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Mallick LM, Shenassa ED. Variation in Breastfeeding Initiation and Duration by Mode of Childbirth: A Prospective, Population-Based Study. Breastfeed Med 2024; 19:262-274. [PMID: 38535749 DOI: 10.1089/bfm.2023.0180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Introduction: Despite known benefits of breastfeeding, including prevention against infections for infants, in the presence of numerous barriers, less than half of infants in high-income countries breastfeed for 6 months. One potential barrier to breastfeeding is birth by cesarean section (C-Section), which can invoke long-term difficulties. However, our structured literature review found that existing empirical research does not fully elucidate this relationship due to differences in operationalization of C-section and breastfeeding, omission of important confounders, and failure to exclude those who did not initiate breastfeeding (or use time-to-event analyses). In this article, we attempt to overcome these limitations. Methods: We analyzed data from 14,414 mother-infant dyads enrolled in the United Kingdom-based prospective Millennium Cohort Study, beginning in 2001. Using multivariable logistic regression, we examined the association between mode of birth (vaginal, emergency C-section, and elective C-section) and likelihood of breastfeeding initiation. We then applied adjusted Accelerated Failure Time survival models to examine the associations between mode of birth and duration of any and exclusive breastfeeding. Results: Those with planned (but not emergency) C-section were less likely to initiate breastfeeding (odds ratio: 0.84, 95% confidence interval [CI]: 0.71-0.99) relative to vaginal births. However, those with either planned or unplanned C-section discontinued both any and exclusive breastfeeding sooner than vaginal births. This effect was more pronounced for those with planned C-section (time ratio [TR]: 0.75, 95% CI: 0.64-0.89) than unplanned C-section (TR: 0.85, 95% CI: 0.74, 0.97) compared with vaginal births. Conclusions: Through application of rigorous methods, this study provides compelling evidence that breastfeeding duration may be impeded by C-section birth. The findings suggest that additional support for mothers who intend to breastfeed and have a C-section birth may be warranted.
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Affiliation(s)
- Lindsay M Mallick
- Maternal and Child Health Program, Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
- College of Behavioral and Social Sciences, Maryland Population Research Center, University of Maryland, College Park, Maryland, USA
- Avenir Health, Glastonbury, Connecticut, USA
| | - Edmond D Shenassa
- Maternal and Child Health Program, Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
- College of Behavioral and Social Sciences, Maryland Population Research Center, University of Maryland, College Park, Maryland, USA
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland, USA
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA
- Department of Epidemiology & Biostatistics, School of Medicine, University of Maryland, Baltimore, Maryland, USA
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Ulfa Y, Maruyama N, Igarashi Y, Horiuchi S. Early initiation of breastfeeding up to six months among mothers after cesarean section or vaginal birth: A scoping review. Heliyon 2023; 9:e16235. [PMID: 37292274 PMCID: PMC10245156 DOI: 10.1016/j.heliyon.2023.e16235] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 05/01/2023] [Accepted: 05/10/2023] [Indexed: 06/10/2023] Open
Abstract
Background Early initiation of breastfeeding is important for establishing continued breastfeeding. However, previous research report that cesarean section (C-section) may hinder early initiation of breastfeeding. Despite this, there is currently a lack of literature that examines the rates of breastfeeding after both cesarean section and vaginal birth globally. Research aims The objective of this scoping review was to systematically assess the available literature on the rate of early initiation of breastfeeding within the first hour and exclusive breastfeeding up to 6 months after C-section and vaginal birth, as well as any other factors associated with initiation and exclusive breastfeeding. Methods We adhered to the PRISMA extension guidelines for scoping reviews in conducting our review. In August 2022, we carried out an electronic database search on CINALH, PubMed, EMBASE, and Cochrane Library, and also manually searched the reference list. Results A total of 55 articles were included in the scoping review. The majority of these studies found that mothers who delivered vaginally had higher rates of breastfeeding compared to those who underwent a C-section, at various time points such as breastfeeding initiation, hospital discharge, one month, three months, and six months postpartum. Notably, there was a significant difference in the rate of early initiation of breastfeeding between the two groups. However, at 3 and 6 months after delivery the gap of exclusive breastfeeding rate between C-section and vaginal delivery is narrow. Breastfeeding education, health care providers support, and mother and baby bonding are other factors associate with initiation and exclusive breastfeeding. Conclusions The rate of breastfeeding initiation after C-section has remained low to date. This is due in part to insufficient knowledge about and support for breastfeeding from healthcare providers.
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Affiliation(s)
- Yunefit Ulfa
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
- National Research and Innovation Agency, Jakarta, Indonesia
| | - Naoko Maruyama
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - Yumiko Igarashi
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - Shigeko Horiuchi
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
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The Relationship between Psychological Suffering, Value of Maternal Cortisol during Third Trimester of Pregnancy and Breastfeeding Initiation. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020339. [PMID: 36837540 PMCID: PMC9960982 DOI: 10.3390/medicina59020339] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023]
Abstract
Background and Objectives: Cortisol, the stress hormone, is an important factor in initiating and maintaining lactation. Maternal suffering during pregnancy is predictive for the initiation and shorter duration of breastfeeding and can also lead to its termination. The aim of this study is to evaluate the relationship between the level of salivary cortisol in the third trimester of pregnancy and the initiation of breastfeeding in the postpartum period in a cohort of young pregnant women who wanted to exclusively breastfeed their newborns during hospitalization. Materials and Methods: For the study, full-term pregnant women were recruited between January and May 2022 in the Obstetrics and Gynecology Clinic of the Mureș County Clinical Hospital. Socio-demographic, clinical obstetric and neonatal variables were collected. Breastfeeding efficiency was assessed using the LATCH Breastfeeding Assessment Tool at 24 and 48 h after birth. The mean value of the LATCH score assessed at 24 and 48 h of age was higher among mothers who had a higher mean value of salivary cortisol measured in the third trimester of pregnancy (p < 0.05). A multivariate logistic regression model was used to detect risk factors for the success of early breastfeeding initiation. Results: A quarter of pregnant women had a salivary cortisol level above normal limits during the third trimester of pregnancy. There is a statistically significant association between maternal smoking, alcohol consumption during pregnancy and the level of anxiety or depression. Conclusions: The most important finding of this study was that increased salivary cortisol in the last trimester of pregnancy was not associated with delayed initiation/absence of breastfeeding.
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Oddo-Sommerfeld S, Schermelleh-Engel K, Konopka M, La Rosa VL, Louwen F, Sommerlad S. Giving birth alone due to COVID-19-related hospital restrictions compared to accompanied birth: psychological distress in women with caesarean section or vaginal birth - a cross-sectional study. J Perinat Med 2022; 50:539-548. [PMID: 35357796 DOI: 10.1515/jpm-2021-0368] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 02/07/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVES We examined the mental health of mothers after unaccompanied birth (unaccompanied group, UG) due to COVID-19-related visiting bans and compared the data with a control group with accompanied birth (AG). Additionally, a distinction was made between caesarean section (CS) and vaginal birth (VB), as existing research indicates a higher risk for mental distress after CS. METHODS The cross-sectional study included 27 mothers in the UG and 27 matched controls (AG). Anxiety, depression, postpartum traumatic stress symptoms (PTSS), and psychological well-being were assessed. Additionally, emotions and attitudes related to the restrictions were measured by self-developed items. RESULTS Psychological distress was high especially in the UG (anxiety: 23%, PTSS: 34.6%, low well-being: 42.3%, depression: 11.5%). Mothers in the AG had lower psychological distress than those in the UG, but still had enhanced rates of PTSS (11.1%) and diminished well-being (22.2%). In both groups, women with CS reported higher anxiety and trauma scores and lower well-being than women with VB. Unaccompanied mothers with CS perceived visitation restrictions as less appropriate and felt more helpless, angry, worried, and frustrated about the partner's absence than women with VB. CONCLUSIONS The partner's absence during, but also after childbirth has a major impact on psychological outcomes. Particularly, higher rates of anxiety and PTSS can lead to negative consequences for mothers and their children. Therefore, it is strongly recommended to relax visitation bans and avoid unaccompanied births. Psychological treatment in obstetric units is more urgently needed than ever, especially for women with a caesarean section.
