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Monge-Montero C, van der Merwe LF, Tagliamonte S, Agostoni C, Vitaglione P. Why do mothers mix milk feed their infants? Results from a systematic review. Nutr Rev 2024; 82:1355-1371. [PMID: 38041551 PMCID: PMC11384123 DOI: 10.1093/nutrit/nuad134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023] Open
Abstract
CONTEXT Combining or supplementing breastfeeding with formula feeding, also called mixed milk feeding (MMF), is a common infant feeding practice. However, there is no well-established MMF evidence-base for informing and guiding parents. A better understanding of the reasons why mothers practice MMF may facilitate identification of efficient strategies for supporting exclusive breastfeeding, and/or opportunities to prolong breastfeeding, at least partially. OBJECTIVE An updated systematic literature review was undertaken with the primary aim of gaining a deeper understanding of the reasons why mothers choose MMF. DATA SOURCES Six databases were searched for relevant articles published in English from January 2012 to January 2022. DATA EXTRACTION Two reviewers independently performed the screenings and data extraction, and any differences were resolved by a third reviewer. Data from 138 articles were included, 90 of which contained data on MMF reasons/drivers, and 60 contained data on infant age and/or maternal demographic factors associated with MMF. DATA ANALYSIS A total of 13 different unique MMF drivers/reasons were identified and categorized according to whether the drivers/reasons related to perceived choice, necessity, or pressure. Risk of bias was evaluated using the Quality Assessment Tool of Diverse Studies and the JBI Systematic Reviews tool. Several different terms were used to describe and classify MMF across the studies. The most commonly reported reasons for MMF were related to a perception of necessity (39% of drivers, eg, concerns about infant's hunger/perceived breast milk insufficiency or breastfeeding difficulties), followed by drivers associated with perceived choice (34%; eg, having more flexibility) and perceived pressure (25%; eg, returning to work or healthcare professionals' advice). This was particularly true for infants aged 3 months or younger. CONCLUSION The key global drivers for MMF and their distribution across infant age and regions were identified and described, providing opportunities for the provision of optimal breastfeeding support. A unified definition of MMF is needed in order to enable more comparable and standardized research. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022304253.
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Affiliation(s)
- Carmen Monge-Montero
- Department of Research, Monge Consultancy Food and Nutrition Research, Leiden, The Netherlands
| | | | - Silvia Tagliamonte
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
| | - Carlo Agostoni
- Fondazione IRCCS Ospedale Maggiore Policlinico, Pediatric Clinic, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paola Vitaglione
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
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Erkal Aksoy Y, Bay H, Dereli Yilmaz S. Factors Affecting Primiparous Women’s Breastfeeding Self-Efficacy Levels. CLINICAL LACTATION 2022. [DOI: 10.1891/cl-2021-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTIONThe aim of this study is to reveal the factors affecting primiparous pregnant women’s breastfeeding self-efficacy levels. This is a descriptive correlational study.METHODThe sample included 512 primiparous pregnant women. A personal information form, the Prenatal Breastfeeding Self-Efficacy Scale (PBSES), the Multidimensional Scale of Perceived Social Support (MSPSS) and the Pregnancy-Related Anxiety Questionnaire–Revised (PRAQ-R2) were used for data collection.RESULTSThe pregnant women’s mean total PBSES scores were found to differ significantly based on their descriptive and obstetric characteristics. There was a positive correlation between their mean PBSES scores and their MSPSS total and subscale mean scores. Additionally, there was a negative correlation between the participants’ mean total PBSES scores and their mean total PRAQ-R2 and “concern about own appearance” subscale scores. Place of residence for the longest time, pregnancy risk group, folic acid use before pregnancy, perceived family support, perceived support from friends and concern about own appearance were significant factors in explaining the variance in the pregnant women’s PBSES total scores.DISCUSSIONBoth descriptive and obstetric characteristics of the primiparous pregnant women affected their breastfeeding self-efficacy levels. Social support was also determined to affect the participants’ breastfeeding self-efficacy levels positively, and whereas anxiety affected these levels negatively.
