RESEARCH AIM: This study aimed to explore and understand the challenges for women during induced lactation in Malaysia.
METHODS: This qualitative study was done in 2017 and utilized in-depth interview among women who induced lactation in five states based on five regions in Malaysia [Central Region (Selangor), Northern Region (Penang), Southern Region (Johor), East Coast Region (Kelantan), Malaysia Borneo (Sabah)]. All interviews were consented, audio-recorded then transcribed verbatim, followed by identification of main themes.
RESULTS: Data saturation was achieved after interviewing a total of 23 induced lactation women. Data synthesized using thematic analysis revealed six themes describing the main challenges during the induction process were (1) health condition, (2) work commitment, (3) overexertion, (4) not eligible to take leave, (5) inability to follow the treatment plan, and (6) difficulty attaching the adopted baby to initiate breastfeeding during induced lactation process.
CONCLUSIONS: The challenges faced by women during the process of induced lactation were complex and the induced lactation process requires considerable dedication and determination. The findings of this research will help other women and their spouses/partners comprehend the challenges, obstacles, and support that are needed along the induced lactation process. The Government and other stakeholders have roles in more efforts and programs to help these mothers breastfeed their adoptive child and make them feel more accomplished as women and mothers.
METHODS: A qualitative secondary analysis conducted on 73 WLHIV from all over Malaysia comprised 11 in-depth interviews and 16 focus group discussions. Data were extracted from the original interview transcripts that emerged from the following questions: (1) "What are your experiences as a woman living with HIV in relation to your sexual and reproductive health and rights?" (2) "What are your experiences in accessing contraception?" (3) "What are your day-to-day experiences as a woman living with HIV?" Data were analyzed using thematic analysis.
RESULTS: Four themes emerged from the study findings: "lack of negotiation," "idealism in pregnancy," "coping with restrictions," and "past and future fears." The four themes are grounded in religion, a patriarchal culture, meaning and expectations of motherhood, taking risks and going against medical advice to pursue fertility desires, fear of HIV transmission, and the side effects of contraceptive use.
CONCLUSION: The complexities involved in decision-making regarding contraceptive use revealed how WLHIV may have unresolved reproductive health needs inconsistent with healthcare providers' focus on HIV management and prevention. Suggestions are made for improving the sexual and reproductive health and rights of WLHIV in Malaysia, which include establishing a reproductive health counseling program.
Methods: A comprehensive electronic search was conducted using PubMed, the Library of Congress, Google Scholar, SAGE, and ScienceDirect. The following search keywords were used: adoptive breastfeeding, induced lactation, non-puerperal lactation, extraordinary breastfeeding, and milk kinship. The search was restricted to articles written in English and published from 1956 to 2019. All study designs were included except for practice protocols.
Results: A total of 50 articles about induced lactation were retrieved. Of these, 17 articles identified the experiences of women who underwent induced lactation. The articles included original papers (n=7), reviews (n=5), and case reports (n=5). Four articles were specifically related to Malaysia, and the others were international. These 17 articles concerning the experiences of women who induced lactation will be reviewed based on four themes related to inducing lactation: (a) understanding women's perception of satisfaction, (b) emotional aspects, (c) enabling factors, and (d) challenges.
Conclusion: Identifying a total of only 17 articles on induced lactation published over the last 53 years suggests that the subject is understudied. This review provides emerging knowledge regarding the experiences of women who have induced lactation in terms of satisfaction, emotions, enabling factors and challenges related to inducing lactation.
METHODS: A total of 171 women admitted for elective cesarean delivery at two tertiary hospitals in Kelantan, Malaysia, participated in this study. On day two after cesarean delivery, face-to-face interviews were conducted with the mothers to get information on feeding practice. Descriptive statistics, including simple and multiple logistic regressions, were used for data analysis.
RESULTS: Seventy-three percent of mothers initiated breastfeeding within 1 hour of birth. Approximately 15.8% and 10.5% of mothers initiated breastfeeding within 24 hours and ≥24 hours, respectively. Skin-to-skin contact between mothers and their infants occurred in 77.8% of cases after cesarean delivery. Breastfeeding initiation was significantly associated with skin-to-skin contact (odds ratio [OR], 14.42; 95% confidence interval [CI], 3.58-58.06), mothers who exclusively breastfed during hospitalization (OR, 36.37; 95% CI, 5.60-236.24), and infants who were not sleepy during attempts at breastfeeding (OR, 5.17; 95% CI, 1.32-20.21).
