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Gross SM, Lerman JL, Hurley KM, Venkataramani M, Sharma R, Ogunwole SM, Zhang A, Bennett WL, Bass EB, Caulfield LE. Breastfeeding Outcomes Associated With the Special Supplemental Nutrition Program for Women, Infants, and Children: A Systematic Review. Acad Pediatr 2023; 23:244-260. [PMID: 36272723 DOI: 10.1016/j.acap.2022.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 08/06/2022] [Accepted: 10/10/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) promotes and supports breastfeeding for low-income women and children. A prior review reported negative associations of WIC with breastfeeding outcomes. WIC food package changes in 2009 increased breastfeeding support. OBJECTIVE The objectives of this systematic review were to 1) evaluate evidence on WIC participation and breastfeeding outcomes and 2) evaluate breastfeeding outcomes of WIC participants before versus after the 2009 food package. DATA SOURCES PubMed, Embase®, CINAHL, ERIC, SCOPUS, PsycINFO, and the Cochrane Central Register of Controlled Trials for papers published January 2009 to April 2022. ELIGIBILITY CRITERIA Included studies compared breastfeeding outcomes (initiation, duration, exclusivity, early introduction of solid foods) of WIC participants with WIC-eligible nonparticipants, or among WIC participants before versus after the 2009 package change. STUDY APPRAISAL METHODS Two independent reviewers evaluated each study and assessed risk of bias using EHPHP assessment. RESULTS From 13 observational studies we found: 1) moderate strength of evidence (SOE) of no difference in initiation associated with WIC participation; 2) insufficient evidence regarding WIC participation and breastfeeding duration or exclusivity; 3) low SOE that the 2009 food package change is associated with greater breastfeeding exclusivity; 4) low SOE that WIC breastfeeding support services are positively associated with initiation and duration. LIMITATIONS Only observational studies, with substantial risk of bias and heterogeneity in outcomes and exposures. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS WIC participation is not associated with a difference in breastfeeding initiation compared to WIC-eligible nonparticipants, but the 2009 food package change may have improved breastfeeding exclusivity among WIC participants and receipt of breastfeeding support services may have improved breastfeeding initiation and duration.
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Affiliation(s)
- Susan M Gross
- Department of Population, Family and Reproductive Health (SM Gross), The Johns Hopkins Bloomberg School of Public Health, Baltimore, Md
| | - Jennifer L Lerman
- Center for Human Nutrition (JL Lerman, KM Hurley, and LE Caulfield), The Johns Hopkins Bloomberg School of Public Health, Baltimore, Md
| | - Kristen M Hurley
- Center for Human Nutrition (JL Lerman, KM Hurley, and LE Caulfield), The Johns Hopkins Bloomberg School of Public Health, Baltimore, Md
| | - Maya Venkataramani
- Division of General Internal Medicine (M Venkataramani, SM Ogunwole, WL Bennett, and EB Bass), The Johns Hopkins University, Baltimore, Md
| | - Ritu Sharma
- The Johns Hopkins University Evidence-based Practice Center (R Sharma, A Zhang, and EB Bass), Baltimore, Md
| | - S Michelle Ogunwole
- Division of General Internal Medicine (M Venkataramani, SM Ogunwole, WL Bennett, and EB Bass), The Johns Hopkins University, Baltimore, Md
| | - Allen Zhang
- The Johns Hopkins University Evidence-based Practice Center (R Sharma, A Zhang, and EB Bass), Baltimore, Md
| | - Wendy L Bennett
- Division of General Internal Medicine (M Venkataramani, SM Ogunwole, WL Bennett, and EB Bass), The Johns Hopkins University, Baltimore, Md
| | - Eric B Bass
- Division of General Internal Medicine (M Venkataramani, SM Ogunwole, WL Bennett, and EB Bass), The Johns Hopkins University, Baltimore, Md; The Johns Hopkins University Evidence-based Practice Center (R Sharma, A Zhang, and EB Bass), Baltimore, Md
| | - Laura E Caulfield
- Center for Human Nutrition (JL Lerman, KM Hurley, and LE Caulfield), The Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
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2
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Zaikman Y, Houlihan AE. It’s just a breast: an examination of the effects of sexualization, sexism, and breastfeeding familiarity on evaluations of public breastfeeding. BMC Pregnancy Childbirth 2022; 22:122. [PMID: 35151260 PMCID: PMC8840320 DOI: 10.1186/s12884-022-04436-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 01/27/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Despite the legal right to breastfeed in public, women may be concerned about negative reactions from others, which may in turn impact their decision to breastfeed in public. The current study examined whether women breastfeeding in public (e.g., at a coffee shop) would be evaluated differently than women breastfeeding in private (e.g., at home) and explored several explanations for the possible differences: sexualization of the female breast (including the perceivers’ gender and sexual comfort level, as well as the exposure of the breast while breastfeeding), sexist attitudes, and familiarity with breastfeeding.
Methods
In August 2018, 506 adult participants, residing in the United States and recruited from Amazon Mechanical Turk, were randomly assigned to view an image of a woman breastfeeding (or not) while wearing a cover (or not), in a private or public location. Participants then completed measures of their emotional responses, perceptions, and behavioral intentions toward the woman in the image as well as their sexual comfort level, hostile and benevolent sexism, and knowledge of and experience with breastfeeding.
Results
People had more favorable evaluations of breastfeeding (vs. non-breastfeeding) women, especially when they had greater sexual comfort, were more knowledgeable about breastfeeding, and were parents with at least one child who was breastfed. The location (public vs. private) and the presence or absence of a cover did not differentially influence evaluations of breastfeeding and non-breastfeeding women, nor did participants’ gender or level of sexist attitudes.
Conclusions
In general, people’s evaluations of breastfeeding appear to be favorable to the degree that the location of the breastfeeding is not particularly relevant to those evaluations.
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3
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Erdim L, Zengin N. Validity and reliability of the Infant Feeding Attitude Scale in young people in Turkey. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-020-01253-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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4
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Moran-Lev H, Farhi A, Bauer S, Nehama H, Yerushalmy-Feler A, Mandel D, Lubetzky R. Association of Socioeconomic Factors and Infant Nutrition Decisions: Breastfeeding and Type of Formula. Breastfeed Med 2021; 16:553-557. [PMID: 33835839 DOI: 10.1089/bfm.2020.0398] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: Breastfeeding is considered the gold standard of infant feeding during the first year of life. However, many women experience difficulty breastfeeding and do not breastfeed to the extent that they initially planned. Our aims were to present factors influencing parents' choices of infant nutrition and to examine whether these choices are influenced by socioeconomic status (SES). Materials and Methods: We conducted a cross-sectional survey by interviewing mothers attending family health centers in various areas of Tel Aviv, Israel. Results: A total of 239 mothers participated in the survey. The choice of source of their infants' nutrition up to the age of 6 months was divided between exclusive breastfeeding, a combination of infant formula (IF) and breastfeeding, and exclusive IF (36%, 34%, and 30%, respectively). Exclusive breastfeeding was related to a higher SES (p = 0.02). The leading cause for combining IF in the infant's diet was maternal difficulty in breastfeeding (60%). The leading factors that influenced the choice of a specific IF product were continuation from the IF given in the hospital nursery (20%), advice from friends or family (20%) and cost (10%). There was a significant difference based on SES. A greater proportion of responders in a higher SES continued the IF that was supplied in the hospital, whereas lower SES parents tended to choose a formula according to its price (p < 0.05 for both). Conclusion: There is an overall lower prevalence of exclusive breastfeeding among low-income families. The maternal choice of the type of IF is associated with parental SES, with the choice of high SES mothers what was fed in the hospital and the choice of low SES related to price.
