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Kimuli D, Nakaggwa F, Namuwenge N, Nsubuga RN, Isabirye P, Kasule K, Katwesige JF, Nyakwezi S, Sevume S, Mubiru N, Amuron B, Bukenya D. Sociodemographic and health-related factors associated with exclusive breastfeeding in 77 districts of Uganda. Int Breastfeed J 2023; 18:66. [PMID: 38053098 DOI: 10.1186/s13006-023-00604-x] [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: 09/22/2023] [Accepted: 11/27/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Uganda surpasses many African nations and the global average in exclusive breastfeeding (EBF) rates. Yet, malnutrition is a critical issue, with stunting impacting roughly 29% of children under 5 years. Enhancing EBF could mitigate such nutritional challenges. This study focused on determining the current EBF prevalence and identifying associated factors across 77 surveyed districts. METHODS Pooled data from the Lot Quality Assurance Sampling (LQAS) surveys conducted in 77 districts in Uganda during 2021 and 2022 were analyzed. The analysis involved 7,210 mothers of children under 6 months, EBF was considered as the proportion of infants who received breast milk only in the 24 hours before the survey. A mother practicing EBF was (1) currently breastfeeding (2) had not started giving foods other than breastmilk (3) had not given any other probed liquids or (4) semi-solid foods the previous day or night. Multivariable logistic regression was used to identify factors associated with EBF, presenting adjusted odds ratios (aOR) with corresponding 95% confidence intervals at a 5% significance level. RESULTS The prevalence of EBF was 62.3%. In the adjusted analysis, EBF was more common among older mothers 20-24 years, 25-29 years and 30 + years (aOR 1.4; 95% CI 1.2,1.6), (aOR 1.4; 95% CI 1.1, 1.6) and (aOR 1.3; 95% CI 1.1, 1.5) respectively compared to teenage mothers. Also, EBF was more likely among mothers who lived in rural areas compared to urban areas (aOR 1.1; 95% CI 1.0, 1.3) and those who attended antenatal care (ANC) (aOR 2.2; 95% CI 1.5, 3.1). On the contrary, EBF was less common for children aged 3-5 months compared to younger (aOR 0.5; 95% CI 0.5, 0.6) and children who had received Vitamin A supplementation (aOR 0.7; 95% 0.6, 0.8). CONCLUSION The study suggests that most districts in Uganda might not have made significant strides in improving EBF rates over the last twenty years, pointing to possible ongoing hurdles that need urgent attention. Particularly, there's a pressing need to focus on teenage mothers. Maintaining and strengthening programs that advocate EBF, such as ANC, is crucial to bridge the gaps and bring about more equitable rates among different groups.
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Affiliation(s)
- Derrick Kimuli
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda.
| | - Florence Nakaggwa
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Norah Namuwenge
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Rebecca N Nsubuga
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Paul Isabirye
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Kenneth Kasule
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Justine Fay Katwesige
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Sheila Nyakwezi
- The United States Agency for International Development Uganda, US Mission Compound - South Wing, Kampala, Uganda
| | - Solome Sevume
- The United States Agency for International Development Uganda, US Mission Compound - South Wing, Kampala, Uganda
| | - Norbert Mubiru
- The United States Agency for International Development Uganda, US Mission Compound - South Wing, Kampala, Uganda
| | - Barbara Amuron
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
| | - Daraus Bukenya
- Social & Scientific Systems, Inc., a DLH Holdings company / United States Agency for International Development Strategic Information Technical Support Activity, Kampala, Uganda
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Eticha TG, Girma S, Mamo G, Asefa F, Birhanu A, Taye B, Alemu A, Niguse K, Gedefaw A, Genet T, Amenu D, Mekuria T, Tura AK. Knowledge of lactation amenorrhea method among postpartum women in Ethiopia: a facility-based cross-sectional study. Sci Rep 2023; 13:14916. [PMID: 37689818 PMCID: PMC10492808 DOI: 10.1038/s41598-023-42196-w] [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] [Received: 07/12/2023] [Accepted: 09/06/2023] [Indexed: 09/11/2023] Open
Abstract
While the importance of knowledge about contraceptives in improving their utilization and thereby reducing the risk of unintended pregnancies is well documented, there are limited studies documented about the Lactational Amenorrhea Method (LAM). Thus, understanding the knowledge of postpartum mothers about LAM is essential for designing tailored interventions. This study assessed the level of knowledge about LAM and its associated factors among postpartum mothers in Ethiopia. A facility-based cross-sectional study was conducted among 3148 randomly selected postpartum participants. The study utilized multistage sampling approach in hospitals located across five regions and one city administration in Ethiopia. Data were collected using face-to-face interviews at discharge. A participant was categorized as having knowledge of LAM if she correctly answered the three LAM criteria: amenorrhea, the first 6 months, and exclusive breast feeding. A binary logistic regression model was used to identify factors associated with knowledge of LAM. Variables with p < 0.25 in the binary logistic regression were included in the multiple logistic regression. Then, associations were described using the adjusted odds ratio (AOR) along with the 95% confidence interval (CI), and statistical significance was declared at p < 0.05. Only four in 10 participants (40.6%; 95% CI 38.9-42.3) had knowledge of LAM. Participants who attended college or above educational level (AOR = 2.1, 95% CI 1.5-2.8), those with parity of two (AOR = 2.3; 95% CI 1.6-3.6) or more than two (AOR = 2.4; 95% CI 1.5-4.0), those who expressed a desire for further fertility (AOR = 1.3; 95% CI 1.1-1.5), individuals who received counselling on LAM (AOR = 3.0; 95% CI 2.6-3.7), and those who gave birth in hospital (AOR = 2.6; 95% CI 1.4-2.6) had higher odds of knowledge about LAM, compared to their counter parts. In contrary, participants resided far away from health facilities had 30% lower odd of knowledge about LAM compared to those resided near the health facilities (AOR = 0.70; 95% CI 0.6-0.8). The proportion of participants who had knowledge of LAM was low. Strengthening counseling about LAM during antenatal care and delivery with due attention to women with limited access to health facilities should be considered for increasing their level of knowledge on LAM.
