Dietary Knowledge and Myths Vary by Age and Years of Schooling in Pregnant Mexico City Residents

Nutritional Knowledge and Practices of Low-Income Women During Pregnancy: A Qualitative Study in Two Oaxacan Cities

Background

Adequate dietary intake is critical for healthy pregnancies. Recent changes in social services in Mexico, coupled with high levels of food insecurity, call into question whether expecting women of the lowest socioeconomic status are able to meet their dietary and nutritional needs in this changing context. The aim of this study was to explore the nutritional practices, education and received and employed among women during their pregnancy.

Methods

Guided by Ecological Systems Theory and an Intersectionality Framework, this qualitative study was carried out in Oaxaca City and Puerto Escondido, in Oaxaca, a Mexican state with high levels of food insecurity. Women who had at least one child in the past five years and had lived in Oaxaca for the past five years were eligible to participate. Twenty-five women participated in semi-structured in-depth interviews conducted between June and December of 2023. A grounded theory approach was used for coding. NVivo was used for coding and analyses.

Results

Five key themes emerged linked to individual-level characteristics and the multiple social identities related to the social support for nutritional knowledge and practices among low-income Oaxacan women during pregnancy: 1) Life experiences, sociodemographic, and health characteristics that influence nutritional practices and knowledge during pregnancy; 2) Female family members as a primary source of nutritional knowledge and food support; 3) Support from other members of women's social networks; 4) Medical guidance for nutrition during pregnancy; and 5) Quality and gaps in the broader health care system and social services. These themes highlight how women's own experiences and social identities and the different interpersonal and community-level environments, particularly those of mothers and grandmothers and health care providers, interact and shape women's nutritional knowledge and practices, such as foods and nutritional supplements consumed, during pregnancy.

Conclusion

Nutritional knowledge and practices during pregnancy are impacted by multiple social identities women have and different factors at the individual, group, and structural level. Future research and programming that use multi-level approaches (considering the individual and the family and other social influences) are needed to address the gaps in nutrition that women in Oaxaca go through during the prenatal period.

Experiences accessing nutritious foods and perceptions of nutritional support needs among pregnant and post-partum mothers with low income in the United States

Access to nutritious foods, a social determinant of health, contributes to disparities in maternal and infant health outcomes such as mental health, breastfeeding intensity and cardiometabolic risk. This study explored perceived nutrition access and intake among pregnant or post-partum women eligible for Medicaid. Qualitative, semistructured interviews were conducted with 18 women who were either currently pregnant (n = 4) or up to 12 months post-partum (n = 14) in 2021-2022. Mothers spoke English (n = 11) or Spanish (n = 7) and lived in the Texas Panhandle. Interviews were audio-recorded, transcribed, translated (Spanish to English) and verified. Two or more researchers coded each interview until consensus was reached using thematic analysis with ATLAS.ti software. The study revealed five drivers for nutrition access. (1) Social factors influenced nutrition; those with less support expressed limited ability to eat healthfully. (2) The Women, Infants and Children program was perceived as a helpful resource for some, while others faced challenges obtaining it. (3) Stress was bidirectionally related to unhealthy food choices, with food sometimes used as a coping mechanism. (4) Mothers prioritized their babies and others and had limited ability and time to prepare healthy meals. (5) Most participants felt they received inadequate nutrition guidance from their healthcare providers. Participants provided positive responses to a proposed nutritious home-delivered meal intervention. Low-income women may experience nutritional challenges specific to this life stage. Interventions that reduce stress and burden of household tasks (e.g. cooking) and improve education and access to nutritious foods may improve mothers' ability to consume nutritious foods.

Serum Folate, Red Blood Cell Folate, and Zinc Serum Levels Are Related with Gestational Weight Gain and Offspring's Birth-Weight of Adolescent Mothers

BACKGROUND

Gestational weight gain below or above the Institute of Medicine recommendations has been associated with adverse perinatal and neonatal outcomes. Very few studies have evaluated the association between serum and red blood cell folate concentrations and gestational weight gain in adolescents. Additionally, zinc deficiency during pregnancy has been associated with impaired immunity, prolonged labor, preterm and post-term birth, intrauterine growth restriction, low birth weight, and pregnancy-induced hypertension.

OBJECTIVE

The purpose of our study is to evaluate the association between serum concentrations of zinc, serum folate, and red blood cell folate, with the increase in gestational weight and the weight and length of the newborn in a group of adolescent mothers from Mexico City.