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Affiliation(s)
- Silvia Oddo-Sommerfeld
- Division of Obstetrics and Fetomaternal Medicine, University Hospital of Frankfurt, Frankfurt, Germany
| | | | - Marie Konopka
- Division of Obstetrics and Fetomaternal Medicine, University Hospital of Frankfurt, Frankfurt, Germany
| | | | - Frank Louwen
- Division of Obstetrics and Fetomaternal Medicine, University Hospital of Frankfurt, Frankfurt, Germany
| | - Sarah Sommerlad
- Division of Obstetrics and Fetomaternal Medicine, University Hospital of Frankfurt, Frankfurt, Germany
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Hongo MA, Fryer K, Zimmer C, Tucker C, Palmquist AEL. Path analysis model of epidural/spinal anesthesia on breastfeeding among healthy nulliparous women: Secondary analysis of the United States Certificate of Live Births 2016. Birth 2022; 49:261-272. [PMID: 34741473 DOI: 10.1111/birt.12601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 10/12/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The effect of epidural/spinal anesthesia during labor on breastfeeding is unclear. Few studies had assessed whether or how medically assisted delivery (operative vaginal delivery or unscheduled cesarean birth) plays a mediating role. We aimed to examine whether the relationship between using epidural/spinal anesthesia and breastfeeding is mediated by increased medically assisted delivery among healthy nulliparous women. METHODS A secondary, cross-sectional analysis was conducted using US birth certificate data from 2016 (n = 381 199). Logistic regression was used to examine associations between factors. Structural equation modeling (SEM) was used to analyze the model fit of the path models and to quantify the direct, indirect, and total effect of anesthesia on breastfeeding at discharge, considering medically assisted delivery as a mediator. RESULTS Women who were administered epidural/spinal anesthesia were more likely to experience medically assisted delivery (adjusted odds ratio [AOR]: 95% confidence interval [CI] 3.01 (2.91-3.12)) and less likely to be breastfeeding at discharge (0.95 [0.92-0.98]). Operative vaginal and unscheduled cesarean deliveries were significantly associated with nonbreastfeeding at discharge (0.81 [0.77-0.84] and 0.81 [0.79-0.84], respectively). SEM revealed excellent model fit for our model. The indirect effect was significant (β = -0.038; 95% CI, -0.043 to -0.033), as was the total effect (β = -0.038; 95% CI, -0.043 to -0.033). CONCLUSIONS Epidural/spinal anesthesia is associated with nonbreastfeeding at discharge, mediated through medically assisted delivery. Health care providers should consider these risks and provide adequate support to help all parents attain their breastfeeding goals.
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Affiliation(s)
- Manami Anna Hongo
- Department of Obstetrics and Gynecology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Kimberly Fryer
- Department of Obstetrics and Gynecology, University of South Florida, Tampa, Florida, USA
| | - Catherine Zimmer
- Sociology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Christine Tucker
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Aunchalee E L Palmquist
- Department of Maternal and Child Health, Gillings School of Global Public Health, Carolina Global Breastfeeding Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Daher S, Ziade F, Nasreddine L, Baroudi M, Naja F. Breastfeeding and complementary feeding in fragile settings: the case of Syrian refugees and their host communities in North Lebanon. Int Breastfeed J 2022; 17:37. [PMID: 35568877 PMCID: PMC9107246 DOI: 10.1186/s13006-022-00480-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 04/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adequate breastfeeding and complementary feeding practices are paramount in fragile situations where access to food and healthcare is limited. The objectives of this study are to examine breastfeeding and complementary feeding practices among Syrian refugees and their Lebanese host communities and to investigate the correlates of exclusive breastfeeding (EBF) at four and 6 months in these communities. METHODS Using two-stage stratified sampling, a cross-sectional survey was conducted in Akkar, a region with a high density of Syrian refugees in Lebanon, between April and November 2019. In one-to-one interviews, mothers of children (6-24 months) completed a questionnaire including specific questions about breastfeeding and complementary feeding practices, a 24-h recall, and socio-demographic characteristics for 189 Syrian refugees and 182 Lebanese host community households. Descriptive statistics, simple and multiple logistic regression were used in data analysis. RESULTS Among breastfeeding practices, ever-breastfeeding was most prevalent (90%), followed by early initiation of breastfeeding (64.8%), EBF at four (49.6%), and six (36%) months. One in four children was introduced to solids before 6 months of age, and less than a third was given iron-fortified baby cereals as the first complementary foods. Only 24.4% and 9.2% of children met the minimum dietary diversity and minimum acceptable diet requirements, respectively. Compared to children of the Lebanese host communities, those of Syrian refugees had higher rates of EBF at four and 6 months as well as continued breastfeeding at 1 year, whereas only 17.9% of Syrian refugees' children met minimum dietary diversity compared to 30.9% of Lebanese host community children (p < 0.05). Among refugees, education and spouse's employment status were associated with higher odds of EBF at 4 months. As for Lebanese households, female children were less likely to be exclusively breastfed at 4 months and 6 months, while a natural delivery increased the odds of EBF at 6 months. CONCLUSION Breastfeeding and complementary feeding practices are suboptimal among children of Syrian refugees and their Lebanese host communities in North Lebanon. There is a need for intervention strategies to tackle gaps in services and assistance delivery programs to enhance infant and young child feeding practices among both communities.
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Affiliation(s)
- Sara Daher
- Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Fouad Ziade
- Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Riad El Solh, 1107 2020, Lebanon
| | - Moomen Baroudi
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Riad El Solh, 1107 2020, Lebanon
| | - Farah Naja
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, 27272, UAE.
- Faculty of Agriculture and Food Sciences, American University of Beirut, Riad El Solh, 1107 2020, Lebanon.
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Martin M, Keith M, Olmedo S, Edwards D, Barrientes A, Pan A, Valeggia C. Cesarean section and breastfeeding outcomes in an Indigenous Qom community with high breastfeeding support. Evol Med Public Health 2022; 10:36-46. [PMID: 35154778 PMCID: PMC8830290 DOI: 10.1093/emph/eoab045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 12/27/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Cesarean section may lead to suboptimal breastfeeding outcomes, though evidence has been mixed. Factors, such as premature birth, birth weight and maternal age may independently increase risk of cesarean and hinder breastfeeding initiation, while maternal preferences, support and sociostructural barriers may influence breastfeeding practices beyond the immediate postpartum period. METHODOLOGY We assessed impacts of cesarean section and gestational factors on breastfeeding duration among Indigenous Qom mothers in Argentina who have strong traditional breastfeeding support. We modeled transitions from exclusive breastfeeding to complementary feeding and from complementary feeding to full weaning in a Bayesian time-to-event framework with birth mode and gestational covariates (n = 89 infants). RESULTS Estimated median time to full weaning was 30 months. Cesarean-delivered babies were weaned an average of 5 months later adjusting for gestational age, maternal parity and infant sex. No factors were associated with time-to-complementary feeding, and time-to-complementary feeding was not associated with time-to-full weaning. CONCLUSIONS AND IMPLICATIONS Among Indigenous Qom mothers in Argentina, cesarean section was not associated with suboptimal breastfeeding outcomes. Although some Qom mothers do experience early breastfeeding problems, particularly following first birth, problems are not more frequent following cesarean delivery. Traditional postpartum kin and community support during prolonged postpartum periods may be instrumental in helping mothers to overcome early breastfeeding problems due to cesarean or other risk factors.
