Factors influencing exclusive breastfeeding duration in Pakistan: a population-based cross-sectional study

Experiences of mothers with early weaning: a grounded theory

OBJECTIVE

To understand the experiences of mothers with early weaning.

METHOD

Qualitative research with a theoretical-methodological contribution from Grounded Theory (Straussian perspective), carried out in the context of primary health care in a medium-sized municipality in the northeast of Brazil. 19 collaborators participated by theoretical sampling. Data collection took place between April and September 2018, with in-depth interviews, and was analyzed in three stages: open and axial coding, and integration.

RESULTS

The central category "Women experiencing guilt and overload due to early weaning" was supported by three categories: a) conditions: "Showing the factors that limit breastfeeding"; b) actions/interactions: "Trying to balance motherhood and work during breastfeeding" and "Insufficient social support to keep exclusive breastfeeding"; and c) consequences: "Introducing formula and complementary foods before six months" and "Blaming oneself for the early weaning".

FINAL CONSIDERATIONS

The theoretical model can give support to managers and health professionals to advocate for longer maternity leaves and confront gender disparities and inequities, professional performance with conflicts of interest, and abusive marketing regarding the use of formula.

How is parental education associated with infant and young child feeding in Bangladesh? a systematic literature review

BACKGROUND

Education is expected to bring about positive behavioral changes which could lead to improved health behaviors. Parental education is a primary determinant of child health and development. However, some evidence showed inverse associations between high parental education and recommended infant and young child feeding (IYCF) in Bangladesh. How the association of parental education differs with specific IYCF components has not been reviewed. Therefore, the role of parental education on optimal IYCF practices in Bangladesh appears to be inconclusive. The objective of this review is to summarize how parental education is associated with IYCF practices in Bangladesh.

METHOD

This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. A systematic literature search was conducted in PubMed, Web of Science, Embase, and Google Scholar. Record searching, study selection, and data extraction was performed using Endnote online and Covidence tool, respectively. The Newcastle-Ottawa scale was used for quality assessment of the included studies.

RESULTS

Out of 414 initial hits, 34 studies were included for this review. Of the included studies, 32 were cross-sectional, one was a randomized controlled trial, and one was a retrospective cohort. Most of the studies (n = 24) were nationally representative whereas 10 studies had populations from district and sub-district level. Included studies considered different IYCF-related indicators, including breastfeeding (n = 22), complementary feeding (n = 8), both breastfeeding and complementary feeding (n = 2), both breastfeeding and bottle feeding (n = 1), and pre-lacteal feeding (n = 1). Parental education was found to be positively associated with complementary feeding practices. However, the role of parental education on breastfeeding, in general, was ambiguous. High parental education was associated with bottle-feeding practices and no initiation of colostrum.

CONCLUSION

Public health interventions need to focus not only on non- and/or low-educated parents regarding complementary feeding but also on educated mothers for initiation of colostrum and proper breastfeeding practices.

TRIAL REGISTRATION

This systematic review is registered to PROSPERO ( https://www.crd.york.ac.uk/prospero/ ) with registration ID: CRD42022355465.

Modeling the Ranked Antenatal Care Visits Using Optimized Partial Least Square Regression

The frequency and timing of antenatal care visits are observed to be the significant factors of infant and maternal morbidity and mortality. The present research is conducted to determine the risk factors of reduced antenatal care visits using an optimized partial least square regression model. A data set collected during 2017-2018 by Pakistan Demographic and Health Surveys is used for modeling purposes. The partial least square regression model coupled with rank correlation measures are introduced for improved performance to address ranked response. The proposed models included PLSρ_s, PLSτ_A, PLSτ_B, PLSτ_C, PLS _D, PLSτ_GK, PLS _G, and PLS _U. Three filter-based factor selection methods are executed, and leave-one-out cross-validation by linear discriminant analysis is measured on predicted scores of all models. Finally, the Monte Carlo simulation method with 10 iterations of repeated sampling for optimization of validation performance is applied to select the optimum model. The standard and proposed models are executed over simulated and real data sets for efficiency comparison. The PLSρ_s is found to be the most appropriate proposed method to model the observed ranked data set of antenatal care visits based on validation performance. The optimal model selected 29 influential factors of inadequate use of antenatal care. The important factors of reduced antenatal care visits included women's educational status, wealth index, total children ever born, husband's education level, domestic violence, and history of cesarean section. The findings recommended that partial least square regression algorithms coupled with rank correlation coefficients provide more efficient estimates of ranked data in the presence of multicollinearity.

Child Feeding Practices of Childbearing Mothers and Their Household Food Insecurity in a Coastal Region of Bangladesh

The current condition of ensuring WHO-recommended newborn and young child feeding practice is becoming a challenge in many developing nations, particularly in places where family food security is threatened. Because many households in underdeveloped nations frequently face acute food shortage due to poverty, optimal child nutrition is jeopardized. The purpose of this study was to analyze the child feeding behaviors of mothers with children aged 0-24 months and to investigate their household food insecurity in a coastal region of Bangladesh, Suborno Char (one of Noakhali District's coastal neighbourhoods) was studied from October 2019 to April 2020. In this study, a cross-sectional survey with multistage sampling technique was employed, and Suborno Char of Noakhlai district was purposely sampled of 400 women and their children aged 0-24 months. Data were obtained using a standard questionnaire and were analyzed using statistical functions in SPSS 20.0.0. Exclusive breastfeeding 53.5%, timely supplemental feeding 75.5%, and feeding children meals from homemade, canned/formula/fortified, both homemade and canned, milk these 4 food groups were at 22.2%. The moms' education level was strongly associated with their child feeding practices. Mothers from food insecure homes were less likely to exclusively breastfeed than mothers from food secure households after drawing interpretation of univariate & multivariate analysis of variables crude odds ratio (COR) and adjusted odds ratio (AOR) and confidence interval (CI) (COR .233 at 95% CI 0.083, .655 and AOR .478 at 95% CI 0.133, 1.713). Similar outcomes were seen for early complementary feeding and minimal dietary diversification of children. In conclusion, this study discovered a less dietary inclusion trend of child feeding practices among moms (0-24 months childbearing) in Bangladesh's coastal region.