1
|
Suglo M, Kpekura S, Yiryuo L. Breastfeeding challenges among adolescent mothers: a phenomenological study at the Korle Bu Teaching Hospital in Ghana. BMJ Open 2024; 14:e077504. [PMID: 38950996 PMCID: PMC11218013 DOI: 10.1136/bmjopen-2023-077504] [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: 07/07/2023] [Accepted: 05/30/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND The natural and best approach to give newborns the nutrients they need for healthy growth and development is through breast feeding. Breastfeeding rates fall more sharply with time for mothers under the age of 20 years. AIM This study sought to explore the challenges experienced by adolescent mothers who visit the department of obstetrics and gynaecology of Korle Bu Teaching Hospital in Ghana. METHOD This study employed a qualitative phenomenology design and collected data from adolescent mothers. Data were gathered with the aid of a semistructured in-depth interview guide from 13 breastfeeding adolescent mothers. Data for the study were analysed using content analysis. The study was conducted at the obstetrics and gynaecology department of Korle Bu Teaching Hospital, Ghana. FINDINGS Two major themes were generated from the study to be the challenges that confront adolescent breastfeeding mothers, and they are maternal factors of breastfeeding barriers and societal factors of breastfeeding barriers. Subcategories were generated for both themes during the process. CONCLUSION AND RECOMMENDATION Training of pregnant adolescents during antenatal care visits on how to manage the inability to lactate, breastfeeding stress, painful and sore nipple, engorged breast, stigma from society will lessen their burden. Furthermore, training close family members and friends on how to be kind and support adolescent mothers during breast feeding is important. In-service training should be organised for health workers to enhance their knowledge and practice of approaching and guiding adolescent mothers on effective breast feeding and the provision of cubicles in public places where adolescent mothers can comfortably breastfeed.
Collapse
Affiliation(s)
- Mavis Suglo
- Neonatal Intensive Care. P. O. Box 16, Tamale Teaching Hospital, Tamale, Ghana
| | - Stephen Kpekura
- Department of Nursing and Preventive, C. K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | - Lilian Yiryuo
- Department of Pediatrics, St. Joseph's Hospital, P. O. Box 3, Ghana Health Service, Jirapa, Ghana
| |
Collapse
|
2
|
Kushwaha A, Jacob AM. Fathers' Attitudes Toward Mothers with Infants and its Association with Exclusive Breastfeeding in a Rural Community of Karnataka. Indian J Community Med 2024; 49:433-437. [PMID: 38665438 PMCID: PMC11042123 DOI: 10.4103/ijcm.ijcm_422_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/03/2023] [Indexed: 04/28/2024] Open
Abstract
Male participation in reproductive and child health improves breastfeeding rates. The role of fathers in breastfeeding may be crucial in improving exclusive breastfeeding (EBF) rates. This study explored the fathers' attitudes and support and its association with EBF in mothers with infants attending a rural primary health center in Karnataka. A cross-sectional descriptive study was conducted on mothers with infants visiting a rural primary health center between December 2020 and February 2021. A pretested semi-structured questionnaire was used to collect data to ascertain the exclusivity of breastfeeding and other sociodemographic factors. The fathers' attitudes and support toward mothers during and after pregnancy were measured on a 5-point Likert scale. Quantitative variables were expressed in median and interquartile ranges, and qualitative variables were expressed using percentages and proportions. The association was determined using the Chi-square test and Spearman's correlation test. The data were collected using Epi Data and analyzed using Epi info v 3. A total of 169 mothers participated in the study. The self-reported EBF was 148 (87.1%). The fathers' attitudes and support to the mothers were found to be more favorable during the antenatal period in 97% of the women. The fathers' attitudes and support in the antenatal period and after delivery were not associated with the mothers' exclusivity in breastfeeding. The present study concluded that there is no association between the fathers' attitudes and support before and after the delivery of the infant and mothers' exclusivity in breastfeeding.
Collapse
Affiliation(s)
- Anupriya Kushwaha
- Department of Community Medicine, KS Hegde Medical Academy (Nitte Deemed to be University), Nityanandanagar P.O., Derlakatte, Mangalore, Karnataka, India
| | - Ankeeta Menona Jacob
- Department of Community Medicine, KS Hegde Medical Academy (Nitte Deemed to be University), Nityanandanagar P.O., Derlakatte, Mangalore, Karnataka, India
| |
Collapse
|
3
|
Mgongo M, Ickes SB, Leyaro BJ, Mboya IB, Grounds S, Seiger ER, Hashim TH, Conklin JL, Kimani-Murage EW, Martin SL. Early Infant Feeding Practices among Women Engaged in Paid Work in Africa: A Systematic Scoping Review. Adv Nutr 2024; 15:100179. [PMID: 38246350 PMCID: PMC10877690 DOI: 10.1016/j.advnut.2024.100179] [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: 06/16/2023] [Revised: 01/05/2024] [Accepted: 01/14/2024] [Indexed: 01/23/2024] Open
Abstract
Around the world, paid work without appropriate structural support is a key barrier to optimal breastfeeding practices. To better protect, promote, and support optimal breastfeeding practices among working women in Africa, this scoping review sought to understand how paid work influences infant feeding practices in the first 6 mo of life and what support women need to manage work and optimal infant feeding practices. We systematically searched PubMed, Scopus, Global Health, and CINAHL Plus, screened 2436 abstracts, and reviewed 322 full-text articles using Covidence for review and charting. We identified 203 articles that met the inclusion criteria. We identified 32 quantitative, 10 qualitative, 3 mixed-methods, and 2 review articles that focused on examining the relationship between work and breastfeeding, and 109 quantitative, 22 qualitative, 21 mixed-methods, and 4 review articles that included work as part of broader breastfeeding research but did not focus on work. Most studies reported a significant negative association between work and exclusive breastfeeding. Three major domains were reported in the qualitative studies: challenges to managing work and infant feeding, receiving support from employers and family members/caregivers, and strategies for feeding infants when the mother is working. Reviewed studies proposed recommendations to increase support for breastfeeding through changes to policies and support within worksites, the health system, and childcare; however, evidence of previously implemented policies or programs is limited. We recommend more consistent definitions and measurement of women's work. Future research is needed on the impact of implementing various strategies and benefits for breastfeeding at workplaces, as well as efforts to support breastfeeding among informal workers.
Collapse
Affiliation(s)
- Melina Mgongo
- Institute of Public Health, Department of Community and Global Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania; Better Health for the African Mother and Child, Moshi, Tanzania.
| | - Scott B Ickes
- Department of Biological and Health Sciences, Wheaton College, Wheaton, IL, United States; Kenya Medical Research Institute, Nairobi, Kenya; Program in Nutritional Sciences, and Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States; Department of Kinesiology and Health Sciences, William and Mary, WIlliamsburg, VA, United States
| | - Beatrice J Leyaro
- Institute of Public Health, Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
| | - Innocent B Mboya
- Institute of Public Health, Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania; Department of Translational Medicine, Lund University, Malmo, Sweden
| | - Samantha Grounds
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Emily R Seiger
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Tamara H Hashim
- Institute of Public Health, Department of Community and Global Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
| | - Jamie L Conklin
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Stephanie L Martin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| |
Collapse
|
4
|
Oduro MS, Iddi S, Asiedu L, Asiki G, Kadengye DT. Utilizing a multi-stage transition model for analysing child stunting in two urban slum settlements of Nairobi: A longitudinal analysis, 2011-2014. PLoS One 2024; 19:e0272684. [PMID: 38408049 PMCID: PMC10896550 DOI: 10.1371/journal.pone.0272684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 02/05/2024] [Indexed: 02/28/2024] Open
Abstract
INTRODUCTION Stunting is common among children in many low and middle income countries, particularly in rural and urban slum settings. Few studies have described child stunting transitions and the associated factors in urban slum settlements. We describe transitions between stunting states and associated factors among children living in Nairobi slum settlements. METHODS This study used data collected between 2010 and 2014 from the Nairobi Urban and Demographic Surveillance System (NUHDSS) and a vaccination study nested within the surveillance system. A subset of 692 children aged 0 to 3 years, with complete anthropometric data, and household socio-demographic data was used for the analysis. Height-for-age Z-scores (HAZ) was used to define stunting: normal (HAZ ≥ 1), marginally stunted (-2 ≤ HAZ < -1), moderately stunted (-3 ≤ HAZ < -2), and severely stunted (HAZ < -3). Transitions from one stunting level to another and in the reverse direction were computed. The associations between explanatory factors and the transitions between four child stunting states were modeled using a continuous-time multi-state model. RESULTS We observed that 48%, 39%, 41%, and 52% of children remained in the normal, marginally stunted, moderately stunted, and severely stunted states, respectively. About 29% transitioned from normal to marginally stunted state, 15% to the moderately stunted state, and 8% to the severely stunted state. Also, 8%, 12%, and 29% back transitioned from severely stunted, moderately stunted, and marginally stunted states, to the normal state, respectively. The shared common factors associated with all transitions to a more severe state include: male gender, ethnicity (only for mild and severe transition states), child's age, and household food insecurity. In Korogocho, children whose parents were married and those whose mothers had attained primary or post-primary education were associated with a transition from a mild state into a moderately stunted state. Children who were breastfed exclusively were less likely to transition from moderate to severe stunting state. CONCLUSION These findings reveal a high burden of stunting and transitions in urban slums. Context-specific interventions targeting the groups of children identified by the socio-demographic factors are needed. Improving food security and exclusive breastfeeding could potentially reduce stunting in the slums.
