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Açikgöz A, Çakirli M, Şahin BM, Çelik Ö. Predicting mothers' exclusive breastfeeding for the first 6 months: Interface creation study using machine learning technique. J Eval Clin Pract 2024. [PMID: 38741561 DOI: 10.1111/jep.14009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/24/2024] [Accepted: 04/28/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Machine learning techniques (MLT) build models to detect complex patterns and solve new problems using big data. AIM The present study aims to create a prediction interface for mothers breastfeeding exclusively for the first 6 months using MLT. METHOD All mothers who had babies aged 6-24 months between 15.09.2021 and 15.12.2021 and to whom the surveys could be delivered were included. 'Personal Information Form' created by the researchers was used as a data collection tool. Data from 514 mothers participating in the study were used for MLT. Data from 70% of mothers were used for educational purposes, and a prediction model was created. The data obtained from the remaining 30% of the mothers were used for testing. RESULTS The best MLT algorithm for predicting exclusive breastfeeding for the first 6 months was determined to be the Random Forest Classifier. The top five variables affecting the possibility of mothers breastfeeding exclusively for the first 6 months were as follows: "the mother not having any health problems during pregnancy," "there were no people who negatively affected the mother's morale about breastfeeding," "the amount of water the mother drinks in a day," "thinking that her milk supply is insufficient," "having no problems breastfeeding the baby". CONCLUSIONS Using created prediction model may allow early identification of mothers with a risk of not breastfeeding their babies exclusively for the first 6 months. In this way, mothers in the risk group can be closely monitored in the early period.
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Affiliation(s)
- Ayfer Açikgöz
- Department of Child Health and Disease Nursing, Eskisehir Osmangazi University Health Sciences, Eskisehir, Turkey
| | - Merve Çakirli
- Department of Child Health and Disease Nursing, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Berrak Mizrak Şahin
- Obstetrics and Gynecology Nursing, Bilecik Seyh Edebali University Health Sciences, Bilecik, Turkey
| | - Özer Çelik
- Department of Mathematics and Computer, Eskisehir Osmangazi University Faculty of Science, Eskisehir, Turkey
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Oberfichtner K, Oppelt P, Fritz D, Hrauda K, Fritz C, Schildberger B, Lastinger J, Stelzl P, Enengl S. Breastfeeding in primiparous women - expectations and reality: a prospective questionnaire survey. BMC Pregnancy Childbirth 2023; 23:654. [PMID: 37689660 PMCID: PMC10493027 DOI: 10.1186/s12884-023-05971-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/04/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND Breastfeeding provides the optimal nutrition for infants and offers numerous benefits for both mother and child. The World Health Organisation recommends exclusive breastfeeding during the first 6 months of life and the introduction of complementary feeding between the fifth and seventh months of life. There is a discrepancy between breastfeeding recommendations and the actual duration of breastfeeding. The aim of this study was to analyse breastfeeding behaviour in primiparous women in order to be able to provide support for mothers. METHODS In this prospective, questionnaire-based study conducted between 2020 and 2022, primiparous women were asked to complete three questionnaires at three defined survey time points (routine prepartum presentation, postpartum hospitalization, completed sixth month of life). RESULTS A total of 140 women were included and returned all three questionnaires. Fifty-eight percent performed breastfeeding exclusively at least until their baby had reached the age of 6 months, whereas 20% already stopped within the first 6 months. The main reasons given for early cessation were insufficient milk supply and inadequate infant weight gain. A comprehensive level of prepartum knowledge had a significant positive effect on participants' sense of confidence with breastfeeding. Sociodemographic factors such as age and educational level were also associated with breastfeeding behaviour, but significant corresponding differences in the duration of breastfeeding were not observed. Women with postpartum midwifery care breastfed significantly longer (p < 0.05). CONCLUSIONS Breastfeeding behaviour and duration are influenced by multiple factors. Although certain sociodemographic factors are unalterable, comprehensive prepartum knowledge transfer and postpartum midwifery care have a positive impact on breastfeeding behaviour. TRIAL REGISTRATION The study was retrospectively registered at the German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS) on 6 December 2022 (DRKS00030763).
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Affiliation(s)
- Katrin Oberfichtner
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria.
| | - Peter Oppelt
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Daniela Fritz
- University of Applied Sciences for the Health Professions, Linz, Austria
| | - Katharina Hrauda
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Christian Fritz
- Institute for Statistical Analysis Jaksch & Partner GmbH, Linz, Austria
| | | | - Julia Lastinger
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Patrick Stelzl
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Sabine Enengl
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
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3
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Apanga PA, Christiansen EJ, Weber AM, Darrow LA, Riddle MS, Tung WC, Liu Y, Kohnen T, Garn JV. The role of state breastfeeding laws and programs on exclusive breastfeeding practice among mothers in the special supplemental nutrition program for Women, Infants, and Children (WIC). Int Breastfeed J 2022; 17:46. [PMID: 35752853 PMCID: PMC9233787 DOI: 10.1186/s13006-022-00490-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 06/18/2022] [Indexed: 11/20/2022] Open
Abstract
Background It is unclear if state laws supporting breastfeeding are associated with exclusive breastfeeding (EBF) practice among low-income mothers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The main objectives of our study were to assess the relationship between such laws and EBF among WIC-participating mothers and to assess whether this association varied by employment status. We also assessed how mother’s exposure to WIC breastfeeding consultation was associated with EBF. Methods A cross-sectional study was conducted across seven WIC program locations (i.e., Georgia, Massachusetts, Nevada, Pennsylvania, Wisconsin, Wyoming, Chickasaw Nation) between July–August 2020. Data were collected using convenient sampling from each program location and surveys were administered electronically or on paper to WIC-participating mothers. We restricted our analysis to data from 1161 WIC-participating mothers with infants aged zero to five months old. Multivariable mixed models were used to estimate the relationship between our exposures of interest (i.e., number of laws supporting breastfeeding, employment-related breastfeeding laws, WIC breastfeeding consultation) and EBF, while controlling for potential confounders and accounting for clustering by program location. Effect modification by employment status was assessed on the additive and multiplicative scales. Results Among WIC-participating mothers living in program locations with no employment-related breastfeeding laws, EBF was 26% less prevalent for employed mothers compared to unemployed mothers (adjusted prevalence ratios [aPR]: 0.74, 95% CI: 0.67,0.83). Among all mothers, a one-unit increase in laws supporting breastfeeding was not associated with EBF (aPR: 0.88, 95% CI: 0.71,1.10). However, among employed mothers, living in areas with more employment-related laws was associated with a higher prevalence of EBF (aPR: 1.43, 95% CI: 0.83, 2.44). Infants whose mothers received a WIC breastfeeding consultation had 33% higher prevalence of being exclusively breastfed compared to infants whose mothers did not receive a WIC breastfeeding consultation (aPR: 1.33, 95% CI: 1.05,1.70). Conclusions Infants whose WIC-participating mothers were employed, were less likely to be exclusively breastfed, but our effect modification analyses showed that laws supporting breastfeeding at the workplace may promote EBF among employed women. EBF was more prevalent among mothers who received a WIC breastfeeding consultation compared to those who did not receive such a consultation. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-022-00490-9.
