Miriam Labbok - Academia.edu (original) (raw)

Papers by Miriam Labbok

The Lancet. Global health, 2015

Optimisation of breastfeeding practices could reduce high mortality rates in children younger tha... more Optimisation of breastfeeding practices could reduce high mortality rates in children younger than 5 years, but in DR Congo, despite near-universal breastfeeding initiation and nine of ten children still breastfeeding at 1 year of age, exclusivity remains a difficulty. We assessed the effect on breastfeeding outcomes of a short-cut implementation of a programme called the Ten Steps to Successful Breastfeeding, the key component of the Baby-Friendly Hospital Initiative (BFHI). We did a cluster-randomised controlled trial and randomly assigned health-care clinics in Kinshasa, DR Congo, to standard care (control group), BFHI steps 1-9 (steps 1-9 group), or BFHI steps 1-9 plus additional support during well-child visits (steps 1-10 group) with computer-generated random numbers used to assign matched pairs to study groups. Mothers at these clinics who had given birth to one healthy baby during enrolment, and who expressed their intentions of visiting a well-baby session at the same clini...

Background: Teen mothers have the lowest rates of breastfeeding of any demographic group. Althoug... more Background: Teen mothers have the lowest rates of breastfeeding of any demographic group. Although these mothers face many difficult social, cultural, and economic barriers to breastfeeding, there are few breastfeeding promotion interventions for this population. Further research is needed to identify programs that can successfully promote breastfeeding among teen mothers. Purpose: To collect qualitative data on the values, experiences and needs of teen mothers for use in planning a new breastfeeding promotion program. Methods: Focus groups were conducted with 31 teenage mothers at a YWCA in North Carolina. The mothers were split into groups based on whether they did not breastfeed at all, breastfed only in the hospital, breastfed for less than one month, breastfed for less than two months, exclusively breastfed at least two months, and teens that were currently pregnant. Results: Focus group results confirm that young women's experiences are influenced by factors of social ecol...

Background The Surgeon General’s Call to Action (2011) addresses the need for maternity and commu... more Background The Surgeon General’s Call to Action (2011) addresses the need for maternity and community support to enable mothers to meet their breastfeeding goals. This paper describes the role of an academic institute in informing and supporting related State level activities. Methods Carolina Global Breastfeeding Institute (CGBI) hosted a meeting of stakeholders to discuss breastfeeding needs in NC. As a result, a working group was formed to address the 2006 NC Blueprint for Action on Breastfeeding, including academic, health professional and NGO groups, and delegates from the NC Division of Public Health (NCDPH). This group was invited to serve as a task force of the NC Child Fatality Task Force. Results Outcomes of this effort included the call for a NC Maternity Care Breastfeeding-Friendly Designation (NCMCBFD); CGBI supported development of criteria and the designation application based on CGBI research and national criteria. A similar designation process, the NC Breastfeeding-...

BACKGROUND An objective of Healthy People 2020 is for hospitals to become more breastfeeding-frie... more BACKGROUND An objective of Healthy People 2020 is for hospitals to become more breastfeeding-friendly, i.e., implement the Ten Steps to Successful Breastfeeding. US studies exploring such implementation are predominantly single hospital studies. The Breastfeeding Friendly Healthcare Project (BFHC) explores Ten Steps implementation in multiple hospitals and identifies strategies across similar and differing contexts. METHODS The study follows a phased quasi-experimental operations research design using multiple-case study methods. The BFHC collected breastfeeding and Ten Step compliance data by reviewing documents and medical records and administering the Baby-friendly Self Appraisal Tool, the CDC mPINC, an individual-level Electronic Survey of hospital staff, and Key Informant Interviews. Pre-post changes in breastfeeding rates and Step compliance were tested for statistical significance. Facility-specific strategies for Step implementation were documented. Strategies were triangula...

BACKGROUND Increasing breastfeeding-friendly practices in hospitals is an objective of Healthy Pe... more BACKGROUND Increasing breastfeeding-friendly practices in hospitals is an objective of Healthy People 2020. Assessment of breastfeeding-friendliness is important to achieving this objective. This study explores the construct validity of the Breastfeeding Friendly Healthcare Project (BFHC) Electronic Survey (E-Survey) for assessing breastfeeding-friendliness. METHODS BFHC staff developed an E-Survey using questions from the CDC mPINC and previously tested instruments. BFHC staff distributed the E-Survey to maternity staff. The authors used Exploratory Factor Analysis with oblique oblimin rotation to assess the instrument's construct validity. The authors retained extracted factors with Eigen Values greater than or equal to one. Item-factor correlations assessed correlations between each item and its assigned factor. RESULTS The E-Survey had 933 respondents. Factor analyses showed the E-Survey measured two constructs related to breastfeeding-friendliness: Teaching/Counseling Moms ...

