1
|
Dinour LM, Bai Y. Impact of Milk on the Move breastfeeding support campaign on students' and employees' attitudes, subjective norms, intention, knowledge, and awareness. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1599-1608. [PMID: 35728072 DOI: 10.1080/07448481.2022.2086011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 04/29/2022] [Accepted: 05/30/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To evaluate the impact of a campus-based breastfeeding support campaign grounded in the Theory of Reasoned Action. PARTICIPANTS Seventy-eight students and employees. METHODS An online survey was administered pre- and post-campaign to measure attitudes, subjective norm, normative and behavioral beliefs, intention, knowledge, and awareness. Regression analyses identified the most influential factors for intention to support breastfeeding on campus at both times. Paired sample t-tests compared changes over time. RESULTS Attitudes, but not subject norm, had a significant impact on intention to support breastfeeding on campus at both times (p < .01). Subjective norm improved over time (p = .04), whereas changes to attitudes, normative and behavioral beliefs, intention, and knowledge were small and mostly not significant. Participants' gained awareness that a lactation space is available on campus (p = .034) and that students can be excused from class to pump (p = .005). CONCLUSIONS Future campus-based efforts should target breastfeeding attitudes, knowledge, and awareness of breastfeeding supports.
Collapse
Affiliation(s)
- Lauren M Dinour
- Department of Nutrition and Food Studies, Montclair State University, Montclair, New Jersey, USA
| | - Yeon Bai
- Department of Nutrition and Food Studies, Montclair State University, Montclair, New Jersey, USA
| |
Collapse
|
2
|
Terefe B, Habtie A, Chekole B. Multilevel modeling analysis of bottle feeding and its determinants among children 0-23 months in East Africa: evidence from recent DHS data (2015-2022). Int Breastfeed J 2024; 19:24. [PMID: 38589943 PMCID: PMC11003063 DOI: 10.1186/s13006-024-00629-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 03/18/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Despite breastfeeding recommendations, the prevalence and length of breast milk feeding in developing nations is rapidly decreasing, with bottle feeding taking its place. This reduces the effectiveness of breastfeeding and is associated with diarrheal disease mortality and morbidity. The purpose of this study was to determine the prevalence, distribution, and determinants of bottle feeding among under-two-year-old children in the region. METHODS The ten East African countries' Demographic and Health Surveys (DHS) recent data from 2015 to 2022 was used. The data were weighted using sample weights for probability sampling and nonresponse. The study used 43,150 weighted children. A multi-level logistic regression model was used, and P - values of ≤ 0.2 and < 0.05 were used to declare candidate variables in the binary, and multivariable to declare significant variables, respectively. RESULTS The prevalence of bottle feeding among children under-two-years-old in East Africa was 10.08% (95% CI 9.79, 10.36), ranging from 4.04% (95% CI 3.56, 4.53) in Tanzania to 33.40% (95% CI 32.72, 34.08) in Kenya. High antenatal care communities (AOR 1.22; 95% CI 1.11, 1.35), mothers aged 25-34 years (AOR 1.17; 95% CI 1.06, 1.28), high wealth index communities (AOR 1.12; 95% CI 1.02,1.25), women who had at least one types mass media exposure (AOR 1.64; 95% CI 1.53, 1.77), women from communities with high level mass media exposure (AOR 1.36; 95% CI 1.23, 1.52), given first birth after teenage years (AOR 1.17; 95% CI 1.09, 1.26), having more than one health visit in the year (AOR 1.37; 95% CI 1.27,1.47), multiple children (AOR 1.46; 95% CI 1.22, 1.75) were associated with higher rates of bottle feeding. Whereas a primary education (AOR 0.51; 95% CI 0.47, 0.54), having 3-5 living children (AOR 0.86; 95% CI 0.79, 0.95), a rural setting (AOR 0.53; 95% CI 0.49, 0.58), and a long distance from health facilities (AOR 0.84; 95% CI, 0.78, 0.91) were associated with lower rates of bottle feeding. CONCLUSIONS The overall prevalence of bottle feeding was moderate in East African countries. Improving the availability and accessibility of health facilities to mothers, utilizing maternal healthcare, and media exposure will contribute to a significant decrease in the inappropriate bottle feeding of children in East Africa.
Collapse
Affiliation(s)
- Bewuketu Terefe
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara region, Ethiopia.
| | - Adane Habtie
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Southern, Ethiopia
| | - Bogale Chekole
- Department of Comprehensive Nursing, College of Medicine and Health Sciences, Wolkite University, Southern, Ethiopia
| |
Collapse
|
3
|
Gunawardhana G, Rokonuzzaman SM, Islam S, Alarm N, Ferdous TE, Kirkwood EK, Raynes-Greenow C, Billah SM. Knowledge, Attitude, and Practices Towards COVID-19 Among Pregnant and Postpartum Women in Rural Bangladesh: A Cross-Sectional Study. Matern Child Health J 2024; 28:758-766. [PMID: 38294606 DOI: 10.1007/s10995-024-03900-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/01/2024]
Abstract
OBJECTIVE To identify knowledge, attitudes, and practices toward COVID-19 among pregnant and postpartum women in rural Bangladesh, and to assess any association with antenatal care attendance (ANC). METHODS This cross-sectional study was conducted in Northern Bangladesh's Sherpur district with a sample of pregnant and post-partum women enrolled in 'Poriborton', a community-based cluster Randomised Controlled Trial. Knowledge, attitude, and practices toward COVID-19, and any association with antenatal care practices were assessed through face-to-face interviews using a structured questionnaire. Composite measures for knowledge, attitude, and practices of COVID-19 were generated. Specific knowledge on COVID-19 and the association of antenatal care were presented as descriptive statistics. An adjusted odds ratio was used to examine the association between categorical variables. RESULTS Out of 4835 women, 34.0% correctly identified five or more COVID-19 symptoms, 31.8% knew three or more modes of coronavirus transmission, and 57.0% knew five or more preventive measures. Most (90.1%) had a "more positive attitude to testing" and 65.1% reported adequate practice of preventive measures. Women with adequate knowledge of COVID-19 were more likely to report both a positive attitude to testing (OR:2.96; 95% CI: 1.38-6.37) and adopt adequate practices of preventive measures (OR: 4.30;95% CI: 2.90-6.36). Education and being employed influenced KAP related to COVID-19. Only 14.9% were satisfied with their knowledge of COVID-19. Television was the main source of COVID-19-related specific information. CONCLUSIONS We found that improved knowledge was associated with positive attitudes and behaviours that lead to the adoption of preventive measures. There was no association with ANC practices as attendance was very low in this region. The findings could be utilised to develop communication strategies for future public health emergencies in similar settings.
Collapse
Affiliation(s)
- Gayani Gunawardhana
- Sydney School of Public Health, The University of Sydney, Camperdown, Australia.
| | | | - Sajia Islam
- Maternal and Child Health Division, ICDDR, Dhaka, Bangladesh
| | - Neeloy Alarm
- Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | | | | | | | - Sk Masum Billah
- Sydney School of Public Health, The University of Sydney, Camperdown, Australia
- Maternal and Child Health Division, ICDDR, Dhaka, Bangladesh
| |
Collapse
|
4
|
Dinour LM, Shefchik M. Representation Matters: Content Analysis of Breastfeeding Images in a Commercial Stock Image Bank. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01910-8. [PMID: 38286977 DOI: 10.1007/s40615-024-01910-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/05/2023] [Accepted: 01/07/2024] [Indexed: 01/31/2024]
Abstract
Several behavioral change theories posit that normative influences contribute to breastfeeding behaviors and disparities. Given that media has historically presented a narrow view of what is deemed normative in human milk feeding, this study describes who and what is represented in breastfeeding images available in a stock image bank, and whether differences exist based on the breastfeeding parent's skin color. Using content analysis, the most relevant 2% (n = 2284) of breastfeeding and lactation images in Adobe Stock were coded for 60 variables within 12 categories, such as skin color, ability, setting, skin exposure, etc. Descriptive statistics were used to characterize the sample, and the Chi-square test of independence and Mann-Whitney U test were used to compare images of breastfeeding parents with light and non-light skin color. Most images portrayed breastfeeding parents and breastfed children with light colored skin, only one child, an infant-aged child, and no other person. Scant images included accessories considered non-normative. Light skin parents were more frequently depicted with a wedding ring compared to non-light skin parents. Non-light skin parents were more often photographed outdoors compared to light skin parents. Images of light skin parents more frequently showed breast skin, whereas images of non-light skin parents more often showed nipple and/or areola skin. The paucity of diverse people and portrayals of breastfeeding in many ways mirror, and may even perpetuate, societal breastfeeding challenges and inequities. These findings highlight an immediate need for an expanded library of images showcasing a wider variety of breastfeeding experiences.