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Affiliation(s)
- Hadar Moran-Lev
- Department of Pediatrics, and Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Pediatric Gastroenterology, and Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adir Farhi
- Department of Pediatrics, and Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Smadar Bauer
- Department of Pediatrics, and Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Haim Nehama
- Public Health Department, Tel-Aviv Municipality, Tel Aviv, Israel
| | - Anat Yerushalmy-Feler
- Department of Pediatric Gastroenterology, and Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dror Mandel
- Public Health Department, Tel-Aviv Municipality, Tel Aviv, Israel.,Department of Neonatology, Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ronit Lubetzky
- Department of Pediatrics, and Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Perez MR, de Castro LS, Chang YS, Sañudo A, Marcacine KO, Amir LH, Ross MG, Coca KP. Breastfeeding Practices and Problems Among Obese Women Compared with Nonobese Women in a Brazilian Hospital. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2021; 2:219-226. [PMID: 34235509 PMCID: PMC8243705 DOI: 10.1089/whr.2021.0021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/27/2021] [Indexed: 12/28/2022]
Abstract
Background: Women who are obese have lower rates of breastfeeding initiation and duration and are less likely to breastfeed exclusively compared with women who are not obese. To develop programs to improve breastfeeding practices among this group of women, we investigated the association between maternal obesity and breastfeeding practices and problems in the first days postpartum. Methods: We analyzed medical records from postpartum women at a rooming-in maternity ward in State of São Paulo, Brazil, between 2016 and 2018. We included those who had intended to exclusively breastfeed, had given birth to a singleton and were admitted to rooming-in. We analyzed exclusive breastfeeding and nonexclusive breastfeeding each day of hospitalization and the presence of breastfeeding problems, comparing women in the obese category (body mass index [BMI] ≥30 kg/m2) to normal and overweight women (≥18.6 to ≤29.9 kg/m2). Results: Two hundred and twenty-four postpartum women participated, including 86 women in the obese category. More than 50% of women with obesity reported a breastfeeding problem in the first and second postpartum days (p = 0.026 and p = 0.017, respectively) compared with the 41% and 38% nonobese group. Children of obese women were 2.8 times more likely to have poor latch during breastfeeding (95% confidence interval [CI]: 1.29-6.10) compared with the nonobese group on the third day. Conclusion: Maternal obesity increased the probability of breastfeeding difficulties and nonexclusive breastfeeding at discharge. Professionals need to support breastfeeding techniques in the days immediate after delivery to improve breastfeeding outcomes for mothers with obesity.
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Affiliation(s)
- Marina Rico Perez
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Lucíola Sant'Anna de Castro
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Yan-Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Adriana Sañudo
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Lisa H Amir
- Judith Lumley Centre, La Trobe University, Victoria, Australia
- Breastfeeding Service, Royal Women's Hospital, Victoria, Australia
| | - Michael G. Ross
- Obstetrics and Gynecology, Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Kelly Pereira Coca
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil
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6
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Monge-Montero C, van der Merwe LF, Papadimitropoulou K, Agostoni C, Vitaglione P. Mixed milk feeding: a systematic review and meta-analysis of its prevalence and drivers. Nutr Rev 2020; 78:914-927. [PMID: 32357372 DOI: 10.1093/nutrit/nuaa016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
CONTEXT Extensive literature is available on exclusive breastfeeding and formula-feeding practices and health effects. In contrast, limited and unstructured literature exists on mixed milk feeding (MMF), here defined as the combination of breastfeeding and formula feeding during the same period in term infants > 72 hours old (inclusion criterion). OBJECTIVE A systematic review and meta-analysis were performed, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, on the global prevalence of MMF (primary outcome) and related drivers and practices (secondary outcomes). DATA SOURCES The search of MMF in generally healthy populations was conducted across 6 databases, restricted to publications from January 2000 to August 2018 in English, Spanish, French, and Mandarin. DATA EXTRACTION Two reviewers independently performed screenings and data extraction according to a priori inclusion and exclusion criteria. DATA ANALYSIS Of the 2931 abstracts identified, 151 full-text publications were included for data extraction and 96 of those were included for data synthesis (the majority of those were cross-sectional and cohort studies). The authors summarized data across 5 different categories (feeding intention prenatally, and 4 age intervals between > 72 hours and > 6-23 months) and 5 regional subgroups. The overall prevalence of MMF across different age intervals and regions varied between 23% and 32%; the highest rate was found for the age group 4-6 months (32%; 95% confidence interval, 27%-38%); regional comparisons indicated highest MMF rates in Asia (34%), North and South America (33%), and Middle East and Africa together (36%), using a random effects meta-analysis model for proportions. Some drivers and practices for MMF were identified. CONCLUSION MMF is a widespread feeding reality. A shared and aligned definition of MMF will help shed light on this feeding practice and evaluate its influence on the duration of total breastfeeding, as well as on infants' nutrition status, growth, development, and health status in the short and long terms. PROSPERO registration number CRD42018105337.
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Affiliation(s)
- Carmen Monge-Montero
- Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy
| | | | | | - Carlo Agostoni
- Pediatric Clinic, Fondazione IRCCS Ospedale Maggiore Policlinico, Milano, Italy; and the Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paola Vitaglione
- Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy
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7
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Tseng JF, Chen SR, Au HK, Chipojola R, Lee GT, Lee PH, Shyu ML, Kuo SY. Effectiveness of an integrated breastfeeding education program to improve self-efficacy and exclusive breastfeeding rate: A single-blind, randomised controlled study. Int J Nurs Stud 2020; 111:103770. [PMID: 32961461 DOI: 10.1016/j.ijnurstu.2020.103770] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 08/29/2020] [Accepted: 08/30/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Low self-efficacy affects new mothers' ability to sustain breastfeeding. Interventions that increase self-efficacy could improve sustained breastfeeding. OBJECTIVES To develop an integrated breastfeeding education program based on self-efficacy theory, and evaluate the effect of the intervention on first-time mothers' breastfeeding self-efficacy and attitudes. DESIGN A single-blind, randomised controlled trial. SETTING A prenatal clinic of a teaching hospital. PARTICIPANTS First-time mothers with a singleton pregnancy (12-32 weeks' gestation) and their support partners were selected by convenience sampling (N = 104) and allocated by block-randomization to an intervention or control group. METHODS A 3-week breastfeeding intervention program was developed based on self-efficacy theory. The intervention group received the breastfeeding program; the control group received standard care. Data between groups were compared for scores on breastfeeding self-efficacy, infant feeding attitude, and breastfeeding practice, which were assessed using the Breastfeeding Self-Efficacy Scale-Short Form, the Iowa Infant Feeding Attitude Scale, and a structured questionnaire, respectively. Repeated data measurements were collected at baseline, 36-weeks' gestation, and postpartum at 1-week, and 1-, 3-, and 6-months. RESULTS Ninety-three mothers completed the study. Data were compared for the self-efficacy intervention group (n = 50) with the control group (n = 43). Baseline measures did not differ between groups. The intervention group had significantly higher breastfeeding self-efficacy at 36 weeks' gestation (mean difference (MD): 7.3, p < .001), and postpartum at 1-week (p < .001), 1-month (p < .001) and 3-months (p < .01) with MD: 6.7, 7.9, and 8.1, respectively; differences in scores from baseline were also significantly greater from 36 weeks' gestation to 3-months (MD from 9.1~9.9, p < .001) and 6-months postpartum (MD: 7.0, p < .05). Infant feeding attitude scores significantly improved from 36 weeks' gestation to 6-months postpartum for the intervention group (MD from 3.5~7.4, p < .05). Rates for exclusive and predominant breastfeeding postpartum were significantly higher for the intervention group vs control (p < .02) at 1-week (98% vs. 86%), 1-month (100% vs. 90.7%), and 3-months (94% vs. 76.7%). Odds ratio (OR) postpartum for exclusive and predominant breastfeeding was greater for the intervention group at 3-months (OR = 4.7, 95% Confidence interval (CI), 1.2 -18.6; p = .05) and for exclusive breastfeeding at 6-months (OR: 2.82, 95% CI 1.0-8.1; p = .05). CONCLUSIONS The breastfeeding education intervention improved breastfeeding self-efficacy, infant feeding attitudes, and exclusive breastfeeding rates. The breastfeeding education program could be effective for sustaining breastfeeding in new mothers. TRIAL REGISTRATION Registered with www.clinicaltrials.gov (NCT03807726).
