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Temesgen K, Andarge E, Fikadu T, Bekele M, Chisha Y, Esubalew H, Toma TM. Early cessation of breastfeeding and the associated factors among mothers with children aged 2 to 3 years in rural Southern Ethiopia: a community-based cross-sectional study. BMC Nutr 2023; 9:22. [PMID: 36721185 PMCID: PMC9887840 DOI: 10.1186/s40795-023-00681-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/19/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Breast milk is the first natural food for babies. It has nutritional, immunological, developmental, psychological, societal and environmental advantages. Failing to feed children for twenty-four months has so many negative consequences to children. Though studies have well documented the duration of breast feeding in the first six months, the proportion of women completing the recommended duration and factors associated with it has not been well investigated in rural places of Ethiopia. Therefore, this study aims to fill this gap in evidence among mothers with children aged 2 to 3 years in Arba Minch Health and Demographic Surveillance Site in 2021 E.C. METHODS A community-based cross-sectional study was conducted in all kebeles of the surveillance site by employing multi-stage sampling technique. Descriptive statistics was done to summarize findings and binary logistics regression model was used to identify factors significantly associated with early breast-feeding cessation respectively. OR with its 95% CI was obtained to quantify the degree of association between explanatory variables and early breastfeeding cessation. RESULT The proportion of early cessations of breast feeding was 29.30% (25.02, 33.64%). Being from a household with no fathers 'education or primary education [AOR=0.22; 95%CI (0.07, 0.74)] and [AOR=0.30; 95%CI (0.12, 0.76)], farmer mothers [AOR=6.40; 95%CI: (1.38, 29.74)], birth interval of less than 2 years [AOR=2.07; 95%CI: (1.03, 4.16)], and with mothers' one or two to three antenatal care visits [AOR = 2.73; 95%CI: (1.27,5.88)] were factors significantly associated with early cessations of breast feeding. CONCLUSION AND RECOMMENDATION The proportion of early cessations of breast feeding was high. Father's education, being farmer, birth interval and ante natal care visit were significant factors. Health education about proper breast feeding practice and improving ante natal care attendance might improve premature cessation of breast feeding among women.
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Affiliation(s)
- Kidus Temesgen
- grid.442844.a0000 0000 9126 7261School of public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Eshetu Andarge
- grid.442844.a0000 0000 9126 7261School of public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia ,grid.1014.40000 0004 0367 2697College of Medicine and Public health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia Australia
| | - Teshale Fikadu
- grid.442844.a0000 0000 9126 7261School of public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia ,grid.411903.e0000 0001 2034 9160Department of nutrition and dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Muluken Bekele
- grid.442844.a0000 0000 9126 7261School of public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Yilma Chisha
- grid.442844.a0000 0000 9126 7261School of public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Habtamu Esubalew
- grid.442844.a0000 0000 9126 7261School of public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Temesgen Mohammed Toma
- Department of Public health, Arba Minch College of Health Science, Arba Minch, Ethiopia
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Early Cessation of Breastfeeding and Determinants: Time to Event Analysis. J Nutr Metab 2020; 2020:3819750. [PMID: 32399288 PMCID: PMC7210562 DOI: 10.1155/2020/3819750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 03/31/2020] [Indexed: 11/18/2022] Open
Abstract
Background The onset of breastfeeding has a high success rate in most countries, but the time for termination of breastfeeding varies between countries. Objective This survey was aimed to determine the effective factors on the early termination of breastfeeding. Methods This study was conducted in 2018, in Iran. About 410 mothers were enrolled in the study. All considered factors were evaluated as factors influencing the continuity of breastfeeding. Survival analysis was used to analyze data. Results The mean age of the mothers was equal to 29.48 ± 5.8 years. The frequency of termination of breastfeeding before the first 2 years was equal to 34%. The mean of breastfeeding duration was equal to 21.49 ± 5.3 months. The percentage of infants who had been breastfed for 24 months was equal to 65.8%. An infant's birth weight (2500-4000 gr) (hazard ratio: 0.54), neonatal birth order (hazard ratio: 0.69), neonatal pathologic jaundice (hazard ratio: 1.52), starting time of using complementary food (hazard ratio: 2.45), using pacifier (hazard ratio: 2.82), and the status of using artificial milk (hazard ratio: 3.29) were significantly associated with cessation of breastfeeding before 24 months of age. The probability of termination of breastfeeding at 6, 12, 18, and 24 months of age was reported by 6%, 8%, 15%, and 34%, respectively. Conclusions There were notifiable variations in breastfeeding rates both in national and international levels. Nevertheless, in this study, the mean of breastfeeding duration was longer compared to a number of countries and previous national studies.
