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Shaw V, Anderson C, Desloovere A, Greenbaum LA, Haffner D, Nelms CL, Paglialonga F, Polderman N, Qizalbash L, Renken-Terhaerdt J, Stabouli S, Tuokkola J, Vande Walle J, Warady BA, Shroff R. Nutritional management of the infant with chronic kidney disease stages 2-5 and on dialysis. Pediatr Nephrol 2023; 38:87-103. [PMID: 35378603 PMCID: PMC9747855 DOI: 10.1007/s00467-022-05529-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/05/2022] [Accepted: 03/07/2022] [Indexed: 01/10/2023]
Abstract
The nutritional management of children with chronic kidney disease (CKD) is of prime importance in meeting the challenge of maintaining normal growth and development in this population. The objective of this review is to integrate the Pediatric Renal Nutrition Taskforce clinical practice recommendations for children with CKD stages 2-5 and on dialysis, as they relate to the infant from full term birth up to 1 year of age, for healthcare professionals, including dietitians, physicians, and nurses. It addresses nutritional assessment, energy and protein requirements, delivery of the nutritional prescription, and necessary dietary modifications in the case of abnormal serum levels of calcium, phosphate, and potassium. We focus on the particular nutritional needs of infants with CKD for whom dietary recommendations for energy and protein, based on body weight, are higher compared with children over 1 year of age in order to support both linear and brain growth, which are normally maximal in the first 6 months of life. Attention to nutrition during infancy is important given that growth is predominantly nutrition dependent in the infantile phase and the growth of infants is acutely impaired by disruption to their nutritional intake, particularly during the first 6 months. Inadequate nutritional intake can result in the failure to achieve full adult height potential and an increased risk for abnormal neurodevelopment. We strongly suggest that physicians work closely with pediatric renal dietitians to ensure that the infant with CKD receives the best possible nutritional management to optimize their growth and development.
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Affiliation(s)
- Vanessa Shaw
- University College London Great Ormond Street Hospital Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.
| | - Caroline Anderson
- grid.430506.40000 0004 0465 4079University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - An Desloovere
- grid.410566.00000 0004 0626 3303University Hospital Ghent, Ghent, Belgium
| | | | - Dieter Haffner
- grid.10423.340000 0000 9529 9877Children’s Hospital, Hannover Medical School, Hannover, Germany
| | | | - Fabio Paglialonga
- grid.414818.00000 0004 1757 8749Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nonnie Polderman
- grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital, Vancouver, Canada
| | - Leila Qizalbash
- grid.459561.a0000 0004 4904 7256Great North Children’s Hospital, Newcastle upon Tyne, UK
| | - José Renken-Terhaerdt
- grid.417100.30000 0004 0620 3132Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Stella Stabouli
- grid.4793.900000001094570051st Department of Pediatrics, Aristotle University Thessaloniki, Thessaloniki, Greece
| | - Jetta Tuokkola
- grid.7737.40000 0004 0410 2071Children’s Hospital and Clinical Nutrition Unit, Internal Medicine and Rehabilitation, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Johan Vande Walle
- grid.410566.00000 0004 0626 3303University Hospital Ghent, Ghent, Belgium
| | - Bradley A. Warady
- grid.239559.10000 0004 0415 5050Children’s Mercy Kansas City, Kansas City, MO USA
| | - Rukshana Shroff
- grid.83440.3b0000000121901201University College London Great Ormond Street Hospital Institute of Child Health, 30 Guilford Street, London, WC1N 1EH UK
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Jiravisitkul P, Thonginnetra S, Kasemlawan N, Suntharayuth T. Supporting factors and structural barriers in the continuity of breastfeeding in the hospital workplace. Int Breastfeed J 2022; 17:87. [PMID: 36536399 PMCID: PMC9761035 DOI: 10.1186/s13006-022-00533-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The World Health Organization recommends that babies should receive exclusive breastfeeding (EBF) for six months, and mothers should be encouraged to breastfeed until their infant is aged two years or older. The breastfeeding rate in Thailand is currently much lower than the target. One critical factor is lactating mothers returning to work, especially in a hospital workplace with high job stress. In this study, we aimed to identify supporting factors and obstacles to sustaining breastfeeding in hospital-type workplaces. METHODS We conducted a mixed methods study between February 2021 and August 2021 at Chulabhorn Hospital, Thailand. Quantitative data were collected using questionnaires, and qualitative data were gathered in a focus group discussion among purposefully chosen participants, including mothers with both successful and unsuccessful continuation of breastfeeding after returning to work. We conducted multivariate analysis and thematic analysis in quantitative and qualitative data analysis, respectively. RESULTS Questionnaires were completed by 65 permanent employees of the hospital, and seven of these participated in focus group discussion. The rate of exclusive breastfeeding from birth to six months was sixty six percent, and was measured by the responses from questionnaires, which defined as a practice whereby the infants receive only breastmilk without mixing it with other food. Seventy-seven percent of participants were continuing to breastfeed when they returned to work, with 24% (12/50) having to stop after three months. Factors associated with exclusive breastfeeding was caesarean delivery (OR 7.9; 95% CI 2.00, 31.08). Additionally, childcare at the workplace and the attitude of colleagues were found to be supporting factors for sustaining breastfeeding. Barriers included inadequate private facilities (location and equipment), lack of a breastfeeding break, workload, and inconvenient uniform. CONCLUSIONS Effort is needed to sustain breastfeeding after maternal return to work. Our findings are crucial in determining how best to support nursing mothers in breastfeeding after returning to work, particularly during the ongoing COVID-19 pandemic. A breastfeeding-friendly policy with clear operating guidelines in the workplace is critical to sustaining breastfeeding. Learning from others who have had a positive experience will ensure that all breastfeeding women are better supported in the workplace in future.
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Affiliation(s)
- Paveewan Jiravisitkul
- Department of Pediatrics, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Saraiorn Thonginnetra
- Department of Pediatrics, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Naruporn Kasemlawan
- Department of Pediatrics, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Thitiphong Suntharayuth
- grid.512982.50000 0004 7598 2416Data Management Unit, Centre of Learning and Research in Celebration of HRH Princess Chulabhorn’s 60th Birthday Anniversary, Chulabhorn Royal Academy, Bangkok, Thailand
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Maria A, Mukherjee R, Upadhyay S, Pratima K, Bandyopadhyay T, Gupta R, Dubey B, Sharma A, Mall PK, Sahoo M, Pathak KK, Pawar P, Mohapatra A. Barriers and enablers of breastfeeding in mother-newborn dyads in institutional settings during the COVID-19 pandemic: A qualitative study across seven government hospitals of Delhi, India. Front Nutr 2022; 9:1052340. [PMID: 36570141 PMCID: PMC9773092 DOI: 10.3389/fnut.2022.1052340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/10/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction The COVID-19 pandemic disrupted newborn care and breastfeeding practices across most healthcare facilities. We undertook this study to explore the barriers and enablers for newborn care and breastfeeding practices in hospitals in Delhi, India for recently delivered mother (RDM)-newborn dyads during the first wave of the COVID-19 pandemic (2020) and inductively design a "pathway of impaction" for informing mitigatory initiatives during the current and future pandemics, at least in the initial months. Materials and methods We used an exploratory descriptive design (qualitative research method) and collected information from seven leading public health facilities in Delhi, India. We conducted separate interviews with the head and senior faculty from the Departments of Pediatrics/Neonatology (n = 12) and Obstetrics (n = 7), resident doctors (n = 14), nurses (labor room/maternity ward; n = 13), and RDMs (n = 45) across three profiles: (a) COVID-19-negative RDM with healthy newborn (n = 18), (b) COVID-19-positive RDM with healthy newborn (n = 19), and (c) COVID-19 positive RDM with sick newborn needing intensive care (n = 8) along with their care-giving family members (n = 39). We analyzed the data using grounded theory as the method and phenomenology as the philosophy of our research. Results Anxiety among clients and providers, evolving evidence and advisories, separation of the COVID-positive RDM from her newborn at birth, providers' tendency to minimize contact duration and frequency with COVID-positive mothers, compromised counseling on breastfeeding, logistic difficulties in expression and transportation of COVID-positive mother's milk to her baby in the nursery, COVID restrictions, staff shortage and unavailable family support in wards and nursery, and inadequate infrastructure were identified as major barriers. Keeping the RDM-newborn together, harmonization of standard operating procedures between professional associations and within and between departments, strategic mobilization of resources, optimization of human resources, strengthening client-provider interaction, risk triaging, leveraging technology, and leadership-in-crisis-situations were notable enablers. Conclusion The separation of the RDM and newborn led to a cascade of disruptions to newborn care and breastfeeding practices in the study institutions. Separating the newborn from the mother should be avoided during public health emergencies unless there is robust evidence favoring the same; routine institutional practices should be family centered.
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Affiliation(s)
- Arti Maria
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India,*Correspondence: Arti Maria
| | - Ritika Mukherjee
- Generating Research Insights for Development (GRID) Council, Executive Office, Noida, Uttar Pradesh, India
| | - Swati Upadhyay
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Kumari Pratima
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Tapas Bandyopadhyay
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Rachita Gupta
- WHO Country Office for India, Nutrition, R.K. Khanna Stadium, Safdarjung Enclave, New Delhi, India
| | - Bhawna Dubey
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Abhinav Sharma
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Pranaya Kumar Mall
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Manaswinee Sahoo
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Keshav Kumar Pathak
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Priyanka Pawar
- Generating Research Insights for Development (GRID) Council, Executive Office, Noida, Uttar Pradesh, India
| | - Archisman Mohapatra
- Generating Research Insights for Development (GRID) Council, Executive Office, Noida, Uttar Pradesh, India,Archisman Mohapatra
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Yin N, Liu X, Zhang X, Wen J, Ma H, Yin X, Xie C, Hou Y, Wang J. Comparison of the effects of different infant formulas on the growth and development and intestinal flora of infants. Food Sci Nutr 2022; 11:1113-1126. [PMID: 36789049 PMCID: PMC9922136 DOI: 10.1002/fsn3.3149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 11/05/2022] [Accepted: 11/06/2022] [Indexed: 12/12/2022] Open
Abstract
The purpose of this study was to compare the effects of different infant formulas on the growth and development, sleep, allergy symptoms, and intestinal flora of infants. A total of 428 infants participated in the study. Breastfeeding (BF) was used as the control, and the remaining subjects were randomly assigned to the full goat milk protein formula group (FGM), partial goat milk protein formula group (PGM), and cow milk formula group (M). During the 6-month feeding experiment, data on the growth, sleep, allergy symptoms, and intestinal flora of infants were collected using questionnaires, anthropometric measurements, and biochemical examinations. In general, the basic information of the participants was consistent among the groups. There were no differences in infant weight, length, or head circumference among the groups (p > .05). The sleep time of infants in the formula-fed groups was longer than that of the breastfeeding group at baseline (p < .05), but there were no differences at mid-term or outcome (p > .05). The incidence of allergic symptoms continued to decrease, and the total scores of allergic symptoms did not differ among the groups (p > .05). The relative abundance of intestinal Bifidobacteriaceae in the PGM group was lower than that in the other groups (p < .05). There was no difference in the β-diversity of intestinal flora between formula-fed and breastfed infants (p > .05). There were strong correlations in the composition of the main intestinal flora at the family level between the formula and breastfeeding groups. This study showed that within 6 months of feeding, there were no significant differences in the growth and development, allergic symptoms, or intestinal flora of the infants among the groups.
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Affiliation(s)
- Ning Yin
- Department of Nutrition and Food Hygiene, School of Public HealthPeking UniversityBeijingChina
| | - Xinran Liu
- Department of Nutrition and Food Hygiene, School of Public HealthPeking UniversityBeijingChina
| | - Xiaoxuan Zhang
- Department of Nutrition and Food Hygiene, School of Public HealthPeking UniversityBeijingChina
| | - Jing Wen
- Department of Nutrition and Food Hygiene, School of Public HealthPeking UniversityBeijingChina
| | - Huijuan Ma
- Department of Nutrition and Food Hygiene, School of Public HealthPeking UniversityBeijingChina
| | - Xueqian Yin
- Department of Nutrition and Food Hygiene, School of Public HealthPeking UniversityBeijingChina
| | | | - Yanmei Hou
- Ausnutria Hyproca Nutrition Co., Ltd.ChangshaChina
| | - Junbo Wang
- Department of Nutrition and Food Hygiene, School of Public HealthPeking UniversityBeijingChina,Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food SafetyPeking UniversityBeijingChina
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Olbertz D, Proquitté H, Patzer L, Erler T, Mikolajczak A, Sadowska-Krawczenko I, Wolff C, Radke M. Potential Benefit of Probiotic E. Coli Nissle in Term Neonates. KLINISCHE PADIATRIE 2022. [PMID: 36446590 PMCID: PMC10328724 DOI: 10.1055/a-1970-4340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Probiotics are often viewed as an immunity enhancing agent. The objective of this study was to investigate whether oral administration of Escherichia coli Nissle 1917 reduces the number of infections, their duration, and severity in the first 24 months after parturition in healthy neonates. SUBJECTS AND METHODS This prospective, confirmatory, randomised, double-blind, placebo-controlled study enrolled 567 healthy neonates from four German and two Polish sites. Neonates received 10e8 viable E. coli Nissle (n=283) or placebo (n=284) daily in the first week and every second day in week 2 and 3. After 6 and 12 months, the subjects received additional instillations on ten subsequent days. The overall efficacy was assessed by the number of infections per observation period. RESULTS Incidence rates of infection, infection duration and severity showed no statistically significant difference between groups after 24 months. Post-hoc analyses, however, revealed a short-term benefit of E. coli Nissle four weeks after treatment start which became less pronounced after eight weeks. E. coli Nissle was safe and well tolerated. CONCLUSIONS A long-term effect after colonising the healthy neonate´s gut with E. coli Nissle to protect against infections could not be shown. Additional studies are needed to confirm a transitory, yet clinically significant role of probiotics in the first four weeks after parturition.
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Affiliation(s)
- Dirk Olbertz
- Department of Neonatology, Klinikum Südstadt Rostock, Rostock, Germany
| | - Hans Proquitté
- Section of Neonatology and Neonatal Intensive Care, Department of Pediatrics, Jena University Hospital, Jena, Germany
| | - Ludwig Patzer
- Pediatrics, Children's Hospital St. Elisabeth and St. Barbara, Halle/Saale, Germany
| | - Thomas Erler
- Department of Pediatrics, Klinikum Westbrandenburg, Potsdam, Germany
| | - Alexsandra Mikolajczak
- Department of Neonatology, University Clinical Centre of Warsaw Medical University, Warsaw, Poland
| | - Iwona Sadowska-Krawczenko
- Department of Neonatology, Nicolaus Copernicus University in Toruń Ludwik Rydygier Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Corinna Wolff
- Department of Clinical Research, Ardeypharm GmbH, Herdecke, Germany
| | - Michael Radke
- Department of Pediatrics, University Hospital Rostock, Rostock, Germany
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Ijaiya MA, Anjorin S, Uthman OA. Individual and contextual factors associated with childhood malnutrition: a multilevel analysis of the double burden of childhood malnutrition in 27 countries. Glob Health Res Policy 2022; 7:44. [PMID: 36419186 PMCID: PMC9686063 DOI: 10.1186/s41256-022-00276-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/30/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Malnutrition is a key global health challenge and a major contributor to childhood morbidity and mortality. In recent times, the contrasting coexistence of undernutrition including micronutrient deficiencies and overweight/obesity called double burden of malnutrition has been noted at individual, household or population level and/or at different times in life. The objective of this study was to examine individual, neighborhood and country level factors that are associated with the double burden of childhood malnutrition. METHODS We conducted multivariable multilevel logistic regression analyses on the most recent demographic and health datasets from surveys conducted between 2015 and 2020 in low- and middle-income countries. We analyzed data of 138,782 children (level 1) living in 13,788 communities (level 2) from 27 countries (level 3). RESULTS The results of our analysis show variation in childhood malnutrition across the 27 countries from as low as 6.5% in Burundi to as high as 29.5% in Timor Leste. After adjusting for all level factors, we found that those who were wasted/overweight tended to have had an episode of diarrhea or fever in the last two weeks preceding the survey, were part of a multiple birth, were being breastfed at the time of the survey and born to mothers with more than one under 5-child resident in neighborhoods with high illiteracy and unemployment rates. The intra-neighbourhood and intra-country correlation coefficients were estimated using the intercept component variance; 44.3% and 21.0% of variance in odds of double burden of childhood malnutrition are consequent upon neighborhood and country level factors respectively. CONCLUSIONS Evidence of geographical clustering in childhood malnutrition at community and country levels was found in our study with variability due to neighborhood level factors twice that of country level factors. Therefore, strategies in tackling the double burden of malnutrition must consider these shared drivers, contextual barriers and geographical clustering effects.
