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Bernate Angulo SV, Nezami BT, Martin SL, Kay MC, Richardson TN, Wasser HM. Concordance in dietary intake among caregivers and infants during the period of complementary feeding: A scoping review. Appetite 2024; 194:107178. [PMID: 38141877 PMCID: PMC11027945 DOI: 10.1016/j.appet.2023.107178] [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: 08/22/2023] [Revised: 12/07/2023] [Accepted: 12/17/2023] [Indexed: 12/25/2023]
Abstract
Dietary intake during infancy shapes later food preferences and is important for short- and long-term health and wellbeing. Although caregivers are thought to influence the developing food preferences of infants, children less than two years have been notably absent in existing meta-analyses on the topic. This scoping review seeks to fill this gap by using a systematic process to identify and summarize the published literature on the resemblance of caregiver and infant diet during the period of complementary feeding (6-23 months). Articles were included if they assessed intake of foods or beverages other than human milk or commercial milk formula and reported a test of association between the intake of caregivers and infants. Four electronic databases (PubMed, EMBASE, Scopus, and Global Health) were systematically searched for articles published since 2000. Thirty-three articles, representing 32 studies, were identified. The majority of studies examined infant intake of food groups/items (n = 20), seven studies examined infant dietary patterns, and six studies examined dietary diversity. Studies predominantly reported associations between diets of mothers and infants (n = 31); three studies reported associations for fathers. Most studies assessed infant diet at one timepoint (n = 26), with 12 studies combining the intakes of younger (0-11 months) and older infants (12-23 months). Food groups examined, in order of frequency, included 'non-core' foods and beverages (n = 14), vegetables (n = 13), fruits (n = 12), protein foods (n = 6), grains (n = 5), and dairy foods (n = 4). Definitions of variables for food groups and dietary patterns were highly heterogeneous, but consistent for dietary diversity. Nearly all studies (n = 31) reported significant associations between dietary intakes of caregivers and infants. Findings suggest caregiver diet may be a promising focus for interventions aiming to shape the food preferences and dietary intakes of infants.
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Affiliation(s)
- Sara V Bernate Angulo
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Brooke T Nezami
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Stephanie L Martin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Melissa C Kay
- Department of Pediatrics, Duke University, Durham, NC, 27708, USA
| | - Taylor N Richardson
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Heather M Wasser
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
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Higginbottom GM, Safipour J, Yohani S, O'Brien B, Mumtaz Z, Paton P, Chiu Y, Barolia R. An ethnographic investigation of the maternity healthcare experience of immigrants in rural and urban Alberta, Canada. BMC Pregnancy Childbirth 2016; 16:20. [PMID: 26818961 PMCID: PMC4729163 DOI: 10.1186/s12884-015-0773-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 12/03/2015] [Indexed: 11/14/2022] Open
Abstract
Background Canada is among the top immigrant-receiving nations in the world. Immigrant populations may face structural and individual barriers in the access to and navigation of healthcare services in a new country. The aims of the study were to (1) generate new understanding of the processes that perpetuate immigrant disadvantages in maternity healthcare, and (2) devise potential interventions that might improve maternity experiences and outcomes for immigrant women in Canada. Methods The study utilized a qualitative research approach that focused on ethnographic research design and data analysis contextualized within theories of organizational behaviour and critical realism. Data were collected over 2.5 years using focus groups and in-depth semistructured interviews with immigrant women (n = 34), healthcare providers (n = 29), and social service providers (n = 23) in a Canadian province. Purposive samples of each subgroup were generated, and recruitment and data collection – including interpretation and verification of translations – were facilitated through the hiring of community researchers and collaborations with key informants. Results The findings indicate that (a) communication difficulties, (b) lack of information, (c) lack of social support (isolation), (d) cultural beliefs, e) inadequate healthcare services, and (f) cost of medicine/services represent potential barriers to the access to and navigation of maternity services by immigrant women in Canada. Having successfully accessed and navigated services, immigrant women often face additional challenges that influence their level of satisfaction and quality of care, such as lack of understanding of the informed consent process, lack of regard by professionals for confidential patient information, short consultation times, short hospital stays, perceived discrimination/stereotyping, and culture shock. Conclusions Although health service organizations and policies strive for universality and equality in service provision, personal and organizational barriers can limit care access, adequacy, and acceptability for immigrant women. A holistic healthcare approach must include health informational packages available in different languages/media. Health care professionals who care for diverse populations must be provided with training in cultural competence, and monitoring and evaluation programs to ameliorate personal and systemic discrimination.
