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Yuan Y, Zhao J, Liu Q, Liu Y, Liu Y, Tian X, Qiao W, Zhao Y, Liu Y, Chen L. Human milk sphingomyelin: Function, metabolism, composition and mimicking. Food Chem 2024; 447:138991. [PMID: 38520905 DOI: 10.1016/j.foodchem.2024.138991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/28/2024] [Accepted: 03/08/2024] [Indexed: 03/25/2024]
Abstract
Human milk, which contains various nutrients, is the "gold standard" for infant nutrition. Healthy human milk meets all the nutritional needs of early infant development. Polar lipids mainly exist in the milk fat globule membrane, accounting for approximately 1-2% of human milk lipids; sphingomyelin (SM) accounts for approximately 21-24% of polar lipids. SM plays an important role in promoting the development of the brain and nervous system, regulating intestinal flora, and improving skin barriers. Though SM could be synthesized de novo, SM nutrition from dietary is also important for infants. The content and composition of SM in human milk has been reported, however, the molecular mechanisms of nutritional functions of SM for infants required further research. This review summarizes the functional mechanisms, metabolic pathways, and compositional, influencing factors, and mimicking of SM in human milk, and highlights the challenges of improving maternal and infant early/long-term nutrition.
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Affiliation(s)
- Yuying Yuan
- Key Laboratory of Dairy Science, Ministry of Education, Food Science College, Northeast Agricultural University, Harbin 150030, China; National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China
| | - Junying Zhao
- National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China
| | - Qian Liu
- Key Laboratory of Dairy Science, Ministry of Education, Food Science College, Northeast Agricultural University, Harbin 150030, China; National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China
| | - Yan Liu
- National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China
| | - Yan Liu
- National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China
| | - Xiaoyan Tian
- Key Laboratory of Dairy Science, Ministry of Education, Food Science College, Northeast Agricultural University, Harbin 150030, China; National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China
| | - Weicang Qiao
- National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China
| | - Yanyan Zhao
- National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Affiliated Hospital of Weifang Medical University, Weifang, Shandong 261031, China
| | - Yanpin Liu
- National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China
| | - Lijun Chen
- Key Laboratory of Dairy Science, Ministry of Education, Food Science College, Northeast Agricultural University, Harbin 150030, China; National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China.
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ZEHNATI A, SIDI-YAKHLEF A. [Prevalence and determinants of continued breastfeeding beyond 6 months among Algerian women. Evidence for Multiple Indicators Cluster Surveys]. MEDECINE TROPICALE ET SANTE INTERNATIONALE 2024; 4:mtsi.v4i1.2024.499. [PMID: 38846119 PMCID: PMC11151907 DOI: 10.48327/mtsi.v4i1.2024.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/27/2024] [Indexed: 06/09/2024]
Abstract
Background and rationale Breastfeeding is considered the best nutrition for infants and plays a significant role in a child's growth and development. In this regard, the World Health Organization (WHO) strongly recommends exclusive breastfeeding for the first 6 months of life, as well as continued breastfeeding when safe and appropriate complementary foods are introduced, up to 2 years of age or beyond. Nonetheless, breastfeeding practices remain sub-optimal in many parts of the world. In this respect, many children have shown not to be breastfed up to 6 months of age or are not breastfed during their first hours of life or are weaned too early. This allows for the use of infant formula, which can be life threatening due to poor hygiene, storage conditions or inappropriate foods. Likewise, breastfeeding rates in the Middle East and North Africa (MENA) region are lower than the global average. In Algeria, the breastfeeding rate up to 6 months of age is among the lowest in the world according to previous Multiple Indicators Cluster Surveys (MICS) reports. In addition, by the end of the sixth month, the percentage of children exclusively breastfed is less than 3% and only 23% of children receive breast milk at 22-23 months. The median duration of breast-feeding is 12 weeks. However, the socio-demographic factors associated with this sub-optimal breastfeeding practice are not explored in these reports, as studies and research conducted in this context using other data are few and mostly conducted in limited geographical areas. Materials and methods This stands for a descriptive cross-sectional study of all children who were breastfed in the MICS database, carried out in 2019, 8 709 children, including 4 471 boys and 4 238 girls, registered in the database. To explore factors associated with the duration of breastfeeding, we only included weaned children to minimize bias related to children who were still breastfeeding. This allowed to analyze data from 3 761 children, including 1 930 boys (5.4%) and 1,831 girls (48.6%). Through using a logistic regression model, we could attain the assessment of the role of different socio-demographic, economic and geographical factors in the maintenance of breastfeeding beyond 6 months. Results The prevalence of breastfeeding is 81.1%; the rate of exclusive breastfeeding of children aged 0-6 months is 28.7%. The factors associated with breastfeeding beyond six months are area of residence, mother's occupational status and wealth quintile. In fact, rural area appears to be a factor favoring the continuation of breastfeeding beyond six months, compared with urban area (OR = 1.29; CI [1.032-1.369]). Mothers living in the Eastern Highlands geographic region appear to be 1.56 times more likely to maintain breastfeeding for more than six months compared to those living in the Southern region (OR = 1.56; CI [1.123 - 1.677]). Children of non-working mothers are almost 1.5 times more likely to be breastfed after 6 months than those of working mothers (OR = 1.489; CI [1.107 - 1.947]). Parents belonging to the "richest" wealth quintiles appear to increase the chance of continued breastfeeding after 6 months with a 1.24-fold increase compared to those belonging to the "poorest" quintile (OR = 1.24; CI [1.086 - 1.812]). Factors such as the child's gender, maternal education level, and functional difficulties do not appear to be determining factors for the continuation of breastfeeding after six months. Discussion and conclusion The prevalence and factors associated with the initiation and continuation of breastfeeding vary from one country to another. Notwithstanding the numerous studies to better comprehend mothers' breastfeeding behaviour and various initiatives for promotion thereof, many countries have low rates. In consequence, the downward trend in breastfeeding is directly linked to advances in the production and marketing of industrial milks, the lack of information and awareness among mothers and the lack of training of health professionals. In this respect, it is highly recommended to encourage behavioural changes, to improve communication about the duration of breastfeeding, to increase the use of postnatal counselling and training of paramedical staff according to the recommendations with support for mothers.This study is of great interest in developing countries like Algeria, in order to adopt preventive interventions, and to organise communication and pre- and post-natal counselling in the breastfeeding project. Clearly, this study should be enhanced with supplementary qualitative studies concerning the factors contributing to early discontinuation of breastfeeding.
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Affiliation(s)
- Ahcène ZEHNATI
- Directeur de recherche au Centre de recherche en économie appliquée pour le Développement (CREAD), Algérie et chercheur associé au Laboratoire d’économie de Dijon (LEDi), France
| | - Adel SIDI-YAKHLEF
- Professeur au Département des sciences sociales, Faculté des sciences humaines et sociales, Université Abou-Bakr-Belkaid Tlemcen, Algérie
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Zhu Z, Narayan A, Zhang S, Wang L, Zhu Y, Yang W, Cheng Y, Zeng L, Chang S. How the marketing practices of commercial milk formula companies impact infant breastfeeding practices in China. BMJ Glob Health 2023; 8:e012803. [PMID: 37949499 PMCID: PMC10649769 DOI: 10.1136/bmjgh-2023-012803] [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: 05/15/2023] [Accepted: 10/21/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The marketing practices used by commercial milk formula (CMF) companies undermine breast feeding. However, it remains unclear how specific types of marketing practices result in suboptimal breast feeding. OBJECTIVES We aimed to examine the associations of CMF marketing practices with breastfeeding outcomes, determine the influencing pathways, how it changes the perceptions and attitudes of mothers towards CMF, and how it impacts breastfeeding outcomes. METHODS A cross-sectional survey was conducted in Beijing and Jinan, China that mapped the CMF marketing practices in 2020. Mothers were interviewed about the feeding practices for the youngest child under the age of 18 months. Maternal attitude towards CMF was assessed using a set of five questions. Six common CMF marketing practices were reviewed. A logistic regression was performed to examine the associations between the CMF marketing practices and predominant breast feeding, with adjustments for maternal age, education, occupation, socioeconomic class and caesarean section. Furthermore, a path analysis was conducted to explore the pathways between the CMF marketing practices, maternal attitude towards CMF and predominant breast feeding. RESULTS A total of 750 mothers were interviewed, with 20.0% of mothers predominantly breast feeding their young children. Two marketing practices, online engagement with CMF companies and promotions and discounts, were statistically associated with a lower likelihood of predominant breast feeding, with an adjusted ORs of 0.53 (95% CI 0.35 to 0.82) and 0.45 (95% CI 0.22 to 0.92). Furthermore, per CMF marketing practice increase mothers concurrently exposed to was associated with a 0.79 (95% CI 0.68 to 0.92) times lower likelihood of predominant breast feeding. In addition, online engagement and free formula samples distributed in hospitals had indirect effects on suboptimal breastfeeding outcomes, which was partly mediated by positive maternal attitude towards CMF. CONCLUSIONS CMF marketing practices were associated with a lower likelihood of optimal breastfeeding through influencing the maternal attitude towards CMF.
