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Hunegnaw MT, Gelaye KA, Ali BM. Factors associated with the time to cessation of breastfeeding among mothers who have index children aged two to three years in Debre Markos, northwest Ethiopia: a retrospective follow up study. BMC Pediatr 2018; 18:77. [PMID: 29471793 PMCID: PMC5822633 DOI: 10.1186/s12887-018-1012-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 01/28/2018] [Indexed: 12/03/2022] Open
Abstract
Background Breastfeeding of children, which needs to continue until two years and beyond, is one of the essential requirements for child survival. However, in Ethiopia there is scarcity of literatures on the duration of breastfeeding. Therefore, the aim of this study was to assess the rate of cessation of breastfeeding among mothers with index children aged 2 to 3 years, northwest Ethiopia. Methods A retrospective follow-up study was conducted at Debre Markos town from March 1, 2014 to March 30, 2016. A total of 500 mother-child pairs were selected using the systematic random sampling method by moving from house to house with an interval of three eligible houses. A structured questionnaire was used to collect data. The Cox regression model was employed to identify the predictors of breastfeeding cessation. Results The proportion of women breastfeeding until 2 years was 13.70 per 1000 person- months. HIV-positive mothers decreased the time of breastfeeding by 3.4 times compared to HIV-negative mothers (AHR = 3.41, 95% CI: 1.96, 5.94). Government employee mothers decreased the time of breastfeeding by 2.8 times compared to housewives (AHR = 2.8, 95% CI: 1.80, 4.40).Better education increased the time of breastfeeding (AHR = 0.45, 95% CI: 0.24, 0.58). Number of children, family income, and place of delivery were the other significant predictors of time to cessation of breastfeeding (p < 0.05). Conclusion In this study, the rate of cessation of breastfeeding was good. HIV negative mothers, government employment, number of children, place of delivery, and family monthly income were significant predictors to the time of breastfeeding cessation. Therefore, family planning and breastfeeding education in health institutions are essential to increase breastfeeding duration.
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Affiliation(s)
- Melkamu Tamir Hunegnaw
- Department of Human Nutrition, College of Medicine and Health Sciences, the University of Gondar, P.O. Box 196, Gondar, Ethiopia.
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, The University of Gondar, Gondar, Ethiopia
| | - Bekri Mohammed Ali
- Department of Human Nutrition, College of Medicine and Health Sciences, the University of Gondar, P.O. Box 196, Gondar, Ethiopia
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Goulding AN, Wouk K, Stuebe AM. Contraception and Breastfeeding at 4 Months Postpartum Among Women Intending to Breastfeed. Breastfeed Med 2018; 13:75-80. [PMID: 29091478 DOI: 10.1089/bfm.2017.0064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To estimate the association between postpartum contraception and breastfeeding among women intending to breastfeed. METHODS We analyzed data from the Infant Feeding Practices Study II, a prospective cohort study of U.S. mothers (2005-2007). Among 1,349 women with prenatal intention to breastfeed at least 4 months who reported contraception use 3 months postpartum, we used multivariable logistic regression to estimate odds and predicted probabilities of breastfeeding by contraceptive category. We considered prenatal breastfeeding intention, age, race, education, income, marital status, region, depressive symptoms, parity, and timing of return to work as potential confounders, using standard statistical methods to determine model covariates. RESULTS At 3 months postpartum, contraception was reported as follows: 720 (53%) nonhormonal contraceptives (NHCs), 256 (19%) combined hormonal contraceptives (CHCs), 217 (16%) progestin-only pills (POPs), 92 (7%) intrauterine devices, and 64 (5%) depot medroxyprogesterone acetate. Compared with NHCs, adjusted odds ratio (aOR) for any breastfeeding at 4 months postpartum among women using POPs was 3.15 (95% confidence interval [CI] 1.42-7.02), and for women using CHCs aOR was 0.17 (95% CI 0.10-0.29). For women using NHCs, predicted probability of any breastfeeding at 4 months postpartum was 90% (95% CI 85-94); it was 97% (95% CI 92-99) among those using POPs and 61% (95% CI 46-74) among those using CHCs. CONCLUSION In a cohort of women intending to breastfeed at least 4 months, women using POPs were most likely, and women using CHCs were least likely, to achieve their breastfeeding intentions.
