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Zimmerman E, Gachigi KK, Rodgers RF, Watkins DJ, Woodbury M, Cordero JF, Alshawabkeh A, Meeker JD, Huerta-Montañez G, Pabon ZR, Hines M, Velez-Vega CM, Camargo CA, Zhu Y, Nozadi SS, Comstock SS, Hockett C, Tarwater PM. Association between Quality of Maternal Prenatal Food Source and Preparation and Breastfeeding Duration in the Environmental Influences on Child Health Outcome (ECHO) Program. Nutrients 2022; 14:4922. [PMID: 36432608 PMCID: PMC9695213 DOI: 10.3390/nu14224922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/02/2022] [Accepted: 11/06/2022] [Indexed: 11/22/2022] Open
Abstract
This study examined the relationship between maternal food source and preparation during pregnancy and the duration of breastfeeding among 751 mother-child dyads in the United States. The data collected from the Environmental influences on Child Health Outcomes (ECHO) Program included twelve cohorts of mothers (age ≥ 18) who delivered infant(s). Three categories of maternal food source and preparation including, High, Moderate, or Low Food Source Quality were derived from the mother report. The mean duration of breastfeeding differed strongly across the three categories. The High Food Source Quality group breastfed an average of 41 weeks, while shorter durations were observed for the Moderate (26 weeks) and Low (16 weeks) Food Source Quality groups. Cox proportional hazards models were used to estimate the relative hazard of time to breastfeeding cessation for each participant characteristic. The full model adjusted for clustering/cohort effect for all participant characteristics, while the final model adjusted for the subset of characteristics identified from variable reduction modeling. The hazard of breastfeeding cessation for those in the High Food Source Quality group was 24% less than the Moderate group (RH = 0.76; 95% CI, 0.63-0.92). Pregnant women in the High Food Source Quality group breastfed longer than the Moderate and Low groups. We encourage more detailed studies in the future to examine this relationship longitudinally.
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Grants
- UG3 OD035509 NIH HHS
- UG3 OD035517 NIH HHS
- UH3 OD023282 NIH HHS
- U2COD023375, U24OD023382, U24OD023319, UH3OD023251, UH3OD023313, UH3OD023328 , UH3OD023289, UH3OD023285, UH3OD023271, UH3OD023253, UH3OD023279, UH3OD023332, UH3OD023305, and UH3OD023286, UH3OD023282, UH3OD023244, UH3OD023275, UH3OD023268, UH3OD023272, U NIH HHS
- UG3 OD023282 NIH HHS
- P30 ES017885 NIEHS NIH HHS
- UH3OD023337, UH3OD023271 NIH HHS
- UH3 OD023251 NIH HHS
- UH3 OD023279 NIH HHS
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Affiliation(s)
- Emily Zimmerman
- Department of Communication Sciences and Disorders, Northeastern University, 228C Forsyth Building, 360 Huntington Ave, Boston, MA 02115, USA
| | - Kennedy K. Gachigi
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Rachel F. Rodgers
- Department of Applied Psychology, Northeastern University, Boston, MA 02115, USA
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, 34090 Montpellier, France
| | - Deborah J. Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Megan Woodbury
- Department of Communication Sciences and Disorders, Northeastern University, 228C Forsyth Building, 360 Huntington Ave, Boston, MA 02115, USA
| | - José F. Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA 30602, USA
| | - Akram Alshawabkeh
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA 02115, USA
| | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Gredia Huerta-Montañez
- Department of Electrical and Computer Engineering, Northeastern University, Boston, MA 02115, USA
| | - Zaira Rosario Pabon
- Department of Electrical and Computer Engineering, Northeastern University, Boston, MA 02115, USA
| | - Morgan Hines
- Department of Communication Sciences and Disorders, Northeastern University, 228C Forsyth Building, 360 Huntington Ave, Boston, MA 02115, USA
| | - Carmen M. Velez-Vega
- Department of Electrical and Computer Engineering, Northeastern University, Boston, MA 02115, USA
- Department of Social Sciences, University of Puerto Rico, Medical Sciences Campus, San Juan, PR 00936, USA
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
| | - Sara S. Nozadi
- Health Sciences Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
| | - Sarah S. Comstock
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA
| | - Christine Hockett
- Avera Research Institute, Sioux Falls, SD 57108, USA
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD 57105, USA
| | - Patrick M. Tarwater
- Department of Epidemiology and Biostatistics, Texas A&M University, College Station, TX 77843, USA
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Sokou R, Parastatidou S, Ioakeimidis G, Tavoulari EF, Makrogianni A, Isaakidou E, Iacovidou N, Konstantinidi A. Breastfeeding in Neonates Admitted to an NICU: 18-Month Follow-Up. Nutrients 2022; 14:nu14183841. [PMID: 36145216 PMCID: PMC9500865 DOI: 10.3390/nu14183841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction: The admission of neonates to Neonatal Intensive Care Units (NICUs) has been identified as a primary inhibiting factor in the establishment of breastfeeding. The aims of this study were to (1) estimate the prevalence and duration of breastfeeding in infants/toddlers who had been admitted to an NICU in Greece and (2) to investigate factors, associated with the NICU stay, which affected the establishment and maintenance of breastfeeding in infants/toddlers previously admitted to the NICU. Materials and methods: Data for this cohort study were retrieved from interviews with mothers of infants/toddlers who had been admitted to our NICU as neonates during the period of 2017−2019. Interviews were conducted based on a questionnaire regarding the child’s nutrition from birth to the day of the interview, including previous maternal experience with breastfeeding. Information