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Affiliation(s)
- Mukhtar A. Ijaiya
- Jhpiego, Plot 971, Rueben Okoya Crescent, Off Okonjo Iweala Street, Wuye District, Abuja, FCT Nigeria
| | - Seun Anjorin
- Division of Health Sciences, Warwick Centre for Global Health, Warwick Medical School, University of Warwick, Coventry, CV4 7AL UK
| | - Olalekan A. Uthman
- Division of Health Sciences, Warwick Centre for Global Health, Warwick Medical School, University of Warwick, Coventry, CV4 7AL UK
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Hossain S, Mihrshahi S. Exclusive Breastfeeding and Childhood Morbidity: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14804. [PMID: 36429518 PMCID: PMC9691199 DOI: 10.3390/ijerph192214804] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/06/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Globally, diarrheal diseases and acute respiratory infections are the leading causes of morbidity and mortality in children under 5 years old. The benefits of exclusive breastfeeding in reducing the risk of gastrointestinal and respiratory infections are well documented. Optimal breastfeeding may potentially save the lives of about 800,000 children in low-income settings. Despite the evidence, around 63% of infants from birth to 6 months are not exclusively breastfed worldwide. We searched the literature published between 2010 and 2022 in Medline, Embase, and Scopus on the association between exclusive breastfeeding and infectious diseases. We selected and reviewed 70 relevant studies. Our findings expand and confirm the positive association between exclusive breastfeeding and reduced risk of a number of gastrointestinal, respiratory, and other infections in 60 out of 70 studies observed in both low- and high-income settings. Several studies analyzing exclusive breastfeeding duration reported that a longer exclusive breastfeeding duration is protective against many infectious diseases. This review also reported a lack of standardized definition for measuring exclusive breastfeeding in many studies. Overall, the results highlight the benefits of exclusive breastfeeding in many studies and suggests reporting exclusive breastfeeding in future studies using a consistent definition to enable better monitoring of exclusive breastfeeding rates.
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Mardani RAD, Wu WR, Nhi VT, Huang HC. Association of breastfeeding with undernutrition among children under 5 years of age in developing countries: A systematic review and meta-analysis. J Nurs Scholarsh 2022; 54:692-703. [PMID: 35844158 DOI: 10.1111/jnu.12799] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 06/01/2022] [Accepted: 06/15/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This meta-analysis was conducted to examine the association between breastfeeding and undernutrition among children under 5 years of age in developing countries. STUDY DESIGN Systematic review and meta-analysis. METHODS A comprehensive literature search was conducted of datasets from Embase, CINHAL, PubMed, Cochrane Library, and Indonesian databases to include eligible studies. Comprehensive Meta-Analysis 3.0 statistical software was used to perform data entry and data analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were extracted from each study or were calculated based on the reported number of cases and controls in each study. Random-effects models or fixed-effects models were used to demonstrate overall risk estimates. A moderator analysis was conducted to examine possible moderators explaining the heterogeneity across studies. FINDINGS In total, 33 studies were included which examined the association of breastfeeding with undernutrition. A random-effects model showed that breastfeeding had inverse correlations with overall undernutrition (OR = 0.82, 95% CI = 0.68, 0.99) and the stunting type of undernutrition (OR = 0.73, 95% CI = 0.55, 0.95). A moderator analysis showed that studies which included exclusive breastfeeding and unclear birth weights had low risks of overall undernutrition (p < 0.05). Moreover, studies which included exclusive breastfeeding and adopted a case-control study design exhibited a low risk of the stunting type of undernutrition (p < 0.05). CONCLUSIONS Providing breastfeeding or exclusive breastfeeding can benefit children under 5 years of age in developing countries reduce overall undernutrition and the stunting type of undernutrition. CLINICAL RELEVANCE Healthcare professionals should develop and implement suitable strategies to increase awareness regarding the importance of breastfeeding and enhance breastfeeding and exclusive breastfeeding adherence.
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Affiliation(s)
- Raden Ahmad Dedy Mardani
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan.,Sekolah Tinggi Ilmu Kesehatan Yarsi Mataram, Mataram, Indonesia
| | - Wan-Ru Wu
- Department of Nursing, College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Vo Thi Nhi
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan.,Faculty of Nursing, University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Hui-Chuan Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
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Nguyen TT, Cashin J, Tran HT, Hoang TA, Mathisen R, Weissman A, Murray JCS. Birth and newborn care policies and practices limit breastfeeding at maternity facilities in Vietnam. Front Nutr 2022; 9:1041065. [PMID: 36407547 PMCID: PMC9668009 DOI: 10.3389/fnut.2022.1041065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 10/10/2022] [Indexed: 09/29/2023] Open
Abstract
The prevalence of early and exclusive breastfeeding in Vietnam remains sub-optimal. The objective of this study was to determine factors associated with early initiation of breastfeeding (EIBF) and exclusive breastfeeding for the first 3 days after birth (EBF3D). We conducted a population-based, cross-sectional survey of 726 mothers with children aged 0-11 months in two provinces and one municipality from May to July 2020. Multinomial logistic regression was used to examine factors associated with EIBF and EBF3D. The prevalence of EIBF was 39.7% and EBF3D 18.0%. The EIBF prevalence is positively associated with immediate and uninterrupted skin-to-skin contact (SSC) for 10-29 min (aOR: 2.55; 95% CI: 1.49, 4.37), 30-59 min (aOR: 4.15; 95% CI: 2.08, 8.27), 60-80 min (aOR: 4.35; 95% CI: 1.50, 12.6), or ≥90 min (aOR: 5.87; 95% CI: 3.14, 10.98). EIBF was negatively associated with cesarean birth (aOR: 0.24; 95% CI: 0.11, 0.51), bringing infant formula to the birth facility (aOR: 0.49; 95% CI: 0.30, 0.78), purchased it after arrival (aOR: 0.37; 95% CI: 0.24, 0.60), or did both (aOR: 0.43; 95% CI: 0.21, 0.89). EBF3D was negatively associated with cesarean section birth (aOR: 0.15; 95% CI: 0.06, 0.39), vaginal birth with episiotomy (aOR: 0.40; 95% CI: 0.18, 0.88), bringing formula to the maternity facility (aOR: 0.03; 95% CI: 0.01, 0.07), purchased it after arrival (aOR: 0.02; 95% CI: 0.01, 0.06) or did both (aOR: 0.04; 95% CI: 0.02, 0.10). Receiving counseling from any source was not significantly associated with early breastfeeding practices. Policy and health service delivery interventions should be directed at eliminating infant formula from birthing environments, reducing unnecessary cesarean sections and episiotomies, providing immediate and uninterrupted SSC for all births, and improving breastfeeding counseling and support.
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Affiliation(s)
- Tuan T. Nguyen
- Alive & Thrive East Asia Pacific, FHI 360, Hanoi, Vietnam
| | - Jennifer Cashin
- Alive & Thrive East Asia Pacific, FHI 360, Washington, DC, United States
| | - Hoang T. Tran
- Neonatal Unit and Human Milk Bank, Department of Pediatrics, School of Medicine and Pharmacy, Da Nang Hospital for Women and Children, The University of Da Nang, Da Nang, Vietnam
| | - Tuan A. Hoang
- Department of Maternal and Child Health, Vietnam Ministry of Health, Hanoi, Vietnam
| | - Roger Mathisen
- Alive & Thrive East Asia Pacific, FHI 360, Hanoi, Vietnam
| | - Amy Weissman
- Alive & Thrive East Asia Pacific, FHI 360, Hanoi, Vietnam
- Asia Pacific Regional Office, FHI 360, Bangkok, Thailand
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Early Life Beef Consumption Patterns Are Related to Cognitive Outcomes at 1–5 Years of Age: An Exploratory Study. Nutrients 2022; 14:nu14214497. [PMID: 36364760 PMCID: PMC9654367 DOI: 10.3390/nu14214497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/20/2022] [Accepted: 10/22/2022] [Indexed: 11/25/2022] Open
Abstract
Protein, iron, zinc, and choline affect early brain development and are found in beef. The aims of this study were to describe (1) early feeding practices related to introduction of beef in the rural US west (Idaho); (2) parental perceptions of beef as a first food, and (3) associations between early beef consumption and child cognition at 1–5 years. A total of 61 children and their parents were enrolled. Parents completed a survey and a food frequency questionnaire to assess perceptions of beef and early feeding practices along with their child’s dietary intake at 6–12 months. Children’s cognitive function was assessed using the Bayley-4 Scales of Infant and Toddler Development (12–35 months) and the NIH Toolbox for Assessment of Neurological and Behavioral Function (NIHTB) (3–5 years). Parents introduced beef at 7.79 ± 2.65 months of age, primarily so that their children could eat what the family was eating. Higher intake of beef (r = 0.41, p = 0.02), zinc (r = 0.45, p = 0.01), and choline (r = 0.39, p = 0.03) at 6–12 months was associated with better attention and inhibitory control at 3–5 years of age. These findings support the role of beef as an early food for cognitive development, although controlled dietary intervention studies are needed.
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Gavine A, Shinwell SC, Buchanan P, Farre A, Wade A, Lynn F, Marshall J, Cumming SE, Dare S, McFadden A. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev 2022; 10:CD001141. [PMID: 36282618 PMCID: PMC9595242 DOI: 10.1002/14651858.cd001141.pub6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is extensive evidence of important health risks for infants and mothers related to not breastfeeding. In 2003, the World Health Organization recommended that infants be breastfed exclusively until six months of age, with breastfeeding continuing as an important part of the infant's diet until at least two years of age. However, current breastfeeding rates in many countries do not reflect this recommendation. OBJECTIVES 1. To describe types of breastfeeding support for healthy breastfeeding mothers with healthy term babies. 2. To examine the effectiveness of different types of breastfeeding support interventions in terms of whether they offered only breastfeeding support or breastfeeding support in combination with a wider maternal and child health intervention ('breastfeeding plus' support). 3. To examine the effectiveness of the following intervention characteristics on breastfeeding support: a. type of support (e.g. face-to-face, telephone, digital technologies, group or individual support, proactive or reactive); b. intensity of support (i.e. number of postnatal contacts); c. person delivering the intervention (e.g. healthcare professional, lay person); d. to examine whether the impact of support varied between high- and low-and middle-income countries. SEARCH METHODS We searched Cochrane Pregnancy and Childbirth's Trials Register (which includes results of searches of CENTRAL, MEDLINE, Embase, CINAHL, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform (ICTRP)) (11 May 2021) and reference lists of retrieved studies. SELECTION CRITERIA Randomised or quasi-randomised controlled trials comparing extra support for healthy breastfeeding mothers of healthy term babies with usual maternity care. Support could be provided face-to-face, over the phone or via digital technologies. All studies had to meet the trustworthiness criteria. DATA COLLECTION AND ANALYSIS: We used standard Cochrane Pregnancy and Childbirth methods. Two review authors independently selected trials, extracted data, and assessed risk of bias and study trustworthiness. The certainty of the evidence was assessed using the GRADE approach. MAIN RESULTS This updated review includes 116 trials of which 103 contribute data to the analyses. In total more than 98,816 mother-infant pairs were included. Moderate-certainty evidence indicated that 'breastfeeding only' support probably reduced the number of women stopping breastfeeding for all primary outcomes: stopping any breastfeeding at six months (Risk Ratio (RR) 0.93, 95% Confidence Interval (CI) 0.89 to 0.97); stopping exclusive breastfeeding at six months (RR 0.90, 95% CI 0.88 to 0.93); stopping any breastfeeding at 4-6 weeks (RR 0.88, 95% CI 0.79 to 0.97); and stopping exclusive breastfeeding at 4-6 (RR 0.83 95% CI 0.76 to 0.90). Similar findings were reported for the secondary breastfeeding outcomes except for any breastfeeding at two months and 12 months when the evidence was uncertain if 'breastfeeding only' support helped reduce the number of women stopping breastfeeding. The evidence for 'breastfeeding plus' was less consistent. For primary outcomes there was some evidence that 'breastfeeding plus' support probably reduced the number of women stopping any breastfeeding (RR 0.94, 95% CI 0.91 to 0.97, moderate-certainty evidence) or exclusive breastfeeding at six months (RR 0.79, 95% CI 0.70 to 0.90). 'Breastfeeding plus' interventions may have a beneficial effect on reducing the number of women stopping exclusive breastfeeding at 4-6 weeks, but the evidence is very uncertain (RR 0.73, 95% CI 0.57 to 0.95). The evidence suggests that 'breastfeeding plus' support probably results in little to no difference in the number of women stopping any breastfeeding at 4-6 weeks (RR 0.94, 95% CI 0.82 to 1.08, moderate-certainty evidence). For the secondary outcomes, it was uncertain if 'breastfeeding plus' support helped reduce the number of women stopping any or exclusive breastfeeding at any time points. There were no consistent findings emerging from the narrative synthesis of the non-breastfeeding outcomes (maternal satisfaction with care, maternal satisfaction with feeding method, infant morbidity, and maternal mental health), except for a possible reduction of diarrhoea in intervention infants. We considered the overall risk of bias of trials included in the review was mixed. Blinding of participants and personnel is not feasible in such interventions and as studies utilised self-report breastfeeding data, there is also a risk of bias in outcome assessment. We conducted meta-regression to explore substantial heterogeneity for the primary outcomes using the following categories: person providing care; mode of delivery; intensity of support; and income status of country. It is possible that moderate levels (defined as 4-8 visits) of 'breastfeeding only' support may be associated with a more beneficial effect on exclusive breastfeeding at 4-6 weeks and six months. 'Breastfeeding only' support may also be more effective in reducing women in low- and middle-income countries (LMICs) stopping exclusive breastfeeding at six months compared to women in high-income countries (HICs). However, no other differential effects were found and thus heterogeneity remains largely unexplained. The meta-regression suggested that there were no differential effects regarding person providing support or mode of delivery, however, power was limited. AUTHORS' CONCLUSIONS: When 'breastfeeding only' support is offered to women, the duration and in particular, the exclusivity of breastfeeding is likely to be increased. Support may also be more effective in reducing the number of women stopping breastfeeding at three to four months compared to later time points. For 'breastfeeding plus' interventions the evidence is less certain. Support may be offered either by professional or lay/peer supporters, or a combination of both. Support can also be offered face-to-face, via telephone or digital technologies, or a combination and may be more effective when delivered on a schedule of four to eight visits. Further work is needed to identify components of the effective interventions and to deliver interventions on a larger scale.
