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Ke K, Chi X, Lv H, Zhao J, Jiang Y, Jiang T, Lu Q, Qiu Y, Tao S, Qin R, Huang L, Xu X, Liu C, Dou Y, Huang B, Xu B, Ma H, Jin G, Shen H, Hu Z, Lin Y, Du J. Association of Breastfeeding and Neonatal Jaundice With Infant Neurodevelopment. Am J Prev Med 2024; 66:698-706. [PMID: 38052381 DOI: 10.1016/j.amepre.2023.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 12/07/2023]
Abstract
INTRODUCTION Exclusive breastfeeding is advantageous for infant neurodevelopment. Nevertheless, insufficient human milk supply in exclusively breastfed infants may elevate the risk of neonatal jaundice, which can potentially result in neurological harm. Whether mothers should adhere to exclusive breastfeeding in infants with neonatal jaundice remains unclear. METHODS Data comes from the Jiangsu Birth Cohort (JBC), a prospective and longitudinal birth cohort study in China. A total of 2,577 infants born from November 2017 to March 2021 were included in the analysis. Multivariate linear regression models were used to analyze the associations between breastfeeding status, neonatal jaundice, and their interaction with infant neurodevelopment. Analysis was performed in 2022. RESULTS Compared with "exclusive breastfeeding," fine motor scores of infants were lower for "mixed feeding" (βadj, -0.16; 95% CI, -0.29 to -0.03; p=0.016) and "no breastfeeding" (βadj, -0.41; 95% CI, -0.79 to -0.03; p=0.034). Compared with "no neonatal jaundice," infants with "severe neonatal jaundice" had lower scores for cognition (βadj, -0.44; 95% CI, -0.66 to -0.23; p<0.001) and fine motor (βadj, -0.19; 95% CI, -0.35 to -0.03; p=0.024). In infants with severe neonatal jaundice, the termination of exclusive breastfeeding before 6 months was associated with worse cognition (βadj, -0.28; 95% CI, -0.57 to 0.01), while this association was not observed in those without neonatal jaundice (βadj, 0.09; 95% CI, -0.26 to 0.43). CONCLUSIONS Exclusive breastfeeding for the first 6 months is beneficial to the neurodevelopment of infants, especially in those with severe neonatal jaundice.
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Affiliation(s)
- Kang Ke
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xia Chi
- Department of Child Health Care, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu, China
| | - Hong Lv
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Jing Zhao
- Department of Reproduction, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Hospital, Nanjing, Jiangsu, China
| | - Yangqian Jiang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Tao Jiang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qun Lu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yun Qiu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Shiyao Tao
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Rui Qin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lei Huang
- Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xin Xu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Cong Liu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuanyan Dou
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Bo Huang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Bo Xu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hongxia Ma
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Guangfu Jin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Hongbing Shen
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Zhibin Hu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Yuan Lin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China; Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jiangbo Du
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China.
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Schorn M, Mendes MS, Giugliani ERJ. Factors associated with breastfeeding abandonment in the first month after the mother's return to work. CIENCIA & SAUDE COLETIVA 2023; 28:2733-2742. [PMID: 37672461 DOI: 10.1590/1413-81232023289.19162022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/31/2023] [Indexed: 09/08/2023] Open
Abstract
The return to work of lactating mothers has been identified as an important risk factor for breastfeeding interruption. We proposed to identify factors associated with breastfeeding abandonment in the first month after return. 252 women working at a hospital who had children aged 12 to 36 months and who were still breastfeeding when returned to work answered a questionnaire containing questions on sociodemographic characteristics, pregnancy, childbirth, breastfeeding and work-related factors. The associations were estimated using adjusted prevalence ratio (aPR), calculated with the hierarchical Poisson multivariable regression model. The following factors showed a significant association with breastfeeding abandonment: using a pacifier (aPR 4.58), cohabiting with someone other than partner (aPR 3.77), having no intention or having doubts about maintaining breastfeeding after returning (aPR 3.39), having a college degree (aPR 2.66), having no support from the infant's caregiver (aPR 2.26), and infant being older when the woman returned to work (PR 1.16 for each additional month of infant age). Longer duration of exclusive breastfeeding was a protective factor (aPR 0.990). Most of the factors associated with discontinuation of breastfeeding in the first month after the mother's return to work are not directly related to the woman's work.
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Affiliation(s)
- Monique Schorn
- Departamento de Pediatria, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2400, Santa Cecília. 90035-003 Porto Alegre RS Brasil.
| | - Michele Saraiva Mendes
- Departamento de Pediatria, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2400, Santa Cecília. 90035-003 Porto Alegre RS Brasil.
| | - Elsa R J Giugliani
- Departamento de Pediatria, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2400, Santa Cecília. 90035-003 Porto Alegre RS Brasil.
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Zhang J, Clayton GL, Hansen SN, Olsen A, Lawlor DA, Dahm CC. Maternal Pre-Pregnancy BMI, Offspring Adiposity in Late Childhood, and Age of Weaning: A Causal Mediation Analysis. Nutrients 2023; 15:2970. [PMID: 37447295 DOI: 10.3390/nu15132970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Infant feeding practices have been hypothesized to influence offspring's body mass index (BMI) later in life, and women with overweight or obesity tend to wean their infants earlier than women with healthy BMI. We, therefore, aimed to investigate how much early age of weaning mediated the maternal-offspring adiposity relationship. The study included 4920 mother-child pairs from the Avon Longitudinal Study of Parents and Children birth cohort. G-computation was applied to estimate the natural direct (NDE) and indirect (NIE) effects, via the age of weaning (<3 months, 3 months, >3 months), of maternal pre-pregnancy overweight or obesity on offspring's BMI and fat mass index. The NDE of maternal overweight or obesity on offspring BMI at 17 years old was 2.63 kg/m2 (95% CI: 2.27 to 2.99). The NIE via the age of weaning was 0.02 kg/m2 (95% CI: 0.00 to 0.04), corresponding to 0.8% of the total effect. Similar results were observed for the offspring's fat mass index. The NDE and NIE were similar to the main analyses when we looked at the relationship stratified by breastfeeding status. Our study found a minimal influence of age of weaning on the pathway between maternal and offspring adiposity, indicating the age of weaning may not be a key mediator.
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Affiliation(s)
- Jie Zhang
- Department of Public Health, Aarhus University, DK-8000 Aarhus, Denmark
| | - Gemma L Clayton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
- MRC Integrative Epidemiology Unit, Bristol BS8 2BN, UK
| | | | - Anja Olsen
- Department of Public Health, Aarhus University, DK-8000 Aarhus, Denmark
- Danish Cancer Society Research Center, DK-2100 Copenhagen, Denmark
| | - Deborah A Lawlor
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
- MRC Integrative Epidemiology Unit, Bristol BS8 2BN, UK
| | - Christina C Dahm
- Department of Public Health, Aarhus University, DK-8000 Aarhus, Denmark
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Bailey RL, Stang JS, Davis TA, Naimi TS, Schneeman BO, Dewey KG, Donovan SM, Novotny R, Kleinman RE, Taveras EM, Bazzano L, Snetselaar LG, de Jesus J, Casavale KO, Stoody EE, Goldman JD, Moshfegh AJ, Rhodes DG, Herrick KA, Koegel K, Perrine CG, Pannucci T. Dietary and Complementary Feeding Practices of US Infants, 6 to 12 Months: A Narrative Review of the Federal Nutrition Monitoring Data. J Acad Nutr Diet 2022; 122:2337-2345.e1. [PMID: 34688966 PMCID: PMC10851078 DOI: 10.1016/j.jand.2021.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 10/20/2022]
Abstract
Complementary foods and beverages (CFBs) are key components of an infant's diet in the second 6 months of life. This article summarizes nutrition and feeding practices examined by the 2020 Dietary Guidelines Advisory Committees during the CFB life stage. Breastfeeding initiation is high (84%), but exclusive breastfeeding at 6 months (26%) is below the Healthy People 2030 goal (42%). Most infants (51%) are introduced to CFBs sometime before 6 months. The primary mode of feeding (ie, human milk fed [HMF]; infant formula or mixed formula and human milk fed [FMF]) at the initiation of CFBs is associated with the timing of introduction and types of CFBs reported. FMF infants (42%) are more likely to be introduced to CFBs before 4 months compared with HMF infants (19%). Different dietary patterns, such as higher prevalence of consumption and mean amounts, were observed, including fruit, grains, dairy, proteins, and solid fats. Compared with HMF infants of the same age, FMF infants consume more total energy (845 vs 631 kcal) and protein (22 vs 12 g) from all sources, and more energy (345 vs 204 kcal) and protein (11 vs 6 g) from CFBs alone. HMF infants have a higher prevalence of risk of inadequate intakes of iron (77% vs 7%), zinc (54% vs <3%), and protein (27% vs <3%). FMF infants are more likely to have an early introduction (<12 months) to fruit juice (45% vs 20%) and cow's milk (36% vs 24%). Registered dietitian nutritionists and nutritional professionals should consider tailoring their advice to caregivers on dietary and complementary feeding practices, taking into account the primary mode of milk feeding during this life stage to support infants' nutrient adequacy. National studies that address the limitations of this analysis, including small sample sizes and imputed breast milk volume, could refine findings from this analysis.
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Affiliation(s)
- Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN.
| | - Jaime S Stang
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota - Twin Cities, MN
| | - Teresa A Davis
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Timothy S Naimi
- Section of General Internal Medicine, Boston University Medical Center, Boston, MA
| | | | - Kathryn G Dewey
- Department of Nutrition, University of California, Davis, CA
| | - Sharon M Donovan
- Department of Food Science and Human Nutrition, Endowed Chair in Nutrition and Health, University of Illinois, Urbana-Champaign, IL
| | - Rachel Novotny
- Department Human Nutrition Food and Animal Science, University of Hawai'i at Mānoa, Honolulu, HI
| | - Ronald E Kleinman
- Harvard Medical School, Boston, MA; Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
| | - Elsie M Taveras
- Department of Pediatrics, Harvard Medical School, Boston, MA; Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, MA
| | - Lydia Bazzano
- Tulane Center for Lifespan Epidemiology Research, New Orleans, LA
| | - Linda G Snetselaar
- Department of Epidemiology, Endowed Chair in Preventive Nutrition Education, University of Iowa, Iowa City, IA
| | - Janet de Jesus
- Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD
| | - Kellie O Casavale
- Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, US Department of Health and Human Services, College Park, MD
| | - Eve E Stoody
- Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Joseph D Goldman
- Food Surveys Research Group, Agricultural Research Service, US Department of Agriculture, Beltsville, MD
| | - Alanna J Moshfegh
- Food Surveys Research Group, Agricultural Research Service, US Department of Agriculture, Beltsville, MD
| | - Donna G Rhodes
- Food Surveys Research Group, Agricultural Research Service, US Department of Agriculture, Beltsville, MD
| | - Kirsten A Herrick
- Risk Factor Assessment Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - Kristin Koegel
- Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Cria G Perrine
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA
| | - TusaRebecca Pannucci
- Food Surveys Research Group, Agricultural Research Service, US Department of Agriculture, Beltsville, MD
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Nielsen C, Li Y, Lewandowski M, Fletcher T, Jakobsson K. Breastfeeding initiation and duration after high exposure to perfluoroalkyl substances through contaminated drinking water: A cohort study from Ronneby, Sweden. ENVIRONMENTAL RESEARCH 2022; 207:112206. [PMID: 34653413 DOI: 10.1016/j.envres.2021.112206] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 09/29/2021] [Accepted: 10/09/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The drinking water in parts of Ronneby was heavily contaminated with perfluoroalkyl substances (PFAS) for decades. Although PFAS has endocrine-disrupting properties and may interfere with breastfeeding, the effects in populations with a point source of high exposure are unknown. OBJECTIVES To investigate associations between high PFAS exposure and 1) initiation and 2) duration of breastfeeding. METHODS We retrieved data on infant feeding practices for 2374 children born between 1999 and 2009 from Child Health Care centers in Ronneby and a reference municipality. Residential address before delivery was used as a proxy for exposure, and confounders were obtained from charts and registers. We used modified Poisson regressions to estimate the relative risks (RR) of not initiating breastfeeding, not breastfeeding exclusively after 3 months, and not breastfeeding at all at 6 months. We also estimated hazard ratios (HR) of cessation of exclusive breastfeeding before 6 months and any breastfeeding before 12 months. RESULTS Mothers who had received contaminated water seemed to have a higher risk of not initiating breastfeeding (RR = 2.4; 95% CI: 0.8, 6.7). Primiparous mothers from the exposed area were at a 1.2 times increased risk (95% CI: 0.9, 1.6) of not exclusively breastfeeding at 3 months and a 1.6 times increased risk (95% CI: 1.2, 2.1) of not breastfeeding at 6 months. The results were confirmed by the Cox regressions, which further showed that the HR for cessation of any breastfeeding was time dependent and higher in early lactation, thereafter decreasing as lactation progressed. We observed no overall associations in multiparous mothers. DISCUSSION Exposure to high levels of PFAS seemed to be associated with increased risks of not initiating breastfeeding and shorter breastfeeding duration in primiparous mothers. The findings imply that the ability of first-time mothers to establish breastfeeding is a sensitive outcome after high exposure to PFAS.
