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Auteur Sarah A. Keim
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Comparison of Support for Breastfeeding Beyond 12 Months of Age from Conventional and Alternative Pediatric Primary Care Providers / Sarah A. Keim in Breastfeeding Medicine, Vol. 12, n°6 (Juillet - Août 2017)
Titre : Comparison of Support for Breastfeeding Beyond 12 Months of Age from Conventional and Alternative Pediatric Primary Care Providers Type de document : texte imprimé Auteurs : Sarah A. Keim, Auteur ; Alexis Tchaconas, Auteur Année de publication : 2017 Article en page(s) : pp. 345-350 Langues : Anglais (eng) Catégories : Données scientifiques
Professionnel de santé
Spécialité médicale ou paramédicale
Résumé : "Objective: Conventional medicine pediatric care providers (e.g., pediatricians) have been shown to be influential in women's decisions to initiate and sustain breastfeeding. Alternative pediatric care providers (e.g., naturopaths and chiropractors) may also provide breastfeeding support, but this has not been the subject of prior research. Our objective was to compare breastfeeding mothers' perceptions of support from these two provider types in a large sample of women who breastfed for more than 12 months.
Methods: We conducted a cross-sectional study of 49,091 U.S. women through online questionnaire distributed through peer breastfeeding groups. We used log-binomial regression to compare those who used an alternative pediatric healthcare provider to care for their child to those who used a conventional provider on perceptions of support and key factors influencing the decision to breastfeed for more than 12 months.
Results: Those who used an alternative provider were more likely to discuss breastfeeding (Adj RR = 1.25, 95% CI 1.17–1.33), feel comfortable discussing breastfeeding (Adj RR = 1.17; 95% CI 1.15–1.19), and feel supported by the provider (Adj RR = 1.25; 95% CI 1.23–1.28). However, providers' recommendations were not important factors in these women's decision to breastfeed beyond 12 months of age.
Conclusions: Mothers who used an alternative care provider as their child's primary source of healthcare rated the provider's breastfeeding support more favorable than those who used a conventional provider (usually a pediatrician). Improving breastfeeding support may be one way to retain families in conventional pediatric primary care, and thereby, ensure children receive comprehensive, evidence-based care." [Résumé de l'auteur]
in Breastfeeding Medicine > Vol. 12, n°6 (Juillet - Août 2017) . - pp. 345-350[article]Pediatric Care Providers, Family, and Friends as Sources of Breastfeeding Support Beyond Infancy / Alexis Tchaconas in Breastfeeding Medicine, Vol. 13, n°2 (Mars 2018)
Titre : Pediatric Care Providers, Family, and Friends as Sources of Breastfeeding Support Beyond Infancy Type de document : texte imprimé Auteurs : Alexis Tchaconas, Auteur ; Sarah A. Keim, Auteur ; Debbi Heffern, Auteur ; Andrew Adesman, Auteur Année de publication : 2018 Article en page(s) : pp. 116-122 Langues : Anglais (eng) Catégories : Allaitement long
de 12 à 24 mois
Durée de l'allaitement
Professionnel de santé
Résumé : "Objective: To examine women's perceptions about support from pediatric primary care providers (PCPs), family, and friends for breastfeeding beyond 12 months, which is an increasing common practice.
Study Design: Women who breastfed at least one child beyond 12 months completed an online questionnaire distributed via La Leche League USA (2013). Questionnaire content focused on sources of support for breastfeeding beyond 12 months, support ratings, and participant characteristics. Bivariate statistics and multivariable log-binomial regression compared ratings of support across sources, by PCP sex, and with breastfeeding duration.
Results: Of 48,379 eligible U.S. women, about half discussed their decision to breastfeed beyond infancy with their child's PCP. In contrast, almost all (91.4%) did so with their spouse, partner, or significant other. Women were consistently more comfortable discussing their decision to breastfeed for more than a year with their family and closest friend than they were with their child's PCP (all p < 0.001). Three-fourths of PCPs were rated as supportive, but 11.1% were somewhat or very unsupportive. Female pediatricians received similar ratings as males (adjusted risk ratio = 1.01, 95% confidence interval: 1.00, 1.03). Thirty-eight percent of women who reported their PCP was unsupportive changed PCPs.
Conclusion: Family and PCP support is likely to be important for the growing proportion of U.S. mother–child dyads who are breastfeeding beyond 12 months. Many, but not all, women rated their child's PCP as supportive, and lack of support was a reason women reported for changing PCPs. Evidence-based interventions in primary care to support breastfeeding beyond infancy are needed." [Résumé de l'auteur]
in Breastfeeding Medicine > Vol. 13, n°2 (Mars 2018) . - pp. 116-122[article]Pumping Milk Without Ever Feeding at the Breast in the Moms2Moms Study / Sarah A. Keim in Breastfeeding Medicine, Vol 12, n°7 (Septembre 2017)
Titre : Pumping Milk Without Ever Feeding at the Breast in the Moms2Moms Study Type de document : texte imprimé Auteurs : Sarah A. Keim, Auteur ; Kelly M Boone, Auteur ; Reena Oza-Franck, Auteur Année de publication : 2017 Article en page(s) : pp. 422-429 Langues : Anglais (eng) Catégories : Accouchement prématuré
Durée de l'allaitement
Niveau socio économique
Résumé : "Background: More than 85% of contemporary lactating women in the United States express their milk at least sometimes. Some produce milk exclusively through pumping. We characterized women who pumped but never fed at the breast and compared their infant feeding practices with those of women who fed at the breast with or without pumping.
Subjects and Methods: Study participants were those delivered at Ohio State University Wexner Medical Center in 2011 and completed a questionnaire at 12 months postpartum (n = 478). We used bivariate and multivariate approaches (survival analysis) to compare women who pumped but never fed at the breast with women who fed at the breast with or without pumping.
Results: Women (n = 33, 6.9%) who pumped but never fed at the breast comprised a diverse group but were more likely to have delivered preterm and were of lower socioeconomic status on average. They initiated pumping and formula feeding earlier (median = day 1 after delivery) and were more likely to report difficulty making enough milk compared with women who fed at the breast with or without pumping. They had much shorter total duration of milk production (adjusted hazard ratio = 3.3, 95% confidence interval: 2.1, 5.2) after controlling for clinical and sociodemographic confounders.
Conclusions: Pumping without feeding at the breast is associated with shorter milk feeding duration and earlier introduction of formula compared with feeding at the breast with or without pumping. Establishing feeding at the breast, rather than exclusive pumping, may be important for achieving human milk feeding goals."[résumé de l'auteur]
in Breastfeeding Medicine > Vol 12, n°7 (Septembre 2017) . - pp. 422-429[article]