Collapse
Affiliation(s)
- Michael S. Oduro
- Pfizer, Inc., Pharm Sci and PGS Statistics, Groton, Connecticut, United States of America
- Department of Applied Statistics and Research Methods, University of Northern Colorado, Greeley, Colorado, United States of America
| | - Samuel Iddi
- Research Division, African Population and Health Research Center (APHRC), Nairobi, Kenya
- Department of Statistics and Actuarial Science, University of Ghana, Legon, Accra, Ghana
| | - Louis Asiedu
- Department of Statistics and Actuarial Science, University of Ghana, Legon, Accra, Ghana
| | - Gershim Asiki
- Research Division, African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Damazo T. Kadengye
- Research Division, African Population and Health Research Center (APHRC), Nairobi, Kenya
- Department of Economics and Statistics, Kabale University, Kabale, Uganda
| |
Collapse
|
5
|
Makwela MS, Mashaba RG, Ntimana CB, Seakamela KP, Maimela E. Barriers and enablers to exclusive breastfeeding by mothers in Polokwane, South Africa. Front Glob Womens Health 2024; 5:1209784. [PMID: 38414908 PMCID: PMC10897026 DOI: 10.3389/fgwh.2024.1209784] [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: 04/21/2023] [Accepted: 01/31/2024] [Indexed: 02/29/2024] Open
Abstract
Background Exclusive breastfeeding (EBF) for six months, with the introduction of appropriate complementary feeding thereafter, and breastfeeding continuing for up to 2 years and beyond, is highly recommended. This could save the lives of up to 1.4 million children each year worldwide. Despite this, breastfeeding rates in South Africa remain sub-optimal, with the recommended target of 50% by the World Health Assembly (WHA) not being achieved. The study aimed to investigate the reasons influencing mothers' practice of exclusive breastfeeding in the Polokwane municipality of Limpopo province in South Africa. Methodology A cross-sectional health facility-based quantitative and descriptive survey was conducted using a validated-structured questionnaire administered to 146 mothers. The data was analyzed using STATA. Chi-square tests were used to determine the relationship between selected demographic variables and their reasons not to breastfeed exclusively. Results Although 94% of the mothers had initiated breastfeeding, at the time of data collection 8% had stopped. Of those who had stopped breastfeeding, 5% did so within one month of starting. Thirty- nine percent of mothers' breastfed exclusively, while 61% practiced mixed feeding. A positive association between exclusive breastfeeding practices and the age of the mother were observed, with older mothers more likely to breastfeed. The reasons mothers stopped breastfeeding were: the mother was ill (45%) or they returned to school or work (27%). Reasons for not breastfeeding were cited as: medical conditions, not enough milk, and infant refusal to breastfeed (33%). Mothers believe that HIV-positive women should breastfeed their infants (57%), and health workers were found to be the main source of HIV information to mothers (77%). Discussion Exclusive breastfeeding during the first six months was less practiced. Infant formula and solid foods were introduced at an early age, usually within the first month of breastfeeding. This study sheds light on factors influencing the early initiation of breastfeeding and the practice of EBF as practiced in Polokwane.
Collapse
Affiliation(s)
- Maishataba Solomon Makwela
- Department of Public Health, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
- Department of Human Nutrition and Dietetics, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Reneilwe Given Mashaba
- DIMAMO Population Health Research Centre, University of Limpopo, Polokwane, South Africa
| | - Cairo Bruce Ntimana
- DIMAMO Population Health Research Centre, University of Limpopo, Polokwane, South Africa
| | - Kagiso Peace Seakamela
- DIMAMO Population Health Research Centre, University of Limpopo, Polokwane, South Africa
| | - Eric Maimela
- Department of Public Health, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
- DIMAMO Population Health Research Centre, University of Limpopo, Polokwane, South Africa
| |
Collapse
|
6
|
Soltani S, Hosseinzadeh M, Mirghafourvand M, Aghajari P, Burns E. Breastfeeding challenges and the impact of social support in Iranian Muslim mothers: A cross-sectional study. Women Health 2024; 64:142-152. [PMID: 38258420 DOI: 10.1080/03630242.2024.2304898] [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: 05/31/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024]
Abstract
Breast milk is the perfect food during infancy. Adequate support from family and health systems can be helpful to continue breastfeeding. This study aimed to determine the status of breastfeeding challenges and its relationship with social support and socio-demographic factors. In this correlational-descriptive study, 348 breastfeeding mothers were recruited using cluster random sampling from health care centers in Tabriz, Iran in 2022. Socio-demographic, breastfeeding challenges and social support questionnaires were used for data collection. Data were analyzed for descriptive and inferential statistics (Pearson correlation tests, independent t-test, one-way ANOVA and general linear model) using SPSS version 16. Difficulty in completing household tasks and breastfeeding at the same time (32.5 percent) was the most common challenge reported by mothers. There was an inverse and significant correlation between perceived social support and experiencing challenges (r = -0.199؛ p = .001). Based on the adjusted general linear model, with increasing social support, the score of breastfeeding challenges decreased (B = -0.165; 95 percent CI: -0.07-0.25, p < .001). Considering the relationship between perceived social support and the challenges experienced during breastfeeding, it can be concluded that adequate support from family along with training and guidance from health care providers can lead women to have better breastfeeding experiences and overcome breastfeeding problems.
Collapse
Affiliation(s)
- Sepideh Soltani
- Department of Community Health Nursing, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mina Hosseinzadeh
- Department of Community Health Nursing, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parvaneh Aghajari
- School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Elaine Burns
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
| |
Collapse
|
7
|
Walls H, Pries A, Chotivichien S, Huynh P, Fahmida U, Blankenship J. Health first, convenience second: Caregiver perspectives of commercially produced complementary foods in five Southeast Asian capital cities. MATERNAL & CHILD NUTRITION 2023; 19 Suppl 2:e13600. [PMID: 38062001 PMCID: PMC10719061 DOI: 10.1111/mcn.13600] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 10/17/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023]
Abstract
Caregivers in low- and middle-income countries increasingly feed commercially produced complementary foods (CPCF) to older infants and young children-shaped by factors including industry promotion. The dynamics of CPCF consumption and caregiver knowledge, attitudes and behaviours regarding complementary feeding practices are poorly understood in these settings. We examined how caregiver knowledge/attitudes/behaviours about CPCF shape the feeding of older infants and young children in the capital cities of five countries in Southeast Asia (Bangkok, Hanoi, Jakarta, Kuala Lumpur, Manila). An online, web-based, cross-sectional panel survey was conducted among mothers of a child aged 6-23 months. One hundred participants were included in each of the five capital cities. Questionnaires were undertaken in the official language of each city. Data were analysed in Stata (version 17.0), using χ2 tests to examine difference between variables of interest. All mothers purchased CPCF for their youngest child aged 6-23 months at the time of survey. CPCF were commonly fed to children at least once per day, and in many of the five cities at most or every feeding. While factors such as convenience and affordability influenced CPCF purchase, mothers primarily purchased CPCF for nutritional reasons. The most common source of feeding information was health care professionals, followed by social media. CPCF are ubiquitous in the diets of older infants and young children of educated middle-upper socioeconomic status mothers in capital cities of Southeast Asia, with perceived healthiness a key driver in selecting CPCF. A strong governmental regulatory response to industry marketing/promotion will be critical to addressing CPCF appropriateness, including health and nutritional claim use.