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Affiliation(s)
- Tadesse Gure Eticha
- Department of Obstetrics and Gynecology, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
| | - Sagni Girma
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Department of Obstetrics and Gynaecology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Galana Mamo
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fekede Asefa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Department of Pediatrics, College of Medicine, The University of Tennessee Health Science Center (UTHSC)-Oak Ridge National Laboratory (ORNL) Center for Biomedical Informatics, Memphis, TN38103, USA
| | - Abdi Birhanu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bedasa Taye
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kabtamu Niguse
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abel Gedefaw
- School of Medicine, College of Health and Medical Sciences, Hawassa University, Hawassa, Ethiopia
| | - Tinsae Genet
- School of Medicine, College of Health and Medical Sciences, University of Gondar, Gondar, Ethiopia
| | - Demesew Amenu
- School of Medicine, College of Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Thomas Mekuria
- School of Medicine, St. Paul's Millennium Medical College Hospital, Addis Ababa, Ethiopia
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Thaithae S, Yimyam S, Polprasarn P. Prevalence and Predictive Factors for Exclusive Breastfeeding at Six Months among Thai Adolescent Mothers. CHILDREN 2023; 10:children10040682. [PMID: 37189931 DOI: 10.3390/children10040682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 03/27/2023] [Accepted: 03/31/2023] [Indexed: 04/07/2023]
Abstract
Exclusive breastfeeding (EBF) in the first six months of life is the best and the most frequent choice for infants since it has important benefits for the infants and their mothers. However, the exclusive breastfeeding rate in Thailand remains low, especially among adolescent mothers. This predictive correlation study aimed to investigate factors predicting breastfeeding at six months among 253 Thai adolescent mothers from nine hospitals of the Bangkok Metropolitan Administration. Data were collected by using seven questionnaires: the Personal Characteristics, Pregnancy Intention and Breastfeeding Practice, Perceived Benefits of Breastfeeding, Perceived Barriers to Breastfeeding, Breastfeeding Self-Efficacy, Family Support, Maternity Care Practice, and Digital Technology Literacy Questionnaires. Data were analyzed by using descriptive statistics and logistic regression. The findings revealed that the prevalence of EBF at six months among Thai adolescent mothers was only 17.39%, and predictive factors were occupation (work/study) (p = 0.034), digital technology literacy (p < 0.001), family support (p = 0.021), pregnancy intention (p = 0.001), breastfeeding self-efficacy (p = 0.016), and perceived benefits of breastfeeding (p = 0.004). These factors could, together, predict the EBF rate at six months among Thai adolescent mothers in 42.2% (Nagelkerke R2 = 0.422) of the cases. These findings may help health professionals to develop activities and strategies for promoting exclusive breastfeeding by increasing breastfeeding self-efficacy, perceived benefits of breastfeeding, and family support, as well as improving digital technology skill among Thai adolescent mothers, especially student/employed adolescents who have unintended pregnancies.
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Affiliation(s)
- Suparp Thaithae
- Kuakarun Faculty of Nursing, Navamindradhiraj University, 131/5 Khao Road, Wachira Sub-District, Dusit District, Bangkok 10300, Thailand
| | - Susanha Yimyam
- Faculty of Nursing, Chiang Mai University, 110/406 Inthawaroros Road, Suthep Sub-District, Mueang District, Chiang Mai 50200, Thailand
| | - Pridsadaporn Polprasarn
- Excellence Center of Community Health Promotion, Walailak University, Nakhon Si Thammarat 80160, Thailand
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Yamunaque-Carranza M, Medina-Ramirez SA, Mamani-García CS, Caira-Chuquineyra B, Fernandez-Guzman D, Urrunaga-Pastor D, Bendezu-Quispe G. Factors Associated with Adequate Breastfeeding: Evidence from the Peruvian Demographic and Health Survey, 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13607. [PMID: 36294187 PMCID: PMC9602776 DOI: 10.3390/ijerph192013607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To assess the factors associated with adequate breastfeeding (ABF) among Peruvian mothers during 2019. MATERIALS AND METHODS We performed a secondary analysis of the 2019 Demographic and Family Health Survey (ENDES) database of Peru. ABF was defined based on the recommendations of the World Health Organization, which defined it as starting breastfeeding within the first hour of life and continuing with exclusive breastfeeding for up to 6 months. To determine the factors associated with ABF, a Poisson generalized linear models with log-link function was used. Adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95% CI) were calculated. RESULTS A prevalence of ABF of 48.1% was identified among 11,157 women who reported at least one child in the last five years. Most of them were young (68.6%) and lived in urban areas (65.5%). Furthermore, being unemployed (aPR:1.02; 95% CI:1.00-1.04); residing on the coast, except for Metropolitan Lima (aPR:1.08; 95% CI:1.04-1.11), the highlands (aPR:1.14; 95% CI:1.11-1.18), and the jungle (aPR:1.20; 95% CI: 1.16-1.24); having had a vaginal delivery (aPR:1.30; 95% CI:1.27-1.05); and having two children (aPR:1.03; 95% CI:1.01-1.05) or three or more children (aPR:1.03; 95% CI:1.01-1.05) were associated with a higher frequency of ABF. CONCLUSIONS One out of two women between 18-59 with children performed ABF. The factors associated with ABF were the current occupation, region of residence, type of delivery, and parity. Health policies and strategies should be implemented, considering our results, to promote maternal counseling by health personnel in order to increase the prevalence of ABF in the Peruvian population.
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Affiliation(s)
- Mariela Yamunaque-Carranza
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo 14012, Peru
- Sociedad Científica de Estudiantes de Medicina Veritas (SCIEMVE), Chiclayo 14012, Peru
| | - Sebastian A. Medina-Ramirez
- Departamento de Ciencias Básicas, Facultad de Medicina Humana, Universidad Peruana Unión (UPeU), Lima 15464, Peru
| | - Carlos S. Mamani-García
- Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, Arequipa 04001, Peru
- Sociedad Científica de Estudiantes de Medicina Agustinos (SOCIEMA), Arequipa 04001, Peru
| | - Brenda Caira-Chuquineyra
- Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, Arequipa 04001, Peru
- Sociedad Científica de Estudiantes de Medicina Agustinos (SOCIEMA), Arequipa 04001, Peru
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15074, Peru
| | - Daniel Fernandez-Guzman
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15074, Peru
- Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco, Cusco 08000, Peru
| | - Diego Urrunaga-Pastor
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Carrera de Medicina Humana, Lima 15067, Peru
| | - Guido Bendezu-Quispe
- Centro de Investigación Epidemiológica en Salud Global, Universidad Privada Norbert Wiener, Lima 15046, Peru
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Grant-Alfieri A, Burke K, Zeinomar N, Delgado ML, Terry MB. Cancer Education Interventions in Adolescents: A Systematic Review of Scope and Content. HEALTH EDUCATION & BEHAVIOR 2022; 49:993-1003. [PMID: 35898117 DOI: 10.1177/10901981221109142] [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: 11/17/2022]
Abstract
Given the long induction time of many cancers and the fact that modifiable risk factors (e.g., cigarette smoking) including preventive factors (e.g., human papillomavirus [HPV] vaccination, healthy dietary and physical activity patterns) are influenced in adolescence, educating adolescents about cancer causation and risk reduction may have a large impact on reducing the cancer burden. We conducted a systematic review of literature evaluating the impact of cancer education interventions on adolescent knowledge of cancer risk reduction. We searched for articles published from 2000 to 2019 and identified 33 studies meeting our criteria. Given the methodological heterogeneity across studies, we briefly assessed effectiveness but focused on examining the design of the intervention and study. The majority of studies took place outside of the United States (67%). Most studies solely addressed skin or cervical cancer (67%) with only 18% (n = 6) discussing multiple cancers. The majority of interventions were a single-session (55%), did not involve a control or comparison group (67%), and were evaluated using a pre-test and a single post-test (61%); some studies administered multiple post-tests. Few studies (12%) investigated adolescents' knowledge of lifestyle and environmental risk factors at both the individual and community level. Most studies (94%) reported improvement in knowledge following an intervention. Our review revealed wide methodological variation and a deficit in research evaluating interventions that address multiple cancer types and risk factors. Future research should robustly test whether comprehensive cancer education for adolescents can reduce the cancer burden, particularly in communities with major cancer health disparities.