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Affiliation(s)
- Anna Gavine
- Mother and Infant Research Unit, School of Health Sciences, University of Dundee, Dundee, UK
| | - Shona C Shinwell
- Mother and Infant Research Unit, School of Health Sciences, University of Dundee, Dundee, UK
| | | | - Albert Farre
- Mother and Infant Research Unit, School of Health Sciences, University of Dundee, Dundee, UK
| | - Angela Wade
- Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, London, UK
| | - Fiona Lynn
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, Belfast, UK
| | - Joyce Marshall
- Division of Maternal Health, University of Huddersfield, Huddersfield, UK
| | - Sara E Cumming
- Mother and Infant Research Unit, School of Health Sciences, University of Dundee, Dundee, UK
- Mother and Infant Research Unit, University of Dundee, Dundee, UK
| | - Shadrach Dare
- Mother and Infant Research Unit, School of Health Sciences, University of Dundee, Dundee, UK
| | - Alison McFadden
- Mother and Infant Research Unit, School of Health Sciences, University of Dundee, Dundee, UK
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Stanton AM, O'Cleirigh C, Knight L, Davey DLJ, Myer L, Joska JA, Mayer KH, Bekker L, Psaros C. The importance of assessing and addressing mental health barriers to PrEP use during pregnancy and postpartum in sub-Saharan Africa: state of the science and research priorities. J Int AIDS Soc 2022; 25:e26026. [PMID: 36251124 PMCID: PMC9575939 DOI: 10.1002/jia2.26026] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Pregnant and postpartum women (PPW) in sub‐Saharan Africa are at disproportionately high risk of HIV infection compared to non‐pregnant women. When used consistently, pre‐exposure prophylaxis (PrEP) can prevent HIV acquisition and transmission to the foetus or infant during these critical periods. Recent studies have demonstrated associations between mental health challenges (e.g. depression and traumatic stress associated with intimate partner violence) and decreased PrEP adherence and persistence, particularly among adolescents, younger women and women in the postpartum period. However, mental health is not currently a major focus of PrEP implementation research and programme planning for PPW. Discussion PrEP implementation programmes for PPW need to assess and address mental health barriers to consistent PrEP use to ensure effectiveness and sustainability in routine care. We highlight three key research priorities that will support PrEP adherence and persistence: (1) include mental health screening tools in PrEP implementation research with PPW, both to assess the feasibility of integrating these tools into routine antenatal and postpartum care and to ensure that limited resources are directed towards women whose symptoms may interfere most with PrEP use; (2) identify cross‐cutting, transdiagnostic psychological mechanisms that affect consistent PrEP use during these periods and can realistically be targeted with intervention in resource‐limited settings; and (3) develop/adapt and test interventions that target those underlying mechanisms, leveraging strategies from existing interventions that have successfully mitigated mental health barriers to antiretroviral therapy use among people with HIV. Conclusions For PPW, implementation of PrEP should be guided by a robust understanding of the unique psychological difficulties that may act as barriers to uptake, adherence and persistence (i.e. sustained adherence over time). We strongly encourage PrEP implementation research in PPW to incorporate validated mental health screening tools and ultimately treatment in routine antenatal and postnatal care, and we stress the potential public health benefits of identifying women who face mental health barriers to PrEP use.
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Affiliation(s)
- Amelia M. Stanton
- Department of Psychological and Brain SciencesBoston UniversityBostonMassachusettsUSA,Massachusetts General HospitalBostonMassachusettsUSA,Fenway HealthBostonMassachusettsUSA
| | - Conall O'Cleirigh
- Massachusetts General HospitalBostonMassachusettsUSA,Fenway HealthBostonMassachusettsUSA,Harvard Medical SchoolBostonMassachusettsUSA
| | - Lucia Knight
- School of Public HealthUniversity of Cape TownCape TownSouth Africa
| | - Dvora L. Joseph Davey
- School of Public HealthUniversity of Cape TownCape TownSouth Africa,Division of Infectious Diseases, Geffen School of MedicineUniversity of California Los AngelesLos AngelesCaliforniaUSA
| | - Landon Myer
- School of Public HealthUniversity of Cape TownCape TownSouth Africa
| | - John A. Joska
- HIV Mental Health Research Unit, Division of Neuropsychiatry, Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
| | - Kenneth H. Mayer
- Fenway HealthBostonMassachusettsUSA,Harvard Medical SchoolBostonMassachusettsUSA,HIV Mental Health Research Unit, Division of Neuropsychiatry, Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa,Beth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | | | - Christina Psaros
- Massachusetts General HospitalBostonMassachusettsUSA,Harvard Medical SchoolBostonMassachusettsUSA
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Sultana M, Dhar S, Hasan T, Shill LC, Purba NH, Chowdhury AI, Shuvo SD. Knowledge, attitudes, and predictors of exclusive breastfeeding practice among lactating mothers in Noakhali, Bangladesh. Heliyon 2022; 8:e11069. [PMID: 36276726 PMCID: PMC9578980 DOI: 10.1016/j.heliyon.2022.e11069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/22/2021] [Accepted: 10/07/2022] [Indexed: 11/03/2022] Open
Abstract
Background Mothers' knowledge, attitudes, and practices toward exclusive breastfeeding are crucial to both child and mother's health and wellbeing. Hence, This study aimed to assess knowledge, attitudes, and practices of exclusive breastfeeding among lactating mothers as well as the predictors of their exclusive breastfeeding practice. Methodology This cross-sectional study included 397 mothers having infants aged 0-6 months who sought care at Noakhali Sadar Upazila, Noakhali, Bangladesh. A field-tested and validated Food and Agriculture Organization of the United Nations (FAO) questionnaire was utilized to collect information from participants. Results Of those evaluated; 29.0% of mothers could not define exclusive breastfeeding accurately, 11.3% and 59.3% did not know the benefits of exclusive breastfeeding for babies and mothers, respectively. More than half (51.4%) of the mothers reported feeling good about exclusive breastfeeding for six months, did not find difficulties to breastfeed exclusively for six months (39.5%) and on-demand (58.2%). The mothers had an overall favorable attitude towards exclusive breastfeeding; however, 38.3% of mothers did not exclusively breastfeed their children. Literate mothers tended to exclusively breastfeed more (AOR: 3.06, 95% CI: 1.01-9.32; P = 0.049) than illiterate mothers. Mothers having one baby were more likely to breastfeed exclusively (AOR: 3.07, 95% CI: 1.21-7.78; P = 0.018) than mothers having more than one baby. Moreover, mothers with higher knowledge and favorable attitude had more than two times (AOR: 2.58, 95% CI: 1.315.07; P = 0.006) and forty-three times (AOR: 43.18, 95% CI: 21.513-86.66; P < 0.001) the higher tendency of exclusive breastfeeding compared to others. Conclusion Despite having satisfactory knowledge and attitude, the practice of exclusive breastfeeding among mothers was poor. We recommend that interventions must be focused more on ensuring exclusive breastfeeding practice among mothers in addition to improving their knowledge and attitudes.
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Affiliation(s)
- Marjia Sultana
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Shishir Dhar
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Towhid Hasan
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh,Corresponding author.
| | - Lincon Chandra Shill
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Nafisa Habib Purba
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Akibul Islam Chowdhury
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Suvasish Das Shuvo
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore 7408, Bangladesh
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Marume A, Archary M, Mahomed S. Dietary patterns and childhood stunting in Zimbabwe. BMC Nutr 2022; 8:111. [PMID: 36224638 PMCID: PMC9555084 DOI: 10.1186/s40795-022-00607-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 09/19/2022] [Indexed: 11/26/2022] Open
Abstract
Background Diet is one important predictor of children’s growth, and often dietary interventions can assist with reversing adverse nutrition outcomes. Traditionally research has focused on individual food items or food classes to generate an understanding of disease risk. Dietary patterns provide a holistic approach to understanding the relationship between exposure and outcome. Method A matched case-control study was conducted. Caregivers of 450 children (225 cases, 225 controls) aged 6–59 months were asked to describe the diet their children had consumed in the previous 7 days using a Food Frequency Questionnaire. Dietary patterns were developed using factor analysis and regression analysis was conducted to assess which dietary pattern was associated with childhood stunting. Results Three dietary patterns were identified: modern (n = 181), low animal-source (n = 158), and traditional (n = 111). Children with the low animal source dietary pattern had increased odds of being stunted (AOR 1.03, p < 0.05). Three demographic factors (Child’s age, father’s age and having a sibling < 24 months apart) were identified as significant predictors of consumption of any of the traditional and low animal source diet (P < 0.001). Conclusion Nutrition intervention such as health education, counselling and supplementary feeding should include a holistic approach to dietary education not only focusing on promoting a balanced diet but improvement strengthening the upgrading of child’s dietary pattern taking into cognisant both quantity, and quality of nutrients provided to the child. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00607-7.
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Affiliation(s)
- Anesu Marume
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.,Ministry of Health and Child Care, Harare, Zimbabwe
| | - Moherndran Archary
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.,King Edward VIII Hospital, Durban, South Africa
| | - Saajida Mahomed
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Miller EB, Whipps MDM, Bogen DL, Morris PA, Mendelsohn AL, Shaw DS, Gross RS. Collateral benefits from a school-readiness intervention on breastfeeding: A cross-domain impact evaluation. MATERNAL & CHILD NUTRITION 2022; 19:e13446. [PMID: 36218286 PMCID: PMC9749611 DOI: 10.1111/mcn.13446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 11/05/2022]
Abstract
This study evaluated the collateral, or unanticipated, impacts of Smart Beginnings (SB), a two-site, tiered intervention designed to promote responsive parenting and school readiness, on breastfeeding intensity in a low-income sample. Impact analyses for the SB intervention were conducted using an intent-to-treat design leveraging a two-arm random assignment structure. Mothers assigned to the SB intervention group were more than three times more likely to give breastmilk as the only milk source at infant age 6 months than mothers assigned to the control group at one site, an effect not evident at the other study site. As development and growth are the two most salient domains of child health, understanding how interventions impact subsequent parenting practices across both domains is critical to address long-term economic and racial/ethnic disparities. Implications of the findings are discussed for improving the efficacy of interventions based on paediatric primary care.
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Affiliation(s)
- Elizabeth B. Miller
- Department of Population HealthNYU Grossman School of MedicineNew YorkNew YorkUSA
| | | | - Debra L. Bogen
- Department of PediatricsUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Pamela A. Morris
- Department of Applied PsychologyNew York UniversityNew YorkNew YorkUSA
| | - Alan L. Mendelsohn
- Department of PediatricsNYU Grossman School of MedicineNew YorkNew YorkUSA
| | - Daniel S. Shaw
- Department of PsychologyUniversity of Pittsburgh, PittsburghPennsylvaniaUSA
| | - Rachel S. Gross
- Department of PediatricsNYU Grossman School of MedicineNew YorkNew YorkUSA
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Bengough T, Dawson S, Cheng H, McFadden A, Gavine A, Rees R, Sacks E, Hannes K. Factors that influence women's engagement with breastfeeding support: A qualitative evidence synthesis. MATERNAL & CHILD NUTRITION 2022; 18:e13405. [PMID: 36006012 PMCID: PMC9480951 DOI: 10.1111/mcn.13405] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 05/05/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022]
Abstract
Breastfeeding is an integral part of early childhood interventions as it can prevent serious childhood and maternal illnesses. For breastfeeding support programmes to be effective, a better understanding of contextual factors that influence women's engagement and satisfaction with these programmes is needed. The aim of this synthesis is to suggest strategies to increase the level of satisfaction with support programmes and to better match the expectations and needs of women. We systematically searched for studies that used qualitative methods for data collection and analysis and that focused on women's experiences and perceptions regarding breastfeeding support programmes. We applied a maximum variation purposive sampling strategy and used thematic analysis. We assessed the methodological quality of the studies using a modified version of the CASP tool and assessed our confidence in the findings using the GRADE-CERQual approach. We included 51 studies of which we sampled 22 for in-depth analysis. Our sampled studies described the experiences of women with formal breastfeeding support by health care professionals in a hospital setting and informal support as for instance from community support groups. Our findings illustrate that the current models of breastfeeding support are dependent on a variety of contextual factors encouraging and supporting women to initiate and continue breastfeeding. They further highlight the relevance of providing different forms of support based on socio-cultural norms and personal backgrounds of women, especially if the support is one-on-one. Feeding decisions of women are situated within a woman's personal situation and may require diverse forms of support.
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Affiliation(s)
- Theresa Bengough
- Research Group SoMeTHin'K (Social, Methodological and Theoretical Innovation/Kreative), Faculty of Social SciencesKU LeuvenLeuvenBelgium
- National Centre for Early Childhood InterventionThe Austrian Public Health InstituteViennaAustria
| | - Shoba Dawson
- Faculty of Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Hui‐Lin Cheng
- School of NursingThe Hong Kong Polytechnic UniversityKowloonHong Kong
| | - Alison McFadden
- School of Health SciencesUniversity of DundeeDundeeScotlandUK
| | - Anna Gavine
- School of Health SciencesUniversity of DundeeDundeeScotlandUK
| | - Rebecca Rees
- EPPI‐Centre, Social Science Research Unit, UCL Institute of EducationUniversity College LondonLondonUK
| | - Emma Sacks
- Department of International HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Karin Hannes
- Research Group SoMeTHin'K (Social, Methodological and Theoretical Innovation/Kreative), Faculty of Social SciencesKU LeuvenLeuvenBelgium
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Doherty T, Engebretsen IMS, Tylleskär T, Burgoine K, Baerug A, Mercer R, Baker P, Clark D, Pereira-Kotze CJ, Kroon M. Questioning the ethics of international research on formula milk supplementation in low-income African countries: response. BMJ Glob Health 2022. [PMCID: PMC9438033 DOI: 10.1136/bmjgh-2022-010227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Tanya Doherty
- Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa
- School of Public Health, University of the Western Cape Faculty of Community and Health Sciences, Cape Town, South Africa
- Department of Paediatrics and Child Health, University of Cape Town Faculty of Health Sciences, Observatory, South Africa
| | - Ingunn Marie S Engebretsen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Thorkild Tylleskär
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Centre for Intervention Science in Maternal and Child Health, University of Bergen, Bergen, Norway
| | - Kathy Burgoine
- Neonatal Unit, Mbale Regional Referral Hospital, Mbale, Uganda
| | - Anne Baerug
- Unit on Breastfeeding, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Raul Mercer
- Program of Social Sciences and Health, Latin American School of Social Sciences (FLACSO), Buenos Aires, Argentina
| | - Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - David Clark
- Giovine-Clark Consultancy, Independent, New York, New York, USA
| | - Catherine Jane Pereira-Kotze
- School of Public Health, University of the Western Cape Faculty of Community and Health Sciences, Cape Town, South Africa
| | - Max Kroon
- Department of Paediatrics and Child Health, University of Cape Town Faculty of Health Sciences, Observatory, South Africa
- Neonatal Service, Mowbray Maternity Hospital, Mowbray, South Africa
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How do the determinants of exclusive breast-feeding change over time? A multi-survey quasi-longitudinal study in Lao People's Democratic Republic. Public Health Nutr 2022; 25:2380-2394. [PMID: 35657684 PMCID: PMC9991563 DOI: 10.1017/s1368980022001380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The current study aimed to assess trends, associated factors and the changes in these factors for exclusive breast-feeding (EBF) over the past two decades in Lao People's Democratic Republic (Lao PDR). DESIGN The current study used a quasi-longitudinal design. Descriptive analyses were done with correction for complex survey design. Inferential analyses were done for survey years separately using multiple logistic regression. Finally, pooled logistic regression analysis was done using interaction terms to quantify the difference in association per year. SETTING The current study used data from all provinces of Lao PDR collected in the years 2000, 2006, 2011/2012 and 2017. PARTICIPANTS Children aged six months or younger from Lao PDR. RESULTS EBF practice was estimated at 19·03 %, 26·87 %, 40·67 % and 44·89 % in the four survey years, respectively. Factors significantly associated with EBF included: region of residence, ethnicity, wealth index and age of child. Region and ethnicity saw significant changes in association, and the South developing positively over time as well as in the Lao-Thai ethnic group. Having had any antenatal visits was not associated with EBF practice, nor did this change over time. CONCLUSIONS Our study shows how EBF trends, and factors associated with EBF, changed over time. We applied an easily replicable methodology to assess similar public health phenomena. We argue that such analysis is particularly relevant for transitioning countries. In such rapidly evolving settings, it is crucial to take into account changing underlying factors when assessing and developing public health policy.