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Affiliation(s)
- Gina M Higginbottom
- Mary Seacole Professor of Ethnicity and Community Health School of Health Sciences, University of Nottingham, Rm 1976, A Floor, South Block Link Queen's Medical Centre, Nottingham, NG7 2HA, UK.
| | - Jalal Safipour
- University of Alberta, Alberta, Canada. .,Department of Health and Caring Sciences, Linnaeus University, Building: K2244, 35195 Vaxjo, Linnaeus, Sweden.
| | - Sophie Yohani
- Department of Educational Psychology, University of Alberta, 6-107D Education North, Edmonton, Canada.
| | - Beverly O'Brien
- Faculty of Nursing, University of Alberta, 3rd Floor Edmonton Clinic Health Academy, 11405 87th Avenue, Edmonton, T6G 1C9, Canada.
| | - Zubia Mumtaz
- School of Publin Health, University of Alberta, 3rd Floor Edmonton Clinic Health Academy, 11405 87th Avenue, Alberta, T6G 1C9, Canada.
| | - Patricia Paton
- Alberta Health Services, College and Association of Registered Nurses of Alberta, 11620 168 Street, Edmonton, T5M 4A6, Canada.
| | - Yvonne Chiu
- Multicultural Health Brokers Coop, # 301, 9955-114 Street, Edmonton, T5K 1P7, Canada.
| | - Rubina Barolia
- University of Alberta, Alberta, Canada. .,School of Nursing and Midwifery, Aga Khan University, stadium Road, Karachi, 74800, Pakistan.
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Burnham L, Matlak S, Makrigiorgos G, Braun N, Knapp BP, Merewood A. Breastfeeding and coffee consumption in children younger than 2 years in Boston, Massachusetts, USA. J Hum Lact 2015; 31:267-72. [PMID: 25678326 DOI: 10.1177/0890334415570971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 01/13/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Although introduction of inappropriate foods and liquids in early childhood and their association with breastfeeding is commonly reported in US children, coffee use in very young US children and its association with breastfeeding is not. OBJECTIVES This study aimed to determine the proportion of 1- and 2-year-olds in an urban population consuming coffee, their rate of consumption, and predictors of consumption, including breastfeeding status. METHODS We used data from a prospective cohort study on infant weight gain and diet, and body mass index at age 2. We used bivariate analyses to examine variables associated with coffee consumption at 1 and 2 years and multivariate logistic regression to control for variables of interest. RESULTS This study included 315 mother-infant dyads. At 1 year, the rate of coffee consumption reported was 2.5%; at 2 years, it was 15.2% and average daily consumption was 1.09 oz (range, 0.01- 4.00 oz). The only characteristic associated with coffee consumption at 1 year was breastfeeding at 1 year (P = .0275), which did not remain significant after controlling for confounding variables. Variables significantly associated with coffee consumption at year 2 were lower maternal education (P = .0016), non-US maternal place of birth (P = .0015), maternal Hispanic ethnicity (P < .0001), infant female sex (P = .0495), and receiving any breast milk at 1 year of age (P = .0189). After multivariate logistic regression, maternal Hispanic ethnicity (P = .0139) and infant female sex (P = .0371) remained significant. CONCLUSION Coffee consumption is not uncommon among toddlers in Boston, Massachusetts, USA. After controlling for possible confounding factors, maternal ethnicity and infant sex were significantly associated with this practice.