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Affiliation(s)
- Zhonghai Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
- Center for Chronic Disease Control and Prevention, Global Health Institution, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Anuradha Narayan
- Nutrition and Child Development Section, United Nations Children's Fund, Headquarters, New York, New York, USA
| | - Shuyi Zhang
- Department of Integrated Early Child Development, Capital Institute of Pediatrics, Beijing, China
| | - Liang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Yingze Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Wenfang Yang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yue Cheng
- Department of Nutrition and Food Safety Research, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
- Center for Chronic Disease Control and Prevention, Global Health Institution, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Suying Chang
- China Health Development Section, United Nations Children's Fund, Office for China, Beijing, China
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Dib S, Fewtrell M, Wells JCK. Maternal capital predicts investment in infant growth and development through lactation. Front Nutr 2023; 10:1272938. [PMID: 37885440 PMCID: PMC10598761 DOI: 10.3389/fnut.2023.1272938] [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] [Received: 08/04/2023] [Accepted: 09/15/2023] [Indexed: 10/28/2023] Open
Abstract
Introduction Maternal capital (MC) is a broad term from evolutionary biology, referring to any aspects of maternal phenotype that represent resources available for investment in offspring. We investigated MC in breastfeeding mothers of late preterm and early term infants, examining its relationship with infant and breastfeeding outcomes. We also determined whether MC modified the effect of the relaxation intervention on these outcomes. Methods The data was collected as part of a randomized controlled trial investigating breastfeeding relaxation in 72 mothers of late preterm and early term infants. Indicators of MC (socioeconomic, social, somatic, reproductive, psychological, and cognitive) were collected at baseline at 2-3 weeks post-delivery. Principal Component Analysis was conducted for the MC measures and two components were identified: 1."Subjective" maternal capital which included stress and depression scores, and 2."Objective" maternal capital which included height, infant birth weight, and verbal memory. Univariate linear regression was conducted to assess the relationship between objective and subjective MC (predictors) and infant growth, infant behavior, maternal behavior, and infant feeding variables (outcomes) at 6-8 weeks. The interaction of MC and intervention assignment with outcomes was assessed. Results Higher objective MC was significantly associated with higher infant weight (0.43; 95%CI 0.21,0.66) and length z-scores (0.47; 95%CI 0.19,0.76), shorter duration of crying (-17.5; 95%CI -33.2,-1.9), and lower food (-0.28; 95%CI -0.48,-0.08) and satiety responsiveness (-0.17; 95%CI -0.31,-0.02) at 6-8 weeks. It was also associated with greater maternal responsiveness to infant cues (-0.05, 95%CI -0.09,-0.02 for non-responsiveness). Greater subjective maternal capital was significantly associated with higher breastfeeding frequency (2.3; 95%CI 0.8,3.8) and infant appetite (0.30; 95%CI 0.07,0.54). There was a significant interaction between the intervention assignment and objective MC for infant length, with trends for infant weight and crying, which indicated that the intervention had greater effects among mothers with lower capital. Conclusion Higher MC was associated with better infant growth and shorter crying duration. This was possibly mediated through more frequent breastfeeding and prompt responsiveness to infant cues, reflecting greater maternal investment. The findings also suggest that a relaxation intervention was most effective among those with low MC, suggesting some reduction in social inequalities in health.
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Affiliation(s)
| | | | - Jonathan C. K. Wells
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
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Li Z, Jia Y, Parshley I, Zhang Y, Wang J, Long Q. Current prevalence, changes, and determinants of breastfeeding practice in China: data from cross-sectional national household health services surveys in 2013 and 2018. Int Breastfeed J 2023; 18:40. [PMID: 37568207 PMCID: PMC10416475 DOI: 10.1186/s13006-023-00572-2] [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] [Received: 08/31/2022] [Accepted: 07/10/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND The World Health Organization and the government of China have made many efforts to improve breastfeeding practices. The evidence of breastfeeding practices over the past decade in China is limited. The current study aimed to describe the current prevalence, variation trends, and determinants of breastfeeding practices in China using data from the National Household Health Service Surveys (NHHSS) in 2013 and 2018. METHODS Women who had at least one live birth in the five years from the 2013 NHHSS numbered 10,544, and 12,766 women from the 2018 NHHSS were included in the current study. The rates of breastfeeding, early initiation of breastfeeding within the first hour after birth, exclusive breastfeeding for at least six months since birth, and continued breastfeeding accompanied by adequate complementary feeding for over two years were measured. Logistic regressions were performed to study the associations between breastfeeding practices and maternal-based, healthcare-based, and infant-based characteristics. RESULTS In the 2018 survey, the rates of practiced any breastfeeding, early initiation of breastfeeding within the first hour after birth, exclusive breastfeeding for at least six months, and continued breastfeeding for over two years were 91.50%, 28.16%, 47.90%, and 4.78%, respectively, showing significant improvements compared to the 2013 survey period. Women who received high education, were from a household with high incomes, had more than one child, and had more antenatal and postnatal visits, were more likely to practice breastfeeding and initiate it within the first hour, but they were less likely to breastfeed the infants for two years. Births by caesarean section and low birthweight were associated with worse breastfeeding practices. CONCLUSIONS The rates of practicing breastfeeding and exclusive breastfeeding for six months or more in China improved over the past decades, suggesting improved awareness and knowledge of breastfeeding among women. However, individual and social factors may impact practices of early initiation and continued breastfeeding. Strengthening breastfeeding support from family, community, and health professionals (e.g., family member engagement, friendly work environment, and professional consultation, etc.) during the postpartum and infant period may improve women's confidence in breastfeeding practices.
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Affiliation(s)
- Zeyu Li
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
| | - Yufei Jia
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
| | - Iris Parshley
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
| | - Yaoguang Zhang
- Centre for Health Statistics and Information, National Health Commission, 38 Beilishi Road, Xicheng, Beijing, 100810, NO, China.
| | - Jia Wang
- Yuzhong District Center for Diseases Prevention and Control, 254 Heping Road, Yuzhong District, Chongqing, 400010, China.
| | - Qian Long
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
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Kota K, Chomienne MH, Geneau R, Yaya S. Socio-economic and cultural factors associated with the utilization of maternal healthcare services in Togo: a cross-sectional study. Reprod Health 2023; 20:109. [PMID: 37488593 PMCID: PMC10367352 DOI: 10.1186/s12978-023-01644-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/02/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Proper utilization of maternal healthcare services plays a major role on pregnancy and birth outcomes. In sub-Saharan Africa, maternal and child mortality remains a major public health concern, especially in least developed countries such as Togo. In this study, we aimed to analyze factors associated with use of maternal health services among Togolese women aged 15-49 years. METHODS This study used data from third round of nationally representative Demographic and Health Survey conducted in Togo in 2013. Analysis included 4,631 women aged 15-49 years. Outcome variables were timely first antenatal care (ANC) visits, adequate ANC4 + visits, and health facility delivery. Data were analyzed using Stata version 16. RESULTS Overall, proportion of maternal healthcare utilization was 27.53% for timely first ANC visits, 59.99% for adequate ANC visits, and 75.66% for health facility delivery. Our multivariable analysis showed significant differences among women in highest wealth quintile, especially in rural areas with increasing odds of timely first ANC visits (Odds ratio (OR) = 3.46, 95% CI = 2.32,5.16), attending adequate ANC visits (OR = 2.19, 95% CI = 1.48,3.24), and delivering in health facilities (OR = 8.53, 95% CI = 4.06, 17.92) compared to those in the poorest quintile. Also, women with higher education had increased odds of timely first ANC visits (OR = 1.37, 95% CI = 1.11,1.69), and attending adequate ANC visits (OR = 1.73, 95% CI = 1.42,2.12) compared to those with no formal education. However, having higher parity and indigenous beliefs especially in rural areas decreased odds of using healthcare services. CONCLUSIONS Findings from this study showed that socio-economic inequality and socio-cultural barriers influenced the use of maternal healthcare services in Togo. There is therefore a need to improve accessibility and the utilization of maternal healthcare services through women's economic empowerment and education to reduce the barriers.
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Affiliation(s)
- Komlan Kota
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON Canada
| | - Marie-Hélène Chomienne
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Robert Geneau
- Applied Research Division, Public Health Agency of Canada, Ottawa, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, ON K1N 6N5 Canada
- The George Institute for Global Health, Imperial College London, London, UK
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Zhu Y, Yin X, Qiu L, Sun N, An R, Gong Y. Association between breastfeeding and perinatal depressive symptoms: A 13-months cross-lagged analysis in China. Asian J Psychiatr 2023; 82:103474. [PMID: 36709612 DOI: 10.1016/j.ajp.2023.103474] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/21/2023]
Abstract
Breastfeeding is associated with perinatal depressive symptoms, the directionality of this relationship, however, remains unclear. Therefore, the present study aimed to evaluate the longitudinal relationship between breastfeeding and perinatal depressive symptoms. A longitudinal study was conducted from September 2018 to August 2020 in two cities of China. Depressive symptoms and breastfeeding behaviors were investigated during the third trimester and at 1, 3, 6, and 12 months postpartum. A total of 856 women participated in the present study. The cross-lagged model revealed that after adjustments were made for covariates, depressive symptoms at 3 and 6 months postpartum predicted breastfeeding at 6 and 12 months postpartum, respectively. Additionally, prenatal and 1-month postpartum depressive symptoms were not found to predict breastfeeding. Nor was found that breastfeeding, in turn, predicted depressive symptoms. These results indicated that women who experienced depressive symptoms at 3 months postpartum were more likely to discontinue breastfeeding. The first 3-months postpartum period seems to be the optimal time to identify and treat depressive symptoms to maintain and increase breastfeeding rates. Early intervention of perinatal depressive symptoms is warranted.