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Affiliation(s)
| | - Kimberly Burke
- Columbia University Mailman School of Public Health, New York, NY, USA.,Columbia University Irving Medical Center, New York, NY, USA
| | - Nur Zeinomar
- Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Mary Beth Terry
- Columbia University Mailman School of Public Health, New York, NY, USA.,Columbia University Irving Medical Center, New York, NY, USA
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Birabwa C, Bakkabulindi P, Wafula ST, Waiswa P, Benova L. Knowledge and use of lactational amenorrhoea as a family planning method among adolescent mothers in Uganda: a secondary analysis of Demographic and Health Surveys between 2006 and 2016. BMJ Open 2022; 12:e054609. [PMID: 35193915 PMCID: PMC8867379 DOI: 10.1136/bmjopen-2021-054609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To assess the level of knowledge and use of the lactational amenorrhoea method (LAM) among adolescents in Uganda between 2006 and 2016 using nationally representative data from Demographic and Health Surveys (DHS). DESIGN Cross-sectional design involving analysis of three DHS (2006, 2011, and 2016) in Uganda. SETTING The data collection took place in Uganda. The DHS are nationally representative surveys on a wide range of indicators including contraception knowledge and use. PARTICIPANTS A total of 1948 (2006), 2026 (2011) and 4276 (2016) adolescents (15-19 years) and 1662 (2006), 1666 (2011) and 3782 (2016) young women (20-24 years) were included. PRIMARY OUTCOME MEASURE Use of LAM among adolescents and young women with a live birth within 6 months before each survey. RESULTS In 2016, less than 1.0% (95% CI: 0.2% to 3.5%) of eligible adolescents correctly used LAM, and 56.3% (95% CI: 48.8% to 63.6%) were passively benefitting from LAM. The median duration of postpartum amenorrhoea (PPA) among adolescents in 2016 was 6.9 months, declining from 8.3 months in 2006. Compared with adolescents (56.7%), eligible young women had higher knowledge of LAM (64.1%) and higher median PPA duration (8.0 months) in 2016. The percentage of eligible adolescents who met the LAM criteria irrespective of whether they reported LAM use (were protected by LAM) decreased from 76.4% (95% CI: 66.5% to 84.0%) in 2006 to 57.2% (95% CI: 49.5% to 64.6%) in 2016. More than 50.0% (95% CI: 49.2% to 63.8%) of eligible adolescents were aware of LAM in 2016, increasing from 6.0% (95% CI: 2.5% to 13.8) in 2006. CONCLUSION Despite increasing awareness of LAM, reported and correct use of LAM was low among adolescents who could benefit from this method in Uganda, and declining over time. Support for adolescents to harness the benefits of correct LAM use should be increased. Additional research is needed to better understand the dynamics of LAM use in adolescents, including the transition to use of other modern contraceptive methods.
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Affiliation(s)
- Catherine Birabwa
- School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Pamela Bakkabulindi
- School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
- Health Support Initiatives, Kampala, Uganda
| | - Solomon T Wafula
- School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Peter Waiswa
- School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
- Division of Global Health, Karolinska Institutet, Stockholm, Sweden
| | - Lenka Benova
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
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Hernández MIN, Riesco ML. Abandono do aleitamento materno exclusivo em mães adolescentes: um estudo de coorte em serviços primários de saúde. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.6252.3787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Resumo Objetivo: analisar os fatores associados ao abandono do aleitamento materno exclusivo em mães adolescentes durante os primeiros seis meses de vida do bebê. Método: trata-se de um estudo de coorte com 105 mães adolescentes acompanhadas aos dois, quatro e seis meses de vida de seus filhos. Uma abordagem epidemiológica, apoiada por um paradigma positivista, foi adotada. As variáveis de exposição escolhidas foram aquelas diretamente relacionadas ao aleitamento materno e a condições sociodemográficas, familiares, maternas e infantis. Os dados usados foram coletados através de entrevistas e analisados por estatísticas bivariadas e multivariadas. A razão de risco (RR) foi calculada com um intervalo de confiança de 95% (IC95%). Os testes foram realizados, admitindo um erro tipo I de 5%. A confidencialidade dos dados foi garantida. Resultados: as incidências acumuladas de abandono do aleitamento materno exclusivo foram de 33,3%, 52,2% e 63,8%, aos dois, quatro e seis meses de vida dos bebês, respectivamente. As variáveis que permaneceram no modelo multivariado final foram percepção materna da qualidade de seu leite (HR=11,6; 95% IC 3,6-37,5), uso de chupeta (HR=1,9; 95% IC 1,2-3,3) e tempo de primeira sessão de aleitamento materno depois do nascimento (HR=1,4; 95% IC 0,5-12,9). Conclusão: a maior taxa de abandono ocorre antes do quarto mês de vida dos bebês. Mães adolescentes que julgaram seu leite como ruim e bebês que usam chupeta são fatores que favorecem o abandono do aleitamento materno exclusivo. A determinação dos fatores associados ao abandono do aleitamento materno pode permitir sua gestão oportuna, especialmente em populações mais vulneráveis.
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Hernández MIN, Riesco ML. Exclusive breastfeeding abandonment in adolescent mothers: a cohort study within health primary services. Rev Lat Am Enfermagem 2022; 30:e3786. [DOI: 10.1590/1518-8345.6252.3786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/08/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract Objective: to analyze the factors associated with the abandonment of exclusive breastfeeding in adolescent mothers during the first 6 months of the infant’s life. Method: this is a cohort study of 105 adolescent mothers followed at the child’s 2-, 4- and 6-months of age. The epidemiological approach was adopted, supported by the positivism paradigm. Exposure variables were those directly related to breastfeeding and sociodemographic, family, maternal and child conditions. Data were collected by interview and analyzed by bivariate and multivariate statistics. The Hazard Ratio (HR) was calculated with a 95% confidence interval (95%CI). The tests were performed, admitting an error type I of 5%. The confidentiality of data was ensured. Results: the cumulative incidences of exclusive breastfeeding abandonment were 33.3%, 52.2% and 63.8%, at 2, 4 and 6 months, respectively. The variables that remain in the final multivariate model were maternal perception of milk quality (HR=11.6; 95%CI 3.6-37.5), pacifier use (HR=1.9; 95%CI 1.2-3.3), and time of first breastfeeding session (HR=1.4; 95%CI 0.5-12.9). Conclusion: the highest abandonment rate occurs before the fourth month. A perception of having poor-quality milk by the adolescent mother and pacifier use are factors that favor the abandonment of exclusive breastfeeding. Determining the factors associated with breastfeeding abandonment may allow their timely management, especially in more vulnerable populations.