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Affiliation(s)
- Juei-Fen Tseng
- Department of Nursing, Tri-service General Hospital, Taipei, Taiwan; School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, 11031 Taipei, Taiwan
| | - Su-Ru Chen
- School of Nursing and Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
| | - Heng-Kien Au
- Department of Obstetrics, Taipei Medical University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; TMU Research Center for Cell Therapy and Regeneration Medicine, Taipei Medical University, Taipei, Taiwan
| | - Roselyn Chipojola
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, 11031 Taipei, Taiwan; Kamuzu College of Nursing, Lilongwe, Malawi
| | - Gabrielle T Lee
- Applied Psychology, Faculty of Education, Western University, London, ON, Canada.
| | - Pi-Hsia Lee
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, 11031 Taipei, Taiwan.
| | - Meei-Ling Shyu
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, 11031 Taipei, Taiwan.
| | - Shu-Yu Kuo
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, 11031 Taipei, Taiwan.
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8
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Mergen H, Kacmaz N, Baltali O, Ersu A, Erdogmus Mergen B. Assessment by the Turkish version of the Iowa Infant Feeding Attitude Scale in pediatrics polyclinic. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2019. [DOI: 10.23736/s0393-3660.18.03961-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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9
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Li K, Wen M, Reynolds M, Zhang Q. WIC Participation and Breastfeeding after the 2009 WIC Revision: A Propensity Score Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152645. [PMID: 31344937 PMCID: PMC6696206 DOI: 10.3390/ijerph16152645] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 07/20/2019] [Accepted: 07/21/2019] [Indexed: 01/29/2023]
Abstract
In this study, we examined the association between participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and breastfeeding outcomes before and after the 2009 revisions. Four-thousand-three-hundred-and-eight WIC-eligible children younger than 60 months were included from the 2005–2014 National Health and Nutrition Examination Survey (NHANES). We compared two birth cohorts with regard to their associations between WIC participation and being ever-breastfed and breastfed at 6 months. We estimated the average effect of the treatment for the treated to assess the causal effect of WIC participation on breastfeeding based on propensity score matching. The results showed that WIC-eligible participating children born between 2000 and 2008 were significantly less likely than WIC-eligible nonparticipating children to ever receive breastfeeding (p < 0.05) or to be breastfed at 6 months (p < 0.05). Among children born between 2009 and 2014, WIC-eligible participating children were no longer less likely to ever receive breastfeeding compared to WIC-eligible nonparticipating children; the gap remained in breastfeeding at 6-months (p < 0.05). The disparities in prevalence of ever breastfed between WIC-eligible participants and nonparticipants have been eliminated since the 2009 WIC revision. More efforts are needed to improve breastfeeding persistence among WIC-participating mother–infant dyads.
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Affiliation(s)
- Kelin Li
- Department of Sociology, California State University-Dominguez Hills, Carson, CA 90747, USA
| | - Ming Wen
- Department of Sociology, University of Utah, Salt Lake City, UT 84112, USA
| | - Megan Reynolds
- Department of Sociology, University of Utah, Salt Lake City, UT 84112, USA
| | - Qi Zhang
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA.
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10
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Pineros-Leano M, Tabb KM, Simonovich SD, Wang Y, Meline B, Huang H. Racial Differences in Breastfeeding Initiation Among Participants in a Midwestern Public Health District. Health Equity 2018; 2:296-303. [PMID: 30364880 PMCID: PMC6198273 DOI: 10.1089/heq.2018.0016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose: Although variations in breastfeeding initiation are well documented, the contributing role of maternal race remains poorly understood, especially among the multiracial—two or more races—population. The purpose of this study is to examine differences in breastfeeding initiation among a racially and ethnically diverse population of low-income women. Methods: Participants for this study (n=1010) were enrolled in the supplemental nutrition program for women, infant, and children and concurrently enrolled in a perinatal depression registry at a public health clinic in the Midwest. Race was obtained from medical records. Breastfeeding initiation was gathered through a clinical interview during the first postpartum visit. Logistic regression was conducted using STATA 14.2. Results: Sixty-eight percent of study participants reported breastfeeding initiation. The bivariate analysis demonstrated that there were significant differences in rates of breastfeeding initiation by race/ethnicity. The logistic regression models showed that after adjusting for maternal education, age, income, nativity, parity, body mass index, and antenatal smoking, Black (odds ratio [OR] 0.47; confidence interval [95% CI] 0.34–0.66), multiracial (OR 0.21; 95% CI 0.07–0.65), and Latina women (OR 0.48; 95% CI 0.26–0.86) were significantly less likely to initiate breastfeeding compared with White women. Conclusion: These findings highlight the need for further understanding of the underlying barriers to the initiation of breastfeeding among low-income Black, multiracial, and Latina women. Moreover, breastfeeding should remain a priority for intervention and policy development, particularly among racially and ethnically diverse low-income women.
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Affiliation(s)
- Maria Pineros-Leano
- School of Social Work, Boston College, Chestnut Hill, Massachusetts.,IDEA Research Team, University of Illinois, Urbana, Illinois
| | - Karen M Tabb
- IDEA Research Team, University of Illinois, Urbana, Illinois.,School of Social Work, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Shannon D Simonovich
- IDEA Research Team, University of Illinois, Urbana, Illinois.,School of Nursing, College of Science & Health, DePaul University, Chicago, Illinois
| | - Yang Wang
- IDEA Research Team, University of Illinois, Urbana, Illinois.,School of Social Work, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Brandon Meline
- IDEA Research Team, University of Illinois, Urbana, Illinois.,Maternal and Child Health Division, Champaign-Urbana Public Health District, Champaign, Illinois
| | - Hsiang Huang
- IDEA Research Team, University of Illinois, Urbana, Illinois.,Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts
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11
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Muda CMC, Ismail TAT, Jalil RA, Hairon SM, Sulaiman Z, Johar N. Maternal Factors Associated with the Initiation of Exclusive Breastfeeding among Mothers at One Week after Delivery in Two Selected Hospitals in Kelantan, Malaysia. Malays J Med Sci 2018; 25:112-121. [PMID: 30914853 PMCID: PMC6422543 DOI: 10.21315/mjms2018.25.4.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 05/31/2018] [Indexed: 11/17/2022] Open
Abstract
Background The first week following delivery usually coincides with the initiation of exclusive breastfeeding. This study aimed to determine the prevalence of and the associated factors regarding the initiation of exclusive breastfeeding among mothers at one week after delivery in two selected hospitals in the state of Kelantan, Malaysia. Methods A cross-sectional study was conducted from March to August 2015 among post-partum mothers, who were selected through systematic sampling. A newly developed and validated questionnaire on the participants’ data, knowledge and attitude items and a breastfeeding practice checklist were used. The mothers were interviewed in the post-natal ward, and their breastfeeding practices were determined through a phone call at one week following delivery. Descriptive statistics and simple and multiple logistic regressions were used for the data analysis. Results A total of 335 participants were included. The prevalence of exclusive breastfeeding at one week post-partum was 77.9% (95% CI: 73.0%, 82.2%), with significant associated factors being previous exclusive breastfeeding experience [adjusted odds ratio (AOR) 2.48; 95% CI: 1.37, 4.49; P-value = 0.003] and the mean total score of knowledge [AOR 1.06; 95% CI: 1.01, 1.11; P-value = 0.011]. Conclusion Every mother should receive breastfeeding education, with special emphasis on those with no previous experience. The weak areas of knowledge identified herein should be strengthened during health education.