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Affiliation(s)
- Yi Zhu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China.
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China.
| | - Lei Qiu
- Department of Epidemiology, School of Public Health, Hainan Medical University, Xue Yuan Road 3, Haikou 571199, Hainan, PR China.
| | - Na Sun
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China.
| | - Rongrong An
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China.
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China.
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Wu JL, Jiang XM, Zheng QX, Chen XQ, Liu GH. Mothers' breastfeeding six weeks postpartum and factors influencing exclusive breastfeeding during the first six months. Health Care Women Int 2023; 44:262-275. [PMID: 34346293 DOI: 10.1080/07399332.2021.1947287] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We aimed to assess the feeding pattern and influencing factors within six weeks postpartum on exclusive breastfeeding duration among Chinese mothers. This study was conducted using 2:1 matched case-control study. Cases and controls were matched for maternal age, parity and mode of birth. A total of 210 women were included. Approximately 67.9% of women stopped exclusive breastfeeding within the first six weeks postpartum. Maternal non-exclusive breastfeeding intention, lower maternal educational level, mother-infant skin to skin contact over one hour, unsatisfied breastfeeding self-evaluation and maternal unhealthy condition within the first six weeks were risk factors for ceasing exclusive breastfeeding early.
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Affiliation(s)
- Jing-Ling Wu
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiu-Min Jiang
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Qing-Xiang Zheng
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Xiao-Qian Chen
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Gui-Hua Liu
- Department of Child Health, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
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Spyrakou E, Magriplis E, Benetou V, Zampelas A. Factors Associated with Breastfeeding Initiation and Duration in Greece: Data from the Hellenic National Nutrition and Health Survey. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111773. [PMID: 36421222 PMCID: PMC9688813 DOI: 10.3390/children9111773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/08/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022]
Abstract
Despite its well-documented benefits, breastfeeding rates and duration worldwide do not meet the recommended goals set by the World Health Organization. Data on infant feeding, socio-demographic, lifestyle and perinatal factors were used from 490 mothers (and 958 children), participants at the Hellenic National Nutrition and Health Survey between 2013−2015. Clustered multiple logistic regression and multilevel mixed-model regression analyses were performed to identify factors associated with breastfeeding initiation and duration, respectively. Maternal lower education [Odds Ratio (OR): 2.29, 95% Confidence intervals (95% CI): 1.30−4.04; p = 0.004], smoking during pregnancy (OR: 3.08, 95% CI: 1.64−5.77; p < 0.001), caesarean section (OR = 3.26, 95% CI: 1.83−5.83; p < 0.001), prematurity (OR = 2.74, 95% CI: 1.40−5.37; p = 0.003) and higher birth order (OR = 1.30, 95% CI: 1.04−1.62; p = 0.020) were associated with increased odds of not initiating breastfeeding. Living in rural areas [beta coefficient b = −27.93, p = 0.043], smoking during pregnancy (b = −64.47, p < 0.001), caesarean section (b = −28.76, p = 0.046) and prematurity (b = −46.67, p = 0.048) were significantly associated with shorter breastfeeding duration. Children born chronologically closer to the survey were more likely to breastfeed and for longer periods. Educational promotion and enhancement of breastfeeding awareness that account for maternal exposures are required. Prevention of prematurity and avoidance of unnecessary caesarean section is crucial, while additional breastfeeding support is needed when preterm birth occurs, or caesarean section cannot be avoided.
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Affiliation(s)
- Efthimia Spyrakou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 115 27 Athens, Greece
| | - Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
| | - Vassiliki Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 115 27 Athens, Greece
- Correspondence:
| | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
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Yang F, Chen G. The nutritional functions of dietary sphingomyelin and its applications in food. Front Nutr 2022; 9:1002574. [PMID: 36337644 PMCID: PMC9626766 DOI: 10.3389/fnut.2022.1002574] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
Sphingolipids are common structural components of cell membranes and are crucial for cell functions in physiological and pathophysiological conditions. Sphingomyelin and its metabolites, such as sphingoid bases, ceramide, ceramide-1-phosphate, and sphingosine-1-phosphate, play signaling roles in the regulation of human health. The diverse structures of sphingolipids elicit various functions in cellular membranes and signal transduction, which may affect cell growth, differentiation, apoptosis, and maintain biological activities. As nutrients, dietary sphingomyelin and its metabolites have wide applications in the food and pharmaceutical industry. In this review, we summarized the distribution, classifications, structures, digestion, absorption and metabolic pathways of sphingolipids, and discussed the nutritional functioning of sphingomyelin in chronic metabolic diseases. The possible implications of dietary sphingomyelin in the modern food preparations including dairy products and infant formula, skin improvement, delivery system and oil organogels are also evaluated. The production of endogenous sphingomyelin is linked to pathological changes in obesity, diabetes, and atherosclerosis. However, dietary supplementations of sphingomyelin and its metabolites have been shown to maintain cholesterol homeostasis and lipid metabolism, and to prevent or treat these diseases. This seemly paradoxical phenomenon shows that dietary sphingomyelin and its metabolites are candidates for food additives and functional food development for the prevention and treatment of chronic metabolic diseases in humans.
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Affiliation(s)
- Fang Yang
- School of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, China
- *Correspondence: Fang Yang,
| | - Guoxun Chen
- Department of Nutrition, The University of Tennessee, Knoxville, TN, United States
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Duan Y, Yang Z, Bi Y, Wang J, Pang X, Jiang S, Zhang H, Xu L, Lai J. What are the determinants of low exclusive breastfeeding prevalence in China? A cross‐sectional study. MATERNAL & CHILD NUTRITION 2022; 18:e13324. [PMID: 35137523 PMCID: PMC8932722 DOI: 10.1111/mcn.13324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/18/2021] [Accepted: 01/04/2022] [Indexed: 11/26/2022]
Abstract
Exclusive breastfeeding (EBF) status is far from the national target in China. To identify the modifiable factors associated with EBF of infants aged under 6 months in China. A cross‐sectional study was conducted in 12 provinces/municipalities across China in 2017–2018. We used multistage stratified cluster sampling and collected data through face‐to‐face interviews with mothers using an electronic questionnaire. Totally, 5287 pairs of mother–infant aged <6 months were investigated. The EBF prevalence was 29.2% (1544/5287). Mothers with correct knowledge of colostrum (adjusted odds ratio [AOR]:1.32, 95% confidence interval [CI]: 1.07, 1.62), EBF (AOR: 1.39, 95% CI: 1.06, 1.81) and the highest scores of perceptions for breastfeeding benefits (AOR: 1.36, 95% CI: 1.14, 1.61) were more likely to exclusively breastfeed. However, mothers with more frequent unwillingness of breastfeeding during the first month postpartum were less likely to practice EBF (AOR: 0.68, 95% CI: 0.52, 0.90). Infants having their first breast milk within 24 h of birth increased the odds of EBF (AOR: 2.41, 95% CI: 1.86, 3.13). Infants were less likely to be exclusively breastfed in the families in which the main caregiver was the grandmothers. Mothers without receiving infant formula feeding suggestions via the health facilities, media, or the Internet (AOR: 1.57, 95% CI: 1.33, 1.85) or without the experience of infant formula feeding in public (AOR: 1.45, 95% CI: 1.23, 1.72) might more likely to practice EBF. To acquire comprehensively correct knowledge and keep a positive attitude of breastfeeding for the mothers are crucial for improving the EBF prevalence. Family supports are potential interventions worth focusing on. Infant formula promotion remains a great barrier for EBF in China. This is the first study with a large sample size that examined determinants at individual, family, community and social levels potentially affecting EBF practice in China. In this cross‐sectional study, mothers with completely correct knowledge and positive attitude of breastfeeding, infants having their first breast milk within 24 h of birth, and without exposure to infant formula feeding suggestions or experience might more likely to practice EBF. Dissemination of comprehensively correct knowledge and operational skills of breastfeeding, initiation of breastfeeding as soon as possible, reducing the influence of infant formula might be effective methods for improving the EBF prevalence in China.