Collapse
Affiliation(s)
- Lauren M Dinour
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ, USA.
| | - Melanie Shefchik
- Department of Public Health, Montclair State University, Montclair, NJ, USA
| |
Collapse
|
5
|
Terefe B, Shitu K. Exploring the determinants of exclusive breastfeeding among infants under six months in the Gambia using gambian demographic and health survey data of 2019-20. BMC Pregnancy Childbirth 2023; 23:220. [PMID: 37005575 PMCID: PMC10067212 DOI: 10.1186/s12884-023-05544-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 03/24/2023] [Indexed: 04/04/2023] Open
Abstract
INTRODUCTION For infants, no one is as nutritious as breastmilk for the rest of their lives. It is a great guarantee for their future health, especially if they can exclusively breastfeed for the next few months, from the moment they are born until the end of the fifth month. Although breastfeeding rates are very low, there is no data record about it in the Gambia. OBJECTIVE This study aimed to assess the status of exclusive breastfeeding and its determinants among infants under six months of age in the Gambia. METHODS It is a secondary data analysis using the 2019-20 Gambia demographic and health survey data. A total of 897 weighted mother-infant paired samples were included in the study. A logistic regression analysis method was employed to declare factors significantly associated with exclusive breastfeeding among infants under six months of age in Gambia. Variables with a p-value of 0.2 were entered into multiple logistic regression analysis, and after controlling other confounding factors, an adjusted odds ratio of 95% CI was applied to identify associated variables. RESULTS Exclusive breastfeeding was found in 53.63% only among infants under six months of age. Being a rural resident (AOR = 2.14, 95% CI: 1.33, 3.41), reading a newspaper (AOR = 5.62, 95% CI: 1.32, 24.09), and being counseled on breastfeeding by a health professional (AOR = 1.36, 95% CI: 1.01, 1.82) are times more likely to practice exclusive breastfeeding, respectively. On the other hand, a child with a fever (AOR = 0.56, 95% CI: 0.37, 0.84), a child whose age is 2-3 months (AOR = 0.41, 95 CI: 0.28, 0.59), and a child whose age is 4-5 months (AOR = 0.11, 95% CI: 0.07, 0.16) is less likely to be fed exclusively than a 0-1-month-old child. CONCLUSION Exclusive breastfeeding remains among the public health challenges in the Gambia. Strengthening health professionals' counseling techniques on breastfeeding and infant illnesses, promoting the pros of breastfeeding, and designing timely policies and interventions are urgently needed in the country.
Collapse
Affiliation(s)
- Bewuketu Terefe
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Po. Box: 196, Gondar, Ethiopia.
| | - Kegnie Shitu
- Department of Health Education and Behavioral Science, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
6
|
Jewett S, Pilime S, Richter L. (Non)Marketing of Breastmilk Substitutes in South African Parenting Magazines: How Marketing Regulations May Be Working. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6050. [PMID: 35627584 PMCID: PMC9141163 DOI: 10.3390/ijerph19106050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 12/04/2022]
Abstract
Although exclusive breastfeeding (EBF) for the first six months is optimal for child health, it remains low globally. Breastmilk substitutes (BMS) marketing undermines breastfeeding. In 2012, South Africa introduced Regulation 991, which prohibits marketing BMS products for infants below 6 months. Our study aimed to explore if and how BMS products were presented in South African parenting magazines post-R991. We applied a mixed-methods cross-sectional content analysis design, analyzing all 2018 issues of two popular parenting magazines. We descriptively analyzed quantitative codes, derived from an a priori framework, and conducted qualitative content analysis on a subset of texts and images. We found there was no overt marketing of BMS to parents with infants below 6 months. However, BMS advertisements were placed next to articles about young infants, and vague wording and images were ways by which BMS companies may indirectly benefit. Medical experts in both magazines promoted the introduction of solids before six months. To conclude, while BMS companies in South Africa were abiding by R991 by not overtly advertising BMS in parental print media, their influence persists. Continued monitoring of print media as well as other channels is advisable. This study may be of interest to countries considering stronger regulations of BMS advertising.
Collapse
Affiliation(s)
- Sara Jewett
- Division of Health & Society, School of Public Health, University of the Witwatersrand, Johannesburg 2193, South Africa;
| | - Sukoluhle Pilime
- Division of Health & Society, School of Public Health, University of the Witwatersrand, Johannesburg 2193, South Africa;
| | - Linda Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg 2193, South Africa;
| |
Collapse
|
7
|
Lisi C, de Freitas C, Barros H. The Impact of Formula Industry Marketing on Breastfeeding Rates in Native and Migrant Mothers. Breastfeed Med 2021; 16:725-733. [PMID: 33891498 DOI: 10.1089/bfm.2021.0041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introduction: Lifelong benefits of breastfeeding are far-reaching. However, optimal breastfeeding practices may be negatively affected by the marketing of different forms of breast milk substitutes. In addition, whether market factors have a different impact on migrants' breastfeeding practices when compared to natives has been poorly investigated. Objectives: Our study's aims are (1) to assess the effect of market factors on breastfeeding discontinuation (any and exclusive), (2) comparing migrant and native women. Methods: A longitudinal study was conducted within baMBINO, a nationwide project on perinatal health among migrant women in Portugal. Our final sample included 1,251 migrants and 1,150 natives recruited between April 2017 and March 2019 in 32 public maternities. Cox regression analysis was performed, adjusting for important confounders, and interactions were tested. Results: Market factors were associated with any and exclusive breastfeeding discontinuation. Participants receiving free formula samples from a health professional were more likely to stop exclusive breastfeeding (adjusted hazard ratios [aHR] = 1.37, 95% confidence intervals [95% CI] = 1.13-1.66, p = 0.002). Reporting exposure to formula discounts was associated with discontinuation of exclusive (aHR = 1.22, 95% CI = 1.09-1.38, p = 0.001) and any breastfeeding (aHR = 1.21, 95% CI = 1.00-1.46, p = 0.046). No interactions were found between being migrant and exposure to market factors. Conclusions: Market factors influence discontinuation of any and exclusive breastfeeding. The impact of marketing does not differ between native and migrant women.
Collapse
Affiliation(s)
- Cosima Lisi
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Cláudia de Freitas
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Centre for Research and Studies in Sociology, University Institute of Lisbon (ISCTE-IUL), Lisbon, Portugal
| | - Henrique Barros
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| |
Collapse
|
8
|
Jillani Z, Scott VC, Thorpe AM, Taylor YJ. Depiction of Breastfeeding in Newspapers in the United States: 2007-2016. Breastfeed Med 2020; 15:739-746. [PMID: 32813552 DOI: 10.1089/bfm.2020.0010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Introduction: Depictions of infant feeding practices in the media influence public attitudes toward breastfeeding and breastfeeding behaviors. Understanding how breastfeeding is represented in the media can provide insights into breastfeeding experiences and outcomes. This study describes trends in breastfeeding portrayals in the United States newsprint media between 2007 and 2016. Methods: We conducted a retrospective content analysis of 452 newspaper articles identified from the Nexis Uni database. Articles were coded for tone toward breastfeeding (supporting, neutral, or opposing), message frame, and region (Midwest, South, West, Northeast). We frequency weighted articles by publication circulation to account for differences in readership volume. Results: Findings indicate that breastfeeding has been positively portrayed and increasingly discussed. Among the four regions, the South had the most supportive tones, while the Midwest had the most opposing tones. The topics of Health Benefits and Breastfeeding Support and Resources received the most coverage. Positive portrayals surrounding Workplace/University Issues are increasing, while negative portrayals surrounding Indecent Exposure are decreasing. Conclusion: Positive portrayals of breastfeeding in newspapers may signify increased support for breastfeeding as a normal practice. Future research is needed to better understand the direct and indirect impact of newsprint messages on breastfeeding in the United States.
Collapse
Affiliation(s)
- Zara Jillani
- Department of Sociology, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Victoria C Scott
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Anna M Thorpe
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Yhenneko J Taylor
- Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, North Carolina, USA
| |
Collapse
|
9
|
Tahiru R, Agbozo F, Garti H, Abubakari A. Exclusive Breastfeeding and Associated Factors among Mothers with Twins in the Tamale Metropolis. Int J Pediatr 2020; 2020:5605437. [PMID: 32099551 PMCID: PMC6996674 DOI: 10.1155/2020/5605437] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 11/09/2019] [Accepted: 11/20/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Exclusive breastfeeding (EBF) for the first six months after birth has been recommended by the WHO as the best infant feeding strategy. Data on EBF rates among twin infants in Ghana remain limited and for that matter hypothesized to be low. AIM The study sought to measure the prevalence of EBF and identify associated factors among twins in the Tamale metropolis. METHODS A cross-sectional survey involving 185 mother-twin pairs was conducted in four health facilities in the Tamale metropolis providing Child welfare Clinic (CWC) services. Socio-demographics data on both mother and twin were taken. Biomedical (e.g. perceived onset of lactation, confidence of producing enough milk, parity, delivery place, delivery type, time of breastfeeding initiation) and bio cultural factors (e.g. family cooperation for current infant feeding, breastfeeding counselling) were also obtained. In-depth interviews were also conducted with a sub sample of mothers (30) who were purposively selected to generate qualitative data on breastfeeding and associated cultural factors in twins as this data was necessary to aid in the explanation of the quantitative results. RESULTS Only 17% of twin infants were exclusively breastfed for six months. Women who were not confident that they could produce enough breast milk were about 83% less likely to practice exclusive breast-feeding (EBF) compared to those who were confident that they could produce enough breast milk (AOR = 0.17; CI = 0.04, 0.73; p-value = 0.017). Moreover, mothers who had no access to radio were about 87% less likely to practice EBF (AOR = 0.13; CI = 0.02, 0.79; p-value = 0.017). Moreover, mothers who had no access to radio were about 87% less likely to practice EBF (AOR = 0.13; CI = 0.02, 0.79. CONCLUSIONS The study shows that, ownership of radio, confidence of producing enough breast milk and admission of the children into NICU were identified as the most important factors affecting exclusive breastfeeding of twins. Beyond Educating, encouraging and assuring twin mothers of their abilities to produce enough breast milk to satisfy their children, healthcare professionals should pay more attention on providing appropriate information on breastfeeding to mothers and caregivers.
