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Thompson KA, White JP, Bardone-Cone AM. Associations between pressure to breastfeed and depressive, anxiety, obsessive-compulsive, and eating disorder symptoms among postpartum women. Psychiatry Res 2023; 328:115432. [PMID: 37669578 DOI: 10.1016/j.psychres.2023.115432] [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: 03/01/2023] [Revised: 08/04/2023] [Accepted: 08/24/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Data from qualitative interviews indicate postpartum individuals feel pressure from their healthcare providers, the media, and their partners to breastfeed their infant(s). However, the link between pressure to breastfeed and maternal mental health symptoms has not been evaluated quantitatively. The goal of the current study was to evaluate the associations between perceived pressure to breastfeed from various sources and depressive, anxiety, obsessive-compulsive, and eating disorder symptoms among postpartum individuals. METHODS Participants were 306 women, ages 18-39, who gave birth in the past 12 months in the United States (primarily in North Carolina). They completed an online survey about their health history (including mental health symptoms) and breastfeeding experiences. RESULTS Results found postpartum women perceived more pressure to breastfeed from healthcare providers and from the media compared to pressure to breastfeed from their partners. Pressure from healthcare providers was associated with depressive, obsessive-compulsive, and eating disorder symptoms, but not with anxiety symptoms. Pressure from the media was associated with only depressive and eating disorder symptoms. Pressure from partners was not significantly associated with mental health symptoms. Above and beyond the other sources of pressure, pressure from healthcare providers explained a unique proportion of variance of obsessive-compulsive and eating disorder symptoms. LIMITATIONS Limitations include the cross-sectional design (which limits causal interpretations), and the homogenous sample (87% identified as White). CONCLUSIONS Messaging and information about breastfeeding (particularly from healthcare providers) should be reviewed to determine if there is language which could be perceived as "pressure." It is important to screen for a variety of mental health symptoms, including eating disorders, in perinatal populations when discussing breastfeeding.
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Affiliation(s)
- Katherine A Thompson
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States; Department of Psychology and Neurosciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Jennifer P White
- Department of Psychiatry, UNC School of Medicine, Chapel Hill, NC, United States
| | - Anna M Bardone-Cone
- Department of Psychology and Neurosciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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2
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Tsai SY. Shift-work and breastfeeding for women returning to work in a manufacturing workplace in Taiwan. Int Breastfeed J 2022; 17:27. [PMID: 35392946 PMCID: PMC8991565 DOI: 10.1186/s13006-022-00467-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 03/12/2022] [Indexed: 11/24/2022] Open
Abstract
Background Although breastfeeding-friendly workplaces are provided to promote an employed mother’s breastfeeding intention, few studies have explored breastfeeding intentions and behavior after a mother returns to work on a shift work or non-shift work schedule. To explore the impact of breastfeeding-friendly support on the intention of working mothers with different work schedules to continue breastfeeding, we conducted a survey at a female labor-intensive electronics manufacturer in Taiwan from August 2011 to April 2012. Methods Female workers who met the inclusion criteria (maternity leave between January 2009 and January 2011) were invited to participate in the survey. A structured questionnaire survey was administered to 715 working mothers employed at an electronics manufacturing plant in Tainan Science Park in Southern Taiwan. The questionnaire content included female employee demographic characteristics, employment characteristics, continued breastfeeding behavior after returning to work, access to lactation rooms, and employee perception of the breastfeeding policy and support when raising their most recently born child. Results A total of 715 employed mothers’ data were collected. Of the shift workers, 90.1% breastfed during maternity leave, but the breastfeeding rates after returning to work decreased to 21.5% for one to six months and 17.9% for more than six months. Of the non-shift workers, 87.6% breastfed during maternity leave and the breastfeeding rates after returning to work were 24.1% for one to six months and 34.6% for more than six months. Using a lactation room and taking advantage of breast-pumping breaks were significant factors for continuing to breastfeed one to six months after returning to work and more than six months after returning to work among shift workers and non-shift workers. In addition, among non-shift workers, a higher education level of the mother (odds ratio (OR) = 9.57) and partner support (OR = 4.89) had positive effects toward a mother continuing breastfeeding for more than six months after returning to work. Conclusions Workplaces or employers should provide more support to encourage employed mothers to take advantage of the breastfeeding room and breast-pumping breaks, enhance the frequency of the usage of lactation rooms, and increase the rate of continued breastfeeding. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-022-00467-8.
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Affiliation(s)
- Su-Ying Tsai
- Department of Health Management, I-Shou University, Kaohsiung, Taiwan.
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3
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Wako WG, Wayessa Z, Fikrie A. Effects of maternal education on early initiation and exclusive breastfeeding practices in sub-Saharan Africa: a secondary analysis of Demographic and Health Surveys from 2015 to 2019. BMJ Open 2022; 12:e054302. [PMID: 35292494 PMCID: PMC8928244 DOI: 10.1136/bmjopen-2021-054302] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Early initiation of breast feeding (EIBF) and exclusive breast feeding (EBF) are the cheapest, feasible and simplest nutritional interventions for infants. Effects of maternal education on EIBF and EBF are not consistent across studies. This study assessed the effects of maternal education on EIBF and EBF. METHODS A cross-sectional study was done based on data collected for phase 7 Demographic and Health Surveys conducted in 16 sub-Saharan African countries from 2015 to 2019. Data of the last-born children younger than 6 (n=19 103) and 24 (n=75 293) months were analysed to assess associations between maternal education and EIBF and EBF practices, respectively. To assess the associations, X2 test and logistic regression were done. Adjusted ORs (AORs) and their 95% CIs were used to declare statistical significance of the associations. RESULTS After controlling for all other potentially confounding variables, mothers who completed primary school were 1.29 (95% CI AOR: 1.24 to 1.34) times more likely to initiate breast feeding within the first 1 hour of delivery compared with mothers without education. However, mothers with secondary (AOR: 1.01; 95% CI: 0.96 to 1.06) or higher (AOR: 0.96; 95% CI: 0.87 to 1.05) level of education were not significantly different from mothers without education concerning EIBF. Similarly, mothers educated to primary school were 1.37 (95% CI AOR: 1.27 to 1.48) times more likely to exclusively breast feed compared with mothers without education. However, mothers educated to secondary (AOR: 1.07; 95% CI: 0.98 to 1.17) or higher (AOR: 1.07; 95% CI: 0.89 to 1.27) level of education were not significantly different from uneducated mothers regarding EBF practices. CONCLUSIONS Effects of maternal education on EIBF and EBF depend on the level of educational attainment. Future studies should look for reasons for the lower rate of EIBF and EBF among mothers with higher educational status.
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Affiliation(s)
- Wako Golicha Wako
- School of Public Health, Bule Hora University, Bule Hora, Oromia Regional State, Ethiopia
| | - Zelalem Wayessa
- Department of Midwifery, Bule Hora University, Bule Hora, Oromia Regional State, Ethiopia
| | - Anteneh Fikrie
- School of Public Health, Bule Hora University, Bule Hora, Oromia Regional State, Ethiopia
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4
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van Dellen SA, Wisse B, Mobach MP, Albers CJ, Dijkstra A. A cross-sectional study of lactation room quality and Dutch working mothers' satisfaction, perceived ease of, and perceived support for breast milk expression at work. Int Breastfeed J 2021; 16:67. [PMID: 34488788 PMCID: PMC8422697 DOI: 10.1186/s13006-021-00415-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 08/23/2021] [Indexed: 11/20/2022] Open
Abstract
Background The challenge of combining professional work and breastfeeding is a key reason why women choose not to breastfeed or to stop breastfeeding early. We posited that having access to a high-quality lactation room at the workplace could influence working mothers’ satisfaction and perceptions related to expressing breast milk at work, which could have important longer term consequences for the duration of breastfeeding. Specifically, we aimed to (1) develop a checklist for assessing the quality of lactation rooms and (2) explore how lactation room quality affects lactating mothers’ satisfaction and perceptions. Drawing on social ecological insights, we hypothesized that the quality of lactation rooms (operationalized as any space used for expressing milk at work) would be positively related to mothers’ satisfaction with the room, perceived ease of, and perceived support for milk expression at work. Methods We conducted two studies. In Study 1 we developed a lactation room quality checklist (LRQC) and assessed its reliability twice, using samples of 33 lactation rooms (Study 1a) and 31 lactation rooms (Study 1b). Data were collected in the Northern part of the Netherlands (between December 2016 and April 2017). Study 2 comprised a cross-sectional survey of 511 lactating mothers, working in a variety of Dutch organizations. The mothers were recruited through the Facebook page of a popular Dutch breastfeeding website. They completed online questionnaires containing the LRQC and measures aimed at assessing their satisfaction and perceptions related to milk expression at work (in June and July 2017). Results The LRQC was deemed reliable and easy to apply in practice. As predicted, we found that objectively assessed higher-quality lactation rooms were associated with increased levels of satisfaction with the lactation rooms, perceived ease of milk expression at work, and perceived support from supervisors and co-workers for expressing milk in the workplace. Conclusions The availability of a high-quality lactation room could influence mothers’ decisions regarding breast milk expression at work and the commencement and/or continuation of breastfeeding. Future studies should explore whether and how lactation room quality affects breastfeeding choices, and which aspects are most important to include in lactation rooms. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-021-00415-y.
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Affiliation(s)
- Sjoukje A van Dellen
- Department of Psychology, University of Groningen, Groningen, The Netherlands. .,Institute of Future Environments, Hanze University of Applied Sciences, Groningen, The Netherlands.
| | - Barbara Wisse
- Department of Psychology, University of Groningen, Groningen, The Netherlands.,Department of Management & Marketing, Durham University, Durham, UK
| | - Mark P Mobach
- Institute of Future Environments, Hanze University of Applied Sciences, Groningen, The Netherlands.,Faculty of Management and Organization, The Hague University of Applied Sciences, The Hague, The Netherlands
| | - Casper J Albers
- Department of Psychology, University of Groningen, Groningen, The Netherlands
| | - Arie Dijkstra
- Department of Psychology, University of Groningen, Groningen, The Netherlands
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5
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Usheva N, Lateva M, Galcheva S, Koletzko BV, Cardon G, De Craemer M, Androutsos O, Kotowska A, Socha P, Moreno LA, Manios Y, Iotova V. Breastfeeding and Overweight in European Preschoolers: The ToyBox Study. Nutrients 2021; 13:nu13082880. [PMID: 34445041 PMCID: PMC8401161 DOI: 10.3390/nu13082880] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 12/04/2022] Open
Abstract
The benefits of breastfeeding (BF) include risk reduction of later overweight and obesity. We aimed to analyse the association between breastfeeding practices and overweight/obesity among preschool children participating in the ToyBox study. Data from children in the six countries, participating in the ToyBox-study (Belgium, Bulgaria, Germany, Greece, Poland, and Spain) 7554 children/families and their age is 3.5–5.5 years, 51.9% were boys collected cross-sectionally in 2012. The questionnaires included parents’ self-reported data on their weight, height, socio-demographic status, and infant feeding practices. Measurements of preschool children’s weight and height were done by trained researchers using standard protocols and equipment. The ever breastfeeding rate in the total sample was 85.0% (n = 5777). Only 6.3% (n = 428) of the children from the general sample were exclusively breastfed (EBF) for the duration of the first six months. EBF for four to six months was significantly (p < 0.001) less likely among mothers with formal education < 12 years (adjusted Odds Ratio (OR) = 0.61; 95% Confidence interval (CI) 0.44–0.85), smoking throughout pregnancy (adjusted OR = 0.39; 95% CI 0.24–0.62), overweight before pregnancy (adjusted OR = 0.67; 95%CI 0.47–0.95) and ≤25 years old. The median duration of any breastfeeding was five months. The prevalence of exclusive formula feeding during the first five months in the general sample was about 12% (n = 830). The prevalence of overweight and obesity at preschool age was 8.0% (n = 542) and 2.8% (n = 190), respectively. The study did not identify any significant association between breastfeeding practices and obesity in childhood when adjusted for relevant confounding factors (p > 0.05). It is likely that sociodemographic and lifestyle factors associated with breastfeeding practices may have an impact on childhood obesity. The identified lower than desirable rates and duration of breastfeeding practices should prompt enhanced efforts for effective promotion, protection, and support of breastfeeding across Europe, and in particular in regions with low BF rates.