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Huang Y, Ouyang YQ, Redding SR. Previous breastfeeding experience and its influence on breastfeeding outcomes in subsequent births: A systematic review. Women Birth 2019; 32:303-309. [DOI: 10.1016/j.wombi.2018.09.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 08/31/2018] [Accepted: 09/10/2018] [Indexed: 10/28/2022]
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Villar M, Santa-Marina L, Murcia M, Amiano P, Gimeno S, Ballester F, Julvez J, Romaguera D, Fernández-Somoano A, Tardón A, Ibarluzea J. Social Factors Associated with Non-initiation and Cessation of Predominant Breastfeeding in a Mother-Child Cohort in Spain. Matern Child Health J 2019; 22:725-734. [PMID: 29349652 DOI: 10.1007/s10995-018-2441-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objective The aim of the study was to identify factors associated with non-initiation and cessation of predominant breastfeeding (PBF) in a mother-child cohort from Spain. Materials and Methods The analysis included 2195 mother-infant from birth to 14 months post- delivery recruited between 2004 and 2008. Maternal characteristics were collected during the pregnancy. Lactation data were obtained at 6 and 14 months after delivery. PBF was defined as intake of breast milk plus liquids like juices or water. The PBF cessation was calculated using the date that women started PBF and the date that she reported to start giving infant formula and/or food. The relationship between maternal variables and PBF initiation and cessation was modeled using logistic and Cox proportional hazards regression analysis. Results The prevalence of PBF at hospital discharge was 85.3, 53.4% at 3 months, 46.1% at 4 months and 7.2% at 6 month. Only two women continued PBF at 12 months and none at 14 months. The initiating of PBF was associated with higher levels of maternal education, being a first-time mother and worked in a non-manual occupation. Higher level of physical activity, not smoking and having a healthy BMI, were also positively associated with PBF initiation. PBF cessation was higher in young, obese women, who had had complications during the pregnancy, and who had lower levels of education and smoked. The employment status of women, in week 32 of pregnancy and also in month 14 post-delivery, determined likelihood of PBF cessation. Conclusions Healthier habits and education positively influenced PBF initiation and duration. Decrease in PBF duration rates in Spain can be interpreted in part as a consequence of women returning to work.
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Affiliation(s)
- Maria Villar
- Health Research Institute, Biodonostia, San Sebastián, Spain
| | - Loreto Santa-Marina
- Health Research Institute, Biodonostia, San Sebastián, Spain. .,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain. .,Public Health Division of Gipuzkoa, Basque Government, Avenida Navarra No 4, 20013, San Sebastián, Gipuzkoa, Spain.
