Speakers: Fadiah Maharani and Josi Noviani
Facilitator: Marcela Mendoza
Background: The nutrition of a newborn during the initial six months is crucial, and exclusive breastfeeding is advised to fulfill these requirements. Nonetheless, numerous variables, including employed mothers, sometimes obstruct attaining exclusive breastfeeding objectives. The WHO established Global Nutrition Targets 2025 aiming for at least 50% of newborns to be exclusively breastfed; however, current data indicates that some regions, including Indonesia, have failed to achieve these targets.
Case report: Our presentation examines the continuity of care activities of a 28-year-old woman, a working mother who dedicated herself to exclusive breastfeeding upon returning to work. The care encompasses health promotion, the advantages of exclusive breastfeeding, nutrition to enhance breast milk production, engagement of support networks, preparation of exclusive breastfeeding management, and oxytocin massage techniques. There were factors influencing the success of exclusive breastfeeding, such as the hospital policy forbidding formula milk distribution to newborns. This policy relies on the adherence of healthcare professionals who encourage and motivate mothers to maintain exclusive breastfeeding without introducing formula milk. This support is provided during pregnancy and extends into the postpartum period, with the expectation that continuity of care initiatives will significantly benefit aided mothers and enhance the effectiveness of exclusive breastfeeding among working women.
Conclusion: Ongoing support from family and continuity of care from health professionals are crucial in enabling working women to breastfeed exclusively. Engagement of family members and modifications to workplace policies can enhance the likelihood of successful exclusive breastfeeding.
Speaker: Melese Siyoum
Facilitator: Indri Astuti Purwanti
Back ground: Pelvic organ prolapse (POP) is a common condition that can significantly impact a woman’s quality of life. Pelvic floor muscle training (PFMT) is recommended as a first-line conservative treatment for prolapse, but evidence from low-resource settings is limited.
Objectives: This study aimed to assess midwife-led pelvic floor muscle training on prolapse symptoms and health-related quality of life (HRQoL) among women with mild to moderate prolapse in Ethiopia, 2024.
Methods: A community-based, parallel, two-arm cluster randomized controlled trial was conducted in Dale and Wonsho districts of Sidama Region, Ethiopia. Women with symptomatic POP stage I-III were randomized by cluster to receive either midwife-led PFMT plus lifestyle counseling (intervention group) or lifestyle counseling alone (control group). The primary outcomes were change in prolapse symptom score (POP-SS) and prolapse quality of life (P-QoL). Mixed-effects generalized linear model was used to determine the effect size at 99% confidence level.
Results: A total of 187 women were randomized (intervention = 89 and control = 98). At sixth month, the intervention group showed significantly greater improvements with a mean change difference of: -4.1 (99% CI: -5.38, -2.83) in prolapse symptoms; -11.48 (99% CI: -15.9, -7.1) in physical domain, -12.65 (99% CI: -19.3, -6.1) in psychological domain and -9.47 (99% CI: -15.5, -3.5) in personal relationship domain of P-QoL. A significantly higher number of women in the intervention group perceived their condition as ‘better’ after the intervention. Women with earlier stages of prolapse (stage I and II) experienced higher benefits compared to stage III.
Conclusions: A midwife-led PFMT combined with lifestyle counseling significantly improves prolapse symptoms and quality of life in mild to moderate POP. This strategy can be integrated into the existing maternal and reproductive health programs to address POP in low-income settings where access to trained specialist is limited.
