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Bolton KA, Kremer P, Hesketh KD, Laws R, Kuswara K, Campbell KJ. Differences in infant feeding practices between Chinese-born and Australian-born mothers living in Australia: a cross-sectional study. BMC Pediatr 2018; 18:209. [PMID: 29954351 PMCID: PMC6022504 DOI: 10.1186/s12887-018-1157-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 05/24/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chinese immigrants are the third largest immigrant group in Australia. Recent qualitative evidence from Victorian Maternal and Child Health nurses indicate that infants of Chinese parents commonly have rapid growth trajectories and that high value is placed on rapid growth and having a fatter child; with low breastfeeding rates and overfeeding of infant formula. The aim of this study was to compare infant feeding practices (breastfeeding, infant formula, other liquids, solids) of Chinese-born and Australian-born mothers living in Australia. METHODS Using the Australian National Infant Feeding Survey dataset (2010-2011), infant feeding data from Chinese-born mothers (n = 602) were compared with a random sub-sample of Australian-born mothers (n = 602). Group differences on feeding practices were tested using Chi-square or t-tests and the effect of ethnicity on infant feeding behaviours assessed using regression. RESULTS Compared to infants of Australian-born mothers, infants of Chinese-born mothers were younger when they first consumed infant formula, water-based drinks and fruit juice and older when they first ate solid foods (p < 0.05). Furthermore, infants of Chinese-born mothers were less likely to have ever had cow's milk (OR: 0.37 95%CI:, 0.18-0.78) and solids (0.41, 0.25-0.68); but were more likely to have ever had infant formula (2.19, 1.32-3.62), water (2.45, 1.55-3.87), toddler milk (3.39, 1.60-7.18), water-based drinks (e.g. cordial, soft drink, tea; 2.48, 1.12-5.49), and fruit juice (4.03, 2.50-6.51). Those ≤4 months of age were more likely to have had water-based drinks (7.77, 1.96-30.77) and fruit juice (3.44, 1.14-10.38) (p < 0.05) compared to infants of Australian-born mothers. CONCLUSION Differences in mothers' early infant feeding practices exist between Chinese-born and Australian-born mothers living in Australia. Better understanding these ethnically patterned infant feeding practices is important for identifying key opportunities to promote best nutrition and growth in early life in different ethnic groups within our population.
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Affiliation(s)
- Kristy A. Bolton
- Institute for Physical Activity and Nutrition (IPAN), School Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Peter Kremer
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Kylie D. Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, Sydney, Australia
| | - Rachel Laws
- Institute for Physical Activity and Nutrition (IPAN), School Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, Sydney, Australia
- Centre for Obesity Prevention and Management Research Excellence in Primary Heath Care (COMPaRE-PHC), Sydney, Australia
| | - Konsita Kuswara
- Institute for Physical Activity and Nutrition (IPAN), School Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Karen J. Campbell
- Institute for Physical Activity and Nutrition (IPAN), School Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, Sydney, Australia
- Centre for Obesity Prevention and Management Research Excellence in Primary Heath Care (COMPaRE-PHC), Sydney, Australia
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Thomas EV. "Why Even Bother; They Are Not Going to Do It?" The Structural Roots of Racism and Discrimination in Lactation Care. QUALITATIVE HEALTH RESEARCH 2018; 28:1050-1064. [PMID: 29557297 DOI: 10.1177/1049732318759491] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Through semi-structured interviews with 36 International Board Certified Lactation Consultants (IBCLCs) who assist mothers with breastfeeding, this study takes a systematic look at breastfeeding disparities. Specifically, this study documents race-based discrimination against patients in the course of lactation care and links the implicit bias literature to breastfeeding disparities. IBCLCs report instances of race-based discrimination against patients such as unequal care provided to patients of color and overt racist remarks said in front of or behind patient's backs. This study connects patient discrimination in lactation to institutional inequality and offers suggestions to address these inequities.
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Affiliation(s)
- Erin V Thomas
- 1 Graduate of Georgia State University, Atlanta, Georgia, USA ORISE Research Fellow, Oak Ridge Tennesee, USA
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Muelbert M, Giugliani ERJ. Factors associated with the maintenance of breastfeeding for 6, 12, and 24 months in adolescent mothers. BMC Public Health 2018; 18:675. [PMID: 29855364 PMCID: PMC5984453 DOI: 10.1186/s12889-018-5585-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 05/22/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Previous studies have demonstrated that adolescent mothers present a higher risk of not breastfeeding or of early interruption of this practice. Considering the scarcity of studies investigating the determining factors of breastfeeding in adolescent mothers, and the absence of studies exploring the determining factors of breastfeeding maintenance for different periods of time in a single population of adolescent mothers, the aim of this research was to identify factors associated with breastfeeding maintenance for at least 6, 12, and 24 months in adolescent mothers. METHODS Data analysis from a randomised control trial involving adolescent mothers recruited at a university hospital in southern Brazil. Participants were followed through the first year of life of their infants and reassessed at 4-7 years. Factors associated with any breastfeeding for at least 6, 12, and 24 months were assessed using multivariate Poisson regression. RESULTS Data for 228, 237, and 207 mothers were available, respectively. Breastfeeding maintenance for at least 6, 12, and 24 months was observed in 68.4, 47.3, and 31.9% of the sample, respectively. Only one factor was associated with breastfeeding maintenance at all outcomes: infant not using a pacifier showed a higher probability of breastfeeding maintenance in the first 2 years. Maternal grandmother breastfeeding support and exclusive breastfeeding duration were associated with breastfeeding maintenance for 6 and 12 months. The other factors evaluated were associated with breastfeeding maintenance at only one of the time points assessed: 6 months, maternal skin color (black/brown); 12 months, female infant and partner breastfeeding support; and 24 months, older paternal age and multiparity. CONCLUSIONS The present findings shed light upon barriers and facilitators of breastfeeding practices among adolescent mothers. In order to contribute to the challenge of increasing BF duration among adolescent mothers interventions aimed at boosting breastfeeding maintenance among this population should take into consideration the determining factors here identified. Additionally, breastfeeding education and support should be provided continuously as factors influencing these practices vary with time. Thus, support for adolescent mothers during the different stages of breastfeeding need to be tailored to have a positive impact on breastfeeding experience.
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Affiliation(s)
- Mariana Muelbert
- Post-Graduate Program in Child and Adolescent Health, Department of Pediatrics, Faculty of Medicine, Rua Ramiro Barcelos, 2400 2º andar, Porto Alegre, RS CEP: 90035003, Brazil.
| | - Elsa R J Giugliani
- Post-Graduate Program in Child and Adolescent Health, Department of Pediatrics, Faculty of Medicine, Rua Ramiro Barcelos, 2400 2º andar, Porto Alegre, RS CEP: 90035003, Brazil
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Fryer K, Santos HP, Pedersen C, Stuebe AM. The Hispanic Paradox: Socioeconomic Factors and Race/Ethnicity in Breastfeeding Outcomes. Breastfeed Med 2018; 13:174-180. [PMID: 29485909 PMCID: PMC5899276 DOI: 10.1089/bfm.2017.0157] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Breastfeeding has multiple benefits for both mother and infant. Previous studies have shown that Hispanic/Latina women have higher rates of breastfeeding and better health outcomes than non-Hispanic black (NHB) women of similar socioeconomic status. Our primary objective was to explore the association of race/ethnicity with breastfeeding rates and the impact of socioeconomic factors on initiation and continuation of breastfeeding. MATERIALS AND METHODS We performed a hypothesis-generating secondary analysis of a prospective cohort study of perinatal mental health in a diverse sample of 213 mothers. Twenty-eight participants self-identified as non-Hispanic white, 43 as NHB, and 142 as Hispanic/Latina. We examined bivariate relationships and performed logistic regression analysis for a series of maternal, infant, and psychosocial factors to examine their individual effect on the breastfeeding and race/ethnicity relationship odds ratio (OR). RESULTS Hispanic/Latina women were more likely to initiate exclusive breastfeeding at delivery compared with NHB women (OR 2.4, 95% confidence interval: 1.2-4.9, p = 0.01). Adjustment for maternal, infant, and psychosocial factors measured did not statistically significantly attenuate the OR for initiation of breastfeeding between NHB and Hispanic/Latina women. Women with a history of sexual abuse were also more likely to initiate exclusive breastfeeding (67%) compared with women without a sexual abuse history (54%, p < 0.05). CONCLUSIONS In this low socioeconomic status cohort study, Hispanic/Latina women had higher proportions of any amount of breastfeeding compared with their NHB counterparts. This difference was not attenuated by any of the maternal, infant, or psychosocial factors examined, although our secondary analysis of this prospective cohort was limited by the available covariates in the parent study.
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Affiliation(s)
- Kimberly Fryer
- 1 Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina
| | - Hudson P Santos
- 2 School of Nursing, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina
| | - Cort Pedersen
- 3 Department of Psychiatry, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina
| | - Alison M Stuebe
- 4 Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.,5 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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Santana GS, Giugliani ERJ, Vieira TDO, Vieira GO. Factors associated with breastfeeding maintenance for 12 months or more: a systematic review. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2018. [DOI: 10.1016/j.jpedp.2017.09.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Lok KYW, Bai DL, Chan NPT, Wong JYH, Tarrant M. The impact of immigration on the breastfeeding practices of Mainland Chinese immigrants in Hong Kong. Birth 2018; 45:94-102. [PMID: 28960460 DOI: 10.1111/birt.12314] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 08/20/2017] [Accepted: 08/21/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Researchers have found breastfeeding disparities between immigrant and native-born women in many countries. However, most studies on immigration and breastfeeding practices have been in Western countries. The aim of this study was to examine the effect of length of time since immigration on the breastfeeding practices of Mainland Chinese immigrants living in Hong Kong. METHODS We recruited 2704 mother-infant pairs from the postnatal wards of four public hospitals in Hong Kong. We examined the effect of migration status on the duration of any and exclusive breastfeeding. RESULTS Breastfeeding duration was progressively shorter as the time since immigration increased. When compared with mothers who had lived in Hong Kong for <5 years, Hong Kong-born participants had a 30% higher risk of stopping any breastfeeding (hazard ratio [HR] 1.34 [95% confidence interval {CI} 1.10-1.63]) and exclusive breastfeeding (HR 1.33 [95% CI 1.11-1.58]). In both Hong Kong-born and immigrant participants, breastfeeding cessation was associated with return to work postpartum and the husband's preference for infant formula or mixed feeding. Intention to exclusively breastfeed and to breastfeed for >6 months, and previous breastfeeding experience substantially reduced the risk of breastfeeding cessation for both Hong Kong-born and immigrant participants. CONCLUSIONS Health care professionals should consider immigration history in their assessment of pregnant women and provide culturally adapted breastfeeding support and encouragement to this population.
