Breastfeeding and later psychosocial development in the Philippines

The Impact of Breast Milk on the Normal Growth of the Baby

Other advantages of breastfeeding are: it costs less than artificial feeding; helps a mother and baby to bond closely — strengthens a deep love relationship; helps the baby develop; can help delay a new pregnancy; protects maternal health. Helps the uterus return to its previous size. This helps reduce bleeding and can help prevent anemia. Breastfeeding also reduces the risk of ovarian cancer and possible breast cancer in the mother.

Time trends and determinants of breastfeeding practices among adolescents and young women in Nigeria, 2003-2018

Introduction

Optimal breastfeeding practices have far-reaching health and economic benefits. Evidence suggests disparities in breastfeeding practices by maternal age-groups, with younger mothers often having lower rates of breastfeeding initiation, continuation and exclusivity compared with older mothers. There is limited knowledge of trends and factors associated with breastfeeding practices, particularly among adolescent and younger mothers in Nigeria. We examine key breastfeeding practices in Nigeria over a 15-year period, comparing adolescent mothers to young women.

Methods

We used four Nigeria Demographic and Health Surveys collected between 2003 and 2018. We constructed six key breastfeeding indicators to cover the time period of breastfeeding from initiation to child age 24 months in women of three maternal age groups at the time of birth: young adolescents (<18 years), older adolescents (18–19.9 years) and young women (20–24.9 years). We used logistic regression to examine the association between maternal age group and select breastfeeding behaviours on the 2018 survey.

Results

Analysis showed an increase in optimal breastfeeding practices across the four surveys and among all maternal age groups examined. Adolescent mothers had consistently lower prevalence for three of the six key breastfeeding indicators: early initiation of breastfeeding, exclusive breastfeeding <6 months and no prelacteal feed. Compared with young women, adolescent mothers had a higher prevalence of continued breastfeeding at 1 and 2 years. In multivariate analysis, we found that maternal age group was not associated with early breastfeeding initiation or with exclusive breastfeeding <6 months. However, several sociodemographic (ethnicity, region of residence) and healthcare-related (mode of delivery, antenatal care, postnatal breastfeeding counselling) factors were strongly associated with these two practices.

Conclusions

In Nigeria, there is need to better support breastfeeding and nutritional practices in adolescents and young women focusing on ethnic groups (Hausa, Fulani, Kanuri/Beriberi) and geographic regions (South East) that are lagging behind.

Examining developmental plasticity in the skeletal system through a sensitive developmental windows framework

Developmental plasticity facilitates energetically costly but potentially fitness-enhancing adjustments to phenotypic trajectories in response to environmental stressors, and thus may significantly impact patterns of growth, morbidity, and mortality over the life course. Ongoing research into epigenetics and developmental biology indicate that the timing of stress exposures is a key factor when assessing their impact on developmental processes. Specifically, stress experienced within sensitive developmental windows (SDWs), discrete developmental periods characterized by heightened energy requirements and rapid growth, may alter the pace and tempo of growth in ways that significantly influence phenotypic development over both the short and long term. In human skeletal biology, efforts to assess how developmental environments shape health outcomes over the life course could be enhanced by incorporating the SDW concept into existing methodological approaches. The goal of this article is to outline an interpretive framework for identifying and interpreting evidence of developmental stress in the skeletal system using the SDW concept. This framework provides guidance for the identification of elements most likely to capture evidence of stress most relevant to a study's core research questions, the interpretation of developmental stress exhibited by those elements, and the relationship of skeletal indicators of stress to the demographic patterning of morbidity and mortality. Use of the SDW concept in skeletal biology has the potential to enrich traditional approaches to addressing developmental origins of health and disease hypotheses, by targeting periods in which individuals are most susceptible to stress and thus most likely to exhibit plasticity in response.

Early life risk factors of motor, cognitive and language development: a pooled analysis of studies from low/middle-income countries

OBJECTIVE

To determine the magnitude of relationships of early life factors with child development in low/middle-income countries (LMICs).

DESIGN

Meta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data.

DATA SOURCES

We searched Medline, bibliographies of key articles and reviews, and grey literature to identify studies from LMICs that collected data on early life exposures and child development. The most recent search was done on 4 November 2014. We then invited the first authors of the publications and investigators of unpublished studies to participate in the study.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Studies that assessed at least one domain of child development in at least 100 children under 7 years of age and collected at least one early life factor of interest were included in the study.

ANALYSES

Linear regression models were used to assess SMDs in child development by parental and child factors within each study. We then produced pooled estimates across studies using random effects meta-analyses.

RESULTS

We retrieved data from 21 studies including 20 882 children across 13 LMICs, to assess the associations of exposure to 14 major risk factors with child development. Children of mothers with secondary schooling had 0.14 SD (95% CI 0.05 to 0.25) higher cognitive scores compared with children whose mothers had primary education. Preterm birth was associated with 0.14 SD (-0.24 to -0.05) and 0.23 SD (-0.42 to -0.03) reductions in cognitive and motor scores, respectively. Maternal short stature, anaemia in infancy and lack of access to clean water and sanitation had significant negative associations with cognitive and motor development with effects ranging from -0.18 to -0.10 SDs.

CONCLUSIONS

Differential parental, environmental and nutritional factors contribute to disparities in child development across LMICs. Targeting these factors from prepregnancy through childhood may improve health and development of children.

