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Su X, Wang H, McQueen K, Dennis CL, Zhang Y, Chen M, Liu G. The reliability and validity of the Postpartum Partner Support Scale among Chinese women. Midwifery 2024; 136:104067. [PMID: 38901127 DOI: 10.1016/j.midw.2024.104067] [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: 01/24/2024] [Revised: 05/04/2024] [Accepted: 06/12/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND The benefits of partner support have been well documented for maternal and child health and wellbeing. Chinese women who practice traditional postpartum rituals may lack support during the confinement and often rely heavily on their partners. Currently, there is no validated measure to assess postpartum partner support in China. AIM To translate the Postpartum Partner Support Scale (PPSS) into Chinese, evaluate its psychometric properties and assess postpartum support among Chinese women. METHODS The PPSS was translated into Chinese using a validated process and administered to 428 postpartum women residing in the city of Quanzhou in the Fujian Province in China between September 2021 and July 2022. RESULTS Reliability analysis demonstrated a Cronbach's α coefficient of 0.97, a split-half coefficient of 0.93, and a retest correlation coefficient of 0.91 (p < 0.01). The item analysis and content validity results fell within the recommended range, with no items requiring deletion. Exploratory factor analysis revealed the extraction of a single common factor, which accounted for 74.05% of the cumulative variance. Confirmatory factor analysis yielded a χ2/df ratio of 1.48 and an RMSEA value of 0.05. Several demographic variables were associated with significantly lower levels of postnatal partner support including older maternal and paternal age, lower maternal education, higher household income, fair relationship with in-law family, female infant sex, and premature birth. CONCLUSION The Chinese version of the PPSS exhibited good reliability and validity providing evidence that it may be suitable for evaluating partner support among postpartum women in China.
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Affiliation(s)
- Xiaojuan Su
- Department of Nursing, Quanzhou Medical College, Quanzhou, Fujian 362011, China
| | - Huifang Wang
- Department of Obstetrics and Gynecology, Quanzhou Medical College, Quanzhou, Fujian 362011, China
| | - Karen McQueen
- Lakehead University School of Nursing, Thunder Bay, Ontario P7B 5E1, Canada
| | - Cindy-Lee Dennis
- Bloomberg Faculty of Nursing, University of Toronto, Ontario M5T 1P8, Canada
| | - Yuezhen Zhang
- Department of Nursing, Quanzhou Medical College, Quanzhou, Fujian 362011, China.
| | - Meide Chen
- Nursing Department, Quanzhou Women and Children(')s Hospital, Quanzhou, Fujian 362000, China
| | - Guihua Liu
- Department of Child Health Care, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian 350001, China
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Gabriela Alejandra GB, Ana SR, Gabriela MO, Gabriel CT, Marco Julián CO, Martha DA, Barbara V. Social representations of breastfeeding in health science students: A first step to strengthening their training. Nurse Educ Pract 2024; 78:103991. [PMID: 38823293 DOI: 10.1016/j.nepr.2024.103991] [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: 10/04/2023] [Revised: 04/29/2024] [Accepted: 05/04/2024] [Indexed: 06/03/2024]
Abstract
AIM This study aims to describe the social representations of breastfeeding among Mexican health science students. BACKGROUND Breastfeeding is a complex phenomenon involving biological, affective and sociocultural aspects. Its definition includes diverse beliefs, attitudes, traditions and myths. Being aware of the connections between biological and sociocultural concepts in the social representations of breastfeeding in health science students may facilitate our comprehension of their attitudes/behaviors towards breastfeeding. DESIGN A qualitative study was carried out based on the structuralist approach of the social representations theory. METHODS Data were collected with free-listing questionnaires with breastfeeding as an inducer word among a random sample of nutrition, medical and nursing undergraduate students (n=124). The analyses used were similitude/meanings of words, prototypical and categorical analyses. RESULTS The findings suggest that the structure of the social representation is composed of breastfeeding essentials (baby, mother, & milk), affective (attachment, love & link), biological (nutrition, breasts, & health) and sociocultural elements (taboo, responsibility, & economic). Only instrumental elements are found in the nucleus, whereas biological, affective and sociocultural elements are observed in the peripheries. Moreover, emerging thematic categories such as the "affective bond" and "feeding" introduced additional dimensions, thereby emphasizing the complexity and richness of the social representation of breastfeeding in the context of health science students. CONCLUSIONS The structure of the social representation of breastfeeding among some Mexican undergraduate health science students focuses on the instrumental aspects, emphasizing essential elements. However, they downplay more scientifically oriented elements specific to their academic training. These findings, when extrapolated to different contexts, present an opportunity that could assist the development of tailored and culturally adapted educational strategies to strengthen breastfeeding training for health students. This approach can significantly contribute to enhancing breastfeeding promotion in society by addressing practical, scientific and language-inclusive aspects in the training of health professionals.