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Affiliation(s)
| | - Dorothy Li Bai
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Noel P T Chan
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Janet Y H Wong
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Marie Tarrant
- School of Nursing, The University of British Columbia, Okanagan Campus, Canada
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Santana GS, Giugliani ERJ, Vieira TDO, Vieira GO. Factors associated with breastfeeding maintenance for 12 months or more: a systematic review. J Pediatr (Rio J) 2018; 94:104-122. [PMID: 28886401 DOI: 10.1016/j.jped.2017.06.013] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 04/10/2017] [Accepted: 04/21/2017] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Synthesize the information about the factors associated with maintenance of breastfeeding for 12 months or more. DATA SOURCE A systematic review was conducted in the Pubmed/Medline, Scielo, and Lilacs databases, including articles published in Portuguese or English since 2004 on the factors associated with breastfeeding maintenance for at least 12 months; review articles and those with qualitative design were excluded. The factors were organized into four levels, according to the chronological proximity to the outcome: distal, distal intermediate, proximal intermediate, and proximal; nationality and place/area of residence were considered contextual factors. SUMMARY OF DATA 1174 articles were identified, of which 19 were included in this review, comprising seven cohort studies and 12 cross-sectional studies. A total of 39 of the 75 assessed factors were associated with the outcome at least once. The factors with the highest percentages of associations with maintenance of breastfeeding for 12 months or more, considering the number of times they were tested were: children whose parents are the caregivers (100%), none type of maternal exposure to smoke (54%), children and/or parents are immigrants/foreigners (50%), live in urban areas (42.9%), older maternal age (40%), married women (37.5%), higher level of maternal education (31.3%), greater parity (30.8%), and lower income (30%). CONCLUSIONS The maintenance of breastfeeding for 12 months or more is associated with multiple factors, emphasizing the contextual factors and those related to some maternal sociodemographic characteristics. Associations differ in effect and magnitude between the different populations studied.
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Affiliation(s)
- Géssica S Santana
- Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brazil.
| | - Elsa Regina J Giugliani
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Pediatria, Porto Alegre, RS, Brazil
| | | | - Graciete O Vieira
- Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brazil
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Holland ML, Thevenent-Morrison K, Mittal M, Nelson A, Dozier AM. Breastfeeding and Exposure to Past, Current, and Neighborhood Violence. Matern Child Health J 2018; 22:82-91. [PMID: 28766093 PMCID: PMC5764770 DOI: 10.1007/s10995-017-2357-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objectives Breastfeeding has short- and long-term health benefits for children and mothers, but US breastfeeding rates are suboptimal. Exposure to violence may contribute to these low rates, which vary by race/ethnicity. We studied: (1) whether patterns of violence exposure differ by race/ethnicity and (2) whether these patterns are associated with breastfeeding outcomes. Methods We conducted a secondary analysis of data drawn from self-report surveys completed by a convenience sample of low-income postpartum women (n = 760) in upstate New York. Latent class analysis was used to identify groups of women with similar responses to seven violence measures, including childhood physical and/or sexual violence, experience of partner violence during or just after pregnancy (physical, emotional, verbal), and neighborhood violence (perceived or by ZIP code). Logistic regression and survival analysis were utilized to determine if classes were associated with breastfeeding initiation, duration, and exclusivity, controlling for demographics. Results Exposure to at least one form of violence was high in this sample (87%). We identified 4 classes defined by violence exposure (combining current and historical exposures). Violence exposure patterns differed between racial/ethnic groups, but patterns were inconsistently associated with breastfeeding plans or outcomes. For White women, history of violence exposure increased the likelihood of earlier breastfeeding cessation. By contrast, among Black women, history of violence exposure increased the likelihood of having a breastfeeding plan and initiating breastfeeding. Conclusions for Practice Some differences between violence exposure classes are likely due to the correlation between race/ethnicity and socioeconomic status in the community studied. Additional studies are warranted to better understand how exposure to violence is related to breastfeeding and how best to support women making decisions about intention, initiation, and duration of breastfeeding.
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Affiliation(s)
- Margaret L Holland
- Yale University School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA.
| | - Kelly Thevenent-Morrison
- Department of Public Health Sciences, University of Rochester, 265 Crittenden Blvd, Rochester, NY, 14642, USA
| | - Mona Mittal
- Department of Family Science, School of Public Health, University of Maryland, 255 Valley Drive, College Park, MD, 20742, USA
| | - Alice Nelson
- , 22018 South Central Point Road, Canby, OR, 97013, USA
| | - Ann M Dozier
- Department of Public Health Sciences, University of Rochester, 265 Crittenden Blvd, Rochester, NY, 14642, USA
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Kersuzan C, Tichit C, Thierry X. Les pratiques d’allaitement des immigrées et des natives en France, à partir de la cohorte Elfe. POPULATION 2018. [DOI: 10.3917/popu.1803.0571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Lindsay AC, Le Q, Greaney ML. Infant Feeding Beliefs, Attitudes, Knowledge and Practices of Chinese Immigrant Mothers: An Integrative Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 15:ijerph15010021. [PMID: 29295487 PMCID: PMC5800121 DOI: 10.3390/ijerph15010021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 12/18/2017] [Accepted: 12/20/2017] [Indexed: 12/15/2022]
Abstract
Chinese are a fast-growing immigrant population group in several parts of the world (e.g., Australia, Canada, Europe, Southeast Asia, United States). Research evidence suggests that compared to non-Hispanic whites, individuals of Asian-origin including Chinese are at higher risk of developing cardiovascular disease and type 2 diabetes at a lower body mass index (BMI). These risks may be possibly due to genetic differences in body composition and metabolic responses. Despite the increasing numbers of Chinese children growing up in immigrant families and the increasing prevalence of obesity among Chinese, little research has been focused on children of Chinese immigrant families. This integrative review synthesizes the evidence on infant feeding beliefs, attitudes, knowledge and practices of Chinese immigrant mothers; highlights limitations of available research; and offers suggestions for future research. Using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, we searched four electronic academic/research databases (CINAHL, Medline, PsycINFO, and PubMed) to identify peer-reviewed, full-text papers published in English between January 2000 and September 2017. Only studies with mothers 18+ years old of normally developing infants were included. Of the 797 citations identified, 15 full-text papers were retrieved and 11 studies (8 cross-sectional studies, 3 qualitative studies) met the inclusion criteria and were included in this review. Reviewed studies revealed high initiation rates of breastfeeding, but sharp declines in breastfeeding rates by six months of age. In addition, reviewed studies revealed that the concomitantly use of breast milk and formula, and the early introduction of solid foods were common. Finally, reviewed studies identified several familial and socio-cultural influences on infant feeding beliefs and practices that may increase risk of overweight and obesity during infancy and early childhood among Chinese children of immigrant families. Nonetheless, as only 11 studies were identified and because the majority of studies (n = 8) were conducted in Australia, additional research including longitudinal studies, and studies conducted in countries with large Chinese immigrant population are needed to further identify and understand influences on Chinese immigrant mothers' beliefs, attitudes, and practices related to infant feeding that may increase risk of child overweight and obesity. This information is needed to develop interventions tailored to the beliefs and needs of this fast-growing immigrant group and aimed at promoting healthy infant feeding practices to prevent childhood overweight and obesity.
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Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA.
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Qun Le
- Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA.
| | - Mary L Greaney
- Health Studies and Department of Kinesiology, University of Rhode Island, Kingston, RI 02881, USA.
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A Qualitative Study to Understand Nativity Differences in Breastfeeding Behaviors Among Middle-Class African American and African-Born Women. Matern Child Health J 2017; 20:2100-11. [PMID: 27334637 DOI: 10.1007/s10995-016-2029-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective To explore nativity differences and the role of attitudes, social norms, and behavioral control perceptions surrounding breastfeeding initiation and duration among middle-class African-American (AA) and African-born (AB) mothers in the US. Methods Semi-structured individual interviews were conducted with 20 middle-class AA and AB mothers in central Ohio from December 2012 to February 2013. Interview questions were developed based on the Theory of Planned Behavior (TPB). Interviews were analyzed for salient themes by TPB constructs. Differences in themes were examined by nativity status. Results All study participants had initiated breastfeeding or bottle-feeding with expressed breast milk, noting the benefits it conferred as well as the persuasive encouragement they received from others. Persistent encouragement was often cited as a factor for sustaining breastfeeding. More AA mothers had discontinued breastfeeding by the time of the interview, which was often attributed to health, lactation, and work challenges. Inconsistent support from health providers, dissuasive remarks from others, ambivalent breastfeeding attitudes, and diminished family support led some mothers to begin formula supplementation. Analysis of maternal narratives revealed nativity differences across sources of encouragement. Specifically, important sources of encouragement were health providers for AA mothers and family, friends, partners and culture for AB mothers. Only AB mothers expressed concerns about difficulty they encountered with breastfeeding due to the lack of proximal family support. Conclusions Findings reveal that both groups of mothers may be susceptible to unsupportive breastfeeding norms in the US and also highlight the need for intervention in health care settings and workplaces to improve AA women's breastfeeding rates.
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Parker MGK, Colson ER, Provini L, Rybin DV, Kerr SM, Heeren T, Corwin MJ. Variation in Safe Sleep and Breastfeeding Practices Among Non-Hispanic Black Mothers in the United States According to Birth Country. Acad Pediatr 2017; 17:887-892. [PMID: 28729127 DOI: 10.1016/j.acap.2017.07.003] [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] [Received: 01/19/2017] [Revised: 07/07/2017] [Accepted: 07/11/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To examine variation in safe sleep and breastfeeding practices among US non-Hispanic black (NHB) mothers according to birth country. METHODS We analyzed NHB mothers who were surveyed regarding safe sleep and breastfeeding practices when their infants were 2 to 6 months of age in 2011 to 2014, as part of a larger national study. We examined prevalences of safe sleep and breastfeeding practices according to birth country and examined odds of adherence to American Academy of Pediatrics recommended safe sleep and breastfeeding practices in foreign-born NHB mothers, compared with US-born NHB mothers. Our multivariate models included adjustment for maternal age, education, income, and US geographic region, and infant age at the time of the survey. RESULTS Among 828 NHB mothers, 690 (83%) were US-born, 42 (5%) were African-born, 47 (6%) were Haitian-born, 24 (3%) were Jamaican-born, and 25 (3%) were born elsewhere. In the analysis of 803 US, African-, Haitian-, and Jamaican-born mothers, we found that Jamaican-born mothers had a lower rate of supine sleep compared with US-born mothers (40% vs 66%; adjusted odds ratio, 0.34; 95% confidence interval, 0.18-0.63). African-born mothers had lower rates of bedsharing compared with US-born mothers (11% vs 25% adjusted odds ratio, 0.22; 95% confidence interval, 0.11-0.46). Foreign-born mothers had higher rates of any and exclusive breastfeeding, compared with US-born mothers (85% and 40% vs 23% and 13%, respectively). CONCLUSIONS Safe sleep and breastfeeding practices vary among US NHB mothers according to birth country. These data illustrate the importance of recognizing heterogeneity of safe sleep and breastfeeding practices within racial/ethnic groups.
