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Shiferaw R, Yirgu R, Getnet Y. Evaluating the association between duration of breastfeeding and fine motor development among children aged 20 to 24 months in Butajira, Ethiopia: a case-control study. BMC Pediatr 2024; 24:216. [PMID: 38532394 DOI: 10.1186/s12887-023-04391-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 10/27/2023] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND A Suitable environment and proper child nutrition are paramount to a child's physical and mental development. Different environmental factors contribute to proper child development. Breast milk is an important source of nutrition during the early years of life and contains essential nutrients that are the building blocks for growth and development. OBJECTIVE To assess the association between the duration of breastfeeding and fine motor development among children aged 20 to 24 months living in Butajira, southern Ethiopia. METHOD Community-based case-control study design was employed among mother-child dyads of children aged 20 to 24 months in Butajira Southern Ethiopia. Children were screened for fine motor delay using the Denver II developmental screening and identified as cases and controls. A repeated visit was done to gather the rest of the information and 332 samples, 83 cases, and 249 controls were available and assessed. Epi-data version 4.4.2.1 software was used to prepare a data entry template, which was later exported to and analyzed using STATA version 14 statistical software. Finally, a Multivariable logistic regression model was used to adjust for confounders and estimate the independent effect of breastfeeding duration on fine motor development. RESULT We didn't find a significant association between the duration of breastfeeding from 21 to 24 months and fine motor delay compared to children who were breastfed less than 18 months[AOR: 0.86, 95% CI: (0.36, 2.05)]. Children who have mothers > 35 years of age were 78% less likely than children who had mothers younger than 25 years, Children who had mothers in secondary school and above were 77% less likely than mothers who didn't have formal education, Females were 1.86 times more likely than males, and Children who scored 20-29 on the Home score were 51% less likely than Children who scored < 20 to have fine motor delay. CONCLUSION Duration of breastfeeding was not significantly associated with fine motor delay for children aged 20 to 24 months old. The age of the mother, the educational status of the mother, being female, and Home score were identified to have a significant association with fine motor delay. Improving the educational status and empowerment of women is essential. Further work should be done on avoiding gender differences starting from a young age and creating a conducive environment for child development is crucial.
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Affiliation(s)
- Rediate Shiferaw
- Department of Reproductive Health and Nutrition, School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia.
| | - Robel Yirgu
- Department of nutrition and dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yalemwork Getnet
- Department of nutrition and dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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Balistreri KS. Structural Sexism and Breastfeeding in the United States, 2016-2021. Matern Child Health J 2024; 28:431-437. [PMID: 38379060 DOI: 10.1007/s10995-023-03895-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 02/22/2024]
Abstract
INTRODUCTION Recent studies demonstrate that structural sexism erodes women's health and impedes access to healthcare. This study extends this research to examine the relationship between structural sexism and breastfeeding initiation and duration in the United States. METHOD A multifaceted state-level structural sexism index was constructed and merged with responses from the 2016-2021 National Survey of Children's Health by state and child's birth year. For children ages six months to 5 years, the prevalence of being ever breastfed and breastfed for at least six months was measured across levels of structural sexism. Multivariable logistic regression analyzed the association of structural sexism with breastfeeding outcomes, net of individual and family characteristics. RESULTS Higher levels of structural sexism were associated with lower odds of breastfeeding initiation and lower odds of breastfeeding for at least six months net of family and child characteristics. In addition, sensitivity analyses show that variations in state breastfeeding laws did not explain these differences. DISCUSSION This study highlights structural sexism's role in limiting breastfeeding initiation and duration. Breastfeeding promotions and guidelines should consider the broader context of structural sexism.
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Mills M, Lee S, Piperata BA, Garabed R, Choi B, Lee J. Household environment and animal fecal contamination are critical modifiers of the gut microbiome and resistome in young children from rural Nicaragua. Microbiome 2023; 11:207. [PMID: 37715296 PMCID: PMC10503196 DOI: 10.1186/s40168-023-01636-5] [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] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/31/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND Early life plays a vital role in the development of the gut microbiome and subsequent health. While many factors that shape the gut microbiome have been described, including delivery mode, breastfeeding, and antibiotic use, the role of household environments is still unclear. Furthermore, the development of the gut antimicrobial resistome and its role in health and disease is not well characterized, particularly in settings with water insecurity and less sanitation infrastructure. RESULTS This study investigated the gut microbiome and resistome of infants and young children (ages 4 days-6 years) in rural Nicaragua using Oxford Nanopore Technology's MinION long-read sequencing. Differences in gut microbiome diversity and antibiotic resistance gene (ARG) abundance were examined for associations with host factors (age, sex, height for age z-score, weight for height z-score, delivery mode, breastfeeding habits) and household environmental factors (animals inside the home, coliforms in drinking water, enteric pathogens in household floors, fecal microbial source tracking markers in household floors). We identified anticipated associations of higher gut microbiome diversity with participant age and vaginal delivery. However, novel to this study were the significant, positive associations between ruminant and dog fecal contamination of household floors and gut microbiome diversity. We also identified greater abundance of potential pathogens in the gut microbiomes of participants with higher fecal contamination on their household floors. Path analysis revealed that water quality and household floor contamination independently and significantly influenced gut microbiome diversity when controlling for age. These gut microbiome contained diverse resistome, dominated by multidrug, tetracycline, macrolide/lincosamide/streptogramin, and beta-lactam resistance. We found that the abundance of ARGs in the gut decreased with age. The bacterial hosts of ARGs were mainly from the family Enterobacteriaceae, particularly Escherichia coli. CONCLUSIONS This study identified the role of household environmental contamination in the developing gut microbiome and resistome of young children and infants with a One Health perspective. We found significant relationships between host age, gut microbiome diversity, and the resistome. Understanding the impact of the household environment on the development of the resistome and microbiome in early life is essential to optimize the relationship between environmental exposure and human health. Video Abstract.
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Affiliation(s)
- Molly Mills
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH, USA
- Environmental Sciences Graduate Program, The Ohio State University, Columbus, OH, USA
| | - Seungjun Lee
- Department of Food Science and Nutrition, College of Fisheries Science, Pukyong National University, Busan, Republic of Korea
| | - Barbara A Piperata
- Department of Anthropology, The Ohio State University, Columbus, OH, USA
| | - Rebecca Garabed
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, OH, USA
| | - Boseung Choi
- Division of Big Data Science, Korea University, Sejong, Republic of Korea
| | - Jiyoung Lee
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH, USA.
- Environmental Sciences Graduate Program, The Ohio State University, Columbus, OH, USA.
- Department of Food Science & Technology, The Ohio State University, Columbus, OH, USA.
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Oberfichtner K, Oppelt P, Fritz D, Hrauda K, Fritz C, Schildberger B, Lastinger J, Stelzl P, Enengl S. Breastfeeding in primiparous women - expectations and reality: a prospective questionnaire survey. BMC Pregnancy Childbirth 2023; 23:654. [PMID: 37689660 PMCID: PMC10493027 DOI: 10.1186/s12884-023-05971-1] [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: 04/06/2023] [Accepted: 09/04/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND Breastfeeding provides the optimal nutrition for infants and offers numerous benefits for both mother and child. The World Health Organisation recommends exclusive breastfeeding during the first 6 months of life and the introduction of complementary feeding between the fifth and seventh months of life. There is a discrepancy between breastfeeding recommendations and the actual duration of breastfeeding. The aim of this study was to analyse breastfeeding behaviour in primiparous women in order to be able to provide support for mothers. METHODS In this prospective, questionnaire-based study conducted between 2020 and 2022, primiparous women were asked to complete three questionnaires at three defined survey time points (routine prepartum presentation, postpartum hospitalization, completed sixth month of life). RESULTS A total of 140 women were included and returned all three questionnaires. Fifty-eight percent performed breastfeeding exclusively at least until their baby had reached the age of 6 months, whereas 20% already stopped within the first 6 months. The main reasons given for early cessation were insufficient milk supply and inadequate infant weight gain. A comprehensive level of prepartum knowledge had a significant positive effect on participants' sense of confidence with breastfeeding. Sociodemographic factors such as age and educational level were also associated with breastfeeding behaviour, but significant corresponding differences in the duration of breastfeeding were not observed. Women with postpartum midwifery care breastfed significantly longer (p < 0.05). CONCLUSIONS Breastfeeding behaviour and duration are influenced by multiple factors. Although certain sociodemographic factors are unalterable, comprehensive prepartum knowledge transfer and postpartum midwifery care have a positive impact on breastfeeding behaviour. TRIAL REGISTRATION The study was retrospectively registered at the German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS) on 6 December 2022 (DRKS00030763).
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Affiliation(s)
- Katrin Oberfichtner
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria.
| | - Peter Oppelt
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Daniela Fritz
- University of Applied Sciences for the Health Professions, Linz, Austria
| | - Katharina Hrauda
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Christian Fritz
- Institute for Statistical Analysis Jaksch & Partner GmbH, Linz, Austria
| | | | - Julia Lastinger
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Patrick Stelzl
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Sabine Enengl
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
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Sharma N, Bhargava N, Boruah B, Dutta RA, Agrawal M. Evaluation of Mode of Delivery and Various Postnatal Factors on Acquisition of Oral Streptococcus mutans in Infants: A Prospective Study. Int J Clin Pediatr Dent 2023; 16:663-666. [PMID: 38162238 PMCID: PMC10753111 DOI: 10.5005/jp-journals-10005-2680] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Aim of the study The objective of the current study is to assess and establish a relationship between the mode of delivery and postnatal factors in the early colonization of Streptococcus mutans (S. mutans) in infants' oral cavities. Materials and methods The primary goal of the investigation is to assess and compare the oral microflora of newborns immediately after birth and at 3, 6, 9, and 12 months of age in babies born by normal vaginal delivery and lower segment cesarean section and divided into (group III) and (group V), respectively. Around 50 mother-baby pairs in total had their swab samples collected for the identification of S. mutans and were monitored for a year. The role of other postnatal factors in the acquisition of S. mutans in infants was also evaluated. Results Data analysis showed that different postnatal factors like feeding patterns, oral hygiene practices, and socioeconomic factors affected the infant's oral cavity's initial colonization by S. mutans. Conclusion Infants' first exposure to oral S. mutans depends on the delivery method and various postnatal factors. How to cite this article Sharma N, Bhargava N, Boruah B, et al. Evaluation of Mode of Delivery and Various Postnatal Factors on Acquisition of Oral Streptococcus mutans in Infants: A Prospective Study. Int J Clin Pediatr Dent 2023;16(5):663-666.
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Affiliation(s)
- Nitin Sharma
- Department of Pedodontics, Rajasthan Dental College & Hospital, Jaipur, Rajasthan, India
| | - Neha Bhargava
- Department of Pedodontics, Rajasthan Dental College & Hospital, Jaipur, Rajasthan, India
| | - Beeva Boruah
- Department of Community Medicine, Diphu Medical College & Hospital, Diphu, Assam, India
| | - Rajashree A Dutta
- Department of Pedodontics, Rajasthan Dental College & Hospital, Jaipur, Rajasthan, India
| | - Milind Agrawal
- Department of Pedodontics, Rajasthan Dental College & Hospital, Jaipur, Rajasthan, India
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Karthigesu K, Balakumar S, Arasaratnam V. Determinants of early cessation of exclusive breastfeeding practices among rural mothers from Jaffna District of Sri Lanka. Int Breastfeed J 2023; 18:42. [PMID: 37580743 PMCID: PMC10426130 DOI: 10.1186/s13006-023-00575-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/13/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Sri Lanka is an upper-middle-income country with excellent health statistics. However, 2016 Demographic and Health Survey data have shown 82% and 64% of mothers exclusively breastfed infants aged 0-6 months and 4-5 months, respectively. The short duration of exclusive breastfeeding (EBF) has an impact on the growth and development of babies. Since no studies have been reported on EBF practices of the rural mothers in Jaffna District, an administrative district among 25 districts of Sri Lanka, this study aimed to assess the factors influencing the early cessation of EBF. METHODS For this community-based cross-sectional study, 338 mother-child pairs were selected from 2013-14. EBF was defined as children not receiving any food or drink, including complementary foods, formula milk or milk products except for medicines and vitamins or mineral drops, other than breast milk since birth. Socio-economic and demographic factors, the influence of the mode of delivery, and knowledge on EBF were obtained using an interviewer-administered questionnaire. The details of EBF and reasons for the cessation of breastfeeding before six months were obtained from a subgroup of mothers (n = 208). Multivariate analysis was performed to explore the correlates of breastfeeding. RESULTS In this study, 71.2% (95% CI 64.5, 77.2) had practiced EBF for six months. Early discontinuation of EBF was practiced by employed mothers (AOR 4.3; 95% CI 1.3, 13.9), mothers of low birth weight babies (AOR 3.6; 95% CI 1.6, 8.2) and those who experienced Cesarean section birth (AOR 2.9; 95% CI 1.2, 6.9). The EBF practiced by mothers of rural Jaffna was not associated with the gender of the babies, type of family, number of children in a family, religion of the household, knowledge on EBF, or family income. CONCLUSION The prevalence of EBF up to six months was low in rural Jaffna, and it was influenced by employment, birthweight of the babies, and the mode of delivery. To enhance EBF, the Regional Directorate of Health Service, Jaffna, should take necessary action with policymakers to increase maternity leave for at least six months, reduce the Cesarean section rate, and provide nutritional support to pregnant mothers.