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Affiliation(s)
- Grover-Baltazar Gabriela Alejandra
- Doctorado en Ciencias de la Salud Pública, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Colonia Independencia, Guadalajara, C.P. 44340, Jalisco, Mexico; Secretaría de Salud Jalisco, Dr. Baeza Alzaga 107, Guadalajara, C.P. 44100, Jalisco, Mexico
| | - Sandoval-Rodríguez Ana
- Instituto de Biología Molecular en Medicina, CUCS, UdeG, Sierra Mojada 950, Colonia Independencia, Guadalajara, C.P. 44340, Jalisco, Mexico
| | - Macedo-Ojeda Gabriela
- Doctorado en Ciencias de la Salud Pública, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Colonia Independencia, Guadalajara, C.P. 44340, Jalisco, Mexico; Instituto de Investigación de Ciencias Biomédicas, CUCS, UdeG, Sierra Mojada 950, Colonia Independencia, Guadalajara, C.P. 44340, Jalisco, Mexico
| | - Chavira Trujillo Gabriel
- Doctorado en Ciencias de la Salud Pública, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Colonia Independencia, Guadalajara, C.P. 44340, Jalisco, Mexico; Departamento de Epidemiología del Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Colonia Sección XVI, Alcaldía de Tlalpan, Ciudad de México, C.P. 1408, Mexico
| | | | - De Alba Martha
- Departamento de Sociología, Universidad Autónoma Metropolitana Unidad Iztapalapa, Av. San Rafael Atlixco 108, Leyes de Reforma 1ra. Sección, Iztapalapa, Ciudad de México, C.P. 09310, Mexico.
| | - Vizmanos Barbara
- Doctorado en Ciencias de la Salud Pública, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Colonia Independencia, Guadalajara, C.P. 44340, Jalisco, Mexico; Laboratorio de Evaluación del Estado Nutricio, Instituto de Nutrigenética y Nutrigenómica, CUCS, Universidad de Guadalajara, Sierra Mojada 950, Colonia Independencia, Guadalajara, C.P. 44340, Jalisco, Mexico.
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Savaş EH, Tümkaya MN, Semerci R, Eroğlu K. Comparison of the effect of natural products and breast milk for preventing and treating nipple trauma and pain in lactating women: A systematic review and meta-analysis. Explore (NY) 2024; 20:103019. [PMID: 38937192 DOI: 10.1016/j.explore.2024.103019] [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: 09/23/2023] [Revised: 04/19/2024] [Accepted: 06/18/2024] [Indexed: 06/29/2024]
Abstract
INTRODUCTION Prevention and management of nipple problems are crucial during the postpartum period for effective breastfeeding. Breastmilk is the most commonly recommended method for lactating women. However, insufficient studies have proven its superiority over other methods in the current literature. This study aims to determine the effects of natural products compared to breast milk in preventing and treating nipple trauma and pain in lactating women. METHODS In this review, we investigated studies from PubMed, Web of Science, Cochrane Library, MEDLINE, CINAHL, Scopus, and Google Scholar databases that met the inclusion criteria. We also assessed the studies' methodological quality with the Cochrane and JBI checklists. This study was performed based on the Guidelines of Systematic Reporting of Examination presented in the PRISMA checklist. The search protocol has been registered at the PROSPERO International Prospective Register of Systematic Reviews. RESULTS A total of ten published studies, including 1139 lactating women, were included in this review. The meta-analysis results showed a significant effect of natural product intervention on nipple trauma (Hedge's g -0.702, Q = 81,154, I2 =91,374 %, p < 0.001), soreness (Hedge's g =-0.648, Q = 7,092, I2 =71,801 %, p < 0.001), and pain levels (Hedge's g =-0.613, Q = 25,058, I2 =76,056 %, p < 0.001) experienced by lactating women. CONCLUSION The findings showed that natural products have greater potential than breast milk in managing nipple pain, trauma, and soreness. However, the evidence for these interventions is low or very low quality. Further research is needed to determine the most effective treatment for nipple trauma in lactating women.
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Affiliation(s)
- Eyşan Hanzade Savaş
- Koç University, Graduated School of Health Sciences, Davutpaşa St. No: 4, 34010, Topkapı, Istanbul, Türkiye.
| | - Maide Nur Tümkaya
- Halic University Faculty of Health Sciences, 5th Levent District, 15 Temmuz Sehitler St., No: 14/12, 34060 Eyüpsultan, Istanbul, Türkiye
| | - Remziye Semerci
- Koç University, School of Nursing, Davutpaşa St. No: 4, Koç University School of Nursing, 34010, Topkapı, Istanbul, Türkiye
| | - Kafiye Eroğlu
- Atlas University, School of Nursing, Hamidiye, Anadolu St. No:40, 34408, 34403 Kagithane, Istanbul, Türkiye
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Pereira TLB, Rajendran PDO, Nantsupawat A, Shorey S. Fathers' breastfeeding knowledge, attitudes, and involvement in the Asian context: A mixed-studies review. Midwifery 2024; 131:103956. [PMID: 38401252 DOI: 10.1016/j.midw.2024.103956] [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: 09/09/2022] [Revised: 01/17/2024] [Accepted: 02/13/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Despite numerous initiatives attempting to enhance BF across Asia, recent studies show that exclusive BF rates remain alarmingly low. With globalization, society has shifted from traditional family roles towards more egalitarian marriages, where Asian fathers are now more involved in parenting. As fathers' involvement in breastfeeding is highly complex and context-sensitive, evaluation of a wide range of concepts and evidence within the Asian context is necessary. OBJECTIVE This review aims to consolidate and appraise empirical studies exploring fathers' breastfeeding knowledge, attitude, and involvement within the Asian context. DESIGN A systematic mixed-studies review was conducted. Six electronic databases (PubMed, CINAHL, PsycINFO, Embase, Scopus, and ProQuest Dissertations and Theses Global) were searched from each database's inception date until June 2022. Studies were appraised using the Mixed Method Appraisal Tool and data was synthesised using the results-based convergent integration method. FINDINGS Twenty-two studies were included in this review. The synthesis of findings identified two main themes and six sub-themes. KEY CONCLUSIONS Asian fathers have a varied understanding of breastfeeding and their involvement in breastfeeding is influenced by personal, cultural, religious, social, and environmental factors. IMPLICATIONS FOR PRACTICE Perinatal care professionals play a crucial role in engaging and enhancing fathers' involvement in breastfeeding education programmes. The findings also urge policymakers to introduce more 'father-friendly' breastfeeding guidelines and educate perinatal care professionals to be more aware and sensitive to the needs of fathers. There is also a need to introduce more flexible and economically sensitive paternal leave policies to improve fathers' breastfeeding involvement.
