1
|
Vidal-Batres M, Marquis GS, Pareja RG. Infant and Maternal Morbidity Symptoms as Predictors for the Interruption of Exclusive Breastfeeding in Lima, Peru: A Prospective Study. J Pediatr Health Care 2024; 38:564-573. [PMID: 38483355 DOI: 10.1016/j.pedhc.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/16/2024] [Accepted: 02/18/2024] [Indexed: 07/05/2024]
Abstract
INTRODUCTION The global prevalence of exclusive breastfeeding for 6 months is 48%. This analysis examined the relationship between infant and maternal morbidity symptoms and the interruption of exclusive breastfeeding. METHODS Data from a cohort study among women living in a peri-urban community in Peru were used. Data were collected during pregnancy, birth, and the first 6 months postpartum among 179 dyads... RESULTS After the first month, interruption of exclusive breastfeeding was almost twofold (adjusted odds ration [aOR] = 1.99, 95% confidence interval [CI]: 1.14, 3.45) more likely among infants with symptoms (e.g., diarrhea, cough) than those without. Maternal morbidity symptoms (e.g., gastrointestinal, respiratory) and breast problems were positively associated with interruption of exclusive breastfeeding throughout the first 6 months (aOR = 1.77, 95% CI: 1.11, 2.82 and aOR = 3.23, 95% CI: 1.84, 5.69, respectively). DISCUSSION Mother-infant dyads often experience illness symptoms that are not contraindications to breastfeeding. Health professionals need to reinforce that exclusive breastfeeding should continue during illness.
Collapse
Affiliation(s)
- Marisol Vidal-Batres
- Marisol Vidal-Batres, Research Coordinator, School of Human Nutrition, McGill University, Montreal, Québec, Canada.
| | - Grace S Marquis
- Grace S. Marquis, Associate Professor, School of Human Nutrition, McGill University, Montreal, Québec, Canada
| | - Rossina G Pareja
- Rossina G. Pareja, Principal Researcher, Instituto de Investigación Nutricional, Lima, Perú
| |
Collapse
|
2
|
Khanal V. Influence of breastfeeding education and support on predominant breastfeeding: Findings from a community-based prospective cohort study in Western Nepal. Health Sci Rep 2023; 6:e1548. [PMID: 37680209 PMCID: PMC10480414 DOI: 10.1002/hsr2.1548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023] Open
Abstract
Background and Aims Breastfeeding education and support have the potential to improve breastfeeding outcomes. However, there is a lack of research on the impact of breastfeeding education on predominant breastfeeding in Nepal and other South Asian countries. This study aimed to report the rate of predominant breastfeeding at the first, fourth, and sixth months of birth and examine the influence of breastfeeding promotion on predominant breastfeeding. Methods A community-based prospective cohort study was conducted in western Nepal. A total of 735 mother-infant pairs were recruited within 30 days of childbirth and followed up at the fourth and sixth months to collect data on infant feeding practices. Results The rate of predominant breastfeeding at first, fourth, and sixth months were 88.6% (N = 735), 78.2% (N = 715), and 26.3% (N = 711), respectively, showing a significant decline with infant age. Mothers who received support on breastfeeding skills (Adjusted Odds Ratio [AOR]: 2.55; 95% confidence interval [CI]: 1.73-3.75), those who received advice on keeping mother-infant together (AOR: 2.19; 95% CI: 1.14-4.22) and who had initiated breastfeeding within 1 h of childbirth (AOR: 2.55; 95% CI: 1.73-3.75), and who were educated, had higher likelihood of predominant breastfeeding at sixth month. Conclusion This study asserts a need for continuous and focused breastfeeding promotion programs to educate and support lactating mothers.
