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Hulman A, Varga K, Csákvári T, Pakai A. Assessing the Implementation of the Baby-Friendly Hospital Initiative in Hungary: A Cross-Sectional Study. Children (Basel) 2024; 11:412. [PMID: 38671629 PMCID: PMC11049491 DOI: 10.3390/children11040412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/27/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024]
Abstract
We assessed the prevalence of the "Ten Steps to Successful Breastfeeding" in Hungary and identified possible associations of the steps with breastfeeding. Our quantitative, cross-sectional research was conducted anonymously online in Hungary with a self-administered questionnaire in 2021. Targeted sampling was used, with biological motherhood and having at least one child no older than 60 months as inclusion criteria (n = 2008). The implementation of the "Ten Steps to Successful Breastfeeding" was analyzed separately for breastfeeding and non-breastfeeding mothers. A breastfeeding mother was defined as breastfeeding for at least six months. Descriptive statistics, χ2 test, and t-test were calculated with SPSSv25 (p < 0.05). No significant differences were found between breastfeeding and non-breastfeeding mothers in terms of supplementary feeding at the advice of a health professional (p = 0.624) and in terms of assistance with breastfeeding or suggested breastfeeding positions during hospitalization (p = 0.413). Significant differences were found for receiving breastfeeding-friendly recommendations by staff (p = 0.006), valuing breastfeeding (p < 0.001), skin-to-skin contact within 1 h (p = 0.002), receiving supplementary feeding (p < 0.001), rooming-in (p < 0.001), responsive feeding, recognizing hunger signs (p < 0.001), pacifier/bottle use (p < 0.001), and availability of breastfeeding support (p = 0.005). Significant differences were observed between breastfeeding and non-breastfeeding subsamples regarding the implementation of baby-friendly steps (p < 0.001). Breastfeeding mothers experienced the implementation of more baby-friendly steps and a higher rate of breastfeeding, while there was no significant difference in the duration of exclusive (p = 0.795) and partial breastfeeding (p = 0.250) based on the results. We concluded that exposure to the Baby-Friendly Hospital Initiative may be associated with increased 6-month breastfeeding but may not influence longer durations.
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Affiliation(s)
- Anita Hulman
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 4 Vörösmarty Str., H-7621 Pécs, Hungary
| | - Katalin Varga
- Department of Affective Psychology, Institute of Psychology, ELTE Eötvös Loránd University, 46 Izabella Str., H-1064 Budapest, Hungary
| | - Tímea Csákvári
- Department of Health Economics and Health Care Management, Institute of Health Insurance, Faculty of Health Sciences, University of Pécs, 33 Landorhegyi Str., H-8900 Zalaegerszeg, Hungary
| | - Annamária Pakai
- Institute of Basics of Health Sciences, Midwifery and Health Visiting, Faculty of Health Sciences, University of Pécs, 4 Vörösmarty Str., H-7621 Pécs, Hungary;
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Hulman A, Pakai A, Csákvári T, Keczeli V, Varga K. The Impact of Mode of Delivery and Postpartum Conditions on Breastfeeding: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:248. [PMID: 38255135 PMCID: PMC10814997 DOI: 10.3390/healthcare12020248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
Breast milk is the optimal and essential source of nutrients for babies. Many women, however, do not breastfeed or stop early after giving birth, often due to lack of support. For newborns delivered by caesarean section, there is often a delay, or no skin-to-skin contact after birth; thus, early breastfeeding is not achieved. Separation, complementary feeding or pacifier use also limits the mother's ability to breastfeed. A quantitative, cross-sectional study was conducted. Sociodemographic data, the mode of delivery and postpartum circumstances, information on breastfeeding, and the method and duration of feeding were collected (n = 2008). Two-thirds of children born by caesarean section did not have skin-to-skin contact after birth (p < 0.001). Lack of rooming-in placement increased the incidence of more frequent complementary feeding (p < 0.001) and shortened the duration of exclusive breastfeeding (p < 0.001). The duration of breastfeeding may also be negatively affected by scheduled feeding (p = 0.007) and pacifier utilization (p < 0.001). The mode of delivery and postpartum circumstances directly affecting the mother and the newborn can affect the feasibility of breastfeeding and the duration of exclusive and partial breastfeeding. For positive breastfeeding outcomes, skin-to-skin contact immediately after birth, rooming-in and unrestricted, demand breastfeeding, as well as the avoidance of the use of pacifiers, are recommended.
