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Gessesse AD, Belete MB, Tadesse F. Time, cause of early neonatal death, and its predictors among neonates admitted to neonatal intensive care units at Bahir Dar City public hospitals, northwest Ethiopia: a prospective follow-up study. Front Pediatr 2024; 12:1335858. [PMID: 38919840 PMCID: PMC11196776 DOI: 10.3389/fped.2024.1335858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/15/2024] [Indexed: 06/27/2024] Open
Abstract
Background Globally, 75% of neonatal deaths occur during the first weeks of life and more than 43% of deaths are covered by sub-Saharan Africa. Health-related policymakers and decision-makers need to use evidence-based treatments to reduce the time to early neonatal death and associated predictors. However, there are limited studies on median survival time, cause, incidence, and predictors in the study area as well as the country. Therefore, the aim of the present study was to assess time, the cause of early neonatal death, and its predictors among neonates admitted to neonatal intensive care units at Bahir Dar City public hospitals in northwest Ethiopia. Methods An institution-based prospective follow-up study design was conducted among 387 early neonates selected by systematic sampling between 22 February and 22 April 2023. Statistical software, Epi Data version 4.6 and Stata version 14, was used for entry and analysis, respectively. Proportional hazard assumption and model fitness were checked by the Schoenfeld residual test and the Cox-Snell residual test, respectively. Descriptive statistics, the Kaplan-Meier curve, and the life table were used to describe variables. The Cox regression analysis model was fitted to identify the predictors of early neonatal death. Result During the follow-up time, 59 (15.25%) early neonates died, with an incidence of 31.79 per 1,000 early neonate days [95% confidence interval (CI): 0.024-0.041]. The leading causes of early neonatal death were prematurity complications, asphyxia, sepsis, meconium aspiration syndrome, and necrotizing enterocolitis. The mean survival time was 2.72 days. Being born from a multigravida mother [adjusted hazard ratio (AHR) 4.34; 95% CI: 1.63-11.55], a grand multigravida mother (AHR 3.50; 95% CI: 1.12-10.95), respiratory distress syndrome (AHR 2.60; 95% CI: 1.03-6.58), birth asphyxia (AHR 7.51; 95% CI: 2.30-24.51), a small gestational age (AHR 2.05; 95% CI: 1.08-4.92), and being unable to exclusively breastfeed (AHR 3.46; 95% CI: 1.52-7.88) were significantly associated predictors for time to early neonatal death. Conclusion and recommendations The incidence of early neonatal death was high, and the mean survival time was 2.72 days. Gravidity, respiratory distress syndrome, birth asphyxia, and being unable to exclusively breastfeed were identified as predictors of early neonatal death. Therefore, future research will consist of long-term prospective follow-up studies at a multicenter, nationwide level.
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Affiliation(s)
- Abraham Dessie Gessesse
- Department of Nursing, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Minyichil Birhanu Belete
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Fikir Tadesse
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Amzat J, Aminu K, Matankari B, Ismail A, Almu B, Kanmodi KK. Sociocultural context of exclusive breastfeeding in Africa: A narrative review. Health Sci Rep 2024; 7:e2115. [PMID: 38742092 PMCID: PMC11089088 DOI: 10.1002/hsr2.2115] [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: 10/16/2023] [Revised: 04/20/2024] [Accepted: 04/27/2024] [Indexed: 05/16/2024] Open
Abstract
Background and Aims Although exclusive breastfeeding (EBF) has many benefits, it is not commonly practiced in several countries as a result of context-specific challenges. EBF practice is thus a global health discourse because over 200 million children suffer from malnutrition despite the abundance of human milk. The risk of starvation remains very high among African children with less than 40% of them exclusively breastfed. In Africa, the adoption or nonadherence to EBF is a sociocultural issue. Hence, this narrative review examined the sociocultural context of EBF in the region. Methods PubMed, Google Scholar, and Scopus were searched using keywords related to EBF and Africa. Relevant data from selected studies were synthesized narratively and reported using a structured narrative format. Results EBF is strongly rooted in every culture and is a culturally determined behavior. Some believe that colostrum is dirty and harmful to newborns and, thus, needs to be purified. Despite the belief that human milk is the best food for babies, mothers often complement human milk with other foods right from birth because of perceived lactation inadequacy. Most African mothers believe in prelacteal feeding to help cleanse the infant's gastrointestinal tract for digestion, quench thirst, flush the bladder and help the mother to rest after childbirth before breastfeeding (BF) is initiated. The role of significant others was equally found important in the decision and duration of BF. The availability of family support (especially from grandmothers and husbands) reportedly encouraged EBF in Africa. The duration and exclusivity of BF in Africa are negatively associated with demographic variables like young age, low level of education, being unmarried, low income, out of employment, and parity (first-time mother). Conclusion While there have been some efforts and policies to improve EBF, it is important to consider context-specific challenges and sociocultural factors. There is a need for more deliberate efforts to encourage mothers through the implementation of effective best practices concerning EBF in Africa.
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Affiliation(s)
- Jimoh Amzat
- Department of SociologyUsmanu Danfodiyo UniversitySokotoNigeria
- Department of SociologyUniversity of JohannesburgJohannesburgSouth Africa
| | - Kafayat Aminu
- Centre for Child and Adolescent Mental HealthUniversity College HospitalIbadanNigeria
| | | | - Abbas Ismail
- Department of SociologyUmaru Musa Yar'adua UniversityKatsinaNigeria
| | - Bello Almu
- Department of SociologyUsmanu Danfodiyo UniversitySokotoNigeria
| | - Kehinde Kazeem Kanmodi
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
- Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
- School of DentistryUniversity of RwandaKigaliRwanda
- Cephas Health Research Initiative IncIbadanNigeria
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Yismaw GA, Abuhay HW, Alemayehu MA, Derseh NM, Agimas MC, Tesfie TK. Geospatial variation of exclusive breastfeeding and its determinants among mothers of infants under 6 months in Ethiopia: spatial and geographical weighted regression analysis. BMJ Paediatr Open 2024; 8:e002573. [PMID: 38684333 PMCID: PMC11086437 DOI: 10.1136/bmjpo-2024-002573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 03/26/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Exclusive breastfeeding (EBF) is a major public health problem in Ethiopia. However, the spatial variation of EBF and the associated factors have not been studied as much as we have searched. This study aimed at assessing geospatial variation and the predictors of EBF using geographically weighted regression. METHODS A cross-sectional study was conducted using the 2019 Mini-Ethiopian Demographic and Health Survey data set. The study used a total weighted sample of 548 infants. Hotspot spatial analysis showed the hotspot and cold spot areas of EBF. The spatial distribution of EBF was interpolated for the target population using spatial interpolation analysis. SaTScan V.9.6 software was used to detect significant clusters. Ordinary least squares regression analysis identified significant spatial predictors. In geographically weighted regression analysis, the effect of predictor variables on the spatial variation of EBF was detected using local coefficients. RESULTS The weighted prevalence of EBF in Ethiopia was 58.97% (95% CI 52.67% to 64.99%), and its spatial distribution was found to be clustered (global Moran's I=0.56, p<0.001). Significant hotspot areas were located in Amhara, Tigray, Southern Nations, Nationalities, and Peoples' Region, and Somali regions, while significant cold spots were located in Dire Dawa, Addis Ababa and Oromia regions. Kulldorff's SaTScan V.9.6 was used to detect significant clusters of EBF using a 50% maximum cluster size per population. The geographically weighted regression model explained 35.75% of the spatial variation in EBF. The proportions of households with middle wealth index and married women were significant spatial predictors of EBF. CONCLUSION Middle wealth index and married women were significant spatial predictors of EBF. Our detailed map of EBF hotspot areas will help policymakers and health programmers encourage the practice of EBF in hotspot areas and set national and regional programmes focused on improving EBF in cold spots by considering significant predictor variables.