Breastfeeding and behavior disorders among children and adolescents: a systematic review

OBJECTIVE

This systematic review study aimed to assess the evidence available for the association between breastfeeding and behavior disorders in childhood and adolescence.

METHODS

The search was carried out in the PubMed, Lilacs, and PsycINFO databases up to December 2016. Inclusion criteria were as follows: prospective, retrospective and cross-sectional studies assessing the association between breastfeeding and behavior disorders in childhood or adolescence, using psychometric tests, carried out in humans and published in Portuguese, English, or Spanish. The search was performed in several stages by two independent researchers using pre-established criteria.

RESULTS

Eighteen studies met the inclusion criteria. Breastfeeding for a period equal to or higher than three or four months seemed to be inversely associated with total behavior and conduct disorders in childhood; however, the association remains unclear for other behavior disorders. Only four studies assessed behavior disorders in adolescence, and when an association was found, it was likely to be positive. The duration of breastfeeding seemed to be more important than the exclusive or non-exclusive pattern of breastfeeding.

CONCLUSIONS

Breastfed children for at least three to four months had fewer total behavior and conduct disorders in childhood. Further studies are needed to better understand this association, particularly in adolescence and involving other behavioral profiles.

Prolonged breastfeeding for 24 months or more and mental health at 6 years of age: evidence from the 2004 Pelotas Birth Cohort Study, Brazil

BACKGROUND

There is scarce and conflicting evidence on medium- to long-term effects of prolonged breastfeeding on child behavior.

METHOD

A population-based birth cohort study started in 2004 in the city of Pelotas, Southern Brazil. Children were followed up at 3, 12, 24, and 48 months and 6 years of age. Breastfeeding duration was determined based on information collected around the time of weaning. Psychiatric disorders were assessed using the Development and Well-Being Assessment (DAWBA). Children who were never breastfed were excluded from the analysis. Crude and adjusted analyses were performed using Poisson regression with robust variance.

RESULTS

Data on breastfeeding and mental health at the age of 6 years were available for 3377 children. Prevalence of breastfeeding for 24-35 months and ≥36 months was 16.1% (95% CI: 14.8-17.3) and 8.1% (95% CI: 7.2-9.1), respectively. Prevalence of psychiatric disorders among those who were breastfed for <24 months, 24-35 months and ≥36 months was 12.4% (95% CI: 11.1-13.7), 13.1% (95% CI: 10.4-16.2) and 12.3% (95% CI: 8.7-16.8), respectively. No association was found between breastfeeding for 24 months or more and psychiatric disorders among children aged 6 years both in the crude and adjusted analyses.

CONCLUSIONS

In this cohort there was no association between breastfeeding for 24 months or more and an increased prevalence of psychiatric disorders at the age of 6 years. Studies analyzing the medium- and long-term effects of prolonged breastfeeding for 2 years or more are scarce and further research is needed regarding this practice.

Infant feeding and school attainment in five cohorts from low- and middle-income countries

BACKGROUND

Performance in intelligence tests tends to be higher among individuals breastfed as infants, but little is known about the association between breastfeeding and achieved schooling. We assessed the association of infant feeding with school achievement in five cohorts from low- and middle-income countries. Unlike high-income country settings where most previous studies come from, breastfeeding is not positively associated with socioeconomic position in our cohorts, thus reducing the likelihood of a spurious positive association.

METHODOLOGY AND PRINCIPAL FINDINGS

Participants included 10,082 young adults from five birth cohorts (Brazil, India, Guatemala, the Philippines, and South Africa). The exposures variables were whether the subject was ever breastfed, total duration of breastfeeding, and age at introduction of complementary foods. We adjusted the estimates for age at follow up, sex, maternal age, smoking during pregnancy, birthweight and socioeconomic position at birth. The key outcome was the highest grade achieved at school. In unadjusted analyses, the association between ever breastfeeding and schooling was positive in Brazil, inverse in the Philippines, and null in South Africa; in adjusted analyses, these associations were attenuated. In Brazil, schooling was highest among individuals breastfed for 3-12 months whereas in the Philippines duration of breastfeeding was inversely associated with schooling; and null associations were observed in South Africa and Guatemala. These associations were attenuated in adjusted models. Late introduction of solid foods was associated with lower schooling achievement in Brazil and South Africa.

CONCLUSION

Measures of breastfeeding are not consistently related to schooling achievement in contemporary cohorts of young adults in lower and middle-income countries.

Breastfeeding up to two years of age or beyond and its influence on child growth and development: a systematic review

A systematic review was undertaken to identify studies describing the global prevalence of breastfeeding up to two years of age or beyond and its effects on child growth and development. The MEDLINE and LILACS databases were searched without any language or date restrictions, retrieving 3,561 titles. All retrieved titles, 453 abstracts and 49 full-text articles were read. Articles with maximum breastfeeding duration of over two years were included. An analysis was carried out of 19 articles that met the inclusion criteria resulting in a combined prevalence of breastfeeding at two years of age of 33 % (95%CI: 0.23; 0.42). Increasing trends towards breastfeeding up to two years of age or beyond were observed in the past decades in South Asia. The six studies analyzing the effects of breastfeeding up to two years of age or beyond on child growth showed contradictory results. No association was found with child development. It is concluded that evidence on the medium-term effects of breastfeeding up to two years of age or beyond is scarce and contradictory. Hence, further research is needed regarding this practice.