human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Studies have identified numerous factors affecting breastfeeding initiation and duration , including maternal education , mode of delivery , birth weight , socioeconomic status , and support of the infant ’s father . Objective : The objective was to investigate the effects of an antenatal education session and postnatal support targeted to fathers . Methods : The Fathers Infant Feeding Initiative ( FIFI Study ) is a r and omized controlled trial to increase the initiation and duration of breastfeeding that was conducted in 8 public maternity hospitals in Perth , Western Australia . A total of 699 couples were r and omized within hospitals to either intervention or control groups . The intervention consisted of a 2-hour antenatal education session and postnatal support provided to fathers . Results : The any breastfeeding rate for the intervention group was significantly greater at 6 weeks : 81.6 % in the intervention group compared to 75.2 % in the control group , odds ratio 1.46 ( 95 % CI , 1.01 - 2.13 ) . After adjustment for age and hospital , the odds ratio for any breastfeeding in the intervention group was 1.58 ( 1.06 - 2.35 ) and for socioeconomic status ( SES ) , 1.56 ( 1.06 - 2.30 ) . The infants of older fathers were more likely to be breastfed at 6 weeks compared to infants of younger fathers ( P < .01 ) , and infants of fathers with high SES more likely than infants of fathers with low SES ( P = .013 ) . Conclusion : Even a small increase in breastfeeding rates brings public health benefits . In this study , a minimal intervention was found to significantly increase any breastfeeding at 6 weeks : 81.6 % in the intervention group compared to 75.2 % in the control group Objective : To determine the impact of breast crawl on breast feeding and its feasibility and acceptability in a busy labor room . Study Design : A prospect i ve , single blinded , r and omized controlled clinical trial . Impact of breast crawl was studied in one group and the outcome was compared with the other group where breast crawl was not performed . Feasibility and acceptability was determined by analysis of question naire given to obstetricians and nurses . Descriptive statistics and χ2- analysis was applied to evaluate the question naire and to compare the outcome in the two groups . Result : Breast crawl had a significant positive impact on the onset of lactation ( P=0.0005 ) as well as extent of neonatal weight loss on day 3 ( 0.032 ) . Conclusion : Our study adds to the body of evidence that breast crawl results in positive short-term breast feeding outcome but acceptability of breast crawl as a routine in a busy labor room remains a major issue OBJECTIVE To pilot , among women with gestational diabetes mellitus ( GDM ) , the feasibility of a prenatal/postpartum intervention to modify diet and physical activity similar to the Diabetes Prevention Program . The intervention was delivered by telephone , and support for breastfeeding was addressed . RESEARCH DESIGN AND METHODS The goal was to help women return to their prepregnancy weight , if it was normal , or achieve a 5 % reduction from prepregnancy weight if overweight . Eligible participants were identified shortly after a GDM diagnosis ; 83.8 % consented to be r and omly assigned to intervention or usual medical care ( 96 and 101 women , respectively ) . The retention was 85.2 % at 12 months postpartum . RESULTS The proportion of women who reached the postpartum weight goal was higher , although not statistically significant , in the intervention condition than among usual care ( 37.5 vs. 21.4 % , absolute difference 16.1 % , P = 0.07 ) . The intervention was more effective among women who did not exceed the recommended gestational weight gain ( difference in the proportion of women meeting the weight goals : 22.5 % , P = 0.04 ) . The intervention condition decreased dietary fat intake more than the usual care ( condition difference in the mean change in percent of calories from fat : −3.6 % , P = 0.002 ) and increased breastfeeding , although not significantly ( condition difference in proportion : 15.0 % , P = 0.09 ) . No differences in postpartum physical activity were observed between conditions . CONCLUSIONS This study suggests that a lifestyle intervention that starts during pregnancy and continues postpartum is feasible and may prevent pregnancy weight retention and help overweight women lose weight . Strategies to help postpartum women overcome barriers to increasing