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Quigley MA, Harrison S, Levene I, McLeish J, Buchanan P, Alderdice F. Breastfeeding rates in England during the Covid-19 pandemic and the previous decade: Analysis of national surveys and routine data. PLoS One 2023; 18:e0291907. [PMID: 37819882 PMCID: PMC10566678 DOI: 10.1371/journal.pone.0291907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 09/07/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Few studies have compared breastfeeding rates before and during the pandemic using comparable data across time. We used data from two national maternity surveys (NMS) to compare breastfeeding rates in England before and during the pandemic. METHODS Analysis was conducted using the NMS from 2018 (pre-pandemic; n = 4,509) and 2020 (during the pandemic; n = 4,611). The prevalence of breastfeeding initiation, and 'any' breastfeeding and exclusive breastfeeding (EBF) at 6 weeks and 6 months were compared between these surveys. Data were interpreted in the context of underlying trends in these prevalences from previous NMS (from 2010 and 2014), and annual routine data for England (from 2009-10 to 2020-21). Modified Poisson regression was used to estimate adjusted risk ratios (aRR) for the effect of birth during the pandemic (2020 versus 2018) on breastfeeding, with adjustment for sociodemographic and birth-related factors. RESULTS Breastfeeding initiation and any breastfeeding at 6 weeks remained relatively constant in the NMS and the routine data. Birth during the pandemic was associated with a 3 percentage point decrease in EBF at 6 weeks in the NMS (aRR 0.92, 95%CI: 0.87, 0.98 for pandemic versus pre-pandemic), but a smaller decrease in the routine data. Birth during the pandemic was associated with a 3 percentage point increase in any breastfeeding at 6 months in the NMS (aRR 1.05, 95%CI: 1.00, 1.10). Breastfeeding varied across different groups of women in the NMS (i.e. marked inequalities), but the small changes observed between the pandemic and pre-pandemic NMS were broadly similar across the sociodemographic and birth-related factors examined (i.e. no change in inequalities). CONCLUSION Breastfeeding initiation and any breastfeeding at 6 weeks in England were unaffected by the pandemic, and the persistent inequalities in breastfeeding did not widen. Services should aim to reduce these inequalities in breastfeeding which have been documented since the 1970s.
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Affiliation(s)
- Maria A. Quigley
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Sian Harrison
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Ilana Levene
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Jenny McLeish
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Phyll Buchanan
- Breastfeeding Supporter, The Breastfeeding Network, Paisley, United Kingdom
| | - Fiona Alderdice
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Guajardo‐Villar A, Demiguel V, Smaïli S, Boudet‐Berquier J, Pilkington H, Blondel B, Salanave B, Regnault N, Pelat C. Trends and disparities in breastfeeding initiation in France between 2010 and 2016: Results from the French National Perinatal Surveys. MATERNAL & CHILD NUTRITION 2022; 18:e13410. [PMID: 35909344 PMCID: PMC9480949 DOI: 10.1111/mcn.13410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/17/2022] [Accepted: 07/07/2022] [Indexed: 11/29/2022]
Abstract
Breastfeeding (BF) initiation rates in French maternity units are among the lowest in Europe. After increasing for several years, they decreased between 2010 and 2016, although several maternal characteristics known to be positively associated with BF in France were more frequent. We aimed to (1) quantify adjusted trends in BF initiation rates between 2010 and 2016; (2) examine associations between BF initiation rates and newborn, maternal, maternity unit, and department‐level characteristics. Using data from the 2010 (n = 12,224) and 2016 (n = 11,089) French National Perinatal Surveys, we analysed BF initiation (exclusive, mixed, and any) through a succession of six mixed‐effect multinomial regression models, progressively adding adjustment covariates. Adjusted exclusive and any BF initiation rates decreased by 9.6 and 4.5 points, respectively, versus by 7.7 and 1.8 points, respectively, in the crude analysis. In both years, adjusted exclusive and any BF initiation rates were lowest in the following categories of mothers: low education level, single, high body mass index and multiple or premature births. Exclusive BF initiation decreased most in primiparous mothers, those with the lowest household income, mothers that had a vaginal delivery, women born in an African country and those who delivered in a maternity unit without Baby‐Friendly Hospital Initiative designation. The 2010–2016 decrease in BF initiation rates in France cannot be explained by changes in mothers' characteristics; quite the opposite, adjustment increased its magnitude. Additional efforts should be put in place to understand why this decrease is particularly sharp in some subgroups of mothers. While some maternal characteristics previously known to be positively associated with breastfeeding (BF) in France were more frequent in 2016 than 2010, any BF initiation rate in maternity units in France decreased by 2 points (from 68.7% to 66.7%), and exclusive BF by 8 points (from 60.3% to 52.2%). Even greater decreases (4.5 and 9.6 points, respectively) were observed after adjusting for the characteristics of mothers, newborns, maternity units, and departments. Between 2010 and 2016, the largest decreases in adjusted exclusive BF initiation rates were observed in primiparous mothers, those with the lowest household income, mothers that had a vaginal delivery, women born in an African country and those who delivered in a maternity unit without Baby‐Friendly Hospital Initiative designation.