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Affiliation(s)
- Alison N Goulding
- 1 Department of Obstetrics and Gynecology, University of North Carolina School of Medicine , Chapel Hill, North Carolina
| | - Kathryn Wouk
- 2 Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina
| | - Alison M Stuebe
- 1 Department of Obstetrics and Gynecology, University of North Carolina School of Medicine , Chapel Hill, North Carolina.,2 Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina
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53
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Benjamin-Neelon SE, Gonzalez-Nahm S, Grossman E, Davis ML, Neelon B, Ayers Looby A, Frost N. State Variations in Infant Feeding Regulations for Child Care. Pediatrics 2017; 140:peds.2017-2076. [PMID: 29093136 DOI: 10.1542/peds.2017-2076] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Early care and education (ECE) settings have become primary targets for policy change in recent years. In our 2008 study, we assessed state and regional variation in infant feeding regulations for ECE and compared them to national standards. We conducted the same regulatory review to assess change over time. Because all but 2 states have updated their regulations, we hypothesized that states would have made substantial improvements in the number of regulations supporting infant feeding in ECE. METHODS For this cross-sectional study, we reviewed infant feeding regulations for all US states for child care centers (centers) and family child care homes (homes). We compared regulations with 10 national standards and assessed the number of new regulations consistent with these standards since our previous review. RESULTS Comparing results from 2008 and 2016, we observed significant improvements in 7 of the 10 standards for centers and 4 of the 10 standards for homes. Delaware was the only state with regulations meeting 9 of the 10 standards for centers in 2008. In 2016, Delaware and Michigan had regulations meeting 8 of the 10 standards. Previously, Arkansas, the District of Columbia, Minnesota, Mississippi, Ohio, and South Carolina had regulations consistent with 4 of the 10 standards for homes. In 2016, Delaware, Mississippi, and Vermont had regulations meeting 7 of the 10 standards. CONCLUSIONS Evidence suggests that enacting new regulations may improve child health outcomes. Given that many states recently enacted regulations governing infant feeding, our findings point to the growing interest in this area.
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Affiliation(s)
- Sara E Benjamin-Neelon
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland;
| | - Sarah Gonzalez-Nahm
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Elyse Grossman
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Melanie L Davis
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina; and
| | - Brian Neelon
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina; and
| | - Anna Ayers Looby
- Public Health Law Center, Mitchell Hamline School of Law, St Paul, Minnesota
| | - Natasha Frost
- Public Health Law Center, Mitchell Hamline School of Law, St Paul, Minnesota
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Gonzalez-Nahm S, Grossman ER, Frost N, Benjamin-Neelon SE. Early feeding in child care in the United States: Are state regulations supporting breastfeeding? Prev Med 2017; 105:232-236. [PMID: 28965756 DOI: 10.1016/j.ypmed.2017.09.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 09/13/2017] [Accepted: 09/24/2017] [Indexed: 10/18/2022]
Abstract
Most women in the US are not meeting the recommendation of exclusively breastfeeding their infants for the first 6months of life. The child care environment can be especially influential in a mother's ability to continue breastfeeding after returning to employment. For this study, we reviewed child care regulations related to breastfeeding for centers and homes in all 50 states and the District of Colombia in late 2016, and compared them to 5 national standards. We coded regulations as either not meeting, partially meeting, or fully meeting each standard. We assessed correlations between number of regulations consistent with standards and 1) geographic census region and 2) last year of update. This study provides an update to a previous review conducted in 2012. No state met all 5 of the included standards, and only 2 states for centers and 1 state for homes at least partially met 4 of the 5 standards. More states had regulations consistent with standards encouraging general support for breastfeeding and requiring a designated place for mothers to breastfeed onsite. Number of regulations consistent with standards was associated with geographic census region, but not last year of update. States in the South had a greater number of regulations consistent with standards and states in the West had the fewest number of regulations consistent with standards. Overall support for breastfeeding at the state child care regulation level continues to be insufficient. States should improve child care regulations to include greater support for breastfeeding in child care facilities.
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Affiliation(s)
- Sarah Gonzalez-Nahm
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States.