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Affiliation(s)
- Kandeepan Karthigesu
- Department of Biochemistry, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka.
| | | | - Vasanthy Arasaratnam
- Department of Biochemistry, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
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Crawford KA, Gallagher LG, Baker ER, Karagas MR, Romano ME. Predictors of Breastfeeding Duration in the New Hampshire Birth Cohort Study. Matern Child Health J 2023; 27:1434-1443. [PMID: 37269393 DOI: 10.1007/s10995-023-03714-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Breastfeeding has significant health benefits for infants and birthing persons, including reduced risk of chronic disease. The American Academy of Pediatrics recommends exclusively breastfeeding infants for 6 months and recently extended its recommendation for continuing to breastfeed with supplementation of solid foods from one to two years. Studies consistently identify lower breastfeeding rates among US infants, with regional and demographic variability. We examined breastfeeding in birthing person-infant pairs among healthy, term pregnancies enrolled in the New Hampshire Birth Cohort Study between 2010 and 2017 (n = 1176). METHODS Birthing persons 18-45 years old were enrolled during prenatal care visits at ~ 24-28 weeks gestation and have been followed since enrollment. Breastfeeding status was obtained from postpartum questionnaires. Birthing person and infant health and sociodemographic information was abstracted from medical records and prenatal and postpartum questionnaires. We evaluated the effects of birthing person age, education, relationship status, pre-pregnancy body mass index, gestational weight gain (GWG), smoking and parity, and infant sex, ponderal index, gestational age and delivery mode on breastfeeding initiation and duration using modified Poisson and multivariable linear regression. RESULTS Among healthy, term pregnancies, 96% of infants were breastfed at least once. Only 29% and 28% were exclusively breastfed at 6-months or received any breastmilk at 12-months, respectively. Higher birthing person age, education, and parity, being married, excessive GWG, and older gestational age at delivery were associated with better breastfeeding outcomes. Smoking, obesity, and cesarean delivery were negatively associated with breastfeeding outcomes. CONCLUSIONS Given the public health importance of breastfeeding for infants and birthing persons, interventions are needed to support birthing persons to extend their breastfeeding duration.
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Affiliation(s)
- Kathryn A Crawford
- Environmental Studies Program, Middlebury College, 276 Bicentennial Way, Middlebury, VT, 05753, USA.
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
| | - Lisa G Gallagher
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Emily R Baker
- Maternal Fetal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Megan E Romano
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
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Shen LP, Pang XH, Wang J, Duan YF, Zhang Q, Wang YY, Chen BW, Xu T, Zhao WH, Yang ZY. Association of Breastfeeding Duration with Body Composition in Children Aged 3-5 Years. Biomed Environ Sci 2023; 36:569-584. [PMID: 37533381 DOI: 10.3967/bes2023.085] [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] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/15/2023] [Indexed: 08/04/2023]
Abstract
Objective This study aimed to assess the relationship between the body composition of children aged 3-5 years and breastfeeding status and duration. Methods The study was conducted using data from the National Nutrition and Health Systematic Survey for children 0-17 years of age in China (CNHSC), a nationwide cross-sectional study. Breastfeeding information and potential confounders were collected using standardized questionnaires administered through face-to-face interviews. The body composition of preschool children was measured using bioelectrical impedance analysis. A multivariate linear regression model was used to assess the relationship between breastfeeding duration and body composition after adjusting for potential confounders. Results In total, 2,008 participants were included in the study. Of these, 89.2% were ever breastfed and the median duration of breastfeeding was 12 months (IQR 7-15 months). Among children aged 3 years, the height-for-age Z-score (HAZ) for the ever breastfed group was lower than that for never breastfed group (0.12 vs. 0.42, P = 0.043). In addition, the weight-for-age Z-score (WAZ) of the ever breastfed group was lower than that of the never breastfed group (0.31 vs. 0.65, P = 0.026), and the WAZ was lower in children aged 4 years who breastfed between 12 and 23 months than in those who never breastfed. Compared to the formula-fed children, the fat-free mass of breastfed infants was higher for children aged 3 years (12.84 kg vs. 12.52 kg, P = 0.015) and lower for those aged 4 years (14.31 kg vs. 14.64 kg, P = 0.048), but no difference was detected for children aged 5 years (16.40 kg vs. 16.42 kg, P = 0.910) after adjusting for potential confounders. No significant difference was detected in the weight-for-height Z-score (WHZ), body mass index (BMI)-for-age Z-score (BAZ), fat-free mass index, and body fat indicators in the ever breastfed and never breastfed groups and among various breastfeeding duration groups for children aged 3-5 years. Conclusion No obvious associations were detected between breastfeeding duration, BMI, and fat mass indicators. Future prospective studies should explore the relationship between breastfeeding status and fat-free mass.
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Affiliation(s)
- Li Ping Shen
- National Institution for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China;Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Xue Hong Pang
- National Institution for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Jie Wang
- National Institution for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yi Fan Duan
- National Institution for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Qian Zhang
- National Institution for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yu Ying Wang
- National Institution for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Bo Wen Chen
- Capital Institute of Pediatrics, Beijing 100020, China
| | - Tao Xu
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing 100081, China
| | - Wen Hua Zhao
- National Institution for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Zhen Yu Yang
- National Institution for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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Pereira EL, Estabrooks PA, Arjona A, Cotton-Curtis W, Lin JCP, Saetermoe CL, Blackman KCA. A systematic literature review of breastfeeding interventions among Black populations using the RE-AIM framework. Int Breastfeed J 2022; 17:86. [PMID: 36528606 PMCID: PMC9758845 DOI: 10.1186/s13006-022-00527-z] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 10/15/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Lactation support resources are less likely to be located in close proximity to where Black families live and there is a systemic racist health care belief that Black women prefer bottle feeding (with infant formula) over breastfeeding. Together, these lead to lower reported breastfeeding rates of Black babies compared to other racial / ethnic groups. It is imperative to have a deeper understanding of the cultural aspects as well as the underlying limitations that prevent Black women / persons from being supported to breastfeed. There is a need to know how effective breastfeeding interventions are in reaching the intended population; how well they work in promoting breastfeeding initiation and continuation; and how successful they are when implemented at the setting and staff level. The purpose of this investigation was to establish the level of internal and external validity that was reported by breastfeeding intervention studies among Black communities. METHODS Studies on breastfeeding interventions on Black people that were published between the years 1990 and 2019 were carefully examined through PubMed, EBSCOhost, Web of Science, and OneSearch. A total of 31 studies fulfilled the requirements to be included for this evaluation. In order to extract the information from the articles, the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework extraction tool was utilized. RESULTS On average, the proportion of studies that reported across reach, effectiveness, adoption, implementation, and maintenance indicators was 54, 35, 19, 48, and 9%, respectively. Across core RE-AIM indicators only sample size (100%) and breastfeeding outcomes (90%) were reported consistently. External validity indicators related to representativeness of participants (16%) and sites (3%) were rarely reported. Similarly, adherence to intervention protocol, and indicator of internal validity, was reported in a small proportion of articles (19%). CONCLUSION This body of literature under-reported on aspects associated to both internal and external validity across all RE-AIM domains. The reporting of the individual level of representativeness; the setting level of representativeness; the intervention's adherence to the protocol; the expenses; and the factors of sustainability would benefit from improvement in future research.
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Affiliation(s)
| | - Paul A Estabrooks
- Department of Health & Kinesiology, University of Utah, Salt Lake City, USA
| | - Alejandro Arjona
- Department of Family & Consumer Sciences, California State University Northridge, Northridge, USA
| | - Wyconda Cotton-Curtis
- Department of Health Sciences, California State University Northridge, Northridge, USA
| | - Judith C P Lin
- The Health Equity Research and Education Center, California State University Northridge, Northridge, USA
| | - Carrie L Saetermoe
- The Health Equity Research and Education Center, California State University Northridge, Northridge, USA
| | - Kacie C A Blackman
- Department of Health Sciences, California State University Northridge, Northridge, USA.
- The Health Equity Research and Education Center, California State University Northridge, Northridge, USA.
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Wang YX, Arvizu M, Rich-Edwards JW, Manson JE, Wang L, Missmer SA, Chavarro JE. Breastfeeding duration and subsequent risk of mortality among US women: A prospective cohort study. EClinicalMedicine 2022; 54:101693. [PMID: 36263395 PMCID: PMC9574410 DOI: 10.1016/j.eclinm.2022.101693] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Breastfeeding has been associated with a reduced maternal long-term risk of chronic diseases, but its association with mortality is poorly known. METHODS We included 166,708 female United States (US) nurses from the Nurses' Health Study (1986-2016) and the Nurses' Health Study II (1989-2019) who experienced at least one pregnancy lasting at least six months across their reproductive lifespan. Hazard ratios and 95% confidence intervals (CI) for mortality according to lifetime breastfeeding duration were estimated with time-dependent Cox proportional hazards regression models. FINDINGS During 4,705,160 person-years of follow-up, 36,634 deaths were documented in both cohorts, including 9880 from cancer and 7709 from cardiovascular disease (CVD). Lifetime total breastfeeding duration was associated with a lower subsequent risk of all-cause mortality in a non-linear manner (p-value for non-linearity=0.0007). The pooled multivariable-adjusted hazard ratios of all-cause mortality were 0.95 (95% CI: 0.92 to 0.98), 0.94 (95% CI: 0.91 to 0.98), 0.93 (95% CI: 0.90 to 0.97), and 0.93 (95% CI: 0.89 to 0.97), respectively, for women reporting lifetime total breastfeeding duration of 4-6, 7-11, 12-23, and ≥24 months, compared to women who breastfed for ≤3 months over their reproductive lifespan. Cause-specific analysis showed a similar pattern of non-linear inverse associations between lifetime total breastfeeding duration and CVD and cancer mortality (both p-values for non-linearity <0.01). There was no evidence of interactions between breastfeeding duration and pre-pregnancy lifestyle factors on mortality risk. INTERPRETATION Parous women with longer lifetime breastfeeding duration had a modestly lower risk of mortality. FUNDING The National Institutes of Health grants.
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Affiliation(s)
- Yi-Xin Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Corresponding author at: Harvard T.H. Chan School of Public Health, Building II 3rd floor, 655 Huntington Avenue, Boston, MA 02115, USA.
| | - Mariel Arvizu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Janet W. Rich-Edwards
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, USA
| | - JoAnn E. Manson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Liang Wang
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Stacey A. Missmer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Jorge E. Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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11
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Kennedy R, Roberts L, Davis G, Mangos G, Pettit F, Brown MA, O'Sullivan AJ, Henry A. The P4 study: Subsequent pregnancy maternal physiology after hypertensive and normotensive pregnancies. Pregnancy Hypertens 2021; 27:29-34. [PMID: 34864294 DOI: 10.1016/j.preghy.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/08/2021] [Revised: 09/09/2021] [Accepted: 10/22/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Hypertensive disorders of pregnancy are associated with subsequent increased risk of cardiometabolic disease. Adverse cardiometabolic measures are noted soon after hypertensive versus normotensive pregnancy (NP); to what degree these persist into a subsequent pregnancy (SP) is unknown. This study aimed to assess women's physiology early in SP after hypertensive pregnancy (HP: preeclampsia or gestational hypertension) or NP and compare SP to 6 months postpartum findings from the index pregnancy. STUDY DESIGN Prospective sub-study of the P4 (Postpartum, Physiology, Psychology and Paediatric) observational cohort. Measurements six months after NP versus HP, and the SP at 11-13 weeks gestation. MAIN OUTCOME MEASURES Blood pressure (BP), blood and urine tests (urine ACR, HOMA-IR, LDL cholesterol), body composition, and contribution of maternal characteristics and inter-pregnancy factors to BP and body fat (FM%) in SP. RESULTS 49 women (34 NP, 15 HP). In the SP, post-HP women had higher BP (112/70 mmHg HP vs 102/64 mmHg NP; p < .001), with no significant drop from six months postpartum to early SP. On regression analysis, systolic and diastolic BP at 6-months were the major predictors for SP systolic (p < 0.001) and diastolic (p = 0.009) BP respectively in the SP. Longer interpregnancy interval and increased FM% 6-months postpartum were associated with higher SP FM% (p < 0.001). CONCLUSIONS BP and body fat six months postpartum were similar early in the SP for HP group, and postpartum BP and FM% were major predictors of their corresponding SP measurements. Postpartum/inter-pregnancy intervention programs to improve these cardiometabolic risk markers might help improve women's long-term health and require investigation.