Collapse
Affiliation(s)
- Rafatu Tahiru
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P. O. Box 1883, Tamale, Ghana
- Yendi Nursing and Midwifery Training College, Ghana Health Service, Yendi, Ghana
| | - Faith Agbozo
- University of Health and Allied Sciences, Ho, Ghana
| | - Hmphrey Garti
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P. O. Box 1883, Tamale, Ghana
| | - Abdulai Abubakari
- Department of Public Health, School of Allied Health Sciences, University for Development Studies, P. O. Box 1883, Tamale, Ghana
| |
Collapse
|
10
|
Chan K, Whitfield KC. Exploring Breastfeeding Knowledge and Attitudes among Noncaregivers: A Narrative Review. CAN J DIET PRACT RES 2019; 81:97-104. [PMID: 31736323 DOI: 10.3148/cjdpr-2019-029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Exclusive breastfeeding to 6 months with continued breastfeeding up to 2 years and beyond are well-established infant feeding recommendations based on evidence that breastfeeding has unparalleled maternal and infant health benefits as well as environmental and economic benefits. As with many high-income countries, breastfeeding rates remain suboptimal with only a quarter of Canadian and European infants receiving breast milk exclusively for the first 6 months. Breastfeeding promotion efforts have largely targeted caregivers in the prenatal and postnatal period; however, breastfeeding outcomes have been shown to be associated with broader sociocultural factors. Noncaregivers play an influential role in infant feeding at both an individual level (e.g., cues and input from health care practitioners and caregivers' social networks; as future parents) as well as a broader population level (sociocultural norms and policy decisions). This paper outlines recent research on breastfeeding knowledge and attitudes of noncaregivers by population subgroup. Positive correlations have been identified between breastfeeding attitudes, infant feeding knowledge, breastfeeding exposure, and breastfeeding intention among different subgroups; however, key knowledge gaps, lack of exposure to breastfeeding, and negative public perceptions of breastfeeding persist. Dietitians can advocate for breastfeeding promotion strategies that consider the role of noncaregivers to address sociocultural norms around breastfeeding.
Collapse
Affiliation(s)
- Kathleen Chan
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS.,Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Kyly C Whitfield
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS.,Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| |
Collapse
|
11
|
Foss KA, Blake K. "It's natural and healthy, but I don't want to see it": Using Entertainment-Education to Improve Attitudes Toward Breastfeeding in Public. HEALTH COMMUNICATION 2019; 34:919-930. [PMID: 29474130 DOI: 10.1080/10410236.2018.1440506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
While it has been well established that breastfeeding provides the best nourishment for children, few women achieve the recommended breastfeeding duration. Negative media messages have been identified as one explanation for the lack of individual and public support for breastfeeding. This study explored the influence of media on the knowledge and attitudes of a nearly childless population to ascertain if and how entertainment media can positively impact perceptions of breastfeeding. Using cultivation and parasocial interaction, this research measured entertainment television's effect on breastfeeding attitudes using randomized-group experiments involving 375 students. Overall, participants generally held positive attitudes but were uncomfortable seeing breastfeeding. Moreover, results indicate that viewing a prime-time television clip that depicted public breastfeeding not only significantly lessened the extent to which participants believed that breastfeeding was a private activity but also improved attitudes and support for breastfeeding in public. This study concludes that more pro-breastfeeding media messages in entertainment media could help create a climate conducive to breastfeeding success.
Collapse
Affiliation(s)
| | - Ken Blake
- a School of Journalism , Middle Tennessee State University
| |
Collapse
|
12
|
Brown P, Kwan V, Vallerga M, Obhi HK, Woodhead EL. The Use of Anecdotal Information in a Hypothetical Lung Cancer Treatment Decision. HEALTH COMMUNICATION 2019; 34:713-719. [PMID: 29393661 DOI: 10.1080/10410236.2018.1433415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This mixed-methods study examined variables associated with use of experience-based (i.e., anecdotal) decisional strategies among 85 undergraduate students presented with 2 hypothetical lung cancer scenarios. Participants were asked to think aloud while they made their treatment choice. Eleven decisional strategies were identified and grouped into either data or experience-based strategies. Approximately, 25% of participants used experience-based strategies. Use of experience-based strategies was more likely if the participant reported involvement in the life of someone going through cancer treatment, and if they rated print-based media sources as less important. Use of experience-based strategies was associated with choosing surgery instead of radiation for lung cancer treatment.
Collapse
Affiliation(s)
- Preston Brown
- a Department of Psychology , San José State University , San José , CA , USA
| | - Victor Kwan
- a Department of Psychology , San José State University , San José , CA , USA
| | - Michael Vallerga
- a Department of Psychology , San José State University , San José , CA , USA
| | - Hardeep K Obhi
- a Department of Psychology , San José State University , San José , CA , USA
| | - Erin L Woodhead
- a Department of Psychology , San José State University , San José , CA , USA
| |
Collapse
|
13
|
Noh JW, Kim YM, Akram N, Yoo KB, Cheon J, Lee LJ, Kwon YD, Stekelenburg J. Factors Affecting Breastfeeding Practices in Sindh Province, Pakistan: A Secondary Analysis of Cross-Sectional Survey Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1689. [PMID: 31091768 PMCID: PMC6571742 DOI: 10.3390/ijerph16101689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/09/2019] [Accepted: 05/09/2019] [Indexed: 11/16/2022]
Abstract
Breastfeeding practices are critical for child health and growth. This paper investigates demographic factors, socioeconomic status, and information sources that affect breastfeeding practices in Sindh Province, Pakistan. A secondary analysis was performed of data on 10,028 women with a birth in the preceding two years who had participated in the 2013-14 Maternal and Child Health Program Indicator Survey. Multiple logistic regressions were used to test the association between breastfeeding status (ever breastfed and still breastfeeding) and age, number of living children, residence, education, wealth, information sources about breastfeeding, assistance during delivery, and place of delivery. Of the 9955 women included in the analysis, 97.9% had breastfed and 83.9% were still breastfeeding at the time of the survey. Being in the second, third, or fourth wealth quintiles and receiving breastfeeding information from relatives and friends were associated with ever breastfeeding. Women who were 35 years or older, living in a town/small city, higher maternal education, middle wealth quintile, and receiving breastfeeding information from the media were associated with still breastfeeding. The findings suggest the need to develop interventions considering maternal socioeconomic status and peer counseling interventions. Mass media campaigns to promote breastfeeding practices should be accompanied by governmental restrictions on the marketing of infant formula.
Collapse
Affiliation(s)
- Jin-Won Noh
- Department of Healthcare Management, Eulji University, Seongnam 13135, Korea.
- Global Health Unit, Department of Health Sciences, University Medical Centre Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.
| | - Young-Mi Kim
- Jhpiego, Johns Hopkins University, Baltimore, MD 21231, USA.
| | - Nabeel Akram
- Jhpiego, Johns Hopkins University, Baltimore, MD 21231, USA.
| | - Ki-Bong Yoo
- Department of Health Administration, Department of Information & Statistics, Yonsei University, Wonju 26493, Korea.
| | - Jooyoung Cheon
- Department of Nursing Science, Sungshin University, Seoul 01133, Korea.
| | - Lena J Lee
- National Institutes of Health Clinical Center, Bethesda, MD 20892, USA.
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, The Catholic University of Korea, Seoul 06591, Korea.
| | - Jelle Stekelenburg
- Global Health Unit, Department of Health Sciences, University Medical Centre Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.
- Department of Obstetrics and Gynecology, Medical Centre Leeuwarden, 8934 AD Leeuwarden, The Netherlands.
| |
Collapse
|
14
|
Rahman A, Akter F. Reasons for formula feeding among rural Bangladeshi mothers: A qualitative exploration. PLoS One 2019; 14:e0211761. [PMID: 30807588 PMCID: PMC6391007 DOI: 10.1371/journal.pone.0211761] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 01/22/2019] [Indexed: 11/19/2022] Open
Abstract
In Bangladesh the exclusive breastfeeding rate remains low and prelacteal, formula and bottle feeding is increasing. This study aims to explore reasons behind infant formula feeding practices from mothers, caregivers, and health care provider's perspective. This was a qualitative study carried out in four sub-districts of Sylhet and Jessore of rural Bangladesh. Data were collected through focus group discussions (12), in-depth interviews (4) and key informant interviews (12) from January to February 2014. The qualitative data collected and were analyzed using thematic content analysis. This study clearly showed the factor behind formula feeding by Bangladeshi rural women. One of the major findings was that women could not differentiate between formula and other milk. Main differences between formula and powder milk were the type of consumer where formula only was taken by infant and children less than 2 years. Other major reasons include; poor breastfeeding practices, lack of appropriate breastfeeding practices, superficial knowledge on harmful effect on infant formula; perceived insufficient breast milk production, the influence of family and society and authoritarian power of hospital staff. Rural mothers have intension to feed infant formula to their infants due to various factors including individual, social, cultural and institutional. These identified factors can contribute to policy making and develop more specific interventions targeting expected mother and their family members that can contribute to stop formula feeding and increase breastfeeding practices in rural Bangladesh.