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Affiliation(s)
- Christel Nielsen
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
| | - Ying Li
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Magdalena Lewandowski
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Tony Fletcher
- London School of Hygiene and Tropical Medicine, London, UK
| | - Kristina Jakobsson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
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Cerrito P, Nava A, Radovčić D, Borić D, Cerrito L, Basdeo T, Ruggiero G, Frayer DW, Kao AP, Bondioli L, Mancini L, Bromage TG. Dental cementum virtual histology of Neanderthal teeth from Krapina (Croatia, 130-120 kyr): an informed estimate of age, sex and adult stressors. J R Soc Interface 2022; 19:20210820. [PMID: 35193386 PMCID: PMC8864341 DOI: 10.1098/rsif.2021.0820] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/27/2022] [Indexed: 11/12/2022] Open
Abstract
The evolution of modern human reproductive scheduling is an aspect of our life history that remains vastly uncomprehended. The present work aims to address this gap by validating a non-destructive cutting-edge methodology to infer adult life-history events on modern teeth with known life history and then applying it to fossil specimens. We use phase-contrast synchrotron X-ray microtomography to visualize the dental cementum of 21 specimens: nine contemporary humans; 10 Neanderthals from Krapina (Croatia, 130-120 kyr); one Neolithic Homo sapiens from Ajmana (Serbia); and one Mesolithic H. sapiens from Vlasac (Serbia). We were able to correctly detect and time (root mean square error = 2.1 years; R2 = 0.98) all reproductive (menarche, parturition, menopause) and other physiologically impactful events in the modern sample. Nonetheless, we could not distinguish between the causes of the events detected. For the fossil specimens, we estimated age at death and age at occurrence of biologically significant events. Finally, we performed an exploratory analysis regarding possible sexual dimorphism in dental cementum microstructure, which allowed us to correctly infer the sex of the Neolithic specimen, for which the true value was known via DNA analysis.
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Affiliation(s)
- Paola Cerrito
- Department of Anthropology, New York University, New York, NY, USA
- New York Consortium in Evolutionary Primatology, New York, NY, USA
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, NY, USA
| | - Alessia Nava
- Skeletal Biology Research Centre, School of Anthropology and Conservation, University of Kent, Canterbury, UK
| | - Davorka Radovčić
- Department of Geology and Paleontology, Croatian Natural History Museum, Zagreb, Croatia
| | - Dušan Borić
- Dipartimento di Biologia Ambientale, Sapienza Università di Roma, Rome, Italy
| | | | - Tricia Basdeo
- Department of Anthropology, Adelphi University, New York, NY, USA
| | - Guido Ruggiero
- Ruggiero-Piscopo Dental Practice, Naples, Italy
- Molise Regional Health Authority, Venafro, Italy
| | - David W. Frayer
- Department of Anthropology, University of Kansas, Lawrence, KS, USA
| | - Alexander P. Kao
- Elettra-Sincrotrone Trieste S.C.p.A., 34149 Basovizza, Trieste, Italy
| | - Luca Bondioli
- Department of Cultural Heritage, University of Padua, Padua, Italy
| | - Lucia Mancini
- Elettra-Sincrotrone Trieste S.C.p.A., 34149 Basovizza, Trieste, Italy
| | - Timothy G. Bromage
- Department of Anthropology, New York University, New York, NY, USA
- New York Consortium in Evolutionary Primatology, New York, NY, USA
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, NY, USA
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7
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Mahurin-Smith J, Beck A. Caregivers' Experiences of Infant Feeding Problems: The Role of Self-Compassion and Stress Management. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1856-1865. [PMID: 34191539 DOI: 10.1044/2021_ajslp-20-00298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Introduction Infant feeding problems are strongly associated with caregiver stress, which in turn is linked to poorer outcomes for children. Self-compassion is a modifiable trait strongly associated with improved mental health and greater resilience. The purpose of this study was to investigate the relationships among self-compassion, stress management practices, and caregiver stress in a sample of parents who identified feeding problems in their infants. Method Parents who identified feeding problems in their infants completed an online survey. They described the feeding problems, completed the Self-Compassion Scale and the Perceived Stress Scale, and detailed their stress management practices. Results Higher self-compassion was strongly associated with lower overall stress and more modestly associated with lower feeding-related distress. More severe feeding problems were significantly more stressful for caregivers. Participants reported a wide variety of stress management approaches. Discussion These findings indicate that higher self-compassion is associated with lower caregiver stress for parents whose infants experience feeding problems. Implications for service providers are reviewed. Supplemental Material https://doi.org/10.23641/asha.14831028.
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Affiliation(s)
- Jamie Mahurin-Smith
- Department of Communication Sciences and Disorders, Illinois State University, Normal
| | - Ann Beck
- Department of Communication Sciences and Disorders, Illinois State University, Normal
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McBride GM, Stevenson R, Zizzo G, Rumbold AR, Amir LH, Keir AK, Grzeskowiak LE. Use and experiences of galactagogues while breastfeeding among Australian women. PLoS One 2021; 16:e0254049. [PMID: 34197558 PMCID: PMC8248610 DOI: 10.1371/journal.pone.0254049] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/19/2021] [Indexed: 02/05/2023] Open
Abstract
Background Galactagogues are substances thought to increase breast milk production, however evidence to support their efficacy and safety remain limited. We undertook a survey among Australian women to examine patterns of use of galactagogues and perceptions regarding their safety and effectiveness. Methods An online, cross-sectional survey was distributed between September and December 2019 via national breastfeeding and preterm birth support organisations, and networks of several research institutions in Australia. Women were eligible to participate if they lived in Australia and were currently/previously breastfeeding. The survey included questions about galactagogue use (including duration and timing), side effects and perceived effectiveness (on a scale of 1 [Not at all effective] to 5 [Extremely effective]). Results Among 1876 respondents, 1120 (60%) reported using one or more galactagogues. Women were 31.5 ± 4.8 years (mean ± standard deviation) at their most recent birth. Sixty-five percent of women were currently breastfeeding at the time of the survey. The most commonly reported galactagogues included lactation cookies (47%), brewer’s yeast (32%), fenugreek (22%) and domperidone (19%). The mean duration of use for each galactagogue ranged from 2 to 20 weeks. Approximately 1 in 6 women reported commencing galactagogues within the first week postpartum. Most women reported receiving recommendations to use herbal/dietary galactagogues from the internet (38%) or friends (25%), whereas pharmaceutical galactagogues were most commonly prescribed by General Practitioners (72%). The perceived effectiveness varied greatly across galactagogues. Perceived effectiveness was highest for domperidone (mean rating of 3.3 compared with 2.0 to 3.0 among other galactagogues). Over 23% of domperidone users reported experiencing multiple side effects, compared to an average of 3% of women taking herbal galactagogues. Conclusions This survey demonstrates that galactagogues use is common in Australia. Further research is needed to generate robust evidence about galactagogues’ efficacy and safety to support evidence-based strategies and improve breastfeeding outcomes.
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Affiliation(s)
- Grace M. McBride
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Robyn Stevenson
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Gabriella Zizzo
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Alice R. Rumbold
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Lisa H. Amir
- Judith Lumley Centre, La Trobe University, Melbourne, Australia
- Breastfeeding Service, Royal Women’s Hospital, Parkville, Australia
| | - Amy K. Keir
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Luke E. Grzeskowiak
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
- SA Pharmacy, SA Health, Adelaide, Australia
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
- * E-mail:
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9
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Campos AP, Vilar-Compte M, Hawkins SS. Association Between Breastfeeding and Child Overweight in Mexico. Food Nutr Bull 2021; 42:414-426. [PMID: 34044629 DOI: 10.1177/03795721211014778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Globally, the prevalence of child overweight has increased over the past few decades. The largest burden of child overweight is identified among upper-middle-income countries, such as Mexico. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child overweight. OBJECTIVE To examine the association between breastfeeding and child overweight while sequentially controlling for individual, household, and area factors in Mexican children. METHODS Secondary data analysis using the 2012 Mexican National Health and Nutrition Survey which included risk factors for overweight on 2089 children aged 6 to 35 months and analyzed data to estimate fixed- and mixed-effects logistic regression models. RESULTS Overall, 9.0% of children were overweight and 71.1% of mothers reported any breastfeeding for ≥ 6 months. We found no evidence for a protective effect of any breastfeeding for ≥ 6 months on child overweight when compared to children who were never breastfed in the fully adjusted model and across all models (model 4, adjusted odds ratio [AOR] [95% CI] = 0.76 [0.31-1.86]). We identified risk factors for child overweight at the individual and area levels, with maternal obesity and offspring high birthweight being significant in the fully adjusted model and across all models (model 4, AOR [95% CI] = 2.26 [1.32-3.85] and 2.83 [1.44-5.56], correspondingly). CONCLUSIONS Our results suggest shared obesogenic environment influences from which the overweight-obese maternal-child dyads are emerging in Mexican households. More research is needed to better understand these obesogenic environments grounded on the particular contexts among upper-middle-income countries.
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Affiliation(s)
- Ana Paola Campos
- 205730Boston College School of Social Work, McGuinn Hall, Chestnut Hill, MA, USA
| | - Mireya Vilar-Compte
- EQUIDE Research Institute, 27829Iberoamericana University, Mexico City, Mexico
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10
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Moss KM, Dobson AJ, Tooth L, Mishra GD. Which Australian Women Do Not Exclusively Breastfeed to 6 Months, and why? J Hum Lact 2021; 37:390-402. [PMID: 32484717 DOI: 10.1177/0890334420929993] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Rates of exclusive breastfeeding in Australia lag behind international targets. Reasons for non-exclusive breastfeeding are poorly understood. RESEARCH AIMS To describe demographic profiles of participants reporting different feeding practices, and reasons for not exclusively breastfeeding to 6 months. METHODS Demographics for 2888 mothers (5340 children) and reasons for 1879 mothers (3018 children) from the Mothers and Their Children's Health Study (a sub-study of the Australian Longitudinal Study on Women's Health) were examined using descriptive statistics and multivariable regression. RESULTS Only 34.4% of children were exclusively breastfed to 6 months. Five non-exclusive feeding practices were identified: never breastfed (3.9%), breastfed < 6 months (20.8%), and breastfed to 6 months but had formula (6.8%), solids (24.5%), or both formula and solids (9.7%). Mothers of children who received < 6 months of human milk were more likely to have a lower education, be overweight/obese, smoke, and live in cities (compared to mothers of children exclusively breastfed). Reasons for never breastfeeding and for breastfeeding < 6 months were primarily insufficient milk and breastfeeding difficulties (e.g., latching issues). Reasons for introducing solids were primarily cues for solids (e.g., showing interest). Reasons for formula were insufficient milk and practical considerations (e.g., return to work). Reasons for both solids and formula were diverse, including insufficient milk, weaning cues, and practical considerations. CONCLUSIONS Mothers who did not exclusively breastfeed to 6 months were a heterogeneous group, indicating that both targeted and universal strategies are required to increase rates of exclusive breastfeeding. Support should encompass the broad range of feeding practices.
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Affiliation(s)
- Katrina M Moss
- 1974 The University of Queensland, Faculty of Medicine, School of Public Health, Centre for Longitudinal and Life Course Research, Australia
| | - Annette J Dobson
- 1974 The University of Queensland, Faculty of Medicine, School of Public Health, Centre for Longitudinal and Life Course Research, Australia
| | - Leigh Tooth
- 1974 The University of Queensland, Faculty of Medicine, School of Public Health, Centre for Longitudinal and Life Course Research, Australia
| | - Gita D Mishra
- 1974 The University of Queensland, Faculty of Medicine, School of Public Health, Centre for Longitudinal and Life Course Research, Australia
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11
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Bovbjerg ML, Uphoff AE, Rosenberg KD. Two-Year Test-Retest Reliability of the Breastfeeding Duration Question Used By the Pregnancy Risk Assessment Monitoring System (PRAMS): Implications for Research. Matern Child Health J 2021; 25:1126-1135. [PMID: 33909204 DOI: 10.1007/s10995-021-03145-z] [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] [Accepted: 04/19/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION A large literature exists on positive sequelae of breastfeeding, relying heavily on maternal self-reported infant feeding behaviors. Many such studies use PRAMS data, though estimates of reliability for the breastfeeding duration question on PRAMS have not been published. METHODS We used data from Oregon PRAMS (respondents are a median 3.5 months postpartum) and PRAMS-2 (median 25 months) to assess test-retest reliability of maternal self-reported breastfeeding duration, among women who had weaned prior to completing the PRAMS survey. RESULTS The sample-wide kappa for the paired, self-reported breastfeeding duration was 0.014, and the intraclass correlation coefficient was 0.17, both of which indicate poor agreement. More than 80% of women reported a longer duration on PRAMS-2; the median (interquartile range) difference was +1.0 (0.31 - 2.1) months. DISCUSSION Recent literature on this topic from high-income countries falls into two categories: entirely retrospective versus "prospective" reliability assessments. Entirely retrospective assessments (both inquiries occur well after weaning) universally report exceedingly high reliability, whereas "prospective" assessments (women report infant feeding behavior during infancy, immediately after weaning, and some years later are asked to replicate their original answer) universally report poorer reliability. Interestingly, all "prospective" reliability studies, including ours, found that women over-report past breastfeeding durations by about 1 month upon the second inquiry. Researchers need not refrain from using maternal self-reported breastfeeding durations, because participants are largely still ranked correctly, relative to each other. However, such research efforts must avoid attempting to determine any optimal threshold duration.