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Comparative Analysis of the Protein Composition of Goat Milk from French Alpine, Nubian, and Creole Breeds and Holstein Friesian Cow Milk: Implications for Early Infant Nutrition. Animals (Basel) 2022; 12:ani12172236. [PMID: 36077959 PMCID: PMC9454708 DOI: 10.3390/ani12172236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 11/23/2022] Open
Abstract
Simple Summary Goat’s milk is a food that contains proteins of value for nutrition. The protein profile in the milk of goat breeds is different from that of cow milk, with a lower relative abundance of allergenic proteins. In addition, regardless of the breed, goat milk has beta-casein of type A2 in a more significant proportion than cow milk, which impacts different bioactive peptides hydrolyzed in the milk of the species. Abstract Of the diversity of proteins and high digestibility, goat milk will be a food of significant value for infant nutrition. The genetic polymorphisms of milk proteins play an essential role in the different degrees of allergic reactions. This work aimed to identify the proteins and peptides in the composition of goat milk and compare them to those in cow’s milk. The work was performed with goats French Alpine, Nubian, and Creole breeds and Holstein Friesian milking cows at the Universidad Autónoma de Querétaro, Amazcala. We investigated the relative abundance of goat and cow milk protein fractions by SDS-PAGE resolution and the densitometric analysis of gels. The protein alfa-casein was (17.67 ± 0.46) for Creole, (19.18 ± 0.88) French Alpine, (17.35 ± 0.49) Nubian, and (35.92 ± 1.96) Holstein cows. The relative abundance obtained from alfa-casein was statistically different between goats and cows, and this protein was vital because it is a protein related to allergies. On the other hand, the amino acid in position 67 of the beta-casein from three goat breeds is a Proline, so it is assumed that the beta-casein variant of goat milk is an A2-type. The latter has excellent relevance for infant nutrition and differs from cow milk.
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Kortesniemi M, Jafari T, Zhang Y, Yang B. 1H NMR Metabolomics of Chinese Human Milk at Different Stages of Lactation among Secretors and Non-Secretors. Molecules 2022; 27:molecules27175526. [PMID: 36080292 PMCID: PMC9458218 DOI: 10.3390/molecules27175526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/17/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
Human milk is an intricate, bioactive food promoting infant health. We studied the composition of human milk samples collected over an 8-month lactation using 1H NMR metabolomics. A total of 72 human breast milk samples were collected from ten Chinese mothers at eight different time points. The concentrations of ten human milk oligosaccharides (HMOs), fucose and lactose were quantified. Six of the mothers were classified as Lewis-positive secretors (Se+Le+) and four as Lewis-positive non-secretors (Se−Le+) based on the levels of 2′-fucosyllactose (2′-FL), lacto-N-fucopentaose (LNFP) II, lactodifucotetraose (LDFT) and lacto-N-neotetraose (LNnT). Acetate, citrate, short/medium-chain fatty acids, glutamine and urea showed a time-dependent trend in relation to the stage of lactation. The concentrations of 2′-FL, 3-FL (3-fucosyllactose), 3′-SL (3′-sialyllactose), LDFT, LNFP I, LNFP II, LNFP III, LNnT, LNT (lacto-N-tetraose), and fucose were statistically different between secretors and non-secretors. A temporal difference of approximately 1–2 months between the development of non-secretor and secretor HMO profiles was shown. The results highlighted the importance of long-term breastfeeding, especially among non-secretors.
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Affiliation(s)
- Maaria Kortesniemi
- Food Sciences, Department of Life Technologies, University of Turku, FI-20014 Turku, Finland
- Correspondence: (M.K.); (Y.Z.)
| | - Tahereh Jafari
- Food Sciences, Department of Life Technologies, University of Turku, FI-20014 Turku, Finland
| | - Yumei Zhang
- Department of Nutrition and Food Hygiene, Peking University, Xueyuan Road 38, Haidian District, Beijing 100191, China
- Correspondence: (M.K.); (Y.Z.)
| | - Baoru Yang
- Food Sciences, Department of Life Technologies, University of Turku, FI-20014 Turku, Finland
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Mulville K, Kai J, Kearney JM, Ng-Osorio J, Boushey CJ, Fialkowski MK. A Qualitative Analysis of a Caregivers' Experience of Complementary Feeding in a Population of Native Hawaiian, Other Pacific Islander and Filipino Infants: The Timing of the Introduction of Complementary Foods, and the Role of Transgenerational Experience. Nutrients 2022; 14:nu14163268. [PMID: 36014772 PMCID: PMC9412982 DOI: 10.3390/nu14163268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to investigate caregivers’ experiences of complementary feeding (CF) among the Native Hawaiian and Other Pacific Islander (NHPI), and Filipino populations. Research focused on the timing of CF commencement, and the influence of transgenerational experience on feeding practices. The experiences and practices of those who fed human milk exclusively (HME), were compared to those who included infant formula (F&HM). Caregivers of a subset of 32 infants who were participating in a larger longitudinal study relating to CF and diet diversity, took part in voluntary in-depth interviews relating to CF practices. Interviews were recorded and transcribed. Two researchers analyzed interview transcripts. Interrater reliability and saturation were established. Institutional Review Board exemption was confirmed prior to study commencement. Interviews with 29 caregivers of infants were included in this study. Only infants of the F&HM group had an early introduction to complementary foods (<4 months of age). Caregivers reported receiving conflicting advice from healthcare professionals (HCPs) in relation to timing of the introduction of complementary foods. Nonetheless, the majority of caregivers reported following the advice of HCPs. Extended family (including grandparents) played less of a role in infant feeding, compared to previous generations. While transgenerational practices were valued and included, ultimately, the perceived health and safety of the practice for infants influenced decisions.
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Affiliation(s)
- Kara Mulville
- School of Biological Sciences, Technological University Dublin, Grangegorman, D02 HW71 Dublin, Ireland
- Trinity College Dublin, The University of Dublin, College Green, D02 PN40 Dublin, Ireland
| | - Jessie Kai
- Department of Human Nutrition, Food, and Animal Sciences, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - John M. Kearney
- School of Biological Sciences, Technological University Dublin, Grangegorman, D02 HW71 Dublin, Ireland
| | - Jacqueline Ng-Osorio
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI 96813, USA
| | - Carol J. Boushey
- University of Hawaii Cancer Center, University of Hawai‘i at Mānoa, Honolulu, HI 96813, USA
| | - Marie K. Fialkowski
- Department of Human Nutrition, Food, and Animal Sciences, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
- Correspondence:
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Hophing L, Kyriakopoulos P, Bui E. Sex and gender differences in epilepsy. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 164:235-276. [PMID: 36038205 DOI: 10.1016/bs.irn.2022.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Sex and gender differences in epilepsy are important influencing factors in epilepsy care. In epilepsy, the hormonal differences between the sexes are important as they impact specific treatment considerations for patients at various life stages particularly during early adulthood with establishment of the menstrual cycle, pregnancy, perimenopause and menopause. Choice of antiseizure medication may have direct consequences on hormonal cycles, hormonal contraception, pregnancy and fetal risk of major congenital malformation. Conversely hormones whether intrinsic or extrinsically administered may have direct impact on antiseizure medications and seizure control. This chapter explores these important influences on the management of persons with epilepsy.
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Affiliation(s)
- Lauren Hophing
- Krembil Brain Institute, University Health Network, University of Toronto, Toronto, Canada
| | | | - Esther Bui
- Krembil Brain Institute, University Health Network, University of Toronto, Toronto, Canada.
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Duarte Lopes E, Monteiro AMRL, Varela DOBFC, Trigueiros DELR, Monteiro Spencer Maia I, de Jesus Xavier Soares J, da Luz Pires Vieira NM. The prevalence of exclusive breastfeeding and its associated factors in Cape Verde. BMC Nutr 2022; 8:74. [PMID: 35927737 PMCID: PMC9351167 DOI: 10.1186/s40795-022-00554-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 06/20/2022] [Indexed: 11/30/2022] Open
Abstract
Background Exclusive breastfeeding (EBF) for the first 6 months of life is essential for maternal and child health. Breast milk is considered the most suitable food for the child in early years of life. Studies carried out in Cape Verde (INE; MSSS, Apresentação dos Principais Resultados Preliminares do IDSR-III, 2018) showed prevalence of EBF below the values recommended by the (WHO & UNICEF, Global Breastfeeding Scorecard, 2018. Enabling Women To Breastfeed Through Better Policies And Programmes, 2019). However, the determinants of EBF across the country have never been identified. The objective of this study is to estimate prevalence and identify the determinants of EBF in Cape Verde. Methods This is a quantitative, descriptive and cross-sectional study carried out between July 2018 and March 2019. The study population consisted of 1717 mothers of children aged less than or equal to 2 years, users of the Health Centers of the islands of Santo Antão, S. Vicente, Sal, Santiago and Fogo. A structured questionnaire was applied to mothers through an interview. The prevalence of exclusive breastfeeding was estimated by frequency analysis. The chi-square test was used to assess the association between the duration of EB and the variables maternity leave, mother’s education, family income and health care variables. In order to identify the determinants of EBF, a binary logistic regression analysis was used. Results At the time of data collection, 32.50% of mothers practiced EBF. The present study shows that exclusive breastfeeding is influenced by several factors. The most representatives are maternal age (OR = 0.001*), level of education (OR = 0.028*), parity (OR = 0.004*) and number of prenatal consultations (OR = 0.019*). Receiving breastfeeding counseling was the only health care variable that was associated with the duration of EBF (p = 0.029). Conclusion In Cape Verde, the prevalence of EBF can be considered reasonable. The present study shows that EBF in the country is influenced by maternal age, level of education, parity and number of prenatal consultations. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00554-3.
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Wood NK, Odom-Maryon T, Smart DA. Factors Associated With Exclusive Direct Breastfeeding in the First 3 Months. Nurs Womens Health 2022; 26:299-307. [PMID: 35714762 DOI: 10.1016/j.nwh.2022.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/01/2022] [Accepted: 05/19/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To identify factors associated with exclusive direct breastfeeding in the first 3 months among mother and infant dyads living in the United States. DESIGN A secondary analysis of data collected using a cross-sectional online survey completed over a 4-month period in late 2019. PARTICIPANTS We recruited a convenience sample of 370 mothers with healthy full-term singleton infants between 1 and 12 weeks of age whose feeding methods consisted of direct breastfeeding at least once a day. Mothers had not returned to work/school at the time of the survey completion. MEASUREMENTS The questionnaire consisted of 34 questions about maternal and infant factors that influence decisions about infant feeding, professional support, and parental preferences. RESULTS Mothers who practiced feeding on demand (adjusted OR [aOR] = 35.76, 95% confidence interval [CI] [2.04, 500.00]) and mothers of infants 1 to 4 weeks of age (aOR = 2.74, 95% CI [1.54, 4.85]) were more likely to use exclusive direct breastfeeding. The odds of exclusive direct breastfeeding decreased with mothers who breastfed with a nipple shield while in the hospital/birth center/home (aOR = 0.13, 95% CI [0.05, 0.35]), used pacifiers (aOR = 0.31, 95% CI [0.21, 0.65]), or had perceptions of insufficient milk (aOR = 0.11, 95% CI [0.04, 0.26]). CONCLUSION Demand feeding and an infant's age of 1 to 4 weeks contributed to exclusive direct breastfeeding. Lower rates of exclusive direct breastfeeding were associated with the use of nipple shields immediately after birth, pacifier use, and perceptions of insufficient milk. Further investigation is warranted to fully differentiate exclusive direct breastfeeding from exclusive breastfeeding.
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75
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Bedford R, Piccinini-Vallis H, Woolcott C. The relationship between skin-to-skin contact and rates of exclusive breastfeeding at four months among a group of mothers in Nova Scotia: a retrospective cohort study. CANADIAN JOURNAL OF PUBLIC HEALTH 2022; 113:589-597. [PMID: 35362936 PMCID: PMC9263019 DOI: 10.17269/s41997-022-00627-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/10/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Exclusive breastfeeding is the ideal source of nutrition for the first 6 months of life. Although skin-to-skin contact (SSC) has been shown to be associated with greater rates of exclusive breastfeeding, the results are heterogeneous. SSC involves placing a naked infant on its mother's bare chest immediately after birth. We examined the association between SSC immediately after birth and exclusive breastfeeding at 4 months. METHODS A retrospective cohort of healthy, term, singleton infants who were liveborn from 2008 to 2019 was constructed from the Nova Scotia Atlee Perinatal Database. Our main outcome was exclusive breastfeeding at 4 months, available for a subset of the cohort through linkage to a primary care database (n=256). Our secondary outcome was exclusive breastfeeding at hospital discharge, available for the broader cohort (n=56,459). Odds ratios (OR) for the association between SSC and exclusive breastfeeding at 4 months were estimated from logistic regression models. RESULTS The odds of breastfeeding exclusively at 4 months were 4.14 (95% confidence interval (CI) 1.89-9.25) times greater among those who had SSC than among those who did not. The odds of breastfeeding exclusively at hospital discharge were 3.81 (95% CI 3.64-3.99) times greater among those who had SSC than among those who did not. The association between SSC and exclusive breastfeeding at hospital discharge was heterogeneous by birth year (OR 4.35, CI 4.07-4.65 in 2008-2011; OR 2.81, CI 2.57-3.07 in 2012-2015; OR 1.89, CI 1.63-2.10 in 2016-2019). CONCLUSION Skin-to-skin contact appears to be associated with greater odds of exclusive breastfeeding at discharge and 4 months postpartum. Early SSC should continue to be supported for breastfeeding promotion.
