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Mantzorou M, Papandreou D, Vasios GK, Pavlidou E, Antasouras G, Psara E, Taha Z, Poulios E, Giaginis C. Exclusive Breastfeeding for at Least Four Months Is Associated with a Lower Prevalence of Overweight and Obesity in Mothers and Their Children after 2-5 Years from Delivery. Nutrients 2022; 14:nu14173599. [PMID: 36079855 PMCID: PMC9459704 DOI: 10.3390/nu14173599] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/23/2022] [Accepted: 08/30/2022] [Indexed: 12/16/2022] Open
Abstract
Introduction: Obesity is a current public health concern. Higher body weight is influenced by genetic and environmental parameters, and their interplay and is associated with a greater risk for several chronic diseases. Breastfeeding has been suggested as a preventive measure against obesity, which can further reduce long-term negative health outcomes for both women and children. Aim: The aim of the present study was to evaluate the role of breastfeeding on maternal and childhood overweight and obesity. Materials and Methods: This is a cross-sectional study conducted on 2515 healthy mothers and their children, aged 2−5 years, enrolled from nine different Greek rural and urban regions. Validated, standardized questionnaires were administrated that included anthropometric indices, socio-demographic characteristics of mothers and children, as well as breastfeeding practices. Results: Overall, 68% of participated women exclusively breastfed their children for at least 4 months. Mothers that exclusively breastfed showed a significantly lower prevalence of overweight and obesity after 2−5 years from delivery (p < 0.0001). Children that had exclusively been breastfed showed a significantly lower prevalence of overweight and obesity at the age of 2−5 years (p < 0.0001). Using multivariate regression analysis, exclusive breastfeeding for at least 4 months was associated with a two-fold lower risk for maternal and childhood overweight and obesity after 2−5 years from delivery, independent from maternal age, educational and economic status, and smoking habits (p < 0.0001). Conclusion: Exclusive breastfeeding for at least 4 months had a positive effect on childhood overweight and obesity, also contributing beneficially to post-natal maternal weight control. The beneficial effects of breastfeeding should be communicated to future and new mothers, while supportive actions for all mothers to initiate and continue breastfeeding their offspring should be implemented.
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Affiliation(s)
- Maria Mantzorou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Dimitrios Papandreou
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 144534, United Arab Emirates
- Correspondence:
| | - Georgios K. Vasios
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Eleni Pavlidou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Evmorfia Psara
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Zainab Taha
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 144534, United Arab Emirates
| | - Efthymios Poulios
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
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Zhao Y, Lin Q, Wang J. An evaluation of a prenatal individualised mixed management intervention addressing breastfeeding outcomes and postpartum depression: A ramdomised controlled trial. J Clin Nurs 2021; 30:1347-1359. [PMID: 33528901 DOI: 10.1111/jocn.15684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 01/18/2021] [Accepted: 01/22/2021] [Indexed: 12/21/2022]
Abstract
AIMS AND OBJECTIVES To determine the effects of an individualised mixed management combined lactation education and psychoeducation intervention on breastfeeding outcomes and postpartum depression (PPD) at 3 and 42 days postpartum. BACKGROUND Pregnant women with antenatal depression are prone to postpartum depression and failure in breastfeeding. DESIGN Eligible women participated in a randomised single-blind controlled trial. Results are reported as per the CONSORT 2010 statement. METHODS Participants were recruited from December 2017-August 2018 at a major teaching hospital located in Shanghai. Primiparous women (n = 182) with an Edinburgh Postnatal Depression Scale score ≥9 were randomly enrolled in the intervention group (n = 91) or the control group (n = 91). The intervention group participated in a 4-session face-to-face mixed management intervention targeting perinatal depression and breastfeeding. The control group received usual care. Breastfeeding and psychological outcomes were measured during the third trimester (≥28 weeks and <35 weeks), and at 3 and 42 days postpartum. RESULTS There were statistically significant differences in rates of overall and exclusive breastfeeding, initial breastfeeding experience, breastfeeding behaviour and self-efficacy between the two groups at 3 and 42 days postpartum (p < .05). Intention-to-treat linear mixed model analysis showed that EPDS scores were statistically significantly different between groups over time (F = 20.42, p < .001). Intervention group were more satisfied with their husbands' care and care received during the first month postpartum (p < .05). CONCLUSIONS The results demonstrate the effectiveness and feasibility of delivering an individualised mixed management intervention combining lactation guidance with psychological support during pregnancy. RELEVANCE TO CLINICAL PRACTICE This study supports the need to identify pregnant women at risk of perinatal depression and indicates that the prenatal individualised mixed management intervention has the potential to reduce PPD and help achieve better breastfeeding outcomes.