Collapse
|
3
|
Mirza Alizadeh A, Hosseini H, Hosseini MJ, Hassanzadazar H, Hashempour-Baltork F, Zamani A, Mohseni M. Melamine in Iranian foodstuffs: A systematic review, meta-analysis, and health risk assessment of infant formula. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 256:114854. [PMID: 37018855 DOI: 10.1016/j.ecoenv.2023.114854] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 03/25/2023] [Accepted: 03/29/2023] [Indexed: 06/19/2023]
Abstract
The presence of melamine in food is one of the most significant threats to consumer health and food safety now confronting the communities. The goal of this systematic review and meta-analysis was to determine the melamine content of different food products available on the Iranian market. The pooled melamine concentration (95% confidence interval) on 484 samples of animal-based foodstuffs was as follows: 0.22 (0.08, 0.36 mg kg-1) for milk, 0.39 (0.25, 0.53 mg kg-1) for coffee mate, 1.45 (1.36, 1.54 mg kg-1) for dairy cream, 0.90 (0.50, 1.29 mg kg-1) for yoghurt, 1.25 (1.20, 1.29 mg kg-1) for cheese, 0.81 (-0.16, 1.78 mg kg-1) for hen eggs, 1.28 (1.25, 1.31 mg kg-1) for poultry meat, 0.58 (0.35, 0.80 mg kg-1) for chocolates, and 0.98 (0.18, 1.78 mg kg-1) for infant formula. Based on the results of health risk assessment study on toddlers under 2 years old who ingested infant formula (as a melamine-sensitive group), all groups of toddlers are at an acceptable level of non-carcinogenic risk (THQ ≤ 1). Toddlers were classified according to their ILCR (carcinogenic risk) levels due to infant formula consumption as follows: under 6 months (0.0000056), 6-12 months (0.0000077), 12-18 months (0.0000102), and 18-24 months (0.0000117). The melamine carcinogenicity in infant formula for children had an ILCR value of 0.000001-0.0001 in the investigation, which was considerable risk. According to the findings, Iranian food products (notably infant formula) should be analyzed for melamine contamination on a regular basis.
Collapse
Affiliation(s)
- Adel Mirza Alizadeh
- Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran; Department of Food Safety and Hygiene, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Hedayat Hosseini
- Department of Food Science and Technology, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Science and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Food Safety Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mir-Jamal Hosseini
- Zanjan Applied Pharmacology Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Hassan Hassanzadazar
- Department of Food Safety and Hygiene, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Fataneh Hashempour-Baltork
- Halal Research Center of IRI, Iran Food and Drug Administration, Ministry of Health and Medical Education, Tehran, Iran.
| | - Abbasali Zamani
- Environmental Science Research Laboratory, Department of Environmental Science, Faculty of Science, University of Zanjan, Zanjan, Iran.
| | - Mehran Mohseni
- Zanjan Applied Pharmacology Research Center, Zanjan University of Medical Sciences, Zanjan, Iran; Department of Food and Drug Control, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran.
| |
Collapse
|
4
|
Al Naseeb NM, Badr H, Alghamdi S. A correlational study of breastfeeding duration among Saudi mothers: The role of self-efficacy, intention, and social support. BELITUNG NURSING JOURNAL 2023; 9:132-138. [PMID: 37469583 PMCID: PMC10353599 DOI: 10.33546/bnj.2510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/14/2023] [Accepted: 03/20/2023] [Indexed: 07/21/2023] Open
Abstract
Background Breastfeeding is an essential source of nutrition for infants and offers numerous benefits for both the mother and child. Despite the consensus on its advantages, limited research in Saudi Arabia has explored the factors influencing breastfeeding duration. Objective This study aimed to examine the relationships between breastfeeding self-efficacy, intention, social support, and breastfeeding duration. Methods The study employed a correlational research design, and data were collected from three armed forces hospitals in Taif, Saudi Arabia, from December 2020 to February 2021. The samples comprised 356 conveniently selected breastfeeding mothers, assessed using the Breastfeeding Personal Efficacy Beliefs Inventory, Modified Infant Feeding Intention Scale, and Exclusive Breastfeeding Social Support Scale. Simple linear regressions were conducted for data analysis. Results Breastfeeding duration was divided into two groups. Group 1 consisted of mothers still breastfeeding at the time of data collection, while Group 2 comprised those who had discontinued breastfeeding. Of the total samples, 51.6% (n = 184) of mothers were classified under Group 1, while the remaining 48.4% (n = 172) were allocated to Group 2. Specifically, 78.3% of mothers had stopped breastfeeding by the time their infants were six months old, and 93.3% intended to introduce formula feeding at three months. In Group 1, the results revealed that self-efficacy (β = 0.625, p <0.001), intention (β = 0.643, p <0.001), and social support (β = 0.612, p <0.001) were positively associated with breastfeeding duration. Similarly, in Group 2, a strong positive correlation was observed between self-efficacy (β = 0.72, p <0.001), intention (β = 0.73, p <0.001), social support (β = 0.699, p <0.001), and breastfeeding duration. These three factors jointly explained 40% of the variance in breastfeeding duration in Group 1 (adjusted R2 = 0.4) and 50% in Group 2 (adjusted R2 = 0.5). Conclusion Breastfeeding intention was found to have a more significant impact on breastfeeding duration than self-efficacy and social support. These results can inform nurses and midwives in supporting breastfeeding mothers by providing them with the necessary information and increasing their awareness of breastfeeding-related factors.
