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De Silva DA, Anderson EA, Kim J, Ting Lee ML, Thoma ME. The Association Between Prenatal Food Insecurity and Breastfeeding Initiation and Exclusive Breastfeeding Duration: A Longitudinal Study Using Oregon PRAMS and PRAMS-2, 2008-2015. Breastfeed Med 2024; 19:368-377. [PMID: 38506260 DOI: 10.1089/bfm.2023.0126] [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: 03/21/2024]
Abstract
Background: In the United States, 11.1% of households experience food insecurity; however, pregnant women are disproportionately affected. Maternal food insecurity may affect infant feeding practices, for example, through being a source of chronic stress that may alter the decision to initiate and continue breastfeeding. Thus, we sought to determine whether prenatal food insecurity was associated with breastfeeding (versus not) and exclusive breastfeeding duration among Oregon women. Method: The Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) data of live births from 2008 to 2015 and the Oregon PRAMS-2 follow-up survey were used (n = 3,624) in this study. Associations with breastfeeding initiation and duration were modeled with multivariable logistic regression and accelerated failure time (AFT), respectively. Models were adjusted for maternal sociodemographic and pre-pregnancy health characteristics. Results: Nearly 10% of women experienced prenatal food insecurity. For breastfeeding initiation, unadjusted models suggested non-significant decreased odds (odds ratio (OR) 0.88 [confidence intervals (CI): 0.39, 1.99]), whereas adjusted models revealed a non-significant increased odds (OR 1.41 [CI: 0.58, 3.47]). Unadjusted AFT models suggested that food-insecure mothers had a non-significant decrease in exclusive breastfeeding duration (OR 0.76 [CI: 0.50, 1.17]), but adjustment for covariates attenuated results (OR 0.89 [CI: 0.57, 1.39]). Conclusions: Findings suggest minimal differences in breastfeeding practices when exploring food security status in the prenatal period, though the persistence of food insecurity may affect exclusive breastfeeding duration. Lower breastfeeding initiation may be due to other explanatory factors correlated with food insecurity and breastfeeding, such as education and marital status.
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Affiliation(s)
- Dane A De Silva
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Elaine A Anderson
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Jinhee Kim
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Mei-Ling Ting Lee
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Marie E Thoma
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
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2
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Pasha VC, Gerchow L, Lyndon A, Clark-Cutaia M, Wright F. Understanding Food Insecurity as a Determinant of Health in Pregnancy Within the United States: An Integrative Review. Health Equity 2024; 8:206-225. [PMID: 38559844 PMCID: PMC10979674 DOI: 10.1089/heq.2023.0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 04/04/2024] Open
Abstract
Background Food insecurity is a major public health concern in the United States, particularly for pregnant and postpartum individuals. In 2020, ∼13.8 million (10.5%) U.S. households experienced food insecurity. However, the association between food security and pregnancy outcomes in the United States is poorly understood. Purpose The purpose of this review was to critically appraise the state of the evidence related to food insecurity as a determinant of health within the context of pregnancy in the United States. We also explored the relationship between food insecurity and pregnancy outcomes. Methods PubMed, CINAHL, Web of Science, and Food and Nutrition Science databases were used. The inclusion criteria were peer-reviewed studies about food (in)security, position articles from professional organizations, and policy articles about pregnancy outcomes and breastfeeding practices. Studies conducted outside of the United States and those without an adequate definition of food (in)security were excluded. Neonatal health outcomes were also excluded. Included articles were critically appraised with the STROBE and Critical Appraisal Skills Program checklists. Results Nineteen studies met the inclusion criteria. Inconsistencies exist in defining and measuring household food (in)security. Pregnant and postpartum people experienced several adverse physiological and psychological outcomes that impact pregnancy compared with those who do not. Intersections between neighborhood conditions and other economic hardships were identified. Findings regarding the impact of food insecurity on breastfeeding behaviors were mixed, but generally food insecurity was not associated with poor breastfeeding outcomes in adjusted models. Conclusion Inconsistencies in definitions and measures of food security limit definitive conclusions. There is a need for standardizing definitions and measures of food insecurity, as well as a heightened awareness and policy change to alleviate experiences of food insecurity.
