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Aşkan ÖÖ, Karpuzoğlu FH, Kayı AB, Özden TA, Gökçay G, Keskindemirci G. Unique content of breastmilk: neurotrophic growth factors in breastmilk at 2 years and beyond. Eur J Pediatr 2024; 183:4729-4734. [PMID: 39207457 DOI: 10.1007/s00431-024-05732-y] [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: 06/28/2024] [Revised: 08/08/2024] [Accepted: 08/12/2024] [Indexed: 09/04/2024]
Abstract
The aim of our study was to show the presence of neurotrophic factors in breast milk that have a significant impact on neurocognitive development of children aged two years and beyond. Mothers expressed at least 5 mL of breast milk into sterile containers when their children 18, 24, and ≥ 25 months of age, and then specimens were transferred to Eppendorf tubes and stored at -20 °C. One day before the analysis, specimens were kept at +4 °C and then thawed at room temperature to prepare them for analysis. Brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), and S100B neurotrophic growth factor levels were analyzed using the sandwich enzyme-linked immunosorbent assay (ELISA) principles. Sixty-two mothers with children aged 18 months were included in the study. The mean age of the mothers was 33.4 (± 0.71) years. Due to the detection limits of the commercial kits, BDNF and S100B analyses could not be conducted. Therefore, only GDNF was analyzed. The presence of GDNF was found in the breast milk samples taken at 18, 24, and ≥ 25 months, and the median (min max) values were 315,505 ng/mL (193,067 750,718), 316,721 ng/mL (161,278 l-752,252), and 564,577 ng/mL (238,528-781,104) respectively. There were no significant differences between GDNF levels of breast milk samples collected from the same mother at the three different time points (18, 24, and ≥ 25 months) (p = 0.278). Conclusion: Our study was the first to show the presence of neurotrophic factors in the breast milk of mothers with healthy children over one year of age. Our results provide evidence-based data on the importance of breastfeeding until children are at least two years of age. What is Known: • Presence of Brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), and S100B neurotrophic growth factor have been shown in the breast milk of mothers whose infants are the first year of life. What is New: • Glial Cell Line-Derived Neurotrophic factors continue to present in breast milk of mothers with children aged 18, 24, and ≥ 25 months, without any significant difference in level between months.
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Affiliation(s)
- Öykü Özbörü Aşkan
- Institute of Child Health, Department of Social Pediatrics, İstanbul University, Istanbul, Türkiye
| | - Fatma Hande Karpuzoğlu
- İstanbul Faculty of Medicine, Department of Medical Biochemistry, İstanbul University, Istanbul, Türkiye
| | - Alev Bakır Kayı
- Institute of Child Health, Department of Social Pediatrics, İstanbul University, Istanbul, Türkiye
| | - Tülin Ayşe Özden
- İstanbul Faculty of Medicine, Department of Medical Biochemistry, İstanbul University, Istanbul, Türkiye
| | - Gülbin Gökçay
- Institute of Child Health, Department of Social Pediatrics, İstanbul University, Istanbul, Türkiye
| | - Gonca Keskindemirci
- Istanbul Faculty of Medicine, Department of Pediatrics, Division of Social Pediatrics, İstanbul University, Topkapı Mah. Turgut Özal Cad 34093 Fatih, Istanbul, Türkiye.
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Zeng J, Zheng QX, Wang QS, Liu GH, Liu XW, Lin HM, Guo SB. Father support breastfeeding self-efficacy positively affects exclusive breastfeeding at 6 weeks postpartum and its influencing factors in Southeast China: a multi-centre, cross-sectional study. BMC Public Health 2024; 24:2698. [PMID: 39363194 PMCID: PMC11448394 DOI: 10.1186/s12889-024-20136-1] [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: 05/13/2024] [Accepted: 09/19/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND The exclusive breastfeeding condition in China is not optimism now. Maternal breastfeeding self-efficacy stands as a pivotal factor influencing exclusive breastfeeding. Interestingly, studies have suggested that father support breastfeeding self-efficacy is a pivotal mediator in infant breastfeeding. Thus, the current research aimed to investigate the association between father support breastfeeding self-efficacy and exclusive breastfeeding at six weeks postpartum, and the influencing factors of father support breastfeeding self-efficacy. METHODS This research was structured as a multi-centre cross-sectional study, involving 328 fathers, whose partners were six weeks postpartum, and recruited from two public hospitals in Southeast China. Self-designed demographic questionnaires, namely, Father Support Breastfeeding Self-Efficacy Scale-Short Form, Breastfeeding Knowledge Questionnaire, Positive Affect Scale and the 14-item Fatigue Scale, were applied. Descriptive statistics, Chi-square test, logistic regression univariate analysis and multiple linear regression were used to analyse data. RESULTS Results indicate a significant difference between the infant feeding methods at six weeks postpartum and fathers with different levels of support breastfeeding self-efficacy (p < 0.05). Particularly, father support breastfeeding self-efficacy positively affected exclusive breastfeeding at six weeks postpartum after adjusting all the demographic characteristics of fathers (OR: 2.407; 95% CI: 1.017-4.121). Moreover, results show that the significant influencing factors of father support breastfeeding self-efficacy include breastfeeding knowledge, fatigue, positive affect, successfully experienced helping mothers to breastfeed, spousal relationships and companionship time. CONCLUSIONS High-level father support breastfeeding self-efficacy effectively increased exclusive breastfeeding rate at six weeks postpartum. To enhance the exclusive breastfeeding rate, nurses or midwives can endeavour to design educational programmes or take supportive interventions customised for fathers, such as enhancing their breastfeeding knowledge education, reducing fatigue and mobilising positive emotions, thereby bolstering paternal self-efficacy in breastfeeding.
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Affiliation(s)
- Jing Zeng
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, 18 Daosan Road, Gulou District, Fuzhou City, Fujian Province, China
- Fujian Obstetrics and Gynecology Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou City, Fujian Province, China
| | - Qing-Xiang Zheng
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, 18 Daosan Road, Gulou District, Fuzhou City, Fujian Province, China
- Fujian Obstetrics and Gynecology Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou City, Fujian Province, China
| | - Qiang-Shan Wang
- Fujian Medical University, Fuzhou City, Fujian Province, China
| | - Gui-Hua Liu
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, 18 Daosan Road, Gulou District, Fuzhou City, Fujian Province, China
| | - Xiu-Wu Liu
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, 18 Daosan Road, Gulou District, Fuzhou City, Fujian Province, China
| | - Hui-Min Lin
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, 18 Daosan Road, Gulou District, Fuzhou City, Fujian Province, China
- Fujian Obstetrics and Gynecology Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou City, Fujian Province, China
| | - Sheng-Bin Guo
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, 18 Daosan Road, Gulou District, Fuzhou City, Fujian Province, China.
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Nilsson I, Busck-Rasmussen M, Villadsen SF. Development of a complex intervention to strengthen municipality-based breastfeeding support to reduced social inequity in breastfeeding. Arch Public Health 2024; 82:174. [PMID: 39358759 PMCID: PMC11447984 DOI: 10.1186/s13690-024-01401-6] [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: 06/30/2024] [Accepted: 09/17/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND Breastfeeding is the ideal nutrition for infants and protects infants and mothers from a range of adverse health outcomes during their lifespan. In Denmark, while the breastfeeding initiation rate is high, only 14% of mothers meet the World Health Organization's recommendation of exclusive breastfeeding at six months. Furthermore, a notable social inequity exists among those who achieve this recommendation. Knowledge of effective interventions to reduce breastfeeding inequity is limited. A previous hospital-based intervention succeeded in increasing breastfeeding duration. However, most breastfeeding support is provided in Danish municipalities by health visitors. This called for adapting the intervention to the health visiting program and developing an intensified intervention addressing the social inequity in breastfeeding. This article describes the adaptation and development process of a municipality-based intervention. METHODS During a 15-month period in 2020-21, the municipal intervention was iteratively developed using a three-stage framework for developing complex health interventions described by Hawkins et al. The three stages were 1) need assessment and stakeholder consultation, 2) co-production and 3) prototyping. The process was inspired by O'Cathain et al.'s principles for a user-centred, co-created and theory- and evidence-based approach, involving parents and health visitors. RESULTS In stage 1, we identified the needs and priorities of the target groups of the intervention. In stage 2, the intervention was developed through action research design and inspired by Duus' 'learning cycles' as the method to enhance motivation and ownership and to strengthen the implementation process by creating a joint room for learning and reflection with health visitors and developers. In stage 3, the intervention was tested for feasibility and usefulness during a 2.5-month period accompanied by monthly dialogue meetings with health visitors and developers. In this period, the intervention was refined based on the gathered experiences and was subsequently prepared for evaluation. CONCLUSION The description of the development of this complex intervention, aimed at increasing breastfeeding duration and reducing inequity, offers breastfeeding practitioners and researchers a transparent foundation for continuously improving breastfeeding support and a methodology for complex intervention development. TRIAL REGISTRATION Registered at Clinical Trials NCT05311631.
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Affiliation(s)
- Ingrid Nilsson
- Danish Committee for Health Education, Classensgade 71, 5, Copenhagen, 2100, Denmark.
| | | | - Sarah Fredsted Villadsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, CCS, Øster Farimagsgade 5A, Copenhagen, 1353, Denmark
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Bjerregaard LG, Johansen TSD, Dahl CM, Baker JL. Duration and intensity of being breastfed and educational attainment, income and labour force participation: a prospective cohort and sibling study from Denmark. Public Health 2024; 237:37-43. [PMID: 39321661 DOI: 10.1016/j.puhe.2024.08.026] [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: 04/08/2024] [Revised: 08/13/2024] [Accepted: 08/25/2024] [Indexed: 09/27/2024]
Abstract
OBJECTIVE Breastfeeding improves cognitive ability in childhood, but the long-term impact on socioeconomic outcomes remains unknown. We examined associations between durations of predominant and any breastfeeding and educational attainment, income, and labor force participation in adulthood, and whether these varied by maternal education. STUDY DESIGN Prospective cohort study. METHODS We followed 84,255 individuals born 1959-1967 with prospectively collected information on breastfeeding duration and intensity from the Copenhagen Infant Health Nurse Records. Socioeconomic outcome information came from national registers (1980-2020). Linear and Poisson regression were used, and models were adjusted for prenatal and postnatal variables across three levels of maternal education. RESULTS Durations of being breastfed exhibited associations with all outcomes, with most being more pronounced among mothers with low education. Compared with infants breastfed <1 month, those breastfed ≥5 months had 0.68 (95% confidence interval: 0.60-0.76), 0.55 (0.45-0.65), and 0.65 (0.46-0.84) additional years of education for infants born to mothers with low, medium, or high education, respectively. Moreover, infants breastfed ≥5 months had 4047, 3713, and 1902 US$ higher annual incomes and were 23% less likely to be outside the labor force at age 50 years. These associations were stronger with longer breastfeeding durations and for predominant than any breastfeeding. CONCLUSIONS Prolonged and higher breastfeeding intensity consistently exhibited dose-dependent associations with improved socioeconomic indicators in adulthood. Notably, these relationships were more pronounced among individuals whose mothers had lower educational attainment. Consequently, our findings suggest that breastfeeding may have a lasting positive influence on socioeconomic outcomes, particularly for the most disadvantaged infants.
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Affiliation(s)
- L G Bjerregaard
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
| | - T S D Johansen
- Department of Economics, University of Southern Denmark, Denmark
| | - C M Dahl
- Department of Economics, University of Southern Denmark, Denmark
| | - J L Baker
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
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Hassen HM. Trends and disparities in ever-breastfeeding practice and early breastfeeding initiation in Ethiopia: a 20-year trend analysis from EDHS datasets. BMC Public Health 2024; 24:2558. [PMID: 39300468 DOI: 10.1186/s12889-024-19945-1] [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: 05/13/2024] [Accepted: 08/29/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Ethiopia has had a long-standing national commitment to improving child health for the last five decades. However, evidence on trends of ever-breastfeeding and early initiation remained fragmented, and there existed a paucity of holistic evidence on the extent of the impacts of the policy and the associated factors. This study examined trends, disparities, and factors influencing ever-breastfed and early initiation in the last twenty years. METHODS The Ethiopian Demographic and Health Surveys (EDHS 2000-2019) datasets were used and extracted for children aged 0-23 months and their mothers. Data analyses were performed using SPSS version 25. Trend and time-series analysis was used to visualize changes over time. Multivariable logistic regression was used to identify associated factors. RESULTS Prevalence of ever-breastfeeding declined from 99.4% in 2000, to 84.01% in 2019; and early initiation showed inconsistency, increasing from 48.55% in 2000 to 69.57% in 2016 and remained unchanged (69.78%) in 2019. Maternal age, religion, and maternal healthcare utilization significantly influenced early initiation (p < 0.001). Both ever-breastfeeding and early initiation varied across regional states (< 0.001). Disparities in breastfeeding and early initiation were observed across socio-cultural settings and regional states (p < 0.05). CONCLUSION The prevalence of ever-breastfeeding declined nationwide between 2000 and 2019, which was not uniform and early initiation showed inconsistency across socio-cultural settings and regional states. These findings highlight the need to revisit current policies and interventions. Further research is crucial to inform the development of regionally tailored and culturally sensitive strategies that promote equitable and sustained breastfeeding improvement across Ethiopia.
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Affiliation(s)
- Hailemariam Mamo Hassen
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, P.O. Box 1362, Dire Dawa, Ethiopia.
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Wang N, Gong L, Ye C. Clinical study of ultrasound-guided minimally invasive catheterization combined with compound cortex phellodendri fluid in the treatment of lactational breast abscess. PLoS One 2024; 19:e0308548. [PMID: 39283924 PMCID: PMC11404787 DOI: 10.1371/journal.pone.0308548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 07/26/2024] [Indexed: 09/20/2024] Open
Abstract
OBJECTIVE To retrospectively analyze the clinical practicability and value of ultrasound-guided minimally invasive catheterization combined with compound Phellodendron Phellodendri liquid in the treatment of breast abscess during lactation. METHODS 139 patients with lactational breast abscess discharged from our hospital from January 2021 to November 2023 were selected. We divided them into groups according to treatment methods, analyzed whether there were statistical differences in observation indexes among groups and the risk factors affecting breastfeeding rate and treatment satisfaction. RESULTS We found that numerical rating scale(NRS) score and incidence of breast fistula in group A were significantly lower than other, the continuous decrease of postoperative drainage in group A was higher than other, there were significant differences among groups (p<0.001). Univariate analysis showed that recovery time, drainage tube placement time, postoperative redness and swelling regression time, scar length, and VAS score of six groups were statistically significant (p<0.001). We found that the overall satisfaction and the rate of continued breastfeeding in group A (96.2%) were higher than other, the differences were statistically significant(p<0.05). Logistic regression analysis revealed that the significant risk factors influencing treatment satisfaction included the time of drainage tube placement, postoperative redness and swelling regression time, treatment group, surgical method, NRS score on the first day after operation, postoperative drainage volume, healing time, scar length, flushing drugs, and VAS score. Postoperative redness and swelling regression time, treatment group, operation method and VAS score are all risk factors that influence the outcome of breastfeeding. CONCLUSION Ultrasound-guided minimally invasive catheterization combined with compound cortex phellodendri fluid in the treatment of breast abscess during lactation can not only reduce the pain caused by dressing change, but also offer numerous advantages, including shorter healing time, beautiful appearance, lower incidence of breast fistula, high satisfaction and high rate of continued breastfeeding.