Collapse
Affiliation(s)
- Nourah. M Al Naseeb
- Maternity and Child Department, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
- Armed Forces Hospital in Al-Hada, Saudi Arabia
| | - Hanan Badr
- Maternity and Child Department, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Salmah Alghamdi
- Maternity and Child Department, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
5
|
Yalcin SS, Aydin Aksoy E, Yalcin S, Eryurt MA. Breastfeeding status and determinants of current breastfeeding of Syrian refugee children in Turkey. Int Breastfeed J 2023; 18:10. [PMID: 36721151 PMCID: PMC9890821 DOI: 10.1186/s13006-022-00538-w] [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: 04/22/2022] [Accepted: 12/20/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Turkey hosts the highest number of refugees in the World including 65% of Syrian refugees who reside in Turkey. Mothers and children were the most negatively affected among the Syrian refugees who had to migrate from their countries as a result of the civil war in Syria. One of the most important issues in terms of child health is breastfeeding. Breastfeeding in migrants should be promoted worldwide to mitigate infant mortality and diseases. The aim of this study is to examine the association between breastfeeding status in Syrian refugee children under two years and socio-demographic characteristics of Syrian refugee mothers with further analysis of Turkey Demographic and Health Survey-Syrian Migrant-2018 (TDHS-SM-2018) data. METHODS: The data source is the TDHS-SM-2018. Data for the last-born children with a gestational duration greater than 32 weeks from the mothers' singleton pregnancy, aged less than two years old and living with the mother were included (unweighted n = 744). The dependent variable was the breastfeeding status (breastfeeding in the last 24 h during the study period) in children under two years. Complex sample logistic regression evaluated the associations. RESULTS The percentage of breastfeeding in children under the age of two years was found to be 62.4%, and the total median breastfeeding duration was 14.6 months. Univariate analysis showed that the earlier mothers immigrated to Turkey, the higher the current breastfeeding rate. Breastfeeding rates were found to be higher among people living in the South and East regions (65.2% and 65.1% respectively). Multivariable binary complex sample logistic regression revealed that breastfeeding status at the study period was associated with long preceding birth interval; delivery in a public hospital; absence of prelacteal feeding; being non-pregnant; and the region and age of the child. No relationship for current breastfeeding was found with maternal activities, maternal life satisfaction, financial satisfaction, and educational status. CONCLUSION Current breastfeeding in our sample was more likely among mothers with a longer birth interval who avoided prelacteal feeding. The Baby-Friendly approach and family planning services should be integrated into refugee health centers.
Collapse
Affiliation(s)
- Siddika Songül Yalcin
- Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - Esin Aydin Aksoy
- grid.14442.370000 0001 2342 7339Departmant of Social Pediatrics, Institute of Child Health, Hacettepe University, Ankara, Turkey
| | - Suzan Yalcin
- grid.17242.320000 0001 2308 7215Department of Food Hygiene and Technology, Faculty of Veterinary Medicine, Selçuk University, Konya, Turkey
| | - Mehmet Ali Eryurt
- grid.14442.370000 0001 2342 7339Institute of Population Studies, Hacettepe University, Ankara, Turkey
| |
Collapse
|
6
|
Freund-Azaria A, Bar-Shalita T, Regev R, Bart O. The Role of Motor Coordination, ADHD-Related Characteristics and Temperament among Mothers and Infants in Exclusive Breastfeeding: A Cohort Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5509. [PMID: 35564903 PMCID: PMC9099549 DOI: 10.3390/ijerph19095509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 02/05/2023]
Abstract
Although exclusive breastfeeding is recommended for the first 6 months of life, breastfeeding rates are low. Motor skills and ADHD-related characteristics have not yet been examined as breastfeeding barriers. The aim of this study was to explore whether mothers' and infants' motor skills, mothers' ADHD-related characteristics and infants' temperament are associated with exclusive breastfeeding at 6 months after birth. Participants were 164 mothers and their infants recruited 2 days after birth. Mothers completed a demographic and delivery information questionnaire, the Infant Feeding Intentions Scale and the Iowa Infant Feeding Attitude Scale. At 6 months, mothers completed the Adult DCD (developmental coordination disorder)/Dyspraxia Checklist, the Adult ADHD (attention deficit hyperactivity