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Umstattd Meyer MR, Houghtaling B, Wende ME, Kheshaifaty KH, Delgado H, Eze SA, Mecate C, Summerall Woodward R, Morgan RL, Krey KJ. A scoping review of policies to encourage breastfeeding, healthy eating, and physical activity among rural people and places in the United States. BMC Public Health 2024; 24:2160. [PMID: 39123168 PMCID: PMC11313091 DOI: 10.1186/s12889-024-19173-7] [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: 12/29/2023] [Accepted: 06/17/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Rural U.S. residents experience a disproportionate burden of diet and physical activity (PA) related chronic disease compared to urban residents, due to resource and economic challenges. Diverse policy approaches for chronic disease prevention have been implemented to address barriers to breastfeeding, healthy eating, and PA. Therefore, the purpose of this paper is to describe policy supports for breastfeeding, healthy eating, and/or PA occurring in rural U.S. areas. METHODS A scoping review was conducted March-June 2020 to identify policy, systems, and environment change approaches occurring in the rural U.S. for breastfeeding, healthy eating, and PA. Search procedures were guided by the PRISMA-ScR, Arksey and O'Malley's work (2007), and a science librarian. Medline, PubMed, Web of Science, and Agricola were used to identify peer-reviewed research. ProQuest Dissertations and Theses A&I were used to identify dissertation research. Grey literature searches included Google, Google Scholar, government pages, and public health, federal nutrition assistance program, Cooperative Extension Services, and related webpages. Policy results are reported and inclusion criteria were: (1) breastfeeding, healthy eating, and/or PA focus; (2) about policy factors; (3) specific to U.S. rural populations/places; and (4) English language. Outcomes (study/source design, objective(s), methods/measurement, setting, population characteristics, behavioral focus, policy-specific results) were extracted into a standardized Excel document. RESULTS Results include 122 total sources: original research, with some sources referencing multiple behaviors, (n = 74 sources: 8 breastfeeding, 41 healthy eating, 42 PA), grey literature (n = 45 sources: 16 breastfeeding, 15 healthy eating, 27 PA), and graduate research (n = 3 sources: 1 breastfeeding, 2 healthy eating, 1 PA). Breastfeeding policy initiatives included policies or programs at hospitals, increasing access to resources, and improving culture or norms at workplaces. Healthy eating policy initiatives included increasing access to healthy foods, reducing financial burden, implementing programs, food assistance programs, and healthy food prescriptions at healthcare facilities. PA policy initiatives focused on Complete Streets, joint or shared use efforts, Safe Routes to Schools, master plans for greenways, trails, and/or transportation, school health plans, and childcare/school standards. CONCLUSIONS Results from this scoping review compile and offer commentary on existing policy solutions to improve breastfeeding, healthy eating, and/or PA in the rural U.S.
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Affiliation(s)
- M Renée Umstattd Meyer
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA.
| | | | - Marilyn E Wende
- Department of Health Education and Behavior, College of Health and Human Performance University of Florida, Gainesville, FL, USA
| | - Khawlah H Kheshaifaty
- School of Nutrition and Food Science, Louisiana State University Agricultural Center, Louisiana State University, Baton Rouge, LA, USA
| | - Haley Delgado
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Stephanie A Eze
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Cassady Mecate
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Rebekah Summerall Woodward
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | | | - Kathy J Krey
- School of Education, Baylor University, Waco, TX, USA
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Girma D, Abita Z. Rural versus urban variations of factors associated with early initiation of breastfeeding in Ethiopia. Heliyon 2024; 10:e33427. [PMID: 39027529 PMCID: PMC467058 DOI: 10.1016/j.heliyon.2024.e33427] [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: 10/17/2021] [Revised: 06/19/2024] [Accepted: 06/21/2024] [Indexed: 07/20/2024] Open
Abstract
Background Early initiation of breastfeeding is an important strategy to reduce under-five mortality. Nevertheless, it remains under-practiced in developing countries. In Ethiopia, there were studies done to identify determinants of early initiation of breastfeeding. However, the variation of factors among rural versus urban residents has not been investigated. Therefore, the main objective of this study is to investigate the variation of factors associated with early initiation of breastfeeding among rural versus urban residences. Methods The 2016 Ethiopian Demographic and Health Survey data was used to conduct the study. Mothers whose index child aged less than 24 months have participated in the study. We excluded mothers who had fetal death during birth and who didn't live with their child. Accordingly, a total of 3396 weighted samples of mothers from rural residences and 478 weighted samples of mothers from urban residences were included in the final analysis. A multivariable logistic regression analysis has been used to explore determinants of early initiation of breastfeeding. Finally, statistically significant associations have been declared by using AOR with a 95%CI at a p-value of <0.05. Results In rural residences, age of mothers 15-24 years (AOR: 1.39, 95 % CI: 1.08, 1.79), mothers who are not currently working (AOR: 1.45, 95 % CI: 1.19, 1.78), large birth size (AOR: 1.49, 95 % CI: 1.17, 1.92), and giving birth at health facility (AOR: 1.25, 95 % CI: 1.01, 1.53) were factors associated with a higher odds of early initiation of breastfeeding. Whereas, in urban residences, being second to third birth order (AOR: 1.94, 95 % CI: 1.01, 3.75), skin-to-skin contact care (AOR: 2.58, 95 % CI: 1.44, 4.63) and antenatal care visit were factors associated with early initiation of breastfeeding. Regardless of residences, vaginal delivery (Rural AOR: 4.06, 95 % CI: 1.75, 9.44; Urban AOR: 2.52, 95 % CI: 1.15, 5.54) and involvement of mothers in health care decisions (Rural AOR: 1.52, 95 % CI: 1.25, 1.85; Urban AOR: 2.62, 95 % CI: 1.33, 5.17) were common determinants of early initiation of breastfeeding. Conclusions This study concludes that the factors associated with early initiation of breastfeeding are different among rural versus urban residences. Accordingly, maternal ages, maternal current working status, birth sizes, and place of delivery are identified as factors associated with early initiation of breastfeeding among rural residences. Whereas, antenatal care visits, skin-to-skin contact care, and birth order are identified as factors associated with early initiation of breastfeeding among urban residences. Regardless of residence, mode of delivery, and involvement of mothers in health care decisions are common determinants of early initiation of breastfeeding. Therefore, irrespective of the residence, special emphasis has to be given to newborns delivered by cesarean section to increase the rate of early initiation of breastfeeding.
