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Little EE. Allomilk: An Anthropogeny-Based Framework for Human Milk as a Climate Solution. J Hum Lact 2024:8903344241271344. [PMID: 39229875 DOI: 10.1177/08903344241271344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
Climate change is an urgent threat to perinatal and infant health, with the greatest effects of climate change exposures being felt disproportionately by global majority communities who have been most harmed by systems of oppression. Human milk feeding is one recognized solution to bolster climate resilience. Yet, policies and practices to support human milk as a climate solution are inconsistent and under-prioritized, which is unsurprising given the lack of alignment between human history and current cultural context with regard to lactation and human milk access. This paper presents a new framework on lactation as a climate solution, which is unique in its incorporation of the critical history of cooperative breastfeeding in our species. Rooted in anthropogeny, or the study of human origins, and antiracist principles of lactation, the Allomilk Framework highlights five concepts of the ideal application of human milk as a climate solution, bridging ancient allonursing with present-day lactation and human milk access. These ideal applications-and the proposed development of measures to operationalize them-will advance the field through a shared understanding of the qualities that should be prioritized in the assessment of policies and practices at the intersection of climate resilience and human milk access. Application of the Allomilk Framework to assess and design future policies and practices will advance the field by increasing the potential for climate resilience and climate mitigation while working with-rather than against-the importance of cooperative breastfeeding in human history.
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Ross A, MacPherson C, Baker L, Kim S, Njau G, Williams AD. Impact of Breastfeeding Barriers on Racial/Ethnic Disparities in Breastfeeding Outcomes in North Dakota. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01943-z. [PMID: 38393463 DOI: 10.1007/s40615-024-01943-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE Exclusive breastfeeding is recommended for the first 6 months of life, but there are racial/ethnic disparities in meeting this recommendation. METHODS 2017-2020 North Dakota Pregnancy Risk Assessment Monitoring System (weighted N = 11,754) data were used to examine racial/ethnic differences in the association between self-reported breastfeeding barriers and breastfeeding duration. Breastfeeding duration was self-reported breastfeeding at 2 and 4 months, and number of weeks until breastfeeding cessation. Self-reported breastfeeding barriers were yes/no responses to 13 barriers (e.g., "difficulty latching," "household duties"). Logistic regression estimated odds ratios and 95% confidence intervals to determine if barriers accounted for breastfeeding disparities by race/ethnicity. Cox proportional hazard models estimated hazard ratios for stopping breastfeeding for American Indian and other race/ethnicity individuals, compared to White individuals. Models were adjusted for birthing parents' demographic and medical factors. RESULTS Logistic regression results suggest American Indian birthing parents had similar odds for breastfeeding duration (2-month duration: OR 0.94 (95%CI 0.50, 1.77); 4-month duration: OR 1.24 (95%CI 0.43, 3.62)) compared to White birthing parents, after accounting for breastfeeding barriers. Cox proportional hazard models suggest American Indian birthing parents had a lower hazard of stopping breastfeeding (HR 0.76 (95%CI 0.57, 0.99)) than White parents, after accounting for breastfeeding barriers. CONCLUSIONS Accounting for breastfeeding barriers eliminated observed disparities in breastfeeding outcomes between American Indian and White birthing parents. Targeted and culturally safe efforts to reduce barriers to breastfeeding are warranted to reduce racial/ethnic disparities in breastfeeding.
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Affiliation(s)
- Anna Ross
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave NW #2, Washington, DC, 20037, USA
| | - Cora MacPherson
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave NW #2, Washington, DC, 20037, USA
| | - Lannesse Baker
- University of North Dakota School of Medicine and Health Sciences, Room E166, 1301 North Columbia Road Stop 9037, Grand Forks, ND, 58202-9037, USA
| | - Soojung Kim
- Department of Communication, University of North Dakota, O'Kelly Hall Room 202, 221 Centennial Drive Stop 7169, Grand Forks, ND, 58202-7169, USA
| | - Grace Njau
- North Dakota Department of Health & Human Services, 600 E Boulevard Ave Dept 325, Bismarck, ND, 58505, USA
| | - Andrew D Williams
- University of North Dakota School of Medicine and Health Sciences, Room E166, 1301 North Columbia Road Stop 9037, Grand Forks, ND, 58202-9037, USA.