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Affiliation(s)
- R Kennedy
- School of Women's and Children's Health, UNSW Medicine and Health, UNSW Sydney, Australia; St George and Sutherland Clinical School, UNSW Medicine and Health, UNSW Sydney, Australia.
| | - L Roberts
- St George and Sutherland Clinical School, UNSW Medicine and Health, UNSW Sydney, Australia; Department of Women and Children's Health, St George Hospital, Sydney, Australia
| | - G Davis
- School of Women's and Children's Health, UNSW Medicine and Health, UNSW Sydney, Australia; St George and Sutherland Clinical School, UNSW Medicine and Health, UNSW Sydney, Australia; Department of Women and Children's Health, St George Hospital, Sydney, Australia
| | - G Mangos
- St George and Sutherland Clinical School, UNSW Medicine and Health, UNSW Sydney, Australia; Department of Renal Medicine, St George Hospital, Sydney, Australia
| | - F Pettit
- Department of Renal Medicine, St George Hospital, Sydney, Australia
| | - M A Brown
- St George and Sutherland Clinical School, UNSW Medicine and Health, UNSW Sydney, Australia; Department of Renal Medicine, St George Hospital, Sydney, Australia
| | - A J O'Sullivan
- St George and Sutherland Clinical School, UNSW Medicine and Health, UNSW Sydney, Australia; Department of Endocrinology, St George Hospital, Sydney, Australia
| | - A Henry
- School of Women's and Children's Health, UNSW Medicine and Health, UNSW Sydney, Australia; Department of Women and Children's Health, St George Hospital, Sydney, Australia; The George Institute for Global Health, Sydney, Australia.
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12
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Gómez-Acebo I, Lechosa-Muñiz C, Paz-Zulueta M, Sotos TD, Alonso-Molero J, Llorca J, Cabero-Perez MJ. Feeding in the first six months of life is associated with the probability of having bronchiolitis: a cohort study in Spain. Int Breastfeed J 2021; 16:82. [PMID: 34663376 PMCID: PMC8522099 DOI: 10.1186/s13006-021-00422-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 09/13/2021] [Indexed: 12/02/2022] Open
Abstract
Background Breastfeeding is associated with lower incidence and severity of lower respiratory tract disease. However, little is known about the relationship between feeding type and breastfeeding duration with bronchiolitis in a child’s first year. Methods A prospective cohort study of 969 newborn babies were followed-up for 12 months to determine breastfeeding duration, feeding type, feeding trajectory, and bronchiolitis episodes at Marqués de Valdecilla University Hospital, Spain in 2018. Type of feeding was recorded by interviewing mothers at the time of hospital discharge and at 2, 4, 6, 9 and 12 months of life, in three categories: breastfeeding, mixed feeding and infant formula. Type of feeding at hospital discharge refers to feeding from birth to discharge. In any other times studied, it refers to feeding in the last 24 h. The association between the feeding type and bronchiolitis was analysed using logistic regression. Poisson regression was used to evaluate the association between feeding type and the number of bronchiolitis episodes with Kaplan-Meier estimators presenting the cumulative probability of suffering bronchiolitis. The results were adjusted for mother and child characteristics. Results Our data shows exclusive breastfeeding and mixed breastfeeding reduce the number of episodes of bronchiolitis. Regarding feeding at 4 months, exclusive breastfeeding reduced by 41% the number of episodes of bronchiolitis (adjusted incidence Ratio (aIR) 0.59, 95% CI 0.46, 0.76) and mixed feeding by 37% (aIR 0.63, 95% CI 0.47, 0.86). Moreover, changing from exclusive breastfeeding to mixed feeding increased the incidence of bronchiolitis compared with continuing exclusive breastfeeding. An early swap to mixed breastfeeding before months 2 or 4, was associated with a reduced the number of episodes of bronchiolitis, (aIR 0.53, 95% CI 0.39, 0.73 if introduction of mixed breastfeeding before month 2, and aIR 0.61, 95% CI 0.45, 0.83 if introduction of mixed breastfeeding before month 4), when compared with infant formula alone. Conclusions Any breastfeeding was associated with lower incidence of bronchiolitis and number of episodes of bronchiolitis in the first year of life. Consequently, promoting programmes facilitating exclusive or mixed breastfeeding would be a relevant measure in the prevention of bronchiolitis.
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Affiliation(s)
- Inés Gómez-Acebo
- Universidad de Cantabria - IDIVAL, Santander, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | | | | | - Trinidad Dierssen Sotos
- Universidad de Cantabria - IDIVAL, Santander, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Javier Llorca
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universidad de Cantabria, Santander, Spain
| | - María J Cabero-Perez
- Universidad de Cantabria - IDIVAL, Santander, Spain.,Hospital Universitario Marqués de Valdecilla, Santander, Spain
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13
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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14
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Ungváry R, Ittzés A, Bóné V, Török S. Psychometric properties of the original and short Hungarian version of the Iowa infant feeding attitude scale. Int Breastfeed J 2021; 16:54. [PMID: 34271964 PMCID: PMC8284002 DOI: 10.1186/s13006-021-00403-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 07/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Iowa Infant Feeding Attitude Scale (IIFAS) is a widely used tool to assess attitudes towards infant feeding. Attitudes towards breastfeeding are one of the main influencing factors of feeding choice and breastfeeding duration. Adaptation of the IIFAS to the Hungarian context provides an opportunity for cross-cultural comparisons and helps to target breastfeeding support interventions. The growing number of shortened scales in various fields of research, demonstrates the necessity to adapt to a changing context of data collection to avoid fatigue and dropout among respondents. However, international comparisons are difficult due to the lack of a consensual shortened form of the scale. The aim of our study was to examine the psychometric properties of the Hungarian version of the IIFAS (IIFAS-H) and propose an 8-item short version that has appropriate construct validity. METHODS The original IIFAS was translated into Hungarian and then translated back to English. A cross-sectional study based on an internet survey in 2019 was conducted among 553 mothers whose most recent child's age was between 6 and 36 months. Psychometric properties of the Hungarian IIFAS were determined and compared with international results. In order to obtain a shorter version of the Hungarian scale, we preferably kept those items that are common with other international abbreviated IIFAS versions and deleted items with a corrected item-total correlation or factor loading of less than 0.3, where factor loadings came from a principal component analysis forcing the extraction of one principal component (factor). RESULTS The 17-item IIFAS-H showed good psychometric properties with a Cronbach's alpha of0.73. Further analyses proved that the examined three shortened versions of the IIFAS consisting of 11, 9, and 8 items also showed good properties (Cronbach's alpha = 0.79, 0.79, 0.76, respectively). CONCLUSIONS The Hungarian version of the original 17-item long IIFAS proved to be a good measurement tool with good psychometric properties. Based on our analyses, we suggest the use of the 8-item short version (IIFAS-H8) of the scale.
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Affiliation(s)
- Renáta Ungváry
- Faculty of Health and Public Administration, Institute of Mental Health, Semmelweis University, Budapest, Hungary.
| | - András Ittzés
- Department of Applied Statistics, Institute of Mathematics and Basic Science, Hungarian University of Agriculture and Life Sciences, Budapest, Hungary.,Department of Methodology for Business Analysis, Faculty of Commerce, Hospitality and Tourism, Budapest Business School, Budapest, Hungary
| | - Veronika Bóné
- Faculty of Health and Public Administration, Institute of Mental Health, Semmelweis University, Budapest, Hungary
| | - Szabolcs Török
- Faculty of Health and Public Administration, Institute of Mental Health, Semmelweis University, Budapest, Hungary
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15
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Courtois F, Péneau S, Salanave B, Andreeva VA, Roland-Cachera MF, Touvier M, Galan P, Hercberg S, Fezeu LK. Trends in breastfeeding practices and mothers' experience in the French NutriNet-Santé cohort. Int Breastfeed J 2021; 16:50. [PMID: 34215307 PMCID: PMC8254215 DOI: 10.1186/s13006-021-00397-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 06/15/2021] [Indexed: 11/26/2022] Open
Abstract
Background France has one of the lowest rates in the world regarding breastfeeding initiation and duration. Few studies have explored breastfeeding practices in France since the middle of the twentieth century, or following from initiation to cessation. The purpose of our study was to determine trends in breastfeeding over the past decades regarding public health recommendations, and to examine mothers’ perceptions about factors known to have an impact on breastfeeding support and cessation. Methods From the NutriNet-Santé cohort, 29,953 parous women (launched in 2009 to study relation between nutrition and health), were included in the present study. Using web-questionnaires, they were asked retrospectively if they had breastfed their youngest child or not, and if so, the duration of exclusive and total breastfeeding. For those who had breastfed, we investigated their perceptions about support at initiation and during the entire breastfeeding period and reasons for breastfeeding cessation. We also asked those who did not breastfeed about their perceptions and reasons for infant formula feeding their youngest child. Analyses were weighted according to the French census data. Results In the NutriNet-Santé cohort, 67.3% of mothers breastfed their youngest child. The proportion of breastfed children increased over the past few decades, from 55.0% (95% CI 54.3, 55.6) in the 1970s to 82.9% (82.4, 83.4) in the 2010s. Total and exclusive breastfeeding duration went from 3.3 months and 2.4 months respectively in the 1970s to 5.9 months and 3.2 months respectively in the 2010s. Most mothers felt supported at initiation and during the breastfeeding period. A reported desire to have breastfed longer than two months was 59.5%. Mothers who did not breastfeed did it by choice (64.3%). They did not feel guilty (78.2%) and did not perceive a problem not to breastfeed (58.8%), but almost half of them would have liked to have breastfed (45.9%). Conclusion Breastfeeding duration has increased in the past decades but did not reach the public health recommendations threshold. Targets other than mothers have to be considered for breastfeeding education, like the partner and her environment, to increase breastfeeding practices. Trial registration The study was registered at ClinicalTrials.gov (NCT03335644). Supplementary Information The online version contains supplementary material available at 10.1186/s13006-021-00397-x.
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Affiliation(s)
- Frédéric Courtois
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), SMBH-74 rue Marcel Cachin, 93017, Bobigny, France
| | - Sandrine Péneau
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), SMBH-74 rue Marcel Cachin, 93017, Bobigny, France
| | - Benoît Salanave
- Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency, Sorbonne Paris Nord University, Epidemiology and Statistics Research Center - University of Paris (CRESS), 93017, Bobigny, France
| | - Valentina A Andreeva
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), SMBH-74 rue Marcel Cachin, 93017, Bobigny, France
| | - Marie Françoise Roland-Cachera
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), SMBH-74 rue Marcel Cachin, 93017, Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), SMBH-74 rue Marcel Cachin, 93017, Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), SMBH-74 rue Marcel Cachin, 93017, Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), SMBH-74 rue Marcel Cachin, 93017, Bobigny, France.,Public Health Department, Avicenne Hospital, AP-HP, 93017, Bobigny, France
| | - Léopold K Fezeu
- Sorbonne Paris Nord University, Inserm, Inrae, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), SMBH-74 rue Marcel Cachin, 93017, Bobigny, France.