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Affiliation(s)
- Paschal A Apanga
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Elizabeth J Christiansen
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Ann M Weber
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Lyndsey A Darrow
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Mark S Riddle
- School of Medicine, University of Nevada, Reno, 1664 N Virginia St, NV, 89557, Reno, USA
| | - Wei-Chen Tung
- The Valley Foundation of School of Nursing, San Jose State University, 1 Washington Sq, San Jose, CA, 95192, USA
| | - Yan Liu
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Taya Kohnen
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA
| | - Joshua V Garn
- School of Public Health, University of Nevada, Reno, 1664 N Virginia St, SMS suite 102, NV, 89557, Reno, USA.
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4
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Hayashi Y, Fisher NM, Hantula DA, Furman L, Washio Y. A behavioral economic demand analysis of mothers' decision to exclusively breastfeed in the workplace. J Exp Anal Behav 2022; 118:132-147. [PMID: 35607847 DOI: 10.1002/jeab.772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 04/15/2022] [Accepted: 05/03/2022] [Indexed: 11/05/2022]
Abstract
The present study determined whether behavioral economic demand analysis could characterize mothers' decision to exclusively breastfeed in the workplace. Females, aged between 18 and 50 who have given birth in the past three years, completed a novel demand task with hypothetical scenarios, in which they returned to work with a 2-month-old baby. Participants rated their likelihood of breastfeeding their baby at a workplace lactation room versus formula-feeding their baby at their desk. The distance to the lactation room ranged from 10 s to 60 min. This assessment was conducted with and without hypothetical financial incentives for 6-month exclusive breastfeeding. Primary dependent measures were demand intensity and change in demand elasticity, which could conceptually represent initiation and continuation of breastfeeding, respectively. Demand for breastfeeding was more intense and less elastic (i.e., more likely to initiate and continue breastfeeding) among mothers with an experience of 6-month exclusive breastfeeding and under the condition with the financial incentives. The novel demand task can potentially provide a useful behavioral marker for quantifying mothers' decision to initiate and continue exclusive breastfeeding in the workplace, informing workplace policy regarding lactation rooms, identifying risk for early cessation, and developing and individualizing an intervention to assist mothers to exclusively breastfeed in the workplace.
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Affiliation(s)
- Yusuke Hayashi
- Division of Social Sciences and Education, Pennsylvania State University, Hazleton
| | - Nicole M Fisher
- Division of Social Sciences and Education, Pennsylvania State University, Hazleton
| | | | - Lydia Furman
- Department of Pediatrics, Rainbow Babies and Children's Hospital
| | - Yukiko Washio
- Substance Use, Gender and Applied Research, RTI International.,Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University Lewis Katz School of Medicine
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5
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Naja F, Chatila A, Ayoub JJ, Abbas N, Mahmoud A, Abdulmalik MA, Nasreddine L. Prenatal breastfeeding knowledge, attitude and intention, and their associations with feeding practices during the first six months of life: a cohort study in Lebanon and Qatar. Int Breastfeed J 2022; 17:15. [PMID: 35209913 PMCID: PMC8867651 DOI: 10.1186/s13006-022-00456-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 02/05/2022] [Indexed: 11/30/2022] Open
Abstract
Background Prenatal knowledge, attitude, and intention related to breastfeeding are postulated as important modulators of feeding practices. Using data from the Mother and Infant Nutritional Assessment (MINA) study, a three year cohort conducted in Lebanon and Qatar, this study aimed to characterize breastfeeding practices during the first six months postnatally and examine their associations with prenatal breastfeeding knowledge, attitude, exposure, and intention. Methods Pregnant women during their first trimester were recruited from primary healthcare centers in Beirut and Doha. Data collection was conducted in 2015 − 2018. Participants were followed-up until the child was twoyears old. Exposure, knowledge, attitude, and intentions regarding breastfeeding were assessed during the third trimester of pregnancy (n = 230), using validated questionnaires and scales. Breastfeeding practices were evaluated at four months (n = 185) and six months (n = 151) postpartum. Early initiation of breastfeeding was defined as putting the infant to the breast within one hour of birth, and exclusive breastfeeding (EBF) as feeding exclusively with breast milk. Results Breastfeeding practices were as follows: ever breastfeeding: 95.8%; early initiation of breastfeeding: 72.8%; breastfeeding at four and six months: 70.3% and 62.3%; EBF at four and six months: 35.7% and 18.5%. Over 95% of participants had high breastfeeding exposure, and 68.8% had strong / very strong intentions to breastfeed. Only 25% had very good knowledge, and 9.2% reported positive/strong positive attitude towards breastfeeding. After adjustment, high exposure was associated with greater odds of breastfeeding initiation (OR 10.1: 95% CI 1.25, 80.65). Both positive attitude towards breastfeeding and strong intention to breastfeed were associated with EBF at four months (OR 2.51; 95% CI 1.02, 6.16 and OR 4.0; 95% CI 1.67, 9.6), breastfeeding at four months (OR 2.92: 95% CI 1.29, 6.62 and OR 5.00: 95% CI 2.25, 11.1), and breastfeeding at six months (OR 3.74: 95% CI 1.24, 11.32 and OR 8.29: 95% CI 2.9, 23.68). Conclusions Findings of this study documented suboptimal knowledge and attitude towards breastfeeding and showed that prior exposure, a positive attitude, and a strong intention to breastfeed prenatally were significant predictors of breastfeeding practices postnatally. This highlights the need to develop specific interventions and policies aimed at improving breastfeeding attitudes and creating an enabling environment that supports women throughout their breastfeeding journey. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-022-00456-x.
