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Tebeje TM, Seifu BL, Mare KU, Asgedom YS, Asmare ZA, Asebe HA, Shibeshi AH, Lombebo AA, Sabo KG, Fente BM, Kase BF. Geospatial determinants and spatio-temporal variation of early initiation of breastfeeding and exclusive breastfeeding in Ethiopia from 2011 to 2019, a multiscale geographically weighted regression analysis. BMC Public Health 2024; 24:2011. [PMID: 39068397 PMCID: PMC11282616 DOI: 10.1186/s12889-024-19552-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 07/22/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Breastfeeding offers numerous benefits for infants, mothers, and the community, making it the best intervention for reducing infant mortality and morbidity. The World Health Organization (WHO) recommends initiating breastfeeding within one hour after birth and exclusively breastfeeding for the first six months. This study investigated the trend, spatio-temporal variation, and determinants of spatial clustering of early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) in Ethiopia from 2011 to 2019. METHODS Data from the Ethiopian Demographic and Health Survey (EDHS), which was conducted in 2011, 2016, and 2019, were analyzed utilizing a weighted sample of 10,616 children aged 0-23 years for EIBF and 2,881 children aged 0-5 months for EBF. Spatial autocorrelation analysis was used to measure whether EIBF and EBF were dispersed, clustered, or randomly distributed and Kriging interpolation was employed to predict the outcome variables in the unmeasured areas. Spatial scan statistics were used to identify spatial clusters with a high prevalence of cases. Both global and local regression modeling techniques were employed to examine the spatial relationships between the explanatory variables and the dependent variables. RESULTS The trend analysis revealed a notable increase in the prevalence of EIBF from 51.8% in 2011 to 71.9% in 2019. Similarly, the prevalence of EBF increased from 52.7% in 2011 to 58.9% in 2019. Spatial analysis demonstrated significant spatial variation in both EIBF and EBF throughout the country. Cold spots or clusters with a low prevalence of EIBF were observed consistently in the Tigray and Amhara regions, and significant cold spot areas of EBF were observed consistently in the Afar and Somali regions. Multiscale geographically weighted regression analysis revealed significant predictors of spatial variations in EIBF, including the religious affiliation of being a follower of the orthodox religion, parity of 1-2, absence of antenatal care visits, and delivery via cesarean section. CONCLUSIONS Despite the increase in both EIBF and EBF rates over time in Ethiopia, these rates still fall below the national target. To address this issue, the government should prioritize public health programs aimed at improving maternal healthcare service utilization and maternal education. It is essential to integrate facility-level services with community-level services to achieve optimal breastfeeding practices. Specifically, efforts should be made to promote breastfeeding among mothers who have delivered via cesarean section. Additionally, there should be a focus on encouraging antenatal care service utilization and adapting maternal healthcare services to accommodate the mobile lifestyle of pastoralist communities. These steps will contribute to enhancing breastfeeding practices and achieving better outcomes for maternal and child health.
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Affiliation(s)
- Tsion Mulat Tebeje
- School of Public Health, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia.
| | - Beminate Lemma Seifu
- Department of Public Health, College of Medicine and Health Science, Samara University, Afar, Ethiopia
| | - Kusse Urmale Mare
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Afar, Ethiopia
| | - Yordanos Sisay Asgedom
- Department of Epidemiology and Biostatics, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Zufan Alamrie Asmare
- Department of Ophthalmology, School of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Hiwot Altaye Asebe
- Department of Public Health, College of Medicine and Health Science, Samara University, Afar, Ethiopia
| | - Abdu Hailu Shibeshi
- Department of Statistics, College of Natural and Computational Science, Samara University, Afar, Ethiopia
| | - Afework Alemu Lombebo
- School of Medicine, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kebede Gemeda Sabo
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Afar, Ethiopia
| | - Bezawit Melak Fente
- Department of General Midwifery, School of Midwifery, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bizunesh Fantahun Kase
- Department of Public Health, College of Medicine and Health Science, Samara University, Afar, Ethiopia
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Lai HJ, Bach TR, Miller T, McDonald CM, Maguiness KM, Seffrood EE, Leonard JB, Farrell PM. Breastfeeding, growth, and lung disease in the first 3 years of life in children with cystic fibrosis. J Cyst Fibros 2024:S1569-1993(24)00791-4. [PMID: 39019722 DOI: 10.1016/j.jcf.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 07/08/2024] [Accepted: 07/10/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND The 2009 cystic fibrosis (CF) infant care guidelines recommend breastmilk as the initial feeding but do not address if/when it should be fortified or supplemented with formula to promote optimal growth and pulmonary health. METHODS We conducted a prospective multi-center cohort study in breastfed and formula-fed infants that included 172 infants with CF who were born during 2012-17, enrolled after newborn screening at age 1.9 ± 1.0 months, and evaluated growth and lung disease manifestations in the first 3 years of life. RESULTS Seventy-two percent of our study cohort was breastfed at birth, but 64 % transitioned to receiving fortified feedings (breastmilk, formula, or a combination) by 6 months of age to reverse the downward trajectory of their growth curves. Fortified feedings accelerated catch-up growth to normal weight-for-age (0.12 ± 0.80 z-score) and near normal height-for-age (-0.13 ± 0.90 z-score) at 3 years of age. Within the fortified group, breastmilk and formula were similarly effective in promoting catch-up growth, but proportionately fewer infants with CF fed predominantly breastmilk (30 %) experienced severe or moderate early-onset lung disease compared to those fed predominantly formula (62 %), p = 0.02. CONCLUSIONS Most infants with CF require fortified feedings to recuperate from growth faltering and achieve normal growth at 3 years of age. For these infants, the proactive/preventive strategy of fortified breastmilk feedings starting soon after CF diagnosis, an alternative to the reactive/monitoring approach, can minimize the risk of prolonged postnatal growth faltering, accelerate the potential of attaining catch-up growth, and decrease the likelihood of experiencing more severe early-onset lung disease.
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Affiliation(s)
- HuiChuan J Lai
- Department of Nutritional Sciences, University of Wisconsin College of Agriculture and Life Sciences, Madison, WI, USA; Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
| | - Taiya R Bach
- Department of Nutritional Sciences, University of Wisconsin College of Agriculture and Life Sciences, Madison, WI, USA; Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Tami Miller
- Clinical Nutrition, Children's Wisconsin, Milwaukee, WI, USA
| | | | - Karen M Maguiness
- Pediatric Pulmonology, Riley Hospital for Children at IU Health, Indianapolis, IN, USA
| | - Erin E Seffrood
- Clinical Nutrition, University of Wisconsin Hospital and Clinics, Madison, WI, USA
| | | | - Philip M Farrell
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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3
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Grano C, Fernandes M, Conner M. Predicting intention and maintenance of breastfeeding up to 2-years after birth in primiparous and multiparous women. Psychol Health 2023; 38:1536-1552. [PMID: 35007452 DOI: 10.1080/08870446.2021.2025374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 10/12/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Breastfeeding up to 2-years has been associated with short and long-term health benefits for both newborns and mothers. However, few women breastfeed up to 2-years after birth. This study extends previous research on the theory of planned behaviour (TPB) examining the predictors of intention and maintenance of breastfeeding up to 2-years in both primiparous and multiparous women. DESIGN 155 pregnant women participated in this longitudinal study. METHODS Expectant mothers completed a questionnaire and then 2-years after the child's birth were asked to report breastfeeding behaviour. Interactions among parity and TPB constructs were examined. RESULTS Attitudes, descriptive and injunctive norms, and perceived behavioural control (PBC) explained 58% of the variance in mothers' intention to breastfeed. Attitudes were the strongest predictor, followed by PBC, descriptive norms and parity. A significant interaction was found between parity and PBC, showing that PBC was only a significant predictor of intention to breastfeed at 2-years in multiparous women. Intentions predicted breastfeeding behaviour at 2-years. CONCLUSION Promoting intentions may be a useful way to increase breastfeeding duration to 2-years and targeting attitudes and norms may be one way to increase intentions. Further, targeting PBC may also be useful to increase intentions, but only in multiparous women.
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Affiliation(s)
- Caterina Grano
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Mark Conner
- School of Psychology, University of Leeds, Leeds, UK
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Bahawi YO, Al-Wassia HK, Bahaidarah SA, Aloufi FS, Aljehani MA, Alfaydi RA, Alghamdi JS. Are Pediatric Residents in Saudi Arabia Equipped to Provide Breastfeeding Care? A Cross-Sectional Study. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2023; 11:319-325. [PMID: 37970454 PMCID: PMC10634463 DOI: 10.4103/sjmms.sjmms_208_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 10/11/2022] [Accepted: 06/13/2023] [Indexed: 11/17/2023]
Abstract
Background There is a progressive reduction in breastfeeding rates in Saudi Arabia. Counseling and support from health-care providers are useful in overcoming barriers to continuing breastfeeding. However, medical education and residency programs often do not adequately provide breastfeeding training. Objective To determine the knowledge, comfort level, perception, and clinical practices of pediatric residents regarding breastfeeding in Saudi Arabia and to measure the level and type of education received during their residency training. Materials and Methods This cross-sectional study included pediatric residents from across Saudi Arabia who were registered with the Saudi Commission for Health Sciences and was conducted from February 2021 to January 2022. A validated self-reported questionnaire was used to elicit information from the respondents. Knowledge score was calculated as a percentage of correct answers. Results A total of 253 residents completed the survey. The mean knowledge score was 58.4% ± 22.7%, which was lower than the cut-off threshold of good knowledge. Almost half of the residents (49.4%) were confident about addressing breastfeeding-related concerns. Although nearly all residents (91.7%) agreed that breastfeeding promotion is part of their role, 35% never or rarely met the mother before birth to discuss breastfeeding. Didactic teaching was the most prevalent educational tool during their training (34.3%); however, most residents preferred learning through interactive workshops (83.7%) and following lactation consultants (82.8%). Conclusion Despite positive perceptions and confidence in providing breastfeeding care, pediatric residents in Saudi Arabia lack optimal knowledge of breastfeeding. These findings indicate the need for enhancing breastfeeding curricula in pediatric residency programs to improve breastfeeding consultation and management.