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Affiliation(s)
- Marit L Bovbjerg
- Epidemiology Program, College of Public Health and Human Sciences, Oregon State University, 103 Milam Hall, Corvallis, OR, 97331, USA.
| | - Adrienne E Uphoff
- Department of Obstetrics and Gynecology, Carilion Clinic, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Kenneth D Rosenberg
- Oregon Health and Science University-Portland State University School of Public Health, Portland, OR, USA
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12
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Smith TM, Cook L, Dirks W, Green DR, Austin C. Teeth reveal juvenile diet, health and neurotoxicant exposure retrospectively: What biological rhythms and chemical records tell us. Bioessays 2021; 43:e2000298. [PMID: 33721363 DOI: 10.1002/bies.202000298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 01/14/2023]
Abstract
Integrated developmental and elemental information in teeth provide a unique framework for documenting breastfeeding histories, physiological disruptions, and neurotoxicant exposure in humans and our primate relatives, including ancient hominins. Here we detail our method for detecting the consumption of mothers' milk and exploring health history through the use of laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) mapping of sectioned nonhuman primate teeth. Calcium-normalized barium and lead concentrations in tooth enamel and dentine may reflect milk and formula consumption with minimal modification during subsequent tooth mineralization, particularly in dentine. However, skeletal resorption during severe illness, and bioavailable metals in nonmilk foods, can complicate interpretations of nursing behavior. We show that explorations of the patterning of multiple elements may aid in the distinction of these important etiologies. Targeted studies of skeletal chemistry, gastrointestinal maturation, and the dietary bioavailability of metals are needed to optimize these unique records of human health and behavior.
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Affiliation(s)
- Tanya M Smith
- Australian Research Centre for Human Evolution, Griffith University, Nathan, Queensland, Australia.,Griffith Centre for Social and Cultural Research, Griffith University, Nathan, Queensland, Australia
| | - Luisa Cook
- School of Nursing, Midwifery and Social Work, University of Queensland, Saint Lucia, Queensland, Australia
| | - Wendy Dirks
- Department of Anthropology, Durham University, Durham, Durham, UK
| | - Daniel R Green
- Department of Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Christine Austin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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13
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Are Mothers Certain About Their Perceptions of Recalled Infant Feeding History? J Pediatr Health Care 2021; 35:156-162. [PMID: 33020013 PMCID: PMC7965233 DOI: 10.1016/j.pedhc.2020.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/27/2020] [Accepted: 09/07/2020] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Maternal recall of infant feeding, a potential measurement bias, is used to identify the relationship between mothers' own milk (MOM) feeding and subsequent health outcomes. This study describes maternal recall certainty of MOM feedings at four time periods. METHOD In this secondary analysis, mothers of children ages 4-36 months describe infants' MOM feeding and rate certainty of their recall. RESULTS MOM was the first feeding for 78.5% of infants and received by 83% the first week, 85% the first month, and 62% the fourth month. Ratings of recall certainty were > 95% for each time period. Recall certainty was significantly different for four time periods (χ2 = 9.67, p = 0.02), with no two periods significantly different in post hoc analyses. DISCUSSION Maternal recall certainty of infant feeding was high regardless of elapsed time. Measuring maternal recall certainty may be useful in clinical practice and studies linking MOM exposure to subsequent health outcomes.
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14
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Cordero L, Stenger MR, Blaney SD, Finneran MM, Nankervis CA. Prior breastfeeding experience and infant feeding at discharge among women with pregestational diabetes mellitus. J Neonatal Perinatal Med 2020; 13:563-570. [PMID: 32007962 DOI: 10.3233/npm-190308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare multiparous women with pregestational diabetes mellitus (PGDM) with and without prior breastfeeding (BF) experience and to ascertain their infants' feeding type during hospitalization and at discharge. METHODS A retrospective cohort study of 304 women with PGDM who delivered at ≥34 weeks gestational age (GA). Prior BF experience and infant feeding preference was declared prenatally. At discharge, BF was defined as exclusive or partial. RESULTS BF experience and no experience groups were similar in diabetes type 1 and 2, race and number of pregnancies. Women with no experience had more spontaneous abortions (35 vs 27%), fewer term deliveries (51 vs 61%) and living children (median 1 vs 2). In the current pregnancy, mode of delivery: vaginal (36 & 37%), cesarean (64 & 63%), birthweight (3592 & 3515 g), GA (38 & 37 w), NICU admission (14 & 11%) and hypoglycemia (44 & 43%) were similar. Women with experience intended to BF (79 vs 46%), their infants' first feeding was BF (64 vs 36%) and had lactation consults (96 vs 63%) more often than those without experience. At discharge, women with BF experience were different in rate of exclusive BF (33 vs 11%), partial BF (48 vs 25%) and formula feeding (19 vs 64%). CONCLUSION Prior BF experience leads to better BF initiation rates while the absence of BF experience adds a risk for BF initiation failure. A detailed BF history could provide insight into obstacles that lead to unsuccessful BF experiences and may help define appropriate preventive or corrective strategies.
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Affiliation(s)
- L Cordero
- Pediatrics and Obstetrics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - M R Stenger
- Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - S D Blaney
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - M M Finneran
- Maternal Fetal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - C A Nankervis
- Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
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15
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Abstract
Background Globally, the prevalence of child stunting has been decreasing over the past decades. However, in low- and middle-income countries such as Mexico, stunting is still the most prevalent form of undernutrition affecting a large number of children in the most vulnerable conditions. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child stunting. Objective To examine the association between breastfeeding (defined as never breastfed, any breastfeeding for <6 months, and any breastfeeding for ≥6 months) and other individual-, household-, and area-level factors with child stunting (defined as length/height-for-age-z-score for sex under -2 standard deviations of the World Health Organization child growth standards' median) in Mexico. Methods Secondary data analysis using the 2012 Mexican Health and Nutrition Survey, which allowed representativeness of rural and urban areas at national level and among 4 regions in Mexico. Our subset included data on 2,089 singleton Mexican children aged 6-35 months with information on previously identified risk and protective factors for stunting. We conducted fixed- and mixed-effects logistic regression models sequentially controlling for each level of factors. Findings Overall, 12.3% of children were stunted and 71.1% were breastfed for ≥6 months. Any breastfeeding and being female were consistent protective factors against child stunting across all models. In contrast, child low birthweight, maternal short stature, higher number of children aged <5 years per household, and moderate to severe food insecurity were consistent risk factors for child stunting across all models. Conclusions According to our findings, efforts to reduce child stunting in Mexico should include prenatal strategies aiming to prevent low birthweight offspring particularly among short-stature women, moderate to severe food insecure households, families with a higher number of children aged <5 years, and indigenous communities. Postnatal components should include multilevel strategies to support breastfeeding.
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16
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Mirzaei Salehabadi S, Sengupta D, Ghosal R. Estimating menarcheal age distribution from partially recalled data. Biostatistics 2020; 21:876-894. [PMID: 31086969 DOI: 10.1093/biostatistics/kxz013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 03/05/2019] [Accepted: 03/24/2019] [Indexed: 11/12/2022] Open
Abstract
In a cross-sectional study, adolescent and young adult females were asked to recall the time of menarche, if experienced. Some respondents recalled the date exactly, some recalled only the month or the year of the event, and some were unable to recall anything. We consider estimation of the menarcheal age distribution from this interval-censored data. A complicated interplay between age-at-event and calendar time, together with the evident fact of memory fading with time, makes the censoring informative. We propose a model where the probabilities of various types of recall would depend on the time since menarche. For parametric estimation, we model these probabilities using multinomial regression function. Establishing consistency and asymptotic normality of the parametric maximum likelihood estimator requires a bit of tweaking of the standard asymptotic theory, as the data format varies from case to case. We also provide a non-parametric maximum likelihood estimator, propose a computationally simpler approximation, and establish the consistency of both these estimators under mild conditions. We study the small sample performance of the parametric and non-parametric estimators through Monte Carlo simulations. Moreover, we provide a graphical check of the assumption of the multinomial model for the recall probabilities, which appears to hold for the menarcheal data set. Our analysis shows that the use of the partially recalled part of the data indeed leads to smaller confidence intervals of the survival function.
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17
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Kim MY, Kim HJ, Noh JH, Kim SA, Hwang DS, Lee CH, Ha IH. Relationship of breastfeeding duration with joint pain and knee osteoarthritis in middle-aged Korean women: a cross-sectional study using the Korea National Health and Nutrition Examination Survey. BMC WOMENS HEALTH 2020; 20:213. [PMID: 32972416 PMCID: PMC7517693 DOI: 10.1186/s12905-020-01078-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 09/17/2020] [Indexed: 11/21/2022]
Abstract
Background The effect of joint health on the quality of life of middle-aged and older women is becoming more widely recognized with the aging of the world’s population. However, the association of long-term breastfeeding with joint pain and knee osteoarthritis has not been fully examined. The aim of this study was to determine the association of prior breastfeeding duration with current joint pain and knee osteoarthritis in middle-aged Korean women. Methods This cross-sectional study was conducted among 3454 women aged ≥50 years who underwent knee radiography and answered a questionnaire on breastfeeding and joint pain for the 5th Korea National Health and Nutrition Examination Survey (2010–2011). After adjusting for confounding sociodemographic, medical history, and obstetric and gynecologic variables, logistic regression analysis was conducted to analyze the prevalence of joint pain and knee osteoarthritis according to breastfeeding and its duration. Results Among the 3454 participants, 298 had not breastfed and 1042, 815, and 1299 had breastfed for 1–24, 25–48, and ≥ 49 months, respectively. Of all participants, 1731 had joint pain and 739 were diagnosed with knee osteoarthritis after radiography. Using the non-breastfeeding group as a reference, the odds ratio (OR) for joint pain among women who breastfed ≥1 month was 1.49 (95% confidence interval [CI] 1.01–2.21). As the breastfeeding duration increased, the OR of joint pain prevalence also increased (p for trend; p = 0.002). For knee osteoarthritis, the OR was 2.30 in the 25–48 months group (95% CI 1.09–4.86). The OR of knee osteoarthritis in the ≥49 months group was 2.17 (95% CI 1.01–4.64). Sensitivity analysis after selecting only participants aged ≥60 years showed that the prevalence of joint pain and knee osteoarthritis was more positively correlated with extended breastfeeding duration (joint pain, p for trend; p = 0.005) (knee osteoarthritis, p for trend; p = 0.012). Conclusions Long-term feeding for more than 25 months was associated with an increased prevalence of joint pain and degenerative arthritis in Korean women aged ≥50 years.
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Affiliation(s)
- Min-Young Kim
- Daejeon Jaseng Hospital of Korean Medicine, Daejeon, South Korea
| | - Hyun-Joong Kim
- Daejeon Jaseng Hospital of Korean Medicine, Daejeon, South Korea
| | - Je-Heon Noh
- Daejeon Jaseng Hospital of Korean Medicine, Daejeon, South Korea
| | - Sun-A Kim
- Daejeon Jaseng Hospital of Korean Medicine, Daejeon, South Korea
| | - Deok-Sang Hwang
- Department of Korean Medicine Gynecology, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Chang-Hoon Lee
- Department of Korean Medicine Gynecology, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F JS tower, 538 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea.
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18
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de Deus VF, Gomes E, da Silva FC, Giugliani ERJ. Influence of pacifier use on the association between duration of breastfeeding and anterior open bite in primary dentition. BMC Pregnancy Childbirth 2020; 20:396. [PMID: 32641129 PMCID: PMC7346668 DOI: 10.1186/s12884-020-03054-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 06/11/2020] [Indexed: 11/17/2022] Open
Abstract
Background The literature is controversial with regard to the association between longer breastfeeding duration and lower prevalence of anterior open bite. Pacifier use may be involved in this controversy. Thus, the objective of the study was to assess the influence of pacifier use and its duration on the association between longer breastfeeding duration and lower prevalence of anterior open bite in children with primary dentition. Methods This was a cross-sectional study nested in a cohort study involving 153 infants recruited at a maternity hospital in the municipality of Porto Alegre, southern Brazil. The study outcome (anterior open bite) was assessed when the children were between 3 and 5 years old. Data on breastfeeding and pacifier use were collected at 7, 30, 60, 120, and 180 days of life and on the date of the evaluation here described. Poisson regression with robust variance was used to analyze the association between the prevalence of anterior open bite and breastfeeding duration, expressed in months. Results The univariate analysis showed a protective effect of breastfeeding against anterior open bite (prevalence ratio [PR] 0.96; 95% confidence interval [95%CI] 0.95–0.98). This effect remained significant after adjustment for pacifier use at any time between birth and the date of dental assessment (PR0.98; 95%CI; 0.96–0.99), i.e., there was a reduction of 2% in the prevalence of anterior open bite for each month of breastfeeding. However, this effect lost significance when pacifier use duration was included in the multivariate analysis (PR1.00; 95%CI; 0.99–1.01). Conclusions Pacifier use duration influences the association between longer breastfeeding duration and lower prevalence of anterior open bite. It is likely that prolonged pacifier use reduces the magnitude of this association.