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Affiliation(s)
- Riiko Bedford
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
| | | | - Christy Woolcott
- Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, Nova Scotia, Canada
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Nisa' F, Damayanti NA, Suhariadi F, Herisanty W, Afiyah RK. Internal factors affecting the mother's psychological capital in exclusive breastfeeding during the COVID-19 pandemic. J Public Health Res 2022; 11:22799036221106619. [PMID: 35911426 PMCID: PMC9335479 DOI: 10.1177/22799036221106619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 11/15/2022] Open
Abstract
Background: During the pandemic, in terms of breastfeeding, most mothers experience anxiety and discomfort. The impact of this condition will decrease the production of breast milk. The purpose of this study was to determine the internal factors that affect the psychological capital of mothers when breastfeeding during the COVID-19 pandemic in Petiken Village, Gresik. Design and methods: This study was an analytical study with a cross-sectional approach. The population of this study was all breastfeeding mothers who had babies aged 6–12 months. The sampling technique used was simple random sampling involving 102 respondents. The independent variables were motivation, perception, and attitude. The dependent variable was psychological capital. Data were collected from June to July 2021. The data analysis was conducted using the logistic regression test to determine the variable with a significance level of p < 0.05. Results: The results of the multivariate analysis showed that the motivation variable was p = 0.036. Motivation had effect on psychological capital. While the perception variable was p = 0.056 (p > 0.05), the perception had no effect on psychological capital. The attitude variable p = 0.055 (p > 0.05), the attitude had no effect on psychological capital. The factor that affects the mother’s psychological capital in relation to exclusive breastfeeding during the COVID-19 pandemic was motivation. Conclusion: It is expected that mothers have a high motivation which can affect the mother’s psychological capital. It is needed to increase and succeed at providing exclusive breastfeeding.
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Affiliation(s)
- Fauziyatun Nisa'
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.,Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama, Surabaya, Indonesia
| | | | - Fendy Suhariadi
- Faculty of Psychology, Universitas Airlangga, Surabaya, Indonesia
| | - Wesiana Herisanty
- Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama, Surabaya, Indonesia
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Peregoy JA, Pinheiro GM, Geraghty SR, Dickin KL, Rasmussen KM. Human milk-sharing practices and infant-feeding behaviours: A comparison of donors and recipients. MATERNAL & CHILD NUTRITION 2022; 18:e13389. [PMID: 35757994 PMCID: PMC9480963 DOI: 10.1111/mcn.13389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 03/04/2022] [Accepted: 03/14/2022] [Indexed: 11/28/2022]
Abstract
Human milk sharing (HMS) is growing in popularity as an infant-feeding strategy in the United States. HMS families are a hidden population because HMS is a nonnormative and stigmatized behaviour. Thus, gaining access to HMS participants is challenging, and research on this topic remains limited. In particular, little is known about the broader infant-feeding behaviours of HMS parents. This study aimed to describe and compare the infant-feeding behaviours and HMS practices among a network of HMS donors and recipients. A detailed online survey was distributed to HMS parents in the Washington, DC region. Bivariate analyses were used to summarize the data by donor/recipient status when possible. Group differences were tested using analysis of variance for continuous variables and χ2 tests for categorical variables. Donors and recipients did not differ in their sociodemographic characteristics. Recipients were significantly more likely than donors to have experienced complications of labour and delivery, traumatic birth, postpartum depression or a negative breastfeeding experience. Donors and recipients did not differ significantly in their duration of lactation or HM-feeding. Interestingly, 30% of recipients ever produced excess milk and 21% of donors ever had difficulty producing enough milk for their child. Compared with donors, recipients faced numerous maternal health challenges, but were still able to achieve a long duration of HM-feeding. HMS recipients represent a vulnerable group who may benefit from additional psychosocial and lactation support to improve their health and breastfeeding outcomes. Additional research is needed to investigate the associations between HMS participation, infant-feeding behaviours and lactation outcomes.
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Affiliation(s)
| | | | | | - Katherine L. Dickin
- Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA,Department of Public and Ecosystem HealthCornell UniversityIthacaNYUSA
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Grant FKE, Ackatia-Armah R, Okuku HS, Kakuhenzire R. Association Between Nutrition Social Behavior Change Communication and Improved Caregiver Health and Nutrition Knowledge and Practices in Rural Tanzania. Front Public Health 2022; 10:736666. [PMID: 35795709 PMCID: PMC9251192 DOI: 10.3389/fpubh.2022.736666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 05/19/2022] [Indexed: 01/09/2023] Open
Abstract
Background Efforts to improve infant and young child feeding practices include the use of nutrition behavior change communication among caregivers of children under 5 years. We assessed the association between monthly participation in community-level nutrition group meetings on caregiver health and nutrition knowledge and practices (KPs). Methods Data from a community-based cross-sectional survey conducted in the Eastern and Southern Highland Zones of Tanzania were used. Indices were developed for caregivers' knowledge of nutrition, health and childcare, household (HDD) and young child dietary diversity (CDD), and vitamin A (VA) intakes. The comparison of means and proportions was assessed using Student's t-test and the Chi-square test, respectively, between the caregivers participating in nutrition group meetings and non-participants. The impact of the number of nutrition meeting attendance on caregiver KPs scores was examined using multiple regression. Results Of 547 caregivers surveyed, 49.7% attended nutrition group meetings and received information on nutrition social behavior change communication (SBCC). Overall, 28% of participating women had a moderate level of nutrition knowledge, 62% had a high level of VA knowledge, and 57% had a high level of health and childcare knowledge. Participation in nutrition group meetings was significantly associated with the health and childcare knowledge score (HKS), HDD and CDD scores, and household and young child VA intake; the magnitude of the associations was greater for caregivers who attended at least four meetings. Conclusion The findings emphasize the need for programs that seek to address the issues present in the use of nutrition SBCC at the community level to improve maternal or caregiver KPs and subsequently the nutrition status of infants and young children.
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Exploring Infant Feeding Practices and associated factors among HIV Positive Mothers Attending Early Infant Diagnosis Clinic in Northern Uganda. Epidemiol Infect 2022; 150:e130. [PMID: 35718949 PMCID: PMC9306008 DOI: 10.1017/s0950268822001091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Buckland C, Hector D, Kolt GS, Thepsourinthone J, Arora A. Experiences of young Australian mothers with infant feeding. BMC Pregnancy Childbirth 2022; 22:489. [PMID: 35705921 PMCID: PMC9199343 DOI: 10.1186/s12884-022-04796-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the overwhelming evidence of health and other benefits of breastfeeding and recommendations to breastfeed by peak health bodies, breastfeeding rates are significantly lower than recommended in Australia and globally. Young mothers are identified as being at high risk of not breastfeeding their infants according to infant feeding recommendations. This study aimed to gain an in-depth understanding of young Australian mothers' experiences of infant feeding, and to explore the factors which facilitated or hindered adherence to recommended breastfeeding practices. METHODS Purposive and snowball sampling were used to recruit young mothers in Australia (n = 17) aged 18-25 years who had given birth to their first child within the last two years. Data were collected through semi-structured interviews via online videoconferencing. Interviews were audio-recorded, transcribed verbatim, coded, and subsequently analysed. Thematic analysis was conducted using Quirkos, a qualitative data management and analysis software. RESULTS Four major themes were identified: Breastfeeding is challenging; Feeling judged about infant feeding choices; Experiences with breastfeeding support; and Experiences and views on breastfeeding education. Most mothers reported experiencing breastfeeding challenges, particularly those arising from lactation difficulties, yet many were able to overcome these challenges through their determination to breastfeed. Many mothers expressed perceiving judgement from others for breastfeeding in public. Some mothers who were bottle feeding their infants, whether with expressed breast milk or infant formula, felt that they were being judged for using a bottle. Many mothers reported professional, partner, family, and peer support as critical facilitators to the continuation of breastfeeding. Most mothers shared positive experiences of attending breastfeeding education sessions, but indicated the need for community education to reduce judgement toward mothers' infant feeding decisions. CONCLUSIONS The barriers and enablers to infant feeding experienced by young mothers are similar to those experienced by mothers of all ages. Young mothers experience significant breastfeeding challenges and need support from partner, family, peers, and professionals to continue breastfeeding in line with recommendations. Breastfeeding campaigns to support young mothers should be aimed at the wider community to increase awareness of breastfeeding challenges, reduce stigma associated with breastfeeding in public, and to support mothers in their infant feeding decisions.
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Affiliation(s)
- Christa Buckland
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia. .,Health Equity Laboratory, Campbelltown, NSW, 2560, Australia.
| | - Debra Hector
- Cancer Australia, Surry Hills, NSW, 2010, Australia
| | - Gregory S Kolt
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Jack Thepsourinthone
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,Health Equity Laboratory, Campbelltown, NSW, 2560, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,Health Equity Laboratory, Campbelltown, NSW, 2560, Australia.,Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia.,Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW, 2010, Australia
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Moore AM, Smith JJ, Stansfield BK, Savage JS, Lavner JA. Patterns and Predictors of Breast Milk Feeding from Birth to Age 4 Months among Primiparous African American Mother–Infant Dyads. Nutrients 2022; 14:nu14112350. [PMID: 35684150 PMCID: PMC9182812 DOI: 10.3390/nu14112350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 11/16/2022] Open
Abstract
The health benefits of breast milk feeding have been well-established, yet disparities exist, with African American mothers having the lowest breast milk feeding rates in the United States. This prospective, longitudinal study examined infant feeding (breast milk and/or infant formula) from birth to age 16 weeks, predictors of any breast milk feeding by age 1 week, and predictors of cessation of any breast milk feeding by ages 3, 8, and 16 weeks among primiparous African American mothers. This secondary analysis included 185 mother–infant dyads from the Sleep SAAF (Strong African American Families) study, a randomized clinical trial testing a responsive parenting vs. child safety control intervention. Mothers reported sociodemographic and psychosocial characteristics at age 1 week and infant feeding practices at ages 1, 3, 8, and 16 weeks. Rates of any breast milk feeding decreased from 66.5% at 1 week to 23.3% at 16 weeks. Bivariate logistic regression models showed that prepregnancy BMI (OR = 1.09), working prepregnancy (OR = 2.25), and food insecurity (OR = 2.49) significantly increased the odds of mothers feeding any breast milk by 1 week, whereas Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation (OR = 0.21) significantly decreased the odds. Bivariate logistic regression models showed that Supplemental Nutrition Assistance Program (SNAP) participation (OR = 2.86) and racial discrimination (OR = 2.14) significantly increased the odds of cessation of any breast milk feeding by 3 weeks. SNAP (OR = 2.33) and WIC (OR = 2.38) participation significantly increased the odds of cessation of any breast milk feeding by 8 weeks, whereas higher prepregnancy BMI (OR = 0.95) decreased the odds. Higher mother’s age (OR = 0.92) significantly decreased the odds of cessation of any breast milk feeding by 16 weeks. The findings can be used to inform targeted interventions to promote mothers feeding any breast milk and help reduce breast milk feeding disparities among African American mothers.
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Affiliation(s)
- Amy M. Moore
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA 16802, USA;
- Correspondence:
| | - Jessica J. Smith
- Center for Family Research, University of Georgia, Athens, GA 30602, USA;
| | - Brian K. Stansfield
- Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
| | - Jennifer S. Savage
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA 16802, USA;
| | - Justin A. Lavner
- Department of Psychology, University of Georgia, 156 Psychology Building, Athens, GA 30602, USA;
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Foong SC, Foong WC, Tan ML, Ho JJ. Mothers' hygiene experiences in confinement centres: A cohort study. PLoS One 2022; 17:e0268676. [PMID: 35604895 PMCID: PMC9126405 DOI: 10.1371/journal.pone.0268676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/04/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Ethnic Malaysian Chinese used to observe the 1-month postpartum confinement period at home and many families would engage a traditional postpartum carer to help care for the mother and newborn. A recent trend has been the development of confinement centres (CCs) which are private non-healthcare establishments run by staff not trained in health care. Concerns about hygiene in CCs arose after infections were reported. We describe the practice of hand hygiene observed in CCs, the availability of resources for hygiene, and the prevalence of health-related problems in CCs. Methods This is a cohort study of ethnic Chinese mothers intending to breastfeed their healthy infants. They were recruited post-delivery along with a comparison group who planned to spend their confinement period at home. After their 1-month confinement period, they were contacted for a structured telephone interview about their experience. To avoid any alteration in behaviour, mothers were not told at recruitment that they had to observe hygiene practices. Multiple logistic regression was used to assess the effect of place of confinement on rates of infant health problems. Results Of 187 mothers, 88(47%) went to 27 different CCs while 99(53%) stayed at home. Response rates for the 1-month interviews were 88%(CC) versus 97%(home). Mothers in CC group stayed in one to four-bedded rooms and 92% of them had their baby sleeping separately in a common nursery described to have up to 17 babies at a time; 74% of them spent less than six hours a day with their babies; 43% noticed that CC staff had inadequate hand hygiene practices; 66% reported no hand basins in their rooms; 30% reported no soap at hand basins; 28% reported inexperienced or inadequate staff and 4% reported baby item sharing. Among the mothers staying at home, 35% employed a traditional postpartum carer for her baby; 32% did not room-in with their babies, but only 11% spent less than 6 hours a day with their babies. Of mothers who employed traditional postpartum carers, 32% did not know if their carer washed hands after changing diapers and 18% reported that their carer did not. Health problems that were probably related to infection (HPRI) like fever and cough were similar between the groups: 14%(CC) versus 14%(home) (p = 0.86). Multiple logistic regression did not show that CCs were a factor for HPRI: aOR 1.28 (95% CI 0.36 to 4.49). Three mothers reported events that could indicate transmission of infection in CCs. Conclusion We found unsatisfactory hygiene practices in CCs as reported by mothers who spent their confinement period there. Although we were not able to establish any direct evidence of infection transmission but based on reports given by the mothers in this study, it is likely to be happening. Therefore, future studies, including intervention studies, are urgently needed to establish an appropriate hygiene standard in CCs as well as the best method to implement this standard. Training CC staff with hygiene knowledge so that they can be empowered to contribute to the development of these standards would be important.
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Affiliation(s)
- Siew Cheng Foong
- Department of Paediatrics, RCSI & UCD Malaysia Campus (formerly Penang Medical College), George Town, Penang, Malaysia
- * E-mail:
| | - Wai Cheng Foong
- Department of Paediatrics, RCSI & UCD Malaysia Campus (formerly Penang Medical College), George Town, Penang, Malaysia
| | - May Loong Tan
- Department of Paediatrics, RCSI & UCD Malaysia Campus (formerly Penang Medical College), George Town, Penang, Malaysia
| | - Jacqueline Judith Ho
- Department of Paediatrics, RCSI & UCD Malaysia Campus (formerly Penang Medical College), George Town, Penang, Malaysia
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Hatmal MM, Al-Hatamleh MAI, Olaimat AN, Alshaer W, Hasan H, Albakri KA, Alkhafaji E, Issa NN, Al-Holy MA, Abderrahman SM, Abdallah AM, Mohamud R. Immunomodulatory Properties of Human Breast Milk: MicroRNA Contents and Potential Epigenetic Effects. Biomedicines 2022; 10:biomedicines10061219. [PMID: 35740242 PMCID: PMC9219990 DOI: 10.3390/biomedicines10061219] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 02/07/2023] Open
Abstract
Infants who are exclusively breastfed in the first six months of age receive adequate nutrients, achieving optimal immune protection and growth. In addition to the known nutritional components of human breast milk (HBM), i.e., water, carbohydrates, fats and proteins, it is also a rich source of microRNAs, which impact epigenetic mechanisms. This comprehensive work presents an up-to-date overview of the immunomodulatory constituents of HBM, highlighting its content of circulating microRNAs. The epigenetic effects of HBM are discussed, especially those regulated by miRNAs. HBM contains more than 1400 microRNAs. The majority of these microRNAs originate from the lactating gland and are based on the remodeling of cells in the gland during breastfeeding. These miRNAs can affect epigenetic patterns by several mechanisms, including DNA methylation, histone modifications and RNA regulation, which could ultimately result in alterations in gene expressions. Therefore, the unique microRNA profile of HBM, including exosomal microRNAs, is implicated in the regulation of the genes responsible for a variety of immunological and physiological functions, such as FTO, INS, IGF1, NRF2, GLUT1 and FOXP3 genes. Hence, studying the HBM miRNA composition is important for improving the nutritional approaches for pregnancy and infant's early life and preventing diseases that could occur in the future. Interestingly, the composition of miRNAs in HBM is affected by multiple factors, including diet, environmental and genetic factors.
