Abstracts from The Academy of Breastfeeding Medicine 23 rd Annual International Meeting San Francisco, California November 14–17, 2018
2018; Mary Ann Liebert, Inc.; Volume: 13; Issue: S2 Linguagem: Inglês
10.1089/bfm.2018.29106.abstracts
ISSN1556-8342
Tópico(s)COVID-19 Impact on Reproduction
ResumoBreastfeeding MedicineVol. 13, No. S2 AbstractsFree AccessAbstracts from The Academy of Breastfeeding Medicine 23rd Annual International Meeting San Francisco, California November 14–17, 2018Published Online:12 Oct 2018https://doi.org/10.1089/bfm.2018.29106.abstractsAboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail Platform Abstracts1. IMPROVING PERFORMANCE: A MULTIDISCIPLINARY APPROACH TO NICU BREAST MILK UTILIZATIONKrishnan Ravi1, Tumbaga Purificacion1, Ahmad Irfan2, Leeper Shawna1, Mott Stacy1, Nordeck Jessica1, Mieir Lisa1, Johnson Wendy1, Stephens Cathy1, Straw Nora11Providence St Joseph Health, St Mary Medical Center, Apple Valley, USA2CHOC, Orange, California, USACategory: Quality Improvement AdvocacyBackground: Breast milk utilization at our hospital is below the recognized standard based on CPQCC and VON, which can potentially lead to poor patient outcomes.Objective(s): To increase the percentage of breast milk usage at discharge by 10% from baseline of 52.84% to 62.84% by December 2017 for all infants admitted to the NICU.Materials/Methods: Multidisciplinary team was established, and processes developed, PDSA cycles initiated and audited. Processes developed included breast pump initiation within 12 hours of NICU admission, lactation consult including hand expression education, referral to Mommy and Me Breast Feeding Support Clinic and prescription for multivitamins.Results: Breast pump initiation improved from a baseline of 33 to 86% after first and 92% after the second PDSA cycle. Lactation consult including hand expression reached 100%. Physician prescription for multivitamins went up from 52 to 86%. Physician referral to Mommy and Me clinic went from 93 to 100%. Any Breast milk within 24 hours of discharge improved from 52.84 to 62.84%.Conclusions: Improved HealthStream nursing education during first PDSA cycle and lactation audits in second PDSA cycle led to improvements in breast pump use. Lactation service was very successful in initiating hand expression and physicians were able to make referrals to breast feeding support clinic for all our babies. This led to significant improvements in use of breast milk at discharge for our preterm babies. Regular audits, staff education and teamwork were the key drivers to success. Our future goals include breast pump initiation within 6 hours rather than 12 hours, ongoing education for NICU staff, lactation follow up survey for ongoing lactation support, lactation education and support discussed during antenatal consults, monitoring of colostrum usage and studying the impact of the donor human breast milk program for our ISAM babies.2. ANALGESIC EFFECT OF BREAST MILK COMPARED TO ORAL SUCROSE SOLUTION IN NEONATES LESS THAN 33 WEEKS GESTATIONAL AGE UNDERGOING MINOR PAINFUL PROCEDURES: A RANDOMIZED, SINGLE-BLIND TRIALDina Pele1, Hummel Patricia1, Naber Margaret1, Weiss Marc1, Sajous Christine11Loyola University Medical Center, Maywood, Illinois, USACategory: ResearchBackground: In the NICU, premature neonates are exposed to average of 34 painful procedures in the first two weeks of life. Heel lance or heel sticks are the majority of those painful procedures. Studies showed that exposure to pain at this young age can generate short- and long-term effects. Pharmacologic and non-pharmacologic interventions for pain management in neonates have been studied extensively. Although there have been limited studies in late preterm infants, this is the first complete study in preterm neonates less than 33 weeks gestational age.Objective(s): The purpose was to compare the analgesic effect of breast milk (either maternal or donor) to oral sucrose solution (24%) in neonates less than 33 weeks gestational age (GA) undergoing heel lance in the NICU.Materials/Methods: In this randomized single blind control cross over study, preterm neonates were randomized to receive breast milk or sucrose for the first heel lance, crossing over to the other for the second, and continuing to alternate for a total of 4 separate heel lances. The amount of analgesic was GA specific. The primary outcome was the Neonatal Pain, Agitation and Sedation Scale (N-PASS) score. The secondary outcomes were Premature Infant Pain Profile (PIPP) score and heart rate. Multivariable linear mixed effects model was used. The study had an 80% power to detect a 1-point difference in N-PASS score.Results: We enrolled 46 neonates 25 to 32 weeks. 