Yuko Nakao

Initiation of breastfeeding within 120 minutes after birth is associated with breastfeeding at four months among Japanese women: A self-administered questionnaire survey

BackgroundThe proportion of mothers in Japan who breastfeed exclusively has been low since the 1970s. The purpose of this study was to examine the association between the time of first breastfeed after birth and the proportion of mothers fully breastfeeding up to four months postpartum.MethodsA survey was conducted using a self-administered questionnaire. The participants were 318 mothers who participated in a physical examination of their four month old infants in Nagasaki City, Japan in 2003.ResultsThe time of first breastfeeding up to 120 minutes was significantly associated with the proportion of mothers fully breastfeeding during their stay in the clinic/hospital (p = 0.006), at one month (p = 0.004) and at four months after birth (p = 0.003). There was no significant difference in the proportion of full breastfeeding in mothers who first breastfed between the period of less 30 minutes after birth and that of between 31 and 120 minutes after birth. Logistic regression analysis indicated that the proportion of mothers who continued full breastfeeding at four months was significantly higher in those who breastfed their baby within 120 minutes compared with more than 120 minutes (OR 2.5, p = 0.01), but was not significantly different in those who breastfed within 30 minutes compared with more than 30 minutes (OR 1.8, p = 0.06). Early breastfeeding was affected by caesarean section, premature delivery and severe bleeding during delivery.ConclusionCommencement of early breastfeeding was associated with the proportion of mothers who fully breastfed their infants up to four months. Early breastfeeding, especially within two hours, is recommended for child and maternal health.

Oxytocin Mediates a Calming Effect on Postpartum Mood in Primiparous Mothers

OBJECTIVES The current study sought to characterize changes in salivary oxytocin (OT) secretion patterns across the breastfeeding cycle, and to evaluate whether breastfeeding has a positive effect on mood disturbances related to postpartum depression, via endogenous OT release. MATERIALS AND METHODS Twenty-four primiparous mothers who delivered vaginally at term and were exclusively breastfeeding were examined 4-5 days postpartum. Salivary OT was measured using enzyme immunoassays at 30 minutes before breastfeeding (baseline), during breastfeeding (feeding), and 30 minutes after completing breastfeeding (postfeeding). In addition, maternal mood changes were evaluated at baseline and postfeeding using the Profile of Mood States (POMS) questionnaire. RESULTS OT levels rose significantly during feeding (pcorr < .05) and postfeeding (pcorr < 0.05), compared with baseline. POMS scores for Tension-Anxiety were decreased postfeeding compared with baseline (p < 0.001). This decrease was significantly associated with increased OT (feeding minus baseline: r = -0.52, rpart = -0.51, postfeeding minus baseline: r = -0.53, rpart = -0.52, ps < 0.05). POMS scores for Fatigue and Confusion also decreased, while Vigor significantly increased. Significant correlations were found between Fatigue decreases and OT increases (feeding minus baseline: r = -0.48, rpart = -0.53, postfeeding minus baseline: rpart = -0.60, ps < 0.05). This result partially contradicted with the finding of no correlation between increased Vigor and increased OT. CONCLUSIONS OT is released across the breastfeeding cycle and can be detected with salivary measurement. This OT release exhibited a temporary anxiolytic-like calming effect on postpartum maternal mood disturbances.

Errata to “Associations among anthropometric measures, food consumption, and quality of life in school-age children in Tanzania”[J Rural Med 12(1): 38-45]

[This corrects the article on p. 38 in vol. 12, PMID: 28593016.].

Early Initiation of Breastfeeding and Its Beneficial Effects in Japan

In Japan, the proportion of mothers who breastfed exclusively at 1 month was 71 percent in the 1960s; this figure decreased to 32 percent in the 1970s and has been low ever since (42 percent in 2005). In 2005, there were only 40 baby-friendly hospitals in Japan, which represents only 1.3 percent of the total number of Japanese maternity hospitals. Kangaroo mother care for low-birthweight infants was introduced in Japan in 1998. Kangaroo mother care has now expanded to include full-term infants in most Japanese maternity hospitals, since kangaroo mother care has been shown to have some beneficial effects, including promotion of mother’s milk secretion. Early skin-to-skin contact is also common in Japanese maternity hospitals. However, the Japanese tradition of bathing a baby immediately after birth continues, as does the use of supplemental feeding with sugar water. The World Health Organisation recommends helping mothers initiate breastfeeding within a half-hour of birth in Step 4 ofEvidence for the Ten Steps to Successful Breastfeeding (see Chapter 10 in this volume). However, there is controversy about the importance of breastfeeding within 30 min after delivery. Our previous study showed that early breastfeeding after delivery was significantly associated with continuation of full breastfeeding. Logistic regression analysis indicated that the proportion of mothers who continued full breastfeeding at 4 months was 2.5-fold higher in those who breastfed their baby within 2 h compared with more than 2 h. Moreover, maternal satisfaction with first breastfeeding was also associated with early initiation of breastfeeding within 2 h. Some mothers described their feelings about breastfeeding in a questionnaire as ‘I felt motherly love’, ‘I felt calm’ and ‘I had greater pleasure with childbirth’. Early breastfeeding not only increased the proportion of mothers maintaining full breastfeeding but also produced positive mental effects in the mothers. Helping mothers initiate early breastfeeding, especially within 2 h, is strongly recommended for child and maternal health.