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16
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Syeda B, Agho K, Wilson L, Maheshwari GK, Raza MQ. Relationship between breastfeeding duration and undernutrition conditions among children aged 0-3 Years in Pakistan. Int J Pediatr Adolesc Med 2021; 8:10-17. [PMID: 33718571 PMCID: PMC7922841 DOI: 10.1016/j.ijpam.2020.01.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 01/19/2020] [Accepted: 01/21/2020] [Indexed: 01/12/2023]
Abstract
Background The World Health Organization recommends that a child should be breastfed up to 2 years of age as it is essential for proper growth and development but population-based studies around the world have found conflicting results on the subject. Our study aims to analyze whether there is a relationship between the duration of breastfeeding and undernutrition among children aged from birth up to 3 years of age in Pakistan. Methods A secondary analysis of the Pakistan Demographic and Health Survey 2013-2014 with 1072 children aged 3 years and under was conducted. The relationship between breastfeeding duration and undernutrition status was estimated through multiple logistic regression analysis. Results The prevalence of stunting, wasting and underweight were 40.6%, 15.8% and 33.9% respectively, while prevalence of severe stunting is at 22.5%; severe wasting at 4.5% and severe underweight at 12.2% in children in our study. Odds of being stunted were significantly higher for children in their 3rd year of life [AOR: 4.35, CI 95% = (2.01, 9.33)] compared to children being breastfed in their 2nd year of life [AOR: 2.43, CI 95% = (1.55, 3.79) after being adjusted for maternal, child, demographic and healthcare access variables. Similarly, children being breastfed in their third year of life were more susceptible to developing severe stunting [AOR: 6.19, CI 95% = (3.31, 11.56)] in comparison to children in their second year [AOR: 2.84, CI 95% = (1.81, 4.46)]. There was no significant association between breastfeeding and wasting/severe wasting, or between breastfeeding and underweight/severe underweight. Conclusion Breastfeeding in the 2nd and 3rd year of life was found to have significant relationship with stunting and severe stunting. Mothers need to be educated about the risks of prolonged breastfeeding to reduce the burden of undernutrition in the country.
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Affiliation(s)
- Batool Syeda
- Western Sydney University, School of Science and Health, Narellan Road, Campbelltown, NSW, 2570, Australia.,Peoples University of Medical and Health Sciences for Women, Department of Community Medicine, Hospital Road, Nawabshah, 67450, Pakistan
| | - Kingsley Agho
- Western Sydney University, School of Science and Health, Narellan Road, Campbelltown, NSW, 2570, Australia
| | - Leigh Wilson
- Western Sydney University, School of Science and Health, Narellan Road, Campbelltown, NSW, 2570, Australia.,University of Sydney, Faculty of Health Science, 75 East Street, Lidcombe, NSW, 2141, Australia
| | - Greesh Kumar Maheshwari
- Peoples University of Medical and Health Sciences for Women, Department of Community Medicine, Hospital Road, Nawabshah, 67450, Pakistan
| | - Muhammad Qasim Raza
- Medicine Unit 2, Sir Ganga Ram Hospital, Queens Road, Lahore, 54000, Pakistan
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17
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Zhang Y, Yang J, Li W, Wang N, Ye Y, Yan S, Wang S, Zeng T, Huang Z, Zhang F, Li Y, Yao S, Wang H, Rozelle S, Xu T, Jin X. Effects of baby-friendly practices on breastfeeding duration in China: a case-control study. Int Breastfeed J 2020; 15:92. [PMID: 33143740 PMCID: PMC7640486 DOI: 10.1186/s13006-020-00334-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 10/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Baby-Friendly Hospital Initiative is generally considered an effective way to promote breastfeeding. Although China has the largest number of baby-friendly hospitals in the world, research on baby-friendly practices in China is limited, and the rate of exclusive breastfeeding (EBF) at 6 months, 20.7%, compared to the 2025 global goal of 50% is low. It is, therefore, important to determine the factors that remain significant barriers to EBF in China. To explore how the key baby-friendly practices affect EBF duration in China, we used a case-control study to compare the effects of baby-friendly-related practices on both EBF and non-breastfeeding (NBF) mothers at 3 months and to investigate the effects of both single and comprehensive baby-friendly practices in promoting EBF duration at 3 months, which is one step toward EBF at 6 months. METHODS Participants were recruited from four maternal and child health hospitals in western (Chongqing), eastern (Qingdao), southern (Liuzhou), and central China (Maanshan). A total of 421 mothers (245 in the EBF group, 176 in the NBF group) of infants aged 3 months were surveyed through a self-reported questionnaire from April 2018 to March 2019. The experience of baby-friendly practices and breastfeeding during hospitalization were assessed with yes/no questions. Socio-demographic factors that influenced breastfeeding at 3 months were analyzed using bivariate and multivariate logistic regression analyses. RESULTS Of mothers in the EBF group, 65.57% reported engaging in at least seven baby-friendly practices compared to 47.72% of mothers in the NBF group. Significantly more mothers in the EBF group engaged in baby-friendly practices than in the NBF group. These practices included "breastfeeding within one hour after birth" (74.29% vs. 59.09%), "breastfeeding on demand" (86.48% vs. 75.00%), and "never use a pacifier" (46.53% vs. 31.25%). After adjusting for confounding variables, we found that the mothers who engaged in fewer than seven baby-friendly practices were about 1.7 times less likely to breastfeed than were those who engaged in seven or more baby-friendly practices (odds ratio [OR] 1.720, 95% confidence interval [CI] 1.106, 2.667). Further, the mothers who did not breastfeed on demand were as likely to not breastfeed up to 3 months (OR 2.263, 95% CI 1.265, 4.049), as were mothers who did not breastfeed during hospitalization (OR 4.379, 95% CI 1.815, 10.563). CONCLUSIONS These data from hospitals in China suggest that higher compliance with baby-friendly practices may have a positive impact on EBF at 3 months, particularly in terms of promoting the implementation of breastfeeding on demand and breastfeeding during hospitalization in China.
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Affiliation(s)
- Yue Zhang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, 100081, China.
| | - Jinliuxing Yang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, 100081, China
| | - Wenhao Li
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Nianrong Wang
- Chongqing Health Center for Women and Children, Chongqing, 400000, China
| | - Ya Ye
- Chongqing Health Center for Women and Children, Chongqing, 400000, China
| | - Shuangqin Yan
- Ma'anshan Maternal and Child Health Hospital, Ma'anshan, 243011, Anhui, China
| | - Sumei Wang
- Ma'anshan Maternal and Child Health Hospital, Ma'anshan, 243011, Anhui, China
| | - Ting Zeng
- Liuzhou Maternity and Child Healthcare Hospital, Liuzhou, 545001, Guangxi, China
| | - Zijuan Huang
- Liuzhou Maternity and Child Healthcare Hospital, Liuzhou, 545001, Guangxi, China
| | - Fenghua Zhang
- Qingdao Maternal and Children Healthcare Center, Qingdao, 26600, Shandong, China
| | - Yin Li
- Qingdao Maternal and Children Healthcare Center, Qingdao, 26600, Shandong, China
| | - Shiyi Yao
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, 100081, China
| | - Haijun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Scott Rozelle
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, California, 94305, USA
| | - Tao Xu
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, 100081, China
| | - Xi Jin
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, 100081, China
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18
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Ávila-Ortiz MN, Castro-Sánchez AE, Martínez-González EA, Núñez-Rocha GM, Zambrano-Moreno A. Factors associated with abandoning exclusive breastfeeding in Mexican mothers at two private hospitals. Int Breastfeed J 2020; 15:73. [PMID: 32814577 PMCID: PMC7436974 DOI: 10.1186/s13006-020-00316-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 08/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exclusive breastfeeding (EBF) has multiple benefits for both the child and the mother; however, there is little data regarding the reason why Mexican mothers with a high socio-economic level abandon EBF before 6 months, and there is limited information about the practice of breastfeeding in private hospitals. The objective was to identify the factors associated with the cessation of exclusive breastfeeding in Mexican mothers at two private hospitals. METHODS A cross-sectional study was conducted with 218 upper-class mothers selected according to their place of residence by geographic location, socio-economic level, and pediatric consultations cost. They were over 18 years old and with children aged 6 to 24 months. Data were collected between July and November 2016 by face to face interview using a structured questionnaire while the mothers waited for the pediatric postnatal care consultation in two private hospitals in northeastern Mexico. Exclusive breastfeeding was measured according to World Health Organization (WHO) recommendations, which consist of providing only breast milk for the first 6 months of life. Chi-squared tests and multivariate logistic regression were performed. RESULTS Mean maternal age was 31.4 years (SD of 4.4) and most of the participants had an undergraduate education, were married, and worked outside the home. The prevalence of exclusive breastfeeding at 6 months was 28%. Upper-class working mothers are less likely to continue breastfeeding. There was a negative association with employment (AOR 13.69; 95% CI 1.59, 111.11), bottle use in the first 6 months (AOR 7.93; 95% CI 3.07, 20.48), and a low level of knowledge (AOR 2.18; 95% CI 1.04, 4.56). After 6 months, only 61 mothers (28%) maintained exclusive breastfeeding. CONCLUSIONS Knowledge level, bottle use, and employment are associated with premature cessation of EBF in Mexican upper-class mothers, attending two private hospitals. There was a high percentage of breastfeeding cessation in the sample. It is necessary to reinforce a strategy that coordinates the action of the different laws, regulations and programs affecting the exclusive breastfeeding practice, in order to adequately promote breastfeeding and support mothers in both public and private sectors.
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Affiliation(s)
- María Natividad Ávila-Ortiz
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico.
| | - Ana Elisa Castro-Sánchez
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico
| | - Elizabeth Andrea Martínez-González
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico
| | - Georgina Mayela Núñez-Rocha
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico
| | - Adriana Zambrano-Moreno
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico
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Martin H, Thevenet-Morrison K, Dozier A. Maternal pre-pregnancy body mass index, gestational weight gain and breastfeeding outcomes: a cross-sectional analysis. BMC Pregnancy Childbirth 2020; 20:471. [PMID: 32807132 PMCID: PMC7433137 DOI: 10.1186/s12884-020-03156-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 08/04/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND It is well established that mothers with above-normal pre-pregnancy BMI are at increased risk of breastfeeding cessation; however, the impact of pregnancy weight-gain (PWG) is less well-defined. Excess PWG may alter the hormonal preparation of breast tissue for lactation, increase the risk of complications that negatively impact breastfeeding (e.g. Cesarean-section, gestational diabetes), and may make effective latch more difficult to achieve. METHODS Our objective was to determine the impact of PWG and pre-pregnancy BMI on the risk of breastfeeding cessation utilizing the Institute of Medicine's 2009 recommendations. Cox proportional hazards models were utilized to estimate the risk of cessation of exclusive breastfeeding, and cessation of any breastfeeding among women who initiated exclusive and any breastfeeding, respectively, in a cross sectional sample of survey respondents from a New York county (N = 1207). PWG category was interacted with pre-pregnancy BMI (3 levels of pre-pregnancy BMI, 3 levels of PWG). Confounders of the relationship of interest were evaluated using directed acyclic graphs and bivariate analyses; variables not on the proposed causal pathway and associated with the exposure and outcome were included in multivariate models. RESULTS After adjustment, women of normal and obese pre-pregnancy BMI with greater-than-recommended PWG had 1.39 (1.03-1.86) and 1.48 (1.06-2.07) times the risk of any breastfeeding cessation within the first 3 months postpartum compared to women with normal pre-pregnancy BMI who gained within PWG recommendations. Overweight women with greater-than-recommended PWG were at increased risk of cessation, although not significantly (aHR [95% CI]: 1.29 [0.95-1.75]). No significant relationship was observed for exclusive breastfeeding cessation. CONCLUSIONS Pre-pregnancy BMI and PWG may be modifiable risk factors for early breastfeeding cessation. Understanding the mechanism behind this risk should be ascertained by additional studies aimed at understanding the physiological, social, logistical (positioning) and other issues that may lead to early breastfeeding cessation.
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Affiliation(s)
- Hayley Martin
- Public Health Sciences, University of Rochester School of Medicine and Dentistry, 265 Crittenden Blvd. CU 420644, Rochester, NY, 14642, USA
| | - Kelly Thevenet-Morrison
- Public Health Sciences, University of Rochester School of Medicine and Dentistry, 265 Crittenden Blvd. CU 420644, Rochester, NY, 14642, USA
| | - Ann Dozier
- Public Health Sciences, University of Rochester School of Medicine and Dentistry, 265 Crittenden Blvd. CU 420644, Rochester, NY, 14642, USA.