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Affiliation(s)
- Margaret G K Parker
- Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Mass.
| | - Eve R Colson
- Department of Pediatrics, Yale School of Medicine, New Haven, Conn
| | - Lauren Provini
- Department of Pediatrics, Yale School of Medicine, New Haven, Conn
| | - Denis V Rybin
- Department of Biostatistics, Boston University School of Public Health, Mass
| | | | - Timothy Heeren
- Department of Biostatistics, Boston University School of Public Health, Mass
| | - Michael J Corwin
- Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Mass; Slone Epidemiology Center, Boston University, Mass
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Cheng ER, Taveras EM, Hawkins SS. Paternal Acculturation and Maternal Health Behaviors: Influence of Father's Ethnicity and Place of Birth. J Womens Health (Larchmt) 2017; 27:724-732. [PMID: 29087779 DOI: 10.1089/jwh.2017.6439] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Studies show disparities in maternal health behaviors according to acculturation, but whether paternal factors influence these patterns is unknown. We assessed the relationships between fathers' ethnicity and place of birth with maternal smoking during pregnancy and breastfeeding initiation overall and for 30 major ethnic groups. MATERIALS AND METHODS Data were from the Standard Certificate of Live Births on 1,053,096 births in Massachusetts between 1996 through 2010. We examined the concordance of maternal and paternal ethnicity and place of birth across three categories (United States-born white, United States-born Other ethnicity, and foreign-born), and then in relation to maternal smoking during pregnancy and breastfeeding initiation. Multivariable models adjusted for maternal age, marital status, education, plurality, parity, prenatal care, delivery source of payment, and year of birth. RESULTS United States-born white mothers were less likely to smoke during pregnancy (adjusted odds ratio [AOR] 0.66; 95% confidence interval [CI]: 0.60, 0.73) and more likely to initiate breastfeeding (AOR 1.56; 95% CI: 1.46, 1.66) if their partners were foreign-born. In contrast, foreign-born mothers whose partners were United States-born of Other ethnicity or United States-born white had a 1.65-5.12 higher odds of smoking during pregnancy and were 26%-41% less likely (AORs 0.59-0.74) to initiate breastfeeding than if their partners were also foreign-born. Results were consistent across most racial/ethnic groups. CONCLUSIONS Our findings offer new insight into the social pathways by which acculturation impacts maternal health behaviors and add to growing evidence that fathers are valuable to maternal health. Future efforts to understand how acculturation results in poorer maternal health behaviors should account for paternal influences.
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Affiliation(s)
- Erika R Cheng
- 1 Section of Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine , Indianapolis, Indiana
| | - Elsie M Taveras
- 2 Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children , Boston, Massachusetts.,3 Department of Nutrition, Harvard T.H. Chan School of Public Health , Boston, Massachusetts
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Differences in the Protective Effect of Exclusive Breastfeeding on Child Overweight and Obesity by Mother's Race. Matern Child Health J 2017; 20:1971-9. [PMID: 27178429 DOI: 10.1007/s10995-016-2015-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objectives To examine the relationship between infant feeding and risk of child overweight and obesity across race and ethnicity in a diverse community-based cohort. Methods 2172 mother baby dyads were drawn from a prospective cohort constructed using data from electronic medical records linked to birth records. The primary exposure was exclusive breastfeeding at 2 months of age; outcome was BMI Z-score and BMI ≥ 85th percentile (overweight and obese) at 4 years of age. Regression models were adjusted for confounding using covariance balanced propensity score and inverse probability weighting. Results At age 4, exclusively breast fed children had lower BMI Z-score (-0.109, SE = 0.048) and a decreased odds of a BMI ≥ 85th percentile (0.832; 95 % CI 0.792, 0.994), when compared to those exclusively formula-fed or had mixed feeding. Race and ethnicity significantly moderated these associations. Sub-population analysis showed the effect was significant for BMI Z-score (p = 0.0002) and BMI ≥ 85th percentile (p < 0.0001) only for children of NH white mothers. For children of NH black mothers exclusive breastfeeding was not associated with a significant difference in BMI Z-score, however there was an increased odds of overweight or obesity (p = 0.0145). Conclusions The protective effect of breastfeeding against early childhood overweight and obesity may differ by race and ethnicity. This suggests that programs aiming to reduce obesity by increasing rates of breastfeeding may have limited impact for some groups and should be coupled with other racially and ethnically focused efforts to encourage healthy feeding practices in infancy and early childhood.
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Louis-Jacques A, Deubel TF, Taylor M, Stuebe AM. Racial and ethnic disparities in U.S. breastfeeding and implications for maternal and child health outcomes. Semin Perinatol 2017. [PMID: 28624126 DOI: 10.1053/j.semperi.2017.04.007] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Marked racial and ethnic disparities exist in infant feeding in the United States. Based on a review of recent literature, this article examines current discrepancies between the 2020 Healthy People breastfeeding goals and current breastfeeding rates among women from different ethnic groups in the United States. We discuss maternal and child health outcomes associated with breastfeeding, and we review potential causes of racial and ethnic disparities in breastfeeding outcomes in the United States, especially among non-Hispanic Black, American Indian/Alaska Native, and Hispanic/Latina populations. We conclude with an overview of best practices in interventions aimed to increase U.S. breastfeeding rates, such as adoption of the baby friendly hospital initiative (BHFI) and programs that utilize peer counseling strategies to increase breastfeeding promotion and support.
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Affiliation(s)
- Adetola Louis-Jacques
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, 2 Tampa General Circle, 6th Floor, Tampa, FL 33579.
| | - Tara F Deubel
- Department of Anthropology, University of South Florida, Tampa, FL
| | - Melina Taylor
- Department of Anthropology, University of South Florida, Tampa, FL; College of Public Health, University of South Florida, Tampa, FL
| | - Alison M Stuebe
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC; Department of Maternal and Child Health, Carolina Global Breastfeeding Institute, Gillings School of Global Public Health, Chapel Hill, NC
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Abstract
Exclusive breastfeeding is recommended for the first 6 months of life, and up to 1 year with complementary food. Breastfeeding rates have improved over the last 20 years, but exclusive breastfeeding, and breastfeeding to 6 months have not yet met Healthy People 2020 goals. Given that the majority of women return to work shortly after delivery, workplace support for breastfeeding could facilitate breastfeeding continuance. The Patient Protection and Affordable Care Act (ACA) was the first federal legislation to address breastfeeding in the workplace. This article examines employee breastfeeding behavior before and after implementation of workplace breastfeeding support policies and practices. Breastfeeding behavior change over time was assessed by comparing employees' responses by age of their youngest children. Results indicated that breastfeeding among employees and breastfeeding after returning to work improved after initiation of breastfeeding support policies in this university setting.
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Olson JS, Hayward MD. Breastfeeding, overweight status, and inflammation. SOCIAL SCIENCE RESEARCH 2017; 64:226-236. [PMID: 28364846 PMCID: PMC5380147 DOI: 10.1016/j.ssresearch.2016.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 07/15/2016] [Accepted: 10/28/2016] [Indexed: 05/16/2023]
Abstract
Research documents a host of health benefits of breastfeeding for infants and children, including long-term health conditions arising from inflammation. Here, we provide new evidence about this association, focusing on the link between breastfeeding in infancy and inflammation in early adulthood. Our study is based on the National Longitudinal Study of Adolescent to Adult Health (Add Health) which allows us investigate a potentially important mediating pathway - overweight status from early adolescence into young adulthood. Results from pathway analyses in a structural equation modeling framework indicate that, in addition to a direct pathway linking breastfeeding and inflammation, an indirect pathway through overweight status across adolescence into young adulthood partially explains the association between breastfeeding and inflammation. Overweight status, moreover, links breastfeeding to inflammation not only through proximal timing of overweight status, but also through an indirect cascading process of overweight status over the life course that is evident in adolescence. Overall, this study highlights the importance of considering breastfeeding, overweight status and inflammation as dynamic life course processes that contribute to development of health inequalities.
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Pinheiro PS, Callahan KE, Ragin C, Hage RW, Hylton T, Kobetz EN. Black Heterogeneity in Cancer Mortality: US-Blacks, Haitians, and Jamaicans. Cancer Control 2017; 23:347-358. [PMID: 27842324 DOI: 10.1177/107327481602300406] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION The quantitative intraracial burden of cancer incidence, survival and mortality within black populations in the United States is virtually unknown. METHODS We computed cancer mortality rates of US- and Caribbean-born residents of Florida, specifically focusing on black populations (United States, Haiti, Jamaica) and compared them using age-adjusted mortality ratios obtained from Poisson regression models. We compared the mortality of Haitians and Jamaicans residing in Florida to populations in their countries of origin using Globocan. RESULTS We analyzed 185,113 cancer deaths from 2008 to 2012, of which 20,312 occurred in black populations. The overall risk of death from cancer was 2.1 (95% CI: 1.97-2.17) and 1.6 (95% CI: 1.55-1.71) times higher for US-born blacks than black Caribbean men and women, respectively (P < .001). CONCLUSIONS Race alone is not a determinant of cancer mortality. Among all analyzed races and ethnicities, including Whites and Hispanics, US-born blacks had the highest mortality rates while black Caribbeans had the lowest. The biggest intraracial difference was observed for lung cancer, for which US-blacks had nearly 4 times greater mortality risk than black Caribbeans. Migration from the islands of Haiti and Jamaica to Florida resulted in lower cancer mortality for most cancers including cervical, stomach, and prostate, but increased or stable mortality for 2 obesity-related cancers, colorectal and endometrial cancers. Mortality results in Florida suggest that US-born blacks have the highest incidence rate of "aggressive" prostate cancer in the world, rather than Caribbean men.
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Affiliation(s)
- Paulo S Pinheiro
- University of Nevada Las Vegas, School of Community Health Sciences, African-Caribbean Cancer Consortium, Las Vegas, NV, USA.
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Hendrick CE, Potter JE. Nativity, Country of Education, and Mexican-Origin Women's Breastfeeding Behaviors in the First 10 Months Postpartum. Birth 2017; 44:68-77. [PMID: 27779318 PMCID: PMC5654533 DOI: 10.1111/birt.12261] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Breastfeeding is associated with numerous health benefits for the infant and mother. Latina women in the United States have historically had high overall rates of initiation and duration of breastfeeding. However, these rates vary by nativity and time lived in the United States. Exclusive breastfeeding patterns among Latina women are unclear. In this study, we investigate the current and exclusive breastfeeding patterns of Mexican-origin women at four time points from delivery to 10 months postpartum to determine the combined association of nativity and country of education with breastfeeding duration and supplementation. METHODS Data are from the Postpartum Contraception Study, a prospective cohort study of postpartum women ages 18-44 recruited from three hospitals in Austin and El Paso, Texas. We included Mexican-origin women who were born in either the United States or Mexico in the analytic sample (n = 593). RESULTS Women completing schooling in Mexico had higher rates of overall breastfeeding throughout the study period than women educated in the United States, regardless of country of birth. This trend held in multivariate models while diminishing over time. Women born in Mexico who completed their schooling in the United States were least likely to exclusively breastfeed. DISCUSSION Country of education should also be considered when assessing Latina women's risk for breastfeeding discontinuation. Efforts should be made to identify the barriers and facilitators to breastfeeding among US-educated Mexican-origin women to enhance existing breastfeeding promotion efforts in the United States.
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Provini LE, Corwin MJ, Geller NL, Heeren TC, Moon RY, Rybin DV, Shapiro-Mendoza CK, Colson ER. Differences in Infant Care Practices and Smoking among Hispanic Mothers Living in the United States. J Pediatr 2017; 182:321-326.e1. [PMID: 27979582 PMCID: PMC5328962 DOI: 10.1016/j.jpeds.2016.11.053] [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] [Received: 08/08/2016] [Revised: 10/03/2016] [Accepted: 11/15/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the association between maternal birth country and adherence to the American Academy of Pediatrics safe sleep recommendations in a national sample of Hispanic mothers, given that data assessing the heterogeneity of infant care practices among Hispanics are lacking. STUDY DESIGN We used a stratified, 2-stage, clustered design to obtain a nationally representative sample of mothers from 32 US intrapartum hospitals. A total of 907 completed follow-up surveys (administered 2-6 months postpartum) were received from mothers who self-identified as Hispanic/Latina, forming our sample, which we divided into 4 subpopulations by birth country (US, Mexico, Central/South America, and Caribbean). Prevalence estimates and aORs were determined for infant sleep position, location, breastfeeding, and maternal smoking. RESULTS When compared with US-born mothers, we found that mothers born in the Caribbean (aOR 4.56) and Central/South America (aOR 2.68) were significantly more likely to room share without bed sharing. Caribbean-born mothers were significantly less likely to place infants to sleep supine (aOR 0.41). Mothers born in Mexico (aOR 1.67) and Central/South America (aOR 2.57) were significantly more likely to exclusively breastfeed; Caribbean-born mothers (aOR 0.13) were significantly less likely to do so. Foreign-born mothers were significantly less likely to smoke before and during pregnancy. CONCLUSIONS Among US Hispanics, adherence to American Academy of Pediatrics safe sleep recommendations varies widely by maternal birth country. These data illustrate the importance of examining behavioral heterogeneity among ethnic groups and have potential relevance for developing targeted interventions for safe infant sleep.