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Affiliation(s)
- Vanessa Felipe de Deus
- Postgraduate Program in Child and Adolescent Health, Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Porto Alegre, RS, CEP 90035-003, Brazil
| | - Erissandra Gomes
- Department of Surgery and Orthopedics, School of Dentistry, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2492, Porto Alegre, RS, CEP 90035-003, Brazil.
| | - Fernanda Caramez da Silva
- Postgraduate Program in Child and Adolescent Health, Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Porto Alegre, RS, CEP 90035-003, Brazil
| | - Elsa Regina Justo Giugliani
- Postgraduate Program in Child and Adolescent Health, Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Porto Alegre, RS, CEP 90035-003, Brazil
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19
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Li R, Ingol TT, Smith K, Oza-Frank R, Keim SA. Reliability of Maternal Recall of Feeding at the Breast and Breast Milk Expression 6 Years After Delivery. Breastfeed Med 2020; 15:224-236. [PMID: 32049572 PMCID: PMC7175623 DOI: 10.1089/bfm.2019.0186] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: The reliability of long-term maternal recall of breastfeeding has been assessed previously, but not maternal milk expression (pumping) and child consumption of expressed milk. Objective: To examine the reliability of maternal recall of feeding at the breast, maternal milk expression, and child consumption of expressed milk 6 years after delivery using the Brief Breastfeeding and Milk Expression Recall Survey (BaByMERS). Methods: At 12 months postpartum, women who delivered a singleton, live-born infant at >24 weeks of gestation at a major U.S. academic hospital completed BaByMERS. Five years later, they were recontacted to complete the same questionnaire. Kappa statistics (κ), intraclass correlation coefficient (ICC), and Bland/Altman plots examined agreement. Sociodemographics were examined through stratified comparisons. Results: Of 299 women who completed both questionnaires, 35% had a postgraduate education and 82% identified as white/Caucasian. Kappa statistics showed substantial agreement for ever breastfeeding or feeding breast milk (combined) (κ = 0.71, 95% confidence interval [CI]: 0.44-0.98) and ever feeding at the breast (κ = 0.76, 95% CI: 0.62-0.89). Recall for duration of feeding at the breast was excellent (ICC = 0.96, 95% CI: 0.95-0.97), and of maternal milk expression was slightly less so (ICC = 0.83, 95% CI: 0.80-0.97). Maternal minority race/ethnicity, lower educational attainment, unmarried marital status, public/no health insurance, and smoking were associated with lower reliability; these differences were usually small and not consistent across all feeding practices. Conclusions: Maternal recall of contemporary lactation and infant feeding using BaByMERS was strongly reliable 6 years after delivery. BaByMERS may be useful to collect recall data, with attention to subpopulations that may exhibit lower recall reliability.
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Affiliation(s)
- Rui Li
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.,Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Taniqua T Ingol
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Katie Smith
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Reena Oza-Frank
- Department of Obstetrics and Gynecology, College of Medicine, The Ohio State University, Columbus, Ohio.,Ohio Department of Health, Columbus, Ohio
| | - Sarah A Keim
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio.,Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio
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20
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Sun J, Wu L, Zhang Y, Li C, Wang Y, Mei W, Zhang J. Association of breastfeeding duration, birth weight, and current weight status with the risk of elevated blood pressure in preschoolers. Eur J Clin Nutr 2020; 74:1325-1333. [PMID: 32203240 DOI: 10.1038/s41430-020-0608-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Few studies have examined the effects of the weight status at birth and preschool age on the risk of elevated blood pressure (EBP) in early childhood, and whether the effects can be modified by breastfeeding duration remains unclear. We aimed to evaluate the effects of high birth weight (HBW) with overweight/obese or abdominal obesity on the risk of EBP in preschoolers, and further evaluate the effects classified by breastfeeding duration (<6 and ≥6 months). SUBJECTS/METHODS This cross-sectional study was conducted in 2018 in Zhuhai, China. Out of 2390 3-4-year-old preschoolers originally recruited, a total of 1899 were included in the analysis. Logistic regression analysis was performed to examine the effects of the weight status at the two age points and breastfeeding duration on the risk of EBP. RESULTS Preschoolers with current overweight/obese had a 1.13-fold increased risk of EBP than those with persistent normal weight, irrespective of their birth weight. However, the preschoolers with HBW had no increased risk of EBP, when they became normal weight (OR 1.70, 0.78-3.72). Similar results were found for the current abdominal obesity and the risk of EBP. In addition, the EBP risk of obese status was minimized if preschoolers were breastfed for ≥6 months. CONCLUSIONS Obesity status at preschool age can increase the risk of EBP, irrespective of birth weight. However, this EBP risk can be mitigated if HBW changes to current normal weight. Longer breastfeeding duration can partially offset the risk of EBP in preschoolers with obesity status.
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Affiliation(s)
- Jiahong Sun
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Wuhan, 430030, Hubei, China
| | - Lisha Wu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Wuhan, 430030, Hubei, China
| | - Yuanyuan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Wuhan, 430030, Hubei, China
| | - Chunan Li
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Wuhan, 430030, Hubei, China
| | - Yake Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Wuhan, 430030, Hubei, China
| | - Wenhua Mei
- Department of Information, Zhuhai Public Hospital Administration, 41 Jiaoyu Rd., Zhuhai, 519000, Guangdong, China.,Department of Epidemiology, Jinan University, 601 Huangpu Western Rd., Guangzhou, 510632, Guangdong, China
| | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd., Wuhan, 430030, Hubei, China.
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Dharel D, Dhungana R, Basnet S, Gautam S, Dhungana A, Dudani R, Bhattarai A. Breastfeeding practices within the first six months of age in mid-western and eastern regions of Nepal: a health facility-based cross-sectional study. BMC Pregnancy Childbirth 2020; 20:59. [PMID: 32000701 PMCID: PMC6990469 DOI: 10.1186/s12884-020-2754-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 01/20/2020] [Indexed: 11/20/2022] Open
Abstract
Background The World Health Organization recommends initiation of breastfeeding within 1 hour of birth and exclusive breastfeeding up to 6 months of age. Infant feeding practices, including suboptimal breastfeeding practices, are associated with stunting. Rate of stunting was highest in the Mid-western region and lowest in the Eastern region of Nepal. This study aimed to assess the breastfeeding practices in these two regions, as well as to identify factors associated with partial breastfeeding. Methods We conducted a health facility-based cross-sectional study in the Mid-western and Eastern regions of Nepal from December 2017 to May 2018. Investigators administered a pre-tested questionnaire among consecutive 574 mother-infant dyads at different levels of health facilities. We dichotomized the breastfeeding pattern to partial breastfeeding and full (exclusive or predominant) breastfeeding. We conducted multivariable logistic regression to identify factors associated with partial breastfeeding within 6 months of age. Results There were 574 infants included in the study, all of which received at least some breastfeeding. Only 23.2% of infants were exclusively breastfed until 6 months, with 28.2% predominantly breastfed and 48.6% partially breastfed. Partial breastfeeding rate was 52.3% in the Mid-western region and 44.4% in the Eastern region. Breastfeeding was initiated within an hour from birth in 67.2% of infants. One-quarter of infants were given pre-lacteal feed, honey being the commonest. Knowledge of the recommended duration of exclusive breastfeeding was inadequate in 16, and 65% of mothers reported breastfeeding problems in the first 6 months. Firstborn and low birth weight infants had a significantly higher rate of partial breastfeeding. Partial breastfeeding was also higher when infants were not breastfed within 1 hour from birth, mothers reported having breastfeeding-related problems or had inadequate knowledge of the duration of exclusive breastfeeding. Conclusion Nearly half of the infants were fully breastfed at 6 months of age in Nepal. The rate of partial breastfeeding was higher with inadequate knowledge on duration of exclusive breastfeeding or late initiation of breastfeeding or perceived breastfeeding problems. Hence, programs should address knowledge and practice gaps in breastfeeding practices, particularly among mothers of low birth weight and firstborn infants.
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Affiliation(s)
- Dinesh Dharel
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, 1403 29th Street NW, Calgary, AB, T2N 2T9, Canada. .,BP Koirala Institute of Health Sciences, Dharan, Nepal.
| | | | - Sushma Basnet
- Lifeline Hospital Institute of Health Sciences, Damak, Jhapa, Nepal
| | - Swotantra Gautam
- BP Koirala Institute of Health Sciences, Dharan, Nepal.,Population Health Research Institute (PHRI), Hamilton, Canada
| | | | - Rajesh Dudani
- John H Stroger Hospital of Cook Country, Chicago, USA
| | - Asmita Bhattarai
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Manohar N, Hayen A, Bhole S, Arora A. Predictors of Early Introduction of Core and Discretionary Foods in Australian Infants-Results from HSHK Birth Cohort Study. Nutrients 2020; 12:E258. [PMID: 31963864 PMCID: PMC7019241 DOI: 10.3390/nu12010258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 11/21/2022] Open
Abstract
Early introduction of complementary foods can have a detrimental impact on children's long-term health. This study examined the timing and determinants of early introduction of core and discretionary foods among infants in Sydney, Australia. Mothers (n = 1035) from an ongoing population-based birth cohort study were interviewed at 8, 17, 34 and 52 weeks postpartum. The outcome was 'age at which particular core and discretionary food items were first introduced'. Multivariable logistic regression models were used to investigate family and infant-related determinants of early introduction of core (<17 weeks of age) and discretionary foods (<52 weeks of age). Of the 934 mother-infant dyads interviewed, 12% (n = 113) of infants were introduced core foods before 17 weeks of age (median: 22). Mothers working part-time (adjusted odds ratio (OR): 3.42, 95% confidence interval (CI): 1.54-7.62) and those exclusively formula-feeding their babies at four-weeks postpartum (adjusted OR 3.26, 95% CI: 1.99-5.33) were most likely to introduce core foods early. Ninety-five percent (n = 858) of infants were introduced discretionary foods before 52 weeks of age (median: 28). Low socio-economic status was significantly associated with early introduction of discretionary foods (adjusted OR: 3.72, 95% CI: 1.17-11.78). Compliance with infant feeding guidelines related to core foods was better; however, discretionary foods were introduced early in most infants.
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Affiliation(s)
- Narendar Manohar
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia;
| | - Andrew Hayen
- Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia;
| | - Sameer Bhole
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW 2010, Australia;
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW 2010, Australia
- Oral Health Alliance, Oral Health Centre, University of Queensland, Brisbane, QLD 4072, Australia
- Metro North Oral Health Services, Stafford, QLD 4053, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia;
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW 2010, Australia;
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, University of Sydney Faculty of Medicine and Health, Westmead, NSW 2050, Australia
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Impact of voluntary community-based health insurance on child stunting: Evidence from rural Uganda. Soc Sci Med 2019; 245:112738. [PMID: 31855728 DOI: 10.1016/j.socscimed.2019.112738] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 12/12/2019] [Accepted: 12/13/2019] [Indexed: 01/07/2023]
Abstract
While community-based health insurance increasingly becomes part of the health financing landscape in developing countries, there is still limited research about its impacts on health outcomes. Using cross-sectional data from rural south-western Uganda, we apply a two-stage residual inclusion instrumental variables method to study the impact of insurance participation on child stunting in under-five children. We find that one year of a household's participation in community-based health insurance was associated with a 4.3 percentage point less probability of stunting. Children of two years or less dominated the effect but there were also statistically significant benefits of enrolling in insurance after a child's birth. The expansion of community-based health insurance might have more dividends to improving health, in addition to financial protection and service utilisation in rural developing countries.
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24
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Rehayem A, Taki S, Brown N, Denney-Wilson E. Infant feeding beliefs and practices of Arabic mothers in Australia. Women Birth 2019; 33:e391-e399. [PMID: 31353232 DOI: 10.1016/j.wombi.2019.07.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/06/2019] [Accepted: 07/08/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Culturally sensitive care in the health care system is imperative for optimal outcomes of all patients, especially women and their infants. For Arabic mothers in Australia, there is minimal research exploring their beliefs that could impact on their infant feeding decisions and practices. AIM The aim of this study was to explore the experiences, knowledge and influences around infant feeding in Arabic women in Australia. METHOD A qualitative descriptive approach was used. Focus groups were conducted with Arabic women in community organisations (Catholic & Islamic) in Sydney. A thematic analysis was undertaken. The Iowa Infant Feeding Attitude Scale (IIFAS) was also used to measure maternal attitudes towards infant feeding. FINDINGS A total of 17 women participated in three focus groups. Themes relating to infant feeding were identified, including (1) sources of knowledge and education, particularly, where mothers obtained their infant feeding knowledge, and how this was influenced; (2) cultural beliefs related to the support and direction of family members.; (3) religious beliefs surrounding the continuation of infant feeding practices; (4) social and personal themes as an influence on infant feeding decisions and practices, and (5) factors associated with cessation of exclusive breastfeeding, including the lack of support from health care professionals. CONCLUSION The Arabic women in this study have expressed their need for further culturally sensitive care surrounding infant feeding knowledge and practices, and for that care to be situated in their community. Further intervention-based studies in the community focusing on culturally competent and sensitive care are recommended.
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Affiliation(s)
- Amanda Rehayem
- Clinical Midwife Specialist, Midwifery Group Practice, South Eastern Sydney Local Health District, Australia.
| | - Sarah Taki
- Health Promotion Unit, Sydney Local Health District, School of Public Health, The University of Sydney, Australia
| | - Nicola Brown
- Professional Practice and Innovation Centre, Tresillian Family Care Centres, Australia
| | - Elizabeth Denney-Wilson
- Sydney Local Health District and Susan Wakil School of Nursing, The University of Sydney, Australia
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Chetwynd EM, Stuebe AM, Rosenberg L, Troester MA, Palmer JR. Prepregnancy Diabetes and Breastfeeding Cessation Among Black Women in the United States. Breastfeed Med 2019; 14:249-255. [PMID: 30839228 PMCID: PMC6532327 DOI: 10.1089/bfm.2018.0074] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: The incidence of diabetes is rising, and with it, the number of pregnancies affected by diabetes. U.S. black women have a disproportionately high prevalence of diabetes and lower rates of breastfeeding. Objective: The objective of this study was to quantify the relationship between diabetes before pregnancy and breastfeeding duration among black women in the United States. Materials and Methods: We analyzed women from the Black Women's Health Study (N = 59,000) to assess the relationship between prepregnancy diabetes and time to breastfeeding cessation occurring up to 24 months postdelivery using Kaplan-Meier survival curves, log rank tests, and Cox proportional hazards models. The study population included primiparous women with births between 1995 and 2009 (N = 3,404). Obesity, hypertension before pregnancy, and family history of diabetes were examined for effect modification. Results: Survival curves demonstrated a markedly reduced duration of breastfeeding in women who had been diagnosed with prepregnancy diabetes (p < 0.01). The hazard ratio for breastfeeding cessation for women with prepregnancy diabetes was 1.5 (95% confidence interval 1.1-2.0) compared with women without prepregnancy diabetes after control for age, body mass index (BMI) at age 18, prepregnancy BMI, other metabolic factors, demographics, and health behaviors. Conclusions: Our results suggest that prepregnancy diabetes is a strong predictor of curtailed breastfeeding duration, even after control for BMI. This underscores the need for targeted lactation support for diabetic women.