physical activity are needed Objective To assess whether exclusive and prolonged breast feeding reduces the risk of childhood asthma and allergy by age 6.5 years . Design Cluster r and omised trial . Setting 31 Belarussian maternity hospitals and their affiliated polyclinics . Participants A total of 17 046 mother-infant pairs were enrolled , of whom 13 889 ( 81.5 % ) were followed up at age 6.5 years . Intervention Breastfeeding promotion intervention modelled on the WHO/UNICEF baby friendly hospital initiative . Main outcome measures International study of asthma and allergies in childhood ( ISAAC ) question naire and skin prick tests of five inhalant antigens . Results The experimental intervention led to a large increase in exclusive breast feeding at 3 months ( 44.3 % v 6.4 % ; P<0.001 ) and a significantly higher prevalence of any breast feeding at all ages up to and including 12 months . The experimental group had no reduction in risks of allergic symptoms and diagnoses or positive skin prick tests . In fact , after exclusion of six sites ( three experimental and three control ) with suspiciously high rates of positive skin prick tests , risks were significantly increased in the experimental group for four of the five antigens . Conclusions These results do not support a protective effect of prolonged and exclusive breast feeding on asthma or allergy . Trial registration Current Controlled Trials IS RCT N37687716 CONTEXT The evidence that breastfeeding improves cognitive development is based almost entirely on observational studies and is thus prone to confounding by subtle behavioral differences in the breastfeeding mother 's behavior or her interaction with the infant . OBJECTIVE To assess whether prolonged and exclusive breastfeeding improves children 's cognitive ability at age 6.5 years . DESIGN Cluster-r and omized trial , with enrollment from June 17 , 1996 , to December 31 , 1997 , and follow-up from December 21 , 2002 , to April 27 , 2005 . SETTING Thirty-one Belarussian maternity hospitals and their affiliated polyclinics . PARTICIPANTS A total of 17,046 healthy breastfeeding infants were enrolled , of whom 13,889 ( 81.5 % ) were followed up at age 6.5 years . INTERVENTION Breastfeeding promotion intervention modeled on the Baby-Friendly Hospital Initiative by the World Health Organization and UNICEF . MAIN OUTCOME MEASURES Subtest and IQ scores on the Wechsler Abbreviated Scales of Intelligence , and teacher evaluations of academic performance in reading , writing , mathematics , and other subjects . RESULTS The experimental intervention led to a large increase in exclusive breastfeeding at age 3 months ( 43.3 % for the experimental group vs 6.4 % for the control group ; P < .001 ) and a significantly higher prevalence of any breastfeeding at all ages up to and including 12 months . The experimental group had higher means on all of the Wechsler Abbreviated Scales of Intelligence measures , with cluster-adjusted mean differences ( 95 % confidence intervals ) of + 7.5 ( + 0.8 to + 14.3 ) for verbal IQ , + 2.9 ( -3.3 to + 9.1 ) for performance IQ , and + 5.9 ( -1.0 to + 12.8 ) for full-scale IQ . Teachers ' academic ratings were significantly higher in the experimental group for both reading and writing . CONCLUSION These results , based on the largest r and omized trial ever conducted in the area of human lactation , provide strong evidence that prolonged and exclusive breastfeeding improves children 's cognitive development . TRIAL REGISTRATION is rct n.org Identifier : IS RCT N37687716 Background In Sub-Saharan Africa over one million newborns die annually . We developed a sustainable and scalable home-based counselling intervention for delivery by community volunteers in rural southern Tanzania to improve newborn care practice s and survival . Here we report the effect on newborn care practice s one year after full implementation . Methods All 132 wards in the 6-district study area were r and omised to intervention or comparison groups . Starting in 2010 , in intervention areas trained volunteers made home visits during pregnancy and after childbirth to promote recommended newborn care practice s including hygiene , breastfeeding and identification and extra care for low birth weight babies . In 2011 , in a representative sample of 5,240 households , we asked women who had given birth in the previous year both about counselling visits and their childbirth and newborn care practice s. Results Four of 14 newborn care practice s were more commonly reported in