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Suppiger D, Natalucci G, Reinelt T. Reliability and validity of the German version of the Iowa infant feeding attitude scale (IIFAS-G) and relations to breastfeeding duration and feeding method. Int Breastfeed J 2024; 19:58. [PMID: 39169418 PMCID: PMC11337571 DOI: 10.1186/s13006-024-00665-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 08/12/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Public health initiatives (e.g., the Baby Friendly Hospital Initiative) have led to an increase in breastfeeding rates worldwide. However, as (exclusive) breastfeeding duration is still below WHO recommendations, it is crucial to understand the factors that influence decisions on breastfeeding practice. Modifiable psychological factors such as intention to breastfeed have therefore become targets of recent interventions. As the intention to breastfeed is among the strongest predictors of breastfeeding duration, reliable tools for measuring the intention to breastfeed are needed. The Iowa Infant Feeding Attitude Scale (IIFAS) measures attitudes towards infant feeding and is used in various languages and across different cultural contexts. However, there has been no German version of the IIFAS (IIFAS-G) so far. The aim of this study was to investigate reliability, validity, and associations of the IIFAS-G with feeding method and breastfeeding duration. METHODS Between August and November 2022, a total of 353 mothers (Mage = 35 years, SDage = 4.2 years) of singleton infants (47.3% female (1 undetermined), Mage = 10.8 months, SDage = 4.7 months, age range: 3-547 days; 90.4% living in Switzerland) participated in an online survey. The IIFAS-G was administered as a part of a larger study on early child development and infant feeding method. RESULTS The translated IIFAS-G showed unsatisfactory model fit for the two factor 17-item solution. Four items showed low factor loadings. After item reduction, a 13-item two factor solution showed satisfactory model fit (CFI = 0.92, TLI = 0.90, RMSEA = 0.07) and high internal consistency (Cronbach's α = 0.85). The IIFAS-G score was higher for mothers who exclusively breastfed their infants compared to mothers who additionally or exclusively fed infant formula. Moreover, mothers with higher IIFAS-G scores were less likely to stop breastfeeding their child over the course of 1.5years (HR = 0.87). CONCLUSION A shorter two-factor IIFAS-G is proposed to investigate attitudes towards breastfeeding and formula feeding in German-speaking mothers.
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Affiliation(s)
- Debora Suppiger
- Family Larsson-Rosenquist Foundation Center for Neurodevelopment, Growth, and Nutrition of the Newborn, Department of Neonatology, University Hospital Zurich and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland.
| | - Giancarlo Natalucci
- Family Larsson-Rosenquist Foundation Center for Neurodevelopment, Growth, and Nutrition of the Newborn, Department of Neonatology, University Hospital Zurich and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland
| | - Tilman Reinelt
- Family Larsson-Rosenquist Foundation Center for Neurodevelopment, Growth, and Nutrition of the Newborn, Department of Neonatology, University Hospital Zurich and University of Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland
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2
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Louis-Jacques AF, Bartick M, Awomolo A, Zhang J, Feldman-Winter L, Leonard SA, Meek J, Mitchell KB, Crowe S. Bedsharing among breastfeeding physicians: Results of a nationwide survey. PLoS One 2024; 19:e0305625. [PMID: 39088472 PMCID: PMC11293648 DOI: 10.1371/journal.pone.0305625] [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: 06/07/2023] [Accepted: 06/03/2024] [Indexed: 08/03/2024] Open
Abstract
INTRODUCTION Bedsharing is common but advised against by the American Academy of Pediatrics. It is unknown if breastfeeding physicians bedshare more or less than the general population. OBJECTIVES To determine the prevalence of bedsharing among physicians, their reasons for bedsharing or not, and whether bedsharing was associated with a longer duration of breastfeeding. METHODS An online survey was adapted from surveys administered by the Centers for Disease Control and Prevention. The survey was administered to physicians and medical students who birthed children from October 2020 through August 2021. Respondents were asked to report on a singleton birth, and questions centered around sleep practices and breastfeeding. Survival analysis was used to examine the association between bedsharing and breastfeeding duration. RESULTS Of 546 respondents with bedsharing data, 68% reported some history of bedsharing, and 77% were in specialties that involved caring for pregnant people and/or infants. Those who bedshared breastfed an average of four months longer than those who never bedshared (18.08 versus 14.08 months p<0.001). The adjusted risk of breastfeeding cessation was markedly lower for those who bedshared compared to those who did not (Hazard Ratio 0.57, 95% Confidence Interval 0.45, 0.71). The primary reason for bedsharing was to breastfeed (73%); the primary reason for not bedsharing was safety concerns (92%). Among those who bedshared (n = 373), 52% did not inform their child's healthcare provider. CONCLUSIONS Bedsharing is common among our sample of mainly breastfeeding physicians, including those who care for pregnant people and/or infants. It is also associated with a longer duration of breastfeeding, which has implications for population health. Practicing bedsharing implies cognitive dissidence and may affect how physicians counsel about bedsharing. Additionally, lack of disclosure of bedsharing practices has implications for practical guidance about having open non-judgmental conversations and may be a missed opportunity to counsel on bedsharing safety.
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Affiliation(s)
- Adetola F. Louis-Jacques
- Department of Obstetrics and Gynecology, University of Florida Health, Gainesville, FL, United States of America
| | - Melissa Bartick
- Department of Medicine, Harvard Medical School, Boston, MA, United States of America
- Department of Medicine, Mount Auburn Hospital/Beth Israel Lahey Health, Cambridge, MA, United States of America
| | - Adeola Awomolo
- Department of Obstetrics and Gynecology, University of Arizona College of Medicine, Tucson, AZ, United States of America
| | - Jiaqi Zhang
- Department of Obstetrics and Gynecology, Stanford Medicine School of Medicine, Palo Alto, CA, United States of America
| | - Lori Feldman-Winter
- Department of Pediatrics, Cooper Medical School of Rowan University, Cooper University Health Care, Camden, NJ, United States of America
| | - Stephanie A. Leonard
- Department of Obstetrics and Gynecology, Stanford Medicine School of Medicine, Palo Alto, CA, United States of America
| | - Joan Meek
- Department of Clinical Sciences, Florida State University College of Medicine, Tallahassee, FL, United States of America
| | - Katrina B. Mitchell
- Ridley Tree Cancer Center at Sansum Clinic, Santa Barbara, CA, United States of America
| | - Susan Crowe
- Department of Obstetrics and Gynecology, Stanford Medicine School of Medicine, Palo Alto, CA, United States of America
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Cioffredi LA, Garner B, Maxwell JR, Merhar S, Peralta-Carcelen M, Scott LS, Sisodia M, DeMauro SB. Infant and early childhood physical health assessments in the HEALthy Brain and Child Development (HBCD) Study. Dev Cogn Neurosci 2024; 69:101414. [PMID: 39032415 PMCID: PMC11315127 DOI: 10.1016/j.dcn.2024.101414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 07/05/2024] [Accepted: 07/11/2024] [Indexed: 07/23/2024] Open
Abstract
The HEALthy Brain and Child Development (HBCD) Study, a multi-site prospective longitudinal cohort study, will examine human brain, cognitive, behavioral, social and emotional development beginning prenatally and planned through early childhood. Many prenatal and early childhood exposures impact both later physical health and development. Moreover, early deficits in physical health, such as growth and vision, are associated with differences in brain development, language and cognitive functioning. For these reasons, the HBCD Study includes measures of early childhood physical health, many of which have clinical relevance, and are applicable for use as both predictors and outcomes. Study measures assess a broad range of physical health domains and include both objective measurement of child growth and health and subjective caregiver report of behaviors and attitudes about constructs known to influence growth and physical development. Lastly, we obtain caregiver report of the child's routine medical care as well as acute and chronic medical issues. We anticipate that these data will contextualize the impact of child physical growth and health on child brain development and function. In this report we present the rationale for each domain and an overview of the physical health measures included in the current HBCD Study protocol.
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Affiliation(s)
- Leigh-Anne Cioffredi
- University of Vermont Larner College of Medicine, Vermont Children's Hospital, United States.
| | - Bailey Garner
- Department of Psychology, University of Florida, United States
| | - Jessie R Maxwell
- Division of Neonatology, Department of Pediatrics, University of New Mexico, United States
| | - Stephanie Merhar
- Perinatal Institute, Cincinnati Children's Hospital, Department of Pediatrics, University of Cincinnati, United States
| | | | - Lisa S Scott
- Department of Psychology, University of Florida, United States
| | | | - Sara B DeMauro
- Children's Hospital of Philadelphia, United States; University of Pennsylvania Perelman School of Medicine, United States
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4
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Cummings JR, Lipsky LM, Faith MS, Nansel TR. Associations of Appetitive Traits and Parental Feeding Style With Diet Quality During Early Childhood. J Acad Nutr Diet 2024; 124:864-873.e5. [PMID: 38325502 DOI: 10.1016/j.jand.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 01/24/2024] [Accepted: 02/01/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Appetitive traits and parent feeding styles are associated with body mass index in children, yet their associations with child diet quality are unclear. OBJECTIVE The objective was to examine relations of appetitive traits and parental feeding style with diet quality in 3.5-year-old children. DESIGN The study was a secondary, cross-sectional analysis of data from Sprouts, a follow-up study of the Pregnancy Eating Attributes Study (PEAS). Birthing parents completed the Child Eating Behavior Questionnaire, Caregiver's Feeding Styles Questionnaire, and proxy 24-hour dietary recalls for their children from February 2019 to December 2020. PARTICIPANTS/SETTING Participants were 162 birthing parents (early pregnancy BMI ≥ 18.5 and absence of preexisting diabetes, any medical condition contraindicating study participation, self-reported eating disorder, or medications that could affect diet or weight) and their children living in North Carolina. MAIN OUTCOME MEASURES Healthy Eating Index-2015 (HEI-2015) total scores were calculated. STATISTICAL ANALYSES PERFORMED Path modeling was conducted using PROC CALIS with full information maximum likelihood (FIML) to account for missing data (< 2% of all data in dataset). Associations of child appetitive traits and parental feeding style with child HEI-2015 scores, adjusting for exclusive breastfeeding duration and household income-poverty ratio, were examined. Tests of simple effects were conducted in subsamples split by parental feeding style. Hypotheses were formulated during data collection. RESULTS A 1-standard deviation (SD) greater food fussiness was associated with a 2.4-point lower HEI-2015 total score (P = .02; 95% confidence interval [CI] [-4.32, -0.48]) in children. When parental feeding style was authoritarian, a 1-SD greater food responsiveness was associated with a 4.1-point higher HEI-2015 total score (P = .007; 95% CI [1.12, 7.01]) in children. When parental feeding style was authoritative, a 1-SD greater slowness in eating was associated with a 5.8-point lower HEI-2015 total score (P = .01; 95% CI [-10.26, -1.33]) in children. CONCLUSIONS Parental feeding style may modify the association of appetitive traits with diet quality in young children. Future research could determine whether matching parent feeding styles to child appetitive trait profiles improves child diet quality.
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Affiliation(s)
| | - Leah M Lipsky
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Myles S Faith
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo - SUNY, Buffalo, NY
| | - Tonja R Nansel
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.
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dos Santos BG, Shenker N, Weaver G, Perrin MT. Donation barriers, enablers, patterns and predictors of milk bank donors in the United States and United Kingdom. MATERNAL & CHILD NUTRITION 2024; 20:e13652. [PMID: 38606492 PMCID: PMC11168376 DOI: 10.1111/mcn.13652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/25/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
Pasteurised donor human milk is recommended for very low birthweight infants who do not have access to their mother's milk. Although the use of donor milk continues to increase, little is known about the donation experiences of milk bank donors. We aimed to describe and compare enablers, barriers and patterns of human milk donation and identify factors predicting donation volume in a convenience sample of approved milk bank donors in the United Kingdom and the United States. A cross-sectional online survey was conducted from August 2022 to December 2022. Approved milk bank donors (n = 556) from three milk banks in the United States (n = 369, Mothers' Milk Bank of Florida, Mother's Milk Bank of North Texas and Northwest Mothers Milk Bank) and one milk bank in the United Kingdom (n = 187, Hearts Milk Bank) completed the survey. A substantial portion of donors in both settings reported participating in other forms of milk exchange (51% of U.S. donors vs. 39% of UK donors, p = 0.009). Top donation barriers reported in both settings were completing the serological screening and having enough space to store collected milk. Most donors started donating when their infant was 3 months old or older and reported donating mature milk. The most common source of information related to milk banking in each setting was the internet (United Kingdom-70% vs. United States - 63%, p = 0.112). Variables that predicted lifetime donation volume differed between the United States and the United Kingdom, highlighting the importance of setting-specific milk banking research.
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Affiliation(s)
| | - Natalie Shenker
- Human Milk FoundationRothamsted InstituteHarpendenUK
- Department of Surgery and CancerImperial College London, IRDBLondonUK
| | | | - Maryanne T. Perrin
- Department of NutritionUniversity of North Carolina GreensboroGreensboroNorth CarolinaUSA
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Nansel TR, Schwedhelm C, Lipsky LM, Faith MS, Siega-Riz AM. Socioeconomic Characteristics and the Home Food Environment Are Associated With Feeding Healthful and Discretionary Foods During the First Year of Life in the Pregnancy Eating Attributes Study. J Acad Nutr Diet 2024:S2212-2672(24)00249-1. [PMID: 38777149 DOI: 10.1016/j.jand.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Feeding of nutrient-poor foods begins in infancy and may adversely influence long-term food preferences. OBJECTIVE To examine associations of socioeconomic characteristics, childbearing parent eating behaviors, and home food environment with infant feeding characteristics. DESIGN Secondary analysis of a prospective cohort study from first trimester of pregnancy through 12 months postpartum. PARTICIPANTS/SETTING Participants with uncomplicated singleton pregnancies and no major chronic illness were enrolled from November 2014 through October 2016 from 2 university-based obstetrics clinics in Chapel Hill, NC. Of 458 enrolled, 321 were retained through 12 months postpartum. MAIN OUTCOME MEASURES Participants completed infant food frequency questionnaires indicating age at introduction and frequency of consuming multiple food groups. Exposures included childbearing parent socioeconomic characteristics, hedonic hunger, addictive-like eating, Healthy Eating Index 2015 calculated from three 24-hour diet recalls, and home food environment fruit/vegetable and obesogenic scores. STATISTICAL ANALYSES PERFORMED Multiple imputation using Heckman selection model; linear and logistic regressions examining associations with infant feeding characteristics. RESULTS Lower education and income were associated with later infant age at introduction to, and lower frequency of consuming fruits and vegetables at age 12 months. Socioeconomic characteristics were not associated with age at introduction to discretionary solid foods; however, lower education and income were associated with greater infant frequency of intake of discretionary foods and greater odds of introducing fruit juice and sweetened beverages by age 12 months. Childbearing parent Healthy Eating Index 2015, hedonic hunger, and addictive-like eating were not consistently associated with infant feeding characteristics. A more obesogenic food environment was associated with greater frequency of intake of discretionary foods, lower frequency of intake of fruit, and greater odds of fruit juice introduction by age 12 months. CONCLUSIONS Infant feeding characteristics may be important intervention targets for addressing socioeconomic disparities in child diet quality. Efforts to reduce routine feeding of discretionary foods across socioeconomic groups are needed; modifying the home food environment may promote healthful infant feeding.
