Short duration of breastfeeding and early introduction of cow's milk as a result of mothers' low level of education

Untimely Initiation of Whole Cow Milk, Stunting, and Related Factors in South Gondar, Ethiopia

Introduction

Despite being an excellent source of essential nutrients, whole cow's milk poses risks for young children. This is mainly due to its association with adverse effects, including growth inhibition, delayed brain and motor development, and increased morbidity and mortality. The current study aimed to evaluate the occurrence of untimely introduction of whole cow milk, stunting and related factors among children below the age of 5 years.

Methods

A community-centered survey was implemented on 806 mother-child matches. Expressive statistics such as frequency, magnitude, mean and standard deviation were computed. Multivariable logistic regression was done to discover independent determinants of the dependent variables. A p-value of <0.05 was used to affirm significant association.

Results

From the survey participant children 311 (39.2%) of them were stunted. About 453 (57.1%) of children were fed whole cow milk earlier than the age of one year. Mothers who are able to read and write were 49% less likely to initiate cow milk earlier than the age of one year with AOR = 0.51, 95% CI 0.33-0.78. Not attending the growth monitoring and promotion service is a risk for untimely introduction of whole cow milk (AOR = 3.47, 95% CI 2.43-4.94). Children who did not start consuming whole cow milk earlier than the age of one year were 54% less likely to be stunted than those who started consuming whole cow milk before the age of one year (AOR = 0.46, 95% CI 0.33-0.65).

Conclusion

More than half of the study participant children started consuming whole cow milk before the age of one year. Children who did not start consuming whole cow milk early were less likely to be stunted.

Predictors of exclusive breastfeeding: observations from the Alberta pregnancy outcomes and nutrition (APrON) study

Background

Despite growing evidence that supports the importance of 6-month exclusive breastfeeding, few Canadian mothers adhere to this, and early weaning onto solids is a common practice. This study assessed infant feeding transitions during the first 6 months postpartum and factors that predicted exclusive breastfeeding to 3 and 6 months.

Methods

This prospective cohort study was part of the Alberta Pregnancy Outcomes and Nutrition study (APrON). From an initial sample of 600 pregnant women recruited from Edmonton and Calgary, 402 mothers provided complete details at 3 months postpartum; 300 stayed on to provide information at 6 months postpartum. During pregnancy and at 3 and 6 months postpartum, data on maternal and infant socio-demographic, behavior, and feeding were collected.

Results

Even though there was a high rate of “ever having breastfed” (98.6%), exclusive breastfeeding rates for 3 and 6 months were 54.0% and 15.3%, respectively. After controlling for potential confounders, the study showed that mothers who held post-graduate university degrees were 3.76 times more likely to breastfeed exclusively for 6 months than those without a university degree (95% CI: 1.30-10.92; p = 0.015). In addition, mother of previous children were more likely to breastfeed exclusively for 6 months (OR: 2.21, 95% CI: 1.08-4.52; p = 0.031). Mothers who were in the highest quartile of the Iowa Infant Feeding Attitude Score were 4.29 and 5.40 times more likely to breastfeed exclusively for 3 months (95% CI: 1.31-14.08; p-trend < 0.001) and 6 months (95% CI: 2.75-10.60; P-trend < 0.001), respectively.

Conclusions

The 6-month exclusive breastfeeding rate in Alberta is considerably below national and international breastfeeding recommendations. Professional advice that focuses on prenatal maternal knowledge, attitudes, and misperceptions may promote adherence to World Health Organization breastfeeding guidelines. Knowing that exclusive breastfeeding is less likely to take place among lower-educated, primiparous women may help health practitioners focus their support and education for this group.

Early introduction of non-formula cow's milk to southern Ontario infants

BACKGROUND

Early introduction of cow's milk is a risk factor for the development of anaemia and iron deficiency, which is associated with lower childhood developmental scores. The objective of this paper is to describe the incidence of the introduction of cow's milk before the recommended age of nine months and factors associated with early introduction.

METHODS

Mothers of healthy term infants were invited to take part in the Infant Feeding Survey in 2002-2003. These mothers, from Southern Ontario, were interviewed by telephone at three and nine months postpartum to determine infant feeding practices.

RESULTS

One in eight (12.7%) mothers completing the second interview indicated that they were feeding their infant non-formula cow's milk as the primary source of milk before nine months. Multivariate logistic regression analysis showed that mothers feeding cow's milk before nine months were younger, lived in households with lower annual incomes, and were less likely to have attended prenatal classes or to recall receiving information on the introduction of solid foods. They were also more likely to have introduced solid foods or skimmed milk before the recommended ages.

CONCLUSION

A substantial proportion of Southern Ontario infants are receiving cow's milk before the recommended age, putting them at increased risk for iron deficiency and the resulting sequelae. Further research into why guidelines are not followed is indicated.