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Affiliation(s)
- Natalya Usheva
- Department of Social Medicine and Health Care Organization, Medical University of Varna, 9002 Varna, Bulgaria
- Correspondence: ; Tel.: +359-52677164
| | - Mina Lateva
- Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria; (M.L.); (S.G.); (V.I.)
| | - Sonya Galcheva
- Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria; (M.L.); (S.G.); (V.I.)
| | - Berthold V. Koletzko
- Division of Metabolic and Nutritional Medicine, Department Paediatrics, Dr. von Hauner Children’s Hospital, LMU University Hospitals, 80337 Munich, Germany;
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Marieke De Craemer
- Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium;
- Research Foundation Flanders, 1000 Brussels, Belgium
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 382 21 Volos, Greece;
| | - Aneta Kotowska
- Public Health Department, Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (A.K.); (P.S.)
| | - Piotr Socha
- Public Health Department, Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (A.K.); (P.S.)
| | - Luis A. Moreno
- GENUD (Growth, Exercise, Drinking Behaviour and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain;
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, 176 76 Athens, Greece;
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria; (M.L.); (S.G.); (V.I.)
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Sanefuji M, Senju A, Shimono M, Ogawa M, Sonoda Y, Torio M, Ichimiya Y, Suga R, Sakai Y, Honjo S, Kusuhara K, Ohga S. Breast feeding and infant development in a cohort with sibling pair analysis: the Japan Environment and Children's Study. BMJ Open 2021; 11:e043202. [PMID: 34380712 PMCID: PMC8359520 DOI: 10.1136/bmjopen-2020-043202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To investigate the association between breast feeding and infant development during the first year of life using sibling comparison. DESIGN Nationwide prospective birth cohort study with sibling pair analysis. SETTING 15 regional centres that participated in the Japan Environment and Children's Study. PARTICIPANTS This study included 77 119 children (singleton, term birth and no malformation/severe diseases) whose mothers were registered between January 2011 and March 2014, including 3521 duos or trios of siblings. PRIMARY OUTCOME MEASURES The primary outcome was developmental delay at 6 and 12 months of age, assessed using the Japanese translation of the Ages and Stages Questionnaires, third edition. Multivariable regression analyses adjusted for confounders were performed to estimate the risk ratios of delay associated with any or exclusive breast feeding. Pairs of siblings discordant for statuses were selected, and conditional regression analyses were conducted with a matched cohort design. RESULTS Developmental delay was identified in 6162 (8.4%) and 10 442 (14.6%) children at 6 and 12 months of age, respectively. Any breast feeding continued until 6 months or 12 months old was associated with reduced developmental delay at 12 months of age (adjusted risk ratio (95% CI): 0.81 (0.77 to 0.85) and 0.81 (0.78 to 0.84), respectively). Furthermore, exclusive breast feeding until 3 months was associated with reduced developmental delay at 12 months of age (adjusted risk ratio, 0.86 (95% CI 0.83 to 0.90)). In sibling pair analysis, the association between any breast feeding until 12 months and reduced developmental delay at 12 months of age persisted (adjusted risk ratio, 0.64 (95% CI 0.43 to 0.93)). CONCLUSIONS The present study demonstrated the association of continuous breast feeding with reduced developmental delay at 1 year of age using sibling pair analysis, in which unmeasured confounding factors are still present but less included. This may provide an argument to promote breastfeeding continuation.
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Affiliation(s)
- Masafumi Sanefuji
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ayako Senju
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masayuki Shimono
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masanobu Ogawa
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuri Sonoda
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Michiko Torio
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuko Ichimiya
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Reiko Suga
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yasunari Sakai
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoshi Honjo
- Department of Pediatrics, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan
| | - Koichi Kusuhara
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shouichi Ohga
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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7
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Duro-Gómez J, Franco Jiménez A, González Jiménez C, Duro Gómez L, Castelo-Branco C. Current lifestyle and exclusive breastfeeding: an impossible balance? J OBSTET GYNAECOL 2021; 42:198-201. [PMID: 33971780 DOI: 10.1080/01443615.2021.1882972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
427 women were included in this observational cohort study to determine the rate of exclusive (EB), mixed (MB) and artificial breastfeeding (AB) and the personal reasons and social factors influencing this decision. An initial survey was conducted within the first 36 h postpartum and a second wave was carried out 3 months after delivery. 55.74% (238) of the patients intended to EB, 32.55% (139) AB and 11.71% (50) MB. After 3 months, a high percentage in group EB (75.23%) maintained EB. The main reason for switching to AB was the absence of milk or weight loss of the newborn. In conclusion, EB is the preferred form for feeding newborns. When these women returned to their workplace, most of them wanted to continue with EB. Women with higher academic degrees chose more often EB.IMPACT STATEMENTWhat is already known on this subject? The benefits of exclusive breastfeeding are well known. However, in modern western societies, it is not easy to combine breastfeeding with day-to-day activity. Work activity, age or previous parity are some of the factors that may influence the election of the type of lactation.What do the results of this study add? Exclusive breastfeeding is the preferred method for feeding newborns immediately postpartum and 3 months later. Work activity does not seem to influence or to switch the choice. However, the level of education could be a determinant of adherence to exclusive breastfeeding.What are the implications of these findings for clinical practice and/or further research? Assessing the factors that favour adherence to exclusive breastfeeding might be a useful tool to its promotion. This study warrants further multivariate analyses on the same topic and additional studies in other social contexts.
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Affiliation(s)
- Jorge Duro-Gómez
- Department of Obstetrics and Gynecology, Reina Sofía University Hospital of Córdoba, Córdoba, Spain
| | - Adriana Franco Jiménez
- Department of Obstetrics and Gynecology, Reina Sofía University Hospital of Córdoba, Córdoba, Spain
| | | | - Lourdes Duro Gómez
- Department of Cardiology, Santa Lucía University General Hospital of Cartagena, Murcia, Spain
| | - Camil Castelo-Branco
- Faculty of Medicine-University of Barcelona, Clinic Institute of Gynecology, Obstetrics and Neonatology, Hospital Clinic - Institut d´Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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8
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Complementary Feeding and Overweight in European Preschoolers: The ToyBox-Study. Nutrients 2021; 13:nu13041199. [PMID: 33916419 PMCID: PMC8066073 DOI: 10.3390/nu13041199] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/04/2021] [Accepted: 03/30/2021] [Indexed: 11/25/2022] Open
Abstract
Complementary feeding (CF) should start between 4–6 months of age to ensure infants’ growth but is also linked to childhood obesity. This study aimed to investigate the association of the timing of CF, breastfeeding and overweight in preschool children. Infant-feeding practices were self-reported in 2012 via a validated questionnaire by >7500 parents from six European countries participating in the ToyBox-study. The proportion of children who received breast milk and CF at 4–6 months was 51.2%. There was a positive association between timing of solid food (SF) introduction and duration of breastfeeding, as well as socioeconomic status and a negative association with smoking throughout pregnancy (p < 0.005). No significant risk to become overweight was observed among preschoolers who were introduced to SF at 1–3 months of age compared to those introduced at 4–6 months regardless of the type of milk feeding. Similarly, no significant association was observed between the early introduction of SF and risk for overweight in preschoolers who were breastfed for ≥4 months or were formula-fed. The study did not identify any significant association between the timing of introducing SF and obesity in childhood. It is likely that other factors than timing of SF introduction may have impact on childhood obesity.
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9
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Hashemi-Nazari SS, Hasani J, Izadi N, Najafi F, Rahmani J, Naseri P, Rajabi A, Clark C. The effect of pre-pregnancy body mass index on breastfeeding initiation, intention and duration: A systematic review and dose-response meta-analysis. Heliyon 2020; 6:e05622. [PMID: 33319092 PMCID: PMC7725724 DOI: 10.1016/j.heliyon.2020.e05622] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/28/2020] [Accepted: 11/25/2020] [Indexed: 01/26/2023] Open
Abstract
Overweight and obesity not only are major risk factors for number of chronic diseases, but also a risk factor for pregnancy complications in women. The present study aims to investigate the association between pre-pregnancy BMI and the persistence and duration of BF. The electronic databases including Medline (PubMed), Scopus, Embase, Web of Science and Google Scholar were searched for papers with titles and/or abstracts including one of our keywords and published up to 15 April 2019. For dose-response relationship, the two-stage random-effects meta-analysis was performed using the “dosresmeta” function in R software. Thirty-two studies with the effect of pre-pregnancy BMI on BF initiation, intention and duration were included in the present study. Based on crude and adjusted OR models, the risk of BF cessation increased by 4% (OR = 1.04; 95% CI: 1.02–1.05) with an increase in a unit of BMI. In addition, based on crude and adjusted RR models, the risk of BF cessation increases by 2% and 1% (crude RR = 1.02; 95% CI: 1.01–1.03 and adjusted RR = 1.01; 95% CI: 0.99–1.02) with an increase in one unit of BMI. Based on the result, the health care professionals and other key stakeholders should be aware of the impact excess weight, and that women who are overweight or obese should be encouraged with continued access to guidance, counseling and support, starting from conception, to maximize BF outcomes.
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Affiliation(s)
- Seyed-Saeed Hashemi-Nazari
- Prevention of Cardiovascular Disease Research Center, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jalil Hasani
- Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
| | - Neda Izadi
- Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farid Najafi
- Department of Epidemiology, Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jamal Rahmani
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Naseri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdolhalim Rajabi
- Environmental Health Research Center, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Cain Clark
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, CV1 5FB, United Kingdom
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10
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Slagter KW, Raghoebar GM, Hamming I, Meijer J, Vissink A. Effect of frenotomy on breastfeeding and reflux: results from the BRIEF prospective longitudinal cohort study. Clin Oral Investig 2020; 25:3431-3439. [PMID: 33315177 PMCID: PMC8137608 DOI: 10.1007/s00784-020-03665-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 10/28/2020] [Indexed: 11/25/2022]
Abstract
Objectives To assess the Efficacy of Frenotomy with regard to Breastfeeding and Reflux Improvement (BRIEF) in infants with breastfeeding problems. Materials and methods A cohort of 175 consecutive breastfeeding women with breastfeeding and reflux problems related to a tongue-tie or lip-tie fulfilling the inclusion criteria was longitudinally followed for 6 months. The effect of frenotomy on these problems was studied by a standardized oral assessment and completing the validated Breastfeeding Self-Efficacy Short Form (BSES-SF), nipple pain score (Visual Analogue Scale, VAS), and Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R) questionnaires pre-frenotomy and at 1 week, 1 month, and 6 months’ post frenotomy. Results All 175 women completed the 1-month follow-up and 146 women the 6 months’ follow-up. Frenotomy resulted in a significant improvement of BSES-SF, nipple pain score, and I-GERQ-R after 1 week, which improvement maintained to be significant after 1 month for BSES-SF and I-GERQ-R, and after 6 months for I-GERQ-R. The improvements were irrespective of the type lip-tie or tongue-tie underlying the breast feeding and reflux problems. No post-operative complications were observed. About 60.7% of infants still was breastfed 6 months after treatment. Conclusions Frenotomy is a safe procedure with no post-operative complications and resulting in significant improvement of breastfeeding self-efficacy, nipple pain, and gastro-oesophageal reflux problems. Clinical relevance Frenotomy of a tongue-tie and or lip-tie can lead to improvement of breastfeeding and reflux problems irrespective of the type of tongue-tie or lip-tie and should be considered by clinicians as a proper tool to resolve these problems if non-interventional support did not help. International trial register ISRCTN64428423 Supplementary Information The online version contains supplementary material available at 10.1007/s00784-020-03665-y.