| | - Mario Murcia
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Pilar Amiano
- Health Research Institute, Biodonostia, San Sebastián, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,Public Health Division of Gipuzkoa, Basque Government, Avenida Navarra No 4, 20013, San Sebastián, Gipuzkoa, Spain
| | | | - Ferran Ballester
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Jordi Julvez
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,ISGlobal Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Hospital del Mar Research Institute, Barcelona, Spain
| | - Dora Romaguera
- Research Unit, University Hospital Son Espases, Palma, Spain
| | | | - Adonina Tardón
- Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain
| | - Jesús Ibarluzea
- Health Research Institute, Biodonostia, San Sebastián, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,Public Health Division of Gipuzkoa, Basque Government, Avenida Navarra No 4, 20013, San Sebastián, Gipuzkoa, Spain
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5
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Hunegnaw MT, Gelaye KA, Ali BM. Factors associated with the time to cessation of breastfeeding among mothers who have index children aged two to three years in Debre Markos, northwest Ethiopia: a retrospective follow up study. BMC Pediatr 2018; 18:77. [PMID: 29471793 PMCID: PMC5822633 DOI: 10.1186/s12887-018-1012-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 01/28/2018] [Indexed: 12/03/2022] Open
Abstract
Background Breastfeeding of children, which needs to continue until two years and beyond, is one of the essential requirements for child survival. However, in Ethiopia there is scarcity of literatures on the duration of breastfeeding. Therefore, the aim of this study was to assess the rate of cessation of breastfeeding among mothers with index children aged 2 to 3 years, northwest Ethiopia. Methods A retrospective follow-up study was conducted at Debre Markos town from March 1, 2014 to March 30, 2016. A total of 500 mother-child pairs were selected using the systematic random sampling method by moving from house to house with an interval of three eligible houses. A structured questionnaire was used to collect data. The Cox regression model was employed to identify the predictors of breastfeeding cessation. Results The proportion of women breastfeeding until 2 years was 13.70 per 1000 person- months. HIV-positive mothers decreased the time of breastfeeding by 3.4 times compared to HIV-negative mothers (AHR = 3.41, 95% CI: 1.96, 5.94). Government employee mothers decreased the time of breastfeeding by 2.8 times compared to housewives (AHR = 2.8, 95% CI: 1.80, 4.40).Better education increased the time of breastfeeding (AHR = 0.45, 95% CI: 0.24, 0.58). Number of children, family income, and place of delivery were the other significant predictors of time to cessation of breastfeeding (p < 0.05). Conclusion In this study, the rate of cessation of breastfeeding was good. HIV negative mothers, government employment, number of children, place of delivery, and family monthly income were significant predictors to the time of breastfeeding cessation. Therefore, family planning and breastfeeding education in health institutions are essential to increase breastfeeding duration.
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Affiliation(s)
- Melkamu Tamir Hunegnaw
- Department of Human Nutrition, College of Medicine and Health Sciences, the University of Gondar, P.O. Box 196, Gondar, Ethiopia.
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, The University of Gondar, Gondar, Ethiopia
| | - Bekri Mohammed Ali
- Department of Human Nutrition, College of Medicine and Health Sciences, the University of Gondar, P.O. Box 196, Gondar, Ethiopia
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Wenzel D, Souza SBD. Fatores associados ao aleitamento materno nas diferentes Regiões do Brasil. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2014. [DOI: 10.1590/s1519-38292014000300005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objetivos: identificar os fatores que determinam o aleitamento materno nas diferentes regiões do país. Métodos: os dados fazem parte da Pesquisa de Orçamento Familiar de 2002-2003 realizada no Brasil. A amostra foi de 2958 crianças de zero a um ano, representativas da população nacional. Um modelo de regressão linear (GLM) com família binomial e ligação logarítmica foi criado para cada região, com um intervalo de confiança de 90%. Resultados: o aumento do número de moradores no domicilio é o principal fator negativo para a amamentação em todas as regiões do Brasil. Foram considerados como fatores desfavoráveis, no conjunto da amostra: mães com idade avançada, ter quatro ou mais moradores no domicílio, maior renda, maior escolaridade materna e uso de creche. Os fatores favoráveis foram: ter dois ou mais filhos menores de cinco anos em casa e mães de cor preta ou parda. Conclusões: as regiões que apresentaram um número maior de fatores desfavoráveis ao aleitamento materno foram Sudeste e Sul, sendo que o maior número de moradores no domicílio foi a pior situação para a efetivação da amamentação nas regiões do Brasil.