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Affiliation(s)
| | | | | | | | | | - Anne Merewood
- Boston University School of Medicine, Boston, MA, USA
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Higginbottom GMA, Vallianatos H, Forgeron J, Gibbons D, Mamede F, Barolia R. Food choices and practices during pregnancy of immigrant women with high-risk pregnancies in Canada: a pilot study. BMC Pregnancy Childbirth 2014; 14:370. [PMID: 25467067 PMCID: PMC4260194 DOI: 10.1186/s12884-014-0370-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 10/15/2014] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Immigrant women may be regarded as a vulnerable population with respect to access and navigation of maternity care services. They may encounter difficulties when accessing culturally safe and appropriate maternity care, which may be further exacerbated by language difficulties and discriminatory practices or attitudes. The project aimed to understand ethnocultural food and health practices and how these intersect in a particular social context of cultural adaptation and adjustment in order to improve the care-giving capacities of health practitioners working in multicultural perinatal clinics. METHODS This four-phase study employed a case study design allowing for multiple means of data collection and different units of analysis. Phase one consists of a scoping review of the literature. Phases two and three incorporate pictorial representations of food choices with semi-structured photo-elicited interviews. This study was undertaken at a Prenatal and Obstetric Clinic, in an urban Canadian city. In phase four, the research team will inform the development of culturally appropriate visual tools for health promotion. RESULTS Five themes were identified: (a) Perceptions of Health, (b) Social Support (c) Antenatal Foods (d) Postnatal Foods and (e) Role of Health Education. These themes provide practitioners with an understanding of the cultural differences that affect women's dietary choices during pregnancy. The project identified building collaborations between practitioners and families of pregnant immigrant women to be of utmost importance in supporting healthy pregnancies, along with facilitating social support for pregnant and breastfeeding mothers. CONCLUSION In a multicultural society that contemporary Canada is, it is challenging for health practitioners to understand various ethnocultural dietary norms and practices. Practitioners need to be aware of customary practices of the ethnocultural groups that they work with, while simultaneously recognizing the variation within-not everyone follows customary practices, individuals may pick and choose which customary guidelines they follow. What women choose to eat is also influenced by their own experiences, access to particular foods, socioeconomic status, family context, and so on. The pilot study demonstrated the efficacy of the employed research strategies and we subsequently acquired funding for a national study.
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Affiliation(s)
- Gina M A Higginbottom
- University of Alberta, Faculty of Nursing, 3rd Floor Edmonton Clinic Health Academy, 11405 87th Avenue, Edmonton, Alberta, T6G 1C9, Canada.
| | - Helen Vallianatos
- Department of Anthropology, University of Alberta, 13-15 HM Tory Building, Edmonton, Alberta, T6G 2H4, Canada.
| | - Joan Forgeron
- Alberta Health Services, Lois Hole Hospital for Women, 10240 Kingsway Avenue, Edmonton, Alberta, T5H 3 V9, Canada.
| | - Donna Gibbons
- Alberta Health Services, Lois Hole Hospital for Women, 10240 Kingsway Avenue, Edmonton, Alberta, T5H 3 V9, Canada.
| | - Fabiana Mamede
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil.
| | - Rubina Barolia
- University of Alberta, Faculty of Nursing, 3rd Floor Edmonton Clinic Health Academy, 11405 87th Avenue, Edmonton, Alberta, T6G 1C9, Canada.