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Affiliation(s)
- Getaneh Awoke Yismaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habtamu Wagnew Abuhay
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Meron Asmamaw Alemayehu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nebiyu Mekonnen Derseh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muluken Chanie Agimas
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tigabu Kidie Tesfie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Khalid N, Zhou Z, Nawaz R. Exclusive breastfeeding and its association with intimate partner violence during pregnancy: analysis from Pakistan demographic and health survey. BMC Womens Health 2024; 24:186. [PMID: 38509533 PMCID: PMC10953127 DOI: 10.1186/s12905-024-02996-2] [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: 05/07/2023] [Accepted: 02/24/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a global social issue and increasingly asks for the attention of policymakers. IPV is one of the main factors that affect the health of pregnant women and their infants during pregnancy and after childbirth; it will not only cause direct harm to women themselves but also reduce women's exclusive breastfeeding (EBF) behavior and pose a threat to newborn health. Existing facts on the association between IPV and EBF in the Pakistani context are negligible and incomplete to an enduring measure of IPV practice. To this effect, the present study aims to investigate the relationship between EBF and IPV practiced during the prenatal period and post-delivery. METHODS The statistics study has drawn from the Pakistan Demographic and Health Survey (PDHS) 2018. A total of 1191 breastfeeding females aged 15-49 with children under 6 months were selected for the present study. T-test or chi-square test of Univariate test of hypothesis; Logistic regression model was utilized to explore the potential impact of IPV on female exclusive breastfeeding from three dimensions of physical, sexual and psychological violence, to provide data support for the Pakistani government to formulate policies to promote female EBF. All investigations have been performed in STATA software 16.0 (Stata Corp, College Station, TX, USA) at 95% confidence interval. RESULTS Among the 1191 participants, 43.6% (520 / 1191) of the females were EBF, while the rates of physical, sexual, and emotional IPV were 47.44%, 30.23%, and 51.72%, respectively. Logistic regression analysis showed that females who have experienced physical IPV were 32% less likely to be exclusively breastfed (aOR = 0.68; 95% CI; 0.490, 0.980; P < 0.05), the chances of EBF were reduced by 22% in women who experienced IPV (aOR = 0.78; 95 CI; 0.55, 1.00; P < 0.05), females who experienced emotional IPV were 31% less probable to exclusively breastfed (aOR = 0.69; 95% CI; 0.47, 0.92; P < 0.05). CONCLUSIONS This study determines the adverse effects of sexual and psychological violence on EBF practices in women. Policymakers in Pakistan should actively implement assistance programs to reduce IPV, emphasize monitoring women's experiences of IPV before and after giving birth, and encourage women to break the "culture of silence" when they experience IPV to maximize their access to assistance.
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Affiliation(s)
- Neelum Khalid
- School of Public Policy and Administration, Xi'an Jiaotong University, Shaanxi, PR China
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi'an Jiaotong University, Shaanxi, PR China.
| | - Rashed Nawaz
- School of Public Policy and Administration, Xi'an Jiaotong University, Shaanxi, PR China.
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Quebu SR, Murray D, Okafor UB. Barriers to Exclusive Breastfeeding for Mothers in Tswelopele Municipality, Free State Province, South Africa: A Qualitative Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1380. [PMID: 37628379 PMCID: PMC10453665 DOI: 10.3390/children10081380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
Despite the numerous advantages of exclusive breastfeeding (EBF), the practice remains infrequently adopted in certain countries and is also associated with context-specific obstacles. Consequently, this study explores the experiences and opinions of mothers about the barriers and support systems of exclusive breastfeeding (EBF), in a bid to promote this practice in the Tswelopele Municipality of the Free State Province of South Africa. In-depth individual, semi-structured interviews were conducted with 16 mothers, using an audio recorder after receiving their permission to record the interviews. The analysis of the collected data revealed that opinions clustered around four topics: mother-related barriers to EBF, baby-related barriers to EBF, support systems to enhance EBF, and complications caused by barriers to EBF. The findings from these themes and sub-themes imply that the maternal factor is strongly influenced by other factors regarding the success or failure of this practice. These include extreme breast discomfort, maternal illness, the fear that the mother's milk supply is insufficient, a lack of understanding about EBF, and the influence of different cultural factors. When mothers encounter difficulties with breastfeeding, these challenges may impede their ability to practice EBF. In addition, while some participants were eager to breastfeed their babies and continued EBF for a period of six months, their infant's health and behavioral issues prevented them from doing so. Some of these problems included infant sickness and crying. From the prenatal to the postnatal period, mothers and their families should have access to breastfeeding education and counseling, along with sufficient time to make informed infant nutrition decisions. During counseling sessions, conversations with these stakeholders should focus on fostering a realistic understanding regarding what to expect when breastfeeding for the very first time, debunking breastfeeding-related misconceptions, and addressing inaccurate information and concerns. In addition, health professionals must be empathic and respectful of the mother's traditions and cultures and must also educate mothers and their families on the importance of EBF. Our list of themes and sub-themes could be utilized to enlighten exclusive breastfeeding challenges and potential mitigation efforts, not only in Tswelopele Municipality, South Africa but also in a number of other geographical contexts.