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Affiliation(s)
| | | | | | - Timothy C Heeren
- Department of Biostatistics, Boston University School of Public Health
| | - Rachel Y Moon
- Department of Pediatrics, University of Virginia School of Medicine
| | - Denis V Rybin
- Data Coordinating Center, Boston University School of Public Health
| | - Carrie K Shapiro-Mendoza
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
| | - Eve R Colson
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
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Artieta-Pinedo I, Paz-Pascual C, Grandes G, Espinosa M. Framework for the establishment of a feasible, tailored and effective perinatal education programme. BMC Pregnancy Childbirth 2017; 17:58. [PMID: 28178926 PMCID: PMC5299744 DOI: 10.1186/s12884-017-1234-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/21/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Antenatal education needs to be renewed and adapted to the needs of women. OBJECTIVES to assess women needs, identify factors that influence the desired outcomes, and propose a framework for developing new perinatal education based on the guidance published by the UK Medical Research Council for the development and evaluation of complex interventions in primary care. METHODS For this study: (a) four focus group sessions were held from October to November 2010 in Bizkaia (Spain) with 30 women exploring their needs during pregnancy and postpartum; (b) two literature reviews were conducted on women's needs at these times and theoretical models of healthcare education; and (c) seven discussion and consensus sessions were run with a group of experts composed of midwifes, gynaecologists, paediatricians, and paediatric and postpartum nurses. RESULTS Various areas for improvement were identified: needs assessment of each woman/family, consideration of pregnancy and childbirth as normal physiological processes, participation of fathers, establishment of social networks, continuity of postpartum care, better access to and training for midwives, and more flexible format and contents for the programme. We propose a woman-focused framework that includes three exploratory interviews during pregnancy, personalized interventions coordinated between professionals, empowerment to choose the type of birth, and postpartum activities. CONCLUSION New perinatal education should be on-going and focused on each woman. It is necessary to assess the feasibility of implementing this type of programme, depending on the context, professionals' readiness for change and characteristics of the proposed interventions. Then, its effectiveness and sustainability must be assessed.
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Affiliation(s)
- Isabel Artieta-Pinedo
- Primary Care Midwife Zuazo Health Centre, Barakaldo, (Bizkaia); and Associate Professor of the School of Nursing, University of the Basque Country, Leioa, Bizkaia, Spain.
- Primary Care Research Unit of Bizkaia, Centro de Salud de Deusto, 4ª planta, 48014, Bilbao, Bizkaia, Spain.
| | - Carmen Paz-Pascual
- Primary Care Midwife in Sestao Health Centre, Bizkaia; and Lecturer in the Midwifery Training Unit of the Basque Country, Bilbao, Bizkaia, Spain
| | - Gonzalo Grandes
- Primary Care Research Unit of Bizkaia, Centro de Salud de Deusto, 4ª planta, 48014, Bilbao, Bizkaia, Spain
| | - Maite Espinosa
- Primary Care Research Unit of Bizkaia, Centro de Salud de Deusto, 4ª planta, 48014, Bilbao, Bizkaia, Spain
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Comparison of Infant Sleep Practices in African-American and US Hispanic Families: Implications for Sleep-Related Infant Death. J Immigr Minor Health 2016; 17:834-42. [PMID: 24705738 DOI: 10.1007/s10903-014-0016-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
African-American and Hispanic families share similar socioeconomic profiles. Hispanic rates of sleep-related infant death are four times lower than African-American rates. We conducted a cross-sectional, multi-modal (surveys, qualitative interviews) study to compare infant care practices that impact risk for sleep-related infant death in African-American and Hispanic families. We surveyed 422 African-American and 90 Hispanic mothers. Eighty-three African-American and six Hispanic mothers participated in qualitative interviews. African-American infants were more likely to be placed prone (p < 0.001), share the bed with the parent (p < 0.001), and to be exposed to smoke (p < 0.001). Hispanic women were more likely to breastfeed (p < .001), while African-American women were more knowledgeable about SIDS. Qualitative interviews indicate that, although African-American and Hispanic parents had similar concerns, behaviors differed. Although the rationale for infant care decisions was similar for African-American and Hispanic families, practices differed. This may help to explain the racial/ethnic disparity seen in sleep-related infant deaths.
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Dawson-Hahn E, Pak-Gorstein S, Matheson J, Zhou C, Yun K, Scott K, Payton C, Stein E, Holland A, Grow HM, Mendoza JA. Growth Trajectories of Refugee and Nonrefugee Children in the United States. Pediatrics 2016; 138:peds.2016-0953. [PMID: 27940678 PMCID: PMC5127061 DOI: 10.1542/peds.2016-0953] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2016] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Limited data examine longitudinal nutrition outcomes of refugee children after United States resettlement. Among refugee children, our aims were to (1) assess the changes in weight-based nutritional status between baseline (0-3 months) and 10-24 months after arrival and (2) compare the BMI (BMIz) or weight-for-length z score (WFLz) trajectories to nonrefugee children for up to 36 months after arrival. METHODS We conducted a retrospective study of refugees aged 0-16 years from Washington and Pennsylvania and compared them with an age and sex-matched nonrefugee low-income sample from Washington. Data included anthropometric measurements from the initial screening medical visit and subsequent primary care visits. Multilevel linear mixed-effects regression models evaluated the change in BMIz or WFLz trajectory. RESULTS The study included 512 refugee and 1175 nonrefugee children. The unadjusted prevalence of overweight/obesity increased from 8.9% to 20% (P < .001) for 2- to 16-year-old refugees from baseline to 10-24 months. Refugees (2-16 years old) had a steeper increase in their BMIz per 12 months compared with nonrefugees (coefficient 0.18 vs 0.03; P < .001). Refugees <2 years old had a less steep increase in their WFLz per 12 months compared with nonrefugees (coefficient 0.12 vs 0.36, P = .002). CONCLUSIONS Older refugee children exhibited a higher risk of obesity than nonrefugees, whereas refugees <2 years old exhibited a slower increase in their risk of obesity than nonrefugee children. All age groups experienced increasing obesity prevalence. Targeted and culturally tailored obesity prevention interventions may mitigate health and nutrition inequities among refugee children.
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Affiliation(s)
- Elizabeth Dawson-Hahn
- Departments of Pediatrics and .,Seattle Children's Research Institute, Center for Child Health, Behavior and Development, Seattle, Washington
| | - Suzinne Pak-Gorstein
- Departments of Pediatrics and,Global Health, University of Washington, Seattle, Washington
| | - Jasmine Matheson
- Refugee Health Program, Washington State Department of Health, Shoreline, Washington
| | - Chuan Zhou
- Seattle Children’s Research Institute, Center for Child Health, Behavior and Development, Seattle, Washington
| | - Katherine Yun
- PolicyLab, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kevin Scott
- Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania; and
| | - Colleen Payton
- Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania; and
| | - Elizabeth Stein
- Seattle Children’s Research Institute, Center for Child Health, Behavior and Development, Seattle, Washington
| | - Annette Holland
- Refugee Screening Clinic, Seattle-King County Public Health, Seattle, Washington
| | | | - Jason A. Mendoza
- Departments of Pediatrics and,Seattle Children’s Research Institute, Center for Child Health, Behavior and Development, Seattle, Washington
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Woldeghebriel M, Hromi-Fiedler A, Lartey A, Gallego-Perez D, Sandow A, Pérez-Escamilla R. Length of time in Ghana is associated with the likelihood of exclusive breastfeeding among Liberian refugees living in Buduburam. MATERNAL AND CHILD NUTRITION 2016; 13. [PMID: 27726291 DOI: 10.1111/mcn.12363] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 07/11/2016] [Accepted: 07/13/2016] [Indexed: 11/28/2022]
Abstract
While literature describing immigrant's breastfeeding practices exists, especially among those living within developed countries, there is a significant gap in knowledge on how the host culture may influence the EBF behaviors of refugees, especially those living in protracted situations within sub-Saharan Africa. A cross-sectional study was conducted in the Buduburam Refugee Settlement in Ghana from July-August 2008 to explore the association between the amount of time living in Ghana and exclusive breastfeeding practices among Liberian refugees and Ghanaians in surround villages. The study included 480 women: 239 Liberians living in 12 settlement zones (in two of which Liberians and Ghanaians co-exist), 121 Ghanaians living in two settlement zones, and 120 Ghanaians living in nearby urban village of Awutu. Liberian mothers who lived in Ghana at least eight years were significantly more likely to exclusively breastfeed (OR: 1.78, 95% CI: 1.02, 3.09) compared to Ghanaian mothers living in Awutu. These findings suggest that increased time living in Buduburam improved the chances of EBF success among Liberians, perhaps as a result of unique EBF education/support opportunities offered in the settlement to Liberian refugees that were not readily available to Ghanaians. Further research to understand the "mechanisms" explaining exclusive breastfeeding differences as a function of time spent in host country is needed for improving breastfeeding support in refugee settlements and host communities.
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Affiliation(s)
- Meley Woldeghebriel
- Division of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Amber Hromi-Fiedler
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
| | - Anna Lartey
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana
| | - Daniel Gallego-Perez
- Boston University School of Public Health, Boston, Massachusetts, USA.,Buduburam Nutrition Program, National Catholic Secretariat, Accra, Ghana
| | - Adam Sandow
- Buduburam Nutrition Program, National Catholic Secretariat, Accra, Ghana
| | - Rafael Pérez-Escamilla
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
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Grewal NK, Andersen LF, Kolve CS, Kverndalen I, Torheim LE. Food and Nutrient Intake among 12-Month-Old Norwegian-Somali and Norwegian-Iraqi Infants. Nutrients 2016; 8:nu8100602. [PMID: 27690092 PMCID: PMC5083990 DOI: 10.3390/nu8100602] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 09/12/2016] [Accepted: 09/19/2016] [Indexed: 11/16/2022] Open
Abstract
The aim of the present paper was to describe food and nutrient intake among 12-month-old Norwegian-Somali and Norwegian-Iraqi infants, with a focus on iron and vitamin D intake. A cross-sectional survey was conducted from August 2013 through September 2014. Eighty-nine mothers/infants of Somali origin and 77 mothers/infants of Iraqi origin residing in Eastern Norway participated in the study. Data were collected using two 24-h multiple-pass recalls. Forty percent of the Norwegian-Somali infants and 47% of the Norwegian-Iraqi infants were breastfed at 12 months of age (p = 0.414). Median energy percentages (E%) from protein, fat and carbohydrates were within the recommended intake ranges, except the level of saturated fats (12-13 E%). Median intakes of almost all micronutrients were above the recommended daily intakes. Most of the infants consumed iron-enriched products (81%) and received vitamin D supplements (84%). The median intakes of iron and vitamin D were significantly higher among infants receiving iron-enriched products and vitamin D supplements compared to infants not receiving such products (p < 0.001). The findings indicate that the food and nutrient intake of this group of infants in general seems to be in accordance with Norwegian dietary recommendations. Foods rich in iron and vitamin D supplements were important sources of the infants' intake of iron and vitamin D and should continue to be promoted.