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Affiliation(s)
- Andrea Guajardo‐Villar
- Data Support, Processing and Analysis Department (DATA), Santé publique France French National Public Health Agency Saint‐Maurice France
| | - Virginie Demiguel
- Non‐Communicable Diseases and Trauma Department (DMNTT), Santé publique France French National Public Health Agency Saint‐Denis France
| | - Sabira Smaïli
- Data Support, Processing and Analysis Department (DATA), Santé publique France French National Public Health Agency Saint‐Maurice France
| | - Julie Boudet‐Berquier
- Non‐Communicable Diseases and Trauma Department (DMNTT), Santé publique France French National Public Health Agency Saint‐Denis France
| | - Hugo Pilkington
- Département de Géographie, UMR7533 Ladyss Université Paris 8 Vincennes‐Saint‐Denis Saint‐Denis France
| | - Beatrice Blondel
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center of Research in Epidemiology and Statistics (CRESS), INSERM Université de Paris Cité Paris France
| | - Benoit Salanave
- Non‐Communicable Diseases and Trauma Department (DMNTT), Santé publique France French National Public Health Agency Saint‐Denis France
| | - Nolwenn Regnault
- Non‐Communicable Diseases and Trauma Department (DMNTT), Santé publique France French National Public Health Agency Saint‐Denis France
| | - Camille Pelat
- Data Support, Processing and Analysis Department (DATA), Santé publique France French National Public Health Agency Saint‐Maurice France
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Cozma-Petruţ A, Filip L, Banc R, Mîrza O, Gavrilaş L, Ciobârcă D, Badiu-Tişa I, Hegheş SC, Popa CO, Miere D. Breastfeeding Practices and Determinant Factors of Exclusive Breastfeeding among Mothers of Children Aged 0-23 Months in Northwestern Romania. Nutrients 2021; 13:3998. [PMID: 34836253 PMCID: PMC8623634 DOI: 10.3390/nu13113998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 11/26/2022] Open
Abstract
In terms of breastfeeding (BF) practices in Romania, there is a lack of up-to-date data. The aim of the present study was to assess current BF practices, and to investigate the factors associated with exclusive BF (EBF) under 6 months of age in northwestern Romania. A structured questionnaire was used to collect data among 1399 mothers of children aged 0-23 months, recruited between March and June 2019, from the community. BF practices were evaluated based on the World Health Organization indicators for assessing infant and young child feeding practices, whereas determinants of EBF were explored using logistic regression models. Almost all mothers (95.7%) breastfed their child at least once. The EBF rate was 46.7%, the continued BF rate at one year of age was 54.2%, and the continued BF rate at 2 years of age was 30.3%. The place of delivery and parental leave duration were strong determinants of EBF. The improving rates observed in this study for all the BF practices assessed suggest the continuation of efforts to develop effective national policies and programs for promoting, protecting, and supporting BF in Romania. Particular emphasis should be given to the creation in maternity hospitals of an environment that is supportive towards breastfeeding.