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Affiliation(s)
- Kirsten W Slagter
- Department of Oral and Maxillofacial Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Jiska Meijer
- General Practitioners Research Institute, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
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11
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Lande MS, Nedberg IH, Anda EE. Factors associated with exclusive breastfeeding at hospital discharge: a study using data from the Georgian Birth Registry. Int Breastfeed J 2020; 15:39. [PMID: 32404128 PMCID: PMC7218521 DOI: 10.1186/s13006-020-00286-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 05/06/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The World Health Organization recommends exclusive breastfeeding for six months, defined as no other solids or liquids besides breast milk and essential vitamins or medicines. Data about exclusive breastfeeding are limited in Georgia, and the information that exist are provided by national surveys, that present inconsistent numbers. Georgia has recently established a national birth registry, which includes information about early postpartum breastfeeding. The objective of this study was to identify factors associated with exclusive breastfeeding of term newborns at hospital discharge in Georgia, using national registry data. METHODS All live, singleton, term births registered in the Georgian Birth Registry in November and December 2017 were included, with a final study sample of 7134 newborns. Newborns exclusively breastfed at hospital discharge were compared with those who were not, and potential factors were assessed with logistic regression analysis. Hospital discharge normally occurred between 2 and 5 days postpartum. RESULTS The study identified several factors associated with nonexclusive breastfeeding of term newborns at hospital discharge in Georgia: maternal higher education compared to secondary education or less (Adjusted Odds Ratio [AOR] 0.75; 95% CI 0.59, 0.97), caesarean delivery compared to vaginal or assisted vaginal delivery (AOR 0.47; 95% CI 0.37, 0.60), birthweight < 2500 g compared to 3000-3499 g (AOR 0.51; 95% CI 0.27, 0.97), and admission to neonatal intensive care unit after delivery (AOR 0.02; 95% CI 0.02, 0.03). None of the following factors were associated with exclusive breastfeeding at discharge: mother's age, marital status, Body Mass Index (BMI), parity, in vitro fertilization, maternal intrapartum complications and the sex of the newborn. CONCLUSIONS To the authors' knowledge, this is the first time determinants of exclusive breastfeeding at hospital discharge have been studied in Georgia. Several factors associated with nonexclusive breastfeeding at discharge were identified, most noteworthy were caesarean delivery and admission to neonatal intensive care unit. These findings are of importance to the Georgian health authorities and maternal/child non-governmental organizations.
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Affiliation(s)
- Marie Sigstad Lande
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
| | | | - Erik Eik Anda
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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12
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Hankel MA, Kunseler FC, Oosterman M. Early Breastfeeding Experiences Predict Maternal Self-Efficacy During the Transition to Parenthood. Breastfeed Med 2019; 14:568-574. [PMID: 31314574 DOI: 10.1089/bfm.2019.0023] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: Breastfeeding can be challenging for new mothers. Women with high breastfeeding self-efficacy are more likely to breastfeed with confidence and are more likely to succeed in breastfeeding. The aim of this prospective longitudinal study was to test whether breastfeeding self-efficacy and breastfeeding experiences were related to trajectories of self-efficacy in the parenting domain during the transition to parenthood. Materials and Methods: A group of 1,091 primiparous women completed questionnaires at 32 weeks of gestation (maternal self-efficacy) and 3 months after giving birth (maternal self-efficacy, breastfeeding self-efficacy, and breastfeeding experiences). Only the women who started breastfeeding and completed questionnaires at both time points were included in the analyses (N = 817). Results: High breastfeeding self-efficacy significantly predicted increased maternal self-efficacy through the transition to parenthood. A successful breastfeeding experience fully explained this effect. Conclusion: The mediating effect of positive breastfeeding experiences on the relationship of breastfeeding self-efficacy and the change of maternal self-efficacy during the transition to parenthood implies breastfeeding to be an early target to enhance maternal self-efficacy. By pointing out breastfeeding as a genuine challenge during prenatal maternity courses, it might prepare mothers for one of their first experiences of parenthood. As a result, successful breastfeeding could be a steppingstone from positive prenatal expectations to growing confidence as a parent.
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Affiliation(s)
- Margot A Hankel
- Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands
| | - Florentina C Kunseler
- Faculty of Behavioural and Movement Sciences, VU University Medical Center, Amsterdam, The Netherlands
| | - Mirjam Oosterman
- Faculty of Behavioural and Movement Sciences, VU University Medical Center, Amsterdam, The Netherlands
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13
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Zhuang J, Bresnahan MJ, Yan X, Zhu Y, Goldbort J, Bogdan-Lovis E. Keep Doing the Good Work: Impact of Coworker and Community Support on Continuation of Breastfeeding. HEALTH COMMUNICATION 2019; 34:1270-1278. [PMID: 29771151 DOI: 10.1080/10410236.2018.1476802] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Returning to work poses a challenge to new mothers' breastfeeding success during the first 6 months postpartum. While previous research has shown that breastfeeding-related workplace policy plays a significant role in women's decision to continue breastfeeding, the extent to which interpersonal factors such as coworkers' (lack of) support and stigma affect women's breastfeeding behavior is less understood. Through a cross-sectional survey with 500 working mothers, this research found that female coworker support of other women played an important role in affecting mothers' decision to continue breastfeeding after returning to work and contributed to breastfeeding self-efficacy. The findings suggest that mothers' perception of supportive coworker communication has an impact on sustained breastfeeding. Workplaces need to enhance the mother-friendly climate by encouraging and rewarding coworkers and providing support necessary for breastfeeding colleagues.
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Affiliation(s)
- Jie Zhuang
- Department of Communication Studies, Texas Christian University
| | | | - Xiaodi Yan
- Department of Communication, Michigan State University
| | - Yi Zhu
- Department of Communication, Michigan State University
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14
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Association between birth weight and childhood cardiovascular disease risk factors in West Virginia. J Dev Orig Health Dis 2019; 11:86-95. [PMID: 31412965 DOI: 10.1017/s204017441900045x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The reported associations between birth weight and childhood cardiovascular disease (CVD) risk factors have been inconsistent. In this study, we investigated the relationship between birth weight and CVD risk factors at 11 years of age. This study used longitudinally linked data from three cross-sectional datasets (N = 22,136) in West Virginia; analysis was restricted to children born full-term (N = 19,583). The outcome variables included resting blood pressure [systolic blood pressure (SBP), diastolic blood pressure (DBP)] and lipid profile [total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, non-HDL, and triglycerides (TG)]. Multiple regression analyses were performed, adjusting for child's body mass index (BMI), sociodemographics, and lifestyle characteristics. Unadjusted analyses showed a statistically significant association between birth weight and SBP, DBP, HDL, and TG. When adjusted for the child's BMI, the association between birth weight and HDL [b = 0.14 (95% CI: 0.11, 0.18) mg/dl per 1000 g increase] and between birth weight and TG [b = -0.007 (-0.008, -0.005) mg/dl per 1000 g increase] remained statistically significant. In the fully adjusted model, low birth weight was associated with higher LDL, non-HDL, and TGs, and lower HDL levels. The child's current BMI at 11 years of age partially (for HDL, non-HDL, and TG) and fully mediated (for SBP and DBP) the relationship between birth weight and select CVD risk factors. While effects were modest, these risk factors may persist and amplify with age, leading to potentially unfavorable consequences in later adulthood.
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15
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van Dellen SA, Wisse B, Mobach MP, Dijkstra A. The effect of a breastfeeding support programme on breastfeeding duration and exclusivity: a quasi-experiment. BMC Public Health 2019; 19:993. [PMID: 31340787 PMCID: PMC6657127 DOI: 10.1186/s12889-019-7331-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 07/16/2019] [Indexed: 01/18/2023] Open
Abstract
Background Breastfeeding has important positive long-term health consequences for infants and mothers. The World Health Organization recommends that all infants should be exclusively breastfed for six months or longer, and advises continuation of breastfeeding for two years or beyond. However, these recommendations are not met in many countries. This study examined whether a comprehensive, evidence-based breastfeeding intervention, the Breastfeeding Support Programme (BSP), promotes prolonged duration and exclusivity of breastfeeding among its participants. Methods A quasi-experimental design was used to compare breastfeeding duration and exclusivity in the BSP group (N = 66) to breastfeeding duration and exclusivity in a control group (N = 72). Participants who followed the BSP were provided with 6 consults delivered by a lactation consultant. The consults started during pregnancy and continued up until 10 weeks after delivery. Participants in the control group did not follow the BSP. Pretest and posttest questionnaires were administered through the internet. A Cox proportional hazards regression analysis was used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for cessation of any and exclusive breastfeeding, while controlling for differences at baseline. Results The effect of the BSP on survival rates for any and exclusive breastfeeding were significant while controlling for differences between the two groups at baseline (respectively HR = 0.34, p < .001 [95% CI = 0.18–0.61] and HR = 0.46, p < .001 [95% CI = 0.29–0.72]). Among mothers in the BSP group there was on average 66% less risk of cessation of any breastfeeding and on average 54% less risk of cessation of exclusive breastfeeding at any point in time compared to those in the control group. Conclusions The BSP appears to be an effective means to delay cessation of any and exclusive breastfeeding cessation and therefore to increase breastfeeding duration and exclusivity. This is an important finding, because earlier cessation of breastfeeding than desired is a common problem in many countries. Future research into the effectiveness of the BSP could consider random assignment to conditions and test the effectiveness of the intervention in other populations to investigate further whether wide-scale implementation of this intervention could be useful to promote breastfeeding. Electronic supplementary material The online version of this article (10.1186/s12889-019-7331-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- S A van Dellen
- Department of Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712, TS, Groningen, The Netherlands. .,Hanze University of Applied Sciences, Zernikeplein 7, P.O. Box 70030, 9704, AA, Groningen, The Netherlands.
| | - B Wisse
- Department of Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712, TS, Groningen, The Netherlands.,Durham University Business School, Millhill Lane, Durham, DH1 3LB, UK
| | - M P Mobach
- Hanze University of Applied Sciences, Zernikeplein 7, P.O. Box 70030, 9704, AA, Groningen, The Netherlands.,The Hague University of Applied Sciences, Zernikeplein 7, P.O. Box 70030, 9704, AA, Groningen, The Netherlands
| | - A Dijkstra
- Department of Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712, TS, Groningen, The Netherlands
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16
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Xiang AH, Chow T, Mora-Marquez J, Martinez MP, Wang X, Yu W, Panganiban MB, Richter PM, Schneider DI. Breastfeeding Persistence at 6 Months: Trends and Disparities from 2008 to 2015. J Pediatr 2019; 208:169-175.e2. [PMID: 30876751 DOI: 10.1016/j.jpeds.2018.12.055] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 11/20/2018] [Accepted: 12/28/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To assess trends and disparities in breastfeeding by maternal characteristics (race and ethnicity, age at delivery, obesity, parity, and level of education) and the relative importance among these for breastfeeding at 6 months. STUDY DESIGN This retrospective birth cohort study included 195 861 live singleton children born at 32-42 weeks of gestation from 2008 to 2015 within a single integrated healthcare system. All children had healthcare coverage during the first year of life. Maternal characteristics and breastfeeding status at 6 months of age were extracted from electronic medical records. Trends over time of any breastfeeding ≥6 months were evaluated for the 5 maternal characteristics. Robust Poisson regression models were used to estimate breastfeeding rate differences associated with each of the 5 characteristics. The relative importance among them associated with breastfeeding ≥6 months was assessed by comparing model quasi-likelihood information criteria. RESULTS Rates of breastfeeding ≥6 months significantly increased overall and among groups defined by the maternal characteristics. However, there was little improvement over time in closing disparities associated with maternal race and ethnicity, age at delivery, prepregnancy obesity status, and level of education. Education level contributed to the greatest disparity in breastfeeding ≥6 months. Maternal age was the second factor, followed by prepregnancy obesity and maternal race and ethnicity. CONCLUSIONS Breastfeeding outreach programs focusing on women with less than a college education, women <25 years old, and women from non-Hispanic black or Hispanic race and ethnicity may help to reduce disparities and improve breastfeeding persistence rates within integrated healthcare systems.
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Affiliation(s)
- Anny H Xiang
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
| | - Ting Chow
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Janet Mora-Marquez
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Mayra P Martinez
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Xinhui Wang
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Wei Yu
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | | | - Paula M Richter
- Department of Obstetrics and Gynecology, Kaiser Permanente Southern California, Pasadena, CA
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17
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Umer A, Hamilton C, Edwards RA, Cottrell L, Giacobbi P, Innes K, John C, Kelley GA, Neal W, Lilly C. Association Between Breastfeeding and Childhood Cardiovascular Disease Risk Factors. Matern Child Health J 2019; 23:228-239. [PMID: 30499064 PMCID: PMC6476183 DOI: 10.1007/s10995-018-2641-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Introduction The immediate benefits of breastfeeding are well-established but the long-term health benefits are less well-known. West Virginia (WV) has a higher prevalence of cardiovascular disease (CVD) and lower breastfeeding rates compared to national averages. There is a paucity of research examining the relationship between breastfeeding and subsequent childhood CVD risk factors, an issue of particular relevance in WV. Methods This study used longitudinally linked data from three cross-sectional datasets in WV (N = 11,980). The information on breastfeeding was obtained retrospectively via parental recall when the child was in the fifth grade. The outcome variables included blood pressure measures [systolic blood pressure (SBP), diastolic blood pressure (DBP)] and lipid profile [total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), non-HDL, and triglycerides (TG)]. Multiple regression analyses were performed, adjusting for childhood body mass index (BMI) and additional covariates. Results Only 43% of mothers self-reported ever breastfeeding. The unadjusted analysis showed that children who were ever vs. never breastfed had significantly lower SBP (b = - 1.39 mmHg; 95% CI - 1.97, - 0.81), DBP (b = - 0.79 mmHg; 95% CI - 1.26, - 0.33), log-TG (b = - 0.08; 95% CI - 0.1, - 0.05), and higher HDL (b = 0.95 mg/dL; 95% CI 0.33, 1.56). After adjustment for the child's BMI, socio-demographic and lifestyle factors, log-TG remained significantly associated with breastfeeding (b = - 0.04; 95% CI - 0.06, - 0.01; p = 0.01). Conclusion The observed protective effect of any breastfeeding on childhood TG level was small but significant. This finding provides some support for a protective effect of breastfeeding on later CVD risk.