disorder) Self-Report Scale Symptom Checklist-v1.1, and the Infant Characteristics Questionnaire, and provided information about their breastfeeding status. They were then divided into two groups accordingly: EBF (exclusive breastfeeding) and NEBF (non-exclusive breastfeeding). Infants were observed using the Test of Sensory Functions in Infants and the Alberta Infant Motor Scale. At 6 months, NEBF mothers reported higher prevalence of DCD (10.2% vs. 1.9%, χ2 = 5.561, p = 0.018) and ADHD (20.3% vs. 8.6%, χ2 = 4.680, p = 0.030) compared to EBF mothers. EBF infants demonstrated better motor coordination (t = 2.47, p = 0.016, d = 0.511), but no temperament differences compared to NEBF infants. Maternal DCD, ADHD and poor infant motor coordination are associated with non-exclusive breastfeeding and may become exclusive breastfeeding barriers. These findings may assist in identifying women at risk of not exclusively breastfeeding and encourage tailoring interventions for achieving higher exclusive breastfeeding rates.
Collapse
Affiliation(s)
- Adi Freund-Azaria
- Occupational Therapy Department, School of Health Professions, Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel-Aviv 6997801, Israel; (A.F.-A.); (T.B.-S.)
- Department of Neonatology, Meir Medical Center, Kfar-Saba 4428164, Israel
| | - Tami Bar-Shalita
- Occupational Therapy Department, School of Health Professions, Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel-Aviv 6997801, Israel; (A.F.-A.); (T.B.-S.)
| | - Rivka Regev
- Clalit Health Organization and Neonatal Follow-Up Clinic, Kfar-Saba 4428164, Israel;
| | - Orit Bart
- Occupational Therapy Department, School of Health Professions, Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel-Aviv 6997801, Israel; (A.F.-A.); (T.B.-S.)
| |
Collapse
|
7
|
Pérez‐Escamilla R, Hromi‐Fiedler A, Rhodes EC, Neves PAR, Vaz J, Vilar‐Compte M, Segura‐Pérez S, Nyhan K. Impact of prelacteal feeds and neonatal introduction of breast milk substitutes on breastfeeding outcomes: A systematic review and meta‐analysis. MATERNAL & CHILD NUTRITION 2022; 18 Suppl 3:e13368. [PMID: 35489107 PMCID: PMC9113480 DOI: 10.1111/mcn.13368] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/30/2022] [Accepted: 04/05/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Rafael Pérez‐Escamilla
- Department of Social and Behavioral Sciences Yale School of Public Health New Haven Connecticut USA
| | - Amber Hromi‐Fiedler
- Department of Social and Behavioral Sciences Yale School of Public Health New Haven Connecticut USA
| | - Elizabeth C. Rhodes
- Department of Social and Behavioral Sciences Yale School of Public Health New Haven Connecticut USA
| | - Paulo A. R. Neves
- International Center for Equity in Health Universidade Federal de Pelotas Pelotas Rio Grande do Sul Brazil
| | - Juliana Vaz
- Faculty of Nutrition Universidade Federal de Pelotas Pelotas Rio Grande do Sul Brazil
| | - Mireya Vilar‐Compte
- Department of Public Health Montclair State University Montclair New Jersey USA
| | | | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library Yale University New Haven Connecticut USA
| |
Collapse
|
8
|
Mirafzali S, Akbari Sari A, Iranpour A, Alizadeh S. Breastfeeding Duration and Its Effective Factors in Kerman Province, Iran. Glob Pediatr Health 2022; 9:2333794X221133019. [DOI: 10.1177/2333794x221133019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/28/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Complete cessation of breastfeeding (CCB) at the right time is as important as starting breastfeeding, as well as identifying the factors that affect the duration of breastfeeding, so that breastfeeding promotion programs focus on these causes, to increase mothers’ ability and desire to breastfeed. This study aimed to determine the time of CCB and its related factors. Methods This analytical cross-sectional study was conducted in 2020. This study was performed at all health centers and health homes affiliated to Kerman University of Medical Sciences, in Kerman province, Iran. A total of 802 urban and rural mothers with children aged from 30 to 36 months completed the questionnaire. The validity and reliability of the questionnaire were confirmed by Cronbach’s alpha of 85%. Data were analyzed using SPSS software version 16. Results The mean time of breastfeeding was 19.23 ± 7.09 months and the median was 22-month-year. About 41% of children were breastfed until 24-month. There was a significant relationship between the time of CCB with contraception, number of households, place of residence, and weight at 6-month at the level of 0.05. Conclusion Duration of breastfeeding is influenced by some demographic and cultural factors. The timing of the CCB is near to the suggestions of the World Health Organization (WHO) and religious teachings.