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Affiliation(s)
- Na Wang
- Department of Breast, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Lili Gong
- Department of Breast, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Chunmei Ye
- Department of Breast, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
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Santos-Guzmán A, Rivera JA, Unar-Munguía M, Ramírez-Silva I. Addressing Infant and Young Child Feeding Recommendations From a Planetary Health Perspective. Adv Nutr 2024; 15:100303. [PMID: 39278466 DOI: 10.1016/j.advnut.2024.100303] [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: 06/28/2024] [Revised: 08/21/2024] [Accepted: 09/10/2024] [Indexed: 09/18/2024] Open
Abstract
Current international infant and young child (IYC) feeding recommendations consider nutrition and health but not environmental impacts. Only a handful of countries have dietary guidelines that provide quantitative recommendations for food groups of environmental concern. This study aimed to perform a narrative review of the environmental impacts of commercial milk formula compared with breastfeeding and to analyze the degree to which current country-specific IYC feeding recommendations are aligned with sustainable dietary targets. A mixed-methods review was conducted, including the following: 1) a narrative review of the environmental impact of commercial milk formula compared with breastfeeding and 2) a comparison of recommended intake of meats and dairy for children IYC based on country-specific dietary guidelines compared with the EAT-Lancet Commission dietary targets (ELCT) for children 24 mo or older and adults and if the ELCT should be adjusted for the energy needs of IYC. Formula feeding has a greater environmental impact (∼48% higher carbon footprint) than exclusive breastfeeding. Available country-specific dietary guidelines for meat and dairy products in children IYC are, in general, at or below the upper limits of the ELCT recommended ranges for older children and adults but are in most cases above the upper limit when adjusting for the energy needs of IYC. Exclusive breastfeeding should be protected and promoted not only as the healthier but also as the most sustainable alternative. Available complementary dietary feeding recommendations of nonprocessed meat and dairy fall below current ELCT for older children and adults. Given that IYC require a more nutrient-dense diet than older children and adults and considering the small quantities they consume, we recommend using the unadjusted ELCT as reference for IYC feeding while specific international consumption recommendations are developed for this age group.
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Affiliation(s)
- Andrea Santos-Guzmán
- Center for Health and Nutrition Research, National Instituto of Public Health, Cuernavaca, Morelos, Mexico
| | - Juan A Rivera
- Center for Research in Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Mishel Unar-Munguía
- Center for Health and Nutrition Research, National Instituto of Public Health, Cuernavaca, Morelos, Mexico
| | - Ivonne Ramírez-Silva
- Center for Health and Nutrition Research, National Instituto of Public Health, Cuernavaca, Morelos, Mexico
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Xiong Y, Hu X, Cao J, Shang L, Niu B. A predictive model for stunting among children under the age of three. Front Pediatr 2024; 12:1441714. [PMID: 39290596 PMCID: PMC11405321 DOI: 10.3389/fped.2024.1441714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 08/16/2024] [Indexed: 09/19/2024] Open
Abstract
Background In light of the global effort to eradicate stunting in childhood, the objective of this research endeavor was to assess the prevalence of stunting and associated factors, simultaneously construct and validate a risk prediction model for stunting among children under the age of three in Shenzhen, China. Methods Using the stratified random sampling method, we selected 9,581 children under the age of three for research and analysis. The dataset underwent a random allocation into training and validation sets, adhering to a 8:2 split ratio. Within the training set, a combined approach of LASSO regression analysis and binary logistic regression analysis was implemented to identify and select the predictive variables for the model. Subsequently, model construction was conducted in the training set, encompassing model evaluation, visualization, and internal validation procedures. Finally, to assess the model's generalizability, external validation was performed using the validation set. Results A total of 684 (7.14%) had phenotypes of stunt. Utilizing a combined approach of LASSO regression and logistic regression, key predictors of stunting among children under three years of age were identified, including sex, age in months, mother's education, father's age, birth order, feeding patterns, delivery mode, average daily parent-child reading time, average time spent in child-parent interactions, and average daily outdoor time. These variables were subsequently employed to develop a comprehensive prediction model for childhood stunting. A nomogram model was constructed based on these factors, demonstrating excellent consistency and accuracy. Calibration curves validated the agreement between the nomogram predictions and actual observations. Furthermore, ROC and DCA analyses indicated the strong predictive performance of the nomograms. Conclusions The developed model for forecasting stunt risk, which integrates a spectrum of variables. This analytical framework presents actionable intelligence to medical professionals, laying down a foundational framework and a pivot for the conception and execution of preemptive strategies and therapeutic interventions.
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Affiliation(s)
- Yuxiang Xiong
- Department of Medical Information, School of Public Health, Jilin University, Jilin, China
| | - Xuhuai Hu
- Research Development, Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, China
| | - Jindan Cao
- Department of Medical Information, School of Public Health, Jilin University, Jilin, China
| | - Li Shang
- Research Development, Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, China
| | - Ben Niu
- Department of Software Technology, School of Software Engineering, Shenzhen Institute of Information Technology, Shenzhen, Guangdong, China
- Department of Management Science, College of Management, Shenzhen University, Shenzhen, Guangdong, China
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da Silva TPR, Soares LOD, dos Santos LC, Ferreira FM, Schreck RSC, Gonçalves RM, dos Santos GMV, Matozinhos FP. Factors associated with the length of breastfeeding during the COVID-19 pandemic: a survival study. Rev Esc Enferm USP 2024; 58:e20240078. [PMID: 39178020 PMCID: PMC11343085 DOI: 10.1590/1980-220x-reeusp-2024-0078en] [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: 03/12/2024] [Accepted: 06/21/2024] [Indexed: 08/24/2024] Open
Abstract
OBJECTIVE To investigate the repercussions of COVID-19 on the length of breastfeeding and analyze the associated factors in Belo Horizonte, Minas Gerais, Brazil. METHOD This is an epidemiological, prospective cohort study. Data were collected from medical records and through telephone interviews. Women who weaned were estimated using Kaplan-Meier survival analysis. The log-rank test was used to verify differences between groups, analyzing weaning time, according to sociodemographic and clinical characteristics. The values of hazard ratio and 95% confidence intervals were estimated using Cox regression analysis. RESULTS A total of 1,729 women participated in the study. During the COVID-19 pandemic, brown women and women undergoing cesarean section were more likely to stop breastfeeding. CONCLUSION The birth route and mothers' ethnic characteristics were associated with early weaning during the COVID-19 pandemic. Such findings are important to guide the assistance of the multidisciplinary team, especially nursing, during the post-pandemic period and in future epidemiological scenarios.
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Affiliation(s)
- Thales Philipe Rodrigues da Silva
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Enfermagem na Saúde da Mulher, São Paulo, SP, Brazil
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem, Belo Horizonte, MG, Brazil
| | - Lorrayne Oliveira Dias Soares
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | - Luana Carolina dos Santos
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Nutrição, Belo Horizonte, MG, Brazil
| | - Fernanda Marçal Ferreira
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Psiquiátrica, São Paulo, SP, Brazil
| | - Rafaela Siqueira Costa Schreck
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | - Renata Melgaço Gonçalves
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
| | | | - Fernanda Penido Matozinhos
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brazil
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Spatz DL, Rodríguez SÁ, Benjilany S, Finderle B, von Gartzen A, Yates A, Brumley J. Having Enough Milk to Sustain a Lactation Journey: A Call to Action. Nurs Womens Health 2024; 28:256-263. [PMID: 38823783 DOI: 10.1016/j.nwh.2024.02.007] [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: 01/07/2024] [Revised: 02/26/2024] [Accepted: 04/18/2024] [Indexed: 06/03/2024]
Abstract
The rates of human milk feeding are suboptimal worldwide. Recommendations for healthy, term mother-infant dyads include early breastfeeding initiation, frequent skin-to-skin contact, and frequent breastfeeding. The normal physiology of lactation can be affected by prenatal factors such as diabetes, obesity, and excessive gestational weight gain. Furthermore, birth-related factors such as early-term gestation, stressful labor, unscheduled cesarean birth, and postpartum hemorrhage can additionally disrupt recommended practices such as early initiation of breastfeeding and skin-to-skin contact. Given that the first 2 to 3 days postpartum are critical to achieving timely secretory activation and establishing an adequate volume of milk, a proactive approach to care can include building awareness of risk factors and development of protocols for the effective early initiation of lactation.
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Basbous M, Yehya N, Salti N, Tamim H, Nabulsi M. Cost-benefit analysis of a multicomponent breastfeeding promotion and support intervention in a developing country. PLoS One 2024; 19:e0295194. [PMID: 39028742 PMCID: PMC11259277 DOI: 10.1371/journal.pone.0295194] [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: 11/21/2023] [Accepted: 06/27/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND Studies on breastfeeding promotion and support interventions suggest some economic benefits. This study assessed the direct and indirect costs of a multicomponent breastfeeding promotion and support intervention during the first two years of the infant's life. METHODS This is a cost-benefit analysis of data generated from a randomized controlled trial that investigated whether provision of a multicomponent breastfeeding promotion and support intervention to Lebanese mothers in the first six months postpartum would improve breastfeeding rates compared to standard obstetric and pediatric care. Data of 339 participants on sociodemographics, mother and infant health, infant nutrition, direct and indirect costs of the intervention were used to assess the benefit-cost ratio (BCR) of the intervention at one, six, 12, and 24 months as primary outcome. Secondary outcomes included overall costs of infant nutrition and infant-mother dyad health costs during the first two years. Multiple linear regression models explored the effect of the intervention on the overall infant nutrition cost and mother-infant health costs. Similar regression models investigated the association between cost variables and infant nutrition types (exclusive breastfeeding, mixed feeding, artificial milk). Intention to treat analyses were conducted using SPSS (version 24). Statistical significance was set at a p-value below 0.05. RESULTS The prevalence of Exclusive/Predominant breastfeeding among participants declined from 51.6% in the first month to 6.6% at the end of second year. The multicomponent breastfeeding intervention incurred 485 USD more in costs than the control group during the first six months but was cost-efficient at one year (incremental net benefits of 374 USD; BCR = 2.44), and two years (incremental net benefits of 472 USD; BCR = 2.82). In adjusted analyses, the intervention was significantly associated with fewer infant illness visits in the first year (p = 0.045). Stratified analyses by the infant nutrition type revealed that infants who were on Exclusive/Predominant, or Any Breastfeeding had significantly more favorable health outcomes at different time points during the first two years (p<0.05) compared to infants receiving Artificial Milk only, with health benefits being highest in the Exclusive/Predominant breastfeeding group. Moreover, Exclusive/Predominant and Any Breastfeeding had significantly lower costs of infant illness visits, hospitalizations, and infant medications during the two years (p<0.05) but had additional cost for maternal non-routine doctor visits due to breastfeeding (all p values <0.05). Whereas the overall cost (direct and indirect) during the first six months was significantly lower for the Exclusive/Predominant breastfeeding infants (p = 0.001), they were similar in infants on Mixed Feeding or Artificial Milk. CONCLUSIONS Breastfeeding is associated with significant economic and infant health benefits in the first two years. In the context of the current economic crisis in Lebanon, this study provides further evidence to policymakers on the need to invest in national breastfeeding promotion and support interventions.
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Affiliation(s)
- Maya Basbous
- The Scholars in HeAlth Research Program, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Nadine Yehya
- Department of Public Affairs and Marketing, UC Davis, Davis, CA, United States of America
| | - Nisreen Salti
- Department of Economics, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Hani Tamim
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Mona Nabulsi
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
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12
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Sanghvi TG, Godha D, Frongillo EA. Inequalities in large-scale breastfeeding programmes in Bangladesh, Burkina Faso and Vietnam. MATERNAL & CHILD NUTRITION 2024:e13687. [PMID: 39020511 DOI: 10.1111/mcn.13687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/21/2024] [Accepted: 05/29/2024] [Indexed: 07/19/2024]
Abstract
Inequalities in breastfeeding programmes and practices have slowed global progress in providing the life-saving protection of breastfeeding for millions of infants despite well-known life-long impacts. As breastfeeding interventions are scaled up, inequalities in coverage and breastfeeding practices should be tracked, particularly in disadvantaged groups, who are likely to suffer the most serious health and developmental impacts of poor childhood nutrition. The literature provides evidence of inequalities in breastfeeding practices, but research is limited on socioeconomic disparities in the coverage of breastfeeding interventions. This paper (1) compares inequalities in breastfeeding practices in intervention and nonintervention areas and (2) documents inequalities in programme coverage by type of intervention. We disaggregated endline evaluation surveys in Bangladesh, Burkina Faso and Vietnam, where rigorous evaluations had documented significant overall improvements, and analysed whether inequalities in breastfeeding practices and programme coverage differed by treatment areas. We used Erreygers index to quantify inequalities and found that breastfeeding practices were largely pro-poor; intervention coverage was not consistently pro-poor. While counselling coverage often favoured women from the poorest quintile, public education/media coverage consistently favoured better-off women. Inequalities favoured more educated mothers in the coverage of combined interventions. None of the programmes had explicit equality objectives. The results indicate the need for introducing specific actions to reduce inequalities in breastfeeding policies and programmes. This is a priority unfinished agenda for nutrition programming.
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Affiliation(s)
- Tina G Sanghvi
- Alive & Thrive initiative, FHI 360, Family Health International, Washington DC and Durham, North Carolina, USA
| | - Deepali Godha
- Consultant FHI 360, 406 Ghanshyam Castle, Khajrana Square, Indore, Madhya Pradesh, India
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behaviour, University of South Carolina, Columbia, South Carolina, USA
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13
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Tran LM, Nguyen PH, Young MF, Martorell R, Ramakrishnan U. The relationships between optimal infant feeding practices and child development and attained height at age 2 years and 6-7 years. MATERNAL & CHILD NUTRITION 2024; 20:e13631. [PMID: 38450914 PMCID: PMC11168365 DOI: 10.1111/mcn.13631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/31/2023] [Accepted: 01/23/2024] [Indexed: 03/08/2024]
Abstract
Limited evidence exists on the long-term effects of early feeding practices on child growth and development. We examined the relationships between infant feeding practices and child height and development at ages 2 and 6-7 years. We studied 885 mother-child dyads from a randomized controlled trial of preconception supplementation in Vietnam. Early initiation of breastfeeding (EIBF), exclusive breastfeeding (EBF), breastfeeding (BF) duration and minimum dietary diversity (MDD) were assessed using World Health Organization (WHO) guidelines. Child development was assessed by the Bayley Scales of Infant Development-III at 2 years and the Wechsler Intelligence Scale for Children® - IV at 6-7 years. Child height-for-age z-score (HAZ) was calculated from child height and age. Multivariable regression and structural equation models were used in analyses that controlled for confounding. EIBF and EBF at 6 months occurred in 52% and 62% of children, respectively. Mean breastfeeding duration was 18 months and 83% achieved MDD at 1 year. EIBF was associated with motor (β = 0.13, 95% confidence interval [CI]: 0.00, 0.28) and cognitive development at 2 years (β = 0.12, 95% CI: -0.01, 0.26), which in turn were positively associated with cognitive development at 6-7 years. EBF was directly associated with development at 6-7 years (β = 0.21, 95% CI:0.08, 0.34) whereas motor and cognitive development at 2 years explained 41%-75% of the relationship between EIBF and development at 6-7 years. HAZ at 2 years also mediated 70% of the association between MDD at 1 year and HAZ at 6-7 years. BF duration was not associated with child development and HAZ. Early infant feeding practices, especially EIBF and EBF, have important long-term implications for optimizing child linear growth and cognition as they begin school.