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Affiliation(s)
- Melanie Martin
- Department of Anthropology, University of Washington, 314 Denny Hall, Box 353100, Seattle, WA 98195-3100, USA,Corresponding author. Department of Anthropology, University of Washington, 314 Denny Hall, Box 353100, Seattle, WA 98195-3100, USA. Tel: +1 206-616-7701; E-mail:
| | - Monica Keith
- Department of Anthropology, University of Washington, 314 Denny Hall, Box 353100, Seattle, WA 98195-3100, USA
| | - Sofía Olmedo
- Centro de Investigaciones y Estudios sobre Cultura y Sociedad (CIECS-CONICET), Universidad Nacional de Cordoba, AV. Valparaiso S/N. Ciudad Universitaria, Cordoba, Argentina
| | - Deja Edwards
- Department of Anthropology, University of Washington, 314 Denny Hall, Box 353100, Seattle, WA 98195-3100, USA
| | - Alicia Barrientes
- Department of Anthropology, University of Washington, 314 Denny Hall, Box 353100, Seattle, WA 98195-3100, USA
| | - Anwesha Pan
- Department of Anthropology, University of Washington, 314 Denny Hall, Box 353100, Seattle, WA 98195-3100, USA
| | - Claudia Valeggia
- Department of Anthropology, Yale University, P.O. Box 208277, New Haven, CT 06520-8277, USA
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Budiati T, Adjie S, Gunawijaya J, Setyowati S. Fathers' role in sustainability of exclusive breastfeeding practice in post-cesarean-section mothers. J Public Health Res 2021; 11. [PMID: 35255672 PMCID: PMC8958444 DOI: 10.4081/jphr.2021.2744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 12/04/2022] Open
Abstract
Background: The success of breastfeeding among post-cesarean- section mothers requires strong willingness and commitment, self-confidence, support from various professionals, and internal support (especially from their husband) and the belief and value of their family. Exclusive breastfeeding remains low in some cities such as in West Java, especially in post-cesarean-section mothers, who are influenced by certain factors. The purpose of this study is to identify husbands’ role and their support for post-cesarean-section mothers in exclusive breastfeeding. Design and Methods: This study used a qualitative phenomenological approach. with a combination of different data collection techniques: focus group discussion and in-depth interviews. Twelve husbands of post-cesarean-section mothers participated in this study. Data were analyzed by thematic content analysis. Results: Four themes were identified namely knowledge about exclusive breastfeeding, the role of the father during breastfeeding, the experience of the husband and the family in supporting breastfeeding, and Women’s lack of knowledge, inconvenience due to pain as the most impending factors of exclusive breastfeeding. Conclusion: Most fathers seem eager to be involved and assist their partners to give breastfeeding to their baby. Furthermore, adequate support from family members, health care professionals, and employers can enable fathers to encourage and help their partners initiate and maintain exclusive breastfeeding. Fathers’ emotional, practical, and physical supports are also important factors that promote successful breastfeeding and enrich the experience of mothers. Significance for public health The incidence of cesarean sections in Indonesia continues to increase in both government and private hospitals because of the higher complications that occur in pregnancy with some effects of post-partum condition including the breastfeeding process. Increasing the incidence of cesarean sections also affects breastfeeding mothers’ post-cesarean-section behavior. The successful of breastfeeding among post-cesarean-section mothers requires strong willingness and commitment, self-confidence, support from various professionals, and internal support (especially from their husband) and belief and value of their family This study indicates a significant relationship between husbands’ role and their support for post-cesarean-section mothers in exclusive breastfeeding. This study can provide new insights for family members especially spouse, health care professionals to encourage and help their partners initiate and maintain exclusive breastfeeding.
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Affiliation(s)
- Tri Budiati
- Faculty of Nursing, Universitas Indonesia, Depok, West Java.
| | - Seno Adjie
- Department of Obstetric and Gynecology, Faculty of Medicine, Universitas Indonesia, Depok, West Java.
| | - Jajang Gunawijaya
- Department of Sociology, Faculty of Social and Political Science, Universitas Indonesia, Depok, West Java.
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Tracz J, Gajewska D, Myszkowska-Ryciak J. The Association between the Type of Delivery and Factors Associated with Exclusive Breastfeeding Practice among Polish Women-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010987. [PMID: 34682733 PMCID: PMC8535354 DOI: 10.3390/ijerph182010987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 11/17/2022]
Abstract
The type of delivery influences breastfeeding, both in terms of initiation and duration. The aim of the study was to determine the association between the type of delivery and factors associated with exclusive breastfeeding (EBF) practice among Polish women. Data on sociodemographic variables, pre-pregnancy weight, height, course of pregnancy, type of delivery and duration of breastfeeding were collected using a Computer-Assisted Web Interview. Of the 1024 breastfeeding women who participated in the study, 59.9% gave birth vaginally and 40.1% gave birth by caesarean section. The chance of starting EBF [OR: 0.478; 95% Cl: 0.274, 0.832] and continuing it for four months [OR: 0.836; 95% Cl: 0.569, 0.949] was lower in the case of caesarean delivery. Starting EBF was negatively affected by pre-pregnancy overweight status and obesity in the case of caesarean delivery. EBF practice for four months was negatively affected by age [18–24 years and 25–34 years], elementary education and average income [2001–4000 PLN] in the case of caesarean delivery. A negative impact on the chance of EBF for six months was also observed for younger age [18–24 years], elementary and secondary education and average income [2001–4000 PLN] in the case of caesarean delivery. There was no association between starting EBF and age, net income, place of living, pregnancy complications or the child′s birth weight category in the case of both subgroups, as well as between education and previous pregnancies in the case of vaginal delivery. These results suggest that women who deliver by caesarean section need additional breastfeeding support.
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Benova L, Siddiqi M, Abejirinde IOO, Badejo O. Time trends and determinants of breastfeeding practices among adolescents and young women in Nigeria, 2003-2018. BMJ Glob Health 2021; 5:bmjgh-2020-002516. [PMID: 32764127 PMCID: PMC7412589 DOI: 10.1136/bmjgh-2020-002516] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 05/27/2020] [Accepted: 06/19/2020] [Indexed: 12/21/2022] Open
Abstract
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.
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Affiliation(s)
- Lenka Benova
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Manahil Siddiqi
- Department of Health Services, University of Washington School of Public Health, Seattle, Washington, USA
| | | | - Okikiolu Badejo
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
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Raihana S, Alam A, Huda TM, Dibley MJ. Factors associated with delayed initiation of breastfeeding in health facilities: secondary analysis of Bangladesh demographic and health survey 2014. Int Breastfeed J 2021; 16:14. [PMID: 33482847 PMCID: PMC7821485 DOI: 10.1186/s13006-021-00360-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/12/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Irrespective of the place and mode of delivery, 'delayed' initiation of breastfeeding beyond the first hour of birth can negatively influence maternal and newborn health outcomes. In Bangladesh, 49% of newborns initiate breastfeeding after the first hour. The rate is higher among deliveries at a health facility (62%). This study investigates the maternal, health service, infant, and household characteristics associated with delayed initiation of breastfeeding among health facility deliveries in Bangladesh. METHODS We used data from the 2014 Bangladesh Demographic and Health Survey. We included 1277 last-born children born at a health facility in the 2 years preceding the survey. 'Delayed' breastfeeding was defined using WHO recommendations as initiating after 1 h of birth. We performed univariate and multivariable logistic regression to determine factors associated with delayed initiation. RESULTS About three-fifth (n = 785, 62%) of the children born at a health facility delayed initiation of breastfeeding beyond 1 h. After adjusting for potential confounders, we found delayed initiation to be common among women, who delivered by caesarean section (adjusted Odds Ratio (aOR): 2.93; 95% CI 2.17, 3.98), and who were exposed to media less than once a week (aOR: 1.53; 95% CI 1.07, 2.19). Women with a higher body mass index had an increased likelihood of delaying initiation (aOR: 1.05; 95% CI 1.01, 1.11). Multiparous women were less likely to delay (aOR: 0.71; 95% CI 0.53, 0.96). CONCLUSIONS Delayed initiation of breastfeeding following caesarean deliveries continues to be a challenge, but several other health facility and maternal factors also contributed to delayed initiation. Interventions to promote early breastfeeding should include strengthening the capacity of healthcare providers to encourage early initiation, especially for caesarean deliveries.