21 neonates were randomized to receive breast milk first and 25 neonates were randomized to receive sucrose first. Groups were similar with regard to demographics. Neonates receiving breast milk had higher N-PASS scores on average than those receiving sucrose (p = .036). While, neonates receiving breast milk had comparable PIPP scores and heart rate to those neonates receiving sucrose. Neonates receiving breast milk had duration of cry that was 13.59 seconds longer than those receiving sucrose.Conclusions: Although statistically significant, the small difference in N-PASS score between the groups is not clinically significant.3. THE CONTRIBUTION OF MATERNAL OBESITY TO FORMULA USE IN A BABY-FRIENDLY HOSPITALWard Laura1, Colling Kristina2, Beck Anita3, Nommsen-Rivers Laurie21Cincinnati Children's Hospital Medical Center, Cincinnati, USA2University of Cincinnati College of Allied Health Science, Cincinnati, Ohio, USA3Mercy Hospital Anderson, Cincinnati, Ohio, USACategory: ResearchBackground: Maternal obesity is a risk factor for poorer breastfeeding outcomes. The contribution of obesity to medically necessary, versus elective, formula use in Baby-Friendly Hospitals is unknown.Objective(s): To determine if maternal obesity contributes to: 1) elective formula use, and 2) medically necessary formula use, in the context of a Baby-Friendly Hospital.Materials/Methods: We examined formula use at a community hospital serving eastern Cincinnati. We included all singleton, term deliveries in 2016 after excluding implausible data, and infants who were growth-restricted, transferred, expired, or born to a surrogate. We defined elective formula use as formula given per maternal request, and medically necessary formula as formula given due to excess weight loss, hyperbilirubinemia, hypoglycemia, or low urine output. We used logistic regression to determine the adjusted odds ratio and 95% confidence interval (aOR [95%CI]), for formula use according to BMI class and obesity status. We adjusted for covariates associated with formula use, and further adjusted for mediators between obesity and formula use.Results:1,588 mother-baby pairs met inclusion criteria (42% obese). Overall, 33% of mothers elected to use formula, with significantly higher use in Class III Obesity versus normal BMI after adjusting for covariates (2.4 [95% CI 1.5–3.7]), but not different across other BMI categories. Of the remaining 1,069 mothers, medically necessary formula was used in 99 infants (9.2%). Obesity significantly increased the risk for medically necessary formula, after adjusting for covariates (2.6 [1.7–3.9]) and covariates plus mediating conditions caused by obesity (1.7 [1.1–2.8]).Conclusions: Elective formula use was high across all BMI categories, indicating need for prenatal education on exclusive breastfeeding. Among mothers who attempted exclusive breastfeeding, obesity indirectly or directly increased medically necessary formula by 33%.4. COMPARING THE ANALGESIC EFFECTS OF FOUR NONPHARMACOLOGICAL INTERVENTIONS ON TERM NEWBORNS UNDERGOING HEEL LANCEChang Jie1, Nasr Annette1, Filoteo Lourdes11Stanford Children's Health, Palo Alto, USACategory: ResearchBackground: Healthy newborns are subject to many painful interventions yet, managing this pain using non-pharmacologic mechanisms are not standards of practice.Objective(s): The purpose of this study is to compare the analgesic effects of four non-pharmacological interventions: skin-to-skin contact, breastfeeding, oral sucrose and nonnutritive sucking in newborns receiving a heel lance procedure.Materials/Methods: This study was a randomized control trial that used the Neonatal Pain, Agitation, and Sedation Scale (NPASS), developed and validated by Hummel et al. 2004, as a pain evaluation tool (1). 