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Affiliation(s)
- Ellen M Chetwynd
- 1 Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,2 Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Raleigh, North Carolina
| | - Alison M Stuebe
- 2 Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Raleigh, North Carolina.,3 Department of Maternal, Fetal Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Lynn Rosenberg
- 4 Slone Epidemiology Center, Boston University, Boston, Massachusetts
| | - Melissa A Troester
- 5 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Julie R Palmer
- 4 Slone Epidemiology Center, Boston University, Boston, Massachusetts
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Bell LK, Jansen E, Mallan K, Magarey AM, Daniels L. Poor dietary patterns at 1-5 years of age are related to food neophobia and breastfeeding duration but not age of introduction to solids in a relatively advantaged sample. Eat Behav 2018; 31:28-34. [PMID: 30086453 DOI: 10.1016/j.eatbeh.2018.06.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 06/14/2018] [Accepted: 06/21/2018] [Indexed: 01/17/2023]
Abstract
Previous studies have investigated associations between individual foods or food group intake, and breastfeeding duration, age of solid introduction and food neophobia. This study aimed to investigate associations between whole dietary patterns in young children, and breastfeeding duration, age of solid introduction and food neophobia. Parents of children (N = 234) aged 1-5 years completed an online questionnaire. Dietary risk scores were calculated using the Toddler (1-3 years) or Preschool (>3-<5 years) Dietary Questionnaires which evaluates the previous week's food-group intake (scored 0-100; higher score = higher risk of poor dietary quality). Neophobia was measured using the Child Food Neophobia scale (1.0-4.0; higher score = more neophobic). Associations were investigated using multivariable linear regression, adjusting for covariates. Children (54% female, 3.0 ± 1.4 years) were from advantaged families and were breastfed until 11.8 (5.0-16.0) months, started solids at 5.6 ± 1.4 months of age, moderately neophobic (2.1 ± 0.7) and at moderate dietary risk (29.2 ± 9.2). Shorter breastfeeding duration (β = -0.21; p = 0.001) and poorer child food neophobia scores (β = 0.36; p < 0.001) were associated with higher dietary risk scores. Age of introduction to solids showed no association with dietary risk (p = 0.744). These findings suggest that in addition to breastfeeding promotion, supporting parents to manage neophobic behaviour may be important in promoting healthy eating patterns in early childhood.
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Affiliation(s)
- Lucinda K Bell
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, South Australia 5042, Australia.
| | - Elena Jansen
- Centre for Children's Health Research, Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland 4101, Australia
| | - Kimberley Mallan
- Centre for Children's Health Research, Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland 4101, Australia; School of Psychology, Australian Catholic University, 1100 Nudgee Road, Banyo, Queensland 4014, Australia
| | - Anthea M Magarey
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, South Australia 5042, Australia
| | - Lynne Daniels
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, South Australia 5042, Australia; Centre for Children's Health Research, Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland 4101, Australia
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Allen A, Tosun N, Carlson S, Allen S. Postpartum Changes in Mood and Smoking-Related Symptomatology: An Ecological Momentary Assessment Investigation. Nicotine Tob Res 2018; 20:681-689. [PMID: 28575412 PMCID: PMC5934674 DOI: 10.1093/ntr/ntx118] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 05/25/2017] [Indexed: 11/14/2022]
Abstract
Introduction Postpartum smoking relapse is a highly prevalent public health problem. Mood and breast feeding are significantly associated with smoking relapse, although less is known about the temporality of these relationships. Therefore, this study utilized ecological momentary assessments (EMA) to prospectively examine changes in mood and smoking-related symptomatology in relationship to three events-childbirth, termination of breast feeding, and smoking relapse. We expected all three events to significantly alter mood and smoking-related symptomatology. Methods We enrolled a sample of pregnant women who had recently quit smoking and intended to remain quit during the postpartum. Participants were randomized to active/placebo progesterone to prevent postpartum relapse. Participants also completed daily EMA to collect data mood and smoking-related symptomatology as well as our three events of interest. Results Participants (n = 46) were, on average, 26.5 ± 0.8 years old and, prior to pregnancy, smoked 10.1 ± 0.7 cigarettes/day. We noted a number of significant within- and between-subject relationships. For example, participants reported a 24% decline in negative affect after childbirth (p = .0016). Among those who relapsed to smoking (n = 23), participants randomized to placebo had a significant increase in cigarette craving after relapse (β = 1.06, 95% confidence interval [CI] = 0.62 to 1.49, p value = .0003), whereas participants randomized to active progesterone did not (β = 0.63, 95% CI = -0.35 to 1.62, p value = .1824). Conclusions These observations suggest that mood and smoking-related symptomatology are influenced by childbirth, breast feeding, smoking relapse, and use of exogenous progesterone. Future research should explore how these observations may inform novel postpartum smoking relapse-prevention interventions. Implications Postpartum smoking relapse has been a persistent public health problem for more than 40 years. Although a number of significant predictors of postpartum smoking relapse have been identified (eg, depression and breast feeding), much of these analyses have relied on cross-sectional and/or self-reported retrospective data. Therefore, for the first time, we utilized ecological momentary assessment to explore the effect of childbirth, termination of breast feeding, and smoking relapse on mood and smoking-related symptomatology (eg, craving). Numerous significant relationships were observed, including a 96% increase in craving after smoking relapse. These novel observations can inform new and effective postpartum smoking relapse-prevention programs.
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Affiliation(s)
- Alicia Allen
- Department of Family Medicine & Community Health, University of Minnesota, Minneapolis, MN
| | - Nicole Tosun
- Department of Family Medicine & Community Health, University of Minnesota, Minneapolis, MN
| | - Samantha Carlson
- Department of Family Medicine & Community Health, University of Minnesota, Minneapolis, MN
| | - Sharon Allen
- Department of Family Medicine & Community Health, University of Minnesota, Minneapolis, MN
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Delgado CA, Munhoz TN, Santos IS, Barros FC, Matijasevich A. Prolonged breastfeeding for 24 months or more and mental health at 6 years of age: evidence from the 2004 Pelotas Birth Cohort Study, Brazil. Child Adolesc Ment Health 2017; 22:209-215. [PMID: 32680415 DOI: 10.1111/camh.12224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/20/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is scarce and conflicting evidence on medium- to long-term effects of prolonged breastfeeding on child behavior. METHOD A population-based birth cohort study started in 2004 in the city of Pelotas, Southern Brazil. Children were followed up at 3, 12, 24, and 48 months and 6 years of age. Breastfeeding duration was determined based on information collected around the time of weaning. Psychiatric disorders were assessed using the Development and Well-Being Assessment (DAWBA). Children who were never breastfed were excluded from the analysis. Crude and adjusted analyses were performed using Poisson regression with robust variance. RESULTS Data on breastfeeding and mental health at the age of 6 years were available for 3377 children. Prevalence of breastfeeding for 24-35 months and ≥36 months was 16.1% (95% CI: 14.8-17.3) and 8.1% (95% CI: 7.2-9.1), respectively. Prevalence of psychiatric disorders among those who were breastfed for <24 months, 24-35 months and ≥36 months was 12.4% (95% CI: 11.1-13.7), 13.1% (95% CI: 10.4-16.2) and 12.3% (95% CI: 8.7-16.8), respectively. No association was found between breastfeeding for 24 months or more and psychiatric disorders among children aged 6 years both in the crude and adjusted analyses. CONCLUSIONS In this cohort there was no association between breastfeeding for 24 months or more and an increased prevalence of psychiatric disorders at the age of 6 years. Studies analyzing the medium- and long-term effects of prolonged breastfeeding for 2 years or more are scarce and further research is needed regarding this practice.
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Affiliation(s)
- Carlos Alberto Delgado
- Centro de Pesquisas Epidemiológicas - Universidade Federal de Pelotas, Rua Marechal Deodoro, CEP: 96020-220, Caixa Postal 464, 1160 Pelotas, RS, Brazil
| | - Tiago N Munhoz
- Centro de Pesquisas Epidemiológicas - Universidade Federal de Pelotas, Rua Marechal Deodoro, CEP: 96020-220, Caixa Postal 464, 1160 Pelotas, RS, Brazil
| | - Iná S Santos
- Centro de Pesquisas Epidemiológicas - Universidade Federal de Pelotas, Rua Marechal Deodoro, CEP: 96020-220, Caixa Postal 464, 1160 Pelotas, RS, Brazil
| | - Fernando C Barros
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Centro de Pesquisas Epidemiológicas - Universidade Federal de Pelotas, Rua Marechal Deodoro, CEP: 96020-220, Caixa Postal 464, 1160 Pelotas, RS, Brazil.,Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
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Chetwynd EM, Stuebe AM, Rosenberg L, Troester M, Rowley D, Palmer JR. Cumulative Lactation and Onset of Hypertension in African-American Women. Am J Epidemiol 2017; 186:927-934. [PMID: 28535171 DOI: 10.1093/aje/kwx163] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 12/08/2016] [Indexed: 12/16/2022] Open
Abstract
Hypertension affects nearly 1 of 3 women and contributes to cardiovascular disease, the leading cause of death in the United States. Breastfeeding leads to metabolic changes that could reduce risks of hypertension. Hypertension disproportionately affects black women, but rates of breastfeeding among black women lag behind those in the general population. In the Black Women's Health Study (n = 59,001), we conducted a nested case-control analysis using unconditional logistic regression to estimate the association between breastfeeding and incident hypertension at ages 40-65 years using data collected from 1995 to 2011. Controls were frequency-matched 2:1 to 12,513 hypertensive women by age and questionnaire cycle. Overall, there was little evidence of association between ever breastfeeding and incident hypertension (odds ratio = 0.97, 95% confidence interval: 0.92, 1.02). However, age modified the relationship (P = 0.02): Breastfeeding was associated with reduced risk of hypertension at ages 40-49 years (odds ratio = 0.92, 95% confidence interval: 0.85, 0.99) but not at older ages. In addition, risk of hypertension at ages 40-49 years decreased with increasing duration of breastfeeding (P for trend = 0.08). Our results suggest that long-duration breastfeeding may reduce the risk of incident hypertension in middle age. Addressing breastfeeding as a potential preventative health behavior is particularly compelling because it is required for only a discrete period of time.
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Ponce-Garcia C, Hernandez IA, Major P, Flores-Mir C. Association between Breast Feeding and Paediatric Sleep Disordered Breathing: a Systematic Review. Paediatr Perinat Epidemiol 2017; 31:348-362. [PMID: 28590549 DOI: 10.1111/ppe.12372] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Breast feeding has been suggested as a potential protective factor against childhood snoring and sleep disordered breathing (SDB). SDB can have major health consequences. The objective of this systematic review is to synthesise the available literature concerning any potential association between infant feeding methods and SDB in young children. METHODS Five electronic databases were searched. All searches were inclusive until August 5, 2016. Two authors independently reviewed potentially relevant articles for eligibility. Any prospective or retrospective study, case-control study, cohort study, clinical trial, and cross-sectional study that evaluated the association between infant feeding methods and SDB were included. Data on study design, aim of study, sample size, study population, assessment tool, infant feeding methods, and outcome measures were extracted. RESULTS Nine studies fulfilled the criteria to be finally included in this review, only cohorts and cross-sectional studies were identified. While seven of the selected studies reported a statistically significant association between breast feeding and reduced risk of SDB, the remaining two studies did not report any association. The main methodological limitation was high heterogeneity in the diagnostic criteria and assessment tools to identify SDB and limited data collection on infant feeding methods. CONCLUSIONS The current evidence may point to a protective association, however, as uncertainty is moderate, any suggestion that breast feeding may or may not decrease the risk of SDB is currently unwarranted. More research on the topic is required to resolve some of the contradictions between included studies.