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Affiliation(s)
- Desalegn Girma
- Department of Midwifery, College of Health Science, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Zinie Abita
- School of Public Health, College of Health Science, Mizan-Tepi University, Mizan Teferi, Ethiopia
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Frandsen AL, Rytter MJH, Beck M, Schiøtz ML, Broberg L. Supporting breastfeeding for women with low education levels, psychosocial problems, and/or socioeconomic constraints: a scoping review protocol. JBI Evid Synth 2024:02174543-990000000-00326. [PMID: 38946452 DOI: 10.11124/jbies-23-00350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
OBJECTIVE This scoping review aims to identify and map interventions and/or strategies used to support the initiation and continuation of breastfeeding for women at risk of delaying initiation, early cessation, or not breastfeeding due to low levels of education, psychosocial problems, and/or socioeconomic challenges in high-income countries. INTRODUCTION While breastfeeding has lifelong beneficial health effects for women and infants, there is a risk of delaying initiation, early cessation, or not initiating breastfeeding at all due to factors related to health inequalities, such as low levels of education, psychosocial problems, and/or socioeconomic constraints. INCLUSION CRITERIA This review will include eligible quantitative, qualitative, and mixed methods studies, as well as systematic reviews and gray literature. We will encompass studies conducted in high-income countries, focusing on interventions and/or strategies to support women with low levels of education, psychosocial problems, and/or socioeconomic constraints in the initiation and continuation of breastfeeding for up to 6 months postpartum. METHODS This review will follow the JBI methodology for scoping reviews, using the Participants, Concept, and Context framework. The primary search will be performed in the following databases: MEDLINE (PubMed), PsycINFO (EBSCOhost), Embase (Ovid), and CINAHL (EBSCOhost). We will include publications in English, Swedish, Norwegian, Danish, German, Bulgarian, Arabic, and Spanish, published from 1991 until the present. A data charting form will be developed and applied to all the included articles. REVIEW REGISTRATION The study is registered in Open Science Framework, DOI 10.17605/OSF.IO/TMP4V.
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Affiliation(s)
- Annemi Lyng Frandsen
- Department of Pediatric and Adolescent Medicine, Slagelse Hospital, Slagelse, Zealand, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Maren Johanne Heilskov Rytter
- Department of Pediatric and Adolescent Medicine, Slagelse Hospital, Slagelse, Zealand, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Malene Beck
- Department of Pediatric and Adolescent Medicine, University Hospital of Zealand, Roskilde, Zealand, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Syddanmark, Denmark
- Department of Technology and People, Nursing Science, Roskilde University Center, Roskilde, Zealand, Denmark
| | - Michaela Louise Schiøtz
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg University Hospital, Frederiksberg, Denmark
| | - Lotte Broberg
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg University Hospital, Frederiksberg, Denmark
- Department of Gynecology and Obstetrics, Slagelse Hospital, Slagelse, Zealand, Denmark
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Tchakounte D, Fomba Kamga B, Zintchem Mbassa MR. The association between intimate partner violence and breastfeeding practices in Cameroon: An analysis from demographic and health survey of 2018. Heliyon 2024; 10:e32062. [PMID: 38882319 PMCID: PMC11176862 DOI: 10.1016/j.heliyon.2024.e32062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/25/2024] [Accepted: 05/28/2024] [Indexed: 06/18/2024] Open
Abstract
Intimate partner violence is a major public health concern around the world. While its degrading effects on maternal health are well documented, it is not clear establishing a link with child health outcomes, especially on breastfeeding practices. Therefore, this paper aims to analyze the association between Intimate partner violence and breastfeeding practices in Cameroon using data from the 2018 demographic and health survey. Intimate partner violence is apprehended from its three dimensions (physical, emotional and sexual violence), and the two key breastfeeding practices are considered: early initiation to breastfeeding within an hour of delivery for children under 24 months of age, and exclusive breastfeeding during 24 h preceding the mother's interview for children under 6 months. The results of descriptive statistics suggest that 51.91 % (n = 1704) of mothers whose infants between 0 and 23 months of age who acquired early initiation to breastfeeding and 39.61 % (n = 484) of mothers whose infants between 0 and 5 months of age practiced exclusive breastfeeding. The estimated results of the logistic regression model suggest that emotional violence and sexual violence were significantly associated with low chances of early initiation to breastfeeding (OR: 0.675; 95 % CI: 0.528, 0.864; p < 0.05; OR: 0.741; 95 % CI: 0.525, 1.046; p < 0.1), which is not the case with physical violence which has no significant association. No dimension of Intimate partner violence was associated with exclusive breastfeeding, independently or with control for infant, maternal and household characteristics. We further performed robustness analysis, and the findings suggest that the associations are robust to consider another measure of Intimate partner violence and the duration of maternity leave. Thus, to improve breastfeeding practices, in particular early initiation to breastfeeding, public decision-makers should strengthen the fight against domestic violence by emphasizing sexual and emotional violence. This paper provides a benchmark for several future investigations that could discuss other breastfeeding practices and the policy challenges towards the length of maternity leave.