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Affiliation(s)
- Yara O. Bahawi
- College of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Heidi K. Al-Wassia
- Department of Pediatrics, Division of Neonatology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Saud A. Bahaidarah
- Department of Pediatrics, Division of Cardiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Faisal S. Aloufi
- College of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed A. Aljehani
- College of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rafah A. Alfaydi
- College of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jana S. Alghamdi
- College of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Nagahashi-Araki M, Tasaka M, Takamura T, Eto H, Sasaki N, Fujita W, Miyazaki A, Morifuji K, Honda N, Miyamura T, Nishitani S. Endogenous oxytocin levels in extracted saliva elevates during breastfeeding correlated with lower postpartum anxiety in primiparous mothers. BMC Pregnancy Childbirth 2022; 22:711. [PMID: 36115939 PMCID: PMC9482205 DOI: 10.1186/s12884-022-05026-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 07/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background Breastfeeding in the early postpartum period is expected to have mental benefits for mothers; however, the underlying psychobiological mechanisms remain unclear. Previously, we hypothesized that the release of oxytocin in response to the suckling stimuli during breastfeeding would mediate a calming effect on primiparous mothers, and we examined salivary oxytocin measurements in primiparous mothers at postpartum day 4 using saliva samples without extraction, which was erroneous. Thus, further confirmation of this hypothesis with a precise methodology was needed. Methods We collected saliva samples at three time points (baseline, feeding, and post-feeding) to measure oxytocin in 24 primiparous mothers on postpartum day 2 (PD2) and 4 (PD4) across the breastfeeding cycle. Salivary oxytocin levels using both extracted and unextracted methods were measured and compared to determine the qualitative differences. State and trait anxiety and clinical demographics were evaluated to determine their association with oxytocin changes. Results Breastfeeding elevated salivary oxytocin levels; however, it was not detected to a significant increase in the extraction method at PD4. We found a weak but significant positive correlation between changes in extracted and unextracted oxytocin levels during breastfeeding (feeding minus baseline); there were no other significant positive correlations. Therefore, we used the extracted measurement index for subsequent analysis. We showed that the greater the increase in oxytocin during breastfeeding, the lower the state anxiety, but not trait anxiety. Mothers who exclusively breastfed at the 1-month follow-up tended to be associated with slightly higher oxytocin change at PD2 than those who did not. Conclusions Breastfeeding in early postpartum days could be accompanied by the frequent release of oxytocin and lower state anxiety, potentially contributing to exclusive breastfeeding. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-05026-x.
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Moon RY, Carlin RF, Hand I. Evidence Base for 2022 Updated Recommendations for a Safe Infant Sleeping Environment to Reduce the Risk of Sleep-Related Infant Deaths. Pediatrics 2022; 150:188305. [PMID: 35921639 DOI: 10.1542/peds.2022-057991] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Every year in the United States, approximately 3500 infants die of sleep-related infant deaths, including sudden infant death syndrome (SIDS) (International Statistical Classification of Diseases and Related Health Problems 10th Revision [ICD-10] R95), ill-defined deaths (ICD-10 R99), and accidental suffocation and strangulation in bed (ICD-10 W75). After a substantial decline in sleep-related deaths in the 1990s, the overall death rate attributable to sleep-related infant deaths have remained stagnant since 2000, and disparities persist. The triple risk model proposes that SIDS occurs when an infant with intrinsic vulnerability (often manifested by impaired arousal, cardiorespiratory, and/or autonomic responses) undergoes an exogenous trigger event (eg, exposure to an unsafe sleeping environment) during a critical developmental period. The American Academy of Pediatrics recommends a safe sleep environment to reduce the risk of all sleep-related deaths. This includes supine positioning; use of a firm, noninclined sleep surface; room sharing without bed sharing; and avoidance of soft bedding and overheating. Additional recommendations for SIDS risk reduction include human milk feeding; avoidance of exposure to nicotine, alcohol, marijuana, opioids, and illicit drugs; routine immunization; and use of a pacifier. New recommendations are presented regarding noninclined sleep surfaces, short-term emergency sleep locations, use of cardboard boxes as a sleep location, bed sharing, substance use, home cardiorespiratory monitors, and tummy time. In addition, additional information to assist parents, physicians, and nonphysician clinicians in assessing the risk of specific bed-sharing situations is included. The recommendations and strength of evidence for each recommendation are published in the accompanying policy statement, which is included in this issue.
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Affiliation(s)
- Rachel Y Moon
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Rebecca F Carlin
- Division of Pediatric Critical Care and Hospital Medicine, Department of Pediatrics, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, New York City, New York
| | - Ivan Hand
- Department of Pediatrics, SUNY-Downstate College of Medicine, NYC Health + Hospitals, Kings County, Brooklyn, New York
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Tafili A, Zakari NMA, Hamadi HY, Spaulding A. Association of hospital and community factors on the attainment of Baby‐Friendly designation: A breastfeeding health promotion. MATERNAL & CHILD NUTRITION 2022; 18:e13388. [PMID: 35686458 PMCID: PMC9218315 DOI: 10.1111/mcn.13388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/12/2022] [Accepted: 05/18/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Aurora Tafili
- Department of Health Services Administration, School of Health Professions University of Alabama at Birmingham Birmingham Alabama USA
| | - Nazik M. A. Zakari
- Department of Nursing, College of Applied Sciences Almaarefa University Dariyah Riyadh Saudi Arabia
| | - Hanadi Y. Hamadi
- Department of Health Administration, Brooks College of Health University of North Florida Jacksonville Florida USA
| | - Aaron Spaulding
- Division of Health Care Delivery Research Center for the Science of Health Care Delivery, College of Medicine, Mayo Clinic Robert D. and Patricia E. Kern Jacksonville Florida USA
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Medicinal Mushroom Leucocalocybe mongolica Imai Extracts Improve Mammary Gland Differentiation in Lactating Rats via Regulating Protein Expression. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:5762847. [PMID: 35761899 PMCID: PMC9233605 DOI: 10.1155/2022/5762847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/27/2022] [Indexed: 11/29/2022]
Abstract
Leucocalocybe mongolica is a known medicinal mushroom in China. It possesses many biological activities. This study investigated the effect of L. mongolica petroleum ether and water extracts (200, 500, and 1,000 mg/kg BW) on mammary gland differentiation during lactation. However, prolactin, growth hormone, progesterone, and estrogen levels were determined in serum by ELISA assay. Immunofluorescence, western blot, and real-time PCR were utilized to evaluate the expression levels of β-casein, α-Lactalbumin, prolactin receptor, progesterone receptor, and STAT-5a. The immunohistochemistry staining was used to detect the presence of steroid receptors. The results showed that petroleum ether and water extracts increased milk yield and milk content of calcium, total fat, total carbohydrate, and total protein. Prolactin and growth hormone levels were significantly upregulated in all treated groups compared with the control group. In contrast, progesterone and estrogen were downregulated. The high doses of petroleum ether and water extracts increased the expression levels of β-Cas, α-Lactalb, PRLR, PR, and STAT-5a. The observation of histological sections showed that the extracts induced higher mammary gland differentiation than the control group. This study is the first to use mushrooms as nutritional supplements to improve milk production and mammary gland differentiation during lactation.
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Providing and Measuring Quality Postpartum Care. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2022. [DOI: 10.1007/s13669-022-00340-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Wang Q, Zhang S. Gender inequality in nutrition intake: Evidence from a large assistance program. ECONOMICS AND HUMAN BIOLOGY 2022; 45:101111. [PMID: 35091348 DOI: 10.1016/j.ehb.2022.101111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/21/2021] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
This paper examines the growth effect of one of the largest nutrition assistance programs in early life. The program covers 5.8 million children in poor rural China and provides 6-24-month old children with a free nutrition supplement that contains nine essential micronutrients. We utilize a phase-in procedure by county for identification and estimate its impact on several early-life health indicators. Robust evidence shows that such nutrition supplements effectively increase boys' weight and reduce their probability of being underweight. No effect is observed on girls of similar age. These health indicators are related to long-term human capital development. The gender differences in policy impact that are identified in this paper have important implications for nutrition subsidy in the early years of life in developing countries.
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Affiliation(s)
- Qing Wang
- International School of Business and Finance, Sun Yat-sen University; Rural Development Institute, Yan'an University, China.
| | - Shiying Zhang
- School of Economics and Management, Harbin Institute of Technology, Shenzhen, China.
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Randhawa JK, Kim ME, Polski A, Reid MW, Mascarenhas K, Brown B, Fabian ID, Kaliki S, Stacey AW, Burner E, Sayegh CS, Poblete RA, Ji X, Zou Y, Sultana S, Rashid R, Sherief ST, Cassoux N, Garcia J, Coronado RD, López AMZ, Ushakova T, Polyakov VG, Roy SR, Ahmad A, Reddy MA, Sagoo MS, Al Harby L, Astbury NJ, Bascaran C, Blum S, Bowman R, Burton MJ, Gomel N, Keren-Froim N, Madgar S, Zondervan M, Berry JL. The Effects of Breastfeeding on Retinoblastoma Development: Results from an International Multicenter Retinoblastoma Survey. Cancers (Basel) 2021; 13:4773. [PMID: 34631159 PMCID: PMC7611784 DOI: 10.3390/cancers13194773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 11/16/2022] Open
Abstract
The protective effects of breastfeeding on various childhood malignancies have been established but an association has not yet been determined for retinoblastoma (RB). We aimed to further investigate the role of breastfeeding in the severity of nonhereditary RB development, assessing relationship to (1) age at diagnosis, (2) ocular prognosis, measured by International Intraocular RB Classification (IIRC) or Intraocular Classification of RB (ICRB) group and success of eye salvage, and (3) extraocular involvement. Analyses were performed on a global dataset subgroup of 344 RB patients whose legal guardian(s) consented to answer a neonatal questionnaire. Patients with undetermined or mixed feeding history, family history of RB, or sporadic bilateral RB were excluded. There was no statistically significant difference between breastfed and formula-fed groups in (1) age at diagnosis (p = 0.20), (2) ocular prognosis measures of IIRC/ICRB group (p = 0.62) and success of eye salvage (p = 0.16), or (3) extraocular involvement shown by International Retinoblastoma Staging System (IRSS) at presentation (p = 0.74), lymph node involvement (p = 0.20), and distant metastases (p = 0.37). This study suggests that breastfeeding neither impacts the sporadic development nor is associated with a decrease in the severity of nonhereditary RB as measured by age at diagnosis, stage of disease, ocular prognosis, and extraocular spread. A further exploration into the impact of diet on children who develop RB is warranted.
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Affiliation(s)
- Jasmeen K. Randhawa
- The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (J.K.R.); (M.E.K.); (A.P.); (M.W.R.); (B.B.)
- USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Mary E. Kim
- The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (J.K.R.); (M.E.K.); (A.P.); (M.W.R.); (B.B.)
- USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Ashley Polski
- The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (J.K.R.); (M.E.K.); (A.P.); (M.W.R.); (B.B.)
- USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Mark W. Reid
- The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (J.K.R.); (M.E.K.); (A.P.); (M.W.R.); (B.B.)
| | | | - Brianne Brown
- The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (J.K.R.); (M.E.K.); (A.P.); (M.W.R.); (B.B.)
| | - Ido Didi Fabian
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (I.D.F.); (N.J.A.); (C.B.); (R.B.); (M.J.B.); (M.Z.)
- Sheba Medical Center, Goldschleger Eye Institute, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (S.B.); (N.K.-F.); (S.M.)
| | - Swathi Kaliki
- The Operation Eyesight Universal Institute for Eye Cancer, Hyderabad 500034, India;
| | - Andrew W. Stacey
- Department of Ophthalmology, University of Washington, Seattle, WA 98195, USA;
| | - Elizabeth Burner
- Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA;
| | - Caitlin S. Sayegh
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA;
| | - Roy A. Poblete
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA;
| | - Xunda Ji
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (X.J.); (Y.Z.)
| | - Yihua Zou
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (X.J.); (Y.Z.)
| | - Sadia Sultana
- Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka 1215, Bangladesh; (S.S.); (R.R.)
| | - Riffat Rashid
- Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka 1215, Bangladesh; (S.S.); (R.R.)
| | - Sadik Taju Sherief
- Department of Ophthalmology, School of Medicine, Addis Ababa University, Addis Ababa 3614, Ethiopia;
| | | | | | - Rosdali Diaz Coronado
- Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru; (R.D.C.); (A.M.Z.L.)
| | | | - Tatiana Ushakova
- N.N. Blokhin National Medical Research Center, Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology, Oncology of Russian Federation, 115478 Moscow, Russia; (T.U.); (V.G.P.)