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Affiliation(s)
- Tonja R Nansel
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
| | - Carolina Schwedhelm
- Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, Molecular Epidemiology Research Group, Berlin, Germany
| | - Leah M Lipsky
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Myles S Faith
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo- SUNY, Buffalo, New York
| | - Anna Maria Siega-Riz
- Epidemiology and Biostatistics, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts
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7
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Harries V, Abraham J, Vesi L, Reupena A, Faaselele-Savusa K, Duckham RL, Bribiescas R, Hawley N. The milk study protocol: A longitudinal, prospective cohort study of the relationship between human milk metabolic hormone concentration, maternal body composition, and early growth and satiety development in Samoan infants aged 1-4 months. PLoS One 2024; 19:e0292997. [PMID: 38728264 PMCID: PMC11086876 DOI: 10.1371/journal.pone.0292997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 10/03/2023] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Current research suggests that energy transfer through human milk influences infant nutritional development and initiates metabolic programming, influencing eating patterns into adulthood. To date, this research has predominantly been conducted among women in high income settings and/or among undernourished women. We will investigate the relationship between maternal body composition, metabolic hormones in human milk, and infant satiety to explore mechanisms of developmental satiety programming and implications for early infant growth and body composition in Samoans; a population at high risk and prevalence for overweight and obesity. Our aims are (1) to examine how maternal body composition influences metabolic hormone transfer from mother to infant through human milk, and (2) to examine the influences of maternal metabolic hormone transfer and infant feeding patterns on early infant growth and satiety. METHODS We will examine temporal changes in hormone transfers to infants through human milk in a prospective longitudinal cohort of n = 80 Samoan mother-infant dyads. Data will be collected at three time points (1, 3, & 4 months postpartum). At each study visit we will collect human milk and fingerpick blood samples from breastfeeding mother-infant dyads to measure the hormones leptin, ghrelin, and adiponectin. Additionally, we will obtain body composition measurements from the dyad, observe breastfeeding behavior, conduct semi-structured interviews, and use questionnaires to document infant hunger and feeding cues and satiety responsiveness. Descriptive statistics, univariate and multivariate analyses will be conducted to address each aim. DISCUSSION This research is designed to advance our understanding of variation in the developmental programming of satiety and implications for early infant growth and body composition. The use of a prospective longitudinal cohort alongside data collection that utilizes a mixed methods approach will allow us to capture a more accurate representation on both biological and cultural variables at play in a population at high risk of overweight and obesity.
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Affiliation(s)
- Victoria Harries
- Department of Anthropology, Yale University, New Haven, Connecticut, United States of America
| | - Jyothi Abraham
- School of Nursing, National University of Samoa, Apia, Samoa
| | - Lupesina Vesi
- Obesity, Lifestyle, and Genetic Adaptations Study Group, Apia, Samoa
| | - Aniva Reupena
- Obesity, Lifestyle, and Genetic Adaptations Study Group, Apia, Samoa
| | | | - Rachel L. Duckham
- Institute of Physical Activity and Nutrition, Deakin University, Geelong, Australia
- Australian Institute for Musculoskeletal Sciences, The University of Melbourne and Western Health, St Albans, Australia
| | - Richard Bribiescas
- Department of Anthropology, Yale University, New Haven, Connecticut, United States of America
| | - Nicola Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States of America
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Luby JL, Herzberg MP, Hoyniak C, Tillman R, Lean RE, Brady R, Triplett R, Alexopoulos D, Loseille D, Smyser T, Rogers CE, Warner B, Smyser CD, Barch DM. Basic Environmental Supports for Positive Brain and Cognitive Development in the First Year of Life. JAMA Pediatr 2024; 178:465-472. [PMID: 38497981 PMCID: PMC10949150 DOI: 10.1001/jamapediatrics.2024.0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/17/2024] [Indexed: 03/19/2024]
Abstract
Importance Defining basic psychosocial resources to facilitate thriving in the first year of life could tangibly inform policy and enhance child development worldwide. Objective To determine if key environmental supports measured as a thrive factor (T-factor) in the first year of life positively impact brain, cognitive, and socioemotional outcomes through age 3. Design, Setting, and Participants This prospective longitudinal cohort study took place at a Midwestern academic medical center from 2017 through 2022. Participants included singleton offspring oversampled for those facing poverty, without birth complications, congenital anomalies, or in utero substance exposures (except cigarettes and marijuana) ascertained prenatally and followed up prospectively for the first 3 years of life. Data were analyzed from March 9, 2023, through January 3, 2024. Exposures Varying levels of prenatal social disadvantage advantage and a T-factor composed of environmental stimulation, nutrition, neighborhood safety, positive caregiving, and child sleep. Main outcomes & measures Gray and white matter brain volumes and cortical folding at ages 2 and 3 years, cognitive and language abilities at age 3 years measured by the Bayley-III, and internalizing and externalizing symptoms at age 2 years measured by the Infant-Toddler Social and Emotional Assessment. Results The T-factor was positively associated with child cognitive abilities (β = 0.33; 95% CI, 0.14-0.52), controlling key variables including prenatal social disadvantage (PSD) and maternal cognitive abilities. The T-factor was associated with child language (β = 0.36; 95% CI, 0.24-0.49), but not after covarying for PSD. The association of the T-factor with child cognitive and language abilities was moderated by PSD (β = -0.32; 95% CI, -0.48 to -0.15 and β = -0.36; 95% CI, -0.52 to -0.20, respectively). Increases in the T-factor were positively associated with these outcomes, but only for children at the mean and 1 SD below the mean of PSD. The T-factor was negatively associated with child externalizing and internalizing symptoms over and above PSD and other covariates (β = -0.30; 95% CI, -0.52 to -0.08 and β = -0.32; 95% CI, -0.55 to -0.09, respectively). Increasing T-factor scores were associated with decreases in internalizing symptoms, but only for children with PSD 1 SD above the mean. The T-factor was positively associated with child cortical gray matter above PSD and other covariates (β = 0.29; 95% CI, 0.04-0.54), with no interaction between PSD and T-factor. Conclusions and Relevance Findings from this study suggest that key aspects of the psychosocial environment in the first year impact critical developmental outcomes including cognitive, brain, and socioemotional development at age 3 years. This suggests that environmental resources and enhancement in the first year of life may facilitate every infant's ability to thrive, setting the stage for a more positive developmental trajectory.
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Affiliation(s)
- Joan L Luby
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, . St Louis, Missouri
| | - Max P Herzberg
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, . St Louis, Missouri
| | - Caroline Hoyniak
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, . St Louis, Missouri
| | - Rebecca Tillman
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, . St Louis, Missouri
| | - Rachel E Lean
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, . St Louis, Missouri
| | - Rebecca Brady
- Department of Neurology, School of Medicine, Washington University in St. Louis, . St. Louis Missouri
| | - Regina Triplett
- Department of Neurology, School of Medicine, Washington University in St. Louis, . St. Louis Missouri
| | - Dimitrios Alexopoulos
- Department of Neurology, School of Medicine, Washington University in St. Louis, . St. Louis Missouri
| | - David Loseille
- Department of Neurology, School of Medicine, Washington University in St. Louis, . St. Louis Missouri
| | - Tara Smyser
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, . St Louis, Missouri
| | - Cynthia E Rogers
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, . St Louis, Missouri
| | - Barbara Warner
- Department of Pediatrics, School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Christopher D Smyser
- Department of Neurology, School of Medicine, Washington University in St. Louis, . St. Louis Missouri
| | - Deanna M Barch
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, . St Louis, Missouri
- Department of Psychological & Brain Sciences, School of Medicine, Washington University in St. Louis, School of Medicine, St Louis, Missouri
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9
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Furman L, McAleer S, Brooks L, Ronis S. A Pilot Breastfeeding-Supportive Texting Program for African American and Black Mothers. Breastfeed Med 2024; 19:325-332. [PMID: 38469623 PMCID: PMC11238827 DOI: 10.1089/bfm.2023.0300] [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] [Indexed: 03/13/2024]
Abstract
Background: Exclusive breastfeeding is recommended through age 6 months, and 24.9% of all U.S. mothers, but only 19.8% of African American or Black (AA/B) mothers, achieved this goal (2020). Smartphone technology, specifically short message service (SMS or texting), may provide a strategy to reach and engage AA/B women who otherwise face barriers related to racism in accessing breastfeeding resources. Unfortunately, few mobile health applications are designed for AA/B women. Methods: We created a culturally sensitive breastfeeding promotion and support text message library that begins at 28 weeks prenatally and continues through 10 weeks postpartum. We tested feasibility and acceptability with a proof-of-concept (POC) trial that enrolled 20 AA/B women, and we tested content and perceived usefulness with a pilot study that enrolled 28 AA/B women. Results: In the POC trial, 95% of participants received all messages, demonstrating feasibility, and none requested fewer or to stop messages, demonstrating acceptability. In the pilot, >85% of participants responded positively regarding the number and helpfulness of the texts received, and whether the information was needed. Using a validated measure for online content for parents, >70% of POC and pilot study participants found that the information was very relevant or relevant, completely understandable, taught them something new, and "will help me improve the health or well-being of my child." Conclusion: A new breastfeeding-supportive text messaging program intended for AA/B mothers appears feasible, acceptable, informative, and relevant. This is the first breastfeeding text messaging application of which we are aware that is tailored for the AA/B population.
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Affiliation(s)
- Lydia Furman
- University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, Ohio, USA
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Sarah McAleer
- University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, Ohio, USA
- Center for Child Health Policy, Rainbow Babies and Children’s Hospital, Cleveland, Ohio, USA
| | - Lasheena Brooks
- University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, Ohio, USA
- Center for Child Health Policy, Rainbow Babies and Children’s Hospital, Cleveland, Ohio, USA
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10
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Knorr S, Aalders J, Overgaard M, Støvring H, Mathiesen ER, Damm P, Clausen TD, Bjerre-Christensen U, Andersen LLT, Vinter C, Kofoed-Enevoldsen A, Lauenborg J, Kampmann U, Fuglsang J, Ovesen PG, Christensen TT, Sørensen A, Ringholm L, Jensen DM. Danish Diabetes Birth Registry 2: a study protocol of a national prospective cohort study to monitor outcomes of pregnancies of women with pre-existing diabetes. BMJ Open 2024; 14:e082237. [PMID: 38670616 PMCID: PMC11057310 DOI: 10.1136/bmjopen-2023-082237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
INTRODUCTION Despite technological developments and intensified care, pregnancies in women with pre-existing diabetes are still considered high-risk pregnancies. The rate of adverse outcomes in pregnancies affected by diabetes in Denmark is currently unknown, and there is a limited understanding of mechanisms contributing to this elevated risk. To address these gaps, the Danish Diabetes Birth Registry 2 (DDBR2) was established. The aims of this registry are to evaluate maternal and fetal-neonatal outcomes based on 5 years cohort data, and to identify pathophysiology and risk factors associated with short-term and long-term outcomes of pregnancies in women with pre-existing diabetes. METHODS AND ANALYSIS The DDBR2 registry is a nationwide 5-year prospective cohort with an inclusion period from February 2023 to February 2028 of pregnancies in women with all types of pre-existing diabetes and includes registry, clinical and questionnaire data and biological samples of mother-partner-child trios. Eligible families (parents age ≥18 years and sufficient proficiency in Danish or English) can participate by either (1) basic level data obtained from medical records (mother and child) and questionnaires (partner) or (2) basic level data and additional data which includes questionnaires (mother and partner) and blood samples (all). The primary maternal outcome is Hemoglobin A1c (HbA1c) levels at the end of pregnancy and the primary offspring endpoint is the birth weight SD score. The DDBR2 registry will be complemented by genetic, epigenetic and metabolomic data as well as a biobank for future research, and the cohort will be followed through data from national databases to illuminate possible mechanisms that link maternal diabetes and other parental factors to a possible increased risk of adverse long-term child outcomes. ETHICS AND DISSEMINATION Approval from the Ethical Committee is obtained (S-20220039). Findings will be sought published in international scientific journals and shared among the participating hospitals and policymakers. TRIAL REGISTRATION NUMBER NCT05678543.
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Affiliation(s)
- Sine Knorr
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jori Aalders
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Martin Overgaard
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Clinical Biochemistry, Odense University Hospital, Odense, Syddanmark, Denmark
| | - Henrik Støvring
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Elisabeth R Mathiesen
- Center for Pregnant Women with Diabetes, Department of Endocrinology and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Peter Damm
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Center for Pregnant Women with Diabetes, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Tine D Clausen
- Center for Pregnant Women with Diabetes, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | | | - Lise Lotte T Andersen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Christina Vinter
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | | | - Jeannet Lauenborg
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Ulla Kampmann
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jens Fuglsang
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus N, Denmark
| | - Per G Ovesen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus N, Denmark
| | - Trine T Christensen
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
| | - Anne Sørensen
- Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Lene Ringholm
- Center for Pregnant Women with Diabetes, Department of Endocrinology and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Dorte M Jensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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11
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Dharod JM, Black MM, McElhenny K, Labban JD, DeJesus JM. Es Niño o Niña?: Gender Differences in Feeding Practices and Obesity Risk among Latino Infants. Curr Dev Nutr 2024; 8:102100. [PMID: 38425439 PMCID: PMC10904161 DOI: 10.1016/j.cdnut.2024.102100] [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: 10/30/2023] [Revised: 01/26/2024] [Accepted: 02/02/2024] [Indexed: 03/02/2024] Open
Abstract
Background Obesity prevalence is significantly higher among Latino boys than girls. Weight status at 12 mo, a significant predictor of childhood obesity, is associated with feeding practices during infancy. Objectives The objectives were to examine breastfeeding and formula-feeding practices overall and by infant gender and to examine relations among infant gender, milk-feeding practices, and obesity risk among Latino infants over the first year of life. Methods Latino mother-infant dyads (n = 90) were recruited from a pediatric clinic. Mothers were interviewed at regular intervals (infants aged 2, 4, 6, and 9 mo), and 24-h feeding recalls were conducted when infants were aged 6 and 9 mo. Infants' lengths and weights were retrieved from clinic records to calculate weight-for-length percentiles. A bivariate analysis was conducted to compare feeding practices by gender and mediation analysis to test whether feeding practices mediated the relation between gender and obesity risk. Results The majority (80%) of mothers were born outside the United States. In early infancy, mixed feeding of formula and breastfeeding was common. At 6 and 9 mo of age, milk-feeding practices differed, with formula feeding more common for boys than girls. At 12 mo, 38% of infants experienced obesity risk (≥85th weight-for-length percentile). Infants' obesity risk increased by 18% per 1 oz increase in powdered formula intake. Formula intake among boys was on average 1.42 oz (in dry weight) higher than that among girls, which, in turn, mediated their increased obesity risk (IERR = 1.27, 95% confidence interval: 1.02, 1.90). Conclusions The increased obesity risk among Latino boys compared with girls at 12 mo was explained by higher rates of formula feeding at 6 and 9 mo of age. Future investigations of cultural values and beliefs in gender-related feeding practices are warranted to understand the differences in obesity risk between Latino boys and girls.