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Negesse A, Girma T, Desalegn BB, Kerac M, Berhane M. The epidemiology and associated factors of non-exclusive breastfeeding: a comparative cross-sectional study of livelihood-secure and insecure areas. Front Nutr 2024; 11:1347780. [PMID: 38826580 PMCID: PMC11141399 DOI: 10.3389/fnut.2024.1347780] [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: 12/01/2023] [Accepted: 04/29/2024] [Indexed: 06/04/2024] Open
Abstract
Introduction Regardless of national commitment, non-exclusive breastfeeding (NEBF) is a public health problem that worsens over time. It can be associated with sociodemographic, economic, and environmental factors and may vary depending on livelihood security. Hence, this study aimed to determine the magnitude of NEBF and identify its associated factors by considering two areas with varied degrees of livelihood security. Methods This study represented a comparative cross-sectional survey of 1,060 under 6 months (u6m) infant-mother pairs. Both descriptive and analytic statistics were evaluated using STATA version 17 packages. A binary logistic regression was used to identify associated factors of NEBF. The odds ratio (OR) with a 95% confidence interval (CI) was used to measure the significance of the association at a p-value of <0.05. Results The pooled magnitude of 51% of NEBF mothers (95% CI: 48.0, 54.0) was 53.1% (95% CI: 49.2, 57.0) and 48.1% (95% CI: 43.4, 52.8) in livelihood-secure and livelihood-insecure areas, respectively. The lack of recollecting the infant's birth date by mothers (AOR = 2.4; 95% CI = 1.15-4.40) had the highest odds of NEBF while household heads with tertiary education (AOR = 0.14; 95% CI = 0.01-0.54) and the poorest households (AOR = 0.43; 95%CI = 0.20-0.82) had the lowest odds of NEBF in livelihood-secure areas but not in livelihood-insecure areas. Moreover, mothers with male infants (AOR = 1.9; 95% CI = 1.18-2.92) had high odds of NEBF in livelihood-insecure areas but not in livelihood-secure areas. Infants of 2 to less than 4-month-old (AOR = 8.5; 95% CI = 3.47-18.63) and 4 to less than 6-month-old (AOR = 22.2; 95% CI = 8.02-51.97) in livelihood-secure areas and infants of 2 to less than 4-month-old (AOR = 4.3; 95% CI = 1.29-11.67) and 4 to less than 6-month-old (AOR = 8.3; 95% CI = 2.44-22.39) in livelihood-insecure areas had high odds of NEBF. Conclusion Over half of the mothers were practicing NEBF, which represents a failure to meet national and international targets. Area vulnerability to livelihood security modifies factors of NEBF. Male infants in insecure areas, infants of unknown age in secure areas, and infants aged 2 months or older, regardless of setting, were more vulnerable to NEBF. However, households with the lowest wealth and higher household head educational status in livelihood-secure areas were less vulnerable to NEBF. Hence, livelihood-based interventions targeting mothers of 2 to less than 6-month-old infants, with emphasis on these factors, may help address and reduce NEBF.
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Affiliation(s)
- Ayenew Negesse
- Academic center of Excellence in Human Nutrition, School of Nutrition, Food Science and Technology (SNFST), Hawassa University, Hawassa, Ethiopia
- Department of Human Nutrition, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Tsinuel Girma
- Department of Paediatrics and Child Health, Jimma University, Jimma, Ethiopia
- University of British Colombia (UBC), Vancouver, BC, Canada
| | - Beruk Berhanu Desalegn
- Academic center of Excellence in Human Nutrition, School of Nutrition, Food Science and Technology (SNFST), Hawassa University, Hawassa, Ethiopia
| | - Marko Kerac
- London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Melkamu Berhane
- Department of Paediatrics and Child Health, Jimma University, Jimma, Ethiopia
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Keenan-Devlin LS, Smart BP, Hirschhorn L, Meier P, Jefferson U, Solomonides A, Wang CE, Handler A, Silver RK, Borders AEB. Clinically Integrated Breastfeeding Peer Counseling to Promote Breastfeeding Equity. Am J Perinatol 2024; 41:e2313-e2325. [PMID: 37494586 DOI: 10.1055/s-0043-1771255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
OBJECTIVE This study aimed to determine whether clinically integrated Breastfeeding Peer Counseling (ci-BPC) added to usual lactation care reduces disparities in breastfeeding intensity and duration for Black and Hispanic/Latine participants. STUDY DESIGN This study is a pragmatic, randomized control trial (RCT) of ci-BPC care at two ci-BPC-naïve obstetrical hospital facilities in the greater Chicago area. Participants will include 720 patients delivering at Hospital Site 1 and Hospital Site 2 who will be recruited from eight prenatal care sites during midpregnancy. Participants must be English or Spanish speaking, planning to parent their child, and have no exposure to ci-BPC care prior to enrollment. Randomization will be stratified by race and ethnicity to create three analytic groups: Black, Hispanic/Latine, and other races. RESULTS The primary outcome will be breastfeeding duration. Additional outcomes will include the proportion of breastmilk feeds during the delivery admission, at 6-week postdelivery, and at 6-month postdelivery. A process evaluation will be conducted to understand implementation outcomes, facilitators, and barriers to inform replication and scaling of the innovative ci-BPC model. CONCLUSION This research will produce findings of relevance to perinatal patients and their families, the vast majority of whom desire to provide breastmilk to their infants and require support to succeed with their feeding goals. As the largest RCT of ci-BPC in the United States to date, this research will improve the quality of evidence available regarding the effectiveness of ci-BPC at reducing disparities. These findings will help patients and stakeholders determine the benefits of accepting and adopting the program and inform policies focused on improving perinatal care and reducing maternal/child health disparities. This study is registered with Clinical Trial (identifier: NCT05441709). KEY POINTS · Ci-BPC can promote racial breastfeeding equity.. · Ci-BPC has not been tested as a generalized lactation strategy in prior trials and is underused.. · This RCT will identify if ci-BPC can reduce breastfeeding disparities for Black and Hispanic patients..