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Hernández MIN, Riesco ML. Abandono de la lactancia materna exclusiva en madres adolescentes: un estudio de cohorte en los servicios de atención primaria de salud. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.6252.3785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Resumen Objetivo: analizar los factores relacionados con el abandono de la lactancia materna exclusiva en madres adolescentes durante los primeros seis meses de vida del bebé. Método: se trata de un estudio de cohorte de 105 madres adolescentes con un seguimiento a los dos, cuatro y seis meses de vida de sus hijos Se adoptó un enfoque epidemiológico, basado en un paradigma positivista. Las variables de exposición escogidas fueron aquellas directamente relacionadas con la lactancia materna y con las condiciones sociodemográficas, familiares, maternas e infantiles. Los datos utilizados fueron recolectados a través de entrevistas y analizados por estadística bivariada y multivariada. El riesgo relativo (RR) se calculó con un intervalo de confianza del 95% (IC 95%). Las pruebas se realizaron asumiendo un error tipo I del 5%. Se garantizó la confidencialidad de los datos. Resultados: las incidencias acumuladas de abandono de la lactancia materna exclusiva fueron del 33,3%, 52,2% y 63,8%, a los dos, cuatro y seis meses de vida de los bebés, respectivamente. Las variables que permanecieron en el modelo final multivariado fueron la percepción materna de la calidad de su leche (HR=11,6; IC 95% 3,6-37,5), uso de chupete (HR=1,9; IC 95% 1, 2-3,3) y momento de la primera lactancia (HR=1,4; IC 95% 0,5-12,9). Conclusión: la mayor tasa de abandono de LME se manifiesta antes del cuarto mes de vida de los bebés. Las madres adolescentes que perciben su leche inadecuada y los bebés que usan chupete son factores que favorecen el abandono de la lactancia materna exclusiva. Determinar las causas relacionadas con el abandono de la lactancia materna exclusiva pueden permitir su adecuada gestión, especialmente en poblaciones más vulnerables.
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Priscilla V, Afiyanti Y, Juliastuti D. A Qualitative Systematic Review of Family Support for a Successful Breastfeeding Experience among Adolescent Mothers. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Family support for adolescent mothers is vital in making breastfeeding decisions and sustaining the feeding since many of these women struggle with identity crises. Therefore, it is essential to synthesize qualitative evidence about the types of family support provided to these young women.
AIM: This study aims to identify, synthesize, and recognize the qualitative evidence of family support for successful breastfeeding among teen mothers.
METHODS: A systematic review of qualitative studies was identified in six electronic databases published from 2000 to 2020. The quality of the reviewed studies was checked using The Critical Appraisal Skills Programs. The data were extracted by two investigators and analyzed using thematic analysis with three steps: coding the text line-by-line, developing the descriptive themes, and generating the analytical themes.
RESULTS: This review includes eight eligible studies. The review founds that family significantly affect the success of breastfeeding practices among adolescent mothers through their appraisal, instrumental, emotional, and informational support. The family strengthens the adolescence’s breastfeeding decisions and confidence, provide financial assistance, share positive breastfeeding information and experience, encourage them to continue the feeding and motivate theme to pursue their study.
CONCLUSION: Breastfeeding a baby and becoming a mother at a young age is not an easy process and need family support for a successful feeding. Health care professionals should actively involve the family in supporting adolescent mothers to breastfeed their babies optimally.
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Benova L, Siddiqi M, Abejirinde IOO, Badejo O. Time trends and determinants of breastfeeding practices among adolescents and young women in Nigeria, 2003-2018. BMJ Glob Health 2021; 5:bmjgh-2020-002516. [PMID: 32764127 PMCID: PMC7412589 DOI: 10.1136/bmjgh-2020-002516] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 05/27/2020] [Accepted: 06/19/2020] [Indexed: 12/21/2022] Open
Abstract
Introduction Optimal breastfeeding practices have far-reaching health and economic benefits. Evidence suggests disparities in breastfeeding practices by maternal age-groups, with younger mothers often having lower rates of breastfeeding initiation, continuation and exclusivity compared with older mothers. There is limited knowledge of trends and factors associated with breastfeeding practices, particularly among adolescent and younger mothers in Nigeria. We examine key breastfeeding practices in Nigeria over a 15-year period, comparing adolescent mothers to young women. Methods We used four Nigeria Demographic and Health Surveys collected between 2003 and 2018. We constructed six key breastfeeding indicators to cover the time period of breastfeeding from initiation to child age 24 months in women of three maternal age groups at the time of birth: young adolescents (<18 years), older adolescents (18–19.9 years) and young women (20–24.9 years). We used logistic regression to examine the association between maternal age group and select breastfeeding behaviours on the 2018 survey. Results Analysis showed an increase in optimal breastfeeding practices across the four surveys and among all maternal age groups examined. Adolescent mothers had consistently lower prevalence for three of the six key breastfeeding indicators: early initiation of breastfeeding, exclusive breastfeeding <6 months and no prelacteal feed. Compared with young women, adolescent mothers had a higher prevalence of continued breastfeeding at 1 and 2 years. In multivariate analysis, we found that maternal age group was not associated with early breastfeeding initiation or with exclusive breastfeeding <6 months. However, several sociodemographic (ethnicity, region of residence) and healthcare-related (mode of delivery, antenatal care, postnatal breastfeeding counselling) factors were strongly associated with these two practices. Conclusions In Nigeria, there is need to better support breastfeeding and nutritional practices in adolescents and young women focusing on ethnic groups (Hausa, Fulani, Kanuri/Beriberi) and geographic regions (South East) that are lagging behind.
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Affiliation(s)
- Lenka Benova
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Manahil Siddiqi
- Department of Health Services, University of Washington School of Public Health, Seattle, Washington, USA
| | | | - Okikiolu Badejo
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
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Dueñas-Espín I, León Cáceres Á, Álava A, Ayala J, Figueroa K, Loor V, Loor W, Menéndez M, Menéndez D, Moreira E, Segovia R, Vinces J. Breastfeeding education, early skin-to-skin contact and other strong determinants of exclusive breastfeeding in an urban population: a prospective study. BMJ Open 2021; 11:e041625. [PMID: 33737421 PMCID: PMC7978273 DOI: 10.1136/bmjopen-2020-041625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE The current study aims to demonstrate independent associations between social, educational and health practice interventions as determinants of exclusive breastfeeding in an urban Ecuadorian population. DESIGN Prospective survival analyses. SETTING Ecuadorian mother-child dyads in urban settings. PARTICIPANTS We followed-up 363 mother-baby dyads who attended healthcare centres in Portoviejo, province of Manabi, for a median time (P25-P75) of 125 days (121-130 days). MAIN OUTCOME MEASURES We performed a survival analysis, by setting the time-to-abandonment of exclusive breastfeeding measured in days of life, that is, duration of exclusive breastfeeding, periodically assessed by phone, as the primary outcome. Crude and adjusted mixed-effects Cox proportional hazards model were performed to estimate HRs for each explanatory variable. RESULTS The incidence rate of abandonment of breastfeeding was 8.9 per 1000 person-days in the whole sample. Multivariate analysis indicated the three most significant protective determinants of exclusive breastfeeding were (a) sessions of prenatal breastfeeding education with an HR of 0.7 (95% CI: 0.5 to 0.9) per each extra session, (b) self-perception of milk production, with an HR of 0.4 (95% CI: 0.3 to 0.6) per each increase in the perceived quantity of milk production and (c) receiving early skin-to-skin contact with an HR of 0.1 (95% CI: <0.1 to 0.3) compared with those not receiving such contact, immediately after birth. CONCLUSIONS Prenatal education on breastfeeding, self-perception of sufficient breast-milk production and early skin-to-skin contact appear to be strong protectors of exclusive breastfeeding among urban Ecuadorian mother-baby dyads.