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Affiliation(s)
- Jigna M Dharod
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Maureen M Black
- RTI International, Research Triangle Park, NC, United States
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Kristen McElhenny
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Jeffrey D Labban
- Office of Research, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Jasmine M DeJesus
- Department of Psychology, College of Arts and Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
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12
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Duh-Leong C, Ortiz R, Messito MJ, Katzow MW, Kim CN, Teli R, Gross RS. Household Food Insecurity and Maternal-Toddler Fruit and Vegetable Dietary Concordance. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:100-109. [PMID: 38142387 PMCID: PMC10922249 DOI: 10.1016/j.jneb.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/28/2023] [Accepted: 10/31/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVE To examine whether prenatal or concurrent household food insecurity influences associations between maternal and toddler fruit and vegetable (FV) intake. DESIGN Application of a life-course framework to an analysis of a longitudinal dataset. SETTING Early childhood obesity prevention program at a New York City public hospital. PARTICIPANTS One-hundred and fifty-six maternal-toddler dyads self-identifying as Hispanic or Latino. VARIABLES MEASURED Maternal and toddler FV intake was measured using Centers for Disease Control and Prevention dietary measures when toddlers were aged 19 months. Household food insecurity (measured prenatally and concurrently at 19 months) was measured using the US Department of Agriculture Food Security Module. ANALYSIS Regression analyses assessed associations between adequate maternal FV intake and toddler FV intake. Interaction terms tested whether prenatal or concurrent household food insecurity moderated this association. RESULTS Adequate maternal FV intake was associated with increased toddler FV intake (B = 6.2 times/wk, 95% confidence interval, 2.0-10.5, P = 0.004). Prenatal household food insecurity was associated with decreased toddler FV intake (B = -6.3 times/wk, 95% confidence interval, -11.67 to -0.9, P = 0.02). There was a significant interaction between the level of maternal-toddler FV association (concordance or similarity in FV intake between mothers and toddlers) and the presence of food insecurity such that maternal-toddler FV association was greater when prenatal household food insecurity was not present (B = -11.6, P = 0.04). CONCLUSIONS AND IMPLICATIONS Strategies to increase FV intake across the life course could examine how the timing of household food insecurity may affect intergenerational maternal-child transmission of dietary practices.
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Affiliation(s)
- Carol Duh-Leong
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY.
| | - Robin Ortiz
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY; Department of Population Health, New York University Grossman School of Medicine, New York, NY; Institute for Excellence in Health Equity, New York University Langone Health, New York, NY
| | - Mary Jo Messito
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY
| | - Michelle W Katzow
- Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY
| | - Christina N Kim
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY; Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Radhika Teli
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY; Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Rachel S Gross
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY; Department of Population Health, New York University Grossman School of Medicine, New York, NY
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13
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Cummings JR, Lipsky LM, Faith MS, Nansel TR. Developmental trajectory of appetitive traits and their bidirectional relations with body mass index from infancy to early childhood. Clin Obes 2024; 14:e12620. [PMID: 37669768 PMCID: PMC10841422 DOI: 10.1111/cob.12620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 09/07/2023]
Abstract
Appetitive traits, including food responsiveness, enjoyment of food, satiety responsiveness and slowness in eating, are associated with childhood body mass index. Change in appetitive traits from infancy to childhood and the direction of causality between appetitive traits and body mass index are unclear. The present study examined the developmental trajectory of appetitive traits and their bidirectional relations with body mass index, from infancy to early childhood. Mothers in the Pregnancy Eating Attributes Study and follow-up (n = 162) reported child appetitive traits using the Baby and Child Eating Behaviour Questionnaires at ages 6 months and 3.5 years, respectively. Standardized body mass index (zBMI) was calculated from child anthropometrics. Cross-lagged panel models estimated bidirectional relations between appetitive traits and zBMI. Food responsiveness, satiety responsiveness and slowness in eating increased from infancy to early childhood. In cross-lagged panel models, lower infant satiety responsiveness (B ± SE = -0.45 ± 0.19, p = .02) predicted greater child zBMI. Infant zBMI did not predict child appetitive traits (p-values >.36). From infancy to early childhood, appetitive traits may amplify. Appetitive traits, particularly satiety responsiveness, appear to influence body mass index during this period, suggesting early intervention targeting these traits may reduce childhood obesity.
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Affiliation(s)
- Jenna R. Cummings
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
| | - Leah M. Lipsky
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
| | - Myles S. Faith
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo – SUNY, 420 Bady Hall, Buffalo, NY, 14250, USA
| | - Tonja R. Nansel
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
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14
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Short VL, Abatemarco DJ, Gannon M. Breastfeeding Intention, Knowledge, and Attitude of Pregnant Women in Treatment for Opioid Use Disorder. Am J Perinatol 2024; 41:82-88. [PMID: 34839473 PMCID: PMC9142755 DOI: 10.1055/s-0041-1740145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The objective of this study was to describe breastfeeding intention, knowledge, and attitude, and sources of infant feeding information during the prenatal period among a cohort of pregnant women in treatment for opioid use disorder (OUD). STUDY DESIGN Pregnant women who were receiving treatment for OUD and in the third trimester completed a questionnaire that measured demographic characteristics, infant feeding intentions, breastfeeding beliefs and attitudes, and sources of breastfeeding information. Frequency counts and percentages and means and standard deviations were used to describe data. RESULTS Sixty-five women completed the survey. Three-fourths reported some intention to breastfeeding. While attitudes around breastfeeding were generally positive, less than half of respondents knew the recommendations and infant health benefits of breastfeeding. CONCLUSION Prenatal programs for women in treatment for OUD should consider addressing patient-reported concerns and gaps in knowledge regarding the benefits of and recommendation for breastfeeding. KEY POINTS · Breastfeeding has unique benefits for mother-infant dyads affected by maternal OUD.. · Breastfeeding decisions are influenced by maternal psychosocial factors (e.g., knowledge and attitudes), however, such factors have not been previously assessed in women in treatment for OUD.. · Results indicate that attitudes around breastfeeding are positive but knowledge gaps exist..
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Affiliation(s)
- Vanessa L Short
- Department of Obstetrics and Gynecology, Sydney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Diane J Abatemarco
- Department of Obstetrics and Gynecology, Sydney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Meghan Gannon
- Department of Obstetrics and Gynecology, Sydney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
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15
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Dharod JM, Frazier CM, Labban J, Black MM. Breastfeeding duration and associations with prevention of accelerated growth among infants from low-income, racially and ethnically diverse backgrounds. Public Health Nutr 2023; 27:e6. [PMID: 38047374 PMCID: PMC10830380 DOI: 10.1017/s1368980023002689] [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: 05/02/2023] [Revised: 08/30/2023] [Accepted: 11/27/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE To describe breastfeeding rates from early to late infancy and to examine associations between breastfeeding duration and infant growth, including rapid weight gain (RWG, > 0·67 SD increase in weight-for-age Z-score), among infants from low-income, racially and ethnically diverse backgrounds. DESIGN A short, prospective cohort study was conducted assessing breastfeeding status at infant ages 2, 4, 6, 9 and 12 months. Infant length and weight measurements were retrieved from electronic health records to calculate weight-for-length Z-scores and the rate of weight gain. SETTING Pediatric clinic in the Southeastern USA. PARTICIPANTS Mother-infant dyads (n = 256). RESULTS Most participants were African American (48 %) or Latina (34 %). Eighty-one per cent were participating in the Special Supplemental Nutrition Program for Women, Infants and Children. Infants were breastfed for a median duration of 4·75 months, with partial more common than exclusive breastfeeding. At 12 months, 28 % of the participants were breastfeeding. Infants breastfed beyond 6 months had significantly lower growth trajectories than infants breastfed for 0-2 months (β = 0·045, se = 0·013, P = 0·001) or 3-6 months (β = 0·054, se = 0·016, P = 0·001). Thirty-six per cent of the infants experienced RWG. RWG was more common among infants who were breastfed for 2 months or less than 6+ month breastfed group (relative risk = 1·68, CI95 (1·03, 2·74), P = 0·03). CONCLUSIONS Breastfeeding beyond 6 months is associated with the prevention of accelerated growth among infants from low-income, racially and ethnically diverse backgrounds, suggesting progress toward health equity.
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Affiliation(s)
- Jigna M Dharod
- Department of Nutrition, School of Health and Human Sciences, 319 College Avenue, University of North Carolina at Greensboro, Greensboro, NC27412, USA
| | - Christina M Frazier
- Office of Research, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, USA
| | | | - Maureen M Black
- Department of Pediatrics, University of Maryland, School of Medicine, Baltimore, MD, USA
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16
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Lipsky L, Cummings J, Siega-Riz AM, Nansel T. Relationships of pregnancy and postpartum diet quality with offspring birth weight and weight status through 12 months. Obesity (Silver Spring) 2023; 31:3008-3015. [PMID: 37731285 PMCID: PMC10872787 DOI: 10.1002/oby.23891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE This study examined relationships of maternal pregnancy and postpartum diet quality with infant birth size and weight status indicators through 12 months and tested whether breastfeeding duration modifies these associations. METHODS In the Pregnancy Eating Attributes Study (PEAS), dietary intake was assessed six times in 458 mothers who were followed from early pregnancy through 12 months postpartum (2014-2018). Logistic and linear mixed models estimated relationships of pregnancy and postpartum diet quality (Healthy Eating Index [HEI]) with offspring who were large-for-gestational-age (LGA) at birth, as well as BMI z score (BMIz) and weight-for-length z score (WFLz) at birth, 6 weeks, 6 months, and 12 months. RESULTS Pregnancy HEI was inversely related to LGA (odds ratio [OR] = 0.95, 95% CI: 0.92 to 0.98); HEI was also inversely related to WFLz (β = -0.01, 95% CI: -0.02 to -0.002) and BMIz (β = -0.009, 95% CI: -0.02 to -0.0009) from birth through 12 months. Postpartum HEI was inversely related to WFLz (β = -0.01, 95% CI: -0.02 to -0.0009) and BMIz (β = -0.008, 95% CI: -0.02 to 0.0007) in infants who were breastfed for at least 6 months, but not in those who were breastfed for a shorter duration. CONCLUSIONS Maternal diet quality during pregnancy (and during postpartum in mothers who breastfed for a longer duration) was inversely related to LGA and weight status indicators from birth through 12 months. Increasing maternal diet quality may have use for promoting healthy infant weight development.
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Affiliation(s)
- Leah Lipsky
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda MD
| | - Jenna Cummings
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda MD
- Current: Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Anna Maria Siega-Riz
- Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC; current: Departments of Nutrition and Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA
| | - Tonja Nansel
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda MD
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17
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Langevin B, Gopalakrishnan M, Kuttamperoor J, Van Den Anker J, Murphy J, Arcaro KF, Daines D, Sylvetsky AC. The MILK study: Investigating intergenerational transmission of low-calorie sweeteners in breast milk. Contemp Clin Trials Commun 2023; 36:101212. [PMID: 37881407 PMCID: PMC10594547 DOI: 10.1016/j.conctc.2023.101212] [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: 04/21/2023] [Revised: 08/27/2023] [Accepted: 10/01/2023] [Indexed: 10/27/2023] Open
Abstract
Introduction Forty-four percent of lactating women in the United States consume beverages containing low calorie sweeteners (LCS), and the presence of LCS in the food supply has continued to increase in recent years. While LCS are approved by the United States Food and Drug Administration (FDA) and are believed to be safe for human consumption, intergenerational LCS transmission and the health impacts of early life LCS exposure are severely understudied. Methods and analysis In a tightly controlled, single site, prospective interventional study, mothers' plasma and breast milk, and infants' plasma will be collected from 40 mother-infant dyads over the course of 72 h, with rich sampling following maternal ingestion of a LCS sweetened beverage containing sucralose and acesulfame potassium (ace-K). Concentration-time data will be used to build maternal and infant pharmacokinetic models for future simulations and analysis. Conclusion This study aims to measure LCS concentrations in breast milk, maternal plasma, and infant plasma, to gain insight into infant exposure and inform recommendations for LCS consumption during breastfeeding.
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Affiliation(s)
- Brooke Langevin
- Center for Translational Medicine, University of Maryland School of Pharmacy, Baltimore, USA
| | - Mathangi Gopalakrishnan
- Center for Translational Medicine, University of Maryland School of Pharmacy, Baltimore, USA
| | - Janae Kuttamperoor
- Department of Exercise and Nutrition Sciences, The George Washington University, Washington D.C., USA
| | - John Van Den Anker
- Division of Clinical Pharmacology, Children's National Medical Center, Washington D.C., USA
| | - Jeanne Murphy
- School of Nursing, The George Washington University, Washington D.C., USA
| | - Kathleen F. Arcaro
- Department of Veterinary and Animal Sciences, University of Massachusetts Amherst, Amherst, USA
| | - Dina Daines
- Department of Obstetrics and Gynecology, The George Washington University, Washington D.C., USA
| | - Allison C. Sylvetsky
- Department of Exercise and Nutrition Sciences, The George Washington University, Washington D.C., USA
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18
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Bragg MG, Westlake M, Alshawabkeh AN, Bekelman TA, Camargo CA, Catellier DJ, Comstock SS, Dabelea D, Dunlop AL, Hedderson MM, Hockett CW, Karagas MR, Keenan K, Kelly NR, Kerver JM, MacKenzie D, Mahabir S, Maldonado LE, McCormack LA, Melough MM, Mueller NT, Nelson ME, O’Connor TG, Oken E, O’Shea TM, Switkowski KM, Sauder KA, Wright RJ, Wright RO, Zhang X, Zhu Y, Lyall K. Opportunities for Examining Child Health Impacts of Early-Life Nutrition in the ECHO Program: Maternal and Child Dietary Intake Data from Pregnancy to Adolescence. Curr Dev Nutr 2023; 7:102019. [PMID: 38035205 PMCID: PMC10681943 DOI: 10.1016/j.cdnut.2023.102019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 12/02/2023] Open
Abstract
Background Longitudinal measures of diet spanning pregnancy through adolescence are needed from a large, diverse sample to advance research on the effect of early-life nutrition on child health. The Environmental influences on Child Health Outcomes (ECHO) Program, which includes 69 cohorts, >33,000 pregnancies, and >31,000 children in its first 7-y cycle, provides such data, now publicly available. Objectives This study aimed to describe dietary intake data available in the ECHO Program as of 31 August, 2022 (end of year 6 of Cycle 1) from pregnancy through adolescence, including estimated sample sizes, and to highlight the potential for future analyses of nutrition and child health. Methods We identified and categorized ECHO Program dietary intake data, by assessment method, participant (pregnant person or child), and life stage of data collection. We calculated the number of maternal-child dyads with dietary data and the number of participants with repeated measures. We identified diet-related variables derived from raw dietary intake data and nutrient biomarkers measured from biospecimens. Results Overall, 66 cohorts (26,941 pregnancies, 27,103 children, including 22,712 dyads) across 34 US states/territories provided dietary intake data. Dietary intake assessments included 24-h recalls (1548 pregnancies and 1457 children), food frequency questionnaires (4902 and 4117), dietary screeners (8816 and 23,626), and dietary supplement use questionnaires (24,798 and 26,513). Repeated measures were available for ∼70%, ∼30%, and ∼15% of participants with 24-h recalls, food frequency questionnaires, and dietary screeners, respectively. The available diet-related variables describe nutrient and food intake, diet patterns, and breastfeeding practices. Overall, 17% of participants with dietary intake data had measured nutrient biomarkers. Conclusions ECHO cohorts have collected longitudinal dietary intake data spanning pregnancy through adolescence from a geographically, socioeconomically, and ethnically diverse US sample. As data collection continues in Cycle 2, these data present an opportunity to advance the field of nutrition and child health.