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Affiliation(s)
- Lauren S Keenan-Devlin
- Department of Obstetrics and Gynecology NorthShore University HealthSystem, Evanston, Illinois
- Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Britney P Smart
- Department of Obstetrics and Gynecology NorthShore University HealthSystem, Evanston, Illinois
| | - Lisa Hirschhorn
- Medical and Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Paula Meier
- Department of Women, Children and Family Nursing, Rush University College of Nursing, Chicago, Illinois
| | - Urmeka Jefferson
- Department of Women, Children and Family Nursing, Rush University College of Nursing, Chicago, Illinois
| | | | - Chi Ed Wang
- Research Institute, NorthShore University HealthSystem, Evanston, Illinois
| | - Arden Handler
- Community and Health Sciences, University of Illinois Chicago School of Public Health, Chicago, Illinois
| | - Richard K Silver
- Department of Obstetrics and Gynecology NorthShore University HealthSystem, Evanston, Illinois
- Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Ann E B Borders
- Department of Obstetrics and Gynecology NorthShore University HealthSystem, Evanston, Illinois
- Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, Chicago, Illinois
- Institute for Public Health and Medicine, Northwestern University Center for Healthcare Studies, Chicago, Illinois
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Hoyos-Loya E, Pérez Navarro C, Burrola-Méndez S, Hernández-Cordero S, Omaña-Guzmán I, Sachse Aguilera M, Ancira-Moreno M. Barriers to promoting breastfeeding in primary health care in Mexico: a qualitative perspective. Front Nutr 2024; 10:1278280. [PMID: 38264191 PMCID: PMC10803647 DOI: 10.3389/fnut.2023.1278280] [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: 08/16/2023] [Accepted: 12/18/2023] [Indexed: 01/25/2024] Open
Abstract
Objective This article aimed to identify the main barriers related to promoting and counseling breastfeeding (BF) at the Primary Health Care (PHC) in Mexico. Methodology A qualitative study with a phenomenological approach was carried out in 88 health centers of the Ministry of Health in the states of Chihuahua, Oaxaca, Chiapas, Veracruz, Mexico, and Yucatan. From September to November 2021, we interviewed 88 key health professionals (HPs) (physicians, nurses, nutritionists, and others) from the PHC of the Ministry of Health in Mexico and 80 parents of children under 5 years old. In addition, nine focus groups were conducted with parents and caregivers. The data obtained were triangulated with information from focus groups and semi-structured interviews. Results Of the total interviews, 43.2% (n = 38) were nurses, 29.5% (n = 26) were physicians, 19.3% (n = 17) were nutritionists, and the rest were other health professionals. In the group of users, 97.6% (n = 121) were women. We identified contextual barriers, such as the lack of well-trained health professionals and the scarcest nutrition professionals, as material resources in the health units, without mentioning the low user attendance at their control consultations. Furthermore, we identified barriers related to the orientation and promotion of breastfeeding in health units, including a lack of specific strategies, ineffective communication, and the recommendations of commercial milk formulas. Conclusion The results presented reflect the reality of Mexico in relation to BF, making it urgent to take immediate action to improve the quality of nutritional care related to the promotion and orientation of BF at the PHC.
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Affiliation(s)
- Elizabeth Hoyos-Loya
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Mexico City, Mexico
| | - Cecilia Pérez Navarro
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Mexico City, Mexico
- Health Department, Universidad Iberoamericana, Mexico City, Mexico
| | - Soraya Burrola-Méndez
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Mexico City, Mexico
- Health Department, Universidad Iberoamericana, Mexico City, Mexico
| | - Sonia Hernández-Cordero
- Health Department, Universidad Iberoamericana, Mexico City, Mexico
- Research Center for Equitable Development EQUIDE, Universidad Iberoamericana, Mexico City, Mexico
| | - Isabel Omaña-Guzmán
- Health Department, Universidad Iberoamericana, Mexico City, Mexico
- Pediatric Obesity Clinic and Wellness Unit, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico
| | | | - Mónica Ancira-Moreno
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Mexico City, Mexico
- Health Department, Universidad Iberoamericana, Mexico City, Mexico
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Eksioglu A, Unal İ, Akyar A. Factors Affecting Breastfeeding in Births Given During the Day and at Night; A Cross-Sectional Comparative Study. Breastfeed Med 2023; 18:913-920. [PMID: 38100439 DOI: 10.1089/bfm.2023.0228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Objective: How giving birth at night and during the day affects the breastfeeding process should be evaluated when health services are planned. In this study, we investigated the effect of giving birth at night and during the day on the breastfeeding process. Materials and Methods: In this cross-sectional comparative study, we included 228 women who gave birth at night and 192 women who gave birth during the day. We compared the effect of giving birth at night or during the day on breastfeeding with the univariate analysis in terms of intrapartum and postpartum factors. Results: While the mothers who gave birth during the daytime started the first breastfeeding earlier (p < 0.001), the duration of the first breastfeeding and skin-to-skin contact practice was longer in mothers who gave birth at night (p < 0.05). While the rate of formula supplementing in babies born at night was 44.8%, it was 55.2% in babies born during the day (p < 0.001). The rate of receiving support from health workers (p = 0.040) and intending to breastfeed babies exclusively after discharge (p < 0.05) was higher in mothers who gave birth during the day than it was in mothers who gave birth at night. Conclusion: Day and night labor have different advantages and disadvantages on breastfeeding. It is important to address these differences in terms of intrapartum and postpartum care process to prevent negative breastfeeding experiences in the early period.
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Affiliation(s)
- Aysun Eksioglu
- Midwifery Department, Ege University Faculty of Health Sciences, Izmir, Turkey
| | - İlkay Unal
- Midwifery Department, Ege University Faculty of Health Sciences, Izmir, Turkey
| | - Ayşe Akyar
- Izmir Democracy University Buca Seyfi Demirsoy Training and Research Hospital, Izmir, Turkey
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Nurokhmah S, Middleton L, Februhartanty J, Hendarto A. Trends and determinants of early initiation of breastfeeding in Indonesia: A multivariate decomposition analysis. PLoS One 2023; 18:e0294900. [PMID: 38015943 PMCID: PMC10684084 DOI: 10.1371/journal.pone.0294900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 11/12/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Early initiation of breastfeeding (EIBF) is key to reducing neonatal morbidity and mortality, however, little is known about the determinants of the trends of EIBF prevalence in Indonesia. This study aims to assess the contributing factors to the changes in the prevalence of EIBF between 2007 and 2017. METHODS We analysed data from the 2007, 2012, and 2017 Indonesia Demographic and Health Surveys to estimate the trends in EIBF. A multivariate logistic decomposition model was fitted to examine variables associated with changes in the percentage of EIBF from 2007 to 2017. The contributing factors to changes in EIBF prevalence were categorized into either compositional or behavioural changes, with each of them divided into portions or percentages of contribution (pct) of the independent variables. The former refers to the changes in the distribution of samples, while the latter refers to the changes in the behavioural responses toward EIBF in both surveys. All analyses accounted for the complex study design and potential confounding factors. RESULTS An increase in the prevalence of EIBF from 49.9% to 56.5% was recorded between 2012 and 2017, with an overall increase of 16.9 percentage points from 2007 to 2017. At the aggregate level, the compositional differences did not significantly contribute to the changes in the percentage of EIBF, while 98.3pct (p < 0.001) was associated with changes in mothers' behavioural response towards EIBF. The composition changes in the geographical region of Sumatra, and caesarean delivery negatively contributed to the changes in EIBF prevalence with -0.6pct and -14.2pct, respectively. However, the compositional differences in those living in Kalimantan & Sulawesi, first-time mothers, and small-born infants positively contributed to the change. Behaviour changes in mothers with higher education (8.8pct), from higher income households (-17.5pct), and those residing in Sumatra (-8.2pct) and Kalimantan & Sulawesi (-10.2pct) significantly contributed to the upward trend in EIBF prevalence. CONCLUSIONS Almost half of the newborns experienced delayed breastfeeding initiation despite the improvement in the prevalence of EIBF. Therefore, further research and interventions on behaviour change in mother's attitudes towards EIBF, especially among those undergoing caesarean delivery, living in Kalimantan or Sulawesi, and from wealthier households, are recommended to close this gap.