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Affiliation(s)
- Ying Zhao
- School of Nursing, Fudan University, Shanghai, PR China
| | - Qiping Lin
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| | - Jing Wang
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
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Fontalba-Navas A, Zafra Aparici E, Prata-Gaspar MCDM, Herrera-Espejo E, Company-Morales M, Larrea-Killinger C. Motivating Pregnant and Breastfeeding Women in Spain to Avoid Persistent Toxic Substances in Their Diet. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8719. [PMID: 33255320 PMCID: PMC7727663 DOI: 10.3390/ijerph17238719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/16/2020] [Accepted: 11/21/2020] [Indexed: 11/18/2022]
Abstract
The objective of this study was to explore what motivates pregnant and breastfeeding women to make changes in their diet, specifically to examine how their perceptions regarding diet facilitate or act as obstacles to introducing healthy eating habits. For the optimal development of the mother, the fetus, or breastfeeding baby, it is important to avoid foods containing substances, such as persistent toxic substances (PTSs), that are harmful to health during pregnancy and after the baby's birth. This study used a qualitative research methodology, based on semi-structured individual interviews, food diaries, free lists, and focus groups with 111 pregnant and breastfeeding women in Spain. This approach was followed by a systematic and exhaustive exploitation of the qualitative data obtained, following the methodological principles of grounded theory. From the study results, we conclude that the motivation for a change in diet to avoid PTSs is based on the desire to promote good health, beliefs about the importance of having a varied diet, and the avoidance of potential risks. The main obstacles to change can be attributed to inadequate information, contradictory discourses, and socioeconomic difficulties.
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Affiliation(s)
- Andres Fontalba-Navas
- Antequera Hospital, Northern Málaga Integrated Healthcare Area, 29200 Antequera, Málaga, Spain
- Department of Public Health and Psychiatry, University of Málaga, 29016 Málaga, Spain
| | - Eva Zafra Aparici
- Department of Anthropology, Philosophy and Social Work, University Rovira y Virgili, 43003 Tarragona, Spain;
| | | | | | - Miguel Company-Morales
- Seron Primary Care Center, Northern Almería Integrated Healthcare Area, 04600 Huercal-Overa, Almería, Spain;
- Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 La Cañada, Almería, Spain
| | - Cristina Larrea-Killinger
- Department of Social Anthropology, University of Barcelona, 08007 Barcelona, Spain; (M.C.d.M.P.-G.); (C.L.-K.)
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Iris S, Yael B, Zehava Y, Ella P, Hannah G, Miriam E, Lior Y, David Y, Adi YW. The impact of breastfeeding on pelvic floor recovery from pregnancy and labor. Eur J Obstet Gynecol Reprod Biol 2020; 251:98-105. [PMID: 32492606 DOI: 10.1016/j.ejogrb.2020.04.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Pelvic floor dysfunction (PFD) symptoms are prevalent during pregnancy and are mostly reversible thereafter. The pelvic floor muscles and their surrounding connective tissue support are estrogen-responsive. Breastfeeding is a condition of estrogen deficiency. We hypothesized that in breastfeeding women there may be a slower spontaneous recovery of PFD symptoms following birth. We aimed to determine the impact of breastfeeding on recovery from gestational PFD symptoms. METHODS We conducted a prospective cohort study of women who gave birth at the Soroka University Medical Center, Beer-Sheva, Israel. Those who have consented completed the Pelvic Floor Distress Inventory-20 (PFDI-20), after delivery and three months postpartum. Breastfeeding status was evaluated three months after delivery. Clinical and obstetrical characteristics were retrieved from the participants' medical records. RESULTS A total of 119 women had completed the PFDI-20 after delivery and three months postpartum. We found a significant difference between PFD during pregnancy, and PFD three months postpartum (P < 0.001). The overall PFDI-20 score was significantly decreased from a scale score of 64 to 27 (delta 36, P < 0.001), and this decrease remained significant for all components of the PFDI-20: pelvic organ prolapse distress (delta 14, P < 0.001); colorectal and anal dysfunction (delta 3.9, P = 0.01); and urinary dysfunction (delta 18, P < 0.001). No significant differences were noted in the extent of recovery of PFD symptoms between women who did and did not breastfeed (P = 0.59). CONCLUSIONS There is a clinical and statistically significant spontaneous recovery from gestational PFD symptoms at three months postpartum. Women with PFD symptoms prior to or during pregnancy can be reassured that breastfeeding probably does not delay the pelvic floor recovery.
