1
|
Fisher E, Patel P, Wouk KG, Neupane B, Alkhalifah F, Bartholmae MM, Tang C, Zhang Q. Breastfeeding Perceptions and Decisions among Hispanic Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children: A Qualitative Study. Nutrients 2024; 16:1565. [PMID: 38892499 PMCID: PMC11173851 DOI: 10.3390/nu16111565] [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] [Received: 05/08/2024] [Revised: 05/19/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a nutrition assistance program in the U.S. WIC served 2.5 million eligible Hispanic women, infants, and children under the age of five in 2021, which is WIC's largest racial/ethnic group. However, limited research has been conducted to understand Hispanic WIC participants' perceptions of WIC breastfeeding recommendations and their breastfeeding decisions. For this qualitative study, we interviewed 18 of these pregnant and postpartum WIC participants on their experiences and decision-making processes related to breastfeeding. Hispanic cultures and home country norms were identified as prominent influences on breastfeeding decisions, along with perceptions of WIC's breastfeeding support. These results can help the WIC program to refine its breastfeeding education to better meet the needs of Hispanic participants.
Collapse
Affiliation(s)
- Emily Fisher
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA; (E.F.); (P.P.); (B.N.); (F.A.); (M.M.B.)
| | - Priyanka Patel
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA; (E.F.); (P.P.); (B.N.); (F.A.); (M.M.B.)
| | - Kathryn G. Wouk
- Pacific Institute for Research and Evaluation, Chapel Hill, NC 27514, USA;
| | - Bidusha Neupane
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA; (E.F.); (P.P.); (B.N.); (F.A.); (M.M.B.)
| | - Futun Alkhalifah
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA; (E.F.); (P.P.); (B.N.); (F.A.); (M.M.B.)
| | - Marilyn M. Bartholmae
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA; (E.F.); (P.P.); (B.N.); (F.A.); (M.M.B.)
- Department of Psychiatry and Behavioral Health, Eastern Virginia Medical School, Norfolk, VA 23510, USA
| | - Chuanyi Tang
- Department of Marketing, Old Dominion University, Norfolk, VA 23529, USA;
| | - Qi Zhang
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA; (E.F.); (P.P.); (B.N.); (F.A.); (M.M.B.)
| |
Collapse
|
2
|
Izumi C, Trigg J, Stephens JH. A systematic review of migrant women's experiences of successful exclusive breastfeeding in high-income countries. MATERNAL & CHILD NUTRITION 2024; 20:e13556. [PMID: 37584632 PMCID: PMC10750009 DOI: 10.1111/mcn.13556] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 07/20/2023] [Accepted: 07/27/2023] [Indexed: 08/17/2023]
Abstract
The World Health Organisation recommends exclusive breastfeeding for the first 6 months after childbirth. However, since breastfeeding is influenced by cultural practice, it differs between migrant mothers and nonmigrant mothers. This systematic review examined migrant mothers' perceptions and experiences impacting achievement of exclusive breastfeeding after immigration from a low-middle-income country to a high-income country. CINAHL, Medline, Scopus, Web of Science, PsycINFO and Emcare were searched for qualitative studies published from 2010 to August 2022. Eleven studies met inclusion criteria. We used meta-ethnographic synthesis to identify overarching themes, resulting in five themes: Migrant mothers (1) 'recognised the differences in breastfeeding practice between their home and host country'. During acculturation, mothers modify or stick to their breastfeeding practice in their host country based on their (2) 'breastfeeding knowledge' by combining their (3) 'original ethnic identity' with the (4) 'influence of family members, healthcare workers, infants, peers and workplace'. Although they face barriers, their (5) 'autonomy' motivated them to continue breastfeeding in a country where the breastfeeding norm differs from where they come from. Intrapersonal and interpersonal socio-ecological factors played a significant role in their breastfeeding practice in the host country. Findings indicate public health policy and practice to support breastfeeding for migrant women in high-income countries can be improved, particularly by emphasising the importance of providing affirmative, comprehensive and practical support from healthcare professionals.
Collapse
Affiliation(s)
- Chieko Izumi
- College of Medicine and Public HealthFlinders UniversityAdelaideSouth AustraliaAustralia
- Ehime Prefectural University of Health SciencesEhimeJapan
| | - Joshua Trigg
- College of Medicine and Public HealthFlinders UniversityAdelaideSouth AustraliaAustralia
- Flinders Health and Medical Research InstituteAdelaideSouth AustraliaAustralia
| | - Jacqueline H. Stephens
- College of Medicine and Public HealthFlinders UniversityAdelaideSouth AustraliaAustralia
- Flinders Health and Medical Research InstituteAdelaideSouth AustraliaAustralia
| |
Collapse
|
3
|
Barriers and facilitators to exclusive breastfeeding in rural Pakistan: a qualitative exploratory study. Int Breastfeed J 2022; 17:59. [PMID: 35986337 PMCID: PMC9389710 DOI: 10.1186/s13006-022-00495-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/12/2022] [Indexed: 11/10/2022] Open
Abstract
Background Exclusive breastfeeding (EBF) of children until six months of age is considered one of the most critical interventions in tackling childhood undernutrition. EBF rates are suboptimal in Pakistan, particularly in rural areas where child undernutrition is most prevalent. This study aimed to explore barriers to EBF in a rural context of Pakistan. Methods The study was conducted in the rural district Matiari of Sindh, Pakistan, during Jan-March 2020. We used a qualitative exploratory study design and conducted 36 focus group discussions (FGDs). Participants were purposively selected mothers who had not practiced EBF during their previous childbirth, their spouses and mothers-in-law, and lady health workers (LHWs) serving in the study catchment. FGDs were audio-recorded, transcribed, and translated into English from the local language and analysed using thematic content analysis. Results Barriers to EBF included low awareness and cultural practices of prelacteal feeds, insufficient breast milk production, undernutrition of mothers, mothers’ occupation as fieldworkers, less birth spacing, low awareness about the correct technique of breastfeeding, maternal and child ailments, abnormal breasts, and influence of in-laws to start top-up feeds. Several facilitators were identified: family support, appropriate maternal diet, maternal awareness, and support in the neighborhood. Conclusion Barriers to EBF are multifaceted in rural areas, and interventions aiming to improve adherence to EBFshould be multipronged. Awareness-raising alone might not be sufficient, and other interventions should be designed to address the barriers of maternal malnutrition, insufficient milk production, and socio-cultural practices. In addition, safe alternatives to breast milk may be necessary if breastfeeding is truly not feasible. Lack of breast milk substitutes is particularly challenging for poor rural women who cannot afford infant formula milk.