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Affiliation(s)
- Ma’mon M. Hatmal
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan;
- Correspondence: (M.M.H.); (R.M.)
| | - Mohammad A. I. Al-Hatamleh
- Department of Immunology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia;
| | - Amin N. Olaimat
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan; (A.N.O.); (M.A.A.-H.)
| | - Walhan Alshaer
- Cell Therapy Center (CTC), The University of Jordan, Amman 11942, Jordan;
| | - Hanan Hasan
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan;
| | - Khaled A. Albakri
- Faculty of Medicine, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan;
| | - Enas Alkhafaji
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, The University of Jordan, Amman 11942, Jordan;
| | - Nada N. Issa
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan;
| | - Murad A. Al-Holy
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan; (A.N.O.); (M.A.A.-H.)
| | - Salim M. Abderrahman
- Department of Biology and Biotechnology, Faculty of Sciences, The Hashemite University, P.O. Box 330127, Zarqa 13133, Jordan;
| | - Atiyeh M. Abdallah
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha 2713, Qatar;
| | - Rohimah Mohamud
- Department of Immunology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia;
- Correspondence: (M.M.H.); (R.M.)
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84
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Mixed Milk Feeding: A New Approach to Describe Feeding Patterns in the First Year of Life Based on Individual Participant Data from Two Randomised Controlled Trials. Nutrients 2022; 14:nu14112190. [PMID: 35683990 PMCID: PMC9182968 DOI: 10.3390/nu14112190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/16/2022] [Accepted: 05/20/2022] [Indexed: 11/16/2022] Open
Abstract
'Mixed Milk Feeding' (MMF), whereby infants are fed with both breastmilk and infant formula during the same period, is a common feeding practice. Despite its high prevalence, knowledge regarding MMF practices and their association with (health) outcomes is limited, potentially because MMF behaviours are highly variable and difficult to standardise longitudinally. In this paper, we applied a statistical clustering algorithm on individual infant feeding data collected over the first year of life from two clinical trials: 'TEMPO' (n = 855) and 'Venus' (n = 539); these studies were conducted in different years and world regions. In TEMPO, more than half of infants were MMF. Four distinct MMF clusters were identified: early exclusive formula feeding (32%), later exclusive formula feeding (25%), long-term MMF (21%), and mostly breastfeeding (22%). The same method applied to 'Venus' resulted in comparable clusters, building trust in the robustness of the cluster approach. These results demonstrate that distinct MMF patterns can be identified, which may be applicable to diverse populations. These insights could support the design of future research studying the impact of infant feeding patterns on health outcomes. To standardise this in future research, it is important to establish a unified definition of MMF.
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85
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Andresen EC, Hjelkrem AGR, Bakken AK, Andersen LF. Environmental Impact of Feeding with Infant Formula in Comparison with Breastfeeding. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116397. [PMID: 35681983 PMCID: PMC9180168 DOI: 10.3390/ijerph19116397] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/16/2022] [Accepted: 05/20/2022] [Indexed: 11/24/2022]
Abstract
Young children have unique nutritional requirements, and breastfeeding is the best option to support healthy growth and development. Concerns have been raised around the increasing use of milk-based infant formulas in replacement of breastfeeding, in regards to health, social, economic and environmental factors. However, literature on the environmental impact of infant formula feeding and breastfeeding is scarce. In this study we estimated the environmental impact of four months exclusive feeding with infant formula compared to four months exclusive breastfeeding in a Norwegian setting. We used life-cycle assessment (LCA) methodology, including the impact categories global warming potential, terrestrial acidification, marine and freshwater eutrophication, and land use. We found that the environmental impact of four months exclusive feeding with infant formula was 35–72% higher than that of four months exclusive breastfeeding, depending on the impact category. For infant formula, cow milk was the main contributor to total score for all impact categories. The environmental impact of breastfeeding was dependant on the composition of the lactating mother’s diet. In conclusion, we found that breastfeeding has a lower environmental impact than feeding with infant formula. A limitation of the study is the use of secondary LCA data for raw ingredients and processes.
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Affiliation(s)
- Ellen Cecilie Andresen
- Department of Nutrition, University of Oslo, 0317 Oslo, Norway;
- Correspondence: ; Tel.: +47-99744145
| | - Anne-Grete Roer Hjelkrem
- Division of Food Production and Society, Norwegian Institute of Bioeconomy Research (NIBIO), 1431 Ås, Norway; (A.-G.R.H.); (A.K.B.)
| | - Anne Kjersti Bakken
- Division of Food Production and Society, Norwegian Institute of Bioeconomy Research (NIBIO), 1431 Ås, Norway; (A.-G.R.H.); (A.K.B.)
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86
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Mohammadi S, Shafiee M, Faraji SN, Rezaeian M, Ghaffarian-Bahraman A. Contamination of breast milk with lead, mercury, arsenic, and cadmium in Iran: a systematic review and meta-analysis. Biometals 2022; 35:711-728. [PMID: 35575819 DOI: 10.1007/s10534-022-00395-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/29/2022] [Indexed: 12/29/2022]
Abstract
Breast milk is a complete food for the development of the newborn, but it can also be an important route for environmental pollutants transmission to the infants. This study was aimed to evaluate the status of heavy metals including lead (Pb), mercury (Hg), cadmium (Cd) and arsenic (As) in the breast milk of Iranian mothers. The international databases including Scopus, PubMed, Web of Science and the Persian electronic databases including Scientific Information Database, IranMedex and Magiran were examined to find relevant articles published until July 2021. A total of 23 studies examined the levels of toxic metals in Iranian breast milk samples. According to the findings, the pooled average concentrations (µg/L) of Pb, Cd, Hg and As were 25.61, 2.40, 1.29 and 1.16, respectively. The concentration of Hg and Pb in colostrum milk was more than twice of mature milk. The Hg mean concentration in the breast milk of mothers with at least one amalgam-filled tooth was approximately three times that of mothers without amalgam-filled teeth. Risk assessment analysis indicated that the intake of Pb and Hg by infants through breastfeeding can be considered a health concern in Iran. It seems necessary to reduce the Pb exposure of pregnant and lactating women in Iran. However, more extensive studies are needed to clarify the toxic metals' exposure status of infants through breast milk in other parts of the country.
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Affiliation(s)
- Salman Mohammadi
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Maryam Shafiee
- Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Nooreddin Faraji
- School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Rezaeian
- Department of Epidemiology and Biostatistics, Occupational Environment Research Center, Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ali Ghaffarian-Bahraman
- Occupational Environment Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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Freund-Azaria A, Bar-Shalita T, Regev R, Bart O. The Role of Motor Coordination, ADHD-Related Characteristics and Temperament among Mothers and Infants in Exclusive Breastfeeding: A Cohort Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5509. [PMID: 35564903 PMCID: PMC9099549 DOI: 10.3390/ijerph19095509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 02/05/2023]
Abstract
Although exclusive breastfeeding is recommended for the first 6 months of life, breastfeeding rates are low. Motor skills and ADHD-related characteristics have not yet been examined as breastfeeding barriers. The aim of this study was to explore whether mothers' and infants' motor skills, mothers' ADHD-related characteristics and infants' temperament are associated with exclusive breastfeeding at 6 months after birth. Participants were 164 mothers and their infants recruited 2 days after birth. Mothers completed a demographic and delivery information questionnaire, the Infant Feeding Intentions Scale and the Iowa Infant Feeding Attitude Scale. At 6 months, mothers completed the Adult DCD (developmental coordination disorder)/Dyspraxia Checklist, the Adult ADHD (attention deficit hyperactivity disorder) Self-Report Scale Symptom Checklist-v1.1, and the Infant Characteristics Questionnaire, and provided information about their breastfeeding status. They were then divided into two groups accordingly: EBF (exclusive breastfeeding) and NEBF (non-exclusive breastfeeding). Infants were observed using the Test of Sensory Functions in Infants and the Alberta Infant Motor Scale. At 6 months, NEBF mothers reported higher prevalence of DCD (10.2% vs. 1.9%, χ2 = 5.561, p = 0.018) and ADHD (20.3% vs. 8.6%, χ2 = 4.680, p = 0.030) compared to EBF mothers. EBF infants demonstrated better motor coordination (t = 2.47, p = 0.016, d = 0.511), but no temperament differences compared to NEBF infants. Maternal DCD, ADHD and poor infant motor coordination are associated with non-exclusive breastfeeding and may become exclusive breastfeeding barriers. These findings may assist in identifying women at risk of not exclusively breastfeeding and encourage tailoring interventions for achieving higher exclusive breastfeeding rates.
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Affiliation(s)
- Adi Freund-Azaria
- Occupational Therapy Department, School of Health Professions, Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel-Aviv 6997801, Israel; (A.F.-A.); (T.B.-S.)
- Department of Neonatology, Meir Medical Center, Kfar-Saba 4428164, Israel
| | - Tami Bar-Shalita
- Occupational Therapy Department, School of Health Professions, Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel-Aviv 6997801, Israel; (A.F.-A.); (T.B.-S.)
| | - Rivka Regev
- Clalit Health Organization and Neonatal Follow-Up Clinic, Kfar-Saba 4428164, Israel;
| | - Orit Bart
- Occupational Therapy Department, School of Health Professions, Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel-Aviv 6997801, Israel; (A.F.-A.); (T.B.-S.)
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88
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Hodgson EC, Livingston MH, Robinson T, Farrokhyar F, Walton JM. Use of breast milk in infants with uncomplicated gastroschisis: A retrospective cohort study. J Pediatr Surg 2022; 57:840-845. [PMID: 35058060 DOI: 10.1016/j.jpedsurg.2021.12.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 12/30/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Infants with gastroschisis often experience slow return of bowel function following closure. The purpose of this study was to determine whether exclusive breast milk is associated with decreased time to enteral autonomy. METHODS We conducted a retrospective cohort study of infants with uncomplicated gastroschisis from a tertiary pediatric hospital. The primary outcome was enteral autonomy, defined as days from initiating enteral feeds to stopping parenteral nutrition. Secondary outcomes included days of parenteral nutrition, length of stay, positive culture, necrotizing enterocolitis, cholestasis, additional surgery, readmission, and mortality. RESULTS We identified 100 infants with gastroschisis treated from 2005 to 2019. Twenty-five were excluded due to gestational age <32 weeks, birth weight <1500 g, or gastroschisis-associated complications (e.g., intestinal atresia). Seventy-five were included in the analysis. Mean gestational age was 36 weeks, 48% were female, and all were diagnosed antenatally. Sixty-five infants (87%) received exclusive maternal (n = 64) or donor (n = 1) breast milk, while 10 others (13%) were fed formula for 1-16 days (mean 7 days). Two infants received formula only. Demographics and gastroschisis prognostic scores were similar between groups. Infants who were given breast milk exclusively demonstrated decreased time to enteral autonomy (median 18 versus 25 days, p = 0.023) and shorter duration of parenteral nutrition (median 20 versus 26 days, p = 0.037). CONCLUSION Exclusive breast milk may be associated with improved outcomes among infants with gastroschisis. Further research is needed to evaluate the economic impact of this association and explore possible confounders. These efforts may expand the role of donor breast milk for these patients.
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Affiliation(s)
- Emily C Hodgson
- Division of General Surgery, McMaster University, Hamilton, Canada; Biomedical Graduate Studies, University of Pennsylvania, Philadelphia, USA; Division of Pediatric General, Thoracic and Fetal Surgery, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Michael H Livingston
- Division of Pediatric Surgery, McMaster University, Hamilton, Canada; McMaster Pediatric Surgery Research Collaborative, McMaster University, Hamilton, Canada
| | - Tessa Robinson
- Division of Pediatric Surgery, McMaster University, Hamilton, Canada; Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, Hamilton, Canada
| | - Forough Farrokhyar
- Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, Hamilton, Canada; Department of Surgery, McMaster University, Hamilton, Canada
| | - J Mark Walton
- Division of Pediatric Surgery, McMaster University, Hamilton, Canada; McMaster Pediatric Surgery Research Collaborative, McMaster University, Hamilton, Canada.
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Panahi F, Rashidi Fakari F, Nazarpour S, Lotfi R, Rahimizadeh M, Nasiri M, Simbar M. Educating fathers to improve exclusive breastfeeding practices: a randomized controlled trial. BMC Health Serv Res 2022; 22:554. [PMID: 35468827 PMCID: PMC9040207 DOI: 10.1186/s12913-022-07966-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 04/20/2022] [Indexed: 02/08/2023] Open
Abstract
Background Fathers’ involvement is crucial for promoting breastfeeding. There are a few studies on the effectiveness of fathers’ educational programs to promote exclusive breastfeeding. This study aims to assess the effectiveness of a fathers’ educational program on their support for breastfeeding, mothers’ breastfeeding practice, and exclusive breastfeeding status. Methods This was a randomized controlled trial on 76 fathers who were randomly assigned to two groups of intervention and control, in a selected health center in Iran, 2018. The tools for data collection were: 1) a questionnaire for “Demographic and Maternal-Infant Information”; 2) a questionnaire to assess “Fathers’ support for Breastfeeding”, and 3) an observational checklist to assess “Mothers’ Breastfeeding Practice”; and 4) a questionnaire to assess “Exclusive Breastfeeding Status”. The questionnaires were filled up through an interview. The checklist was completed through observation by the researcher. The fathers (with the mothers) of the intervention group were educated using individual face-to-face education and counseling, in two sessions, with the duration of about 40 min and one-week interval, whereas, the fathers of the control group did not receive any education and only mothers were educated with the same instruction. The content of the education was: fathers’ education about “benefits of breast milk” and “the supporting ways for breastfeeding including the women encouragement”. Then, the scores of “father’s support for breastfeeding”, “mothers’ breastfeeding practice” and “exclusive breastfeeding status” were compared before and after 4 months of intervention in each group, and also between groups. Data were analyzed using SPPS-23, and t- and paired-tests, Chi-square, and Generalized-Estimating-Equations (GEE) tests. Results The results showed two groups were not significantly different regarding the demographic and any other possible confounding variables before the intervention (P < 0.05). The before and after comparisons also demonstrated significant improvements in the two variables including “father’s support for breastfeeding”, and “mothers’ breastfeeding practice after 4 months, in the intervention group (Paired t-test: P<0.001 and P<0.0001, respectively) however, there was a significant decrease in “father’s support for breastfeeding” and no improvement in “mothers’ breastfeeding practice” after 4 months in the control group (Paired t-test: P < 0.001 and P = 0.07, respectively). Between groups comparison showed also significant higher scores for “father’s support for breastfeeding”, “mothers’ breastfeeding practice” and “exclusive breastfeeding status” in the intervention group comparing to the control group, after 4 months (T-test: P < 0.001 and P < 0.0001; Chi2: P < 0.001, respectively). The interaction effects of time and group were significant in the GEE test for the fathers’ support for breastfeeding (B-group = 31.93, B-time = 22.15, p < 0.001) and mothers’ breastfeeding practice (B-group = 26.32, B-time = 12.86, p < 0.0). Conclusion The results showed that the father’s education improves mothers’ breastfeeding practice and increases the rate and continuity of exclusive breastfeeding. Trial registration IRCT201508248801N10. “31/08/2016”. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07966-8.