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Affiliation(s)
- Anamaria Cozma-Petruţ
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (A.C.-P.); (L.F.); (O.M.); (L.G.); (D.C.); (D.M.)
| | - Lorena Filip
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (A.C.-P.); (L.F.); (O.M.); (L.G.); (D.C.); (D.M.)
| | - Roxana Banc
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (A.C.-P.); (L.F.); (O.M.); (L.G.); (D.C.); (D.M.)
| | - Oana Mîrza
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (A.C.-P.); (L.F.); (O.M.); (L.G.); (D.C.); (D.M.)
| | - Laura Gavrilaş
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (A.C.-P.); (L.F.); (O.M.); (L.G.); (D.C.); (D.M.)
| | - Daniela Ciobârcă
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (A.C.-P.); (L.F.); (O.M.); (L.G.); (D.C.); (D.M.)
| | - Ioana Badiu-Tişa
- Department of Mother and Child Care, “Iuliu Haţieganu” University of Medicine and Pharmacy, 2–4 Câmpeni Street, 400217 Cluj-Napoca, Romania;
| | - Simona Codruţa Hegheş
- Department of Pharmaceutical Analysis, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania;
| | - Cristian Olimpiu Popa
- Department of European Studies, Babeș-Bolyai University, 1 E. de Martonne Street, 400090 Cluj-Napoca, Romania;
| | - Doina Miere
- Department of Bromatology, Hygiene, Nutrition, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6 Pasteur Street, 400349 Cluj-Napoca, Romania; (A.C.-P.); (L.F.); (O.M.); (L.G.); (D.C.); (D.M.)
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Llupià A, Torà I, Lladó A, Cobo T, Sotoca JM, Puig J. Factors related to inhibition of lactation by pharmacological means at birth in a Spanish referral hospital (2011-2017). GACETA SANITARIA 2021; 36:6-11. [PMID: 34246499 DOI: 10.1016/j.gaceta.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/29/2021] [Accepted: 05/17/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the maternal, neonatal and pregnancy characteristics related to inhibition of lactation (IL) with cabergoline. METHOD We assessed 20,965 occasions of breastfeeding initiation, according to data collected from obstetric records at the Hospital Clinic of Barcelona (Spain) between January 2011 and December 2017. RESULTS IL decreased over the study period from 8.78% to 6.18% (odds ratio [OR]: 0.93 per year; 95% confidence interval [95%CI]: 0.90-0.95). Women with a lower educational level (OR: 2.5; 95%CI: 2.0-3.0), mothers living in more depressed areas (OR: 1.08 per 10 extra points over 100; 95%CI: 1.04-1.12), smokers (OR: 2.2; 95%CI: 1.9-2.6), and those with more children (OR: 1.2 for each sibling; 95%CI: 1.1-1.3), preterm birth (OR: 1.8; 95%CI: 1.4-2.3), multiple births (OR: 1.6; 95%CI: 1.2-2.1) and a higher risk pregnancy (OR: 1.3 per risk point; 95%CI: 1.2-1.4) showed a higher prevalence of IL. Compared to women born in Spain, IL was less likely in all other women with the exception of Chinese women (OR: 7.0; 95%CI: 5.7-8.6). These disparities remained during the study period. CONCLUSIONS Factors related to lower socioeconomic status and poor health were more likely to be associated with IL. The overall use of cabergoline decreased during the study period while inequalities persisted. Taking these inequalities into account is the first step to addressing them.
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Affiliation(s)
- Anna Llupià
- Preventive Medicine and Epidemiology Unit, Hospital Clínic, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain.
| | - Isabel Torà
- Preventive Medicine and Epidemiology Unit, Hospital Clínic, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Alba Lladó
- BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Barcelona, Spain
| | - Teresa Cobo
- BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Barcelona, Spain; Fetal I+D Fetal Medicine Research Center, IDIBAPS, University of Barcelona, Barcelona, Spain; Center for Biomedical Research on Rare Diseases (CIBER-ER), Spain
| | | | - Joaquim Puig
- Department of Mathematics, Universitat Politècnica de Catalunya, Barcelona, Spain
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Brown LJ, Myers S, Page AE, Emmott EH. Subjective Environmental Experiences and Women's Breastfeeding Journeys: A Survival Analysis Using an Online Survey of UK Mothers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217903. [PMID: 33126713 PMCID: PMC7662350 DOI: 10.3390/ijerph17217903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/26/2020] [Accepted: 10/26/2020] [Indexed: 01/02/2023]
Abstract
Local physical and social environmental factors are important drivers of human health and behaviour. Environmental perception has been linked with both reproduction and parenting, but links between subjective environmental experiences and breastfeeding remain unclear. Using retrospective data from an online survey of UK mothers of children aged 0-24 months, Cox-Aalen survival models test whether negative subjective environmental experiences negatively correlated with any and exclusive breastfeeding (max n = 473). Matching predictions, hazards of stopping any breastfeeding were increased, albeit non-significantly, across the five environmental measures (HR: 1.05-1.26) Hazards for stopping exclusive breastfeeding were however (non-significantly) reduced (HR: 0.65-0.87). Score processes found no significant time-varying effects. However, estimated cumulative coefficient graphs showed that the first few weeks postpartum were most susceptible to environmental influences and that contrary to our predictions, mothers with worse subjective environmental experiences were less likely to stop breastfeeding at this time. In addition, the hazard of stopping exclusive breastfeeding declined over time for mothers who thought that littering was a problem. The predicted increased hazards of stopping breastfeeding were only evident in the later stages of any breastfeeding and only for mothers who reported littering as a problem or that people tended not to know each other. Perceived harsher physical and social environmental conditions are assumed to deter women from breastfeeding, but this may not always be the case. Women's hazards of stopping breastfeeding change over time and there may be particular timepoints in their breastfeeding journeys where subjective environmental experiences play a role.