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Affiliation(s)
- Yifan Duan
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention Beijing China
| | - Zhenyu Yang
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention Beijing China
| | - Ye Bi
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention Beijing China
| | - Jie Wang
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention Beijing China
| | - Xuehong Pang
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention Beijing China
| | - Shan Jiang
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention Beijing China
| | - Huanmei Zhang
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention Beijing China
| | - Lili Xu
- Institute for the Prevention and Control of Chronic Non Communicable Diseases Heilongjiang Provincial Center for Disease Control and Prevention Harbin Heilongjiang China
| | - Jianqiang Lai
- Key Laboratory of Trace Element Nutrition of National Health and Family Planning Commission, National Institute for Nutrition and Health Chinese Center for Disease Control and Prevention Beijing China
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Wang L, He J. Exclusive breastfeeding of full-term infants during the first 6 months after discharge from a neonatal unit in China: A cross-sectional study. Jpn J Nurs Sci 2021; 19:e12466. [PMID: 34931439 DOI: 10.1111/jjns.12466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/22/2021] [Accepted: 11/26/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To elucidate breastfeeding patterns, the reasons for stopping exclusive breastfeeding, and the sociodemographic characteristics associated with exclusive breastfeeding of full-term infants during the 6 months after discharge from a neonatal unit in China. METHODS This cross-sectional study included mothers of full-term infants who were discharged from the 40-bed neonatal unit (level IIA) of a tertiary hospital in Hunan province, China between August 2019 and September 2020. Information on breastfeeding patterns was collected through telephone interviews with the mothers 6 months after their infants had been discharged from the neonatal unit. Binary logistic regression was used to determine the factors associated with exclusive breastfeeding. RESULTS This study included 489 mother-infant dyads. At 6 months after discharge, 51.5% of mothers were exclusively breastfeeding, 29.0% of mothers were partially breastfeeding, and 19.4% of mothers were not breastfeeding. The most common reason for stopping breastfeeding was "poor milk supply" (81.2%). Factors associated with exclusive breastfeeding included multiparity, exclusive breastfeeding before the hospitalization, providing breast milk to the hospitalized infant, and a high level of maternal education. CONCLUSIONS In the Chinese culture, mothers who experienced multiparity and higher-level education were more likely to breastfeed their infants to 6 months after discharge from the neonatal unit. In addition, infants who were exclusively breastfed before and during hospitalization were also more likely to be exclusively breastfed after discharge. The results will help inform future research aimed at identifying interventions to reduce early breastfeeding cessation.
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Affiliation(s)
- Li Wang
- Nursing Department, Shenzhen University General Hospital, Shen Zhen, China
| | - Junli He
- Department of Pediatrics, Shenzhen University General Hospital, Shen Zhen, China
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Chooniedass R, Tarrant M, Turner S, Lok Fan HS, Del Buono K, Masina S, Becker AB, Mandhane P, Turvey SE, Moraes T, Sears MR, Subbarao P, Azad MB. Factors associated with breast-feeding initiation and continuation in Canadian-born and non-Canadian-born women: a multi-centre study. Public Health Nutr 2021; 25:1-12. [PMID: 34859767 PMCID: PMC9991853 DOI: 10.1017/s1368980021004699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 11/22/2021] [Accepted: 11/28/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To identify factors associated with breast-feeding initiation and continuation in Canadian-born and non-Canadian-born women. DESIGN Prospective cohort of mothers and infants born from 2008 to 2012: the Canadian Healthy Infant Longitudinal Development (CHILD) Cohort Study. SETTING General community setting in four Canadian provinces. PARTICIPANTS In total, 3455 pregnant women from Vancouver, Edmonton, Winnipeg and Toronto between 2008 and 2012. RESULTS Of 3010 participants included in the current study, the majority were Canadian-born (75·5 %). Breast-feeding initiation rates were high in both non-Canadian-born (95·5 %) and Canadian-born participants (92·7 %). The median breast-feeding duration was 10 months in Canadian-born participants and 11 months in non-Canadian-born participants. Among Canadian-born participants, factors associated with breast-feeding initiation and continuation were older maternal age, higher maternal education, living with their partner and recruitment site. Rooming-in during the hospital stay was also associated with higher rates of breast-feeding initiation, but not continuation at 6-month postpartum. Factors associated with non-initiation of breast-feeding and cessation at 6-month postpartum were maternal smoking, living with a current smoker, caesarean birth and early-term birth. Among non-Canadian-born participants, maternal smoking during pregnancy was associated with lower odds of breast-feeding initiation and lower odds of breast-feeding continuation at 6 months, and older maternal age and recruitment site were associated with breast-feeding continuation at 6 months. CONCLUSIONS Although Canadian-born and non-Canadian-born women in the CHILD cohort have similar breast-feeding initiation rates, breast-feeding initiation and continuation are more strongly associated with socio-demographic characteristics in Canadian-born participants. Recruitment site was strongly associated with breast-feeding continuation in both groups and may indicate geographic disparities in breast-feeding rates nationally.
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Affiliation(s)
- Rishma Chooniedass
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
- Children’s Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Marie Tarrant
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
| | - Sarah Turner
- Manitoba Interdisciplinary Lactation Centre, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Heidi Sze Lok Fan
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, SAR, People’s Republic of China
| | - Katie Del Buono
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
| | - Stephanie Masina
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
| | - Allan B Becker
- Children’s Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Piushkumar Mandhane
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Stuart E Turvey
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Theo Moraes
- Department of Paediatrics, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Malcolm R Sears
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Padmaja Subbarao
- Department of Paediatrics, University of Toronto and Hospital for Sick Children, Toronto, ON, Canada
| | - Meghan B Azad
- Manitoba Interdisciplinary Lactation Centre, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Factors associated with exclusive breastfeeding practice among mothers in nine community health centres in Nanning city, China: a cross-sectional study. Int Breastfeed J 2021; 16:71. [PMID: 34556129 PMCID: PMC8461910 DOI: 10.1186/s13006-021-00416-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of exclusive breastfeeding (EBF) is suboptimal in China. There is limited evidence of effective interventions to increase EBF in China. Therefore, it is urgent to explore the potential factors that may be effective in promoting exclusive breastfeeding. Previous studies have mainly focused on socio-demographic factors and the Han ethnic group. This study explores more modifiable influencing factors of EBF in the Guangxi Zhuang Autonomous Region of China. METHODS The cross-sectional data used in this study were collected to provide baseline information on EBF prevalence for a breastfeeding promotion project. A total of 494 mothers of infants aged 0-5 months were recruited from nine community health centres in Nanning, China, in October 2019. Data were collected through face-to-face interviews using structured questionnaires. Infant feeding was measured by 24-h recall. The Chinese version of the Breastfeeding Self-Efficacy Scale-Short Form was used to examine the maternal breastfeeding self-efficacy. Univariate and multivariate logistic regressions were used to examine the factors associated with EBF practices. RESULTS In the present study, the prevalence of exclusive breastfeeding was 37.0%. Higher breastfeeding self-efficacy scores (adjusted odds ratio [AOR] 1.93; 95% confidence interval [CI] 1.25, 2.98), a college degree or above (AOR 2.15; 95% CI 1.24, 3.71), and early initiation of breastfeeding (AOR 2.06; 95% CI 1.29, 3.29) were positively associated with EBF practice. However, the preparation for infant formula before childbirth (AOR 0.30; 95% CI 0.17, 0.52) and premature birth (AOR 0.30; 95% CI 0.10, 0.87) were negatively associated with EBF practice. CONCLUSIONS Exclusive breastfeeding practice was suboptimal and associated with various factors in the study area. The prevalence of EBF was positively associated with higher breastfeeding self-efficacy, education level of mothers, and early initiation of breastfeeding, whereas premature birth and preparation for infant formula before childbirth were barriers to exclusive breastfeeding. Future intervention projects should target mothers with premature babies, lower levels of education, and breastfeeding self-efficacy. Breastfeeding-friendly practices, such as the early initiation of breastfeeding and regulations on breastmilk substitutes, should also be encouraged.