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Affiliation(s)
- Siti Nurokhmah
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia Indonesia–Dr. Cipto Mangunkusumo National Central Hospital, Jakarta, Indonesia
- Department of Nutrition Science, Faculty of Health Science, Universitas Muhammadiyah Surakarta, Surakarta, Indonesia
| | - Lucinda Middleton
- Research Institute for the Environment and Livelihoods, Charles Darwin University, Ellengowan Drive, Australia
| | - Judhiastuty Februhartanty
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia Indonesia–Dr. Cipto Mangunkusumo National Central Hospital, Jakarta, Indonesia
- South-East Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO—RECFON), Jakarta, Indonesia
| | - Aryono Hendarto
- Department of Child Health, Faculty of Medicine, Universitas Indonesia–Dr. Cipto Mangunkusumo National Central Hospital, Jakarta, Indonesia
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Gebretsadik GG, Berhe K, Gebregziabher H. Determinants of early initiation of breast feeding during COVID-19 pandemic among urban-dwelling mothers from Tigray, Northern Ethiopia: a community-based cross-sectional study. BMJ Open 2023; 13:e070518. [PMID: 37429688 DOI: 10.1136/bmjopen-2022-070518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2023] Open
Abstract
OBJECTIVES The objective of this study was to assess the practice of early initiation of breast feeding (EIBF) and its determinant factors among urban-dwelling mothers from Tigray during the COVID-19 pandemic. DESIGN A community-based cross-sectional study was conducted from April to June 2021. Data were analysed using StataSE Version 16 software. To identify determinant factors of the dependent variable, multivariate logistic regression analyses was used at a statistical significance of p<0.05. The strength of the association was measured by OR and 95% CI. SETTING AND PARTICIPANTS The study was conducted among 633 lactating mothers of infants under the age of 6 months living in Mekelle city, Tigray, Northern Ethiopia from April to June 2021. A three-stage cluster sampling was used to select study participants. MAIN OUTCOME MEASURE EIBF or no EIBF. RESULTS Three hundred and sixty eight (59.6%) mothers/caregivers practised EIBF. Maternal education (adjusted OR, AOR 2.45, 95 % CI 1.01 to 5.88), parity (AOR 1.20, 95 % CI 1.03 to 2.20), caesarean section delivery (AOR 0.47, 95 % CI 0.32 to 0.69) and breastfeeding information and support postdelivery (AOR 1.59, 95% CI 1.10 to 2.31) were found to be significant determinants of EIBF. CONCLUSIONS EIBF is defined as initiation of breastfeeding within 1 hour after delivery. EIBF practice was far from optimal. During the COVID-19 pandemic, maternal education, parity, type of delivery and the provision of up-to-date breastfeeding information and support right after delivery determined the time of breastfeeding initiation.
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Affiliation(s)
| | - Kidanemaryam Berhe
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Hadush Gebregziabher
- Department of Nutrition and Dietetics, Mekelle University, Mekelle, Tigray, Ethiopia
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Efendi F, Sebayang SK, Astutik E, Reisenhofer S, McKenna L. Women's empowerment and contraceptive use: Recent evidence from ASEAN countries. PLoS One 2023; 18:e0287442. [PMID: 37368912 PMCID: PMC10298759 DOI: 10.1371/journal.pone.0287442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND A fundamental element of gender equity are women's rights to reproductive choice. Women's empowerment is often linked to enabling decisions around contraceptive use and reduced fertility worldwide, although limited evidence is currently available around contraceptive use and decision making in ASEAN countries. OBJECTIVE To examine the association between women's empowerment and contraceptive use in five selected ASEAN member states. METHODS Data from the latest Demographic and Health Survey of Cambodia, Indonesia, Myanmar, The Philippines, and Timor-Leste were used. The main outcome was contraceptive use among married women (15-49 years) from these five countries. We considered four indicators of empowerment: labor force participation; disagreement with reasons for wife beating; decision-making power over household issues; and knowledge level. RESULTS Labor force participation was found to be significantly associated with contraceptive use in all nations. Disagreement with justification of wife beating was not significantly related to contraceptive use in any country. Decision-making power (higher) was only associated with contraceptive use in Cambodia, while higher knowledge levels were associated with contraceptive use in Cambodia, and Myanmar. CONCLUSION This study suggests women's labor force participation is an important determinant of contraceptive use. Policies designed to open the labor market and empower women through education should be implemented to enable women's participation. Gender inequality may also be tackled by engaging women in decision-making processes at national, community and family levels.
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Affiliation(s)
- Ferry Efendi
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Susy Katikana Sebayang
- Department of Epidemiology, Biostatistics, Population Studies and Health Promotion, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | - Erni Astutik
- Department of Epidemiology, Biostatistics, Population Studies and Health Promotion, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | - Sonia Reisenhofer
- School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
| | - Lisa McKenna
- School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
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Woolley E, Buck G, Jackson J, Bowman R, Fox L, Gallagher S, Sorrell M, Ghimire PR. Exclusive Breastfeeding at Discharge in Regional New South Wales, Australia: The Role of Antenatal Care (2011-2020). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6135. [PMID: 37372722 DOI: 10.3390/ijerph20126135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023]
Abstract
Increasing the number of infants exclusively breastfeeding on discharge from the hospital after birth is a key goal of breastfeeding policy in New South Wales (NSW), Australia. Despite consistent efforts, exclusive breastfeeding on discharge rates have declined over the past decade. Using pooled data from the New South Wales Perinatal Data Collection from 2011 to 2020, we examined the association between antenatal care (ANC) and exclusive breastfeeding at discharge from birth admission outcomes for mother-baby dyads in Southern New South Wales Local Health District (SNSWLHD). Our study confirmed that exclusive breastfeeding rates in SNSWLHD have declined over the past decade, providing local evidence to support action. Late entry to ANC and a failure to attend the recommended number of ANC visits were important predictors of a lower rate of exclusive breastfeeding on discharge. Improving accessibility to ANC visits for rural and regional mothers has potential to positively impact breastfeeding rates in SNSWLHD. We suggest that wider implementation of caseload midwifery models may have a positive impact on breastfeeding outcomes in the region for all mother-baby dyads, but particularly for Aboriginal mothers and infants, younger mothers and mothers experiencing disadvantage.