CONCLUSION: Based on our results, it is possible to increase the proportion of mothers initiating breastfeeding within 1 hour among women who undergo elective cesarean delivery. Therefore, it is important that health practitioners educate women beginning in the antenatal period who plan to undergo cesarean delivery by emphasizing the importance of early initiation of breastfeeding.
METHODS: A comparative cross-sectional study was conducted in two tertiary referral hospitals in 2014. Postpartum women with severe morbidity and without severe morbidity who fulfilled the inclusion and exclusion criteria were eligible as cases and controls, respectively. The study population included all postpartum women regardless of their age. Pregnancy at less than 22 weeks of gestation, more than 42 days after the termination of pregnancy and non-Malaysian citizens were excluded. Consecutive sampling was applied for the selection of cases and for each case identified, one unmatched control from the same hospital was selected using computer-based simple random sampling. Simple and multiple logistic regressions were performed using Stata Intercooled version 11.0.
RESULTS: A total of 23,422 pregnant women were admitted to these hospitals in 2014 and 395 women with severe maternal morbidity were identified, of which 353 were eligible as cases. An age of 35 or more years old [Adj. OR (95 % CI): 2.6 (1.67, 4.07)], women with past pregnancy complications [Adj. OR (95 % CI): 1.7 (1.00, 2.79)], underwent caesarean section deliveries [Adj. OR (95 % CI): 6.8 (4.68, 10.01)], preterm delivery [Adj. OR (95 % CI): 3.4 (1.87, 6.32)] and referral to tertiary centres [Adj. OR (95 % CI): 2.7 (1.87, 3.97)] were significant associated factors for severe maternal morbidity.
CONCLUSIONS: Our study suggests the enhanced screening and monitoring of women of advanced maternal age, women with past pregnancy complications, those who underwent caesarean section deliveries, those who delivered preterm and the mothers referred to tertiary centres as they are at increased risk of severe maternal morbidity. Identifying these factors may contribute to specific and targeted strategies aimed at tackling the issues related to maternal morbidity.
METHODS: We searched the Central and MEDLINE databases and went through all the reference lists in the related articles. We also searched for ongoing trials at http://www.who.int/ictrp/en/ and www.clinicaltrials.gov. Randomized controlled trials comparing vitamin D supplementation with a placebo or no treatment in pregnant women published in the English language up to March 2019 were included. Two reviewers extracted data independently using a predefined protocol and assessed the risk of bias using the Cochrane risk of bias tool, with differences agreed upon by consensus. The predefined primary outcome was the number of offspring who had RTIs. The secondary outcome was the presence of measurable serum immunoglobulin E levels.
RESULTS: Three trials involving 3,224 participants (mother-child pairs) met the inclusion criteria and were included in this review. The present analysis reported that maternal supplementation with vitamin D had no effect on RTIs among children (n=1,486 offspring; risk ratio, 0.95; 95% confidence interval, 0.82-1.11; random effects; I2 statistics, 0%).
CONCLUSION: Maternal vitamin D supplementation had no effect on RTIs in children. Therefore, consideration of other prevention methods in this regard is recommended.
METHODOLOGY: Total of 13 menopausal women recruited using a combination of purposive and snowball techniques from two sources, tertiary hospital and local communities in the state of Kelantan, Malaysia. The in-depth semi-structured interview guided was used to explore how they perceived supports provided by their husbands. The data were then analysed using a thematic analysis.
RESULTS: Five (5) themes have emerged which comprises of emotional, instrumental, appraisal, guidance, and sexual supports. One of which was a new theme (sexual intimacy support) that had not been existed previously in other literature reviews.
CONCLUSION: Majority of menopausal women perceived the supports provided by their husband were negative, rather than positive supports that they had hoped. These findings suggest that an education program tool for husbands as a support person is much needed to ensure women walk through the menopause phase in a more meaningful life.
METHODS: We searched the Cochrane Central Register of Controlled Trials and MEDLINE for randomized controlled trials comparing metoclopramide with a placebo, no treatment, or other galactagogue drugs. We included breastfeeding women with term or preterm infants.
RESULTS: We retrieved 164 records from our search of the electronic databases and 20 records from other sources. Eight trials involving 342 lactating women that used metoclopramide were included in this review after assessing the eligibility criteria. The meta-analysis of these trials revealed that metoclopramide did not increase the milk volume of the intervention groups compared to that of the control groups. There was a significant increase in the serum concentrations of prolactin when the mothers were administered metoclopramide. No significant adverse events were reported.
CONCLUSION: Metoclopramide did not improve milk production in lactating women. Therefore, we do not recommend using metoclopramide to increase milk production in lactating women.