Collapse
Affiliation(s)
- Helen Walls
- London School of Hygiene & Tropical Medicine, Faculty of Public Health & PolicyLondonUK
- Helen Keller InternationalNew YorkNew YorkUSA
| | | | | | | | - Umi Fahmida
- Department of Nutrition, Faculty of MedicineUniversitas Indonesia–Dr. Cipto Mangunkusumo General HospitalDepokIndonesia
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO RECFON)Pusat Kajian Gizi Regional Universitas IndonesiaJakartaIndonesia
| | | |
Collapse
|
8
|
Opoku Agyemang G, Attu SS, Annan RA, Okonogi S, Sakura T, Asamoah-Boakye O. Factors associated with food consumption and dietary diversity among infants aged 6-18 months in Ashanti Region, Ghana. PLoS One 2023; 18:e0294864. [PMID: 38033108 PMCID: PMC10688859 DOI: 10.1371/journal.pone.0294864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/10/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Studies have reported a poor diet quality among children in Ghana and other developing countries. Inadequate dietary diversity among children may lead to deficiencies in micronutrient intake necessary for growth and other cognitive functions. Understanding factors associated with infants' diverse diets is a key step to promoting adequate infant and young child nutrition. This study sought to determine the factors associated with food consumption and dietary diversity (DD) among infants. METHODS In this cross-sectional study among 1503 mothers-infant (aged 6-18 months) pairs from rural, urban, and peri-urban districts of Ashanti Region, factors associated with food consumption and DD were evaluated. The FAO 18-food group DD questionnaire was used to determine previous food group intake, while a structured questionnaire was used to capture data on the mother's socio-demographic parameters and child morbidity. Data were analyzed using descriptive statistics, the Chi-square test, and binary logistic regression to compare mothers and infants who had adequate and inadequate DDS of 9 out of 18 food groups and the predictors of dietary diversity. RESULTS About 64.7% of the infants did not meet the minimum dietary diversity. Over two-third (77.4%) of the children consumed maize porridge the previous day. Foods which were less consumed included vegetables (35%), animal milk (38.9%), and meat (organ 14%, any meat 26%). The mean food group intake from 18 food groups was 7.0, and the majority (64.7%) did not meet the recommended 9 food group intake. Significantly more younger children (6-11 months) (74%, p<0.001) compared with older children (12-18 months) (52.5%) did not meet the minimum DDS. Also compared with the older children, the younger ones had above two times increased odds of inadequate DD (OR = 2.5, p<0.001, 95% CI = 1.4-4.4). When controlled for gender, children from peri-urban areas (OR = 5.2, p = 0.260, 95% CI = 0.2-93.2) and rural areas (OR = 1.8, p = 0.650, 95% CI = 0.2-9.3) had increased odds of lower DD than urban children. Children of unemployed caregivers had an increased odds of low DD (OR = 2.3 p<0.001, 95% CI 1.7-3.2) compared with children of employed caregivers. Finally, children of caregivers with better nutrition knowledge (nine correct answers from 12 questions) had lower odds of having lower dietary diversity (adjusted OR = 0.9, p = 0.85, 95%CI = 0.5-1.6) than those with less knowledge. CONCLUSIONS Low DD was common among infants and associated with infants age, caregivers' areas of residence, employment status, and level of nutrition education. Children who did not meet the minimum dietary diversity were not fed particular foods such as vegetables, animal milk, and organ meat. Proper maternal nutrition education and feeding practices targeting age-specific needs and community livelihood support systems are necessary to improve dietary diversity of infants.
Collapse
Affiliation(s)
- Godwin Opoku Agyemang
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, PMB, Kumasi, Ghana
| | - Samuel Selorm Attu
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, PMB, Kumasi, Ghana
| | - Reginald Adjetey Annan
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, PMB, Kumasi, Ghana
| | - Satoru Okonogi
- Department of Agricultural and Resource Economics, the University of Tokyo, Tokyo, Japan
| | - Takeshi Sakura
- Department of Agricultural and Resource Economics, the University of Tokyo, Tokyo, Japan
| | - Odeafo Asamoah-Boakye
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, PMB, Kumasi, Ghana
| |
Collapse
|
9
|
Selvamani S, Kapoor N, Ajmera A, El Enshasy HA, Dailin DJ, Sukmawati D, Abomoelak M, Nurjayadi M, Abomoelak B. Prebiotics in New-Born and Children's Health. Microorganisms 2023; 11:2453. [PMID: 37894112 PMCID: PMC10608801 DOI: 10.3390/microorganisms11102453] [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: 09/07/2023] [Revised: 09/27/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
At present, prebiotics, like probiotics, are receiving more attention as a promising tool for health maintenance. Many studies have recognized the role of prebiotics in preventing and treating various illnesses including metabolic disorders, gastrointestinal disorders, and allergies. Naturally, prebiotics are introduced to the human body in the first few hours of life as the mother breastfeeds the newborn. Prebiotic human milk oligosaccharides (HMOs) are the third largest constituent of human breastmilk. Studies have proven that HMOs modulate an infant's microbial composition and assist in the development of the immune system. Due to some health conditions of the mother or beyond the recommended age for breastfeeding, infants are fed with formula. Few types of prebiotics have been incorporated into formula to yield similar beneficial impacts similar to breastfeeding. Synthetic HMOs have successfully mimicked the bifidogenic effects of breastmilk. However, studies on the effectiveness and safety of consumption of these synthetic HMOs are highly needed before massive commercial production. With the introduction of solid foods after breastfeeding or formula feeding, children are exposed to a range of prebiotics that contribute to further shaping and maturing their gut microbiomes and gastrointestinal function. Therefore, this review evaluates the functional role of prebiotic interventions in improving microbial compositions, allergies, and functional gastrointestinal disorders in children.
Collapse
Affiliation(s)
- Shanmugaprakasham Selvamani
- Institute of Bioproduct Development, Universiti Teknologi Malaysia (UTM), Skudai, Johor Bahru 80000, Malaysia; (S.S.); (H.A.E.E.); (D.J.D.)
- Nutrition Technologies SDN. BHD., No 1 & No 3, Jalan SiLC 2, Kawasan Perindustrian SiLC, Iskandar Puteri, Johor Bahru 80150, Malaysia
- Faculty of Chemical and Energy Engineering, Universiti Teknologi Malaysia (UTM), Skudai, Johor Bahru 80000, Malaysia
| | - Nidhi Kapoor
- Center for Digestive Health and Nutrition, Arnold Palmer Hospital for Children, Orlando, FL 32806, USA (A.A.)
| | - Arun Ajmera
- Center for Digestive Health and Nutrition, Arnold Palmer Hospital for Children, Orlando, FL 32806, USA (A.A.)
| | - Hesham Ali El Enshasy
- Institute of Bioproduct Development, Universiti Teknologi Malaysia (UTM), Skudai, Johor Bahru 80000, Malaysia; (S.S.); (H.A.E.E.); (D.J.D.)
- Faculty of Chemical and Energy Engineering, Universiti Teknologi Malaysia (UTM), Skudai, Johor Bahru 80000, Malaysia
- City of Scientific Research and Technology Applications, New Burg Al Arab, Alexandria 21500, Egypt
| | - Daniel Joe Dailin
- Institute of Bioproduct Development, Universiti Teknologi Malaysia (UTM), Skudai, Johor Bahru 80000, Malaysia; (S.S.); (H.A.E.E.); (D.J.D.)
- Faculty of Chemical and Energy Engineering, Universiti Teknologi Malaysia (UTM), Skudai, Johor Bahru 80000, Malaysia
| | - Dalia Sukmawati
- Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Negeri Jakarta, Rawamangun, Jakarta Timur 13530, Indonesia; (D.S.); (M.N.)
| | | | - Muktiningsih Nurjayadi
- Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Negeri Jakarta, Rawamangun, Jakarta Timur 13530, Indonesia; (D.S.); (M.N.)
| | - Bassam Abomoelak
- Center for Digestive Health and Nutrition, Arnold Palmer Hospital for Children, Orlando, FL 32806, USA (A.A.)
- Specialty Diagnostic Laboratory, Arnold Palmer Hospital for Children, Orlando, FL 32806, USA
| |
Collapse
|
10
|
Li Z, Jia Y, Parshley I, Zhang Y, Wang J, Long Q. Current prevalence, changes, and determinants of breastfeeding practice in China: data from cross-sectional national household health services surveys in 2013 and 2018. Int Breastfeed J 2023; 18:40. [PMID: 37568207 PMCID: PMC10416475 DOI: 10.1186/s13006-023-00572-2] [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: 08/31/2022] [Accepted: 07/10/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND The World Health Organization and the government of China have made many efforts to improve breastfeeding practices. The evidence of breastfeeding practices over the past decade in China is limited. The current study aimed to describe the current prevalence, variation trends, and determinants of breastfeeding practices in China using data from the National Household Health Service Surveys (NHHSS) in 2013 and 2018. METHODS Women who had at least one live birth in the five years from the 2013 NHHSS numbered 10,544, and 12,766 women from the 2018 NHHSS were included in the current study. The rates of breastfeeding, early initiation of breastfeeding within the first hour after birth, exclusive breastfeeding for at least six months since birth, and continued breastfeeding accompanied by adequate complementary feeding for over two years were measured. Logistic regressions were performed to study the associations between breastfeeding practices and maternal-based, healthcare-based, and infant-based characteristics. RESULTS In the 2018 survey, the rates of practiced any breastfeeding, early initiation of breastfeeding within the first hour after birth, exclusive breastfeeding for at least six months, and continued breastfeeding for over two years were 91.50%, 28.16%, 47.90%, and 4.78%, respectively, showing significant improvements compared to the 2013 survey period. Women who received high education, were from a household with high incomes, had more than one child, and had more antenatal and postnatal visits, were more likely to practice breastfeeding and initiate it within the first hour, but they were less likely to breastfeed the infants for two years. Births by caesarean section and low birthweight were associated with worse breastfeeding practices. CONCLUSIONS The rates of practicing breastfeeding and exclusive breastfeeding for six months or more in China improved over the past decades, suggesting improved awareness and knowledge of breastfeeding among women. However, individual and social factors may impact practices of early initiation and continued breastfeeding. Strengthening breastfeeding support from family, community, and health professionals (e.g., family member engagement, friendly work environment, and professional consultation, etc.) during the postpartum and infant period may improve women's confidence in breastfeeding practices.