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Affiliation(s)
- Navnit Kaur Grewal
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, P.O. Box 4 St. Olavs Plass, 0130 Oslo, Norway.
| | - Lene Frost Andersen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern, 0317 Oslo, Norway.
| | - Cathrine Solheim Kolve
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, P.O. Box 4 St. Olavs Plass, 0130 Oslo, Norway.
| | - Ingrid Kverndalen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, P.O. Box 4 St. Olavs Plass, 0130 Oslo, Norway.
| | - Liv Elin Torheim
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, P.O. Box 4 St. Olavs Plass, 0130 Oslo, Norway.
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Gillette MT, Lohman BJ, Neppl TK. Lower levels of maternal capital in early life predict offspring obesity in adulthood. Ann Hum Biol 2016; 44:252-260. [DOI: 10.1080/03014460.2016.1213314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Meghan T. Gillette
- Department of Human Development and Family Studies, Iowa State University, Ames, IA, USA
| | - Brenda J. Lohman
- Department of Human Development and Family Studies, Iowa State University, Ames, IA, USA
| | - Tricia K. Neppl
- Department of Human Development and Family Studies, Iowa State University, Ames, IA, USA
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Tavoulari EF, Benetou V, Vlastarakos PV, Psaltopoulou T, Chrousos G, Kreatsas G, Gryparis A, Linos A. Factors affecting breastfeeding duration in Greece: What is important? World J Clin Pediatr 2016; 5:349-357. [PMID: 27610353 PMCID: PMC4978630 DOI: 10.5409/wjcp.v5.i3.349] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 06/03/2016] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate factors associated with breastfeeding duration (BD) in a sample of mothers living in Greece.
METHODS: Four hundred and twenty-eight mothers (438 infants) were initially recruited in a tertiary University Hospital. Monthly telephone interviews (1665 in total) using a structured questionnaire (one for each infant) were conducted until the sixth postpartum month. Cox regression analysis was used to assess factors influencing any BD.
RESULTS: Any breastfeeding rates in the first, third, and sixth month of the infant’s life reached 87.5%, 57.0% and 38.75%, respectively. In the multivariate analysis, maternal smoking in the lactation period [hazard-ratio (HR) = 4.20] and psychological status (HR = 1.72), and the introduction of a pacifier (HR = 2.08), were inversely associated, while higher maternal education (HRuniversity/collegevsprimary/high school = 0.53, HRmaster’svsprimary/high school = 0.20), and being an immigrant (HR = 0.35) were positively associated with BD.
CONCLUSION: Public health interventions should focus on campaigns against smoking during lactation, target women of lower educational status, and endorse the delayed introduction of pacifiers.
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McKinney CO, Hahn-Holbrook J, Chase-Lansdale PL, Ramey SL, Krohn J, Reed-Vance M, Raju TN, Shalowitz MU. Racial and Ethnic Differences in Breastfeeding. Pediatrics 2016; 138:peds.2015-2388. [PMID: 27405771 PMCID: PMC4960721 DOI: 10.1542/peds.2015-2388] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Breastfeeding rates differ among racial/ethnic groups in the United States. Our aim was to test whether racial/ethnic disparities in demographic characteristics, hospital use of infant formula, and family history of breastfeeding mediated racial/ethnic gaps in breastfeeding outcomes. METHODS We analyzed data from the Community and Child Health Network study (N = 1636). Breastfeeding initiation, postnatal intent to breastfeed, and breastfeeding duration were assessed postpartum. Hierarchical linear modeling was used to estimate relative odds of breastfeeding initiation, postnatal intent, and duration among racial/ethnic groups and to test the candidate mediators of maternal age, income, household composition, employment, marital status, postpartum depression, preterm birth, smoking, belief that "breast is best," family history of breastfeeding, in-hospital formula introduction, and WIC participation. RESULTS Spanish-speaking Hispanic mothers were most likely to initiate (91%), intend (92%), and maintain (mean duration, 17.1 weeks) breastfeeding, followed by English-speaking Hispanic mothers (initiation 90%, intent 88%; mean duration, 10.4 weeks) and white mothers (initiation 78%, intent 77%; mean duration, 16.5 weeks); black mothers were least likely to initiate (61%), intend (57%), and maintain breastfeeding (mean duration, 6.4 weeks). Demographic variables fully mediated disparities between black and white mothers in intent and initiation, whereas demographic characteristics and in-hospital formula feeding fully mediated breastfeeding duration. Family breastfeeding history and demographic characteristics helped explain the higher breastfeeding rates of Hispanic mothers relative to white and black mothers. CONCLUSIONS Hospitals and policy makers should limit in-hospital formula feeding and consider family history of breastfeeding and demographic characteristics to reduce racial/ethnic breastfeeding disparities.
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Affiliation(s)
- Chelsea O. McKinney
- NorthShore University HealthSystem Department of Pediatrics and Research Institute, Evanston, Illinois
| | | | | | - Sharon L. Ramey
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, Virginia
| | - Julie Krohn
- Lake County Health Department and Community Health Center, Waukegan, Illinois
| | | | - Tonse N.K. Raju
- Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland; and
| | - Madeleine U. Shalowitz
- NorthShore University HealthSystem Department of Pediatrics and Research Institute, Evanston, Illinois;,Department of Pediatrics, University of Chicago, Pritzker School of Medicine, Chicago, Illinois
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Breast-feeding perceptions, beliefs and experiences of Marshallese migrants: an exploratory study. Public Health Nutr 2016; 19:3007-3016. [PMID: 27230629 DOI: 10.1017/s1368980016001221] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To determine perceptions, beliefs and experiences affecting breast-feeding in Marshallese mothers residing in Northwest Arkansas, USA. DESIGN A qualitative, exploratory study using a brief survey and focus groups. Marshallese women, 18 years or older who had a child under 7 years of age, were included in the study. SETTING Community-based organization in Northwest Arkansas. RESULTS The majority of mothers viewed breast milk as superior to formula, but had concerns about adequate milk supply and the nutritional value of their milk. The primary barriers to exclusive breast-feeding in the USA included public shaming (both verbal and non-verbal), perceived milk production and quality, and maternal employment. These barriers are not reported in the Marshall Islands and are encountered only after moving to the USA. Breast-feeding mothers rely heavily on familial support, especially the eldest female, who may not reside in the USA. The influence of institutions, including the Special Supplemental Nutrition Program for Women, Infants, and Children, is strong and may negatively affect breast-feeding. CONCLUSIONS Despite the belief that breast milk is the healthiest option, breast-feeding among Marshallese mothers is challenged by numerous barriers they encounter as they assimilate to US cultural norms. The barriers and challenges, along with the strong desire to assimilate to US culture, impact Marshallese mothers' perceptions, beliefs and experiences with breast-feeding.
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Vanderlinden K, Van de Putte B. Pathways of equality through education: impact of gender (in)equality and maternal education on exclusive breastfeeding among natives and migrants in Belgium. MATERNAL AND CHILD NUTRITION 2016; 13. [PMID: 27169791 DOI: 10.1111/mcn.12309] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 12/13/2015] [Accepted: 02/04/2016] [Indexed: 01/12/2023]
Abstract
Even though breastfeeding is typically considered the preferred feeding method for infants worldwide, in Belgium, breastfeeding rates remain low across native and migrant groups while the underlying determinants are unclear. Furthermore, research examining contextual effects, especially regarding gender (in)equality and ideology, has not been conducted. We hypothesized that greater gender equality scores in the country of origin will result in higher breastfeeding chances. Because gender equality does not operate only at the contextual level but can be mediated through individual level resources, we hypothesized the following for maternal education: higher maternal education will be an important positive predictor for exclusive breastfeeding chances in Belgium, but its effects will differ over subsequent origin countries. Based on IKAROS data (GeÏntegreerd Kind Activiteiten en Regio Ondersteunings Systeem), we perform multilevel analyses on 27 936 newborns. Feeding method is indicated by exclusive breastfeeding 3 months after childbirth. We measure gender (in)equality using Global Gender Gap scores from the mother's origin country. Maternal education is a metric variable based on International Standard Classification of Education indicators. Results show that 3.6% of the variation in breastfeeding can be explained by differences between the migrant mother's country of origin. However, the effect of gender (in)equality appears to be non-significant. After adding maternal education, the effect for origin countries scoring low on gender equality turns significant. Maternal education on its own shows strong positive association with exclusive breastfeeding and, furthermore, has different effects for different origin countries. Possible explanations are discussed in-depth setting direction for further research regarding the different pathways gender (in)equality and maternal education affect breastfeeding. © 2016 John Wiley & Sons Ltd.
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81
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Abstract
Purpose: To investigate how breastfeeding initiation and duration affect the likelihood of being overweight and obese in children aged 2 to 5. Design: Cross-sectional data from the 2003 National Survey of Children’s Health. Setting: Rural and urban areas of the United States. Subjects: Households where at least one member was between the ages of 2 and 5 (sample size 8207). Measures: Parent-reported body mass index, breastfeeding initiation and duration, covariates (gender, family income and education, ethnicity, child care attendance, maternal health and physical activity, residential area). Analysis: Partial proportional odds models. Results: In early childhood, breastfed children had 5.3% higher probability of being normal weight ( p = .002) and 8.9% ( p < .001) lower probability of being obese compared to children who had never been breastfed. Children who had been breastfed for less than 3 months had 3.1% lower probability of being normal weight ( p = .013) and 4.7% higher probability of being obese ( p = .013) with respect to children who had been breastfed for 3 months and above. Conclusion: Study findings suggest that length of breastfeeding, whether exclusive or not, may be associated with lower risk of obesity in early childhood. However, caution is needed in generalizing results because of the limitations of the analysis. Based on findings from this study and others, breastfeeding promotion policies can cite the potential protective effect that breastfeeding has on weight in early childhood.
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Affiliation(s)
- Francesca V. Hansstein
- School of Public Economics and Administration, Shanghai University of Finance and Economics (SHUFE), Shanghai, China
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82
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Barcelona de Mendoza V, Harville E, Theall K, Buekens P, Chasan-Taber L. Acculturation and Intention to Breastfeed among a Population of Predominantly Puerto Rican Women. Birth 2016; 43:78-85. [PMID: 26554873 PMCID: PMC4755899 DOI: 10.1111/birt.12199] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/18/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Latinas have high overall breastfeeding initiation rates, yet Puerto Ricans have among the lowest exclusive breastfeeding rates. This study sought to determine if acculturation was associated with intent to breastfeed in a predominantly Puerto Rican population. METHODS A cohort of Latina women were enrolled in Proyecto Buena Salud, and provided information on infant feeding intent (n = 1,323). Acculturation was assessed via the Psychological Acculturation Scale (PAS), language preference, and generation in the United States. RESULTS Increasing acculturation as measured by English language preference (aOR 0.61 [95% CI 0.42-0.88]) and second or third generation in the United States (aOR 0.70 [95% CI 0.52-0.95)] was inversely associated with odds of intending to exclusively breastfeed. Similarly, women with higher levels of acculturation as measured by the PAS (aOR 0.67 [95% CI 0.45-0.99]), English language preference (aOR 0.48 [95% CI 0.33-0.70]) and second or third generation in the United States (aOR 0.42 [95% CI 0.31-0.58]) were less likely to report intent to combination feed as compared with women with lower acculturation. CONCLUSIONS Acculturation was inversely associated with intent to exclusively breastfeed and intent to combination feed in this predominantly Puerto Rican sample.
