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Rahmartani LD, Quigley MA, Carson C. Do various types of prelacteal feeding (PLF) have different associations with breastfeeding duration in Indonesia? A cross-sectional study using Indonesia Demographic and Health Survey datasets. BMJ Glob Health 2024; 9:e014223. [PMID: 38857945 PMCID: PMC11168184 DOI: 10.1136/bmjgh-2023-014223] [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: 10/11/2023] [Accepted: 04/16/2024] [Indexed: 06/12/2024] Open
Abstract
INTRODUCTION Prelacteal feeding (PLF) is anything other than breastmilk given to newborns in the first few days of birth and/or before breastfeeding is established. PLF comes in many forms and is known as a challenge to optimal breastfeeding. Interestingly, both breastfeeding and PLF are common in Indonesia. This study investigated the association between PLF (any PLF, formula, honey, water and other milk) and breastfeeding duration. METHODS This study used Indonesia Demographic and Health Surveys data from 2002, 2007 and 2017. Sample sizes were 5558 (2007), 6268 (2007) and 6227 (2017) mothers whose last child was aged 0-23 months. We used Cox regression survival analysis to assess the association between PLF and breastfeeding duration, estimating hazard ratios (HR) for stopping earlier. RESULTS Overall PLF was prevalent (59%, 67% and 45% in 2002, 2007 and 2017, respectively), with formula being the most common (38%, 50% and 25%). No association between any PLF and breastfeeding duration in 2002 (HR 0.90 (95% CI 0.70 to 1.16)), but in 2007 and 2017, mothers who gave any PLF were more likely to stop breastfeeding earlier than those who did not (HR 1.33 (95% CI 1.11 to 1.61) and 1.47 (95% CI 1.28 to 1.69), respectively), especially in the first 6 months (HR 2.13 (95% CI 1.55 to 2.92) and 2.07 (95% CI 1.74 to 2.47), respectively). This association was more consistent for milk-based PLF. For example, HR in 2017 was 2.13 (95% CI 1.78 to 2.53) for prelacteal formula and 1.73 (95% CI 1.39 to 2.15) for other milk. The associations were inconsistent for the other PLF types. Prelacteal water showed no association while prelacteal honey showed some association with a longer breastfeeding duration in 2002 and 2007. CONCLUSION The impact of PLF on breastfeeding duration varied by type. While this study supports current recommendations to avoid PLF unless medically indicated, the potential consequences of different PLF types on breastfeeding outcomes should be clearly communicated to healthcare providers and mothers. Further research should explore the reasons for the high PLF prevalence in this setting.
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Affiliation(s)
- Lhuri D Rahmartani
- Department of Epidemiology, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Maria A Quigley
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Claire Carson
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Boccolini CS, Lacerda EMDA, Bertoni N, Oliveira N, Alves-Santos NH, Farias DR, Crispim SP, Carneiro LBV, Schincaglia RM, Giugliani ERJ, Castro IRRD, Kac G. Trends of breastfeeding indicators in Brazil from 1996 to 2019 and the gaps to achieve the WHO/UNICEF 2030 targets. BMJ Glob Health 2023; 8:e012529. [PMID: 37666574 PMCID: PMC10481725 DOI: 10.1136/bmjgh-2023-012529] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/13/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND The comprehension of breastfeeding patterns and trends through comparable indicators is essential to plan and implement public health policies. OBJECTIVE To evaluate the trends of breastfeeding indicators in Brazil from 1996 to 2019 and estimate the gap to achieve the WHO/UNICEF 2030 targets in children under 5 years. METHODS Microdata from two National Surveys on Demography and Health of Women and Children (PNDS-1996 and PNDS-2006) and the Brazilian National Survey on Child Nutrition-2019 were used. The indicators of early initiation of breastfeeding (EIBF), exclusive breastfeeding of infants 0-5 months of age (EBF<6 mo), continued breastfeeding at 1 year of age (CBF1yr) and CBF at 2 years of age (CBF2yr) were analysed using prevalence and 95% CI. The average annual variation and years to achieve the WHO/UNICEF 2030 targets were calculated for Brazil and the macroregions. Statistical analyses considered the survey's complex sample design for each database. RESULTS EIBF increased from 36.3% (95% CI 33.6% to 39.0%) in 1996 to 60.9% (95% CI 56.5% to 65.3%) in 2006 (statistically significant) and 62.5% (95% CI 58.3% to 66.6%) in 2019. EBF<6 mo increased from 26.9% (95% CI 21.3% to 31.9%) in 1996 to 39.0% (95% CI 31.0% to 47.1%) in 2006 and 45.8% (95% CI 40.9% to 50.7%) in 2019 (significant increases for 1996-2019 for Brazil, Northeast and Midwest regions). CBF1yr rose from 36.6% (95% CI 30.8% to 42.4%) in 1996 to 48.7% (95% CI 38.3% to 59.0%) in 2006, and 52.1% (95% CI 45.4% to 58.9%) in 2019. CBF2yr increased from 24.7% (95% CI 19.5% to 29.9%) in 1996 to 24.6% (95% CI 15.7% to 33.5%) in 2006 and 35.5% (95% CI 30.4% to 40.6%) in 2019 (significant increase for 1996-2019). The South and Southeast regions need to double the 2019 prevalence to reach the target for the CBF1yr and CBF2yr; the Northeast and North need to increase 60% the current prevalence for the indicator of EBF<6 mo. CONCLUSION A substantial improvement in breastfeeding indicators occurred in Brazil from 1996 to 2019, although at an insufficient rate to achieve the WHO/UNICEF 2030 targets.
