Annelies Allain has been at the forefront of global efforts to support and promote breastfeeding for more than 30 years. Her accomplishments continue to affect all of us who work with breastfeeding families. Born in the Netherlands in 1945, Annelies Allain-van Elk received a scholarship and completed a BA from the University of Minnesota, Duluth, USA. Back in Europe, she obtained a BA in French language and literature (University of Geneva, Switzerland) as well as a translator's diploma. After 4 years working in West Africa and visits to South America, she returned to Geneva to obtain an MA in development studies. She is fluent in English, French, and Dutch and has working knowledge of Spanish, Portuguese, Italian, and German. Ms. Allain was a co-founder of IBFAN (1979) and the coordinator of IBFAN Europe (1980-1984). In 1984, she moved to Penang, Malaysia, and IBFAN work soon took over as a full-time job. She was instrumental in developing the Code Documentation Centre (1985) and by 1991 it became a foundation (ICDC) registered in the Netherlands. Subsequently, the Centre has trained over 2,000 officials from 148 countries about the International Code, making it the world's top International Code implementation institution. Among her many other education and advocacy activities, Ms. Allain was a co-founder of WABA (1990) and for many years has been a consultant with UNICEF and WHO's Western Pacific Regional Office on International Code implementation and monitoring. In this interview she provides a firsthand account of how most of the major global breastfeeding protection efforts influencing our current situation came into being. (This is a verbatim interview: MA = Maryse Arendt; AA = Annelies Allain.).
INTRODUCTION: Globally many women suffer from depression during pregnancy. This study investigated the impact of antenatal depressive symptoms on the duration of breastfeeding up to 6 months among women in Sabah, Malaysia.
SUBJECTS AND METHODS: A prospective cohort study of 2,072 women was conducted in Sabah during 2009-2010. Participants were recruited at 36-38 weeks of gestation and followed up at 1, 3, and 6 months postpartum. Depressive symptoms were assessed using the validated Malay version of the Edinburgh Postnatal Depression Scale (EPDS). Cox regression analyses were performed to determine the relationship between antenatal EPDS scores and cessation of breastfeeding before 6 months postpartum.
RESULTS: In total, 1,078 (52%) women with complete information on breastfeeding duration were included in the final sample. Approximately 99% of mothers were breastfeeding at discharge, and 87% of them continued to breastfeed at 6 months postpartum. Women with an antenatal EPDS score of 8 or above were twice more likely to stop breastfeeding before 6 months (adjusted hazards ratio=1.95; 95% confidence interval, 1.26, 3.01) than those who scored less than 4 on the EPDS.
CONCLUSIONS: Depressive symptoms during pregnancy appeared to be associated with early breastfeeding cessation for mothers residing in Sabah.
BACKGROUND: Mastitis can be caused by ineffective positioning of the baby at the breast or restricted feeding. Infective mastitis is commonly caused by Staphylococcus Aureus. Incidence of mastitis in breastfeeding women may reach 33%. Effective milk removal, pain medication and antibiotic therapy have been the mainstays of treatment.
OBJECTIVES: This review aims to examine the effectiveness of antibiotic therapies in relieving symptoms for breastfeeding women with mastitis with or without laboratory investigation.
SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (December 2007), the Cochrane Central Register of Clinical Trials (The Cochrane Library 2007, Issue 4), MEDLINE (1996 to 2007) and EMBASE (January 1985 to 2007). We contacted investigators and other content experts known to us for unpublished trials and scanned the reference lists of retrieved articles
SELECTION CRITERIA: Randomized and quasi-randomized clinical trials comparing the effectiveness of various types of antibiotic therapies or antibiotic therapy versus alternative therapies for the treatment of mastitis were selected.
DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. When in dispute, we consulted a third author.
MAIN RESULTS: Two trials met the inclusion criteria. One small trial (n = 25) compared amoxicillin with cephradine and found no significant difference between the two antibiotics in terms of symptom relief and abscess formation. Another, older study compared breast emptying alone as "supportive therapy" versus antibiotic therapy plus supportive therapy, and no therapy. The findings of the latter study suggested faster clearance of symptoms for women using antibiotics, although the study design was problematic.