Collapse
Affiliation(s)
- Atiya Rahman
- Research and Evaluation Division (RED), BRAC, Mohakhali, Dhaka, Bangladesh
| | - Fahmida Akter
- Research and Evaluation Division (RED), BRAC, Mohakhali, Dhaka, Bangladesh
| |
Collapse
|
15
|
Dai Z. Chinese News Media Discourse of Doulas and Doula Care. J Perinat Educ 2018; 27:243-252. [PMID: 31073270 PMCID: PMC6491159 DOI: 10.1891/1058-1243.27.4.243] [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] Open
Abstract
This article highlights the relationships among Chinese society, the discourse about doulas and doula care in childbirth, and Chinese women. The author used a critical feminist lens to analyze the discourse about doulas, doula care in childbirth, and women in Chinese mainstream news media. This analysis showed that the Chinese news media and government encouraged and promoted becoming a doula as a profession and doula care in labor in terms of cultural, social, and political factors. An argument was presented that these discourses obscure a nuanced understanding of Chinese women's maternal health in general.
Collapse
|
16
|
Hitt R, Zhuang J, Anderson J. Media Presentation of Breastfeeding Beliefs in Newspapers. HEALTH COMMUNICATION 2018; 33:1293-1301. [PMID: 28820632 DOI: 10.1080/10410236.2017.1351275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Despite numerous health benefits for babies and mothers, many women do not either initiate or continue breastfeeding for the recommended duration, and increasing breastfeeding is a national priority. It is important to understand media messages on the topic, given that breastfeeding is influenced by many environmental factors and that perceived norms, social support, and perceptions of difficulties predict breastfeeding. The current study analyzes how media covers (1) breastfeeding in general, (2) public breastfeeding, and (3) extended breastfeeding (past 1 year). Guided by the theory of planned behavior, this study analyzes 318 news articles sampled from 10 of the most commonly read mainstream newspapers from 2008-2013. This sample covers a wide range of topics related to breastfeeding, including health benefits, societal reform efforts, social/human interest stories, parenting choices, and stories about pumped breast milk and formula. The results indicate approving social norms by public health officials and medical professionals about breastfeeding in general. A significantly larger number of articles discussed positive behavioral beliefs associated with breastfeeding rather than negative behavioral beliefs. However, articles more often presented barriers, rather than factors that facilitate breastfeeding. Theoretical and practical implications are discussed.
Collapse
Affiliation(s)
- Rose Hitt
- a Department of Humanities and Communication , Albany College of Pharmacy and Health Sciences
| | - Jie Zhuang
- b Department of Communication , Michigan State
| | - Jennifer Anderson
- c Department of Communication Studies & Theatre , South Dakota State University
| |
Collapse
|
17
|
Southwell BG, Eder M, Finnegan J, Hirsch AT, Luepker RV, Duval S, Russell C, O'Byrne S. Use of online promotion to encourage patient awareness of aspirin use to prevent heart attack and stroke. J Epidemiol Community Health 2018; 72:1059-1063. [PMID: 30082425 DOI: 10.1136/jech-2018-210676] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 06/07/2018] [Accepted: 07/19/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND Literature on health promotion evaluation and public understanding of health suggests the importance of investigating behaviour over time in conjunction with information environment trends as a way of understanding programme impact. We analysed population response to online promotion of an educational tool built by the Ask About Aspirin campaign in the USA to inform people about aspirin as a preventive aid. METHODS We collected 156 weeks of time series data on audience behaviour, namely use of a self-assessment tool. We then used the Autoregressive Integrated Moving Average (ARIMA) modelling to predict that outcome as a function of paid search engine advertising, paid social media promotion and general search interest in aspirin. RESULTS Through ARIMA modelling of tool engagement data adjusted for outcome series autocorrelation, we found a significant effect of online promotional effort on audience behaviour. Total paid search advertising positively predicted weekly total of individuals who started using the self-assessment tool, coefficient=0.023, t=3.28, p=0.001. This effect did not appear to be an artefact of broader secular trends, as Google search data on the topic of aspirin use did not add explanatory power in the final model nor did controlling for general search interest eliminate the significant coefficient for paid search promotion. CONCLUSION Results hold implications both for educational tool development and for understanding health promotion campaign effects. We witnessed substantial but ephemeral effects on tool use as a function of paid search efforts, suggesting prioritisation of efforts to affect search engine results as a dissemination tactic.
Collapse
Affiliation(s)
- Brian G Southwell
- Science in the Public Sphere Program, RTI International, Research Triangle Park, North Carolina, USA
| | - Milton Eder
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - John Finnegan
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Alan T Hirsch
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Russell V Luepker
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sue Duval
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | | | | |
Collapse
|
18
|
Coyne SM, Liechty T, Collier KM, Sharp AD, Davis EJ, Kroff SL. The Effect of Media on Body Image in Pregnant and Postpartum Women. HEALTH COMMUNICATION 2018; 33:793-799. [PMID: 28481162 DOI: 10.1080/10410236.2017.1314853] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Much research has found that exposure to certain types of media portrayals of women can be related to body image concerns among women. The current paper focuses on the impact of certain messages on pregnant and postpartum women. These women are rarely examined in a media research context but are particularly vulnerable to body image concerns. This experimental study involved 192 pregnant or postpartum women who read a magazine containing glamorized media portrayals of pregnant/postpartum women or a control magazine. Pregnant women reported lower body image after only five minutes of exposure to the magazine with pregnant/postpartum women compared to the control group. There was no immediate effect on postpartum women. Implications for the media industry, health professionals, and women are discussed.
Collapse
Affiliation(s)
| | - Toni Liechty
- b Department of Recreation, Sport and Tourism , University of Illinois at Urbana-Champaign
| | | | | | | | | |
Collapse
|
19
|
Who Supports Breastfeeding Mothers? : An Investigation of Kin Investment in the United States. HUMAN NATURE-AN INTERDISCIPLINARY BIOSOCIAL PERSPECTIVE 2018; 28:231-253. [PMID: 28214982 DOI: 10.1007/s12110-017-9286-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Breastfeeding is one important form of maternal investment that is influenced by support from kin and non-kin. This paper investigates who provides support for breastfeeding mothers and their children, what type of support they provide, and how support impacts breastfeeding duration. The data were derived from a survey of 594 American mothers and were analyzed using quantitative methods, including Cox regression. Analyses indicate that mothers receive significant support, particularly from spouses and maternal grandmothers. More frequent breastfeeding discussions with La Leche League and maternal grandfathers were associated with longer duration, whereas discussions with physicians were associated with shorter breastfeeding duration. Results indicate that consulting others specifically about breastfeeding may influence breastfeeding decisions. The results are consistent with the idea that social support may influence breastfeeding duration and that some types of support are more influential than others. Furthermore, support persons should be educated about breastfeeding to prevent early weaning.
Collapse
|
20
|
Ek WE, Karlsson T, Hernándes CA, Rask-Andersen M, Johansson Å. Breast-feeding and risk of asthma, hay fever, and eczema. J Allergy Clin Immunol 2018; 141:1157-1159.e9. [PMID: 29132959 DOI: 10.1016/j.jaci.2017.10.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 10/13/2017] [Accepted: 10/18/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Weronica E Ek
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
| | - Torgny Karlsson
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Carlos Azuaje Hernándes
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Mathias Rask-Andersen
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Åsa Johansson
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| |
Collapse
|
21
|
Sheehan A, Bowcher WL. Messages to new mothers: an analysis of breast pump advertisements. MATERNAL & CHILD NUTRITION 2017; 13:e12313. [PMID: 27103601 PMCID: PMC6866098 DOI: 10.1111/mcn.12313] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 02/08/2016] [Accepted: 02/11/2016] [Indexed: 11/28/2022]
Abstract
The mass media is replete with all kinds of advice, products and ideas about 'motherhood' with advertising being a major source of information on the latest products and consumer trends. Advertising is a key means of promoting ideas about infant feeding, and yet, there has been little in the way of critical analyses of breast pump advertisements in order to reveal the kinds of messages they convey about this method of feeding. This article makes an important step towards addressing this gap through analysing three advertisements for breast pumps from a popular Australian magazine for mothers. We utilize a social semiotic framework to investigate not just what choices are made in the design of the ads but also what those choices mean in terms of the overall message of the ads. Our analysis identifies three core messages: 'breastfeeding and breast pumping are the same with the purpose being to produce breast milk only', 'using breast pumps facilitates quality time with the baby' and 'mothers need outside expertise (including breast pumps) to ensure baby's development'. We believe it is important for those who provide information and support for breastfeeding women to be aware of the subtle, naturalized messages that ads convey so that they may better understand what may be underlying women's decisions regarding methods of infant feeding. © 2016 John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- Athena Sheehan
- School of Nursing and MidwiferyWestern Sydney UniversityPenrithNew South WalesAustralia
| | | |
Collapse
|
22
|
Pereira C, Ford R, Feeley AB, Sweet L, Badham J, Zehner E. Cross-sectional survey shows that follow-up formula and growing-up milks are labelled similarly to infant formula in four low and middle income countries. MATERNAL AND CHILD NUTRITION 2017; 12 Suppl 2:91-105. [PMID: 27061959 PMCID: PMC5071731 DOI: 10.1111/mcn.12269] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This cross-sectional survey assessed the characteristics of labels of follow-up formula (FUF) and growing-up milk (GUM) compared with infant formula (IF), including cross-promotion practices between FUF/GUM and IF manufactured by the same company, sold in Phnom Penh, Cambodia; Kathmandu Valley, Nepal; Dakar Department, Senegal; and Dar es Salaam, Tanzania. All products were imported. A wide recommended age/age range for introduction was provided by manufacturers across all sites, with products with an age recommendation of 0-6 months being most prevalent in three sites, representing over a third of all products. Various age categories (e.g. 1, 1+ and Stage 1) commonly appeared on labels. A number of descriptive names (e.g. infant formula and milk formula) per category of age of introduction were used with some appearing across more than one category. Images of feeding bottles were found on most labels across all age categories, but prevalence decreased with older age categories. The majority of FUF/GUM manufactured by IF companies across all sites displayed at least one example of cross-promotion with one or more of the company's IF: two-thirds or more contained similar colour schemes/designs and similar brand names; 20-85% had similar slogans/mascots/symbols. A wide and potentially confusing range of ages/categories of introduction and descriptive names were found, and cross-promotion with IF was common on FUF/GUM labels. Global guidance from normative bodies forms the basis of most low and middle income countries policies and should provide specific guidance to prohibit cross-promotion between FUF/GUM and IF, and all three categories should be classified as breastmilk substitutes.