Current allergy and asthma reports, 2011

Human milk provides infants with antimicrobial, anti-inflammatory, and immunomodulatory agents th... more Human milk provides infants with antimicrobial, anti-inflammatory, and immunomodulatory agents that contribute to optimal immune system function. The act of breastfeeding allows important bacterial and hormonal interactions between the mother and baby and impacts the mouth, tongue, swallow, and eustachian tubes. Previous meta-analyses have shown that lack of breastfeeding and less intensive patterns of breastfeeding are associated with increased risk of acute otitis media, one of the most common infections of childhood. A review of epidemiologic studies indicates that the introduction of infant formula in the first 6 months of life is associated with increased incidence of acute otitis media in early-childhood. More recent research raises the issues of how long this increased risk persists, and whether lack of breastfeeding is associated with diagnosis of otitis media with effusion. However, many studies suffer from lack of study of younger populations and imprecise definitions of i...

The American journal of clinical nutrition, 1990

The objective of this paper is to identify social and biomedical variables that influence the sel... more The objective of this paper is to identify social and biomedical variables that influence the selection of methods of infant feeding in the United States and to provide guidelines for the choice of control variables in the design and interpretation of studies that examine the influence of breast-feeding on infant and child health. Data were drawn from a national household survey, the Child Health Supplement of the 1981 Health Interview Survey conducted by the National Center for Health Statistics. Relationships between demographic, socioeconomic, and health variables were studied for the total sample of children under age 5 y as well as for black and white women separately. The data provide evidence for the importance of both social and health variables as selection factors for breast-feeding in the United States.

Infant, child & adolescent nutrition, 2011

OBJECTIVE: Lack of support for breastfeeding mothers has been consistently identified in the lite... more OBJECTIVE: Lack of support for breastfeeding mothers has been consistently identified in the literature as a barrier for breastfeeding across racial and ethnic groups. Using a community-based participatory approach, academic and community-based partners conducted an iterative process to assess barriers, facilitators and potential mediating interventions for breastfeeding in the African-American community in Durham, North Carolina. METHODS: Eight focus groups were conducted with African-American mothers, fathers and grandmothers. Researchers transcribed and coded each focus group and analyzed using Atlas ti. 5.2. Patterns and themes that emerged informed the development of community stakeholder interviews; 41 interviews were conducted with community representatives. These findings informed the development of a support group pilot intervention. The pilot support groups were evaluated for increase in knowledge of attendees. RESULTS: Focus group and community interviews indicate that Af...

Advances in Contraception, 1994

Studies in Family Planning, 1990

Social Science & Medicine, 1997

Social Science & Medicine, 1989

Tenwek mission hospital, situated in the west-central highlands of Kenya, initiated a community h... more Tenwek mission hospital, situated in the west-central highlands of Kenya, initiated a community health programme in 1984. This paper describes the major features of the programme and assesses the impact on a number of health and family planning practices after 3 years of implementation. Comparison of the results in the programme areas with the baseline survey and with control areas show significant changes in several indicators. It is concluded that Tenwek hospital demonstrated the impact a hospital can have on health of communities by effectively moving into community-based health care.

Nature Reviews Immunology, 2004

Journal of Human Lactation, 2011

Journal of Human Lactation, 2006

Journal of Human Lactation, 1996

Journal of Human Lactation, 1995

The Journal of Clinical Endocrinology & Metabolism, 1987

Assays of first morning urine samples for pregnanediol-3 alpha-glucuronide (PdG), estradiol-17 be... more Assays of first morning urine samples for pregnanediol-3 alpha-glucuronide (PdG), estradiol-17 beta-glucuronide (E2G), and LH were used to monitor endocrine function in 16 regularly cycling women and 22 postpartum nonbreastfeeding women. Twice weekly blood samples were also obtained from the postpartum group. Ovulation was inferred by a significant rise in LH and PdG, and reversal of the E2G to PdG ratio. Luteal phase PdG excretion was measured by the peak of smoothed PdG levels and the area under the smoothed luteal phase PdG curve. The lower limits of normal established in 16 cycling women were a peak luteal phase PdG of 4 micrograms/ml and an area under the PdG curve of 20 micrograms/ml. In the postpartum women, 32% of first cycles were anovulatory, and among ovulatory cycles, 73% had abnormally low luteal phase PdG excretion or short luteal phases. In second and subsequent cycles, 15% were anovulatory and 26% had luteal phase abnormalities. There was a progressive increase in luteal PdG excretion from the first to third cycles. The mean delay before first ovulation was 45.2 days, and no woman ovulated before 25 days after delivery. The correlations between blood and urinary hormone levels were 0.78 for PdG, 0.65 for E2G, and 0.55 for LH. We conclude that assays of daily early morning urine samples provide reliable information on ovulation and luteal phase adequacy, and that there is gradual recovery of pituitary ovarian function after parturition.

Journal of Biosocial Science, 1993