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Affiliation(s)
- Emma Woolley
- Integrated Care and Allied Health, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
| | - Gretchen Buck
- Integrated Care and Allied Health, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
| | - Jackie Jackson
- Integrated Care and Allied Health, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
| | - Rebekah Bowman
- Nursing and Midwifery, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
| | - Louise Fox
- Integrated Care and Allied Health, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
| | - Shirlena Gallagher
- People and Culture, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
| | | | - Pramesh Raj Ghimire
- Integrated Care and Allied Health, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
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Lane A, Whitaker KM, Tahir M, Barone Gibbs B, Catov J, Carnethon M, Gunderson EP. Associations of Physical Activity and Lactation Duration With Cardiometabolic Risk Factors: The CARDIA Study. JACC. ADVANCES 2023; 2:100378. [PMID: 37584014 PMCID: PMC10426753 DOI: 10.1016/j.jacadv.2023.100378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 03/13/2023] [Accepted: 03/24/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Physical activity (PA) and lactation benefit cardiometabolic health. OBJECTIVES The purpose of this study was to describe the joint associations of PA and lactation with cardiometabolic risk. METHODS We averaged PA across exams and summed lifetime lactation in Black and White parous women in the Coronary Artery Risk Development in Young Adults Study. Categories were created for PA (-PA: RESULTS The median PA was 256 exercise units and 54% reported lactation duration of ≥3 months. Of 1,068 participants, 303 were in the -PA/-L category, 231 in -PA/+L, 184 in +PA/-L, and 350 in +PA/+L. +PA/+L participants were older, had more years of education, lower body mass index, gained less weight, and less likely to be Black vs -PA/-L participants. Risk scores differed between categories except -PA/+L and +PA/-L (P = 0.08): -PA/-L: 0.23+/-0.04, -PA/+L: 0.08+/-0.04, +PA/-L: -0.02+/-0.05, and +PA/+L: -0.23+/-0.03. After adjustment, +PA/+L was associated with a lower/better risk score (β = -0.15, 95% CI: -0.25 to -0.04). CONCLUSIONS Above average PA throughout adulthood combined with ≥3 months of lactation was associated with lower risk scores. Participants with either behavior had lower risk vs those with neither behavior. Attaining these levels of behaviors may reduce cardiometabolic risk in parous women.
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Affiliation(s)
- Abbi Lane
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Kara M. Whitaker
- Department of Health and Human Physiology, Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Muna Tahir
- ICON plc, San Francisco, California, USA
| | - Bethany Barone Gibbs
- Department of Epidemiology and Biostatistics, School of Public Health, University of West Virginia, Morgantown, West Virginia, USA
| | - Janet Catov
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Obstetrics and Gynecology, Magee-Women’s Research Center, Pittsburgh, Pennsylvania, USA
| | - Mercedes Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Erica P. Gunderson
- Division of Research, Kaiser Permanente of Northern California, Oakland, California, USA
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Dehghani M, Kazemi A, Heidari Z, Mohammadi F. The relationship between women's breastfeeding empowerment and conformity to feminine norms. BMC Pregnancy Childbirth 2023; 23:287. [PMID: 37098471 PMCID: PMC10131328 DOI: 10.1186/s12884-023-05628-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 04/20/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Women empowerment is effective in successful breastfeeding. Hence,identifying the relationship between psychosocial factors, such as acceptance of feminine norms, and empowerment can be beneficial in designing interventions.. Therefore, this study aimed to determine the relationship between breastfeeding empowerment and conformity to feminine norms. METHODS This cross-sectional study was conducted on 288 primiparous mothers in the postpartum period using validated questionnaires of conformity to gender norms and breastfeeding empowerment in the following domains: "sufficient knowledge and skills for breastfeeding," "a sense of breastfeeding competence," "conscious belief in the value of breastfeeding," "overcoming breastfeeding problems," "negotiation and obtaining family support" and "self-efficacy in breastfeeding" which were completed through the self-report method. Data were analyzed using the multivariate linear regression test. RESULTS The mean score of 'conformity to feminine norms' and 'breastfeeding empowerment' were 142.39 and 144.14, respectively. The score of breastfeeding empowerment was positively related to conformity to feminine norms (p = 0.003). Among the dimensions of breastfeeding empowerment, 'mothers' adequate knowledge and skills for breastfeeding' (p = 0.001), 'belief in the value of breastfeeding' (p = 0.008), and 'negotiation and obtaining family support' (p = 0.01) were positively related to conformity to feminine norms. CONCLUSIONS The results indicate a positive relationship between the level of conformity to feminine norms and breastfeeding empowerment. Accordingly, it is recommended that supporting breastfeeding as a valuable role of women be considered in programs designed to improve breastfeeding empowerment.
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Affiliation(s)
- Maryam Dehghani
- Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zeinab Heidari
- Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Mohammadi
- Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
- Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Hezar Jerib Street, Isfahan, 8174673461, Iran.