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Tesema GA, Tessema ZT. Pooled prevalence and associated factors of health facility delivery in East Africa: Mixed-effect logistic regression analysis. PLoS One 2021; 16:e0250447. [PMID: 33891647 PMCID: PMC8064605 DOI: 10.1371/journal.pone.0250447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 04/06/2021] [Indexed: 11/19/2022] Open
Abstract
Background Many mothers still give birth outside a health facility in Sub-Saharan Africa particularly in East African countries. Though there are studies on the prevalence and associated factors of health facility delivery, as to our search of literature there is limited evidence on the pooled prevalence and associated factors of health facility delivery in East Africa. This study aims to examine the pooled prevalence and associated factors of health facility delivery in East Africa based on evidence from Demographic and Health Surveys. Methods A secondary data analysis was conducted based on the most recent Demographic and Health Surveys (DHSs) conducted in the 12 East African countries. A total weighted sample of 141,483 reproductive-age women who gave birth within five years preceding the survey was included. All analyses presented in this paper were weighted for the sampling probabilities and non-response using sampling weight (V005), primary sampling unit (V023), and strata (V021). The analysis was done using STATA version 14 statistical software, and the pooled prevalence of health facility delivery with a 95% Confidence Interval (CI) was presented using a forest plot. For associated factors, the Generalized Linear Mixed Model (GLMM) was fitted to consider the hierarchical nature of the DHS data. The Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), and Likelihood Ratio (LR)-test were done to assess the presence of a significant clustering effect. Besides, deviance (-2LLR) was used for model comparison since the models were nested models. Variables with a p-value of less than 0.2 in the bivariable mixed-effect binary logistic regression analysis were considered for the multivariable analysis. In the multivariable mixed-effect analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported to declare the strength and significance of the association between the independent variable and health facility delivery. Results The proportion of health facility delivery in East Africa was 87.49% [95% CI: 87.34%, 87.64%], ranged from 29% in Ethiopia to 97% in Mozambique. In the Mixed-effect logistic regression model; country, urban residence [AOR = 2.08, 95% CI: 1.96, 2.17], primary women education [AOR = 1.61, 95% CI: 1.55, 1.67], secondary education and higher [AOR = 2.96, 95% CI: 2.79, 3.13], primary husband education [AOR = 1.19, 95% CI: 1.14, 1.24], secondary husband education [AOR = 1.38, 95% CI: 1.31, 1.45], being in union [AOR = 1.23, 95% CI: 1.18, 1.27], having occupation [AOR = 1.11, 95% CI: 1.07, 1.15], being rich [AOR = 1.36, 95% CI: 1.30, 1.41], and middle [AOR = 2.14, 95% CI: 2.04, 2.23], health care access problem [AOR = 0.76, 95% CI: 0.74, 0.79], having ANC visit [AOR = 1.54, 95% CI: 1.49, 1.59], parity [AOR = 0.56, 95% CI: 0.55, 0.61], multiple gestation [AOR = 1.83, 95% CI: 1.67, 2.01] and wanted pregnancy [AOR = 1.19, 95% CI: 1.13, 1.25] were significantly associated with health facility delivery. Conclusion This study showed that the proportion of health facility delivery in East African countries is low. Thus, improved access and utilization of antenatal care can be an effective strategy to increase health facility deliveries. Moreover, encouraging women through education is recommended to increase health facility delivery service utilization.
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Affiliation(s)
- Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Alshammari MB, Haridi HK. Prevalence and Determinants of Exclusive Breastfeeding Practice among Mothers of Children Aged 6-24 Months in Hail, Saudi Arabia. SCIENTIFICA 2021; 2021:2761213. [PMID: 33854807 PMCID: PMC8019643 DOI: 10.1155/2021/2761213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 03/14/2021] [Accepted: 03/17/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The WHO recommends that infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development, and health. Nonadherence to exclusive breastfeeding (EBF) depends largely on the individual, sociocultural context, and institutional factors. The aim of this study is to estimate coverage and factors associated with adherence to EBF among mothers in the urban Hail region, Saudi Arabia. METHODS A cross-sectional study was carried out during February-June 2019 among 450 mothers of children aged 6-24 months attending immunization and well-baby clinics in 6 primary healthcare centers in Hail city. A pretested structured questionnaire was used to interview the consented participants. RESULTS The majority of mothers (72.9%) were aware of EBF; 24% reported initiation of breastfeeding within one hour after delivery; however, 71.1% did during the first 24 hours. The majority (76.8%) fed colostrum to their newborn; nevertheless, 50.1% had given a prelacteal feeding. Mothers who reported EBF practice were 50.7% (CI 45.9-55.4). The adjusted logistic regression analysis revealed that mother's awareness about EBF (aOR 3.03; 95% CI 1.78-5.18), antenatal care received at the governmental facility (aOR 2.63; 95% CI 1.28-5.41), breastfeeding a previous child (aOR 2.42; 95% CI 1.46-4.03), counseling received after delivery (aOR 2.47; 95% CI 1.34-4.53), and colostrum feeding given (aOR 4.24; 95% CI 2.31-7.77) were positively associated with EBF practice. On the other hand, mother's education (OR 0.39; 95% CI 0.15-0.99), higher family income (aOR 0.04; 95% CI 0.00-0.31), and practice prelacteal feeding (aOR 0.61; 95% CI 0.38-0.97) were negatively associated with EBF practice. CONCLUSION EBF rate in urban Hail is still far below WHO recommendations. Efforts to strengthen mothers' counseling/support during antenatal care and immediately after delivery are needed to promote EBF practice, especially in the private sector.
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Affiliation(s)
| | - Hassan Kasim Haridi
- The Designated Institutional Official (DIO) for Academic Affairs & Postgraduate Studies, Health Affairs, Najran, Saudi Arabia
- Research Department, Health Affairs, Hail Region, Saudi Arabia
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Binns C, Low WY. The Rich Get Richer and the Poor Get Poorer: The Inequality of COVID-19. Asia Pac J Public Health 2021; 33:185-187. [PMID: 33759590 DOI: 10.1177/10105395211001662] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Colin Binns
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Wah Yun Low
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Asia-Europe Institute, University of Malaya, Kuala Lumpur, Malaysia
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Abstract
This review provides an overview of the composition, structure, and biological activities of milk fat globule membrane (MFGM) compounds with focus on the future application of this compound as a food ingredient. MFGM is a particular component of mammalian milks and is comprised of a tri-layer of polar lipids, glycolipids and proteins. In recent years, MFGM has been extensively studied for the purpose of enhancing the efficacy of infant nutrition formula. For example, infant formulas supplemented with bovine MFGM have shown promising results with regard to neurodevelopment and defense against infections. Components of MFGM have been shown to present several health benefits as the proteins of the membrane have shown antiviral activity and a reduction in the incidence of diarrhea. Moreover, the presence of sphingomyelin, a phospholipid, implies beneficial effects on human health such as enhanced neuronal development in infants and the protection of neonates from bacterial infections. The development of a lipid that is similar to human milk fat would represent a significant advance for the infant formula industry and would offer high technology formulas for those infants that depend on infant formula. The complexity of the structure of MFGM and its nutritional and technological properties is critically examined in this review with a focus on issues relevant to the dairy industry.
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An Evaluation of a Perinatal Education and Support Program to Increase Breastfeeding in a Chinese American Community. Matern Child Health J 2020; 25:214-220. [PMID: 33196922 DOI: 10.1007/s10995-020-03016-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION In 2015, a community health center implemented a multipronged, Chinese language, health education initiative to increase breastfeeding. Perinatal education, hospital visits after delivery, and postpartum support were implemented to provide informational and emotional support. This study evaluates the impact of the breastfeeding program for Chinese American women. METHODS This is a quasi-experimental study to assess the change in any and exclusive breastfeeding at 4-6 weeks postpartum. A difference-in-differences regression analysis was used to determine change in breastfeeding attributable to the program at an intervention site after adjusting for change in a control site during the same period. Change in breastfeeding was also examined by sociodemographic characteristics. RESULTS A total of 1475 women who received perinatal care at two community center sites in 2014 and 2016 were included in the study. Within the women who received the intervention, any breastfeeding increased by 24 percentage points to 71% and exclusive breastfeeding increased by 13 percentage points to 27%. After adjusting for the change in the control group during the same period, the increases in any and exclusive breastfeeding attributable to the program were 17 (p < 0.01) and 9 percentage points (p < 0.05), respectively. Primiparous women and those who have been in the US longer than 5 years experienced the highest increase in any breastfeeding from the program. Exclusive breastfeeding was most improved in those with non-Medicaid insurance. CONCLUSIONS A bilingual and bicultural breastfeeding program incorporated into routine pregnancy care at an intervention site experienced increases in both any and exclusive breastfeeding, even after adjusting for changes in breastfeeding in a control group. SIGNIFICANCE STATEMENT What is known on this subject? Chinese Americans are the least likely to breastfeed among all ethnicities in New York City. Cultural and language barriers plus the lack of Chinese language resources contribute to low breastfeeding rates. What this study adds? A bilingual and bicultural breastfeeding program of perinatal education and postpartum support incorporated into routine pregnancy care increased both any and exclusive breastfeeding in a Chinese American population. Increase in any breastfeeding was the greatest in primiparous women and those who had been in the US for a longer time and increase in exclusive breastfeeding was greatest in women not using Medicaid insurance.
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Yin XH, Zhao C, Yang YM, Shi HF, Wu TC, Xie JL, Niu JQ, Wang XL, Fang J. What is the impact of rural-to-urban migration on exclusive breastfeeding: a population-based cross-sectional study. Int Breastfeed J 2020; 15:86. [PMID: 33054799 PMCID: PMC7560081 DOI: 10.1186/s13006-020-00330-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 10/09/2020] [Indexed: 12/03/2022] Open
Abstract
Background In China, less than one third of infants under 6 months of age are being exclusively breastfed. Maternal rural-to-urban migration contributes to these low rates of breastfeeding practices. Therefore, the aim of this study was to assess the prevalence of breastfeeding practices and associated factors among rural-to-urban migrant children and local children with infants aged 0–12 months in China, 2018. Methods Data were collected from a population-based cross-sectional survey in 2018 that included 6995 infants from eight urban areas (four metropolis and four medium sized/small cities) in China. The prevalence of breastfeeding practices was calculated using a 24-h recall questionnaire for all infants aged under 12 months. Logistic regression was conducted to examine the association between the prevalence of breastfeeding practices and maternal migrant status, after adjusting for sociodemographic characteristics, mother-infant health information and supportive information. For exclusive breastfeeding, we further analyzed its association with maternal rural-to-urban migration, stratified by maternal education level, maternal resident place and maternal ethnicity, respectively. Results The overall prevalence of ever breastfeeding, exclusive breastfeeding, predominant breastfeeding and age-appropriate breastfeeding (exclusive breastfeeding of infants under 6 months of age and complementary feeding from six to 12 months of age) was 97.51, 29.84, 59.89 and 45.07%, respectively. Rural-to-urban migrant children were less likely to be exclusively breastfed compared to local children (AOR 0.81, 95% CI 0.68, 0.95). Stratified by different sociodemographic variables, a negative association between exclusive breastfeeding and rural-to-urban migration was only found in the group with high education level, in the group living in metropolis and in the group of minorities, respectively. Conclusions The overall prevalence of breastfeeding practices was low in both rural-to-urban migrant children and local children. Besides common strategies, special approaches should be provided for urban highly educated migrants.