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Affiliation(s)
- Anita Hulman
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 4 Vörösmarty Str., H-7621 Pécs, Hungary
| | - Annamária Pakai
- Institute of Basics of Health Sciences, Midwifery and Health Visiting, Faculty of Health Sciences, University of Pécs, 4 Vörösmarty Str., H-7621 Pécs, Hungary
| | - Tímea Csákvári
- Department of Health Economics and Health Care Management, Institute of Health Insurance, Faculty of Health Sciences, University of Pécs, 33 Landorhegyi Str., H-8900 Zalaegerszeg, Hungary
| | - Viola Keczeli
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 4 Vörösmarty Str., H-7621 Pécs, Hungary
| | - Katalin Varga
- Department of Affective Psychology, Institute of Psychology, ELTE Eötvös Loránd University, 46 Izabella Str., H-1064 Budapest, Hungary
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Hulman A, Varga K, Ádám Z, Pakai A. [Comparison of the feeding habits of breastfeeding and non-breastfeeding mothers and the sociodemographic factors influencing breastfeeding]. Orv Hetil 2023; 164:1693-1700. [PMID: 37898878 DOI: 10.1556/650.2023.32885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/17/2023] [Indexed: 10/31/2023]
Abstract
INTRODUCTION Breastfeeding is the most ideal form of infant feeding, the biological norm that affects the mother's nutrition as well as certain sociodemographic factors. OBJECTIVE The aim of this research is to compare the nutritional habits of breastfeeding and non-breastfeeding mothers during the postpartum period, and to further examine the correlations of sociodemographic factors with breast milk feeding. METHOD Our quantitative, cross-sectional study was conducted between 26. 03. 2021 and 18. 07. 2021. During the non-random, targeted, expert sample selection, the target group included those biological mothers who raised at least one child born alive after the 37th gestational week in their own care. Exclusion criteria included adoption, pregnancy with the first child, inadequate completion of the mandatory questions, and reports of a congenital and/or acquired physical or mental illness that makes breastfeeding impossible. 2008 people met the inclusion and exclusion criteria. The survey was carried out anonymously via a self-filled questionnaire online. The statistical analysis was performed using the IBM SPSS 25 program, the significance level was determined at p<0.05. RESULTS There was a significant difference between the group of breastfeeding mothers and non-breastfeeding mothers in terms of age (p<0.001), place of residence (p<0.001), marital status (p<0.001), education (p<0.001), income status (p<0.001), the number of children (p = 0.005), the method of delivery (p = 0.018), how many children completed the questionnaire (p = 0.021). Varied nutrition was characteristic in a significantly higher proportion during the postpartum period among breastfeeding mothers (p = 0.006). There was a relationship between the two groups in terms of energy intake (p = 0.002) and daily vitamin/mineral/trace element intake (p = 0.044). CONCLUSION During the period of childbirth, breastfeeding mothers pay more attention to their nutrition than non-breastfeeding mothers. Breastfeeding can be significantly influenced by certain sociodemographic factors. Orv Hetil. 2023; 164(43): 1693-1700.
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Affiliation(s)
- Anita Hulman
- 1 Pécsi Tudományegyetem, Egészségtudományi Kar, Egészségtudományi Doktori Iskola Pécs Magyarország
| | - Katalin Varga
- 2 Eötvös Loránd Tudományegyetem, Pedagógiai és Pszichológiai Kar, Affektív Pszichológiai Tanszék Budapest Magyarország
| | - Zsombor Ádám
- 3 Medaille University, Master of Arts in Psychology Buffalo, NY 14214 United States
| | - Annamária Pakai
- 4 Pécsi Tudományegyetem, Egészségtudományi Kar, Egészségtudományi Alapozó, Szülésznői és Védőnői Intézet Szombathely Magyarország
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Faerch K, Quist JS, Hulman A, Witte DR, Tabak AG, Brunner EJ, Kivimäki M, Jørgensen ME, Panda S, Vistisen D. Prospective association between late evening food consumption and risk of prediabetes and diabetes: the Whitehall II cohort study. Diabet Med 2019; 36:1256-1260. [PMID: 30897241 PMCID: PMC6754814 DOI: 10.1111/dme.13951] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/18/2019] [Indexed: 12/15/2022]
Abstract