- Medical Academy of Postgraduate Education, 125445 Moscow, Russia
| | - Vladimir G. Polyakov
- N.N. Blokhin National Medical Research Center, Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology, Oncology of Russian Federation, 115478 Moscow, Russia; (T.U.); (V.G.P.)
- Medical Academy of Postgraduate Education, 125445 Moscow, Russia
| | - Soma Rani Roy
- Chittagong Eye Infirmary & Training Complex, Chittagong 4202, Bangladesh;
| | - Alia Ahmad
- The Children’s Hospital and the Institute of Child Health, Lahore 54000, Pakistan;
| | - M. Ashwin Reddy
- The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK; (M.A.R.); (M.S.S.); (L.A.H.)
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
| | - Mandeep S. Sagoo
- The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK; (M.A.R.); (M.S.S.); (L.A.H.)
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
- UCL Institute of Ophthalmology, London EC1V 2PD, UK
| | - Lamis Al Harby
- The Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK; (M.A.R.); (M.S.S.); (L.A.H.)
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
- UCL Institute of Ophthalmology, London EC1V 2PD, UK
| | - Nicholas John Astbury
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (I.D.F.); (N.J.A.); (C.B.); (R.B.); (M.J.B.); (M.Z.)
| | - Covadonga Bascaran
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (I.D.F.); (N.J.A.); (C.B.); (R.B.); (M.J.B.); (M.Z.)
| | - Sharon Blum
- Sheba Medical Center, Goldschleger Eye Institute, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (S.B.); (N.K.-F.); (S.M.)
| | - Richard Bowman
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (I.D.F.); (N.J.A.); (C.B.); (R.B.); (M.J.B.); (M.Z.)
- Ophthalmology Department, Great Ormond Street Children’s Hospital, London WC1N 3JH, UK
| | - Matthew J. Burton
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (I.D.F.); (N.J.A.); (C.B.); (R.B.); (M.J.B.); (M.Z.)
- UCL Institute of Ophthalmology, London EC1V 2PD, UK
| | - Nir Gomel
- Tel Aviv Sourasky Medical Center, Division of Ophthalmology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 39040, Israel;
| | - Naama Keren-Froim
- Sheba Medical Center, Goldschleger Eye Institute, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (S.B.); (N.K.-F.); (S.M.)
| | - Shiran Madgar
- Sheba Medical Center, Goldschleger Eye Institute, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (S.B.); (N.K.-F.); (S.M.)
| | - Marcia Zondervan
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (I.D.F.); (N.J.A.); (C.B.); (R.B.); (M.J.B.); (M.Z.)
| | - Jesse L. Berry
- The Vision Center at Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (J.K.R.); (M.E.K.); (A.P.); (M.W.R.); (B.B.)
- USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
- Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
- The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA
- Correspondence:
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12
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Bader LR, Ward J, Fouts HN, Jaekel J. Infant Care Practices among Resettled Refugee Mothers from East and Central Africa. CHILDREN (BASEL, SWITZERLAND) 2020; 7:children7060063. [PMID: 32560348 PMCID: PMC7346106 DOI: 10.3390/children7060063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/27/2020] [Accepted: 06/13/2020] [Indexed: 11/20/2022]
Abstract
Refugees often parent under extreme circumstances. Parenting practices have implications for child outcomes, and parenting in the context of refugee resettlement is likely to be dynamic as parents negotiate a new culture. This study examined African origin mothers’ infant care values and practices related to feeding, carrying, and daily activities following resettlement in the Southeastern region of the U.S. Ten African origin mothers were asked about their infant care practices through semi-structured interviews. Results indicated that mothers valued breastfeeding but often chose to use formula as a supplement or instead of breastfeeding. In addition, participants valued carrying their infants close to the body but used equipment such as strollers. Mothers expressed that perceptions of American culture and rules, social support, interactions with community agencies, and the need to engage in formal employment were factors that influenced their infant care practices.
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Affiliation(s)
- Lauren R. Bader
- Institute for Advanced Study in Toulouse, University of Toulouse Capitole, 31080 Toulouse CEDEX 06, France;
| | - Jennifer Ward
- Institute of Agriculture, University of Tennessee, Knoxville, TN 37996, USA;
| | - Hillary N. Fouts
- Department of Child & Family Studies, University of Tennessee Knoxville, Knoxville, TN 37996, USA;
| | - Julia Jaekel
- Department of Child & Family Studies, University of Tennessee Knoxville, Knoxville, TN 37996, USA;
- Department of Psychology, University of Tennessee Knoxville, Knoxville, TN 37996, USA
- Department of Psychology, University of Warwick, Coventry CV4 7AL, UK
- Correspondence:
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13
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Zhuang J, Hitt R, Goldbort J, Gonzalez M, Rodriguez A. Too Old to Be Breastfed? Examination of Pre-Healthcare Professionals' Beliefs About, and Emotional and Behavioral Responses toward Extended Breastfeeding. HEALTH COMMUNICATION 2020; 35:707-715. [PMID: 30822154 DOI: 10.1080/10410236.2019.1584739] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
While breastfeeding seems to be widely accepted in the United States, extended breastfeeding (defined as breastfeeding beyond 12 months of age) tends to be stigmatized. Healthcare professionals are assumed to play a significant role in supporting women who desire to practice extended breastfeeding; however, how healthcare professionals react to extended breastfeeding has not been well understood. This research surveyed 116 healthcare students, who majored in nursing and human medicine, and examined their perceived advantages and disadvantages, emotional responses to, and advice that they would provide to future mothers regarding extended breastfeeding. The results indicated that students responded predominantly with negative emotions and neutral responses to extended breastfeeding, with a small number of participants responding with positive emotions. Many participants believed that it would bring benefits to the child and that it would be burdensome to the mother. Participants displayed a variety of behavioral responses when asked about advice that they would provide to future mothers with whom they will interact in a clinical setting. Practical implications are discussed.
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Affiliation(s)
- Jie Zhuang
- Department of Communication Studies, Texas Christian University
| | - Rose Hitt
- Department of Humanities and Communication, Albany College of Pharmacy and Health Sciences
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14
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Olieman J, Kastelijn W. Nutritional Feeding Strategies in Pediatric Intestinal Failure. Nutrients 2020; 12:E177. [PMID: 31936393 PMCID: PMC7019898 DOI: 10.3390/nu12010177] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 12/31/2019] [Accepted: 01/04/2020] [Indexed: 12/20/2022] Open
Abstract
Intestinal failure is defined as a critical reduction of the gut mass or function, below the minimum needed to absorb nutrients and fluids. The ultimate goal in intestinal failure is to promote bowel adaptation and reach enteral autonomy while a healthy growth and development is maintained. The condition is heterogeneous and complex. Therefore, recommendations for the type and duration of parenteral, enteral, and oral nutrition are variable, with the child's age as an additional key factor. The aim of this review is to provide an overview of nutritional feeding strategies in this heterogeneous population. Different perspectives on nutritional management, nutrition and adaptation, and microbiome and nutrition will be discussed.
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Affiliation(s)
- Joanne Olieman
- Department of Internal Medicine, Division of Dietetics, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 40, 3015 GD Rotterdam, The Netherlands;
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15
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Zhao J, Li M, Freeman B. A Baby Formula Designed for Chinese Babies: Content Analysis of Milk Formula Advertisements on Chinese Parenting Apps. JMIR Mhealth Uhealth 2019; 7:e14219. [PMID: 31782743 PMCID: PMC6911233 DOI: 10.2196/14219] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 09/06/2019] [Accepted: 09/24/2019] [Indexed: 11/23/2022] Open
Abstract
Background China is the largest market for infant formula. With the increasing use of smartphones, apps have become the latest tool used to promote milk formula. Formula manufacturers and distributors both have seized the popularity of apps as an avenue for marketing. Objective This study aimed to identify and analyze milk formula ads featured on Chinese pregnancy and parenting apps, to build the first complete picture of app-based milk formula marketing techniques being used by milk formula brand variants on these apps, and to more fully understand the ad content that potentially undermines public health messaging about infant and young child feeding. Methods We searched for free-to-download Chinese parenting apps in the 360 App Store, the biggest Android app store in China. The final sample consisted of 353 unique formula ads from the 79 apps that met the inclusion criteria. We developed a content analysis coding tool for categorizing the marketing techniques used in ads, which included a total of 22 coding options developed across 4 categories: emotional imagery, marketing elements, claims, and advertising disclosure. Results The 353 milk formula ads were distributed across 31 companies, 44 brands, and 79 brand variants. Overall, 15 of 31 corporations were international with the remaining 16 being Chinese owned. An image of a natural pasture was the most commonly used emotional image among the brand variants (16/79). All variants included branding elements, and 75 variants linked directly to e-shops. Special price promotions were promoted by nearly half (n=39) of all variants. A total of 5 variants included a celebrity endorsement in their advertising. A total of 25 of the 79 variants made a product quality claim. Only 14 variants made a direct advertisement disclosure. Conclusions The purpose of marketing messages is to widen the use of formula and normalize formula as an appropriate food for all infants and young children, rather than as a specialized food for those unable to breastfeed. Policy makers should take steps to establish an appropriate regulatory framework and provide detailed monitoring and enforcement to ensure that milk formula marketing practices do not undermine breastfeeding norms and behaviors.
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Affiliation(s)
- Jing Zhao
- School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia.,China Studies Centre, The University of Sydney, Sydney, Australia
| | - Mu Li
- School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia.,China Studies Centre, The University of Sydney, Sydney, Australia
| | - Becky Freeman
- School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
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16
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Wallenborn JT, Wheeler DC, Lu J, Perera RA, Masho SW. Importance of Familial Opinions on Breastfeeding Practices: Differences Between Father, Mother, and Mother-in-Law. Breastfeed Med 2019; 14:560-567. [PMID: 31298574 DOI: 10.1089/bfm.2019.0049] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Multiple types of individuals compose a mother's social support network. Women may value opinions of individuals' within their support network differently. Our study examined the relationship between breastfeeding opinions from individuals within the social support network and breastfeeding initiation and duration. Materials and Methods: Data from the Infant Feeding Practices Survey II were analyzed. The importance of individuals' opinions on a mother's breastfeeding decision was investigated for the baby's father, the participant's mother and mother-in-law, the infant's pediatrician, and the participant's obstetrician. The main outcomes were breastfeeding initiation (yes; no) and breastfeeding duration (weeks). Logistic regression provided the odds of never breastfeeding, while Cox proportional hazard models were used to assess the risk of breastfeeding cessation. Results: Women who stated that the father's opinion was not at all important were more likely to never breastfeed and prematurely cease breastfeeding compared to women who stated that the father's opinion was very important for their breastfeeding decisions. Conversely, women had lower odds of never breastfeeding and a decreased risk of breastfeeding cessation if they reported that the mother-in-law's opinion was not at all important or not very important compared to women who reported that the mother-in-law was very important. No statistically significant relationship was found between the participant's mother and breastfeeding initiation and cessation. Conclusion: This study found a hierarchical association between individuals in a social support network and breastfeeding initiation and duration. Inverse relationships were found between the importance of fathers' and mother-in-laws' opinions. Interventions aimed at increasing breastfeeding initiation, and duration rates should include a wider range of individuals within a social support network.