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Affiliation(s)
- Cecilia Ponce-Garcia
- Division of Orthodontics, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | | | - Paul Major
- Division of Orthodontics, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Carlos Flores-Mir
- Division of Orthodontics, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Zamora-Kapoor A, Omidpanah A, Nelson LA, Kuo AA, Harris R, Buchwald DS. Breastfeeding in Infancy Is Associated with Body Mass Index in Adolescence: A Retrospective Cohort Study Comparing American Indians/Alaska Natives and Non-Hispanic Whites. J Acad Nutr Diet 2017; 117:1049-1056. [PMID: 28082060 PMCID: PMC5586593 DOI: 10.1016/j.jand.2016.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 11/17/2016] [Indexed: 01/16/2023]
Abstract
BACKGROUND American Indians and Alaska Natives have the highest obesity prevalence in the United States, but the influence of early childhood variables on body mass index (BMI; calculated as kg/m2) is not well understood. Previous studies have investigated the association between breastfeeding in infancy and offspring BMI, but rarely included American Indians and Alaska Natives. OBJECTIVE This study investigated the association between breastfeeding in infancy and BMI in American Indians and Alaska Native and non-Hispanic white adolescents and young adults. DESIGN Longitudinal analysis based on data from the National Longitudinal Study of Adolescent to Adult Health (1994 to 2008). PARTICIPANTS Adolescent respondents who self-identified as American Indians and Alaska Native or non-Hispanic white, and whose parents completed the parental questionnaire, reported their height and weight. The final sample included 655 American Indians and Alaska Native and 10,305 non-Hispanic white respondents. STATISTICAL ANALYSES PERFORMED Generalized estimating equations were used to measure the mean differences, 95% CIs, and P values of the association between breastfeeding in infancy and offspring BMI in adolescence, stratifying by race, and adjusting for demographic and socioeconomic variables. RESULTS The length of breastfeeding was inversely associated with BMI in both populations. American Indians and Alaska Natives that were breastfed for 6 to 12 months or for more than 12 months had a mean BMI of 2.69 (95% CI -3.46 to -1.92; P<0.01) and 1.54 (95% CI -2.75 to -0.33; P<0.05) units lower than those that were never breastfed. Non-Hispanic whites that were breastfed for 3 to 6 months, 6 to 12 months, or more than 12 months had a mean BMI of 0.71 (95% CI -0.93 to -0.50; P<0.01), 0.68 (95% CI -0.87 to -0.50; P<0.01), and 0.85 (95% CI -1.09 to -0.62; P<0.01) units lower than those that were never breastfed. The association between the length of breastfeeding and offspring BMI varied by race (P<0.01). CONCLUSIONS Breastfeeding in infancy is associated with lower mean BMI. Future research should investigate causal pathways and whether interventions promoting breastfeeding in American Indians and Alaska Natives can prevent increasing BMI.
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Affiliation(s)
- Anna Zamora-Kapoor
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
- Department of Pediatrics, University of Washington, Seattle, WA
| | - Adam Omidpanah
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
| | - Lonnie A. Nelson
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
| | - Alice A. Kuo
- Department of Pediatrics, University of California-Los Angeles, Los Angeles, CA
| | - Raymond Harris
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
| | - Dedra S. Buchwald
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
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Media audit reveals inappropriate promotion of products under the scope of the International Code of Marketing of Breast-milk Substitutes in South-East Asia. Public Health Nutr 2017; 20:1333-1342. [PMID: 28294089 DOI: 10.1017/s1368980016003591] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To review regulations and to perform a media audit of promotion of products under the scope of the International Code of Marketing of Breast-milk Substitutes ('the Code') in South-East Asia. DESIGN We reviewed national regulations relating to the Code and 800 clips of editorial content, 387 advertisements and 217 Facebook posts from January 2015 to January 2016. We explored the ecological association between regulations and market size, and between the number of advertisements and market size and growth of milk formula. SETTING Cambodia, Indonesia, Myanmar, Thailand and Vietnam. RESULTS Regulations on the child's age for inappropriate marketing of products are all below the Code's updated recommendation of 36 months (i.e. 12 months in Thailand and Indonesia; 24 months in the other three countries) and are voluntary in Thailand. Although the advertisements complied with the national regulations on the age limit, they had content (e.g. stages of milk formula; messages about the benefit; pictures of a child) that confused audiences. Market size and growth of milk formula were positively associated with the number of newborns and the number of advertisements, and were not affected by the current level of implementation of breast-milk substitute laws and regulations. CONCLUSIONS The present media audit reveals inappropriate promotion and insufficient national regulation of products under the scope of the Code in South-East Asia. Strengthened implementation of regulations aligned with the Code's updated recommendation should be part of comprehensive strategies to minimize the harmful effects of advertisements of breast-milk substitutes on maternal and child nutrition and health.
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Ambikapathi R, Kosek MN, Lee GO, Mahopo C, Patil CL, Maciel BL, Turab A, Islam MM, Ulak M, Bose A, Paredes Olortegui M, Pendergast LL, Murray-Kolb LE, Lang D, McCormick BJJ, Caulfield LE. How multiple episodes of exclusive breastfeeding impact estimates of exclusive breastfeeding duration: report from the eight-site MAL-ED birth cohort study. MATERNAL AND CHILD NUTRITION 2016; 12:740-56. [PMID: 27500709 PMCID: PMC5095788 DOI: 10.1111/mcn.12352] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 06/02/2016] [Accepted: 06/07/2016] [Indexed: 11/28/2022]
Abstract
The duration of exclusive breastfeeding (EBF) is often defined as the time from birth to the first non‐breast milk food/liquid fed (EBFLONG), or it is estimated by calculating the proportion of women at a given infant age who EBF in the previous 24 h (EBFDHS). Others have measured the total days or personal prevalence of EBF (EBFPREV), recognizing that although non‐EBF days may occur, EBF can be re‐initiated for extended periods. We compared breastfeeding metrics in the MAL‐ED study; infants' breastfeeding trajectories were characterized from enrollment (median 7 days, IQR: 4, 12) to 180 days at eight sites. During twice‐weekly surveillance, caretakers were queried about infant feeding the prior day. Overall, 101 833 visits and 356 764 child days of data were collected from 1957 infants. Median duration of EBFLONG was 33 days (95% CI: 32–36), compared to 49 days based on the EBFDHS. Median EBFPREV was 66 days (95% CI: 62–70). Differences were because of the return to EBF after a non‐EBF period. The median number of returns to EBF was 2 (IQR: 1, 3). When mothers re‐initiated EBF (second episode), infants gained an additional 18.8 days (SD: 25.1) of EBF, and gained 13.7 days (SD: 18.1) (third episode). In settings where women report short gaps in EBF, programmes should work with women to return to EBF. Interventions could positively influence the duration of these additional periods of EBF and their quantification should be considered in impact evaluation studies. © 2016 John Wiley & Sons Ltd
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Affiliation(s)
- Ramya Ambikapathi
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA.,Center for Human Nutrition, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Margaret N Kosek
- Center for Human Nutrition, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Gwenyth O Lee
- Center for Human Nutrition, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Cloupas Mahopo
- Department of Nutrition, School of Health Sciences, University of Venda, Thohoyandou, Limpopo Province, South Africa
| | - Crystal L Patil
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Bruna L Maciel
- Department of Nutrition, State University of Ceará, Fortaleza, Ceará, Brazil
| | - Ali Turab
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - M Munirul Islam
- Centre for Nutrition and Food Security, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Manjeswori Ulak
- Department of Child Health and Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | | | | | - Laura L Pendergast
- School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA
| | - Laura E Murray-Kolb
- Department of Nutritional Sciences, The Pennsylvania State University, State College, Pennsylvania, USA
| | - Dennis Lang
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Laura E Caulfield
- Center for Human Nutrition, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
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Demirci JR, Bogen DL. Feasibility and acceptability of a mobile app in an ecological momentary assessment of early breastfeeding. MATERNAL AND CHILD NUTRITION 2016; 13. [PMID: 27411497 DOI: 10.1111/mcn.12342] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 05/03/2016] [Accepted: 05/10/2016] [Indexed: 11/26/2022]
Abstract
Ecological momentary assessment (EMA) is a novel data collection method that samples subject experiences in real-time - minimizing recall bias. Here, we describe the feasibility of EMA to track breastfeeding behaviour through a mobile phone app. During their birth hospitalization, we approached healthy, first-time mothers intending to exclusively breastfeed for at least 2 months to participate in a study tracking breastfeeding through 8 weeks postpartum. Participants downloaded a commercially available smartphone app, entered information and thoughts about breastfeeding as they occurred, and emailed this data weekly. We called participants at 2 and 8 weeks to assess breastfeeding status. At the 8-week call, we also assessed participants' experiences using the app. Of the 61 participants, 38% sent complete or nearly complete feeding data, 24% sent some data, and 38% sent no data; 58% completed at least one free-text breastfeeding entry, and five women logged daily or near daily entries. Compared with women who sent no data, those who sent any were more likely to be married, highly educated, intend to breastfeed more than 6 months, have a more favourable baseline attitude towards breastfeeding, and less likely to have used formula during hospitalization. There was a high degree of agreement between participant-reported proportion of breast milk feeds via app and interview data at 2 weeks (ICC 0.97). Experiences with the app ranged from helpful to too time-consuming or anxiety-provoking. Participants and researchers encountered technical issues related to app use and analysis, respectively. While our data do not support the feasibility of stand-alone app-based EMA to track breastfeeding behaviour, it may provide rich accounts of the breastfeeding experience for certain subgroups of women. © 2016 John Wiley & Sons Ltd.
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Affiliation(s)
- Jill R Demirci
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Debra L Bogen
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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van Zyl Z, Maslin K, Dean T, Blaauw R, Venter C. The accuracy of dietary recall of infant feeding and food allergen data. J Hum Nutr Diet 2016; 29:777-785. [PMID: 27333813 DOI: 10.1111/jhn.12384] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Research investigating the association of infant dietary factors with later health outcomes often relies on maternal recall. It is unclear what the effect of recall bias is on the accuracy of the information obtained. The present study aimed to determine the extent of recall bias on the accuracy of infant feeding and food allergen data collected 10 years later. METHODS Mothers were recruited from a prospective birth cohort from the Isle of Wight. When their child was 10 years of age (2011/2012), mothers were requested to complete a retrospective infant feeding questionnaire asking the same questions as those solicited in 2001/2002. RESULTS In total, 125 mothers participated. There was substantial agreement for recollection of any breastfeeding (κ = 0.79) and the duration of breastfeeding from 10 years earlier (r = 0.84). Some 94% of mothers recalled accurately that their child had received formula milk. The exact age at which formula milk was first given was reliably answered (r = 0.63). The brand of formula milk was poorly recalled. Recall of age of introduction of solid food was not reliable (r = 0.16). The age of introduction of peanuts was the only food allergen that was recalled accurately (86%). CONCLUSIONS The present study highlights the importance of maternal recall bias of infant feeding practices over 10 years. Recall related to breastfeeding and formula feeding were reliable, whereas recalls related to age of introduction of solid or allergenic foods, apart from peanut, were not. Caution should be applied when interpreting studies relying on dietary recall.
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Affiliation(s)
- Z van Zyl
- Division of Human Nutrition, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - K Maslin
- School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK.,David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK
| | - T Dean
- School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK.,David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK
| | - R Blaauw
- Division of Human Nutrition, Department of Interdisciplinary Health Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - C Venter
- School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK.,David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK
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da Silva CF, Nunes LM, Schwartz R, Giugliani ERJ. Effect of a pro-breastfeeding intervention on the maintenance of breastfeeding for 2 years or more: randomized clinical trial with adolescent mothers and grandmothers. BMC Pregnancy Childbirth 2016; 16:97. [PMID: 27141951 PMCID: PMC4855844 DOI: 10.1186/s12884-016-0878-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 04/19/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Being an adolescent mother and cohabiting with the maternal grandmother have been shown to be risk factors for a shorter breastfeeding duration. The objective of this study was to assess whether the positive effects of a pro-breastfeeding intervention aimed at adolescent mothers and maternal grandmothers on the prevalence of breastfeeding observed in the first year of life were maintained at 2 years of age. METHODS This study is the continuation of a randomized clinical trial initiated in 2006 involving 323 adolescent mothers, their newborns and maternal grandmothers when cohabiting. The intervention consisted of six breastfeeding counseling sessions, the first one held at the maternity ward and the others at the participants' homes at 7, 15, 30, 60, and 120 days postpartum. The present study reports data collected when the children were 4 to 7 years old, concerning the maintenance of breastfeeding at 2 years. Data were analyzed using multivariable Poisson regression model with robust variance, with breastfeeding at 2 years of age as the outcome. RESULTS Maintenance of breastfeeding for 2 years or more was present in 32.2% of the sample. When the intervention and control groups were compared, the prevalence of breastfeeding at 2 years was similar (29.9 vs. 34.3%, respectively; p = 0.605). Multivariable analysis failed to reveal an association between exposure to the intervention and maintenance of breastfeeding at 2 years in the different models tested. CONCLUSIONS The positive impact of the intervention on the prevalence of breastfeeding observed in the first year of life was not maintained at 2 years of age. TRIAL REGISTRATION The study was registered at ClinicalTrials.gov on May 28, 2009 under protocol no. NCT00910377.
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Affiliation(s)
- Cristiano Francisco da Silva
- Graduate Program in Child and Adolescent Health, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
- , CLN 115 Bloco C Apt 117 m, CEP 70772-530, Brasília, DF, Brazil.
| | - Leandro Meirelles Nunes
- Graduate Program in Child and Adolescent Health, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Renata Schwartz
- Graduate Program in Child and Adolescent Health, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Elsa Regina Justo Giugliani
- Graduate Program in Child and Adolescent Health, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Kearns AD, Castro MC, Lourenço BH, Augusto RA, Cardoso MA. Factors Associated with Age at Breastfeeding Cessation in Amazonian Infants: Applying a Proximal-Distal Framework. Matern Child Health J 2016; 20:1539-48. [PMID: 27084366 DOI: 10.1007/s10995-016-1953-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction Breastfeeding is an important determinant of child survival and normal growth and development, but breastfeeding prevalence is generally low in Brazil. Factors associated with infant feeding practices there are not well understood. This paper examines factors associated with breastfeeding cessation in a township in the western Brazilian Amazon. Methods A cross-sectional, population-based study was conducted among children younger than 25 months and collected information on maternal and child characteristics. Survival analysis based on a proximal-distal framework examined the association between breastfeeding duration and socioeconomic and maternal/child biological factors. Results The median breastfeeding duration among 101 children who were no longer breastfeeding was 120 days. Almost two-thirds (63 %) of these children stopped breastfeeding before 6 months of age. In the larger sample of 209 children, 74.6 % had previously been bottle-fed. Considering the full proximal-distal model, a child who had ever been bottle-fed was expected to cease breastfeeding about 88 % sooner than one who was never bottle-fed (p < 0.001). Children in the second-poorest wealth quartile stopped breastfeeding sooner than children in the poorest quartile (p < 0.05). Discussion Breastfeeding cessation in the study area occurred much earlier than the recommended 2 years of age. Factors associated with ending breastfeeding early included ever-use of a bottle, having a single mother, and belonging to the second-poorest wealth quartile. Further research is needed to better understand these factors and other barriers women face to continuing breastfeeding.