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Affiliation(s)
- Che Muzaini Che' Muda
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.,Kedah State Health Office, Simpang Kuala, Jalan Kuala Kedah, 05400 Alor Setar, Kedah, Malaysia
| | - Tengku Alina Tengku Ismail
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Rohana Ab Jalil
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Suhaily Mohd Hairon
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Zaharah Sulaiman
- Women's Health Development Unit, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Nazirah Johar
- Lactation Secretariat, Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
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12
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Schalla SC, Witcomb GL, Haycraft E. Body Shape and Weight Loss as Motivators for Breastfeeding Initiation and Continuation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070754. [PMID: 28696385 PMCID: PMC5551192 DOI: 10.3390/ijerph14070754] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 07/04/2017] [Accepted: 07/06/2017] [Indexed: 11/16/2022]
Abstract
Breastfeeding rates in the UK are low. Efforts to promote breastfeeding typically include the known health benefits for mother and child, many of which are not immediate. Gaining immediate benefits can be effective motivators of behaviour. Body-related changes resulting from breastfeeding could be an immediate benefit. This study explored breastfeeding mothers’ reports of body-related changes as benefits of breastfeeding. Mothers (N = 182) who currently, or had recently, breastfed an infant completed a survey detailing their infant feeding choices and the perceived benefits of breastfeeding on their bodies. Half of the mothers felt that breastfeeding had a positive effect on their body. Benefits were grouped into five themes: (1) Returning to pre-pregnancy body shape; (2) Health benefits; (3) Physical benefits; (4) Eating benefits; (5) Psychological benefits. These themes highlight the numerous body-related benefits that mothers identified as resulting from breastfeeding and suggest that immediate, personal, and appearance-related gains of breastfeeding are highly valued. These findings indicate that interventions would likely benefit from emphasising the more immediate physical and psychological benefits of breastfeeding, alongside the health and bonding benefits, as a way to promote breastfeeding initiation and continuation in more women. This may be particularly effective for groups such as young mothers, where breastfeeding rates are low and whose emphasis on body image may be greater.
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Affiliation(s)
- Sophie C Schalla
- School of Sport, Exercise & Health Sciences, Loughborough University, Leicestershire LE11 3TU, UK.
| | - Gemma L Witcomb
- School of Sport, Exercise & Health Sciences, Loughborough University, Leicestershire LE11 3TU, UK.
| | - Emma Haycraft
- School of Sport, Exercise & Health Sciences, Loughborough University, Leicestershire LE11 3TU, UK.
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Nguyen T, Dennison BA, Fan W, Xu C, Birkhead GS. Variation in Formula Supplementation of Breastfed Newborn Infants in New York Hospitals. Pediatrics 2017; 140:peds.2017-0142. [PMID: 28759408 DOI: 10.1542/peds.2017-0142] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/20/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We examined the variation between 126 New York hospitals in formula supplementation among breastfed infants after adjusting for socioeconomic, maternal, and infant factors and stratifying by level of perinatal care. METHODS We used 2014 birth certificate data for 160 911 breastfed infants to calculate hospital-specific formula supplementation percentages by using multivariable hierarchical logistic regression models. RESULTS Formula supplementation percentages varied widely among hospitals, from 2.3% to 98.3%, and was lower among level 1 hospitals (18.2%) than higher-level hospitals (50.6%-57.0%). Significant disparities in supplementation were noted for race and ethnicity (adjusted odds ratios [aORs] were 1.54-2.05 for African Americans, 1.85-2.74 for Asian Americans, and 1.25-2.16 for Hispanics, compared with whites), maternal education (aORs were 2.01-2.95 for ≤12th grade, 1.74-1.85 for high school or general education development, and 1.18-1.28 for some college or a college degree, compared with a Master's degree), and insurance coverage (aOR was 1.27-1.60 for Medicaid insurance versus other). Formula supplementation was higher among mothers who smoked, had a cesarean delivery, or diabetes. At all 4 levels of perinatal care, there were exemplar hospitals that met the HealthyPeople 2020 supplementation goal of ≤14.2%. After adjusting for individual risk factors, the hospital-specific, risk-adjusted supplemental formula percentages still revealed a wide variation. CONCLUSIONS A better understanding of the exemplar hospitals could inform future efforts to improve maternity care practices and breastfeeding support to reduce unnecessary formula supplementation, reduce disparities, increase exclusive breastfeeding and breastfeeding duration, and improve maternal and child health outcomes.
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Affiliation(s)
- Trang Nguyen
- New York State Department of Health, Albany, New York; and .,School of Public Health, University at Albany, State University of New York, Rensselaer, New York
| | - Barbara A Dennison
- New York State Department of Health, Albany, New York; and.,School of Public Health, University at Albany, State University of New York, Rensselaer, New York
| | - Wei Fan
- New York State Department of Health, Albany, New York; and
| | - Changning Xu
- New York State Department of Health, Albany, New York; and
| | - Guthrie S Birkhead
- School of Public Health, University at Albany, State University of New York, Rensselaer, New York
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Delara RMM, Madden E, Bryant AS. Short interpregnancy intervals and associated risk of preterm birth in Asians and Pacific Islanders. J Matern Fetal Neonatal Med 2017; 31:1894-1899. [PMID: 28511627 DOI: 10.1080/14767058.2017.1331431] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE The prevalence of short interpregnancy intervals (IPIs) and associated rates of preterm birth has been understudied in Asian and Pacific Islander populations. We sought to estimate rates of short IPI among Asian subgroups and Pacific Islanders and associated risk of preterm birth. MATERIALS AND METHODS For this retrospective cohort study, we linked records of women in California with a first birth in 1999-2000 and a second birth before 2005 with hospital discharge data. We used multivariate modeling to determine whether specific Asian ethnicities and Pacific Islanders were at greater risk of short IPI (<6 months, 6-18 months) and if a short IPI increased risk for preterm birth in these groups. RESULTS Our sample included 189,931 women. In multivariable analyses, Asian subgroups and Pacific Islanders were more likely to have an IPI <6 months than were White women (Pacific Islanders: OR 3.31 (95%CI [2.7, 4.1]); Filipinas: OR 1.51 (95%CI [1.33, 1.71]); Southeast Asians: OR 1.93 (95%CI [1.73, 2.1]); East Asians: OR 1.65 (95%CI [1.48, 1.84]); other Asians: OR 2.04 (95%CI [1.70, 2.4])). CONCLUSIONS Asian and Pacific Islander women have higher rates of IPI <6 months, but this did not significantly increase their risk of preterm birth.