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Affiliation(s)
- Laura J. Brown
- Department of International Development, London School of Economics & Political Science, London WC2A 2AE, UK
- Institute for Global Health, University College London, London NW3 2PF, UK
- Correspondence:
| | - Sarah Myers
- UCL Anthropology, University College London, London WC1H 0BW, UK; (S.M.); (E.H.E.)
- BirthRites Independent Max Planck Research Group, Max Planck Institute for Evolutionary Anthropology, 04103 Leipzig, Germany
| | - Abigail E. Page
- Department of Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
| | - Emily H. Emmott
- UCL Anthropology, University College London, London WC1H 0BW, UK; (S.M.); (E.H.E.)
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Increase of breast-feeding in the past decade in Greece, but still low uptake: cross-sectional studies in 2007 and 2017. Public Health Nutr 2020; 23:961-970. [PMID: 31951189 DOI: 10.1017/s1368980019003719] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To estimate breast-feeding prevalence in Greece in 2007 and 2017, compare breast-feeding indicators and maternity hospital practices between these years, and investigate breast-feeding determinants. DESIGN Two national cross-sectional studies (2007 and 2017) using systematic cluster sampling of babies with the same sampling design, data collection and analysis methodology. SETTING Telephone interview with babies' mothers or fathers. PARTICIPANTS Representative sample of infants who participated in the national neonatal screening programme (n 549 in 2017, n 586 in 2007). RESULTS We found that breast-feeding indicators were higher in 2017 compared with 10 years before. In 2017, 94 % of mothers initiated breast-feeding. Breast-feeding rates were 80, 56 and 45 % by the end of the 1st, 4th and 6th completed month of age, respectively. At the same ages, 40, 25 and <1 % of babies, respectively, were exclusively breast-feeding. We also found early introduction of solid foods (after the 4th month of age). Maternity hospital practices favouring breast-feeding were more prevalent in 2017, but still suboptimal (63 % experienced rooming-in; 51 % experienced skin-to-skin contact in the first hour after birth; 19 % received free sample of infant formula on discharge). CONCLUSIONS We observed an increasing trend in all breast-feeding indicators in the past decade in Greece, but breast-feeding rates - particularly rates of exclusive breast-feeding - remain low. Systematic public health initiatives targeted to health professionals and mothers are needed in order to change the prevailing baby feeding 'culture' and successfully implement the WHO recommendations for exclusive breast-feeding during the first 6 months of life.
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Wagner KJP, de Fragas Hinnig P, Rossi CE, de Almeida Alves M, Leite MS, de Assis Guedes de Vasconcelos F. Time trends in the prevalence of breastfeeding among schoolchildren from public and private schools in Florianópolis, Southern Brazil: From 2002 to 2013. Am J Hum Biol 2020; 32:e23386. [PMID: 31930770 DOI: 10.1002/ajhb.23386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE To describe breastfeeding trends from 2002 to 2012/2013, and to investigate whether breastfeeding practices differ between mothers of children in public and private schools. METHODS Data were obtained from three school-based cross-sectional studies conducted with 7 to 10 years old children. The total sample was 7264 individuals. Data related to breastfeeding were analyzed descriptively and compared using the chi-square test for heterogeneity or trend. RESULTS In the 10-year period was observed a decrease in the total percentage of schoolchildren who were not breastfed (12.9%-10.5%) and an increase in the percentage of schoolchildren breastfed for >12 months (23.9%-36.7%). In public schools, the increase of breastfeeding for >12 months was independent of maternal age and years of schooling. In private schools, the increase was observed for schoolchildren born to older mothers and to more educated mothers, although the highest percentage was observed for schoolchildren born to less educated mothers. CONCLUSIONS The results confirm the complexity of determining breastfeeding behaviors, and understanding these dynamics is fundamental to develop and improve programs and actions aimed at encouraging, supporting, and protecting breastfeeding. However, strategies developed in Brazil during the first decade of the 21st century should explain the increase of proportion of breastfed children for more than 12 months, and the concomitant decrease of never breastfeed children in the city of Florianopolis (Southern Brazil).
