RESUMEN
Return to work is one of the most significant barriers to breastfeeding (BF). Family-friendly policies are critical to ensure that BF and maternal work are not mutually exclusive. This study aims to determine contextual factors and underlying mechanisms influencing the implementation of workplace policies in Mexico. Following a qualitative approach, the study was conducted in the following four cities in Mexico: Mérida, Chihuahua, Guadalajara, and Monterrey. Interviews were conducted in 14 workplaces, and included 49 (potential) beneficiaries, 41 male employees, and 21 managers and human resources personnel. The information collected was analyzed through a deductive thematic analysis and mapped against the Context-Mechanism-Outcome framework of Breastfeeding Interventions at the Workplace. Contextual factors influencing a BF-friendly environment in the workplace were as follows: work-schedule flexibility, provision of lactation services (i.e., BF counseling) other than a lactation room, women's previous experience with BF and family-friendly environments in the workplace. The underlying mechanisms enabling/impeding a BF-friendly environment at the workplace were as follows: awareness of Mexican maternity protection legislation, usage of BF interventions in the workplace, culture, supervisor/co-worker support and BF-friendly physical space. To achieve a BF-friendly environment in the workplace, actions at the level of public policy and workplaces must accompany adherence to Mexican legislation.
Asunto(s)
Lactancia Materna , Lugar de Trabajo , Femenino , Humanos , Masculino , México , Madres/psicología , Embarazo , Política PúblicaRESUMEN
Marijuana is the most commonly used illicit drug in pregnancy, and the prevalence of use during pregnancy is increasing in the United States. Although much of the existing research investigating marijuana use in pregnancy is limited by study design and confounding factors, a growing accumulation of data suggests adverse outcomes. Studies have identified associations with decreased birth weight, increased spontaneous preterm birth, and impaired neurodevelopment among children and adults with in utero exposure. Moderate concentrations of marijuana have also been identified in breast milk. Due to these findings, multiple professional societies have issued clear statements against marijuana use during pregnancy and lactation.
Asunto(s)
Cannabis/efectos adversos , Feto/efectos de los fármacos , Lactancia , Uso de la Marihuana/efectos adversos , Exposición Materna/efectos adversos , Complicaciones del Embarazo/etiología , Mujeres Embarazadas , Adulto , Peso al Nacer/efectos de los fármacos , Lactancia Materna , Niño , Femenino , Humanos , Recién Nacido de Bajo Peso , Recién Nacido , Fumar Marihuana/efectos adversos , Leche Humana/metabolismo , Trastornos del Neurodesarrollo/etiología , Embarazo , Nacimiento Prematuro/etiología , Efectos Tardíos de la Exposición Prenatal , Estados UnidosRESUMEN
INTRODUCTION: The purpose of this study was to examine the effects of CenteringPregnancy group prenatal care on breastfeeding outcomes, relative to traditional prenatal care delivered in an individual format. METHODS: A quasi-experimental research design was conducted with 794 women receiving prenatal care delivered in a group or individual format at 4 sites in Tennessee. Propensity scores were used to create groups of women statistically matched on background demographics and medical history. Outcomes included breastfeeding at discharge and breastfeeding at postpartum follow-up. RESULTS: Compared with the matched comparison group of women receiving prenatal care in an individual format, women in CenteringPregnancy group prenatal care had significantly higher odds of any breastfeeding at discharge (odds ratio [OR], 2.08; 95% confidence interval [CI], 1.32-3.26; P < .001). Across the 4 sites, there were no consistent differences in the odds of any breastfeeding at follow-up or exclusive breastfeeding at discharge or postpartum follow-up. DISCUSSION: CenteringPregnancy group prenatal care may have beneficial effects on initial rates of breastfeeding relative to individually delivered care. However, there is not sufficient evidence to conclude that CenteringPregnancy group prenatal care has robust effects on exclusive breastfeeding at discharge or postpartum follow-up.