Collapse
Affiliation(s)
- Zeyu Li
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
| | - Yufei Jia
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
| | - Iris Parshley
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
| | - Yaoguang Zhang
- Centre for Health Statistics and Information, National Health Commission, 38 Beilishi Road, Xicheng, Beijing, 100810, NO, China.
| | - Jia Wang
- Yuzhong District Center for Diseases Prevention and Control, 254 Heping Road, Yuzhong District, Chongqing, 400010, China.
| | - Qian Long
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
| |
Collapse
|
11
|
Abraham M, Lak MA, Gurz D, Nolasco FOM, Kondraju PK, Iqbal J. A Narrative Review of Breastfeeding and Its Correlation With Breast Cancer: Current Understanding and Outcomes. Cureus 2023; 15:e44081. [PMID: 37750138 PMCID: PMC10518059 DOI: 10.7759/cureus.44081] [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: 07/05/2023] [Accepted: 08/24/2023] [Indexed: 09/27/2023] Open
Abstract
Breastfeeding has been extensively studied in relation to breast cancer risk. The results of the reviewed studies consistently show a decreased risk of breast cancer associated with breastfeeding, especially for 12 months or longer. This protective effect is attributed to hormonal, immunological, and physiological changes during lactation. Breastfeeding also appears to have a greater impact on reducing breast cancer risk in premenopausal women and specific breast cancer subtypes. Encouraging breastfeeding has dual benefits: benefiting infants and reducing breast cancer risk long-term. Healthcare professionals should provide evidence-based guidance on breastfeeding initiation, duration, and exclusivity, while public health policies should support breastfeeding by creating enabling environments. This review examines the existing literature and analyzes the correlation between breastfeeding and breast cancer risk.
Collapse
Affiliation(s)
- Merin Abraham
- Department of Internal Medicine, Kasturba Medical College, Manipal, IND
| | - Muhammad Ali Lak
- Department of Internal Medicine, Combined Military Hospital, Lahore, PAK
| | - Danyel Gurz
- Department of Internal Medicine, Combined Military Hospital, Lahore, PAK
| | | | | | - Javed Iqbal
- Department of Neurosurgery, Mayo Hospital, Lahore, PAK
| |
Collapse
|
12
|
Mohammed S, Yakubu I, Fuseini AG, Abdulai AM, Yakubu YH. Systematic review and meta-analysis of the prevalence and determinants of exclusive breastfeeding in the first six months of life in Ghana. BMC Public Health 2023; 23:920. [PMID: 37208682 DOI: 10.1186/s12889-023-15758-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 04/26/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Exclusive breastfeeding is a public health priority in sub-Saharan Africa. However, systematic reviews on its determinants in Ghana remain scarce. Therefore, we systematically reviewed the prevalence and determinants of exclusive breastfeeding in children 0-6 months in Ghana. METHODS We conducted systematic searches in Embase, Medline, and Africa-Wide Information from the databases' inception until February 2021 for studies that assessed the prevalence and determinants of exclusive breastfeeding in children 0-6 months in Ghana. Random-effects meta-analysis was used to estimate the pooled prevalence of exclusive breastfeeding and narrative synthesis to summarise the determinants. We calculated the proportion of total variability that was due to between study heterogeneity using I² statistics, and Egger's test assessed publication bias. The review is registered with PROSPERO, CRD42021278019. RESULTS Out of the 258 articles identified, 24 met the inclusion criteria. Most of the included studies were cross-sectional and were published between 2005 and 2021. The pooled prevalence of exclusive breastfeeding (EBF) among children 0-6 months in Ghana was 50% (95%CI 41.0-60.0%). The prevalence was higher in rural areas (54%) than in urban areas (44%). Several factors were identified as facilitators of EBF, including older maternal age, self-employment, unemployment, living in a large house, being a house owner, giving birth in a health facility, non-caesarean delivery, adequate antenatal attendance, counselling services, participation in support groups, adequate knowledge about EBF, positive attitude towards EBF, and higher maternal education among rural dwellers. Additionally, having an average birthweight facilitated EBF. Barriers to EBF were also identified, including higher maternal education among urban dwellers, less than three months of maternity leave, maternal HIV-positive status, the experience of partner violence, lack of access to radio, inadequate breastmilk production, lack of family support, having a partner who wants more children, counselling on complementary feeding, healthcare worker recommendation of complementary feed, single marital status, and infant admission to neonatal intensive care units. CONCLUSION In Ghana, EBF rates are low, with only about half of all children aged 0-6 months breastfed exclusively. A multi-dimensional approach is required to tackle the diverse sociodemographic, obstetric, and infant-related issues that hinder EBF practice in Ghana.
Collapse
Affiliation(s)
- Shamsudeen Mohammed
- MedicineDepartment of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Ibrahim Yakubu
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand.
- Department of Nursing, Nursing and Midwifery Training College, Gushegu, Ghana.
| | | | - Abdul-Malik Abdulai
- Department of Nursing, Nurses' and Midwives' Training College, Tamale, Ghana
| | - Yakubu H Yakubu
- School of Clinical Sciences, Department of Nursing, Auckland University of Technology, Auckland, New Zealand
- Department of Intensive Care Unit, Tamale Teaching Hospital, Tamale, Ghana
| |
Collapse
|
13
|
Obeng C, Jackson F, Nsiah-Asamoah C, Amissah-Essel S, Obeng-Gyasi B, Perry CA, Gonzalez Casanova I. Human Milk for Vulnerable Infants: Breastfeeding and Milk Sharing Practice among Ghanaian Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416560. [PMID: 36554441 PMCID: PMC9779609 DOI: 10.3390/ijerph192416560] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 06/13/2023]
Abstract
Human milk has the best impact on childhood survival. In Ghana, it is estimated that 43% of women exclusively breastfeed for 0-5 months and only 42% of breastfeeding mothers continue through 20-23 months. Although the Ghanaian government has implemented policies to facilitate exclusive breastfeeding, substantial gaps to achieve optimal newborn health and wellbeing remain. The purpose of this study was to evaluate breastfeeding prevalence and human milk sharing practices among Ghanaian women. Qualitative responses were received from Ghanaian females (n = 1050). In our sample, 81% indicated they breastfed their children and 8% reported ever sharing breastmilk with another mother. Reasons for sharing milk included (i) insufficient breastmilk production of the recipient mother, and (ii) mother's unavailability prompting women to offer their milk to a crying baby. About 60% of our sample reported that they were not concerned about sharing their milk. Findings present a strong indicator for milk donation towards the establishment of a human milk bank in Ghana. Health promotion efforts should aim at increasing education about the risks involved in milk sharing as well as the benefits of human milk donation through formal and safer channels such as a Human Milk Bank.
Collapse
Affiliation(s)
- Cecilia Obeng
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN 47405, USA
| | - Frederica Jackson
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN 47405, USA
| | - Christiana Nsiah-Asamoah
- Department of Clinical Nutrition and Dietetics, University of Cape Coast, Cape Coast TF0494, Ghana
| | - Salome Amissah-Essel
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast TF0494, Ghana
| | - Barnabas Obeng-Gyasi
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN 47405, USA
| | - Cydne A. Perry
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN 47405, USA
| | - Ines Gonzalez Casanova
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN 47405, USA
| |
Collapse
|
14
|
Gyamfi A, Jefferson UT, O'Neill B, Lucas R, Spatz DL, Henderson WA. Disparities in 6 Month Exclusive Breastfeeding in Ghana, Africa: A Scoping Review. J Hum Lact 2022:8903344221130988. [PMID: 36305494 DOI: 10.1177/08903344221130988] [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: 11/15/2022]
Abstract
BACKGROUND Exclusive breastfeeding practice for 6 months is a critical global public health goal. In 2020, only 44% of infants globally, 31% in Central and West Africa, and 43% in Ghana, were exclusively breastfed for the first 6 months of life. RESEARCH AIM To critically evaluate disparities in exclusive breastfeeding practice for 6 months in Ghana. METHODS The scoping review was guided by Arksey and O'Malley's (2005) six-stage scoping review process. The online databases of American Psychological Association PsychInfo (APA PsychInfo), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Scopus were searched with keywords inclusive of Ghana, exclusive breastfeeding, breastfeeding, infant feeding, lactation, lactating, and exclusive. Eligibility criteria included full-text, peer-reviewed research articles written in the English language without limitation to specific years. Data were analyzed thematically. RESULTS Initially, 317 records were identified, and 15 full-text articles were eligible for the scoping review. Four main themes emerged as disparities in exclusive breastfeeding practice in Ghana. The themes were healthcare (prenatal clinic visits, delivery place, exclusive breastfeeding knowledge), personal (maternal age, Human Immunodeficiency Virus status, parity, type of delivery, breast problem), employment (unemployed, formal, or informal sector worker), and sociocultural (ethnicity/region, family support, religious beliefs, cultural practices). CONCLUSION Disparities in exclusive breastfeeding in Ghana warrant the collaborative efforts of stakeholders for successful mitigation. Future researchers should explore the role of religion and sociocultural practices to protect, promote, and support 6 months of exclusive breastfeeding in Ghana.