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Abstract
Background Breastfeeding rates among high income, western countries vary considerably. This research examines three countries, Sweden, Ireland, and the United States, with respect to both public health initiatives and policy initiatives. Methods This article uses a historical qualitative analysis of breastfeeding rates over time. It uses the welfare state structure as a framework for understanding the variation in breastfeeding outcomes among these three countries. Results With its strong family policies and early adherence to international public health recommendations, Sweden was able to build high rates of breastfeeding initiation and duration. However, Sweden’s breastfeeding rates have been declining, which may be a result of increasing encouragement for fathers to take equal leave, and because Sweden is no longer prioritizing breastfeeding in its public health goals. Ireland has experienced rapid growth of both breastfeeding initiation and participation in the Baby-Friendly Hospital Initiative, though its rates still lag behind much of the Western world. The United States has seen increases in participation with the Baby-Friendly Hospital Initiative, but lacks state support in public health and labor policies. Conclusion This analysis suggests that in a country with a strong welfare state and early adoption of internationally recommended public policy, breastfeeding is able to flourish. It also suggests that the Baby-Friendly hospital Initiative is a predictor of breastfeeding success.
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Affiliation(s)
- Amanda Marie Lubold
- Department of Multidisciplinary Studies, Indiana State University, Holmstedt Hall, 290, Terre Haute, IN 47809 USA
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21
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Chen C, Cheng G, Pan J. Socioeconomic status and breastfeeding in China: an analysis of data from a longitudinal nationwide household survey. BMC Pediatr 2019; 19:167. [PMID: 31133000 PMCID: PMC6535851 DOI: 10.1186/s12887-019-1551-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 05/21/2019] [Indexed: 12/03/2022] Open
Abstract
Background Socioeconomic status is an important factor affecting the initiation and cessation of breastfeeding. However, limited evidence exists regarding the association between socioeconomic status and breastfeeding behavior in China on a national level. This study aims to investigate the relationship between socioeconomic status and the initiation and duration of breastfeeding in China. Methods Data were collected from the China Family Panel Studies, a longitudinal nationwide household survey. A total of 2938 infants born between 2010 and 2014 were included in the study. The logistic regression model was used to investigate the relationship between socioeconomic status and the initiation of breastfeeding. Meanwhile, the Cox proportional hazards model was used to investigate the relationship between socioeconomic status and the risk of breastfeeding cessation. Results Overall, 90.5% of infants were breastfed, while the average duration of breastfeeding was 8.66 months in China. The breastfeeding continuance rate at 12 months declined sharply, to 30.1%. The study’s findings also indicate that socioeconomic status did not significantly affect breastfeeding initiation. However, infants whose mothers had a high school or higher education and who scored 33–58 on the International Socio-Economic Index of Occupational Status (ISEI) were more likely to experience breastfeeding cessation, as were infants whose fathers had an ISEI score of 59–90. Conclusions Efforts to promote breastfeeding practices should be conducted comprehensively to target mothers with a high school or higher education, mothers with a medium occupational status, and fathers with a high occupational status.
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Affiliation(s)
- Chu Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China
| | - Guo Cheng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China
| | - Jay Pan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China. .,West China Research Centre for Rural Health Development, Sichuan University, No.17, Section 3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China.
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Tang K, Liu Y, Meng K, Jiang L, Tan S, Liu Y, Chen J. Breastfeeding duration of different age groups and its associated factors among Chinese women: a cross-sectional study. Int Breastfeed J 2019; 14:19. [PMID: 31086559 PMCID: PMC6506932 DOI: 10.1186/s13006-019-0212-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 04/26/2019] [Indexed: 11/13/2022] Open
Abstract
Background The current situation of breastfeeding in China has been discussed in many articles, and a declining trend of breastfeeding duration has been confirmed. The associations between various socioeconomic, reproductive factors and breastfeeding duration have been discussed as well. However, there remains a lack of evidence on breastfeeding duration amongst different age groups. Methods Data was extracted from the baseline of a large cohort study: a sample of 300,000 adult women born in the 1930s’ through 1970s’ from 10 geographically distinct regions was obtained. The breastfeeding duration was assumed by breastfeeding duration of the first child. Different age groups were categorized by 10-year age groups, and they were born in 1930–1938, 1939–1948, 1949–1958, 1959–1968, and 1969–1974. Multivariable linear regression was used to evaluate the associations between breastfeeding duration and sociodemographic, and reproductive factors (i.e.: different age groups, education, household size, use of oral contraceptive pills, age at menarche, and age at first birth). Results The mean breastfeeding duration (Standard Deviation) of women born in 1930–1938, 1939–1948, 1949–1958, 1959–1968, and 1969–1974 were 15.4 (9.2), 14.8 (8.2), 14.7 (8.9), 12.8 (7.2), 13.1 (7.2) months, respectively. Younger age groups, higher levels of education, and use of oral contraceptive pills were negatively associated with breastfeeding duration. In particular, the negative association with higher levels of education (for urban regions: βmiddle school = − 1.3, βhigh school & above = − 1.6; for rural regions: βmiddle school = − 0.6, βhigh school & above = − 1.2; all p < 0.0001) was found significant in both rural and urban areas, household size (β = − 0.1, p < 0.0001) and age at first birth (β = − 0.2, p < 0.0001) were negatively associated with breastfeeding duration only in urban areas, but were all positively associated with breastfeeding duration in rural areas. Conclusions This research demonstrated that, among Chinese women, younger age groups and higher levels of education were negatively associated with breastfeeding duration. Considering the declining trend of breastfeeding duration in China, healthcare providers need to continue advocating for breastfeeding practices. We also call for collaboration with various sectors and concerned groups to actions that promote breastfeeding-friendly environment and measures.
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Affiliation(s)
- Kun Tang
- 1Research Center for Public Health, Tsinghua University School of Medicine, Haidian District, Beijing, 10084 China
| | - Yaqian Liu
- 1Research Center for Public Health, Tsinghua University School of Medicine, Haidian District, Beijing, 10084 China
| | - Ke Meng
- 2School of Public Policy and Management, Tsinghua University, Haidian District, Beijing, 100084 China
| | - Li Jiang
- 3Peking University People's Hospital, No. 11 Xizhimen South Ave., Xicheng District, Beijing, 100044 China
| | - Shihui Tan
- 4School of Basic Medical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing, 100191 China
| | - Yuning Liu
- 5Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 USA
| | - Jiawen Chen
- 6School of Nursing, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing, 100191 China
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Mattar L, Hobeika M, Zeidan RK, Salameh P, Issa C. Determinants of Exclusive and Mixed Breastfeeding Durations and Risk of Recurrent Illnesses in Toddlers Attending Day Care Programs Across Lebanon. J Pediatr Nurs 2019; 45:e24-e34. [PMID: 30655117 DOI: 10.1016/j.pedn.2018.12.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 12/30/2018] [Accepted: 12/31/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE Breastfeeding rates continue to decrease in Lebanon. Studies addressing the relationship between breastfeeding duration and health outcomes in Middle Eastern countries are scarce. This study is the first in Lebanon to have investigated the determinants of both exclusive and mixed breastfeeding durations and the relationship with health in infants and toddlers. DESIGN AND METHODS Our sample of 1051 toddlers is nationwide and representative of all toddlers enrolled in daycare centers, and aged between 12 and 36 months. RESULTS Median of exclusive breastfeeding duration was 15 days and mean age of formula introduction was 2.03 (±3.22) months. Exclusive breastfeeding was initiated at a mean age of 10.56 (±27.12) hours and half of the toddlers (51.6%) were exposed to formula milk since day one following birth. Determinants of both exclusive and total breastfeeding durations were related to several parents' socio-demographic and behavioral factors. A longer duration of exclusive breastfeeding was associated with a lower frequency of pediatrician visits, antibiotic prescriptions, absence from daycare, and a lower risk of otitis, colic and UTI occurrence, after adjusting for cofounders. Similarly, a longer duration of total breastfeeding was associated with less antibiotic prescriptions and a lower risk of otitis. CONCLUSIONS Our study highlights the health benefits of extending exclusive breastfeeding duration. It is urgent to address alarmingly low breastfeeding rates in Lebanon. Policy implementation and enforcement along with raising awareness and creating a supportive environment for breastfeeding mothers should involve the various stakeholders in order to succeed in increasing breastfeeding rates and duration.
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Affiliation(s)
- Lama Mattar
- Nutrition Division, Natural Sciences Department, Lebanese American University, Beirut, Lebanon
| | - Maria Hobeika
- Faculty of Public Health II, Lebanese University, Fanar, Lebanon
| | | | - Pascale Salameh
- Faculty of Public Health II, Lebanese University, Fanar, Lebanon
| | - Carine Issa
- Faculty of Public Health II, Lebanese University, Fanar, Lebanon.
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Sebastian RA, Coronado E, Otero MD, McKinney CR, Ramos MM. Associations Between Maternity Care Practices and 2-Month Breastfeeding Duration Vary by Race, Ethnicity, and Acculturation. Matern Child Health J 2019; 23:858-867. [PMID: 30659460 DOI: 10.1007/s10995-018-02711-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives This study examines the associations between specific maternity care practices and breastfeeding duration for Spanish-speaking Hispanic, English-speaking Hispanic, non-Hispanic Native American, and non-Hispanic White women. Methods We analyzed data from the 2012-2014 New Mexico Pregnancy Risk Assessment Monitoring System. We used survey language as a proxy measure of acculturation and categorized women as Spanish-speaking Hispanic, English-speaking Hispanic, non-Hispanic Native American, and non-Hispanic White. We conducted bivariate analyses to compare rates of breastfeeding at 2 months and experiences of maternity care practices and logistic regression analysis to estimate the effects of these practices on breastfeeding duration for each group. Results Hispanic women were less likely than non-Hispanic women to breastfeed for at least 2 months (67.9% vs. 76.6%; p = 0.000); however, this varied significantly by acculturation level: 78.1% of Spanish-speaking Hispanic women compared to 66.1% of English-speaking Hispanic women breastfed for at least 2 months (p = 0.000). The effects of specific maternity care practices on duration varied across groups. Among non-Hispanic White, Native American, and English-speaking Hispanic women, breastfeeding while at the hospital had the strongest effect (AOR 2.09, 95% CI 1.67-2.61; AOR 2.71, 95% CI 2.08-3.52; and AOR 1.99, 95% CI 1.76-2.25, respectively). Among Spanish-speaking Hispanic women, being encouraged to breastfeed on demand had the strongest effect (AOR 5.179, 95% CI 3.86-6.94). Conclusions for Practice The effects of maternity care practices on breastfeeding duration vary by race, ethnicity, and acculturation level. Health care systems must acknowledge the diversity of their patient populations when seeking to develop and implement breastfeeding-friendly practices.
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Affiliation(s)
- Rachel A Sebastian
- Child Policy Research Consulting, LLC, 124 Basswood Circle, Fort Wright, KY, 41011, USA.
| | - Eirian Coronado
- New Mexico Department of Health, 1190 S. St. Francis Drive, Santa Fe, NM, 87505, USA
| | - Maria D Otero
- Nuestra Salud, LLC, 4282 Alexander Blvd NE, Albuquerque, NM, 87107, USA
| | - Courtney R McKinney
- Department of Pediatrics, University of New Mexico School of Medicine, 625 Silver Avenue SW, Suite 324, Albuquerque, NM, 87102, USA
| | - Mary M Ramos
- Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico School of Medicine, MSC 10 5590, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA
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Zhou N, Zhu H, Chen Y, Jiang W, Lin X, Tu Y, Chen D, Chen H. Dental caries and associated factors in 3 to 5-year-old children in Zhejiang Province, China: an epidemiological survey. BMC Oral Health 2019; 19:9. [PMID: 30630468 PMCID: PMC6329098 DOI: 10.1186/s12903-018-0698-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 12/18/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dental caries in preschool children is prevalent worldwide, but data regarding its magnitude and associated factors were not available for preschool children in Zhejiang Province, China. This study examines the dental caries situation and its associated factors in Zhejiang Province. METHODS A total of 1591 children aged 3-5 years and their parents or caregivers were enrolled in this study. The condition of their teeth was assessed by three dental technicians qualified to WHO 2013 criteria. A structured questionnaire was completed by the children's parents or caregivers. A logistic regression analysis was used to analyze the risk factors that may be associated with dental caries occurring among preschool children. RESULTS Caries prevalence (dmft> 0) of 3-5 year old children in Zhejiang Province was 70.4%. The mean decayed, missing and filled teeth (dmft) scores of the 3, 4 or 5 year old children surveyed were 2.96 ± 4.07, 4.42 ± 4.66, and 5.75 ± 5.19 respectively. The negative binomial regression model found that higher dental caries prevalence was found in children as age increased, with lower body mass index (BMI), with longer breastfeeding duration and with fewer hours of sleep. CONCLUSIONS The dental caries prevalence and dmft score of 3-5-year-old children in Zhejiang Province was high, and it was associated with age, BMI, breastfeeding duration and hours slept.