226 infants were assigned to either a control group without pain intervention (50) or one of the four intervention groups (176).Results: The intervention groups demonstrated a significantly reduced N-PASS score when compared to the control group (P < 0.01). Oral sucrose showed a superior analgesic effect than skin-to-skin contact group (P < 0.01)), but no statistical significance comparing with breastfeeding (P > 0.05), and nonnutritive sucking (P > 0.05). The intervention groups also showed a significant reduction in the duration of newborns' crying time during the procedure (P < 0.01), and the overall time to perform the heel lance (P < 0.01).Conclusions: Breastfeeding, oral sucrose, non-nutritive sucking and skin to skin contact all have analgesic effects for newborns undergoing a minor painful procedure. They are clinically applicable, acceptable, with a minimal side effect profile. Providing a pain intervention also aids to shorten the duration of performing procedures and reduces newborn crying time.5. MACRONUTRIENT VARIABILITY IN HUMAN MILK FROM DONORS TO A MILK BANK: IMPLICATIONS FOR FEEDING PRETERM INFANTSHamilton-Spence Erin1, Perrin Maryanne2, Maillart Lisa3, Sun Ruichen3, Schaefer Andrew41Mother's Milk Bank of North Texas, Fort Worth, Texas, USA2University of North Carolina Greensboro, Greensboro, USA3University of Pittsburgh, Department of Industrial Engineering, Pittsburg, Pennsylvania, USA4Rice University, Department of Computational and Applied Mathematics, Houston, Texas, USACategory: Human Milk CompositionBackground: The composition of human milk varies widely. This impacts the ability to meet nutrient requirements with fortification for preterm infants.Objective(s): The objective of this study is to describe factors impacting human milk composition and determine how macronutrient variability in pooled donor milk influences the ability to meet target nutrient intake with commercial fortifiers.Materials/Methods: This is a retrospective, observational study that analyzes the macronutrient data of 1,289 human milk samples from 524 individual donors to a milk bank. We simulate a random pooling of multiple donors to model the impact of macronutrient variability on pooled donor milk. Additionally, we test fortification strategies with potential basic, intermediate, and high protein and calorie commercial fortifiers.Results: Over 75% of mature milk samples fortified with a basic protein fortifier did not meet protein targets of 3.5 g/kg without exceeding volumes of 160 ml/kg/day. Fat was the most variable nutrient and accounted for 80% of the difference in calories. A subject-effect predicted more of the variability after 4 weeks postpartum in all macronutrients (R2 > = 0.50) than a time-effect (R2 < = 0.26). When pooling multiple donors, variability was reduced by increasing the number of donors randomly selected for a pool or targeted pooling based on donor macronutrient profiles.Conclusions: There is a strong individual signature to human milk that impacts the pooling of donor milk, and the ability to meet protein and energy requirements for the preterm infant with basic and intermediate protein and calorie fortifiers.6. DECREASED HUMAN MILK GLUCOSE AT 1 MONTH PREDICTS CESSATION OF EXCLUSIVE BREASTFEEDING BY 3 MONTHSKummer Leslie1, Demerath Ellen2, Fields David3, Haapala Jacob4, Jacobs David4, Kunin-Batson Alicia4, Whitaker Kara5, Smith Katy6, Foster Laurie7, Harnack Lisa4, McGovern Patricia4, Schoenfuss Tonya4, Teague April61University of Minnesota School of Medicine, Minneapolis, Minnesota, USA2University of Minnesota School of Public Health, Minneapolis, Minnesota, USA3University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA4University of Minnesota, USA5University of Iowa, USA6University of Oklahoma College of Medicine, USA7MILK Study Coordinator, USACategory: Human Milk CompositionBackground: A growing body of research links maternal obesity with shorter breastfeeding duration. Few studies have explored whether obesity-related milk components could reflect altered lactocyte function and provide predictive biomarkers of compromised lactation, once exclusive breastfeeding is established.Objective(s): To examine associations of obesity-related milk components (insulin, leptin, adiponectin, glucose, and lactose) at 1 month, with the likelihood of non-exclusive breastfeeding (N-EBF) at 3 