Collapse
Affiliation(s)
- Adwoa Gyamfi
- St Michael's Midwifery Training School, Ashanti Region, Ghana.,School of Nursing, University of Connecticut, Storrs, CT, USA
| | | | - Barbara O'Neill
- School of Nursing, University of Connecticut, Storrs, CT, USA
| | - Ruth Lucas
- School of Nursing, University of Connecticut, Storrs, CT, USA.,School of Medicine, University of Connecticut, Farmington, CT, USA
| | - Diane Lynn Spatz
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Wendy A Henderson
- School of Nursing, University of Connecticut, Storrs, CT, USA.,School of Medicine, University of Connecticut, Farmington, CT, USA
| |
Collapse
|
15
|
Sultana M, Dhar S, Hasan T, Shill LC, Purba NH, Chowdhury AI, Shuvo SD. Knowledge, attitudes, and predictors of exclusive breastfeeding practice among lactating mothers in Noakhali, Bangladesh. Heliyon 2022; 8:e11069. [PMID: 36276726 PMCID: PMC9578980 DOI: 10.1016/j.heliyon.2022.e11069] [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: 07/07/2021] [Revised: 10/22/2021] [Accepted: 10/07/2022] [Indexed: 11/03/2022] Open
Abstract
Background Mothers' knowledge, attitudes, and practices toward exclusive breastfeeding are crucial to both child and mother's health and wellbeing. Hence, This study aimed to assess knowledge, attitudes, and practices of exclusive breastfeeding among lactating mothers as well as the predictors of their exclusive breastfeeding practice. Methodology This cross-sectional study included 397 mothers having infants aged 0-6 months who sought care at Noakhali Sadar Upazila, Noakhali, Bangladesh. A field-tested and validated Food and Agriculture Organization of the United Nations (FAO) questionnaire was utilized to collect information from participants. Results Of those evaluated; 29.0% of mothers could not define exclusive breastfeeding accurately, 11.3% and 59.3% did not know the benefits of exclusive breastfeeding for babies and mothers, respectively. More than half (51.4%) of the mothers reported feeling good about exclusive breastfeeding for six months, did not find difficulties to breastfeed exclusively for six months (39.5%) and on-demand (58.2%). The mothers had an overall favorable attitude towards exclusive breastfeeding; however, 38.3% of mothers did not exclusively breastfeed their children. Literate mothers tended to exclusively breastfeed more (AOR: 3.06, 95% CI: 1.01-9.32; P = 0.049) than illiterate mothers. Mothers having one baby were more likely to breastfeed exclusively (AOR: 3.07, 95% CI: 1.21-7.78; P = 0.018) than mothers having more than one baby. Moreover, mothers with higher knowledge and favorable attitude had more than two times (AOR: 2.58, 95% CI: 1.315.07; P = 0.006) and forty-three times (AOR: 43.18, 95% CI: 21.513-86.66; P < 0.001) the higher tendency of exclusive breastfeeding compared to others. Conclusion Despite having satisfactory knowledge and attitude, the practice of exclusive breastfeeding among mothers was poor. We recommend that interventions must be focused more on ensuring exclusive breastfeeding practice among mothers in addition to improving their knowledge and attitudes.
Collapse
Affiliation(s)
- Marjia Sultana
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Shishir Dhar
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Towhid Hasan
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh,Corresponding author.
| | - Lincon Chandra Shill
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Nafisa Habib Purba
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Akibul Islam Chowdhury
- Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Suvasish Das Shuvo
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore 7408, Bangladesh
| |
Collapse
|
16
|
Osunmakinwa OO, Oladoyin VO, Okunlola O, Ibirongbe D, Oyeyemi OT, Awosusi A, Adebimpe OW, Ogundele O, Akinkuotu J, Adejuwon K. Addressing Malnutrition in Children: An Appraisal of the Ondo State Nutrition Program. Cureus 2022; 14:e28595. [PMID: 36185876 PMCID: PMC9521623 DOI: 10.7759/cureus.28595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2022] [Indexed: 11/05/2022] Open
|
17
|
Mohammed S, Oakley LL, Marston M, Glynn JR, Calvert C. Time trends in the prevalence and determinants of age-appropriate breast feeding among children aged 0-23 months in Ghana: a pooled analysis of population-based surveys, 2003-2017. BMJ Open 2022; 12:e059928. [PMID: 36008076 PMCID: PMC9422843 DOI: 10.1136/bmjopen-2021-059928] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We assessed the sociodemographic and maternal-child characteristics associated with age-appropriate breast feeding among children aged 0-23 months in Ghana. METHODS We pooled data on 12 743 children aged 0-23 months from three Demographic and Health Surveys (2003, 2008 and 2014) and three Multiple Indicator Cluster Surveys (2006, 2011 and 2017-2018). The outcome was age-appropriate breast feeding from birth to 23 months, with age-appropriate breast feeding defined as exclusive breast feeding at 0-5 months (ie, at less than 6 months) and breastfeeding alongside appropriate complementary feeding at 6-23 months. Potential determinants were maternal-child sociodemographic, obstetric and healthcare factors. Logistic regression was used to determine the factors associated with age-appropriate breast feeding. We accounted for the complex sampling design of the cross-sectional surveys in the analysis. RESULTS Most children aged 0-3 months were exclusively breastfed. Among children aged 4-5 months, the most common feeding pattern was breastfeeding alongside water and/or solid foods. Exclusive breastfeeding prevalence in children less than 6 months peaked in 2008 at 62.8% and declined to 42.9% in 2017. For 6-11 month olds, the percentage experiencing age-appropriate breast feeding has been stable over the last four surveys, ranging from 79.3% in 2008 to 81.1% in 2017. Age-appropriate breast feeding in 12-23 month olds declined from 77.8% in 2003 to 61.2% in 2017. Rural residence, younger age, non-facility births and multiple births were associated with decreased odds of exclusively breast feeding. For 6-11 month olds, age-appropriate breast feeding was less likely if the woman did not receive postnatal care. Younger age, being unmarried, high income, wanting a child later and earlier birth order were associated with decreased odds of age-appropriate breast feeding in 12-23 month olds. CONCLUSION Ghanaian children are now less likely to be exclusively breastfed than they were a decade ago. To succeed, breastfeeding promotion programmes should adopt approaches that address the predictors of suboptimal breast feeding at each age, as identified in this study.
Collapse
Affiliation(s)
- Shamsudeen Mohammed
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Laura L Oakley
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Milly Marston
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Judith R Glynn
- Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Clara Calvert
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| |
Collapse
|
18
|
Okal JO, Sarna A, Lango D, Matheka J, Owuor D, Kinywa EA, Kalibala S. Client Experiences in a Mobile-Phone Counseling Intervention for Enhancing Access to Prevention of Mother To-Child Transmission (PMTCT) Services in Kenya. Front Glob Womens Health 2022; 3:785194. [PMID: 35720809 PMCID: PMC9204057 DOI: 10.3389/fgwh.2022.785194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 04/12/2022] [Indexed: 11/25/2022] Open
Abstract
Background The prevention of mother-to-child transmission (PMTCT) is considered one of the most successful HIV prevention strategies in detecting and reducing HIV acquisition in utero or at birth. It is anticipated that with the increasing growth of digital technologies mobile phones can be utilized to enhance PMTCT services by improving provider-client interactions, expanding access to counseling services, and assisting in counteracting social and structural barriers to uptake of PMTCT services. Understanding the subjective experiences of women accessing PMTCT services in different settings has the potential to inform the development and promotion of such methods. This paper explores the perspectives of HIV-positive pregnant women attending maternal and neonatal clinic services in Kisumu, Kenya. Methods Data are reported from in-depth interviews with women, following a longitudinal study investigating the impact of a structured, counselor-delivered, mobile phone counseling intervention to promote retention in care and adherence to ARV prophylaxis/treatment, for HIV-positive pregnant women. Thematic content analysis was conducted. Results Discussions indicated that mobile-phone counseling provided useful health-related information, enhanced agency, and assisted mothers access critical PMTCT services across the cascade of care. Similarly, mobile-phone counseling offered personalized one-to-one contact with trained health providers including facilitating discussion of personal issues that likely affect access to services. Findings also identified barriers to the uptake of services, including a lack of partner support, poor health, poverty, facility-related factors, and provider attitudes. Discussion Overall, findings show that mobile-phone counseling is feasible, acceptable, and can enhance access to PMTCT services by overcoming some of the individual and facility-level barriers. Although mobile-phone counseling has not been routinized in most health facilities, future work is needed to assess whether mobile-phone counseling can be scaled-up to aid in the effective use of HIV and PMTCT services, as well as improving other related outcomes for mother and child dyad.
Collapse
Affiliation(s)
- Jerry Okoth Okal
- Population Council, Nairobi, Kenya
- *Correspondence: Jerry Okoth Okal
| | | | | | | | | | | | - Sam Kalibala
- Population Council, Washington, DC, United States
| |
Collapse
|
19
|
Ketema B, Bosha T, Feleke FW. Effect of maternal employment on child nutritional status in Bale Robe Town, Ethiopia: a comparative cross-sectional analysis. J Nutr Sci 2022; 11:e28. [PMID: 35573460 PMCID: PMC9066325 DOI: 10.1017/jns.2022.26] [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: 12/21/2021] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 11/07/2022] Open
Abstract
Adequate nutrition is essential for early childhood to ensure healthy growth, proper organ formation, and function, a strong immune system, neurological and cognitive development. The main aim of the present study was to assess the effect of maternal employment on nutritional status among children aged 6-23 months in the town of Bale Robe, Ethiopia. A community-based comparative cross-sectional study was conducted on about 597 (293 unemployed and 304 employed) having children aged 6-23-month-old children sampled were employed with a multistage sampling technique. A face-to-face interview was conducted using a structured pretested questionnaire. Descriptive statistics, binary and multivariable logistic regression analyses were used for the statistical analysis. The magnitude of stunting (39.9 %), underweight (39⋅9 %) and wasting (22⋅2 %) was greater in 6-23-month-old children born to employed mothers than their counterparts in unemployed ones [stunted (31⋅3 %), underweight (24⋅0 %) and wasted (11⋅8 %)]. Being a girl [AOR 0⋅31; 95 % CI (0⋅17, 0⋅54)] in employed mothers and [AOR 0⋅29; 95 % CI (0⋅16, 0⋅51)] in unemployed people significantly protected stunting. This study demonstrated that the nutritional status of 6-23-month-old children is better among unemployed mothers than among employed mothers. Therefore, concerted efforts may decrease child undernutrition in a study area.