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Affiliation(s)
- Na Zhou
- Department of Conservative Dentistry and Endodontics, Stomatological Hospital Affiliated to Medical College, Zhejiang University, 395 Yan'an Road, Hangzhou, China.
| | - Haihua Zhu
- Department of Conservative Dentistry and Endodontics, Stomatological Hospital Affiliated to Medical College, Zhejiang University, 395 Yan'an Road, Hangzhou, China
| | - Yadong Chen
- Department of Conservative Dentistry and Endodontics, Stomatological Hospital Affiliated to Medical College, Zhejiang University, 395 Yan'an Road, Hangzhou, China
| | - Wen Jiang
- Department of Conservative Dentistry and Endodontics, Stomatological Hospital Affiliated to Medical College, Zhejiang University, 395 Yan'an Road, Hangzhou, China
| | - Xiaolong Lin
- Department of Conservative Dentistry and Endodontics, Stomatological Hospital Affiliated to Medical College, Zhejiang University, 395 Yan'an Road, Hangzhou, China
| | - Yan Tu
- Department of Conservative Dentistry and Endodontics, Stomatological Hospital Affiliated to Medical College, Zhejiang University, 395 Yan'an Road, Hangzhou, China
| | - Dingwan Chen
- Hangzhou Medical College, 481 Binwen Road, Hangzhou, China
| | - Hui Chen
- Department of Conservative Dentistry and Endodontics, Stomatological Hospital Affiliated to Medical College, Zhejiang University, 395 Yan'an Road, Hangzhou, China
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Susiloretni KA, Hadi H, Blakstad MM, Smith ER, Shankar AH. Does exclusive breastfeeding relate to the longer duration of breastfeeding? A prospective cohort study. Midwifery 2018; 69:163-171. [PMID: 30522038 DOI: 10.1016/j.midw.2018.11.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 06/14/2018] [Revised: 10/24/2018] [Accepted: 11/18/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Suboptimal breastfeeding contributes to morbidity and mortality in children. Studies in high-income countries (HICs) show that exclusive-breastfeeding (EBF) is associated with longer breastfeeding duration. The aim of this study was to determine whether maternal reports of EBF at six months are associated with longer duration of breastfeeding during the first two years of life in a low and middle-income country (LMIC) setting, and to identify determinants of breastfeeding duration. METHODS This prospective cohort includes data from an EBF promotion program in Demak District, Central Java Province, Indonesia, with a non-randomized pretest-posttest control group. Mothers and infants were followed through 26 months postnatal age. Data were analyzed using Cox proportional hazard regression with time to cessation of EBF as the outcome. RESULTS A total of 147 families were included in the study. Longer EBF duration was not associated with prolonged duration of breastfeeding. Longer breastfeeding duration was associated with mothers who disagreed with a statement of being ashamed to breastfeed (HR 0.035, 95%CI 0.003,0.44). Risk factors for shorter breastfeeding duration included mothers' plan to breastfeed for less than 24 months (HR 4.28 95%CI 1.91,9.60), mothers' belief that breastfeeding less than 24 months was the norm (HR 2.98 95%CI 1.31,6.77) and exposure to EBF promotion (HR:4.09 95%CI 2.14,7.82). CONCLUSIONS In a LMIC community where long breastfeeding duration is common, EBF is not associated with breastfeeding duration. However, modifiable behavioral factors were significant predictors of breastfeeding duration. We therefore recommend that prolonged breastfeeding duration can be achieved through programs that improve breastfeeding behavior.
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Affiliation(s)
- Kun A Susiloretni
- Department of Nutrition, Department of Applied Midwifery, Semarang Health Polytechnic, Ministry of Health of the Republic of Indonesia, Poltekkes Kemenkes Semarang, Jl. Wolter Monginsidi 115 Semarang 52192, Indonesia.
| | - Hamam Hadi
- Alma Ata Center for Healthy Life and Food (ACHEAF), Alma Ata University, Yogyakarta, Indonesia.
| | - Mia M Blakstad
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.
| | - Emily R Smith
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.
| | - Anuraj H Shankar
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
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Schafer EJ, Buch ED, Campo S, Ashida S. From initiation to cessation: Turning points and coping resources in the breastfeeding experience of first-time mothers. Women Health 2018; 59:449-463. [PMID: 29920174 DOI: 10.1080/03630242.2018.1487904] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
While most mothers initiate breastfeeding, many do not continue for recommended durations. This study aimed to understand the gap between breastfeeding initiation and duration through an in-depth exploration of first-time mothers' breastfeeding experiences. Contextual factors that may facilitate or deter breastfeeding maintenance were explored by identifying common turning points (significant events or periods promoting a change in thoughts/behaviors or facilitating maintenance) described by mothers with varied breastfeeding durations. In semistructured interviews conducted from March to June 2015, twenty-eight first-time mothers in Iowa were asked to describe their breastfeeding experiences from initiation through cessation. Using thematic analysis, seven turning points, consistent across varied durations and experiences were identified: breastfeeding problems, the unknowns, recurring stressors, living new life with baby, reentering social roles, special occasions, and letting go. Turning points were usually associated with stressful situations, and mothers described intrapersonal (e.g., determination) and interpersonal (e.g., social support) coping resources as facilitators of breastfeeding maintenance. These findings highlight contextual factors that may trigger turning points, representing critical intervention periods, and the importance of enhancing support networks. Interventions to facilitate longer breastfeeding durations should consider key turning points and availability of coping resources to determine strategies that best fit the mother at each point.
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Affiliation(s)
- Ellen J Schafer
- a Department of Community and Environmental Health , Boise State University College of Health Sciences , Boise , Idaho , USA
| | - Elana D Buch
- b Department of Anthropology , University of Iowa , Iowa City , Iowa , USA
| | - Shelly Campo
- c Department of Community and Behavioral Health , University of Iowa College of Public Health , Iowa City , Iowa , USA
| | - Sato Ashida
- c Department of Community and Behavioral Health , University of Iowa College of Public Health , Iowa City , Iowa , USA
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Al Ketbi MI, Al Noman S, Al Ali A, Darwish E, Al Fahim M, Rajah J. Knowledge, attitudes, and practices of breastfeeding among women visiting primary healthcare clinics on the island of Abu Dhabi, United Arab Emirates. Int Breastfeed J 2018; 13:26. [PMID: 29988693 PMCID: PMC6029179 DOI: 10.1186/s13006-018-0165-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 05/14/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The World Health Organization recommends continued breastfeeding up to 2 years of age or beyond. This study assessed breastfeeding knowledge, attitudes, and practices among women residing on the island of Abu Dhabi and identified associated factors. METHODS We conducted a cross-sectional study using a self-administered questionnaire among mothers visiting primary healthcare clinics in Abu Dhabi between November 2014 and 2015. Participants were women aged at least 18 years who had at least one child aged 2 years or younger at the time of the study. Breastfeeding knowledge, attitudes, and practices were assessed on the basis of experience with last child. Selected questions were used to develop a scaled scoring system to categorize these aspects as good, fair, or poor. Exclusive breastfeeding is defined as the act of feeding infants only breast milk since birth, without providing water, formula, or other liquid supplements. RESULTS The participants were 344 women. Exclusive breastfeeding for 6 months was reported by only 46 (16.9%, 95% CI 0.10, 0.17, n = 272). 79 (28.7%, n = 275) of the participants were breastfeeding and planning to continue after the child was ≥24 months. Multivariate logistic regression analysis revealed that the following factors were associated with exclusive breastfeeding: mothers with female children (adjusted OR [AOR] 2.42; 95% CI 1.18, 4.97) and better breastfeeding knowledge scores (AOR 1.25; 95% CI 1.04, 1.50). The following factors were associated with less likelihood of exclusively breastfeeding: working mothers (AOR 0.29; 95% CI 0.12, 0.72), living with relatives (AOR 0.21; 95% CI 0.05, 0.81), no past exclusive breastfeeding experience (AOR 0.23; 95% CI 0.09, 0.58) and being offered readymade liquid formula in hospital (AOR 0.33; 95% CI 0.15, 0.72). The most common reason for stopping breastfeeding was insufficient breast milk production (68/89, 76%), and the most common work related reason was inadequate maternity leave (24/89, 15%). CONCLUSION Although breastfeeding knowledge was generally good, breastfeeding practice was still suboptimal. Modifiable factors found to predict exclusive breastfeeding included breastfeeding knowledge and mothers' employment status.
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Affiliation(s)
- Mai Isam Al Ketbi
- Sheikh Khalifa Medical City (SKMC), P.O. Box: 51900, Abu Dhabi, United Arab Emirates
| | - Sultan Al Noman
- Sheikh Khalifa Medical City (SKMC), P.O. Box: 51900, Abu Dhabi, United Arab Emirates
| | - Abdelqadir Al Ali
- Sheikh Khalifa Medical City (SKMC), P.O. Box: 51900, Abu Dhabi, United Arab Emirates
| | - Ebtihal Darwish
- Ethraa Consultation and Training, P.O. Box: 32311, Dubai, United Arab Emirates
| | - Maha Al Fahim
- Sheikh Khalifa Medical City (SKMC), P.O. Box: 51900, Abu Dhabi, United Arab Emirates
| | - Jaishen Rajah
- Sheikh Khalifa Medical City (SKMC), P.O. Box: 51900, Abu Dhabi, United Arab Emirates
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Muelbert M, Giugliani ERJ. Factors associated with the maintenance of breastfeeding for 6, 12, and 24 months in adolescent mothers. BMC Public Health 2018; 18:675. [PMID: 29855364 PMCID: PMC5984453 DOI: 10.1186/s12889-018-5585-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 05/22/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Previous studies have demonstrated that adolescent mothers present a higher risk of not breastfeeding or of early interruption of this practice. Considering the scarcity of studies investigating the determining factors of breastfeeding in adolescent mothers, and the absence of studies exploring the determining factors of breastfeeding maintenance for different periods of time in a single population of adolescent mothers, the aim of this research was to identify factors associated with breastfeeding maintenance for at least 6, 12, and 24 months in adolescent mothers. METHODS Data analysis from a randomised control trial involving adolescent mothers recruited at a university hospital in southern Brazil. Participants were followed through the first year of life of their infants and reassessed at 4-7 years. Factors associated with any breastfeeding for at least 6, 12, and 24 months were assessed using multivariate Poisson regression. RESULTS Data for 228, 237, and 207 mothers were available, respectively. Breastfeeding maintenance for at least 6, 12, and 24 months was observed in 68.4, 47.3, and 31.9% of the sample, respectively. Only one factor was associated with breastfeeding maintenance at all outcomes: infant not using a pacifier showed a higher probability of breastfeeding maintenance in the first 2 years. Maternal grandmother breastfeeding support and exclusive breastfeeding duration were associated with breastfeeding maintenance for 6 and 12 months. The other factors evaluated were associated with breastfeeding maintenance at only one of the time points assessed: 6 months, maternal skin color (black/brown); 12 months, female infant and partner breastfeeding support; and 24 months, older paternal age and multiparity. CONCLUSIONS The present findings shed light upon barriers and facilitators of breastfeeding practices among adolescent mothers. In order to contribute to the challenge of increasing BF duration among adolescent mothers interventions aimed at boosting breastfeeding maintenance among this population should take into consideration the determining factors here identified. Additionally, breastfeeding education and support should be provided continuously as factors influencing these practices vary with time. Thus, support for adolescent mothers during the different stages of breastfeeding need to be tailored to have a positive impact on breastfeeding experience.