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Affiliation(s)
- Amna Umer
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV, 26506, USA.
| | - Candice Hamilton
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
| | - Roger A Edwards
- Department Health Professions Education Program, Center for Interprofessional Studies and Innovation, MGH Institute of Health Professions, Boston, MA, USA
| | - Lesley Cottrell
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
| | - Peter Giacobbi
- Department of Social and Behavioral Sciences, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, 26506, USA
| | - Kim Innes
- Department of Epidemiology, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, 26506, USA
| | - Collin John
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
| | - George A Kelley
- Department of Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, 26506, USA
| | - William Neal
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
| | - Christa Lilly
- Department of Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, 26506, USA
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18
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Lifestyle intervention strategies in early life to improve pregnancy outcomes and long-term health of offspring: a narrative review. J Dev Orig Health Dis 2018; 10:314-321. [PMID: 30409238 DOI: 10.1017/s2040174418000855] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Adverse exposures during fetal life and the postnatal period influence physical, cognitive and emotional development, and predispose to an increased risk of various chronic diseases throughout the life course. Findings from large observational studies in various populations and experimental animal studies have identified different modifiable risk factors in early life. Adverse maternal lifestyle factors, including overweight, unhealthy diet, sedentary behavior, smoking, alcohol consumption and stress in the preconception period and during pregnancy, are the most common modifiable risk factors leading to a suboptimal in-utero environment for fetal development. In the postnatal period, breastfeeding, infant growth and infant dietary intake are important modifiable factors influencing long-term offspring health outcomes. Despite the large amount of findings from observational studies, translation to lifestyle interventions seems to be challenging. Currently, randomized controlled trials focused on the influence of lifestyle interventions in these critical periods on short-term and long-term maternal and offspring health outcomes are scarce, have major limitations and do not show strong effects on maternal and offspring outcomes. New and innovative approaches are needed to move from describing these causes of ill-health to start tackling them using intervention approaches. Future randomized controlled lifestyle intervention studies and innovative observational studies, using quasi-experimental designs, are needed focused on the effects of an integrated lifestyle advice from preconception onwards on pregnancy outcomes and long-term health outcomes in offspring on a population level.
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19
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Wang L, van Grieken A, Yang-Huang J, Vlasblom E, L'Hoir MP, Boere-Boonekamp MM, Raat H. Relationship between socioeconomic status and weight gain during infancy: The BeeBOFT study. PLoS One 2018; 13:e0205734. [PMID: 30388128 PMCID: PMC6214496 DOI: 10.1371/journal.pone.0205734] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 09/26/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Increased weight gain during infancy is a risk factor for obesity and related diseases in later life. The aim of the present study was to investigate the association between socioeconomic status (SES) and weight gain during infancy, and to identify the factors mediating the association between SES and infant weight gain. METHODS Subjects were 2513 parent-child dyads participating in a cluster randomized controlled intervention study. Family SES was indexed by maternal education level. Weight gain in different time windows (infant age 0-3, 0-6, and 6-12 months) was calculated by subtracting the weight for age z-score (WAZ) between the two time-points. Path analysis was performed to examine the mediating pathways linking SES and infant weight gain. RESULTS On average, infants of low-educated mothers had a lower birth weight and caught-up at approximately 6 months. In the period of 0-6 months, infants with low-educated mothers had an 0.42 (95% CI 0.27-0.57) higher gain in weight for age z-score compared to children with high-educated mothers. The association between maternal education level and increased infant weight gain in the period of 0-6 months can be explained by infant birth weight, gestational age at child birth, duration of breastfeeding, and age at introduction of complementary foods. After adjusting all the mediating factors, there was no association between maternal education level and infant weight gain. CONCLUSION Infants with lower SES had an increased weight gain during the first 6 months of infancy, and the effect can be explained by infant birth weight, gestational age at child birth, and infant feeding practices.
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Affiliation(s)
- Lu Wang
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Amy van Grieken
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Junwen Yang-Huang
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - Monique P. L'Hoir
- Department of Agrotechnology and Food Sciences, Subdivision Human Nutrition, Wageningen University & Research, Wageningen, the Netherlands
| | - Magda M. Boere-Boonekamp
- Department Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
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20
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The breastfeeding self-efficacy scale-short form: Psychometric characteristics in Portuguese pregnant women. Midwifery 2018; 66:49-55. [DOI: 10.1016/j.midw.2018.07.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 06/14/2018] [Accepted: 07/20/2018] [Indexed: 11/19/2022]
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21
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Vogelezang S, Santos S, van der Beek EM, Abrahamse-Berkeveld M, Duijts L, van der Lugt A, Felix JF, Jaddoe VWV. Infant breastfeeding and childhood general, visceral, liver, and pericardial fat measures assessed by magnetic resonance imaging. Am J Clin Nutr 2018; 108:722-729. [PMID: 30107466 DOI: 10.1093/ajcn/nqy137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 05/22/2018] [Indexed: 12/14/2022] Open
Abstract
Background Although a longer duration of breastfeeding has been associated with a lower risk of childhood obesity, the impact on specific organ fat depots is largely unknown. Objective We examined the associations of any breastfeeding, duration and exclusiveness of breastfeeding, and of age at introduction of solid foods with measures of general, visceral, and organ adiposity at 10 y. Design In a population-based prospective cohort study in 4444 children, we obtained information on infant feeding by questionnaires. At the mean age of 9.8 y, we estimated body mass index from height and weight; fat mass index and fat-free mass index by dual-energy X-ray absorptiometry; and visceral fat index, pericardial fat index, and liver fat fraction by MRI. MRI scans were performed in a subgroup of 2646 children. Results After adjustment for age and sex, we observed associations of infant feeding with all general, visceral, and organ fat outcomes, except for pericardial fat index, at the age of 10 y. After further adjustment for family-based sociodemographic, maternal lifestyle-related, and childhood factors, only the associations of shorter breastfeeding duration and nonexclusive breastfeeding with a lower fat-free mass index remained significant (P < 0.05). The associations of infant feeding with visceral fat index and liver fat fraction were attenuated to nonsignificant. Maternal education was found to be the strongest confounder. Conclusion Our results suggest that the assoiations of any breastfeeding, duration and exclusiveness of breastfeeding, and age at the introduction of solid foods with general, visceral, and organ fat measures at the age of 10 y are largely explained by family-based sociodemographic factors.
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Affiliation(s)
- Suzanne Vogelezang
- The Generation R Study Group, University Medical Center, Rotterdam, The Netherlands.,Epidemiology, University Medical Center, Rotterdam, The Netherlands.,Pediatrics, University Medical Center, Rotterdam, The Netherlands
| | - Susana Santos
- The Generation R Study Group, University Medical Center, Rotterdam, The Netherlands.,Epidemiology, University Medical Center, Rotterdam, The Netherlands.,Pediatrics, University Medical Center, Rotterdam, The Netherlands
| | - Eline M van der Beek
- Nutricia Research, Danone Nutricia Early Life Nutrition, Utrecht, The Netherlands.,Department of Pediatrics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Liesbeth Duijts
- Respiratory Medicine and Allergology, University Medical Center, Rotterdam, The Netherlands.,Neonatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Aad van der Lugt
- Radiology; Department of Pediatrics, University Medical Center, Rotterdam, The Netherlands
| | - Janine F Felix
- The Generation R Study Group, University Medical Center, Rotterdam, The Netherlands.,Epidemiology, University Medical Center, Rotterdam, The Netherlands.,Pediatrics, University Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, University Medical Center, Rotterdam, The Netherlands.,Epidemiology, University Medical Center, Rotterdam, The Netherlands.,Pediatrics, University Medical Center, Rotterdam, The Netherlands
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22
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Catipovic M, Markovic M, Grguric J. Educational intervention about breastfeeding among secondary school students. HEALTH EDUCATION 2018. [DOI: 10.1108/he-10-2017-0057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeBreastfeeding education in the school setting offers the opportunity to improve knowledge base and positively influence beliefs and intentions for students. The purpose of this paper is to analyze the effect of short education program among secondary school students on breastfeeding knowledge and intentions.Design/methodology/approachTotal of 106 female and 155 male students from four different high schools in Bjelovar were given online questionnaire about intentions to breastfeed and test of knowledge about breastfeeding, both before and shortly after education. The effect of education and school on breastfeeding intentions and knowledge was examined using mixed design ANOVA. Univariate tests were used to examine relation of several independent variables to breastfeeding intention and knowledge scores before and after education.FindingsResults showed statistically significant effect of education on both intentions and knowledge, whereas the effect of school was significant only for intentions. Students show more positive intentions and better knowledge about breastfeeding after education than before education.Research limitations/implicationsThis paper does not entail validation of breastfeeding questionnaire and knowledge test. Due to comprehensiveness and report length, study on validity and reliability of measures is the subject of another paper.Practical implicationsThe authors hope that results of the study will influence professional public in Croatia and encourage it to support implementation of breastfeeding education in curriculum.Originality/valueThis paper offers the first national intervention data in relation to breastfeeding intentions and knowledge among secondary school students. It provides an evidence for necessity of implementation of well-structured education module in regular curriculum of secondary education in Croatia.
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23
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Fryer K, Santos HP, Pedersen C, Stuebe AM. The Hispanic Paradox: Socioeconomic Factors and Race/Ethnicity in Breastfeeding Outcomes. Breastfeed Med 2018; 13:174-180. [PMID: 29485909 PMCID: PMC5899276 DOI: 10.1089/bfm.2017.0157] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Breastfeeding has multiple benefits for both mother and infant. Previous studies have shown that Hispanic/Latina women have higher rates of breastfeeding and better health outcomes than non-Hispanic black (NHB) women of similar socioeconomic status. Our primary objective was to explore the association of race/ethnicity with breastfeeding rates and the impact of socioeconomic factors on initiation and continuation of breastfeeding. MATERIALS AND METHODS We performed a hypothesis-generating secondary analysis of a prospective cohort study of perinatal mental health in a diverse sample of 213 mothers. Twenty-eight participants self-identified as non-Hispanic white, 43 as NHB, and 142 as Hispanic/Latina. We examined bivariate relationships and performed logistic regression analysis for a series of maternal, infant, and psychosocial factors to examine their individual effect on the breastfeeding and race/ethnicity relationship odds ratio (OR). RESULTS Hispanic/Latina women were more likely to initiate exclusive breastfeeding at delivery compared with NHB women (OR 2.4, 95% confidence interval: 1.2-4.9, p = 0.01). Adjustment for maternal, infant, and psychosocial factors measured did not statistically significantly attenuate the OR for initiation of breastfeeding between NHB and Hispanic/Latina women. Women with a history of sexual abuse were also more likely to initiate exclusive breastfeeding (67%) compared with women without a sexual abuse history (54%, p < 0.05). CONCLUSIONS In this low socioeconomic status cohort study, Hispanic/Latina women had higher proportions of any amount of breastfeeding compared with their NHB counterparts. This difference was not attenuated by any of the maternal, infant, or psychosocial factors examined, although our secondary analysis of this prospective cohort was limited by the available covariates in the parent study.