Collapse
Key Words
- Bale Robe
- EBF, Exclusive Breastfeeding
- Ethiopia
- HAZ, Height-for-Age Z-score
- Infant and young child
- MAD, Minimum Acceptable Diet
- MDD, Minimum Diet Diversity
- MMF, Minimum Meal Frequency
- MUAC, Mid-upper arm circumference
- MUACAZ, Mid-upper arm circumference-for-age Z-score
- PCA, Principal Component Analysis
- PI, Principal Investigator
- SPSS, Statistical Product and Service Solutions
- Stunting
- UNICEF, United Nations Children's Fund
- Underweight
- WAZ, Weight-for-Age Z-score
- WHO, World Health Organization
- WHZ, Weight-for-Height Z-Score
- Wasting
- sd, Standard Deviation
Collapse
Affiliation(s)
- Bezawit Ketema
- College of Agriculture, Hawassa University, P.O. Box 05, Hawassa, Ethiopia
| | - Tafese Bosha
- College of Agriculture, Hawassa University, P.O. Box 05, Hawassa, Ethiopia
| | - Fentaw Wassie Feleke
- College of Agriculture, Hawassa University, P.O. Box 05, Hawassa, Ethiopia
- College of Health Science, Woldia University, P.O. Box 400, Woldia, Ethiopia
| |
Collapse
|
20
|
Agyekum MW, Codjoe SNA, Dake FAA, Abu M. Enablers and inhibitors of exclusive breastfeeding: perspectives from mothers and health workers in Accra, Ghana. Int Breastfeed J 2022; 17:21. [PMID: 35313914 PMCID: PMC8935745 DOI: 10.1186/s13006-022-00462-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 02/22/2022] [Indexed: 11/12/2022] Open
Abstract
Background Despite the health and economic benefits of exclusive breastfeeding, there is evidence of a decline globally and in Ghana. Previous studies addressing this problem are mostly quantitative with only a few of such studies using qualitative or mixed methods to examine the predictors, benefits, ways of improving and managing exclusive breastfeeding, and the challenges associated with exclusive breastfeeding from the perspective of exclusive and nonexclusive breastfeeding mothers, and health workers. This study employs the health belief model to examine the experiences of mothers and health workers regarding exclusive breastfeeding to fill this gap in the literature. Methods A cross-sectional qualitative study involving in-depth interviews was conducted among health workers and mothers attending child welfare clinic at two polyclinics in Madina, Accra-Ghana in 2019. Purposive sampling was used to select health facilities and participants for the study. Twenty participants comprising ten exclusive breastfeeding mothers, six non-exclusive breastfeeding mothers and four health workers were interviewed for the study. The data were analyzed based on emerging themes from inductive and deductive coding. Results The decision to practice exclusive breastfeeding was based on mothers’ work, advertisement on exclusive breastfeeding and education on breastfeeding provided by health workers. Insufficient flow of breast milk, pressure from family and friends, and insufficient breast milk for infants were among the reasons for discontinuing exclusive breastfeeding. The factors that help improve exclusive breastfeeding include eating healthy food and breastfeeding on demand, while counselling and monitoring, restricting advertisement on infant formula and granting maternity leave for breastfeeding mothers were identified as factors that can facilitate the practice of exclusive breastfeeding. Conclusion Different levels of experience affect and shape exclusive breastfeeding practice in Ghana. The decision to practice exclusive breastfeeding, as well as the challenges and strategies employed in managing exclusive breastfeeding, emanates from mothers’ personal experiences and interactions with institutional factors. In view of this, there should be counselling on the management of challenges associated with exclusive breastfeeding and provision of accurate information on exclusive breastfeeding to enable mothers practice exclusive breastfeeding. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-022-00462-z.
Collapse
Affiliation(s)
- Martin Wiredu Agyekum
- Institute for Educational Research and Innovation Studies, University of Education, Winneba, P. O. Box 25, Winneba, Ghana. .,Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon-Accra, Ghana.
| | - Samuel N A Codjoe
- Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon-Accra, Ghana
| | - Fidelia A A Dake
- Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon-Accra, Ghana
| | - Mumuni Abu
- Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon-Accra, Ghana
| |
Collapse
|
21
|
Cartmill MK, Blackmore I, Sarange C, Mbeyu R, Cheupe C, Cheupe J, Kamau-Mbuthia E, Iannotti L, Wamukota A, Humphries A, Lesorogol C. Fish and complementary feeding practices for young children: Qualitative research findings from coastal Kenya. PLoS One 2022; 17:e0265310. [PMID: 35286341 PMCID: PMC8920237 DOI: 10.1371/journal.pone.0265310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/28/2022] [Indexed: 11/23/2022] Open
Abstract
This study examines barriers to fish consumption during the complementary feeding period in two coastal counties of Kenya with high rates of child malnutrition. Study findings indicate that young child fish consumption is impacted by factors related to accessibility, food preferences, and caregiver's knowledge and beliefs about fish during the complementary feeding period. These factors are influenced by prominent community figures such as elder women and health workers, whose own beliefs and understandings are impacted by underlying cultural norms, potentially limiting fish consumption. To our knowledge, this is the first study conducted in the coastal region of Kenya to focus on understanding fish consumption attitudes and beliefs during the complementary feeding phase. Our findings represent a critical first step towards the creation of more effective policies and interventions to address the significant nutritional disparities that exist in the study population.
Collapse
Affiliation(s)
- Mary Kate Cartmill
- Brown School, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Ivy Blackmore
- Brown School, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | | | - Ruth Mbeyu
- Department of Human Nutrition, Egerton University, Nakuru, Kenya
| | | | - Joaquim Cheupe
- Department of Environmental Sciences, Pwani University, Kilifi, Kenya
| | | | - Lora Iannotti
- Brown School, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Andrew Wamukota
- Department of Environmental Sciences, Pwani University, Kilifi, Kenya
| | - Austin Humphries
- Department of Fisheries, Animal and Veterinary Sciences, University of Rhode Island, Kingston, Rhode Island, United States of America
- Graduate School of Oceanography, University of Rhode Island, Narragansett, Rhode Island, United States of America
| | - Carolyn Lesorogol
- Brown School, Washington University in St. Louis, St. Louis, Missouri, United States of America
| |
Collapse
|
22
|
Onwuka C. A cross-sectional study of determinants of exclusive breastfeeding among working mothers in Enugu. JOURNAL OF WEST AFRICAN COLLEGE OF SURGEONS 2022; 12:75-80. [PMID: 36213806 PMCID: PMC9536408 DOI: 10.4103/jwas.jwas_102_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/17/2022] [Indexed: 11/18/2022]
Abstract
Introduction: The practice of exclusive breastfeeding (EBF) has remained low despite its benefits. This is worsened when the woman has to combine breastfeeding with work in order to support her family. Objective: The objective was to determine the factors influencing EBF among working mothers in Enugu, South-eastern Nigeria. Materials and Methods: This was a questionnaire-based study of 315 nursing mothers in postpartum period, attending the immunisation centres of the Institute of Child Health of both University of Nigeria Teaching Hospital and Enugu State University Teaching Hospital. The information obtained was analysed using SPSS version 22. A P value of less than 0.05 was considered statistically significant. Results: Although 82.5% (n = 260) of the respondents were aware of EBF recommendation, only 69% (n = 217) practised EBF. A majority of the mothers (87%) initiated breastfeeding within 1 h of delivery. Ninety-nine percent of the mothers did not have workplace facilities (such as breastfeeding rooms, nursery, refrigerator, and privacy) that support breastfeeding practice. The main reasons for not practising EBF were pressure of work (40.8%, n = 40/98) and medical conditions (32.7%, n = 32/98). Low parity (P = 0.018) and registration for antenatal care in the hospital (P = 0.009) were significantly associated with EBF. Conclusion: The prevalence of EBF among working mothers in Enugu South-Eastern Nigeria is still suboptimal; thus there is a need for policy change in order to remove or mitigate associated factors. A multi-institutional national survey on the determinants of EBF among working mothers across the six geopolitical zones of the country may be necessary.