Collapse
|
4
|
Bookhart LH, Anstey EH, Kramer MR, Perrine CG, Reis‐Reilly H, Ramakrishnan U, Young MF. A nation‐wide study on the common reasons for infant formula supplementation among healthy, term, breastfed infants in US hospitals. MATERNAL & CHILD NUTRITION 2022; 18:e13294. [PMID: 34905644 PMCID: PMC8932686 DOI: 10.1111/mcn.13294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 11/29/2022]
Abstract
In‐hospital infant formula supplementation of breastfed infants reduces breastfeeding duration, yet little is known about common reasons for infant formula supplementation. We examined the three most common reasons for in‐hospital infant formula supplementation of healthy, term, breastfed infants in the US reported by hospital staff. Hospital data were obtained from the 2018 Maternity Practices in Infant Nutrition and Care survey (n = 2045), which is completed by hospital staff. An open‐ended question on the top three reasons for in‐hospital infant formula supplementation was analyzed using thematic qualitative analysis and the frequencies for each reason were reported. The top three most common reasons for in‐hospital infant formula supplementation reported by hospital staff included medical indications (70.0%); maternal request/preference/feelings (55.9%); lactation management‐related issues (51.3%); physical but non‐medically indicated reasons (36.1%); social influences (18.8%); perceived cultural/societal/demographic factors (8.2%) and medical staff/institutional practices (4.7%). These findings suggest that a variety of factors should be considered to address unnecessary infant formula supplementation. Lactation management support delivered in a timely and culturally sensitive manner and targeted to mother‐infant dyads with potential medical and physical indications may reduce unnecessary in‐hospital infant formula supplementation. The three most commonly reported reasons by hospital staff for infant formula supplementation were found to be related to medical indications (70.0%); maternal request/preference/feelings about breastfeeding such as frustration or lack of confidence (55.9%); lactation management‐related issues (51.3%); physical but non‐medically indicated reasons (36.1%); social influences (18.8%); perceived cultural/societal/demographic factors (8.2%); and medical staff/institutional practices (4.7%). Underlying many of the reported three most common reasons for infant formula supplementation is potentially lack of lactation management support that considers the social influences (e.g. from family and friends) and that is culturally relevant. These findings suggest that a variety of factors should be considered to address unnecessary infant formula supplementation.
Collapse
Affiliation(s)
- Larelle H. Bookhart
- Hubert Department of Global Health, Doctoral Program in Nutrition and Health Sciences, Laney Graduate School Emory University Atlanta Georgia USA
| | - Erica H. Anstey
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention Atlanta Georgia USA
| | - Michael R. Kramer
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta Georgia USA
| | - Cria G. Perrine
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention Atlanta Georgia USA
| | - Harumi Reis‐Reilly
- Maternal and Child Health National Association of County and City Health Officials Washington District of Columbia USA
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Doctoral Program in Nutrition and Health Sciences, Laney Graduate School Emory University Atlanta Georgia USA
- Hubert Department of Global Health Emory University Atlanta Georgia USA
| | - Melissa F. Young
- Hubert Department of Global Health, Doctoral Program in Nutrition and Health Sciences, Laney Graduate School Emory University Atlanta Georgia USA
- Hubert Department of Global Health Emory University Atlanta Georgia USA
| |
Collapse
|
5
|
Agyekum MW, Codjoe SNA, Dake FAA, Abu M. Enablers and inhibitors of exclusive breastfeeding: perspectives from mothers and health workers in Accra, Ghana. Int Breastfeed J 2022; 17:21. [PMID: 35313914 PMCID: PMC8935745 DOI: 10.1186/s13006-022-00462-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 02/22/2022] [Indexed: 11/12/2022] Open
Abstract
Background Despite the health and economic benefits of exclusive breastfeeding, there is evidence of a decline globally and in Ghana. Previous studies addressing this problem are mostly quantitative with only a few of such studies using qualitative or mixed methods to examine the predictors, benefits, ways of improving and managing exclusive breastfeeding, and the challenges associated with exclusive breastfeeding from the perspective of exclusive and nonexclusive breastfeeding mothers, and health workers. This study employs the health belief model to examine the experiences of mothers and health workers regarding exclusive breastfeeding to fill this gap in the literature. Methods A cross-sectional qualitative study involving in-depth interviews was conducted among health workers and mothers attending child welfare clinic at two polyclinics in Madina, Accra-Ghana in 2019. Purposive sampling was used to select health facilities and participants for the study. Twenty participants comprising ten exclusive breastfeeding mothers, six non-exclusive breastfeeding mothers and four health workers were interviewed for the study. The data were analyzed based on emerging themes from inductive and deductive coding. Results The decision to practice exclusive breastfeeding was based on mothers’ work, advertisement on exclusive breastfeeding and education on breastfeeding provided by health workers. Insufficient flow of breast milk, pressure from family and friends, and insufficient breast milk for infants were among the reasons for discontinuing exclusive breastfeeding. The factors that help improve exclusive breastfeeding include eating healthy food and breastfeeding on demand, while counselling and monitoring, restricting advertisement on infant formula and granting maternity leave for breastfeeding mothers were identified as factors that can facilitate the practice of exclusive breastfeeding. Conclusion Different levels of experience affect and shape exclusive breastfeeding practice in Ghana. The decision to practice exclusive breastfeeding, as well as the challenges and strategies employed in managing exclusive breastfeeding, emanates from mothers’ personal experiences and interactions with institutional factors. In view of this, there should be counselling on the management of challenges associated with exclusive breastfeeding and provision of accurate information on exclusive breastfeeding to enable mothers practice exclusive breastfeeding. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-022-00462-z.
Collapse
Affiliation(s)
- Martin Wiredu Agyekum
- Institute for Educational Research and Innovation Studies, University of Education, Winneba, P. O. Box 25, Winneba, Ghana. .,Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon-Accra, Ghana.