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Affiliation(s)
- Veronica C. Pasha
- Department of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Lauren Gerchow
- Department of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Audrey Lyndon
- Department of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Maya Clark-Cutaia
- Department of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Fay Wright
- Department of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
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3
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Mildon A, Francis J, Stewart S, Underhill B, Ng YM, Rousseau C, Tarasuk V, Di Ruggiero E, Dennis CL, O’Connor DL, Sellen DW. Household food insecurity is prevalent in a cohort of postpartum women who registered in the Canada Prenatal Nutrition Program in Toronto. Public Health Nutr 2023; 26:1468-1477. [PMID: 36919863 PMCID: PMC10346032 DOI: 10.1017/s1368980023000459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 11/18/2022] [Accepted: 02/20/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE To assess the prevalence, severity and socio-demographic predictors of household food insecurity among vulnerable women accessing the Canada Prenatal Nutrition Program (CPNP) and to examine associations between household food insecurity and breastfeeding practices to 6 months. DESIGN Cohort investigation pooling data from two studies which administered the 18-item Household Food Security Survey Module at 6 months postpartum and collected prospective infant feeding data at 2 weeks and 2, 4 and 6 months. Household food insecurity was classified as none, marginal, moderate or severe. Logistic regression analyses were performed to assess predictors of household food insecurity and associations between household food security (any and severity) and continued and exclusive breastfeeding. SETTING Three Toronto sites of the CPNP, a federal initiative targeting socially and/or economically vulnerable women. PARTICIPANTS 316 birth mothers registered prenatally in the CPNP from 2017 to 2020. RESULTS Household food insecurity at 6 months postpartum was highly prevalent (44 %), including 11 % in the severe category. Risk of household food insecurity varied by CPNP site (P < 0·001) and was higher among multiparous participants (OR 2·08; 95 % CI 1·28, 3·39). There was no association between the prevalence or severity of food insecurity and continued or exclusive breastfeeding to 6 months postpartum in the adjusted analyses. CONCLUSIONS Household food insecurity affected nearly half of this cohort of women accessing the CPNP. Further research is needed on household food insecurity across the national CPNP and other similar programmes, with consideration of the implications for programme design, service delivery and policy responses.
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Affiliation(s)
- Alison Mildon
- Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ONM5S 1A8, Canada
| | - Jane Francis
- Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ONM5S 1A8, Canada
- Translational Medicine Program, The Hospital for Sick Children, Toronto, ON, Canada
| | - Stacia Stewart
- Health Promotion and Community Engagement, Parkdale Queen West Community Health Centre, Toronto, ON, Canada
| | - Bronwyn Underhill
- Health Promotion and Community Engagement, Parkdale Queen West Community Health Centre, Toronto, ON, Canada
| | - Yi Man Ng
- Health Promotion and Community Engagement, Parkdale Queen West Community Health Centre, Toronto, ON, Canada
| | | | - Valerie Tarasuk
- Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ONM5S 1A8, Canada
| | - Erica Di Ruggiero
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Cindy-Lee Dennis
- Lawrence-Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Deborah L O’Connor
- Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ONM5S 1A8, Canada
- Translational Medicine Program, The Hospital for Sick Children, Toronto, ON, Canada
- Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, ON, Canada
- Pediatrics, Sinai Health, Toronto, ON, Canada
| | - Daniel W Sellen
- Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ONM5S 1A8, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, ON, Canada
- Anthropology, Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada
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4
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Dharod JM, Hernandez M, Labban JD, Black MM, Ammerman A, Frazier C, Raynor N, Ramos-Castillo I. Associations between early introduction to complementary foods, subsequent cereal-added bottle feeding and daily macronutrient intake among infants. Appetite 2023; 182:106453. [PMID: 36621723 PMCID: PMC9907061 DOI: 10.1016/j.appet.2023.106453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 12/19/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023]
Abstract
Introducing complementary foods early during infancy has been associated with an increased risk of overweight later in life, but the pathway is an understudied topic. Hence the study was conducted with low-income and primarily minority mother-infant dyads to: 1) understand how the introduction of complementary foods prior to 4 months was associated with socio-demographic characteristics and food security status; 2) determine the association between early introduction to complementary foods and breastfeeding and adding cereal into the bottle in later infancy (i.e., at 6 and 9 months), and; 3) examine how adding infant cereal into the bottle was related to daily calorie and macronutrient intake in infancy. We conducted interviews with mothers (n = 201) at 4 months of age and 24-h feeding recalls at age 6 and 9 months. Results indicated that 29% of the infants were fed complementary foods before 4 months of age. Introducing complementary foods early was negatively associated with breastfeeding and positively associated with adding cereal into the bottle at 6-months. This practice was more common among those who experienced marginal to very low levels of food security. Comparing by race/ethnicity, Latinx mothers were significantly less likely to introduce solids early. After controlling for sex, infants fed cereal in the bottle were consuming significantly more calories compared to their counterparts. Specifically, adding cereal into the bottle resulted in approximately 10% additional daily calorie intake among infants. Understanding how these feeding practices affect appetite development and weight status during infancy is warranted.