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Affiliation(s)
- Kimberly Fryer
- 1 Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina
| | - Hudson P Santos
- 2 School of Nursing, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina
| | - Cort Pedersen
- 3 Department of Psychiatry, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina
| | - Alison M Stuebe
- 4 Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.,5 Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina
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Initiation and maintenance of breastfeeding: the need for essential support. ASIAN BIOMED 2017. [DOI: 10.1515/abm-2018-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
Breastfeeding is beneficial for both infant and mother, but discontinuation of breastfeeding is very common.To investigate maternal breastfeeding intention and the rate of breastfeeding based on the theory of reasoned action, and analyze the predominant factors associated with breastfeeding and breastfeeding problems.This observational study was conducted in 3 hospitals. Three researchers recruited women at 3 time points in the hospitals: initial documentation of pregnancy at the outpatient department, prenatal admission, and postpartum discharge. SPSS version 21 was used for statistical analyses. Significance was set at P < .05. In the multivariate analysis, binary logistic regression was used and odds ratios (ORs) with 95% confidence intervals (CI) were calculated.We recruited 1260 women, with 420 pregnant women at each time point. 55.1% of the infants were exclusively breastfed, 40.6% were mixed fed, and 4.3% were formula fed when discharged from hospital. A total of 53.8% of the mothers declared having breastfeeding problems. The multivariate analysis showed that nonsuccessful breastfeeding was associated with neonatal birth length, food intake before breastfeeding, infrequent sucking, the intention of breastfeeding, understanding level of the benefits of breastfeeding and that breastfeeding problems were related with the understanding level of the benefits of breastfeeding, neonatal birth length, normal vaginal delivery, breast size, the experience of breastfeeding, use of pacifier and the needs of family member's support in breastfeeding.Most mothers who intended to practice exclusive breastfeeding initially chose to add formula and had breastfeeding problems when discharged from hospital. Successful breastfeeding depends on antenatal and postnatal breastfeeding education and on support provided by healthcare professionals.
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Affiliation(s)
- Pan Huang
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, People's Republic of China
| | - Jianhua Ren
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, People's Republic of China
| | - Yi Liu
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, People's Republic of China
| | - Biru Luo
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, People's Republic of China
| | - Xiufang Zhao
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, People's Republic of China
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Bærug A, Laake P, Løland BF, Tylleskär T, Tufte E, Fretheim A. Explaining socioeconomic inequalities in exclusive breast feeding in Norway. Arch Dis Child 2017; 102:708-714. [PMID: 28235835 DOI: 10.1136/archdischild-2016-312038] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 02/01/2017] [Accepted: 02/02/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND OBJECTIVE In high-income countries, lower socioeconomic position is associated with lower rates of breast feeding, but it is unclear what factors explain this inequality. Our objective was to examine the association between socioeconomic position and exclusive breast feeding, and to explore whether socioeconomic inequality in exclusive breast feeding could be explained by other sociodemographic characteristics, for example, maternal age and parity, smoking habits, birth characteristics, quality of counselling and breastfeeding difficulties. METHODS We used data from a questionnaire sent to mothers when their infants were five completed months as part of a trial of a breastfeeding intervention in Norway. We used maternal education as an indicator of socioeconomic position. Analyses of 1598 mother-infant pairs were conducted using logistic regression to assess explanatory factors of educational inequalities in breast feeding. RESULTS Socioeconomic inequalities in exclusive breast feeding were present from the beginning and persisted for five completed months, when 22% of the most educated mothers exclusively breast fed compared with 7% of the least educated mothers: OR 3.39 (95% CI 1.74 to 6.61). After adjustment for all potentially explanatory factors, the OR was reduced to 1.49 (95% CI 0.70 to 3.14). This decrease in educational inequality seemed to be mainly driven by sociodemographic factors, smoking habits and breastfeeding difficulties, in particular perceived milk insufficiency. CONCLUSIONS Socioeconomic inequalities in exclusive breast feeding at 5 months were largely explained by sociodemographic factors, but also by modifiable factors, such as smoking habits and breastfeeding difficulties, which can be amenable to public health interventions. TRIAL REGISTRATION NUMBER NCT01025362.
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Affiliation(s)
- Anne Bærug
- Norwegian National Advisory Unit on Breastfeeding, Women and Children's Division, Oslo University Hospital, Oslo, Norway
| | - Petter Laake
- Centre for Biostatistics and Epidemiology, Department of Biostatistics, University of Oslo, Oslo, Norway
| | - Beate Fossum Løland
- Norwegian National Advisory Unit on Breastfeeding, Women and Children's Division, Oslo University Hospital, Oslo, Norway
| | | | - Elisabeth Tufte
- Norwegian National Advisory Unit on Breastfeeding, Women and Children's Division, Oslo University Hospital, Oslo, Norway
| | - Atle Fretheim
- Knowledge Centre for the Health Services, Norwegian Institute of Public Health, Oslo, Norway.,Institute of Health and Society, University of Oslo, Oslo, Norway
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Dumas A, Toutain S, Simmat-Durand L. Alcohol Use During Pregnancy or Breastfeeding: A National Survey in France. J Womens Health (Larchmt) 2017; 26:798-805. [DOI: 10.1089/jwh.2016.6130] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Agnès Dumas
- Centre for Research in Epidemiology and Population Health (CESP), INSERM U1018, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
- Université Paris-Sud, Orsay, France
| | - Stéphanie Toutain
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Centre de Recherche Médecine, Sciences, Santé, Santé Mentale et Société (CERMES3), UMR CNRS 8211, INSERM U988, EHESS, Paris, France
| | - Laurence Simmat-Durand
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Centre de Recherche Médecine, Sciences, Santé, Santé Mentale et Société (CERMES3), UMR CNRS 8211, INSERM U988, EHESS, Paris, France
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de Barse LM, Jansen PW, Edelson-Fries LR, Jaddoe VW, Franco OH, Tiemeier H, Steenweg-de Graaff J. Infant feeding and child fussy eating: The Generation R Study. Appetite 2017; 114:374-381. [DOI: 10.1016/j.appet.2017.04.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 03/10/2017] [Accepted: 04/05/2017] [Indexed: 12/17/2022]
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Tobback E, Behaeghel K, Hanoulle I, Delesie L, Loccufier A, Van Holsbeeck A, Vogelaers D, Mariman A. Comparison of subjective sleep and fatigue in breast- and bottle-feeding mothers. Midwifery 2017; 47:22-27. [DOI: 10.1016/j.midw.2017.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 01/12/2017] [Accepted: 01/15/2017] [Indexed: 10/20/2022]
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Herich LC, Cuttini M, Croci I, Franco F, Di Lallo D, Baronciani D, Fares K, Gargano G, Raponi M, Zeitlin J. Maternal Education Is Associated with Disparities in Breastfeeding at Time of Discharge but Not at Initiation of Enteral Feeding in the Neonatal Intensive Care Unit. J Pediatr 2017; 182:59-65.e7. [PMID: 27865429 DOI: 10.1016/j.jpeds.2016.10.046] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/30/2016] [Accepted: 10/12/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate the relationship between maternal education and breastfeeding in very preterm infants admitted to neonatal intensive care units. STUDY DESIGN This prospective, population-based cohort study analyzed the data of all very preterm infants admitted to neonatal care during 1 year in 3 regions in Italy (Lazio, Emilia-Romagna, and Marche). The use of mothers' own milk was recorded at initial enteral feedings and at hospital discharge. We used multilevel logistic analysis to model the association between maternal education and breastfeeding outcomes, adjusting for maternal age and country of birth. Region was included as random effect. RESULTS There were 1047 very preterm infants who received enteral feeding, and 975 were discharged alive. At discharge, the use of mother's own milk, exclusively or not, and feeding directly at the breast were significantly more likely for mothers with an upper secondary education or higher. We found no relationship between maternal education and type of milk at initial enteral feedings. However, the exclusive early use of the mother's own milk at initial feedings was related significantly with receiving any maternal milk and feeding directly at the breast at discharge from hospital, and the association with feeding at the breast was stronger for the least educated mothers. CONCLUSION In this population-based cohort of very preterm infants, we found a significant and positive association between maternal education and the likelihood of receiving their mother's own milk at the time of discharge. In light of the proven benefits of maternal milk, strategies to support breastfeeding should be targeted to mothers with less education.
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Affiliation(s)
- Lena Carolin Herich
- Research Unit of Perinatal Epidemiology, Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Marina Cuttini
- Research Unit of Perinatal Epidemiology, Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Ileana Croci
- Research Unit of Perinatal Epidemiology, Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesco Franco
- Hospital Network Planning and Research Area, Lazio Regional Health Authority, Rome, Italy
| | - Domenico Di Lallo
- Hospital Network Planning and Research Area, Lazio Regional Health Authority, Rome, Italy
| | - Dante Baronciani
- Hospital Care Services, General Directorate for Health and Social Policies, Emilia Romagna Region, Bologna, Italy
| | - Katia Fares
- Neonatal Intensive Care Unit, Salesi Children's Hospital, Ancona, Italy
| | - Giancarlo Gargano
- Neonatal Intensive Care Unit, Department of Obstetrics and Pediatrics, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Massimiliano Raponi
- Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Jennifer Zeitlin
- INSERM, Obstetrics, Perinatal and Paediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics (U1153), and DHU Risks in Pregnancy, Paris Descartes University, Paris, France
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Hendrick CE, Potter JE. Nativity, Country of Education, and Mexican-Origin Women's Breastfeeding Behaviors in the First 10 Months Postpartum. Birth 2017; 44:68-77. [PMID: 27779318 PMCID: PMC5654533 DOI: 10.1111/birt.12261] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Breastfeeding is associated with numerous health benefits for the infant and mother. Latina women in the United States have historically had high overall rates of initiation and duration of breastfeeding. However, these rates vary by nativity and time lived in the United States. Exclusive breastfeeding patterns among Latina women are unclear. In this study, we investigate the current and exclusive breastfeeding patterns of Mexican-origin women at four time points from delivery to 10 months postpartum to determine the combined association of nativity and country of education with breastfeeding duration and supplementation. METHODS Data are from the Postpartum Contraception Study, a prospective cohort study of postpartum women ages 18-44 recruited from three hospitals in Austin and El Paso, Texas. We included Mexican-origin women who were born in either the United States or Mexico in the analytic sample (n = 593). RESULTS Women completing schooling in Mexico had higher rates of overall breastfeeding throughout the study period than women educated in the United States, regardless of country of birth. This trend held in multivariate models while diminishing over time. Women born in Mexico who completed their schooling in the United States were least likely to exclusively breastfeed. DISCUSSION Country of education should also be considered when assessing Latina women's risk for breastfeeding discontinuation. Efforts should be made to identify the barriers and facilitators to breastfeeding among US-educated Mexican-origin women to enhance existing breastfeeding promotion efforts in the United States.
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Health Parameters Related to Maternal Education in Iranian Families With Young Children. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2016. [DOI: 10.5812/pedinfect.33739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Quigley C, Taut C, Zigman T, Gallagher L, Campbell H, Zgaga L. Association between home birth and breast feeding outcomes: a cross-sectional study in 28 125 mother-infant pairs from Ireland and the UK. BMJ Open 2016; 6:e010551. [PMID: 27503858 PMCID: PMC4985866 DOI: 10.1136/bmjopen-2015-010551] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To examine the association between breast feeding outcomes and place of birth (home vs hospital birth). DESIGN Population-based cross-sectional study. SETTING Ireland and UK. PARTICIPANTS 10 604 mother-infant pairs from the Growing Up in Ireland study (GUI, 2008-2009) and 17 521 pairs from the UK Millennium Cohort Study (UKMCS, 2001-2002) at low risk of delivery complications were included in the study. PRIMARY AND SECONDARY OUTCOME MEASURES Breast feeding initiation, exclusivity and duration. RESULTS Home birth was found to be significantly associated with breast feeding at all examined time points, including at birth, 8 weeks, 6 months and breast feeding exclusively at 6 months. In GUI, adjusted OR was 1.90 (95% CI 1.19 to 3.02), 1.78 (1.18 to 2.69), 1.85 (1.23 to 2.77) and 2.77 (1.78 to 4.33), respectively, and in UKMCS it was 2.49 (1.84 to 3.44), 2.49 (1.92 to 3.26), 2.90 (2.25 to 3.73) and 2.24 (1.14 to 4.03). CONCLUSIONS Home birth was strongly associated with improved breast feeding outcomes in low-risk deliveries. While the association between home birth and breast feeding is unlikely to be directly causal, further research is needed to determine which factor(s) drive the observed differences, to facilitate development of perinatal care that supports breast feeding.