| | - Samuel N A Codjoe
- Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon-Accra, Ghana
| | - Fidelia A A Dake
- Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon-Accra, Ghana
| | - Mumuni Abu
- Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon-Accra, Ghana
| |
Collapse
|
6
|
Dharod JM, Hernandez M, Frazier C, Labban J, Raynor N, Ramos-Castillo I, Cooper J. Food and Housing Insecurity: Do They Affect the Continuation of Breastfeeding at Four Months of Age? JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2053629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jigna M. Dharod
- Department of Nutrition, School of Health and Human Science, University of North Carolina, Greensboro, USA
| | - Marlen Hernandez
- Department of Nutrition, School of Health and Human Science, University of North Carolina, Greensboro, USA
| | - Christina Frazier
- Department of Nutrition, School of Health and Human Science, University of North Carolina, Greensboro, USA
| | - Jeffery Labban
- Office of Research, School of Health and Human Science, University of North Carolina, Greensboro
| | - Nichole Raynor
- Department of Nutrition, School of Health and Human Science, University of North Carolina, Greensboro, USA
| | - Isa Ramos-Castillo
- Department of Nutrition, School of Health and Human Science, University of North Carolina, Greensboro, USA
| | - Jessica Cooper
- Department of Nutrition, School of Health and Human Science, University of North Carolina, Greensboro, USA
| |
Collapse
|
7
|
Beggs B, Koshy L, Neiterman E. Women's Perceptions and Experiences of Breastfeeding: a scoping review of the literature. BMC Public Health 2021; 21:2169. [PMID: 34836514 PMCID: PMC8626903 DOI: 10.1186/s12889-021-12216-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 11/10/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Despite public health efforts to promote breastfeeding, global rates of breastfeeding continue to trail behind the goals identified by the World Health Organization. While the literature exploring breastfeeding beliefs and practices is growing, it offers various and sometimes conflicting explanations regarding women's attitudes towards and experiences of breastfeeding. This research explores existing empirical literature regarding women's perceptions about and experiences with breastfeeding. The overall goal of this research is to identify what barriers mothers face when attempting to breastfeed and what supports they need to guide their breastfeeding choices. METHODS This paper uses a scoping review methodology developed by Arksey and O'Malley. PubMed, CINAHL, Sociological Abstracts, and PsychInfo databases were searched utilizing a predetermined string of keywords. After removing duplicates, papers published in 2010-2020 in English were screened for eligibility. A literature extraction tool and thematic analysis were used to code and analyze the data. RESULTS In total, 59 papers were included in the review. Thematic analysis showed that mothers tend to assume that breastfeeding will be easy and find it difficult to cope with breastfeeding challenges. A lack of partner support and social networks, as well as advice from health care professionals, play critical roles in women's decision to breastfeed. CONCLUSION While breastfeeding mothers are generally aware of the benefits of breastfeeding, they experience barriers at individual, interpersonal, and organizational levels. It is important to acknowledge that breastfeeding is associated with challenges and provide adequate supports for mothers so that their experiences can be improved, and breastfeeding rates can reach those identified by the World Health Organization.
Collapse
Affiliation(s)
- Bridget Beggs
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada.
| | - Liza Koshy
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| | - Elena Neiterman
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| |
Collapse
|
8
|
Bookhart LH, Joyner AB, Lee K, Worrell N, Jamieson DJ, Young MF. Moving Beyond Breastfeeding Initiation: A Qualitative Study Unpacking Factors That Influence Infant Feeding at Hospital Discharge Among Urban, Socioeconomically Disadvantaged Women. J Acad Nutr Diet 2021; 121:1704-1720. [PMID: 33715976 DOI: 10.1016/j.jand.2021.02.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 01/18/2021] [Accepted: 02/02/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Factors that influence breastfeeding initiation and duration have been well established; however, there is limited understanding of in-hospital exclusive breastfeeding (EBF), which is critical for establishing breastfeeding. Grady Memorial Hospital, which serves a high proportion of participants receiving Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and racial/ethnic minorities, had an in-hospital EBF rate in 2018 by the Joint Commission's definition of 29% and sought contextualized evidence on how to best support breastfeeding mothers. OBJECTIVE The objectives were to (1) identify facilitators and barriers to in-hospital EBF and (2) explore breastfeeding support available from key stakeholders across the social-ecological model. DESIGN In-depth, semistructured interviews were conducted and analyzed using thematic analysis. PARTICIPANTS The sample included a total of 38 purposively sampled participants from Grady Memorial Hospital (10 EBF mothers, 10 non-EBF, and 18 key stakeholders such as clinicians, community organizations' staff, and administrators). RESULTS Key themes included that maternal perception of inadequate milk supply was a barrier to in-hospital EBF at the intrapersonal level. At the interpersonal level, a personable and individualized approach to breastfeeding counseling may be most effective in supporting EBF. At the institutional level, key determinants of EBF were gaps in prenatal breastfeeding education, limited time to provide comprehensive prenatal education to high-risk patients, and practical help with latching and positioning. Community-level WIC services were perceived as a facilitator due to the additional benefits provided for EBF mothers; however, the distribution of WIC vouchers for formula to mothers while they are in the hospital undermines the promotion of EBF. Cultural norms and a diverse patient population were reported as barriers to providing support at the macrosystem level. CONCLUSION Multipronged approaches that span the social-ecological model may be required to support early EBF in hospital settings.
Collapse
|
9
|
Nguyen NT, Prasopkittikun T, Payakkaraung S, Vongsirimas N. Factors predicting six-month exclusive breastfeeding among mothers in Ho Chi Minh City, Vietnam. JOURNAL OF HEALTH RESEARCH 2021. [DOI: 10.1108/jhr-03-2020-0080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeExclusive breastfeeding (EBF) rates continue to be low in Vietnam. This study aimed to determine the factors predicting 6-month EBF among mothers in Ho Chi Minh City, Vietnam.Design/methodology/approachA cross-sectional study was conducted with 259 mothers of infants aged between six to nine months at well-baby clinics in Ho Chi Minh City. The questionnaires used for data collection included personal background questionnaire, perceived benefits of breastfeeding scale, breastfeeding self-efficacy scale-short form, perceived barriers to breastfeeding scale and the family support of breastfeeding scale. Descriptive statistics, bivariate and multiple logistic regression were used for data analysis.FindingsAbout 32% of the Vietnamese mothers practiced 6-month EBF. By increasing one unit of perceived benefits of breastfeeding, perceived self-efficacy in breastfeeding and family support, the mothers' likelihood to give 6-month EBF would increase 19% (AOR = 1.19, 95% CI = 1.08, 1.31), 12% (AOR = 1.12, 95% CI = 1.04, 1.19) and 10% (AOR = 1.10, 95% CI = 1.04, 1.16), while previous breastfeeding experience, maternal age and maternal education could not significantly contribute to the 6-month EBF.Originality/valueThis is the first study in Vietnam using a nursing model, the health promotion model, as a framework to identify factors predicting 6-month EBF. An effective program for promoting EBF could be developed by manipulating and tailoring the predicting factors to fit the Vietnamese mothers' needs through a mother class, lactation clinic or individual approach.