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Lutsiv O, Pullenayegum E, Foster G, Vera C, Giglia L, Chapman B, Fusch C, McDonald SD. Women's intentions to breastfeed: a population-based cohort study. BJOG 2013; 120:1490-8. [DOI: 10.1111/1471-0528.12376] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2013] [Indexed: 11/28/2022]
Affiliation(s)
- O Lutsiv
- Department of Epidemiology, Biostatistics and Occupational Health; McGill University; Montreal QC Canada
| | - E Pullenayegum
- Department of Clinical Epidemiology & Biostatistics; McMaster University; Hamilton ON Canada
- Centre for Evaluation of Medicines; St Joseph's Healthcare; Hamilton ON Canada
| | - G Foster
- Department of Clinical Epidemiology & Biostatistics; McMaster University; Hamilton ON Canada
- Biostatistics Unit; Father Sean O'Sullivan Research Centre; St Joseph's Healthcare; Hamilton ON Canada
| | - C Vera
- Departmento de Obstetricia y Ginecologia; Escuela de Medicina; Pontificia Universidad Catolica de Chile; Santiago Chile
| | - L Giglia
- Division of General Pediatrics; Department of Pediatrics; McMaster University; Hamilton ON Canada
| | - B Chapman
- Better Outcomes Registry and Network (BORN) Ontario (formerly OPSS); Ottawa ON Canada
| | - C Fusch
- Division of Neonatology; Department of Pediatrics; McMaster University; Hamilton ON Canada
| | - SD McDonald
- Department of Clinical Epidemiology & Biostatistics; McMaster University; Hamilton ON Canada
- Division of Maternal-Fetal Medicine; Departments of Obstetrics & Gynecology and Diagnostic Imaging; McMaster University; Hamilton ON Canada
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Costopoulou D, Vassiliadou I, Leondiadis L. Infant dietary exposure to dioxins and dioxin-like compounds in Greece. Food Chem Toxicol 2013; 59:316-24. [PMID: 23792085 DOI: 10.1016/j.fct.2013.06.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 06/04/2013] [Accepted: 06/10/2013] [Indexed: 10/26/2022]
Abstract
The dietary exposure of infants to polychlorinated dibenzo dioxins and furans (PCDD/Fs) and dioxin like polychlorinated biphenyls (dl-PCBs) is an issue of great social impact. We investigated for the first time the dietary intake of these compounds in infants living in Greece. We included in our study two age groups: 0-6 months, when infants are fed exclusively by human milk and/or formula milk, and 6 to 12 months, when solid food is introduced to nutrition. We took into consideration analytical results for PCDD/Fs and dl-PCBs concentrations in the most popular infant formulae in the Greek market, previous data for mother milk concentrations of PCDD/Fs and dl-PCBs from Greece, and finally analytical data for fat-containing food products from the Greek market. In the first study group, it was found than in infants exclusively fed by breast milk, the calculated sum of PCDD/Fs and dioxin-like PCBs (60.3-80.4 TEQ pg/kg body weight) was significantly higher than that of infants that consume a combination of human milk and formula (31.2-41.6 TEQ pg/kg body weight). In the second study group, separate daily intake estimations were performed for babies receiving human milk (estimated total daily intake 19.76-24.95 TEQ pg/kg body weight) and formula milk (estimated total daily intake 1.60-2.24 TEQ pg/kg body weight). The risks of this exposure should not be overestimated because nursing is restricted to a limited period of human life and besides, the potential consumption of higher levels of dioxin-like compounds is fully compensated by the significant benefits of breast-feeding.
