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Ogundare E, Babatola A, Omoyajowo A, Ajite A, Adeniyi A, Fatunla O, Ojo T, Agbesanwa T, Olubosede O, Taiwo A, Oluyi A, Ajibola A, Komolafe A, Airemionkhale A, Oluwayemi I, Olatunya O. Breastfeeding: Knowledge, Perception, And Intention to Practice Among Female Students of Tertiary Institutions in Ekiti, Southwest Nigeria. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2023; 44:15-28. [PMID: 34353176 DOI: 10.1177/0272684x211034349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Breastfeeding is a public health practice that is critical for the survival of infants and young children. This study aimed at determining the knowledge, attitude, and future intention to breastfeed among female undergraduates in tertiary institutions in Ekiti State, Southwest Nigeria.Methodology: A prospective cross-sectional study was conducted among 1312 female students of the tertiary institutions in Ekiti State. By convenience sampling, female students were invited to participate in the study after giving verbal consent and those studying medical, nursing, and other courses allied to medicine were excluded. Internal consistency of the data obtained from this research instrument was determined using Cronbach's coefficient Alpha with a reliability value of 0.82. Data analysis was conducted using SPSS version 25. Descriptive as well as inferential statistics were computed. Results were summarized as frequencies and percentages. The differences in knowledge, attitude, and intention to practice breastfeeding as well as other responses among the participants were compared among age groups, faculties and the sources of information using Chi-square test. RESULT Although 93% of the respondents agreed that breast milk is important for the development of the infant's brain thereby demonstrating good knowledge; 51.6% of the respondents demonstrated poor perception to breastfeeding believing breastfeeding makes the breast to sag while only 34% of the respondents indicated their intention to breastfeed their future babies. CONCLUSION The intention to breastfeed among our study participants was poor. This study revealed the need to increase awareness about breastfeeding and its benefits among this huge population of future mothers.
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Affiliation(s)
- Ezra Ogundare
- Department of Paediatrics and Child Health, Ekiti State University, Ado-Ekiti, Nigeria
- Department of Paediatrics and Child Health, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Adefunke Babatola
- Department of Paediatrics and Child Health, Ekiti State University, Ado-Ekiti, Nigeria
- Department of Paediatrics and Child Health, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | | | - Adebukola Ajite
- Department of Paediatrics and Child Health, Ekiti State University, Ado-Ekiti, Nigeria
- Department of Paediatrics and Child Health, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Adewuyi Adeniyi
- Department of Paediatrics and Child Health, Ekiti State University, Ado-Ekiti, Nigeria
- Department of Paediatrics and Child Health, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Odunayo Fatunla
- Department of Paediatrics and Child Health, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Temitope Ojo
- Department of Community Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Tosin Agbesanwa
- Department of Paediatrics and Child Health, Ekiti State University, Ado-Ekiti, Nigeria
- Department of Paediatrics and Child Health, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Omolayo Olubosede
- Department of Paediatrics, University of Medical Sciences Teaching Hospital, Akure, Nigeria
| | - Adekunle Taiwo
- Department of Paediatrics and Child Health, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Adedayo Oluyi
- Department of Paediatrics and Child Health, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Ayotunde Ajibola
- Department of Paediatrics and Child Health, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Akinwumi Komolafe
- Department of Paediatrics and Child Health, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Alfred Airemionkhale
- Department of Paediatrics and Child Health, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Isaac Oluwayemi
- Department of Paediatrics and Child Health, Ekiti State University, Ado-Ekiti, Nigeria
- Department of Paediatrics and Child Health, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Oladele Olatunya
- Department of Paediatrics and Child Health, Ekiti State University, Ado-Ekiti, Nigeria
- Department of Paediatrics and Child Health, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
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Alabedi RF, Aljebouri AH, Al-Maaroof ZW. Acute Otitis Media-Associated Diarrhea in Children Less than 2 Years Old. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: the reported incidence of diarrhea in non-enteric infections can be questioned because many cases of diarrhea are adverse events associated with antibiotics. Although it is well known that one of the none-enteric infections that has diarrhea as one of its manifestations is acute otitis media, its sometimes missed as a possible cause. Objectives: to estimate the prevalence of acute otitis media in children presented with diarrhea and to describe the characteristics of acute otitis media-associated diarrhea after exclusion of antibiotics use. Method: sixty patients (age < 2 years) complaining from diarrhea as their chief complaint were included in this cross sectional study. Their ears had been examined using pneumatic otoscopy, looking for evidence of acute otitis media. Mother-directed specific questions related to the characters of diarrhea, constitutional symptoms, and associated symptoms had been used, in addition to laboratory stool exam. Results: patients involved in this study were 60, 22 (36.7%) females and 38 (63.3%) males. Their ages range from 1-19 months (8.31± 4.30). Acute otitis media was present in 27 cases (45%). There was significant association between acute otitis media-associated diarrhea and age under 1 year (p 0.017), underweight (p 0.012), and ear pain (p <0.001). Conclusions: acute otitis media is a very possible diagnosis for any young baby presented with diarrhea, especially in underweight infant with ear pain, so pneumatic otoscopic ear examination is recommended to be a routine for them.
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Venter C, Smith PK, Arshad H. Dietary strategies for the prevention of asthma in children. Curr Opin Allergy Clin Immunol 2022; 22:123-131. [PMID: 35197434 DOI: 10.1097/aci.0000000000000805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW This review summarizes information relating to dietary intake during pregnancy, lactation and early life that may prevent childhood asthma. This review also summarizes how future studies may be improved. RECENT FINDINGS Recent findings from observational studies suggest that eating according to certain dietary patterns during pregnancy, such as the dietary inflammatory index, Mediterranean diet and Maternal diet index, may reduce asthma and or wheeze in the child. Vitamin D supplementation with higher doses than recommended during pregnancy may be associated with reduced early transient childhood wheezing in the offspring. Higher levels of omega-3 fatty acids in breast milk may be protective against childhood asthma. Breastfeeding infants has been shown to offer many benefits to mother and child but a direct relationship between breastfeeding and the development of asthma has not been established. During childhood, infants and children may need to reduce their intake of advanced glycation end products, increase their food intake according to the traditional Mediterranean diet and increase the diversity of foods eaten. SUMMARY Current evidence provides limited suggestions regarding dietary changes for preventing early transient childhood wheezing. In order to harmonize methods for future data collection and reporting, it is important to harmonize relevant definitions and other important factors. The aim of the considerations described here is to enable a better comparison of future studies and provide better guidance to patients and families.
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Affiliation(s)
- Carina Venter
- Section of Allergy & Immunology, Department of Pediatrics, Children's Hospital Colorado, Denver, Aurora, Colorado, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Peter K Smith
- Griffith University Department of Clinical Medicine
- Qld Allergy Services, Southport, Queensland, Australia
| | - Hasan Arshad
- University of Southampton, Southampton
- The David Hide Asthma and Allergy Center, Isle of Wight, UK
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Brough HA, Lanser BJ, Sindher SB, Teng JMC, Leung DYM, Venter C, Chan SM, Santos AF, Bahnson HT, Guttman‐Yassky E, Gupta RS, Lack G, Ciaccio CE, Sampath V, Nadeau KC, Nagler CR. Early intervention and prevention of allergic diseases. Allergy 2022; 77:416-441. [PMID: 34255344 DOI: 10.1111/all.15006] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/09/2021] [Indexed: 12/12/2022]
Abstract
Food allergy (FA) is now one of the most common chronic diseases of childhood often lasting throughout life and leading to significant worldwide healthcare burden. The precise mechanisms responsible for the development of this inflammatory condition are largely unknown; however, a multifactorial aetiology involving both environmental and genetic contributions is well accepted. A precise understanding of the pathogenesis of FA is an essential first step to developing comprehensive prevention strategies that could mitigate this epidemic. As it is frequently preceded by atopic dermatitis and can be prevented by early antigen introduction, the development of FA is likely facilitated by the improper initial presentation of antigen to the developing immune system. Primary oral exposure of antigens allowing for presentation via a well-developed mucosal immune system, rather than through a disrupted skin epidermal barrier, is essential to prevent FA. In this review, we present the data supporting the necessity of (1) an intact epidermal barrier to prevent epicutaneous antigen presentation, (2) the presence of specific commensal bacteria to maintain an intact mucosal immune system and (3) maternal/infant diet diversity, including vitamins and minerals, and appropriately timed allergenic food introduction to prevent FA.