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Affiliation(s)
- Katia Jakovljevic Pudla Wagner
- Department of Nutrition, Federal University of Santa Catarina, School of Health Science, Campus Universitário, Trindade, Brazil.,Campus Curitibanos - Centro, Federal University of Santa Catarina, Curitibanos, Brazil
| | - Patrícia de Fragas Hinnig
- Department of Nutrition, Federal University of Santa Catarina, School of Health Science, Campus Universitário, Trindade, Brazil
| | - Camila E Rossi
- Department of Nutrition, Federal University of Santa Catarina, School of Health Science, Campus Universitário, Trindade, Brazil.,Federal University of Fronteira Sul. Campus, Realeza, Brazil
| | - Mariane de Almeida Alves
- Department of Nutrition, Federal University of Santa Catarina, School of Health Science, Campus Universitário, Trindade, Brazil.,Public Health Faculty, Department of Nutrition, São Paulo University, São Paulo, Brazil
| | - Mauricio S Leite
- Department of Nutrition, Federal University of Santa Catarina, School of Health Science, Campus Universitário, Trindade, Brazil
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Parizkova P, Dankova N, Frühauf P, Jireckova J, Zeman J, Magner M. Associations between breastfeeding rates and infant disease: A survey of 2338 Czech children. Nutr Diet 2019; 77:310-314. [DOI: 10.1111/1747-0080.12532] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 12/20/2018] [Accepted: 02/24/2019] [Indexed: 01/07/2023]
Affiliation(s)
| | - Nika Dankova
- Czech Society of Midwives Czech Republic
- Department of Obstetrics and GynaecologyCharles University and General University Hospital in Prague Czech Republic
| | - Pavel Frühauf
- Department of Paediatrics and Adolescent Medicine, First Faculty of MedicineCharles University and General University Hospital in Prague Czech Republic
| | - Jitka Jireckova
- Department of Paediatrics and Adolescent Medicine, First Faculty of MedicineCharles University and General University Hospital in Prague Czech Republic
| | - Jiri Zeman
- Department of Paediatrics and Adolescent Medicine, First Faculty of MedicineCharles University and General University Hospital in Prague Czech Republic
| | - Martin Magner
- Department of Paediatrics and Adolescent Medicine, First Faculty of MedicineCharles University and General University Hospital in Prague Czech Republic
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Twenty-five-year trends in breastfeeding initiation: The effects of sociodemographic changes in Great Britain, 1985-2010. PLoS One 2019; 14:e0210838. [PMID: 30653579 PMCID: PMC6336342 DOI: 10.1371/journal.pone.0210838] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/02/2019] [Indexed: 11/23/2022] Open
Abstract
Background Data from the UK Infant Feeding Surveys indicate that breastfeeding initiation increased between 1985 and 2010. During this period, societal changes in GB also influenced the sociodemographic characteristics of women in the childbearing population. As breastfeeding behaviour is highly socially patterned in GB, the increasing trend in breastfeeding initiation may have hidden inequalities in breastfeeding practices. This study examines the sociodemographic inequalities in breastfeeding initiation in GB between 1985 and 2010, exploring whether and how this may have been influenced by social and policy changes. Methods Data drawn from the nationally representative 1985, 1990, 1995, 2000, 2005 and 2010 Infant Feeding Surveys were used to estimate changes in the proportion of mothers in selected sociodemographic groups over time. Logistic regression models estimated the independent associations between breastfeeding initiation in each survey year and maternal sociodemographic characteristics. Associations were adjusted for maternal sociodemographic, pregnancy-related and support factors. Evidence of a change in the association between breastfeeding initiation and each sociodemographic characteristic over time was assessed using a test for statistical heterogeneity. Results The sociodemographic characteristics of mothers in GB changed substantially between 1985 and 2010. Mothers were increasingly more likely to be 30 or over; have higher education and socioeconomic status; and be single or cohabiting. An increasing proportion of mothers in GB identified as being of black or minority ethnic origin. Reported smoking in pregnancy declined. These same characteristics independently predicted higher odds of breastfeeding initiation; the associations between these characteristics and breastfeeding initiation did not vary significantly over time. Conclusions Marked inequalities in breastfeeding initiation persisted over the study period, hidden among the increasing initiation rate at the population level. The increasing overall rate of initiation was most likely driven by the rising prevalence of those groups of mothers who were, and remain, characteristically most likely to breastfeed.