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Affiliation(s)
- Shahreen Raihana
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales Australia
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Ashraful Alam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales Australia
| | - Tanvir M. Huda
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales Australia
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Michael J. Dibley
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales Australia
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Benton M, Salter A, Tape N, Wilkinson C, Turnbull D. Women's psychosocial outcomes following an emergency caesarean section: A systematic literature review. BMC Pregnancy Childbirth 2019; 19:535. [PMID: 31888530 PMCID: PMC6937939 DOI: 10.1186/s12884-019-2687-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 12/17/2019] [Indexed: 11/10/2022] Open
Abstract
Background Given the sudden and unexpected nature of an emergency caesarean section (EmCS) coupled with an increased risk of psychological distress, it is particularly important to understand the psychosocial outcomes for women. The aim of this systematic literature review was to identify, collate and examine the evidence surrounding women’s psychosocial outcomes of EmCS worldwide. Methods The electronic databases of EMBASE, PubMed, Scopus, and PsycINFO were searched between November 2017 and March 2018. To ensure articles were reflective of original and recently published research, the search criteria included peer-reviewed research articles published within the last 20 years (1998 to 2018). All study designs were included if they incorporated an examination of women’s psychosocial outcomes after EmCS. Due to inherent heterogeneity of study data, extraction and synthesis of both qualitative and quantitative data pertaining to key psychosocial outcomes were organised into coherent themes and analysis was attempted. Results In total 17,189 articles were identified. Of these, 208 full text articles were assessed for eligibility. One hundred forty-nine articles were further excluded, resulting in the inclusion of 66 articles in the current systematic literature review. While meta-analyses were not possible due to the nature of the heterogeneity, key psychosocial outcomes identified that were negatively impacted by EmCS included post-traumatic stress, health-related quality of life, experiences, infant-feeding, satisfaction, and self-esteem. Post-traumatic stress was one of the most commonly examined psychosocial outcomes, with a strong consensus that EmCS contributes to both symptoms and diagnosis. Conclusions EmCS was found to negatively impact several psychosocial outcomes for women in particular post-traumatic stress. While investment in technologies and clinical practice to minimise the number of EmCSs is crucial, further investigations are needed to develop effective strategies to prepare and support women who experience this type of birth.
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Affiliation(s)
- Madeleine Benton
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia.
| | - Amy Salter
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Nicole Tape
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Chris Wilkinson
- Maternal Fetal Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Deborah Turnbull
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
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Li R, Perrine CG, Anstey EH, Chen J, MacGowan CA, Elam-Evans LD. Breastfeeding Trends by Race/Ethnicity Among US Children Born From 2009 to 2015. JAMA Pediatr 2019; 173:e193319. [PMID: 31609438 PMCID: PMC6802058 DOI: 10.1001/jamapediatrics.2019.3319] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Large racial/ethnic disparities in breastfeeding are associated with adverse health outcomes. OBJECTIVES To examine breastfeeding trends by race/ethnicity from 2009 to 2015 and changes in breastfeeding gaps comparing racial/ethnic subgroups with white infants from 2009-2010 to 2014-2015. DESIGN, SETTING, AND PARTICIPANTS This study used data from 167 842 infants from the National Immunization Survey-Child (NIS-Child), a random-digit-dialed telephone survey among a complex, stratified, multistage probability sample of US households with children aged 19 to 35 months at the time of the survey. This study analyzed data collected from January 1, 2011, through December 31, 2017, for children born between 2009 and 2015. EXPOSURES Child's race/ethnicity categorized as Hispanic or non-Hispanic white, black, Asian, or American Indian or Alaskan Native. MAIN OUTCOMES AND MEASURES Breastfeeding rates, including ever breastfeeding, exclusive breastfeeding through 6 months, and continuation of breastfeeding at 12 months. RESULTS This study included 167 842 infants (mean [SD] age, 2.33 [0.45] years; 86 321 [51.4%] male and 81 521 [48.6%] female). Overall unadjusted breastfeeding rates increased from 2009 to 2015 by 7.1 percentage points for initiation, 9.2 percentage points for exclusivity, and 11.3 percentage points for duration, with considerable variation by race/ethnicity. Most racial/ethnic groups had significant increases in breastfeeding rates. From 2009-2010 to 2014-2015, disparities in adjusted breastfeeding rates became larger between black and white infants. For example, the difference for exclusive breastfeeding through 6 months between black and white infants widened from 0.5 to 4.5 percentage points with a 4.0% difference in difference (P < .001) from 2009-2010 to 2014-2015. In contrast, the breastfeeding differences between Hispanic, Asian, and American Indian or Alaskan Native infants and white infants became smaller or stayed the same except for continued breastfeeding at 12 months among Asians. For example, the difference in continued breastfeeding at 12 months between Hispanic and white infants decreased from 7.8 to 3.8 percentage points between 2 periods, yielding a -4.0% difference in difference (P < .001). Because of positive trends among all race/ethnicities, these reduced differences were likely associated with greater increases among white infants throughout the study years. CONCLUSIONS AND RELEVANCE Despite breastfeeding improvements among each race/ethnicity group, breastfeeding disparities between black and white infants became larger when breastfeeding improvements decreased even further among black infants in 2014-2015. The reduced breastfeeding gaps among all other nonwhite groups may be associated with greater increases among white infants. More efforts appear to be needed to improve breastfeeding rates among black infants.
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Affiliation(s)
- Ruowei Li
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cria G. Perrine
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Erica H. Anstey
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jian Chen
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carol A. MacGowan
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Laurie D. Elam-Evans
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Budiati T, Setyowati. The influence culture and maternal care on exclusive breastfeeding practice in post caesarean section mothers. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2019.04.121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Gestational weight gain and unplanned or emergency cesarean delivery in the United States. Women Birth 2019; 32:263-269. [DOI: 10.1016/j.wombi.2018.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 07/03/2018] [Accepted: 07/19/2018] [Indexed: 11/24/2022]
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16
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Veile A, Faria AA, Rivera S, Tuller SM, Kramer KL. Birth mode, breastfeeding and childhood infectious morbidity in the Yucatec Maya. Am J Hum Biol 2019; 31:e23218. [PMID: 30702176 DOI: 10.1002/ajhb.23218] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 12/08/2018] [Accepted: 12/29/2018] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES Cesarean delivery is linked to breastfeeding complications and child morbidity. These outcomes may disproportionately affect Latin American indigenous populations that are experiencing rising cesarean delivery rates, but often inhabit environments that exacerbate postnatal morbidity risks. We therefore assess relationships between birth mode, infant feeding practices, and childhood infectious morbidity in a modernizing Yucatec Maya community, where prolonged breastfeeding is the norm. We predicted that under these conditions, cesarean delivery would increase risk of childhood infectious morbidity, but prolonged breastfeeding postcesarean would mitigate morbidity risk. METHODS Using a longitudinal child health dataset (n = 88 children aged 0-60 months, 24% cesarean-delivered, 2290 observations total), we compare gastrointestinal infectious (GI) and respiratory infectious (RI) morbidity rates by birth mode. We model associations between cesarean delivery and breastfeeding duration, formula feeding and child nutritional status, then model GI and RI as a function of birth mode, child age, and feeding practices. RESULTS Cesarean delivery was associated with longer breastfeeding durations and higher child weight-for-age, but not with formula feeding, GI, or RI. Adolescent motherhood and RI were risk factors for GI; formula feeding and GI were risk factors for RI. Regional housing materials protected against GI; breastfeeding protected against RI and mitigated the effect of formula feeding. CONCLUSIONS We find no direct link between birth mode and child infectious morbidity. Yucatec Maya mothers practice prolonged breastfeeding, especially postcesarean, and in conjunction with formula feeding. This practice protects against childhood RI, but not GI, perhaps because GI is more susceptible to maternal and household factors.