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Affiliation(s)
- Helen A. Brough
- Department Women and Children’s Health (Pediatric Allergy) School of Life Course Sciences Faculty of Life Sciences and Medicine King’s College London London UK
- Peter Gorer Department of Immunobiology School of Immunology and Microbial Sciences King’s College London London UK
- Children’s Allergy Service Evelina Children’s Hospital Guy’s and St. Thomas’s NHS Foundation Trust London UK
| | - Bruce Joshua Lanser
- Division of Pediatric Allergy‐Immunology Department of Pediatrics National Jewish Health Denver CO USA
| | - Sayantani B. Sindher
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University Stanford University Stanford CA USA
- Division of Pulmonary and Critical Care Medicine Department of Medicine Stanford University Stanford CA USA
- Division of Allergy, Immunology and Rheumatology Department of Medicine Stanford University Stanford CA USA
| | - Joyce M. C. Teng
- Department of Dermatology Lucile Packard Children's Hospital at the Stanford University School of Medicine Palo Alto CA USA
| | - Donald Y. M. Leung
- Division of Pediatric Allergy‐Immunology Department of Pediatrics National Jewish Health Denver CO USA
| | - Carina Venter
- Section of Allergy & Immunology School of Medicine University of Colorado DenverChildren's Hospital Colorado Aurora CO USA
| | - Susan M. Chan
- Department Women and Children’s Health (Pediatric Allergy) School of Life Course Sciences Faculty of Life Sciences and Medicine King’s College London London UK
- Peter Gorer Department of Immunobiology School of Immunology and Microbial Sciences King’s College London London UK
- Children’s Allergy Service Evelina Children’s Hospital Guy’s and St. Thomas’s NHS Foundation Trust London UK
| | - Alexandra F. Santos
- Department Women and Children’s Health (Pediatric Allergy) School of Life Course Sciences Faculty of Life Sciences and Medicine King’s College London London UK
- Peter Gorer Department of Immunobiology School of Immunology and Microbial Sciences King’s College London London UK
- Children’s Allergy Service Evelina Children’s Hospital Guy’s and St. Thomas’s NHS Foundation Trust London UK
- Asthma UK Centre in Allergic Mechanisms of Asthma London UK
| | - Henry T. Bahnson
- Benaroya Research Institute and Immune Tolerance Network Seattle WA USA
| | - Emma Guttman‐Yassky
- Department of Dermatology and the Immunology Institute Icahn School of Medicine at Mount Sinai New York NY USA
- Laboratory for Investigative Dermatology The Rockefeller University New York NY USA
| | - Ruchi S. Gupta
- Center for Food Allergy and Asthma Research Northwestern University Feinberg School of Medicine Chicago IL USA
- Ann & Robert H. Lurie Children's Hospital of Chicago Chicago IL USA
| | - Gideon Lack
- Department Women and Children’s Health (Pediatric Allergy) School of Life Course Sciences Faculty of Life Sciences and Medicine King’s College London London UK
- Peter Gorer Department of Immunobiology School of Immunology and Microbial Sciences King’s College London London UK
- Children’s Allergy Service Evelina Children’s Hospital Guy’s and St. Thomas’s NHS Foundation Trust London UK
| | | | - Vanitha Sampath
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University Stanford University Stanford CA USA
| | - Kari C. Nadeau
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University Stanford University Stanford CA USA
- Division of Pulmonary and Critical Care Medicine Department of Medicine Stanford University Stanford CA USA
- Division of Allergy, Immunology and Rheumatology Department of Medicine Stanford University Stanford CA USA
| | - Cathryn R. Nagler
- Department of Pathology and Pritzker School of Molecular Engineering University of Chicago Chicago IL USA
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Frank NM, Lynch KF, Uusitalo U, Yang J, Lönnrot M, Virtanen SM, Hyöty H, Norris JM. The relationship between breastfeeding and reported respiratory and gastrointestinal infection rates in young children. BMC Pediatr 2019; 19:339. [PMID: 31533753 PMCID: PMC6749679 DOI: 10.1186/s12887-019-1693-2] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 08/26/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Although breastfeeding is touted as providing many health benefits to infants, some aspects of this relationship remain poorly understood. METHODS The Environmental Determinants of Diabetes in the Young (TEDDY) is a prospective longitudinal study that follows children from birth through childhood, and collects data on illness events, breastfeeding duration, and time to introduction of formula or foods at 3 month intervals up until 4 years of age and at 6 months intervals thereafter. Exclusive and non-exclusive breastfeeding is examined in relation to the 3-month odds of a respiratory or gastrointestinal infection for 6861 children between the ages of 3-18 months, and 5666 children up to the age of 4 years. Analysis was performed using logistic regression models with generalized estimating equation methodology. All models were adjusted for potential confounding variables. RESULTS At 3-6 months of age, breastfeeding was found to be inversely associated with the odds of respiratory infections with fever (OR = 0.82, 95% CI = 0.70-0.95), otitis media (OR = 0.76, 95% CI = 0.62-0.94), and infective gastroenteritis (OR = 0.55, 95% CI = 0.46-0.70), although the inverse association with respiratory illnesses was observed only for girls during the winter months. Between 6 and 18 months of age, breastfeeding within any 3 month period continued to be inversely associated with the odds of ear infection and infective gastroenteritis, and additionally with the odds of conjunctivitis, and laryngitis and tracheitis, over the same 3 month period within this age range. However, breastfeeding in this group was associated with increased reports of common cold. Duration of exclusive breastfeeding was inversely associated with the odds of otitis media up to 48 months of age (OR = 0.97, 95% CI = 0.95-0.99) after breastfeeding had stopped. CONCLUSIONS This study demonstrates that breastfeeding can be protective against multiple respiratory and gastrointestinal acute illnesses in some children up to at least 6 months of age, with duration of exclusive breastfeeding being somewhat protective of otitis media even after breastfeeding has stopped. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT00279318 . Date of registration: January 17, 2006 (proactively registered). First Posted: January 19, 2006.