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Gerchow L, Squires A, Jones S. Disparities in Breastfeeding Duration of New York City Latinx Mothers by Birth Region. Breastfeed Med 2021; 16:607-613. [PMID: 33826404 DOI: 10.1089/bfm.2021.0030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background: Disparities in breastfeeding patterns by race and ethnicity in the United States have been documented, and Latinx ethnicity is often associated with higher rates of breastfeeding initiation and longer breastfeeding duration compared to other U.S. racial and ethnic groups. Despite marked differences in infant feeding practices in Latinx countries of origin, U.S. breastfeeding data are routinely presented with Latinx as a single category. Objective: To analyze breastfeeding duration of New York City Latinx mothers by birth region. Methods: Using data from the 2016 New York City Work and Family Leave Survey (WAFLS) surveying residents who gave birth in 2014, we conducted a survival analysis of breastfeeding duration in a sample of Latinx-identifying mothers (n = 271), who reported having ever breastfed their child. Kaplan-Meier survival curves for time to breastfeeding cessation were created for four birth regions (United States, Caribbean, Mexico/Central America, and South America) and compared using the log-rank test. Adjusted hazard ratios (AHRs) were calculated using Cox regression. Results: Survival curves and median breastfeeding duration were significantly different between the four regions. AHR models found that non-Caribbean birthplace was significantly associated with a lower risk of early breastfeeding cessation. Being partnered at the time of childbirth and neonate hospitalization of 6 days or longer was associated with a greater risk of earlier breastfeeding cessation. Conclusion: The significant differences reinforce the need to separate breastfeeding findings by birth region in the Latinx population. Within-group differences are lost in combined analyses and reinforce conclusions that Latinx mothers have optimal breastfeeding behaviors.
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Affiliation(s)
- Lauren Gerchow
- New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Allison Squires
- New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Simon Jones
- Department of Population Health, New York University School of Medicine, New York, New York, USA
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Economou M, Kolokotroni O, Paphiti-Demetriou I, Kouta C, Lambrinou E, Hadjigeorgiou E, Hadjiona V, Middleton N. The association of breastfeeding self-efficacy with breastfeeding duration and exclusivity: longitudinal assessment of the predictive validity of the Greek version of the BSES-SF tool. BMC Pregnancy Childbirth 2021; 21:421. [PMID: 34107927 PMCID: PMC8188677 DOI: 10.1186/s12884-021-03878-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 05/13/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION While breastfeeding self-efficacy (BSES) is an important modifiable determinant of breastfeeding, a structured assessment is not standard practice in Cyprus. We assessed the Greek version of the Breastfeeding Self-Efficacy Scale (BSES-SF), including its predictive validity in terms of Breastfeeding (BF) and Exclusive Breastfeeding (EBF) up to the sixth month. METHODS A methodological study with longitudinal design among 586 mother-infant dyads, as part of the "BrEaST Start in Life" project. BSES was assessed 24-48 h after birth and at the first month. Breastfeeding status was assessed at the clinic, the 1st, 4th and 6th month. The association between BSES and breastfeeding was estimated in logistic regression models and its diagnostic ability in ROC analysis. RESULTS With Mean = 3.55 (SD = 0.85), BSES was moderate, and lower among Cypriot women, primiparas and those who delivered by Cesarean Section (C/S). There was good internal consistency across the 14 items (Cronbach's α = 0.94) while factor analysis revealed a two-factor structure. BSES scores were higher among mothers who initiated exclusive breastfeeding (M = 3.92, SD = 0.80) compared to breastfeeding not exclusively (M = 3.29, SD = 0.84) and not breastfeeding (M = 3.04, SD = 1.09; p-value < 0.001). There was a stepwise association with exclusivity (40.5% in the highest vs 7.9% lowest quartile of self-efficacy). The association between in-hospital BSES and long-term EBF persisted in multivariable models. Women in the upper quartile of BSES at 48 h were more likely to breastfeed exclusively by adjOR = 5.3 (95% CI 1.7-17.1) at the 1st and adjOR = 13.7 (95% CI 2.7-68.6) at the 4th month. Similar associations were observed between self-efficacy at the 1st month and BF at subsequent time-points. High first month BSES (> 3.96 as per ROC) had 58.9% positive and 79.6% negative predictive value for breastfeeding at 6 months which reflects higher sensitivity but lower specificity. CONCLUSIONS The Greek version of BSES-SF showed good metric properties (construct, know-group, concurrent and predictive validity). In the absence of community support structures or programmes in Cyprus, prevalence of breastfeeding remains low. This suggests a need for policy, educational and community support interventions, including the systematic use of BSES scale as a screening tool to identify those at higher risk for premature BF discontinuation.