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Affiliation(s)
- Amanda Veile
- Department of Anthropology, Purdue University, West Lafayette, Indiana, USA
| | - Amy A Faria
- Department of Consumer Science, Purdue University, West Lafayette, Indiana, USA
| | - Sydney Rivera
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Sydney M Tuller
- Department of Anthropology, Purdue University, West Lafayette, Indiana, USA
| | - Karen L Kramer
- Department of Anthropology, University of Utah, Salt Lake City, Utah, USA
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Factors Associated with Breastfeeding Initiation and Continuation: A Meta-Analysis. J Pediatr 2018; 203:190-196.e21. [PMID: 30293638 DOI: 10.1016/j.jpeds.2018.08.008] [Citation(s) in RCA: 189] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 07/12/2018] [Accepted: 08/08/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To use a quantitative approach to evaluate the literature for quantity, quality, and consistency of studies of maternal and infant characteristics in association with breastfeeding initiation and continuation, and to conduct a meta-analysis to produce summary relative risks (RRs) for selected factors. STUDY DESIGN A systematic review using PubMed and CINAHL through March 2016 was conducted to identify relevant observational studies in developed nations, reporting a measure of risk for 1 or more of 6 quantitatively derived, high impact factors in relation to either breastfeeding initiation or continuation. One author abstracted data using a predesigned database, which was reviewed by a second independent author; data evaluation and interpretation included all co-authors. These factors were summarized using standard meta-analysis techniques. RESULTS Six high impact factors were identified (smoking [39 papers], mode of delivery [47 papers], parity [31 papers], dyad separation [17 papers], maternal education [62 papers], and maternal breastfeeding education [32 papers]). Summary RR from random-effects models for breastfeeding initiation were highest for high vs low maternal education (RR 2.28 [95% CI 1.92-2.70]), dyad connection vs not (RR 2.01 [95% CI 1.38-2.92]), and maternal nonsmoking vs smoking (RR = 1.76 [95% CI 1.59-1.95]); results were similar for breastfeeding continuation. CONCLUSIONS Despite methodological heterogeneity across studies, relatively consistent results were observed for these perinatally identifiable factors associated with breastfeeding initiation and continuation, which may be informative in developing targeted interventions to provide education and support for successful breastfeeding in more families.
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Goetz AR, Mara CA, Stark LJ. Greater Breastfeeding in Early Infancy Is Associated with Slower Weight Gain among High Birth Weight Infants. J Pediatr 2018; 201:27-33.e4. [PMID: 30007772 PMCID: PMC9578150 DOI: 10.1016/j.jpeds.2018.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/31/2018] [Accepted: 06/01/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To examine whether feeding patterns from birth to age 6 months modify the association between birth weight and weight at 7-12 months of age. STUDY DESIGN Longitudinal mixed models were used to examine feeding trajectories across categories of birth weight and weight at 7-12 months of age in 1799 mother-infant dyads enrolled in the Infant Feeding Practices Study II. The percentage of breast milk received and the average daily formula consumption were calculated from birth to 6 months of age. Birth weights were classified as high (≥4000 g) and normal (≥2500 g and <4000 g). Weights at 7-12 months of age were categorized as high (z score >1) or normal (z score ≤1). A secondary analysis was performed using categories defined by birth weight adjusted for gestational age percentiles (>90% and 10th-90th percentile). RESULTS High birth weight (HBW) infants with high weights at 7-12 months of age demonstrated a rapid decline in the percentage of breast milk feedings compared with HBW infants with normal weights at 7-12 months of age. Normal birth weight infants with high weights at 7-12 months of age received a lower percentage of breast milk and had greater absolute intakes of formula than those with normal weights at 7-12 months of age; these associations did not vary over time. Results were similar when infants were categorized by birth weight percentiles. CONCLUSIONS A lower proportion of breast milk feedings was associated with excess weight at 7-12 months of age in HBW infants. These findings suggest an initial target for obesity prevention programs focusing on the first 6 months after birth.
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The association between caesarean delivery and the initiation and duration of breastfeeding: a prospective cohort study in China. Eur J Clin Nutr 2018; 72:1644-1654. [DOI: 10.1038/s41430-018-0127-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 12/13/2017] [Accepted: 01/30/2018] [Indexed: 11/08/2022]
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Economou M, Kolokotroni O, Paphiti-Demetriou I, Kouta C, Lambrinou E, Hadjigeorgiou E, Hadjiona V, Tryfonos F, Philippou E, Middleton N. Prevalence of breast-feeding and exclusive breast-feeding at 48 h after birth and up to the sixth month in Cyprus: the BrEaST start in life project. Public Health Nutr 2018; 21:967-980. [PMID: 29173197 PMCID: PMC10284717 DOI: 10.1017/s1368980017003214] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/16/2017] [Accepted: 10/02/2017] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess the prevalence and sociodemographic determinants of breast-feeding (BF) and exclusive breast-feeding (EBF) in Cyprus up to the sixth month. DESIGN Cross-sectional and longitudinal descriptive study. BF and EBF were estimated based on mothers' self-reported BF status in line with Step 7 of the WHO/UNICEF Baby-Friendly Hospital Initiative questionnaire and based on 24 h recall. SETTING Maternity wards in all public hospitals and twenty-nine (of thirty-five) private maternity clinics nationwide. SUBJECTS Consecutive sample of 586 mothers recruited within 48 h from birth, followed up by telephone interview at the first, fourth and sixth month. RESULTS Although 84·3 % of mothers initiated BF before discharge, prevalence of BF at the sixth month was 32·4 %, with the highest reduction observed between the first and fourth months. Prevalence of EBF at 48 h was 18·8 % and fell gradually to 5·0 % at the sixth month. Mothers with higher educational attainment or higher family income were more likely to breast-feed until the sixth month. In terms of EBF, an association was observed only with education, which persisted until the sixth month. Other than social gradient, mode of delivery was the strongest determinant of BF initiation, exclusivity and continuation. Mothers who gave birth vaginally were three to four times more likely to initiate BF (OR=3·1; 95 % CI 1·7, 5·4) and EBF (OR=4·3; 95 % CI 2·7, 6·8). CONCLUSIONS The low prevalence of BF and EBF in Cyprus, together with the fact that caesarean section rates are currently among the highest in Europe, suggest the need for further research to understand this multidimensional phenomenon and for interdisciplinary policy action to protect, promote and support BF.
