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Syahri IM, Laksono AD, Fitria M, Rohmah N, Masruroh M, Ipa M. Exclusive breastfeeding among Indonesian working mothers: does early initiation of breastfeeding matter? BMC Public Health 2024; 24:1225. [PMID: 38702668 PMCID: PMC11069251 DOI: 10.1186/s12889-024-18619-2] [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] [Accepted: 04/16/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Early initiation of breastfeeding (EIBF) is a starting point that lays the foundation for breastfeeding and bonding between mother and baby. Meanwhile, working mothers are one of the vulnerable groups for the success of exclusive breastfeeding (EBF). The study analyzed the role of EIBF on EBF among Indonesian working mothers. METHODS The cross-sectional study examined secondary data from the 2021 Indonesian National Nutritional Status Survey. The study analyzed 4,003 respondents. We examined EBF practice as an outcome variable and EIBF as an exposure variable. We included nine control variables (residence, maternal age, marital, education, prenatal classes, wealth, infant age, sex, and birth weight). All variables were assessed by questionnaire. The study employed a binary logistic regression test in the last stage. RESULTS The result showed that the proportion of EBF among working mothers in Indonesia in 2021 was 51.9%. Based on EIBF, Indonesian working mothers with EIBF were 2.053 times more likely than those without to perform EBF (p < 0.001; AOR 2.053; 95% CI 2.028-2.077). Moreover, the study also found control variables related to EBF in Indonesia: residence, maternal age, marital, education, prenatal classes, wealth, infant age, sex, and birth weight. CONCLUSION The study concluded that EIBF was related to EBF. Indonesian working mothers with EIBF were two times more likely than those without to perform EBF. The government needs to release policies that strengthen the occurrence of EIBF in working mothers to increase EBF coverage.
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Affiliation(s)
| | - Agung Dwi Laksono
- National Research and Innovation Agency Republic of Indonesia, Jakarta, Indonesia
| | - Maya Fitria
- Faculty of Public Health, Universitas Sumatera Utara, Medan, Indonesia
| | - Nikmatur Rohmah
- Faculty of Health Sciences, Muhammadiyah University of Jember, Jember, Indonesia
| | - Masruroh Masruroh
- Faculty of Health Science, Universitas Pesantren Tinggi Darul Ulum, Jombang, Indonesia
| | - Mara Ipa
- National Research and Innovation Agency Republic of Indonesia, Jakarta, Indonesia
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Vila-Candel R, Soriano-Vidal FJ, Franco-Antonio C, Garcia-Algar O, Andreu-Fernandez V, Mena-Tudela D. Factors Influencing Duration of Breastfeeding: Insights from a Prospective Study of Maternal Health Literacy and Obstetric Practices. Nutrients 2024; 16:690. [PMID: 38474818 DOI: 10.3390/nu16050690] [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: 02/08/2024] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
Numerous factors concerning early breastfeeding abandonment have been described, including health literacy (HL). This study's objective was to analyze factors related to early breastfeeding abandonment (<6 months). This prospective multicentric study examined the duration of breastfeeding at 6 months postpartum and was conducted in four different regions of Spain from January 2021 to January 2023. A total of 275 women participated in this study, which focused on maternal HL and obstetric practices. A decrease in the breastfeeding rate was observed from hospital discharge (n = 224, 81.5%) to the sixth month postpartum (n = 117, 42.5%). A Cox regression analysis revealed that inadequate HL levels, lack of mobilization during labour, and induced labour were significantly associated with early breastfeeding cessation (p = 0.022, p = 0.019, and p = 0.010, respectively). The results highlight that women with adequate HL had a 32% lower risk of early breastfeeding abandonment. In comparison, mobilization during labour and induction of labour were linked to a 32.4% reduction and a 53.8% increase in this risk, respectively. These findings emphasize the importance of considering obstetric and HL factors when addressing the breastfeeding duration, indicating opportunities for educational and perinatal care interventions.