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Affiliation(s)
- Jordyn T Wallenborn
- Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - David C Wheeler
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Juan Lu
- Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Robert A Perera
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - Saba W Masho
- Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
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17
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Nutritional status and human milk intake of exclusively breast-fed infants at high altitude in La Paz, Bolivia. Br J Nutr 2019; 120:158-163. [PMID: 29947320 DOI: 10.1017/s0007114518001137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Breast-feeding habits are related to the nutritional status and the risk of illness and death in children under 2 years of age. For the first 6 months, infants should be exclusively breast-fed. This study aimed to evaluate the relationship between the infant's nutritional status and human milk intake by breast-fed infants at high altitude. A quantitative, descriptive, correlational study was conducted including mother/baby pairs of infants aged 2-6 months. The amount of human milk consumed by the infants was assessed by the deuterium oxide dose-to-mother technique. The lipid content of human milk was measured by creamatocrit, and anthropometric measurements were performed. A total of eighteen mother/baby pairs were assessed. The mean human milk intake was 888 (sd 149) g/d, and the intake of water from other sources was 24·3 (sd 29·8) g/d. The lipid content in human milk was 41 (sd 12) g/l. The infant's nutritional indicators were normal in all cases. A moderate positive correlation was found between milk volume and z scores weight-for-length r 0·58 (P=0·01), BMI-for-age r 0·56 (P=0·01) and weight-for-age r 0·45 (P=0·05). There was no correlation with length-for-age z score. The mean of breast milk intake in this study was similar to that found in other studies in the world. The lipid content is comparable to similar studies and was within the normal range. Children older than 3 months showed signs of stunting despite adequate volume and lipid content of breast milk.
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18
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Esselmont E, Moreau K, Aglipay M, Pound CM. Residents' breastfeeding knowledge, comfort, practices, and perceptions: results of the Breastfeeding Resident Education Study (BRESt). BMC Pediatr 2018; 18:170. [PMID: 29788928 PMCID: PMC5964719 DOI: 10.1186/s12887-018-1150-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 05/16/2018] [Indexed: 12/29/2022] Open
Abstract
Background Physicians have a significant impact on new mothers’ breastfeeding practices. However, physicians’ breastfeeding knowledge is suboptimal. This knowledge deficit could be the result of limited breastfeeding education in residency. This study aimed to explore pediatric residents’ breastfeeding knowledge, comfort level, clinical practices, and perceptions. It also investigated the level and type of education residents receive on breastfeeding and their preferences for improving it. Methods Descriptive, cross-sectional, self-reported online questionnaires were sent to all residents enrolled in a Canadian general pediatric residency program, as well as to their program directors. Resident questionnaires explored breastfeeding knowledge, comfort level, clinical practices, perceptions, educational experiences and educational preferences. Program director questionnaires collected data on current breastfeeding education in Canadian centers. For the resident survey, breastfeeding knowledge was calculated as the percent of correct responses. Demographic factors independently associated with overall knowledge score were identified by multiple linear regression. Descriptive statistics were used for the program director survey. Results Overall, 201 pediatric residents, and 14 program directors completed our surveys. Residents’ mean overall breastfeeding knowledge score was 71% (95% CI: 69-79%). Only 4% (95% CI: 2-8%) of residents were very comfortable evaluating latch, teaching parents breastfeeding positioning, and addressing parents’ questions regarding breastfeeding difficulties. Over a quarter had not observed a patient breastfeed. Nearly all agreed or strongly agreed that breastfeeding promotion is part of their role. Less than half reported receiving breastfeeding education during residency and almost all wanted more interactive breastfeeding education. According to pediatric program directors, most of the breastfeeding education residents receive is didactic. Less than a quarter of program directors felt that the amount of breastfeeding education provided was adequate. Conclusion Pediatric residents in Canada recognize that they play an important role in supporting breastfeeding. Most residents lack the knowledge and training to manage breastfeeding difficulties but are motivated to learn more about breastfeeding. Pediatric program directors recognize the lack of breastfeeding education.
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Affiliation(s)
- Elizabeth Esselmont
- University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.,Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Katherine Moreau
- University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada
| | - Mary Aglipay
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 5B2, Canada
| | - Catherine M Pound
- University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada. .,Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
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19
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Habibi M, Laamiri FZ, Aguenaou H, Doukkali L, Mrabet M, Barkat A. The impact of maternal socio-demographic characteristics on breastfeeding knowledge and practices: An experience from Casablanca, Morocco. Int J Pediatr Adolesc Med 2018; 5:39-48. [PMID: 30805532 PMCID: PMC6363246 DOI: 10.1016/j.ijpam.2018.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 12/24/2017] [Accepted: 01/18/2018] [Indexed: 12/21/2022]
Abstract
Background Breastfeeding is universally recognized by the World Health Organization as the best way of feeding infants. Therefore, several countries have initiated health promotion interventions to support successful breastfeeding based on the factors influencing breastfeeding outcomes. Objective To examine the association between the knowledge of breastfeeding and maternal socioeconomic and demographic characteristics, and to determine any impact on child nutritional status. Methods A cross-sectional study using both qualitative and quantitative methods was conducted with mothers of infants aged six- to twenty-four months. Data was collected by a semi-structured questionnaire and face-to-face, in-depth interviews with mothers to get an insight into their breastfeeding perceptions and experiences. Educational achievement and occupational class were used as indicators of socio-demographic status. Nutritional status was assessed by anthropometric measurements. Results A significant relationship between exclusive breastfeeding and the mother's education (P < .001) and socio-economic status (P < .001) has been highlighted. A significant link was pointed out between breastfeeding and length-for-age Z score (LAZ) (P < .001), and weight-for-age Z score (WAZ) (P = .005). Moreover, a strong association was found between maternal employment and exclusive breastfeeding (P < .001). Conclusions Our findings shed some light on challenges faced by mothers, as well as an association between socio-demographic characteristics and practices for facilitating exclusive breastfeeding to guide the mothers in breastfeeding management.
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Affiliation(s)
- Mouna Habibi
- Research Team on Health and Nutrition of Mother and Child, University Mohammed V, Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Fatima Zahra Laamiri
- Research Team on Health and Nutrition of Mother and Child, University Mohammed V, Faculty of Medicine and Pharmacy, Rabat, Morocco.,Higher Institute of Nursing Professions and Technical Health, Rabat, Morocco
| | - Hassan Aguenaou
- Joint Unit for Nutrition and Food Research at Ibn Tofaïl University (URAC 39), National Centre for Nuclear Energy, Sciences and Technology (CNESTEN), RDC-Nutrition AFRA/AIEA, Morocco
| | - Loubna Doukkali
- Research Team on Health and Nutrition of Mother and Child, University Mohammed V, Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Mustapha Mrabet
- Research Team on Health and Nutrition of Mother and Child, University Mohammed V, Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Amina Barkat
- Research Team on Health and Nutrition of Mother and Child, University Mohammed V, Faculty of Medicine and Pharmacy, Rabat, Morocco.,National Reference Center for Neonatology and Nutrition, Children's Hospital, Ibn Sina University Hospital Centre, Rabat, Morocco
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20
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Shen J, Zhang BM, Zhu SG, Chen JJ. No direct correlation between rotavirus diarrhea and breast feeding: A meta-analysis. Pediatr Neonatol 2018; 59:129-135. [PMID: 28958831 DOI: 10.1016/j.pedneo.2017.06.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 05/04/2017] [Accepted: 06/16/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Some studies indicated that children with exclusive breast feeding had a reduction in the prevalence of rotavirus diarrhea, while some others held the opposite views. In this study, we aimed to systematically find the associations between rotavirus diarrhea and breast feeding. METHODS A literature search up to June 2016 in electronic literature databases, including PubMed and Embase, was performed. The Newcastle-Ottawa Scale was used to conduct the quality assessment of all the selected studies. Statistical analyses were performed using the R package version 3.12 (R Foundation for Statistical Computing, Beijing1, China, meta package), and odds ratio (OR) and 95% confidence interval (CI) were used to assess the strength of the association. The heterogeneity was assessed by Cochran's Q-statistic and I2 test, and the sensitivity analysis was performed by trimming one study at a time. RESULTS A total of 17 articles, which included 10,841 participants, were investigated in the present meta-analysis. There was no significant difference between the case group and control group (OR, 0.59 95% CI 0.33-1.07) in the meta-analysis of exclusive breast feeding, and no significant difference was found between the case group and the control group (OR, 0.86; 95% CI 0.63-1.16) in the meta-analysis of breast feeding. No significant difference was found between the case group and control group (OR, 0.78 95% CI 0.59-1.04) for all quantitative data. CONCLUSIONS There may be no direct correlation between rotavirus diarrhea and breast feeding.
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Affiliation(s)
- Jian Shen
- Department of Pediatrics, SHUGUANG Hospital Attached to the Shanghai University of Traditional Chinese Medical, Shanghai 201203, China.
| | - Bi-Meng Zhang
- Department of Acupuncture and Moxibustion, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, China
| | - Sheng-Guo Zhu
- Department of Pediatrics, SHUGUANG Hospital Attached to the Shanghai University of Traditional Chinese Medical, Shanghai 201203, China
| | - Jian-Jie Chen
- Department of Infectious Diseases, SHUGUANG Hospital Attached to the Shanghai University of Traditional Chinese Medical, Shanghai 201203, China.
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21
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Thompson JMD, Tanabe K, Moon RY, Mitchell EA, McGarvey C, Tappin D, Blair PS, Hauck FR. Duration of Breastfeeding and Risk of SIDS: An Individual Participant Data Meta-analysis. Pediatrics 2017; 140:peds.2017-1324. [PMID: 29084835 DOI: 10.1542/peds.2017-1324] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2017] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Sudden infant death syndrome (SIDS) is a leading cause of postneonatal infant mortality. Our previous meta-analyses showed that any breastfeeding is protective against SIDS with exclusive breastfeeding conferring a stronger effect.The duration of breastfeeding required to confer a protective effect is unknown. OBJECTIVE To assess the associations between breastfeeding duration and SIDS. DATA SOURCES Individual-level data from 8 case-control studies. STUDY SELECTION Case-control SIDS studies with breastfeeding data. DATA EXTRACTION Breastfeeding variables, demographic factors, and other potential confounders were identified. Individual-study and pooled analyses were performed. RESULTS A total of 2267 SIDS cases and 6837 control infants were included. In multivariable pooled analysis, breastfeeding for <2 months was not protective (adjusted odds ratio [aOR]: 0.91, 95% confidence interval [CI]: 0.68-1.22). Any breastfeeding ≥2 months was protective, with greater protection seen with increased duration (2-4 months: aOR: 0.60, 95% CI: 0.44-0.82; 4-6 months: aOR: 0.40, 95% CI: 0.26-0.63; and >6 months: aOR: 0.36, 95% CI: 0.22-0.61). Although exclusive breastfeeding for <2 months was not protective (aOR: 0.82, 95% CI: 0.59-1.14), longer periods were protective (2-4 months: aOR: 0.61, 95% CI: 0.42-0.87; 4-6 months: aOR: 0.46, 95% CI: 0.29-0.74). LIMITATIONS The variables collected in each study varied slightly, limiting our ability to include all studies in the analysis and control for all confounders. CONCLUSIONS Breastfeeding duration of at least 2 months was associated with half the risk of SIDS. Breastfeeding does not need to be exclusive to confer this protection.