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Strong G, Gober M, Walker M. Speaking the Same Language: A Call for Standardized Lactation Terminology in the United States. J Hum Lact 2023; 39:121-131. [PMID: 36511175 DOI: 10.1177/08903344221131041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Genae Strong
- Loewenberg College of Nursing, University of Memphis, Memphis, TN, USA
| | - Merrilee Gober
- National Lactation Consultant Alliance, Inc, Atlanta, GA, USA
| | - Marsha Walker
- National Lactation Consultant Alliance, Inc, Atlanta, GA, USA
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Palmquist AEL, Tomori C, Tumlinson K, Fox C, Chung S, Quinn EA. Pandemic policies and breastfeeding: A cross-sectional study during the onset of COVID-19 in the United States. FRONTIERS IN SOCIOLOGY 2022; 7:958108. [PMID: 36405376 PMCID: PMC9669788 DOI: 10.3389/fsoc.2022.958108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
The United States is one of the few countries, and the only high-income country, that does not federally mandate protection of postpartum employment through paid postpartum maternity and family leave policies. At the onset of the COVID-19 pandemic in the U.S., stay-at-home orders were implemented nationally, creating a natural experiment in which to document the effects of de facto paid leave on infant feeding practices in the first postpartum year. The purpose of this cross-sectional, mixed-methods study was to describe infant and young child feeding intentions, practices, decision-making, and experiences during the first wave of the COVID-19 pandemic in the U.S. Quantitative and qualitative data were collected March 27-May 31, 2020 via online survey among a convenience sample of respondents, ages 18 years and older, who were currently feeding a child 2 years of age or younger, yielding 1,437 eligible responses. Nearly all (97%) respondents indicated an intention to feed their infant exclusively with human milk in the first 6 months. A majority of respondents who were breastfeeding (66%) reported no change in breastfeeding frequency after the implementation of COVID-19 stay-at-home orders. However, thirty-one percent indicated that they breastfed more frequently due to stay-at-home orders and delayed plans to wean their infant or young child. Key themes drawn from the qualitative data were: emerging knowledge and perceptions of the relationship between COVID-19 and breastfeeding, perceptions of immune factors in human milk, and the social construction of COVID-19 and infant and young child feeding perceptions and knowledge. There were immediate positive effects of stay-at-home policies on human milk feeding practices, even during a time of considerable uncertainty about the safety of breastfeeding and the transmissibility of SARS-CoV-2 via human milk, constrained access to health care services and COVID-19 testing, and no effective COVID-19 vaccines. Federally mandated paid postpartum and family leave are essential to achieving more equitable lactation outcomes.
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Affiliation(s)
- Aunchalee E. L. Palmquist
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Cecília Tomori
- Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, MD, United States
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Katherine Tumlinson
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Carolyn Fox
- Department of Anthropology, Washington University in St. Louis, St. Louis, MO, United States
| | - Stephanie Chung
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - E. A. Quinn
- Department of Anthropology, Washington University in St. Louis, St. Louis, MO, United States
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Nidey N, Hoyt-Austin A, Chen MJ, Bentley B, Tabb KM, Anyigbo C, Wilder C, Terplan M, McAllister JM, Wexelblatt SL, Murnan A, Kair LR. Racial Inequities in Breastfeeding Counseling Among Pregnant People Who Use Cannabis. Obstet Gynecol 2022; 140:878-881. [PMID: 36201781 PMCID: PMC9588485 DOI: 10.1097/aog.0000000000004834] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/07/2022] [Indexed: 11/06/2022]
Abstract
We examined how breastfeeding advice in the context of cannabis use differed by race and ethnicity. Data from the 2017-2018 PRAMS (Pregnancy Risk Assessment Monitoring System) survey were used to assess differences in breastfeeding guidance related to cannabis use among 1,213 individuals who self-reported cannabis use 3 months before or during pregnancy. A multivariable logistic regression model was specified to examine the extent to which the odds of receiving prenatal advice against breastfeeding if using cannabis differed by self-reported race and ethnicity. We found that non-Hispanic Black people were four times more likely than non-Hispanic White people to be advised against breastfeeding if using cannabis (adjusted odds ratio 4.1, 95% CI 2.1-8.2). Pregnant non-Hispanic Black people were disproportionately advised not to breastfeed if using cannabis.
