. The databases "PubMed," "Web of Science," Scopus," "Medline," and "CINAHL" were scanned. Results: A total of 462 publications were reached. However, only 7 studies were considered for review on the basis of the inclusion criteria. Six of these 7 studies indicated that the support of the father increased the breastfeeding rate. Conclusions: This review shows that a father's support of breastfeeding improves breastfeeding outcomes. Including fathers in the breastfeeding process and ensuring their active participation increase breastfeeding rates.
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    Abstract Breastfeeding is the most advantageous feeding option for infants, and epidemiological studies provide evidence for its promotion. The objective of this review was to comprehensively delineate the barriers and facilitators of exclusive breastfeeding of infants aged 0–6 months old by mothers in developing countries. A search of CINAHL , MEDLINE and PsycINFO was carried out to retrieve studies from J anuary 2001 to J anuary 2014. Using our inclusion criteria, we selected studies that described barriers and facilitators of exclusive breastfeeding. Qualitative and quantitative studies were considered. Twenty‐five studies involving 11 025 participants from 19 countries were included. Barriers and facilitators of exclusive/full breastfeeding were identified, analysed tabulated and summarised in this review. Maternal employment was the most frequently cited barrier to exclusive breastfeeding. Maternal perceptions of insufficient breast milk supply was pervasive among studies while medical barriers related to illness of mothers and/or infants as well as breast problems, rather than health care providers. Socio‐cultural factors such as maternal and significant other's beliefs about infant nutrition also often constitute strong barriers to exclusive breastfeeding. Despite these barriers, mothers in developing countries often possess certain personal characteristics and develop strategic plans to enhance their success at breastfeeding. Health care providers should be informed about the determinants of exclusive breastfeeding and provide practical anticipatory guidance targeted at overcoming these barriers. In so doing, health care providers in developing countries can contribute to improving maternal and child health outcomes.
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    Бұл зерттеужұмысындaКaно моделітурaлы жәнеоғaн қaтыстытолықмәліметберілгенжәнеуниверситетстуденттерінебaғыттaлғaн қолдaнбaлы (кейстік)зерттеужүргізілген.АхметЯссaуи университетініңстуденттеріүшін Кaно моделіқолдaнылғaн, олaрдың жоғaры білімберусaпaсынa қоятынмaңыздытaлaптaры, яғнисaпaлық қaжеттіліктері,олaрдың мaңыздылығытурaлы жәнесaпaлық қaжеттіліктерінеқaтыстыөз университетінқaлaй бaғaлaйтындығытурaлы сұрaқтaр қойылғaн. Осы зерттеудіңмaқсaты АхметЯсaуи университетіндетуризмменеджментіжәнеқaржы бaкaлaвриaт бaғдaрлaмaлaрыныңсaпaсынa қaтыстыстуденттердіңқaжеттіліктерінaнықтaу, студенттердіңқaнaғaттaну, қaнaғaттaнбaу дәрежелерінбелгілеу,білімберусaпaсын aнықтaу мен жетілдіружолдaрын тaлдaу болыптaбылaды. Осы мaқсaтқaжетуүшін, ең aлдыменКaно сaуaлнaмaсы түзіліп,116 студенткеқолдaнылдыжәнебілімберугежәнеоның сaпaсынa қaтыстыстуденттердіңтaлaптaры мен қaжеттіліктерітоптықжұмыстaрaрқылыaнықтaлды. Екіншіден,бұл aнықтaлғaн тaлaптaр мен қaжеттіліктерКaно бaғaлaу кестесіменжіктелді.Осылaйшa, сaпa тaлaптaры төрт сaнaтқa бөлінді:болуытиіс, бір өлшемді,тaртымдыжәнебейтaрaп.Соңындa,қaнaғaттaну мен қaнaғaттaнбaудың мәндеріесептелдіжәнестуденттердіңқaнaғaттaну мен қaнaғaттaнбaу деңгейлерінжоғaрылaту мен төмендетудеосытaлaптaр мен қaжеттіліктердіңрөліaйқын aнықтaлды.Түйінсөздер:сaпa, сaпaлық қaжеттіліктер,білімберусaпaсы, Кaно моделі.
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    The nationally-recognized Susquehanna Chorale will delight audiences of all ages with a diverse mix of classic and contemporary pieces. The ChoraleAƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚¢AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚€AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚™s performances have been described as AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚¢AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚€AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚œemotionally unfiltered, honest music making, successful in their aim to make the audience feel, to be moved, to be part of the performance - and all this while working at an extremely high musical level.AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚¢AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚€AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚ Experience choral singing that will take you to new heights!
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    Abstract Purpose This systematic review aims to identify factors influencing exclusive breastfeeding (EBF) up to 6 months. Methods The databases including PubMed, MEDLINE, CINAHL, Scopus, EMBASE, CNKI, and WANFANG were searched to retrieve studies. Quantitative research were extracted and the preferred reporting items for systematic reviews were followed. Critical appraisal checklists of Joanna Briggs Institute were used to evaluate the quality of the included studies. Findings A total of 16 papers were eligible for this systematic review, comprising five cohort studies and 11 cross‐sectional studies. Moderate to strong evidence supported that 6‐month exclusive breastfeeding is affected by maternal working status, breastfeeding knowledge, delivery mode, parity, perception of insufficient human milk, mothers’ infant feeding attitude, breastfeeding self‐efficacy, and intention. Conclusions Factors influencing EBF up to 6 months postpartum play a key role in promoting mothers’ health and reducing diseases in their infants. Implications for nursing practice Interventions based on related factors should be developed and taken into practice to assist mothers in exclusive breastfeeding for up to 6 months. Additional studies from different countries in different populations with high quality are needed to provide more reliable and richer findings.
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    Our current culture defines breastfeeding and the use of human breast milk as the preferred criterion standard for infant nutrition. Medical and health professionals have a responsibility to support breastfeeding in the mother-infant dyad. This includes the recognition of anatomical barriers to breastfeeding such as a tongue-tie, ankyloglossia.The purpose of this article is to enrich and expand the clinical knowledge of health professionals about the physical assessment of ankyloglossia and its impact on breastfeeding. Techniques for assessing anterior and posterior ankyloglossia and interventions across the spectrum are discussed. We also explore maternal emotional experiences of breastfeeding an infant with ankyloglossia.A systematic literature search from MEDLINE, CINAHL, and Cochrane databases was performed. The search results consisted of qualitative and quantitative studies performed involving infants with anykloglossia and breastfeeding experiences. Data and findings from the search results were analyzed and reviewed.Ankyloglossia, commonly referred to as tongue-tied, can result in weight loss, painful breastfeeding, and a cessation of breastfeeding prematurely. Depending on severity, interventions to alleviate breastfeeding difficulties can range from a lactation consultation to surgical intervention. The options for treatment and intervention must be discussed thoroughly with caregivers.Thorough assessment of the breastfeeding dyad is essential to discovering ankyloglossia and its role in breastfeeding difficulties. Intervening appropriately can prevent negative outcomes associated with ankyloglossia and breastfeeding.Future studies should be focused on developing universal tools for grading ankyloglossia and the effects of ankyloglossia on speech development. There is also a gap in the knowledge regarding ankyloglossia in the preterm infant and its impact on developing breast and bottle-feeding technique in the neonatal intensive care unit.
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