| | - Elyse R Grossman
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States
| | - Natasha Frost
- Public Health Law Center, Mitchell Hamline School of Law, St Paul, MN 55105, United States
| | - Sara E Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States
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55
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Moraes de Oliveira M, Camelo JS. Gestational, perinatal, and postnatal factors that interfere with practice of exclusive breastfeeding by six months after birth. Int Breastfeed J 2017; 12:42. [PMID: 29026430 PMCID: PMC5627475 DOI: 10.1186/s13006-017-0132-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 09/11/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Despite evidences indicating the superiority of breastfeeding and recent advances in the indicators of breastfeeding in Brazil, exclusive breastfeeding (EBF) during the first six months after birth continues to be an infrequent practice in the country. The objective of the present study was to determine which gestational, perinatal, and postnatal factors of the mother-baby dyad might be associated with the cessation of EBF by six months after birth. METHODS Data were collected at the rooming-in facility of the Reference Center of Women's Health of Ribeirão Preto-Mater (CRSM-Mater) during the postpartum period (24 to 72 h after birth) from December 2012 to April 2013 and by telephone contact between the researcher and participating mothers by six months after birth. Questionnaires were applied to collect data, such as the practice of EBF in the last 24 h in the sixth month after birth. The hierarchical theoretical model was proposed and data were analyzed statistically by log-binomial regression models using SAS 9.3. RESULTS The study involved 283 mother-baby dyads in which the mother evaluated did not present pregnancy-puerperal complications that could impede breastfeeding and confirmed the interest in breastfeeding her child. After the telephone contact in the exact sixth month after the birth of each participating baby, 84.8% of the participating mothers reported that they were no longer exclusively breastfeeding their babies. After statistical analysis, we found that there was a significant association between cessation of EBF and maternal report of previous experience with EBF for one month (0.91, 95% CI 0.81, 0.99) and six months (0.81; 95% CI 0.68, 0.94). These practices were associated with the maintenance of EBF and, even after adjustment for maternal socio-demographic variables, this association was maintained (0.85; 95% CI 0.73, 0.99). Thus, there is a greater chance of practicing and maintaining EBF by six months after birth when mother had previous experience with it. CONCLUSION The identification of the risk variables associated with cessation of EBF by six months postpartum, such as previous experience with exclusive breastfeeding, may contribute to the effectiveness of EBF intervention and support measures during the first six months after birth.
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Affiliation(s)
- Mariana Moraes de Oliveira
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Faculdade de Medicina de Ribeirao Preto, Departamento de Puericultura e Pediatria, Universidade de São Paulo, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirao Preto, São Paulo, SP 14048-900 Brazil
| | - José Simon Camelo
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Fernández-Cañadas Morillo A, Durán Duque M, Hernández López AB, Muriel Miguel C, Martínez Rodríguez B, Oscoz Prim A, Pérez Riveiro P, Salcedo Mariña A, Royuela Vicente A, Casillas Santana ML, Marín Gabriel MA. A Comparison of Factors Associated with Cessation of Exclusive Breastfeeding at 3 and 6 Months. Breastfeed Med 2017; 12:430-435. [PMID: 28787188 DOI: 10.1089/bfm.2017.0045] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIM To analyze the association of labor and sociodemographic factors with cessation of exclusive breastfeeding (EBF) at 3 and 6 months of life. MATERIALS AND METHODS A prospective cohort study (n = 529) was performed in a tertiary hospital with the Baby-Friendly Hospital Initiative (BFHI) award. Labor and sociodemographic factors were investigated. Single-term newborns were included. After 3 and 6 months, telephone calls were made to determine the type of lactation. Univariate analysis was performed with the chi-square test or Fisher's exact test. Multivariable logistic regression models were developed to determine risk factors associated with cessation of breastfeeding at 3 and 6 months. RESULTS At 3 months, 523 participants (98.9%) were contacted, of whom 64.4% maintained EBF. Factors associated with cessation were pacifier use (odds ratio [OR] 3.49; 95% confidence interval [95% CI] 2.24-5.43), cesarean delivery (OR 4.49; 95% CI 2.96-6.83), no college degree (OR 2.01; 95% CI 1.35-3.01), and not attending breastfeeding support groups (OR 1.96; 95% CI 1.22-3.12). At 6 months, 512 participants (96.8%) were contacted, of whom 31.4% maintained EBF. Factors associated with cessation were reintegration into the workplace (OR 4.49; 95% CI 2.96-6.83), pacifier use (OR 3.49; 95% CI 2.24-5.43), and primiparity (OR 1.61; 95% CI 1.05-2.46). CONCLUSIONS Several risk factors are associated with the premature cessation of EBF. There is a need to define strategies to correct modifiable factors and to promote protective factors with the aim of improving the success rate of EBF to reach the recommendations of the World Health Organization.
