Evidence map›Paper›PMID 37940987›Full record

ArticleInternational breastfeeding journal2023

Facilitators, barriers, and key influencers of breastfeeding among low birthweight infants: a qualitative study in India, Malawi, and Tanzania.

Linda Vesel, Emily Benotti, Sarah Somji, Roopa M Bellad, Umesh Charantimath, Sangappa M Dhaded, Shivaprasad S Goudar, Chandrashekhar Karadiguddi, Geetanjali Mungarwadi, Sunil S Vernekar and 25 more

Abstract read
In one paragraph

Article in International breastfeeding journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

35 authors.

Linda VeselAriadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA. lvesel@ariadnelabs.org.
Emily BenottiAriadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Sarah SomjiDepartment of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Roopa M BelladKLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
Umesh CharantimathKLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
Sangappa M DhadedKLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
Shivaprasad S GoudarKLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
Chandrashekhar KaradiguddiKLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
Geetanjali MungarwadiKLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
Sunil S VernekarKLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
Rodrick KisengeDepartment of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Karim ManjiDepartment of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Nahya SalimDepartment of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Abraham SammaDepartment of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Christopher R SudfeldDepartments of Global Health and Population and Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Irving F HoffmanInstitute for Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Tisungane MvaloUniversity of North Carolina Project Malawi, Lilongwe, Malawi.
Melda PhiriUniversity of North Carolina Project Malawi, Lilongwe, Malawi.
Friday SaidiUniversity of North Carolina Project Malawi, Lilongwe, Malawi.
Jennifer TsekaUniversity of North Carolina Project Malawi, Lilongwe, Malawi.
Mercy TsidyaUniversity of North Carolina Project Malawi, Lilongwe, Malawi.
Bethany A CarusoHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Christopher P DugganDepartments of Global Health and Population and Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Kiersten Israel-BallardAriadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Anne Cc LeeDepartment of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Kimberly L MansenMaternal, Newborn, Child Health and Nutrition Program, PATH, Seattle, WA, USA.
Stephanie L MartinDepartment of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Krysten NorthDepartment of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Melissa F YoungHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Eliza FishmanAriadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Katelyn FlemingAriadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Katherine Ea SemrauAriadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Lauren SpigelAriadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Danielle E TullerAriadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Natalie HenrichAriadne Labs at Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Funding

ROLE OF DIETARY CONSTITUENTS ON GENE EXPRESSION IN INTESTINAL EPITHELIUMP30DK040561 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI MARTIN TORRIANI · 1994 to 2026
$31.6M
Patient-oriented Research in Pediatric Diarrheal DiseasesK24DK104676 · NIDDK · BOSTON CHILDREN'S HOSPITAL · PI DUGGAN, CHRISTOPHER P · 2015 to 2019
$903k
The Roles of Perinatal Nutrition, Infection and Inflammation in the Neurodevelopment of Bangladeshi InfantsK23HD091390 · NICHD · BRIGHAM AND WOMEN'S HOSPITAL · PI LEE, ANNE SHEE CC · 2017 to 2021
$864k
Bill & Melinda Gates Foundation OPP1192260NICHD NIH HHS K23 HD091390NIDDK NIH HHS K24 DK104676NIDDK NIH HHS P30 DK040561
6 · The paper itself

Abstract

backgroundLow birthweight (LBW) infants are at increased risk of morbidity and mortality. Exclusive breastfeeding up to six months is recommended to help them thrive through infection prevention, growth improvements, and enhancements in neurodevelopment. However, limited data exist on the feeding experiences of LBW infants, their caregivers and key community influencers. The qualitative component of the Low Birthweight Infant Feeding Exploration (LIFE) study aimed to understand practices, facilitators, and barriers to optimal feeding options in the first six months for LBW infants in low-resource settings.

methodsThis study was conducted in four sites in India, Malawi, and Tanzania from July 2019 to August 2020. We conducted 37 focus group discussions with mothers and family members of LBW infants and community leaders and 142 in-depth interviews with healthcare providers, government officials, and supply chain and donor human milk (DHM) experts. Data were analyzed using a framework approach.

resultsAll participants believed that mother's own milk was best for LBW infants. Direct breastfeeding was predominant and feeding expressed breast milk and infant formula were rare. DHM was a new concept for most. Adequate maternal nutrition, lactation support, and privacy in the facility aided breastfeeding and expression, but perceived insufficient milk, limited feeding counseling, and infant immaturity were common barriers. Most believed that DHM uptake could be enabled through community awareness by overcoming misconceptions, safety concerns, and perceived family resistance.

conclusionThis study fills an evidence gap in LBW infant feeding practices and their facilitators and barriers in resource-limited settings. LBW infants face unique feeding challenges such as poor latching and tiring at the breast. Similarly, their mothers are faced with numerous difficulties, including attainment of adequate milk supply, breast pain and emotional stress. Lactation support and feeding counseling could address obstacles faced by mothers and infants by providing psychosocial, verbal and physical support to empower mothers with skills, knowledge and confidence and facilitate earlier, more and better breast milk feeding. Findings on DHM are critical to the future development of human milk banks and highlight the need to solicit partnership from stakeholders in the community and health system.

Indexed as

Breast FeedingMothersBirth WeightFemaleHumansInfantMalawiTanzaniaBarriersBreastfeedingFacilitatorsInfant feedingLow birthweightQualitative

Identifiers

PMID37940987
PMCPMC10634072

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.