Collapse
|
23
|
Mello S, Tan AS. Who's Responsible? Media Framing of Pediatric Environmental Health and Mothers' Perceptions of Accountability. JOURNAL OF HEALTH COMMUNICATION 2016; 21:1217-1226. [PMID: 27858529 PMCID: PMC5548552 DOI: 10.1080/10810730.2016.1240267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
How the media frames issues of environmental health may affect mothers' views of who is responsible for addressing environmental risks to pediatric health and, ultimately, their protective behaviors. This article describes how information-oriented media sources attribute responsibility for such risks and examines associations between mothers' routine media exposure, or scanning, and perceptions of responsibility. First, a content analysis was conducted on a sample of 474 media stories (i.e., Associated Press, parenting magazines, and websites) about childhood exposure to environmental chemicals over a 6-month period (September 2012-February 2013). We found that media stories attributed responsibility most frequently to parents, though significant differences were observed across media sources, such that websites focused more on parents and general news more on government agencies and manufacturers. Next, we conducted an online survey of mothers (N = 819) and revealed that website scanning during the prior 6 months was significantly associated with perceived personal responsibility, even after we adjusted for potential confounders. Scanning general news was also significantly associated with perceived government and manufacturer responsibility. Understanding media framing of these issues highlights opportunities for health communicators to offset pressure placed on mothers by encouraging greater social and policy support in and exposure to certain media.
Collapse
Affiliation(s)
- Susan Mello
- Northeastern University, Department of Communication Studies, Boston, USA
| | - Andy S.L. Tan
- Dana-Farber Cancer Institute, Population Sciences Division, Center for Community Based Research, Boston, USA
- Harvard School of Public Health, Department of Social and Behavioral Sciences, Boston, USA
| |
Collapse
|
24
|
Pitt MB, Berger JN, Sheehan KM. Compliance of Parenting Magazines Advertisements with American Academy of Pediatrics Recommendations. CHILDREN (BASEL, SWITZERLAND) 2016; 3:E23. [PMID: 27809284 PMCID: PMC5184798 DOI: 10.3390/children3040023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/19/2016] [Accepted: 10/19/2016] [Indexed: 12/31/2022]
Abstract
This study examined 3218 advertisements from the two parenting magazines with highest circulation in the United States. The authors compared each advertisement for a product for use by children, against all the published recommendations of the American Academy of Pediatrics (AAP) on topics such as toy safety, helmet use, age-defined choking hazards, infant sleep safety, and others. Any advertisement with images or products which went against a published AAP recommendation was deemed as non-adherence and was categorized according to the statement it contradicted. Nearly one in six (15.7%) of the advertisements contained example(s) of non-adherence to AAP recommendations, with twelve categories of offense represented. Categories ranked by overall share from most to least include: non-Food and Drug Administration (FDA) approved medical treatments, age-defined choking hazards, vitamins, cold medicine, formula, oral care, screen time, toy/playground safety, infant sleep, nutrition, water safety, and fall risk. Given that repeated exposure to messages in advertisements has been associated with changes in health decision-making, and parents often turn to parenting magazines for advice and ideas regarding their children, the publishers might consider screening the content in order to prevent confusing and potentially dangerous messages from being disseminated in the media.
Collapse
Affiliation(s)
- Michael B Pitt
- Department of Pediatrics, University of Minnesota Masonic Children's Hospital, M653 2450 Riverside Avenue South, Minneapolis, MN 55454, USA.
| | - Jennifer N Berger
- Ann & Robert H. Lurie Children's Hospital of Chicago; 225 E Chicago Avenue, Chicago, IL 60611, USA.
| | - Karen M Sheehan
- Northwestern University's Feinberg School of Medicine, 420 East Superior Street, Chicago, IL 60611, USA.
| |
Collapse
|
25
|
Gearhart S, Dinkel D. Mother knows breast: A content analysis of breastfeeding in television network news. HEALTH COMMUNICATION 2016; 31:884-891. [PMID: 26726733 DOI: 10.1080/10410236.2015.1012631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Major health organizations worldwide have touted the benefits of breastfeeding and engaged in campaigns to increase rates of practice. This study content analyzes network television news transcripts (N = 475) to investigate the coverage of breastfeeding over a 15-year time period (1999-2013) across three networks (ABC, NBC, CBS). Results revealed that although television news reports on breastfeeding have steadily increased, topics have become more trivial. Reports were also found to heavily rely on episodic frames and primarily appear in morning news programs. Such coverage may have the ability to diminish the importance breastfeeding has on society and to deter policy advancement. Theoretical and practical implications for campaign development and promotion are discussed.
Collapse
Affiliation(s)
| | - Danae Dinkel
- b School of Health, Physical Education and Recreation , University of Nebraska at Omaha
| |
Collapse
|
26
|
Mello S, Hornik RC. Media Coverage of Pediatric Environmental Health Risks and its Effects on Mothers' Protective Behaviors. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2016; 36:605-622. [PMID: 26268577 DOI: 10.1111/risa.12467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study explores the relationship between exposure to U.S. media coverage of chemical threats to pediatric environmental health and mothers' behaviors to protect their children. Prior content analytic work revealed that media coverage volume from September 2012 to February 2013 differed significantly by type of chemical (i.e., pesticides = high coverage volume; bisphenol A [BPA] = moderate; and arsenic = low). Survey data collected from new and expecting mothers in March 2013 (n = 822) revealed mothers incidentally encountered-or scanned-this information in the media in the prior six months, and after adjusting for a series of potential confounders, such scanning was positively associated with mothers' self-reported behaviors to reduce chemical exposures. To test the hypothesis that coverage volume moderates the relationship between scanning and behavior, content analysis and survey data were combined in mixed effects regression analyses. Results showed significant differences between the effects of media scanning at different levels of coverage volume, but in a direction not entirely consistent with the study's hypothesis. The relationship between scanning and behavior was strongest for BPA, suggesting that a characteristic of media coverage other than volume may drive maternal responses to environmental health threats. Implications of these findings for risk communication research and practice are discussed.
Collapse
Affiliation(s)
- Susan Mello
- Department of Communication Studies, Northeastern University, Boston, MA, USA
| | - Robert C Hornik
- Annenberg School of Communication, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
27
|
Benoit B, Goldberg L, Campbell-Yeo M. Response to "The emotional storms of breast feeding and points to remember". Midwifery 2016; 34:261-262. [PMID: 26908035 DOI: 10.1016/j.midw.2016.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 02/05/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Britney Benoit
- Dalhousie University School of Nursing, 5869 University Avenue, Halifax, Nova Scotia, Canada B3H 4R2; Centre for Pediatric Pain Research, IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia, Canada B3K 6R8.
| | - Lisa Goldberg
- Dalhousie University School of Nursing, 5869 University Avenue, Halifax, Nova Scotia, Canada B3H 4R2; Caritas Coach, Watson Caring Science Institute (WCSI), 4450 Araphoe Avenue, Ste 100 Boulder, CO 80303, USA.
| | - Marsha Campbell-Yeo
- Dalhousie University School of Nursing, 5869 University Avenue, Halifax, Nova Scotia, Canada B3H 4R2; Centre for Pediatric Pain Research, IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia, Canada B3K 6R8; Women and Newborn Program, IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia, Canada B3K 6R8.
| |
Collapse
|
28
|
Doub AE, Small M, Birch LL. A call for research exploring social media influences on mothers' child feeding practices and childhood obesity risk. Appetite 2016; 99:298-305. [PMID: 26767614 DOI: 10.1016/j.appet.2016.01.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 12/30/2015] [Accepted: 01/04/2016] [Indexed: 10/22/2022]
Abstract
There is increasing interest in leveraging social media to prevent childhood obesity, however, the evidence base for how social media currently influences related behaviors and how interventions could be developed for these platforms is lacking. This commentary calls for research on the extent to which mothers use social media to learn about child feeding practices and the mechanisms through which social media influences their child feeding practices. Such formative research could be applied to the development and dissemination of evidence-based childhood obesity prevention programs that utilize social media. Mothers are identified as a uniquely important target audience for social media-based interventions because of their proximal influence on children's eating behavior and their high engagement with social media platforms. Understanding mothers' current behaviors, interests, and needs as they relate to their social media use and child feeding practices is an integral first step in the development of interventions that aim to engage mothers for obesity prevention. This commentary highlights the importance of mothers for childhood obesity prevention; discusses theoretical and analytic frameworks that can inform research on social media and mothers' child feeding practices; provides evidence that social media is an emerging context for social influences on mothers' attitudes and behaviors in which food is a salient topic; and suggests directions for future research.