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Affiliation(s)
- Mary Economou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Vragadinou 15, 3041 Limassol, Cyprus
| | - Ourania Kolokotroni
- University of Nicosia Medical School, Nicosia, Cyprus
- Cyprus Breastfeeding Association – ‘Gift for Life’, Nicosia, Cyprus
| | | | - Christiana Kouta
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Vragadinou 15, 3041 Limassol, Cyprus
| | - Ekaterini Lambrinou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Vragadinou 15, 3041 Limassol, Cyprus
| | - Eleni Hadjigeorgiou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Vragadinou 15, 3041 Limassol, Cyprus
| | - Vasiliki Hadjiona
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Vragadinou 15, 3041 Limassol, Cyprus
| | - Froso Tryfonos
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Vragadinou 15, 3041 Limassol, Cyprus
| | - Elena Philippou
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Nicos Middleton
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Vragadinou 15, 3041 Limassol, Cyprus
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Addressing barriers to exclusive breast-feeding in low- and middle-income countries: a systematic review and programmatic implications. Public Health Nutr 2017; 20:3120-3134. [PMID: 28965508 DOI: 10.1017/s1368980017002531] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Despite numerous global initiatives on breast-feeding, trend data show exclusive breast-feeding (EBF) rates have stagnated over the last two decades. The purpose of the present systematic review was to determine barriers to exclusive breast-feeding in twenty-five low- and middle-income countries and discuss implications for programmes. DESIGN A search of Scopus, MEDLINE, CINAHL and PsychINFO was conducted to retrieve studies from January 2000 to October 2015. Using inclusion criteria, we selected both qualitative and quantitative studies that described barriers to EBF. SETTING Low- and middle-income countries. SUBJECTS Following application of systematic review criteria, forty-eight articles from fourteen countries were included in the review. RESULTS Sixteen barriers to EBF were identified in the review. There is moderate evidence of a negative association between maternal employment and EBF practices. Studies that examined EBF barriers at childbirth and the initial 24 h post-delivery found strong evidence that caesarean section can impede EBF. There is moderate evidence for early initiation of breast-feeding and likelihood of practising EBF. Breast-feeding problems were commonly reported from cross-sectional or observational studies. Counselling on EBF and the presence of family and/or community support have demonstrated improvements in EBF. CONCLUSIONS Improving the counselling skills of health workers to address breast-feeding problems and increasing community support for breast-feeding are critical components of infant and young child feeding programming, which will aid in attaining the 2025 World Health Assembly EBF targets. Legislation and regulations on marketing of breast-milk substitutes, paid maternity leave and breast-feeding breaks for working mothers require attention in low- and middle-income countries.
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Kling D, Haile ZT, Francescon J, Chertok I. Association Between Method of Delivery and Exclusive Breastfeeding at Hospital Discharge. J Osteopath Med 2017; 116:430-9. [PMID: 27367948 DOI: 10.7556/jaoa.2016.087] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
CONTEXT Studies have shown that exclusive breastfeeding at hospital discharge is associated with longer duration of breastfeeding. Method of delivery (MOD) is a barrier that may hinder breastfeeding practices. However, research examining the association between MOD and exclusive breastfeeding at hospital discharge is lacking. OBJECTIVE To examine the association between MOD and exclusive breastfeeding at hospital discharge. METHODS We used a cross-sectional study design to conduct a secondary data analysis of 1494 women who participated in the Infant Feeding Practices Study II between 2005 and 2007. Multiple logistic regression was conducted to estimate the OR and 95% CI for the association between MOD and exclusive breastfeeding at hospital discharge, after adjusting for potential confounding variables. RESULTS The crude prevalence rates of vaginal delivery and cesarean delivery were 74.8% and 25.2%, respectively. The prevalence of exclusive breastfeeding at hospital discharge was 70.6% among respondents who gave birth by cesarean delivery compared with 79.9% of women who gave birth vaginally (P=.001). After adjusting for sociodemographic, behavioral, and anthropometric factors, the odds of exclusive breastfeeding at hospital discharge were lower among women who gave birth by cesarean delivery compared with women who gave birth vaginally (OR, 0.41; 95% CI, 0.24-0.71). CONCLUSION Women who give birth by cesarean delivery may require additional attention, assistance, and encouragement during their hospital stay to improve rates of exclusive breastfeeding at discharge. Health care professionals should address the issue of MOD when promoting exclusive breastfeeding to maximize the potential for longer-term breastfeeding success.
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Lau Y, Tha PH, Ho-Lim SST, Wong LY, Lim PI, Citra Nurfarah BZM, Shorey S. An analysis of the effects of intrapartum factors, neonatal characteristics, and skin-to-skin contact on early breastfeeding initiation. MATERNAL AND CHILD NUTRITION 2017; 14. [PMID: 28799193 DOI: 10.1111/mcn.12492] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 05/31/2017] [Accepted: 06/20/2017] [Indexed: 12/16/2022]
Abstract
This study aims to determine relationships between intrapartum factors, neonatal characteristics, skin-to-skin contact (SSC), and early breastfeeding initiation after spontaneous vaginal and Caesarean section or operative vaginal birth. A total of 915 mother-newborn dyads were considered in a hypothetical model based on integrated concepts of breastfeeding initiation model, infant learning framework, and attachment theory. Multiple-group path analysis was used to determine whether differences exist between effects of immediate SSC (≤30 min) on early breastfeeding initiation in different modes of birth. SSC, mode of birth, labour duration, and neonatal intensive care unit admission were significantly associated with early breastfeeding initiation, as indicated by the path analysis model, which included all samples. Women with immediate SSC were more likely to initiate early breastfeeding in different modes of birth. In the spontaneous vaginal birth group, women showed a lower likelihood of initiating early breastfeeding when their neonates were admitted to the neonatal intensive care unit and presented an Apgar score of <7 at 1 min. Multiple-group analysis showed no significant difference between effects of immediate SSC on early breastfeeding initiation in different modes of birth (critical ratio = -0.309). Results showed that models satisfactorily fitted the data (minimum discrepancy divided by degrees of freedom = 1.466-1.943, goodness of fit index = 0.981-0.986, comparative fit index = 0.947-0.955, and root mean square error of approximation = 0.023-0.032). Our findings emphasize the crucial importance of prioritizing promotion of immediate SSC under different modes of birth.
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Affiliation(s)
- Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Pyai Htun Tha
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Lai Ying Wong
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Peng Im Lim
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | | | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Tie WJ, Gardner H, Lai CT, Hepworth AR, Al‐Tamimi Y, Paech MJ, Hartmann PE, Geddes DT. Changes in milk composition associated with pethidine-PCEA usage after Caesarean section. MATERNAL & CHILD NUTRITION 2017; 13:e12275. [PMID: 27040350 PMCID: PMC6865999 DOI: 10.1111/mcn.12275] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 11/27/2015] [Accepted: 11/29/2015] [Indexed: 12/01/2022]
Abstract
The effect of pethidine as patient-controlled epidural analgesia (PCEA) on specific biochemical components in breast milk in relation to the timing of secretory activation is not well investigated. The aim of this study was to compare biochemical timing of secretory activation between women who had a vaginal (V) or Caesarean birth with pethidine-PCEA (CBP). Several milk samples were collected daily from 36 mothers (17 V, 19 CBP) for the first 265 h post-partum. Protein and lactose concentrations and Na+ and K+ ion levels were measured. Samples were assigned to three time periods: 0-72, >72-165 and >165-265 h post-partum for statistical analyses. Data were analyzed using linear mixed effect models. In the first 72 h post-partum, the mean difference in lactose concentration was 5 gL-1 higher in group V (P < 0.05). From >72-165 h post-partum, protein and Na+ concentrations were lower in group V (P = 0.05, P = 0.02), and K+ levels were higher in group V (P < 0.001). From >165-265 h post-partum, there were no significant differences between the groups. Biochemically, secretory activation had occurred by 72 h post-partum in both groups. There were greater variations in measured biochemical components observed within group CBP initially. However, by 165 h post-partum, there were no differences in the biochemical components between the groups. This suggests that effects of pethidine-PCEA are diminished by 72 h post-partum and undetected by 165 h.