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Affiliation(s)
- Iván Dueñas-Espín
- Instituto de Salud Pública, Postgrado de Medicina Familiar y Comunitaria, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Ángela León Cáceres
- Instituto de Salud Pública, Postgrado de Medicina Familiar y Comunitaria, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
- Faculty of Medicine, Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Angelica Álava
- Distrito 13D02, Centro de Salud San Juan, Ministerio de Salud Pública, Manta, Manabí, Ecuador
| | - Juan Ayala
- Distrito 09d06, Ministerio de Salud Publica, Portoviejo, Manabí, Ecuador
| | - Karina Figueroa
- Zona 4 Manabí - Santo Domingo Distrito de Salud 13D11 Sucre - "San Vicente", Centro de Salud tipo A "San Clemente", Ministerio de Salud Publica, San Clemente, Ecuador
| | - Vanesa Loor
- Distrito 13D01, Centro de salud Palma Juntas y Centro de Salud de San Pablo, Ministerio de Salud Pública, San Pablo, Manabí, Ecuador
| | - Wilmer Loor
- Distrito de Salud 13d11, Centro de salud tipo A "San Andrés de Canoa", "San Vicente", Ministerio de Salud Pública, San Vicente-Sucre, Ecuador
| | - Mónica Menéndez
- Zona 4 Manabí - Santo Domingo, Distrito de Salud 13d01 - Centro de Salud El Limón, Ministerio de Salud Pública, El Limón, Ecuador
| | - David Menéndez
- Distrito 13D01, Centro de Salud tipo A "Pimpiguasi", Ministerio de Salud Publica, Portoviejo, Ecuador
| | - Eddy Moreira
- Distrito de Salud 13d11, Centro de Salud Tipo A "Salinas", San Vicente-Sucre, Ministerio de Salud Publica, San Vicente-Sucre, Ecuador
| | - René Segovia
- Distrito 13D04, Centro de Salud "Santa Ana", Ministerio de Salud Pública, Santa Ana, Manabí, Ecuador
| | - Johanna Vinces
- Centro de Salud Tipo A Carapungo 1, Ministerio de Salud Publica, Quito, Ecuador
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Trends and Determinants of EBF among Adolescent Children Born to Adolescent Mothers in Rural Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249315. [PMID: 33322838 PMCID: PMC7768375 DOI: 10.3390/ijerph17249315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/19/2020] [Accepted: 11/04/2020] [Indexed: 11/18/2022]
Abstract
Exclusive breastfeeding (EBF) has proven benefits for both mothers and infants; however, adolescent mothers have poor EBF practices globally. In Bangladesh, the practice of EBF among adolescent mothers remains unexplored. The aim of our study was to understand the EBF practices among adolescent mothers and their determinants in both the Health and Demographic Surveillance (HDSS) system areas of the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b) service area (ISA) and government service area (GSA) in rural Matlab, Bangladesh. For the purpose of our study, we collected relevant information from the database of the Health and Demographic Surveillance System (HDSS) of icddr,b and performed analysis to understand the trends and identify the determinants of EBF and identify the determinants of EBF among adolescent mothers living in two areas between 2007 and 2015. In total, 2947 children born to adolescent mothers were included in our final analysis. We used the Kaplan–Meier and the Cox-proportional hazards models to determine the differences in EBF practices in the two areas. We noted a lower trends of EBF in the ISA compared to the GSA in bivariate analysis. However, after adjusting for confounding variables, EBF status was 15% lower in the GSA than the ISA (HR: 0.85, 95% CI: 0.72–0.99). The father’s education was significantly different among the two populations. In both study areas, the coverage of EBF among adolescent mothers was lower than the national average (42% vs. 65%). Ensuring that adolescent mothers receive optimal care may improve EBF behavior.
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Acheampong AK, Ganga-Limando M, Aziato L. Perceived enablers of exclusive breastfeeding by teenage mothers in Ghana. S Afr Fam Pract (2004) 2020; 62:e1-e5. [PMID: 33054255 PMCID: PMC8377796 DOI: 10.4102/safp.v62i1.5108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 03/13/2020] [Indexed: 11/10/2022] Open
Abstract
Background Exclusive breastfeeding for the first 6 months can prevent diseases, boost immunity and improve quality of lives of infants. Ghana implemented programmes aimed at reaching the global target of increasing exclusive breastfeeding for the first 6 months to at least 50% by the year 2025. The country witnessed a decline in the overall rate of exclusive breastfeeding and an increase in the number of teenage mothers. Globally, teenage mothers are less likely to breastfeed than mothers of other age groups. Understanding enablers of exclusive breastfeeding by teenage mothers is important for any intervention aimed at improving exclusive breastfeeding rates and the quality of lives of infants. Method The study used a qualitative, exploratory, descriptive and contextual design, with focus groups. A total of six group discussions were conducted with 30 pregnant teenagers recruited from six public hospitals. Results Seven enablers emerged from the analysis of data. These included positive beliefs about the benefits of breast milk, family history of positive exclusive breastfeeding outcomes, support of the intimate partner, approval of closed-family members, expert opinions of antenatal care staff, teenage-oriented breastfeeding education and community-based breastfeeding education. Conclusion Health professionals and policy makers could learn from these enablers and use them to promote exclusive breastfeeding practices amongst teenage mothers in Ghana.