Collapse
Affiliation(s)
| | - Ali Akbari Sari
- Department of Health Economics and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abedin Iranpour
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Somayeh Alizadeh
- Health education & Promotion, Department of Health Education and Promotion, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
9
|
Cavalcante VDO, de Sousa ML, Pereira CDS, da Silva NO, Rodrigues de Albuquerque T, Callou Cruz RDSBL. Consequences of Using Artificial Nipples in Exclusive Breastfeeding: An Integrative Review. AQUICHAN 2021. [DOI: 10.5294/aqui.2021.21.3.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: To describe the consequences of using artificial nipples to exclusive breastfeeding.
Materials and method: An integrative review carried out in the Medline®, Cinahl, Lilacs, Web of Science, and Scopus databases to answer the following question: What are the consequences of using artificial nipples to exclusive breastfeeding?
Results: 38 articles were analyzed; the analysis gave rise to two categories: neonatal factors and maternal factors influencing exclusive breastfeeding. Breastfeeding interruption was the neonatal factor most associated with the use of artificial nipples, while the level of maternal education stood out as an intervening factor in exclusive breastfeeding. Pacifiers were the dummy type more commonly mentioned, followed by feeding bottles and nipple shields.
Conclusions: The consequences of offering artificial nipples to breastfed infants are mostly negative and associated with the newborn, such as early weaning, refusal to breastfeed, impaired suction technique, incorrect latch-on, interference with orofacial development, and interruption of exclusive breastfeeding. Mothers who offered artificial nipples to their infants are more likely to experience pain, nipple fissures, frustration, and reduced interaction with their infants.
Collapse
|
10
|
Riaz R, Ahmed M, Baloch M, Rizvi SAH, Shahid N, Siddiqui FQ, Haq MS, Saleem S. Frequency and Predictors of Pacifier Use in the Low Socioeconomic Group of Karachi, Pakistan: A Cross-Sectional Study. Cureus 2020; 12:e12324. [PMID: 33520522 PMCID: PMC7837666 DOI: 10.7759/cureus.12324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2020] [Indexed: 12/02/2022] Open
Abstract
Background Pacifier use has been popular for ages. They are prevalent all over the world because of their various perceived benefits. On the other hand, there is a common belief that they do carry health risks as well. Due to these contradicting belief systems, the frequency of their use, and the factors that determine them, need to be thoroughly evaluated. Since Pakistan is a developing country with a low literacy rate, it can be implied that a vast majority of the country's population may lack awareness regarding the advantages and disadvantages of pacifier use, making them incapable of weighing associated risks versus benefits. The data evaluating these factors in this region are however scarce in the published literature. We, therefore, aimed to highlight the frequency and predictors of pacifier use in the low socioeconomic group of Karachi, Pakistan. Materials and methods A descriptive, cross-sectional study was conducted on a sample of 300 mothers visiting a tertiary care hospital in Karachi, Pakistan. We included mothers who had at least one child under the age of two years, and whose child did not have any oro-nasal anomaly that could prevent them from sucking a pacifier. Data were collected using pre-tested questionnaires and analyzed using the Statistical Package for Social Sciences (SPSS version 23.0, IBM Corp., Armonk, NY, US). Frequencies were calculated and presented in the form of tables. The chi-square test was used to determine the significance of all categorical variables. A P-value of <0.05 was considered to be statistically significant. Results Almost half of our respondents (49%) gave pacifiers to their children. A significant number (59%) of these mothers were uneducated. Almost all (97%) of the users had annual household income less than 15,000 Pakistani rupees (PKR); 34% were primiparous and more than two-thirds (71%) had a normal vaginal delivery. Out of all the factors, maternal age less than 20, annual household income less than 15,000 PKR, and primiparity were significantly associated with pacifier use in mothers (P<0.05). Only a half of the users (51%) cleaned the pacifiers by boiling; one-fourth (25%) washed it with water only; while 18% washed it with soap and water. The majority (84%) of the mothers used the pacifier to soothe the baby when upset. Among mothers who did not use a pacifier, about a third (30%) did not do so as they believed it's a bad practice. About one-fourth (27%) believed it was unhygienic. Conclusions Our study highlights the gap in the awareness of mothers regarding pacifier use. Using this data, we can target to disseminate specific information to this population to integrate safe and healthy child care habits in society.