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Affiliation(s)
- Simthandile Rebecca Quebu
- Department of Public Health, University of Fort Hare, 5 Oxford Street, East London 5201, South Africa;
| | - Daphne Murray
- Department of Nursing Science, University of Fort Hare, 50 Church Street, East London 5201, South Africa;
| | - Uchenna Benedine Okafor
- Faculty of Health Sciences, University of Fort Hare, 5 Oxford Street, East London 5201, South Africa
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K B C, R H, R A, G JJB, J P D, Banjara SK, M A, K PR, B N, M SP. Macronutrient composition of term and preterm human milk of different socio economic groups. Prostaglandins Leukot Essent Fatty Acids 2023; 192:102571. [PMID: 37079956 DOI: 10.1016/j.plefa.2023.102571] [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] [Received: 01/10/2023] [Revised: 03/24/2023] [Accepted: 03/29/2023] [Indexed: 04/22/2023]
Abstract
Assessment of the nutritional composition of Human Breast Milk (HBM) is important to understand its sufficiency as the sole nutrient source in infants. The present study is aimed to analyze the proximate composition along with total amino acid and fatty acid profile in term and preterm HBM of different socio economic status. This cross sectional study included, 120 lactating mothers with term or preterm gestation from maternity hospitals located in Hyderabad, Telangana. Nutritional proximate, total amino and fatty acid profiles were estimated in pooled human milk collected from each participant within the first week of postpartum. The macronutrient composition in term was similar to that of preterm breast milk. The essential amino acid Leucine was significantly high in preterm (8.91 ± 0.18) when compared to term (8.61 ± 0.23). ω-5 fatty acid Myristoleic acid was significantly high in preterm (0.14 ± 0.02) when compared to term (0.11 ± 0.02), whereas ω-6 fatty acids like Docosadienoic Acid and Eicosadienoic acid were found to be significantly high in term when compared to preterm. Further, it was also found that the mono unsaturated and ω-9 fatty acids were significantly high in lower socio economic group, whereas, poly unsaturated and ω -3 and 6 fatty acids were significantly high in upper socio economic group. The present study concludes that, nutritional composition like essential amino and fatty acids of human milk vary significantly between different gestational age as well as in socio economic groups.
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Affiliation(s)
- Chathyushya K B
- Clinical Epidemiology Division, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India
| | - Hemalatha R
- Director. ICMR-National Institute of Nutrition, Hyderabad, Telangana, India
| | - Ananthan R
- Food Chemistry Division, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India
| | - J J Babu G
- Clinical Epidemiology Division, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India
| | - Devraj J P
- Clinical Epidemiology Division, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India
| | - Santosh Kumar Banjara
- Maternal and Child Health Division, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India
| | - Alimelu M
- Department of Neonatology, Niloufer Hospital, Osmania Medical College, Hyderabad, Telangana, India
| | - Pradeep Reddy K
- Neonatology, Rainbow Children Hospital, Banjarahills, Hyderabad, Telangana, India
| | - Nitasha B
- Neonatology, Rainbow Children Hospital, Banjarahills, Hyderabad, Telangana, India
| | - Shiva Prakash M
- Former Scientist, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India.
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Dadzie B, Bayor F, Doat AR, Kappiah JB, Akayuure CA, Lamptey AA, Yakong VN, Kampo S. Investigating factors that influence the practice of exclusive breastfeeding among mothers in an urban general hospital in Ghana: a cross-sectional study. BMC Womens Health 2023; 23:24. [PMID: 36650492 PMCID: PMC9847114 DOI: 10.1186/s12905-023-02164-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/06/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND In Ghana, only 52% of mothers exclusively breastfeed their babies and the rate of increase has been steadily slow across all geographical areas of Ghana. The purpose of this study was to determine the various factors that influence exclusive breastfeeding (EBF) among mothers who visited the child welfare clinic at the Tema General Hospital, Accra, Ghana. METHODOLOGY This descriptive cross-sectional study was carried out at the Child Welfare Clinic of the Tema General Hospital, Accra, Ghana. A random sampling technique was used to recruit mothers with children between the ages of 6 months and 24 months attending the Child Welfare Clinic. Mothers were interviewed with the aid of a structured questionnaire. RESULTS Out of the 222 of mothers interviewed, 68.8% of them exclusively breastfed their infants up to 6 months. Mothers who have good knowledge were more than 3 times (AOR = 3.484, 95% CI 1.200, 10.122, P = 0.022) likely to breastfeed their children exclusively. Those who had positive attitudes towards EBF were about 4 times (COR: 4.018, 95% = 1.444, 11.181, P = 0.008) more likely to exclusively breastfeed than those who had poor attitudes towards EBF. Also, mothers whose spouses complained about EBF were about 3 times (AOR: 2.655, 95% CI 0.620, 11.365, P = 0.018) at increased odds of not exclusively breastfeeding their babies. CONCLUSIONS High rate of EBF among mothers who visited the child welfare clinic was found. The mothers' level of knowledge and attitude towards EBF significantly influenced the 6 months of EBF. Spouses also showed a high influence on whether or not mothers should exclusively breastfeed their babies.
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Affiliation(s)
- Baaba Dadzie
- School of Medicine, University of Health and Allied Sciences, Ho, Ghana
| | - Fidelis Bayor
- Department of Physiology, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | - Abdul-Razak Doat
- Department of Nursing, School of Nursing and Midwifery, C. K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | - Jamilatu B Kappiah
- Department of Nursing, School of Nursing and Midwifery, C. K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | - Collins Adombire Akayuure
- Department of Nursing, School of Nursing and Midwifery, C. K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | - Aubrey A Lamptey
- Department of Pediatric Critical Care, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis TN, Accra, Ghana
| | - Vida Nyagre Yakong
- Department of Preventive Health Nursing, School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | - Sylvanus Kampo
- Department of Nursing, School of Nursing and Midwifery, C. K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana.
- Department of Anaesthesia and Intensive Care, School of Medicine and Dentistry, C. K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana.
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Exclusive Breastfeeding and Its Determinants in Yaoundé, Cameroon: A Retrospective Survival Analysis. J Pregnancy 2022; 2022:8396586. [PMID: 36091867 PMCID: PMC9453101 DOI: 10.1155/2022/8396586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 02/11/2022] [Accepted: 08/02/2022] [Indexed: 12/05/2022] Open
Abstract
Exclusive breastfeeding (EBF) of infants for the first six months of life is a global public health goal that is linked to the reduction of morbidity and mortality in infants, especially in low middle-income countries. In low middle-income countries like Cameroon, it is realistic that compliance with EBF can significantly reduce the burden of under five mortality rate. The purpose of this study was to assess adherence and determinants influencing the duration of exclusive breastfeeding in Yaoundé, Cameroon. Data was collected through a mixed method and systematically through a retrospective survival analysis approach where a total number of 503 randomly selected individuals in Yaoundé, Cameroon, participated in the study. Data was collected between November 2019 and May 2020. A Cox proportional hazard modelling and Kaplan-Meier analysis were employed to identify prognostic factors affecting survival time defined as the duration, in months, from birth until the time of stopping EBF. The average time for nursing mothers to practice EBF was 3.61 ± 0.010 months. This study found that more than 90% of mothers were aware of the importance of compliance with EBF but only 38% practiced EBF and 62% of mothers could not adhere to EBF recommendations. Factors that influence compliance with EBF included a mother being married (HR: 0.70; 95% CI = [0.55-0.89], P =0.003) which was a protective factor while mother's tertiary education (HR: 1.43; 95% CI = [1.11-1.84], P =0.005) was a risk factor with non-compliance with EBF when compared to those with basic or no formal education. The Kaplan-Meier curve indicated that as time goes on, babies are less likely to be exclusively breastfed after a specific time period within two and three months. This implies that the chance for a baby to remain exclusively breastfed after five months is 74.3% (0.74). Continuous sensitization and enforcement measures are recommended to promote EBF.