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Affiliation(s)
- Travis Lanz-Brian Pereira
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Priyadharshni DO Rajendran
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Shefaly Shorey
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Mei H, Zhang Y, Chang R, Xu K, Zhang J, Wang F. Mediating role of birth at a baby-friendly hospital in the association between parental socioeconomic status and infant exclusive breastfeeding at six months old. BMC Public Health 2024; 24:78. [PMID: 38172763 PMCID: PMC10762853 DOI: 10.1186/s12889-023-17586-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 12/26/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Current evidence suggests that the exclusive breastfeeding (EBF) rate at six months postpartum in China falls considerably below the targets recommended by the World Health Organization (WHO). Socioeconomic disparities in EBF have been observed in developing countries, with significant heterogeneity across studies. Despite the implementation of the Baby-Friendly Hospital Initiative (BFHI) in China since the 1990s to promote breastfeeding, there has been a lack of assessment concerning infants from different socioeconomic backgrounds. This study sought to investigate the association between socioeconomic status (SES) and EBF and explore the potential impact of giving birth at a Baby-Friendly Hospital (BFH) on this association. METHODS We analyzed data from 98,469 mother-child dyads selected from the Maternal and Child Health Management Information System. We used log-binomial models to examine the relationships between SES and EBF, SES and giving birth at a BFH, as well as BFH births and EBF. Additionally, we explored a counterfactual mediation approach to assess the mediating role of BFH births in the SES-EBF association. FINDINGS We identified a significant association between SES and EBF (RRMedium vs. Low = 1.47, 95% CI 1.39-1.55; RRHigh vs. Low = 1.40, 95% CI 1.32-1.49). Mothers with higher SES were more likely to give birth at BFHs (RRMedium vs. Low = 1.85, 95% CI 1.81-1.88; RRHigh vs. Low=2.29, 95% CI 2.25-2.33). The significance of the SES-EBF association was attenuated when the type of hospital for childbirth was considered, revealing the significant mediating effect of BFH births in the SES-EBF association. CONCLUSION Socioeconomic disparities are linked to infant EBF rates, with giving birth at a BFH mediating this association, especially for cases with low SES in rural areas.
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Affiliation(s)
- Hong Mei
- Institute of Maternal and Child Health, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital, Huazhong University of Science and Technology, 100 Hongkong Road, Wuhan, Hubei, China
| | - Yuanyuan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13, Hangkong Road, Wuhan, Hubei, China
| | - Ruixia Chang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13, Hangkong Road, Wuhan, Hubei, China
| | - Ke Xu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13, Hangkong Road, Wuhan, Hubei, China
| | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13, Hangkong Road, Wuhan, Hubei, China.
| | - Fang Wang
- Department of Obstetrics, Tongji Medical College, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital, Huazhong University of Science and Technology, 100 Hongkong Road, Wuhan, Hubei, China.
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Acevedo-Bedoya SY, Londoño-Sierra DC, Sterling-Villada MDLA, Osorio-Posada A, Garnica-Cardona C, Restrepo-Mesa SL. Breastfeeding experiences from the perspective of the breastfeeding woman: qualitative study. REVISTA COLOMBIANA DE OBSTETRICIA Y GINECOLOGIA 2023; 74:287-296. [PMID: 38421224 PMCID: PMC10911416 DOI: 10.18597/rcog.4105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/21/2023] [Indexed: 03/02/2024]
Abstract
Objectives To understand the breastfeeding experience from the perspective of a group of women who breastfeed for the first time. Materials and Methods Qualitative study from an ethnographic perspective, focusing on a group of women from the eastern region of the Department of Antioquia (Colombia). Intentional sampling until data saturation was used. The group included 16 first-time breastfeeding mothers aged 18 or older, with children under 24 months of age and who were breastfeeding or had breastfed exclusively for at least three months. Semi-structured interviews and participant observations were carried out. Data were analyzed by triangulation and open and axial coding. The results are presented in the form of category descriptions. Results Four categories were identified in relation to the breastfeeding experience: exhaustion and pain dispelled by love, breastfeeding and the new order of things, emotions of a woman embodied in a mother, and breastfeeding as a social act. Conclusions Protection of breastfeeding requires special attention to the woman as a subject beyond the act of breastfeeding, giving priority to her physical and emotional health as essential elements that must be kept in mind by healthcare professionals. Studies to assess the effects of creating support groups that foster the exchange of insights to help the breastfeeding woman are required.