AUTHORS' CONCLUSIONS: There is insufficient evidence to confirm or refute the effectiveness of antibiotic therapy for the treatment of lactational mastitis. There is an urgent need to conduct high-quality, double-blinded randomized clinical trials to determine whether antibiotics should be used in this common postpartum condition.
Matched MeSH terms: Breast Feeding/adverse effects*
Introduction: Studies have found that breastfeeding problems are associated with negative breastfeeding outcomes. Unfortunately, assessing breastfeeding problems can be quite difficult. The objective of the paper is to share the process of tool development for the assessment of breastfeeding problem in an Indonesian setting. Methods: The development of the tool was a two-stage process, consisting of understanding the range and pattern of breastfeeding problems (through literature review, discussions with lactation experts, and in-depth interviews with nursing mothers) and the production of the tool (through discussions with graphic designers and communication practitioners, pre-testing the tools, and finalising a workable, viable tool). The process led the authors to use flash cards for assessing the breastfeeding problems. Each card consisted of information about age, a code number, an image and a description of the breastfeeding problem. Each set of the flash cards represented an age period of 0-1, 1-3, and 3-6 months. The final flash cards were used in a cross-sectional study of 205 mothers of infants aged 6-12 months in Maros District, South Sulawesi. Results: The flash cards captured patterns of breastfeeding problems experienced by mothers within the first month, such as sore nipple, no milk production, fatigue, breast engorgement, and sleepy baby, or those problems that persisted throughout the six-month period such as infants' refusal to breastfeed and mothers feeling fatigued. The decreasing or increasing magnitude of a problem over time was also reflected in the flash cards. Conclusion: Identification of the dynamic patterns and magnitude of breastfeeding problems was successfully captured with the use of flash cards.
Breastfeeding is the best form of feeding for premature infants. However, mothers with premature delivery are frequently reported to be depressed, and this has been especially the case during the Coronavirus Disease-2019 (COVID-19) pandemic. We aimed to measure the level of breastfeeding attitude and its association with postpartum depression among mothers with premature infants in the Neonatal Intensive Care Unit (NICU) during the COVID-19 pandemic. A total of 248 mothers with a premature infant were observed in this cross-sectional study from the chosen NICUs of government hospitals in Selangor, Malaysia. The Iowa Infant Feeding Attitude Score (IIFAS) and the Edinburgh Postnatal Depression Scale, along with sociodemographic questionnaires, were used to obtain information on the mothers' attitudes towards breastfeeding and the risk of postpartum depression. A higher percentage of mothers had a positive attitude towards breastfeeding (64.9%), with a mean IIFAS score of 66.30 ± 6.92. Meanwhile, about 27% of mothers with premature infants were reported to have high risk of depressive symptoms. Mothers with a high risk of depression were less likely to have a positive attitude towards breastfeeding (OR 0.37, 95% CI 0.199, 0.675) as compared to mothers with a low risk of depression (p < 0.01). We found that there is an association between the risk of depression and the attitude towards breastfeeding. Early identification of maternal mental health problems should be addressed to ensure the willingness of mothers to continue breastfeeding.