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Affiliation(s)
- Rafael Vila-Candel
- Faculty of Health Sciences, Universidad Internecinal de Valencia (VIU), 46002 Valencia, Spain
- La Ribera Primary Health Department, 46600 Alzira, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain
| | - Francisco Javier Soriano-Vidal
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain
- Department of Obstetrics and Gynecology, Xàtiva-Oninyent Health Department, 46800 Xàtiva, Spain
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
| | | | - Oscar Garcia-Algar
- Neonatology Unit, ICGON, Hospital Clinic-Maternitat, BCNatal, 08028 Barcelona, Spain
| | - Vicente Andreu-Fernandez
- Instituto de Investigaciones Biosanitarias, Universidad Internacional de Valencia (VIU), 46002 Valencia, Spain
| | - Desirée Mena-Tudela
- Department of Nursing, Instituto Universitario de Estudios Feministas y de Género Purificación Escribano, Universitat Jaume I, 12071 Castellón de la Plana, Spain
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Doan DTT, Binns C, Lee A, Zhao Y, Pham MN, Dinh HTP, Nguyen CC, Bui HTT. Factors associated with intention to breastfeed in Vietnamese mothers: A cross-sectional study. PLoS One 2023; 18:e0279691. [PMID: 38085730 PMCID: PMC10715656 DOI: 10.1371/journal.pone.0279691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 12/13/2022] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Breastfeeding has many benefits for mothers, children, and the environment over both the short and longr-term. Prenatal intention to breastfeed is a powerful predictor of short-term breastfeeding outcomes. OBJECTIVE This study aims to analyze breastfeeding intentions, including the intention to feed infants with breastmilk only and to continue exclusive breastfeeding to 6 months among pregnant mothers in Hanoi, Vietnam. METHODS The analysis included 1230 singleton mothers, between 24- and 36-weeks' gestation, who attended antenatal clinics in two hospitals in Hanoi in 2020. RESULTS The proportion of mothers with an "breastfeeding intention" (i.e., intention to feed an infant with breastmilk only) and "exclusive breastfeeding intention" to 6 months was 59.9% and 41.7%, respectively. Mothers who were 25 years or older (aOR = 1.35, 95%CI:1.00-1.81), had an undergraduate educational degree or higher (aOR = 1.38, 95%CI: 1.08-1.76), had observed another woman breastfeeding (aOR = 1.43, 95%CI: 1.03-2.00), were not living with parents-in-law (aOR = 1.34, CI: 1.05-1.70), and were multiparous (aOR = 1.60, 95%CI: 1.16-2.19) had higher odds of "exclusive breastfeeding intention" to 6 months. Among primiparous women, those who thought their husbands support breastfeeding were more likely to intend to feed an infant with breastmilk only. Among multiparous women, feeding the previous child with breastmilk exclusively before the introduction of complementary foods and not giving solid foods together with water until 6 months, were significant predictors for both breastfeeding intentions. CONCLUSION Mothers without exclusive breastfeeding experience should be provided with greater support to promote exclusive breastfeeding intention and outcomes.
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Affiliation(s)
- Duong Thi Thuy Doan
- Hanoi University of Public Health, Hanoi, Vietnam
- School of Public Health, Curtin University, Western Australia, Australia
| | - Colin Binns
- School of Public Health, Curtin University, Western Australia, Australia
| | - Andy Lee
- School of Public Health, Curtin University, Western Australia, Australia
| | - Yun Zhao
- School of Public Health, Curtin University, Western Australia, Australia
| | - Minh Ngoc Pham
- School of Public Health, Curtin University, Western Australia, Australia
- Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
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Meira CAR, Buccini G, Azeredo CM, Conde WL, Rinaldi AEM. Infant feeding practices in three Latin American countries in three decades: what demographic, health, and economic factors are relevant? Front Nutr 2023; 10:1239503. [PMID: 37860032 PMCID: PMC10582640 DOI: 10.3389/fnut.2023.1239503] [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: 06/13/2023] [Accepted: 09/08/2023] [Indexed: 10/21/2023] Open
Abstract