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Affiliation(s)
| | - Cristina Taut
- Department of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
| | - Tamara Zigman
- Department of Paediatrics, “Sestre Milosrdnice” University Hospital Centre, Zagreb, Croatia
| | - Louise Gallagher
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Harry Campbell
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Lina Zgaga
- Department of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
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Bærug A, Langsrud Ø, Løland BF, Tufte E, Tylleskär T, Fretheim A. Effectiveness of Baby-friendly community health services on exclusive breastfeeding and maternal satisfaction: a pragmatic trial. MATERNAL & CHILD NUTRITION 2016; 12:428-39. [PMID: 27062084 PMCID: PMC5071711 DOI: 10.1111/mcn.12273] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 11/25/2015] [Accepted: 11/26/2015] [Indexed: 11/28/2022]
Abstract
The WHO/UNICEF Baby-friendly Hospital Initiative has been shown to increase breastfeeding rates, but uncertainty remains about effective methods to improve breastfeeding in community health services. The aim of this pragmatic cluster quasi-randomised controlled trial was to assess the effectiveness of implementing the Baby-friendly Initiative (BFI) in community health services. The primary outcome was exclusive breastfeeding until 6 months in healthy babies. Secondary outcomes were other breastfeeding indicators, mothers' satisfaction with the breastfeeding experience, and perceived pressure to breastfeed. A total of 54 Norwegian municipalities were allocated by alternation to the BFI in community health service intervention or routine care. All mothers with infants of five completed months were invited to participate (n = 3948), and 1051 mothers in the intervention arm and 981 in the comparison arm returned the questionnaire. Analyses were by intention to treat. Women in the intervention group were more likely to breastfeed exclusively compared with those who received routine care: 17.9% vs. 14.1% until 6 months [cluster adjusted odds ratio (OR) = 1.33; 95% confidence interval (CI): 1.03, 1.72; P = 0.03], 41.4% vs. 35.8% until 5 months [cluster adjusted OR = 1.39; 95% CI: 1.09, 1.77; P = 0.01], and 72.1% vs. 68.2% for any breastfeeding until 6 months [cluster adjusted OR = 1.24; 95% CI: 0.99, 1.54; P = 0.06]. The intervention had no effect on breastfeeding until 12 months. Maternal breastfeeding experience in the two groups did not differ, neither did perceived breastfeeding pressure from staff in the community health services. In conclusion, the BFI in community health services increased rates of exclusive breastfeeding until 6 months. © 2015 Blackwell Publishing Ltd.
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Affiliation(s)
- Anne Bærug
- Norwegian National Advisory Unit on Breastfeeding, Women and Children's DivisionOslo University HospitalOsloNorway
| | | | - Beate F. Løland
- Norwegian National Advisory Unit on Breastfeeding, Women and Children's DivisionOslo University HospitalOsloNorway
| | - Elisabeth Tufte
- Norwegian National Advisory Unit on Breastfeeding, Women and Children's DivisionOslo University HospitalOsloNorway
| | | | - Atle Fretheim
- Global Health UnitNorwegian Knowledge Centre for the Health ServicesOsloNorway
- Institute of Health and SocietyUniversity of OsloOsloNorway
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Fallon V, Bennett KM, Harrold JA. Prenatal Anxiety and Infant Feeding Outcomes: A Systematic Review. J Hum Lact 2016; 32:53-66. [PMID: 26342007 DOI: 10.1177/0890334415604129] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 08/11/2015] [Indexed: 11/15/2022]
Abstract
Prenatal anxiety may negatively affect infant health in multiple domains, including infant feeding. However, the relationship between prenatal anxiety and infant feeding is not well understood. Given the benefits of recommended infant feeding practices, clarifying this relationship is important. This review was conducted to examine the relationship between prenatal anxiety and infant feeding outcomes. Electronic searches were performed in relevant databases. A hand search of selected journals and reference lists of included articles was then conducted. All studies were considered that provided information related to infant feeding outcomes and anxiety during pregnancy. Quality assessment and data extraction were conducted by 2 reviewers; 99 studies were identified, of which 6 were eligible. No associations were found between prenatal anxiety and breastfeeding initiation or breastfeeding in any quantity. However, relationships between high levels of prenatal anxiety and a reduction in both breastfeeding intention and breastfeeding exclusivity were identified. The review was limited by the small number of studies included. Sample sizes lacking power and heterogeneous measures and definitions all significantly affected the comparability of findings. It is concluded that there is insufficient evidence to clarify the relationship between prenatal anxiety and infant feeding outcomes.
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Rayfield S, Oakley L, Quigley MA. Association between breastfeeding support and breastfeeding rates in the UK: a comparison of late preterm and term infants. BMJ Open 2015; 5:e009144. [PMID: 26567257 PMCID: PMC4654355 DOI: 10.1136/bmjopen-2015-009144] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To explore the association between breastfeeding support and breastfeeding among late preterm (gestation 34-36 weeks) and term (gestation ≥37 weeks) infants. METHODS Secondary analysis of the UK 2010 Infant Feeding Survey. Logistic regression was used to determine the association of breastfeeding support with breastfeeding at 10 days and 6 weeks in late preterm and term infants. RESULTS The study included 14,525 term and 579 late preterm infants. A total of 11,729 infants initiated breastfeeding (11,292 (81.1%) term, 437 (79.4%) late preterm infants, p=0.425). Of these, 9230 (84.3%) term and 365 (85.6%) late preterm infants were breastfeeding at 10 days (p=0.586); of these 7547 (82.0%) term and 281 (75.4%) late preterm infants were still breastfeeding at 6 weeks (p=0.012). Mothers who reported receiving contact details for breastfeeding support groups had a higher likelihood of breastfeeding late preterm (adjusted ORs, aOR 3.14, 95% CI 1.40 to 7.04) and term infants (aOR 2.24, 95% CI 1.86 to 2.68) at 10 days and term infants at 6 weeks (aOR 1.83, 95% CI 1.51 to 2.22). Those who reported that they did not receive enough help with breastfeeding in hospital had a lower likelihood of breastfeeding late preterm at 10 days and term infants at 10 days and 6 weeks, compared to those who reported having enough help. CONCLUSIONS Receiving sufficient help with breastfeeding in hospital and the contact details for breastfeeding support groups is associated with breastfeeding term infants up to 6 weeks and late preterm infants at 10 days.
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Affiliation(s)
- Sarah Rayfield
- Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Laura Oakley
- Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Maria A Quigley
- Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
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Tielemans MJ, Erler NS, Leermakers ETM, van den Broek M, Jaddoe VWV, Steegers EAP, Kiefte-de Jong JC, Franco OH. A Priori and a Posteriori Dietary Patterns during Pregnancy and Gestational Weight Gain: The Generation R Study. Nutrients 2015; 7:9383-99. [PMID: 26569303 PMCID: PMC4663604 DOI: 10.3390/nu7115476] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 10/29/2015] [Accepted: 11/04/2015] [Indexed: 01/17/2023] Open
Abstract
Abnormal gestational weight gain (GWG) is associated with adverse pregnancy outcomes. We examined whether dietary patterns are associated with GWG. Participants included 3374 pregnant women from a population-based cohort in the Netherlands. Dietary intake during pregnancy was assessed with food-frequency questionnaires. Three a posteriori-derived dietary patterns were identified using principal component analysis: a "Vegetable, oil and fish", a "Nuts, high-fiber cereals and soy", and a "Margarine, sugar and snacks" pattern. The a priori-defined dietary pattern was based on national dietary recommendations. Weight was repeatedly measured around 13, 20 and 30 weeks of pregnancy; pre-pregnancy and maximum weight were self-reported. Normal weight women with high adherence to the "Vegetable, oil and fish" pattern had higher early-pregnancy GWG than those with low adherence (43 g/week (95% CI 16; 69) for highest vs. lowest quartile (Q)). Adherence to the "Margarine, sugar and snacks" pattern was associated with a higher prevalence of excessive GWG (OR 1.45 (95% CI 1.06; 1.99) Q4 vs. Q1). Normal weight women with higher scores on the "Nuts, high-fiber cereals and soy" pattern had more moderate GWG than women with lower scores (-0.01 (95% CI -0.02; -0.00) per SD). The a priori-defined pattern was not associated with GWG. To conclude, specific dietary patterns may play a role in early pregnancy but are not consistently associated with GWG.
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Affiliation(s)
- Myrte J Tielemans
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Nicole S Erler
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
- Department of Biostatistics, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Elisabeth T M Leermakers
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Marion van den Broek
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Vincent W V Jaddoe
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Eric A P Steegers
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
- Department of Global Public Health, Leiden University College the Hague, P.O. Box 13228, 2501 EE the Hague, The Netherlands.
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
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Acharya P, Khanal V. The effect of mother's educational status on early initiation of breastfeeding: further analysis of three consecutive Nepal Demographic and Health Surveys. BMC Public Health 2015; 15:1069. [PMID: 26482789 PMCID: PMC4610048 DOI: 10.1186/s12889-015-2405-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 10/12/2015] [Indexed: 11/13/2022] Open
Abstract
Background The World Health Organization recommends initiating breastfeeding within the first hour of birth. This study is aimed at assessing the effect of the mother’s education on early initiation of breastfeeding. Methods Data from the Nepal Demographic and Health Surveys (NDHS) 2001, 2006 and 2011 were used which included 12,845 last born children born within 5 years before the surveys. Early initiation of breastfeeding was defined as the initiation of breastfeeding within the first hour after birth. Hierarchical modelling was used to ascertain the association of maternal education and early initiation of breastfeeding, after controlling for other covariates in a multiple logistic regression. Results Maternal education was associated with a higher likelihood of early initiation of breastfeeding in each survey. Pooled data analysis revealed higher odds of early initiation of breastfeeding among the mothers with primary education (adjusted odds ratio (OR) 1.24, 95 % confidence interval (CI): 1.09, 1.42) and secondary or higher education (OR: 1.63 95 % CI: 1.42, 1.88). In the most recent NDHS 2011 survey, odds of early initiation of breastfeeding was higher among mothers with primary education (OR: 1.52; 95 % CI: 1.21, 1.91) and mothers with secondary or higher education (OR: 2.20; 95 % CI: 1.76, 2.76) compared to mothers with no education. Similarly, the odds of early initiation of breastfeeding was higher among mothers with secondary and higher education in the 2006 data (OR: 1.66; 95 % CI: 1.30, 2.12) and in 2001 (OR = 1.30; 95 % CI: 1.00, 1.67). Conclusions As the association between a mother’s educational status and her likelihood of early initiation of breastfeeding increases, long-term approaches to prioritising education for women and girls should be explored. In the short term, uneducated mothers should be targeted with breastfeeding promotion strategies such as counselling and peer education. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2405-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Vishnu Khanal
- Nepal Development Society, Bharatpur, Nepal. .,School of Public Health, Curtin University, Perth, Australia.
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Umer A, Hamilton C, Britton CM, Mullett MD, John C, Neal W, Lilly CL. Association between Breastfeeding and Childhood Obesity: Analysis of a Linked Longitudinal Study of Rural Appalachian Fifth-Grade Children. Child Obes 2015; 11:449-55. [PMID: 26186180 DOI: 10.1089/chi.2015.0026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Although breastfeeding is associated with improving numerous health outcomes for the child, its role in reducing childhood obesity is contested. Despite this controversy, both the CDC and the US Department of Health and Human Services promote breastfeeding as one of the strategies for reducing childhood obesity. Rural Appalachia has one of the highest rates of childhood obesity and low rates of breastfeeding, compared to rest of the nation. The aim of this study was to examine the association between breastfeeding and childhood obesity at 11 years in the rural Appalachian state of West Virginia (WV). METHODS The study used linked data from two cross-sectional data sets to examine this relationship longitudinally in fifth-grade WV children. The main outcome variable was BMI adjusted percent (BMI%) and the main exposure was defined as occurrence of breastfeeding. Mean BMI% of children who were not breastfed was significantly higher, compared to children who were breastfed. RESULTS The result of the multiple regression analysis showed that breastfeeding significantly predicted BMI% of children after controlling for maternal education, health insurance, family history of hypercholesterolemia and diabetes, child's asthma status, and birth weight of the infant. CONCLUSIONS Our results are consistent with other studies that have shown a significant, but small, inverse association between breastfeeding and childhood obesity. Findings from this study suggest the need to improve breastfeeding rates in the rural Appalachian state of WV as one of the potential strategies to prevent obesity during childhood and adolescence.