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Affiliation(s)
- Megan G. Bragg
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Matt Westlake
- RTI International, Research Triangle Park, NC, United States
| | | | - Traci A. Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Carlos A. Camargo
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | | | - Sarah S. Comstock
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Anne L. Dunlop
- Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Monique M. Hedderson
- Kaiser Permanente Northern California Division of Research, Oakland, CA, United States
| | - Christine W. Hockett
- Avera Research Institute, Sioux Falls, SD, United States
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, United States
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Kate Keenan
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, United States
| | - Nichole R. Kelly
- Department of Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR, United States
| | - Jean M. Kerver
- Departments of Epidemiology & Biostatistics and Pediatrics & Human Development, College of Human Medicine, Michigan State University, East Lansing, MI, United States
| | - Debra MacKenzie
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Somdat Mahabir
- National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Luis E. Maldonado
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Lacey A. McCormack
- Avera Research Institute, Sioux Falls, SD, United States
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, United States
| | - Melissa M. Melough
- Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, DE, United States
- Department of Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Noel T. Mueller
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | | | - Thomas G. O’Connor
- Departments of Psychiatry, Neuroscience, Obstetrics and Gynecology, University of Rochester, Rochester, NY, United States
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - T Michael O’Shea
- Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States
| | - Karen M. Switkowski
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - Katherine A. Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Rosalind J. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Robert O. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Xueying Zhang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Yeyi Zhu
- Kaiser Permanente Northern California Division of Research, Oakland, CA, United States
| | - Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
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19
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Ventura AK, Drewelow VM. Knowledge and Use of Paced Bottle-Feeding Among Mothers of Young Infants. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:796-802. [PMID: 37737815 DOI: 10.1016/j.jneb.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/01/2023] [Accepted: 08/15/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE To describe mothers' awareness and use of paced bottle-feeding (PBF) and to investigate whether the use of PBF was associated with maternal characteristics and infant feeding practices. METHODS Cross-sectional, online survey. Participants were mothers of infants < 12 months of age (n = 197). Participants self-reported their awareness and use of PBF, demographic characteristics, and infant feeding practices. RESULTS Of the 41% of participants who indicated they had or maybe had heard of PBF, 23% used PBF and 35% sometimes used PBF. Use of PBF was not associated with mother or infant characteristics. Participants who used PBF were significantly less likely to encourage their infant to finish the bottle (odds ratio, 0.04; 95% confidence interval, 0.01-0.79). CONCLUSIONS AND IMPLICATIONS Paced bottle-feeding was associated with lower likelihood of one dimension of pressuring feeding practices, encouraging infant bottle-emptying. More research is needed to determine the effectiveness of PBF in promoting healthy feeding outcomes.
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Affiliation(s)
- Alison K Ventura
- Department of Kinesiology and Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, CA.
| | - Vivian M Drewelow
- Department of Kinesiology and Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, CA
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20
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Gutierrez Dos Santos B, Shenker N, Weaver G, Perrin MT. Comparison of Breastfeeding and Pumping Experiences of Milk Bank Donors in the United States and United Kingdom. Breastfeed Med 2023; 18:870-880. [PMID: 37889994 DOI: 10.1089/bfm.2023.0172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Abstract
Background/Objective: As human milk banking services expand, information about lifestyle characteristics and infant feeding experiences of milk bank donors is relatively limited. Our goal was to describe and compare milk bank donors' demographic, clinical, and lifestyle characteristics, and breastfeeding experiences in a variety of geographic settings. Methods: A cross-sectional online survey was conducted from August 2022 to December 2022 with approved donors from three milk banks in the United States (n = 369), and one milk bank in United Kingdom (n = 187). Results: Donors in all settings were predominantly in their early 30s, White, married, educated, and identified as female. U.K. donors reported more frequently being on maternity leave (33% versus 5%, p < 0.001), predominantly feeding directly at the breast in the first 3 months postpartum (51% versus 28%, p < 0.001), and breastfeeding a single child longer (21.2 versus 13.3 months, p < 0.001) than U.S. donors. Significantly more U.S. donors reported pumping due to work (34% versus 11%, p < 0.001) and pumping multiple times per day (57% versus 36%, p < 0.001). Most donors reported receiving information about breastfeeding from a health care provider (94% United States and 88% United Kingdom, p = 0.022), while the internet was the most popular source of information about pumping (65% United States and 64% United Kingdom, p = 0.751). Conclusion: Factors not directly related to milk banking (e.g., maternity leave, sources of breastfeeding/pumping assistance) may have an impact on how donors feed their children and ultimately on their milk donation pattern. The impact of donor characteristics and feeding practices on donation patterns warrants further investigation.
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Affiliation(s)
| | - Natalie Shenker
- Human Milk Foundation, Rothamsted Institute, Harpenden, United Kingdom
- Department of Surgery and Cancer, Imperial College London, IRDB, London, United Kingdom
| | - Gillian Weaver
- Human Milk Foundation, Rothamsted Institute, Harpenden, United Kingdom
| | - Maryann T Perrin
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, North Carolina, USA
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21
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Warner BB, Rosa BA, Ndao IM, Tarr PI, Miller JP, England SK, Luby JL, Rogers CE, Hall-Moore C, Bryant RE, Wang JD, Linneman LA, Smyser TA, Smyser CD, Barch DM, Miller GE, Chen E, Martin J, Mitreva M. Social and psychological adversity are associated with distinct mother and infant gut microbiome variations. Nat Commun 2023; 14:5824. [PMID: 37726348 PMCID: PMC10509221 DOI: 10.1038/s41467-023-41421-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/29/2023] [Indexed: 09/21/2023] Open
Abstract
Health disparities are driven by underlying social disadvantage and psychosocial stressors. However, how social disadvantage and psychosocial stressors lead to adverse health outcomes is unclear, particularly when exposure begins prenatally. Variations in the gut microbiome and circulating proinflammatory cytokines offer potential mechanistic pathways. Here, we interrogate the gut microbiome of mother-child dyads to compare high-versus-low prenatal social disadvantage, psychosocial stressors and maternal circulating cytokine cohorts (prospective case-control study design using gut microbiomes from 121 dyads profiled with 16 S rRNA sequencing and 89 dyads with shotgun metagenomic sequencing). Gut microbiome characteristics significantly predictive of social disadvantage and psychosocial stressors in the mothers and children indicate that different discriminatory taxa and related pathways are involved, including many species of Bifidobacterium and related pathways across several comparisons. The lowest inter-individual gut microbiome similarity was observed among high-social disadvantage/high-psychosocial stressors mothers, suggesting distinct environmental exposures driving a diverging gut microbiome assembly compared to low-social disadvantage/low-psychosocial stressors controls (P = 3.5 × 10-5 for social disadvantage, P = 2.7 × 10-15 for psychosocial stressors). Children's gut metagenome profiles at 4 months also significantly predicted high/low maternal prenatal IL-6 (P = 0.029), with many bacterial species overlapping those identified by social disadvantage and psychosocial stressors. These differences, based on maternal social and psychological status during a critical developmental window early in life, offer potentially modifiable targets to mitigate health inequities.
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Affiliation(s)
- Barbara B Warner
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA.
| | - Bruce A Rosa
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - I Malick Ndao
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Phillip I Tarr
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
- Department of Molecular Microbiology, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - J Philip Miller
- Institute for Informatics, Data Science and Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Sarah K England
- Department of Obstetrics and Gynecology, Center for Reproductive Health Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Cynthia E Rogers
- Departments of Psychiatry and Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Carla Hall-Moore
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Renay E Bryant
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Jacqueline D Wang
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Laura A Linneman
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Tara A Smyser
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Christopher D Smyser
- Departments of Neurology, Pediatrics and Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Deanna M Barch
- Department of Psychological and Brain Sciences, Psychiatry, & Radiology, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Gregory E Miller
- Institute for Policy Research & Department of Psychology, Northwestern University, Evanston, IL, 60208, USA
| | - Edith Chen
- Institute for Policy Research & Department of Psychology, Northwestern University, Evanston, IL, 60208, USA
| | - John Martin
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - Makedonka Mitreva
- Departments of Medicine and Genetics, and McDonnell Genome Institute, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA.
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22
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Griebel-Thompson AK, Fazzino TL, Cramer E, Paluch RA, Morris KS, Kong KL. Early exposure to added sugars via infant formula may explain high intakes of added sugars during complementary feeding beyond maternal modeling. Front Nutr 2023; 10:1188852. [PMID: 37743928 PMCID: PMC10512548 DOI: 10.3389/fnut.2023.1188852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/25/2023] [Indexed: 09/26/2023] Open
Abstract
Background Research has shown that early exposure to added sugars from table food is related to increased intake of added sugars in later childhood. The earliest window of exposure to added sugars may be in infancy via infant formula. However, beyond the well-established factors of maternal lifestyle and modeling, there is a lack of research examining how exposure to added sugars from infant formula influences infant/toddler added sugar intakes from table foods and sugar sweetened beverages (SSB). Objective While accounting factors previously associated with infant/toddler added sugar intakes and maternal SSB consumption (proximal measure of maternal modeling), this study aims to examine if there is an association between added sugars in infant formula and added sugar intakes from table foods and SSB during the complementary feeding period. Methods This is a secondary, cross-sectional analysis using three-day caregiver-reported 24-h dietary recalls in a cohort of infant/toddlers (n = 95), ages 9- < 16 mos., enrolled in a music intervention trial. Hierarchical stepwise regression was used to estimate the association between exposure to added sugars from infant formula and (1) intake of added sugars from table food and (2) SSB consumption. Infant/toddler SSB consumption was transformed to account for distributional properties. We performed incremental F-tests to determine whether the addition of each step improved model fit (R2). Results Early exposure to added sugars via infant formula was associated with infant/toddler SSB (ΔR2 = 0.044, Finc (1, 87) =6.009, p = 0.016) beyond sociodemographic and maternal SSB consumption, but not with infant/toddler added sugar intakes from table foods (ΔR2 = 0.02, Finc (1, 87) =3.308, p = 0.072). Conclusion While past studies have identified circumstantial (i.e., sociodemographic), or indirect (i.e., maternal lifestyle and modeling), mechanisms contributing to higher infant/toddler added sugar intakes, this study identifies exposure to added sugars from infant formula as a possible direct mechanism explaining why some infants/toddlers consume more added sugars.
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Affiliation(s)
- Adrianne K. Griebel-Thompson
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children’s Mercy Hospital, Kansas City, MO, United States
| | - Tera L. Fazzino
- Department of Psychology, University of Kansas, Lawrence, KS, United States
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, United States
| | - Emily Cramer
- Biostatistics and Epidemiology Core, Division of Health Services and Outcomes Research, Children’s Mercy Hospital, Kansas City, MO, United States
- Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Rocco A. Paluch
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | | | - Kai Ling Kong
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children’s Mercy Hospital, Kansas City, MO, United States
- Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO, United States
- Center for Children’s Healthy Lifestyles and Nutrition, University of Kansas Medical Center, Kansas City, KS, United States
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23
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Schneider-Worthington CR, Lauzon M, Berger PK, Goran MI, Salvy SJ. Complementary Feeding and Child Appetitive Traits in a Sample of Hispanic Mother-Child Dyads. J Acad Nutr Diet 2023; 123:1340-1350. [PMID: 36375769 PMCID: PMC10175514 DOI: 10.1016/j.jand.2022.11.005] [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: 01/24/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Complementary feeding practices may contribute to toddler eating practices that affect weight outcomes. Studies are needed to understand the relationship between complementary feeding practices and toddler dietary self-regulation. OBJECTIVE This study tests the hypothesis that earlier complementary food introduction predicts toddler food responsiveness and emotional overeating (ie, tendency to overeat in response to food cues and emotions, respectively), and considers whether introduction of certain foods better predict toddler dietary self-regulation. DESIGN This study is a secondary analysis of data from a parent longitudinal birth cohort study on early growth/development among Hispanic mother-infant dyads. PARTICIPANTS/SETTING The analytic sample included 174 mother-child dyads recruited from maternity clinics affiliated with the University of Southern California in Los Angeles County. Recruitment and data collection were ongoing from July 2016 to April 2020. At 1-, 6-, 12-, and 24-months postpartum, mothers reported exclusive breastfeeding duration and age of complementary food introduction via questionnaire. MAIN OUTCOME MEASURES Child food responsiveness and emotional overeating scores calculated from the Child Eating Behavior Questionnaire at 12 and 24 months of age. STATISTICAL ANALYSES PERFORMED Separate linear mixed models with repeated measures were used to examine associations between age of complementary food introduction as a predictor of child food responsiveness or emotional overeating, controlling for infant sex, birth body mass index z score, duration of exclusive breastfeeding, and mother's body mass index. RESULTS In separate models, delaying complementary food introduction by 1 month was associated with a 6% reduction in food responsiveness (P = 0.007) and a 5% reduction in emotional overeating scores (P = 0.013). Fifty-eight unique combinations of complementary foods introduced first were found, precluding analyses to examine whether specific combinations were related to eating behavior outcomes due to sample size limitations. CONCLUSIONS Earlier complementary feeding was associated with higher food responsiveness and emotional overeating scores among Hispanic children. Future studies in larger samples are needed to characterize patterns of complementary food introduction and their influence on child self-regulation.
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Affiliation(s)
| | - Marie Lauzon
- Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, California
| | - Paige K Berger
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michael I Goran
- Department of Pediatrics, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California
| | - Sarah-Jeanne Salvy
- Research Center for Health Equity, Department of Medicine, Cedars-Sinai Medical Center, West Hollywood, California
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24
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McCaffery H, Zaituna J, Busch S, Kaciroti N, Miller AL, Lumeng JC, Rosenblum KL, Gearhardt A, Pesch MH. Developmental trajectories of eating behaviors and cross-lagged associations with weight across infancy. Appetite 2023; 188:106978. [PMID: 37495177 PMCID: PMC10844930 DOI: 10.1016/j.appet.2023.106978] [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: 02/08/2023] [Revised: 07/01/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023]
Abstract
Examining typical developmental trajectories of infant eating behaviors, correlates of those trajectories, and cross-lagged associations between eating behaviors and anthropometry, is important to understand the etiology of these behaviors and their relevance to growth early in the lifespan. Mothers (N = 276) completed the Baby Eating Behavior Questionnaire (BEBQ) and infant anthropometrics were measured at ages 1, 2, 4, 6, and 10 months. Infant and maternal characteristics were collected by maternal report. Trajectories of eating behaviors were identified using latent class growth modeling and bivariate analyses examined associations of infant eating behavior trajectory membership with infant and maternal characteristics. Cross-lagged analyses examined associations between BEBQ subscales and infant weight-for-length z-score. Infant eating behavior trajectories included: Consistently High (62%) and Consistently Moderate (38%) Enjoyment of Food; Consistently High (9%), Moderate & Decreasing (43%), and Low & Decreasing (48%) Food Responsiveness; and Consistently High (62%) and Moderate & Decreasing (38%) General Appetite. Trajectory group membership was not associated with infant sex, gestational age, birthweight, or having been exclusively fed breastmilk at 2 months. Consistently High trajectories for Enjoyment of Food, Food Responsiveness, and General Appetite were associated with maternal demographic markers of psychosocial risk (e.g., lower maternal age and educational attainment). Food Responsiveness and General Appetite tracked strongly across infancy within individuals. Cross-lagged associations of Enjoyment of Food, Food Responsiveness, and General Appetite with weight-for-length z-score across infancy were generally null. Much additional work is needed to understand eating behaviors in infancy, their development, and their etiology. Further understanding of infant eating behaviors will provide the basis for future interventions to improve life course nutrition, growth, and health.