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Affiliation(s)
- Cristiano Siqueira Boccolini
- Laboratório de Informática em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Elisa Maria de Aquino Lacerda
- Departamento de Nutrição e Dietética, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Neilane Bertoni
- Divisão de Pesquisa Populacional, Instituto Nacional de Cancer, Rio de Janeiro, Brazil
| | - Natália Oliveira
- Observatório de Epidemiologia Nutricional, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Nadya Helena Alves-Santos
- Instituto de Estudos em Saúde e Biológicas, Universidade Federal do Sul e Sudeste do Pará, Maraba, Brazil
| | - Dayana Rodrigues Farias
- Observatório de Epidemiologia Nutricional, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Raquel Machado Schincaglia
- Observatório de Epidemiologia Nutricional, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Elsa Regina Justo Giugliani
- Departamento de Pediatria, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Inês Rugani Ribeiro de Castro
- Departamento de Nutrição Social, Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gilberto Kac
- Observatório de Epidemiologia Nutricional, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Coca KP, Lee EY, Chien LY, Souza ACP, Kittikul P, Hong SA, Chang YS. Postnatal women's breastfeeding beliefs, practices, and support during the COVID-19 pandemic: a cross-sectional comparative study across five countries. Int Breastfeed J 2022; 17:58. [PMID: 35978362 PMCID: PMC9385077 DOI: 10.1186/s13006-022-00497-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background Women with COVID-19 experienced numerous concerns and doubts about the safety of breastfeeding their babies, and lack of support may have impacted breastfeeding practices. This study aims to compare breastfeeding beliefs, practices, and contact with healthcare professionals regarding the level of postnatal feeding support provided during the COVID-19 pandemic in Brazil, South Korea, Taiwan, Thailand, and the United Kingdom. Methods A multi-country cross-sectional study was conducted with postnatal women in five countries. Women up to six months postpartum were invited to complete an online survey concerning the transmission of preventative measures, beliefs toward breastfeeding, infant feeding practices in the last 24 hours and experiences of postnatal infant feeding support between July to November 2021. Bivariate and multivariate analyses were performed to identify the association. Results Of the 3,253 eligible responses received, 39.5% of children were aged between one and two months, but in Taiwan (36%) and South Korea (42.8%) they were between three and four months. The mean of the belief score was significantly different among countries (p < 0.0001). Women in Brazil and the UK had a higher rate of breastfeeding at the breast (90.7% and 85.4%, respectively) compared to the three Asian countries (p < 0.0001) while feeding with expressed breastmilk in Thailand (59.9%), Taiwan (52.6%), and South Korea (50.4%) was higher than the others (p < 0.0001). Brazil and UK mothers (mean = 16.0 and 14.5 respectively) had a higher mean score for belief toward breastfeeding during the COVID-19 than the others. These results are inversely associated with breastfeeding but positively related to formula feeding practice. Postnatal feeding support during the COVID-19 pandemic was mainly provided by healthcare professionals (67.1%) and peers / family through face-to-face personal contact (51.6%) in all countries. Conclusion Some differences were found in breastfeeding beliefs during the COVID-19 pandemic in Asian countries. A positive breastfeeding belief was associated with the practice of breastfeeding at the breast. Women from all countries received postpartum infant feeding support from health professionals and peers / family through personal contacts. Governments need to emphasize and disseminate the importance of breastfeeding safety, especially in Asian countries.