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Affiliation(s)
- Amna Umer
- 1 Department of Epidemiology, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University , Morgantown, WV
| | - Candice Hamilton
- 2 Department of Pediatrics, School of Medicine, Robert C. Byrd Health Sciences Center, West Virginia University , Morgantown, WV
| | - Cris M Britton
- 2 Department of Pediatrics, School of Medicine, Robert C. Byrd Health Sciences Center, West Virginia University , Morgantown, WV
| | - Martha D Mullett
- 2 Department of Pediatrics, School of Medicine, Robert C. Byrd Health Sciences Center, West Virginia University , Morgantown, WV
| | - Collin John
- 2 Department of Pediatrics, School of Medicine, Robert C. Byrd Health Sciences Center, West Virginia University , Morgantown, WV
| | - William Neal
- 2 Department of Pediatrics, School of Medicine, Robert C. Byrd Health Sciences Center, West Virginia University , Morgantown, WV
| | - Christa L Lilly
- 3 Department of Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University , Morgantown, WV
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Jansen MAE, van den Heuvel D, van Zelm MC, Jaddoe VWV, Hofman A, de Jongste JC, Hooijkaas H, Moll HA. Decreased memory B cells and increased CD8 memory T cells in blood of breastfed children: the generation R study. PLoS One 2015; 10:e0126019. [PMID: 25993335 PMCID: PMC4436360 DOI: 10.1371/journal.pone.0126019] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 03/27/2015] [Indexed: 11/27/2022] Open
Abstract
Background Breastfeeding provides a protective effect against infectious diseases in infancy. Still, immunological evidence for enhanced adaptive immunity in breastfed children remains inconclusive. Objective To determine whether breastfeeding affects B- and T-cell memory in the first years of life. Methods We performed immunophenotypic analysis on blood samples within a population-based prospective cohort study. Participants included children at 6 months (n=258), 14 months (n=166), 25 months (n=112) and 6 years of age (n=332) with both data on breastfeeding and blood lymphocytes. Total B- and T-cell numbers and their memory subsets were determined with 6-color flow cytometry. Mothers completed questionnaires on breastfeeding when their children were aged 2, 6, and 12 months. Multiple linear regression models with adjustments for potential confounders were performed. Results Per month continuation of breastfeeding, a 3% (95% CI -6, -1) decrease in CD27+IgM+, a 2% (95 CI % -5, -1) decrease in CD27+IgA+ and a 2% (95% CI -4, -1) decrease in CD27-IgG+ memory B cell numbers were observed at 6 months of age. CD8 T-cell numbers at 6 months of age were 20% (95% CI 3, 37) higher in breastfed than in non-breastfed infants. This was mainly found for central memory CD8 T cells and associated with exposure to breast milk, rather than duration. The same trend was observed at 14 months, but associations disappeared at older ages. Conclusions Longer breastfeeding is associated with increased CD8 T-cell memory, but not B-cell memory numbers in the first 6 months of life. This transient skewing towards T cell memory might contribute to the protective effect against infectious diseases in infancy.
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Affiliation(s)
- Michelle A. E. Jansen
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- The Department of Pediatrics, Sophia Children’s Hospital, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- The Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Diana van den Heuvel
- The Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Menno C. van Zelm
- The Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- * E-mail:
| | - Vincent W. V. Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- The Department of Pediatrics, Sophia Children’s Hospital, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- The Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Albert Hofman
- The Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Johan C. de Jongste
- The Department of Pediatrics, Sophia Children’s Hospital, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Herbert Hooijkaas
- The Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Henriette A. Moll
- The Department of Pediatrics, Sophia Children’s Hospital, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Does breastfeeding behavior run in families? Evidence from twins, their sisters and their mothers in the Netherlands. Twin Res Hum Genet 2015; 18:179-87. [PMID: 25728689 DOI: 10.1017/thg.2015.5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The aim of the present article was to study the prevalence and the heritability of the initiation of breastfeeding in the Netherlands. The study was carried out in 5,581 participants from the Netherlands Twin Register, and included female twins, their sisters and mothers. All of the participants were born between 1911 and 1991. Breastfeeding was self-reported by the participants, and its prevalence was estimated conditional on birth cohort (born before 1955, 1955-1964, 1965-1974, 1975, or later). To estimate the heritability, we conducted extended twin-family modeling using the SEM package OpenMx in R. Mothers of twins had lower prevalence to initiate breastfeeding and the prevalence of initiation of breastfeeding increased with birth cohort: among mothers of twins 66% in the oldest (pre-1955) to 74% in the youngest (post-1974) and among mothers, who were twins themselves or sisters of twins, 79% in the oldest (pre-1955) to 85% in the youngest (post-1974). When accounting for prevalence differences between mothers of twins and other women, heritability of initiation of breastfeeding was 70%. However, the familial resemblance for sister and mother-daughter pairs was clearly lower than for DZ twin pairs, but as the number of non-twin sisters was relatively low, this observation did not lead to a significant contribution of a special shared twin environment.
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Sajjad A, Tharner A, Kiefte-de Jong JC, Jaddoe VVW, Hofman A, Verhulst FC, Franco OH, Tiemeier H, Roza SJ. Breastfeeding duration and non-verbal IQ in children. J Epidemiol Community Health 2015; 69:775-81. [DOI: 10.1136/jech-2014-204486] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 02/05/2015] [Indexed: 11/04/2022]
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Carling SJ, Demment MM, Kjolhede CL, Olson CM. Breastfeeding duration and weight gain trajectory in infancy. Pediatrics 2015; 135:111-9. [PMID: 25554813 PMCID: PMC4279065 DOI: 10.1542/peds.2014-1392] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Short breastfeeding duration may exacerbate accelerated early growth, which is linked to higher obesity risk in later life. This study tested the hypothesis that infants at higher risk for obesity were more likely to be members of a rising weight-for-length (WFL) z score trajectory if breastfed for shorter durations. METHODS This prospective, observational study recruited women from an obstetric patient population in rural central New York. Medical records of children born to women in the cohort were audited for weight and length measurements (n = 595). We identified weight gain trajectories for infants' WFL z scores from 0 to 24 months by using maximum likelihood latent class models. Individual risk factors associated with weight gain trajectories (P ≤ .05) were included in an obesity risk index. Logistic regression analysis was performed to investigate whether the association between breastfeeding duration (<2 months, 2-4 months, >4 months) and weight gain trajectory varied across obesity risk groups. RESULTS Rising and stable weight gain trajectories emerged. The obesity risk index included maternal BMI, education, and smoking during pregnancy. High-risk infants breastfed for <2 months were more likely to belong to a rising rather than stable weight gain trajectory (odds ratio, 2.55; 95% confidence interval, 1.14-5.72; P = .02). CONCLUSIONS Infants at the highest risk for rising weight patterns appear to benefit the most from longer breastfeeding duration. Targeting mothers of high-risk infants for breastfeeding promotion and support may be protective against overweight and obesity during a critical window of development.
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Affiliation(s)
- Stacy J Carling
- Division of Nutritional Sciences, Cornell University, Ithaca, New York; and
| | - Margaret M Demment
- Division of Nutritional Sciences, Cornell University, Ithaca, New York; and
| | - Chris L Kjolhede
- Mary Imogene Bassett Hospital and Research Institute, Cooperstown, New York
| | - Christine M Olson
- Division of Nutritional Sciences, Cornell University, Ithaca, New York; and
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Oosterhoff A, Hutter I, Haisma H. It takes a mother to practise breastfeeding: Women's perceptions of breastfeeding during the period of intention. Women Birth 2014; 27:e43-50. [PMID: 25199453 DOI: 10.1016/j.wombi.2014.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 07/31/2014] [Accepted: 08/10/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND In the Netherlands, 81% of mothers initiate breastfeeding. After one month the percentage of mothers still breastfeeding drops, despite positive intentions. Little is known about women's perceptions of breastfeeding during the period of intention. AIM This qualitative study aimed to gain insight into these perceptions among first-time mothers from middle and high socioeconomic backgrounds in the northern part of the Netherlands. METHODS We used the theory of planned behaviour as the deductive model. In 2008, 16 in-depth interviews were conducted with 8 mothers who intended to breastfeed. The interviews were conducted at two time points (prepartum and postpartum) and covered the same period (that is, from the time when the intention was formed until after childbirth). The interviews were transcribed verbatim and analysed using grounded theory. FINDINGS Five inductive themes were identified: combining breastfeeding with work, learning about breastfeeding, making arrangements for childbirth, reflecting on the intention, and becoming a mother. During the extended period of intention, the women anticipated breastfeeding, but were cautious in expressing their intentions. They felt that the experience of becoming a mother would be critical to their breastfeeding outcomes. CONCLUSION The theory of planned behaviour has been widely used in breastfeeding research. However, the period of intention is relatively long for breastfeeding. Rather than recommending an intensification of antenatal breastfeeding education, recommendations must incorporate the awareness that practising breastfeeding should not be considered the continuous outcome of the intention to do so - it takes a mother to practise breastfeeding.
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Affiliation(s)
- Alberta Oosterhoff
- Population Research Centre, Department of Demography, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD Groningen, Netherlands; Research and Innovation Group in Health Care and Nursing, School of Health, Hanze University of Applied Sciences, Eyssoniusplein 18, 9714 CE Groningen, Netherlands.
| | - Inge Hutter
- Population Research Centre, Department of Demography, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD Groningen, Netherlands
| | - Hinke Haisma
- Population Research Centre, Department of Demography, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD Groningen, Netherlands
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Durmuş B, Heppe DHM, Gishti O, Manniesing R, Abrahamse-Berkeveld M, van der Beek EM, Hofman A, Duijts L, Gaillard R, Jaddoe VWV. General and abdominal fat outcomes in school-age children associated with infant breastfeeding patterns. Am J Clin Nutr 2014; 99:1351-8. [PMID: 24622802 DOI: 10.3945/ajcn.113.075937] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Breastfeeding may have a protective effect on the development of obesity in later life. Not much is known about the effects of infant feeding on more-specific fat measures. OBJECTIVE We examined associations of breastfeeding duration and exclusiveness and age at the introduction of solid foods with general and abdominal fat outcomes in children. DESIGN We performed a population-based, prospective cohort study in 5063 children. Information about infant feeding was obtained by using questionnaires. At the median age of 6.0 y (95% range: 5.7 y, 6.8 y), we measured childhood anthropometric measures, total fat mass and the android:gynoid fat ratio by using dual-energy X-ray absorptiometry, and preperitoneal abdominal fat by using ultrasound. RESULTS We observed that, in the models adjusted for child age, sex, and height only, a shorter breastfeeding duration, nonexclusive breastfeeding, and younger age at the introduction of solid foods were associated with higher childhood general and abdominal fat measures (P-trend < 0.05) but not with higher childhood body mass index. The introduction of solid foods at a younger age but not breastfeeding duration or exclusivity was associated with higher risk of overweight or obesity (OR: 2.05; 95% CI: 1.41, 2.90). After adjustment for family-based sociodemographic, maternal lifestyle, and childhood factors, the introduction of solid food between 4 and 4.9 mo of age was associated with higher risks of overweight or obesity, but the overall trend was not significant. CONCLUSIONS Associations of infant breastfeeding and age at the introduction of solid foods with general and abdominal fat outcomes are explained by sociodemographic and lifestyle-related factors. Whether infant dietary composition affects specific fat outcomes at older ages should be further studied.