Introduction Studies in Latin America have focused either on analyzing factors associated with exclusive breastfeeding (EBF) or infant formula (IF). Purpose Analyze the association between economic, sociodemographic, and health factors with EBF, mixed milk feeding (MixMF), and exclusive use of IF in three Latin American and Caribbean countries in the 1990s, 2000s, and 2010s. Methods Cross-sectional time-series study using data from Demographic and Health Surveys between the 1990s and 2010s in Colombia (1995-2010), Haiti (1994-2017), and Peru (1996-2012) accounting for a sample of 12,775 infants under 6 months. Hierarchical logistic multilevel regression models were used to estimate the adjusted association between infant feeding outcomes (EBF, MixMF, exclusive use of IF) and contextual level DHS survey decade (1990s, 2000s and 2010s) and economic factors (Gross Domestic Product by purchasing power parity, female wage and salaried workers, labor force participation rate female) as well as individual level sociodemographic (maternal age, maternal education, number of children in the household, wealth index, mother living with a partner, area of residence, mother working outside of home), and health factors (breastfed in the first hour, C-section). Results Factors associated with EBF cessation were c-section (OR: 0.76; 95%CI: 0.64, 0.92), mothers working outside of the home (OR: 0.79; 95%CI: 0.69, 0.90), families in the highest income quintile (OR: 0.64; 95%CI: 0.49, 0.84), and female wage and salaried workers (OR: 0.92; 95%CI: 0.91, 0.94). MixMF was associated with women with higher education (OR: 1.54; 95%CI: 1.21, 1.97), mother working outside of the home (OR: 1.26; 95%CI: 1.10, 1.43), c-section (OR: 1.37; 95%CI: 1.15, 1.62), families in the highest income quintiles (OR: 2.77; 2.10, 3.65). and female wage and salaried workers (OR: 1.08;95% CI: 1.05, 1.09). Exclusive use of IF was associated with a mother working outside of the home (OR: 2.09; 95%CI: 1.41, 3.08), c-section (OR: 1.65; 95%CI: 1.09, 2.51), families in the highest income quintiles (OR: 12.08; 95% CI: 4.26, 34.28), the 2010s (OR: 3.81; 95%CI: 1.86, 7.79), and female wage and salaried workers (OR: 1.12; 95%CI: 1.07, 1.16). Discussion/Conclusion Factors related to women empowerment and gender equality jeopardized EBF and favored the exclusive use of IF in Latin America. Therefore, workplace interventions to promote, protect, and support breastfeeding practices are key to reducing exclusive use of IF.
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Affiliation(s)
| | - Gabriela Buccini
- School of Public Health, University of Nevada, Las Vegas, NV, United States
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Chen Y, Zhao Y, Wang W, Wang F, Jiang H, Wang L. Factors associated with exclusive breastfeeding during postpartum in Lanzhou city, China: a cross-sectional study. Front Public Health 2023; 11:1089764. [PMID: 37711249 PMCID: PMC10498539 DOI: 10.3389/fpubh.2023.1089764] [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: 11/04/2022] [Accepted: 08/15/2023] [Indexed: 09/16/2023] Open
Abstract
Aim Breastfeeding generates short-term and long-term benefits for both mother and child. Exclusive breastfeeding (EBF) is promoted in China for years, but its practice still lags far behind the international average, even among low- and middle- income countries. This study aimed to investigate factors associated with EBF during postpartum. Methods This study was conducted in a tertiary referral hospital in Gansu Province, Northwest China from October 2019 to April 2020. 3,738 postnatal women were finally included and each of them completed an elaborately designed questionnaire. Infant feeding patterns (EBF or not) and reasons for NEBF (non-exclusive breastfeeding) were collected. The feeding knowledge score was based on 17 questions in relation to breastfeeding. The total score ranges from 0 to 17. Higher score means better understanding about breastfeeding knowledge. Multivariate logistic regression models were used to determine associated factors of EBF during postpartum. A subgroup analysis was conducted to investigate the association between feeding knowledge score and exclusive breastfeeding. Results Six weeks after childbirth, 1891 mothers (50.6%) maintained EBF. Among the NEBF mothers, 57.01% (n = 1,053) of them stopped exclusive breastfeeding due to self-perceived lack of breast milk production. Factors associated with NEBF were higher maternal age, ethnic minorities and cesarean section. Protective factors of EBF included multipara, positive feeding attitude and high breastfeeding knowledge score. In subgroup analysis, we found the breastfeeding knowledge score had a significant impact on the mothers of Han nationality, underwent cesarean or natural delivery, both primiparous and multiparous, and those with positive attitude towards breastfeeding (p < 0.05). Conclusion We need a comprehensive and individualized framework of strategies to support children, mothers and their families. During puerperium, improving maternal knowledge of breastfeeding is beneficial to EBF practice. However, for ethnic minorities and those with less active breastfeeding attitudes, breastfeeding knowledge is of limited use, more researches are needed to explore the uncovered reasons, so that more personalized interventions could be developed for them.