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Wolde FB, Haidar J, Getnet Y. Employers' perceptions of breastfeeding practice of employed mothers in Addis Ababa, Ethiopia: a qualitative study. Int Breastfeed J 2022; 17:41. [PMID: 35606772 PMCID: PMC9125913 DOI: 10.1186/s13006-022-00482-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/04/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND The Ethiopian Demographic and Health Survey 2019 shows that 59% of children are exclusively breastfed for the first 6 months of life, then the rate decreases sharply with age. Nearly half of the Ethiopian labor force (46%) is comprised of women. This is encouraging since women's employment is one way of ensuring women's empowerment. However, various factors related to employment make it one of the commonly mentioned factors contributing for the low prevalence of breastfeeding. Hence, there needs to be a conducive work environment that accommodates maternal needs to not fall back from empowerment and to improve breastfeeding practice. There are not many studies in Ethiopia that focus on work environment in relation with employers' experience and their perception of breastfeeding of employed mothers. Therefore, this study aims to explore employers' experience and perception of employed mothers' breastfeeding experience in different working environments in Addis Ababa, Ethiopia. METHODS A qualitative study design using a descriptive phenomenology strategy was employed in this study and purposive sampling technique was used to recruit study participants. Data was collected between December 2016 and May 2017 in Addis Ababa city from 10 employers from private, governmental and non-governmental institutions through an in-depth interview. Thematic data analysis was performed where collected data was organized, coded and categorized into themes to give meaningful contributions to answering the research questions. RESULTS Understanding breastfeeding, current maternity leave, perception of breastfeeding supporting the conditions and mother-friendly work environment were the themes generated after analysis. Almost all employers in this study recognized the importance of breastfeeding despite their different work environments and they also acknowledged the importance of making the working environment mother-friendly for stability and motivation of employed mothers. CONCLUSIONS Providing mothers with a friendly environment is understood as a positive thing by employers. The current maternity leave of 3 months has low acceptance and both onsite childcare center and six-month maternity leave are believed to help in creating a mother-friendly work environment despite their pros and cons.
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Affiliation(s)
| | - Jemal Haidar
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yalemwork Getnet
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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Egbon OA, Belachew AM, Bogoni MA. Risk factors of concurrent malnutrition among children in Ethiopia: a bivariate spatial modeling approach. ALL LIFE 2022. [DOI: 10.1080/26895293.2022.2067251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
- Osafu Augustine Egbon
- Institute of Mathematical and Computer Sciences, University of São Paulo, São Carlos, Brazil
- Department of Statistics, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Asrat Mekonnen Belachew
- Institute of Mathematical and Computer Sciences, University of São Paulo, São Carlos, Brazil
- Department of Mathematics, Ambo University, Ambo, Ethiopia
| | - Mariella Ananias Bogoni
- Institute of Mathematical and Computer Sciences, University of São Paulo, São Carlos, Brazil
- Department of Statistics, Universidade Federal de São Carlos, São Carlos, Brazil
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Cheikh Ismail L, Al Dhaheri AS, Ibrahim S, Ali HI, Chokor FAZ, O’Neill LM, Mohamad MN, Kassis A, Ayesh W, Kharroubi S, Hwalla N. Nutritional status and adequacy of feeding Practices in Infants and Toddlers 0-23.9 months living in the United Arab Emirates (UAE): findings from the feeding Infants and Toddlers Study (FITS) 2020. BMC Public Health 2022; 22:319. [PMID: 35168591 PMCID: PMC8848814 DOI: 10.1186/s12889-022-12616-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/20/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Infant and young child feeding practices (IYCF) impact the early and later health status of the population. Limited data is available regarding IYCF in the United Arab Emirates (UAE). This study aimed to evaluate the nutritional status and adequacy of feeding practices, energy, food, and nutrient intakes of UAE infants and toddlers ages 0-23.9 months. METHODS This study is a population-based cross-sectional survey of 276 infants and toddlers aged 0-23.9 months of which 180 were nationals and 96 were Arab non-nationals living in the UAE. Data were collected from the three major emirates: Abu Dhabi, Dubai, and Sharjah. Anthropometry was collected and assessed using WHO Anthro-Survey Analyzer, and a multicomponent age-specific questionnaire was used to evaluate IYCF and sociodemographic characteristics. Usual intake of energy, micronutrients, and macronutrients, including supplements, were collected using multiple-pass 24-h dietary recall and analyzed using the PC-side software. IYCF practices were assessed using the WHO indicators. RESULTS Overall, 4% of children were malnourished, 8% wasted, 15% stunted, 18% at risk of overweight, and 7% overweight and obese. 95% of infants were ever breastfed and 37% exclusively breastfed at 6 months. Around 98% of infants had a timely introduction of complementary food. Macronutrient intake exceeded AMDR for fat, carbohydrates, and protein for 27%, 8% and 2% of toddlers respectively. As for the percentage of those exceeding the ESPGHAN cut-off for free sugars set at 5% of energy intake, 28.6% had excessive intakes overall, 10% in 0-5.9, 21.9% in 6-11.9 and 56.7% in 12-23.9 month. Usual iron intake was below the Estimated Average Requirement (EAR) in 47% of infants 6-11.9 months. Above 12 months, the usual intake of iron and vitamin D were below EAR in 11% and 49% of toddlers respectively. Usual intake exceeded the tolerable upper intake levels (UL) for vitamin A (14 to 18%) and zinc (11 to 22%) across all ages. Approximately 93% of toddlers ages 12-23.9 months did not meet food groups' recommendations for vegetables, 87% for fruits, 48% for milk/dairy, 54% for lean meat and beans, and 33% for grains. CONCLUSIONS This study revealed that a high percentage of infants and toddlers aged 0-23.9 m suffer from a double burden of malnutrition, which is the coexistence of both undernutrition, and overweight and obesity in the same population. In addition to suboptimal feeding practices and inadequate/overconsumption of various nutrients. The findings highlight the need for the development of culturally specific programs aiming to improve the nutritional status of infants and toddlers in the UAE.