related to the prenatal period, gestation age, delivery mode, duration of NICU stay, and neonatal feeding strategies during their hospital stay were recorded. Results: The response rate to the telephone interviews was 57%, resulting in 279 mother−infant pairs being included in this study. The results showed that 78.1% of children received maternal milk during their first days of life. Of all infants, 58.1% were exclusively breastfed during their first month, with a gradual decrease to 36.9% and 19.4% by the end of the third and sixth months of life, respectively. The prevalence of breastfed children reached 14.7% and 7.5% at the ages of twelve and eighteen months, respectively. In the multivariate analysis, prematurity emerged as an independent prognostic factor for the duration of exclusive and any breastfeeding (aHR 1.64, 95% CI: 1.03−2.62; and 1.69, 95% CI: 1.05−2.72, respectively; p < 0.05). Additionally, the nationality of the mother, NICU breastfeeding experience, the administration of maternal milk during neonatal hospital stay, and previous breastfeeding experience of the mother were independent prognostic factors for the duration of breastfeeding. Conclusions: Although breastfeeding is a top priority in our NICU, the exclusive-breastfeeding rates at 6 months were quite low for the hospitalized neonates, not reaching World Health Organization (WHO) recommendations. Mothers/families of hospitalized neonates should receive integrated psychological and practical breastfeeding support and guidance.
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Affiliation(s)
- Rozeta Sokou
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 3 D. Mantouvalou Str., Nikea, 18454 Piraeus, Greece
- Neonatal Department, Aretaieio Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
- Correspondence: ; Tel.: +30-2132077346 or +30-2132077000
| | - Stavroula Parastatidou
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 3 D. Mantouvalou Str., Nikea, 18454 Piraeus, Greece
| | - Georgios Ioakeimidis
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 3 D. Mantouvalou Str., Nikea, 18454 Piraeus, Greece
| | - Evangelia-Filothei Tavoulari
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 3 D. Mantouvalou Str., Nikea, 18454 Piraeus, Greece
| | - Athanasia Makrogianni
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 3 D. Mantouvalou Str., Nikea, 18454 Piraeus, Greece
| | - Elina Isaakidou
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 3 D. Mantouvalou Str., Nikea, 18454 Piraeus, Greece
| | - Nicoletta Iacovidou
- Neonatal Department, Aretaieio Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Aikaterini Konstantinidi
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 3 D. Mantouvalou Str., Nikea, 18454 Piraeus, Greece
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Daneshzad E, Moradi M, Maracy MR, Brett NR, Bellissimo N, Azadbakht L. The association of maternal plant-based diets and the growth of breastfed infants. Health Promot Perspect 2020; 10:152-161. [PMID: 32296629 PMCID: PMC7146038 DOI: 10.34172/hpp.2020.25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 12/01/2019] [Indexed: 12/28/2022] Open
Abstract
Background: Studies are needed to further understand how different plant-based dietary patterns of mothers relate to infant growth. Thus, we investigated the association between maternal plant-based diets and infant growth in breastfed infants during the first 4 months of life. Methods: This cross-sectional study included 290 Iranian mothers and infants. Maternal dietary intake was assessed using a 168-question validated semi-quantitative food frequency questionnaire (FFQ). Three plant-based diet indices (PDIs) were then created to evaluate dietary intakes. Eighteen food groups were classified in three main categories by scoring method: wholeplant diet, healthy plant diet, and animal and unhealthy plant diet. Results: Participants in the top tertile of unhealthy PDI (uPDI) had a lower intake of potassium,phosphorus, zinc, magnesium, calcium, folate and vitamin C, B1, B2, and B3. The upper tertileof uPDI was associated with stunting at 4-month in infants (uPDI: odds ratio [OR] = 3.27, 95%CI= 1.32, 8.10). There were no significant associations between plant-based diet scores and anthropometric indices, including weight, weight status and head circumference (P > 0.05). Conclusion: In conclusion, higher adherence to uPDI may be associated with stuntingamong Iranian infants. Other PDIs were not associated with anthropometric measures. Future studies are needed to further understand the association between plant-based diets and infant growth.
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Affiliation(s)
- Elnaz Daneshzad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Maedeh Moradi
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad R Maracy
- Department of Epidemiology & Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Neil R Brett
- School of Nutrition, Ryerson University, Toronto, Ontario, Canada
| | - Nick Bellissimo
- School of Nutrition, Ryerson University, Toronto, Ontario, Canada
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.,Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
Human milk analyzers can measure macronutrient content in native breast milk to tailor adequate supplementation with fortifiers. This article reviews all studies using milk analyzers, including (i) evaluation of devices, (ii) the impact of different conditions on the macronutrient analysis of human milk, and (iii) clinical trials to improve growth. Results lack consistency, potentially due to systematic errors in the validation of the device, or pre-analytical sample preparation errors like homogenization. It is crucial to introduce good laboratory and clinical practice when using these devices; otherwise a non-validated clinical usage can severely affect growth outcomes of infants.
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