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Affiliation(s)
| | - Erin Madden
- b Northern California Institute for Research and Education , San Francisco , CA , USA
| | - Allison S Bryant
- c Department of Obstetrics and Gynecology , Massachusetts General Hospital , Boston , MA , USA
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Chen PL, Soto-Ramírez N, Zhang H, Karmaus W. Association Between Infant Feeding Modes and Gastroesophageal Reflux: A Repeated Measurement Analysis of the Infant Feeding Practices Study II. J Hum Lact 2017; 33:267-277. [PMID: 28107099 DOI: 10.1177/0890334416664711] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Gastroesophageal reflux in neonates is frequently reported by parents, potentially motivating changes in infant feeding mode and/or addition of solid food. OBJECTIVE The authors prospectively analyzed associations between repeated measurement of feeding modes and reflux in infancy. METHODS The Infant Feeding Practices Study II, conducted between 2005 and 2007 (2,841 infants), provides data on reflux and feeding modes at nine time points from months 1 to 12. Feeding modes were defined based on direct breastfeeding, feeding of bottled human milk, formula feeding, their combinations, and use of solid food. Repeated measurements were investigated using 1-month delayed models to estimate risk ratios (RRs) and their 95% confidence intervals (CIs). Risk ratios of different feeding modes were estimated for reflux; addressing a reverse association, RRs for feeding mode were estimated as responses to prior reflux. RESULTS Compared to direct breastfeeding, combinations with formula feeding showed a statistically significant risk for reflux (bottled human milk plus formula feeding: RR = 2.19, 95% CI [1.11, 4.33]; formula feeding: RR = 1.95, 95% CI [1.39, 2.74]; and mixed breastfeeding plus formula feeding: RR = 1.59, 95% CI [1.40, 2.42]). Addition of solid food was not protective (RR = 1.21, 95% CI [0.86, 1.70]). Analyses of reverse association (reflux → feeding) showed fewer breastfed infants among those with reflux in the prior month. CONCLUSION Any combination of infant feeding with formula seems to be a risk for reflux. Although breastfeeding was protective, mothers with a child with reflux were more likely to wean their child.
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Affiliation(s)
- Pei-Lin Chen
- 1 Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Nelís Soto-Ramírez
- 2 College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Hongmei Zhang
- 1 Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Wilfried Karmaus
- 1 Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
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Newhook JT, Ludlow V, Newhook LA, Bonia K, Goodridge JM, Twells L. Infant-Feeding among Low-Income Women: The Social Context that Shapes their Perspectives and Experiences. Can J Nurs Res 2017; 45:28-49. [DOI: 10.1177/084456211304500303] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Comparison of Infant Sleep Practices in African-American and US Hispanic Families: Implications for Sleep-Related Infant Death. J Immigr Minor Health 2016; 17:834-42. [PMID: 24705738 DOI: 10.1007/s10903-014-0016-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
African-American and Hispanic families share similar socioeconomic profiles. Hispanic rates of sleep-related infant death are four times lower than African-American rates. We conducted a cross-sectional, multi-modal (surveys, qualitative interviews) study to compare infant care practices that impact risk for sleep-related infant death in African-American and Hispanic families. We surveyed 422 African-American and 90 Hispanic mothers. Eighty-three African-American and six Hispanic mothers participated in qualitative interviews. African-American infants were more likely to be placed prone (p < 0.001), share the bed with the parent (p < 0.001), and to be exposed to smoke (p < 0.001). Hispanic women were more likely to breastfeed (p < .001), while African-American women were more knowledgeable about SIDS. Qualitative interviews indicate that, although African-American and Hispanic parents had similar concerns, behaviors differed. Although the rationale for infant care decisions was similar for African-American and Hispanic families, practices differed. This may help to explain the racial/ethnic disparity seen in sleep-related infant deaths.
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Twells LK, Midodzi WK, Ludlow V, Murphy-Goodridge J, Burrage L, Gill N, Halfyard B, Schiff R, Newhook LA. Assessing Infant Feeding Attitudes of Expectant Women in a Provincial Population in Canada: Validation of the Iowa Infant Feeding Attitude Scale. J Hum Lact 2016; 32:NP9-NP18. [PMID: 25425631 DOI: 10.1177/0890334414559647] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 10/19/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Maternal attitudes to infant feeding are predictive of intent and initiation of breastfeeding. OBJECTIVES The Iowa Infant Feeding Attitude Scale (IIFAS) has not been validated in the Canadian population. This study was conducted in Newfoundland and Labrador, a Canadian province with low breastfeeding rates. Objectives were to assess the reliability and validity of the IIFAS in expectant mothers; to compare attitudes to infant feeding in urban and rural areas; and to examine whether attitudes are associated with intent to breastfeed. METHODS The IIFAS assessment tool was administered to 793 pregnant women. Differences in the total IIFAS scores were compared between urban and rural areas. Reliability and validity analysis was conducted on the IIFAS. The receiver operating characteristic (ROC) of the IIFAS was assessed against mother's intent to breastfeed. RESULTS The mean ± SD of the total IIFAS score of the overall sample was 64.0 ± 10.4. There were no significant differences in attitudes between urban (63.9 ± 10.5) and rural (64.4 ± 9.9) populations. There were significant differences in total IIFAS scores between women who intend to breastfeed (67.3 ± 8.3) and those who do not (51.6 ± 7.7), regardless of population region. The high value of the area under the curve (AUC) of the ROC (AUC = 0.92) demonstrates excellent ability of the IIFAS to predict intent to breastfeed. The internal consistency of the IIFAS was strong, with a Cronbach's alpha greater than .80 in the overall sample. CONCLUSION The IIFAS examined in this provincial population provides a valid and reliable assessment of maternal attitudes toward infant feeding. This tool could be used to identify mothers less likely to breastfeed and to inform health promotion programs.