months.Materials/Methods: Participants were 212 exclusively breastfeeding (EBF) mother-infant dyads in the Mothers and Infants LinKed for Health (MILK) study, who provided milk samples at 1 month and self-reported their EBF status at 3 months. Milk components that differed (p < 0.05) by 3-month EBF status were identified using t-tests. We used logistic regression to examine crude and adjusted associations with N-EBF at 3 months. Maternal race was associated with EBF status at 3 months (p = 0.002) and was thus included as a covariate in our adjusted model.Results: At 3 months, 194 participants (91.5%) remained EBF, and 18 (8.5%) were N-EBF. Milk glucose at 1 month was higher in 3-month EBF women (mean: 30.3, SD: 10.3, mg/dl) than in 3-month N-EBF women (mean: 20.0, SD: 9.3 mg/dl; p = 0.000). Log-transformed milk insulin at 1 month was lower in 3-month EBF women (mean: 3.22, SD 0.61; μIU/mL) than in 3-month N-EBF women (mean: 3.48, SD 0.49; p = 0.044). Milk leptin, adiponectin, and lactose did not differ between outcome groups. Adjusting for race, 1-month milk glucose, but not insulin, remained significantly associated with N-EBF at 3 months (AOR 0.35 [95% CI 0.20, 0.63] and AOR 1.38 [95% CI 0.83, 2.27], respectively).Conclusions: In this group of EBF women, decreased milk glucose at 1 month was associated with N-EBF at 3 months. Previous human studies have shown a decrease in milk glucose during active weaning. To our knowledge, this is the first study to identify subclinical alterations in milk glucose as an EBF cessation predictor. These findings may have implications for early identification of compromised lactation, allowing for proactive clinical support of exclusive breastfeeding.7. GESTATIONAL DIABETES REDUCES BREASTFEEDING DURATION: A PROSPECTIVE COHORT STUDY IN VIETNAMNguyen Phung11Curtin University, Perth, AustraliaCategory: ResearchBackground: Gestational diabetes mellitus (GDM) and its complications are major concerns due to the negative effects of GDM during antenatal period and on the future health of mothers and infants. Breastfeeding is beneficial for GDM mothers and their babies to reduce future health risks. Little is known about the link between GDM and the duration of ‘any’ breastfeeding.Objective(s): To determine the effect of GDM on the duration for which Vietnamese women breastfeed their babies postpartum.Materials/Methods: A cohort of 2,030 pregnant women between 24 and 28-week gestation was recruited. The GDM status was determined using a 75g oral glucose tolerance test. Included mothers were then followed up from discharge after childbirth until twelve months postpartum to monitor their breastfeeding duration. Cox's regression model was used to examine the association between GDM and breastfeeding duration.Results: 94.4% of all women reported ‘any’ breastfeeding at discharge, and 72.9% of women were still breastfeeding at twelve months. There were no significant differences in breastfeeding outcomes at discharge (early initiation, pre-lacteal feeding, and ‘any’ breastfeeding rate) between GDM and non-GDM mothers. However, breastfeeding duration (weeks) was shorter in GDM women compared to other mothers after adjustment for potential confounding factors (HR 1.38, 95% CI 1.12–1.70, p = 0.002).Conclusions: GDM often results in shorter breastfeeding duration during twelve months postpartum. Women with GDM require ongoing support after hospital discharge to maintain long term breastfeeding.Poster Abstracts1. A FAMILY-BASED HEALTH COMMUNICATION COMPREHENSIVE MODEL ON EXCLUSIVE BREASTFEEDING FOR INFANT's QUALITY OF LIFE IN HEALTH SERVICESArya Insi1, Setiawati Elsa1, Sekarwana Nanan1, Gurnida Dida1, Suryani Mira2, Ferdian Dani11Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia2Faculty of Mathematic and Natural Science, Unversitas Padjadjaran, Sumedang, IndonesiaCategory: ResearchBackground: SDG's Goal No.3 is to ensure healthy lives and promote wellbeing for all at all ages. Early Initiation and Exclusive Breastfeeding (EBF) offers many benefits for the health of infant and their mothers. Breastfeeding may contribute to preventing morbidities in adulthood. Although various policies exist, there are still many factors that make this exclusive breastfeeding program not yet achieved. Recommendation of WHO for Exclusive