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Affiliation(s)
- Lan Mai Tran
- Hubert Department of Global Health, Rollins School of Public HealthEmory UniversityAtlantaGeorgiaUSA
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate SchoolEmory UniversityAtlantaGeorgiaUSA
| | - Phuong H. Nguyen
- Nutrition, Diets, and Health Unit, International Food Policy Research InstituteWashingtonDistrict of ColumbiaUSA
- Thai Nguyen University of Pharmacy and MedicineThai NguyenVietnam
| | - Melissa F. Young
- Hubert Department of Global Health, Rollins School of Public HealthEmory UniversityAtlantaGeorgiaUSA
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate SchoolEmory UniversityAtlantaGeorgiaUSA
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public HealthEmory UniversityAtlantaGeorgiaUSA
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate SchoolEmory UniversityAtlantaGeorgiaUSA
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Rollins School of Public HealthEmory UniversityAtlantaGeorgiaUSA
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate SchoolEmory UniversityAtlantaGeorgiaUSA
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14
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Kamal S, Clementina R, Aftab MA, Haider A, Ibrahim M, Abid N, Ali A, Ali A, Gul N, Ahmad A. Comprehensive Analysis of Breastfeeding's Influence on Child Health Outcomes: A Cross-Sectional Study. Cureus 2024; 16:e64194. [PMID: 39130997 PMCID: PMC11310490 DOI: 10.7759/cureus.64194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2024] [Indexed: 08/13/2024] Open
Abstract
Background Breastfeeding is recognized as a crucial determinant of child health and development, yet its multifaceted effects remain underexplored in many contexts. This cross-sectional study investigates the association between breastfeeding practices and various health and developmental outcomes in infants and young children, focusing on exclusive breastfeeding, partial breastfeeding, and formula feeding. Done at Khyber Teaching Hospital, Pakistan, the research aims to provide comprehensive insights into the nuanced impacts of breastfeeding on child well-being. Objectives This study aims to assess the association between breastfeeding duration and practices with the incidence of infectious diseases in infants and young children. It investigates the relationship between different breastfeeding practices: exclusive breastfeeding, partial breastfeeding, and formula feeding and cognitive development outcomes in early childhood. Additionally, the study evaluates the role of breastfeeding in the development of motor skills in infants and young children. Methodology A cohort of 390 participants, aged one month to three years, participated in the study. Data collection encompassed parental interviews, clinical assessments using standardized tools such as the Bayley Scales of Infant Development, and reviews of medical records. Statistical analyses, including frequency analysis and chi-square tests, were conducted to elucidate the relationships between breastfeeding practices and health outcomes. Results Exclusive breastfeeding exhibited a significantly lower incidence of infectious diseases compared to partial breastfeeding and formula feeding. Specifically, among exclusively breastfed children, incidences of colds, pneumonia, and diarrhea were 32%, 39.7%, and 40%, respectively. These rates were notably higher in partially breastfed and formula-fed children. Cognitive development outcomes also varied significantly across feeding groups. Exclusively breastfed children demonstrated superior cognitive performance, with 34.2% rated above average, compared to only 6.5% in the formula-fed group. Additionally, the prevalence of developmental delays was lowest among exclusively breastfed children (14.1%), contrasting with 62.8% in the partial breastfeeding group and 77.0% in the formula-feeding group. Conclusions The study underscores the pivotal role of exclusive breastfeeding in promoting optimal child health and development. Exclusive breastfeeding is associated with significantly reduced incidences of infectious diseases, superior cognitive development outcomes, and a lower prevalence of developmental delays. These findings highlight the importance of supportive interventions and policies aimed at encouraging exclusive breastfeeding practices, ultimately enhancing child well-being and developmental trajectories.
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Affiliation(s)
- Sidra Kamal
- Internal Medicine, Karachi Medical and Dental College, Karachi, PAK
| | | | | | - Aqsa Haider
- Internal Medicine, Khyber Medical College, Peshawar, PAK
| | | | - Nimra Abid
- Surgery, Institute of Medical Sciences, Khyber Medical University, Kohat, PAK
| | - Ayaz Ali
- Internal Medicine, Khyber Medical College, Peshawar, PAK
| | - Ashraf Ali
- Internal Medicine, Khyber Medical College, Peshawar, PAK
| | - Nida Gul
- Medicine, Khyber Medical College, Peshawar, PAK
| | - Afaq Ahmad
- Internal Medicine, Rehman Medical Institute, Peshawar, PAK
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15
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Brani P, Mrvoljak-Theodoropoulou I, Pechlivani F, Iliadou M, Antoniou E, Daskalakis G, Drakakis P, Dagla M. Breastfeeding Intention and Breastfeeding Postpartum Outcomes between High-Risk and Low-Risk Pregnant Women: A Greek Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:755. [PMID: 38929000 PMCID: PMC11204224 DOI: 10.3390/ijerph21060755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 05/26/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND This prospective cohort study, conducted from pregnancy to six months postpartum and grounded in STROBE methodology, quantitatively explores the relationship between antenatal breastfeeding intentions and subsequent breastfeeding outcomes among high-risk pregnant women, compared to a low-risk pregnancy group. METHODS The study was conducted in one of the largest public hospitals in Attica that provides care to pregnant women, enrolling 380 participants divided into high-risk (n = 200) and low-risk (n = 180) cohorts. Data were collected over 20 months (starting from the end of May 2020 until January 2022), spanning from pregnancy to six months postpartum, via comprehensive questionnaires. RESULTS Statistical analysis revealed a pronounced correlation between prenatal breastfeeding intentions and actual breastfeeding behaviors across both groups. Specifically, 81.1% of women in the high-risk group and 82.5% in the low-risk group expressed intentions of exclusively breastfeeding during pregnancy. By six months postpartum, 54.9% of the high-risk and 64.3% of the low-risk pregnancy group managed to sustain breastfeeding. Extended antenatal hospitalization emerged as a statistically significant factor (p = 0.045) negatively impacting exclusive breastfeeding intentions among high-risk pregnancies. CONCLUSION The findings illuminate the critical influence of antenatal intentions on breastfeeding outcomes, particularly among high-risk pregnancies. Moreover, the study identifies the detrimental effect of prolonged hospital stays on breastfeeding aspirations. These insights underscore the necessity for nuanced, supportive interventions aimed at bolstering breastfeeding rates, thereby advancing maternal and neonatal health objectives aligned with World Health Organization recommendations.
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Affiliation(s)
- Panagiota Brani
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (M.I.); (E.A.)
| | | | - Fani Pechlivani
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (M.I.); (E.A.)
| | - Maria Iliadou
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (M.I.); (E.A.)
| | - Evangelia Antoniou
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (M.I.); (E.A.)
| | - Georgios Daskalakis
- First Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Peter Drakakis
- Third Department of Obstetrics and Gynecology, University General Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Maria Dagla
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece; (P.B.); (F.P.); (M.I.); (E.A.)
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16
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Grevet LT, Teixeira DS, Pan PM, Jackowski AP, Zugman A, Miguel EC, Rohde LA, Salum GA. The association between duration of breastfeeding and the trajectory of brain development from childhood to young adulthood: an 8-year longitudinal study. Eur Child Adolesc Psychiatry 2024; 33:1863-1873. [PMID: 37650992 DOI: 10.1007/s00787-023-02283-9] [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: 03/26/2023] [Accepted: 08/14/2023] [Indexed: 09/01/2023]
Abstract
Breastfeeding has been associated with several short- and long-term health benefits, including positive cognitive and behavioral outcomes. However, the impact of breastfeeding on structural brain development over time remains unclear. We aimed to assess the association between breastfeeding duration in childhood and the developmental trajectory of overall cortical thickness, cortical area, and total intracranial volume during the transition from childhood to early adulthood. Participants included 670 children and adolescents with 1326 MRI scans acquired over 8 years from the Brazilian High-Risk Cohort for Mental Conditions (BHRCS). Breastfeeding was assessed using a questionnaire answered by the parents. Brain measures were estimated using MRI T1-weighted images at three time points, with 3-year intervals. Data were evaluated using generalized additive models adjusted for multiple confounders. We found that a longer breastfeeding duration was directly associated with higher global cortical thickness in the left (edf = 1.0, F = 6.07, p = 0.01) and right (edf = 1.0, F = 4.70, p = 0.03) hemispheres. For the total intracranial volume, we found an interaction between duration of breastfeeding and developmental stage (edf = 1.0, F = 6.81, p = 0.009). No association was found between breastfeeding duration and brain area. Our study suggests that the duration of breastfeeding impacts overall cortical thickness and the development of total brain volume, but not area. This study adds to the evidence on the potential impact of breastfeeding on brain development and provides relevant insights into the mechanisms by which breastfeeding might confer cognitive and mental health benefits.
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Affiliation(s)
- Laura Tietzmann Grevet
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), School of Medicine, Avenida Ipiranga, 6681-Partenon, Porto Alegre, Rio Grande do Sul, 90619-900, Brazil.
| | - Danielle Soares Teixeira
- Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Pedro Mario Pan
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, SP, Brazil
- Universidade Federal de São Paulo (UNIFESP), Iterdisciplinary Lab for Clinical Neurosciences (LiNC), São Paulo, SP, Brazil
| | - Andrea Parolin Jackowski
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, SP, Brazil
- Universidade Federal de São Paulo (UNIFESP), Iterdisciplinary Lab for Clinical Neurosciences (LiNC), São Paulo, SP, Brazil
| | - André Zugman
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, SP, Brazil
- Universidade Federal de São Paulo (UNIFESP), Iterdisciplinary Lab for Clinical Neurosciences (LiNC), São Paulo, SP, Brazil
| | - Euripedes Constantino Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, SP, Brazil
- Department and Institute of Psychiatry, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Luis Augusto Rohde
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, SP, Brazil
- ADHD Outpatient Program and Developmental Psychiatry Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Giovanni Abrahão Salum
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, SP, Brazil
- Child Mind Institute, New York, NY, USA
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17
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Elgersma KM, Engel ML, Ramel SE, Davis JA, McKechnie AC, Pfister KM. Human milk, breastfeeding, and early neurodevelopmental outcomes for infants with critical CHD. Cardiol Young 2024:1-9. [PMID: 38738385 DOI: 10.1017/s1047951124025228] [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: 05/14/2024]
Abstract
Human milk improves neurodevelopment for preterm infants, but relationships between human milk and neurodevelopment for infants with critical CHD are unknown. We aimed to (1) explore associations between human milk/direct breastfeeding and neurodevelopment at 1-year and 2-year follow-up and (2) describe patterns of human milk (maternal, donor) and commercial formula during hospitalisation in the first year of life.This retrospective cohort study included infants who underwent surgery for CHD < 6 months old. The primary outcome was neurodevelopment via Bayley Scales of Infant Development-IV. Analysis included adjusted linear regression for associations between exclusive human milk while inpatient during the first 6 months or any direct breastfeeding while inpatient during the first year of life and 1-year Bayley-IV scores. Models were adjusted for race, insurance type, genetic diagnosis, and length of stay.Of 98 eligible infants, 40% followed up at 1 year; 27% at 2 years. There were differences in follow-up related to demographics (race, ethnicity) and social determinants of health (insurance type, distance from clinic). In adjusted models, infants who directly breastfed had 13.18 points higher cognition (95% CI: 0.84-25.53, p = 0.037); 14.04 points higher language (2.55-25.53, p = 0.018); and 15.80 points higher motor scores (3.27-28.34, p = 0.015) at 1-year follow-up. Infants fed exclusive human milk had 12.64 points higher cognition scores (-0.53-25.82, p = 0.059).Future investigation into nutrition and neurodevelopment in the context of critical CHD is warranted. As neurodevelopmental follow-up becomes standard of care in this population, efforts are needed to mitigate disparities in access to this care.
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Affiliation(s)
| | - Melissa L Engel
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Sara E Ramel
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Jessica A Davis
- Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Anne C McKechnie
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - Katie M Pfister
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN, USA
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18
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Ouyang YQ, Guo J, Zhou J, Zhouchen Y, Huang C, Huang Y, Wang R, Redding SR. Theoretical approaches in the development of interventions to promote breastfeeding: A scoping review. Midwifery 2024; 132:103988. [PMID: 38583270 DOI: 10.1016/j.midw.2024.103988] [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: 08/02/2023] [Revised: 03/19/2024] [Accepted: 04/02/2024] [Indexed: 04/09/2024]
Abstract
PROBLEM AND BACKGROUND There is a low world rate of exclusive breastfeeding and a short duration of breastfeeding. More studies have constructed interventions to improve breastfeeding behavior, but the actual effect is not significant. AIM The purpose of this review is identifying the ways that various theories have an influence on theory-based breastfeeding intervention studies. METHODS A scoping review using Arksey and O'Malley's framework explored breastfeeding promotion practices. PubMed, The Cochrane Library, Web of Science, Embase, and CINAHL databases were searched from database creation to March 9, 2024. Building on previous research, key terms were used to search the literature. Data analysis involved descriptive and interpretive summaries of theories used and the proposed interventions. FINDINGS An online search yielded 906 articles, with 28 meeting the inclusion criteria for the scoping review, including 5 reviews and 23 articles. Reviews demonstrated that interventions based on theories were more effective. Articles promoting breastfeeding used theories of self-efficacy (n = 9), theory of planned behavior (n = 8), social cognitive theory (n = 5) and individual and family self-management theory (n = 1). These theories were used in developing specific content of the intervention program (n = 20, 86.9%), constructing the framework of the program (n = 10, 43.5%), and evaluating outcomes (n = 19, 82.6%). Most interventions focused on education, professional support, and/or peer support for breastfeeding. CONCLUSION AND DISCUSSION Theory can guide decisions and play a role in selecting a methodology or lens. Researchers should make deliberate choices in the use of a theory that relates to aspects of breastfeeding behavior. Future interventions based on theories should be more varied and effective and need to consider families' and social factors.
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Affiliation(s)
| | - Jinyi Guo
- School of Nursing, Wuhan University, Wuhan, China.
| | - Jie Zhou
- School of Nursing, Wuhan University, Wuhan, China.
| | | | - Canran Huang
- School of Nursing, Wuhan University, Wuhan, China
| | - Yiyan Huang
- School of Nursing, Wuhan University, Wuhan, China
| | - Rong Wang
- Renmin Hospital of Wuhan University, Wuhan, China
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Kumar N, Al-Nahar M, Harris N, Sampath V. Early and Higher Volumes of Formula Supplementation after Birth Impact Breastfeeding Rates at Discharge in Well-Baby Nursery: A Retrospective Cohort Study. Am J Perinatol 2024; 41:e3293-e3304. [PMID: 38011861 DOI: 10.1055/a-2217-9174] [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: 11/29/2023]
Abstract
OBJECTIVE Physiologic breast milk production in the first 24 hours is estimated to be between 2 and 10 mL per feed. Many mothers intending to breastfeed use formula supplementation (FS) early on, which can affect successful breastfeeding. Whether the volume and timing of FS introduced in the first 24 hours of life (24 HOL) impacts the rate of "breastfeeding at discharge" (BFAD) is not well-studied and was investigated herein. STUDY DESIGN Single-center, retrospective, chart review of breastfeeding infants born at ≥35 weeks who received supplementation in the first 24 HOL. Comprehensive demographic data pertaining to maternal and infant characteristics, along with infant feeding data, were collected. Four supplementation characteristics, (timing, rate, volume [mL/kg per feed], and type [expressed breast milk (EBM) or formula]) were correlated with BFAD. RESULTS Among 3,102 supplemented infants in whom mothers intended to breastfeed, 1,031 (33.2%) infants were BFAD. At baseline, African American, Medicaid-insured, and single mothers had lower odds of BFAD. The overall maximum volume of FS per feed was 11.0 mL/kg (interquartile range 8.0-14.4). With each hour of delay in first supplementation, the odds of BFAD increased by 2.8% (95% confidence interval [CI] 0.022, 0.035). With every 1 mL/kg increase in the first formula volume, subsequent supplementation frequency increased by 4.5%. A positive association was observed between BFAD and a lower rate of supplementation (cutoff value ≤35.1%). However, among infants with these lower rates of supplementation, each unit increase in maximum FS, from 2 to 15 mL/kg, decreased the probability of BFAD by 4.2% (3.6-4.7%). Additionally, we observed that infants who were given at least one EBM supplementation (n = 223; 7.2%) had substantially increased rates of BFAD (odds ratio [OR] = 9.8, 95% CI 7.2-13.3). CONCLUSION Early and higher volumes of FS negatively impacted BFAD. Birthweight-based FS of feeding with physiological volumes may increase breastfeeding rates at discharge. KEY POINTS · Higher volumes of first supplementation increases subsequent supplementation frequency.. · For each unit increase in maximum supplementation, BFAD probability decreases by 4.2%.. · Even one EBM supplementation increases rates of BFAD..