Collapse
Affiliation(s)
- Allison E Doub
- Pennsylvania State University, Department of Human Development and Family Studies, College of Health and Human Development, USA.
| | - Meg Small
- Pennsylvania State University, Bennett Pierce Prevention Research Center for the Promotion of Human Development, USA
| | - Leann L Birch
- University of Georgia, Department of Foods and Nutrition, College of Family and Consumer Sciences, USA
| |
Collapse
|
29
|
Piwoz EG, Huffman SL. The Impact of Marketing of Breast-Milk Substitutes on WHO-Recommended Breastfeeding Practices. Food Nutr Bull 2015; 36:373-86. [DOI: 10.1177/0379572115602174] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Suboptimal breastfeeding results in 800 000 child deaths annually. There are multiple causes of suboptimal breastfeeding, including marketing of breast-milk substitutes. Objectives: To describe sales and marketing of breast-milk substitutes and their influence on World Health Organization-recommended breastfeeding behaviors, focusing on low- and middle-income countries. Methods: Literature review. Results: Global sales of breast-milk substitutes reached US$40 billion in 2013. Growth in sales exceeds 10% annually in many low- and middle-income countries, while it is close to stagnant in high-income countries. Breast-milk substitutes are marketed directly to consumers via mass media and print advertisements and indirectly via incentives, free supplies, and promotions to and through health workers and facilities, retailers, and policy makers. Internet marketing via company web sites and social media is on the rise. Marketing influences social norms by making formula use seem to be extensive, modern, and comparable to or better than breast milk. Clear evidence of a negative impact is found when breast-milk substitutes are provided for free in maternity facilities and when they are promoted by health workers and in the media. Influences through other channels are plausible, but rigorous studies are lacking. It was not possible with the data available to quantify the impact of marketing relative to other factors on suboptimal breastfeeding behaviors. Marketing remains widespread even in countries that have adopted the International Code of Marketing of Breast-milk Substitutes to restrict such activities. Conclusion: Adoption of stricter regulatory frameworks coupled with independent, quantitative monitoring and compliance enforcement are needed to counter the impacts of formula marketing globally.
Collapse
|
30
|
Chen YC, Chang JS, Gong YT. A Content Analysis of Infant and Toddler Food Advertisements in Taiwanese Popular Pregnancy and Early Parenting Magazines. J Hum Lact 2015; 31:458-66. [PMID: 25766374 DOI: 10.1177/0890334415576513] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 01/14/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mothers who are exposed to formula advertisements (ads) are less likely to initiate breastfeeding and more likely to breastfeed for a shorter duration than other mothers. OBJECTIVE The purpose of this study was to examine infant and toddler food ads in pregnancy and early parenting magazines. METHODS A content analysis of infant and toddler food ads printed in 12 issues of 4 magazines published in 2011 was performed. Coding categories of ads included product category, advertisement category, marketing information, and advertising appeal. The target age and health-related message of each product were coded. RESULTS The researchers identified 756 infant and toddler food ads in the magazines. Compared with complementary food ads, formula product ads used more marketing strategies such as antenatal classes and baby contests to influence consumers and promote products. Nutritional quality and child health benefits were the two most frequently used advertising appeals. In addition, this study identified 794 formula products and 400 complementary food products; 42.8% of the complementary food products were intended for 4-month-old infants. Furthermore, 91.9% of the ads for formula products and 81% of the ads for complementary food products contained claims concerning health function or nutrient content. CONCLUSIONS Taiwanese pregnancy and early parenting magazines contain numerous infant and toddler food ads. These ads generally use health-related claims regarding specific nutrient content and health functions to promote infant and toddler foods. Health professionals should provide more information to parents on the differences between breast milk and formula milk, and they should be aware of the potential effect of infant and toddler food ads on parents' infant feeding decisions.
Collapse
Affiliation(s)
- Yi-Chun Chen
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
| | - Jung-Su Chang
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
| | - Yu-Tang Gong
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
31
|
Cattaneo A, Pani P, Carletti C, Guidetti M, Mutti V, Guidetti C, Knowles A. Advertisements of follow-on formula and their perception by pregnant women and mothers in Italy. Arch Dis Child 2015; 100:323-8. [PMID: 25512963 DOI: 10.1136/archdischild-2014-306996] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess how follow-on formula milks for infants aged 6-12 months are presented to and understood by mothers. DESIGN A quantitative and qualitative cross-sectional study including (1) an analysis of advertisements in three magazines for parents; (2) in-depth semistructured qualitative interviews to pregnant women on their perception of two advertisements for follow-on formula and (3) self-administered questionnaires for mothers to explore their exposure to and perception of formula advertisements. PARTICIPANTS Eighty pregnant women 32-36 weeks of gestation with no previous children and 562 mothers of children <3 years old. SETTING Maternal and child health centres in eight cities of Italy. RESULTS Advertisements of formula (n=89) represented about 7% of all advertisements in the three magazines, the majority (58%) being for follow-on formula. Advertisements were parent-oriented, aimed at helping parents solve health problems of their babies or at eliciting good feelings, or both. The qualitative interviews to pregnant women showed inability to define the advertised products at first glance due to the ambiguity of the numeral 2 and the presumed age of the portrayed baby; this inability did not disappear after carefully viewing the advertisements and reading the text. When asked in the self-administered questionnaires whether they had ever come across advertisements of infant formula, 81% of mothers reported that they had, despite the legal inexistence of such advertisements, and 65% thought that it was for a product to be used from birth. CONCLUSIONS Advertisements of follow-on formula are perceived by pregnant women and mothers as promoting infant formula.
Collapse
Affiliation(s)
- Adriano Cattaneo
- Health Services Research and International Health, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Paola Pani
- Health Services Research and International Health, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Claudia Carletti
- Health Services Research and International Health, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | | | | | | | - Alessandra Knowles
- Health Services Research and International Health, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | | |
Collapse
|
32
|
Mello S. Media Coverage of Toxic Risks: A Content Analysis of Pediatric Environmental Health Information Available to New and Expecting Mothers. HEALTH COMMUNICATION 2015; 30:1245-1255. [PMID: 25616733 DOI: 10.1080/10410236.2014.930398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Mass media play a central role in providing environmental health information to the public. Despite several decades of environmental and health communication research, the nature of environmental health information available to one of the most vulnerable populations--new and expecting mothers--has received limited attention. To address this gap, this study poses two questions: (1) How prevalent is information related to prenatal and pediatric environmental health (PPEH) in the media, and (2) how much coverage do the most concerning chemical threats to PPEH receive? A content analysis of 2,543 texts in popular media sources (i.e., the Associated Press [AP], parenting magazines, and parenting websites) from September 2012 to February 2013 revealed that roughly three pieces of PPEH information were made available to mothers daily. Prior research has shown that media coverage of environmental health issues has decreased over the years; however, these results suggest that at-risk populations are likely to encounter this type of information in the media. Also, while certain chemicals received ample coverage (i.e., pesticides, cigarette smoke, mercury), other issues deemed concerning by federal agencies did not (i.e., lead, phthalates). This study also introduces a novel method for harvesting online content encountered incidentally. Implications of these findings for communication research and practice are discussed.
Collapse
Affiliation(s)
- Susan Mello
- a Communication Studies, College of Arts, Media and Design , Northeastern University
| |
Collapse
|
33
|
Smith J, Blake M. Infant food marketing strategies undermine effective regulation of breast-milk substitutes: trends in print advertising in Australia, 1950-2010. Aust N Z J Public Health 2014; 37:337-44. [PMID: 23895476 DOI: 10.1111/1753-6405.12081] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This study addresses the issue of whether voluntary industry regulation has altered companies' marketing of breast-milk substitutes in Australia since the adoption of the World Health Organization (WHO) International Code on the Marketing of Breast-milk Substitutes 1981. METHODS Print advertisements marketing breast-milk substitutes were systematically sampled from the Australian Women's Weekly (AWW) magazine and the Medical Journal of Australia (MJA) for the 61 years from 1950 to 2010. RESULTS Breast-milk substitute advertising in both the MJA and the AWW peaked and began declining before the introduction of the WHO Code in 1981. Although there was almost no infant formula advertising in AWW after 1975-79, other breast-milk substitute advertising has been increasing since 1992, in particular for baby food, toddler formula and food and brand promotion. CONCLUSIONS Companies have adopted strategies to minimise the effects of the Code on sales and profit in Australia, including increasing toddler formula and food advertisements, increasing brand promotion to the public, and complying with more limited voluntary regulatory arrangements. IMPLICATIONS Comprehensive regulation is urgently required to address changed marketing practices if it is to protect breastfeeding in Australia.