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Affiliation(s)
- Jigna M Dharod
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, USA.
| | - Marlen Hernandez
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, USA
| | - Jeffrey D Labban
- Office of Research, School of Health and Human Sciences, University of North Carolina at Greensboro, USA
| | - Maureen M Black
- RTI International, Research Triangle Park, NC, USA; Department of Pediatrics, University of Maryland School of Medicine, USA
| | - Alice Ammerman
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA; Center for Health, Promotion and Disease Prevention, University of North Carolina at Chapel Hill, USA
| | - Christina Frazier
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, USA
| | - Nichole Raynor
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, USA
| | - Isa Ramos-Castillo
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, USA
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5
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Frazier CM, Dharod J, Labban J, Raynor AN, Villasenor M, Hernandez M, Ramos-Castillo I. Breastfeeding: How is it related to food insecurity and other factors among low-income mothers? Health Care Women Int 2023; 44:234-245. [PMID: 34280071 PMCID: PMC10719584 DOI: 10.1080/07399332.2021.1929992] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 04/18/2021] [Accepted: 05/11/2021] [Indexed: 10/20/2022]
Abstract
A cross-sectional study was conducted to (1) examine breastfeeding initiation and continuation rates, and; (2) investigate association between food insecurity and breastfeeding status, among low-income mothers. Mothers of infants two-months or younger were recruited from a local pediatric clinic serving primarily low-income families. Upon giving consent, mothers were interviewed in-person or over the phone in either English or Spanish. Of the total 92 mothers interviewed, 90% initiated breastfeeding, but only 24% were doing exclusive breastfeeding at 2 months of infant's age. After controlling for socio-demographics, it was found that food-insecure mothers were less likely to continue with breastfeeding (β = -1.51, p = .024). Future research is warranted to understand pathways through which food insecurity affects breastfeeding and how this disparity can be prevented to ensure a safe and secure start for infants worldwide.
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Affiliation(s)
- Christina M Frazier
- Department of Nutrition, University of North Carolina at Greensboro School of Health and Human Sciences, Greensboro, NC, USA
| | - Jigna Dharod
- Department of Nutrition, University of North Carolina at Greensboro School of Health and Human Sciences, Greensboro, NC, USA
| | - Jeff Labban
- Offices of Research, University of North Carolina at Greensboro School of Health and Human Sciences, Greensboro, NC, USA
| | - A Nichole Raynor
- Department of Nutrition, University of North Carolina at Greensboro School of Health and Human Sciences, Greensboro, NC, USA
| | - Miguel Villasenor
- Department of Nutrition, University of North Carolina at Greensboro School of Health and Human Sciences, Greensboro, NC, USA
| | - Marlen Hernandez
- Department of Nutrition, University of North Carolina at Greensboro School of Health and Human Sciences, Greensboro, NC, USA
| | - Isa Ramos-Castillo
- Department of Nutrition, University of North Carolina at Greensboro School of Health and Human Sciences, Greensboro, NC, USA
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6
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Reno R, Whipps M, Wallenborn JT, Demirci J, Bogen DL, Gross RS, Mendelsohn AL, Morris PA, Shaw DS. Housing Insecurity, Housing Conditions, and Breastfeeding Behaviors for Medicaid-Eligible Families in Urban Settings. J Hum Lact 2022; 38:760-770. [PMID: 35775199 PMCID: PMC9596949 DOI: 10.1177/08903344221108073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Research exploring associations between exposure to social determinants of health and breastfeeding is needed to identify breastfeeding barriers. Housing insecurity and household conditions (chaos and crowding) may affect breastfeeding by increasing maternal stress and discomfort and decreasing time available to breastfeed. RESEARCH AIM We aimed to examine the relationships between housing insecurity, breastfeeding exclusivity intention during the early postnatal period, and breastfeeding exclusivity at 6 months postpartum among a sample "at risk" for suboptimal breastfeeding rates. METHODS This study is a secondary data analysis of a longitudinal study at two time periods. Data were collected from English- and Spanish-speaking, Medicaid-eligible mother-infant dyads (N = 361) at near-birth and child aged 6 months, in New York City and Pittsburgh. Structural equation modeling was used to examine direct and indirect effects of housing insecurity on breastfeeding exclusivity at child aged 6 months. RESULTS The path model showed that experiencing more markers of housing insecurity (i.e., foreclosure/eviction threat, history of homelessness, late rent) was predictive of significantly lower breastfeeding exclusivity at 6 months. This was partially mediated through less exclusive breastfeeding intention during the early postnatal period. Greater household crowding was associated with 6-month breastfeeding exclusivity when mediated by intention. Household crowding had differential effects by study site and participant race/ethnicity. CONCLUSION Refinement of housing insecurity as a multi-dimensional construct can lead to the development of standardized data collection instruments, inform future methodological decisions in research addressing social determinants of health, and can inform the development of responsive individual- and structural-level interventions.The data used in this study were collected as part of the SMART Beginnings Randomized Controlled Trial (NCT02459327 registered at ClinicalTrials.gov).