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Affiliation(s)
- Navin Kumar
- Department of Pediatrics/Neonatology, Hurley Children's Hospital, Flint, Michigan
| | - Mohammed Al-Nahar
- Department of Pediatrics/Neonatology, Hurley Children's Hospital, Flint, Michigan
| | - Nathalee Harris
- Department of Pediatrics/Neonatology, Hurley Children's Hospital, Flint, Michigan
| | - Venkatesh Sampath
- Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri
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20
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Paus T. Population Neuroscience: Principles and Advances. Curr Top Behav Neurosci 2024. [PMID: 38589637 DOI: 10.1007/7854_2024_474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
In population neuroscience, three disciplines come together to advance our knowledge of factors that shape the human brain: neuroscience, genetics, and epidemiology (Paus, Human Brain Mapping 31:891-903, 2010). Here, I will come back to some of the background material reviewed in more detail in our previous book (Paus, Population Neuroscience, 2013), followed by a brief overview of current advances and challenges faced by this integrative approach.
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Affiliation(s)
- Tomáš Paus
- Department of Psychiatry and Neuroscience, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
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21
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Ke K, Chi X, Lv H, Zhao J, Jiang Y, Jiang T, Lu Q, Qiu Y, Tao S, Qin R, Huang L, Xu X, Liu C, Dou Y, Huang B, Xu B, Ma H, Jin G, Shen H, Hu Z, Lin Y, Du J. Association of Breastfeeding and Neonatal Jaundice With Infant Neurodevelopment. Am J Prev Med 2024; 66:698-706. [PMID: 38052381 DOI: 10.1016/j.amepre.2023.11.025] [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] [Received: 07/01/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 12/07/2023]
Abstract
INTRODUCTION Exclusive breastfeeding is advantageous for infant neurodevelopment. Nevertheless, insufficient human milk supply in exclusively breastfed infants may elevate the risk of neonatal jaundice, which can potentially result in neurological harm. Whether mothers should adhere to exclusive breastfeeding in infants with neonatal jaundice remains unclear. METHODS Data comes from the Jiangsu Birth Cohort (JBC), a prospective and longitudinal birth cohort study in China. A total of 2,577 infants born from November 2017 to March 2021 were included in the analysis. Multivariate linear regression models were used to analyze the associations between breastfeeding status, neonatal jaundice, and their interaction with infant neurodevelopment. Analysis was performed in 2022. RESULTS Compared with "exclusive breastfeeding," fine motor scores of infants were lower for "mixed feeding" (βadj, -0.16; 95% CI, -0.29 to -0.03; p=0.016) and "no breastfeeding" (βadj, -0.41; 95% CI, -0.79 to -0.03; p=0.034). Compared with "no neonatal jaundice," infants with "severe neonatal jaundice" had lower scores for cognition (βadj, -0.44; 95% CI, -0.66 to -0.23; p<0.001) and fine motor (βadj, -0.19; 95% CI, -0.35 to -0.03; p=0.024). In infants with severe neonatal jaundice, the termination of exclusive breastfeeding before 6 months was associated with worse cognition (βadj, -0.28; 95% CI, -0.57 to 0.01), while this association was not observed in those without neonatal jaundice (βadj, 0.09; 95% CI, -0.26 to 0.43). CONCLUSIONS Exclusive breastfeeding for the first 6 months is beneficial to the neurodevelopment of infants, especially in those with severe neonatal jaundice.
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Affiliation(s)
- Kang Ke
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xia Chi
- Department of Child Health Care, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu, China
| | - Hong Lv
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Jing Zhao
- Department of Reproduction, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Hospital, Nanjing, Jiangsu, China
| | - Yangqian Jiang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Tao Jiang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qun Lu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yun Qiu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Shiyao Tao
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Rui Qin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lei Huang
- Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xin Xu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Cong Liu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuanyan Dou
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Bo Huang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Bo Xu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hongxia Ma
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Guangfu Jin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Hongbing Shen
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Zhibin Hu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Yuan Lin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China; Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jiangbo Du
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China.
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22
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Leusin F, Damiano RF, Mendes LST, Hoffmann MS, Manfro AG, Pan PM, Gadelha A, de Jesus Mari J, Manfro GG, Miguel EC, Rohde LA, Bressan RA, Salum GA. Perinatal and neonatal factors and mental disorders in children and adolescents: looking for the contributions of the early environment to common and dissociable aspects of psychopathology. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02402-0. [PMID: 38519607 DOI: 10.1007/s00787-024-02402-0] [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] [Received: 02/15/2023] [Accepted: 02/17/2024] [Indexed: 03/25/2024]
Abstract
High rates of co-occurrence of mental disorders have been hypothesized to represent a result of common susceptibility to overall psychopathology. The purpose of this study is to test the hypothesis that commonalities among psychiatric disorders might be partially driven by sharable perinatal and neonatal environmental factors for mental disorders. Participants were 6-14 years of age children and their parents. Primary caregivers provided data on perinatal and neonatal information assessed retrospectively (n = 2231). Psychiatric disorders diagnoses were assessed using the Development and Well Being Behavior Assessment (DAWBA). We used bifactor models to disentangle common from dissociable aspects of psychopathology. These models allow modeling psychiatric disorders as the result of a common domain of psychopathology (p-factor) and three dissociable domains (fear, distress, and externalizing symptoms). Associations were tested using linear and tobit regression models. The p-factor was associated with male sex, low socioeconomic status, gestational smoking, gestational drinking, low levels of maternal education and presence of mental disorder in the mother. Associations with specific factors also emerged suggesting some risk factors might also have some role for fear, distress and externalizing factors. Our study supports the hypothesis that overall susceptibility to psychopathology might be partially driven by sharable perinatal and neonatal factors.
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Affiliation(s)
- Fabiane Leusin
- Section On Negative Affect and Social Process, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Rodolfo Furlan Damiano
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil.
- Instituto de Psiquiatria da Faculdade de Medicina da USP, Rua Ovídio Pires de Campos, 785-Cerqueira César, São Paulo, SP, 05403-903, Brazil.
| | - Lorenna Sena Teixeira Mendes
- Section On Negative Affect and Social Process, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Maurício Scopel Hoffmann
- Department of Neuropsychiatry, Universidade Federal de Santa Maria (UFSM), Camobi, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Mental Health Epidemiology Group (MHEG), Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
- London School of Economics and Political Science, Care Policy and Evaluation Centre, London, UK
| | - Arthur Gus Manfro
- Section On Negative Affect and Social Process, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Pedro Mario Pan
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
- Departamento de Psiquiatria da Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ary Gadelha
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
- Departamento de Psiquiatria da Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Jair de Jesus Mari
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
- Departamento de Psiquiatria da Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Gisele Gus Manfro
- Section On Negative Affect and Social Process, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Eurípedes Constantino Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
- Instituto de Psiquiatria da Faculdade de Medicina da USP, Rua Ovídio Pires de Campos, 785-Cerqueira César, São Paulo, SP, 05403-903, Brazil
| | - Luis Augusto Rohde
- Section On Negative Affect and Social Process, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Rodrigo Affonseca Bressan
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
- Departamento de Psiquiatria da Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Giovanni Abrahão Salum
- Section On Negative Affect and Social Process, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
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23
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Horta BL, Coca KP, Desai M, Dias MS, B Jaccottet M, Ross MG. Breastfeeding moderates the association of maternal pre-pregnancy nutritional status with offspring body composition at 30 years. J Dev Orig Health Dis 2024; 15:e3. [PMID: 38487898 DOI: 10.1017/s2040174424000047] [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] [Indexed: 04/10/2024]
Abstract
Maternal pre-pregnancy body mass index is positively associated with offspring obesity, even at adulthood, whereas breastfeeding decreases the risk of obesity. The present study was aimed at assessing whether breastfeeding moderates the association of maternal pre-pregnancy body mass index with offspring body composition at adulthood, using data from 3439 subjects enrolled in a southern Brazilian birth cohort. At 30 years of age, maternal pre-pregnancy body mass index was positively associated with offspring prevalence of obesity, abdominal obesity, as well as body mass index and fat and lean mass index. Breastfeeding moderated the association of maternal pre-pregnancy obesity with offspring adiposity at 30 years of age. For those breastfed<6 months, body mass index was 4.13 kg/m2 (95% confidence interval: 2.98; 5.28) higher among offspring of obese mothers, in relation to offspring of normal weight mothers, whereas among those breastfed≥6 months the magnitude of the difference was small [2.95 kg/m2 (95% confidence interval: 1.17; 4.73)], p-value for interaction = 0.03. Concerning obesity, among those who had been breastfed < 6 months, the prevalence of obesity was 2.56 (95% confidence interval: 1.98; 3.31) times higher among offspring of obese mothers. On the other hand, among those who were breastfed ≥ 6 months, the prevalence of obesity was 1.82 (95% confidence interval: 1.09; 3.04) times higher among offspring of obese mothers. Therefore, among overweight mothers breastfeeding for more than 6 months should be supported, as it may mitigate the consequences of maternal overweight on offspring body composition.
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Affiliation(s)
- Bernardo L Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Kelly P Coca
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Mina Desai
- Perinatal Research Laboratory, The Lundquist Institute at Harbor-UCLA Medical Center, Department of Obstetrics and Gynecology, Torrance, CA, USA Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Mariane S Dias
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Manoella B Jaccottet
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Michael G Ross
- Perinatal Research Laboratory, The Lundquist Institute at Harbor-UCLA Medical Center, Department of Obstetrics and Gynecology, Torrance, CA, USA Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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24
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Parker LA, Koernere R, Fordham K, Bubshait H, Eugene A, Gefre A, Bendixen M. Mother's Own Milk Versus Donor Human Milk: What's the Difference? Crit Care Nurs Clin North Am 2024; 36:119-133. [PMID: 38296370 DOI: 10.1016/j.cnc.2023.09.002] [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] [Indexed: 02/08/2024]
Abstract
Mother's own milk (MOM) is known to decrease complications in preterm infants and when unavailable, it is recommended that preterm very low-birth weight infants be fed donor human milk (DHM). Due to the pasteurization, processing, and lactation stage of donors, DHM does not contain the same nutritional, immunologic, and microbial components as MOM. This review summarizes the differences between MOM and DHM, the potential effects on health outcomes, and the clinical implications of these differences. Finally, implications for research and clinical practice are discussed.
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Affiliation(s)
- Leslie A Parker
- College of Nursing, University of Florida, Box 100187 College of Nursing, Gainesville, FL, USA.
| | - Rebecca Koernere
- College of Nursing, University of Florida, Box 100187 College of Nursing, Gainesville, FL, USA
| | - Keliy Fordham
- College of Nursing, University of Florida, Box 100187 College of Nursing, Gainesville, FL, USA
| | - Hussah Bubshait
- College of Nursing, University of Florida, Box 100187 College of Nursing, Gainesville, FL, USA
| | - Alissandre Eugene
- College of Nursing, University of Florida, Box 100187 College of Nursing, Gainesville, FL, USA
| | - Adrienne Gefre
- College of Nursing, University of Florida, Box 100187 College of Nursing, Gainesville, FL, USA
| | - Marion Bendixen
- College of Nursing, University of Florida, Box 100187 College of Nursing, Gainesville, FL, USA
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25
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Neupane S, de Oliveira CVR, Palombo CNT, Buccini G. Association between breastfeeding cessation among under six-month-old infants and postpartum depressive symptoms in Nevada. PLoS One 2024; 19:e0297218. [PMID: 38277396 PMCID: PMC10817202 DOI: 10.1371/journal.pone.0297218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/29/2023] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Postpartum depression affects 13% of women after childbirth in the United States. Mothers who experience depression are less likely to breastfeed than those who do not experience depression. On the other hand, breastfeeding may have a positive effect on maternal mental health. RESEARCH AIM We aimed to analyze whether breastfeeding cessation is associated with postpartum depression symptoms among mothers of infants under six months old in Clark County, Nevada. METHOD A cross-sectional study was conducted in 2021 using a purposive sample of 305 mother-infant dyads. Postpartum depression symptoms were assessed using the Patient Health Questionnaire-2 (PHQ-2), and the breastfeeding cessation was determined through a 24-hour dietary recall. Descriptive, bivariate, and multivariate logistic regression analyses were conducted. RESULTS Most participants were between 25 and 34 years old (n = 183, 60.0%), multiparous (n = 167, 55.1%), and had a vaginal delivery (n = 204, 70.6%). High frequency of postpartum depressive symptoms was found among mothers who were young (18-24 years) (24.2%), without a partner (25.0%), had unplanned pregnancies (12.7%), and were primiparous (13.2%). Breastfeeding cessation was independently associated with postpartum depressive symptoms (AOR = 3.30, 95% CI: 1.16-9.32) after controlling for sociodemographic, environmental, and obstetric characteristics. CONCLUSION Breastfeeding cessation is strongly associated with postpartum depressive symptoms among mother-infant dyads in Nevada. Early identification of postpartum depressive symptoms and the promotion of breastfeeding can create a positive feedback loop to foster the well-being of mothers and infants.
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Affiliation(s)
- Smriti Neupane
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Nevada, United States of America
| | | | | | - Gabriela Buccini
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Nevada, United States of America
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26
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Amici F, Liebal K, Ersson-Lembeck M, Holodynski M. A longitudinal comparison of maternal behaviour in German urban humans (Homo sapiens) and captive chimpanzees (Pan troglodytes). Sci Rep 2024; 14:1517. [PMID: 38233560 PMCID: PMC10794219 DOI: 10.1038/s41598-024-51999-4] [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: 08/29/2023] [Accepted: 01/12/2024] [Indexed: 01/19/2024] Open
Abstract
Comparative perspectives are crucial in the study of human development, yet longitudinal comparisons of humans and other primates are still relatively uncommon. Here, we combined theoretical frameworks from cross-cultural and comparative psychology, to study maternal style in 10 mother-infant pairs of German urban humans (Homo sapiens) and 10 mother-infant pairs of captive chimpanzees (Pan troglodytes), during the first year of infants' development. We conducted focal observations of different behaviours (i.e. nursing, carrying, body contact, touching, grooming, restraining, approaching, leaving, rejection, aggression, mutual gaze, object stimulation), during natural interactions. Analyses revealed a more distal maternal style in WEIRD humans than in captive chimpanzees, with different behaviours being generally more common in one of the two species throughout development. For other behaviours (i.e. nursing), developmental trajectories differed between WEIRD humans and captive chimpanzees, although differences generally decreased through infants' development. Overall, our study confirms functional approaches as a valid tool for comparative longitudinal studies.