Collapse
Affiliation(s)
- Ramsha Riaz
- Internal Medicine, Dr Ruth KM Pfau Civil Hospital Karachi, Dow University of Health Sciences, Karachi, PAK
| | - Madiha Ahmed
- Medicine, Dr Ruth KM Pfau Civil Hospital Karachi, Dow University of Health Sciences, Karachi, PAK
| | - Mariam Baloch
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Syed Asad Hasan Rizvi
- Internal Medicine, Dr Ruth KM Pfau Civil Hospital Karachi, Dow University of Health Sciences, Karachi, PAK
| | - Naureen Shahid
- Internal Medicine, Dr Ruth KM Pfau Civil Hospital Karachi, Dow University of Health Sciences, Karachi, PAK
| | - Fatima Qadir Siddiqui
- Internal Hospital, Dr Ruth KM Pfau Civil Hospital Karachi, Dow University of Health Sciences, Karachi, PAK
| | - Muhammad S Haq
- Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, PAK
| | - Sania Saleem
- Research and Development, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Internal Medicine, King Edward Medical University, Mayo Hospital, Lahore, PAK
| |
Collapse
|
11
|
Zarshenas M, Zhao Y, Binns CW, Scott JA. Incidence and Determinants of Caesarean Section in Shiraz, Iran. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165632. [PMID: 32764231 PMCID: PMC7459978 DOI: 10.3390/ijerph17165632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/02/2020] [Accepted: 08/03/2020] [Indexed: 11/22/2022]
Abstract
The rate of Caesarean section (CS) without medical indication has increased markedly worldwide in the past decades. This study reports the incidence of CS and identifies the determinants of elective and emergency CS as separate pregnancy outcomes in a cohort of Iranian women. Mothers (n = 700) of healthy, full-term infants were recruited from five maternity hospitals in Shiraz. The association between maternal socio-demographic and biomedical factors with mode of delivery was explored using multivariable, multinomial logistic regression. Most mothers underwent either an elective (35.4%) or emergency (34.7%) CS. After adjustment, women were more likely to deliver by elective CS than vaginally if they were older (≥30 year) compared to younger mothers (<25 year) (Relative Risk Ratio (RRR) 2.22; 95% Confidence Interval (CI) 1.28, 3.84), and had given birth at a private hospital (RRR 3.64; 95% CI 1.79, 7.38). Compared to those educated to primary or lower secondary level, university educated women were more likely to have undergone an elective (RRR 2.65; 95% CI 1.54, 4.58) or an emergency CS (RRR 3.92; 95% CI 2.27, 6.78) than a vaginal delivery. Similarly, overweight or obese women were more likely than healthy weight women to have undergone an elective (RRR 1.91; 95% CI 1.27, 2.87) or an emergency CS (RRR 2.02; 95% CI 1.35, 3.02) than a vaginal delivery. Specialist education of obstetricians and midwives along with financial incentives paid to private hospitals to encourage natural delivery may help in the reduction of unnecessary CS in Iran. In addition, to increase their childbirth knowledge and self-efficacy, pregnant women need to have the opportunity to attend purposefully designed antenatal childbirth preparation classes where they receive evidence-based information on natural childbirth and alternative methods of pain control, as well as the risks and indications for CS.
Collapse
Affiliation(s)
- Mahnaz Zarshenas
- Fatemeh College of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
| | - Yun Zhao
- School of Public Health, Curtin University, Perth 6102, Australia
| | - Colin W Binns
- School of Public Health, Curtin University, Perth 6102, Australia
| | - Jane A Scott
- School of Public Health, Curtin University, Perth 6102, Australia
| |
Collapse
|