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Affiliation(s)
- Rebecca Reno
- University of California, Berkeley School of Public Health, Berkeley, CA, USA
| | - Mackenzie Whipps
- Steinhardt School of Culture, Education and Human Development, New York University, NY, USA
| | - Jordyn T Wallenborn
- University of California, Berkeley School of Public Health, Berkeley, CA, USA.,Swiss Tropical and Public Health Institute, University of Basel
| | - Jill Demirci
- University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA
| | - Debra L Bogen
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Rachel S Gross
- Department of Pediatrics, New York University Grossman School of Medicine, NY, USA
| | - Alan L Mendelsohn
- Department of Pediatrics, New York University Grossman School of Medicine, NY, USA
| | - Pamela A Morris
- Steinhardt School of Culture, Education and Human Development, New York University, NY, USA
| | - Daniel S Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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7
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Association of Exclusive Breastfeeding with Asthma Risk among Preschool Children: An Analysis of National Health and Nutrition Examination Survey Data, 1999 to 2014. Nutrients 2022; 14:nu14204250. [PMID: 36296941 PMCID: PMC9607098 DOI: 10.3390/nu14204250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/01/2022] [Accepted: 10/08/2022] [Indexed: 11/23/2022] Open
Abstract
Breastmilk contains many important nutrients, anti-inflammatory agents, and immunomodulators. It is the preferred nutrition source for infants. However, the association of the duration of exclusive breastmilk feeding (BMF) with asthma development is unclear. Data on children from the United States who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014 were obtained. We examined the association between the duration of exclusive BMF and asthma in 6000 children (3 to 6 years old). After calculating the duration of exclusive breastfeeding according to answers to NHANES questionnaires, the estimated duration of exclusive BMF was divided into five categories: never breastfed or BMF for 0 to 2 months after birth; BMF for 2 to 4 months after birth; BMF for 4 to 6 months after birth; and BMF for ≥6 months after birth. The overall prevalence of asthma in children aged 3 to 6 years was approximately 13.9%. The risk of asthma was lower in children with an exclusive BMF duration of 4 to 6 months (aOR, 0.69; 95% CI, 0.48–0.98), after adjustment for potentially confounding factors. Subgroup analysis revealed that children of younger ages (3 to 4 years old) benefited most from the protective effects of exclusive BMF for 4 to 6 months (aOR, 0.47; 95% CI, 0.27, 0.8). We found that exclusive BMF, especially BMF for 4 to 6 months, is associated with a decreased risk of asthma in preschool-age children. The protective effect appeared to be diminished in older children. The potential mechanism needs further investigation.