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Affiliation(s)
- Farah Naja
- Clinical Nutrition and Dietetics Department, College of Health Sciences, University of Sharjah, Sharjah, UAE.,Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, UAE.,Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Aya Chatila
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Jennifer J Ayoub
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Nada Abbas
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Amira Mahmoud
- Public Health Department, Ministry of Public Health, Doha, Qatar
| | | | | | - Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon.
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6
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Wu Q, Tang N, Wacharasin C. Factors influencing exclusive breastfeeding for 6 months postpartum: A systematic review. Int J Nurs Knowl 2022; 33:290-303. [PMID: 35088945 DOI: 10.1111/2047-3095.12360] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/11/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE This systematic review aims to identify factors influencing exclusive breastfeeding (EBF) up to 6 months. METHODS The databases including PubMed, MEDLINE, CINAHL, Scopus, EMBASE, CNKI, and WANFANG were searched to retrieve studies. Quantitative research were extracted and the preferred reporting items for systematic reviews were followed. Critical appraisal checklists of Joanna Briggs Institute were used to evaluate the quality of the included studies. FINDINGS A total of 16 papers were eligible for this systematic review, comprising five cohort studies and 11 cross-sectional studies. Moderate to strong evidence supported that 6-month exclusive breastfeeding is affected by maternal working status, breastfeeding knowledge, delivery mode, parity, perception of insufficient human milk, mothers' infant feeding attitude, breastfeeding self-efficacy, and intention. CONCLUSIONS Factors influencing EBF up to 6 months postpartum play a key role in promoting mothers' health and reducing diseases in their infants. IMPLICATIONS FOR NURSING PRACTICE Interventions based on related factors should be developed and taken into practice to assist mothers in exclusive breastfeeding for up to 6 months. Additional studies from different countries in different populations with high quality are needed to provide more reliable and richer findings.
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Affiliation(s)
- Qian Wu
- Faculty of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China.,Faculty of Nursing, Burapha University, Chon Buri, Thailand
| | - Nan Tang
- Faculty of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China.,Faculty of Nursing, Burapha University, Chon Buri, Thailand
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Vitamin D Supplementation in Exclusively Breastfed Infants Is Associated with Alterations in the Fecal Microbiome. Nutrients 2022; 14:nu14010202. [PMID: 35011077 PMCID: PMC8747039 DOI: 10.3390/nu14010202] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/24/2021] [Accepted: 12/30/2021] [Indexed: 02/01/2023] Open
Abstract
Breastfeeding and introduction of solid food are the two major components of infant feeding practices that influence gut microbiota composition in early infancy. However, it is unclear whether additional factors influence the microbiota of infants either exclusively breastfed or not breastfed. We obtained 194 fecal samples from infants at 3–9 months of age, extracted DNA, and sequenced the V4 region of the 16S rRNA gene. Feeding practices and clinical information were collected by questionnaire and abstraction of birth certificates. The gut microbiota of infants who were exclusively breastfed displayed significantly lower Shannon diversity (p-adjust < 0.001) and different gut microbiota composition compared to infants who were not breastfed (p-value = 0.001). Among the exclusively breastfed infants, recipients of vitamin D supplements displayed significantly lower Shannon diversity (p-adjust = 0.007), and different gut microbiota composition structure than non-supplemented, breastfed infants (p-value = 0.02). MaAslin analysis identified microbial taxa that associated with breastfeeding and vitamin D supplementation. Breastfeeding and infant vitamin D supplement intake play an important role in shaping infant gut microbiota.
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8
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Hadi H, Fatimatasari F, Irwanti W, Kusuma C, Alfiana RD, Asshiddiqi MIN, Nugroho S, Lewis EC, Gittelsohn J. Exclusive Breastfeeding Protects Young Children from Stunting in a Low-Income Population: A Study from Eastern Indonesia. Nutrients 2021; 13:4264. [PMID: 34959815 PMCID: PMC8706015 DOI: 10.3390/nu13124264] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 12/27/2022] Open
Abstract
The prevalence of stunting in young Indonesian children is the highest among countries belonging to the Association of Southeast Asian Nations (ASEAN). Breastfed children are reported to grow better than non-breastfed. The present study examined the protective effect of exclusive breastfeeding against stunting in children under two years old (CU2) and its interaction with monthly household expenditure. Secondary analyses were conducted based on a 2012 cross-sectional study including 408 children aged 6-24 months and their caregivers from 14 villages in rural Eastern Indonesia. Data on breastfeeding history, childcare, and household expenditures were collected using structured questionnaires. Focus Group Discussions (FGDs) were conducted in each village (n = 14). Nearly two-thirds (61%) of caregivers who identified as the biological mother exclusively breastfed their child at 6 months. Exclusively-breastfed CU2 from poorer households were 20% less likely to be stunted than their non-exclusively-breastfed peers. Further, exclusively-breastfed CU2 from wealthier households were 50% less likely to be stunted than non-exclusively-breastfed CU2 from poorer households. FGDs revealed that some mothers were unaware of the importance of recommended breastfeeding practices. Exclusive breastfeeding may protect low-income children against stunting. Health promotion to improve caregiver motivation to exclusively breastfeed is critical in the present setting and beyond.
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Affiliation(s)
- Hamam Hadi
- Alma Ata Graduate School of Public Health, the University of Alma Ata, Yogyakarta 55183, Indonesia; (C.K.); (S.N.)
- Alma Ata Center for Healthy Life and Foods (ACHEAF), the University of Alma Ata, Yogyakarta 55183, Indonesia
| | - Fatimatasari Fatimatasari
- Department of Midwifery, Faculty of Health Sciences, the University of Alma Ata, Yogyakarta 55183, Indonesia; (F.F.); (R.D.A.)
| | - Winda Irwanti
- Department of Nutrition, Faculty of Health Sciences, The University of Alma Ata, Yogyakarta 55183, Indonesia;
| | - Chahya Kusuma
- Alma Ata Graduate School of Public Health, the University of Alma Ata, Yogyakarta 55183, Indonesia; (C.K.); (S.N.)
| | - Ratih Devi Alfiana
- Department of Midwifery, Faculty of Health Sciences, the University of Alma Ata, Yogyakarta 55183, Indonesia; (F.F.); (R.D.A.)
| | - M. Ischaq Nabil Asshiddiqi
- Department of Nursing, Faculty of Health Sciences, the University of Alma Ata, Yogyakarta 55183, Indonesia;
| | - Sigit Nugroho
- Alma Ata Graduate School of Public Health, the University of Alma Ata, Yogyakarta 55183, Indonesia; (C.K.); (S.N.)
| | - Emma Clare Lewis
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; (E.C.L.); (J.G.)
| | - Joel Gittelsohn
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; (E.C.L.); (J.G.)
