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Vehling L, Chan D, McGavock J, Becker AB, Subbarao P, Moraes TJ, Mandhane PJ, Turvey SE, Lefebvre DL, Sears MR, Azad MB. Exclusive breastfeeding in hospital predicts longer breastfeeding duration in Canada: Implications for health equity. Birth 2018; 45:440-449. [PMID: 29498088 DOI: 10.1111/birt.12345] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/26/2018] [Accepted: 01/29/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Breastfeeding has many established health benefits for women and children. We examined the association between maternal education, newborn feeding in hospital, and long-term breastfeeding duration. METHODS We studied 3195 Canadian mother-infant dyads in the CHILD pregnancy cohort. Newborn feeding was documented from hospital records. Caregivers reported sociodemographic factors and infant feeding at 3, 6, 12, 18, and 24 months. RESULTS Overall, 97% of newborns initiated breastfeeding and 74% were exclusively breastfed in hospital. Exclusively breastfed newborns were ultimately breastfed longer compared with those who received formula supplementation during their hospital stay (median 11.0 vs 7.0 months, P < .001). After controlling for maternal age, ethnicity, birth mode, and gestational age, exclusively breastfed newborns had a 21% reduced risk of breastfeeding cessation (HR = 0.79, 0.71-0.87). This effect was strongest among women without a postsecondary education (HR = 0.65, 0.53-0.79). DISCUSSION Exclusive breastfeeding in hospital is associated with longer breastfeeding duration, particularly among women of lower socioeconomic status. Initiatives that support exclusive breastfeeding of newborns in hospital could improve long-term breastfeeding rates and help reduce health inequities arising in early life.
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Affiliation(s)
- Lorena Vehling
- Department of Pediatrics and Child Health, Health Sciences Centre, CE-208 Children's Hospital, University of Manitoba, Winnipeg, MB, Canada.,Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.,Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Deborah Chan
- Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.,College of Nursing, University of Manitoba, Winnipeg, MB, Canada
| | - Jon McGavock
- Department of Pediatrics and Child Health, Health Sciences Centre, CE-208 Children's Hospital, University of Manitoba, Winnipeg, MB, Canada.,Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Allan B Becker
- Department of Pediatrics and Child Health, Health Sciences Centre, CE-208 Children's Hospital, University of Manitoba, Winnipeg, MB, Canada.,Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Padmaja Subbarao
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Theo J Moraes
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | | | - Stuart E Turvey
- Department of Pediatrics, Child & Family Research Institute and BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Diana L Lefebvre
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Malcolm R Sears
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Meghan B Azad
- Department of Pediatrics and Child Health, Health Sciences Centre, CE-208 Children's Hospital, University of Manitoba, Winnipeg, MB, Canada.,Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
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Ricci G, Cipriani F. Which advises for primary food allergy prevention in normal or high-risk infant? Pediatr Allergy Immunol 2016; 27:774-778. [PMID: 27612289 DOI: 10.1111/pai.12652] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2016] [Indexed: 11/28/2022]
Abstract
In the last decades, international guidelines proposed different strategies of complementary foods introduction during weaning to prevent allergy. Avoidance measures, such as late introduction of allergenic foods, failed to show a significant preventive effect towards allergy. Recently, prospective randomized controlled studies suggested that the early introduction of solid foods - rather than the late introduction - could be a strategy to prevent allergic sensitization and food allergy. However, at today clear evidence of effectiveness and safety of early introduction are not yet available to recommend a radical change in the current clinical practice. A realistic advice for the general population could be to begin the weaning at 4-5 months with the progressive introduction of different foods. The advices for introduction of solid foods during weaning should also take in consideration the global development of child to chose the better timing of introduction of foods.
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Affiliation(s)
- Giampaolo Ricci
- Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Francesca Cipriani
- Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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