RESULTS

In our study, 406 adolescent-neonate dyads participated. The adolescents' median age was 15.8 years old. The predominant socioeconomic level was middle-low (57.8%), single (57%), 89.9% were engaged in home activities, and 41.3% completed secondary education. Excessive gestational weight gain was observed in 36.7% of cases, while insufficient gestational weight gain was noted in 38.4%. Small for gestational age infants were observed in 20.9% of the sample. Low serum folate (OR 2.1, 95% CI 1.3-3.3), decreased red blood cell folate (OR 1.6, 95% CI 1.0-2.6), and reduced serum zinc concentrations (OR 3.3, 95% CI 2.1-5.2) were associated with insufficient gestational weight gain. Decreased serum zinc levels (OR 1.2, 95% CI 1.2-3.4) were linked to an increased probability of delivering a baby who is small for their gestational age.

CONCLUSIONS

Low serum folate, red blood cell folate, and serum zinc concentrations were associated with gestational weight gain and having a small gestational age baby. Both excessive and insufficient gestational weight gain, as well as having a small gestational age baby, are frequent among adolescent mothers.

Effect of nutrition-related infodemics and social media on maternal experience: A nationwide survey in a low/middle income country

BACKGROUND

Undernutrition is a crucial cause of morbidity and mortality among children in low- or middle-income countries (LMICs). A better understanding of maternal general healthy nutrition knowledge, as well as misbeliefs, is highly essential, especially in such settings. In the current era of infodemics, it is very strenuous for mothers to select not only the right source for maternal nutrition information but the correct information as well.

AIM

To assess maternal healthy nutritional knowledge and nutrition-related misbeliefs and misinformation in an LMIC, and to determine the sources of such information and their assessment methods.

METHODS

This cross-sectional analytical observational study enrolled 5148 randomly selected Egyptian mothers who had one or more children less than 15 years old. The data were collected through online questionnaire forms: One was for the general nutrition knowledge assessment, and the other was for the nutritional myth score. Sources of information and ways of evaluating internet sources using the Currency, Relevance, Authority, Accuracy, and Purpose test were additionally analyzed.

RESULTS

The mean general nutrition knowledge score was 29 ± 9, with a percent score of 70.8% ± 12.1% (total score: 41). The median myth score was 9 (interquartile range: 6, 12; total score: 18). The primary sources of nutrition knowledge for the enrolled mothers were social media platforms (55%). Half of the mothers managed information for currency and authority, except for considering the author's contact information. More than 60% regularly checked information for accuracy and purpose. The mothers with significant nutrition knowledge checked periodically for the author's contact information (P = 0.012). The nutrition myth score was significantly lower among mothers who periodically checked the evidence of the information (P = 0.016). Mothers dependent on their healthcare providers as the primary source of their general nutritional knowledge were less likely to hold myths by 13% (P = 0.044). However, using social media increased the likelihood of having myths among mothers by approximately 1.2 (P = 0.001).

CONCLUSION

Social media platforms were found to be the primary source of maternal nutrition information in the current era of infodemics. However, healthcare providers were the only source for decreasing the incidence of maternal myths among the surveyed mothers.

Nutrition and diet myths, knowledge and practice during pregnancy and lactation among a sample of Egyptian pregnant women: a cross-sectional study

BACKGROUND

Globally, the burden of maternal malnutrition remains an enormous public health problem; malnourished pregnant women are at increased risk of having low-birth-weight (LBW) infants. Several reports suggest a possible association between malnutrition among lactating mothers and the production of smaller quantities of breast milk. Many women have incorrect nutrition knowledge during pregnancy due to false beliefs derived from popular practices. Our study was conducted to assess nutritional knowledge, myths, and practices among Egyptian women during pregnancy and lactation.

METHODOLOGY

A pretested 2-page interview questionnaire was used to collect data from the study participants after written informed consent was obtained from them after clarification of the study's aim. Obstetrics and gynecology experts collected the data from pregnant females who agreed to participate in private and university hospital antenatal care clinics in Cairo, Egypt.

RESULTS

A total of 468 pregnant females completed the interview questionnaire. The mean knowledge score was 5 ± 3, with a median score of 5 and an IQR of 3-7, and the mean holding myths score was 3 ± 2, with a median score of 2 and an IQR of 2-4. Regarding the correct answers to the knowledge questions, more than 70% of the participants correctly answered that during the first six months of life, breast milk is the only food a baby requires, and less than 20% of them correctly answered that caffeine consumption could provoke premature birth. Regarding the holding myths questions, more than half of the participants held the myth that drinking moghat and helba increases the breast milk supply. We found that the most common source of knowledge during pregnancy and lactation among the participants was family and friends' advice (60%), followed by others (doctors, previous education in school or university) (45%).