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Grants
- U01 DK063821 NIDDK NIH HHS
- UC4 DK063863 NIDDK NIH HHS
- U01 DK063861 NIDDK NIH HHS
- U01 DK63829, U01 DK63861, U01 DK63821, U01 DK63865, U01 DK63863, U01 DK63836, U01 DK63790, UC4 DK63829, UC4 DK63861, UC4 DK63821, UC4 DK63865, UC4 DK63863, UC4 DK63836, UC4 DK95300, UC4 DK100238, UC4 DK106955, UC4 DK112243, UC4 DK117483, and Contract No. HHSN267200700014C NIDDK NIH HHS
- HHSN267200700014C NLM NIH HHS
- U01 DK063836 NIDDK NIH HHS
- U01 DK063829 NIDDK NIH HHS
- U01 DK063865 NIDDK NIH HHS
- UC4 DK095300 NIDDK NIH HHS
- UC4 DK063861 NIDDK NIH HHS
- UC4 DK063829 NIDDK NIH HHS
- UC4 DK063821 NIDDK NIH HHS
- UC4 DK117483 NIDDK NIH HHS
- UL1 TR001082 NCATS NIH HHS
- UC4 DK063836 NIDDK NIH HHS
- UC4 DK112243 NIDDK NIH HHS
- UC4 DK063865 NIDDK NIH HHS
- U01 DK063863 NIDDK NIH HHS
- U01 DK063790 NIDDK NIH HHS
- UL1 TR000064 NCATS NIH HHS
- UC4 DK106955 NIDDK NIH HHS
- UC4 DK100238 NIDDK NIH HHS
- National Institute of Diabetes and Digestive and Kidney Diseases
- National Institute of Diabetes and Digestive and Kidney Diseases (US)
- National Institute of Child Health and Human Development
- National Institute of Environmental Health Sciences
- National Center for Injury Prevention and Control (US)
- Juvenile Diabetes Research Foundation United States of America
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Affiliation(s)
- Nicole M. Frank
- University of Virginia Children’s Hospital, Charlottesville, VA USA
| | - Kristian F. Lynch
- Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL USA
| | - Ulla Uusitalo
- Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL USA
| | - Jimin Yang
- Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL USA
| | - Maria Lönnrot
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Suvi M. Virtanen
- National Institute for Health and Welfare, Helsinki, Finland
- School of Health Sciences, University of Tampere, Tampere, Finland
- Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland
- The Science Center of Pirkanmaa Hospital District, Tampere, Finland
| | - Heikki Hyöty
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
- Fimlab Laboratories, Pirkanmaa Hospital District, Tampere, Finland
| | - Jill M. Norris
- Department of Epidemiology, University of Colorado Denver, Colorado School of Public Health, Aurora, CO USA
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Das A, Chatterjee R, Karthick M, Mahapatra T, Chaudhuri I. The Influence of Seasonality and Community-Based Health Worker Provided Counselling on Exclusive Breastfeeding - Findings from a Cross-Sectional Survey in India. PLoS One 2016; 11:e0161186. [PMID: 27513642 PMCID: PMC4981308 DOI: 10.1371/journal.pone.0161186] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 08/01/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Exclusive breastfeeding (EBF) during the first six months of life is considered a high impact but low-cost measure for reducing the morbidity and mortality among children. The current study investigated the association of seasonality and frontline worker(FLW) provided counselling with practice of EBF in Bihar, India. METHODS We used the 'Lot Quality Assurance Sampling' technique to conduct a multi-stage sampling survey in 8 districts of Bihar. Regarding EBF, mothers of 0-5 (completed) months old children were asked if they had given only breastmilk to their children during the previous day, while mothers of 6-8 (completed) months old children were inquired about the total duration of EBF. We tested for association between EBF during the previous day with season of interview and EBF for full 6 months with nursing season. We also assessed if receiving counselling on EBF and complementary feeding had any association with relevant EBF indicators. RESULTS Among the under-6 month old children, 76% received EBF during the previous day, whereas 92% of 6-8 (completed) months old children reportedly received EBF for the recommended duration. Proportion of 0-5 (completed) month old children receiving only breastmilk (during last 24 hours) decreased significantly with increasing age and with change of season from colder to warmer months. Odds of receiving only breastmilk during the previous day was significantly higher during the winter months (Adjusted odds ratio(AOR) = 1.50; 95% CI = 1.37, 1.63) compared to summer. Also, the children nursed primarily during the winter season had higher odds of receiving EBF for 6 months (AOR = 1.90, 95% CI = 1.43, 2.52) than those with non-winter nursing. Receiving FLW-counselling was positively associated with breastfeeding exclusively, even after adjusting for seasonality and other covariates (AOR = 1.82; 95% CI = 1.67, 1.98). CONCLUSIONS Seasonality is a significant but non-modifiable risk factor for EBF. However, FLW-counselling was found to increase practice of EBF irrespective of season. Scale-up of FLW-counselling services, with emphasis on summer months and mothers of older infants, can potentially reduce the impact of seasonality on EBF.
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Affiliation(s)
- Aritra Das
- CARE India Solutions for Sustainable Development, H No. 14, Patliputra Colony, Patna, Bihar, India
| | - Rahul Chatterjee
- CARE India Solutions for Sustainable Development, H No. 14, Patliputra Colony, Patna, Bihar, India
| | - Morchan Karthick
- CARE India Solutions for Sustainable Development, H No. 14, Patliputra Colony, Patna, Bihar, India
| | - Tanmay Mahapatra
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, United States of America
- * E-mail:
| | - Indrajit Chaudhuri
- CARE India Solutions for Sustainable Development, H No. 14, Patliputra Colony, Patna, Bihar, India
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Casazza K, Brown A, Astrup A, Bertz F, Baum C, Brown MB, Dawson J, Durant N, Dutton G, Fields DA, Fontaine KR, Heymsfield S, Levitsky D, Mehta T, Menachemi N, Newby PK, Pate R, Raynor H, Rolls BJ, Sen B, Smith DL, Thomas D, Wansink B, Allison DB. Weighing the Evidence of Common Beliefs in Obesity Research. Crit Rev Food Sci Nutr 2015; 55:2014-53. [PMID: 24950157 PMCID: PMC4272668 DOI: 10.1080/10408398.2014.922044] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Obesity is a topic on which many views are strongly held in the absence of scientific evidence to support those views, and some views are strongly held despite evidence to contradict those views. We refer to the former as "presumptions" and the latter as "myths." Here, we present nine myths and 10 presumptions surrounding the effects of rapid weight loss; setting realistic goals in weight loss therapy; stage of change or readiness to lose weight; physical education classes; breastfeeding; daily self-weighing; genetic contribution to obesity; the "Freshman 15"; food deserts; regularly eating (versus skipping) breakfast; eating close to bedtime; eating more fruits and vegetables; weight cycling (i.e., yo-yo dieting); snacking; built environment; reducing screen time in childhood obesity; portion size; participation in family mealtime; and drinking water as a means of weight loss. For each of these, we describe the belief and present evidence that the belief is widely held or stated, reasons to support the conjecture that the belief might be true, evidence to directly support or refute the belief, and findings from randomized controlled trials, if available. We conclude with a discussion of the implications of these determinations, conjecture on why so many myths and presumptions exist, and suggestions for limiting the spread of these and other unsubstantiated beliefs about the obesity domain.
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Affiliation(s)
- Krista Casazza
- a Department of Nutrition Sciences , University of Alabama at Birmingham , Birmingham , Alabama USA
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Silva DE, Nóbrega L, Valente A, Dias C, Almeida F, Cruz JL, Neves E, Afonso C, Guerra A. Aleitamento materno e caracterização dos hábitos alimentares na primeira infância: experiência de São Tomé e Príncipe. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2014. [DOI: 10.1590/s1519-38292014000300008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivos: avaliação da amamentação, da diversificação e frequência alimentar, em crianças de São Tomé e Príncipe (STP). Métodos: trata-se de uma amostra constituída por 1285 crianças. O protocolo incluiu a prevalência do aleitamento materno exclusivo (AME) e Total (AMT), início da diversificação alimentar (DA) e um questionário de frequência alimentar. O tratamento estatístico foi efetuado no SPSS®. Os resultados foram apresentados de acordo com o total da amostra. Resultados: 45,5% são do sexo feminino e a média de idades 26±18 meses. 46,6% fez AME até aos 6 meses (média 5±2). A média de AMT foi 12±7 meses e o início da DA aos 6±3 meses (mediana=6), sendo as farinhas e a canja de peixe os primeiros alimentos oferecidos. 42% das crianças são incluídas na dieta familiar aos 7±3 meses (mediana=6). Elevada porcentagem de crianças nunca ingere: leite de vaca (74%) ou iogurte (40%), contrariamente ao elevado consumo de óleo alimentar (34%) e açúcar (33%). A idade média de iniciação da cerveja é aos 18±12 meses e vinho de palma 13±10 meses. Conclusões: observa-se uma elevada prevalência de AME e uma precoce introdução da DA. Embora existam recursos alimentares disponíveis, não há informação/ formação adequada para elaborar um plano alimentar saudável durante a infância.