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Brown LL, Talker R, Stoddard GJ, Clayton J, Millar MM, Jo Y, Bardsley T, Stipelman CH. Breastfeeding Attitudes and Practices in a Rural Utah Navajo Community. Matern Child Health J 2021; 26:397-406. [PMID: 34633615 DOI: 10.1007/s10995-021-03247-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Despite known health benefits of breastfeeding, the Navajo have low reported frequency of breastfeeding initiation and support. We evaluated breastfeeding frequencies and practices in the predominately Navajo community of rural San Juan County, Utah, to identify factors that affect breastfeeding decisions and duration. METHODS We performed retrospective chart review for 135 infants aged 0 to 12 months, and surveys of 85 mothers of infants aged 0 to 2 years, and eight primary care providers. We characterized demographic factors using counts/percentages and medians/inter-quartile ranges, and compared mothers who breastfed for 6 months or less versus greater than 6 months. RESULTS In 96 infants with complete feeding documentation, 86 infants (90%) received some breast milk and 36 infants (38%) were exclusively breastfed at age 2 months. In 67 infants with complete feeding documentation at ≥ 6 months, 22 infants (33%) were exclusively breastfed 6 months. Most mothers knew about breastfeeding benefits. In 56 mothers whose infants were aged ≥ 6 months at the time of the survey, breastfeeding for more than 6 months had been planned by 44 mothers (79%) but performed by only 29 mothers (52%). Mothers who breastfed for > 6 months were more likely to have been influenced by WIC and less likely to have introduced formula at an early age. Barriers to breastfeeding included maternal pain, latch difficulties, and concerns about inadequate milk supply. Primary care providers reported limited confidence in providing breastfeeding support but would support telehealth-driven interventions. CONCLUSIONS FOR PRACTICE Practical, culturally sensitive interventions, including telehealth and improved provider education, may improve breastfeeding outcomes and community health in this underserved population.
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Affiliation(s)
- Laura L Brown
- Division of General Pediatrics, Department of Pediatrics, School of Medicine, University of Utah, PO Box 581289, Salt Lake City, UT, 84158, USA.
| | - Revina Talker
- Navajo Mountain Community Health Clinic, Utah Navajo Health Services, Inc., P.O. Box 10100, Tonalea, AZ, 86044, USA
| | - Gregory J Stoddard
- Department of Internal Medicine, University of Utah School of Medicine, 30 N 1900 E, Room 4C104, Salt Lake City, UT, 84132, USA
| | - Jessica Clayton
- Division of General Pediatrics, Department of Pediatrics, School of Medicine, University of Utah, PO Box 581289, Salt Lake City, UT, 84158, USA
| | - Morgan M Millar
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Williams Building, 295 South Chipeta Way, Salt Lake City, UT, 84158, USA
| | - Yeonjung Jo
- Department of Population Health Sciences, University of Utah School of Medicine, Williams Building, 295 South Chipeta Way, Salt Lake City, UT, 84158, USA
| | - Tyler Bardsley
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Williams Building, 295 South Chipeta Way, Salt Lake City, UT, 84158, USA
| | - Carole H Stipelman
- Division of General Pediatrics, Department of Pediatrics, School of Medicine, University of Utah, PO Box 581289, Salt Lake City, UT, 84158, USA
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10
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Rozensztrauch A, Klaniewska M, Berghausen-Mazur M. Factors affecting the mother's choice of infant feeding method in Poland: a cross-sectional preliminary study in Poland. Ir J Med Sci 2021; 191:1735-1743. [PMID: 34535884 PMCID: PMC9308570 DOI: 10.1007/s11845-021-02751-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 08/15/2021] [Indexed: 11/25/2022]
Abstract
Background The World Health Organization identifies exclusive breastfeeding as the gold standard for child nutrition. Breastfeeding provides many benefits to both the baby and the mother. First days after birth are crucial for breastfeeding and determining its further path. Unfortunately, very often it is also the time of facing the first breastfeeding problems. The aim of this study was to analyse selected factors influencing a mother’s decision to breastfeed. Methods This is a cross-sectional study conducted between March 2019 and November 2019 in selected Polish maternity wards. Data were collected through completion of author’s questionnaire and a standardised questionnaire and the Multidimensional Perceived Social Support Scale and also through informal interviews with mothers. During statistical analysis, the chi-square test of independence and the Kolmogorov–Smirnov test as well as the non-parametric Mann–Whitney U test in addition to Fisher’s exact test were performed. Results The results showed that there is no correlation between the mode of delivery and the mother’s choice of infant feeding method. Knowledge of the benefits of breastfeeding and received support affects the mother’s decision on infant feeding method. The study also showed that the 83% of newborns were put to the breast within the first 2 h after birth. However, only 58% continued to be breastfed in the subsequent days. As many as 42% of the newborns were supplemented with formula despite early initiation of breastfeeding. Analyses showed that exclusive breastfeeding was more often chosen by mothers with higher education. And the most common breastfeeding problem reported by 62% of the respondents was perceived insufficient milk supply and also breastfeeding pain, reported in 48.5% mothers. Conclusions It is extremely important to continually promote breastfeeding among women. The role of midwives is crucial in this regard, as they should encourage the initiation of breastfeeding, support mothers during the perinatal and postnatal periods, and increase their sense of competence and confidence in their ability to breastfeed. Accessible, professional, and empathetic support can help reduce the number of women supplementing with modified milk. Undoubtedly, the postpartum period is important for breastfeeding outcomes, but it is significant that breastfeeding education and promotion begin during pregnancy.
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Affiliation(s)
- Anna Rozensztrauch
- Department of Pediatrics, Division of Neonatology, Wroclaw Medical University, Wroclaw, Poland
| | - Magdalena Klaniewska
- Department of Pediatrics, Division of Pediatrics and Rare Disorders, Wroclaw Medical University, Wroclaw, Poland
| | - Marta Berghausen-Mazur
- Department of Pediatrics, Division of Neonatology, Wroclaw Medical University, Wroclaw, Poland
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Fadjriah RN, Krisnasari S, Gugu Y. Relationship between Family Social Support and Exclusive Breastfeeding Behavior at Talise Health Center, Indonesia. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The failure of exclusive breastfeeding has a big impact on the health of a child. Family social support is a factor that plays a major role in the behavior of exclusive breastfeeding.