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8
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Chandran D, Confair A, Warren K, Kawasawa YI, Hicks SD. Maternal Variants in the MFGE8 Gene are Associated with Perceived Breast Milk Supply. Breastfeed Med 2022; 17:331-340. [PMID: 34939829 DOI: 10.1089/bfm.2021.0216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: The World Health Organization recommends exclusive breastfeeding for ≥6 months, but many mothers are unable to meet this goal. A major reason why mothers undergo early, unplanned breastfeeding cessation is perceived inadequate of milk supply (PIMS). We hypothesized that defining genetic polymorphisms associated with PIMS could aid early identification of at-risk mothers, providing an opportunity for targeted lactation support. Materials and Methods: This prospective observational cohort study followed 221 breastfeeding mothers for 12 months, collecting medical, demographic, and breastfeeding characteristics. Eighteen mammary secretory genes were assessed for single-nucleotide polymorphisms in 88 women (45 with PIMS and 43 with perceived adequate milk supply [PAMS]), matched by age/race/parity. Hierarchical regressions were used to assess the ability of genotype to aid PIMS prediction. Results: Mothers with PIMS exclusively breastfed for a shorter period (7 ± 12 weeks; p = 0.001) and reported lower milk production (17.6 ± 13.3 oz/day; p = 0.001), and their infants displayed reduced weight-for-length Z-score gains (0.74 ± 1.4; p = 0.038) relative to mothers with PAMS (22 ± 19 weeks; 27.03 ± 12.2 oz/day; 1.4 ± 1.5). Maternal genotype for the rs2271714 variant within milk fat globule EGF and factor V/VIII domain containing gene (MFGE8) was associated with PIMS status (p = 0.009, adjusted p = 0.09, likelihood ratio = 9.33) and duration of exclusive breastfeeding (p = 0.009, adjusted p = 0.09, χ2 = 9.39). Addition of MFGE8 genotype to a model employing maternal characteristics (age, parity, previous breast-feeding duration, body mass index, education, and depression status) significantly increased predictive accuracy for PIMS status (p = 0.001; χ2 = 13.5; area under the curve = 0.813 versus 0.725). Conclusions: Genotyping one lactogenic gene aided identification of mothers at risk for PIMS. If validated in a larger cohort, such an approach could be used to identify mothers who may benefit from increased lactation support.
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Affiliation(s)
- Desirae Chandran
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Alexandra Confair
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Kaitlyn Warren
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Yuka Imamura Kawasawa
- Department of Pharmacology, and Penn State College of Medicine, Hershey, Pennsylvania, USA.,Department of Biochemistry and Molecular Biology, Penn State College of Medicine, Hershey, Pennsylvania, USA.,Institute for Personalized Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Steven D Hicks
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA
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9
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Dharod JM, Hernandez M, Frazier C, Labban J, Raynor N, Ramos-Castillo I, Cooper J. Food and Housing Insecurity: Do They Affect the Continuation of Breastfeeding at Four Months of Age? JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2053629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jigna M. Dharod
- Department of Nutrition, School of Health and Human Science, University of North Carolina, Greensboro, USA
| | - Marlen Hernandez
- Department of Nutrition, School of Health and Human Science, University of North Carolina, Greensboro, USA
| | - Christina Frazier
- Department of Nutrition, School of Health and Human Science, University of North Carolina, Greensboro, USA
| | - Jeffery Labban
- Office of Research, School of Health and Human Science, University of North Carolina, Greensboro
| | - Nichole Raynor
- Department of Nutrition, School of Health and Human Science, University of North Carolina, Greensboro, USA
| | - Isa Ramos-Castillo
- Department of Nutrition, School of Health and Human Science, University of North Carolina, Greensboro, USA
| | - Jessica Cooper
- Department of Nutrition, School of Health and Human Science, University of North Carolina, Greensboro, USA
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10
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Vázquez-Osorio IM, Vega-Sánchez R, Maas-Mendoza E, Heller Rouassant S, Flores-Quijano ME. Exclusive Breastfeeding and Factors Influencing Its Abandonment During the 1st Month Postpartum Among Women From Semi-rural Communities in Southeast Mexico. Front Pediatr 2022; 10:826295. [PMID: 35252066 PMCID: PMC8894443 DOI: 10.3389/fped.2022.826295] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/24/2022] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION In this study we describe breastfeeding practices among women from semi-rural communities in southeast Mexico, and explore which factors, modifiable or not, are associated with such practices. MATERIALS AND METHODS This was a formative cross-sectional study that included 143 mothers with infants 4-6 months old, from semi-rural communities in Tabasco, Mexico. We collected data on two categories of factors: (1) women's sociodemographic characteristics, and (2) maternal / infant factors. We first analyzed the frequency of various breastfeeding practices. Then, we classified participants into the up to 1 month of exclusive breastfeeding group ( ≤ 1 m-EBF) and the beyond 1 month EBF group (>1 m-EBF), if they practiced EBF for less or more than 1 month, respectively. We compared the two categories of factors between groups and then, using logistic regression models, explored which factors were associated with practicing >1 m-EBF. RESULTS By the end of the 1st month postpartum, 51.7% of participants had abandoned EBF, introduced milk formula (35%), other food (9.1%), non-nutritive liquids (7.7%), or had stopped breastfeeding completely. In the next months, EBF practice fell sharply and mixed feeding grew importantly.Logistic regression models showed that women were more likely to be in the >1 m-EBF group if they lived with the baby's father, had complications during pregnancy, delivered vaginally and attended a health center at least three times postpartum. To the contrary, women were less likely to be practice >1 m-EBF if they gave infants other liquids during their hospital stay; experienced pain or discomfort in breasts/nipples, or used a pacifier after hospitalization; had larger bodies (i.e., higher BMI); and believed that you should give the infant powdered milk or some other food when the baby is not full. CONCLUSION Many factors associated with abandoning EBF, particularly in the early postpartum period, are modifiable and can be altered through timely interventions that include giving correct information and ensuring its comprehension; assertive personal counseling and accompaniment must be provided to mothers; and reinforcement during the early postpartum at health facilities and other settings.