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Affiliation(s)
| | - Modesto Durán Duque
- 1 Department of Midwifery, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain
| | - Ana B Hernández López
- 1 Department of Midwifery, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain
| | - Cristina Muriel Miguel
- 1 Department of Midwifery, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain
| | - Begoña Martínez Rodríguez
- 2 Neonatology and Newborn Nursery Division, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain
| | - Ana Oscoz Prim
- 2 Neonatology and Newborn Nursery Division, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain
| | - Pilar Pérez Riveiro
- 2 Neonatology and Newborn Nursery Division, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain
| | - Angel Salcedo Mariña
- 3 Department of Obstetrics, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain
| | - Ana Royuela Vicente
- 4 Clinical Biostatistics Unit, Puerta de Hierro Majadahonda University Hospital , Instituto de Investigación Puerta de Hierro (IDIPHIM), Madrid, Spain
| | | | - Miguel A Marín Gabriel
- 6 Department of Neonatology, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain .,7 Department of Pediatrics, Autónoma University , Madrid, Spain
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Costa S, Adams J, Gonzalez-Nahm S, Benjamin Neelon SE. Childcare in Infancy and Later Obesity: a Narrative Review of Longitudinal Studies. CURRENT PEDIATRICS REPORTS 2017; 5:118-131. [PMID: 28845369 PMCID: PMC5550538 DOI: 10.1007/s40124-017-0134-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review was to summarize the current literature on the longitudinal relationship between non-parental childcare during infancy and later obesity. RECENT FINDINGS Eleven studies met the inclusion criteria, comprising 74 associations relevant to the review. Studies were highly heterogeneous in terms of defining childcare, categorizing different types of childcare, assessing obesity, and age at measurement of outcome and exposure. Most of the associations were either non-significant (42 associations, 57%) or showed a significant association between increased exposure to childcare and greater obesity (30 associations, 41%). There were very few examples of associations indicating that childcare was associated with lower obesity. SUMMARY There is limited research on the longitudinal relationship between childcare in infancy and later obesity. Existing studies showed mixed results, similar to recent reviews reporting on cross-sectional studies and older ages. The different definitions of childcare and wide variety of measures of exposure make comparisons between studies challenging.
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Affiliation(s)
- Silvia Costa
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Jean Adams
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Sarah Gonzalez-Nahm
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
| | - Sara E Benjamin Neelon
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
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West JM, Power J, Hayward K, Joy P. An Exploratory Thematic Analysis of the Breastfeeding Experience of Students at a Canadian University. J Hum Lact 2017; 33:205-213. [PMID: 28135477 DOI: 10.1177/0890334416679621] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The demographic of today's university student includes breastfeeding mothers. Few studies have examined the breastfeeding experience that women face upon their return to school. Research aim: The purpose of this research was to explore the breastfeeding experience of students on a university campus. METHODS This qualitative study used semistructured interviews. Responses were audiotaped, transcribed, and coded according to common themes using MAXQDA software. RESULTS A total of eight women were interviewed for the study. All women reported "feelings of isolation" and expressed concern over "what will others think." In addition, "nowhere to breastfeed" and "challenges of pumping" emerged as common barriers to breastfeeding. Regrettably, "forced decisions" emerged as a major theme, with four out of eight women reporting having to supplement with formula because they returned to school. CONCLUSION Student breastfeeding mothers are faced with emotional and physical challenges upon their return to school. Lack of space to breastfeed or pump as well as lack of support on campus are the main reasons that students stop breastfeeding prematurely. A day care facility on campus that accepts young infants, a Baby-Friendly space, and enhanced education are required to support student mothers in their choice to breastfeed.
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Affiliation(s)
| | - Jessica Power
- 1 Mount Saint Vincent University, Halifax, NS, Canada
| | | | - Phillip Joy
- 1 Mount Saint Vincent University, Halifax, NS, Canada
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59
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Development and measurement properties of the Chinese breastfeeding self-regulation questionnaire. Midwifery 2017; 44:24-34. [DOI: 10.1016/j.midw.2016.10.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 09/26/2016] [Accepted: 10/26/2016] [Indexed: 11/19/2022]
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Practices, predictors and consequences of expressed breast-milk feeding in healthy full-term infants. Public Health Nutr 2016; 20:492-503. [DOI: 10.1017/s136898001600241x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo investigate the prevalence and predictors of expressed breast-milk feeding in healthy full-term infants and its association with total duration of breast-milk feeding.DesignProspective cohort study.SettingIn-patient postnatal units of four public hospitals in Hong Kong.SubjectsA total of 2450 mother–infant pairs were recruited in 2006–2007 and 2011–2012 and followed up prospectively for 12 months or until breast-milk feeding had stopped.ResultsAcross the first 6 months postpartum, the rate of exclusive expressed breast-milk feeding ranged from 5·1 to 8·0 % in 2006–2007 and from 18·0 to 19·8 % in 2011–2012. Factors associated with higher rate of exclusive expressed breast-milk feeding included supplementation with infant formula, lack of previous breast-milk feeding experience, having a planned caesarean section delivery and returning to work postpartum. Exclusive expressed breast-milk feeding was associated with an increased risk of early breast-milk feeding cessation when compared with direct feeding at the breast. The hazard ratio (95 % CI) ranged from 1·25 (1·04, 1·51) to 1·91 (1·34, 2·73) across the first 6 months.ConclusionsMothers of healthy term infants should be encouraged and supported to feed directly at the breast. Exclusive expressed breast-milk feeding should be recommended only when medically necessary and not as a substitute for feeding directly at the breast. Further research is required to explore mothers’ reasons for exclusive expressed breast-milk feeding and to identify the health outcomes associated with this practice.