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Affiliation(s)
- K P Coca
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil
| | - E Y Lee
- Department of Nursing, Catholic Kkottongnae University, Cheongju-si, Republic of Korea
| | - L Y Chien
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Yang-Ming Campus, Taipei, Taiwan
| | - A C P Souza
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil
| | - P Kittikul
- Breastfeeding Clinic Nakhon Pathom Hospital, Nakhon Pathom, Thailand
| | - S A Hong
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand. .,Institute for Health and Society, Hanyang University, Seoul, Republic of Korea.
| | - Y S Chang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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Miolski J, Raus M, Radusinović M, Zdravković V. Breast milk components and factors that may affect lactation success. ACTA FACULTATIS MEDICAE NAISSENSIS 2022. [DOI: 10.5937/afmnai39-31436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction. Breastfeeding is the most important way to feed a newborn, infant and a young child. Lactogenesis is the ability of secreting milk from the mammary gland and includes secretory initiation and activation. The birth of the placenta and decrease in progesterone levels stimulate an increase in prolactin levels and the secretion of milk from the breast. Human milk contains carbohydrates, lipids, proteins, vitamins, minerals, fatty acids, amino acids and trace elements. In addition, numerous cells, macrophages, bacteria, chemokines, cytokines, immunoglobulins, hormones, growth factors, and mucin are present. The composition of milk differs depending on the phase of secretion. Colostrum is secreted for the first five days after birth, then comes transitional milk, and mature milk two weeks after birth. During the very act of breastfeeding, there is a difference between pre-milk and last milk. In pre-milk, the fat content is low and increases with the duration of lactation, and in breast milk it is relatively high. Aim: To point out the importance of milk composition and factors that are influential for breastfeeding. Conclusion: Maternal parity, age or socioeconomic status and education can affect the concentration of certain components of breast milk. Adequate social policy and support, along with education related to early breastfeeding experiences, can be the key factors in initiating and maintaining breastfeeding. Besides the mother and the child, the entire social community would benefit from that.
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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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Souza DRS, de Morais TNB, Costa KTDS, de Andrade FB. Maternal health indicators in Brazil: A time series study. Medicine (Baltimore) 2021; 100:e27118. [PMID: 34871202 PMCID: PMC8568415 DOI: 10.1097/md.0000000000027118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/14/2021] [Accepted: 08/17/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT In addition to the maternal death indicator, Stork Network proposes the number of prenatal consultations, the gestational age of onset of prenatal care and the number of children breastfeeding.The study aims to analyze maternal health indicators representative of the actions proposed by Stork Network in Brazil, after its implementation. Therefore, this is an ecological study of maternal health indicators in Brazil from 2012 to 2017.Thus, it was found that the number of prenatal consultations per pregnant woman in Brazil from 2012 to 2017 increased >4 times between the first and the last year analyzed. The proportion of pregnant women who started prenatal care in the first trimester of pregnancy increased progressively each year in Brazil.The breastfeeding coefficient also increased progressively between 2014 and 2017 in Brazil. It was found that maternal health indicators improved between 2012 and 2017 in the Brazilian territory.
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Affiliation(s)
- Dandara Rayssa Silva Souza
- Nurse. Master in Collective Health. Postgraduate Program in Public Health. Federal University of Rio Grande do Norte, Natal, Brazil
| | | | | | - Fábia Barbosa de Andrade
- Nurse. Doctor of Health Sciences. Department of Nurse. Federal University of Rio Grande do Norte, Natal, Brazil
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Association between birth attendant and early newborn care in Senegal. Midwifery 2020; 90:102804. [PMID: 32721638 DOI: 10.1016/j.midw.2020.102804] [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: 02/24/2020] [Revised: 07/15/2020] [Accepted: 07/19/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To examine the association between type of birth attendant and early newborn care in Senegal. DESIGN This was a secondary analysis of cross-sectional data from the 2017 Continuous Demographic and Health Survey. PARTICIPANTS The study included data on 6328 women with live births in the three years preceding the survey. MEASUREMENTS The main exposure was the type of birth attendant (doctor, nurse/midwife, auxiliary midwife/matrone, traditional birth attendant, or "others (friend, relative, or no one)). We assessed three outcomes: 1) early initiation of breastfeeding, 2) breastfeeding support, and 3) cord examination. We used multivariable logistic regression to estimate the odds ratios and 95% confidence intervals of early newborn care after adjusting for potential confounders. FINDINGS The coverage of all three newborn care indicators of interest was low. In the adjusted regression models, women whose births were assisted by a nurse/midwife were nearly twice as likely to initiate breastfeeding early compared to those assisted by doctors (odds ratio: 1.87, 95% confidence interval: 1.00-3.45). Women assisted at birth by doctors were significantly more likely to report breastfeeding support and newborn cord examination than those assisted by other types of birth attendants. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Although most recent births were facility-based and assisted by skilled birth attendants, the prevalence of early newborn care was suboptimal. This presents a missed opportunity to improve neonatal outcomes. Training and supporting skilled birth attendants may bridge the gap between opportunity and practice, and lead to improved coverage and quality of newborn care in Senegal.
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