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Affiliation(s)
- Mary Economou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.
| | - Ourania Kolokotroni
- St George University of London Medical School at the University of Nicosia, Nicosia, Cyprus
- Cyprus Breastfeeding Association - 'Gift for Life', Nicosia, Cyprus
| | | | - Christiana Kouta
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Ekaterini Lambrinou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Eleni Hadjigeorgiou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Vasiliki Hadjiona
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Nicos Middleton
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
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Shiraishi M, Matsuzaki M, Kurihara S, Iwamoto M, Shimada M. Post-breastfeeding stress response and breastfeeding self-efficacy as modifiable predictors of exclusive breastfeeding at 3 months postpartum: a prospective cohort study. BMC Pregnancy Childbirth 2020; 20:730. [PMID: 33238937 PMCID: PMC7687691 DOI: 10.1186/s12884-020-03431-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 11/16/2020] [Indexed: 11/25/2022] Open
Abstract
Background The rate of exclusive breastfeeding at 3 months postpartum is only 50% in Japan. In order to increase this rate, we aimed to examine modifiable factors related to exclusive breastfeeding at 3 months postpartum by focusing on breastfeeding-related and psychosocial variables at 1 month postpartum. Methods This prospective cohort study was conducted at a secondary medical care center in Osaka, Japan from February 2017 to October 2018. Demographic variables, infant feeding modality, breastfeeding-related variables, and psychosocial variables were obtained using questionnaires at 1 month postpartum. Daytime salivary cortisol levels before and after breastfeeding at 1 month postpartum were measured as a biological marker for stress responses associated with breastfeeding. Each infant’s feeding modality was re-assessed at 3 months postpartum. Multiple logistic regression analyses were performed to examine factors affecting exclusive breastfeeding at 3 months postpartum. Results Of the 104 participants, 61 reported exclusive breastfeeding at 3 months postpartum. The following factors were significantly associated with exclusive breastfeeding at 3 months postpartum: multiparity (adjusted odds ratio, 95% confidence interval: 11.13, 2.08–59.59), having a university degree (5.25, 1.04–26.53), no plan to return to work by 6 months postpartum (0.02, 0.00–0.46), and exclusive breastfeeding (42.84, 6.05–303.52), lower cortisol level after breastfeeding (0.00, 0.00–0.02), and higher breastfeeding self-efficacy scale score (1.07, 1.00–1.14) at 1 month postpartum. In parity-specific analyses, exclusive breastfeeding (25.33, 4.75–134.98) and lower cortisol level after breastfeeding (0.00, 0.00–0.21) at 1 month postpartum in primiparous women, and lower cortisol level after breastfeeding (0.00, 0.00–0.94), higher breastfeeding self-efficacy score (1.18, 1.05–1.32), and absence of breast complications (0.09, 0.01–0.82) at 1 month postpartum in multiparous women were associated with exclusive breastfeeding at 3 months postpartum. Conclusions Stress levels after breastfeeding, breastfeeding self-efficacy, and the presence of breast complications could be modifiable factors associated with subsequent exclusive breastfeeding. Further research is needed to examine whether approaches to reducing breastfeeding-related stress, improving breastfeeding self-efficacy, and preventing breast complications during lactation are effective to increase exclusive breastfeeding practices.