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Affiliation(s)
- Xiao Han Yin
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Chen Zhao
- China Development Research Foundation, Beijing, China
| | - Yu Mei Yang
- School of Economics and Management, Beijing Forestry University; China Center for the Economics of Human Development, Beijing, China
| | - Hui Feng Shi
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Tian Chen Wu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Jia Lei Xie
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Jie Qiong Niu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Xiao Li Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China. .,National Health Commission Key Laboratory of Reproductive Health, Beijing, China.
| | - Jin Fang
- China Development Research Foundation, Beijing, China.
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Li J, Duan Y, Bi Y, Wang J, Lai J, Zhao C, Fang J, Yang Z. Predictors of exclusive breastfeeding practice among migrant and non-migrant mothers in urban China: results from a cross-sectional survey. BMJ Open 2020; 10:e038268. [PMID: 32895284 PMCID: PMC7476475 DOI: 10.1136/bmjopen-2020-038268] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To explore and compare the predictors for exclusive breast feeding (EBF) among migrant and non-migrant mothers in China. DESIGN A large-scale cross-sectional study. SETTING 12 counties/districts were covered in China. PARTICIPANTS A total number of 10 408 mothers were recruited, of whom 3571 mothers of infants aged 0-5 months in urban China were used for analysis. OUTCOME The practice of EBF was calculated based on the foods and drinks consumed in the last 24 hours, as recommended by WHO. RESULTS Around 30% of Chinese mothers with infants aged 0-5 months practised EBF in urban areas, with no significant difference between migrant and non-migrant mothers (p=0.433). Among the migrant mothers, factors associated with EBF included residence in big cities (adjusted OR, AOR 1.68 (95% CI 1.20 to 2.34)), premature birth (AOR 0.27 (95% CI 0.09 to 0.81)), knowledge about EBF (AOR 2.00 (95% CI 1.51 to 2.65)), low intention of breast feeding in the first month postpartum (AOR 0.59 (95% CI 0.36 to 0.97)) and mothers working in agriculture-related fields or as casual workers (AOR 1.77 (95% CI 1.18 to 2.64)). Among non-migrant mothers, in addition to similar predictors including residence in big cities (AOR 1.40 (95% CI 1.13 to 1.73)), knowledge about EBF (AOR 1.25 (95% CI 1.02 to 1.53)) and low intention of breast feeding in the first month post partum (AOR 0.46 (95% CI 0.31 to 0.70)], early initiation of breast feeding (EIBF) (AOR 1.78 (95% CI 1.35 to 2.33)) and caesarean delivery (AOR 0.74 (95% CI 0.60 to 0.89)) were also factors associated with EBF. CONCLUSIONS There was no significant difference in the prevalence of EBF between migrant and non-migrant mothers in urban China. Premature birth and maternal occupation in agriculture-related fields or casual work were distinctive factors associated with EBF for migrants, while EIBF and caesarean delivery were unique predictors for non-migrants. TRIAL REGISTRATION NUMBER ChiCTR-ROC-17014148; Pre-results.
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Affiliation(s)
- Jia Li
- Business School, Nanjing University of Information Science & Technology, Nanjing, China
- Child Development Center, China Development Research Foundation, Beijing, China
| | - Yifan Duan
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ye Bi
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jianqiang Lai
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chen Zhao
- Child Development Center, China Development Research Foundation, Beijing, China
| | - Jin Fang
- Child Development Center, China Development Research Foundation, Beijing, China
| | - Zhenyu Yang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
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22
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Fang Z, Liu Y, Wang H, Tang K. The Patterns and Social Determinants of Breastfeeding in 12 Selected Regions in China: A Population-Based Cross-Sectional Study. J Hum Lact 2020; 36:436-447. [PMID: 31513461 DOI: 10.1177/0890334419868156] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND With rapid industrialization and urbanization, there is a growing need for women to enter the workforce, and affluent people are drawn to the infant formula market. The breastfeeding rates in China are below the optimal level. Large scale quantitative research studying breastfeeding practices after 2015 in China are lacking. RESEARCH AIM We aimed to (1) explore the latest patterns and (2) identify the determinants of breastfeeding in China. METHODS The study was a population-based, cross-sectional survey. A multi-stage sampling technique was adopted for the selection of participants. We recruited 10,408 mothers with children under 12 months old, in 12 regions of China, and conducted a questionnaire survey about breastfeeding patterns. The associations between social and biophysical determinants and breastfeeding outcomes were analyzed using a logistic regression model. RESULTS The exclusive breastfeeding rate was 29.32% (n = 3,052) decreasing from 32.71% (n = 3,404) to 15.83% (n = 1,648) among children aged 0-5 months. Cesarean section had a negative association with early breastfeeding initiation (OR = .33, 95% CI [.30, .36]), exclusive breastfeeding (OR = .78, 95% CI [.69, .89]), and predominant breastfeeding (OR = .73, 95% CI [.65, .83]). Compared to participants with an annual household income lower than 40,000 Yuan ($5,817 USD), those with over 100,000 Yuan ($14,542 USD) had an OR of .78 (95% CI [.67, .90]) in exclusive breastfeeding. Compared with illiterate and unemployed groups, middle/high school education and a current work status, respectively, were associated with a lower likelihood of exclusive breastfeeding (OR = .73, 95% CI [.63, .84]; OR = .58, 95% CI [.37, .89]). CONCLUSIONS The prevalence of breastfeeding in 12 selected regions in China was low and interventions focusing on the targeted population should be strengthened.
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Affiliation(s)
- Zhe Fang
- 33133 School of Public Health, Peking University Health Science Centre, Beijing, China.,12442 Research Center for Public Health, Tsinghua University, Beijing, China
| | - Yuning Liu
- 234189 Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Hanyu Wang
- Institute for Medical Humanities, Peking University Health Science Centre, Beijing, China
| | - Kun Tang
- 12442 Research Center for Public Health, Tsinghua University, Beijing, China
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23
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Saleh M, Zadeh Modarres S, Esmaeili S, Asadi Shahmirzadi S, Panahi M, Mardi P, Bakhtiyari M. Effects of assisted reproduction techniques on breastfeeding outcomes. J Matern Fetal Neonatal Med 2020; 35:2464-2468. [PMID: 32654585 DOI: 10.1080/14767058.2020.1786518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM The aim of this study was to compare the breastfeeding outcome between those who conceived via assisted reproduction techniques (ART) and those who had spontaneous conception. METHODS This case-control study was conducted during a 2-year period between 2014 and 2016 in a tertiary healthcare center in Tehran, capital of Iran. We included a total number of 80 women with ATR conception and 81 women with spontaneous conception. The two study groups were matched regarding the age, parity and the gestational age. Those with contraindication of breastfeeding and history of psychiatric disorders were excluded. The breastfeeding outcome was measured using a structured-based interview and the results were compared between the two study groups. RESULTS The exclusive breastfeeding was significantly higher in spontaneous conception (p < .001). The duration of the breastfeeding was significantly higher in those with spontaneous conception (p < .001). In the same way, the exclusive breastfeeding within the first week was significantly higher in the spontaneous conception group (p = .002). The ATR conception was associated with higher bad feeling during the breastfeeding (p < .001), higher breastfeeding dysfunction (p < .001) and higher experience with difficult breastfeeding (p < .001). The return of the work after 3 months was significantly higher in spontaneous conception (p = .004). CONCLUSIONS The results of this study demonstrate that ATR conception is associated with worse breastfeeding outcome determined by lower rate of exclusive breastfeeding and higher rate of breastfeeding dysfunction and bad feeling during breastfeeding.