AIM: This study aimed to determine the relationship between social-informational support, emotional, instrumental, and family assessment support on exclusive breastfeeding behavior at Talise Health Center, Palu City.
MATERIALS AND METHODS: The research method was quantitative, with a cross-sectional study design. The population was 70 mothers who have babies aged 7–24 months and live in the Talise Health Center working area. The sampling technique was total sampling. Data analysis was the chi square test with a significance level of p <0.05 using SPSS.
RESULTS: Univariate analysis showed that the dominant age of the mother was 29–37 years (75.7%), bachelor degree education level (85.7%), multiparous parity status (68.6%), and exclusive breastfeeding status (68.6%). The results showed that there was a significant relationship between social-information support (p = 0.042), instrumental (p = 0.013), emotional (p = 0.038), and assessment (p = 0.020) on the behavior of exclusive breastfeeding.
CONCLUSION: Lack of social support from the family, including informational, instrumental, emotional, and assessment, would hinder exclusive breastfeeding behavior and impact on the failure of exclusive breastfeeding.
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Fadjriah RN, Krisnasari S, Gugu Y. Relationship between Family Social Support and Exclusive Breastfeeding Behavior at Talise Health Center, Indonesia. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2020.5987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The failure of exclusive breastfeeding has a big impact on the health of a child. Family social support is a factor that plays a major role in the behavior of exclusive breastfeeding.
AIM: This study aimed to determine the relationship between social-informational support, emotional, instrumental, and family assessment support on exclusive breastfeeding behavior at Talise Health Center, Palu City.
MATERIALS AND METHODS: The research method was quantitative, with a cross-sectional study design. The population was 70 mothers who have babies aged 7–24 months and live in the Talise Health Center working area. The sampling technique was total sampling. Data analysis was the chi square test with a significance level of p <0.05 using SPSS.
RESULTS: Univariate analysis showed that the dominant age of the mother was 29–37 years (75.7%), bachelor degree education level (85.7%), multiparous parity status (68.6%), and exclusive breastfeeding status (68.6%). The results showed that there was a significant relationship between social-information support (p = 0.042), instrumental (p = 0.013), emotional (p = 0.038), and assessment (p = 0.020) on the behavior of exclusive breastfeeding.
CONCLUSION: Lack of social support from the family, including informational, instrumental, emotional, and assessment, would hinder exclusive breastfeeding behavior and impact on the failure of exclusive breastfeeding.
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Bērziņš K, Harrison SDL, Leong C, Fraser-Miller SJ, Harper MJ, Diana A, Gibson RS, Houghton LA, Gordon KC. Qualitative and quantitative vibrational spectroscopic analysis of macronutrients in breast milk. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2021; 246:118982. [PMID: 33017792 PMCID: PMC7684643 DOI: 10.1016/j.saa.2020.118982] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/23/2020] [Accepted: 09/17/2020] [Indexed: 06/11/2023]
Abstract
Raman and attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy were used to analyze 208 breast milk samples as part of a larger research study. Comprehensive qualitative and quantitative analysis was carried out using chemometric methods: principal component analysis (PCA) and partial least squares (PLS) regression. The obtained information on the main macronutrients (protein, fat and carbohydrate) were primarily evaluated in relation to the available metadata of the samples, where study location and respective primary food sources revealed a stronger differentiation in fat composition than its absolute content. The limitations and challenges of using both spectroscopic techniques for the type of analysis are also highlighted.
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Affiliation(s)
- Kārlis Bērziņš
- The Dodd-Walls Centre for Photonic and Quantum Technologies, Department of Chemistry, University of Otago, Dunedin 9016, New Zealand
| | - Samuel D L Harrison
- The Dodd-Walls Centre for Photonic and Quantum Technologies, Department of Chemistry, University of Otago, Dunedin 9016, New Zealand
| | - Claudia Leong
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand
| | - Sara J Fraser-Miller
- The Dodd-Walls Centre for Photonic and Quantum Technologies, Department of Chemistry, University of Otago, Dunedin 9016, New Zealand
| | - Michelle J Harper
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand
| | - Aly Diana
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand; Faculty of Medicine, Universitas Padjadjaran, West Java, Indonesia
| | - Rosalind S Gibson
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand
| | - Lisa A Houghton
- Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand
| | - Keith C Gordon
- The Dodd-Walls Centre for Photonic and Quantum Technologies, Department of Chemistry, University of Otago, Dunedin 9016, New Zealand.
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Grubesic TH, Durbin KM. The complex geographies of telelactation and access to community breastfeeding support in the state of Ohio. PLoS One 2020; 15:e0242457. [PMID: 33232335 PMCID: PMC7685454 DOI: 10.1371/journal.pone.0242457] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 11/03/2020] [Indexed: 01/29/2023] Open
Abstract
The availability of breastfeeding support resources, including those provided by Baby-Friendly Hospitals, International Board Certified Lactation Consultants, breastfeeding counselors and educators, and volunteer-based mother-to-mother support organizations, such as La Leche League, are critically important for influencing breastfeeding initiation and continuation for the mother-child dyad. In addition, the emergence of community support options via information and communication technologies such as Skype and Facetime, social media (e.g., Facebook), and telelactation providers are providing mothers with a new range of support options that can help bridge geographic barriers to traditional community support. However, telelactation services that use information and communication technologies to connect breastfeeding mothers to remotely located breastfeeding experts require reliable, affordable, high-quality broadband connections to facilitate interaction between mothers and their support resources. The purpose of this paper is to explore the complex spatial landscape of virtual and face-to-face breastfeeding support options for mothers in the state of Ohio (U.S.), identifying barriers to support. Using a range of spatial and network analytics, the results suggest that a divide is emerging. While urban areas in Ohio benefit from both a density of face-to-face breastfeeding support resources and robust broadband options for engaging in telelactation, many rural areas of the state are lacking access to both. Policy implications and several potential strategies for mitigating these inequities are discussed.