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Brown LJ, Sear R. Local environmental quality positively predicts breastfeeding in the UK's Millennium Cohort Study. Evol Med Public Health 2017; 2017:120-135. [PMID: 29354262 PMCID: PMC5766197 DOI: 10.1093/emph/eox011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 07/31/2017] [Indexed: 12/29/2022] Open
Abstract
Background and Objectives: Breastfeeding is an important form of parental investment with clear health benefits. Despite this, rates remain low in the UK; understanding variation can therefore help improve interventions. Life history theory suggests that environmental quality may pattern maternal investment, including breastfeeding. We analyse a nationally representative dataset to test two predictions: (i) higher local environmental quality predicts higher likelihood of breastfeeding initiation and longer duration; (ii) higher socioeconomic status (SES) provides a buffer against the adverse influences of low local environmental quality. Methodology: We ran factor analysis on a wide range of local-level environmental variables. Two summary measures of local environmental quality were generated by this analysis-one 'objective' (based on an independent assessor's neighbourhood scores) and one 'subjective' (based on respondent's scores). We used mixed-effects regression techniques to test our hypotheses. Results: Higher objective, but not subjective, local environmental quality predicts higher likelihood of starting and maintaining breastfeeding over and above individual SES and area-level measures of environmental quality. Higher individual SES is protective, with women from high-income households having relatively high breastfeeding initiation rates and those with high status jobs being more likely to maintain breastfeeding, even in poor environmental conditions. Conclusions and Implications: Environmental quality is often vaguely measured; here we present a thorough investigation of environmental quality at the local level, controlling for individual- and area-level measures. Our findings support a shift in focus away from individual factors and towards altering the landscape of women's decision making contexts when considering behaviours relevant to public health.
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Affiliation(s)
- Laura J Brown
- Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Rebecca Sear
- Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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Newman SL, Gowland RL. Dedicated Followers of Fashion? Bioarchaeological Perspectives on Socio-Economic Status, Inequality, and Health in Urban Children from the Industrial Revolution (18th-19th C), England. INTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY 2017; 27:217-229. [PMID: 28553062 PMCID: PMC5428467 DOI: 10.1002/oa.2531] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 04/11/2016] [Accepted: 04/14/2016] [Indexed: 06/07/2023]
Abstract
The 18th and 19th centuries in England were characterised by a period of increasing industrialisation of its urban centres. It was also one of widening social and health inequalities between the rich and the poor. Childhood is well-documented as being a stage in the life course during which the body is particularly sensitive to adverse socio-economic environments. This study therefore aims to examine the relationship between health and wealth through a comprehensive skeletal analysis of a sample of 403 children (0-17 years), of varying socio-economic status, from four cemetery sites in London (c.1712-1854). Measurements of long bone diaphyseal length, cortical thickness, vertebral neural canal size, and the prevalence of a range of pathological indicators of health stress were recorded from the Chelsea Old Church (high status), St Benet Sherehog (middle status), Bow Baptist (middle status), and Cross Bones (low status) skeletal collections. Children from the low status Cross Bones site demonstrated deficient growth values, as expected. However, those from the high status site of Chelsea Old Church also demonstrated poor growth values during infancy. Fashionable child-care practices (e.g. the use of artificial infant feeds and keeping children indoors) may have contributed to poor infant health amongst high status groups. However, differing health risks in the lower status group revealed the existence of substantial health inequality in London at this time.