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Affiliation(s)
- Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, 27272 United Arab Emirates
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, OX1 2JD UK
| | - Ayesha S. Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, 15551 United Arab Emirates
| | - Sarah Ibrahim
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut, Lebanon
| | - Habiba I. Ali
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, 15551 United Arab Emirates
| | - Fatima Al Zahraa Chokor
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut, Lebanon
| | - Lynda M. O’Neill
- Nestlé Institute of Health Sciences, Nestlé Research Center, Société des Produits Nestlé S.A., Vers-chez-les-Blanc, 1000, 26 Lausanne, Switzerland
| | - Maysm N. Mohamad
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, 15551 United Arab Emirates
| | - Amira Kassis
- Whiteboard Nutrition Science, Beaconsfield, Quebec, Canada
| | - Wafaa Ayesh
- Public Health Protection Department, Dubai Health Authority, Dubai, United Arab Emirates
| | - Samer Kharroubi
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut, Lebanon
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, Beirut, Lebanon
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Tulelo PM, Mulaudzi FM. Indigenous neonatal feeding and bathing practices of caregivers in Vhembe District, Limpopo province. Health SA 2021; 26:1632. [PMID: 34917404 PMCID: PMC8661288 DOI: 10.4102/hsag.v26i0.1632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 09/15/2021] [Indexed: 11/30/2022] Open
Abstract
Bac kground Caregivers are offered health information on neonatal care before they are discharged from the healthcare facilities after giving birth. However, they continue to feed and bath neonates in ways that are informed by indigenous traditions. Notably, these ways include the provision of supplementary feeds before 6 months and bathing the neonate as early as possible, which are practices that contradict the World Health Organization (WHO) recommendations of neonatal care. Objectives This study aimed to explore and describe the indigenous neonatal feeding and bathing practices of caregivers in Vhembe District, Limpopo province. Setting This study was conducted in Limpopo province at Vhembe District, Makhado Municipality. Methodology A qualitative, explorative and descriptive enquiry was used to conduct 18 semi-structured individual interviews to explore and describe their indigenous neonatal feeding and bathing practices. Purposive and snowball sampling methods were used to select participants. Creswell’s method of data analysis was used to analyse data. Ethical principles were maintained. Results Two themes with sub-themes resulted from data analysis presenting indigenous neonatal feeding practices and indigenous neonatal bathing practices. Conclusion This study revealed that caregivers use indigenous neonatal feeding and bathing practices across age groups and social standing. Younger mothers receive guidance from older women in their families or community. Midwives should know the indigenous neonatal feeding and bathing practices of the communities they serve to offer relevant culture-sensitive health education. Contributions This study contributes to the creation of knowledge about indigenous neonatal care practices amongst mothers and caregivers.
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Affiliation(s)
- Patience M Tulelo
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Appiah PK, Amu H, Osei E, Konlan KD, Mumuni IH, Verner ON, Maalman RSE, Kim E, Kim S, Bukari M, Jung H, Kofie P, Ayanore MA, Amenuvegbe GK, Adjuik M, Tarkang EE, Alhassan RK, Donkor ES, Zotor FB, Kweku M, Amuna P, Gyapong JO, Kim SY. Breastfeeding and weaning practices among mothers in Ghana: A population-based cross-sectional study. PLoS One 2021; 16:e0259442. [PMID: 34767566 PMCID: PMC8589154 DOI: 10.1371/journal.pone.0259442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 10/19/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Children need good nutrition to develop proper immune mechanisms and psychosocial maturity, but malnutrition can affect their ability to realize this. Apart from the national demographic and health survey, which is carried out every 5 years, there have not been enough documented studies on child breastfeeding and weaning practices of caregivers in the Volta Region. We, therefore, examined child breastfeeding and weaning practices of mothers in the Volta Region of Ghana. METHODS A sub-national survey method was adopted and a semi-structured questionnaire was used to collect data from 396 mothers and their children. Descriptive and inferential statistics comprising frequency, percentage, chi-square, and logistic regression were employed in analysing the data. We defined exclusive breastfeeding as given only breast milk to an infant from a mother or a wet nurse for six months of life except drops or syrups consisting of vitamins, minerals, supplements, or medicines on medical advice, and prolonged breastfeeding as breastfeeding up to 24 months of age. RESULTS The prevalence of exclusive breastfeeding (EBF) was 43.7%. Mothers constituting 61.1% started breastfeeding within an hour of giving birth. In addition to breast milk, 5.1% gave fluids to their children on the first day of birth. About 66.4% started complementary feeding at 6 months, 22.0% breastfed for 24 months or beyond, while 40.4% fed their children on-demand. Child's age (AOR: 0.23, 95% CI:0.12-0.43, p<0.0001), prolonged breastfeeding (AOR: 0.41, 95%CI: 0.12-0.87, p = 0.001), mother's religion (AOR: 3.92, 95%CI: 1.23-12.61, p = 0.021), feeding practices counselled on (AOR: 1.72, 95%CI: 1.96-3.09, p = 0.023), mother ever heard about EBF (AOR: 0.43, 95%CI: 1.45-2.41, p = 0.039), child being fed from the bottle with a nipple (AOR: 1.53, 95%CI: 1.94-2.48, p = 0.003), and age at which complementary feeding was started (AOR: 17.43, 95%CI: 3.47-87.55, p = 0.008) were statistically associated with EBF. CONCLUSION Breastfeeding education has been ongoing for decades, yet there are still gaps in the breastfeeding practices of mothers. To accelerate progress towards attainment of the sustainable development goal 3 of ensuring healthy lives and promoting well-being for all at all ages by the year 2030, we recommend innovative policies that include extensive public education to improve upon the breastfeeding and weaning practices of mothers.
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Affiliation(s)
- Prince Kubi Appiah
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
- Department of Medical Law and Ethics, Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, Republic of Korea
- * E-mail:
| | - Hubert Amu
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Eric Osei
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
- Department of Public Health, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Kennedy Diema Konlan
- School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
- College of Nursing, Yonsei Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Iddris Hadiru Mumuni
- School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | | | | | - Eunji Kim
- Korea Foundation for International Healthcare Ghana Office, Accra, Ghana
| | - Siwoo Kim
- Department of Medical Law and Ethics, Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Mohammed Bukari
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Hajun Jung
- Department of Medical Law and Ethics, Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Philip Kofie
- Yonsei University - University of Health and Allied Sciences Partnership Project Office, Ho, Ghana
| | | | | | - Martin Adjuik
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | | | - Robert Kaba Alhassan
- Directorate of International Affairs, University of Health and Allied Sciences, Ho, Ghana
| | | | - Francis Bruno Zotor
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Margaret Kweku
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Paul Amuna
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - John Owusu Gyapong
- Office of the Vice-Chancellor, University of Health and Allied Sciences, Ho, Ghana
| | - So Yoon Kim
- Department of Medical Law and Ethics, Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, Republic of Korea
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Kim S, Park M, Ahn S. The Impact of Antepartum Depression and Postpartum Depression on Exclusive Breastfeeding: A Systematic Review and Meta-Analysis. Clin Nurs Res 2021; 31:866-880. [PMID: 34719979 DOI: 10.1177/10547738211053507] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to systematically review the impact of antepartum depression on exclusive breastfeeding. A total of 15 studies were included in the review and 12 studies were used for the meta-analysis. The mean values of antepartum depression indicated that women who breastfed exclusively between 3 and 6 months had less antepartum depression symptoms (Mean Difference = -0.55, 95% CI = -0.76 to -0.35). The analysis also showed that the existence of antepartum depression was negatively related to continuing exclusive breastfeeding for longer than 3 months postpartum as well as for 8 weeks postpartum (OR = 0.48, 95% CI = 0.26-0.88 and OR = 0.83, 95% CI = 0.75-0.91, respectively). The cumulative evidence is conclusive that antepartum depressive symptoms are negatively associated with exclusive breastfeeding, particularly between 3 and 6 months postpartum. This review supports the necessity of screening and follow-up for depression throughout the perinatal period to promote exclusive breastfeeding for 6 months.