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Affiliation(s)
- Danae Costopoulou
- Mass Spectrometry and Dioxin Analysis Laboratory, NCSR Demokritos, Athens, Greece
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Inoue M, Binns CW, Otsuka K, Jimba M, Matsubara M. Infant feeding practices and breastfeeding duration in Japan: A review. Int Breastfeed J 2012; 7:15. [PMID: 23098220 PMCID: PMC3514256 DOI: 10.1186/1746-4358-7-15] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 10/16/2012] [Indexed: 11/29/2022] Open
Abstract
The Japanese health system places great emphasis on healthy development. However, the prevalence of Exclusive Breastfeeding at one month postpartum between 1980 and 2005 has remained unchanged, fluctuating between 42% and 49%. At the same time, the Any Breastfeeding prevalence has gradually increased from about 80% to 95%. In 2010, the latest national breastfeeding report showed that 'exclusive' and 'any' breastfeeding rates have improved. However, as the World Health Organization (WHO) definition of breastfeeding practices was not used in this study or in other national surveys, it is difficult to interpret these latest results. While the Japanese government has launched several promotion projects, there have been few studies and reviews of risk factors that influence breastfeeding duration. The objectives of this review were to summarise the factors that have influenced the duration of breastfeeding in Japan to provide information relevant to breastfeeding promotion programs. A search of electronic databases in Japanese and English was undertaken up to 2011. The inclusion criteria for this review were studies that focused on infant feeding practices and targeted Japanese mothers, fathers, or health professionals, but excluded mothers' friends and peer groups. In total, 12 articles were selected for the final analysis. Smoking status, low birth weight of infants and maternal perceptions of insufficient breast milk supply were negative influences on breastfeeding duration, while support from husbands/partners is associated with continued breastfeeding. Some factors that have been found to be associated with breastfeeding in other countries, including maternal age, family income, maternal educational levels, and living with grandparents of infants have not been confirmed in Japan. While the national breastfeeding rates were higher than other countries of similar health status, inconsistent knowledge of breastfeeding benefits and inappropriate hospital practices remain in Japan may be associated with increased the use of infant formula and reduced breastfeeding duration. Most of the studies reviewed were cross-sectional in design, with only a limited number of cohort studies. Also many published studies used small sample sizes. Cohort studies of infant feeding practices with larger sample sizes are required to monitor trends in rates and risk factors for breastfeeding outcomes.
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Affiliation(s)
- Madoka Inoue
- School of Public Health, Curtin Health Innovation Research Institute, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia
| | - Colin W Binns
- School of Public Health, Curtin Health Innovation Research Institute, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia
| | - Keiko Otsuka
- Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Manami Matsubara
- School of Nursing, St. Mary College, 422, Tsubukuhonmachi, Kurume City, Fukuoka, Japan
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Wen LM, Simpson JM, Rissel C, Baur LA. Awareness of breastfeeding recommendations and duration of breastfeeding: findings from the Healthy Beginnings Trial. Breastfeed Med 2012; 7:223-9. [PMID: 22568472 PMCID: PMC3411340 DOI: 10.1089/bfm.2011.0052] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND To date, there are no studies examining the role of awareness of the World Health Organization's breastfeeding recommendation in determining mothers' breastfeeding decisions and practice. This study sought to determine whether awareness of the recommendation to breastfeed exclusively to age 6 months and intention to meet this recommendation are translated into breastfeeding practice. METHODS We analyzed longitudinal data from 201 first-time mothers who participated in the Healthy Beginnings Trial as a control group. The mothers' awareness of the breastfeeding recommendation and their intention to meet the recommendation were assessed at baseline antenatally, and breastfeeding duration was assessed at 6 and 12 months postpartum, through telephone and face-to-face interviews, respectively. Logistic regression and Cox regression analyses were conducted. RESULTS Mothers who knew the recommendation were 26% more likely to initiate breastfeeding (adjusted risk ratio [ARR] 1.26, 95% confidence interval [CI] 1.14 to 1.37, p=0.001) and 34% less likely to have stopped breastfeeding (adjusted hazard ratio 0.66, 95% CI 0.46 to 0.95, p=0.03) at 12 months than those who did not. Having an intention to meet the recommendation was weakly positively associated with the initiation of breastfeeding only (ARR 1.09, 95% CI 1.03 to 1.20, p=0.07). CONCLUSIONS Awareness of the breastfeeding recommendation to breastfeed exclusively for 6 months is an independent positive predictor of breastfeeding initiation and duration. Improving mothers' awareness of the recommendation and strengthening their intention to breastfeed could lead to increased breastfeeding initiation and duration.