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Affiliation(s)
- Tony H. Grubesic
- Geoinformatics & Policy Analytics Laboratory, School of Information, University of Texas at Austin, Austin, TX, United States of America
- * E-mail:
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Ávila-Ortiz MN, Castro-Sánchez AE, Martínez-González EA, Núñez-Rocha GM, Zambrano-Moreno A. Factors associated with abandoning exclusive breastfeeding in Mexican mothers at two private hospitals. Int Breastfeed J 2020; 15:73. [PMID: 32814577 PMCID: PMC7436974 DOI: 10.1186/s13006-020-00316-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 08/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exclusive breastfeeding (EBF) has multiple benefits for both the child and the mother; however, there is little data regarding the reason why Mexican mothers with a high socio-economic level abandon EBF before 6 months, and there is limited information about the practice of breastfeeding in private hospitals. The objective was to identify the factors associated with the cessation of exclusive breastfeeding in Mexican mothers at two private hospitals. METHODS A cross-sectional study was conducted with 218 upper-class mothers selected according to their place of residence by geographic location, socio-economic level, and pediatric consultations cost. They were over 18 years old and with children aged 6 to 24 months. Data were collected between July and November 2016 by face to face interview using a structured questionnaire while the mothers waited for the pediatric postnatal care consultation in two private hospitals in northeastern Mexico. Exclusive breastfeeding was measured according to World Health Organization (WHO) recommendations, which consist of providing only breast milk for the first 6 months of life. Chi-squared tests and multivariate logistic regression were performed. RESULTS Mean maternal age was 31.4 years (SD of 4.4) and most of the participants had an undergraduate education, were married, and worked outside the home. The prevalence of exclusive breastfeeding at 6 months was 28%. Upper-class working mothers are less likely to continue breastfeeding. There was a negative association with employment (AOR 13.69; 95% CI 1.59, 111.11), bottle use in the first 6 months (AOR 7.93; 95% CI 3.07, 20.48), and a low level of knowledge (AOR 2.18; 95% CI 1.04, 4.56). After 6 months, only 61 mothers (28%) maintained exclusive breastfeeding. CONCLUSIONS Knowledge level, bottle use, and employment are associated with premature cessation of EBF in Mexican upper-class mothers, attending two private hospitals. There was a high percentage of breastfeeding cessation in the sample. It is necessary to reinforce a strategy that coordinates the action of the different laws, regulations and programs affecting the exclusive breastfeeding practice, in order to adequately promote breastfeeding and support mothers in both public and private sectors.
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Affiliation(s)
- María Natividad Ávila-Ortiz
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico.
| | - Ana Elisa Castro-Sánchez
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico
| | - Elizabeth Andrea Martínez-González
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico
| | - Georgina Mayela Núñez-Rocha
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico
| | - Adriana Zambrano-Moreno
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico
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Wasser HM, Thompson AL, Suchindran CM, Goldman BD, Hodges EA, Heinig MJ, Bentley ME. Home-based intervention for non-Hispanic black families finds no significant difference in infant size or growth: results from the Mothers & Others randomized controlled trial. BMC Pediatr 2020; 20:385. [PMID: 32811460 PMCID: PMC7433206 DOI: 10.1186/s12887-020-02273-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 08/04/2020] [Indexed: 01/30/2023] Open
Abstract
Background Non-Hispanic black (NHB) infants are twice as likely as non-Hispanic white infants to experience rapid weight gain in the first 6 months, yet few trials have targeted this population. The current study tests the efficacy of “Mothers & Others,” a home-based intervention for NHB women and their study partners versus an attention-control, on infant size and growth between birth and 15 months. Methods Mothers & Others was a two-group randomized controlled trial conducted between November 2013 and December 2017 with enrollment at 28-weeks pregnancy and follow-up at 3-, 6-, 9-, 12-, and 15-months postpartum. Eligible women self-identified as NHB, English-speaking, and 18–39 years. The obesity prevention group (OPG) received anticipatory guidance (AG) on responsive feeding and care practices and identified a study partner, who was encouraged to attend home visits. The injury prevention group (IPG) received AG on child safety and IPG partners only completed study assessments. The primary delivery channel for both groups was six home visits by a peer educator (PE). The planned primary outcome was mean weight-for-length z-score. Given significant differences between groups in length-for-age z-scores, infant weight-for-age z-score (WAZ) was used in the current study. A linear mixed model, using an Intent-To-Treat (ITT) data set, tested differences in WAZ trajectories between the two treatment groups. A non-ITT mixed model tested for differences by dose received. Results Approximately 1575 women were screened for eligibility and 430 were enrolled. Women were 25.7 ± 5.3 years, mostly single (72.3%), and receiving Medicaid (74.4%). OPG infants demonstrated lower WAZ than IPG infants at all time points, but differences were not statistically significant (WAZdiff = − 0.07, 95% CI − 0.40 to 0.25, p = 0.659). In non-ITT models, infants in the upper end of the WAZ distribution at birth demonstrated incremental reductions in WAZ for each home visit completed, but the overall test of the interaction was not significant (F2,170 = 1.41, p = 0.25). Conclusions Despite rich preliminary data and a strong conceptual model, Mothers & Others did not produce significant differences in infant growth. Results suggest a positive impact of peer support in both groups. Trial registration ClinicalTrials.gov, NCT01938118, 09/10/2013.
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Affiliation(s)
- Heather M Wasser
- Department of Nutrition, University of North Carolina, 135 Dauer Drive, CB# 7400, Chapel Hill, NC, 27599-7400, USA. .,University of North Carolina, Chapel Hill, NC, USA.
| | - Amanda L Thompson
- Department of Nutrition, University of North Carolina, 135 Dauer Drive, CB# 7400, Chapel Hill, NC, 27599-7400, USA.,University of North Carolina, Chapel Hill, NC, USA
| | | | | | | | | | - Margaret E Bentley
- Department of Nutrition, University of North Carolina, 135 Dauer Drive, CB# 7400, Chapel Hill, NC, 27599-7400, USA.,University of North Carolina, Chapel Hill, NC, USA
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Factors associated with exclusive breastfeeding in relation to knowledge, attitude and practice of breastfeeding mothers in Rabigh community, Western Saudi Arabia. World J Pediatr 2019; 15:601-609. [PMID: 31214890 DOI: 10.1007/s12519-019-00275-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 05/28/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND There is much concern about declining rates of exclusive breastfeeding (EBF) all over the world including Saudi Arabia which deprives infants from many immunological, nutritional, and psychosocial benefits. This study was performed to determine EBF prevalence and factors influencing EBF in relation to knowledge, attitude and practice (KAP) of breastfeeding mothers (BFM) in Rabigh, Western Saudi Arabia. METHODS Data about factors that could be associated with EBF and KAP of BFM were collected by cross-sectional questionnaire-based study from 420 BFM. RESULTS Prevalence of EBF for 6 months was 27.6% which is far below World Health Organization recommendations. Demographic, socioeconomic, biomedical as well as most studied variables of KAP of 50% to over 90% of participating mothers were adequate to account for low EBF rate. Proper knowledge about benefits of colostrum and continuation of breastfeeding for 2 years was given by only 86.2% and 36.7% of BFM, respectively. The most significant independent factors associated with EBF were perception of sufficient human milk [adjusted odds ratio (AOR) 2.89; 95% confidence interval (CI) 1.72-4.89], absence of nipple pain (AOR 2.77; 95% CI 1.72-4.45) and mothers without university education (AOR 1.86; 95% CI 1.15-3.01). Early introduction of formula in hospital after birth was the main inappropriate feeding practice in 76.2% of infants of BFM. CONCLUSION Findings of this study should be utilized by Rabigh community and other national or worldwide communities with similar characters to promote EBF by targeted educational programs after identification of significant factors influencing EBF and gaps in KAP of BFM.