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Soomro JA, Shaikh ZN, Saheer TB, Bijarani SA. Employers' perspective of workplace breastfeeding support in Karachi, Pakistan: a cross-sectional study. Int Breastfeed J 2016; 11:24. [PMID: 27606000 PMCID: PMC5013577 DOI: 10.1186/s13006-016-0084-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 08/30/2016] [Indexed: 11/25/2022] Open
Abstract
Background Breastfeeding is considered to be an important measure to achieve optimum health outcomes for children, women’s return to work has frequently been found to be a main contributor to the early discontinuation of breastfeeding. The aim of the study is to assess workplace breastfeeding support provided to working mothers in Pakistan. Method A workplace based cross-sectional survey was conducted from April through December 2014. Employers from a representative sample of 297 workplaces were interviewed on pre-tested and structured questionnaire. The response rate was 93.7 %. Prevalence of workplace breastfeeding facilities were assessed in the light of World Alliance for Breastfeeding Action (WABA) guidelines. Results Among non-physical facilities, all workplaces offered 3 months paid maternity leave, 45 % of the sites were offering task adjustment to mothers during lactation period. Only 15 % of the sites were offering breastfeeding breaks to working mothers. Physical facilities that include a breastfeeding corner, refrigerator for storing breast milk, breast milk pump and nursery for childcare were provided in less than 7 % of the sites. Multinational organizations provided better support compared to national organizations. Conclusion Support for continuation of breastfeeding by working women at workplaces is inadequate; hence, women discontinue breastfeeding earlier than planned. Policies need to be developed and enforced, employers and employees need to be educated and supportive environment needs to be created to encourage and facilitate breastfeeding friendly worksite environment.
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Affiliation(s)
- Jamil Ahmed Soomro
- Department of Community Medicine, Isra University, Hala Naka Road, 71000 Hyderabad, Pakistan
| | - Zeeshan Noor Shaikh
- Department of Community Medicine, Dow University of Health Sciences, Karachi, 74200 Pakistan
| | | | - Suhail Ahmed Bijarani
- Department of Community Medicine, Isra University, Hala Naka Road, 71000 Hyderabad, Pakistan
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Tarrant M, Lok KYW, Fong DYT, Wu KM, Lee ILY, Sham A, Lam C, Bai DL, Wong KL, Wong EMY, Chan NPT, Dodgson JE. Effect on Baby-Friendly Hospital Steps When Hospitals Implement a Policy to Pay for Infant Formula. J Hum Lact 2016; 32:238-49. [PMID: 26286469 DOI: 10.1177/0890334415599399] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 06/14/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Baby-Friendly Hospital Initiative requires hospitals to pay market price for infant formula. No studies have specifically examined the effect of hospitals paying for infant formula on breastfeeding mothers' exposure to Baby-Friendly steps. OBJECTIVES To investigate the effect of hospitals implementing a policy of paying for infant formula on new mothers' exposure to Baby-Friendly steps and examine the effect of exposure to Baby-Friendly steps on breastfeeding rates. METHODS We used a repeated prospective cohort study design. We recruited 2 cohorts of breastfeeding mother-infant pairs (n = 2470) in the immediate postnatal period from 4 Hong Kong public hospitals and followed them by telephone up to 12 months postpartum. We assessed participants' exposure to 6 Baby-Friendly steps by extracting data from the medical record and by maternal self-report. RESULTS After hospitals began paying for infant formula, new mothers were more likely to experience 4 out of 6 Baby-Friendly steps. Breastfeeding initiation within the first hour increased from 28.7% to 45%, and in-hospital exclusive breastfeeding rates increased from 17.9% to 41.4%. The proportion of mothers who experienced all 6 Baby-Friendly steps increased from 4.8% to 20.5%. The risk of weaning was progressively higher among participants experiencing fewer Baby-Friendly steps. Each additional step experienced by new mothers decreased the risk of breastfeeding cessation by 8% (hazard ratio = 0.92; 95% CI, 0.89-0.95). CONCLUSION After implementing a policy of paying for infant formula, breastfeeding mothers were exposed to more Baby-Friendly steps, and exposure to more steps was significantly associated with a lower risk of breastfeeding cessation.