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Affiliation(s)
- John M D Thompson
- Department of Paediatrics: Child and Youth Health and Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand;
| | | | - Rachel Y Moon
- Pediatrics, University of Virginia, Charlottesville, Virginia
| | - Edwin A Mitchell
- Department of Paediatrics: Child and Youth Health and Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
| | - Cliona McGarvey
- National Paediatric Mortality Register, Temple Street Children's University Hospital, Dublin, Ireland
| | - David Tappin
- Department of Child Health, School of Medicine, University of Glasgow, Glasgow, United Kingdom; and
| | - Peter S Blair
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
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22
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Abstract
BACKGROUND More than 95% of higher-order multiples are born preterm and more than 90% are low birth weight, making this group of infants especially vulnerable to sudden infant death syndrome (SIDS). Emerging evidence suggests that families with twins face challenges adhering to the American Academy of Pediatrics (AAP) recommendations to reduce SIDS risks. Adherence to the AAP recommendations in families with higher-order multiples has not been described. PURPOSE This study describes SIDS risk reduction infant care practices for higher-order multiples during the first year of life. METHODS Mothers caring for higher-order multiple-birth infants were recruited from an online support group. An online survey was used to assess infant care practices when the infants were first brought home from the hospital as well as at the time of the survey. RESULTS Ten mothers of triplets and 4 mothers of quadruplets responded. Less than 80% of the mothers practiced "back to sleep" immediately postdischarge. Supine sleep positioning decreased over time, particularly during daytime naps. Only 50% of the infants shared the parents' bedroom and approximately 30% bed-shared with their siblings. Sleep-time pacifier use was low. IMPLICATIONS FOR PRACTICE Safe sleep education must include specific questions regarding home sleeping arrangements, encouragement of breast milk feedings, supine positioning, and pacifier use at every sleep for higher-order multiple infants well before discharge in order for parents to plan a safe sleep environment at home. IMPLICATIONS FOR RESEARCH Prospective studies to identify barriers and facilitators can inform future strategies supporting adherence to safe sleep practices for higher-order multiple infants.
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23
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Moon RY, Mathews A, Joyner BL, Oden RP, He J, McCarter R. Impact of a Randomized Controlled Trial to Reduce Bedsharing on Breastfeeding Rates and Duration for African-American Infants. J Community Health 2017; 42:707-715. [PMID: 28064421 PMCID: PMC7327503 DOI: 10.1007/s10900-016-0307-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Bedsharing is associated with both increased breastfeeding and increased risk of sudden and unexpected infant deaths. The objective was to determine impact of sleep location and counseling about sleep location on breastfeeding exclusivity and duration in African-Americans. 1194 mothers of newborns were randomized to receive messaging emphasizing either safe sleep practices to reduce SIDS risk or safe sleep practices to prevent SIDS/suffocation. Mothers completed four interviews in the 6 months after delivery. The most common sleep arrangement was roomsharing without bedsharing ("roomsharing"). Duration of any breastfeeding was 6.1 and 5.3 weeks for infants who usually bedshared or roomshared, respectively (p = 0.01). Duration of exclusive breastfeeding was 3.0 and 1.6 weeks for infants who usually bedshared or roomshared, respectively (p < 0.001). Group assignment did not affect breastfeeding duration. The most common sleep arrangement for African-American infants <6 months was roomsharing. An intervention designed to discourage bedsharing did not impact breastfeeding duration.
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Affiliation(s)
- Rachel Y Moon
- Division of General Pediatrics, Department of Pediatrics, University of Virginia, PO Box 800386, Charlottesville, VA, 22908, USA.
| | - Anita Mathews
- Division of General Pediatrics and Community Health, Children's National Medical Center, Washington, DC, USA
| | - Brandi L Joyner
- Division of General Pediatrics and Community Health, Children's National Medical Center, Washington, DC, USA
| | - Rosalind P Oden
- Division of General Pediatrics and Community Health, Children's National Medical Center, Washington, DC, USA
| | - Jianping He
- Center for Translational Science, Children's National Medical Center, Washington, DC, USA
| | - Robert McCarter
- Center for Translational Science, Children's National Medical Center, Washington, DC, USA
- Department of Pediatrics, George Washington University, Washington, DC, USA
- Department of Epidemiology and Biostatistics, Washington, DC, USA
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Gizaw Z, Woldu W, Bitew BD. Child feeding practices and diarrheal disease among children less than two years of age of the nomadic people in Hadaleala District, Afar Region, Northeast Ethiopia. Int Breastfeed J 2017; 12:24. [PMID: 28592985 PMCID: PMC5460459 DOI: 10.1186/s13006-017-0115-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 05/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diarrhea is a serious public health problem in Ethiopia. It is responsible for 24-30% of all infant deaths and there is a lack of evidence on the health burdens among the nomadic people. This study was therefore designed to assess the prevalence of diarrhea among children less thanvtwo year's of age and its association with feeding practices among the nomadic people in Hadaleala district, northeast Ethiopia. METHODS A cross-sectional study was conducted in Hadaleala district. A total of 367 children less than two years of age were included using the multistage cluster sampling technique. Data were collected by a structured questionnaire. Multivariable binary logistic regression analysis was used to identify variables associated with diarrheal disease. RESULTS The prevalence of diarrhea among children less than two year's of age during the two week period was 31.3% (95% CI, 25.9, 36.1%). Diarrhea occurrence was associated with; children aged between 6-11 months (AOR 6.28, 95% CI, 3.00, 13.12), aged between 12-24 months (AOR 6.21, 95% CI, 3.13, 12.30), illiterate mothers (AOR 6.61, 95% CI, 2.27, 19.21), delay to initiate early breastfeeding for children aged less than six months (AOR 9.13, 95% CI, 1.78, 46.72), children less than six months of age not currently exclusively breastfed (AOR 13.33, 95% CI, 1.59, 112.12), delay to initiate early breastfeeding for children aged 6-24 months (AOR 2.87, 95% CI, 1.49, 5.51), no breastfeeding at the time of the survey (AOR 3.51, 95% CI, 1.57, 7.82), children aged 6-24 months who didn't exclusively breastfeed in the first six months (AOR 19.24, 95% CI, 8.26, 44.82), consuming uncooked foods (AOR 6.99, 95% CI, 2.89, 16.92), not eating cooked foods immediately after cooking (AOR 3.74, 95% CI, 1.48, 9.45), hand washing with only water (AOR 24.94, 95% CI, 6.68, 93.12), and rotavirus vaccination (AOR 0.09, 95% CI, 0.03, 0.29). CONCLUSIONS The prevalence of diarrhea among children less than two year's of age in Hadaleala district was high. To prevent diarrhea, the mothers should start breastfeeding early and practice exclusive breastfeeding. Moreover, mothers should improve the hygiene of supplementary foods.
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Affiliation(s)
- Zemichael Gizaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wondwoson Woldu
- Hadaleala District Health Office, Hadaleala District, Afar Regional State Ethiopia
| | - Bikes Destaw Bitew
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Naz S, Page A, Agho KE. Household air pollution from use of cooking fuel and under-five mortality: The role of breastfeeding status and kitchen location in Pakistan. PLoS One 2017; 12:e0173256. [PMID: 28278260 PMCID: PMC5344381 DOI: 10.1371/journal.pone.0173256] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 02/17/2017] [Indexed: 11/19/2022] Open
Abstract
Household air pollution (HAP) mainly from cooking fuel is one of the major causes of respiratory illness and deaths among young children in low and middle-income countries like Pakistan. This study investigates for the first time the association between HAP from cooking fuel and under-five mortality using the 2013 Pakistan Demographic and Health Survey (PDHS) data. Multi-level logistic regression models were used to examine the association between HAP and under-five mortality in a total of 11,507 living children across four age-groups (neonatal aged 0-28 days, post-neonatal aged 1-11 months, child aged 12-59 months and under-five aged 0-59 months). Use of cooking fuel was weakly associated with total under-five mortality (OR = 1.22, 95%CI = 0.92-1.64, P = 0.170), with stronger associations evident for sub-group analyses of children aged 12-59 months (OR = 1.98, 95%CI = 0.75-5.25, P = 0.169). Strong associations between use of cooking fuel and mortality were evident (ORs >5) in those aged 12-59 months for households without a separate kitchen using polluting fuels, and in children whose mother never breastfed. The results of this study suggest that HAP from cooking fuel is associated with a modest increase in the risk of death among children under five years of age in Pakistan, but particularly in those aged 12-59 months, and those living in poorer socioeconomic conditions. To reduce exposure to cooking fuel which is a preventable determinant of under-five mortality in Pakistan, the challenge remains to promote behavioural interventions such as breastfeeding in infancy period, keeping young children away from the cooking area, and improvements in housing and kitchen design.
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Affiliation(s)
- Sabrina Naz
- Centre of Health Research, School of Medicine, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia
| | - Andrew Page
- Centre of Health Research, School of Medicine, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia
| | - Kingsley Emwinyore Agho
- School of Science and Health, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia
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Wood NK, Sanders EA. Mothers With Perceived Insufficient Milk: Preliminary Evidence of Home Interventions to Boost Mother–Infant Interactions. West J Nurs Res 2017; 40:1184-1202. [DOI: 10.1177/0193945916687552] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Perceived insufficient milk (PIM) is the primary reason for breastfeeding discontinuation globally. This study evaluated the short-term impact of mother–infant interactions through home interventions designed to overcome PIM as a result of the infant’s behavior, delivered to 14 dyads of breastfeeding mothers and their full-term singleton infants. A single group, three-occasion prepost design was used. Mother–infant interactions were measured by the Nursing Child Assessment Feeding Scale (NCAFS) at 6, 13, and 27 days postpartum. There were significantly increased mother–infant interactions during intervention. Specifically, significant growth over the intervention occurred for mother’s sensitivity to cues, cognitive growth fostering, infant’s clarity of cues, and responsiveness to caregiver. The NCAFS total score was also significantly improved. Although modifications are required, the three home intervention sessions showed promise in improving mother–infant interactions during breastfeeding. Further investigation using a randomized experimental design is warranted.