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Affiliation(s)
- Laurie K Twells
- School of Pharmacy and Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada
| | - William K Midodzi
- Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada
| | - Valerie Ludlow
- Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada
| | - Janet Murphy-Goodridge
- Perinatal Program NL, Janeway Children's Health & Rehabilitation Centre, St John's, Newfoundland and Labrador, Canada
| | - Lorraine Burrage
- Perinatal Program NL, Janeway Children's Health & Rehabilitation Centre, St John's, Newfoundland and Labrador, Canada
| | - Nicole Gill
- Research and Evaluation, Newfoundland and Labrador Centre for Health Information, St John's, Newfoundland and Labrador, Canada
| | - Beth Halfyard
- Research and Evaluation, Newfoundland and Labrador Centre for Health Information, St John's, Newfoundland and Labrador, Canada
| | - Rebecca Schiff
- Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada
| | - Leigh Anne Newhook
- Janeway Pediatric Research Unit, Discipline of Pediatrics, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada
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Negin J, Coffman J, Vizintin P, Raynes-Greenow C. The influence of grandmothers on breastfeeding rates: a systematic review. BMC Pregnancy Childbirth 2016; 16:91. [PMID: 27121708 PMCID: PMC4847220 DOI: 10.1186/s12884-016-0880-5] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 04/19/2016] [Indexed: 11/30/2022] Open
Abstract
Background Exclusive breastfeeding for the first six months of an infant’s life has enormous potential to reduce mortality and morbidity. The older generation, particularly the infant’s grandmothers, play a central role in various aspects of pregnancy and child rearing decision-making within the family unit. This is particularly true in low- and middle-income countries where older women are seen as owners of traditional knowledge. Despite this, most health programs target the individual person most directly involved in the target behaviour – usually new mothers – without a commensurate understanding of who else influences those decisions. In this systematic review we aim to quantify the impact of the grandmother on influencing a mother’s breastfeeding practices. Methods We conducted a systematic review using Web of Science, Scopus, and Medline databases using search terms for grandmother and breastfeeding. Eligible studies reported on the duration of exclusive breastfeeding and included estimates of effect of a grandmother’s influence including whether or not the grandmother lived with the infant’s family, the grandmother’s education, and the grandmother’s attitudes towards and prior experience with breastfeeding. Results We identified 568 articles and, after review, 13 articles were assessed as meeting the selection criteria. They were conducted in both developed and developing countries and included cross-sectional surveys, prospective cohort studies and one randomised controlled trial. Eight studies examined the effects of attitudes or experiences of older generations with respect to breastfeeding and five of the eight found a significant positive impact on breastfeeding when grandmothers of the infants had had their own breastfeeding experience or were positively inclined towards breastfeeding, resulting in effects of between 1.6 to 12.4 times more likely to exclusively breastfeed or refrain from introducing solid foods. A Chinese study however found that highly educated grandmothers were associated with decreased exclusive breastfeeding. The majority of the studies were assessed to be of weak or moderate quality. Conclusions This review found evidence that demonstrates that grandmothers have the capacity to influence exclusive breastfeeding. Programs that seek to influence exclusive breastfeeding should include grandmothers in their interventions to achieve maximum impact.
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Affiliation(s)
- Joel Negin
- Sydney School of Public Health, University of Sydney, Edward Ford Building (A27), Sydney, NSW, 2006, Australia.
| | - Jenna Coffman
- Sydney School of Public Health, University of Sydney, Edward Ford Building (A27), Sydney, NSW, 2006, Australia
| | - Pavle Vizintin
- Sydney School of Public Health, University of Sydney, Edward Ford Building (A27), Sydney, NSW, 2006, Australia
| | - Camille Raynes-Greenow
- Sydney School of Public Health, University of Sydney, Edward Ford Building (A27), Sydney, NSW, 2006, Australia
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Leshi O, Samuel FO, O. Ajakaye M. Breastfeeding Knowledge, Attitude and Intention among Female Young Adults in Ibadan, Nigeria. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/ojn.2016.61002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Rozga MR, Kerver JM, Olson BH. Self-reported reasons for breastfeeding cessation among low-income women enrolled in a peer counseling breastfeeding support program. J Hum Lact 2015; 31:129-37; quiz 189-90. [PMID: 25158829 DOI: 10.1177/0890334414548070] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Peer counseling programs have demonstrated efficacy in improving breastfeeding rates in the low-income population, but there is little research concerning why women enrolled in these programs ultimately discontinue breastfeeding. OBJECTIVE This study aimed to describe the self-reported reasons for discontinuing breastfeeding among women who are receiving peer counseling support by participant characteristics and timing of discontinuation. METHODS This study is a secondary analysis of data collected from 7942 participants who discontinued breastfeeding while enrolled in a peer counseling breastfeeding support program from 2005 to 2011. Reasons for discontinuing breastfeeding were assessed in relation to participant characteristics and weaning age using chi-square analyses and Kruskall-Wallis analyses of variance. RESULTS The most common reasons reported for discontinuing breastfeeding were mother's preference (39%) and low milk supply (21%), although reasons differed by age of infant weaning (P < .001). Among participants who discontinued the earliest, the most commonly cited reasons were breastfeeding challenges [median duration (interquartile range), 4.7 (2.0, 13.4) weeks], followed by low milk supply [8.9 (4.6, 19.1) weeks] and mother's preference [12.9 (5.0, 25.7) weeks]. Women who were younger, were less educated, were non-Hispanic black, were unmarried, and had no prior breastfeeding experience were the most likely to discontinue breastfeeding due to mother's preference. CONCLUSION Peer counselors are in a unique position to offer breastfeeding education and encouragement and may be able to use evidence presented here to anticipate specified concerns either prenatally or postpartum, to prevent early breastfeeding discontinuation.
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Affiliation(s)
- Mary R Rozga
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA
| | - Jean M Kerver
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Beth H Olson
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
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Abstract
OBJECTIVES There is a dearth of information on the long-term maternal effects of breastfeeding. The objective of this study was to examine adherence to breastfeeding recommendations of exclusive breastfeeding for ≥4 months and continuation of breastfeeding for ≥1 year and maternal weight retention 6 years after delivery. METHODS Using data from the Infant Feeding Practices Study II (IFPS II), we categorized women by the degree to which they met breastfeeding recommendations. Mothers' self-reported weight 6 years after delivery (IFPS Year 6 Follow-Up) was compared with self-reported prepregnancy weight from IFPS II. Using linear regression models, adjusting for covariates, we examined associations between breastfeeding recommendation adherence and weight retention. RESULTS Of the 726 women in our study, 17.9% never breastfed. Among those who initiated breastfeeding, 29.0% breastfed exclusively for ≥4 months, and 20.3% breastfed exclusively for ≥4 months and continued breastfeeding for ≥12 months. Prepregnancy BMI modified the association between breastfeeding recommendation adherence and weight retention. Adjusting for covariates, we found no association between breastfeeding recommendations adherence and weight retention among normal and overweight mothers. Among obese mothers, there was a significant linear trend (P = .03), suggesting that those who fully adhered to breastfeeding recommendations retained less weight (-8.0 kg) than obese women who never breastfed. CONCLUSIONS This study suggests that improving adherence to breastfeeding recommendations may help reduce long-term maternal weight retention among obese mothers. Larger studies, with diverse populations and similar longitudinal designs, are needed to explore this relationship.