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Affiliation(s)
- Federica Amici
- Faculty of Life Sciences, Institute of Biology, Human Biology & Primate Cognition, Leipzig University, Talstrasse 33, 04103, Leipzig, Germany.
- Department of Comparative Cultural Psychology, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany.
| | - Katja Liebal
- Faculty of Life Sciences, Institute of Biology, Human Biology & Primate Cognition, Leipzig University, Talstrasse 33, 04103, Leipzig, Germany
- Department of Comparative Cultural Psychology, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
- Department of Education and Psychology, Comparative Developmental Psychology, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany
| | - Manuela Ersson-Lembeck
- Department of Education and Psychology, Comparative Developmental Psychology, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany
| | - Manfred Holodynski
- Faculty of Psychology/Sport and Exercise Studies, Institute for Psychology in Education, University of Münster, Fliednerstrasse 21, 48149, Münster, Germany
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27
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Martins FA, Ramalho AA, de Andrade AM, Opitz SP, Koifman RJ, de Aguiar DM, da Silva IF. Minimum acceptable diet in a cohort of children aged between 6 and 15 months: Complementary feeding assessment and associated factors in the Brazilian western Amazon. Nutrition 2024; 117:112231. [PMID: 37976617 DOI: 10.1016/j.nut.2023.112231] [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: 06/12/2023] [Accepted: 09/17/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE The goal of the article was to assess complementary feeding patterns, and associated factors, of children between 6 and 15-month old in Rio Branco-Acre, Brazil, based on the minimum acceptable diet indicator. METHODS This study was cross-sectional, including 857 children between ages 6 and 15 mo, from a 2015 birth cohort of Rio Branco, Brazil. The prevalence of complementary feeding indicators, minimum meal frequency, minimum dietary diversity, and minimum acceptable diet was estimated based on the recommendations of the World Health Organization. Sociodemographic characteristics, infant and maternal habits, prenatal information, birth characteristics, breastfeeding, and complementary feeding were evaluated. Differences between the proportions were evaluated by the χ2 test and univariate and multiple logistic regression analyses, to determine associated factors with child minimum acceptable diet. RESULTS The minimum frequencies of meals and dietary diversity were observed in 81.0% and 51.8% of the children, respectively. The minimum acceptable diet prevalence was 47.1%. Also, minimum acceptable diet was inversely associated with C, D, and E social classes (adjusted odds ratio = 0.49; 95% CI, 0.33-0.72), number of living siblings (adjusted odds ratio for two or three children = 0.69; 95% CI, 0.48-0.98, and adjusted odds ratio for ≥ 4 children = 0.56; 95% CI, 0.37-0.84). Maternal regular consumption of fruits, vegetables, and legumes (adjusted odds ratio = 2.62; 95% CI, 1.69-4.05), child age from 12 to 15 mo (adjusted odds ratio = 2.05; 95% CI, 1.32-3.18), and receiving guidance regarding complementary feeding during postnatal consultations (adjusted odds ratio = 1.38; 95% CI, 1.03-1.86) were directly associated with minimum acceptable diet. CONCLUSIONS Fewer than 50% of the children received adequate food with adequate frequency and diversity. Low socioeconomic status and having ≥ 2 living siblings reduced the chance of minimum acceptable diet, whereas maternal healthy diet, child age (12-15 mo), and complementary feeding counseling during postnatal appointments increased the chance of minimum acceptable diet.
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Affiliation(s)
| | | | | | - Simone Perufo Opitz
- Graduate Program of Community Health, Federal University of Acre, Rio Branco, Brazil
| | - Rosalina Jorge Koifman
- Department of Epidemiology and Quantitative Methods of Health, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Debora Melo de Aguiar
- Graduate Program of Community Health, Federal University of Acre, Rio Branco, Brazil
| | - Ilce Ferreira da Silva
- Department of Epidemiology and Quantitative Methods of Health, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
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28
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Acheampong AK, Abukari AS. Myths About Breastfeeding as Voiced by Lactating Nurses and Midwives: A Qualitative Study at the Greater Accra Region of Ghana. SAGE Open Nurs 2024; 10:23779608231226068. [PMID: 38268950 PMCID: PMC10807345 DOI: 10.1177/23779608231226068] [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: 02/23/2022] [Revised: 12/07/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
Introduction Breastfeeding has proven over the years to be one of the most effective means to ensure child survival. The advocators and myth busters of breastfeeding myths are supposed to be health professionals. However very little is known about myths surrounding breastfeeding as expressed by these health professionals (nurses and midwives). Hence this study. Objective The study aimed at exploring the myths about breastfeeding as voiced by lactating nurses and midwives. Method Qualitative exploratory descriptive design was used to investigate the subject matter. Twenty-five nurses and midwives were purposely selected to participate in the study after they had voluntarily opted to be part of the study. Data was audiotaped, transcribed verbatim and inductively analyzed. Results It was evident that participants believed in myths about breastfeeding. The main themes discovered were breastfeeding myth beliefs and sociocultural myth influences. Six sub-themes identified were green stools/diarrhoea, childhood disease, teeth discoloration, child becoming stupid, culture and close relatives. Conclusion Health professionals believe in unfounded myths about breastfeeding. Steps should be taken for them to get better lactation support. The outcomes of this study underscore the need for health professionals to address breastfeeding myths, understand the sociocultural context, and support evidence-based practice. Improving lactation support and education for nurses and midwives can lead to better clinical practice and, as a result, help to promote successful and healthy breastfeeding in Ghana.
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Sabo A, Abba J, Sunusi Usman U, Musa Saulawa I, Alzoubi MM, Al-Mugheed K, Alsenany SA, Farghaly Abdelaliem SM. Knowledge, attitude, and practice of exclusive breastfeeding among mothers of childbearing age. Front Public Health 2023; 11:1277813. [PMID: 38169742 PMCID: PMC10758446 DOI: 10.3389/fpubh.2023.1277813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
Background The American Academy of Pediatrics and the World Health Organization recommend exclusive breastfeeding (EBF) for up to 6 months. Despite the importance of breast milk, EBF is far less prevalent in Nigeria than is recommended for developing countries. Worse still, the odds of EBF practice are very low in rural communities. Hence, the aim of this study was to assess the knowledge, attitude, and practice of EBF as well as identify the factors associated with EBF practice among mothers of childbearing age in Chamo town, Jigawa State, Nigeria. Methods The study is a cross-sectional design using a questionnaire to assess the required information. The methodology involved the use of simple random sampling to select mothers of reproductive age from Chamo town, which is a rural community located in Jigawa State, Nigeria. A semi-structured questionnaire was used to assess the mother's knowledge, attitude, and practices regarding EBF. Simple and multiple logistic regression analyses were performed to determine the factors associated with the practice of EBF. Results A total of 400 mothers between the ages of 18 and 41 took part in the study. More than half of the participants (57.8%) were between the ages of 26 and 33 and had a primary level of education (30.5%). Only 26.8% of the respondents practice EBF. Those with a tertiary education (AOR = 10.00, p < 0.001), civil servants (AOR = 12.51, p < 0.001), those aware of EBF (AOR = 3.65, p = 0.002), those with correct EBF knowledge (AOR = 4.61, p < 0.001), those with a positive attitude toward EBF demand (AOR = 0.51, p = 0.050), and those who received encouragement from their community (AOR = 9.87, p < 0.001) were more likely to practice EBF. Conclusion The findings of the study revealed that the majority of the respondents' knowledge, attitude, and practice of EBF were minimal. This shows the need to step up efforts to educate mothers about the advantages of EBF for both their own health and that of their children while they are in the hospital recovering from childbirth.
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Affiliation(s)
- Abdulwali Sabo
- Department of Public and Environmental Health, Faculty of Basic Medical Sciences, College of Medicine and Allied Medical Sciences, Federal University Dutse, Dutse, Nigeria
| | - Justina Abba
- Department of Public and Environmental Health, Faculty of Basic Medical Sciences, College of Medicine and Allied Medical Sciences, Federal University Dutse, Dutse, Nigeria
| | - Usman Sunusi Usman
- Department of Community Medicine, Faculty of Clinical Sciences, College of Medicine and Allied Medical Sciences, Federal University Dutse, Dutse, Nigeria
| | - Ibrahim Musa Saulawa
- Department of Community Medicine, Faculty of Clinical Sciences, College of Medicine and Allied Medical Sciences, Federal University Dutse, Dutse, Nigeria
| | - Majdi M. Alzoubi
- Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | | | - Samira Ahmed Alsenany
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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Benoit B, Cassidy C, Campbell-Yeo M, Gillis D, Kirk S, Sim SM, LeDrew M, Loring S, Tomblin Murphy G, Elliott Rose A, Betker C, MacKeen L, Arseneau L, Shebib K, Reid T, Daman R. Development of Interventions to Support Provincial Implementation of the Baby-Friendly Initiative: A Study Protocol. NURSING REPORTS 2023; 13:1731-1741. [PMID: 38133119 PMCID: PMC10745531 DOI: 10.3390/nursrep13040143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/24/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
Breastfeeding is internationally recognized as the optimal form of infant nutrition. The Baby-Friendly Initiative (BFI) is an evidence-informed program that leads to improved breastfeeding outcomes. Despite the benefits of breastfeeding, Nova Scotia has one of the lowest breastfeeding rates in Canada. Additionally, only two birthing hospitals in the province have BFI designation. We aim to address this gap using a sequential qualitative descriptive design across three phases. In Phase 1, we will identify barriers and facilitators to BFI implementation through individual, semi-structured interviews with 40 health care professionals and 20 parents. An analysis of relevant policy and practice documents will complement these data. In Phase 2, we will develop implementation interventions aimed at addressing the barriers and facilitators identified in Phase 1. An advisory committee of 10-12 administrative, clinical, and parent partners will review these interventions. In Phase 3, the interventions will be reviewed by a panel of 10 experts in BFI implementation through an online survey. Feedback on the revised implementation interventions will then be sought from 20 health system and parent partners through interviews. This work will use implementation science methods to support integrated and sustained implementation of the BFI across hospital/community and rural/urban settings in Nova Scotia. This study was not registered.
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Affiliation(s)
- Britney Benoit
- Rankin School of Nursing, Faculty of Science, St. Francis Xavier University, Antigonish, NS B2G 2W5, Canada; (L.A.); (R.D.)
| | - Christine Cassidy
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada; (C.C.); (M.C.-Y.)
| | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada; (C.C.); (M.C.-Y.)
| | - Doris Gillis
- Human Nutrition Department, Faculty of Science, St. Francis Xavier University, Antigonish, NS B2G 2W5, Canada;
| | - Sara Kirk
- School of Health & Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada;
| | - S. Meaghan Sim
- Research, Innovation, & Discovery, Nova Scotia Health, Halifax, NS B3S 0H6, Canada; (S.M.S.); (G.T.M.)
| | - Michelle LeDrew
- Breastfeeding Committee for Canada, Glen Margaret, NS B3Z 3H8, Canada; (M.L.); (S.L.)
| | - Sally Loring
- Breastfeeding Committee for Canada, Glen Margaret, NS B3Z 3H8, Canada; (M.L.); (S.L.)
| | - Gail Tomblin Murphy
- Research, Innovation, & Discovery, Nova Scotia Health, Halifax, NS B3S 0H6, Canada; (S.M.S.); (G.T.M.)
| | | | - Claire Betker
- National Collaborating Centre for Determinants of Health, St. Francis Xavier University, Antigonish, NS B2G 2W5, Canada;
| | - Leanne MacKeen
- Reproductive Care Program of Nova Scotia, Halifax, NS B3H 1Y6, Canada;
| | - Lindsay Arseneau
- Rankin School of Nursing, Faculty of Science, St. Francis Xavier University, Antigonish, NS B2G 2W5, Canada; (L.A.); (R.D.)
| | - Kim Shebib
- Public Health, Nova Scotia Health, Halifax, NS B3S 1B8, Canada; (K.S.); (T.R.)
| | - Trudy Reid
- Public Health, Nova Scotia Health, Halifax, NS B3S 1B8, Canada; (K.S.); (T.R.)
| | - Ripu Daman
- Rankin School of Nursing, Faculty of Science, St. Francis Xavier University, Antigonish, NS B2G 2W5, Canada; (L.A.); (R.D.)
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Basbous M, Yehya N, Salti N, Tamim H, Nabulsi M. Cost-benefit analysis of a multicomponent breastfeeding promotion and support intervention in a developing country. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.17.23298704. [PMID: 38014286 PMCID: PMC10680883 DOI: 10.1101/2023.11.17.23298704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Background Studies evaluating breastfeeding promotion and support interventions suggest some economic benefits. This study assessed the direct and indirect costs of a multicomponent breastfeeding promotion and support intervention during the first two years of the infant's life. Methods This is a cost-benefit analysis of data generated from a randomized controlled trial that aimed at investigating whether provision of a multicomponent breastfeeding promotion and support intervention to Lebanese mothers in the first six months postpartum would improve breastfeeding rates compared to standard obstetric and pediatric care. Data on 339 participants included information on maternal socio-demographics and health, infant nutrition and health, and direct and indirect costs of the intervention. The primary outcome was the benefit-cost ratio (BCR) of the intervention at one, six, 12, and 24 months. Secondary outcomes included the overall costs of infant nutrition and infant-mother dyad health costs during the first two years. Multiple linear regression models investigated the effect of the multicomponent intervention (independent variable) on the overall infant nutrition cost and the overall mother-infant health costs (as dependent variables), adjusting for monthly income and number of children (confounders) at different time points in the first two years. Similar regression models investigated the association between infant nutrition type (exclusive breastfeeding, mixed feeding, artificial milk) and infant nutrition costs and infant-mother health costs. Intention to treat analyses were conducted using SPSS (version 24). Statistical significance was set at a p-value below 0.05. Results The prevalence of Exclusive/Predominant breastfeeding among participants declined from 51.6% in the first month to 6.6% at the end of second year. The multicomponent breastfeeding intervention incurred 485 USD more in costs than the control group during the first six months but was cost-efficient by the end of the first year (incremental net benefits of 374 USD; BCR=2.44), and by the end of the second year (incremental net benefits of 472 USD; BCR=2.82). In adjusted analyses, the intervention was significantly associated with fewer infant illness visits in the first year (p=0.045). Stratified analyses by the type of infant nutrition revealed that infants who were on Exclusive/Predominant, or Any Breastfeeding had significantly more favorable health outcomes at different time points during the first two years (p<0.05) compared to infants receiving Artificial Milk only, with health benefits being highest in the Exclusive/Predominant breastfeeding group. Moreover, Exclusive/Predominant and Any Breastfeeding had significantly lower costs of infant illness visits, hospitalizations, and infant medications during the two years (p<0.05), but had additional cost for maternal non-routine doctor visits due to breastfeeding (all p values <0.05). Whereas the overall cost (direct and indirect) during the first six months was significantly lower for the Exclusive/Predominant breastfeeding infants (p=0.001), they were similar in infants on Mixed Feeding or Artificial Milk. Conclusions Breastfeeding is associated with significant economic and infant health benefits in the first two years. In the context of the current economic crisis in Lebanon, this study provides further evidence to policymakers on the need to invest in national breastfeeding promotion and support interventions.