Collapse
|
23
|
McLennan JD, Pérez Agramonte M, Mosquea Hernández M. A mixed method inquiry of early complementary feeding of infants in the Dominican Republic. Appetite 2021; 170:105873. [PMID: 34923031 DOI: 10.1016/j.appet.2021.105873] [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: 04/17/2021] [Revised: 12/05/2021] [Accepted: 12/13/2021] [Indexed: 11/02/2022]
Abstract
Exclusive breastfeeding (EBF) is infrequent and decreasing over time in the Dominican Republic. This study aimed to identify patterns of, and women's rationale for, early complementary feeding. Mothers of children under 12 months of age living in a low-resource peri-urban community had three opportunities to contribute: (i) responding to feeding questions embedded in a standardized questionnaire used at a well-baby clinic (n = 101), (ii) participating in focus groups (n = 31), and (iii) engaging in home-based, semi-structured individual interviews (n = 25). Quantitative questionnaire data were analyzed to identify feeding practices as a function of child age. Textual data from the individual interviews and focus groups were systematically reviewed and coded to identify key constructs through a qualitative descriptive approach. The majority (>86%) of mothers reported breastfeeding at all monthly age bands up to six months. However, EBF was rare, with more than half reporting use of other milks and other foods by the infants' second and fifth month, respectively. Overarching themes to explain early complementary feeding from the qualitative data can be broadly captured by the complementary perceptions that there are problems with relying on breastfeeding alone and that there are benefits to early complementary feeding in the early months of an infant's life. EBF was experienced as (A) insufficient, (B) not always available, (C) sometimes not safe, (D) having potentially negative effects on the mother, and (E) bringing challenges. Complementary feeding was identified as helpful in addressing each of these concerns. Although mothers typically endorsed breastmilk as the preferable and best option for infant feeding, this did not translate into EBF and was not presented as contradictory to the use and perceived benefits of early complementary feeds.
Collapse
Affiliation(s)
- John D McLennan
- Departments of Psychiatry & Community Health Sciences, Cumming School of Medicine, Alberta Children's Hospital Research Institute, and Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada.
| | - Miki Pérez Agramonte
- Hospital Dr. Elías Santana, Los Alcarrizos, Santo Domingo Oeste, Dominican Republic
| | | |
Collapse
|
24
|
Miller JD, Workman CL, Panchang SV, Sneegas G, Adams EA, Young SL, Thompson AL. Water Security and Nutrition: Current Knowledge and Research Opportunities. Adv Nutr 2021; 12:2525-2539. [PMID: 34265039 PMCID: PMC8634318 DOI: 10.1093/advances/nmab075] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/22/2021] [Accepted: 05/24/2021] [Indexed: 12/14/2022] Open
Abstract
Water is an essential nutrient that has primarily been considered in terms of its physiological necessity. But reliable access to water in sufficient quantities and quality is also critical for many nutrition-related behaviors and activities, including growing and cooking diverse foods. Given growing challenges to water availability and safety, including climate change, pollution, and infrastructure degradation, a broader conceptualization of water and its diverse uses is needed to sustainably achieve global nutrition targets. Therefore, we review empirical and qualitative evidence describing the linkages between water security (the reliable availability, accessibility, and quality of water for all household uses) and nutrition. Primary linkages include water security for drinking, food production and preparation, infant and young child feeding, and limiting exposure to pathogens and environmental toxins. We then identify knowledge gaps within each linkage and propose a research agenda for studying water security and nutrition going forward, including the concurrent quantification of both food and water availability, accessibility, use, and stability. By making explicit the connections between water security and nutritional well-being, we aim to promote greater collaboration between the nutrition and water, sanitation, and hygiene sectors. Interdisciplinary policies and programs that holistically address the water-nutrition nexus, versus those that focus on water and nutrition independently, are likely to significantly advance our ability to ensure equitable access to healthy foods and safe water for all.
Collapse
Affiliation(s)
- Joshua D Miller
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Cassandra L Workman
- Department of Anthropology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Sarita V Panchang
- Social Research and Evaluation Center, Louisiana State University, Baton Rouge, LA, USA
| | - Gretchen Sneegas
- Department of Geography, Texas A&M University, College Station, TX, USA
| | - Ellis A Adams
- Keough School of Global Affairs, University of Notre Dame, Notre Dame, IN, USA
| | - Sera L Young
- Department of Anthropology, Northwestern University, Evanston, IL, USA
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - Amanda L Thompson
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
25
|
Dadzie LK, Amo-Adjei J, Esia-Donkoh K. Women empowerment and minimum daily meal frequency among infants and young children in Ghana: analysis of Ghana demographic and health survey. BMC Public Health 2021; 21:1700. [PMID: 34535097 PMCID: PMC8449451 DOI: 10.1186/s12889-021-11753-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 09/08/2021] [Indexed: 11/24/2022] Open
Abstract
Background The nutritional quality of food has an important impact on the health and well-being of families, especially children whose bodies need to grow, develop and reach their full physical and mental potential. Traditionally, women in Ghana provide care and nourishment for their children and families if they have the means to do so or if they are financially, legally and socially empowered. Women’s empowerment is not only important for women’s human rights, but also improves nutrition and health outcomes of both mothers and their children. Women’s empowerment is concerned with increasing ability to make strategic life choices in situations where the ability was hitherto denied. This study sought to investigate the association between women’s empowerment and minimum daily meal frequency (minimum number of meals to be consumed in a day) in Ghana. Methods The study used data from the 2014 Ghana Demographic and Health Survey (GDHS). A sample of 1640 mother-child dyad was used. Mothers ages ranged from 15 to 49 while children’s ages ranged from 6 to 23 months. Univariate and multiple linear regression techniques were applied to identify women empowerment (economic, socio-familial and legal) and sociodemographic factors associated with minimum daily meal frequency scores. Data was analyzed by the STATA statistical package software version 13.0. Statistical significance level was set at P < 0.10. Results Data from decisions on large household purchases (β = 0.351, p < 0.01) family visits (β = 0.743, p < 0.01), home ownership (β = − 0.245, p < 0.10), age of child (β = 1.387, p < 0.01), mother’s educational attainment (β = 0.496, p < 0.10) and place of residence (β = − 0.298, p < 0.10) showed significant positive association with minimum daily meal frequency in Ghana. Conclusion Minimum daily meal frequency was largely influenced by economic and socio-familial factors that contribute to empowerment of women. as decisions on large household purchases and family visits showed significant positive association with minimum daily meal frequency. Interventional programs should target households and mothers with lower socio-demographic characteristics such as lower educational levels and low economic status to improve minimal daily meal frequency in their children thereby ensuring better child health and well-being. Minimum daily meal frequency is influenced by various dimensions of empowerment of women such as economic and socio-familial empowerment. There is the need for improved advocacy for women to be involved in decision-making on family visits and large household purchases as these activities promote frequent meal attainment of children Interventional programs should target households and mothers with lower socio-demographics characteristics such as lower educational level, lower income and those residing in rural areas to improve feeding at least the minimum daily meal frequency to children for their better health and well-being.
Collapse
Affiliation(s)
- Louis Kobina Dadzie
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
| | - Joshua Amo-Adjei
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Kobina Esia-Donkoh
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| |
Collapse
|
26
|
Ejie IL, Eleje GU, Chibuzor MT, Anetoh MU, Nduka IJ, Umeh IB, Ogbonna BO, Ekwunife OI. A systematic review of qualitative research on barriers and facilitators to exclusive breastfeeding practice in sub-Saharan African countries. Int Breastfeed J 2021; 16:44. [PMID: 34090461 PMCID: PMC8178897 DOI: 10.1186/s13006-021-00380-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 04/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies reporting factors associated with exclusive breastfeeding are mostly quantitative. No study has performed a systematic qualitative summary to document the recurring constraints and facilitators to exclusive breastfeeding in sub-Saharan African countries from breastfeeding mothers' perspective. This study systematically reviews the literature reporting barriers and facilitators to exclusive breastfeeding from the breastfeeding mothers' perspective in sub-Saharan Africa to develop an educational intervention to optimize exclusive breastfeeding. METHODS A systematic literature review of qualitative studies such as phenomenological studies, followed by a risk of bias and methodological assessment of the included studies' quality using the Critical Appraisal Skills Programme (CASP) tool was conducted. MEDLINE and Google Scholar were searched from January 1990 to October 2019 to retrieve studies of breastfeeding mothers who had infants aged between 0 and 12 months. Two authors independently carried out the review process and resolved disagreements through consensus. We analyzed the data thematically. RESULTS After reviewing 92 studies, 20 studies involving 836 participants from 11 countries were eligible. Of the 72 studies excluded, 39 were not conducted in sub-Saharan Africa, and 33 included other participants such as fathers. Three themes emerged as barriers to exclusive breastfeeding (EBF) and five additional themes were identified with facilitators of maternal-infant factors being the most significant in both cases. Maternal employment and knowledge of the benefits of EBF were the most common maternal-infant factors that served as a barrier and a facilitator, respectively. The study's limitations were that the review involved only primary research among breastfeeding mothers living in sub-Saharan Africa and excluded studies not available in the English language. The information synthesized from this review could be used to develop communication strategies employed during individual and group patient education in the hospitals to improve breastfeeding mothers' understanding, acceptance, and practice of exclusive breastfeeding. This review was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42020133761. CONCLUSIONS This review found that maternal-infant factors have the most significant influence over the practice of exclusive breastfeeding. Therefore, interventions targeted towards maternal-infant factors will improve and optimize exclusive breastfeeding significantly and, ultimately, improve maternal-child health outcomes.