Collapse
|
10
|
Mandelbaum J, Mesa A, Alhabas M, Blake CE. Early Initiation of Combination Feeding among Latina Mothers in the Deep South: Perspectives for Clinicians. South Med J 2021; 114:32-34. [PMID: 33398358 DOI: 10.14423/smj.0000000000001188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jennifer Mandelbaum
- From the Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia
| | - Anna Mesa
- From the Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia
| | - Maryam Alhabas
- From the Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia
| | - Christine E Blake
- From the Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia
| |
Collapse
|
11
|
Ávila-Ortiz MN, Castro-Sánchez AE, Martínez-González EA, Núñez-Rocha GM, Zambrano-Moreno A. Factors associated with abandoning exclusive breastfeeding in Mexican mothers at two private hospitals. Int Breastfeed J 2020; 15:73. [PMID: 32814577 PMCID: PMC7436974 DOI: 10.1186/s13006-020-00316-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 08/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exclusive breastfeeding (EBF) has multiple benefits for both the child and the mother; however, there is little data regarding the reason why Mexican mothers with a high socio-economic level abandon EBF before 6 months, and there is limited information about the practice of breastfeeding in private hospitals. The objective was to identify the factors associated with the cessation of exclusive breastfeeding in Mexican mothers at two private hospitals. METHODS A cross-sectional study was conducted with 218 upper-class mothers selected according to their place of residence by geographic location, socio-economic level, and pediatric consultations cost. They were over 18 years old and with children aged 6 to 24 months. Data were collected between July and November 2016 by face to face interview using a structured questionnaire while the mothers waited for the pediatric postnatal care consultation in two private hospitals in northeastern Mexico. Exclusive breastfeeding was measured according to World Health Organization (WHO) recommendations, which consist of providing only breast milk for the first 6 months of life. Chi-squared tests and multivariate logistic regression were performed. RESULTS Mean maternal age was 31.4 years (SD of 4.4) and most of the participants had an undergraduate education, were married, and worked outside the home. The prevalence of exclusive breastfeeding at 6 months was 28%. Upper-class working mothers are less likely to continue breastfeeding. There was a negative association with employment (AOR 13.69; 95% CI 1.59, 111.11), bottle use in the first 6 months (AOR 7.93; 95% CI 3.07, 20.48), and a low level of knowledge (AOR 2.18; 95% CI 1.04, 4.56). After 6 months, only 61 mothers (28%) maintained exclusive breastfeeding. CONCLUSIONS Knowledge level, bottle use, and employment are associated with premature cessation of EBF in Mexican upper-class mothers, attending two private hospitals. There was a high percentage of breastfeeding cessation in the sample. It is necessary to reinforce a strategy that coordinates the action of the different laws, regulations and programs affecting the exclusive breastfeeding practice, in order to adequately promote breastfeeding and support mothers in both public and private sectors.
Collapse
Affiliation(s)
- María Natividad Ávila-Ortiz
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico.
| | - Ana Elisa Castro-Sánchez
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico
| | - Elizabeth Andrea Martínez-González
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico
| | - Georgina Mayela Núñez-Rocha
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico
| | - Adriana Zambrano-Moreno
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico
| |
Collapse
|
12
|
Patil DS, Pundir P, Dhyani VS, Krishnan JB, Parsekar SS, D'Souza SM, Ravishankar N, Renjith V. A mixed-methods systematic review on barriers to exclusive breastfeeding. Nutr Health 2020; 26:323-346. [PMID: 33000699 DOI: 10.1177/0260106020942967] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The World Health Organization recommends exclusive breastfeeding for every newborn during the first 6 months of life, yet women come across various challenges to continuing it. AIM This systematic review was intended to identify barriers to exclusive breastfeeding among mothers. METHODS MEDLINE, Cumulative Index to Nursing and Allied health literature, ProQuest, Web of Science and Scopus databases were searched from January 1990 to October 2017. The systematic review included quantitative, qualitative and mixed-methods studies to identify barriers to exclusive breastfeeding among mothers of reproductive age with an infant aged between 0 and 12 months. All studies were screened based on titles, abstracts and full text by two reviewers independently. The methodological quality of included studies was assessed using appropriate tools. Of the 9737 eligible records, 44 studies were included for analysis. Classification of barriers to exclusive breastfeeding was adopted from the conceptual framework of factors affecting breastfeeding practices given by Hector and colleagues. RESULTS In total 32 barriers were grouped under individual, group and society level factors. Meta-analysis indicated that mothers who smoked had 2.49 times more odds of not exclusively breastfeeding than non-smoking mothers and mothers who had undergone caesarean section had 1.69 times more risk of cessation of exclusive breastfeeding than mothers who have had a vaginal childbirth. CONCLUSION The systematic review revealed a complex interplay of various barriers related to exclusive breastfeeding. It is recommended that context-specific strategies should be designed in accordance with barriers existing in a region or country.
Collapse
Affiliation(s)
| | - Prachi Pundir
- Public Health Evidence South Asia, Prasanna School of Public Health, India
| | - Vijay Shree Dhyani
- Public Health Evidence South Asia, Prasanna School of Public Health, India
| | - Jisha B Krishnan
- Public Health Evidence South Asia, Prasanna School of Public Health, India
| | - Shradha S Parsekar
- Public Health Evidence South Asia, Prasanna School of Public Health, India.,Department of Community Medicine, Kasturba Medical College, India
| | | | - N Ravishankar
- Department of Statistics, Prasanna School of Public Health, India
| | - Vishnu Renjith
- Department of Neurology, 123320Sree Chitra Tirunal Institute for Medical Sciences and Technology, India
| |
Collapse
|
13
|
Stamenkovic Z, Matejic B, Djikanovic B, Bjegovic-Mikanovic V. Surprising Differences in the Practice of Exclusive Breastfeeding in Non-Roma and Roma Population in Serbia. Front Public Health 2020; 8:277. [PMID: 32714892 PMCID: PMC7342049 DOI: 10.3389/fpubh.2020.00277] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 05/27/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Exclusive breastfeeding is essential for early childhood development, although the use of adaptive milk formulas instead of breastfeeding is widespread nowadays. This study aimed to examine the prevalence of exclusively breastfed infants under the age of 6 months in non-Roma and Roma population and factors associated with this practice. Materials and Methods: This study is a secondary analysis of the Serbian Multiple Indicator Cluster Survey investigating non-Roma and Roma infants under the age of 6 months. The study included mothers of 321 non-Roma and 164 Roma infants younger than 6 months. Univariate and multivariate logistic regression served to analyze factors associated with the practice of exclusive breastfeeding in both populations. Results: The prevalence of exclusive breastfeeding was almost the same among mothers in both non-Roma and Roma population (13.3 vs. 13%, p = 0.910). Exclusive breastfeeding was significantly more often (p < 0.001) among wealthier women, women whose newborns were over 2,500 g on birth, multipara, and women who had not established menstrual cycle among both populations. Living outside the capital significantly diminishes the chance for exclusively breastfed infants in the non-Roma community (Vojvodina: OR 0.16, CI 95% 0.03–0.92; eastern Serbia: OR 0.02, CI 95% 0.01–0.35) as well as living in the rural area (urban: OR 10.35, CI 95% 1.94–55.28). Unexpectedly, in the non-Roma population, not staying in the same room with the newborn in the maternity ward increases the chance for the baby to be exclusively breastfed (OR 7.19, CI 95% 1.80–28.68). The same pattern has been observed in Roma population. Non-Roma mothers multipara are more likely to exclusively breastfeed their children than primipara (OR 7.78, CI 95% 1.09–20.93), while among Roma mothers, the inverse association has been found although not significant (OR 0.42, CI 95% 0.14–1.23). Attending a childbirth preparation program more than 18 times increases the chances of infants being exclusively breastfed (OR 18.65, CI 95% 1.34–53.67). In the Roma population, there was no single woman that attended a childbirth preparation program. Conclusion: The pattern of exclusive breastfeeding significantly differs between non-Roma and Roma populations. Preventive work should have focus on strengthening support to mothers and medical staff in maternity wards.