Breastfeeding prevalence is 50% by 2025. Health Research achievements of Indonesia according to the base year exclusive breastfeeding in Indonesia reached 30.2%. Family involvement in breastfeeding education impacts breastfeeding outcomes. Communication intervention such as breastfeeding counseling can support and strengthened EBF practice.Objective(s): To develop a family-based health communication comprehensive model on exclusive breastfeeding for infant's quality of life in health services.Materials/Methods: We will conduct a mix method using action research approach. First, we will do qualitative study to explore the models of health communication platform trough developing mobile health application for mothers and family also for the counselor in health services. Informants of Focus Group Discussion are pregnant mothers, families and health care provider. For in-depth interview will be breastfeeding counselor, IT expert and communication expert. Second, we will do the experimental study using health communication platform for about 8 months intervention. The sample will be the pregnant mothers and family in Bandung district west java Indonesia. The period of this study will take 2 years.Results: The result plan for this study is health communication platform that can be used by family and health provider to increase exclusive breastfeeding for infant's quality of life.Conclusions: The Comprehensive model on EBF should be based strengthen by theory of health behavior, personalize and contextual, Enhancing the interactivity of communication, and describe the impact of interpersonal connections.2. SIDS, SUID, AND SOCIAL JUSTICE: A SYNDEMICS APPROACHBartick Melissa1, Tomori Cecilia21Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts, USA2Durham University, Department of Anthropology, Durham, United KingdomCategory: ResearchBackground: Sudden Unexpected Infant Death (SUID) and Sudden Infant Death Syndrome (SIDS) prevention has focused on modifying individual behaviors, especially bedsharing, despite evidence that these conditions are most common among poor and marginalized people in wealthy countries. The US has surpassed New Zealand Māori and now has the world's highest prevalence of SUID/SIDS.Objective(s): Examine SUID and SIDS using syndemics theory – the socially-driven clustering of co-occurring epidemics that may interact to produce health disparities.Materials/Methods: In selected world populations where the SUID/SIDS rates are particularly high or low, we examine rates of known risk factors: maternal smoking, bedsharing, formula feeding, sleep position, alcohol use, prenatal care, and preterm birth.Results: Populations with the world's lowest rates of SUID/SIDS, including the Netherlands, Japan and Sweden, have low income inequality or relative wealth, early prenatal care, generally low rates of preterm birth, high breastfeeding rates and lower harmful health behaviors. Yet they also have high to moderate rates of bedsharing. In contrast, populations with high prevalence, including US Blacks, Indians/Alaskan Natives, Māori, Australian Aborigines, and indigenous Canadians, have experienced historical trauma and racism, and continue to experience high rates of poverty, often unequal access to care, high preterm birth, lower breastfeeding rates, higher harmful health behaviors, and bedsharing. Many risk factors linked to poverty and discrimination have negative effects on perinatal outcomes, offsetting gains from breastfeeding and tobacco cessation.Conclusions: The disproportionately high prevalence of SUID/SIDS in some populations may be driven by legacies of historical trauma and social inequities that result in co-occurring epidemics that may interact to amplify risk. These risks may increase US infant mortality rates given current trends, where the SIDS rate even in whites approaches that of Māori. Because risk factors for preterm birth and SUID overlap and are two of the biggest causes of infant mortality in the industrialized world, they should be addressed together. Medical organizations play an important role in advocating for policies that address the root causes of infant mortality via poverty and discrimination interventions, tobacco control, and provision of culturally appropriate support throughout