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Ayalew T. Exclusive breastfeeding practice and associated factors among first-time mothers in Bahir Dar city, North West Ethiopia, removed: A community based cross sectional study. Heliyon 2020; 6:e04732. [PMID: 32944666 PMCID: PMC7481526 DOI: 10.1016/j.heliyon.2020.e04732] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/24/2020] [Accepted: 08/12/2020] [Indexed: 12/04/2022] Open
Abstract
Background Breastfeeding can offer the ideal food for infants. It contains all the necessary nutrients for the growthand development of infants and antibodies that can protect from many childhood illnesses. Understanding the extent of, and barriers to exclusive breastfeeding in Ethiopia is important for learning how to best improve level of exclusive breastfeeding. No single study has been conducted on first-time mothers in the country. . Therefore, this study aimed to assess prevalence of exclusive breastfeeding practice and associated factors among first-time mothers in Bahir Dar city, North West Ethiopia. Method A community-based cross-sectional study was conducted from March to April, 2016 among (n = 400) randomly selected first-time mothers in Bahir Dar city, northwest Ethiopia. Data were collected using structured interviewer-administered questionnaire and analyzed using SPSS version20., bivariate and multivariate logistic regression analyses were carried out. Odds ratio with 95% confidence interval was used to measure the strength of association. Statistical significance was declared at P -value <0.05. Results Prevalence of exclusive breastfeeding practice 24 h before the survey was 57.3% (95%CI: 52.3%–62%). Mothers not being married (aOR = 2.79, 95 %CI: 1.08, 7.17), supported by their husband (aOR = 4.15, 95%CI: 2.13, 6.28), with no breast complication (aOR = 3.66, 95% CI: 2.13, 6.28), who had four or more antenatal care (aOR = 2.51, 95%CI: 1.49, 4.23) were more likely to practice exclusive breastfeeding. Conclusion A significant proportion of mothers had a low level of exclusive breastfeeding practice that was lower than the national recommended level. Mothers not being married, supported by their husbands, with no breast problems who had four or more antenatal care visits were more likely to practice exclusive breastfeeding. These results suggest that multi-sectorial and multi-disciplinary approaches are needed to increase exclusive breastfeeding in the first-time mothers.
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Affiliation(s)
- Tilksew Ayalew
- Department of Child Health Nursing, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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16
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Salim YM, Stones W. Determinants of exclusive breastfeeding in infants of six months and below in Malawi: a cross sectional study. BMC Pregnancy Childbirth 2020; 20:472. [PMID: 32807130 PMCID: PMC7433092 DOI: 10.1186/s12884-020-03160-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 08/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND UNICEF and WHO recommend that all children should be exclusively breastfed for the first 6 months of life as breastmilk contains all the nutrients an infant needs during this period. In Malawi, exclusive breastfeeding has been declining from 72% (2009), 70.2% (2014) and 61% in the most recent survey (2015-16). We aimed to determine factors associated with exclusive breastfeeding in Malawi. METHODS We used data from the Malawi Demographic and Health Survey (MDHS) 2015-2016. Survey records for 2059 mothers of children aged 6 months and below were identified and potential factors influencing infant feeding were examined. Logistic regression analysis was carried out to model determinants of exclusive breastfeeding (EBF). RESULTS EBF declined in proportion to the age of the infant. Significant associations with continuing EBF were age of the mother, ethnicity of the mother, sex of infant and number of siblings. Members of the Tumbuka (OR = 1.71, CI. 1.13-2.59) and Ngoni (OR = 2.05, CI. 1.38-3.05) communities were more likely to practice EBF. In addition, mothers with female babies (OR = 1.35, CI. 1.08-1.70) and those with 3-4 children (OR = 1.47, CI. 1.04-2.08) were more likely to engage in EBF. CONCLUSION We identify important variations in EBF practices among population sub-groups in Malawi that need to be considered when framing health education messaging. Work is needed to assess the impact of more targeted messaging, whether delivered via 'ten steps' to successful breastfeeding under Baby Friendly Hospital Initiative (BFHI) programming or other health education and awareness campaigns to sensitize communities on implications of some cultural practices on the lives of babies. The potential role for mass media, targeted Health Surveillance Assistants' (HSA) home visits and male involvement also require exploration.
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Affiliation(s)
- Yusuf M Salim
- Karonga District Hospital, Private Bag 1, Karonga, Malawi.
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17
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Kebede T, Woldemichael K, Jarso H, Bekele BB. Exclusive breastfeeding cessation and associated factors among employed mothers in Dukem town, Central Ethiopia. Int Breastfeed J 2020; 15:6. [PMID: 32019563 PMCID: PMC7001375 DOI: 10.1186/s13006-019-0250-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 12/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Employed women tend to exclusively breastfeed less than non-employed women. Early returning to work has been major reason why employed women stop exclusive breastfeeding. The aim of this study was to investigate exclusive breastfeeding (EBF) cessation and associated factors among employed mothers in Dukem town, Central Ethiopia. METHODS A cross-sectional study was conducted from February to March 2015 using total sample of 313 randomly selected permanently employed women. Information regarding participants' work-related factors, health service and sociodemographic factors were collected by face to face interview using structured questionnaire. Data were checked for completeness, entered and analyzed by SPSS version 20. Binary logistic regression was done to identify factors associated with exclusive breastfeeding cessation. The strength of association was measured using odds ratio with 95% confidence intervals. RESULTS Prevalence of exclusive breastfeeding cessation was 75.7% (95% CI 71.0, 80.5%). Having a short duration of maternity leave (AOR 9.3; 95% CI 3.8, 23), being a full time employee (AOR 3.5; 95% CI 1.7, 11), being private organization employee (AOR=2.1, 95% CI(1, 4.3)), lack of flexible work time (AOR 3.0; 95% CI 1.2, 7.5), not pumping breast milk (AOR 4.3; 95% CI 1.7, 11), lack of a lactation break (AOR 6.7; 95% CI 3,14.5) and work place far away from her child (AOR 3.1; 95% CI 3.1, 6.3), were significantly associated with cessation of EBF among employed mothers. CONCLUSION Prevalence of exclusive breastfeeding cessation was much higher than the international and national expectation. The concerned governmental bodies should consider improving the legislation of the 3 months postpartum maternity leave to reduce employed mother's exclusive breastfeeding cessation.
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Affiliation(s)
- Tolossa Kebede
- Public Health Emergency Management and Health Research Office, Oromia Regional Health Bureau Addis Ababa, Addis Ababa, Ethiopia
| | - Kifle Woldemichael
- Department of Epidemiology, Institute of Health Sciences, Jimma University, 378, Jireen Street, Jimma, Ethiopia
| | - Habtemu Jarso
- Department of Epidemiology, Institute of Health Sciences, Jimma University, 378, Jireen Street, Jimma, Ethiopia
| | - Bayu Begashaw Bekele
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260,, Mizan Aman, Ethiopia.
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, 4028, Hungary.