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Affiliation(s)
- Annie D Kearns
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Marcia C Castro
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Bárbara H Lourenço
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo 715, São Paulo, 01246-904, Brazil
| | - Rosângela A Augusto
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo 715, São Paulo, 01246-904, Brazil
| | - Marly A Cardoso
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo 715, São Paulo, 01246-904, Brazil
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Schwartz R, Vigo Á, Dias de Oliveira L, Justo Giugliani ER. The Effect of a Pro-Breastfeeding and Healthy Complementary Feeding Intervention Targeting Adolescent Mothers and Grandmothers on Growth and Prevalence of Overweight of Preschool Children. PLoS One 2015; 10:e0131884. [PMID: 26161657 PMCID: PMC4498782 DOI: 10.1371/journal.pone.0131884] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 06/08/2015] [Indexed: 12/29/2022] Open
Abstract
Introduction The pattern and duration of breastfeeding (BF) and the age at onset of complementary feeding, as well as its quality, have been associated with the prevalence of overweight in childhood. Objective To assess the effect of a pro-BF and healthy complementary feeding intervention, targeted to adolescent mothers and maternal grandmothers, on growth and prevalence of overweight and obesity in children at preschool age. This intervention had a positive impact on duration of BF and timing of onset of complementary feeding. Methods This randomized clinical trial involved 323 adolescent mothers, their infants, and the infants’ maternal grandmothers, when they cohabited. Mothers and grandmothers in the intervention group received counseling sessions on BF and healthy complementary feeding at the maternity ward and at home (7, 15, 30, 60, and 120 days after delivery). When children were aged 4 to 7 years, they underwent anthropometric assessment and collection of data on dietary habits. Multivariable Poisson regression with robust estimation was used for analysis. Results BMI-for-age and height-for-age were similar in the intervention and control groups, as was the prevalence of overweight (39% vs. 31% respectively; p=0.318). There were no significant between-group differences in dietary habits. Conclusion Although the intervention prolonged the duration of exclusive BF and delayed the onset of complementary feeding, it had no impact on growth or prevalence of overweight at age 4 to 7 years. Trial Registration ClinicalTrials.gov NCT00910377
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Affiliation(s)
- Renata Schwartz
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- * E-mail:
| | - Álvaro Vigo
- Department of Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luciana Dias de Oliveira
- Department of Nutrition, Universidade Federal do Rio Grande do Sul, Center for Food and Nutrition Studies (CESAN), Hospital de Clínicas de Porto Alegre, HCPA, Porto Alegre, Rio Grande do Sul, Brazil
| | - Elsa Regina Justo Giugliani
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Birungi N, Fadnes LT, Okullo I, Kasangaki A, Nankabirwa V, Ndeezi G, Tumwine JK, Tylleskär T, Lie SA, Åstrøm AN. Effect of Breastfeeding Promotion on Early Childhood Caries and Breastfeeding Duration among 5 Year Old Children in Eastern Uganda: A Cluster Randomized Trial. PLoS One 2015; 10:e0125352. [PMID: 25938681 PMCID: PMC4418833 DOI: 10.1371/journal.pone.0125352] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 03/21/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Although several studies have shown short term health benefits of exclusive breastfeeding (EBF), its long term consequences have not been studied extensively in low-income contexts. This study assessed the impact of an EBF promotion initiative for 6 months on early childhood caries (ECC) and breastfeeding duration in children aged 5 years in Mbale, Eastern Uganda. METHODS Participants were recruited from the Ugandan site of the PROMISE- EBF cluster randomised trial (ClinicalTrials.gov no: NCT00397150). A total of 765 pregnant women from 24 clusters were included in the ratio 1:1 to receive peer counselled promotion of EBF as the intervention or standard of care. At the 5 year follow-up, ECC was recorded under field conditions using the World Health Organization's decayed missing filled tooth (dmft) index. Adjusted negative binomial and linear regression were used in the analysis. RESULTS Mean breastfeeding duration in the intervention and control groups (n=417) were 21.8 (CI 20.7-22.9) and 21.3(CI 20.7-21.9) months, respectively. The mean dmft was 1.5 (standard deviation [SD] 2.9) and 1.7 (SD 2.9) in the intervention and control groups, respectively. Corresponding prevalence estimates of ECC were 38% and 41%. Negative binomial regression analysis adjusted for cluster effects and loss-to-follow-up by inverse probability weights (IPW) showed an incidence-rate ratio (IRR) of 0.91 (95% CI 0.65-1.2). Comparing the effect of the trial arm on breastfeeding duration showed a difference in months of 0.48 (-0.72 to 1.7). CONCLUSION PROMISE EBF trial did not impact on early childhood caries or breastfeeding duration at 5 years of age. This study contributes to the body of evidence that promotion of exclusive breastfeeding does not raise oral health concerns. However, the high burden of caries calls for efforts to improve the oral health condition in this setting. TRIAL REGISTRATION ClinicalTrials.gov NCT00397150.
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Affiliation(s)
- Nancy Birungi
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Lars T. Fadnes
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Isaac Okullo
- Department of Dentistry, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Arabat Kasangaki
- Department of Dentistry, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Victoria Nankabirwa
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, United States of America
| | - Grace Ndeezi
- Department of Paediatrics and Child health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - James K. Tumwine
- Department of Paediatrics and Child health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Thorkild Tylleskär
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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Raskovalova T, Teasley SL, Gelbert-Baudino N, Mauri PA, Schelstraete C, Massoutier M, Berger M, François P, Labarère J. Breastfeeding Assessment Score: Systematic Review and Meta-analysis. Pediatrics 2015; 135:e1276-85. [PMID: 25869379 DOI: 10.1542/peds.2014-3072] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/04/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Previous studies have revealed conflicting results for the Breastfeeding Assessment Score (BAS) in predicting early breastfeeding cessation. Our objective was to externally validate the BAS and provide summary accuracy estimates for this clinical prediction model. METHODS We used the original data from a prospective cohort study. Additional studies were identified by searching electronic databases (Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane) from 2002 to 2013 and contacting research groups that had derived or validated the BAS. Prospective cohort studies were eligible if the BAS was computed at baseline and mothers were followed up for breastfeeding cessation. Two physicians extracted relevant information and independently assessed the methodological quality for the included studies. RESULTS In the external validation cohort, 22 of 424 mothers (5.2%) discontinued breastfeeding within 14 days of infant age. The BAS predicted early breastfeeding cessation with an area under the curve of 0.70 (95% confidence interval [CI]: 0.65 to 0.74) and inadequate calibration. When restricting the meta-analysis to 3169 mother-infant pairs enrolled in 4 higher-quality studies, a BAS value <8 predicted early cessation with 0.80 sensitivity (95% CI: 0.69 to 0.91) and 0.51 specificity (95% CI: 0.32 to 0.70) summary estimates. CONCLUSIONS Substantial between-study heterogeneity limited the interpretation of summary accuracy estimates. The BAS predicts early breastfeeding cessation with moderate accuracy, although local recalibration is advised before implementation. Further study is warranted to determine whether the BAS can help pediatricians in identifying mother-infant pairs that may benefit from more extensive breastfeeding assessment and support.
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Affiliation(s)
| | | | | | | | | | | | - Marc Berger
- University Hospital, Clermont-Ferrand, France
| | - Patrice François
- University Hospital, Grenoble, France; and Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble, Unité Mixte de Recherche 5525, Centre National de la Recherche Scientifique, Université Joseph Fourier-Grenoble 1, Grenoble, France
| | - José Labarère
- University Hospital, Grenoble, France; and Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble, Unité Mixte de Recherche 5525, Centre National de la Recherche Scientifique, Université Joseph Fourier-Grenoble 1, Grenoble, France
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Tsutaya T, Yoneda M. Reconstruction of breastfeeding and weaning practices using stable isotope and trace element analyses: A review. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2014; 156 Suppl 59:2-21. [DOI: 10.1002/ajpa.22657] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 10/17/2014] [Indexed: 01/09/2023]
Affiliation(s)
- Takumi Tsutaya
- Department of Integrated Biosciences; Graduate School of Frontier Sciences, The University of Tokyo; Kashiwanoha 5-1-5 Kashiwa Chiba 277-8562 Japan
| | - Minoru Yoneda
- Department of Integrated Biosciences; Graduate School of Frontier Sciences, The University of Tokyo; Kashiwanoha 5-1-5 Kashiwa Chiba 277-8562 Japan
- The University Museum, The University of Tokyo; Hongo 7-3-1 Bunkyo Tokyo 113-0033 Japan
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Riskin A, Mansovsky M, Coler-Botzer T, Kugelman A, Shaoul R, Hemo M, Wolff L, Harpaz S, Olchov Z, Bader D. Tongue-tie and breastfeeding in newborns-mothers' perspective. Breastfeed Med 2014; 9:430-7. [PMID: 25290824 DOI: 10.1089/bfm.2014.0072] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study explored clinical implications of tongue-tie (TT) on breastfeeding from the mothers' perspective and evaluated the assistance provided. MATERIALS AND METHODS This was a single-center observational study using a structured survey. All newborns with TT born in 2005-2010 were identified; two controls without TT were assigned for each. Mothers were interviewed using a uniform structured questionnaire regarding breastfeeding experience, challenges, lactation consultation, and frenotomy, if performed. RESULTS One hundred eighty-three TT mothers and 314 controls were interviewed. Although the overall rates of breastfeeding problems in the first month were similar (59% vs. 52%, respectively), TT mothers reported significantly more problems with latching, prolonged breastfeeding, and infant's exhaustion during feedings, but not pain or sore nipples. Breastfeeding rates at 6 months were similar. TT mothers more frequently used pumped breastmilk to supplement breastfeeding. Significantly more TT mothers sought consultation after discharge, and a significantly greater proportion of them felt that lactation consultation helped. Eighty-seven percent of the mothers were aware of their children's TT, yet only 50% associated it with breastfeeding problems. Of the TT infants at 2 years of age or older, 11.9% were reported to have speech problems. The possibility of frenotomy was mentioned to 69% of mothers, and it was performed in 35% of cases. Procedure satisfaction was generally poor, except for when done to solve breastfeeding problems. CONCLUSIONS TT infants had significantly more breastfeeding problems in the first month, but similar rates and durations of breastfeeding. Early diagnosis and lactation consultation may assist mother-infant dyads substantially. Mothers whose infants underwent frenotomies for breastfeeding more frequently found the procedure alleviated breastfeeding problems.
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Affiliation(s)
- Arieh Riskin
- 1 Department of Neonatology, Bnai Zion Medical Center , Haifa, Israel
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Breastfeeding duration: a survival analysis-data from a regional immunization survey. BIOMED RESEARCH INTERNATIONAL 2014; 2014:529790. [PMID: 24991563 PMCID: PMC4065740 DOI: 10.1155/2014/529790] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 05/20/2014] [Indexed: 11/17/2022]
Abstract
Objective. To report the duration of and factors associated with exclusive and any breastfeeding among the French-speaking community of Belgium (Wallonia). Material and Methods. A two-stage cluster sample was drawn from the population of children aged 18–24 months living in the area in 2012. Anamnestic data on breastfeeding and sociodemographic information were collected from 525 mothers. Cox's proportional hazards model was used to identify factors associated with discontinuing breastfeeding. Results and Discussion. Only 35.1% of the women were satisfied with their duration of any breastfeeding. At 3 months, 54.1% of the infants were breastfed, of which 40.6% exclusively, with these percentages falling to 29.1% and 12.6% at 6 months. Exclusive and any breastfeeding durations were independently positively associated (P < 0.05) with foreign-born mothers, awareness of WHO recommendations, and maternity leave >3 months. Exclusive BF duration was associated with higher parental income and the prenatal decision to breastfeed. The duration of any breastfeeding was associated with the mothers' age of ≥30 years and whether they were exclusively breastfeeding at discharge from the maternity unit. Conclusions. Programs promoting and supporting BF should concentrate on training prenatal health-care professionals. Prenatal professional advice may promote adherence to WHO BF guidelines. The benefits of exclusive BF should be emphasized. Pregnant women should be discouraged from introducing supplementary feeding in the maternity ward.