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Affiliation(s)
- Andrea J Sharma
- US Public Health Service Commissioned Corps, Atlanta, Georgia; Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and
| | - Deborah L Dee
- US Public Health Service Commissioned Corps, Atlanta, Georgia; Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and
| | - Samantha M Harden
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia
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Hayes DK, Mitchell KM, Donohoe-Mather C, Zaha RL, Melcher C, Fuddy LJ. Predictors of exclusive breastfeeding at least 8 weeks among Asian and Native Hawaiian or other Pacific Islander race subgroups in Hawaii, 2004-2008. Matern Child Health J 2014; 18:1215-23. [PMID: 24096640 PMCID: PMC4300954 DOI: 10.1007/s10995-013-1355-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Breastfeeding is nurturing, cost-effective, and beneficial for the health of mother and child. Babies receiving formula are sick more often and are at higher risk for childhood obesity, diabetes, asthma, and other conditions compared with breastfed children. National and international organizations recommend exclusive breastfeeding for 6 months. Exclusive breastfeeding in Asian and Native Hawaiian or Other Pacific Islander (NHOPI) subgroups is not well characterized. Data from the 2004-2008 Hawaii Pregnancy Risk Assessment Monitoring System, a population-based surveillance system on maternal behaviors and experiences before, during, and after pregnancy, were analyzed for 8,508 mothers with a recent live birth. We examined exclusive breastfeeding status for at least 8 weeks. We calculated prevalence risk ratios across maternal race groups accounting for maternal and socio-demographic characteristics. The overall estimate of exclusive breastfeeding for at least 8 weeks was 36.3%. After adjusting for maternal age, pre-pregnancy weight, cesarean delivery, return to work/school, and self-reported postpartum depressive symptoms, the racial differences in prevalence ratios for exclusive breastfeeding for each ethnic group compared to Whites were: Samoan (aPR = 0.54; 95% CI 0.43-0.69), Filipino (aPR = 0.58; 95% CI 0.53-0.63), Japanese (aPR = 0.58; 95% CI 0.52-0.65), Chinese (aPR = 0.64; 95% CI 0.58-0.70), Native Hawaiian (aPR = 0.67; 95% CI 0.61-0.72), Korean (aPR = 0.72; 95% CI 0.64-0.82), and Black (aPR = 0.79; 95% CI 0.65-0.96) compared to white mothers. Providers and community groups should be aware that just over one-third of mothers breastfeed exclusively at least 8 weeks with lower rates among Asian, NHOPI, and Black mothers. Culturally appropriate efforts to promote exclusive breastfeeding are recommended particularly among Asian subgroups that have high breastfeeding initiation rates that do not translate into high exclusivity rates.
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Affiliation(s)
- Donald K Hayes
- Family Health Services Division, Hawaii Department of Health, 1250 Punchbowl St, Room 216, Honolulu, HI, 96813, USA,
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Engaging Field-Based Professionals in a Qualitative Assessment of Barriers and Positive Contributors to Breastfeeding Using the Social Ecological Model. Matern Child Health J 2014; 19:6-16. [DOI: 10.1007/s10995-014-1488-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mbada CE, Olowookere AE, Faronbi JO, Oyinlola-Aromolaran FC, Faremi FA, Ogundele AO, Awotidebe TO, Ojo AA, Augustine OA. Knowledge, attitude and techniques of breastfeeding among Nigerian mothers from a semi-urban community. BMC Res Notes 2013; 6:552. [PMID: 24359943 PMCID: PMC3878086 DOI: 10.1186/1756-0500-6-552] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 12/18/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mothers' poor knowledge and negative attitude towards breastfeeding may influence practices and constitute barriers to optimizing the benefits of the baby-friendly initiative. This study assessed breastfeeding knowledge, attitude and techniques of postures, positioning, hold practice and latch-on among Nigerian mothers from a Semi-Urban community. METHODS Three hundred and eighty three consenting lactating mothers who have breastfed for 6 months and up to two years volunteered for this cross-sectional survey, yielding a response rate of 95.7%. A self-administered questionnaire that sought information on maternal socio-demographic variables, knowledge, attitudes and breastfeeding techniques of mothers was employed. RESULTS Based on cumulative breastfeeding knowledge and attitude scores, 71.3% of the respondents had good knowledge while 54.0% had positive attitude. Seventy one point three percent practiced advisable breastfeeding posture. Sitting on a chair to breastfeed was common (62.4%); and comfort of mother/baby (60.8%) and convenience (29.5%) were the main reasons for adopting breastfeeding positions. Cross-cradle hold (80.4%), football hold technique (13.3%), breast-to-baby (18.0%) and baby-to-breast latch-on (41.3%) were the common breastfeeding techniques. A majority of the respondents (75.7%) agreed that neck flexion, slight back flexion, arm support with pillow and foot rest was essential during breastfeeding. There was no significant association between breastfeeding posture practice and each of cumulative breastfeeding knowledge score levels (X2 = 0.044; p = 0.834) and attitude score levels (X2 = 0.700; p = 0.403). CONCLUSION Nigerian mothers demonstrated good knowledge and positive attitude towards breastfeeding. Most of the mothers practiced advisable breastfeeding postures, preferred sitting on a chair to breastfeed and utilized cross-cradle hold and baby-to-breast latch-on.
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Affiliation(s)
- Chidozie E Mbada
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile – Ife, Nigeria
| | | | - Joel O Faronbi
- Department of Nursing Sciences, Obafemi Awolowo University, Ile – Ife, Nigeria
| | | | - Funmilola A Faremi
- Department of Nursing Sciences, Obafemi Awolowo University, Ile – Ife, Nigeria
| | - Abiola O Ogundele
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile – Ife, Nigeria
| | - Taofeek O Awotidebe
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile – Ife, Nigeria
| | - Adepeju A Ojo
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile – Ife, Nigeria
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Abstract
OBJECTIVE To assess the extent to which women received contraceptive services within 90 days after birth at their first or subsequent visits and whether contraceptive provision was associated with optimal interpregnancy intervals. METHOD We linked California's 2008 Birth Statistical Master File with Medicaid databases to build a cohort of women aged 15-44 years who had given birth in 2008 and received publicly-funded health care services in the 18 months after their previous live birth (N=117,644). We determined whether provision of contraception within 90 days after birth was associated with optimal interpregnancy intervals when controlling for covariates. RESULT Only 41% (n=48,775) of women had a contraceptive claim within 90 days after birth. To avoid short interpregnancy intervals, 6 women would need to receive contraception to avoid one additional short interval (number needed to treat=6.38). Receipt of a contraceptive method, receiving contraception at the first clinic visit, and being seen by Medi-Cal and its family planning expansion program were significantly associated with avoidance of short interpregnancy intervals. Receiving contraception at the first postpartum clinic visit had an additional independent effect on avoiding short interpregnancy intervals when controlling for the other variables. Although foreign-born women had 47% higher odds of avoiding short interpregnancy intervals than U.S.-born women, women of Asian and Pacific Islander ethnicity had 24% lower odds of avoiding short interpregnancy intervals than white women. CONCLUSION Findings of this study suggest that closer attention to provision of postpartum contraception in publicly-funded programs has the potential to improve optimal interpregnancy intervals among low-income women. LEVEL OF EVIDENCE II.
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Ma X, Liu J, Smith M. WIC participation and breastfeeding in South Carolina: updates from PRAMS 2009-2010. Matern Child Health J 2013; 18:1271-9. [PMID: 24057992 DOI: 10.1007/s10995-013-1362-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Few studies examined breastfeeding initiation and duration among mothers who were eligible for the Women Infants Children (WIC) program and did not participate. This study is sought to understand the role of WIC participation and poverty level in breastfeeding initiation and duration in South Carolina. The data came from the 2009-2010 South Carolina Pregnancy Risk Assessment Monitoring System (unweighted N = 1,796). All participants were classified as WIC participants, income-eligible non-WIC participants, and income-ineligible non-WIC participants. Logistic regression models were used to analyze the association between breastfeeding initiation and WIC participation. The Kaplan-Meier method and Cox proportional hazards models were used to determine whether the continuation of breastfeeding and hazards of discontinuing breastfeeding differed by WIC participation groups. In South Carolina, two out of three women (67.2%) initiated breastfeeding. The breastfeeding initiation rate was higher among income-ineligible (84.0%) and income-eligible (78.9%) non-WIC participants than among WIC participants (55.5%). Compared to WIC participants, both income-ineligible [odds ratio (OR) = 2.1, 95% confidence interval (CI) 1.2-4.0] and income-eligible (OR = 2.6, 95% CI 1.1-4.3) non-WIC participants were more likely to initiate breastfeeding. Among mothers who already initiated breastfeeding, after adjusting covariates, the hazard ratios for weaning within 34 weeks postpartum were not significantly different by WIC participation groups. This study confirmed WIC participants were less likely to initiate breastfeeding. Once initiated, WIC participation did not significantly impact breastfeeding duration in the early postpartum period. Poverty status may not play an important role in explaining disparities in breastfeeding initiation between WIC and non-WIC participants.