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Behzadifar M, Saki M, Behzadifar M, Mardani M, Yari F, Ebrahimzadeh F, Majidi Mehr H, Abdi Bastami S, Bragazzi NL. Prevalence of exclusive breastfeeding practice in the first six months of life and its determinants in Iran: a systematic review and meta-analysis. BMC Pediatr 2019; 19:384. [PMID: 31656169 PMCID: PMC6815441 DOI: 10.1186/s12887-019-1776-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 10/09/2019] [Indexed: 12/12/2022] Open
Abstract
Background Exclusive breastfeeding (EBF) in the first 6 months of life is the best and most complete option for an infant, in that supplies the vitamins and minerals the baby needs. Several studies in Iran have been conducted concerning the prevalence of EBF. The aim of this study was to determine the prevalence of EBF in the first 6 months of life and associated factors in Iran synthesizing published studies. Methods We searched PubMed/MEDLINE, Embase, Scopus, ISI/Web of Science, the Cochrane Library, Directory of Open Access Journals Directory (DOAJ) and Google Scholar as well as Iranian databases (Barakathns, MagIran and the Scientific Information Database or SID) up to November 2018. The Newcastle-Ottawa Scale was used to assess the quality of studies. Analyses were performed by pooling together studies using DerSimonian-Laird random-effects model with 95% confidence interval. To test for heterogeneity, I2 test was used. The Egger’s regression test and funnel plot were used to evaluate the publication bias. The strength of EBF determinants was assessed computing the Odds-ratios (OR) using the Mantel–Haenszel method. Results In the initial search 725 records were found. Finally, 32 studies were selected based on inclusion/exclusion criteria. The sample size of studies varied between 50 and 63,071 subjects. The overall prevalence of EBF in Iran was 53% (CI 95%; 44–62). The OR for breastfeeding education received before pregnancy was 1.13 (0.94–1.36), for mother’s job 1.01 (0.81–1.27), for education level 1.12 (0.89–1.42), for type of delivery 1.16 (0.98–1.37), and for gender of child 1.03 (0.83–1.28). Conclusion In Iran health policy- and decision-makers should try to take interventions that encourage mothers to use their milk to breastfeed the infants.
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Affiliation(s)
- Meysam Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mandana Saki
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Masoud Behzadifar
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Mahnaz Mardani
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Fatemeh Yari
- Department of Midwifery, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorrmabad, Iran
| | - Farzad Ebrahimzadeh
- Department of Biostatistics, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Hadis Majidi Mehr
- Department of Public Health, Faculty of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Shadi Abdi Bastami
- Department of Public Health, Faculty of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Nicola Luigi Bragazzi
- School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
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Dasoqi KA, Safadi R, Badran E, Basha AS, Jordan S, Ahmad M. Initiation and continuation of breastfeeding among Jordanian first-time mothers: a prospective cohort study. Int J Womens Health 2018; 10:571-577. [PMID: 30349401 PMCID: PMC6181471 DOI: 10.2147/ijwh.s175850] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed to examine the rates of initiation and continuation of breastfeeding (BF) and their relationship with mothers' sociodemographic, obstetric, neonatal, and medical interventions. Methods Data were collected from 199 first-time Jordanian mothers using medical records, face-to-face interviews within 24 hours of birth, and two telephone interviews at 6 weeks and 6 months after birth. Results The rate of BF initiation within the first 4 hours after birth was only 13%. The rate of exclusive BF at 6 weeks was 25.5%, and this rate dropped to 2.1% at 6 months. Mothers who initiated BF before discharge were older, were employed, had normal vaginal birth, and had undergone antenatal or after-birth BF education. Infants' birth weight or gender was not interrelated with BF initiation. There was no relationship between initiation and continuation of BF and use of medications for labor pain or for induction/augmentation. The only significant relationship was found between the dose of ergometrine and BF failure and painful BF at 6 weeks. Conclusion There is a need for increasing health care providers and public awareness about the role of intrapartum medications and procedures on the initiation and continuation of BF at 6 weeks and 6 months after birth.
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Affiliation(s)
- Khadeejeh Al Dasoqi
- Department of Maternal and Child Health Nursing, School of Nursing, University of Jordan, Amman, Jordan,
| | - Reema Safadi
- Department of Maternal and Child Health Nursing, School of Nursing, University of Jordan, Amman, Jordan,
| | - Eman Badran
- Department of pediatrics, School of Medicine, University of Jordan, Amman, Jordan
| | - Asma Sa'd Basha
- Department of Obstetrics and Gynecology, School of Medicine, University of Jordan, Amman, Jordan
| | - Sue Jordan
- Department of Nursing, Swansea University, Swansea, UK
| | - Muayyad Ahmad
- Clinical Nursing Department, School of Nursing, University of Jordan, Amman, Jordan
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Tshering D, Gurung MS, Wangmo N, Pelzom D, Tejativaddhana P, Dzed L. Prevalence of Exclusive Breastfeeding and Factors Associated With Exclusive Breastfeeding of Children in Trongsa District, Bhutan. Asia Pac J Public Health 2018; 30:369-377. [PMID: 29629818 DOI: 10.1177/1010539518768573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The World Health Organization estimated that about 800 000 infant deaths could be prevented annually by exclusively breastfeeding infants for the first 6 months of life. This study aimed to examine the prevalence of exclusive breastfeeding and its associated factors. A total of 192 mothers participated. The prevalence of exclusive breastfeeding practice in Trongsa district was 97% at 1 month, declining to 58% at 6 months. Mothers who returned to formal work were less likely to exclusively breastfeed than those who were farmers or housewives. The main reasons stated by the mothers for not exclusively breastfeeding were lack of the mother's self-confidence that the child is getting enough breastmilk and mothers having to return to work, 59% and 22%, respectively. The rate of exclusive breastfeeding in Trongsa district of Bhutan is high, and every effort should be made to maintain and improve this rate.
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Affiliation(s)
- Dolley Tshering
- 1 Dzongkhag Health Sector, Trongsa, Ministry of Health, Bhutan
| | - Mongal Singh Gurung
- 2 Health Research and Epidemiology Unit, Policy and Planning Division, Ministry of Health, Thimphu, Bhutan
| | - Neyzang Wangmo
- 3 Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Dorji Pelzom
- 4 Bhutan Health Management and Information Unit, Ministry of Health, Thimphu, Bhutan
| | | | - Laigden Dzed
- 6 National Nutrition Programme, Department of Public Health, Ministry of Health, Thimphu, Bhutan
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Senghore T, Omotosho TA, Ceesay O, Williams DCH. Predictors of exclusive breastfeeding knowledge and intention to or practice of exclusive breastfeeding among antenatal and postnatal women receiving routine care: a cross-sectional study. Int Breastfeed J 2018; 13:9. [PMID: 29507600 PMCID: PMC5833059 DOI: 10.1186/s13006-018-0154-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 02/15/2018] [Indexed: 11/20/2022] Open
Abstract
Background Despite consistent evidence showing the importance of exclusive breastfeeding (EBF) for six months, it remains a sub-optimal practice in The Gambia. This study aimed at investigating the determinants of EBF knowledge and intention to or practice of EBF. Methods A cross-sectional study was conducted among 334 women receiving care at the Edward Francis Small Teaching Hospital (EFSTH) from December 2015 to February 2016. Using a structured interviewer-administered questionnaire, knowledge on EBF was determined and scored. Participants scoring above or equal to the median were determined to have sufficient EBF knowledge. Multivariate logistic regression analyses were used to identify predictors of EBF knowledge and intention to or practice of exclusive breastfeeding. Results The proportion of women with sufficient exclusive breastfeeding knowledge and intended to or practice EBF were 60.2% and 38.6% respectively, while only 34.4% received EBF counseling. Earning ≥1500 GMD monthly (Adjusted Odds Ratio [aOR] 1.98; 95% Confidence Interval [Cl] 1.24, 3.16), having positive attitude (aOR 2.40; 95% Cl 1.40, 4.10) and partner supporting EBF (aOR 2.18; 95% Cl 1.23, 3.87) predicted sufficient EBF knowledge. Mothers aged 26–34 years (aOR 0.50; 9 5% Cl 0.31, 0.82) and EBF counseling (aOR 2.68; 95% Cl 1.68, 4.29) significantly associated with intention to or practice of exclusive breastfeeding. Conclusion In conclusion, improving EBF rates will, therefore, require improved access to information on EBF targeting low socio-economically disadvantaged and older mothers. In addition, emphasis on strengthening the ongoing EBF counseling already within the health system is required.