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Affiliation(s)
- Maya Basbous
- The Scholars in HeAlth Research Program, Faculty of Medicine, American University of Beirut, Beirut-Lebanon
| | - Nadine Yehya
- Department of Public Affairs and Marketing, UC Davis, USA
| | - Nisreen Salti
- Department of Economics, Faculty of Arts and Sciences, American University of Beirut, Beirut-Lebanon
| | - Hani Tamim
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut-Lebanon
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Mona Nabulsi
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut-Lebanon
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Tran HT, Luu HM, Le TD, Pham NTQ, Sobel HL, Murray JCS. Factors associated with high exclusive breastfeeding rates among preterm infants under 34 weeks of gestation in Da Nang, Vietnam: A retrospective cohort study. J Glob Health 2023; 13:04121. [PMID: 37934970 PMCID: PMC10630854 DOI: 10.7189/jogh.13.04121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023] Open
Abstract
Background Preterm infants have higher mortality than full-term infants. While breastfeeding dramatically reduces preterm death, it is limited by biological and practice barriers, particularly for babies born before 34 weeks gestational age. Da Nang Hospital for Women and Children developed a quality improvement approach to improve breastfeeding of preterm infants by strengthening feeding support, non-separation, and kangaroo mother care (KMC). Methods To determine breastfeeding outcomes following discharge and explore factors associated with improved feeding, mothers of infants under 34 weeks gestational age born October 2021 to March 2022 and discharged alive were interviewed at six months and their medical records were reviewed. Results Out of 104 preterm infants included, all were exclusively breastfed at discharge and one month, 86.5% at three months, and 63.5% at six months; 47.1% received immediate skin-to-skin contact, 31.7% immediate and continuous KMC, and the remaining 68.3% continuous KMC beginning at a median of three days. Exclusive breastfeeding at six months was associated with the mother antenatally seeking breastfeeding information (odds ratio (OR) = 14.5; 95% confidence interval (CI) = 1.2-173.6), avoiding bottle-feeding at home (OR = 7.7; 95% CI = 1.7-33.7) and reduced with each day delay between birth and full breastfeeding (OR = 0.8; 95% CI = 0.6-0.9). Conclusions Hospital environments that limit mother-baby separations and feeding delays, including rooming-in of mothers and infants, KMC, and breastfeeding support from birth, enabled 100% of preterm infants born before 34 weeks gestational age to breastfeed exclusively with continued rates higher than previously reported. Addressing antenatal and post-natal factors limiting practice can further improve longer-term breastfeeding outcomes. The approach can be adapted to achieve high exclusive breastfeeding rates, regardless of gestational age.
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Affiliation(s)
- Hoang Thi Tran
- Neonatal Unit, Da Nang Hospital for Women and Children, Da Nang, Vietnam
- Department of Paediatrics, School of Medicine and Pharmacy, Da Nang University, Vietnam
| | - Hanh My Luu
- Neonatal Unit, Da Nang Hospital for Women and Children, Da Nang, Vietnam
- Department of Paediatrics, School of Medicine and Pharmacy, Da Nang University, Vietnam
| | - Thao Dieu Le
- Neonatal Unit, Da Nang Hospital for Women and Children, Da Nang, Vietnam
- Department of Paediatrics, School of Medicine and Pharmacy, Da Nang University, Vietnam
| | - Nga Thi Quynh Pham
- World Health Organization Representative Office in Viet Nam, Ha Noi, Vietnam
| | - Howard L Sobel
- World Health Organization Western Pacific Regional Office, United Nations Avenue, Manila, Philippines
| | - JCS Murray
- World Health Organization Western Pacific Regional Office, United Nations Avenue, Manila, Philippines
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Rodrigues JDS, Matijasevich A, Tovo-Rodrigues L, Munhoz TN, Santos IS, Pastor-Valero M. Risk factors for executive function impairment in adolescence: an analysis of data from the 2004 Pelotas Birth Cohort study. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2023; 45:470-481. [PMID: 37995276 PMCID: PMC10897774 DOI: 10.47626/1516-4446-2023-3277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/24/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE To investigate risk factors associated with impaired attention-related executive functions (EFs) at age 11 and working memory at age 15. METHODS Data from participants of the population-based 2004 Pelotas Birth Cohort at ages 11 (n=3,582) and 15 (n=1,950) were analyzed. The study measured attentional control, cognitive flexibility, and selective attention using the Test of Everyday Attention for Children (TEA-Ch). Spatial working memory was assessed by the Cambridge Neuropsychological Test Automated Battery (CANTAB). Logistic regression was employed to explore the relationship between perinatal and childhood exposures and EF impairment. RESULTS Low maternal education had a significant negative impact on EFs. At age 11, it was associated with decreased attentional control (OR = 3.04; 95%CI 2.09-4.43), and at age 15, it was linked to impaired spatial working memory (OR = 2.21; 95%CI 1.58-3.09). Additional risk factors included low household income, black or brown maternal skin color, high parity, prematurity, low birth weight, and multiple siblings. Breastfeeding, regardless of duration, was found to be a protective factor against impaired cognitive flexibility (OR = 0.38; 95%CI 0.22-0.65). CONCLUSION This study underscores the lasting impact of perinatal exposures on EF development. Policies that mitigate the negative effects of risk factors and promote EF development, especially among vulnerable populations, are needed.
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Affiliation(s)
- Júlia de Souza Rodrigues
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Facultad de Medicina, Universidad Miguel Hernández de Elche, Elche, Spain
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luciana Tovo-Rodrigues
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil
| | - Tiago N Munhoz
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil. Faculdade de Psicologia, UFPel, Pelotas, RS, Brazil
| | - Iná S Santos
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil
| | - Maria Pastor-Valero
- Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Facultad de Medicina, Universidad Miguel Hernández de Elche, Elche, Spain. Centro de Investigación Biomédica en Red, Madrid, Spain
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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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Flood MM, Pollock WE, McDonald SJ, Cullinane F, Davey MA. Primary postpartum haemorrhage adversely impacts breastfeeding initiation in Victoria, Australia. Women Birth 2023; 36:e582-e590. [PMID: 37183136 DOI: 10.1016/j.wombi.2023.05.001] [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: 11/13/2022] [Revised: 03/30/2023] [Accepted: 05/02/2023] [Indexed: 05/16/2023]
Abstract
PROBLEM Breastfeeding has many important benefits for both mother and baby but sustained breastfeeding is sub-optimal. BACKGROUND Identifying women who need increased support to establish breastfeeding has the potential to improve this. Analysis of the relationship between primary postpartum haemorrhage (PPH) and primary severe PPH and breastfeeding may prove informative as PPH has potentially negative impacts on breastfeeding. AIM To determine the relationship between PPH and severe PPH and breastfeeding at postnatal discharge and formula use for breastfed babies in hospital. METHODS Population-based retrospective cohort study using the Victorian Perinatal Data Collection for all liveborn singleton births at ≥ 37 weeks' gestation (n = 339,854) for 2009-13 in Victoria. Estimated blood loss was categorised as PPH ≥ 500 mL and severe PPH ≥ 1500 mL. Descriptive analysis was conducted and multivariable logistic regression was used to determine the adjusted odds ratio for the relationship between PPH/severe PPH and breastfeeding outcomes after adjustment for relevant confounders. FINDINGS Overall, 94.9% of women initiated breastfeeding. Babies whose mother had a PPH or severe PPH were less likely than others to be exclusively breastfeeding at discharge (aOR 0.88; (95% CI 0.86, 0.90) and aOR 0.57; (95% CI 0.53, 0.61) respectively). Formula - given to 25.9% of all breastfed babies - was more likely for those whose mothers had a PPH or severe PPH (aOR 1.15; (95% CI 1.12, 1.17) and aOR 2.15; (95% CI 2.01, 2.29) respectively. CONCLUSIONS Women have greater challenges establishing exclusive breastfeeding following PPH and severe PPH. Improving support in hospital for women following PPH may increase breastfeeding success.
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Affiliation(s)
- Margaret M Flood
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.
| | - Wendy E Pollock
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia; School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Susan J McDonald
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia; Mercy Health, Heidelberg 3084, Victoria, Australia
| | - Fiona Cullinane
- Maternity Services, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Mary-Ann Davey
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
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Gala Z, Shetye S, Sadawarte DM, Autade M. Barriers in exclusive breastfeeding encountered by mothers in urban slum area of a metropolitan city. J Family Med Prim Care 2023; 12:2690-2695. [PMID: 38186763 PMCID: PMC10771160 DOI: 10.4103/jfmpc.jfmpc_990_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/19/2023] [Accepted: 08/11/2023] [Indexed: 01/09/2024] Open
Abstract
Background Breastfeeding is considered the most important source of nutrients for the baby. But owing to ignorance, lack of education, and cultural norms, exclusive breastfeeding (EBF) is not done by majority of the mothers. Hence, this study is carried out to determine various barriers faced by the mothers that influenced their decision on EBF. Methods A descriptive qualitative study was conducted among the mothers whose children were less than 1 year of age visiting a well-baby clinic and Immunisation OPD of Urban Health Centre catering to the Urban Slum of Malvani in the Metropolitan city of Mumbai. In-depth interviews (IDIs) were done with 17 participants from August to November 2022. Thematic analysis was conducted on the qualitative data obtained. Results Four major themes were generated from the transcripts. They are -barriers and concerns faced by mothers to exclusively breastfeed, enablers/motivators, sources of knowledge regarding EBF, and breastfeeding practices. Various barriers faced by mothers were gaps in knowledge, maternal Illness, religious reasons, inadequate milk production, bias toward top feeds, lack of autonomy to take decisions, and cultural norms, while positive family support, good knowledge about breastfeeding, and a supportive home environment motivated mothers to exclusively breastfeed their infants. Sources of knowledge were identified to be doctors and health care workers, mothers/mothers-in-law, sisters, friends, and social media. Conclusions There are various challenges as well as motivators identified for EBF. Barriers, such as gaps in knowledge, and the negative influence of social media can be improved upon by health education. Therefore, it is crucial to teach expectant mothers as well as families about breastfeeding. Additionally, we advise stepping up public health education initiatives to support breastfeeding.
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Affiliation(s)
- Zil Gala
- Department of Community Medicine, Seth G.S Medical College and KEM Hospital, Parel, Mumbai, India
| | - Sonal Shetye
- Department of Community Medicine, Seth G.S Medical College and KEM Hospital, Parel, Mumbai, India
| | - Deepika M. Sadawarte
- Department of Community Medicine, Seth G.S Medical College and KEM Hospital, Parel, Mumbai, India
| | - Mrunali Autade
- Department of Community Medicine, Seth G.S Medical College and KEM Hospital, Parel, Mumbai, India
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Gribble KD, Smith JP, Gammeltoft T, Ulep V, Van Esterik P, Craig L, Pereira-Kotze C, Chopra D, Siregar AYM, Hajizadeh M, Mathisen R. Breastfeeding and infant care as 'sexed' care work: reconsideration of the three Rs to enable women's rights, economic empowerment, nutrition and health. Front Public Health 2023; 11:1181229. [PMID: 37886047 PMCID: PMC10599145 DOI: 10.3389/fpubh.2023.1181229] [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: 03/16/2023] [Accepted: 09/11/2023] [Indexed: 10/28/2023] Open
Abstract
Women's lifelong health and nutrition status is intricately related to their reproductive history, including the number and spacing of their pregnancies and births, and for how long and how intensively they breastfeed their children. In turn, women's reproductive biology is closely linked to their social roles and situation, including regarding economic disadvantage and disproportionate unpaid work. Recognizing, as well as reducing and redistributing women's care and domestic work (known as the 'Three Rs'), is an established framework for addressing women's inequitable unpaid care work. However, the care work of breastfeeding presents a dilemma, and is even a divisive issue, for advocates of women's empowerment, because reducing breastfeeding and replacing it with commercial milk formula risks harming women's and children's health. It is therefore necessary for the interaction between women's reproductive biology and infant care role to be recognized in order to support women's human rights and enable governments to implement economic, employment and other policies to empower women. In this paper, we argue that breastfeeding-like childbirth-is reproductive work that should not be reduced and cannot sensibly be directly redistributed to fathers or others. Rather, we contend that the Three Rs agenda should be reconceptualized to isolate breastfeeding as 'sexed' care work that should be supported rather than reduced with action taken to avoid undermining breastfeeding. This means that initiatives toward gender equality should be assessed against their impact on women's ability to breastfeed. With this reconceptualization, adjustments are also needed to key global economic institutions and national statistical systems to appropriately recognize the value of this work. Additional structural supports such as maternity protection and childcare are needed to ensure that childbearing and breastfeeding do not disadvantage women amidst efforts to reduce gender pay gaps and gender economic inequality. Distinct policy interventions are also required to facilitate fathers' engagement in enabling and supporting breastfeeding through sharing the other unpaid care work associated with parents' time-consuming care responsibilities, for both infants and young children and related household work.
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Affiliation(s)
- Karleen D. Gribble
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW, Australia
| | - Julie P. Smith
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Tine Gammeltoft
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark
| | - Valerie Ulep
- Philippine Institute for Development Studies, Quezon City, Philippines
| | - Penelope Van Esterik
- Department of Anthropology, York University, Toronto, ON, Canada
- Department of Sociology and Anthropology, University of Guelph, Guelph, ON, Canada
| | - Lyn Craig
- School of Social and Political Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Catherine Pereira-Kotze
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Deepta Chopra
- Institute of Development Studies, University of Sussex, Brighton, United Kingdom
| | - Adiatma Y. M. Siregar
- Center for Economics and Development Studies, Department of Economics, Faculty of Economics and Business, Universitas Padjadjaran, Bandung, Indonesia
| | - Mohammad Hajizadeh
- School of Health Administration, Dalhousie University, Halifax, NS, Canada
| | - Roger Mathisen
- Alive and Thrive East Asia Pacific, FHI Solutions, Hanoi, Vietnam
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Peña‐Ruiz LS, Unar‐Munguía M, Colchero MA, Alarid‐Escudero F, Pérez‐Escamilla R. Breastfeeding is associated with the intelligence of school-age children in Mexico. MATERNAL & CHILD NUTRITION 2023; 19:e13534. [PMID: 37218453 PMCID: PMC10483941 DOI: 10.1111/mcn.13534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 05/24/2023]
Abstract
Breastfeeding has been consistently associated with higher intelligence since childhood. However, this relation could be confounded due to maternal selection bias. We estimated the association between predominant breastfeeding and intelligence in school-age children considering potential selection bias and we simulated the intelligence gap reduction between low versus higher socioeconomic status children by increasing breastfeeding. We analysed predominant breastfeeding practices (breastmilk and water-based liquids) of children 0-3 years included in the Mexican Family Life Survey (MxFLS-1). Intelligence was estimated as the z-score of the abbreviated Raven score, measured at 6-12 years in the MxFLS-2 or MxFLS-3. We predicted breastfeeding duration among children with censored data with a Poisson model. We used the Heckman selection model to assess the association between breastfeeding and intelligence, correcting for selection bias and stratified by socioeconomic status. Results show after controlling for selection bias, a 1-month increase in predominant breastfeeding duration was associated with a 0.02 SD increase in the Raven z-score (p < 0.05). The children who were predominantly breastfed for 4-6 months versus <1 month had 0.16 SD higher Raven z-score (p < 0.05). No associations were found using multiple linear regression models. Among low socioeconomic status children, increasing predominantly breastfeeding duration to 6 months would increase their mean Raven z-score from -0.14 to -0.07 SD and reduce by 12.5% the intelligence gap with high socioeconomic status children. In conclusion, predominant breastfeeding duration was significantly associated with childhood intelligence after controlling for maternal selection bias. Increased breastfeeding duration may reduce poverty-driven intelligence inequities.