intervention than comparison areas : delaying the baby ’s first bath by at least six hours ( 81 % versus 68 % , OR 2.0 ( 95 % CI 1.2 - 3.4 ) ) , exclusive breastfeeding in the three days after birth ( 83 % versus 71 % , OR 1.9 ( 95 % CI 1.3 - 2.9 ) ) , putting nothing on the cord ( 87 % versus 70 % , OR 2.8 ( 95 % CI 1.7 - 4.6 ) ) , and , for home births , tying the cord with a clean thread ( 69 % versus 39 % , OR 3.4 ( 95 % CI 1.5 - 7.5 ) ) . For other behaviours there was little evidence of differences in reported practice s between intervention and comparison areas including childbirth in a health facility or with a skilled attendant , thermal care practice s , breastfeeding within an hour of birth and , for home births , the birth attendant having clean h and s , cutting the cord with a clean blade and birth preparedness activities . Conclusions A home-based counselling strategy using volunteers and design ed for scale-up can improve newborn care behaviours in rural communities of southern Tanzania . Further research is needed to evaluate if , and at what cost , these gains will lead to improved newborn survival . Trial registration Trial Registration Number NCT01022788 ( http://www . clinical trials.gov , 2009 AIMS To evaluate the effects of a breastfeeding intervention on primiparous mothers '  breastfeeding self-efficacy , breastfeeding duration and exclusivity at 4 and 8 weeks postpartum . BACKGROUND Few studies have examined the effects of breastfeeding self-efficacy on improved breastfeeding outcomes among primiparous mothers in China . DESIGN An experimental pre-test and posttest , two-group design was used in the study . METHODS A total of 74 participants were recruited to the study from a tertiary hospital in central China , from June-October 2012 . An individualized , st and ardized nursing intervention based on the Self-Efficacy Theory was delivered to enhance mothers ' breastfeeding self-efficacy , breastfeeding duration and exclusivity at 4 and 8 weeks postpartum . Participants were r and omly assigned to an intervention or referent group . Participants in the intervention group received three individualized , self-efficacy-enhancing sessions . Participants in the referent group received st and ard care . RESULTS Participants in the intervention group showed significantly greater increases in breastfeeding self-efficacy , exclusivity and duration than participants in the control group at 4 and 8 weeks postpartum ( except for duration at 4 weeks ) . High baseline breastfeeding self-efficacy predicted higher breastfeeding self-efficacy later and more exclusive breast-feeding . CONCLUSION The findings in this study suggest that intervention aim ed at increasing self-efficacy has a significant impact on maternal breastfeeding self-efficacy and short-term breastfeeding outcomes We evaluated the single and combined effects of introducing a motivational video and peer counseling into four matched WIC clinics on breastfeeding initiation and continuation at 7 - 10 days among African-American WIC participants . Of the 242 women with complete data , 48 % initiated breastfeeding , but only 31 % were still breastfeeding at 7 - 10 days . Initiation was associated with cesarean delivery , infant feeding instruction , no artificial milk discharge pack , attending the peer counselor only-intervention site , and intention to breastfeed . Continuation was influenced by infant feeding instruction , no artificial milk discharge pack , and intention to breastfeed . Overall , trends toward a positive impact of the breastfeeding promotion activities were evident but weak , and largely gone by 7 - 10 days postpartum Background Immediate and exclusive initiation of breastfeeding after delivery has been associated with better neonatal survival and child health and are recommended by the WHO . We report its impact on early infant feeding practice s from the PROMISE-EBF trial . Methods PROMISE-EBF was a cluster r and omised behaviour change intervention trial of exclusive breastfeeding ( EBF ) promotion by peer counsellors in Burkina Faso , Ug and a and South Africa implemented during 2006 - 2008 among 2579 mother-infant pairs .  