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Affiliation(s)
- Wan Jun Tie
- School of Chemistry and BiochemistryUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Hazel Gardner
- School of Chemistry and BiochemistryUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Ching Tat Lai
- School of Chemistry and BiochemistryUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Anna Rachel Hepworth
- School of Chemistry and BiochemistryUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | | | - Michael James Paech
- School of Medicine and PharmacologyUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Peter Edwin Hartmann
- School of Chemistry and BiochemistryUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Donna Tracy Geddes
- School of Chemistry and BiochemistryUniversity of Western AustraliaPerthWestern AustraliaAustralia
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Linares AM, Rayens MK, Gomez ML, Gokun Y, Dignan MB. Intention to Breastfeed as a Predictor of Initiation of Exclusive Breastfeeding in Hispanic Women. J Immigr Minor Health 2016; 17:1192-8. [PMID: 24903355 DOI: 10.1007/s10903-014-0049-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Exclusive breastfeeding (EBF) is the most efficacious form of infant feeding and nutrition. Hispanic mothers in the US are more likely than mothers of other racial/ethnic groups to supplement with formula in the first 2 days of life. The purpose of this study was to explore infant feeding intentions during the prenatal period as a predictor of EBF at postpartum discharge in a sample of Hispanic women (n = 99). At discharge, 51 % of the women were EBF, 44 % were breastfeeding and supplementing with formula, and 5 % were feeding only formula. Intention to breastfeed was found to be a strong and potentially modifiable predictor of breastfeeding behavior, showing a significant association with EBF upon discharge from the hospital after birth when linked with acceptance of pregnancy and method of delivery. Prenatal care offers a unique opportunity to enhance intentions to breastfeed that may lead to improved EBF in this health vulnerable population.
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Affiliation(s)
- Ana M Linares
- College of Nursing, University of Kentucky, 315 College of Nursing Building, Lexington, KY, 40536-0230, USA,
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Poston L, Caleyachetty R, Cnattingius S, Corvalán C, Uauy R, Herring S, Gillman MW. Preconceptional and maternal obesity: epidemiology and health consequences. Lancet Diabetes Endocrinol 2016; 4:1025-1036. [PMID: 27743975 DOI: 10.1016/s2213-8587(16)30217-0] [Citation(s) in RCA: 655] [Impact Index Per Article: 81.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 07/25/2016] [Accepted: 07/28/2016] [Indexed: 12/16/2022]
Abstract
Obesity in women of reproductive age is increasing in prevelance worldwide. Obesity reduces fertility and increases time taken to conceive, and obesity-related comorbidities (such as type 2 diabetes and chronic hypertension) heighten the risk of adverse outcomes for mother and child if the woman becomes pregnant. Pregnant women who are obese are more likely to have early pregnancy loss, and have increased risk of congenital fetal malformations, delivery of large for gestational age infants, shoulder dystocia, spontaneous and medically indicated premature birth, and stillbirth. Late pregnancy complications include gestational diabetes and pre-eclampsia, both of which are associated with long-term morbidities post partum. Women with obesity can also experience difficulties during labour and delivery, and are more at risk of post-partum haemorrhage. Long-term health risks are associated with weight retention after delivery, and inherent complications for the next pregnancy. The wellbeing of the next generation is also compromised. All these health issues could be avoided by prevention of obesity among women of reproductive age, which should be viewed as a global public health priority. For women who are already obese, renewed efforts should be made towards improved management during pregnancy, especially of blood glucose, and increased attention to post-partum weight management. Effective interventions, tailored to ethnicity and culture, are needed at each of these stages to improve the health of women and their children in the context of the global obesity epidemic.
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Affiliation(s)
- Lucilla Poston
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK.
| | - Rishi Caleyachetty
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Sven Cnattingius
- Department of Medicine Solna, Karolinska Universitetssjukhuset, Stockholm, Sweden
| | - Camila Corvalán
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Ricardo Uauy
- Division of Pediatrics, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago, Chile; Center for Obesity Research and Education, Departments of Medicine and Public Health, Temple University, Philadelphia, PA, USA
| | - Sharron Herring
- Center for Obesity Research and Education, Departments of Medicine and Public Health, Temple University, Philadelphia, PA, USA
| | - Matthew W Gillman
- Office of the Director, Environmental Influences on Child Health Outcomes (ECHO), National Institutes of Health, Rockville, MD, USA
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Hobbs AJ, Mannion CA, McDonald SW, Brockway M, Tough SC. The impact of caesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum. BMC Pregnancy Childbirth 2016; 16:90. [PMID: 27118118 PMCID: PMC4847344 DOI: 10.1186/s12884-016-0876-1] [Citation(s) in RCA: 276] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 04/19/2016] [Indexed: 12/16/2022] Open
Abstract
Background The caesarean section (c-section) rate in Canada is 27.1 %, well above the 5–15 % of deliveries suggested by the World Health Organization in 2009. Emergency and planned c-sections may adversely affect breastfeeding initiation, milk supply and infant breastfeeding receptivity compared to vaginal deliveries. Our study examined mode of delivery and breastfeeding initiation, duration, and difficulties reported by mothers at 4 months postpartum. Methods The All Our Babies study is a prospective pregnancy cohort in Calgary, Alberta, that began in 2008. Participants completed questionnaires at <25 and 34–36 weeks gestation and approximately 4 months postpartum. Demographic, mental health, lifestyle, and health services data were obtained. Women giving birth to singleton infants were included (n = 3021). Breastfeeding rates and difficulties according to mode of birth (vaginal, planned c-section and emergency c-section) were compared using cross-tabulations and chi-square tests. A multivariable logistic regression model was created to examine the association between mode of birth on breastfeeding duration to 12 weeks postpartum. Results More women who delivered by planned c-section had no intention to breastfeed or did not initiate breastfeeding (7.4 % and 4.3 % respectively), when compared to women with vaginal births (3.4 % and 1.8 %, respectively) and emergency c-section (2.7 % and 2.5 %, respectively). Women who delivered by emergency c-section were found to have a higher proportion of breastfeeding difficulties (41 %), and used more resources before (67 %) and after (58 %) leaving the hospital, when compared to vaginal delivery (29 %, 40 %, and 52 %, respectively) or planned c-sections (33 %, 49 %, and 41 %, respectively). Women who delivered with a planned c-section were more likely (OR = 1.61; 95 % CI: 1.14, 2.26; p = 0.014) to discontinue breastfeeding before 12 weeks postpartum compared to those who delivered vaginally, controlling for income, education, parity, preterm birth, maternal physical and mental health, ethnicity and breastfeeding difficulties. Conclusions We found that when controlling for socio-demographic and labor and delivery characteristics, planned c-section is associated with early breastfeeding cessation. Anticipatory guidance around breastfeeding could be provided to women considering a planned c-section. As well, additional supportive care could be made available to lactating women with emergency c-sections, within the first 24 hours post birth and throughout the early postpartum period. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-0876-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Amy J Hobbs
- Cumming School of Medicine, Department of Community Health Sciences, University of Calgary, TRW Building 3rd Floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
| | - Cynthia A Mannion
- Faculty of Nursing, University of Calgary, 2800 University Way NW, Calgary, AB, T2N1N4, Canada
| | - Sheila W McDonald
- Cumming School of Medicine, Department of Paediatrics, University of Calgary, 2888 Shaganappi Trail NW, Calgary, Alberta, T3B 6A8, Canada
| | - Meredith Brockway
- Faculty of Nursing, University of Calgary, 2800 University Way NW, Calgary, AB, T2N1N4, Canada
| | - Suzanne C Tough
- Cumming School of Medicine, Department of Community Health Sciences, University of Calgary, TRW Building 3rd Floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.,Cumming School of Medicine, Department of Paediatrics, University of Calgary, 2888 Shaganappi Trail NW, Calgary, Alberta, T3B 6A8, Canada
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Nnebe-Agumadu UH, Racine EF, Laditka SB, Coffman MJ. Associations between perceived value of exclusive breastfeeding among pregnant women in the United States and exclusive breastfeeding to three and six months postpartum: a prospective study. Int Breastfeed J 2016; 11:8. [PMID: 27076839 PMCID: PMC4830081 DOI: 10.1186/s13006-016-0065-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 03/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Successful breastfeeding often starts with prenatally established intention. Yet, few mothers with the intention to exclusively breastfeed achieve their intended breastfeeding duration goal. This study examined the degree to which having a strong value of exclusive breastfeeding is associated with exclusive breastfeeding duration for at least 3 and 6 months postpartum among women who reported prenatal intention to exclusively breastfeed. METHODS Data were from the Infant Feeding Practices Study II, a longitudinal US national survey that followed maternal-infant dyads from pregnancy to 1 year postpartum. Bivariate and multivariate regression examined the degree to which strong maternal value of exclusive breastfeeding predicted exclusive breastfeeding duration. RESULTS Of the 1799 women who prenatally intended to exclusively breastfeed within the first few weeks postpartum, 34 and 9 % exclusively breastfed for at least 3 months and 6 months, respectively. Thirty-six percent of women reported strongly valuing exclusive breastfeeding out of which 46 % exclusively breastfeed to three months. In adjusted results, women who reported that they strongly value exclusive breastfeeding had more than twice the odds of exclusive breastfeeding for at least 3 months (Adjusted Odds Ratio [AOR] 2.29; 95 % confidence interval [CI] 1.84, 2.85) and for 6 months (AOR 2.49; 95 % CI 1.76, 3.53) compared to those who did not strongly value exclusive breastfeeding. CONCLUSION Valuing the benefits of exclusive breastfeeding during pregnancy is a strong independent predictor of actual exclusive breastfeeding duration. A minority of pregnant women strongly value exclusive breastfeeding and are able to exclusively breastfeed to 3 months even among women with established prenatal intention to exclusively breastfeed. Prenatal maternal education and environmental lactation support that extends into the postnatal period can promote longer duration of exclusive breastfeeding.