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Affiliation(s)
- Marie Tarrant
- School of Nursing, The University of Hong Kong, Hong Kong
| | - Kris Y W Lok
- School of Nursing, The University of Hong Kong, Hong Kong
| | | | - Kendra M Wu
- School of Public Health, The University of Hong Kong, Hong Kong
| | | | - Alice Sham
- United Christian Hospital, Kowloon, Hong Kong
| | - Christine Lam
- Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - Dorothy Li Bai
- School of Nursing, The University of Hong Kong, Hong Kong
| | - Ka Lun Wong
- School of Nursing, The University of Hong Kong, Hong Kong
| | - Emmy M Y Wong
- Department of Health and Physical Education, The Hong Kong Institute of Education, Hong Kong
| | - Noel P T Chan
- School of Nursing, The University of Hong Kong, Hong Kong
| | - Joan E Dodgson
- College of Nursing and Healthcare Innovation, Arizona State University, AZ, USA
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63
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Bai DL, Fong DYT, Lok KYW, Tarrant M. Relationship between the Infant Feeding Preferences of Chinese Mothers' Immediate Social Network and Early Breastfeeding Cessation. J Hum Lact 2016; 32:301-8. [PMID: 26887843 DOI: 10.1177/0890334416630537] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 01/06/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND The relationship between support from members of a mother's social network and breastfeeding continuation is receiving increased attention. OBJECTIVES The objectives of this study were to describe the infant feeding preferences of Chinese mothers' immediate social network and to examine the association between these preferences and early breastfeeding cessation. METHODS In total, 1172 mother-infant pairs were recruited from 4 public hospitals in Hong Kong and followed prospectively for 12 months or until breastfeeding stopped. RESULTS Over 40% of participants' partners preferred breastfeeding and half had no infant feeding preference. Only about 20% of participants' mothers or mothers-in-law preferred breastfeeding, and less than 10% reported that all of the 3 significant family members (partner, mother, and mother-in-law) preferred breastfeeding. The partner's preference for infant formula or mixed feeding (odds ratio [OR], 2.60; 95% confidence interval [CI], 1.43-4.71) or having no preference (OR, 1.64; 95% CI, 1.16-2.30) was strongly associated with higher odds of stopping breastfeeding before 1 month. For every additional family member who preferred breastfeeding, the odds of stopping breastfeeding was reduced by almost 20% (OR, 0.81; 95% CI, 0.68-0.97). However, living with a parent-in-law (OR, 1.45; 95% CI, 1.02-2.07) was also a predictor of early breastfeeding cessation. Knowing someone who had breastfed for ≥ 1 month (OR, 0.64; 95% CI, 0.42-0.97) or having been breastfed as a child (OR, 0.67; 95% CI, 0.45-0.98) significantly lowered the odds of early breastfeeding cessation. CONCLUSIONS The infant feeding preferences of mothers' immediate social network are significantly associated with breastfeeding continuation. Prenatal breastfeeding education programs should involve significant family members to promote breastfeeding.