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Affiliation(s)
- Nichole Nidey
- Division of Biostatistics and Epidemiology and the Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital, the Department of Pediatrics and the Center for Addiction Research, University of Cincinnati College of Medicine, the Division of General and Community Pediatrics and the Perinatal Institute, Cincinnati Children's Hospital Medical Center, and the College of Nursing, University of Cincinnati, Cincinnati, Ohio; the Department of Pediatrics and the Department of Obstetrics and Gynecology, University of California, Davis, Davis, California; the School of Social Work, University of Illinois at Urbana-Champaign, Champaign, Illinois; and the Friends Research Institute, Baltimore, Maryland
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Zhang Q, Li K, Wouk K, Lamichhane R, Guthrie J. Prenatal Perception of WIC Breastfeeding Recommendations Predicts Breastfeeding Exclusivity and Duration in the Infants' First Year. J Nutr 2022; 152:2931-2940. [PMID: 36149318 PMCID: PMC9839998 DOI: 10.1093/jn/nxac221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/01/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Pregnant participants who perceived that the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) recommends breastfeeding only were more likely to have better early breastfeeding outcomes. OBJECTIVES Our objective was to examine the association between prenatal perception of WIC's breastfeeding recommendations and breastfeeding duration through the first year of infant life. METHODS This observational study used a national longitudinal sample of 1594 pregnant participants in the WIC Infant and Toddler Feeding Practices Study-2 in 2013. Four measures of breastfeeding duration were used: 1) a discrete measure of exclusive breastfeeding through 5 mo; 2) a continuous measure of exclusive breastfeeding (in days up to 7 mo); 3) a discrete measure of any breastfeeding through 11 mo; and 4) a continuous measure of any breastfeeding (in days up to 13 mo). The primary explanatory variable was the participant's prenatal perception of whether WIC recommended breastfeeding only. The univariate analyses of time to breastfeeding cessation were performed using Kaplan-Meier curves. The Cox regression model was adopted to estimate the likelihood of breastfeeding outcomes over time. All analyses accounted for complex survey design effects. RESULTS Compared with their peers who perceived WIC to recommend formula only or both breastfeeding and formula equally, participants who perceived WIC as recommending breastfeeding only were less likely to stop exclusive breastfeeding through 5 mo (HR = 0.83; 95% CI: 0.69, 0.99) or to stop any breastfeeding through 11 mo (HR = 0.80; 95% CI: 0.69, 0.92), without controlling for prenatal infant feeding intentions. Similar patterns were observed in the 2 continuous measures, as they were also less likely to stop exclusive breastfeeding by 7 mo (HR = 0.78; 95% CI: 0.69, 0.90) or to stop any breastfeeding by 13 mo (HR = 0.82; 95% CI: 0.71, 0.95). CONCLUSIONS Prenatal perception of WIC's breastfeeding recommendation can be a useful predictor of breastfeeding duration in WIC participants.