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Grubesic TH, Durbin KM. A Spatial Analysis of Breastfeeding and Breastfeeding Support in the United States: The Leaders and Laggards Landscape. J Hum Lact 2019; 35:790-800. [PMID: 31206311 DOI: 10.1177/0890334419856615] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND To better track progress in achieving the Healthy People 2020 goals, the Centers for Disease Control and Prevention (CDC) publishes an annual Breastfeeding Report Card (BRC) that represents a compilation of data on breastfeeding practices in all states. With data drawn from the CDC National Immunization Survey, the BRC provides an especially valuable source of information about geographic trends in breastfeeding and related support activities. RESEARCH AIM This study aimed to identify important geographic trends in both breastfeeding practices and support structures in the United States, highlighting their spatial disparities. METHODS Exploratory spatial data analysis, including local indicators of spatial association, is combined with spatial regression models to highlight geographic variations in breastfeeding practices and support. RESULTS Geographic variation in both breastfeeding practices and allied support exists within the United States. Geographic hot spots of breastfeeding are found in the western and northeastern sections of the United States, and cool spots are located primarily in the Southeast. Regression results suggested that unemployment and demographic diversity are negatively associated with breastfeeding rates, whereas higher education and the presence of International Board Certified Lactation Consultants® (IBCLCs®) are positively connected to persistent breastfeeding practices. Further, although the availability of professional support (IBCLC) strengthened nationwide between 2011 and 2016, the availability of mother-to-mother support (La Leche League) softened. CONCLUSION Although breastfeeding initiation rates continue to increase in the United States, rates of exclusive breastfeeding at 3 and 6 months remain low, displaying significant geographic variation. The ability to pinpoint lagging regions can help to efficiently allocate additional breastfeeding support resources and interventions.
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Affiliation(s)
- Tony H Grubesic
- Center for Spatial Reasoning & Policy Analytics, Watts College of Public Service & Community Solutions, Arizona State University, Phoenix, AZ, USA
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Chang PC, Li SF, Yang HY, Wang LC, Weng CY, Chen KF, Chen W, Fan SY. Factors associated with cessation of exclusive breastfeeding at 1 and 2 months postpartum in Taiwan. Int Breastfeed J 2019; 14:18. [PMID: 31080493 PMCID: PMC6505256 DOI: 10.1186/s13006-019-0213-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 04/26/2019] [Indexed: 11/12/2022] Open
Abstract
Background Breastfeeding benefits both mothers and infants. Even though Taiwan national policy promotes exclusive breastfeeding (EBF), the rates in Taiwan are below those in other developed countries. This study aimed to investigate factors associated with EBF cessation at 1 and 2 months postpartum. Methods This study was conducted in a community hospital in southern Taiwan between December 2016 and June 2017. Birth mothers (n = 1077) were interviewed by telephone at 1 and 2 months postpartum to collect information on infant feeding patterns (EBF since birth or not) and reasons for EBF cessation. Multivariate logistic regression models were used to determine risk factors associated with EBF cessation at 1 and 2 months. Results At 1 month, 432 participants (40.1%) maintained EBF. Factors associated with cessation were lack of tertiary education, primiparity, perceived low milk quantity, mother/infant separation, medical condition in mother, inconvenience/fatigue due to breastfeeding, and baby-centered factors. At 2 months, 316 participants (29.3%) maintained EBF. Factors associated with cessation were lack of tertiary education, primiparity, perceived low milk quantity, and return to work. Conclusions Education level, primiparity, perceived low milk quantity, and return to work are associated with premature cessation of EBF in Taiwan. Strategies about health education, family support, and baby-mother friendly environment can be used to achieve higher EBF rate.
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Affiliation(s)
- Pei-Chi Chang
- 1Division of Community Nursing, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Sin-Fong Li
- 1Division of Community Nursing, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Hsin-Yi Yang
- 2Clinical Research Center, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Li-Chu Wang
- 1Division of Community Nursing, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Cing-Ya Weng
- 1Division of Community Nursing, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Kuan-Fen Chen
- 1Division of Community Nursing, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Wei Chen
- 3Department of Community Health, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Sheng-Yu Fan
- 4Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Chinese women's experiences, emotions and expectations of breast-feeding in public: a qualitative study. Public Health Nutr 2018; 21:1565-1572. [PMID: 29386081 DOI: 10.1017/s1368980017003937] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To explore Chinese mothers' experiences, emotions and expectations of breast-feeding in public places. DESIGN Exploratory qualitative study. Purposive sampling was used to recruit participants and face-to-face interviews were conducted. Themes were identified by content analysis. SETTING Two different geographical communities in Wuhan, Hubei Province, central China, March-May 2016. SUBJECTS A total of twenty-seven mothers aged 23-33 years, who had one child under 3 years of age and had experience of breast-feeding in public places. RESULTS Seven themes emerged from the interviews: struggling to balance infant's needs and personal feelings; embarrassed or natural emotion regarding breast-feeding in public places; effect of cultural and social norms; internalized concerns going beyond actual social reaction; measures to make breast-feeding in public places easier; desire for more public facilities; and expecting emotional support from society members. CONCLUSIONS More positive social support, favourable policies and necessary facilities were desired to enable mothers to breast-feed in an appropriate public location. Women expected increased public acceptance of breast-feeding practices and support from government health officials to ensure women's success in breast-feeding in public settings.