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Affiliation(s)
- Harlan McCaffery
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Julie Zaituna
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Sophie Busch
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Niko Kaciroti
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Alison L Miller
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Julie C Lumeng
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA; School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
| | | | - Ashley Gearhardt
- Department of Psychology, College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI, USA
| | - Megan H Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
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25
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Keck-Kester T, Hicks SD. Infant Saliva Microbiome Activity Modulates Nutritional Impacts on Neurodevelopment. Microorganisms 2023; 11:2111. [PMID: 37630671 PMCID: PMC10459261 DOI: 10.3390/microorganisms11082111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Neurodevelopment is influenced by complex interactions between environmental factors, including social determinants of health (SDOH), nutrition, and even the microbiome. This longitudinal cohort study of 142 infants tested the hypothesis that microbial activity modulates the effects of nutrition on neurodevelopment. Salivary microbiome activity was measured at 6 months using RNA sequencing. Infant nutrition was assessed longitudinally with the Infant Feeding Practices survey. The primary outcome was presence/absence of neurodevelopmental delay (NDD) at 18 months on the Survey of Wellbeing in Young Children. A logistic regression model employing two microbial factors, one nutritional factor, and two SDOH accounted for 33.3% of the variance between neurodevelopmental groups (p < 0.001, AIC = 77.7). NDD was associated with Hispanic ethnicity (OR 18.1, 2.36-139.3; p = 0.003), no fish consumption (OR 10.6, 2.0-54.1; p = 0.003), and increased Candidatus Gracilibacteria activity (OR 1.43, 1.00-2.07; p = 0.007). Home built after 1977 (OR 0.02, 0.001-0.53; p = 0.004) and Chlorobi activity (OR 0.76, 0.62-0.93, p = 0.001) were associated with reduced risk of NDD. Microbial alpha diversity modulated the effect of fish consumption on NDD (X2 = 5.7, p = 0.017). These data suggest the benefits of fish consumption for neurodevelopment may be mediated by microbial diversity. Confirmation in a larger, randomized trial is required.
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Affiliation(s)
| | - Steven D. Hicks
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA 17033, USA
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26
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Bucko AG, Armstrong B, McIver KL, McLain AC, Pate RR. Longitudinal associations between sleep and weight status in infants and toddlers. Pediatr Obes 2023; 18:e13056. [PMID: 37246280 PMCID: PMC10524641 DOI: 10.1111/ijpo.13056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/02/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND The limited research assessing relationships between sleep duration and weight status in infants and toddlers relies primarily on parent-reported sleep and cross-sectional studies. OBJECTIVES Examine whether average sleep duration and changes in sleep duration among 6-24-month-old children were associated with weight-for-length z-scores, and whether these associations varied by race/ethnicity, socioeconomic status and sex. METHODS Data were collected when children were approximately 6, 12, 18 and 24 months old (N = 116). Sleep duration was measured using actigraphy. Weight-for-length z-scores were calculated using children's height and weight. Physical activity was assessed using accelerometry. Diet was assessed using a feeding frequency questionnaire. Demographic characteristics included sex, race/ethnicity and socioeconomic status. Separate associations of between- and within-person changes in sleep duration were estimated with weight-for-length z-score treated as the outcome variable in linear mixed model analyses. Additional models were assessed that included interactions between sleep and demographic characteristics. RESULTS At time points where children slept longer at night compared to their own average, their weight-for-length z-score was lower. This relationship was attenuated by physical activity levels. CONCLUSIONS Increasing sleep duration can improve weight status outcomes in very young children who have low physical activity levels.
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Affiliation(s)
- Agnes G Bucko
- College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, North Carolina
| | - Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Kerry L McIver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- South Carolina First Steps to School Readiness, Columbia, SC
| | - Alexander C. McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Russell R. Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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27
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Yang B, Ferdousi MS, Morris J, Durnell RH, Chan D, Rekić N, Rideout TC, Wen X. Maternal Bean Consumption during Pregnancy: Distribution and Nutritional Outcomes. Nutrients 2023; 15:2234. [PMID: 37432402 DOI: 10.3390/nu15092234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/29/2023] [Accepted: 05/01/2023] [Indexed: 07/12/2023] Open
Abstract
(1) Background: Due to their high nutritional value, we aimed to characterize the frequency and amount of maternal consumption of beans during pregnancy and their associations with diet quality and nutrient intake. (2) Methods: We conducted a secondary data analysis of US pregnant women (n = 1444) from the Infant Feeding Practices Study II, a longitudinal study that followed mother-infant pairs from late pregnancy to 1 year postpartum. Maternal bean intake (food types [dried beans, chili, and bean soup], frequency, serving size, and amount), diet quality (Healthy Eating Index [HEI]), and nutrient intake were estimated with a Food Frequency Questionnaire taken in the third trimester of pregnancy. Associations of bean consumption with diet quality and nutrient intake were examined with analysis of variance, Fisher's least significant difference tests, correlation coefficients, and coefficients of determination. (3) Results: In general, maternal bean consumption was low during pregnancy: 0.31 cups/week of dried beans, 0.37 cups/week of chili, and 0.10 cups/week of bean soup. Maternal bean consumption varied by socio-demographics and geographic regions. In comparison with those who never consumed dried beans, mothers who ate dried beans ≥ 1 time per week had a higher mean HEI score (67.5 vs. 63.6), intake of total fiber (24.4 vs. 17.4 g/day), and protein (93.4 vs. 79.9 g/day), but a lower percentage of energy from added sugar (12.6 vs. 15.2%). Higher dried bean consumption had weak-to-moderate correlations with intake of total fiber (correlation coefficient, 0.320), insoluble fiber (0.316), soluble fiber (0.310), and folate (0.286). Similar but less extensive correlations were observed for chili and bean soup consumption. (4) Conclusions: In this US cohort of pregnant women, bean consumption was low. Increased intake of beans (≥1 time per week) may improve maternal diet quality during pregnancy.
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Affiliation(s)
- Bokun Yang
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY 14214, USA
| | - Mariyam S Ferdousi
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14214, USA
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY 14214, USA
| | - Julianna Morris
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY 14214, USA
| | - Rose H Durnell
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14214, USA
| | - Daren Chan
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14214, USA
| | - Neila Rekić
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14214, USA
| | - Todd C Rideout
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY 14214, USA
| | - Xiaozhong Wen
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14214, USA
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Edwards AC, Jacobson SW, Senekal M, Dodge NC, Molteno CD, Meintjes EM, Jacobson JL, Carter RC. Fetal Alcohol-Related Postnatal Growth Restriction Is Independent of Infant Feeding Practices and Postnatal Alcohol Exposure in a Prospective South African Birth Cohort. Nutrients 2023; 15:2018. [PMID: 37432143 DOI: 10.3390/nu15092018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/04/2023] [Accepted: 04/13/2023] [Indexed: 07/12/2023] Open
Abstract
Prenatal alcohol exposure (PAE) causes growth restriction that worsens in the first year of life. However, the roles of postnatal nutrition in fetal alcohol growth restriction and the impact of postnatal alcohol exposure via breastmilk on growth remain unknown. We aimed to compare infant feeding practices during the first 6.5 months of life between heavy drinkers and abstainers/light drinkers, to examine whether these practices play confounding roles in fetal alcohol growth restriction, and to determine the impact of postnatal alcohol exposure via breastmilk on growth. Eighty-seven heavy-drinking pregnant women and 71 abstainers/light drinkers (controls) were recruited prenatally from antenatal clinics in Cape Town, South Africa. Demographic background and alcohol, cigarette, marijuana, and methamphetamine use during pregnancy were assessed pre- and postnatally. Infant feeding practices were assessed at 6.5 months postpartum using the USDA Infant Feeding Questionnaire. Infant weight, length, and head circumference were measured at 2 weeks, 6.5 and 12 months, and 5 years. Neither prenatal nor postnatal alcohol consumption was related to the duration of breastfeeding, exclusive breastfeeding, exclusive formula, or mixed feeding. Complementary feeding practices were remarkably similar between exposure groups. PAE was related to all postnatal anthropometry measures at all age points, independent of infant feeding practices. Postnatal alcohol exposure via breastmilk was unrelated to any anthropometry outcome after control for PAE. In conclusion, fetal alcohol-related postnatal growth restriction was not attributable to differences in postnatal infant feeding practices or postnatal alcohol exposure and is thus likely a direct teratogenic effect of PAE.
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Affiliation(s)
- Alexia C Edwards
- Departments of Emergency Medicine and Pediatrics, Institute of Human Nutrition, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
- Adult & Pediatric Intensive Care Units, State University of New York Downstate Medical Center, Brooklyn, NY 11203, USA
| | - Sandra W Jacobson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town 7925, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town Faculty of Health Sciences, Cape Town 7925, South Africa
| | - Marjanne Senekal
- Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town 7925, South Africa
| | - Neil C Dodge
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Christopher D Molteno
- Department of Psychiatry and Mental Health, University of Cape Town Faculty of Health Sciences, Cape Town 7925, South Africa
| | - Ernesta M Meintjes
- Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town 7925, South Africa
| | - Joseph L Jacobson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town 7925, South Africa
| | - R Colin Carter
- Departments of Emergency Medicine and Pediatrics, Institute of Human Nutrition, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
- Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town 7925, South Africa
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Luby JL, England SK, Barch DM, Warner BB, Rogers C, Smyser CD, Triplett R, Arora J, Smyser TA, Slavich GM, Zhao P, Stout M, Herzog E, Miller JP. Social disadvantage during pregnancy: effects on gestational age and birthweight. J Perinatol 2023; 43:477-483. [PMID: 36914799 PMCID: PMC10079545 DOI: 10.1038/s41372-023-01643-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/26/2023] [Accepted: 02/24/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE Whether psychosocial adversity during pregnancy impacts fetal health outcomes at birth remains underexplored. This is a critical issue given significant social disadvantage and psychosocial stress faced by pregnant women worldwide. STUDY DESIGN Measures of social disadvantage and psychological factors, and medical/reproductive and nutritional health status in pregnant women were obtained at each trimester. Using Structural Equation Modeling (SEM), we investigated the relationship of forms of adversity to each other and to infant gestational age, and birthweight. RESULTS Among 399 singletons, Social Disadvantage significantly predicted gestational age (p = 0.003), and residual birthweight (p = 0.006). There was a 0.4 week decrease in gestational age and a 3% decrease in birthweight for each standard deviation increase in Social Disadvantage. CONCLUSION Significant negative effects of social adversity on the developing fetus were found. Notably, these effects emerged despite good prenatal care and after accounting for maternal age and medical reproductive risk factors.
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Affiliation(s)
- Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
| | - Sarah K England
- Department of Obstetrics and Gynecology, Center for Reproductive Health Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Barbara B Warner
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Cynthia Rogers
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Christopher D Smyser
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Regina Triplett
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Jyoti Arora
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Tara A Smyser
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Peinan Zhao
- Department of Obstetrics and Gynecology, Center for Reproductive Health Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Molly Stout
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Erik Herzog
- Department of Biology, Washington University in St. Louis, St. Louis, MO, USA
| | - J Philip Miller
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
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Doughty KN, Abeyaratne D, Merriam AA, Taylor SN. Self-Efficacy and Outcomes in Women with Diabetes: A Prospective Comparative Study. Breastfeed Med 2023; 18:307-314. [PMID: 36999939 PMCID: PMC10124167 DOI: 10.1089/bfm.2022.0298] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
Background: Breastfeeding is especially beneficial to women with diabetes and their infants, yet diabetic mothers frequently experience less favorable breastfeeding outcomes. Objectives: To identify facilitators and barriers to breastfeeding for women with diabetes by comparing cognitive and social factors, health and hospital-related factors, and breastfeeding outcomes between women with and without diabetes. Design/Methods: Women with any type of diabetes (n = 28) and without diabetes (n = 29) were recruited during pregnancy. Data were collected from the electronic medical record and maternal surveys at 24-37 weeks' gestation, birth hospitalization, and 4 weeks' postbirth. We compared differences in mother's regard for breastfeeding, breastfeeding intention, and birth hospital experience by diabetes status, and estimated odds ratios for exclusive breastfeeding (EBF) and unmet intention to breastfeed. Results: Women with and without diabetes had similar breastfeeding intentions, attitudes, and self-efficacy. Women with diabetes were less likely to EBF, and more likely to have unmet intentions to EBF at hospital discharge, compared to women without diabetes. At 4 weeks' postpartum, there was no difference in breastfeeding by diabetes status, although EBF at hospital discharge was strongly associated with EBF at 4 weeks. Infant neonatal intensive care unit (NICU) admission and hypoglycemia were significantly associated with diabetes status, reduced EBF rates, and unmet breastfeeding intentions. Conclusions: Despite having a strong intent to breastfeed, women with diabetes experienced less favorable early breastfeeding outcomes and were less likely to meet their own breastfeeding goals. These differences may be driven by neonatal complications, such as infant hypoglycemia and NICU admissions, rather than maternal cognitive and social factors.
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Affiliation(s)
- Kimberly N Doughty
- Egan School of Nursing and Health Studies, Public Health Fairfield University, Fairfield, Connecticut, USA
| | - Dhatri Abeyaratne
- Yale School of Medicine, Department of Pediatrics, Division of Neonatology, New Haven, Connecticut, USA
| | - Audrey A Merriam
- Yale School of Medicine, Department of Pediatrics, Division of Neonatology, New Haven, Connecticut, USA
| | - Sarah N Taylor
- Yale School of Medicine, Department of Pediatrics, Division of Neonatology, New Haven, Connecticut, USA
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Magalhães M, Havelaar AH, Varma DS, Cacho N, Sullivan S, Parker LA. Leveraging mHealth and a milk expression frequency biomarker during postpartum to prolong lactation among parents of critically ill infants: a pilot study. J Perinatol 2023; 43:616-623. [PMID: 36882532 PMCID: PMC9991875 DOI: 10.1038/s41372-023-01639-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 12/29/2022] [Accepted: 02/23/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVE To assess the feasibility and potential benefits of personalized biomarker-based text messages in prolonging lactation among parents of critically ill infants. STUDY DESIGN Thirty-six participants were randomized to receive either daily texts with Mother's Own Milk (MOM) sodium levels or standard care. Surveys at months 1 and 3 assessed whether infants were receiving exclusive MOM feeding, any MOM feeding, and whether the parent was still lactating. Kaplan-Meier and log-rank tests were used for time-to-event analysis within and between intervention and control groups. RESULTS Participants were predominantly on Medicaid (72%), delivered infants <1500 g, and by c-section (56%). Kaplan-Meier probabilities at month 3 suggest prolonged MOM feeding (63% [0.95CI, 0.43-0.91] vs. 41% [0.95CI, 0.21-0.67]) and lactation (63% [0.95CI, 0.42-0.95] vs. 37% [0.95CI, 0.18-0.76]) in the enhanced group compared to the control group. CONCLUSION Personalized biomarker-based text messages are feasible and may prolong lactation and MOM feeding among parents of critically ill infants.