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Affiliation(s)
- Diana e Silva
- Unidade de Nutrição/Hospital Pediátrico Integrado/Centro Hospitalar São João. Faculdade Ciências Nutrição e Alimentação. Universidade Porto. Alameda Professor Hernâni Monteiro. 4200-455. Porto, Portugal. E-mail: , Portugal
| | - Laura Nóbrega
- Unidade de Nutrição/Hospital Pediátrico Integrado/Centro Hospitalar São João. Faculdade Ciências Nutrição e Alimentação. Universidade Porto. Alameda Professor Hernâni Monteiro. 4200-455. Porto, Portugal. E-mail: , Portugal
| | - Ana Valente
- Unidade de Nutrição/Hospital Pediátrico Integrado/Centro Hospitalar São João. Faculdade Ciências Nutrição e Alimentação. Universidade Porto. Alameda Professor Hernâni Monteiro. 4200-455. Porto, Portugal. E-mail: , Portugal
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Hamade H, Naja F, Keyrouz S, Hwalla N, Karam J, Al-Rustom L, Nasreddine L. Breastfeeding knowledge, attitude, perceived behavior, and intention among female undergraduate university students in the Middle East: the case of Lebanon and Syria. Food Nutr Bull 2014; 35:179-90. [PMID: 25076765 DOI: 10.1177/156482651403500204] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND The Middle East has one of the lowest rates of exclusive breastfeeding in the world, highlighting the need to promote breastfeeding in this region. Young adults represent a key population of interest, since decisions about infant-feeding appear to be made before children are even conceived. OBJECTIVE To examine breastfeeding knowledge, attitude, and perceived behavior among female undergraduate students in Lebanon and Syria and determine factors associated with intention to breastfeed in this population. METHODS This cross-sectional study was conducted in 2010/11 in Damascus and Beirut. Four universities were selected in each city. A multicomponent questionnaire was administered to a convenience sample of participants (n = 194 from Beirut and n = 199 from Damascus). The questionnaire included breastfeeding knowledge (measured by the Infant Feeding Knowledge Test Form), attitude (Iowa Infant Feeding Attitude Scale), perceived behavior (Breastfeeding Behavior Questionnaire), and intention (Infant Feeding Intention Scale). Factors associated with intention to breastfeed were examined by multivariate linear regression analysis. RESULTS The participants had an average breastfeeding knowledge level (mean score, 10.39 +/- 2.09) and neutral perceived behavior (mean score, 22.00 +/- 3.68), while having relatively positive attitudes (mean score, 58.12 +/- 6.49). Knowledge gaps and negative perceptions were identified, particularly linked to breastfeeding in public and among working mothers. Breastfeeding intention was found to be significantly associated with knowledge and attitude in Lebanon (beta = 0.103 and beta = 0.230, respectively), and with perceived behavior in Syria (beta = -0.135). CONCLUSIONS By revealing specific knowledge gaps and misconceptions and identifying country-specific disparities in the predictors of the intention to breastfeed, the findings of this study may provide a basis for devising culture-specific interventions aimed at promoting breastfeeding.
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Lippitt M, Reese Masterson A, Sierra A, Davis AB, White MA. An Exploration of Social Desirability Bias in Measurement of Attitudes toward Breastfeeding in Public. J Hum Lact 2014; 30:358-366. [PMID: 24692103 DOI: 10.1177/0890334414529020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Measurement of attitudes toward breastfeeding has been based on self-report, which may be subject to social desirability. Increasing the perceived anonymity of questionnaires may reduce social desirability bias, producing more accurate results. OBJECTIVE We compare a standard questionnaire (SQ) with the unmatched count technique (UCT) to understand the effect of increased perceived anonymity on self-reported attitudes toward breastfeeding in public. METHODS Measures of attitudes toward breastfeeding in public were adapted from existing questionnaires, subjected to expert review, and pilot tested. A web-based survey was then constructed to compare the UCT and the SQ technique. Participants were recruited online and randomly assigned to either the SQ or the UCT condition. RESULTS In the overall sample (N = 1477), the UCT condition had significantly higher endorsement for the statement, "Breastfeeding in some public settings should be against the law" [χ2(1, n = 1455) = 9.58, P = .002]. Women more frequently endorsed that item in the UCT condition (15.6%) than in the SQ condition (7.1%) [χ2(1, n = 1025) = 18.27, P < .001]. In contrast, among men, rates of endorsement did not vary between experimental and control groups for that question. CONCLUSION Perceived anonymity may have influenced responses to some questions about attitudes toward breastfeeding in public. The effects of perceived anonymity may operate differently within demographic sectors. The direction of the effects was not always consistent with hypotheses, and future research is needed to fully explore the various dimensions of attitudes toward breastfeeding. The UCT method shows promise for improving the accuracy of reporting attitudes toward breastfeeding.
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Affiliation(s)
| | | | - Ana Sierra
- School of Public Health, Yale University, New Haven, CT, USA
| | - Amy B Davis
- School of Public Health, Yale University, New Haven, CT, USA
| | - Marney A White
- School of Public Health, Yale University, New Haven, CT, USA Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Evans A, Marinelli KA, Taylor JS. ABM clinical protocol #2: Guidelines for hospital discharge of the breastfeeding term newborn and mother: "The going home protocol," revised 2014. Breastfeed Med 2014; 9:3-8. [PMID: 24456024 PMCID: PMC3903163 DOI: 10.1089/bfm.2014.9996] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.
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Affiliation(s)
- Amy Evans
- University of California San Francisco—Fresno, Fresno, California
- Center for Breastfeeding Medicine and Mother's Resource Center at Community Regional Medical Center, Fresno, California
| | - Kathleen A. Marinelli
- Division of Neonatology and Connecticut Human Milk Research Center, Connecticut Children's Medical Center, Hartford, Connecticut
- University of Connecticut School of Medicine, Farmington, Connecticut
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Li Y, Dang S, Deng H, Wang W, Jia X, Gao N, Li M, Wang J. Breastfeeding, previous Epstein-Barr virus infection, Enterovirus 71 infection, and rural residence are associated with the severity of hand, foot, and mouth disease. Eur J Pediatr 2013; 172:661-6. [PMID: 23344210 DOI: 10.1007/s00431-013-1939-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Accepted: 01/09/2013] [Indexed: 12/12/2022]
Abstract
Severe hand, foot, and mouth disease (HFMD) is likely to develop critical complications such as brainstem encephalitis, acute pulmonary edema, and circulatory failure, which cause child mortality during outbreaks. This study aims to investigate factors that predict the severity of HFMD. One hundred sixteen in-patient children with severe HFMD and 202 with mild HFMD were retrospectively enrolled. Potential factors were collected for each child including sex, age, residence, modes of delivery, birth weight, virus types causing HFMD, and virus exposure history. Univariate and multivariable logistic regression were used to determine which factors were associated with HFMD severity. In the univariate analysis, breastfeeding (OR 0.514, 95 % CI 0.309-0.856), rural residence (OR 1.971, 95 % CI 1.239-3.137), current Enterovirus 71 (EV71) infection (OR 2.539, 95 % CI 1.504-4.287), and previous Epstein-Barr virus (EBV) exposure (OR 3.136, 95 % CI 1.863-5.278) were each associated with the severity of HFMD. In the multivariate model, breastfeeding (OR 0.570, 95 % CI 0.332-0.980), rural residence (OR 1.973, 95 % CI 1.202-3.237), current EV71 infection (OR 2.290, 95 % CI 1.315-3.987), and previous EBV exposure (OR 2.550, 95 % CI 1.470-4.422) remained independently associated with the severity of HFMD. In conclusion, previous EBV exposure, EV71 infection, and rural residence are risk factors for severe HFMD; breastfeeding is a protective factor.