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Affiliation(s)
- Yuelu Chen
- Department of Reproductive Health and Infertility, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
| | - Yong Zhao
- College of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Wenling Wang
- Perinatology Center, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, China
| | - Fengdi Wang
- Department of Reproductive Health and Infertility, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
| | - Huimin Jiang
- Department of Reproductive Health and Infertility, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
| | - Lianlian Wang
- Department of Reproductive Health and Infertility, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
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Mena-Tudela D, Soriano-Vidal FJ, Vila-Candel R, Quesada JA, Martínez-Porcar C, Martin-Moreno JM. Is Early Initiation of Maternal Lactation a Significant Determinant for Continuing Exclusive Breastfeeding up to 6 Months? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3184. [PMID: 36833878 PMCID: PMC9966801 DOI: 10.3390/ijerph20043184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND The World Health Organization (WHO) recommends early initiation of breastfeeding (EIBF) within the first hour after birth. However, certain perinatal factors, namely caesarean section, may prevent this goal from being achieved. The aim of our study was to examine the relationship between EIBF (maternal lactation in the first hours and degree of latching before hospital discharge) and the maintenance of exclusive breastfeeding (MBF) up to the recommended 6 months of age (as advocated by the WHO). METHODS This observational, retrospective cohort study included a random sample of all births between 2018 and 2019, characterising the moment of breastfeeding initiation after birth and the infant's level of breast latch (measured by LATCH assessment tool) prior to hospital discharge. Data were collected from electronic medical records and from follow-up health checks of infants up to 6 months postpartum. RESULTS We included 342 women and their newborns. EIBF occurred most often after vaginal (p < 0.001) and spontaneous births with spontaneous amniorrhexis (p = 0.002). LATCH score <9 points was associated with a 1.4-fold relative risk of abandoning MBF (95%CI: 1.2-1.7) compared with a score of 9-10 points. CONCLUSIONS Although we were unable to find a significant association between EIBF in the first 2 h after birth and MBF at 6 months postpartum, low LATCH scores prior to discharge were associated with low MBF, indicating the importance of reinforcing the education and preparation efforts of mothers in the first days after delivery, prior to the establishment of an infant feeding routine upon returning home.
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Affiliation(s)
- Desirée Mena-Tudela
- Department of Nursing, Universitat Jaume I, 12071 Castellón de la Plana, Spain
| | - Francisco Javier Soriano-Vidal
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
- Department of Obstetrics and Gynaecology, Xàtiva-Oninyent Health Department, 46800 Xàtiva, Spain
| | - Rafael Vila-Candel
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, 46600 Alzira, Spain
| | - José Antonio Quesada
- Department of Clinical Medicine, Universidad Miguel Hernández, 03202 Elche, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), 03550 Alicante, Spain
| | - Cristina Martínez-Porcar
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, 46600 Alzira, Spain
| | - Jose M. Martin-Moreno
- Department of Preventive Medicine and Public Health, Universitat de València, 46010 Valencia, Spain
- Biomedical Research Institute INCLIVA, Clinic University Hospital, 46010 Valencia, Spain
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Yamunaque-Carranza M, Medina-Ramirez SA, Mamani-García CS, Caira-Chuquineyra B, Fernandez-Guzman D, Urrunaga-Pastor D, Bendezu-Quispe G. Factors Associated with Adequate Breastfeeding: Evidence from the Peruvian Demographic and Health Survey, 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13607. [PMID: 36294187 PMCID: PMC9602776 DOI: 10.3390/ijerph192013607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To assess the factors associated with adequate breastfeeding (ABF) among Peruvian mothers during 2019. MATERIALS AND METHODS We performed a secondary analysis of the 2019 Demographic and Family Health Survey (ENDES) database of Peru. ABF was defined based on the recommendations of the World Health Organization, which defined it as starting breastfeeding within the first hour of life and continuing