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Affiliation(s)
- Masoumeh Saleh
- Department of Gynecology & Obstetric, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahrzad Zadeh Modarres
- Department of Gynecology & Obstetric, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samaneh Esmaeili
- Department of Gynecology & Obstetric, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Masoumeh Panahi
- Department of Gynecology and Obstetrics, Shiraz University of Medical Science, Shiraz, Iran
| | - Parham Mardi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahmood Bakhtiyari
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
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24
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Tang K, Wang H, Tan SH, Xin T, Qu X, Tang T, Wang Y, Liu Y, Gaoshan J. Association between maternal education and breast feeding practices in China: a population-based cross-sectional study. BMJ Open 2019; 9:e028485. [PMID: 31467048 PMCID: PMC6720234 DOI: 10.1136/bmjopen-2018-028485] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To investigate the association between maternal education and breast feeding in the Chinese population, with a consideration of household income and health-seeking behaviours. DESIGN A nationally representative population-based cross-sectional study. SETTING 77 counties from 12 geographically distinct regions in China. PARTICIPANTS 10 408 mothers with children from 0 to 12 months of age, aged 15-53 years old (mean: 29.15, SD: 5.11) were classified into primary school or below group (n=781), middle school group (n=3842), high school/vocational school group (n=1990), college or above group (n=3795), according to their highest completed education. OUTCOMES Five breastfeeding outcomes, including early initiation of breast feeding (EIB), exclusive breast feeding (EBF) under 6 months, predominant breast feeding under 6 months, current breast feeding and children ever breast fed, were calculated based on the standardised questionnaire from the WHO and Wellstart International's toolkit for monitoring and evaluating breastfeeding activities. RESULTS The absolute risk of EIB and EBF in the lowest maternal education level was 64.85% and 26.53%, respectively, whereas the absolute risk of EIB and EBF in the highest maternal education level was 77.21% and 14.06%, respectively. A higher level of maternal education was positively associated with EIB (risk ratio (RR): 1.22; 95% CI: 1.12 to 1.30) and was inversely associated with EBF (RR: 0.59; 95% CI: 0.38 to 0.88). Stratified by household income, a positive association with EIB was observed only in the group with the highest household income and an inverse association with EBF was found in both low household and high household income groups. CONCLUSIONS Mothers with a higher education were more likely to initiate early breast feeding when they were also from a high-income household while also being less likely to exclusively breast feed their babies. Routine and successful nursing is crucial for the health of infants and is influenced by maternal education. Future public health interventions to promote breast feeding should consider the issues related to the educational level of mothers.
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Affiliation(s)
- Kun Tang
- Research Center for Public Health, Tsinghua University, Beijing, China
| | - Hanyu Wang
- Institute for Medical Humanities, Peking University Health Science Centre, Beijing, China
| | - Shi Hui Tan
- School of Basic Medical Sciences, Peking University Health Science Centre, Beijing, China
| | - Tong Xin
- Department of Global Health, Peking University Health Science Centre, Beijing, China
| | - Xueqi Qu
- School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Tianyu Tang
- Research Center for Public Health, Tsinghua University, Beijing, China
| | - Yuqi Wang
- Institute for Medical Humanities, Peking University Health Science Centre, Beijing, China
| | - Yuning Liu
- School of Public Health, Peking University Health Science Centre, Beijing, China
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25
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Chen C, Cheng G, Pan J. Socioeconomic status and breastfeeding in China: an analysis of data from a longitudinal nationwide household survey. BMC Pediatr 2019; 19:167. [PMID: 31133000 PMCID: PMC6535851 DOI: 10.1186/s12887-019-1551-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 05/21/2019] [Indexed: 12/03/2022] Open
Abstract
Background Socioeconomic status is an important factor affecting the initiation and cessation of breastfeeding. However, limited evidence exists regarding the association between socioeconomic status and breastfeeding behavior in China on a national level. This study aims to investigate the relationship between socioeconomic status and the initiation and duration of breastfeeding in China. Methods Data were collected from the China Family Panel Studies, a longitudinal nationwide household survey. A total of 2938 infants born between 2010 and 2014 were included in the study. The logistic regression model was used to investigate the relationship between socioeconomic status and the initiation of breastfeeding. Meanwhile, the Cox proportional hazards model was used to investigate the relationship between socioeconomic status and the risk of breastfeeding cessation. Results Overall, 90.5% of infants were breastfed, while the average duration of breastfeeding was 8.66 months in China. The breastfeeding continuance rate at 12 months declined sharply, to 30.1%. The study’s findings also indicate that socioeconomic status did not significantly affect breastfeeding initiation. However, infants whose mothers had a high school or higher education and who scored 33–58 on the International Socio-Economic Index of Occupational Status (ISEI) were more likely to experience breastfeeding cessation, as were infants whose fathers had an ISEI score of 59–90. Conclusions Efforts to promote breastfeeding practices should be conducted comprehensively to target mothers with a high school or higher education, mothers with a medium occupational status, and fathers with a high occupational status.
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Affiliation(s)
- Chu Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China
| | - Guo Cheng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China
| | - Jay Pan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China. .,West China Research Centre for Rural Health Development, Sichuan University, No.17, Section 3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China.
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26
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Tang K, Liu Y, Meng K, Jiang L, Tan S, Liu Y, Chen J. Breastfeeding duration of different age groups and its associated factors among Chinese women: a cross-sectional study. Int Breastfeed J 2019; 14:19. [PMID: 31086559 PMCID: PMC6506932 DOI: 10.1186/s13006-019-0212-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 04/26/2019] [Indexed: 11/13/2022] Open
Abstract
Background The current situation of breastfeeding in China has been discussed in many articles, and a declining trend of breastfeeding duration has been confirmed. The associations between various socioeconomic, reproductive factors and breastfeeding duration have been discussed as well. However, there remains a lack of evidence on breastfeeding duration amongst different age groups. Methods Data was extracted from the baseline of a large cohort study: a sample of 300,000 adult women born in the 1930s’ through 1970s’ from 10 geographically distinct regions was obtained. The breastfeeding duration was assumed by breastfeeding duration of the first child. Different age groups were categorized by 10-year age groups, and they were born in 1930–1938, 1939–1948, 1949–1958, 1959–1968, and 1969–1974. Multivariable linear regression was used to evaluate the associations between breastfeeding duration and sociodemographic, and reproductive factors (i.e.: different age groups, education, household size, use of oral contraceptive pills, age at menarche, and age at first birth). Results The mean breastfeeding duration (Standard Deviation) of women born in 1930–1938, 1939–1948, 1949–1958, 1959–1968, and 1969–1974 were 15.4 (9.2), 14.8 (8.2), 14.7 (8.9), 12.8 (7.2), 13.1 (7.2) months, respectively. Younger age groups, higher levels of education, and use of oral contraceptive pills were negatively associated with breastfeeding duration. In particular, the negative association with higher levels of education (for urban regions: βmiddle school = − 1.3, βhigh school & above = − 1.6; for rural regions: βmiddle school = − 0.6, βhigh school & above = − 1.2; all p < 0.0001) was found significant in both rural and urban areas, household size (β = − 0.1, p < 0.0001) and age at first birth (β = − 0.2, p < 0.0001) were negatively associated with breastfeeding duration only in urban areas, but were all positively associated with breastfeeding duration in rural areas. Conclusions This research demonstrated that, among Chinese women, younger age groups and higher levels of education were negatively associated with breastfeeding duration. Considering the declining trend of breastfeeding duration in China, healthcare providers need to continue advocating for breastfeeding practices. We also call for collaboration with various sectors and concerned groups to actions that promote breastfeeding-friendly environment and measures.
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Affiliation(s)
- Kun Tang
- 1Research Center for Public Health, Tsinghua University School of Medicine, Haidian District, Beijing, 10084 China
| | - Yaqian Liu
- 1Research Center for Public Health, Tsinghua University School of Medicine, Haidian District, Beijing, 10084 China
| | - Ke Meng
- 2School of Public Policy and Management, Tsinghua University, Haidian District, Beijing, 100084 China
| | - Li Jiang
- 3Peking University People's Hospital, No. 11 Xizhimen South Ave., Xicheng District, Beijing, 100044 China
| | - Shihui Tan
- 4School of Basic Medical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing, 100191 China
| | - Yuning Liu
- 5Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 USA
| | - Jiawen Chen
- 6School of Nursing, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing, 100191 China
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27
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Wu X, Gao X, Sha T, Zeng G, Liu S, Li L, Chen C, Yan Y. Modifiable Individual Factors Associated with Breastfeeding: A Cohort Study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E820. [PMID: 30845743 PMCID: PMC6427345 DOI: 10.3390/ijerph16050820] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 02/21/2019] [Accepted: 03/01/2019] [Indexed: 12/19/2022]
Abstract
Breast milk is an ideal first food for infants in the initial months of life. This study aimed to identify modifiable individual factors in breastfeeding during the first six months of life in Hunan. This birth cohort study was conducted in three communities in Changsha, Hunan province. Data were collected through maternal health manuals and self-administered questionnaires during the follow-up period. To find risk factors and calculate odds ratios, generalized estimating equation models were applied. The final study included 951 mother-infant pairs. The prevalence of exclusive breastfeeding and any breastfeeding in this study was below the World Health Organization's breastfeeding goals. Infant age, passive smoking after delivery, minor postnatal depression, and feeding-bottles were shown to act negatively on both exclusive breastfeeding and any breastfeeding. In addition, cesarean delivery and delayed breastfeeding initiation had adverse effects on exclusive breastfeeding. Multiparas were less likely to continue any breastfeeding during the first few months. This study highlights the importance of screening probable maternal depression during primary care service and reducing secondhand smoke and feeding-bottle use. The results also suggest that healthcare professionals should provide more assistance and education to multiparas and mothers with cesarean delivery or delayed breastfeeding initiation.