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Affiliation(s)
- Mariana Muelbert
- Post-Graduate Program in Child and Adolescent Health, Department of Pediatrics, Faculty of Medicine, Rua Ramiro Barcelos, 2400 2º andar, Porto Alegre, RS CEP: 90035003, Brazil.
| | - Elsa R J Giugliani
- Post-Graduate Program in Child and Adolescent Health, Department of Pediatrics, Faculty of Medicine, Rua Ramiro Barcelos, 2400 2º andar, Porto Alegre, RS CEP: 90035003, Brazil
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Abstract
Background Sex of child has been shown to impact breastfeeding duration in India, Australia, Scandinavia, Latin America, and, within the US, in a sample in Eastern Connecticut and in a separate sample of Indian and Chinese immigrants. Objectives The objective of this study is to examine differences in breastfeeding initiation and duration by sex of child across racial/ethnic groups in the US. Methods We used the Pregnancy Risk Assessment Monitoring System 2009-2010 and logistic regression to examine whether sex of child impacts breastfeeding initiation and duration for at least 8 weeks by women's racial/ethnic group. Results Among the 66,107 women in our sample representing 12 different race/ethnic groups, Hispanic women (n = 9049) had lower odds of breastfeeding initiation (adjusted odds ratio [AOR] = 0.81, 95% CI 0.71-0.93) and breastfeeding duration (AOR = .87, 95% CI 0.80-0.96) if they have sons compared to Hispanic women who have daughters. Sex of child did not impact the odds of breastfeeding initiation or duration among any other race/ethnic group. Conclusion We have shown that, for Hispanics in the US, sex of child may have an impact on breastfeeding, a health behavior that has a variety of positive impacts on infants throughout their lives. Boys, relative to girls, were at a disadvantage in breastfeeding initiation and duration. Future work is necessary to unpack the mechanisms behind these findings. In particular, how sex of child impacts how mothers and fathers view the nutritional needs of their children and breastfeeding more broadly.
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Thomson JL, Tussing-Humphreys LM, Goodman MH, Landry AS, Olender SE. Low rate of initiation and short duration of breastfeeding in a maternal and infant home visiting project targeting rural, Southern, African American women. Int Breastfeed J 2017; 12:15. [PMID: 28405211 PMCID: PMC5385043 DOI: 10.1186/s13006-017-0108-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/20/2017] [Indexed: 12/18/2022] Open
Abstract
Background Despite the benefits of breastfeeding for both infant and mother, rates in the United States remain below Healthy People 2020 breastfeeding objectives. This paper describes breastfeeding outcomes of the Delta Healthy Sprouts participants during gestational and postnatal periods. Of specific interest was whether breastfeeding intent, knowledge, and beliefs changed from the early to late gestational period. Additionally, analyses were conducted to test for associations between breastfeeding initiation and breastfeeding intent, knowledge and beliefs as well as sociodemographic characteristics and other health measures. Methods Eighty-two pregnant women were enrolled in this project spanning three Mississippi counties. Participants were randomly assigned to one of two treatment groups. Because both groups received information about breastfeeding, breastfeeding outcomes were analyzed without regard to treatment assignment. Hence participants were classified into two groups, those that initiated breastfeeding and those that did not initiate breastfeeding. Generalized linear mixed models were used to test for significant group, time, and group by time effects on breastfeeding outcomes. Results Breastfeeding knowledge scores increased significantly from baseline to late gestational period for both groups. Across time, breastfeeding belief scores were higher for the group that initiated breastfeeding as compared to the group that did not breastfeed. Only 39% (21 of 54) of participants initiated breastfeeding. Further, only one participant breastfed her infant for at least six months. Breastfeeding intent and beliefs as well as pre-pregnancy weight class significantly predicted breastfeeding initiation. Conclusions Our findings indicate that increasing knowledge about and addressing barriers for breastfeeding were insufficient to empower rural, Southern, primarily African American women to initiate or continue breastfeeding their infants. Improving breastfeeding outcomes for all socioeconomic groups will require consistent, engaging, culturally relevant education that positively influences beliefs as well as social and environmental supports that make breastfeeding the more accepted, convenient, and economical choice for infant feeding. Trial Registration clinicaltrials.gov NCT01746394. Registered 5 December 2012.
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Affiliation(s)
- Jessica L Thomson
- United States Department of Agriculture, Agricultural Research Service, 141 Experiment Station Road, Stoneville, MS 38776 USA
| | - Lisa M Tussing-Humphreys
- Department of Medicine and Cancer Center, University of Illinois at Chicago, 416 Westside Research Office Building, 1747 West Roosevelt Road, Chicago, IL 60608 USA
| | - Melissa H Goodman
- United States Department of Agriculture, Agricultural Research Service, 141 Experiment Station Road, Stoneville, MS 38776 USA
| | - Alicia S Landry
- Department of Family and Consumer Sciences, University of Central Arkansas, 201 Donaghey, 113 McAlister Hall, Conway, AR 72035 USA
| | - Sarah E Olender
- Department of Medicine and Cancer Center, University of Illinois at Chicago, 416 Westside Research Office Building, 1747 West Roosevelt Road, Chicago, IL 60608 USA
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Oras P, Thernström Blomqvist Y, Hedberg Nyqvist K, Gradin M, Rubertsson C, Hellström-Westas L, Funkquist EL. Skin-to-skin contact is associated with earlier breastfeeding attainment in preterm infants. Acta Paediatr 2016; 105:783-9. [PMID: 27100380 DOI: 10.1111/apa.13431] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 02/07/2016] [Accepted: 04/07/2016] [Indexed: 11/28/2022]
Abstract
AIM This study investigated the effects of skin-to-skin contact on breastfeeding attainment, duration and infant growth in preterm infants, as this has not been sufficiently explored. METHODS A prospective longitudinal study on Kangaroo mother care was carried out, comprising 104 infants with a gestational age of 28 + 0 to 33 + 6 and followed up to one year of corrected age. Parents and staff recorded the duration of skin-to skin contact during the stay in the neonatal intensive care unit (NICU). Medical data were collected through patient records, and follow-up questionnaires were filled in by parents. RESULTS The 53 infants who attained full breastfeeding in the NICU did so at a median (range) of 35 + 0 (32 + 1 to 37 + 5) weeks of postmenstrual age, and skin-to-skin contact was the only factor that influenced earlier attainment in the regression analysis (R(2) 0.215 p < 0.001). The daily duration of skin-to-skin contact during the stay in the NICU did not affect the duration of breastfeeding or infant growth after discharge. Furthermore, infant growth was not affected by the feeding strategy of exclusive, partial breastfeeding or no breastfeeding. CONCLUSION A longer daily duration of skin-to-skin contact in the NICU was associated with earlier attainment of exclusive breastfeeding.
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Affiliation(s)
- Paola Oras
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | | | | | - Maria Gradin
- Department of Paediatrics; Faculty of Medicine and Health; Örebro University; Örebro Sweden
| | | | | | - Eva-Lotta Funkquist
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
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Agarwal SS, Sharma M, Nehra K, Jayan B, Poonia A, Bhattal H. Validation of Association between Breastfeeding Duration, Facial Profile, Occlusion, and Spacing: A Cross-sectional Study. Int J Clin Pediatr Dent 2016; 9:162-6. [PMID: 27365941 PMCID: PMC4921889 DOI: 10.5005/jp-journals-10005-1356] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 10/21/2015] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION This cross-sectional retrospective study was designed to assess the relationships among breastfeeding duration, nonnutritive sucking habits, convex facial profile, nonspaced dentition, and distoclusion in the deciduous dentition. MATERIALS AND METHODS A sample of 415 children (228 males, 187 females) aged 4 to 6 years from a mixed Indian population was clinically examined by two orthodontists. Information about breastfeeding duration and nonnutritive sucking habits was obtained by written questionnaire which was answered by the parents. RESULTS Chi-square test did not indicate any significant association among breastfeeding duration, convex facial profile, and distoclusion. Statistically significant association was observed between breastfeeding duration and nonspaced dentition and also between breastfeeding duration and nonnutritive sucking habits. Nonnutritive sucking habits had a statistically significant association with distoclusion and convex facial profile (odds ratio 7.04 and 4.03 respectively). Nonnutritive sucking habits did not have a statistically significant association with nonspaced dentition. CONCLUSION The children breastfed < 6 months had almost twofold increased probability for developing sucking habits and nonspaced dentition, respectively, than the children who had breastfeeding > 6 months duration. It can also be hypothesized that nonnutritive sucking habits may act as a dominant variable in the relationship between breastfeeding duration and occurrence of convex facial profile and distoclusion in deciduous dentition. How to cite this article: Agarwal SS, Sharma M, Nehra K, Jayan B, Poonia A, Bhattal H. Validation of Association between Breastfeeding Duration, Facial Profile, Occlusion, and Spacing: A Cross-sectional Study. Int J Clin Pediatr Dent 2016;9(2):162-166.
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Affiliation(s)
- Shiv Shankar Agarwal
- Dental Officer, Department of Orthodontics and Dentofacial Orthopedics Indian Army Dental Corps, New Delhi, India
| | - Mohit Sharma
- Assistant Professor, Department of Orthodontics and Dentofacial Orthopedics Armed Forces Medical College, Pune, Maharashtra, India
| | - Karan Nehra
- Assistant Professor, Department of Orthodontics and Dentofacial Orthopedics Army Dental Centre (R&R), New Delhi, India
| | - Balakrishna Jayan
- Professor and Head, Department of Orthodontics and Dentofacial Orthopedics Army Dental Centre (R&R), New Delhi, India
| | - Anish Poonia
- Dental Officer, Department of Pediatric and Preventive Dentistry, Army Dental Centre (R&R), New Delhi, India
| | - Hiteshwar Bhattal
- Dental Officer, Department of Pediatric and Preventive Dentistry, Indian Army Dental Corps, New Delhi, India
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Kearns AD, Castro MC, Lourenço BH, Augusto RA, Cardoso MA. Factors Associated with Age at Breastfeeding Cessation in Amazonian Infants: Applying a Proximal-Distal Framework. Matern Child Health J 2016; 20:1539-48. [PMID: 27084366 DOI: 10.1007/s10995-016-1953-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction Breastfeeding is an important determinant of child survival and normal growth and development, but breastfeeding prevalence is generally low in Brazil. Factors associated with infant feeding practices there are not well understood. This paper examines factors associated with breastfeeding cessation in a township in the western Brazilian Amazon. Methods A cross-sectional, population-based study was conducted among children younger than 25 months and collected information on maternal and child characteristics. Survival analysis based on a proximal-distal framework examined the association between breastfeeding duration and socioeconomic and maternal/child biological factors. Results The median breastfeeding duration among 101 children who were no longer breastfeeding was 120 days. Almost two-thirds (63 %) of these children stopped breastfeeding before 6 months of age. In the larger sample of 209 children, 74.6 % had previously been bottle-fed. Considering the full proximal-distal model, a child who had ever been bottle-fed was expected to cease breastfeeding about 88 % sooner than one who was never bottle-fed (p < 0.001). Children in the second-poorest wealth quartile stopped breastfeeding sooner than children in the poorest quartile (p < 0.05). Discussion Breastfeeding cessation in the study area occurred much earlier than the recommended 2 years of age. Factors associated with ending breastfeeding early included ever-use of a bottle, having a single mother, and belonging to the second-poorest wealth quartile. Further research is needed to better understand these factors and other barriers women face to continuing breastfeeding.
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Affiliation(s)
- Annie D Kearns
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Marcia C Castro
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Bárbara H Lourenço
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo 715, São Paulo, 01246-904, Brazil
| | - Rosângela A Augusto
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo 715, São Paulo, 01246-904, Brazil
| | - Marly A Cardoso
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo 715, São Paulo, 01246-904, Brazil
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Nnebe-Agumadu UH, Racine EF, Laditka SB, Coffman MJ. Associations between perceived value of exclusive breastfeeding among pregnant women in the United States and exclusive breastfeeding to three and six months postpartum: a prospective study. Int Breastfeed J 2016; 11:8. [PMID: 27076839 DOI: 10.1186/s13006-016-0065-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 03/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Successful breastfeeding often starts with prenatally established intention. Yet, few mothers with the intention to exclusively breastfeed achieve their intended breastfeeding duration goal. This study examined the degree to which having a strong value of exclusive breastfeeding is associated with exclusive breastfeeding duration for at least 3 and 6 months postpartum among women who reported prenatal intention to exclusively breastfeed. METHODS Data were from the Infant Feeding Practices Study II, a longitudinal US national survey that followed maternal-infant dyads from pregnancy to 1 year postpartum. Bivariate and multivariate regression examined the degree to which strong maternal value of exclusive breastfeeding predicted exclusive breastfeeding duration. RESULTS Of the 1799 women who prenatally intended to exclusively breastfeed within the first few weeks postpartum, 34 and 9 % exclusively breastfed for at least 3 months and 6 months, respectively. Thirty-six percent of women reported strongly valuing exclusive breastfeeding out of which 46 % exclusively breastfeed to three months. In adjusted results, women who reported that they strongly value exclusive breastfeeding had more than twice the odds of exclusive breastfeeding for at least 3 months (Adjusted Odds Ratio [AOR] 2.29; 95 % confidence interval [CI] 1.84, 2.85) and for 6 months (AOR 2.49; 95 % CI 1.76, 3.53) compared to those who did not strongly value exclusive breastfeeding. CONCLUSION Valuing the benefits of exclusive breastfeeding during pregnancy is a strong independent predictor of actual exclusive breastfeeding duration. A minority of pregnant women strongly value exclusive breastfeeding and are able to exclusively breastfeed to 3 months even among women with established prenatal intention to exclusively breastfeed. Prenatal maternal education and environmental lactation support that extends into the postnatal period can promote longer duration of exclusive breastfeeding.