pregnancy, birth, and breastfeeding.3. DOES EDUCATIONAL LEVEL OR SPECIALTY CERTIFICATION INFLUENCE THE LEVEL OF BREASTFEEDING SUPPORT THAT NURSES INTEND TO PROVIDE TO NEWLY DELIVERED MOTHERS?Bauley Cynthia1, Cassar Linda2, Cross Tracy3, Brannon Monica4, Friesen Mary Ann5, Schneider Martha5, Brown Lani6, Collins Frances6, Boresky Dorothy4, Stanger Debra31Inova Fairfax Women's Hospital, Falls Church, Virginia, USA2George Washington University, Washington, District Of Columbia, USA3Inova Loudoun Hospital, Leesburg, Virginia, USA4Inova Alexandria Hospital, Alexandria, Virginia, USA5Inova Health System, Falls Church, Virginia, USA6Inova Fair Oaks Hospital, Fairfax, Virginia, USACategory: ResearchBackground: Breastfeeding is the optimal method of feeding newborns. Breastfeeding assistance in the hospital without educated, supportive staff may lead to lower exclusive breastfeeding rates. A better understanding is needed of the factors that influence a nurse's intent to support new mothers with breastfeeding.Objective(s): This study was conducted to determine what, if any, correlation existed between nurses' level of education or possession of any maternal-newborn specialty certification and their intent to support newly delivered mothers in their breastfeeding efforts.Materials/Methods: Utilizing a modified, 51 item version of the “Nursing Support for Breastfeeding Questionnaire”, a quantitative study that utilized a descriptive comparative survey design was performed. Registered nurse participants rated their level of support and attitudes about breastfeeding using a seven-point Likert type scale for each question. A convenience sample of Labor and Delivery, Mother/Baby, High-Risk Antepartum and Neonatal Intensive Care nurses working full or part-time in a multi-hospital system participated in the survey.Results: A total of 291 surveys met the inclusion criteria for the study. The level of nursing education achieved, or possession of a specialty certification was not found to be statistically significant for nurse's intent to support breastfeeding mothers. One hundred and eighty-seven (64.3%) of the nurses in the study reported completing the Virginia Breastfeeding Friendly Consortium Training. This instruction consists of 15 hours of lactation education and satisfies the didactic requirement for Baby Friendly designation. The nurses in this group were more likely to report an intention to provide breastfeeding support (p = .001).Conclusions: Nurses who complete targeted lactation education are more likely to report intention to provide informational, technical, and emotional support for newly delivered mothers in their breastfeeding efforts. Maternity hospitals should consider mandatory lactation training to all nurses who work with this population.4. THE PREVALENCE OF “PUMP AND DUMP” POLICIES IN HOSPITALS ACROSS THE UNITED STATESKaltenecker Brian1, Hoyle Abigail1, Borger Judith21CFVH OB Gyn Residency, Fayetteville, North Carolina, USA2CFVH ED Residency, Fayetteville, North Carolina, USACategory: Quality Improvement AdvocacyBackground: Recent data has established the safety of continuous uninterrupted breastfeeding after iodinated or gadolinium-containing contrast media administration for imaging studies. This data advocates minimal transmission to the infant, refuting previous adages that the expression of contrast in breast milk could harm the infant. However, despite multiple committee and society opinions encouraging uninterrupted breastfeeding after contrast, it is unclear how many hospitals have adapted their policies to the current society recommendations as there is no published data regarding current hospital policies on the matter.Objective(s): To establish the prevalence and characteristics of hospitals requiring breastfeeding mothers to “pump and dump”, meaning express and discard breast milk, after imaging studies requiring iodinated or gadolinium containing contrast media.Materials/Methods: An anonymous 8 question survey was distributed to physicians via physician-only social media sites.Results: 64 responses from 62 different hospitals across 26 states were obtained. 