Collapse
Affiliation(s)
- Izuchukwu Loveth Ejie
- Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Nigeria. .,Research Group for Evidence-Based Health Care, Nnamdi Azikiwe University, Awka, Nigeria.
| | - George Uchenna Eleje
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.,Effective Care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Moriam Taiwo Chibuzor
- Effective Care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria.,Calabar Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Moore Road, Calabar, Nigeria
| | - Maureen Ugonwa Anetoh
- Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Nigeria.,Research Group for Evidence-Based Health Care, Nnamdi Azikiwe University, Awka, Nigeria
| | - Ifeoma Jovita Nduka
- Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Nigeria.,Research Group for Evidence-Based Health Care, Nnamdi Azikiwe University, Awka, Nigeria
| | - Ifeoma Blessing Umeh
- Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Nigeria.,Research Group for Evidence-Based Health Care, Nnamdi Azikiwe University, Awka, Nigeria
| | - Brian Onyebuchi Ogbonna
- Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Nigeria
| | - Obinna Ikechukwu Ekwunife
- Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Nigeria.,Research Group for Evidence-Based Health Care, Nnamdi Azikiwe University, Awka, Nigeria
| |
Collapse
|
27
|
Kyei-Arthur F, Agyekum MW, Afrifa-Anane GF. The association between paternal characteristics and exclusive breastfeeding in Ghana. PLoS One 2021; 16:e0252517. [PMID: 34081726 PMCID: PMC8174696 DOI: 10.1371/journal.pone.0252517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/17/2021] [Indexed: 12/29/2022] Open
Abstract
Background Studies have shown that partners play an influential role in exclusive breastfeeding practice and that they can act as either deterrents or supporters to breastfeeding. However, there are limited studies on the influence of partners’ characteristics on exclusive breastfeeding in Ghana. This study examined the association between partners’ characteristics and exclusive breastfeeding in Ghana. Methods This cross-sectional study used data from the 2014 Ghana Demographic and Health Survey. Infants less than 6 months old (exclusively breastfed or not) with maternal and paternal characteristics were included in the study. A total of 180 participants were used for the study. A binary logistic regression was used to examine the influence of partners’ characteristics on exclusive breastfeeding. Results Partners’ characteristics such as education, desire for children, religion, and children ever born were associated with exclusive breastfeeding. Mothers whose partners had primary education (AOR = 0.12; CI 95%: 0.02–0.93; p = 0.04) were less likely to practice exclusive breastfeeding compared to those whose partners had no formal education. Also, mothers whose partners desired more children (AOR = 0.20; CI 95%: 0.06–0.70; p = 0.01) were less likely to practice exclusive breastfeeding compared to those whose partners desire fewer children. Conclusion Improving EBF requires the involvement of partners in exclusive breastfeeding campaigns/programmes. A more couple-oriented approach is required by health practitioners to educate and counsel both mothers and partners on the importance of exclusive breastfeeding in Ghana.
Collapse
Affiliation(s)
- Frank Kyei-Arthur
- Regional Institute for Population Studies, University of Ghana, Legon, Accra, Ghana
- * E-mail:
| | | | | |
Collapse
|
28
|
Thomas CL, Murphy LD, Mills MJ, Zhang J, Fisher GG, Clancy RL. Employee lactation: A review and recommendations for research, practice, and policy. HUMAN RESOURCE MANAGEMENT REVIEW 2021. [DOI: 10.1016/j.hrmr.2021.100848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
29
|
Nyantakyi-Frimpong H. Climate change, women's workload in smallholder agriculture, and embodied political ecologies of undernutrition in northern Ghana. Health Place 2021; 68:102536. [PMID: 33639447 DOI: 10.1016/j.healthplace.2021.102536] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 02/02/2021] [Accepted: 02/12/2021] [Indexed: 11/30/2022]
Abstract
The burden of child undernutrition across Africa remains extraordinarily high. Among children under age five, chronic and acute undernutrition is responsible for more ill-health than any other cause. While climate change exacerbates the multiple burdens of undernutrition, we know very little about the embodied effects on women's workload in agriculture and implications for feeding practices, especially for infants whose nutrition depends on mothers' time. In this article, political ecologies of health, with its nested, place-based analysis, is used as a framework to address this knowledge gap. The study took place in Ghana's Upper West Region, a semi-arid and resource-poor setting with higher undernutrition rates. In-depth interviews were conducted with smallholder farmers (n = 33) whose infants have sub-optimal growth, and key informants (n = 7) with expertise in nutrition and health. Findings from the study demonstrate how climate change puts pressure on women's productive time, leading to poor child feeding practices and undernutrition. Ultimately, the article argues that there are hidden impacts of climate change on undernutrition. Global undernutrition interventions should therefore move beyond biomedical solutions to address these hidden impacts, some of which are social, gendered, and structural in nature.
Collapse
Affiliation(s)
- Hanson Nyantakyi-Frimpong
- University of Denver, Department of Geography & the Environment, 2050 East Iliff Avenue, Denver, CO, 80210, USA.
| |
Collapse
|
30
|
Aldalili AYA, El Mahalli AA. Research Title: Factors Associated with Cessation of Exclusive Breastfeeding. J Multidiscip Healthc 2021; 14:239-246. [PMID: 33564240 PMCID: PMC7866906 DOI: 10.2147/jmdh.s277819] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/12/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The study aimed to determine the prevalence of exclusive breastfeeding (EBF), measure the association between EBF and sociodemographic and obstetric characteristics of lactating mothers, and determine challenges of EBF. Methods The study was cross-sectional and was conducted in four primary health care centres (PHCCs) at Alehsa region in Saudi Arabia (SA). Lactating mothers coming to vaccinate their babies (0–6 months) were recruited. Sample size totalled 372, where 93 were randomly selected from each centre. Sociodemographic and obstetric characteristics of participants, breastfeeding (BF) status, and challenges of EBF were collected. Basic univariate descriptive statistics were conducted to explore the sociodemographic and obstetric characteristics, BF status and challenges of BF. Bivariate analyses were done to explore the association between the dependent and independent variables. Binary logistic regression models were then executed. A 2-tailed p-value < 0.05 was considered significant. Results EBF rate was nearly 60%. Cessation of EBF was associated with younger age, inconvenience/fatigue due to BF, sore breasts or nipples/too painful, perceived low milk quantity, BF skills were not effective, maternal choice, and baby-centred factors. Conclusion and Recommendations EBF was associated with problems/difficulties in BF technique. It is recommended that health care professionals like doctors, nurses, and midwives should train mothers during and after pregnancy regarding BF technique or pumping breast milk in case of BF difficulties, improve mothers’ confidence about the ability to breastfeed and enhance mothers’ knowledge on the normal process of lactation. Secondly, it is the role of policymakers to ensure implementation of Baby-Friendly Hospital Initiative (BFHI) guidelines in hospitals to meet the WHO’s global target of infants being exclusively breastfed until six months of age.
Collapse
Affiliation(s)
| | - Azza Ali El Mahalli
- Department of Public Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| |
Collapse
|
31
|
Dattilo AM, Carvalho RS, Feferbaum R, Forsyth S, Zhao A. Hidden Realities of Infant Feeding: Systematic Review of Qualitative Findings from Parents. Behav Sci (Basel) 2020; 10:E83. [PMID: 32349324 PMCID: PMC7287829 DOI: 10.3390/bs10050083] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 01/22/2023] Open
Abstract
A growing, global conversation, regarding realities and challenges that parents experience today is ever-present. To understand recent parent's attitudes, beliefs, and perceptions regarding infant feeding, we sought to systematically identify and synthesize original qualitative research findings. Following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) framework, electronic databases were searched with a priori terms applied to title/abstract fields and limited to studies published in English from 2015 to 2019, inclusive. Study quality assessment was conducted using the Critical Appraisal Skills Programme (CASP) checklist, and thematic analyses performed. Of 73 studies meeting inclusion criteria, four major themes emerged. (1) Breastfeeding is best for an infant; (2) Distinct attitudes, beliefs, and perceptions of mothers that breastfeed, and those that could not or chose not to breastfeed, are evident; (3) Infant feeding behaviors are influenced by the socio-cultural environment of the family, and (4) Parent's expectations of education and support addressing personal infant feeding choices from health care providers are not always met. This systematic review, guided by constructs within behavioral models and theories, provides updated findings to help inform the development of nutrition education curricula and public policy programs. Results can be applied within scale-up nutrition and behavioral education interventions that support parents during infant feeding.
Collapse
Affiliation(s)
- Anne M. Dattilo
- Nestlé Nutrition, Avenue Nestle, 55 CH-1800 Vevey, Switzerland;
| | | | - Rubens Feferbaum
- Children’s Institute University of São Paulo, Rua Tremembé, São Paulo-SP 01256-010, Brazil;
| | - Stewart Forsyth
- School of Medicine, University of Dundee, Dundee DD5 1JG, UK;
| | - Ai Zhao
- School of Public Health, Peking University Health Science Center, Xueyuan Road No. 38., Beijing 100191, China;
| |
Collapse
|