Collapse
Affiliation(s)
- Julie Smith
- Australian Centre for Economic Research on Health, College of Medicine, Biology and Environment, The Australian National University, ACT, Australia.
| | | |
Collapse
|
34
|
Parry K, Taylor E, Hall-Dardess P, Walker M, Labbok M. Understanding women's interpretations of infant formula advertising. Birth 2013; 40:115-24. [PMID: 24635466 DOI: 10.1111/birt.12044] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/01/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Exclusive breastfeeding for 6 months and continued breastfeeding for at least 1 year is recommended by all major health organizations. Whereas 74.6 percent of mothers initiate breastfeeding at birth, exclusivity and duration remain significantly lower than national goals. Empirical evidence suggests that exposure to infant formula marketing contributes to supplementation and premature cessation. The objective of this study was to explore how women interpret infant formula advertising to aid in an understanding of this association. METHODS Four focus groups were structured to include women with similar childbearing experience divided according to reproductive status: preconceptional, pregnant, exclusive breastfeeders, and formula feeders. Facilitators used a prepared protocol to guide discussion of infant formula advertisements. Authors conducted a thematic content analysis with special attention to women's statements about what they believed the advertisements said about how the products related to human milk (superior, inferior, similar) and how they reported reacting to these interpretations. RESULTS Participants reported that the advertisements conveyed an expectation of failure with breastfeeding, and that formula is a solution to fussiness, spitting up, and other normal infant behaviors. Participants reported that the advertisements were confusing in terms of how formula-feeding is superior, inferior or the same as breastfeeding. This confusion was exacerbated by an awareness of distribution by health care practitioners and institutions, suggesting provider endorsement of infant formula. CONCLUSIONS Formula marketing appears to decrease mothers' confidence in their ability to breastfeed, especially when provided by health care practitioners and institutions. Therefore, to be supportive of breastfeeding, perinatal educators and practitioners could be more effective if they did not offer infant formula advertising to mothers.
Collapse
Affiliation(s)
- Kathleen Parry
- Public Health, Carolina Global Breastfeeding Institute, Chapel Hill, NC, USA
| | | | | | | | | |
Collapse
|
35
|
Joo Kean Y. Commentary: Stewart Forsyth's article - Non-compliance with the International Code of Marketing of Breast Milk Substitutes is not confined to the infant formula industry. J Public Health (Oxf) 2013; 35:193-4. [DOI: 10.1093/pubmed/fdt026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
36
|
Gage H, Von Rosen-Von Hoewel J, Laitinen K, Jakobik V, Martin-Bautista E, Schmid M, Egan B, Morgan J, Williams P, Decsi T, Campoy C, Koletzko B, Raats M. Health effects of infant feeding: Information for parents in leaflets and magazines in five European countries. PUBLIC UNDERSTANDING OF SCIENCE (BRISTOL, ENGLAND) 2013; 22:365-379. [PMID: 23833060 DOI: 10.1177/0963662511435452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Parents' decisions about whether to breastfeed their infant, and when to introduce complementary foods, are important public health issues. Breastfeeding has beneficial health effects and is widely promoted. Leaflets and magazine articles on infant feeding were collected in 2005, in five European countries (England, Finland, Germany, Hungary, Spain), and screened for statements that link feeding behaviours to infant health outcomes. A total of 127 leaflets contained 512 statements (0.38 / published page). Magazines contained approximately 1 article / month. Health outcomes were more intensively covered in England and Germany. Most statements referred to short term health implications. Lack of scientific agreement may underlie lack of cover of longer term health effects. Scope may exist to promote improved infant feeding practices by increasing the quantity and specificity of messages about health effects. Further research is required to evaluate the impact of alternative means of providing information on infant feeding practices.
Collapse
|
37
|
Abstract
OBJECTIVE Childhood obesity is a growing problem in the USA. As parents play a major role in shaping a child's diet, the present study examines food advertisements (ads) directed towards parents in parenting and family magazines. DESIGN Given the potential for magazines to influence attitudes and knowledge, we used content analysis to examine the food ads appearing in four issues each of six different parenting and family magazines from 2008 (n 24). SETTING USA. SUBJECTS Food ads in parenting and family magazines. RESULTS We identified 476 food ads, which represented approximately 32 % of all ads in the magazine sample. Snack foods (13 %) were the most frequently observed food ads, followed by dairy products (7 %). The most frequently used sales theme was ‘taste’ (55 %). Some ads promoted foods as ‘healthy’ (14 %) and some made specific health claims (18 %), such as asserting the product would help lower cholesterol. In addition to taste and health and nutrition appeals, we found several themes used in ad messages to promote products, including the following: ‘convenience’, ‘economical’, ‘fun’ and ‘helping families spend time together’. We also found that over half (n 405, 55·9 %) of products (n 725) advertised were products of poor nutritional quality based on total fat, saturated fat, sodium, protein, sugar and fibre contents, and that ads for such products were slightly more likely to use certain sales themes like ‘fun’ (P = 0·04) and ‘no guilt’ (P = 0·03). CONCLUSIONS Interventions should be developed to help parents understand nutritional information seen in food ads and to learn how various foods contribute to providing a balanced family diet.
Collapse
|
38
|
Barennes H, Empis G, Quang TD, Sengkhamyong K, Phasavath P, Harimanana A, Sambany EM, Koffi PN. Breast-milk substitutes: a new old-threat for breastfeeding policy in developing countries. A case study in a traditionally high breastfeeding country. PLoS One 2012; 7:e30634. [PMID: 22347392 PMCID: PMC3276495 DOI: 10.1371/journal.pone.0030634] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Accepted: 12/20/2011] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Developing countries with traditionally breastfeeding are now experiencing the increasing pressure of formula milk marketing. This may endanger lives and undermine the efforts of national policies in achieving the objectives of the Millennium Development Goals. We examined the use of, and factors for use, of all available breast-milk substitutes (BMS) in a country with a traditionally high rate of breastfeeding. METHODS Randomised multi-stage sampling surveys in 90 villages in 12/17 provinces in Laos. PARTICIPANTS 1057 mothers with infants under 24 months of age. TOOLS 50-query questionnaire and a poster of 22 BMS (8 canned or powdered milk; 6 non-dairy; 6 formulas; 2 non-formulas). OUTCOME MEASURES INCLUDED: prevalence of use and age of starting BMS in relation to socio-demographic characteristics and information sources, by univariate and multivariate analyses. RESULTS Of 1057 mothers: 72.5% currently breastfed; 25.4% gave BMS (10.6% infant formula); 19.6% gave BMS before 6 months of age (of them: 83% non-dairy or cereals; mean age: 2.9 months; 95% Confidence interval: 2.6-3.2). One formula and one non-formula product accounted for 85% of BMS. BMS were considered as milk by the majority of mothers. Thai TV was the main source of information on BMS for mothers. Lao Loum mothers (the main ethnic group) living in concrete houses with good sanitary conditions, were more likely than others to use BMS before 6 months (OR: 1.79, (1.15-2.78), p<0.009). Mothers who fed their infants colostrum at birth were less likely to use BMS before 6 months of age (OR: 0.63, (0.41-0.99), p = 0.04). Unemployed mothers living in rural areas were less likely to consider BMS better than breast milk. CONCLUSION In Laos, mothers with the highest socio-economic status are showing a tendency to give up breastfeeding. Successful educational strategies and advocacy measures should be urgently developed to promote and sustain breastfeeding in developing countries.
Collapse
Affiliation(s)
- Hubert Barennes
- Institut de la Francophonie pour la Médecine Tropicale, Vientiane, Lao People's Democratic Republic.
| | | | | | | | | | | | | | | |
Collapse
|
39
|
Affiliation(s)
- David L Clark
- Nutrition Section, UNICEF, New York, New York 10017, USA.
| | | | | |
Collapse
|
40
|
Stang J, Hoss K, Story M. Health Statements Made in Infant Formula Advertisements in Pregnancy and Early Parenting Magazines. ACTA ACUST UNITED AC 2010. [DOI: 10.1177/1941406409359806] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Pregnant women and mothers of infants are the target audience for advertisements of infant formula. The purpose of this pilot study was to assess the prevalence and content of health statements made in infant formula advertisements found in pregnancy and early parenting magazines from August 2006 to August 2007. A total of 173 infant formula advertisements were found in 77 individual issues of 16 different magazines. Forty-two unduplicated advertisements were used for the content analysis. Statistical analysis included kappa scores, frequencies, and percentages. Results showed that 9 of the 16 magazines analyzed contained ads for infant formulas. Of these, more than half of all infant formula advertisements made some type of health statement. Health statements varied greatly but generally advertised improvements in gastrointestinal, brain, or eye health; language development; or reduced incidence of allergies, food intolerances, and gastrointestinal disorders. Such health statements may influence a mother’s decision on which method of infant feeding to provide. A greater understanding of how these statements are perceived by new mothers as well as how they affect infant feeding decisions is needed.