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Affiliation(s)
- Sehee Kim
- Chungnam National University, Daejeon, Republic of Korea
| | - Mihyeon Park
- Chungnam National University, Daejeon, Republic of Korea
| | - Sukhee Ahn
- Chungnam National University, Daejeon, Republic of Korea
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El-Asheer OM, Darwish MM, Abdullah AM, Mohamad HA. Complementary feeding pattern and its impact on growth and development of under 2-years infants in upper Egypt. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2021. [DOI: 10.1186/s43054-021-00061-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Exclusive BF till the age of 6 months is rare in developing countries and complimentary feeding (CF) are introduced at an early age which is linked to the development of chronic conditions such as childhood obesity, celiac disease, diabetes, and eczema. The aim of our work is to assess complementary feeding practices of infants under the age of 2 years and to study their impact on their growth and development. This study is a cross-sectional study that was carried out over 3 years between March 2016 and March 2019, included 1000 apparently healthy infants aged less than 2 years old who attended University Children Hospital, Egypt. Practices among mothers including timing and types of foods introduced. Semi-structured questionnaire used for data collection and anthropometric measurements analyzed following the WHO Growth Charts.
Results
The study found that about 80% of infants were introduced to solid foods before 4 months of age. Also, a large number of infants were given liquids other than breast milk before completing their fourth month of age.
Conclusion
Despite the better mental development of the infants, there is a considerable gap between WHO Guiding Principles for Complementary Feeding and the practices among mothers of infants aged less than 2 years in Egypt.
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A. Alwabr G, A. Alwabr N. Nutritional status of children under five years of age and factors associated in rural areas of Sana'a Governorate, Yemen. CHRISMED JOURNAL OF HEALTH AND RESEARCH 2021. [DOI: 10.4103/cjhr.cjhr_95_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lopez-Peña N, Cervera-Gasch A, Valero-Chilleron MJ, González-Chordá VM, Suarez-Alcazar MP, Mena-Tudela D. Nursing student's knowledge about breastfeeding: Design and validation of the AprendeLact questionnaire. NURSE EDUCATION TODAY 2020; 93:104539. [PMID: 32717699 DOI: 10.1016/j.nedt.2020.104539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 05/29/2020] [Accepted: 07/14/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Breastfeeding is the best source of food that a mother can offer her child during the first months of life because it provides numerous benefits for both mother and baby. Despite breastfeeding being an innate act, it requires qualified health professionals for advice and support. OBJECTIVES AND PARTICIPANTS To design and validate a questionnaire to evaluate nursing student breastfeeding knowledge. METHODS AND DESIGN Cross-sectional study. Construction and validation of the questionnaire (content validity, test-retest reliability and internal consistency). Descriptive and bivariate analyses of socio-demographic variables and the questionnaire results. RESULTS Optimum results were obtained in terms of internal consistency (KR-20 = 0.9) and test-retest reliability (ICC = 0.925) with a samples of 144 participants (mean age of 22.69 years). Statistical significance were observed among the questionnaire score and academic year, clinical practice, type of breastfeeding in childhood, knowing about support groups and participating in a breastfeeding workshop or course. CONCLUSION A questionnaire on breastfeeding knowledge was validated. Nursing students progressively acquire breastfeeding skills as they advance in their undergraduate studies.
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Affiliation(s)
- Natividad Lopez-Peña
- Nursing Department, Univesitat Jaume I, Avda Sos Baynat s/n, 12071 Castellón, Spain.
| | - Agueda Cervera-Gasch
- Nursing Department, Univesitat Jaume I, Avda Sos Baynat s/n, 12071 Castellón, Spain.
| | | | | | | | - Desirée Mena-Tudela
- Nursing Department, Univesitat Jaume I, Avda Sos Baynat s/n, 12071 Castellón, Spain.
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Cessation of Exclusive Breastfeeding and Determining Factors at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Int J Pediatr 2020; 2020:8431953. [PMID: 32256615 PMCID: PMC7109560 DOI: 10.1155/2020/8431953] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 01/02/2020] [Accepted: 03/02/2020] [Indexed: 12/21/2022] Open
Abstract
Background Exclusive breastfeeding (EBF) is the gold standard of infant feeding practice which lasts up to 6 months postpartum. Not all infants are exclusively breastfed in developing countries, including Ethiopia. This study, therefore, assessed the magnitude and determining factors of EBF cessation practice among mothers at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Method Institutional-based cross-sectional study design using a systematic random sampling technique was applied to select 344 mothers of infants aged 9 months came for measles vaccination. Pretested structured questionnaire was used to collect the data. Data were entered, cleaned, and analyzed by using SPSS version 21. Independent variables with a P value of <0.05 indicated association. Result The magnitude of cessation of EBF was 21.5% with 95% CI (17.24-25.76). Maternal age ≤ 19 years [AOR = 5.53; 95% CI (1.07-28.57)], civil servants [AOR = 4.73; 95% CI (2.20-10.19)], illiterate husbands [AOR = 3.76; 95% CI (1.13-12.49)], primi-para [AOR = 2.42; 95% CI (1.22-4.79)], no postnatal follow up [AOR = 2.62; 95% CI (1.44-4.80)], and having poor knowledge on breastfeeding benefits and composition of breastmilk [AOR = 3.15; 95% CI (1.56-6.35)] were independent factors significantly associated with cessation of EBF. Conclusion and recommendation. The magnitude of cessation of EBF was high. Maternal age, parity, employment status, postnatal follow-up, and breastfeeding knowledge as well as spouse literacy level were independent factors significantly associated with cessation of EBF. Our study provides further impetus for empowering young and primi-para with breastfeeding knowledge, an extension of maternity leave time, and support for breastfeeding at the workplace.