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Affiliation(s)
- Yaping Li
- Department of Infectious Diseases, Second Affiliated Hospital of Medical School, Xi'an Jiaotong University, No. 157, Xiwu Road, Xi'an, Shaanxi 710004, China
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Galbally M, Lewis AJ, McEgan K, Scalzo K, Islam FA. Breastfeeding and infant sleep patterns: an Australian population study. J Paediatr Child Health 2013; 49:E147-52. [PMID: 23331519 DOI: 10.1111/jpc.12089] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/13/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Our purpose was to determine if babies breastfed at 6 months of age were more likely to wake at night and less likely to sleep alone than formula-fed babies. PATIENTS AND METHODS Data were drawn from the first wave of The Longitudinal Study of Australian Children, an ongoing, nationally representative study of the growth and development of Australia's children. The 4507 participants met the criteria for this study. The measures examined infant sleep problems as the outcome and breastfeeding at 6 months of age as the exposure in addition to the demographic data, maternal mental health, infant birthweight and gestational age at delivery. RESULTS After adjustment for covariates, reports by mothers of infants that breastfed at 6 months of age suggested infants were 66% more likely to wake during the night and 72% more likely to report difficulty sleeping alone. However, breastfeeding had a strongly protective effect on wheezing, coughing, snoring and breathing problems, and it was not associated with restless sleep or problems getting to sleep for the infant. CONCLUSIONS Breastfeeding was found to be associated with increased night waking and this is consistent with other studies. There are biological reasons why this might be required to ensure breastfeeding continues to 6 months and beyond. The current low rates of sustained breastfeeding in many Western countries needs to be reconsidered in relation to parental and public health practices promoting prolonged nocturnal infant sleep patterns.
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Affiliation(s)
- Megan Galbally
- Perinatal Mental Health Unit, Deakin University, Melbourne, Victoria, Australia.
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Lee HC, Kurtin PS, Wight NE, Chance K, Cucinotta-Fobes T, Hanson-Timpson TA, Nisbet CC, Rhine WD, Risingsun K, Wood M, Danielsen BH, Sharek PJ. A quality improvement project to increase breast milk use in very low birth weight infants. Pediatrics 2012; 130:e1679-87. [PMID: 23129071 PMCID: PMC3507251 DOI: 10.1542/peds.2012-0547] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To evaluate a multihospital collaborative designed to increase breast milk feeding in premature infants. METHODS Eleven NICUs in the California Perinatal Quality of Care Collaborative participated in an Institute for Healthcare Improvement-style collaborative to increase NICU breast milk feeding rates. Multiple interventions were recommended with participating sites implementing a self-selected combination of these interventions. Breast milk feeding rates were compared between baseline (October 2008-September 2009), implementation (October 2009-September 2010), and sustainability periods (October 2010-March 2011). Secondary outcome measures included necrotizing enterocolitis (NEC) rates and lengths of stay. California Perinatal Quality of Care Collaborative hospitals not participating in the project served as a control population. RESULTS The breast milk feeding rate in the intervention sites improved from baseline (54.6%) to intervention period (61.7%; P = .005) with sustained improvement over 6 months postintervention (64.0%; P = .003). NEC rates decreased from baseline (7.0%) to intervention period (4.3%; P = .022) to sustainability period (2.4%; P < .0001). Length of stay increased during the intervention but returned to baseline levels in the sustainability period. Control hospitals had higher rates of breast milk feeding at baseline (64.2% control vs 54.6% participants, P < .0001), but over the course of the implementation (65.7% vs 61.7%, P = .049) and sustainability periods (67.7% vs 64.0%, P = .199), participants improved to similar rates as the control group. CONCLUSIONS Implementation of a breast milk/nutrition change package by an 11-site collaborative resulted in an increase in breast milk feeding and decrease in NEC that was sustained over an 18-month period.
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Affiliation(s)
- Henry C. Lee
- Division of Neonatology, Department of Pediatrics, University of California, San Francisco, San Francisco, California;,California Perinatal Quality Care Collaborative, Stanford, California
| | - Paul S. Kurtin
- Department of Quality Management, Rady Children’s Hospital, San Diego, California
| | - Nancy E. Wight
- Sharp Mary Birch Hospital for Women and Infants, San Diego, California
| | - Kathy Chance
- Children’s Medical Services Branch, California Department of Health Care Services, Sacramento, California
| | | | | | | | | | | | | | | | - Paul J. Sharek
- California Perinatal Quality Care Collaborative, Stanford, California;,General Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California;,Center for Quality and Clinical Effectiveness, Lucile Packard Children’s Hospital, Palo Alto, California; and
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Ogbuanu C, Glover S, Probst J, Hussey J, Liu J. Balancing work and family: effect of employment characteristics on breastfeeding. J Hum Lact 2011; 27:225-38; quiz 293-5. [PMID: 21393503 DOI: 10.1177/0890334410394860] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article describes an investigation of the effect of postpartum employment and occupational type on breastfeeding initiation and duration. Data were from the Early Childhood Longitudinal Study-Birth Cohort. Postpartum employment status was classified as full-time, part-time, and not employed. Among postpartum workers, occupational type was classified as management, professional, service, sales, administrative, and "other." In adjusted analysis, professional women had a 20% greater likelihood of initiating breastfeeding than administrative workers (risk ratio [RR] 1.20; 95% confidence interval [CI], 1.06-1.30). Full-time workers had a 10% lower likelihood of initiating breastfeeding than those not employed (RR 0.90; 95% CI, 0.82-0.97). Among breastfeeding initiators, full-time workers had a 19% lower likelihood of any breastfeeding beyond 6 months than those not employed (RR 0.81; 95% CI, 0.65-0.99). To improve breastfeeding initiation and duration in the United States, part-time options may be an effective solution for working mothers.
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Affiliation(s)
- Chinelo Ogbuanu
- Georgia Department of Community Health, Atlanta, GA 30303, USA.
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Ogbuanu C, Glover S, Probst J, Liu J, Hussey J. The effect of maternity leave length and time of return to work on breastfeeding. Pediatrics 2011; 127:e1414-27. [PMID: 21624878 PMCID: PMC3387873 DOI: 10.1542/peds.2010-0459] [Citation(s) in RCA: 154] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We investigated the effect of maternity leave length and time of first return to work on breastfeeding. METHODS Data were from the Early Childhood Longitudinal Study-Birth Cohort. Restricting our sample to singletons whose biological mothers were the respondents at the 9-month interview and worked in the 12 months before delivery (N = 6150), we classified the length of total maternity leave (weeks) as 1 to 6, 7 to 12, ≥ 13, and did not take; paid maternity leave (weeks) as 0, 1 to 6, ≥ 7, and did not take; and time of return to work postpartum (weeks) as 1 to 6, 7 to 12, ≥ 13, and not yet returned. Analyses included χ(2) tests and multiple logistic regressions. RESULTS In our study population, 69.4% initiated breastfeeding with positive variation by both total and paid maternity leave length, and time of return to work. In adjusted analyses, neither total nor paid maternity leave length had any impact on breastfeeding initiation or duration. Compared with those returning to work within 1 to 6 weeks, women who had not yet returned to work had a greater odds of initiating breastfeeding (odds ratio [OR]: 1.46 [1.08-1.97]; risk ratios [RR]: 1.13 [1.03-1.22]), continuing any breastfeeding beyond 6 months (OR: 1.41 [0.87-2.27]; RR: 1.25 [0.91-1.61]), and predominant breastfeeding beyond 3 months (OR: 2.01 [1.06-3.80]; RR: 1.70 [1.05-2.53]). Women who returned to work at or after 13 weeks postpartum had higher odds of predominantly breastfeeding beyond 3 months (OR: 2.54 [1.51-4.27]; RR: 1.99 [1.38-2.69]). CONCLUSION If new mothers delay their time of return to work, then duration of breastfeeding among US mothers may lengthen.