Collapse
Affiliation(s)
- Zeljka Stamenkovic
- Institute of Social Medicine, Medical Faculty University of Belgrade, Belgrade, Serbia
| | - Bojana Matejic
- Institute of Social Medicine, Medical Faculty University of Belgrade, Belgrade, Serbia
| | - Bosiljka Djikanovic
- Institute of Social Medicine, Medical Faculty University of Belgrade, Belgrade, Serbia
| | | |
Collapse
|
14
|
Effect of Education Based on Extended Theory of Planned Behavior on Exclusive Breastfeeding in Pregnant Women in Darmian in 2017. HEALTH SCOPE 2020. [DOI: 10.5812/jhealthscope.100277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Appropriate breastfeeding reduces health disorders and death among infants. Objectives: The present study was conducted to evaluate the effects of educational intervention based on the extended theory of planned behavior. Methods: In this semi-experimental study, 168 pregnant women from 20 health centers were allocated into intervention and control groups by a multi-stage sampling method. The data collecting tool included demographic and constructs of an extended theory of planned behavior. The validity and reliability of the questionnaire were confirmed by an expert panel and Cronbach's alpha test, respectively. The educational methods encompassed face to face training, pamphlet and flashcards distribution, and clip presentation. Two 45-minute educational sessions were conducted; the data were recollected 6 months after the delivery. Results: The mean ages of the intervention and control group were 29 ± 6 and 28.7 ± 5.9. The pregnancy rate and age of the pregnancy in the intervention group were 2.7 ± 1.4 and 29 weeks, respectively. After the intervention, the mean score of the behavior in the intervention group increased compared to the control group. The intention (B = 0.4, P = 0.01) and perceived behavior control (B = 0.42, P = 0.03) were the predictors of the behavior. Conclusions: The structures of the extended theory of planned behavior are suitable framework to promote exclusive breastfeeding among pregnant women.
Collapse
|
15
|
Wagner LPB, Mazza VDA, Souza SRRK, Chiesa A, Lacerda MR, Soares L. Strengthening and weakening factors for breastfeeding from the perspective of the nursing mother and her family. Rev Esc Enferm USP 2020; 54:e03563. [PMID: 32401890 DOI: 10.1590/s1980-220x2018034303564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 08/13/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To describe the strengthening and weakening factors for breastfeeding. METHOD This is a descriptive multiple case qualitative study, conducted in Curitiba, Parana, with members of 17 families with children between 6 and 12 months old, through semi-structured interview and construction of genograms, analyzed by the strategy of cross case synthesis. RESULTS 28 people participated in the study. Strengthening factors for breastfeeding were: the desire to breastfeed; child with facility for breastfeeding; mother with time available to the child; previous breastfeeding experience and family history of breastfeeding; the support and encouragement to breastfeed. Weakening factors were: negative expectations; the myth of weak milk; child's disease; maternal illness; negative experiences of the mother; the absence of family history of breastfeeding; lack of a support network. CONCLUSION Breastfeeding is a family and social phenomenon. Therefore, practices that go beyond the mother-baby dyad are necessary. The care process should include the social and subjective dimension, strengthening the support network of nursing mothers, in order to obtain more satisfactory professional practices that promote breastfeeding.
Collapse
Affiliation(s)
| | | | | | - Anna Chiesa
- Departamento de Enfermagem em Saúde Coletiva, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Maria Ribeiro Lacerda
- Programa de Pós-graduação em Enfermagem, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Larissa Soares
- Programa de Pós-graduação em Enfermagem, Universidade Federal do Paraná, Curitiba, PR, Brazil
| |
Collapse
|
16
|
Dattilo AM, Carvalho RS, Feferbaum R, Forsyth S, Zhao A. Hidden Realities of Infant Feeding: Systematic Review of Qualitative Findings from Parents. Behav Sci (Basel) 2020; 10:E83. [PMID: 32349324 PMCID: PMC7287829 DOI: 10.3390/bs10050083] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 01/22/2023] Open
Abstract
A growing, global conversation, regarding realities and challenges that parents experience today is ever-present. To understand recent parent's attitudes, beliefs, and perceptions regarding infant feeding, we sought to systematically identify and synthesize original qualitative research findings. Following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) framework, electronic databases were searched with a priori terms applied to title/abstract fields and limited to studies published in English from 2015 to 2019, inclusive. Study quality assessment was conducted using the Critical Appraisal Skills Programme (CASP) checklist, and thematic analyses performed. Of 73 studies meeting inclusion criteria, four major themes emerged. (1) Breastfeeding is best for an infant; (2) Distinct attitudes, beliefs, and perceptions of mothers that breastfeed, and those that could not or chose not to breastfeed, are evident; (3) Infant feeding behaviors are influenced by the socio-cultural environment of the family, and (4) Parent's expectations of education and support addressing personal infant feeding choices from health care providers are not always met. This systematic review, guided by constructs within behavioral models and theories, provides updated findings to help inform the development of nutrition education curricula and public policy programs. Results can be applied within scale-up nutrition and behavioral education interventions that support parents during infant feeding.
Collapse
Affiliation(s)
- Anne M. Dattilo
- Nestlé Nutrition, Avenue Nestle, 55 CH-1800 Vevey, Switzerland;
| | | | - Rubens Feferbaum
- Children’s Institute University of São Paulo, Rua Tremembé, São Paulo-SP 01256-010, Brazil;
| | - Stewart Forsyth
- School of Medicine, University of Dundee, Dundee DD5 1JG, UK;
| | - Ai Zhao
- School of Public Health, Peking University Health Science Center, Xueyuan Road No. 38., Beijing 100191, China;
| |
Collapse
|
17
|
Angelo BHDB, Pontes CM, Sette GCS, Leal LP. Knowledge, attitudes and practices of grandmothers related to breastfeeding: a meta-synthesis. Rev Lat Am Enfermagem 2020; 28:e3214. [PMID: 32074204 PMCID: PMC7021479 DOI: 10.1590/1518-8345.3097.3214] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 08/04/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Evaluate the knowledge, attitudes and practices of grandmothers that support or discourage the breastfeeding process. METHOD This is a meta-synthesis based on the theoretical and methodological framework of meta-ethnography developed by Noblit and Hare. A critical evaluation of the articles was conducted using the consolidated criteria for reporting qualitative research (Coreq). Primary and secondary constructs derived from the results of nine articles were grouped into a new theory, leading to tertiary constructs that were presented in a diagram based on the functionality of Sanicola's Social Network Theory. RESULTS Grandmothers know the benefits of breastfeeding, the importance of a special diet and proper hydration for the production of good quality milk, but report inadequacies in the treatment of breast complications and the need for breast milk complementation before the sixth month of life. These aspects were also observed: religious interference, opposition of ideas about breastfeeding, and family decisions based on the grandmother figure. CONCLUSION Through knowledge, attitudes and practices, grandmothers, central figures in breastfeeding support, support their daughters and daughters-in-law in breastfeeding or discourage breastfeeding with contrary opinions and inadequate guidance.