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Affiliation(s)
| | - Emily Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine,
| | - Katherine Theall
- Department of Global Community Health and Behavioral Sciences at Tulane University School of Public Health and Tropical Medicine,
| | - Pierre Buekens
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine,
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83
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Lee A, Brann L. Influence of Cultural Beliefs on Infant Feeding, Postpartum and Childcare Practices among Chinese-American Mothers in New York City. J Community Health 2016; 40:476-83. [PMID: 25331609 DOI: 10.1007/s10900-014-9959-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
As one of the fastest growing communities in the United States, Chinese-Americans receive relatively little research attention on their rates of breastfeeding versus formula feeding, and what factors influence that choice. This research aims to examine the influence of elders and cultural beliefs on postpartum, infant feeding, and childcare practices. Semi-structured interviews with 22 recently postpartum mothers who met the recruiting criteria were conducted between July 2012 and February 2013. The traditional postpartum practice, zuo yuezi, presented negative physical and emotional outcomes and maternal reporting of delay in lactation. Early introduction of solids for traditional reasons was reported. The support from husbands and elders were necessary for breastfeeding success, while some mothers had to first negotiate with elders for breastfeeding. The practice of sending infants back to China to be taken care of by extended families presented cultural implications related to grandparents' involvement in raising grandchildren. With the respect and appreciation for elders and traditions, it is likely that Chinese mothers negotiate between cultural traditions and societal expectation in the western home.
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Affiliation(s)
- Adele Lee
- Nutrition Program, Department of Public Health, Food Studies and Nutrition, Syracuse University, 426 Ostrom Avenue, Syracuse, NY, 13244, USA,
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84
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Abstract
Demographics indicate that pediatricians increasingly care for children in immigrant families in routine practice. Although these children may be at risk for health disparities relating to socioeconomic disadvantage and cultural or linguistic challenges, immigrant families have unique strengths and potential for resilience. Adaptive and acculturation processes concerning health and well-being can be mediated by cultural media. Pediatricians have a professional responsibility to address the medical, mental health, and social needs of immigrant families. Advocacy and research at the practice level and beyond can further explore the unique needs of this population and evidence-based strategies for health promotion.
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85
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Wu WC, Wu JCL, Chiang TL. Variation in the association between socioeconomic status and breastfeeding practices by immigration status in Taiwan: a population based birth cohort study. BMC Pregnancy Childbirth 2015; 15:298. [PMID: 26572970 PMCID: PMC4647632 DOI: 10.1186/s12884-015-0732-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 11/04/2015] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The relationship between socioeconomic status (SES) and breastfeeding has been extensively discussed in the literature. However, there is some evidence that this relationship can differ with immigration status. To date the majority of research investigating the relationships among SES, breastfeeding and immigration status has been conducted in Europe and the United States with a lack of similar research from Asia. Therefore, the aim of this study was to describe differences in breastfeeding practices between native-born Taiwanese mothers and immigrant mothers in Taiwan and to investigate any differences in the relationship between SES and breastfeeding practices by immigration status. METHODS Data analyzed came from the Taiwan Birth Cohort Study, the first longitudinal study of babies in Taiwan with a nationally representative sample born in 2005. In the present study, we included 21,217 mothers or primary caregivers who completed interview surveys when their child was 6 months old. Socioeconomic status was measured by the education level of mothers and fathers, and the couple's monthly income. Data analysis involved multiple logistic regression. Control variables included residential area, mother's employment status, age of the father and mother, and sex of the infant. RESULTS The proportion of immigrant mothers predominantly breastfeeding for 4 and for 6 months (Mainland Chinese mothers: 18.25 %, 36.29 %; Southeast Asian mothers: 10.71 %, 24.85 %) was significantly higher than that observed in their Taiwan-born counterparts (7.03 %, 16.22 %). Analysis stratified by immigration status showed that a higher level of parental education was associated with a greater likelihood of predominantly breastfeeding in Taiwanese mothers. However, no statistically significant relationship was observed between education and predominantly breastfeeding in immigrant mothers. Higher monthly income was also significantly associated with a greater likelihood of predominantly breastfeeding in Taiwanese mothers. However, there was no significant linear relationship between monthly income and predominantly breastfeeding in immigrant women. CONCLUSION The relationship between SES and breastfeeding is different in immigrant mothers and native-born Taiwanese mothers. Taiwanese policy should continue to encourage breastfeeding in immigrant mothers. However, greater attention should be placed on Taiwanese mothers from a low SES background.
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Affiliation(s)
- Wen-chi Wu
- Department of Health Healing and Health Marketing, School of Healthcare Management, Kainan University, No.1 Kainan Road, Luzhu Dist., Taoyuan City, 338, Taiwan.
| | - Jennifer Chun-Li Wu
- Department of Early Childhood and Family Education, College of Education, National Taipei University and Education, No.134, Sec. 2, Heping E. Road., Taipei, 106, Taiwan.
| | - Tung-liang Chiang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Room 620, 6F, No. 17, Xuzhou Road., Taipei, 100, Taiwan.
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86
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Zhu Y, Hernandez LM, Mueller P, Dong Y, Hirschfeld S, Forman MR. Predictive Models for Characterizing Disparities in Exclusive Breastfeeding Performance in a Multi-ethnic Population in the US. Matern Child Health J 2015; 20:398-407. [PMID: 26515468 DOI: 10.1007/s10995-015-1838-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Maternal lactation performance varies across populations, yet the relative impact of maternal sociodemographics, perinatal factors, and birth outcomes on disparities in exclusive breastfeeding (XBR) outcomes is not well known. We aimed to develop predictive models and compare the relative contribution of predictors for XBR initiation and XBR ≥ 6 months. METHODS Infant feeding data were obtained from women with children aged 0-6 years (n = 1471) in a multi-ethnic cross-sectional study in the US (2011-2012). We compared discriminant ability of predictors for ever XBR and XBR ≥ 6 months using discriminant function analysis, respectively. We also calculated adjusted ORs for factors associated with XBR outcomes and breast-bottle feeding (BrBot) subgroups. RESULTS Maternal sociodemographics (education level, marital status, nativity, and age at childbirth) had greater discriminating abilities in predicting ever XBR and XBR ≥ 6 months than birth outcomes and perinatal factors. Foreign-born women were two-fold more likely to initiate XBR but not necessarily continue to 6 months compared to their US-born counterparts. Factors associated with BrBot subgroups differed from those associated with XBR outcomes, whereas maternal age was the only predictor consistently associated with ever XBR, XBR ≥ 6 months, and BrBot subgroups. The areas under the receiver operating characteristic curves for models predicting ever XBR and XBR ≥ 6 months were 0.88 (95 % CI 0.85, 0.91) and 0.90 (95 % CI 0.88, 0.93), respectively. CONCLUSIONS Findings underscore the importance of educational, clinical, and social support to promote XBR in mothers with sociodemographic factors predictive of none or poor XBR outcomes.
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Affiliation(s)
- Yeyi Zhu
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, 78703, USA. .,Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA. .,Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, 20852, USA.
| | - Ladia M Hernandez
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, 78703, USA
| | - Peter Mueller
- Department of Mathematics, University of Texas at Austin, Austin, TX, USA
| | - Yongquan Dong
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, 78703, USA
| | - Steven Hirschfeld
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Michele R Forman
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, 78703, USA.,School of Human Ecology, University of Texas at Austin, Austin, TX, USA
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87
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Akinyemiju TF, Pisu M, Waterbor JW, Altekruse SF. Socioeconomic status and incidence of breast cancer by hormone receptor subtype. SPRINGERPLUS 2015; 4:508. [PMID: 26405628 PMCID: PMC4573746 DOI: 10.1186/s40064-015-1282-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 08/27/2015] [Indexed: 11/10/2022]
Abstract
Recent developments in genetics and molecular biology have classified breast cancer into subtypes based on tumor markers of estrogen (ER), progesterone (PR) and human epidermal growth Factor-2 receptors (Her-2), with the basal-like (ER-, PR-, Her2-) subtype commonly referred to as "triple negative" breast cancer (TNBC) being the most aggressive. Prior studies have provided evidence that higher socio-economic status (SES) is associated with increased breast cancer risk, likely due to hormone related risk factors such as parity and hormonal contraceptive use. However, it is unclear if the relationship between SES and overall breast cancer incidence exists within each subtype, and if this association varies by race/ethnicity. Analysis was based on data obtained from the SEER database linked to 2008-2012 American Community Survey data, and restricted to women diagnosed with breast cancer in 2010. The NCI SES census tract SES index based on measures of income, poverty, unemployment, occupational class, education and house value, was examined and categorized into quintiles. Age-adjusted incidence rate ratios were calculated comparing the lowest to the highest SES groups by subtype, separately for each race/ethnic group. We identified 47,586 women with breast cancer diagnosed in 2010. The majority was diagnosed with Her2-/HR+ tumors (73 %), while 12 % had triple negative tumors (TNBC). There was a significant trend of higher incidence with increasing SES for Her2-/HR+ (IRR Highest vs. Lowest SES: 1.32, 95 % CI 1.27-1.39; p value trend: 0.01) and Her2+/HR+ tumors (IRR Highest vs. Lowest SES: 1.46, 95 % CI 1.27-1.68; p value trend: 0.01) among White cases. There was no association between SES and incidence of HR- subtypes (Her2+/HR- or TNBC). Similar associations were observed among Black, Hispanic and Asian or Pacific Islander cases. The positive association between SES and breast cancer incidence is primarily driven by hormone receptor positive tumors. To the extent that neighborhood SES is a proxy for individual SES, future studies are still needed to identify etiologic risk factors for other breast cancer subtypes.
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Affiliation(s)
- Tomi F Akinyemiju
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL USA ; Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL USA
| | - Maria Pisu
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL USA ; Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL USA
| | - John W Waterbor
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL USA ; Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL USA
| | - Sean F Altekruse
- Cancer Statistics Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD USA
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88
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Masho SW, Cha S, Morris MR. Prepregnancy obesity and breastfeeding noninitiation in the United States: an examination of racial and ethnic differences. Breastfeed Med 2015; 10:253-62. [PMID: 25898171 PMCID: PMC4490588 DOI: 10.1089/bfm.2015.0006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Prepregnancy overweight/obesity can adversely affect breastfeeding initiation, but studies examining this association among different racial/ethnic groups of U.S. women are limited. This study used a large, nationally representative sample to assess racial/ethnic differences in breastfeeding noninitiation among U.S. women of different body mass index (BMI) classifications. MATERIALS AND METHODS This study analyzed data from the Pregnancy Risk Assessment Monitoring System, including 95,141 women who delivered a live, singleton baby from 2009 to 2011 and provided BMI and breastfeeding information. Prepregnancy BMI was categorized as underweight (<18.5 kg/m(2)), normal weight (18.5-24.9 kg/m(2)), overweight (25.0-29.9 kg/m(2)), and obese (≥30.0 kg/m(2)). Breastfeeding initiation was reported as having ever breastfed after delivery (yes or no). Adjusted models, which included only potential confounders resulting in a 10% or greater change in estimate, generated adjusted odds ratios (AOR) and 95% confidence intervals (CI) for breastfeeding noninitiation. Analysis was stratified by race/ethnicity. RESULTS Compared with normal weight non-Hispanic white women, the odds of breastfeeding noninitiation were 17% and 25% higher among overweight (AOR=1.17, 95% CI=1.07-1.29) and obese (AOR=1.25, 95% CI=1.14-1.36) non-Hispanic white women, respectively. Among non-Hispanic black women, the odds of breastfeeding noninitiation were 29% higher only in obese women compared with normal weight non-Hispanic black women. No association was observed among Hispanic women or women of other races. CONCLUSIONS Prepregnancy BMI is a significant predictor for breastfeeding noninitiation for non-Hispanic white and non-Hispanic black women. Further exploration of the differences underlying the association between prepregnancy BMI and breastfeeding behaviors among racial subpopulations of women in the United States is warranted.