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Affiliation(s)
- Shoham Iris
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Baumfeld Yael
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yohay Zehava
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Pardo Ella
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Glinter Hannah
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Erenberg Miriam
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yahav Lior
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yohay David
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Y Weintraub Adi
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Ludwig A, Doyle IM, Löffler A, Breckenkamp J, Spallek J, Razum O, Miani C. The impact of psychosocial factors on breastfeeding duration in the BaBi-Study. Analysis of a birth cohort study in Germany. Midwifery 2020; 86:102688. [PMID: 32276156 DOI: 10.1016/j.midw.2020.102688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 03/01/2020] [Accepted: 03/02/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Angelique Ludwig
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Universitätsstr. 25, Bielefeld 336015, Germany; ZIG OWL, Centre for Innovation in health care industry, Paulusstr. 1, Bielefeld 33602, Germany.
| | - Ina-Merle Doyle
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Universitätsstr. 25, Bielefeld 336015, Germany; Institute for General Practice, Hannover Medical School, Hannover, Germany
| | - Antje Löffler
- Department of Public Health, Brandenburg University of Technology, Senftenberg, Germany
| | - Jürgen Breckenkamp
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Universitätsstr. 25, Bielefeld 336015, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology, Senftenberg, Germany
| | - Oliver Razum
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Universitätsstr. 25, Bielefeld 336015, Germany
| | - Céline Miani
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Universitätsstr. 25, Bielefeld 336015, Germany
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Acharya D, Singh JK, Kandel R, Park JH, Yoo SJ, Lee K. Maternal Factors and the Utilization of Maternal Care Services Associated with Infant Feeding Practices among Mothers in Rural Southern Nepal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1887. [PMID: 31142032 PMCID: PMC6603766 DOI: 10.3390/ijerph16111887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 05/21/2019] [Accepted: 05/21/2019] [Indexed: 12/18/2022]
Abstract
This study aimed to investigate the maternal factors and utilization of maternal care services associated with infant feeding practices in rural areas of Southern Nepal. Data from a cluster randomized controlled trial 'MATRI-SUMAN'(Maternal Alliance for Technological Research Initiative on Service Utilization and Maternal Nutrition) conducted between 2015-2016 were analyzed. A total of 426 pregnant women in their second trimester were recruited from the MATRI-SUMAN trial, which was conducted on six villages in rural areas of the Dhanusha district, Nepal. A total of 379 mothers that had ever breastfed their infants, and followed for at least seven months after birth were included in the analysis. Multivariate logistic regression analysis was used to identify independent risk factors associated with child feeding practices after controlling for potential confounders. Of the 379 mothers, 41.4%, 53%, and 43% initiated breast feeding within the first hour of birth (EIBF), practiced exclusive breastfeeding (EBF), and initiated timely complementary feeding (CF) at six months, respectively. Multiple logistic regression results revealed that maternal education (secondary or higher), an occupation in the service/business/household sectors, receipt of MATRI-SUMAN intervention, more than four ANC (antenatal care) visits, and delivery in a health facility were associated with higher odds ratios of EIBF. Similarly, mothers with a primary, secondary and higher level of education, that worked in the service/business/household sectors, primiparous mothers, those that received MATRI-SUMAN intervention, visited ANC more than four times, and made a PNC (postnatal care) visit had higher odds ratios of EBF, while mothers who were 35-45 years of age were less likely to have used EBF. In addition, education to the secondary or a higher level, a male baby, receipt of MATRI-SUMAN intervention and a PNC visit had higher odds ratios of CF initiation at six months. The promotion of maternal ANC visits, birth at a health institution, and postnatal visits should be recommended in order to improve child feeding practices in Nepal.
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Affiliation(s)
- Dilaram Acharya
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju 38066, Korea.
- Department of Community Medicine, Kathmandu University, Devdaha Medical College and Research Institute, Rupandehi 32907, Nepal.
| | - Jitendra Kumar Singh
- Department of Community Medicine and Public Health, Janaki Medical College, Tribhuvan University, Janakpur 44618, Nepal.
| | - Rajendra Kandel
- Personal Social Services Research Unit, London School of Economics and Political Science, London WC2A2AE, UK.
| | - Ji-Hyuk Park
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju 38066, Korea.
| | - Seok-Ju Yoo
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju 38066, Korea.
| | - Kwan Lee
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju 38066, Korea.
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Abstract
PURPOSE OF REVIEW The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend exclusive breastfeeding for 6 months after an infant is born. Although the recommendations are well known, mothers face barriers that make breastfeeding difficult. This article reviews the recent literature on barriers to breastfeeding as well as strategies for pediatricians to use to help women overcome them. RECENT FINDINGS The mode of delivery, mother's socioeconomic status, return to work, and prenatal breastfeeding education have been reported as factors that influence breastfeeding. Family-centered models for breastfeeding, peer support groups, and technology have been studied as potential ways to help women meet their breastfeeding goals. SUMMARY Pediatricians are the first providers to care for babies after hospital discharge and are likely the first doctors that mothers see after childbirth. These early visits create opportunities for pediatricians to learn about the barriers that their patients face and open the doors to addressing these barriers.
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