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Monge-Montero C, van der Merwe LF, Tagliamonte S, Agostoni C, Vitaglione P. Why do mothers mix milk feed their infants? Results from a systematic review. Nutr Rev 2023:nuad134. [PMID: 38041551 DOI: 10.1093/nutrit/nuad134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023] Open
Abstract
CONTEXT Combining or supplementing breastfeeding with formula feeding, also called mixed milk feeding (MMF), is a common infant feeding practice. However, there is no well-established MMF evidence-base for informing and guiding parents. A better understanding of the reasons why mothers practice MMF may facilitate identification of efficient strategies for supporting exclusive breastfeeding, and/or opportunities to prolong breastfeeding, at least partially. OBJECTIVE An updated systematic literature review was undertaken with the primary aim of gaining a deeper understanding of the reasons why mothers choose MMF. DATA SOURCES Six databases were searched for relevant articles published in English from January 2012 to January 2022. DATA EXTRACTION Two reviewers independently performed the screenings and data extraction, and any differences were resolved by a third reviewer. Data from 138 articles were included, 90 of which contained data on MMF reasons/drivers, and 60 contained data on infant age and/or maternal demographic factors associated with MMF. DATA ANALYSIS A total of 13 different unique MMF drivers/reasons were identified and categorized according to whether the drivers/reasons related to perceived choice, necessity, or pressure. Risk of bias was evaluated using the Quality Assessment Tool of Diverse Studies and the JBI Systematic Reviews tool. Several different terms were used to describe and classify MMF across the studies. The most commonly reported reasons for MMF were related to a perception of necessity (39% of drivers, eg, concerns about infant's hunger/perceived breast milk insufficiency or breastfeeding difficulties), followed by drivers associated with perceived choice (34%; eg, having more flexibility) and perceived pressure (25%; eg, returning to work or healthcare professionals' advice). This was particularly true for infants aged 3 months or younger. CONCLUSION The key global drivers for MMF and their distribution across infant age and regions were identified and described, providing opportunities for the provision of optimal breastfeeding support. A unified definition of MMF is needed in order to enable more comparable and standardized research. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022304253.
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Affiliation(s)
- Carmen Monge-Montero
- Department of Research, Monge Consultancy Food and Nutrition Research, Leiden, The Netherlands
| | | | - Silvia Tagliamonte
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
| | - Carlo Agostoni
- Fondazione IRCCS Ospedale Maggiore Policlinico, Pediatric Clinic, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paola Vitaglione
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
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Ren Z, Zhang A, Fan X, Feng J, Xia H. Utility of the capability, opportunity, and motivation behaviour (COM-B) model in explaining the negative association between pre-pregnancy body mass index and exclusive breastfeeding at six weeks postpartum. Appetite 2023; 188:106631. [PMID: 37302414 DOI: 10.1016/j.appet.2023.106631] [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: 12/06/2022] [Revised: 05/21/2023] [Accepted: 06/08/2023] [Indexed: 06/13/2023]
Abstract
The mechanisms underlying the negative associations between pre-pregnancy body mass index (BMI) and exclusive breastfeeding remain poorly understood. Thus, the study aimed to determine whether the negative associations between high pre-pregnancy BMI and exclusive breastfeeding at six weeks postpartum are mediated by components of the capability, opportunity, and motivation behaviour (COM-B) model. In this prospective observational study, we assigned 360 primiparous women to a pre-pregnancy overweight/obese group (n = 180) and a normal-BMI group (n = 180). A structural equation model was designed to study how capabilities (onset of lactogenesis II, perceived milk supply, breastfeeding knowledge, and postpartum depression), opportunities (pro-breastfeeding hospital practices, social influence, social support), and motivations (breastfeeding intention, breastfeeding self-efficacy, and attitudes towards breastfeeding) affected exclusive breastfeeding at six weeks postpartum in groups of women with different pre-pregnancy BMIs. In all, 342 participants (95.0%) possessed complete data. Women with high pre-pregnancy BMI were less likely to exclusively breastfeed at six weeks postpartum than women with a normal BMI were. We observed a significant negative direct effect of high pre-pregnancy BMI on exclusive breastfeeding at six weeks postpartum and a significantly negative indirect effect of high pre-pregnancy BMI via the explanatory mediating variables of capabilities (onset of lactogenesis II, perceived milk supply, and breastfeeding knowledge) and motivations (breastfeeding self-efficacy) on exclusive breastfeeding at six weeks postpartum. Our findings support certain capabilities (onset of lactogenesis II, perceived milk supply, and breastfeeding knowledge) and motivations (breastfeeding self-efficacy), partially explaining the negative association between high pre-pregnancy BMI and exclusive breastfeeding outcome. We suggest that interventions aimed at promoting exclusive breastfeeding among women with high pre-pregnancy BMI should address the capacity and motivation factors specific to this population.
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Affiliation(s)
- Ziqi Ren
- School of Nursing, Fudan University, 305 Fenglin Road, Xuhui District, 200032, Shanghai, China.
| | - Aixia Zhang
- Department of Nursing, The Women's Hospital of Nanjing Medical University, 123 Tianfei Lane, Mochou Road, Qinhuai District, 210004, Nanjing, China.
| | - Xuemei Fan
- Department of Nursing, The Women's Hospital of Nanjing Medical University, 123 Tianfei Lane, Mochou Road, Qinhuai District, 210004, Nanjing, China.
| | - Jingyi Feng
- Faculty of Science, The Hong Kong Polytechnic University, 11 Yuk Chai Road, Hung Hom, 999077, Hong Kong, China.
| | - Haiou Xia
- School of Nursing, Fudan University, 305 Fenglin Road, Xuhui District, 200032, Shanghai, China.