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Affiliation(s)
- Uche H. Nnebe-Agumadu
- />Affiliated with the Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223 USA
| | - Elizabeth F. Racine
- />Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223 USA
| | - Sarah B. Laditka
- />Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223 USA
| | - Maren J. Coffman
- />School of Nursing, College of Health and Human Services, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223 USA
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Miller J, Beharie MC, Taylor AM, Simmenes EB, Way S. Parent Reports of Exclusive Breastfeeding After Attending a Combined Midwifery and Chiropractic Feeding Clinic in the United Kingdom: A Cross-Sectional Service Evaluation. J Evid Based Complementary Altern Med 2016; 21:85-91. [PMID: 26763046 PMCID: PMC4768400 DOI: 10.1177/2156587215625399] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 12/03/2015] [Indexed: 12/24/2022] Open
Abstract
This service evaluation investigated an interdisciplinary allied professional health care strategy to address the problem of suboptimal breastfeeding. A clinic of midwives and chiropractors was developed in a university-affiliated clinic in the United Kingdom to care for suboptimal feeding through a multidisciplinary approach. No studies have previously investigated the effect of such an approach. The aim was to assess any impact to the breastfeeding dyad and maternal satisfaction after attending the multidisciplinary clinic through a service evaluation. Eighty-five initial questionnaires were completed and 72 (85%) follow-up questionnaires were returned. On follow-up, 93% of mothers reported an improvement in feeding as well as satisfaction with the care provided. Prior to treatment, 26% of the infants were exclusively breastfed. At the follow-up survey, 86% of mothers reported exclusive breastfeeding. The relative risk ratio for exclusive breastfeeding after attending the multidisciplinary clinic was 3.6 (95% confidence interval = 2.4-5.4).
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Affiliation(s)
- Joyce Miller
- Anglo-European College of Chiropractic, Bournemouth, UK
| | | | | | | | - Susan Way
- Bournemouth University, Bournemouth, UK
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Benoit A, Bell L, Simoneau-Roy J, Blouin S, Gallagher F. Les facteurs associés à la poursuite de l’allaitement maternel chez les jeunes mères canadiennes. SANTÉ PUBLIQUE 2015. [DOI: 10.3917/spub.151.0007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Abstract
BACKGROUND Changes in health care access and birthing practices may pose barriers to optimal breastfeeding in modernizing rural populations. OBJECTIVES We evaluated temporal and maternal age-related trends in birth and breastfeeding in a modernizing Maya agriculturalist community. We tested 2 hypotheses: (1) home births would be associated with better breastfeeding outcomes than hospital births, and (2) vaginal births would be associated with better breastfeeding outcomes than cesarean births. METHODS We interviewed 58 Maya mothers (ages 21-85) regarding their births and breastfeeding practices. General linear models were used to evaluate trends in birthing practices and breastfeeding outcomes (timing of breastfeeding initiation, use of infant formula, age of introduction of complementary feeding, and breastfeeding duration). We then compared breastfeeding outcomes by location (home or hospital) and mode of birth (vaginal or cesarean). RESULTS Timing of breastfeeding initiation and the rate of formula feeding both increased significantly over time. Younger mothers introduced complementary foods earlier, breastfed for shorter durations, and formula fed more than older mothers. Vaginal hospital births were associated with earlier breastfeeding initiation and longer breastfeeding durations than home births. Cesarean births were associated with later breastfeeding initiation, shorter breastfeeding durations, and more formula feeding than vaginal hospital births. CONCLUSION We have observed temporal and maternal age-related trends toward suboptimal breastfeeding patterns in the Maya community. Contrary to our first hypothesis, hospital births per se were not associated with negative breastfeeding outcomes. In support of our second hypothesis, cesarean versus vaginal births were associated with negative breastfeeding outcomes.
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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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Benites Rosito D, Gomes E, Cançado Figueiredo M, de Lima Flores I, Wisniewski F, Carletto-Körber F. The influence of the type of birth and maternal diet on the period of breastfeeding. JOURNAL OF ORAL RESEARCH 2014. [DOI: 10.17126/joralres.2014.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
BACKGROUND Nipple pain and damage are common in the early postpartum period and are associated with early cessation of breastfeeding and comorbidities such as depression, anxiety, and mastitis. The incidence of nipple vasospasm has not been reported previously. This article describes nipple pain and damage prospectively in first-time mothers and explores the relationship between method of birth and nipple pain and/or damage. SUBJECTS AND METHODS A prospective cohort of 360 primiparous women was recruited in Melbourne, Australia, in the interval 2009-2011, and after birth participants were followed up six times. The women completed a questionnaire about breastfeeding practices and problems at each time point. Pain scores were graphically represented using spaghetti plots to display each woman's experience of pain over the 8 weeks of the study. RESULTS After birth, before they were discharged home from hospital, 79% (250/317) of the women in this study reported nipple pain. Over the 8 weeks of the study 58% (198/336) of women reported nipple damage, and 23% (73/323) reported vasospasm. At 8 weeks postpartum 8% (27/340) of women continued to report nipple damage, and 20% (68/340) were still experiencing nipple pain. Ninety-four percent (320/340) of the women were breastfeeding at the end of the study, and there was no correlation between method of birth and nipple pain and/or damage. CONCLUSIONS Nipple pain is a common problem for new mothers in Australia and often persists for several weeks. Further studies are needed to establish the most effective means of preventing and treating breastfeeding problems in the postnatal period.
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Affiliation(s)
- Miranda L Buck
- 1 Mother and Child Health Research, La Trobe University , Melbourne, Victoria, Australia
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Wiwanitkit V. Breast feeding intent and early challenges after caesarean childbirth. Midwifery 2014; 30:e166. [PMID: 24529922 DOI: 10.1016/j.midw.2014.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 01/22/2014] [Indexed: 11/17/2022]
Affiliation(s)
- Viroj Wiwanitkit
- Hainan Medical University, China; Joseph Ayobabalola University, Nigeria; Faculty of Medicine, University of Nis, Serbia.
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Kroelinger CD, Barfield WD, Callaghan WM. Expanding and enhancing federal, state, tribal, and academic partnerships to advance the field of maternal and child health. Matern Child Health J 2012. [PMID: 23196411 DOI: 10.1007/s10995-012-1193-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Charlan D Kroelinger
- Division of Reproduction Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA 30341, USA.
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