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Affiliation(s)
- Marina Magalhães
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA. .,Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Arie H Havelaar
- Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, USA.,Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.,Food Systems Institute, University of Florida, Gainesville, FL, USA
| | - Deepthi S Varma
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL, USA
| | - Nicole Cacho
- Division of Neonatology, Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Sandra Sullivan
- Division of Neonatology, Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Leslie A Parker
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
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Dharod JM, Hernandez M, Labban JD, Black MM, Ammerman A, Frazier C, Raynor N, Ramos-Castillo I. Associations between early introduction to complementary foods, subsequent cereal-added bottle feeding and daily macronutrient intake among infants. Appetite 2023; 182:106453. [PMID: 36621723 PMCID: PMC9907061 DOI: 10.1016/j.appet.2023.106453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 12/19/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023]
Abstract
Introducing complementary foods early during infancy has been associated with an increased risk of overweight later in life, but the pathway is an understudied topic. Hence the study was conducted with low-income and primarily minority mother-infant dyads to: 1) understand how the introduction of complementary foods prior to 4 months was associated with socio-demographic characteristics and food security status; 2) determine the association between early introduction to complementary foods and breastfeeding and adding cereal into the bottle in later infancy (i.e., at 6 and 9 months), and; 3) examine how adding infant cereal into the bottle was related to daily calorie and macronutrient intake in infancy. We conducted interviews with mothers (n = 201) at 4 months of age and 24-h feeding recalls at age 6 and 9 months. Results indicated that 29% of the infants were fed complementary foods before 4 months of age. Introducing complementary foods early was negatively associated with breastfeeding and positively associated with adding cereal into the bottle at 6-months. This practice was more common among those who experienced marginal to very low levels of food security. Comparing by race/ethnicity, Latinx mothers were significantly less likely to introduce solids early. After controlling for sex, infants fed cereal in the bottle were consuming significantly more calories compared to their counterparts. Specifically, adding cereal into the bottle resulted in approximately 10% additional daily calorie intake among infants. Understanding how these feeding practices affect appetite development and weight status during infancy is warranted.
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Affiliation(s)
- Jigna M Dharod
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, USA.
| | - Marlen Hernandez
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, USA
| | - Jeffrey D Labban
- Office of Research, School of Health and Human Sciences, University of North Carolina at Greensboro, USA
| | - Maureen M Black
- RTI International, Research Triangle Park, NC, USA; Department of Pediatrics, University of Maryland School of Medicine, USA
| | - Alice Ammerman
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA; Center for Health, Promotion and Disease Prevention, University of North Carolina at Chapel Hill, USA
| | - Christina Frazier
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, USA
| | - Nichole Raynor
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, USA
| | - Isa Ramos-Castillo
- Department of Nutrition, School of Health and Human Sciences, University of North Carolina at Greensboro, USA
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Lyons GC, Kay MC, Duke NN, Bian A, Schildcrout JS, Perrin EM, Rothman RL, Yin HS, Sanders LM, Flower KB, Delamater AM, Heerman WJ. Social Support and Breastfeeding Outcomes Among a Racially and Ethnically Diverse Population. Am J Prev Med 2023; 64:352-360. [PMID: 36460526 PMCID: PMC9974778 DOI: 10.1016/j.amepre.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/28/2022] [Accepted: 10/03/2022] [Indexed: 12/05/2022]
Abstract
INTRODUCTION Social support is a modifiable social determinant of health that shapes breastfeeding outcomes and may contribute to racial and ethnic breastfeeding disparities. This study characterizes the relationship between social support and early breastfeeding. METHODS This is a cross-sectional analysis of baseline data collected in 2019-2021 for an RCT. Social support was measured using the Enhancing Recovery in Coronary Heart Disease Social Support Instrument. Outcomes, collected by self-report, included (1) early breastfeeding within the first 21 days of life, (2) planned breastfeeding duration, and (3) confidence in meeting breastfeeding goals. Each outcome was modeled using proportional odds regression, adjusting for covariates. Analysis was conducted in 2021-2022. RESULTS Self-reported race and ethnicity among 883 mothers were 50% Hispanic, 17% Black, 23% White, and 10% other. A large proportion (88%) of mothers were breastfeeding. Most breastfeeding mothers (82%) planned to breastfeed for at least 6 months, with more than half (58%) planning to continue for 12 months or more. Most women (65%) were confident or very confident in meeting their breastfeeding duration goal. In adjusted models, perceived social support was associated with planned breastfeeding duration (p=0.042) but not with early breastfeeding (p=0.873) or confidence in meeting breastfeeding goals (p=0.427). Among the covariates, maternal depressive symptoms were associated with lower breastfeeding confidence (p<0.001). CONCLUSIONS The associations between perceived social support and breastfeeding outcomes are nuanced. In this sample of racially and ethnically diverse mothers, social support was associated with longer planned breastfeeding duration but not with early breastfeeding or breastfeeding confidence.
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Affiliation(s)
| | - Melissa C Kay
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
| | - Naomi N Duke
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
| | - Aihua Bian
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Eliana M Perrin
- Department of Pediatrics, Schools of Medicine and Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Russell L Rothman
- Institute of Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee
| | - H Shonna Yin
- Department of Pediatrics, New York University School of Medicine, New York, New York; Department of Population Health, New York University School of Medicine, New York, New York
| | - Lee M Sanders
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Kori B Flower
- Division of General Pediatrics and Adolescent Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida
| | - William J Heerman
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
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Multi-omic factors associated with future wheezing in infants. Pediatr Res 2023; 93:579-585. [PMID: 36167817 DOI: 10.1038/s41390-022-02318-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/23/2022] [Accepted: 09/13/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND The pathophysiology of wheezing is multifactorial, impacted by medical, demographic, environmental, and immunologic factors. We hypothesized that multi-omic analyses of host and microbial factors in saliva would enhance the ability to identify infants at risk for wheezing. METHODS This longitudinal cohort study included 161 term infants. Infants who developed wheezing (n = 27) within 24 months of delivery were identified using the International Study of Asthma and Allergies in Childhood Written Questionnaire and review of the medical record. Standardized surveys were used to assess infant traits and environmental exposures. Saliva was collected for multi-omic assessment of cytokines, microRNAs, mRNAs, and microbiome/virome RNAs. RESULTS Two infant factors (daycare attendance, family history of asthma) and three salivary "omic" features (miR-26a-5p, Elusimicrobia, Streptococcus phage phiARI0131-1) differed between the two groups (adjusted p < 0.05). miR-26a-5p levels were correlated with Elusimicrobia (R = -0.87, p = 3.7 × 10-31). A model employing the three omic features plus daycare attendance and family asthma history yielded the highest predictive accuracy for future wheezing episodes (AUC = 0.74, 95% CI: 0.703-0.772, 77% sensitivity, 62% specificity). CONCLUSIONS Host-microbiome interactions in saliva may yield pathophysiologic clues about the origins of wheezing and aid identification of infants at risk of future wheezing episodes. IMPACT Wheezing is multi-factorial, but the relative contributions of infant traits, environment, and underlying biology are poorly understood. This multi-omic study identifies three molecular factors, including salivary microRNAs, microbes, and viral phages associated with increased risk of infant wheezing. Measurement of these molecular factors enhanced predictive accuracy for future wheezing when combined with family asthma history and daycare attendance. Validation of this approach could be used to identify infants at risk for wheezing and guide personalized medical management.
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Eagleton SG, Shriver LH, Buehler C, Wideman L, Leerkes EM. Longitudinal Associations Among Food Insecurity During Pregnancy, Parental Mental Health Symptoms, Controlling Feeding Styles, and Infant Food Responsiveness. J Nutr 2023; 152:2659-2668. [PMID: 36166350 PMCID: PMC9840003 DOI: 10.1093/jn/nxac225] [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: 03/24/2022] [Revised: 09/09/2022] [Accepted: 09/23/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Research is needed to identify pathways by which household food insecurity (FI) contributes to parental controlling feeding styles and infant food responsiveness, 2 factors that play a role in shaping obesity risk across infancy and early childhood. OBJECTIVES This longitudinal study tested the hypothesis that prenatal FI would be positively associated with higher infant food responsiveness via greater parental mental health symptomatology and controlling feeding styles (pressuring, restrictive). METHODS Participants included a community sample of 170 birth parents and their infants participating in an ongoing longitudinal study. Parents self-reported household FI and mental health symptoms (depression and anxiety) during pregnancy. Postnatally, parents reported their mental health symptoms, their use of controlling feeding styles, and infant food responsiveness. Path analyses with bias-corrected 95% bootstrapped CIs tested direct and indirect associations between prenatal FI and infant food responsiveness. RESULTS Prenatal FI was indirectly associated with higher infant food responsiveness via greater parental mental health symptomatology and pressuring to finish (b = 0.01; 95% CI: 0.001, 0.025). Prenatal FI was associated with greater parental mental health symptomatology across the peripartum period (β = 0.54; P < 0.001), which in turn was associated with more pressuring to finish at 2 months pospartum (β = 0.29; P = 0.01) and higher infant food responsiveness at 6 months (β = 0.17; P = 0.04). There were no direct effects of prenatal FI on controlling feedings styles or infant food responsiveness. CONCLUSIONS Our findings point to parental mental health as a potential pathway by which FI may be associated with obesity-promoting parental feeding styles and infant appetitive behaviors. In addition to ensuring reliable access to enough quality food during pregnancy, multipronged assistance that promotes emotional well-being during the peripartum period and clinical guidance on noncontrolling feeding styles could benefit parent and infant health and well-being.
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Affiliation(s)
- Sally G Eagleton
- Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Lenka H Shriver
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Cheryl Buehler
- Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Laurie Wideman
- Department of Kinesiology, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Esther M Leerkes
- Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, NC, USA
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Frequency of Infant Egg Consumption and Risk of Maternal-Reported Egg Allergy at 6 Years. J Nutr 2023; 153:364-372. [PMID: 36913473 DOI: 10.1016/j.tjnut.2022.11.023] [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: 08/16/2022] [Revised: 11/03/2022] [Accepted: 11/28/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Recent research suggests that early egg introduction during infancy may help to prevent egg allergy development. However, the infant egg consumption frequency that is sufficient to induce this immune tolerance remains uncertain. OBJECTIVES We examined the associations between the infant egg consumption frequency and maternal-reported child egg allergy at 6 y. METHODS We analyzed data of 1252 children from the Infant Feeding Practices Study II (2005-2012). Mothers reported the frequency of infant egg consumption at 2, 3, 4, 5, 6, 7, 9, 10, and 12 mo old. Mothers reported the status of their child's egg allergy at the 6-y follow-up. We used Fisher exact test, Cochran-Armitage Trend Test, and log Poisson regression models to compare 6-y egg allergy risk by the frequency of infant egg consumption. RESULTS The risk of maternal-reported egg allergy at 6 y significantly (P-trend = 0.004) decreased with infant egg consumption frequency at 12 mo: 2.05% (11/537) for infants not consuming eggs, 0.41% (1/244) for those consuming eggs <2 times per wk, and 0.21% (1/471) for those consuming eggs ≥2 times per wk. A similar but nonsignificant trend (P-trend=0.109) was observed for egg consumption at 10 mo (1.25%, 0.85%, and 0%, respectively). After adjusting for socioeconomic confounders, breastfeeding, complementary food introduction, and infant eczema, infants who consumed eggs ≥2 times per wk at 12 mo had a significantly lower RR of maternal-reported egg allergy at 6 y (confounder-adjusted RR: 0.11; 95% CI: 0.01, 0.88; P = 0.038), whereas those who consumed <2 times per wk (confounder-adjusted RR: 0.21; 95% CI: 0.03, 1.67; P = 0.141) did not have a significantly lower risk than those who did not consume eggs at all. CONCLUSIONS Consumption of eggs ≥2 times per wk in late infancy is associated with a reduced risk of developing egg allergy later in childhood.
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Hicks SD, Beheshti R, Chandran D, Warren K, Confair A. Infant consumption of microRNA miR-375 in human milk lipids is associated with protection from atopy. Am J Clin Nutr 2022; 116:1654-1662. [PMID: 36166840 DOI: 10.1093/ajcn/nqac266] [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: 05/24/2022] [Accepted: 09/19/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Human milk is thought to reduce infant atopy risk. The biologic mechanism for this protective effect is not fully understood. OBJECTIVES We tested the hypothesis that infant consumption of 4 microRNAs (miR-146b-5p, miR-148b-3p, miR-21-5p, and miR-375-3p) in human milk would be associated with reduced atopy risk. METHODS The Breast Milk Influence of the Microtranscriptome Profile on Atopy in Children over Time (IMPACT) study involved a cohort of mother-infant dyads who planned to breastfeed beyond 4 mo. Infant consumption of the 4 human milk microRNAs (miRNAs) in the first 6 mo was calculated as the product of milk miRNA concentration and the number of human milk feeds, across 3 lactation stages: early milk (0-4 wk), transitional milk (4-16 wk), and mature milk (16-24 wk). The primary outcome was infant atopy in the first year, defined as atopic dermatitis (AD), food allergies, or wheezing. The final analysis included 432 human milk samples and 7824 wk of longitudinal health data from 163 dyads. RESULTS Seventy-three infants developed atopy. Forty-one were diagnosed with AD (25%), 33 developed food allergy (20%), and 10 had wheezing (6%). Eleven developed >1 condition (7%). Infants who did not develop atopy consumed higher concentrations of miR-375-3p (d = 0.18, P = 0.022, adj P = 0.044) and miR-148b-3p (d = 0.23, P = 0.007, adj P = 0.028). The consumption of miR-375-3p (X2 = 5.7, P = 0.017, OR: 0.92, 95% CI: 0.86, 0.99) was associated with reduced atopy risk. Concentrations of miR-375-3p increased throughout lactation (r = 0.46, F = 132.3, P = 8.4 × 10-34) and were inversely associated with maternal body mass (r = -0.11, t = -2.1, P = 0.032). CONCLUSIONS This study provides evidence that infant consumption of miR-375-3p may reduce atopy risk.