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Affiliation(s)
- Lidia Sarahi Peña‐Ruiz
- Department of Maternal, Child and Adolescent Nutrition, Center for Research on Health and NutritionNational Institute of Public HealthCuernavacaMorelosMexico
| | - Mishel Unar‐Munguía
- Department of Maternal, Child and Adolescent Nutrition, Center for Research on Health and NutritionNational Institute of Public HealthCuernavacaMorelosMexico
| | - Mónica Arantxa Colchero
- Department of Health Economics, Center for Research on Health SystemsNational Institute of Public HealthCuernavacaMorelosMexico
| | - Fernando Alarid‐Escudero
- Department of Health Policy, School of MedicineStanford UniversityCAUS
- Center for Health PolicyFreeman Spogli Institute, Stanford UniversityCAUS
| | - Rafael Pérez‐Escamilla
- Department of Social and Behavioral ScienceYale School of Public Health, Yale UniversityNew HavenConnecticutUSA
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Lee JS, Shin JI, Kim S, Choi YS, Shin YH, Hwang J, Shin JU, Koyanagi A, Jacob L, Smith L, Jeong HE, Noh Y, Oh IS, Rhee SY, Min C, Cho SH, Turner S, Fond G, Boyer L, Suh DI, Acharya KP, Shin JY, Lee SW, Yon DK. Breastfeeding and impact on childhood hospital admissions: a nationwide birth cohort in South Korea. Nat Commun 2023; 14:5819. [PMID: 37730734 PMCID: PMC10511528 DOI: 10.1038/s41467-023-41516-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/05/2023] [Indexed: 09/22/2023] Open
Abstract
Benefits of breastfeeding for both the mother and the child are well established, but a comprehensive and robust study to investigate the protective effect of breastfeeding and attenuated time effect stratified by cause of morbidity are lacking. This study is based on the nationwide birth cohort in Korea that includes data on all infants born from 2009 to 2015. Of 1,608,540 children, the median follow-up period was 8.41 years (interquartile range, 6.76-10.06). When compared to children with fully formula feeding, the hospital admission rate was 12% lower in those with partially breastfeeding and 15% lower in those with exclusive breastfeeding. The apparent protective effect of breastfeeding was reduced with increasing age. Our study provides potential evidence of the beneficial association of breastfeeding on subsequent hospital admissions. The protective effect declined over time as the children grew older. Encouraging any breastfeeding for at least the first 6 months among infants is an important public health strategy to improve overall child health.
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Affiliation(s)
- Jeong-Seon Lee
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University School of Medicine, Bucheon, Republic of Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sunyeup Kim
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Yong-Sung Choi
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Youn Ho Shin
- Department of Pediatrics, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Republic of Korea
| | - Jimin Hwang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jung U Shin
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain
- Department of Physical Medicine and Rehabilitation, Lariboisière-Fernand Widal Hospital, AP-HP, Université Paris Cité, Paris, France
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Han Eol Jeong
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
| | - Yunha Noh
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
- Deparments of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Canada
| | - In-Sun Oh
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
- Deparments of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Canada
| | - Sang Youl Rhee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Chanyang Min
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Seong Ho Cho
- Division of Allergy-Immunology, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Steve Turner
- Maternity and Child Health Division, NHS Grampian, Aberdeen, UK
| | - Guillaume Fond
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Laurent Boyer
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | | | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea.
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, Republic of Korea.
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea.
| | - Dong Keon Yon
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
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Lawal TV, Lawal DI, Adeleye OJ. Determinants of Kangaroo Mother Care among low-birth-weight infants in low resource settings. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002015. [PMID: 37699007 PMCID: PMC10497168 DOI: 10.1371/journal.pgph.0002015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/14/2023] [Indexed: 09/14/2023]
Abstract
Kangaroo Mother Care involves direct contact between a baby's bare skin and a caregiver, typically the mother. It has many benefits for both baby and caregiver and is often used to regulate body temperature, promote breastfeeding, enhance growth, and bonding. This study aims to explore factors associated with Kangaroo Mother Care uptake in low-resource countries for babies born with low-birth-weight. Demographic and Health Survey data from 34 low- and middle- income countries were analyzed. Cross-sectional data of 57,223 children were pooled and analyzed. Hierarchical multivariable analysis was performed to determine the factors associated with skin-to-skin contact. Statistical significance was set to 5%. The prevalence of Kangaroo Mother Care ranged from 11.04% to 84.36%; highest in Benin (84.36%), Tajikistan (80.88%), and Uganda (80.86%) and lowest in Burundi (11.04%), Bangladesh (16.58%), and Pakistan (19.24%). Higher odds of Kangaroo Mother Care were estimated among low-birth-weight infants who were put to breast immediately, had low-birth-weight (≥1.5kg), born through normal delivery, born at health facility, those whose mothers were exposed to media, had high antenatal care visits, had formal education, and in the younger age bracket. Also, women living in communities with high illiteracy, countries in the lower-middle income region had higher odds of Kangaroo Mother Care. Women domiciled in Europe and Central Asia, Sub-Saharan Africa, Latin America and The Caribbeans, and East Asia and Pacific had lower odds of Kangaroo Mother Care. This study found a low uptake of Kangaroo Mother Care in countries with limited resources, which is a concerning issue that requires urgent attention. Increasing awareness, education, and support for mothers and families to practice Kangaroo Mother Care, as well as training healthcare practitioners, can lead to better outcomes for newborns and reduce neonatal death.
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Affiliation(s)
- Temitayo Victor Lawal
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, FCT, Nigeria
| | - Damilola Israel Lawal
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| | - Oluwafemi John Adeleye
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
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Kumar N, Oredein I, Al-Nahar M, Harris N, Sampath V. Impact of feeding volumes in the first 24 h of life on neonatal feeding intolerance. Front Pediatr 2023; 11:1245947. [PMID: 37705598 PMCID: PMC10495575 DOI: 10.3389/fped.2023.1245947] [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] [Received: 06/24/2023] [Accepted: 08/03/2023] [Indexed: 09/15/2023] Open
Abstract
Objective This study investigates whether volumes of intake in the first 24 h of life (24 HOL), in relation to birth weight (BW) and gestational age (GA), impact neonatal feeding intolerance (FI). Methods This study employed a retrospective chart review of 6,650 infants born at ≥35 weeks. The volumes of each formula feed per kg BW in the first 24 HOL were assessed. FI was defined as evidenced by chart documentation of emesis, abdominal distension, abdominal x-ray, and/or switching to a sensitive formula. Results Overall, the maximum volume of formula intake per feed was inversely correlated with GA and was higher in infants with FI (β = -1.39, p < 0.001) compared with infants without FI (β = -1.28, p < 0.001). The odds of emesis in late preterm infants with first feeding of >8 ml/kg [adjusted odds ratio (AOR) = 2.5, 95% confidence interval (CI): 1.4-4.6] and formula switching in the exclusively formula-fed group with volumes >10.5 ml/kg [AOR = 2.2, 95% CI (1.8-2.6)] were high. In the breastfeeding group, the odds of FI increased by 2.8-, 4.6-, and 5.2-fold with 5-10, 10-15, and >15 ml/kg of supplementations, respectively. Conclusion A higher volume of intake in relation to BW often exceeds the physiological stomach capacity of newborns and is associated with early FI. Optimizing early feeding volumes based on infant BW and GA may decrease FI, which may be an issue of volume intolerance.
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Affiliation(s)
- Navin Kumar
- Division of Neonatology, Hurley Children’s Hospital, Flint, MI, United States
| | | | - Mohammed Al-Nahar
- Division of Neonatology, Hurley Children’s Hospital, Flint, MI, United States
| | - Nathalee Harris
- Division of Neonatology, Hurley Children’s Hospital, Flint, MI, United States
| | - Venkatesh Sampath
- Division of Neonatology, Children’s Mercy Hospital, Kansas City, MO, United States
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Muro-Valdez JC, Meza-Rios A, Aguilar-Uscanga BR, Lopez-Roa RI, Medina-Díaz E, Franco-Torres EM, Zepeda-Morales ASM. Breastfeeding-Related Health Benefits in Children and Mothers: Vital Organs Perspective. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1535. [PMID: 37763654 PMCID: PMC10536202 DOI: 10.3390/medicina59091535] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 07/30/2023] [Accepted: 08/16/2023] [Indexed: 09/29/2023]
Abstract
Breast milk (BM) is a constantly changing fluid that represents the primary source of nutrition for newborns. It is widely recognized that breastfeeding provides benefits for both the child and the mother, including a lower risk of ovarian and breast cancer, type 2 diabetes mellitus, decreased blood pressure, and more. In infants, breastfeeding has been correlated with a lower risk of infectious diseases, obesity, lower blood pressure, and decreased incidence of respiratory infections, diabetes, and asthma. Various factors, such as the baby's sex, the health status of the mother and child, the mother's diet, and the mode of delivery, can affect the composition of breast milk. This review focuses on the biological impact of the nutrients in BM on the development and functionality of vital organs to promote the benefit of health.
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Affiliation(s)
- Julio César Muro-Valdez
- Laboratorio de Análisis Clínicos y Bacteriológicos (Vinculación), Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico; (J.C.M.-V.); (A.M.-R.)
| | - Alejandra Meza-Rios
- Laboratorio de Análisis Clínicos y Bacteriológicos (Vinculación), Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico; (J.C.M.-V.); (A.M.-R.)
| | - Blanca Rosa Aguilar-Uscanga
- Laboratorio de Microbiología Industrial, Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico
| | - Rocio Ivette Lopez-Roa
- Laboratorio de Investigación y Desarrollo Farmacéutico, Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico
| | - Eunice Medina-Díaz
- Instituto Transdisciplinar de Investigación y Servicios, CUCEI, Universidad de Guadalajara, Av. José Parres Arias 5, Rinconada de la Azalea, Industrial Belenes, Zapopan 45150, Mexico
| | - Esmeralda Marisol Franco-Torres
- Laboratorio de Investigación y Desarrollo Farmacéutico, Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico
| | - Adelaida Sara Minia Zepeda-Morales
- Laboratorio de Análisis Clínicos y Bacteriológicos (Vinculación), Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico; (J.C.M.-V.); (A.M.-R.)
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Pereyra-Elías R, Carson C, Quigley MA. Association between breastfeeding duration and educational achievement in England: results from the Millennium Cohort Study. Arch Dis Child 2023; 108:665-672. [PMID: 37277226 PMCID: PMC10423478 DOI: 10.1136/archdischild-2022-325148] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/29/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To evaluate the association between breastfeeding duration and educational outcomes at the end of secondary education among children from the Millennium Cohort Study. DESIGN Cohort study comparing school results at age 16 according to breastfeeding duration. SETTING England. PARTICIPANTS Children born in 2000-2002 (nationally representative sample). EXPOSURE Self-reported breastfeeding duration (categorised). MAIN OUTCOME MEASURES Standardised school assessments taken at the end of secondary education (General Certificate of Secondary Education (GCSEs), marked 9-1) in English and Mathematics, categorised as: 'fail, marks <4', 'low pass, marks 4-6' and 'high pass, marks ≥7 (equivalent to A-A*)'. Additionally, overall achievement was measured using the 'attainment 8' score (adding the marks of eight GCSEs, English and Mathematics double weighted; 0-90). RESULTS Approximately 5000 children were included. Longer breastfeeding was associated with better educational outcomes. For example, after full adjustment for socioeconomic markers and maternal cognitive ability, in comparison with children who were never breastfed, those who were breastfed for longer were more likely to have a high pass in their English and Mathematics GCSEs, and less likely to fail the English GCSE (but not the Mathematics GCSE). Additionally, compared with those never breastfed, those breastfed for at least 4 months had, on average, a 2-3 point higher attainment 8 score (coefficients: 2.10, 95% CI 0.06 to 4.14 at 4-6 months; 2.56, 95% CI 0.65 to 4.47 at 6-12 months and 3.09, 95% CI 0.84 to 5.35 at ≥12 months). CONCLUSIONS A longer breastfeeding duration was associated with modest improvements in educational outcomes at age 16, after controlling for important confounders.
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Affiliation(s)
- Reneé Pereyra-Elías
- 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
| | - Maria A Quigley
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Mohammed S, Webb EL, Calvert C, Glynn JR, Sunny BS, Crampin AC, McLean E, Munthali-Mkandawire S, Lazarous Nkhata Dube A, Kalobekamo F, Marston M, Oakley LL. Effects of exclusive breastfeeding on educational attainment and longitudinal trajectories of grade progression among children in a 13-year follow-up study in Malawi. Sci Rep 2023; 13:11413. [PMID: 37452129 PMCID: PMC10349128 DOI: 10.1038/s41598-023-38455-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/08/2023] [Indexed: 07/18/2023] Open
Abstract
The benefits of exclusive breastfeeding (EBF) for infant health and survival are well documented. However, its impact on educational outcomes has been contested and poorly researched in Africa. It has been hypothesised that positive associations reported in high-income countries can be attributed to residual confounding by socioeconomic status (SES). Our study investigated whether EBF duration in infancy is associated with educational attainment and age-for-grade attainment trajectories at school-age in rural Malawi. Longitudinal data on 1021 children at the Karonga demographic surveillance site in Malawi were analysed. Breastfeeding data were collected 3 months after birth and again at age one. The school grade of each child was recorded each year from age 6 until age 13. We calculated age-for-grade based on whether a child was at, over, or under the official expected age for a grade. Generalised estimating equations estimated the average effect of breastfeeding on age-for-grade. Latent class growth analysis identified age-for-grade trajectories, and multinomial logistic regression examined their associations with EBF. Maternal-child characteristics, SES, and HIV status were controlled. Overall, 35.9% of the children were exclusively breastfed for 6 months. Over-age for grade steadily increased from 9.6% at age 8 to 41.9% at age 13. There was some evidence that EBF for 6 months was associated with lower odds of being over-age for grade than EBF for less than 3 months (aOR = 0.82, 95%CI = 0.64-1.06). In subgroup analyses, children exclusively breastfed for 6 months in infancy were less likely to be over-age for grades between ages 6-9 (aOR = 0.64, 95%CI = 0.43-0.94). Latent class growth analysis also provided some evidence that EBF reduced the odds of falling behind in the early school grades (aOR = 0.66, 95%CI = 0.41-1.08) but not later. Our study adds to the growing evidence that EBF for 6 months has benefits beyond infant health and survival, supporting the WHO's recommendation on EBF.