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Affiliation(s)
- Inocente Manuel Vázquez-Osorio
- Licenciatura de Nutrición, División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Mexico.,Jurisdicción Sanitaria 4 del Municipio de Centro, Secretaría de Salud, Villahermosa, Mexico
| | - Rodrigo Vega-Sánchez
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Eric Maas-Mendoza
- Licenciatura de Nutrición, División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Mexico
| | - Solange Heller Rouassant
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Mexico City, Mexico.,Private Practitioner, Naucalpan, Estado de México, Mexico, Mexico
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11
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Sim SM, Rothfus M, Aston M, Kirk SFL, Frank L, Jefferies K, Macdonald M. Breastfeeding experiences among mothers living with food insecurity in high resource, Western countries: a qualitative systematic review protocol. JBI Evid Synth 2021; 19:675-681. [PMID: 33074987 DOI: 10.11124/jbies-20-00052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objectives of this review are to identify, appraise, and synthesize the qualitative evidence on the breastfeeding experiences of mothers living with food insecurity in high-resource, Western countries. INTRODUCTION Breastfeeding and food insecurity are inter-related health issues. Globally, breastfeeding augments food security at individual, household, and community levels, but a growing body of evidence from high-resourced countries also suggests that a mother's breastfeeding practice may be negatively impacted by the additional experience of food insecurity. This protocol outlines a systematic approach to understanding the experiences of breastfeeding from the perspective of mothers living with food insecurity. Findings will provide much-needed evidence toward guiding policies and practices that support mothers to breastfeed. INCLUSION CRITERIA The review will consider studies that explore the breastfeeding experiences of mothers aged 18 years and older who self-identify, or are classified using a screening tool, as food insecure. Papers that will be included in this review will consider all qualitative methodologies and will be limited to studies from countries identified as being within the United Nations classification of Western European and Other States Group (WEOG). METHODS The authors will conduct a three-step search process across both published and gray literature to identify relevant studies for inclusion. A preliminary search using the PubMed database was undertaken in January 2020. Studies published in English from 1981 to 2020 will be included. The recommended JBI methodology for qualitative systematic review for study selection, critical appraisal, data extraction, and data synthesis will be followed. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020183652.
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Affiliation(s)
- Sarah Meaghan Sim
- Healthy Populations Institute, Faculty of Health, Dalhousie University, Halifax, NS, Canada.,Nova Scotia Health Authority Research, Innovation and Discovery, Halifax, NS, Canada.,Aligning Health Needs and Evidence for Transformative Change (AHNET-C): A JBI Centre of Excellence, Halifax, NS, Canada
| | - Melissa Rothfus
- WK Kellogg Health Sciences Library, Dalhousie Libraries, Dalhousie University, Halifax, NS, Canada.,Aligning Health Needs and Evidence for Transformative Change (AHNET-C): A JBI Centre of Excellence, Halifax, NS, Canada
| | - Megan Aston
- Aligning Health Needs and Evidence for Transformative Change (AHNET-C): A JBI Centre of Excellence, Halifax, NS, Canada.,School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Sara F L Kirk
- Healthy Populations Institute, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Lesley Frank
- Department of Sociology, Faculty of Arts, Acadia University, Wolfville, NS, Canada
| | - Keisha Jefferies
- Aligning Health Needs and Evidence for Transformative Change (AHNET-C): A JBI Centre of Excellence, Halifax, NS, Canada.,School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Marilyn Macdonald
- Aligning Health Needs and Evidence for Transformative Change (AHNET-C): A JBI Centre of Excellence, Halifax, NS, Canada.,School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
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