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Yang X, Ip WY, Gao LL. Maternal intention to exclusively breast feed among mainland Chinese mothers: A cross-sectional study. Midwifery 2017; 57:39-46. [PMID: 29169075 DOI: 10.1016/j.midw.2017.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 11/01/2017] [Accepted: 11/03/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE to examine postpartum maternal recall of their intentions to exclusively breast feed among breastfeeding women and identify its predictors. DESIGN AND SETTING a cross-sectional descriptive study was conducted in a regional teaching hospital at Guangzhou, China between April 1 and July 14, 2014. PARTICIPANTS 571 mothers who were within four days after delivery were recruited to the study. MEASUREMENTS data were collected by four research assistants with maternal intention to breast feed data sheet, the Network Support for Breastfeeding Scale (NSBS), and a socio-demographic data sheet. FINDINGS greater than half of the mothers (69.5%) intended to exclusively breast feed. The logistic regression analysis revealed six variables which predicted postpartum maternal recall of their intentions to exclusively breast feed. They were support from husband, being breast-fed as an infant, previous breast feeding experience, attending antenatal breast feeding class, time of decision to breast feed, and the rating of the importance of my baby's health. CONCLUSION AND IMPLICATIONS FOR PRACTICE health care professionals could develop strategies to enhance mothers' intention to exclusively breast feed, such as providing antenatal breast feeding class on internet, a strong focus on the benefits of exclusive breast feeding on the baby's health in the education programme, and more efforts directed toward educating school-aged children and adolescents to modify societal perceptions of what are considered normal infant feeding. Mothers' husband could be encouraged in supporting exclusive breast feeding.
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Affiliation(s)
- Xiao Yang
- School of Nursing, Zhengzhou University, Henan, China.
| | - Wan-Yim Ip
- New Asia College, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | - Ling-Ling Gao
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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Lok KYW, Bai DL, Tarrant M. Family members' infant feeding preferences, maternal breastfeeding exposures and exclusive breastfeeding intentions. Midwifery 2017; 53:49-54. [PMID: 28755584 DOI: 10.1016/j.midw.2017.07.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 06/28/2017] [Accepted: 07/03/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Maternal breastfeeding intentions are strongly associated with breastfeeding exclusivity and duration. Factors that affect new mothers' exclusive breastfeeding intentions have not been adequately examined. OBJECTIVE The purpose of this study was to examine the association between family member's infant feeding preferences, breastfeeding exposures, and womens' exclusive breastfeeding intentions. METHODS 1277 breastfeeding mother-infant pairs were recruited from four public hospitals in Hong Kong. We used multiple logistic and linear regression models to explore the impact of the family members' infant feeding preferences and breastfeeding exposures on exclusive breastfeeding intentions. RESULTS 78.1% mothers reported an intention to exclusively breastfeed, and the median intended duration of exclusive breastfeeding was 26 weeks. The husband's preference for breastfeeding (aOR = 1.67; 95% CI 1.20-2.31), previous breastfeeding experience (aOR = 1.56; 95% CI 1.10-2.23) and attendance at an antenatal breastfeeding class (aOR = 2.09; 95% CI 1.45-3.02) were all strongly associated with higher maternal intention to exclusively breastfeed. For every additional family member who preferred breastfeeding, the odds of intending to exclusively breastfeed increased by 32% (aOR1.32; 95% CI, 1.13-1.55). Similarly, the proportion of participants intending to exclusively breastfeed increased progressively with more breastfeeding exposures. CONCLUSIONS Including fathers and other significant family members in antenatal breastfeeding education can help to maximize breastfeeding support for the new mother and encourage new mothers to exclusively breastfeed.
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Affiliation(s)
- Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
| | - Dorothy Li Bai
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Marie Tarrant
- School of Nursing, The University of British Columbia, Okanagan Campus, Canada
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Wasser HM, Thompson AL, Suchindran CM, Hodges EA, Goldman BD, Perrin EM, Faith MS, Bulik CM, Heinig MJ, Bentley ME. Family-based obesity prevention for infants: Design of the "Mothers & Others" randomized trial. Contemp Clin Trials 2017; 60:24-33. [PMID: 28600160 DOI: 10.1016/j.cct.2017.06.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 05/29/2017] [Accepted: 06/05/2017] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Our goal is to test the efficacy of a family-based, multi-component intervention focused on infants of African-American (AA) mothers and families, a minority population at elevated risk for pediatric obesity, versus a child safety attention-control group to promote healthy weight gain patterns during the first two years of life. DESIGN, PARTICIPANTS, AND METHODS The design is a two-group randomized controlled trial among 468 AA pregnant women in central North Carolina. Mothers and study partners in the intervention group receive anticipatory guidance on breastfeeding, responsive feeding, use of non-food soothing techniques for infant crying, appropriate timing and quality of complementary feeding, age-appropriate infant sleep, and minimization of TV/media. The primary delivery channel is 6 home visits by a peer educator, 4 interim newsletters and twice-weekly text messaging. Intervention families also receive 2 home visits from an International Board Certified Lactation Consultant. Assessments occur at 28 and 37weeks gestation and when infants are 1, 3, 6, 9, 12, and 15months of age. RESULTS The primary outcome is infant/toddler growth and likelihood of overweight at 15months. Differences between groups are expected to be achieved through uptake of the targeted infant feeding and care behaviors (secondary outcomes) and change in caregivers' modifiable risk factors (mediators) underpinning the intervention. CONCLUSIONS If successful in promoting healthy infant growth and enhancing caregiver behaviors, "Mothers and Others" will have high public health relevance for future obesity-prevention efforts aimed at children younger than 2years, including interventional research and federal, state, and community health programs. TRIAL REGISTRATION ClinicalTrials.gov, NCT01938118, August 9, 2013.
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Affiliation(s)
| | | | | | - Eric A Hodges
- University of North Carolina, Chapel Hill, NC, United States.
| | | | - Eliana M Perrin
- 3643 N. Roxboro Street, Duke University, Durham, NC 27704, United States.
| | | | - Cynthia M Bulik
- University of North Carolina, Chapel Hill, NC, United States; Karolinska Institutet, Stockholm, Sweden.
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Martínez-Galán P, Martín-Gallardo E, Macarro-Ruiz D, Martínez-Martín E, Manrique-Tejedor J. Educación prenatal e inicio de la lactancia materna: Revisión de la literatura. ENFERMERÍA UNIVERSITARIA 2017. [DOI: 10.1016/j.reu.2016.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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