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Affiliation(s)
- Mie Shiraishi
- Department of Children and Women's Health, Division of Health Sciences, Graduate School of Medicine, Osaka University, 1-7, Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Masayo Matsuzaki
- Department of Children and Women's Health, Division of Health Sciences, Graduate School of Medicine, Osaka University, 1-7, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Shoko Kurihara
- Department of Children and Women's Health, Division of Health Sciences, Graduate School of Medicine, Osaka University, 1-7, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Maki Iwamoto
- Department of Children and Women's Health, Division of Health Sciences, Graduate School of Medicine, Osaka University, 1-7, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Mieko Shimada
- Department of Children and Women's Health, Division of Health Sciences, Graduate School of Medicine, Osaka University, 1-7, Yamadaoka, Suita, Osaka, 565-0871, Japan.,Graduate Program of Midwifery, Dokkyo Medical University, Tochigi, Japan
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Social representations of breastfeeding and infant formula: An exploratory study with mothers and health professionals to inform policy making. Appetite 2020; 151:104683. [DOI: 10.1016/j.appet.2020.104683] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 11/21/2022]
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Góes FGB, Ledo BC, Santos ASTD, Pereira-Ávila FMV, Silva ACSSD, Christoffel MM. Cultural adaptation of Infant Feeding Intentions Scale (IFI) for pregnant women in Brazil. Rev Bras Enferm 2020; 73 Suppl 4:e20190103. [PMID: 32696943 DOI: 10.1590/0034-7167-2019-0103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 10/27/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to translate and culturally adapt the Infant Feeding Intentions Scale for pregnant women in Brazil. METHODS methodological study that included stages of translation, synthesis, face and content validation, back translation and semantic assessment. In the face and content and semantic validation stages, we used the Content Validity Index for individual items and for the overall scale for clarity and representativeness. RESULTS nine (100.0%) experts participated in face and content validation, and the average index obtained was 85.0% for representativeness. In the semantic assessment, performed with 31 (100.0%) pregnant women, the tool was considered clear, obtaining an average index of 91.0%. CONCLUSIONS the Brazilian version of the scale was considered representative and clear. After assessing psychometric properties, the scale is expected to be valid and reliable to assess maternal intention to breastfeed exclusively until the infant's six months of life in different Brazilian settings.
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9
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Linares AM, Barbier D, Schoeffler KM, Collins RL. Assessing Barriers to Implement Birth Kangaroo Care in Kentucky Birthing Hospitals. CLINICAL LACTATION 2020; 11:93-102. [PMID: 34733582 DOI: 10.1891/clinlact-d-19-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction Kentucky continues to have one of the lowest state breastfeeding rates in the country. In 2014, the majority of the birthing hospitals in Kentucky implemented a practice change to the healthcare model known as Birth Kangaroo Care (BKC) as an effort to increase breastfeeding initiation. The goal of this study was to identify current practices and barriers to implementing BKC. Methods An evaluation/surveillance study that incorporated an Internet survey to collect information about the practices and policies of BKC in birthing hospitals in Kentucky was completed. Findings The response rate was 54% (n = 25). The birthing hospitals responders to the survey (84%) reported that a BKC policy was established after the educational intervention. Data identified two perceived barriers regarding uninterrupted BKC. One barrier was the interruption by family members to hold the newborn, and the second was a delay in BKC for medical evaluations of the baby by staff members. Conclusion Breastfeeding rates after implementation of the BKC policy in Kentucky birthing hospitals showed a statistically significant (p = .02) improvement of "ever breastfed" infants.
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10
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Integrative Review of Fathers' Perspectives on Breastfeeding Support. J Obstet Gynecol Neonatal Nurs 2019; 49:16-26. [PMID: 31756305 DOI: 10.1016/j.jogn.2019.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2019] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To critically review and summarize the results of published articles on fathers' perspectives regarding breastfeeding support for their partners. DATA SOURCES We searched the following databases for articles published between January 2010 and May 2019: CINAHL, MEDLINE, PubMed, Scopus, Web of Science, ThaiJo, and ThaiLis. We included articles published in English and Thai. STUDY SELECTION After duplicates were removed, our initial search yielded 3,927 articles. We excluded articles in accordance with pre-established criteria. We performed a quality appraisal of the selected full-text articles and ultimately included 27 in this review. DATA EXTRACTION We analyzed studies that met inclusion criteria and extracted and organized data related to fathers' perspectives on breastfeeding support into a structured table. DATA SYNTHESIS The data were synthesized into three themes: Attitude Toward Breastfeeding, Knowledge of Breastfeeding, and Fathers' Perceptions of the BreastfeedingSupportThey Provided. CONCLUSION Our results showed that fathers' perspectives on breastfeeding support were shaped by their knowledge of breastfeeding and participation in the breastfeeding process. To promote breastfeeding, further research is required to design and implement appropriate interventions to help fathers effectively support their breastfeeding partners.