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Affiliation(s)
- Chinelo Ogbuanu
- Maternal and Child Health Program, Division of Public Health, Georgia Department of Community Health, Atlanta, Georgia, USA.
| | - Saundra Glover
- Department of Health Services Policy and Management, ,Institute for Partnerships to Eliminate Health Disparities, and
| | - Janice Probst
- Department of Health Services Policy and Management, ,South Carolina Rural Health Research Center, Columbia, South Carolina
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; and
| | - James Hussey
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; and
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Krause KM, Lovelady CA, Østbye T. Predictors of breastfeeding in overweight and obese women: data from Active Mothers Postpartum (AMP). Matern Child Health J 2011; 15:367-75. [PMID: 20821042 PMCID: PMC3059395 DOI: 10.1007/s10995-010-0667-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Excess maternal weight has been negatively associated with breastfeeding. We examined correlates of breastfeeding initiation and intensity in a racially diverse sample of overweight and obese women. This paper presents a secondary analysis of data from 450 women enrolled in a postpartum weight loss intervention (Active Mothers Postpartum [AMP]). Sociodemographic measures and body mass index (BMI), collected at 6 weeks postpartum, were examined for associations with breastfeeding initiation and lactation score (a measure combining duration and exclusivity of breastfeeding until 12 months postpartum). Data were collected September 2004-April 2007. In multivariable analyses, BMI was negatively associated with both initiation of breastfeeding (OR: .96; CI: .92-.99) and lactation score (β -0.22; P = 0.01). Education and infant gestational age were additional correlates of initiation, while race, working full-time, smoking, parity, and gestational age were additional correlates of lactation score. Some racial differences in these correlates were noted, but were not statistically significant. Belief that breastfeeding could aid postpartum weight loss was initially high, but unrelated to breastfeeding initiation or intensity. Maintenance of this belief over time, however, was associated with lower lactation scores. BMI was negatively correlated with breastfeeding initiation and intensity. Among overweight and obese women, unrealistic expectations regarding the effect of breastfeeding on weight loss may negatively impact breastfeeding duration. In general, overweight and obese women may need additional encouragement to initiate breastfeeding and to continue breastfeeding during the infant's first year.
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Affiliation(s)
- Katrina M Krause
- Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27710, USA.
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Li J, Dykman RA, Jing H, Gilchrist JM, Badger TM, Pivik RT. Cortical responses to speech sounds in 3- and 6-month-old infants fed breast milk, milk formula, or soy formula. Dev Neuropsychol 2011; 35:762-84. [PMID: 21038165 DOI: 10.1080/87565641.2010.508547] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Controversy exists about the safety of soy formula, with the main concern relating to potential estrogenic effects of soy protein. Since estrogens influence early brain development, we compared behavioral development and cortical responses (event-related potentials; ERPs) to speech sounds in infants fed either breast milk or formula (milk- or soy-based). Across-groups ERP measures were generally similar and behavioral measures were within normal ranges, suggesting no important influences of soy formula on behavioral development and brain function during the study period. Analyses relating ERP and behavioral measures revealed diet- and gender-specific emphases that may reflect differences in developmental trajectories of brain-behavior relationships.
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Affiliation(s)
- Juan Li
- Arkansas Children's Nutrition Center, Little Rock, Arkansas 72202, USA
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Abstract
OBJECTIVE This study investigated associations between maternal and infant factors and breastfeeding practices in infants born <30 weeks gestation in the neonatal intensive care unit (NICU). STUDY DESIGN This study was a retrospective cohort. Mother and infant characteristics were investigated for associations with breastfeeding outcomes using multivariate logistic regression. RESULTS Seventy-eight percent of infants initiated breastmilk feedings, 48% of those continued to have breastmilk at discharge, and 52% were breastfed in the hospital. The average duration of breastmilk feedings was 43 days. Mothers who were married and had a multiple-infant birth were more likely to initiate breastmilk feeds, African American mothers and younger mothers had less success with maintaining breastmilk feeds until hospital discharge, and African American mothers and mothers of lower socioeconomic status were less likely to participate in direct breastfeeding in the NICU. CONCLUSIONS Infant factors, such as birth weight and gestational age, were not associated with breastfeeding behaviors. Mothers can succeed with breastfeeding the premature infant. By understanding what maternal groups are at risk for breastfeeding failure, targeted interventions in the NICU can be implemented.
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Haughton J, Gregorio D, Pérez-Escamilla R. Factors associated with breastfeeding duration among Connecticut Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants. J Hum Lact 2010; 26:266-73. [PMID: 20689103 PMCID: PMC3131548 DOI: 10.1177/0890334410365067] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This retrospective study aimed to identify factors associated with breastfeeding duration among women enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) of Hartford, Connecticut. The authors included mothers whose children were younger than 5 years and had stopped breastfeeding (N = 155). Women who had planned their pregnancies were twice as likely as those who did not plan them to breastfeed for more than 6 months (odds ratio, 2.15; 95% confidence interval, 1.00-4.64). One additional year of maternal age was associated with a 9% increase on the likelihood of breastfeeding for more than 6 months (odds ratio, 1.09; 95% confidence interval, 1.02-1.17). Time in the United States was inversely associated with the likelihood of breastfeeding for more than 6 months (odds ratio, 0.96; 95% confidence interval, 0.92-0.99). Return to work, sore nipples, lack of access to breast pumps, and free formula provided by WIC were identified as breastfeeding barriers. Findings can help WIC improve its breastfeeding promotion efforts.
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Ho YJ, McGrath JM. A Review of the Psychometric Properties of Breastfeeding Assessment Tools. J Obstet Gynecol Neonatal Nurs 2010; 39:386-400. [DOI: 10.1111/j.1552-6909.2010.01153.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
Human milk is the preferred choice for infant feeding. When a sick or premature infant's own mother's milk is unavailable, donor human milk is becoming more widely used. Many potential milk donors do not live within close proximity to the 10 North American not-for-profit milk banks. Transporting milk via commercial carriers can be inconvenient and costly for recipient banks. A network of donor human milk depots is one practical way to increase the quantity of available donor human milk. This article provides guidelines and practical suggestions for establishing a donor human milk depot.
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Bai Y, Middlestadt SE, Peng CYJ, Fly AD. Predictors of continuation of exclusive breastfeeding for the first six months of life. J Hum Lact 2010; 26:26-34. [PMID: 19910521 DOI: 10.1177/0890334409350168] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to investigate the relative importance of the psychosocial factors underlying mother's decision to continue exclusive breastfeeding (EBF) for 6 months using the theory of planned behavior. A cohort of EBF-mothers (N = 78) completed a questionnaire assessing theoretical constructs at baseline and phone-interviewed at follow-up. Multiple regression analyses were performed to find important predictors of intention, overall and married vs unmarried. Attitude, subjective norm, and perceived behavioral control together explained 50.2% (P < .01) of the variance in mothers' intention to continue EBF for 6 months. Attitude and subjective norm were better predictors of the intention than perceived behavioral control. The role of subjective norm was greater in married than in unmarried women. A strong, positive correlation (gamma = 0.67, P < .01) was found between intended and actual EBF duration. Intervention programs designed to positively influence mother's attitude and social support may be effective in improving intention, thereby increasing EBF maintenance for 6 months.
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Affiliation(s)
- Yeon Bai
- Department of Health and Nutrition Sciences at Montclair State University, NJ 07043, USA.