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Affiliation(s)
- Steven D Hicks
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
| | - Ramin Beheshti
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
| | - Desirae Chandran
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
| | - Kaitlyn Warren
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
| | - Alexandra Confair
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
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Kong KL, Eiden RD, Morris KS, Paluch RA, Carr KA, Epstein LH. Reducing relative food reinforcement of infants using a music enrichment program: a randomized, controlled trial. Am J Clin Nutr 2022; 116:1642-1653. [PMID: 36250608 PMCID: PMC9761746 DOI: 10.1093/ajcn/nqac209] [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: 03/04/2022] [Revised: 06/15/2022] [Accepted: 07/28/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Food reinforcement or one's motivation to eat may be established early in life; it might not be the food reinforcement per se that drives weight gain, but rather the imbalance between food and nonfood reinforcement. OBJECTIVES We implemented a 2-y randomized, controlled trial to assess the effects of a music enrichment program (music, n = 45) compared with an active play date control (control, n = 45) in 9- to 15-mo-old healthy infants who were strongly motivated to eat. METHODS The 12-mo intensive intervention phase included 4 semesters of Music Together® or a play date program (Winter, Spring, Summer, and Fall), comprised of once per week group meetings, followed by a 12-mo maintenance phase with monthly meetings. Parents were encouraged to listen to the Music Together® program CD or play with the play date group's toy with their infants at home, respectively. We performed a modified intention-to-treat analysis using all randomly assigned, non-excluded subjects for the outcome measures [relative reinforcing value of food (RRVfood), food reinforcement, music reinforcement, and weight-for-length z-score (WLZ)]. RESULTS There were significant differential group changes across time for RRVfood (group × month; P = 0.016; Cohen's f2 = 0.034). The music group had significantly greater RRVfood decreases than the control group from baseline to the end of the intensive intervention phase (music change = -0.211; control change = -0.015; P = 0.002; Cohen's D = 0.379). However, these differences were not maintained during months 12-24 (music change = -0.187; control change = -0.143; P = 0.448; D = 0.087). We observed an overall moderation effect by sex for food reinforcement and WLZ. Boys in the music group had a significant attenuation in food reinforcement and WLZ compared with boys in the control group. CONCLUSIONS This study extends our knowledge in infant eating behavior by providing insight into the role of nonfood alternatives in altering one's motivation to eat. There may be sex differences in altering one's motivation to eat.This trial was registered at clinicaltrials.gov as NCT02936284.
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Affiliation(s)
- Kai Ling Kong
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children's Mercy Research Institute, Children's Mercy Hospital, Kansas City, MO, USA
- Department of Pediatrics, University of Missouri–Kansas City, Kansas City, MO, USA
- Center for Children's Healthy Lifestyles and Nutrition, University of Kansas Medical Center, Kansas City, KS, USA
| | - Rina D Eiden
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Katherine S Morris
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Rocco A Paluch
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Katelyn A Carr
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Leonard H Epstein
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
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Multi-Omic Profiles in Infants at Risk for Food Reactions. Genes (Basel) 2022; 13:genes13112024. [DOI: 10.3390/genes13112024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
Food reactions (FR) are multifactorial and impacted by medical, demographic, environmental, and immunologic factors. We hypothesized that multi-omic analyses of host-microbial factors in saliva would enhance our understanding of FR development. This longitudinal cohort study included 164 infants followed from birth through two years. The infants were identified as FR (n = 34) or non-FR (n = 130) using the Infant Feeding Practice II survey and medical record confirmation. Saliva was collected at six months for the multi-omic assessment of cytokines, mRNAs, microRNAs, and the microbiome/virome. The levels of one miRNA (miR-203b-3p, adj. p = 0.043, V = 2913) and one viral phage (Proteus virus PM135, adj. p = 0.027, V = 2955) were lower among infants that developed FRs. The levels of one bacterial phylum (Cyanobacteria, adj. p = 0.048, V = 1515) were higher among infants that developed FR. Logistical regression models revealed that the addition of multi-omic features (miR-203b-3p, Cyanobacteria, and Proteus virus PM135) improved predictiveness for future FRs in infants (p = 0.005, X2 = 12.9), predicting FRs with 72% accuracy (AUC = 0.81, sensitivity = 72%, specificity = 72%). The multi-omic analysis of saliva may enhance the accurate identification of infants at risk of FRs and provide insights into the host/microbiome interactions that predispose certain infants to FRs.
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Adams LE, Sommer EC, Truesdale KP, Barkin SL, Heerman WJ. Validation of a new scoring approach of a child dietary questionnaire for use in early childhood among low-income, Latino populations. BMC Nutr 2022; 8:125. [PMID: 36316788 PMCID: PMC9620651 DOI: 10.1186/s40795-022-00618-4] [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: 08/27/2021] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Measuring diet quality in early childhood requires time-intensive and costly measurements (e.g., 24-hour diet recall) that are especially burdensome for low-income, minority populations. This study aimed to validate a new method for calculating overall diet quality among low-income, Latino preschoolers. METHODS This study was an observational study using data from a randomized controlled trial. Participants included parents of Latino preschoolers who reported child diet quality at baseline, 4-month, 7-month, 12-month, and 13-month follow-up. At each timepoint parents responded to a 28-item child dietary questionnaire (CDQ), based on the National Health and Nutrition Examination Survey (NHANES) dietary module, which generated the number of times/day that a child ate each of 28 foods in the past month. These 28 items were then used to create a total standardized child diet quality index (possible range 0-100), using a percent of maximum method. Parents were asked to complete three 24-hour diet recalls at the 13-month follow-up, from which the 2015 Healthy Eating Index (HEI) was derived. Construct validity was evaluated by Spearman's rank correlations between the new child diet quality index and the 2015 HEI at the 13-month follow-up. Test-retest reliability was assessed by intraclass correlation coefficients (ICC) for sequential pairs of time points. RESULTS Among 71 eligible parent-child pairs, mean child age was 4.2 (SD = 0.8) years, 50.7% of children were female, and mean child body mass index (BMI) was 17.8 (SD = 2.0) kg/m2. Mean Child Diet Quality Index was 45.2 (SD = 3.2) and mean HEI was 68.4 (SD = 10.5). Child Diet Quality Index and HEI total scores were significantly correlated (r = 0.37; p = 0.001). Test-retest ICCs were statistically significant between all sequential pairs of time points. CONCLUSION The new approach for calculating a measure of overall diet quality from the previously-validated 28-item dietary questionnaire demonstrated modest construct validity. When time and resources are limited, this new measure of overall diet quality may be an appropriate choice among low-income, Latino preschoolers. TRIAL REGISTRATION This reports presents observational data collected as a part of a clinical trial, which was registered on clinicaltrials.gov prior to participant enrollment (NCT03141151).
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Affiliation(s)
- Laura E. Adams
- grid.412807.80000 0004 1936 9916Department of Pediatrics, Vanderbilt University Medical Center, 2146 Belcourt Ave, 37232-9225 Nashville, TN USA
| | - Evan C. Sommer
- grid.412807.80000 0004 1936 9916Department of Pediatrics, Vanderbilt University Medical Center, 2146 Belcourt Ave, 37232-9225 Nashville, TN USA
| | - Kimberly P. Truesdale
- grid.410711.20000 0001 1034 1720Department of Nutrition, University of North Carolina, McGavran-Greenberg Hall, 2209, 27599 Chapel Hill, NC USA
| | - Shari L. Barkin
- grid.412807.80000 0004 1936 9916Department of Pediatrics, Vanderbilt University Medical Center, 2146 Belcourt Ave, 37232-9225 Nashville, TN USA
| | - William J. Heerman
- grid.412807.80000 0004 1936 9916Department of Pediatrics, Vanderbilt University Medical Center, 2146 Belcourt Ave, 37232-9225 Nashville, TN USA
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Griebel-Thompson AK, Murray A, Morris KS, Paluch RA, Jacobson L, Kong KL. The Association between Maternal Sugar-Sweetened Beverage Consumption and Infant/Toddler Added Sugar Intakes. Nutrients 2022; 14:4359. [PMID: 36297043 PMCID: PMC9607505 DOI: 10.3390/nu14204359] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 11/17/2022] Open
Abstract
Intake of added sugars during early life is associated with poor health outcomes. Maternal dietary intake influences the intake of their children, but little research investigates the relationship between maternal sugar sweetened beverage (SSB) and infant/toddler added sugar intakes. Our objective was to explore the relationship between maternal total sugars and SSB intakes and infant/toddler added sugar intakes. This cross-sectional study (n = 101) of mother-infant dyads measured maternal dietary intake by food frequency questionnaire and infant intake by three 24-h dietary recalls. Pearson’s correlations explored the relations between maternal total sugars and SSB intakes and infant added sugar intakes. Hierarchical stepwise regressions determined if maternal total sugars and SSB intakes explained the variation in infant added sugar intakes after accounting for known risk factors for early introduction of added sugars. Maternal total sugars (r = 0.202, p = 0.043) and SSB (r = 0.352, p < 0.001) intakes were positively correlated with infant/toddler added sugar intakes. In the hierarchical models, maternal total sugar intakes did not account for more variance in infant added sugar intakes (β = 0.046, p = 0.060), but maternal SSB intake was a significant contributor of infant added sugar intakes (β = 0.010, p = 0.006) after accounting for confounders. Interventions to reduced maternal SSB consumption may help reduce infant/toddler added sugar intakes.
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Affiliation(s)
- Adrianne K Griebel-Thompson
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children's Mercy Research Institute, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA
| | - Abigail Murray
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children's Mercy Research Institute, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA
| | - Katherine S Morris
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Rocco A Paluch
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Lisette Jacobson
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS 67214, USA
| | - Kai Ling Kong
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children's Mercy Research Institute, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA
- Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO 64108, USA
- Center for Children's Healthy Lifestyles and Nutrition, University of Kansas Medical Center, Kansas City, KS 66103, USA
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Eagleton SG, Shriver LH, Buehler C, Wideman L, Leerkes EM. Bidirectional associations between maternal controlling feeding and food responsiveness during infancy. Front Public Health 2022; 10:975067. [PMID: 36299755 PMCID: PMC9589151 DOI: 10.3389/fpubh.2022.975067] [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: 06/21/2022] [Accepted: 09/22/2022] [Indexed: 01/25/2023] Open
Abstract
Parental controlling feeding styles and practices have been associated with greater food-approaching appetitive behaviors (i.e., food responsiveness) linked to childhood obesity. Recent longitudinal research suggests that this relationship may be reciprocal such that controlling feeding predicts child appetite and vice versa. However, to date no studies have considered these associations during infancy. The current study investigates prospective bidirectional associations between controlling feeding (restriction, pressure, and food to soothe) and infant food responsiveness. Mothers (N = 176) reported their controlling feeding and their infant's food responsiveness at infant age 2, 6, and 14 months. A 3-wave cross-lagged panel model was used to test the effect of controlling feeding at an earlier time point on infant food responsiveness at a later time point, and vice versa. Maternal controlling feeding and infant food responsiveness showed moderate stability across infancy. Net of covariates, we observed parent-driven prospective relations between pressuring feeding styles and food to soothe with infant food responsiveness. Pressuring to finish was a significant predictor of increases in food responsiveness from 2 to 6 months (p = 0.004) and pressuring with cereal was a significant predictor of increases in food responsiveness from 6 to 14 months (p = 0.02). Greater use of situational food to soothe was marginally associated with higher food responsiveness from 2 to 6 months (p = 0.07) and 6 to 14 months (p = 0.06). Prospective associations between restrictive feeding styles and infant food responsiveness were not observed. Findings point to pressuring feeding styles and food to soothe as potential early life intervention targets to prevent increases in food responsiveness in infancy. Longitudinal research with follow-up in the toddler and preschool years are needed to understand how these associations unfold over time and whether child-driven effects of food responsiveness become apparent as children get older.
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Affiliation(s)
- Sally G. Eagleton
- Department of Human Development and Family Studies, UNC Greensboro, Greensboro, NC, United States,*Correspondence: Sally G. Eagleton
| | - Lenka H. Shriver
- Department of Nutrition, UNC Greensboro, Greensboro, NC, United States
| | - Cheryl Buehler
- Department of Human Development and Family Studies, UNC Greensboro, Greensboro, NC, United States
| | - Laurie Wideman
- Department of Kinesiology, UNC Greensboro, Greensboro, NC, United States
| | - Esther M. Leerkes
- Department of Human Development and Family Studies, UNC Greensboro, Greensboro, NC, United States
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Mi B, Liu H, Wang Y, Small H, Surguy‐Bowers A, Rideout TC, Cameron CE, Lehman HK, Starke K, Wen X. Infant age at egg introduction and malnutrition‐related child growth in the United States. MATERNAL & CHILD NUTRITION 2022; 18:e13390. [PMID: 35712809 PMCID: PMC9480938 DOI: 10.1111/mcn.13390] [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: 10/10/2021] [Revised: 04/16/2022] [Accepted: 05/24/2022] [Indexed: 11/30/2022]
Abstract
To evaluate the relationship between infant age of egg introduction and malnutrition‐related growth outcomes in the United States, we analysed secondary data of 1716 mother–child dyads in the Infant Feeding Practices Study II and its Year 6 Follow‐Up Study. Malnutrition‐related growth outcomes included body mass index z‐score (BMIZ), obesity (weight‐for‐height z‐score [WHZ] ≥3 or BMIZ ≥ 2), WHZ, wasting (WHZ < −2), height‐for‐age z‐score (HAZ), and stunting (HAZ < –2). Infant age at egg introduction was analysed as a continuous variable. We used generalised estimating equations to estimate the mean difference in continuous outcomes and relative risk [RR]) for binary outcomes, adjusting for related maternal and child confounders. We also explored interactions with child sex, maternal race/ethnicity, maternal educational level, ever breastfeeding, and formula feeding. In the total sample, a later infant age at egg introduction was associated with a lower mean difference in HAZ (confounder‐adjusted mean difference = −0.08, 95% confidence interval [CI]: −0.12 to −0.03 per month) and a higher risk of stunting (confounder‐adjusted RR = 1.17, 95% CI: 1.03–1.33 per month) at 6 years. The associations between infant age at egg introduction and 12‐month growth outcomes differed by child sex. Among females but not among males, later introduction of eggs was associated with a lower mean WHZ (−0.06 [−0.12 to 0.00] per month) at 12 months. Later egg introduction during infancy was associated with a lower mean HAZ and a higher risk of stunting in 6‐year‐old children. Besides this, it was associated with a lower WHZ among females at 12 months. This secondary data analysis evaluated the relationship between infant age at egg introduction and malnutrition‐related growth outcomes among young US children within the Infant Feeding Practices Study II and its Year 6 Follow‐up Study. In the total sample, a later infant age at egg introduction was associated with a lower mean 6‐year height‐for‐age z‐score and a higher risk of stunting at 6 years. The associations between infant age at egg introduction and 12‐month growth outcomes differed by child sex. Later introduction of eggs was associated with a lower mean weight‐for‐height z‐score among females. However, this association was not observed among males.