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Paramashanti BA, Dibley MJ, Huda TM, Prabandari YS, Alam NA. Factors influencing breastfeeding continuation and formula feeding beyond six months in rural and urban households in Indonesia: a qualitative investigation. Int Breastfeed J 2023; 18:48. [PMID: 37653430 PMCID: PMC10472632 DOI: 10.1186/s13006-023-00586-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 08/25/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Global and Indonesian guidelines suggest that breastfeeding should continue for at least the first two years of life. While many studies have focused on six-month exclusive breastfeeding practices, little is known about why mothers do not sustain breastfeeding beyond this period. This qualitative study aimed to explore factors influencing breastfeeding continuation and formula feeding beyond six months, regardless of any additional food consumed, focusing on Indonesia's rural and urban areas. METHODS We collected the data through 46 in-depth interviews in Pati District and Surakarta City, Central Java, Indonesia. Participants were mothers, grandmothers, health care practitioners, and village kader (frontline female health workers). We used thematic analysis combining deductive and inductive techniques for analysing the data. RESULTS Rural mothers practised breastfeeding and intended to breastfeed for a longer duration than urban mothers. Maternal attitude towards breastfeeding, breastfeeding knowledge, previous experiences, and other breastfeeding strategies (e.g., enhancing maternal dietary quality) positively influenced breastfeeding sustainability. In the urban setting, mothers encountered several breastfeeding barriers, such as perceived breast milk insufficiency and child hunger and satiety, child biting, and breastfeeding refusal, causing them to provide formula milk as a breast milk substitute or supplement. In addition, families, communities, health practitioners, and employment influenced maternal decisions in breastfeeding continuation and formula-feeding practices. CONCLUSIONS Optimal breastfeeding practices up to two years of age are determined by the individual and setting (i.e., community, healthcare, employment) factors. Providing breastfeeding education covering practical breastfeeding guidance will encourage mothers to breastfeed for longer. Such interventions should involve families, communities, health workers, and the work environment as a breastfeeding support system. Policymakers should develop, enforce, and monitor the implementation of breastfeeding policies to protect, promote, and support breastfeeding in households, communities, health systems, and work settings.
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Affiliation(s)
- Bunga Astria Paramashanti
- Department of Nutrition, Faculty of Health Sciences, Universitas Alma Ata, Yogyakarta, Indonesia.
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
| | - Michael J Dibley
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Tanvir M Huda
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Yayi Suryo Prabandari
- Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Neeloy Ashraful Alam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Wu JL, Pang SQ, Jiang XM, Zheng QX, Lin Y. Which mothers' breastfeeding behaviours within six weeks postpartum do health workers need to notice? Developing an indicator system based on the Delphi method and analytic hierarchy process. Midwifery 2023; 119:103603. [PMID: 36724574 DOI: 10.1016/j.midw.2023.103603] [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: 11/22/2021] [Revised: 06/04/2022] [Accepted: 01/22/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The six weeks postpartum is the high-incidence period of stopping breastfeeding. The clarity of the internal mechanism of behaviour was an effective way to promote breastfeeding. The aim was to reach a consensus on indicators what should be used and prioritised in evaluating mothers' breastfeeding behaviour within six weeks postpartum in order to provide a theoretical reference for health workers to take targeted strategies toward promoting breastfeeding practices. DESIGN Two rounds of Delphi method and analytic hierarchy process was conducted in this study. The two-rounds Delphi was performed to select essential indicators and collect revised suggestion. The analytic hierarchy process was adopted for pairwise comparison to rank the significance of primary and secondary indicators. SETTING AND PARTICIPANTS The panel included twenty experts with rich breastfeeding information and different general characteristics from China. FINDINGS Consensus was achieved to include three primary indicators, seven secondary indicators, and forty-five tertiary indicators in the final indicators system of the mothers' breastfeeding behaviour within six weeks postpartum. The weight sequence of primary indicators was self-regulation behaviour (0.401), at-the-breast feeding behaviour (0.383), and resource utilisation behaviour (0.216). The rank of the secondary indicators was breastfeeding operation skills (0.267), self-decision behaviour (0.144), self-control behaviour (0.130), self-coping behaviour (0.127), breastfeeding self-perception (0.116), resource acquisition behaviour (0.115), and resource coordination behaviour (0.101). KEY CONCLUSION The study builds a new and reliable indicators system that intuitively reflects the constituent elements of the mothers' breastfeeding behaviour within six weeks postpartum and provides priorities in primary indicators and secondary indicators. IMPLICATIONS FOR PRACTICES The study helps form a clear and scientific cognition on mothers' breastfeeding behaviour within six weeks postpartum and provides a new perspective and intuitive theoretical reference for health workers to take targeted measures to promote breastfeeding practices and achieve substantial public health gains.
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Affiliation(s)
- Jing-Ling Wu
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Shu-Qin Pang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Xiu-Min Jiang
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
| | - Qing-Xiang Zheng
- Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yan Lin
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
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Wu JL, Pang SQ, Jiang XM, Lin Y, Zheng QX. The mothers' breastfeeding behaviour within six weeks postpartum: new scale development and psychometric validation study. BMC Pregnancy Childbirth 2023; 23:138. [PMID: 36864400 PMCID: PMC9979542 DOI: 10.1186/s12884-023-05439-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 02/09/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND The evaluation of mothers' breastfeeding behaviour within 6 weeks postpartum could help health workers comprehensively identify maternal breastfeeding shortcomings, clarify nursing problems, and provide targeted interventions. However, no prior study was found, therefore this study aimed to develop and validate the reliability and validity of the mothers' breastfeeding behaviour scale within 6 weeks postpartum. METHODS A main two-step approach was used: (1) a qualitative pilot study using the purposive sampling method was adopted to test the fitness, simplicity, and clarity of items with 30 mothers; (2) a cross-sectional survey using the convenient sampling method was conducted for item analysis and psychometric validation with 600 mothers. RESULTS The final version of the scale consisted of 36 items with seven dimensions, explaining 68.852% of the total variance. The Cronbach's α, split-half, and retest coefficients were 0.958, 0.843, and 0.753, respectively. The validity of the scale: (1) Content validity: content validity index (CVI) range of items was between 0.882 and 1.000. The scale-level-CVI was 0.990. (2) Structure validity: The fitting indices were as follows: χ2/ⅆf =2.239, RMR = 0.049, RMSEA = 0.069, TLI = 0.893, CFI = 0.903, IFI = 0.904, PGFI = 0.674, and PNFI = 0.763. (3) Convergent validity: The composite reliability and average variance extracted (AVE) of the seven dimensions were between 0.876 and 0.920 and between 0.594 and 0.696. (4) Distinguish validity: The correlation coefficients were less than the square root of the AVE, except for self-decision behaviour, self-coping behaviour, and self-control behaviour. However, the fit index of the original three-factor model was better than that of the other new models, with significant differences (P < 0.001). (5) Calibration validity: The area under the curve was 0.860 or 0.898 when the scale was used to predict exclusive or any breastfeeding at 42 days. The correlation coefficients of the maternal breasting feeding evaluation scale, breastfeeding self-efficacy short-form scale, and the scale were 0.569 and 0.674, respectively. CONCLUSION The newly developed mothers' breastfeeding behaviour scale within 6 weeks postpartum consists of 36 items belonging to seven dimensions with good reliability and validity and is a reliable and valid instrument to be used in future maternal breastfeeding behaviour assessments and interventions.