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Holbrook KE, White MC, Heyman MB, Wojcicki JM. Maternal sociodemographic characteristics and the use of the Iowa Infant Attitude Feeding Scale to describe breastfeeding initiation and duration in a population of urban, Latina mothers: a prospective cohort study. Int Breastfeed J 2013; 8:7. [PMID: 23835065 PMCID: PMC3711781 DOI: 10.1186/1746-4358-8-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 07/03/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The World Health Organization recommends exclusive breastfeeding until 6 months of age. Maternal attitudes toward infant feeding are correlated with chosen feeding method and breastfeeding duration. The Iowa Infant Feeding Attitude Scale (IIFAS) has been used to assess attitudes towards breastfeeding prenatally and is predictive of breastfeeding decisions in certain population groups. METHODS In a cohort of pregnant Latina women recruited from two hospitals in the San Francisco Bay Area (n=185), we administered the IIFAS prior to delivery. Information regarding feeding choice, maternal sociodemographic information, and anthropometrics were collected at 6 months and 1 year postpartum. Analysis of predictors for breastfeeding initiation, breastfeeding at 6 and 12 months and exclusive breastfeeding at 6 months were evaluated using multivariate logistic regression adjusting for potential confounders. RESULTS In our cohort of Latina mothers, breastfeeding a previous infant was associated with breastfeeding initiation (OR 8.29 [95% CI 1.00, 68.40] p = 0.05) and breastfeeding at 6 months (OR 18.34 [95% CI 2.01, 167.24] p = 0.01). College education was associated with increased exclusive breastfeeding at 6 months (OR 58.67 [95% CI 4.97, 692.08] p = 0.001) and having other children was associated with reduced breastfeeding at six months (OR 0.08 [95% CI 0.01, 0.70] p = 0.02). A higher IIFAS score was not associated with breastfeeding initiation, breastfeeding at 6 or 12 months or exclusive breastfeeding at 6 months of age. CONCLUSIONS Initial choices about breastfeeding will likely influence future breastfeeding decisions, so breastfeeding interventions should specifically target new mothers. Mothers with other children also need additional encouragement to maintain breastfeeding until 6 months of age. The IIFAS, while predictive of breastfeeding decisions in other population groups, was not associated with feeding decisions in our population of Latina mothers.
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Affiliation(s)
- Katherine E Holbrook
- Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, 500 Parnassus Avenue, MU 4-East, San Francisco, CA, 94143-0136, USA.
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Kieffer EC, Welmerink DB, Sinco BR, Welch KB, Schumann CY, Uhley V. Periconception diet does not vary by duration of US residence for Mexican immigrant women. J Acad Nutr Diet 2013; 113:652-8. [PMID: 23474270 DOI: 10.1016/j.jand.2013.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Accepted: 01/02/2013] [Indexed: 10/27/2022]
Abstract
This cross-sectional study assessed the influence of duration of residence in the United States on periconception dietary intake of pregnant Mexican immigrant women, using baseline data from Healthy Mothers on the Move, a randomized control trial conducted with 234 women from 2004 to 2006 in Detroit, MI. Average maternal age was 27.3±5.2 years (range=18 to 41 years) with 5.99±4.76 years of US residence (range=0 to 36 years). Women's usual dietary intake during the past 12 months was recorded on a validated food frequency questionnaire (17.3 weeks average gestation). Intakes of selected micronutrients, macronutrients, and food groups were compared by US residence categories (≤5, 6 to 10, or ≥11 years) using analysis of covariance. The percent of women with intakes below the Estimated Average Requirement and the percent not meeting US dietary guidelines were calculated. There was no association between dietary intake and duration of US residence in this population. Percentages of women with dietary intake below the Estimated Average Requirement were: 12.0% for folate, 7.7% for vitamin C, 23.9% for calcium, 11.2% for protein, and 5.1% for carbohydrates. US dietary guidelines were not met for fruit by 17.5% and for vegetables by 74.8% of women. Typical diets were high in saturated fat and cholesterol. Of the 2,195 kcal average daily energy intake, >25% came from saturated fats, trans fats, and added sugars that may replace nutrients important for healthy fetal growth and development and women's health. Interventions to improve intake before, during, and after pregnancy are important in this population, regardless of duration of US residence.
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Affiliation(s)
- Edith C Kieffer
- School of Social Work, University of Michigan, Ann Arbor, MI 48109-1106, USA.