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Gabriel AA, Bayaga CLT, Magallanes EA, Aba RPM, Tanguilig KMN. Fates of pathogenic bacteria in time-temperature-abused and Holder-pasteurized human donor-, infant formula-, and full cream cow's milk. Food Microbiol 2020; 89:103450. [PMID: 32138997 DOI: 10.1016/j.fm.2020.103450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 01/29/2020] [Accepted: 01/30/2020] [Indexed: 11/19/2022]
Abstract
This study was conducted to address the dearth in works that simultaneously compare the growth and inactivation behaviors of selected pathogens in different milk products. In worst-case scenarios where hygienic practices are absent and heavy microbiological contaminations occur, Salmonella enterica, Escherichia coli O157:H7, Listeria monocytogenes, Pseudomonas aeruginosa, and Staphylococcus aureus multiplied in all samples at room temperature (27 °C). Most organisms readily proliferated with growth lag (tlag) values ranging from 0.00 to 5.95 h. Growth rates (KG) ranged from 0.16 to 0.67 log CFU/h. Sanitary risk times (SRTs) for a 1-log population increase ranged from 1.85 to 6.27 h, while 3.69-12.55 h were the SRTs determined for 2-log population increase. Final populations (Popfin) ranged from 7.11 to 9.36 log CFU/mL. Inactivation in heavily contaminated milk during Holder pasteurization revealed biphasic inactivation behavior with total log reduction (TLR) after exposure to 62.5 °C for 30 min ranging from 1.91 (90.8%) to 6.00 (99.9999%). These results emphasize the importance food safety systems in the handling of milk and milk products during manufacture and preparation.
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Affiliation(s)
- Alonzo A Gabriel
- Laboratory of Food Microbiology and Hygiene, Department of Food Science and Nutrition, College of Home Economics, Alonso Hall, A. Ma. Regidor Street, University of the Philippines Diliman, 1101, Quezon City, Philippines.
| | - Cecile Leah T Bayaga
- Breastmilk Research Laboratory, Department of Food Science and Nutrition, College of Home Economics, University of the Philippines Diliman, Philippines
| | - Eiric A Magallanes
- Laboratory of Food Microbiology and Hygiene, Department of Food Science and Nutrition, College of Home Economics, Alonso Hall, A. Ma. Regidor Street, University of the Philippines Diliman, 1101, Quezon City, Philippines
| | - Richard Paolo M Aba
- Laboratory of Food Microbiology and Hygiene, Department of Food Science and Nutrition, College of Home Economics, Alonso Hall, A. Ma. Regidor Street, University of the Philippines Diliman, 1101, Quezon City, Philippines
| | - Karen May N Tanguilig
- Laboratory of Food Microbiology and Hygiene, Department of Food Science and Nutrition, College of Home Economics, Alonso Hall, A. Ma. Regidor Street, University of the Philippines Diliman, 1101, Quezon City, Philippines
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O'Neill LM, Dwyer JT, Bailey RL, Reidy KC, Saavedra JM. Harmonizing Micronutrient Intake Reference Ranges for Dietary Guidance and Menu Planning in Complementary Feeding. Curr Dev Nutr 2020; 4:nzaa017. [PMID: 32161844 PMCID: PMC7059853 DOI: 10.1093/cdn/nzaa017] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 01/29/2020] [Accepted: 01/31/2020] [Indexed: 01/21/2023] Open
Abstract
There are no published harmonized nutrient reference values for the complementary feeding period. The aim of the study was to develop proposals on adequate and safe intake ranges of micronutrients that can be applied to dietary guidance and menu planning. Dietary intake surveys from 6 populous countries were selected as pertinent to the study and reviewed for data on micronutrients. The most frequently underconsumed micronutrients were identified as iron, zinc, calcium, magnesium, phosphorus, potassium, and vitamins A, B6, B12, C, D, E, and folate. Key published reference values for these micronutrients were identified, compared, and reconciled. WHO/FAO values were generally identified as initial nutrient targets and reconciled with nutrient reference values from the Institute of Medicine and the European Food Standards Authority. A final set of harmonized reference nutrient intake ranges for the complementary feeding period is proposed.
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Affiliation(s)
| | - Johanna T Dwyer
- Tufts University School of Medicine and Friedman School of Nutrition Science and Policy, Boston, MA, USA
| | - Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | | | - Jose M Saavedra
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Nigatu D, Azage M, Motbainor A. Effect of exclusive breastfeeding cessation time on childhood morbidity and adverse nutritional outcomes in Ethiopia: Analysis of the demographic and health surveys. PLoS One 2019; 14:e0223379. [PMID: 31577821 PMCID: PMC6774524 DOI: 10.1371/journal.pone.0223379] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 09/19/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Though exclusive breastfeeding (EBF) for the first six months is recommended, it remains a debatable issue in both developed and developing countries. Thus, this study investigated the effect of EBF cessation time on childhood morbidity and adverse nutritional outcome in Ethiopia. METHODS We used the 2011 and 2016 Ethiopian Demographic and Health Surveys. The study involved 2,433 children under six months of age. Logistic regression model was applied to determine the effect of EBF cessation time on outcome variables. Population Attributable Fraction was calculated to evaluate the public health impacts of EBF termination in the population. RESULTS Discontinuing EBF at 0-3 months (adjusted odds ratio (AOR): 1.95, 95% confidence interval (CI): 1.08, 3.53)) and 4-6 months (AOR: 3.57, 95% CI: 2.19, 5.83) increased diarrhea occurrence compared to children who continued EBF up to 6 months. Children who had terminated EBF at 4-6 months had increased odds of fever (AOR: 1.73, 95% CI: 1.11, 2.68) and acute respiratory illnesses (ARIs) (AOR: 2.74, 95% CI: 1.61, 4.65). Cessation of EBF earlier than 4 months or between 4-6 months was associated with increased odds of having at least one childhood morbidity. Termination of EBF at 0-3 months and at 4-6 months were associated with increased occurrence of wasting (AOR: 2.32, 95% CI: 1.45, 3.74) and underweight (AOR: 2.30, 95% CI: 1.36, 3.91), respectively. Exclusive breastfeeding can avert 42% of diarrhea, 27% of ARI, 21% of fever, 26% of wasting and 23% of underweight burden among children under six months of age. CONCLUSIONS Termination of EBF before six months was associated with increased occurrence of diarrhea, fever and ARIs. It was also linked with increased occurrence of childhood wasting and underweight. The finding emphasized EBF for the first six months to reduce childhood morbidity and adverse nutritional outcomes.