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Kronborg H, Sievertsen HH, Wüst M. Care around birth, infant and mother health and maternal health investments - Evidence from a nurse strike. Soc Sci Med 2016; 150:201-11. [PMID: 26771337 DOI: 10.1016/j.socscimed.2015.12.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 01/30/2015] [Revised: 12/08/2015] [Accepted: 12/23/2015] [Indexed: 11/26/2022]
Abstract
Care around birth may impact child and mother health and parental health investments. We exploit the 2008 national strike among Danish nurses to identify the effects of care around birth on infant and mother health (proxied by health care usage) and maternal investments in the health of their newborns. We use administrative data from the population register on 39,810 Danish births in the years 2007-2010 and complementary survey and municipal administrative data on 8288 births in the years 2007-2009 in a differences-in-differences framework. We show that the strike reduced the number of mothers' prenatal midwife consultations, their length of hospital stay at birth, and the number of home visits by trained nurses after hospital discharge. We find that this reduction in care around birth increased the number of child and mother general practitioner (GP) contacts in the first month. As we do not find strong effects of strike exposure on infant and mother GP contacts in the longer run, this result suggests that parents substitute one type of care for another. While we lack power to identify the effects of care around birth on hospital readmissions and diagnoses, our results for maternal health investments indicate that strike-exposed mothers-especially those who lacked postnatal early home visits-are less likely to exclusively breastfeed their child at four months. Thus reduced care around birth may have persistent effects on treated children through its impact on parental investments.
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Affiliation(s)
- Hanne Kronborg
- Department of Public Health - Department of Science in Nursing, Aarhus University, Denmark
| | - Hans Henrik Sievertsen
- SFI-The Danish National Center for Social Research, Herluf Trolles Gade 11, 1052 Copenhagen, Denmark
| | - Miriam Wüst
- SFI-The Danish National Center for Social Research, Herluf Trolles Gade 11, 1052 Copenhagen, Denmark.
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Wallwiener S, Müller M, Doster A, Plewniok K, Wallwiener CW, Fluhr H, Feller S, Brucker SY, Wallwiener M, Reck C. Predictors of impaired breastfeeding initiation and maintenance in a diverse sample: what is important? Arch Gynecol Obstet 2016; 294:455-66. [PMID: 26711837 DOI: 10.1007/s00404-015-3994-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 12/10/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE This study aimed to investigate socio-demographic, medical and psychological factors that have an impact on breastfeeding. METHODS Questionnaires were administered to 330 women prenatally (TI third trimester) and postpartum (TII 3-4 days, TIII 4 months). Medical data were collected from the hospital records. Self-reported data on initiation and maintenance of breastfeeding was collected simultaneously. Primary endpoint was breastfeeding initiation and maintenance. Data analyses were performed using Spearman's ρ correlations between breastfeeding and other study variables and generalized multiple ordinal logistic regression analysis. RESULTS Neonatal admission to the NICU, high BMI, cesarean section, difficulties with breastfeeding initiation and high maternal state anxiety were the strongest predictors of impaired breastfeeding initiation, explaining together 50 % of variance. After 4 months, the strongest predictors of impaired maintenance of breastfeeding were maternal smoking, a high BMI and a history of postpartum anxiety disorder, explaining 30 % of variance. CONCLUSIONS Successful initiation and maintenance of breast feeding is a multifactorial process. Our results underline the need of interdisciplinary approaches to optimise breastfeeding outcomes by demonstrating the equality of medical and psychological variables. Whereas practices on maternity wards are crucial for optimal initiation, continuous lifestyle modifying and supporting approaches are essential for breastfeeding maintenance. Healthcare providers can also significantly influence breastfeeding initiation and maintenance by counselling on the importance of maternal BMI.
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Cox K, Binns CW, Giglia R. Predictors of breastfeeding duration for rural women in a high-income country: evidence from a cohort study. Acta Paediatr 2015; 104:e350-9. [PMID: 25772350 DOI: 10.1111/apa.12999] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 02/24/2015] [Accepted: 03/09/2015] [Indexed: 12/29/2022]
Abstract
AIM To determine the prevalence of exclusive and 'any breastfeeding' at six months in rural Western Australia and to identify the predictors of exclusive and 'any breastfeeding' duration up to 12 months. METHODS A total of 427 mothers (52% of those contacted) were recruited from maternity services in rural WA and asked to complete a baseline questionnaire. Mothers were recontacted at 4, 6, 10, 16, 26, 32, 40 and 52 weeks to determine factors associated with feeding practices. RESULTS Smoking during pregnancy was the strongest predictor of exclusive breastfeeding cessation before six months (aHR 3.21, 95% CI 1.89, 5.46). A favourable attitude towards breastfeeding, a body mass index of <30 and a return to work after six months were associated with reduced risk of breastfeeding cessation before both six and 12 months. CONCLUSION Breastfeeding duration in rural Western Australia is influenced by modifiable factors such as smoking during pregnancy and prepregnancy obesity, therefore strategies to address these risk factors in rural women prior to delivery may contribute to improved breastfeeding rates.
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Affiliation(s)
- Kylee Cox
- School of Public Health; Curtin University; Perth WA Australia
| | - Colin W. Binns
- School of Public Health; Curtin University; Perth WA Australia
| | - Roslyn Giglia
- School of Public Health; Curtin University; Perth WA Australia
- Telethon Kids Institute; Perth WA Australia
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Fisher J, Hammarberg K, Wynter K, McBain J, Gibson F, Boivin J, McMahon C. Assisted conception, maternal age and breastfeeding: an Australian cohort study. Acta Paediatr 2013; 102:970-6. [PMID: 23815687 DOI: 10.1111/apa.12336] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Revised: 06/18/2013] [Accepted: 06/26/2013] [Indexed: 11/29/2022]
Abstract
AIM To establish the relationships between age, mode of conception and breastfeeding. METHOD Consecutive cohorts of nulliparous women >25 weeks pregnant who had conceived through ART (ARTC) or spontaneously (SC) in three age groups ≤30, 31-36 and ≥37 years were recruited. Data were obtained via telephone interviews and postal questionnaires in late pregnancy and 4 months postpartum. Sociodemographic characteristics, reproductive health, birth and breastfeeding experiences were assessed by study-specific questions. Self-rated general health and symptoms of depression and anxiety were assessed with standardized psychometric instruments. Main outcomes were exclusive breastfeeding at discharge from maternity hospital and 4 months postpartum. RESULTS Of 1179 eligible women, 791 (67%) participated; 549 (93%) had singleton infants, provided complete data and were included in analyses. Overall, 37.2% of participants aged ≤30, 33% aged 31-36 and 55.1% aged ≥37 years experienced Caesarean births. Regardless of age, compared with the SC group, ARTC women had twice the rate of Caesareans prior to labour. Controlling for other factors, exclusive breastfeeding rates at hospital discharge and 4 months postpartum were lowest amongst ARTC women who experienced Caesarean prior to labour (p < .001). CONCLUSION Independent of age, assisted conception increases the risk conferred by Caesarean birth to breastfeeding initiation and maintenance.
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Affiliation(s)
- Jane Fisher
- Jean Hailes Research Unit; School of Public Health and Preventive Medicine; Monash University; Melbourne; Victoria; Australia
| | - Karin Hammarberg
- Jean Hailes Research Unit; School of Public Health and Preventive Medicine; Monash University; Melbourne; Victoria; Australia
| | - Karen Wynter
- Jean Hailes Research Unit; School of Public Health and Preventive Medicine; Monash University; Melbourne; Victoria; Australia
| | - John McBain
- Melbourne IVF; Melbourne; Victoria; Australia
| | - Frances Gibson
- Institute of Early Childhood; Macquarie University; Sydney; NSW; Australia
| | - Jacky Boivin
- School of Psychology; Cardiff University; Cardiff; UK
| | - Catherine McMahon
- Centre for Emotional Health; Department of Psychology; Macquarie University; Sydney; NSW; Australia
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Sipsma HL, Magriples U, Divney A, Gordon D, Gabzdyl E, Kershaw T. Breastfeeding behavior among adolescents: initiation, duration, and exclusivity. J Adolesc Health 2013; 53:394-400. [PMID: 23725911 PMCID: PMC3755029 DOI: 10.1016/j.jadohealth.2013.04.005] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 04/09/2013] [Accepted: 04/09/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Despite a substantial amount of evidence on breastfeeding among non-adolescent mothers, research and strategies uniquely designed to target adolescent mothers are critical because their rates of breastfeeding are disproportionately low and their transition to parenthood is often unlike that of older mothers. Literature to date, however, offers limited evidence for designing effective interventions. Therefore, we aimed to fill this gap in the literature by examining breastfeeding behaviors among a cohort of female adolescents as they transition to parenthood. METHODS Data were derived from a longitudinal cohort of pregnant adolescent females (ages 14-21 years) and their male partners, observed from pregnancy through 6 months postpartum. Means and frequencies were used to describe breastfeeding experiences, breastfeeding behaviors, and sociodemographic characteristics. We used multivariate logistic regression and Cox proportional hazards models to identify factors independently associated with breastfeeding initiation, exclusive breastfeeding, and breastfeeding duration. RESULTS Approximately 71% initiated breastfeeding. Intending to breastfeed, having had complications in labor and delivery, and lower social support were associated with greater odds of breastfeeding initiation. Of the adolescent mothers who initiated breastfeeding, 84% had stopped by 6 months postpartum; among those, average breastfeeding duration was 5 weeks. Participants who exclusively breastfed had longer breastfeeding duration, and participants who had experienced intimate partner violence had shorter breastfeeding duration. Obese women and women who had more difficulty breastfeeding had lower odds of exclusive breastfeeding. CONCLUSIONS Enhanced clinical support and the promotion of exclusive breastfeeding should be considered when designing interventions to improve breastfeeding rates among adolescent mothers.
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Affiliation(s)
- Heather L Sipsma
- Department of Women, Children, and Family Health Science, University of Illinois at Chicago College of Nursing, Chicago, IL, USA.
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Abstract
Background We aimed to evaluate the risk factors for recurrent wheezing in patients diagnosed with acute bronchiolitis. Method From 2009 to 2011, 500 patients from the pediatric clinics, with first attack of acute bronchiolitis were included in this prospective study. Each patient’s age, gender, birth weight, duration of breastfeeding, family history of atopy and asthma, smoking exposure, source of heating in the house, the presence of pets, any history of chronic disease have been questioned. The patients were followed for a duration of 12 - 24 months. Results In this study, 39% (n = 195) of the cases were female and 61% (n = 305) were male, with a median age of 3 months old. Male gender, low birth weight (< 2,500 g), low gestational age (< 37 weeks), breastfeeding of less than 6 months, congenital heart disease, family history of atopy, asthma, smoking exposure, stove warming, was found as significant risk factors for recurrent wheezing, however, presence of pets at home was found to be a protective factor. Conclusions Informing parents about the risk factors such as exposure to cigarette smoke, heating mode, duration of breastfeeding can significantly decrease recurrent episodes of wheezing.
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Affiliation(s)
- Abdulkadir Bozaykut
- Zeynep Kamil Maternity and Childrens' Disease Training and Research Hospital, Department of Pediatrics, Uskudar 34668, Istanbul, Turkey
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