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Robert E, Despiegelaere M, Dramaix M, Swennen B. [Breastfeeding in the French-speaking community of Belgium (2009)]. Arch Pediatr 2014; 21:355-62. [PMID: 24680200 DOI: 10.1016/j.arcped.2014.01.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 09/30/2013] [Accepted: 01/28/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE The objectives of this paper were to study the prevalence of breastfeeding in the French-speaking community of Belgium, to assess whether the targets of the Maternal and Child Health program (MCH) were met (prevalence of breastfeeding of 85, 70, 50, and 25% at the maternity hospital and at 3, 6, and 12 months of age, respectively), and to identify factors associated with breastfeeding at the maternity hospital and at 6 months of age. MATERIALS AND METHODS A sample (two-stage cluster sampling) was drawn from the population of children aged 18-24 months living in the area. A face-to-face questionnaire was administered by trained investigators. Anamnestic data on breastfeeding at the maternity hospital and at 3, 6, and 12 months as well sociodemographic information were collected from 522 mothers. The survey took place in 2009. RESULTS At the maternity hospital, 75.7% (95%CI [72.7-79.5]) of the mothers were breastfeeding: 72.4% among the Belgians (and French) and 89.0% among foreign mothers. At 3 months of age, the breastfeeding prevalence was 48.3% (CI, 44.0-52.6): 42.5% among the Belgians (and French) and 72.0% among foreign mothers (p<0.001). At 6 months of age, 26.0% of the mothers were breastfeeding (CI, 22.3-29.8): 19.3% among the Belgians (and French) and 53.0% among foreign mothers (p<0.001). At 12 months of age, 10.0% (CI, 7.4-12.5) of the mothers were breastfeeding: 4.8% among the Belgians (and French) and 31.0% among the foreign mothers (p<0.001). When fitting a logistic model, the predictors associated with breastfeeding at the maternity hospital were educational level, nationality of birth, and parity. At 6 months, logistic models were fitted separately in the two strata. Among the Belgians, the level of education and attending a MCH consultation were significantly associated with breastfeeding. In the stratum of foreign mothers, the only factor associated with breastfeeding was working time. No association was observed between breastfeeding and the mother's age at the maternity hospital or at 6 months. DISCUSSION The targets of the MCH were not reached in Belgian and French mothers, while they were in mothers of other nationalities. Until now, transversal surveys have been the only way of knowing the prevalence and the factors associated with breastfeeding in the French-speaking community of Belgium. These first representative data on breastfeeding came from the 2009 vaccine coverage survey.
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Affiliation(s)
- E Robert
- École de santé publique, politiques et système de santé, santé internationale, université Libre de Bruxelles, route de Lennik, 808, 1070 Bruxelles, Belgique.
| | - M Despiegelaere
- École de santé publique, politiques et système de santé, santé internationale, université Libre de Bruxelles, route de Lennik, 808, 1070 Bruxelles, Belgique
| | - M Dramaix
- École de santé publique, épidémiologie, biostatistiques et recherche clinique, université Libre de Bruxelles, route de Lennik, 808, 1070 Bruxelles, Belgique
| | - B Swennen
- École de santé publique, politiques et système de santé, santé internationale, université Libre de Bruxelles, route de Lennik, 808, 1070 Bruxelles, Belgique
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Rousseaux J, Duhamel A, Turck D, Molnar D, Salleron J, Artero EG, De Henauw S, Dietrich S, Manios Y, Piccinelli R, Sjöström M, Moreno LA, Gottrand F. Breastfeeding shows a protective trend toward adolescents with higher abdominal adiposity. Obes Facts 2014; 7:289-301. [PMID: 25277836 PMCID: PMC5644886 DOI: 10.1159/000368583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 07/15/2014] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The question of whether breastfeeding has a protective effect against the development of overweight or obesity later in life remains controversial, especially during adolescence. The objective was to assess the relationship between breastfeeding and adolescents' body composition. METHODS The HELENA study is a cross-sectional study involving 3,528 adolescents from 10 European cities. The outcome measures were body weight and height, subscapular skinfolds as well as waist circumferences. Breastfeeding, smoking status, and parental socioeconomic status were assessed by self-administered questionnaires. Dietary intake was recorded using two 24-hour recall surveys. Two adjustment approaches were used: i) covariance analysis adjusted for confounding factors (propensity score adjustment) and ii) multivariate quantile regression. RESULTS After adjustment, no significant associations were observed between breastfeeding and body composition parameters (BMI Z-score; sum of skinfolds; waist-to-height ratio). An adjusted quantile regression analysis showed a non-significant trend for a protective effect of breastfeeding toward the highest percentiles of adiposity in boys but not in girls. This is of particular interest with respect to the superiority of the waist-to-height ratio over waist circumference and BMI for detecting cardiometabolic risk factors. CONCLUSION This first European study, including a large set of factors influencing adolescents' body composition, showed a non-significant trend toward a protective effect of breastfeeding on highest percentiles of adolescent's abdominal adiposity.
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Affiliation(s)
- Julien Rousseaux
- Unité de Biostatistiques, CERIM, EA2694, UDSL, Université Lille Nord de France, Lille, France
- *Dr. Julien Rousseaux, CERIM — Nutrition, Faculté de Médecine, Université Lille Nord de France, Place de Verdun, 59045 Lille cedex (France),
| | - Alain Duhamel
- Unité de Biostatistiques, CERIM, EA2694, UDSL, Université Lille Nord de France, Lille, France
| | - Dominique Turck
- Inserm U995, IFR114, Department of Pediatrics, Faculty of Medicine, University Lille 2, Lille, France
| | - Denes Molnar
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | - Julia Salleron
- Unité de Biostatistiques, CERIM, EA2694, UDSL, Université Lille Nord de France, Lille, France
| | - Enrique Garcia Artero
- Department of Physical Education and Sport, School of Education, University of Almeria, Almeria, Spain
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Sabine Dietrich
- Klinische Psychologie, Gesundheitspsychologie Psychosomatisches Zentrum Waldviertel, Eggenburg, Austria
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | - Michael Sjöström
- Unit for Preventive Nutrition, Department of Biosciences and Nutrition, Karolinska Institute, Huddinge, Sweden
| | - Luis Aznar Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
| | - Frédéric Gottrand
- Inserm U995, IFR114, Department of Pediatrics, Faculty of Medicine, University Lille 2, Lille, France
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Susiloretni KA, Krisnamurni S, Sunarto, Widiyanto SYD, Yazid A, Wilopo SA. The Effectiveness of Multilevel Promotion of Exclusive Breastfeeding in Rural Indonesia. Am J Health Promot 2013; 28:e44-55. [DOI: 10.4278/ajhp.120425-quan-221] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To examine the effectiveness of multilevel promotion on exclusive breastfeeding (EBF) duration and prevalence. Design. A pretest-posttest control group design, quasi-experiment. Setting. Two public health centers in the Demak District, Central Java, Indonesia. Subjects. A total of 163 families were enrolled, including pregnant mothers, fathers, and grandmothers. Intervention. The multilevel promotion of EBF was conducted at the subdistrict, village, family, and individual levels. This was a complex intervention that modified breastfeeding determinants, integrated multidisciplinary partnerships, and involved community leaders (i.e., voluntary health workers, traditional birth attendants, Muslim scholars, and heads of villages). The strategies applied were advocacy, training, media, and home visit counseling. Measures. EBF duration and prevalence. Analysis. Survival analyses, Cox proportional-hazard model. Results. The duration of EBF increased after the multilevel promotion. The median postintervention duration in the intervention group was 18 weeks compared with .1 week in the control group (p < .001). The prevalence of EBF at 1, 8, 16, and 24 weeks for the intervention versus control groups was 75.3% vs. 28.0%, 64.2% vs. 14.6%, 50.6% vs. 8.5%, and 37.0% vs. 3.7%, respectively (p < .001). Mothers in the control group were three times more likely to stop exclusive breastfeeding per unit of time than were mothers in the intervention group (adjusted hazard ratio 3.01; 95% confidence interval: 1.96, 4.63). Conclusion. Multilevel promotion can prolong the duration and increase the prevalence of EBF.
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Masumo R, Bardsen A, Mashoto K, Åstrøm AN. Feeding practice among 6-36 months old in Tanzania and Uganda: reliability and relationship with early childhood caries, ECC. Acta Odontol Scand 2013; 71:1309-18. [PMID: 23330987 DOI: 10.3109/00016357.2012.762991] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess the reproducibility of caregivers' responses to dietary recall from birth and 24-h dietary recall with respect to infants' intake of sugared snacks and to assess whether those assessment methods provide comparable results for groups of infants. Re-test reliability and clinical covariates of time to first exposure of sugared snacks and time to termination of breastfeeding were also examined. It was hypothesized that time to first exposure/termination would vary according to socio-demographic profile and ECC. METHOD Interviews and clinical oral examinations were carried out in Kampala and Manyara, including 1221 and 816 child-caregiver pairs. Reproducibility was assessed using Cohen's kappa and Intra Class Correlation Coefficient, ICC. Adjusted Cox regression was used to model time to first exposure of sugared snacks and time to termination of breastfeeding. RESULTS Cohen's kappa for intake of sugar items ranged from 0.40-1.0, with no differences observed between average intakes at test-re-test. Mean sugar score based on 24-h recall increased significantly by increasing quartiles of the sugar score based on recall from birth. Cox regression revealed that the odds ratio, OR, for early exposure to various sugared snacks and the ORs for early termination of breastfeeding were significantly smaller in infants with than without ECC. CONCLUSION Fair-to-good reproducibility was established. Infant's sugar consumption emerge as early as 6 months of age. Survival of any breastfeeding and non-exposure to sugared snacks was most prolonged among infants with ECC. This has implications for interventions needed to improve feeding habits of infants and toddlers.
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Affiliation(s)
- Ray Masumo
- Department of Clinical Dentistry, Community Dentistry, University of Bergen, Norway
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Kristiansen AL, Laugsand Lillegaard IT, Frost Andersen L. Effect of changes in a food frequency questionnaire: comparing data from two national dietary survey instruments among 12-month-old infants. BMC Public Health 2013; 13:680. [PMID: 23883290 PMCID: PMC3724696 DOI: 10.1186/1471-2458-13-680] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 07/19/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND National dietary surveys among Norwegian 12-months olds have been conducted twice: in 1999 and 2007. At both time-points diet were assessed by a semi-quantitative food frequency questionnaire (SFFQ) (the SFFQ-1999 and the SFFQ-2007). Modifications in the SFFQ-2007 compared to the SFFQ-1999 have been made; therefore, the objective of the present study has been to explore the comparability of the data obtained by the two questionnaires. Moreover, reliability of maternal recall of infant feeding practices was assessed. METHODS Three hundred Norwegian infants born in April 2007 were invited to participate by completing both the SFFQ-1999 and the SFFQ-2007. An invitation letter and one of two questionnaires were sent by mail to the mother/parents about two weeks before the child turned 12 months of age. The study had a cross-over design where half of the sample received the SFFQ-1999 first and then about 2-3 weeks later they received the SFFQ-2007. The second half received the SFFQ-2007 first, and then 2-3 weeks later they received the SFFQ-1999. RESULTS Ninety three participants completed both questionnaires (SFFQ-1999 and SFFQ-2007). For nutrients, the largest significant differences between the questionnaires were found for intake of vitamin D and added sugar, where added sugar was reported lower and vitamin D was reported higher with the SFFQ-2007 compared to the SFFQ-1999. For food items, lower intake of yoghurt and higher intake of vegetables and fish were observed with the SFFQ-2007 compared to the SFFQ-1999. In addition, reliable answers with regard to breastfeeding status, age for breastfeeding cessation and age for introducing solid foods were found. CONCLUSION There was reasonable comparability between the two questionnaires for most nutrients and foods. The differences between the two questionnaires could mainly be explained by modifications that had occurred over time, where changes in the food composition databases used and especially changes in commercial recipes with regard to baby food products seemed to be of major importance. The differences are important to take into account when interpreting dietary trends among Norwegian 12 month-olds in the period from 1999 to 2007. This study also implies that maternal recall of infant feeding practices is reliable.
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Affiliation(s)
- Anne Lene Kristiansen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Blindern, PO Box 1046, Oslo, 0316, Norway.
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Nambiar S, Truby H, Davies PS. Exploring the influence of breastfeeding on abdominal adiposity in young children using the waist to height ratio. Nutr Diet 2013. [DOI: 10.1111/1747-0080.12025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Smita Nambiar
- Children's Nutrition Research Centre; School of Medicine; Royal Children's Hospital, The University of Queensland; Brisbane; Queensland; Australia
| | - Helen Truby
- Nutrition and Dietetics; Southern Clinical School; Monash University; Monash Medical Centre; Melbourne; Victoria; Australia
| | - Peter S.W. Davies
- Children's Nutrition Research Centre; School of Medicine; Royal Children's Hospital, The University of Queensland; Brisbane; Queensland; Australia
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Austin C, Smith TM, Bradman A, Hinde K, Joannes-Boyau R, Bishop D, Hare DJ, Doble P, Eskenazi B, Arora M. Barium distributions in teeth reveal early-life dietary transitions in primates. Nature 2013; 498:216-9. [PMID: 23698370 PMCID: PMC3725337 DOI: 10.1038/nature12169] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 04/08/2013] [Indexed: 11/09/2022]
Abstract
Early-life dietary transitions reflect fundamental aspects of primate evolution and are important determinants of health in contemporary human populations. Weaning is critical to developmental and reproductive rates; early weaning can have detrimental health effects but enables shorter inter-birth intervals, which influences population growth. Uncovering early-life dietary history in fossils is hampered by the absence of prospectively validated biomarkers that are not modified during fossilization. Here we show that large dietary shifts in early life manifest as compositional variations in dental tissues. Teeth from human children and captive macaques, with prospectively recorded diet histories, demonstrate that barium (Ba) distributions accurately reflect dietary transitions from the introduction of mother's milk through the weaning process. We also document dietary transitions in a Middle Palaeolithic juvenile Neanderthal, which shows a pattern of exclusive breastfeeding for seven months, followed by seven months of supplementation. After this point, Ba levels in enamel returned to baseline prenatal levels, indicating an abrupt cessation of breastfeeding at 1.2 years of age. Integration of Ba spatial distributions and histological mapping of tooth formation enables novel studies of the evolution of human life history, dietary ontogeny in wild primates, and human health investigations through accurate reconstructions of breastfeeding history.
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Affiliation(s)
- Christine Austin
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA
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