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Affiliation(s)
- Li Ming Wen
- Sydney School of Public Health, University of Sydney, Sydney, Australia.
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Vassilaki M, Chatzi L, Bagkeris E, Papadopoulou E, Karachaliou M, Koutis A, Philalithis A, Kogevinas M. Smoking and caesarean deliveries: major negative predictors for breastfeeding in the mother-child cohort in Crete, Greece (Rhea study). MATERNAL AND CHILD NUTRITION 2012; 10:335-46. [PMID: 22642318 DOI: 10.1111/j.1740-8709.2012.00420.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Although benefits of breastfeeding have been widely promoted and accepted, exclusive breastfeeding for the first 6 months of life is far from the norm in many countries. In a prospective mother-child cohort study in Crete, Greece ('Rhea' study), we assessed the frequency of breastfeeding and its socio-demographic predictors. Information on breastfeeding was available for a period of 18 months post-partum for a cohort of 1181 mothers and their 1208 infants. The frequency of exclusive and predominant breastfeeding in the first month post-partum was 17.8% and 3.4%, respectively, with almost three-quarters of women (73.6%) ceasing any breastfeeding after 4 months post-partum. Women were less likely to initiate breastfeeding if they had a caesarean delivery (CD), whereas they were more likely to initiate breastfeeding if they had a higher education or gave birth to a private clinic. Among women breastfeeding, those who had a CD, were ex-smokers or smokers during pregnancy had a statistically significant shorter duration of breastfeeding, whereas higher education and being on leave from work were associated with a longer duration of breastfeeding. Study findings suggest suboptimal levels of exclusive and any breastfeeding and difficulty maintaining longer breastfeeding duration. CD and smoking are common in Greece and are strong negative predictors for breastfeeding initiation and/or duration, necessitating targeting women at risk early in the prenatal period so as to have a meaningful increase of breastfeeding practices in future cohorts of mothers.
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Affiliation(s)
- Maria Vassilaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain Municipal Institute for Medical Research (IMIM - Hospital del Mar), Barcelona, Spain CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain National School of Public Health, Aleksandras 196, Athens, Greece
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Pereira RSV, Oliveira MICD, Andrade CLTD, Santos Brito AD. [Factors associated with exclusive breastfeeding: the role of primary health care]. CAD SAUDE PUBLICA 2011; 26:2343-54. [PMID: 21243229 DOI: 10.1590/s0102-311x2010001200013] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Accepted: 08/18/2010] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to assess the association between promotion, protection, and support for breastfeeding in primary health care services and prevalence of exclusive breastfeeding in the first six months of life. A cross-sectional study was conducted in a representative sample of 1,029 mothers of infants younger than six months treated at primary health care facilities in the city of Rio de Janeiro, in southeastern Brazil. Prevalence ratios (PR) were estimated by Poisson regression. Prevalence of exclusive breastfeeding was 58.1%. Factors associated with increased prevalence of exclusive breastfeeding were: white skin color (PR = 1.20; 95% CI: 1.05-1.36); schooling (PR = 1.19; 95% CI: 1.05-1.35); marital status (married or in common-law marriage) (PR = 1.72; 95% IC:1.02-2.90); previous breastfeeding (PR = 1.27; 95% CI: 1.08-1,49); exclusive breastfeeding at the time of hospital discharge (PR = 2.01; 95% CI: 1.20-3.36); group support for the mother (PR = 1.14; 95% CI: 1.01-1.28); and orientation on breastfeeding (PR = 1.20; 95% CI: 1.08-1.33). Prevalence of exclusive breastfeeding decreased 17% per month in the infant's life. Support groups and orientation by primary health care for breastfeeding were associated with increased exclusive breastfeeding prevalence.