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Pérez-Escamilla R, Tomori C, Hernández-Cordero S, Baker P, Barros AJD, Bégin F, Chapman DJ, Grummer-Strawn LM, McCoy D, Menon P, Ribeiro Neves PA, Piwoz E, Rollins N, Victora CG, Richter L. Breastfeeding: crucially important, but increasingly challenged in a market-driven world. Lancet 2023; 401:472-485. [PMID: 36764313 DOI: 10.1016/s0140-6736(22)01932-8] [Citation(s) in RCA: 128] [Impact Index Per Article: 128.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 08/18/2022] [Accepted: 09/26/2022] [Indexed: 02/10/2023]
Abstract
In this Series paper, we examine how mother and baby attributes at the individual level interact with breastfeeding determinants at other levels, how these interactions drive breastfeeding outcomes, and what policies and interventions are necessary to achieve optimal breastfeeding. About one in three neonates in low-income and middle-income countries receive prelacteal feeds, and only one in two neonates are put to the breast within the first hour of life. Prelacteal feeds are strongly associated with delayed initiation of breastfeeding. Self-reported insufficient milk continues to be one of the most common reasons for introducing commercial milk formula (CMF) and stopping breastfeeding. Parents and health professionals frequently misinterpret typical, unsettled baby behaviours as signs of milk insufficiency or inadequacy. In our market-driven world and in violation of the WHO International Code for Marketing of Breast-milk Substitutes, the CMF industry exploits concerns of parents about these behaviours with unfounded product claims and advertising messages. A synthesis of reviews between 2016 and 2021 and country-based case studies indicate that breastfeeding practices at a population level can be improved rapidly through multilevel and multicomponent interventions across the socioecological model and settings. Breastfeeding is not the sole responsibility of women and requires collective societal approaches that take gender inequities into consideration.
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Affiliation(s)
- Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA.
| | - Cecília Tomori
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Sonia Hernández-Cordero
- Research Center for Equitable Development (EQUIDE), Universidad Iberoamericana, Mexico City, Mexico
| | - Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Aluisio J D Barros
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | | | | | | | - David McCoy
- International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | - Purnima Menon
- International Food Policy Research Institute, New Delhi, India
| | | | | | - Nigel Rollins
- Department of Maternal, Newborn, Child and Adolescent Health, WHO, Geneva, Switzerland
| | - Cesar G Victora
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Linda Richter
- Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
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Magalhães M, Ojeda A, Mechlowitz K, Brittain K, Daniel J, Roba KT, Hassen JY, Manary MJ, Gebreyes WA, Havelaar AH, McKune SL. Socioecological predictors of breastfeeding practices in rural eastern Ethiopia. Int Breastfeed J 2022; 17:93. [PMID: 36578078 PMCID: PMC9795740 DOI: 10.1186/s13006-022-00531-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 12/11/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Estimates by the World Health Organization indicate that over 800,000 global neonatal deaths each year are attributed to deviations from recommended best practices in infant feeding. Identifying factors promoting ideal breastfeeding practices may facilitate efforts to decrease neonatal and infant death rates and progress towards achieving the Sustainable Development Goals set for 2030. Though numerous studies have identified the benefits of breastfeeding in reducing the risk of childhood undernutrition, infection and illness, and mortality in low- and middle-income countries, no studies have explored predictors of breastfeeding practices in rural eastern Ethiopia, where undernutrition is widespread. The aim of this study is to examine predictors of infant feeding practices in Haramaya, Ethiopia, using a multi-level conceptual framework. METHODS This study uses data collected from household questionnaires during the Campylobacter Genomics and Environmental Enteric Dysfunction (CAGED) project among 102 households in the Haramaya woreda, Eastern Hararghe Zone, Eastern Ethiopia, and investigates factors influencing breastfeeding practices: early initiation, prelacteal feeding, and untimely complementary feeding. RESULTS Nearly half (47.9%) of infants in this study were non-exclusively breastfed (n = 96). Generalized liner mixed effects models of breastfeeding practices revealed that prelacteal feeding may be a common practice in the region (43.9%, n = 98) and characterized by gender differences (p = .03). No factors evaluated were statistically significantly predictive of early initiation and untimely complementary feeding (82% and 14%, respectively). Severely food insecure mothers had more than 72% lower odds of early breastfeeding initiation, and participants who self-reported as being illiterate had 1.53 times greater odds of untimely complementary feeding (95% CI, [0.30,7.69]) followed by male children having 1.45 greater odds of being untimely complementary fed compared to female (95% CI,[0.40,5.37]). CONCLUSIONS This study found high rates of prelacteal feeding and low prevalence of exclusive breastfeeding, with girls more likely to be exclusively breastfed. While no predictors evaluated in this multi-level framework were associated with prevalence of early initiation or complementary feeding, rates may be clinically meaningful in a region burdened by undernutrition. Findings raise questions about gendered breastfeeding norms, the under-examined role of khat consumption on infant feeding, and the complex factors that affect breastfeeding practices in this region. This information may be used to guide future research questions and inform intervention strategies.
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Affiliation(s)
- Marina Magalhães
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, USA
- Present address: Department of Pediatrics, Stanford University School of Medicine, Stanford, CA USA
| | - Amanda Ojeda
- Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, USA
- Department of Microbiology and Cell Science, University of Florida, Gainesville, USA
| | - Karah Mechlowitz
- Department of Environmental and Global Health, College of Public Health, University of Florida, 1225 Center Dr., Gainesville, FL 32603 USA
| | - Kaitlin Brittain
- Department of Environmental and Global Health, College of Public Health, University of Florida, 1225 Center Dr., Gainesville, FL 32603 USA
| | - Jenna Daniel
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Jemal Yousuf Hassen
- Department of Rural Development and Agricultural Extension, College of Agriculture and Environmental Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Mark J. Manary
- Department of Pediatrics, School of Medicine, Washington University, St. Louis, USA
| | | | - Arie H. Havelaar
- Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, USA
- Institute for Sustainable Food Systems, University of Florida, Gainesville, USA
| | - Sarah L. McKune
- Department of Environmental and Global Health, College of Public Health, University of Florida, 1225 Center Dr., Gainesville, FL 32603 USA
- Center for African Studies, University of Florida, Gainesville, USA
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Lucha TA, Mengistu AK. Factors associated with early initiation of breastfeeding among children less than 24 months old: the 2019 Ethiopian mini demographic and health survey. Arch Public Health 2022; 80:164. [PMID: 35794649 PMCID: PMC9258214 DOI: 10.1186/s13690-022-00920-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background The world Health Organization recommended that all mothers be supported to initiate breastfeeding as soon as possible after birth, within the first hour. This study examined the determinants of early initiation of breastfeeding in Ethiopia by using data from the 2019 Ethiopia Mini Demographic and Health Survey. Methods The data for this study was extracted from the 2019 Ethiopia Mini Demographic and Health Survey. A total of 1948 children aged less than 24 months at the time of the survey were included for analysis from the nine regional states and two city administrations. The analysis was carried out in STATA Version 14.2 software using survey commands to account for the complex sample design and apply sampling weights. A manual backward stepwise elimination approach was applied. Result The prevalence of early initiation of breastfeeding in Ethiopia was noted to be 75.2% [95% CI (71.9, 78.5%)]. In the multivariable analysis, mothers who had vaginal deliveries [AOR = 3.02 (95% CI: 1.55, 5.88)] had 3 times higher odds practicing early initiation of breastfeeding compared to mothers who had a cesarian section. Mothers aged between 35 and 49 years [AOR = 2.40, 95% CI: 1.20, 4.49] had 2.4 times higher odds of practicing early initiation of breastfeeding compared to mothers aged below 20 years. In addition, early initiation of breastfeeding was also associated with the region where mothers resided, in particular mothers in Amhara and Somali region, had lower odds of practicing early initiation of breastfeeding as compared with mothers residing in Tigray region. Conclusion Early initiation of breastfeeding in Ethiopia was found to be significantly associated with mode of delivery, mother’s age, and region. As a result, raising awareness about early initiation of breastfeeding is especially important for mothers who have had a cesarean section, which could be accomplished with the help of the health extension workforce.