Counselling started in the last pregnancy trimester and mothers were offered at least five postnatal visits . Early infant feeding practice s : use of prelacteal feeds ( any foods or drinks other than breast milk given within the first 3 days ) , expressing and discarding colostrum , and timing of initiation of breastfeeding are presented by trial arm in each 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Studies have identified numerous factors affecting breastfeeding initiation and duration , including maternal education , mode of delivery , birth weight , socioeconomic status , and support of the infant ’s father . Objective : The objective was to investigate the effects of an antenatal education session and postnatal support targeted to fathers . Methods : The Fathers Infant Feeding Initiative ( FIFI Study ) is a r and omized controlled trial to increase the initiation and duration of breastfeeding that was conducted in 8 public maternity hospitals in Perth , Western Australia . A total of 699 couples were r and omized within hospitals to either intervention or control groups . The intervention consisted of a 2-hour antenatal education session and postnatal support provided to fathers . Results : The any breastfeeding rate for the intervention group was significantly greater at 6 weeks : 81.6 % in the intervention group compared to 75.2 % in the control group , odds ratio 1.46 ( 95 % CI , 1.01 - 2.13 ) . After adjustment for age and hospital , the odds ratio for any breastfeeding in the intervention group was 1.58 ( 1.06 - 2.35 ) and for socioeconomic status ( SES ) , 1.56 ( 1.06 - 2.30 ) . The infants of older fathers were more likely to be breastfed at 6 weeks compared to infants of younger fathers ( P < .01 ) , and infants of fathers with high SES more likely than infants of fathers with low SES ( P = .013 ) . Conclusion : Even a small increase in breastfeeding rates brings public health benefits . In this study , a minimal intervention was found to significantly increase any breastfeeding at 6 weeks : 81.6 % in the intervention group compared to 75.2 % in the control group Objective : To determine the impact of breast crawl on breast feeding and its feasibility and acceptability in a busy labor room . Study Design : A prospect i ve , single blinded , r and omized controlled clinical trial . Impact of breast crawl was studied in one group and the outcome was compared with the other group where breast crawl was not performed . Feasibility and acceptability was determined by analysis of question naire given to obstetricians and nurses . Descriptive statistics and χ2- analysis was applied to evaluate the question naire and to compare the outcome in the two groups . Result : Breast crawl had a significant positive impact on the onset of lactation ( P=0.0005 ) as well as extent of neonatal weight loss on day 3 ( 0.032 ) . Conclusion : Our study adds to the body of evidence that breast crawl results in positive short-term breast feeding outcome but acceptability of breast crawl as a routine in a busy labor room remains a major issue OBJECTIVE To pilot , among women with gestational diabetes mellitus ( GDM ) , the feasibility of a prenatal/postpartum intervention to modify diet and physical activity similar to the Diabetes Prevention Program . The intervention was delivered by telephone , and support for breastfeeding was addressed . RESEARCH DESIGN AND METHODS The goal was to help women return to their prepregnancy weight , if it was normal , or achieve a 5 % reduction from prepregnancy weight if overweight . Eligible participants were identified shortly after a GDM diagnosis ; 83.8 % consented to be r and omly assigned to intervention or usual medical care ( 96 and 101 women , respectively ) . The retention was 85.2 % at 12 months postpartum . RESULTS The proportion of women who reached the postpartum weight goal was higher , although not statistically significant , in the intervention condition than among usual care ( 37.5 vs. 21.4 % , absolute difference 16.1 % , P = 0.07 ) . The intervention was more effective among women who did not exceed the recommended gestational weight gain ( difference in the proportion of women meeting the weight goals : 22.5 % , P = 0.04 ) . The intervention condition decreased dietary fat intake more than the usual care ( condition difference in the mean change in percent of calories from fat : −3.6 % , P = 0.002 ) and increased breastfeeding , although not significantly ( condition difference in proportion : 15.0 % , P = 0.09 ) . No differences in postpartum physical activity were observed between conditions . CONCLUSIONS This study suggests that a lifestyle intervention that starts during pregnancy and continues postpartum is feasible and may prevent pregnancy weight retention and help overweight women lose weight . Strategies to help postpartum women overcome barriers to increasing physical activity