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Affiliation(s)
- Farideh Panahi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh Rashidi Fakari
- Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences-Bojnurd, Bojnurd, Iran
| | - Soheila Nazarpour
- Department of Midwifery, Chalous Branch, Islamic Azad University, Chalous, Iran
| | - Razieh Lotfi
- Department of Midwifery, School of Nursing and Midwifery, Alborz University of Medical Sciences-Karaj, Karaj, Iran
| | - Mitra Rahimizadeh
- Department of Biostatistics, Social Determinant of Health Research Center, Alborz University of Medical Sciences-Karaj, Karaj, Iran
| | - Maliheh Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery Shahid Beheshti University of Medical Sciences Tehran, Tehran, Iran
| | - Masoumeh Simbar
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Vali-Asr Avenue, Cross of Vali-Asr and Hashemi Highway, Opposite to Rajaee Heart Hospital, Tehran, 1996835119, Iran.
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90
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Yang MT, Lan QY, Liang X, Mao YY, Cai XK, Tian F, Liu ZY, Li X, Zhao YR, Zhu HL. Lactational Changes of Phospholipids Content and Composition in Chinese Breast Milk. Nutrients 2022; 14:nu14081539. [PMID: 35458100 PMCID: PMC9030290 DOI: 10.3390/nu14081539] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 02/04/2023] Open
Abstract
Phospholipids are pivotal polar lipids in human milk and essential for infants’ growth and development, especially in the brain and cognitive development. Its content and composition are affected by multiple factors and there exist discrepancies in different studies. In this study, we determined five major phospholipids classes (phosphatidylethanolamine, phosphatidylinositol, phosphatidylserine, phosphatidylcholine, and sphingomyelin) in 2270 human milk samples collected from 0 to 400 days postpartum in six regions of China. The high-performance liquid chromatography coupled with an evaporative light scattering detector (HPLC-ELSD) was performed to quantify the phospholipids. Total phospholipid median (IQR) content was in a range between 170.38 ± 96.52 mg/L to 195.69 ± 81.80 mg/L during lactation and was higher concentrated in colostrum milk and later stage of lactation (after 200 days postpartum) compared with that in the samples collected between 10 to 45 days postpartum. Variations in five major sub-class phospholipids content were also observed across lactation stages (phosphatidylethanolamine: 52.61 ± 29.05 to 59.95 ± 41.74 mg/L; phosphatidylinositol: 17.65 ± 10.68 to 20.38 ± 8.55 mg/L; phosphatidylserine: 15.98 ± 9.02 to 22.77 ± 11.17 mg/L; phosphatidylcholine: 34.13 ± 25.33 to 48.64 ± 19.73 mg/L; sphingomyelin: 41.35 ± 20.31 to 54.79 ± 35.26 mg/L). Phosphatidylethanolamine (29.18–32.52%), phosphatidylcholine (19.90–25.04%) and sphingomyelin (22.39–29.17%) were the dominant sub-class phospholipids in Chinese breast milk during the whole lactation period. These results updated phospholipids data in Chinese human milk and could provide evidence for better development of secure and effective human milk surrogates for infants without access to breast milk.
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Affiliation(s)
- Meng-Tao Yang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (M.-T.Y.); (Q.-Y.L.); (Z.-Y.L.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou 510080, China
| | - Qiu-Ye Lan
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (M.-T.Y.); (Q.-Y.L.); (Z.-Y.L.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou 510080, China
| | - Xue Liang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing 102401, China;
| | - Ying-Yi Mao
- Abbott Nutrition Research & Development Center, Abbott Ltd., Shanghai 200233, China; (Y.-Y.M.); (X.-K.C.); (F.T.); (X.L.)
| | - Xiao-Kun Cai
- Abbott Nutrition Research & Development Center, Abbott Ltd., Shanghai 200233, China; (Y.-Y.M.); (X.-K.C.); (F.T.); (X.L.)
| | - Fang Tian
- Abbott Nutrition Research & Development Center, Abbott Ltd., Shanghai 200233, China; (Y.-Y.M.); (X.-K.C.); (F.T.); (X.L.)
| | - Zhao-Yan Liu
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (M.-T.Y.); (Q.-Y.L.); (Z.-Y.L.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou 510080, China
| | - Xiang Li
- Abbott Nutrition Research & Development Center, Abbott Ltd., Shanghai 200233, China; (Y.-Y.M.); (X.-K.C.); (F.T.); (X.L.)
| | - Yan-Rong Zhao
- Abbott Nutrition Research & Development Center, Abbott Ltd., Shanghai 200233, China; (Y.-Y.M.); (X.-K.C.); (F.T.); (X.L.)
- Correspondence: (Y.-R.Z.); (H.-L.Z.); Tel.: +86-21-2082-2472 (Y.-R.Z.); +86-20-8733-1811 (H.-L.Z.)
| | - Hui-Lian Zhu
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (M.-T.Y.); (Q.-Y.L.); (Z.-Y.L.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou 510080, China
- Correspondence: (Y.-R.Z.); (H.-L.Z.); Tel.: +86-21-2082-2472 (Y.-R.Z.); +86-20-8733-1811 (H.-L.Z.)
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91
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Wang S, Wei Y, Liu L, Li Z. Association Between Breastmilk Microbiota and Food Allergy in Infants. Front Cell Infect Microbiol 2022; 11:770913. [PMID: 35096637 PMCID: PMC8790183 DOI: 10.3389/fcimb.2021.770913] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 12/17/2021] [Indexed: 12/27/2022] Open
Abstract
Regulating the composition of human breastmilk has the potential to prevent allergic diseases early in life. The composition of breastmilk is complex, comprising varying levels of oligosaccharides, immunoactive molecules, vitamins, metabolites, and microbes. Although several studies have examined the relationship between different components of breastmilk and infant food allergies, few have investigated the relationship between microorganisms in breastmilk and infant food allergy. In the present study, we selected 135 healthy pregnant women and their full-term newborns from a cohort of 202 mother-infant pairs. Among them, 69 infants were exclusively breastfed until 6 mo after birth. At follow-up, 11 of the 69 infants developed a food allergy in infancy while 22 showed no signs of allergy. Thirty-three breastmilk samples were collected within 1 mo after delivery, and 123 infant fecal samples were collected at five time points following their birth. These samples were analyzed using microbial 16S rRNA gene sequencing. The abundance and evenness of the milk microbiota and the number of differential bacteria were higher in the breastmilk samples from the non-allergy group than in those from the food allergy group. The non-allergy group showed relatively high abundance of Bifidobacterium, Akkermansia, Clostridium IV, Clostridium XIVa, Veillonella, and butyrate-producing bacteria such as Fusobacterium, Lachnospiraceae incertae sedis, Roseburia, and Ruminococcus. In contrast, the abundance of Proteobacteria, Acinetobacter, and Pseudomonas in breastmilk was higher in the food allergy group. A comparison of the changes in dominant differential breastmilk microbiota in the intestinal flora of the two groups of infants over time revealed that the changes in Bifidobacterium abundance were consistent with those in the breastmilk flora. Functional pathway prediction of breastmilk microflora showed that the enhancement of the metabolic pathways of tyrosine, tryptophan, and fatty acids was significantly different between the groups. We suggest that changes in the breastmilk microbiota can influence the development of food allergies. Breastmilk contains several microbes that have protective effects against food allergies, both by influencing the colonization of intestinal microbiota and by producing butyrate. This study may provide new ideas for improving infant health through early intervention with probiotics.
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Affiliation(s)
- Shuo Wang
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Yuan Wei
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Luyan Liu
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Zailing Li
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
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92
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Darling AJ, Gatta LA, Tucker A, Adkins LD, Mitchell C, Reiff E, Dotters-Katz S. Gestational weight gain and patterns of breastfeeding among patients with class III obesity. J Matern Fetal Neonatal Med 2022; 35:9851-9856. [PMID: 35382671 DOI: 10.1080/14767058.2022.2060734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Maternal obesity is associated with delayed lactogenesis and shorter duration of breastfeeding compared to patients with a normal BMI. RESEARCH AIM/QUESTION We investigated the impact of excessive gestational weight gain, defined as greater than the Institute of Medicine guidelines (>9.1 kg), on the initiation and duration of breastfeeding in patients with class III obesity. METHODS Retrospective cohort of patients with body mass index ≥40 in first trimester, delivering a singleton term infant at a tertiary care center between July 2013 and December 2017. Primary outcome was exclusive breastfeeding at discharge and at postpartum visit. Secondary outcomes included any breastfeeding at discharge and postpartum visit, and cessation of breastfeeding by the postpartum visit. Descriptive statistics were used to compare those whose gestational weight gain exceeded (eIOM) versus met (mIOM) Institute of Medicine guidelines. Regression models were performed to adjust for baseline confounding factors. RESULTS Of 294 women included, 117(39.8%) were in the eIOM group. These women were more likely to be primigravida, have a higher delivery BMI, greater delivery blood loss, and have a neonate admitted to the intensive care unit. Exclusive breastfeeding at discharge was not different between eIOM and mIOM (66.7% vs 70.9%, p = .44), nor did eIOM impact likelihood of exclusive breastfeeding at postpartum visit (40.1% vs 34.2%, p = .31). When controlling for confounding factors, breastfeeding at discharge (aOR 1.54 95% CI [0.68-3.49]) or postpartum visit (aOR 0.67[0.31-1.47]) did not differ between eIOM compared to mIOM. CONCLUSIONS Among women with class III obesity, excessive gestational weight gain did not impact the rate of exclusive breastfeeding at discharge or postpartum visit.
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Affiliation(s)
- Alice J Darling
- Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC, USA
| | - Luke A Gatta
- Department of Obstetrics & Gynecology, Duke University, Durham, NC, USA
| | - Ann Tucker
- Department of Obstetrics & Gynecology, University of Mississippi, Jackson, MS, USA
| | - LaMani D Adkins
- Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC, USA
| | - Courtney Mitchell
- Department of Obstetrics & Gynecology, Duke University, Durham, NC, USA
| | - Emily Reiff
- Department of Obstetrics & Gynecology, Brigham and Women's Hospital, Boston, MA, USA
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93
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Tateoka Y. Effectiveness of aloe fomentation for nipple-related complications during the early puerperium period: a randomized, controlled, interventional study. BMC Res Notes 2022; 15:94. [PMID: 35255973 PMCID: PMC8900332 DOI: 10.1186/s13104-022-05980-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 02/21/2022] [Indexed: 11/10/2022] Open
Abstract
Objective Nipple-related complications are major factors that prevent breastfeeding for many new mothers. Hence, we tested the effects of aloe arborescens fomentation applied to the nipples as a treatment for nipple-related complications. Results This study included 60 women who breastfed for the first time on day 1 after delivery. Every 24 h, all women breastfed six times and bottle-fed two times (at night). Women were classified into an intervention group (aloe arborescens fomentation) and a control group (no treatment). Aloe fomentation was applied after breastfeeding six times per day. We observed the nipples three times per day for 5 days after delivery. The most common nipple-related complication in this study was redness. A significant decrease was observed for women in the intervention group. Trial Registration Retrospectively Registered to registry: UMIN; Registration no.: UMIN000044514; Registered on: 11th June 2021.
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94
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Niu Z, Naya CH, Reynaga L, Toledo-Corral CM, Johnson M, Yang T, Grubbs B, Lurvey N, Lerner D, Dunton GF, Habre R, Breton CV, Bastain TM, Farzan SF. Association of Breastfeeding Duration with 12-Month Postpartum Blood Lipids in a Predominately Lower-Income Hispanic Pregnancy Cohort in Los Angeles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3008. [PMID: 35270701 PMCID: PMC8910591 DOI: 10.3390/ijerph19053008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 02/02/2023]
Abstract
Breastfeeding may protect women’s long-term cardiovascular health; however, breastfeeding-related postpartum lipid changes remain unclear. We aim to examine associations of breastfeeding duration with maternal lipids at 12 months postpartum. In a subsample (n = 79) of the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) cohort, breastfeeding status and duration at 3, 6, and 12 months postpartum were self-reported. Serum levels of lipids, including total cholesterol, triglycerides (TG), high-, low-, and very low-density lipoprotein cholesterol (HDL-C, LDL-C, VLDL-C), were measured from blood samples collected at 12 months postpartum. We used linear regression models to compare lipids by breastfeeding duration, adjusting for potential confounders. Women who were breastfeeding at 12 months had higher HDL-C (mean: 41.74 mg/dL, 95% CI: 37.27−46.74 vs. 35.11 mg/dL, 95% CI: 31.42−39.24), lower TG (80.45 mg/dL, 95% CI: 66.20−97.77 vs. 119.11 mg/dL, 95% CI: 98.36−144.25), and lower VLDL-C (16.31 mg/dL, 95% CI: 13.23, 20.12 vs. 23.09 mg/dL, 95% CI: 18.61−28.65) compared to women who breastfed for <6 months. No lipids were significantly different between women who breastfed for 6−11 months and for <6 months. Each month’s increase in breastfeeding duration was significantly, inversely associated with TG and VLDL-C and positively with HDL-C. Adjusting for fasting status, demographics, pre-pregnancy body mass index, breastfeeding frequency, and pregnancy complications did not appreciably change effect estimates. Breastfeeding at 12 months postpartum and a longer duration of breastfeeding in the first year postpartum were both associated with increased HDL-C and decreased TG and VLDL-C at 12 months postpartum.
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Affiliation(s)
- Zhongzheng Niu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90039, USA; (Z.N.); (C.H.N.); (C.M.T.-C.); (M.J.); (T.Y.); (B.G.); (G.F.D.); (R.H.); (C.V.B.); (T.M.B.)
| | - Christine H. Naya
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90039, USA; (Z.N.); (C.H.N.); (C.M.T.-C.); (M.J.); (T.Y.); (B.G.); (G.F.D.); (R.H.); (C.V.B.); (T.M.B.)
| | - Lorena Reynaga
- Department of Health Sciences, College of Health and Human Development, California State University Northridge, Northridge, CA 91330, USA;
| | - Claudia M. Toledo-Corral
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90039, USA; (Z.N.); (C.H.N.); (C.M.T.-C.); (M.J.); (T.Y.); (B.G.); (G.F.D.); (R.H.); (C.V.B.); (T.M.B.)
- Department of Health Sciences, College of Health and Human Development, California State University Northridge, Northridge, CA 91330, USA;
| | - Mark Johnson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90039, USA; (Z.N.); (C.H.N.); (C.M.T.-C.); (M.J.); (T.Y.); (B.G.); (G.F.D.); (R.H.); (C.V.B.); (T.M.B.)
| | - Tingyu Yang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90039, USA; (Z.N.); (C.H.N.); (C.M.T.-C.); (M.J.); (T.Y.); (B.G.); (G.F.D.); (R.H.); (C.V.B.); (T.M.B.)
| | - Brendan Grubbs
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90039, USA; (Z.N.); (C.H.N.); (C.M.T.-C.); (M.J.); (T.Y.); (B.G.); (G.F.D.); (R.H.); (C.V.B.); (T.M.B.)
- Department of Obstetrics & Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90039, USA
| | - Nathana Lurvey
- Eisner Health, Los Angeles, CA 90015, USA; (N.L.); (D.L.)
| | - Deborah Lerner
- Eisner Health, Los Angeles, CA 90015, USA; (N.L.); (D.L.)
| | - Genevieve F. Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90039, USA; (Z.N.); (C.H.N.); (C.M.T.-C.); (M.J.); (T.Y.); (B.G.); (G.F.D.); (R.H.); (C.V.B.); (T.M.B.)