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Moon RY. SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment. Pediatrics 2016; 138:peds.2016-2940. [PMID: 27940805 DOI: 10.1542/peds.2016-2940] [Citation(s) in RCA: 356] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Approximately 3500 infants die annually in the United States from sleep-related infant deaths, including sudden infant death syndrome (SIDS), ill-defined deaths, and accidental suffocation and strangulation in bed. After an initial decrease in the 1990s, the overall sleep-related infant death rate has not declined in more recent years. Many of the modifiable and nonmodifiable risk factors for SIDS and other sleep-related infant deaths are strikingly similar. The American Academy of Pediatrics recommends a safe sleep environment that can reduce the risk of all sleep-related infant deaths. Recommendations for a safe sleep environment include supine positioning, use of a firm sleep surface, room-sharing without bed-sharing, and avoidance of soft bedding and overheating. Additional recommendations for SIDS risk reduction include avoidance of exposure to smoke, alcohol, and illicit drugs; breastfeeding; routine immunization; and use of a pacifier. New evidence and rationale for recommendations are presented for skin-to-skin care for newborn infants, bedside and in-bed sleepers, sleeping on couches/armchairs and in sitting devices, and use of soft bedding after 4 months of age. In addition, expanded recommendations for infant sleep location are included. The recommendations and strength of evidence for each recommendation are published in the accompanying policy statement, "SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment," which is included in this issue.
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Abstract
BACKGROUND Breastfeeding initiation rates vary considerably across racial and ethnic groups, maternal age, and education level, yet there are limited data concerning the influence of geography on community rates of breastfeeding initiation. OBJECTIVE This study aimed to describe how community rates of breastfeeding initiation vary in geographic space, highlighting "hot spots" and "cool spots" of initiation and exploring the potential connections between race, socioeconomic status, and urbanization levels on these patterns. METHODS Birth certificate data from the Kentucky Department of Health for 2004-2010 were combined with county-level geographic base files, Census 2010 demographic and socioeconomic data, and Rural-Urban Continuum Codes to conduct a spatial statistical analysis of community rates of breastfeeding initiation. RESULTS Between 2004 and 2010, the average rate of breastfeeding initiation for Kentucky increased from 43.84% to 49.22%. Simultaneously, the number of counties identified as breastfeeding initiation hot spots also increased, displaying a systematic geographic pattern in doing so. Cool spots of breastfeeding initiation persisted in rural, Appalachian Kentucky. Spatial regression results suggested that unemployment, income, race, education, location, and the availability of International Board Certified Lactation Consultants are connected to breastfeeding initiation. CONCLUSION Not only do spatial analytics facilitate the identification of breastfeeding initiation hot spots and cool spots, but they can be used to better understand the landscape of breastfeeding initiation and help target breastfeeding education and/or support efforts.
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Affiliation(s)
- Tony H Grubesic
- 1 Center for Spatial Reasoning & Policy Analytics, College of Public Service & Community Solutions, Arizona State University, Phoenix, AZ, USA
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Wallenborn JT, Masho SW, Ratliff S. Paternal Pregnancy Intention and Breastfeeding Duration: Findings from the National Survey of Family Growth. Matern Child Health J 2016; 21:554-561. [DOI: 10.1007/s10995-016-2139-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Harrison A, Fletcher-Groves S, Gordon-Strachan G, Thame M. Factors Affecting the Choice and Desire to Exclusively Breastfeed in Jamaica: A Cross-Sectional Study at 6 Weeks Postpartum. J Hum Lact 2016; 32:292-300. [PMID: 26138917 DOI: 10.1177/0890334415593540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 06/01/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND Exclusive breastfeeding rates (EBRs) may be influenced by sociodemographic and sociocultural factors, including maternal age, socioeconomic status, education, and breastfeeding knowledge. The EBR in Jamaica has been low and declining, leaving a need for better determination of the specific local contributory factors. OBJECTIVES This study aimed to better elucidate the factors that influence mothers exclusively breastfeeding, including antenatal intentions to breastfeed, mothers' knowledge of the benefits of breastfeeding, and mothers' infant feeding practices in general, inclusive of breastfeeding, formula feeding, and complementary feeding. METHODS A cross-sectional survey was conducted using a 52-item interviewer-administered questionnaire with mothers attending their 6-week postnatal clinic visit. Sociodemographic data were collected on all participants as well as data regarding participants' breastfeeding knowledge, attitudes, and practices. Statistical analyses were done using χ(2) tests, t tests, and risk analyses. RESULTS Two hundred participants were interviewed; the mean ± SD age of participants was 26.2 ± 6.46 years (range, 15-46 years). The EBR in this study sample was 32%. Sociodemographic factors, including maternal age and socioeconomic status, as well as antenatal and postnatal breastfeeding sessions, did not significantly affect the likelihood of exclusively breastfeeding at 6 weeks postpartum. The only factor significantly associated with the EBR was mothers' belief that exclusively breastfeeding was able to ensure infant satiety. CONCLUSION Antenatal and postnatal breastfeeding sessions should place more emphasis on dispelling maternal myths and misperceptions regarding signs of satiety and hunger in infants and reinforcing the knowledge that breast milk alone is sufficient for the first 6 months of life.
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Affiliation(s)
- Abigail Harrison
- Department of Child and Adolescent Health, University of the West Indies, Kingston, Jamaica
| | - Shani Fletcher-Groves
- Department of Child and Adolescent Health, University of the West Indies, Kingston, Jamaica
| | | | - Minerva Thame
- Department of Child and Adolescent Health, University of the West Indies, Kingston, Jamaica
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Naz S, Page A, Agho KE. Household air pollution and under-five mortality in India (1992-2006). Environ Health 2016; 15:54. [PMID: 27113939 PMCID: PMC4845508 DOI: 10.1186/s12940-016-0138-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 04/19/2016] [Indexed: 05/16/2023]
Abstract
BACKGROUND Household air pollution (HAP) - predominantly from cooking fuel is a major public health hazard and one of the leading causes of respiratory illness and deaths among children under-five years in India. This study investigates the association between HAP from cooking fuel and under-five mortality using India's National Family and Health Survey (NFHS) datasets over the period 1992-2006 (total of 166,382 children), and the extent to which the association differed by environmental and behavioral factors affecting level of exposure. METHODS The association between HAP and under-five mortality of three age-groups (neonatal age between 0-28 days, post-neonatal age between 1-11 months and children aged between 12-59 months) was examined using multi-level logistic regression models. RESULTS HAP was associated with mortality among children aged under-five (OR = 1.30, 95%CI = 1.18-1.43, P < 0.001) and was more strongly associated in sub-group analyses of post-neonatal mortality (OR = 1.42, 95%CI = 1.19-1.71, P < 0.001) and child mortality (OR = 1.42, 95%CI = 1.05-1.91, P = 0.021) than neonatal mortality (OR = 1.23, 95%CI = 1.09-1.39, P = 0.001). The association was stronger for households in rural areas and for households without a separate kitchen using polluting fuel, and in women who had never breastfed for all age-groups. CONCLUSION Use of cooking fuel in the household is associated with increased risk of mortality in children aged under-five years. Factors relating to access to clean fuels, improvements in infrastructure and household design and behavioral factors are discussed, and can result in further declines in under-five mortality in India.
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Affiliation(s)
- Sabrina Naz
- />Centre of Health Research, School of Medicine, Western Sydney University, Building 3, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia
| | - Andrew Page
- />Centre of Health Research, School of Medicine, Western Sydney University, Building 3, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia
| | - Kingsley Emwinyore Agho
- />School of Science and Health, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia
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Characteristics associated with breastfeeding behaviors among urban versus rural women enrolled in the Kansas WIC program. Matern Child Health J 2015; 19:828-39. [PMID: 25047788 DOI: 10.1007/s10995-014-1580-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a public nutritional assistance program for low-income women and their children up to age five. This study provides insight into maternal characteristics associated with breastfeeding among urban versus rural women. A secondary analysis was conducted using the Pregnancy Nutrition Surveillance System dataset of women enrolled in the Kansas WIC program in 2011. Geographic residency status was obtained through application of the Census tract-based rural-urban commuting area codes. Descriptive variables included maternal demographics, health, and lifestyle behaviors. A multivariable binary logistic regression was used to obtain adjusted odds ratios with 95 % confidence intervals. The outcome variable was initiation of breastfeeding. A P value of ≤0.05 was considered statistically significant. The total sample size was 17,067 women. Statistically significant differences regarding socio-demographics, program participation, and health behaviors for urban and rural WIC participants were observed. About 74 % of all WIC mothers initiated breastfeeding. Urban women who were Hispanic, aged 18-19, high school graduates, household income >$10,000/year, and started early prenatal care were more likely to breastfeed. Urban and rural women who were non-Hispanic black with some high school education were less likely to breastfeed. Increased breastfeeding initiation rates are the result of a collaborative effort between WIC and community organizations. Availability of prenatal services to rural women is critical in the success of breastfeeding promotion. Findings help inform WIC program administrators and assist in enhancing breastfeeding services to the Kansas WIC population.
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Household Air Pollution and Under-Five Mortality in Bangladesh (2004-2011). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:12847-62. [PMID: 26501296 PMCID: PMC4627003 DOI: 10.3390/ijerph121012847] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 08/30/2015] [Accepted: 10/09/2015] [Indexed: 11/17/2022]
Abstract
Household air pollution (HAP) is one of the leading causes of respiratory illness and deaths among children under five years in Bangladesh. This study investigates the association between HAP from cooking fuel and under-five mortality using Bangladesh Demographic and Health Survey (BDHS) datasets over the period 2004–2011 (n = 18,308 children), and the extent to which this association differed by environmental and behavioral factors affecting level of exposure. The association between HAP and neonatal (age between 0–28 days), infant (age between 0 and 11 months) and under–five (age between 0 and 59 months) mortality was examined using multilevel logistic regression models. HAP was not strongly associated with overall neonatal (OR = 1.49, 95% CI = 1.01–2.22, p = 0.043), infant (OR = 1.27, 95% CI = 0.91–1.77, p = 0.157) or under-five mortality (OR = 1.14, 95% CI = 0.83–1.55, p = 0.422) in the context of overall decreasing trends in under-five mortality. The association was stronger for households with an indoor kitchen using polluting fuels, and in women who had never breastfed. Reductions in exposure to pollution from cooking fuel, given it is a ubiquitous and modifiable risk factor, can result in further declines in under-five mortality with household design and behavioural interventions.