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Affiliation(s)
- Dorothy Li Bai
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Marie Tarrant
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
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High education and increased parity are associated with breast-feeding initiation and duration among Australian women. Public Health Nutr 2016; 19:2551-61. [PMID: 26996672 DOI: 10.1017/s1368980016000367] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Breast-feeding is associated with positive maternal and infant health and development outcomes. To assist identifying women less likely to meet infant nutritional guidelines, we investigated the role of socio-economic position and parity on initiation of and sustaining breast-feeding for at least 6 months. DESIGN Prospective cohort study. SETTING Australia. SUBJECTS Parous women from the Australian Longitudinal Study on Women's Health (born 1973-78), with self-reported reproductive and breast-feeding history (N 4777). RESULTS While 89 % of women (83 % of infants) had ever breast-fed, only 60 % of infants were breast-fed for at least 6 months. Multiparous women were more likely to breast-feed their first child (~90 % v. ~71 % of primiparous women), and women who breast-fed their first child were more likely to breast-feed subsequent children. Women with a low education (adjusted OR (95 % CI): 2·09 (1·67, 2·62)) or a very low-educated parent (1·47 (1·16, 1·88)) had increased odds of not initiating breast-feeding with their first or subsequent children. While fewer women initiated breast-feeding with their youngest child, this was most pronounced among high-educated women. While ~60 % of women breast-fed their first, second and third child for at least 6 months, low-educated women (first child, adjusted OR (95 % CI): 2·19 (1·79, 2·68)) and women with a very low (1·82 (1·49, 2·22)) or low-educated parent (1·69 (1·33, 2·14)) had increased odds of not breast-feeding for at least 6 months. CONCLUSIONS A greater understanding of barriers to initiating and sustaining breast-feeding, some of which are socio-economic-specific, may assist in reducing inequalities in infant breast-feeding.
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Kair LR, Colaizy TT. Breastfeeding Continuation Among Late Preterm Infants: Barriers, Facilitators, and Any Association With NICU Admission? Hosp Pediatr 2016; 6:261-8. [PMID: 27048247 DOI: 10.1542/hpeds.2015-0172] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Late preterm birth (at 34-36 6/7 weeks' gestation) is a risk factor for early breastfeeding cessation. The objective of this study was to determine barriers to and facilitators of breastfeeding continuation among late preterm infants (LPI) and to compare the barriers faced by LPI admitted to the well nursery versus the NICU. METHODS The SAS Complex Survey was used to perform multivariable logistic regression analysis by using data from the Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System. Data from 3 states (Illinois, Maine, and Vermont) for the years 2004 to 2008 were used. RESULTS A total of 2530 mothers of LPI were surveyed. Odds of breastfeeding initiation were similar among LPI admitted to the NICU versus the well nursery (adjusted odds ratio, 1.24 [95% confidence interval, 0.88-1.73]; P = .209). Odds of breastfeeding for ≥ 10 weeks were no different between LPI admitted to the NICU versus those admitted to the well-nursery (adjusted odds ratio, 1.02 [95% confidence interval, 0.73-1.43]; P = .904). Factors associated with increased odds of breastfeeding for ≥ 10 weeks among LPI were higher maternal education, mother being married, and normal maternal BMI. Regardless of NICU admission, the top reasons cited by mothers of LPI for early breastfeeding discontinuation were perceived inadequate milk supply and nursing difficulties. CONCLUSIONS Among LPIs, NICU admission was not associated with early breastfeeding cessation. Mothers of LPIs with lower odds of sustaining breastfeeding for at least 10 weeks were single mothers, those with a high school education only, and those who were obese. Breastfeeding support should be enhanced for LPIs and should address perceived maternal milk supply concerns and nursing difficulties.
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Affiliation(s)
- Laura R Kair
- Department of Pediatrics, University of Iowa Stead Family, Carver College of Medicine, Iowa City, Iowa, 52242, USA.
| | - Tarah T Colaizy
- Department of Pediatrics, University of Iowa Stead Family, Carver College of Medicine, Iowa City, Iowa, 52242, USA
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Triviño-Juárez JM, Nieto-Pereda B, Romero-Ayuso D, Arruti-Sevilla B, Avilés-Gámez B, Forjaz MJ, Oliver-Barrecheguren C, Mellizo-Díaz S, Soto-Lucía C, Plá-Mestre R. Quality of life of mothers at the sixth week and sixth month post partum and type of infant feeding. Midwifery 2015; 34:230-238. [PMID: 26621376 DOI: 10.1016/j.midw.2015.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 10/26/2015] [Accepted: 11/01/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION there is little scientific evidence on the relationship between maternal quality of life and type of infant feeding. The purpose of this study was to determine if there were differences in mother's quality of life by type of infant feeding. MATERIAL AND METHODS longitudinal prospective study with 364 women who gave birth at a public hospital at Madrid, Spain, between February and October 2013. To be included, the participants had to be a healthy primigravida aged 18-45 years who gave birth to a healthy newborn with a gestational age between 36 and 42 completed weeks, regardless of birth type. The hospital interviews were performed between 36 and 48 hours post partum in women who had case of vaginal/instrumental births and 60-72 hours post partum for women who had a caesarean birth. Telephone interviews were conducted at the sixth week and sixth month post partum, and included the SF-36 to measure quality of life. SF-36 scores were compared between breast feeding and artificial milk feeding. We also analysed the longitudinal change in SF-36 scores in both groups. RESULTS at the sixth week post partum, regardless of the infant feeding modality, an increased mental health score was recorded for mothers who reported that their children ate and slept well and for those who did not go to the emergency hospital service because of concern over their baby's health. No significant differences in quality of life were found between the two groups at six months post partum. Between the sixth week and sixth month post partum, quality of life improved significantly in both groups. DISCUSSION at the sixth week post partum, the proportion of children who ate and slept well and did not have to attend in an emergency hospital service was higher in the breast feeding group. This observation was associated with greater maternal quality of life. This positive indirect relationship between breast feeding and quality of life should be considered an additional maternal health benefit in the short term.