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Affiliation(s)
- Jing-Ling Wu
- grid.411504.50000 0004 1790 1622School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian China ,grid.256112.30000 0004 1797 9307Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian China
| | - Shu-Qin Pang
- grid.411504.50000 0004 1790 1622School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian China
| | - Xiu-Min Jiang
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China.
| | - Yan Lin
- grid.256112.30000 0004 1797 9307Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian China
| | - Qing-Xiang Zheng
- grid.256112.30000 0004 1797 9307Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian China
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12
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Özdil K, Çatıker A, Bulucu Büyüksoy GD. Breastfeeding within the circle of motherhood, restriction, and patriarchy: A qualitative study. Health Care Women Int 2023; 44:246-261. [PMID: 34339611 DOI: 10.1080/07399332.2021.1935958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Our purpose in the present study is to analyze the opinions of women regarding the factors that support and hinder their breastfeeding. This is a phenomenological and qualitative study. The present study included 32 breastfeeding women who live in different provinces in the Central Anatolia Region of Turkey. The data were collected using a semi-structured interview form and were evaluated using the content analysis method. Three themes and ten sub-themes about women's experience on breastfeeding their babies and factors affecting their breastfeeding were found. The themes identified were: motherhood, restriction, patriarchy.Supplemental data for this article is available online at https://doi.org/10.1080/07399332.2021.1935958 .
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Affiliation(s)
- Kamuran Özdil
- Aged Care Program, Nevsehir Haci Bektaş Veli University, Health Services Vocational School, Nevşehir, Turkey
| | - Aslıhan Çatıker
- Department of Nursing, Ordu University Faculty of Health Sciences, Ordu, Turkey
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13
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Hao Y, Wang L, Wang C, Peng A, Gao W, Marc I, Semenic S, Fraser WD, Narayan A, Wu Y, Chang S, Huang H. Breastfeeding Practices and Associated Factors in Shanghai: A Cross-Sectional Study. Nutrients 2022; 14:nu14204429. [PMID: 36297120 PMCID: PMC9610171 DOI: 10.3390/nu14204429] [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] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/14/2022] [Accepted: 10/16/2022] [Indexed: 11/18/2022] Open
Abstract
The status of breastfeeding practices remains unsatisfactory across China, but regional differences persist. However, disaggregated data for specific provinces are limited. This representative survey determined the status of breastfeeding and factors associated with breastfeeding practices in Shanghai. The questionnaire was designed in compliance with indicators for assessing infant and young child-feeding practices defined by the World Health Organization and the United Nations Children's Fund (UNICEF). A total of 2665 children aged two years and younger (0-730 days) were investigated, among whom 1677 were aged under six months. The early initiation of breastfeeding (EIBF) rate was 60.3%. Among children aged under six months, 43.4% were exclusively breastfed (EBF). The univariate regression analysis showed that the EBF rate was influenced by multiple factors, including individual, socioeconomic, workplace and employment, and health system. The subsequent multivariate analysis suggested that mothers with a higher rate of EBF shared the following characteristics: intention to breastfeed during pregnancy, breastfeeding knowledge, and higher satisfaction with support through the healthcare system after delivery. The rate of EBF in Shanghai is over 40%, and supporting breastfeeding requires measures at multiple levels, including individual attributes, women's work and employment conditions, breastfeeding knowledge, and health services.
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Affiliation(s)
- Yanhui Hao
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200032, China
| | - Lulu Wang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200032, China
| | - Caifeng Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Aiping Peng
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Wei Gao
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Isabelle Marc
- Department of Pediatrics, Research Center of CHU de Québec-Université Laval, Faculty of Medicine, Laval University, Québec, QC G1V 0A6, Canada
| | - Sonia Semenic
- Ingram School of Nursing, McGill University, Montréal, QC H3A 0G4, Canada
| | - William D. Fraser
- Department of Obstetrics and Gynecology, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
| | - Anuradha Narayan
- United Nations Children’s Fund, Office for China, Beijing 100600, China
| | - Yanting Wu
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200032, China
- Correspondence: (Y.W.); (S.C.); (H.H.)
| | - Suying Chang
- United Nations Children’s Fund, Office for China, Beijing 100600, China
- Correspondence: (Y.W.); (S.C.); (H.H.)
| | - Hefeng Huang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200032, China
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai 200011, China
- Correspondence: (Y.W.); (S.C.); (H.H.)
