Exclusive breastfeeding (EBF) during the first 6 months of life is crucial for optimizing child growth, development and survival, as well as the mother's wellbeing. Mother's employment may hinder ...optimal breastfeeding, especially in the first 6 months. We assessed the effectiveness of a baby‐friendly workplace support intervention on EBF in Kenya. This pre‐post intervention study was conducted between 2016 and 2018 on an agricultural farm in Kericho County. The intervention targeted pregnant/breastfeeding women residing on the farm and consisted of workplace support policies and programme interventions including providing breastfeeding flexi‐time and breaks for breastfeeding mothers; day‐care centres (crèches) for babies near the workplace and lactation centres with facilities for breast milk expression and storage at the crèches; creating awareness on available workplace support for breastfeeding policies; and home‐based nutritional counselling for pregnant and breastfeeding women. EBF was measured through 24‐h recall. The effect of the intervention on EBF was estimated using propensity score weighting. The study included 270 and 146 mother–child dyads in the nontreated (preintervention) group and treated (intervention) group, respectively. The prevalence of EBF was higher in the treated group (80.8%) than in the nontreated group (20.2%); corresponding to a fourfold increased probability of EBF risk ratio (RR) 3.90; 95% confidence interval (CI) 2.95–5.15. The effect of the intervention was stronger among children aged 3–5 months (RR 8.13; 95% CI 4.23–15.64) than among those aged <3 months (RR 2.79; 95% CI 2.09–3.73). The baby‐friendly workplace support intervention promoted EBF especially beyond 3 months in this setting.
Abstract
Background
Exclusive breastfeeding (EBF) during the first six months of life is crucial for optimising child’s growth, development and survival. Mother’s employment may hinder optimal ...breastfeeding. We assessed the effectiveness of a workplace support intervention on EBF in Kenya.
Methods
This quasi-experimental study employing a pre-post intervention design was conducted between 2016 and 2018 on an agricultural farm in Kericho County. The intervention targeted pregnant/breastfeeding women residing on the farm and consisted of: day-care centers, sensitization on available workplace baby-friendly policies, and home-based nutritional counselling of pregnant and breastfeeding women. The effect of the interventions on EBF was estimated using propensity score weighting.
Results
The study included 223 and 146 mother-infant dyads in the non-treated (pre-intervention) and treated (intervention) groups, respectively. The prevalence of EBF was 20.2% in the non-treated group and 80.8% in the treated group; corresponding to a 4-fold increased probability of EBF (RR 3.99; 95% CI 2.95–5.15). In age-stratified results, the effect of the interventions was stronger among children aged 3-5 months (RR 8.13; 95% CI 4.23–15.64) than among those aged < 3 months (RR 2.79; 95% CI 2.09–3.73).
Conclusions
The baby-friendly workplace support intervention promoted EBF especially beyond three months in this setting.
Key messages
Maintaining EBF while working is more likely when employers provide the support that women need to do so. Workplace policies and programmes to support women to combine work with breastfeeding are needed.
Membrane transporters can be major determinants in the targeting and effectiveness of pharmaceutical agents. A large number of biologically important membrane transporters have been identified and ...localized to a variety of tissues, organs and cell types. However, little is known about the expression of key membrane transporters in the inner ear, a promising site for targeted therapeutics, as well as a region vulnerable to adverse drug reactions and environmental factors. In this study, we examined the levels of endogenous membrane transporters in rat cochlea by targeted PCR array analysis of 84 transporter genes, followed by validation and localization in tissues by immunohistochemistry. Our studies indicate that several members of the SLC, VDAC and ABC membrane transporter families show high levels of expression, both at the RNA and protein levels in the rat cochlea. Identification and characterization of these membrane transporters in the inner ear have clinical implications for both therapeutic and cytotoxic mechanisms that may aid in the preservation of auditory function.
•Levels of 84 membrane transporters in rat cochlea using PCR array analysis.•Selective localization of highest genes in tissues by immunohistochemistry.•High expression of several SLC, VDAC and ABC transporter families in cochlea.
Background: Employment poses a barrier in achieving the World Health Organization’s recommendation of exclusive breastfeeding for the first six months of life. Effective strategies and evidence to ...improve breastfeeding for women working in the agricultural sector – the main employer for women in Kenya – is lacking. This study aimed to inform (with evidence) the design and implementation of a scalable model of workplace support for breastfeeding in an agricultural setting in Kenya; as well as investigated the model’s potential operational feasibility and potential effectiveness, and its cost-effectiveness.
Methods: The study employed a mixed methods approach and participatory methods at the pre-implementation, implementation and post-implementation phases. The pre-implementation phase generated evidence to inform the implementation. Mothers with children under 12 months were interviewed at the pre-implementation (2016) and post-implementation (2018) phase. Managers, supervisors, decision and policy makers, as well as other community members were also targeted. Statistical methods will include analysis of covariance and logistic regression. Additionally, cost-effectiveness and cost-benefit analyses will be done. Qualitative data will be analysed in vivo, using thematic analysis technique.
Conclusions: Findings from this study aimed to inform the potential feasibility and potential effectiveness of a baby-friendly workplace support for breastfeeding initiative in an agricultural setting with a goal of improving child nutrition and health. The findings also contribute to policy and practice in Kenya by informing the development of workplace support guidelines.
Trial Registration: ISRCTN registry, ISRCTN 64692465; date of registration: 21 December 2016 – retrospectively registered, http://www.isrctn.com/ISRCTN64692465.
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