42% of hospitals were encouraging patients to pump and dump after IV contrast. Various categories were evaluated including location, type of hospital, size, and time period requiring the discarding of breast milk. In urban and rural communities, only 37% and 30% of hospitals encouraged pump and dump respectively, whereas, in the suburban setting, 53% of hospitals still endorsed pump and dump policies. When comparing community vs academic hospitals, 43% and 36% encouraged pump and dump, respectively. Upon evaluation of hospital size, in all capacities apart from 1,000+ beds, 40–50% of hospitals were encouraging mothers to pump and dump. The 1,000+ group, (only 3 hospitals) had 67% encouraging pump and dump. Finally, when looking at the amount of time mothers were encouraged to dump, the majority of hospitals encouraged the practice for 12–24 hours.Conclusions: This data shows that there is still significant work to be done among all hospital groups in order to update hospital policies to be aligned with current data as well as society recommendations. This study aims to be used as a fulcrum for future research, and for creating effective quality improvement projects aimed at decreasing the incidence of pumping and dumping. We hope to promote the longevity of breastfeeding, which remains the best form of neonatal nutrition.5. ASSOCIATION OF GENDER ROLES ON FATHERS' ATTITUDES AND BREASTFEEDING PRACTICESOlivas Irma Esthela Smith1, Gutierrez Diana Bueno11Universidad Autonoma de Baja California, Tijuana, MexicoCategory: ResearchBackground: Research studies have shown that support from the baby's father largely impact breastfeeding rates. Fathers' attitudes regarding breastfeeding may be influenced by gender roles, particularly in regions with higher prevalence of machismo, such as Mexico, which also has one of the lowest breastfeeding rates of Latin America with 14.4% of exclusive breastfeeding under six months.Objective(s): To determine the association of gender roles on fathers' attitudes and breastfeeding practices in Tijuana, Mexico.Materials/Methods: A convenience sample of 99 men older than 18 years, who had children less than 5 years of age, and attended a Family Medicine Clinic in Tijuana, Mexico, was selected. We applied a questionnaire that included socio-demographic data, GEM (Gender Equitable Men) and IIFAS (Iowa Infant feeding attitude) scale. We used X2 and bivariate correlation for statistical analysis.Results: The mean age of the sample was 28 years, 50.5% were married and 37.4% had attended middle school. Participants had a general average of 61.21 (SD ±6.6) on the IIFAS scale with mostly neutral attitudes (75.8%), followed by 20.2% positive towards breastfeeding. The GEM scale mean was 22.4 (SD ±4.5). The majority presented low attitudes of inequity (81.8%) and the rest showed moderate attitudes. A significant correlation between the inequitable attitude indexes of GEM and Infant feeding attitudes in IIFAS (r = −0.2, p = 0.043) was found. The 85.7% of participants who reported that had used milk formula had higher rates of inequity. Likewise, 61.5% of men who stated that they had chosen breastfeeding had lower rates of inequity (p = 0.026).Conclusions: In this study, an association between higher gender equity and positive attitudes and practices toward breastfeeding was observed. Future research and interventions need to include a gender perspective to determine the influence on breastfeeding practices, particularly in Mexico, where low breastfeeding rates and high gender inequity converge.6. IMPROVING EARLY INITIATION AND EXCLUSIVE BREASTFEEDING AT A TERTIARY CARE URBAN FACILITY IN INDIAChawla Deepak1, Manerkar Swati2, Khan Aisha3, Sinha Minu Manuhar4, Shanbhag Sunita5, Mondkar Jayashree6, Sachdeva Ruchika Chugh7, Kandasamy Praveen81Professor, Department of Pediatrics, Government Medical College Hospital, Chandigarh, Chandigarh, India2Associate Professor, Mumbai, India3Project Officer, Mumbai, India4Project Officer, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Mumbai, India5Project Manager, Lokmanya Tilak Municipal Medical College and Lokmanya General Hospital, Mumbai, India6Professor and Head, Department of Neonatology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak General Hospital, Mumbai, India7Team Leader, Maternal, Newborn, Child Health and Nutrition, New Delhi, India8Technical Project Man
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