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Affiliation(s)
- Baibing Mi
- Department of Epidemiology and Biostatistics, School of Public Health Xi'an Jiaotong University Health Science Center Xi'an Shaanxi China
- Center for Chronic Diseases Control and Prevention, Global Health Institute, School of Public Health Xi'an Jiaotong University Health Science Center Xi'an Shaanxi China
| | - Huimeng Liu
- Department of Epidemiology and Biostatistics, School of Public Health Xi'an Jiaotong University Health Science Center Xi'an Shaanxi China
- Center for Chronic Diseases Control and Prevention, Global Health Institute, School of Public Health Xi'an Jiaotong University Health Science Center Xi'an Shaanxi China
| | - Yutong Wang
- Department of Epidemiology and Biostatistics, School of Public Health Xi'an Jiaotong University Health Science Center Xi'an Shaanxi China
- Center for Chronic Diseases Control and Prevention, Global Health Institute, School of Public Health Xi'an Jiaotong University Health Science Center Xi'an Shaanxi China
| | - Hannah Small
- Division of Behavioural Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences State University of New York at Buffalo Buffalo New York USA
| | - Ariana Surguy‐Bowers
- Division of Behavioural Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences State University of New York at Buffalo Buffalo New York USA
| | - Todd C. Rideout
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions State University of New York at Buffalo Buffalo New York USA
| | - Claire E. Cameron
- Department of Learning and Instruction, Graduate School of Education State University of New York at Buffalo Buffalo New York USA
| | - Heather K. Lehman
- Division of Allergy/Immunology and Rheumatology, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, John R. Oishei Children's Hospital State University of New York at Buffalo Buffalo New York USA
| | - Krystal Starke
- Department of Learning and Instruction, Graduate School of Education State University of New York at Buffalo Buffalo New York USA
| | - Xiaozhong Wen
- Division of Behavioural Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences State University of New York at Buffalo Buffalo New York USA
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Hamner HC, Nelson JM, Sharma AJ, Jefferds MED, Dooyema C, Flores-Ayala R, Bremer AA, Vargas AJ, Casavale KO, de Jesus JM, Stoody EE, Scanlon KS, Perrine CG. Improving Nutrition in the First 1000 Days in the United States: A Federal Perspective. Am J Public Health 2022; 112:S817-S825. [PMID: 36122314 PMCID: PMC9612192 DOI: 10.2105/ajph.2022.307028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2022] [Indexed: 11/04/2022]
Abstract
The first 1000 days begins with pregnancy and ends at the child's second birthday. Nutrition throughout the life course, and especially during the first 1000 days, supports maternal health and optimal growth and development for children. We give a high-level summary of the state of nutrition in the first 1000 days in the United States. We provide examples where continued efforts are needed. We then discuss select opportunities to strengthen federal research and surveillance, programs, and communication and dissemination efforts aimed at improving nutrition and positively, and equitably, influencing the health and well-being of mothers and children. (Am J Public Health. 2022;112(S8):S817-S825. https://doi.org/10.2105/AJPH.2022.307028).
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Affiliation(s)
- Heather C Hamner
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Jennifer M Nelson
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Andrea J Sharma
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Maria Elena D Jefferds
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Carrie Dooyema
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Rafael Flores-Ayala
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Andrew A Bremer
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Ashley J Vargas
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Kellie O Casavale
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Janet M de Jesus
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Eve E Stoody
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Kelley S Scanlon
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Cria G Perrine
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
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Kebbe M, Altazan AD, Beyl RA, Gilmore LA, Redman LM. Infant Feeding Varies Across Eating Behavior and Feeding Modalities in Mothers With Low Income. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:827-834. [PMID: 35764453 PMCID: PMC9464659 DOI: 10.1016/j.jneb.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To examine if eating behaviors in mothers with low income relate to attitudes toward infant feeding and whether associations differed between breastfeeding and formula-feeding mothers. DESIGN Cross-sectional study. PARTICIPANTS Forty postpartum women (aged ≥ 18 years, body mass index ≥ 25 and < 40 kg/m<sup>2</sup>) in the Louisiana Women, Infants, and Children program participated in a telehealth postpartum intervention for health and weight loss. MAIN OUTCOME MEASURE(S) Maternal eating behaviors and infant feeding styles, assessed 6-8 weeks after birth (baseline) using validated questionnaires. ANALYSIS Significance was detected using independent t tests, chi-square tests for independence, or linear models (P < 0.05). RESULTS Most mothers formula-fed (n = 27, 68%). In formula-feeding mothers, maternal disinhibition and perceived hunger were positively associated with restrictive infant feeding (β = 0.41, P <0.001 and β = 0.41, P = 0.001, respectively). These relationships were significantly higher (Δ = -0.85, P = 0.006 and Δ = -0.59, P = 0.003, respectively) than among breastfeeding mothers. Comparatively, pressuring/overfeeding was lower in formula-feeding mothers than among breastfeeding mothers with dietary restraint (Δ slopes: 1.06, P = 0.02). CONCLUSIONS AND IMPLICATIONS In this cohort of mothers with low income, maternal eating behavior was associated with infant feeding styles only when feeding modality was considered. Mothers may benefit from education on how their eating behaviors can influence their infants and children.
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Affiliation(s)
- Maryam Kebbe
- Reproductive Endocrinology and Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | - Abby D Altazan
- Reproductive Endocrinology and Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | - Robbie A Beyl
- Reproductive Endocrinology and Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | - L Anne Gilmore
- Department of Clinical Nutrition, UT Southwestern Medical Center, Dallas, TX
| | - Leanne M Redman
- Reproductive Endocrinology and Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA.
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Cummings JR, Faith MS, Lipsky LM, Liu A, Mooney JT, Nansel TR. Prospective relations of maternal reward-related eating, pregnancy ultra-processed food intake and weight indicators, and feeding mode with infant appetitive traits. Int J Behav Nutr Phys Act 2022; 19:100. [PMID: 35922793 PMCID: PMC9351142 DOI: 10.1186/s12966-022-01334-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/15/2022] [Indexed: 11/10/2022] Open
Abstract
Background Infant appetitive traits including eating rate, satiety responsiveness, food responsiveness, and enjoyment of food predict weight gain in infancy and early childhood. Although studies show a strong genetic influence on infant appetitive traits, the association of parent and infant appetite is understudied. Furthermore, little research examines the influence of maternal pregnancy dietary intake, weight indicators, and feeding mode on infant appetite. The present study investigated relations of maternal reward-related eating, pregnancy ultra-processed food intake and weight indicators, and feeding mode with infant appetitive traits. Methods Mothers in the Pregnancy Eating Attributes Study (458 mothers enrolled, 367 retained through delivery) completed self-report measures of reward-related eating, and principal component analysis yielded two components: (1) food preoccupation and responsiveness and (2) reinforcing value of food. Mothers completed 24-h dietary recalls across pregnancy, and the standardized NOVA (not an acronym) system categorized recalled foods based on processing level. Maternal anthropometrics were measured across pregnancy. At infant age 6 months, mothers reported on feeding mode and infant appetitive traits. Linear regressions were conducted predicting infant appetitive traits from household income-poverty ratio (step 1); maternal reward-related eating components (step 2); pregnancy ultra-processed food intake (% of energy intake), early pregnancy body mass index, and gestational weight gain (step 3); and exclusive breastfeeding duration (step 4). Results A 1-SD greater maternal food preoccupation and responsiveness was associated with 0.20-SD greater infant satiety responsiveness (p = .005). A 1-SD greater % energy intake from ultra-processed foods during pregnancy was associated with 0.16-SD lower infant satiety responsiveness (p = .031). A 1-SD longer exclusive breastfeeding duration was associated with 0.18-SD less infant food responsiveness (p = .014). Other associations of maternal reward-related eating, pregnancy ultra-processed food intake and weight indicators, and feeding mode with infant appetitive traits were non-significant. Conclusions Proximal early-life environmental factors including maternal pregnancy dietary intake and feeding mode may facilitate or protect against obesogenic infant appetitive traits, whereas infant appetite may not parallel maternal reward-related eating. Further investigation into the etiology of appetitive traits early in development, particularly during solid food introduction, may elucidate additional modifiable risk factors for child obesity. Trial registration Clinicaltrials.gov. Registration ID – NCT02217462. Date of registration – August 13, 2014. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01334-9.
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Affiliation(s)
- Jenna R Cummings
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
| | - Myles S Faith
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo - SUNY, 420 Bady Hall, Buffalo, NY, 14250, USA
| | - Leah M Lipsky
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
| | - Aiyi Liu
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
| | - Jan T Mooney
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA.,Health Psychology PhD Program, University of North Carolina at Charlotte, Colvard Hall, 9201 University City Boulevard, Charlotte, NC, 28223, USA
| | - Tonja R Nansel
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA.
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47
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Wu AJ, Aris IM, Hivert MF, Fiechtner L, Davison KK, Redline S, Taveras EM. Associations of Healthy Infant Feeding Practices and Early Childhood Adiposity in the Rise & SHINE Cohort. J Pediatr Gastroenterol Nutr 2022; 75:e15-e19. [PMID: 35641893 PMCID: PMC9329206 DOI: 10.1097/mpg.0000000000003495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
We studied healthy infant feeding practices among 308 mother-infant pairs, including exclusive breastmilk, satiety cues, complementary food introduction, sugary beverage intake, and bottle use in bed. We examined associations of individual and cumulative infant feeding practices through 12 months of age with body mass index (BMI) z -score at 2 years. Exclusive breastmilk and avoidance of bottle use in bed were associated with lower BMI z -score (β -0.29 units; 95% CI, -0.56, -0.02 units and β -0.32 units; 95% CI, -0.57, -0.07, respectively), when accounting for maternal pre-pregnancy BMI, household income, infant sex, race, and ethnicity. Adherence to 4--5 practices, compared to ≤ 2 practices, was associated with lower BMI z -score (β -0.84 units; 95% CI, -1.35, -0.34 units). Adherence to healthy infant feeding practices may reduce risk of excessive adiposity in early childhood. Targeting multiple infant feeding practices may be a more effective way to prevent childhood adiposity.
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Affiliation(s)
- Allison J Wu
- From the Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA, USA
| | - Izzuddin M Aris
- the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Marie-France Hivert
- the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- the Diabetes Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, MA, USA
| | - Lauren Fiechtner
- the Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
- the Division of Gastroenterology and Nutrition, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Kirsten K Davison
- the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- the School of Social Work, Boston College, Chestnut Hill, MA, USA
| | - Susan Redline
- the Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Elsie M Taveras
- the Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
- the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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Vandyousefi S, Messito MJ, Katzow MW, Scott MA, Gross RS. Infant appetite traits, feeding practices and child obesity in low-income Hispanic families. Pediatr Obes 2022; 17:e12913. [PMID: 35274484 PMCID: PMC9283219 DOI: 10.1111/ijpo.12913] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 02/11/2022] [Accepted: 02/28/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Appetite traits and feeding practices are important determinants of child weight and obesity. OBJECTIVES This study examined whether: (1) infant appetite traits were associated with feeding practices and (2) feeding practices mediated the link between appetite traits and weight-for-age z-scores at age 3 years. METHODS We conducted a secondary data analysis from the 'Starting Early Program' of low-income, Hispanic mother-child pairs. Appetite traits were assessed using the Baby Eating Behaviour Questionnaire. Infant feeding practices were collected using 24-h dietary recalls and surveys: (1) breastfeeding exclusivity, intensity and duration; (2) early introduction to complementary foods/liquids and (3) any 100% fruit juice consumption at age 10 months. Regression and mediation analyses were used to explore associations between appetite, feeding and weight. RESULTS Higher infant Slowness in Eating scores were associated with greater breastfeeding exclusivity, intensity and duration, compared to lower Slowness in Eating. Infants with higher Slowness in Eating and Satiety Responsiveness had lower odds of early introduction to complementary foods/liquids. Infants with higher Enjoyment of Food had greater odds of 100% juice consumption. Breastfeeding duration mediated the relationship between higher infant Slowness in Eating and lower weight-for-age z-scores. CONCLUSIONS Appetite traits represent potential targets for early life infant feeding interventions.
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Affiliation(s)
- Sarvenaz Vandyousefi
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY 10016, United States
| | - Mary Jo Messito
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY 10016, United States
| | - Michelle W. Katzow
- Department of Pediatrics, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Cohen Children’s Medical Center, Hempstead, NY 11040
| | - Marc A. Scott
- Department of Applied Statistics, Social Science, and Humanities, New York University Steinhardt School of Culture, Education, and Human Development, New York, NY
| | - Rachel S. Gross
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY 10016, United States
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Pearsall MS, Stuebe AM, Seashore C, Sullivan C, Tully KP. Welcoming, supportive care in US birthing facilities and realization of breastfeeding goals. Midwifery 2022; 111:103359. [PMID: 35567867 PMCID: PMC9828127 DOI: 10.1016/j.midw.2022.103359] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/13/2022] [Accepted: 05/01/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Emotional and physical support for birthing parents is positively associated with realization of their breastfeeding goals. However, few studies have investigated maternal descriptions of their postnatal unit experience of these domains. RESEARCH AIM The objective was to investigate maternal report of their birthing facility experiences and quantify the extent to which accounts of postpartum support were associated with meeting their breastfeeding goals. METHODS After IRB review, data were obtained through an online survey distributed from November 2016-May 2017. This analysis utilizes data from 2,771 birthing parents who were at least 18 years of age, experienced maternity care in the United States within five years, and reported that they had intended to breastfeed. Bivariate analysis was followed by logistic regression controlling for significant covariates. RESULTS In this sample of primarily non-Hispanic white birthing parents with intent to exclusively breastfeed, the following postnatal unit variables were associated with higher odds of meeting their breastfeeding goals, birthing parents feeling: welcomed (adjusted OR=1.36), that health care promoted their physical health (adjusted OR=1.41), that care promoted their emotional health (adjusted OR=1.38), that they were supported (adjusted OR=1.56), and that they were recognized by their health care team (adjusted OR=1.30). All the measured postnatal unit support variables were significantly correlated with each other, with correlation coefficients ranging from 0.15 to 0.81. CONCLUSIONS Before the COVID-19 pandemic, birthing parents' experiences on the postnatal unit were interrelated and associated with meeting their breastfeeding goals. As health care services are reviewed and prioritized during the COVID-19 pandemic and as part of ongoing strengthening of systems, qualitative and observational research can address the mechanisms underlying breastfeeding outcomes to inform the provision of more holistic and effective support.
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Affiliation(s)
- Marina Stranieri Pearsall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Alison M Stuebe
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hill; Carolina Global Breastfeeding Institute, Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Carl Seashore
- Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill
| | - Catherine Sullivan
- Carolina Global Breastfeeding Institute, Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Kristin P Tully
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hill.
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Yadav SP, Meghpara M, Marwah N, Nigam AG, Godhani S, Chalana S. Association of Early Childhood Caries with Feeding, Dietary Habits, and Oral Hygiene Practices among Rural and Urban School Children of Jaipur. Int J Clin Pediatr Dent 2022; 15:273-279. [PMID: 35991783 PMCID: PMC9357528 DOI: 10.5005/jp-journals-10005-2396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Satya P Yadav
- Department of Pediatric and Preventive Dentistry, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Mili Meghpara
- Department of Oral Medicine and Radiology, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
- Mili Meghpara, Department of Pediatric and Preventive Dentistry, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India, Phone: +91 9904025363, e-mail:
| | - Nikhil Marwah
- Department of Pediatric and Preventive Dentistry, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Anant G Nigam
- Department of Pedodontics and Preventive Dentistry, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Shubham Godhani
- Department of Prosthodontics and Crown and Bridge and Implantology, Daswani Dental College and Research Centre, Kota, Rajasthan, India
| | - Srishty Chalana
- Department of Pediatric and Preventive Dentistry, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
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