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Biomedical subjects

S S Humenick

Publications and source records attributed to S S Humenick.

At least 19 recordsLinked to original sources
PubMed1998

Breastfeeding and health professional encouragement.

The objective of the study was to ascertain the nature of health professional contacts related to breastfeeding for 341 women. Subjects were prospectively queried by phone or home visit over a 20-week period regarding the number and nature of contacts with health care professionals related to breastfeeding. Lactation consultants gave significantly more positive encouragement (98%) (p = .01) than either nurses (75%) or physicians (68%) did. However, of the 233 health provider contacts that included breastfeeding advice, only 21% involved lactation consultants. Primiparae were likely to decrease their level of breastfeeding if a health professional encouraged supplemental foods (39%) or weaning (86%) during the prior week. Multiparae who were experienced at breastfeeding (3+ weeks breastfeeding the previous infant) decreased their breastfeeding slowly across the weeks with the current infant, and their level of breastfeeding in general appeared independent of health care provider advice. Multiparae who lacked previous sustained breastfeeding experience (0-3 weeks) had the most rapid decrease (65%) in their breastfeeding rates even with health care provider encouragement to continue. Thus, they too appeared to act independently of health care provider advice.

Adult↗
PubMed1998

Breast-milk sodium as a predictor of breastfeeding patterns.

This study partially replicates and extends a study reporting that elevated breast-milk sodium BM [Na+] during early lactogenesis was predictive of poor breastfeeding outcomes. The present study used 6-day postpartum breast milk. Consistent with the findings of the earlier study, 80% of those with a BM [Na+] of 16 mmol/L or lower at day 6 sustained a high level of breastfeeding at week 4, compared to only 50% of those with an elevated BM [Na+] (chi 2 = 4.05, df = 1, p = .04). This difference was even greater in a subgroup of mothers predicted to be at high risk for insufficient milk supply on the basis of support density and self-perception variables. Of the latter group, 75% with low BM [Na+] sustained a high level of breastfeeding at 4 weeks postpartum, compared to only 22% with an elevated BM [Na+] (chi 2 = .65, df = 1, p = .01). In contrast, among the low-risk mothers BM [Na+] levels were not associated with any difference in breast-milk sustainment (89% and 82% sustainment for low- and high-sodium groups, respectively). Thus a normal drop in BM [Na+] is predictive of higher sustainment of breastfeeding. However, the predictive validity of this marker appears to be enhanced by combining it with the psychosocial variables of support density and self-perception of breastfeeding by the mother.

Adult↗
PubMed1997

Effects of parity and weaning practices on breastfeeding duration.

The purpose of this project was to examine (a) patterns of breastfeeding and (b) duration with parity and breastfeeding experience, and (c) mothers' reasons for termination of breastfeeding. A convenience sample of 120 breastfeeding mothers was followed by home visits and telephone for 20 weeks after delivery. The sample consisted of 69 primiparas, 40 multiparas with previous breastfeeding experience, and 11 multiparas with no prior breastfeeding experience. Parity was not significantly associated with the continuation of breastfeeding but there was a trend toward a difference made by breastfeeding experience. Inadequate milk supply and employment were the two most common reasons reported for weaning. Implications for support in the workplace and for first-time breastfeeding mothers are discussed.

Adult↗
PubMed1997

Does early supplementation affect long-term breastfeeding?

The purpose of this secondary data analysis from two different samples was to examine the effect of early supplementation with manufactured milks on breastfeeding status at 20 weeks postpartum in mothers of healthy term infants. In two convenience samples of 120 and 223, respectively, breastfeeding mothers were followed up for 20 weeks postpartum or until weaning occurred. The breastfeeding rate at 20 weeks postpartum was significantly greater for mothers who reported feeding exclusively mother's milk the second week after delivery compared with mothers who breastfed and simultaneously supplemented with manufactured infant milks. Of the mothers in samples one and two who exclusively fed human milk during week 2 postpartum, 63.0% and 59.7%, respectively, were still breastfeeding at week 20, compared with 28.1% and 24.2%, respectively, who supplemented with artificial milks. There was no significant difference between these two groups of mothers and their intended duration of breastfeeding. Early introduction of supplemental bottles of artificial milks is associated with a decrease in the amount of human milk the infant receives as well as with early weaning.

Bottle Feeding↗
PubMed1995

Comparison of subjects who fully versus minimally participated in a breast-feeding study.

Sampling bias occurs in research when a large percentage of subjects who are eligible for the study refuse to participate. During Phase I of a two-phase multisite Mother-Baby Feeding Project, approximately 50% of the 235 potential participants at four of five sites declined to enter the study. This report compares subjects who fully participated with those who minimally participated and explores factors related to subjects' refusal to participate. Data regarding sociodemographic data, breast-feeding experience, and reason for refusal were collected from 92 subjects who declined to enter but agreed to minimally participate. The fully participating subjects had more education than those who participated minimally. However, the breast-feeding outcomes studied were similar for both groups. This provides support for generalizing additional study findings beyond the group of fully participating subjects when considering breast-feeding outcomes. Findings lend insight into the problem of subject recruitment that is not well-addressed in the nursing literature.

Adult↗
PubMed1994

The occurrence of breast engorgement.

This study describes breast engorgement during days 1-14 postpartum of 114 first and second time vaginal- and cesarean-delivery breastfeeding mothers. Most mothers reported experiencing their most intense engorgement after hospital discharge. Previous breastfeeding experience of the mother is a more critical variable than parity in predicting engorgement. Second time breastfeeding mothers experienced engorgement sooner and more severely than did first time breastfeeding mothers, regardless of delivery method. Anticipatory guidance by the care provider is discussed in an effort to enhance the experience of the breastfeeding dyad.