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Reasons why women do not initiate breastfeeding: A southeastern state study. Womens Health Issues 2009; 19:268-78. [PMID: 19589476 DOI: 10.1016/j.whi.2009.03.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Revised: 02/18/2009] [Accepted: 03/17/2009] [Indexed: 01/07/2023]
Abstract
PURPOSE Despite the increase in breastfeeding initiation and duration in the United States, only five states have met the three Healthy People 2010 breastfeeding objectives. Our objectives are to study women's self-reported reasons for not initiating breastfeeding and to determine whether these reasons vary by race/ethnicity, and other maternal and hospital support characteristics. METHODS Data are from the 2000-2003 Arkansas Pregnancy Risk Assessment Monitoring System, restricting the sample to women who did not initiate breastfeeding (unweighted n=2,917). Reasons for not initiating breastfeeding are characterized as individual reasons, household responsibilities, and circumstances. Analyses include the chi(2) test and multiple logistic regression. RESULTS About 38% of Arkansas mothers of live singletons did not initiate breastfeeding. There was a greater representation of non-Hispanic Blacks among those who did not initiate breastfeeding (32%) than among those who initiated breastfeeding (9.9%). Among those who never breastfed, individual reasons were most frequently cited for noninitiation (63.0%). After adjusting for covariates, Hispanics had three times the odds of citing circumstances than Whites (odds ratio [OR], 3.07; 95% confidence interval [CI], 1.31-7.18). Women who indicated that the hospital staff did not teach them how to breastfeed had more than two times greater odds of citing individual reasons (OR, 2.25; 95% CI, 1.30-3.91) or reasons related to household responsibilities (OR, 2.27; 95% CI, 1.19-4.36) as compared with women who indicated they were taught. CONCLUSIONS Findings suggest the need for targeting breastfeeding interventions to different subgroups of women. In addition, there are implications for policy particularly regarding breastfeeding support in hospitals.
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Acker M. Breast is Best…But Not Everywhere: Ambivalent Sexism and Attitudes Toward Private and Public Breastfeeding. SEX ROLES 2009. [DOI: 10.1007/s11199-009-9655-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Galson SK. The 25th anniversary of the Surgeon General's Workshop on Breastfeeding and Human Lactation: the status of breastfeeding today. Public Health Rep 2009; 124:356-8. [PMID: 19445409 DOI: 10.1177/003335490912400302] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Mickens AD, Modeste N, Montgomery S, Taylor M. Peer support and breastfeeding intentions among black WIC participants. J Hum Lact 2009; 25:157-62. [PMID: 19414821 DOI: 10.1177/0890334409332438] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to identify what factors impact low-income women's infant feeding decisions. A cross-sectional convenience sample of 109 black pregnant women, ages 18 to 45, regularly attending Women, Infant, and Children (WIC) clinics and associated programs in the Inland Empire Region of California were recruited to complete a structured questionnaire about their breastfeeding beliefs and intentions. Multivariable logistic regression was used to explore participant's intentions to breastfeed. After adjusting for confounding factors, results indicate that women who attended support groups were more than twice as likely to intend to breastfeed compared with women who did not. These results highlight the importance of social influences on the decision to breastfeed, and indicate the need for broadened community-based education for the promotion of breastfeeding.
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Buitrago MI, Crompton JA, Bertolami S, North DS, Nathan RA. Extremely Low Excretion of Daptomycin into Breast Milk of a Nursing Mother with Methicillin-ResistantStaphylococcus aureusPelvic Inflammatory Disease. Pharmacotherapy 2009; 29:347-51. [DOI: 10.1592/phco.29.3.347] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Silk KJ, Horodynski MA, Rienzo M, Mercer L, Olson B, Aldrich R. Strategies to Increase Health Literacy in The Infant Feeding Series (TIFS): A Six-Lesson Curriculum for Low-Income Mothers. Health Promot Pract 2008; 11:226-34. [DOI: 10.1177/1524839908326380] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Low literacy can be a serious barrier to educating audiences about important health issues. This article explicates strategies used to increase health literacy in The Infant Feeding Series, a six-lesson curriculum on infant feeding practices. The curriculum was developed by a multidisciplinary team of researchers, health educators, and community stakeholders with the primary goal of increasing low-income mothers’ knowledge and self-efficacy to delay the introduction of solid foods into infants’ diets. Strategies used to develop the low literate accessible materials include (a) incorporation of formative research and theory, (b) media components, (c) reading level assessment of materials, (d) review of materials by multiple stakeholders, (e) one-on-one home delivery, (f) pilot evaluation of lessons, and (g) a workbook incentive designed to integrate knowledge and motivate participants to complete the curriculum through scrapbook activities. These strategies are discussed as they relate to lesson content and curriculum effectiveness.
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Affiliation(s)
- Kami J. Silk
- Department of Communication, Michigan State University, East Lansing, Michigan
| | | | - Marie Rienzo
- Office of Market Research and Evaluation, National Cancer Institute, Bethesda, Maryland
| | - Laura Mercer
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Beth Olson
- Department of Food Science and Human Nutrition at Michigan State University, East Lansing, Michigan
| | - Rosalie Aldrich
- Department of Communication at the University of Kentucky, Lexington, Kentucky
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31
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McCarter-Spaulding D. Is breastfeeding fair? Tensions in feminist perspectives on breastfeeding and the family. J Hum Lact 2008; 24:206-12. [PMID: 18436973 DOI: 10.1177/0890334408316076] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Breastfeeding is widely acknowledged to have health benefits for mothers and infants. Because it is sex-specific, it challenges the feminist principle of gender-neutral childbearing. Various feminist theories addressing breastfeeding from the perspective of gender ideology, cultural feminism, and history are reviewed and contrasted. Employment and race disparities are addressed within feminist contexts. Feminist health activism is suggested as a unifying perspective.
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32
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Kaiser L, Allen LH. Position of the American Dietetic Association: nutrition and lifestyle for a healthy pregnancy outcome. ACTA ACUST UNITED AC 2008; 108:553-61. [PMID: 18401922 DOI: 10.1016/j.jada.2008.01.030] [Citation(s) in RCA: 142] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
It is the position of the American Dietetic Association that women of child-bearing ages should maintain good nutritional status through a lifestyle that optimizes maternal health and reduces the risk of birth defects, suboptimal fetal growth and development, and chronic health problems in their children. The key components of a health-promoting lifestyle during pregnancy include appropriate weight gain; appropriate physical activity; consumption of a variety of foods in accordance with the Dietary Guidelines for Americans 2005; appropriate and timely vitamin and mineral supplementation; avoidance of alcohol, tobacco, and other harmful substances; and safe food handling. Pregnant women with inappropriate weight gain, hyperemesis, poor dietary patterns, phenylketonuria, certain chronic health problems, or a history of substance abuse should be referred to a registered dietitian for medical nutrition therapy. Prenatal weight gain within the Institute of Medicine recommended ranges has been associated with better pregnancy outcomes. Most pregnant women need 2,200 to 2,900 kcal a day, but prepregnancy body mass index, rate of weight gain, maternal age, and appetite must be considered when tailoring this recommendation to the individual. The consumption of more food to meet energy needs, and the increased absorption and efficiency of nutrient utilization that occurs in pregnancy, are generally adequate to meet the needs for most nutrients. However, vitamin and mineral supplementation is appropriate for some nutrients and situations. This position paper also includes recommendations pertaining to use of alcohol, tobacco, caffeine, and illicit drugs.