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Affiliation(s)
- Dabere Nigatu
- Department of Reproductive Health and Population Studies, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Muluken Azage
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Achenef Motbainor
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Impact of Maternal Diet on Human Milk Composition Among Lactating Women in Latvia. ACTA ACUST UNITED AC 2019; 55:medicina55050173. [PMID: 31137596 PMCID: PMC6572110 DOI: 10.3390/medicina55050173] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/24/2019] [Accepted: 05/16/2019] [Indexed: 12/15/2022]
Abstract
Background and objectives: Many studies indicate that the maternal diet is an important factor affecting human milk composition. Human milk composition among lactating women in Latvia, as well as the maternal diet during lactation, has not been sufficiently studied. The aim of this research was to assess dietary habits and macronutrient intake among lactating women in Latvia and to examine the effect of diet on human milk composition. Materials and Methods: Research was conducted between November 2016 and December 2017. Mature human milk samples (n = 61) along with a 72h food diary, a food frequency questionnaire (FFQ), and a questionnaire about maternal and infant characteristics were obtained from voluntary women who were recruited via an invitation published in a social media member group for nursing mothers. Fat content in human milk was determined by LVS ISO 2446:2008, protein content was determined by LVS EN ISO 8968-1:2014, lactose was determined by ISO 22662:2007, and the fatty acid profile was analyzed using gas chromatography. Dietary data were evaluated using the Finnish food composition database Fineli, release 19 (3 March 2018). Results: Median values for fat, protein, and lactose in mature human milk were 4.40%, 1.08%, and 6.52%, respectively. Predominant fatty acids in human milk were oleic acid (C18:1 n9c), palmitic acid (C16:0), and linoleic acid (C18:2 n6c) at 34.60%, 24.00%, and 11.00% of total fatty acids, respectively. The trans elaidic acid (C18:1 n9t) level was <0.10% in all human milk samples. Significant, positive associations (p < 0.05) were found between maternal dietary intake of linoleic, α-linolenic, docosahexaenoic, total cis-monounsaturated, total cis-polyunsaturated, and total n-6 and n-3 polyunsaturated fatty acids, the ratio of n-6/n-3, and the level of these fatty acids in human milk. Total energy and carbohydrate intake among participants were lower, but total fat, saturated fat, and sugar intake were higher than recommended. Protein, linoleic acid, and α-linolenic acid intake were adequate, but docosahexaenoic acid intake was noticeably lower than recommended. Women should be supported with information regarding their nutritional needs during lactation and the possible impact of diet on human milk composition. Conclusion: Macronutrient (fat, protein, and lactose) content in human milk is not affected by maternal diet. Conversely, the human milk fatty acid profile is affected by the immediate diet consumed by the mother. Habitual dietary habits can also impact the fatty acid profile of human milk.
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Mahesh PKB, Gunathunga MW, Arnold SM, Jayasinghe C, Pathirana S, Makarim MF, Manawadu PM, Senanayake SJ. Effectiveness of targeting fathers for breastfeeding promotion: systematic review and meta-analysis. BMC Public Health 2018; 18:1140. [PMID: 30249216 PMCID: PMC6154400 DOI: 10.1186/s12889-018-6037-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 09/13/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Further research gaps exist in relation to the promotion of breastfeeding. Robust scientific evidence obtained by a meta-analysis would provide objectively summarized data while enabling the assessment of consistency of findings. This review includes the first documented meta-analysis done on the effectiveness of targeting fathers for promoting breastfeeding (BF). Assessments have been done for a primary outcome and for six more secondary outcomes. METHODS PubMed, EMBASE, Google Scholar, CENTRAL databases and unpublished researches were searched. Selections of randomized-controlled trials and quasi-experimental studies were done in three rounds. Heterogeneity and potential publication bias were assessed. Eight studies were included in meta-analysis and others in narrative synthesis of the outcomes. Pooling was done with the Mental- Haenszel method using risk ratio (RR). Summary-of-Findings table was composed by Review-Manager (version 5.3) and GRADEproGDT applications. Subsequent sensitivity analysis was done. RESULTS Selected eight interventional studies included 1852 families. Exclusive BF at six months was significantly higher (RR = 2.04, CI = 1.58-2.65) in the intervention groups. The RR at 4 months was 1.52 (CI = 1.14 to 2.03). Risk of full-formula-feeding (RR = 0.69, CI = 0.52-0.93) and the occurrence of lactation-related problems were lower in the intervention groups (RR = 0.24, CI = 0.10-0.57). More likelihood of rendering support in BF-related issues was seen in intervention groups (RR = 1.43, CI = 1.22-1.68). Increase of maternal knowledge and favorable attitudes on BF were higher in the intervention groups (P ≤; 0.001). The quality of evidence according to GRADE was "low" (for one outcome), "moderate" (for four outcomes), and "high" (for two outcomes). CONCLUSIONS Targeting fathers in promotion of BF has provided favorable results for all seven outcomes with satisfactory quality of evidence. This review was registered in the PROSPERO-registry (ID: 2017-CRD42017076163) prior to its commencement.
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Does Kangaroo care affect the weight of preterm/low birth-weight infants in the neonatal setting of a hospital environment? ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.jnn.2017.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Coomson JB, Aryeetey R. Perception and practice of breastfeeding in public in an urban community in Accra, Ghana. Int Breastfeed J 2018; 13:18. [PMID: 29796057 PMCID: PMC5960163 DOI: 10.1186/s13006-018-0161-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 04/23/2018] [Indexed: 01/06/2023] Open
Abstract
Background Reported stigmatization and confrontation (verbal and aggressive), of women when breastfeeding in public spaces constitutes a barrier to the recommendation to breastfeed infants on demand. While such stigma of breastfeeding in public has been reported more commonly in Western country media, there is no documented evidence of this stigma in developing country settings. The current study describes community perception and experience of breastfeeding in public in Accra, Ghana. A secondary objective is to explore factors associated with breastfeeding in public. Methods A mixed methods design comprising a survey (n = 300), five Focus Group Discussions (FGD) with lactating women (n = 50), and nine In-Depth Interviews (IDI) with adult males (n = 5) and female health workers (n = 4) were also conducted. All data were collected between May and June, 2016 in the Ayawaso-West Sub-Metropolis, Accra. Data on sociodemographic characteristics; obstetric and breastfeeding history; and also perception, experience, and practice of breastfeeding in public, were collected. FGDs and IDI data were triangulated with survey data and presented using descriptive and analytical statistics and content analysis. Results Majority of the survey respondents (92%) reported ever practicing breastfeeding in public. However, some reported feeling uncomfortable (52%), embarrassed (27%), or stigmatized (15%). Nevertheless, 72% of respondents felt they should be able to breastfeed anywhere. Almost all respondents (81%) reported covering their breasts when breastfeeding in public, and 70% felt private places should be used when they breastfed in public. Women in FGDs and IDI mentioned that they bottle feed their children in public places as a way to overcome the challenges of breastfeeding in public. Otherwise, they breastfeed in public because their children need to feed. Women were more likely to breastfeed in public if they reported support from a spouse (OR 3.99, 95% CI 1.50, 10.57) or other family members (OR 3.27, 95% CI 1.31, 8.18). Conclusions Although women reported discomfort associated with breastfeeding in public, the practice is common. Awareness creation is needed to empower women to comfortably breastfeed and to sustain societal support of breastfeeding in public.
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Affiliation(s)
| | - Richmond Aryeetey
- School of Public Health, University of Ghana, P.O. Box LG 13, Legon, Accra Ghana
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Common gastrointestinal distress among infants: Role of optimal nutritional interventions. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2018. [DOI: 10.1016/j.cegh.2017.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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