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90039, USA; (Z.N.); (C.H.N.); (C.M.T.-C.); (M.J.); (T.Y.); (B.G.); (G.F.D.); (R.H.); (C.V.B.); (T.M.B.)
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90039, USA; (Z.N.); (C.H.N.); (C.M.T.-C.); (M.J.); (T.Y.); (B.G.); (G.F.D.); (R.H.); (C.V.B.); (T.M.B.)
| | - Theresa M. Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90039, USA; (Z.N.); (C.H.N.); (C.M.T.-C.); (M.J.); (T.Y.); (B.G.); (G.F.D.); (R.H.); (C.V.B.); (T.M.B.)
| | - Shohreh F. Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90039, USA; (Z.N.); (C.H.N.); (C.M.T.-C.); (M.J.); (T.Y.); (B.G.); (G.F.D.); (R.H.); (C.V.B.); (T.M.B.)
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95
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Hassan HF, Elaridi J, Kharma JA, Abiad MG, Bassil M. Persistent Organic Pollutants in Human Milk: Exposure Levels and Determinants among Lactating Mothers in Lebanon. J Food Prot 2022; 85:384-389. [PMID: 34762730 DOI: 10.4315/jfp-21-325] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/28/2021] [Indexed: 11/11/2022]
Abstract
ABSTRACT Exposure of newborns to persistent organic pollutants (POPs) is a public health concern. The objective of this study was to assess the prevalence of POPs in human milk collected from lactating mothers in Lebanon and to investigate the sociodemographic, nutritional, and other lifestyle determinants. Fifty-four breast milk samples were collected as per World Health Organization guidelines. A survey was used to assess the anthropometric and demographic characteristics of participants. Dietary habits were evaluated based on a semiquantitative food frequency questionnaire. Organochlorine pesticides and polychlorinated biphenyls were measured in milk samples with liquid-liquid extraction and gas chromatography. Among the screened POPs, dichlorodiphenyldichloroethylene (DDE) was the only POP detected in breast milk samples and was found in only 17.9% of the samples, with a mean (SD) of 11.6 (5.0) μg/L and a range of 5.7 to 21.4 μg/L. Prepregnancy body mass index and age were positively associated with DDE contamination in breast milk. Women who consumed cereals at least two times per week had detectable DDE contamination in their breast milk. Consumption of potatoes and beans at least once per week was also associated with DDE contamination. Our study is the first to assess the presence of POPs in breast milk in Lebanon. The benefits of breastfeeding compensate for the low prevalence of DDE in the breast milk. Our findings highlight the high need to implement monitoring policies, good agricultural practices, and education programs for breastfeeding mothers. HIGHLIGHTS
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Affiliation(s)
- Hussein F Hassan
- Nutrition Program, Lebanese American University, Beirut, Lebanon
| | - Jomana Elaridi
- Chemistry Program, Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon
| | | | - Mohamad Ghassan Abiad
- Department of Nutrition and Food Sciences and Laboratories for the Environment, Agriculture, and Food, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Maya Bassil
- Nutrition Program, Lebanese American University, Beirut, Lebanon.,Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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96
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Rushender R, Krishnamoorthy Y, Hussain Siraja AA. Factors associated with the knowledge about breastfeeding among antenatal and postnatal women in selected rural villages of Chengalpattu, Tamil Nadu: A community-based cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:72. [PMID: 35372624 PMCID: PMC8974921 DOI: 10.4103/jehp.jehp_425_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 07/12/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Addressing good breastfeeding practices among antenatal and postnatal mothers is important as it helps in bringing about a positive change in the behavior, attitude, and practice with appropriate health education. Hence, this study was done to determine the awareness level of antenatal and postnatal mothers about the breastfeeding practices and benefits and identify the factors associated with it in rural Chengalpattu, Tamil Nadu, India. MATERIALS AND METHODS We conducted this community-based cross-sectional study among 377 antenatal and postnatal mothers in the selected rural villages of Chengalpattu between October 2019 and September 2020. Details regarding the sociodemographic characteristics and awareness/knowledge about the breastfeeding were collected using pretested semistructured questionnaire. Knowledge adequacy was summarized as proportion with 95% confidence interval (CI), and factors associated with knowledge were interpreted as adjusted prevalence ratio (aPR) with 95% CI using log-binomial regression. RESULTS About 19.6% (95% CI: 15.7%-24.0%) mothers had inadequate knowledge about breastfeeding. Women who were unemployed (aPR = 1.60; 95% CI: 1.02-2.51), belonging to the lower socioeconomic status (aPR = 2.62; 95% CI: 1.80-3.82), belonging to Muslim religion (aPR = 1.63; 95% CI: 1.14-2.35), and living in joint family (aPR = 1.58; 95% CI: 1.12-2.21) had significant higher risk of inadequate knowledge about breastfeeding practices compared to those who were employed, belonging to puper socioeconomic status, Hindu religion, and living in nuclear family. CONCLUSION We found that almost one-fifth of the antenatal and/or postnatal mothers had inadequate knowledge about the breastfeeding benefits and practices. Health education sessions are required to promote the awareness about breastfeeding during antenatal and postnatal check-ups.
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Affiliation(s)
- Rajan Rushender
- Department of Community Medicine, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Srm Nagar, Kattankulathur, Kanchipuram, Chennai, Tn, India
| | - Yuvaraj Krishnamoorthy
- Assistant Professor, Department of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, India
| | - Ameenah Anwar Hussain Siraja
- Department of Community Medicine, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Srm Nagar, Kattankulathur, Kanchipuram, Chennai, Tn, India
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97
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Lundquist A, McBride BA, Donovan SM, Wszalek M. Father support for breastfeeding mothers who plan to utilize childcare: A qualitative look at Mothers' perspectives. Appetite 2022; 169:105854. [PMID: 34890723 DOI: 10.1016/j.appet.2021.105854] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/23/2021] [Accepted: 12/06/2021] [Indexed: 02/02/2023]
Abstract
Breastfeeding exerts many health benefits for the infant and the benefit is affected by exclusivity and duration, however, most mothers in the U.S. breastfeed for a shorter duration than recommended. First-time mothers who return to work outside the home, utilize childcare, and pump to continue to provide human milk, all of which have been found to reduce breastfeeding duration individually, represent a subset of breastfeeding mothers facing several known barriers to breastfeeding continuation and at risk for early breastfeeding cessation. The aim of this study is to understand and describe the perceptions of first-time mothers with prenatal intentions to breastfeed and utilize childcare, of paternal support for the breastfeeding experience. A semi-structured interview guided data collection with 24 first-time breastfeeding mothers and responses were analyzed using thematic analysis. Two main themes from mothers' experiences highlight the perceptions of first-time mothers, who had prenatal intentions to breastfeed and utilize childcare, were shaped by the actions, behaviors, and beliefs of their partners throughout the breastfeeding process, as well as illustrate both mothers and fathers lack knowledge of how to optimally involve fathers in breastfeeding. Our findings extend evidence for two existing models of father support to promote breastfeeding as relevant to mothers who return to work outside the home and utilize childcare, and additionally identify an area of support not included in either model. Early and improved education that situates breastfeeding within the co-parenting relationship and includes paternal support for pumping has the potential to improve mothers' breastfeeding experience and breastfeeding duration through mothers' return to work and infants' transition to childcare.
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Affiliation(s)
- Alexandra Lundquist
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Child Development Lab, 1105 West Nevada Street, Urbana, IL, 61801, USA.
| | - Brent A McBride
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Child Development Lab, 1105 West Nevada Street, Urbana, IL, 61801, USA; Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, 2013 Christopher Hall, 904 West Nevada Street, Urbana, IL, 61801, USA.
| | - Sharon M Donovan
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, 339 Bevier Hall, 905 S. Goodwin Ave, Urbana, IL, 61801, USA.
| | - Maris Wszalek
- Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
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98
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Wu Q, Tang N, Wacharasin C. Factors influencing exclusive breastfeeding for 6 months postpartum: A systematic review. Int J Nurs Knowl 2022; 33:290-303. [PMID: 35088945 DOI: 10.1111/2047-3095.12360] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/11/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE This systematic review aims to identify factors influencing exclusive breastfeeding (EBF) up to 6 months. METHODS The databases including PubMed, MEDLINE, CINAHL, Scopus, EMBASE, CNKI, and WANFANG were searched to retrieve studies. Quantitative research were extracted and the preferred reporting items for systematic reviews were followed. Critical appraisal checklists of Joanna Briggs Institute were used to evaluate the quality of the included studies. FINDINGS A total of 16 papers were eligible for this systematic review, comprising five cohort studies and 11 cross-sectional studies. Moderate to strong evidence supported that 6-month exclusive breastfeeding is affected by maternal working status, breastfeeding knowledge, delivery mode, parity, perception of insufficient human milk, mothers' infant feeding attitude, breastfeeding self-efficacy, and intention. CONCLUSIONS Factors influencing EBF up to 6 months postpartum play a key role in promoting mothers' health and reducing diseases in their infants. IMPLICATIONS FOR NURSING PRACTICE Interventions based on related factors should be developed and taken into practice to assist mothers in exclusive breastfeeding for up to 6 months. Additional studies from different countries in different populations with high quality are needed to provide more reliable and richer findings.
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Affiliation(s)
- Qian Wu
- Faculty of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China.,Faculty of Nursing, Burapha University, Chon Buri, Thailand
| | - Nan Tang
- Faculty of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China.,Faculty of Nursing, Burapha University, Chon Buri, Thailand
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99
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Krishnamoorthy Y, Rushender R, Siraja AAH. Development and validation of scale assessing the knowledge about breast feeding benefits and practices among antenatal and postnatal mothers in South India. J Clin Transl Res 2022; 8:43-48. [PMID: 35187288 PMCID: PMC8848738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 12/14/2021] [Accepted: 01/08/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Developing a scale to address the breastfeeding benefits and practices among antenatal and postnatal mothers is important as it helps in evaluating the change in the behavior, attitude, and practice with appropriate health education. AIM This study was done to develop and validate a scale to assess the knowledge about the breastfeeding benefits and practices in Tamil language among antenatal and postnatal mothers belonging to rural areas of Chengalpattu, South India. METHODS We developed a scale to assess the knowledge about the benefits and practices of breastfeeding through literature review and expert opinion. Final version was administered among 377 antenatal and postnatal mothers in selected villages of rural Chengalpattu, South India. Construct validation was evaluated through principal component analysis (PCA). Confirmatory factor analysis was performed to check the goodness-of-fit of results. Internal consistency was evaluated through the Cronbach's alpha co-efficient. RESULTS A total of 11 questions were finalized in the questionnaire following face and content validity. In PCA, three factor models were obtained with the eigen values of 4.18, 1.91 and 1.48, respectively. These three factors were able to explain for about 68.9% of the variance. Goodness-of-fit indices revealed satisfactory comparative fit indices (0.81), Tucker-Lewis Index (0.73), standardized root mean square residual (0.11), and root mean square error of approximation (0.14). The reliability co-efficient for the questionnaire was 0.80. CONCLUSION We have developed an internally valid and reliable tool for evaluating the knowledge about breastfeeding benefits and practices. The scale should thus facilitate and fast-track the development of a structured breastfeeding educational program for antenatal and postnatal mothers receiving care at the primary health care level. RELEVANCE FOR PATIENTS This questionnaire allows for the objective monitoring of effectiveness of educational activities and also help in comparing the efficiency of various educational models targeting the antenatal and postnatal mothers.
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Affiliation(s)
- Yuvaraj Krishnamoorthy
- 1Department of Community Medicine, ESIC Medical College and PGIMSR, K.K. Nagar, Chennai, India
| | - Rajan Rushender
- 2Department of Community Medicine, SRM Medical College Hospital and Research Centre, Kattankulathur, Kanchipuram, Chennai, Tamil Nadu, India,Corresponding author: Rajan Rushender Department of Community Medicine, SRM Medical College Hospital and Research Centre, Kattankulathur, Kanchipuram, Chennai, Tamil Nadu, India. Tel: +91 9486150944
| | - Ameenah Anwar Hussain Siraja
- 2Department of Community Medicine, SRM Medical College Hospital and Research Centre, Kattankulathur, Kanchipuram, Chennai, Tamil Nadu, India,3SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Kanchipuram, Chennai, Tamil Nadu, India
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100
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Hooper L, Esio-Bassey C, Brainard J, Fynn J, Jennings A, Jones N, Tailor BV, Abdelhamid A, Coe C, Esgunoglu L, Fallon C, Gyamfi E, Hill C, Howard Wilsher S, Narayanan N, Oladosu T, Parkinson E, Prentice E, Qurashi M, Read L, Getley H, Song F, Welch AA, Aggett P, Lietz G. Evidence to Underpin Vitamin A Requirements and Upper Limits in Children Aged 0 to 48 Months: A Scoping Review. Nutrients 2022; 14:nu14030407. [PMID: 35276767 PMCID: PMC8840537 DOI: 10.3390/nu14030407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/31/2021] [Accepted: 01/10/2022] [Indexed: 02/04/2023] Open
Abstract
Vitamin A deficiency is a major health risk for infants and children in low- and middle-income countries. This scoping review identified, quantified, and mapped research for use in updating nutrient requirements and upper limits for vitamin A in children aged 0 to 48 months, using health-based or modelling-based approaches. Structured searches were run on Medline, EMBASE, and Cochrane Central, from inception to 19 March 2021. Titles and abstracts were assessed independently in duplicate, as were 20% of full texts. Included studies were tabulated by question, methodology and date, with the most relevant data extracted and assessed for risk of bias. We found that the most recent health-based systematic reviews and trials assessed the effects of supplementation, though some addressed the effects of staple food fortification, complementary foods, biofortified maize or cassava, and fortified drinks, on health outcomes. Recent isotopic tracer studies and modelling approaches may help quantify the effects of bio-fortification, fortification, and food-based approaches for increasing vitamin A depots. A systematic review and several trials identified adverse events associated with higher vitamin A intakes, which should be useful for setting upper limits. We have generated and provide a database of relevant research. Full systematic reviews, based on this scoping review, are needed to answer specific questions to set vitamin A requirements and upper limits.
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Affiliation(s)
- Lee Hooper
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
- Correspondence: ; Tel.: +44-1603-591268
| | - Chizoba Esio-Bassey
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Julii Brainard
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Judith Fynn
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Amy Jennings
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Natalia Jones
- School of Environmental Sciences, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK;
| | - Bhavesh V. Tailor
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Asmaa Abdelhamid
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Calvin Coe
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Latife Esgunoglu
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Ciara Fallon
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Ernestina Gyamfi
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Claire Hill
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Stephanie Howard Wilsher
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Nithin Narayanan
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Titilopemi Oladosu
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Ellice Parkinson
- School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK;
| | - Emma Prentice
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Meysoon Qurashi
- Department of Medicine, Luton and Dunstable Hospital NHS Foundation Trust, Lewsey Road, Luton LU4 0DZ, UK;
| | - Luke Read
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Harriet Getley
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Fujian Song
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Ailsa A. Welch
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK; (C.E.-B.); (J.B.); (J.F.); (A.J.); (B.V.T.); (A.A.); (C.C.); (L.E.); (C.F.); (E.G.); (C.H.); (S.H.W.); (N.N.); (T.O.); or (E.P.); (L.R.); (H.G.); (F.S.); (A.A.W.)
| | - Peter Aggett
- Lancashire School of Postgraduate Medicine and Health, University of Central Lancashire, Preston PR1 2HE, UK;
| | - Georg Lietz
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne NE2 4HH, UK;
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