Collapse
Affiliation(s)
- Bárbara Helena de Brito Angelo
- Universidade Federal de Pernambuco, Recife, PE, Brasil
- Universidade Federal de Pernambuco, Hospital das Clínicas, Núcleo
Interno de Regulação, Recife, PE, Brasil
| | - Cleide Maria Pontes
- Universidade Federal de Pernambuco, Departamento de Enfermagem,
Recife, PE, Brasil
| | | | - Luciana Pedrosa Leal
- Universidade Federal de Pernambuco, Departamento de Enfermagem,
Recife, PE, Brasil
| |
Collapse
|
18
|
Facilitators and Barriers to Breastfeeding and Exclusive Breastfeeding in Kilimanjaro Region, Tanzania: A Qualitative Study. Int J Pediatr 2019; 2019:8651010. [PMID: 30853994 PMCID: PMC6378044 DOI: 10.1155/2019/8651010] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 01/09/2019] [Indexed: 11/28/2022] Open
Abstract
Background Breastfeeding is the best way to feed infants. It is a simple intervention to improve child health and development. Despite its advantages, there is a low global rate of exclusive breastfeeding (EBF) and, in Kilimanjaro region, Tanzania, EBF is rarely practiced. The aim of this paper is to explore social and cultural factors that might influence the practice of breastfeeding and exclusive breastfeeding in Kilimanjaro region. Methods A qualitative design was used. Three districts in Kilimanjaro region, namely, Same, Moshi Municipal Council, and Rombo, were selected. In each district three focus group discussions (FGDs) were conducted with mothers with infants aged 0-12 months. Results A total of 78 mothers participated in the focus group discussions. A majority of the mothers were positive towards breastfeeding. They believed that it prevents child sickness, creates happiness, and is good for family economy. Despite the positive attitudes, the mothers revealed many perceptions that interfered with breastfeeding and exclusive breastfeeding. These included the following: breast milk is very light and has bad odor, breastfeeding may affect mothers appearance, chango (abdominal pain) has to be treated, there is fear of the evil eye when breastfeeding in public places, breast milk may become unclean, and there is a need of pauses in breastfeeding after the child has burped on the breast. Conclusion There are beliefs that promote the practice of breastfeeding in this setting; these local beliefs could be used to develop breastfeeding messages to improve breastfeeding practices. However, there is also a need to address beliefs that interfere with the practice of exclusive breastfeeding in this setting.
Collapse
|
19
|
Sebastian RA, Coronado E, Otero MD, McKinney CR, Ramos MM. Associations Between Maternity Care Practices and 2-Month Breastfeeding Duration Vary by Race, Ethnicity, and Acculturation. Matern Child Health J 2019; 23:858-867. [PMID: 30659460 DOI: 10.1007/s10995-018-02711-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives This study examines the associations between specific maternity care practices and breastfeeding duration for Spanish-speaking Hispanic, English-speaking Hispanic, non-Hispanic Native American, and non-Hispanic White women. Methods We analyzed data from the 2012-2014 New Mexico Pregnancy Risk Assessment Monitoring System. We used survey language as a proxy measure of acculturation and categorized women as Spanish-speaking Hispanic, English-speaking Hispanic, non-Hispanic Native American, and non-Hispanic White. We conducted bivariate analyses to compare rates of breastfeeding at 2 months and experiences of maternity care practices and logistic regression analysis to estimate the effects of these practices on breastfeeding duration for each group. Results Hispanic women were less likely than non-Hispanic women to breastfeed for at least 2 months (67.9% vs. 76.6%; p = 0.000); however, this varied significantly by acculturation level: 78.1% of Spanish-speaking Hispanic women compared to 66.1% of English-speaking Hispanic women breastfed for at least 2 months (p = 0.000). The effects of specific maternity care practices on duration varied across groups. Among non-Hispanic White, Native American, and English-speaking Hispanic women, breastfeeding while at the hospital had the strongest effect (AOR 2.09, 95% CI 1.67-2.61; AOR 2.71, 95% CI 2.08-3.52; and AOR 1.99, 95% CI 1.76-2.25, respectively). Among Spanish-speaking Hispanic women, being encouraged to breastfeed on demand had the strongest effect (AOR 5.179, 95% CI 3.86-6.94). Conclusions for Practice The effects of maternity care practices on breastfeeding duration vary by race, ethnicity, and acculturation level. Health care systems must acknowledge the diversity of their patient populations when seeking to develop and implement breastfeeding-friendly practices.
Collapse
Affiliation(s)
- Rachel A Sebastian
- Child Policy Research Consulting, LLC, 124 Basswood Circle, Fort Wright, KY, 41011, USA.
| | - Eirian Coronado
- New Mexico Department of Health, 1190 S. St. Francis Drive, Santa Fe, NM, 87505, USA
| | - Maria D Otero
- Nuestra Salud, LLC, 4282 Alexander Blvd NE, Albuquerque, NM, 87107, USA
| | - Courtney R McKinney
- Department of Pediatrics, University of New Mexico School of Medicine, 625 Silver Avenue SW, Suite 324, Albuquerque, NM, 87102, USA
| | - Mary M Ramos
- Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico School of Medicine, MSC 10 5590, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA
| |
Collapse
|
20
|
Coburn SS, Luecken LJ, Rystad IA, Lin B, Crnic KA, Gonzales NA. Prenatal Maternal Depressive Symptoms Predict Early Infant Health Concerns. Matern Child Health J 2018; 22:786-793. [PMID: 29427015 DOI: 10.1007/s10995-018-2448-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Recent research suggests that health disparities among low-SES and ethnic minority populations may originate from prenatal and early life exposures. Postpartum maternal depressive symptoms have been linked to poorer infant physical health, yet prenatal depressive symptoms not been thoroughly examined in relation to infant health. METHODS In a prospective study of low-income Mexican American mothers and their infants, women (N = 322, median age 27.23, IQR = 22.01-32.54) completed surveys during pregnancy (median gestation 39.50, IQR = 38.71-40.14 weeks) and 12 weeks after birth. We investigated (1) if prenatal depressive symptoms predicted infant physical health concerns at 12 weeks of age, (2) whether these associations occurred above and beyond concurrent depressive symptoms, and (3) if birth weight, gestational age, and breastfeeding were mediators of prenatal depression predicting subsequent infant health. RESULTS Higher prenatal depressive symptoms were associated with more infant physical health concerns at 12 weeks (p < .001), after accounting for 12-week maternal depressive symptoms, breastfeeding, gestational age, and birth weight. Twelve-week maternal depressive symptoms were concurrently associated with more infant health concerns (p < .01). Birth weight, gestational age, and breastfeeding were not associated with maternal depression or infant health concerns. DISCUSSION Results establish a link between prenatal depressive symptoms and an elevated risk of poor health evident shortly after birth. These findings underscore the importance of the prenatal period as a possible sensitive period for infants' health, and the need for effective interventions for depression during pregnancy to mitigate potentially teratogenic effects on the developing fetus and reduce risks for later health concerns.