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Social and Institutional Factors that Affect Breastfeeding Duration Among WIC Participants in Los Angeles County, California. Matern Child Health J 2011; 16:1887-95. [DOI: 10.1007/s10995-011-0937-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Higginbottom GM, Vallianatos H, Forgeron J, Gibbons D, Malhi R, Mamede F. Food choices and practices during pregnancy of immigrant and Aboriginal women in Canada: a study protocol. BMC Pregnancy Childbirth 2011; 11:100. [PMID: 22152052 PMCID: PMC3252281 DOI: 10.1186/1471-2393-11-100] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 12/07/2011] [Indexed: 11/17/2022] Open
Abstract
Background Facilitating the provision of appropriate health care for immigrant and Aboriginal populations in Canada is critical for maximizing health potential and well-being. Numerous reports describe heightened risks of poor maternal and birth outcomes for immigrant and Aboriginal women. Many of these outcomes may relate to food consumption/practices and thus may be obviated through provision of resources which suit the women's ethnocultural preferences. This project aims to understand ethnocultural food and health practices of Aboriginal and immigrant women, and how these intersect with respect to the legacy of Aboriginal colonialism and to the social contexts of cultural adaptation and adjustment of immigrants. The findings will inform the development of visual tools for health promotion by practitioners. Methods/Design This four-phase study employs a case study design allowing for multiple means of data collection and different units of analysis. Phase 1 consists of a scoping review of the literature. Phases 2 and 3 incorporate pictorial representations of food choices (photovoice in Phase 2) with semi-structured photo-elicited interviews (in Phase 3). The findings from Phases 1-3 and consultations with key stakeholders will generate key understandings for Phase 4, the production of culturally appropriate visual tools. For the scoping review, an emerging methodological framework will be utilized in addition to systematic review guidelines. A research librarian will assist with the search strategy and retrieval of literature. For Phases 2 and 3, recruitment of 20-24 women will be facilitated by team member affiliations at perinatal clinics in one of the city's most diverse neighbourhoods. The interviews will reveal culturally normative practices surrounding maternal food choices and consumption, including how women negotiate these practices within their own worldview and experiences. A structured and comprehensive integrated knowledge translation plan has been formulated. Discussion The findings of this study will provide practitioners with an understanding of the cultural differences that affect women's dietary choices during maternity. We expect that the developed resources will be of immediate use within the women's units and will enhance counseling efforts. Wide dissemination of outputs may have a greater long term impact in the primary and secondary prevention of these high risk conditions.
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Abstract
Research has noted a rural disadvantage in breastfeeding initiation; however, most previous research has been based on nonrepresentative samples and has been limited in its ability to compare racial/ethnic differences in breastfeeding initiation based on residential location. This research fills this gap by examining a nationally representative sample of births using the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) to explore associations between rural-urban residence and maternal race/ethnicity on breastfeeding initiation. Results indicate that associations observed for rural-urban breastfeeding initiation differ based on maternal race/ethnicity and poverty status. These patterns likely reflect differences in economic resources, work environments, and social support among rural minority postpartum women.
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Affiliation(s)
- P Johnelle Sparks
- Department of Demography and Organization Studies, University of Texas at San Antonio, San Antonio, TX 78207, USA
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Sandy JM, Anisfeld E, Ramirez E. Effects of a prenatal intervention on breastfeeding initiation rates in a Latina immigrant sample. J Hum Lact 2009; 25:404-11; quiz 458-9. [PMID: 19487705 DOI: 10.1177/0890334409337308] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A randomized controlled trial study design was used to investigate the effectiveness of a Healthy Families America model prenatal intervention for increasing breastfeeding rates among Latina immigrants residing in an impoverished New York City community. Exposure to the intervention did not affect mother report of any breastfeeding (ABF) during the first week postpartum, but it did affect mother report of exclusive breastfeeding (EBF). Thirty-two percent (44/137) of mothers exposed to the intervention reported EBF during the first week postpartum compared to 20% (20/101) of mothers not exposed to the intervention (odds ratio 1.92; 95% confidence interval 1.05-3.52). This positive effect of the intervention on EBF remained statistically significant after controlling for the negative effect of household income on EBF (adjusted odds ratio, 1.89; 95% confidence interval, 1.02-3.50). Additional research is needed on the effectiveness of breastfeeding promotion programs targeting low-income Latinas.