AIMS We examined whether late evening food consumption was prospectively associated with the risk of developing prediabetes or diabetes in a large observational study of individuals with normoglycaemia. METHODS Participants were 2642 men and women with normoglycaemia (HbA1c < 39 mmol/mol; < 5.7%) from the Whitehall II study. Time of last eating episode (TLEE) before the examination day was assessed at baseline. We studied the associations of TLEE with 5-year changes in HbA1c and risk of developing prediabetes or diabetes (HbA1c ≥ 39 mmol/mol; ≥ 5.7%). Potential heterogeneity in the association between TLEE and prediabetes or diabetes was examined using recursive partitioning modelling for time-to-event outcomes. RESULTS There was a tendency of an overall association of TLEE with change in HbA1c but with little effect size [β per 1-h increase in TLEE = 0.2 mmol/mol, 95% CI -0.0 to 0.3 (0.01%, -0.00 to 0.03); P = 0.055] and no association with the risk of developing prediabetes/diabetes (risk ratio per 1-h increase in TLEE = 1.03, 95% CI 0.94 to 1.13; P = 0.511). According to the recursive partitioning modelling, women with HbA1c ≤ 36 mmol/mol and TLEE after 21:00 had a 1.51 times (95% CI 1.16 to 1.93) higher 5-year risk of developing prediabetes or diabetes than those having their TLEE between 16:00 and 21:00 (35.4% vs. 23.5%; P = 0.003). CONCLUSIONS There was no overall association of TLEE with the development of prediabetes or diabetes in the Whitehall II population. However, explorative analyses suggested that eating late in the evening was associated with increased risk of developing prediabetes/diabetes among women with good glycaemic control. Whether restricting late evening food consumption is effective and feasible for the prevention of Type 2 diabetes needs testing in randomized controlled trials.
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Affiliation(s)
- K Faerch
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - J S Quist
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - A Hulman
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Danish Diabetes Academy, Odense, Denmark
| | - D R Witte
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Danish Diabetes Academy, Odense, Denmark
| | - A G Tabak
- 1st Department of Internal Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - E J Brunner
- Department of Epidemiology & Public Health, University College London, London, UK
| | - M Kivimäki
- Department of Epidemiology & Public Health, University College London, London, UK
| | - M E Jørgensen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
- National Institute of Public Health, Southern Denmark University, Copenhagen, Denmark
| | - S Panda
- Salk Institute for Biological Studies, La Jolla, CA, USA
| | - D Vistisen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark
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Silverman-Retana O, Hulman A, Simmons RK, Nielsen J, Witte DR. Trajectories of obesity by spousal diabetes status in the English Longitudinal Study of Ageing. Diabet Med 2019; 36:105-109. [PMID: 30175888 DOI: 10.1111/dme.13811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2018] [Indexed: 12/18/2022]
Abstract
AIMS To examine whether the development of obesity with age was different for individuals with and without a spouse with diabetes. METHODS We analysed data from the English Longitudinal Study of Ageing [n= 7123, median (interquartile range) age 59 (53-67) years, 51% men], which included four clinical examination waves between 1998 and 2012. The main exposure was having a spouse with diabetes. Outcomes of interest were BMI and waist circumference. We fitted quadratic age-related trajectories using mixed-effect models stratified by sex and adjusted for education, smoking and the corresponding interaction terms between age and spousal diabetes status. RESULTS The baseline spousal diabetes prevalence was 4.4%. Men with a wife with diabetes experienced a steeper increase in BMI (1.6 kg/m2 ) between ages 50 to 65 years than men with a wife without diabetes (0.9 kg/m2 ). Women with a husband with diabetes had a similarly shaped BMI trajectory to women with a husband without diabetes, but their average BMI levels were higher between ages 55 and 65 years. Waist circumference trajectories showed a similar shape by spousal diabetes status for men and women, although individuals with a spouse with diabetes had higher waist circumference values throughout follow-up. CONCLUSIONS We found a positive association between spousal diabetes status and obesity development, which differed by sex among middle-aged individuals. Evidence from couple-based interventions is needed to test whether the latter could improve the current individual-focused public health strategies for obesity prevention.
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Affiliation(s)
- O Silverman-Retana
- Department of Public Health, Aarhus University, Aarhus
- Danish Diabetes Academy, Odense University Hospital, Odense
| | - A Hulman
- Department of Public Health, Aarhus University, Aarhus
- Danish Diabetes Academy, Odense University Hospital, Odense
| | - R K Simmons
- Healthcare Improvement Studies (THIS) Institute, University of Cambridge, Cambridge, UK
| | - J Nielsen
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - D R Witte
- Department of Public Health, Aarhus University, Aarhus
- Danish Diabetes Academy, Odense University Hospital, Odense
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