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14
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Long T, Ning Z, Fu B, Yao Y, Wu L, Luo J, Lin Z, Ma H. Maintaining Breastfeeding During the Treatment of Breast Abscesses Is Not Contraindicated. Breastfeed Med 2022; 17:753-757. [PMID: 36121389 DOI: 10.1089/bfm.2022.0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: World Health Organization guidelines recommend maintaining breastfeeding if a woman develops breast abscess, because of benefits to her recovery and the infant's health. However, clinical staff recommend weaning to promote faster recovery from the abscess. The purpose of this study was to determine whether maintaining breastfeeding after development of a breast abscess has any influence on the resolution of the breast abscess. Methods: The records of 212 patients who were breastfeeding and developed breast abscess treated at Guangzhou Women and Children's Medical Center from January 2018 to December 2019 were retrospectively reviewed. Patients were divided into two groups: those who maintained breastfeeding (study group) and those who stopped breastfeeding (control group). Results: There were 139 patients in study group and 73 patients in the control group. Baseline characteristics were similar between the two groups. The time to cure in the study group and in the control group was 7.20 ± 2.21 days and 7.01 ± 2.39 days, respectively (t = 0.579, p = 0.563). Common complications were milk fistula and galactocele, and the frequency of both was similar between the two groups (milk fistula: 7.9% versus 8.2%, respectively; χ2 = 0.006, p = 0.938; galactocele: 8.6% versus 9.6%, respectively; χ2 = 0.054, p = 0.817). There was no significant difference in the recurrence rates between the two groups (5.0% versus 2.7%; χ2 = 0.184, p = 0.668). Conclusion: Maintaining breastfeeding during treatment of breast abscess does not affect the outcome of treatment provided, on condition that the abscess is treated appropriately.
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Affiliation(s)
- Tianzhu Long
- Department of Breast Surgery, and Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Ziyu Ning
- Department of Breast Surgery, and Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Benjie Fu
- Department of Breast Surgery, and Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Yuzhi Yao
- Department of Surgical Clinic, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Ling Wu
- Department of Breast Surgery, and Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Jiayue Luo
- Department of Breast Surgery, and Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Zeyu Lin
- Department of Hepatobiliary Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hongmin Ma
- Department of Breast Surgery, and Guangzhou Women and Children's Medical Center, Guangzhou, China
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Foong SC, Foong WC, Tan ML, Ho JJ, Omer-Salim A. A Participatory, Needs-Based Approach to Breastfeeding Training for Confinement Centres. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10914. [PMID: 36078639 PMCID: PMC9517788 DOI: 10.3390/ijerph191710914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
With a focus on traditional practices rather than evidence-based practices, breastfeeding support is sub-optimal in confinement centres (CCs). We used a participatory, needs-based approach to develop a training module for CC staff adopting Kern's six-step approach as our conceptual framework. Of 46 identified CCs, 25 accepted our invitation to a dialogue aimed at establishing relationships and understanding their needs. An interactive training workshop was developed from the dialogue's findings. The workshop, attended by 32 CCs (101 participants), was conducted four times over a four-month period. Questions raised by the participants reflected deficits in understanding breastfeeding concepts and erroneous cultural beliefs. Correct answers rose from 20% pre-test to 51% post-test. Post-workshop feedback showed that participants appreciated the safe environment to ask questions, raise concerns and correct misconceptions. An interview conducted 14 months later showed that while some CCs improved breastfeeding support, others made no change due to conflict between breastfeeding and traditional postnatal practices, which was aggravated by a lack of support due to the COVID-19 pandemic. A participatory approach established a trustful learning environment, helping CCs appreciate the value of learning and adopting new concepts. However, cultural perceptions take time to change, hence continuous training and support are vital for sustained changes.
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Affiliation(s)
- Siew Cheng Foong
- Department of Paediatrics, RCSI & UCD Malaysia Campus (Formerly Penang Medical College), George Town 10450, Malaysia
| | - Wai Cheng Foong
- Department of Paediatrics, RCSI & UCD Malaysia Campus (Formerly Penang Medical College), George Town 10450, Malaysia
| | - May Loong Tan
- Department of Paediatrics, RCSI & UCD Malaysia Campus (Formerly Penang Medical College), George Town 10450, Malaysia
| | - Jacqueline J. Ho
- Department of Paediatrics, RCSI & UCD Malaysia Campus (Formerly Penang Medical College), George Town 10450, Malaysia
| | - Amal Omer-Salim
- World Alliance for Breastfeeding Action, George Town 10850, Malaysia
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16
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Abstract
Background: There are no national data on the prevalence of breastfeeding during pregnancy (BDP) in the world. Also, there is no consensus for the BDP. Aim: The purpose was to determine the prevalence of breastfeeding status in pregnant mothers having children younger than 24 months of age and to evaluate the associated sociodemographic factors and characteristics of the last-born child and current pregnancy through two consecutive national health survey. Methods: Data from the 2012 and 2017 Jordan Family Health and Population Survey were merged. Individual, household, and community-level factors associated with BDP were analyzed by using complex sample multivariate logistic regression. Results: Two surveys enrolled 6,858 women having at least one child younger than 24 months and 8.8% (weighted count: 603) of them got pregnant also. Of the pregnant women, 8.9% continued breastfeeding their last-born children. Being younger than 12 months positively affected breastfeeding compared to last-born child aged 12-23 months. Multivariate analysis revealed that BDP was associated positively with wealth index (richest vs. poorest) and postnatal care for the last-born child within 2 months (presence vs. absence), whereas negatively with bottle use (presence vs. absence), traditional contraceptive methods (abstinence/withdrawn vs. modern, lactational amenorrhea vs. modern), short interpregnancy interval (months), and current pregnancy duration (months) in Jordan. Conclusions: The prevalence for BDP differs according to some maternal, last-born infant, and current pregnancy characteristics. Prospective cohort studies are necessary to evaluate the impact of BDP on "mother, last-child, and future-child," and to detect the duration and prevalence of BDP in different countries.