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Affiliation(s)
- Lucia Kaiser
- Cooperative Extension, University of California, Davis, USA
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33
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Hurley KM, Black MM, Papas MA, Quigg AM. Variation in breastfeeding behaviours, perceptions, and experiences by race/ethnicity among a low-income statewide sample of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants in the United States. MATERNAL AND CHILD NUTRITION 2008; 4:95-105. [PMID: 18336643 DOI: 10.1111/j.1740-8709.2007.00105.x] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objective of this study was to examine how breastfeeding behaviours, perceptions and experiences vary by race/ethnicity among a low-income sample in the USA. Bilingual interviewers conducted a cross-sectional telephone survey of 767 white, African American or Hispanic mothers who received the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Rates of breastfeeding initiation and duration varied by race/ethnicity. Hispanic mothers were more likely to initiate breastfeeding than African American (91% vs. 65%) or white (61%) mothers. Hispanic mothers breastfed longer (mean 5 months) than either African American (mean 3.5 months) or white (mean 3 months) mothers. The most common reason for not breastfeeding was fear of difficulty or pain during breastfeeding (35.6%). Among mothers who did not initiate breastfeeding, African American and white mothers were more likely than Hispanic mothers to report perceptions of breastfeeding difficulty or pain, and Hispanic mothers were more likely than African American and white mothers to report perceptions of infant breast rejection. The most common reason reported for breastfeeding cessation was not having enough milk (23.4%). Hispanic mothers were more likely than African American and white mothers to cite perceptions of milk insufficiency and infant breast refusal than concerns regarding breast discomfort or pain. African American mothers were more likely than white mothers to report cessation to return to work. In conclusion, while breastfeeding initiation rates approach Healthy People 2010 goals, breastfeeding duration remains far below these goals. Race/ethnicity differences in experiences related to breastfeeding cessation suggest that culturally sensitive breastfeeding interventions are necessary.
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Affiliation(s)
- Kristen M Hurley
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
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34
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Individual Net-Benefit Maximization: A Model for Understanding Breastfeeding Cessation among Low-Income Women. Matern Child Health J 2008; 13:241-9. [DOI: 10.1007/s10995-008-0337-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2007] [Accepted: 02/22/2008] [Indexed: 10/22/2022]
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35
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Correlation of 4-month infant feeding modes with their growth and iron status in Beijing. Chin Med J (Engl) 2008. [DOI: 10.1097/00029330-200803010-00002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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36
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ABM Clinical Protocol #2 (2007 revision): guidelines for hospital discharge of the breastfeeding term newborn and mother: "the going home protocol". Breastfeed Med 2007; 2:158-65. [PMID: 17903102 DOI: 10.1089/bfm.2007.9990] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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37
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Horodynski M, Olson B, Arndt MJ, Brophy-Herb H, Shirer K, Shemanski R. Low-income mothers' decisions regarding when and why to introduce solid foods to their infants: influencing factors. J Community Health Nurs 2007; 24:101-18. [PMID: 17563282 DOI: 10.1080/07370010701316247] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Preventive measures for long-life illnesses such as asthma, obesity, and diabetes can start as early as in infant feeding practices. The American Academy of Pediatrics recommends introducing babies to solid foods, anything other than breast milk or formula, no earlier than 4-6 months of age (Kleinman, 2004). This study's purpose was to assess beliefs and attitudes of mothers enrolled in Medicaid about the introduction of solid foods and other infant feeding behaviors. Six focus groups (N = 23) were conducted with Black and Caucasian mothers with infants under 1 year old. The Theory of Planned Behavior was used as a framework for moderator questions and interpretation of themes. Maternal knowledge about infant feeding, maternal perceptions of applicability of infant feeding guidelines, and manner and type of information useful for infant feeding decisions emerged as themes. Implications of themes for informing an educational program for mothers to delay the introduction of solid foods are discussed.
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Affiliation(s)
- M Horodynski
- College of Nursing, Michigan State University, Lansing, MI 48824, USA.
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38
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Meier ER, Olson BH, Benton P, Eghtedary K, Song WO. A qualitative evaluation of a breastfeeding peer counselor program. J Hum Lact 2007; 23:262-8. [PMID: 17666536 DOI: 10.1177/0890334407303892] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Breastfeeding Initiative program is a collaboration between the Michigan Department of Community Health (Women, Infants, and Children Division) and Michigan State University Extension. It aims to increase breastfeeding rates among low-income women through the use of peer counselors. The study's purpose was to identify the program's strengths, operation procedures, and improvement areas from participants' and peer counselors' perspectives. Six focus groups were conducted: 3 of peer counselors and 3 of program participants. Findings revealed that peer counselors and participants were satisfied with the quality of services due to emotional and practical assistance and breast pumps provided by peer counselors. Peer counselors' job satisfaction was explained positively by the intrinsic rewards of helping others and negatively by perceived inadequate resources and recognition. Operating procedures varied greatly. Possible improvements include expanding services, providing peer counselors with additional support, and standardizing peer counselor operating procedures. The peer counselor model can effectively support low-income breastfeeding women.
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Affiliation(s)
- Emily R Meier
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, Michigan 48824, USA
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39
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Kitzmiller JL, Dang-Kilduff L, Taslimi MM. Gestational diabetes after delivery. Short-term management and long-term risks. Diabetes Care 2007; 30 Suppl 2:S225-35. [PMID: 17596477 DOI: 10.2337/dc07-s221] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- John L Kitzmiller
- Division of Maternal-Fetal Medicine, Santa Clara County Health System, San Jose, California, USA.
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40
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Li R, Rock VJ, Grummer-Strawn L. Changes in public attitudes toward breastfeeding in the United States, 1999-2003. ACTA ACUST UNITED AC 2007; 107:122-7. [PMID: 17197280 DOI: 10.1016/j.jada.2006.10.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2006] [Indexed: 10/23/2022]
Abstract
Data from the HealthStyles survey, an annual national mail survey to US adults, were examined to understand changes in public attitudes toward breastfeeding. The 1999 and 2003 HealthStyles surveys included four breastfeeding items related to public attitudes toward breastfeeding in public and toward differences between infant formula and breastmilk. The percentage of respondents in agreement with the statement, "Infant formula is as good as breastmilk," increased significantly from 14.3% in 1999 to 25.7% in 2003. The increase was particularly large among people of low socioeconomic status. The percentage increase in agreement that "feeding a baby formula instead of breastmilk increases the chances the baby will get sick" grew at a statistically significant level, but the total change was small (2.7 percentage points). No significant total changes were found for the other two survey items. The perception that infant formula is as good as breastmilk would be expected to soften a woman's commitment to breastfeeding should she be faced with obstacles to doing so. The findings underscore the need to educate the general public that breastfeeding is the best method of feeding and nurturing infants. Pediatricians and other health professionals should recommend human milk for all infants for whom breastfeeding is not specifically contraindicated.
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Affiliation(s)
- Ruowei Li
- National Center for Chronic Diseases Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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41
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42
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Abstract
This article reports a preliminary situation-specific theory of breastfeeding developed using an integrative, inductive approach (Im & Meleis, 1999). The theory purports varying levels of conflict versus congruity existing between the mother/infant dyad, a mother and her support networks, and both between and within the networks, all of which either block or facilitate breastfeeding. The theory proposes that to decrease conflict, professionals need to carefully consider their approach to promoting and supporting breastfeeding so as to respect the right of maternal decision-making and to avoid semblances of coercion or paternalism. “Salutary breastfeeding” is proposed as a new, ideal breastfeeding experience that is positive, healthy, and fulfilling, yet encompasses acknowledgement of diversity in maternal/infant dyads and situational context.
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Affiliation(s)
- Antonia M Nelson
- School of Nursing, University of Connecticut Storrs, CT 06269-2026, USA.
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43
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Couch SC, Falciglia GA. Improving the diets of the young: considerations for intervention design. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 2005; 106:S10-1. [PMID: 16376626 DOI: 10.1016/j.jada.2005.10.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2005] [Indexed: 11/29/2022]
Affiliation(s)
- Sarah C Couch
- Department of Nutritional Sciences, University of Cincinnati Medical Center, 3202 Goodman Avenue, Cincinnati, OH 45267-0394, USA.
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