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Affiliation(s)
- Qi Zhang
- Address correspondence to QZ (e-mail: )
| | - Kelin Li
- Department of Sociology, California State University-Dominguez Hills, Carson, CA, USA
| | - Kathryn Wouk
- Pacific Institute for Research and Evaluation, Chapel Hill, NC, USA
| | - Rajan Lamichhane
- Department of Clinical and Translational Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Joanne Guthrie
- US Department of Agriculture/Economic Research Service, Washington, DC, USA
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Schindler-Ruwisch J, Aluc A. The Relationship of Race and Ethnicity to the Perception of Visual Images of Breastfeeding Mothers. Breastfeed Med 2022; 17:459-465. [PMID: 35180357 DOI: 10.1089/bfm.2021.0296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introduction: Breastfeeding biases, both implicit and explicit, can impact perceived norms of breastfeeding appropriateness in a variety of contexts and influence breastfeeding behaviors. The purpose of this research was to uncover breastfeeding biases, norms, patterns, and perceptions that potentially affect the decision to initiate or sustain breastfeeding and investigate how a diverse group of women perceive images of racially/ethnically similar and different women breastfeeding. Materials and Methods: Using a panel of nationally representative respondents (oversampling key racial/ethnic subpopulations), an online mixed-methods survey was completed by a sample of women who were primary caregivers of children under 3 in November 2020. The survey included diverse images of individuals breastfeeding in various settings and respondents were asked to generate word associations and indicate perceived appropriateness and ease of breastfeeding for each image in direct, timed comparisons. Results: Respondents (N = 144) racial/ethnic identity influenced perceptions of breastfeeding ease and norms surrounding breastfeeding in public settings or in front of others. Furthermore, respondents perceived breastfeeding to be more or less appropriate based on racial identity, in particular, respondents of color seeing breastfeeding as less appropriate among racially and ethnically similar others. Conclusions: While respondents readily acknowledged the health benefits of breastfeeding and were generally supportive of images of others breastfeeding, biases about breastfeeding in public or in front of others and by race/ethnicity were apparent. Community, policy, and societal interventions are necessary to dismantle breastfeeding biases that may inequitably impact mothers' and infants' health.
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Affiliation(s)
- Jennifer Schindler-Ruwisch
- Marion Peckham Egan School of Nursing and Health Studies, Public Health, Fairfield University, Fairfield, Connecticut, USA
| | - Aika Aluc
- Milken Institute School of Public Health, Department of Prevention and Community Health, The George Washington University, Washington, District of Columbia, USA
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Zhang Q, Lamichhane R, Wouk K, Guthrie J, Li K. Prenatal perception of breastfeeding recommendations predicts early breastfeeding outcomes of participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Am J Clin Nutr 2021; 114:1949-1959. [PMID: 34302329 PMCID: PMC8634569 DOI: 10.1093/ajcn/nqab268] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 07/22/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Prenatal psychosocial factors predict breastfeeding practices but are not assessed in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). OBJECTIVES This study examined how prenatal perceptions of WIC's breastfeeding recommendations were associated with early breastfeeding outcomes. METHODS This study used longitudinal data from a national sample of 2053 pregnant participants in the WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2) in 2013, the only national data assessing prenatal perceptions of WIC's breastfeeding recommendations. Early breastfeeding outcomes included breastfeeding initiation, breast milk first fed after birth, breastfeeding in the first hour, breast milk first fed after leaving the hospital, and breastfeeding status at the first and third months. The primary predictor was the participant's prenatal perception of whether WIC recommended breastfeeding only or not. Log-binomial regression was used with adjustment for socio-demographics, previous breastfeeding, WIC participation, breastfeeding support, and infant feeding intentions (IFI). RESULTS Without controlling for IFI, the perception of WIC recommending breastfeeding only predicted breastfeeding outcomes positively. The risk ratio (RR) associated with prenatal perceptions varied from 1.14 (95% CI: 1.03, 1.25; P = 0.008) for breastfeeding in the first hour, to 1.27 (95% CI: 1.12, 1.43; P < 0.001) for breast milk first fed after leaving hospital, to 1.66 (95% CI: 1.35, 2.04; P < 0.001) for 3-mo breastfeeding only. After controlling for IFI, the RRs were 1.13 (95% CI: 1.02, 1.24; P = 0.017) for breastfeeding in the first hour, 1.20 (95% CI: 1.06, 1.35; P = 0.004) for breast milk first fed after leaving hospital, and 1.49 (95% CI: 1.21, 1.84; P < 0.001) for 3-mo breastfeeding only, suggesting that prenatal perception was independently associated with breastfeeding outcomes. CONCLUSIONS Prenatal perception of WIC's breastfeeding recommendations can be regarded as a new psychosocial predictor of breastfeeding and a possible target for future intervention.
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Affiliation(s)
- Qi Zhang
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA, USA
| | - Rajan Lamichhane
- Department of Clinical and Translational Sciences, Joan C Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Kathryn Wouk
- Carolina Global Breastfeeding Institute, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | | | - Kelin Li
- Department of Sociology, California State University-Dominguez Hills, Carson, CA, USA
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