Introduction: Initiating and sustaining breastfeeding are influence by many factors including involvement, attitude and support from the partner. Research on breastfeeding mostly investigate maternal factors, although the father’s behaviour and role may influence the success of breastfeeding. Hence, this study aimed to determine the associa- tions of father’s attitude and support with the duration of exclusive breastfeeding new parents. Methods: The study involved 104 new parents in Kuala Lumpur, Malaysia, recruited at three randomly selected antenatal clinics using purposive sampling. Fathers’ breastfeeding attitude was measured using Iowa-Infant-Feeding-Attitude-Scale, whereas paternal support using Subjective Norms and Paternal-Breastfeeding-Influence-Scale questionnaires. Mothers were asked about breastfeeding practice. Results: Exclusive breastfeeding duration rates at six months was 27.9%. The average score for paternal attitude on breastfeeding was 61.0 ±6.3, indicating father’s positive attitude towards breastfeeding. The mean score of paternal breastfeeding supports for subjective norms surrounding breastfeeding and overall support score were 4.3+0.6 and 4.06+0.6, respectively, demonstrating frequent paternal engaging and support in breastfeeding. Duration of exclusive breastfeeding were positively associated with the paternal attitude (β=0.235, p=0.027) and overall mean score for breastfeeding support (β=2.166, p=0.028), but negatively associated with support strategies score (β= -2.203, p=0.026). Conclusion: Overall, paternal support and positive attitude were associated with breastfeeding duration. It is important to increase public awareness on the important roles of fathers during the breastfeeding process such as emphasizing the husband’s role in supporting their wives to breastfeed, as well as the importance of paternal role in caring the baby, especially among new couples.
Analyses previously reported, based on data from the World Fertility Survey (WFS), are replicated here with data from the Malaysian Family Life Survey. Comparison of results, when data limitations inherent in the World Fertility Surveys are reproduced or relaxed, suggests that these limitations cause little distortion, and thus bolsters confidence in the validity of results based on WFS data in which these limitations are inescapable. Generalizations based on the present investigation and on the body of previous work that it tends to validate are presented. Most significantly, these include the greater importance of both breastfeeding and birth spacing under generally unfavorable conditions, the variability of durations to which some benefit of continued breastfeeding persists, and the observation that the great majority of birth-spacing effects operate through some mechanism other than the association of breastfeeding with birth interval lengths.
PIP: Analyses previously reported, based on data from the World Fertility Survey (WFS) are replicated with data from the Malaysian Family Life Survey, based on a stratified probability sample for 1,262 ever-married women 50 years of age in Peninsular Malaysia. Comparison of the results, when data limitations inherent in the WFS are reproduced or relaxed, suggests that these limitations cause little distortion, and thus bolsters confidence in the validity of results based on WFS data in which these limitations are inescapable. Generalizations based on the present investigation and on the body of previous work that it tends to validate are presented. The greater importance of both breastfeeding and birth spacing under generally unfavorable conditions becomes clear. The relationship between breastfeeding and survival for all births, as well as for the last 2 births, emphasized in this model, has a logit coefficint significant at the .01 level for the 1st month of life as well as the period from birth to 1 year. The durations to which some benefit of continued breastfeeding persists, are variable. In countries where the situation generally is more favorable to child survival, as indicated by rates of infant mortality, breastfeeding's positive effects on child survival are less significant. Breastfeeding promotion and continuation should be the goal especially for programs operating among very poor groups. The great majority of birth spacing effects operate through some mechanism other than the association of breastfeeding with birth interval lengths, as indicated by the fact that significant survival advantages are often associated with birth spacing after controlling for breastfeeding
Breast cancer is one of the commonest cancers among women in Malaysia. The relation between lifestyle practices and the risk of breast cancer in Chinese women aged 21-55 years were assessed using data collected from June to October 2001, via a face-to face interview in a case control study in the Breast Clinics of Kuala Lumpur Hospital and University Malaya Medical Centre. A total of 89 cases with breast cancer were compared with 85 controls without the disease. Our study showed that breastfeeding had an odds ratio of 4.43 after adjustment for confounders. The results add to the evidence of a protective association between breast feeding practices and breast cancer particularly among Chinese women receiving treatment at two government hospitals in the Klang Valley.
The advantages of breastfeeding have been well established. The objective of this study was to determine the practice and knowledge of breastfeeding in an urban com-munity and identify the influencing factors. This is a cross-sectional study. All mothers attending the Maternal and Child Health Clinic during the study period, who fulfilled the selection criteria, were included in the study. The mothers were interviewed using a self administered questionnaire. A total of 162 mothers participated in the study. The prevalence of initiating breastfeeding during the first week after childbirth was 93.8%. Breastfeeding was found to be higher among Malay mothers (p value
Study site: a Child Health Clinic in Cheras Baru, Kuala Lumpur