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Affiliation(s)
- Büşra Durmuş
- From the Generation R Study Group (BD, DHMH, OG, RG, and VWVJ) and the Departments of Pediatrics (DHMH, OG, LD, RG, and VWVJ) and Epidemiology (BD, DHMH, OG, AH, LD, RG, and VWVJ), Erasmus University Medical Center, Rotterdam, Netherlands; the Department of Radiology, Radboud University, Nijmegen, Netherlands (RM); and Nutricia Research, Utrecht, Netherlands (MA-B and EMvdB)
| | - Denise H M Heppe
- From the Generation R Study Group (BD, DHMH, OG, RG, and VWVJ) and the Departments of Pediatrics (DHMH, OG, LD, RG, and VWVJ) and Epidemiology (BD, DHMH, OG, AH, LD, RG, and VWVJ), Erasmus University Medical Center, Rotterdam, Netherlands; the Department of Radiology, Radboud University, Nijmegen, Netherlands (RM); and Nutricia Research, Utrecht, Netherlands (MA-B and EMvdB)
| | - Olta Gishti
- From the Generation R Study Group (BD, DHMH, OG, RG, and VWVJ) and the Departments of Pediatrics (DHMH, OG, LD, RG, and VWVJ) and Epidemiology (BD, DHMH, OG, AH, LD, RG, and VWVJ), Erasmus University Medical Center, Rotterdam, Netherlands; the Department of Radiology, Radboud University, Nijmegen, Netherlands (RM); and Nutricia Research, Utrecht, Netherlands (MA-B and EMvdB)
| | - Rashindra Manniesing
- From the Generation R Study Group (BD, DHMH, OG, RG, and VWVJ) and the Departments of Pediatrics (DHMH, OG, LD, RG, and VWVJ) and Epidemiology (BD, DHMH, OG, AH, LD, RG, and VWVJ), Erasmus University Medical Center, Rotterdam, Netherlands; the Department of Radiology, Radboud University, Nijmegen, Netherlands (RM); and Nutricia Research, Utrecht, Netherlands (MA-B and EMvdB)
| | - Marieke Abrahamse-Berkeveld
- From the Generation R Study Group (BD, DHMH, OG, RG, and VWVJ) and the Departments of Pediatrics (DHMH, OG, LD, RG, and VWVJ) and Epidemiology (BD, DHMH, OG, AH, LD, RG, and VWVJ), Erasmus University Medical Center, Rotterdam, Netherlands; the Department of Radiology, Radboud University, Nijmegen, Netherlands (RM); and Nutricia Research, Utrecht, Netherlands (MA-B and EMvdB)
| | - Eline M van der Beek
- From the Generation R Study Group (BD, DHMH, OG, RG, and VWVJ) and the Departments of Pediatrics (DHMH, OG, LD, RG, and VWVJ) and Epidemiology (BD, DHMH, OG, AH, LD, RG, and VWVJ), Erasmus University Medical Center, Rotterdam, Netherlands; the Department of Radiology, Radboud University, Nijmegen, Netherlands (RM); and Nutricia Research, Utrecht, Netherlands (MA-B and EMvdB)
| | - Albert Hofman
- From the Generation R Study Group (BD, DHMH, OG, RG, and VWVJ) and the Departments of Pediatrics (DHMH, OG, LD, RG, and VWVJ) and Epidemiology (BD, DHMH, OG, AH, LD, RG, and VWVJ), Erasmus University Medical Center, Rotterdam, Netherlands; the Department of Radiology, Radboud University, Nijmegen, Netherlands (RM); and Nutricia Research, Utrecht, Netherlands (MA-B and EMvdB)
| | - Liesbeth Duijts
- From the Generation R Study Group (BD, DHMH, OG, RG, and VWVJ) and the Departments of Pediatrics (DHMH, OG, LD, RG, and VWVJ) and Epidemiology (BD, DHMH, OG, AH, LD, RG, and VWVJ), Erasmus University Medical Center, Rotterdam, Netherlands; the Department of Radiology, Radboud University, Nijmegen, Netherlands (RM); and Nutricia Research, Utrecht, Netherlands (MA-B and EMvdB)
| | - Romy Gaillard
- From the Generation R Study Group (BD, DHMH, OG, RG, and VWVJ) and the Departments of Pediatrics (DHMH, OG, LD, RG, and VWVJ) and Epidemiology (BD, DHMH, OG, AH, LD, RG, and VWVJ), Erasmus University Medical Center, Rotterdam, Netherlands; the Department of Radiology, Radboud University, Nijmegen, Netherlands (RM); and Nutricia Research, Utrecht, Netherlands (MA-B and EMvdB)
| | - Vincent W V Jaddoe
- From the Generation R Study Group (BD, DHMH, OG, RG, and VWVJ) and the Departments of Pediatrics (DHMH, OG, LD, RG, and VWVJ) and Epidemiology (BD, DHMH, OG, AH, LD, RG, and VWVJ), Erasmus University Medical Center, Rotterdam, Netherlands; the Department of Radiology, Radboud University, Nijmegen, Netherlands (RM); and Nutricia Research, Utrecht, Netherlands (MA-B and EMvdB)
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Gishti O, Gaillard R, Durmuş B, Hofman A, Duijts L, Franco OH, Jaddoe VWV. Infant diet and metabolic outcomes in school-age children. The Generation R Study. Eur J Clin Nutr 2014; 68:1008-15. [PMID: 24781689 DOI: 10.1038/ejcn.2014.81] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 03/19/2014] [Accepted: 03/26/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Breastfeeding duration is associated with the risks of cardio-metabolic diseases in adulthood. We examined the associations of infant feeding patterns with metabolic outcomes in children and whether any association was explained by family-based socio-demographic, maternal lifestyle-related or childhood factors. SUBJECTS/METHODS We performed a population-based prospective cohort study in 3417 children to examine the associations of breastfeeding duration and exclusivity and age at introduction of solid foods with blood levels of lipids, insulin and C-peptide and risk of clustering of cardio-metabolic risk factors at the median age of 6.0 years (90% range 5.7-6.8). RESULTS We observed that, in the models only adjusted for child's age and sex, ever breastfeeding was not associated with childhood blood levels of lipids but was associated with higher insulin and C-peptide concentrations (P-value<0.05). Breastfeeding duration and exclusivity were not consistently associated with metabolic outcomes. Early introduction of solid foods was associated with higher levels of total cholesterol (P-value<0.05) but not with high-density lipoprotein and low-density lipoprotein cholesterol, triglycerides and insulin levels. Shorter breastfeeding duration and exclusive breastfeeding were associated with increased risks of clustering of cardio-metabolic risk factors. After additional adjustment for family, maternal and childhood factors, none of these associations remained significant. CONCLUSIONS In conclusion, we found no consistent associations of infant feeding patterns with metabolic outcomes at school age, after taking into account family-based socio-demographic, maternal lifestyle-related or childhood factors. Whether infant diet composition influences metabolic outcomes in later life should be further studied.
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Affiliation(s)
- O Gishti
- 1] Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - R Gaillard
- 1] Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - B Durmuş
- Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - L Duijts
- 1] Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - O H Franco
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - V W V Jaddoe
- 1] Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
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Majorana A, Cagetti MG, Bardellini E, Amadori F, Conti G, Strohmenger L, Campus G. Feeding and smoking habits as cumulative risk factors for early childhood caries in toddlers, after adjustment for several behavioral determinants: a retrospective study. BMC Pediatr 2014; 14:45. [PMID: 24528500 PMCID: PMC3930287 DOI: 10.1186/1471-2431-14-45] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 02/11/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several maternal health determinants during the first period of life of the child, as feeding practice, smoking habit and socio-economic level, are involved in early childhood health problems, as caries development. The potential associations among early childhood caries, feeding practices, maternal and environmental smoking exposure, Socio-Economic Status (SES) and several behavioral determinants were investigated. METHODS Italian toddlers (n = 2395) aged 24-30 months were recruited and information on feeding practices, sweet dietary habit, maternal smoking habit, SES, and fluoride supplementation in the first year of life was obtained throughout a questionnaire administered to mothers. Caries lesions in toddlers were identified in visual/tactile examinations and classified using the International Caries Detection and Assessment System (ICDAS). Associations between toddlers' caries data and mothers' questionnaire data were assessed using chi-squared test. Ordinal logistic regression was used to analyze associations among caries severity level (ICDAS score), behavioral factors and SES (using mean housing price per square meter as a proxy). RESULTS Caries prevalence and severity levels were significantly lower in toddlers who were exclusively breastfed and those who received mixed feeding with a moderate-high breast milk component, compared with toddlers who received low mixed feeding and those exclusively fed with formula (p < 0.01). No moderate and high caries severity levels were observed in an exclusively breastfed children. High caries severity levels were significantly associated with sweet beverages (p < 0.04) and SES (p < 0.01). Toddlers whose mothers smoked five or more cigarettes/day during pregnancy showed a higher caries severity level (p < 0.01) respect to those whose mothers did not smoke. Environmental exposure to smoke during the first year of life was also significantly associated with caries severity (odds ratio =7.14, 95% confidence interval = 6.07-7.28). No association was observed between caries severity level and fluoride supplementation. More than 50% of toddlers belonging to families with a low SES, showed moderate or high severity caries levels (p < 0.01). CONCLUSIONS Higher caries severity levels were observed in toddlers fed with infant formula and exposed to smoke during pregnancy living in area with a low mean housing price per square meter.
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Affiliation(s)
| | | | | | | | | | | | - Guglielmo Campus
- Department of Health Science, WHO Collaborating Center of Milan for Epidemiology and Community Dentistry, University of Milan, Milan, Italy.
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Is breast truly best? Estimating the effects of breastfeeding on long-term child health and wellbeing in the United States using sibling comparisons. Soc Sci Med 2014; 109:55-65. [PMID: 24698713 DOI: 10.1016/j.socscimed.2014.01.027] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 01/16/2014] [Accepted: 01/18/2014] [Indexed: 11/23/2022]
Abstract
Breastfeeding rates in the U.S. are socially patterned. Previous research has documented startling racial and socioeconomic disparities in infant feeding practices. However, much of the empirical evidence regarding the effects of breastfeeding on long-term child health and wellbeing does not adequately address the high degree of selection into breastfeeding. To address this important shortcoming, we employ sibling comparisons in conjunction with 25 years of panel data from the National Longitudinal Survey of Youth (NLSY) to approximate a natural experiment and more accurately estimate what a particular child's outcome would be if he/she had been differently fed during infancy. Results from standard multiple regression models suggest that children aged 4 to 14 who were breast- as opposed to bottle-fed did significantly better on 10 of the 11 outcomes studied. Once we restrict analyses to siblings and incorporate within-family fixed effects, estimates of the association between breastfeeding and all but one indicator of child health and wellbeing dramatically decrease and fail to maintain statistical significance. Our results suggest that much of the beneficial long-term effects typically attributed to breastfeeding, per se, may primarily be due to selection pressures into infant feeding practices along key demographic characteristics such as race and socioeconomic status.
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Spinelli MG, Endicott J, Goetz RR. Increased breastfeeding rates in black women after a treatment intervention. Breastfeed Med 2013; 8:479-84. [PMID: 23971683 PMCID: PMC3868278 DOI: 10.1089/bfm.2013.0051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
There has been a considerable increase in rates of breastfeeding in the United States. Despite these trends, black women continue to fall below medical recommendations. Impoverished and poorly educated women also have a comparatively lower rate of breastfeeding. Provider encouragement and supportive interventions increase breastfeeding initiation among women of all backgrounds. The data presented come from a three-site randomized controlled bilingual depression treatment trial from 2005 to 2011 that examined the comparative effectiveness of interpersonal psychotherapy and a parenting education program. Breastfeeding education and support were provided for the majority of participants in each intervention. Breastfeeding status was queried at postpartum week 4. We found higher rates of breastfeeding in black women compared with those reported in national surveys. The black breastfeeding rate did not significantly differ from that of white or Hispanic women. American-born black women were just as likely to breastfeed as American-born white women, both at significantly greater rates than American-born Hispanic women. We also found no differences in breastfeeding rate in poorly educated and impoverished women. These data must be seen against the backdrop of a significant intervention to treat depression. Because breastfeeding interventions have been shown to increase breastfeeding rates, the support provided in our study likely increased rates in groups that lag behind.
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Affiliation(s)
- Margaret G Spinelli
- Columbia University College of Physicians and Surgeons , New York State Psychiatric Institute, New York, New York
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Low maternal education is associated with increased growth velocity in the first year of life and in early childhood: the ABCD study. Eur J Pediatr 2013; 172:1451-7. [PMID: 23793139 DOI: 10.1007/s00431-013-2063-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 06/05/2013] [Indexed: 10/26/2022]
Abstract
UNLABELLED The objective of this study is first to examine the relation of maternal education and growth velocity during the first year of life and early childhood (1-5 years). The second objective is to determine the potential explanatory role of standardized birth weight, maternal smoking during pregnancy, maternal prepregnancy body mass index (BMI), and infant feeding practice in this relation. We used longitudinal growth data of 1,684 participants with Dutch ethnicity participating in a population-based cohort study (Amsterdam Born Children and their Development study). Growth velocity of weight and of weight-for-length were calculated by subtracting the weight and weight-for-length standard deviation scores (SDS), respectively of two time periods. In the first year of life, children with low-educated mothers had an increase in SDS of 0.26 (95 % confidence interval (CI) 0.08-0.45) for weight compared to children with high-educated mothers. In early childhood, children with low-educated mothers had a 0.27 SDS (95 % CI 0.11-0.42) increase for weight-for-length, compared to children with high-educated mothers. Using path analysis, these inequalities could partly be explained by maternal smoking, duration of breastfeeding, maternal age, and maternal BMI. CONCLUSION Children with low-educated mothers had an increased weight gain during the first year of life and an increased weight-for-length gain in early childhood compared to children with high-educated mothers. Although underlying mechanisms were not completely clarified, an optimal duration of breastfeeding, cessation of maternal smoking, and reduction of maternal BMI seem to reduce these educational inequalities in early growth and possible adverse consequences of accelerated growth.
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