Collapse
Affiliation(s)
- S S Coburn
- Department of Psychology, Arizona State University, Tempe, AZ, USA. .,Division of Gastroenterology, Hepatology, and Nutrition, Children's National Medical Center, 111 Michigan Ave NW, Washington, DC, USA.
| | - L J Luecken
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - I A Rystad
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - B Lin
- Department of Psychology, Arizona State University, Tempe, AZ, USA.,Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - K A Crnic
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - N A Gonzales
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| |
Collapse
|
21
|
Parker MG, Lopera AM, Kalluri NS, Kistin CJ. "I Felt Like I Was a Part of Trying to Keep My Baby Alive": Perspectives of Hispanic and Non-Hispanic Black Mothers in Providing Milk for Their Very Preterm Infants. Breastfeed Med 2018; 13:657-665. [PMID: 30299981 DOI: 10.1089/bfm.2018.0104] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background: Compared with non-Hispanic white, Hispanic and non-Hispanic black mothers of very preterm infants are less likely to provide mother's milk at the point of hospital discharge; the perspectives of these mothers are poorly understood. Objectives: To examine the perceived barriers and facilitators of providing milk for very preterm infants during the hospitalization among Hispanic and non-Hispanic black mothers. Materials and Methods: We conducted 23 in-depth, semistructured interviews of English and Spanish-speaking Hispanic and non-Hispanic black mothers that initiated milk production for their very preterm infants, ≤1,750 g at birth. Following thematic saturation, results were validated through expert triangulation and member checking. Results: Twelve mothers were Hispanic, where three were English speaking and nine were Spanish speaking. Eleven mothers were non-Hispanic black and English speaking. We found themes pertaining to general experiences: (1) Breastfeeding intent impacts mothers' success in providing milk throughout the hospitalization; (2) Pumping milk for a hospitalized infant is repetitive, exhausting, and does not elicit the same emotional connection as breastfeeding; (3) Hospital providers are an important source of support, when sufficient time is spent to address ongoing issues; (4) Providing milk creates a unique sense of purpose when mothers otherwise feel a lack of control; and we found themes pertaining to the experiences of Hispanic and non-Hispanic black mothers: (1) Breastfeeding as a cultural norm influences mothers' intent to initiate and continue breastfeeding; (2) Hospital staff are viewed as more supportive when interactions and treatment are perceived as racially/ethnically unbiased and (3) when communication occurs in the primary language; and (4) Mother-infant separation creates logistical challenges that negatively impact ongoing milk production. Conclusions: While providing milk for a hospitalized very preterm infant is exhausting, and logistically challenging, Hispanic and non-Hispanic black mothers are inspired to do so because of their intent to breastfeed, support from hospital providers, and feelings of purpose.
Collapse
Affiliation(s)
- Margaret G Parker
- Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Adriana M Lopera
- Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Nikita S Kalluri
- Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Caroline J Kistin
- Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| |
Collapse
|
22
|
Ma A, Merçon-Vargas EA, Chambers BD, Nyambe M, Williams TA. Context of Breastfeeding among Latina Mothers using a Social-ecological Approach: An Exploratory Study. JOURNAL OF PUBLIC HEALTH ISSUES AND PRACTICES 2018; 2:124. [PMID: 31414077 PMCID: PMC6693519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Emerging research has begun to examine the breastfeeding experiences among racial/ethnic minority women. However, limited research to date has explored the potential factors that impact Latina mothers' breastfeeding through a multi-level lens. We examined the context of breastfeeding among Latina mothers in an exploratory study. METHODS We conducted semi-structured interviews with a convenience sample of 9 Latina mothers. Guided by the social-ecological model, thematic content analysis was used. RESULTS Latina mothers described individual- (e.g., knowledge of breastfeeding), interpersonal- (e.g., social support and norms), institutional- (e.g., healthcare system), and community-level (e.g., cultural norms) influences on their breastfeeding. Mothers recommended provision of bilingual and bicultural health professionals, information on US breastfeeding norms, and Latino-friendly informational materials in other languages. CONCLUSIONS Considering the multi-level factors that shape Latina mothers' breastfeeding is essential to develop and implement culturally tailored initiatives and facilitate access to breastfeeding support to improve maternal and infant health.
Collapse
Affiliation(s)
- Alice Ma
- Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, IL, 62025-1126, USA
| | - Elisa A. Merçon-Vargas
- Department of Social and Developmental Psychology, Federal University of Espírito Santo, Vitória, Espírito Santo, 29075-073, Brazil
| | - Brittany D. Chambers
- Department of Epidemiology and Biostatistics, UCSF Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, 94158, USA
| | - Monde Nyambe
- Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, IL, 62025-1126, USA
| | - Tiffany A. Williams
- Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, IL, 62025-1126, USA
| |
Collapse
|
23
|
Harris-Luna ML, Badr LK. Pragmatic Trial to Evaluate the Effect of a Promotora Telephone Intervention on the Duration of Breastfeeding. J Obstet Gynecol Neonatal Nurs 2018; 47:738-748. [PMID: 30292773 DOI: 10.1016/j.jogn.2018.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2018] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of a telephone intervention delivered by promotoras (lay health care workers) to increase the duration of exclusive breastfeeding (EBF) in Hispanic women at 12 weeks postpartum. Secondary objectives were to assess breastfeeding duration (BFD) and to evaluate background variables that may be associated with EBF and BFD. DESIGN Pragmatic trial. SETTING Two obstetric clinics affiliated with a community medical center in Southern California. PARTICIPANTS We recruited 61 participants from the two clinics. Participants were 18 to 45 years old and planned to breastfeed their infants. Women who showed interest in the study were sequentially divided into an intervention (n = 31) or a control group (n = 30). METHODS The intervention consisted of telephone support for breastfeeding provided by certified and trained promotoras. RESULTS Fourteen out of 31 (45%) participants in the intervention group continued to practice EBF compared with 4 out of 30 (13%) in the control group (odds ratio = 3.39, p = .04). Breastfeeding duration in days was significantly longer for the participants in the intervention group (F =1/59 = 29.88, p < .01). The positive predictors of EBF at 12 weeks after birth were prior breastfeeding experience, perceived breastfeeding support, promotora telephone support, and higher scores on the acculturation scale. Positive predictors of BFD were breastfeeding support, promotora telephone support, and higher scores on breastfeeding self-efficacy. A negative predictor was lower household income. CONCLUSION Our results indicate that a telephone support intervention delivered by promotoras may increase the rates of EBF by threefold at 12 weeks after birth.