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Linares AM, Cartagena D, Rayens MK. Las Dos Cosas Versus Exclusive Breastfeeding: A Culturally and Linguistically Exploratory Intervention Study in Hispanic Mothers Living in Kentucky. J Pediatr Health Care 2019; 33:e46-e56. [PMID: 31655788 PMCID: PMC6954491 DOI: 10.1016/j.pedhc.2019.07.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/21/2019] [Accepted: 07/22/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Formula supplementation among infants of breastfeeding Hispanic immigrants is common practice known as las dos cosas. The purpose of this study was to assess the feasibility, effectiveness, and acceptability of a culturally and linguistically diverse intervention to promote exclusive breastfeeding (EBF) for the first 6 months. METHODS A sample of 39 Hispanic pregnant women was recruited and randomly assigned to intervention (n = 20) and control groups (n = 19). The intervention included a peer counselor and professional support, and mothers were followed from pregnancy to 6 months after birth. RESULTS After the study, women assigned to the intervention group were over three times more likely to EBF their baby through all four postpartum assessed time points (odds ratio = 3.1, 95% confidence interval: 1.1-8.7). DISCUSSION This culturally and linguistically diverse intervention contributed to increased EBF duration and decreased formula supplementation in Hispanic mothers up to 6 months postpartum.
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12
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Lee YH, Chang GL, Chang HY. Effects of education and support groups organized by IBCLCs in early postpartum on breastfeeding. Midwifery 2019; 75:5-11. [DOI: 10.1016/j.midw.2019.03.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 03/19/2019] [Accepted: 03/29/2019] [Indexed: 11/27/2022]
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Kaar JL, Sauder KA, Shapiro AL, Starling AP, Ringham BM, Johnson SL, Dabelea D. Infant Feeding Practices In a Diverse Group of Women: The Healthy Start Study. CLINICAL MEDICINE INSIGHTS-PEDIATRICS 2019; 13:1179556518824362. [PMID: 30718970 PMCID: PMC6348534 DOI: 10.1177/1179556518824362] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 12/09/2018] [Indexed: 11/17/2022]
Abstract
Background To describe infant feeding practices among a diverse group of mother-offspring pairs and identify factors associated with adherence to the American Academy of Pediatrics (AAP) recommendations. Methods Data were analyzed from 835 mother-offspring dyads in The Healthy Start Study, an ongoing longitudinal prebirth cohort in Denver, Colorado. Maternal report of infant feeding practices was obtained at 4 to 6 months and 18 to 24 months postnatally. Practices were classified according to the following AAP recommendations: exclusive breastfeeding for first 6 months, continued breastfeeding through 12 months, and introduction of solid foods around 6 months of age. Participants who met all 3 recommendations were categorized as "adherent." All others were categorized as "not adherent." Results About 77% of dyads did not adhere fully to the AAP recommendations. Women who worked ⩾35 hours/week or had a higher prepregnancy body mass index were more likely to be nonadherent. Women who were older, college educated, or had offspring with greater weight for gestational age at birth were less likely to be nonadherent. Conclusions Most of the women in a large contemporary cohort are not adhering to AAP infant feeding recommendations. Our results highlight the specific subgroups of women who may need additional support to optimize infant feeding practices.