with exclusive breastfeeding for up to 6 months. To determine the factors associated with ABF, a Poisson generalized linear models with log-link function was used. Adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95% CI) were calculated. RESULTS A prevalence of ABF of 48.1% was identified among 11,157 women who reported at least one child in the last five years. Most of them were young (68.6%) and lived in urban areas (65.5%). Furthermore, being unemployed (aPR:1.02; 95% CI:1.00-1.04); residing on the coast, except for Metropolitan Lima (aPR:1.08; 95% CI:1.04-1.11), the highlands (aPR:1.14; 95% CI:1.11-1.18), and the jungle (aPR:1.20; 95% CI: 1.16-1.24); having had a vaginal delivery (aPR:1.30; 95% CI:1.27-1.05); and having two children (aPR:1.03; 95% CI:1.01-1.05) or three or more children (aPR:1.03; 95% CI:1.01-1.05) were associated with a higher frequency of ABF. CONCLUSIONS One out of two women between 18-59 with children performed ABF. The factors associated with ABF were the current occupation, region of residence, type of delivery, and parity. Health policies and strategies should be implemented, considering our results, to promote maternal counseling by health personnel in order to increase the prevalence of ABF in the Peruvian population.
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Affiliation(s)
- Mariela Yamunaque-Carranza
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo 14012, Peru
- Sociedad Científica de Estudiantes de Medicina Veritas (SCIEMVE), Chiclayo 14012, Peru
| | - Sebastian A. Medina-Ramirez
- Departamento de Ciencias Básicas, Facultad de Medicina Humana, Universidad Peruana Unión (UPeU), Lima 15464, Peru
| | - Carlos S. Mamani-García
- Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, Arequipa 04001, Peru
- Sociedad Científica de Estudiantes de Medicina Agustinos (SOCIEMA), Arequipa 04001, Peru
| | - Brenda Caira-Chuquineyra
- Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, Arequipa 04001, Peru
- Sociedad Científica de Estudiantes de Medicina Agustinos (SOCIEMA), Arequipa 04001, Peru
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15074, Peru
| | - Daniel Fernandez-Guzman
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15074, Peru
- Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco, Cusco 08000, Peru
| | - Diego Urrunaga-Pastor
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Carrera de Medicina Humana, Lima 15067, Peru
| | - Guido Bendezu-Quispe
- Centro de Investigación Epidemiológica en Salud Global, Universidad Privada Norbert Wiener, Lima 15046, Peru
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Arocha-Zuluaga GP, Caicedo-Velasquez B, Forero-Ballesteros LC. [Economic, social, and health determinants that influence exclusive breastfeeding in Colombia]. CAD SAUDE PUBLICA 2022; 38:e00186621. [PMID: 36169511 DOI: 10.1590/0102-311xes186621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 07/25/2022] [Indexed: 11/22/2022] Open
Abstract
Exclusive breastfeeding (EBF) is an important practice that offers many benefits, such as nutritional support, prevention of infectious and chronic diseases, and assistance in psychosocial and cognitive development. This study aims to identify the determinants associated with EBF abandonment in 1,527 children under six months of age, based on information collected by the Colombian National Survey of Nutritional Status and the Colombian National Demographic and Health Survey, 2010. This is an observational cross-sectional cohort study, in which a hierarchical Poisson regression model with robust variance was applied; considering in the first level the factors associated with the mother and child and, in the second level, the information of 32 departments and Bogotá. We noticed a high rate abandonment of EBF (57.6%) and its variation between departments. The factors associated with a longer time of EBF were higher maternal schooling level, having a partner, knowledge in breastfeeding, belonging to a lower level of income, living in the eastern region, having delivery assisted by qualified team, and low birth weight. According to the variance partition coefficient (VPC), 3.2% of the probability of abandonment of EBF may be related to factors within the departmental scope. The median odds ratio (MOR) indicates that the individual risk of abandoning EBF of a child would increase by 47% if the child moved from a department with a low prevalence of abandonment to a department with high prevalence. This study allows a better understanding of the abandonment of EBF from its determinants, providing evidence to implement more effective interventions for child nutrition.