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Affiliation(s)
- Xiaoguang Ma
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA,
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Furman LM, Banks EC, North AB. Breastfeeding among high-risk inner-city African-American mothers: a risky choice? Breastfeed Med 2013; 8:58-67. [PMID: 22823328 DOI: 10.1089/bfm.2012.0012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study identified barriers to breastfeeding among high-risk inner-city African-American mothers. SUBJECTS AND METHODS We used audiotaped focus groups moderated by an experienced International Board Certified Lactation Consultant, with recruitment supported by the community partner MomsFirst™ (Cleveland Department of Public Health, Cleveland, OH). Institutional Review Board approval and written informed consent were obtained. Notes-based analysis was conducted with use of a prior analytic structure called Factors Influencing Beliefs (FIBs), redefined with inclusion/exclusion criteria to address breastfeeding issues. RESULTS Three focus groups included 20 high-risk inner-city expectant and delivered mothers. Relevant FIBs domains were as follows: Risk Appraisal, Self Perception, Relationship Issues/Social Support, and Structural/Environmental Factors. Risk Appraisal themes included awareness of benefits, fear of pain, misconceptions, and lack of information. Self Perception themes included low self-efficacy with fear of social isolation and limited expression of positive self-esteem. Relationship Issues/Social Support themes included formula as a cultural norm, worries about breastfeeding in public, and challenging family relationships. Structural/Environmental Factors themes included negative postpartum hospital experiences and lack of support after going home. CONCLUSIONS Several findings have been previously reported, such as fear of pain with breastfeeding, but we identified new themes, including self-esteem and self-efficacy, and new concerns, for example, that large breasts would suffocate a breastfeeding infant. The FIBs analytic framework, as modified for breastfeeding issues, creates a context for future analysis and comparison of related studies and may be a useful tool to improve understanding of barriers to breastfeeding among high-risk inner-city women.
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Affiliation(s)
- Lydia M Furman
- Division of General Academic Pediatric and Adolescent Medicine, Department of Pediatrics, Rainbow Babies and Children’s Hospital,Cleveland, Ohio 44106, USA.
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Mutuli LA, Walingo MK, Othuon LA. Assessing Predictive Power of Psychosocial Factors on Breastfeeding Behavior of Mothers Attending Postnatal Clinics in Western Kenya. ACTA ACUST UNITED AC 2012. [DOI: 10.1177/1941406412450614] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This cross-sectional study aimed at determining predictive power of psychosocial factors influencing breastfeeding behavior of breastfeeding mothers. The study was conducted from April to August 2010 in Kakamega Central District within 4 postnatal clinics that were purposively sampled. Proportionate stratified technique was employed to obtain 230 respondents. A structured questionnaire was used to collect quantitative data where exploratory factor analysis tested dimensionality of questions, whereas skewness and kurtosis assessed normality of data. Structural equation modeling determined predictive power of latent variables. The model fitted data acceptably well, χ2 = 156, P < .001, Tucker–Lewis index = .93, comparative fit index = .95, root mean square error of approximation = .090, Hoelter’s critical N (0.01 = 230), with regard to breastfeeding behavior. Regression weights showed predictive power for maternal attitude (β = .38, P < .01), subjective norm (β = .25, P < .05), perceived behavioral control (β = .25, P < .05), and intention (β = .95, P < .001). This study provides information on a better approach for promoting optimal breastfeeding that will increase initiation, exclusivity, and breastfeeding continuation rates.
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Affiliation(s)
- Lucy Amanya Mutuli
- The Community Nutrition and Development Programme (LAM), Maseno University, Maseno, Kenya
- School of Public Health & Community Development (MKW), Maseno University, Maseno, Kenya
- Department of Educational Psychology (LAO), Maseno University, Maseno, Kenya
| | - Mary Khakoni Walingo
- The Community Nutrition and Development Programme (LAM), Maseno University, Maseno, Kenya
- School of Public Health & Community Development (MKW), Maseno University, Maseno, Kenya
- Department of Educational Psychology (LAO), Maseno University, Maseno, Kenya
| | - Lucas Ayado Othuon
- The Community Nutrition and Development Programme (LAM), Maseno University, Maseno, Kenya
- School of Public Health & Community Development (MKW), Maseno University, Maseno, Kenya
- Department of Educational Psychology (LAO), Maseno University, Maseno, Kenya
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Ludlow V, Newhook LA, Newhook JT, Bonia K, Goodridge JM, Twells L. How formula feeding mothers balance risks and define themselves as ‘good mothers’. HEALTH RISK & SOCIETY 2012. [DOI: 10.1080/13698575.2012.662635] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Tully KP, Ball HL. Trade-offs underlying maternal breastfeeding decisions: a conceptual model. MATERNAL AND CHILD NUTRITION 2011; 9:90-8. [PMID: 22188564 DOI: 10.1111/j.1740-8709.2011.00378.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This paper presents a new conceptual model that generates predictions about breastfeeding decisions and identifies interactions that affect outcomes. We offer a contextual approach to infant feeding that models multi-directional influences by expanding on the evolutionary parent-offspring conflict and situation-specific breastfeeding theories. The main hypothesis generated from our framework suggests that simultaneously addressing breastfeeding costs and benefits, in relation to how they are interpreted by mothers, will be most effective. Our approach focuses on contributors to the attitudes and commitment underlying breastfeeding outcomes, beginning in the prenatal period. We conclude that some maternal-offspring conflict is inherent with the dynamic infant feeding relationship. Guidance that anticipates and addresses family trade-offs over time can be incorporated into breastfeeding support for families.
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Affiliation(s)
- Kristin P Tully
- Carolina Consortium on Human Development, Duke University, Durham, North Carolina, USA.
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Brown A, Lee M. An exploration of the attitudes and experiences of mothers in the United Kingdom who chose to breastfeed exclusively for 6 months postpartum. Breastfeed Med 2011; 6:197-204. [PMID: 21657889 DOI: 10.1089/bfm.2010.0097] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Levels of exclusive breastfeeding are negligible in the United Kingdom despite World Health Organization recommendations to practice exclusive breastfeeding for the first 6 months postpartum. Although numerous studies have explored the reasons behind low levels of breastfeeding, few have examined the behaviors of women who do breastfeed successfully. However, understanding the influences upon the decision to breastfeed exclusively is important in supporting women to continue breastfeeding. METHODS In the current study, 33 women with an infant 6-12 months old who exclusively breastfed for the first 6 months postpartum took part in an interview to explore their motivation and experiences while breastfeeding. The interview explored issues such as sources of support, difficulties, and familial and peer behavior. RESULTS Mothers reported high levels of confidence and determination in their decision despite difficulties in reaching their goal and discussed a range of techniques they adopted to overcome issues faced. CONCLUSIONS Ingrained and strong beliefs that their choice of feeding method was the normal and healthiest way to feed an infant enabled mothers to overcome problems and continue breastfeeding.
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Affiliation(s)
- Amy Brown
- College of Human and Health Sciences, Swansea University, Swansea, United Kingdom.
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