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Affiliation(s)
- Shamsudeen Mohammed
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Emily L Webb
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Clara Calvert
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Judith R Glynn
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Bindu S Sunny
- United Nations Educational, Scientific and Cultural Organization, Paris, France
| | - Amelia C Crampin
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Estelle McLean
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | | | | | | | - Milly Marston
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Laura L Oakley
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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Tarsha MS, Narvaez D. The evolved nest, oxytocin functioning, and prosocial development. Front Psychol 2023; 14:1113944. [PMID: 37425179 PMCID: PMC10323226 DOI: 10.3389/fpsyg.2023.1113944] [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: 12/01/2022] [Accepted: 05/16/2023] [Indexed: 07/11/2023] Open
Abstract
Prosociality, orientation to attuned, empathic relationships, is built from the ground up, through supportive care in early life that fosters healthy neurobiological structures that shape behavior. Numerous social and environmental factors within early life have been identified as critical variables influencing child physiological and psychological outcomes indicating a growing need to synthesize which factors are the most influential. To address this gap, we examined the influence of early life experiences according to the evolved developmental niche or evolved nest and its influence on child neurobiological and sociomoral outcomes, specifically, the oxytocinergic system and prosociality, respectively. To-date, this is the first review to utilize the evolved nest framework as an investigatory lens to probe connections between early life experience and child neurobiological and sociomoral outcomes. The evolved nest is comprised of characteristics over 30 million years old and is organized to meet a child's basic needs as they mature. Converging evidence indicates that humanity's evolved nest meets the needs of a rapidly developing brain, optimizing normal development. The evolved nest for young children includes soothing perinatal experiences, breastfeeding, positive touch, responsive care, multiple allomothers, self-directed play, social embeddedness, and nature immersion. We examined what is known about the effects of each evolved nest component on oxytocinergic functioning, a critical neurobiological building block for pro-sociomorality. We also examined the effects of the evolved nest on prosociality generally. We reviewed empirical studies from human and animal research, meta-analyses and theoretical articles. The review suggests that evolved nest components influence oxytocinergic functioning in parents and children and help form the foundations for prosociality. Future research and policy should consider the importance of the first years of life in programming the neuroendocrine system that undergirds wellbeing and prosociality. Complex, interaction effects among evolved nest components as well as among physiological and sociomoral processes need to be studied. The most sensible framework for examining what builds and enhances prosociality may be the millions-year-old evolved nest.
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Gebeyehu NA, Tegegne KD, Shewangashaw NE, Biset G, Abebaw N, Tilahun L. Knowledge, attitude, practice and determinants of exclusive breastfeeding among women in Ethiopia: Systematic review and meta-analysis. PUBLIC HEALTH IN PRACTICE 2023; 5:100373. [PMID: 36941951 PMCID: PMC10023906 DOI: 10.1016/j.puhip.2023.100373] [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: 05/31/2022] [Revised: 01/31/2023] [Accepted: 02/09/2023] [Indexed: 03/07/2023] Open
Abstract
Objective This study aimed to assess the pooled estimate of Ethiopia's women's knowledge, attitudes, practices, and determinants of exclusive breastfeeding. Methods PubMed, Google Scholar, Scopus, Science Direct, and Addis Ababa University online library were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Publication bias was checked by forest plot, Begg's rank test, and Egger's regression test. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by region, study setting, and publication. The pooled odds ratio for associated factors was also computed. Results Out of 995 studies reviewed, 33 met our eligibility criteria and were included in this meta-analysis study. The total number of study participants was 13,397. The pooled prevalence of good knowledge, positive attitude, and poor practice of kangaroo mother care were 74.2% (95% CI: 62.9-85.4), 77.2% (95%CI: 68.3-86.0), and 58.3% (95% CI: 49.9-66.6), respectively. In sub-group analysis, the highest prevalence of knowledge was in institution-based studies (78.3%) and unpublished studies (76.3%). A positive attitude was also highest in institutional-based studies (81%). The highest practice prevalence was in Afar (68%) and the lowest was in Addis Ababa (34.6%).Women who had a secondary level of education (AOR = 3.3; 95%CI: 1.8-6.0) were a housewife (AOR = 3.1; 95%CI: 2.1-4.7), delivered vaginally (AOR = 2.0; 95%CI: 1.4-2.9), health facility delivery (AOR = 3.3; 95%CI: 2.1-5.1) and attending antenatal care were predictors of exclusive breastfeeding. Conclusion Although women have good knowledge and positive attitude toward exclusive breastfeeding, there is a significant gap in exclusive breastfeeding practice. Maternal education, occupation, vaginal delivery, institutional delivery, and antenatal care visit were predictors of exclusive breastfeeding. It is recommended to strengthen maternal and child health services.
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Affiliation(s)
- Natnael Atnafu Gebeyehu
- School of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia
| | - Kirubel Dagnaw Tegegne
- Department of Comprehensive Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | | | - Gebyaw Biset
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Nigussie Abebaw
- Department of Midwifery, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Lehulu Tilahun
- Department of Emergency Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Norrish I, Sindi A, Sakalidis VS, Lai CT, McEachran JL, Tint MT, Perrella SL, Nicol MP, Gridneva Z, Geddes DT. Relationships between the Intakes of Human Milk Components and Body Composition of Breastfed Infants: A Systematic Review. Nutrients 2023; 15:nu15102370. [PMID: 37242254 DOI: 10.3390/nu15102370] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/12/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
Human milk provides all of the elements necessary for infant growth and development. Previous studies have reported associations between breastfeeding and a reduced risk of developing obesity and late-onset metabolic disorders; however, the underlying mechanisms are poorly understood. Recently, intakes of human milk components have been associated with infant body composition, which is likely partially implicated in the reduced risk of developing childhood obesity among breastfed infants. In this systematic review, we searched electronic bibliographic databases for studies that explored relationships between the 24 h intakes of human milk macronutrients and bioactive components and infant body composition and/or growth parameters. Of 13 eligible studies, 10 assessed relationships of infant body composition and growth outcomes with human milk macronutrients, while 8 studies assessed relationships with human milk bioactive components. Significant time-dependent relationships with infant anthropometrics and body composition were found for intakes and no relationships for concentrations of several human milk components, such as lactose, total protein, and human milk oligosaccharides, suggesting that measuring concentrations of human milk components without quantifying the intake by the infant may provide a limited understanding. Future studies investigating the effect of human milk components on infant growth and body composition outcomes should consider measuring the actual intake of components and employ standardised methods for measuring milk intake.
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Affiliation(s)
- Isabella Norrish
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Azhar Sindi
- Division of Obstetrics and Gynaecology, The University of Western Australia, Crawley, WA 6009, Australia
- College of Applied Medical Sciences, Umm Al-Qura University, Makkah 24381-8156, Saudi Arabia
| | - Vanessa S Sakalidis
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Jacki L McEachran
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Mya Thway Tint
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A * STAR), Singapore 117609, Singapore
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Sharon L Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Mark P Nicol
- School of Biomedical Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
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Zheng S, Fang J, Bai G, He X, Hua M, Zhu B, Chen W, Dong W, Wang L, Huang X, Wang H, Shao J. The association between parental risks and childhood development: findings from a community-based survey in East China. BMC Public Health 2023; 23:878. [PMID: 37173709 PMCID: PMC10176942 DOI: 10.1186/s12889-023-15702-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/18/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Nurturing care is necessary for optimal early childhood development. This study aimed to investigate the prevalence of parental risks in rural East China and assess their impacts on early development in children younger than three years old. METHODS This community-based cross-sectional survey was conducted among 3852 caregiver-child pairs in Zhejiang Province from December 2019 to January 2020. Children aged 0 to 3 years were recruited from China's Early Childhood Development Program (ECD). Local child health care providers conducted face-to-face interviews with the primary caregivers. Demographic information of the participants was collected by questionnaire. Each child was screened for parental risk through the Parental Risk Checklist designed by the ECD program. The Ages and Stages Questionnaire (ASQ) was used to identify children with potential developmental delays. Multinomial logistic regression model and linear trend test were applied to assess the association between parental risks and suspected developmental delays. RESULTS Among the 3852 children included in the analyses, 46.70% had at least one parental risk and 9.01% presented suspected developmental delays in any domain of ASQ. Parental risk was statistically associated with the overall suspected developmental delay in young children (Relative Risk Ratio (RRR): 1.36; 95% confidence interval (CI): 1.08, 1.72; P = 0.010) after adjusting potential confounders. Compared with children with no parental risk, children exposed to 3 or more parental risks had 2.59, 5.76, 3.95, and 2.84 times higher risk of the suspected developmental delay in overall ASQ, communication, problem-solving, and personal-social domain, respectively (P values < 0.05). The linear trend tests found that the more parental risks, the higher possibility of developmental delay (P values < 0.05). CONCLUSIONS Parental risks are prevalent among children under three years in rural East China, which may increase the risk of developmental delays in children. Meanwhile, parental risk screening can be used to recognize poor nurturing care in primary health care settings. Targeted interventions are warranted to improve nurturing care for optimal early childhood development.
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Affiliation(s)
- Shuangshuang Zheng
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 57 Zhu-Gan Road, Gongshu District, 310003, Hangzhou, China
| | - Jianing Fang
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 57 Zhu-Gan Road, Gongshu District, 310003, Hangzhou, China
| | - Guannan Bai
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 57 Zhu-Gan Road, Gongshu District, 310003, Hangzhou, China
| | - Xinyu He
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 57 Zhu-Gan Road, Gongshu District, 310003, Hangzhou, China
| | - Mengdi Hua
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 57 Zhu-Gan Road, Gongshu District, 310003, Hangzhou, China
| | - Bingquan Zhu
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 57 Zhu-Gan Road, Gongshu District, 310003, Hangzhou, China
| | - Weijun Chen
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 57 Zhu-Gan Road, Gongshu District, 310003, Hangzhou, China
| | - Wenhong Dong
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 57 Zhu-Gan Road, Gongshu District, 310003, Hangzhou, China
| | - Lei Wang
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 57 Zhu-Gan Road, Gongshu District, 310003, Hangzhou, China
| | - Xiaona Huang
- Section of Child Health and Development, the United Nations Children's Fund, UNICEF Office for China, Beijing, China
| | - Huishan Wang
- Department of Children Health, National Center for Maternal and Children Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Shao
- Department of Child Health Care, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 57 Zhu-Gan Road, Gongshu District, 310003, Hangzhou, China.
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Wang S, De Souza C, Ramachandran M, Luo Y, Zhang Y, Yi H, Ma Z, Zhang L, Lin K. Lipidomics insight on differences between human MFGM and dietary-derived lipids. Food Chem 2023; 422:136236. [PMID: 37130453 DOI: 10.1016/j.foodchem.2023.136236] [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: 11/15/2022] [Revised: 03/24/2023] [Accepted: 04/22/2023] [Indexed: 05/04/2023]
Abstract
Milk fat globule membrane (MFGM) contains lipids, which are essential for promoting infant brain development and improving cognition. In this study, the lipid differences between human MFGM and four dietary lipid sources (cow MFGM, soybean, krill, and yolk) were compared using the UHPLC-Q-Exactive MS-based lipidomics techniques. A total of 45 lipid classes and 5048 lipid species were detected. The analysis of phospholipid classes revealed that the lipid composition of human MFGM and cow MFGM was more similar than the other dietary-derived lipids. Additionally, the human MFGM lipid species were compared with cow MFGM, soybean, krill, and yolk, and 401, 416, 494, and 444 significantly different lipids were identified, respectively. Through lipid metabolic pathway analysis, differential lipids were mainly involved in the glycerophospholipid metabolic pathway. Overall, these results will provide a rationale for the future addition of lipids to infant formula to more closely approximate human MFGM lipid profiles.
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Affiliation(s)
- Shaolei Wang
- College of Food Science and Engineering, Ocean University of China, Qingdao 266003, China; National Center of Technology Innovation for Dairy, Hohhot 010000, China
| | - Cristabelle De Souza
- Department of Stem Cell Research and Regenerative Medicine, School of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Mythili Ramachandran
- Department of Biochemistry and Molecular Medicine, UC Davis Comprehensive Cancer Center, University of California Davis, Sacramento, CA 95817, USA
| | - Ya Luo
- College of Food Science and Engineering, Ocean University of China, Qingdao 266003, China
| | - Yixin Zhang
- College of Food Science and Engineering, Ocean University of China, Qingdao 266003, China
| | - Huaxi Yi
- College of Food Science and Engineering, Ocean University of China, Qingdao 266003, China
| | - Zhao Ma
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (MOE), School of Pharmacy, Cheeloo College of Medicine, Shandong University, Jinan 250012 Shandong, China
| | - Lanwei Zhang
- College of Food Science and Engineering, Ocean University of China, Qingdao 266003, China; National Center of Technology Innovation for Dairy, Hohhot 010000, China.
| | - Kai Lin
- College of Food Science and Engineering, Ocean University of China, Qingdao 266003, China; National Center of Technology Innovation for Dairy, Hohhot 010000, China.
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Bakken KS, Kvestad I, Bjørkevoll SMG, Solvik BS, Kaldenbach S, McCann A, Holten-Andersen MN, Ersvær E, Konijnenberg C, Strand TA. Vitamin B 12 status in infancy and the effect of a vitamin B 12 injection in infants with subclinical vitamin B 12 deficiency: study protocol for a register-based randomised controlled trial. BMJ Open 2023; 13:e069102. [PMID: 37080624 PMCID: PMC10124272 DOI: 10.1136/bmjopen-2022-069102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
INTRODUCTION Vitamin B12 (cobalamin) is crucial for optimal child development and growth, yet deficiency is common worldwide. The aim of this study is twofold; (1) to describe vitamin B12 status and the status of other micronutrients in Norwegian infants, and (2) in a randomised controlled trial (RCT), investigate the effect of vitamin B12 supplementation on neurodevelopment in infants with subclinical vitamin B12 deficiency. METHODS AND ANALYSIS Infant blood samples, collected at public healthcare clinics, are analysed for plasma cobalamin levels. Infants with plasma cobalamin <148 pmol/L are immediately treated with hydroxocobalamin and excluded from the RCT. Remaining infants (cobalamin ≥148 pmol/L) are randomly assigned (in a 1:1 ratio) to either a screening or a control group. In the screening group, baseline samples are immediately analysed for total homocysteine (tHcy), while in the control group, the baseline samples will be analysed after 12 months. Screening group infants with plasma tHcy >6.5 µmol/L, are given an intramuscular injection of hydroxocobalamin (400 µg). The primary outcomes are cognitive, language and motor development assessed using the Bayley Scales of Infant and Toddler Development at 12 months of age. ETHICS AND DISSEMINATION The study has been approved by the Regional Committee for Medical and Health Research Ethics (ref: 186505). Investigators who meet the Vancouver requirements will be eligible for authorship and be responsible for dissemination of study findings. Results will extend current knowledge on consequences of subclinical vitamin B12 deficiency during infancy and may inform future infant feeding recommendations. TRIAL REGISTRATION NUMBER NCT05005897.
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Affiliation(s)
- Kjersti S Bakken
- Women's Clinic, Innlandet Hospital Trust, Brumunddal, Norway
- Center for International Health, University of Bergen, Bergen, Norway
| | - Ingrid Kvestad
- Women's Clinic, Innlandet Hospital Trust, Brumunddal, Norway
| | - Sol Maja Graasvold Bjørkevoll
- Center for International Health, University of Bergen, Bergen, Norway
- Department of Pediatrics, Innlandet Hospital Trust, Brumunddal, Norway
| | - Beate Stokke Solvik
- Women's Clinic, Innlandet Hospital Trust, Brumunddal, Norway
- Center for International Health, University of Bergen, Bergen, Norway
| | - Siri Kaldenbach
- Department of Pediatrics, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Adrian McCann
- Women's Clinic, Innlandet Hospital Trust, Brumunddal, Norway
| | - Mads Nikolaj Holten-Andersen
- Department of Pediatrics, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elisabeth Ersvær
- Department of Medical Biochemistry and Blood Bank Laboratory Services, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Biotechnology, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Carolien Konijnenberg
- Women's Clinic, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Psychology, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Tor A Strand
- Center for International Health, University of Bergen, Bergen, Norway
- Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
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