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Affiliation(s)
- Saba W Masho
- Department of Family Medicine and Population Health, School of Medicine , Virginia Commonwealth University, Richmond, Virginia
| | - Susan Cha
- Department of Family Medicine and Population Health, School of Medicine , Virginia Commonwealth University, Richmond, Virginia
| | - Michelle R Morris
- Department of Family Medicine and Population Health, School of Medicine , Virginia Commonwealth University, Richmond, Virginia
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89
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Abstract
This article's aim is to review the literature on racial and ethnic disparities in breastfeeding rates and practices, address barriers to breastfeeding among minority women, conduct a systematic review of breastfeeding interventions, and provide obstetrician-gynecologists with recommendations on how they can help increase rates among minority women. In order to do so, the literature of racial and ethnic disparities in breastfeeding rates and barriers among minority women was reviewed, and a systematic review of breastfeeding interventions among minority women on PubMed and MEDLINE was conducted. Racial and ethnic minority women continue to have lower breastfeeding rates than white women and are not close to meeting the Healthy People 2020 goals. Minority women report many barriers to breastfeeding. Major efforts are still needed to improve breastfeeding initiation and duration rates among minority women in the United States. Obstetrician-gynecologists have a unique opportunity to promote and support breastfeeding through their clinical practices and public policy, and their efforts can have a meaningful impact on the future health of the mother and child.
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Affiliation(s)
- Katherine M. Jones
- Department of Research, American College of Obstetricians and Gynecologists, Washington, D.C
- Department of Psychology, American University, Washington, D.C
| | - Michael L. Power
- Department of Research, American College of Obstetricians and Gynecologists, Washington, D.C
| | - John T. Queenan
- Department of Obstetrics and Gynecology, Georgetown University School of Medicine, Washington, D.C
| | - Jay Schulkin
- Department of Research, American College of Obstetricians and Gynecologists, Washington, D.C
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90
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Dancel LD, Perrin E, Yin SH, Sanders L, Delamater A, Perreira KM, Bronaugh AB, Eden S, Shintani A, Rothman RL. The relationship between acculturation and infant feeding styles in a Latino population. Obesity (Silver Spring) 2015; 23:840-6. [PMID: 25755135 PMCID: PMC4380799 DOI: 10.1002/oby.20986] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 11/10/2014] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To assess the relationship between parental acculturation and infant feeding style in a sample of Latino parents. METHODS A post hoc analysis was performed using data from an ongoing four-site randomized controlled trial to promote early childhood obesity prevention. Cross-sectional data of parent-child dyads at the 12-month well-child visit who self-reported their Latino ethnicity were analyzed. The Short Acculturation Scale for Hispanics (SASH) and a subset of the Infant Feeding Style Questionnaire (IFSQ) that assessed four primary feeding styles were administered. SASH level (low vs. high) with each feeding style was compared by analyses. RESULTS Complete SASH data were available for 398 of 431 Latino dyads. Median SASH score was 1.8 (IQR 1.4-2.7); 82% of participants had low acculturation (score < 3). Of the nine outcome variables, four were significantly associated with SASH: "Laissez-Faire/attention" (AOR: 2.3; 95% CI: 1.06-5.13; P = 0.004), "Laissez-Faire/diet quality" (AOR: 3.9; 95% CI: 1.7-8.75; P = 0.005), "Pressuring as soothing" (AOR: 3.6; 95% CI:1.63-8.05; P = 0.007), and "Restrictive/diet quality" (AOR: 0.4; 95% CI: 0.19-0.94; P = 0.031). CONCLUSIONS Latino parents with lower acculturation were more likely than those with higher acculturation to endorse feeding styles that are associated with child obesity. Further research is needed to determine why acculturation and feeding style relate.
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Affiliation(s)
- Liz D Dancel
- Pediatric Gastroenterology, Greenville Health System, University of South Carolina, Greenville, Greenville, South Carolina, USA
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91
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Kost K, Lindberg L. Pregnancy intentions, maternal behaviors, and infant health: investigating relationships with new measures and propensity score analysis. Demography 2015; 52:83-111. [PMID: 25573169 PMCID: PMC4734627 DOI: 10.1007/s13524-014-0359-9] [Citation(s) in RCA: 176] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The premise that unintended childbearing has significant negative effects on the behavior of mothers and on the health of infants strongly influences public health policy and much of current research on reproductive behaviors. Yet, the evidence base presents mixed findings. Using data from the U.S. National Survey of Family Growth, we employ a measure of pregnancy intentions that incorporates the extent of mistiming, as well as the desire scale developed by Santelli et al. (Studies in Family Planning, 40, 87-100, 2009). Second, we examine variation in the characteristics of mothers within intention status groups. Third, we account for the association of mothers' background characteristics with their pregnancy intentions and with the outcomes by employing propensity score weighting. We find that weighting eliminated statistical significance of many observed associations of intention status with maternal behaviors and birth outcomes, but not all. Mistimed and unwanted births were still less likely to be recognized early in pregnancy than intended ones. Fewer unwanted births received early prenatal care or were breast-fed, and unwanted births were also more likely than intended births to be of low birth weight. Relative to births at the highest level of the desire scale, all other births were significantly less likely to be recognized early in pregnancy and to receive early prenatal care.
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Affiliation(s)
- Kathryn Kost
- Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY, 10038, USA,
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92
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Nolan A, Layte R. The 'healthy immigrant effect': breastfeeding behaviour in Ireland. Eur J Public Health 2014; 25:626-31. [PMID: 25422364 DOI: 10.1093/eurpub/cku177] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The benefits of breastfeeding for babies, mothers and society have been demonstrated in a large scientific literature. Irish rates of breastfeeding are amongst the lowest in Europe (in 2010, Ireland had the lowest breastfeeding initiation rate of 14 European countries). One of the most distinctive features of breastfeeding behaviour in Ireland is the large difference in breastfeeding rates between immigrants to Ireland and the Irish-born. Data from the 2010 Irish National Perinatal Reporting System show that just 46.1% of Irish-born mothers were breastfeeding at hospital discharge, in comparison with 84.2% of immigrant mothers. Descriptive patterns suggest that breastfeeding behaviour in Ireland may exhibit a 'healthy immigrant' effect, whereby the health status and behaviours of immigrants are better than the native-born on arrival, but converge to native levels as length of time since migration increases. METHODS Using nationally representative data from two cohorts of children in Ireland, the purpose of this article is to examine the evidence for a 'healthy immigrant' effect with respect to breastfeeding behaviour. RESULTS The results indicate that immigrants are significantly more likely to breastfeed than Irish-born mothers, but that immigrant breastfeeding rates converge towards Irish-born rates of breastfeeding as length of time since migration increases. CONCLUSION The decline in breastfeeding behaviour among immigrants to Ireland with length of time since migration highlights the need for appropriate interventions aimed at countering the particular negative attitudes to breastfeeding that are observed in Irish society.
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Affiliation(s)
- Anne Nolan
- 1 The Irish Longitudinal Study on Ageing (TILDA), Trinity College, Dublin 2 Social Research Division, Economic and Social Research Institute, Dublin
| | - Richard Layte
- 2 Social Research Division, Economic and Social Research Institute, Dublin 3 Department of Sociology, Trinity College, Dublin
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93
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Tavoulari EF, Benetou V, Vlastarakos PV, Andriopoulou E, Kreatsas G, Linos A. Factors affecting breast-feeding initiation in Greece: What is important? Midwifery 2014; 31:323-31. [PMID: 25467601 DOI: 10.1016/j.midw.2014.10.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 10/04/2014] [Accepted: 10/28/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVE to investigate the association between breast-feeding initiation and socio-demographic, lifestyle-related, clinical and lactation-related factors in a sample of mothers living in Greece. DESIGN cross-sectional study. SETTING Tertiary University Hospital, maternity ward. PARTICIPANTS 428 mothers were interviewed (43.2% response rate) from February until December 2009, using a structured face-to-face questionnaire after at least 24 hours from childbirth. MEASUREMENTS AND FINDINGS 71.0% of mothers were Greeks and 29.0% immigrants; the mean age was 32.0 years. 44.4% initiated exclusive breast feeding, 7.9% artificial milk -feeding and 47.7% partial feeding. In the multivariate analysis, exclusive breast feeding was inversely related to maternal body mass index (BMI) at the beginning of gestation (odds ratio (OR)=0.93, 95% confidence intervals (95%CI)=0.89-0.98) and caesarean section (OR=0.54, 95% CI=0.35-0.84). Lactation-related factors which favourably affected exclusive breast-feeding initiation included previous breast-feeding experience (OR=2.29, 95% CI=1.39-3.78), information about breast feeding (OR=2.38, 95% CI=1.41-4.01) and rooming-in (OR=1.62 95% CI=1.03-2.54), whilst any breast feeding was favourably affected by encouraging women to breast feed (OR=5.42, 95% CI=1.90-15.50), providing information about breast feeding (OR=6.92, 95% CI=2.53-18.89), and rooming-in (OR=6.93 95% CI=2.01-23.88), and negatively associated with caesarean section (OR=0.11, 95% CI=0.03-0.39). Being an immigrant mother was also positively associated with any breast-feeding initiation (OR=7.97, 95% CI=1.02-62.19). Maternal age, education and income, as well as, smoking status, were not associated with any breast-feeding initiation. KEY CONCLUSIONS maternal BMI and immigrant status, information provided by midwives and encouragement, rooming-in and mode of childbirth (caesarean section), were found to be important for breast-feeding initiation in this study population. No other indicator of socio-demographic status was found to be associated with breast-feeding initiation. IMPLICATIONS FOR PRACTICE focus should be given to pregnant women with higher BMI at the beginning of pregnancy, and women who had undergone caesarean section. Breast-feeding information and encouragement should be provided to all women in the maternity ward, along with the dedicated practice of rooming-in, in order to promote and increase breast-feeding initiation rates.