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Affiliation(s)
- Xialing Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 110 Xiangya Road, Kaifu District, Changsha 410078, China.
| | - Xiao Gao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 110 Xiangya Road, Kaifu District, Changsha 410078, China.
| | - Tingting Sha
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 110 Xiangya Road, Kaifu District, Changsha 410078, China.
| | - Guangyu Zeng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 110 Xiangya Road, Kaifu District, Changsha 410078, China.
| | - Shiping Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 110 Xiangya Road, Kaifu District, Changsha 410078, China.
| | - Ling Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 110 Xiangya Road, Kaifu District, Changsha 410078, China.
| | - Cheng Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 110 Xiangya Road, Kaifu District, Changsha 410078, China.
| | - Yan Yan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 110 Xiangya Road, Kaifu District, Changsha 410078, China.
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28
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Khan AA, Mohiuddin O, Wahid I, Khan BS, Khan SH. Predicting the Relationship Between Breastfeeding and Gross Motor Milestones Development: The Practice and Prevalence of Breastfeeding in Metropolitan Areas of Sindh, Pakistan. Cureus 2019; 11:e4039. [PMID: 31011501 PMCID: PMC6456361 DOI: 10.7759/cureus.4039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective Breastfeeding is known to be beneficial for the health of both the child and the mother. The primary aim of this study is to assess the effect of lactation on the development of gross motor milestones. The evaluation of breastfeeding practices and the frequency of lactation among mothers living in the urban city of Karachi, Pakistan, is the secondary aim of this study so that interventions can be made to improve breastfeeding practices. Methods A cross-sectional study was conducted using a well-designed questionnaire. A population of 360 mothers living in Karachi, Pakistan, with children aged between two and six years, was selected. The questionnaire included demographic data, the duration of breastfeeding, the age of milestone development, and the educational and financial status of the mothers. The relationship between the duration of breastfeeding and the development of gross motor milestones was analyzed using the Pearson chi-square test via Statistical Package for the Social Sciences (SPSS) version 22.0. A p-value < 0.05 was rendered significant. Descriptive statistics were applied to calculate the frequency of the varying duration of breastfeeding among mothers with respect to their socioeconomic status and educational class. Results The study revealed that 68.6% of children were breastfed for four months or more with supplementary feed or solids started at four months or later (prolonged exclusive). Along with this, 6.4% were breastfed only before two months (short duration), 5.6% had been breastfed beyond two months but ceased before four months (intermediate duration) while 14.7% were breastfed for four months or more with supplementary feed or solids started before four months (prolonged partial). Mothers belonging to low (67.7%), moderate (67.5%), and higher (72.2%) socioeconomic status (SES) preferred to breastfeed for a prolonged exclusive duration. With respect to education, uneducated mothers (72.6%), mothers with primary education (63.6%), secondary education (65.90%), and tertiary education (68.6%) also breastfed for a prolonged exclusive duration. No statistically significant correlation was found between gross motor milestone development and the duration of breastfeeding (p-value > 0.05). Conclusion Breastfeeding was found to have an insignificant impact on the development of gross motor milestones despite the fact that mothers, irrespective of educational background and socioeconomic status, were found to be breastfeeding for a prolonged exclusive duration.
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Affiliation(s)
- Anosh A Khan
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Osama Mohiuddin
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Iqra Wahid
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Bareerah S Khan
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Sulhera H Khan
- Medical Education and Simulation, Dow University of Health Sciences, Karachi, PAK
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Aguilar-Ortega JM, González-Pascual JL, Cardenete-Reyes C, Pérez-de-Algaba-Cuenca C, Pérez-García S, Esteban-Gonzalo L. Adherence to initial exclusive breastfeeding among Chinese born and native Spanish mothers. BMC Pregnancy Childbirth 2019; 19:44. [PMID: 30691401 PMCID: PMC6348660 DOI: 10.1186/s12884-018-2161-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 12/21/2018] [Indexed: 11/10/2022] Open
Abstract
Background Benefits of breastfeeding on the health of children, mothers and society are well known. However, breastfeeding rates vary according to the population examined. Chinese-born women migrated to high-income countries have shown low breastfeeding rates. Nevertheless, studies comparing breastfeeding rates of Chinese-born immigrants and natives are scarce. The aims of this study were therefore: 1) to compare the rate of exclusive breastfeeding at hospital discharge after giving birth between Chinese-born women resident in Spain and native Spanish women, 2) to assess the influence of the biological, socioeconomic, work-related and cultural factors on exclusive breastfeeding in women of Chinese origin. Methods A cross-sectional descriptive study with between group comparisons. This study included 73 postpartum women (33 Chinese-born and 40 native Spanish women). The association between exclusive breastfeeding and the country of origin was assessed by binary logistic regression. Results Native Spanish women showed a greater prevalence of exclusive breastfeeding (80%) compared to Chinese born immigrant women (36.4%) (adjusted for socioeconomic status, parental level of education, age, cesareans and birth weight) (OR = 0.21; 95% CI 0.05–0.91; p = 0.037). However, in other models that considered both work and cultural influences, no differences were observed. Discussion The classic biological and socioeconomic variables (educational and socioeconomic levels) do not seem to explain the lower rates of exclusive breastfeeding among Chinese immigrant women. This paradigm of inequity appears to be based on both the work conditions as well as cultural characteristics of Chinese born women in Spain, such as their overall attitude towards breastfeeding.
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Affiliation(s)
- Juana María Aguilar-Ortega
- "12 de Octubre" University Hospital, Madrid, Spain.,Nursing Department, Rey Juan Carlos University, Alcorcón, Spain
| | - Juan Luis González-Pascual
- Nursing Department, School of Biomedical and Health Sciences, Universidad Europea de Madrid (UEM), Edificio A. Departamento de Enfermería. c/ Tajo, s/n, 28670, Villaviciosa de Odón, Madrid, Spain.
| | - César Cardenete-Reyes
- Nursing Department, School of Biomedical and Health Sciences, Universidad Europea de Madrid (UEM), Edificio A. Departamento de Enfermería. c/ Tajo, s/n, 28670, Villaviciosa de Odón, Madrid, Spain
| | | | - Santiago Pérez-García
- "12 de Octubre" University Hospital, Madrid, Spain.,Nursing Department, Complutense de Madrid University, Madrid, Spain
| | - Laura Esteban-Gonzalo
- Nursing Department, School of Biomedical and Health Sciences, Universidad Europea de Madrid (UEM), Edificio A. Departamento de Enfermería. c/ Tajo, s/n, 28670, Villaviciosa de Odón, Madrid, Spain
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30
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Lindsay AC, Le Q, Greaney ML. Infant Feeding Beliefs, Attitudes, Knowledge and Practices of Chinese Immigrant Mothers: An Integrative Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 15:ijerph15010021. [PMID: 29295487 PMCID: PMC5800121 DOI: 10.3390/ijerph15010021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 12/18/2017] [Accepted: 12/20/2017] [Indexed: 12/15/2022]
Abstract
Chinese are a fast-growing immigrant population group in several parts of the world (e.g., Australia, Canada, Europe, Southeast Asia, United States). Research evidence suggests that compared to non-Hispanic whites, individuals of Asian-origin including Chinese are at higher risk of developing cardiovascular disease and type 2 diabetes at a lower body mass index (BMI). These risks may be possibly due to genetic differences in body composition and metabolic responses. Despite the increasing numbers of Chinese children growing up in immigrant families and the increasing prevalence of obesity among Chinese, little research has been focused on children of Chinese immigrant families. This integrative review synthesizes the evidence on infant feeding beliefs, attitudes, knowledge and practices of Chinese immigrant mothers; highlights limitations of available research; and offers suggestions for future research. Using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, we searched four electronic academic/research databases (CINAHL, Medline, PsycINFO, and PubMed) to identify peer-reviewed, full-text papers published in English between January 2000 and September 2017. Only studies with mothers 18+ years old of normally developing infants were included. Of the 797 citations identified, 15 full-text papers were retrieved and 11 studies (8 cross-sectional studies, 3 qualitative studies) met the inclusion criteria and were included in this review. Reviewed studies revealed high initiation rates of breastfeeding, but sharp declines in breastfeeding rates by six months of age. In addition, reviewed studies revealed that the concomitantly use of breast milk and formula, and the early introduction of solid foods were common. Finally, reviewed studies identified several familial and socio-cultural influences on infant feeding beliefs and practices that may increase risk of overweight and obesity during infancy and early childhood among Chinese children of immigrant families. Nonetheless, as only 11 studies were identified and because the majority of studies (n = 8) were conducted in Australia, additional research including longitudinal studies, and studies conducted in countries with large Chinese immigrant population are needed to further identify and understand influences on Chinese immigrant mothers' beliefs, attitudes, and practices related to infant feeding that may increase risk of child overweight and obesity. This information is needed to develop interventions tailored to the beliefs and needs of this fast-growing immigrant group and aimed at promoting healthy infant feeding practices to prevent childhood overweight and obesity.
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Affiliation(s)
- Ana Cristina Lindsay
- Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA.
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Qun Le
- Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA 02125, USA.
| | - Mary L Greaney
- Health Studies and Department of Kinesiology, University of Rhode Island, Kingston, RI 02881, USA.
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