Collapse
Affiliation(s)
- Jamie Stang
- University of Minnesota, School of Public Health, Division
of Epidemiology and Community Health, Minneapolis, Minnesota,
| | | | - Mary Story
- University of Minnesota, School of Public Health, Division
of Epidemiology and Community Health, Minneapolis, Minnesota
| |
Collapse
|
41
|
Putthakeo P, Ali M, Ito C, Vilayhong P, Kuroiwa C. Factors influencing breastfeeding in children less than 2 years of age in Lao PDR. J Paediatr Child Health 2009; 45:487-92. [PMID: 19702610 DOI: 10.1111/j.1440-1754.2009.01547.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This study aimed to investigate the prevalence of, and factors influencing, exclusive breastfeeding (EBF) at 6 months and continued breastfeeding (CBF) at 2 years. METHODS Between January and February 2007, a cross-sectional study was conducted using a semi-structured questionnaire in 40 villages in the Vientiane capital and the Vientiane province of Lao PDR. A total of 400 mothers with children less than 2 years old were recruited by multistage random sampling. Based on the 1991 World Health Organization Breastfeeding Indicators, children were classified into three groups, 6-23-month-old children for assessing EBF at 6 months, 12-15-month-old children for CBF at 1 year and 20-23-month-old children for CBF at 2 years. RESULTS The prevalence of EBF at 6 months and CBF at 2 years were 19.4% (n= 283) and 18.6% (n= 43), respectively. Some of the factors influencing EBF at 6 months in a univariate logistic regression model included: location of residence, (OR: 19.19, 95% CI 6.96-57.01), ethnicity (OR: 3.15, 95% CI 1.63-6.08), encouragement of the child's father (OR: 9.03, 95%CI 1.21-67.57) and inter-spousal communication (OR: 5.20, 95% CI 2.34-11.56). A majority of the mothers (75.0%) had watched television advertisements for infant formula from Thailand, and 48.4% reported that they wanted to buy formula milk after having watched them. CONCLUSION This study showed a low prevalence of EBF at 6 months in the studied area in Lao PDR. Some of the factors that had a strong impact on EBF at 6 months included: location of residence, ethnicity, father's involvement, early breastfeeding plan, Mother's Card in antenatal care and television advertisement. There may be opportunities for government to review a range of policies relating to paternal involvement, antenatal care and formula advertising that could help to improve EBF rate.
Collapse
Affiliation(s)
- Pornpai Putthakeo
- Department of Health Policy and Planning, University of Tokyo, Japan
| | | | | | | | | |
Collapse
|
42
|
Joyner BL, Gill-Bailey C, Moon RY. Infant sleep environments depicted in magazines targeted to women of childbearing age. Pediatrics 2009; 124:e416-22. [PMID: 19706591 DOI: 10.1542/peds.2008-3735] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The goal was to evaluate pictures in magazines widely read by women of childbearing age, for adherence to American Academy of Pediatrics (AAP) guidelines for safe infant sleep practices. METHODS Magazines were included in this study if they had an average female readership of >5 million, circulation of >900000, and median age of female readers of 20 to 40 years. Twenty magazines met these criteria. An additional 8 magazines targeted toward expectant parents and parents of young children were included, for a total of 28 magazines. Pictures of infant sleep environments and sleeping infants in articles and advertisements in issues of these 28 magazines were analyzed for adherence to AAP guidelines for decreasing the risk of sudden infant death syndrome. RESULTS A total of 391 unique pictures from 34 magazine issues were included in the analysis. Only 57 pictures (64%) portraying sleeping infants not being held by an adult portrayed the infants in the supine position, and 14.8% of sleeping infants were portrayed as sleeping with another person. Only 36 pictures (36.4%) of infant sleep environments portrayed a safe sleep environment, as recommended by the AAP. CONCLUSIONS More than one third of pictures of sleeping infants in magazines geared toward childbearing women demonstrated infants in an inappropriate sleep position, and two thirds of pictures of infant sleep environments were not consistent with AAP recommendations. Messages in the media that are inconsistent with health care messages create confusion and misinformation about infant sleep safety and may lead inadvertently to unsafe practices.
Collapse
Affiliation(s)
- Brandi L Joyner
- Goldberg Center for Community Pediatric Health, Children's National Medical Center, Washington, DC 20010, USA
| | | | | |
Collapse
|
43
|
Obesity Related Programming Statements in Materials on Infant Feeding Aimed at Parents in Five European Countries. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2009; 646:175-81. [DOI: 10.1007/978-1-4020-9173-5_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
44
|
Mordini B, Bortoli E, Pagano R, Barozzi G, Ferrari F. Correlations between welfare initiatives and breastfeeding rates: a 10-year follow-up study. Acta Paediatr 2009; 98:80-5. [PMID: 18710434 DOI: 10.1111/j.1651-2227.2008.00986.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the prevalence of full breastfeeding during the first 6 months of age and to discover if training programs for health caregivers and welfare initiatives at the community level could improve breastfeeding rates. METHODS Newborn babies with gestational age > or =36 weeks and birth weight > or =2500 g, discharged from the hospital within the first week of life, without any underlying pathologies, were enrolled in 3-month long sample periods between 1997 and 2006. A questionnaire was distributed to the mothers, to be completed and submitted before hospital discharge. Data were collected from phone interviews at 1, 3 and 6 months. RESULTS Full breastfeeding rates at hospital discharge showed an oscillation between 69.9% and 87%. The rate decreased in the following months and reached very low levels at 6 months of age (< 24%), with the exception of the last sample period in 2006 (44.9%). CONCLUSION A simple questionnaire, combined with standardized phone interviews, can be easily reproduced and may be used as an indicator for quality of neonatal care at hospital nurseries. A social and cultural change of the whole community towards breastfeeding promotion will result in increasing breastfeeding rates.
Collapse
Affiliation(s)
- Bruno Mordini
- Department of Neonatology, University Hospital, Via Del Pozzo 71, Modena, Italy.
| | | | | | | | | |
Collapse
|
45
|
Brown JD, Peuchaud SR. Media and breastfeeding: friend or foe? Int Breastfeed J 2008; 3:15. [PMID: 18680582 PMCID: PMC2518136 DOI: 10.1186/1746-4358-3-15] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2008] [Accepted: 08/04/2008] [Indexed: 11/16/2022] Open
Abstract
The mass media have the potential to be powerful friends or foes in promoting breastfeeding. The media could help by putting the issue of breastfeeding on policy agendas and by framing breastfeeding as healthy and normative for baby and mother. Currently, however, it looks as if the media are more often contributing to perceptions that breastfeeding is difficult for mothers and potentially dangerous for babies. This paper presents a brief overview of research on the media and breastfeeding, some insights into the market forces and human psychological factors that may play into media representations of breastfeeding, and strategies to help breastfeeding advocates work more effectively with the media.
Collapse
Affiliation(s)
- Jane D Brown
- School of Journalism and Mass Communication, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sheila Rose Peuchaud
- School of Journalism and Mass Communication, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| |
Collapse
|
46
|
Quintero Romero S, Bernal R, Barbiero C, Passamonte R, Cattaneo A. A rapid ethnographic study of breastfeeding in the North and South of Italy. Int Breastfeed J 2006; 1:14. [PMID: 16952324 PMCID: PMC1570447 DOI: 10.1186/1746-4358-1-14] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2006] [Accepted: 09/05/2006] [Indexed: 12/04/2022] Open
Abstract
Background The past ten years have witnessed a rising trend in the prevalence and duration of breastfeeding in Italy, but breastfeeding rates increase in an unequal way; they are higher in the North of Italy than in the South. The purpose of this study was to describe the experiences, expectations and beliefs of a sample of mothers, and to identify differences, if any, between the North and the South of Italy. Methods The study was conducted in two regions of Italy, Friuli Venezia Giulia in the Northeast and Basilicata in the South. Two hundred and seventy-nine mothers of infants and children 6 to 23 months of age were interviewed using an 85-item questionnaire including closed and open questions on infant feeding experiences and beliefs, sources of information and support, reasons for intended and actual choices and practices, and some demographic and social variables. Face-to-face interviews were conducted between May 2001 and September 2002. Quantitative and qualitative methods were used for data analysis. Results The distribution of the mothers by age, education, employment and parity did not differ from that of the general population of the two regions. The reported rates of initiation and duration of breastfeeding were also similar: 95% started breastfeeding, exclusive breastfeeding was 32% at three and 9% at six months, with 64% and 35% of any breastfeeding, respectively. Some differences were reported in the rates of full breastfeeding, reflecting different ages of introduction of non-nutritive fluids. These, as well as nutritive fluids – including infant formula – and complementary foods, were introduced far too early. Advice on infant feeding was generally provided by health professionals and often was not based on up-to-date recommendations. Mothers were generally aware of the advantages of breastfeeding, but at the same time reported problems that they were not able to solve alone or through social and health system support. Most mothers would welcome the support of a peer counsellor. More mothers in Basilicata than in Friuli Venezia Giulia reported difficulties with breastfeeding related to returning to work and were not familiar with their rights on breastfeeding and maternity leave. Conclusion Programmes for the protection, promotion and support of breastfeeding in these and similar regions of Italy should concentrate on better training of health professionals with regards to lactation management, communication, and counselling skills. The addition of trained peer counsellors could reinforce the work done by the health system and, through community involvement, could help change social prejudice in the mid- and long-term. The differences between regions should be taken into account in formulating these programmes to avoid increasing, and possibly to decrease, the current gaps.
Collapse
Affiliation(s)
| | - Rosa Bernal
- Centro per la Salute del Bambino, Trieste, Italy
| | | | | | - Adriano Cattaneo
- Unit for Health Services Research and International Health, Institute of Child Health IRCCS Burlo Garofolo, Via dei Burlo 1, 34123 Trieste, Italy
| |
Collapse
|