CONCLUSION

Among a sample of Egyptian women, more than half held at least one myth about nutrition and diet during pregnancy and breastfeeding, so health education at antenatal outpatient clinics should be directed toward those myths to correct them. Older women with sufficient family income showed significantly higher knowledge scores than others.

Myths About Breastfeeding as Voiced by Lactating Nurses and Midwives: A Qualitative Study at the Greater Accra Region of Ghana

Introduction

Breastfeeding has proven over the years to be one of the most effective means to ensure child survival. The advocators and myth busters of breastfeeding myths are supposed to be health professionals. However very little is known about myths surrounding breastfeeding as expressed by these health professionals (nurses and midwives). Hence this study.

Objective

The study aimed at exploring the myths about breastfeeding as voiced by lactating nurses and midwives.

Method

Qualitative exploratory descriptive design was used to investigate the subject matter. Twenty-five nurses and midwives were purposely selected to participate in the study after they had voluntarily opted to be part of the study. Data was audiotaped, transcribed verbatim and inductively analyzed.

Results

It was evident that participants believed in myths about breastfeeding. The main themes discovered were breastfeeding myth beliefs and sociocultural myth influences. Six sub-themes identified were green stools/diarrhoea, childhood disease, teeth discoloration, child becoming stupid, culture and close relatives.

Conclusion

Health professionals believe in unfounded myths about breastfeeding. Steps should be taken for them to get better lactation support. The outcomes of this study underscore the need for health professionals to address breastfeeding myths, understand the sociocultural context, and support evidence-based practice. Improving lactation support and education for nurses and midwives can lead to better clinical practice and, as a result, help to promote successful and healthy breastfeeding in Ghana.

Individual, Family, and Social Factors Associated with Gestational Weight Gain in Adolescents: A Scoping Review

About 56% to 84% of pregnant adolescents have inappropriate (insufficient or excessive) gestational weight gain (GWG); however, the factors associated with GWG in this age group have not been systematically identified. This scoping review aimed to synthesize the available scientific evidence on the association of individual, family, and social factors with inappropriate gestational weight gain in pregnant adolescents. To carry out this review, the MEDLINE, Scopus, Web of Science, and Google Scholar databases were searched for articles from recent years. The evidence was organized according to individual, family, and social factors. The analyzed studies included 1571 adolescents from six retrospective cohorts, 568 from three prospective cohorts, 165 from a case-control study, 395 from a cross-sectional study, and 78,001 from two national representative samples in the USA. At the individual level, in approximately half of the studies, the pre-pregnancy body mass index (pBMI) was positively associated with the GWG recommended by the Institute of Medicine of the USA (IOM). The evidence was insufficient for the other factors (maternal age, number of deliveries, and family support) to determine an association. According to the review, we concluded that pBMI was positively associated with the GWG. More quality studies are needed to assess the association between GWG and individual, family, and social factors.

Factors Associated With Weight, Length, and BMI Change in Adolescents' Offspring in Their First Year of Life

Background: Young maternal age is associated with negative outcomes at birth and with offspring's growth. In low- and middle-income countries, adolescents' offspring growth little has been studied. Objective: To determine the association of maternal sociodemographic characteristics with weight, length, and BMI change in adolescents' offspring in their first year of life. Methods: This is a one-year follow-up study that included adolescent mothers and their offspring from 2010 to 2017. The infant anthropometric variables were performed at birth, 3, 6, and 12 months. Maternal health, pregnancy, and social variables were evaluated as well as birth outcomes. Crude, percentage, Z score, and percentile changes of weight, length, and BMI were evaluated from birth to 1-year-old. Statistical analyses were adjusted by maternal chronological age, socioeconomic status, breastfeeding duration, the timing of introduction of complementary feeding, among other variables. Results: We examined 186 dyads (mother-infant). The median maternal age was 15.5 years, and the mean pre-pregnancy BMI was 20. The mean gestational age was 39.1 weeks for infants, birth weight was 3,039 g, and length at birth was 49.5-cm. Maternal chronological age, the timing of introduction of complementary feeding, socioeconomic status, and maternal occupation were associated with offspring's weight gain at 12 months. Length gain was associated with exclusive breastfeeding. Socioeconomic status and occupation were associated with offspring's BMI change. When performing adjusted multivariable analyses, weight and length at birth were associated weight and BMI at 12 months. Conclusions: Weight at birth may negatively predict infant's weight and BMI changes at 12 months, while length at birth may positively predict the changes. Maternal chronological age, socioeconomic level, occupation, and the timing of the introduction of complementary feeding were associated with the weight change. Only exclusive breastfeeding was associated with length Z-score change in adolescents' offspring in their first 12-months of life.