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Affiliation(s)
- Jill Landsbaugh Kaar
- Department of Pediatrics, School of Medicine, University of Colorado, Anschutz Medical Campus
| | - Katherine A Sauder
- Department of Pediatrics, School of Medicine, University of Colorado, Anschutz Medical Campus
| | - Allison Lb Shapiro
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus
| | - Anne P Starling
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus
| | - Brandy M Ringham
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus
| | - Susan L Johnson
- Department of Pediatrics, School of Medicine, University of Colorado, Anschutz Medical Campus
| | - Dana Dabelea
- Department of Pediatrics, School of Medicine, University of Colorado, Anschutz Medical Campus.,Department of Epidemiology, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus
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Dozier AM, Brownell EA, Thevenet-Morrison K, Martin H, Hagadorn JI, Howard C. Predicting Maintenance of Any Breastfeeding from Exclusive Breastfeeding Duration: A Replication Study. J Pediatr 2018; 203:197-203.e2. [PMID: 30297289 PMCID: PMC6310007 DOI: 10.1016/j.jpeds.2018.07.100] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/14/2018] [Accepted: 07/27/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To predict the duration of any breastfeeding using the duration of exclusive breastfeeding in a socioeconomically heterogeneous sample of mothers using receiver operator characteristic (ROC) analysis. STUDY DESIGN The Mother Baby Health Survey, a birth certificate-linked cross-sectional survey was sent at 4-5 months postpartum to a stratified random sample of socioeconomically and racially diverse women in upstate New York; 797 mothers who initiated exclusive breastfeeding were included in this study. Split-sample validation was employed; eligible subjects were divided into training or test samples at random (80% and 20%, respectively). ROC curves were constructed using the training sample and optimal exclusive breastfeeding duration thresholds were tested using the remaining test sample. Logistic regression using the training sample provided estimates of the predictive ability (sensitivity, specificity, positive predictive value) of thresholds in both unadjusted and adjusted analyses (covariates: age, education, parity, marital status, and race). RESULTS The ROC analysis in this sample demonstrated that 9 weeks of exclusivity was required for maintenance of breastfeeding at 3 months, and 14.9 weeks of exclusivity was required for maintenance at 20 weeks. Unadjusted and adjusted models yielded similar results; women who exclusively breastfed for at least 9 weeks had 2.2 times the risk (95% CI 1.7-2.8) of maintaining any breastfeeding at 3 months. CONCLUSIONS These results are similar to our previous results, from a less diverse cohort, and support that these thresholds may be useful in clinical settings for helping mothers achieve breastfeeding duration goals.
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Affiliation(s)
- Ann M Dozier
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY.
| | - Elizabeth A Brownell
- The Connecticut Human Milk Research Center, Division of Neonatology, Connecticut Children's Medical Center, Hartford, CT; Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT
| | | | - Hayley Martin
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY
| | - James I Hagadorn
- The Connecticut Human Milk Research Center, Division of Neonatology, Connecticut Children's Medical Center, Hartford, CT; Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT
| | - Cynthia Howard
- Department of Public Health Sciences, Department of Pediatrics, University of Rochester, Rochester, NY; Rochester General Hospital, Rochester, NY
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Cartagena D, McGrath JM, Linares AM. Associations between Introduction of Age-Inappropriate Foods and Early Eating Environments in Low-Socioeconomic Hispanic Infants. J Pediatr Health Care 2018; 32:e27-e36. [PMID: 29249647 DOI: 10.1016/j.pedhc.2017.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/04/2017] [Accepted: 09/09/2017] [Indexed: 01/28/2023]
Abstract
PURPOSE To examine the associations between feeding practices and eating environments of low-socioeconomic Hispanic infants. METHODS Secondary analysis of cross-sectional data from a sample of 62 low-income immigrant Hispanic mothers and their infants (age range = 4-12 months). Measures of infant feeding practices (food groups and beverages consumption) and eating environment domains were included using the Infant Feeding Scale. RESULTS TV exposure and allowing the infant to play with toys during meals significantly correlated with intake of energy-dense foods in 4- to 6-month-olds (p = .05). Among 7- to 9-month-olds, mealtime TV watching correlated with consumption of snacks (p = .05) and sweetened beverages (p = .01). Consumption of energy-dense foods was significantly different among groups with higher mean intake in older infants (p = < .01). CONCLUSION Findings highlight the need for culturally and socioeconomically sensitive approaches to improve infant feeding practices and support low-income Hispanic families in providing healthy and nurturing eating environments required to prevent later obesity risk.