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Affiliation(s)
- James M Sandy
- Division of General Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
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Hurley KM, Black MM, Papas MA, Quigg AM. Variation in breastfeeding behaviours, perceptions, and experiences by race/ethnicity among a low-income statewide sample of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants in the United States. MATERNAL AND CHILD NUTRITION 2008; 4:95-105. [PMID: 18336643 DOI: 10.1111/j.1740-8709.2007.00105.x] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objective of this study was to examine how breastfeeding behaviours, perceptions and experiences vary by race/ethnicity among a low-income sample in the USA. Bilingual interviewers conducted a cross-sectional telephone survey of 767 white, African American or Hispanic mothers who received the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Rates of breastfeeding initiation and duration varied by race/ethnicity. Hispanic mothers were more likely to initiate breastfeeding than African American (91% vs. 65%) or white (61%) mothers. Hispanic mothers breastfed longer (mean 5 months) than either African American (mean 3.5 months) or white (mean 3 months) mothers. The most common reason for not breastfeeding was fear of difficulty or pain during breastfeeding (35.6%). Among mothers who did not initiate breastfeeding, African American and white mothers were more likely than Hispanic mothers to report perceptions of breastfeeding difficulty or pain, and Hispanic mothers were more likely than African American and white mothers to report perceptions of infant breast rejection. The most common reason reported for breastfeeding cessation was not having enough milk (23.4%). Hispanic mothers were more likely than African American and white mothers to cite perceptions of milk insufficiency and infant breast refusal than concerns regarding breast discomfort or pain. African American mothers were more likely than white mothers to report cessation to return to work. In conclusion, while breastfeeding initiation rates approach Healthy People 2010 goals, breastfeeding duration remains far below these goals. Race/ethnicity differences in experiences related to breastfeeding cessation suggest that culturally sensitive breastfeeding interventions are necessary.
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Affiliation(s)
- Kristen M Hurley
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
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Davis-McFarland E. Family and Cultural Issues in a School Swallowing and Feeding Program. Lang Speech Hear Serv Sch 2008; 39:199-213. [DOI: 10.1044/0161-1461(2008/020)] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
This article presents a rationale for speech-language pathologists (SLPs) to provide culturally competent evaluation, diagnostic, and intervention services for children with oral motor, swallowing, and feeding disorders in school settings. There is also a discussion of how changing American public school demographics necessitate the consideration of cultural issues and family-focused approaches to dysphagia services.
Method
This article provides an overview of cultural, religious, and health beliefs of several ethnic groups, as well as information on the dynamics and requirements of cultural competence and family-focused intervention. Ethnographic interviewing is presented as a culturally sensitive diagnostic method. Information on structuring a culturally relevant individualized educational program process is provided. Guidance in the use of interpreters and translators is also offered.
Conclusion
Attention to cultural and family issues in the diagnosis and treatment of dysphagia in a school setting optimizes the opportunities for successful outcomes and better meets the needs of children and families from culturally/linguistically diverse backgrounds.
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Straub B, Melvin C, Labbok M. A descriptive study of Cambodian refugee infant feeding practices in the United States. Int Breastfeed J 2008; 3:2. [PMID: 18218121 PMCID: PMC2266734 DOI: 10.1186/1746-4358-3-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2007] [Accepted: 01/24/2008] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this exploratory study was to examine Cambodian refugee mothers' infant feeding beliefs, practices, and decision making regarding infant feeding in the U.S. and to explore if a culturally-specific breastfeeding program is appropriate for this community. Methods A self-administered questionnaire and a 30 minute in-person interview were used to collect information from nine women. The audio-taped interviews were transcribed, answers compiled, and themes from each question identified. Results All participants practiced either traditional Cambodian diet (pregnancy and postpartum diet including, tnam sraa, herbs mixed with either wine or tea), traditional Cambodian rituals (like spung, amodified sauna) or both, despite having lived in the U.S. for many years. All nine women initiated breastfeeding, however eight women introduced infant formula while in hospital. Perceived low milk supply and returning to work were the main reasons cited for partial breastfeeding and early cessation of breastfeeding. Conclusion While causes of initiation of other foods are similar to those found in the U.S. as a whole, a culturally-specific Cambodian breastfeeding support program may help overcome some breastfeeding problems reported by Cambodian refugee mothers who have immigrated to the United States.
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Affiliation(s)
- Becky Straub
- Department of Maternal and Child Health University of North Carolina at Chapel Hill, Chapel Hill, USA.