Collapse
|
24
|
Sloand E, Lowe V, Pennington A, Rose L. Breastfeeding Practices and Opinions of Latina Mothers in an Urban Pediatric Office: A Focus Group Study. J Pediatr Health Care 2018; 32:236-244. [PMID: 29361391 DOI: 10.1016/j.pedhc.2017.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 11/10/2017] [Accepted: 11/28/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The purpose of this qualitative study was to explore beliefs about breastfeeding among Latina mothers. The focus groups were part of a sequential mixed methods study. METHODS Two focus groups were conducted. Participants were Spanish-speaking mothers with infants younger than 12 months. Focus groups were conducted in Spanish and audiorecorded. The researchers performed open coding of the data, compared and converged codes, and identified common themes and relationships among the themes. RESULTS Mothers described concerns about adequacy of breastfeeding for their infants' needs, the continued goodness of breast milk, and weaning. They expressed lack of knowledge about using breast pumps and other assists that could help them breastfeed. DISCUSSION Culturally tailored breastfeeding education and support have not been adequately implemented in this urban clinic and likely in other similar settings. More targeted attention to this population could improve exclusive breastfeeding of infants and ultimately result in better child health.
Collapse
|
25
|
Shin CN, Reifsnider E, McClain D, Jeong M, McCormick DP, Moramarco M. Acculturation, Cultural Values, and Breastfeeding in Overweight or Obese, Low-Income, Hispanic Women at 1 Month Postpartum. J Hum Lact 2018. [PMID: 29543552 DOI: 10.1177/0890334417753942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Most Hispanic infants are fed formula during the first 6 weeks, and although 80% of Hispanic women initiate breastfeeding, rates of exclusive breastfeeding are much lower. Research aim: The purpose was to examine the influence of acculturation and cultural values on the breastfeeding practices of pregnant women of Mexican descent participating in the Special Supplemental Nutrition Program for Women, Infants, and Children who were enrolled in a prospective randomized clinical trial that aimed to reduce child obesity. The data were abstracted from a larger randomized clinical trial focused on prevention of child obesity. METHODS The sample consisted of 150 women of Mexican origin who were enrolled at the time of these analyses from the randomized clinical trial and had a prepregnancy body mass index of ≥ 25 and spoke English and/or Spanish. All breastfeeding data for this report came from data collection at 1 month postpartum. RESULTS A higher score on the Anglo orientation scale of the Acculturation Rating Scale for Mexican Americans was associated with less breastfeeding at 1 month postpartum and less exclusive breastfeeding. CONCLUSION Acculturation plays a role in breastfeeding practice. Exploring acculturation associated with breastfeeding can guide us to design culturally relevant interventions to promote breastfeeding exclusivity among immigrant mothers.
Collapse
Affiliation(s)
- Cha-Nam Shin
- 1 College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Elizabeth Reifsnider
- 1 College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Darya McClain
- 1 College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Mihyun Jeong
- 1 College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - David P McCormick
- 2 School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Michael Moramarco
- 1 College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| |
Collapse
|
26
|
Pounds L, Fisher CM, Barnes-Josiah D, Coleman JD, Lefebvre RC. The Role of Early Maternal Support in Balancing Full-Time Work and Infant Exclusive Breastfeeding: A Qualitative Study. Breastfeed Med 2017; 12:33-38. [PMID: 27898210 DOI: 10.1089/bfm.2016.0151] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Support of others is a key factor for mothers who choose to breastfeed their infants, including those who balance work outside the home and breastfeeding. However, little research has been done to understand how maternal support during the postpartum period impacts mothers' ability to later balance work and breastfeeding, in particular full-time work and exclusive breastfeeding. The results of this qualitative study indicate that the timing of support plays a key role in mothers' ability to successfully overcome barriers during the early postpartum period, thus building maternal self-efficacy in addressing problems encountered when they return to work. METHODS To understand the experience of low-income women who successfully balance full-time work and exclusive breastfeeding for the recommended 6 months, interviews were conducted with women who met study criteria for income level, work status, and exclusive breastfeeding. Breastfeeding peer counselors were also interviewed as key informants. Interviews were recorded, transcribed, and coded for themes. The results of both sets of interviews were triangulated with a focused literature review to assure the soundness of the qualitative analysis. RESULTS Timing of support included acute support, such as help establishing a successful latch needed during the first 2 weeks after delivery, to deal with breastfeeding problems that mothers perceived as being mentally and emotionally overwhelming and longer-term support needed to overcome problems perceived as being less intense. CONCLUSIONS The research invites further exploration into the relationship between breastfeeding support provided by mothers' support system, including healthcare professionals, during the postpartum period and rates of breastfeeding duration and exclusivity.
Collapse
Affiliation(s)
- Lea Pounds
- 1 Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center College of Public Health , Omaha, Nebraska
| | | | | | | | - R Craig Lefebvre
- 5 University of South Florida College of Public Health , Tampa, Florida
| |
Collapse
|
27
|
Reifsnider E, Flowers J, Todd M, Bever Babendure J, Moramarco M. The Relationship Among Breastfeeding, Postpartum Depression, and Postpartum Weight in Mexican American Women. J Obstet Gynecol Neonatal Nurs 2016; 45:760-771. [PMID: 27632434 DOI: 10.1016/j.jogn.2016.05.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2016] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To determine if symptoms of postpartum depression and postpartum weight varied according to the level of breastfeeding among women of Mexican origin at 1 month and 6 months postpartum. DESIGN Secondary quantitative analysis to study the differences in postpartum weight and depression among the mothers in the study who breastfed and those who did not. SETTING A heavily Hispanic community located in a major Southwestern U.S. city. PARTICIPANTS Women of Mexican origin (N = 150) who enrolled during their third trimesters in a local Special Supplemental Nutrition Program for Women, Infants, and Children clinic and were followed for 6 months. METHODS Weight was measured at 1 month and at 6 months postpartum at home visits with validated digital scales. Breastfeeding was measured according to World Health Organization criteria and recorded after monthly phone calls. Depression was measured at home visits at 1 month and 6 months with the Edinburgh Postnatal Depression Scale. RESULTS At 6 months postpartum, participants who did not breastfeed had the highest scores on the Edinburgh Postnatal Depression Scale; participants who breastfed nonexclusively had the lowest scores (p = .067). At both time points, there was a significant difference in weight (p = .017) between women who were doing any breastfeeding and women who were not breastfeeding. CONCLUSION Breastfeeding, even if not exclusive, contributed to lower depression scores and significantly lower postpartum weight among this sample of Mexican American women.
Collapse
|
28
|
Affiliation(s)
- Kathleen A Marinelli
- Connecticut Human Milk Research Center, Connecticut Children's Medical Center, Hartford, CT, USA University of CT School of Medicine, Farmington, CT, USA
| | - Sara L Gill
- The University of Texas Health Science Center, San Antonio School of Nursing, San Antonio, TX, USA
| |
Collapse
|