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Wenzel D, Ocaña-Riola R, Maroto-Navarro G, de Souza SB. A multilevel model for the study of breastfeeding determinants in Brazil. MATERNAL AND CHILD NUTRITION 2011; 6:318-27. [PMID: 21050386 DOI: 10.1111/j.1740-8709.2009.00206.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The benefits of breastfeeding for the children's health have been highlighted in many studies. The innovative aspect of the present study lies in its use of a multilevel model, a technique that has rarely been applied to studies on breastfeeding. The data reported were collected from a larger study, the Family Budget Survey-Pesquisa de Orçamentos Familiares, carried out between 2002 and 2003 in Brazil that involved a sample of 48 470 households. A representative national sample of 1477 infants aged 0-6 months was used. The statistical analysis was performed using a multilevel model, with two levels grouped by region. In Brazil, breastfeeding prevalence was 58%. The factors that bore a negative influence on breastfeeding were over four residents living in the same household [odds ratio (OR) = 0.68, 90% confidence interval (CI) = 0.51-0.89] and mothers aged 30 years or more (OR = 0.68, 90% CI = 0.53-0.89). The factors that positively influenced breastfeeding were the following: higher socio-economic levels (OR = 1.37, 90% CI = 1.01-1.88), families with over two infants under 5 years (OR = 1.25, 90% CI = 1.00-1.58) and being a resident in rural areas (OR = 1.25, 90% CI = 1.00-1.58). Although majority of the mothers was aware of the value of maternal milk and breastfed their babies, the prevalence of breastfeeding remains lower than the rate advised by the World Health Organization, and the number of residents living in the same household along with mothers aged 30 years or older were both factors associated with early cessation of infant breastfeeding before 6 months.
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Affiliation(s)
- Daniela Wenzel
- Department of Nutrition, Faculty of Public Health, University of São Paulo, São Paulo, São Paulo 02340-000, Brazil.
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Sparud-Lundin C, Wennergren M, Elfvin A, Berg M. Breastfeeding in women with type 1 diabetes: exploration of predictive factors. Diabetes Care 2011; 34:296-301. [PMID: 21270187 PMCID: PMC3024337 DOI: 10.2337/dc10-1916] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To identify predictive factors for initiation and maintenance of breastfeeding with a focus on mothers with type 1 diabetes. RESEARCH DESIGN AND METHODS This is a prospective observation survey, using a case-control design, comparing the outcomes of 108 mothers with type 1 diabetes with 104 mothers without diabetes that were matched for parity and gestational age. Mother and infant outcomes were collected from medical records and through telephone interviews 2 and 6 months after delivery. Predictive factors were calculated by logistic regression analyses. RESULTS Mothers with diabetes were less likely to partly or exclusively breastfeed their children at 2 months (OR 0.42 [95% CI 0.18-0.96], P = 0.041) and 6 months (0.50 [0.27-0.90], P = 0.022) than mothers without diabetes. On multivariable analysis, type 1 diabetes did not remain an independent predictive factor. Instead, higher education level and breastfeeding at discharge from hospital were predictive factors for breastfeeding at 2 months postpartum. These variables as well as delivery >37 weeks and early breastfeeding predicted breastfeeding 6 months postpartum. CONCLUSIONS Factors associated with maternal diabetes, such as problems with establishing breastfeeding in the early postpartum period, affects the likelihood of long-term breastfeeding.
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Affiliation(s)
- Carina Sparud-Lundin
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden.