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16
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Linares AM, Wambach K, Rayens MK, Wiggins A, Coleman E, Dignan MB. Modeling the Influence of Early Skin-to-Skin Contact on Exclusive Breastfeeding in a Sample of Hispanic Immigrant Women. J Immigr Minor Health 2017; 19:1027-1034. [PMID: 26969615 PMCID: PMC5018413 DOI: 10.1007/s10903-016-0380-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Using data from a longitudinal study of breastfeeding in Hispanics, this study evaluated the influence of early skin-to-skin contact (SSC) on initiation and sustained exclusive breastfeeding (EBF) at 1 month postpartum. Two-thirds of the women in the sample participated in early SSC. At discharge, over half of the women were EBF; this proportion decreased to one-third at 1 month postpartum. Controlling for demographic and clinical variables in the model, participation in early SSC was associated with a greater than sevenfold increase in the odds of EBF at discharge (p = .005) but was not predictive of EBF at 1 month post-discharge (p = .7). Younger maternal age and increased prenatal infant feeding intention were associated with an increased likelihood of EBF across both timepoints. Promoting early SSC may help with initiation of EBF, while further breastfeeding support may be needed to maintain EBF following discharge for this vulnerable population.
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Affiliation(s)
- Ana M. Linares
- College of Nursing, University of Kentucky, Faculty of Health Science, Universidad de Tarapaca, Arica, Chile. 315 College of Nursing Building, University of Kentucky, Lexington, KY, 40536-0230, USA
| | - Karen Wambach
- School of Nursing, University of Kansas, Kansas City, KUMC,
| | - Mary K. Rayens
- College of Nursing and College of Public Health, University of Kentucky,
| | | | | | - Mark B. Dignan
- Department of Internal Medicine and Director of the University of Kentucky, Prevention Research Center,
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Sharma ND. Breastfeeding and the risk of childhood asthma: A two-stage instrumental variable analysis to address endogeneity. Pediatr Allergy Immunol 2017; 28:564-572. [PMID: 28660698 DOI: 10.1111/pai.12750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Several explanations for the inconsistent results on the effects of breastfeeding on childhood asthma have been suggested. The purpose of this study was to investigate one unexplored explanation, which is the presence of a potential endogenous relationship between breastfeeding and childhood asthma. Endogeneity exists when an explanatory variable is correlated with the error term for reasons such as selection bias, reverse causality, and unmeasured confounders. Unadjusted endogeneity will bias the effect of breastfeeding on childhood asthma. METHODS To investigate potential endogeneity, a cross-sectional study of breastfeeding practices and incidence of childhood asthma in 87 pediatric patients in Georgia, the USA, was conducted using generalized linear modeling and a two-stage instrumental variable analysis. First, the relationship between breastfeeding and childhood asthma was analyzed without considering endogeneity. Second, tests for presence of endogeneity were performed and having detected endogeneity between breastfeeding and childhood asthma, a two-stage instrumental variable analysis was performed. The first stage of this analysis estimated the duration of breastfeeding and the second-stage estimated the risk of childhood asthma. RESULTS When endogeneity was not taken into account, duration of breastfeeding was found to significantly increase the risk of childhood asthma (relative risk ratio [RR]=2.020, 95% confidence interval [CI]: [1.143-3.570]). After adjusting for endogeneity, duration of breastfeeding significantly reduced the risk of childhood asthma (RR=0.003, 95% CI: [0.000-0.240]). CONCLUSION The findings suggest that researchers should consider evaluating how the presence of endogeneity could affect the relationship between duration of breastfeeding and the risk of childhood asthma.