Adult↗
PubMed1994

Breast engorgement: patterns and selected outcomes.

For 14 days following birth, 114 breastfeeding mothers rated their level of breast engorgement twice daily, using a six-point engorgement scale. Individual engorgement ratings were plotted by intensity over time to provide a visual display of each subject's breast engorgement experience. Four distinct patterns of breast engorgement emerged; mothers experienced either a bell-shaped pattern, a multi-modal pattern, a pattern of intense engorgement, or a pattern of minimal engorgement. Characteristics of mothers and infants, and feeding frequency were similar across the four breast engorgement patterns.

Adult↗
PubMed1994

The Maturation Index of Colostrum and Milk (MICAM): a measurement of breast milk maturation.

A biological marker, the Maturation Index of Colostrum and Milk (MICAM), was developed using filter paper chromatography. The MICAM consists of five patterns used to measure the individual rate of breast milk maturation among mothers. This article documents the biological basis of MICAM patterns as a gradual breakdown of an emulsion of breast milk that is dependent on the ratio of sterols plus phospholipids to fat content of the milk. Frequencies of MICAM patterns by day, timing of the milk collection, and inter-rater reliability are addressed and the construct validity is explored. This was a partial replication of the original tool development reported by Humenick in 1987. In both studies, the variables of timing of breast-feeding initiation, frequency, and cumulative length of breast-feeding episodes were significantly correlated as predictors of early milk maturation as measured by the MICAM. Milk maturation rate was also significantly correlated as a predictor of infant weight gain, weeks of sustained breast-feeding, and maternal-infant breast-feeding satisfaction. The MICAM can be used as a clinical screening tool to assess the progress of milk maturation in cases where breast-feeding has had a difficult or delayed initiation, and to evaluate interventions designed to support lactation.

Adult↗
PubMed1989

Insufficient milk supply.

A review of the literature reveals the phenomenon of insufficient milk supply (IMS) as being the most likely potential problem for the breastfeeding mother. This article discusses possible determinants and indicators of insufficient milk supply and proposes a conceptual definition and model.

Breast Feeding↗
PubMed1981

Correlates of parent-infant interaction: an exploratory study.

The self-reported parent-infant interaction scores of 66 new parents were compared to selected prenatal, birth, and postpartum experiences. For women, prenatal expectations for infant interaction accounted for 61% of the variance in their parent-infant interaction. For men, a combination of low trait anxiety and high prenatal expectations accounted for 52% of the total variance. Low trait anxiety alone accounted for 27% of the variance and prenatal expectations another 26% of the variance for men, indicating little potential overlap in the combined predictive potential of these variables. Furthermore, the difference between expectation to interact and self-reported interaction for men correlated significantly with trait anxiety (r = 0.50, p = 0.001). No similar correlations of anxiety and parent-infant interaction were noted in women. All other variables relating to parent characteristics and/or the labor/delivery experience were found to have little relationship to parent-infant interaction. More research is recommended to further explore anxiety in new fathers. Parenting education for both parents is discussed in terms of role mastery techniques which can begin in childbirth preparation classes.

Adult↗
PubMedDate not supplied

Relationship between obstetric analgesia and time of effective breast feeding.

The Infant Breast-feeding Assessment Tool (IBFAT) was used to assess the time of effective breast feeding in 48 healthy term infants born to mothers having their first or second baby. Infants of mothers who received an analgesia (butorphanol or nalbuphine) in labor (n = 26) were compared with infants whose mothers did not receive any labor analgesia (n = 22). Timing of the administration of labor analgesia was also examined with infants whose mothers received no analgesia or analgesia within an hour of birth compared with infants whose mothers received analgesia more than one hour before birth. Infants of first-time breast-feeding mothers took longer to establish effective feeding compared with infants of second-time breast-feeding mothers. Male infants also took longer. Labor analgesia significantly affected mother-rated IBFAT scores when initiation time was considered. Infants who received analgesia within an hour of birth, or no analgesia, and who initiated breast feeding early, established effective feeding significantly earlier than infants with longer duration of analgesia and later initiation of breast feeding.

Adult↗
PubMedDate not supplied

Development of the H & H Lactation Scale.

Psychometric properties of the H & H Lactation Scale, based on the Insufficient Milk Supply (IMS) conceptual framework, were examined in two separate studies. The two convenience samples consisted of 110 mothers of low-birth-weight (LBW) infants and 120 mothers of healthy term infants. Both groups planned to breastfeed and were actively breastfeeding or pumping to maintain a milk supply. Subscales identified by factor analysis measured three concepts: maternal confidence/commitment to breastfeeding, perceived infant breastfeeding satiety, and maternal-infant breastfeeding satisfaction. All subscales showed moderate to high internal consistency (alphas .75 to .98) as well as concurrent and predictive validity. The total scale and the three subscales were prospectively significantly related to level of breastfeeding 8 weeks after delivery with both groups of mothers.

Adult↗
PubMedDate not supplied

Breast engorgement: contributing variables and variables amenable to nursing intervention.

The focus of this study was to identify variables that correlate significantly with breast engorgement and that might be amenable to nursing interventions. Data on the initiation of feeding, frequency of feedings, feeding duration, rate of milk maturation, and supplementation were obtained of 54 women. These variables were found to be significantly correlated with breast engorgement.

Adaptation, Physiological↗