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The prevalence and determinants of breast-feeding initiation and duration in a sample of women in Ireland. Public Health Nutr 2009; 13:760-70. [PMID: 19758484 DOI: 10.1017/s1368980009991522] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To assess breast-feeding initiation and prevalence from birth to 6 months in a sample of mothers in Dublin, and to determine the factors associated with breast-feeding initiation and 'any' breast-feeding at 6 weeks in a sample of Irish-national mothers. DESIGN This prospective cross-sectional study involved the recruitment of women during the antenatal period, with subsequent follow-up of mothers who delivered healthy, term singleton infants, at 6 weeks and 6 months postpartum. SETTING Participants were recruited from antenatal clinics in the Coombe Women and Infants University Hospital, Dublin. SUBJECTS In all, 401 Irish-national and forty-nine non-Irish-national mothers met the criteria for inclusion in the present study. RESULTS Breast-feeding initiation rates of the Irish-national and non-Irish-nationals were 47% and 79.6%, respectively. Factors that were significantly (P = 0.000) associated with both breast-feeding initiation and 'any' breast-feeding at 6 weeks included mothers who were >or=35 years, educated to third level, reported positive postnatal encouragement to breast-feed from their partners and had a positive antenatal intention to breast-feed. The maternal negative perception that breast-feeding is an embarrassing way to feed an infant was demonstrated as a major barrier to initiation. CONCLUSIONS Breast-feeding initiation and prevalence rates of the Irish-national population remain low and lag considerably behind national and international targets. Inclusion of the partner in breast-feeding promotional initiatives during the antenatal period may be crucial to increase breast-feeding rates in Ireland. Public health campaigns that focus on increasing the social acceptability of breast-feeding may prove effective in addressing this cultural barrier.
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Abstract
PURPOSE OF REVIEW This review examines recent studies of the relationships between breastfeeding and the epidemiology of allergic diseases, especially atopic dermatitis in infants and asthma in early and later childhood. RECENT FINDINGS Results from observational birth cohort studies, case-control studies, and one cluster randomized intervention trial have generally failed to demonstrate a protective effect of breastfeeding on outcomes of atopic dermatitis, allergic sensitization, wheezing, or asthma. Difficulties in interpretation relate to the absence of nonbreastfed control or reference groups in some studies, meaning outcomes can only be compared between different durations of breastfeeding. Studies with a nonbreastfed control group suggest there is an increased risk for atopy and asthma associated with breastfeeding and that prolonged breastfeeding may eventually reduce this increased risk. The family history, sex of the child, and the presence of other risk factors for allergy and asthma also influence the outcome. SUMMARY Although breastfeeding is strongly recommended for its multiple benefits on child health, most recent studies do not confirm the 'conventional wisdom' that breastfeeding is protective against allergy and asthma. Early reduction in childhood wheezing may reflect protection from viral infections, but allergies and asthma at later ages may be increased.
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Abstract
Breast-feeding is the superior infant feeding method from birth, with research
consistently demonstrating its numerous short- and long-term health benefits for
both mother and infant. As a global recommendation the WHO advises that mothers
should exclusively breast-feed for the first 6-months of life, thus delaying the
introduction of solids during this time. Historically, Irish breast-feeding
initiation rates have remained strikingly low in comparison with international
data and there has been little improvement in breast-feeding duration rates.
There is wide geographical variation in terms of breast-feeding initiation both
internationally and in Ireland. Some of these differences in breast-feeding
rates may be associated with differing socio-economic characteristics. A recent
cross-sectional prospective study of 561 pregnant women attending a Dublin
hospital and followed from the antenatal period to 6 months post partum has
found that 47% of the Irish-national mothers initiated
breast-feeding, while only 24% were still offering
‘any’ breast milk to their infants at 6 weeks.
Mothers' positive antenatal feeding intention to breast-feed is
indicated as one of the most important independent determinants of initiation
and ‘any’ breast-feeding at 6 weeks, suggesting that the
antenatal period should be targeted as an effective time to influence and affect
mothers' attitudes and beliefs pertaining to breast-feeding. These
results suggest that the ‘cultural’ barrier towards
breast-feeding appears to still prevail in Ireland and consequently an
environment that enables women to breast-feed is far from being achieved.
Undoubtedly, a shift towards a more positive and accepting breast-feeding
culture is required if national breast-feeding rates are to improve.
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