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Lane A, Lewis CE, Gunderson EP. Adverse Pregnancy Outcomes: The Missing Link in Discovering the Role of Lactation in Cardiovascular Disease Prevention. J Am Heart Assoc 2022; 11:e027707. [PMID: 36250661 PMCID: PMC9673661 DOI: 10.1161/jaha.122.027707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Abbi Lane
- Department of Exercise Science, Arnold School of Public HealthUniversity of South CarolinaColumbiaSC
| | - Cora E. Lewis
- Department of Epidemiology, School of Public HealthUniversity of Alabama at BirminghamBirminghamAL
| | - Erica P. Gunderson
- Division of ResearchKaiser Permanente Northern CaliforniaOaklandCA
- Department of Health Systems ScienceKaiser Permanente Bernard J. Tyson School of MedicinePasadenaCA
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Wako WG, Wayessa Z, Fikrie A. Effects of maternal education on early initiation and exclusive breastfeeding practices in sub-Saharan Africa: a secondary analysis of Demographic and Health Surveys from 2015 to 2019. BMJ Open 2022; 12:e054302. [PMID: 35292494 PMCID: PMC8928244 DOI: 10.1136/bmjopen-2021-054302] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Early initiation of breast feeding (EIBF) and exclusive breast feeding (EBF) are the cheapest, feasible and simplest nutritional interventions for infants. Effects of maternal education on EIBF and EBF are not consistent across studies. This study assessed the effects of maternal education on EIBF and EBF. METHODS A cross-sectional study was done based on data collected for phase 7 Demographic and Health Surveys conducted in 16 sub-Saharan African countries from 2015 to 2019. Data of the last-born children younger than 6 (n=19 103) and 24 (n=75 293) months were analysed to assess associations between maternal education and EIBF and EBF practices, respectively. To assess the associations, X2 test and logistic regression were done. Adjusted ORs (AORs) and their 95% CIs were used to declare statistical significance of the associations. RESULTS After controlling for all other potentially confounding variables, mothers who completed primary school were 1.29 (95% CI AOR: 1.24 to 1.34) times more likely to initiate breast feeding within the first 1 hour of delivery compared with mothers without education. However, mothers with secondary (AOR: 1.01; 95% CI: 0.96 to 1.06) or higher (AOR: 0.96; 95% CI: 0.87 to 1.05) level of education were not significantly different from mothers without education concerning EIBF. Similarly, mothers educated to primary school were 1.37 (95% CI AOR: 1.27 to 1.48) times more likely to exclusively breast feed compared with mothers without education. However, mothers educated to secondary (AOR: 1.07; 95% CI: 0.98 to 1.17) or higher (AOR: 1.07; 95% CI: 0.89 to 1.27) level of education were not significantly different from uneducated mothers regarding EBF practices. CONCLUSIONS Effects of maternal education on EIBF and EBF depend on the level of educational attainment. Future studies should look for reasons for the lower rate of EIBF and EBF among mothers with higher educational status.
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Affiliation(s)
- Wako Golicha Wako
- School of Public Health, Bule Hora University, Bule Hora, Oromia Regional State, Ethiopia
| | - Zelalem Wayessa
- Department of Midwifery, Bule Hora University, Bule Hora, Oromia Regional State, Ethiopia
| | - Anteneh Fikrie
- School of Public Health, Bule Hora University, Bule Hora, Oromia Regional State, Ethiopia
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Heidari Z, Mohammadi F, Kohan S. Development and psychometric evaluation of the Mothers' breastfeeding empowerment scale: A mixed methods study. Nurs Midwifery Stud 2022. [DOI: 10.4103/nms.nms_58_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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21
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Clinically integrated breastfeeding peer counseling and breastfeeding outcomes. J Perinatol 2021; 41:2095-2103. [PMID: 34035450 DOI: 10.1038/s41372-021-01096-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/12/2021] [Accepted: 05/06/2021] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To evaluate whether clinically integrated breastfeeding peer counseling (ci-BPC) improved breastfeeding outcomes for a diverse cohort of Medicaid-enrolled patients. STUDY DESIGN Medical records were reviewed for a random subset of patients delivering 2014-2015 (baseline, N = 147) and 2017-2019 (post-implementation, N = 281). Chi-squared and logistic regression evaluated differences in breastfeeding initiation, exclusivity, and duration, and results were stratified by race/ethnicity. RESULTS Post-implementation, 90.4% of patients received ci-BPC. Compared to baseline, documented prenatal breastfeeding counseling increased from 5 to 84% (<0.001), and inpatient counseling increased from 12 to 55% (p < 0.001). Breastfeeding initiation was similar (86 to 89%, p = 0.28), while exclusivity increased from 21 to 31% (p = 0.03). Any breastfeeding ≥6 weeks increased from 29 to 65% (p < 0.001) and was most improved for Black (32 to 50%, p < 0.01) and Latinx patients (37 to 71%, p < 0.01). CONCLUSIONS ci-BPC was associated with significant improvement in breastfeeding exclusivity and duration, and may address breastfeeding disparities.
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