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Affiliation(s)
| | - Vassiliki Benetou
- Department of Hygiene, Epidemiology & Medical Statistics, University of Athens, Greece
| | | | - Eirini Andriopoulou
- Department of Hygiene, Epidemiology & Medical Statistics, University of Athens, Greece
| | - George Kreatsas
- 2nd OBG Department, Aretaieion University Hospital, Athens, Greece
| | - Athena Linos
- Department of Hygiene, Epidemiology & Medical Statistics, University of Athens, Greece
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94
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Abstract
To describe gestational weight gain among Hispanic women and to examine psychological, social, and cultural contexts affecting weight gain. A total of 282 Hispanic women were surveyed post-partum before leaving the hospital. Women were queried about their prepregnancy weight and weight gained during pregnancy. Adequacy of gestational weight gain was based on guidelines set by the Institute of Medicine in 2009. Independent risk factors for excessive or insufficient weight gain were examined by logistic regression. Most women were unmarried (59 %), with a mean age of 28.4 ± 6.6 years and an average weight gain of 27.9 ± 13.3 lbs. Approximately 45 % of women had gained too much, 32 % too little, and only 24 % had an adequate amount of weight gain. The mean birth weight was 7.3, 7.9, and 6.8 lbs among the adequate, excessive, and insufficient weight gain groups. Among women who exercised before pregnancy, two-thirds continued to do so during pregnancy; the mean gestational weight gain of those who continued was lower than those who stopped (26.8 vs. 31.4 lbs, p = 0.04). Independent risk factors for excessive weight gain were being unmarried, U.S. born, higher prepregnancy body mass index, and having indifferent or negative views about weight gain. Independent risk factors for insufficient weight gain were low levels of support and late initiation of prenatal care. Depression, stress, and a woman's or her partner's happiness regarding pregnancy were unrelated to weight gain. The results of this study can be used by prenatal programs to identify Hispanic women at risk for excessive or insufficient gestational weight gain.
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95
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Jarlenski M, McManus J, Diener-West M, Schwarz EB, Yeung E, Bennett WL. Association between support from a health professional and breastfeeding knowledge and practices among obese women: evidence from the Infant Practices Study II. Womens Health Issues 2014; 24:641-8. [PMID: 25239780 DOI: 10.1016/j.whi.2014.08.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 08/02/2014] [Accepted: 08/07/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Obese women are less likely to initiate and continue breastfeeding. We described barriers to breastfeeding and examined the association between support from a health professional and breastfeeding knowledge and practices, by prepregnancy obesity status. METHODS Using data from the Infant Feeding Practices Study II, a cohort of U.S. women (N = 2,997), we performed descriptive statistics to describe barriers to breastfeeding by prepregnancy obesity status. We conducted multivariable regression to examine the association of breastfeeding support from a physician or nonphysician health professional with knowledge of the recommended duration of breastfeeding, breastfeeding initiation, and breastfeeding duration, and whether breastfeeding support had different associations with outcomes by prepregnancy obesity status. Average marginal effects were calculated from regression models to interpret results as percentage-point changes. FINDINGS Believing that formula was as good as breast milk was the most commonly cited reason for not initiating breastfeeding, and milk supply concerns were cited as reasons for not continuing breastfeeding. Physician breastfeeding support was associated with a 9.4 percentage-point increase (p < .05) in breastfeeding knowledge among obese women, although no increase was observed among nonobese women. Breastfeeding support from a physician or nonphysician health professional was associated with a significantly increased probability of breastfeeding initiation (8.5 and 12.5 percentage points, respectively) and breastfeeding for 6 months (12.5 and 8.4 percentage points, respectively), without differential associations by prepregnancy obesity. CONCLUSIONS Support for exclusive breastfeeding is an important predictor of breastfeeding initiation and duration among obese and nonobese women. Health educational interventions tailored to obese women might improve their breastfeeding initiation and continuation.
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Affiliation(s)
- Marian Jarlenski
- Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
| | | | - Marie Diener-West
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Eleanor Bimla Schwarz
- Department of Internal Medicine, University of California, Davis School of Medicine, Sacramento, California
| | - Edwina Yeung
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Wendy L Bennett
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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96
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Wenzel D, Souza SBD. Fatores associados ao aleitamento materno nas diferentes Regiões do Brasil. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2014. [DOI: 10.1590/s1519-38292014000300005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objetivos: identificar os fatores que determinam o aleitamento materno nas diferentes regiões do país. Métodos: os dados fazem parte da Pesquisa de Orçamento Familiar de 2002-2003 realizada no Brasil. A amostra foi de 2958 crianças de zero a um ano, representativas da população nacional. Um modelo de regressão linear (GLM) com família binomial e ligação logarítmica foi criado para cada região, com um intervalo de confiança de 90%. Resultados: o aumento do número de moradores no domicilio é o principal fator negativo para a amamentação em todas as regiões do Brasil. Foram considerados como fatores desfavoráveis, no conjunto da amostra: mães com idade avançada, ter quatro ou mais moradores no domicílio, maior renda, maior escolaridade materna e uso de creche. Os fatores favoráveis foram: ter dois ou mais filhos menores de cinco anos em casa e mães de cor preta ou parda. Conclusões: as regiões que apresentaram um número maior de fatores desfavoráveis ao aleitamento materno foram Sudeste e Sul, sendo que o maior número de moradores no domicílio foi a pior situação para a efetivação da amamentação nas regiões do Brasil.
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97
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Hawkins SS, Gillman MW, Shafer EF, Cohen BB. Acculturation and maternal health behaviors: findings from the Massachusetts birth certificate. Am J Prev Med 2014; 47:150-9. [PMID: 24951043 PMCID: PMC4106991 DOI: 10.1016/j.amepre.2014.02.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 02/14/2014] [Accepted: 02/25/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Although prior studies have shown disparities in maternal health behaviors according to race/ethnicity and acculturation, whether these patterns are evident among new immigrant populations remains unclear. PURPOSE To examine the associations among proxies of acculturation and maternal smoking during pregnancy and breastfeeding initiation within each major ethnic group in Massachusetts. METHODS Data were from the Standard Certificate of Live Births on 1,067,375 babies by mothers from 31 ethnic groups for 1996-2009. Mothers reported whether they smoked during pregnancy and the birth facility recorded whether mothers started breastfeeding. The acculturation proxy combined mothers' country of birth and language preference: U.S.-born, foreign-born English-speaking, and foreign-born non-English speaking. For each ethnic group, adjusted logistic regression models were used to examine associations between the acculturation proxy and whether mothers smoked or initiated breastfeeding. Data were analyzed from 2012 to 2013. RESULTS A lower proportion of foreign-born mothers had a high school degree or private insurance than U.S.-born mothers. However, foreign-born mothers who were English (range of AORs=0.07-0.93) or non-English speakers (AORs=0.01-0.36) were less likely to smoke during pregnancy than their U.S.-born counterparts. Foreign-born mothers who were English (AORs=1.22-6.52) or non-English speakers (AORs=1.35-10.12) were also more likely to initiate breastfeeding compared to U.S.-born mothers, except for some mothers with Asian ethnicities. CONCLUSIONS The consistency of the associations of being foreign-born with less smoking and more breastfeeding suggests that for the majority of ethnic groups studied, acculturation in the U.S. results in poorer maternal health behaviors.
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Affiliation(s)
| | - Matthew W Gillman
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Emily F Shafer
- Department of Sociology, Portland State University, Portland, Oregon
| | - Bruce B Cohen
- Bureau of Health Information,, Statistics, Research, and Evaluation, Massachusetts Department of Public Health, Boston, Massachusetts
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98
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99
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Hayes DK, Mitchell KM, Donohoe-Mather C, Zaha RL, Melcher C, Fuddy LJ. Predictors of exclusive breastfeeding at least 8 weeks among Asian and Native Hawaiian or other Pacific Islander race subgroups in Hawaii, 2004-2008. Matern Child Health J 2014; 18:1215-23. [PMID: 24096640 PMCID: PMC4300954 DOI: 10.1007/s10995-013-1355-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Breastfeeding is nurturing, cost-effective, and beneficial for the health of mother and child. Babies receiving formula are sick more often and are at higher risk for childhood obesity, diabetes, asthma, and other conditions compared with breastfed children. National and international organizations recommend exclusive breastfeeding for 6 months. Exclusive breastfeeding in Asian and Native Hawaiian or Other Pacific Islander (NHOPI) subgroups is not well characterized. Data from the 2004-2008 Hawaii Pregnancy Risk Assessment Monitoring System, a population-based surveillance system on maternal behaviors and experiences before, during, and after pregnancy, were analyzed for 8,508 mothers with a recent live birth. We examined exclusive breastfeeding status for at least 8 weeks. We calculated prevalence risk ratios across maternal race groups accounting for maternal and socio-demographic characteristics. The overall estimate of exclusive breastfeeding for at least 8 weeks was 36.3%. After adjusting for maternal age, pre-pregnancy weight, cesarean delivery, return to work/school, and self-reported postpartum depressive symptoms, the racial differences in prevalence ratios for exclusive breastfeeding for each ethnic group compared to Whites were: Samoan (aPR = 0.54; 95% CI 0.43-0.69), Filipino (aPR = 0.58; 95% CI 0.53-0.63), Japanese (aPR = 0.58; 95% CI 0.52-0.65), Chinese (aPR = 0.64; 95% CI 0.58-0.70), Native Hawaiian (aPR = 0.67; 95% CI 0.61-0.72), Korean (aPR = 0.72; 95% CI 0.64-0.82), and Black (aPR = 0.79; 95% CI 0.65-0.96) compared to white mothers. Providers and community groups should be aware that just over one-third of mothers breastfeed exclusively at least 8 weeks with lower rates among Asian, NHOPI, and Black mothers. Culturally appropriate efforts to promote exclusive breastfeeding are recommended particularly among Asian subgroups that have high breastfeeding initiation rates that do not translate into high exclusivity rates.
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Affiliation(s)
- Donald K Hayes
- Family Health Services Division, Hawaii Department of Health, 1250 Punchbowl St, Room 216, Honolulu, HI, 96813, USA,
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100
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St Fleur R, Petrova A. Knowledge and perception of breastfeeding practices in Hispanic mothers in association with their preferred language for communication. Breastfeed Med 2014; 9:261-5. [PMID: 24784835 DOI: 10.1089/bfm.2013.0145] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Economically disadvantaged minority mothers with limited proficiency in English show suboptimal breastfeeding rates. In the present survey, the knowledge and perception of Hispanic mothers regarding their breastfeeding practices were analyzed in association with their language preference for communication. Among the mostly Hispanic-origin Special Supplemental Nutrition Program for Women, Infants, and Children-eligible mothers surveyed at our pediatric clinic, 109 were Spanish-respondent Hispanics (Group 1), 31 were English-respondent Hispanics (Group 2), and 56 were U.S.-born non-Hispanics (Group 3). Overall, 70-90% of mothers reported understanding the beneficial effect of breastmilk, thought breastfeeding was good to do, and had discussed breastfeeding with their obstetricians and pediatricians. Groups 1 and 2 mothers were more likely to have predecided to breastfeed their infant, to feel comfortable about breastfeeding at the doctor's office, and to have discussed with their mothers about how they had been fed. However, they were less likely to be able to identify who to approach for breastfeeding advice. A higher proportion of the Group 1 mothers admitted to inadequate breastfeeding knowledge, unfamiliarity with "latch on," and inability to identify who had educated them about breastfeeding. We conclude that in economically disadvantaged Hispanic mothers, a preference for communication in Spanish is associated with limited breastfeeding knowledge and lack of breastfeeding-related educational networks. Language preference should be addressed while providing breastfeeding education and support for Hispanic mothers to help improve their understanding and breastfeeding networks.
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Affiliation(s)
- Rose St Fleur
- 1 Department of Pediatrics, Jersey Shore University Medical Center , Neptune, New Jersey
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