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Smoking Behaviors Among Urban and Rural Pregnant Women Enrolled in the Kansas WIC Program. J Community Health 2015; 40:1037-46. [DOI: 10.1007/s10900-015-0029-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Dritsakou K, Liosis G, Valsami G, Polychronopoulos E, Skouroliakou M. Improved outcomes of feeding low birth weight infants with predominantly raw human milk versus donor banked milk and formula. J Matern Fetal Neonatal Med 2015; 29:1131-8. [DOI: 10.3109/14767058.2015.1038232] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Pound CM, Moreau K, Rohde K, Barrowman N, Aglipay M, Farion KJ, Plint AC. Lactation support and breastfeeding duration in jaundiced infants: a randomized controlled trial. PLoS One 2015; 10:e0119624. [PMID: 25747308 PMCID: PMC4351896 DOI: 10.1371/journal.pone.0119624] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Accepted: 01/23/2015] [Indexed: 11/18/2022] Open
Abstract
Objectives Neonatal jaundice is the most common problem in full-term infants during the immediate post-natal period. We examined the effect of a lactation support intervention on breastfeeding duration in hospitalized jaundiced infants. Study Design We conducted a randomized controlled trial with a qualitative component involving mothers of hospitalized jaundiced breastfed infants <4 weeks of age. Mothers receiving the intervention met with an International Board-Certified Lactation Consultant in hospital and 1–3 times post discharge. Both groups received the standard care for jaundice. The primary outcome was exclusive breastfeeding at 3 months. To the exception of research assistants enrolling participants and completing qualitative interviews, all research staff, investigators and statisticians were blinded to group assignment. Qualitative interviews elicited feedback on breastfeeding experiences for both groups. Results 99 participants were recruited, and 86 analyzed for primary outcome. There was no difference in exclusive breastfeeding at 3 months between groups (RR 0.84, 95% CI 0.56–1.24, p = 0.40) or in the secondary outcomes. 31 participants were included in the qualitative analysis. Participants in the intervention group described an increase in comfort and confidence levels with breastfeeding. Participants in the control group reported limited lactation support. Conclusions Our hospital-based lactation support program did not result in a higher proportion of mothers exclusively breastfeeding at 3 months compared to current hospital standard care. Qualitative feedback from the intervention group suggests that mothers’ confidence was increased, which is linked to breastfeeding duration. The decision to breastfeed is multifactorial and hospital-based lactation support may be only a small piece of the puzzle in hospitalized jaundiced infants. Further studies may be needed to fully elucidate the impact of an in-hospital lactation support program on successful breastfeeding for these infants. Trial Registration ClinicalTrials.gov NCT00966719 https://www.clinicaltrials.gov/ct2/show/NCT00966719?term=Lactation+Support+and+Breastfeeding+Duration+in+Jaundiced+Infants%3A+a+Randomized+Controlled+Trial&rank=1
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Affiliation(s)
- Catherine M. Pound
- Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
- * E-mail:
| | - Katherine Moreau
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Kristina Rohde
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Research Unit, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Nick Barrowman
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Mary Aglipay
- Clinical Research Unit, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Ken J. Farion
- Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Amy C. Plint
- Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
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Abstract
The prevalence of breastfeeding in France is one of the lowest in Europe: 65% of infants born in France in 2010 were breastfed when leaving the maternity ward. Exclusive breastfeeding allows normal growth until at least 6 months of age, and can be prolonged until the age of 2 years or more, provided that complementary feeding is started after 6 months. Breast milk contains hormones, growth factors, cytokines, immunocompetent cells, etc., and has many biological properties. The composition of breast milk is influenced by gestational and postnatal age, as well as by the moment of the feed. Breastfeeding is associated with slightly enhanced performance on tests of cognitive development. Exclusive breastfeeding for at least 3 months is associated with a lower incidence and severity of diarrhoea, otitis media and respiratory infection. Exclusive breastfeeding for at least 4 months is associated with a lower incidence of allergic disease (asthma, atopic dermatitis) during the first 2 to 3 years of life in at-risk infants (infants with at least one first-degree relative presenting with allergy). Breastfeeding is also associated with a lower incidence of obesity during childhood and adolescence, as well as with a lower blood pressure and cholesterolemia in adulthood. However, no beneficial effect of breastfeeding on cardiovascular morbidity and mortality has been shown. Maternal infection with hepatitis B and C virus is not a contraindication to breastfeeding, as opposed to HIV infection and galactosemia. A supplementation with vitamin D and K is necessary in the breastfed infant. Very few medications contraindicate breastfeeding. Premature babies can be breastfed and/or receive mother's milk and/or bank milk, provided they receive energy, protein and mineral supplements. Return to prepregnancy weight is earlier in breastfeeding mothers during the 6 months following delivery. Breastfeeding is also associated with a decreased risk of breast and ovarian cancer in the premenopausal period, and of osteoporosis in the postmenopausal period.
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Breast, Formula and Combination Feeding in Relation to Childhood Obesity in Nova Scotia, Canada. Matern Child Health J 2015; 19:2048-56. [DOI: 10.1007/s10995-015-1717-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ezeh OK, Agho KE, Dibley MJ, Hall JJ, Page AN. The effect of solid fuel use on childhood mortality in Nigeria: evidence from the 2013 cross-sectional household survey. Environ Health 2014; 13:113. [PMID: 25514998 PMCID: PMC4290397 DOI: 10.1186/1476-069x-13-113] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 11/28/2014] [Indexed: 05/17/2023]
Abstract
BACKGROUND In Nigeria, approximately 69% of households use solid fuels as their primary source of domestic energy for cooking. These fuels produce high levels of indoor air pollution. This study aimed to determine whether Nigerian children residing in households using solid fuels at <5 years of age were at higher risk of death. METHODS The 2013 Nigeria Demographic and Health Survey data were analysed in Cox regression analyses to examine the effects of solid fuel use on deaths of children aged 0-28 days (neonatal), 1-11 months (post-neonatal), and 12-59 months (child). RESULTS The results indicated that approximately 0.8% of neonatal deaths, 42.9% of post-neonatal deaths, and 36.3% of child deaths could be attributed to use of solid fuels. The multivariable analyses found that use of solid fuel was associated with post-neonatal mortality (hazard ratio [HR] =1.92, 95% confidence interval [CI]: 1.42-2.58) and child mortality (HR = 1.63, CI: 1.09-2.42), but was not associated with neonatal mortality (HR = 1.01, CI: 0.73-1.26). Living in rural areas and poor households were associated with an increased risk of death during the three mortality periods. CONCLUSION Living in a rural area and poor households were strongly associated with an increased risk of a child > 1 to < 60 months dying due to use of solid fuels. The health effects of household use of solid fuels are a major public health threat that requires increased research and policy development efforts. Research should focus on populations in rural areas and low socioeconomic households so that child survival in Nigeria can be improved.
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Affiliation(s)
- Osita Kingsley Ezeh
- />School of Medicine, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2571 Australia
| | - Kingsley Emwinyore Agho
- />School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2571 Australia
| | - Michael John Dibley
- />Sydney School of Public Health, University of Sydney, Edward Ford Building (A27), Sydney, NSW 2006 Australia
| | - John Joseph Hall
- />School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW 2308 Australia
| | - Andrew Nicolas Page
- />School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2571 Australia
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Liu A, Dai Y, Xie X, Chen L. Implementation of international code of marketing breast-milk substitutes in China. Breastfeed Med 2014; 9:467-72. [PMID: 25026262 DOI: 10.1089/bfm.2014.0053] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Breastmilk is the best source of nourishment for infants and young children, and breastfeeding is one of the most effective ways to ensure child health and survival. In May 1981, the World Health Assembly adopted the International Code of Marketing Breast-Milk Substitutes. Since then several subsequent resolutions have been adopted by the World Health Assembly, which both update and clarify the articles within the International Code (herein after the term "Code" refers to both the International Code and all subsequent resolutions). The Code is designed to regulate "inappropriate sales promotion" of breastmilk substitutes and instructs signatory governments to ensure the implementation of its aims through legislation. The Chinese Regulations of the Code were adopted by six government sectors in 1995. However, challenges in promotion, protection, and support of breastfeeding remain. This study aimed to monitor the implementation of the Code in China. SUBJECTS AND METHODS Six cities were selected with considerable geographic coverage. In each city three hospitals and six stores were surveyed. The International Baby Food Action Network Interview Form was adapted, and direct observations were made. Research assistants administered the questionnaires to a random sample of mothers of infants under 6 months old who were in the outpatient department of the hospitals. In total, 291 mothers of infants, 35 stores, 17 hospitals, and 26 companies were surveyed. RESULTS From the whole sample of 291 mothers, the proportion who reported exclusively breastfeeding their infant was 30.9%; 69.1% of mothers reported feeding their infant with commercially available formula. Regarding violations of the Code, 40.2% of the mothers reported receiving free formula samples. Of these, 76.1% received the free samples in or near hospitals. Among the stores surveyed, 45.7% were found promoting products in a way that violates the Code. Also, 69.0% of the labeling on the formula products did not comply with the regulations set out in the Code. CONCLUSIONS As the social and economic developments continue, the interactions of more and more factors curb further success in breastfeeding. Support from all sectors of the society is needed in order to create a social environment to enable the promotion of breastfeeding, in addition to the efforts already made by the healthcare system.
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Affiliation(s)
- Aihua Liu
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics , Beijing, China
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Jacobson LT, Wetta R. Breastfeeding interventions in Kansas: a qualitative process evaluation of program goals and objectives. EVALUATION AND PROGRAM PLANNING 2014; 46:87-93. [PMID: 24951925 DOI: 10.1016/j.evalprogplan.2014.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 04/08/2014] [Accepted: 05/14/2014] [Indexed: 06/03/2023]
Abstract
Across the state of Kansas, eighteen public health departments received funding through the 2011 Breastfeeding Grant Initiative to start a breastfeeding intervention. The main objective of this study was to evaluate the progress toward program goals and objectives. This study was a process evaluation. Qualitative data were collected from recipient health departments at two time-points during the program year. Structured, open-ended questions were asked through telephone interviews. This study examined: (1) progress toward program goals and objectives, (2) problems encountered during implementation, and (3) evaluation measures employed to assess program impact. All health departments reported making significant progress toward program goals and objectives and reported successful collaboration with other healthcare providers. The use of breast pumps, educational classes, and professional training of staff were reported as providing the best outcome in the promotion of breastfeeding. The majority of respondents did not measure program impact. From a public health perspective, it is important that infants receive breast milk for the first six months of life. It appears that goals and objectives set a priori guided health departments with the administration of their breastfeeding program. Results may be used to enhance and sustain delivery of breastfeeding support programs in Kansas communities.
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Affiliation(s)
- Lisette T Jacobson
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, 1010 North Kansas, Wichita, KS 67214-3199, United States.
| | - Ruth Wetta
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, 1010 North Kansas, Wichita, KS 67214-3199, United States.
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Rotavirus Diarrhea among Children in Taiz, Yemen: Prevalence-Risk Factors and Detection of Genotypes. Int J Pediatr 2014; 2014:928529. [PMID: 25197286 PMCID: PMC4145802 DOI: 10.1155/2014/928529] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 07/10/2014] [Accepted: 07/11/2014] [Indexed: 11/18/2022] Open
Abstract
Diarrheal diseases are a great public health problem; they are among the most causes leading to morbidity and mortality of infants and children particularly in developing countries and even in developed countries. Rotavirus is the most common cause of severe gastroenteritis in infants and young children in both developed and developing countries. The purpose of this study was to determine the incidence rate of Rotavirus infection, its genotypes, and risk factors among children with diarrhea in Taiz, Yemen. 795 fecal samples were collected from children (less than 5 years old), suffering from diarrhea and attending the Yemeni-Swedish Hospital (YSH) in Taiz , Yemen, from November 2006 to February 2008. Rotavirus was detected by enzyme linkage immunosorbent assay (ELISA) on stool specimens of children. Genotypes of Rotavirus were characterized by reverse transcriptase-polymerase chain reaction (RT-PCR) and polyacrylamide gel electrophoresis (PAGE). The results showed that 358 (45.2%) were Rotavirus-positive and the most prevalent genotypes were G2P[4] (55%), followed by G1P[8] (15%). In addition, Rotavirus was found through the whole year; however, higher frequency during the summer season (53.4%) and lower frequency during the winter season (37.1%).