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Neves PAR, Vaz JS, Ricardo LIC, Armenta-Paulino NN, Barros AJD, Richter L, Rollins N, Peréz-Escamilla R. Disparities in early initiation of breast feeding and prelacteal feeding: A study of low- and middle-income countries. Paediatr Perinat Epidemiol 2022; 36:741-749. [PMID: 35253935 DOI: 10.1111/ppe.12871] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 02/07/2022] [Accepted: 02/13/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Early initiation of breast feeding (EIBF) reduces the risk of neonatal mortality. However, only 45% of newborns are breast-fed within the first hour after birth and prelacteal feeding (PLF) is widely prevalent in low- and middle-income countries (LMICs). OBJECTIVE To assess within- and between-country disparities in EIBF and PLF practices by household wealth and place of birth and to investigate the national-level correlation between these feeding indicators in LMICs. METHODS Data from Demographic Health Surveys and Multiple Indicator Cluster Surveys (2010-2019) in 76 LMICs were used to investigate within-country disparities in EIBF, any PLF, milk-based prelacteal feeding (MPLF), and water-based prelacteal feeding (WPLF) by wealth quintiles and place of childbirth (institutional [private or public sector] or in-home) for children under two years. We examined the between-country Pearson's correlation between EIBF and types of PLF, later adjusted for per capita gross domestic product (GDP). RESULTS No clear wealth-related differences were found for EIBF and WPLF; however, any PLF and MPLF were significantly higher in children belonging to the richest 20% of households but are also prevalent among lower income groups. Prevalence of any PLF was higher among institutional births in all LMICs, but especially for MPLF in private sector deliveries in East Asia & the Pacific, Eastern Europe & Central Asia, and Latin America & the Caribbean. WPLF was more common in all African regions. EIBF was inversely correlated with any PLF (r = -0.59, 95% CI -0.72, -0.42), MPLF (r = -0.41, 95% CI -0.58, -0.21) and WPLF (r = -0.34, 95% CI -0.53, -0.13). Adjustment for log-GDP did not affect the magnitude and direction of the results. CONCLUSION Clear prorich disparities exist in the prevalence of PLF, especially MPLF. Children born in private sector facilities are more likely to receive MPLF. EIBF is negatively associated with PLF practices in LMICs. The promotion of better early feeding practices is urgent to achieve the Sustainable Development Goal to reduce neonatal mortality to 12 deaths per 1000 live births.
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Affiliation(s)
| | - Juliana S Vaz
- International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil.,Faculty of Nutrition, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Luiza I C Ricardo
- International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil
| | | | - Aluísio J D Barros
- International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Linda Richter
- DSI-NRF Centre of Excellence in Child Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Nigel Rollins
- Department of Maternal, Newborn, Child, and Adolescent Health, World Health Organization, Geneva, Switzerland
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Meira CAR, Buccini G, Azeredo CM, Conde WL, Rinaldi AEM. Evolution of breastfeeding indicators and early introduction of foods in Latin American and Caribbean countries in the decades of 1990, 2000 and 2010. Int Breastfeed J 2022; 17:32. [PMID: 35459227 PMCID: PMC9034574 DOI: 10.1186/s13006-022-00477-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 04/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background Early introduction of liquid/solid food before 6 months of age is one of the major barriers to exclusive breastfeeding. Our objective was to analyze the evolution of infant feeding practices for infants under 6 months of age in Latin American and Caribbean countries in the decades of 1990, 2000 and 2010. Method Cross-sectional time series study with data from Demographic and Health Surveys carried out between 1990 and 2017 in six Latin America and Caribbean countries: Bolivia (1994 to 2008), Colombia (1995 to 2010), Dominican Republic (1996 to 2013), Guatemala (1995 to 2015), Haiti (1994/1995 