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Seth JG, Evans AE, Harris KK, Loyo JJ, Ray TC, Spaulding C, Gottlieb NH. Preschooler feeding practices and beliefs: differences among Spanish- and English-speaking WIC clients. FAMILY & COMMUNITY HEALTH 2007; 30:257-70. [PMID: 17563487 DOI: 10.1097/01.fch.0000277768.08150.9c] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
This study explored preschooler feeding practices and beliefs among Spanish- and English-speaking WIC participants in Texas. The Preschooler Feeding Questionnaire examined 9 dimensions of the parent-child feeding interaction among 235 caregivers. Results from ANOVA and post hoc analyses demonstrated significant differences in reported preschooler feeding practices and beliefs among Spanish-speaking Hispanics in comparison with English-speaking Hispanics and non-Hispanics. No significant differences were found between English-speaking Hispanics and non-Hispanics. Results indicated that acculturation may impact behaviors apart from ethnicity. Nutrition professionals should understand and acknowledge the cultural context of the parent-child feeding interaction when developing programs.
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Harley K, Stamm NL, Eskenazi B. The effect of time in the U.S. on the duration of breastfeeding in women of Mexican descent. Matern Child Health J 2007; 11:119-25. [PMID: 17279324 PMCID: PMC3957412 DOI: 10.1007/s10995-006-0152-5] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2006] [Accepted: 09/22/2006] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Although women of Mexican decent have high rates of breastfeeding, these rates may vary considerably by acculturation level. This study investigated whether increased years of residence in the U.S. is associated with poorer breastfeeding practices, including shorter duration of any and exclusive breastfeeding, in a population of low-income mothers of Mexican descent. METHODS Pregnant women (n = 490) were recruited from prenatal clinics serving a predominantly Mexican-origin population in an agricultural region of California. Women were interviewed during pregnancy, shortly postpartum, and when their child was 6 months, 1 year, 2 years, and 3.5 years of age. RESULTS Increased years of residence in the U.S. was associated with decreased likelihood of initiating breastfeeding and shorter duration of exclusive and any breastfeeding. Median duration of exclusive breastfeeding was 2 months for women living in the U.S. for 5 years or less, 1 month for women living in the U.S. for 6 to 10 years, and less than one week for women living in the U.S. for 11 years or more, or for their entire lives (lifetime residents). After controlling for maternal age, education, marital status and work status, lifetime residents of the U.S. were 2.4 times more likely to stop breastfeeding, and 1.5 times more likely to stop exclusive breastfeeding, than immigrants who had lived in the U.S. for 5 years or less. CONCLUSIONS Efforts are needed to encourage and support Mexican-origin women to maintain their cultural tradition of breastfeeding as they become more acculturated in the U.S.
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Affiliation(s)
- Kim Harley
- School of Public Health, UC Berkeley, 2150 Shattuck Ave, Suite 600, Berkeley, CA 94720-7380, USA.
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Briefel R, Ziegler P, Novak T, Ponza M. Feeding Infants and Toddlers Study: characteristics and usual nutrient intake of Hispanic and non-Hispanic infants and toddlers. ACTA ACUST UNITED AC 2006; 106:S84-95. [PMID: 16376633 DOI: 10.1016/j.jada.2005.09.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2005] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare demographic and maternal characteristics and usual nutrient intakes of Hispanic and non-Hispanic infants and toddlers 4 to 24 months of age in the United States. DESIGN We conducted three interviews by telephone to collect information on sociodemographic and maternal characteristics, feeding practices, and dietary intake in the 2002 Feeding Infants and Toddlers Study. We collected 24-hour dietary recalls, including a second day's intake on a subsample, using the Nutrition Data System for Research. We used the Personal Computer version of the Software for Intake Distribution Estimation to estimate usual nutrient intake and nutrient adequacy and excess for three age subgroups-infants 4-5 months, infants 6-11 months, and toddlers 12-24 months-and Hispanic or non-Hispanic ethnicity. SUBJECTS A national sample of 3,022 infants and toddlers age 4-24 months, including 371 Hispanic and 2,637 non-Hispanic subjects. STATISTICAL ANALYSIS We compared means, percentile distributions, and