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Affiliation(s)
- S. L. Newman
- Department of ArchaeologyDurham UniversityDurhamUK
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Peeters A, Blake MRC. Socioeconomic Inequalities in Diet Quality: from Identifying the Problem to Implementing Solutions. Curr Nutr Rep 2016. [DOI: 10.1007/s13668-016-0167-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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de Cock TP, Manniën J, Geerts C, Klomp T, de Jonge A. Exclusive breastfeeding after home versus hospital birth in primary midwifery care in the Netherlands. BMC Pregnancy Childbirth 2015; 15:262. [PMID: 26463347 PMCID: PMC4604719 DOI: 10.1186/s12884-015-0688-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 10/05/2015] [Indexed: 12/29/2022] Open
Abstract
Background Breastfeeding has short-term and long-term health benefits for mother and child. We evaluated in what way birthplace was associated with the rate of exclusive breastfeeding among low risk women who gave birth in midwife-led care and who had expressed the intention to breastfeed. Methods We used data from the DELIVER study, which includes pregnant women from twenty midwifery practices across the Netherlands between September 2009 and April 2011. We used data from two questionnaires: one in the third trimester (after 34 weeks) and one after the birth (median 39 days postpartum). Only women who indicated an intention to breastfeed were included in the analyses. Multivariable logistic regression analysis was used to assess the association between birthplace and exclusive breastfeeding, adjusted for relevant confounders. Results The exclusive breastfeeding rate was 75.0 % for the 547 women who gave birth at home, and 68.5 % for the 165 women who gave birth in midwife-led care in hospital. The adjusted odds ratio for exclusive breastfeeding after a hospital birth compared to a home birth was 0.79 (95 % CI 0.53–1.18). The most frequently reported reason for not breastfeeding at the time of completing the postpartum questionnaire was ‘my baby was not drinking enough’ (47 %). Conclusions In the Netherlands, among low risk women who intended to breastfeed their baby, the breastfeeding success rate did not differ significantly between home and midwife-led hospital births. As breastfeeding has short-term and long-term health benefits for mother and child, women should receive adequate lactation support by healthcare workers during the critical postpartum period, regardless of the place where they give birth.
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Affiliation(s)
- T P de Cock
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
| | - J Manniën
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
| | - C Geerts
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
| | - T Klomp
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
| | - A de Jonge
- Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
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Oakley LL, Kurinczuk JJ, Renfrew MJ, Quigley MA. Breastfeeding in England: time trends 2005-2006 to 2012-2013 and inequalities by area profile. MATERNAL AND CHILD NUTRITION 2014; 12:440-51. [PMID: 25422164 DOI: 10.1111/mcn.12159] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Breastfeeding rates in England have risen steadily since the 1970s, but rates remain low and little is known about area-based trends. We report an ecological analysis of time trends in area breastfeeding rates in England using annual data on breastfeeding initiation (2005-2006 to 2012-2013) and any breastfeeding at 6-8 weeks (2008-2009 to 2012-2013) for 151 primary care trusts (PCTs). Overall, breastfeeding initiation rose from 65.5% in 2005-2006 to 72.4% in 2012-2013 (average annual absolute increase 0.9%). There was a statistically significantly higher (interaction P < 0.001) annual increase in initiation in PCTs in the most deprived (1.2%) compared with the least deprived tertile (0.7%), and in PCTs with low baseline breastfeeding initiation (2005-2006; 1.4%) compared with high baseline initiation (0.6%). Similar trends were observed when PCTs were stratified by the proportion of teenage mothers and maternal smoking, but not when stratified by ethnicity. Although breastfeeding prevalence at 6-8 weeks also increased significantly over the observed time period (41.2% in 2008-2009, 43.7% in 2012-2013; annual increase 0.7%), there was no difference in the average increase by deprivation profile, ethnicity, teenage mothers and maternal smoking. However, PCTs with low baseline prevalence in 2008-2009 saw a significantly larger annual increase (0.8%) compared with PCTs with high baseline prevalence (0.07%). In conclusion, breastfeeding initiation and prevalence have seen higher increases in areas with low initial breastfeeding, and for initiation, more disadvantaged areas. Although these results suggest that inequalities in breastfeeding have narrowed, rates have plateaued since 2010-2011. Sustained efforts are needed to address breastfeeding inequalities.
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Affiliation(s)
- Laura L Oakley
- Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - Jennifer J Kurinczuk
- Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - Mary J Renfrew
- School of Nursing and Midwifery, College of Medicine, Dentistry and Nursing, University of Dundee, Dundee, UK
| | - Maria A Quigley
- Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
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