to 2016/2017), Peru (1996 to 2018). Pooled sample comprised of 22,545 infants under the age of 6 months. Surveys were grouped in three decades: 1990s for surveys from 1990 to 1999, 2000s for surveys from 2000 to 2009, and 2010s for surveys from 2010 to 2017. Exclusive breastfeeding (EBF), predominant breastfeeding (PBF), mixed breastfeeding (mixed BF), supplemented breastfeeding (supplemented BF) and non-breastfeeding (non-BF), and individual foods (water, liquids, milk, infant formula, semi-solid/solid) were analyzed. Prevalence of breastfeeding and food indicators were calculated in pooled sample, according to the infant monthly age groups, decade of survey and residence area(rural/urban). Results Between 1990s and 2010s, there was an increase in the exclusive breastfeeding prevalence (1990s = 38.1%, 2010s = 46.6%) and a reduction in the PBF prevalence (1990s = 51.7%, 2010 s = 43.1%). There was a decrease in the liquids (1990s = 40.7%, 2010s = 15.8%) and milk prevalence (1990s = 20.4%, 2010s = 8.3%) and an increase in water (1990s = 32.3%, 2010s = 37.6%), and infant formula (1990s = 16.6%, 2010s = 25.5%) prevalence. All breastfeeding indicators, except exclusive breastfeeding, progressively increased according to the monthly age group in three decades, and EBF prevalence sharply decreased from 2 to 3 months of age in all decades. Exclusive breastfeeding prevalence was higher in rural area in the three decades (1990s rural = 43.8%, 1990s urban = 32.4%, 2010s rural = 51.1%, 2010s urban = 42.4%) and infant formula prevalence was higher in urban area (1990s rural = 8.6%, 1990s urban = 24.6%, 2010s rural = 15.9%, 2010s urban = 34.1%). Conclusions In the last three decades, in all age groups, there was an increase in exclusive breastfeeding prevalence, as well as a significant reduction in liquids and milk. In the rural area, EBF prevalence remains higher than in urban. Increased water and infant formula feeding are the main barriers to achieving the Global Nutrition Target 2025 for exclusive breastfeeding. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-022-00477-6.
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Hernández-Vásquez A, Chacón-Torrico H. Determinants of early initiation of breastfeeding in Peru: analysis of the 2018 Demographic and Family Health Survey. Epidemiol Health 2020; 41:e2019051. [PMID: 31962038 PMCID: PMC6976726 DOI: 10.4178/epih.e2019051] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 12/25/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Early initiation of breastfeeding (EIBF) is one of the most cost-effective strategies to reduce neonatal mortality. We sought to determine the prevalence and determinants of EIBF in Peru. METHODS We performed a cross-sectional analytical study of the 2018 Peruvian Demographic and Family Health Survey as a secondary data source. In total, 19,595 children born during the 5 years prior to the survey were included in the study. The dependent variable (EIBF status), socio-demographic variables, and pregnancy-related variables were analyzed using a multivariate logistic regression model to identify the determinants of EIBF. RESULTS The prevalence of EIBF in the study population was 49.7%. Cesarean deliveries were associated with a lower likelihood of EIBF (adjusted odds ratio [aOR], 0.06; 95% confidence interval [CI], 0.05 to 0.07) than were vaginal deliveries. Newborns born at public health centers (aOR, 1.37; 95% CI, 1.15 to 1.65) had a higher rate of EIBF than those not born at public or private health centers. Women from the jungle region (aOR, 2.51; 95% CI, 2.17 to 2.89) had higher odds of providing EIBF than those from the coast. Mothers with more than a secondary education (aOR, 0.65; 95% CI, 0.55 to 0.76) were less likely to breastfeed during the first hour of the newborn’s life than women with primary or no education. CONCLUSIONS More than half of Peruvian children do not breastfeed during the first hour after birth. The major determinants of EIBF status were the delivery mode and the region of maternal residence. Strategies are needed to promote early breastfeeding practices.
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Affiliation(s)
- Akram Hernández-Vásquez
- Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Lima, Peru
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