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Affiliation(s)
- José Matías Triviño-Juárez
- Preventive Medicine Service, Hospital General Universitario Gregorio Marañón, Gregorio Marañon Health Research Institute (IiSGM), Madrid, Spain.
| | - Beatriz Nieto-Pereda
- Preventive Medicine Service, Hospital General Universitario Gregorio Marañón, Gregorio Marañon Health Research Institute (IiSGM), Madrid, Spain
| | - Dulce Romero-Ayuso
- Department of Psychology, Castilla-La Mancha University, Talavera de la Reina, Toledo, Spain
| | | | | | - Maria João Forjaz
- National School of Public Health, Carlos III Institute of Health and REDISSEC, Carlos III Institute of Health, Madrid, Spain
| | - Cristina Oliver-Barrecheguren
- Obstetrics and Gynecology Service, Hospital General Universitario Gregorio Marañón, Gregorio Marañon Health Research Institute (IiSGM), Madrid, Spain
| | - Sonia Mellizo-Díaz
- Obstetrics and Gynecology Service, Hospital General Universitario Gregorio Marañón, Gregorio Marañon Health Research Institute (IiSGM), Madrid, Spain
| | - Consuelo Soto-Lucía
- Obstetrics and Gynecology Service, Hospital General Universitario Gregorio Marañón, Gregorio Marañon Health Research Institute (IiSGM), Madrid, Spain
| | - Rosa Plá-Mestre
- Preventive Medicine Service, Hospital General Universitario Gregorio Marañón, Gregorio Marañon Health Research Institute (IiSGM), Madrid, Spain
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Lok KYW, Bai DL, Tarrant M. Predictors of breastfeeding initiation in Hong Kong and Mainland China born mothers. BMC Pregnancy Childbirth 2015; 15:286. [PMID: 26531299 PMCID: PMC4632339 DOI: 10.1186/s12884-015-0719-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 10/23/2015] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND In recent years there has been a steady influx of immigrants into Hong Kong from Mainland China, where breastfeeding patterns differ. Studies in other regions have found substantial differences in breastfeeding rates between native-born and immigrant mothers. The purpose of this study was to examine factors associated with breastfeeding initiation in Hong Kong born and Mainland China born mothers living in Hong Kong. METHODS We used a multi-center cross-sectional study design and recruited 2761 new mothers from the postnatal wards of all eight public hospitals in Hong Kong that offer obstetric services. We assessed breastfeeding status as well as various socio-demographic, maternal and birth characteristics. Chi-square tests and multivariable logistic regression were used to identify the predictors of breastfeeding initiation in Hong Kong born and Mainland China born participants. RESULTS 80.3 % of Hong Kong and 81.1 % of Mainland Chinese born women initiated breastfeeding. In the fully adjusted models, multiparity (Odds Ratio [OR] 0.53, 95 % CI 0.43-0.66) and maternal smoking (OR 0.29, 95 % CI 0.18-0.45) were strongly associated with failure to initiate breastfeeding in both Hong Kong and Mainland China born participants. In Hong Kong born mothers, participants with lower maternal education and those who had a cesarean section were significantly less likely to breastfeed. For Mainland China born mothers, paternal smoking (OR 0.70, 95 % CI 0.49-0.99) and having a pregnancy-related health problem (OR 0.60, 95 % CI 0.38-0.94) were both additional risk factors for not breastfeeding. CONCLUSION This study has identified predictors of breastfeeding initiation in Hong Kong and Mainland China born mothers. Given the current high breastfeeding initiation rates among both groups, antenatal breastfeeding education and promotion programmes need to specifically intervene with sub-groups of pregnant women at risk for not breastfeeding so that their efforts are more strategic and cost-effective.
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Affiliation(s)
- Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR.
| | - Dorothy Li Bai
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR.
| | - Marie Tarrant
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR.
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