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Yehya N, Tamim H, Shamsedine L, Ayash S, Abdel Khalek L, Abou Ezzi A, Nabulsi M. Validation of the Arabic Version of the Infant Feeding Intentions Scale Among Lebanese Women. J Hum Lact 2017; 33:383-389. [PMID: 28099043 DOI: 10.1177/0890334416680790] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Infant Feeding Intentions (IFI) scale was shown to reliably measure maternal intentions to initiate breastfeeding and continue exclusive breastfeeding until 1, 3, or 6 months in English and Spanish but not in Arab contexts. Research aim: This study aimed to validate an Arabic version of the IFI scale (IFI-A) and examine its ability to predict exclusive breastfeeding at 1, 3, or 6 months in pregnant Lebanese women. METHODS The internal consistency reliability and construct validity of the IFI-A scale were tested on 50 pregnant women (Group 1), whereas its predictive ability was tested on 196 pregnant women (Group 2), who were surveyed monthly about their infants' nutrition method until 6 months. RESULTS The IFI-A scale's Cronbach's alpha internal consistency reliability is .82. Its corrected item-total correlations ranged from .26 for Item 2 ("at least give breastfeeding a try") to .86 for Item 4 ("will be exclusively breastfeeding at 3 months"). Exploratory factor analysis revealed that it is unidimensional. IFI-A scores correlated significantly with exclusive breastfeeding duration in Group 1 ( r = .624; p = .001) and with participants' breastfeeding attitude ( r = .390; p < .001) and previous breastfeeding duration ( r = .237; p = .011) in Group 2, thus confirming its external construct validity. In adjusted analysis, the IFI-A scale predicted exclusive breastfeeding at 3 months, albeit weakly (odds ratio = 1.16; 95% confidence interval [0.99, 1.36]), but not at 1 or 6 months. CONCLUSION The IFI-A scale is a reliable and valid tool to assess maternal feeding intentions and predict exclusive breastfeeding at 3 months in the Arab context. Further studies are needed in other Arab contexts to confirm our findings.
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Affiliation(s)
- Nadine Yehya
- 1 Suliman Olayan School of Business, American University of Beirut, Beirut, Lebanon
| | - Hani Tamim
- 2 Clinical Research Institute, Biostatistics Unit, American University of Beirut, Beirut, Lebanon
| | - Lama Shamsedine
- 3 Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Soumaya Ayash
- 3 Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Lama Abdel Khalek
- 1 Suliman Olayan School of Business, American University of Beirut, Beirut, Lebanon
| | - Amanda Abou Ezzi
- 3 Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Mona Nabulsi
- 3 Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
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Guimarães CMDS, Conde RG, Brito BCD, Gomes-Sponholz FA, Oriá MOB, Monteiro JCDS. COMPARISON OF BREASTFEEDING SELF-EFFICACY BETWEEN ADOLESCENT AND ADULT MOTHERS AT A MATERNITY HOSPITAL IN RIBEIRÃO PRETO, BRAZIL. TEXTO & CONTEXTO ENFERMAGEM 2017. [DOI: 10.1590/0104-07072017004100015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to measure and compare the breastfeeding self-efficacy between adolescents and adults mothers in the immediate postpartum. Method: is an observational, cross-sectional and comparative study, developed at a maternity hospital in Ribeirao Preto, Brazil. Data were collected between January and July 2014. The sample consisted of 306 adult mothers and 94 adolescent mothers. The breastfeeding self-efficacy scores were obtained using the Brazilian version of the Breastfeeding Self-Efficacy Scale. Student t-test was used to compare the values of breastfeeding self-efficacy between the groups of participants. We considered a 5% significance level (p=0.05). Results: most adolescents and adults mothers (54%) presented high levels of breastfeeding self-efficacy and there was no statistically significant difference between the scores of the two groups (p=0.3482) . Conclusion: health professionals need to be careful about breastfeeding self-efficacy in order to direct specific actions for each group of mothers (adolescents and adult mothers) to improve the breastfeeding rates.
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Hinic K. Predictors of Breastfeeding Confidence in the Early Postpartum Period. J Obstet Gynecol Neonatal Nurs 2016; 45:649-60. [DOI: 10.1016/j.jogn.2016.04.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2016] [Indexed: 12/20/2022] Open
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