are needed Objective To assess whether exclusive and prolonged breast feeding reduces the risk of childhood asthma and allergy by age 6.5 years . Design Cluster r and omised trial . Setting 31 Belarussian maternity hospitals and their affiliated polyclinics . Participants A total of 17 046 mother-infant pairs were enrolled , of whom 13 889 ( 81.5 % ) were followed up at age 6.5 years . Intervention Breastfeeding promotion intervention modelled on the WHO/UNICEF baby friendly hospital initiative . Main outcome measures International study of asthma and allergies in childhood ( ISAAC ) question naire and skin prick tests of five inhalant antigens . Results The experimental intervention led to a large increase in exclusive breast feeding at 3 months ( 44.3 % v 6.4 % ; P<0.001 ) and a significantly higher prevalence of any breast feeding at all ages up to and including 12 months . The experimental group had no reduction in risks of allergic symptoms and diagnoses or positive skin prick tests . In fact , after exclusion of six sites ( three experimental and three control ) with suspiciously high rates of positive skin prick tests , risks were significantly increased in the experimental group for four of the five antigens . Conclusions These results do not support a protective effect of prolonged and exclusive breast feeding on asthma or allergy . Trial registration Current Controlled Trials IS RCT N37687716 CONTEXT The evidence that breastfeeding improves cognitive development is based almost entirely on observational studies and is thus prone to confounding by subtle behavioral differences in the breastfeeding mother 's behavior or her interaction with the infant . OBJECTIVE To assess whether prolonged and exclusive breastfeeding improves children 's cognitive ability at age 6.5 years . DESIGN Cluster-r and omized trial , with enrollment from June 17 , 1996 , to December 31 , 1997 , and follow-up from December 21 , 2002 , to April 27 , 2005 . SETTING Thirty-one Belarussian maternity hospitals and their affiliated polyclinics . PARTICIPANTS A total of 17,046 healthy breastfeeding infants were enrolled , of whom 13,889 ( 81.5 % ) were followed up at age 6.5 years . INTERVENTION Breastfeeding promotion intervention modeled on the Baby-Friendly Hospital Initiative by the World Health Organization and UNICEF . MAIN OUTCOME MEASURES Subtest and IQ scores on the Wechsler Abbreviated Scales of Intelligence , and teacher evaluations of academic performance in reading , writing , mathematics , and other subjects . RESULTS The experimental intervention led to a large increase in exclusive breastfeeding at age 3 months ( 43.3 % for the experimental group vs 6.4 % for the control group ; P < .001 ) and a significantly higher prevalence of any breastfeeding at all ages up to and including 12 months . The experimental group had higher means on all of the Wechsler Abbreviated Scales of Intelligence measures , with cluster-adjusted mean differences ( 95 % confidence intervals ) of + 7.5 ( + 0.8 to + 14.3 ) for verbal IQ , + 2.9 ( -3.3 to + 9.1 ) for performance IQ , and + 5.9 ( -1.0 to + 12.8 ) for full-scale IQ . Teachers ' academic ratings were significantly higher in the experimental group for both reading and writing . CONCLUSION These results , based on the largest r and omized trial ever conducted in the area of human lactation , provide strong evidence that prolonged and exclusive breastfeeding improves children 's cognitive development . TRIAL REGISTRATION is rct n.org Identifier : IS RCT N37687716 Background In Sub-Saharan Africa over one million newborns die annually . We developed a sustainable and scalable home-based counselling intervention for delivery by community volunteers in rural southern Tanzania to improve newborn care practice s and survival . Here we report the effect on newborn care practice s one year after full implementation . Methods All 132 wards in the 6-district study area were r and omised to intervention or comparison groups . Starting in 2010 , in intervention areas trained volunteers made home visits during pregnancy and after childbirth to promote recommended newborn care practice s including hygiene , breastfeeding and identification and extra care for low birth weight babies . In 2011 , in a representative sample of 5,240 households , we asked women who had given birth in the previous year both about counselling visits and their childbirth and newborn care practice s. Results Four of 14 newborn care practice s were more commonly reported in intervention