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Martínez Salgado H. [Benefits of newborn feeding with the initiation formula: On-demand vs. gastric capacity]. BOLETIN MEDICO DEL HOSPITAL INFANTIL DE MEXICO 2014; 71:193-195. [PMID: 29421250 DOI: 10.1016/j.bmhimx.2014.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 08/27/2014] [Indexed: 06/08/2023] Open
Affiliation(s)
- Homero Martínez Salgado
- Investigador Titular en Ciencias Médicas «F», Hospital Infantil de México Federico Gómez, México D.F., México.
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Yang WC, Zhao LL, Li YC, Chen CH, Chang YJ, Fu YC, Wu HP. Bodyweight loss in predicting neonatal hyperbilirubinemia 72 hours after birth in term newborn infants. BMC Pediatr 2013; 13:145. [PMID: 24053490 PMCID: PMC3849505 DOI: 10.1186/1471-2431-13-145] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 09/11/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Severe dehydration is generally believed to be a cause of significant hyperbilirubinemia in newborn babies. This study aimed to analyze the weight loss of healthy term newborn infants at 24, 48 and 72 hours after birth to predict significant hyperbilirubinemia at 72 hours. METHODS From January 2007 to December 2008, we conducted this retrospective chart review by measuring total bilirubin (transcutaneous and serum) in 343 healthy, term newborns with a birth body weight of more than 2500 g. We then analyzed the association between body weight loss (BWL) and significant hyperbilirubinemia (total bilirubin more than 15 mg/dL) 72 hours after birth. Receiver operating characteristic curves were used to evaluate the appropriate cutoff BWL percentages on the first three days after birth for the prediction of neonatal hyperbilirubinemia 72 hours after birth. RESULTS A total of 115 (33.5%) neonates presented with significant hyperbilirubinemia 72 hours after birth, and the percentages of BWL on the first three days were all higher than those in the non-significant hyperbilirubinemia group (all p < 0.05). Breastfeeding was not statistically correlated with significant hyperbilirubinemia (p=0.86). To predict significant hyperbilirubinemia 72 hours after birth, receiver operating characteristic curve analysis showed that the optimum cutoff BWL percentages were 4.48% on the first day of life (sensitivity: 43%, specificity: 70%, positive likelihood ratio [LR+]: 1.43, and negative likelihood ratio [LR-]: 0.82), 7.60% on day 2 (sensitivity: 47%, specificity: 74%, LR+: 1.81, LR-: 0.72), and 8.15% on day 3 (sensitivity: 57%, specificity: 70%, LR+: 1.92, LR-: 0.61) (all p < 0.05). CONCLUSIONS BWL on the first three days after birth may be a predisposing factor for neonatal hyperbilirubinemia, and may also serve as a helpful clinical factor to prevent significant hyperbilirubinemia 72 hours after birth. The optimal BWL cutoff percentages on the first three days after birth presented in this study may predict hyperbilirubinemia and indicate the need for supplementary feeding.
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Affiliation(s)
- Wen-Chieh Yang
- Department of Pediatrics, Taichung Tzuchi Hospital, The Buddhist Medical Foundation, Taichung, Taiwan, R,O,C.
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Bianco G, Zianni R, Anzillotta G, Palma A, Vitacco V, Scrano L, Cataldi TRI. Dibenzo-p-dioxins and dibenzofurans in human breast milk collected in the area of Taranto (Southern Italy): first case study. Anal Bioanal Chem 2013; 405:2405-10. [DOI: 10.1007/s00216-013-6706-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 12/28/2012] [Accepted: 01/04/2013] [Indexed: 12/01/2022]
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Seth A. Care of the HIV-exposed child--to breast feed or not? Indian J Pediatr 2012; 79:1501-5. [PMID: 22382511 DOI: 10.1007/s12098-012-0700-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Accepted: 01/25/2012] [Indexed: 10/28/2022]
Abstract
Breast milk is the best form of nutrition for infants. However, it places infants born to HIV infected women at risk of acquiring HIV infection. Total avoidance of breastfeeding is the only way of completely avoiding HIV transmission through breast milk. However, this strategy has not proved to be viable in resource constrained nations. A high infection related mortality and morbidity, and a high prevalence of malnutrition have been observed in HIV exposed infants on replacement feeding. Exclusive breastfeeding for the first six months followed by rapid weaning has also not proved to be a good strategy, with a surge in infection related morbidity and malnutrition reported after weaning. Current evidence indicates that continued use of ARV prophylaxis to mother/infant starting during pregnancy and continued to cover the entire duration of breastfeeding offers the infant best chance of HIV free survival, combining the benefits of breast milk with safety induced by ARV prophylaxis.
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Affiliation(s)
- Anju Seth
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi 110001, India.
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Arusei RJ, Ettyang GA, Esamai F. Feeding patterns and growth of term infants in Eldoret, Kenya. Food Nutr Bull 2012; 32:307-14. [PMID: 22590963 DOI: 10.1177/156482651103200401] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There are limited longitudinal data from developing countries on early infant feeding and growth patterns. In Kenya only 34.8% of infants are exclusively breastfed at 2 months. This finding is of concern, and further understanding of infant feeding and growth patterns is important. OBJECTIVE To determine the feeding and growth patterns of Kenyan term infants during early infancy. METHODS A longitudinal study was conducted. One hundred and fifty-one resource-constrained mother-infant pairs were recruited from the West Municipal Health Centre (WMHC) within 24 hours after birth, and subsequent follow-up was performed at the WMHC Maternal and Child Health Clinic. Data on baseline characteristics were collected with the use of a structured questionnaire. Data on nonbreastmilk liquids given to the infants and feeding patterns were gathered with the use of a 24-hour recall. Standard procedures were used to measure infant weight, recumbent length, and head circumference. World Health Organization (WHO) growth standards were used, and tests for variation between and within group means were performed, with alpha < .05 regarded as indicating significance. RESULTS At 6 and 10 weeks, the prevalence of exclusive breastfeeding was 40.4% and 9.9%, respectively. The mothers cited "aids infant's digestion" (38%) as the main reason for partial breastfeeding and "breastmilk was not enough" (48%) as the main reason for predominant breastfeeding. Growth velocity based on weight was similar to that in the WHO reference group. All of the children had normal growth (z-score > -2). Mothers without knowledge about WHO/UNICEF early infant feeding recommendations and those who initiated breastfeeding more than 1 hour post partum were ninefold and eightfold more likely to start mixed feeding by 10 weeks of age, respectively. CONCLUSIONS There is a need to accelerate awareness of optimum infant feeding recommendations and augment the rigorous practice of the WHO Ten Steps to Successful Breastfeeding.
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Donovan SM, Wang M, Li M, Friedberg I, Schwartz SL, Chapkin RS. Host-microbe interactions in the neonatal intestine: role of human milk oligosaccharides. Adv Nutr 2012; 3:450S-5S. [PMID: 22585924 PMCID: PMC3649482 DOI: 10.3945/an.112.001859] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The infant intestinal microbiota is shaped by genetics and environment, including the route of delivery and early dietary intake. Data from germ-free rodents and piglets support a critical role for the microbiota in regulating gastrointestinal and immune development. Human milk oligosaccharides (HMO) both directly and indirectly influence intestinal development by regulating cell proliferation, acting as prebiotics for beneficial bacteria and modulating immune development. We have shown that the gut microbiota, the microbial metatranscriptome, and metabolome differ between porcine milk-fed and formula-fed (FF) piglets. Our goal is to define how early nutrition, specifically HMO, shapes host-microbe interactions in breast-fed (BF) and FF human infants. We an established noninvasive method that uses stool samples containing intact sloughed epithelial cells to quantify intestinal gene expression profiles in human infants. We hypothesized that a systems biology approach, combining i) HMO composition of the mother's milk with the infant's gut gene expression and fecal bacterial composition, ii) gene expression, and iii short-chain fatty acid profiles would identify important mechanistic pathways affecting intestinal development of BF and FF infants in the first few months of life. HMO composition was analyzed by HLPC Chip/time-of-flight MS and 3 HMO clusters were identified using principle component analysis. Initial findings indicated that both host epithelial cell mRNA expression and the microbial phylogenetic profiles provided strong feature sets that distinctly classified the BF and FF infants. Ongoing analyses are designed to integrate the host transcriptome, bacterial phylogenetic profiles, and functional metagenomic data using multivariate statistical analyses.
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Affiliation(s)
- Sharon M. Donovan
- Department of Food Science and Human Nutrition, University of Illinois, Urbana, IL; Departments of,To whom correspondence should be addressed. E-mail:
| | - Mei Wang
- Department of Food Science and Human Nutrition, University of Illinois, Urbana, IL; Departments of
| | - Min Li
- Department of Food Science and Human Nutrition, University of Illinois, Urbana, IL; Departments of
| | - Iddo Friedberg
- Microbiology and,Computer Science and Software Engineering, Miami University, Oxford, OH
| | - Scott L. Schwartz
- Program in Integrative Nutrition and Complex Diseases, Center for Environmental and Rural Health and,Department of Statistics, Texas A&M University, College Station, TX
| | - Robert S. Chapkin
- Program in Integrative Nutrition and Complex Diseases, Center for Environmental and Rural Health and
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Moon RY. SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment. Pediatrics 2011; 128:e1341-67. [PMID: 22007003 DOI: 10.1542/peds.2011-2285] [Citation(s) in RCA: 168] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Despite a major decrease in the incidence of sudden infant death syndrome (SIDS) since the American Academy of Pediatrics (AAP) released its recommendation in 1992 that infants be placed for sleep in a nonprone position, this decline has plateaued in recent years. Concurrently, other causes of sudden unexpected infant death occurring during sleep (sleep-related deaths), including suffocation, asphyxia, and entrapment, and ill-defined or unspecified causes of death have increased in incidence, particularly since the AAP published its last statement on SIDS in 2005. It has become increasingly important to address these other causes of sleep-related infant death. Many of the modifiable and nonmodifiable risk factors for SIDS and suffocation are strikingly similar. The AAP, therefore, is expanding its recommendations from being only SIDS-focused to focusing on a safe sleep environment that can reduce the risk of all sleep-related infant deaths including SIDS. The recommendations described in this report include supine positioning, use of a firm sleep surface, breastfeeding, room-sharing without bed-sharing, routine immunization, consideration of a pacifier, and avoidance of soft bedding, overheating, and exposure to tobacco smoke, alcohol, and illicit drugs. The rationale for these recommendations is discussed in detail in this technical report. The recommendations are published in the accompanying "Policy Statement--Sudden Infant Death Syndrome and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment," which is included in this issue (www.pediatrics.org/cgi/doi/10.1542/peds.2011-2220).
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Ma P, Magnus JH. Exploring the Concept of Positive Deviance Related to Breastfeeding Initiation in Black and White WIC Enrolled First Time Mothers. Matern Child Health J 2011; 16:1583-93. [DOI: 10.1007/s10995-011-0852-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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