percentages by age/Hispanic ethnicity subgroup, and applied the Dietary Reference Intakes to assess nutrient intakes. RESULTS Mothers of Hispanic infants and toddlers were younger, less likely to be married, and had lower education levels than mothers of non-Hispanic infants and toddlers (P<.01). Hispanic infants and toddlers had significantly higher rates of participation in the Special Supplemental Nutrition Program for Women, Infants, and Children than non-Hispanic infants and toddlers (42% to 23%) and were more likely to reside in urban areas and have lower annual household income levels (P<.01). There were no significant differences in usual energy intake between Hispanic and non-Hispanic infants and toddlers, and mean usual energy intake exceeded the mean estimated energy requirement for all age/ethnicity subgroups. Hispanic toddlers consumed a significantly higher proportion of energy from carbohydrate (56% to 53%, P<.01) and a significantly lower percentage of energy from fat (31% to 33%, P<.01) than non-Hispanics. Comparing usual mean intakes, Hispanic infants age 6 to 11 months had a significantly lower intake of calcium than non-Hispanics (means of 574 mg and 626 mg per day, respectively, P<.05) and a significantly higher intake of sodium compared with non-Hispanics of the same age (means of 647 mg to 476 mg per day, P<.01). For infants, mean usual intakes were adequate for all nutrients. For toddlers, the prevalence of nutrient inadequacy was low (<1%) with the exception of vitamin E, which was inadequate for 39% of Hispanic toddlers and 50% of non-Hispanic toddlers. For nutrients with defined Tolerable Upper Intake Levels, more than one third to almost half of toddlers exceeded the Tolerable Upper Intake Levels for vitamin A and zinc, and more than half (53% and 58% for Hispanics and non-Hispanic toddlers, respectively) exceeded the Tolerable Upper Intake Level for sodium. Usual mean intakes of vitamins A, C, and E and folate, potassium, and fiber were significantly higher among Hispanic toddlers compared with non-Hispanic toddlers. CONCLUSIONS The Feeding Infants and Toddlers Study data provide information that is useful to practitioners, Special Supplemental Nutrition Program for Women, Infants, and Children program staff, and parents for delivering nutrition education messages that are consistent with dietary guidance for infants and toddlers as well as compatible with cultural preferences.
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Affiliation(s)
- Ronette Briefel
- Mathematica Policy Research Inc., 600 Maryland Avenue SW, Suite 550, Washington, DC 20024, USA.
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Harley K, Eskenazi B, Block G. The association of time in the US and diet during pregnancy in low-income women of Mexican descent. Paediatr Perinat Epidemiol 2005; 19:125-34. [PMID: 15787887 PMCID: PMC3882002 DOI: 10.1111/j.1365-3016.2005.00640.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study compared nutritional intake during pregnancy among women of Mexican descent according to country of birth (US vs. Mexico) and, for Mexico-born women, according to number of years lived in the US (<or=5 years, 6-10 years, >or= 11 years). A 72-item food frequency questionnaire (FFQ) was used to assess dietary intake in 474 pregnant Mexico-born immigrants and US-born Mexican-Americans. Mexico-born women had significantly higher intakes of calories (P = 0.02), fibre (P < 0.001), vitamin A (P < 0.001), vitamin C (P = 0.03), vitamin E (P < 0.01), folate (P < 0.01), calcium (P < 0.001) and zinc (P = 0.02) from their diets than US-born women. Intakes of all nutrients except vitamin C and zinc remained significantly higher in Mexico-born women when nutrients from both diet and vitamin supplements were considered. Among Mexico-born women, increasing years of residence in the US was associated with lower intake of calories (P(trend) < 0.01), fibre (P(trend) < 0.01), folate (P(trend) = 0.03), iron (P(trend) = 0.05) and zinc (P(trend) = 0.03), although only the trend for iron remained significant when vitamin supplement sources were included. A large percentage of women had inadequate intake of vitamin E (58%), folate (61%), iron (77%) and zinc (47%) from their diets during pregnancy and these rates were higher in US-born women than Mexico-born women.
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Affiliation(s)
- Kim Harley
- School of Public Health, University of California, Berkeley, California
| | - Brenda Eskenazi
- School of Public Health, University of California, Berkeley, California
| | - Gladys Block
- School of Public Health, University of California, Berkeley, California
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