than comparison areas : delaying the baby ’s first bath by at least six hours ( 81 % versus 68 % , OR 2.0 ( 95 % CI 1.2 - 3.4 ) ) , exclusive breastfeeding in the three days after birth ( 83 % versus 71 % , OR 1.9 ( 95 % CI 1.3 - 2.9 ) ) , putting nothing on the cord ( 87 % versus 70 % , OR 2.8 ( 95 % CI 1.7 - 4.6 ) ) , and , for home births , tying the cord with a clean thread ( 69 % versus 39 % , OR 3.4 ( 95 % CI 1.5 - 7.5 ) ) . For other behaviours there was little evidence of differences in reported practice s between intervention and comparison areas including childbirth in a health facility or with a skilled attendant , thermal care practice s , breastfeeding within an hour of birth and , for home births , the birth attendant having clean h and s , cutting the cord with a clean blade and birth preparedness activities . Conclusions A home-based counselling strategy using volunteers and design ed for scale-up can improve newborn care behaviours in rural communities of southern Tanzania . Further research is needed to evaluate if , and at what cost , these gains will lead to improved newborn survival . Trial registration Trial Registration Number NCT01022788 ( http://www . clinical trials.gov , 2009 AIMS To evaluate the effects of a breastfeeding intervention on primiparous mothers '  breastfeeding self-efficacy , breastfeeding duration and exclusivity at 4 and 8 weeks postpartum . BACKGROUND Few studies have examined the effects of breastfeeding self-efficacy on improved breastfeeding outcomes among primiparous mothers in China . DESIGN An experimental pre-test and posttest , two-group design was used in the study . METHODS A total of 74 participants were recruited to the study from a tertiary hospital in central China , from June-October 2012 . An individualized , st and ardized nursing intervention based on the Self-Efficacy Theory was delivered to enhance mothers ' breastfeeding self-efficacy , breastfeeding duration and exclusivity at 4 and 8 weeks postpartum . Participants were r and omly assigned to an intervention or referent group . Participants in the intervention group received three individualized , self-efficacy-enhancing sessions . Participants in the referent group received st and ard care . RESULTS Participants in the intervention group showed significantly greater increases in breastfeeding self-efficacy , exclusivity and duration than participants in the control group at 4 and 8 weeks postpartum ( except for duration at 4 weeks ) . High baseline breastfeeding self-efficacy predicted higher breastfeeding self-efficacy later and more exclusive breast-feeding . CONCLUSION The findings in this study suggest that intervention aim ed at increasing self-efficacy has a significant impact on maternal breastfeeding self-efficacy and short-term breastfeeding outcomes We evaluated the single and combined effects of introducing a motivational video and peer counseling into four matched WIC clinics on breastfeeding initiation and continuation at 7 - 10 days among African-American WIC participants . Of the 242 women with complete data , 48 % initiated breastfeeding , but only 31 % were still breastfeeding at 7 - 10 days . Initiation was associated with cesarean delivery , infant feeding instruction , no artificial milk discharge pack , attending the peer counselor only-intervention site , and intention to breastfeed . Continuation was influenced by infant feeding instruction , no artificial milk discharge pack , and intention to breastfeed . Overall , trends toward a positive impact of the breastfeeding promotion activities were evident but weak , and largely gone by 7 - 10 days postpartum Background Immediate and exclusive initiation of breastfeeding after delivery has been associated with better neonatal survival and child health and are recommended by the WHO . We report its impact on early infant feeding practice s from the PROMISE-EBF trial . Methods PROMISE-EBF was a cluster r and omised behaviour change intervention trial of exclusive breastfeeding ( EBF ) promotion by peer counsellors in Burkina Faso , Ug and a and South Africa implemented during 2006 - 2008 among 2579 mother-infant pairs .  Counselling started in the last pregnancy trimester and mothers were offered at least five postnatal visits . Early infant feeding practice s : use of prelacteal feeds ( any foods or drinks other than breast milk given within the first 3 days ) , expressing and discarding colostrum , and timing of initiation of breastfeeding are presented by trial arm in each 
    Output:
    