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Affiliation(s)
| | | | - Suzan Yalçın
- Department of Food Hygiene and Technology, Faculty of Veterinary Medicine, Selçuk University, Konya, Turkey
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17
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Shu W, Li M, Amaerjiang N, Fan X, Lin S, Segura-Pérez S, Pérez-Escamilla R, Hu Y. A multi-center longitudinal study on responsive breastfeeding in China from the perspective of health equity: research protocol. Int J Equity Health 2021; 20:111. [PMID: 33933082 PMCID: PMC8087879 DOI: 10.1186/s12939-021-01430-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/17/2021] [Indexed: 11/18/2022] Open
Abstract
Background Socio-economic inequities can strongly influence suboptimal infant feeding outcomes. Factors such as lack of knowledge about breastfeeding, low family income, low educational attainment, social and economic status, cultural norms and ethnicity may negatively affect success with offering breastfeeding following a responsive feeding approach (ie. responsive breastfeeding). Such inequities can indeed shorten breastfeeding duration, and negatively affect behavioral and cognitive infant outcomes. In China, there is a dearth of studies focusing on breastfeeding from the responsive and health equity perspective. Objective The aim of this article is to present a protocol of an ongoing longitudinal cohort study investigating factors associated with responsive breastfeeding behaviors, and the child’s behavioral and cognitive development from birth to12 months post-partum in five centers in China. The study seeks to identify breastfeeding barriers and facilitators from a health equity perspective. Methods We are enrolling 700 women and their singleton full term infants in Chongqing, Huizhou and Guangzhou urban and rural areas. The study questionnaires will be administrated within 72 h, 30 days, 3, 6, 9, and 12 months post-partum during the baby’s vaccination visits. We will investigate the difference between urban and rural areas sociodemographic characteristics, breastfeeding knowledge, attitudes and practice, postnatal depression, maternal emotion regulation and parenting stress, and anthropometric and cognitive development indicators of the infants at each time-point. Conclusion Our article illustrates how a cohort study can be designed to understand the barriers and facilitators of responsive breastfeeding taking equity principles into account to help promote infants’ growth and development in China.
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Affiliation(s)
- Wen Shu
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No.10 You'anmenwai Xitoutiao, Fengtai District, Beijing, 100069, China
| | - Menglong Li
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No.10 You'anmenwai Xitoutiao, Fengtai District, Beijing, 100069, China
| | - Nubiya Amaerjiang
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No.10 You'anmenwai Xitoutiao, Fengtai District, Beijing, 100069, China
| | - Xin Fan
- Department of Child Healthcare, Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Shunna Lin
- Department of Pediatrics, Tianhe District Maternal and Child Hospital of Guangzhou, Guangzhou, 510620, China
| | - Sofia Segura-Pérez
- Nutrition Unit, Hispanic Health Council, 175 Main St., Hartford, CT, 06106, USA
| | | | - Yifei Hu
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No.10 You'anmenwai Xitoutiao, Fengtai District, Beijing, 100069, China.
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Dwi Tama T, Astutik E, Katmawanti S, Oka Reuwpassa J. Birth Patterns and Delayed Breastfeeding Initiation in Indonesia. J Prev Med Public Health 2020; 53:465-475. [PMID: 33296587 PMCID: PMC7733752 DOI: 10.3961/jpmph.20.212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 10/12/2020] [Indexed: 11/24/2022] Open
Abstract
Objectives This study was conducted to examine the association between birth patterns (defined in terms of birth order and interval) with delayed breastfeeding initiation in Indonesia. Methods A cross-sectional study was carried out using data from the Indonesian Demographic and Health Survey 2017. The weighted number of respondents was 5693 women aged 15-49 years whose youngest living child was less than 2 years old. Multivariable logistic regression was conducted to evaluate associations between birth patterns and delayed breastfeeding initiation after adjusting for other covariates. Results This study found that 40.2% of newborns in Indonesia did not receive timely breastfeeding initiation. Birth patterns were significantly associated with delayed breastfeeding initiation. Firstborn children had 77% higher odds of experiencing delayed breastfeeding initiation (adjusted odds ratio, 1.77; 95% confidence interval, 1.02 to 3.04; p<0.05) than children with a birth order of 4 or higher and a birth interval ≤ 2 years after adjusting for other variables. Conclusions Firstborn children had higher odds of experiencing delayed breastfeeding initiation. Steps to provide a robust support system for mothers, especially first-time mothers, such as sufficient access to breastfeeding information, support from family and healthcare providers, and national policy enforcement, will be effective strategies to ensure better practices regarding breastfeeding initiation.
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Affiliation(s)
- Tika Dwi Tama
- Department of Public Health, Faculty of Sport Science, Universitas Negeri Malang, Malang, Indonesia
| | - Erni Astutik
- Research Group for Health and Wellbeing of Women and Children, Department of Epidemiology, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | - Septa Katmawanti
- Department of Public Health, Faculty of Sport Science, Universitas Negeri Malang, Malang, Indonesia
| | - Jauhari Oka Reuwpassa
- Functional Medical Staff of Surgical Oncology Department, Dharmais Hospital-National Cancer Center, Jakarta, Indonesia
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