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Affiliation(s)
- Thomas Senghore
- Department of Nursing and Reproductive Health, School of Medicine and Allied Health Sciences, University of The Gambia, P.O. Box 1646, Independence Drive, Banjul, The Gambia
| | - Tobiloba Alex Omotosho
- Department of Nursing and Reproductive Health, School of Medicine and Allied Health Sciences, University of The Gambia, P.O. Box 1646, Independence Drive, Banjul, The Gambia
| | - Omar Ceesay
- Department of Nursing and Reproductive Health, School of Medicine and Allied Health Sciences, University of The Gambia, P.O. Box 1646, Independence Drive, Banjul, The Gambia
| | - Daisy Clara H Williams
- Department of Nursing and Reproductive Health, School of Medicine and Allied Health Sciences, University of The Gambia, P.O. Box 1646, Independence Drive, Banjul, The Gambia
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22
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Moraes de Oliveira M, Camelo JS. Gestational, perinatal, and postnatal factors that interfere with practice of exclusive breastfeeding by six months after birth. Int Breastfeed J 2017; 12:42. [PMID: 29026430 PMCID: PMC5627475 DOI: 10.1186/s13006-017-0132-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 09/11/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Despite evidences indicating the superiority of breastfeeding and recent advances in the indicators of breastfeeding in Brazil, exclusive breastfeeding (EBF) during the first six months after birth continues to be an infrequent practice in the country. The objective of the present study was to determine which gestational, perinatal, and postnatal factors of the mother-baby dyad might be associated with the cessation of EBF by six months after birth. METHODS Data were collected at the rooming-in facility of the Reference Center of Women's Health of Ribeirão Preto-Mater (CRSM-Mater) during the postpartum period (24 to 72 h after birth) from December 2012 to April 2013 and by telephone contact between the researcher and participating mothers by six months after birth. Questionnaires were applied to collect data, such as the practice of EBF in the last 24 h in the sixth month after birth. The hierarchical theoretical model was proposed and data were analyzed statistically by log-binomial regression models using SAS 9.3. RESULTS The study involved 283 mother-baby dyads in which the mother evaluated did not present pregnancy-puerperal complications that could impede breastfeeding and confirmed the interest in breastfeeding her child. After the telephone contact in the exact sixth month after the birth of each participating baby, 84.8% of the participating mothers reported that they were no longer exclusively breastfeeding their babies. After statistical analysis, we found that there was a significant association between cessation of EBF and maternal report of previous experience with EBF for one month (0.91, 95% CI 0.81, 0.99) and six months (0.81; 95% CI 0.68, 0.94). These practices were associated with the maintenance of EBF and, even after adjustment for maternal socio-demographic variables, this association was maintained (0.85; 95% CI 0.73, 0.99). Thus, there is a greater chance of practicing and maintaining EBF by six months after birth when mother had previous experience with it. CONCLUSION The identification of the risk variables associated with cessation of EBF by six months postpartum, such as previous experience with exclusive breastfeeding, may contribute to the effectiveness of EBF intervention and support measures during the first six months after birth.
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Affiliation(s)
- Mariana Moraes de Oliveira
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Faculdade de Medicina de Ribeirao Preto, Departamento de Puericultura e Pediatria, Universidade de São Paulo, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirao Preto, São Paulo, SP 14048-900 Brazil
| | - José Simon Camelo
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Yılmaz E, Yılmaz Z, Isık H, Gultekın IB, Timur H, Kara F, Kucukozkan T. Factors Associated with Breastfeeding Initiation and Exclusive Breastfeeding Rates in Turkish Adolescent Mothers. Breastfeed Med 2016; 11:315-320. [PMID: 27183042 DOI: 10.1089/bfm.2016.0012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study aimed to determine the early initiation time of breastfeeding and exclusive breastfeeding (EBF) rates during the first 6 months and the main factors affecting EBF practice in Turkish adolescent mothers. STUDY DESIGN AND METHODS A cross-sectional study was conducted with 200 adolescent mothers who were raising 6 to 24 month-old children. A face-to-face interview was conducted for sociodemographic characteristics, obstetric history, information about the baby, information about breastfeeding, and the factors affecting breastfeeding. We detected breastfeeding prevalence as well as its initiation time and duration. RESULTS The mean age of the patients was 17.9 ± 1.15 years. The percentage of patients who started breastfeeding within 1 hour was 45.5%. Approximately, 74% of the adolescent mothers provided breastfeeding before any type of formula as the baby's first food. Women who initiated breastfeeding earlier had planned pregnancies, educated for breastfeeding, delivered vaginally, and had boy infants. The mothers who started breastfeeding earlier fed their babies significantly more frequently at night, had longer EBF times, and had longer total breastfeeding times than the mothers who started breastfeeding later than 2 hours. Planned pregnancy, vaginal delivery, and having a boy infant were significantly associated with early breastfeeding. Age, planned pregnancy, postpartum education, frequent breastfeeding at night, and formula initiation time were predictors of EBF. CONCLUSIONS Adolescent pregnants may start breastfeeding earlier when had planned pregnancy, educated and encouraged for breastfeeding from the family and medical staff. Therefore, strategies should be formed to improve breastfeeding programs.
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Affiliation(s)
- Elif Yılmaz
- 1 Department of Obstetrics and Gynecology, Sami Ulus Women's Health/Children Education and Research Hospital , Ankara, Turkey
| | - Zehra Yılmaz
- 2 Department of Obstetrics and Gynecology, Zekai Tahir Women's Health Education and Research Hospital , Ankara, Turkey
| | - Hatice Isık
- 3 Department of Obstetrics and Gynecology, Mevlana University School of Medicine , Konya, Turkey
| | - Ismaıl Burak Gultekın
- 1 Department of Obstetrics and Gynecology, Sami Ulus Women's Health/Children Education and Research Hospital , Ankara, Turkey
| | - Hakan Timur
- 2 Department of Obstetrics and Gynecology, Zekai Tahir Women's Health Education and Research Hospital , Ankara, Turkey
| | - Fadıl Kara
- 1 Department of Obstetrics and Gynecology, Sami Ulus Women's Health/Children Education and Research Hospital , Ankara, Turkey
| | - Tuncay Kucukozkan
- 1 Department of Obstetrics and Gynecology, Sami Ulus Women's Health/Children Education and Research Hospital , Ankara, Turkey
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